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Openly contradicting the government’s top health experts, President Donald Trump predicted Wednesday that a safe and effective vaccine against the coronavirus could be ready as early as next month and in mass distribution soon after, undermining the director of the Centers for Disease Control and Prevention and calling him “confused” in projecting a longer time frame. Trump also disagreed with Dr. Robert Redfield about the effectiveness of protective masks — which the president recommends but almost never wears — and said he’d telephoned Redfield to tell him so. (Perrone, Alonso-Zaldivar and Stobbe, 9/16)

Dr. Robert Redfield told a Senate panel on Wednesday that a limited supply of coronavirus vaccine may be available between November and December, but that it was unlikely to be available to the general public until the summer or fall of next year. His remarks contradicted Trump, who has said a vaccine could be available by the end of the year, perhaps by the Nov. 3 election. Redfield also testified that wearing a face mask might offer more protection against the spread of coronavirus than a vaccine. (Collins and Jackson, 9/16)

When asked why his message on a vaccine timeline and the efficacy of masks differed so profoundly from the CDC director's, Trump said that Redfield had "made a mistake" and "misunderstood" the questions. "He's contradicting himself," Trump said of Redfield. "I think he misunderstood the questions. ... But I'm telling you, here's the bottom line: Distribution is going to be very rapid. He may not know that. Maybe he's not aware of that. And maybe he's not dealing with the military, etc., like I do. Distribution is going to be very rapid, and the vaccine's going to be very powerful." (9/16)

Trump also refuted Redfield’s statements that wearing a mask may be more important than a potential vaccine because there’s clear scientific evidence they work. "I might even go so far as to say that this face mask is more guaranteed to protect me against Covid than when I take a Covid vaccine,” Redfield said, holding up his face mask before the Senate panel. Trump said he spoke to Redfield afterwards and thinks the CDC director could have confused the question and answered "incorrectly." "I think maybe he misunderstood it," Trump said, adding that "the mask is a mixed bag." (Schultz, 9/16)

The sharply divergent messages further undercut any effort to forge a coherent response to the virus that the United Nations secretary general on Wednesday called the “No. 1 global security threat in our world today.” With Mr. Trump saying one thing and his health advisers saying another, many Americans have been left to figure out on their own whom to believe, with past polls showing that they have more faith in the experts than their president. The public scolding of Dr. Redfield was only the latest but perhaps the starkest instance when the president has rejected not just the policy advice of his public health officials but the facts and information that they provided. Public health officials are in strong agreement about the value of masks even as Mr. Trump generally refuses to wear one, mocks his opponent for doing so and twice in the past two days questioned their utility based on the advice of restaurant waiters. (Baker, 9/16)

On Twitter late on Wednesday, Redfield said he believed “100%” in the importance of a vaccine. “A COVID-19 vaccine is the thing that will get Americans back to normal everyday life,” he said. Despite quibbling with Redfield, Trump said he retained confidence in his performance at the CDC. (Mishra, O'Donnell and Alper, 9/16)

Robert Redfield, director of the Centers for Disease Control and Prevention, told a Senate panel that his agency, which is playing a lead role in vaccine distribution, does not have the critical funds that states need for the distribution, which will take place in phases. ... The CDC has about $600 million in dwindling relief money, but states urgently need additional resources, Redfield said, responding to questions from Sen. Roy Blunt (R-Mo.), who chairs the Senate appropriations subcommittee on Labor, Health and Education. (Farzan and Noack, 9/17)

The country's recent progress against Covid-19 could be short-lived if Americans do not continue to take precautions like mask wearing and social distancing, HHS testing czar Brett Giroir said Wednesday. The number of new infections has decreased nationwide by 48 percent following a spike beginning around Memorial Day, while the number of coronavirus patients in intensive care units has dropped by 62 percent and deaths have fallen 33 percent over the same period, Giroir said during a Senate hearing. (Lim, 9/16)

The Centers for Disease Control and Prevention is developing new guidance on how to deploy coronavirus tests for screening purposes that could help reopen schools, businesses and entertainment venues, Director Dr. Robert Redfield said Wednesday. Testing has so far been used in the United States mostly to diagnose people who are sick or have been exposed to someone with a confirmed Covid-19 case. Screening would test virtually everyone in a given community, looking for potentially infectious people. (Feuer, 9/16)

The Department of Health and Human Services’ top communications official is going on medical leave, three days after urging President Trump’s supporters to prepare for an armed insurrection and accusing scientists in his own agency of “sedition,” HHS announced Wednesday. Michael Caputo, assistant secretary for public affairs at HHS, leveled the accusations and promoted other conspiracy theories in a Facebook Live event on Sunday. (Abutaleb, Dawsey and Sun, 9/16)

The leave of absence effectively removes Caputo from government operations through November's election. The statement also announced that Paul Alexander, whom Caputo had brought in as a scientific adviser, would be leaving the department altogether. Last week, Caputo came under fire after reports that he and Alexander sought to edit and delay public health reports from the Centers for Disease Control and Prevention. Emails from Alexander obtained by Politico complained to CDC Director Robert Redfield that the agency's Morbidity and Mortality Weekly Report "hurt the President," and described data-based publications on the risk of the coronavirus in children as "hit pieces on the administration" that undermined Trump's school reopening plan. (Huang, 9/16)

Rep. James Clyburn, D-S.C., who leads a special panel overseeing the government’s COVID-19 response, called the shakeup at HHS “an important first step.” Nonetheless, Clyburn said he has started an investigation into Caputo’s alleged effort to interfere with the CDC publication. Caputo’s short tenure was marked by devotion to Trump, disdain for Democrats and the media, along with some scientists, as well as hints that he felt personally hounded by political enemies. (Alonso-Zaldivar, 9/16)

After it became clear in mid-April that his administration’s response to Covid-19 was threatening his re-election, President Donald Trump considered a leadership shake-up within a health department whose rivalries and battles with the White House had hampered efforts to contain the virus.Instead, Trump made a different move: He personally intervened to place his campaign aide Michael Caputo — a confidant of disgraced operative Roger Stone who had himself come under scrutiny for his ties to top Russian officials — as assistant Health and Human Services secretary for public affairs. Trump — not HHS Secretary Alex Azar — approached Caputo about the job, and Caputo has repeatedly emphasized that he works for the president, health officials told POLITICO. (Diamond, Cancryn and Owermohle, 9/16)

Centers for Disease Control and Prevention (CDC) Director Robert Redfield on Wednesday defended his agency from claims by a top health department official that there is a "resistance unit" plotting against President Trump in the CDC. Redfield was asked at a Senate hearing about an extraordinary Facebook Live video streamed Sunday where the Department of Health and Human Service's (HHS) top spokesman, Michael Caputo, said career scientists are plotting against the president and encouraged Trump supporters to arm themselves ahead of the election. (Sullivan, 9/16)

President Donald Trump blamed "blue states" for increasing the nation's death rate from coronavirus, suggesting that if "you take the blue states out" of the equation the United States would be far more competitive with other countries. Trump has long blamed Democratic leaders for a variety of ills, including "Democrat-run" cities where protests against police have occasionally turned violent. But his remarks Wednesday were his most explicit politicization yet of the handling of COVID-19. (Fritze and Jackson, 9/16)

For months, President Trump has been scrambling to deflect criticism for the breadth of the coronavirus pandemic toward whatever target might be available. During a news briefing Wednesday, he returned to one of his favorites: Democratic leaders. He pointed to a graph that the White House first unveiled in the spring, showing two estimated ranges of possible death tolls depending on the extent of efforts to contain the virus’s spread. “This was a prediction that if we do a really good job, we’ll be at about 100,000 and — 100,000 to 240,000 deaths, and we’re below that substantially, and we’ll see what comes out,” he said. “But that would be if we did a good job. If the not-so-good job was done, you’d be between 1.5 million — I remember these numbers so well — and 2.2 million. That’s quite a difference.” (Bump, 9/16)

Rep. Don Beyer (D-Va.) blasted President Trump on Wednesday after Trump blamed “blue states” for the nation’s death toll from the coronavirus. Beyer said Trump’s remark at Wednesday's White House briefing was “quite simply one of the most appalling and inhuman statements ever uttered by an American President.” (Klar, 9/16)

The wide-ranging headaches that so troubled the USPS in April ultimately foreshadowed a summer of upheaval, thrusting the once-venerated mail service into a political maelstrom months before a presidential election. Newly disclosed details of these struggles are laid bare in nearly 10,000 pages of emails, legal memos, presentations and other documents obtained by The Washington Post from American Oversight, a watchdog group that requested them under the Freedom of Information Act. The documents, which mostly span March and April, depict an agency in distress, as its deteriorating finances collided with a public-health emergency and a looming election that would be heavily reliant on absentee ballots. (Romm, Bogage and Sun, 9/17)

A deal for 150 million rapid coronavirus tests the White House promoted last month as a potential game-changer in battling the pandemic fails to fix the lack of an overarching strategy for a new phase of testing the nation needs to embrace, multiple health experts and state and local officials say. The Trump administration's purchase of the new Abbott Laboratories antigen tests, which can detect the virus in 15 minutes, was hailed by White House press secretary Kayleigh McEnany as a major development that would help Americans get back to work and school. (Devine and Griffin, 9/17)

White House press secretary Kayleigh McEnany on Wednesday would not divulge details of a health care plan President Trump has been promising for months, telling a reporter she should take a job in the White House to learn more about the proposal. Administration officials faced questions a day after Trump said during an ABC News town hall that the vague health care plan he's been promising will be rolled out dating back to last year is "all ready." But three administration health officials have testified that they were not involved in crafting the plan, and McEnany would not specify who has worked on the proposal. (Samuels, 9/16)

Oklahoma health officials raised red flags before President Trump’s indoor rally in June, warning there could be significant spikes of coronavirus cases and deaths from the event, according to internal state documents. Dozens of emails obtained by The Hill through a state freedom of information request reveal growing angst within the Oklahoma public health department in the days leading up to the June 20 rally. (Cusack, 9/16)

In explaining why he repeatedly misled the American public about the early dangers posed by the novel coronavirus, President Trump has argued that he did not want to engender panic — and suggested that his actions showed he took the looming pandemic seriously. But a detailed review of the 10-day period from late January, when Trump was first warned about the scale of the threat, and early February — when he acknowledged to author Bob Woodward the extent of the danger the virus posed — reveals a president who took relatively few serious measures to ready the nation for its arrival. (Parker, Dawsey and Abutaleb, 9/16)

Hours before law enforcement officers violently cleared protesters from a square outside the White House in June, a top military police officer sought out weaponry like powerful sound cannons and a device that “causes targets to feel an unbearable heating sensation,” an Army National Guard major told lawmakers in written testimony. The major, Adam DeMarco, an Iraq war veteran who serves in the District of Columbia National Guard and was called in to enforce the crackdown on protesters, told House lawmakers last month that he had received an email from a top law enforcement official at the Defense Department asking if the Guard was equipped with sound cannons or a nonlethal heat ray, known as the Active Denial System, or A.D.S. (Edmondson, 9/17)

In written responses to the House Committee on Natural Resources obtained by NPR, Major Adam DeMarco of the D.C. National Guard said he was copied on an email from the Provost Marshal of Joint Force Headquarters National Capital Region. He was looking for two things: a long range acoustic device, a kind of sound cannon known as an LRAD, and a device called the Active Denial System, or ADS. The ADS was developed by the military some twenty years ago as a way to disperse crowds. There have been questions about whether it worked, or should be deployed in the first place. It uses millimeter wave technology to essentially heat the skin of people targeted by its invisible ray. (Temple-Raston, 9/16)

D.C. National Guard Maj. Adam D. DeMarco's account contradicts the administration’s claims that protesters were violent, tear gas was never used and demonstrators were given ample warning to disperse — a legal requirement before police move to clear a crowd. His testimony also offers a glimpse into the equipment and weaponry federal forces had — and others that they sought — during the early days of protests that have continued for more than 100 days in the nation’s capital. DeMarco, who provided his account as a whistleblower, was the senior-most D.C. National Guard officer on the ground that day and served as a liaison between the National Guard and U.S. Park Police. (Lang, 9/16)

The push to highlight racism as a public health threat, one that shortens lives and reduces quality of life in a manner similar to smoking or obesity, gained even more momentum in the summer. The coronavirus pandemic and police brutality have emerged in recent months as inescapable crises that have killed non-White people at disproportionately higher rates. (Bellware, 9/15)

The United States plans to begin distributing coronavirus vaccine within 24 hours of one being approved, federal officials said Wednesday. It’s an audacious goal in an already frantically paced COVID-19 vaccine development and distribution program being overseen by the White House's aptly-named Operation Warp Speed. The goal is that 24 hours after a license or an Emergency Use Authorization is issued "we have vaccine moving to administration sites,"  Lt. Gen. Paul A. Ostrowski, Operation Warp Speed deputy chief of supply, production and distribution, said on a media call Wednesday morning. (Weise and Weintraub, 9/16)

The Centers for Disease Control and Prevention outlined a sweeping plan Wednesday to make vaccines for Covid-19 available for free to all Americans. In the plan, the CDC said it anticipates a coronavirus vaccine will initially be granted an emergency use authorization before a full formal approval. Much of the guidance, but not all, described in the plan will overlap with many routine activities for immunizations and pandemic influenza planning, CDC Director Dr. Robert Redfield said on the same call. (Lovelace Jr., 9/16)

But supplying and distributing those vaccines is a complex logistical puzzle involving the US Department of Defense, US Centers for Disease Control and Prevention and other parts of the US Department of Health and Human Services. Vaccines now in trials have different transport and storage requirements, some involving extremely cold temperatures; some require a second dose at 21 or 28 days after the first, and they aren't interchangeable; and some require particular needles and syringes. (Gumbrecht and Thomas, 9/16)

In today's statement, CDC Director Robert Redfield, MD, said the CDC's Advisory Committee on Immunization Practices will play a vital role in deciding how initial limited doses will be allocated, looking at a goal of having more than 100 million doses by January. As part of a three-phase plan, the first doses would go to healthcare workers in high-risk settings, then to other essential workers and those at higher risk of severe disease, such as people age 65 and older. HHS added that McKesson will use the CDC's guidance, with logistical support from the DOD, to ship products to vaccine administration sites. (Schnirring, 9/16)

The Centers for Disease Control and Prevention is requiring states and jurisdictions to submit plans on how they’d administer and distribute a vaccine by Oct. 16. They’re facing a host of challenges, such as how to store a vaccine that’s expected to need to be kept in specialized freezers. ... Doses may be available as early as November to limited groups, but that supply may increase substantially in 2021. Final decisions on who will be first in line to get the shots will be made later. (Roubein and Owermohle, 9/16)

Health officials noted that the plan is flexible, because some variables won't be known until a vaccine is authorized or approved by the Food and Drug Administration (FDA), such as populations for whom a given vaccine is most appropriate, distribution and storage requirements, dosage requirements and other variables. "We're dealing in a world of great uncertainty," Paul Mango, deputy chief of staff for policy at HHS, said during a call with reporters. "We don't know the timing of when we'll have a vaccine, we don't know the quantities, we don't know the efficacy of those vaccines ... so this is a really, quite extraordinary, logistically complex undertaking." (Weixel, 9/16)

State officials are expressing skepticism about federal reviews of potential COVID-19 vaccines, with some going so far as to plan to independently analyze clinical trial data before distributing a vaccine in a sign of how sharply trust in federal health agencies has fallen this year. The wariness, which public health experts call highly unusual if not unprecedented, could undercut the goal of a cohesive national immunization strategy and create a patchwork of efforts that may sabotage hopes of containing the coronavirus. Some red states appear more likely to rely on the Trump administration while blue states may scour the data and be more cautious about vaccinating their residents immediately. (Kopp, 9/17)

If not enough Americans get a Covid-19 vaccine when it becomes available, it won't help reduce the spread of the deadly virus, the nation's top infectious disease official said. In an interview with The Wall Street Journal, Dr. Anthony Fauci addressed the risks of too few people taking the vaccine. Even a third of Americans getting vaccinated against the coronavirus won't be enough, the director of the National Institute of Allergy and Infectious Diseases said. (Waldrop, Erdman and Fox, 9/17)

President Trump on Wednesday called on congressional Republicans to support a massive economic relief bill with “much higher numbers” and stimulus payments for Americans, abruptly proposing an entirely different plan from what the Senate GOP sought to advance in recent days. His Twitter post and subsequent comments at a news conference could reframe talks that have stalled for more than a month, and put new pressure on leaders in both parties. They come at a moment when House Speaker Nancy Pelosi (D-Calif.) is facing a backlash from some House Democrats, including lawmakers in tough reelection races, over congressional inaction on new economic relief. (Werner and Bade, 9/16)

Shortly after Trump first tweeted, White House chief of staff Mark Meadows told CNBC’s “Squawk on the Street” that he is “probably more optimistic about the potential for a deal in the last 72 hours than I have been in the last 72 days.” The comment from Meadows, one of the two leading Trump administration negotiators in stimulus talks, followed the Tuesday release of the plan from the House Problem Solvers Caucus. (Pramuk, 9/16)

Senate Republicans on Wednesday brushed off calls from President Donald Trump for a bigger coronavirus relief package, casting doubt on whether there is enough GOP support to move forward with additional economic stimulus measures just seven weeks before Election Day. In a tweet Wednesday morning, Trump described Democrats as “heartless,” but told Republicans to “go for the much higher numbers ... it all comes back to the USA anyway” on a coronavirus relief package. (Levine and Bresnahan, 9/16)

House Democratic leaders scrambled Wednesday for a cohesive legislative and political strategy on emergency coronavirus aid. The Democrats are seeking a bill that can provide broad-based relief to struggling Americans, energize the party’s progressive base ahead of November and appease the various factions of the caucus now feuding over the right path forward. (Lillis and Wong, 9/16)

Federal Reserve Board Chairman Jerome Powell warned Wednesday that a lack of further fiscal support from Congress and President Trump could “scar and damage” a U.S. economy restrained by the coronavirus pandemic. During a Wednesday press conference, Powell expressed optimism that Democrats and Republicans would find a path forward on another coronavirus relief bill despite a weeks-long stalemate between negotiators. (Lane, 9/16)

Top congressional Democrats are calling for a federal investigation after a nurse who worked at an immigration detention center in Georgia filed a whistleblower complaint alleging a lack of medical care and unsafe work practices that facilitated the spread of COVID-19. She also says that immigrant women received questionable hysterectomies, an allegation that lawmakers seized on in statements issued Tuesday. (Treisman, 9/16)

The complaint, filed by Dawn Wooten, a nurse employed at the Irwin County Detention Center in Ocilla, Ga., along with several civil-rights organizations, alleges that “high rates of hysterectomies” were performed on immigrant women who didn’t need them and weren’t fully aware they were going to be performed. The complaint cites several detained immigrants as witnesses, though many of the accounts are secondhand. Ms. Wooten also appears not to have witnessed the hysterectomies, though she testified in the complaint to speaking with several women who underwent them. “I’ve had several inmates tell me that they’ve been to see the doctor and they’ve had hysterectomies and they don’t know why they went or why they’re going,” she said in the complaint. (Andrews and Hackman, 9/16)

The woman, who like the others was not identified because she feared retaliation from immigration authorities, said she was transported this year to Irwin County Hospital for a procedure but was given three different explanations of what it would be, ranging from having her womb removed entirely to instead having a small amount of tissue scraped away. Ultimately, the complaint says, the hospital declined to operate on the woman because she tested positive for antibodies to the novel coronavirus. But the woman said the experience left her “feeling scared and frustrated, saying it ‘felt like they were trying to mess with my body,’” the complaint said. (Dickerson, 9/16)

The complaint was first reported by LawandCrime.com, a website run by attorney and television personality Dan Abrams. That report is entirely sourced from the filed complaint and mostly focuses on the lack of proper COVID-19 protocols, but the LawandCrime.com headline focused on the alleged sterilizations—“ ‘Like an Experimental Concentration Camp’: Whistleblower Complaint Alleges Mass Hysterectomies at ICE Detention Center.” The story was widely shared on Monday night, and as of Tuesday, multiple other news outlets covered the allegations. Thus far, no one has obtained direct corroboration from women who allege they were forced into a hysterectomy. On Tuesday night, the Intercept published a story on the allegations around the hysterectomies that quoted several anonymous women staying at ICDC who shared stories about how they felt they had been pressured into having a hysterectomy, and who noted that they were frequently forced to go without an interpreter, but it was unclear if they had gone through with the procedure. (Lithwick, 9/15)

Many of the details of the allegations against the Georgia facility are still emerging, and both ICE and the private operator of the facility have called for skepticism of the complaint, which relies on secondhand accounts of the hysterectomies that were allegedly performed. Attorneys have since come forward with firsthand accounts of such procedures, but it is not clear to what extent ICE and the medical staff involved sought the detainees’ consent to perform those procedures or whether they were medically necessary.But the accusations, which echo of the ugly history of coercive sterilization in the US, have sparked widespread outrage — including calls for formal investigations. But this is far from the first time that ICE, the federal agency charged with enforcing immigration law in the US, has been accused of neglecting immigrants’ health and safety, especially amid the coronavirus pandemic. (Narea, 9/16)

With deaths from the coronavirus nearing 200,000 in the United States, Joseph R. Biden Jr. on Wednesday assailed President Trump for playing politics with a potential coronavirus vaccine, saying he did not trust Mr. Trump to determine when a vaccine was ready for Americans. “Let me be clear: I trust vaccines,” Mr. Biden said. “I trust scientists. But I don’t trust Donald Trump, and at this moment, the American people can’t either.” (Ember, 9/16)

Joe Biden on Wednesday expressed reservations about whether a coronavirus vaccine approved by the Trump administration would be safe, raising doubts about the president’s ability to put the health of Americans before politics. Biden said Americans should trust a coronavirus vaccine developed under the Trump administration only if the president gives “honest answers” to questions about its safety, effectiveness and equitable distribution. “I trust vaccines. I trust scientists. But I don’t trust Donald Trump,” Biden said. “And at this point, the American people can’t, either.” (Sullivan, 9/16)

“The American people right now don’t trust what the president says about things related to science,” said Biden, because of Trump’s “incompetence and dishonesty when it came to testing and personal protective equipment” in the early days of the coronavirus pandemic. “We cannot afford a repeat of those fiascos when it comes to a vaccine.”In order to shore up public trust in a government vaccine, said Biden, its rollout will need to be accompanied by “total transparency” about the research process and a review by an independent panel of scientists. (Wilkie, 9/16)

This morning, Biden's campaign unveiled two new ads as part of what his team said would be a $65 million ad buy this week across multiple platforms. The first ad "Little Brother" is airing on broadcast and digital in Michigan, Minnesota, North Carolina, Pennsylvania and Wisconsin. It focuses on a little boy named Beckett who was diagnosed with leukemia when he was two years old. "If Donald Trump gets rid of our health care law, my son won't be protected," his mother's voice says in the ad. "We would have to be making some tough decisions about what medications we could afford," she continues. (Conant, 9/16)

A leading think tank aligned with the Democratic Party is laying the groundwork for an aggressive slate of efforts to lower drug prices that could be implemented almost immediately, should Joe Biden defeat President Trump in November. In a report published Thursday, the Center for American Progress focuses on two major policy changes: the first-ever use of a controversial monopoly-busting mechanism known as “march-in-rights” to crack down on companies that overcharge for medicines, and the resurrection of an Obama-era proposal to change how Medicare pays for many drugs administered by doctors. (Facher, 9/17)

One woman said she's voting for Democratic presidential nominee Joe Biden because President Trump dodged her questions during ABC News's town hall in Philadelphia on Tuesday. Ellesia Blaque is an English professor at Kutztown University and questioned the president Tuesday night about health care and what his administration can do to offer those with preexisting conditions, such as herself, who are paying over $5,000 in copays for a condition she has had since birth. (Deese, 9/16)

A North Texas mother is urging Americans to vote for Joe Biden, arguing that President Donald Trump’s health care policies could come at the expense of her 5-year-old son’s insurance in the middle of his battle with leukemia. “If Donald Trump gets rid of our health care law, my son won’t be protected,” Kaitlin Burge, who lives in Princeton, says in a Biden campaign ad released Wednesday. “We would have to make some tough decisions about what medications we can afford. We need a president who will protect our healthcare, and that’s Joe Biden.” (Cobler, 9/17)

Escambia County, which includes Pensacola, asked residents to stay home so crews can evaluate roads and bridges. Local law enforcement will enforce the dusk to dawn curfew for three nights starting Wednesday. "We are still in an evaluation and lifesaving recovery mission, and we need to be able to do that job," County Commissioner Robert Bender said. "We are still evaluating our roads and bridges to make sure that it is safe." (Karimi, 9/17)

Floodwaters rushed through parts of Alabama and Florida on Wednesday, turning roads into rivers, submerging cars and sending several out-of-control construction barges into waters along the Florida Panhandle as Hurricane Sally dumped a torrent of rain. The surging water reached higher than five feet in Pensacola, Fla., and slammed a barge into a section of the Pensacola Bay Bridge that was under construction, destroying part of it, Sheriff David Morgan of Escambia County said. (9/16)

This is how emergency services are provided in the fall of 2020 at the intersection of twin horrors — natural disasters of record proportions and a global pandemic. There are no longer massive shelters in California where the coronavirus could spread among traumatized people running for their lives; the state prohibits large gatherings. That means no dining halls. No in-person counseling, no hugs, no tissues to dry tears. As wildfires rage in the West and hurricanes pummel the Gulf Coast, disaster aid has been forced to evolve, for better or for worse. When large-scale disasters strike in states with looser restrictions than California’s, the Red Cross has instituted coronavirus precautions in group shelters: health screenings, mandatory face coverings, staggered meal times, extra space between cots and tables. (La Ganga, 9/17)

Wildfires continued raging across a vast swath of the Western U.S. Wednesday, straining states’ resources and sending plumes of smoke out for thousands of miles. Millions of residents across Oregon and California are under advisories to avoid going outside because of particulate matter in the air. Across the country, smoke drifting eastward on the jet stream has created a haze over Washington, D.C., and parts of the Eastern Seaboard. (Lovett, 9/16)

EPA officials said they are working hard to keep people informed about the risks of the poor air. “We do need to learn to live with smoke,” EPA air resource advisor Katie Stewart said. “And it’s unfortunate, but we need to be smoke-ready every year.” (Smith, 9/16)

Every morning for the past few weeks, JoEllen Depakakibo has had a new kind of morning routine. She sets her alarm for 6 and opens the Environmental Protection Agency’s AirNow site on her phone. Newly fluent in the numbers of the air quality indexes, or the AQI, she checks the pollution levels compulsively throughout the day, waiting to make a difficult decision. If the number passes 150, called “unhealthy” by the EPA, Depakakibo has her employees shut the main door and turn on a medical-grade air purifier inside Pinhole Coffee Shop, the cafe she opened here six years ago. If it passes 200, they close the cafe. She’s had to shut five times in recent weeks because of the smoke that has stubbornly settled over the city. (Kelly and Schmidt, 9/16)

The Supreme Court’s first oral arguments in its new term will be held by remote teleconference because of the continued threat posed by the coronavirus pandemic, the justices announced Wednesday. The court is scheduled to hear arguments over five days next month, starting Oct. 5.“ The court building remains open for official business only and closed to the public until further notice,” spokeswoman Kathleen Arberg said in a news release. “The court will continue to closely monitor public health guidance in determining plans for the November and December argument sessions.” (Barnes, 9/16)

The court building will remain closed to the public, as it has been since March due to the pandemic. Six of the justices are 65 or older, considered to be at higher risk for bad outcomes if they contract the coronavirus. That includes Justice Ruth Bader Ginsburg, 87, who is being treated for cancer. The justices canceled their final two argument sessions during the spring and heard about half of those cases during two weeks of conference calls in May. They will use the same procedure when arguments begin Oct. 5, with the audio made available live to the public and the justices participating from remote locations. (Williams, 9/16)

U.S. Sen. Ted Cruz, R-Texas, is making clear that he's not interested in serving on the U.S. Supreme Court, despite President Donald Trump recently naming him to a group of potential nominees. When Trump announced Cruz as part of the 20-name list Wednesday, the senator issued a statement suggesting he was satisfied with remaining in Congress. He more explicitly said he wasn't interested during a Fox News interview Sunday. (Svitek, 9/14)

Sen. Chuck Grassley on Wednesday demanded that Democratic presidential nominee Joe Biden release a list of his potential nominees to the Supreme Court by the end of the month, saying there is “no reason” for the former vice president “to hide” the names. Grassley, R-Iowa, the former chairman of the Senate Judiciary Committee, called on Biden to make his list public, just as President Trump did last week, releasing potential picks for the high court should there be vacancies to the court under a potential second term. (Singman, 9/16)

Live SARS-CoV-2, the virus that causes COVID-19, was isolated from air samples collected 2 to 4.8 meters (6.6 to 15.7 feet) away from two coronavirus patients—one recently released and one newly admitted—in a single hospital room, according to a study published yesterday in the International Journal of Infectious Diseases. Aiming to add to the discussion about whether aerosols can contain infectious coronavirus, University of Florida at Gainesville researchers used new air samplers with a gentle collection process that is less likely than commonly used samplers to inactivate viruses. They were able to detect SARS-CoV-2 only when using the samplers without a high-efficiency particulate air (HEPA) filter on the inlet tube. (9/16)

Two studies published yesterday in the Journal of the Pediatric Infectious Diseases Society describe the presentation of the COVID-19–related multisystem inflammatory syndrome in children (MIS-C) and how heavy coronavirus exposure didn't lead to infection in four siblings aged 9 to 12 years. In addition, an expert review in the same journal recommends best practices for the use of antiviral drugs in infected children. (Van Beusekom, 9/15)

Last November, just as the novel coronavirus was beginning its deadly trajectory through China, the sickle cell community in the U.S. was celebrating. Two potentially transformative drugs for sickle cell had just been approved by the FDA and clinical trials involving cutting-edge gene therapies were well underway. (McFarling, 9/17)

Scientists have developed a new strategy that uses exosomes — tiny, RNA-loaded packets that cells spit out — to regenerate cardiac cells after damage from a heart attack. The heart muscles are made of specialized cells that work continuously to pump blood to our entire body. When one of the heart’s blood vessels gets blocked, it can cause a heart attack, which often leads to tissue damage and scars. Scientists have previously explored whether cell transplants could speed recovery after heart attacks, but the cells often failed to graft, and experts worried about the health risks of such a procedure. (Gopalakrishna, 9/16)

Out-of-body experiences are all about rhythm, a team reported Wednesday in the journal Nature.In mice and one person, scientists were able to reproduce the altered state often associated with ketamine by inducing certain brain cells to fire together in a slow-rhythmic fashion. "There was a rhythm that appeared and it was an oscillation that appeared only when the patient was dissociating," says Dr. Karl Deisseroth, a psychiatrist and neuroscientist at Stanford University. (Hamilton, 9/16)

Some health insurance brokers provided misleading or false information to potential customers about whether their plans covered preexisting conditions, according to an undercover audit completed by the nonpartisan Government Accountability Office. The audit, requested by Senate Democrats, sought to determine whether companies selling health plans exempt from Affordable Care Act coverage requirements were being honest about the limitations of the plans, which tend to be cheaper but aren’t comprehensive and typically don’t cover preexisting conditions like cancer or diabetes. (Hellmann, 9/16)

Santa Clara County health officials announced a newly revised health order on Wednesday that enacts fines of up to $5,000 per violation for private health care providers that do not make coronavirus testing accessible and fast enough for their patients. The revised order, which takes effect Sept. 25, adds to the county’s previous June health order that requires large health care providers, including Kaiser Permanente and Sutter Health, to increase testing. (Ho, 9/16)

New Orleans residents living near Children’s Hospital have been unhappy for months about the hospital’s decision to move its helicopter operations from one side of the Uptown campus to another during its $300 million renovation. Now a City Hall decision that made the move permanent has further upset them, enough to consider legal action, a lawyer hired by the Audubon Riverside Neighborhood Association said. (Woodruff, 9/16)

The Greater Houston region had the highest number of uninsured residents in the country in 2019, with nearly one in five people in the metropolitan area lacking health coverage, according to the Census Bureau. Houston led Texas — which has both the highest rate and number of uninsured residents among states — with 1.4 million uninsured people, or 19.7 percent of residents, without health coverage. Approximately 5.2 million Texans were uninsured last year, or about 18.4 percent of the state’s population. (Wu and Lamm, 9/17)

A federal commission tasked with figuring out the best way to improve care in nursing homes during the coronavirus pandemic called on CMS to be a leader and make changes to improve safety for residents and staff. ...The commission made 27 recommendations, which included the development of a national strategy with a quick turnaround of tests; creation of a process to ensure nursing homes can maintain a three-month supply of safe personal protective equipment; and recognition of visitation as a resident's right, among other recommendations. (Christ, 9/16)

The federally appointed Physician-Focused Payment Model Technical Advisory Committee said Tuesday it has recommended HHS consider a payment model focused on asthma care. The payment model, if approved by HHS, would provide allergists, immunologists and pulmonologists a value-based payment option. A longstanding complaint of the movement to alternative payment models is it has excluded many specialists from participating because quality metrics don't apply to their practice. The model can also be used by primary care doctors who also treat patients with asthma. (Castellucci, 9/16)

Navicent Health is the latest health system to raise its minimum wage.The Macon, Ga.-based health system announced Wednesday it has upped its minimum wage from $7.25 to $10 per hour. Navicent said the change means it's investing an additional $1.2 million in its employees.Navicent CEO Ninfa Saunders said in a statement that the change moves hundreds of employees to a living wage. (Bannow, 9/`6)

Kaiser Health News: Urban Hospitals Of Last Resort Cling To Life In Time Of COVID  

Victor Coronado felt lightheaded one morning last month when he stood up to grab an iced tea. The right side of his body suddenly felt heavy. He heard himself slur his words. “That’s when I knew I was going to have a stroke,” he said. Coronado was rushed to Mercy Hospital & Medical Center, the hospital nearest his home on Chicago’s South Side. Doctors there pumped medicine into his veins to break up the clot that had traveled to his brain. Coronado may outlive the hospital that saved him. Founded 168 years ago as the city’s first hospital, Mercy survived the Great Chicago Fire of 1871 but is succumbing to modern economics, which have underfinanced the hospitals serving the poor. In July, the 412-bed hospital informed state regulators it planned to shutter all inpatient services as soon as February. (Rau and Huetteman, 9/17)

The Federal Trade Commission is issuing a strong warning about a pair of proposed hospital sales in Texas, arguing they could lead to higher costs, lower quality and diminished access to services for local residents. That's about all the federal antitrust regulator can do when it comes to these proposed deals, as Texas lawmakers passed a state law last year that grants such transactions immunity from a federal challenge. Still, in its analysis, the FTC suggested that if not for Texas' new Certificate of Public Advantage law, it would have sued to stop the deals. (Bannow, 9/15)

The patients who answered the ads felt desperate, living with pain, and the company promised medical miracles.Now the state’s attorney general has accused Elite Integrated Medical, a Sandy Springs-based stem cell clinic chain, of using deceptive sales tactics to inject hundreds of vulnerable patients with an unproven drug. (Edwards, 9/15)

An Anchorage dentist who extracted a patient’s tooth while on a hoverboard was sentenced Monday to 12 years in prison for dozens of charges including Medicaid fraud. Seth Lookhart was captured on video extracting the tooth from the unconscious patient. Anchorage Superior Court Judge Michael Wolverton said Monday that Lookhart nearly killed several patients by frequently sedating them for extended periods of time. “In reviewing all this over and over again, I have this visceral response — you darn near killed some people,” he said. (Williams, 9/16)

Healthcare providers could face deeper workforce shortages in upcoming months as they face tighter family and sick leave exemptions starting Wednesday. Although providers initially weren't required to follow the Families First Coronavirus Reponse Act as they treated the pandemic's patients, the Labor Department revised its requirements last week. (Christ, 9/16)

Mass General Brigham said Wednesday it would create two new senior executive positions as part of the company’s effort to better knit its individual hospitals into a more cohesive health care network. Chief executive Dr. Anne Klibanski, who laid out the new integration strategy for the parent of Massachusetts General and Brigham and Women’s hospitals last November, said in an e-mail to employees that Dr. Ron M. Walls has been named chief operating officer. Walls, currently COO of Brigham and Women’s, will be responsible for collaboration across clinical departments, development of specialty hospital services, and consolidation of departments including emergency, radiology, anesthesiology, pathology, and hospitalists. (Edelman, 9/16)

Kaiser Health News: Black Women Turn To Midwives To Avoid COVID And ‘Feel Cared For’ 

From the moment she learned she was pregnant late last year, TaNefer Camara knew she didn’t want to have her baby in a hospital bed. Already a mother of three and a part-time lactation consultant at Highland Hospital in Oakland, Camara knew a bit about childbirth. She wanted to deliver at home, surrounded by her family, into the hands of an experienced female birth worker, as her female ancestors once did. And she wanted a Black midwife. It took the COVID-19 pandemic to get her husband on board. “Up until then, he was like, ‘You’re crazy. We’re going to the hospital,’” she said. (Scheier, 9/17)

A drug being developed by Eli Lilly helped sick patients rid their systems of the virus that causes Covid-19 sooner and may have prevented them from landing in the hospital, according to newly released data. The drug is what is known as a monoclonal antibody, which experts view as being among the most likely technologies to help treat Covid-19. It’s a manufactured version of the antibodies that the body uses as part of its response to a virus. (Herper and Garde, 9/16)

The escalating cost of the only HIV prevention pill may have been a key factor hindering widespread use in recent years, according to a new analysis by U.S. government researchers, underscoring long-standing concerns over the ability to eradicate the virus. From 2014 to 2018, total payments made by government programs, commercial insurers, and patients for Truvada, which was approved to prevent HIV in 2012, jumped from $114 million to nearly $2.1 billion. Yet the number of people who were given prescriptions in 2018 was just 204,700, which amounted to less than 20% of those estimated to have benefited from the medication. (Silverman, 9/16)

Illumina, the dominant maker of machines to sequence DNA, is in talks to purchase Grail, a developer of a blood test to detect cancer that uses Illumina’s technology. The discussions were first reported by Bloomberg News, and confirmed to STAT by a person with knowledge of the talks. The discussions could still fall apart at any time. (Herper, 9/16)

A cardiac patient in Carlsbad sends their doctor in San Francisco a readout of their heart rate, courtesy of an Apple Watch. A New Yorker with hypertension texts with an Alabama health coach about data from their smart blood pressure cuffs. A person with diabetes snaps a photo of their dinner and uses an app to predict how it will impact their blood sugar. Health care is undergoing a monumental shift toward remote patient monitoring — and a new class of patient-consumer is leading the charge, according to a new STAT report. (Brodwin, 9/16)

Beyond the staggering U.S. deaths caused directly by the novel coronavirus, more than 134,200 people have died from Alzheimer’s and other forms of dementia since March. That is 13,200 more U.S. deaths caused by dementia than expected, compared with previous years, according to an analysis of federal data by The Washington Post. (Wan, 9/16)

More people than average are dying from dementia this year as seniors battle the coronavirus pandemic, according to an analysis of federal data by The Washington Post. Patients are dying from dementia at higher rates because of isolation measures in place amid the coronavirus pandemic, the Post found. People who are over 65 were encouraged by health officials early on to isolate because of their vulnerability to the virus. (Moreno, 9/16)

Deaths attributed to Alzheimer’s disease and dementia rose to more than 20 percent above normal over the summer, a staggering figure that won’t factor into the official count of coronavirus deaths but is unmistakably linked to the pandemic’s true toll. Increased isolation and stress during lockdown, lapses in nursing home care and missed Covid-19 diagnoses are all likely contributing factors to the unusually high dementia death toll, adding to the devastation the virus has brought to U.S. nursing homes. (Doherty, 9/16)

A 2-month-old from Michigan died this week of COVID-19 and is believed to be the state's youngest victim of the virus. "Children are not spared from this disease," said Dr. Joneigh Khaldun, chief medical executive and chief deputy for health at the Michigan Department of Health and Human Services, at a news conference Wednesday. "My condolences go out to their parents and family." Additional details, such as the baby's gender, hometown, whether the infant was treated at a hospital or had other health conditions that may have contributed to the death,  were not disclosed. (Shamus, 9/16)

When Memorial Hermann Hospital in The Woodlands allowed some of Francisco Medellin’s family to visit him from a window outside the intensive care unit last month, they all feared it might be the last time they’d see him. Medellin, 69, contracted COVID-19 in June and despite interventions with the logical treatments, the disease ravaged his lungs, leaving him unable to breathe on his own. After a month of no progress, doctors told the family that there was little hope of him recovering. (Ackerman, 9/16)

If you choose not to have your child vaccinated, your pediatrician may refuse to treat your family. More than half of pediatricians' offices in the United States included in a new study published in the medical journal JAMA reported having a dismissal policy for families who refuse to vaccinate their children. Some physicians say this house policy is a way to encourage parents to vaccinate their children, while many also use it as a safeguard against unvaccinated kids who might endanger their other patients. (LaMotte and Thomas, 9/15)

For those lucky enough to keep their jobs during the pandemic, more than half a year of working from home has tested the nerves of many. An unsettled workforce is placing new focus on the need for companies to provide expanded mental health resources to employees. According to a recent report, more than 40% of adults in the U.S. are dealing with depression, anxiety and even substance abuse linked to the coronavirus pandemic. A recent survey by Johns Hopkins University found the percentage of adults in the U.S. who reported symptoms of psychological distress jumped threefold from 2018 to April of this year. (DeFeliciantonio, 9/16)

Six months of turmoil and uncertainty have left two out of five Americans with feelings of depression or anxiety, according to a recent CDC study. In Massachusetts, the worst of the pandemic may be behind us for now, but the trauma caused by the virus, social unrest, and economic recession still lingers. Blue Cross Blue Shield of Massachusetts reported that use of mental health services was up 14 percent from January to July of this year compared to the same period of 2019. A recently published study by a group of researchers from Boston, Providence, and New York City found that symptoms of depression were more than three times as prevalent during the pandemic than before, with an outsized toll exacted on lower-income populations. (Krueger, 9/16)

Almost 30 teenagers have to quarantine after parents sent their child to a Massachusetts school despite knowing they were positive with Covid-19, according to Attleboro Public Schools and the town's mayor. A Covid-19 positive student attended class on Monday, but the school wasn't notified of their diagnosis until the next day, Attleboro High School superintendent David Sawyer said in a letter sent out to families Tuesday night. Twenty-eight students who had close contact with the infected person have been notified and asked to quarantine for 14 days, Sawyer said. (Romine and Holcombe, 9/17)

Kaiser Health News: Students’ Mass Migration Back To College Gets A Failing Grade

Who thought it would be a good idea to move thousands of teenagers and young adults across the country to college campuses, where, unencumbered by parental supervision, many college kids did what college kids do? Actually, Nigel Goldenfeld and Sergei Maslov, two University of Illinois at Urbana-Champaign physics researchers, thought they had it figured out. They created a predictive model for the campus, which showed that with a robust, twice-a-week testing program for students, faculty and staff who are regularly on campus, a mask mandate and an app for contact tracing, COVID-19 cases could be kept below 500 people for the whole semester. They even accounted for close interactions among college students. (Knight, 9/17)

Many factory workers are staying home to watch children who aren’t at day care or school because of the coronavirus pandemic, in another challenge to U.S. manufacturers working to rev up assembly lines. Orders and output for many manufacturers are recovering as factories reopen and consumers buy electronics for remote working and supplies to fix up their homes. But some factories say the challenge of keeping workers on the line is threatening the recovery. U.S. industrial production rose for the fourth consecutive month in August, the Federal Reserve said on Tuesday, but the increase was much slower than earlier in the summer. (Hufford, 9/16)

During the coronavirus pandemic, sexually transmitted disease cases dropped due to individuals "sexually distancing" and decreased testing and reporting, the Centers for Disease Control and Prevention (CDC) said during the STD Prevention Conference this week. The CDC said in a roundtable discussion Monday that it estimated that tens of thousands of cases of chlamydia and gonorrhea and thousands of syphilis cases have gone undetected due to the lack of testing. (McGorry, 9/16)

Twitter users were most likely to retweet public health agency tweets that contained practical information on the medical effects of COVID-19, how to mitigate those effects, and the status of the pandemic, according to a study published today in PLOS One. Led by researchers at the State University of New York in Albany and the University of California at Irvine, the study involved analyzing 149,335 tweets from 690 Twitter accounts of public health, emergency management, and elected officials across the United States from Feb 1 to Apr 30. (Van Beusekom, 9/16)

My wife and I are participating in a clinical trial for a Covid-19 vaccine. We had no antibodies before we received the vaccine, but we now have a lot of them, according to two independent tests. Presumably we are like millions of others who have recovered from Covid-19 and have these antibodies, and so are immune for some time. At what point can I feel comfortable, ethically, not wearing a mask, being with others who haven’t had Covid, eating at a restaurant, going to a bar, traveling to locations with restrictions on “hot spot” visitors and the like? (Anthony Appiah, 9/15)

Ask an infectious diseases expert about the upcoming flu season, and how it may affect, or be affected, by COVID-19, and the word you're likely to hear is "uncertain." For starters, flu is always unpredictable, they'll say. Flu activity and severity largely depend on the strains of virus circulating, and how well the vaccine strains, which are selected in advance of each flu season, match up with the circulating strains. (Dall, 9/16)

It's an epidemic of a different kind. The nation is grappling with a pedestrian safety crisis that has worsened in recent years: The number of pedestrians killed in the U.S. hit a 28-year high of 6,283 in 2018, according to the National Highway Traffic Safety Administration. That figure was up 46% from 2010. While the crisis stems from many factors, a new book brings it into sharper focus. Former Streetsblog USA writer Angie Schmitt's "Right of Way: Race, Class, and the Silent Epidemic of Pedestrian Deaths in America" is an exposé drawing upon comprehensive reporting to articulate the root causes of a public health crisis. (Bomey, 9/17)

A rare and dangerous virus poses a threat to Michiganders — and it isn't COVID-19.The mosquito-borne eastern equine encephalitis is rearing its head in the midst of the coronavirus pandemic. State health officials announced Tuesday that an adult from Barry County is the first suspected human case of Triple E this year. Lab tests to confirm the case are under way and are expected to be completed later this week. (Shamus, 9/16)

Want to live a longer, healthier life? One way is to keep your blood pressure at optimal levels as you age -- preferably below 120 systolic (the top number) and 80 diastolic (the lower number). That's especially important during the pandemic, because having high blood pressure is one of the possible risk factors for developing a more severe case of Covid-19, according to the US Centers for Disease Control and Prevention. (LaMotte, 9/16)

While DJ Jaffe was working as an advertising executive on Madison Avenue, he and his wife became the caretakers of his wife’s half sister, who had moved from Milwaukee as a troubled teenager to live with them in their Manhattan apartment. Before long she became catatonic. She was later found to have schizophrenia and bipolar disorder. The experience plunged Mr. Jaffe, who died on Aug. 23 at 65, into the world of mental health, which he soon came to see as dysfunctional. (Seelye, 9/16)

Five weeks after postponing its football season over safety concerns, the Big Ten Conference reversed course Wednesday, saying it would play this fall even as its colleges and surrounding communities struggle to contain the novel coronavirus. The decision was cheered on not only by fans but by President Trump, who has used the conference’s decision to seek an edge in Midwestern battleground states where Big Ten football reigns. But it raised immediate questions, including from students, about the role politics and economics played in changing the minds of university presidents. (Maese, Giambalvo and Strauss, 9/16)

Wednesday's revival delivers a victory for President Donald Trump, who has demanded sports resume in an athletic conference that represents several swing states ahead of Election Day. The president has even intervened with calls to the Big Ten's commissioner. Conference presidents and chancellors voted unanimously to resume the football season starting the weekend of Oct. 23. Now the president is setting his sights on the western United States and the Pac-12 Conference, the last major college sports organization to hold out of playing a fall season. (Perez Jr., 9/16)

The Penn State athletic department announced Wednesday that 50 student-athletes tested positive for COVID-19 in its latest round of testing, which included 859 total tests. As part of the school's established protocol related to the coronavirus pandemic, the students who tested positive will be placed in isolation for 14 days, the school said, and contact tracing will be utilized to determine who else could have potentially been exposed to the virus. (Bonagura, 9/16)

Florida’s athletic department is seeing a rise in COVID-19 cases. The school reported 61 new positive cases Tuesday, including six for the football team a little more than a week before its season opener at Ole Miss. The spike in infections coincided with the return of student to campus and the start of classes. The Gators ceased activities with the school’s lacrosse and baseball programs due to dozens of positive results. Lacrosse reported 31 coronavirus cases, and baseball had 15. (9/15)

About a third of college athletic trainers said their athletes were fully following COVID-19 safety protocols, and less than half reported that coaches and staff were in full compliance, according to a survey conducted by the National Athletic Trainers' Association. The survey of about 1,200 athletic trainers across college divisions showed that 59% of respondents said athletes were "somewhat" following COVID-19 protocols, and 46% said coaches and staff were somewhat following safety measures. (Lavigne, 9/11)

When Election Day comes in November, the roughly 38,000 students at the University of Georgia will have nowhere on campus to vote. The school on Wednesday blamed the novel coronavirus, saying long lines and insufficient indoor space made voting on campus too dangerous. Yet, as local politicians and observers were quick to note, the university has made numerous accommodations so that the fall football season can play out with crowds of up to 23,000 fans cramming into Sanford Stadium.“If we can have football, we should have voting, too,” the university chapter of Fair Fight, a voting rights advocacy group, tweeted on Wednesday. (Shepherd, 9/17)

Athletes and fans anticipating the start of college basketball will have to wait a little bit longer. The NCAA Division I Council announced on Wednesday that the upcoming men's and women's basketball seasons can begin on Nov. 25, roughly two weeks later than originally planned, in an effort to mitigate the spread of COVID-19. (Treisman, 9/16)

While the deadly coronavirus seems to be subsiding in Connecticut for now, its impact on nursing homes has not. More than 6,700 beds are empty, and it may take many months of financial struggle before occupancy climbs back to pre-pandemic levels. (Jaffe, 9/16)

More than six months after the coronavirus pandemic triggered a deluge of unemployment claims in the Washington region, some jobless Marylanders are still experiencing major problems getting benefits and have endured weeks — or months — without the payments they are supposed to receive. The main frustration, they say, is they cannot get anyone to answer their calls. (Wiggins, 9/16)

Maryland’s top health official warned Wednesday that the approaching flu season could coincide with a higher wave of coronavirus cases than the state saw in the spring, saying it could be more than a year until a vaccine makes it possible to do more than “coexist” with the virus. Meanwhile, Arlington County leaders decided this week to abandon a sidewalk crowding ordinance put in place this summer that was intended to slow the spread of the coronavirus, saying the measure had little success. (Cox, Sullivan, Tan and Wiggins, 9/16)

Health officials in Michigan are reportedly urging people to stay indoors after 10 counties confirmed cases of the mosquito-borne virus Eastern equine encephalitis in 22 horses and one suspected human case... Officials said they will begin aerial treatment Wednesday night in certain high-risk areas of the state to prevent the spread of Eastern equine encephalitis. (Klar, 9/16)

The general overseeing American troops in Bavaria told local officials in an Alpine resort town that the military is committed to containing a coronavirus outbreak traced back to an American woman. Fifty-nine residents of the town of Garmisch-Partenkirchen have tested positive for the coronavirus. Of those, 25 work at Edelweiss Lodge and Resort, run by the U.S. military, according to The Associated Press. An American woman who allegedly visited several bars last week in violation of quarantine rules is believed to be the source of the outbreak. (Budryk, 9/16)

The International Federation of Red Cross and Red Crescent Societies (IFRC) warned on Thursday that the novel coronavirus is driving discrimination towards vulnerable communities in Asia, including migrants and foreigners. The humanitarian agency surveyed 5,000 people in Indonesia, Malaysia, Myanmar and Pakistan and found about half blamed a specific group for spreading the coronavirus, with many mentioning Chinese people, immigrants and foreigners. (9/17)

Bordeaux, France -- Dealing with the first wave was like a sprint, the second will be more like a marathon. That's how Dr. Olivier Joannes-Boyau, head of the intensive care unit at University Hospital in the southwestern city of Bordeaux, describes the resurgence of Covid-19 in France. After young French people took advantage of the lifting of lockdown and summer months to socialize freely, Covid-19 hospitalizations have risen in large cities like Paris, Bordeaux and Marseille on the Mediterranean coast. French hospitals are now preparing for the long slog. (Bell and Bairin, 9/16)

U.K. lawmakers criticized the government’s handling of the COVID-19 testing crisis for a second day Wednesday, as opposition leaders claimed Prime Minister Boris Johnson lacked a cohesive plan to tackle the virus at a time when the country faces a second wave in the pandemic. Johnson defended his efforts to increase testing capacity, telling the House of Commons that the government was responding to a “colossal″ increase in demand and arguing that Britain is testing more people than other European countries. (Kirka and Hui, 9/16)

It feels like a flashback. Pneumonia, a common acute manifestation of the COVID-19 disease, is keeping Spanish intensive care wards busy again. And it’s also leaving medical workers who are still recovering from the pandemic’s peak with an anxious sense of déja vu. Foreseeable as it was, the second wave has arrived in Europe earlier than expected, hitting countries with different intensity. In Madrid, for the second time the capital worst hit by coronavirus outbreaks on the continent, doctors and nurses say that authorities are responding, again, too erratically and too late. (Parra, 9/16)

“What does RadarCOVID not do?” a promotional video for Spain’s contact-tracing app asks. The answer: while navigating the country’s decentralised healthcare system, it does not locate users, identify them, record personal details, or send data. Without a vaccine or a cure for the coronavirus, which has killed nearly 1 million people worldwide, countries around the world have unleashed such technology to help break the chain of infections. Some governments’ contact-tracing tools use location data. But that tool is not available under European privacy laws in countries like Spain. Instead, they use Bluetooth to generate anonymous codes logging proximity between people’s phones. (Binnie, 9/17)

About 12 million people in South Africa have “probably” been infected with the coronavirus, but that startlingly high number has not caused a similarly high death rate and might indicate a widespread “level of immunity,” the country’s health minister says. More than 20% of South Africa’s population of 58 million have had the virus at some point, Dr. Zweli Mkhize estimated this week. He cited studies that found the presence of coronavirus antibodies in blood samples taken from parts of the population. The findings have prompted the government to launch a national study, he said. (Imray, 9/16)

A study by UK researchers published today in Clinical Infectious Diseases indicates that findings of the Oral Versus Intravenous Antibiotics (OVIVA) trial can be implemented into clinical practice. The OVIVA trial, conducted in the United Kingdom, found that oral antibiotic therapy was non-inferior to intravenous therapy when used during the first 6 weeks in patients with bone and joint infections (BJIs). The results of the trial were initially presented in 2017 and published in 2019, but to date there have been no reports describing their reproducibility in real-world settings. (9/14)

One-third of outpatient antibiotic prescriptions for pediatric acute respiratory tract infections (ARTIs) are inappropriate. We evaluated a distance learning program’s effectiveness for reducing outpatient antibiotic prescribing for ARTI visits. (Kronman et al, 9/1)

The introduction of a rapid diagnostic test (RDT) in conjunction with antimicrobial stewardship (AMS) activities and infectious disease (ID) consultation at an academic tertiary medical center was associated with shortened time to optimal antibiotic therapy in patients with bloodstream infections, University of Maryland researchers reported in Open Forum Infectious Diseases. In the retrospective quasi-experimental study, researchers with the University of Maryland's School of Medicine and School of Pharmacy compared time to optimal antibiotic therapy and clinical outcomes in patients with gram-negative bloodstream infection (GN BSI) during three different periods: pre-RDT/AMS, post-RDT/pre-AMS, and post-RDT/AMS. Rapid diagnostics, stewardship linked to quicker time to optimal antibiotics. (9/14)

A study of patients diagnosed as having pneumonia and urinary tract infections (UTIs) at 46 hospitals in Michigan found that about half had antibiotic overuse after discharge, researchers reported late last week in Clinical Infectious Diseases. The retrospective cohort study, led by researchers with Michigan Medicine, looked at patients treated for pneumonia or UTI at hospitals in the Michigan Hospital Medicine Safety Consortium from July 2017 through 2019 to quantify the proportion of patients discharged with antibiotic overuse, which was defined as unnecessary antibiotic use, excess antibiotic duration, or suboptimal fluoroquinolone use. The researchers used linear regression analysis to assess hospital-level association between antibiotic overuse after discharge in patients treated for pneumonia versus patients treated for UTI. (9/14 )

Myocarditis is a significant cause of sudden cardiac death in competitive athletes and can occur with normal ventricular function.1 Recent studies have raised concerns of myocardial inflammation after recovery from coronavirus disease 2019 (COVID-19), even in asymptomatic or mildly symptomatic patients.2 Our objective was to investigate the use of cardiac magnetic resonance (CMR) imaging in competitive athletes recovered from COVID-19 to detect myocardial inflammation that would identify high-risk athletes for return to competitive play. (Rajpal et al, 9/11)

Preliminary data from a small study published today in Nature Medicine suggests convalescent plasma may have some efficacy in patients with severe COVID-19. The retrospective, propensity score-matched case-control study involved 39 patients who received convalescent plasma for severe or life-threatening COVID-19 at Mount Sinai Hospital in New York from Mar 20 to Apr 20. The patients, who were an average age of 55 and had few baseline comorbidities other than obesity (mean mass body index, 31.7), received convalescent plasma under compassionate use guidelines an average of 4 days after admission. For the analysis, they were matched 1:4 to 156 control patients admitted during the same period. (9/15)

Respiratory viruses, including coronaviruses, are known to have a high incidence of infection during winter, especially in temperate regions. Dry and cold conditions during winter are the major drivers for increased respiratory tract infections as they increase virus stability and transmission and weaken the host immune system. The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged in China in December 2020 and swiftly spread across the globe causing substantial health and economic burdens. Several countries are battling with the second wave of the virus after a devastating first wave of spread, while some are still in the midst of their first wave. It remains unclear whether SARS-CoV-2 will eventually become seasonal or will continue to circulate year-round. In an attempt to address this question, we review the current knowledge regarding the seasonality of respiratory viruses including coronaviruses and the viral and host factors that govern their seasonal pattern. Moreover, we discuss the properties of SARS-CoV-2 and the potential impact of meteorological factors on its spread. (Audi et al, 9/15)

The Centers for Disease Control and Prevention (CDC) has issued new recommendations for the prevention and control of Staphylococcus aureus in neonatal intensive care unit (NICU) patients. The guidelines are based on current understanding of the transmission dynamics of S aureus in the NICU and were developed through a systematic review of the best available literature available through August 2019. The review was guided by questions about the most effective strategies for preventing S aureus transmission from colonized or infected NICU patients, which sampling sites and laboratory assays most effectively identify colonization in NICU patients, and what risk factors exist for S aureus infection in NICU patients. (9/15)

A teacher who was thinking of quitting the profession because of the coronavirus recently contacted me. He had read about the infection triggering a wave of heart disease and about patients who were symptomatic weeks or months after recovering from their initial coronavirus infection. He was concerned about returning to school and the prospect of carrying the virus home and infecting his family. (Uan Ashley, 9/17)

Denial is a river that runs through Donald Trump.At Tuesday night’s town hall meeting, he denied that he played down the pandemic, saying, “in many ways I up-played it.”But Bob Woodward has released an audio recording of him saying, literally, “I wanted to always play it down.”Trump further denied that he said President Xi Jinping was “doing a good job” with the coronavirus. “I didn’t say one way or the other,” Trump claimed. (Dana Milbank, 9/16)

Although I now call New York City home, Athens, Georgia, has been a base to me since the late 1970s. It’s where I started REM, and it is a place that I have returned to again and again, even as I have travelled and lived in other places around the globe. Sadly, Athens – also home to the University of Georgia – is now a place that exemplifies the most dangerous aspects of public policy decision-making amid the Covid-19 pandemic. (Michael Stipe, 9/17)

The coronavirus has affected all sectors of our society. It is all too predictable, however, that the virus is disproportionately affecting people of color, the poor, the homeless, and other more-vulnerable and disenfranchised populations. People whose jobs do not allow them to work from home, who lack access to preventive healthcare — and thus have underlying health conditions — and whose jobs and living situations force them into close proximity with others all are more vulnerable. That ‘s why Congress should ensure that, in subsequent rounds of COVID-19 legislation, extra support is directed to these affected populations. Undocumented immigrants, too, are incredibly vulnerable to the effects of COVID-19. They are our neighbors, our fellow church members, our friends, our family and our students. (Kent Ingle, 9/16)

President Donald Trump has asked the Supreme Court to overturn the Affordable Care Act (ACA ) — a move that would wipe out coverage for more than 18 million Americans — during a killing pandemic. Does Trump have an alternative health-care plan? Just ask him. “I have it all ready,” Trump said at a town hall two days ago, “...it’s a much better plan for you and it’s a much better plan.” In fact, Trump already has a plan. It was the “American Health Care Act” (called “the Act” here to avoid confusion of ACA and AHCA) of 2017. It nearly passed except for John McCain’s “No” vote. (Arthur Garson, Jr., 9/17)

This past weekend, HHS spokesman Michael Caputo took to Facebook to proclaim the United States was on the verge of mass violence in the wake of the November election, claimed his own life was in danger and said he was tortured by “shadows on the ceiling in my apartment.” Caputo has since taken medical leave, which sounds like a very good idea. But while public attention was focused on the unfortunate Caputo, many missed this Politico scoop: HHS Secretary Alex Azar, frustrated with the high standards the Food and Drug Administration was insisting on before approving coronavirus diagnostic tests, loosened the standards for lab-developed tests. Yet again, the Trump White House is taking full advantage of the fact that most people find the word “regulation” sleep-inducing, while almost everyone can thrill to the latest bit of presidential or administration craziness. (Helaine Olen, 9/16)

Over the course of a single week in mid-June, most of Tampa Bay’s local governments wisely enacted mandatory mask ordinances. The move sent the right message: That wearing masks is an easy and important step in controlling the virus. Fast forward to today. The number of daily infections has dropped for the peaks in July. Deaths are down, too. But people are still getting sick, and an uptick in cases is still very much possible. This is not the time to pull back on face masks in public indoor spaces, as Pinellas County commissioners said they would consider last week. (9/16)

The patients walk into Dr. Melissa Marshall’s community clinics in Northern California with the telltale symptoms. They’re having trouble breathing. It may even hurt to inhale. They have a cough, and the sore throat is definitely there. A straight case of COVID-19? Not so fast. This is wildfire country. (Mark Kreidler, 9/16)

Among the few remaining advantages that Americans can claim over other countries is the relative cleanliness of our air. Air pollution is a leading risk factor for early death; it is linked to an estimated 4 million premature fatalities around the world annually. But over the last 50 years, since Congress passed environmental legislation in 1970, air quality in the United States has steadily improved. Today, America’s air is significantly cleaner than in much of the rest of the world, including in many of our wealthy, industrialized peers. Over the last few years, for weeks and sometimes months in late summer and fall, my home state, California, and other parts of the American West erupt in hellish blaze, and plumes of smoke turn the heavens visibly toxic. (Farhad Manjoo, 9/16)

Michigan Gov. Gretchen Whitmer pulled out all the stops trying to be the most aggressively anti-COVID-19 chief executive, vying with New York’s Andrew Cuomo and California’s Gavin Newsom. She imposed harsh lockdowns, which many citizens considered irrational (why prohibit landscaping?), hypocritical (why allow — and participate in — BLM protests?) and ultimately more harmful than beneficial. (Paul Moreno, 9/16)

The pandemic is shining a light on the courage and dedication of our front-line health care workers, but beneath the surface our heroes are suffering. Emergency physicians are struggling to manage their mental health. Even before the pandemic, nearly two-thirds of emergency physicians said they experienced burnout on the job, according to research published in the Annals of Emergency Medicine. Research indicates that in the U.S. alone, about 6,000 emergency physicians contemplated suicide in 2018, with nearly 400 attempting to take their life. Circumstances have become more dire as the fight against COVID-19 continues. (Jennifer Feist, Corey Feist and William Jaquis, 9/17)

Safe and effective vaccines represent the most effective way to restore the health and economic security disrupted by the Covid-19 pandemic. To help achieve that goal, the U.S. government launched Operation Warp Speed in May to accelerate development and manufacturing of several Covid-19 vaccines, with a goal of having 300 million doses available to the U.S. population by January 2021. (Luciana Borio and Jesse L. Goodman, 9/17)

When it comes to vaccines, the best decision for any single nation will depend on the decisions and actions of other nations. So vaccine policies cannot, and should not, be made in isolation — which means, as the internet likes to say, that it’s time for some game theory.Consider the United Arab Emirates’ recent approval of the new China-based Sinopharm vaccine. The vaccine was tested in the UAE for six weeks, and now there is an emergency-use authorization. By approving a vaccine early, the UAE government appears hands-on and efficient to its citizens. It might also improve its standing in the region, holding some bartering chips in the form of vaccine doses. (Tyler Cowan, 9/16)

The Food and Drug Administration is about to make the most momentous decision in its history: whether to authorize the early use of a vaccine to protect against the coronavirus without the normal safety and effectiveness protocols.This is happening against the backdrop of the presidential election season, in which the pandemic has become a fraught political issue for the Trump administration. The wrong decision could seriously undermine efforts to prevent the spread of this deadly virus. (William B. Schultz, 9/17)

As physicians and members of Congress, we know the surest and safest way to defeat coronavirus and return life to a state of normal is by developing a safe, effective vaccine. When the coronavirus pandemic began, the Trump administration had the foresight to launch Operation Warp Speed (OWS), a multi-agency wide effort to develop and deliver a vaccine, therapeutics, and diagnostic tests that could identify and treat the virus in record time. This public-private partnership, which uses federal research dollars to supplement and accelerate private companies’ vaccine development efforts, could now be mere months away from having a COVID-19 vaccine approved and ready to save lives. (Rep. Phil Roe, Rep. Brad Wenstrup, Rep. Andy Harris, Rep. Larry Bucshon, 9/16)

The battle against Covid-19 is entering a new phase, and the choice for society is whether to live with the virus or to live for it. This new phase has been marked by four developments: Many states have weathered post-shutdown outbreaks and case counts are falling; the percentage of Americans saying the pandemic is worsening peaked in July and is trending down, according to Gallup polling; the culture wars over lockdowns and distancing mandates are cooling; and inexpensive rapid testing and a vaccine will soon be available widely. These developments create an atmosphere of possibility—and an opportunity to pivot away from the fear-fueled policy-making that has characterized the pandemic. (Joseph A. Ladapo, 9/16)

I’ve never been in a medical trial before and I never wanted to be. As someone who suffers from pretty significant anxiety about my health, I am, in theory, the last person who should ever do any medical trial at all, and, on the way, up to the hospital, this thought occurred to me numerous times. But on Tuesday, Sept. 8, I did it anyway. I drove up to Yale New Haven Hospital to get my first of two doses of the experimental Pfizer coronavirus vaccine. (Molly Jong-Fast, 9/17)

The scary thing about the U.K.’s much-publicized problems with Covid-19 testing is not that the system is encountering difficulties — those were inevitable. It’s that the government failed to anticipate them, it has not been transparent about what went wrong or convincing on the question of when the problems will be resolved.Boris Johnson and Health Secretary Matt Hancock have been getting an earful from lawmakers from all parties as stories mounted of a meltdown in the country’s testing system. Many people with Covid symptoms have been instructed to travel hundreds of miles for tests and those were the lucky ones. Others seeking to book a test spent hours in a front a screen hitting the refresh button with no joy. (Therese Raphael, 9/17)