AP: Pfizer Seeking Emergency Use Of Its COVID-19 Vaccine In US
Pfizer said Friday it is asking U.S. regulators to allow emergency use of its COVID-19 vaccine, starting the clock on a process that could bring limited first shots as early as next month and eventually an end to the pandemic -- but not until after a long, hard winter. The action comes days after Pfizer Inc. and its German partner BioNTech announced that its vaccine appears 95% effective at preventing mild to severe COVID-19 disease in a large, ongoing study. (Neergaard, 11/20)

CNN: Pfizer And BioNTech To Submit To FDA Today For Emergency Authorization For Their Coronavirus Vaccine 
Pfizer and BioNTech said they will submit to the US Food and Drug Administration today for an emergency use authorization for their coronavirus vaccine candidate. This is the first coronavirus vaccine to seek a regulatory OK in the United States. The companies said in a statement that their vaccine candidate, known as BNT162b2, will potentially be available for use in high-risk populations in the United States by the middle to end of December. (Gumbrecht, 11/20)

The Washington Post: Pfizer To Seek Emergency Vaccine Approval; U.S. Infections Reach Grim New Heights
Pfizer and its German partner BioNTech will be the first companies to seek emergency authorization for a coronavirus vaccine in the United States, prompting Health and Human Services Secretary Alex Azar to say that there was “light at the end of the tunnel.” The move means a vaccine could be available on a limited basis within weeks. But conditions around the country remain dire: The United States reported more than 185,000 new coronavirus cases on Thursday, yet another record. Coronavirus-related hospitalizations are also at an all-time high. (Noori Farzan and Mellen, 11/20)

Reuters: Pfizer Is First To Apply For U.S. Emergency Use For COVID-19 Vaccine
The application also includes safety data on about 100 children 12-15 years of age. The company said 45% of U.S. trial participants are 56-85 years old. If the data is solid, “we literally could be weeks away from the authorization of a 95% effective vaccine,” U.S. Health Secretary Alex Azar said on CBS’ “This Morning”. (11/20)

In more news on what comes next —

The Wall Street Journal: Next Stop For Covid-19 Vaccines: FDA Review
As part of that review, FDA scientists are expected to look at data from individual patients, such as for indications of any troubling side effects. After the FDA staff review, an independent panel of doctors from major U.S. academic centers will meet to advise the FDA on the vaccines’ efficacy—likely in early December. ... After the review, the FDA then will decide whether to grant an “emergency use authorization,” a quicker version of the normal FDA approval. (Burton and Walker, 11/19)

Bloomberg: Pfizer Covid Vaccine Still Faces Hurdles After FDA Filing Friday
A key step along the way is a meeting of outside FDA advisers, all experts in infectious diseases and vaccines. They’re set to confer Dec. 8-10, according to a person with knowledge of the situation. The FDA will spend the few short weeks between the emergency authorization request and the meeting sorting through the trial data. (Edney, 11/20)

FiercePharma: Pfizer Aims To Ship COVID-19 Vaccine Doses 'Within Hours' Of Regulatory Nods, CEO Says
After Pfizer’s leading COVID-19 vaccine turned in strong data in a late-stage trial, the company planned to submit its program to U.S. authorities for an emergency use authorization “within days.” And as soon as it gets go-aheads from regulators, it'll be ready to distribute, CEO Albert Bourla says.Once granted an authorization, Pfizer plans to begin shipping doses “within hours” of the notice, Bourla told Sky News after the company’s positive phase 3 announcement. And it'll start shipping those doses wherever the vaccine is authorized first, he added, raising the prospect of a “race to regulate” as authorities seek to quickly review data and secure early doses for their countries. (Sagonowsky, 11/19)

CNBC: Covid Vaccine: Ex-Obama FDA Chief Trusts Agency's Approval Process
Dr. Margaret Hamburg, former Food and Drug Administration commissioner in the Obama administration, told CNBC on Wednesday that she trusts the regulatory agency will adhere to strict scientific principles as it evaluates coronavirus vaccines. “It’s an agency that is so committed to strong science, the integrity of the people who work there,” Hamburg said on “Closing Bell.” “And I really feel confident that everyone there has been working 24/7 to help accelerate the process of vaccine development and review as much as possible but that no corners will be cut in terms of assuring the soundness of the scientific data on which decisions will be made.” (Stankiewicz, 11/18)

Politico: CDC Urges Against Thanksgiving Travel 
The Centers for Disease Control and Prevention on Thursday advised Americans not to travel for Thanksgiving and to limit gatherings to people within the same household as coronavirus cases continue to surge. The agency's guidance is at odds with recent messaging from the White House, including fierce criticism of state-level mitigation efforts from President Donald Trump's press secretary. But it lines up with a growing number of new state Covid-19 restrictions that are being imposed in response to record numbers of new cases and more than 250,000 U.S. deaths. (Ehley, 11/19)

NPR: CDC Pleads With Americans To Avoid Thanksgiving Travel
The better bet, the CDC advised, was for people instead to spend Thanksgiving with the folks with whom they have been living for the two weeks leading up to the holiday. "If people have not been actively living with you for the 14 days before you're celebrating, they're not considered a member of your household," Erin Sauber-Schatz of the CDC said at a news briefing Thursday. "And therefore you need to take those extra precautions, even wearing masks within your own home." (Dwyer, 11/20)

NPR: Don't Travel For Thanksgiving, CDC Warns
The C.D.C.’s warning runs counter to messages from administration officials, who have denounced concerns that Thanksgiving celebrations will speed the virus’s spread. ... Members of the White House coronavirus task force did not even mention Thanksgiving at a news conference on Thursday, even as they warned of the hazards associated with indoor gatherings and urged “vigilance” in the face of rampant infections. (Rabin, 11/19)

The Hill: Medical Groups Urge Americans To Scale Back Holiday Plans Amid COVID-19 Surge 
Leading medical societies on Thursday urged Americans to scale back Thanksgiving gatherings because spiking coronavirus cases are overwhelming hospitals across the country. "In the strongest possible terms, we urge you to celebrate responsibly," the American Medical Association, the American Hospital Association and the American Nurses Association said in an open letter to the public. (Weixel, 11/19)

In related news —

Detroit Free Press: Detroit Cancels Plans For Live Thanksgiving Day Parade
Detroit's top public health official has scuttled plans for a live performance in downtown next week for the city's annual Thanksgiving Day parade. Denise Fair, chief public health officer for the Detroit Health Department, determined that organizers' plans to have roughly 800 participants and 22 floats in downtown for a live parade would violate Michigan's recent public health restrictions on outdoor gatherings of more than 25 people, according to a city spokesman. (Reindl, 11/19)

AP: Oklahoma Governor's Holiday Plans Flout CDC, Virus Surge
Oklahoma’s Republican Gov. Kevin Stitt said Thursday he planned to attend a college football game over the weekend and spend Thanksgiving with his parents, even as coronavirus cases in the state continued to surge this week and the nation’s top public health agency pleaded with Americans not to travel for the holidays. During a press conference with state health officials, Stitt said he planned to watch the annual Bedlam matchup between the University of Oklahoma-Oklahoma State University in Norman in person Saturday and spend time with family members he doesn’t live with next week. (Murphy, 11/20)

The New York Times: How Do I Make Thanksgiving Grocery Shopping Safer? 
So you’ve canceled your Thanksgiving travel plans, quarantined the college student and created a scaled-back, family-only holiday menu. Good job. Now you just need to tackle the food shopping. The crush of grocery store shoppers on the days leading up to Thanksgiving can be maddening in the best of times, but it’s especially stressful this year. The coronavirus is raging around the country, and many communities are imposing new restrictions and closings. (Parker-Pope, 11/19)

The New York Times: After A Long Absence, The U.S. Coronavirus Task Force Returns With A Plea For Vigilance.
The Trump administration’s coronavirus response coordinator, appearing at the White House with other top federal health officials for the first time in months, issued a dire assessment of the pandemic on Thursday, along with an urgent warning for Americans to “increase their vigilance” as they await the approval of a vaccine. Dr. Deborah L. Birx made the remarks after the White House coronavirus task force met with Vice President Mike Pence — who offered a far rosier assessment as he defended the administration’s handling of a pandemic that has now claimed more than 250,000 lives in the United States, and killed nearly 2,000 Americans on Wednesday alone. (11/20)

The Hill: Fauci, Birx Urge Americans To Take Precautions Against Virus In Rare White House Appearance 
Top Trump administration health officials made a rare appearance at the White House on Thursday to plead with Americans to redouble their efforts to mitigate the spread of the coronavirus. But — even with the country facing a worsening pandemic and ongoing attacks on the electoral process from President Trump — Vice President Pence, Anthony Fauci, Deborah Birx and Centers for Disease Control and Prevention (CDC) Director Robert Redfield did not take questions from the press. It was the first time they had delivered remarks from the White House briefing room in several months. (Samuels, 11/19)

NPR: White House Urges Vigilance On Coronavirus But Rejects Lockdowns As Solution
The White House Coronavirus Task Force and President-elect Joe Biden separately gave updates on the worsening COVID-19 pandemic and how their teams were working to defeat it as health officials on Thursday warned against holiday travel to limit the virus's spread. Speaking from the White House briefing room, members of the coronavirus task force, led by Vice President Pence, spoke encouragingly about the process of vaccine development. The task force acknowledged the rise in cases across the country, but speakers said the administration still would not support a national lockdown to slow the spread of the coronavirus. (Wise, 11/19)

Business Insider: A Map From White House Coronavirus Task Force Shows COVID-19 All Over
The US is covered in the coronavirus from shore to shore. ... One million new cases of the virus were diagnosed nationwide last week, washing the map of the country in red. (Brueck, 11/19)

Also —

Deadline: Reporters Scream Questions At Pence After He Declines To Take Queries 
Vice President Mike Pence declined to take questions after an hour-plus coronavirus task force briefing, the first in months, as reporters screamed queries at him as he left the lectern. Jon Karl, ABC News’ chief White House correspondent, stood up in the front row as Pence left and said, “What is going on?” Another person was heard shouting, “You are all undermining the democratic election.”“Mr. @VP — it’s not a press briefing if you do not take questions. Why the refusal to answer a single question?” Karl later tweeted. (Johnson, 11/19)

NBC News: Atlas On The Outs With Coronavirus Task Force But Still Pushing Trump's Pandemic Claims
President Donald Trump’s top medical adviser on the coronavirus pandemic, Dr. Scott Atlas, has not attended White House task force meetings in person since late September, according to two administration officials, as he continues to spread misinformation about the worsening health crisis. The growing split between Atlas and task force leaders came after the group’s leading medical experts — Dr. Deborah Birx and Dr. Anthony Fauci — indicated that they did not appreciate Atlas’ controversial input or contributions in the Situation Room gatherings. (Alba and Lee, 11/19)

Los Angeles Times: California Imposes 'Limited' Curfew Amid COVID-19 Surge
Gov. Gavin Newsom has announced a mandatory overnight stay-at-home order that will be instituted throughout most of California to combat a surge in new coronavirus cases, a measure that comes just days after the governor enacted a dramatic rollback of reopening in much of the state. The order issued by the California Department of Public Health will prohibit most nonessential activity outside the home from 10 p.m. to 5 a.m. in counties in the strictest tier of the state’s reopening road map — the purple tier. The restriction goes into place on Saturday and lasts through Dec. 21, though it could be extended. (Willon, Luna and Reyes-Velarde, 11/19)

AP: California Adopts Stricter Workplace Pandemic Safety Rules
California officials on Thursday approved new regulations requiring employers to implement safety measures aimed at limiting the spread of COVID-19 in the workplace, the latest state to adopt stricter rules. The state’s Occupational Safety and Health Standards Board heard testimony on an emergency temporary standard that requires businesses to educate employees on ways to prevent infection, provide free personal protective equipment and offer free COVID-19 testing to all employees if three or more employees are infected with the coronavirus within a 14-day period, among other measures. (Rodriguez, 11/20)

The Hill: New Hampshire To Issue Statewide Mask Mandate 
New Hampshire Gov. Chris Sununu (R) on Thursday issued an executive order implementing a statewide mask mandate beginning Friday amid a new surge in coronavirus infections. According to the order, everyone within the state over the age of five must wear facial coverings while in public, both outside and indoors, “where they are unable to or do not consistently maintain a physical distance of at least six feet from persons outside their own households.” (Castronuovo, 11/19)

Also —

The New York Times: States That Imposed Few Restrictions Now Have The Worst Outbreaks
Coronavirus cases are rising in almost every U.S. state. But the surge is worst now in places where leaders neglected to keep up forceful virus containment efforts or failed to implement basic measures like mask mandates in the first place, according to a New York Times analysis of data from the University of Oxford. ... Outbreaks are comparatively smaller in states where efforts to contain the virus were stronger over the summer and fall — potential good news for leaders taking action now. States and cities are reinstating restrictions and implementing new ones: In recent days, the governors of Iowa, North Dakota and Utah imposed mask mandates for the first time since the outbreak began. (Leatherby and Harris, 11/18)

KHN: Trump’s Lame-Duck Status Leaves Governors To Wing It On COVID
Not long after the world learned that President Donald Trump had lost his reelection bid, states began issuing a new round of crackdowns and emergency declarations against the surging coronavirus. Taking action this time were Republican governors who had resisted doing so during the spring and summer. Now they face an increasingly out-of-control virus and fading hope that help will come from a lame-duck president who seems consumed with challenging the election results. (Volz, 11/20)

AP: 'Help Us': Doctors Implore Minnesotans To Follow Virus Rules
Doctors urged Minnesotans on Thursday to take COVID-19 seriously and to comply with new restrictions that take effect Friday night as they provided dramatic accounts of how the state’s health care system — especially its health care workers — is at a breaking point. Dr. Carolyn McClain, an emergency physician at Twin Cities hospitals, said the pandemic has been one of the hardest times of her life. She worked in Haiti after the catastrophic earthquake of 2010 but said that she could at least go home after that. (Karnowski and Forliti, 11/20)

ABC News: Contact Tracing For COVID-19 Maxed Out In Colorado 
Colorado's contact tracing capacity is tapped out, according to local health departments. "Right now, we have about 1,400 cases or contacts of cases waiting to be reached out to," Christine Billings, the emergency preparedness and response coordinator for Jefferson County Public Health told ABC Denver affiliate KMGH-TV. (Schumaker, 11/19)

CNN: The US Just Recorded More Than 2,000 Covid-19 Deaths In A Day. One Model Predicts That Number Will Keep Growing
More than 2,000 American deaths were recorded by Johns Hopkins University on Thursday -- the highest number since early May. And as the virus runs unabated across US communities, experts warn the coming weeks will likely be brutal and the pandemic's death toll will keep climbing. (Maxouris, 11/20)

The Atlantic: America Is On Track To Hit A COVID-19 Death Record 
The United States has made huge advances in fighting the coronavirus. The astonishingly high death rates the country saw during the spring have fallen, and Americans are much more likely now than they were then to survive a COVID-19 hospitalization. New treatments have, in some cases, helped speed recovery—President Donald Trump has trumpeted his own bout with the virus as proof that there is a “cure” for the illness. (There is not.) These developments have given Americans the impression that no matter how high cases surge, deaths might not reach the heights of the spring. But the truth is grimmer. The story people want to believe about how much treatments have improved in recent months does not hold up to quantitative scrutiny. (Madrigal and Moser, 11/19)

The Wall Street Journal: U.S. Infections Set Another Daily Record 
The U.S. logged its highest number of newly reported Covid-19 infections in a day and reported record hospitalizations for the 10th day in a row, as the coronavirus pandemic surges through the country. The U.S. reported 187,833 new cases for Thursday, according to data compiled by Johns Hopkins University, exceeding its last daily record by more than 10,000. That record was set last Friday, when the U.S. reported 177,224 new cases. (Martin, 11/20)

More on the death toll —

The Washington Post: Comparing 250,000 Covid-19 Deaths To Other U.S. History Death Tolls In Wars And Pandemics 
At least 250,000 people in the United States have died of covid-19, the disease caused by the coronavirus, since February, and many public health officials warn the pandemic is just entering its deadliest phase. Yet, as the country confronts this horrifying death toll, there is little understanding of what a loss of this size represents. Here is some historical perspective about losing a quarter of a million people, looking at major events in our past that have cost American lives. (Brockell, 11/19)

ABC News: An American Tragedy: Inside The Towns Hardest Hit By Coronavirus 
A South Dakota doctor is moonlighting as a newspaper columnist, urging readers to protect themselves against the virus that killed both his parents. The sheriff in a Kansas town is fighting for his life in a Denver hospital he was sent to for critical care. (Schumaker and Nichols, 11/19)

NPR: COVID-19 Denial Still Rampant In Some Coronavirus Hot Spots
Signs posted at the entrance to the grocery store in northwest Montana told customers to wear a mask. Public health officials in Flathead County urged the same. Coronavirus infection rates here are among the highest in the state. Infection rates in the state are among the highest in the United States. And still, Craig Mann walked out of the grocery store, past the signs and toward his truck, maskless and resolute. The pandemic that everyone's talking about? "It's absolute garbage," he said. (Rott, 11/19)

The Wall Street Journal: Trump Administration To Release New Rules Reducing Drug Costs 
The Trump administration is planning on Friday to roll out two final rules aimed at lowering drug prices—one curbing rebates paid to middlemen in Medicare and another pegging the prices of certain prescription drugs in the U.S. to their prices in other developed countries, according to a person familiar with the planning. The plans, slated to be announced in the White House Rose Garden, have been a signature pledge of President Trump’s since his 2016 election campaign. Both rules are expected to be final, meaning they have completed the required public comment period and can take effect immediately. (Armour, 11/19)

Reuters: Trump Will Announce On Friday Rules To Lower U.S. Drug Prices
U.S. President Donald Trump will announce on Friday two rules designed to lower drug prices, an administration official said on Thursday. ... One rule, known as “most favored nation,” would require Medicare to tie the prices it pays for drugs to those paid by other wealthy countries. The other rule would limit rebates paid to middlemen in Medicare. (11/19)

Also —

The Hill: Top Pentagon Official Tests Positive For COVID-19 
Pentagon official and retired Brigadier Gen. Anthony Tata has tested positive for the coronavirus, the Department of Defense (DoD) announced Thursday. Tata, whose official title is performing the duties of under secretary of defense for policy, this week met with several top defense officials, including acting Defense Secretary Christopher Miller, Chairman of the Joint Chiefs of Staff Mark Milley and Deputy Defense Secretary David Norquist. It was unclear when he last briefed top officials. (Budryk, 11/19)

CNN: Trump Administration Overrules Jerome Powell And Cuts Off Fed Emergency Lending Programs
US Treasury Secretary Steven Mnuchin has pulled the plug on emergency Federal Reserve lending programs, drawing a rare rebuke from the central bank, which said they are needed to support the economy as the coronavirus pandemic continues to rage. In a letter sent Thursday to Fed Chairman Jerome Powell, Mnuchin asked the central bank to return some $455 billion in unused funding for programs set to expire December 31. He added that Congress would then be able to use the money for other purposes. (McLean, 11/20)

Politico: Trump Team To Yank Emergency Economic Support, Triggering Public Fed Dissent 
Treasury Secretary Steven Mnuchin on Thursday asked the Federal Reserve to return all unused coronavirus relief funds set aside for its emergency lending programs by the end of the year, taking away a lifeline even as a resurgence in Covid cases threatens to upend the budding economic recovery. Mnuchin said the programs are no longer needed, but the move goes against the Fed’s desire to keep them going, according to a statement from the central bank, in a rare show of public disagreement between the two government agencies. (Guida, 11/19)

In related news about a COVID-relief bill —

ABC News: Congress Heads Home For Thanksgiving Without Pandemic Relief Deal
Congress will head home for a week-long Thanksgiving holiday recess without passing any sort of compromise coronavirus relief bill as the U.S. death toll passes 250,000 and millions of Americans remain on unemployment. But there is some hope that renewed talks could see some sort of coronavirus relief aid in the coming weeks even with little time remaining on the legislative calendar before the end of the year. (Khan, 11/19)

Roll Call: Crapo Poised For Starring Role In Economic, Health Care Policy
The most powerful committee in Congress hasn’t had a top Republican not named Charles E. Grassley or Orrin G. Hatch in two decades. That’s about to change in January when a Harvard Law School-trained attorney from Idaho Falls is expected to take the Senate Finance gavel — or the ranking member slot in an evenly divided Senate, depending on the Georgia runoffs. Either way, Michael D. Crapo will be at the center of economic and health care policymaking in a pivotal year, as a new administration takes office amid the devastation of COVID-19. (Sword and Clason, 11/20)

The Hill: Ocasio-Cortez On Controlling COVID-19: 'We Need To Pay People To Stay Home' 
Rep. Alexandria Ocasio-Cortez (D-N.Y.) slammed congressional inaction on another coronavirus relief package, saying that “pay[ing] people to stay home” was vital to preventing the spread of the virus.“ To get the virus under control, we need to pay people to stay home,” the New York congresswoman tweeted Thursday. (Budryk, 11/19)

Also —

The Washington Post: Weekly Unemployment Claims Rose Last Week For The First Time In A Month 
The number of new unemployment claims rose last week to 742,000, an increase of 31,000 from the previous week, as rising coronavirus cases have spurred a new wave of restrictions and closures begin to weigh on parts of the economy. Since Oct. 10, weekly jobless claims have been slowly trending downward or remaining flat, according to Labor Department data. (Rosenberg, 11/19)

The Hill: Biden Vows He Will Not Implement A Nationwide Shutdown 
President-elect Joe Biden on Thursday said he would not implement a nationwide shutdown as part of his effort to control the spread of the coronavirus. "I’m not going to shut down the economy, period. I’m going to shut down the virus," Biden said. "I’ll say it again. No national shutdown." (Easley, 11/19)

AP: Biden Chides Trump For Lack Of Cooperation On Vaccine
President-elect Joe Biden met Thursday with governors from both parties and criticized President Donald Trump’s unprecedented attempt to block the peaceful transition of power, saying it was hindering the flow of information about programs to develop a vitally important coronavirus vaccine. “Unfortunately, my administration hasn’t been able to get everything we need,” Biden said during a video conference with the National Governors Association’s leadership team, which consists of five Republicans and four Democrats. (Peoples and Weissert, 11/20)

The Washington Post: Biden Paints Trump As Reckless As Pence And Science Advisers Cheer Vaccine News 
President Trump will be remembered as one of the nation's most reckless leaders for holding up cooperation on the deadly coronavirus pandemic after losing his bid for reelection, President-elect Joe Biden said Thursday. At the White House, Vice President Pence tried to apply a veneer of calm to a tumultuous outgoing administration as he and federal health officials held what has become a rare public discussion of the federal government’s efforts to address the pandemic. (Gearan and Min Kim, 11/19)

CNN: Joe Biden's Plans For Mask Mandates Nationwide Will Be An Early Test Of His Power Of Persuasion 
President-elect Joe Biden's team is discussing ways to persuade resistant Republican governors to get on board with mandating masks to stop the spread of Covid-19, according to sources familiar with those conversations. The Biden transition team is treading lightly so far, saying little about how the incoming administration plans to address what is likely to be among the first tests of Biden's ability to bridge political divides and find consensus. (Warren, Merica and Subramaniam, 11/19)

NBC News: Biden Urged To Pick Person Of Color For Top Health Job Amid Pandemic's Toll On Minority Groups
President-elect Joe Biden is being pushed to name a person of color as his health and human services secretary, a move supporters say is designed to acknowledge the need to address the disproportionate burden the pandemic has put on communities of color. (Pettypiece, Bennett and Golden, 11/19)

Politico: Biden Pledges To Pay For National Guard’s Covid Work 
President-elect Joe Biden pledged Thursday to fully fund the National Guard's coronavirus relief work once he's sworn in, and criticized the Trump administration for making most states pick up 25 percent of the cost of having soldiers and airmen run testing sites, staff hospitals, conduct contact tracing and do other work amid the pandemic. “It costs a lot of money and governors need that paid for,” Biden said after a video call with a bipartisan group of governors. “The fact is that this is a national emergency — that’s what FEMA is supposed to deal with. Our view is that should be done. When it comes to deploying the National Guard for Covid relief, that should be paid for.” (Ollstein, 11/19)

Also, it's Biden's birthday —

AP: Birthday Time: Biden Turns 78, Will Be Oldest U.S. President
President-elect Joe Biden turned 78 on Friday. In exactly two months, he’ll take the reins of a politically fractured nation facing the worst public health crisis in a century, high unemployment and a reckoning on racial injustice. As he wrestles with those issues, Biden will be attempting to accomplish another feat: Demonstrate to Americans that age is but a number and he’s up to the job. (Madhani, 11/20)

And what does a pandemic inauguration look like? —

The Washington Post: Inauguration Day: Officials Are Trying To Plan Amid Pandemic 
The inaugural platform is going up near the Capitol, and the District has repaved Pennsylvania Avenue for the traditional parade. But the crowds huddled together enjoying a concert on the Mall and the celebratory balls that go late into the night? They are less certain. In fact, much remains unknown about how the coronavirus pandemic will change the inaugural celebration that normally transforms the city every four years. Nine weeks away from the 59th presidential inauguration, officials are under pressure to stage an event that will begin to heal a nation bruised by its deep partisan divides. But they are also operating under the constraints of a health crisis that has upended traditions dependent on massive gatherings and cross-country travel. The result is citywide preparation for a ceremony still shrouded in uncertainty as constituents clamor for tickets and the coronavirus continues to surge around them. (Davies and Jouvenal, 11/19)

Stat: WHO Recommends Against Remdesivir For Hospitalized Covid-19 Patients
A World Health Organization panel is now recommending against the use of the antiviral remdesivir in hospitalized Covid-19 patients, saying there is no evidence that the drug — which U.S. regulators have approved for the treatment of the coronavirus — improves mortality. (Joseph, 11/19)

Reuters: WHO Advises Against Gilead's Remdesivir For All Hospitalised COVID-19 Patients 
Gilead’s remdesivir is not recommended for patients hospitalised with COVID-19, regardless of how ill they are, as there is no evidence the drug improves survival or reduces the need for ventilation, a World Health Organization panel said on Friday. “The ... panel found a lack of evidence that remdesivir improved outcomes that matter to patients such as reduced mortality, need for mechanical ventilation, time to clinical improvement, and others,” the guideline said. (Kelland, 11/19)

AP: Health Experts Clash Over Use Of Certain Drugs For COVID-19
Health officials around the world are clashing over the use of certain drugs for COVID-19, leading to different treatment options for patients depending on where they live. On Friday, a World Health Organization guidelines panel advised against using the antiviral remdesivir for hospitalized patients, saying there’s no evidence it improves survival or avoids the need for breathing machines. But in the U.S. and many other countries, the drug has been the standard of care since a major, government-led study found other benefits — it shortened recovery time for hospitalized patients by five days on average, from 15 days to 10. (Marchione, 11/20)

In other news —

Indianapolis Star: Eli Lilly Drug Gains Emergency FDA Authorization For Treating COVID-19
The Food and Drug Administration on Thursday granted emergency use authorization of a drug made by Eli Lilly and Co. that could reduce recovery time from COVID-19. The FDA authorized the distribution and emergency use of baricitinib, an oral prescription tablet which, when used in combination with remdesivir, is "shown to reduce time to recovery within 29 days after initiating treatment" for coronavirus, according to federal regulators. (Andrea, 11/19)

Forbes: FDA Gives Emergency Approval To Covid-19 Treatment That Combines Eli Lilly Arthritis Drug With Remdesivir
The Food and Drug Administration Thursday issued an emergency use authorization for Eli Lilly’s rheumatoid arthritis drug baricitinib and remdesivir for coronavirus treatment, the first drug combination authorized by the FDA as a therapeutic for the virus.  (Sandler, 11/19)

Also —

Modern Healthcare: Gilead Applied For Hospital Add-On Payment For Remdesivir
Gilead has applied to CMS for a Medicare add-on payment for the FDA-approved COVID-19 treatment remdesivir, according to federal filings. If the normal timeline for obtaining a New Technology Add-On Payment applies, the earliest a payment would be effective is October 2021. There's a chance that the prevalence of the coronavirus could be mitigated by that time if vaccines are effective and distributed quickly, but the payment would still apply if CMS approves it. (Cohrs, 11/19)

Stat: Hospitals Scramble To Solve Challenges With New Covid-19 Drug 
When the federal government started handing out a newly authorized Covid-19 treatment last week, some hospitals weren’t sure they should accept their share. On the surface, it sounded crazy. Decline a medication that might keep patients from getting severely ill? But like so many other pandemic-time medical decisions, this one offered only flawed choices. (Boodman, 11/20)

NPR: ApiJect To Get $590 Million Loan For Device To Help Deliver Coronavirus Vaccine
As the nation gears up for a massive vaccination effort, the Trump administration is doubling down on a novel, unproven injection device by providing more than half a billion dollars in government financing for something still awaiting Food and Drug Administration approval. Later Thursday, the U.S. International Development Finance Corp, or DFC, is expected to announce it has extended a $590 million loan to ApiJect Systems America, NPR has learned. The Connecticut company makes a disposable injection device that it says can be mass-produced to deliver vaccines and medications around the world. (Temple-Raston, 11/19)

Reuters: ApiJect Gets $590 Million U.S. Loan To Produce COVID-19 Vaccine Injections
Pre-filled syringe maker ApiJect Systems Corp said on Thursday it has been approved by the U.S. government for a $590-million loan to make single-dose injectors that are capable of delivering nearly all leading COVID-19 vaccine candidates. The loan is part of the Trump administration’s initiatives to bolster the country’s ability to produce drugs and pharmaceutical raw materials. (11/19)

WISTV.com: Columbia Pharmaceutical Company To Package, Fill Millions Of COVID-19 Vaccines
A South Carolina pharmaceutical company will play a huge role in getting a COVID-19 vaccine to the American people. Columbia-based Ritedose Corporation announced Thursday it’s been named a partner in Operation Warp Speed and will be responsible for filling and packaging millions of vaccines. (Coleburn, 11/19)

ABC11 Raleigh-Durham: ApiJect Gigafactory: Campus That Will Be Used For COVID 19 Vaccine Production Will Bring Jobs To Research Triangle Park, North Carolina 
Many companies in central North Carolina are already on the forefront of the fight against COVID-19. Now another facility is being built in Research Triangle Park. Pre-filled syringe maker ApiJect Systems Corp. announced that it will be building a 'gigafactory' that will assist in the distribution of vaccines -- including the highly-anticipated COVID-19 vaccine. (11/19)

Stat: Purdue Was Advised To Pay Rebates To Insurers For Each Overdose
As Purdue Pharma faced serious challenges to OxyContin sales, the company was advised to consider paying rebates of up to $14,000 to health insurers for each patient who was harmed by its opioid painkiller in order to maintain those crucial business relationships, according to court documents. (Silverman, 11/19)

In other news —

Crain's New York Business: Newer Drugs Improve Health Outcomes, Lower Care Costs: NYC Study
Prescription drug costs have skyrocketed in the U.S. in recent years. But research from Columbia Business School in Morningside Heights found that access to newer medications increases patients' likelihood of taking them, improving health outcomes and decreasing care costs. The research, which was announced this week, from Frank Lichtenberg, professor of healthcare management, found that patients are 2.5% more likely to start and stay on a course of treatment for every 10-year decrease in a drug's time on the market. That's equivalent to a $0.35 reduction in copayment for each day of a patient's therapy. (Henderson, 11/19)

Stat: A Leading AI Researcher Calls For Standards To Ensure Equity And Fairness
A top researcher at the Massachusetts Institute of Technology on Thursday said that artificial intelligence systems developed for medicine must be more transparent and judged against a set of common standards to ensure fairness and equity. (Ross, 11/19)

Milwaukee Journal Sentinel: Milwaukee Health Staffers Facing Death Threats, Doxxing, Officials Say
Milwaukee Health Department staffers are facing death threats and online "doxxing" over the enforcement of coronavirus orders, and in some cases people have shown up looking for workers, city officials said Thursday. The Milwaukee Journal Sentinel reported this week on a death threat health staffers received after attempting to enforce the city's order aimed at combating the spread of COVID-19 during a Saturday rally held by supporters of President Donald Trump outside Serb Hall. (Spicuzza, 11/19)

NPR: A National Group For Christian Doctors Pleads With Churches To Worship At Home
As coronavirus cases spike, a national group that represents thousands of evangelical Christian doctors and other healthcare providers is asking churches to stop holding services in person. In a statement provided to NPR, titled, "A Plea to Our Churches," leaders of the Christian Medical & Dental Associations say that Christians who persist in holding large gatherings at this time could "appear to care only about our individual freedoms and don't care that we may be contributing to others getting this illness because of our selfishness." (McCammon, 11/19)

The New York Times: Hospitals, Health Care Workers Issue A Call To Arms For Wearing Masks
“Our shields are worn. Our resolve is being tested.” So say the most immediate, frontline health care workers in a new ad campaign as the coronavirus pandemic rages across the United States, breaking records nearly every day for deaths — and cases — in state after state. The campaign, in print and video, by about 100 of the nation’s largest and best-known hospital groups begins on Thursday, and aims to counter public resistance to mask-wearing. (Abelson, 11/19)

CNN: 'Busting Out Of The Seams': West Texas Hospitals Pushed To The Limit In Unprecedented Covid-19 Surge 
Denise Mourning tried to hold back the tears behind her face shield. The acute care nurse practitioner in Odessa, Texas, was reflecting on the emotional arc of the coronavirus pandemic, one that began with a sense of unity but has unraveled into exasperation." At first it was, 'Thank you so much, you're frontline, we appreciate what you're doing,'" she said. "And now, I mean, I'm getting threats." (Killough and Jimenez, 11/19)

The Washington Post: Utah Hospital Workers Rushed To NYC To Help With Covid In The Spring. NYC Workers Just Returned The Favor. 
Darya Haurylava was exhausted and overwhelmed, and so was everyone around her. It was April, and coronavirus cases flooded the New York City hospital where she is an intensive care nurse. “The number of cases kept rising every day — every single patient in my ICU was breathing on a ventilator,” she said. “It felt like the whole world had stopped making sense.” (Free, 11/19)

CNN: Coronavirus Terrified This Doctor When It Stole His Ability To Breathe
When coronavirus first hit in March, Dr. David Burkard found himself having some of the toughest conversations of his life. He had to let patients know when it was time to say their final goodbyes to their families. "The hard thing is having to be the person that talks to the patient with Covid, who says, 'You know what? It's time to call your wife. We are going to have to put a breathing tube down and it's time for you to say goodbye,'" Burkard said. (Sidner, 11/19)

KHN: These Front-Line Workers Could Have Retired. They Risked Their Lives Instead. 
Sonia Brown’s husband died on June 10. Two weeks later, the 65-year-old registered nurse was back at work. Her husband’s medical bills and a car payment loomed over her head. “She wanted to make sure all those things were taken care of before she retired,” her son David said. ... But her invincibility couldn’t withstand COVID-19, and on 29 July she died after contracting the deadly virus. (Dubnow, 11/20)

Also —

KHN: Florida’s New Hospital Industry Head Ran Medicaid In State And Fought Expansion 
With its choice of a new leader, the Florida Hospital Association has signaled that seeking legislative approval to expand Medicaid to nearly 850,000 uninsured adults won’t be among its top priorities. In October, Mary Mayhew became the association’s CEO. Mayhew, who led the state’s Medicaid agency since 2019, has been a vocal critic of the Affordable Care Act’s Medicaid expansion adopted by 38 other states. She has argued that expansion puts states in a difficult position because the federal government is unlikely to keep its financial commitment to pay its share of the costs. (Galewitz, 11/20)

Stat: Delirium Could Signal Covid-19 Infection In Older Adults, Study Finds 
Delirium may be an early warning sign of Covid-19 infection in older adults, a new study has found. In some cases, it was the only symptom in patients who tested positive for the virus. More than one-fourth of older patients in the study arrived at hospital emergency rooms with delirium, and 37% of these patients had no typical Covid-19 signs, such as fever or shortness or breath. (Cooney, 11/19)

CIDRAP: Delirium Fairly Common In Older COVID-19 Patients 
A study published today in JAMA Network Open shows that 28% of older COVID-19 patients at seven US emergency departments (EDs) had delirium, putting them at higher risk of an intensive care unit (ICU) stay and death. A research team led by Massachusetts General Hospital scientists found that, of 817 COVID-19 patients 65 and older arriving at EDs, 226 (28%) had delirium, which was the sixth most common of all signs and symptoms. Delirium was a primary symptom in 37 (16%) of patients with delirium. Eighty-four patients with delirium (37%) had no typical COVID-19 symptoms, such as fever or shortness of breath. (Older adults are less likely than younger people to respond to infection with a fever.) (Van Beusekom, 11/19)

Also —

ABC News: Number Of COVID-19 'Long Haulers,' Survivors Experiencing Lasting Virus Symptoms, Is Growing 
New mothers often experience many sleepless, tired nights taking care of their newborns. But for Reyna Lopez, the past five months have been a brutal nightmare -- she was diagnosed with COVID-19 just two months since giving birth. "I had a fever. I had chills. I would get very dizzy and lightheaded when I would have any movement -- sitting down, standing up, just turning my head. I was getting nauseous. My body was hurting," said Reyna. (Schwartz-Lavares, Reshef, Pearle and Yamada, 11/18)

Nature: What The Data Say About Asymptomatic COVID Infections
How many people don’t experience any symptoms after becoming infected with SARS-CoV-2? And what is their role in spreading COVID-19? These have been key questions since the beginning of the pandemic. Now, evidence suggests that about one in five infected people will experience no symptoms, and they will transmit the virus to significantly fewer people than someone with symptoms. But researchers are divided about whether asymptomatic infections are acting as a ‘silent driver’ of the pandemic. (Nogrady, 11/18)

Nature: How To Shift Into COVID-19 Research
As a postdoctoral researcher in disease ecology at the University of Montpellier, France, Amandine Gamble spent the first two months of 2019 hunting down unsuspecting albatrosses on the Falkland Islands. Gamble was finishing some fieldwork on avian cholera, which required her to sneak up on the massive seabirds to take blood samples. A little more than a year later, the tables were turned: this time, Gamble was being pursued. (DePaul, 11/20)

Stat: Cancer Vaccine Cocktail Boosts Immune Response After Surgery, Study Says
Immunotherapies have transformed cancer care by enlisting the body’s own immune system to fight tumors that have evaded or hijacked normal defenses. But while checkpoint inhibitor drugs and bespoke CAR-T treatments have gained significant ground in recent years, another type of immunotherapy — cancer vaccines — have seen far less success. (Cooney, 11/20)

Medical News Today: Combination Cancer Vaccine Effective In Mouse Models
A team of scientists has recently developed a new vaccine for treating cancer, and it has shown promising results in mice — even in difficult-to-treat cancer. The treatment combines chemotherapy and immunotherapy in a single injection, which may open the door to a personalized, highly effective, and easy-to-administer therapy. (Huzar, 11/17)

Science: ‘Exceptional’ Cancer Patients Yield Clues To Better Drug Treatments 
Although even the best cancer drugs don’t buy much time for most people whose cancer has spread, there are rare exceptions: the patients whose multiple tumors melt away and who remain healthy years later. Researchers have long dismissed these “exceptional responders” as unexplainable outliers. Now, an effort to systematically study them is yielding data that could help improve cancer treatments. (Kaiser, 11/19)

In news about HIV and AIDS —

The New York Times: H.I.V. Death Rates Fell By Half 2010-2018, C.D.C. Says
Deaths related to H.I.V. in the United States fell significantly from 2010 through 2018, regardless of sex, age, race or region, the Centers for Disease Control and Prevention reported on Thursday. The death rate declined over all by about half, a welcome sign in the fight against the virus, experts said. But the data also highlighted some troubling trends: Gains among women, Black people and those of multiple races were much smaller. And the rate of death was about twice as high in Southern states as in the Northeast. (Mandavilli, 11/19)

Axios: U.S. HIV Death Rate Dropped By Roughly Half Between 2010 And 2018 
HIV-related deaths in the United States decreased significantly between 2010 and 2018 for all genders, ages, races and regions of the country, the Centers for Disease Control and Prevention reported in its weekly Morbidity and Mortality report on Thursday. The big picture: CDC researchers said in a new analysis that the decline is likely the result of improvements in diagnosing infections, treatment and medical care, but noted the data highlights higher death rates among women and people of color. (Knutson, 11/19)

NPR: A Long-Lasting, More Effective HIV Drug Is A Psychological Relief For Patients
Steven used to take a pill every morning to control his HIV. Then he heard about a study for a ground-breaking treatment where he wouldn't have to take any pills at all. "I get an injection in each butt cheek once a month," says Steven, an attorney based in Pittsburgh, Pa., who tested positive in 2015.He's asked us to withhold his last name because while he came out as gay last year, he hasn't come out to all his professional contacts. The drug he's getting is called Cabenuva. It's one of a new type of anti-AIDS drugs that need to be taken only a few times a year. (Beaubien, 11/19)

Las Vegas Review-Journal: Carson City Official Calls For Field Hospital To Treat Prisoners
The Carson City manager on Thursday requested that the state supply a field hospital to treat the 470 prisoners who have tested positive for the coronavirus at Warm Springs Correctional Center, which advocates and family members said is a “human rights crisis.” During Nevada’s weekly COVID-19 task force meeting, Carson City Manager Nancy Paulson called for the Department of Corrections to establish a field hospital “in an effort to reduce the impact of our overall hospital operations” at Carson Tahoe Regional Medical Center. (Newberg, 11/19)

In other health industry news —

Modern Healthcare: Blues Patient-Matching Project Hits 99.5% Accuracy
The Sequoia Project, a healthcare interoperability not-for-profit, on Thursday released a supplement to a patient-matching framework it released in 2018, this time focusing on matching people between payers. The supplement, a case study with the Blue Cross and Blue Shield Association, reports reaching a 99.5% accuracy rate when matching members to their records by creating a new member-matching algorithm, applying principles from the Sequoia Project's 2018 framework for cross-organizational patient identity management. (Kim Cohen, 11/19)

Modern Healthcare: Provider Groups Urge Congress To Pare Back MACRA Requirements
Nineteen provider organizations asked Congressional leaders to lower some Quality Payment Program requirements. The letter, sent on Thursday, claims many clinicians can't meet key thresholds in the Quality Payment Program going into effect Jan. 1, 2021, and will drop out of the program as a result. The Medicare Access and CHIP Reauthorization Act of 2015, which established the Quality Payment Program, requires in 2021 that clinicians receive at least 75% of Medicare part B payments through an advanced alternative payment model or see at least 50% of Medicare beneficiaries through the advanced model in order to receive a 5% bonus on part B Medicare claims. The requirements are different from 2020 when 50% of Medicare part B payments or 35% of Medicare beneficiaries have to be through the advanced alternative payment model to qualify for the bonus. (Castellucci, 11/19)

Modern Healthcare: Nuance To Sell Transcription, EHR Go-Live Services Businesses
Nuance Communications on Wednesday unveiled plans to sell two of its business lines in a move to focus on its artificial intelligence work. Burlington, Mass.-based Nuance plans to sell its health information management transcription and electronic health record go-live services business to a newly formed company, dubbed DeliverHealth Solutions, in early 2021. DeliverHealth is an independent company; however, Nuance is a minority shareholder and will provide it with technology support. (Kim Cohen, 11/19)

Las Vegas Review-Journal: COVID-19 Cases Increase Among TSA Employees Nationwide
As coronavirus cases surge across the country, there also has been a spike in positive cases in Transportation Security Administration employees at the nation’s airports. There have been 24 new cases of COVID-19 among TSA officers at McCarran International Airport reported since Oct. 22, according to TSA data. Since the pandemic began, the total number of TSA employees testing positive for the virus at McCarran sits at 65. (Akers, 11/19)

CNN: Flying During A Pandemic: The Risks And How To Make It Safer 
In any other year, we'd be happily flying over the rivers and past the woods to get to Grandma's house more quickly for the holidays. But it's 2020, and globally there are more than 1.3 million deaths from the novel coronavirus so far -- with no end in sight. "I'm particularly worried about air travel," said pediatrician Dr. David Rubin, who directs PolicyLab, a research and public policy center at Children's Hospital of Philadelphia. The center is tracking Covid-19 cases in communities across the country. (LaMotte, 11/18)

The Washington Post: Travel During Covid-19: These 3 Tools Detail Quarantine And Testing Policies 
Since the coronavirus pandemic began in March, many states have implemented rolling travel restrictions that change often. The coronavirus case rates in both a traveler’s origin and destination can determine if a trip across state lines — even a short one — could result in necessary tests or quarantine. Now with a surge of U.S. infections, even more states are updating their policies and tightening their restrictions ahead of the holiday travel season. (McMahon, 11/19)

KHN: Fear Of Flying Is A COVID-Era Conundrum
The holidays are approaching just as COVID-19 case rates nationwide are increasing at a record-breaking pace, leading to dire warnings from public health experts. The Centers for Disease Control and Prevention has issued cautions and updated guidelines related to family gatherings. Dr. Anthony Fauci, a White House coronavirus adviser and director of the National Institute of Allergy and Infectious Diseases, said in interviews that his kids won’t be coming home for Thanksgiving because of coronavirus risks. “Relatives getting on a plane, being exposed in an airport,” he told CBS News. “And then walking in the door and saying ‘Happy Thanksgiving’ — that you have to be concerned about.” (Knight, 11/20)

In sports and celebrity news —

USA Today: Former Notre Dame Football Coach Lou Holtz Tests Positive For Coronavirus
Legendary college football coach Lou Holtz has confirmed he has tested positive for COVID-19. Holtz, 83, told ABC Columbia on Thursday that he is recovering from the virus. “I don’t have a lot of energy right now,” said Holtz, who's best known for his 11-year tenure at Notre Dame that included a Fiesta Bowl win and a national championship in the 1988 season. (Gardner, 11/19)

USA Today: Cowboys QB Andy Dalton Still Hasn't Fully Regained Sense Of Taste, Smell After COVID-19 Bout
Sixteen days after landing on the reserve/COVID-19 list, Andy Dalton’s sense of taste and smell still elude him. “You can tell things are sweet,” the Cowboys quarterback said Thursday from the Star. “You can tell things are salty. You just don’t get the flavor with it.” After a whirlwind month battling a concussion and then the novel coronavirus, Dalton will settle for that. (Epstein, 11/19)

AP: Pac-12 Allows Flexibility To Schedule Nonconference Games
The Pac-12 Conference has approved a plan to allow member schools to schedule nonconference football opponents subject to certain conditions if games are canceled. The conference has had five of its 18 scheduled games during the first three weeks canceled amid COVID-19 issues. California and UCLA were able to schedule a game against each other last weekend on 45 hours’ notice after Cal’s game against Arizona State and UCLA’s matchup against Utah were canceled due to the Sun Devils and Utes having several positive COVID-19 tests. (11/19)

The Washington Post: As Her Partner Battles Covid-19, A Quarantined Rachel Maddow Pleads: ‘Don’t Get This Thing’
After two weeks away from her nightly MSNBC show, Rachel Maddow returned on Thursday night in a live-feed broadcast from her living room. As the show began, an emotional Maddow told viewers the reason behind her previously unexplained absence. Her partner of 21 years, the artist and photographer Susan Mikula, tested positive for the novel coronavirus almost two weeks ago and then became seriously ill. (Shepherd, 11/20)

USA Today: Schools Are Closing For Millions Of Kids As Teachers Get Sick And COVID Cases Surge. Some Districts Are Holding Out.
The dominos are beginning to fall at America's schools. After weeks or months of operating in person, schools are shifting students back to remote learning as the nation grapples with soaring COVID-19 infections. Starting Monday, millions more students will be connected to their teachers only by whatever internet or phone connection they can secure. (Richards and Aspegren, 11/20)

CNN: 'An Incredibly Traumatic 24 Hours': New York City School Closures Set Off New Round Of Infighting 
New York City's decision to close schools as coronavirus rates rise has set off a torrent of political infighting and a fresh round of public frustration over muddled -- and occasionally conflicting -- messages from city and state leaders. (Moghe and Krieg, 11/19)

The New York Times: NYC Parents Say School Shutdown Hurts Children: 'Remote Learning Is Not Working'
Laura Espinoza took an hourlong subway ride on Thursday morning from her Brooklyn neighborhood to City Hall, where she joined several dozen families gathered to protest Mayor Bill de Blasio’s decision to shut down the nation’s largest school system as virus cases have surged across the city. Ms. Espinoza has 6-year-old twins, both of whom have disabilities. They were attending school five days a week, a rarity for city students, but now they will have classes at home indefinitely. (Shapiro and Kim, 11/19)

The Washington Post: A Maskless Teacher With Covid-19 Came To Work. The Day Care Told Parents Covid Was A Hoax. 
The complaints started to mount after a teacher who tested positive for the coronavirus had been at work maskless — working with toddlers and infants. In fact, no one was wearing masks at Little Lambs Christian Dayschool, the day care at Fairlawn Christian Academy in Radford, according to Virginia Department of Health records. But on Monday, Pastor Stephen Phillips sent a memo to parents, telling them that there was nothing to be worried about — and that they shouldn’t trust federal health authorities. (Flynn, Pulliam Bailey and Boorstein, 11/19)

In related news —

NPR: Use It Or Lose It: Parents Set Wages Aside For Child Care. Now It's At Risk
Norah Perez's children had been going to day care since they were four months old. That came to an abrupt end this spring when the coronavirus hit and their day care closed. Like many parents, Perez initially thought it might last a few weeks. Turns out, that was wishful thinking. Now, she could lose some of the money she set aside from her paycheck, pre-tax, to pay for day care. She has $2,200 stuck in what's called a dependent-care flexible spending account, money that is "use it or lose it" unless Congress or the IRS act. (Hsu, 11/19)

USA Today: Teens Glued To Screens In COVID Pandemic Need Sleep And Reality Checks, Experts Say
Young people have turned to digital devices to fill holes left by the COVID-19 pandemic, a practice that elevates depression, anxiety and hopelessness, suggests a California study released Wednesday. "Our kids weren't built to live their lives chained to supercomputers," said Jennifer Siebel Newsom, who is married to the California governor and founder of the California Partners Project, which wrote the study alongside the Child Mind Institute.  (Aspegren, 11/18)

AP: US Adult Smoking Rate Looks Unchanged, Vaping Rate Higher
The U.S. decline in cigarette smoking could be stalling while the adult vaping rate appears to be rising, according to a government report released Thursday. About 14% of U.S adults were cigarette smokers last year, the third year in a row the annual survey found that rate. But health officials said a change in the methodology make it hard to compare that to the same 14% reported for 2017 and 2018.The adult smoking rate last saw a substantial drop in 2017, when it fell from 16% the year before. (Stobbe, 11/19)

Reuters: Big Tobacco Gets A Pandemic Pick-Me-Up
In homes across the world, people ... are giving Big Tobacco a boost during the pandemic, despite public health advice that smoking increases the risk of severe illness from COVID-19. A combination of anxiety, boredom, stress, and the unexpected freedoms of social isolation are among reasons they give. In recent weeks, tobacco companies Philip Morris International Inc, Japan Tobacco Inc (JT), Imperial Brands Plc and Altria Group Inc all raised their sales or profit targets, saying the industry had done better than expected, mostly in the United States and Europe. Imperial said staying home in the pandemic gave people more chances to smoke and more cash to spend. (Geller and Cavale, 11/19)

In other public health news —

USA Today: Execution Of Only Woman On Federal Death Row Delayed After Her Attorneys Contract COVID-19
A federal judge has delayed the execution of the only woman on federal death row after two of her attorneys — Tennessee-based public defenders — contracted severe cases of COVID-19. Lisa Montgomery's execution has been delayed until at least Dec. 31 under an order filed Thursday by U.S. District Judge Randolph D. Moss in Washington, D.C. A new date has not yet been set. (Timms, 11/19)

The Washington Post: Rationing Is Back For Toilet Paper And Disinfecting Wipes
Consumers are panic-buying key items again as the coronavirus surges across the country — paper towels, disinfecting wipes, baking mixes and wine — but this time around, grocery chains and food manufacturers say they will be able to meet America’s urge to hoard and keep supply chains moving, even during the holiday season. While Kroger, Giant, Target and other grocery chains have reinstated limits on high-demand items such as paper goods and disinfecting wipes, causing anxiety among shoppers, retailers and supply chain experts say they do not expect a return to the panicked hoarding and empty shelves of the spring. (Reiley and Bhattarai, 11/19)

The Washington Post: The Pandemic Isn't Ending Anytime Soon. And Our Bodies Are Feeling The Stress. 
The story of the pandemic is written on our bodies, from our eyes to our brains, on our teeth and our skin, all the way down to our feet. And that’s without actually even contracting the coronavirus. This abnormal way we’ve been living — in lockdown and online, masked and under stress, praying and caring for those who have this deadly disease while trying to avoid it ourselves — is showing itself in remarkable ways to physicians across the nation. (Dvorak, 11/19)

ABC News: 'Wrecked Our Lives': Families Of 3 Young Adults Who Died From COVID-19 Share Heartbreaking Stories 
Michael Lang, an 18-year-old who grew up in a close-knit community in La Grange, Illinois, was ready for the next chapter in his life: college. The teen, who loved the outdoors and fishing, wasn't anxious about heading off to the University of Dayton during the pandemic. (Shapiro, 11/19)

Also —

Dayton Daily News: Air Force Needs Volunteers To Test New Maternity Uniform
The Air Force Uniform Office is asking for for pregnant service members at Wright-Patterson Air Force Base to try out the new Maternity Flight Duty Uniform in fit-and-wear tests in January. ... In September last year, the Air Force updated its policy to reduce barriers on pregnant aviators who perform flight duties and have uncomplicated pregnancies. This update allows the continuation of flight duties during pregnancy, said the office, part of the Air Force Life Cycle Management Center, which is based at Wright-Patterson. (Gnau, 11/19)

The Washington Post: Light Box Therapy Lamps Could Help With Seasonal Depression 
For some people, the beginning of winter signals more than a change in weather. The shorter, darker days trigger a noticeable shift in their mood and behavior, causing what’s known as seasonal affective disorder, or SAD. And this winter, the onset of SAD may be exacerbated by the coronavirus pandemic. Cases are surging nationwide again, prompting another round of restrictions and lockdown measures in some places.“Folks are noticing [seasonal depression] a lot more because of trying to maintain their social distancing and quarantine and follow the rules related to stay-at-home,” said Dorothy Sit, an associate professor of psychiatry and behavioral sciences at Northwestern University’s Feinberg School of Medicine. (Chiu and Raben, 11/18)

The Washington Post: Woman Sues After Learning ‘Anonymous’ Sperm Donor Was Her Own Fertility Doctor 
When a relative gave her a genealogy kit as a Christmas present last year, Julie Druyor made three shattering discoveries. First, that she had a half brother. Second, that the man who raised her was not her biological father. Third, that her biological father was her mother’s fertility doctor. Druyor’s mother, Katherine Richards, is now suing the doctor, Michael Kiken, who she says effectively assaulted her 40 years ago. (Weiner, 11/19)

KHN: KHN On The Air This Week
KHN Midwest correspondent Lauren Weber discussed COVID-19 surges in Wisconsin with Wisconsin Public Radio’s “Central Time” on Nov. 13. ... California Healthline correspondent Angela Hart and editor Emily Bazar discussed how the Supreme Court case about the Affordable Care Act could affect California with the CalMatters and Capital Public Radio’s “California State of Mind” podcast. (11/20)

The Washington Post: Democrats Say ICE Must Not Deport Women At Georgia Facility Who Accused Gynecologist
A group of more than 100 congressional Democrats demanded Thursday that U.S. Immigration and Customs Enforcement release female detainees from a Georgia detention facility who allege they received subpar gynecological care while detained there. The lawmakers say the women may be potential witnesses in an ongoing federal investigation into Mahendra Amin, a physician who the women allege conducted “nonconsensual and medically unnecessary” gynecological procedures on female detainees at Irwin County Detention Center. Their letter calls for the women to receive necessary certifications for a chance to apply for U-visas, which allow undocumented immigrants who have assisted law enforcement to apply to stay in the country legally. (Armus, 11/19)

In news from Iowa, Arkansas and Nebraska —

The Washington Post: Tyson Foods Supervisors Placed Bets On How Many Workers Would Catch Coronavirus, Lawsuit Says 
As the novel coronavirus ripped through a pork processing plant in Waterloo, Iowa, in April, Tyson Foods supervisors not only kept the facility open — they also placed bets on how many workers would catch the virus, a recent wrongful death lawsuit claims. More than 1,000 employees eventually tested positive amid the outbreak, which eventually shut down the meat-processing plant and spurred harsh condemnations from local officials who said the company had failed to provide the necessary protections for its workforce. (Shepherd, 11/19)

Arkansas Democrat-Gazette: Treatment Plant Part Of Study On Detecting Coronavirus In Waste
Health officials have warned of the various ways that the coronavirus can spread. According to the Centers for Disease Control and Prevention, the virus that causes covid-19 is spread mainly from person to person, mostly through respiratory droplets produced when an infected person coughs, sneezes or talks. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. An ongoing study at Pine Bluff Wastewater Utility, conducted by Camila Silva of the National Center for Toxicological Research, has detected the virus in the wastewater at the Boyd Point Wastewater Treatment Facility. (Colvin, 11/19)

USA Today: Nebraska Server Loses Job Over Video Of Maskless Gov. Pete Ricketts
Karina Montanez was fired this week for violating her employer's social media policy after sharing a video of Nebraska Gov. Pete Ricketts without a mask inside an Omaha-area sports bar. She doesn't regret it, either. Montanez originally posted the video of the Republican governor on Nov. 3 – the night of the election – on her Snapchat account before sharing it on Twitter. It gained widespread attention on Tuesday and, hours later, she got a call from her boss who fired her from her job as a server at DJ's Dugout. (Flores, 11/19)

In news from North Carolina, Kentucky, New Jersey and the Washington, D.C., metro area —

AP: 3 More Dead From COVID-19 Outbreak Linked To NC Church
Health officials said Thursday that three more people have died of coronavirus complications linked to a series of convocation events at a North Carolina church last month, raising the death toll to 12. Large crowds attended events at the United House of Prayer for All People in October in west Charlotte. In that time, public health contact tracers and Mecklenburg County officials have connected 213 COVID-19 cases to the events, which includes attendees and people who came in close contact with participants, The Charlotte Observer reported. (11/20)

Courier-Journal: Beshear Asks Kentucky Religious Leaders To Suspend In-Person Services To Curb Virus Spread
Kentucky Gov. Andy Beshear asked religious leaders Thursday to suspend in-person services at houses of worship, resurfacing a controversial issue in Kentucky's battle to curb the surging coronavirus. And while some members of the Kentucky Council of Churches are receptive to the idea, other church officials immediately rejected the request and said they won't change their plans. (Tobin and Archie, 11/19)

The New York Times: How 'Magic' Mushrooms Caused A Snag In NJ's Marijuana Legalization 
Winning a constitutional right for adults to smoke pot in New Jersey was, apparently, the easy part. The ballot question drew overwhelming support on Election Day, in spite of a muted pandemic-era campaign that had minimal financial backing from the national cannabis industry. But creating a legislative pathway to reach proponents’ goals — establishing New Jersey as the dominant East Coast marijuana market, right next to New York, while ending the disproportionate rates of arrest in minority communities — is proving to be far more complicated. (Tully, 11/19)

The Washington Post: Smithsonian Museums, Zoo To Close As Coronavirus Caseload In D.C. Region Hits Record For 16th Day
The Smithsonian Institution [announced] it will temporarily close eight facilities in the Washington region that had reopened. It did not announce a reopening date, but officials said the closure will last at least through January. (Hedgpeth and Wiggins, 11/19)

The Washington Post: Forensic Genetic Genealogy: DOJ Grant To Prince George' Could Solve Cold Cases With DNA Tracing 
Prince George’s County is one of 10 jurisdictions across the country that will receive a $470,000 grant from the Justice Department to reopen cold cases using forensic genetic genealogy — a new investigative technique that draws on privately curated DNA databases from popular genealogy websites to compare with samples collected from crimes. The funding could help investigators reopen as many as 60 cold cases over the next three years, Prince George’s prosecutors and police said at a news conference Thursday. (Mettler, 11/19)

Reuters: Exclusive: EU Could Pay Over $10 Billion For Pfizer And CureVac Vaccines - Source
The European Union could pay more than $10 billion to secure hundreds of millions of doses of the vaccine candidates being developed by Pfizer-BioNTech and CureVac, an EU official involved in the talks told Reuters. The bloc has agreed to pay 15.50 euros ($18.34) per dose for the COVID-19 vaccine candidate being developed by Pfizer and BioNTech, according to the official. (Guarascio, 11/20)

AP: Mexico Tops 100,000 COVID-19 Deaths, 4th Country To Do So
Mexico passed the 100,000 mark in COVID-19 deaths, becoming only the fourth country to do so amid concerns about the lingering physical and psychological scars on survivors. José Luis Alomía Zegarra, Mexico’s director of epidemiology, announced late Thursday that Mexico had 100,104 confirmed COVID-19 deaths, behind only the United States, Brazil and India. (Delgado, 11/20)

Reuters: Patriarch Of Serbian Orthodox Church Dies Of COVID-19 
Patriarch Irinej, the head of the Serbian Orthodox Church, has died after contracting COVID-19, President Aleksandar Vucic said on Friday. Church bells tolled in Belgrade and many people flocked to the capital’s main St Sava cathedral to mark his death at the age of 90, a decade after becoming Patriarch. (Vasovic, 11/20)

The New York Times: Inside The Chaotic, Cutthroat Gray Market For N95 Masks 
In his 30 years as a doctor, Andrew Artenstein had never worried about N95 respirators. The chief physician executive of Baystate Health, he ran his four hospitals in western Massachusetts exactingly, and an essential face covering being out of stock was inconceivable. His doctors, nurses and other responders went through about 4,000 a month, usually for treating patients with airborne diseases. There were always more in the warehouse, just outside the city of Springfield, where Baystate is based. But on April 6, as the novel coronavirus stampeded through the Northeast, Artenstein rose in predawn darkness, on a mission to secure about a quarter-million masks for his thousands of staff members. Baystate Health was just days away from running out. (Bock Clark, 11/17)

The Washington Post: A 28-Year-Old ‘Nerd’ In Baltimore Invented A New Type Of Mask, And Tapped Into The Strangeness Of This 2020 Holiday Season 
Narwhals are social creatures. The whales with spiraled tusks jutting from their heads have been known to live in small groups that, at times, come together to form large pods. In that way, they are not unlike humans during the holidays. That alone would have made the name Narwall Mask fitting for the product Alex Rattray invented and publicly launched this week. When the Baltimore resident first started creating the full-face mask based on snorkeling gear, he held hopes it would bring people together during a pandemic that was forcing them apart. (Vargas, 11/18)

Los Angeles Times: T-shirt? Towel? Some Experts Say It’s Time To Get Beyond States’ Anything-Goes Approach To Masks
With more states requiring face coverings indoors to prevent the spread of COVID-19, gaiters and bandannas have become popular accessories, particularly among college students and other young adults. Less restrictive than masks, they can easily be pulled up or down as needed — and don’t convey that just-out-of-the-hospital vibe. But tests show those hipper face coverings are not as effective as surgical or cloth face masks. Bandannas, like plastic face shields, allow the virus to escape out the bottom in aerosolized particles that can hang in the air for hours. And gaiters are often made of such thin material that they don’t trap as much virus as cloth masks. (Hawryluk, 11/18)

The Wall Street Journal: Covid-19 Pandemic Underscored Importance Of IT In Medical Research
Data storage, cloud computing and artificial intelligence were important tools for Covid-19 investigators this year, as scientific teams learned about the virus and its impact on patients. Beginning in March, multidisciplinary teams with skills in medical imaging analysis and machine learning were critical for sifting through large Covid-19 data sets, said Jayashree Kalpathy-Cramer, scientific director at the Center for Clinical Data Science. The center is part of Massachusetts General Hospital and Brigham and Women’s Hospital in Boston. “Many of us dropped all other research and tried to focus entirely on doing Covid modeling,” Dr. Kalpathy-Cramer said. (Casetellanos, 11/13)

Modern Healthcare: Tattoos With Microsensors Could One Day Warn Of Health Risks
Someday, your tattoo may do more than adorn your skin. It could save your life—or at least alert you to a medical threat. That’s the proposition behind research by Carson Bruns, assistant professor of materials, biomedical, micro/nanoscale at the University of Colorado at Boulder. (11/14)

Undark: Wasp Venom Can Save Lives. But The Supply Chain Is Shaky.
One morning in the fall of 2019, Zach Techner stepped into a heavily woven white beekeeper’s suit, pulled on rubber boots and thick orange gloves, and wrapped duct tape around his cuffs and along the zipper. He slid safety glasses over his eyes and a netted hood over his head and zipped it shut. He was preparing to collect one of the most dangerous wild creatures in the United States: yellow jackets. (Hoag, 11/16)

The Washington Post: Echoes Of A Pandemic: Experts Fear Lessons From The 2009 H1N1 Vaccine Drive Are Being Ignored
News that a vaccine would be available in record time brought relief to Kelly Moore, director of the Tennessee Immunization Program, and a whole new set of worries: how to build a network of pandemic vaccine providers from scratch and guarantee equitable access to communities of color and rural spots across the state’s 95 counties. It was just over a decade ago, and the H1N1 influenza virus was rampaging across the country. “We invested huge amounts in 2009,” said Moore, now associate director of the vaccine education organization Immunization Action Coalition, describing a whirlwind of spreadsheets and brainstorming sessions that ultimately brought 1,500 pharmacies, hospitals and clinics together in a coordinated operation. (Stead Sellers, 11/7)

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NPR: More People Can Access Surgery. That's Great For Them, Awful For The Planet
Add surgeries to the list of human activities making the climate hotter and more volatile. "Surgical, obstetric, and anaesthesia care is one of the major contributors to climate change within the health sector," according to an article published this month in The Lancet scientific journal by doctors and researchers from the Harvard T.H. Chan School of Public Health. They worry that the climate impact of current surgical practices will get worse as lifesaving procedures become accessible to the 5 billion people around the world, mostly in low- and middle-income countries, who currently can't get them. (Lu, 11/17)

Houston Chronicle: Death Doulas Help The Dying Meet Their End With Affirmation Instead Of Anxiety
Just as birth doulas help expectant parents bring new life into the world, end-of-life doulas help the dying cope with their next journey. They help the dying and their survivors face death with empowerment and affirmation instead of fear and anxiety. Also known as death doulas, these trained professionals provide the terminally ill and their families physical and emotional support before, during and after death. These are nonmedical services that often include relaxation exercises, funeral planning, educating the family on their loved one’s condition and simple companionship. (Guzman, 11/18)

NPR: Inside China's Online Fentanyl Chemical Networks Helping Fuel The Opioid Crisis 
He is a slight, bespectacled man. Colleagues at the industrial materials company where he works describe him as a humorous but diligent employee, known for driving his white Jeep around town in northwestern China's Ningxia region to meet potential clients. Unbeknownst to them, he goes by Benjamin Chen online, where he has a whole other business: He is a popular seller of the chemicals used to make the potent synthetic opioid fentanyl. NPR has identified him but is not using his real name because of the illegal activity in which he's involved. (Feng, 11/17)

The Washington Post: The Unusually Flexible Joints That Gave Her A Boost In Gymnastics Portended A Malady That Took Years To Diagnose 
Tarryn Simone Jacobson remembers walking out of a tryout for an elite New Jersey gymnastics team, climbing into her mother’s car and tearfully announcing she had broken her wrist. Her mother was skeptical: Wouldn’t the coaches have told her if something serious had happened to her 9-year-old? Hours later, X-rays confirmed the little girl’s claim. Jacobson’s growth plate was fractured in several places, the first of multiple sprains, dislocations, torn ligaments and other afflictions that would befall her as a young gymnast and later an adult. (Boodman, 11/14)

The New York Times: Recession With A Difference: Women Face Special Burden
For millions of working women, the coronavirus pandemic has delivered a rare and ruinous one-two-three punch. First, the parts of the economy that were smacked hardest and earliest by job losses were ones where women dominate — restaurants, retail businesses and health care. Then a second wave began taking out local and state government jobs, another area where women outnumber men. (Cohen, 11/17)

The New York Times: Your Bubble Is Bigger Than You Think It Is
Experts and officials are unequivocal: Stay home for the holidays. Getting together with family for Thanksgiving without quarantining beforehand is like “bringing a loaded pistol for Grandma’s head,” Jared Polis, the governor of Colorado, warned earlier this month. Mark Horne, the president of the Mississippi State Medical Association, sketched out grandma’s demise in even more horrifying detail. “You’re going to say ‘Hi’ at Thanksgiving, ‘It’s so nice to see you’,” he said in a recent briefing, and then “you’re either going to be visiting her by FaceTime in the I.C.U. or planning a small funeral by Christmas.” (Farhad Manjoo, 11/20)

Fox News: COVID-Phobia – Americans Should Not Fear Routine Medical Care, They Worry About Not Getting It 
For America's doctors, the greatest public health crisis in a generation has been incredibly bad for business. Eighty-one percent of physicians report that their revenues are still below pre-pandemic levels, according to a survey from the American Medical Association. A separate survey conducted earlier this spring found that only one-third of primary care practices had enough cash on hand to operate for four weeks. These financial struggles could drive doctors into early retirement or other careers -- and thus exacerbate our nation's existing physician shortage. (Sally Pipes, 11/17)

The Washington Post: Schools Are Mostly Covid-19 Safe. Keep Them Open.
Attention is focused on what Michigan Gov. Gretchen Whitmer (D) is closing in the face of an explosion of covid-19 cases: indoor restaurant dining, offices, high schools and colleges. As the pandemic surges, and other governors are facing similar decisions, it is important to focus also on what Whitmer is keeping open and why: schools for kindergarten through eighth grade. She is right to do so. (Danielle Allen and Ashish Jha, 11/19)

The Wall Street Journal: He Was Right About Schools, Too
Post-election, American media outlets seem to be relaxing the unwritten rule that positive comments about President Donald Trump’s policies must be buried beneath several paragraphs of personal condemnations. Yesterday this column noted the underreported accuracy of the President’s vaccine predictions. Today there is a growing if grudging acceptance that his critics have done enormous damage to poor children by rejecting his calls to keep schools open. (James Freeman, 11/19)

CNN: Blue States Are Blowing The Covid-19 Response, Too. We Need A National Response 
This week, America crossed another grim milestone: a quarter of a million people dead from Covid-19. With positive test and hospitalization rates increasing, and winter and the holidays looming, there is every reason to believe that things will get much, much worse before they get better. Unfortunately, our elected officials have failed us at nearly every level, from the White House to governors and city mayors -- and not just in the red states where Covid-19 denial thrives, but in blue cities and states as well. (Jill Filipovic, 11/19)

Bismarck Tribune:  'It Should Be A Wake-Up Call For The Community'
“Our situation has changed, and we must change with it.”-- Gov. Doug Burgum, changing course and issuing a statewide mask mandate. ..."It's kind of like a big runaway train, and the brakes are broken."-- North Dakota State University infectious disease specialist Paul Carson, on the spread of the coronavirus. (11/20)

Stat: Include Public Opinion When Making Medical Rationing Frameworks
When a vaccine for Covid-19 becomes available — and the supply is sure to be limited — who should get it? That depends on who you ask. The Harris Poll released survey data in August that showed how the public believes a future Covid-19 vaccine should be administered. The results were relatively intuitive. Citizens wanted health care workers (73%), people over age 55 (71%), essential workers (60%), and first responders (56%) to receive the first doses. (Mark Dornauer, 11/20)

The Wall Street Journal: Teachers Should Get The Covid Vaccine First
Two vaccine trials reported highly encouraging results in the past week, with both versions looking to be 95% effective or better. If one or both are approved for emergency use, the U.S. might have enough doses for 20 million people in early 2021. How should the initial supply be allocated? Should it be given to populations with a higher mortality risk, or to people who are most likely to spread disease at higher rates? Most agree that America’s 18 million health-care workers should top the list. The 3.3 million teachers should come next. (Aaron Strong and Jonathan Welburn, 11/19)

The Wall Street Journal: A Global Covid Vaccine Heist
Breakthroughs on vaccines and new treatments are finally offering the world a path to end the Covid-19 pandemic. They’re a tribute to private U.S. corporate innovation, but now developing countries led by India and South Africa are making a damaging bid to waive patent protections for these life-saving advances. The attempt will surface Friday when these countries offer a resolution at the World Trade Organization meeting to waive patent protections for Covid vaccines, therapies and other technologies. They say this is needed to ensure poor countries have equal access, but their effort would harm everyone, including the poor. (11/19)

JAMA: How To Leverage The Medicare Program For A COVID-19 Vaccination Campaign
Once a safe and effective coronavirus disease 2019 (COVID-19) vaccine is developed, Medicare data could be used to support a COVID-19 vaccination campaign. This support may include operationalizing the prioritization of vaccine distribution, allocating vaccine to states and local jurisdictions based on the number of individuals at high risk of severe disease, monitoring vaccine uptake, supporting pharmacovigilance once licensed vaccines start to be administered, and identifying waning immunity and potential severe acute respiratory syndrome coronavirus 2 infection and adverse events following vaccination. The analytic support could come from CMS or from external entities with access to comprehensive, up-to-date Medicare data. (Nicole Lurie and Bettina Experton, 11/19)

The Washington Post: Every Day Spent Obstructing The Transition Means More Covid-19 Deaths
The unprecedented obstruction of the transition process by the outgoing Trump administration represents a serious, significant and urgent danger to the American people. As covid-19 cases continue to surge, the incoming Biden administration must immediately be given access to all necessary information and all government departments. Both of us have served as part of the federal government’s response to public health threats, such as H1N1, Ebola and Zika. (Leslie Dach and Nicole Lurie, 11/19)

Stat: A Shortage Of Doctors With Experience Treating Hospitalized Patients Looms
As Covid-19 cases reach a record high in the U.S., models project that this third wave of the pandemic may be the worst yet. The confluence of weather patterns, pandemic fatigue, loose social distancing guidelines, and the upcoming flu season have led to a surge of hospitalizations that will continue to rise over the next few months. (Anjali Bhatla and Kira L. Ryskina, 11/20)