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The news Monday that Pfizer’s experimental coronavirus vaccine is more than 90 percent effective sharply increased prospects that federal regulators will authorize the vaccine on an emergency basis as early as mid-December, and that the first shots will be administered before the end of the year or early next year. The findings, announced by drug giant Pfizer and German biotechnology firm BioNTech, provided much-needed hope for a nation battered by surging virus cases, a stumbling economy and a bitterly fought presidential campaign. It augers well for other vaccines and could accelerate the timetable for reining in the pandemic, said scientists, who cautioned that any successful vaccine will still face obstacles, notably distribution to hundreds of millions of people. (McGinley, Sun and Johnson, 11/9)

A top U.S. Army general who is co-leading the federal COVID-19 vaccine initiative anticipates that the first of millions of Americans could start receiving COVID-19 vaccines as soon as next month. "I think a safe and effective vaccine will be available initially in December," Gen. Gustave Perna told NPR's Mary Louise Kelly in an interview Monday. If the Food and Drug Administration authorizes a vaccine by then, "10 to 30 million doses of vaccine will be available that we can start distributing." (Huang, 11/9)

As news of Pfizer’s promising vaccine results rippled across the globe, scientists and public health officials warned that a true solution to the coronavirus pandemic is many months away and that people should continue wearing masks and social distancing. Pfizer said Monday its coronavirus vaccine is 90% effective at preventing COVID-19, sparking enthusiasm that a positive development in the global pandemic may be on the horizon. The findings are based on the first interim analysis of Phase 3 clinical trial data by an independent board, Pfizer said. The results were announced in a news release and have not been peer reviewed. (Ho, 11/9)

A nation in the grip of a raging pandemic got a glimmer of hope Monday with the drug maker Pfizer’s announcement that its COVID-19 vaccine showed early success among a small number of people in its drug trial. But with so many unknowns about the first batch of coronavirus vaccines still in development, vaccine and infectious disease experts warn that the public should be prepared to stay the course with 2020-style precautions for months to come, and perhaps longer. Masks and social distancing deep into 2021 are still likely, they say. (Lazar, 11/9)

The world has been waiting for good news on Covid-19 vaccines. Monday it got a bunch of it. A preliminary analysis of the race frontrunner, Pfizer-BioNTech’s mRNA vaccine, suggested it was 90% effective in preventing symptomatic Covid disease. While these are early findings — the trial is still ongoing — they suggest the vaccine could be very protective. (Branswell, 11/9)

News that Pfizer's coronavirus vaccine strongly protects people against infection is good news for other vaccines being developed against the pandemic, Dr. Anthony Fauci said Monday. Pfizer said its candidate vaccine was more than 90% effective in preventing infection in volunteers. It uses a never-before-approved technology called messenger RNA, or mRNA, to produce an immune response in people who are vaccinated. (Fox, 11/9)

With Pfizer Inc.’s Covid-19 vaccine on track to be authorized as early as next month, Western governments are facing an enormous logistical challenge: getting enough people shots of new vaccines. While previous vaccination programs have spread over years and focused on specific demographics such as children or the elderly, governments are hoping to do something they never have done before and inoculate a majority of the population in a matter of months. (Colchester and Hinshaw, 11/10)

The vaccine’s complex and super-cold storage requirements are an obstacle for even the most sophisticated hospitals in the United States and may impact when and where it is available in rural areas or poor countries where resources are tight. The main issue is that the vaccine, which is based on a novel technology that uses synthetic mRNA to activate the immune system against the virus, needs to be kept at minus 70 degrees Celsius (-94 F) or below. (O'Donnell, 11/9)

The news read like Heritage Foundation fan fiction. Pfizer, a 171-year-old paragon of American industry, was the first to generate truly promising data on a Covid-19 vaccine. And like a pharmaceutical John Henry — or John Galt — the company did it without accepting a single dollar from the federal government and its Operation Warp Speed. (Garde, 11/9)

Pfizer’s surprising news that its COVID-19 vaccine might offer more protection than anticipated — an announcement right after a fraught U.S. presidential election campaign — is raising questions about exactly how the different shots will make it to market. Pfizer Inc. and the maker of the other leading U.S. vaccine candidate, Moderna Inc., have been cautioning for weeks that the earliest they could seek regulatory approval for wider use of their shots would be late November. In Britain, AstraZeneca recently said it hoped to prove its own vaccine was effective by year’s end. (Neergaard, 11/10)

In more good news for the fight against COVID-19, the U.S. Food and Drug Administration late Monday authorized use of a drug that appears to protect infected people at high risk from getting very sick. The FDA issued an emergency use authorization to drug-maker Lilly for bamlanivimab, a monoclonal antibody that mimics the immune system’s response to infection with the virus that causes COVID-19. (Weise and Weintraub, (11/9)

Early results suggest the drug, called bamlanivimab, may help clear the coronavirus sooner and possibly cut hospitalizations in people with mild to moderate COVID-19. A study of it in hospitalized patients was stopped when independent monitors saw the drug did not seem to be helping in that situation. The government previously reached an agreement to buy and supply much of the early production of Lilly’s drug. Only one drug -- Gilead Sciences’ remdesivir -- has full FDA approval for treating COVID-19. Government treatment guidelines also back using dexamethasone and other steroids for certain severely ill, hospitalized patients. (Perrone, 11/10)

The drug, bamlanivimab, must be delivered by intravenous infusion early in the illness. It was authorized for use in patients with mild or moderate cases of the coronavirus who are at high risk of severe disease or hospitalization. Risk factors include being older than 65, diabetes, obesity with different body mass index cutoffs depending on age, a suppressed immune system, and cardiovascular disease or high blood pressure in people over age 55. (Johnson, 11/9)

The authorization, announced on Monday, applies only to people newly infected with the virus, and the agency said it should not be used in hospitalized patients. The treatment is approved for people 12 and older who have tested positive and are at risk for developing a severe form of Covid-19 or being hospitalized for the condition. That includes people who are over 65 and obese, the agency said — a key group that early studies have shown can benefit the most from the treatment. (11/10)

The U.S. reported more than 100,000 coronavirus cases for the seventh day in a row as the virus spread rapidly in many areas of the country and several states hit daily infection records. Nearly 120,000 new cases were reported nationwide for Monday, as the total number of confirmed cases topped 10.1 million, according to data compiled by Johns Hopkins University. (Hall, 11/10)

The seven-day average of newly reported cases has more than doubled since the end of September, while the seven-day average for new daily tests done in the U.S. climbed 31% in the same span, according to case data collected by Johns Hopkins University and testing estimates from the Covid Tracking Project. Meanwhile, the percentage of tests that come back positive continues to grow. And tens of millions of available tests are going unused, prompting the federal government to pause some distribution of rapid tests until states use the supplies that have already been sent. (Krouse, 11/10)

There were just over 59,000 COVID-19 patients in hospitals across the United States on Monday, the country’s highest number ever of in-patients being treated for the disease, with new infections at record levels for the sixth consecutive day. (Maan, 11/9)

The United States became the first country to surpass 10 million confirmed cases of COVID-19 on Monday, according to a count from The Washington Post, a grim milestone that comes as experts warn of a surge this fall and winter. The U.S. continues to have more cases than any other country, averaging more than 111,000 new cases per day. Nearly 133,000 new cases were reported on Friday, the highest number reported in a single day. (Hellmann and Bowden, 11/9)

After topping 100,000 new infections seven days in a row, the US has now surpassed a total of more than 10 million cases since the start of the pandemic -- far more than any other country. And that number will likely keep rapidly climbing, one expert told CNN. (Maxouris, 11/10)

Despite new measures aimed at curbing the spread of Covid-19 in El Paso, Texas, the community remains one of the hardest hit across the country, with soaring infections and hospitalizations that continue to climb. County Judge Ricardo Samaniego said the county has requested four more trailers in addition to the six mobile morgues already on the ground to handle a spike in deaths. (Maxouris, 11/10)

Coronavirus cases across Maryland and Virginia have spiked to record levels in recent days, part of a national trend of rapidly rising infection rates that shows no sign of slowing. Maryland reported more than 1,300 new cases Monday, a record sixth straight day with more than 1,000 new cases reported. At the same time, the state's seven-day positivity rate climbed above 5 percent, the highest it's been since June. (Weixel, 11/9)

President-elect Joe Biden gave clear signals on Monday that his administration will take a completely different approach to the coronavirus pandemic — warning that the United States would face a "very dark winter," unveiling a new Covid advisory group stacked with veteran public health experts, lowering expectations for a rapidly available vaccine and making an urgent plea for Americans to cover their faces and slow the soaring rate of infection. Flanked by a masked Vice President-elect Kamala Harris in Wilmington, Del., Biden made early reference to the "positive news" that drugmaker Pfizer had found its vaccine candidate to be more than 90 percent effective. But he said the shot, if approved, "will not be widely available for many months yet to come." (Miranda Ollstein and Forgey, 11/9)

Biden began with a direct appeal to all Americans to wear masks, a departure from Trump, who has mocked Biden and others who make a point of always wearing protective face coverings when around others. In an official move, the president-elect formed a coronavirus advisory board dominated by scientists and doctors, while Trump has had a falling out with the medical experts on his own virus task force. (Weissert, Marcelo and Madhani, 11/19)

Mr. Biden and Vice President-elect Kamala Harris received their first briefing Monday on the pandemic from the transition team’s newly announced Covid-19 advisory board, after a study showed the Pfizer vaccine to be more than 90% effective in the first 94 subjects who were infected by the new coronavirus and developed at least one symptom. Mr. Biden congratulated the scientists who had been working on the vaccine but said that mask wearing, social distancing and hand washing would be the best defense against the coronavirus until next year at the earliest. (Jamerson and Peterson, 11/9)

Coronavirus cases surged to a new record on Monday, with the United States now averaging 111,000 cases each day for the past week, a grim milestone amid rising hospitalizations and deaths that cast a shadow on positive news about the effectiveness of a potential vaccine. As the number of infected Americans passed 10 million and governors struggled to manage the pandemic, President-elect Joseph R. Biden Jr. tried on Monday to use his bully pulpit — the only tool at his disposal until he replaces President Trump in 72 days — to plead for Americans to set aside the bitterness of the 2020 election and wear a mask. (Shear, 11/9)

As of Jan. 20, 2021 — Inauguration Day — the federal government is about to get much more involved in health care and the COVID-19 pandemic response. Exactly how much more involved, now that Joe Biden is president-elect, depends on whether Republicans keep control of the Senate. And that likely won't be determined until early January, when Georgia's two Senate run-off races are held. Trump's nearly four years as president have been marked by a scaled-back federal investment and involvement in health care in a range of ways — giving states more authority to run their own health insurance markets, for example, and leaving them to come up with their own strategies for COVID-19 testing, contact tracing and more. (Simmons-Duffin, 11/9)

President-elect Joe Biden and Vice President-elect Kamala Harris' newly appointed Transition Covid-19 Advisory Board is led by established public health officials and staffed by a mix of doctors and current and former government officials, some with high-profile media visibility. The advisory board is co-chaired by former FDA Commissioner Dr. David Kessler, former Surgeon General Dr. Vivek Murthy and Dr. Marcella Nunez-Smith, Yale associate professor of medicine and epidemiology. (Levenson, 11/9)

Joe Biden wanted to raise taxes on wealthy estates. Mitch McConnell wanted to keep them low. The two longtime Washington politicians quickly discovered one point of agreement: the vote count. With former president George W. Bush’s tax cuts headed toward expiration in December 2010, McConnell phoned Biden and told him that Senate Republicans had enough votes to keep the lower estate tax. Biden respected McConnell’s math. They eventually struck an agreement that marked the first of several times McConnell and Biden would reach a bipartisan deal to avert a looming financial cliff during the Obama administration, forming what multiple lawmakers and aides described as a sincere, if professional, bond that may soon be the most important in national politics. (Stein and Sullivan, 11/9)

If public health officials want to get people to wear masks to curb the spread of Covid-19, they might take a lesson what is now a widely accepted aspect of American life: buckling up. Beginning in the 1950s, the effort to get people to adopt seat belts took legislation, enforcement, and public health campaigns. And, especially in its early days, it was met with misinformation and pushback, especially around personal freedom. (Silberner, 11/10)

Most states already have some type of mask mandate, but some have no statewide rule -- either leaving it as a recommendation or giving the authority to local officials. Here are the states with no statewide mask requirement. (Asmelash, McNabb and Watts, 11/9)

President-elect Joe Biden on Monday implored every American to put aside political differences and wear masks. "A mask is not a political statement, but it is a good way to start pulling the country together,"  Biden said during a somber address that acknowledged the COVID-19 crisis is likely to get worse before it gets better. (Weixel, 11/9)

Many people watched with relief as President-elect Joe Biden announced an aggressive plan on Monday to control the pandemic that is escalating at an alarming rate. The United States has now surpassed 10 million Covid-19 cases, according to Johns Hopkins University's tally. And coronavirus has already infected 50 million and killed over 1.25 million worldwide. (Hetter, 11/9)

President-elect Joe Biden on Monday lauded the news of Pfizer's progress on a COVID-19 vaccine but urged Americans to be cautious because widespread vaccination is still many months away. In a statement, Biden said Pfizer's announcement that interim data showed its vaccine was 90 percent effective was "excellent news" that gives Americans "cause for hope." (Weixel, 11/9)

President-elect Joe Biden on Monday said a coronavirus vaccine approval process must be guided by science so the public can have confidence it is safe and effective, warning that the United States is still facing a very dark winter and that a vaccine likely won’t be available for months. “I implore you, wear a mask. Do it for yourself. Do it for your neighbor. A mask is not a political statement,” Biden said, adding that he would spare no effort to turn the pandemic around once he is sworn in. (11/9)

Trade groups representing insurers and hospitals Saturday pledged to work President-elect Joe Biden and a new administration on combating the coronavirus pandemic and continuing to reshape the nation's healthcare system." There are many healthcare challenges that our nation must face together—from continuing to battle the COVID-19 crisis, to making healthcare and prescription drugs more affordable, to protecting patients from surprise medical bills, to ensuring stable coverage markets for those who need it most," Matt Eyles president and CEO of America's Health Insurance Plans, said in a statement. (Weinstock, 11/7)

A week after the 2020 election, Republican elected officials and the Trump administration are advancing their latest arguments to get rid of the Affordable Care Act, a long-held GOP goal that has repeatedly failed in Congress and the courts. In arguments scheduled for Tuesday, the Supreme Court will hear its third major fight over the 10-year-old law, popularly known as “Obamacare.” Republican attorneys general in 18 states and the administration want the whole law to be struck down, which would threaten coverage for more than 23 million people. (Sherman, 11/10)

When the Supreme Court weighs the fate of “Obamacare,” arguments will revolve around arcane points of law like severability — whether the justices can surgically snip out part of the law and leave the rest. But what’s at stake has real-world consequences for just about every American, as well as the health care industry, a major source of jobs and tax revenues. Whether the Affordable Care Act stays, goes, or is significantly changed, will affect the way life is lived in the U.S. (Alonso-Zaldivar, 11/10)

Court watchers say a number of outcomes are possible when a decision is handed down, likely in June. The most extreme scenario would involve conservative justices striking down the entire 2010 law, a result that doctors’ groups say would threaten to throw the nation’s health care system into chaos at a time when the country could still be in the grips of the coronavirus pandemic. (Kruzel, 11/9)

Oral arguments in California v. Texas will provide valuable insight into which issues the justices are interrogating most seriously, including the perspective of newly confirmed Justice Amy Coney Barrett. It's impossible to extrapolate how the court will decide based solely on the questioning, but legal experts say the intensity with which justices scrutinize each of the following issues will offer clues. All ears during the remotely held arguments will be on Chief Justice John Roberts, who sided with liberal justices to uphold the individual mandate as a tax in the 2012 case National Federation of Independent Business v. Sebelius, and the three new Trump appointees to the court since the last major ACA case was heard, especially Barrett and Justice Brett Kavanaugh. (Cohrs, 11/9)

KHN: Justices Bound To See ACA As ‘Indispensable,’ Says Californian Leading Defense 

When the U.S. Supreme Court hears a case Tuesday that could decide the fate of the Affordable Care Act, California will be leading the defense to uphold the federal law that touches nearly every aspect of the country’s health care system. It’s usually the federal government’s job to defend a federal law, but President Donald Trump’s administration wants this law, also known as Obamacare, to be overturned. (Young, 11/9)

President-elect Joe Biden is championing the Obama administration’s signature health law as it goes before the Supreme Court in a case that could overturn it. He will deliver a speech on the Affordable Care Act on Tuesday, the same day the high court will hear arguments on its merits. It ruled eight years ago to leave the essential components of the law known as Obamacare intact, but is now controlled 6-3 by a conservative majority after President Donald Trump’s appointment of Justice Amy Coney Barrett. (Weissert, 11/10)

The Massachusetts House, anticipating the possibility that a newly conservative Supreme Court could threaten abortion rights, plans to take up a measure this week that would remove barriers to abortion access, House Speaker Robert A. DeLeo said on Monday. Sought by reproductive rights activists for nearly two years, the proposal would allow an abortion after 24 weeks of gestation if the fetus is diagnosed with a fatal anomaly and is not expected to survive. It would also lower the age limit on abortion, requiring parental consent or a judicial order only for those younger than 16, the age of consent, rather than 18, as it stands under current law. (Ebbert, 11/9)

CMS on Monday wrapped up its long-awaited changes to how states can run their Medicaid and Children's Health Insurance Program plans. The final rule gives states more flexibility to set rates for their managed-care plans and ensure plans have adequate provider networks. The Trump administration hopes the changes will encourage private health plans within Medicaid and CHIP, slash regulations and cut federal exposure to healthcare costs. (Brady, 11/9)

The new rule loosens requirements imposed in 2016 on private Medicaid managed care plans that run the low-income health benefits at a monthly per-person cost to the state. Comprehensive managed care covers 70% of Medicaid enrollees, according to the most recent data from the Centers for Medicare & Medicaid Services. And nearly half of the program’s spending—$300 billion in 2019—goes to the managed care plans. (Brown, 11/9)

The North Carolina Department of Health and Human Services released a statement Friday, saying a new website has been launched where people can learn more about Medicaid Managed Care, which is scheduled to launch in 2021. The enrollment website provides information about who will have to choose a health plan, who will stay in the traditional Medicaid program (NC Medicaid Direct) and who can choose between the two. (11/6)

The Trump administration on Monday signed off Medicaid managed-care changes, but it could wrap up a few more loose ends before President-elect Joe Biden takes office in January. Here's a look at six of the top prospects. (Brady, 11/9)

Housing and Urban Development Secretary Ben Carson and David Bossie, an outside White House adviser, have both tested positive for Covid-19, becoming the latest figures in President Donald Trump's orbit to contract the virus. Bossie, a longtime Trump ally who was tapped to lead the effort to contest the presidential election, tested positive Sunday, according to a person familiar with the situation. Bossie did not immediately respond to a message seeking comment. (O'Donnell, 11/9)

At least three top Trump administration or campaign officials have tested positive for COVID-19 after attending an election night watch party in the White House East Room. ... Ben Carson, the secretary for housing and urban development, tested positive, a department spokesperson confirmed Monday, as did David Bossie, who was recently tasked with overseeing the campaign’s legal challenges contesting the election’s outcome. The event had been under scrutiny since another attendee, White House chief of staff Mark Meadows, contracted the virus, which has now killed more than 238,000 people in the U.S. alone. (Colvin, 11/10)

Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said Monday that he has no intention of leaving his current role." This is an important job. I've been doing it now for a very long time. I've been doing it under six presidents," Fauci told CNN's Wolf Blitzer. "It's an important job and my goal is to serve the American public no matter what the administration is." (Manfredi, 11/9)

A single shot given every two months has proved to be more effective than a daily pill at preventing H.I.V. in women, researchers reported on Monday, an advance that medical experts hailed as groundbreaking in the fight against the deadly virus that causes AIDS. The finding that the long-acting drug would prevent H.I.V. in six doses taken over a year instead of the 365 required for the prevention pill currently on the market was so convincing the researchers decided to end their clinical trial of the drug early. (Mandavilli, 11/9)

Researchers are stopping a study early after finding that a shot of an experimental medicine every two months worked better than daily pills to help keep women from catching HIV from an infected sex partner. The news is a boon for AIDS prevention efforts especially in Africa, where the study took place, and where women have few discreet ways of protecting themselves from infection. Results so far suggest that the drug, cabotegravir, was 89% more effective at preventing HIV infection than Truvada pills, although both reduce that risk. (Marchione, 11/9)

In a notable development for preventing HIV, an interim analysis found that an every-other-month injectable treatment was 89% more effective in preventing infection among women than the Truvada pill, which must be taken daily and is the current standard of care. (Silverman, 11/9)

Brazil’s health regulator Anvisa said Monday it has suspended clinical trials of China’s Sinovac coronavirus vaccine, long expected to be one of the first to be approved in the country, following a “severe adverse event.” Anvisa said late Monday that the event occurred on Oct. 29, without giving further information or an explanation of why it took more than a week to communicate the problem. (Pearson, 11/10)

A novel clinical trial that uses artificial intelligence to rapidly compare Covid-19 treatments has attracted participation from two major drug companies, a key milestone in the effort to shake up the way trials are conducted. Amgen and the Japanese pharmaceutical company Eisai will become the first pharma companies to test their experimental therapies in REMAP-CAP, an adaptive clinical trial that seeks to rapidly evaluate potential Covid-19 treatments in patients around the world. (Ross, 11/10)

Hydroxychloroquine provides no benefit for hospitalized COVID-19 patients, a study from the National Institutes of Health (NIH) has officially concluded. The report was published in the Journal of the American Medical Association on Monday, though the NIH stopped the study in June on the recommendation of an independent data monitoring board. The study found that while hydroxychloroquine did not cause any additional harm, it didn't help patients either. (Weixel, 11/9)

Six in 10 Americans said they are somewhat or very likely to get a Covid-19 vaccine if doing so would lower the risk of becoming infected by about half, according to a new survey from STAT and The Harris Poll. The poll also found that more Americans say they are likely to get a vaccine, practice social distancing, and wear a mask if they or someone they know has contracted Covid-19. (Silverman, 11/10)

A handful of Maine hospitals didn’t follow all federal rules meant to limit the coronavirus’ spread over the summer, with employees at some not wearing face coverings and eye protection, according to regulators who visited the hospitals between June and September. In other cases, inspectors found, hospitals weren’t fully screening workers and visitors for COVID-19 symptoms. (Eichacker, 11/7)

Four employees at Waldo County General Hospital in Belfast have tested positive for the coronavirus, making it the second Maine hospital in a week to record a COVID-19 outbreak among staff members. The outbreak there was one of a number of new outbreaks the Maine Center for Disease Control announced Friday, as cases have continued to surge in Maine with the state continuing to set records for new daily cases. The percentage of coronavirus tests in Maine coming back positive — a key indicator of how actively the virus is spreading — has also more than tripled in the past two weeks. News of the Belfast hospital’s outbreak comes a few weeks after Waldo County began grappling with an outbreak connected to the Brooks Pentecostal Church that’s grown to 60 cases. (Stone, 11/6)

North Dakota Gov. Doug Burgum said Monday that health care workers who have tested positive for COVID-19 but do not have symptoms should be allowed to stay on the job, part of an effort to ease the stress both on hospitals and medical personnel trying to keep up with skyrocketing cases. The governor said the Centers for Disease Control and Prevention has been allowing infected workers without symptoms to keep working as long as they take precautionary measures. The state is also looking to increase rapid testing of healthcare workers to “keep them in the game,” the governor said. (Kolpack, 11/10)

Dr. David Marcozzi, a top medical adviser to Maryland Gov. Larry Hogan on COVID-19, had rehearsed his remarks multiple times before standing in front of the cameras Thursday for a semiregular pandemic news conference at the State House in Annapolis. The 51-year-old emergency doctor has become something of a fixture in the media this year, and he knew his words mattered more during unsettling and isolating times. (Cohn, 11/9)

OhioHealth has launched an effort to improve healthcare access for their homeless population with a care model that is getting more attention from hospitals as they seek to mitigate some of the financial impact of the COVID-19 pandemic. The Columbus-based health system announced Monday the opening of the Medical Respite at Faith Mission, a 3,000 square foot, 16-bed facility that will be open 24 hours a day to provide homeless patients a place to continue their recovery for up to 45 days after they are discharged from an OhioHealth hospital. (Ross Johnson, 11/9)

KHN: ‘No Mercy’ Chapter 7: After A Rural Town Loses Hospital, Is A Health Clinic Enough?

Family physician Maxwell Self is doing his same old job for a new employer. For two decades he was a doctor with Mercy Hospital. But when Mercy packed up and left, a federally qualified health center moved to town — into the hospital building itself — and hired Dr. Self. The Community Health Center of Southeast Kansas does things differently. (Tribble, 11/10)

As Thanksgiving approaches, millions of Americans are weighing the risk of pandemic travel against the yearning to visit friends and family. But one group seems all but certain to be heading home in large numbers just in time for turkey and holiday gatherings: college students. Since the start of the fall semester, most universities have planned to end in-person classes before Thanksgiving and require students to finish the term remotely, partly to avoid an expected wave of cold-weather infections. That means that in a couple of weeks, hundreds of thousands of students will be streaming back to hometowns until the spring semester begins. (Hubler, 11/9)

There’s a variety of places offering coronavirus testing, including urgent care centers, travel clinics, fire stations, pop-up sites, most hospitals, pharmacies and a few airports. Lin Chen, a doctor and director of the Travel Medicine Center at Mount Auburn Hospital in Cambridge, Mass., says potential travelers should check in with their primary care provider, who may know the best options for testing in their area. Other options include looking at city and state health department websites for testing resources. (Compton, 11/9)

Brenda Phillips is accustomed to pain. The 69-year-old had five surgeries that fused some vertebrae in her back following degenerative disc disease. The last surgery she had in 2007, left the Moore county resident with residual damage that makes it difficult to sit, said her husband of 49 years, Noah Phillips. Lately, another urgent medical need cropped up: her teeth are in bad shape. (Engel-Smith, 11/10)

In the spring, Dr. Melissa Brackmann made difficult calls to her patients in Michigan, telling them they had to delay their cancer surgeries because of the rising COVID-19 cases in the state. Now, as Brackmann watches Utah’s coronavirus spike while working as a gynecologic oncologist in Salt Lake City, she’s encouraging her patients to schedule their surgeries as soon as possible. (Jacobs, 11/9)

Riley Kirkpatrick realized he was transgender when he was a teenager. Kirkpatrick, born and raised as a female, says he was always very masculine and was often described as a “tomboy.” It was around the time of his realization — at age 14 — that he began using drugs. (Laguaite, 11/9)

Older adults who break a bone face a serious yet potentially preventable risk of breaking another, often within the next two years. This is especially true for the more than 340,000 people 65 and older who break a hip and the nearly 700,000 who develop a spinal fracture each year. Unlike lightning, which almost never strikes the same place twice, “the person at highest risk of a fracture is the one who’s just had a fracture,” Dr. Ethel S. Siris, endocrinologist and director of the Toni Stabile Osteoporosis Center at the Columbia University Medical Center, told me. (Brody, 11/9)

At this point in 2020 — with a global pandemic, social unrest, natural disasters and a divisive election — we’ve heard plenty of advice about self-care. The need for such guidance probably peaked last week amid a crescendo of election anxiety, as much of the country agonized over the hotly contested presidential race between President Trump and former vice president Joe Biden. (Chiu, 11/9)

McDonald’s Corp. is making changes to its menu and restaurant operations as the coronavirus pandemic persists, including an emphasis on to-go orders and new “McPlant” vegetarian items. The burger company said Monday that it would test a slate of new plant-based products in some markets next year. McDonald’s ran a pilot program earlier this year in Canada to sell patties made by Beyond Meat Inc., a leader in the market to sell new plant-based products that closely mimic meat. (Haddon, 11/9)

Tom Izzo has been an advocate for wearing masks and social distancing, hoping to use his platform at Michigan State as a Basketball Hall of Fame coach to help slow the spread of COVID-19. Despite practicing what he preached, Izzo tested positive for the coronavirus on Monday. It was just the latest example of the challenges facing college basketball to have a season during the pandemic. (Lage, 11/9)

Who gets counted as a COVID-19 death has been questioned for months, with no formal definition in place nationwide as officials adapt to a new disease’s destructive impact. Conspiracy theories have swirled around the idea that coronavirus mortality totals are being inflated. Now, Nevada has released an official definition of what it considers a confirmed COVID-19 death. (Scott Davidson, 11/9)

New Jersey will require restaurants to stop indoor dining by 10 p.m. and will prohibit all indoor, interstate organized sports up to the high school level in an effort to slow the resurgence of Covid-19, Gov. Phil Murphy announced Monday. The new rules take effect Thursday morning, the governor said during his regular coronavirus briefing in Trenton. (Landergan and Sitrin, 11/9)

As the most severe surge in coronavirus cases yet rages across the country and region, New Jersey on Monday imposed new restrictions on indoor dining and sports, Philadelphia urged people who were in postelection crowds to quarantine, and Pennsylvania Health Secretary Rachel Levine said the new wave’s peak has not been reached. At the pandemic’s eight-month mark, Pennsylvania is in the midst of a streak of about 3,000 cases a day, and New Jersey more than 2,000 a day. (McDaniel, Steele and McCarthy, 11/10)

The Episcopal Diocese of Maryland announced Monday that it is suspending all indoor services for at least two weeks and issued new guidance for baptisms and weddings due to the recent surge in coronavirus cases across the state. All indoor worship is suspended until at least Nov. 28, the diocese said, and a decision to resume will be made no later than Nov. 23. (Oxenden, 11/9)

A man convicted of participating in a 1981 murder in Davenport has died from COVID-19 and other health conditions, Iowa prison officials said. David Streets, 70, died Sunday at the University of Iowa Hospitals and Clinics, the Iowa Department of Corrections reported. He was sentenced to life in prison for first-degree murder and kidnapping in the Feb. 8, 1981, death of Mark Webb at Webb’s apartment in Davenport, The Quad City Times reported. He had recently been serving his sentence at the Anamosa State Penitentiary. (11/19)

South Dakota has reported its first case of a prison inmate dying due to complications from COVID-19, according to Department of Corrections data posted Monday. The daily update showed that the inmate was being housed at the Mike Durfee State Prison in Springfield. The report did not say how old the person was or when that person died. (11/10)

State Health Commissioner Lance Frye said health officials and Gov. Kevin Stitt are looking at many options to help stop the spread of COVID-19 and “nothing is off the table” in regard to actions that could be taken to slow transmission. But when asked if he had recommended a mask mandate to Stitt as an option, Frye said he didn’t believe a mandate would be a viable option. (Kemp, 11/10)

At its heart, the emergency order Gov. Gary Herbert issued Sunday night in an effort to turn back Utah’s surge in COVID-19 cases comes down to one rule: If possible, stay home. ...Here are some answers to some commonly asked questions about Herbert’s order. (Means, 11/9)

The Midwestern states are facing an onslaught of coronavirus cases. Minnesota Gov. Tim Walz plans to announce new COVID-19 restrictions Tuesday amid a surge in statewide infections, possibly including stricter rules for bars and restaurants. The governor will also convene a special legislative session Thursday to extend his COVID-19 peacetime emergency powers by another 30 days to help fight the spread of the coronavirus. (Flores, 11/10)

KHN: Orange County Struggles With Health Equity — And Battles State Restrictions 

California’s most popular amusement park has become the focal point of a struggle over how best to contain COVID-19 while keeping the economy afloat. California’s Democratic leaders have tied the fate of Disneyland — “the Happiest Place on Earth” — to the health of the people who live around it, who have been hit hard by the virus. But conservative Orange County officials want to ease restrictions to allow for the reopening of the lucrative tourist attraction, saying the economic health of all residents depends on it. (Almendrala, 11/10)

Anchorage elementary schools won’t open next week as previously planned, primarily because local hospitals are struggling with staffing issues amid high COVID-19 numbers in the community, the school district’s superintendent said Monday. Superintendent Deena Bishop announced the postponement Sunday night, a decision she called “heartbreaking.” When evaluating the risks of opening in-person schools, the district considers multiple factors, including the number of occupied hospital beds and the number of occupied ICU beds, Bishop said in an interview. (Goodykoontz, 11/10)

There are about 10,000 people in the state who identify as Pacific Islander or Native Hawaiian, most of whom reside in Anchorage. They are nearly 30 times more likely to be hospitalized and 12 times more likely to die from COVID-19 as Alaska’s white population, according to state data. William Tauanuu, known by many as “Pastor Willie,” has experienced it first hand. He started to hear about high rates in the community in midsummer, particularly after a well-attended wedding that left dozens infected, he said. (Treinen, 11/8)

Eight months into the COVID-19 pandemic in Alaska, social service providers say they’re seeing rising demand from people who need help with life’s most basic needs, including food, rent and utilities. The growing calls for help come as once-ample government aid funneled directly to individuals has run dry or been delayed, the providers say. In addition, COVID-19 cases are on the rise, and the lack of in-person classes for children has forced thousands of parents to stay home. (DeMarban, 11/8)

Ukrainian President Volodymyr Zelenskiy announced Monday that he has tested positive for the coronavirus and will be working in self-isolation while being treated. “There are no lucky people in the world for whom COVID-19 does not pose a threat,” Zelenskiy tweeted. “However, I feel good. I promise to isolate myself and I continue to work.” (11/9)

The Danish government has dropped an attempt to pass emergency legislation allowing it to cull all mink in the country. Last Wednesday the Danish prime minister, Mette Frederiksen, said all the country’s mink would be culled due to fears that a Covid-19 mutation moving from mink to humans could jeopardise future vaccines. But opposition to the move swiftly emerged. “Massive doubts over whether this cull is properly scientifically based [have] come to light now,” said Jakob Ellemann-Jensen, the leader of Denmark’s largest opposition party, Venstre. “At the same time the government is taking away the livelihood of a large number of people without actually having the legal rights to do so.” (Kevany and Carstensen, 11/9)

Mink farms pose a serious threat to human health in the age of Covid, and will continue to do so even if individual mink mutations of the virus are fought back, according to Kare Molbak, Denmark’s top epidemiologist. The arrival of Covid-19 in the Nordic country was a clear “game changer” for its mink farmers, Molbak told newspaper Politiken in an interview published on Tuesday. Maintaining the industry now “represents far too high a national health risk,” he said. (Buttler, 11/10)

The decision this week by the Danish government to kill millions of mink because of coronavirus concerns, effectively wiping out a major national industry, has put the spotlight on simmering worries among scientists and conservationists about the vulnerability of animals to the pandemic virus, and what infections among animals could mean for humans. (Gorman, 11/8)

It's the moment for which advocates of legal marijuana here have been waiting: Mexican lawmakers, working under a court order, have until mid-December to finalize rules that will make the country the world's largest market for legal pot. Advocates have long argued that legalization would put a dent in the black market; allow for safe, regulated consumption; create jobs; and cut down on crime. (Lang, 11/8)

Every election brings with it debates over health care. Amanda Aronczyk, with our Planet Money podcast, noticed that the word Canada keeps coming up again and again in those debates and how the Canadian system would supposedly never work here. As a Canadian living in the U.S., to Amanda, that was confusing. So she went digging. (Aronczyk, 11/6)

KHN: Trump’s Anti-Abortion Zeal Shook Fragile Health Systems Around The World 

In Ethiopia, health clinics for teenagers once supported by U.S. foreign aid closed down. In Kenya, a decades-long effort to integrate HIV testing and family planning unraveled. And in Nepal, intrepid government workers who once traversed the Himalayas to spread information about reproductive health were halted. Around the world, countries that depend on U.S. foreign aid have scrapped or scaled back ambitious public health projects, refashioning their health systems over the past four years to comport with President Donald Trump’s sweeping anti-abortion restrictions that went further than any Republican president before him. (Varney, 11/10)

On Tuesday, the Supreme Court will hear the latest constitutional challenge to the Affordable Care Act, and the stakes are enormously high. Twenty-one million people currently get their healthcare coverage through the Affordable Care Act, and declaring it unconstitutional in the midst of a pandemic would be devastating to both those covered and the healthcare system. Fortunately, the legal arguments against the law are weak, and if the justices follow the law the act should survive once again. (Erwin Chemerinsky, 11/9)

Today, the newly constituted Supreme Court will hear a challenge to the Affordable Care Act — the seventh in eight years. It is the most challenged statute in modern American history. In addition to the Supreme Court cases, there have been more than 1,700 cases in the lower courts; Republicans in Congress have tried more than 70 times to repeal it; the Trump administration has engaged in an unprecedented array of executive actions to undermine the insurance markets and financially starve the law; red states rebelled against it from the day it was passed; and state initiatives have been enacted by supporters to force states to effectuate it. (Abbe R. Gluck, 11/10)

The ultimate fate of the 2010 Affordable Care Act has been catapulted back into uncertainty, with Supreme Court arguments scheduled for Tuesday. While most of the attention has revolved around the potential impact on preexisting condition protections, there is far more at stake. Indeed, invalidation of the ACA will take important benefits away from Americans regardless of whether they have private insurance, Medicare, or Medicaid. The rationale behind the Supreme Court challenge is best summarized by late Justice Antonin Scalia’s conjecture during oral arguments, in 2012, that “if you take the heart out of the statute, the statute’s gone.” (Ezekiel Emanuel, Andrea M. Cooke, and Connor Boyle, 11/9)

The Supreme Court on Tuesday will hear the Republican Party’s latest attempt to kill the Affordable Care Act, potentially yanking health care coverage from tens of millions of Americans. Many legal analysts believe the lawsuit will fail, despite the court’s new 6-3 conservative majority, because its legal arguments are dubious. Still, that ending Obamacare is even on the table during a pandemic illustrates the challenges facing President-elect Joe Biden. He should start immediately trying to convince Senate Republicans that it’s in their political interest to abandon their campaign of destruction and instead help strengthen the Affordable Care Act. (11/9)

On Tuesday, the Supreme Court will hear California v. Texas, the latest challenge to the Affordable Care Act. Both liberal and conservative legal commentators agree that there is virtually no chance the Supreme Court will strike down the entire ACA because the individual mandate is severable from the rest of the statute. But this doesn’t mean the case is inconsequential. On the contrary, a ruling that the individual mandate is unconstitutional will establish all-too-necessary constraints on Congress’s taxing power and give force to the Framer’s design of the federal government of limited and enumerated powers. (Erin Hawley, 11/9)

On Monday, Pfizer and BioNTech announced that their experimental Covid-19 vaccine candidate prevented more than 90% of infections in healthy volunteers. Based on these encouraging data — potentially among the most effective for any infectious disease — the companies plan to apply for emergency use authorization, which would let the Food and Drug Administration formally authorize an unapproved medical product during a state of emergency. While well-intentioned, this approach is ultimately misguided. The world faces a crisis not an emergency. (Matthew W. McCarthy, David Oshinsky and Arthur Caplan on behalf of the Vaccine Working Group on Ethics and Policy, 11/9)

As acute and infectious disease neurologists, we are often asked if a vaccine is safe. Pfizer’s announcement Monday that its Covid-19 vaccine is 90% effective makes the question even more pertinent. Earlier this year, two late-stage clinical trials, from Johnson & Johnson and AstraZeneca, were briefly paused after reports of neurological concerns in individual study participants. Each of these rare instances was carefully scrutinized as an adverse event—a serious clinical observation that requires review by the Data and Safety Monitoring Board. (Kevin N. Sheth and Serena Spudich, 11/9)

Before the onset of the coronavirus pandemic, leading organizations in clinical research had been gradually discovering, experimenting with, and implementing remote technology. The pandemic has catapulted their transformation agendas forward. (Andrea Bastek, 11/10)

On Monday, a still-divided America received some pandemic news that just about everyone can be happy about: An experimental COVID-19 vaccine developed by drug manufacturer Pfizer and BioNTech, a German pharmaceutical company, is just weeks away from filing for federal approval to start producing millions of doses. What’s more, preliminary data show this vaccine is a whopping 90% effective in protecting against a COVID-19 infection without causing serious side effects. Health officials would have been pleased with a COVID vaccine that protected 70% of the people who took it. The Food and Drug Administration requires only a 50% efficacy rate. (11/10)

Last week I wrote that based on clinical trial math, the earliest looks at coronavirus vaccine data were less likely to succeed. I've never been happier to be wrong. Pfizer Inc. and BioNTech SE announced Monday that their vaccine candidate prevented over 90% of Covid-19 cases in an early look at results from their 44,000-person clinical trial.It's fantastic news and a historic scientific accomplishment. Not only do we have the first effective vaccine, but the data also looks robust. Instead of evaluating the shot at the first possible moment, Pfizer waited for more data, which gives weight to the impressive results. (Max Nisen, 11/9)

The announcement that Pfizer’s coronavirus vaccine is more than 90 percent effective at preventing Covid-19 infections — much better than many anticipated — is cause for celebration. With a vaccine of this efficacy, suppression of the disease is entirely realistic. Unfortunately, this development doesn’t mean we can all relax and start doing more things. It means we need to tighten up even further until the vaccine becomes available. (Aaron E. Carroll and Nicholas Bagley, 11/10)

Prepare for many more ups and downs, but the announcement from Pfizer and its partner BioNTech of Germany is a genuinely promising moment in the difficult battle against the coronavirus pandemic. No one has ever won regulatory approval for an effective vaccine that uses messenger RNA (mRNA) to stimulate an immune response. Now, the pharma companies say their experimental vaccine is more than 90 percent effective at preventing covid-19. (11/9)

On Monday morning, pharmaceutical giant Pfizer announced that its new covid-19 vaccine was proving 90 percent effective in trials. This was spectacularly good news, if it holds up, far exceeding the expectations of many epidemiologists and sending the stock market soaring. But almost immediately, this development — like everything else that seems to happen in modern America — became subsumed in a political fight. (Max Boot, 11/9)

The latest surge of Covid-19 infections in the US could not be occurring at a worse time -- not just because the winter and influenza seasons are approaching or because the entire country is already worn down by the pandemic, but rather because we have entered into the lame-duck period between Election Day and the inauguration of President-elect Joe Biden on January 20, 2021. This interval is a non-trivial 5% of the entire Donald Trump presidency. (Kent Sepkowitz, 11/9)

As COVID-19 cases caused by the novel coronavirus, SARS-CoV-2, continue to surge, U.S. drugmaker Pfizer announced early results indicating that its vaccine is more than 90 percent effective. The announcement represents a major milestone toward controlling the COVID-19 pandemic. However, these are interim results and continued patience and vigilance are required to see a safe and efficacious vaccine to the finish line. There are currently ten other COVID-19 vaccines in late-stage trials. (Felicia Goodrum Sterling and James Alwine, 11/9)

“Look me in the eyes,” the doctor ordered, staring at me from behind her plastic face guard. Her eyes were blue, almost as blue as her hospital mask. Yet, after a moment, I started to turn and face the doctor on my left, who was jabbing a long needle deep into the muscle of my upper arm. “No!” the first doctor snapped. “Look at me!” Then she explained. Because I was part of a double-blind clinical trial of an experimental covid-19 vaccine, they had to make sure that I didn’t get any clues about whether I was being injected with a real dose or merely a placebo made of saline solution. (Walter Isaacson, 11/9)

Monday’s very favorable news from Pfizer Inc. – that its Covid-19 vaccine candidate was found to be more than 90% effective at preventing disease in early clinical-trial results – raises hopes for a day, and soon, when the pandemic is behind us. It is also just one of the many vaccines that are under development. With such good news, it may be tempting for Congress to conclude that a major fiscal relief effort is no longer needed. That would be a mistake. (Mohamed A. El-Erian, 11/9)

This issue of JAMA contains yet another study, and certainly among the best published to date, demonstrating the lack of efficacy of hydroxychloroquine as a treatment of coronavirus disease 2019 (COVID-19). This study, from the National Heart, Lung, and Blood Institute PETAL Clinical Trials Network, focused on hospitalized patients with moderate to severe disease. In this well-conducted, appropriately powered clinical trial, the authors randomized 479 patients to receive hydroxychloroquine (400 mg twice daily for 2 doses, then 200 mg twice daily for 8 doses) (n = 242) or placebo (n = 237). The trial was stopped early at the fourth interim analysis for futility. For the primary outcome, clinical status at 14 days measured on a 7-category ordinal scale, there was no significant difference between the hydroxychloroquine and placebo groups (median [interquartile range {IQR}] score, 6 [4-7] vs 6 [4-7]; adjusted odds ratio, 1.02 [95% CI, 0.73-1.42]). (Michael S. Saag, 11/9)