AP: US Expands COVID Boosters To All Adults, Final Hurdle Ahead
U.S. regulators on Friday opened up COVID-19 booster shots to all adults, expanding the government’s campaign to shore up protection and get ahead of rising coronavirus cases that may worsen with the holidays. Pfizer and Moderna announced the Food and Drug Administration’s decision after at least 10 states already had started offering boosters to all adults. The latest action simplifies what until now has been a confusing list of who’s eligible by allowing anyone 18 or older to choose either company’s booster six months after their last dose — regardless of which vaccine they had first. (Neergaard and Perrone, 11/19)

Stat: FDA Expands Emergency Authorization For Covid Booster Shots To All Adults
The new policy still requires signoff from the Centers for Disease Control and Prevention to go into effect. The CDC’s vaccine advisory panel will meet Friday on the issue. But if the CDC agrees with the FDA, this will be in effect the completion of a Biden administration promise, announced in mid-August, to provide all American adults Covid booster doses this fall. “Authorizing the use of a single booster dose of either the Moderna or Pfizer-BioNTech Covid-19 vaccine for individuals 18 years of age and older helps to provide continued protection against Covid-19, including the serious consequences that can occur, such as hospitalization and death,” acting FDA Commissioner Janet Woodcock said in a statement announcing the agency’s ruling. (Branswell, 11/19)

The Washington Post: FDA Authorizes Pfizer-BioNTech, Moderna Boosters For All Adults 
The new federal approach, many experts note, essentially ratifies what has been occurring on the ground; most people who have sought the shots have gotten them simply by telling pharmacists they are eligible. Even so, only about 37 percent of fully vaccinated people over 65, and 17 percent of all adults have gotten boosters, according to the CDC. (McGinley, 11/19)

Reuters: Wait What? FDA Wants 55 Years To Process FOIA Request Over Vaccine Data
Freedom of Information Act requests are rarely speedy, but when a group of scientists asked the federal government to share the data it relied upon in licensing Pfizer’s COVID-19 vaccine, the response went beyond typical bureaucratic foot-dragging. As in 55 years beyond. That’s how long the Food & Drug Administration in court papers this week proposes it should be given to review and release the trove of vaccine-related documents responsive to the request. If a federal judge in Texas agrees, plaintiffs Public Health and Medical Professionals for Transparency can expect to see the full record in 2076. (Greene, 11/18)

In news on vaccines, and covid drug development —

The Wall Street Journal: Prospects Of Intellectual-Property Waiver On Covid-19 Vaccines Fade
An agreement to waive the intellectual-property rights underpinning Covid-19 vaccines—a prospect poor countries have hoped would ease supplies to the developing world—is becoming increasingly unlikely, say people familiar with the situation, with the U.S. not acting to bridge disagreements between developing world countries and those opposing such a measure. In May, the Biden administration said it would support temporarily suspending patents and other IP linked to the shots to allow developing countries to produce the Covid-19 vaccines created by big drug companies. (Steinhauser, Hinshaw and Hayashi, 11/18)

Stat: Proposal To Waive IP Rights For Covid Vaccines And Drugs Appears Unlikely
A controversial proposal for the World Trade Organization to temporarily waive intellectual property rights and provide greater access to Covid-19 medical products appears unlikely to pass, according to people tracking the latest round of meetings at the global agency. Despite a year-long debate, disagreement remains on the fundamental question of whether a waiver is appropriate and the most effective way to tackle inequitable distribution of Covid-19 vaccines and treatments, according to a trade official who is based in Geneva, Switzerland, where talks are being held. The WTO needs consensus from all of its 164 members for the proposal to be adopted. (Silverman, 11/18)

Reuters: CureVac To Begin Trials For Next-Generation COVID-19 Shots Within Months
German biotechnology company CureVac NV said on Thursday clinical trials for its second-generation COVID-19 vaccine are expected to start within the next few months. Earlier on Thursday, the company published data that showed its next-generation shot, CV2CoV, produced neutralizing antibodies in monkeys that were comparable to those produced by Pfizer Inc's (PFE.N) approved vaccine. The efficacy was also greater than the company's first-generation vaccine, it added. In October, CureVac gave up on its first-generation COVID-19 vaccine candidate, CVnCoV, to focus on collaborating with GSK (GSK.L) to develop improved mRNA vaccine technology. (11/18)

Reuters: AstraZeneca Says To Seek Commercial Price For Preventive Antibody Cocktail 
AstraZeneca (AZN.L) said its antibody cocktail against COVID-19 would - unlike its vaccine - be priced commercially as it negotiates supply contracts with governments around the globe. "We are looking at a commercial pricing strategy. That is part of our negotiations with governments," Iskra Reic, Astra's Executive Vice President for vaccines and immune therapies, said in a media call on Thursday. She added that the group's main objective was to make the shot affordable and broadly available. (11/18)

The Hill: Fauci Says All Adults Should 'Go Get Boosted'
President Biden's chief medical adviser Anthony Fauci on Thursday night urged those 18 and older to get a booster shot for added protection against COVID-19. Fauci said on MSNBC's "All in with Chris Hayes" that he has believed "for some time now" that boosters are effective and should be recommended for all adults in the U.S. who received their vaccine six months ago or longer. "If you're 18 or older, go get boosted," Fauci said. (Breslin, 11/18)

On being "fully" vaccinated —

Axios: America's Booster Fight: What Does It Mean To Be "Fully Vaccinated"? 
As health officials push COVID booster shots, a debate is quickly emerging around whether the definition of "fully vaccinated" should be changed to include an additional dose of the vaccine. Booster shots provide remarkably strong protection against coronavirus infections, at least for a period of time. But getting the majority of Americans to stick out their arm again would be extremely challenging. (Owens, 11/19)

The CT Mirror: Lamont Urges All Connecticut Adults To Get COVID Booster Shots
Amid rising COVID-19 infection rates in Connecticut and elsewhere in the northeast, Gov. Ned Lamont recommended Wednesday that adult residents not wait on federal guidance to get a vaccine booster shot. “If you’re over 18, go get yourself a booster shot right now if you haven’t had one already,” he said. “[If it’s been] six months since your last shot, get a booster shot. I think that’s the right thing to do. Other states around us are getting … a little more infected. We’re not an island. A booster shot will really protect you, your family, and our state.” (Carlesso, 11/17)

The Hill: Connecticut Governor Says Boosters Needed For People To Be Fully Vaccinated
“We’re 11 months into the vaccination program. In my view, if you were vaccinated more than six months ago, you’re not fully vaccinated,” Lamont said Wednesday while urging people to get vaccinated, NBC Connecticut reported. “If you were vaccinated more than six months ago, now is the time and go get that booster. I urge you to get it now,” he added. New Mexico Gov. Michelle Lujan Grisham (D) also said Wednesday that she believes full vaccination against the coronavirus now means that people have a booster shot. (Breslin, 11/18)

On booster news around the country —

The New York Times: Utah And Massachusetts Expand Access To Boosters For All Adults, Joining Several Other States
Utah and Massachusetts on Thursday joined a growing number of states in broadening access to coronavirus vaccine boosters for all adults, just as federal regulators consider granting requests for Pfizer-BioNTech and Moderna boosters to be authorized for all adults as early as this week, according to people familiar with the planning. The administration of Gov. Charlie Baker announced that all Massachusetts residents ages 18 and older could get a booster, if they met the federal timing rules: six months after receiving the second dose of the Pfizer or Moderna vaccines or two months past getting the single-dose Johnson & Johnson vaccine. (Levin, 11/18)

San Francisco Chronicle: Booster Shots: California’s MyTurn Site Just Expanded Eligibility
The California Department of Public Health updated its My Turn website on Thursday to open COVID-19 vaccine booster sign-ups to all people 18 and older. Those who want a shot can schedule an appointment or find a walk-in clinic on the website. Everyone 18 and up is eligible, as long as it has been at least six months since they got their Pfizer or Moderna second dose, or at least two months since they got a Johnson & Johnson shot. (Hwang, 11/18)

On the confusion around the drive for booster shots —

KHN: KHN’s ‘What The Health?’: Boosting Confusion
With covid caseloads rising across much of the country, several governors and mayors are unilaterally expanding access to booster shots, getting out ahead of federal health officials. Speaking of federal health officials, President Joe Biden has finally selected a nominee to head the Food and Drug Administration. If confirmed by the Senate, it would be Dr. Robert Califf’s second stint at the agency that oversees an estimated one fifth of all products sold in the United States. Califf previously served — for less than a year — under President Barack Obama. (11/18)

The New York Times: First Known Covid Case Was Vendor At Wuhan Market, Scientist Says
A scientist who has pored over public accounts of early Covid-19 cases in China reported on Thursday that an influential World Health Organization inquiry had most likely gotten the early chronology of the pandemic wrong. The new analysis suggests that the first known patient sickened with the coronavirus was a vendor in a large Wuhan animal market, not an accountant who lived many miles from it. The report, published on Thursday in the prestigious journal Science, will revive, though certainly not settle, the debate over whether the pandemic started with a spillover from wildlife sold at the market, a leak from a Wuhan virology lab or some other way. The search for the origins of the greatest public health catastrophe in a century has fueled geopolitical battles, with few new facts emerging in recent months to resolve the question. (Zimmer, Mueller and Buckley, 11/18)

The Wall Street Journal: New Reconstruction Points To Animal Origins For Covid-19
For his analysis, Dr. Worobey, said, “I just trawled through anything I could find,” including the World Health Organization-led team’s report, genomic data, local media reports, and announcements from Chinese officials that had been taken down but stored on an internet archive. He found that 10 of 19 early patients evaluated by doctors at hospitals in Wuhan worked at the Huanan market or had been there. A 41-year-old accountant believed to have become sick Dec. 8—making him officially the first known case—actually was ill from a dental problem then and developed Covid-19 symptoms on Dec. 16 instead, Dr. Worobey wrote. That would mean he could have caught the virus from someone in the broader community, since he didn’t visit the market, Dr. Worobey said. (McKay, 11/18)

The Washington Post: Leading Scientist Argues First Coronavirus Cases Point To Wuhan Market Origin
Worobey has been open to the theory of a lab leak. He was one of the 18 scientists who wrote a much-publicized letter to Science in May calling for an investigation of all possible sources of the virus, including a laboratory accident. But he now contends that the geographic pattern of early cases strongly supports the hypothesis that the virus came from an infected animal at the Huanan Seafood Market — an argument that will probably revive the broader debate about the virus’s origins.(Achenbach, 11/18)

CBS News: U.S. Scientist Says He's Found The Real COVID Patient Zero, And "Strong Evidence" Pandemic Started At Animal Market
One criticism of the market theory was that because health authorities raised the alert about cases of a suspicious disease linked to the market as early as December 30, 2019, that would have introduced a bias that led to the identification of more cases there than elsewhere, since attention had already been drawn to it. To counter that argument, Worobey analyzed cases reported by two hospitals before the alert was raised. Those cases were also largely linked to the market, and those which were not were nevertheless geographically concentrated around it. (11/19)

CBS News: Upper Midwest Faces Spike In COVID-19 Infections: "It's Unprecedented"
The nation is currently facing an alarming COVID-19 spike, with average daily cases jumping 35% in recent weeks, according to the CDC. The upper Midwest has seen the largest surge in infections, with one doctor calling the situation "unprecedented." "I have never seen so many people on a ventilator at one time," said Dr. Joshua Huelster, a critical care physician at Abbott Northwestern Hospital in Minneapolis. (Collin, 11/18)

Fox 9: 'It Was Really Scary:' Minnesota Hospitals Struggle With COVID Surge
Minnesota hospitals are caring for 40 percent more COVID-19 patients since the start of November as the state became the country's worst COVID-19 hotspot this week. The surge is straining hospital capacity, overwhelming staff, and affecting patient care, health care professions and Minnesota's top public health officials said. (Keith, 11/18)

St. Louis Post-Dispatch: Missouri Reports Thousands Of Previously Unreleased COVID-19 Deaths, Infections 
On Thursday, the Missouri Department of Health and Senior Services once again reconfigured the state’s COVID-19 data dashboard, adding thousands of previously unreported deaths and infections. Some date back to the spring of 2020, and many are instances of illness or death now attributed to COVID-19 but that weren’t publicly tallied by the state at the time. (Merrilees, 11/18)

ABC News: New Mexico Facing 'Serious Problems' Amid Latest COVID-19 Surge, Health Officials Warn
COVID-19 cases in New Mexico are "trending in a worrisome direction," health officials said this week, as they called on residents to get vaccinated amid the surge. New Mexico reported 1,530 new cases and 539 hospitalizations Wednesday, rivaling numbers last seen in December and January, during the state's last COVID-19 wave. (Deliso, 11/18)

Dallas Morning News: Dallas And Tarrant Counties Surpass Combined 10,000 COVID-19 Deaths
Dallas and Tarrant counties crossed the grim threshold of a combined 10,000 COVID-19 fatalities on Thursday, some 600 days after each county recorded its first death from the virus, according to health data. Dallas County announced 18 deaths Thursday, raising its toll to 5,158, while Tarrant County reported 14 for a total of 4,855. (Williams, 11/18)

But the situation improves slightly in Alaska —

AP: Alaska Health Officials Say Virus Case Numbers Trending Down
State health officials expressed cautious optimism Thursday about lower COVID-19 case numbers in Alaska following an extended surge in cases that strained hospital capacity. Numbers recently have been trending downward after hitting a bit of a plateau, said Dr. Anne Zink, the state’s chief medical officer. “Hoping to continue to see a downward trend,” she told reporters. “This pandemic continues to have all sorts of twists and turns, and just because it turns downward doesn’t mean it’s going to continue downward or stay there. It takes active work from Alaskans getting vaccinated, distancing, masking.” (11/19)

And one woman woke after weeks in a covid-related coma —

CNN: Woman With Covid-19 Wakes Up After Weeks On Ventilator On Day Family Planned To Take Her Off Life Support 
Bettina Lerman was on a ventilator for weeks after getting Covid-19 and hadn't responded to doctors' efforts to wake her from a coma when her family made the difficult decision to take her off of life support. They made funeral arrangements and picked out her casket and headstone as they prepared to say goodbye, her son Andrew Lerman told CNN. On the day they planned to remove her from life support, Lerman said, he got a call from one of her doctors at Maine Medical Center in Portland. "He's like, 'Well, I need you to come here right away.' I was like, 'OK, what's wrong?'" Lerman said. "He goes, 'Well, there's nothing wrong. Your mother woke up.'" (Williams, 11/18)

Modern Healthcare: 70% Of Hospital Workers Vaccinated, New CDC Data Show
Seven out of 10 U.S. hospital workers were vaccinated against COVID-19 as of Sept. 15, according to a Centers for Disease Control and Prevention study issued Wednesday. Staff working in children's hospitals, in metropolitan counties and in counties with higher vaccination rates were more likely to be vaccinated than their peers, agency officials wrote in an article published in the American Journal of Infection Control. (Gillespie, 11/18)

CIDRAP: CDC Survey Shows COVID-19 Vaccine Uptake Stalled At 70% In HCWs
The US Centers for Disease Control and Prevention (CDC) published a new comprehensive survey of vaccine uptake in healthcare workers (HCWs), showing that after initial enthusiasm, vaccine uptake stalled at 70% by Sep 15, 2021. Results of the survey are published in the American Journal of Infection Control. The study was based on data collected by the Department of Health and Human Services Unified Hospital Data Surveillance System on COVID-19 vaccination coverage among hospital-based healthcare personnel between Jan 20 and Sep 15. (11/18)

The Washington Post: Health Groups Urge Businesses To Voluntarily Adopt Biden’s Vaccine Rule
The American Medical Association and more than 60 other health care associations on Thursday called on employers to voluntarily implement President Biden’s contested vaccine-or-testing mandate, saying businesses had no time to waste ahead of the busy holiday season. “We — physicians, nurses and advanced practice clinicians, health experts, and health care professional societies — fully support the requirement that workers at companies with over 100 workers be vaccinated or tested,” the organizations wrote in a joint statement. “From the first day of this pandemic, businesses have wanted to vanquish this virus. Now is their chance to step up and show they are serious.” (Diamond, 11/18)

Other developments on mandates —

The New York Times: The U.S. Army Secretary To National Guard Members Who Resist The Vaccines: Prepare For Discipline
The secretary of the Army has issued a memo warning the hundreds of thousands of soldiers in its National Guard that if they decline to get vaccinated against the coronavirus, they may not be renewed in the guard. “I have determined that all soldiers who refuse the mandatory vaccination order will be flagged,” wrote Christine E. Wormuth, the secretary, in a memo this week, which would prevent them from promotions, awards, bonuses and the like. If troops persist in declining, they will not be permitted “continued service” unless granted an approved exemption from the vaccine, she wrote. (Steinhauer, 11/18)

WUSF Public Media: Special Session Ends With Legislators Approving A Plan To Block Vaccine Mandates 
Rebuking the Biden administration, Florida’s Republican-controlled Legislature on Wednesday passed a measure that seeks to prevent workers from being required to get vaccinated against COVID-19. The votes by the House and Senate came on the third day of a special legislative session called by Gov. Ron DeSantis, who has sparred for months with the White House about COVID-19 policies. But the outcome of the votes was never in doubt — Republican leaders agreed on the bill (HB 1B) before the session started and walled it off from any changes. (Saunders and Urban, 11/18)

AP: Nevada Student Suing Over University Vaccination Mandates
A 19-year-old student who says he is immune from COVID-19 because he already had it is suing the University of Nevada, Reno, the governor and others over the state’s requirement that everyone, with few exceptions, show proof of vaccination in order to register for classes in the upcoming spring semester. Jonah Gold claims there is no solid evidence that people who recover from COVID-19 ever lose their immunity. His lawsuit says any benefit of vaccination is outweighed by the threat of harmful side effects and that “COVID-19 vaccination mandates are an unconstitutional intrusion on normal immunity and bodily integrity.” (Sonner, 11/19)

AP: City Of Phoenix Employees Must Be Fully Vaccinated By Jan.18
All city of Phoenix employees will be required to be fully vaccinated against COVID-19 by Jan. 18 under the federal mandate, according to an email sent to city workers Thursday. The email also said employees not in compliance with the vaccine requirement by the deadline will be subject to discipline up to and including being fired. City officials said religious or medical accommodations will be available for those wishing to opt-out of the policy, but won’t be guaranteed. (11/19)

Crain's Detroit Business: COVID-19 Mandates, Reimbursement Woes Challenge Michigan's Rural Hospitals
Wave after wave of ill patients are landing at the emergency room of Memorial Healthcare in Owosso. The century-old critical-care community hospital 25 miles due west of Flint treated 92 inpatients on Nov. 15, nearly a third of which were COVID-19 positive. The hospital and its 1,500 employees are equipped to handle 85 inpatients — but operating above that threshold is standard now. (Walsh, 11/18)

On the hidden costs of vaccine mandates —

KHN: Vaccine-Or-Test Requirements Increase Work And Costs For Governments
Amanda Kostroski, a 911 dispatcher in Madison, Wisconsin, leaves her busy job once a week to go to a county health clinic to be tested for covid-19. She’s been making the 15-minute drive from work since late September, when Dane County mandated all employees get vaccinated or tested weekly. The testing is free, and she is typically back to work within an hour. Kostroski is among 10% of county employees who are unvaccinated and get weekly tests. She chose not to get immunized because she thinks the vaccines are too new and she fears side effects. (Michelle Gomez and Galewitz, 11/19)

The Washington Post: House Passes Roughly $2 Trillion Spending Package To Expand Social Benefits And Fight Climate Change
More than a year after President Biden clinched the White House on a pledge to “build back better,” House Democrats delivered on that promise, voting to approve more than $2 trillion in spending initiatives that would overhaul federal health care, education, climate, immigration and tax laws. The measure adopted Friday amounts to a dramatic re-envisioning of the role of government in Americans’ daily lives. It sets aside in some cases historic sums to aid workers, families and businesses, seeking to rewire the very fabric of an economy still recovering from the financial devastation wrought by the coronavirus pandemic. (Romm, 11/19)

AP: Dems' Sweeping Social, Climate Bill Passes Divided House
The House approved the legislation by a near party-line 220-213 vote, sending the measure to a Senate where cost-cutting demands by moderate Sen. Joe Manchin, D-W.Va., and that chamber’s strict rules seem certain to force significant changes. That will prompt fresh disputes between party centrists and progressives that will likely take weeks to resolve. Even so, House passage marked a watershed for a measure remarkable for the breadth and depth of the changes it would make in federal policies. Wrapped into one bill are far-reaching changes in taxation, health care, energy, climate change, family services, education and housing. That shows the Democrats’ desire to achieve their goals while controlling the White House and Congress, a dominance that could end after next year’s midterm elections. (Fram, 11/19)

Politico: 'Whole Different Ballgame': Dems Vow They've Learned Obamacare Lessons In Messaging $1.7T Megabill
A huge boost to the nation’s safety net. A looming midterm with the majority on the brink. A flood of GOP attack ads. That’s where House Democrats hope the similarities end between now and 2010. As they take their first pass at President Joe Biden’s $1.7 trillion social spending bill, House Democrats are gambling that its medley of popular family, health care and climate proposals can steer them toward a radically different political fate than eleven years ago -- when a historic electoral wipeout followed the passage of their signature health care overhaul. (Ferris and Caygle, 11/19)

The New York Times: Kevin McCarthy Speaks For More Than Eight Hours To Delay A House Vote
House Minority Leader Kevin McCarthy of California early Friday concluded a marathon speech in opposition to the Democrats’ social policy bill, after talking for eight hours and 32 minutes, surpassing the length of one by Representative Nancy Pelosi in 2018 that held the record for the longest continuous House speech in modern history. (Gross, 11/19)

Roll Call: House, Senate Will Go To Conference On R&D Proposals
House and Senate negotiators will soon go to conference in an effort to send bipartisan legislation aimed at advancing U.S. competitiveness in science and technology to President Joe Biden’s desk, Democratic leaders announced late Wednesday. But it’s unclear exactly which pieces of legislation each body will bring to the conference. (DeChiaro, 11/18)

Houston Chronicle: Biden’s $1.75T Spending Bill Includes Health Coverage For Over 750,000 Texans
Hundreds of thousands of low-income Texans could gain access to health coverage under President Joe Biden’s $1.75 trillion social policy and climate change bill, with the U.S. House preparing to vote on the measure late Thursday. The package includes a provision that would be a temporary workaround to Medicaid expansion in Texas and 11 other states where Republican leaders have refused to fully expand safety net health care coverage under the Affordable Care Act. (Blackman and Scherer, 11/18)

From the states —

The Washington Post: Democratic Divide Puts Congressional Action On Marijuana In Doubt
A split on Capitol Hill over marijuana policy has lawmakers confronting the possibility that they could again fail to pass any meaningful changes to the federal prohibition of cannabis this Congress, even as polls show vast majorities of Americans support at least partial legalization of the drug. The clash, on one level, follows familiar contours for Washington policymaking: A narrower measure with significant bipartisan support — one that would make it easier for banks to do business with legitimate cannabis firms in states where marijuana is legal — is in limbo while a smaller group of lawmakers pushes for a much broader bill. (DeBonis, 11/18)

Bloomberg Law: Hospitals, Foreign Health-Care Workers Press Congress For Action
The Covid-19 pandemic has fueled unprecedented demand for skilled health-care professionals—and the demand will only continue after the U.S. emerges from the pandemic. Without training thousands of new American-born doctors and nurses, the clearest way to fill gaps in the health-care workforce is hiring talent from abroad, experts say. Hospital groups have lobbied Congress for the past 18 months to address a shortage of nurses and physicians by offering green cards to tens of thousands of foreign health-care workers, among a number of proposed legislative options. (Kreighbaum, 11/19)

Stat: A Win For Black Maternal Health Advocates, With Passage Of VA Program
Congress’ action this week is a victory for Black maternal health advocates like Charles Johnson, who’s been pushing for more support for Black mothers after his wife died from childbirth complications. Proponents of addressing America’s Black maternal mortality crisis scored a win this week as Congress overwhelmingly passed legislation to set up a $15 million maternal care program within the Department of Veterans Affairs. It is the first bill in the Black Maternal Health Momnibus to make it through Congress and now awaits President Biden’s signature. (St. Fleur, 11/18)

In congressional election news —

Politico: Pennsylvania Republicans Baffled By Celebrity Doctor’s Senate Bid 
Yes, Dr. Oz is serious about running for the Senate. The famous TV physician’s prospective campaign for an open Senate seat in Pennsylvania remains a hush-hush affair — no one so far has admitted to working on it and the consultants thought to be involved are remaining tight-lipped. But Mehmet Oz is searching for a scheduler and policy director, according to a person contacted about the jobs. He has also recently looked for a home in the Philadelphia suburbs, another source said. (Otterbein and Allison, 11/19)

The Hill: Biden Administration Reverses Trump-Era Waivers Of Nondiscrimination Protections
The Biden administration is reversing Trump-era rules that allowed federally-funded child welfare agencies to bypass non-discrimination rules if they conflicted with providers' religious beliefs. The Department of Health and Human Services (HHS) on Thursday said it was rescinding waivers granted to three states that allowed faith-based foster care groups that contracted with state agencies to turn away same-sex and non-Christian couples while still receiving federal money. (Weixel, 11/18)

Modern Healthcare: How FDA's New Head Could Shape Agency Policy
Dr. Robert Califf was nominated by President Joe Biden last week to lead the Food and Drug Administration. If confirmed, Califf will lead an agency still fighting against the COVID-19 pandemic while working to innovate. Califf previously served as FDA commissioner for nearly a year at the end of the Obama administration. He knows how the agency works and can hit the ground running, stakeholders say. Califf's leadership style revolves around setting key priorities and following through on them, according to Howard Sklamberg, a partner at Arnold & Porter who worked as a deputy commissioner at the FDA during Califf's first tenure. (Goldman, 11/18)

Stat: Former DARPA Director Warns That ARPA-H Should Stand Alone
The former director of DARPA, the Pentagon’s high-stakes research arm, says that for an equivalent health care agency to succeed, it should be fully separated from the National Institutes of Health. Arati Prabhakar, who led DARPA from 2012 to 2017, also warned that the Biden administration should think bigger. Instead of focusing only on new medicines and vaccines, she said, ARPA-H should consider the root causes of poor U.S. health outcomes, ranging from obesity to the overdose crisis. (Facher, 11/18)

AP: Biden Administration Acts To Restore Clean-Water Safeguards
The Biden administration took action Thursday to restore federal protections for hundreds of thousands of small streams, wetlands and other waterways, undoing a Trump-era rule that was considered one of that administration’s hallmark environmental rollbacks. At issue is a regulation sometimes referred to as “waters of the United States,” or WOTUS, that defines the types of waterways qualifying for federal protection under the Clean Water Act. The regulation has long been a point of contention among environmental groups, farmers, homebuilders, lawmakers and the courts. (Naishadham and Daly, 11/19)

CNN: Biden's First Annual Physical As President To Be At Walter Reed Friday
President Joe Biden is set to undergo his routine annual physical Friday at Walter Reed Medical Center -- his first physical in office as the oldest first-term president in US history. ... The last extensive update on Biden's medical state came in December 2019, when the doctor he eventually recruited to serve as White House physician described him as "a healthy, vigorous, 77-year-old male, who is fit to successfully execute the duties of the Presidency." (Collins, Stracqualursi and Klein, 11/19)

The Hill: Hospital Strain Linked To Thousands Of Excess Deaths Two Weeks Later: Research
A new analysis estimates that hospital strain during the pandemic is linked to thousands of ensuing excess deaths, signaling the significance of ensuring hospitals do not reach full capacity amid COVID-19 surges. The research published by the Centers for Disease Control and Prevention (CDC) on Thursday predicted that when the nationwide intensive care unit (ICU) capacity hits 75 percent capacity, an additional 12,000 excess deaths could be expected within the next two weeks. When hospitals surpass 100 percent ICU bed capacity, the study suggests 80,000 excess deaths would be expected two weeks later. (Coleman, 11/18) 

Gizmodo: Over A Million Americans May Have Permanently Lost Their Sense Of Smell To Covid-19
This new study, published Thursday in JAMA Otolaryngology – Head & Neck Surgery, seems to be one of the first to try gauging the toll of chronic covid-related anosmia in the U.S. The authors were compelled to study the issue after seeing many of these patients in their clinics. “In the last couple of months, my colleagues and I noted a dramatic increase in the number of patients seeking medical attention for olfactory dysfunction.” study author Jay Piccirillo, a otolaryngologist at Washington University in St. Louis and an editor at JAMA Otolaryngology, told Gizmodo in an email. (Cara, 11/18)

On antibiotics —

Stat: Analysis: Pharma Is Failing Make New Antibiotics Available In Poor Countries
Although the pharmaceutical industry is making modest progress in countering resistance to superbugs, drug companies are not doing enough to ensure greater access to lifesaving antibiotics in low and middle-income countries, a new analysis finds. Just one-third of 166 treatments assessed have any kind of access strategy in place, such as price adjustments to make antibiotics more affordable or licensing agreements to boost supplies for these countries, according to the report by the Access to Medicines Foundation, an independent, not-for-profit research organization that evaluates drug makers on how they ensure access to medicines. (Silverman, 11/18)

CIDRAP: Report Highlights Lack Of Access To Antibiotics In Poor Countries
A new analysis of how the major players in the antibiotic market are responding to the antimicrobial resistance (AMR) threat suggests that interest in antibiotic research and development is growing and that companies are making greater efforts to curb the environmental impact of antibiotic manufacturing. But efforts to make antibiotics more accessible to people in the countries where they are desperately needed are lagging. (Dall, 11/18)

Also —

Stat: ‘Growing A Chair Is Easy’ And Other Wisdom From George Church 
George Church, the larger-than-life Harvard biologist who pioneered both DNA sequencing and gene editing, is known for making bold bets. He’s founded more than three dozen companies, including ones promising to curb climate change with cold-tolerant elephants, end inherited disease with a dating app, and keep your DNA out of the hands of hackers through, what else, the blockchain. What’s behind his audacity? An “open mind,” Church said in a conversation with STAT senior medical writer Matthew Herper during the 2021 STAT Summit. “One of the reasons people misestimate is because of exponentials.” (Molteni, 11/18)

Bloomberg: J&J Split: What The New Drug Company Will Focus On After Breakup
Johnson & Johnson will focus on developing drugs for conditions such as lung cancer and eye disease as it prepares to make its pharmaceutical and medical-devices business an independent entity. The 135-year-old health giant faces its greatest-ever overhaul as it readies for a spin-out of its consumer unit, following a path trod by rivals such as GlaxoSmithKline Plc and Pfizer Inc. In her first-ever interview, Jennifer Taubert, J&J’s executive vice president and worldwide chairman of pharmaceuticals, told Bloomberg News that the company will invest in new areas of interest. (Griffin, 11/18)

Reuters: J&J Sees Potential For 14 New Multibillion-Dollar Drugs By 2025
Johnson & Johnson (JNJ.N) expects to file for approval of 14 new drugs by 2025, and has projected average peak sales of $4 billion a year for each, a top J&J scientist said ahead of a strategy review of the company's pharmaceuticals unit on Thursday. Among the top pipeline assets, Mathai Mammen, global head of research for J&J's Janssen pharmaceutical division, pointed to a drug combination for non-small cell lung cancer, an anticoagulant it is developing with partner Bristol Myers Squibb (BMY.N) and a vaccine for respiratory syncytial virus (RSV). (Erman and Steenhuysen, 11/18)

In news on CVS, Lasik, Biogen, Northwestern Medicine and Mass General Brigham —

Modern Healthcare: CVS To Close 900 Stores In Big Retail Strategy Shift
Big changes are coming for CVS Health, the company announced Thursday. Over the next three years, CVS Health plans to shutter 900 pharmacies and intensify its efforts to reconceive its retail locations as sites for more comprehensive healthcare services. The company, which also operates Aetna health insurance and CVS Caremark pharmacy benefit management subsidiaries, announced a related senior executive leadership shakeup. (Devereaux, 11/18)

The Wall Street Journal: Dominant Eye Surgery Chain LasikPlus Put Profits Over Patient Care, Some Doctors Say
Since the laser surgery that can fix nearsightedness was approved in the 1990s, one firm, called LasikPlus, has grown into the U.S. industry’s dominant force by using low prices as a draw and vacuuming up rival players. Along with its growth, LasikPlus has accumulated critics, including some of its own doctors, current and former, who alleged in lawsuits and interviews that they were pressured by corporate management to follow practices that they felt put the company’s profits over patient care. Some said they were expected to perform so many procedures each day they worried they couldn’t keep up. “It felt like we were in a war zone all the time,” said Therese Alban, who quit LasikPlus two years ago after 15 years there, part of an exodus of about 20% of the chain’s then 40 or so doctors to a rival firm or private practice. (Maremont, 11/18)

Bloomberg: Insurers Balk at Paying for Biogen’s $56,000-a-Year Alzheimer’s Treatment
U.S. health insurers say they want more proof before paying for Biogen Inc.’s Aduhelm, stalling sales of the costly new Alzheimer’s therapy that the company hailed as a breakthrough for patients. None of the 25 large insurers that responded to a Bloomberg News survey judged the $56,000-a-year drug “medically necessary,” a term used to describe treatments that are needed for specific ailments and meet medical standards. Most have deemed Aduhelm experimental, while some say they’re still evaluating it. (Tozzi, LaVito and Dave, 11/18)

Crain's Chicago Business: Northwestern Medicine Launches Lung Treatment Center
Northwestern Medicine has launched the Canning Thoracic Institute with a $20 million donation from Madison Dearborn Partners founder John Canning and his wife Rita to meet the growing demand for lung transplants and lung treatments due to COVID-19 and lung cancer, the health system said today. Since July 2020, Northwestern Medicine surgeons have performed more than 30 double-lung transplants on COVID patients, the most of any health system in the world, Northwestern said in a statement. And with more than 47 million Americans having already contracted COVID, demand for inpatient and outpatient pulmonary care is expected to grow, the statement said. In addition, nearly a million people in the Chicago area, or about 10% of the population, suffer from some sort of chronic lung disease, the statement said. (Asplund, 11/18)

Chicago Tribune: With COVID-19 Continuing To Damage Patients’ Lungs, Northwestern Announces New Institute Focused On Lung Care, Thanks To $20 Million Donation 
With COVID-19 continuing to wreak havoc on the lungs of its victims, Northwestern Medicine is doubling down on its efforts to be a national leader in lung care with the launch of an institute dedicated to the field. Northwestern announced the opening of its Canning Thoracic Institute on Thursday — named for John and Rita Canning, who donated $20 million to get the institute off the ground. John Canning is the chairman and founder of private equity firm Madison Dearborn Partners. (Schencker, 11/18)

The Boston Globe: Healey Concerned Mass General Brigham’s Expansion Would Bring Higher Health Care Costs
Attorney General Maura Healey is warning that Mass General Brigham’s proposal to build three new surgery centers is likely to increase health care costs across Massachusetts, turning up the pressure on the state’s largest health care provider as it pursues a long-planned and significant expansion. Healey, after reviewing documents from MGB, released a report Wednesday that said the project would have broad implications for the health care market. It would allow Mass General Brigham to draw new patients not just to its outpatient clinics, but to its hospitals as well, through referrals from doctors. (Dayal McCluskey, 11/18)

In other industry news —

Stat: Biotech Companies Scramble To Find Scientists To Manage Troves Of Data
Nikhil Munshi’s lab at the Dana-Farber Cancer Institute has accumulated an overwhelming amount of data — over a thousand terabytes of intel on healthy cells and cancer cells that could help researchers unlock new secrets about health and disease — what he called the “unbelievable complexity of how cells remain normal and become abnormal.” “It’s very, very exciting. We can do things we could not do literally two years ago or five years ago. A petabyte of data sounds like a Star Trek number, but a lot of people have [more],” Munshi, an oncology researcher, said. There’s just one problem: “There’s so much demand for informatics, the supply is not there yet. There really is a shortage of good bioinformaticians.” (Chen, 11/19)

Stat: Gilead Licenses Cancer Drugs From Arcus, A Bet On Its Cancer Business
Gilead Sciences said Thursday that it has exercised an option to license four cancer drugs from Arcus Biosciences, including an immunotherapy that works against a closely followed anti-cancer target called TIGIT. In exchange for licensing rights to the four cancer drugs, Gilead is paying Arcus $725 million. The two companies will co-develop the drugs, share costs, and if approved, split profits in the U.S., the companies said. For Gilead, the Arcus deal represents another potentially lucrative but risky effort to grow its cancer business, which has struggled to gain traction apart from its bespoke CAR-T therapies. (Feuerstein, 11/18)

Stat: GSK's Walmsley Predicts A ‘Landmark’ 2022 For The Company
Next year will be a “landmark” one for GlaxoSmithKline, according to CEO Emma Walmsley — though many of the biggest changes she forecasted may not become evident until next year. On next year’s agenda: fresh data from clinical trials of a vaccine for respiratory syncytial virus, a very common childhood illness; a Food and Drug Administration decision for daprodustat, GSK’s experimental treatment for a type of anemia; and the de-merger of GSK’s consumer business from its pharmaceutical arm — twenty-one years after the massive merger that created GlaxoSmithKline in the first place. (Sheridan, 11/18)

Boston Globe: Generate Biomedicines Raises $370m To Use Machine Learning In Research
Cambridge biotech Generate Biomedicines said Thursday it has raised $370 million in venture capital from investors keen on its plan to use machine learning in drug discovery, money that will enable the startup to expand its workforce more than sixfold. Generate, which was founded in 2018 by venture capital firm Flagship Pioneering, has about 80 employees at 26 Landsdowne St. and expects to hire some 420 more in the next two years, according to top executives. The company plans to move soon to two new buildings, totaling 140,000 square feet, in Andover and Somerville. (Saltzman, 11/18)

Stat: By Selling Bonds Tied To Drug Access And Climate Goals, Teva Takes Pharma In A New Direction 
In a first-of-its-kind move by a drug maker, Teva Pharmaceuticals (TEVA) recently sold $5 billion in bonds that are tied directly to its progress in achieving goals linked to climate change and making medicines accessible in certain low and middle-income countries. The goal is to increase the cumulative number of marketing applications submitted to regulators in low and middle-income countries — as well as the volume of donated medicines — by 150% by 2025, compared with the previous five-year period. The treatments must be considered essential medicines by the World Health Organization and would be used for diabetes and heart disease, among other ailments. (Silverman, 11/18)

The Hill: New Suicide Prevention Hotline To Include Texting Option
The Federal Communications Commission (FCC) voted to include a texting option for a new suicide hotline, 988, set to go live next summer. Advocates have pushed for a more accessible version of the existing 1-800-273-8255, and now providers will be required to support messaging to the number beginning July 16, ABC News reported. Currently, the three-digit number is set up only to support calls. “The bottom line is that it shouldn't matter if you make a voice call or send a text message because we should connect people in crisis to the resources they need no matter how they communicate," FCC Chairwoman Jessica Rosenworcel said during an open meeting, per CNN. (Barnes, 11/18)

Bloomberg: Americans Can Soon Text 988 To Reach National Suicide Prevention Lifeline
Americans will be able to text 988 to access the National Suicide Prevention Lifeline, a move seeking to broaden support for at-risk communities, such as youth and people with disabilities. The Federal Communications Commission approved the move Thursday, the agency said in a statement. In 2020, almost 46,000 people in the U.S. died by suicide, provisional data from the Centers for Disease Control and Prevention show, as the pandemic weighed on mental health. (Sirtori-Cortina, 11/18)

CIDRAP: Amid COVID, A 35% Surge In Calls To Mental Health Helplines
An analysis of 8 million mental health helpline calls from 19 countries early in the pandemic reveals a 35% jump in calls related to fear and loneliness rather than to problems with relationships, finances, domestic violence, and suicidal thoughts that dominated before COVID-19 emerged. The study, published yesterday in Nature, suggests that concerns related directly to the pandemic replaced, rather than aggravated, common underlying anxieties, the researchers said. The study team, led by researchers from the University of Lausanne in Switzerland, said they used helpline call data because they provide a real-time picture of the state of public mental health, unaffected by the design and framing of a study. (VanBeusekom, 11/18)

WUSF Public Media: The Pandemic Strained Mental Health For Black Americans. It’s Also Amplifying Calls For Change 
Vickye, 52, has Lupus, so like many people at risk for severe COVID-19, the St. Petersburg resident spent most of last year at home. She avoided getting sick, but quarantining took a toll in ways she said she couldn’t have imagined. "You were trapped with yourself, you couldn't go anywhere, so you had to face yourself and face your demons and whoever you were trapped with their demons too," she said. Vickye was trapped with an abusive wife, which is why we're not using her last name. Verbal assaults turned physical, until this past February, when Vickye said her now ex-wife shot her six times for threatening to leave. (Colombini, 11/18)

Axios: Fear And Loneliness Caused Surge Of Early Pandemic Calls For Help 
Fear and loneliness replaced relationship and livelihood concerns during the pandemic, a team of scientists said after looking at millions of helpline calls in multiple countries before and after the COVID-19 pandemic started. Doctors and policymakers are trying to assess the impact of quarantines, school closures and other public health measures on our emotional and mental well-being. Using helpline data could become an important assessment tool, the researchers said. (O'Reilly, 11/18)

NPR: Americans Can Wait Many Weeks to See a Therapist. California Law Aims to Fix That.
When Greta Christina fell into a deep depression five years ago, she called up her therapist in San Francisco — someone she'd had a great connection with when she needed therapy in the past. And she was delighted to find out that he was now "in network" with her insurance company, meaning she wouldn't have to pay out of pocket anymore to see him. But her excitement was short-lived. Over time, Christina's appointments with the therapist went from every two weeks, to every four weeks, to every five or six. (11/18)

On suicides on campus —

KHN: What Happens After A Campus Suicide Is A Form Of Prevention, Too
Ethan Phillips was 13 years old when he first heard the term “suicide contagion.” It’s the scientific concept that after one person dies by suicide, others in the community may be at higher risk. Phillips learned the phrase growing up in Fairfax County, Virginia, where more than a dozen teens and preteens died by suicide while he was in middle school. It came up again when a high school classmate killed himself. By the time Phillips entered college at the University of North Carolina-Chapel Hill in 2019, he’d developed “an unfortunate level of experience” in dealing with the topic, he said. (Pattani, 11/19)

Axios: Most States Ranked Poorly In Quality Of Care For People Of Color, Report Says 
Black Americans in almost every state were more likely than white Americans to die from preventable and treatable health conditions, a new report from the Commonwealth Fund out Thursday shows. A lack of health care access, and "timely, high-quality care," were correlated to poorer health outcomes, the authors conclude. (Fernandez, 11/19)

Axios: Health Care Is A Hemisphere-Wide Concern For Latinos 
Health care performance is significantly worse for U.S. Latinos when compared with non-Hispanic white people, while some Latin Americans are also concerned about equitable access to health care in their countries. A report compiled by the Commonwealth Fund underlines profound racial and ethnic health care disparities across the United States. (Reyes, 11/18)

The Wall Street Journal: Sleep Apnea Device Recall From Philips Causes New Worry
Over the summer, Royal Philips NV set off a scramble among sleep apnea sufferers when it recalled millions of machines that many use to breathe at night, citing concerns that the foam in the devices could pose a health risk. Last week, users were thrown another curveball when the Food and Drug Administration warned the replacement machines that the Dutch health giant has been cranking out since September may be harmful, too. The FDA didn’t order a recall of some 250,000 replacement devices Philips has sent to users, but said it was concerned that a silicone-based foam used in the substitute devices could emit harmful gases. That has raised new questions among users about what to do. (Roland, 11/18)

The Hill: CDC: No Trace Of Virus Causing Smallpox Found In Lab Vials, Despite Labels
The Centers for Disease Control and Prevention (CDC) on Thursday determined that vials found at a Pennsylvania facility this week with labels reading "smallpox" did not contain the virus that causes it. "There is no evidence that the vials contain variola virus, the cause of smallpox," the CDC said in a statement, adding that the agency is "in close contact with state and local health officials, law enforcement, and the World Health Organization about these findings." (Jenkins, 11/18)

NBC News: Flu Season: What Outbreaks On College Campuses Tell Us
Flu outbreaks on college campuses most likely indicate a bad flu season ahead, but experts say the unpredictable nature of the flu virus means it’s too soon to know for sure how this season will unfold. The Centers for Disease Control and Prevention is currently investigating an outbreak of influenza at the University of Michigan, where at least 528 students have tested positive for the flu since Oct. 6. The University of Florida, Florida State University, Rowan University in Glassboro, N.J., and the University of Rhode Island are also seeing steep upward trends in campus flu cases this month. (11/19)

KHN: A Covid Head-Scratcher: Why Lice Lurk Despite Physical Distancing
The Marker family opened their door on a recent evening to a woman dressed in purple, with a military attitude to cleanliness. Linda Holmes, who has worked as a technician with LiceDoctors for five years, came straight from her day job at a hospital after she got the call from a dispatcher that the Marker family needed her ASAP. According to those in the world of professional nitpicking, Pediculus humanus capitis, the much-scorned head louse, has returned. (Ellen Bichell, 11/19)

Also —

KHN: The ER Charged Him $6,500 For Six Stitches. No Wonder His Critically Ill Wife Avoided The ER
Jason and DeeAnn Dean recently relocated to her hometown of Dellrose, Tennessee, where she grew up on a farm. Both in their late 40s, they’re trying to start a green dream business that combines organic farming with a health and wellness consulting company. They want to inspire people to grow their own food in this fertile rolling farmland, just north of the border with Alabama. Until the business fully launches, Jason is working construction. In May, he was injured on the job site when a piece of sheet metal slipped and caught him on the kneecap. He bled quite a bit. After closing the wound with a butterfly bandage, he thought that might be enough. But on his drive home, he figured it’d be best to have a professional stitch it up. (Farmer, 11/19)

The Washington Post: Coalition Of State Attorneys General Opens Investigation Into Instagram’s Impact On Children And Teens
A bipartisan coalition of state attorneys general on Thursday announced an investigation into Meta, focusing on whether the parent company of Instagram and Facebook violated consumer protection laws by promoting the app and other social networking products to children and teens. The probe, announced in a news release by Massachusetts Attorney General Maura Healey (D), follows reports that the company’s internal research suggested that its products negatively impact the mental health of young people, especially teen girls. It highlights ballooning regulatory scrutiny of the tech giant, which is already the target of a federal antitrust lawsuit. (Zakrzewski, 11/18)

AP: State Attorneys General Probing Instagram's Effects On Kids
“For too long, Meta has ignored the havoc that Instagram is wreaking on the mental health and well-being of our children and teens,” said California Attorney General Rob Bonta. “Enough is enough. We’ve undertaken this nationwide investigation to get answers about Meta’s efforts to promote the use of this social media platform to young Californians – and to determine if, in doing so, Meta violated the law.” The investigation targets, among other things, the techniques Meta uses to keep young people on its platforms — and the harms that extended time spent on Instagram can cause. (Ortutay, 11/18)

Stat: Can States Convince Courts Opioid Makers Caused A Public Nuisance?
Earlier this week, the state of Washington went to trial relying on a controversial legal theory to win $38 billion from three large pharmaceutical wholesalers for failing to monitor shipments of prescription opioid painkillers and, as a result, jeopardizing public health. As with any trial, legal strategy is something of a gamble. In this instance, Washington Attorney General Bob Ferguson had rejected a settlement offer of $527.5 million over 18 years, which he called “woefully insufficient.” Instead, he believes the state can convincingly argue that the wholesalers caused a “public nuisance,” which generally refers to an action that damages or interferes with a community. (Silverman, 11/18)

AP: Whitmer Proposes $300M In Water Funding For Communities
Gov. Gretchen Whitmer on Thursday proposed $300 million in water spending to help local utilities address elevated lead levels, plan for pipe replacement and connect users of contaminated wells to municipal supplies. The governor said the funding would expand her $500 million MI Clean Water Plan, some of which has been authorized since it was unveiled more than a year ago. The new funds, which would come from U.S. pandemic relief dollars, would need to be approved by Michigan’s Republican-led Legislature. (Eggert, 11/18)

North Carolina Health News: Juul Settlement Funds To Tackle Youth Vaping 
In North Carolina, where tobacco reigned as a king crop for ages, the state budget plan sailing through the General Assembly includes funds for the first time since 2012 to help prevent young people from getting addicted to nicotine through vaping, smoking and chewing tobacco. That’s in large part because of a $40 million settlement that Josh Stein, the state attorney general, reached this summer with Juul, the e-cigarette giant criticized for its flavored products that attract many teens to vaping. (Blythe, 11/19)

Modern Healthcare: Virginia Latest State To Offer Full Year Of Postpartum Medicaid
Virginia became the latest state to offer 12 months of postpartum Medicaid and Children's Health Insurance Program coverage after the Centers for Medicare and Medicaid Services approved the state's Medicaid plan amendment Thursday. More states will likely follow suit next year after an American Rescue Plan provision to simplify the application for expanding postpartum coverage for 12 months goes into effect in April 2022. (Goldman, 11/18)

Chicago Tribune: Toxic Algae Blooms May Be Increasing In Illinois 
Barges carrying mounds of coal toward St. Louis passed by Starved Rock at a snail’s pace, inching past yellow-orange trees and sandstone canyons. A bald eagle hovered above a path leading hikers toward Lover’s Leap. Near the Starved Rock Lock and Dam, a pinch point along the Illinois River, the water was dull and unremarkable. But the area is home to a problem that taints waters throughout the state: toxic algae blooms. (Greene, 11/18)

CBS News: Michigan Marijuana Regulators Recall Cannabis Products From Hundreds Of Stores, Citing "Unreliable" Test Results
The Michigan Marijuana Regulatory Agency issued a recall for marijuana products assessed by testing facilities over the last few months, impacting more than 400 sales locations statewide. The agency said on Wednesday it noticed "inaccurate and/or unreliable results" of products tested by Viridis Laboratories and Viridis North. (Powell, 11/18)

In covid news across the states —

WUSF Public Media: Coronavirus Restrictions Are Eased At Florida's Long-Term Care Facilities
For nearly two years Florida’s long-term care residents and their loved ones have been strained by visitation restrictions meant to protect them from the coronavirus.Guidelines released Friday by the Centers for Medicare & Medicaid Services allow all visitors, excluding those that have recently tested positive for the coronavirus. This ends a long and emotional period for those with family and friends in Florida’s care centers throughout the COVID-19 pandemic. For months, visitors were kept out of nursing homes and assisted living facilities. (LeFever, 11/18)

Atlanta Journal-Constitution: Atlanta Business Chamber Sticks To Sidelines In Vaccine Mandate Debate
Some business groups are part of the growing legal fight against a federal mandate requiring many employers to ensure workers are fully vaccinated against COVID-19 or tested weekly. But the Metro Atlanta Chamber, one of the biggest business organizations in Georgia, is among other groups that aren’t wading into the battle even as Georgia joins other states in suing to try to stop the requirement from taking effect. (Kempner, 11/18)

The New York Times: Austria Announces A Lockdown And Vaccination Mandate For All
Austria will go into a nationwide lockdown on Monday and impose a coronavirus vaccination mandate in February, Chancellor Alexander Schallenberg said on Friday. It is the first such lockdown in a European nation since the spring, and the first national vaccine mandate on the continent. “Nobody wants a lockdown — the lockdown is the very last resort, a crude instrument,” Health Minister Wolfgang Mückstein said. “A lockdown is always an imposition, but it is the most reliable instrument we have to break this fourth wave.” (Schuetze and Peltier, 11/19)

Reuters: Austria Reimposes Full Covid Lockdown, Makes Vaccination Compulsory
Austria will become the first country in western Europe to reimpose a full Covid-19 lockdown this autumn to tackle a new wave of infections, and order its whole population to get vaccinated as of February, its government said on Friday. Roughly two-thirds of Austria’s population is fully vaccinated against Covid-19, one of the lowest rates in western Europe. Its infections are among the highest on the continent, with a seven-day incidence of 991 per 100,000 people. (11/19)

In other news from Europe —

Bloomberg: New Covid Delta Sub-Variant Spreads Fast In U.K., Causes Fewer Symptoms
A more infectious new version of Covid-19’s delta variant is spreading fast in the U.K., accounting for about 12% of the samples gathered in the most recent government survey. That represents a 2.8% daily growth rate for sub-variant AY.4.2 over the course of the REACT survey, from Oct. 19 to Nov. 5, the researchers said. Still, the new sub-variant seemed less likely to cause symptomatic Covid. (Kresge, 11/18)

Reuters: Britain Was Unprepared For COVID-19, Spending Watchdog Finds
The British government was unprepared for a crisis like the coronavirus pandemic, failed to learn from simulation exercises and was distracted by its departure from the European Union, the government's spending watchdog said on Friday. More than 143,000 people have died from COVID-19 in Britain, sparking criticism of Prime Minister Boris Johnson for his response, which was initially based on plans for dealing with a flu pandemic rather than a novel coronavirus. (Smout, 11/19)

Axios: Germany Limits Public Gatherings On Unvaccinated People 
Germany will tighten COVID-19 measures across the country for unvaccinated people as hospitals become full of COVID patients, Reuters reports. The move to limit large gatherings and other restrictions comes as public officials around the world are imposing COVID measures on the unvaccinated amid rising new cases. (Frazier, 11/18)

The New York Times: Greece, Like Some Other E.U. Nations Facing Case Surges, Adds Restrictions For The Unvaccinated
Prime Minister Kyriakos Mitsotakis of Greece announced additional restrictions for the country’s unvaccinated population on Thursday, a bid to keep a recent spike of coronavirus infections from increasing further. As of next Monday, access to more indoor spaces will be limited to the vaccinated, he said during a televised address. Proof of a negative test will no longer be sufficient for unvaccinated people to enter cinemas, theaters, museums and gymnasiums, he said. The new restrictions broaden those imposed in mid-September, which barred the unvaccinated from the indoor areas of cafes and restaurants. (Kitsantonis, 11/18)

Reuters: Russia's Daily COVID-19 Deaths Reach New Record High
Russia on Friday reported 1,254 coronavirus-related deaths in the last 24 hours, a record daily high that follows a surge in cases. The government coronavirus task force also reported 37,156 nationwide infections, including 3,371 in Moscow, down from a peak of 41,335 recorded on Nov. 6. (11/19)

Elsewhere around the globe —

AP: Mexico Sends Some Minors To US To Get Coronavirus Vaccine
Scores of Mexican adolescents were bused to California on Thursday to get vaccinated against the coronavirus as efforts get underway across Mexico to get shots in the arms of teens. Mexico has resisted vaccinating minors ages 12 to 17, in part because the government focused on older adults believed to be more vulnerable. Mexico also has not had enough vaccine supply for most of its minors, who account for one-third of its population. The country this month is preparing to start vaccinating only teens ages 15-17. (Watson, 11/19)

AP: Scientists Mystified, Wary, As Africa Avoids COVID Disaster
Scientists emphasize that obtaining accurate COVID-19 data, particularly in African countries with patchy surveillance, is extremely difficult, and warn that declining coronavirus trends could easily be reversed.But there is something “mysterious” going on in Africa that is puzzling scientists, said Wafaa El-Sadr, chair of global health at Columbia University. “Africa doesn’t have the vaccines and the resources to fight COVID-19 that they have in Europe and the U.S., but somehow they seem to be doing better,” she said. (Cheng and Mutsaka, 11/19)

The New York Times: As India Limits Syringe Exports, A Supply Crunch Has Buyers Looking Elsewhere
Rajiv Nath’s factories were cranking out more than 7,600 syringes a minute when India decided to limit their export last month to shore up its own vaccination campaign. The products were meant for clients around the world as nations scramble to inoculate their people and bring the pandemic to an end, but instead Mr. Nath’s warehouses were left with stocks of more than 45 million syringes that he had largely promised to UNICEF and the Pan American Health Organization. And with India’s export restrictions on syringes in place through the end of this year, experts say the world could experience a shortfall of two billion to four billion needles through the end of next year. The shortages are expected to hit African countries the hardest. (Deep Singh, 11/18)

AP: Taiwan Acknowledges Room To Improve In COVID-19 Response
The task force in charge of Taiwan's COVID-19 response has acknowledged that the island could have done better in fighting the disease, after 12 families that lost relatives to the pandemic filed a claim seeking financial compensation from the government. The families allege that the authorities were underprepared despite having more than a year during which there were few cases, resulting in unnecessary deaths and suffering. (Wu, 11/19)

The Baltimore Sun: In Fight Against COVID, ‘Vaccine Ambassadors’ Can Be Effective 
The strategy used by the Baltimore City Health Department described in “Meet the Baltimore ‘vaccine ambassadors’ working to personally convince those who are still hesitant to get the COVID shot” (Oct. 29) has been successful, but should be reevaluated with interactive collaboration between policymakers, scientists and community members. With misinformation and disinformation about COVID-19 vaccines circulating online and within social circles, these diverse stakeholders should come together to decide the best path forward in curbing the spread of COVID-19. I believe we should consider further expanding the role of community members and social scientist researchers in this vaccination initiative. (11/18)

The Atlantic: You Should Get A Booster Now 
As the air gets colder and drier and people in most of the United States move indoors, a winter spike in COVID-19 cases is beginning to materialize. The drop in new infections across the Deep South after a difficult summer raised hopes that the country could get through this winter without another surge. But that no longer seems likely. With less than 60 percent of Americans fully vaccinated, the U.S. remains vulnerable to renewed winter outbreaks. European countries with even higher vaccination rates are experiencing a substantial uptick in infections. (Ashish K. Jha, 11/18)

The Boston Globe: Why A CDC Investigation Of Boston Public Schools COVID-19 Outbreaks Is Needed Now 
The message dinged our phones on Oct. 27: “Not great news, but a friend just shared there are six confirmed COVID cases in the fourth-grade class. ”The group chat of parents and caregivers of third-graders at the Manning Elementary School in Jamaica Plain is usually about misplaced homework and after-school activities. This was something else, and it eventually became clear that the Manning School was facing the largest COVID-19 outbreak of the year in Boston Public Schools — now surpassed by the Curley K-8 School in Jamaica Plain and Orchard Gardens in Roxbury in total cases. (Kate Mitchell Balla, Mei A. Elansary, Bevin E. Kenney and Philip A. Ledrer, 11/18)

Chicago Tribune: Does Biden’s Vaccination Mandate Actually Need To Be Enforced? 
In September, President Joe Biden announced a COVID-19 vaccination mandate that affects 100 million workers across the public and private sectors. The mandate requires all federal employees and federal contractors to receive a COVID-19 vaccine. It also applies to private sector companies with at least 100 employees. For this latter group, exemptions are possible, which then require weekly testing in lieu of vaccination. The response to the mandate hasmostly fallen along political lines. (Sheldon H. Jacobson, 11/18)

Los Angeles Times: OSHA Suspended Its Vaccine Rule After Judges Got It Wrong
The decision by federal appeals judges to block the Biden administration’s rule requiring vaccination or testing for companies with at least 100 employees shows that some courts in the United States do not consider COVID-19 to be a serious issue. The administration has since suspended enforcement of its rule. The judges, by ignoring reality, are failing us. (Dorit Reiss, 11/18)

The New York Times: What Happens After The Worst Of The Pandemic Is Behind Us?
No one knows when the pandemic will end. But the worst of it may be over for the United States after this winter. For good reasons — growing vaccine eligibility, boosters and new antiviral treatments — and bad — high levels of prior infections — it’s possible the ongoing Delta surge could be the last major spike in hospitalizations and deaths for the United States. (Zeynep Tufekci, 11/18)

The Boston Globe: The COVID Outbreak At The Curley School Highlights Need For More In-School Testing 
It’s the news that every parent in the era of COVID-19 dreads: There’s an uncontrolled coronavirus outbreak at your child’s school, and so it’ll have to close — again.Thankfully, school closures have been rare in Massachusetts since in-person learning resumed. But with infection numbers again rising, and an outbreak in Jamaica Plain offering a fresh reminder of how disruptive closures can be, schools need to redouble their testing efforts in order to keep classrooms open. (11/19)

Stat: Lessons From A Drumming Technique Can Help Advance Telehealth
By day I run a health care company. At night and on weekends I play the drums. My hobby often gets me thinking about the rhythms of work. As I’m drumming away, I’ll ask myself, “Why do I play the bass drum on this beat?” Because it’s always played there? Actually, it may sound better if I change it up, so I try altering the rhythm. Since the pandemic burst upon the world, my colleagues in health care and biotech and other industries have been moving around the sequences; patterns and rhythms scrambled by Covid-19 have shifted the thinking on old routines. That can be a good thing. (Mark Prather, 11/19)

Stat: Health Plans Need To Address Health Inequities As Part Of Their Core Work
Health care companies and organizations across the country are grappling with health inequities, spurred by devastating disparities in the pandemic’s toll as well as the overdue reckoning with racial injustice that has followed the murder of George Floyd. Some have been at this for a while. Others are just beginning. But all have a lot of work to do. (Andrew Dreyfus and Sandhya Rao, 11/19)