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President-elect Joseph R. Biden Jr. arrived in the nation’s capital on Tuesday for the first time since his election, and on the eve of his inauguration, he did what his predecessor declined to do by leading a national mourning for Americans killed by the coronavirus. In a somber sundown ceremony at the Lincoln Memorial in a city virtually occupied by troops on guard against political violence, Mr. Biden paid tribute to the victims of the pandemic on the same day that the death toll in the United States topped a staggering 400,000 — and almost a year to the day from the first report of the virus appearing in the country. (Baker, 1/19)

The ceremony was meant as a demarcation between Biden's presidency and the tenure of Trump, who has mostly ignored the swiftly rising coronavirus caseloads and death toll for months, after insisting during the campaign that the virus would soon disappear. Biden and Harris have cited tackling the virus — by persuading more Americans to use preventive measures and by vaccinating millions vulnerable to it — and the parallel economic collapse as their top priorities when their administration takes power Wednesday. (Viser and Linskey, 1/19)

As he spoke, 400 electric lamps lining the sides of the memorial’s Reflecting Pool were illuminated to honor the lives lost, followed by gospel star Yolanda Adams’ performance of the song “Hallelujah,” then a moment of silence. (Heavey and Hunnicutt, 1/19)

After his remarks, Biden settled at Blair House, across from the White House, where presidents-elect traditionally spend the night before their inaugurations. Biden’s appearance at the Lincoln Memorial was his second public appearance of an emotional day. He started tearing up on Tuesday afternoon as he left Delaware on his final trip to Washington before he is sworn in as the 46th president of the United States. “I know these are dark times, but there’s always light,” Biden said in his home state. (Niedzwiadek and Choi, 1/19)

President-elect Joe Biden plans to take his first steps Wednesday to demonstrate a new strategy to fight the coronavirus, signing executive orders to require masks on federal property, renew emphasis on biodefense and reengage with other nations trying to conquer the global health crisis. These orders, which advisers say Biden will sign from the Oval Office in the afternoon after his swearing-in, follow through on commitments he made either during his campaign or after he won the November election. (Goldstein and Stanley-Becker, 1/20)

In his first hours as president, Joe Biden will aim to strike at the heart of President Donald Trump’s policy legacy, signing a series of executive actions that reverse his predecessor’s orders on immigration, climate change and handling of the pandemic. Biden on Wednesday will end construction on Trump’s border wall, end the ban on travel from some Muslim-majority countries, rejoin the Paris Climate Accord and the World Health Organization, and revoke the approval of the Keystone XL oil pipeline, aides said Tuesday. The new president will sign the orders almost immediately after taking the oath of office at the Capitol, pivoting quickly from his pared-down inauguration ceremony to enacting his agenda. (Miller, 1/20)

Joe Biden swears the oath of office at noon Wednesday to become the 46th president of the United States, taking the helm of a deeply divided nation and inheriting a confluence of crises arguably greater than any faced by his predecessors. The very ceremony in which presidential power is transferred, a hallowed American democratic tradition, will serve as a jarring reminder of the challenges Biden faces: The inauguration unfolds at a U.S. Capitol battered by an insurrectionist siege just two weeks ago, encircled by security forces evocative of those in a war zone, and devoid of crowds because of the threat of the coronavirus pandemic. (Lemire, 1/20)

Stop. Stabilize. Then move — but in a vastly different direction. President-elect Joe Biden is pledging a new path for the nation after Donald Trump’s four years in office. That starts with confronting a pandemic that has killed 400,000 Americans and extends to sweeping plans on health care, education, immigration and more. The 78-year-old Democrat has pledged immediate executive actions that would reverse Trump’s decision to withdraw the U.S. from the Paris climate agreement and rescind the outgoing president’s ban on immigration from certain Muslim nations. (Barrow, 1/20)

No president wants a federal emergency. No one in that role is waiting to call in FEMA reservists or deploy the National Guard. But on Wednesday, after Joe Biden raises his right hand and swears his oath to preserve, protect, and defend the U.S. Constitution, that’s exactly the plan. Their mission: to set up a slew of new vaccination clinics. (Florko, Facher, Cohrs, Joseph and Ross, 1/20)

KHN: Biden’s Covid Challenge: 100 Million Vaccinations In The First 100 Days. It Won’t Be Easy. 

It’s in the nature of presidential candidates and new presidents to promise big things. Just months after his 1961 inauguration, President John F. Kennedy vowed to send a man to the moon by the end of the decade. That pledge was kept, but many others haven’t been, such as candidate Bill Clinton’s promise to provide universal health care and presidential hopeful George H.W. Bush’s guarantee of no new taxes. Now, during a once-in-a-century pandemic, incoming President Joe Biden has promised to provide 100 million covid-19 vaccinations in his first 100 days in office. (Knight, 1/20)

The incoming Biden administration is planning on enforcing far stricter guidelines to protect against the spread of COVID-19 in the White House than its predecessor, according to new guidance sent to staffers Tuesday. The guidelines, reported by Axios, say that staffers will be required to take daily coronavirus tests and wear N95 face masks at all times. (Axelrod, 1/19)

Senate Democrats called on President-elect Joe Biden Tuesday to immediately invoke the Defense Production Act (DPA) to boost production and stockpiling of testing supplies, personal protective equipment (PPE) and medical equipment. Twenty-six senators, led by Sens. Tammy Baldwin (D-Wisc.) and Chris Murphy (D-Conn.), wrote a letter to Biden asking him to fully utilize the DPA just one day before he is sworn into office. (Gangitano, 1/19)

President-elect Joe Biden is slated to issue numerous executive orders on his first day in office aimed at improving the U.S. response to the coronavirus pandemic, including one that will have the country resume its membership in the World Health Organization (WHO). “[Today] starts a new day, a new different approach to managing the country's response to the coronavirus crisis,” said Jeff Zients, coordinator of Biden’s COVID-19 response, in a press call with reporters. (Hellmann, 1/20)

Secretary of State designee Antony Blinken said President-elect Joe Biden intends to join Covax, the World Health Organization-led effort to develop and distribute a coronavirus vaccine to low- and middle-income countries. Biden previously had not officially committed to participating in the initiative. (Weixel, 1/19)

In 2019, Melvine Ouyo, a health policy expert and reproductive rights activist, attended a conference in her city of Nairobi, where antiabortion campaigners were protesting the event. Shortly after that, Ouyo said, she met a pregnant 14-year old girl who had no information about how she could access a safe abortion if she chose. Ouyo said she believes that if the Trump administration’s “global gag rule” — a U.S. foreign aid policy that restricts funding for abortion-related services — had not been in place, the campaigners wouldn’t have had such a prominent platform, and the girl would have had more information about her reproductive health options. (Jamal, 1/19)

In his first official acts as president, Joe Biden is signing executives orders on a broad range of issues, from the coronavirus pandemic to climate change and immigration, to fulfill campaign promises. Highlights of actions Biden is taking Wednesday. (1/20)

Dr. Rachel Levine, who has helped to lead Pennsylvania through an opioid crisis and now the COVID-19 pandemic, was picked Tuesday by President-elect Joe Biden to be his assistant secretary of health, putting her on track to be the first openly transgender federal official to be confirmed by the U.S. Senate. ... Vice President-elect Kamala Harris in a statement described Levine as "a remarkable public servant with the knowledge and experience to help us contain this pandemic, and protect and improve the health and well-being of the American people." (Woodall, 1/19)

“Dr. Rachel Levine will bring the steady leadership and essential expertise we need to get people through this pandemic — no matter their zip code, race, religion, sexual orientation, gender identity, or disability — and meet the public health needs of our country in this critical moment and beyond,” Biden said in a statement. “She is a historic and deeply qualified choice to help lead our administration’s health efforts.” A graduate of Harvard and of Tulane Medical School, Levine is president of the Association of State and Territorial Health Officials. She’s written in the past on the opioid crisis, medical marijuana, adolescent medicine, eating disorders and LGBTQ medicine. (Weissert, 1/19)

In an interview with NPR last month, Levine said the federal government must help states conduct effective vaccine programs to clamp down on the rapid spread of the coronavirus. She also said that despite the promise of COVID-19 vaccines, they do not offer a "quick fix." "It will be essential for the federal government to provide more funding to the states, territories and cities that will be tasked with administering the vaccine," Levine said. She added later, "I think that it really shows that we all have to work together and stand united to stop the spread of this virus." (Chappell, 1/19)

As of Monday, just over 31 million coronavirus vaccine doses had been delivered nationwide. Fewer than half of those have been administered. This despite months of promises from Trump officials that the United States would distribute no fewer than 40 million coronavirus vaccine doses and administer doses to 20 million Americans by the end of December. The Trump administration did not even deliver 20 million vaccine doses until Jan. 7. (Rieger, 1/19)

Donald Trump will walk out of the White House and board Marine One for the last time as president Wednesday morning, leaving behind a legacy of chaos and tumult and a nation bitterly divided. Four years after standing on stage at his own inauguration and painting a dire picture of “American carnage,” Trump departs the office twice impeached, with millions more out of work and 400,000 dead from the coronavirus. Republicans under his watch lost the presidency and both chambers of Congress. He will be forever remembered for the final major act of his presidency: inciting an insurrection at the Capitol that left five dead, including a Capitol Police officer, and horrified the nation. (Colvin, 1/20)

KHN: On Trump’s Last Full Day, Nation Records 400,000 Covid Deaths 

While millions wait for a lifesaving shot, the U.S. death count from covid-19 continues to soar upward with horrifying speed. On Tuesday, the last full day of Donald Trump’s presidency, the death toll reached 400,000 — a once-unthinkable number. More than 100,000 Americans have perished in the pandemic in just the past five weeks. In the U.S., someone now dies of covid every 26 seconds. And the disease is claiming more American lives each week than any other condition, ahead of heart disease and cancer, according to the Institute for Health Metrics and Evaluation at the University of Washington. (Stone, 1/19)

As President Donald Trump entered the final year of his term last January, the U.S. recorded its first confirmed case of COVID-19. Not to worry, Trump insisted, his administration had the virus “totally under control.” Now, in his final hours in office, after a year of presidential denials of reality and responsibility, the pandemic’s U.S. death toll has eclipsed 400,000. And the loss of lives is accelerating. “This is just one step on an ominous path of fatalities,” said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University and one of many public health experts who contend the Trump administration’s handling of the crisis led to thousands of avoidable deaths. (Geller and Har, 1/20)

On his last day in office, President Donald Trump issued commendations to a number people for their contributions to Operation Warp Speed, a White House effort to distribute 300 million doses of a viable COVID-19 vaccine by January 2021, which by Jan. 19 had not been met. A few names on the list of commendations stood out, particularly Dr. Anthony Fauci and Dr. Deborah Birx, both of whom were key members of the White House coronavirus task force in its early days, before having their public-facing roles diminished when the task force ceased providing regular briefings. (Park, 1/19)

Covid-19 has now killed more than 400,000 Americans. The country reached that devastating milestone Tuesday, the eve of the first anniversary of the first confirmed U.S. case and the final full day of Donald Trump’s presidency, which historians say will be defined by his bungling of the public health crisis. ... Trump awarded presidential commendations on Tuesday to officials involved in Operation Warp Speed, which is overseeing vaccine distribution. Recipients included Health and Human Services Secretary Alex Azar, National Institute of Allergy and Infectious Diseases director Anthony S. Fauci and the president’s son-in-law Jared Kushner. (Thebault and Beachum, 1/19)

The Health and Human Services Department has agreed to an industry-backed plan to effectively strip the FDA of oversight of certain genetically modified animals — the latest instance of Trump political appointees overriding the agency's scientists. The deal announced Tuesday would shift regulatory authority to the USDA for reviewing the safety of animals produced for food using gene editing. The FDA would maintain oversight of a certain slice of gene edited products not related to agriculture, such as biopharma and gene therapies. The agency would also act in a “consultation” role as USDA develops and carries out its own regulations, per the agreement. (Cancryn and Crampton, 1/19)

The U.S. Surgeon General on Tuesday released its first ever report that attempts to make the business case for why companies should invest in improving community health. In a call with reporters, U.S. Surgeon General Dr. Jerome Adams said the report is intended to provide guidance for business leaders on how they can work with and invest in communities to address their health challenges. But he felt it could also help raise more awareness about the economic benefits for businesses that make health a factor in their policies and decisions. (Ross Johnson, 1/19)

Just before her father was impeached for the second time Wednesday, Ivanka Trump was on a Zoom call with Christian leaders to promote government food aid. It was her first known public event since a violent mob overtook the U.S. Capitol a week earlier, but the first daughter and top adviser to President Donald Trump steered clear of the insurrection and impeachment. Instead, she talked about the power of distributing boxes with fresh food to people in need during the coronavirus pandemic — and got showered with praise from religious leaders. (Bottemiller Evich and Rodriguez, 1/19)

The coronavirus pandemic revealed a “clash of cultures” between the White House pressing for faster progress on vaccines and treatments and the Food and Drug Administration’s efforts to stick to the science, outgoing Commissioner Stephen Hahn told POLITICO. “I heard loud and clear from the White House — President Trump and others — that they wanted FDA to move faster,” Hahn said in an interview Tuesday, less than 24 hours before President-elect Joe Biden is scheduled to take office. (Owermohle, 1/19)

The head of the Food and Drug Administration (FDA) said he was "disgusted" and considered resigning after rioters overtook the U.S. Capitol on Jan. 6 in an attempt to stop Congress from certifying President-elect Joe Biden's election victory. In an interview with Bloomberg News published Tuesday, Stephen Hahn said he was "horrified" by the mob attack, and that "making a statement with a resignation" was among the responses he considered in the following days. Several top Trump administration officials, such as Transportation Secretary Elaine Chao, resigned in protest after the deadly riot. ... "We have a lot of things going on that are important from a public health point of view that required my attention and the senior leadership's attention. Making a statement with a resignation certainly was a topic of consideration," he added. "I think our public health mission and the need to provide leadership during a very critical time was more important." (Bowden, 1/19)

The coronavirus vaccine developed by Pfizer-BioNTech is likely to be just as effective against a highly transmissible mutant strain of the virus that was first discovered in the U.K., according to a study by the two companies. The variant, known as B.1.1.7., was estimated to have first emerged in the U.K. in September 2020. It has an unusually high number of mutations and is associated with more efficient and rapid transmission. (Meredith, 1/20)

The paper from company scientists, which has not yet been peer-reviewed, is a welcome signal that existing vaccines don’t seem to be weakened by the variant in question, dubbed B.1.1.7. Already, scientists had tested the Pfizer vaccine against one of the key mutations in the variant and found the immunization’s neutralization power was not affected. (Joseph, 1/20)

A new study suggests someone might be able to get infected with one of the new variants of the coronavirus even if they've had Covid-19 before or have been vaccinated. The variant was first spotted in South Africa in October and has now been found in more than a dozen countries. (Cohen, 1/19)

The currently deployed vaccines have proven to be so effective in clinical trials, the new variants likely won’t make them completely ineffective, Dr. Rochelle Walensky, President-elect Joe Biden’s pick to lead the CDC, told the JAMA Network. Both vaccines from Pfizer and Moderna have shown to be roughly 95% effective in preventing Covid-19 in large clinical trials. However, the new strains might cause a dip in how well the vaccines perform outside of those trials. (Higgins-Dunn, 1/19)

“We’re really in a race now,” said Dr. Charles Chiu, the UCSF virologist who identified the L452R variant that’s blown up in parts of the Bay Area over the past month. “This only increases our urgency to mass vaccinate the population before additional variants evolve and emerge.” One worrisome aspect: The more the coronavirus is circulating in the community, the more chances it has to mutate and develop into new variants. And there has never been more virus in California and the United States than now — and many other countries are also struggling to contain it, creating more risk in an interconnected world. (Allday, 1/19)

A small biotechnology firm said that it will start human testing of an experimental Covid-19 vaccine it hopes can target potential strains of the SARS-CoV-2 virus that could evade current vaccines — if such strains ever exist and become a problem. (Herper, 1/19)

For years, Twitter has been biotech’s social media app of choice. But the industry appears to be breaking into a newer, more exclusive social media app: Clubhouse. The app, which is only available for iPhones, lets people join conversations — think of a call-in radio show or a multiway phone call. (Sheridan, 1/20)

At least four new variants of the coronavirus are keeping scientists awake at night. One, first identified in southeast England, has now shown up in at least 50 countries and appears to be spreading more efficiently than older variations of the virus. Its appearance has frightened political leaders, who have closed borders and imposed travel restrictions in attempts to curb its spread. Others, identified in South Africa and Brazil, haven't traveled as far and wide but show a constellation of mutations that have grabbed the attention of geneticists. (Fox, 1/19)

By now, you have likely heard about different variants that first raised trouble in the United Kingdom, South Africa, Brazil, and now maybe California — though the jury is very much out on whether that last one is cause for concern. To make a messy alphabet soup even more jumbled, these variants have unwieldy names, and they each contain mutations with unwieldy names of their own. The result is that people are left trying to differentiate among B.1.1.7 and N501Y and E484K and C-3PO. Wait, sorry, that last one is from “Star Wars.” The point is that all of this is difficult to keep track of, and it will only grow more confusing with more variants likely to turn up. “It’s becoming a mutation-of-the-week game,” said Stephen Goldstein, a coronavirologist at the University of Utah. (Joseph, 1/19)

New research suggests viral genome sequencing of wastewater can be used to identify new COVID-19 variants before they're picked up via other screening methods. In Britain, scientists have been regularly sequencing the DNA of hundreds of COVID-19 samples on a weekly basis. ... Elsewhere in the world, genomic surveillance efforts remain limited. In the United States, for example, hospitals, county health departments and testing labs are already overwhelmed testing and treating patients, while also facilitating an unprecedented vaccination effort. (Hays, 1/19)

New variants of the coronavirus continue to emerge. But one in particular has caused concern in the United States because it’s so contagious and spreading fast. To avoid it, you’ll need to double down on the same pandemic precautions that have kept you safe so far. (Parker-Pope, 1/20)

There’s no evidence that CAL.20C is more lethal than other variants. And scientists have to conduct more research to determine whether CAL.20C is in fact more contagious than other forms of the virus. But Eric Vail, the director of molecular pathology at Cedars-Sinai, said it was possible that CAL.20C is playing a large part in the surge of cases that has overwhelmed Southern California’s hospitals. “I’m decently confident that this is a more infectious strain of the virus,” Dr. Vail said. (Zimmer, 1/19)

Seven cases of COVID-19 in Michigan are now associated with a Washtenaw County woman who traveled to the United Kingdom and brought back with her a new variation of the coronavirus known as B.1.1.7, or the U.K. variant. It's more transmissible — spreading about 50% more efficiently than other known mutations of the virus — and health officials fear this form of the virus could become the predominant strain in the U.S. in March, causing more infections, hospitalizations and deaths. Most of the seven people who've contracted the virus since having close contact with the Washtenaw County woman live in connected households, said Susan Ringler Cerniglia, a spokeswoman for the county health department. It still isn't known whether they, too, have the B.1.1.7 variant. (Jordan Shamus, 1/19)

New York City is going to run out of coronavirus vaccine doses this week and will have to cancel appointments unless they receive more, Mayor Bill de Blasio (D) said Tuesday. The city is aiming to vaccinate 300,000 people this week, but only has 92,000 doses on hand. More than 450,000 doses have been administered to date. (Weixel, 1/19)

San Francisco’s public health department will run out of COVID-19 vaccine Thursday because the city’s allocation dropped substantially from a week ago and doses that had to be discarded were not replaced, city officials said Tuesday. Dr. Grant Colfax, San Francisco’s director of public health, said at a news conference that the city received 12,000 doses a week ago and asked for the same number this week. Instead, the city received only 1,775 doses. On top of that, the city received 8,000 doses of a Moderna vaccine that had to be scrapped because some people in San Diego had allergic reactions to doses from that same batch, prompting the state to issue a warning. Colfax said those 8,000 doses, ordered withdrawn by the state, have not been replaced. (Dolan, 1/19)

Thousands more residents could be getting COVID-19 shots if public health officials' requests for vaccine were being met, the chief operating officer of the Oklahoma City-County Health Department said Tuesday. Phil Maytubby gave a pandemic update at City Hall before the Oklahoma City Council voted to extend the city's mask mandate through March 5, the fourth extension since it was first adopted July 17. Maytubby said the Health Department could "distribute four to five times the vaccine available now." The agency sought 25,000 doses last week and received only 6,000, he said. Hopes are for improvement next week. (Crum, 1/20)

A funeral bell tolled at the Washington National Cathedral 400 times Tuesday, once for every thousand Americans who have died of Covid-19 in the United States. As the numbers climb, health experts and officials have turned their attention to mitigating the impacts of the new variant that has sparked alarm, and they are calling for ramped up vaccinations and preventative measures. (Holcombe, 1/20)

Growing demand for the coronavirus vaccine amid complaints over distribution is sparking friction among local leaders and forcing some jurisdictions in the Washington region to pause appointments. Maryland’s Senate president said the health secretary nominee of Gov. Larry Hogan (R) will not receive a confirmation hearing until the state shows more progress on the rollout of the vaccine. Sen. Bill Ferguson (D-Baltimore City) said state lawmakers are fielding calls from constituents about when and where they can be vaccinated, causing “unacceptable levels of confusion.” (Wiggins, Tan and Chason, 1/19)

Seniors lucky enough to get first doses of a coronavirus vaccine say they’re facing a nightmare trying to book appointments for the required booster shots. Even if they get appointments, it’s not clear if Georgia will have enough doses on hand to administer second shots while still meeting the overwhelming demand for first shots. Last week the Trump administration acknowledged that a stockpile that was promised weeks ago to ensure patients could complete their two-dose regimens didn’t exist. Meanwhile, the state is plowing ahead with putting as many shots into as many arms as possible, counting on more shipments in the coming weeks after President-elect Joe Biden takes office. On Tuesday the head of the Georgia Department of Public Health reiterated the use-’em-up policy, saying local health departments have been told not to hold any doses back. (Edwards, Schrade and Stirgus, 1/19)

Maine health officials discovered that a majority of Moderna vaccine shipments received across the state on Monday were not kept adequately cold during transport, meaning 4,400 doses may have to be thrown out. Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, made the announcement during a "sad and somber" coronavirus briefing on Tuesday and said the problem extends to other states as well. Shah said 35 of the 50 sites that received the vaccine a day earlier reported that "the thermometer on the outside of the boxes ... showed that at some point the required minimum temperature had been exceeded." (Romo, 1/19)

Moderna said Tuesday that it is investigating reported allergic reactions from one batch of its COVID-19 vaccine after California recommended pausing vaccinations. State epidemiologist Erica Pan recommended on Sunday that health care providers pause administering doses from lot 041L20A while the state investigates a “higher-than-usual number of possible allergic reactions” that were reported with doses that were administered at a community vaccination clinic. (Williams, 1/19)

Moderna performed a miracle last year: The Cambridge biotech company, which hadn’t put a product on the market since it was founded in 2010, delivered a coronavirus vaccine in just 11 months. (Edelman, 1/19)

A Wisconsin pharmacist accused of trying to defrost and spoil dozens of vials of COVID-19 vaccine was charged Tuesday with attempted misdemeanor property damage, and prosecutors warned more serious charges could follow if tests show the doses were ruined. Police arrested 46-year-old Steven Brandenburg on Dec. 31 as part of an investigation into how 57 vials of the Moderna vaccine were left for hours outside a refrigerator at Advocate Aurora Health in Grafton, a Milwaukee suburb. The vials contained enough vaccine to inoculate more than 500 people. (Richmond, 1/19)

Supermarket chain Aldi announced Tuesday that it would provide front-line workers in the U.S. up to four hours of paid leave so they can receive two doses of the coronavirus vaccine. “Aldi is ensuring that all hourly workers who wish to receive the vaccine are able to do so without concern about losing pay or taking time away from work,” the company said in a statement. (Gstalter, 1/19)

The Church of Jesus Christ of Latter-day Saints urged its members to get a COVID-19 vaccine when it’s their turn, while announcing Tuesday that eight top leaders and most of their wives received their first doses. Church President Russell M. Nelson, 96, and the others are over the age of 70. They received the shots in Utah, where the state’s plan has shifted to getting seniors vaccinated after first delivering shots to health care workers and first responders. (1/19)

A northern Kentucky couple celebrated their 73rd wedding anniversary by getting their first coronavirus vaccine shot. Noel “Gene” Record, 93, and Virginia Record, 91, were among the first patients in Cincinnati to be vaccinated Tuesday under Ohio’s Phase 1B, WLWT-TV reported. Initial vaccinations went to health care workers. (1/19)

When he assumes the presidency, Joe Biden will inherit what is perhaps the greatest twin crises ever to face an incoming president: a pandemic raging out of control and an economy sitting on shaky foundations. And the greatest weapons in his arsenal to combat both — the Pfizer/BioNTech and Moderna vaccines — are scarce. Things were not supposed to be like this. (Siegfried, 1/20)

Even after much of the general population gets COVID-19 vaccines, they will likely need to get annual doses to protect against future mutations of the virus, according to researchers at the University of Texas Medical Branch at Galveston. Scott Weaver, director of the medical branch’s infectious disease research programs, said viruses like COVID-19 will eventually find ways to mutate in order to continue to infect people, even those who have antibodies from vaccines or previous infections. “We may very well need to do the same thing for influenza vaccines — produce a new one every year or two based on the updated sequences of the rapidly circulating coronavirus strains,” Weaver said during a COVID-19 forum hosted by UTMB Tuesday. (Powell, 1/19)

Nearly 9 in 10 Americans say the coronavirus pandemic is not under control in the United States, but far fewer say they'll get vaccinated against it, a new ABC News/Washington Post poll finds. As the country endures record levels of daily COVID-19 cases, hospitalizations and deaths, 52% say the virus is "not at all" under control, up sharply from 35% (among registered voters) in October. The view is deeply partisan; 7 in 10 Democrats and 55% of independents say the virus is not at all under control, versus 28% of Republicans. (De Jong, 1/19)

Even as overall healthcare employment has rebounded slightly, job numbers in nursing homes continue their downward spiral. After more than a decade of gradual losses, nursing home employment began a free fall in April as the novel coronavirus spread across the country. And it hasn't recovered. Nursing homes need more workers to handle the challenges of COVID-19, yet jobs remain vacant. Low wages, limited healthcare benefits and hard work make these jobs hard to fill, experts say. The added threat of contracting COVID-19 makes it even more difficult. (Christ, 1/19)

KHN: California Is Overriding Its Limits On Nurse Workloads As Covid Surges

California’s telemetry nurses, who specialize in the electronic monitoring of critically ill patients, normally take care of four patients at once. But ever since the state relaxed California’s mandatory nurse-to-patient ratios in mid-December, Nerissa Black has had to keep track of six. And these six patients are really sick: Many of them are being treated simultaneously for a stroke and covid-19, or a heart attack and covid. With more patients than usual needing more complex care, Black said she’s worried she’ll miss something or make a mistake. (Dembosky, 1/20)

Liv Jones, a licensed professional counselor and art therapist, says her agency in Ohio has nearly doubled its staff over the last year to address the need for mental health care during the coronavirus pandemic. Yet, even now, there’s still a waitlist for clients who wish to start therapy, she says. (Yang, 1/19)

COVID-19 patients admitted to intensive care units (ICUs) at US Department of Veterans Affairs (VA) hospitals during peak coronavirus patient surges were twice as likely to die than those treated during low-demand periods, an observational study published today in JAMA Network Open suggests. (Van Beusekom, 1/19)

HHS has yet to declare a revised deadline for healthcare providers to report their Provider Relief Fund grants after scrapping the original one late last week. The agency had originally planned to open its reporting portal on Jan. 15, 2021, with the first submissions required by Feb. 15. That all changed with Congress' passage of the Coronavirus Response and Relief Supplemental Appropriations Act in late December, which poured another $3 billion into the PRF pot and tweaked reporting requirements. HHS said it's reworking its rules so they're consistent with the law. Providers are generally happy about the change, said Aparna Venkateswaran, a senior manager with Moss Adams. (Bannow, 1/19)

KHN: Patients Fend For Themselves To Access Highly Touted Covid Antibody Treatments 

By the time he tested positive for covid-19 on Jan. 12, Gary Herritz was feeling pretty sick. He suspects he was infected a week earlier, during a medical appointment in which he saw health workers who were wearing masks beneath their noses or who had removed them entirely. His scratchy throat had turned to a dry cough, headache, joint pain and fever — all warning signs to Herritz, who underwent liver transplant surgery in 2012, followed by a rejection scare in 2018. He knew his compromised immune system left him especially vulnerable to a potentially deadly case of covid. (Aleccia, 1/20)

KHN: Advocates View Health Care As Key To Driving LGBTQ Rights Conversation

When Allison Scott came out as a trans woman in 2013, she told not only family and friends, but also her primary care physician. She didn’t need his help with hormone therapy. She had another doctor for that. But she wanted to share the information with her doctor of more than 10 years in case it affected other aspects of her health. (Pattani, 1/20)

The airport in Cedar Rapids, Iowa, plans next week to begin screening passengers for symptoms of covid-19 before they go through security, implementing a first-of-its-kind plan that was on hold for months while federal officials reviewed its funding. The top executives of Eastern Iowa Airport wanted to use coronavirus relief money to check passengers for symptoms and won approval from local authorities in July. But airport revenue is strictly regulated, and the officials did not want to move forward without approval from the Federal Aviation Administration. (Duncan, 1/19)

As the United States starts off 2021 with COVID-19 vaccines as well as variants, the Association of Public Health Laboratories (APHL) reasserts the importance of strategic COVID-19 testing strategies with a report published late last week. In the report, "Smart Testing for Optimizing Pandemic Response," the group recommends a coordinated national approach, supply chain management, and a focus on using test results as a means to improve public health surveillance. (McLernon, 1/19)

In a perfect world, the entrance to every office, restaurant and school would offer a coronavirus test — one with absolute accuracy, and able to instantly determine who was virus-free and safe to admit and who, positively infected, should be turned away. That reality does not exist. But as the nation struggles to regain a semblance of normal life amid the uncontrolled spread of the virus, some scientists think that a quick test consisting of little more than a stinky strip of paper might at least get us close. (Wu, 1/19)

As COVID-19 cases surge across the country, the American Red Cross warns that one treatment that could help the sickest patients is now in short supply: convalescent plasma. Authorized by the Food and Drug Administration for emergency use in coronavirus patients back in August 2020, convalescent plasma is antibody-rich blood plasma, collected from donors who have recovered from COVID-19, that is given, via a blood transfusion, to infected patients struggling to fight the virus. (1/19) 

COVID-19 infection rates in US Immigration and Customs Enforcement (ICE) detention centers are higher than those in the general population and eclipse those of surrounding communities, according to a research letter published today in JAMA Network Open. The authors, led by a researcher from the University of Miami in Florida, analyzed data from the COVID Prison Project, the New York Times, and the American Community Survey from May 5 to Sep 15, 2020. (1/19)

One of the passengers who tried to revive a man on a cross-country United flight in December said the airline emailed him a voucher for $200 for his “help/inconvenience on the flight” last week. Tony Aldapa, an intermediate medical technician at a Los Angeles hospital, said that was in addition to a $75 voucher that a flight attendant gave him on the plane. He said a customer service representative also called. (Sampson, 1/19)

Less than a week after his vigorous launch into the New York City mayor’s race, Andrew Yang said on Tuesday that he was halting in-person events and quarantining because a campaign staff member had tested positive for the coronavirus. Mr. Yang, the former presidential candidate, had been seemingly everywhere in recent days, meeting with elected officials across the city and riding the subway and bus to campaign events. His whirlwind appearances have been in sharp contrast to the mostly virtual campaigns that his rivals have been conducting. (Fitzsimmons, 1/19)

Covid-19 had destroyed Elenilson Orellana Garcia’s lungs. The 36-year-old teacher’s aide, known to friends and family as Nelson, was in his third month on life support and his condition had not improved. Doctors at MedStar Washington Hospital Center no longer believed he had the strength to get better. The machines, they said, were just prolonging his suffering. ... But this case was unusual. Many covid-19 patients, once on a ventilator, have come through. Countless others have died within days or weeks. Far fewer have been too weak to recover but too strong to entirely succumb. (Thompson, 1/19)

The city of Albuquerque’s COVID-19 emergency shelter system has run out of room for families, officials said Tuesday. Despite expanding capacity by adding a network of “wellness” hotels, Albuquerque Family and Community Services Director Carol Pierce said the city has maxed out the space it has available for families who are homeless. “We don’t have more rooms available,” she said Tuesday morning during a Homeless Coordinating Council meeting with city, Bernalillo County and University of New Mexico leaders. “As soon as one comes up, they are rapidly filled.” While there is still room for adult men and adult women, the family units are full with what Pierce called a “staggering” number of children. (Dyer, 1/19)

Black mental health matters. To say this is an exponentially tough time for Black people in America would be an understatement ⁠-- and that's why protecting the mental health of this community is vital. (Yates, 1/19)

Last spring, Mary Jo Podgurski taught her usual sex education course to sixth-graders in Washington, Pa. — usual, except one thing: It was over Zoom. Because the kids took the class from home, many of their parents participated as well, so Podgurski decided to include exercises to help parents and children communicate about sex. “Mary Jo helped me build trust with my mom and classmates so if I have any questions in the future, I feel safe asking,” says 13-year-old Cicely Sunseri, one of the students. (Weiss, 1/16)

Tiger Woods announced Tuesday that he recently underwent back surgery and will miss two events on the PGA Tour. It was Woods’s fifth back operation, including a 2017 spinal fusion procedure that led to a remarkable comeback, capped by a triumph at the 2019 Masters. The recent surgery was a less drastic microdiscectomy procedure, which he also had done three times between 2014 and 2015. Woods, 45, said this one was aimed at removing “a pressurized disc fragment” that was pinching his nerve and causing “discomfort” at the PNC Championship. (Bieler, 1/19)

An observational study published yesterday in The Lancet Infectious Diseases suggests that children and teens in Wuhan, China, homes were less vulnerable than older household contacts to COVID-19 infections but were more likely to spread the virus. A team led by researchers from the Wuhan Center for Disease Control and Prevention studied the 27,101 households of all 29,578 confirmed COVID-19 patients and their 57,581 household contacts in Wuhan from Dec 2, 2019, to Apr 18, 2020. Of the household contacts, 10,367 tested positive for COVID-19, 29,658 tested negative, and 17,556 weren't tested. Using a transmission model that assumed a mean incubation period of 5 days and an infectious period of no more than 22 days, the authors estimated that 15.6% of household members became infected. (1/19)

Early last spring, [twin] sisters from Rochester, Michigan, checked themselves into the hospital with fevers and shortness of breath. While Kelly [Standard] was discharged after less than a week, her sister ended up in intensive care. Kimberly spent almost a month in critical condition, breathing through tubes and dipping in and out of shock. Weeks after Kelly had returned to their shared home, Kimberly was still relearning how to speak, walk and chew and swallow solid food she could barely taste. Nearly a year later, the sisters are bedeviled by the bizarrely divergent paths their illnesses took. (Wu, 1/18)

The Center for Infectious Disease Research and Policy (CIDRAP), with support from the Wellcome Trust, a London-based research nonprofit—with an eye toward improving flu vaccines, promoting truly revolutionary versions, and ensuring more equitable distribution—today released a draft of the Influenza Vaccines Research & Development Roadmap (IVR) for public review and comment. The IVR project is being led by a steering group of scientists and policymakers and supported by a CIDRAP core team. It aims to develop a globally oriented influenza strategic planning tool to coordinate research and development (R&D), funding, and stakeholder engagement to produce more effective flu vaccines and reduce the impact of future influenza pandemics. (Paulsen, 1/19)

One in 10 babies around the world is born prematurely, and the vastly improved survival rates of preemies is one of the most striking advances of modern health care -- with the overwhelming majority of those born preterm reaching adulthood. But what are the long-term health risks of being born too early as these infants approach middle and old age? It's a question that has been difficult to answer with many individuals in follow-up studies still too young to draw meaningful conclusions. (Hunt, 1/20)

Israel will begin vaccinating pregnant women against COVID-19 after several medical groups within the country’s health ministry stressed the risks the virus poses to pregnancy. The news comes amid reports of 10 pregnant women being listed in serious condition due to the illness. On Tuesday, the Israeli Association of Obstetrics and Gynecology along with physicians from the National Council for Gynecology and Genetics and the Israeli Society for Maternal and Fetal Medicine published a paper stating that the virus can cause great harm to pregnancies, possibly resulting in premature birth, as well as cause severe illness in mothers. (Friling, 1/19)

Frustration visibly boiled over with some Canadian leaders Tuesday as Pfizer told Canada that it would not receive any vaccine doses next week due to the continuing manufacturing disruptions at its facility in Belgium. Canada's Prime Minister Justin Trudeau sought to reassure Canadians that vaccine deliveries would pick up again in a few weeks and that the overall goal, to have every willing Canadian vaccinated by September, would remain on track. (Newton, 1/20)

Japan aims to vaccinate the majority of its population against Covid-19 by July, according to a report, meaning most of its more than 125 million residents could be inoculated by the time the Tokyo Olympics are scheduled to begin. The country plans to complete vaccination of 50 million people in high-priority tiers, including the elderly and health-care workers, by April, according to the Yomiuri newspaper, citing multiple unidentified people. Japan then plans to begin inoculation of the general public as early as May, depending on the availability of doses, the report said. (Reidy, 1/20)

China is rushing to build a massive quarantine camp that can house more than 4,000 people, after an outbreak of Covid-19 this month that has left tens of millions of people under strict lockdown. The quarantine camp is located on the outskirts of Shijiazhuang, the provincial capital of Hebei province, which surrounds the country's capital, Beijing. (Yeung, 1/20)

A coronavirus antibody test that China has made mandatory for arriving travelers has provoked concerns over its effectiveness after one of a team of international health experts was briefly denied entry last week following a positive result. Although the British expert from the World Health Organization (WHO) subsequently tested negative, it was not immediately clear if the earlier result was a false positive, or the result of previous infection or a COVID-19 vaccination. (1/20)

A group of European Union leaders pressed the bloc’s drugs regulator to green light coronavirus vaccines faster, after its executive arm recommended a target for inoculating at least 70% of the region’s adult population by summer. The EU’s 27 government heads must “send out a strong signal to the European Medicines Agency on Thursday to ensure the approval procedure for vaccine candidates is as efficient as possible,” the leaders of Greece, the Czech Republic, Denmark and Austria said in a joint letter to summit chair Charles Michel. He will host a Jan. 21 EU video conference on the pandemic. (Stearns and Chrysoloras, 1/19)

President Trump’s farewell address was essentially a mini-version of one of his campaign rallies — minus the cheers and applause. Since Trump’s campaign rallies were a rich source of false or misleading claims, the president brought out some of his favorite golden oldies, many of which are on our list of Bottomless Pinocchios. Here’s a quick guide to what was wrong or exaggerated. (Kessler and Rizzo, 1/19)

Strengthen the Affordable Care Act. Restore abortion protections. Lower drug prices. President-elect Joe Biden has a long list of health care promises -- many of which center on reversing policies enacted by the Trump administration over the past four years. However, it will take the President-elect's health officials time to address all of the measures, particularly as battling the coronavirus pandemic remains the top immediate priority. Some items would be easy to undo, but others involve regulations and waivers that can't simply be voided. And some would need approval from Congress, which would be a challenge because Biden can't afford to lose a single Democrat in the Senate -- and few in the House, after his party lost seats in the chamber. (Luhby, Kelly and Cole, 1/19)

Joe Biden and Donald Trump didn’t agree on much, but they did on this: Floridians should be able to import prescription drugs from foreign countries. Trump, the Republican outgoing president, made driving down the cost of prescription drugs a key campaign promise in Florida, which is home to about 4.5 million seniors. Biden, the Democrat who beat Trump by some seven million votes, made a similar pledge during the 2020 campaign. (Wilson, 1/14)

With most Americans focused on COVID-19 vaccines, pharmaceutical companies are quietly raising the list prices of name-brand prescription drugs at a torrid pace. January is typically when increases hit the U.S. market. Already, more price hikes by drugmakers have been recorded in less than half a month (813) this year than for all of January 2020 (737), according to research by Ohio nonprofit 46brooklyn.That two-week 2021 total also is approaching the record for a full January during the past decade, 895, set in 2018. (Rowland, 1/17)

McLaren Health Care Corp. agreed Tuesday to pay a record $7.75 million penalty to settle a federal investigation into officials distributing opioids and other drugs without prescriptions, the largest amount in U.S. history involving allegations of drug diversion. The penalty settles a years-long investigation by the U.S. Drug Enforcement Administration into whether officials at the Grand Blanc-based health system violated federal drug laws by illegally distributing powerful pain medication central to the nation's opioid crisis. (Snell, 1/19)

As a sort of sour welcome for the Biden administration and a final slap in the face for Donald Trump, America’s drug companies jacked up prices on hundreds of prescription drugs, including some of their top sellers, at the very start of this year. Market analysts say the median price hike was 4.8%, a tad below last year’s level, but once you’ve said that you’ve said everything. The increase levied by AbbVie on its rheumatoid arthritis drug Humira, the best-selling drug in the world, was 7.4%. AbbVie collects revenue of about $20 billion a year from Humira, though its patent exclusivity on the drug expires in 2023. Pfizer’s increase on its statin Lipitor was 4.9%. (Michael Hiltzik, 1/19)

The Trump administration’s efforts to increase drug price transparency are likely to survive the transition to the Biden administration, according to a perspective piece published 13 January in the New England Journal of Medicine. Included in the Transparency in Coverage final rule, issued in late October 2020, the drug price transparency provisions aim to require that health insurers publish list prices and historical net prices for prescription drugs. The information must be supplied so that patients and providers can access it both online or in paper format, and in real time. (Denise Fulton, 1/18)

Since the November elections, investors have been focused on President-elect Biden’s efforts to bolster the U.S. economy, including the latest $1.9 trillion plan. But investors should not lose sight of potential regulatory changes that could unwind much of the deregulation that occurred in the Trump era. Three areas – the environment, health care and tech giants – are among those likely to be most affected. It is easy to overlook the impact of regulations on the economy because they are inherently difficult to quantify. Federal agencies are only required to conduct cost-benefit analyses on rules deemed “economically significant,” which are defined as having an annual effect on the economy of at least $100 million. (Nicholas Sargen, 1/18)

Amid a global pandemic, you have a choice: Pay for your lifesaving prescription medication or put food on your family’s table. Which do you choose? This is the harsh reality in the commonwealth, where nearly 1 in 4 Virginians stops taking prescriptions as directed because they can’t afford them. That is unconscionable, and it’s the clear consequence of a broken, predatory drug-pricing system that puts profits first. If elected Virginia’s next governor, I will fight to ensure no Virginian is faced with this choice. (Terry McAuliffe, 1/14)

Some confusion about COVID-19 vaccinations — how to get one, where to sign up, etc. — was inevitable, given the speed of the rollout and uncertainty about how many doses might be available from week to week. It’s the largest inoculation campaign in U.S. history, and data about availability change by the day if not the hour. But the chaos sowed at every level of government has made the confusion worse. Operation Warp Speed was politicized from Day 1, as President Trump used the vaccine initiative as a reelection gambit, contradicting time estimates set by the experts and exaggerating the speed with which vaccine doses could be produced and distributed. Once the first vaccines were available, the number of doses ready to be shipped to each state has been changing weekly, making it hard to plan for dispersal. (1/20)

Faced with a slow, chaotic vaccine rollout and ever-rising Covid-19 cases, President-elect Joe Biden has an ambitious plan: to administer 100 million doses of the coronavirus vaccine in his first 100 days in office. Since the vaccines became publicly available in mid-December, 12.3 million shots have made their way into the arms of Americans, an average of 384,000 doses per day. Mr. Biden’s goal of tripling this rate can be achieved if the United States implements a vaccination campaign that treats Covid-19 more like an act of bioterrorism and less like the seasonal flu. (Thomas J. Bollyky, Jennifer B. Nuzzo and Prasith Baccam, 1/20)

Describing his plan to get the Covid-19 pandemic under control, Joe Biden was blunt. “You have my word,” the president-elect declared last week. “We will manage the hell out of this operation.” He had better. Anything less would be a body blow to his administration and the country. When there is widespread agreement on a course of action, leaders are judged on how well they carry it out. In her 2016 book, “Why Presidents Fail,” my Brookings Institution colleague Elaine Kamarck shows how management failures can make or break presidencies. Jimmy Carter never recovered from the failed mission to rescue American hostages in Iran, nor did George W. Bush from his botched response to Hurricane Katrina. The implosion of the Affordable Care Act’s website significantly weakened the Obama presidency. ...You never get a second chance to make a first impression, and managing the pandemic will be the first impression President Biden makes. (William A. Galston, 1/19)

Joe Biden will take the oath of office as the 46th president of the United States on Wednesday in the center of a city fortified against some of his own countrymen, and in the midst of a pandemic that is killing several thousand Americans every day and that has pushed millions more into poverty. He faces a momentous and urgent set of challenges: leading the nation up from the pandemic, reviving the economy, repairing America’s tarnished reputation on the global stage. Mr. Biden’s first step, a fiscal plan that he introduced last week to address the pandemic and its economic consequences, shows that the incoming president and his advisers have taken some valuable lessons from recent history. (1/19)

I now have an inkling of how the French must have felt when Allied troops liberated Paris in August 1944. Things were terrible; there was wreckage all around, and yet a sense of optimism must have been pervasive. One part of our long national nightmare ends Wednesday as Donald Trump slinks off to Mar-a-Lago in disgrace, and Joe Biden takes over as president. Yet Mr. Trump leaves behind a second national nightmare: a raging pandemic and, largely for that reason, a sputtering economy. When it comes to handling the pandemic, Mr. Trump has set the bar very low. Doing a better job than his predecessor will be a piece of cake for Mr. Biden. But “better” is not nearly good enough when record numbers of Americans are falling ill and dying. Mr. Biden must do vastly better. His comprehensive plans suggest that he will. (Alan S. Blinder, 1/19)

As Joe Biden becomes president this week Americans everywhere are frightened by the growing numbers of coronavirus infections and death. They are looking for direction from the new president and his team. With a new year just beginning it’s important to remember what I wrote in my latest book "COVID: the Politics of Fear and the Power of Science." Fear mushrooms from inconsistencies, pseudo-science and dogma, whereas consistency and perspective reassure us. Here are the top things our new president must do. First and foremost, President-elect Biden must resist the temptation to fear monger, to place blame, to make sweeping cure-all statements or to pursue obsessive masking or lockdowns with an almost religious fervor without regard to scientific evidence that’s accumulated since the coronavirus first arrived in the U.S. almost a year ago. (Dr. Marc Siegel, 1/19)

The last four years have seen a devastating erosion of American leadership on global health. From severely restricting access to reproductive choice for women around the world with an expanded global gag rule, to initiating the U.S. withdrawal from the World Health Organization during a global pandemic, to sowing seeds of doubt about science, the Trump administration retreated from global cooperation at every opportunity. (Kate Dodson, 1/20)

Every identity document brings its own dystopia. Austrian author Stefan Zweig, who saw the modern passport change international travel after the First World War, wrote: “Formerly man had only a body and soul. Now he needs a passport as well, for without it he will not be treated like a human being.” More recently, after the 9/11 terrorist attacks in the U.S., the spread of biometric passports raised concerns over security and privacy. “With the old passport, we knew where we stood,” the BBC reported in 2006. Today, it’s the prospect of a Covid-19 vaccine certificate that’s conjuring up digital-dictatorship fears. The idea is being pushed by the travel industry as a leap towards normality after the worst year on record for international tourism and by technology firms eager for lucrative government contracts and a gold mine of data. Yes, it’s nice to daydream about being able to travel freely again, but critics say it would introduce an unequal society in which an inoculated elite get the freedom to fly long-haul, attend concerts or dine in restaurants. Do we really want to be divided between the jabs and the jab-nots? (Lionel Laurent, 1/20)

When the 117th Congress was sworn in on Jan. 3, America had lost 352,000 souls to COVID-19; by Wednesday, when President-elect Joe Biden takes office, the country will have lost more than 400,000. The higher the death toll, the harder it is to fathom. Nearly one out of every 750 Americans has now died, an entire city’s worth of grief and pain. We are among the few people privileged to know the living, breathing, beautiful value of such numbers. We were once the mayors of Anaheim, Calif., (population 350,000) and Minneapolis (population 429,000); to us, the unfathomable looks a lot like home, like the histories and dreams, the entire worlds, that are nurtured and built across a city’s grid. (Betsy Hodges and Tom Tait, 1/19)

Alex Azar, secretary of the federal Department of Health and Human Services, spent his final days in office under fire for misleading states about the number of coronavirus vaccine doses they would receive this month. Unfortunately, the criticism didn’t deter Azar from closing out his tenure by making yet another promise his department can’t keep, one that puts thousands of existing health and safety protections at risk of automatic repeal. (Jack Lienke, 1/20)

Folks, we just survived something really crazy awful: four years of a president without shame, backed by a party without spine, amplified by a network without integrity, each pumping out conspiracy theories without truth, brought directly to our brains by social networks without ethics — all heated up by a pandemic without mercy. (Thomas L. Friedman, 1/19)