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The White House will buy and distribute 500 million rapid Covid-19 tests for free beginning in January, according to Biden administration officials. The move comes amid a wave of new cases, a large majority of which stem from the Omicron variant of the virus that causes Covid. Health officials across the country reported nearly 238,000 cases on Monday, nearing the totals recorded during the deadly surge in August and September. (Facher, 12/21)

The White House will deploy 1,000 military medical personnel to support hospitals facing a surge of patients infected with Covid this winter, and will purchase 500 million at-home tests that Americans can order online for free with delivery beginning in January, according to senior administration officials. President Joe Biden will announce the plan in a speech later Tuesday addressing how the administration is preparing for the highly contagious omicron variant of Covid-19. Biden warned last week that the unvaccinated face a winter of “severe illness and death,” calling on them to get immunized and to receive a booster shot to protect their health. (Kimball, 12/21)

The federal government also plans to set up 20,000 new testing sites nationwide, with the first one opening in New York City before Christmas, the official said. President Joe Biden is scheduled to deliver a speech Tuesday about the administration's plan to combat the pandemic this winter. Testing remains one of the biggest challenges for the administration, with long lines forming at testing centers in recent days and at-home rapid tests selling out quickly, public health officials have said. (Pettypiece, 12/21)

Four days before Christmas, as coronavirus cases spike and testing lines snake around city blocks, President Biden on Tuesday will again attempt to persuade Americans to take protections to fend off the fast-spreading omicron variant. But at a moment of great urgency — both for the nation’s health and the president’s standing — he has few new tools at his disposal, at least not politically palatable ones, and public health experts fear that exhausted Americans have tuned out their warnings. (Diamond and Pager, 12/20)

Amid this winter surge of Covid-19 cases across the country, CNN is reporting on an important pivot at the White House and among some public health officials -- how to live with the virus instead of how to beat it. That shift is occurring as many Americans struggle to find easy and affordable testing and as pictures of hours-long testing lines emerged over the weekend. President Joe Biden, as part of his address to the nation on Tuesday night, will announce a purchase of a half-billion at-home rapid Covid-19 tests and a plan to distribute them free starting next month to Americans who request them through a website. (Wolf, 12/21)

Americans are encountering a familiar problem as they scramble to safely gather for the holidays despite the spread of Omicron: They're struggling to find coronavirus tests. Testing has always been key to slowing the spread of the virus. Given Omicron's transmissibility, accessible testing is more important than ever for life to go on without massive disruption. (Owens, 12/21)

KHN: Some Groups Are Left Out Of Montana Covid Test Giveaway Program

As Montana’s tally of new covid cases neared 1,000 each day in September, Shelly Stanley-Lehman worried about when the virus would reach her day care in Billings. She wanted to have covid tests on hand to help prevent an outbreak from sweeping through her business, but stores were sold out. She spent days making calls and searching online. When Stanley-Lehman finally got her hands on a box of tests later that month, it was too late — a child’s family member, unknowingly infected, had exposed the day care to covid. The virus quickly spread to four others, including kids and staffers. “We got the tests just in time to close down,” Stanley-Lehman said. (Silvers and Houghton, 12/21)

President Biden was in close contact with a White House official who later tested positive for the coronavirus, the administration said on Monday. The president spent about 30 minutes near the official aboard Air Force One on a trip from South Carolina to Pennsylvania on Friday, Jen Psaki, the White House press secretary, said in a statement. The official, who was vaccinated and had received a booster shot, began experiencing symptoms two days later and tested positive on Monday morning. “The president is tested on a regular basis. As part of that regular testing, the president received an antigen test Sunday, and tested negative,” Ms. Psaki said. “This morning, after being notified of the staffer’s positive test, the president received a P.C.R. test and tested negative.” (Rogers, 12/20)

President Joe Biden tested negative for Covid on Monday, days after he was in close contact with an aide who would eventually test positive for the virus, the White House said. He will be tested again Wednesday, press secretary Jen Psaki said in a release. Biden, who turned 79 in November, is the oldest man ever elected to the presidency. He is in good health, his doctor said in a recent report. The president is also fully vaccinated and boosted. (Calia, 12/20)

The virus has always been far more dangerous for older Americans. For those who remain unvaccinated, the difference is staggering. Vaccination doesn’t completely eliminate the risk of death, but it lowers it significantly. An unvaccinated person age 50 to 65 was about as likely to die from the virus in mid-October as a vaccinated person in the over-80 group that has been ravaged by the virus. (Bump, 12/20)

If you want to protect elderly relatives, you have to begin taking steps one week before a family gathering. "It's not just about what you do when you're hanging out with grandma. It's also about what you do in the days before," says Dr. Emily Landon, an infectious disease specialist at the University of Chicago who has advised students on campus. "Try to avoid having too many contacts with other people outside of your circle," she says. Save up your unmasked, close contacts for the family gathering, so there's less chance of introducing the virus. Remember, omicron appears to be at least two times more transmissible than the delta variant that is still causing nearly 120,000 infections a day. (Aubrey, 12/19)

The omicron variant is now considered the most dominant version of the coronavirus — making up 73% of new COVID-19 infections last week in the U.S., according to new data released by the Centers for Disease Control and Prevention on Monday. The new estimates capture cases for the week that ended on Dec. 18. The new estimates underscore just how rapidly it has spread across the U.S. As of a week prior, Dec. 11, it was only detected in 12.6% of positive COVID-19 cases that were sampled. The CDC said it was working on revising some of the earlier numbers after officials finish analyzing more samples of the strain. (Franklin, 12/20)

The Omicron variant now accounts for 73% of Covid-19 infections being diagnosed in the United States, and in some parts of the country 90% of infections are caused by viruses from the Omicron strain, the Centers for Disease Control and Prevention said late Monday. Though it’s been clear from Omicron’s astonishing spread elsewhere that it would rapidly take over from Delta as the dominant variant in this country, the speed is nevertheless startling to witness. “What we are watching unfold is microbial evolution. This is remarkable,” said Michael Osterholm, director of the University of Minnesota’s Center for Infectious Diseases Research and Policy. “But this is what these viruses can do.” (Branswell, 12/20)

The director general of the World Health Organization on Monday urged people to cancel upcoming events as part of a global effort to avoid “increased cases, overwhelmed health systems and more deaths” over the holiday season amid the spread of the omicron variant. Tedros Adhanom Ghebreyesus’s remarks to journalists come as the new variant is quickly infecting more and more people just before the Christmas holiday. At least 48 U.S. states and 89 countries have reported cases. An unvaccinated Houston-area man in his 50s is believed to be the first to die in the United States after being infected by omicron. (Jeong and Francis, 12/21)

It might be time to rethink your festive plans, the World Health Organization has warned amid a rising number of cases of the coronavirus caused by the Omicron variant. World Health Organization Director-General Tedros Adhanom Ghebreyesus said the pandemic might mean canceling in-person events over the holiday period, adding that "an event canceled is better than a life canceled." (Kottasova and Langmaid, 12/21)

Harris County recorded its first death attributed to the omicron variant of COVID-19, County Judge Lina Hidalgo announced Monday. ABC News said the death was believed to be the first recorded due to the omicron variant. The person who died, a man in his 50s, was a resident of Harris County Precinct Two, Hidalgo said. The man was reportedly unvaccinated. The news was reported hours after Hidalgo raised the county’s coronavirus threat level to ‘significant.” (González Kelly, 12/20)

Harris County reported its first casualty from the COVID-19 omicron variant on Monday, less than one month after the heavily mutated version of the virus was detected in South Africa. Announcing the death, which is believed to be the first recorded due to omicron in the nation, County Judge Lina Hidalgo said the latest variant’s arrival in the Houston area “feels like whiplash” after a period of receding cases. She’s not the only one grappling with the swift rise of omicron amid the busiest travel season of the year: Houston-area doctors watching omicron’s breakneck march across much of the globe said the highly transmissible variant is likely to take hold in the coming months, with potentially severe consequences for the one-third of Texans who remain unvaccinated. The World Health Organization estimates indicate the variant is reproducing itself faster than any previous iteration, with the number of new cases doubling every 1.5 to 3 days. (Mishanec and González Kelly, 12/20)

Mayor Bill de Blasio on Monday said New York City is experiencing a rapid surge of omicron infections, but he expects the wave to peak in a matter of weeks. “It’s going to be a very challenging few weeks. But the good news is based on what our healthcare leadership understands, at this moment, we are talking about a matter of weeks,” De Blasio told the public during a Covid update on Monday. (Kimball, 12/20)

The omicron variant, which health officials estimate to be up to three-times more infectious than the delta variant, was detected in West Virginia last week. “Projections show that for the 2021 holiday season, we will approach the highest number of COVID-19 hospitalizations in West Virginia since the pandemic began,” according to the release. “As a state and a nation, we are in this crisis together, and although there have been multiple calls for action in the past, we need your help now more than ever to ensure health care services are available for everyone who needs them.” (12/20)

The number of Californians being infected and hospitalized with COVID-19 has crept up over the last two weeks — increases that, though slight, may worsen as winter begins and the state contends with the continued spread of the Omicron variant. Even with the recent upticks, both metrics remain well short of the devastating numbers from last winter’s surge, when explosive growth of the coronavirus ravaged the state. But the combination of current conditions and caution surrounding the weeks to come has already prompted officials to issue new health restrictions and organizers to cancel, postpone or recalibrate some sports contests and holiday events. (Money, 12/20)

California is poised for a surge in new coronavirus infections as a far more contagious version of the disease spreads among holiday parties and family gatherings forced indoors by a series of winter storms. But experts say the nation’s most populous state is likely to avoid the worst scenario — spikes in hospitalizations and deaths — because most Californians have either been vaccinated or already been infected. That gives the state a higher level or protection against the omicron variant that, while not guaranteeing people won’t get sick, means they are less likely to need to go to the hospital. (Beam, 12/21)

For U.S. school officials struggling with a sharp rise in Covid-19 cases, winter break can’t come soon enough. There were 646 Covid-related school closings for this week, up from 356 the week before, according to Burbio, a data service that aggregates calendars nationwide. Schools in states including Michigan, Maryland, Pennsylvania and Ohio shifted to virtual learning or closed early for winter break. Several already are planning remote class in January. (Sherman, 12/20)

As the world experiences new, more transmissible Covid-19 variants, scientists and health officials in the U.S. are still struggling to gather accurate and timely domestic data to help inform policy decisions to safeguard Americans. Continuing gaps in the CDC’s data collection program, which almost two years into the pandemic still relies on state health departments who use a mix of often incompatible and outdated state systems to identify cases, impedes the nation’s understanding of where and how fast the virus is spreading, according to more than a dozen state and federal officials involved in tracking cases. (Banco, 12/20)

Wisconsin health officials are once again bracing for a breakdown of health care if COVID-19 does not slow down in the state. The leaders of the state’s Department of Health Services issued a “health advisory” on Monday urging Wisconsin residents to wear face masks indoors, get vaccinated against COVID-19, and consider gathering for the holidays in small groups. Their goal is to prevent hospitals from becoming so overwhelmed that not everyone who needs life-saving care will get it. (Beck and Bentley, 12/20)

Rationing of hospital care is ending in Idaho after conditions improved in the northern part of the state where anti-vaccination sentiment has been widespread. “While the number of COVID-19 patients remains high and continues to stress healthcare systems, the surge is currently no longer exceeding the healthcare resources available,” according to a statement Monday by the Idaho Department of Health and Welfare. So-called crisis standards of care were withdrawn in the rest of Idaho last month. “We’re still watching the Omicron variant very closely because this is a precarious time,” said Dave Jeppesen, director of the state health department. (Del Giudice, 12/20)

Gov. Ron DeSantis says Florida is getting thousands of doses of an antibody treatment that protects immunosuppressed people and those allergic to the COVID-19 vaccines. The two-shot antibody treatment called Evusheld offers about six months of protection if administered before a patient is exposed to the virus. The treatment received an emergency use authorization from the Food and Drug Administration on Wednesday. (Prieur, 12/20)

Maryland’s governor announced Monday that he has tested positive for the coronavirus and is experiencing cold-like symptoms. Gov. Larry Hogan tweeted that he received a positive rapid test Monday morning as part of his regular testing routine. Hogan, a cancer survivor, said he has been vaccinated and has had a booster shot. (12/21)

At least 132 staffers at the SpaceX rocket factory in Hawthorne have tested positive for COVID-19 amid a large, active outbreak that coincides with a busy month of launches for the aerospace manufacturer. The Los Angeles County Department of Public Health released the data as part of a summary of COVID-19 cases throughout the county. There has been at least one other outbreak at SpaceX’s corporate headquarters, where the Elon Musk-led company’s main design, manufacturing and engineering is done, including work on its Falcon 9 rockets and Dragon capsules. (Seidman and Masunaga, 12/20)

New York Health Commissioner Mary Bassett has tested positive for Covid-19, according to New York Governor Kathy Hochul. In a press briefing on Monday, Hochul said Bassett’s breakthrough case came through a regular rapid test and that Bassett has also received her Covid booster. The number of Covid cases in New York has surpassed records in recent days, with over 23,000 daily cases, but hospitalizations remain below last year’s winter surge, Hochul said. Hospitalizations were 4,020, and 60 people died on Sunday, she said. (Clukey, 12/20)

More than 28,500 Marylanders tested positive for COVID-19 during the two weeks since Maryland Department of Health servers were taken offline following a cyberattack and state officials reported little data. The state restored some data reporting Monday, the same day as Gov. Larry Hogan reported that he had tested positive for the virus. Some figures, such as how many people have died and where infections were logged and their ages and demographics, still have not been updated. (Cohn and Wood, 12/20)

While the seasonal flu can be life-threatening, it paled in comparison to the overall numbers of COVID-19 deaths in the U.S. over the last two years. Experts warn about the dual threat from COVID surges and influenza, and say the flu season could be tough because this year's flu shot appears to be poorly matched to the flu strains circulating this season. (Alberti, 12/20)

KHN: Pandemic Poses Short- And Long-Term Risks To Babies, Especially Boys

The pandemic has created a hostile environment for pregnant people and their babies. Stress levels among expectant mothers have soared. Pregnant women with covid are five times as likely as uninfected pregnant people to require intensive care and 22 times as likely to die. Infected moms are four times as likely to have a stillborn child. Yet some of the pandemic’s greatest threats to infants’ health may not be apparent for years or even decades. (Szabo, 12/21)

A federal judge in Missouri added another legal block Monday against President Joe Biden’s requirement that federal contractors receive COVID-19 vaccinations. The new preliminary injunction prohibits enforcement of the contractors’ vaccine mandate in 10 states that collectively sued. It comes on top of a nationwide injunction issued earlier this month by a federal judge in Georgia. (Lieb, 12/21)

The Biden administration’s coronavirus protection requirements intended to persuade millions of health-care and other workers to get vaccinated are taking center stage at the Supreme Court. More than half the states and coalitions of business and religious groups are asking the justices for emergency action to block the administration’s nationwide vaccine-or-testing mandate for large businesses, which would cover about 80 million workers. (Barnes, 12/20)

A San Diego County judge has struck down the student COVID-19 vaccine mandate in the San Diego school system, a ruling with potential implications elsewhere, including in the Los Angeles Unified School District. In a four-page decision, Superior Court Judge John S. Meyer concluded that California school systems did not have the authority under state law to establish their own vaccine mandates. His ruling applies only to San Diego Unified. In separate vaccine mandate litigation against L.A. Unified, an L.A. County judge recently appeared to be leaning in the other direction, siding with the right of the Los Angeles district to impose its own requirements. (Blume and Taketa, 12/20)

As the highly transmissible omicron variant spreads across the country, University of Oregon students, faculty and staff will be required to get a COVID-19 booster shot as soon as they are eligible, school officials announced Monday. Currently the university and the state’s six other public universities require COVID-19 vaccinations for those on campus. As of Monday afternoon, the University of Oregon is the only public university in the state to publicly announce a booster requirement. (12/20)

The NHL will halt its season Wednesday amid a spike in coronavirus cases and the rise of the omicron variant, the league announced Monday night, becoming the first major pro sports league in North America with plans to halt play entirely, albeit briefly. Team facilities will be closed from Wednesday through Saturday, and players will return Sunday for coronavirus testing and practice. Games are in line to resume Monday, Dec. 27. The league’s previously scheduled holiday break was Friday through Sunday. (Pell, 12/20)

With the omicron variant baring its teeth, the NFL’s revamped coronavirus testing policy will lead to an increase in infections among its ranks, experts said Monday, and could risk spreading the virus as hospital systems struggle to bear the weight of another wave of covid-19 infections. But some epidemiologists said the league’s plan also could provide a hint of what the general public can expect as the coronavirus becomes further entrenched in everyday life. (Maese, 12/20)

The NFL’s decision to reduce COVID-19 testing for asymptomatic, vaccinated players could signal a trend for pro sports leagues and provide an example for society to follow heading into 2022. ... The NFL previously required vaccinated players to get tested weekly before amending the protocols. The NFLPA had advocated for daily testing for vaccinated players but eventually agreed to “target” testing. The NBA didn’t require vaccinated players to get tested during the season but revised its policy to increase testing for a two-week period starting Dec. 26. (Maaddi, 12/21)

Several asymptomatic, vaccinated NFL players tested positive for COVID-19 on the first day of “targeted” testing, a person familiar with the results told The Associated Press on Monday. Overall, 47 players were placed on the reserve/COVID-19 list, the most in a single day since the pandemic began. The person, speaking on condition of anonymity because of privacy issues, didn’t specify how many of the players are asymptomatic and fully vaccinated. (Maaddi, 12/21)

Former President Donald J. Trump, who for years falsely claimed vaccines were dangerous and pointedly declined to be seen getting vaccinated against Covid-19 while in office, was booed at an event in Houston after saying publicly for the first time that he had received a booster shot. (Paybarah and McCarthy, 12/20)

Bill O’Reilly has revealed that he had to console Donald Trump after he was booed by his own supporters for getting a vaccine booster shot. Trump told MAGA fans that he’d had his COVID-19 booster during Sunday’s final stop on the “History Tour” he co-headlined with the disgraced ex-Fox News star. ... In an interview with Dan Abrams on NewsNation, O’Reilly said Trump phoned him after the event and was apparently hurt by the reaction.

Nearly 97 percent of Massachusetts residents who’ve contracted COVID-19 after getting vaccinated have avoided severe health outcomes such as hospitalization or death, the state Department of Public Health said Monday. The DPH confirmed the tally in a statement. According to the release, DPH culled the 97-percent figure from a review of breakthrough cases in the Commonwealth, and the agency also zeroed in on the unvaccinated population. The review found unvaccinated residents are five times more likely to get infected than fully vaccinated residents, and that unvaccinated residents are 31 times more likely to become infected than fully vaccinated residents who’ve received a booster, the statement said. (Andersen, 12/20)

About 21% of Philadelphia’s eligible children have received a COVID-19 vaccine more than a month after the young age group was approved. The low rate worries health experts as the holidays approach and the threat of an omicron surge looms. Meanwhile, repeating a pattern seen throughout the vaccination effort, Black and Hispanic populations lag behind other groups. Among 5 to 11 year olds, just 8% of Philadelphia’s Black children and 12% of Hispanic children have received at least one dose, according to city data. About 24% of white children and 31% of Asians have received at least a dose since the vaccine was approved for younger children at the beginning of November. As of Monday, 18,540 Philadelphia children ages 5 to 11 had received their first vaccine dose. (Laughlin and Graham, 12/21)

Florida nursing homes rank third from the bottom nationally when it comes to the percentage of residents who’ve gotten COVID-19 vaccine booster shots. The CDC reports that 81 percent of nursing home residents in Florida are fully vaccinated, but only 39 percent have gotten the booster or third dose. Among U.S. states, only Arizona and Nevada are worse. (Byrnes, 12/20)

The Centers for Disease Control and Prevention is urging all adults eligible for a COVID-19 booster to get one as soon as possible to protect themselves from new variants such as omicron. But if you've had a recent breakthrough case of coronavirus, some health experts suggest you might benefit from waiting to get a booster shot. University of South Florida Health immunologist Michael Teng said people who recently recovered from a breakthrough infection just put their immune system to work. There's no data to suggest getting a booster shortly after that would be harmful. People can safely get boosters so long as their 10-day isolation period has ended and they no longer have symptoms. (Colombini, 12/20)

The Food and Drug Administration on Monday approved the world’s first injectable medication to reduce the risk of sexually transmitted HIV. Previously, the only PrEP (pre-exposure prophylaxis) medications that have been approved were pills required to be taken daily, such as Truvada and Descovy. For some people, adherence to daily medication can prove challenging or “not a realistic option,” said Debra Birnkrant, director of the FDA’s antivirals division. (Pietsch, 12/21)

Two double-blind clinical trials comparing Apretude with Truvada found significantly lower HIV risk in people getting the injection, the FDA noted. The risk was 69% lower in the first trial, of HIV-negative cisgender men and transgender women who have sex with men, and 90% lower in the second trial, which involved cisgender women. Research also found that Apretude was more likely than Truvada to cause side effects such as injection site reactions, headache, fatigue, back pain, myalgia and rash. (Dillinger, 12/20)

What do all the microbes living rent-free in your gut have to do with disease risk? Perhaps a lot. A study of decades-old stool and blood samples from the early AIDS epidemic suggests that men who had high levels of inflammation-causing bacteria in their intestinal tract may have had a greater risk for contracting HIV. At issue is the specific makeup of the bacteria, fungi, algae and other single-celled organisms that colonize everyone's digestive tract. Collectively, they're known as the gut microbiome. (Mozes, 12/19)

One of the things that kept Carl Fox going after he contracted HIV in 1985 was a promise that he made to himself. Fox vowed to survive, he said, so he could testify to what people with HIV and AIDS encountered back then. ... This month marks the halfway point of Fox’s participation in a federally funded TRAILBLAZER study that’s altering the white blood cells of patients to try to control the devastation of HIV without daily medication. He is allowing WCPO to chronicle the experience. (May, 12/21)

Olivia and Amy are sitting outside in the shade, trying to escape from New Zealand’s early-summer humidity. Amy, 10 months old, burbles happily in the background as her mother talks. She is healthy, happy, and oblivious to her status as a world first: one of a handful of babies born from the first sperm bank for HIV-positive donors. The bank, Sperm Positive, launched in New Zealand in 2019, in an effort to reduce the stigma faced by HIV-positive people – and raise awareness that with treatment, the virus was undetectable and untransmissible. It grabbed international headlines when it was launched, but has been more than a publicity gimmick. Two years on, the bank is bearing fruit. (McClure, 12/17)

Biogen Inc (BIIB.O) on Monday cut the price of its Alzheimer's drug by about half to $28,200 for an average weight person after facing slower-than-expected U.S. sales on complaints from hospitals that its high cost was not worth its benefits. The U.S. Food and Drug Administration (FDA) approved the drug, Aduhelm, in June to treat the brain-wasting disease despite the view of its outside advisory panel that Biogen had not proven the treatment's clinical benefit. (Khandekar, 12/20)

Biogen said Monday that it has reduced the price of its Alzheimer’s drug Aduhelm by half and is planning a series of cost-cutting measures across the company next year that aim to save $500 million. The moves follow a disappointing commercial launch of Aduhelm, as well as anger over the drug’s high price. (Feuerstein, 12/20)

In tandem with the price cut, Biogen said it will launch an overhaul with the goal to cut $500 million in annual costs. Translation: Layoffs are likely around the corner. The company said it’s still finalizing the details and will unveil the plan in the first quarter next year. (Liu, 12/20)

Biogen CEO Michel Vounatsos said in a prepared statement that too many patients were not being offered the drug due to "financial considerations," and their disease had progressed beyond the point where Aduhelm could help. (12/20)

Aduhelm's price cut comes less than a week after the European Medicines Agency — the FDA of the European Union — rejected the drug on the grounds that there is no definitive proof it works. "Although Aduhelm reduces amyloid beta in the brain, the link between this effect and clinical improvement had not been established," the EMA said. "Results from the main studies were conflicting and did not show overall that Aduhelm was effective at treating adults with early-stage Alzheimer's disease." (Herman, 12/21)

Patient advocates and Democratic lawmakers want Medicare to lower its Part B premiums for 2022 after Biogen said Monday that it will cut the price of its controversial Alzheimer's drug Aduhelm in half. The Centers for Medicare and Medicaid Services hasn't changed premiums after the fact before as far as Juliette Cubanski, deputy director of the program on Medicare policy at the Kaiser Family Foundation, knows. But that doesn't mean they can't do it, she said. "It would be an unprecedented move, but I don't think it would be an unwarranted move, given that a big part of the reason why the increase for 2022 is as large as it is is because of the price of this drug," she said. (Goldman, 12/20)

Hospitals and other providers are experiencing lags in the delivery of between 8,000-12,000 containers of critical medical supplies and equipment, a setback that could negatively impact patient care and public health. Healthcare resources are being delayed an average of up to 37 days throughout the U.S. transportation system due to supply chain congestion, according to research from the Health Industry Distributors Association. Medical shipments are being held up at U.S. ports for around 17 days. The Long Beach and Los Angeles ports in California have the largest number of delayed medical containers on the West Coast. The Port of Savannah, Georgia is the most congested on the Eastern Seaboard, the association reports. (Devereaux, 12/20)

Oracle on Monday said it plans to acquire electronic health records giant Cerner in a deal valued at $28.3 billion. The Austin, Texas-based tech giant will acquire Kansas City, Missouri-based Cerner through an all-cash tender offer of $95 per share in a transaction expected to close in 2022. The transaction is subject to certain regulatory approvals and closing conditions, including Cerner stockholders agreeing to sell a majority of Cerner's outstanding shares as part of Oracle's offer. (Kim Cohen, 12/20)

An emergency medicine physicians group has sued Envision Healthcare, the giant health care services company, alleging that it violated California laws barring corporations from practicing medicine when it took over staffing of the emergency department at Placentia-Linda Hospital in Placentia, California, in August. The lawsuit was filed by the American Academy of Emergency Medicine Physician Group, or AAEM, a nonprofit professional medical association that provides administrative services to physician groups. For-profit Envision Healthcare says it is the country’s largest emergency medicine group, partnering with 540 health care facilities in 45 states. Envision is owned by KKR, the private equity powerhouse. (Morgenson, 12/21)

More private equity firms took their healthcare provider portfolio companies public in 2021 than ever before, and one research firm thinks the number will almost double in 2022. Data analytics and research firm PitchBook predicts at least 10 private equity-backed healthcare provider platforms will list publicly next year, breaking 2021's record of six such IPOs. The prediction was part of PitchBook's 2022 U.S. private equity outlook. Six PE-backed healthcare provider IPOs in a year might not sound like a lot, but it compares with between zero and two in each of the previous 10 years, PitchBook found. (Bannow, 12/20)

Inspira Health has agreed to acquire Salem Medical Center, a small Salem County nonprofit that has had a tumultuous ownership history in recent years, Inspira announced Monday. The acquisition could bring more stability to a small hospital that has struggled financially. And it would give Inspira a stronger foothold in Salem County, which sits across the Delaware River from Wilmington. (Brubaker, 12/21)

After hearing many constituents complain about the high cost of medical care and hospital billing, Fort Wayne Sen. Justin Busch decided that it was time for the public to have any opportunity to ask questions of the state’s health care institutions. Last year he authored a bill that required hospitals and health insurers doing business in the state to each hold an annual public forum to discuss pricing in the interest of transparency. This year, the first that the bill took effect, many of the affected non-profit hospitals waited until the final weeks of the year to hold their hour-long sessions in which they presented a picture of their finances while touting the work they have done. (Rudavsky, 12/21)

KHN: NICU Bill Installment Plan: That’ll Be $45,843 A Month For 12 Months, Please

Close to midnight on Nov. 12, 2020, Bisi Bennett was sitting on the couch in her pajamas and feeling uncomfortable. She was about seven months pregnant with her first child, Dorian, and the thought that she could be in labor didn’t even cross her mind. Then, she felt a contraction so strong it knocked her off the couch. She shouted to her husband, Chris, and they ran to the car to start the 15-minute drive to AdventHealth hospital in Orlando, Florida. About halfway through the trip, Bennett gave birth to Dorian in her family’s Mitsubishi Outlander. Her husband kept one hand on his newborn son’s back and one hand on the wheel. (Knight, 12/21)

KHN: Covered California’s Insurance Deals Range From ‘No-Brainer’ To Sticker Shock 

If you purchase your own health insurance, it’s time to choose your coverage for 2022. If you buy it through Covered California, the chances are better than ever that you will get a big discount on your monthly premium — or pay no premium at all. Many middle-class families who previously paid full fare for their health plans got financial assistance this year through the American Rescue Plan, a law that significantly expanded federal tax credits that reduce the premiums consumers pay. (Wolfson, 12/21)

KHN: Crash Course: Injured Patients Who Sign ‘Letters Of Protection’ May Face Huge Medical Bills And Risks

Jean Louis-Charles couldn’t afford spine surgery to ease nagging neck and back pain after a car crash. So he signed a document, promising to pay the bill with money he hoped to get from a lawsuit against the driver who caused the collision. That never happened. Louis-Charles, 68, died hours after the operation at a South Florida outpatient surgery center in March 2019. The surgery center had put him in an Uber with his wife, Marie Julien, according to depositions. After a 60-mile ride home, he collapsed, court records show. Her husband’s death left Julien to deal with more than $100,000 in medical debt, as described in the “letter of protection,” or LOP, that Louis-Charles had signed. (Schulte, 12/21)

Rite Aid announced Tuesday it is closing another 63 stores to save about $25 million year. After years of overexpansion, Rite Aid and other giant American pharmacy chains have struggled. They've been closing hundreds of stores over the past few years, despite the pandemic that has drawn people into pharmacies. (Valinsky, 12/21)

CVS Pharmacy will close six of its 21 San Francisco stores in January, a company spokesperson told The Chronicle on Monday. They’re part of a wave of anticipated closures the company first announced mid-November, when it said it would shutter 900 stores nationwide in order to reduce its count by 10%. The closings are to occur at a rate of 300 per year for three years. (Whiting, 12/20)

In its latest bid to defend its franchise product, AbbVie (ABBV) has filed a complaint with the U.S. International Trade Commission in hopes of preventing a would-be rival from selling a lower-cost version of its Humira treatment for rheumatoid arthritis and other ailments. The drug maker argued that Alvotech, which is seeking a toehold in the U.S. for biosimilar medicines, misappropriated trade secrets and should not be allowed to market its version once it becomes available in the U.S. Alvotech, which is based in Iceland, is awaiting regulatory approval after the U.S. Food and Drug Administration cited pandemic travel restrictions that delayed plant inspections. (Silverman, 12/20)

A federal judge’s decision to reject Purdue Pharma’s multibillion-dollar opioid settlement shines a light on a controversial part of bankruptcies that quietly helps grease the wheels for complicated reorganizations. At issue are “non-debtor releases” provided to Purdue's owners, the Sackler family. U.S. District Judge Colleen McMahon said the releases — agreements that shield the family from future litigation — can’t legally be granted by a bankruptcy court. (Marino, 12/20)

A University of Chicago associate professor who worked as a clinical trial investigator for Five Prime Therapeutics was charged with insider trading in connection with study results for a key cancer drug. In November 2020, Daniel Catenacci was a lead physician and investigator for a Phase 2 trial of a stomach cancer treatment when he learned of positive results from a Five Prime executive. The medicine, known as bemarituzumab, was widely tracked since stomach cancer is the third-leading cause of cancer deaths worldwide and prompted Amgen (AMGN) to buy the company for $1.9 billion a few months later. (Silverman, 12/20)

At first, Joann Fouquette's son, Ezra, was hitting all the milestones. It's what every new mom hopes for: a happy, healthy baby. But around 17 months, things started to change. He stopped speaking. He started covering his ears and hitting his head on the floor like something was bothering him. Fouquette remembers her mom telling her, "I think we need to get him tested. There's something definitely going on there. "Five months later, in 2012, Ezra was diagnosed with autism spectrum disorder. (Angley, 12/20)

Surprise diagnoses have a way of making Ph.D. candidates out of everyday people. Walter Feigenson’s education began in 2007, at age 59, when he was wrongly diagnosed with congestive heart failure. Then came carpal tunnel syndrome, which doctors chalked up to his years in front of a keyboard. In 2010 it was a ruptured bicep tendon, and in 2015 a case of a spinal condition called lumbar stenosis. It wasn’t until 2018, when “dumb luck” landed Feigenson in front of a specialist at Oregon Health and Science University, that someone connected the dots between his disparate symptoms: He had a progressive disease that was destroying his heart. (Garde, 12/21)

Two hours before the U.S. Supreme Court convened for the case that could make abortion illegal across much of the country, four women gathered on the court’s steps to propose another path forward. With a mifepristone pill in one hand and a loudspeaker in the other, Amelia Bonow started to chant. “Abortion pills are in our hands and we won’t stop,” yelled the co-founder of the abortion rights organization Shout Your Abortion. Bonow and three others, none of whom were pregnant, then simultaneously swallowed mifepristone, a pill that can be used to end a pregnancy up to 10 weeks gestation and is widely regarded as safe. (Kitchener, 12/20)

Looking at cancer often means taking the long view. Research scientists, oncologists, and patients are all waiting to see what the coronavirus pandemic’s long-term effects might be on cancer detection and treatment, all while trying to navigate daily life made more precarious by the Omicron variant. (Cooney, 12/21)

Major Elijah Bazemore started working at the Durham County Sheriff’s office on April 11, 1988. Since then, there’s been a “paradigm shift,” he said. “You want to help an individual be better when they get out of the facility than when they were when they were detained,” Bazemore said in an interview with NC Health News. He’s been helping people detained at the Durham County Detention Center do just that through the jail’s medication-assisted treatment (MAT) program, where he is the jail’s program administrator. (Thompson, 12/21)

The WHO and EU have now cleared Novavax’s COVID-19 vaccine for emergency use, adding another shot to the global arsenal. The biggest impact will likely be in the developing world as the American company has promised over 1 billion doses to the WHO-backed COVAX initiative. The vaccine can be stored at normal refrigerator temperatures and proved highly effective in clinical trials. (Lawler, 12/20)

A growing number of countries are reducing the wait time for COVID-19 vaccine boosters from six months to as few as three in a bid to ward off a new surge in infections from the Omicron variant. They are reacting to early evidence suggesting that Omicron is spreading faster than its predecessor, Delta, and is more likely to infect people who were vaccinated or had COVID in the past. Some scientists, however, say that giving boosters too soon could compromise the level of longer-term vaccine protection. (Beasley, 12/20)

In mid-August, not long after the Tokyo Olympics had wrapped up, the situation in Japan looked grim to Dr. Hideaki Oka, an infectious disease expert at the Saitama Medical University Hospital outside Tokyo. As he treated COVID-19 patients at his hospital, Japan was in the grip of a fifth wave of infections. New cases nationwide had surged to around 25,000 a day, and the country's medical system was being stretched to its limits. By late September, cases had plunged, and Oka is now getting a respite, of sorts. "We have had zero COVID patients in our hospital for two months straight," he explains, "so we've been able to concentrate on general medicine just as in pre-COVID times." (Kuhn, 12/20)

French police have uncovered 182,000 fake health passes since the documents were introduced this summer in a bid to control the spread of the coronavirus. President Emmanuel Macron introduced the official passes in July, and they have become necessary to gain access to numerous venues, including bars, restaurants and many long-distance trains. They can be obtained through vaccination, recovery from covid-19 or a recent negative test. (Pannett, 12/21)

At this point in the pandemic, many Americans remain unvaccinated because they believe the coronavirus vaccine is unlikely to do them any good. They’re aware of the virus and the damage it can cause, but for any number of reasons, they simply don’t believe they should get a vaccine. We’ve spoken to patients like this in our practice, and we have observed in those conversations that providing more, frightening information intended to change their beliefs is ineffective for many or may even cause further entrenchment against vaccination. (Anupam B. Jena and Christopher M. Worsham, 12/21)

When word gets out that Covid-19 vaccines are locally available, crowds rush to Mbarara Regional Referral Hospital in western Uganda. Hundreds of people will wait for hours in the sweltering heat outside the hospital’s always full vaccination tent; many are turned away when vaccine doses run out. As public health workers supporting vaccination efforts in Uganda — two of us (A.H. and S.A.) on the ground in Uganda — we are constantly confronted with the challenges of getting people vaccinated in places like Mbarara. (Azfar Hossain, Stephen Asiimwe and Louise Ivers, 12/21)

A few days ago, New York Mayor Bill de Blasio announced that the city would provide 500,000 free at-home COVID tests to city residents through community centers. This step toward more equitable testing came days after a heated exchange between White House spokesperson Jen Psaki and a National Public Radio reporter in which Psaki scoffed at the idea of a national COVID testing strategy that included mail-order free tests. In that recent press conference, Psaki outlined the effort the Biden administration has made to improve both the availability of at-home testing and the cost, noting that, after insurance, many people would pay nothing. But the reporter, Mara Liasson, asked why we couldn’t make it simple, make them free and give them out as needed? (Megha Satyanarayana, 12/20)

The omicron variant of Covid-19 is moving into New York City with astonishing speed. The percentage of tests coming up positive doubled in three days last week. Lines at testing sites are again lengthening. Breakthrough cases are closing restaurants and canceling Broadway shows. Strengthening the city’s defenses needs to be a top priority. Mayor Bill de Blasio is right to impose a new mandate for everyone who works in the city to show proof of vaccination. Beginning Dec. 27, businesses will be required to keep track of their employees’ vaccine status and post signs affirming their compliance. Documented medical or religious exemptions are allowed. (12/20)

ERs are already experiencing strains on all fronts. Patient volumes seemed to have returned to pre-pandemic levels this fall (though some systems still experiencing delta surges are well beyond that), but our capacity to manage that volume has changed. We have lost unprecedented numbers of health-care workers from our ranks. Many patients are sicker or more complex to manage, having put off care earlier in the pandemic. (Esther Choo, 12/20)

A new coronavirus is here. It is highly contagious, and case numbers are climbing. New York is the epicenter in the United States. This feels terribly familiar, even reminiscent of March 2020. And yet the situation is also very different because much of the population has acquired some form of immunity. Vaccination is extremely protective against severe illness and death, even for those infected with the Omicron variant. Of course, many people remain unvaccinated, including all children younger than 5, and some vaccinated people are still quite vulnerable. (Emily Oster, 12/21)

Earlier this year, when countries were experiencing COVID-19 surges that overwhelmed health systems, Africa appeared to have avoided that fate. Given the early predictions that Africa would suffer gravely from COVID due to their comparatively weaker health systems, official figures say Africa now accounts for just 3.3 percent of global cases and 4.3 percent of deaths. In contrast, Europe accounts for 28 percent of global cases. (Adam Bradshaw, 12/20)

Meteorologists don't wait until a tornado is on the ground to issue watches and warnings. Alarms sound when conditions are right for violent weather, giving those in its path time to seek shelter and secure their homes. The same batten-down-the-hatches approach is required for COVID's new, highly infectious omicron variant. While there are mixed signals about whether it causes milder illness, the uncertainty and the hurricane-force ferocity with which it has spread merit urgent action from individuals and political leaders. Testing before holiday gatherings (and not going if positive) is especially prudent. (12/20)

For the second year in a row, a winter coronavirus surge is upon us. Infections were already on the rise before the extremely contagious omicron variant emerged; now, some projections have the United States on track to reach more than 1 million new infections a day. Despite these staggering numbers, I don’t think vaccinated people should have to cancel their plans for Christmas, New Year’s Eve and other holidays. Growing research shows that existing vaccines provide significant protection against severe illness as a result of omicron. Those recently boosted with the Pfizer/BioNTech or Moderna vaccines have the best protection, including a decreased likelihood of mild breakthrough infections. (Leana S. Wen, 12/20)

When it comes to pregnancy amid a pandemic, there is no manual. Where once expecting moms could find answers to most of their questions within a copy of “What to Expect When You’re Expecting,” the book contains no chapter on how to navigate pregnancy and new motherhood during a pandemic. For many women, questions regarding their health — and the safety of their child — cast a shadow on what should be a joyful experience. (Ellen Stang, 12/20)

The story of artificial intelligence (AI) driving better health care outcomes has been a convoluted one, with hype-laden chapters on algorithmic cures for cancer and the future of robots replacing doctors. As those promises eventually proved overly ambitious, many people have lost the plot. When the world fixed its collective gaze on the Covid-19 pandemic and AI innovation fell off the hype cycle, it did not die. Instead, it has quietly emerged as a critical link between patients, providers, and payers by helping identify gaps in care, guide strategic decision-making, and improve patient engagement with care managers and primary care providers. Bots may not have replaced clinicians, but they have emerged as an important link in the care-management process. (Prasad Dindigal, 12/21)

It’s taken a pandemic for the world to fully grasp the interdependent nature of mental, physical and socioeconomic health. Yet, while COVID-19 has exponentially increased Google search trends for terms like “social determinants of health,” the foundations of whole person health run centuries deep. In words variably attributed to Osler, Moxon and even Hippocrates, generations of aspiring clinicians have learned the primacy of “knowing what sort of a patient has the disease than what sort of disease the patient has.” (Kody Kinsley and Dr. Chris DeRienzo, 12/21)

After pushing two long years for Laura’s Law to be passed by the Legislature and seeing it signed into law by Governor Charlie Baker last January, I thought my work was over trying to make a difference in my late wife’s name. I couldn’t have been more wrong. There was plenty more to do to implement the law. Since August, I have been meeting with a group of experts and concerned leaders — officially the Patient Access to Emergency Care (Laura’s Law) Workgroup — to come up with a list of recommendations for hospitals to adhere to ensure patients can find and get inside emergency departments as quickly as possible. Common-sense safety checks you might reasonably assume are already in place at your local hospital but, shockingly, often are not. (Peter DeMarco, 12/21)

I’ve never been very good at math, but here are some numbers about me: my age; how old I was when I received my first blood transfusion; and how many transfusions I’ve had since. 35; 6 months; and, at this point, nearly 900. Needing blood is something I can set a watch to — it’s an unavoidable aspect of my life and routine, and has been since I was diagnosed with a chronic blood disorder (beta thalassemia major) as an infant. No matter what else is going on — holidays, work events, global health crises — I still always need another transfusion. (Joelle Zarcone, 12/21)