�������ýҕ�l

At least 1,000 American deaths linked to coronavirus were reported Tuesday, and the spread shows no sign of slowing down. The harrowing death toll comes as states across the country report record-breaking numbers of new cases. More governors are making masks a requirement as overwhelmed testing labs and hospitals are raising alarm. And officials are debating whether to send children back to school. (Maxouris, 7/22)

Nearly 142,000 Americans have now died from the illness caused by the coronavirus, a toll that experts warn will likely surge following recent record spikes in case numbers and an alarming rise in hospitalizations in many states. But in some states, governors and local officials continued to bicker over the best way to respond to the crisis. (McKay and Bernstein, 7/21)

After falling for months, Covid-19 hospitalizations across the US are on the upswing and approaching the peak levels seen in April. ... At the peak of the pandemic in April, 59,538 people were hospitalized nationwide on April 15, according to the Covid Tracking Project. That number reached its lowest level on June 15 with 27,772 people hospitalized. But as of July 20, that number has climbed back up to 58,330 -- just hints beneath April's high. (Kim, 7/22)

Global coronavirus infections surged past 15 million on Wednesday, according to a Reuters tally, with the pandemic gathering pace even as countries remain divided in their response to the crisis. Globally, the rate of new infections shows no sign of slowing, according to the Reuters tally, based on official reports. (Wardell and Issa, 7/22)

Coronavirus infections in the United States are far higher than what has been confirmed, although the number of Americans who have been exposed is far below what is required for widespread immunity, according to data released by the Centers for Disease Control and Prevention. The data appeared on both the CDC website and in the journal JAMA Internal Medicine on Tuesday. (Slotkin, 7/21)

The study, published Tuesday in JAMA Internal Medicine, relied on serological tests — blood screens that search for antibodies to the virus and that determine whether someone was previously infected. ... Overall, an estimated 1% of people in the San Francisco Bay Area have had Covid-19, while 6.9% of people in New York City have, according to the paper’s authors, who included researchers at the Centers for Disease Control and Prevention and state health departments. In seven of the 10 sites, the estimated number of cases was 10 times the number of reported cases. (Joseph, 7/21)

The study is "corroborating other smaller studies previously done" that show "the infection was much more widespread than we thought," said John Brownstein, an epidemiologist and professor of biomedical informatics at Harvard Medical School. The CDC's most recent estimate is that about 40% of infections come from people who don't show symptoms. That means people who are asymptomatic carriers of the virus may play a large role in community transmission (the spread of the virus through an unknown source in a particular area). (Misra, 7/21)

The number of people infected with the coronavirus in different parts of the United States was anywhere from two to 13 times higher than the reported rates for those regions, according to data released Tuesday by the Centers for Disease Control and Prevention. The findings suggest that large numbers of people who did not have symptoms or did not seek medical care may have kept the virus circulating in their communities. (Mandavilli, 7/21)

In related news, health experts urge standardized data collection —

Six months after the first coronavirus case appeared in the United States, most states are failing to report critical information needed to track and control the resurgence of covid-19, the disease caused by the virus, according to an analysis released Tuesday by a former top Obama administration health official. The analysis is the first comprehensive review of covid-19 data that all 50 states and Washington, D.C., are using to make decisions about policies on mask-wearing and opening schools and businesses. In the absence of a national strategy to fight the pandemic, states have had to develop their own metrics for tracking and controlling covid-19. But with few common standards, the data are inconsistent and incomplete, according to the report released by Resolve to Save Lives, a New York nonprofit led by former Centers for Disease Control and Prevention director Tom Frieden and part of the global health organization Vital Strategies. (Sun, 7/21)

A report today overseen by former Centers for Disease Control and Prevention (CDC) Director Tom Frieden, MD, argues that incomplete and inconsistent COVID-19 data from states, along with the absence of national leadership, is behind the poor US response to COVID-19. The report comes as CDC data suggest that the number of people infected with the coronavirus in different parts of the country is likely far higher than the number of reported cases. (Dall, 7/21)

The Centers for Disease Control and Prevention’s self-isolation rules have been a facet of pandemic life since March. Those who test positive for the coronavirus but who do not have symptoms have counted down the minutes until they could be free to venture out, while the sick have worried about how long they could be a danger to their loved ones. Now the CDC, acknowledging expanded understanding about the infectiousness of the novel coronavirus, has changed some of its recommendations. (Eunjung Cha, 7/21)

The Centers for Disease Control and Prevention (CDC) has updated its guidance on self-isolation for people who test positive for COVID-19. According to the new guidelines, people who are symptomatic with COVID-19 should isolate at home for 10 days after symptoms begin and for 24 hours after your fever has broken. "A limited number of persons with severe illness" and those who are severely immunocompromised may need to isolate for 20 days after symptom onset, the agency said. (Weixel, 7/21)

President Trump abruptly departed on Tuesday from his rosy projections about the coronavirus, warning Americans from the White House briefing lectern that the illness would get worse before widespread recovery. “It will probably, unfortunately, get worse before it gets better,” Mr. Trump said. “Something I don’t like saying about things, but that’s the way it is.” (7/21)

President Donald Trump warned on Tuesday that the “nasty horrible’” coronavirus will get worse in the U.S. before it gets better, but he also tried to paint a rosy picture of efforts to conquer the disease that has claimed more than 140,000 American lives in just five months. He also professed a newfound respect for the protective face masks he has seldom worn. He pulled one from his pocket in the White House briefing room but didn’t put it on. (Miller 7/21)

President Trump, six months into a deadly pandemic and less than four months from Election Day, conceded Tuesday that the coronavirus would “get worse before it gets better” and urged all Americans to wear face masks “whether you like the mask or not.” “If you can, use the mask,” he said. “Think about patriotism.” (Stokols, 7/21)

In his first coronavirus briefing since April, President Donald Trump got a little more accurate about the state of the pandemic in the US -- but also continued to make some of the same false claims and promote some of the same misleading narratives of his previous moments in the White House briefing room. (Dale, Subramaniam, Cohen and Wright, 7/21)

Anthony Fauci, one of the most recognized and trusted faces of the federal coronavirus response, said on Tuesday he was not invited to join President Donald Trump later in the day at a news briefing on the White House pandemic response. Trump announced on Monday he would return to the White House lectern to deliver regular news briefings on the coronavirus — a staple this spring in the early months of the pandemic in the U.S. Those briefings often meandered off topic into campaign-style diatribes, and Trump has continued to use news conferences to express his disdain for his Democratic rivals since the last coronavirus briefing in April. (Choi, 7/21)

Also —

Speaker Nancy Pelosi (D-Calif.) dubbed the coronavirus the “Trump virus” on Tuesday evening, ratcheting up her rhetoric over President Trump’s handling of the pandemic. "Well, I think with the president's comments today, he recognized the mistakes he has made by now embracing mask-wearing and the recognition this is not a hoax. It is a pandemic that has gotten worse before it will get better because of his inaction," Pelosi said on CNN's "The Situation Room." (Axelrod, 7/21)

As Americans still struggle to access coronavirus testing and receive prompt results, President Donald Trump is being screened for the disease as many as “multiple times a day,” his top spokesperson acknowledged Tuesday. “As I’ve made clear from this podium, the president is the most tested man in America,” White House press secretary Kayleigh McEnany told reporters. “He’s tested more than anyone, multiple times a day, and we believe that he’s acting appropriately.” (Forgey, 7/21)

President Donald Trump said he doesn't know of a time he's taken more than one coronavirus test in a day, directly contradicting his press secretary in the first question of his press briefing Tuesday. "I don't know about more than one," Trump responded to a reporter who asked why he was tested more than once a day. "I do probably on average a test every two days, three days, and I don't know of any time I've taken two in one day, but I could see that happening." (Liptak, 7/21)

U.S. officials accused China on Tuesday of sponsoring criminal hackers who are targeting biotech firms around the world working on coronavirus vaccines and treatments, as the FBI said the Chinese government was acting like “an organized criminal syndicate.” In an indictment unsealed in Spokane, Wash., the Justice Department charged two former engineering students with hacking companies engaged in high-tech manufacturing, pharmaceuticals and gaming software development, and with targeting dissidents, clergy and human rights activists in the United States, China and Hong Kong. (Nakashima and Barrett, 7/21)

The Department of Justice (DOJ) on Tuesday rolled out an 11-count indictment against two Chinese hackers allegedly involved in targeting "hundreds" of companies around the world, including most recently U.S. groups researching COVID-19 vaccines and treatments. The indictment alleges that Chinese nationals Li Xiaoyu and Dong Jiazhi stole terabytes of data over ten years from companies in nations including the U.S., Sweden, the Netherlands, Spain, the United Kingdom and Australia. (Miller, 7/21)

Also —

House Minority Leader Kevin McCarthy (R-Calif.) on Tuesday introduced legislation to sanction foreign hackers involved in attempts to target and steal research on COVID-19 vaccines and treatments. The Defend COVID Research from Hackers Act would allow the president to impose sanctions on foreign individuals engaging in hacking activity that compromises economic and national security or public health and freeze any American assets of these individuals. (Miller, 7/21)

A major intraparty rift widened between the White House and Senate Republicans on Tuesday as they stumbled to formulate a unified coronavirus budget plan, lacking agreement on policy goals, spending parameters and even deadlines. The Republican and White House positions changed multiple times as the day went on, with some GOP lawmakers refusing to rally behind President Trump’s demand for a payroll tax cut while others worked to convince White House emissaries that more money was needed for testing and the Centers for Disease Control and Prevention. (Werner, Stein and Min Kim, 7/21)

Republican lawmakers led by Senate Majority Leader Mitch McConnell (R-Ky.) want to keep the price tag of the next round of coronavirus relief legislation at $1 trillion, but that is looking like it will be a challenge. The variety of proposals now being pushed by the Trump administration, GOP lawmakers and Democrats could easily push the new coronavirus relief bill beyond the $2 trillion mark, lawmakers and aides acknowledge. (Bolton, 7/22)

With fewer than three weeks to go until the August recess -- and with the virus still ravaging many corners of the country -- Tuesday's negotiations marked little progress, and instead evolved into a day of venting sessions for rank-and-file members, each with his or her own idea of how to tackle the next chapter of spending. It all comes just days before a $600 federal enhancement to unemployment insurance is set to expire. (Mattingly and Fox, 7/21)

McConnell said that after he gets Republicans on board, his proposal will be used as a starting point for bipartisan discussion. He needs at least seven Democratic votes. ... Asked later whether he expects a bill to pass by end of next week, McConnell laughed and said "no," according to a pool report. (Kapur, Tsirkin, Haake and Hunt, 7/21)

Republican leaders labored on Tuesday to avert a party revolt over the next round of coronavirus aid, announcing that they planned to provide $105 billion for schools, direct payments to American families and more aid for struggling small businesses as rank-and-file lawmakers balked at the proposal’s cost. Even as Senator Mitch McConnell of Kentucky, the majority leader, divulged details of his emerging plan, expected to total roughly $1 trillion, President Trump had yet to sign on and Republicans remained deeply divided over several key elements. (Cochrane and Broadwater, 7/21)

Top Democrats on Tuesday pressed GOP leaders to pick up the pace on coronavirus relief, needling the Republicans with the unsubtle reminder that the sides can't negotiate a deal without a GOP bill. "They're all in disarray — you hear different Republicans say different things — and we can't negotiate on a vague concept. That's not how it's going to work," Senate Minority Leader Charles Schumer (D-N.Y.) told reporters. "We need a specific bill," he added. (Lillis, 7/21)

Senate Majority Leader Mitch McConnell (R-Ky.) on Tuesday provided a broad outline for what to expect in the forthcoming Republican coronavirus relief proposal, including help for schools, small businesses and testing. McConnell, speaking from the Senate floor, indicated that he would soon be unveiling the Republican proposal after swapping ideas with the administration in recent weeks. "The majority will be laying down another historic proposal very soon," McConnell said. (Carney, 7/21)

In related news —

The White House has indicated it doesn't want Senate Republicans to push for any additional funding for testing and contact tracing activities in the next major COVID-19 relief package lawmakers are hoping to pass. The Trump administration in June issued guidance letting insurers off the hook for paying for testing for public health surveillance or occupational health purposes. Lawmakers seem unlikely to force insurers to pay; getting government funding for tests is the safest option so employers, patients and labs aren't stuck with the bills. (Cohrs, 7/22)

Despite severe shortages in coronavirus testing supplies and lags in results, the Trump administration is still sitting on billions of dollars in unused funding that Congress allocated months ago. Lawmakers on both sides of the aisle have questions about why the money has not been used as testing continues to fall well short of the national need. (Fox, 7/21)

The pharmaceutical industry does not want you to worry about the safety or efficacy of a future Covid-19 vaccine. Officials from five major vaccine makers — AstraZeneca, Johnson & Johnson, Merck, Moderna, and Pfizer — all used their testimony before a House investigative subcommittee on Tuesday to push back on concerns that the Food and Drug Administration might prematurely approve a vaccine for the novel coronavirus and thereby put Americans at risk. (Garde, 7/21)

Companies behind leading coronavirus vaccine candidates told lawmakers Tuesday they're not worried that political pressure will lower standards for approval of any eventual shot — but they need the government to decide who gets it first. President Donald Trump has repeatedly promised a vaccine by the end of the year, raising concerns that his administration will rush to approve one without adequate proof that it works. (Owermohle, 7/21)

Drug company executives sought to reassure House Democrats that the federal government is not lowering its approval standards, and any coronavirus vaccine that gains approval will be safe. Executives from Moderna, Janssen, Merck, AstraZeneca and Pfizer told lawmakers during an Energy and Commerce subcommittee hearing Tuesday that despite the unprecedented speed, any vaccine candidate will be safe. (Weixel, 7/21)

Representatives of five companies developing coronavirus vaccines testified before a House panel Tuesday about their quest to produce shots in record time — and distribute them worldwide. Pharmaceutical executives’ appearances on the Hill in recent years have almost entirely been tied to the heated debate over high drug costs, from soaring insulin prices to patent games that limit generic competition. (Owermohle, 7/21)

Joe Biden offered a massive plan on Tuesday to create 3 million jobs and improve care for children and the elderly as he accused President Donald Trump of having “quit” on the country during a deadly pandemic. The presumptive Democratic presidential nominee promised to spend more than three quarters of a trillion dollars — $775 billion over 10 years — to increase tax credits for low-income families, bolster care-giving services for veterans and other seniors and provide preschool for all 3- and 4-year-olds. (Weissert and Jaffe, 7/21)

Former Vice President Joe Biden will announce a new plank of his economic recovery plan Tuesday, focused on boosting the nation's workforce of caregivers and early childhood educators. The plan aims to ensure American families have access to affordable child care and builds on the presumptive Democratic presidential nominee's earlier promise of free preschool for all three- and four-year-olds, by way of federal funding, extra tax credits and subsidies provided on a sliding scale. (Gaudiano, 7/21)

Throughout most of his campaign, Joe Biden has sought to put forward a singular idea: I care. On Tuesday, he extended that sentiment into a specific proposal — to provide hundreds of billions of dollars for the care of young and old Americans. The proposal, which would cost $775 billion over 10 years, would provide universal preschool to 3- and 4-year-old children, fund the construction of new child-care facilities and offer tax credits and grants to help pay for care positions for the young and the elderly. (Linskey and Viser, 7/21)

Democratic officials are moving toward a 2020 platform that promises universal access to health care, an overhaul to the U.S. criminal justice system and sharp reductions in carbon pollution driving the climate crisis, but it stops short of many goals pursued by the party’s left flank. An 80-page draft platform obtained Tuesday evening by The Associated Press presents a broadly liberal program for the country. The approach reflects presumptive presidential nominee Joe Biden’s effort to balance the center-left establishment that has been his political home for decades with the party’s ascendant progressive wing. (Barrow, 7/22)

Kaiser Health News: Another Problem On The Health Horizon: Medicare Is Running Out Of Money 
Everyone involved even tangentially in health care today is completely consumed by the coronavirus pandemic, as they should be. But the pandemic is accelerating a problem that used to be front and center in health circles: the impending insolvency of Medicare. With record numbers of Americans out of work, fewer payroll taxes are rolling in to fund Medicare spending, the numbers of beneficiaries are rising, and Congress dipped into Medicare’s reserves to help fund the COVID-19 relief efforts this spring. (Rovner, 7/22)

Clover Health, a venture capital-backed startup that sells health insurance to seniors, is planning a big expansion into more states and counties next year on the heels of rapid membership growth in 2019. San Francisco-based Clover said it intends to sell Medicare Advantage plans in 69 additional counties in its existing markets of Arizona, Georgia, New Jersey, Pennsylvania, South Carolina, Tennessee and Texas. It will also enter five counties in Mississippi, a new market. Currently, Clover sells Advantage plans in 34 counties across seven states. (Livingston, 7/21)

In Medicaid news —

Georgia’s faulty oversight of private Medicaid management contractors has left the state’s Medicaid program vulnerable to overpaying for health care and to fraud, a state auditor’s report has found. Over seven years from 2013 to 2019, a total of $41 million in claims the contractors paid out for Medicaid “were not subject to adequate oversight and claims review,” the report says, and some questionable claims were forwarded to the state for review but left to languish for years. (Hart, 7/21)

U.S. hospitals' median operating margin could sink to -7% by the end of 2020 without additional federal government support to offset COVID-19 losses, a new report finds. The American Hospital Association commissioned the report from healthcare consultancy Kaufman Hall and timed its release on Tuesday to coincide with bipartisan talks around a new federal COVID-19 relief package, just as increased unemployment benefits are set to expire. The prominent hospital lobbying group has released multiple reports during the pandemic to support its requests for more federal grants and loans. (Bannow, 7/21)

Should your doctor ask you to make a donation to help the medical center where you were treated? If you are a generous donor, should you be rewarded with a better room — or your doctor’s cellphone number? Medical centers across the United States are asking patients, especially wealthy ones, to donate money, in addition to whatever they pay for actual care. The money is needed, the providers say, to defray costs or provide charity care. (Kolata, 7/21)

Also —

While healthcare industry lobbying dipped in the second quarter of 2020, private equity-backed physician staffing firms beefed up their work on Capitol Hill. Envision Healthcare and TeamHealth were the two largest backers of a dark-money group that blanketed airwaves with ads opposing benchmarking policies to protect patients from surprise medical bills. Despite cutting physicians' hours due to the COVID-19 pandemic, both increased their lobbying spending last quarter. (Cohrs, 7/21)

A fund launched in 2012 by the biotech venture capital firm Flagship Pioneering is on track to return its investors’ money nine times over. That’s the eyebrow-raising return multiple for Flagship Ventures Fund IV — the highest recorded return multiple in a new STAT report that took a deep dive into returns data for more than a dozen of the country’s top biotech venture capital firms. (Sheridan, 7/22)

Only a small proportion of people in many parts of the United States had antibodies to the novel coronavirus as of this spring, indicating most of the population remains highly susceptible to the pathogen, according to new data from the Centers for Disease Control and Prevention. The agency also reported the number of actual coronavirus infections is probably far higher — by two to 13 times — than reported cases. The higher estimate is based on the study on antibodies, which indicates who has had the virus in the past. Currently, the cumulative number of reported cases in the United States stands at 3.8 million. (McGinley, 7/21)

New research suggests that antibodies the immune system makes to fight the new coronavirus may only last a few months in people with mild illness, but that doesn’t mean protection also is gone or that it won’t be possible to develop an effective vaccine. “Infection with this coronavirus does not necessarily generate lifetime immunity,” but antibodies are only part of the story, said Dr. Buddy Creech, an infectious disease specialist at Vanderbilt University. He had no role in the work, published Tuesday in the New England Journal of Medicine. (Marchione, 7/21)

Aerosol samples collected from the hospital rooms of six COVID-19 patients in April contained infectious virus, adding to mounting evidence that the coronavirus is spread via aerosols in addition to large respiratory droplets, a non–peer-reviewed University of Nebraska study has found. The study, published yesterday on the preprint server medRxiv, identified RNA from SARS-CoV-2, the virus that causes COVID-19, on reverse transcription-polymerase chain reaction, which cannot discern whether the particles are infectious. But increases in viral RNA on cell culture showed significant growth of infectious virus in 3 of 18 aerosol samples after 5 or 6 days. Western blot and transmission electron microscopy also demonstrated evidence of intact virus. (7/21)

Of the 3,334 consecutive patients hospitalized with COVID-19 at a New York City hospital, 553 (16%) had thrombosis (blood clots), according to a research letter published yesterday in JAMA. Researchers at New York University Langone Health who analyzed the data of coronavirus patients hospitalized from Mar 1 to Apr 17 characterized the blood clots as deep vein thrombosis (DVT), pulmonary embolism (PE) and heart attack, ischemic stroke, and another systemic blood clot. (7/21)

In other science news —

One of the great mysteries of the coronavirus is how quickly it rocketed around the world. It first flared in central China and, within three months, was on every continent but Antarctica, shutting down daily life for millions. Behind the rapid spread was something that initially caught scientists off guard, baffled health authorities and undermined early containment efforts — the virus could be spread by seemingly healthy people. As workers return to offices, children prepare to return to schools and those desperate for normalcy again visit malls and restaurants, the emerging science points to a menacing reality: If people who appear healthy can transmit the illness, it may be impossible to contain. (Johnson, Sedensky and Choi, 7/22)

Six months into the pandemic, researchers are homing in on an answer to one of the basic questions about the virus: How deadly is it? Researchers, initially analyzing data from outbreaks on cruise ships and more recently from surveys of thousands of people in virus hot spots, have now conducted dozens of studies to calculate the infection fatality rate of Covid-19. (Abbott and Douglas, 7/21)

Scientists racing to develop a safe and effective COVID-19 vaccine are turning to what may seem like an odd ally: another family of viruses. At least five vaccine candidates are built on the backs of adenoviruses, a common family of pathogens that are often used as vehicles for delivering a variety of therapies to human cells. A sixth candidate uses a near relative of the family. (Wilson, 7/21)

While the race for a Covid-19 vaccine continues, scientists are learning more about the early vaccines used to fight smallpox, the only human infectious disease to be successfully eradicated. A new study published in Genome Biology on Sunday, carried out by scientists and historians from McMaster University, the Mütter Museum and the University of Sydney, identified five vaccine strains used by Civil War-era physicians to protect people from smallpox. (Giuliani-Hoffman, 7/21)

Kaiser Health News: Scientists Want To Know More About Using UV Light To Fight COVID-19 Spread 
High up near the ceiling, in the dining room of his Seattle-area restaurant, Musa Firat recently installed a “killing zone” — a place where swaths of invisible electromagnetic energy penetrate the air, ready to disarm the coronavirus and other dangerous pathogens that drift upward in tiny, airborne particles. Firat’s new system draws on a century-old technology for fending off infectious diseases: Energetic waves of ultraviolet light — known as germicidal UV, or GUV — are delivered in the right dose to wipe out viruses, bacteria and other microorganisms. (Stone, 7/22)

Hearts collected from nearly two dozen patients who died of coronavirus at University Medical Center are offering LSU researchers clues about how the disease affects vital organs, according to new research published Tuesday in Circulation, a journal of the American Heart Association. (Woodruff, 7/21)

The Detroit Public Schools Community District must test summer school students for COVID-19, U.S. District Judge Arthur Tarnow ordered Tuesday. Tarnow ordered the testing to begin Wednesday. Superintendent Nikolai Vitti said the district has worked with the city of Detroit to obtain tests. (Wisely, 7/21)

Tomball Independent School District announced in a press release Monday, July 20, its new partnership with Axiom Medical by providing district staff across all facilities health care support amid the COVID-19 pandemic to guide and encourage employees at schools. On top of safety protocols and guidelines ready in preparation for the 2020-21 school year, Tomball ISD employees will have an extra layer of care when school starts August 18 by using Axiom’s CheckIn2Work application. Axiom Medical is an occupational health services and incident case management provider for employers based out The Woodlands. (Montano, 7/21)

In a major reversal, the superintendents of three large public school systems in Virginia and Maryland are calling for an all-virtual start to the fall semester, scrapping earlier plans to offer a mix of in-person and distance learning. The superintendents of Fairfax County Public Schools and Loudoun County Public Schools, both in Northern Virginia, argued for an online-only start in meetings with their school boards Tuesday. The superintendent of Montgomery County Public Schools in Maryland announced the switch in an email late Tuesday afternoon to parents, students and staffers. (Natanson and St. George, 7/21)

Experts still say if families live in a hot spot or a family member is vulnerable to a severe case of Covid-19, children should remain as dedicated as ever to disinfection routines, distancing from people outside the home, wearing a mask and washing their hands even more than they did before the pandemic. Outside of those situations, parents can relax at least one of the most stringent and challenging measures they took earlier this year — without raising risk significantly: they no longer need to completely isolate their young children, Dr. Chiang said. Similar guidance is implicit in the reopening guidelines for schools released in late June by the American Academy of Pediatrics, or A.A.P., which advocates for “having students physically present in school.” (Lloyd, 7/20)

As schools reopen in the fall, previously common and insignificant situations will carry new prospects of danger. To guide districts’ responses, the state Department of Elementary and Secondary Education this week released protocols for when students, staffers, or families experience symptoms or test positive for COVID-19 — a 19-page plan that makes clear how complicated and challenging the new school year will be. (Martin, 7/21)

In higher education news —

Hopes that college life might begin a slow return to normal this fall were deflated Tuesday, when two University of California campuses announced they would begin the semester with fully remote instruction amid a pandemic surge. UC Berkeley and UC Merced had hoped to open Aug. 26 with a mix of online, in-person and hybrid classes. But they reversed those plans as COVID-19 infections began their record-shattering increases throughout California, with cases now topping more than 400,000 and deaths, 7,800. In Los Angeles County, half of new COVID-19 cases were among those ages 18 to 40. (Watanabe, 7/21)

In January Emerson College seemed poised for a great spring semester. The glass and concrete renovation of the Little Building dormitory, perched on the edge of Boston Common, was open after a multi-year renovation that breathed new life into the historic building. The school’s Los Angeles campus was financially solid, and enrollment was strong. The school had taken on significant debt to finance the renovation, but administrators were confident that strong demand for their well-known arts and media programs would allow them to use 2020 to begin to recover from the expensive building project. (Krantz and Fernandes, 7/20)

Also —

The Trump administration is resisting calls to make it easy for tens of millions of students to get free meals at school this year, even as childhood hunger rates have risen to the highest levels in decades.During the spring and summer, as the coronavirus health crisis exploded, the government allowed most families to pick up free meals from whichever school was closest or most convenient without proving they were low-income. But that effort is on the verge of expiring as states prepare for children to return to school, and as school systems are pushing the federal government to continue the free meals program through the fall. (Bottemiller Evich and Perez Jr., 7/20)

A judge on Monday denied a motion to release a Michigan teenager who has been held at a juvenile detention facility since May for not completing her online coursework, the latest development in a case that has raised a national outcry. Judge Mary Ellen Brennan of the Oakland County Circuit Court ruled that the teenager, who violated the terms of her probation by skipping coursework when her school switched to remote learning because of the coronavirus pandemic, should remain at the juvenile facility. The judge said the decision was intended for the girl’s own good. (Gross, 7/21)

Georgia Gov. Brian Kemp (R) asked his state’s residents to “commit” to wearing a mask for four weeks, despite his ongoing lawsuit against Atlanta officials for mandating a face covering be worn. "Today, I am encouraging all Georgians – from every corner of our great state – to do four things for four weeks to stop the spread of COVID-19," Kemp said in a statement. "If Georgians commit to wearing a mask, socially distancing, washing their hands regularly, and following the guidance in our Executive Order and from public health officials, we can make incredible progress in the fight against COVID-19..." (Axelrod, 7/21)

A month after Harris County Judge Lina Hidalgo issued her order mandating that businesses require customers wear masks, indications are emerging that the novel coronavirus’ surge in the Houston area may be starting to taper off. The improvement is reflected in a number of recent trends — a plateau, then decline, in Texas Medical Center hospitalizations; a drop in the positive diagnostic test rate in the metro area; and a downward trajectory in the amount of viral spread in the community. The improvement follows a post-Fourth of July spike that halted earlier momentum. (Ackerman, 7/21)

Marriott Hotels will soon require guests to use facial coverings in its 7,300 hotels worldwide, chief executive Arne Sorenson announced Monday in a video. The world’s biggest hotel chain has required employees to wear masks for months, but effective Monday, the rule will also apply to customers in all indoor public spaces, Sorenson explained after removing his own purple mask. (Telford, 7/21)

In other news about masks —

HHS' Office for Civil Rights resolved two religious discrimination complaints against hospitals, the agency said Tuesday. Staten Island University Hospital in New York paused medical student rotations in response to the COVID-19 pandemic, later requiring returning students to fit-test and wear N95 respirator masks when serving patients. It asked a returning student to shave his beard to ensure he could wear an N95 mask correctly, even though he passed an N95 fit test with his beard before the COVID-19 outbreak. (Brady, 7/21)

One of the original "Rosie the Riveters" is serving her country once more. Mae Krier, 94, worked in a Boeing factory during World War II, where she helped make warplanes. Now, she's helping fight a different battle — coronavirus. (Asmelash, 7/21)

If people washed their hands regularly, wore masks, and kept their social distance from each other, these three simple behaviors could stop most all of the Covid-19 pandemic, even without a vaccine or additional treatments, according to a new study. The study, published Tuesday in the journal PLoS Medicine, created a new model to look at the spread of the disease and prevention efforts that could help stop it. (Christensen, 7/22)

A state-run veterans nursing home in Pennsylvania where 42 residents have died of COVID-19 failed to take steps to prevent the spread of the coronavirus, state Health Department inspectors concluded. Health inspectors said in a report that Southeastern Veterans’ Center, a 292-bed facility outside Philadelphia, ignored state and federal guidelines meant to control the virus in nursing homes. The lapses put 128 of the facility’s 154 residents in “immediate jeopardy,” according to the Health Department — a legal finding that means Southeastern placed its patients at risk of serious injury or death. (Levy and Rubinkam, 7/21)

On March 10, Loretta Mendoza Dionisio became the first person in Los Angeles County known to have died of COVID-19. Dionisio was 68, had diabetes and had just returned from a trip to her native Philippines. That made her a precursor of the coming pandemic in more ways than one. For a variety of reasons, Filipino Americans have been hit hard by the novel coronavirus. (Wong, 7/21)

Kaiser Health News: Essential And In Danger: Coronavirus Sickens, Even Kills Public Health Workers
As a veteran public health worker, Chantee Mack knew the coronavirus could kill. She already faced health challenges and didn’t want to take any chances during the pandemic. So she asked — twice — for permission to work from home. She was deemed essential and told no. Eight weeks later, she was dead. (Ungar, 7/22)

An Oakland nurse who cared for COVID-19 patients died after contracting the disease, becoming one of more than 100 California health care workers who have lost their lives due to the coronavirus. Janine Paiste-Ponder, 59, who worked as a nurse at Sutter Alta Bates Summit Medical Center, died on July 17, according to the Alameda County coroner. She was a member of the California Nurses Association union for more than 25 years. (Moench, 7/21)

Many of the attacks against Pennsylvania’s health secretary have little to do with the way she has handled the statewide response to the coronavirus pandemic. As a transgender woman, Dr. Rachel Levine has been subjected to a stream of mockery and abuse on social media and elsewhere. Every time she goes on camera to update the public and implore Pennsylvanians to wear masks, wash their hands and “stay calm, stay alert and stay safe,” ugly comments and memes follow. (Rubinkam, 7/21)

A powerful storm could uproot tens of thousands of people at a time when coronavirus infections and deaths from COVID-19 are soaring through the region. Congregate shelters, from school gyms to vast convention centers, risk becoming infection hot spots if evacuees pack into them. Shelters are managed by the American Red Cross under the supervision of the Federal Emergency Management Agency. But the Red Cross intends to adhere to new guidelines based on the Centers for Disease Control and Prevention's social distancing standards, which could cut shelter capacity by as much as 60%, according to local emergency managers. (Wendle, 7/22)

Chronic stress can change your brain. Experiencing racism could make it worse. Racial discrimination may increase stress, lead to health problems and hamper cognitive function for Black women, a new study finds. (Rogers, 7/21)

Right to Life of Michigan has abandoned a petition drive aimed at outlawing an abortion procedure, the group announced Tuesday. Right to Life had collected signatures for a legislative initiative to ban an abortion procedure that is medically known as dilation and evacuation, a procedure that abortion opponents call "dismemberment abortion." (Egan, 7/21)

Kaiser Health News: Bingeing On Doom: Expert On The ‘Black Death’ Attracts Cult Following 
Before COVID-19, Purdue University English professor Dorsey Armstrong was well known in a way that only other enthusiasts of medieval literature and culture might appreciate. That is to say, she once got a discount on a replica of an Anglo-Saxon drinking horn — made from an actual cattle horn — because a guy at a conference recognized her. “That’s the only time I felt famous,” said Armstrong, an expert in medieval studies who heads the English department at Purdue in Indiana. (Aleccia, 7/22)

In tech news —

As digital health tools proliferate, health data experts are raising a new round of alarms about the need to educate consumers about data privacy until legislative protections catch up. The pandemic has sidelined many in-person visits, driving flocks of potential new users toward mental health apps, virtual visits, and other digital tools to manage their care. But consumers are often unaware that the rules that govern health data privacy in hospitals don’t extend to these sprawling, digital territories — each of which can effectively enforce its own policies around how to handle sensitive data, experts said. (Isselbacher, 7/21)

Beth Israel Deaconess Medical Center has a problem familiar to many hospitals: Too many patients aren’t being discharged when they’re healthy enough to go home. It’s an issue with wide-ranging ripple effects: Because of operational holdups, much-needed beds remain filled when they don’t need to be, leading emergency rooms to become congested. Patients must often be sent wherever there’s a free bed, even when it’s not the best ward for them to be treated, which might further delay their discharge. (Robbins, 7/22)

Massachusetts is one of six states launching an online tool designed to help people find addiction treatment. The national nonprofit Shatterproof created the website known as ATLAS, an Addiction Treatment Locator, Assessment and Standards platform. The site offers information about addiction treatment providers, including the types of services, medications and accepted insurance. It also allows patients to see and provide feedback about their experiences with providers. (Becker, 7/21)

Also —

Krista Vernoff, the executive producer behind “Grey's Anatomy,” said the show will be addressing the COVID-19 pandemic in its coming season. During a virtual panel discussion held by the Television Academy that is set to air on YouTube later Tuesday, Vernoff confirmed the series is “going to address this pandemic for sure” in its 17th season, according to an exclusive report by Entertainment Weekly. (Folley, 7/21)

Fifty-nine National Football League (NFL) players in total have tested positive for COVID-19, the players’ union said, with rookies scheduled to report to their teams on Tuesday and training camps opening for all players from July 28. Including other individuals within the NFL, such as staff members, who have tested positive, the total number of cases stand at 95, a spokesman for the union NFLPA said. (7/21)

When the pandemic forced artist and video game developer Steve Derrick to work from home, he found himself with extra time on his hands that he said he did not want to spend watching Netflix or Hulu. When he stumbled on a magazine photo of a nurse who had just spent a long shift treating Covid-19 patients, he decided to paint her with marks from her PPE and all. This led him to paint more than 100 portraits of frontline medical workers and send the paintings to his subjects, free of charge. (Kinder, 7/21)

Planned Parenthood of Greater New York will remove the name of the national organization’s founder, Margaret Sanger, from a Manhattan clinic in an attempt to reckon with her ties to the eugenics movement, the organization announced Tuesday. An early feminist activist, Sanger is widely regarded as a pioneer in American reproductive rights. She opened the first birth control clinic in the United States more than a century ago, and helped create access to birth control for low-income, minority and immigrant women. But she was also a vocal supporter of the now-discredited eugenics movement, which aimed to improve the human race through planned breeding based on genetic traits. (Schmidt, 7/21)

Planned Parenthood of Greater New York will remove the name of pioneering birth control advocate Margaret Sanger from its Manhattan health clinic because of her “harmful connections to the eugenics movement,” the group announced on Tuesday. Sanger, one of the founders of Planned Parenthood of America more than a century ago, has long provoked controversy because of her support for eugenics, a movement to promote selective breeding that often targeted people of color and the disabled. “The removal of Margaret Sanger’s name from our building is both a necessary and overdue step to reckon with our legacy and acknowledge Planned Parenthood’s contributions to historical reproductive harm within communities of color,” Karen Seltzer, the chair of Planned Parenthood of New York, said in a statement. “Margaret Sanger’s concerns and advocacy for reproductive health have been clearly documented, but so too has her racist legacy.” (7/21)

New York, New Jersey and Connecticut are now requiring visitors from 31 states to quarantine for 14 days in an effort to combat the growing number of coronavirus cases in the country. The metro area announced Tuesday that 10 additional states would be added to the travel advisory that mandates the quarantine: Alaska, Delaware, Indiana, Maryland, Missouri, Montana, Nebraska, North Dakota, Virginia and Washington. Minnesota was removed from last week’s list. (Coleman, 7/21)

Black mayors in many of the nation's largest cities on Tuesday formally called on governors to repeal orders prohibiting them from enacting strategies that reduce the spread of COVID-19. The African American Mayors Association passed a resolution beseeching state leaders to repeal any rules that prohibit local leaders from implementing strategies like requiring the use of face masks. (Romo, 7/21)

The Oregon Health Authority has reported 299 additional confirmed and presumptive coronavirus cases in the state, bringing the state’s total number of cases since the pandemic began to more than 15,000. In addition on Tuesday seven more deaths were reported, bringing the state’s death toll to 269 people. That ties the state’s record for the most deaths reported in a single day, The Oregonian/OregonLive reported. The authority also said an outbreak of 23 cases of COVID-19 has been reported at a Walmart Distribution Center in northeastern Oregon’s Umatilla County. (7/21)

Coronavirus testing in Connecticut returned at least 90 false positives due to a “flaw” in the state’s testing system, Connecticut’s Department of Public Health announced Monday. A total of 144 people tested positive using a system developed by Massachusetts-based Thermo Fisher Scientific in the period between June 15 and July 17, the department said. Nearly all of the tests affected by the flaw were taken from residents of nursing homes or assisted living facilities, according to acting Public Heath Commissioner Deidre Gifford. (Budryk, 7/21)

Coronavirus spread so quickly through a convent in Michigan that it claimed the lives of 12 sisters in one month, beginning on Good Friday. They were all members of the Felician Sisters convent in Livonia, outside of Detroit, ranging in ages from 69 to 99, the executive director for mission advancement, Suzanne English, confirmed to CNN on Tuesday. A 13th sister initially survived the virus but passed away from its effects in June. (Jackson, Riess and Paget, 7/21)

Louisiana has extended phase two of its economic reopening plan amid coronavirus pandemic, as the state continues to see a spike in cases and deaths. The extension of the second phase, announced Tuesday by Gov. John Bel Edwards (D), comes as 1,691 news cases of COVID-19 were reported, bringing the total number of cases in the Bayou State during the pandemic to over 96,000. The state's positivity rate has climbed above 15 percent. (Johnson, 7/21)

Navajo Nation health officials on Tuesday reported 22 more confirmed cases of COVID-19 and three additional known deaths. The total of infected tribal members on the vast reservation now stands at 8,639 with 425 known deaths. Residents of the reservation that extends into Arizona, New Mexico and Utah have been under a mandate to wear masks when out in public. (7/22)

The director of the Maine Center for Disease Control and Prevention said the state will do more to promote flu vaccines this year to try to take the strain off the health care system during the coronavirus pandemic. Maine promotes flu shots every year, but they’re especially important this year because of all the resources being used to combat the pandemic, Maine CDC director Nirav Shah said Tuesday. Residents typical start getting flu shots in early fall, and Shah said “it’s likely COVID-19 will still be with us” at that time. (7/21)

In news from Oklahoma —

As the number of people hospitalized due to complications from COVID-19 increases, the Oklahoma State Department of Health updated its hospital surge plan to boost the number of beds available for patients, if needed. The plan state health and hospital officials unveiled Tuesday would add 340 additional beds across seven hospitals in Oklahoma City and one in Tulsa. (Forman, 7/22)

Oklahoma Gov. Kevin Stitt said Tuesday that no one he was in contact with in the days before he tested positive for the coronavirus has come down with the virus. “We’re not out of the woods yet, but it underscores the opportunity for Oklahoma to tackle COVID-19 when we take personal action and listen to the guidance from our public health officials,” that include being tested at the first sign of any symptoms, the Republican governor said. (Miller, 7/21)

In news from California —

A sustained surge in COVID-19 patients pouring into some California hospitals has alarmed local and state officials, and is putting pressure on other counties in the state to prepared for an influx of cases not yet seen since the coronavirus pandemic began. More than 400,700 Californians have been infected by the virus and 7,755 have been killed, as of Tuesday morning. And more Californians are hospitalized with the virus than at any other time: Nearly 7,100 people are in the hospital with COVID-19, and about 28% of those hospitalized patients are receiving intensive care. (Yoon-Hendricks, 7/21)

Essential workers still on the job at San Francisco International Airport say they are grappling with paying for health insurance for themselves and their families, which could leave them more vulnerable to the coronavirus. San Francisco Supervisors Shamann Walton and Rafael Mandelman said Tuesday they are seeking an ordinance that would lower costs for airport workers. (DeFeliciantonio, 7/21)

In news from Texas —

After a sudden surge in reported COVID- 19 cases beginning at the end of June, Houston's daily case count and hospital admission rates seem to be leveling off. Health officials say they're not ready to determine if the data are statistically significant yet, but it's a positive trend. Last Friday, experts were ringing alarm bells. (Harab, 7/21)

More than 500 women at a federal medical prison in Texas have tested positive for the coronavirus, in one of the largest confirmed outbreaks at a federal prison, the Bureau of Prisons said. The number of confirmed cases at the Federal Medical Center-Carswell in Fort Worth jumped to 510 on Tuesday, just two days after the Bureau of Prisons reported that 200 women there had tested positive for COVID-19, the illness caused by the coronavirus. Only the federal prison in Seagoville, also located in the Dallas-Fort Worth area, had more infected inmates, with 1,156 cases as of Tuesday. (7/22)

Chinese officials are hailing a visit by a team of experts sent to Beijing by the World Health Organization to investigate the source of the coronavirus as evidence that the country is a responsible and transparent global power. But the investigation by the W.H.O. is likely to take many months and could face delays. For starters, there are logistical headaches. China has placed the advance team of experts who are laying the groundwork for a broader investigation under a standard 14-day quarantine, forcing them to do some of their detective work from a distance. (Hernandez and Qin, 7/21)

More than one in five people in Delhi have been infected with the coronavirus, according to a study released Tuesday, indicating that most cases in the Indian capital region have gone undetected. The National Center for Disease Control tested 21,387 people selected randomly across Delhi, the state that includes New Delhi, and found that 23.48% had antibodies to the virus. Adjusting for false positives and negatives, it estimated that 22.86% of the population had been infected by the virus, Dr. Sujeet Kumar Singh, who heads the institute, said in a news conference Tuesday. (Schmall and Ghosal, 7/21)

One of the few countries to welcome U.S. tourists has changed its mind, citing soaring infection numbers. The Bahamas will close its borders to most visitors from the United States starting Wednesday, Prime Minister Hubert Minnis said Sunday. While commercial flights from Canada, Britain and the European Union will still be allowed to land, all visitors must show proof that they tested negative for the coronavirus at an accredited lab in the past 10 days. Other international flights will be banned. (Noori Farzan, 7/20)

The tourist hotspot of Niagara Falls has gained a new photo-op for social distancing Canadian visitors on board ferries taking them into the mist of the falls: crowds of Americans. Although cases of COVID-19 continue to rise across the United States, neighboring Canada has largely managed to contain the spread of the virus, helped by strict social distancing measures and mandatory masks in several jurisdictions. At the famous waterfalls on the U.S.-Canadian border, Canadian ferries are limited to just six passengers per boat, out of a 700 person capacity. But on the U.S. side, the ferries are operating at 50% capacity, according to Maid of the Mist boat tours. (Osorio, 7/21)

The Nobel Foundation, which manages the prestigious Nobel Prizes, says it has canceled the traditional December banquet at the Stockholm City Hall due to the coronavirus pandemic. Lars Heikensten, CEO of the Nobel Foundation, said it is not possible to gather up to 1,300 banquet guests and let them sit next to each other amid the current COVID-19 restrictions. He said the pandemic also makes it uncertain whether prize winners can travel to Sweden. (7/22)

Victoria Premier Daniel Andrews said nine out of 10 people did not self-isolate between having symptoms and being tested. More than half did not self-isolate between when they were tested and when they got the results. Andrews also announced two more deaths, both men in their 90s, bringing the national death toll to 128. Face masks will become compulsory from Thursday for residents in lockdown regions when they leave their homes. (7/22)

Residents of Australia’s second most populous city, Melbourne, must wear masks when leaving home from Wednesday as the country posted a record rise in novel coronavirus cases while New South Wales state was on “high alert." Australia recorded 501 new coronavirus infections in the past 24 hours, its highest since the epidemic took hold in March. Its death toll also rose by 2 to 128. Victoria state, of which Melbourne is capital, accounted for most of the new cases, with 484. (Pandey, 7/21)

Lebanon’s hospitals, long considered among the best in the Middle East, are cracking under the country’s financial crisis, struggling to pay staff, keep equipment running or even stay open amid a surge in coronavirus cases. Private hospitals, the engine of the health system, warn they may have to shut down. Chronically underfunded public hospitals, which have led the fight against the virus, fear they will be overrun. (El Deeb, 7/22)

Two government ministers in Brazil have tested positive for the coronavirus as the country – second only to the U.S. in the number of infections – surpassed 80,000 deaths from the disease. Citizenship Minister Onyx Lorenzoni, a close ally of President Jair Bolsonaro, and Education Minister Milton Ribeiro announced separately their diagnoses on social media. (Neuman, 7/21)

In the weeks and months that followed the March 13 diagnoses of four recent travelers from Europe, the nation of 3.4 million would keep the virus in check. Wedged between Brazil, suffering the second-worst outbreak in the world, and Argentina, where infections are now surging, Uruguay has reported just 1,064 cases and 33 deaths — unusually low numbers for a Latin American nation testing widely. In June, it became the first country in the region to reopen virtually all public schools. It’s the only country in Latin America from which the European Union will accept visitors. (Fernandez Simon, 7/21)

The World Health Organization said Tuesday it is facing a “serious funding gap” to battle the new outbreak of Ebola in remote corners of northern Congo amid the global COVID-19 pandemic. The $1.75 million raised so far will only last for a few more weeks, the WHO warned, adding that the response effort is particularly expensive because of how difficult it is to get health teams and supplies into the densely forested area. (Okamba, 7/21)

In Olympics news —

Tokyo Olympics organisers are preparing to host the Games next year even if the global coronavirus pandemic hasn’t eased substantially, organising committee chief executive Toshiro Muto told Reuters on Tuesday. The Tokyo Olympics had been scheduled to start on Friday but were put back to 2021 because of the pandemic. (7/21)

Japan on Wednesday kicked off a national travel campaign aimed at reviving its battered tourism industry, but the effort has drawn heavy criticism amid a jump in new coronavirus cases. “Go To Travel” - dubbed “Go To Trouble” by some local media - offers subsidies of up to 50% on trips to and from prefectures excluding Tokyo, which was removed from the programme last week after infections surged to new highs. But many of Japan’s governors wanted the campaign delayed or amended out of fear it would spread the virus to rural areas with low infection numbers, while a Mainichi newspaper poll this week showed 69% of the public wanted the programme cancelled entirely. (7/22)

One of the biggest questions is the possible cost. BioMarin Pharmaceutical Inc. of San Rafael, Calif., the company that developed the gene therapy, says the treatment could cost as much as $3 million per patient, which would make it the most expensive drug ever approved. "It's just outrageous," says Peter Bach, who studies drug prices at Memorial Sloan Kettering Cancer Center in New York. (Stein, 7/20)

Acadia Pharmaceuticals reported negative results Monday from a pair of late-stage clinical trials seeking to expand the use of its antipsychotic medicine Nuplazid to patients with major depressive disorder. The two identically designed Phase 3 clinical trials involved 300 patients who hadn’t responded well to currently approved depression treatments. In both studies, Nuplazid failed to demonstrate an anti-depressive benefit compared to a placebo when given to patients alongside their current medicines. (Feuerstein, 7/20)

Britain has signed deals to secure 90 million doses of two possible COVID-19 vaccines from an alliance of Pfizer Inc and BioNTech, and French group Valneva, the business ministry said on Monday. Britain secured 30 million doses of the experimental BioNTech/Pfizer vaccine, and a deal in principle for 60 million doses of the Valneva vaccine, with an option of 40 million more doses if it was proven to be safe, effective and suitable, the ministry said. With no working vaccine against COVID-19 yet developed, Britain now has three different types of vaccine under order and a total of 230 million doses potentially available. (Smout, 7/20)

Adar Poonawalla may be the most important figure in the global vaccine race who isn’t working in a laboratory: The Indian vaccine entrepreneur plans to save the world from coronavirus – and then radically remake the international pharma landscape. Drug companies are sounding alarms. The globe-trotting, deal-making son of Dr. Cyrus Poonawalla – an Indian billionaire who founded the Serum Institute of India on his horse farm 54 years ago – is one of the breakout figures of the Covid fight, strategizing from the Indian city of Pune to bring the same low-cost efficiency with which he makes 1.5 billion vaccine doses a year for the developing world into mass-producing a Covid-19 vaccine for the entire world. (Wheaton, 7/19)

Each workday morning in March, Noe Mercado drove through the desolate streets of Boston to a tall glass building on Blackfan Circle, in the heart of the city’s biotech hub. Most residents had gone into hiding from the coronavirus, but Mr. Mercado had an essential job: searching for a vaccine against this new, devastating pathogen. Parking in the underground lot, he put on a mask and rode the empty elevator to the tenth floor, joining a skeleton crew at the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center. Day after day, Mr. Mercado sat at his lab bench, searching for signs of the virus in nasal swabs taken from dozens of monkeys. (Zimmer, 7/17)

Prescription drugs have long provided two bad examples of American exceptionalism. They cost three-to-four times more than anywhere else, and we’re one of only two countries in the world that allows consumer advertising of the drugs. Let’s return to being unexceptional. Americans deserve drug prices in line with those in other countries. They don’t deserve a constant barrage of confusing and misleading ads. (Dean Baker and Gerald Scorse, 7/15)

The coronavirus pandemic continues to create economic uncertainty with fears of a second wave of cases bringing new health and safety concerns. One of these concerns is the impact it will have on individuals’ mental health as isolation, unemployment and reduced social and physical activity all contribute to anxiety and depression.Despite these distresses, a new policy included in the 2021 Notice of Benefit and Payment Parameters (NBPP) could make it harder for those with mental health issues to access their medication. (Debra Wentz, 7/20)

As the novel coronavirus pandemic continues to ravage the United States, another epidemic is surging: gun violence. Most other types of crime fell during the initial phases of the pandemic, but gun violence increased and mass shootings in particular continue to spiral out of control. There are a lot of crises tugging at the public’s attention, but we cannot let this go unresolved. Often when people discuss mass shootings, they focus on the number of people killed, but that overlooks the massive public health and economic toll that nonfatal shootings have on this country. To better take that into account, we define mass shootings as incidents in which four or more people are shot, excluding the shooter. (Devin Hughes, 7/21)

The billionaire Sacklers who own Purdue Pharma, maker of the OxyContin painkiller that helped fuel America’s opioid epidemic, are among America’s richest families. And if they have their way, the federal court handling Purdue’s bankruptcy case will help them hold on to their wealth by releasing them from liability for the ravages caused by OxyContin. The July 30 deadline for filing claims in Purdue’s bankruptcy proceedings potentially implicates not just claims against Purdue, but also claims against the Sacklers. The Sacklers may yet again benefit from expansive powers that bankruptcy courts exercise in complex cases. (Gerald Posner and Ralph Brubaker, 7/22)

Medicine has become a profession accessible mainly to the rich. Just look at the price tag for medical school. In the 1960s, the four years of medical education needed to earn an M.D. in the United States could be had for about $40,000 in today’s dollars. The price is now $300,000, a 750% increase. (David A. Asch, Justin Grischkan and Sean Nicholson, 7/21)

I recently got a note from my secretary with this message from a patient: “Tell the doctor I have no interest in a phone call or one of those video visits. When she is back to seeing patients again in the office, let me know. ”I’m hearing that a lot lately from patients who continue to delay routine medical care, not due to fears of Covid-19 but because they yearn for the old face-to-face office visit. (Amy E. Wheeler, 7/22)

Many of the recent stories are familiar, but still distressing and perplexing. There was the gentleman in Tucson who waited 27 days to get results from a Covid-19 test, only to discover he didn’t have the virus and the two weeks he spent in quarantine had been pointless. There was the nonprofit nursing home chain in the Phoenix area that waited five days for test results, only to learn that several staff members and residents had the coronavirus; the asymptomatic staffers had roamed freely until the results arrived. And there have been many tales of Arizona residents waiting a week, on average, to get test results — and sometimes much longer — even though their state has been a coronavirus hotspot for more than a month. Texas, Florida, California and many other newly resurgent corona-states have similar stories. (Timothy L. O'Brien, 7/22)

The Rockefeller Foundation makes an essential point in a new report about the coronavirus pandemic. “Testing is the only way out of our present disaster,” the research organization says, recommending a $75 billion crash program to ramp up diagnostic testing across the country so that the sick are identified and the healthy can return to work and school. Then there is President Trump. Asked about testing in a Fox News interview broadcast Sunday, he said, “We’re finding — in a way, we’re creating trouble. Certainly, we are creating trouble for the fake news to come along and say, ‘Oh, we have more cases.’ ” (7/21)

As recently as May, President Donald Trump boasted of how his administration would embark on “the most advanced and robust testing system anywhere in the world, by far.” “My administration” he said, “marshaled every resource at our nation’s disposal: public, private, military, economic, scientific, and industrial — all at your disposal.  We launched the largest manufacturing ramp-up since the Second World War. There’s been nothing like it since.” Today, America's ability to test for COVID-19 is well below what is needed. In fact, in some places it is failing miserably.  (7/21)

As coronavirus cases have spread through the South and West, the good news is the lower death toll than in New York and East Coast states in the spring. One reason is better treatments such as Gilead’s anti-viral drug remdesivir, but powerful progressives now want the government to set prices for and even confiscate the Covid-19 treatment. Six Senate Democrats including Elizabeth Warren and Bernie Sanders said in a letter last week to Department of Health and Human Services Secretary Alex Azar that the Trump Administration “acquired its supply of remdesivir at an exorbitant cost” in a deal that allows Gilead Sciences to reap “windfall revenues” that are paid “by increased premiums for American families.” (7/21)

It’s hard to imagine more depressing news than some recent studies showing that antibodies to Covid-19 fade within a few weeks — a blow to any hopes for a vaccine, or for any chance of getting out of the pandemic without years of hardship.Don’t let it raise your blood pressure. (Faye Flam, 7/21)

At least two Americans will die of covid-19 in the time it takes to read this op-ed. The mortality rate is climbing in 13 states as infections rise in more than 30 states. As the pandemic surges, policymakers are asking how they can stop this explosive spread. I see three scenarios for what happens next: 1. Status quo. Texas, Florida and Arizona are among the states already on the brink of overwhelming their health-care systems. More and more intensive-care units will reach and exceed capacity. Arizona has already implemented “crisis standards of care” to ration its increasingly scarce resources. (Leana S. Wen, 7/21)

A growing body of research is showing that Black people are being hit disproportionately hard by the COVID-19 pandemic, but a lack of LGBTQ-inclusive data designed to capture the experiences of people who are both racial and sexual minorities renders many of us invisible — and puts us at even greater risk of harm. There’s growing reason to worry that the pandemic is also particularly dangerous for diverse members of the LGTBQ and same gender loving (SGL), the affirming term some members of the Black community use to define themselves, particularly if they’re older. (David Johns and Earl Fowlkes Jr., 7/21)

Eight is thought to be a lucky number in China because in Chinese it sounds like the word for “fortune”; 444 is a bad number because it rings like “death”; 520 sounds like “I love you.” Having always disliked superstition, I was dismayed to receive a message by WeChat at 4:44 p.m. on May 20, Beijing time, informing me that my uncle Eric, who lived in New York, had died from Covid-19. He was 74. Uncle Eric was a pharmacist, so presumably he contracted the virus from a patient who had visited his shop in Queens. (Yi Rao, 7/22)

COVID-19 has altered the course of our nation’s history in so many ways. Even as we fight to bring the virus under control and save lives, we are also aware that our country will be feeling the effects of the pandemic for years and possibly decades to come. It isn’t enough to beat the virus, we have a responsibility to learn from our mistakes so we can be better prepared in the future. This pandemic has devastated communities across America. As this piece gets posted, nearly 4 million Americans have been confirmed as infected, and more than 140,000 have died. Our home state of California is particularly hard hit, with most of the state seeing a renewed surge of cases and hospitalizations. (Sen. Dianne Feinstein and Rep. Adam Schiff, 7/22)

My state was hit hard by Covid-19. For many weeks, we had the nation’s third-highest number of deaths despite having only the 10th-largest population. As a result, we took some of the most aggressive measures in the country in the fight against the disease, and our hard work paid off. Our actions saved thousands of lives. We are now working around the clock to restart our economy in a way that protects workers, businesses and families. But as people in Michigan and across the country begin to return to work, cases are rising again. To slow the rise and further protect our families from this virus, we need the Trump administration to issue a federal mask mandate. (Michigan Gov. Gretchen Whitmer, 7/22)

Sweden has often been considered a leader when it comes to global humanitarian issues, regarded as a beacon of light in areas such as accepting refugees and working against global warming. In the COVID-19 pandemic, Sweden has also created interest around the world by following its own path of using a “soft” approach — not locking down, introducing mostly voluntary restrictions and spurning the use of masks.This approach has been perceived as more liberal and has shown up in “Be Like Sweden” signs and chants at U.S. protests. Wherever measures have been lenient, though, death rates have peaked. In the United States, areas that are coming out of lockdown early are suffering, and we are seeing the same in other countries as well.The motives for the Swedish Public Health Agency's light-touch approach are somewhat of a mystery. (25 Swedish doctors and scientists, 7/21)

Congress went back to work this week with a crucial task on its plate: crafting another big-money rescue package for a pandemic-battered US economy. It would the latest effort to keep consumers and businesses afloat amid record unemployment and shore up strained public health systems across the country. But after authorizing $2.8 trillion in spending since March, lawmakers are confronting two crises (coronavirus and economic) that are inexorably intertwined and have only gotten worse. (Larry Edelman, 7/21)

Congress shouldn’t overlook access to health care in the next financial package to states. As Congress weighs a new spending package to help Americans through the financial hits that keep coming during this COVID-19 pandemic, we urge our lawmakers to also pay particular close attention to access to health care. (7/22)

The instructions for President Trump could not have been clearer: Stick to the script. Talk about the virus. Be serious and sober. Don’t go off on tangents. And for a few minutes, Trump did as he was supposed to do at Tuesday’s coronavirus briefing, his first in nearly three months. He admitted, “It will probably, unfortunately, get worse before it gets better — something I don’t like saying about things, but that’s the way it is.” He encouraged people to wear masks and maintain social distancing. If only he hadn’t taken the bait when Steven Nelson of the New York Post asked him about Ghislaine Maxwell, the woman accused of aiding Jeffrey Epstein in the sexual abuse of minors. “I just wish her well,” Trump said. (Dana Milbank, 7/21)

President Donald Trump's return to coronavirus briefings delivered exactly the strong public health message America needed to hear -- four months ago. Trump, coaxed back to the White House briefing room by his tumbling poll numbers and plummeting public confidence in his handling of the pandemic, mostly stuck to an unusually disciplined, scripted message on Tuesday. (Stephen Collinson, 7/22)

Who was that man speaking at the White House podium, and what did he do to President Donald Trump? I'm just kidding, of course. The man addressing the media on Tuesday evening was Candidate Trump, terrified that his approval ratings are collapsing and his rival, former Vice President Joe Biden, is leading him by what could turn into a humiliating defeat in November. Unless something changes. (Frida Ghitis, 7/21)

Americans may have lost faith in their most cherished institutions — the presidency, Congress, the media, perhaps even democracy itself — but 65 percent of them still believe in Dr. Anthony Fauci. This, in spite of the fact that he’s practically disappeared from network and cable television while the pandemic has whipped through the country with alarming speed (his message of sober realism does not, one suspects, align well with the wishful thinking of his boss). This, in spite of the fact that the Trump White House waged a highly unusual campaign last week to undermine his credibility, with both named and unnamed administration officials dispatched to impale him like an hors d’oeuvre. (Jennifer Senior, 7/21)

President Trump’s detractors profess to be mystified at the way he plays down the threat of the novel coronavirus, comparing it to the “sniffles” and refusing to wear a mask in public. Liberals accuse him of pandering to libertarians, putting on a macho front, or denying science. Could it be his secret to re-election? Political polarization around the coronavirus could turn out to be a game changer in a race likely to turn on which party is most successful at getting its base to the polls. That’s especially true if the dreaded second wave is cresting by Nov. 3. Who will turn out in greater numbers to stand in long, socially distanced lines outside voting stations—Republicans, who are relatively unconcerned, or Democrats, terrified that going outdoors could kill them? (Ted Rall, 7/21)

I knew something was amiss when I had my car repaired in early June, shortly after Miami began relaxing its coronavirus restrictions. At first glance, the dealership looked as if it was following the recommended precautions: Every other seat was blocked off with tape, and customers and workers were wearing face coverings. On closer inspection, many of the customers’ nostrils protruded above their masks. Staff members wore masks with one-way valves, allowing their breath to escape as they told customers the cost of fixing their clunkers. And no one was enforcing limits on the number of customers who could enter the reception area while waiting for their repairs. (Erin N. Marcus, 7/21)

The Covid-19 pandemic and the disproportionate devastation it has wrought on Black, Hispanic, and poor Americans has (again) raised the call for creating inclusive clinical trials that are representative of patient populations. That’s an important goal, but it’s easier said than done. (Jocelyn Ashford, 7/22)