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In addition to revising its mask guidance on Tuesday, the Centers for Disease Control and Prevention also quietly updated its testing recommendations for people who are fully vaccinated against the coronavirus. The agency now advises that vaccinated people be tested for the virus if they come into contact with someone with Covid-19, even if they have no symptoms. Previously, the health agency had said that fully vaccinated people did not need to be tested after exposure to the virus unless they were experiencing symptoms. (Anthes and Mandavilli, 7/29)

Fully vaccinated people who are exposed to COVID-19 should get tested three to five days after and take additional precautions, new recommendations from the Centers for Disease Control and Prevention say. The new recommendations are included in the CDC’s updated guidelines for fully vaccinated people. They were released Tuesday in response to new data that shows the highly contagious delta variant behaves differently than other strains of COVID and that in “rare occasions” some vaccinated people may be able to spread it to others. (Aldridge, 7/28)

The recent surge of COVID-19 cases is strengthening the case for more frequent testing. The more contagious Delta variant threatens the fuller reopening of offices and schools in the fall. But regular testing — especially with cheap and almost instantaneous tests — could help catch cases before they have a chance to spread. (Walsh, 7/29)

In Florida, where COVID-19 community transmission is ranked high by the Centers for Disease Control and Prevention (CDC), researchers say a new variant that originated in Colombia is popping up in sequencing testing. One hospital official told Local10.com that the spread is likely due to travel between Colombia and Miami. "In the last week, 10% of our patients had the Colombian variant," Carlos Migoya, CEO of Jackson Health, told the news outlet. "Why? Because of the travel between Colombia and Miami." The variant, identified as B.1.621, was first identified in Colombia in Jan. 2021, according to the World Health Organization (WHO). In late May, the health agency designated the variant for "Further Monitoring." The CDC has not yet classified it as a variant of concern or interest, but reports that it’s been detected in about 2.7% of testing samples. (Hein, 7/28)

Health experts will keep B.1.621 on their radar as the fall season looms and as parts of the country still lag in their vaccination efforts, experts told The Post. Public Health England noted last week that there is currently no evidence to indicate that the variant causes more severe disease or evades the efficacy of vaccines. Yet the agency has designated the variant to be under investigation as it continues to conduct lab testing to better understand the impact mutations have on the coronavirus. (Beachum, 7/28)

Texas logged more than 10,000 in daily new virus cases for the first time in almost six months as the latest wave of the pandemic intensifies across the second-most populous U.S. state. The caseload surged by 10,086 in the past 24 hours, a 55% increase from Tuesday’s addition and the highest since Feb. 9, state health department figures showed. Hospitalizations, meanwhile, have more than doubled this month to 5,292, the data showed. Intensive-care occupancy by virus patients has pushed above 10% in three of the state’s 22 trauma service areas, and one of those regions has zero ICU capacity left. (Carroll, 7/28)

Hospitals in states where Covid-19 cases are once again surging are beginning to feel the strain in their emergency departments and intensive care units. State health officials in Mississippi have told hospitals there to delay many elective surgeries beginning next week and are forming a central command to help search for ICU beds. As of Tuesday, 28 hospitals in the Gulf state didn’t have any ICU beds available as Covid-19 admissions tax hospitals that are already dealing with everyday emergencies like strokes and car crashes, said Jim Craig, senior deputy for the Mississippi Department of Health, in a briefing with reporters. (Edney and Armstrong, 7/28)

Officials at Arkansas' largest healthcare organization said not a single COVID-19 patient at Baptist Health Medical Center Little Rock's intensive care unit (ICU) is vaccinated. "The vast majority of patients that are in the hospital are not vaccinated," Dr. Eric Bravo, the medical director of Baptist Health's hospitalist program, told Newsweek on Wednesday. "I would say, I have not personally seen anybody in the ICU that's been vaccinated." (Fung, 7/28)

As the delta variant surges across California, more than half of the Golden State’s 58 counties would now qualify for the most-restrictive purple tier under the state’s recently-retired color-coded blueprint for regulating businesses, schools and social gatherings. Thirty-six counties have COVID case rates that top the threshold — triple the number from last week, according to an analysis by the Bay Area News Group. From tiny Del Norte County on the far north coast, with a vaccination rate of under 50% of its eligible residents, to San Diego on the southern border with more than 80% of its eligible residents at least partially vaccinated. (Blair Rowan, 7/28)

Health officials in Los Angeles County said over 25% of new coronavirus cases are among those who have been fully vaccinated, an increase from last month, according to a report Wednesday. Health officials have called the vaccines effective and said breakthrough cases are to be expected, but the number is a noticeable increase from June when fully vaccinated individuals accounted for 20% of the county’s infections, Fox 11 Los Angeles reported. (DeMarche, 7/28)

The Washington Nationals are postponing their game against the Philadelphia Phillies on Wednesday due to a COVID-19 outbreak on the team. Four players and eight staffers tested positive for the coronavirus on the Nationals team, The Associated Press reported. “Tonight’s scheduled game between the Philadelphia Phillies and the Washington Nationals has been postponed to allow for continued testing and contact tracing involving members of the Nationals organization,” the team’s statement reads. (Lonas, 7/28)

Dr. Scott Gottlieb told CNBC that he expects surging U.S. coronavirus cases, linked to the highly transmissible delta variant, to start decreasing in just a few weeks. “Probably, in two or three weeks, I think that we were probably about three weeks behind the U.K.,” said the former FDA chief in the Trump administration.  “The U.K. clearly is on a downslope...I would expect some of the southern states that really were the epicenter of this epidemic to start rolling over in the next two or three weeks.” (DeCiccio, 7/28)

KHN: Unraveling The Mysterious Mutations That Make Delta The Most Transmissible Covid Virus Yet 

Upon first inspection, the mutations in the highly contagious delta covid variant don’t look that worrisome. For starters, delta has fewer genetic changes than earlier versions of the coronavirus. “When people saw that the epidemic in India was driven by delta, they did not suspect it would be so bad or overtake other variants,” said Trevor Bedford, an evolutionary biologist at the Fred Hutchinson Cancer Research Center. But those expectations were wrong. (Szabo, 7/28)

Across several morning media appearances, the government’s most senior scientists defended the decision Tuesday by the Centers for Disease Control and Prevention to recommend that people wear masks indoors again regardless of vaccination status, particularly in crowded indoor settings. The announcement marked a striking reversal for the nation’s premier public health agency after it previously declared in May that vaccinated Americans no longer needed to wear masks outdoors or indoors in most circumstances. But Anthony Fauci, Biden’s chief medical adviser, insisted Wednesday that “what has changed is the virus” — not the CDC. (Forgey, 7/28)

In the text of the updated masking guidance, the agency merely cited “CDC COVID-19 Response Team, unpublished data, 2021.” Some outside scientists have their own message: Show us the data. “They’re making a claim that people with delta who are vaccinated and unvaccinated have similar levels of viral load, but nobody knows what that means,” said Gregg Gonsalves, an associate professor at the Yale School of Public Health. “It’s meaningless unless we see the data.” (Achenbach, Abutaleb, Guarino and Johnson, 7/28)

The U.S. Department of Defense has issued directions that require anyone inside its facilities to wear a mask, even if they're vaccinated. The updated requirement applies to all service members, federal employees, onsite contractors, and visitors, and requires masks to be worn in indoor facilities and installations in areas of "substantial or high transmission," according to a statement from Deputy Pentagon Press Secretary Jamal Brown. The update rescinds a previous mask guidance, which since May had allowed fully vaccinated Department of Defense personnel to not wear a mask indoors or outdoors. (Fischels, 7/28)

As coronavirus cases continue to soar, two Florida mayors are announcing mask and vaccine mandates and defying the governor who is firmly opposed to any pandemic restrictions. Masks will again be required at indoor county facilities in Florida’s populous Miami-Dade following new federal guidance recommending that even people vaccinated against COVID-19 should wear facial coverings. And in Orange County, home to Walt Disney World and Universal Orlando Resort, the mayor went a step further and announced all 4,200 nonunion county employees will be required to get their first coronavirus vaccine shot by the end of August, and the second shot by the end of September. Disney World announced on its website Wednesday evening that beginning July 30, face coverings will be required for all guests ages 2 and up while indoors and in Disney buses, monorail and Disney Skyliner, regardless of vaccination status. This includes upon entering and throughout all attractions. Face coverings remain optional in outdoor common areas. (Licon and Schneider, 7/29)

Disney has amended the mask policy at its U.S.-based theme parks in the wake of new guidance from health and government officials. Starting Friday, the company will require all guests, regardless of vaccination status, to wear face coverings in indoor locations at Walt Disney World Resort in Florida and the Disneyland Resort in California. Children under the age of two are exempt from this mandate. (Whitten, 7/28)

Gov. Ron DeSantis held a roundtable discussion Monday at the state Capitol that focused on opposition to mask mandates in schools during the COVID-19 pandemic. DeSantis’ office did not giving prior public notice and excluded reporters. The discussion was recorded by the governor’s staff and posted to Rumble. The event was held as hospitals across the state are seeing sharp increases in COVID-19 patients because of the delta variant and lagging vaccination rates. (Dailey, 7/28)

The city of Atlanta and Georgia school districts announced mask mandates Wednesday even as Gov. Brian Kemp repeated his vow that he won’t impose a statewide mask rule or restrict business and public activities. Infections and hospitalizations from COVID-19 in Georgia continued to rise steeply Wednesday. “Georgia will not lock down or impose statewide mask mandates,” Kemp tweeted on Wednesday, repeating a stance that has remained consistent since the Republican lifted closures early in the pandemic. (Amy, 7/29)

New Jersey recommended Wednesday that all residents, regardless of vaccination status, resume wearing masks in public indoor settings, effectively extending Centers for Disease Control and Prevention guidance issued for certain areas Tuesday to the entire state. Warning that a statewide mask mandate or other restrictions could become necessary if case numbers spike, Gov. Phil Murphy was one of many officials in the region and nation Wednesday to urge those who haven’t been vaccinated to get their shots now. (McDaniel and McCarthy, 7/28)

Governor Charlie Baker said Wednesday that he sees no need for Massachusetts to reinstate restrictions in response to rising COVID-19 cases, striking a contrast with President Biden, who is urging Americans to mask up again and requiring many federal workers to get vaccinated. “Massachusetts is in a much better position than the vast majority of the states in this country with respect to how we deal with and how we’re prepared to deal with COVID,” Baker said, speaking at an environmental funding event. But Baker, who tussled with the state’s largest teachers unions over COVID-19 vaccination and safety measures, did say that he is considering mandating masks in public schools this fall. (Fox, Fatima and Andersen, 7/28)

In Missouri, where rampant Covid-19 has once again flooded hospitals, St. Louis County reinstated a mask mandate on Monday, ahead of the C.D.C.’s updated advice — only to face a lawsuit hours later from Eric Schmitt, the state’s Republican attorney general, who accused the county of “unacceptable and unconstitutional” overreach. By Tuesday night, the St. Louis County Council, meeting in a packed chamber where a woman was hoisting a sign that read, “STOP THE TYRANNY,” had voted to overturn the mandate, though the measure’s fate may ultimately be decided by the courts. (Mazzei, 7/28)

Mayor London Breed said Wednesday that San Francisco is exploring how it can “go further with its vaccine mandate” and also considering an indoor mask mandate for everyone, regardless of vaccination status. Breed mentioned the possibility of an indoor mask mandate at a news conference Wednesday, shortly before she spoke to a large, unmasked — but fully vaccinated — crowd at Manny’s on Valencia Street. (Thadani, 7/28)

Apple Inc. plans to restore a mask requirement at most of its U.S. retail stores on Thursday for both customers and staff, even those who are vaccinated, in response to a resurgence in Covid cases. The company informed retail staff of the move Wednesday in a memo obtained by Bloomberg News. Apple already started requiring masks for employees at select stores earlier this month, and it pushed back a return-to-office deadline for corporate employees. It also began requiring masks for customers in a few counties based on local guidelines. (Gurman, 7/28)

Two new JAMA Psychiatry meta-analyses link mental illness with COVID-19 death, with one also finding an association with hospitalization. ... The higher rate of severe COVID-19 "suggests that other factors lead to this health inequity in patients with mental health disorders, including several factors such as barriers to access to care, social determinants of health, immunological disturbances, and the effects of psychotropic drugs," the study authors wrote. (Van Beusekom, 7/28)

Forty percent of 290 COVID-19 survivors completing an Emory University survey 1 to 6 months after release from the hospital reported lingering symptoms such as fatigue, shortness of breath on exertion, and "mental fog." The study, published yesterday in Open Forum Infectious Diseases, involved an emailed survey about persistent COVID-19 symptoms, acute illness severity, and quality of life to better quantify and characterize "long COVID." (7/28)

COVID-19 reduced lifespan by up to 9 years in parts of the United States, per a new "mean unfulfilled lifespan" (MUL) metric, according to a study published yesterday in PLOS One. The MUL is a new indicator of the impact of mortality shocks, such as the novel coronavirus or other natural disaster, on peoples' lifespan. (7/28)

There's more potentially worrisome news for vaccinated people: In very rare cases, people experiencing breakthrough infections may be at risk for long-COVID symptoms. That's according to a small new study of fully vaccinated health care workers in Israel, published Wednesday in The New England Journal of Medicine. The study confirmed what's already known: That it's very rare for fully vaccinated people to get infected or sick with COVID-19. But it also found lingering COVID symptoms did develop in a handful of breakthrough cases. (Stein, 7/28)

There’s been a lot of news around research out of New York University that suggests the Johnson & Johnson Covid vaccine is less effective against the delta variant, because it triggers fewer antibodies. And many are questioning whether, several months out, people’s antibody levels will wane and require a booster shot. Antibody levels are one piece of the puzzle when it comes to fighting Covid, but they don’t tell the whole story when it comes to immunity. (Stieg, 7/28)

President Biden will formally announce on Thursday that all civilian federal employees must be vaccinated against the coronavirus or be forced to submit to regular testing, social distancing, mask requirements and restrictions on most travel, two people familiar with the president’s plans said on Wednesday. White House officials said the administration was still reviewing details of the policy, which the president is expected to announce in a speech from the White House. In a statement on Tuesday, Mr. Biden said his remarks would reveal “the next steps in our effort to get more Americans vaccinated.” (Shear, 7/28)

An individual familiar with the president’s plans, who spoke on condition of anonymity to confirm details that had yet to be announced publicly, emphasized that the new guidance is not a vaccine mandate for federal employees and that those who decide not to get vaccinated aren’t at risk of being fired. The new policy amounts to a recognition by the Biden administration that the government — the nation’s biggest employer — must do more to boost sluggish vaccination rates, as coronavirus cases and hospitalizations rebound, driven largely by the spread of the more infectious delta variant. (Jaffe and Alonso-Zaldivar, 7/29)

The White House is readying its most aggressive action to date on Covid vaccinations. But it's trying to avoid one word: mandate. President Joe Biden is due to issue a directive Thursday requiring some 2 million federal employees to attest they’ve received the shot or submit to weekly testing, according to four people familiar with the plans. The move would avoid the kind of top-down order Biden has resisted using for months to contain the virus. But it would give federal departments and agencies discretion to force certain employees to show proof of vaccination, as the Department of Veterans Affairs did this week with its front-line health workers. (Owermohle, Cancryn, Korecki and Banco, 7/28)

State employees in New York will be required to either get vaccinated or submit to regular coronavirus testing starting on Labor Day, Gov. Andrew Cuomo (D) announced on Wednesday. The announcement comes as some areas have reimposed coronavirus restrictions, as country continues to grapple with the spread of the highly-transmissive Delta variant. (Gonzalez, 7/28)

Senate Minority Leader Mitch McConnell (R-Ky.) said on Wednesday that he did not realize it would be difficult to convince Americans to take the COVID-19 vaccine as the nation deals with soaring cases occurring in the unvaccinated. “Here, we did — developed three highly effective vaccines in under one year. Honestly, it never occurred to me we would have difficulty getting people to take the vaccine,” McConnell told Fox Business Network host Larry Kudlow, a former White House official. (Vakil, 7/28)

U.S. Senate Republican leader Mitch McConnell blamed misinformation for the low rates of COVID-19 vaccination among Americans, which are fueling a rise in coronavirus cases, particularly in Republican-dominated states. "There is bad advice out there, you know. Apparently you see that all over the place: people practicing medicine without a license, giving bad advice. And that bad advice should be ignored," the 79-year-old Kentucky lawmaker told Reuters. (Morgan, 7/28)

Top Senate Republicans are dramatically stepping up their pro-vaccine outreach as several of their home states lag behind national Covid inoculation rates and mask recommendations return in many areas. Senate Minority Leader Mitch McConnell (R-Ky.) is running ads in his home state to combat disinformation, Sen. Roy Blunt is barnstorming Missouri and Sen. Tommy Tuberville of Alabama says “anytime we’re on a press conference, we say something about vaccinations." Several GOP senators released new PSAs in the wake of guidance issued Tuesday by the Centers for Disease Control and Prevention to wear masks in areas of high transmission. (Everett, 7/28)

Senate Minority Leader Mitch McConnell (R-Ky.) plans to use money from his reelection campaign to run radio ads on over 100 Kentucky stations in the coming days to promote getting vaccinated for COVID-19, Reuters reports. The most hardcore opponents of vaccination — the group who say they'll never get one — tend to be older, whiter and more Republican, according to an analysis of our Axios/Ipsos Coronavirus Index. (Gonzalez, 7/28)

House Republicans on Wednesday angrily criticized a new order from the Capitol Hill physician to wear masks inside the Capitol due to the spread of the delta variant of the coronavirus, leading Speaker Nancy Pelosi to call House Minority Leader Kevin McCarthy a “moron” over his argument that the decision was not based on science. Many House Republicans refused to wear masks on the House floor during a series of morning votes, before they called for the chamber to adjourn as GOP members rebuffed attempts by staff to get them to put on a mask. (Sotomayor and Wager, 7/28)

Democratic Rep. Jared Huffman was headed to the House floor Wednesday when he saw a vocal GOP vaccine resistor — unmasked — in the elevator. Huffman decided to take the stairs, but not before issuing a sharp warning to Rep. Byron Donalds, telling the Florida Republican he shouldn’t be crowding into an elevator with other members. The two crossed paths again outside the chamber and Huffman had more to say, calling the GOP freshman “selfish.” (Ferris, Beavers and Caygle, 7/28)

Google on Wednesday became the first major tech company to require COVID vaccinations of employees working at the company's facilities. Shortly afterward, Facebook also said it will make vaccines mandatory for U.S. employees who work in offices. Both companies said they would consider exceptions for medical and other reasons. In a message to Google's 130,000-plus workers worldwide, CEO Sundar Pichai said the policy would go into effect in the U.S. in the coming weeks and abroad in the following months, and it would be dependent on vaccines being widely available. (Ortiz, Miller and Aspegren, 7/28)

Facebook will require U.S. workers returning to its offices to be vaccinated, the company said on Wednesday. “As our offices reopen, we will be requiring anyone coming to work at any of our US campuses to be vaccinated,” VP of People Lori Goler said in a statement. “How we implement this policy will depend on local conditions and regulations.” Facebook will create processes for those who can’t be vaccinated for medical or other reasons, Goler said. The company will continue to evaluate its approach outside the U.S., Goler added. (Feiner, 7/28)

Twitter has closed its San Francisco and New York offices just two weeks after reopening them as virus cases surge. “After careful consideration of the CDC’s updated guidelines, and in light of current conditions, Twitter has made the decision to close our opened offices in New York and San Francisco as well as pause future office reopenings, effective immediately,” the company said. The closure is a blow to San Francisco’s nascent economic recovery and another sign of disruption to the tech industry’s return to work. Google and Apple are also delaying mandatory office returns until at least October. Google and Facebook will require employee vaccinations. (Li, 7/28)

Here are the companies that have announced Covid-19 vaccine requirements for at least some of their employees. (Benveniste, 7/29)

Apple CEO Tim Cook acknowledged the unpredictable nature of COVID-19 and the Delta variant, in particular, which has forced corporations like his to backtrack on plans to reopen fully. "As the last 18 months have demonstrated many times before, progress made is not progress guaranteed. An uneven recovery to the pandemic and the Delta variant surging in many countries around the world have shown us once again that the road to recovery will be a winding one," Cook said on a conference call Tuesday. (Cerullo, 7/28)

Companies are revisiting coronavirus precautions as cases rise across the United States, fueled by the Delta variant. Lyft said on Wednesday that it would not require employees to return to the office until February, while Twitter said it would close its newly reopened offices in San Francisco and New York and indefinitely postpone other reopening plans. (7/29)

The resurgent coronavirus and return of mask recommendations are hampering corporate America’s plans to get back to normalcy. Google on Wednesday said that it will push back its official office return to mid-October and require workers at its campuses to get vaccinated. Lyft Inc. postponed its return date to February, while Twitter Inc. shut its recently reopened offices. Apple Inc. is requiring masks at most U.S. stores, and Walt Disney Co. is again mandating them at its Florida and California parks. (Green, 7/28)

For fear of social ostracism, some people in Missouri who want to be vaccinated against COVID-19 are showing up to doctor's appointments in disguise, internist Priscilla Frase, MD, the chief medical information officer for Ozarks Healthcare, said in a clip shared on the hospital's Facebook page on July 18. The clip has around 1,800 views. As of this writing, Missouri has one of the lowest vaccination rates in the entire nation. Only 41 percent of the Midwestern state's population is fully vaccinated, according to the Missouri Department of Health and Senior Services [MDHSS]. Of those 2,513,969 individuals, more are female than male, multiracial than monoracial, and older than younger, MDHSS data showed. (Tien, 7/28)

Some of the most vaccine-resistant parts of the U.S. are now leading the country in the number of people getting a first dose of vaccine, a Bloomberg analysis shows, as surging infections and rising hospitalizations push formerly reluctant Americans to protect themselves. The increase in vaccinations is concentrated in the Southern and Central parts of the U.S., with the highest daily rate of shots happening in places like Louisiana, Arkansas and Missouri — states that have had some of the lowest rates of vaccination in the eight months since vaccines became available. (Armstrong, 7/28)

On Friday, Texas reported its highest single-day number of vaccines administered in more than a month, with 71,000 doses doled out. While that’s down considerably from the more than 300,000 doses administered daily this April, it represents roughly a 25 percent increase over the average daily vaccination rate logged over the past month, according to a Chronicle analysis of state health data. Houston Methodist Hospital said they’ve seen a similar, new wave of vaccine appointments this week, with more 1,000 doses administered at their clinics on Monday. That was highest number of first doses administered at the hospital system since the beginning of June, shortly after vaccine eligibility was opened to all Texans over the age of 12. (Gill and Downen, 7/28)

In East Baton Rouge, some people appearing before Judge Fred Crifasi, of the 19th Judicial District Court, are being afforded the opportunity to get vaccinated in lieu of certain community service hours. The judge began offering the alternative earlier this week, amid a surge in case numbers in Louisiana. In that time, roughly 19,000 cases have been reported in the state. Louisiana is among states with the highest daily reported cases per capita in the nation, according to date from The Washington Post. (Hauptman, 7/28)

Louisiana’s governor dangled lottery tickets. State and local officials tried going door-to-door. Some ran online campaigns aimed at funneling residents towards information from medical experts, hoping to counter speculation and fear over COVID-19 vaccinations that brewed on social media. None of it seemed to work in Tangipahoa Parish. Vaccinations stagnated even as the more-contagious delta variant spread and cases and hospitalizations soared. So Hammond's North Oaks Hospital tried something new: Giving people cash to get vaccinated. Funded by donations from local businesses and government agencies, the hospital is offering $100 cash payments to those who sign up for the two-shot Pfizer vaccination — $50 after their first shot, with another $50 when they return for the second. (Finn, 7/29)

West Virginia Gov. Jim Justice surprised a retired health care worker with a $1 million check as the most recent winner of the state’s vaccination sweepstakes. Wanda Coleman of Ronceverte got together Wednesday with former coworkers at West Virginia School of Osteopathic Medicine in Lewisburg, believing it was a ceremony to honor a recently retired staff member. ... It was one of 50 prizes announced Wednesday, the governor’s office said. (7/29)

With COVID-19 hospitalizations soaring past 5,000 statewide for the first time in nearly five months, state officials are stepping up vaccination outreach programs and promotional campaigns but Gov. Greg Abbott insists that the state won’t impose any new mandates on Texans. State officials announced Wednesday that Texas has 5,292 people hospitalized with lab-confirmed COVID-19 — the highest number since March 2, the day Abbott announced he was ending all state mask mandates and restrictions on businesses. At that time, Abbott called for “personal diligence” and said statewide mandates are no longer needed. (Wallace, 7/28)

Two of Michigan’s largest health systems will require all employees and physicians at their hospitals and other facilities to be vaccinated against COVID-19. Spectrum Health, a 14-hospital network, and eight-hospital Beaumont Health announced the mandates Wednesday. At least five major hospital systems in the state have announced such requirements. (Eggert and Williams, 7/29)

The presidents of Florida’s 14 state universities wrote an open letter Tuesday urging students to be vaccinated before returning to campus. The letter was written on the same day the Centers for Disease Control and Prevention reversed its earlier guidance and is no encouraging indoor masking for fully vaccinated people. “We strongly recommend that all students get vaccinated for the COVID-19 virus before arriving on campus,” states the letter, which was signed by the presidents of each university. (Lisciandrello, 7/28)

Tennessee lawmakers last week cited a specific federal statute to claim it is illegal for teachers or other school officials to encourage COVID-19 vaccination by creating vaccine policies for students. They were wrong. Legal experts who analyzed the lawmakers' statements found numerous inaccuracies with their interpretation of federal law. The claims came as the state health department is embroiled in a back and forth over childhood vaccinations, including inoculations against COVID-19. Tennessee Department of Health fired its top vaccine official earlier this month. (Timms, 7/28)

Over half of parents surveyed in a national poll said it was unlikely their child would receive a COVID-19 vaccine should the shots see expanded authorization in younger age groups. Findings released Monday from the C.S. Mott Children’s Hospital National Poll on Children’s Health drew from a nationally representative sample of 2,019 parents of kids aged 3 to 18. "Among parents of children 3-11 years, 49% say it is likely their child will get a COVID vaccine once it is approved for their age group, while 51% say it is unlikely," the report reads. Meanwhile, 40% of parents of children aged 12-18 said it’s unlikely their child will get a COVID-19 vaccine. (Rivas, 7/27)

Not vaccinated? That’s no problem for at least one California restaurant. Basilico’s in Huntington Beach, Orange County, has taken a stand against coronavirus vaccination policies, calling them "treasonous, anti-American stupidity," in a sign posted outside the business. Earlier this week, Basilico’s posted on Instagram what it called a "Declaration and Pledge of Defiance." "Challenging fellow business owners to fight with us & fight like us!" the post said. (Calicchio, 7/29)

A Huntington Beach restaurant that has been outspoken in its defiance of state and federal COVID-19 recommendations, such as masks and vaccines, accepted money from the government’s Paycheck Protection Program. Despite its vehement anti-state and federal government social media postings, Basilico’s Pasta E Vino has accepted $57,738 in PPP funds, according to ProPublica’s Small Business Administration loan database. The federal government offered the assistance as a lifeline to small businesses during the coronavirus pandemic to help cover payroll costs. (Valdespino, 7/28)

Pfizer reported on Wednesday that the power of its two-dose Covid vaccine wanes slightly over time, but nonetheless offers lasting and robust protection against serious disease. The company suggested that a third shot could improve immunity, but whether boosters will be widely needed is far from settled, the subject of heated debate among scientists. So far, federal health officials have said boosters for the general population are unnecessary. And experts questioned whether vaccinated people should get more doses when so many people have yet to be immunized at all. (Zimmer, Mandavilli and LaFraniere, 7/28)

The efficacy of the Covid-19 vaccine developed by Pfizer and BioNTech fell from 96% to 84% over six months, according to data released Wednesday, a decline that could fuel Pfizer’s case that a third dose will eventually be required. The data, released in a preprint that has not been reviewed by outside scientists, suggest the vaccine was 91% effective overall at preventing Covid-19 over the course of six months. (Garde and Herper, 7/28)

Pfizer expects revenue from the COVID-19 vaccine, co-developed by BioNTech, will reach $33.5 billion this year — a 29% jump from the previously estimated $26 billion. This vaccine, which has dramatically slowed the coronavirus pandemic, is on pace to be the world's top-selling drug of all time, by far. And now Pfizer is pushing for people to get a third "booster" shot of its vaccine to combat the growing Delta variant. (Herman, 7/28)

The U.S. Food & Drug Administration extended the shelf life for Johnson & Johnson's single-shot COVID-19 vaccine to six months from four-and-a-half months, the company said late Wednesday. The FDA's decision is based on data from ongoing studies, which showed the vaccine is stable at six months when refrigerated at 2 to 8 degrees Celsius (36–46 degrees Fahrenheit), the drugmaker said. (7/28)

Emergent BioSolutions Inc. plans to resume Covid-19 vaccine production at its Baltimore plant after getting the green light from the Food and Drug Administration, according to a statement from the company and an FDA letter reviewed by the Journal. “We are proud to be resuming production of bulk Covid-19 vaccine batches following additional reviews and collaboration with FDA and our manufacturing partners,” Emergent CEO Robert Kramer said in a statement late Wednesday. “We are grateful for the opportunity to help bring this global pandemic to an end.” The plant makes vaccines for Johnson & Johnson. (Burton, 7/28)

AstraZeneca said Thursday that it intends to seek U.S. authorization for its COVID-19 vaccine in the second half of this year, offering a new timetable for the much-delayed application. The Anglo-Swedish drugmaker announced the schedule as it released second-quarter financial results, which showed that the company and its sub-licensees delivered more than 700 million doses of the vaccine to over 170 countries in the first half of this year. That includes 80 million doses that went to the COVAX initiative for low- and middle-income countries. (Kirka, 7/29)

AstraZeneca is not yet sure whether a third dose of its Covid-19 vaccine will be necessary for continued protection against the virus, the company’s CEO told CNBC Thursday. Speaking to CNBC’s “Squawk Box Europe,” Pascal Soriot said the company did not have a “precise answer” on whether booster shots would be needed. (Taylor, 7/29)

A study conducted by AstraZeneca regarding its COVID-19 vaccine found a small risk of blood clots following the first dose of the shot, but none after the second jab. The research, published Wednesday in The Lancet, comes following concerns about the shot’s safety and potential side effects. The shot’s rollout worldwide has been marred by pauses and advisories regarding the potential risk of blood clots in recipients, prompting some countries to recommend using it only in certain populations. The two-dose jab has not yet been approved for use in the U.S. (Hein, 7/28)

AstraZeneca PLC narrowed losses from its Covid-19 vaccine in the second quarter, but the shot continued to weigh on the drug giant’s earnings. The British-Swedish drugmaker pledged last year to distribute the shot at no profit during the pandemic. AstraZeneca Chief Executive Pascal Soriot said Thursday the company and its manufacturing partners had released more than one billion doses of the vaccine for use in more than 170 countries. That included 700 million doses delivered by the end of June. The vaccine boosted second-quarter revenue by $894 million. (Strasburg and Butinni, 7/29)

The Senate has voted to begin work on a nearly $1 trillion national infrastructure plan, acting with sudden speed after weeks of fits and starts once the White House and a bipartisan group of senators agreed on major provisions of the package that’s key to President Joe Biden’s agenda. Biden welcomed the accord as one that would show America can “do big things.” It includes the most significant long-term investments in nearly a century, he said, on par with building the transcontinental railroad or the Interstate highway system. (Mascaro, Freking and Fram, 7/29)

The Senate’s bipartisan infrastructure deal finally moved forward on Wednesday night after weeks of grueling negotiations, handing a group of centrists and President Joe Biden a major win. Though the legislation is still unfinished and failed just a week ago, more than a dozen Republicans took the plunge and voted to break an initial filibuster on the bill. Among them was Senate Minority Leader Mitch McConnell (R-Ky.), who has previously said “100 percent” of his focus was on standing up to Biden’s agenda. (Levine and Everett, 7/28)

The day of breakthroughs began with news of a deal, as a bipartisan bloc of 10 negotiators coalesced around a package to upgrade the nation’s roads, bridges, pipes, ports and Internet connections. The announcement from some of the group’s leaders, including Sens. Rob Portman (R-Ohio) and Kyrsten Sinema (D-Ariz.), capped off a series of frenetic talks that nearly collapsed amid behind-the-scenes battles about the new spending and how to pay for it. With that once-elusive agreement finally in hand, the Senate hours later then took its first formal legislative step. Lawmakers voted 67-32 to put themselves on track to begin debating infrastructure reform this week, clearing the first of many hurdles toward adopting a proposal that the White House has described as historic. (Romm, 7/28)

Although Senate negotiators were celebratory in a post-vote news conference, the bill’s future is already in question in the House, where Speaker Nancy Pelosi has vowed not to take it up until after the Senate approves a $3.5 trillion budget reconciliation package that includes many of Biden’s other domestic priorities. Democratic hopes for a package of that size dimmed a little Wednesday when Sinema said she won't support a price tag that high. House progressives, meanwhile, say they’re not willing to advance one without the other. (Morton, Wehrman and Clason, 7/28)

Sen. Kyrsten Sinema does not support Democrats' $3.5 trillion budget plan that aims to deliver major components of President Joe Biden’s economic agenda that Democrats hope to pass after moving a separate bipartisan infrastructure deal that Sinema negotiated. Sinema, D-Ariz., told The Arizona Republic on Wednesday she had reviewed the Senate Budget Committee’s spending framework and has told Senate leadership and Biden that she supports many of its goals, including job growth and American competitiveness. (Wingett Sanchez, 7/28)

President Joe Biden moved significantly closer Wednesday to achieving his massive infrastructure overhaul — the type of bipartisan win he’s dreamed about since launching his campaign for the presidency. Seventeen Republican senators voted with Democrats to advance a roughly $1 trillion deal that would spend heavily on roads, bridges, broadband and public transit. And though it was a vote merely to start debate, Democrats expressed cautious optimism that a bill would eventually reach Biden’s desk. It was, the White House stressed, a testament to the president’s political skill and persistence. Despite constant fits and starts, grumbling from many in his party, and predictions that negotiations would fall apart, Biden refused to give up on working with Republicans. (Barron-Lopez and Cadelago, 7/28)

The bipartisan deal is less than a quarter the size of the $2.6 trillion plan that President Biden proposed in March, which included $2.2 trillion in spending and around $400 billion in tax credits. It’s also significantly smaller than the counteroffer the White House proposed in May, which scaled back spending by $500 billion, and it leaves out many of the Democrats’ biggest ambitions. ... There were six major areas in Mr. Biden’s original infrastructure proposal: transportation, utilities, pollution, innovation, in-home care and buildings. Almost all these areas were scaled back or eliminated in the bipartisan plan, with one exception: pollution cleanup. (Bhatia and Bui, 7/28)

Here’s a breakdown of where the dollars would go, according to a summary released by the White House on Wednesday. (Freking, 7/29)

The package would invest $55 billion in clean drinking water, which would be enough to replace all of the nation’s lead pipes and service lines. While Congress banned lead water pipes three decades ago, more than 10 million older ones remain, resulting in unsafe lead levels in cities and towns across the country. (Ngo, 7/28)

Despite fervent opposition from hospitals and other healthcare providers, the Senate is slated to vote on an infrastructure bill that would be financed, in part, by extending Medicare payment cuts. The legislation, which includes $550 billion in new spending over five years for roads, bridges and other transportation projects—but nothing for hospital infrastructure—would finance a small fraction of that new spending by continuing the automatic Medicare reimbursement reductions created under budget sequestration in 2013. (Hellmann, 7/28)

Both hospitals and drug makers are on the hook to help pay for the Senate’s grand infrastructure bargain, though hospitals scored a big victory in defending their Covid-19 relief dollars. A group of senators and the White House announced they had reached a $550 billion agreement to fund traditional infrastructure projects such as roads, bridges, public transit, airports and broadband. They turned to health care policy as a piggy bank, proposing cuts to drug makers and hospitals to pay for their wish list, according to a list circulating on Capitol Hill and K Street. The negotiating group has not officially distributed details of the deal, Senate aides said. (Cohrs, 7/28)

Donald Trump tried and failed to pass an infrastructure bill so many times over the course of his presidency that his attempts were reduced to a punchline. Now out of office, Trump is trying to ensure that his successor, Joe Biden, suffers the indignity of the “infrastructure week” jokes as well. The former president has sounded off repeatedly in the past week about the negotiations taking place between Senate Republicans and Democrats on the Hill and in the White House. He’s encouraged GOP lawmakers to abandon the talks and criticized Senate Minority Leader Mitch McConnell (R-Ky.) for even entertaining them. Senate Republicans have said, in interviews, that they have directly asked the former president not just to tone down his criticism but to actually support the infrastructure deal. (McGraw, 7/28)

In a long-awaited move, the Food and Drug Administration has approved the first so-called interchangeable biosimilar version of insulin, which the agency suggested may reduce the price of a life-saving treatment that has been a poster child for the high cost of medicines. The agency endorsed Semglee, a copy of long-acting Lantus (insulin glargine), that it first approved last year. Now, though, the copycat version has also been designated as interchangeable, a regulatory term that means Semglee can be substituted at the pharmacy for Lantus in the same way that generic drugs are substituted for equivalent brand-name medicines. (Silverman, 7/28)

U.S. regulators took action Wednesday that will make it easier to get a cheaper, near-copy of a brand-name insulin at the drugstore. Doctors now have to specifically prescribe what’s called a biosimilar or OK substituting it for a more expensive brand-name insulin. Wednesday’s move by the Food and Drug Administration will allow pharmacists to automatically substitute the cheaper version, just as they do with generic pills for other kinds of drugs. (Johnson, 7/28)

Top researchers who advised the U.S. Food and Drug Administration on Biogen Inc.’s Alzheimer’s drug blasted the agency for approving it, calling the decision a “regulatory failure” that is “at odds with the evidence.” The New England Journal of Medicine opinion piece, signed by seven members of an advisory panel that opposed clearing Biogen’s Aduhelm, is another sign of persistent furor over the agency’s decision. Two committees of the House of Representatives investigating the approval have asked the Cambridge, Massachusetts-based biotech to turn over documents about the drug’s development and approval. (Langreth, 7/28)

Since the controversial approval of the Alzheimer’s drug Aduhelm, both the Food and Drug Administration and the drug’s maker, Biogen, have made an interesting argument: that approving the medicine will speed the development of other Alzheimer’s treatments, whatever one thinks of this medicine’s efficacy. “If we look at the past experience, progress has to be made with the first step, and we can look at HIV, oncology, or [multiple sclerosis],” Biogen’s CEO, Michel Vounatsos, said on the company’s earnings call last week. His remarks echoed those of Patrizia Cavazzoni, who heads the FDA center that regulates new medicines. (Herper, 7/29)

Brendan Frey, the founder and chief executive of Deep Genomics, thinks the wrong people are developing new drugs to treat genetic diseases. In fact, he doesn’t think humans should be doing most of the work. It’s Frey’s view that the next wave of medicines will be discovered using artificial intelligence, and he has support from big investors to create a company that could do that: Deep Genomics on Wednesday announced a $180 million funding round led by Softbank Vision Fund 2, with participation from Fidelity Management & Research Company and others, bringing its total venture haul to $240 million. (Gardizy, 7/28)

Oxford University this week announced the phase 1 trial launch of a vaccine against plague, based on the same adenovirus platform that researchers used to develop the AstraZeneca-Oxford COVID-19 vaccine. The trial will take place in 40 healthy adults ages 18 to 55 and will assess safety and how well the vaccine triggers protective antibody and T-cell responses, Oxford said in a press release. Volunteers will be followed for 12 months. (7/28)

Three years ago, Congress directed the Department of Defense to take steps to lower the cost of medicines discovered with the help of federal funding, but eventually cost Americans substantially more than what is paid in other countries. Now, a pair of lawmakers wants to know what, if anything, the department has done to comply with the directive, the latest move to convince federal agencies to use a controversial provision of federal law to lower the cost of certain prescription medicines. (Silverman, 7/28)

Providers that received HHS COVID-19 relief funds would get until the end of the year or the end public health emergency to spend that money under a bipartisan bill introduced Wednesday. Sens. Michael Bennet (D-Colo.) and Kevin Cramer (R-N.D.) authored the legislation following HHS' decision to require some healthcare providers to spend their relief dollars by June 30. The American Hospital Association and other groups object to that pending deadline on the grounds that the pandemic is still having a negative financial impact on providers. (Hellmann, 7/28)

As the Delta variant raises fresh concerns about the safety of the nation’s nursing homes, the Biden administration has quietly reversed a controversial Trump policy that had limited the fines levied on facilities that endangered or injured residents. Deaths in nursing homes, which peaked at the end of last year, have plummeted since the introduction of the Covid-19 vaccines. They account for nearly a third of the U.S. pandemic’s overall death toll. (Abelson, 7/28)

Virtual platforms that match employers with healthcare workers through an automated process are becoming a highly utilized alternative to traditional recruitment and hiring. These digital marketplaces boast a quicker, more cost effective system that allows qualified candidates to find the position they are best suited for, and employers to skip hours of sifting through candidates who aren't a good fit. These digital solutions come at a time when the industry is struggling to find and retain staff. (Devereaux, 7/28)

Dr. Eveline Shue had always been a standout surgeon, but her most joyful moment at the hospital came when she could finally share some personal good news with her colleagues: After five cycles of in vitro fertilization, she was pregnant with twins. At 24 weeks of pregnancy, she and her husband began to make plans for their future family, purchasing car seats and picking out names. All the while Dr. Shue kept working 60-hour weeks in the hospital. At 34 weeks, she realized that the operating room shifts were wearing on her body and took a brief leave. Two days later, her mother walked into her home and found her unable to speak. Dr. Shue, 39, had suffered pre-eclampsia and a stroke. She was rushed to the hospital, got an emergency cesarean section and then underwent brain surgery. (Goldberg, 7/28)

A Texas man has pleaded guilty to involvement in a scheme to fraudulently sell 50 million N95 respirator masks he did not have for $317.6 million to the government of New South Wales in Australia, U.S. prosecutors said. Arael Doolittle entered his plea to a wire fraud conspiracy charge on Tuesday before U.S. District Judge Lynn Hughes in Houston. (Stempel, 7/28)

KHN: Covid Renews Interest In Radiation, But Docs Caution Against Pilgrimages To Radon-Filled Mines 

Twice a year, Brian Tichenor makes the 1,200-mile drive each way from his home in Kansas to a defunct uranium mine in Montana, where he takes an elevator 85 feet below the surface to sit amid radioactive radon gas to ease the pain from his chronic eye condition. “I found it like I think a lot of people do,” said Tichenor, 67. “It’s a point of desperation with conventional treatment.” While radon is commonly known as a hazardous gas removed from basements, people in pain travel to Montana and pay to breathe, drink and bathe in its radioactive particles. (Houghton, 7/29)

KHN: Pfizer Court Fight Could Legalize Medicare Copays And Unleash ‘Gold Rush’ In Sales 

Three years ago, pharma giant Pfizer paid $24 million to settle federal allegations that it was paying kickbacks and inflating sales by reimbursing Medicare patients for out-of-pocket medication costs. By making prohibitively expensive medicine essentially free for patients, the company induced them to use Pfizer drugs even as the price of one of those medicines, covered by Medicare and Medicaid, soared 44% to $225,000 a year, the Justice Department alleged. (Hancock, 7/29)

University of Houston College of Medicine will open a low-cost direct primary care clinic on the Memorial Hermann Southwest Hospital campus to assist low-income and uninsured residents. The medical school will offer direct primary care to patients — particularly those from low-income backgrounds — and will implement a low monthly membership fee for a range of primary health care services, according to a recent release. (Britto, 7/28)

Admissions rebounded for Community Health Systems in the second quarter, the 84-hospital system reported Wednesday. Adjusted admissions increased 28.5% on a same-store basis for the quarter ended June 30, compared with the prior-year period when the COVID-19 pandemic halted non-urgent procedures. But its 248,000 adjusted admissions on the quarter were still down 22% from its 303,000 adjusted admissions in the second quarter of 2019. (Kacik, 7/28)

The COVID-19 pandemic's impact on Northwell Health's patient business and cleaning and staffing costs, don't entitle the New Hyde Park, N.Y.-based health system to $1.25 billion in insurance claims, a federal judge ruled Tuesday. U.S. District Judge Jed S. Rakoff dismissed the suit from New York's largest healthcare provider, saying the not-for-profit system failed to prove that Boston-based Lexington Insurance Company and Chicago-based Interstate Fire & Casualty Company breached their contract and violated the implied covenant of good faith and fair dealing by denying Northwell's claims. (Tepper, 7/28)

The huge increase in government aid prompted by the coronavirus pandemic will cut poverty nearly in half this year from prepandemic levels and push the share of Americans in poverty to the lowest level on record, according to the most comprehensive analysis yet of a vast but temporary expansion of the safety net. The number of poor Americans is expected to fall by nearly 20 million from 2018 levels, a decline of almost 45 percent. The country has never cut poverty so much in such a short period of time, and the development is especially notable since it defies economic headwinds — the economy has nearly seven million fewer jobs than it did before the pandemic. (DeParle, 7/28)

Lavita Harvey is well aware the federal moratorium on evictions ends Saturday. The Las Vegas mother of two teenagers lost both of her jobs during the coronavirus pandemic and has been unable to pay her $900-per-month rent. "I'm terrified. Job offers are coming in but they're coming in very slowly," she told CBS News. "It's the hardest thing to see in the world when you know that you're a single mother and you have no one to turn to, you'll be homeless." Harvey has been approved for more than $9,000 in federal rent help through a local program but the money hasn't come through yet. More than 8,000 other renters in Nevada's Clark County are still waiting for approval. (Shamlian, 7/28)

Since it opened in 2015, the Clarkston Community Health Center has attracted long lines of impoverished patients, at times becoming so busy that it has been forced to turn some away. The volunteer-run nonprofit has provided free care to more than 5,500 immigrants, refugees and U.S.-born people without health insurance. Some have traveled from Alabama, South Carolina and Tennessee. (Redmon, 7/28)

Pennsylvania officials are warning against a surge in ticks this summer, including black-legged ticks, which carry Lyme disease, as well as invasive ticks from the American South and Asia. The state’s acting physician general, Denise Johnson, said this is the time of year when ticks are most active, noting that “this year we’re seeing more than ever.” She said there’s been an increase in tick bites as well as Lyme disease. “In Pennsylvania, every single county within the state does have ticks that carry Lyme disease,” Johnson said earlier this week. “And then ticks also can carry other diseases. ... This summer don’t let a tick make you sick.” (Kummer, 7/28)

Hard-hit communities across the U.S. hope to combat the rising number of fatal overdoses as the nation reached a morbid milestone in the drug epidemic: Drug overdose deaths soared to a record 93,000 in 2020, according to provisional data from the Centers for Disease Control and Prevention. That marks a 29.4% increase from 2019. In Allegheny County, Pennsylvania, home to Pittsburgh, the rate of overdose deaths noticeably surpassed Keystone State’s rate, which 16% to 5,172. (Goin, 7/28)

When Aiden feels lonely or is struggling with sobriety, he calls the number to the warm line. He can relate to the person on the other end of the phone because they also have experienced personal mental health or substance use issues. “Sometimes it keeps me from drinking, other times it’s just that I want to talk to somebody,” said Aiden, whose name has been changed at his request to protect his identity. “And I don’t know who to talk to. I have no friends left because I screwed up so much.” (Knopf, 7/29)

Bob Odenkirk, star of the “Breaking Bad” spinoff “Better Call Saul,” is in stable condition after suffering a “heart-related incident,” his representatives confirmed Wednesday evening. The 58-year-old actor was hospitalized Tuesday night in Albuquerque after collapsing on set. (Rao and Pietsch, 7/28)

President Joe Biden was widely expected to lift restrictions this summer that have blocked migrants from seeking asylum since the start of the pandemic. The fast-spreading delta variant of the Covid-19 virus and surging numbers of border apprehensions have derailed those plans. The administration will not begin phasing out its use of the public health order, known as Title 42, at the end of this month, despite mounting legal challenges and renewed criticism from allies about the 16-month closure, according to four people familiar with the discussions. (Rodriguez and Kumar, 7/28)

Republican Gov. Greg Abbott issued an executive order Wednesday designed to restrict border entries in Texas, saying the action will cut down on Covid-19 infections, as his party continues to criticize the president’s handling of the border. The move comes about a month after the governor vowed to build a border wall in Texas, a nod to former President Donald Trump’s plan to curb migration. The Republican party has been chiding the Biden administration’s handling of heightened border crossings, urging Vice President Kamala Harris to visit the U.S.-Mexico border and criticizing the trip she made in June. (Sheehey, 7/28)

A Texas border town police department is warning citizens of the potential danger posed by illegal immigrants infected with COVID-19 being released by Border Patrol agents and housed in local hotels. The La Joya, Texas, Police Department issued a public health announcement on Facebook this week and explained that concerned citizens had witnessed a family group coughing and sneezing at a local Whataburger. Police said they were told by the group they had been released by Border Patrol into a local hotel. (Miller, 7/29)

Californians who are at least 50 and living in the country without permission are newly eligible for state health care coverage under legislation signed by Gov. Gavin Newsom on Tuesday, part of a record state budget that includes major investments in mental health, homelessness and housing. The legislation to expand Medi-Cal coverage to low-income adults regardless of immigration status builds upon proposals pushed by Democrats to extend the state’s version of federal Medicaid to children in 2016 and to young adults under 26 in 2020. Around 235,000 people are expected to benefit from this legislation. (7/28)

California has become the first state in the nation to provide taxpayer funded health benefits to elderly illegal immigrants. California’s governor, Democrat Gavin Newsom, signed AB 133 into law Tuesday which opened the state's Medi-Cal rolls to illegal aliens 50 years and older in a move that the governor referred to as a "major milestone." (Miller, 7/28)

American pole vaulter Sam Kendricks is out of the Tokyo Summer Olympics after testing positive for the coronavirus. Kendricks, a world champion, was considered a medal contender. According to a statement from U.S. Olympic officials, Sam Kendricks is ineligible to compete in the Tokyo Games following his positive test. He's been transferred to a hotel and put in isolation. Kendricks' dad, who's also his coach, said on social media his son feels fine and has no symptoms. Kendricks won the last two World Championships in pole vault and a bronze medal at the Rio de Janeiro Summer Olympics in 2016. (Goldman, 7/29)

Japanese officials sounded the alarm Thursday as Tokyo reported record-breaking coronavirus cases for the third straight day with the Olympics well underway. “We have never experienced the expansion of the infections of this magnitude,” Chief Cabinet Secretary Katsunobu Kato told reporters. He said the new cases were soaring not only in the Tokyo area but across the country. Tokyo reported 3,865 new cases Thursday, up from 3,177 on Wednesday and double the numbers a week ago, setting an all-time high since the pandemic began early last year. (Yamaguchi, 7/29)

“This is someone who is putting well-being in front of everything else,” said Joe Puentes, a Santa Rosa sports psychologist. “Because someone can do superhuman physical things does not mean they aren’t still human.” The Games’ biggest star has found support from fellow Olympians like Katie Ledecky to freely talk about mental issues that for years have been percolating under the surface but seemingly have been exacerbated in the era of the coronavirus. (Almond, 7/28)

Gymnastics superstar and defending Olympic champion Simone Biles decided to withdraw from Thursday’s individual all-around competition at the Tokyo Games to focus on her mental health. Biles shared that she was experiencing a mental issue known as the “twisties.” “They saw it a little bit in practice ... having a little bit of the twisties,” Biles told reporters. (DeCiccio, 7/28)

Twenty unnamed athletes are ineligible to compete in the Tokyo Olympics after failing to meet anti-doping guidelines, the Athletics Integrity Unit announced Wednesday. The test's results listed Nigeria the most, with 10 competitors unable to represent the country out of the 23 it entered for the Games. Athletes from "Category A" countries — or those considered to be of "the highest doping risk to the sport" — must undergo at least three urine and blood tests without notice to be conducted no less than three weeks apart within the 10 months leading up to a major event to be eligible to compete at the Olympics, according to National Federation Anti-Doping Obligations. In 2021, the Federation identified seven countries as "Category A" nations, including Belarus, Bahrain, Ethiopia, Kenya, Morocco, Nigeria and Ukraine. (Powell, 7/28)

KHN: Olympic Dream Dashed After Bike Crash And Nightmare Medical Bill Over $200K 

It was a race in Pennsylvania that could have sent cyclist Phil Gaimon to the Tokyo Olympics; instead, a serious crash landed the Californian in two hospitals on the East Coast. Gaimon knows accidents are, unfortunately, part of the sport. He had retired from competitive road cycling three years earlier, but a recruiting call came in spring 2019 from a coach of the USA Cycling track team. The coach needed speed for a four-man event. At the time, Gaimon was making a name for himself, and money, by mountain racing, and he was setting records. (Young, 7/29)

Fully vaccinated travelers from the European Union and the U.S. will no longer need to quarantine when arriving in England, effective Aug. 2 at 4 a.m. local time, the U.K. government announced Wednesday. It's a reflection of the British government's confidence in its highly successful COVID-19 vaccine rollout, despite the spread of the Delta variant. The move stands in stark contrast to the Biden administration's continued refusal to lift restrictions for travelers from the U.K. and Europe. (Doherty, 7/28)

This is a puzzler. Coronavirus cases are plummeting in Britain. They were supposed to soar. Scientists aren't sure why they haven't. The daily number of new infections recorded in the country fell for seven days in a row before a slight uptick Wednesday, when the country reported 27,734 cases. That’s still almost half of where the caseload was a week ago. The trajectory of the virus in Britain is something the world is watching closely and anxiously, as a test of how the delta variant behaves in a society with relatively high vaccination rates. And now people are asking if this could be the first real-world evidence that the pandemic in Britain is sputtering out — after three national lockdowns and almost 130,000 deaths. (Adam and Booth, 7/28)

Burundi’s government now says it will accept COVID-19 vaccines, becoming one of the last countries in the world to embrace them. But the health ministry says it will not take responsibility for any side effects they might cause. Health Minister Thaddee Ndikumana on Wednesday said the vaccines will arrive with the support of the World Bank. It was not immediately clear how many doses the East African country will receive or when. (Kaneza, 7/29)

Uruguay will give a Pfizer Inc. booster shot to people who have already received two doses of the less-effective Sinovac Biotech Ltd. vaccine, less than two weeks after the delta variant was detected in the South American country. After 90 days of the second Sinovac jab, people can receive the mRNA shot from Pfizer. The government will offer a third shot to increase the population’s immunity to Covid-19 variants such as delta, said Graciela Perez, who leads the Health Ministry’s immunization unit. The Ministry will start scheduling those shots in August. (Parks, 7/28)

In the spring, some compared getting Covid-19 shots to competing in "The Hunger Games." Even a few months ago, Canada's vaccination drive was in the doldrums, but the country's efforts have rebounded recently, with around 56 percent of the eligible population fully vaccinated as of this week, according to statistics compiled by Our World in Data. That compares with nearly 49 percent in the U.S. So how did Canada do it? Experts said a number of factors are behind Canada's success. (Da Silva, 7/29)

Australia's biggest city Sydney posted a record one-day rise in local COVID-19 cases on Thursday and warned the outbreak would get worse, as authorities sought military help to enforce a lockdown of 6 million people poised to enter its sixth week. Australia has struggled to contain an outbreak of the highly infectious Delta variant in and around Sydney in recent weeks, which threatens to push the country's A$2 trillion ($1.5 trillion) economy into its second recession in as many years. (Packham and Jose, 7/29)

China’s commitment to a “zero-tolerance” approach for coronavirus infections may be starting to fray. Since the start of the pandemic, China has embraced a stringent approach to containing the coronavirus, sealing off entire cities and tightly controlling borders to keep infection rates down. (Tan and Chen, 7/29)

A baby girl born in Israel earlier this month had the embryo of a twin inside her stomach, in what medical officials say was a 1-in-500,000 medical rarity. The case of "fetus-in-fetu" occurred at Assuta Medical Center in Ashod, Israel, according to The Times of Israel. "We were surprised to discover that it was an embryo," Omer Globus, director of neonatology at the hospital, told the newspaper. (Calicchio, 7/29)

Schizophrenia is often diagnosed well into adulthood, typically from the late teens to early 40s. Are there early indicators that could help predict which individuals will go on to develop this serious mental illness? Researchers in clinical psychology and psychiatry have long sought to answer this question. New research by Distinguished Professor Mark F. Lenzenweger at Binghamton University and Weill Cornell Medical College could point the way. (Binghamton University, 7/27)

Depression is common, and suicide rates are increasing. Adolescent depression screening might miss those with unidentified suicide risk. Our primary objective in this study was to compare the magnitude of positive screen results across different approaches. (Kemper et al, 7/1)

This study characterized the progression of GD behavior in children and adolescents. Less than one-third of GD youth receive an eventual GDRD, and approximately one-quarter receive GAHT. Female sex at birth, older age of initial GD presentation to medical care, and non-Hispanic white race and ethnicity increased the likelihood of receiving diagnosis and treatment. (Wagner et al, 7/1)

Pharmaceutical company Iterum Therapeutics said yesterday that the US Food and Drug Administration (FDA) has rejected the company's new drug application (NDA) for approval of its oral antibiotic sulopenem etzadroxil/probenecid.Iterum is seeking approval of the antibiotic for treatment of uncomplicated urinary tract infections (UTIs) in patients who do not do not respond to treatment with fluoroquinolones. But in a Jul 23 Complete Response Letter (CRL) to the company, the FDA said it could not approve the NDA in its current form. (7/27)

As drug demand surged during the early months of the pandemic, the US Food and Drug Administration (FDA) published temporary guidelines to free up a pharmaceutical drug source that seemed much more domestic: drug compounders, or specific pharmacies and outsourcing facilities that make specialized drug formulations. So to what extent can drug compounding help with shortages? Or, is the very question indicative of a bigger problem? (McLernon, 7/27)

World health experts met recently to discuss an emerging global health crisis linked to the Covid-19 pandemic: plummeting rates of basic vaccinations among the world’s children. While many experts have been acutely aware of the pandemic’s impact on essential health services, startling new immunization data from the World Health Organization and UNICEF indicate that decades of progress against some of the world’s most dangerous diseases is being severely threatened. (Martha Rebour and Lori Sloate, 7/29)

Attorney General Lynn Fitch of Mississippi made nationwide news last week when she asked the Supreme Court to overturn its two leading precedents on the right to abortion, Roe v. Wade and Planned Parenthood v. Casey. I was puzzled by the treatment of this filing as news, unless the news was that a state finally came clean with the court and told the justices what it really wanted them to do. (Linda Greenhouse, 7/29)

The Covid-19 pandemic has brought to the public’s attention alarming racial disparities in health. According to new data from the Centers for Disease Control and Prevention, life expectancy in the U.S. fell in 2020 by 1.5 years, the largest drop since World War II. The drop was far greater for Black and Hispanic Americans, who lost three years in life expectancy over the past year. (Utibe R. Essien, 7/28)

This year, roughly 14,000 Americans will die from hepatitis C, an infectious disease that can be cured by a simple pill in a matter of weeks. It's infuriating that our government hasn't done more to end this highly infectious disease that disproportionately impacts minorities and people struggling with substance use disorder. Curative drugs first hit the market in 2013. But hepatitis C cases actually rose 63 percent between 2015 and 2019, according to a new report from the Centers for Disease Control and Prevention. (Carl Schmid, 7/28)

I awoke with a start, fragments of my dream still tangled with my early morning consciousness. In the dream, I was traveling, but rather than being at the start of my travels or at my final destination, I was in transit. I had a plane to catch and, though I had left hours to get from one terminal to the next, my journey kept being waylaid and confused. The airplane terminals became long curving paths. There were somehow missed taxis along the way, and I was running at the end. In realizing that I had missed my connection I awoke, my heart pounding. As COVID-19 rates are rising again and the Delta variant is spreading at dramatic rates in largely unvaccinated American states, partially vaccinated countries, and globally where access to vaccines has been poor, the fantasy of arriving at our “final destination” — the post-COVID-19 world — appears to be quickly slipping away. (Katherine Gergen Barnett, 7/29)

The Food and Drug Administration’s approval of Biogen’s Alzheimer’s drug Aduhelm has stirred intense controversy, with pundits launching attacks on multiple fronts. Professors focus on population outcomes rather than individual treatment responses; politicians worry about drug pricing rather than disease cost; critics pounce on the FDA’s narrowing of the drug’s label to reflect its clinical trial — all casting doubt on the drug’s effectiveness and value. What’s been lost in the flurry is an understanding of how progress against complex diseases advances — and the historic importance of Aduhelm as a first step in that process. (Andrew C. von Eschenbach, 7/29)

Here’s something I almost never say: The NFL is right. When pro football announced last week that it will impose stiff penalties on teams that experience a COVID-19 outbreak involving unvaccinated players, it exposed a serious vaccination divide among its athletes. Fans also learned in real time that some of their favorite NFL stars are not only vaccine-hesitant but also susceptible to some of the same misinformation that has duped millions of other Americans. (Jemele Hill, 7/28)

I hate that I believe the sentence I’m about to write. It undermines much of what I spend my life trying to do. But there is nothing more overrated in politics — and perhaps in life — than the power of persuasion. It is nearly impossible to convince people of what they don’t want to believe. Decades of work in psychology attest to this truth, as does most everything in our politics and most of our everyday experience. Think of your own conversations with your family or your colleagues. How often have you really persuaded someone to abandon a strongly held belief or preference? Persuasion is by no means impossible or unimportant, but on electric topics, it is a marginal phenomenon. (Ezra Klein, 7/29)

As a new wave of COVID-19 infections sweeps across the country driven by a highly contagious variant, an era of carrot incentives to increase the number of fully vaccinated Americans has played itself out. Enticements ranging from hard scientific facts to Krispy Kreme doughnuts and million dollar lotteries are failing. Months after making free shots available, less than half the U.S. population is fully vaccinated. One hundred million eligible recipients simply say no. Time has come to use the stick. (7/28)

Now that we know that the delta variant galloping through Kansas City can be more easily spread by even those who have been vaccinated than earlier versions of the coronavirus could be, Mayor Quinton Lucas had no choice but to issue a new mask mandate. To those who complain that the guidance keeps changing, that’s because the virus keeps changing. And will keep right on mutating until a lot more of us get vaccinated. All of the vaccines approved for emergency use remain highly effective at preventing hospitalization and death, including from the delta variant. (7/29)

Just two months after the U.S. Centers for Disease Control and Prevention said it was generally safe for those vaccinated against COVID-19 to drop their masks, the agency switched course and now recommends that even the inoculated wear face coverings indoors in areas where the highly transmissible delta variant is spreading rapidly. The guidance change may provoke some whiplash — and it's already generated some backlash, if social media is any measure — but it makes sense. Here's why. (Max Nisen, 7/28)

The highly transmissible delta variant of the coronavirus has forced a return to face masks in some places. Despite the grim disappointment of what might appear to be a step backward, the nation’s pandemic response must not flag. Vaccines have proved to be extraordinarily effective in preventing severe disease and death, and there is no better solution at hand than getting millions more people vaccinated in the United States and the world. Face masks can restrain the spread of this virus. However, it is going to take longer than once hoped. We must not give up. (7/28)

As a doctor and a Christian, I am struck by the profound difference that my fellow Christians could make in the trajectory of the pandemic by getting vaccinated. The delta variant, a much more transmissible form of COVID-19, threatens a new round of restrictions and a new round of deaths. And nearly all the deaths involve people who haven’t been vaccinated. Earlier this year, 45% of white evangelical adults said they would not be vaccinated, according to a Pew Research Center survey. That amounts to more than 45 million Americans or 14% of the population, based on the 2020 Census of American Religion.  If this group alone accepted the COVID-19 vaccine, we could begin to close in on herd immunity and move beyond this painful and deadly season. (Dr. Andrew Wong, 7/28)