First Edition: Oct. 13, 2020

KHN: ‘No Mercy’ Chapter 3: Patchwork Of Urgent Care Frays After A Rural Hospital Closes
Emergency care gets complicated after a hospital closes. On a cold February evening, when Robert Findley fell and hit his head on a patch of ice, his wife, Linda, called 911. The delays that came next exposed the frayed patchwork that sometimes stands in for rural health care. After Mercy Hospital Fort Scott shut down, many locals had big opinions about what kind of health care the town needed. (Tribble, 10/12)

KHN: Black Doctors Work To Make Coronavirus Testing More Equitable
When the coronavirus arrived in Philadelphia in March, Dr. Ala Stanford hunkered down at home with her husband and kids. A pediatric surgeon with a private practice, she has staff privileges at a few suburban Philadelphia hospitals. For weeks, most of her usual procedures and patient visits were canceled. So she found herself, like a lot of people, spending the days in her pajamas, glued to the TV. And then, at the beginning of April, she started seeing media reports indicating that Black people were contracting the coronavirus and dying from COVID-19 at greater rates than other demographic groups. (Feldman, 10/13)

KHN: New Moms Behind Bars Get Help From Someone Who’s Been There 
Nine years ago, Nina Porter gave birth in a hospital bed with one of her ankles chained to the frame. Corrections officers stood watch as Porter held her daughter, Gianna, to her chest for the first time. Back at a nursery inside Indiana Women’s Prison, Gianna slept in a crib in her mother’s cell, about 2 feet from her pillow. The prison program allowed Porter to keep her baby with her — including when she went out into the yard — until her discharge nearly a year later. She didn’t recall ever bonding so closely with her previous 11 kids. She finally felt her life moving in a positive direction. (Bruce, 10/13)

Politico: White House Physician Says Trump Has Tested Negative For Covid, Is No Longer Infectious 
President Donald Trump has tested negative for Covid-19 on consecutive days and is not infectious to others, his physician said on Monday. Antigen tests from Abbott were used, along with laboratory data that included viral load, to determine that the president would not be able to spread the coronavirus to others, Sean Conley said in a memo to White House press secretary Kayleigh McEnany. (Kim, 10/12)

The Hill: Trump Tests Negative For COVID-19 On Consecutive Days, Doctor Says 
Antigen tests are commonly used in the White House, though they are less sensitive than molecular tests, such as the PCR test. For example, the Food and Drug Administration notes on its website that antigen tests are "more likely to miss an active coronavirus infection compared to molecular tests." The president was said to have tested positive for COVID-19 on Oct. 1 with an antigen test and then received a PCR test to confirm the result. (Samuels, 10/12)

USA Today: 'I Just Feel So Powerful.' Trump Hits The Campaign Trail In Florida For First Rally Since COVID-19 Diagnosis
While claiming himself cured of COVID, Trump also asserted he is "immune" from the virus moving forward, though some medical professionals said there is no guarantee of that. "Now they say I'm immune. I just feel so powerful," Trump said. "I'll kiss everyone in that audience. I'll kiss the guys and the beautiful women and the... I'll just give you a big, fat kiss." (Jackson, 10/12)

NPR: Trump Holds Florida Rally A Week After COVID-19 Hospital Stay 
President Trump was back on the campaign trail on Monday, telling a packed outdoor rally in Florida that he feels "powerful" after his bout with the coronavirus. Trump spoke for about an hour to an enthusiastic crowd, at an event that his campaign billed as the start of a breakneck stretch of travel leading up to the Nov. 3 election. (Rascoe, 10/12)

AP: Defiant Trump Defends Virus Record In 1st Post-COVID Rally
Defiant as ever about the coronavirus, President Donald Trump on Monday turned his first campaign rally since contracting COVID-19 into a full-throated defense of his handling of the pandemic that has killed 215,000 Americans, joking that he was healthy enough to plunge into the crowd and give voters “a big fat kiss.” There was no social distancing and mask-wearing was spotty among the thousands who came to see Trump’s return to Florida. He held forth for an hour, trying to get his struggling campaign back on track with just weeks left before Election Day. (Colvin and Lemire, 10/13)

Stat: Trump Prepares To Campaign In Iowa, Where Covid-19 Is 'Out Of Control'
President Trump’s mad dash to campaign with in-person rallies and other events this week will take him to Iowa, a state that even the president’s own Covid-19 task force has warned is seeing an uptick in preventable deaths due to the coronavirus. He’ll visit Pennsylvania and North Carolina, too, both of which have also seen cases spike in the last week. Monday night, he held an event in Florida. (Florko, 10/13)

CNBC: Dr. Fauci Says U.S. Faces 'A Whole Lot Of Trouble' As Coronavirus Cases Rise Heading Into Winter
The United States is “facing a whole lot of trouble” as coronavirus cases continue to surge across the country heading into the cold winter months, Dr. Anthony Fauci, the nation’s top infectious disease expert, told CNBC on Monday. The U.S. reported more than 44,600 new cases on Sunday and the seven-day average rose to over 49,200 new cases per day, up more than 14% compared with a week ago, according to a CNBC analysis of data compiled by Johns Hopkins University. Average daily cases were up by more than 5% in 36 states and the District of Columbia, CNBC’s analysis shows. (Feuer, 10/12)

The Hill: Fauci Tensions With Trump Escalate Over Campaign Ad 
Tensions between Anthony Fauci and President Trump are increasing after the nation’s top infectious disease expert asked the Trump campaign to take down a new ad that features comments of his that he says were taken out of context. The ad, released last week shortly after the president was discharged from Walter Reed National Military Medical Center, touts the president’s response to the virus and includes an edited clip of Fauci that makes it seem as though he was praising Trump’s response to the pandemic. (Weixel, 10/12)

AP: Trump, Biden Try To Line Up By Fauci As They Court Voters
President Donald Trump and Democrat Joe Biden are both looking to harness the credibility of America’s best-known infectious disease expert, Dr. Anthony Fauci, as they make their case to American voters. Trump is quoting him out of context, the doctor says. Biden, for his part, is eagerly promising to seek Fauci’s advice if elected. Overall, it’s an uncomfortable season for Fauci, who’s been studiously apolitical over a five-decade career in public health. The doctor is calling out the Trump campaign for taking one of his quotes and popping it into a campaign ad to suggest Fauci is in the president’s corner. (Madhani, 10/13)

The Washington Post: Barrett Promises To Be Apolitical As Democrats Warn Of Threat To Health Care
Supreme Court nominee Amy Coney Barrett presented herself to the nation Monday as a humble and apolitical judge, opening a pandemic-altered Senate confirmation hearing that Democrats tried to make as much about health care, covid-19 and President Trump as about Barrett’s qualifications. It was the start of what will be an acrimonious four days, as Republicans embark just weeks before Election Day on a historic move to lock in a long-sought 6-to-3 conservative majority on the Supreme Court and perhaps boost Trump’s and their own reelection prospects. (Barnes, Min Kim and Hawkins, 10/12)

The New York Times: Two Parties Offer Dueling Views Of Barrett As Confirmation Fight Begins
Republicans and Democrats offered sharply divergent arguments on Monday in a Supreme Court confirmation fight whose outcome is likely to steer the court to the right for years, vying to define Judge Amy Coney Barrett and frame the political stakes of President Trump’s rush to install her before he faces voters. In a marathon day of opening statements, Democrats assailed Judge Barrett as a conservative ideologue who would overturn the Affordable Care Act and abortion rights, and whose nomination amounted to an illegitimate power grab by a president in the last days before the election. (Fandos, 10/12)

The Hill: Democrats Warn Of ObamaCare Threat From Barrett, Trump 
Democrats on Monday painted Judge Amy Coney Barrett, President Trump’s high court nominee, as an existential threat to the Affordable Care Act (ACA), allowing them to go on offense in the fight over the Supreme Court and the fast-approaching election. Democrats view health care as a politically potent issue that resonates with voters and galvanizes their base with only 22 days left to go until Nov. 3, when they are hoping to win back both the White House and the Senate majority. (Kruzel and Carney, 10/12)

The Washington Post: Sen. Lee, Recently Infected With Coronavirus, Speaks Without A Mask At Barrett Hearing
On Sept. 29, Sens. Ted Cruz (R-Tex.) and Mike Lee (R-Utah) attended a party together to watch the first presidential debate. Two days later, feeling sick, Lee took a test for the novel coronavirus, receiving a positive diagnosis, the first of three GOP senators to announce in a 24-hour span that they contracted the virus. Less than 11 full days later, Lee participated in Monday’s Supreme Court confirmation hearing for Judge Amy Coney Barrett, delivering an opening statement in person — with no mask — and periodically whispering to his GOP colleagues. (Kane, 10/12)

NPR: Joni Ernst Focuses On Amy Coney Barrett's Gender In Hearing
Iowa Republican Sen. Joni Ernst zeroed in on the issue of gender at Monday's confirmation hearing for Amy Coney Barrett. She used her opening statement to link herself to Barrett "as a fellow mom, a fellow Midwesterner" and accused Democrats of launching attacks on the judge's religious beliefs — even though Republicans were the only ones bringing up the issue at the hearing. Ernst pointed out Monday that this was her first chance on the Judiciary Committee to be involved in a confirmation hearing for a Supreme Court nominee. She was one of two female GOP senators added to the panel in 2019 after a contentious confirmation process for Brett Kavanaugh in 2018 highlighted the then-all male lineup on the Republican side of the committee. (Walsh, 10/12 )

AP: Barrett To Face Senators On Health Care, Legal Precedent
Supreme Court nominee Amy Coney Barrett will face senators’ questions over her approach to health care, legal precedent and even the presidential election during a second day of confirmation hearings on track to lock in a conservative court majority for years to come. The mood is likely to shift to a more confrontational tone as Barrett, an appellate court judge with very little trial court experience, is grilled in 30-minute segments Tuesday by Democrats gravely opposed to President Donald Trump’s nominee, yet virtually powerless to stop her rise. Republicans are rushing her to confirmation before Election Day. (Sherman, Mascaro and Jalonick, 10/13)

AP: Health Care Law On Line At Court, But Is It Likely To Fall?
To hear Democrats tell it, a Supreme Court with President Donald Trump’s nominee Amy Coney Barrett could quickly get rid of the law that gives more than 20 million Americans health insurance coverage. But that’s not the inevitable outcome of a challenge the court will hear Nov. 10, just one week after the election. Yes, the Trump administration is asking the high court to throw out the Obama-era healthcare law, and if she is confirmed quickly Barrett could be on the Supreme Court when the court hears the case. (Gresko and Sherman, 10/13)

USA Today: COVID-19 Reinfection: Nevada Man Is First Confirmed American Case
An otherwise healthy 25-year-old Nevada man is the first American confirmed to have caught COVID-19 twice, with the second infection worse than the first. He has recovered, but his case raises questions about how long people are protected after being infected with the coronavirus that causes the disease, and potentially how protective a vaccine might be. "It's a yellow caution light," said Dr. William Schaffner, an infectious disease expert at the Vanderbilt University School of Medicine in Nashville, Tennessee, who was not involved in the research. (Weintraub, 10/12)

NPR: Scientists Confirm Nevada Man Was Infected Twice With Coronavirus
It is the first confirmed case of so-called reinfection with the virus in the U.S. and the fifth confirmed reinfection case worldwide. ... The two infections in the Nevada patient occurred about six weeks apart, according to a case study published Monday in the medical journal The Lancet. The patient originally tested positive for the virus in April and had symptoms including a cough and nausea. He recovered and tested negative for the virus in May.(Hersher, 10/12 )

The Wall Street Journal: Johnson & Johnson Pauses Covid-19 Vaccine Trials Due To Sick Subject 
Johnson & Johnson said it has paused further dosing in all clinical trials of its experimental Covid-19 vaccine because a study volunteer had an unexplained illness. The pause announced Monday affects all trials of J&J’s vaccine, including a large Phase 3 trial that began in September and aimed to enroll as many as 60,000 people in the U.S. and several other countries. (Loftus, 10/12)

Politico: Johnson & Johnson Pauses Dosing Of Its Coronavirus Vaccine 
“We must respect this participant’s privacy,” J&J said in a statement. “We’re also learning more about this participant’s illness, and it’s important to have all the facts before we share additional information.” The company noted that in placebo-controlled clinical trials, it “is not always immediately apparent” if a given individual received the treatment or a placebo. It also cautioned that adverse events — even serious ones — “are an expected part of any clinical study, especially large studies.” (Lim, 10/12)

USA Today: Johnson & Johnson COVID-19 Vaccine Trial Paused By Unexplained Illness
It is not known if the unidentified illness is related to the vaccine, but clinical protocols require a pause while it is investigated. Johnson & Johnson's JNJ-78436735 vaccine is one of four large-scale, final-stage COVID-19 vaccine trials underway in the U.S. Another trial, run by AstraZeneca, was halted Sept. 8 after a second participant was diagnosed with a neurological condition. Johnson & Johnson said Monday it has paused further dosing in its trial while the participant's illness is reviewed and evaluated by an independent Data Safety Monitoring Board as well as the company's clinical and safety physicians. (Weise and Weintraub, 10/12)

The Hill: Abbott Gets Emergency Authorization For New COVID Antibody Test 
Medical device maker Abbott Labs on Monday said it received emergency authorization for a new COVID-19 blood test that can detect more recent infections. The AdviseDx is a lab-based test that can detect the IgM (Immunoglobulin M) antibody. The IgM antibody is most useful for determining a recent infection, as they become undetectable weeks to months following infection. (Weixel, 10/12)

The New York Times: The Race For A Super-Antibody Against The Coronavirus 
Even as vaccines are hailed as our best hope against the coronavirus, dozens of scientific groups are working on an alternate defense: monoclonal antibodies. These therapies shot to prominence just this month after President Trump got an infusion of an antibody cocktail made by Regeneron and credited it for his apparent recovery, even calling it a “cure.” Monoclonal antibodies are distilled from the blood of patients who have recovered from the virus. Ideally, antibodies infused early in the course of infection — or even before exposure, as a preventive — may provide swift immunity. (Mandavilli, 10/12)

Reuters: Roche Plans To Sell COVID-19 Antigen Lab Tests By End-2020 
Roche plans to start selling a higher-volume COVID-19 antigen test for laboratories by the end of the year as the Swiss drugmaker expands diagnostics for the pandemic. “These fully automated systems can provide test results in 18 minutes for a single test (excluding time for sample collection, transport, and preparation), with a throughput of up to 300 tests per hour from a single analyser, depending on the analyser,” the group said in a statement. (10/13)

Stat: How Software Infuses Racism Into U.S. Health Care 
The railroad tracks cut through Weyling White’s boyhood backyard like an invisible fence. He would play there on sweltering afternoons, stacking rocks along the rails under the watch of his grandfather, who established a firm rule: Weyling wasn’t to cross the right of way into the white part of town. The other side had nicer homes and parks, all the medical offices, and the town’s only hospital. As a consequence, White said, his family mostly got by without regular care, relying on home remedies and the healing hands of the Baptist church. (Ross, 10/13)

Stat: Five Takeaways From Investigation Of Bias In Use Of Health Software 
By crunching data on patients, software developers promise to help U.S. hospitals and insurers accomplish a crucial task: identifying those most in need of stepped-up care to manage their chronic illnesses. But a STAT investigation found that these software systems are infusing racism into health care by systematically overlooking obstacles faced by people of color. (Ross, 10/13)

Stat: Selling Stock At A Clip, Top Moderna Doctor Gets $1 Million Richer Each Week
Every Tuesday, Moderna’s top doctor gets about $1 million richer. As the world awaits results from Moderna’s pivotal Covid-19 vaccine study, Chief Medical Officer Tal Zaks has been selling his existing stock like clockwork every week through pre-scheduled trades — earning him more than $50 million since the dawn of the pandemic, according to disclosures made to the Securities and Exchange Commission. (Garde and Feuerstein, 10/13)

Stat: How Would Doctors Navigate Demand For A New, Narrow Alzheimer’s Drug?
For Kristin Davie, it’s a tempting possibility. Her 70-year-old mother has late-stage Alzheimer’s, which likely means she would not get a chance to take an experimental drug for the devastating disease being reviewed next month by a regulatory panel. That’s because the clinical trial data for the medicine, called aducanumab, pertains only to patients in the early stages of the disease. But if regulators approve the experimental Biogen (BIIB) therapy next month, Davie might still pursue the drug for her mother. (Silverman, 10/13)

NPR: Georgia Voters Wait In Hours-Long Lines At Polls For Early Balloting 
Early voting opened Monday in Georgia for the 2020 general election — but the first day was marred by technical issues and lines that in some locations stretched more than five hours long, particularly in the Atlanta metro area. Voters arriving in the morning at Atlanta's State Farm Arena, the home of the NBA's Hawks — and the state's largest early voting site, with 300 voting machines — encountered technical issues, which election officials blamed on problems with the electronic poll pads. (Tsioulcas, 10/12)

Politico: California Officials Tell State GOP To Stop Collecting Ballots With Unofficial Drop Boxes
California officials on Monday sent the state Republican Party a cease-and-desist notice to remove unofficial ballot drop boxes, while Gov. Gavin Newsom slammed the party as "willing to lie, cheat, and threaten our democracy all for the sake of gaining power." The controversy comes as the two major parties feud nationally over how the November election is being conducted during the pandemic. (Bermel, 10/12)

AP: Thousands Of N.C. Voters Wait Weeks For Absentee Ballots
Weeks from the election, three of North Carolina’s most populous counties are often taking two weeks or more to send absentee ballots out to voters who request them, an Associated Press analysis shows. Understaffing, outdated technology and voter registration groups are straining a system that has struggled to handle an unprecedented surge of requests as many seek to avoid the risks of in-person voting during the coronavirus pandemic. (Anderson and Fassett, 10/12)

USA Today: COVID-19 Disrupting College Spring Reopenings, Calendars
Scores of universities and colleges have upended spring schedules as the coronavirus infection rate in the U.S. shows no sign of slowing. After a rocky start to the fall, uncertainty over the next few months of the pandemic has pushed universities from coast-to-coast to overhaul in-person learning, spring break, and graduation. Colleges and universities in California, Mississippi, Nevada, Texas, North Carolina, Indiana, Vermont, Kansas, Pennsylvania and Washington state have already announced changes and more are almost certain to follow. (Aspegren, 10/12)

USA Today: 'Like We're Going Into Quarantine': Americans Plan To Stockpile Food This Fall Over Fears Of COVID-19 Surge, Election Unrest
Slightly more than half of Americans in a recent poll from Sports and Leisure Research Group say they already have or plan to stockpile food and other essentials. The chief reason: fears of a resurgent pandemic, which could lead to disruptions such as new restrictions on businesses. On Oct. 2, the number of COVID-19 cases in the USA was its highest in almost two months. (Picchi, 10/12)

USA Today: Nashville 'Worship Protest' Under Investigation After Drawing Largely Unmasked Crowd Of Thousands
Christian worship leader Sean Feucht hosted a "worship protest" that is now under investigation by health officials after it drew thousands of people who appeared to be largely without masks in Nashville, Tennessee, on Sunday night. Feucht, who is based in California and has amassed hundreds of thousands of followers across social media, posted a video of the gathering, saying the event faced resistance and had three venue changes before landing at the courthouse grounds. (Wegner, 10/12)

Reuters: Mainland China Reports First Local COVID-19 Infections In Nearly Two Months
Mainland China reported its first locally transmitted COVID-19 infections in nearly two months, as Qingdao launched a city-wide testing drive after discovering new cases linked to a hospital designated to treat imported infections. The National Health Commission said in a statement that a total of 13 COVID-19 infections were reported in mainland China on Oct. 12, down from 21 a day earlier. (10/12)

CIDRAP: Chinese Study Shows Possible COVID-19 Transmission Via Sewage
A COVID-19 outbreak investigation in a densely populated community in China provides evidence for possible transmission via sewage, highlighting the importance of sewage management for pandemic control. Prior studies have identified SARS-CoV-2—the virus that causes COVID-19—in patient fecal matter, but sewage transmission has not yet been demonstrated. Today's study in Clinical Infectious Diseases examined an April outbreak in a 2,888-resident community of Guangzhou City in southern China to identify the source of infection and mode of transmission in order to recommend prevention and control measures. (10/12)

The Washington Post: Second Wave Of Covid-19 In Europe Leads To New Restrictions But No National Lockdowns 
England has seen new coronavirus cases quadruple in the past three weeks and now has more covid-19 patients hospitalized than before the government imposed a lockdown in March, health authorities said Monday, laying the groundwork for a fresh package of restrictions. But, like much of Europe, Britain is now pursuing targeted local restrictions — such as closing pubs in Liverpool, England — while doing everything it can to avoid another national lockdown and closure of schools. (Adam, 10/12)

Reuters: Mexico Says Two Women May Have Had Non-Consensual Surgery In U.S. Detention Center 
Mexico’s Foreign Ministry said it has identified two Mexican migrant women who may have had surgery performed on them without their consent while detained at a U.S. immigration center in the state of Georgia. While being held at the Irwin center in Georgia, one Mexican woman was reportedly subject to gynecological surgery without her approval and without receiving post-operative care, the ministry said in a weekend statement. The ministry said its findings were based on actions taken by consular staff and interviews Mexican officials conducted at the center. (10/12)

AP: Danes Start Culling 2.5 Million Minks After Virus Hits Farms
Danish veterinarians and farmers have begun culling at least 2.5 million minks in northern Denmark, authorities said Monday, after coronavirus has been reported in at least 63 farms. ... Denmark is among the largest mink exporters in the world and produces an estimate 17 million furs per year. ... Scientists are still digging into how the minks got infected and if they can spread it to people. Some may have gotten the virus from infected workers. Dutch authorities say some farm workers later caught the virus back from the minks. (Olsen, 10/12)

AP: Cuba Relaxes Coronavirus Restrictions 7 Months Into Pandemic
Cuba relaxed coronavirus restrictions Monday in hopes of boosting its economy, allowing shops and government offices to reopen and welcoming locals and tourists at airports across the island except in Havana. Face masks and social distancing remain mandatory, although authorities will no longer isolate those who have been in contact with suspected cases as the island returns to a semblance of normality. (Rodriguez, 10/13)