USA Today: Heat Wave In Northwest Linked To Hundreds Of Deaths
Authorities from Oregon to British Columbia are investigating hundreds of deaths in connection to the historic heat wave in the Pacific Northwest corridor. Temperatures in Oregon topped 117 Monday, according to the National Weather Service, due to a heat dome trapping hot air over the state and its neighbors. At least 63 people have died since Friday, the State Medical Examiner's office said, and "preliminary investigation suggests may be associated with the Pacific Northwest heatwave," said Oregon State Police Captain Tim Fox. That number was based on reports from each county's medical office and could fluctuate as more information becomes available. (Aspegren, 6/30)

AP: Historic Northwest Heat Wave May Have Killed Hundreds
Hundreds of deaths in Canada, Oregon and Washington may have been caused by the historic heat wave that baked the Pacific Northwest and shattered all-time temperature records in usually temperate cities. Oregon health officials said late Wednesday more than 60 deaths have been tied to the heat, with the state’s largest county, Multnomah, blaming the weather for 45 deaths since the heat wave began Friday. British Columbia’s chief coroner, Lisa Lapointe, said her office received reports of at least 486 “sudden and unexpected deaths” between Friday and 1 p.m. Wednesday. Normally, she said about 165 people would die in the province over a five-day period. (Selsky and Morris, 7/1)

The Oregonian: At Least 63 People Died In Oregon Heatwave, Including 45 In Multnomah County, Officials Say 
Capt. Tim Fox, an Oregon State Police spokesperson, said the death toll as of Wednesday was based on reports from each county’s medical examiner office, but that number could go up as agencies conduct more investigations and determine causes of death. (6/30)

Reuters: Deaths Surge In U.S. And Canada From Worst Heatwave On Record
"This was a true health crisis that has underscored how deadly an extreme heat wave can be," Multnomah County Health Officer Dr. Jennifer Vines said in the statement. "As our summers continue to get warmer, I suspect we will face this kind of event again." The heat dome, a weather phenomenon trapping heat and blocking other weather systems from moving in, weakened as it moved east, but was still intense enough to set records from Alberta to Manitoba, said David Phillips, senior climatologist at Environment and Climate Change Canada, a government agency.(Warburton and Olmos, 6/30)

And in the Northeast —

The Washington Post: Record Heat In Northeast Bakes Boston And New York 
When one side of the Lower 48 is dealing with hot weather, it tends to be relatively cool on the opposite end. Not this week. Heat domes situated over both corners of the contiguous United States on Tuesday promoted record-high temperatures in the Northeast at the same time the Pacific Northwest sizzled amid unprecedented temperatures. Numerous records were set across New England and parts of the Mid-Atlantic region on Tuesday. Both Boston and Hartford, Conn., hit 99 degrees, each setting high marks for the date. Newark matched its highest temperature recorded in June. Records extended from the eastern Great Lakes region to Maine. (Livingston, 6/30)

The New York Times: New York City Alerts Residents To Conserve Energy To Avoid Outages 
If four days of sweltering temperatures had not already distressed some New Yorkers, the emergency alert that jolted residents’ cellphones on Wednesday afternoon surely did. “Conserve energy: NYC is urging all households and businesses to immediately limit energy usage to prevent power outages as the intense heat continues,” read the alert, which was sent out citywide around 4 p.m. “Please avoid the use of energy-intensive appliances such as washers, dryers and microwaves. Limit unnecessary use of air conditioning.” (Zaveri and Wong, 6/30)

In related news about the heat wave —

The New York Times: How To Stay Cool In A Heat Wave 
Staying cool and hydrating often are the two most important things you can do to avoid feeling sick and discomfort when it’s extremely hot. If you don’t have an air conditioning unit, or if your A.C. has been on nonstop and you still feel hot, here are ways to cool your body and home. (Blum, 6/29)

The Oregonian: How Heat Kills 700 In The U.S. Annually 
Nationwide, excessive heat has killed or contributed to killing an average of 702 people annually in the 15 years leading up to 2018, according to the Centers for Disease Control and Prevention. In that time, researchers have expanded their understanding of how it wreaks havoc on the body and who is most likely to die from it. (Green, 6/30)

NBC News: Heat Wave On West Coast Hints At Climate Change, Scientists Say
Larry O'Neill knew a heat wave was coming, but he still couldn't believe what the climate models were telling him. The projected temperatures for this week were so unusually high — between 115 and 120 degrees Fahrenheit across parts of the Pacific Northwest — that O'Neill, Oregon's state climatologist, felt something must be off." The predictions seemed completely outlandish," said O'Neill, an associate professor at Oregon State University. "They were so crazy insane that professional forecasters and people like myself thought something must be wrong with the models." (Chow, 6/29)

Politico: Biden Admin Preps For Next Pandemic As Delta Variant Surges
The Biden administration is rethinking its approach to Covid-19 testing as the pandemic enters an uncertain phase — one in which new infections have dropped to the lowest level since the spring of 2020, but the highly contagious Delta variant is driving fresh outbreaks. Federal health officials, along with testing labs and test makers, are weighing how to implement the lessons they have learned from this pandemic to prepare for the next one. That includes what types of government incentives could help keep companies prepared to quickly develop tests in the face of a new emergency, and whether to stockpile key testing supplies. The administration also recently retooled the leadership of its Covid-19 testing and diagnostic workgroup. (Lim, 7/1)

New Orleans Times-Picayune: First Case Of Delta-Plus, 'Double-Whammy' Variant Of COVID, Detected In Louisiana
The Delta variant of COVID-19 has spawned a new, troubling variant known as Delta-plus that has been identified for the first time in Louisiana, according to officials at Ochsner Health. Delta-plus is thought to have the same higher rate of transmission as the Delta variant, which was originally identified in India and is about two times as infectious as the original coronavirus strain. But it also has a characteristic of variants from South Africa and Brazil that makes it harder for antibodies to block it from entering cells. (Woodruff, 6/30)

In state news about the spread of the coronavirus —

Houston Chronicle: Several Houston-Area Kids Infected With COVID Delta Variant, Hospitals Say
Texas Medical Center hospitals are seeing an uptick in patients infected with the COVID-19 Delta variant, and infections are prevalent among young children and adults who have not been immunized. At Texas Children’s Hospital, fewer than 10 kids have been diagnosed with the Delta variant, which epidemiologists say is more transmissible than the original strain of SARS-CoV-2. Doctors have diagnosed 48 cases of the Delta variant at Houston Methodist since the end of April. “The big concern with Delta is that it could spread like wildfire,” said Dr. James Versalovic, interim pediatrician-in-chief at Texas Children’s Hospital. (Wu, 6/30)

Las Vegas Review-Journal: Nevada Has Higher COVID Case Rate Than Any Other State
Nevada on Wednesday reported 558 new coronavirus cases and three deaths on yet another day where the state’s major COVID-19 metrics continued to rise. Updated data posted by the state Department of Health and Human Services on the state’s coronavirus website pushed the state’s case total to 333,712 and showed the two-week moving average of new COVID-19 cases increasing to 268 per day. The state’s death total increased to 5,681. The three deaths reported were above the two-week moving average of two per day. Nevada’s case count continues to rise at a significant rate, and the state now has a higher seven-day case rate per 100,000 people than any other state in the country, according to data from the Centers for Disease and Control and Prevention. (Dylan, 6/30)

AP: Arkansas Has Biggest One-Day Virus Case Spike In 4 Months
Arkansas reported its biggest one-day spike in coronavirus cases in four months Wednesday, an increase the state’s governor said was being fueled by the delta variant of the virus. The state reported 686 new virus cases, bringing its total since the pandemic began to 349,385. The state’s active cases, meaning those that don’t include people who have recovered or died from the virus, increased by 398 to 3,763. (6/30)

Axios: Why The Delta Variant Has Northwest Arkansas Doctors On Edge 
The Delta variant of COVID-19 is rapidly spreading in NWA and surrounding areas, state epidemiologist Jennifer Dillaha tells Axios. "We suspect that it is spreading in every county in Arkansas and, if not, it soon will be," she says. The variant is beginning to cause another surge in cases and hospitalizations, Dillaha and David Ratcliff, chief medical officer at Washington Regional Medical Center, told Axios. (Golden, 6/30)

Salt Lake Tribune: Utah Reports 574 New Cases Of COVID-19 — The Most In More Than Two Months
Utah reported 574 new cases of COVID-19 on Wednesday — the most in a single day since April 20, when there were 592. The rolling seven-day average stands at 372 a day. There were also three more deaths, bringing the overall total to 2,371. The Utah Department of Health reported 39 coronavirus deaths in the month of June, the smallest one-month total in the past 15 months. (There were nine deaths reported in March 2020; the first COVID-19 death in Utah was reported on March 22, 2020.) (Pierce, 6/30)

AP: California Virus Cases Rising As Delta Variant Spreads
California broadly reopened its economy barely two weeks ago and since then an especially contagious coronavirus variant has spread among the unvaccinated, a development that has health officials on edge and already has prompted Los Angeles County to strongly recommend everyone resume wearing masks inside. The nation’s most populous state is averaging close to 1,000 additional cases reported daily, an increase of about 17% in the last 14 days. Officials expected an increase when capacity limits were lifted for businesses and most mask restrictions and social distancing requirements were eliminated for vaccinated people. (Taxin and Dazio, 7/1)

NBC News: Common Cold Or Covid? Upper Respiratory Symptoms Are Growing More Prevalent, Docs Say
Doctors are beginning to notice Covid-19 cases that look more like a very bad cold, especially in areas of the country where the highly contagious delta variant is quickly spreading. While shortness of breath and other lung issues remain among the most worrisome Covid-19 symptoms, it appears upper respiratory complaints — marked by congestion, a runny nose and headache — may be increasing. (Edwards, 6/30)

In other covid research —

The Wall Street Journal: Vaccinated People Who Get Infected Carry Less Covid-19 Virus, CDC Researchers Say
People who became infected with Covid-19 after getting a messenger RNA vaccine carried less virus and had shorter cases than unvaccinated people who became infected, a study by government health researchers found. Sixteen people in the study who got infected, despite taking a Pfizer Inc. or Moderna Inc. vaccine, had on average 40% less virus in their nose compared with the 155 unvaccinated people who became sick, according to the study, published online Wednesday in the New England Journal of Medicine. (Hopkins, 6/30)

CIDRAP: Some Wildlife Species May Harbor SARS-CoV-2 And Pose Risk To People
Inoculation with SARS-CoV-2 resulted in viral shedding in deer mice, bushy-tailed woodrats, and striped skunks but not cottontail rabbits, fox squirrels, Wyoming ground squirrels, black-tailed prairie dogs, house mice, or raccoons, according to an Emerging Infectious Diseases study yesterday. The researchers chose these animals based on their peridomestic status in the United States. In other words, because these wild animals are often in close contact with humans, they may present future danger if SARS-CoV-2 is able to infect them, evolve, and then cross back to humans. (6/30)

CNN: What Parents Need To Know About Children And The Delta Variant 
The Delta variant of Covid-19 is more contagious than other lineages, and is spreading rapidly in under-vaccinated populations. While vaccination is a matter of choice for adults, many children -- particularly those under the age of 12 -- cannot get vaccinated at all. That leaves a lot of uncertainty, especially for parents and caregivers considering summer camps and school. (Langmaid, 6/30)

The New York Times: Why You Still Might Want To Have A Home Covid Test On Hand 
Got the sniffles? Worried about that night out in a crowded dance club? Or maybe you just want to visit grandma but are concerned about her risk, even though you’re vaccinated. At-home rapid Covid tests — which allow you to swab your own nose and get the results in minutes — can be a useful and reassuring way for both the vaccinated and unvaccinated to navigate the ongoing pandemic. (Parker-Pope, 6/29)

CBS News: Fauci Says It Doesn't Seem The CDC Will Change Mask Recommendations Despite Growing Concern About Delta Variant 
As many U.S. states continue to relax COVID-19 protocols, concerns are growing about the more contagious Delta variant. But while the World Health Organization is encouraging people to keep wearing masks even if they're vaccinated, Dr. Anthony Fauci says it doesn't look like the Centers for Disease Control and Prevention currently plans to change its guidelines. "The CDC continually monitors the situation and I'm sure would remain flexible, that if any changes are warranted based on the evolving situation, they would then make a change in their recommendation. But right now, it doesn't look that way," Fauci said in an interview Wednesday on CBSN. "It looks like they're going to continue to stay by their original recommendation." Under the CDC recommendations, fully vaccinated people can resume most indoor and outdoor activities without wearing a mask or social distancing. (Powell, 6/30)

CNN: It's Time To Rethink 'One-Size-Fits-All' Approach To Mask Guidance, Expert Says, As Delta Variant Is Spotted In Every US State 
With uneven vaccination rates across the US and a the Delta variant now spotted in all 50 states, a health expert is warning the federal government's mask guidance should be more focused. "Part of the problem is that the CDC is trying to use a one-size-fits-all recommendation for the country rather than being a bit more surgical in identifying hot spot areas where transmission is accelerating," Dr. Peter Hotez told CNN's Jake Tapper Wednesday. (Elamroussi, 7/1)

Axios: Delta Variant Threatens Masking Guidance 
Growing nervousness about the Delta variant of COVID-19 is causing some places to consider reinstating mask recommendations. But with conflicting guidance from top health agencies, it's got the potential to create new confusion around masking. Days after the World Health Organization recommended vaccinated people should still wear their masks to slow the spread of the Delta variant, the CDC reiterated its own guidance allowing individuals to unmask and leaving masking rules to states and counties to decide. (Fernandez, 7/1)

In other news about masks —

AP: GOP Congressman Flouts Mask Rules On Airline Flight To Texas
A Texas congressman who has been an outspoken critic of COVID-19 mask mandates went without a mask for at least a portion of a commercial airline flight Tuesday evening, an apparent violation of federal law. Republican Rep. Chip Roy flew from Washington back to his home district in Austin to attend a border security event held Wednesday with former President Donald Trump. (Biesecker, 7/1)

Health News Florida: Masks Are Off In Florida, But Legal Wrangling Continues 
Gov. Ron DeSantis in early May blocked cities and counties from requiring people to wear masks to prevent the spread of COVID-19. But that hasn’t stopped legal battles over mask mandates. Attorneys for Alachua County last week asked the 1st District Court of Appeal to reconsider a decision in a case about the constitutionality of a mask requirement that the county imposed in 2020. A panel of the appeals court on June 11 overturned a decision by an Alachua County circuit judge, who rejected a challenge to the requirement. (Saunders, 6/30)

Stateline: Parents Face Dilemma In States That Ban School Mask Mandates
This month, Tempe mother Kammy Pany was disappointed to learn the Arizona House passed a measure that would prohibit all school districts and charter schools from requiring masks. After being home for a year, her three elementary school-aged children were excited to return to lessons in person this fall. But because of their compromised immune systems and the likely mask change, Pany felt she had no choice but to find a school that offered online learning. After researching about six, she finally found one. “It’s been difficult, and the kids at this point, they stopped asking about going back to school,” Pany said. “They stopped asking about friends. They're just used to this new life. ... It’s been pretty isolating for all of us.” (Wright, 6/30)

And more states ease covid restrictions —

Billings Gazette: Gianforte Lifts Montana COVID Emergency Declaration
Montana Gov. Greg Gianforte on Wednesday lifted the executive order declaring a state of emergency because of the COVID-19 pandemic. The announcement came during a visit to the Montana Club restaurant in Billings where Gianforte met with the restaurant's owner and managers to discuss how the pandemic and employment shortages have affected business during the last 15 months. The executive order, a continuation of a state of emergency initially declared by former Gov. Steve Bullock in March 2020, was signed shortly after Gianforte took office in January. (Etherington, 6/30)

The Oregonian: Masks Are No Longer Required In Most Public Settings Starting Today. Why Some Oregonians Will Keep Wearing Them. 
As Gov. Kate Brown does away with the state’s mask mandates Wednesday in nearly all public settings -- nearly one year to the day after she enacted them -- it’ll change nothing about the way Emily Rader of Canby goes about her daily life. Rader said she’ll continue to wear her mask while shopping indoors and at work even though she’s fully vaccinated against COVID-19. Rader says she’ll cover up, even if most others aren’t, because the vaccines, though highly effective, don’t offer a bullet-proof defense. And wearing a mask simply isn’t that big of an inconvenience for the added peace of mind. (Green, 6/30)

The Baltimore Sun: Some Of Maryland’s COVID Emergency Mandates End Today. What Will Change? 
Many of Maryland’s emergency restrictions, including a statewide mask mandate, will end Thursday. Gov. Larry Hogan announced last month that Maryland would lift its COVID-19 state of emergency in two phases, with some policies ending Thursday and others after a 45-day grace period through Aug. 15. Hogan declared a state of emergency at the onset of the pandemic in March 2020, and extended it as the pandemic persisted. The order allowed the governor to impose restrictions and suspend regulations “if necessary in order to protect the public health, welfare, or safety.” (Lawrence, 7/1)

Detroit Free Press: $5M COVID-19 Vaccine Sweepstakes, Scholarships Coming To Michigan
Are you feeling lucky, Michigan? Gov. Gretchen Whitmer plans to announce details Thursday of a COVID-19 vaccine sweepstakes that will give vaccinated Michiganders a chance to win a combined total of more than $5 million in cash and nine college scholarships worth $55,000 apiece. Called the MI Shot to Win Sweepstakes, the lottery-style raffle will be operated by the state in conjunction with Meijer and the Michigan Association of United Ways as an incentive to encourage more residents to get vaccinated. (Jordan Shamus, 6/30)

In other news on the vaccine rollout —

NPR: White House Celebrates Vaccine Progress With Free Beer And Bill Pullman
America hasn't quite reached President Biden's July Fourth vaccination goal, but the White House isn't letting that get in the way of a good party. Starting Saturday, Biden and other administration officials will fan out around the country to celebrate that hospitalizations and deaths from COVID-19 are way down and life is getting back to normal. And even though not quite 70% of American adults are expected to have received their first shot by the Independence Day milestone, Budweiser is officially unlocking its free beer giveaway, one of many incentives dangled to try to lure people to roll up their sleeves ahead of July Fourth. That news was announced by actor Bill Pullman, who reprised the epic presidential speech of the 1996 blockbuster Independence Day, a movie about an alien invasion. (Keith, 6/30)

AP: First Lady, Second Gentleman Push COVID-19 Shots In Arizona
Jill Biden on Wednesday appealed to Arizona residents to get vaccinated against COVID-19, aiming to counter skepticism by declaring that the vaccines are safe and have been vigorously tested. “I’m here to ask all the viewers on these TV stations to please make the choice to get vaccinated because it’s safe,” she said in a speech before an invited audience and TV cameras after touring a vaccine clinic at Isaac Middle School in Phoenix. Just 40% of eligible Arizonans have been fully vaccinated. (Superville, 6/30)

San Francisco Chronicle: Facebook Will Be Sending A Vaccination Truck Into Bay Area Neighborhoods
Facebook’s community vaccine efforts are going mobile. In an effort to get coronavirus vaccines to underserved communities, the company said it is partnering with Bay Area nonprofits to send a mobile vaccine truck to schools near its Menlo Park headquarters. The truck will show up at different schools on the Peninsula on Fridays and Sundays throughout the summer and can administer up to 40 doses per hour. More information about timing and schedules for the Friday trucks will be posted at www.facebook.com/RavenswoodSchools while Sunday information will be available at facebook.com/FBMobileFarmersMarket. Facebook’s Chief Operating Officer Sheryl Sandberg announced the effort in an online post Wednesday. (DiFeliciantonio, 6/30)

The Boston Globe: Massachusetts Senior Care Company Mandates COVID Shots For Workers — A First For State’s Nursing Homes
Citing rising concern about a rapidly spreading and more contagious strain of the novel coronavirus, a Massachusetts senior care company Wednesday announced it will mandate COVID-19 shots for all of its workers, becoming one of the first in the state to take such action. The decision by Legacy Lifecare comes as vaccination rates remain stubbornly low at many Massachusetts nursing homes and some other senior care facilities, placing thousands of frail residents at risk. Roughly 30 percent of Massachusetts nursing home staff are not vaccinated, according to the most recent state data. (Lazar, 6/30)

St. Louis Post-Dispatch: St. Louis Area Health Officials Want To Turn Around Dismal Teen Vaccination Rates Before School Starts 
Along with notebooks, highlighters and calculators, add a COVID-19 vaccine to the list of things needed for the first day of school, health officials say. “Now is the time to get a shot. Consider it part of your back-to-school list,” said St. Louis County Executive Sam Page. “This is arguably the most important tool your students need for the new school year.” The Pfizer-BioNTech vaccine against COVID-19 is approved for those as young as 12, while Moderna and Johnson & Johnson vaccines are available for those 18 and older. (Munz, 6/30)

Also —

The Washington Post: Washington Rep. Jim Walsh Apologizes For Wearing Star Of David To Protest Covid Measures 
Washington state Rep. Jim Walsh has decried “vaccine segregation” and likened his state’s lottery encouraging immunization against the coronavirus to the “The Hunger Games.” Then, last weekend, the Republican lawmaker wore a yellow Star of David. “It’s an echo from history,” Walsh wrote of the star in the comments below a live stream of his talk Saturday in Lacey, Wash. “… In the current context, we’re all Jews.” (Knowles, 6/30)

Georgia Health News: Georgia Hospital Workers’ Vaccine Rates: The Good, The Bad, And The Unknown 
Houston Healthcare did the typical things to promote COVID-19 vaccination among its hospital workers, including stressing the importance and safety of getting a shot. But the Warner Robins-based system’s successful vaccine effort had a personal dimension as well. The deaths of three beloved staff members from COVID-19 motivated employees to get the shots, says Houston Healthcare’s CEO. (Miller and Goodman, 6/30)

AP: No Indictment For Doctor Accused Of COVID-19 Vaccine Theft
A grand jury on Wednesday declined to indict a former Houston-area health department doctor who was accused of stealing nine doses of coronavirus vaccine from a damaged vial and administering them to family and friends. Prosecutors had alleged that Dr. Hasan Gokal, who worked for Harris County Public Health, stole a vial of the Moderna coronavirus vaccine while working at a vaccination site at a suburban Houston park on Dec. 29. His attorney said Gokal was only trying to save lives by using doses that would have been thrown away. (Lozano, 7/1)

Fox News: Pfizer To Request COVID-19 Vaccine Emergency Approval For Kids Ages 5-11 By Fall
Younger children could become eligible for a COVID-19 vaccine this fall, according to a top executive at Pfizer who noted plans to request emergency approval for use of its vaccine in kids aged 5 to 11 by September or October. Dr. Alejandra Gurtman, vice president of vaccine clinical research and development at Pfizer, appeared along with representatives from other major drugmakers to talk data and timelines behind pediatric clinical trials Thursday during a Johns Hopkins University-University of Washington virtual symposium. Pfizer’s COVID-19 vaccine is currently authorized for use in individuals aged 12 and older. (Rivas, 6/30)

The Baltimore Sun: COVID Experts, Speaking At Symposium Co-Hosted By Johns Hopkins, Lay Out Risks, Benefits Of Vaccines For Young Children
As more adults become vaccinated against COVID-19, the coronavirus has targeted more children not yet eligible for shots. But the first vaccine for those as young as 5 could be ready as soon as September. A collection of experts laid out the benefits — and a few risks — of vaccinating kids during a symposium hosted Wednesday by the Johns Hopkins University and the University of Washington. (Cohn, 7/1)

In other news on vaccine development and research —

USA Today: Johnson & Johnson Vaccine May Protect Against Delta Variant
A top U.S. official suggested Wednesday that people who received the Johnson & Johnson vaccine likely are protected against the delta variant. U.S. Surgeon General Dr. Vivek Murthy told CNBC that data shows the Oxford-AstraZeneca shot — a "cousin" of the J&J — is highly effective against the variant first identified in India and currently surging across the nation. “While we are still awaiting direct studies of Johnson & Johnson and the delta variant, we have reasons to be hopeful, because the J&J vaccine has proven to be quite effective against preventing hospitalizations and deaths, with all the variants that we’ve seen to date,” Murthy said. (Aspegren, 7/1)

Reuters: CureVac COVID-19 Vaccine Records Only 48% Efficacy In Final Trial Readout 
CureVac said its COVID-19 vaccine was 48% effective in the final analysis of its pivotal mass trial, only marginally better than the 47% reported after an initial read-out two weeks ago. The German biotech firm said that efficacy, measured by preventing symptomatic disease, was slightly better at 53% when excluding trial participants older than 60 years, an age group that is by far the most severely affected. (Burger, 7/1)

The New York Times: AstraZeneca Booster Shot Lifts Immune Response, Study Finds 
A third dose of the Covid-19 vaccine developed by AstraZeneca and the University of Oxford generated a strong immune response in clinical trial volunteers, Oxford researchers reported on Monday. The finding indicates that the AstraZeneca vaccine could be an option should third shots end up being needed, for example, to extend immunity. To date, the vaccine has been given as two doses, typically between four and 12 weeks apart. (Robbins, 6/28)

Stat: 12 Lessons Covid-19 Taught Us About Developing Vaccines
The extraordinary drive to develop Covid-19 vaccines was like a moonshot — and like that fabled acceleration of space exploration science, it delivered. Just a little over six months after the first Covid vaccines were authorized for use, nearly 3 billion vaccine doses have been administered around the globe. The world got very lucky; so much went right in the quest for vaccines to end this pandemic. But there have been setbacks (see: Sanofi) and failures (see: Merck) along the way, and the progress toward supplying vaccine to less affluent parts of the world has been scandalously slow. (Branswell, 6/30)

Axios: We Still Don't Know Whether Anyone Will Need Coronavirus Vaccine Booster Shots 
There's no evidence that anyone who's been vaccinated against the coronavirus needs a booster yet. Deciding who needs one — and when — could be complicated. With vaccination rates plateauing at the same time the more transmissible Delta variant of the virus spread across the U.S., it has raised new fears among Americans, including many vaccinated individuals who worry about how long they'll remain protected against COVID. (Owens, 7/1)

WHO13.com: President Biden Signs Rural Mental Health Act Named For Iowa Veteran Into Law
On Wednesday, President Joe Biden signed a mental health bill into law named for Sgt. Brandon Ketchum – an Iowa veteran who took his own life after being denied mental health services in 2016. The ‘Sgt. Ketchum Rural Veterans’ Mental Health Act’ was penned by Iowa congresswoman Cindy Axne. The bill creates new programs within the VA that are specifically targeted at increasing mental healthcare access in rural areas. (Hendrickson, 6/30)

KWWL: Led By Iowa's U.S. House Delegation, Biden Signs Rural Mental Health Act Named For Iowa Veteran Into Law
The law requires the Department of Veterans Affairs to establish and maintain three new centers of the Rural Access Network for Growth Enhancement (RANGE) Program in areas with interest from personnel and a need for additional mental health care for rural veterans. The RANGE Program serves veterans in rural areas who are experiencing mental illness. It also requires the Government Accountability Office to conduct a study and report on whether the VA has sufficient resources to serve rural veterans who need mental health care that is more intensive than traditional outpatient therapy. (Oates, 6/30)

Des Moines Register: Biden Calls Iowan's Mom After Signing VA Mental Health Law Named For Son
Beverly Kittoe was working in her hair salon Wednesday when she received an unexpected call from Washington, D.C. She didn't recognize the number, but decided to answer. The caller was a White House staffer. The staffer asked if Kittoe could spare a few minutes to speak to President Joe Biden about her son, Iowa National Guard veteran Brandon Ketchum. Yes, Kittoe replied. Of course she could. The president had just signed a bill named for Ketchum, who died by suicide in 2016. The bill, co-sponsored by all four Iowa members of the U.S. House of Representatives, aims to improve access to VA mental health services for rural veterans. (Leys, 6/30)

In other news from the Biden administration —

The New York Times: For Surprise Medical Bills, It’s The Beginning Of The End
The Biden administration is expected to take its first steps Thursday toward finalizing the details of a ban on surprise medical bills that Congress passed and President Trump signed into law last winter. Some experts see the policy as the most important consumer protection in health care to come out of Washington in more than a decade. Surprise medical bills happen when a doctor or other provider who isn’t in a patient’s insurance network is unexpectedly involved in a patient’s care. Patients may go to a hospital that accepts their insurance, for example, but get treatment from emergency room physicians or anesthesiologists who don’t — and who then send patients big bills directly. (Kliff and Sanger-Katz, 7/1)

The Washington Post: Biden Names Veteran Of Last Cancer Moonshot To Help Direct New Initiative
President Biden is naming Danielle Carnival, a veteran of the cancer moonshot during the Obama administration, to help oversee a new version of the effort — a cause that has long been of intense personal and professional interest to the president, according to the White House. Carnival, a neuroscientist who is chief executive officer of an ALS nonprofit, will be a senior adviser to Eric Lander, the recently confirmed director of the White House Office of Science and Technology Policy, according to a statement from the White House. (McGinley, 6/30)

Politico: FEMA Changes Rules For Covid-19 Funeral Aid Program After Outcry 
The Federal Emergency Management Agency has changed its pandemic funeral assistance policy to allow family members of those who died from Covid-19 to submit for reimbursement even if the death certificate does not identify the illness as the cause of death. FEMA said Tuesday that people whose family member died between Jan. 20 and May 16, 2020, can apply for aid if they submit a signed letter from a coroner, medical examiner or official who certified their relative’s death certificate that links the death to Covid-19. (Banco, 6/30)

Marketplace: Biden Considers Order To Use Government's Regulatory Power To Boost Competition
President Joe Biden is considering issuing an executive order that would direct the federal government to tighten the reins on industries dominated by a few large companies. The precise wording of the order is not yet known, but the gist of it is that instead of relying on antitrust enforcement, agencies should use regulation to promote competition in industries from agriculture to health care. (McCarty Carino, 6/30)

NPR: The U.S. Will Add A Third Gender Option On Passports
Starting immediately, an applicant for a U.S. passport can simply check "M" or "F" as their gender – without needing to provide medical certification if that gender doesn't match their other documents. And soon, applicants will have the option to select a gender option that isn't male or female, the State Department said Wednesday. Secretary of State Antony Blinken announced the changes as "further steps toward ensuring the fair treatment of LGBTQI+ U.S. citizens, regardless of their gender or sex." They will also fulfill a Biden campaign promise. It will take some time to create a third gender option on passports, the State Department warned. People can not yet apply for a passport with a nonbinary, intersex, or gender nonconforming gender marker. (Wamsley, 6/30)

In news about the infrastructure bill —

Axios: Hospitals Urge Congress Not To Pay For Infrastructure With Unspent COVID Relief 
The nation's largest hospital groups really don't want the Senate to pay for its infrastructure deal with funding that would otherwise go to them. The hospital industry has a lot of sway in Washington, and its opposition could further complicate the deal's narrow pathway to passage. (Owens, 6/30)

The New York Times: Air Pollution’s Invisible Toll On Your Health 
President Biden’s proposed infrastructure plan calling for huge investments in clean energy, public transportation and electric vehicles would do a lot more than slow the rate of devastating climate change. It would also protect the health of every American, especially young children and older adults, by reducing the harmful effects of the invisible air pollutants inhaled year after year. Toxic substances like fine particulate matter, nitrogen dioxide and ozone form primarily when fossil fuels are burned and enter the atmosphere in the exhaust from motor vehicles, heating units and smoke from wildfires. Inhaling such pollutants can cause bodily damage that lasts for years, if not for life, and may even lead to death. (Brody, 6/28)

Oklahoman: 'A Very Joyful Moment': Medicaid Expansion Takes Effect In Oklahoma
After more than a decade of fierce debate about whether Oklahoma should expand Medicaid, the Sooner State on Thursday became the 37th state to implement Medicaid expansion and offer health benefits to more low-income residents. Medicaid expansion has been one of the most heated political topics in Oklahoma since the Affordable Care Act became law in 2010. Supporters of State Question 802, which Oklahoma voters passed last year to expand Medicaid, celebrated the change that is expected to result in roughly 200,000 more Oklahomans qualifying for Medicaid benefits. (Forman, 7/1)

Public Radio Tulsa: Advocates Celebrate Start Of Benefits Under Oklahoma Medicaid Expansion
Voters narrowly approved a state constitutional amendment last June to make more working adults eligible for the program. It was put on the ballot through the initiative petition process after lawmakers declined to expand Medicaid for years. Oklahoma Policy Institute has long made the case for Medicaid expansion. Policy Director Carly Putnam and Legislative and Outreach Director Angela Monson said tying health insurance to a job is problematic. (Trotter, 6/30)

NPR: 12 Holdout States Haven't Expanded Medicaid, Leaving 2 Million People In Limbo
There are more than 2 million people across the United States who have no option when it comes to health insurance. They're in what's known as the "coverage gap" — they don't qualify for Medicaid in their state, and make too little money to be eligible for subsidized health plans on the Affordable Care Act insurance exchanges. Briana Wright is one of those people. She's 27, lives near Jackson, Miss., works at McDonalds, and doesn't have health insurance. So to figure out her options when she recently learned she needed to have surgery to remove her gallbladder, she called Health Help Mississippi, a nonprofit that helps people enroll in health insurances. (Simmons-Duffin, 7/1)

In other Medicaid news from Missouri —

ABC17: Missourians To Rally Thursday, When Voter-Approved Medicaid Expansion Was Supposed To Take Effect 
On Thursday, the day Medicaid expansion would have taken effect, Missourians plan to rally outside the Governors Mansion at 11 a.m. Missourians in support of expansion plan to share their personal health care stories during the rally. (Crowder, 7/1)

St. Louis Post-Dispatch: Missouri House Sends Medicaid Tax Renewal To Parson On Bipartisan Vote
The Missouri House on Wednesday sent renewal of a major tax that funds the state’s Medicaid program to Gov. Mike Parson, warding off the likelihood of deep budget cuts by the governor. Passage of the Federal Reimbursement Allowance came only after long debate on a separate bill banning funds from going to abortion providers and affiliates. The House sent that measure to the Senate, but GOP leaders in the Legislature’s upper chamber said they would not take it up. (Suntrup and Erickson, 6/30)

Kansas City Star: Missouri Renews Medicaid Tax, Averts Budget Cuts 
Missouri lawmakers on Wednesday sent the renewal of a tax critical to funding Medicaid to Gov. Mike Parson, just ahead of a deadline he imposed for enacting drastic budget cuts across the state. The House passed the bill 140-13 with no debate or changes to the version Senators approved Saturday after a bitter impasse. It also passed a bill cutting Planned Parenthood out of Medicaid, which died hours later when the Senate adjourned without acting on it. (Kuang, 6/30)

And from other state Medicaid programs —

The Providence Journal: New England Medicaid Dental Benefits Vary From State To State
For adults on Medicaid in New Hampshire, dental coverage still remains elusive. Last week, Republican Gov. Chris Sununu signed the biennial state budget, and in doing so, scrapped funding for the state's Medicaid adult dental benefit. New Hampshire only provides emergency dental coverage to adults on Medicaid – not for preventative care or other major procedures, which are covered for children 18 and under. (Barndollar, 6/30)

The Columbus Dispatch: Ohio Gov. Mike DeWine Signs State Budget With 14 Vetoes
Still, the governor didn't love everything about the 3,300-page budget. He vetoed 14 items from the final draft, including a controversial provision to let state lawmakers hire outside counsel during the redistricting process. The Ohio House and Senate can override any or all of the governor's vetoes. No word yet on whether that's something they plan to do. So, for now, here are some of the more notable items that DeWine cut from the budget. (Staver, 7/1)

Stat: ICER Nudges Cost-Effective Price For Alzheimer's Drug To $3,000 To $8,400
The controversial new Alzheimer’s drug from Biogen (BIIB) would be cost-effective only if priced between $3,000 and $8,400, which represents an 85% to 95% discount off the $56,000 list price, due to “insufficient” evidence the drug benefits patients, according to a revised analysis. The assessment is very similar to an evaluation that was issued last month, before the Food and Drug Administration approved the medicine and issued a broad label. This means the medication can be prescribed to potentially millions of patients, regardless of the extent of their disease, even though Biogen tested its drug only on people with mild cognitive impairment to mild Alzheimer’s. (Silverman, 6/30)

Stat: Calls Grow For An Investigation Into FDA Approval Of New Alzheimer’s Drug
Former health secretary Donna Shalala called for a federal investigation into the Food and Drug Administration’s polarizing approval of a Biogen treatment for Alzheimer’s disease, citing STAT’s revelation Tuesday that regulators were far more closely aligned with the company than previously disclosed. “When you see a report like this, you have to investigate it,” said Shalala, a former member of Congress who led the Department of Health and Human Services under President Clinton. “You cannot hesitate and you can’t do it with your general counsel. You’ve got to send in the Office of Inspector General. I mean, you shouldn’t hesitate for one second.” (Garde and Florko, 6/30)

In other news about the high cost of drugs —

Axios: Walmart Rolls Out Cash-Pay Novo Nordisk Insulin 
Walmart is now selling rapid-acting insulins, made by drug manufacturer Novo Nordisk, for cash prices of $73 per vial and $86 for a box of five pre-filled syringes. Walmart is attempting to retain and attract more diabetes patients to its stores by offering a more modern insulin at a lower cash price. Novo Nordisk is trying to keep its insulin market share. But this deal doesn't ensure an affordable price for patients and the broader public. (Herman, 6/30)

Bloomberg: Generic Drug Prices For Patients Vary By $50 A Pill Among US Hospitals
Costs for common generic drugs can vary among hospitals by more than $50 a pill, a study has found, with some health centers ignoring federal regulations designed to make pricing information easily accessible to patients. GoodRx Holdings Inc., a digital healthcare platform, compared prices for 12 generic drugs at 16 hospitals. Some charged a nearly 6,000% markup on average compared with the pharmacy price for the same drug. Zoloft, used for depression and anxiety, costs $57 a pill at a Las Vegas hospital but just 50 cents a pill at a Tennessee hospital. (Torrence, 6/30)

Axios: Top Patient Advocacy Groups Take Millions From Drug Companies 
Some of the most recognizable names in patient advocacy take millions from drug companies every year, and many fail to fully disclose those relationships, a new analysis by Patients for Affordable Drugs found. While some of these groups do important work representing patients, others are actually "tools" of the pharmaceutical industry. Either way, many "appear unable or unwilling to take positions on consumer issues such as lowering prescription drug prices that might anger their drug corporation funders," PAD authors write. (Reed, 6/30)

Health News Florida: States Step Up Push To Regulate Pharmacy Benefit Managers 
Under pressure to rein in skyrocketing prescription drug costs, states are targeting companies that serve as conduits for drug manufacturers, health insurers and pharmacies. More than 100 separate bills regulating those companies, known as pharmacy benefit managers, have been introduced in 42 states this year, according to the National Academy for State Health Policy, which crafts model legislation on the topic. The flood of bills comes after a U.S. Supreme Court ruling late last year backed Arkansas’ right to enforce rules on the companies. At least 12 of the states have adopted new oversight laws. But it’s not yet clear how much money consumers will save immediately, if at all. (Houghton, 6/30)

KHN: How One Rural Town Without A Pharmacy Is Crowdsourcing To Get Meds
The building that once housed the last drugstore in this town of fewer than 600 is now a barbecue restaurant, where pit boss Larry Holtman dishes out smoked brisket and pulled pork across the same counter where pharmacists dispensed vital medications more than 30 years ago. It’s an hourlong drive over treacherous mountain passes to Laramie, Wyoming, or Granby or Steamboat Springs, Colorado — and the nearest pharmacies. The routes out of the valley in which Walden lies are regularly closed by heavy winter snows, keeping residents in and medications out. (Hawryluk, 7/1)

In other pharmaceutical news —

Stat: Mallinckrodt Clear To Make Deal For Rare Disease Drug; Parents Worry On Access
A federal bankruptcy court judge has approved the sale of a rare disease drug to a startup company backed by venture capitalist Peter Thiel, a notable step in one of the latest dramas over access to experimental medicines. At issue is adrabetadex, which Mallinckrodt (MNKKQ) was studying to combat Niemann-Pick type C, or NPC, a rare progressive genetic disorder that mainly affects children. But the company ended clinical testing earlier this year after studies indicated the drug had no benefit. That was a devastating decision for families because there is currently no treatment for NPC approved for use in the U.S. (Silverman, 6/30)

Stat: Gene Therapy To Aid Recovery After A Heart Attack Passes A Key Test 
By delivering a viral payload of gene silencers directly to the heart, scientists have developed a new strategy for regenerating cardiac muscle after damage from a heart attack. Described in a paper published Wednesday in Science Translational Medicine, the approach led to new cell growth and improved heart function in pigs. The findings, though preliminary, indicate it’s possible to prod cardiac muscle cells into regenerating, at least long enough to stave off some of the worst after-effects of a heart attack. If the gene therapy bears out as safe and effective in further testing, it might someday be used to address the root cause of heart failure — one of the leading causes of death in the U.S. (Molteni, 6/30)

CNBC: How CRISPR Gene Editing Will Treat Disease: Intellia Founder Doudna
Gene-editing technology CRISPR reached a major milestone this past weekend, completing its first systemic delivery as a medicine to a human body. CRISPR, or clustered regularly interspaced short palindromic repeats, effectively cuts genomes and slices DNA to treat genetic diseases. The latest breakthrough, the result of a trial between biotech company Regeneron and Boston-based startup Intellia Therapeutics, treated a rare disease after being given as an IV infusion. (Thomas, 6/30)

Crain's Detroit Business: Rising Pay In Other Industries Blows Holes In Healthcare's Workforce
Beaumont Health has more than 2,600 open positions across its eight hospitals and more than 165 outpatient centers. Roughly 20% of those positions fall under one job — medical assistant. A medical assistant performs relatively routine tasks, such as filling out insurance forms, scheduling laboratory appointments or preparing patients for treatment. But, increasingly, the job is becoming more clinical and their responsibilities expanding to where medical assistants are functionally bedside nurses. And as one of the lowest paid clinical jobs in healthcare — the median wage in the U.S. is $17.23 per hour and $16.75 per hour in Michigan with an entry-level wage of $13.63 — the roles are increasingly more difficult to fill as workers seek employment in other industries that require less training and offer better benefits and bigger pay than healthcare. (Walsh, 6/30)

Modern Healthcare: Hospitals At Odds Over CMS Plans For New GME Slots
Hospitals are at odds over how CMS should distribute an additional 1,000 graduate medical education slots, according to comments on the agency's proposed inpatient prospective payment system rule. After 25 years of inaction, Congress finally increased the number of Medicare-supported GME slots to address the nation's growing doctor shortage in its December spending bill. The Association of American Medical Colleges estimates the U.S. will need 37,800 to 124,000 more physicians by 2034 to keep up with demand, so the additional capacity is necessary given how long it takes to train doctors. (Brady, 6/30)

Stat: Washington’s Antitrust Push Could Limit Amazon, Google Health Ambitions
Washington is abuzz with an ambitious new antitrust effort to rein in the power of tech industry power players like Apple, Amazon, Google, and Facebook — and the effort could limit their ascent in the health care industry. Tech companies are already major players in the health care space — think Amazon’s decision to launch its own pharmacy, or Google’s acquisition of Fitbit — and they have their sights set even bigger. If major antitrust reform passes, it could inject legal uncertainty into future plans, analysts and attorneys said. (Cohrs, 7/1)

In corporate news —

Modern Healthcare: Blue Cross NC Initiative To Reduce Burden For Independent Physicians
Blue Cross and Blue Shield of North Carolina is investing in a new company aimed at helping independent physicians grow and strengthen their practices. Blue Cross NC has partnered with investment firm Deerfield Management Company in the joint venture, which will offer management infrastructure, technology support and marketplace information. Independent physicians can either allow Blue Cross NC to acquire their practice's non-clinical assets, or they can use the joint venture as a vendor to bring in contracted services to manage their practice's non-clinical operations. (Devereaux, 6/30)

Modern Healthcare: Amedisys To Acquire Skilled Nursing Provider Contessa Health
Amedisys, a home health, hospice and personal care company, on Wednesday said it had signed a definitive agreement to acquire Nashville-based Contessa Health, a hospital-at-home and skilled nursing facility at-home provider, the company said. The $250-million acquisition is expected to close in late summer. Contessa will become a wholly-owned division of Baton Rouge, La.-based Amedisys. Amedisys Chairman and CEO Paul Kusserow characterized the acquisition as "strategic" and said it will allow the company to provide higher-acuity in-home care. (Christ, 6/30)

NBC News: Post-Pandemic Rise In Sexually Transmitted Diseases Imminent, Experts Warn
As Americans start to emerge from the pandemic, public health experts and doctors have a dire warning about a possible new health crisis this summer, one that involves a different type of infection: sexually transmitted diseases. “We are expecting the summer of love,” said David Harvey, executive director of the National Coalition of STD Directors. “People are going to be connecting this summer as they come out of the pandemic and we think that is unfortunately going to drive STI rates even higher,” he said, referring to sexually transmitted infections. (Dunn, 7/1)

In other public health news —

Southern California News Group: Flea-Borne Typhus Cases Are On The Rise In Southern California
Cases of flea-borne typhus are on the rise in Long Beach, officials announced Tuesday, June 29. There have been 10 cases reported so far this year, more than double the four cases that had been reported this time last year. Typhus can cause high fever, chills, headache and rash and enters the skin through scratching a bite from an infected flea, which rats, cats, dogs, raccoons and opossums can carry. Pets and animals do not become sick from typhus, but if it’s left untreated in humans, the disease can cause severe illness. (Munguia, 6/30)

Fox News: Maine Confirms Tick-Borne Powassan Virus Case: Symptoms To Watch For
Maine confirmed the first case of Powassan virus this year in a midcoastal resident who was hospitalized due to the illness. According to a health advisory, the resident, whose age and exact location were not revealed, exhibited symptoms of the illness in June. Officials did not say what the patient’s current health status is. "This individual likely acquired this Powassan encephalitis infection in the state of Maine," the health advisory said. "There are two types of Powassan virus in the United States. The first type, often called lineage 1 Powassan virus is associated with Ixodes cookei or the woodchuck tick. Lineage 2 POW, sometimes called Deer tick virus, is associated with Ixodes scapularis or the deer tick." (Hein, 6/30)

Louisville Courier Journal: First Rabid Bat Found In Oldham County, Kentucky, In Decade
A dead bat found in a La Grange residential area has tested positive for rabies, the first case in almost a decade, according to the Oldham County Health Department. Four other bats have been found in the same area since Friday, the department announced on social media Wednesday. "According to our records, this is the first confirmed rabid bat in Oldham County in nearly ten years," Oldham County Health Department director Matt Rhodes said in a statement. "Currently, there is no imminent risk to Oldham County residents. OCHD is taking all precautions to keep our residents and their pets protected." (Ladd, 6/30)

Carroll County Times: Think Before You Light That Firework. Maryland Fire Officials, Doctors Urge Caution When Celebrating July 4
An M-80, an illegal type of firework in Maryland, can explode a melon in about 5 seconds. A firecracker, also illegal, breaks an egg almost instantly. And sparklers, which are legal in some counties, can burn a cotton shirt in less than 30 seconds. If not properly handled, fireworks can cause severe injuries, state fire marshal Brian Geraci said at Wednesday event at which fire officials and doctors urged for caution celebrating the Fourth of July. (Longo De Freitas, 7/1)

KHN: Damage To Children’s Education — And Their Health — Could Last A Lifetime 
Before the pandemic, 16-year-old Na’ryen Cayou had everything he needed. He had his own room. A partial scholarship to a boys’ prep school. A spot playing trombone in the marching band, performing in parades all over New Orleans. Then covid-19 blew through the Big Easy like a hurricane, washing away nearly everything that helped him feel safe and secure. Schools shut down. His mom lost her job and couldn’t make the rent. Their landlord evicted them. (Szabo, 7/1)

AP: New Jersey Gamblers Can Light Up Sunday As Smoking Ban Ends
New Jersey’s yearlong coronavirus-inspired ban on smoking in Atlantic City casinos will end Sunday, just in time for the Fourth of July holiday. Gov. Phil Murphy said Wednesday that an order he signed ending a public health emergency contained a “sunset” provision winding down the smoking ban within 30 days, which is Sunday. (Parry, 7/1)

Press of Atlantic City: Casino Workers Call On State Officials To Ban Indoor Smoking Permanently
More than 50 casino workers and representatives from Smoke Free Atlantic City and the United Auto Workers gathered on the Boardwalk on Wednesday to call for state and industry officials to permanently ban smoking on the casino floor. Casinos have been operating smoke-free since last year when a temporary ban was initiated by Gov. Phil Murphy shortly after the casinos reopened in July following COVID-19 related closures. That ban ends Sunday. (Shelly, 6/30)

In other news about smoking —

Darien Daily Voice: Designated Pot-Smoking Areas May Be Required In Some CT Towns, Cities
As of Thursday, July 1, marijuana will be legalized for recreational use among adults in Connecticut, though as part of the legislation signed into law by Gov. Ned Lamont, some municipalities will have to create designated spaces outdoors intended for smoking weed. Cities with populations under 50,000 residents can say no to smoking in public, but those over 50,000 have two choices: if they decide to regulate where people can smoke, they must designate a location to allow them to do so or simply let them act as they please. (Failla, 6/30)

The New York Times: What Happens To The ‘Weed Spot’ Now That Weed Is Legal? 
When recreational marijuana was legalized in New York State in March, much of the change was not immediate. But there was one instantly observable difference: While it is not yet legal to sell or buy marijuana in New York, smoking a joint on the street is not a crime anymore. As long as they observe the same restrictions as on cigarettes, smokers can pretty much spark up where they like. This means the furtive trip to the “weed spot” — the reliably low-key loading dock, river cove, rooftop, whatever — is no longer required to smoke a blunt. And while some may miss the routine, that tends not to be the case for New Yorkers of color, who have been ticketed and arrested for marijuana possession at a far greater rate than others in the city. (Stevenson, 7/1)

New York Post: To Quit Smoking, Vapes Are Better Than Nicotine Patches, Gum
As health experts continue to scrutinize the viability of e-cigarettes as a safe approach to smoking cessation, a new study funded by top cancer researchers in the UK has determined that vaping can be “more effective” than patches, gum and other nicotine replacement products for quitting. That’s good news for the estimated 21.5 million adult smokers — over half of all adult smokers in the US — who will attempt to quit smoking this year, according to the most recent data from the Centers for Disease Control and Prevention. (Sparks, 6/30)

Bloomberg: BAT Says Switch To Heated Tobacco Helps Health Markers In Study
British American Tobacco Plc said smokers who switch to its heated-tobacco product had reduced their exposure to toxic chemicals linked to smoking-related illnesses in a study. Smokers who adopted BAT’s Glo product saw most indicators for the risk of lung cancer or cardiovascular disease drop to levels similar to those found in people who had quit smoking after six months, according to peer-reviewed research published Thursday. BAT funded and conducted the trial. (Gretler, 7/1)

North Carolina Health News: Juul Settled With NC For $40 Million. Now What? 
Kelly Kinard knows firsthand how quickly a teenager can become addicted to nicotine after experimenting with e-cigarettes and the flavored pods. Her son Luka was just 14 when he started vaping in his first year of high school in High Point. That would get him to the front row of the bleachers at football games and give him a sense of belonging when he walked up to a group of students who also were smoking. (Blythe, 7/1)

In related news about cancer screenings —

CIDRAP: Sharp US Declines In Cancer Screening During Pandemic
Nearly 16 months after the COVID-19 pandemic began in the United States, new studies are showing just how far reaching the repercussions of the pandemic have been on the US population. A study from the Centers for Disease Control and Prevention (CDC) published in Preventive Medicine shows sharp declines in both routine breast cancer and cervical cancer screenings, with screening for breast cancer declining 87% and cervical cancer screening declining 84% during April 2020 as compared with the previous 5-year averages for that month. (Soucheray, 6/30)

Philadelphia Inquirer: N.J. Hospitals Can Now Build Housing For Those Experiencing Homelessness, Connecting Need To Services
Saying the state has to “think creatively,” New Jersey Gov. Phil Murphy signed legislation Wednesday to let hospitals build housing for people experiencing homelessness, a measure that supporters say represents an important step toward better health care. The idea is that permanent, stable housing is a key to good health. People who are homeless are more likely to be hospitalized more often, to stay in the hospital longer once they’re there, and to require more care during treatment. Providing affordable housing near hospitals could help head that off. Several New Jersey hospitals have been moving forward with plans for partnerships and pilot programs. (Gammage, 7/1)

The New York Times: Sacramento Mulls A New Homeless Strategy: Legally Mandating Housing 
The mayor of Sacramento on Wednesday announced a plan to legally obligate California’s capital city to house its growing homeless population, a policy shift that would open a new front in the state’s struggle to address what has become a signature California social ill. Californians “are becoming homeless faster than we can get people the help they need,” said the mayor, Darrell Steinberg, as he proposed a municipal “right to housing” and a parallel “obligation” for homeless people to accept shelter when it is offered. (Hubler, 6/30)

In other news from Florida, Maine, Texas and California —

WUSF Public Media: Florida Colleges Are Now Shielded From COVID-19 Lawsuits 
Marking a victory for colleges and universities that shut down campuses last year during the COVID-19 pandemic, Gov. Ron DeSantis signed a bill Tuesday shielding the schools from lawsuits seeking refunds for students because of the closures. Campuses closed in March 2020 in an effort to prevent the spread of COVID-19, with students forced to learn online. (Dailey, 6/30)

Politico: Maine Governor Vetoes Bill Partially Decriminalizing Prostitution 
Maine Gov. Janet Mills vetoed legislation that would have made the state the first in the nation to fight sex trafficking by partially decriminalizing prostitution. The measure, which passed the state Legislature along party lines, would have reduced prostitution penalties for people who have been sold into the sex trade and provide them social services and opportunities. It would have also increased punishment for pimps and traffickers who coerce often vulnerable people into the underground network. (Crampton, 6/30)

Dallas Morning News: Dallas’ Ozone Problem Hints At Possible Link Between Grid Trouble, Rising Temperatures And Smog
Texas’ power grid troubles aren’t just causing problems for consumers’ electricity price and supply, they also may be contributing to the state’s notorious air quality problems. According to atmospheric scientists, record levels of ozone in the Dallas area earlier this month may be proof of a cyclical link between rising temperatures, smog and demand. June 16 marked the first time since 2012 that the Dallas area observed Code Purple ozone pollution, meaning that ozone levels exceeded measurements greater than .106 parts per million. The last time ozone levels were as high was in 2007. Ozone, an air pollutant and one of the main ingredients in smog, can make it more difficult for people to breathe. Smog, which increases in intensity as temperatures rise, can also trap heat, exacerbating its effects and making people more likely to ramp up their air conditioners. (O'Hanlon, 6/30)

Los Angeles Times: Anti-Asian Hate Crimes In California Jumped 107%
Anti-Asian hate crimes more than doubled in California in 2020, according to a report from the state attorney general, underscoring fears among Asian Americans about being targeted during the coronavirus pandemic. Overall, hate crimes reported to law enforcement rose 31% in the state last year, with attacks against Asians up by 107%, according to the report released Wednesday. Hate crimes against Black people, which constituted a majority of racially motivated attacks last year, increased by 88%. Anti-Latino crimes rose 38%. (Do, 6/30)

The Washington Post: AstraZeneca Vaccine Doses Produced In India Not Included In Europe’s Vaccine Passport Ahead Of Launch 
The European Union’s much anticipated coronavirus digital certificate, which is intended to facilitate unrestricted movement across the continent for vaccinated travelers, will begin Thursday amid widespread confusion about how the rollout will go. But many vaccinated would-be travelers — particularly those from poorer countries — do not meet the program’s criteria because they received AstraZeneca shots produced by India’s Serum Institute, which has not been approved by E.U. regulators. (Berger, 6/30)

Bloomberg: UK Covid Booster Vaccine Shots For Vulnerable Groups May Start From September
Vulnerable groups in the U.K. may be given Covid-19 booster vaccines starting from September to maintain their immunity during the winter and help ward off new variants. The country’s independent vaccination committee recommended that the government plan to offer boosters in a two-stage program alongside the annual flu vaccination drive. The rollout will depend on further data and the guidance could change, according to the Department of Health & Social Care. (Gemmell, 6/30)

CBS News: Nearly 2,000 COVID-19 Cases In Scotland Linked To People Who Gathered To Watch Soccer 
Nearly 2,000 people who live in Scotland tested positive for COVID-19 after gathering to watch football, or soccer, this month. Many of the cases are people who traveled outside of the country to watch games. (O'Kane, 6/30)

BBC News: Disabled People Forgotten During Covid, BBC Research Reveals
Thousands of deaf and disabled people across the UK have told the BBC of the devastating impact the pandemic has had on their lives. Most said their disability had worsened and more than 2,400 said routine, often vital, medical appointments had been cancelled. More than 3,300 people took part in the research carried out by the BBC. Disability charity Scope said the findings confirmed that disabled people's needs "had been forgotten". (Clegg, 6/29)

Also —

Modern Healthcare: ECRI Wins Contract To Evaluate Drugs In Europe
Eight European countries have come together to figure out if emerging pharmaceutical treatments are worth their cost, selecting not-for-profit ECRI to create a database of clinical evidence behind those drugs. Ultimately, ECRI's findings will help Ireland, Sweden, Norway, Denmark, Netherlands, Belgium, Portugal and Switzerland to decide what drugs should be covered and at what cost. (Gillespie, 6/30)

The New York Times: Pandemic Surges Again In Many Parts Of The World, Fueled By Variants
The nightmare is returning. In Indonesia, grave diggers are working into the night, as oxygen and vaccines are in short supply. In Europe, countries are slamming their doors shut once again, with quarantines and travel bans. In Bangladesh, urban garment workers fleeing an impending lockdown are almost assuredly seeding another coronavirus surge in their impoverished home villages. (Beech and Albeck-Ripka, 6/30)

Reuters: Mexico's COVID-19 Death Toll Could Be 60% Higher Than Official Count 
COVID-19-related deaths in Mexico likely exceed the confirmed toll by about 60%, Health Ministry data released on Wednesday showed. Authorities have said previously that fatalities likely far exceed the official count, and the latest figure is in line with data published in March. (6/30)

In global vaccine news —

The New York Times: Layers Of Red Tape Burden U.S. Vaccine Donations 
When a commercial plane carrying 2.5 million doses of Moderna’s coronavirus vaccine took off on Wednesday from Dallas for Islamabad, Pakistan, U.S. officials had just finished a dizzying bureaucratic back-and-forth to get them there. The United States had arranged a donation agreement with Moderna and Covax, the year-old vaccine-sharing initiative. Covax had previously worked out indemnity agreements with Moderna, which shield the company from liability for potential harm from the vaccine. U.S. Embassy officials in Islamabad had worked with regulators there to evaluate the Food and Drug Administration’s review of the vaccine. And Pakistani regulators had to pore over reams of materials on the vaccine lots and the factory where they were made before authorizing the shots for use. (Weiland, 7/1)

Bloomberg: Anti-Vaxxer Propaganda Spreads In Asia, Endangering Millions
Though Gerry Casida is on the priority list for a free Covid-19 vaccine in the Philippines because of his asthma, he’s isn’t planning to get the shot any time soon. A video he found on social media of a woman claiming vaccines are being used for genocide helps explain why. “I’ve read a lot of posts on Facebook about how many died in other countries because of vaccines, and how that’s being concealed,” said the construction worker, 43, from Manila. “My mom also consulted a folk healer, who said the vaccines could affect my heart.” (Calonzo and Wei Kevin Tan, 6/30)

CNBC: Australia's Mixed Messages On Covid Vaccines Sow Confusion
Australia’s vaccine rollout has been slow and chaotic, with government leaders and health advisors sending out mixed messages. The country’s top professional body for doctors says it’s recommending that people follow guidance from the Australian Technical Advisory Group on Immunisation, when deciding which Covid vaccine to take. ATAGI advises the health minister on vaccine issues in Australia. (Choudhury, 7/1)

The Washington Post: Putin Call-In Show: Russians Press The President On New Coronavirus Vaccine Rules
Russian President Vladimir Putin, facing a devastating coronavirus outbreak in the country coupled with widespread vaccine hesitancy, took to national television Wednesday to field concerns from citizens feeling pressured to get their shots. In an attempt to persuade them, he even revealed new details about his own secretive vaccination and spoke of how people from his "immediate inner circle" had been sick with the virus. (Khurshudyan, 6/30)

Reuters: India's Zydus Cadila Seeks Approval For Its 3-Dose COVID Vaccine 
Indian drugmaker Zydus Cadila said on Thursday it has applied for emergency use approval of its three-dose COVID-19 vaccine that showed efficacy of 66.6% in an interim study and could become the second home-grown shot if regulators consent. Although coronavirus infections have dropped from a devastating peak in April and May that strained healthcare facilities, experts have warned of a third wave, saying widespread vaccination is one of the best pandemic defences. (Mitra, 7/1)

In other global developments —

The New York Times: Why Can't U.S. Residents Travel To Canada?
Americans can now vacation in France, where the one-dose vaccination rate is 49 percent, according to the nonprofit Our World in Data; they can also go to Spain, where the rate is 51 percent, and Greece, 45 percent. But, with very limited exceptions, they still cannot travel to Canada, which, according to one source — the University of Oxford — is leading all countries globally in single-dose vaccination rates. In mid-June, to the frustration of many on both sides of the border, Canada announced it was extending restrictions on nonessential travel until at least July 21. The ban includes travel via land, air and sea. It will ease entry requirements for fully vaccinated Canadians, permanent residents and some eligible foreign nationals on July 5. (Glusac, 6/29)

Reuters: Japan PM Says No Spectators Possible As Samoa Withdraws Weightlifters 
Japan's prime minister said on Thursday it was possible the Olympics would be held without spectators as Samoa withdrew its weightlifting team from the Games, in the latest setback for Tokyo's fraught efforts to stage the world's biggest sporting event during a pandemic. Eleven Samoan athletes have qualified for the Games, but of them only three, its weightlifters, are based in Samoa and have been barred from attending the event set to start later this month, the Pacific island nation's Olympic committee president Patrick Fepuleai told Reuters. (Ranson and Barrett, 7/1)

CNN: Malaria Officially Eliminated In China, WHO Declares 
The World Health Organization declared China officially malaria-free on Wednesday -- making it the first country in the Western Pacific region to eliminate the life-threatening disease in more than 30 years. Malaria, a parasitic disease transmitted through the bite of a female mosquito, kills 400,000 people a year worldwide, the majority children younger than 5, according to WHO. There is no licensed malaria vaccine on the market -- though a number of vaccine candidates are under development, and one has shown unprecedented efficacy levels in trials this year. (Yeung, 7/1)

CIDRAP: Myocarditis Detailed In 30 Patients After MRNA COVID Vaccines
Two recent reports in JAMA Cardiology describe 30 patients with myocarditis, or inflamed heart muscles, less than a week after receiving either a Pfizer/BioNTech or Moderna mRNA COVID-19 vaccine. While these events may indicate a higher prevalence of myocarditis than expected, both reports note their rarity. (McLernon, 6/30)

CIDRAP: Study: Obese Men Not At Increased Risk For COVID-19 ICU Death
A new meta-analysis of 58 studies shows obese men are not at increased risk of death from COVID-19 when admitted to intensive care units (ICUs), but those with a history of smoking, diabetes, or kidney disease were at increased risk. The study, published yesterday in Anaesthesia, contradicts other published findings that have linked male sex and obesity to worse COVID-19 outcomes. (6/30)

CIDRAP: Analysis Of 10 Studies Shows Ivermectin Not Effective In Treating COVID-19
A new meta-analysis of 10 studies shows ivermectin (IVM), an anti-parasite drug, is not an effective treatment for COVID-19 and is not a viable treatment option for patients. The study was published yesterday in Clinical Infectious Diseases. The authors analyzed results from 10 randomized control trials (RCTs) that included 1,173 patients total, and looked for IVM's effect on all-cause mortality, length of hospital stay, adverse events, and viral clearance compared to standard of care. (6/29)

CIDRAP: Metabolic Activator Treatment Reduces COVID-19 Recovery Time
A combination of metabolic activators (CMAs) reduced COVID-19 recovery time in mild to moderate cases, according to phase 2/3 results published in Advanced Science yesterday. Both study phases involved randomized treatment and placebo groups in a 3:1 ratio, with the treatment group receiving a combination of nicotinamide riboside, L-serine, N-acetyl-L-cysteine, and L-carnitine tartrate, which are all involved with mitochondrial function. All participants were outpatients, receiving treatment or placebo daily for 14 days, starting on the day of diagnosis. (6/29)

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American Academy Of Pediatrics: Smoking Susceptibility And Tobacco Media Engagement Among Youth Never Smokers
Smoking susceptibility and exposure to tobacco industry–related marketing were predictive of cigarette smoking. Clinicians should consider screening adolescents for smoking susceptibility and tobacco-related media exposure. (Coreas et al, 6/1)

ScienceDaily: Drug Relieves Persistent Daydreaming, Fatigue, And Brain Sluggishness In Adults With ADHD
Tests of a drug known to stimulate brain activity have shown early success in reducing symptoms of sluggish cognitive tempo in 38 men and women with attention deficit hyperactivity disorder (ADHD.) (NYU Langone Health/NYU Grossman School of Medicine, 6/29)

ScienceDaily: How Environmental Factors Could Provide For A Young Brain 
A stimulating environment keeps the 'hippocampus' -- which is the brain's memory control center -- young, so to speak. Causes of this are molecular mechanisms that affect gene regulation. These current findings from studies in mice provide clues as to why an active, varied life can help preserve mental fitness in old age. (DZNE-German Center for Neurodegenerative Diseases, 6/29)

ScienceDaily: Running To Music Combats Mental Fatigue, Study Suggests
Listening to music while running might be the key to improving people's performance when they feel mentally fatigued a study suggests. The performance of runners who listened to a self-selected playlist after completing a demanding thinking task was at the same level as when they were not mentally fatigued, the research found. The study is the first to investigate the effect of listening to music playlists on endurance running capacity and performance when mentally fatigued. (University of Edinburgh, 6/22)

Scientific American: Mobile Clinics Can Help Reduce Health Inequity 
Grassroots organizers in Boston, primary care innovators in Chicago and even an academic medical center in Philadelphia responded to the COVID pandemic by bringing mobile vaccine clinics directly to the neighborhoods most impacted by the virus. As a result, 85 percent of those vaccinated by Philadelphia’s effort were Black, while 81 percent of those vaccinated by Boston’s effort identified as persons of color. COVID mobile vaccine clinics work. As the number of COVID cases falls in the United States, the frameworks used by mobile vaccine clinics should not be abandoned. Instead, these frameworks should be adopted and applied to health conditions that disproportionately impact communities of color. They provide health care delivery one path forward to achieving health equity. (David E. Velasquez, LaShyra "Lash" Nolen and Alister Martin, 6/30)

Kansas City Star: Defunding Planned Parenthood Won’t Make An Abortion Ban Work 
Those Missouri lawmakers are a bunch of drama kings, waiting until the last possible hours of the last possible day to renew approval of the completely routine tax on hospitals, ambulance runs and pharmacies that funds Medicaid in our state. Had they not done so, Missouri would have had to make up for the more than $4 billion in lost revenue with deep, across-the-board cuts in state spending. Health care for the poor, the disabled and the pregnant is such a trivial matter for some of the not-poor and not-pregnant guys who run our state that they can’t even work up the will to pretend to care. (Melinda Henneberger, 7/1)

Stat: Hospitals Need To Publicly Report Their Greenhouse Gas Emissions 
The health care industry focuses on healing. Yet its pursuit of that mission can cause harm. The harm caused by medical errors is well known. Largely unknown is the hidden harm caused by the industry’s greenhouse gas emissions. An estimated 10% of all U.S. greenhouse gas emissions come from the health care industry. Largely due to fine particulate matter (particles smaller than 2.5 microns, known as PM2.5), which result from burning fossil fuels, the industry’s carbon emissions account for approximately 100,000 US deaths annually and approximately three times that number worldwide. (David Introcaso and Walt Vernon, 6/29)

USA Today: Ageism, Age Discrimination Is Dangerous To Your Health
Older people are discriminated against when it comes to employment and health care. In addition to the obvious ill effects of that discrimination, ageism can also “negatively affect (our) health and well-being,” according to a 2020 study from the National Poll on Healthy Aging. The study describe “everyday ageism,” which is about our insidious exposure to ageist beliefs, assumptions and stereotypes. (Steven Petrow, 7/1)

Stat: A Sister On Watching The Mental Health Care System Fail Her Brother 
In this week’s episode of the “First Opinion Podcast,” Lizzy Feliciano talks about her brother, Louis, who died after years of suffering from depression, anxiety, and alcohol misuse. She struggled to help him find a program that could treat all of his issues holistically, not just one at a time. In a cruel twist of fate, just hours after moving into a facility with a program would treat his addiction and mental health issues — and do it at no cost — Louis Feliciano died of natural causes at age 51. (Patrick Skerrett, 6/30)

Bloomberg: Israel Reached Herd Immunity, But Delta Came Anyhow 
In his inaugural speech to the Israeli parliament, Prime Minister Naftali Bennett addressed an impressively detailed list of the challenges his ruling coalition faces. Only one issue went unmentioned: the fight against Covid 19. As far as the prime minister and the public were concerned, the pandemic was over, the virus vanquished by Israel’s world-leading vaccination campaign. That belief lasted a week. In mid-June, new and alarming cases of the virus began to sprout up. The Delta variant of the virus was responsible, experts said. It was being imported by Israelis returning from abroad. A large percentage of those infected were children. (Zev Chafets, 7/1)

NPR: I'm Vaccinated With Oxford-AstraZeneca But Europe Won't Let Me In 
I'm fully vaccinated. I want to travel to Europe. And fully vaccinated visitors are welcome. But I can't get in. That's because the vaccine I received is not on Europe's list of four approved vaccines: Pfizer, Moderna, Johnson & Johnson and Oxford-AstraZeneca, but only the version manufactured in the United Kingdom or Europe and known as Vaxzevria. The version that's much more widely used around the world, which is made by the Serum Institute of India and branded as Covishield, is not on the list of vaccines approved by the European Medicines Agency. And that's the vaccine I got — along with hundreds of millions of other people, mostly in lower- and middle-income countries. (Ifeanyi Nsofor, 6/30)

Chicago Tribune: Feels Like We’re There, But We’re Not. The Delta Variant Is In The Way
Chicago feels refreshingly alive again. Restaurants across the city — the ones that managed to stay open — bustle with diners. Wrigley Field and Guaranteed Rate Field are once more inviting full capacity. Beaches, the lakefront path, city parks — specked with Chicagoans. That sense of normalcy the city craved for over a year — Chicago can feel it. Time to pop the Champagne? Hold on. The delta variant is derailing party plans. (6/30)

Los Angeles Times: Mask Confusion: The CDC And L.A. County Offer Conflicting Guidance. Who's Right? 
Two weeks after the state lifted the mask mandate, Los Angeles County public health officials recommended that everyone put one back on when they enter movie theaters, grocery stores and other public places, even if they are fully vaccinated. Though COVID-19 cases in the county are still very low, they have been ticking upward exponentially in recent days, driven by the highly infectious Delta variant. But on Wednesday, the Centers for Disease Control and Prevention appeared to pour cold water on that guidance. In an interview on “Today,” Director Rochelle Walensky said that vaccinated people are safe from the Delta variant and confirmed that the CDC maintains its position that vaccinated people don’t need to wear masks indoors. (6/30)

USA Today: Why Getting A COVID-19 Vaccination Is A Patriotic Act
Throughout our history, Americans have put aside their partisan differences and stood together in times of crisis. It is time for us to stand together again. For the past 16 months, the American people have confronted an enemy unlike any in our lifetimes. The coronavirus pandemic has threatened Americans in every community around the country. It has disrupted our daily routines, ravaged our economy and taken far too many lives. Thanks to the scientists engaged in Operation Warp Speed and many others, lifesaving vaccines are widely available and the end of our struggle is, at last, coming into view. (Bill Foster and Mariannette Miller-Meeks, 7/1)

Stat: Something To Celebrate: Delivering Vaccines To Essential Workers 
Covid-19 vaccines are cause for celebration. Family members are reuniting, people are traveling and returning to restaurants. Yet many of the essential workers who have kept transportation running throughout the pandemic, who grow and cook food, and who fill the boxes that arrive on America’s doorsteps still have not been vaccinated. In mid-to-late May 2021, less than half of low-income workers living with children reported being vaccinated. Structural barriers are preventing vaccine access among workers. People facing food and housing insecurity are more likely to be unvaccinated but want a vaccine, as are people with children. It is not a matter of lack of individual responsibility for health among those who haven’t yet been vaccinated because they are providing food, housing, and care for themselves and their families. Policymakers can support essential workers by improving vaccine delivery. (Julia Raifman, Alexandra Skinner and David Michaels, 7/1)