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Surgeon General Vivek Murthy on Sunday defended the administration’s new Covid vaccine requirements, calling them “an appropriate legal measure“ that fit in with traditional safety requirements in schools and workplaces. “We have to put this in context. There are requirements that we put in workplaces and in schools every day to make sure that workplaces and schools are safe,” Murthy said on ABC’s “This Week.” (Cohen, 9/12)

U.S. Surgeon General Dr. Vivek Murthy has advised that the Biden administration will "monitor" to ensure no one abuses COVID-19 vaccine exemptions. President Biden last week announced a mandate that required any company with at least 100 employees to mandate its workforce. The only way to avoid the mandate is to claim an exemption on either religious or medical grounds. Some critics argue that the exemptions allow for simple abuse, but Murthy insists the administration will ensure that does not happen. (Aitken, 9/12)

Millions of Americans still need to get vaccinated to slow or stop the spread of Covid-19 and getting the pandemic under control could take "many, many" more vaccine mandates, Dr. Anthony Fauci said. Fauci, the director of the National Institute of Allergy and Infectious Diseases, said if more people aren't persuaded to get vaccinated by messaging from health officials and "trusted political messengers," additional mandates from schools and businesses may be necessary. (Holcombe, 9/13)

History and the law are on President Joe Biden's side when it comes to coronavirus vaccine mandates, a medical historian and legal experts told the Free Press. Although legal challenges are likely, "the mandates are legal and will ultimately be upheld," said Peter Jacobson, professor emeritus of health law and policy at the University of Michigan, of the sweeping plan Biden announced Thursday to combat the pandemic. The plan includes an emergency order through the U.S. Department of Labor's Occupational Safety and Health Administration that will require as many as 100 million U.S. workers get coronavirus vaccines or submit to weekly testing. (Jordan Shamus, 9/11)

And the surgeon general says more mandates are coming —

U.S. President Joe Biden will announce new steps to slow the spread of COVID-19 before the U.N. General Assembly meets, Surgeon General Dr. Vivek Murthy said Sunday. Murthy did not specify what those steps would be. The next session of the General Assembly opens Tuesday; the first day of general debate will be the following week. (9/12)

In other news from the Biden administration —

The Biden administration on Friday announced plans to release more than $25 billion to health care providers to help with costs related to the Covid-19 pandemic, 11 months after the last major round of funding was released. The funds will be the latest tranche from the total $187 billion lawmakers set aside to help health care providers battling the pandemic. Health care providers and lawmakers from both parties had in recent weeks ratcheted up pressure on the Department of Health and Human Services to release billions in unused funds. (Cohrs, 9/10)

Health care associations applaud the new policy and underscore the importance of getting vaccinated, but they're worried it could exacerbate workforce shortages amid a surge of COVID-19 cases and hospitalizations. This unintended consequence could hit rural hospitals especially hard, said Alan Morgan, chief executive officer of the National Rural Health Association. "Right off the back, vaccines are safe and effective and it’s imperative that all rural health care workforce providers and staff need to be vaccinated,” he said. “But we also know that there are higher rates of hospital workers that are unvaccinated and have no intention of getting vaccinated in the rural context … this is a significant concern.” (Rodriguez, 9/10)

A lawsuit against Henry Ford Health System and its executives over the hospital system's COVID-19 vaccine mandate has been withdrawn. Court records show the 51 employees pulled the lawsuit Friday, only four days after filing in U.S. District Court in Detroit, after President Joe Biden signed an executive order Thursday to force hospitals that receive Medicare or Medicaid payments to mandate the vaccine. Biden said Thursday he'd order all executive branch employees, federal contractors and millions of healthcare workers to be vaccinated against the coronavirus, and that his administration would issue rules requiring large private employers to mandate shots or testing. (9/10)

President Joe Biden’s new Covid-19 plan will mandate vaccines for 100 million working Americans, but one group was conspicuously absent from this week’s announcement: senior citizens. They’re also the most likely to be hospitalized or die from the virus -- by a wide margin. Retired seniors have been far more accepting of vaccines than their working-age counterparts. Their full vaccination rate is about 82%, according to the U.S. Centers for Disease Control and Prevention. Because they’re susceptible to severe illness, even relatively few unvaccinated seniors means more deaths -- and more crowded hospitals -- than would occur in a larger pool of younger adults. (Levin and Wingrove, 9/11)

Some 80 million private sector employees will be required to get a Covid vaccine or weekly Covid test under the federal rules announced by President Joe Biden last week. But don't assume that the workers you come in contact with every day will be covered by the mandate, which only applies to businesses with 100 or more employees. In addition to those 80 million workers, there are another 43 million employees who work at companies that employ fewer than 100 people — and who are not covered by that federal mandate. (Isidore, 9/12)

The email chains and phone calls among tribal leaders and lawyers started soon after President Joe Biden announced a sweeping plan Thursday to vaccinate millions of people against COVID-19. Large private employers must require employees to get vaccinated or face frequent tests. Federal employees, federal contractors and staffers of many health care facilities must also get vaccinated. But how will those requirements affect tribal governments and the businesses they operate? “We’re all trying to understand what the president’s six-point plan means,” said Mary Pavel, a Washington, D.C., attorney and former chief counsel for the Senate Committee on Indian Affairs. (Young, 9/11)

The trade group that represents consumer brands including Coca-Cola (COKE), Kellogg (K) and Campbell Soup (CPB) fired off a letter to President Joe Biden on Monday with a laundry list of questions about his new vaccine mandate. In the letter, Consumer Brands Association CEO Geoff Freeman called for "immediate clarity" on the administration's new Covid-19 Action Plan. (Egan, 9/13)

In related news about mandates —

A group of Los Angeles Police Department employees has filed a federal lawsuit challenging the city’s mandate that all L.A. employees be vaccinated against COVID-19. The lawsuit, filed Saturday in U.S. District Court in Los Angeles, claims the mandate violates the employees’ constitutional rights to privacy and due process, and asks the court to provide immediate and permanent relief from the requirement. The six LAPD employees suing include individuals “who could not assert a medical or religious exemption” to the vaccine requirement, as well as individuals who have “experienced and recovered from COVID-19" and have natural antibodies to fight the virus, the complaint states. (Rector, 9/12)

Like other Republican governors around the country, Tate Reeves of Mississippi reacted angrily to the coronavirus vaccine mandates President Biden imposed on private businesses. Declaring the move “terrifying,” he wrote on Twitter: “This is still America, and we still believe in freedom from tyrants.” There is a deep inconsistency in that argument. Mississippi has some of the strictest vaccine mandates in the nation, which have not drawn opposition from most of its elected officials. Not only does it require children to be vaccinated against measles, mumps and seven other diseases to attend school, but it goes a step further than most states by barring parents from claiming “religious, philosophical or conscientious” exemptions. (Stolberg, 9/12)

Republicans officials on Sunday made further threats of legal action against President Biden’s sweeping plan to get tens of millions of American workers vaccinated, with even those who openly urge that people get shots claiming that the mandate violated civil liberties. (Delkic and Heyward, 9/12)

Latter-day Saint leaders in California have been told not to sign “religious exemption” forms for anti-vax members who want to dodge vaccination mandates by citing their faith. The issue has arisen in that state because it now requires vaccines for health care workers, teachers and others. Some members of The Church of Jesus Christ of Latter-day Saints have asked their lay bishops to support their applications to receive religious waivers from their employers. (Fletcher Stack, 9/10)

President Biden’s new COVID-19 vaccination mandate requires all federal workers and contractors, including all healthcare workers in the nation, to receive their shots or lose their jobs. But administration officials said last week that the new federal vaccination program would allow anyone to request an exemption on “narrow” religious grounds or if they had a qualifying disability, loopholes that are similar in California, which announced a vaccination mandate for healthcare workers on Aug. 5 that takes effect Sept. 30. Sharp HealthCare, San Diego’s largest health system, reported that it had received more than 700 religious exemption requests, with UC San Diego Health receiving 610 and Scripps Health more than 400. Those numbers represent about 3% of each organization’s total workforce, about 16,000 to 22,000 workers. (Sisson, 9/12)

A religious freedom group that threatened legal action against Dallas-based Methodist Health System said the health care provider granted religious exemptions this week to four workers who were initially denied, as well as to “many more” employees. Florida-based Liberty Counsel criticized Methodist Health System and several other large corporations for denying religious exemptions to employees who didn’t want to adhere to corporate mandatory vaccination policies. Liberty Counsel sent a letter to Methodist Health on Tuesday threatening legal action if the exemptions weren’t awarded by Friday. (Arnold, 9/12)

Major religious traditions, denominations and institutions are essentially unanimous in their support of the vaccines against Covid-19. But as more employers across the country begin requiring Covid vaccinations for workers, they are butting up against the nation’s sizable population of vaccine holdouts who nonetheless see their resistance in religious terms — or at least see an opportunity. Vaccine-resistant workers are sharing tips online for requesting exemptions to the requirements on religious grounds; others are submitting letters from far-flung religious authorities who have advertised their willingness to help. (Graham, 9/11)

Acouple dozen people asked the Buffalo Diocese for letters supporting a religious exemption from a Covid-19 vaccination. The University at Buffalo and other area colleges and universities granted several hundred exemptions from their mandatory vaccine policy for students, mostly for faith reasons. A national religious liberty organization is threatening to sue New York State over a vaccine mandate for health care workers that doesn’t include a religious exemption. (Tokasz, 9/13)

As the COVID-19 crisis deepens and communities across the country struggle with a shortage of hospital beds, support is falling for religious exemptions to vaccine mandates. In March, 56% of U.S. adults favored offering exemptions to religious objectors. By June, that figure had dropped four percentage points to 52%, according to Public Religion Research Institute. In general, Americans are skeptical of those who say vaccine mandates, like the one proposed this month by President Joe Biden that will affect private employers with more than 100 workers, violate their religious freedom. (Dallas, 9/11)

No major religious denomination in the U.S. opposes vaccination outright. But an individual's "sincerely held" religious belief does not have to be part of an organized-religion mandate to be considered a valid reason for exemption from getting the vaccine. "It can be a personal, sincerely held religious belief which arises from the very nature of freedom of religion articulated in the First Amendment," said Domenique Camacho Moran, a labor attorney at New York-based law firm Farrell Fritz. (Cerullo, 9/13)

As more and more workplaces and colleges require employees and students to be vaccinated, some Hoosiers are responding with an increasingly familiar refrain: It's against my religion. Ivy Tech Community College, for example, has received roughly 230 requests for religious exemptions since mandating the COVID-19 vaccine for certain students. (Xu, 9/13)

The First District Court of Appeal on Friday granted Florida Gov. Ron DeSantis (R) approval to uphold an order banning mask mandates in schools, per court documents filed Friday. The move reverses a decision from earlier this week that paused the state's ability to enforce a ban on strict mask mandates in schools. The state will be able to resume punishing school districts that enforce mandates, which up until this point has included withholding funds from schools. (Doherty, 9/10)

The Education Department announced Friday that it is investigating Florida over its ban on mask mandates. The investigation, which said the ban could discriminate against students with disabilities or underlying medical conditions, is the latest development in both the legal back-and-forth over masks in Florida schools and between the Biden administration and GOP-led states over mask mandates. (Garfinkel, 9/11)

And New York reopens its public schools for in-person learning —

Classroom doors swing open for about a million New York City public school students on Monday in the nation’s largest experiment of in-person learning during the coronavirus pandemic. The start of the school year coincides with several milestones in the city’s pandemic recovery that hinge on vaccine mandates. Nearly all of the city’s 300,000 employees will be required to be back in their workplaces, in person, Monday as the city ends remote work. Most will either need to be vaccinated, or undergo weekly COVID-19 testing to remain in their jobs. (Matthews, 9/13)

In updates from Georgia —

Faculty members and students from about 20 public colleges and universities in Georgia are scheduled Monday to begin a week-long series of demonstrations demanding tougher COVID-19 safety measures, such as a mask mandate, in all campus buildings. The University System of Georgia has strongly encouraged, but not required, students, employees and visitors wear masks inside classrooms and other buildings. They’ve also recommended, but not ordered, students and employees get a COVID-19 vaccine. (Stirgus, 9/13)

University System of Georgia students, faculty and staff plan to launch daily protests of the system’s lack of a mask mandate at campuses across the state starting Monday. The plan was announced in an email to Acting Chancellor Teresa MacCartney this week. Matthew Boedy, president of the Georgia Conference of the American Association of University Professors, complained that without a mask mandate to discourage the spread of COVID-19, many students, professors and staff are not following the system policy encouraging mask wearing. (Williams, 9/11)

In other school news —

The number of COVID-19 cases reported by school districts across Texas for last week significantly decreased, but the number may not be an accurate depiction of reality, according to data released Friday. Districts reported 13,222 confirmed positive cases among students for the week ending Sept. 5 and 1,836 cases among staffers, according to figures released by the Department State Health Services. The week prior, there were 35,230 newly confirmed cases among students and 5,574 among staffers, up from 18,804 new student cases and 4,523 staff cases throughout the state the week before that. The increases arrived as schools started welcoming students back to classrooms. (Serrano, 9/10)

Texas Attorney General Ken Paxton announced Friday that he's suing six school districts that have defied Gov. Greg Abbott's statewide ban on mask mandates. Some school districts in Texas have sought to implement masking requirements for teachers, students and staff as COVID-19 cases surge across the state. (Frazier, 9/11)

A surge in COVID-19 cases in the opening days of school has left school officials charged with contacting classmates potentially exposed to the virus, deciding whether students need to quarantine and determining if the virus is circulating widely enough that classes need to go remote. The responsibilities have mounted as the coronavirus and its delta variant circulate more actively than a year ago, more students are in school buildings and state guidelines allow many students and staff who have been exposed to the virus to forgo quarantines. (Russell, 9/12)

School lunches, long a fun hallmark of youth friendships and the school day, have transformed into a daily period of anxiety for many families and teachers during the pandemic. It’s the one time during the day when — even in cities like D.C. with strict mask requirements — children can be inside maskless. Some parents say they have kept their unvaccinated children out of restaurants during the pandemic and don’t want them now eating maskless in an indoor cafeteria with dozens of other children. (Stein, 9/12)

Unvaccinated people are 11 times more likely to die from COVID-19 than those who are fully vaccinated, new research has found, bolstering evidence that the inoculations continue to provide powerful protection, even against the delta variant. The latest studies from the Centers for Disease Control and Prevention released on Friday also found that vaccinated people were nearly five times less likely to get infected and 10 times less likely to get so sick they ended up in the hospital. The CDC "looked at COVID-19 cases, hospitalizations and deaths in 13 states and offers further evidence of the power of vaccination," Dr. Rochelle Walensky, director of the CDC, said at a White House COVID-19 briefing on Friday. (Romo, 9/10)

Idaho buckles under a covid surge —

Jeremy Smith and his wife Sheena are on a four-wheeler, leading me up a dirt road on the 20 acres of mostly undeveloped land they live on near Sagle, in the Idaho panhandle. We stop near a big grove of trees and get out. It's beautiful. "We've got some Douglas fir. This is a grand pine. This is a maple," Smith says as he walks along a private trail. Smith and his extended family have been hunkering down here since the pandemic began. They are a minority in this very conservative part of Idaho. They take COVID-19 seriously and wear masks. And unlike 65% of the people in Bonner County, they're fully vaccinated. (Hegyi, 9/12)

Northern Idaho has a long and deep streak of anti-government activism that has confounded attempts to battle a COVID-19 outbreak overwhelming hospitals in the deeply conservative region. A deadly 1992 standoff with federal agents near the Canadian border helped spark an expansion of radical right-wing groups across the country and the area was for a long time the home of the Aryan Nations, whose leader envisioned a “White Homeland” in the county that is now among the worst hit by the coronavirus pandemic. Hospitals in northern Idaho are so packed with COVID-19 patients that authorities announced last week that facilities would be allowed to ration health care. (Geranios, 9/12)

In other updates on the spread of the coronavirus —

As Alaska’s hospitals grapple with short staffing, limited capacity and a health care system under serious strain, the state has reported ever-rising record numbers for COVID-19 hospitalizations. But those tallies are complicated. They include people who may have been admitted for something else and test positive for the virus, but they also omit others who have been hospitalized for COVID-19 for so long that they’re not infectious anymore. That all makes it harder to discern the true burden placed on health care facilities using a single number, Dr. Anne Zink, Alaska’s chief medical officer, said in an interview Friday. (Krakow, 9/12)

An onslaught of new coronavirus cases in West Virginia illustrates the dangers that states with low vaccination rates face as the delta variant spreads in the United States — and controversy over vaccine mandates explodes. West Virginia currently has the highest rate in the United States of new cases per day relative to population, and hospitalizations related to covid-19 are also among the highest in the country. New daily cases have increased by 52 percent over the past week, according to Washington Post data — by far the sharpest spike in the country. (Pietsch and Timsit, 9/13)

Teenagers in many of the cities and towns hardest hit by COVID-19 are getting vaccinated at alarmingly low rates, according to an analysis from a Harvard University researcher, raising concerns there could be a fresh surge in infections as schools open for in-person classes across Massachusetts. The analysis, which focused on 42 communities that have had some of the state’s highest infection rates through most of the pandemic, found that 37 of them recorded teen vaccination rates lower, and in some cases dramatically lower, than the state average for teens. (Lazar, 9/11)

Despite one of the state’s highest vaccination rates, the rural South Texas county is struggling to reach the goal of herd immunity. (Hardy, 9/11)

High vaccination rates, geography and a sense of community in the wake of 2019’s Walmart shootings help keep El Paso’s delta numbers low, experts and locals say. (Brooks Harper, 9/13)

Also on the surge —

The annual migration for many snowbirds is weeks away, but the Covid-19 waves in warm-weather locales like Florida and Arizona are causing some seasonal residents to rethink travel plans. Others say they’re determined to make the trip after missing a season in the sun. Fully vaccinated and equipped with latex gloves to pump gas, Robert Slack and his wife, Lois Slack, plan to drive 1,400 miles from their Ontario, Canada, home to Winter Haven, Fla. (Ansberry, 9/11)

Thirteen western lowland gorillas at Zoo Atlanta are receiving treatment for COVID-19 after initial tests came back positive, the Atlanta-Journal Constitution reported. Zoo Atlanta confirmed in a statement on Friday that "a number" of its 20 gorillas had tested presumptively positive, and that the zoo believes they were infected by a fully vaccinated team member. (Saric, 9/12)

Restaurants’ plans to return diners to indoor tables are unraveling. Chains such as McDonald’s Corp. and Chick-fil-A Inc. are slowing their dining rooms’ reopenings, given the Delta-driven surge in Covid-19 infections. Other restaurants are again losing customers, and trying to squeeze more diners into outdoor patios while weather still allows. (Haddon, 9/12)

A hospital in upstate New York will stop delivering babies later this month after 30 staffers quit in protest of the facility’s COVID-19 vaccine mandate. Lewis County Health System CEO Gerald Cayer announced at a press conference on Friday that Lewis County General Hospital will be “unable to safely staff” its maternity department beginning Sept. 25. (Schnell, 9/12)

When Ray DeMonia was having a cardiac emergency last month, his Alabama family waited anxiously for a nearby hospital with available space in its intensive care unit. But in a state where coronavirus infections and unvaccinated patients have overwhelmed hospitals in recent months, finding an available ICU bed was an ordeal. It was so difficult, his family wrote this month, that the hospital in his hometown of Cullman, Ala., contacted 43 others in three states — and all were unable to give him the care he needed. (Bella, 9/12)

Intermountain Healthcare is pausing almost all surgeries to preserve capacity amid a crush of COVID-19 patients, the not-for-profit integrated health system announced Friday. The pause on "urgent but not immediately life threatening" surgeries begins Sept. 15 and will probably last a couple of weeks, Intermountain Healthcare CEO Dr. Marc Harrison said at a news conference. The suspension of surgeries affects 13 of the Salt Lake City-based health system's 24 hospitals. Rural hospitals and its orthopedic specialty hospital and children's hospital are exempt. (Bannow, 9/10)

In related news —

A northwest Georgia county is negotiating an agreement for its employees to work extra at the local hospital, which is over capacity because of COVID-19 patients. The Chattanooga Times Free Press reports that Gordon County commissioners are near a deal to let county employees assist at AdventHealth Gordon when not working for the county. The hospital would pay the employees. (9/12)

Regulatory waivers established last year to help hospitals and health-care workers fight COVID-19 will expire this month, and those in the field are warning the lapse could exacerbate an ongoing staffing crisis as coronavirus cases rise again. At the beginning of the pandemic, Democratic Gov. Tom Wolf approved nearly 100 waivers to ease some of the rules governing health-care workers and ensure as many professionals as possible were on the ground in hospitals, vaccination clinics, and long-term care facilities. (Ohl, 9/13)

As the leader of a rural North Carolina hospital, Joann Anderson has spent the last 18 months figuring out how to best care for patients sick with COVID-19. Just when she thought the coronavirus pandemic had leveled off this summer, offering a glimmer of hope for a new and calmer kind of normal, a surge in cases began to overwhelm UNC Health Southeastern in Robeson County. Now Anderson is mad, and she’s letting everybody know about it. “I don’t use words like ‘infuriated’ or ‘frustrated,’” said Anderson, president and CEO of the hospital in Lumberton in southeastern North Carolina. “That’s not my norm. But I am about this situation.” (Nagem, 9/12)

The Biden administration in recent weeks has announced a series of mandates that require long-term care facilities to fully vaccinate staff against COVID-19, drawing mixed responses from providers, industry leaders and advocates, including those who said the federal policies will put extra strain on an industry already suffering a workforce shortage. But some nursing homes said they've already successfully implemented their own mandates without a significant impact on their workforces, which officials say showcases how the new federal rules can be carried out to protect vulnerable elderly residents amid yet another coronavirus surge. (Rin Kim and Bhatt, 9/12)

The covid-19 response plan President Biden unveiled Thursday envisions a sweeping expansion of coronavirus testing, aiming to make quick-turnaround test kits cheaper and more accessible than ever as the country tries to quell the wave of infections driven by the delta variant. Leaning on test manufacturers to ramp up production, the administration wants to send hundreds of millions of rapid and at-home tests to local clinics, schools and other establishments nationwide in hopes of making it easier for people to catch infections and contain outbreaks early. Major retailers have also joined the push, offering at-home tests to consumers at less than two-thirds the normal price for the next three months. (Hawkins and Nirappil, 9/12)

CVS Health Corp. and Walgreens Boots Alliance Inc. have begun limiting the number of at-home tests customers can buy online or in stores as they work with test suppliers to ensure they are able to meet demand. Meanwhile, employers already are having a tougher time securing bulk tests to screen employees as retail pharmacies and other testing providers ration supplies, according to consulting group Mercer LLC. (Terlep and Abbott, 9/12)

As part of his new COVID-19 plan, President Biden is backing a push to expand testing — including at-home rapid tests. DIY tests offer the potential to regularly surveil people for COVID-19 and get them out of circulation before they can infect others. But the strategy will only be effective if the tests are extremely cheap and plentiful. (Walsh, 9/11)

KHN: Why At-Home Rapid Covid Tests Cost So Much, Even After Biden’s Push For Lower Prices 
Rapid at-home covid tests are flying off store shelves across the nation and are largely sold out online as the delta variant complicates a return to school, work and travel routines. But at $10 or $15 a test, the price is still far too high for regular use by anyone but the wealthy. A family with two school-age children might need to spend $500 or more a month to try to keep their family — and others — safe. (Norman, 9/13)

Also —

A coronavirus-related lawsuit filed in Nebraska that hinges on trade secrets and involves two Utah companies at the center of Utah’s response to the pandemic will proceed. The public records lawsuit seeks information that validated a diagnostic test provided by Orem’s Nomi Health for Nebraska’s multimillion-dollar COVID-19 testing program. The lawsuit, filed on behalf of Salt Lake Tribune board chair Paul Huntsman, seeks an unredacted copy of the validation report maintained by Nebraska Department of Health and Human Services. The report affirms the test’s process and technical aspects. A Nebraska district judge ruled Thursday an expert witness can review the report and determine if it includes trade secrets. (Becker, 9/12)

Former Food and Drug Administration (FDA) Commissioner Dr. Scott Gottlieb predicted Sunday that the agency he helmed will authorize Pfizer's coronavirus vaccine for emergency use in children ages 5 to 11 by the end of October. In an interview with "Face the Nation," Gottlieb, who serves on Pfizer's board of directors, said the drug company is expecting to have data on its vaccines in young children before the end of September, which will then be filed with the FDA "very quickly." The agency then has said it will be weeks, rather than months, before determining whether it will authorize the vaccine for kids ages 5 to 11. (Quinn, 9/12)

The FDA attempted to shed light on the rigorous review process behind yet-to-be authorized COVID-19 vaccines among kids under 12 on Friday as young children remain ineligible for vaccines amid the start of school, stoking concerns and frustration among parents, teachers and pediatricians. "The FDA is working around the clock to support the process for making COVID-19 vaccines available for children," the agency wrote in a statement, adding in part, "this process is complex and relies on robust manufacturer trials and data." The FDA noted that children might need different doses or strength formulations than older populations, which adds on work to manufacturers’ clinical trials. (Rivas, 9/11)

Schools have reopened around the country, and families with those under 12 are finding ways to get their kids inoculated, even though they’re not officially eligible yet. (Schoch, 9/11)

In other news about the vaccine rollout —

The United States is facing a COVID-19 surge this summer as the more contagious delta variant spreads. More than 655,000 Americans have died from COVID-19 while over 4.6 million people have died from the disease worldwide, according to real-time data compiled by the Center for Systems Science and Engineering at Johns Hopkins University. Just 62.7% of Americans ages 12 and up are fully vaccinated against COVID-19, according to data from the U.S. Centers for Disease Control and Prevention. (Winsor, Shapiro, Pereira, Deliso and Lenthang, 9/12)

Misinformation — especially authoritative-sounding articles posted online and circulated on social media — plays a significant role in keeping many Nevadans from getting vaccinated against COVID-19, according to public health experts. In interviews with the Review-Journal about a dozen unvaccinated residents cited a variety of factors for their decisions not to get the COVID-19 vaccine. Almost all fell into one of these six categories: The vaccines hasn’t undergone enough testing and may have side effects that are not yet known.  The shot or shots don’t work because people who are inoculated still get COVID-19... (Dylan, 9/11)

For those who have put off getting vaccinated because they’ve already been infected with the coronavirus, a growing body of evidence suggests vaccination plus natural immunity leads to particularly robust protection, including against variants of the virus. So-called hybrid immunity — that is, natural immunity from an infection combined with the immunity provided by the vaccine — appears to result in stronger protection than just infection or vaccination alone. (Syal, 9/13)

Roving central Colorado with three vans, pop-up tents and folding chairs, public health workers in Jefferson County set out this spring to get coronavirus vaccines to the people who were hardest to reach. They brushed off heckling from passersby who sometimes yelled that covid-19 was a hoax or that the shots were “poison.” But the harassment grew more frequent, said Jefferson County Public Health Executive Director Dawn Comstock. And more threatening. (Knowles, 9/12)

Office politics have been a thing of the past for most of us over the last 18 months, as millions of people worked from home throughout Covid-induced lockdowns. Now, as many employees return to their offices, tensions appear to be emerging along new lines: those who are vaccinated against Covid, and those who are not. (Ellyatt, 9/13)

There’s a growing realization among Democrats that their plans for a $3.5 trillion spending package to reshape the nation’s social safety net and to tackle climate change will have to be slimmed down because of anxious centrists worried about the 2022 midterms. Democrats by and large feel confident that President Biden’s ambitious “human” infrastructure agenda has strong public support and that a majority of Americans favor raising taxes on corporations and the wealthy to help pay for it. (Bolton, 9/12)

Democrats’ internal wrangling over a massive new social spending plan will soon be eclipsed by much more urgent problems: avoiding an economic collapse and a government shutdown. There is growing worry among some rank-and-file Democrats that their tunnel-vision mentality on a $3.5 trillion budget reconciliation bill could provoke economic blowback if Republicans hold the line and tank efforts to lift the debt ceiling. And Democrats' threadbare majorities in Congress are leaving the party with little time to wriggle out of a dangerous economic morass that could overwhelm their other priorities, from voting rights to tax increases on the wealthy to a sweeping expansion of the social safety net. (Everett and Caygle, 9/12)

As top Democrats hashed out a plan this summer for a historic expansion of the social safety net, Sen. Bernie Sanders privately struck a deal with White House officials and Majority Leader Charles E. Schumer that is now having major ramifications. Sanders (I-Vt.), a self-described democratic socialist, agreed to support a $3.5 trillion package — much smaller than he wanted — in exchange for a promise that more than a tenth of the money, at least $380 billion, would go toward his longtime goals, chiefly expanding Medicare to cover hearing, vision and dental care. (Sullivan, Sotomayor, Pager and Stein, 9/12)

A powerful panel of House Democrats on Sunday circulated a draft plan that would raise $2.9 trillion in new taxes and revenue predominantly targeted toward wealthy Americans, corporations and investors, as party lawmakers continued to spar in public over the size and scope of their new tax-and-spending package. The new proposal includes many measures Democrats are widely expected to embrace, such as increasing the top tax rate on Americans earning over $435,000 from 37 percent to 39.6 percent. It also calls for a new corporate tax rate of 26.5 percent for large profitable businesses, up from the current rate of 21 percent but lower than President Biden’s original proposal of 28 percent. Some smaller firms would see their taxes stay the same or even cut under the plan. (Romm and Stein, 9/12)

House Democrats proposed extending the expanded child tax credit through 2025 and making permanent its key feature aimed at helping low-income families, as part of a plan to provide tax breaks for families and renewable-energy producers. The plan, released Friday night, is the latest piece of Democratic legislation that could total $3.5 trillion over a decade. It includes more than $1.2 trillion in tax cuts and refundable tax credits, nearly half of which is the child tax credit, according to estimates released Saturday by the nonpartisan Joint Committee on Taxation. Lawmakers also aim to expand Medicare, create a national paid-leave program and attempt to address climate change, paid for with tax increases on high-income households and corporations. (Rubin, 9/11)

It’s a situation that appears incongruous: Congressional Democrats want to expand Medicare’s benefits while a trust fund that supports the program is facing insolvency. Indeed, some Republican lawmakers have seized on that looming problem as a reason to oppose a proposal to add dental, vision and hearing coverage to Medicare. The provision is included in Democrats’ 10-year, $3.5 trillion spending plan that would expand the social safety net and battle climate change, among other policy goals. (O'Brien, 9/12)

In related news —

Sen. Joe Manchin (W.Va.), a key moderate Democrat, said on Sunday that he can't support President Biden’s $3.5 trillion spending plan. "We don't have the need to rush into this and get it done within one week because there's some deadline we're meeting or someone's going to fall through the cracks," Manchin said on NBC's "Meet the Press." (Oshin, 9/12)

Sen. Mark Warner (D-Va.) is warning that he could vote against the $3.5 trillion budget package if more money isn’t added for housing assistance to close the racial wealth gap in the current House version of the bill, Axios has learned. (Nichols, 9/12)

And in other news from Capitol Hill —

Six U.S. senators are calling for a federal probe into Amazon's treatment of pregnant employees at its warehouses. It's the latest push by lawmakers across the country to focus regulatory attention on the working conditions for the company's ballooning workforce. The U.S. Equal Employment Opportunity Commission should investigate whether "Amazon systematically denies reasonable accommodations for pregnant employees at its fulfillment centers," Sen. Kirsten Gillibrand, D-N.Y., wrote in a letter co-signed by Sen. Bernie Sanders, I-Vt., Sen. Elizabeth Warren, D-Mass., and three other Democrats. (Selyukh, 9/11)

Supreme Court Justice Amy Coney Barrett expressed concerns Sunday that the public may increasingly see the court as a partisan institution. Justices must be “hyper vigilant to make sure they’re not letting personal biases creep into their decisions, since judges are people, too,” Barrett said at a lecture hosted by the University of Louisville’s McConnell Center. (Blackburn, 9/13)

Supreme Court Justice Stephen Breyer on Sunday defended himself against progressives’ calls for him to step down while both a Democratic president and Democratic Senate are in power. "I didn't retire because I had decided on balance I wouldn't retire,” Breyer said in an interview on “Fox News Sunday.” (Hooper, 9/12)

In news about Roe v. Wade and abortion —

The Supreme Court allowing an unprecedented pre-viability abortion ban to go into effect in Texas has prompted questions on the status of Roe v. Wade, the 1973 landmark ruling that's supposed to protect the right to abortion nationally. To some experts, this marks the end of the line for the right to abortion to be federally protected, especially with an upcoming case soon to be heard by the court that directly challenges Roe. (Svokos, 9/12)

On Sept. 3, just two days after Texas banned abortions, Vivek Bhaskaran, the chief executive of an Austin-based online survey software company, quickly assembled the handful of female employees that are based in the city. In a virtual town hall that lasted about 15 minutes, he told the women that regardless of insurance, the company would cover out-of-state abortion services. “I’m not a politician; I can’t change anything. But I’m still responsible for my employees in Texas, and I have a moral responsibility to them,” said Bhaskaran, CEO of QuestionPro. (Abril and De Vynck, 9/12)

Salesforce told thousands of employees in a Slack message on Friday that if they and their families are concerned about the ability to access reproductive care in the wake of Texas’ aggressive anti-abortion law, the company will help them relocate. Texas’ Senate Bill 8 became law in May and went into effect earlier this month. The law says doctors cannot perform or induce abortions if they have “detected a fetal heartbeat for the unborn child,” except in medical emergencies. Additionally, ordinary citizens can file lawsuits against those who aid or abet abortions after the detection of a heartbeat. (Novet, 9/10)

For companies offering abortion coverage as part of their employee health benefits, Texas’ restrictive new abortion law raises a chilling question: Could they, too, be held legally liable if their employees get an abortion? The so-called Heartbeat Act that outlaws the procedure at six weeks creates a new reality for Texans as they decipher what aiding and abetting means under the new law. Employers could be at risk of expensive lawsuits and media coverage attaching them to one of the most controversial and highly politicized health care procedures in modern history. (Wolf, 9/12)

Jonathan F. Mitchell grew increasingly dismayed as he read the Supreme Court’s decision in June 2016 striking down major portions of a Texas anti-abortion bill he had helped write. Not only had the court gutted the legislation, which Mr. Mitchell had quietly worked on a few years earlier as the Texas state government’s top appeals court lawyer, but it also had called out his attempt to structure the law in a way that would prevent judicial action to block it, essentially saying: nice try. (Schmidt, 9/12)

KHN: Journalists Explain Ramifications Of Theranos Trial And Texas’ New Abortion Law
KHN Editor-in-Chief Elisabeth Rosenthal discussed health tech and the start of the fraud trial of Elizabeth Holmes, who founded the biological screening company Theranos, on WGN’s “The John Williams Show” on Wednesday. ... KHN senior correspondent Julie Appleby discussed abortion law in Texas, covid-19 and vaccination rates on NPR’s weekly news roundup “1A” on Sept. 3. (9/11)

Daniel Elliott, a Georgia resident and patient of St. Joseph's/Candler Hospital Health System, has filed a class-action lawsuit on behalf of himself and the 1.4 million patients, professionals, and clients whose personal, financial and health information may have been compromised in the ransomware attack against the hospital's IT systems. Filed on Aug. 28, by the Savannah-based personal injury firm of Harris Lowry Manton LLP, the lawsuit alleges that SJ/C, the region's largest health care system, violated its privacy policy and acted negligently when it failed to adequately secure patients' information and take preventive measures to avoid the ransonware attack and data breach, which was detected on June 17. (Habersham, 9/11)

Health insurers are preparing for a volatile 2022, factoring increased competition, regulatory changes and pandemic uncertainty into their bids for the coming enrollment season on the health insurance exchanges. Next year is poised to be the most competitive yet on Affordable Care Act's exchanges since they opened for business in 2013, said Ari Gottlieb, a principal at the consultancy A2 Strategy. At least 11 insurers plan to enter new markets for the 2022 plan year and some current participants are expanding their footprints, according to data compiled by the consumer guide HealthInsurance.org. Exchange customers have had increasingly more carriers from which to choose over the past three years. Last year, just 10% of counties had a single insurer, down from 25% in 2019. (Tepper, 9/13)

Blue Shield of California and Walgreens are teaming up to offer healthcare services to Blue Shield commercial members aimed at improving condition management and delivering whole-person care, according to a news release on Friday. Eligible Blue Shield beneficiaries will be able to get blood pressure screenings, blood tests to diagnose diabetes, mammography care coordination and other services through Walgreens' Health Corner locations. Pharmacists, dieticians or nurses are available at each site to offer health, nutrition and disease management help and advice to members. (Brady, 9/10)

Newly named CEO Chris Osentowski began working at HCA Houston Medical Center amid a generational pandemic with a vision of creating a hospital Houstonians can be proud of. Located across from the Houston Museum of Natural Science, Osentowski has been leading the medical staff at the hospital since August 23. According to him, stepping into the position during a generational pandemic and staffing crisis for Texas hospitals creates a unique challenge of supporting his staff while expanding hospital capacity because of COVID-19. (Nickerson, 9/12)

OptumHealth Education has co-created a free, publicly available and accredited program to educate healthcare professionals on the LGBTQ community's specific care needs. The series of virtual lessons from Optum and OutCare Health, a national not-for-profit LGBTQ health equity organization, are meant to help providers build and promote a more affirming and supportive healthcare environment for LGBTQ people. This program is a large part of UnitedHealth Group's commitment to advancing health equity, said Amy Nguyen Howell, Optum senior national medical director, Office for Provider Advancement. (Devereaux, 9/10)

Among the many tragic stories in the aftermath of Hurricane Ida are the deaths of seven Louisiana nursing home residents who were evacuated to a warehouse where health inspectors say conditions quickly became unsafe once the storm struck. The squalid conditions found at the Tangipahoa Parish warehouse that sheltered more than 840 people raised new questions and concerns about whether Louisiana is doing enough to protect its most vulnerable residents. (Deslatte, 9/12)

It’s only been a week since 843 nursing home residents were rescued from a partially flooded warehouse in Tangipahoa Parish where they were living in squalor after Hurricane Ida, but the lawsuits are already piling up. At least four separate lawsuits have been filed this week in Orleans, Jefferson and East Baton Rouge parishes over the ordeal, each of them naming Bob Dean and the seven nursing homes he owns as defendants. The suits make a number of claims against Dean, but a persistent theme across them is that Dean violated the bill of rights that’s enshrined in state law for nursing home residents. (Gallo, Simerman and Russell, 9/11)

In news about covid at nursing homes —

More than 68,000 COVID-19 cases and 16,000 related deaths in US nursing homes may have gone uncounted because they occurred before federal guidelines required facilities to report case and death data in late May 2020, suggests a study yesterday in JAMA Network Open. Led by a Harvard University researcher, the study compared the number of COVID-19 cases and deaths reported by 15,415 nursing homes in 20 states to the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) with those reported to state departments of health by May 24, 2020. Analysis took place from December 2020 to May 2021. (Van Beusekom, 9/10)

Researchers at Brown University will study waning COVID-19 vaccine effectiveness among nursing home residents to further inform the country’s booster shot rollout. The two-year study, aimed to inform real-time policy decisions, was awarded $4.9 million from the Centers for Disease Control and Prevention (CDC). The team is set to study the duration of protective immunity among 800-1,200 nursing home residents following vaccination or when administered a booster shot, when federally recommended to do so, given emerging COVID-19 variants, according to a news release. Researchers plan to share interim data with the CDC as it becomes available. (Rivas, 9/11)

Also —

The handwritten doctor’s order was just eight words long, but it solved a problem for Dundee Manor, a nursing home in rural South Carolina struggling to handle a new resident with severe dementia. David Blakeney, 63, was restless and agitated. The home’s doctor wanted him on an antipsychotic medication called Haldol, a powerful sedative. “Add Dx of schizophrenia for use of Haldol,” read the doctor’s order, using the medical shorthand for “diagnosis.” But there was no evidence that Mr. Blakeney actually had schizophrenia. (Thomas, Gebeloff and Silver-Greenberg, 9/11)

A new analysis finds that the clinical trials conducted by Biogen (BIIB) for its controversial Alzheimer’s treatment would have excluded as many as 92% of Medicare beneficiaries — a key portion of the targeted patient population — based on their age or existing medical conditions. Breaking it down, a total of 92% of patients with Alzheimer’s and related disorders, 91% with Alzheimer’s specifically, and 85.5% with mild cognitive impairment met at least one of the criteria for exclusion from the studies, according to the analysis published in JAMA. (Silverman, 9/10)

In other pharmaceutical industry news —

One-third of the uses for cancer drugs granted speedy approvals remained on product labeling even after follow-up studies failed to confirm their benefits, according to a new analysis in BMJ. And at the same time, widely-read guidelines for physicians also continued to recommend these treatments. At issue is the accelerated approval program created nearly three decades ago to hasten availability of drugs for serious conditions with unmet medical needs. However, since the program allows regulators to rely on surrogate measures that are likely to prove effectiveness in exchange for access, drug makers must run trials to later verify the medicines are benefiting patients as intended. (Silverman, 9/13)

After building Facebook’s search bar into a pivotal part of its platform, Tom Stocky is setting his sights on a new target: biology. The onetime tech executive decided to switch tracks after taking a weekly biotech class at Stanford. “I was inspired. I thought, maybe there’s something I can do to deliver medications faster to people,” Stocky, who recently joined AI-powered drug development startup Insitro as vice president of product, told STAT. (Brodwin, 9/13)

Aubrey de Grey, the anti-aging research pioneer who was removed last month as chief scientific officer of the SENS Research Foundation, made offensive sexual comments to two prominent, young entrepreneurs in the longevity community, according to the findings of an independent investigation conducted at the request of the organization. Released Friday night, an 18-page executive summary of the report from the law firm Van Dermyden Makus gave corroborating evidence for previous allegations made by Laura Deming and Celine Halioua. Though they are not named in the report, the women confirmed to STAT that they are the two complainants. (Molteni, 9/11)

In early January 2020, most of the world hadn’t yet awakened to the fact that life was soon to change profoundly. But Barney Graham saw a possible need coming, and set out to fill it. Graham was deputy director of the National Institutes of Health’s Vaccine Research Center and chief of the viral pathogenesis laboratory. Mere days after Chinese scientists posted to an international database the genetic sequence of a new, as yet unnamed coronavirus that was causing a fast-expanding outbreak in Wuhan, Graham and his colleague Kizzmekia Corbett had designed the structure for a vaccine that later became the prototype for Moderna’s Covid-19 shot and laid the foundation for Covid vaccines made by Johnson & Johnson, Novavax, and others. (Branswell, 9/13)

A delayed decision Thursday from the Food and Drug Administration (FDA) on whether to allow vaping brand Juul to stay on the market was met with strong criticism from the American Academy of Pediatrics (AAP). "This is a reckless decision that will allow products proven to addict and endanger young people to continue being sold," Dr. Lee Savio Beers, president of the AAP, said in part in a statement. (Rivas, 9/11)

In other public health news —

Cruise ship passengers readied to leave Baltimore’s port for the first time in 18 months on Sunday, a celebratory moment after putting in place plenty of COVID-19 safety precautions for guests. As a steel drummer played in the port terminal, the Carnival Pride welcomed 1,500 passengers for a weeklong voyage to the Bahamas, The Baltimore Sun reported. (9/12)

Is that stress pumping steadily through your veins? Even if your blood pressure is normal right now, high stress levels may put you at risk of developing hypertension within the next decade or so, a new study found. When the stress hormone cortisol continues to increase over time, you may also be at higher risk of having a stroke, heart attack or heart disease, according to the research published Monday in Circulation, the journal of the American Heart Association. (LaMotte, 9/13)

Latinos who think they have good social standing in the U.S. are more likely to have better cardiovascular health, according to a peer-reviewed paper. The study looked into how perception of status, success and prestige relative to other people correlates to health factors such as body mass index, blood pressure and levels of cholesterol. (Franco, 9/11)

In North Carolina, lawmakers are considering whether to legalize marijuana use for some medical conditions through the NC Compassionate Care Act, or Senate Bill 711, introduced by Republican Bill Rabon. The proposal recently got the green light from a Senate judiciary committee, but it’s unclear whether there’s enough support in the Republican-led General Assembly for full approval in a state that has long resisted joining the list of 37 others that have legalized medical marijuana. (Dougani, 9/13)

When Kimberly Sheldon was 47, she says made the biggest mistake of her life. That was in 2018, when she says that a dentist explained to her that cutting the tissue under her tongue would help her jaw pain, gum recession, and occasional headaches. Her issues, he said, could be due to the fact that the back of her tongue couldn’t reach the roof of her mouth. With a quick laser slice, a $600 charge, and some instruction on tongue exercises, he seemed confident that she would feel better soon after. But, according to her account, the dentist didn’t explain the possible risks, which include nerve damage and scarring that can restrict the tongue. Sheldon only found out about the issues after she experienced them. Since then, she says, the effects have torn her life apart. (Szalinski and Undark, 9/12)

California Gov. Gavin Newsom on Tuesday will be the first governor in a recall election to face voters divided over Covid-19 restrictions and collectively angry about a pandemic that continues to upend lives nationwide. State leaders around the U.S. have exercised broad authority to try to safeguard the health and well-being of both their residents and economies over the past 18 months, including decisions that have drawn fire from all sides. (Mai-Duc, 9/12)

The polls do not look good for Gov. Gavin Newsom’s foes, led by Larry Elder, the conservative Republican radio host who has emerged as the most prominent challenger likely to lead the field of replacements on Tuesday’s ballot. Over the summer, surveys showed Newsom barely surviving the recall attempt. But now, about 60 percent of California voters say they plan to keep him in office. Newsom earned the ire of more than 2 million voters who signed a recall petition in the year after he issued initial lockdown orders. But the governor has taken an improbable path to his current and far more favorable situation: He has doubled down on his calls for vaccine mandates, mask mandates and for the strictest adherence to public health measures that he says are necessary to protect Californians. (Wilson, 9/12)

KHN: Health Care Unions Defending Newsom From Recall Will Want Single-Payer Payback 
Should Gavin Newsom survive the Republican-driven attempt to oust him from office, the Democratic governor will face the prospect of paying back supporters who coalesced behind him. And the leaders of California’s single-payer movement will want their due. Publicly, union leaders say they’re standing beside Newsom because he has displayed political courage during the covid-19 pandemic by taking actions such as imposing the nation’s first statewide stay-at-home order. But behind the scenes, they are aggressively pressuring him to follow through on his 2018 campaign pledge to establish a government-run, single-payer health care system. (Hart, 9/13)

California's recalls are like no other elections. Voters have to decide whether to recall the officeholder — in this case, Gov. Gavin Newsom — and then answer a second ballot question over who should be the replacement. This unorthodox process has had wild outcomes before — it led to actor Arnold Schwarzenegger becoming governor in 2003.Five things to look for in Tuesday's unusual contest. (9/13)

Parents of adults with severe autism and other disabilities say New York officials are threatening to revoke funding for their children’s long-term care at out-of-state care centers unless they agree to send their children to a secure, in-state facility. Some parents believe they have no alternative but to send their adult children to the Sunmount Developmental Center in Franklin County in the Adirondacks, the Times Union of Albany reported Sunday. They describe the facility as remote and prison-like. (9/12)

California and New York take a closer look at covid data —

The California State Senate approved a bill late Friday evening that upholds the state’s ability to keep the details of workplace COVID-19 outbreaks secret, a win for business groups after key transparency clauses were slashed at the last minute. AB 654 was revised days before the end of the legislative session Friday to erase a requirement that the California Department of Public Health publicize COVID outbreaks by location, contradicting the author’s stated purpose in drafting the bill and dealing a blow to employees, advocates and epidemiologists who have long argued that such information is essential to protecting workers. (Kelliher, 9/12)

Norma Saunders doesn’t know exactly how many neighbors at her public housing development in the Bronx have died from Covid-19 — she just knows there have been many. She’s lived at Bronx River Houses, run by the New York City Housing Authority, her entire life and serves as the tenant association president. But since the start of the pandemic last year, she’s had to rely mostly on word of mouth to track Covid cases in the nine-building public housing complex. In one instance, a woman alerted Saunders in April 2020 that she hadn’t heard from her 81-year-old neighbor in a week. When NYCHA didn’t have a spare key they called the police, who broke down the door to find the man had died. (Kvetenadze, 9/12)

In other news from Michigan, Oklahoma, Iowa, California and Georgia —

A New York law firm may have used unregistered portable X-ray scanners on Flint residents for one year longer than state officials were told, records show. A sworn affidavit from a Flint resident, along with emails showing when the Napoli Shkolnik law firm sought to lease the devices, suggest the use of scanners, which are tools in the scrap metal and mining industries but are not designed for use on human beings, began around September 2019. That is about 18 months before either of the two devices was registered with the state of Michigan, as required by law. (Egan, 9/12)

When Patrick Keegan set out to clean up some old oilfield land he owned in Lincoln County, he wanted the site tested for radiation. An Oklahoma Department of Environmental Quality technician found increased levels of gamma radiation near one old wellhead, 30 to 90 times greater than normal background radiation. The state's response to the presence of radiation at the site has been, in Keegan's eyes, unsatisfactory. The dangers of this type and level of radiation are unclear, but there is some research indicating it could expose humans and the rest of the environment. (Denwalt, 9/12)

The Centers for Disease Control and Prevention (CDC) today confirmed two new variant flu cases in Iowa, according to its weekly Fluview update. One case involves the influenza A H3N2 variant (H3N2v) and the other the influenza A H1N2 variant (H1N2v). Both infections are in children. Neither was hospitalized, and both have fully recovered, the CDC said. Household members of one of the patients kept or cared for swine, while the other child had  direct contact with swine. No human-to-human transmission has been associated with either case. (9/10)

San Francisco is beginning a program that will provide housing, therapy and drug and alcohol counseling for men instead of sending them to jail, or as a place to land when they get out. What’s noteworthy is that it uses a rare and sometimes controversial model in San Francisco to help participants who struggle with addiction. The program isn’t a licensed drug treatment facility, and its organizers stress it promotes overall lifestyle changes, “not simply abstinence from drug use.” One goal, though, is for participants to stop using drugs without the help of medication to stave off the cravings, standard in most programs in San Francisco and supported by evidence as effective. (Moench, 9/10)

KHN: Georgia Eyes New Medicaid Contract. But How Is The State Managing Managed Care? 
Just before Frank Berry left his job as head of Georgia’s Medicaid agency this summer, he said the state “will be looking for the best bang for the buck” in its upcoming contract with private insurers to cover the state’s most vulnerable. But whether the state — and Medicaid patients — are getting an optimal deal on Medicaid is up for debate. (Grapevine and Miller, 9/13)

France has become the latest European country -- and the most significant tourism destination -- to remove the United States from its safe travel list, following EU recommendations in the wake of a US Covid spike. A French government decree issued on Thursday bumped the United States and Israel from the country's "green" list, down to "orange," effectively prohibiting nonessential travel to France for unvaccinated visitors. (Neild and Vandoome, 9/10)

France granted citizenship to 12,000 COVID frontline workers this week in a show of gratitude for their efforts and sacrifices. Immigrants comprise a quarter of the essential workers who remained active in the Île-de-France province during lockdowns, per data from a French health observatory. (Chen, 9/11)

France's former health minister Agnès Buzyn has been indicted and accused of "endangering the lives of others" during her response to the pandemic, per AFP. She will appeal the charge. Buzyn was health minister when the pandemic exploded in France last year. Buzyn, who was accused Friday of "failing to fight a disaster," is the first French official charged over the coronavirus crisis, Le Monde notes. It comes as President Emmanuel Macron faces scrutiny over his response to the health crisis. (9/12)

In updates on vaccine "passports" —

Boris Johnson will unveil the U.K.’s new approach in tackling Covid this week, preparing the country for a mass booster vaccination program and potential shots for teenagers -- but scrapping plans for mandatory vaccine certificates in England. The prime minister is expected to hold a press conference Tuesday outlining how a beefed-up inoculation program will try to keep the virus under control over the high-risk period of autumn and winter. “The prime minister will be setting out tomorrow a lot more of the detail of the roadmap ahead, preparing for winter,” Cabinet minister Therese Coffey told Sky News on Monday. (Ashton, 9/13)

Australians have been told to "dust off (their) passports" after the federal government announced it would begin a trial of vaccine passports with some countries this week -- the latest step in Australia's reopening to the world. Australia closed its borders almost 18 months ago in a bid to contain Covid-19. But now, with vaccination rates rising, the country is possibly just months away from relaxing restrictions on international travel. (Westcott, 9/13)

In news about covid booster shots —

While most countries are still trying to finish inoculating their populations for the first time, Israel is already preparing for a second round of booster doses. The country is making efforts to secure sufficient supply in case a fourth round of Covid-19 shots is needed, according to a top health official. “We don’t know when it will happen; I hope very much that it won’t be within six months, like this time, and that the third dose will last for longer,” Health Ministry Director General Nachman Ash said in an interview with Radio 103FM. Israel began a drive to administer booster shots at the beginning of August, and has so far inoculated about 2.8 million people with a third dose. (Al Lawati, 9/12)

The European Medicines Agency is reviewing booster data from Pfizer and Moderna, with a decision on the use of a Pfizer booster dose six months after the second shot expected in the next few weeks. The moves are in line with the U.S. plans to roll out booster shots beginning Sept. 20, subject to approval from health officials. “There is still overall considerable protection from severe disease and hospitalization in the general population” from the initial vaccines, Marco Cavaleri, head of vaccines strategy at the EMA, said Thursday in a briefing. “However, an increase in breakthrough infections has been reported in different parts of the world due to the delta variant” and most EU members are now discussing whether vulnerable groups would benefit from a third dose. (Ring, 9/11)

In other global developments —

The U.K. government is ending a data deal with Palantir Technologies Inc., following criticism from privacy groups about the lack of transparency on how the contracts were awarded to the U.S. data giant. The Department of Health and Social Care put out a tender in August to shift its Adult Social Care Dashboard away from third-party providers to its own system, built by BAE Systems Plc, Europe’s largest defense firm, according to public documents. These said DHSC had until Sept. 30 to transfer the data to this platform before it would have to renew its license with Palantir. (Turner, 9/10)

Britain's state-run National Health Service will on Monday begin the world's biggest trial of Grail Inc's (GRAL.O) flagship Galleri blood test that can be used to detect more than 50 types of cancer before symptoms appear. The Galleri test looks at the DNA in a patient's blood to determine if any come from cancer cells. Earlier diagnosis of cancers leads to dramatically increased survival rates. (9/12)

Thirty cases of pneumonic plague have been reported in Madagascar, according to the latest communicable disease threats report from the European Centre for Disease Prevention and Control (ECDC). The cases, 12 of which have been confirmed, were reported on Aug 29 by health authorities in the Arivonimamo district in the Itasy region of Madagascar. Seven cases have been fatal, all of them in the municipality of Miandrandra. (9/10)

An outbreak of dengue fever is suspected of killing dozens of people in India's northern state of Uttar Pradesh since the start of September, and authorities have launched a campaign to destroy mosquito breeding grounds. Dinesh Kumar Premi, the chief medical officer in Firozabad, the most affected district in the state, told Reuters that 58 people, many of them children, had died in his district alone, raising fears that Uttar Pradesh is in the midst of its worst dengue outbreak in years. (Sharma, 9/13)

The health care system in Afghanistan is teetering on the edge of collapse, endangering the lives of millions and compounding a deepening humanitarian crisis, public health experts warn. The country’s health care has been propped up by aid from international donors. But after the Taliban seized power, the World Bank and other organizations froze $600 million in health care aid. The Biden administration, too, is struggling with how to dispense donor money to a country now being run by several senior Taliban leaders whom the United State (Mandavilli, 9/12)

America has a death problem. No, I’m not just talking about the past year and a half, during which COVID-19 deaths per capita in the United States outpaced those in similarly rich countries, such as Canada, Japan, and France. And I’m not just talking about the past decade, during which drug overdoses skyrocketed in the U.S., creating a social epidemic of what are often called “deaths of despair.” (Derek Thompson, 9/12)

Believe it or not, Mexico is potentially opening the gates to Texas women who may want to seek safe abortions and evade all those private citizens the state just turned into abortion-avengers. In a stunning turn of events for women’s rights, Mexico’s Supreme Court on Tuesday decriminalized abortion in the heavily Catholic country. The court ruling doesn’t automatically provide blanket legal protection across Mexico, but it paves the way to legalize the procedure currently allowed in only four states – Mexico City, Oaxaca, Veracruz and Hidalgo. (Elvia Diaz, 9/12)

Join us, if you will, in a thought experiment. It’s the fall of 2022. Dr. H., an obstetrician-gynecologist, practices in a red state. Much has changed in the reproductive rights landscape by then: In the spring, her state rushed to pass a law similar to the notorious 2021 Texas law that bans a large majority of abortions and incentivizes private citizens to sue anyone helping someone get an abortion. The Supreme Court also overturned Roe v. Wade in the Dobbs v. Jackson Women’s Health Organization case that year, leaving the issue of abortion regulation to individual states; a few years before, Dr. H.’s state passed a trigger ban that automatically banned the few abortions that were still legal in the state when Roe fell. In her state, the law now allows an abortion only when a pregnancy threatens the life of a pregnant person. (Carole Joffe and Jody Steinauer, 9/12)

The public has lost confidence in our public health agencies and officials—and also our political leaders—thanks to confusing and contradictory pronouncements and policies related to the coronavirus pandemic. But don't think for a moment that leadership failures in health care are confined to COVID-19. Two other recent stories highlight how both government and industry are missing an opportunity to use new machine learning technology to deliver better health care at a lower cost. (Steve Forbes, 9/10)

Blood-testing technology has rocketed ahead in the last five years — the interval of time since it came to light that the former $9 billion startup Theranos Inc. hadn’t actually invented a way to do thousands of lifesaving blood tests using a finger stick. Today, some companies really can do thousands of tests using a single drop of blood. But that advance hasn’t revolutionized medicine, a blood-testing fantasy promoted as science by Theranos founder Elizabeth Holmes, who went on trial this week for wire fraud and conspiracy. Here’s how she put her vision in a 2014 TED talk: “We see a world in which every person has access to actionable health information at the time it matters. A world in which no one has to say, ‘If only I’d known sooner,’ a world in which no one has to say goodbye too soon.” (Faye Flam, 9/12)

Elizabeth Holmes, Silicon Valley's one-time darling for founding and leading the now failed biotech company Theranos, is on trial in one of the most highly anticipated criminal fraud cases in the country -- and one of her potential defense strategies is not what you might expect. At the age of 32, Holmes was dubbed the "youngest self-made woman billionaire" by Forbes. Her revolutionary biotech startup, Theranos, had a market valuation of over $9 billion, and was by all accounts the elusive Silicon Valley unicorn: a company promising to democratize the health care system through proprietary blood diagnostic technology. Holmes boasted the ability to do an array of blood tests from a single finger pinprick with just a few drops of blood, and claimed she could do it better, quicker, and cheaper than traditional blood testing. Except she couldn't. (Caroline Polisi, 9/12)

I’ve been a science reporter for 40 years. I’ve wanted to assume that the experts I interview can be trusted to understand their subjects. Put simply, to get it right. But watching researchers in the field of obesity almost blindly follow a failed paradigm has led me to cross a line that few journalists ever do, to publicly embrace and promote a minority opinion that many in the obesity field think is quackery. (Gary Taubes, 9/13)

Both cigarettes and opioids are highly addictive—and potentially deadly. Both substances are sold by profiteering companies using science distorted by spin or outright lies. And both have been the subjects of multi-billion-dollar lawsuits. But opioids are not cigarettes. And as the opioid settlements finally near completion, it is crucial not to misapply lessons learned from tobacco. Fundamentally, this means accepting that—unlike cigarettes—opioids have genuine uses in both pain and addiction medicine. (Maia Szalavitz, 9/12)

Health care professionals of all stripes were battling burnout and mental illness before the pandemic began, and Covid-19 has only made it worse. The struggles of physicians and nurses get the lion’s share of attention. One group left out of the news stories and conversations are clinical research workers. (Andrea Bastek, 9/13)

Many issues with COVID-19 have led to a discomforting conflation of politics and science: the value of masks, when to forbid gatherings and whether vaccines will stop transmission. In some cases, we needed new evidence to make the policy decision. In others, there were tradeoffs with economic or liberty concerns. Yet, on one issue, the public health scientific community has been of one voice: There is virtually no logic to closing the border to asylum-seekers to prevent the public from contracting COVID-19. (S. Patrick Kachur and Leslie "Les" Roberts, 9/12)

In the days before Covid, I’d often get frustrated by the response that doctors would give when I turned up at their clinics with some infection or other: “It’s just a virus,” they’d say. As someone who’s long been fascinated by the detective work that goes into tracing the origins and history of infections, 1 the answer always seemed too perfunctory. Which virus was it? Where and when did this strain emerge? How many other people were getting infected with this same variant this year? (David Fickling, 9/12)

This pandemic will eventually be over, and the Delta surge—in which most of those not yet vaccinated against the coronavirus could become infected—may well be America’s last destructive wave. But just because we’re eager to move past the virus doesn’t mean it’s finished with us. In our large, open, and globally connected society, getting to zero COVID, the goal that Australia and New Zealand have pursued, is as politically unrealistic as it is biologically implausible. Americans are mostly done with the onerous shutdowns that such a goal would require. The virus has now spread so widely in the world that even tight, long-lasting limits on Americans’ movement—restrictions far beyond what we would tolerate—could not stamp it out entirely. Instead, SARS-CoV-2 will become an endemic virus, settling alongside the other four strains of coronaviruses that circulate widely among us. (Scott Gottlieb, 9/12)

President Biden was skeptical about vaccine mandates last December, but his attempt to persuade people to get vaccinated fell short as the delta variant sent infections skyrocketing. Now, he wants all large businesses in the United States to impose a vaccine mandate on their employees, or have them show a negative test once a week. This significant extension of executive authority over the private sector will almost certainly run into logistical and legal hurdles, and meet political resistance, but the effort is justifiable at a time of national emergency. (9/11)

An evolving enemy gaining ground necessitates a bold new battle plan. On Thursday, President Joe Biden rolled out such a strategy against COVID-19, taking the fight against the virus to the next level by targeting one of its few weaknesses: vulnerability to free, widely available vaccines. A sweeping new requirement to get the shots or undergo frequent testing is the most potent pandemic-fighting tool available. It's also likely the most controversial. But with the delta variant overwhelming health care systems and threatening the nation's economic recovery, Biden shouldered the political risk inherent in a mandate and made the right call: new requirements for employees at large private employers, federal workers and contractors, as well as most health care staff. (9/11)