The Washington Post: Nearly 200,000 Deaths, Millions Of Ripples. Each Covid-19 Fatality Shifts Attitudes About The Virus.
As the nation is set to pass another dark milestone in the virus’s long, deadly march — with no end in sight — the political battles over how to curb its spread have stolen much of the nation’s attention, making it more difficult to notice just how searing each death’s impact can be. Two hundred thousand deaths is akin to losing the entire population of Salt Lake City or Montgomery, Ala. — a devastation. It is also the number of covid-19 fatalities that President Trump said at a March 29 news conference would mean that “we all together have done a very good job.” (Fisher, Gowen, Rozsa and Sacchetti, 9/19)

NBC News: U.S. Covid-19 Death Toll Surpasses 200,000
In the predawn hours of March 30, Dr. Deborah Birx stepped in front of the camera on the White House lawn and made an alarming prediction about the coronavirus, which had, by then, killed fewer than 3,000 people in the United States. "If we do things together, well, almost perfectly, we can get in the range of 100,000 to 200,000 fatalities," Birx, coordinator of the White House coronavirus task force, told Savannah Guthrie of NBC News' "Today" show. ... On Saturday, Birx's prediction came true, as the number of lives lost to Covid-19 in the U.S. topped 200,000. (Edwards and Chow, 9/19)

CNN: More Than Half Of States Are Reporting More New Coronavirus Cases As The US Nears 200,000 Deaths
The United States is closing in on the somber milestone of 200,000 deaths from Covid-19 as more than half of states are reporting a rise in cases. The climb comes after many states had seen case numbers decline following a summer resurgence of infections. (Holcombe, 9/21)

The New York Times: With Flags, Crosses And Photos, Mourning 200,000 Dead
The loved ones left behind are trapped in an extraordinary state of torment. They have seen their spouses, parents and siblings fall ill from the virus. They have endured the deaths from a distance, through cellphone connections or shaky FaceTime feeds. Now they are left to grieve, in a country still firmly gripped by the coronavirus pandemic, where everywhere they turn is a reminder of their pain. That aftermath has been uniquely complicated, and cruel. In dozens of conversations, people across the United States who have lost family members to the coronavirus described a maelstrom of unsettled frustration, anger and isolation, all of it intensified by the feeling that the pandemic is impossible to shut out. (Bosman, Kovaleski and Fortin, 9/20)

The New York Times: How The Unpredictable Coronavirus Pandemic Took A Terrible Toll 
It is a staggering toll, almost 200,000 people dead from the coronavirus in the United States, and nearly five times that many — close to one million people — around the world. And the pandemic, which sent cases spiking skyward in many countries and then trending downward after lockdowns, has reached a precarious point. Will countries like the United States see the virus continue to slow in the months ahead? Or is a new surge on the way? (Romero, Fernandez and Santora, 9/20)

Also —

Politico: Testing Czar Says Cases Are Down, Even As U.S. Nears 200,000 Covid-19 Deaths
Even as the U.S. nears 200,000 Covid-19 deaths, HHS testing czar Brett Giroir said Sunday morning that progress was being made on many fronts. “From the peaks in early July and late July, the number of cases are down by 41 percent,” the Health and Human Services official told CNN’s Jake Tapper. “The number of people in an ICU are down 62 percent. The number of deaths are down almost 30 percent. But we have to stay strong and do the things that could decrease the spread.” (Weaver, 9/20)

The Washington Post: ACA And The Supreme Court: How Ruth Bader Ginsburg's Death Could Jeopardize Affordable Care Act 
The death of Justice Ruth Bader Ginsburg injects fresh uncertainty into the future of the Affordable Care Act, as the Supreme Court prepares to consider anew the constitutionality of the law that has reshaped the United States’ health-care system in the past decade. As the senior member of the court’s liberal bloc, Ginsburg was a reliable vote to uphold the ACA in the past and had been expected to do so when the high court reviews the law a third time in its coming term. The sudden shift in the court’s composition provides the latest lawsuit seeking to get rid of the health-care law a greater opportunity, though not a certain victory, while mobilizing Democratic and swing voters focused on the issue in the upcoming elections, according to legal scholars and political analysts. (Goldstein, 9/19)

Vox: What Ruth Bader Ginsburg’s Death Means For Supreme Court’s Obamacare Case 
The Affordable Care Act is coming before the Supreme Court in November — and this time, with no Justice Ruth Bader Ginsburg there to protect the law. Ginsburg, who was appointed to the Court by President Bill Clinton in 1993 and served until her death on Friday, voted to uphold the law in 2012. Along with the three other liberal justices and Chief Justice John Roberts, she saved Obamacare then from a legal challenge that would have invalidated the law entirely. (Scott, 9/18)

The Wall Street Journal: Justice Ruth Bader Ginsburg’s Death Puts Spotlight On Affordable Care Act 
The death of Justice Ruth Bader Ginsburg is a devastating blow to the Supreme Court’s liberal minority, pushing out of reach—should President Trump succeed in gaining confirmation of another nominee—the occasional victory it claimed from a right-moving court by finding common ground with a single conservative justice. It still takes five votes on an eight-member court to issue a decision, so if one justice on the right joins those on the left to produce a tie, the lower-court decision on review remains in force, but produces no nationwide precedent. (Bravin, 9/19)

Vice: Ruth Bader Ginsburg's Death Puts Obamacare In Jeopardy
The death of Supreme Court Justice Ruth Bader Ginsburg has increased the chances that Obamacare could be struck down. A challenge to the landmark healthcare law is scheduled to come before the court on Nov. 10, just days after Election Day. With Ginsburg on the court, there had been five justices who’d protected the law against its earlier challenge in 2012 and appeared likely to protect it against the latest attack from Republican officials. But her Friday death has turned Obamacare’s survival from a seeming sure thing to an open question. (Joseph, 9/19)

BuzzFeed: Obamacare Is In Danger After Ruth Bader Ginsburg's Death
The fight to replace the late justice Ruth Bader Ginsburg on the Supreme Court could determine whether Obamacare is repealed next year, potentially stripping tens of millions of people of their health insurance during a global pandemic. After Republicans in Congress failed to repeal the Affordable Care Act in 2017, 20 red state attorneys general led by Texas launched a lawsuit to have the law overturned by the courts. The case is scheduled to go before the Supreme Court for oral arguments on November 10, one week after the election. A decision could come in the first half of 2021. (McLeod, 9/19)

NBC News: Obamacare May Be Doomed If 8-Member Supreme Court Presses Ahead With Fall Cases
Ruth Bader Ginsburg's death, ending one of the most remarkable careers in American legal history, leaves the Supreme Court under a cloud of uncertainty as it prepares to begin its new term in two weeks, with questions about who will put her successor on the court, when will that happen and how will it affect some of the major cases on the docket — including the fate of Obamacare. Ginsburg's death on Friday leaves eight justices on the court, which raises the prospect of 4-4 tie votes. After Justice Antonin Scalia died in 2016, the remaining justices ended up deferring contentious issues or deciding cases without sweeping rulings. But his death left an even number of generally liberal and conservative votes. (Williams, 9/19)

Also —

Axios: Pelosi: Trump Wants To "Crush" Affordable Care Act With Ginsburg Replacement 
House Speaker Nancy Pelosi said on ABC's "This Week" on Sunday that President Trump is rushing to replace the late Supreme Court Justice Ruth Bader Ginsburg because he "wants to crush the Affordable Care Act." Why it matters: Pelosi wants to steer the conversation around the potential Ginsburg replacement to health care, which polls show is a top issue for voters, especially amid the coronavirus pandemic. The Trump administration has urged the courts to strike down the law, and with it, protections for millions with pre-existing conditions. (9/20)

Healthcare Dive: 'People Should Worry:' ACA In Limbo After Bader Ginsburg's Passing  
In less than two months, the Supreme Court is set to hear the case that could overturn the Affordable Care Act — without Ruth Bader Ginsburg on the bench, fanning anxieties the landmark law is in greater jeopardy due to her passing. "People should worry," Nicholas Bagley, a health law expert and professor at the University of Michigan, said. The death of the liberal justice on Friday at the age of 87 means that of the nine justices, there are now only three appointed by Democratic presidents instead of four. (Liss, 9/19)

Health Affairs: After Justice Ginsburg’s Loss, What A New Court Could Mean For The ACA 
The loss of Justice Ginsburg has led to a flood of questions about what comes next for the Court and the country. Who will be nominated to fill her seat? Will a new justice be seated by the time the Court is scheduled to hear California v. Texas on November 10? How does the new makeup of the Court, without Justice Ginsburg, affect the potential outcome in Texas? And what is the role of Congress in addressing the lawsuit? This post grapples with the answers to some of these questions and what they mean for the fate of the Affordable Care Act (ACA). (Keith, 9/20)

Kaiser Health News: Without Ginsburg, Judicial Threats To The ACA, Reproductive Rights Heighten 
On Feb. 27, 2018, I got an email from the Heritage Foundation, alerting me to a news conference that afternoon held by Republican attorneys general of Texas and other states. It was referred to only as a “discussion about the Affordable Care Act lawsuit. ”I sent the following note to my editor: “I’m off to the Hill anyway. I could stop by this. You never know what it might morph into.” Few people took that case very seriously — barely a handful of reporters attended the news conference. But it has now “morphed into” the latest existential threat against the Affordable Care Act, scheduled for oral arguments at the Supreme Court a week after the general election in November. And with the death of Justice Ruth Bader Ginsburg on Friday, that case could well morph into the threat that brings down the law in its entirety. (Rovner, 9/21)

Politico: How The Supreme Court Could Now Limit Abortion Rights 
Republicans’ vows to quickly fill the vacancy left by Justice Ruth Bader Ginsburg’s death will dramatically accelerate the push to restrict abortion access, no matter what happens to Roe v. Wade.T here’s no guarantee that even an expanded conservative majority at the Supreme Court would target the landmark decision that legalized abortion nationwide nearly 50 years ago, given some justices’ anxiety about overturning precedent. But even without touching Roe, the Court could greenlight many narrower restrictions that would effectively eliminate access to the procedure for much of the country. (Ollstein, 9/19)

NPR: Ginsburg's Death A 'Pivot Point' For Abortion Rights, Advocates Say
[Ruth Bader] Ginsburg's death sets up a divisive nomination fight in the midst of a presidential campaign. And advocates on opposing sides of the issue agree that it could be a turning point in the long-running debate over one of the most divisive issues for the court: abortion rights. (McCammon, 9/19)

San Francisco Chronicle: Ginsburg’s Death Sets Up Titanic Battle Over Abortion Rights 
In a political year dominated by a deadly pandemic and a fight for racial equality, the death of Supreme Court Justice Ruth Bader Ginsburg may rocket the abortion question back to the center of American consciousness, with the future of that constitutional right hanging in the balance in the selection of her successor. “I think there is hope,” Alexandra Snyder, executive director of Life Legal Defense Foundation, an anti-abortion law firm based in Napa, said Saturday. (Asimov, 9/20)

In related news —

The Hill: Planned Parenthood: 'The Fate Of Our Rights' Depends On Ginsburg Replacement 
Planned Parenthood sounded the alarm Friday night after the death of Supreme Court Justice Ruth Bader Ginsburg, noting that abortion rights could be decided on the high court based on her replacement. “Tonight we honor that legacy, but tomorrow, we’re going to need to get to work to preserve the ideals she spent her life’s work defending. Because this is not an understatement: The fate of our rights, our freedoms, our health care, our bodies, our lives, and our country depend on what happens over the coming months,” Planned Parenthood President Alexis McGill Johnson said in a statement. (Axelrod, 9/18)

USA Today: Doug Collins Slammed For Tweet On Ruth Bader Ginsburg's Abortion Stance
As condolences for Ruth Bader Ginsburg's family and fond memories of her life poured in from Democrats and Republicans alike, GOP Rep. Doug Collins' voice was missing from those honoring her. Instead, Collins received backlash for his tweet Friday night focusing on Ginsburg's position on abortion rights. "RIP to the more than 30 million innocent babies that have been murdered during the decades that Ruth Bader Ginsburg defended pro-abortion laws," Collins tweeted. "With @realDonaldTrump nominating a replacement that values human life, generations of unborn children have a chance to live." (Santucci, 9/19)

Newsweek: Ruth Bader Ginsburg's Most Famous Supreme Court Cases
Few Supreme Court Justices have left a legacy as ideologically coherent as Ruth Bader Ginsburg. The second of only four female justices to be sworn in, Ginsburg was always an ardent defender of women's rights and gender equality. ... Ginsburg's powerful voice influenced her colleagues and colored court opinions on a number of issues. Her work has been a driving force in advocating for reproductive rights, gender equality, and fourth amendment rights. (Crowley, 9/18)

USA Today: Front-Runner For Supreme Court Nomination To Replace Ginsburg Is A Favorite Of Religious Conservatives
The front-runner for President Donald Trump's Supreme Court nomination in the aftermath of Associate Justice Ruth Bader Ginsburg's death is a darling of religious conservatives. Amy Coney Barrett, 48, a finalist for Trump's second high court nod in 2018 that ultimately went to Brett Kavanaugh, could move the high court further to the right – perhaps for decades to come. ... She has written that Supreme Court precedents are not sacrosanct, which liberals have interpreted as a threat to the 1973 Roe v. Wade decision legalizing abortion nationwide. (Wolf and Groppe, 9/19)

The New York Times: To Conservatives, Barrett Has ‘Perfect Combination’ Of Attributes For Supreme Court 
Two years ago, after nominating Brett M. Kavanaugh to the Supreme Court, President Trump strongly hinted that his choice for the next opening would be a former law professor he had named to a federal appeals court the year before: Judge Amy Coney Barrett. Now, three years into that job, Judge Barrett is regarded — at least for now — as the leading contender to replace Justice Ruth Bader Ginsburg, who died on Friday. If Judge Barrett were nominated and confirmed, she would be the sitting justice with the least courtroom experience, but one viewed as a home run by conservative Christians and anti-abortion activists. (Dias and Liptak, 9/20)

The Washington Post: Amy Coney Barrett, Potential Supreme Court Nominee, Wrote Influential Ruling On Campus Sexual Assault
Amy Coney Barrett, a leading contender for the Supreme Court seat held by the late Ruth Bader Ginsburg, wrote an influential appellate decision last year that made it easier for students accused of sexual assault to challenge universities’ handling of their cases. Barrett led a three-woman panel of judges that said Purdue University may have discriminated against a male student accused of sexual assault when it suspended him for a year, a punishment that cost him his spot in the Navy ROTC program. (Reinhard and Brown, 9/20)

Bloomberg: Ginsburg Successor Could Shift Law On Abortion, Health-Care Act 
A conservative successor to Justice Ruth Bader Ginsburg would move the U.S. Supreme Court closer to overturning the right to abortion, threaten the Affordable Care Act and, if confirmed quickly enough, strengthen President Donald Trump’s hand in legal disputes over the November election. Ginsburg’s death Friday gives the president and his Republican allies an opening to leave a transformational mark on a court already shaped by two Trump appointments. Senate Majority Leader Mitch McConnell vowed Friday to bring a new Trump nominee up for a vote, even though the election is less than seven weeks away. (Stohr, 9/18)

The Washington Post: Trump Says, Without Evidence, Every American Will Get Coronavirus Vaccine By April 
President Trump said Friday that every American would have access to a coronavirus vaccine by April, contradicting his own statement of two days earlier and sowing deeper confusion about the process and timing of vaccine approval and distribution. When Centers for Disease Control and Prevention Director Robert Redfield said earlier in the week that the general public was unlikely to get access to a vaccine until the second and third quarters of 2021, echoing other scientific leaders in the administration, Trump said he’d misspoken. ... Then, at a news briefing Friday, Trump announced a specific timeline, not far off from the one Redfield had laid out two days earlier. (Itkowitz and Johnson, 9/18)

CNN: Trump Says Every American Can Get A Coronavirus Vaccine By April, But Health Experts Say That's Not Likely 
"We'll have manufactured at least 100 million vaccine doses before the end of the year, and likely much more than that," [Trump] said. "Millions of doses will be available every month, and we expect to have enough vaccines for every American by April." (Fox and Carvajal, 9/18)

Politico: Trump Says U.S. Will Have Vaccine Doses For All Americans In April
Trump touted the timeline as evidence of "historic progress," and said of a vaccine, "we essentially have it — we will be announcing it soon." Notably, the president did not repeat his familiar prediction that the government would authorize a vaccine by election day, which top government scientists have said would be unlikely. The Food and Drug Administration has not yet given emergency authorization or approval to any of the coronavirus vaccines now in development. Vaccines from Moderna, Pfizer and AstraZeneca are now in the final stage of clinical trials in the United States, and the government has pre-purchased hundreds of millions of doses of at least a half-dozen experimental shots. (Owermohle, 9/18)

USA Today: Coronavirus: Trump Says Americans Will Have COVID-19 Vaccine By April
Trump's critics expressed skepticism about the speed of delivery, citing logistical challenges as well as concerns that Trump will promise virtually anything in the weeks before the election and as the nation wrestles with a pandemic that has killed nearly 200,000 Americans. Though several vaccine trials are underway, none have been approved and public health experts have noted the process takes months at best. (Fritze, Collins and Jackson, 9/18)

In related news —

The New York Times: Health Officials Tiptoe Around Trump’s Vaccine Timeline 
As the nation’s coronavirus death toll neared 200,000, top administration health officials on Sunday delicately sidestepped President Trump’s ambitious declaration last week that a vaccine would be available for every American by April. Instead, Adm. Brett Brett P. Giroir, who heads up national testing efforts, and Alex M. Azar II, the secretary of health and human services, offered a slightly more conservative timetable for vaccine availability. (9/20)

The Washington Post: CDC Reverses Controversial Coronavirus Guidelines For Testing People Without Symptoms 
The Centers for Disease Control and Prevention on Friday reversed heavily criticized guidelines on who should be tested for the novel coronavirus after experts inside and outside the agency raised alarms about public confusion over testing and concerns about the country’s ability to control the epidemic. The agency updated its recommendations to call for testing anyone who has been in close contact with anyone found to have the novel coronavirus. The guidance includes testing of those who do not have symptoms of covid-19, the disease caused by the virus. (Sun, 9/18)

Fox News: CDC Reverses Course Again, Says Asymptomatic People Should Be Tested 
This is the second time that the CDC has reversed course on their testing policy. On August 26th, the agency ignited a controversy when it changed its guidance to say that asymptomatic individuals do not need to be tested, even if they came into close contact with someone who has coronavirus. The reversal Friday moves the CDC back in line with its original guidance. (Best, 9/19)

The New York Times: C.D.C. Reverses Testing Guidelines For People Without Covid-19 Symptoms 
The change comes after widespread criticism of the earlier guideline, as well as reporting from The New York Times that the recommendation came from political appointees in the Trump administration and skipped the agency’s usual rigorous scientific review. The previous phrasing, which suggested asymptomatic people who have had close contact with an infected individual “do not necessarily need a test,” now clearly instructs them: “You need a test.” (Mandavilli, 9/18)

Politico: CDC Reverses Course On Testing For Asymptomatic People Who Had Covid-19 Contact
In addition to recommending testing for close contacts of sick people, the CDC now says that contacts should self-quarantine at home for 14 days, even if they test negative — and stay away from other household members in a separate bedroom if possible. "A single negative test does not mean you will remain negative at any time point after that test," the new CDC guidelines warn. "Even if you have a negative test, you should still self-isolate for 14 days." (Lim, 9/18)

In related news —

The New York Times: Emails Detail Effort To Silence C.D.C. And Question Its Science
Dr. Alexander’s point-by-point assessment, broken into seven parts and forwarded by Mr. Caputo to Dr. Robert R. Redfield, the C.D.C. director, was one of several emails obtained by The New York Times that illustrate how Mr. Caputo and Dr. Alexander attempted to browbeat career officials at the C.D.C. at the height of the pandemic, challenging the science behind their public statements and attempting to silence agency staff. Far from hiding what they knew about the virus’s danger, as Bob Woodward’s new book contends President Trump was doing, the emails seem to indicate that aides in Washington were convinced of their own rosy prognostications, even as coronavirus infections were shooting skyward. (Weiland, 9/18)

The New York Times: In ‘Power Grab,’ Health Secretary Azar Asserts Authority Over F.D.A. 
In a stunning declaration of authority, Alex M. Azar II, the secretary of health and human services, this week barred the nation’s health agencies, including the Food and Drug Administration, from signing any new rules regarding the nation’s foods, medicines, medical devices and other products, including vaccines. Going forward, Mr. Azar wrote in a Sept. 15 memorandum obtained by The New York Times, such power “is reserved to the Secretary.” The bulletin was sent to heads of operating and staff divisions within H.H.S. (Kaplan, 9/19)

Bloomberg: Former FDA Head Calls Azar’s Rule-Making Move A ‘Distraction’
Former FDA commissioner Scott Gottlieb said Health and Human Services Secretary Alex Azar’s move to bar agencies under his authority from signing their own rules is a “major distraction” that creates “an implication, or at least a specter” that the FDA’s independence is being eroded or influenced.“The timing of this is really poor right now, because it’s going to distract the agency and frankly creates headlines that could leave the perception that the agency is being bullied,” Gottlieb said on CBS on Sunday. (Shields and Yang, 9/19)

CBS News: Gottlieb Says HHS Move To Centralize Control Over Agencies "Makes No Sense" 
Dr. Scott Gottlieb, the former head of the Food and Drug Administration (FDA), criticized a new policy by the Department of Health and Human Services (HHS) giving only the secretary the authority to sign off on new rules, saying the timing "makes no sense" and risks creating the perception that the agency he helmed is being bullied. "I think that this is the wrong move at the wrong time," Gottlieb said Sunday on "Face the Nation. "At a time that they should be reaffirming the independence and the integrity of these agency, to do this now just makes no sense." (Quinn and Tillett, 9/20)

In other HHS news —

Modern Healthcare: HHS Finalizes Rules To Increase Living-Donor Organ Transplants
HHS on Friday finalized rulemaking that aims to increase living organ donations by providing more financial support to donors. The policies have widespread support from stakeholders, and HHS didn't make many changes from the initial versions. Under the proposals, living donors would be reimbursed for the expenses they take on while they're hospitalized and recovering, such as lost wages or childcare. (Cohrs, 9/18)

CNN: Woman Suspected Of Sending Poisoned Letter To Trump Arrested 
A woman suspected of sending a letter containing the poison ricin to President Donald Trump was arrested as she tried to enter the US from Canada at a border crossing in New York state, a US law enforcement official said. The woman was carrying a gun and arrested by US authorities, according to the law enforcement official. US prosecutors in Washington, DC, are expected to bring charges against her. (Perez, 9/20)

USA Today: Woman Suspected Of Sending Ricin To Donald Trump Arrested: Reports
The package, addressed to President Donald Trump, was intercepted by federal authorities in the past week, a law enforcement official said Saturday. The woman was taken into custody by U.S. Customs and Border Protection officers at the Peace Bridge border crossing near Buffalo and is expected to face federal charges, three law enforcement officials told The Associated Press on Sunday. NBC News also reported the woman's arrest, citing a federal law enforcement official. Her name was not immediately released. The FBI, in a brief statement, described the missive as "a suspicious letter received at a U.S. government mail facility." (Johnson, 9/19)

The New York Times: Woman Suspected Of Sending Ricin To Trump Is Arrested 
The suspect had been living in the United States last year and was arrested in March 2019 by the Mission, Texas, police for possession of an unlicensed weapon, resisting arrest and carrying a fake driver’s license, according to a senior intelligence official. While in the Hidalgo County Jail in Edinburg, Texas, authorities discovered that she had overstayed her six-month visa and had violated the terms of her passport by committing a crime while in the United States, and she was deported back to Canada, the official said. (Benner and Draper, 9/20)

AP: Biden To Focus On Health Care In Supreme Court Debate
Joe Biden on Sunday used the sudden Supreme Court vacancy to reinforce his argument that the upcoming election should be a referendum on President Donald Trump’s handling of health care and the coronavirus. The death of Justice Ruth Bader Ginsburg jolted the presidential campaign just six weeks before the election and as several states are already voting. Trump has seized on the opportunity to nominate a new justice to motivate his most loyal voters. Biden kept the focus on health care, which has proven to be a winning issue for Democrats during previous elections and could be even more resonant amid the pandemic. (Jaffe, 9/20)

Politico: Pandemic Supercharges Campaign Battles Over Obamacare 
The Obamacare wars are back. President Donald Trump and Joe Biden are starting to talk about the Affordable Care Act and its protections for people with pre-existing conditions as voters clamor for assurances that their health coverage will remain secure at a time of great upheaval. Competing pledges to maintain protections for people with pre-existing conditions are also emerging in key Senate and battleground House races across the country — even from incumbents who voted to repeal the ACA. (Luthi and Ollstein, 9/18)

The New York Times: Abortion Was Back-Burnered In The Presidential Race. Not Anymore. 
For Joshua Hon, the prospect of another open seat on the Supreme Court was the moment he’s been waiting for since voting for President Trump four years ago.“I would not say that I love Trump, but I do believe that abortion is killing babies,” said Mr. Hon, 35, who lives in Durham County in North Carolina. (Lerer and Dias, 9/20)

Modern Healthcare: Biden, Trump Offer Distinct Healthcare Agendas
Former Vice President Joe Biden and President Donald Trump undoubtedly cast drastically different visions of their healthcare agendas. Biden touted the landmark law that the Trump administration wants to strike down in its entirety. Trump offered vague bullet points as his agenda, while Democrats released a 91-page platform document. As both campaigns shift into high gear, industry leaders will be on the lookout for more details to emerge on policy initiatives that could reshape payment, coverage and overall operations in the coming years. (Cohrs, 9/19)

Also —

Kaiser Health News: Trump-Biden Race Could Hinge On How Florida’s Pinellas County Swings 
Betty Jones voted for President Donald Trump in 2016, but the lifelong Republican has her doubts she will do it again this year.The federal response to the coronavirus pandemic that has killed about 200,000 Americans and forced older adults to restrict their activities has her contemplating a leadership change. (Galewitz and Snipe, 9/21)

AP: Law And Order Vs. Health Care As Dems, GOP Vie For Suburbs
Scores of suburban districts are back in play in the GOP’s long-shot attempt to win House control in November’s election. Democrats who used health care to capture the majority in 2018 are emphasizing it anew, saying they’ll shield voters from Republicans trying to tear coverage away during a pandemic. “This is as current an issue as can possibly be,” said Leslie Dach, who heads the Democratic-backed Protect Our Care Coalition. (Fram and Salter, 9/20)

Modern Healthcare: Verma Confirms Medicare Loan Recoupment Delay Amid Hill Negotiations
CMS Administrator Seema Verma on Friday confirmed the agency is holding off on garnishing providers' Medicare payments amid congressional negotiations on repayment terms for the program's COVID-19 loans. The Coronavirus Aid, Relief, and Economic Security Act expanded the Medicare Accelerated and Advance Payment Program in the spring and required CMS to begin garnishing 100% of loan recipients' Medicare payments starting four months after the loans were issued. The first loans went out in April, and recoupment should have started in August. But Modern Healthcare previously reported that CMS had not started withholding payments. (Cohrs and Livingston, 9/18)

Also —

Modern Healthcare: Medicaid Payments Under Threat As COVID Pummels State Budgets
Like many hospitals struggling to cope with the financial fallout of the COVID-19 pandemic, University Medical Center of Southern Nevada has made tough decisions and reevaluated its business strategy to survive. The Las Vegas hospital has gotten federal relief funding, but “it’s just not enough” to offset increasing care costs and declining revenue, UMC CEO Mason Van Houweling said. The hospital’s fortunes are deeply intertwined with the state’s tourism-heavy economy, which has been hammered for the past six months as casinos shuttered, and conferences were canceled. (Brady, 9/19)

Modern Healthcare: CMS Approves Chronic Kidney Disease Payment Model
CMS on Friday unveiled its alternative payment model for patients with chronic kidney disease. The End-Stage Renal Disease ESRD Treatment Choices—ETC—model encourages increased home dialysis use and kidney transplants. According to the agency, it will affect nearly a third of kidney care providers and save the federal government about $23 million over five and a half years. (Brady, 9/18)

Modern Healthcare: Capitated Payment Models Come With Some Hurdles
At IKP Family Medicine, a 10-provider practice in northwest Houston, the sudden, forced switch to video visits amid the COVID-19 pandemic could have been a disaster, as some patients are in their 80s and 90s and still use flip phones. Fortunately, IKP has been reimbursed in part through capitated models for at least 16 years, so its doctors are used to treating patients however it makes sense for them, without worrying about how they’ll get paid. When a 92-year-old patient recently needed a medication refill but was terrified to come in for fear of getting COVID, for example, Dr. Timothy Irvine simply called her to sort it out. (Bannow, 9/19)

Reuters: U.S. Sets Record With Over One Million Coronavirus Tests In A Day
The United States set a one-day record with over 1 million coronavirus diagnostic tests being performed, but the country needs 6 million to 10 million a day to bring outbreaks under control, according to various experts. The country performed 1,061,411 tests on Saturday, according to data from The COVID Tracking Project, a volunteer-run effort to track the outbreak. (9/20)

The Hill: US Sets Record With 1M Coronavirus Tests Conducted, Well Short Of What Experts Say Is Needed 
Single day testing numbers had decreased in recent weeks, with the U.S. testing an average 650,000 people a day during the week ending Sept. 13. In July, the U.S. tested an average of more than 800,000 people daily. A shortage of testing materials has made identifying those with COVID-19 difficult and has led to hours-long lines to get tested in certain areas like Houston and Miami when cases were surging there. (Coleman, 9/20)

In related news about COVID testing —

The Hill: Connecticut Democrat Tests Positive For Coronavirus 
A Connecticut Democrat announced on Sunday that she had been diagnosed with coronavirus. Rep. Jahana Hayes (D-Conn.) tweeted that she would quarantine for two weeks after testing positive following several unsuccessful attempts to get tested. "This morning I received a positive COVID-19 test result and will be quarantined for the 14 days," she wrote. "After going to 2 urgent care centers yesterday, I finally got an appointment at a 3rd site and was tested this morning." (Bowden, 9/20)

FierceHealthcare: CVS Aims To Have 4,000 Drive-Thru Testing Sites Open By Mid-October 
CVS Health is planning to double the number of its drive-thru testing sites by mid-October, the healthcare giant announced on Thursday. CVS intends to add more than 2,000 sites at its pharmacies in the next several weeks, bringing its total to more than 4,000 nationwide. The new locations will be opened in waves, beginning with 400 new sites opening on Friday. CVS currently offers testing in 33 states and the District of Columbia. (Minemyer, 9/17)

CNBC: Bill Gates: It's 'Outrageous' Americans Can't Get Coronavirus Test Results In 24 Hours
Microsoft co-founder and global health philanthropist Bill Gates criticized the current state of the United States’ response to the Covid-19 pandemic on Sunday, including slow turnaround times for tests. Gates told “Fox News Sunday” that the access to fast testing is still inadequate more than six months into the pandemic and that the U.S. was set up for a rough fall of virus cases. “Even today, people don’t get their results in 24 hours. It’s outrageous that we still have that,” Gates said. (Pound, 9/20)

Stat: What Facebook Can Learn From Pinterest's Vaccine Misinformation Fight
The battle over misinformation amid the Covid-19 pandemic has pitted health experts, parts of the public, and the leaders of online platforms against one another. So far, one social media giant seems to be winning the fight against falsehoods: Pinterest. (Brodwin, 9/21)

The Hill: Fewer Americans Say They Would Take A COVID-19 Vaccine Compared To Four Months Ago
Confidence in potential COVID-19 vaccines is slipping, with only 51 percent of Americans in a new poll saying they would get a vaccine if it was available today, compared to 72 percent who said the same four months ago. The roughly half of Americans who said they'd get a vaccine includes 21 percent who said they would “definitely” get one, compared to 42 percent that said the same in May, according to a poll from the Pew Research Center. (Hellmann, 9/18)

Stat: Black Doctors' Group Creates Panel To Vet Covid-19 Vaccines 
As trust in federal health agencies has withered over the last few months, a group of Black physicians has been working on an antidote: creating their own expert task force to independently vet regulators’ decisions about Covid-19 drugs and vaccines as well as government recommendations for curbing the pandemic. Organized by the National Medical Association — founded in 1895 as an answer to racist professional societies excluding Black doctors — the committee is meant to safeguard against any unscientific guidance from the Centers for Disease Control and Prevention and the Food and Drug Administration. (Boodman, 9/21)

AP: Push Is Underway To Test COVID-19 Vaccines In Diverse Groups
In front of baskets of tomatoes and peppers, near a sizzling burrito grill, the “promotoras” stop masked shoppers at a busy Latino farmers market: Want to test a COVID-19 vaccine? Aided by Spanish-speaking “health promoters” and Black pastors, a stepped-up effort is underway around the U.S. to recruit minorities to ensure potential vaccines against the scourge are tested in the populations most ravaged by the virus. (Neergaard and Narancio, 9/18)

CIDRAP: COVID-19 Likely Spreading From People To Animals—And Vice Versa
Three new studies suggest that high proportions of cats and dogs may have acquired COVID-19 from their owners and that the virus jumped back and forth between humans and minks on farms in the Netherlands. The first, a small, unpublished study from the University of Guelph in Ontario, Canada, suggests that a large proportion of pet cats and dogs may have gotten COVID-19 from their owners, as evidenced by antibodies against the coronavirus in their blood. (Van Beusekom, 9/18)

In other scientific developments —

CIDRAP: Certain Underlying Conditions Stand Out As COVID-19 Hospitalization Risk Factors
Increased age, male sex, non-Hispanic black ethnicity, and certain underlying health conditions are associated with a greater risk of hospitalization from COVID-19, according to an analysis of data from more than 5,000 hospitalized adults. A group based at the Centers for Disease Control and Prevention (CDC) reported its findings today in Clinical Infectious Diseases. (9/18)

Fox News: Coronavirus Causing 'Persistent Fatigue' In More Than Half Of Recovered Patients, Study Finds
As researchers work to understand both the short and long-term effects of the novel coronavirus, more than half of participants in a recent study who have recovered from COVID-19 are still experiencing “persistent fatigue” related to the disease. The study, conducted by Dr. Liam Townsend, St. James's Hospital and Trinity Translational Medicine Institute, Trinity College, Dublin, Ireland, and others, found that fatigue was present in more than half of the patients studied “regardless of the seriousness of their infection,” according to a news release on the findings. (Farber, 9/19)

Reuters: Coronavirus Found On Imported Squid Packaging In China 
Authorities in China’s northeastern Jilin province have found the novel coronavirus on the packaging of imported squid, health authorities in the city of Fuyu said on Sunday, urging anyone who may have bought it to get themselves tested. One of the packages had arrived in the city via the provincial capital Changchun, Fuyu city’s health office said on its official WeChat account on Sunday. (9/20)

AP: Drug Shows Promise In 1st Largely Minority COVID-19 Study
A drug company said Friday that a medicine it sells to tamp down inflammation has helped prevent the need for breathing machines in hospitalized COVID-19 patients in the first large study that primarily enrolled Hispanics and Blacks. Switzerland-based Roche reported the results for tocilizumab, sold now as Actemra and RoActemra for treating rheumatoid arthritis and some other diseases. The company said it would quickly publish the results, which have not yet been reviewed by independent scientists, and would speak with regulators about next steps. (Marchione, 9/18)

NPR: New Drugs For COVID-19 In The Works 
If the coronavirus vaccines currently being tested don't pan out, don't expect new drugs to fill the gap any time soon. Many drugs are in the works, and those that succeed could play a role in reducing symptoms and sometimes saving lives. But, given the way drugs are developed, it's unlikely that any single medicine will be anywhere as potent against the coronavirus as a successful vaccine. (Harris, 9/18)

In other pharmaceutical news —

CIDRAP: Study Warns Of Pairing Azithromycin With Drugs That Affect Heart Rhythm 
A large new study of patients who received either azithromycin or amoxicillin found no increased risk of cardiac events associated with azithromycin, except among patients also taking medications that affect the electrical impulses of the heart, researchers reported this week in JAMA Network Open. (Dall, 9/18)

Stat: Three Lessons From Covid-19 On Accelerating Biopharma Innovation 
The health care research ecosystem has shifted into overdrive in response to Covid-19, sparking unprecedented speed and agility. The economic and public health burdens it has generated demand that we rethink our approach to developing new vaccines and therapies. Researchers are now examining what we can learn from these experiences and more broadly apply this innovation to research and development in the future. (White, 9/18)

Stat: New Drug Combo Extends Survival With Advanced Kidney Cancer 
Patients with advanced kidney cancer live longer when treated with a combination of drugs from Bristol Myers Squibb and Exelixis compared to an older medicine, according to new clinical trial results reported Sunday. Convincing physicians to prescribe the new combination regimen for kidney cancer patients, though, will face a challenge: equally effective treatments already in use. (Feuerstein, 9/19)

Stat: Durable Responses Seen With Amgen's KRAS-Blocking Cancer Drug 
Amgen said Sunday that patients with advanced lung cancer who were given its drug to block a protein called KRAS lived for a median of six months without their tumors worsening. That’s a measure of response durability that experts say could be strong enough to secure the drug’s approval — if replicated in a larger clinical trial that will read out later this year. (Feuerstein, 9/20)

FiercePharma: AstraZeneca, Merck's Lynparza Boosts Prostate Cancer Survival By 31% Over J&J, Pfizer-Astellas Rivals 
Last year at the European Society for Medical Oncology annual meeting, AstraZeneca and Merck showed Lynparza could beat two top rivals at fending off prostate cancer progression. This year, they’re showing it can help patients live longer, too.In results unveiled Sunday at the ESMO virtual congress, Lynparza cut the risk of death by 31% over Johnson & Johnson’s Zytiga or Pfizer and Astellas’ Xtandi in patients with metastatic, castration-resistant prostate cancer and one of three genetic mutations. (9/20)

Also —

Stat: Promising Results For Trodelvy, A Drug Just Acquired By Gilead 
When Gilead Sciences announced its $21 billion acquisition of Immunomedics one week ago, Gilead executives said that clinical data on Immunomedics’ cancer drug Trodelvy — shared confidentially during negotiations — justified the high cost of the deal. On Saturday, data from Trodelvy studies in bladder cancer and triple-negative breast cancer were presented publicly for the first time at the annual meeting of the European Society for Medical Oncology. The results were better than expected, which may boost Trodelvy’s chances of growing into a multi-billion dollar drug and in, turn, ease investor concerns about Gilead’s acquisition. (Feuerstein, 9/19)

FiercePharma: New Trodelvy Breast, Bladder Cancer Data Show Why Gilead's Going Big For Immunomedics 
Compared with the spate of multibillion-dollar buyouts last year, biopharma M&A has been relatively quiet in 2020—until last week, when Gilead Sciences surprised the market with its $21 billion purchase of Immunomedics. Now, two sets of new cancer data from Immunomedics’ first-in-class antibody-drug conjugate Trodelvy offer a glimpse into why Gilead paid such big money for the biotech—even as they illuminate the potential competition ahead. (Liu, 9/19)

Bloomberg: COVID-19 Grows Less Deadly As Doctors Gain Practice And Drugs Improve
Doctors and experts say that improved medical tactics and earlier treatment are helping improve the outcomes for very sick patients, said Andrew Badley, head of Mayo Clinic’s Covid Research Task Force. “Health-care preparedness today is much better than it was in February and March,” Badley said in an interview. “We have better and more rapid access to diagnosis. We have more knowledge about what drugs to use and what drugs not to use. We have more experimental treatments available. All of those contribute to possible improvements in the mortality rate.” (Raimonde, 9/19)

NPR: Advances In ICU Care Are Saving More Patients Who Have COVID-19
If you think all the coronavirus news is bad, consider the uplifting story of Don Ramsayer. The 59-year-old man from Cumming, Ga., is living evidence that doctors in intensive care units quickly figured out how to help more patients survive. In early August, Ramsayer was helping his son pack up the car for his freshman year at The Citadel, the Military College of South Carolina. Ramsayer had been having night sweats and wasn't feeling that well, but he tried to play it down. (Harris, 9/20)

Also —

Kaiser Health News: ‘An Arm And A Leg’: A Primer On Persisting In Difficult And Uncertain Times
Laura Derrick lived with an undiagnosed medical condition for decades, and when she finally got answers and access to effective treatment, medical bills threatened to swamp her family. During her personal fight for affordable health care, she was inspired by and swept up in a historic political fight. This is a great time for Derrick’s story, which is all about persistence through difficult and uncertain times. In late 2018, it was one of the first stories on “An Arm and a Leg,” and it has special resonance right now when we’re all enduring a lot. (Weissmann, 9/21)

Stat: Teladoc Accuses Amwell Of Infringing On Its Telehealth Patents 
Telehealth provider Teladoc last week accused Amwell of infringing on its patents and demanded that its rival stop offering the products in question — setting the stage for a potential legal dispute between the two most prominent companies in telemedicine. In a Sept. 14 letter to Amwell obtained by STAT, Teladoc’s intellectual property attorneys pointed to Amwell’s digital scope and stethoscope, as well as several of its telemedicine carts — wheeled devices equipped with cameras and screens that telehealth providers use to connect remote clinicians with patients on-site. (Robbins, 9/21)

NBC News: Kentucky Doctor Who Urged Mask-Wearing Early On Dies Of Covid-19
In the early weeks of the pandemic, before coronavirus cases crushed hospitals in New York and spiked in other states, Dr. Rebecca Shadowen asked her friends a question on Facebook. "If you could save the life of another person without harming your own, would you?" Shadowen, an infectious disease specialist in Kentucky, posted on March 13. (Ortiz, 9/19)

The Washington Post: Nearly 11,000 People Have Been Exposed To The Coronavirus On Flights, The CDC Says
The Centers for Disease Control and Prevention investigated 1,600 cases of people who flew while at risk of spreading the coronavirus, identifying nearly 11,000 people who potentially were exposed to the virus on flights. But though the agency says some of those travelers subsequently fell ill, in the face of incomplete contact tracing information and a virus that incubates over several days, it has not been able to confirm a case of transmission on a plane. (Duncan, 9/19)

The Hill: New Study Shows Dangers Of In-Flight COVID-19 Transmission 
One person with COVID-19 infected 15 others during a long-haul flight from London to Vietnam in early March, according to a new analysis. The study from the Centers for Disease Control and Prevention, which was released ahead of its final publication in November, is one of the first to analyze the dangers of in-flight transmission of the SARS-CoV-2 virus. (Weixel, 9/18)

New York Post: Woman Spread Coronavirus To 15 People Aboard London-To-Vietnam Flight
A single sickened airplane passenger spread coronavirus to 15 other people aboard a flight from London to Vietnam, according to a newly published study. The passenger, identified as a 27-year-old businesswoman from Vietnam, had a sore throat and cough before boarding the March 1 flight and tested positive for coronavirus four days later, the study in the journal Emerging Infectious Diseases said. (Garger, 9/21)

In related airline industry news —

USA Today: Tracing COVID-19-Infected Airline Passengers Isn't Easy
It's the call no airline passenger wants to receive. You are contacted after your plane lands to let you know a fellow traveler from your flight tested positive for COVID-19. The notification likely comes from local health officials with an advisory to go into 14-day self-quarantine. The Centers for Disease Control and Prevention logged 1,600 COVID-19 investigations on commercial aircraft between January and August. By comparison, the agency had to deal with only about 150 cases of communicable diseases on flights in each of 2018 and 2019, usually the measles, reported spokeswoman Caitlin Shockey. (Woodyard, 9/18)

Business Insider: Airline Workers Have Lower Rates Of COVID-19 Than General Population 
The coronavirus spreads when people are in close quarters for extended periods of time, breathing the same air with little space between them. So you might expect airplanes to be the perfect environment for the transmission. But some surprising data from airline workers show that is not the case. In fact, flight attendants and other airline workers have had a lower incidence of COVID-19 than the general population. (Slotnick, 9/17)

CBS News: United Airlines Fights COVID-19 With Antimicrobial Coating On Seats, Trays And Bins 
United Airlines said Wednesday it is using an antimicrobial coating on the seats, trays, bins and bathrooms on 30 planes, with plans to expand the practice to its entire mainline and express fleet by the end of the year. The new coating is part of the airline's efforts to protect passengers from the coronavirus and restore public confidence in flying.  The Zoono Microbe Shield, which United said is an Environmental Protection Agency-registered antimicrobial coating, inhibits the growth of microbes after forming a long-lasting bond with surfaces, according to the carrier. Its use will create an "an extra level of protection on our aircraft to help better protect our employees and customers," Toby Enqvist, United's chief customer officer, said in a statement. (Picchi, 9/16)

In other travel news —

Burlington Free Press: COVID-19 Restrictions: Canada-U.S. Border Closure Extended Into October
Canada remains off-limits for at least another month. Officials from both the United States and its neighbor to the north on Friday confirmed that the ban on non-essential traffic between the two nations will be extended until Oct. 21. The prohibition has been in place since March. (Danforth, 9/18)

The Hill: Gates Says Travel Ban Made COVID-19 Worse In US 
Microsoft co-founder and philanthropist Bill Gates said the implementation of the government’s travel ban may have exacerbated the coronavirus outbreak in the U.S. earlier this year. In an interview with Fox News Sunday, part of which was released Friday, Gates said the ban led people abroad to rush back to the U.S. and that proper safety and testing measures were not in place upon their return, sparking further spread of the virus. (Axelrod, 9/18)

The New York Times: ‘This Does Not Look Good For Children’: Fires Pose Risk To Young Lungs 
Ian MacDonald, a 14-year-old in Portland, Ore., got a treat from his parents the other day. He was allowed to go outside. It was for less than five minutes. “I let him take out the garbage. We wore N95 masks,” said his father, Dr. Kelvin MacDonald, who has been insisting his family stay in the house as wildfires flare nearby. Dr. MacDonald is a pediatric pulmonologist, and he is concerned about the health risks to children from the ashen-thick air. (Richtel, 9/18)

AP: Wildfire Smoke Leaves Lung Damage Long After Air Clears
When researchers arrived in this town tucked in the Northern Rockies three years ago, they could still smell the smoke a day after it cleared from devastating wildfires. Their plan was to chart how long it took for people to recover from living for seven weeks surrounded by relentless smoke. They still don’t know, because most residents haven’t recovered. In fact, they’ve gotten worse. Forest fires had funneled hazardous air into Seeley Lake, a town of fewer than 2,000 people, for 49 days. The air quality was so bad that on some days the monitoring stations couldn’t measure the extent of the pollution. The intensity of the smoke and the length of time residents had been trapped in it were unprecedented, prompting county officials to issue their first evacuation orders due to smoke, not fire risk. (Houghton, 9/18)

In other public health news —

Fox News: Adult Obesity On Rise In US, CDC Says
New data released Wednesday show that adult obesity increased in the U.S., last year, while racial and ethnic disparities persist, according to the Centers for Disease Control and Prevention (CDC). The findings may be especially concerning amid the pandemic as obesity lends worse outcomes from COVID-19, and minorities are disproportionately impacted by both the virus and obesity. (Rivas, 9/19)

The Washington Post: Covid-19 Vs. Flu Symptoms: Is It Possible To Tell The Difference? 
The confluence of the coronavirus pandemic and the annual flu season this fall and winter has public-health officials nervous. Simultaneous surges of both respiratory viruses — sometimes called a “twindemic” — could overwhelm hospitals, straining resources and health-care workers’ time.Infectious-disease doctors are urging people to get a flu vaccine to lower their risk of contracting influenza viruses and helping them to spread. But flu symptoms and warning signs of covid-19, the illness caused by the novel coronavirus, are similar, and it can be hard to tell the difference. Here’s how experts respond to common questions about the illnesses. (Iati, 9/18)

NPR: Listen, Open Up, Connect: A Mental Health Expert's Advice On Living Through A Crisis
Terri Cheney did not expect she would be weathering the pandemic so well. The author of Modern Madness: An Owner's Manual has been living with mental illness her entire life. She realizes now, this has been good preparation for the impositions of 2020. "With anxiety," she said, "you're used to feeling unpredictable and always being afraid of what's going to happen. With depression, there's that loss of interest in things, the lack of productivity, and the loss of hope for the future." "That's what America is experiencing right now," she says, while "these are all traits that mentally ill people have learned how to deal with." (Dangor, 9/19)

ABC News: Colleges Scrapping Spring Break Amid Travel Concerns During Coronavirus Pandemic 
An increasing number of colleges and universities are canceling spring break six months ahead of time amid concerns about travel during the coronavirus pandemic. The University of Michigan became one of the latest schools to amend its calendar and scrap the traditional spring break. On Thursday, its Board of Regents approved updated academic calendars across its three campuses that eliminated the spring recess. (Deliso, 9/20)

The Washington Post: Why Some Colleges And Universities Do Better Than Others In Keeping Campuses Open 
When the school year began, Gettysburg College looked well-positioned to weather the tumult of the coronavirus pandemic and Arizona State University seemed vulnerable. The private liberal arts college in Pennsylvania planned meticulously for the arrival of more than 2,200 students to its small-town campus in August, pledging to test them all for the novel coronavirus and do its utmost to safeguard public health while teaching as much as possible in person. (Anderson, Svrluga, Lumpkin, Douglas-Gabriel and Heim, 9/20)

Also —

Atlanta Journal-Constitution: Some Schools Withhold COVID-19 Infection Information From Parents, Teachers
Around Georgia, groups of parents and teachers are criticizing what they see as a dangerous trend. Although some school districts publish detailed data about coronavirus case counts, others reveal little or no information. (Tagami, 9/21)

Boston Globe: At Mass. Schools, Officials Face Challenges Brought On By COVID-19 Early In Year
Two Massachusetts regional high schools struggled with challenges brought on by the pandemic Sunday, as more than 80 students and staff were quarantined following a COVID-19 case on Cape Cod, while police in Sudbury considered charges in connection with a large party that delayed in-person education there. (Hilliard, 9/20)

San Francisco Chronicle: Outbreak In Sonoma County: Virus Hits 13 Child Care Centers, Schools 
Thirteen schools and child care facilities in Sonoma County reported coronavirus outbreaks that infected 62 people, including 25 children, health officials said this week.Most of the children who were infected were 6 years old and younger. Ten members of school staff and 27 family members were also infected, according to Sonoma County Public Health Officer Dr. Sundari Mase. Exposure to the virus occurred at the child care centers.Officials did not name the schools and child care facilities that suffered the outbreaks. (Arredondo, 9/18)

AP: For Most NYC Students, Back To School, But Not The Classroom
Monday’s return to New York City schools won’t be the return anyone planned for. For most, it won’t be a return at all.Only pre-kindergarten and some special education students are scheduled to end a six-month absence from school buildings after a last-minute decision to postpone, for the second time, plans to be among the first big districts to resume in-person instruction after the coronavirus forced students and staff home. Schoolchildren in kindergarten through 12th grade are still starting the new school year Monday, but fully remotely, the same way students in Los Angeles, Chicago, Houston and many of New York’s other urban districts have. (Thompson and Peltz, 9/21)

The Washington Post: The District's Infection Rate Is Low. Some Parents Wonder Why Schools Are Not Open. 
D.C. Mayor Muriel E. Bowser (D) said she wants to bring small groups of students back into schools by the end of September, but with less than two weeks to go, her administration has no plan and has not reached an agreement with teachers to return to classrooms. The mayor on Thursday referred questions about reopening buildings to the school system’s chancellor, but he had almost no details. The school system, he said in a statement, is “actively considering options” for a return to in-person school and would prioritize serving students “furthest from opportunity.” (Stein, 9/20)

The New York Times: How One District Got Its Students Back Into Classrooms 
When schools shuttered in March, David Miyashiro, the superintendent of the Cajon Valley Union School District, immediately started connecting with families and teachers. During hundreds of calls, Zoom meetings and socially distanced in-person gatherings, he heard desperate pleas from poor parents torn between work and home instruction, or who needed support for high-needs students. Mr. Miyashiro vowed to reopen schools in the fall, and over the coming months, he took steps to pave the way. The district near San Diego offered free emergency child care for essential workers in April. It ran an in-person summer enrichment program for more than a third of its 17,000 mostly low-income students, road-testing safety measures. One cohort of students had to quarantine for 14 days after a parent informed the school she had tested positive for the coronavirus, but no student or teacher cases materialized. (Anderson, 9/20)

Politico: Where Are All The Kindergartners? Pandemic Creates Rare Gap Year
Amy Neier carefully wrote “first day of kindergarten” on a whiteboard and posed her 5-year-old son Hunter with the sign to capture the milestone she had long waited for. Then Hunter headed off for another year of preschool instead. Neier and parents across the nation are skipping kindergarten in droves during the most tumultuous school year in generations. Frustrated by the thought of sticking their 5-year-olds in front of screens during the pivotal first year of school, they are sending their children to extended preschool, forming learning pods or foregoing formal instruction altogether. (Mays, 9/18)

CBS News: Pandemic Leaves Domestic Workers Facing Tough Choices, Often Without A Safety Net 
Before the coronavirus pandemic, Alicia Cleveland worked as a nanny for three families in the Atlanta area. But as the outbreak spread this spring, she had to give up the work to look after her three children, who were at home after schools closed and all of whom have pre-existing medical conditions. The sudden loss of income and additional demands on her time as a mother were jarring. "To say my experience during the pandemic has been difficult would be an understatement," Cleveland said this week in a media call organized by the National Domestic Workers Alliance. (Gibson, 9/18)

Portland Press Herald: Spread Of COVID-19 In York County Hits Portsmouth Naval Shipyard, With 18 Cases Reported 
The Portsmouth Naval Shipyard has been hit by 18 cases of COVID-19, and Maine public health officials suspect the outbreak may be connected to a commuter van that transports workers from the Sanford area in York County, the site of additional disease outbreaks. Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said it is the “early, initial hypothesis” that the commuting van started the outbreak. (Lawlor, 9/17)

CBS News: Residents Are Angry After Maine Wedding Linked To 7 Virus Deaths: "We Can't Go Nowhere" 
A wedding in rural Maine became a coronavirus "superspreader" event that left seven people dead and 177 infected. Now, for the community and wider region, which had relaxed social-distancing rules introduced earlier in the crisis, the news was a brutal wake-up call. (9/18)

In other news from the East —

WBUR: Statewide Opioid Screening Day To Help People Assess Their Risk And Find Treatment 
Hospitals and clinics around Massachusetts are gearing up to help people access treatment for opioid use disorder, as part of a statewide event aimed at increasing awareness of the disease. The September 22 event, called Massachusetts Opioid Screening and Awareness Day, will feature a free virtual panel discussion with experts in opioid use disorder and people with lived experience. The event is open to the general public. (Joliocoeur, 9/19)

The Wall Street Journal: New York Lawmakers Seek Independent Probe Of Nursing-Home Coronavirus Deaths 
With lingering questions about how the novel coronavirus killed thousands of New Yorkers who lived in nursing homes, a group of state lawmakers is pushing to create an independent commission to get answers from the state Department of Health. State Sen. Jim Tedisco, a Republican from the Schenectady suburbs, last week announced an online petition drive to build public support for such a commission. He said a pair of August hearings, convened by Democrats who control the state Assembly and Senate, didn’t produce the information needed to evaluate and adjust state policies before a predicted second wave of the virus. (Vielkind, 9/20)

The Washington Post: Virginia Reports First Child Coronavirus Death; Maryland To Expand Indoor Dining Capacity Monday 
Virginia health officials on Friday reported the state’s first coronavirus-related death of a child since the start of the pandemic. As state health officials reminded residents that no age group is immune from the effects of the coronavirus, Maryland announced it will expand indoor-dining capacity — changes that won’t be coming to the state’s harder-hit Washington suburbs. (Cox, Lumpkin and Moyer, 9/18)

Atlanta Journal-Constitution: Public Comment Window Extended On Kemp Plan To Block ACA Shopping Site
People who want to comment on Gov. Brian Kemp’s plan to block Georgians' access to the Affordable Care Act health insurance shopping website healthcare.gov now have six more days to weigh in. The new deadline for public comment on the proposal is Sept. 23, the U.S. Department of Health and Human Services told the AJC on Thursday night. It extended the deadline after the AJC discovered that the email address posted for submitting public comment was incorrect and reported it. (Hart, 9/18)

New Orleans Times-Picayune: Some Louisiana Nursing Homes Are Undercounting Coronavirus Deaths, Coroner Data Reveals 
At least eight residents of the Maison Orleans nursing home in Uptown New Orleans have died from the coronavirus — according to records provided by the Orleans Parish coroner’s office, anyhow. But the state Department of Health only lists three Maison Orleans residents among Louisiana’s 5,172 COVID-19 deaths. (Russell, 9/20)

In news from the Midwest and West —

AP: Nebraska Prisons Say 6 More Workers Test Positive For Virus
Six more state corrections employees have tested positive for the coronavirus as the number of cases in the state prison system continues to grow. Three employees at the Nebraska State Penitentiary in Lincoln and three employees at the state Diagnostic and Evaluation Center tested positive for COVID-19, the Nebraska Department of Correctional Services said in a news release Saturday. (9/20)

AP: Active COVID-19 Cases In South Dakota Drop By More Than 100
South Dakota health officials said Sunday that active cases of the coronavirus dropped by 102 in the last day, decreasing the total number to 2,843. The report comes one day after the state reached 200 deaths due to complications from COVID-19. Officials confirmed two more deaths Sunday, both elderly men from Minnehaha County. (9/20)

Dallas Morning News: Dallas Plans To Expand This Mental Health Crisis Team. Should Police Still Be Involved?
The three-member team, called RIGHT Care, is a pilot program run by the Dallas police and fire departments and Parkland Health & Hospital Systems. Started in 2018 to change how Dallas police respond to the 13,000 mental health crisis calls that emergency dispatch receives each year, the team is on patrol from 7 a.m. until 11 p.m. daily in the city’s south central neighborhoods. And now, City Hall and its partners plan to expand RIGHT Care across Dallas as part of its response to a summer of protests against police brutality and systemic racism. (Garcia and Cooper, 9/18)

Kaiser Health News: California’s Deadliest Spring In 20 Years Suggests COVID Undercount 
The first five months of the COVID-19 pandemic in California rank among the deadliest in state history, deadlier than any other consecutive five-month period in at least 20 years. And the grim milestone encompasses thousands of “excess” deaths not accounted for in the state’s official COVID death tally: a loss of life concentrated among Blacks, Asians and Latinos, afflicting people who experts say likely didn’t get preventive medical care amid the far-reaching shutdowns or who were wrongly excluded from the coronavirus death count. (Reese, 9/21)

San Francisco Chronicle: First Cases Of Flu Hit Bay Area, Marking Start Of A Dangerous Season Ahead
Bay Area hospitals have reported their first cases of influenza, signaling the start of what could be a turbulent flu season with COVID-19 in the mix. The flu season doesn’t typically begin in earnest until December or January in California, but doctors already are bracing for a worst-case scenario of widespread influenza on top of the coronavirus and other respiratory viruses that may be circulating. (Allday, 9/20)

Reuters: UK At Critical Point In COVID Pandemic, Top Medical Adviser Says 
Britain is at a critical point in the COVID-19 pandemic and faces a very challenging winter, one of the government’s top medical advisers will warn at a public briefing on Monday. Cases in Britain are on the increase in what Prime Minister Boris Johnson has labelled a second wave of the virus, with large areas of the country subject to restrictions on social freedom and London expected to be next in line. (9/20)

The Hill: As Virus Pummels US, Europe Sees Its Own Spike 
Major European countries are seeing new spikes in coronavirus cases, illustrating how easily the virus can snap back after periods of relative calm. The U.S. is averaging about 40,000 new cases and 850 new deaths every day, among the worst numbers in the world. After declining for weeks, cases across the United States are now starting to tick back up. (Sullivan, 9/20)

AP: Virus Measures Targeted By Protesters Despite Case Spikes
Demonstrators took the streets of London, Tel Aviv and other cities on Saturday to protest coronavirus restrictions, decrying how the measures have affected daily life even with infection rates rising in many places and the global death toll approaching 1 million.In the U.K., the latest official estimates released Friday showed that new infections and coronavirus hospital admissions have been doubling every seven to eight days. Britain has Europe’s highest death toll since the start of the pandemic, with 41,821 confirmed virus-related deaths. (Hui and Ghirda, 9/19)

Reuters: Australia's Daily Coronavirus Tally Falls To Lowest In More Than Three Months 
Australia reported on Monday its smallest daily increase in new coronavirus infections in more than three months, but authorities in the nation’s virus hotspot of Victoria said they could not hasten the easing of curbs. The 16 new infections are Australia’s smallest daily jump since June 14, while two additional deaths were reported. “This light at the end of the tunnel is getting closer every day,” Nick Coatsworth, the chief deputy medical officer told reporters in Canberra, the capital. (Packham, 9/21)

AP: Guatemalan President Tests Positive For New Coronavirus
Guatemalan President Alejandro Giammattei said Friday he has tested positive for the new coronavirus, but he told a local radio station he feels well. However, in a televised address to the nation, Giammattei looked a bit out of breath. “My symptoms are very mild. Up to now, I have body aches, it hurt more yesterday than today, like a bad cold,” the president said. “I don’t have a fever, I have a bit of a cough.” (9/18)

AP: Sweden Spared Surge Of Virus Cases But Many Questions Remain
A train pulls into the Odenplan subway station in central Stockholm, where morning commuters without masks get off or board before settling in to read their smartphones. Whether on trains or trams, in supermarkets or shopping malls — places where face masks are commonly worn in much of the world — Swedes go about their lives without them. When most of Europe locked down their populations early in the pandemic by closing schools, restaurants, gyms and even borders, Swedes kept enjoying many freedoms. (Keyton, 9/20)

Modern Healthcare: Trump, GOP Still Suing To Overturn The ACA Amid COVID-19
America is in the midst of unprecedented public health and economic crises that have shaken the foundations of our nation. Nearly 200,000 Americans are dead because of COVID-19, millions have contracted the virus, and unemployment levels rival the Great Recession. And our national emergency isn’t likely to be over anytime soon. Yet, even amid a pandemic that has made access to healthcare more important than ever, President Donald Trump and Republican state attorneys general are moving forward with their lawsuit to strike down the Affordable Care Act in its entirety. This assault on the healthcare of millions, at this moment of crisis, is as inexplicable as it is unforgivable. (Sen. Chris Murphy, 9/20)

CNN: Obamacare Could Be Doomed If Trump Fills Another Court Seat 
On November 10, the court is scheduled to hear arguments in California v. Texas, a case which could, yet again, decide the fate of the Barack Obama-era Affordable Care Act. Republican-appointed judges have already deemed it unconstitutional in a series of lower court rulings in 2018, setting up this appeal. Obamacare survived its last Supreme Court battle by one vote, and the man who has spent years trying to destroy it now wants to hand-pick the successor of one of the five justices who voted to uphold it. If Trump's appointee is seated prior to November 10, it could mean the end of the law as we know it -- and leave millions of Americans without healthcare in a pandemic. (Abdul El-Sayed, 9/20)

The Hill: Social Security And Medicare Are On The Ballot This November 
Ever since President Franklin D. Roosevelt's son, Rep. James Roosevelt, Sr., founded our organization to protect Social Security and Medicare in 1982, we have not endorsed presidential candidates, focusing instead on congressional races. Until now. For the first time in 38 years, we are throwing our weight behind Joe Biden for President of the United States. As an organization rooted in the social insurance policies of FDR's New Deal — and after observing relentless attacks on lifeline programs like Social Security and Medicare — we could not in good conscience remain neutral this year. (Max Richtman, 9/20)

Los Angeles Times: Ruth Bader Ginsburg Protected Your Abortion Rights. Be Afraid Now That She's Gone 
There were two things about Supreme Court Justice Ruth Bader Ginsburg I admired deeply. One was her relentless defense of abortion and reproductive rights, and the other was her excellent planking form in the gym. Balancing your body weight on your hands and feet for 30 to 60 seconds is a challenge at any age, let alone 80-plus years old. But, then, fighting for abortion rights and holding a plank draw on some of the same skills — tenacity and a willingness to push through fatigue. Reproductive rights have been constantly under attack in the nearly half century since the court ruled women had a right to a legal and safe abortion in Roe vs. Wade — and Ginsburg never gave up the fight. (Carla Hall, 9/19)

Modern Healthcare: How To Achieve Universal, Resilient, Affordable Healthcare For All
Before the pandemic, families were already struggling with the skyrocketing costs of healthcare and prescription drugs. Then, the pandemic struck, and it has shown that our healthcare system must be more resilient and less vulnerable to disaster; more equitable and less prone to racial injustice; and more affordable and less financially destructive. My solution: Pass the Medicare for America Act, a bill I introduced with Rep. Jan Schakowsky (D-Ill.) that would achieve universal, affordable, high-quality health coverage. Based on Medicare and Medicaid, it expands the benefits and services covered to include prescription drugs, dental, vision, hearing services, and long-term services and supports. (Rosa DeLauro, 9/19)

Modern Healthcare: Too Many Americans Continue To Slip Through The Cracks Of Our Healthcare System
Since I became chair of the Ways and Means Committee, we have fought to make healthcare more affordable and expand access to coverage, while President Donald Trump and congressional Republicans have continued their crusade to weaken the system and to strip protections from those with preexisting conditions. Continuing to improve our healthcare system has always been an urgent and challenging undertaking, but the COVID-19 pandemic has exacerbated existing problems and also shone a harsh light on long-standing healthcare inequities in the U.S. (Richard Neal, 9/19)

USA Today: Trump-Biden Debate: How Would They Fix Chaotic, Costly Health System?
In medical school, we rely on acronyms to summarize critical aspects of complicated topics. We have one such acronym to describe key aspects that we hope our health care system will one day embody: USA — universal, simple, affordable. Today, health care in America meets none of these criteria. Our country is the only industrialized nation that has yet to commit to providing all of its residents access to affordable, quality care. As medical students in Cleveland and leaders of our school's health justice organizations, we find it fitting that the first 2020 presidential debate will be hosted on Sept. 29 on the Health Education Campus, an education hub we share with other health professional students. (Rohit Anand, Dhiksha Balaji, Aparna Narendrula and Jasmine Serpen, 9/21)

Fox News: Biden's Coronavirus Lies – Don't Fall For Them. Here Are The Facts 
If President Trump acted sooner on coronavirus 'all the people would still be alive'Joe Biden is either a coward or more forgetful than even his harshest critics realize. It’s one or the other. Last week, during a speech in Michigan, Biden said President Donald Trump “failed to do his job on purpose” when the coronavirus arrived, effectively accusing the president of murder. “It was a life and death betrayal of the American people,” Biden continued. “Experts say that if he had acted just one week sooner, 36,000 people would have been saved.” Biden even accused the president of sending the economy into a “tailspin,” adding that the recession was “created by Donald Trump’s negligence.” (Newt Gingrich, 9/20)

Modern Healthcare: It's Time To Move The Country Forward On Racial Health Disparities
The commission should develop and coordinate initiatives designed to address the social determinants of health to target infant mortality, mental health, healthy aging, substance abuse and other chronic issues. It should emphasize the importance of public health, articulate a national target for healthcare expenditures, and outline the path to achieve that goal.Closing the racial divide means we must also look inward. (Michael Ugwueke, 9/19)

Bloomberg: Trump EPA Rule On Coal Ash Puts Lives And The Environment At Risk
To help some of the country’s dirtiest electric-power plants save a little money, the Environmental Protection Agency is willing to imperil the lives and health of Americans who live downstream from them. A new rule that relaxes restrictions on ash pollution is the latest effort by President Donald Trump’s administration to sustain coal power in the face of crushing competition from renewables. And like the others, it’s sure to prove ineffective, wasteful and hugely damaging to the environment. (9/18)

Modern Healthcare: Let's Work Harder To End Racism, Health Disparities
Cities and counties in my home state of Ohio have led the charge in declaring racism a public health crisis. And I joined colleagues Sens. Kamala Harris (D-Calif.) and Cory Booker (D-N.J.) to continue the effort at the federal level. We introduced a Senate resolution that declares racism a national public health crisis, and acknowledges the systemic barriers that people of color, especially Black Americans, continue to face in our healthcare system. (Sherrod Brown, 9/19)

Politico: How Much Are We Paying To Treat Covid? 
Sixty-three thousand, five hundred dollars. That’s about how much a Covid-19 survivor in my home state of South Carolina was told she owed after spending eight of the worst days of her life in a local hospital. She never knew her care would cost that much. Her first inkling came with the bill — a bill she couldn’t possibly afford. Her story is far from unique. Countless Americans have faced a similar crisis. In Colorado, a man recently received a bill for more than $840,000. In Seattle, a 70-year-old ran up charges of more than $1.1 million. In Manhattan, a 48-year-old learned that his time in the hospital racked up nearly $2 million. While most of these folks ended up paying less because of insurance, the fact remains that the price of their care was hidden from view until after the fact. They walked in blind and could have come out broke. This injustice is a feature of American health care. (Nikki Haley, 9/21)

Stat: Give Teachers High Priority Access To Covid-19 Treatments, Vaccines 
The Covid-19 pandemic has revealed what far too few Americans acknowledge about schools and teachers: they are essential to society. Teachers play indispensable roles in human development, particularly for children in elementary, middle, and high school, that cannot be replaced by remote learning. As schools reopen and teachers expose themselves to the risk of Covid-19 infection, we must grant teachers the same priority access to vaccines and treatments that society readily gives to health care workers. (Charles E. Binkley, 9/21)

Modern Healthcare: Success Of A COVID-19 Vaccine Requires Proper Planning For Equitable Distribution
I am cautiously optimistic about the current pace of COVID-19 vaccine development and encouraged that a number of drug companies are seeing promising results. Current projections show that we may begin vaccinating the public by the end of this year or early 2021, but it will take hundreds of millions of vaccine doses to effectively curb this virus. Not all of those doses will be available at once, so difficult decisions will have to be made regarding how to prioritize distribution. That is why the Trump administration must develop a national COVID-19 vaccine distribution plan now. (Raul Ruiz, 9/19)

The Wall Street Journal: You Can Trust The FDA’s Vaccine Process
If one or more Covid vaccines prove safe and effective in large clinical trials, the Food and Drug Administration should make them available, in a careful and limited way, to those at highest risk of contracting infection and suffering a bad outcome. Last week we wrote on these pages how the FDA could allow a Covid vaccine to be used by specific groups of patients through an Emergency Use Authorization. This authority, created by Congress to allow the FDA to respond to a public-health emergency, lets the agency authorize the distribution of a product before a full approval. (Scott Gottlieb and Mark McClellan, 9/20)

Bloomberg: How Covid-19 Killed Good Manners And What To Do About It 
One casualty of the current pandemic is likely to be good manners. True, manners and civility have been dying for ages, but Covid-19 is sure to finish them off. Which is too bad. We often think of manners and civility as the same thing, but the first is only a part of the second. Civility is the sum of all the sacrifices that we make for the sake of living in a workable society. Manners matter to civility not only because they are valuable in themselves (although they may be) but because they have traditionally constituted what the historian Arthur Schlesinger Sr. described as our “letter of introduction” to strangers. At a time when information about people was relatively expensive, Schlesinger saw good manners as signaling what sort of people we were. (Stephen L. Carter, 9/20)

Modern Healthcare: Act Now To Build On Painful Lessons Learned During COVID-19
In this social-media age, attention spans are short. Even with an event as devastating as COVID-19, memories fade and our attention moves quickly to the next crisis. That makes it imperative that Congress act this year, while we have our eye on the ball, to take advantage of the most important lessons learned so far during this pandemic. (Lamar Alexander, 9/19)

Atlanta Journal-Constitution: This Pandemic May Trigger A Renewed Debate Over School Choice
Six months with this pandemic, and months to go before we exit the trap, has changed many minds on many things.Health care for one. You can expect state Democrats to focus on Medicaid expansion in the final 40 days left in this election season, especially as they reach for votes in COVID-battered rural Georgia. Then there is the experience that millions of parents — along with their student-aged children — have suffered through with virtual learning, suddenly thrust upon them by the shuttering of classrooms across the state. (Galloway, 9/18)

Modern Healthcare: COVID-19 Has Exposed The True Cost Of Underinvestment In Public Health
After decades of neglect, our healthcare system cannot conjure epidemiologists or contact tracers from thin air to address a pandemic. It cannot magically conduct massive public outreach, provide sustained support for vulnerable populations, and, eventually, administer hundreds of millions of vaccine doses without sufficient personnel and resources in place. (Michael Bennet, 9/19)

Modern Healthcare: This Year's Flu Season Will Be A Testing Ground For Distributing A COVID Vaccine
Since the first U.S. case of this novel coronavirus was identified in January, nearly 200,000 Americans have died, more than 6 million have been infected, and nearly every aspect of American life has been disrupted. While we cannot undo the damage already done, we can keep ourselves from falling into the same trap. Right now, the world’s best scientists and doctors are working tirelessly on vaccines to neutralize the threat of COVID-19. Once a vaccine—proven safe and effective—is ready, we must deploy it efficiently, effectively and ethically. There is little room for error when so many lives are at stake. (Donna Shalala, 9/19)

Dallas Morning News: The Pandemic Highlights Nationwide Nursing Shortage That Is Acute In Texas
Long before the 7 p.m. ovations rang out across the United States amid the stresses of COVID-19, America admired its health care workers. For 17 consecutive years and counting, nursing has topped Gallup’s poll of most trusted professions. But it took a pandemic for many to gain a deeper appreciation and respect for the contributions that our nurses provide to a community’s health and wellness. (Susan Hernandez, 9/20)

Detroit Free Press: Group Pushing For 100K Jobs For Adults With Autism
Seeing a huge need and severe lack of opportunities, the Autism Alliance of Michigan has launched a new effort to try to create 101,000 jobs over the next decade for Michiganders on the autism spectrum. “We are calling this our ‘moonshot’ because it’s a bold and audacious goal,” said Colleen Allen, president and CEO of the group. She’s hoping to channel the spirit of the challenge put forth by President John. F. Kennedy when he called on NASA to put a man on the moon. (Carol Cain, 9/19)