The Washington Post: CDC Advisers Weigh Mix And Match Coronavirus Booster Shots
Advisers to the Centers for Disease Control and Prevention are meeting Thursday to vote on recommendations about mixing and matching coronavirus booster doses of all three vaccines authorized in the United States. The all-day meeting of the Advisory Committee on Immunization Practices comes after the Food and Drug Administration authorized boosters doses of the Johnson & Johnson, Moderna and Pfizer-BioNTech coronavirus vaccines for different populations and on different timelines. (Jeong, Timsit and Sun, 10/21)

CNBC: FDA Clears Moderna And J&J Covid Vaccine Boosters, Allows 'Mix And Match' Shots
The Food and Drug Administration on Wednesday night authorized booster shots of both Johnson & Johnson’s and Moderna’s Covid vaccines, another critical step in distributing extra doses to tens of millions of people. At the same time, U.S. regulators authorized “mixing and matching” vaccines, allowing Americans to get a booster shot from a different drugmaker than the one that made their initial doses. (Lovelace Jr., 10/20)

NPR: The FDA Authorizes Moderna And J&J COVID Vaccine Boosters
In a related decision, the FDA also authorized boosters that differ from the vaccine originally used to immunize a person against COVID-19. So, for instance, a person who got a Johnson & Johnson vaccine could receive one from Moderna or Pfizer-BioNTech as a booster. The regulatory moves open the gate for boosters to be used more widely. In September, the FDA authorized a booster dose of the Pfizer COVID-19 vaccine. "The available data suggest waning immunity in some populations who are fully vaccinated," said the FDA's acting commissioner, Dr. Janet Woodcock, in a statement. "The availability of these authorized boosters is important for continued protection against COVID-19 disease." (Hensley, 10/20)

Stat: Covid-19 Vaccine Delivery Is Going Next-Level Difficult
The U.S. Covid-19 vaccine rollout is about to get a lot more complicated. When the shots arrived late last year, the message from health officials was simple: Get vaccinated when you become eligible, and get whichever jab is offered to you. But with boosters becoming available for select groups of people, and a lower-dose shot for young children expected shortly, the campaign is moving from a simple set of instructions to more of a messy flow chart for people organizing and delivering the jabs. (Joseph and Branswell, 10/21)

Roll Call: White House Prepares For Younger Kids' COVID-19 Vaccinations 
Vaccinating children ages 5 to 11 against COVID-19 will require an approach that differs from vaccinating adults, and the White House on Wednesday announced additional steps it is taking to prepare states for new protocols to vaccinate school-age kids even though the shots are not yet authorized. The United States has enough supply to vaccinate the 28 million kids in this group who could become eligible once the Food and Drug Administration authorizes the shot, which is expected as early as next week. In the first week after the anticipated authorization, the administration plans to ship 15 million doses for this group. (Cohen, 10/20)

Axios: White House Unveils Plan To "Quickly" Vaccinate Kids Ages 5-11 
The White House on Wednesday released its plan to vaccinate children between the ages of five and 11, pending authorization from the Food and Drug Administration of the first COVID-19 shot for that age group. The White House said it has secured enough vaccine supply to equip more than 25,000 pediatric and primary care offices, hundreds of school and community health clinics, as well as tens of thousands of pharmacies, to administer the shots. (Gonzalez, 10/20)

The Wall Street Journal: Covid-19 Vaccine For Kids Ages 5-11 To Be Given At Pediatric Offices, Schools Once Authorized
In a step to extend the reach of its Covid-19 vaccination drive, the Biden administration is preparing to distribute shots to children at doctors’ offices, pharmacies and schools should federal regulators clear the inoculations for kids ages 5-11. The Biden administration said it has procured enough doses to vaccinate the nation’s children and will begin shipping supplies if and when the shots are cleared for use. Officials aim to have a plan in place as soon as young children are eligible in hopes of getting as many as possible vaccinated quickly. (Siddiqui and Hopkins, 10/20)

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The Boston Globe: Vaccinating 5- To 11-Year-Olds Against COVID Could Help Tame The Pandemic, But Some Parents Will Need Persuasion
Nationwide, some 28 million youngsters, ages 5 to 11 — roughly 8 percent of the country’s population — would be eligible for the shots if authorized by federal health regulators at their upcoming meetings starting next Tuesday. Yet many parents are hesitant, as on the one hand, studies show that kids can harbor high levels of coronavirus as well as transmit the lethal disease to others, yet on the other, they are unlikely to become seriously ill themselves. Heightening anxiety are reports of a very rare but concerning risk among teens of myocarditis, or inflammation of the heart, and pericarditis, an inflammation of the outer lining of the heart, after getting vaccinated. (Lazar, 10/20)

AP: US Marks 200M COVID-19 Shots Shared With World
The U.S. on Thursday donated its 200 millionth COVID-19 shot to help vaccinate the rest of the world, the White House announced. The Biden administration aims to lead a global vaccination campaign even as it rolls out boosters for domestic use, which critics say diverts doses from those who are in greater need around the world. (Miller, 10/21)

Axios: The Biden Administration Is Under Pressure To Close The Global Coronavirus Vaccine Gap 
The world still needs more coronavirus vaccines, particularly low-income countries. Pressure is increasing on the Biden administration to close the gap — and the Biden administration, in turn, is pushing Moderna to fill it. Getting global vaccination rates as high as possible isn't just a humanitarian effort; it also reduces the risk of vaccine-resistant variants emerging. (Owens, 10/20)

Also —

The Atlantic: 'Waning' Immunity: What Falling Antibody Counts Really Mean
In early March, Deepta Bhattacharya, an immunologist at the University of Arizona, celebrated a milestone: hitting the point of full vaccination, two weeks after getting his second Pfizer shot. Since then, he’s been watching the number of coronavirus antibodies in his blood slowly but surely decline. The drop hasn’t been precipitous, but it’s definitely happening—regular checkups have shown his antibody levels, also known as titers, ticking down, down, down, from spring through summer, now into fall. The slump fits the narrative that countless reports have been sounding the alarm on for a while now: In the months after vaccination, our antibodies peace out, a trend that’s often been described as a “waning” of immunity, and evidence that we’re all in dire need of boosters to shore our defenses back up. (Wu, 10/20)

Salt Lake Tribune: Salt Lake County Calculated COVID-19 Vaccination Rates By Zodiac Sign. The News Is Not Good For Scorpios
Surprising perhaps no one, Salt Lake County residents born under the exuberant, high-achieving, let-no-opportunity-pass sign of Leo have been vaccinated for the coronavirus at higher rates than those of any other zodiac sign. That’s according to an analysis of immunization and population data released this week by the Salt Lake County Health Department. The department found that vaccination rates vary dramatically by astrological sign, from 70% of Leos to just 46% of Scorpios, who, if zodiac stereotypes hold true, perhaps hope to contract COVID-19 in order to deliberately infect someone else in retaliation against a perceived slight. “We already weaponize ourselves,” health department spokesman Nicholas Rupp — himself a vaccinated Scorpio — said of the most notoriously intense grudge-holders in the cosmos. (Alberty, 10/20)

Bloomberg: Ivermectin Poisonings Rise As Unproven Use For Covid Soars
Poisonings from taking ivermectin, an antiparasitic drug that some people have used in an attempt to treat or prevent Covid-19, rose sharply in August, according to a report from the Oregon Poison Center. The center, which also serves Alaska and Guam, received 21 calls from people reporting ivermectin toxicity in August, up from a previous average of less than one per month, according to the report published Wednesday in the New England Journal of Medicine. Approved to treat parasitic worms in both people and livestock, ivermectin has surged in popularity recently as fringe groups, vaccine skeptics and social-media figures hype it as a cheap and accessible treatment for the coronavirus. (Langreth, 10/20)

In other news about the spread of the coronavirus —

The Hill: Navy Identifies 15th Sailor Killed By COVID-19
A Navy sailor who died of coronavirus-related complications earlier this month has been identified as Master-at-Arms Senior Chief Michael Haberstumpf. Haberstumpf, 42, of Whispering Pines, N.C., died Oct. 10 at UNC Medical Center in Chapel Hill, N.C. due to COVID-19 related complications, the Navy said in a Wednesday statement. ... The release did not say whether he had received any COVID-19 vaccines, which active-duty Navy sailors are required to have done in full by Nov. 28. Reserve sailors, meanwhile, have until Dec. 28. (Mitchell, 10/20)

San Francisco Chronicle: Court Overturns Order For ICE To Consider Releasing Medically Vulnerable Detainees During Pandemic
A federal judge’s April 2020 order requiring immigration officials to reassess their COVID-19 detention policies, and consider releasing thousands of detainees who were medically vulnerable, was overturned Wednesday by a federal appeals court, which said the order intruded on government authority over immigration. The injunction by U.S. District Judge Jesus Bernal of Los Angeles effectively placed the nation’s 250 immigrant detention facilities “under control of a single District Court,” the Ninth U.S. Circuit Court of Appeals in San Francisco said in a 2-1 ruling. Although the initial response of U.S. Immigration and Customs Enforcement to the pandemic “may have been imperfect, even at times inadequate,” there was no evidence that ICE had been “deliberately indifferent” to the migrants’ health, the standard for judicial intervention, the court said. (Egelko, 10/20)

The Baltimore Sun: Baltimore To Use $80M In Federal Recovery Money To Battle COVID With Vaccines, Testing, Contact Tracing And Telehealth
Baltimore officials announced they will direct $80 million in American Rescue Plan funding to the city’s health department for the fight against the coronavirus — the city’s first allocation from the more than $640 million it received from the federal recovery package. The money, which will be spent over the course of four years, will help fund lab tests for COVID as well as at-home testing kits that health officials hope to distribute in areas of Baltimore where residents have more difficulty getting to a coronavirus testing site. (Opilo, 10/20)

Also —

NBC News: NBA Player Karl-Anthony Towns On Losing 8 Relatives From Covid-19
NBA All-Star Karl-Anthony Towns opened up about the loss of his mother and seven other family members to Covid-19 during a candid episode of the Facebook Watch show “Peace of Mind with Taraji.” The series, hosted by actor Taraji P. Henson and her friend Tracie Jade Jenkins, the executive director of Henson’s mental health advocacy group, tackles mental health awareness. (Breen, 10/20)

KHN: The Yelp Of Covid: Vigilantes Crowdsource Pandemic Safety Tips For Consumers 
Melissa Lee had more to deal with than funeral planning when her husband, Dan Lee, died by suicide in January. She also was faced with continuing Dan’s 1,400-member Facebook group, “Athens, GA Mask Grades 2.0,” designed to help residents of Athens protect themselves from covid-19 by grading local businesses on their safety measures. The group follows a strict template that Melissa Lee compares to a Yelp review. The review includes information about a company’s physical distancing provisions, the availability of outdoor services, vaccination requirements, and the percentages of masked employees and customers. (Gonzales, 10/21)

The Wall Street Journal: New York City Issues Covid-19 Vaccine Mandate For All Public Employees 
New York City Mayor Bill de Blasio announced an order mandating that all municipal workers must get vaccinated against Covid-19, setting up a conflict with unions that said they opposed the new rule. Mr. de Blasio’s move on Wednesday ended an existing option of weekly testing and means some 46,000 city workers need to get their first shot by Oct. 29 or potentially lose their jobs, a spokeswoman for the Democrat said. (Vielkind, Mai-Duc and Kamp, 10/20)

The New York Times: Unmasked NYPD Officers Remove Subway Rider After He Confronts Them
A New York City police officer grabs a male commuter by his jacket and pushes him through an emergency exit door at a subway station in Manhattan, video posted to social media shows. “You’re being disruptive,” the officer tells him. The man in the 35-second video clip — which has garnered more than one million views and ushered in a fresh wave of criticism of the police — said in an interview that the confrontation erupted when he asked the officer and his partner to put on masks. (Closson, 10/20)

Bloomberg: Adams, Sliwa Battle Over Vaccine Mandates In NYC Mayoral Debate
New York City Democratic mayoral candidate Eric Adams said he supports coronavirus vaccine mandates and would be open to students going back to remote classes if they don’t get shots in a wide-ranging debate with Republican contender Curtis Sliwa Wednesday night. In the first of two debates between the candidates, Adams sought to paint Sliwa as an unserious opponent and at times refused to engage as he taunted him. On at least two occasions, moderators asked if he wanted to respond directly to Silwa, a radio host and the founder of the Guardian Angels anticrime group, and he declined. (Chen and Akinnibi, 10/21)

In other news about covid mandates —

Fox Business: Advocate Aurora Health Fires More Than 400 Workers Over Lack Of Vaccinations: Reports
Health care company Advocate Aurora Health has fired more than 400 employees because they haven’t been vaccinated against the coronavirus, according to reports. About half the affected workers were part-timers, FOX 32 of Chicago reported, citing information from the Chicago Sun-Times. The move follows a vaccination mandate for health care workers in Illinois that was issued in August by Illinois Gov. J.B. Pritzker, a Democrat, the Sun-Times reported. (Calicchio, 10/21)

The Boston Globe: Mass General Brigham Employees Lose Bid To Halt Unpaid Leave Over Vaccine Mandate
On the day that 229 Mass General Brigham employees were placed on unpaid leave for failing to get a COVID-19 vaccine, a federal judge in Boston on Wednesday denied their motion to prevent the company from enforcing its vaccine mandate. Employees of the state’s largest hospital system had until Wednesday to show they had received at least one shot or be placed on unpaid leave. Those who have not received their first shot by Nov. 5 now face termination. A federal lawsuit filed by employees in US District Court on Sunday sought to halt those actions, saying the workers’ disability and religious exemptions had been wrongly denied without explanation or “meaningful interactive process” and “without a showing of undue hardship.” (Alanez, 10/20)

Charleston Gazette-Mail: Vaccine Exemption Bill Heads To Justice
If signed into law as is, House Bill 335 would force any private or public employer in West Virginia to accept religious or medical exemptions for the COVID-19 vaccine if being vaccinated is a requirement of employment for the business. It would be the first piece of state code ever to dictate vaccine practices outside of those for public school registration. It also would be the first time the state codifies religious exemptions for any kind of vaccination. The current Department of Health and Human Resources webpage on vaccine exemptions reads, “non-medical exemptions [for immunization] have been associated with increased occurrence of vaccine-preventable disease outbreaks originating in and spreading through schools.” (Coyne, 10/20)

Atlanta Journal-Constitution: TSA Works To Increase Employee Vaccination Rate
Last month, President Joe Biden issued an executive order that requires federal employees to get fully vaccinated by November 22. In the order, Biden said he was doing so to ensure “the health and safety of the Federal workforce and the efficiency of the civil service.” About 60% of the TSA’s workforce has been vaccinated, “and that number needs to go quite a bit higher over the next few weeks,” TSA Administrator David Pekoske told CNN in an interview last week. But a TSA spokesman said Monday that the agency doesn’t have information on the vaccination status of all of its employees. Thus, the figure is likely not an accurate reflection of the actual vaccination rate, he said. “Thousands of TSA employees upload their vaccination every week,” TSA spokesman R. Carter Langston said in an email. He added, “We anticipate that the vast majority of TSA employees will get vaccinated.” (Yamanouchi, 10/18)

Bloomberg: Fed Survey Says Vaccine Mandates Contributing To Labor Turnover
Employers across the U.S. are struggling to attract and retain talent, and in some areas, vaccine mandates have made it even more challenging to hold onto workers, the Federal Reserve’s Beige Book said Wednesday. The central bank said vaccine mandates were “widely cited” as contributing to high labor turnover, along with child-care issues and Covid-related absences. However, diving into the comments of the five regional Fed banks that mentioned vaccines, the repercussions of mandates varied. (Pickert, 10/20)

Also —

AP: Vaccine Doubts Fuel Doctor's Rise In Minnesota Governor Race
The small-town family doctor angling to become Minnesota’s next governor smiled, leaned into the camera and told his Facebook viewers that Sweden had just paused the Moderna vaccine for people under age 30 over “significant concern” about heart inflammation. Dr. Scott Jensen, clad in a white lab coat, quickly pivoted: “So what happens to military people who are threatened with a dishonorable discharge if they are unwilling to potentially put their heart health at risk?” (Karnowski, 10/21)

The Washington Post: Travis Tritt Cancels Shows With Vaccination And Mask Mandates That Are ‘Trying To Shame People’
During a week in which he announced the cancellation of four concerts at venues with coronavirus safety protocols, country artist Travis Tritt reiterated on Tuesday night to Fox News host Tucker Carlson how he was “putting my money where my mouth is” by not playing at places requiring vaccination, masks or negative coronavirus tests. (Bella, 10/20)

The Hill: Under Pressure, Democrats Cut Back Spending
Democratic lawmakers are swiftly cutting back their spending on the Build Back Better agenda after President Biden made clear to progressive lawmakers that the package will spend far less than they had hoped on key priorities. Progressive and centrist Democrats alike say a new reality is setting in after weeks of stalemate over the shape and size of the social spending bill, which had also brought work on an infrastructure measure passed by the Senate to an impasse. (Bolton, 10/20)

AP: Big Changes In White House Ideas To Pay For $2 Trillion Plan
In an abrupt change, the White House on Wednesday floated new plans to pay for parts of President Joe Biden’s $2 trillion social services and climate change package, shelving a proposed big increase in corporate tax rates though also adding a new billionaires’ tax on the investment gains of the very richest Americans. The reversal came as Biden returned to his hometown of Scranton, Pennsylvania, to highlight the middle class values he says are at the heart of the package that Democrats are racing to finish. Biden faces resistance from key holdouts, including Sen. Kyrsten Sinema, D-Ariz., who has not been on board with her party’s plan to undo Trump-era tax breaks to help pay for it. (Mascaro, Superville and Fram, 10/21)

The New York Times: Biden Backs Compromise To Achieve His Vast Social Agenda 
As he tries to steer his party toward a vast, once-in-a-generation investment in social programs, President Biden is paring back his ambitions for clean energy, access to college and help for families. The president proposed abandoning his signature campaign promise of two years of free community college, according to people who attended White House meetings with Democratic lawmakers and others who had been briefed on them. He conceded that negotiators would dump a clean electricity program spurned by Senate centrists. He raised the idea of limiting an extension of payments to families with children to one year. And he said the length of federal paid leave could shrink. (Shear, Cochrane and Tankersley, 10/20)

The Washington Post: Biden Accelerates His Involvement In Agenda Talks
For weeks, President Biden has met repeatedly with Democratic lawmakers as part of the tortuous negotiations over his agenda — but to the frustration of many, he has revealed few opinions of his own on what should remain in the plan and what should be jettisoned. This week, however, Biden is doing something new: getting specific and plunging into details, telling lawmakers exactly what he thinks needs to go into the package that could define his presidency. (Linskey, Sullivan and Viser, 10/20)

The Wall Street Journal: Sinema’s Opposition Stymies Democrats’ Planned Tax-Rate Increases 
Senate Democrats are considering abandoning central tax elements of their social policy and climate package, as a key senator continues to oppose any increase in marginal rates for businesses, high-income individuals or capital gains, according to people familiar with the matter. Sen. Kyrsten Sinema (D., Ariz.) has previously told lobbyists that she is opposed to any increase in those rates, according to a person familiar with her remarks, but her stance is now pushing Democrats to plan more seriously for a bill that doesn’t include those major revenue increases. (Duehren, Rubin and Peterson, 10/20)

Politico: Democrats Weigh Slashing $200B In Housing Aid From Spending Bill 
Democrats are considering cutting housing funding in President Joe Biden's massive social spending plan to $100 billion, roughly a third of the initial amount proposed as they try to lower the cost of the bill, congressional aides said. The potential cuts are fueling resentment among progressives, who are fighting to preserve programs proposed in what was originally a $3.5 trillion plan as centrists such as Sen. Joe Manchin (D-W.Va.) try to slash the size of the bill. (O'Donnell and Cassella, 10/20)

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Stat: Democrats Push Back On Idea That Expanding Medicare Would Bankrupt It
Key Senate Democrats used a hearing Wednesday to push back on the argument that expanding Medicare to include dental and vision coverage would bankrupt the program — a not-so-subtle message for Democratic Sen. Joe Manchin, who has said he opposes the expansion on those grounds and who remains a key vote for any major legislation. Senate Democrats are hoping to expand Medicare coverage to include dental, vision, and hearing coverage as part of their massive social spending package — but the West Virginia senator suggested in September that he wants to shore up the program’s long-term solvency first. (Osman, 10/20)

The Washington Post: Meghan, Duchess Of Sussex, Appeals To Congressional Leaders To Pass Paid Family And Medical Leave 
Meghan, Duchess of Sussex, sent a letter to congressional leaders Wednesday asking that they pass paid family and medical leave, arguing that comprehensive leave should be a “national right, rather than a patchwork option.” In the letter, addressed to House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Charles E. Schumer (D-N.Y.), the duchess made clear that she was writing not as a politician but “as a mom.” ...The duchess, who grew up in Los Angeles, recounted the challenges her parents faced while trying to make ends meet. She started working at 13, she said, “to cover odds and ends.” “I grew up on the $4.99 salad bar at Sizzler — it may have cost less back then (to be honest, I can’t remember) — but what I do remember was the feeling: I knew how hard my parents worked to afford this because even at five bucks, eating out was something special, and I felt lucky,” she wrote. (Alfaro, 10/20)

Modern Healthcare: CMS Focuses On Health Equity, Accountable Care In Its New Strategic Plan
For its second decade in operation, Centers for Medicare and Medicaid Services Innovation Center is implementing strategies to drive healthcare transformation, using demographic data, industry feedback and more accessible payment models. In a Wednesday webinar, CMS leaders outlined the agency's five new objectives and how they will advance health equity, expand coverage and improve health outcomes going forward. Driving accountable care: The first goal guiding the agency's work is to increase the number of people in relationships with providers that are accountable for patients' costs and improving their care history, said Dr. Liz Fowler, CMS Innovation Center director, during the virtual conference. (Devereaux, 10/20)

In other Medicare and Medicaid news —

Modern Healthcare: CMMI Official Pushes For More Participation In Value-Based Care Models
The Biden administration hopes to increase participation in alternative payment models as a way to save the government money and improve care for beneficiaries, a senior official said Wednesday. Purva Rawal, chief strategy officer for the Center for Medicare and Medicaid Innovation, speaking at the Better Medicare Alliance conference, said the administration wants to "accelerate" the movement to value-based care through Accountable Care Organizations and other models. "We need to recognize we need to increase the number of ACOs and the beneficiaries assigned to them, increase opportunities for providers who want to participate and deliver whole-person, integrated care," Rawal said. (Hellmann, 10/20)

Modern Healthcare: Feds: UnitedHealthcare Scored $3.7B In Questionable Medicare Advantage Pay
UnitedHealth Group generated $3.7 billion in Medicare Advantage payments in 2016 by listing patient conditions unverified through outside medical claims, according to a Wednesday report by federal investigators. The announcement stems from a September report by the Office of Inspector General, which now indicates the Minnetonka, Minnesota-based health giant captured a significant number of member diagnoses through chart reviews and health risk assessment services, tactics that "may be particularly vulnerable to misuse by Medicare Advantage companies," since they are often performed by the health plan or conducted by vendors hired by the health plan, OIG said. The Star Tribune first reported the finding. (Tepper, 10/20)

AP: Auditor: Iowa's Privatized Medicaid Illegally Denies Care
Iowa’s privatized Medicaid system has illegally denied services or care to program recipients, and both private insurance companies managing the system have violated terms of their contracts with the state, according to a state audit released Wednesday. Auditor Rob Sand released a report from his investigation that examined cases from 2013 through 2019. He said his investigators found a massive increase in illegal denials of care by managed care organizations, or MCOs, under privatized Medicaid. (Pitt, 10/21)

CNBC: Switching To Medicare From Public Exchange: How To Avoid Mistakes
For anyone nearing age 65 who gets health insurance through the public marketplace, it’s almost time to make the move to Medicare. Generally speaking, you must sign up when you reach that age unless you have qualifying coverage elsewhere. And health plans through the exchanges, whether federal or state, do not count. “You need to be prepared to make that change,” said Karen Pollitz, a senior fellow with the Kaiser Family Foundation. “Otherwise you can face [costs] for being late to enroll in Medicare and for being late getting out of the marketplace.” (O'Brien, 10/20)

Axios: Aduhelm Is Bombing 
Biogen sold $300,000 worth of Aduhelm in the third quarter, well below Wall Street's expectations, which prompted analysts at Raymond James to call the Alzheimer's drug "potentially the worst drug launch of all time" amid Biogen's "persistent hyperbole about the drug's purported benefits." Aduhelm's controversial approval and high price tag have shaped the market reaction. Health insurers are hesitant to cover Aduhelm until Medicare makes a decision next year, and doctors aren't embracing the drug either. (Herman, 10/21)

The Wall Street Journal: Biogen’s New Alzheimer’s Drug Meets Slow Rollout
Biogen Inc. reported slow uptake of its new Alzheimer’s disease drug Aduhelm in the third-quarter, as some doctors stayed on the fence about whether to prescribe the drug and others struggled to coordinate the complex process of onboarding new patients for treatment. Aduhelm sales were $300,000 in the first full quarter since the drug was approved in June, falling short of the $12 million projected by analysts, according to FactSet. The Cambridge, Mass., company continues to expect minimal Aduhelm revenue this year, but sales should start ramping up in 2022, Biogen said on Wednesday. (Walker and Grossman, 10/20)

AP: Biogen CEO: 'Major Bottleneck' Still Limits Alzheimer's Drug
A new Alzheimer’s drug from Biogen brought in only $300,000 in sales during its first full quarter on the market, extending a slow debut complicated by coverage questions and doctor concerns. The infused drug, hailed as a potential breakthrough treatment for a fatal disease, has encountered a health care system that “remains a major bottleneck” in keeping the treatment from patients, CEO Michel Vounatsos said Wednesday. (Murphy, 10/20)

In updates on Amazon Pharmacy —

Stat: How Amazon Pharmacy Stacks Up A Year After Its Ambitious Launch
It was the launch that sent pharmacy stocks into a tailspin. Within hours of Amazon announcing it was starting Amazon Pharmacy last November, analysts began issuing warnings to investors in would-be rivals including CVS and Walgreens. “Today’s announcement is a net negative” for drug stores, one note from Evercore analysts read. “Retail Pharmacy is trading down big pre-market,” noted another, from Baird. But nearly a year after Amazon Pharmacy’s public debut — and three years after its purchase of specialty pharmacy startup PillPack — it remains unclear how Amazon will carve out its corner in an increasingly crowded market. (Brodwin, 10/21)

In news about the opioid crisis —

AP: Maricopa County Signs Onto National Opioid Settlement
Maricopa County has become the first local government in Arizona to sign onto a massive settlement agreement with pharmaceutical companies over the nation’s opioid epidemic. The county Board of Supervisors voted unanimously Wednesday to approve the settlement, which is expected to bring the county about $80 million of Arizona’s anticipated allocation, which could reach $550 million or more. (10/20)

ABC News: NHL Player Jimmy Hayes' Death Highlights Spike In Fentanyl-Related Drug Overdose Deaths
Family members of a former NHL player who had cocaine and fentanyl in his system when he died are now speaking out to warn people about the risks of fentanyl, a powerful synthetic opioid. Jimmy Hayes, a 31-year-old father of two who played seven seasons in the NHL, was found dead at his home near Boston on Aug. 23. (Kindelan, 10/19)

ABC News: Largest Nurses Union Applauds Possible OSHA Action Against 3 States Over PPE
The country's largest nurses' union praised the federal government on Wednesday after officials said three states tasked with implementing their own safety measures for health care workers would lose that right unless they adhered to agreed-upon guidelines. The U.S. Occupational Safety and Health Administration had announced Tuesday it was considering stripping Arizona, Utah and South Carolina of their abilities to oversee workplace safety enforcement because they're not in compliance with an emergency standard order passed over the summer that guarantees certain protections. (Pereira, 10/20)

KHN: Worn-Out Nurses Hit The Road For Better Pay, Stressing Hospital Budgets — And Morale 
In parts of the country where covid-19 continues to fill hospitals, a rotating cast of traveling nurses helps keep intensive care units fully staffed. Hospitals have to pay handsomely to get that temporary help, and those higher wages are tempting some staff nurses to hit the road, too. Nearly two years into the pandemic, there’s some truth in a joke circulating among frustrated ICU nurses: They ask their hospitals for appropriate compensation for the hazards they’ve endured. And the nurses are rewarded with a pizza party instead. (Farmer, 10/21)

In other health care industry news —

AP: Princeton Hospital Joining WVU Health System
Princeton Community Hospital is joining the West Virginia University Health System. The hospital’s board of directors, the WVU Health System and the city of Princeton have signed a letter of intent for the hospital to be integrated into the WVU system, the university said in a news release Wednesday. (10/21)

AP: Former HCA CEO, Wife Donate $10M To Belmont Medical School
The former HCA Healthcare CEO who is currently Belmont University’s board chairman and his wife have donated $10 million to the Nashville institution’s new medical school. The private university says Milton Johnson and his wife, Denice, announced the gift Wednesday for the Thomas F. Frist Jr. College of Medicine. (10/21)

CNBC: Bomb Threat Locks Down Walter Reed Hospital, Navy Base
A shelter-in-place order was lifted Wednesday afternoon at a U.S. Navy base just outside of Washington, D.C., hours after a bomb threat was made against Walter Reed Medical Center located there. The order ended a lockdown at the base in Bethesda, Maryland, which had closed the facility’s gates to nonemergency traffic, according to tweets posted by the base and Walter Reed accounts. (Mangan and Breuninger, 10/20)

AP: Reports: Health Problems Tied To Global Warming On The Rise
Health problems tied to climate change are all getting worse, according to two reports published Wednesday. The annual reports commissioned by the medical journal Lancet tracked 44 global health indicators connected to climate change, including heat deaths, infectious diseases and hunger. All of them are getting grimmer, said Lancet Countdown project research director Marina Romanello, a biochemist. “Rising temperatures are having consequences,” said University of Washington environmental health professor Kristie Ebi, a report co-author. (Borenstein, 10/21)

The Boston Globe: Climate Change Is Taking Lives, And The Time To Act Is Running Out, Health Experts Say In New Report
As the planet heats up, an increase in wildfires, extreme heat, and drought is upending millions of lives worldwide, according to a new report from public health leaders around the world, putting the planet on the precipice of a global epidemic that could dwarf the COVID-19 crisis. The report, published Wednesday in The Lancet, details how little progress has been made to protect the world’s population from the health impacts of climate change, despite years of scientific reporting on the impacts of the crisis. (Shankman, 10/20)

Axios: Study: More Infectious Diseases Inevitable Due To Climate Change 
Climate change is creating ideal conditions for infectious diseases to spread more quickly, according to The Lancet Countdown's annual climate report out Wednesday. It's just one of the increasingly urgent threats to human health emerging from global climate change. (Fernandez, 10/21)

USA Today: Climate Change And Heat Waves Are Affecting Health In Deadly Ways
Working construction under the merciless Arizona sun, Eleazar Castellanos knew the signs that heat exhaustion was settling in. On the days when the temperature would top 100 degrees, he and his coworkers would sweat profusely. Then came the cramps in their arms and legs, and the overwhelming urge to stop: take a break, get some water, cool down. But they couldn’t. Not if they wanted to get paid and return home to their families as breadwinners. “Many of the employers don’t understand, we need to have breaks, to have water,” Castellanos said. “You don’t stop, because you know if you stop, you stop getting money. We try to get it done whatever the situation is.” (Bagenstose, 10/20)

Bloomberg: Hundreds Sick As Onion-Linked Salmonella Outbreak Hits 37 States
People across the U.S. have been advised to throw away all unlabeled red, white and yellow onions after a mass salmonella outbreak sickened hundreds of people across 37 states. The Centers for Disease Control and Prevention said one source of infections had been traced to onions imported from Chihuahua, Mexico, and distributed by ProSource Inc. So far 652 people have been reported sick, with 129 hospitalized. No deaths have been reported. The CDC said the actual number of people made ill was likely to be much higher, with most going unreported. Infections were recorded between May 31 and Sept. 30. (Millson, 10/21)

In other public health news —

The Washington Post: AMC Bringing Captions To Big Screens Across The Country
The world’s largest movie chain is bringing open captions to the big screen, creating more accessibility for people who are deaf and hard of hearing at a time when younger audiences are used to seeing the spoken word flash on their streaming and social media feeds. AMC Entertainment said the rollout will cover 240 movie houses in 100 markets, or roughly 40 percent of the company’s U.S. theaters. The company said filmgoers will be able to find locations and showtimes on its app and website, and that availability could be adjusted based on audience demand and guest feedback. (Shaban, 10/20)

New York Post: Broken Heart Diagnoses On The Rise In The US: Study
Hearts are breaking at rising rates, researchers have found. The life-threatening medical condition known as broken heart syndrome is being reported at increasing rates, according to a new study published Wednesday in the Journal of the American Heart Association. The temporary condition, also known as Takotsubo cardiomyopathy, causes the heart muscle to become suddenly weakened and generally happens following a period of severe emotional or physical stress. While potentially life-threatening, most people recover within two months. (Frishberg, 10/20)

Stat: Should Breast Cancer Screening Start Sooner For Black Women?
For years, health experts have recommended that, starting at the age of 50, every woman should get a mammogram every two years. But Christina Chapman, an oncologist and researcher at the University of Michigan, looked at the devastating disparities in breast cancer outcomes for Black women and wondered whether medicine could serve Black women better with a different recommendation just for them. (Chen, 10/18)

AP: McLaren Will Pay $5M, Not $20M, In Flint Water Settlement
A $641 million settlement with people affected by Flint’s lead-contaminated water was reduced by $15 million Wednesday after a judge agreed that a hospital could cut its pledge. McLaren Health will pay $5 million instead of $20 million. It had the right to drop out completely if not enough claimants signed up for its share of the settlement. (10/20)

In related news about water contamination —

AP: Lawsuits: Mississippi Capital City's Water Harms Children
Two new lawsuits claim hundreds of children have been exposed to dangerous lead levels through the drinking water in Mississippi’s capital city, which has been facing water system problems for years. One lawsuit represents one child, while the other seeks to be a class action with about 600 children as plaintiffs. The suits, filed Tuesday in federal court in Jackson, say the city of Jackson and the state Health Department have made “conscience-shocking decisions and have shown deliberate indifference that have led to Plaintiffs’ exposure to toxic lead in Jackson’s drinking water.” (Pettus, 10/20)

In other news from across the U.S. —

Fox News: Leptospirosis Cases Surge In NYC: What To Know About The Rat-Spread Infectious Disease
New York City has reported an increase in human cases of leptospirosis, a bacterial disease that the city reports has been spread by rats. In a late September advisory, the city's Department of Health and Mental Hygiene reported that 14 cases of human leptospirosis had been identified this year, a number it said was more than the total number reported to the city's health department in any previous year. Cases had been identified in all boroughs except Staten Island with "no obvious clustering." (Musto, 10/20)

Billings Gazette: Attorney General Appeals Injunction Halting New Abortion Laws
The Montana attorney general is appealing a preliminary injunction by a Yellowstone County judge halting the implementation of three laws restricting access to abortions in Montana. District Court Judge Michael Moses issued the injunction earlier this month, blocking the laws while a legal challenge filed by Planned Parenthood of Montana seeking to permanently overturn them plays out. Republican Attorney General Austin Knudsen filed the notice of appeal with the state Supreme Court on Tuesday. The office did not respond to an email Wednesday seeking comment about the filing. (Michels, 10/20)

AP: US Government Awards $1M To WV For Mother, Child Health Care
The U.S. Department of Health and Human Services has awarded more than $1 million to the West Virginia Department of Health and Human Resources for maternal and child health services in the state. West Virginia’s U.S. senators, Democrat Joe Manchin and Republican Shelley Moore Capito, announced the award Wednesday. (10/21)

Las Vegas Review-Journal: Nevada Overdose Deaths Continue To Climb, Reports Show
Drug overdose deaths among Nevadans under 25 nearly tripled from 2019 to 2020, while fatalities among the Hispanic community more than doubled, according to a recently released report from the state’s Division of Public Health and Behavioral Health. Last year, 106 Nevadans younger than 25 died of drug overdoses, compared with 38 in 2019, the report made public earlier this month stated. For Hispanics Nevadans death rose to 145 in 2020 from 66 the year prior. And the numbers continue to climb. (Torres-Cortez, 10/20)

The Kansas City Star: A Rural Missouri Clinic Closing Its Doors Has A Final Prescription For Patients: Medicaid 
In her final days as clinic administrator, Sheri Noble has a parting plea for the 400-odd patients she’s seen come through the Good Samaritan Care Clinic the past year: Apply for Medicaid. The rules have changed, she’s explained. And because the free clinic, run from a converted church parsonage for the last 17 years, is closing its doors next month, she wants them to be able to find another doctor they can afford to see. Financial straits caused by the pandemic are one reason for the closure, but so is Missouri’s recent expansion of Medicaid, which gives many patients a better health care option. (Kuang, 10/20)

KHN: DC’s Harllee Harper Is Using Public Health Tools To Prevent Gun Violence. Will It Work? 
After four people were murdered in one week in early September — all in the same Washington, D.C., neighborhood — residents made a plea for help. “We’ve been at funerals all week,” said Janeese Lewis George, a City Council member who represents the neighborhood. “What can we do as a community?” (Gomez, 10/21)

AP: Russians To Stay Off Work For A Week As Virus Deaths Rise 
President Vladimir Putin on Wednesday ordered most Russians to stay off work for a week later this month amid rising COVID-19 infections and deaths, and he strongly urged reluctant citizens to get vaccinated. The government coronavirus task force reported 1,028 deaths in the past 24 hours, the highest number since the start of the pandemic. That brought Russia's death toll to 226,353, by far the highest in Europe. (10/20)

Axios: India Hits 1 Billion COVID Vaccinations Milestone 
India's Prime Minister Narendra Modi announced Thursday that the country's health workers have now administered more than 1 billion COVID-19 vaccines doses. While this is a significant milestone for the country of 1.4 billion, which has been devastated by the coronavirus, only about 30% of the eligible population has been fully vaccinated against the virus, per AP. Roughly 75% has received at least one dose. (10/21)

In covid updates from Europe —

Bloomberg: NHS Chair Says Young May Be Infecting Old In U.K. Covid Surge
Amid concern that a new twist on the delta variant could be driving the current U.K. coronavirus surge, National Health Service chair David Prior said it’s more likely that school-aged children are infecting older people whose vaccine-induced immunity is on the wane. “It’s too early to say, but that’s what we think is the most likely explanation,” Prior said Tuesday evening in an interview at a Boston health conference. Former U.S. Food and Drug Administration Commissioner Scott Gottlieb tweeted on Sunday that “urgent research” was needed to determine if the new delta variant AY.4 -- which represents 8% of recently sequenced cases in the U.K. -- was more transmissible and better at evading immune defenses. (Goldberg, 10/20)

CNN: New Delta Descendant Is Rising In The UK. Here's What To Know 
British and international authorities are closely monitoring a subtype of the Delta variant that is causing a growing number of infections in the United Kingdom. This descendant of the Delta variant, known as AY.4.2, accounted for an estimated 6% of cases in the week of September 27 -- the last week with complete sequencing data -- and is "on an increasing trajectory," a report by the UK Health Security Agency said. Little is known about AY.4.2. Some experts have suggested it could be slightly more transmissible than the original Delta variant, though that has not yet been confirmed. While it accounts for a growing number of infections, it is not yet classified in the UK as a "variant of concern." (John, 10/20)

In other health news from the U.K. —

Stat: U.K. To Launch New System For Registering Clinical Trials Automatically
In its latest bid to boost clinical trial transparency, the U.K. government will automatically register new studies with an independent registry, a move that is designed to lessen reliance on companies, universities, and researchers for up-to-date submissions. The effort will begin in January 2022 as a partnership between the Health Research Authority and ISRCTN, a registry in London that is part of a World Health Organization network of globally recognized trial registries. Trial registrations will be based on ethics committee approvals for all new studies from around the country, which are centrally housed with the HRA. (Silverman, 10/20)

The Washington Post: U.K. To Check Social Media And Medical Records Of Gun License Applicants
Britain’s first mass shooting in more than a decade occurred in August. Just over two months later, London is requiring British police to check medical records and in some cases delve into applicants’ social media history before issuing gun licenses. Jake Davison killed five people including his mother and a 3-year-old girl in a shooting rampage in the southwestern seaside city of Plymouth in August, before taking his own life. The attack stunned a nation where gun violence is rare. (Pannett, 10/21)

The Hill: UK Sees Increase In Women Being 'Needle Spiked' With Date Rape Drugs
The United Kingdom has seen a disturbing increase in women being injected with "spiked needles" filled with date rape drugs, often at nightclubs in cities with large student populations, according to reports from BBC News. The spate of incidents has left women in the U.K. "terrified of going out" and has spurred to a petition with 150,000 signatures asking the U.K. government to make searching guests at bars a legal requirement, the BBC reported. (Breslin, 10/20)

CIDRAP: Asymptomatic COVID-19 May Significantly Contribute To Transmission
Seventy-five percent of asymptomatic COVID-19 outpatients had mean to high RNA viral loads, and 50.6% of those whose samples were tested with culture assays had live cultures, according to a study today in Scientific Reports. The researchers say this indicates that COVID-19 asymptomatic adult outpatients could play a large role in perpetuating COVID outbreaks. The study was conducted before the much more transmissible Delta (B1617.2) variant was circulating. (10/18)

JAMA Network: Association Between Risk Of COVID-19 Infection In Nonimmune Individuals And COVID-19 Immunity In Their Family Members 
This nationwide cohort study showed that individuals without COVID-19 immunity had a 45% to 97% lower risk of infection that was in line with the increase in the number of immune family members. Similar results were found regardless of whether immunity was acquired from a previous infection, a single dose of vaccine, or full vaccination. These findings suggest that vaccines are associated with a reduction in the transmission of the SARS-CoV-2 virus within families, which likely has implications for herd immunity and pandemic control. However, caution is warranted given the emerging variants of concern, which appear more transmissible and may be less sensitive to a single dose of vaccine. (Nordstrom et al, 10/11)

CIDRAP: Obesity Linked To COVID-19 Death, Longer ICU Stay
High body mass index (BMI) was independently associated with death and longer intensive care unit (ICU) stays for hospitalized COVID-19 patients, according to a study published yesterday in PLOS One. The researchers looked at Sweden's nationwide ICU population from Mar 6 to Aug 30, 2020, and found 1,649 adults with COVID-19, of whom 78.3% were at least overweight (25 kilograms per square meter [kg/m2] or more). Besides having an overrepresentation of obese people compared with Sweden's general population (39% in the cohort), the study group also consisted of more men (74.4%). Mean age was 60.1 years. (10/14)

CIDRAP: Overweight, Obesity Linked To More, Longer Mild COVID-19 Symptoms
COVID-19 outpatients were more likely to have more respiratory symptoms if they were overweight or obese, according to a study published yesterday in Influenza and Other Respiratory Viruses. The researchers enrolled 522 people, 63.8% of whom were considered overweight or obese, from June 2020 to January 2021 within 2 weeks of a known household exposure to COVID-19. During a 28-day follow-up in which participants reported their symptoms and sought regular testing, 85.1% ended up positive for COVID-19 (261 adults, 61 adolescents 12 to 17 years old, and 148 children). (10/20)

CIDRAP: Hospital-Acquired COVID-19 Affects Patients, Workers, Study Says
While the absolute risk of acquiring COVID-19 in the hospital was low—up to 0.75% risk per day of exposure pre-Delta (B1617.2) variant—patients or healthcare workers (HCWs) with COVID-19 nonetheless can be factors in the spread of COVID-19, a study published yesterday in PLOS One says. The researchers looked at four UK teaching hospitals, where 66,184 patients were hospitalized and 5,569 HCWs were on the job from Jan 12 to Oct 2, 2020. Of the patients, 1.4% had a positive test within the same period, and 10.5% of those (97) had their first positive test post-hospitalization at least 7 days after admission, wherein they were considered a nosocomial case. Patients who likely acquired COVID-19 infections while in the hospital were older, had longer lengths of stay, and had more readmission, the researchers note. (10/13)

CIDRAP: Study: Home Monoclonal Antibody Program Averted COVID Hospital Care
A research letter today in JAMA Network Open describes how nurses in Michigan may have reduced emergency department visits and hospitalizations of high-risk COVID-19 patients by coordinating at-home administration of neutralizing monoclonal antibodies (MABs) during the spring 2021 surge. (Van Beusekom, 10/14)

The Washington Post: Why I Chose The Pfizer Booster After The Johnson & Johnson Vaccine 
After months of waiting, I finally received my second coronavirus vaccine shot. It’s not that I’ve procrastinated. Like 15 million Americans, I was initially inoculated with the one-dose Johnson & Johnson vaccine. Since then, I’ve been watching with growing concern as more and more studies emerged that showed one dose of J&J is inferior to the two-dose mRNA vaccines (Pfizer and Moderna). (Leana S. Wen, 10/20)

Bloomberg: Valneva's Covid Vaccine Trial Success Comes With Caveats
The U.K. government never said publicly why it abruptly pulled plug in September on its 1.4 billion-euro ($1.98 billion) contract for a new vaccine from Valneva SE, to be manufactured at a plant in Scotland. But Monday’s news that a Phase 3 trial of the French pharmaceutical company’s vaccine compared favorably to the Oxford-AstraZeneca Plc vaccine has brought fresh questions about that decision and the role this new vaccine might play in building Covid defenses. (Sam Fazeli and Therese Raphael, 10/20)

The Atlantic: Selflessness Alone Can't Fight The Pandemic
This winter, COVID-19 will continue to demand our attention, and we’ve unfortunately exhausted our store of soft-touch options to rouse those inner angels. More will be required if we are to leverage one of our greatest natural advantages as a species: the impulse to help others. From the start of the pandemic, we have seen a mix of selfless and abhorrent behaviors. A puzzling feature of human nature is that they exist in a delicate balance. (Nicholas A. Christakis, 10/20)

Houston Chronicle: Just How Bad Is The Lead Problem In Houston's Water?
It may take years to know whether children growing up in Houston’s Fifth Ward will have lead coursing through their bloodstreams at levels high enough to affect them for the rest of their lives. Too few children across Texas are being tested for lead, despite laws requiring it, according to a federal inspector general’s report this week. (10/21)

The Baltimore Sun: Housing Policy Affects Population Health, Research Shows 
While there has been a growing recognition that housing and health are intertwined, current research and policy debates around these two emergent issues remain woefully siloed. There are, however, existing policies, that — as our recent research shows — demonstrate the relationship between affordable housing and better population health. (Gregory Squires and Antwan Jones, 10/20)

Modern Healthcare: Sen. Brown: Calling Big Pharma’s Bluff And Making Prescription Drugs More Affordable 
Bringing down the cost of prescription drugs ought to be ripe for bipartisan cooperation. Members of both parties talk about how drug prices are too high. And seniors don’t see this as a partisan issue—they see it as a dire budget issue, and sometimes even a life-or-death issue. Yet during the previous administration, despite a lot of lip service from President Donald Trump and some of his allies in Congress, nothing got done. In the first half of 2019 alone, the price of 3,400 drugs increased. And despite bipartisan efforts by the Senate Finance Committee, Majority Leader Mitch McConnell (R-Ky.) refused to bring the committee-passed legislation to lower the cost of prescription drugs to the Senate floor for consideration and a vote—yet again choosing to stand on the side of big pharmaceutical corporations over American families. (Sen. Sherrod Brown, 10/19)

The Baltimore Sun: Raising Health Insurance Costs Not The Way To Fight Tobacco Use
The serious health risks associated with smoking tobacco have been too well established for too long to harbor any doubts about that link. On average, studies show, people who smoke die about 10 years earlier than those who do not. It’s the leading preventable cause of death. And smoking is linked to about 30% of all cancer deaths in the United States. As a result, virtually any public policy choice — from public education and outreach programs that warn against smoking to state laws banning tobacco sales to teens —can be relied upon to pay enormous public health dividends. Tobacco is linked to about 480,000 deaths in the U.S. each year. That is COVID-19 pandemic territory. (10/19)

Stat: Making Clinicians Worthy Of Medical AI: Lessons From Tesla 
Tesla is in the midst of conducting an unprecedented social experiment: testing drivers of its cars to see if they are safe enough operators to receive the company’s Full Self-Driving (FSD) Beta software update, which expands the car’s autonomous capabilities, most notably on city streets. The company is automatically evaluating humans based on a safety score composed of five factors, including forward collision warnings per thousand miles driven, aggressive turning, and forced autopilot disengagements. (Arjun K. Manrai and Isaac S. Kohane, 10/21)

The Star Tribune: American Health Care: How To Climb From Wealthy World's Worst To First 
Another year, another damning report for American medicine. In August, the Commonwealth Fund ranked U.S. health care dead last among 11 of the world's wealthiest nations (for the seventh time in seven reports since 2004). Compared with its global peers, the United States is home to the lowest life expectancy, highest infant- and maternal-mortality rates, and most preventable deaths per capita. Worse, Americans spend twice as much on medical care as their international counterparts in exchange for these rock-bottom clinical outcomes. (Robert Pearl, 10/20)

Newsweek: Texas And The Future Of Roe V. Wade 
Here in Texas, the Heartbeat Act is causing quite the stir. The pro-life community embraces it as progress toward protecting unborn lives, abortion rights advocates view it as an outrageous affront to Roe v. Wade and analysts on both sides wonder how it will fare in the courts. The legal tug-of-war is already underway. Days after the measure went into effect, a federal judge blocked its enforcement. Then an appeals court reinstated it. Then the Biden Justice Department asked that court for a stay, to prevent the law's implementation. On Thursday, that motion was denied. (Mark Davis, 10/20)