The New York Times: The Pandemic’s Real Toll? 300,000 Deaths, And It’s Not Just From The Coronavirus 
The coronavirus pandemic caused nearly 300,000 deaths in the United States through early October, federal researchers said on Tuesday. The new tally includes not only deaths known to have been directly caused by the coronavirus, but also roughly 100,000 fatalities that are indirectly related and would not have occurred if not for the virus. The study, published by the Centers for Disease Control and Prevention, is an attempt to measure “excess deaths” — deaths from all causes that statistically exceed those normally occurring in a certain time period. The total included deaths from Covid-19, the illness caused by the coronavirus, that were misclassified or missed altogether. (Rabin, 10/20)

The Washington Post: The Coronavirus Pandemic Has Caused Nearly 300,000 More Deaths Than Expected In A Typical Year 
The CDC said the novel coronavirus, which causes covid-19, has taken a disproportionate toll on Latinos and Blacks, as previous analyses have noted. But the CDC also found, surprisingly, that it has struck 25- to 44-year-olds very hard: Their “excess death” rate is up 26.5 percent over previous years, the largest change for any age group. It is not clear whether that spike is caused by the shift in covid-19 deaths toward younger people between May and August or deaths from other causes, the CDC said. (Bernstein, 10/20)

STAT: CDC Reports Nearly 300,000 'Excess Deaths' In The U.S. Amid Pandemic
Some people who die might never have been tested for the disease, for example, and if people die at home without receiving medical care, they might not make it into the confirmed data. To address that, researchers often look to what are called excess deaths — the number of deaths overall during a particular period of time compared to how many people die during the stretch in a normal year. Now, in the most updated count to date, researchers at the Centers for Disease Control and Prevention have found that nearly 300,000 more people in the United States died from late January to early October this year compared the average number of people who died in recent years. (Joseph, 10/20)

The New York Times: ‘It Has Hit Us With a Vengeance’: Virus Surges Again Across the United States
In Ohio, more people are hospitalized with the coronavirus than at any other time during the pandemic. North Dakota, which is leading the nation in coronavirus cases per capita, reported more than 1,000 cases on Tuesday, the state’s worst daily total yet. And as of Monday, 16 states had added more cases in the prior week than in any other seven-day stretch. After weeks of spread and warnings in certain areas, a third surge of coronavirus infections has now firmly taken hold across much of the United States. (Mervosh and Tompkins, 10/21)

CNN: US Is Nearing 'Rapid Acceleration' Of Covid-19 Cases, Expert Warns, As Daily Infections Top 60,000
A leading health expert says US Covid-19 cases will begin to rapidly accelerate in a week as the country topped 60,000 new infections Tuesday -- triple what the daily average was back in June, when restrictions had begun to ease. The prediction comes after several state leaders reimposed some measures to help curb the spread of the virus, fueled by small gatherings increasingly moving indoors with the colder weather, as well as other factors such as college and school reopenings. (Maxouris, 10/21)

Boston Globe: Interactive: See How COVID-19 Hospitalizations Have Spiked Around The US Since March 
COVID-19 has spread lethally, yet unevenly through all 50 states. One way to measure the level of infections is hospitalizations. Here’s how hospitalizations in the US have changed over time, state by state, since March 1, 2020. (Hancock and Ciras, 10/21)

Politico: Trump’s Broadsides Against Science Put GOP Governors In A Bind
Republican governors are pleading for basic public health precautions as their states face a new wave of coronavirus cases, even as President Donald Trump downplays the pandemic’s severity and tells people to move on with their lives. The clashing messages come as large swaths of the country experience uncontrolled spread that state officials fear could swamp their already strapped health systems. They’re putting out calls for volunteers to help staff hospitals, placing new limits on public gatherings and urging, or in some cases mandating, the wearing of masks. (Goldberg and Ollstein, 10/21)

NPR: COVID-19 Death Rates Are Going Down, And Not Just Among The Young And Healthy 
Two new peer-reviewed studies are showing a sharp drop in mortality among hospitalized COVID-19 patients. The drop is seen in all groups, including older patients and those with underlying conditions, suggesting that physicians are getting better at helping patients survive their illness. "We find that the death rate has gone down substantially," says Leora Horwitz, a doctor who studies population health at New York University's Grossman School of Medicine and an author on one of the studies, which looked at thousands of patients from March to August. (Brumfiel, 10/20)

The Hill: NIH Chief: Trump Has Not Met With White House COVID-19 Task Force In 'Quite Some Time' 
President Trump has not met with the White House coronavirus task force in "quite some time," the head of the National Institutes of Health (NIH) said Tuesday. NIH Director Francis Collins told NPR's "Morning Edition" that Trump instead gets his information from Vice President Pence and task force member Scott Atlas, neither of whom are infectious disease experts. (Weixel, 10/20)

The New York Times: How The F.D.A. Stood Up To The President 
In what might be the final months of the Trump administration, and close enough to the election to make his firing unlikely, Dr. [Stephen M.] Hahn seems to be trying to save the F.D.A. from the fate of its sister agency, the Centers for Disease Control and Prevention, whose scientists have been stripped of much of their authority and independence in responding to the pandemic. “It’s better late than never, but I do think we can see a lot of damage has been done,” said Dr. Jesse L. Goodman, the F.D.A.’s chief scientist from 2009 to 2014. “And I don’t think they are out of the woods yet.” (Kaplan, LaFraniere, Weiland and Haberman, 10/20)

ProPublica: The EPA Refuses To Reduce Pollutants Linked To Coronavirus Deaths
In April, as coronavirus cases multiplied across the country, the head of the U.S. Environmental Protection Agency rejected scientists’ advice to tighten air pollution standards for particulate matter, or soot. In the next few weeks, EPA Administrator Andrew Wheeler likely will reaffirm that decision with a final ruling, despite emerging evidence that links particulate pollution to COVID-19 deaths. (Song and Younes, 10/21)

The Hill: DeVos Says It Isn't Department Of Education's Job To Track Schools' Coronavirus Reopening Plans 
Education Secretary Betsy DeVos said Tuesday it is not the job of her department to track school districts’ reopening plans or the number of coronavirus cases they are grappling with as districts look for guidance as to how to conduct classes safely during the pandemic. “Well I'm not sure there's a role for the Department of Education to compile and conduct that research,” DeVos said Tuesday at an event hosted by the Milken Institute in response to a question about the role of the federal government to boost confidence regarding in-person schooling. (Axelrod, 10/20)

The New York Times: A Viral Theory Cited By Health Officials Draws Fire From Scientists
As the coronavirus pandemic erupted this spring, two Stanford University professors — Dr. Jay Bhattacharya and Dr. Scott W. Altas — bonded over a shared concern that lockdowns were creating economic and societal devastation. Now Dr. Atlas is President Trump’s pandemic adviser, a powerful voice inside the White House. And Dr. Bhattacharya is one of three authors of the so-called Great Barrington Declaration, a scientific treatise that calls for allowing the coronavirus to spread naturally in order to achieve herd immunity — the point at which enough people have been infected to stall transmission of the pathogen in the community. While Dr. Atlas and administration officials have denied advocating this approach, they have praised the ideas in the declaration. (Mandavilli and Gay Stolberg, 10/19)

Politico: White House Looks At Cutting Covid Funds, Newborn Screenings In ‘Anarchist’ Cities
The White House is considering slashing millions of dollars for coronavirus relief, HIV treatment, screenings for newborns and other programs in Democratic-led cities that President Donald Trump has deemed “anarchist jurisdictions,” according to documents obtained by POLITICO. New York, Portland, Ore., Washington, D.C., and Seattle could lose funding for a wide swath of programs that serve their poorest, sickest residents after the president moved last month to restrict funding, escalating his political battle against liberal cities he’s sought to use as a campaign foil. (Ehley and Roubein, 10/20)

USA Today: COVID Deaths Of Native Americans Linked To Underfunded Health Care
Melvina Musket stared at her dying father through the cellphone screen. His mouth hung open, his eyes were clamped shut and a beard covered his chin. She heard nurses crying in the background. “Jesus is waiting for you,” she told him. Musket, 52, had never seen her father with facial hair. Benjamin Musket, 80, was a former Marine, a retired machinery mechanic, a basketball coach and a board member at their church. He didn’t do beards. (Wagner and Grantham-Philips, 10/20)

The Hill: Progress, But No Breakthrough, On Coronavirus Relief 
After months of slow-moving talks on another round of coronavirus relief, the top negotiators on Tuesday appeared to be where they’ve been for weeks: making some progress but without a major breakthrough to report. Speaker Nancy Pelosi (D-Calif.) had indicated over the weekend that Tuesday would be a make-or-break moment for the fate of the legislation, the day to decide if the sides were close enough to a stimulus deal to enact it before Election Day. (Lillis and Wong, 10/20)

The Washington Post: McConnell Warns White House Against Making Stimulus Deal As Pelosi And Mnuchin Inch Closer 
Prospects for an economic relief package in the next two weeks dimmed markedly on Tuesday after Senate Majority Leader Mitch McConnell (R-Ky.) revealed that he has warned the White House not to strike an agreement with House Speaker Nancy Pelosi before the Nov. 3 election. In remarks at a closed-door Senate GOP lunch, McConnell told his colleagues that Pelosi (D-Calif.) is not negotiating in good faith with Treasury Secretary Steven Mnuchin, and that any deal they reach could disrupt the Senate’s plans to confirm Amy Coney Barrett to the Supreme Court next week. Republicans have voiced concerns that a stimulus deal could splinter the party and exacerbate divisions at a time when they are trying to rally behind the Supreme Court nominee. The comments were confirmed by three people who spoke on the condition of anonymity to discuss them. (Stein and Werner, 10/20)

The New York Times: McConnell Moves To Head Off Stimulus Deal As Pelosi Reports Progress
Mr. McConnell’s remarks, confirmed by four Republicans familiar with them, threw cold water on Mr. Trump’s increasingly urgent push to enact a new round of pandemic aid before Election Day. They came just as Ms. Pelosi offered an upbeat assessment of her negotiations with Steven Mnuchin, the Treasury secretary, telling Democrats that their latest conversation had yielded “common ground as we move closer to an agreement.” (Cochrane and Fandos, 10/20)

USA Today: McConnell Urges White House Against Stimulus Deal
The Kentucky Republican, who has blasted Democrats in negotiations, voiced concerns there would not be enough GOP votes to back a package and worries that voting on such legislation could negatively affect the timing on Judge Amy Coney Barrett's confirmation vote to the Supreme Court, the source said. Republicans disagree about the size and details of an aid bill. Some Republicans rejected Democratic offers they said are too costly and will add to the federal deficit, though President Donald Trump has pushed for Republicans to offer even more than Democrats. (Wu and Hayes, 10/20)

Politico: Pelosi And Mnuchin Brush Past Stimulus Deadline Amid Hopes For A Deal 
Pelosi and Mnuchin plan to speak again Wednesday after a productive, 45-minute call on Tuesday afternoon. Though a deal was not reached by her self-imposed Tuesday night deadline, enough progress was made that both sides felt like talks should continue, with Washington still waiting to see whether months of negotiations between the two will culminate in a multitrillion-dollar stimulus plan just two weeks before the presidential election. (Caygle and Ferris, 10/20)

More from Capitol Hill —

Politico: Lawmakers Press HHS For Documents On Trump’s Drug-Card Plan 
Senior Democratic lawmakers are demanding that the health department turn over internal documents on President Donald Trump's plan to give seniors $200 discount cards to buy prescription drugs, following a POLITICO report that the department's top lawyer warned the plan could violate election law. The media reports "appear to confirm our concerns that the Trump Administration is relying on dubious legal authority to justify a blatant political gambit by the President that would be paid for using taxpayer dollars," Reps. Frank Pallone and Richard Neal and Sen. Ron Wyden wrote to Health and Human Services Secretary Alex Azar, demanding the documents by Monday. (Diamond, 10/20)

Stat: Lawmakers Ask Justice Department To Consider Criminal Charges Against Purdue And The Sacklers
More than three dozen Democratic lawmakers asked the Department of Justice to consider filing criminal charges against Purdue Pharma executives and members of the wealthy Sackler family, which controls the drug maker, for their role in fomenting the opioid crisis. In a letter to U.S. Attorney General William Barr, the lawmakers objected that federal authorities are reportedly nearing a plea agreement that would not require anyone from the company or the family to serve a “single day in prison,” despite having run a “criminal scheme” that caused “millions of unsuspecting people” to become addicted to the OxyContin painkiller. (Silverman, 10/20)

The Hill: Democrats Unveil Bill To Reduce Police Violence Against People With Mental Illness 
A group of House Democrats introduced legislation on Tuesday that provides grants to cities to allow trained mental health professionals to respond to 911 calls for a person in a mental health crisis. The proposal is an effort to reduce the number of people killed by police in such situations. (Marcos, 10/20)

The Washington Post: Senators Urge Pentagon To Suspend Implementation Of Army’s New Fitness Test 
Democratic senators appealed Tuesday for support of a legislative proposal that would suspend implementation of the Army’s new fitness test, arguing that the high-profile initiative to improve physical readiness is based on faulty data and could undermine the goal of creating a diverse force. In an Oct. 20 letter to the chairmen and ranking members of the House and Senate Armed Services committees, Sens. Kirsten Gillibrand (D-N.Y.) and Richard Blumenthal (D-Conn.) called the rollout of the Army Combat Fitness Test (ACFT) “premature” and said the exam could damage some soldiers’ professional prospects. (Ryan, 10/20)

The Wall Street Journal: Several Lawmakers Denied Access To Postal Facilities 
Efforts by some members of Congress to observe firsthand how mail is being processed at large facilities in the final weeks of the election have been blocked—a policy departure by the U.S. Postal Service for visits that were once routinely approved, the lawmakers said. It’s unclear how many lawmakers have sought access to postal plants, but at least five, all Democrats, said they’d received inconsistent explanations for the denials. (Smith, 10/20)

Stat: Trump Leans On Health Care Agencies To Aid His Campaign
Amid mounting desperation about his reelection odds, President Trump has increasingly come to rely on an unorthodox campaign tool: the Department of Health and Human Services. As the Nov. 3 election draws closer, HHS and the agencies within it have rolled out several initiatives clearly motivated as much by the election as by policy considerations. Most notably, the administration has announced plans to spend billions of taxpayer dollars on seemingly political projects like a mass marketing campaign to “inspire hope” about Covid-19 and a pending plan to mail $200 pharmacy gift certificates to millions of seniors. (Facher, 10/21)

And news on voter safety —

Politico: California Wants Court To Force Republicans To Divulge Ballot Box Details
California Attorney General Xavier Becerra is pursuing a court order to wring more information from the California Republican Party about its unofficial ballot collection boxes. Becerra wants the California GOP to share the locations of the boxes and the identity of voters who have used them. In a court filing, Becerra argued that such information is critical to ensuring that votes are counted and that the California Republican Party is abiding by election laws governing how it collects ballots. The filing says the Republican Party has refused to share the information requested. (White, 10/20)

Politico: Federal Appeals Court Won’t Lift North Carolina Ballot-Receipt Extension 
A bitterly divided federal appeals court has denied an attempt by Republicans to block an agreement by North Carolina state officials allowing absentee ballots in next month’s election to be counted if they are postmarked by Election Day and received up to nine days later. (Gerstein, 10/21)

The New York Times: Voters Prefer Biden Over Trump On Almost All Major Issues, Poll Shows 
Mr. Biden, if he wins, will find consensus on some of his policy priorities. Two in three voters supported allowing people to buy a health insurance plan through the federal government, a so-called public option, and the same supermajority backed Mr. Biden’s $2 trillion plan to increase the use of renewable energy and build energy-efficient infrastructure. (Burns and Martin, 10/20)

NBC News: For Latino Voters, Health Care Is A Top Issue As Obamacare Gains Reverse Under Trump
As more people lose health insurance, the cost and the availability of coverage are top-tier issues for Hispanics this election cycle. Latinos rank it even ahead of jobs and the economy and place more importance on it than they did about this time in 2016. (Gamboa, 10/20)

The Hill: Obama Hits Trail To Help Biden, Protect Legacy 
When former President Obama hits the trail on Wednesday, he'll be campaigning not just for his onetime partner Joe Biden but for his own policies that have been severed under President Trump. (Parnes, 10/21)

In other congressional and state elections news —

CNN: Republican Senators Drop Coronavirus Ad Messaging In Final Weeks
Throughout the spring, summer and fall, vulnerable Senate Republicans and their allies ran TV ads touting their efforts to pass multi-trillion dollar bills addressing the coronavirus pandemic. In Georgia, a Republican super PAC praised "quick action" from Sen. David Perdue to direct funding to hospitals, while North Carolina Sen. Thom Tillis ran ads about setting up the Paycheck Protection Program to save small businesses. But Senate Republicans have largely dropped mentioning coronavirus in TV ads during the final weeks of the election, while Senate Democrats have continued to emphasize the pandemic and health care throughout their campaigns, according to a CNN analysis of Kantar Media/CMAG advertising data. (Wright and Rogers, 10/20)

AP: Worsening Opioid Crisis Overshadowed In Presidential Race
Like millions of Americans, Diane Urban watched the first presidential debate last month at home with her family. When it was over, she turned off the television and climbed into the bed her 25-year-old son Jordan used to sleep in. It was where she found Jordan’s lifeless body after he overdosed on the opioid fentanyl one morning in April 2019. After watching President Donald Trump target the son of former Vice President Joe Biden for his history of substance abuse, Urban was reminded again of the shame her son lived with during his own battle with addiction. (Amiri and Mulvihill, 10/21)

KHN: Despite Pandemic Threat, Gubernatorial Hopefuls Avoid COVID Nitty-Gritty
Just 15 days ahead of the election, Montana Lt. Gov. Mike Cooney laid out his ideas on how he’d handle the COVID-19 pandemic if elected governor. Details were few, but the Democrat’s plan became one of only a handful being offered by candidates in the 11 U.S. governor’s races about how they’ll approach what’s certain to be the dominant issue of their terms, should they win. While much of the nation’s focus is on who will be president come January, voters who are deciding the next occupant of their governor’s mansion are also effectively choosing the next leader of their state’s COVID-19 response. The virus has made governors’ power highly visible to voters. As the states’ top executives, they decide whether to issue mask mandates, close businesses and order people to stay home. (Houghton and Volz, 10/21)

The Washington Post: Rep. Abigail Spanberger And Del. Nick Freitas Debate On Heathcare, Income Inequality, Coronavirus Relief 
Rep. Abigail Spanberger (D-Va.) clashed with Republican Del. Nick Freitas on everything from income inequality to coronavirus relief, as Spanberger pitched herself as a moderate focused on issues affecting rural Americans while Freitas stressed the need for limited government and cutting red tape. ... The candidates are locked in one of the most competitive Congressional races in Virginia, in a district that voted for President Trump by roughly 7 points in 2016 but that political analysts believe leans slightly in Spanberger’s favor. Spanberger, a former CIA officer and Postal Service investigator, flipped the seat blue in 2018. (Flynn, 10/20)

USA Today: Arthritis Drug Tocilizumab Shown Effective For Sickest COVID Patients
The list of drugs shown effective for treating COVID-19 got longer Tuesday, even as another well-used drug lost some of its luster. In a large clinical study, tocilizumab, an immune modulator long used to treat rheumatoid arthritis, showed it can save lives if given to critically ill COVID-19 patients within the first two days of being admitted to an intensive care unit. The study, published in JAMA Internal Medicine, showed just over 27% of ICU patients treated with tocilizumab died within a month, compared with 37% of those just as seriously ill but did not receive the drug.  (Weintraub, 10/20)

CIDRAP: Studies Offer Little Hope For Tocilizumab In Treating COVID 
JAMA Internal Medicine today published a trio of studies on use of the immunosuppressive drug tocilizumab in COVID-19 patients with pneumonia, one of them a large US observational study that suggested some promise and two randomized clinical trials from Italy and France that found no benefit. The first study involved 3,924 adult COVID-19 patients admitted to intensive care units (ICUs) at 68 hospitals in the United States from Mar 4 to May 10. (Van Beusekom, 10/20)

Treatment shortages are also expected —

The New York Times: Antibody Treatments, Though Promising, Will Be In Short Supply 
Nearly two weeks ago, President Trump told Americans that they would soon be getting an antibody treatment that he had promoted, without evidence, as a “cure” for the coronavirus. This weekend, as the country braced for another major wave of coronavirus infections, Mr. Trump’s health secretary promised such therapies were just around the corner. But these statements are misleading, at best. Even if the drugs are proven to work — still a big if — there’s little chance that they will soon be widely available. A smooth distribution of the antibody treatments will be dependent on the very same factors that have so far bedeviled the country’s response to Covid-19: fast and plentiful testing, coordination between state and federal officials, and equitable access to health care. (Thomas, 10/20)

Reuters: Lilly Hires External Adviser For COVID-19 Drug Plant Problems
Eli Lilly and Co said late on Tuesday it had hired an independent consultant to review a plant producing its COVID-19 antibody drug after receiving a notice from the U.S. health regulator. The company reiterated that it had not received a warning letter from the U.S. Food and Drugs Administration (FDA) following its plant inspection, which was first reported by Reuters last week. (10/21)

Stat: Will This Be The Most-Watched FDA Meeting Ever? 
The FDA’s panel of outside vaccine experts will meet Thursday to discuss approval standards for an eventual Covid-19 vaccine. These meetings are typically attended only by the nerdiest biotech investors and FDA lawyers, but this one is expected to attract so much attention that the FDA is setting up a Youtube stream for the event instead of its typical (often rage-inducing) internal streaming service. (Florko, 10/20)

WBUR: NIH Director 'Guardedly Optimistic' About COVID-19 Vaccine Approval By End Of 2020
Coronavirus cases appear headed for a new surge in the U.S., which could eclipse the explosion of cases in July.Much of the new surge is driven by cases in the Midwest and Great Plains states. (Doubek and Inskeep, 10/20)

Stat: Health Experts Push Vaccine Makers To Release Covid-19 Trial Protocols
Amid concerns over a lack of transparency Covid-19 product development, more than two dozen academics and health policy experts are urging federal officials and several vaccine makers to fully disclose all information concerning their clinical trial protocols and agreements. In an open letter, they acknowledged that sharing such details is unusual, but in this instance, such a step would help to ensure accountability, advance scientific understanding, and build public trust, especially at a time when the race to develop a safe and effective Covid-19 vaccine has become highly politicized by the Trump administration. (Silverman, 10/20)

Meanwhile, vaccine distribution obstacles loom —

Nature: How Obesity Could Create Problems For A COVID Vaccine
Researchers are still unsure whether or not obesity will affect vaccine efficacy. And there might be ways to counteract problems if they arise. But scientists are also concerned that clinical trials might not be well designed to capture such issues promptly. “It‘s something the experts need to really look at,” says Ryan. (Ledford, 10/20)

The Boston Globe: Colder Than Antarctica In Winter: Super Cooling Concerns For The Possible First COVID-19 Vaccine
The race to create safe and effective vaccines against the coronavirus is facing another complex challenge: how to safely deliver tens of millions of doses to all corners of the world while ensuring they remain in super cold storage until ready for use. Just how cold? As in minus 103 Fahrenheit for the first vaccine expected to be given the green light. That’s nearly four times colder than your home freezer, colder even than Antarctica in winter. (Lazar, 10/20)

In global vaccine news —

AP: Chinese Drugmaker Setting Up Vaccine Production Lines
A state-owned Chinese drugmaker is setting up production lines to supply 1 billion doses of two possible coronavirus vaccines that are being tested on 50,000 people in 10 countries, the company chairman said Tuesday. Testing by SinoPharm Group is “in the last kilometer of a long march,” chairman Liu Jingzhen said at a news conference. He gave no indication when results are expected. (10/20)

Reuters: Chinese City To Offer COVID-19 Vaccine Candidate As Emergency Use Expands 
A city in China’s Zhejiang province will offer experimental coronavirus vaccines to its residents, as China broadens an emergency use programme to people in non-priority groups. Residents aged between 18 and 59 in the city of Shaoxing, who are not in priority groups, can apply online for inoculation, the city’s health commission said on Tuesday on its WeChat account. It did not name the vaccine, say when inoculation would start or how many doses would be offered. (10/21)

Reuters: Five South Koreans Die After Getting Flu Shots, Sparking Vaccine Fears
Five people have died after getting flu shots in South Korea in the past week, authorities said, raising concerns over the vaccine’s safety just as the seasonal inoculation programme is expanded to head off potential COVID-19 complications. Authorities said there was no reason to believe the deaths were linked to the vaccine but an investigation, including post mortems, was underway. (10/21)

Modern Healthcare: CMS To Streamline And Automate Emergency Waiver Requests
CMS is developing a streamlined, automated process to standardize emergency waiver requests based on lessons learned during the COVID-19 pandemic, according to a proposed information collection on Tuesday. The agency said the new system would be based mainly on the volume of requests to ensure facilities receive a quick response. CMS will collect relevant information from healthcare providers and suppliers to decide whether to approve their waiver request. The new waiver request form was approved on an emergency basis Oct. 15. (Brady, 10/20)

Modern Healthcare: CMS Approves Nebraska's Medicaid Expansion Waiver
CMS will allow Nebraska to offer extra benefits to newly eligible Medicaid beneficiaries under the state's program expansion if they agree to follow work and wellness requirements, the agency said Tuesday. The "prime" tier will allow expansion enrollees to receive the same Medicaid benefits as Nebraska's traditional Medicaid population if they fulfill community engagement, personal responsibility and wellness activities. The "basic" package would cover basic health services and prescription drugs but drop coverage for dental, vision and over-the-counter drugs. (Brady, 10/20)

Atlanta Journal-Constitution: Even Some Doctors Won’t Wear Masks In A Pandemic, Patients Complain
In Georgia and across the country, patients have filed complaints with state licensing boards accusing doctors and their staffers of failing to wear face masks, making people with medical degrees an unlikely subgroup of Americans bucking the CDC’s safety recommendations. (Edwards, 10/20)

WBUR: Health Care Workers Ask Therapist: 'Why Aren't More People Taking This Seriously?'
New cases of coronavirus in the U.S. are climbing, and may hit peaks rivaling the summer surge. Cases are exploding in the upper Midwest and around the Great Lakes, with intensive care units approaching capacity and field hospitals being set up for overflow patients. Health care workers in the Midwest now face some of the same nightmarish scenarios that their colleagues in New York City saw this spring. (Shapiro and Pao, 10/20)

KHN: ‘All You Want Is To Be Believed’: The Impacts Of Unconscious Bias In Health Care 
In mid-March, Karla Monterroso flew home to Alameda, California, after a hiking trip in Utah’s Zion National Park. Four days later, she began to develop a bad, dry cough. Her lungs felt sticky. The fevers that persisted for the next nine weeks grew so high — 100.4, 101.2, 101.7, 102.3 — that, on the worst night, she was in the shower on all fours, ice-cold water running down her back, willing her temperature to go down. ... But what happened in the emergency room at Alameda Hospital only confirmed her worst fears. (Dembosky, 10/21)

The Wall Street Journal: Some California Hospitals Refused Covid-19 Transfers For Financial Reasons, State Emails Show 
Several large Southern California hospital systems improperly refused or delayed accepting Covid-19 patients based on their insurance status, according to internal emails among local and state government, hospital and emergency-response officials, leaving severely ill patients waiting for care and adding strain on hospitals overrun by the pandemic. Disaster-response experts said the refusals and delays exposed ways that some hospitals have put finances ahead of pandemic relief. Some instances might have violated a federal law that protects access to emergency care, while in other instances the actions ran counter to medical ethics, the experts said. (Evans, Berzon and Hernandez, 10/19)

Modern Healthcare: Health Systems Launch Treatment Programs For Patients Post-COVID
As patients recover from COVID-19, the medical community is discovering some patients continue to suffer from lingering symptoms and side effects weeks and even months after they test negative for the virus. Called COVID-19 long haulers, the conditions run the gamut from shortness of breath, dizziness, blood clots, fatigue, blurry vision, persistent headaches and even mental health challenges.In response, some health systems — particularly ones based in areas hard hit with coronavirus cases — are building programs specifically to help these patients. (Castellucci, 10/20)

Atlanta Journal-Constitution: Ex-VP At Gwinnett Health Care Company Sentenced To Federal Prison
A Duluth man was sentenced to one year and one day in federal prison after he was convicted of sabotaging his former employer and delaying shipments of medical supplies needed to combat the coronavirus pandemic. Christopher Dobbins, 41, pleaded guilty in July to reckless damage to a protected computer related to the hacking of electronic shipping records at Stradis Healthcare, a medical device packing company based in Gwinnett County. (Prince, 10/20)

North Carolina Health News: Union, Cabarrus Counties Cut Ties To Cardinal 
With little debate, members of the Union County board of commissioners voted unanimously Monday afternoon to disengage the county from their relationship with Cardinal Innovations, which has managed mental health services there for years. Several hours later, Cabarrus County commissioners followed suit, initiating the process of severing ties with the organization, which once built a multimillion dollar corporate headquarters there. (Hoban, 10/20)

Meanwhile, a firm has scored big for its work for states and insurers hurt by the federal government's actions --

Modern Healthcare: Investor Scores $100 Million Payout From Bet On Insurers' Lawsuits
A specialized investor that bet health insurers would prevail in a challenge over unpaid Affordable Care Act funds is now reaping rewards from its gamble. Last week, Chicago-based litigation finance firm Juris Capital collected $35.4 million in legal winnings from the Connecticut insurance department following the U.S. Supreme Court's ruling earlier this year that the federal government owed health insurers billions of dollars in outstanding payments under the now-concluded ACA risk-corridor program. (Livingston, 10/21)

Reuters: Abbott Raises Annual Profit View, Signals Recovery In Medical Device Sales
Abbott Laboratories raised its annual profit forecast on Wednesday and signaled a recovery in sales of its medical devices, while strong demand for its COVID-19 tests helped quarterly profit beat estimates, sending its shares up 1.5%. The company said the number of medical procedures in its cardiovascular and neuromodulation businesses improved significantly from the prior quarter as patients opted for surgeries that they had put off due to the pandemic. (10/21)

CNBC: ‘Long Covid’: These 5 Factors Make It More Likely You’ll Suffer Long-Term From Coronavirus
A new study has identified the main factors that make it more likely that patients will suffer long term from the coronavirus. “Long Covid” is the term given to people who had a confirmed (or suspected) coronavirus case and who recover from the initial infection but continue to suffer from a wide range of symptoms, from shortness of breath and migraines to chronic fatigue. ... The team found that older or overweight people, women, those with asthma and those with a greater number of different symptoms in the first week of their illness were more likely to develop “long Covid.” (Ellyatt, 10/21)

WBUR: Do Masks On Plane Flights Really Cut Your Risk Of Catching COVID-19? 
So the big question is this: How well do the masks work? Do they make it safe to fly across the country for a family visit?Scientists are just beginning to answer that question. And their findings offer a glimmer of hope as well as fresh ideas about what's most important for protecting yourself on a plane. (Doucleff, 10/20)

Stat: Covid-19’s Wintry Mix: Dry Indoor Air Helps The Virus Spread 
It’s not just the cold, it’s the humidity. Winter in the northern United States will soon drive even the most diehard outdoor diners and backyard socializers indoors, bringing with them heightened risk for contracting and spreading Covid-19. The worry is not just that people might mingle more closely inside, but that the air they breathe will make the virus more dangerous. Cold, dry air facilitates the spread of the coronavirus, and the social distancing that helped outside won’t be as effective indoors, scientists said. (Cooney, 10/21)

Modern Healthcare: COVID Adds To Surging Demand For Chicago Lab Space
Life sciences companies are looking for more than three times as much lab space in Chicago than they were at the beginning of last year as COVID-19 fuels demand for places to do biotech and pharmaceutical research, according to a new report. At the end of the second quarter, bioscience companies were seeking 658,000 square feet of lab space in the Chicago area, up from 175,000 square feet at the beginning of 2019, according to an analysis by real estate services firm CBRE. (Ecker, 10/20)

KHN: Bridging The Miles — And The Pandemic — Teledentistry Makes Some Dentists Wince 
Donella Pogue has trouble finding dentists in her rural area willing to accommodate her 21-year-old son, Justin, who is 6 feet, 8 inches tall, is on the autism spectrum and has difficulty sitting still when touched. And this summer, he had a cavity and his face swelled. Pogue, of Bristol, New York, reached out to the Eastman Institute for Oral Health in Rochester, which offers teledentistry. (Berger, 10/21)

USA Today: Pandemic Shows Importance Of Early Intervention Programs For Families
For once, being a biracial, low income, Medicaid patient didn't work against Selina Martinez. In 2015, two weeks after giving birth at a Manhattan hospital, Martinez arrived at Montefiore Medical Center in the Bronx where she was diagnosed with salmonella. During a monthlong stay, hospital staff members learned times were tough for the new mom. She'd been getting psychiatric care since the stillbirth of her last child, her husband was recovering at home from pancreatic cancer treatment and a neighbor was caring for her infant son, Blake.  (O'Donnell, 10/20)

CIDRAP: Experts: Don't Count On Mild Flu Season Amid COVID-19 
The Southern Hemisphere had a very light flu season in 2020, with Australia seeing only 315 cases over its winter, down 99.8% from the 130,000 cases seen in most years. But flu experts say that, while the low numbers could portend a similar scenario in the Northern Hemisphere, it would be a foolhardy not to prepare for high caseloads this winter. Edward Belongia, MD, an infectious disease epidemiologist at Marshfield Research Institute in Wisconsin, said that he doesn't think anyone can predict how severe the flu season will be or how it will co-circulate with COVID-19, because much is still unknown about the novel coronavirus and there is no clear relationship between events in the hemispheres. (Van Beusekom, 10/20)

CNN: Flu Shot Effectiveness: Get Good Sleep To Increase Its Power, Experts Say 
We all know how much better we feel after a good night's sleep. It turns out that sleep may be vital to arm us in the fight against influenza and Covid-19. Medical professionals are recommending that people make sure to get their flu shots this year, in part because some Covid-19 and flu symptoms are similar. A flu shot reduces the likelihood that your symptoms (if you get sick) are from the flu. (Lyons and Lamotte, 10/21)

WBUR: A Big Alzheimer's Drug Study Is Proceeding Cautiously Despite The Pandemic 
Medical research was an early casualty of the COVID-19 pandemic. After cases began emerging worldwide, thousands of clinical trials unrelated to COVID-19 were paused or canceled amid fears that participants would be infected. But now some researchers are finding ways to carry on in spite of the coronavirus. (Hamilton, 10/20)

WBUR: Ebola Never Went Away. But Now There's A Drug To Treat It
While scientists work to develop effective treatments for COVID-19, there is good news on another disease front. This month the U.S. Food and Drug Administration granted formal approval to an antibody cocktail from the pharmaceutical company Regeneron that's been shown to reduce an Ebola patient's chances of dying dramatically. (Beaubien, 10/20)

In cancer news —

Cincinnati Enquirer: Double-Digit Drops In Mammography Worry Experts About Deaths To Come
Though more women are getting back on their mammogram schedules through the pandemic, alarmed cancer experts said Ohio and the nation now are caught in an unprecedented experiment with dangerous consequences. The pandemic has nearly undone decades of effort – pink-ribbon 5K runs to raise research money, awareness campaigns anchored in October since 1985, ultimately better insurance coverage of mammography – to persuade women not to forget about the one tool that finds breast tumors early, when they are most treatable and survivable. (Saker, 10/19)

Carroll County Times: With Cancer Screenings Dropping During Pandemic, Carroll County Medical Professionals Urging Patients To Reschedule 
Because of the coronavirus pandemic, cancer screenings were shut down from March 24 until May 7, under Gov. Larry Hogan’s executive order. Many patients during that time had appointments canceled and still haven’t rescheduled, leading to a decline in the number of screenings. Since March, Americans and health centers have been urged to delay routine cancer screenings to avoid potential exposure to COVID-19 and mitigate the spread. As a result, screenings for breast, cervical and colon cancer are down between 86% and 94%. (Conaway, 10/21)

The Baltimore Sun: Patient, Nutritionist Agree: Healthy Eating, Balanced Diet Important During Cancer Treatments 
Eating healthy — and constantly — can help people going through cancer treatments, a Carroll Hospital oncologist nutritionist says. Rhonda Andrews was diagnosed with breast cancer on March 19. She has been through 16 weeks of chemotherapy. She will need to have a mastectomy and five weeks of radiation. “The support of my family and friends have been helping me get through this,” Andrews said. (Conaway, 10/21)

The Washington Post: Rush Limbaugh Says His Lung Cancer Is Terminal 
Conservative talk radio giant Rush Limbaugh told his listeners Monday that the advanced lung cancer he announced this year is terminal. Limbaugh, whose program is nationally syndicated, said he received lung scans last week that showed “some progression of the cancer” after it was previously reduced to a manageable level. He described his illness as a roller coaster with many ups and downs. (Iati, 10/20)

On surging cases and hospital capacity —

Dallas Morning News: Dallas Is On Its Way To A Second, ‘Worse’ Spike In COVID-19 Cases, Says Parkland CEO
At the peak of Dallas County’s summer coronavirus wave, Parkland Memorial Hospital had a special COVID-19 unit known as the “red box” and 300 staffers to help people fight the disease at the center of a pandemic. By early September, the public hospital tasked with caring for the county’s poorest residents closed that area as cases trended down. But now, the hospital’s top doctor is warning that a nascent wave of COVID-19 could turn into something much worse. (Garcia, 10/20)

The Oklahoman: Officials Say Beds Still Available As COVID Hospitalizations Rise To Record Highs
As the number of people hospitalized due to complications of COVID-19 hit an all-time high Monday, state officials were quick to reassure Oklahomans that hospitals still have capacity. In a news conference Tuesday, officials also outlined a new, four-tiered hospital surge plan that they say will be complete in the coming days. Figures provided in conjunction with the surge plan also offered the first glimpse at just how many COVID-19 patients Oklahoma’s hospitals can handle. (Forman, 10/21)

Bloomberg: Covid Pandemic: Southwest Detroit Faces Pollution, Covid-19 Outbreaks
Generations of activists in Southwest Detroit say they’re tired of living under a cloud. They’ve demonstrated, filed petitions, shown up at public hearings, and watched as industry won regulatory victory after regulatory victory. This summer, as the Black Lives Matter protests raged, residents of an overwhelmingly minority Detroit-area neighborhood filed a civil-rights complaint related to the approval of a hazardous-waste storage facility’s ninefold expansion, arguing that pollution is a form of racism, too. (Koons and Ivry, 10/21)

AP: DC Debuts Smartphone-Based COVID-19 Exposure Alert System
The nation’s capital has become one of the first jurisdictions in the country to employ a new COVID-19 notification system, a joint Google-Apple venture that delivers alerts to people’s phones, notifying them that they may have been exposed to the coronavirus. Mayor Muriel Bowser on Tuesday urged all residents with Apple or Android smartphones to opt in to the new DC COVID Alert Notice system, or DC CAN. Bowser called it “a quick and easy way to know if you might have been exposed to COVID-19. Opting in is one more way you can protect yourself, your friends and family, and our entire community.” (Khalil, 10/20)

AP: Tennessee Launches New Website For COVID-19 Info
The Tennessee Department of Health has launched a new website to keep the public up to speed on the COVID-19 pandemic. The department says COVID19.tn.gov is designed to simplify some of the most frequently requested coronavirus data for desktop and mobile users. (10/21)

On state's vaccine distribution planning —

Detroit Free Press: Health Care Workers Will Get First COVID-19 Vaccine Doses In Michigan
Health care workers will be the first people in Michigan to get a coronavirus vaccine, according to an interim priority plan state health officials released Tuesday evening for when a COVID-19 vaccine is green-lighted in the U.S.  After that, local health departments will distribute the vaccine in their communities, prioritizing the people most vulnerable to severe complications of COVID-19, according to a Michigan Department of Health and Human Services COVID-19 Vaccination Plan. (Shamus, 10/20)

The Washington Post: Maryland Coronavirus Plan Says 14 Percent Of Residents Eligible For Early Vaccine When Available 
Fourteen percent of Maryland residents will be eligible for a coronavirus vaccine when one is available, according to a draft of the state’s vaccine distribution plan that was made public Tuesday. The plan was due to the Centers for Disease Control and Prevention last week, part of a requirement that all states followed to give the federal government a glimpse of how officials would distribute a vaccine when one becomes available. (Fadulu, 10/20)

The Baltimore Sun: Maryland Plans 2-Phase Distribution Plan For Coronavirus Vaccine Once It’s Available 
Even though no coronavirus vaccine has been approved by regulators and widespread availability is likely months away, health officials are planning for how to vaccinate Marylanders. In a draft plan submitted to the federal government, Maryland health officials envision a two-phase program that would first vaccinate health care workers and some of the most vulnerable state residents, and eventually turn to the general population once a vaccine becomes widely available. (Wood and Miller, 10/20)

Cincinnati Enquirer: COVID-19 Vaccine Progress: Who Will Be First In Ohio To Get COVID-19 Vaccine?
A COVID-19 vaccine is likely months away for most Ohioans, but Ohio officials have already submitted a plan for how to distribute it. Ohio will prioritize high-risk healthcare workers, first responders and elderly and at-risk Ohioans in nursing homes and other congregate care settings in the first phase of distribution, according to a plan submitted to the U.S. Centers for Disease Control and Prevention. The Enquirer obtained the draft through a public records request.  (Borchardt, 10/20)

In state prison news —

San Francisco Chronicle: San Quentin Must Release Or Transfer Half Its Prisoners Because Of Lack Of COVID Care, Court Rules
Finding that state officials have acted with “deliberate indifference” to the health of prisoners at San Quentin — where 75% of them have tested positive for the coronavirus and 28 have died — a state appeals court took the unprecedented step Tuesday of ordering at least half of the prison’s 2,900 inmates transferred or released. (Egelko, 10/20)

North Carolina Health News: Prison Deaths Continue As COVID Stabilizes 
The last photo Jennifer Wren has of her father shows him lying in a cardboard box, waiting for the crematorium. They’d spoken just two weeks before. Another month was passing quickly, and her father Roy Hood, an inmate at Greene Correctional Institution, answered what had become weekly questions about his persistent cough. (Critchfield, 10/21)

And more on COVID-19 in the states —

Modern Healthcare: COVID Adds To Surging Demand For Chicago Lab Space
Life sciences companies are looking for more than three times as much lab space in Chicago than they were at the beginning of last year as COVID-19 fuels demand for places to do biotech and pharmaceutical research, according to a new report. At the end of the second quarter, bioscience companies were seeking 658,000 square feet of lab space in the Chicago area, up from 175,000 square feet at the beginning of 2019, according to an analysis by real estate services firm CBRE. (Ecker, 10/20)

The Salt Lake Tribune: Utah Lawmakers Continue To Debate Governor’s Emergency Powers As Coronavirus Wears On
As they continue to face pressure from constituents who want them to end the COVID-19 state of emergency, Utah’s lawmakers met again Tuesday to discuss ways to rein in the executive branch’s powers but indicated there’s still a lack of consensus on how to move forward. Sen. Jake Anderegg, R-Lehi, said he and other lawmakers are working to find compromise on the issue among the House and Senate as well as the governor’s office and state and local health departments. But without language drafted, he said any changes to the state’s Emergency Management Act likely won’t come until next year’s general legislative session. (Stevens, 10/20)

Atlanta Journal-Constitution: Top U.S. Health Official To Tour Atlanta Hospitals, Tout Coronavirus Response
Health and Human Services Secretary Alex Azar is headed to Atlanta on Wednesday to tour local hospitals and meet with experts at the Centers for Disease Control and Prevention to highlight the Trump administration’s response to a still-raging pandemic that’s killed more than 7,000 Georgians. Azar will visit Grady Memorial Hospital, the state’s largest safety-net healthcare facility, to discuss how the team is grappling with the COVID-19 pandemic and then to Emory University Hospital to discuss new treatments for the virus. He’s also set to meet with emergency operations staff at the CDC and hold a press conference with local health officials. (Bluestein, 10/20)

Los Angeles Times: Disneyland, California Theme Parks Get Path To Reopening 
It might be many months before major parks are allowed to welcome guests again. Based on an Orange County official’s projections, Disneyland probably won’t open before summer — news that incensed park executives and local officials. The protocols announced Tuesday require large parks to wait longer than smaller ones. A large park, defined as one with a capacity of more than 15,000 visitors, can reopen once coronavirus transmission in its home county has fallen enough for the county to reach Tier 4 — the state’s least-restrictive designation. A small park, meanwhile, can welcome guests once its home county reaches Tier 3, the second-least-restrictive level. (Martin, 10/20)

Boston Globe: Officials Prevented Large Outdoor Gathering In Revere; Baker Says Such Meetings Threaten Everyone’s Health 
Tipped off by social media postings, state and Revere officials said Tuesday they prevented a large outdoor gathering planned for Oct. 10 in a city now facing its highest positive testing results since May, especially among younger people. Health and Human Services Secretary Mary Lou Sudders and Revere Mayor Brian J. Arrigo joined Governor Charlie Baker at a new testing site set up on the grounds of Suffolk Downs in Revere, a city that was one of the first hot spots when the coronavirus pandemic reached Massachusetts. (Ellement and Andersen, 10/20)

AP: Man Gets Prison For Sabotage That Caused PPE Delivery Delay
A former vice president of a medical device packaging company has been sentenced to a year in federal prison for sabotaging his former employer’s electronic shipping records, which prosecutors said delayed the delivery of personal protective equipment to health care providers. Christopher Dobbins, 41, received his last paycheck from Stradis Healthcare on March 26, and three days later used a fake user account he had created while working there to access the company’s computer systems, prosecutors in Atlanta said. He then created a second fake user account and used that to edit 115,581 records and delete 2,371 records before deactivating both fake accounts and logging out, prosecutors said. (10/20)

CNN: University Of Michigan Students Given Immediate Stay-At-Home Order Amid A Spike In Covid-19 Cases 
All University of Michigan undergraduate students are now under an emergency stay-in-place order, after data shows that Covid-19 cases among Michigan students represents more than 60% of all local cases. The order came from the Washtenaw County Health Department on Tuesday, and is set to continue until November 3. (Asmelash, 10/20)

Detroit News: UM Under Stay-Home Order Attributes Spike To Social Gatherings
Washtenaw County is experiencing a rapidly growing number of COVID-19 cases, and leaders at the University of Michigan warned many of them can be traced back to maskless social gatherings around the Ann Arbor campus. In response to the surge of cases in the county, the Washtenaw County Health Department on Tuesday issued a two-week, stay-at-home emergency order. The edict is immediate and runs through 7 a.m. Nov. 3. (Kozlowski, 10/20)

The New York Times: College Students Are Missing From Campus. Will Their Missing Votes Make A Difference? 
The air still became crisper, and the leaves still changed from green to gold. But many college towns looked a lot different this fall, their campuses quiet as universities adopted online instruction to help stop the spread of the coronavirus. With that change came a new political wrinkle: Some House candidates, typically Democrats, can usually count on support from students living on college campuses in their districts — but many of those students are now living back home, tied to their computers for classes. (Gray, 10/20)

FOX 5 Atlanta: Fulton County High School Temporarily Stops In-Person Classes After COVID-19 Cases
A week after Fulton County Schools gave students and parents the option to return to in-person learning, the school district has shut down a second high school due to COVID-19 concerns. Officials announced on Facebook that Cambridge High School will switch to virtual learning for the next few days to address an increase in COVID-19 cases. (10/20)

AP: California School Fined For Violating Court COVID-19 Order
A California private school has been ordered to pay $15,000 for defying a judge’s order to close classrooms and stop in-person teaching, in what may be the first judgment of its kind against a California school for violating health orders aimed at slowing the spread of coronavirus. Tuesday’s decision in the Fresno County Superior Court ends a nearly three-month legal battle between Immanuel Schools, a private K-12 Christian school in California’s Central Valley, and county and state officials. (Gecker, 10/21)

New Orleans Times-Picayune: What Contributes To Louisiana's High Maternal Mortality Rate? The Distance To Care, Research Says 
Louisiana has among the highest rate of death for pregnant women in the U.S. One of the reasons, according to new research, is the lack of maternal care in many areas of the state, which forces women to travel long distances for routine checkups, emergency visits and deliveries. (Woodruff, 10/20)

Charlotte Observer: How Hurricanes, Climate Change Affect Asthma Patients In NC
Pamlico County, wedged between its namesake sound and the mouth of the Neuse River, is surrounded by water on three sides and is a target for hurricanes that sweep up the North Carolina coast. In 2011, Hurricane Irene made landfall near Cape Lookout and dropped more than 17 inches of rain over part of Pamlico County. Flood waters inundated Pamlico County homes, including those in Vantisha Williams’ old neighborhood. When the floodwaters receded, mold growth followed. And that, Williams believes, triggered her daughter Nazri’s asthma. Nazri was then 3 years old. (Bonner, 10/20)

The Baltimore Sun: Complaint Alleges Maryland Agency Has Failed To Protect Workers During Coronavirus Pandemic 
Attorneys with a Baltimore public-interest law center allege that Maryland’s occupational safety program has failed to properly investigate workplace hazards, leaving workers in danger during the coronavirus pandemic. The Public Justice Center filed a complaint with the federal agency charged with protecting workers, seeking a “full investigation” on its claims that Maryland Occupational Safety and Health has not followed its own procedures on when to conduct workplace inspections. (Knezevich, 10/21)

San Francisco Chronicle: S.F.’s Homeless, Mentally Ill And Drug Addicted Are Struggling More Than Ever. When Will Help Arrive?
San Francisco has made “significant progress” in helping those struggling with mental illness and drug use since the city began an effort last year to fix the system that serves them, the Department of Public Health said Monday .But that doesn’t exactly match the reality on the streets. Those with extreme mental illness are still cycling from the hospital to the sidewalk. More people are dying of overdoses than ever — and more are being saved from them — as the powerful opioid fentanyl continues to devastate the city. Meanwhile, case managers and social workers say the pandemic has made it even harder for the city’s most vulnerable to get the help they need. (Thadani, 10/20)

San Francisco Chronicle: Oakland Restricts Locations Where Homeless Encampments Can Set Up 
The Oakland City Council unanimously approved a controversial policy Tuesday that restricts homeless people living in encampments from sleeping in parks and near homes, businesses and schools but allows them to set up camp elsewhere. Under the policy, city staff will not cite or arrest anyone for camping and will instead help with making sure people follow the rules. (Ravani, 10/20)

Boston Globe: 9-8-8 Suicide Prevention Hot Line Bill Signed Into Law 
Local and national suicide prevention advocates are praising a new federal law that designates 9-8-8 the national phone number for mental health emergencies, saying it will provide a critical resource that could help save lives. The National Suicide Hotline Designation Act, introduced by Representative Seth Moulton, a Salem Democrat, calls for the three-digit number to be implemented nationwide by July 2022. (Sweeney and Fox, 10/20)

Atlanta Journal-Constitution: High-Dose Flu Vaccine In Limited Supply In Georgia
Some health care providers across Georgia and the rest of the country already are running low on the high-dose flu vaccine recommended for older Americans as many in the public heed warnings about the dangers of contracting the flu and COVID-19 at the same time. Public health officials have said it’s more important than ever to get the flu shot this year, with the pandemic still raging, because contracting both viruses could pose a grave risk to a person’s health. Also, officials worry that a “twindemc” could overwhelm the health care system. (Oliviero, 10/2)

NPR: Trump Vs. Biden On Health Care, Prescription Drugs, Medicare 
Biden's proposal would work to lower prescription drug prices within Medicare, create an independent commission to oversee and regulate the price of new drugs, and get rid of the tax breaks given to pharmaceutical corporations on advertising. ... Trump has attempted to usher through prescription drug reforms via a series of executive orders signed in July and September, though the timeline for seeing these policies implemented remains uncertain. A notable order would lower drug prices for those on Medicare parts B and D to comparable costs seen internationally. (Moore, 10/16)

Forbes: 7 Ways To Save On Medications In The Pandemic
Millions of Americans are struggling to afford their medications during Covid-19, including some with health insurance, the nearly 27 million who lost coverage due to a job loss and those who never had it. But there are quite a few ways to lower your prescription drug costs in the pandemic. The sticker shock is real. In July, according to the GoodRx site, 67 prescription drug prices rose an average of 3.1%; prices for 857 brand-name and generic drugs increased by an average of 6.8% from January 1 to June 30, 2020. Refills for common medications such as insulin for diabetes and Nexium for heartburn can cost around $300. (Flynn Jay, 10/18)

Healthline: Dissecting Insulin Price Policy And Misinformation
Insulin prices continue to dominate the national discussion and remain a divisive topic in the midst of the political debate over drug pricing policy reform. The common understanding is that U.S. insulin prices have been jacked up to an unconscionable level and that needs to change, but the details on how to address this problem are anything but clear. (Hoskins, 10/19)

PolitiFact: Arizona House Race Attack Ad Zeroes In On Prescription Drug Prices
Handicappers rate the House race in Arizona’s 6th Congressional District as a toss-up, with the edge going to the Republican incumbent, David Schweikert. The high cost of prescription drugs resonates in retiree-heavy Arizona and a major union backing Democrat Hiral Tipirneni in the race has taken Schweikert to task for his voting record on the issue. (Greenberg, 10/19)

And news about Medicare prices —

(Park Hills, Mo.) Daily Journal: 4 Smart Ways Medicare Beneficiaries Are Cutting Prescription Costs 
Medicare open enrollment started October 15 and will run through December 7. For many retirees, shopping for coverage during open enrollment is the best chance to keep medical costs down by choosing an insurance plan well-suited to their needs. But while choosing the right Medicare policy is essential, many seniors will still face at least some out-of-pocket expenses for prescriptions, regardless of what plan they have. (Bieber, 10/20)

Forbes: If You’re A Diabetic Medicare Beneficiary, Here’s What You Should Know About $35 Insulin
On March 11, the Centers for Medicare and Medicaid Services (CMS) announced the Part D Senior Savings Model. Plans that provide Part D prescription drug coverage can choose to offer insulin for a maximum copayment of no more than $35. In 2020, a monthly copayment for insulin can range from $2 to $200 or more, depending on the medication, plan and place of residence. According to the CMS announcement, the Senior Savings Model could save beneficiaries who take insulin about $466 a year.  The opportunity to get insulin for $35 a month is a very good deal. However, this isn’t automatic and some diabetic beneficiaries may be left out in the cold. (Omdahl, 10/20)

The Detroit News: Trump Offers False Hope With Canadian Drug Plan
On September 24, the Trump administration finalized its plan to allow for the importation of prescription drugs from foreign markets. Under the plan, states could develop proposals for federal government approval to facilitate the importation of certain drugs from Canada. The Trump administration plan is politically motivated and provides a false hope to voters that the plan would lead to lower drug costs and that the drugs would be safe. (Kent Kaiser, 10/15)

Pittsburgh Post-Gazette: No, Canada, The Difficulty Of Importing Canadian Drug Prices To Pa.
For some in U.S. and Pennsylvania politics, “O Canada” is an anthem of health care policy. Many Canadian prescription drug prices are lower than America’s, and the idea of bringing those lower prices across the 49th parallel — or simply across Lake Erie — appeals to many lawmakers. It may work in Pennsylvania, but not for long. (Robert Graboyes, 10/20)

Center For American Progress: Too Little, Too Late: Trump’s Prescription Drug Executive Order Does Not Help Patients 
On September 13, President Donald Trump issued his “Lowering Drug Prices by Putting America First” executive order, his most recent attempt at tricking the public into believing that his administration will make meaningful changes to prescription drug prices. As usual, the president tried to circumvent Congress and give the appearance of making significant changes through a rushed and lackluster executive order. This column provides an overview of the Trump administration’s attempts to use executive authority to appear to take action on lowering drug prices and explains how this most recent order is nothing but another example of bluster on prescription drug prices without delivering for the American people. (Thomas Waldrop and Nicole Rapfogel, 10/15)

Greenfield (Mass.) Recorder: President Plays “Trump Card” With Seniors
On Sept. 24, Donald Trump held a press conference in Charlotte, N.C. to present the media with his new America First Health Care Plan. Trump signed an executive order outlining the three pillars of his plan — including a plan to lower the price of prescription drugs — a promise he made as a candidate four years ago. Under Trump’s drug plan, “we will pay the exact same price as other countries … we will be matching the lowest price with what’s now many times the highest price, and we won’t pay a penny more.…This will lead to a very large savings for American families and plummeting drug prices.” (Al Norman, 10/16)

The Wall Street Journal: End The School Shutdown
Tens of millions of students started the school year completely online, including those in 13 of the 15 largest school districts in the U.S. The primary reason is concern over safety for students and staff. But recent data are shifting the discussion on school safety and infection rates of Covid-19. They argue strongly for opening K-12 schools. Previous evidence has suggested that schools are not superspreaders. That research came from other countries (whose rates and environments are different) or very specific cases in America, such as YMCA summer camps. While this suggested little impact on infection rates from opening the schools, it was possible that the unique environment of U.S. public schools would cause different outcomes. (David R. Henderson and Ryan Sullivan, 10/20)

Bloomberg: Covid-19 Is More Serious For The Elderly. So What?
Advocates of “herd immunity” strategies often claim that Covid-19 is relatively safe for the young and that most of the victims are old. This observation is correct, but the question is what to make of it. Often the implication — stated or not — is that the response to the pandemic need not be so vigorous because the loss of life, as measured in years, is less than it appears.It is an uncomfortable but necessary discussion, they say. So be it — but once the conversation turns to which deaths matter the most, other questions about Covid-19 start to arise, almost all of which push in the direction of a very vigorous response. When either foreign enemies or pathogens attack U.S. lives on a noticeable scale, the pushback needs to be very hard indeed. (Tyler Cowan, 10/20)

The Washington Post: Fauci’s Refusal To Quit Shouldn’t Surprise Anyone 
Forget asking why Anthony S. Fauci hasn’t been fired. Why hasn’t he quit? President Trump has called his top infectious-disease expert a “disaster,” just sentences after implying he is also an “idiot.” He has trashed the doctor’s decisions on a campaign call, not long after twisting Fauci’s words into praise in an advertisement. And on top of all that, he has smeared the man responsible for shepherding the country toward a vaccine with this supposedly grievous insult: “Tony threw out perhaps the worst first pitch in the history of Baseball!” (Molly Roberts, 10/20)

Boston Globe: This Year, Voting Like Your Life Depends On It Rings True
Every four years, partisans on both sides of the political fence ramp up their rhetoric and remind their supporters, “Vote like your life depends on it.” This year those words are literally true.More than 220,000 Americans have died from COVID-19, and cases are surging again. But the Trump administration has walked off the field indifferent to the fact that hundreds of Americans are dying every day from COVID-19 — and that tens of thousands more will probably lose their lives in the weeks and months to come. The numbers are terrifying. (Michael A. Cohen, 10/21)

Axios: Biden Leads Trump On Coronavirus Response, Protecting Pre-Existing Conditions
Health care has fragmented into multiple issues in this campaign cycle, and Joe Biden leads President Trump on almost all of them, according to our KFF polling.The big picture: Biden’s commanding leads on protecting people with pre-existing conditions and managing the coronavirus outbreak suggest that Trump’s record and rhetoric on those issues, while popular with his base, may have backfired with the electorate generally. (Drew Altman, 10/21)

New York Post: Biden Has Absolutely Nothing To Add When It Comes To Fighting COVID-19
During his town hall last week, Joe Biden made a startling admission: “You can’t mandate a mask.” This was puzzling, because he had spent August badgering President Trump to implement a national mask mandate.The confusion is of a piece with the ex-veep’s wider struggle to explain what, exactly, he would have done differently in response to the pandemic were he the one in power. (Karol Markowicz, 10/19)

The New York Times: She’s Evangelical, ‘Pro-Life’ And Voting For Biden 
A granddaughter of the Rev. Billy Graham, Jerushah Duford is a committed evangelical Christian who describes herself as “pro-life.” For most of her life, she voted Republican. Yet this year, she is voting for Joe Biden and is encouraging fellow Christians to distance themselves from a president who she says is trying “to hijack our faith for votes.”“The Jesus we serve promotes kindness, dignity, humility, and this president doesn’t represent our faith,” Duford said. (Nicholas Kristof, 10/21)

The New York Times: To Stop A Winter Coronavirus Surge, Pay Restaurants And Bars To Close 
If we really want to stem the spread of the coronavirus as winter looms and we wait for a vaccine, here’s an idea: The government should pay bars, many restaurants and event venues to close for some months. That may sound radical, but it makes scientific sense and even has a political precedent. We pay farmers not to cultivate some fields (in theory, at least, to protect the environment), so why not pay bars that cannot operate safely to shut down (to protect public health)? (Elisabeth Rosenthal, 10/21)

Stat: Children And Families Need Resources To Address Trauma At Its Roots 
Like many nations across the globe, the U.S. continues to combat the devastation of the coronavirus pandemic. The Trump administration’s deficient response has elevated the emotional, physical, and economic harm suffered by families in America. As we move through this moment of collective trauma, we must adopt focused, evidence-based approaches to make our country whole again and ensure that these approaches prioritize a precious responsibility — our children’s future. (Ayanna Pressley and Carolyn B. Maloney, 10/21)

The Wall Street Journal: ‘White Market Drugs’ Review: Addiction By Prescription
More than a century ago, the nation had its first opioid crisis. Narcotic-laced patent medicines, morphine powder and opium tinctures formed the core of a physician’s pharmacopeia. Such medicines relieved the chronic wounds of Civil War veterans and treated a wide spectrum of ailments, including neuralgia, “female complaints,” respiratory disorders and anxiety. Patients who became addicted at the hands of doctors were generally seen as innocent victims. Think of Mary Tyrone in Eugene O’Neill’s “Long Day’s Journey Into Night.” But those who developed an opium habit outside a doctor’s care, presumed to be seeking mere pleasure, were condemned by moral crusaders. By the Progressive Era, drugs and their users were firmly divided between licit and illicit. The distinction guides drug policy to this day. (Sally Satel, 10/20)

Dallas Morning News: Another Alleged Domestic Killer In Dallas County Got Out On Low Bond. How Can We Stop This?
A system that is not structured to keep a person like Ford away from his victim and out of society while he awaits trial is broken. The law is clear on that bail should be fixed at an amount that protects “the future safety of the victim of the alleged offense and the community.” That did not happen here, and why it did not happen is baffling. We have said before and will continue to say that bail reform is needed. Nonviolent defendants should not be held simply because they cannot pay. (10/21)