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The director of the Centers for Disease Control and Prevention on Friday overruled a recommendation by an agency advisory panel that had refused to endorse booster shots of the Pfizer-BioNTech Covid vaccine for frontline workers. It was a highly unusual move for the director, Dr. Rochelle Walensky, but aligned C.D.C. policy with the Food and Drug Administration’s endorsements over her own agency’s advisers. The C.D.C.’s Advisory Committee on Immunization Practices on Thursday recommended the boosters for a wide range of Americans, including tens of millions of older adults, and younger people at high risk for the disease. But they excluded health care workers, teachers and others whose jobs put them at risk. That put their recommendations at odds with the F.D.A.’s authorization of booster shots for all adults with a high occupational risk. (Mandavilli and Mueller, 9/24)

The recommendations of the panel are not binding, but it is rare for a director to overrule the committee. Walensky endorsed the other recommendations of the Advisory Committee on Immunization Practices, making them official and paving the way for tens of millions of adults to get a third Pfizer shot six months after completing the original two-shot regimen. With the CDC approval, the shots are expected to be available immediately at locations where the Pfizer vaccine is already being administered, including pharmacies, health departments, clinics and some doctor’s offices. (Sun and McGinley, 9/24)

CDC Director Rochelle Walensky said her agency had to make recommendations based on complex, often imperfect data. "In a pandemic, even with uncertainty, we must take actions that we anticipate will do the greatest good," she said in a statement. ... The CDC recommendation follows U.S. Food and Drug Administration authorization and clears the way for a booster rollout to begin as soon as this week for millions of people who had their second dose of the Pfizer shot at least six months ago. (Erman and Maddipatla, 9/24)

The boosters should be given to people who got the vaccine from Pfizer and partner BioNTech SE at least six months after their second dose. The committee didn’t vote on mixing and matching vaccines. Those who qualify for boosters will have to attest to their eligibility but won’t have to provide additional documentation, CDC officials said. (Schwartz, 9/23)

Following days of lengthy debate among vaccine experts, booster shots of the Pfizer/BioNTech Covid-19 vaccine can now be officially administered to some adults in the United States. Early Friday morning, US Centers for Disease Control and Prevention Director Dr. Rochelle Walensky diverged from the agency's independent vaccine advisers to recommend boosters for a broader group of people -- those ages 18 to 64 who are at increased risk of Covid-19 because of their workplaces or institutional settings -- in addition to older adults, long-term care facility residents and some people with underlying health conditions. (Gumbrecht, 9/24)

An estimated 270,000 Connecticut residents who are 65 years and older and who originally received Pfizer’s COVID-19 vaccine, including nursing home residents, can begin getting their third booster shot as soon as Friday, Gov. Ned Lamont’s administration said Thursday. Residents ages 50 to 64 with risky underlying health conditions and who received the Pfizer vaccine will also be allowed to obtain a third dose at more than 800 locations across the state. They can be found online. (Haigh, 9/23)

California is preparing to administer third “booster” vaccine shots against COVID-19 for older people and immunocompromised adults as well as initial shots for students under 12 once the federal government approves them for children. On Thursday, state officials released a vaccine action plan. It still depends on direction that is expected to come from the U.S. Centers for Disease Control and Prevention. (9/23)

Education Secretary Miguel Cardona on Thursday declared his support for mandatory Covid-19 vaccinations for eligible schoolchildren, saying the FDA’s full approval of jabs for certain adolescents should clear the way for state officials to implement plans to begin vaccinations. “Not only do I support it, but I’m encouraging states to come up with a plan to make sure it happens,” Cardona told POLITICO between stops on a multistate tour of schools and child care facilities. “I would like governors who hold those decisions to make those decisions now that [vaccines] are FDA-approved.” (Perez Jr., 9/23)

Cardona pointed to the effectiveness of the measles vaccine — which is required for children in childcare or public schools in all 50 states and Washington, D.C. — in protecting against infections as reason why the coronavirus vaccine should be mandatory for schoolchildren. “There’s a reason why we’re not talking about measles today,” Cardona added. “It was a required vaccination, and we put it behind us. So I do believe at this point we need to be moving forward.” (Schnell, 9/23)

A Florida school district has received cash from President Joe Biden’s administration to make up for state pay cuts imposed over a board’s vote for a student anti-coronavirus mask mandate. Alachua County school Superintendent Carlee Simon said in a news release Thursday the district has received $148,000 through a U.S. Department of Education program. (9/23)

The U.S. Department of Education on Thursday repaid several Florida school board members who saw their salary slashed by the DeSantis administration for requiring students to wear masks this fall. In total, the Biden administration sent school officials in Alachua County $147,719 to make up for fines from the Florida Department of Education, marking the first awards granted by the feds in the fight against Republican-led states and their Covid-19 policies. Alachua is one of 11 school districts in Florida to mandate masks for students in defiance of Gov. Ron DeSantis, who wants parents to have the ultimate say on face coverings in schools. (Atterbury, 9/23)

Indiana State University will require that all students and staff show proof of vaccination by Jan. 1 or be tested each week for COVID-19, the school’s president said Thursday. The announcement by Deborah Curtis is a shift in policy. The university has been encouraging vaccinations this fall but has not made them mandatory. Masks are required indoors. (9/24)

Weekly COVID-19 testing of asymptomatic students and staff at three K-12 public schools in Omaha, Nebraska, roughly doubled the detection rate of symptom-based testing and exceeded that of the rest of the local county, according to a study yesterday in JAMA Network Open. ... At that time, all district schools offered hybrid instruction, alternating cohorts for distance and in-person instruction; 50% to 60% of students chose in-person learning. Routine staff COVID-19 testing was mandatory, while it was optional for students. (Van Beusekom, 9/23)

On a recent day at West Towson Elementary School, there was one student with COVID symptoms waiting to be tested. Two more students were coming from the gym with shortness of breath and needed their asthma inhalers. A diabetic child had dropping blood sugar. “Those were just the urgent needs at that moment,” said Lisa Vanderwal, the school’s veteran nurse who says the coronavirus pandemic is causing her to make unprecedented choices about who gets priority among the hundreds of students in her care. “I’ve had days where I don’t know if I can keep doing it.” (Cohn, 9/24)

KHN: Mounting Covid Deaths Fuel School Bus Drivers’ Fears 

Natalia D’Angelo got sick right after school started in August. She was driving a school bus for special education students in Griffin-Spalding County School System about 40 miles south of Atlanta and contracted covid-19. One of her three sons, Julian Rodriguez-D’Angelo, said his mother, who was not vaccinated against the covid virus, had a history of health problems, including Graves’ disease and cancer. (Miller and Galewitz, 9/24)

Ohioans ages 12-25 who receive the coronavirus vaccine can enter a new lottery making them eligible for five $100,000 college scholarships and 50 $10,000 scholarships, Gov. Mike DeWine announced Thursday in his latest effort to boost number of people vaccinated against COVID-19. Details of the new Ohio Vax-to-College program will be announced soon, and is aimed at the group of Ohioans with the most room to grow in terms of receiving the vaccination, the Republican governor said. (Welsh-Huggins, 9/23)

There remain 18 states that have yet to fully vaccinate at least half of all residents, data shows: Alabama, Alaska, Arkansas, Georgia, Idaho, Indiana, Louisiana, Mississippi, Missouri, Montana, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, Tennessee, West Virginia, and Wyoming. The state with the highest rate of vaccination is Vermont at 69% of all residents, followed by Connecticut, Rhode Island, Massachusetts and New Jersey. (Caldwell, 9/24)

Yolanda Orosco-Arellano decided she would get the coronavirus vaccine long before it became available. But securing an appointment for it was less straightforward. The hotel housekeeper and mother of four worried about her anemia, a risk factor for severe illness from the virus. But Orosco-Arellano doesn’t have a car and needed a vaccination slot scheduled around her shifts at the hotel. Barriers to getting the shot and information about the vaccines have hindered the “unvaccinated but willing,” who account for approximately 10 percent of the American population, according to a report last month by the Department of Health and Human Services. (Kornfield, 9/23)

Vaccinated Americans are more worried about contracting a COVID infection than unvaccinated Americans, according to new Harris polling that was conducted in consultation with the CDC and provided exclusively to Axios. The science says that the unvaccinated have much more to fear, and are largely driving the current surge of hospitalizations and deaths. (Owens, 9/24)

As the Biden administration urges workers across the U.S. to get their shots against COVID-19, many Americans are asking their employers to exempt them from vaccination requirements on medical grounds. ... Although an individual may be allergic to a given ingredient in one vaccine that is not present in another, allergies to vaccine components are extremely uncommon, according to disease experts. "The only real exemption I can imagine is severe allergic reaction mainly in the Pfizer and Moderna mRNA vaccines, but they are very, very rare — like one in a million," Dr. Peter Chin-Hong, an infectious disease physician at the University of California San Francisco, told CBS MoneyWatch. "Someone would have to argue that they had a severe allergic reaction to a previous dose of the vaccine or to a vaccine component — not just a rash or some muscle soreness, but having difficulty breathing, swelling in their throat or something of that nature," said Dr. David Dowdy, an infectious disease epidemiologist at Johns Hopkins University School of Medicine. (Cerullo, 9/23)

Moderna’s chief executive says that the coronavirus pandemic could be over in a year and that a boost in production will mean enough vaccines for “everyone on this Earth” by then. More booster shots should be available, too, to some extent, and even babies will be able to get vaccines, Stéphane Bancel told a Swiss newspaper in an interview published Thursday. Asked whether that could spell “a return to normal” next year, he replied: “As of today, in a year, I assume.” (Francis, 9/23)

"If you look at the industry-wide expansion of production capacities over the past six months, enough doses should be available by the middle of next year so that everyone on this earth can be vaccinated. Boosters should also be possible to the extent required," he told the newspaper in an interview. Vaccinations would soon be available even for infants, he said. (9/23)

COVID-19 vaccinations are believed to be key to ending the pandemic but only 32 percent of the world has been fully vaccinated and reaching global herd immunity could be eight months away. The historic speed at which COVID-19 vaccines were developed was met with a slow global vaccination effort, partially fueled by vaccine inequity. The World Health Organization has long stressed the need for a global approach to vaccinations, warning that significant portions of unvaccinated people in low and middle-income countries will perpetuate the pandemic, but vaccine hesitancy has left even high-income countries struggling to inoculate large swaths of their populations. (Fink, 9/23)

Generic drug companies have asked Pfizer, Moderna and Johnson & Johnson to license their COVID-19 vaccine technology to help increase global production, but so far the vaccine makers have given them the cold shoulder. Other companies are saying they have extra capacity to make more vaccines. Not using that extra capacity could prolong the pandemic throughout the world. (Herman, 9/24)

Now is a crucial time to lay the groundwork to quash future threats from pathogens, top science advisers in the U.S. and U.K. said this week. Governments, industries and organizations are trying to bolster early warning systems, improve manufacturing supply chains for vaccines and treatments, and build infrastructure to be able to better contain future outbreaks — all while the current pandemic is still raging. (Snyder, 9/23)

The new numbers come a day after state officials announced they would implement crisis standards of care statewide, a worst-case scenario that forces hospitals to ration care due to resource and staffing limitations. Those limitations and continually high numbers of COVID-19 patients have overwhelmed health care facilities around the state. At least one rural cardiac patient died recently when a bed in Anchorage wasn’t available. (Berman and Krakow, 9/24)

Alaska now has the highest rate of Covid in America. On Wednesday the state hit its record number of cases and hospitalizations in the entire pandemic, and the numbers continue rising as its rolling seven-day average of daily cases tops 800. For Dr Anne Zink, Alaska’s chief medical officer and a practicing ER physician, this is the worst part of the pandemic. “It’s awful. It’s exhausting,” she told the Guardian. “We went in this to care for patients, and it’s heartbreaking to not be able to give the care that you know could potentially save their life.” And, she said, it’s only going to get worse. (Schreiber, 9/24)

While Kentucky’s prolonged surge of COVID-19 cases has shown signs of leveling off, overstressed hospitals can’t sustain the current pace of seriously ill virus patients, Gov. Andy Beshear said Thursday as he pleaded with people to take preventive steps. The governor — who had much of his pandemic-fighting authority taken away by lawmakers — stressed that the more Kentuckians who get vaccinated and wear masks when indoors in public, the “faster we can get this thing on the way down.” (Schreiner, 9/23)

Health care officials are lodging complaints about a reopened transfer center intended to help Nebraska hospitals find places to send patients who need additional care as COVID-19 cases have surged in recent weeks. Officials at Lincoln’s Bryan Health and at smaller hospitals around the state have complained that the transfer center has not proven helpful in recent cases where very sick patients need to get to a larger hospital, the Lincoln Journal Star reported. In some cases, hospital staff reported they got no help from the system and, instead, had to make numerous calls themselves to find an intensive care bed. (9/23)

An ongoing nursing shortage in Arizona will likely keep non-COVID-19 patients from quickly getting transferred to more equipped hospitals. State health officials this week rejected a request to expand the state “surge line,” a call-in system to find beds for critically ill COVID-19 patients, to include people with other medical needs, the Arizona Daily Star reported. (9/23)

Alabama has averaged more than 100 deaths a day from COVID-19 over the last week, statistics showed Thursday, giving it the nation’s highest death rate over the period even as hospitalizations linked to the coronavirus pandemic continue to decline. Statistics from Johns Hopkins University show 106 deaths were reported statewide daily over the last seven days, although some of those could have occurred earlier because of a lag in reporting. Alabama’s rate of 18 deaths for every 100,000 people over the last week is far above second-place West Virginia, which had 10 deaths per 100,000 people, according to the U.S. Centers for Disease Control and Prevention. (9/23)

Gov. Jim Justice compared the skyrocketing number of coronavirus deaths in West Virginia to some of the state’s worst coal mining disasters, asking why the daily tolls don’t motivate more people to get their COVID-19 shots. This month’s virus deaths have surpassed the total from the worst coal mining disaster in U.S. history and is on pace to eclipse the previous four months of the pandemic combined. The 25 deaths reported Thursday pushed the September total to at least 408 with a week still left, according to state health data. (Raby, 9/23)

Colorado is spending $16 million to purchase 2 million rapid COVID-19 tests and plans to start sending them to residents for free starting this week. The new effort is designed to curb the spread of the Delta variant amid a fifth wave of infections that is threatening hospital bed capacity in some areas of the state. (Frank, 9/23)

A 26-year-old Fond du Lac police officer died of complications from COVID-19, his department said Thursday. Officer Joseph Kurer’s death on Wednesday came a day after his second child was born, according to police Chief Aaron Goldstein. Because evidence indicates he contracted COVID-19 while working, he died in the line of duty and his death will be treated as such, Goldstein said. (9/23)

KHN: A Daily Pill To Treat Covid Could Be Just Months Away, Scientists Say 

Within a day of testing positive for covid-19 in June, Miranda Kelly was sick enough to be scared. At 44, with diabetes and high blood pressure, Kelly, a certified nursing assistant, was having trouble breathing, symptoms serious enough to send her to the emergency room. When her husband, Joe, 46, fell ill with the virus, too, she really got worried, especially about their five teenagers at home: “I thought, ‘I hope to God we don’t wind up on ventilators. We have children. Who’s going to raise these kids?” (Aleccia, 9/24)

Multisystem inflammatory syndrome in adults (MIS-A) is a rare but severe hyperinflammatory condition that begins roughly 4 weeks after COVID-19 symptom onset and likely results from an outsized immune response, concludes a systematic review yesterday in JAMA Network Open. Researchers from the US Centers for Disease Control and Prevention conducted a literature review from May 1, 2020, to May 25, 2021, identifying 221 patients around the world diagnosed as having MIS-A. First identified in children (MIS-C) in April 2020, the syndrome has since also been recognized in adults. (9/23)

The Montana Medical Association, three health care providers and several patients with compromised immune systems are suing the state over a law that bans employers from mandating vaccines for employees. The law in question gave vaccine status protection under the Montana Human Rights Act, which in effect prohibits government agencies and businesses from requiring employee vaccinations. (Ragar, 9/24)

The public health officer in a small northern Montana county is resigning because of the “constant negativity, pushback, disregard and lack of support” that health officials have faced throughout the coronavirus pandemic, she said. Blaine County public health nurse Jana McPherson-Hauser said her resignation would take effect Oct. 15, KOJM-AM reported. The county’s health board accepted her resignation Wednesday. (9/23)

A group of federal workers and contractors filed suit against the U.S. government over its Covid-19 vaccination mandates. The lawsuit, filed in Washington Thursday, challenges President Joe Biden’s executive order earlier this month requiring federal workers to be vaccinated and the U.S. Defense Department’s August memorandum that members of the military must be protected against coronavirus. (Davis, 9/23)

D.C. is cracking down on vaccine mandates for some workers, going further than surrounding counties by getting rid of test-out options for public employees. With the region's rate of partially vaccinated individuals hovering around 70%, government mandates are a key tool in fighting COVID-19. (Cirruzzo, 9/23)

Rancorous opposition to vaccine mandates from a fraction of the hospital workforce has drowned out the voices of the administrators and staff who desperately want to feel safer at work during a pandemic that has killed thousands of healthcare personnel. Before President Joe Biden declared that all healthcare providers that participate in Medicare and Medicaid must vaccinate their 17 million employees against COVID-19, dozens of hospitals and health systems around the U.S. took the step on their own. The CEOs of three pioneer hospitals—Houston Methodist, the Medical University of South Carolina and Inova Health System—say their successes demonstrate the wisdom of requiring vaccines. (Young, 9/23)

Gainesville city employees won a court battle Wednesday when they were granted a temporary injunction, or a request to refrain from taking a certain action, against an imposed vaccine mandate. A lawsuit was filed against the city on Aug. 26 after city officials imposed a vaccine mandate or risk termination for all city employees. 200 plus employees were against the mandate. (Leandri, 9/23)

Sporting a mask, Toronto Maple Leafs winger William Nylander opened his news conference at the start of training camp by informing reporters he was not yet fully vaccinated. “Had couple medical things to take care of,” he said. “I’ll be fully vaccinated by the beginning of the season.” The NHL is counting on it and said last week that 98% of its players will be vaccinnated by the time the season begins Oct. 12. That would leave 10-15 players out of 700 on 32 teams lacking the vaccine, including Detroit’s Tyler Bertuzzi. (9/23)

White House officials prioritized President Donald Trump’s attempt to challenge the election over the pandemic response last winter, according to emails obtained by the House select subcommittee probing the government’s coronavirus response and shared with The Washington Post. Steven Hatfill, a virologist who advised White House trade director Peter Navarro and said he was intimately involved in the pandemic response, repeatedly described in the emails how “election stuff” took precedence over coronavirus, even as the outbreak surged to more than 250,000 new coronavirus cases per day in January. (Diamond, 9/23)

Americans who relied most on former President Donald Trump and the White House coronavirus task force for COVID-19 news in the early days of the pandemic are now among those least likely to have been vaccinated against the virus, according to a new Pew Research Center survey. In late April 2020, as part of the Center’s American News Pathways Project, respondents were asked to name the source they relied on most for pandemic news. At that point, it had been more than a month since the World Health Organization had declared the coronavirus outbreak to be a pandemic, businesses and schools in the United States were closing their doors, and the nation was approaching the 1 million mark in number of confirmed cases as the sweeping impact of the pandemic was becoming clearer. (Jurkowitz and Mitchell, 9/23)

Alabama's population is dwindling for the first time in state's history as a result of COVID-19's deadly spread throughout its residents. "Our state literally shrunk in 2020, based on the numbers that we have managed to put together, and actually by quite a bit," State Health Officer Scott Harris said in a Friday press conference, according to The Guardian. "2020 is going to be the first year that we know of in the history of our state where we actually had more deaths than births." (Skolnik, 9/23)

Dr. Anthony Fauci — arguably the nation’s most famous, and suddenly most polarizing doctor — is a movie star, in a manner of speaking. A new documentary titled, simply, “Fauci,” had a limited run this month in 11 cities (in theaters that required proof of vaccinations and masks) and will begin streaming in early October on Disney+. (Stolberg, 9/22)

Former FDA commissioner Scott Gottlieb can now add published author to his long list of titles, which also includes board member of Pfizer and Illumina, senior fellow at the American Enterprise Institute and CNBC contributor. His book about the pandemic, “Uncontrolled Spread: Why COVID-19 Crushed Us and How We Can Defeat the Next Pandemic,” was released Tuesday. He spoke with STAT to discuss his book, his thoughts on the pandemic, and much more. (Feuerstein, Garde and Tirrell, 9/24)

The CIA has removed its top officer in Vienna following criticism of his management, including what some considered an insufficient response to a growing number of mysterious health incidents at the U.S. Embassy there, according to current and former U.S. officials. The sidelining of the station chief in one of the largest and most prestigious CIA posts is expected to send a message that top agency leaders must take seriously any reports of “Havana Syndrome,” the phenomenon named after the Cuban capital where U.S. diplomats and intelligence officers had first reported unusual and varied symptoms, from headaches to vision problems and dizziness to brain injuries, that started in 2016. (Hudson and Harris, 9/23)

Since then, abortion providers in Texas say their worst fears have come to fruition. They describe women traveling hundreds of miles to get an abortion while out-of-state clinics grow backlogged and their own clinics rapidly confront possible closure. This time abortion providers want the court ... to act rather than wait for its ongoing lawsuit to proceed at the 5th U.S. Circuit Court of Appeals. The conservative-leaning appeals court is not poised to act before December, the abortion providers say. (Weber, 9/23)

Before the law took effect, abortion rights advocates and providers sued to block Texas state judges from enforcing the law and court clerks from accepting lawsuits alleging violations of S.B. 8. The defendants, who are state officials, in turn claim the lawsuit against them is improper, and have asked that the case be dismissed. That case is pending before the U.S. Court of Appeals for the 5th Circuit, which despite expediting the proceedings, will not hear the matter until December at the earliest. (Kruzel, 9/23)

The city of Chicago has taken out full-page ads in The Dallas Morning News to encourage Texans unhappy with the state’s new abortion law and other issues to leave the state. The ads tout Chicago’s tech and business sector as well as the city’s more liberal politics, pointing to voting rights, abortion and an emphasis on science as a means to combat COVID-19. (Kelley, 9/23)

Ohio Republican Senate candidate J.D. Vance appeared to defend the near-total ban on abortion in Texas during a local news interview this week, saying he did not believe that rape or incest should necessarily be exceptions for the procedure. "I think in Texas they're trying to make it easier for unborn babies to be born," Vance told Spectrum News's Curtis Jackson in Columbus on Wednesday when asked about the Texas law. "There is a view, common among leaders of the Democratic Party, that babies deserve no legal protections in the womb. That is a common view in the Democratic Party and all I'm saying is that view's wrong." (Manchester, 9/23)

Guam’s government is appealing a judge’s ruling that removed a barrier to women in the U.S. territory accessing telemedicine abortions. ... The Guam attorney general’s office and the Guam Medical Board of Examiners filed notice in court this week they are appealing a preliminary injunction that temporarily blocked a provision of Guam law that forced patients to have an in-person visit before abortion medication can be prescribed via telemedicine. (Kelleher, 9/24)

A federal appeals court plans to hear arguments Friday on whether it should overturn a lower court ruling that permanently blocked a restrictive abortion law passed in Georgia in 2019.The hearing comes amid a heightened focus on abortion with the U.S. Supreme Court earlier this month allowing a similarly restrictive Texas law to take effect. The justices also plan to hear arguments in December on Mississippi’s attempt to overturn the high court’s decisions in Roe v. Wade and Planned Parenthood v. Casey, which affirmed the right to an abortion. (Brumback, 9/24)

House Speaker Nancy Pelosi (D-Calif.) on Thursday pushed back against a San Francisco archbishop’s denunciation of the Women’s Health Protection Act, a bill in Congress to create a statutory right for health-care professionals to provide abortions. ... The House legislation, H.R. 3755, would codify the protections provided by the Supreme Court’s landmark Roe v. Wade ruling, legalized abortion nationwide. In a statement Tuesday, Archbishop Salvatore J. Cordileone condemned the measure as “nothing short of child sacrifice” and asked Catholics to “immediately to pray and fast for members of Congress to do the right thing and keep this atrocity from being enacted in the law.” (Sonmez, 9/23)

Approval of the U.S. Supreme Court fell to a new low of 40 percent this month, according to a new poll released by Gallup on Thursday. The surveys were conducted from Sept. 1-17, around the time the Supreme Court declined to block an extremely restrictive Texas abortion law as well as allow college vaccine mandates to continue, Gallup noted. (Choi, 9/23)

House progressives appear poised for a showdown with their own leadership team as Democrats steamroll toward a Monday vote on a Senate-passed infrastructure bill that is a key part of President Biden’s agenda. Progressives on Thursday — one day after a high-profile White House meeting — insisted they’ll vote against Biden’s bipartisan infrastructure bill, which some call the “BIF,” if Speaker Nancy Pelosi (D-Calif.) goes ahead with a vote she promised to deliver to centrists in her caucus by Sept. 27. (Lillis and Wong, 9/23)

Top Democratic leaders and tax writers have narrowed a “menu of options” on how to pay for their multitrillion-dollar budget reconciliation package that takes a controversial inheritance tax proposal off the table but leaves many others with shaky support. Senate Majority Leader Charles E. Schumer made a brief appearance at Speaker Nancy Pelosi’s weekly news conference Thursday morning with Treasury Secretary Janet L. Yellen to announce they “reached agreement on a framework” on how to pay for sweeping social spending measure that will fund new programs on paid leave, child care, climate and much more.  (McPherson and Weiss, 9/23)

Several Senate Democrats on Thursday said that they hadn't seen a "framework" for how to pay for their sweeping social spending bill and appeared to be caught off guard by Senate Majority Leader Charles Schumer's (D-N.Y.) announcement of a deal between the Senate, House and White House. Schumer, speaking at a press conference and separately with reporters, described it as a deal on the "menu of options" that Democrats will use to pay for the eventual bill, which will cover climate change policies, health care and a host of other party priorities. (Carney, 9/23)

Democratic leaders' efforts to infuse momentum into turbulent negotiations over President Joe Biden's social spending plans are falling flat so far with key players on Capitol Hill. And as Congress hurtles toward a crucial week that could make or break Biden’s agenda, centrists and progressives remained largely unmoved from their entrenched positions. That leaves Speaker Nancy Pelosi days away from a vote on a $550 billion Senate-passed infrastructure bill without a clear path to passage. (Caygle, Ferris and Scholtes, 9/23)

Democratic leaders raced Thursday to find enough agreement around a roughly $3.5 trillion spending package to assuage concerns between the party’s dueling centrist and liberal factions that threatened to derail a separate vote on an infrastructure package next week. Liberal Democrats have said the two bills are linked and have balked at voting for the roughly $1 trillion infrastructure package on Monday in the House unless the broader healthcare, education and climate-change package has passed. The infrastructure bill has already cleared the Senate with bipartisan support, and moderates have urged leadership to bring it to the floor in the House. (Duehren and Rubin, 9/23

Sen. Joe Manchin (D-W.Va.) is firing a warning shot at progressives' hopes of using a sweeping social spending bill to expand Medicare, arguing Democrats should first focus on shoring up the program.  Manchin, leaving the Capitol after a vote on Thursday, was asked about expanding Medicare to cover hearing, vision and dental, something included in House Democrats' $3.5 trillion plan and being championed in the Senate by Sen. Bernie Sanders (I-Vt.). (Carney, 9/23)

KHN: KHN’s ‘What The Health?’: The Autumn Of Democrats’ Discontent

Democrats in Congress and the White House are feverishly negotiating to pass as much of President Joe Biden’s domestic agenda as they can agree on, even as Republicans who oppose much of the increased spending threaten to shut down the government and default on the nation’s debt. Meanwhile, confusion over so-called booster shots for covid-19 continues, and advocates on both sides of the abortion debate try to test Texas’ novel abortion law that the Supreme Court allowed to take effect Sept. 1. (9/23)

In a nation’s capital seemingly more hopelessly split by intense partisan rhetoric than ever, Georgia Democratic U.S. Sen. Jon Ossoff and Republican Sen. Chuck Grassley from Iowa have introduced a bill designed to help rural communities fight the opioid epidemic. On Wednesday, Ossoff and Grassley introduced the Rural Opioid Abuse Prevention Act, which they said would help ensure rural communities experiencing a high level of opioid overdoses have the resources they need to respond to the crisis. (Darnell, 9/23)

Facebook agreed to send Antigone Davis, global head of safety, to testify before the Senate Commerce subcommittee on consumer protection on Sept. 30, a Facebook spokesperson confirmed to CNBC. The Washington Post reported the news earlier Thursday. The hearing comes after The Wall Street Journal published a series of reports detailing internal discussions at Facebook, based on documents it obtained. (Feiner, 9/23)

Washington Gov. Jay Inslee said Thursday the state’s eviction protections will remain in place through the end of October because counties aren’t getting federal and state COVID-19 relief funds intended for rental assistance out fast enough ahead of the current moratorium that was set to expire Sept. 30. Under an eviction moratorium “bridge” that Inslee announced in June, landlords were prevented from evicting tenants for any past-due rent owed from Feb. 29, 2020 through July 31, 2021. (La Corte, 9/23)

Unemployment claims in California rocketed to their highest level in five months last week, raising fresh uncertainties about the strength of a statewide economy attempting to recover from coronavirus-spawned maladies. California workers filed 75,800 initial claims for unemployment during the week ended Sept. 18, an increase of 24,200 from the prior week, the U.S. Labor Department reported on Thursday. (Avalos, 9/23)

For the first time in 18 months, many jobless people in the Washington region and beyond in September did not receive enhanced payments from federal programs designed to help them weather the pandemic. These programs expired Labor Day, when many people hoped the pandemic would have effectively ended and a new season of economic opportunity would have begun. But instead, the delta variant emerged with vengeance and hamstrung efforts to boost the economy — leaving millions of workers without extra government support while still struggling to find gainful employment. (Davies and Hilton, 9/23)

Cassie Norris is stuck in what can feel like an inescapable poverty trap. Her family hasn’t been able to afford child care, so she watches the kids — ages 1, 2, 5, and 9 — during the day while her husband goes to work for a little more than minimum wage as a small-engine salesman and technician at a local shop. She’s depressed and desperate to start working again, but it would cost hundreds of dollars to send their youngest children to day care while she looks for a job. Mississippi, where she lives, has child care assistance programs, but Norris says she would have to already be working to qualify. You can see the conundrum: Given their finances, she can’t buy herself that time. “One week of child care would completely change our entire situation,” Norris says. (Stewart, 9/22)

KHN: Low Wages And Pandemic Gut Staffing Support For Those With Disabilities 

Ernestine “Erma” Bryant likes her job, but the pay is a problem. She works in a caregiver role as a “direct support professional” in Tifton, Georgia, helping people who have intellectual and developmental disabilities with basic functions such as dressing, bathing and eating. Bryant said it’s fulfilling work. “You can help people be successful — people who are confined to the bed,” she said. “It gives me joy knowing that I can help that person get out of the house.” But she said she’s being paid less than $10 an hour and is trying to get a second job. (Miller, 9/24)

1964 was a record-breaking boom year for the U.S. economy, and CBS News followed along as Corbett Rachal and his wife Sallye tried to buy their piece of it. It's the same area where "CBS Mornings" co-host Tony Dokoupil's grandfather found a home just a decade earlier. But as the Rachals visited real estate offices and asked to see properties, they ran into a problem that Dokoupil's grandfather did not. CBS News documented in rare hidden-camera footage the Rachals repeatedly being turned away by real estate agents because of they were Black. "So, what do you have that you can show me today?" Corbett is seen asking in the 1964 CBS News clip. "Nothing in this price range. Nothing at all," a real estate agent replied. (9/23)

Rep. Lauren Boebert, R-Colo., improperly spent thousands of dollars in campaign funds on rent and utilities, her campaign acknowledged this week in a filing with the Federal Election Commission, but it said the money had been paid back. The FEC had asked Boebert's campaign treasurer in a letter last month for more information about $6,000 in payments that had been listed in her quarterly filing as a "personal expense of Lauren Boebert billed to campaign account in error." The filing said the money had already been paid back. (Gregorian, 9/23)

According to the statement published Thursday in the journal Nature Reviews Endocrinology, a growing body of research shows that "prenatal exposure to APAP might alter fetal development, which could increase the risks of some neurodevelopmental, reproductive and urogenital disorders." The statement is not health guidance, but urges health care providers and regulators to take action. (LaMotte, 9/23)

Nearly 100 doctors and scientists issued a consensus statement Thursday warning of possible links between the use of acetaminophen during pregnancy and developmental problems in children, including neurological and reproductive issues that start in the womb. In a paper published by Nature Reviews Endocrinology, the authors reviewed the medical literature going back 25 years to make a set of recommendations. The group is calling on clinicians and regulatory agencies to change their guidelines for the use of acetaminophen during pregnancy while more research is conducted to study the full range of effects the drug could have on fetal development and children. (Cueto, 9/23)

A prominent baby-product manufacturer is recalling 3.3 million lounger pads for newborns after at least eight infant deaths were associated with the pillows in less than five years, federal safety regulators said on Thursday. The pillowlike pads, made by the Boppy Company, are not safe for babies to sleep in because they can cause suffocation, the Consumer Product Safety Commission said. (Vigdor, 9/23)

Vaccinating against Covid does not increase the risk of miscarriage or birth defects, officials from the Centers for Disease Control and Prevention said. The CDC tracked 1,613 pregnant women who received a Covid-19 vaccine, 30% of whom were vaccinated in the second trimester, while the remaining 70% received their inoculations in the third trimester, Dr. Christine Olson, a CDC medical officer, told the agency’s Advisory Committee on Immunization Practices on Wednesday. Those participants gave birth to 1,634 infants, including 42 twins. (Towey, 9/23)

Nicole Torres’ prenatal visits all start the same way: with her obstetrician inquiring whether she has received her Covid-19 shot yet. Torres, 24, who is 33 weeks pregnant with her second daughter, has not. It’s not because of a lack of information. Torres knows that pregnant women face a higher risk of severe illness if they catch Covid, and she has had discussions with her obstetrician about the data showing the vaccine is safe for pregnant women and their babies. She has considered getting vaccinated, but alarming claims about the vaccine that she and her husband have read online have made her question whether it is the right thing to do. (Chuck, 9/22)

A new study found that children whose mothers experienced depression during and soon after pregnancy are more likely to experience depression themselves. While experts said more research is needed on the subject, they emphasized that this new finding reinforces the urgent need to identify and treat depression among pregnant women -- not just for their sake, but potentially for the sake of their child as well. (Rutledge, 9/24)

U.S. Latinos are more likely to suffer from potentially preventable cancers than non-Hispanic whites, according to a report released Tuesday. The report underlines how a lack of health care for Latinos blocks early detection of preventable cancers, such as stomach, liver and cervical cancer. It was published in CA: A Cancer Journal for Clinicians. (Gonzalez, 9/23)

A former Tempe police detective has died after contracting West Nile virus, authorities said Thursday. Police officials said Nathan Ryberg had been in a medically induced coma since Sept. 11 while fighting the virus plus encephalitis, which is an inflammation of the brain. ... There have been 132 cases of West Nile virus so far this year and five deaths reported in Arizona as of Thursday with nearly all of the cases being in Maricopa County. (9/23)

Just yards from where thousands of migrants are waiting to be processed by American immigration authorities at the US-Mexico border in Del Rio, Texas, a new field hospital has opened up. The hospital became fully operational on Tuesday, and treated roughly 70 patients in its first 24 hours, according to Dr. David Tarantino, chief medical officer for Customs and Border Protection (CBP). Before the facility was opened, CBP emergency medical technicians and paramedics who had been deployed to the border treated about 1,000 people. (Flores and Maxouris, 9/23)

Congress set up a massive, $178 billion fund in 2020 meant to help mitigate the impacts of the Covid-19 pandemic on health care providers, known as the Provider Relief Fund. The Trump and Biden administrations haven’t always been great about sending out the money — or sending it on time. But STAT’s new analysis of a Health and Human Services database of the money reveals where it’s flowing and who has received the most so far. (Parker, 9/24)

Supermodel Linda Evangelista filed a lawsuit alleging that a fat-freezing procedure left her permanently disfigured and ruined her career. "Today I took a big step towards righting a wrong that I have suffered and have kept to myself for over five years. To my followers who have wondered why I have not been working while my peers' career have been thriving, the reason is that I was brutally disfigured by Zeltiq's CoolSculpting procedure which did the opposite of what it promised," she wrote in an Instagram post Wednesday. (Burke and Dasrath, 9/23)

An expert task force on Thursday released a new and much-anticipated approach for diagnosing kidney function, saying there is no need for controversial algorithms that consider race in the assessment of kidney disease. The new recommendations come as a victory for a growing number of physicians and activists who argue the use of race-based tools in medicine is outdated and wrong because race is not a good proxy for genetic difference — and sends the message that some races are biologically inferior. Many also argue that the separate racial thresholds for classifying kidney disease underestimate the extent of disease in Black patients, leaving them less likely to receive the specialty kidney care they need or be placed on transplant waitlists. (McFarling, 9/23)

A scientific task force on Thursday called for jettisoning a common measure of kidney function that adjusts results by race, providing different assessments for Black patients than for others. The adjustment may make Black patients seem less ill than they really are, according to many experts. Instead, doctors should rely on a race-neutral method for diagnosing and managing kidney disease, concluded a report from the National Kidney Foundation and the American Society of Nephrology. (Rabin, 9/23)

The National Institutes of Health will renew three awards totaling $73.2 million over the next five years to expand a precision medicine effort at several large systems and medical schools. Five institutions and principal investigators will receive the awards: Christa Martin and Erin Riggs at Geisinger Health System, Jonathan Berg at the University of North Carolina at Chapel Hill, Sharon Plon and Aleks Milosavljevic at Baylor College of Medicine, Teri Klein at Stanford University, and the Broad Institute's Heidi Rehm. (9/23)

CMS is reevaluating hospitals' applications for exceptions from reimbursement cuts to their off-campus outpatient facilities following pushback from the industry. In January, CMS rejected more than 60% of the mid-build exceptions, which is designed to preserve higher payments if hospitals document that their off-campus outpatient departments were under construction when the Bipartisan Budget Act passed in 2015. (Kacik, 9/23)

Devoted Health, a health insurance startup that focuses on Medicare Advantage plans, is raising up to $1.2 billion in new funding at around an $11.5 billion valuation, according to a Delaware stock authorization filing. The Waltham, Massachusetts-based company serves around 40,000 seniors in four states, more than double from the first half of 2020, and wants to eventually become a nationwide provider. (Primack and Herman, 9/23)

St. Joseph's/Candler Health System announced Thursday that it plans to build a medical complex on six acres it has purchased near the Bryan County Mega-site at the I-16/Highway 280 interchange. The medical facility eventually will encompass 40,000 square feet of space at full build-out and will include office space for the Development Authority of Bryan County. The DABC was also a key player in acquiring the adjacent 2,200-acre mega-site. (Nicholson, 9/23)

Amid mounting concerns over the U.S. pharmaceutical supply chain, a Department of Defense watchdog found an overreliance on foreign suppliers that could harm national security and that the Pentagon failed to assess the risks of shortages or develop strategies to mitigate disruptions. Among the shortcomings, the Defense Department did not aggregate and analyze the origins of finished medicines or active ingredients to determine the reliance on foreign suppliers or identify gaps in information about where the products are made, according to the Office of Inspector General at DOD. The OIG report also noted the military is not required to run such analyses. (Silverman, 9/23)

Six drugmakers could soon face steep fines over their refusal to discount drug prices for pharmacies that contract with 340B providers. The Health Resources and Services Administration on Wednesday sent letters to Eli Lilly, AstraZeneca, Novartis, Novo Nordisk, Sanofi and United Therapeutics, informing them that it has asked the Department of Health and Human Services' Office of the Inspector General to determine whether they should pay fines for the violations. The drugmakers could get fined more than $5,000 for each instance. (Brady, 9/23)

Biogen has certainly faced an uphill battle trying to convince physicians to prescribe the drugmaker’s highly scrutinized Alzheimer’s disease drug Aduhelm. It doesn't make it any easier if clinics won’t even let the company's sales reps through the front door. But that’s the case at the Neurology Center in Washington, D.C., which has gone so far as to ban Biogen employees from entering their seven office locations in response to the controversy shrouding the company’s new med. (Higgins-Dunn, 9/22)

Two months ago, Novartis Gene Therapies chief Dave Lennon left the company to lead a biotech startup that is operating in stealth mode. It was with similar stealth that the unit Lennon formerly headed up fell victim to a reorganization by the company. In a move that was effective in February, Novartis Gene Therapies was broken up and integrated into the company, costing nearly 150 employees their jobs, Endpoints reported on Tuesday. A spokesperson for Novartis confirmed the report in a statement emailed to Fierce Pharma. Remaining employees from the gene therapy unit now report to Novartis’ respective organizational units, including pharmaceuticals, technical operations, global drug development and biomedical research. (Dunleavy, 9/22)

First, it was powerhouse investor Elliott Management urging GlaxoSmithKline to take steps necessary to turn around its declining fortunes. Now, a much smaller but burgeoning activist investor, Bluebell Capital Partners, has taken over the tag-team match, applying pressure on GSK’s embattled CEO Emma Walmsley. In a letter to the company’s board of directors, Bluebell asked GSK to force Walmsley to reapply for her job, launch a search for new leadership and beef up the board’s scientific expertise, according to a report from the Financial Times.  (Dunleavy, 9/22)

The death toll has risen from seven to 15 among nursing home residents evacuated before Hurricane Ida to a warehouse where conditions were found too squalid for safety, the state health department said Thursday. However, a department statement noted that some deaths may be unrelated to the storm or conditions in the warehouse. “As time passes and given the health conditions that required a nursing home level of care, unfortunately the number of deaths among this group is likely to increase,” it said. “That is why it is important to make a distinction between the number of total deaths regardless of cause and the number of storm-related deaths.” (McConnaughey, 9/23)

New York State health commissioner Howard Zucker resigned on Thursday following pressure for his role in withholding nursing home COVID-19 death numbers under former Gov. Andrew Cuomo. Zucker led New York's response to COVID-19 last year but came under fire for reportedly undercounting the death toll in nursing homes by as much as 50%. (Frazier, 9/23)

Maryland will allow out-of-state licensed nurses to practice here, encourage early graduation for nursing students and ask hospital leaders to recruit nurses from other states as the country faces a nationwide shortage of medical staff amid the ongoing coronavirus pandemic. Gov. Larry Hogan announced the new measures Thursday as a way to increase nursing personnel at hospitals, although COVID cases in Maryland remain relatively low. (Wagner, 9/23)

West Virginia’s Capitol Complex will offer a place for people to dispose of unused or expired medications next month as part of National Prescription Drug Take Back Day, officials said. The new Safe Zone at the bus turnaround next to the Culture Center will serve as a collection site on Oct. 23, a statement from the West Virginia Department of Homeland Security said. (9/24)

Mississippi House and Senate negotiators said Thursday that they have agreed on a proposed medical marijuana program. Leaders are expected to ask Republican Gov. Tate Reeves to call the Legislature into session to put the plan into law. The step comes months after the Mississippi Supreme Court tossed out a medical marijuana initiative that voters approved last November. Justices ruled in May that Mississippi’s initiative process was out of date and the medical marijuana proposal was not properly on the ballot. (Pettus, 9/23)

KHN: California Moves On Climate Change, But Rejects Aggressive Cuts To Greenhouse Emissions 

As California trudges into another autumn marred by toxic wildfire smoke and drought-parched reservoirs, state lawmakers have cast climate change as a growing public health threat for the state’s 40 million residents. But they were willing to push the argument only so far. On Thursday, against the smoldering backdrop of Sequoia National Park, where the massive KNP Complex Fire is burning uncontained, Gov. Gavin Newsom signed a $15 billion legislative package that he described as an unprecedented investment by any state in climate resiliency. The legislation outlines significant new efforts to bolster wildfire prevention, expand clean water supplies and build a network of community-level safeguards to protect people from episodes of extreme and potentially deadly heat. (Young, 9/23)

As wealthy countries begin to consider whether to offer their populations a third COVID-19 shot, African nations still waiting for their first gave this stark reminder to world leaders at the U.N. General Assembly on Thursday: “No one is safe unless we are all safe.” That message was repeated throughout the day as the inequity of vaccine distribution came into sharp focus. As of mid-September, fewer than 4% of Africans have been fully immunized and most of the 5.7 billion vaccine doses administered around the world have been given in just 10 rich countries. (Sarkar, 9/23)

As dawn breaks, pilot Matthew Monson makes the final checks on his small plane and gets ready for a busy day. He'll spend it flying health workers on the front line of the fight against the coronavirus pandemic to the most remote parts of the tiny African nation of Lesotho.   Dubbed "The Mountain Kingdom" for good reason, the towering peaks and deep river valleys make many parts of Lesotho incredibly hard to reach. That's why the work being done by the Lesotho Flying Doctor Services is so vital. Thanks in part to donations from the U.S., the country has all the vaccine doses needed to inoculate its entire adult population — but acquiring them was only the first challenge. Now it must get them to the people. (Patta, 9/23)

In a statement today summing up major announcements that came at the summit, the WHO said Sweden pledged an additional $243 million in cash contributions and vaccine that it will make available in 2021 and 2022.Other dose donations came from Japan, with a pledge of 60 million doses, Italy with 30 million, and Spain with 7.5 million. Denmark announced at the UN General Assembly that it would double its dose donation, which will now total 6 million. In another development, Team Europe added to its previous pledge, which now totals 500 million vaccine doses by the middle of 2022. (Schnirring, 9/23)

A woman with Down’s syndrome who took Sajid Javid to court over the UK’s abortion law has lost her case in the high court. Heidi Crowter, who brought the case alongside Máire Lea-Wilson, whose son Aidan has Down’s syndrome, and a child with Down’s syndrome identified only as A, had argued that allowing pregnancy terminations up to birth if the foetus has Down’s syndrome is discriminatory and stigmatises disabled people. They challenged the Department of Health and Social Care over the Abortion Act 1967, which sets a 24-week time limit for abortions unless there is “substantial risk” of the child being “seriously handicapped”. (Topping, 9/23)

Police are looking for a man in Canada they say punched a nurse in the face multiple times, knocking her to the ground after she administered a Covid-19 vaccine to his wife without his permission. On Monday, around 9:15 a.m., a man walked into a Brunet Pharmacy in Sherbrooke, a city in southern Quebec, and accused a nurse in her 40s, who police have not named, of vaccinating his wife, Sherbrooke Police spokesman Martin Carrier told CNN. (Ebrahimji, 9/23)

Nations, companies and foundations pledged billions of dollars to feed the world in connection with an ambitious United Nations food summit Thursday, while some grassroots anti-hunger groups and food experts blasted the event as too corporate, tech-focused and top-down. Held as part of the annual U.N. General Assembly meeting of world leaders, the “food systems summit” aimed to tackle the life-and-death puzzle of hunger, nutrition, environmental sustainability and inequality. Worldwide, more than 2 billion people don’t have enough to eat, while 2 billion are overweight or obese, and nearly a third of the food that gets produced ends up discarded, according to the U.N. (Peltz, 9/23)

McDonald’s Corp. is upgrading some of its self-service kiosks to make them more accessible to blind people. Company-owned McDonald’s restaurants are mounting new keypads and headphone jacks onto the touch-screen kiosks it introduced in 2015 as alternatives to ordering at the counter. Blind users can connect their headphones to the system and browse the digital menu using screen-reader technology and tactile arrow buttons, adding items to their basket by pressing a central button. (Deighton, 9/17)

During the pandemic, Curtis Chong has avoided the 2-½ hour journey to his grocery store pharmacy — including a round-trip bus ride — to pick up his prescription. Even though Mr. Chong, a retiree in Aurora, Colo., said he is readily identifiable as a blind person, because he uses a white cane for mobility, his pharmacist never suggested he could have his medications labeled in an accessible way. Through a Zoom meeting, Mr. Chong learned about Accessible Pharmacy Services, a start-up, that now delivers his medication with labels that convert text to speech. (Brockman, 9/21)

Plenty of couples think they’re made for each other, but Denver husbands Reid Alexander and Rafael Díaz have medical proof. When Alexander, 24, needed a new kidney, Díaz, 28, turned out to be an ideal donor for the lifesaving organ. “It just feels like it was meant to be,” Díaz said. Alexander had been diagnosed at 17 with Alport syndrome, a genetic condition that scars the kidneys and eventually leads to renal failure. (Avery, 9/23)

Allison Draper loved anatomy class. As a first-year medical student at the University of Miami, she found the language clear, precise, functional. She could look up the Latin term for almost any body part and get an idea of where it was and what it did. The flexor carpi ulnaris, for instance, is a muscle in the forearm that bends the wrist — exactly as its name suggests. Then one day she looked up the pudendal nerve, which provides sensation to the vagina and vulva, or outer female genitalia. The term derived from the Latin verb pudere: to be ashamed. The shame nerve, Ms. Draper noted: “I was like, What? Excuse me?” (Gross, 9/21)

As the world’s population ages, the number of people suffering from dementia — 50 million in 2020 — is expected to nearly double every 20 years. Alzheimer’s, the most prevalent form of dementia, understandably commands the most attention, as does the doctor, Alois Alzheimer, for whom it is named. The history of Alzheimer’s, however, has one curiously neglected figure: Solomon Carter Fuller, a neurologist, the first U.S. psychiatrist of African descent — and the person who, in the early stages of Alzheimer’s research, arguably did the most to reveal the true nature of the disease. (Cavanaugh, 9/21)

White paper signs provided a sort of bread-crumb trail up to the second floor of the Shane Lalani Center for the Arts. In a room next to a darkened rehearsal space, Mariana Olsen and her husband Will Bernard were busy putting out coffee and snacks. On a small table next to Oreos and other treats was a plastic skull that Bernard named Edward wearing a flat-brimmed hat, silently welcoming visitors to the town’s first ever Death Café. The purpose of a Death Café is not to focus on the macabre or gruesome aspects of dying. Rather, it serves as a communal space where people can discuss all things death-related, from the immediate feelings of losing a loved one to funeral expenses and the administrative side of death, all while enjoying coffee, tea and snacks. (Miller, 9/20)

Twenty miles outside Phoenix in a desolate cemetery, a funeral director opened the door of a black minivan, dusty from the desert dirt. He lifted out the remains of Marjorie Anderson, her ashes inside a plastic urn transported in a cardboard Costco box. An Episcopal chaplain and a few county workers were on hand for her burial, but nobody was there who knew Anderson, a 51-year-old mother of two. Her urn looked exactly the same as 13 others placed alongside the edge of a freshly dug trench. (Jordan and Sullivan, 9/17)

Antitobacco organization Truth Initiative recently hawked a new vaping product to stores and ad agencies, but it wasn’t actually looking to make any sales. The product, the Depression Stick, wasn’t real. It was fabricated to be used as part of a larger marketing campaign titled “We’re Messing With Your Heads,” which aims to convince teenagers that there is a correlation between nicotine products and anxiety and depression. (Bruell, 9/19)

On Nov. 15, 1985, just two months after President Ronald Reagan finally uttered the word “AIDS” publicly, the televangelist Tammy Faye Bakker did something considered bold and fearless at the time: She interviewed a gay man living with HIV on live television and treated him with compassion. “How sad that we as Christians — who are to be the salt of the earth, we who are supposed to be able to love everyone — are afraid so badly of an AIDS patient that we will not go up and put our arm around them and tell them that we care,” Bakker said tearfully during her 24-minute interview with Steve Pieters. (Kacala, 9/17)

This fall, Britain is poised to ban virginity tests—and will consider banning hymen-repair surgery too. That would be an impressive victory, because in an era that prioritizes novel and sensational issues, feminists find it hard to sustain interest in slow, incremental campaigns against harmful traditions. (Lewis, 9/16)

Dr. Mercedes Sobreviela, a gynecologist in this city in northeast Spain, believes it is a woman’s choice whether she has an abortion. She says the “right decision” for a woman is “always the one she wants.” But as a physician in Spain, Dr. Sobreviela believes she has the right to choose as well, and she has chosen not to perform abortions. Her public hospital, University Clinic Hospital of Zaragoza, does not perform them either. In fact, no public hospital in the surrounding region of Aragón, which includes 1.3 million people, will do the procedure. (Casey, 9/21)

The Beizhong International Travel Agency in the eastern city of Tianjin has had only one customer since coronavirus outbreaks that began in July prompted Chinese leaders to renew city lockdowns and travel controls. Most of China is virus-free, but the abrupt, severe response to outbreaks has left would-be tourists jittery about traveling to places they might be barred from leaving. (McDonald and Wu, 9/21)

The Nenets are one of the few Indigenous minorities on the Yamal Peninsula in northwestern Siberia. Their lifestyle is nomadic, following the seasonal migrations of the reindeer they herd. While Covid brought travel to a halt in much of the world, the Nenets of Yamal kept moving. (Babenko, 9/20)

Physicians are taught to treat their patients with compassion. The patient who needs dialysis due to lifestyle choices should be treated just as kindly as the one whose diabetes is hereditary. It’s not the physician’s place to judge. Until it is. Physicians must ration organs based on the ability of patients to fly to transplant centers on short notice. They ration detox beds based on insurance coverage. And in times of crisis, such as during a pandemic, they ration care to patients. (Teneille R. Brown, 9/23)

With 678,000 deaths and rising, Covid-19 is now the deadliest epidemic ever to hit the United States, surpassing the death toll of the 1918 flu, and indeed the combined US military deaths in World War I, World War II, the Korean War, the Vietnam War, the Gulf Wars and the Afghanistan War. There is one overwhelming and grim reality: most of the Covid deaths could have been prevented, but America's fractured culture -- political, economic and personal -- mainly delivered death rather than life. (Jeffrey Sachs, 9/22)

Imagine my surprise when I opened the door to the dental clinic and saw that no one was wearing a mask. Not the two patients in the waiting room and not the three staffers behind the counter. “We don’t have to wear masks?” I asked the receptionist. (David McGrath, 9/23)

For many fully vaccinated Americans, the Delta surge spoiled what should’ve been a glorious summer. Those who had cast their masks aside months ago were asked to dust them off. Many are still taking no chances. Some have even returned to all the same precautions they took before getting their shots, including avoiding the company of other fully vaccinated people. (Craig Spencer, 9/23)

According to their website, the Massachusetts State Police “protect all residents and visitors to the Commonwealth. We regularly partner with local, state, and federal law enforcement agencies on investigations, operations, and training to make Massachusetts a safer place for all. ”With those words, they are proudly in the safety and protection business. So, getting vaccinated against COVID-19 should be a given. It’s a way to keep them safe from a deadly virus and protect themselves and the public. Instead, the union representing some 1,809 of them is taking Governor Charlie Baker to court over the vaccine mandate. (9/23)

Good for California health officials, who are considering a vaccine mandate for the state’s school-age children. Health and Human Services Secretary Dr. Mark Ghaly revealed the state’s thinking on the matter during a briefing Thursday. In mandating COVID-19 vaccines for all eligible students — which currently means ages 12 and older — the state would be taking a page from the Los Angeles and Oakland unified school districts, and a couple of others as well. (9/23)

The map shows where radioactive fallout from 12 years of above-ground atomic testing in the Nevada desert spread during the 1950s and 1960s. Utah and Nevada are almost completely blacked out, and the dark ink spreads across the Midwest and as far north as New York and Canada.Our government has never been forthcoming about what radioactive fallout did to the folks living under those clouds. Even in my hometown of Salt Lake City, people who have suffered cancer, leukemia and other related illnesses and who have lost family, friends and neighbors don't realize how that fallout may have affected them. (Mary Dickson, 9/23)

Recently, former Baltimore Sun reporter, “The Wire” creator and editorialist-at-heart David Simon announced on Twitter that his newest TV project, a nonfiction miniseries “based on events in Texas” won’t be filmed in the Lone Star State. His reasoning was simple. The state’s abortion law, the most restrictive in the U.S. as it essentially bans the procedure after six weeks of pregnancy, precludes it. When closely questioned on this point (which is apt to happen on the social media platform), his response was, if not perfect, at least in proximity to it. Skipping over the more profane moments (another Simon trademark), he observed: “I can’t and won’t ask female cast/crew to forgo civil liberties to film there.” Or, as he later explained: “My first obligation as an employer is to the people working on the production. I can’t ask them to locate in Texas and forgo civil liberties. Not ethical. Ever.” (9/23)

As the government wrestles with lowering health care costs, one strategy gaining momentum is allowing Medicare to negotiate prices for brand name drugs. There is no doubt that such a move would lower the nation’s drug bill. But it would also lower the revenues of biopharmaceutical companies and that, in turn, will reduce the number of new drugs produced each year. (John LaMattina, 9/24)

Schools should be safe, affirming spaces where all students are set up for academic success and provided with equal opportunity to pursue their talents — not a source of discrimination and harassment. Sadly, some Texas state lawmakers are working overtime to make life harder for transgender and nonbinary students, a group of young people who already face significantly increased risk for bullying, depression and suicide. (Amit Paley, Ricardo Martinez and Emmett Schelling, 9/24)

The $3.5 trillion economic reordering bill now moving through Congress contains a long-held Democratic goal—one that was even endorsed by President Trump several years ago—to empower the Department of Health and Human Services to negotiate lower drug prices. Yet, prices are already negotiated by large and powerful health insurers. While the federal government is an even larger payer, it is far from clear that size is what matters in solving America's drug pricing problem. (Karne Mulligan and Darius Lakdawalla, 9/23)

With Democrats' dream of passing a $3.5 trillion budget reconciliation bill in peril, recent reporting suggests that they may get one item on their wish list: a new, permanent federal entitlement to paid family and medical leave. The primary question appears to be whether the proposed entitlement will be modeled after Senator Kirsten Gillibrand's (D-N.Y.) FAMILY Act or Representative Richard Neal's (D-Mass.) universal paid leave proposal. But passing either of these proposals through a rushed, partisan process could hurt workers and endanger Social Security and Medicare. Moderate Democrats would be wise to put this effort on hold as part of Senator Joe Manchin's (D-W.V.) "strategic pause," and to consider alternative paths to paid leave. (Kristin A. Shapiro, 9/23)

More than 70,000 people in the United States died from drug-related overdoses in 2019. The nearly fourfold increase since 1999, fueled by the opioid epidemic, underscores the need for new strategies rather than the failed punitive approach that has criminalized generations of Americans without dealing with their underlying problems. Other countries have shown promising results by setting up overdose prevention sites where people can use illegal drugs under the supervision of trained staff able to offer clean injection equipment, help in the event of an overdose and counseling on treatment. However, any plans to replicate those efforts in the United States have been hindered by the Trump administration’s perverse use of federal drug laws and the apparent refusal of the Biden administration to get involved. (9/23)