The Washington Post: Senate Democrats Reach $3.5 Trillion Budget Deal
Senate Democrats on Tuesday reached an early agreement to pursue a sweeping $3.5 trillion reconciliation package that would expand Medicare benefits, boost federal safety net programs and combat climate change, aiming to sidestep Republican opposition and deliver on President Biden’s top economic priorities. The wide array of planned health, education and social programs would represent a historic burst of federal spending if lawmakers ultimately adopt it, as Democrats aim to seize on their slim but powerful majorities in Washington to expand the footprint of government and catalyze major changes in the economy. (Romm, Kim and Stein, 7/13)

The Hill: Democrats Reach Deal On $3.5T Price Tag For Infrastructure Bill
Senate Majority Leader Charles Schumer (D-N.Y.) and Budget Committee Democrats, led by Sen. Bernie Sanders (I-Vt.), have reached a deal on a $3.5 trillion price tag for a Democratic-only infrastructure package. Schumer, emerging from an hours-long meeting with Budget Committee Democrats, said they had reached a deal on the budget resolution — which greenlights reconciliation, the process Democrats will use to bypass a GOP filibuster on the infrastructure bill — including a $3.5 trillion top-line figure. President Biden is going to meet with Senate Democrats on Wednesday as Democrats work to lock down support for the deal. (Carney, 7/13)

NBC News: Senate Democrats Reveal $3.5 Trillion Plan To Invest In Health Care, Climate Change And More
Senate Majority Leader Chuck Schumer, D-N.Y., said the $3.5 trillion would be in addition to the $579 billion in new spending in the bipartisan infrastructure agreement. He said the deal would include a "robust expansion of Medicare" that would include new benefits like dental, vision and hearing coverage, along with major funding for clean energy. "If we pass this, this is the most profound change to help American families in generations," he said. (Kapur and Thorp V, 7/13)

AP: Senate Democrats' $3.5T Budget Deal Backs Up Biden's Goals
All told, the ambitious proposal reflects Biden’s vision for making the most substantive potential investments in the nation in years, some say on par with the New Deal of the 1930s. Together with a slimmer, $1 trillion bipartisan effort of traditional road, highway and public works also being negotiated, they represent close to the president’s initial $4 trillion-plus effort that could reach almost every corner of the country. The Democrats’ goal is to push a budget resolution reflecting Tuesday’s agreement through the House and the Senate before lawmakers leave for their August recess. The resolution sets only broad spending and revenue parameters, leaving the actual funding and specific decisions about which programs are affected — and by how much — for later legislation. (Fram and Mascaro, 7/13)

KHN: As Congress Wrestles With Plans To Expand Medicare, Becerra Says Any One Will Do 
The Biden administration will support whatever expansions to Medicare Congress is willing to make, Health and Human Services Secretary Xavier Becerra said Tuesday. Democratic lawmakers on Capitol Hill are working on plans both to add benefits to the health program for seniors and to lower its eligibility age from 65 to 60. But the efforts are mired in competing priorities among different wings of the party as they try to push through a spending plan this year that Republicans have vowed to oppose. President Joe Biden called for the change in Medicare age eligibility while campaigning in 2020. (Rovner, 7/13)

KHN: KHN’s ‘What The Health?’: Becerra Urges Congress To Expand Medicare, Address Rx Prices 
The Biden administration stands ready to work with Congress to address drug prices and expand Medicare, Health and Human Services Secretary Xavier Becerra said in a wide-ranging interview with “What the Health?” on Tuesday. The former California attorney general also said his top priority while in office is to attack health disparities. “There are a whole bunch of Black and brown communities that have never had the kind of access to care that others have,” he said. “And when they come to the doctor, they come with the kind of conditions that show they didn’t have health care before.” (7/13)

In other news about Medicare and Medicaid —

Health News Florida: Florida Will Seek $945 Million To Boost Medicaid 
Florida plans on tapping into $945 million in additional federal health care dollars made available by President Joe Biden’s administration to enhance access to home- and community-based health care services for poor, disabled and elderly people, a top Republican in charge of health care spending in the state told The News Service of Florida Monday. State Sen. Aaron Bean, R-Fernandina Beach, said Gov. Ron DeSantis’ administration is poised to send a proposal to the federal government that would allow the state to draw down a 10 percentage-point increase in federal Medicaid funds. (7/13)

Modern Healthcare: Medicare Telehealth Access Preserved In Physician Pay Rule
CMS wants to make it easier for Medicare beneficiaries to use telehealth services, improve its diabetes prevention program and overhaul its Quality Payment Program, according to the proposed 2022 Medicare physician fee schedule released on Tuesday. During the COVID-19 pandemic, CMS temporarily allowed Medicare providers to deliver a wide range of healthcare services via telehealth until the public health emergency ends. Now, many patients, providers and lawmakers want to make those changes permanent. But some experts worry that CMS doesn't have enough information about how those expanded telehealth services affect the Medicare program and its beneficiaries in terms of healthcare use and quality. (Brady, 7/13)

The CT Mirror: Up To 40,000 People Could Qualify For Free Health Coverage In CT
The state is devoting $8 million this year and $15.6 million next year to an initiative it is calling the Covered Connecticut program, which is expected to provide free health coverage for up to 40,000 people. During the 2021 legislative session, lawmakers were aiming to improve health care access by expanding the state’s Medicaid program, known as HUSKY, by adjusting the qualifying threshold so more people could enroll in coverage. Gov. Ned Lamont’s administration floated an alternative: Use state funds to boost subsidies on the exchange that could make health plans free for people who meet certain guidelines. Lamont’s plan was ultimately successful, and the state expects a 50% federal reimbursement in the second year. (Carlesso, 7/13)

The Wall Street Journal: U.S. Covid-19 Case Counts Have Doubled In Recent Weeks
New Covid-19 cases are on the rise in a number of states across the U.S., worrying health officials and epidemiologists as many Americans remain unvaccinated and the highly transmissible Delta variant spreads. The U.S. is averaging more than 23,000 new cases a day, double the seven-day average of around 11,300 cases three weeks ago, according to a Wall Street Journal analysis of data from Johns Hopkins University. On 17 of the past 18 days, the seven-day case average was higher than the 14-day average, also suggesting cases have been rising nationally. (Ansari, 7/13)

AP: US COVID-19 Cases Rising Again, Doubling Over Three Weeks
The COVID-19 curve in the U.S. is rising again after months of decline, with the number of new cases per day doubling over the past three weeks, driven by the fast-spreading delta variant, lagging vaccination rates and Fourth of July gatherings. Confirmed infections climbed to an average of about 23,600 a day on Monday, up from 11,300 on June 23, according to Johns Hopkins University data. And all but two states — Maine and South Dakota — reported that case numbers have gone up over the past two weeks. (Hollingsworth and Funk, 7/14)

CNBC: Hospitalizations Rising Again As Delta Variant Spreads Among The Unvaccinated, Doctors Say
Top infectious disease specialists say the spread of the delta variant across unvaccinated pockets of the country is causing flare-ups and leading to an increase in hospitalizations as cases climb. Nationwide, cases are once again on the rise as the highly transmissible variant takes hold as the dominant strain in the U.S. The seven-day average of newly confirmed Covid cases has climbed to about 23,300 a day, almost double the average from a week ago, according to data compiled by Johns Hopkins University. (Mendez, 7/13)

NBC News: Coronavirus Strains' Spread Boosted By Superspreader Events
Superspreader events that first seeded the coronavirus in the United States are keeping the pandemic smoldering, with experts pointing to human behavior and social circles as the main drivers. The problem persists even as the country nears the milestone of having half of its population fully vaccinated. At a church camp in South Texas in late June, an outbreak was linked to more than 125 cases of Covid-19. Eighty-five infections in central Illinois were traced back to a summer camp in mid-June. (Chow, 7/14)

In other updates on the spread of the coronavirus —

Modern Healthcare: Hospitals In Low-Vaccination States Struggle As COVID-19 Surges
More than two dozen states have experienced increases in COVID-19 cases over the past seven days, according to data from Johns Hopkins University School of Medicine's Coronavirus Tracking Center. States with the highest seven-day average increases in cases also have some of the country's lowest vaccination rates. In Missouri, the rate of new cases over the past week was 127 for every 100,000 residents, only 46% of the state's population have received at least one dose of COVID-19 vaccine and just 40% have been fully vaccinated, according to the Centers for Disease Control and Prevention. In the U.S. overall, new cases were 31 per 100,000, 56% of people have gotten at least one shot and 48% are fully vaccinated, CDC data show. (Ross Johnson, 7/13)

CNN: What Hospitals Look Like In US Covid-19 Hot Spots Right Now 
Dr. Sergio Segarra says when Covid-19 patient numbers in the Miami hospital he works in dipped below 20 last month, he began feeling optimistic. "I remember seeing articles in the news about hospitals in California with empty Covid units and I longed for that experience," Segarra, the chief medical officer with Baptist Health's Baptist Hospital, said. "It's an experience we were working our way towards that unfortunately has taken a rather sad turn." (Maxouris, 7/14)

The Hill: Seven Mississippi Children Hospitalized As Delta Variant Surges
Seven Mississippi children are currently in the hospital due to COVID-19 infections, with two of the young people on life support, the state’s top health official announced Tuesday. Mississippi State Health Officer Thomas Dobbs said in a tweet that seven children infected with the virus were in the intensive care unit (ICU) and two of them were on ventilators. (Castronuovo, 7/13)

Mississippi Clarion Ledger: Mississippi Delta Variant Cases On The Rise As Vaccinations Stagnate
Mississippi COVID-19 cases have risen almost 25% over the past two weeks and hospitalizations at University of Mississippi Medical Center are at the highest numbers in three months. On Tuesday, State Health Officer Dr. Thomas Dobbs tweeted that of seven children currently in intensive care due to COVID-19 infections, two are on ventilators. It was not immediately clear whether these children were infected with the Delta variant or had been vaccinated against the virus, their ages or where they are located in the state. (Haselhorst, 7/13)

In related news about children and covid —

NBC Chicago: Top FDA Advisor Says Kids Need To Be Vaccinated Against Covid 
Children need to be vaccinated against Covid-19, a top advisor to the Food and Drug Administration on children’s vaccines told the agency Thursday. “It just seems silly to think that we’re not going to have to include children as part of that,” said Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia and advisor to the FDA. “They can suffer and be hospitalized and occasionally die.” He said 300 kids have died from Covid so far. (Mendez, 7/14)

CNN: Young Children Will Pay The Price If Enough US Adults Don't Get Vaccinated Against Covid-19, Expert Says 
Children will likely pay the price for adults in the US not getting vaccinated at high enough rates to slow or stop the spread of Covid-19, which has been surging in most states, a vaccine expert said. Dr. Peter Hotez, a vaccinologist and dean of the National School of Tropical Medicine at Baylor College of Medicine, told CNN's Anderson Cooper Tuesday that if vaccination rates among adults and kids 12 and older continue to lag amid increased spread of the virus, the youngest members of the population will be most affected. (Holcombe, 7/14)

Fox News: 'Foolish' Not To Vaccinate Young Kids If COVID-19 Shots Found Safe, Effective, Expert Says
If ongoing clinical trials and regulators conclude COVID-19 vaccines in younger children aged 6 to 11 are safe and effective, an expert with the Infectious Diseases Society of America (IDSA) said "we would be foolish not to vaccinate" kids. The comments from Dr. Andrew Pavia, chief of the Division of Pediatric Infectious Diseases at University of Utah School of Medicine, adjunct professor of internal medicine, professor of pediatrics at the University of Utah and fellow at IDSA, come as the debate over school reopenings intensifies. "As somebody who takes care of very sick kids, it drives me crazy to hear over and over again that the virus is not serious for children," Pavia told a virtual IDSA, CDC briefing Tuesday. "It’s not nearly as serious as it is for adults and particularly for older adults but by every measure, the impact is greater than the impact of influenza." (Rivas, 7/13)

Nature: Long COVID And Kids: Scientists Race To Find Answers
As COVID-19 has ripped through communities, children have often been spared the worst of the disease’s impacts. But the spectre of long COVID developing in children is forcing researchers to reconsider the cost of the pandemic for younger people. The question is particularly relevant as the proportion of infections that are in young people rises in countries where many adults are now vaccinated — and as debates about the benefits of vaccinating children intensify. (Lewis, 7/14)

NPR: COVID-19 Cases In Parts Of Missouri And Arkansas Rebound To Winter Levels
In Springfield, Mo., firefighters are giving vaccine shots. Churches are scrambling to schedule vaccine clinics. Students and staff at summer school at the public schools are back to wearing masks. Dozens of traveling nurses are due to arrive at one of the city's two biggest hospitals over the coming weeks; extra ventilators from around Missouri and Arkansas were transported to the other major hospital after it ran short over the July Fourth weekend. The outbreak of COVID-19 in southwest Missouri and northern Arkansas has become the nation's largest and is mostly driven by the highly contagious delta variant. Officials warn it could continue to grow unchecked if vaccination rates stay low. (Sullivan, 7/13)

USA Today: COVID-19 Outbreak Rattles Missouri: Patients Are 'Younger And Sicker'
The COVID-19 crisis in and around Springfield, Missouri, where hospitals are now flooded with coronavirus cases, is likely a preview of what's in store for the rest of the state as the delta variant continues to spread. That's the belief of Steve Edwards, CEO of CoxHealth, a key health care system in southwest Missouri. Cox is currently treating 127 patients, similar to the number it had during last winter's horrific surge, and nearly a tenfold increase from the 14 such patients seven weeks ago. Edwards said he hopes people in other parts of Missouri, whose vaccination rate ranks in the bottom 20 among states, "begin to realize that we're kind of a harbinger for the rest of the state." (Ortiz and Bacon, 7/13)

ABC News: Route 66 Summer Festival In Missouri Canceled Due To COVID-19 Surge 
The city of Springfield, Missouri, announced Monday that it was canceling a major summer festival as COVID-19 surges in the region. The Birthplace of Route 66 Festival, which was scheduled for Aug. 13-14 and typically includes live music and a classic car parade, has been called off for the second year in a row due to COVID-19. In 2019, the last year the festival was held, it drew 65,000 attendees over two days, and it was expected to host 75,000 this year, according to the city. (Schumaker, 7/13)

And covid continues to surge in other states —

Georgia Health News: Georgia Among 47 States Seeing Troubling Rise In COVID Infections 
Georgia’s color-coded county map has begun to show shades that reflect an uptick of COVID cases. And the state’s graph that tracks daily infections has turned upward after a June bottom. The state, along with 46 others, has seen an increase of COVID infections over the past two weeks, according to New York Times data. Georgia’s 143 percent rise over the last two weeks exceeds the U.S. average of 94 percent. (Miller, 7/14)

Salt Lake Tribune: Utah Hospitals Are Filling Up, And More Than 95% Of The COVID Patients Weren’t Vaccinated
There are 231 Utahns hospitalized for COVID-19, the Utah Department of Health reported Tuesday — and a leading Utah doctor confirmed that most didn’t get a COVID-19 vaccine. ”The vast majority of the patients that are being admitted are in the unvaccinated population,” Dr. Eddie Stenehjem, an infectious diseases physician at Intermountain Healthcare, said in a COVID-19 community briefing Tuesday over Facebook Live. “From a caregiver’s standpoint, that’s just really disappointing, because these are preventable hospitalizations.” (Means and Pierce, 7/13)

Albuquerque Journal: In NM, Surgeon General Warns Of Pandemic Toll
For U.S. Surgeon General Vivek Murthy, the toll of COVID-19 is measured in deaths and hospital occupancy rates, but in less visible metrics, too. During a Tuesday trip to New Mexico, Murthy expressed concern about the mental health implications of the pandemic, particularly among children, and said more resources need to be targeted at an issue that could take years to fully manifest. “What we’ve been through collectively and individually is trauma,” Murthy said during a Santa Fe event honoring eight health care officials, nurses and scientists from around New Mexico for their role in the state’s pandemic response. (Boyd, 7/13)

KHN: Red State, Blue State, Twin Outbreak: Behind Wyoming And Colorado’s Anomalous Covid Spikes 
Brandon Graves said covid-19 arrived in Wheatland the way new movies do in this High Plains farming town: months after hitting the big cities and without much fanfare. “It kind of trickled in and it never really exploded here,” said Graves, a lifelong resident and mayor of the town of about 3,500, the largest in Platte County. (Bichell, 7/14)

Los Angeles Times: COVID-19 Cases Surge In L.A. County, Fueled By ‘Enormously Selfish’ Unvaccinated
For the fifth consecutive day, Los Angeles County has recorded more than 1,000 new coronavirus cases. Health officials say the upward trajectory is almost entirely driven by transmission among those who have yet to be vaccinated for COVID-19, as well as increased circulation of the easily spread Delta variant of the virus. “It’s clear that the threat of COVID-19 is still with us and that we are dealing with a more infectious variant that causes it,” county Health Officer Dr. Muntu Davis said. “The best collective action that each of us can take is to get vaccinated against COVID-19 if you’re eligible, and to take sensible precautions if you are not eligible or choose not to get vaccinated.” (Money, 7/13)

San Francisco Chronicle: Coronavirus Outbreaks At California Workplaces Have Increased Since Reopening
California’s reopening last month coincided with a spike in coronavirus outbreaks at workplaces across the state, according to the California Department of Public Health data. The state defines an outbreak as three cases in a single location in a two-week period. Coronavirus outbreaks at workplaces declined rapidly at the beginning of this year, from more than 2,400 in January to just over 200 in May, according to state health department data provided to the California Occupational Safety and Health — or Cal/OSHA — Standards Board. (DiFeliciantonio, 7/13)

CNN: Justice Clarence Thomas Rejects Longshot Bid To Disrupt Biden's Mask Mandate For Public Transport 
Justice Clarence Thomas on Tuesday rejected an emergency request to block Biden administration's Covid-19 mask requirement for public travel. The request was brought by a man seeking to leave Florida by airplane, who said his Generalized Anxiety Disorder prevented him from wearing a mask. While the Supreme Court has been willing to disrupt other coronavirus-related regulations, particularly as they affected religious gatherings, there was no apparent appetite for disturbing the public transportation mask mandate. (Sneed, 7/13)

In other news about mask-wearing —

Modern Healthcare: Nurses Ask CDC To Reinstate Universal Masking Rule
National Nurses United, the largest union of registered nurses, is urging the CDC to reestablish its recommendation for everyone to wear masks in public, regardless of vaccination status, to prevent COVID-19 infections and variants from spreading. In a letter sent Monday to the Centers for Disease Control and Prevention, NNU asked the agency to reinstate universal masking, update its COVID-19 guidance to fully recognize aerosol transmission and require infection tracking and reporting among essential workers as well as those who are fully vaccinated. (Devereaux, 7/13)

Fox News: St. Louis County Urges Masks Regardless Of Vaccination Status
St. Louis County health officials are urging residents to mask up while in indoor public settings and even while at large outdoor gatherings when social distancing is not possible regardless of vaccination status amid a surge in COVID-19 cases. The update, posted Monday, follows an advisory issued July 1 warning about increases in community transmission due to the Delta variant.  The official guidance from the Centers for Disease Control and Prevention (CDC) has remained that vaccinated individuals do not need to wear a mask while indoors, or while in large gatherings. However, amid the variant spread, Dr. Anthony Fauci has been pressed on whether the guidance will change. (Hein, 7/13)

St. Louis Post-Dispatch: Masks Will Be Optional At St. Louis-Area Roman Catholic Schools This Fall 
Students at most St. Louis-area Roman Catholic schools will not be required to wear masks this fall, the Archdiocese of St. Louis announced Tuesday. The decision came amid warnings from local health officials about troubling signs of COVID-19 infections spreading among unvaccinated children in the region. “Beginning this upcoming academic year, the wearing of masks in archdiocesan schools will be optional and at the discretion of each individual family,” the Archdiocese of St. Louis said in a message sent Tuesday. “The archdiocese urges all school families, students, leadership, faculties and staffs to be thoughtful of their own health — and that of their community — in all of their decisions, especially regarding the wearing of masks and monitoring for COVID-19 symptoms.” (Bernhard and Munz, 7/14)

Southern California News Group: State Walks Back Order Banning Unmasked Students On Campus, But Masks Still Required On Site
California health officials, after initially banning children who refuse to comply with the mask-wearing mandate from campuses, has scrapped that order and left enforcement up to individual school districts. State officials announced Monday, July 12 that K-12 students in California who refuse to wear masks inside school buildings will be barred from campuses and offered “alternative educational opportunities.” The exception will be for students granted exemptions, such as those whose medical condition makes it too difficult for them to keep a mask on. (Tat, 7/13)

New Orleans Times-Picayune: As COVID Cases Tick Up, New Orleans Officials Weigh Mask Rules For Fall Events For Unvaccinated
With cases of the more transmissive delta variant of the coronavirus rising in Louisiana and across the U.S., New Orleans officials on Tuesday warned residents to take precautions and asked them to get vaccinated if they haven't already. “Delta is here, delta is dangerous, and delta is killing people. This should scare the hell out of you,” said Beau Tidwell, spokesperson for Mayor LaToya Cantrell, during a news conference. “The message from the mayor is that this is very serious, and you need to get your shot. We can’t be more clear or more stark than that.” (Sorapuru, 7/13)

AP: Variant Could Mean Mask Mandates At Big New Orleans Events
Efforts to mitigate COVID-19 at large New Orleans events — including mask mandates or requirements attendees be vaccinated or have a negative test — will likely continue into the fall because of low state vaccination rates and the spread of dangerous variants, the city’s health director said Tuesday. Dr. Jennifer Avegno’s remarks came at a news conference focusing on the city’s efforts to encourage vaccinations in a state that has one of the nation’s lowest vaccination rates. Louisiana health officials on Tuesday said COVID-19 cases are surging, largely among non-vaccinated people, as the more easily transmissible Delta variants spread in the state. (McGill, 7/14)

CNN: Tennessee Is Halting All Outreach On Vaccines For Adolescents, Including For Covid-19 
The Tennessee Department of Health is halting all adolescent vaccine outreach, even for vaccines not related to Covid-19, according to internal documents. The halt impacts all outreach to adolescents, including Covid-19 second-dose reminders, HPV reminders and kindergarten vaccination surveys, according the documents circulated within the department obtained by CNN and first reported by The Tennessean. The department of health did not respond to CNN inquiries on whether outreach and vaccination practices on Covid -19 or other vaccinations had changed. (Holcombe, 7/14)

USA Today: Tennessee Halts Vaccine Outreach To Minors, Not Just For COVID-19
The Tennessee Department of Health will halt all adolescent vaccine outreach – not just for coronavirus, but all diseases – amid pressure from Republican state lawmakers, according to an internal report and agency emails obtained by the Tennessean. If the health department must issue any information about vaccines, staff are instructed to strip the agency logo off the documents. The health department will also stop all COVID-19 vaccine events on school property, despite holding at least one such event this month. The decisions to end vaccine outreach and school events come directly from Health Commissioner Dr. Lisa Piercey, the internal report states. (Kellman, 7/13)

AP: Ex-Tennessee Vaccine Leader: Firing Put Politics Over Health
Tennessee’s former top vaccinations official said Tuesday that she couldn’t stay silent after she was fired this week amid scrutiny from Republican state lawmakers over her department’s outreach efforts to vaccinate teenagers against COVID-19. Dr. Michelle Fiscus, who was the medical director for vaccine-preventable diseases and immunization programs at the Tennessee Department of Health, said the state’s elected leaders put politics over the health of children by firing her for her efforts to get more Tennesseans vaccinated. (Mattise, 7/14)

Bloomberg: CDC Vaccine Panel To Discuss J&J’s Covid Vaccine, Guillain-Barré Syndrome
Covid-19 vaccine safety, including the possible risks from a rare immune-system disorder, will be the focus of an advisory panel meeting scheduled by the U.S. Centers for Disease Control and Prevention on July 22. The announcement by the CDC comes a day after the fact sheet for Johnson & Johnson’s Covid-19 shot was revised by federal regulators to warn about a “small possible risk” for Guillain-Barré Syndrome, in which the immune system attacks the nerves. The Advisory Committee on Immunization Practices, or ACIP, includes medical and public health experts that advise the agency on vaccine use and safety. (Rutherford, 7/13)

Fox News: CDC 'Keenly Interested' Whether COVID-19 Booster Vaccines Linked To Higher Risk Of Side Effects, Expert Says
People seeking a COVID-19 booster vaccine dose in hopes of greater protection are doing so as the evidence relating to safety remains unclear, top experts said. A journalist questioned Dr. Jay Butler, deputy director for infectious diseases at the Centers for Disease Control and Prevention (CDC) and Dr. Andrew Pavia, pediatric infectious diseases specialist at University of Utah School of Medicine, over potential safety concerns behind a third dose, noting some fully vaccinated people have sought out booster shots on their own. (Rivas, 7/13)

Axios: The Debate Begins Over The Timeline For COVID Vaccine Boosters 
Conflicting statements from Pfizer and the Biden administration were just the beginning of what will likely be a contentious debate over if and when vaccinated Americans need another shot to protect them against the coronavirus. Making decisions based on emerging science is difficult on a good day. But until global supply outpaces global demand for the vaccine, how to allocate doses will remain a life-or-death decision. (Owens, 7/13)

Stat: Vaccine Developer Sees Booster Shots As Key To Exiting Covid-19 Pandemic
The world will not get the Covid-19 pandemic under control without using booster shots for messenger RNA vaccines, one of the key figures involved in the development of the Pfizer and BioNTech vaccine said Tuesday. Ugur Sahin, co-founder and CEO of BioNTech, insisted booster shots are going to be necessary, despite caution from some experts. “At the end of the day it really matters that we get this pandemic under control. And we will not get it under control without boosting. That’s my strong opinion,” Sahin said. (Branswell, 7/13)

In other vaccine-development news —

CIDRAP: Pfizer COVID Vaccine Shows 78% Efficacy In Pregnancy
Two doses of the Pfizer/BioNTech COVID-19 vaccine were safe and 78% effective in preventing infection in pregnant women in a real-world study in Israel. Led by researchers at Maccabi Healthcare Services in Tel Aviv, the retrospective, observational study was published yesterday in JAMA. It involved analyzing data on 15,060 women in a pregnancy registry of a large, state-mandated healthcare system who were vaccinated with a first dose from Dec 19, 2020, to Feb 28, 2021. (Van Beusekom, 7/13)

CNBC: Fauci Says He Would Be 'Astounded' If Pfizer, Moderna And J&J Covid Vaccines Don't Get Full FDA Approval
White House chief medical advisor Dr. Anthony Fauci fully expects the coronavirus vaccines from Pfizer, Moderna and Johnson & Johnson will receive full approval from U.S. drug regulators, he told CNBC on Tuesday. “The data are about as good as it gets. ... I would be astounded if these vaccines, namely the mRNA and the J&J, didn’t get full approval,” Fauci said on “Squawk Box.” All three Covid vaccines are currently authorized for distribution in the U.S. on an emergency basis, but none of them have received full approval from the Food and Drug Administration yet. Full approval would allow the drugmakers to market the shots directly to consumers and give employers more flexibility in mandating them. (Stankiewicz, 7/13)

CNN: Norwegian Cruise Line Sues Florida Surgeon General Over Vaccine Passport Ban 
Norwegian Cruise Line Holdings is suing Florida's surgeon general over the state's law that prohibits companies from requiring customers and employees to provide documentation of Covid-19 vaccination status. According to the complaint filed Tuesday, NCLH says the lawsuit is a "last resort" because Florida had indicated it would prevent the company from "safely and soundly resuming passenger cruise operations" next month. It described the state law as an "anomalous, misguided intrusion." (Riess, 7/14)

CBS News: Carnival Cruises Requiring Unvaccinated Passengers Be Insured Before Boarding
Unvaccinated passengers who want to board a Carnival-owned cruise ship must first buy a travel insurance policy worth at least $10,000, according to a recently announced company rule. The insurance requirement takes effect July 31 and applies to excursions leaving from Florida, Carnival said on its booking website. Carnival has four Florida ports, in Jacksonville, Miami, Orlando and Tampa. (Brooks, 7/13)

In other news about vaccine mandates —

Atlanta Journal-Constitution: Piedmont To Require Staff To Be Vaccinated Against COVID-19
The Piedmont Healthcare system will require doctors, hospital leaders and new employees to get vaccinated for COVID-19 by Sept. 1, the Atlanta-based nonprofit organization said Monday. Other employees at Piedmont facilities will be required to get COVID shots “in the near future,’' Piedmont said in a statement. “It’s important to consider that vaccination is a leading factor in patients and team members feeling safe within a health care setting, as shown by research we conducted,’' said the statement from Piedmont, a fast-growing system with 11 hospitals in the state. “Moreover, it is in keeping with our peers from other leading health systems throughout the United States.’' (Miller, 7/13)

Crain's Chicago Business: UChicago Medicine To Require COVID Vaccine For Workers
The University of Chicago Medicine system is requiring workers to be vaccinated against COVID-19, according to an internal memo obtained by Crain's. The mandate follows a UChicago announcement today that all university employees are expected to get vaccinated, unless they’re exempt for medical, religious or another authorized reason. Three-hospital Loyola Medicine also is mandating COVID vaccines for employees, a move its Michigan-based parent announced last week. (Goldberg, 7/13)

The Washington Post: Organizations Call For Requiring Health Workers To Get Coronavirus Shots 
A coalition of health-care organizations called on medical facilities Tuesday to mandate that their workers get vaccinated against the coronavirus, saying the strategy has worked to fight influenza and other infectious diseases and is necessary to contain the pandemic. “COVID-19 vaccination should be a condition of employment for all healthcare personnel,” the coalition’s statement reads, warning that “a sufficient vaccination rate is unlikely to be achieved” without a vaccine mandate. (Diamond, 7/13)

Boston Herald: Boston College Faces Fury Over Vaccine Exemptions Denied Over Abortion Link
Boston College is facing a wave of Catholic parents and students “disgusted” by religious exemptions being denied over a link to aborted fetal tissue used to test the efficacy of coronavirus vaccines. Some of those parents told the Herald Monday they are rallying together in a desperate attempt to change the Jesuit school’s stance before fall classes begin on August 30. Some are also concerned top athletes could drop out. “This is a nightmare,” said one mother. “This is not what BC taught me when I was there,” said an alumna. “Even my priest couldn’t believe it.” (Dwinell, 7/13)

Charleston Gazette-Mail: Biden Taps Gupta To Be Next US Drug Czar; WV Leaders Praise President's Pick
Dr. Rahul Gupta, the former top health officer in the Mountain State, is President Joe Biden’s pick to become the nation’s top anti-drug official. If the U.S. Senate approves his nomination, Gupta will be the first physician to lead the Office of National Drug Control Policy, a position commonly referred to as the drug czar. It’s the second time during his first year in office that Biden has tapped a West Virginian for a federal post. Biden appointed Gayle Manchin, wife of Sen. Joe Manchin, D-W.Va., as co-chairwoman of the Appalachian Regional Commission earlier this year. (Pierson, 7/13)

AP: Biden Picks Ex-West Virginia Health Official As Drug Czar
The nomination drew bipartisan praise from West Virginia officials. Republican Gov. Jim Justice called it “great news,” and Democratic Sen. Joe Manchin said the pick “means someone with firsthand knowledge of the opioid crisis, especially in West Virginia, will be coordinating the national fight against the drug epidemic that continues to ravage our nation.” “Dr. Gupta will bring over a decade of extensive experience combatting the drug epidemic to ONDCP – the office charged with addressing the drug epidemic that has killed over 90,000 Americans just last year,” Manchin said in a statement. (Miller, 7/13)

And Biden picks a surgeon from Brigham and Women’s Hospital for a position at USAID —

Stat: Biden To Nominate Atul Gawande For Global Health Position 
President Biden will nominate noted surgeon and writer Atul Gawande for a global health position at the U.S. Agency for International Development, the White House said Tuesday. Gawande is a surgeon at Boston’s Brigham and Women’s Hospital, has professorships at Harvard’s medical and public health schools, and has written top-selling books and for the New Yorker about medicine and health policy. (Joseph, 7/13)

In other news from Capitol Hill —

Bloomberg: Marijuana Legalization Put On Congress's Agenda By Senate Democrats
Senate Majority Leader Chuck Schumer, Finance Chairman Ron Wyden and New Jersey Senator Cory Booker will release a discussion draft of their marijuana legalization bill at a press conference Wednesday, according to a person familiar with their plans. The bill will be called the Cannabis Administration and Opportunity Act and is expected to remove marijuana from the federal list of controlled substances. The bill would also tax and regulate marijuana on the federal level, while leaving states able to enforce their own laws regarding the drug. (Dennis, 7/13)

Axios: Pay Gaps Persist In Academic Internal Medicine Specialties 
Women who teach internal medicine specialties still get paid less and have less representation in leadership, according to a new study from JAMA Internal Medicine. In their analysis across 154 medical schools in the U.S. between 2018 and 2019, researchers found women were paid at least 90% of men's median annual salary in 10 of 13 internal medicine specialties. (Fernandez, 7/13)

AP: Surgeon General Thanks Health Care Workers In New Mexico
Surgeon General Vivek Murthy met with New Mexico officials and spoke at an awards ceremony honoring health care workers. Murthy thanked nurses, doctors, and a laboratory manager for their work fighting the pandemic, but warned that the task of caring for the sick and inoculating the hesitant is not over. (Attanasio, 7/14)

Arkansas Democrat-Gazette: Health System Ordered To Pay 4 Ex-Workers In Bias Suit
White River Health System Inc., which provides health care services to a large part of north-central Arkansas, was ordered Tuesday to pay $52,500 to four former employees as part of an age discrimination lawsuit filed by the U.S. Equal Employment Opportunity Commission. The lawsuit, filed in February 2020, alleged that White River Health System fired the four employees because its insurance policy excluded drivers older than 72. According to a consent decree agreed upon by the EEOC and White River Health System, part of the settlement included payment of $52,500 to three named employees, James Kipfer, Julie Milburn, Donna Boyd and an unnamed member of the class-action lawsuit. (Ellis, 7/14)

In other health care industry news —

Houston Chronicle: VA Expands Veteran Healthcare Options With Humble Clinic
The Department of Veterans Affairs opened a new clinic in Humble this summer that give veterans in north Houston easier access to care. The outpatient clinic offers primary care, mental health, and phlebotomy services. According to Public Affairs Officer Maureen Dyman, Humble is one of the fastest growing areas for new enrollment for veteran health care. The Humble VA Outpatient Clinic will join their Tomball and Conroe locations in providing care to veterans outside of the fullsize hospital in Houston. (Nickerson, 7/13)

Axios: Hospitals Launch Antitrust Lawsuit Against Intuitive Surgical 
Several hospitals have mounted a legal battle against the company that makes the da Vinci surgical robot, alleging its monopoly position forces hospitals to buy its maintenance services and replacement parts at inflated prices even though cheaper options exist. In one allegation, a hospital says Intuitive Surgical remotely shut down a hospital's surgical robot "in the middle of a procedure" which forced the surgeon "to convert the procedure to open surgery with the patient on the operating table," after the hospital said it was considering a service contract with a third party. (Herman, 7/13)

San Francisco Chronicle: Laguna Honda Hospital Patient Abuse: S.F. Settles First Of Three Lawsuits
A Laguna Honda hospital patient alleged to have suffered abuse at the hands of staff will get $800,000 in a settlement stemming from a scandal that rocked one of the nation’s largest skilled nursing facilities. The Board of Supervisors approved the settlement Tuesday. The San Francisco Department of Public Health revealed two years ago that two dozen patients at Laguna Honda Hospital and Rehabilitation Center endured systemic abuse at the hands of six hospital employees between 2016 and January 2019. (Moench, 7/13)

Bloomberg: Nassau County Hospital Seeks Another Round Of Turnaround Advice
A Long Island hospital that treats some of the area’s most vulnerable residents is seeking another round of turnaround advice after an earlier recommendation to shut its inpatient unit and sell its nursing facility. Nassau Health Care Corp. this month issued a request for advisers to help boost revenues and performance at the 530-bed Nassau University Medical Center and its 589-bed skilled nursing facility. Like other so-called safety net hospitals, most of Nassau Medical’s patients are on publicly funded insurance -- about 80% according to a December report issued by Alvarez & Marsal, the advisers previously hired. (Coleman-Lochner, 7/13)

Axios: UnitedHealth Group To Kick Off Health Care's Q2 Earnings
Corporate America is expecting big jumps in profits in the second quarter. That's especially the case in health care, an industry that hasn't really lost a lot of financial momentum throughout the coronavirus pandemic. Health care spending is basically back to pre-COVID levels. Expect big numbers across the board. (Herman, 7/14)

AP: West Virginia Opposes Purdue Pharma Bankruptcy Plan
West Virginia Attorney General Patrick Morrisey said he will oppose OxyContin maker Purdue Pharma’s bankruptcy plan, arguing that his state, one of the hardest hit by the opioid epidemic, would get shorted in settlement money. “I remain vigorously opposed to a proposed allocation formula that would distribute settlement funds largely based on a state or local government’s population – not intensity of the problem,” Morrisey said Tuesday. (7/14)

AP: Maine Governor To Hold 3rd Annual Opioid Crisis Summit
Maine’s governor plans to host the a virtual summit about the opioid crisis this week. Democratic Gov. Janet Mills said she has scheduled the third annual Governor’s Opioid Response Summit for Thursday. She said the event is designed to assemble health care providers, policy experts, law enforcement officials and members of the public to work together on the opioid crisis. (7/14)

CBS News: "Game Changer"? Tarantula Venom May Yield Powerful Pain Med To Help Curb Opioid Epidemic 
Researchers at the University of California-Davis are trying to use the venom from tarantulas to develop a pain medication to help curb the opioid epidemic, reports CBS Sacramento. "Nature offers such a wide diversity of proteins that basically, for us, are building blocks of future medicines," Dr. Vladimir Yarov-Yarovoy of UC Davis Health says. He's one of the lead researchers in a 20-person team. (7/14)

NPR: A Tragic Death Shows How ERs Fail Patients Who Struggle With Addiction
Jameson Rybak tried to quit using opioids nearly a dozen times within five years. Each time, he'd wait out the vomiting, sweating and chills from withdrawal in his bedroom. It was difficult to watch, says his mother, Suzanne Rybak, though she admired his persistence. On March 11, 2020, however, Suzanne grew worried. Jameson, 30 years old at the time, was slipping in and out of consciousness and saying he couldn't move his hands. (Pattani, 7/14)

In updates on the new Alzheimer's drug —

The Boston Globe: ‘This Is Unprecedented’: Several Private Insurers Won’t Cover Biogen’s Alzheimer’s Drug
At least half-a-dozen private health insurers in some of the nation’s largest states are balking at covering Biogen’s controversial drug for Alzheimer’s disease, saying it is an experimental and unproven treatment despite being approved by the federal government one month ago. Six affiliates of Blue Cross and Blue Shield in Florida, New York, Michigan, North Carolina, and Pennsylvania say in newly adopted policies they will not cover the Cambridge biotech’s drug, Aduhelm, because they consider it “investigational” or “experimental” or because “a clinical benefit has not been established.” Aduhelm, which is priced at $56,000 a year, is intended to slow cognitive decline in patients with early Alzheimer’s symptoms, regardless of their age. (Saltzman, 7/13)

Stat: Biogen's New Alzheimer's Drug Could Cost Medicaid Up To $2.2 Billion A Year
A pricey new Alzheimer’s drug already mired in controversy could cost Medicaid anywhere from $720 million to nearly $2.2 billion each year depending on the number of patients treated, according to a new analysis. The medication, which is called Aduhelm and carries a $56,000 price tag, is generating concern over its potential impact on the overall health care system. The Centers for Medicare & Medicaid Services, for instance, is about to begin a process for determining whether Medicare will establish a national coverage policy for the drug, which is sold by Biogen (BIIB) and won regulatory approval last month. (Silverman, 7/13)

Stat: ‘Aduhelm Left Room’: Lilly CEO Eyes Competition With Rival Alzheimer's Drug
Though a rival’s Alzheimer’s drug reached the market first, the CEO of Eli Lilly spoke confidently Tuesday about its amyloid-clearing product’s potential to take on Biogen’s recently launched Aduhelm. Speaking at STAT’s Breakthrough Science Summit, CEO David Ricks said Lilly last month asked the Food and Drug Administration to expedite approval of its drug donanemab for “business reasons, competitive reasons, but more importantly, patient reasons.” (Cooney, 7/13)

In other pharmaceutical and biotech news —

Modern Healthcare: Premier, Honeywell To Boost Supply Of U.S.-Made Exam Gloves
Premier and Honeywell will team up to increase the supply of exam gloves made in the U.S., the organizations announced Tuesday. The group purchasing and consulting organization and the manufacturing conglomerate initially will produce 750 million nitrile gloves over a year. While the supply of most personal protective equipment has replenished since the height of the COVID-19 pandemic, medical-grade exam gloves are still running short amidst global raw material scarcity, port closures and delays, and higher-than-average demand. (Kacik, 7/13)

Stat: Judge Rules Insulin Makers And PBMs Must Face Racketeering Claims
A federal judge dropped allegations that three drug makers engaged in antitrust practices by scheming to overcharge for insulin, but the companies will continue to face racketeering claims in a lawsuit brought by pharmaceutical wholesalers. In the lawsuit, the insulin makers — Eli Lilly (LLY), Sanofi  (SNY), and Novo Nordisk (NVO) — were accused of inflating prices by paying kickbacks in the form of rebates and various administrative fees to pharmacy benefit managers in exchange for favorable placement on formularies. These are lists of medicines for which coverage is provided by health insurers that hire PBMs to negotiate on their behalf. (Silverman, 7/13)

Stat: Patient Data Company Truveta Raises $95 Million, Lands Hospital Partners
A company formed to aggregate and sell de-identified data on millions of American patients has attracted a trio of new hospital partners, adding providers in Dallas and Washington, D.C., to a national network that now includes 17 health systems. Truveta, helmed by former Microsoft executive Terry Myerson, has signed on D.C.-based MedStar Health and the Dallas-based health systems Baylor Scott & White and Texas Health Resources. The hospitals now participating in the company’s efforts account for about 15% of care delivered across 40 U.S. states. (Ross, 7/13)

KHN: Dying Patients With Rare Diseases Struggle To Get Experimental Therapies 
At 15, Autumn Fuernisen is dying. She was diagnosed at age 11 with a rare degenerative brain disorder that has no known cure or way to slow it down: juvenile-onset Huntington’s disease. “There’s lots of things that she used to be able to do just fine,” said her mom, Londen Tabor, who lives with her daughter in Gillette, Wyoming. Autumn’s speech has become slurred and her cognitive skills slower. She needs help with many tasks, such as writing, showering and dressing, and while she can walk, her balance is off. Autumn has been turned down for clinical trials because she is too young. (Bennett, 7/14)

Los Angeles Times: Long Delay In Alerting Public To Massive Beach Sewage Spill Raises Alarm
After 17 million gallons of raw sewage were discharged into the ocean off Los Angeles beaches early Monday, county officials waited hours before notifying the public to avoid swimming in areas potentially affected by high levels of bacteria. The delay occurred even though officials from the Los Angeles County Department of Public Health, which is responsible for notifying the public, were at the Hyperion Water Reclamation Plant in Playa del Rey during the emergency discharge procedure that began Sunday evening and ended Monday around 4:30 a.m., according to interviews. (Lopez and Kuo, 7/13)

CBS News: 17 Million Gallons Of Sewage Discharged Into The Ocean After Power Outage In California
Seventeen million gallons of untreated sewage was discharged into the Santa Monica Bay on Sunday after a power outage, officials said Monday night. The sewage has forced beaches across Southern California to close to the public this week. Los Angeles County's largest and oldest sewage plant, Hyperion Water Reclamation, said Monday that it "became inundated with overwhelming quantities of debris, causing backup of the headworks facilities." The spill into Santa Monica Bay lasted for eight hours, where 6% of the plant's daily load was released, the plant said. (Powell, 7/13)

In other environmental health news —

AP: Death Toll Rises To 210 From February Cold Wave In Texas
State officials on Tuesday added 59 deaths to the toll wrought by the Feb. 14 cold wave and the ensuing collapse of the Texas electric power grid. The deaths newly tallied by the Texas Department of State Health Services boost the toll from 151 to 210 deaths, most from exposure to the sometimes-subzero temperatures. Still, some were blamed on carbon monoxide poisoning as freezing Texans sought warmth from cars and outdoor grills. (7/14)

The Washington Post: Wildfire Smoke Clogging Skies In Western U.S., Canada 
Tens of millions of Americans and Canadians have been greeted by gray skies, eerily fiery sunrises and sunsets, and a dingy veil of haze obscuring the sky overhead. The culprit? Dozens of raging wildfires burning across the West, emitting smoke some 40,000 feet into the atmosphere and signaling what may be a long, devastating fire season. The smoke is also compromising air quality in areas near the blazes. (Cappucci, 7/13)

Indianapolis Star: Fireworks' Smoke Is Laced With Toxins, Can Have Impact On Your Health
The July Fourth holiday was a weekend of barbecues, time with family and fireworks displays by starlight. But the holiday also sparked something else: a question about the impacts of fireworks. For many, the bright lights of fireworks disappear as quickly as they came. But the explosions involve far more than just the flash. They leave something that’s a little harder to see in the dark: smoke. That’s the faint burning smell you might sometimes notice when you or your neighbors set off fireworks, or perhaps the haze you see when you go to a city display. That smoke is air pollution made up of harmful particulates and toxic chemicals that can hang in the air and get into the water, soil and your lungs. (Bowman, 7/13)

Also —

CNN: Drinking Alcohol Linked With Cancer, Study Finds 
Over 4% of all new cancer cases in 2020 were attributable to alcohol consumption, according to a study published Tuesday in the journal The Lancet Oncology. The researchers analyzed available data on population-level alcohol use in 2010 and on cancer cases in 2020. They assumed a 10-year period between alcohol consumption and the appearance of cancer, since the types of cancer included in the study -- lip and oral cavity cancer, laryngeal cancer and breast cancer (among females) -- have lengthy development periods and previous evidence of a causal relationship with alcohol consumption. (Rogers, 7/13)

CBS News: 18 Attorneys General Call For Improved Car-Seat Standards Following CBS News Reports
Attorneys general in 17 states and the District of Columbia are demanding federal regulators create a side-impact crash-test standard and better labeling standards for children's car seats. In a letter sent Tuesday to Transportation Secretary Pete Buttigieg and Steven Cliff, the acting administrator of the National Highway Traffic Safety Administration, the attorneys general called for "NHTSA to take swift action." (Van Cleave, 7/13)

AP: Hospital: Patient Gets Kidney Meant For Someone Else
An Ohio hospital has acknowledged that a patient received a new kidney meant for someone else. Officials at University Hospitals in Cleveland on Monday apologized for the mistake and said two employees have been placed on administrative leave. The kidney given to the wrong patient is compatible and the person is expected to recover, officials said. (7/13)

Fox News: Boy, 3, Dies At Dentist After 'Unanticipated Reaction To Medicine,' Report Says
A 3-year-old Kansas boy died after what police said was an "unanticipated reaction to medicine" given to him during a dental procedure, a local report said. Abiel Zapata-Valenzuela, of Scott City, was reportedly at the dentist to have teeth extracted. "The last thing I told him was cause he cried cause he felt the needle and stuff, so I told him, ‘Papi, everything is going to be okay.’ I’m like ‘You’re fine,’ and as a mother, you just feel like I failed him," Nancy Valenzuela, the boy’s mother, told KWCH.com. (Hein, 7/13)

NPR: Women Say There Are Too Many Barriers To Accessing Postpartum Depression Drug 
When Miriam McDonald decided she wanted to have another baby at age 44, her doctor told her she had a better chance of winning the lottery. So when she got pregnant right away, she and her husband were thrilled. But within three days of giving birth to their son, in September 2019, everything turned. "I was thinking, 'Oh my God, what did I do?' I just brought this baby into this world and I can barely take care of myself right now," she says. "I feel exhausted. I haven't slept in three days. I haven't really eaten in three days." As the weeks went by, her depression got worse. She felt sad, but also indifferent. She didn't want to hold her baby, she didn't want to change him. She says she felt no connection with him at all. (Dembosky, 7/13)

USA Today: American Fitness Index: Arlington, Virginia, No. 1; Oklahoma City Last
Americans were shut out of gyms and other indoor exercise venues for much of last year as COVID-19 raged and leaders locked down group gatherings. The annual ranking of the fittest U.S. cities released Tuesday shows Americans’ options to stay physically fit during the pandemic hinged on geography. Those who lived in communities with walkable neighborhoods, trails and bike paths had more ways to stay active and stave off high blood pressure, obesity or heart disease. The American College of Sports Medicine and the Anthem Foundation publishes the annual American Fitness Index ranking the nation’s 100 most populous cities by 34 variables of personal health behaviors, outcomes and community indicators such as air quality and walkability. The report aims to evaluate a community’s strengths and resources to bolster healthy living and barriers that prevent people from staying fit. (Alltucker, 7/13)

In updates from Michigan, North Carolina, Florida and Texas —

AP: 'Some Crumbs': Critics Urge Rejection Of $641M Flint Deal
A federal judge listened Tuesday to Flint residents who were victims of the city’s lead-contaminated water, a step in determining whether she should sign off on a $641 million deal that would settle claims against the state of Michigan. More than a dozen people without lawyers signed up to speak, all in opposition. Thousands more are represented by attorneys who negotiated the settlement with Michigan and other parties and urged approval a day earlier. (White, 7/13)

North Carolina Health News: N.C Environmental Management Commission Directs DEQ To Investigate 1,4 Dioxane Discharge 
The North Carolina Environmental Management Commission wants additional investigation of a large discharge of the likely carcinogen 1,4 dioxane that was detected on June 30 at a Greensboro wastewater treatment plant. The commission voted Tuesday to direct the state Department of Environmental Quality’s Division of Water Resources to investigate the discharge, which resulted in elevated levels of the contaminant reaching downstream Pittsboro’s drinking water supply. (Barnes, 7/14)

The Washington Post: Florida Gov. DeSantis Sells Anti-Fauci Merchandise As Doctor Draws Republican Ire 
“Don’t Fauci My Florida,” read drink koozies and T-shirts that Florida Gov. Ron DeSantis’s campaign team rolled out just as his state sees some of the highest coronavirus hospitalizations, new infections and deaths per capita in the country. It’s the latest example of Republicans running on their opposition to virus-fueled shutdowns and mask mandates. A pandemic hero to some and villain to others, Fauci has become a high-profile target. (Knowles, 7/13)

Dallas Morning News: Abortion Providers Sue To Stop Texas’ ‘Heartbeat Bill’ From Being Implemented
A group of abortion providers, doctors and clergy members filed a federal lawsuit on Tuesday, seeking to stop to implementation of Texas’ strict six-week anti-abortion law from taking effect later this year. Senate Bill 8, which was signed into law by Gov. Greg Abbott in May and takes effect in September, outlaws abortions once a fetal heartbeat is detected — roughly six weeks into pregnancy and before many women know they are pregnant. According to the Center for Reproductive Rights, at least 85% of abortions in Texas are performed after six weeks. (Williams, 7/13)

In updates from Vermont and New York —

Burlington Free Press: Potentially Harmful Cyanobacteria 'Blooms' Close Burlington Beaches
Floating colonies of potentially harmful cyanobacteria, also known as blue-green algae, prompted Burlington officials to close all of the city's public beaches to swimming Monday. The alert, issued by the Department of Parks, Recreation and Waterfront, remains in effect at least until mid-morning Tuesday. Boaters, although at far less risk than swimmers from waterborne illness, should avoid contact with any soupy-thick "blooms" of cyanobacteria they might encounter, the department posted on its website. (Banner Baird, 7/13)

The New York Times: N.Y.C.’s Plan To Move Homeless People From Hotels Is Blocked By A Judge
New York City’s plan to move 8,000 homeless people out of hotels and into barracks-style shelters was disrupted on Tuesday when a federal judge ruled that officials were not adequately considering the health of those being moved. The ruling blocks the city from transferring anyone with a disability to another site until evaluating whether it meets their needs. Because the city does not know who might qualify for such so-called reasonable accommodations, the entire program must pause for at least a week, said Joshua Goldfein, a staff lawyer for the Legal Aid Society, which filed a legal challenge to the moves. (Newman, 7/13)

In updates from California and Montana —

CalMatters: 'Menstrual Equity' Bill Would Require CA Colleges To Provide Period Products
A bill pending in the Legislature would require California’s public universities, community colleges and secondary schools to provide free menstrual products on campus. Students pushing for the bill say they are trying to break through taboos surrounding a matter of basic hygiene, and that many low-income students suffer from “period poverty,” in which they are unable to afford the pads and tampons they need. (Forschen, 7/13)

Montana Free Press: Frustration Builds In Border Towns As ‘Temporary’ Closure Drags On
While the country and Montana emerge from the pandemic and the economic downturn it created, recovery in the Eureka area has been stunted by the ongoing border closure. And while American tourists are flooding the nearby Flathead Valley, filling short-term rentals and visiting Glacier National Park in record numbers — the northern part of Lincoln County is considerably quieter. (Franz, 7/9)

AP: French Rush To Get Vaccinated After President's Warning
More than 1 million people in France made vaccine appointments in less than a day, according to figures released Tuesday, after the president cranked up pressure on everyone to get vaccinated to save the summer vacation season and the French economy. Some bristled at President Emmanuel Macron’s admonition to “get vaccinated!” immediately, but many people signed up for shots, accepting that getting injected was the only way to return to some semblance of pre-pandemic life. (Gouvy and Charlton, 7/13)

Reuters: Masks To Remain Mandatory On London Transport After National Rule Easing 
Masks will remain mandatory on London's public transport network after July 19, the city's mayor said on Wednesday, as Prime Minister Boris Johnson's government plans to lift most COVID-19 restrictions from that date in England despite rising cases. The public will be expected, rather than compelled by law, to wear masks in indoor enclosed spaces across the country from next week, as rules decided upon by the Conservative administration are eased. (7/14)

Fox News: COVID-19 Infects About 100 Vaccinated Crewmembers On HMS Queen Elizabeth: Report
About 100 vaccinated crewmembers aboard the Royal Navy’s HMS Queen Elizabeth carrier have been diagnosed with COVID-19 but the outbreak is being managed, a report said Wednesday. The BBC reported that there are more infections on warships in the carrier group, which consists of about 3,700 personnel. The flagship of the Royal Navy has entered the Indian Ocean and will eventually head to Japan. A spokeswoman told the BBC that the cases were discovered during routine testing and there "are no effects on the deployment." (DeMarche, 7/14)

Bloomberg: Indonesia’s Daily Cases Surpass India, Marking New Epicenter
Indonesia surpassed India’s daily Covid-19 case numbers, marking a new Asian virus epicenter as the spread of the highly-contagious delta variant drives up infections in Southeast Asia’s largest economy. The country has seen its daily case count cross 40,000 for two straight days -- including a record high of 47,899 on Tuesday -- up from less than 10,000 a month ago. Officials are concerned that the more transmissible new variant is now spreading outside of the country’s main island, Java, and could exhaust hospital workers and supplies of oxygen and medication. (Hong and Jiao, 7/14)

Bloomberg: Russia And Serum Institute Of India Sign Deal To Boost Sputnik V Covid Vaccines
Russia signed a deal with the world’s largest vaccine manufacturer to boost annual production of Sputnik V coronavirus shots by 300 million doses in India, as the South Asian nation struggles with supplies. The Serum Institute of India Ltd., which is already producing AstraZeneca Plc’s vaccine, aims to deliver its first batch of Sputnik V by September, the company and the state-run Russian Direct Investment Fund, which backed the vaccine’s development and is in charge of its foreign sales, said in a joint statement Tuesday. (Kay, 7/13)

In updates on the Tokyo Olympics —

Reuters: COVID-19 Cases Found At Olympic Hotel As IOC Hails "Historic" Games
A coronavirus cluster at a Japanese hotel where dozens of Brazilian Olympic team members are staying has raised new concern about infections at what the world's top Olympics official promised on Wednesday would be "historic" Games. Just over a week before the opening ceremony of the postponed Games, seven staff at the hotel in Hamamatsu city, southwest of Tokyo, had tested positive, a city official said. (Park and Slodkowski, 7/14)

Reuters: Olympics Tokyo Governor Vows City's Medical System Is Ready For Games
Tokyo Governor Yuriko Koike said on Tuesday that a sufficient number of hospitals combined with a speed-up in the COVID-19 vaccination rollout among the elderly meant the city will be able to hold "safe and secure" Olympics in 10 days. But Koike, speaking to Reuters in an interview at the Tokyo government headquarters that has for the last few weeks doubled as a vaccination site, also warned the coronavirus pandemic was far from over and the spreading Delta variant remained a risk. (Slodkowski and Miyazaki, 7/13)

The Wall Street Journal: Team USA’s Family Section For The Tokyo Olympics Will Be In Orlando 
With the Tokyo Olympics banning foreign spectators—and nearly all others—from watching the Games in person, the U.S. Olympic & Paralympic Committee, NBCUniversal and two sponsors are paying to send athletes’ closest friends and family to a remote viewing-and-cheering hub at an NBCU resort in Orlando. The setup gives Olympic athletes’ loved ones a place to congregate—and it gives U.S. media-rights owner NBCUniversal, a unit of Comcast Corp. , a central spot for filming reaction shots to athlete performances 7,200 miles and 13 time zones away. (Bachman, 7/13)

Axios: Experts Fear Olympics Could Be A Superspreader Event
Health experts fear the Tokyo Olympics could become a COVID-19 superspreader event. Infectious disease experts say the Olympics don't have strong enough protocols for testing or ventilation, either in competition venues or in the Olympic village. (Reed, 7/14)

In other global developments —

AP: Pope Francis Seen Leaving Hospital 10 Days After Surgery
Pope Francis was seen leaving the hospital on Wednesday, 10 days after undergoing planned surgery to remove half his colon. Associated Press journalists saw a car carrying Francis, 84, leaving Rome’s Gemelli Polytechnic hospital Wednesday morning. He was sitting in the front passenger seat. (7/14)

Becker's Hospital Review: Why The Pharmaceutical Industry Has 'Mixed Views' On Biden's Latest Executive Order
The American Pharmacists Association "has mixed views" on the executive order President Joe Biden signed July 9 to address competition among drugmakers, hospitals, health insurers and hearing aid manufacturers. The executive order directs the FDA to work with states and tribal programs to import prescription drugs from Canada. In addition to its drug importation guidance, the order asks the Federal Trade Commission to ban "pay for delay" agreements, under which makers of brand name drugs pay generic drugmakers to keep out of a market. It also calls on HHS to increase support for generic and biosimilar drugs and to create a plan within 45 days to address high drug prices and price gouging. (Adams, 7/13)

Yahoo Finance: Here's How Biden's Exec Order Could Bring Down Health Care Costs
President Biden’s recent executive order aims to help Americans save on medical and drug costs while expanding health care coverage access. His order requires changes with prescription drugs, enhancing price transparency rules, standardizing plan options in the health care marketplace, and allowing hearing aids to be sold over the counter. (Belmonte, 7/13)

FiercePharma: With Sweeping Executive Order, Biden Puts Drug Pricing, Anti-Competitive Strategies In The Crosshairs
President Joe Biden campaigned on the goal of lowering prescription drug costs. So far, those promises haven't amounted to much. But late last week, the president unveiled a series of initiatives taking aim at pricing, anti-competitive practices, and more. In an executive order penned Friday, Biden doubled down on efforts to combat high prescription drug prices in the U.S. by promoting generic and biosimilar competition, allowing Medicare to negotiate drug costs and more. Despite the administration’s lofty ambitions, it remains “far from clear” whether Biden’s goals will pan out, one antitrust and competition lawyer said. (Kansteiner, 7/12)

Bloomberg: Prescription Drug Prices In Sights Of Legislation Limiting Drugmaker Deals 
Lawmakers will have a hard time objecting to legislation aimed at lowering prescription drug prices by limiting deals between name brand and generic manufacturers, Sen. Amy Klobuchar said Tuesday. “The stakes could not be higher,” Klobuchar (D-Minn.), chair of the Senate Judiciary Committee’s antitrust panel, said at a hearing. (Lopez, 7/13)

Also —

KTNV: Nevada Representative Introduces New Bills On Lowering Prescription Drug Costs
Nevada's Democratic Rep. Steven Horsford has made lowering prescription drug costs a key pillar of his election promises, and on Tuesday the congressman plans to introduce two bills in an attempt to help people pay less at the pharmacy. The first bill, called the SPIKE Act, is designed to discourage quick price hikes by forcing any company that "spikes" the cost of a drug to justify the raise to the Secretary of the Department of Health and Human Services. (DeLancey, 7/13)

WGAL: Pennsylvania State Representatives Are Introducing Legislation To Lower The Cost Of Prescription Drugs
Pennsylvania state representatives are introducing legislation to lower the cost of prescription drugs. The bill would create a prescription drug advisory board, setting limits on what pharmacies, providers and patients pay for some medications. The proponents say it would be similar to boards that already exist in other states. Rep. Dan Frankel, a Democrat serving part of Allegheny County, is sponsoring the legislation. (Merriman, 7/13)

Times Leader: Rep. Pashinski: Cost Of Prescription Drugs Driving Up Health Care Costs
State Rep. Eddie Day Pashinski Monday said the increasing cost of prescription drugs is driving up health care costs. Pashinski, D-Wilkes-Barre, and Rep. Emily Kinkead, D-Pittsburgh, hosted a public hearing to discuss the need for drastic reforms to drive down the costs of prescription drugs for the well-being of Pennsylvanians who rely on medications for an improved quality of life. (O'Boyle, 7/13)

Milwaukee Journal Sentinel: Biden Order Promotes Competitiveness, Helps Farmers, Small Businesses
President Joe Biden signed off on an executive order July 9 aimed at increasing federal agencies' ability to promote competitiveness in the economy. We applaud this administration's actions to address oligopoly, or limited competition in the marketplace. For the first time in a long while, our members’ hopes are raised that some anti-capitalistic practices will be addressed. For example, currently only a few sellers control all the sales in many markets, barriers to entry are imposed, and corporate interdependence keeps prices high and competitors out. The president’s executive orders could begin to improve the vitality of our economy, reduce prices on goods and services, increase producers’ agency in the supply chain, and improve choices for consumers. (Shawn Phetteplace and Julie Keown-Bomar, 7/12)

Stat: Biden Wants A Drug Pricing Plan. Who’s Going To Write It? 
President Biden signed an executive order Friday ordering HHS to come up with a drug pricing plan within 45 days. But there’s one problem: The administration hasn’t even said publicly who’s leading drug pricing policy within the federal health department. STAT surveyed a number of Washington’s top drug pricing advocacy organizations and health care lobbyists — the types of people who would usually be coordinating or at least meeting with HHS on a drug pricing plan — and almost all of them failed to name a staffer at HHS charged with the task. However, clues are emerging. (Nicholas Florko, 7/13)

Des Moines Register: For Veterans And For Everybody Else, Lower Drug Prices Now
As a retired Air Force veteran who spent 24 years serving my country, I understand what it’s like to fight for the basics. Millions of veterans have sacrificed and contributed in countless ways to protect freedoms, ensure security and save lives through the years. But, as we all learned during the COVID-19 pandemic, sometimes the status quo needs to be changed rather than protected. Prescription drug prices are a great example. The ridiculously high price of prescriptions in the United States presents a clear and present danger to millions of Americans, including veterans, who can’t afford medicines because lawmakers allow drug corporations to hike prices at will. Whether it’s new drugs like the Alzheimer's treatment that just launched at $56,000 per year or insulin, which has been around for a hundred years, drug corporations’ monopoly power forces Americans to pay two to four times more for medicines than people in other countries.  (David Hind, 7/13)

PennLive.com: My Patients Deserve To Know Why Drug Costs Keep Going Up
Not long ago, a patient collapsed just steps away from the emergency department where I work as a physician. The patient’s heart stopped pumping due to dangerously low blood potassium levels. When the body lacks potassium, a condition known as hypokalemia, electrical signals that are critical to muscle functions, especially the heart muscle, can short circuit. Thankfully, our team was able to quickly diagnose the problem and save our patient’s life. When he woke and we were able to speak to him, we learned the patient was rationing his medications because he couldn’t afford them. He was taking multiple medications to manage chronic conditions. Some of these medications lower potassium levels. He was prescribed a potassium supplement, but due to the overall cost of his prescriptions he decided to skip this important one — and it almost killed him. (Dr. Max Cooper, 7/13)

Los Angeles Times: Immunocompromised Shouldn't Wait For COVID Booster Shots 
Last week, Pfizer announced that it plans to request an emergency use authorization for a booster vaccine shot for COVID-19. Within hours, the Food and Drug Administration and the Centers for Disease Control and Prevention issued a joint statement asserting, “Americans who have been fully vaccinated do not need a booster shot at this time.” The Department of Health and Human Services reiterated this after it and senior U.S. scientists met with top Pfizer representatives this week. Immunologists, health policy experts, the director of the World Health Organization and pundits have criticized Pfizer for planning to request this approval. Some suggest that it’s a cash grab for the vaccine maker and others assert simply that more data are needed. What these responses ignore is growing evidence that a third shot may provide lifesaving protection to immunocompromised people (including organ transplant patients), which represent approximately 3% to 4% of our adult population. (Jennifer Mnookin and Robert Mnookin, 7/13)

USA Today Network: Firing Tennessee's Top Vaccine Official As COVID-19 Flares Up Is Absurd And Dangerous
Politics trounced public health when the Tennessee Department of Health fired top vaccine official Michelle Fiscus on Monday. The losers: the citizens of Tennessee. Fiscus was terminated as TDOH's medical director for vaccine-preventable diseases and immunization programs because she apparently was trying too hard to get every Tennessean to receive the COVID-19 vaccine. That's absurd and dangerous. (7/13)

The Washington Post: Vermont’s And South Dakota’s Covid Infection Rates Are Remarkably Similar — But Their Outcomes Are Not 
Two states. Two different paths in responding to covid-19. Together, they offer invaluable lessons about the road ahead for the nation — especially as infection rates creep up because of the delta variant. The two states are Vermont and South Dakota. Both feature among the three states that Covid Act Now classifies as falling in the lowest-risk category, along with Massachusetts. This may be a surprise. While New England states are known to have done extraordinarily well in vaccinating their populations, South Dakota is in the middle of the pack. So, what explains the fact that South Dakota has infection numbers almost as low as Vermont, the most vaccinated state in the nation? (Ashish K. Jha, 7/13)

The Wall Street Journal: Realism About Vaccine Hesitancy 
Watching my teams lose is often more compelling than watching the Fox evening lineup, but I was nonetheless doubtful when a New York Times headline claimed “Fox News hosts smear America’s vaccination efforts.” It turned out, on visiting the transcript, that Laura Ingraham and Tucker Carlson had merely reacted in their usual hyperbolic way to a Joe Biden suggestion to send vaccinators door to door. Mr. Carlson, in particular, seemed like he might grasp the law of diminishing returns, because he started his remarks by praising U.S. success so far in getting 67% of adults vaccinated. (Holman W. Jenkins Jr., 7/13)

The Washington Post: Visiting My Family, Warily, In Pandemic-Beleaguered Brazil 
My mother and I stood under a canopy of coconut trees and watched the full moon rise, illuminating the sand and sea before us. I clasped her hand and put my head on her shoulder, closing my eyes and saying a silent prayer of gratitude. After a coronavirus test, a self-imposed quarantine and a 22-hour trip that included four airports and three flights, I had arrived in Brazil in mid-June and was able to hug my family for the first time since the pandemic tore the world apart. I had purchased the ticket to Brazil in January, after my first dose of the Pfizer vaccine, as an act of faith. By the summer in the Northern Hemisphere, I hoped, my parents and siblings would be fully vaccinated in Bahia, the impoverished but wonderful Brazilian state I’m from, as would I and my partner and daughter in Arizona. (Fernanda Santos, 7/12)