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Life expectancy in the United States declined by a year and a half in 2020, according to the Centers for Disease Control and Prevention, which says the coronavirus is largely to blame. COVID-19 contributed to 74% of the decline in life expectancy from 78.8 years in 2019 to 77.3 years in 2020, according to the CDC's National Center for Health Statistics. It was the largest one-year decline since World War II, when life expectancy dropped by 2.9 years between 1942 and 1943. Hispanic and Black communities saw the biggest declines. (Greenhalgh, 7/21)

Life expectancy in the U.S. plunged last year in the largest one-year drop since World War II, the Centers for Disease Control and Prevention reported Wednesday, further widening the longevity gap between the U.S. and comparable countries. Deaths from Covid-19 and drug overdoses fueled the decline — wiping out any improvements the country made in decreasing deaths from cancer and chronic lower respiratory diseases — leading to a 1.5-year drop and bringing the life expectancy at birth down to 77.3 years. (Life expectancy at birth refers to how long a person born in the year being studied — in this case, 2020 — is expected to live.) (Sullivan, 7/21)

The Covid-19 pandemic drove average life expectancies in the U.S. down by about a year and a half last year, marking the largest one-year decline since World War II, according to new data from the Centers for Disease Control and Prevention. Americans are now expected to live an average of 77.3 years, down from 78.8 years in 2019, according the report released Wednesday by the CDC’s National Center for Health Statistics. Hispanics saw the biggest drop in life expectancy last year, followed by Black Americans. (Mendez, 7/21)

The delta variant of the novel coronavirus is now responsible for 83 percent of all sequenced COVID-19 cases in the United States, Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky said Tuesday. That estimate is a major increase from just over two weeks ago. For cases tallied during the week of July 3, the CDC estimated the delta variant accounted for about 50 percent of new infections. (Weixel, 7/20)

The Delta (B1617.2) variant, first detected in India and now sweeping the globe, represents 83% of COVID-19 sequenced samples in United States, according to Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky, MD, MPH, who testified today in a Senate committee hearing on the pandemic. "This is a dramatic increase, up from 50% for the week of July 3," Walensky said. "In some parts of the country the percentage is even higher, particularly in areas of low vaccination rates." Walensky explained that the pandemic in the United States was not affecting the unvaccinated. (Soucheray, 7/20)

In Florida, hospitals are preparing for the worst. At Miami's Jackson Health System, there's been a 111% jump in COVID patients over the last two weeks, meaning most visitors will be banned. About 95% of patients with the virus who are being treated there are unvaccinated. "It's frustrating. It's passed beyond sadness," said Alix Zacharski, a nurse manager at the hospital. "The amount of disease they go through is incredible it's terrible, it's absolutely terrible." Zacharski says the patients are coming in younger, and with the Delta variant, they're getting sicker, faster. "We just got a very young patient in her 20s. She has asthma, did not get vaccinated, and she ended up passing out, passing away," she said. (Bojorquez, 7/20)

The highly contagious delta variant is the dominant version of the coronavirus in Virginia and Maryland and is expected to be on the rise in D.C., but officials so far say they have no plans to reinstate mask mandates and social distancing restrictions just as the economy is rebounding. Instead, public health experts are focused on getting people inoculated against the virus. But vaccination rates are stalling throughout the region, and testing — which is key to understanding the spread of variants — is down sharply from earlier in the pandemic. (Portnoy, Wiggins and Fadulu, 7/20)

Public health researchers on Tuesday called the rapid rise in coronavirus cases and hospitalizations in Arkansas a “raging forest fire,” and the state’s top health official warned that he expects significant outbreaks in schools. The model by the University of Arkansas for Medical Sciences’ Fay W. Boozman College of Public Health projected a daily average of 1,039 new cases over the next week. The model also predicted an average increase of 169 new cases per day in children under the age of 17. (DeMillo, 7/21)

With the now-dominant delta variant still on the rise in California, COVID-19 hospitalizations are also increasing, passing thresholds in the Bay Area and state not seen since the spring. On Monday, confirmed COVID-19 hospitalizations in California crossed the 2,000 mark — with more than 500 of those patients in intensive care units — for the first time since early April, according to state data. Meanwhile, the Bay Area surpassed 300 hospitalizations for the first time since early April, and on Tuesday exceeded 100 ICU admissions for the first time since late March. (Hwang, 7/20)

State officials dispatched teams of health workers to Cape Cod and issued new safety guidance amid worrisome signs Tuesday that COVID cases are on the rise across the renowned summer playground. Despite having one of the most vaccinated populations in the state, Cape Cod now has the highest rate of new COVID cases in Massachusetts. Health officials are battling an outbreak in Provincetown that has infected at least 132 people since July 1 — most of them vaccinated — as well as a cluster in a Yarmouth nursing home, where as many as 33 residents and staff are infected, many of them already vaccinated, too. (Lazar and Caldera, 7/20)

One local hospital is reinstating visitor limits and Harris County Judge Lina Hidalgo is mulling a change to the county’s threat level amid a wave of COVID-19 variant cases that medical leaders warned Tuesday could overwhelm area hospitals and wreak further havoc as schools reopen next month. The warning came amid massive spikes in hospitalizations across the Houston region, which Hidalgo’s office is closely monitoring to decide if the county needs to raise its emergency threat level from yellow to orange — or moderate to significant. (Downen, 7/20)

A recent and significant resurgence of COVID-19 in Alaska continued over the weekend, with state data showing 456 new cases reported since Friday plus an uptick in hospitalizations, causing the state to return to a high alert level for the first time since May. “Case counts are increasing at a rapid rate,” Dr. Joe McLaughlin, Alaska’s state epidemiologist said Monday. “And that is concerning, especially as we see hospitalization rates also increasing.” By Monday, virus-related hospitalizations in the state had surpassed a previous surge in May. There were a total of 69 Alaskans hospitalized statewide with confirmed or suspected COVID-19, according to Alaska’s Department of Health and Social Services — including 12 people who were on ventilators. (Berman, 7/20)

Chicago added three states and a U.S. territory to its COVID-19 travel advisory Tuesday. State and local-level travel rules were a blunt-force approach to slowing the pandemic last year — and ones that often proved difficult to actually enforce. But with vaccination rates in many states stalling and concern about the more contagious Delta variant growing, it's possible that they may return. (Walsh, 7/21)

In 50 living rooms and home offices, Delaware contact tracers arm themselves every morning with laptops and cellphones, the weapons they need to curb coronavirus outbreaks. They spend hours each day calling people who have recently tested positive for the virus. They dial each person in the morning, afternoon, and evening until they answer, listening to ring after ring, hoping to hear a voice on the other end of the line. Eventually, they’ll reach about 80% of cases with a valid phone number. Now, more than at any other point in the pandemic, this team says it can help stop surges and — with vaccinations — keep case rates low, said Tracey Johnson, director of Delaware’s Office of Contact Tracing. The state, with a population just under a million, has been averaging 45 new cases a day. (McCarthy, 7/21)

The Centers for Disease Control and Prevention (CDC) told Fox News on Tuesday that the agency has "no plans to update" mask use recommendations. The comment comes after Dr. Anthony Fauci said earlier Tuesday the CDC was "carefully looking" at its guidance relating to mask use in schools after the American Academy of Pediatrics (AAP) broke from federal health guidance, advising anyone above the age of 2 wear masks inside schools to protect against the spread of the coronavirus, "regardless of vaccination status." "CDC has no plans to update any guidance regarding masks," Kristen Nordlund, CDC spokeswoman, told Fox News. (Rivas, 7/20)

President Joe Biden's top COVID officials are set to testify before Congress on Tuesday as guidance on masks is splintering at the local level -- with some cities and medical organizations recommending a return to universal mask wearing, despite federal guidance that vaccinated Americans can go without masks. Dr. Anthony Fauci, chief White House medical adviser, said Monday that it was "reasonable" for a leading group of pediatricians to push back against federal guidance that vaccinated Americans can go without masks. (Flaherty and Haslett, 7/20)

Students in Wichita, Kansas, public schools can ditch the masks when classes begin. Detroit public schools will probably require them unless everyone in a room is vaccinated. In Pittsburgh, masks will likely be required regardless of vaccination status. And in some states, schools cannot mandate face coverings under any circumstances. With COVID-19 cases soaring nationwide, school districts across the U.S. are yet again confronting the realities of a polarized country and the lingering pandemic as they navigate mask requirements, vaccine rules and social distancing requirements for the fast-approaching new school year. (Hollingsworth, Webber and Richmond, 7/21)

Six more California counties are urging residents to wear masks in indoor public settings amid concerning upticks in coronavirus cases and continued circulation of the highly contagious Delta variant. The latest recommendations from Santa Barbara, Monterey, Napa, San Benito, Santa Cruz and Ventura raise to 17 the number of counties now asking even fully vaccinated individuals to wear face coverings as a precaution while inside places like grocery stores, movie theaters and retail outlets. (Money, 7/20)

Elected officials in tourism-dependent Las Vegas worried Tuesday about public health and the economic effects of a spike COVID-19 cases — particularly the highly contagious delta variant. But they decided not to impose a full mask mandate for everyone strolling the Strip and gathering in crowded spaces and casinos. (Ritter, 7/21)

A popular Massachusetts tourist destination issued a mask advisory Monday after an outbreak of Covid-19 cases following the July 4 holiday weekend. As of Friday, 132 Covid cases that are associated with Provincetown have been reported to the Massachusetts Department of Public Health, according to a joint release from the town's Board of Health and the Barnstable County Department of Health and Environment. It's unclear how many who tested positive were vaccinated. (Fieldstadt, 7/20)

On Tuesday, two federal U.S. agencies, the Federal Aviation Administration (FAA) and Transportation Security Administration (TSA) sounded the alarm on the increasingly unfriendly skies. The FAA announced nearly 100 more in-flight incidents with unruly passengers -- a week after it’s worst weekly report of unruly passengers this summer -- bringing this year's total to 3,509 reports. An overwhelming majority of these incidents, 2,605, involve passengers who refuse to comply with the federal mask mandate. (Kaji, 7/20)

A recent study reveals another devastating impact the coronavirus pandemic has had on children around the world. Researchers at Boston Children’s Hospital estimate more than a million children may have been orphaned because of a COVID-19-related death, according to their model published Tuesday in The Lancet. They defined orphaned as losing at least one parent. The authors estimate 1.13 million children lost a parent or custodial grandparent, and of these, 1.04 million losta mother, father, or both. Overall, 1.56 million children were estimated to have experienced the death of at least one parent or a custodial grandparent, or other grandparent living with them. (Rodriguez, 7/20)

Since the onset of the pandemic, children in the U.S. have faced multiple challenges and hardships. Tragically, recent data reveals that a staggering number of children have been faced with the most heartbreaking reality: the loss of a caregiver to COVID-19. An estimated 119,000 children across the country have lost a primary caregiver due to COVID-19 associated death, and more than 140,000 children experienced the death of a primary or secondary caregiver, defined as co-residing grandparents or kin, according to data in an internal Centers for Disease Control and Prevention document obtained exclusively by ABC News. (Mitropoulos, 7/20)

New Covid-19 cases among children are back on the rise after months of declines, just as schools across the United States are gearing up to reopen in a few weeks. The American Academy of Pediatrics (AAP) said Tuesday more than 23,550 child cases of Covid were reported between July 8 and 15 -- nearly double what was being reported in late June. Child age ranges vary by state, according to the group's most recent report, with more than half of states defining children as anyone 19 or younger, and two states -- Utah and Florida -- limiting the range to anyone 14 or younger. (Maxouris, 7/20)

Wyatt Gibson waved at strangers in the grocery store because he knew it made them happy. The 5-year-old danced around in tiny cowboy boots, strumming a toy guitar and singing, “I love donkeys and I love dogs.” He enjoyed building things with Legos, visiting the Tennessee Aquarium and helping take care of the horses on his family’s farm in Calhoun. Wyatt died Friday after he was diagnosed with COVID-19, according to his godmother, Amanda Summey, who spoke on behalf of his parents. His death comes amid a surge of COVID-19 cases and hospitalizations around the world, much of it driven by the spread of the disease among the unvaccinated and the highly contagious delta variant. No vaccines are authorized for children under 12. (Redmon, 7/20)

Children's National Hospital in Washington, D.C. and the National Institutes of Allergy and Infectious Disease are launching a $40 million study to examine long COVID and multi-system inflammatory syndrome in children. While kids have been comparatively unscathed by COVID, this is the largest study of its kind aimed at understanding the long-term impacts COVID can have on children when they do have more serious outcomes. (Reed, 7/20)

An unseasonal surge of winter viruses is landing children in the hospital in the middle of summer. The illnesses include severe colds, croup, which causes a severe cough, and respiratory syncytial virus, or RSV. The rise worries already overwhelmed doctors as the school year approaches. (Edwards, 7/20)

Loneliness among adolescents around the globe has skyrocketed since a decade ago — and it may be tied to smartphone use, a new study finds. In 36 out of 37 countries, feelings of loneliness among teenagers rose sharply between 2012 and 2018, with higher increases among girls, according to a report released Tuesday in the Journal of Adolescence. (Bahrampour, 7/20)

The Biden administration has once again renewed a declaration that a "public health emergency" exists due to the continued spread of the coronavirus. Department of Health and Human Services Secretary Xavier Becerra issued the renewal on Monday – the sixth time the federal government has done so since the initial declaration was made at the start of the pandemic last year. Following the declarations, the federal government can tap into certain funds to combat the public health emergency, amongst other actions. (Norman, 7/20)

President Biden on Tuesday touted the progress the U.S. has made against the coronavirus pandemic but acknowledged that the country has a long way to go amid a rise in cases due to the delta variant. Speaking at a Cabinet meeting marking his first six months in office, Biden said that his administration’s focus is on persuading those who are not yet vaccinated against COVID-19 to get their shot. (Chalfant, 7/20)

As President Joe Biden scrambles to convince hesitant Americans to get the Covid-19 vaccine, his White House has largely steered clear of Fox News, the major cable news outlet whose opinion hosts and guests have been spreading unsubstantiated fears about vaccinations. The White House has so far taken an arms-length approach to Fox, despite its strong following among supporters of former President Donald Trump, who watch the network more regularly than any other cable outlet, and are less likely to be vaccinated than the average American. Administration officials have appeared only sparingly on the network to discuss the necessity of the vaccine and counter persistent doubts about its efficacy being voiced there. And off of Fox’s airwaves, they have been reluctant to call out the network. (Cadelago and Stein, 7/20)

A resurgence in coronavirus cases is threatening the Biden administration’s promises of a swift economic recovery, with Wall Street getting battered on Monday and some leading forecasters beginning to rethink their extremely rosy projections. The administration is closely monitoring the economic risks associated with the delta variant, and senior U.S. officials have in recent days suggested that local restrictions may have to be reimposed in response to the pandemic. (Stein and Long, 7/20)

The Johnson & Johnson COVID-19 vaccine may be less effective in battling coronavirus variants than other shots, a new study suggests. The results, published by bioRxiv but not yet peer reviewed or published in a journal, suggest that the mRNA vaccines made by Pfizer-BioNTech or Moderna could better protect against the delta and lambda strains than the Johnson & Johnson vaccine. (Polus, 7/20)

The coronavirus vaccine made by Johnson & Johnson is much less effective against the Delta and Lambda variants than against the original virus, according to a new study posted online on Tuesday. Although troubling, the findings result from experiments conducted with blood samples in a laboratory, and may not reflect the vaccine’s performance in the real world. But the conclusions add to evidence that the 13 million people inoculated with the J.&J. vaccine may need to receive a second dose — ideally of one of the mRNA vaccines made by Pfizer-BioNTech or Moderna, the authors said. (Mandavilli, 7/20)

Intensive-care unit and lung doctor Dr. Vin Gupta told CNBC that he’s already encouraging patients who received the single-shot Johnson & Johnson Covid vaccine to get a Pfizer or Moderna booster shot amid the dramatic increase in delta variant cases across the U.S. Gupta, a professor at the University of Washington’s Institute for Health Metrics and Evaluation, told “The News with Shepard Smith” that “AstraZeneca, when combined with a Pfizer or Moderna booster, is showing tremendous levels of protection against delta, in terms of the antibody levels that are generated in patients.” (DeCiccio, 7/20)

Sen. Mitt Romney is frustrated that some in Israel can get a third shot of the COVID-19 vaccine, but people in the United States cannot. He pressed national health leaders on the availability of booster shots during a Senate committee hearing Tuesday. “Why should we not allow people who are elderly or have other compromised conditions to be able to get that booster?” Romney asked. “We have people who want to get that booster, and I’m hearing that from people who are at risk and concerned.” And he sure sounded like he wanted to get a third injection. (Canham, 7/20)

KHN: Analysis: Necessary Or Not, Covid Booster Shots Are Probably On The Horizon 

The drugmaker Pfizer recently announced that vaccinated people are likely to need a booster shot to be effectively protected against new variants of covid-19 and that the company would apply for Food and Drug Administration emergency use authorization for the shot. Top government health officials immediately and emphatically announced that the booster isn’t needed right now — and held firm to that position even after Pfizer’s top scientist made his case and shared preliminary data with them last week. This has led to confusion. Should the nearly 60% of adult Americans who have been fully vaccinated seek out a booster or not? Is the protection that has allowed them to see loved ones and go out to dinner fading? (Rosenthal, 7/21)

For months, Mayor Bill de Blasio has been reluctant to make coronavirus vaccinations mandatory for anyone, hoping that encouragement, convenience and persuasion would be enough. But with two million adult New Yorkers still unvaccinated — including a high percentage of employees in the public hospital system — and the Delta variant threatening the city with a third wave of cases, City Hall is trying out a new tactic: requiring workers in city-run hospitals and health clinics to get vaccinated or else get tested on a weekly basis, the mayor’s spokesman said Tuesday. (Goldstein, 7/20)

A New Jersey hospital network has fired a half-dozen high-ranking employees who refused to comply with a new policy requiring them to get vaccinated against COVID-19. RWJBarnabas Health, one of the largest health care systems in the Garden State and in the nation, announced in May that it was mandating COVID-19 vaccination for all staff at the supervisory level and above, effective immediately. Those employees were required to have completed their course of vaccinations no later than June 30. (Winsor, 7/20)

“It’s not just hospital workers,’’ the email said. A GHN reader was responding to stories about hospital workers who are unvaccinated, which we co-published with WebMD and Medscape. The emailer told me that he was having trouble finding a home health care company with workers who had been vaccinated against COVID-19. (Miller, 7/20)

The spread of COVID-19 on Cape Cod grew more alarming Tuesday with news that 33 cases of the virus have been reported in a nursing home in West Yarmouth, the Massachusetts Department of Public Health confirmed. Twenty-four residents and 9 staff members at Maplewood at Mayflower Place in West Yarmouth have tested positive for the virus since July 10, a DPH spokesperson confirmed in an email to the Globe on Tuesday. (Chaidez, 7/20)

Nevada has plummeted to the bottom of a federal list for the percentage of vaccinations for the most vulnerable population — nursing home residents. New data from the Centers for Medicare and Medicaid Services shows Nevada stands as the worst U.S. state for protecting seniors living in care facilities. The shocking 61 percent vaccination rate of seniors in Nevada nursing homes, compared to 95 percent for Vermont, prompted the state’s U.S. senators to urge Health Secretary Xavier Becerra to target elderly in the state for federal funds and efforts. Another analysis this week by AARP found similar results and prompted that nonprofit senior advocacy group to sound the alarm in Nevada. (Martin, 7/20)

Nursing home staff in Florida are the second-least vaccinated against COVID-19 as the state faces a surge of new infections driven by the virulent Delta variant. Just 41.8 percent of Florida nursing home staff have been fully vaccinated against the virus, not far from Louisiana's national low of 41.1 percent, according to data released Tuesday by AARP. Almost 84 percent of staff were vaccinated in top-ranked Hawaii, while the national average vaccination rate for nursing home staff is 56 percent. (Slisco, 7/21)

San Francisco bar-goers may soon need to show up with vaccine cards at more bars. The San Francisco Bar Owner Alliance, which represents 500 bars, announced Tuesday that it’s considering a new program that asks patrons to show proof of vaccination before entry. With COVID-19 cases back on the rise in the Bay Area and beyond due to the delta variant, the group’s founder and chair Ben Bleiman said the topic is under discussion with its members. SF Gate first reported on the development; Bleiman confirmed the news to The Chronicle. (Warerkar, 7/20)

Dr. Anthony Fauci, the nation’s top infectious disease expert, angrily confronted Kentucky GOP Sen. Rand Paul on Tuesday in testimony on Capitol Hill, rejecting Paul’s insinuation that the U.S. helped fund research at a Chinese lab that could have sparked the COVID-19 outbreak. Paul suggested that Fauci had lied before Congress when in May he denied that the National Institutes of Health funded so-called “gain of function” research — the practice of enhancing a virus in a lab to study its potential impact in the real world — at a Wuhan virology lab. U.S. intelligence agencies are currently exploring theories that an accidental leak from that lab could have led to the global pandemic. (7/21)

"On May 11, you stated that the NIH has not ever and does not now fund gain-of-function research to the Wuhan Institute of Virology and yet, gain-of-function research was done entirely to the Wuhan Institute by Dr. Shi [Zhengli] and was funded by the NIH," Paul said. The senator said that in Shi's study, she stated that she had received a grant from NIH for her work, which involved combining genetic information from various coronavirus that only infected animals to test transmissibility in humans. "Senator Paul, I have never lied before the Congress and I do not retract that statement," Fauci said. "This paper that you are referring to was judged by qualified staff up and down the chain as not being gain-of-function."(Fung, 7/20)

PAUL: "You take an animal virus and you increase its transmissibility to humans, you're saying that's not gain-of-function?" FAUCI: "That is correct. And Senator Paul, you do not know what you are talking about, quite frankly. And I want to say that officially. You do not know what you are talking about." ... PAUL: "All of the evidence is pointing that it came from the lab. There will be responsibility for those who funded the lab, including yourself." FAUCI: "I totally resent the lie you are now propagating, senator. ... You are implying that what we did was responsible for the deaths of individuals. I totally resent that and if anybody is lying here, senator, it is you." (7/20)

It's not unusual for conservative Republicans and allies of former President Trump to clash with Fauci during hearings; Paul has done so on numerous occasions, as has Rep. Jim Jordan (R-Ohio). In the past, Fauci has tried to remain relatively calm, if terse, even as he responds to personal attacks and accusations of a cover-up. But on Tuesday, Paul stepped up his fight, implying that Fauci had lied to Congress, and that he was fully aware of what the Wuhan lab was doing with grant money that came from NIH. He also suggested that Fauci and the NIH could be partly responsible for the pandemic and the deaths of 4 million people worldwide.(Weixel, 7/20)

Scientists with differing opinions about COVID-19 origins than Dr. Anthony Fauci keep it to themselves because because the top disease expert controls much of their funding, Sen. Rand Paul, R-Kentucky, told "Fox News Primetime" Tuesday night. Paul subjected Fauci to stiff questioning during a Senate hearing chaired by Democrat Amy Klobuchar of Minnesota earlier in the day, with Fauci quibbling over Paul's definition of gain-of-function research, which the lawmaker said came from a document sourced by another epidemiological expert. The senator went on to urge Fauci, the head of the National Institutes of Allergy & Infectious Disease, to reconsider prior testimony denying NIAID or NIH's particular funding endeavors at the Wuhan lab; where many believe COVID-19 originated – citing federal perjury laws. (Creitz, 7/21)

Senate Republican leader Mitch McConnell implored unvaccinated Americans Tuesday to take the COVID-19 shot, issuing a stark and grave warning of a repeat of last year’s rising caseloads and shutdowns if people refuse to protect themselves from the coronavirus. McConnell urged Americans to ignore the “demonstrably bad advice” coming from pundits and others against the vaccines. As cases skyrocket, he noted that nearly all the new virus hospitalizations in the U.S. are among people who have not been vaccinated. (Mascaro, 7/21)

A growing number of top Republicans are urging GOP supporters to get vaccinated as the delta coronavirus variant surges across the United States, marking a notable shift away from the anti-vaccine conspiracy theorizing that has gripped much of the party in opposition to the Biden administration’s efforts to combat the virus. Senate Minority Leader Mitch McConnell (R-Ky.) was part of the rising chorus on Tuesday, stressing the need for unvaccinated Americans to receive coronavirus shots and warning that the country could reverse its progress in moving on from the pandemic. (Sotomayor, Alemany and DeBonis, 7/20)

Rep. Steve Scalise, the No. 2 Republican in the House, got vaccinated against COVID-19 on Sunday after months of waiting, citing the rise of the delta variant and increasing cases and hospitalizations, primarily among people who are unvaccinated. His decision, reported on Nola.com, comes as lawmakers and the White House try to reach those hardest to convince to get vaccinated, and those with limited access. The messaging is delicate as there are also mild cases among people who are vaccinated — including in Washington, D.C. "These shots need to get into everybody's arm as rapidly as possible, or we're going to be back in a situation in the fall — that we don't yearn for — that we went through last year," Senate Minority Leader Mitch McConnell told reporters on Tuesday. (Wise, 7/20)

On Tuesday, Representative Steve Scalise of Louisiana, the No. 2 House Republican who said he had received his first Pfizer vaccine shot only on Sunday, blamed the hesitance on Mr. Biden and his criticism of Donald J. Trump’s vaccine drive last year. Senator Tommy Tuberville, Republican of Alabama, said skeptics would not get their shots until “this administration acknowledges the efforts of the last one.” And Senator Roger Marshall of Kansas pointed the finger at the White House press secretary, Jen Psaki, and the director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony S. Fauci. Amid a widening partisan divide over coronavirus vaccination, most Republicans have either stoked or ignored the flood of misinformation reaching their constituents and instead focused their message about the vaccine on disparaging President Biden. (Weisman and Stolberg, 7/20)

When Dr. Alexa Mieses Malchuk talks to patients about the COVID-19 vaccine, she tries to feel out where they get their information from. “Sometimes I feel like the education I have to provide depends on what news channel that they watch,” the doctor in Durham, North Carolina, said. The mixed messaging can come from the same media outlet — and even the same source. On Fox News Channel on Monday, host Sean Hannity looked straight into the camera to deliver a clear message: “It absolutely makes sense for many Americans to get vaccinated. I believe in science. I believe in the science of vaccinations.” (Bauder, 7/21)

KHN: The Delta Variant Thrives In A State Of Political And Public Health Discord 

The day after Missouri Gov. Mike Parson finished his bicentennial bus tour to drum up tourism to the state in mid-July, Chicago issued a travel advisory warning about visiting Missouri. Earlier this summer, as covid-19 case counts began to tick up when the highly transmissible delta variant took hold in the state, the Republican-majority legislature successfully enacted laws limiting public health powers and absolving businesses from covid legal exposure. (Weber, 7/21)

Linda Zuern, a supporter of former President Donald Trump and a protester against COVID-19 vaccines, has died of coronavirus. She lived in Bourne, Massachusetts. She was 70. Zuern reportedly contracted the virus after visiting her mother in South Dakota, following the death of her father. During their return trip to Bourne, both women contracted the illness, the Cape Cod Times reported. ... Zuern opposed local vaccinations efforts, both as a member of the county government council, the Barnstable County Assembly of Delegates, and as a volunteer with a local conservative group called United Cape Patriots. Last December, while serving her third term on the Assembly, she pushed for local doctors to use hydroxychloroquine to treat COVID-19 patients. (Villarreal, 7/20)

House Minority Leader Kevin McCarthy’s trip to Israel got postponed. Nearly half of House members are masked on the floor again. One Senate Democrat even floated a “proof of vaccination” card to enter the Capitol. As Covid infections have crept back onto the Hill, they've shattered the sense of calm that had just begun to settle across the complex after the deadly pandemic and insurrection. After a weekslong trudge toward normalcy, fears are now spiking over the highly contagious Delta variant, which the Capitol physician confirmed Tuesday has been reported in Capitol office buildings. (Ferris and Tully-McManus, 7/20)

Congress, staffers and reporters are wearing masks again as Capitol Hill faces a new wave of the coronavirus despite widespread vaccinations. Why it matters: The Delta variant is surging, and Congress is a potential petri dish for the new variant. House and Senate leaders are weighing whether to reintroduce coronavirus protocols to the Capitol. While most lawmakers have been vaccinated, they fit high-risk profiles and work in close quarters. (Treene, 7/20)

Three Republican U.S. House members have lost appeals challenging fines for not wearing face coverings on the House floor earlier this year. On Tuesday, the U.S. House Ethics Committee released statements noting that U.S. Reps. Marjorie Taylor Greene of Georgia, Thomas Massie of Kentucky and Ralph Norman of South Carolina had failed in their appeals of $500 fines issued in May. (Kinnard, 7/21)

A senior spokesperson for House Speaker Nancy Pelosi and a White House official tested positive for Covid-19 after coming into contact with Democrats from the Texas state legislature last week. The Pelosi spokesperson had helped show the Texas lawmakers, who came to Washington, D.C., to stop their majority-conservative state legislature from passing new voting restrictions, around the Capitol. (Sheehey, 7/20)

Press secretary Jen Psaki on Tuesday confirmed that there have been multiple breakthrough coronavirus cases among White House staffers. What she's saying: Psaki said that the White House has committed to sharing when a commissioned officer — "the highest level ranking people in the White House," she explained — tests positive for the virus. She did not clarify if that meant that the White House would not announce when a non-commissioned official gets infected. (Gonzalez, 7/20)

The White House has not disclosed past breakthrough cases of COVID-19 among fully vaccinated staff members, although none of the cases have occurred among commissioned officers, White House press secretary Jen Psaki confirmed during Tuesday's press briefing. Psaki's comments came after a White House official confirmed Tuesday that a fully vaccinated White House official tested positive for the virus off campus, although the White House Medical Unit determined the individual had no close contacts among White House principals and staff. The breakthrough case comes as multiple members of a Texas delegation to Washington, D.C., tested positive, despite being fully vaccinated. After meeting with members of the Texas delegation, a fully vaccinated spokesperson for House Speaker Nancy Pelosi tested positive as well, according to Pelosi's deputy chief of staff. (Watson, 7/20)

A bipartisan Senate deal to improve the nation’s infrastructure again appeared in political peril Tuesday as Republican negotiators demanded a delay on an upcoming vote on the proposal until next week. With Senate Majority Leader Charles E. Schumer (D-N.Y.) refusing to bend, GOP senators indicated that they plan to oppose a vote to begin debate on the deal they helped craft. (Romm, DeBonis and Kim, 7/20)

Schumer’s push to move forward on the bipartisan infrastructure framework comes as Senate Democrats also prepare a $3.5 trillion social spending plan that they expect to wrestle through without GOP buy-in. Schumer has also set a Wednesday deadline for Senate Democrats to reach an agreement detailing how committees will construct that bill. It’s not clear if the failure of the bipartisan deal would force an increase in the separate bill's $3.5 trillion price tag. (Levine and Everett, 7/20)

Democrats have been pursuing a two-track infrastructure strategy, trying to reach an agreement on a smaller bipartisan deal and Democratic unity on a second, larger bill that will include a host of other priorities for the party and Biden. The balancing act is made more complex because support for the bipartisan bill is tied up with Democrats’ plans for the second $3.5 trillion plan, which is to be passed under budget reconciliation rules — the process to avoid a GOP filibuster. (Carney, 7/20)

Shortly before Chuck Schumer cued up a vote on the staggering bipartisan infrastructure agreement reached by five of his centrists, he gathered them all in person for a gut check. The Senate majority leader wanted to explain his thinking in greater detail to the Democrats who’ve labored to cut a nearly $600 billion deal with Republicans, according to two sources familiar with the meeting. He needed to make sure everyone in his tight-knit 50-member caucus was behind him before taking a gamble that could endanger the bipartisan talks he’s spent weeks supporting. (Everett and Levine, 7/20)

A federal judge on Tuesday temporarily blocked an Arkansas law banning nearly all abortions, calling it an “imminent threat” to the constitutional rights of women seeking abortions in the state. Judge Kristine Baker of the U.S. District Court for the Eastern District of Arkansas issued a preliminary injunction, preventing the law from being enforced until she can issue a final ruling. (Pietsch, 7/21)

Republican Arkansas Gov. Asa Hutchinson signed the bill into law in March and has been blunt about its goal of overhauling abortion rights. He told CNN's Dana Bash on "State of the Union" later that month, "I signed it because it is a direct challenge to Roe v. Wade," the 1973 Supreme Court ruling that legalized the procedure nationally. The American Civil Liberties Union, the American Civil Liberties Union of Arkansas and Planned Parenthood, which filed the lawsuit against the Arkansas ban along with other abortion rights groups, cheered the order. (Kelly and Riess, 7/20)

Guerilla art collective Indecline said in a press release that it is responsible for a “God Bless Abortions” banner hanging across the 67-foot statue of Jesus located atop Magnetic Mountain. The group calls the banner a piece of protest art in “direct response to the dramatic attempts being made in Arkansas and throughout the South, to ban abortion services to women in need.” Indecline says it was smuggled onto the mountain by a small team disguised as a construction crew and strung up before sunrise on Friday. (Brantley, 7/9)

The National Association of Christian Lawmakers has officially launched a nationwide push against abortion rights. At its first annual policy conference last weekend, group members voted to make a controversial new Texas law, the “Texas Heartbeat Bill,” the organization’s first piece of model legislation, meaning that similar bills may soon pop up in state capitols across the country. The model legislation, called the Heartbeat Model Act, was accepted unanimously by the executive committee during a Saturday meeting. (Jaradat, 7/20)

Mexico’s Gulf coast state of Veracruz became the fourth of the country’s 32 states to legalize abortion Tuesday. The Veracruz state legislature voted 25-13 to allow abortions in the first 12 weeks of a pregnancy. Those who perform abortions on women after the first three months can be punished by 15 to 60 days in prison, which can be substituted by a fine and 50 to 100 of community work. (7/21)

Self-insured employers face low market power, stripping them of their ability to negotiate for lower prices with providers, according to a study. Published July 13 in the American Journal of Managed Care, the study drew a line between hospital price negotiating power and employer market power. (Moran, 7/20)

So you need surgery? Good luck figuring out exactly what the procedure will cost you. Not a single one of the eight California hospitals, including Stanford Hospital and UCSF Helen Diller Medical Center at Parnassus Heights, analyzed in a new report by the nonprofit Patient Rights Advocate (PRA) comply with a price transparency rule that requires medical centers to post standard charges and other information online so that patients can more easily figure out the cost of their health care upfront. The report found that just 5.6% of 500 hospitals across the country comply fully with the rule, which took effect in January. (DeRuy, 7/20)

Americans increasingly struggled to pay their medical bills during the pandemic because of being infected with the coronavirus, losing income or losing employer health insurance coverage, a new survey shows. More than a third of insured adults and half of uninsured adults said they had difficulty   paying for a medical bill. The national survey by the Commonwealth Fund between March and June 2021 asked 5,450 working-age adults about how the pandemic affected their health insurance coverage and medical debt. “They suffered ruined credit ratings. They were unable to afford basic life necessities like food, heat or their rent,” said lead author Dr. Sara Collins, Commonwealth Fund's vice president for health care coverage, access and tracking. (Avery, 7/20)

UnitedHealthcare said Tuesday it will pay for either a 12-month digital Peloton membership or a four-month "all-access" Peloton membership (each costs $156) for workers who are in a fully insured plan. Health insurers want their members to be as young and healthy as possible so they don't have to pay out as much in medical claims. UnitedHealthcare is attempting to attract more of this affluent, healthy crowd through this Peloton perk. (Herman, 7/20)

For-profit hospital giant HCA Healthcare is benefiting from a rebound in patient traffic this year after a dismal 2020 marked by COVID-19 shutdowns and anxious patients delaying care. HCA's admissions jumped 17.5% year-over-year in the second quarter of 2021, which ended June 30. The biggest gains occurred in outpatient surgeries, emergency room visits and urgent care visits, the company disclosed in its financial statement. (Bannow, 7/20)

Anthem Blue Cross and Dignity Health could not agree on new contract terms, removing more than two dozen Dignity hospitals, medical groups and clinics across California from Anthem's network as of July 16. Dignity, which is part of CommonSpirit Health and has the largest hospital network in California, threatened to end its contract for the vast majority of its Anthem business if the insurer didn't agree to "excessive rate increases that will make care at Dignity even less affordable," Anthem Blue Cross said. The contract termination impacts Anthem commercial PPO, EPO, HMO and POS members as well as some Medicaid and Medicare Advantage policyholders, but the company could not specify how many customers were affected. (Kacik, 7/20)

Two New York City hospitals, Maimonides Medical Center and New York Community Hospital combined to form a new local health network in the Brooklyn borough, the organizations said July 19. The formal agreement builds on a clinical service agreement in place since 2018.Under the agreement, which recently received state approval, the 711-bed Maimonides Medical Center will be a co-operator of the 134-bed New York Community Hospital. (Paavola, 7/20)

In a move that is expected to prove transformative to the national HIV-prevention effort, the federal government has announced that almost all health insurers must cover the HIV prevention pill, known as PrEP, or pre-exposure prophylaxis, with no cost sharing — including for the drug itself and, crucially, for clinic visits and lab tests. This means the entire experience of maintaining a prescription to Truvada or Descovy, the two approved forms of PrEP, should now be totally free for almost all insured individuals. A prescribing physician, however, must persuade an insurer that Descovy in particular is medically necessary for any specific patient to qualify for zero cost sharing for that drug’s use as HIV prevention. (Ryan, 7/20)

New York reached a $1.1 billion settlement on Tuesday with three of the country's largest drug distributors for their alleged role in the opioid epidemic, New York Attorney General Letitia James said. The settlement comes as the three companies — McKesson, Cardinal Health, and Amerisource Bergen — as well as Johnson & Johnson near a $26 billion deal with states and municipalities that would settle thousands of lawsuits related to the opioid crisis, the New York Times reports. (Doherty, 7/20)

The settlement would not conclude all of the multifaceted nationwide opioid litigation but would end legal action against some of the companies with the deepest pockets in the pharmaceutical supply chain: the country’s major medical distributors, Cardinal Health, McKesson and AmerisourceBergen, along with the pharmaceutical giant Johnson & Johnson. (Hoffman, 7/20)

Three of the largest pharmaceutical wholesalers in the U.S. agreed to pay up to $1.1 billion to settle a lawsuit in which the state of New York claimed the companies contributed to the opioid crisis by failing to monitor suspicious shipments. The deal – which involves AmerisourceBergen (ABC), Cardinal Health (CAH), and McKesson (MCK) – comes amid a trial that was already underway and as the companies also attempt to reach a deal to settle nationwide litigation brought by numerous states, cities, counties and Native American tribes. An agreement worth $21 billion is reportedly set to be announced this week. (Silverman, 7/20)

West Virginia residents with serious medical conditions can register with the state at an upcoming public event for medical cannabis products. The state Office of Medical Cannabis will conduct the event next Monday at the Kanawha-Charleston Health Department. The Department of Health and Human Resources said appointments are strongly encouraged. (7/21)

New [Florida] rules laying out the do’s and don’ts physicians must follow when certifying patients to smoke medical marijuana took effect last week, but it’s not clear that doctors or patients are fully aware of them. Patients certified or recertified to smoke medical marijuana must sign a new standardized consent form as of last Tuesday. That form for the first time includes information about the dangers of smoking near oxygen tanks and advises patients to check their marijuana supplies for mold contaminants. (Sexton, 7/20)

The U.S. cannabis industry had eagerly awaited a federal legalization bill that executives, investors and interest groups had hoped would be a panacea for the partisan divide over a hotly contested issue. What they saw last week from Senate Majority Leader Chuck Schumer left many underwhelmed. Cannabis stocks flagged after the bill was unveiled, and critics piled on from all directions. It’s not a surprise that the legislation wouldn’t please everyone, given the controversies around cannabis. Even the bill’s own authors acknowledge shortcomings, saying in a summary of the proposal that there’s still no standard to measure drugged driving, or research on how marijuana affects fetal health, and that limits their ability to be as comprehensive as they’d like. The plan is to fund more research on those and other topics, but that could take years. (Kary, 7/19)

Pandemics aside, medical conferences are popular destinations for doctors, who are barraged with information about pharmaceuticals. And now, the Food and Drug Administration wants to know how much of that messaging is false and misleading. The agency plans to conduct a study to learn what physicians are digesting as they walk among the exhibit booths at those conferences. Why? In disclosing its plans, the FDA pointed to a 2006 study that found at least 80% of physicians attend at least one medical conference each year and spent an average of seven hours on the exhibit hall floor at each event. (Silverman, 7/21)

If ever there were a cautionary tale for the Food and Drug Administration’s approval of the Alzheimer’s drug Aduhelm, it might be in the 2016 approval of Exondys 51. In signing off on the drug, the FDA bucked the recommendation of an independent advisory committee and issued a landmark accelerated approval for the drug, which is aimed at a devastating childhood disease called Duchenne muscular dystrophy. (Silberner, 7/21)

More people said they experienced negative emotions and feelings in 2020 than any other year in recent history, according to Gallup's latest Negative Experience Index. "2020 officially became the most stressful year in recent history," Gallup writes. Gallup surveyed adults in 115 countries, finding that 4 in 10 said they experienced worry or stress last year. (Gonzalez, 7/20)

Playing puzzles, card games, reading books and engaging in other mentally stimulating activities later in life can help delay the onset of Alzheimer’s dementia by five years, researchers found. Findings published in Neurology on July 14 analyzed nearly 2,000 patients about 80 years old on average and free of dementia at the study start. During seven years of follow-up with annual exams and cognitive tests, some 457 people about 90 years old on average developed dementia, or "impaired ability to remember, think, or make decisions that interferes with doing everyday activities," according to the Centers for Disease Control and Prevention (CDC). (Rivas, 7/20)

More than 200 people in 27 states are being monitored for possible exposure to monkeypox after they had contact with an individual who contracted the disease in Nigeria before traveling to the United States this month, according to the Centers for Disease Control and Prevention. To date, no additional cases have been detected. State and local health authorities are working with the CDC to identify and assess the individuals, and follow up with them daily until late this month, said Andrea McCollum, who leads the poxvirus epidemiology unit at the agency’s National Center for Emerging and Zoonotic Infectious Diseases. (Branswell, 7/20)

KHN: Though Millions Are At Risk For Diabetes, Medicare Struggles To Expand Prevention Program 

Damon Diessner tried for years to slim down from his weight of more than 400 pounds, partly because his size embarrassed his wife but even more because his doctors told him he was at risk of developing Type 2 diabetes. His hemoglobin A1c level, a blood sugar marker, was 6.3%, just below the diabetes range of 6.5%. Then, two years ago, one of his doctors helped get him into a YMCA-run Diabetes Prevention Program not far from his home in Redmond, Washington. The group classes, at first held in person and then via Zoom during the covid-19 pandemic, were led by a lifestyle coach. He learned how to eat better, exercise more and maintain a healthier lifestyle overall. He now weighs 205 pounds, with an A1c level of 4.8%, which is in the normal range. (Meyer, 7/21)

A resurgent COVID pandemic is pushing Apple to delay its return-to-office deadline by at least a month, to October at the earliest, people familiar with the matter said. The Cupertino iPhone giant was responding to the new coronavirus variants that are dramatically increasing case rates and hospitalizations around the world, according to the people, who asked not to be identified because they were discussing the firm’s internal policy. Apple last month told employees to be back in the office at least three days a week starting in early September, prompting more than 1,700 workers to sign a letter to company executives asking for more flexibility to work remotely, tech website The Verge first reported. This month, Apple employees again wrote to their leaders, objecting to a lack of action on flexibility, according to tech site Recode. (Barron, 7/20)

Paul S. Auerbach was an adventurer — a deep-sea diver, a trekker and, in his vocation as a physician, a doctor who instinctively ran toward the scene of disaster. Early in his career, he discovered that when adventure and disaster combined, and a hiker developed frostbite, a camper was struck by lightning or a swimmer was stung by a stingray, even many doctors were ill-prepared to respond. Just a few years out of his residency, Dr. Auerbach established himself as a father of the field that came to be known as wilderness medicine. With Edward C. Geehr, a fellow specialist in emergency medicine, he co-edited the volume “Management of Wilderness and Environmental Emergencies” (1983), a reference guide that a reviewer for the New England Journal of Medicine described as “long overdue” and one that “doubtless will be a fixture in every emergency room.” (Langer, 7/20)

Smoke from the wildfires ravaging the West Coast is reaching as far east as New York City, according to the National Oceanic and Atmospheric Administration (NOAA). The wildfires, 80 of which were reported as of Monday in 13 different states, are causing harmful air quality conditions across the country. (Polus, 7/20)

Wildfires raging across the western United States and Canada, including a "monster" two-week-old blaze in Oregon, on Tuesday belched smoke and soot that gusted eastward and caused harmful air pollution as far away as New York City. In 13 western states, more than 80 large active wildfires have charred almost 1.3 million acres (526,090 hectares) of drought-parched vegetation in recent weeks, an area larger than Delaware, according to the National Interagency Fire Center (NIFC) in Boise, Idaho. (Szekely and Gorman, 7/20)

Drug overdose deaths increased significantly across the country last year, but Florida in particular saw a huge spike. More than 93,000 people died of a drug overdose in the U.S. in 2020, according to data released by the Centers for Disease Control and Prevention. That’s the highest number of overdose deaths the country has ever recorded, and reflects a 29.4% increase from 2019. Florida ranks second in the nation for overdose deaths, behind California. Last year, 7,579 people died from a drug overdose, an increase of 37% from 2019. (Wentz, 7/20)

Tennessee officials say they’ve finished deconstructing emergency COVID-19 care sites in Nashville and Memphis. According to a news release, the Tennessee Emergency Management Agency said this week that the sites finished serving their purpose of providing additional hospital capacity for COVID-19 patients. (7/21)

Health insurance premiums are expected to stay stable next year for individuals buying coverage on the Colorado insurance exchange, continuing a cost-saving trend under a state-run program that covers the most expensive cases, Gov. Jared Polis said Tuesday. Individuals buying on the exchange are expected to save more than 24% next year compared with what they would pay if they had to purchase coverage without the state program, the Democratic governor said in a statement. The average cost will be 1.4% more than this year, according to preliminary estimates. (Anderson, 7/20)

If denied entry, disengage. If a person facing involuntary hospitalization becomes combative or refuses services, disengage. No more restraints. No more forced entry. Leave and try again later. De-escalation is the essence of the Boston Police Department’s new rules of engagement, distributed departmentwide last week, for interacting with people in mental health crises. The guidelines, effective immediately, call for calm and measured responses and attention to the needs of the person in crisis, and affirm that “persons suffering from possible mental illness are afforded the same constitutional rights as everyone else.” “It gives us protocols where there were none before,” said Sergeant Detective John Boyle, the police spokesman. “It’s a coordinated response to mental health issues.” (Alanez, 7/20)

San Francisco paramedics - not just police officers and doctors - can now order people to be held in confinement for up to 72 hours if they believe those people are experiencing a mental health crisis and are a danger to themselves or others. A new law will give about three dozen paramedics the authority to impose mental health holds on disturbed people as the city turns to non-police responses to deal with crises often visible on the streets. The Board of Supervisors unanimously approved the legislation sponsored by Supervisor Ahsha Safaí on Tuesday. (Moench, 7/20)

A Tuesday report from advocacy group Mental Health America (MHA) says that a majority of states are not ready to address youth mental health as schools prepare to reopen for in-person learning in the fall. The analysis reports that just 14 states have fully expanded Medicaid to cover mental health services in schools, and only a handful have legislation requiring mental health education. (Coleman, 7/20)

The chief of the Tokyo 2020 organizing committee addressed concerns of rising COVID-19 cases during a press conference on Tuesday and did not rule out the possibility of a last-minute cancellation of the games. “We can't predict what will happen with the number of coronavirus cases. So we will continue discussions if there is a spike in cases. I think that is all I can say at this juncture,” said Tokyo 2020 CEO Toshiro Muto, in a response translated from Japanese. (Yamada, 7/20)

The Tokyo Olympics should not be judged by the tally of COVID-19 cases that arise because eliminating risk is impossible, the head of the World Health Organization told sports officials Wednesday as events began in Japan. How infections are handled is what matters most, WHO director general Tedros Adhanom Ghebreyesus said in a speech to an International Olympic Committee meeting. “The mark of success is making sure that any cases are identified, isolated, traced and cared for as quickly as possible and onward transmission is interrupted,” he said. (Dunbar, 7/21)

With events now underway, Tokyo 2020 organizers and national Olympic committees will have to balance concerns about individuals’ well-being with preserving the integrity of medal competitions for which athletes have spent years preparing. Here’s an overview of the protocols an athlete must follow if they test positive for the coronavirus and how their team or individual competition proceeds in the meantime. (Wallace, 7/20)

The Tokyo Olympics is facing the first major test of its Covid protocols, after three people linked to the South African men’s soccer team tested positive for the coronavirus and put into jeopardy its match against Japan scheduled the day before the opening ceremony. Two players and one video analyst from the South African side have tested positive, and 18 others from the delegation who had been in close contact are in isolation. South Africa now has to put together a squad of at least 13 people who can clear health protocols for Thursday’s match. (Herskovitz, 7/21)

The Tokyo 2020 Olympics, postponed for a year because of the coronavirus pandemic, is being held under unprecedented conditions including tight quarantine rules to prevent the spread of COVID-19.A number of cases have emerged among athletes and other people involved with the Games already, however. Following is a list of cases, with the latest first. (7/21)

Seven-time Olympic medalist Shannon Miller shares her journey through cancer diagnosis, treatment and recovery in St. Louis-based Ascension's most recent marketing campaign. In 2011, the then 33-year-old gymnast was diagnosed with ovarian cancer after a routine screening that she almost delayed. After receiving care at Ascension, Ms. Miller — who is now 10 years cancer-free — teamed up with the health system to help ensure other women catch diagnoses before it's too late. (Adams, 7/20)

The Canadian border reopens to fully vaccinated U.S. citizens on Aug. 9, but negative PCR tests will still be required before crossing. A polymerase chain reaction, or PCR, test is a real-time diagnostic test conducted via a nasal or throat swab and can detect SARS-CoV-2. "Regardless of whether you're Canadian or American or any other nationality, and regardless of whether you're fully vaccinated or not, it's mandatory for everybody ages 5 and up to have a valid PCR test, or the equivalent, within 72 hours before arriving," said a Canadian border agent. (Rahal, 7/20)

The total number of excess deaths in India during the pandemic is likely more than than 3 million and could be as high as 4.9 million, according to a study released Tuesday. The number is almost 10 times the country's official death toll, making it "arguably India’s worst human tragedy," said the research team, who includes a former chief economic adviser to the government of Prime Minister Narendra Modi. (Gonzalez, 7/20)

The French government, which last week introduced some of Europe’s toughest measures against COVID-19, has been forced to row back on some restrictions following a pushback from industries and street protests. Among the new rules, French President Emmanuel Macron sought to turbo-drive vaccinations by making proof of vaccination or immunity mandatory to enter cafés, restaurants and a range of other venues this summer. (Caulcutt, 7/20)

U.K. leader Boris Johnson’s pandemic strategy descended into disarray after his own ministers said the public could ignore orders to isolate at home. Two business ministers -- Paul Scully and Gerry Grimstone -- made the point that there is no legal requirement for people to self-isolate if they are “pinged” by the National Health Service’s contact tracing smart-phone app and told to quarantine. The technology uses Bluetooth to identify people who have are at risk because they’ve come into close contact with someone who tested positive for Covid-19. But the app has been at the center of a storm this week, after businesses and employers complained staff shortages were pushing them to the brink, with an estimated 1.73 million people across the country isolating. (Ross, 7/20)

Three million doses of the Moderna coronavirus vaccine donated by the United States arrived in Guatemala on Tuesday. The air shipment landed in Guatemala City, bringing to 4.5 million the number of doses that the United States has given Guatemala so far. (7/21)

Blocked from boosting revenues through enhanced Internal Revenue Service enforcement, congressional Democrats are turning to reducing drug spending as a possible way to salvage their $600 billion bipartisan infrastructure deal. Negotiators are looking for billions of dollars in revenue for the infrastructure package now that Republicans have nixed the idea of bolstering the IRS, which lawmakers have suggested could bring in as much as an additional $100 billion over a decade. (Luhby, 7/19)

A chance for meaningful drug pricing reform is upon us, dozens of purchasers, healthcare and employer groups contend. But Congress needs to capitalize on its “time-limited” opportunity, or the problem could stagnate or worsen. In a letter to a bipartisan group of lawmakers, groups comprised of Families USA, Lower Drug Prices Now, Patients for Affordable Drugs and more called on (PDF) Congress to empower Medicare and the Department of Health and Human Services (HHS) to negotiate drug prices, install price-hike limits and redesign Medicare Part D to slash costs for beneficiaries and taxpayers. (Kansteiner, 7/14)

Senate Democrats have a new pay-for to finance a "soft" infrastructure bill: renegotiating Medicare prescription drug prices to save $600 billion — setting up a battle between progressives and well-capitalized drug companies. Why it matters: By targeting pharma, Democrats are opening up a funding stream President Biden didn't initially include in his $4 trillion Build Back Better agenda. It relied on hiking taxes on corporations and Americans earning over $400,000. (Nichols, 7/15)

AARP is ramping up pressure on Congress, launching a digital ad campaign on Monday to call on lawmakers to lower prescription drug prices. The seven-figure ad campaign will focus on the Washington, D.C., area, appearing in The New York Times, The Washington Post, CNN, Politico and Axios through July 30. (Coleman, 7/19)

Repealing one of former President Trump's last big moves on drug pricing may go a long way toward helping Democrats pay for two of their big legislative priorities. The big picture: Repealing Trump's regulations on drug rebates could give Democrats upwards of $100 billion to help pay for other priorities. Where it stands: Repealing Trump's rebate rule has been pitched as a way to help pay for both a bipartisan infrastructure deal and Democrats' partisan "soft infrastructure" push. (Owens, 7/21)

Last month, Republicans and Democrats in Congress came together to announce a historic bipartisan deal on a $1.2 trillion infrastructure bill.  For months, members on both sides of the aisle worked together to negotiate a compromise that will improve the lives of Americans all across the country. As the drama unfolded, we all saw what can happen when congressional leaders are determined. We now need Speaker of the U.S. House of Representatives Nancy Pelosi (D-Calif.) and Senate Majority Leader Chuck Schumer (D-N.Y.) to make lowering prescription drug prices a top priority.  (Sean Shaw, 7/19)

One of the heartbreaking realities of the United States health care system is that sick people must pay exorbitant amounts of money to obtain life-saving medication. We have heard countless tragedies of people losing their lives solely because they couldn’t pay for prescriptions. These stories have led to progressives calling on the federal government to be the sole negotiator of drug prices to lower them — a policy that must be a priority for Congress. (Shahab Khan, 7/19)

Since the Lower Drug Costs Now Act was first introduced three years ago, the pharmaceutical industry has spent billions of dollars on lobbyists to persuade my colleagues to vote against it. For decades, this industry and its allies have worked overtime to stop any legislative action that could take away drug corporations' unlimited power to price-gouge patients and inflate their profits. (U.S. Rep. Salud Carbajal, 7/15)

Americans should be deeply concerned about our “sick-care” health system. We wait until people fall seriously ill, and then we apply rescue care. But we don’t provide the average American with the highest quality care at the early stages of a disease. Instead, the system is designed to withhold the best medicines, medical devices, and operations until their health deteriorates, and then belatedly, rescue care is offered. It’s a penny-wise, pound-foolish approach to clinical care that puts patients at risk. There’s a far better alternative. (Gary Puckrein, 7/19)

As a country, we have made outstanding progress on the national vaccination effort. The U.S. has crossed over 330 million shots. More than two-thirds of adult Americans have at least one shot, and 58% are fully vaccinated. The strides we have made are a testament to the hard work and collaboration across the public, private and healthcare sectors. (Dr. Bechara Choucair, 7/20)

In much of America, vaccine hesitancy has turned into vaccine defiance. Several states have banned or are considering banning demands by businesses that people show proof of vaccination. Tennessee — where only 38% of adults are fully inoculated and the Covid-19 caseload is growing fast — has gone so far as to cancel public schools’ efforts to encourage eligible children to get their shots (including flu shots). For good measure, the state has fired its medical director for vaccine programs. These actions make it harder to protect the public from Covid-19 as the highly infectious delta variant spreads. States should instead be issuing their own vaccine passports, and requiring health-care workers to be vaccinated — as President Emmanuel Macron has done in France. President Joe Biden should go beyond cajoling the vaccine-hesitant and call on hospitals and nursing homes across the U.S. to insist that their employees get their shots. (7/20)

“Just like we’ve been saying, please take COVID seriously. Enough people have died. We don’t need any more deaths. Research like crazy. Talk to your doctor,” Fox News’s Sean Hannity said last night. “It absolutely makes sense for many Americans to get vaccinated.”Hannity’s “just like we’ve been saying” is doing a lot of work. He reportedly called the pandemic a “hoax” early on, and his colleague Tucker Carlson continues to cast doubt on vaccines, including on yesterday’s program. But Hannity is not alone now. His statement comes as several other major conservatives are speaking up too. (David A. Graham, 7/21)

On Tuesday, White House communications director Kate Bedingfield said the Biden administration is reviewing whether social media companies should be held legally accountable for the spread of misinformation on their sites by changing Section 230 of the Communications Decency Act, which protects their ability to moderate users' content. This statement comes at a time when misinformation -- especially about Covid-19 vaccines -- is spurring both public outcry and the belief among many that social media companies should be more aggressive in their efforts to fight back. (Kara Alaimo, 7/20)

These many pandemic-rattled months, the Tribune Editorial Board has argued many times that the residents of Illinois should shoot off to their vaccination appointments, ideally faster than Jeff Bezos’ rocket ship. Most wise Illinois heads have quietly read the efficacy data of Moderna and Pfizer vaccines, assessed the risks to self, family and community, and done precisely that. No need for any governmental admonition nor lottery prize. According to public health officials, around half the state’s population is fully vaccinated. (8/20)

Last week, nearly every state in the U.S. experienced an increase in daily coronavirus cases. Driven by the Delta variant, this rise and an accompanying increase in hospitalizations have sparked a debate about returning to indoor mask mandates for all, regardless of vaccination status. Los Angeles County announced Thursday that face masks will be required indoors for both vaccinated and unvaccinated people, and the state of Hawaii has maintained a similar requirement amid rising cases. However, officials in both New York City and Chicago recently rejected the idea of a new universal indoor mask mandate. (Peter K. Enns and Jake Rothschild, 7/20)

We know. You are so done with this pandemic. And many of you can honestly say you’ve done everything you can, as a responsible citizen, as a parent, as a good neighbor, to stop the COVID curse from spreading. You wore your mask even though it itched. You kept your distance in grocery store lines. And when that vaccine came available, you called every drugstore to get on the list. (7/20)

Late last week President Biden achieved something I’d thought impossible: He got me to feel bad for Mark Zuckerberg. Sure, it was only a little bad, but that’s no small feat. As I spent the weekend brushing up on funereal dirges to play on my tiny violin, I couldn’t help but marvel at the president’s rhetorical shoddiness regarding Facebook’s role in Americans’ refusal to get vaccinated, the most important obstacle to the nation’s full recovery from the pandemic. (Farhad Manjoo, 7/20)

Much as his predecessors warned Americans against tobacco and opioid abuse, Surgeon General Vivek Murthy issued a formal advisory last Thursday that misinformation—such as the widespread propaganda now sowing doubts about coronavirus vaccines on social media—is “an urgent threat to public health.” It is, but the discussion soured quickly. After President Joe Biden said social-media platforms that turn users against vaccines are “killing people,” an anonymous Facebook official told CNN that “the White House is looking for scapegoats for missing their vaccine goals.” When Press Secretary Jen Psaki said the White House is “flagging problematic posts for Facebook,” conservatives and Twitter contrarians inferred that the government was telling the company to censor people. The journalist Glenn Greenwald described the effort as “fascism.” (Renee DiResta, 7/20)

Parking at the Northern California hospital where I work, I quickly break into a sweat during the 80-foot walk to the entrance. It’s 100 degrees outside, and it’s only 8 a.m. Outdoors, I can feel the intense sunlight on my skin, but inside the cool wards of the hospital, I experience the effects of the recent heat wave in my soul: My first patient of the day is gravely sick from severe heat stroke. A healthy athlete, he became severely lightheaded, disoriented and unable to put together a coherent sentence. He had only spent 15 minutes in a car driving without air conditioning, but these effects were lasting hours. At one point, we thought he was developing a true stroke in his brain and not just heat stroke. (Dr. Thomas K. Lew, 7/21)

A drug that can help obese people safely cut an average of 15% of their body weight sounds like a miracle for those who can’t keep pounds off with diet and exercise alone. Wegovy, a Novo Nordisk A/S drug that the Food and Drug Administration approved in early June, appears to do exactly that. It helps people lose substantially more weight than with existing drugs and showed sustained benefit with limited side effects in clinical trials. Despite that exciting data, it’s not clear that many of those who could use the drug will end up taking it because of uncertain insurance coverage and the baffling values of the U.S. health-care system. (Max Nisen, 7/19)

I’ve been hard on American medicine. Americans are overtested, overdiagnosed and overtreated, I’ve argued, because physicians and hospitals in our capitalist culture care more about profits than patients. In 2019, I touted Medical Nihilism by philosopher Jacob Stegenga. Most medical interventions work poorly, if at all, Stegenga contends, and many do more harm than good; we should therefore resort to tests and treatments far more sparingly. Stegenga’s diagnosis and prescription seemed sensible to me. (John Horgan, 7/20)

The growing use of artificial intelligence in medicine is paralleled by growing concern among many policymakers, patients, and physicians about the use of black-box algorithms. In a nutshell, it’s this: We don’t know what these algorithms are doing or how they are doing it, and since we aren’t in a position to understand them, they can’t be trusted and shouldn’t be relied upon. A new field of research, dubbed explainable artificial intelligence (XAI), aims to address these concerns. (Boris Babic and Sara Gerke, 7/21)

Wage-earning women in Britain have found their voices in yet another singularly female affliction requiring workplace concessions — menopause. Apparently, women of a certain age, roughly 45-55, are suffering consequential menopause symptoms in sufficient numbers to warrant accommodation. A report found that “droves” of women are leaving jobs and careers because they can’t take the heat, so to speak. Hot flashes, which occur when estrogen supplies naturally decrease with age, is the most-oft cited complaint. (Kathleen Parker, 7/20)