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The United States on Thursday passed the grim milestone of 4 million confirmed coronavirus infections. ... The rapid spread of the virus this summer is striking, taking just 15 days to go from 3 million confirmed cases to 4 million. By comparison, the increase from 1 million cases to 2 million spanned 45 days from April 28 to June 11, and the leap to 3 million then took 27 days. (Gearan, Iati and Dupree, 7/23)

The U.S. death toll from the coronavirus pandemic rose above 144,000 as several states reported record single-day fatalities. The U.S. reported more than 68,000 new cases Thursday, slightly lower than the previous day’s tally. The nation accounts for more than a quarter of the more than 15.5 million coronavirus cases world-wide, according to data compiled by Johns Hopkins University. Higher case counts in the U.S. are partly attributable to expanded testing across the country, while a patchwork of rules and regulations has contributed to a resurgence of new cases. (Hall, 7/24)

July continues to look like April for the United States, with the death toll for the novel coronavirus reaching more than 1,000 fatalities for the second day in a row as cases continue to surge across much of the South and Western parts of the country. (Soucheray, 7/23)

About as many people are now known to be hospitalized with the coronavirus in the United States as during any other time in the pandemic, matching the previous peak in April. ... The New York Times gathered data for nearly 50 metropolitan areas, including 15 of the 20 largest cities in the country, from state and local health departments to provide the first detailed national look at where people are falling seriously ill. (Gamio, Mervosh and Collins, 7/23)

In related news, hot spots show no signs of lessening —

When everything shut down in March as the coronavirus took off in California, Canter’s Deli, a mainstay in the Fairfax District of Los Angeles, laid off dozens of employees. A few months later, it called them back to work. By then, the state appeared to have emerged from the initial virus crisis in much better shape than other parts of the country. But now California’s caseload is exploding, with rising deaths and hospitalizations. As quickly as things had opened up, they have shut down again. (Arango and Mervosh, 7/23)

California and Florida reported record numbers of daily coronavirus fatalities Thursday, as the total number of infections in the U.S. surpassed 4 million. California's 157 deaths on Wednesday continued a week of coronavirus records in the state that had once been considered a COVID success story. Gov. Gavin Newsom (D) on Wednesday said 12,807 new coronavirus infections had been reported statewide in 24 hours, a record high. (Weixel, 7/23)

White House coronavirus task force coordinator Deborah Birx said in a private meeting with local and state health officials that the task force is tracking increases in the virus in 12 U.S. cities. "There are cities that are lagging behind and we have new increases in Miami, New Orleans, Las Vegas, San Jose, St. Louis, Indianapolis, Minneapolis, Cleveland, Nashville, Pittsburgh, Columbus and Baltimore, so we're tracking this very closely,” Birx said in the audio, first obtained by the nonprofit Center for Public Integrity. “We're working with the state officials to make sure we're responding together, but when you first see that increased test positivity, that is when to start the mitigation efforts." (Budryk, 7/23)

A monthlong resurgence in Covid-19 cases appears to be hitting a peak, but a new assessment of the coronavirus’ trajectory is fueling conflicting interpretations about whether the worst is over. Slowing caseloads in Florida and Arizona have fanned a narrative that the worst of the disease spread is cresting in some of the nation’s worst hot spots — repeating a pattern seen in early June. But public health experts on Thursday issued new warnings that the virus is still spiraling out of control, only in the form of a rolling series of outbreaks in almost half the states, with more troubling signs in many others. (Doherty, 7/23)

Three variables determine the fluctuations of a country’s population: births, deaths, and migration flows. The coronavirus pandemic is disrupting all three. ... The pandemic very likely won’t alter that long-term population trajectory, but the varied and devastating effects it has had—and will continue having—will in all likelihood slow the population’s growth rate even more, pushing it to its lowest level in the past 100 years. (The last time the U.S. population shrank was 1918, which also happened to be a pandemic year.) (Pinsker, 7/23)

As the US hit a sobering 4 million cases of Covid-19 and the rising daily rate of confirmed cases and hospitalizations suggest the virus is far from under control, medical experts are urging political leaders to shut down the country and start over to contain the pandemic. At least 4,038,748 coronavirus cases and 144,304 deaths have been recorded in the United States, according to data from Johns Hopkins University. As the numbers climb, more than 150 prominent US medical experts, scientists, teachers, nurses and others have signed a letter to political leaders urging them to shut down the country and start over to contain the surging coronavirus pandemic. (Holcombe, 7/24)

Surging coronavirus cases across the country are threatening to explode into new epicenters as the hard-won progress earned by months of painful lockdowns unravels into a summer of lost opportunity. More than 4 million people in the United States have tested positive for the SARS-CoV-2, and 140,000 have died. (Wilson, 7/23)

Also —

Former President Obama said in remarks released Thursday that the U.S. is not dealing with the coronavirus pandemic as “smartly” as other countries with similar resources. The former president made the remarks during a conversation with presumptive Democratic presidential nominee Joe Biden, saying he was confident that if his former vice president is elected in November he will respond to the crisis effectively. (Klar, 7/23)

The global surge in COVID-19 cases is mainly driven by intense transmission in a relatively few countries, the head of the World Health Organization (WHO) said today, with South Africa now among the five hardest-hit countries. The global total today is at 15,348,877 cases, and 626,190 people have died from their illnesses, according to the Johns Hopkins online dashboard. (Schnirring, 7/23)

Global hot spot South Africa is seeing a “huge discrepancy” between confirmed COVID-19 deaths and an unusually high number of excess deaths from natural causes, while Africa’s top health official said Thursday the coronavirus is spreading there “like wildfire.” A new report by the South African Medical Research Council, released late Wednesday, shows more than 17,000 excess deaths from May 6 to July 14 as compared to data from the past two years, while confirmed COVID-19 deaths have surpassed 6,000. (Anna and Ntshangase, 7/23)

“People thought what happened elsewhere wouldn’t happen here, that it couldn’t happen here,” said Evaldt, a Porto Alegre banker. “Now it is very clear that a safe place doesn’t exist. No one is safe.” The sheer relentlessness of the surge here underscores Brazil’s failure to quell the world’s second-worst coronavirus outbreak. On Wednesday, Latin America’s largest country posted a record 67,860 new cases, bringing the total infected to 2.2 million, with nearly 83,000 dead. Both counts are second only to the United States. (McCoy, 7/23)

Also —

World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus on Thursday dismissed Secretary of State Mike Pompeo’s reported criticism that he was “bought” by China, calling them "untrue and unacceptable." Tedros said the organization is focused on “saving lives” and “will not be distracted” by the comments from Pompeo reported in the British media. (Coleman, 7/23)

Senate Republicans were forced to delay the rollout of a $1 trillion coronavirus relief package after differences between the White House and GOP leadership derailed the timing for unveiling the measure — an embarrassing setback that could have serious consequences for millions of unemployed Americans. The main area of dispute was over extension of federal unemployment assistance for workers that have lost their jobs as the United States economy shut down during in response to the coronavirus pandemic. These $600-per-week payments begin to expire this week. Just on Thursday, the federal government announced that 1.4 million new unemployment claims had been filed in the past week. (Bresnahan and Levine, 7/23)

GOP senators expected to introduce the package of bills on Thursday after days of closed-door haggling among themselves and the White House and publicly struggling to get on the same page. But Senate Majority Leader Mitch McConnell (R-Ky.) said key senators will instead unveil it Monday, pointing at the White House as the reason behind the delay. (Carney, 7/23)

Senate Republicans and the White House wasted a week at the worst possible time. Amid a series of crises — with 30 million Americans unemployed and coronavirus cases spiking nationally — White House officials and Senate GOP leaders couldn’t even come to an agreement among themselves on a starting point for a new relief package, let alone begin bipartisan talks with Democrats. (Levine and Bresnahan, 7/23)

The nation got another dose of bad economic news Thursday as the number of laid-off workers seeking jobless benefits rose for the first time since late March, intensifying concerns the resurgent coronavirus is stalling or even reversing the economic recovery. And an extra $600 in weekly unemployment benefits, provided by the federal government on top of whatever assistance states provide, is set to expire July 31, though this is the last week recipients will get the extra funds. It is the last major source of economic help from the $2 trillion relief package that Congress approved in March. A small business lending program and one-time $1,200 payment have largely run their course. (Rugaber, 7/24)

Sensing the potential economic calamity of pulling back these benefits for up to 30 million people all at once, Treasury Secretary Steven Mnuchin suggested Congress consider a smaller bill to keep these benefits in place while other details are negotiated on Capitol Hill. But Democrats and Republicans roundly dismissed that idea immediately. “This terrible virus is still with us. It kills more Americans every day,” Majority Leader Mitch McConnell (R-Ky.) said on the Senate floor late Thursday afternoon, hours after a planned rollout of the legislation was scratched at the last minute. (Werner, Min Kim and Stein, 7/23)

The 160 million Americans who got stimulus checks earlier this year would get another payment as soon as next month under a plan being negotiated by Treasury Secretary Steven Mnuchin and Senate Majority Leader Mitch McConnell. (Davison and Litvan, 7/23)

An additional $600 per week that has provided a vital financial cushion for unemployed Americans is set to expire next week. On Thursday, top Republicans said they had reached agreement on a proposal to replace a benefit that has helped millions of laid-off workers and been a boon to consumer spending amid a deep recession. Their plan would continue to offer larger-than-normal payments to workers filing for unemployment benefits. But it would significantly reduce the amount of money flowing each week to those without a job, at a time when 30 million people remain unemployed and the recovery from a pandemic recession is stuck in the mud. (Tankersley and Casselman, 7/23)

A forthcoming Senate Republican coronavirus proposal will mirror a March stimulus bill that included a one-time $1,200 stimulus check for some Americans, according to a top negotiator. Treasury Secretary Steven Mnuchin, asked how the direct payments will be structured in the soon-to-be-released GOP bill, said it would be exactly the same as the language in the $2.2 trillion bill signed into law in late March. (Carney, 7/23)

President Trump is likely to sign executive orders on Friday aimed at lowering drug prices, elevating a key issue for voters in an election year. While the plans could shift at the last minute, some GOP lawmakers have been invited to a presidential event on drug pricing Friday at 3 p.m. at the White House in the South Court Auditorium to make the announcement, according to an invitation obtained by The Hill. (Sullivan, 7/23)

The pharmaceutical industry made it clear to the Food and Drug Administration that it wants the regulatory flexibilities the agency has embraced during the Covid-19 pandemic to be made permanent — and it’s ready to push to make sure it happens. “There is a pressing need for FDA and industry to identify actions taken during the Covid-19 pandemic and evaluate their effectiveness and applicability to innovative drug development beyond the public health emergency,” said Lucy Vereshchagina, vice president of science and regulatory affairs at PhRMA. (Florko, 7/23)

In other news from the FDA on the opioid crisis —

The Food and Drug Administration announced Thursday that it would require drug manufacturers to include information about naloxone, the overdose-reversal medication, on the labels of opioid painkillers. The move comes just weeks after the federal government released new data showing that U.S. drug overdose deaths reached an all-time high in 2019, surpassing the previous peak recorded two years earlier. (Facher, 7/23)

Prescribing instructions for all opioids, such as Percocet and OxyContin, will recommend doctors discuss how to get the overdose-reversal drug, which can be obtained from pharmacists without a prescription. For patients with a higher risk of overdose, such as those with a history of opioid addiction, doctors should consider prescribing naloxone alongside the opioid. The same recommendations will appear on drugs used to control opioid addiction, such as methadone. (Perrone, 7/23)

The completion of a coronavirus vaccine could allow the U.S. to return to “real normality” in 2021, Anthony Fauci, the nation’s top infectious diseases expert, said Thursday. "The timetable … of getting into 2021, well into the year, then I can think with a successful vaccine — if we could vaccinate the overwhelming majority of the population — we could start talking about real normality again," Fauci said Thursday on CNN contributor David Axelrod’s podcast “The Axe Files.” "But it is going to be a gradual process." (Budryk, 7/23)

Anthony Fauci, the nation’s top infectious diseases expert, said Thursday that he has received “serious threats” to himself and his family since he became one of the public faces of the federal response to the coronavirus pandemic. The doctor said that the anger has appeared on a different level than when he began his work during the HIV/AIDS crisis. (Budryk, 7/23)

Also —

It's time again to "Play ball!" — but this year, amid a pandemic. On Thursday, MLB finally returned to the field, and all eyes were on the defending World Champions — the Washington Nationals. Since the season was shortened due to the coronavirus crisis, it's perhaps only fitting that the ceremonial first pitch was thrown out by none other than Dr. Anthony Fauci, a huge Nationals fan besides being the nation's leading infectious disease expert. (Lantry, 7/23)

With President Trump facing sagging support in the suburbs, his administration on Thursday targeted an Obama-era affordable housing regulation, the latest in a series of appeals to white voters’ fears of crime and declining property values. The U.S. Department of Housing and Urban Development announced that it would scrap a regulation known as Affirmatively Furthering Fair Housing, which was implemented by President Obama in an attempt to promote more integrated communities. Under the rule, cities receiving some federal housing aid had to develop plans to address patterns of segregation or risk losing money. (Megerian, Dillon and Stokols, 7/23)

The rule, introduced in 2015, requires cities and towns to identify patterns of discrimination, implement corrective plans and report results. The administration’s decision to complete a process of rescinding it culminates a yearslong campaign to gut the rule by conservative critics and members of the administration who claimed it overburdened communities with complicated regulations. (Fuchs, 7/23)

In a Wednesday announcement, the White House said it would be rolling back the rule as a part of a broader deregulation push. The rule has gained attention because Trump has been referencing it heavily in his push for suburban voters, falsely saying that former Vice President Joe Biden wants to "abolish" suburbs. Biden has no such plan, and his campaign calls this argument a "smear." (Kurtzleben, 7/23)

Bowing to the coronavirus threat, President Donald Trump has scrapped plans for a four-night Republican National Convention celebration in Florida that had been set to draw more than 10,000 people to a pandemic hot spot to mark his renomination. Trump had already moved the convention’s public events out of North Carolina because of virus concerns. But the spiking virus shifted to the South, too, and the planned gathering in Jacksonville increasingly appeared to be both a health and political risk. Trump and his advisers feared that going forward with big parties and “infomercial” programming in Florida would ultimately backfire on the president. (Miller and Farrington, 7/24)

On Wednesday evening, President Donald Trump convened his top political advisers, including campaign manager Bill Stepien and Republican National Committee Chairwoman Ronna McDaniel, for a conference call to consider a move that would have been unthinkable just a few weeks ago: Cancel his party’s upcoming convention in Jacksonville, Fla. By Thursday afternoon, with coronavirus raging in the state, the president who all year envisioned a boisterous send-off to the final months of his reelection campaign, had made up his mind: It was a no-go. (Isenstadt, Dixon and Fineout, 7/23)

Trump has for months instructed his advisers to find a way to stage a loud, boisterous and packed convention celebration, after North Carolina officials said they could not guarantee such an event in Charlotte. Advisers scoured the country for a new location to host a multi-night televised spectacle, settling on Jacksonville, where the mayor and Florida’s governor are Trump’s allies. The president’s ambition, however, ran headlong into a massive spike in coronavirus cases in Florida, growing local opposition and enormous logistical hurdles. At one point, convention planners announced they would administer daily coronavirus tests to thousands of delegates, donors and members of the media to help reduce the viral risk. That plan was later scrapped to move large portions of the celebrations to an outdoor venue. (Scherer, Dawsey and Itkowitz, 7/23)

Some county health departments are behind in processing and reporting thousands of negative coronavirus tests, which could distort some daily virus data reported by the state. Local health officials are experiencing backlogs in processing negative tests, which pushed Dane County this week not to calculate its percentage of positive tests — a data point the public uses to determine how intense infection is in an area. (Beck and Heim, 7/23)

People in Massachusetts may be able to get a coronavirus test, but it could take them a while to learn the results. According to health care providers, a recent increase in demand has caused some tests to take more than a week to process. (Becker, 7/24)

Nearly four months after the pandemic’s peak, New York City is facing such serious delays in returning coronavirus test results that public health experts are warning that the problems could hinder efforts to reopen the local economy and schools. Despite repeated pledges from Gov. Andrew M. Cuomo and Mayor Bill de Blasio that testing would be both widely accessible and effective, thousands of New Yorkers have had to wait a week or more for results, and at some clinics the median wait time is nine days. One prominent local official has even proposed the drastic step of limiting testing. (Goldstein and McKinley, 7/23)

University Medical Center is reversing course by asking members of the public without COVID-19 symptoms or exposure to a confirmed case of the disease not to make an appointment at one of its large drive-thru testing sites. (Hynes, 7/23)

The Trump administration said Thursday it is not recommending universities require students be tested for COVID-19 before they head back to campus this fall. “In general, testing people before going back to the university … is not a strategy that we recommend, nor does the CDC recommend, because you're only negative for that one moment,” Adm. Brett Giroir, assistant secretary at the Department of Health and Human Services who is in charge of COVID-19 testing strategy, told reporters. (Hellmann, 7/23)

College students are getting ready to head back to school as the coronavirus continues and campuses are preparing as well. Rice University has contracted 60,000 coronavirus tests to conduct on campus. Rice will test undergraduate students on arrival with a free two-step testing process, the Houston Chronicle reports. Random screenings will also occur weekly for some of the community. (Rosenthal, 7/23)

Labs across the country are facing backlogs in coronavirus testing thanks in part to a shortage of tiny pieces of tapered plastic. Researchers need these little disposables, called pipette tips, to quickly and precisely move liquid between vials as they process the tests. As the number of known coronavirus cases in the United States passes 4 million, these new shortages of pipette tips and other lab supplies are once again stymieing efforts to track and curb the spread of disease. (Wu, 7/23)

National health insurer Humana said Thursday that it will mail more than 1 million in-home colon cancer and diabetic management screening kits to Medicare Advantage and Medicaid members. Humana said the screening kits will help expand access to preventative care that members may have put off during the COVID-19 pandemic. Providing in-home preventative care could also help Humana maintain its scores on certain quality and performance measures that are important to its bottom line and ability to attract seniors to its health plans. Colorectal cancer screening and diabetes care are two of those measures. (Livingston, 7/23)

In other testing news —

A Marine assigned to the military helicopter squadron responsible for transporting the president has tested positive for Covid-19, a Marine Corps spokesperson told POLITICO. The Marine, assigned to Marine Helicopter Squadron 1, was tested on Tuesday and received the positive result on Thursday, said spokesperson Capt. Joseph Butterfield, adding that the squadron administers 80 to 100 tests per week. (Seligman, Lippman and Caputo, 7/23)

After months of detailed drafting, Major League Baseball’s return-to-play plan couldn’t make it to the season’s first pitch before facing a problem that demonstrates the enormous challenge of playing amid the coronavirus pandemic. About five hours before the Washington Nationals were set to play the first game of the shortened 2020 campaign against the New York Yankees, the team announced that star outfielder Juan Soto had tested positive for Covid-19. Upon finding out Thursday, the 21-year-old Soto took multiple rapid-response coronavirus tests that came back negative, a person familiar with the matter said. Nonetheless, Soto must sit out until he produces two lab-confirmed negative tests, spaced 24 hours apart. The entire episode provided insight into the fragility of baseball’s carefully crafted protocols—and how difficult it will be to avoid an outbreak of infection over the next three months. (Diamond and Radnofsky, 7/23)

A Georgia judge on Thursday ordered the governor and Atlanta’s mayor to enter mediation over the governor’s lawsuit aimed at stopping the city from enforcing its requirement that people wear masks in public during the coronavirus pandemic. Fulton Superior Court Judge Jane Barwick ordered Governor Brian Kemp and Mayor Keisha Lance Bottoms to attend mediation with another judge and try to resolve the dispute before an emergency hearing scheduled in the case for Tuesday. (McKay, 7/23)

Iowa Gov. Kim Reynolds is encouraging Iowans to wear face masks in public, although she has declined to join the growing list of governors who have ordered mask wearing to slow spread of the coronavirus. (Leys and Smith, 7/23)

Two Florida mayors who govern Miami and Miami-Dade County encouraged their residents on Thursday to wear masks inside to lower the transmission rate of COVID-19 between family members. Miami Mayor Francis Suarez (R) explained that while the city's number of daily new cases is down, the virus is still being spread easily through households, as multigenerational households are commonplace in Miami. (Johnson, 7/23)

Three Democratic senators are criticizing Interior Secretary David Bernhardt over reports that he refused to wear a mask in a meeting with tribes in Oregon earlier this month. “On your July 9 visit with the Klamath Tribes of Oregon, the tribe expressed concerns that you and a member of the U.S. House of Representatives from the State of California refused to wear a mask ” wrote Democratic Sens. Elizabeth Warren (Mass.), Ron Wyden (Ore.) and Jeff Merkley (Ore.). (Frazin, 7/23)

In other mask news —

Homemade face masks should ideally be made from multiple layers of fabric to trap the viral-laden droplets from the nose and mouth associated with the spread of Covid-19, a study found. Scientists in Australia compared the effectiveness of single and double-layer cloth face coverings with a surgical mask. Using a tailored LED lighting system and high-speed video camera, they showed a single layer reduced the spread of droplets from speaking, but less than a double layer. (Gale, 7/23)

When Ben Sass and Aliza Jaffe Sass learned in January that they had a baby boy on the way, preparations for a bris started immediately. Along with the rest of the logistical advance work of pregnancy, they now had to decide which family members would have the honors of escorting their new son into the ceremony, who would hold the child during the circumcision procedure, and what they would serve their guests at the reception afterward. They didn’t plan for how they would facilitate a surgery on an infant in their Philadelphia apartment during a global pandemic. (Rubin, 7/23)

Hundreds of worshipers, led by an organizer affiliated with a megachurch whose members believe they can heal the sick and raise the dead, gathered Wednesday at the Sundial Bridge in Redding, flouting mask-wearing orders and bans on large crowds. (Sabalow and Stanton, 7/23)

Hampered by dwindling staff numbers, hospital leaders across the state on Thursday warned they are at or near capacity, amid a surge in cases that made Louisiana the 12th and smallest state to confirm 100,000 infections. The wave of infections that continued climbing this week comes as Gov. John Bel Edwards signs an order to keep the state in a modified version of its Phase 2 reopening plan – one that shutters bars and mandates masks when people are out in public – for two more weeks. ... And the governor asked the federal government for several hundred health care workers to aid shortages at facilities across the state. (Karlin, 7/23)

Kaiser Health News: Lost On The Frontline 
A lab assistant who spoke out about employee safety. A disease intervention specialist who hoped to follow her mother into nursing. A father of three who juggled jobs at three nursing homes. These are some of the people just added to “Lost on the Frontline,” a special series from The Guardian and KHN that profiles health care workers who died of COVID-19. (7/24)

And in other news on health workers --

Surgical team nurses at UC Davis Health protested Thursday outside the medical center in Sacramento, saying management’s move to require them to work overtime poses a danger to patient health. (Anderson, 7/23)

About three dozen Dignity Health workers protested Thursday in front of Mercy General Hospital, saying Black members in the union have been subjected to racist language and double standards. Upon reporting the incidents to managers, union officials said, no actions were taken against those who used offensive language or who unfairly applied standards. (Anderson and Smith, 7/23)

Moderna, racing to develop a vaccine for Covid-19, lost a key patent decision Thursday, one that could delay the company’s progress or force it to hand over a cut of profits. The U.S. Patent and Trademark Office denied Moderna’s claim that a patent held by a rival company was invalid. The patent, which covers technology used to deliver messenger RNA treatments, is held by the Canadian firm Arbutus. (Garde, 7/23)

One of the first Chinese projects to start testing its Covid-19 vaccine candidates overseas said it would have a vaccine ready for the public before the end of the year. Liu Jingzhen, chairman of state-owned China National Pharmaceutical Group, also known as Sinopharm, said on state broadcaster CCTV on Tuesday that clinical trials that began in Abu Dhabi last week should be completed in roughly three months, paving the way for a vaccine to go to the market this year. (Deng, 7/23)

Imperial College London’s Covid-19 vaccine trial is expanding to additional sites throughout England, according to a statement dated July 24. Starting next week, the vaccine, which has received more than 40 million pounds ($51 million) in U.K. government funding in addition to five million pounds philanthropic donations, will be trialled in six additional centers. (Keatinge, 7/24)

The Trump administration’s nearly $2 billion investment in Pfizer and a smaller German biotechnology company for a coronavirus vaccine is raising eyebrows among lawmakers and drug pricing advocates. The deal announced Wednesday is the largest yet for “Operation Warp Speed,” the Trump administration’s sprawling push to have a coronavirus vaccine widely available by early next year. (Weixel, 7/23)

Also —

When a coronavirus vaccine becomes available, who should get it first? A preliminary plan devised by the Centers for Disease Control and Prevention this spring gives priority to health care workers, then to people with underlying medical conditions and older people. The C.D.C. has not yet decided whether the next in line should be Blacks and Latinos, groups disproportionately affected by the coronavirus .But let’s suppose that health care workers and people with underlying medical conditions use up the first doses of the available vaccine. Should some be held in reserve for Black and Latino people? What about bus drivers and train conductors? Perhaps teachers or schoolchildren should get it so they can return to classrooms with peace of mind. (Kolata, 7/23)

A small study published yesterday in Clinical Microbiology and Infection found live SARS-CoV-2, the virus that causes COVID-19, in one nose-throat swab and two saliva specimens of five infected hospital patients in Korea 11 to 15 days after symptom onset. Researchers collected nose-throat swabs, saliva, urine, and stool samples from the patients hospitalized from Feb 25 to Mar 5 on days 8, 11, 13, 15, and 30 after study enrollment. They performed quantitative reverse transcription-polymerase chain reaction (qRT-PCR) to detect SARS-CoV-2 RNA and cell culture to detect viable virus. No live virus—only viral RNA—was isolated on cell culture from five urine, two saliva, four nose-throat, and three fecal specimens. (7/23)

Imagine inhaling a sensor that could monitor lung disease patients’ response to therapy, emitting a signal when they breathe out. Like a breathalyzer that recognizes alcohol, such a device could sniff out compounds released only by specific illnesses to gauge how well treatment is working. Biomedical engineers at the Massachusetts Institute of Technology have developed a synthetic biosensor using specialized nanoparticles to detect and then report the presence of molecules indicating bacterial pneumonia or the genetic disease alpha-1 antitrypsin deficiency. (Cooney, 7/24)

A 9-year-old girl from Putnam County is the youngest person to have died in Florida from coronavirus complications, according to the state department of health. The 9-year-old's death is not a travel-related case and the child did not have close contact with anyone who recently tested positive for Covid-19, records show. Putnam County Health Officer Mary Garcia confirmed the fatality to CNN on Wednesday and said she was unaware of any underlying medical conditions in the girl's case. (Royal and Flores, 7/23)

About 47% of US adults have an underlying condition strongly tied to severe COVID-19 illness, researchers at the Centers for Disease Control and Prevention (CDC) have found. The model-based study, published today in the CDC's Morbidity and Mortality Weekly Report, used self-reported data from the 2018 Behavioral Risk Factor Surveillance System and the US Census. (Van Beusekom, 7/23)

When the District’s public libraries began gradually reopening in late May, many residents rushed to check out books for the first time in six weeks. By mid-July, the library was opening its doors for six hours a day, five days a week, for patrons who could come inside to borrow items and spend time using public computers at 14 locations. But librarians say the reopening has been poorly handled, exposing both staff members and the public to potential coronavirus risks. They also say library managers have kept staff in the dark about colleagues who come down with the virus and have struggled with cleaning protocols and mask requirements. (Zauzmer, 7/23)

Of course you are allowed to say no. You are allowed to say that at all times, to all invitations, under all circumstances. But especially right now, in the middle of a pandemic. So it’s less about whether you can say it and more about how, experts say. Tone matters. Put a smile on your face when you make the call and keep it simple: “Thank you for the invitation, I’m so sorry but I can’t make it.” (Roy, 7/23)

The State Fair of Virginia has been cancelled this year because of the coronavirus pandemic. The Richmond Times-Dispatch reported Thursday that the fair’s organizers were unable to find a way to pull it off safely. (7/23)

Softening his earlier stance, President Donald Trump on Thursday acknowledged that some schools may need to delay their reopening this fall as the coronavirus continues to surge. It marks a shift from Trump’s previous demand for a full reopening of the nation’s schools. Speaking at a White House news conference, Trump said districts in some virus hot spots “may need to delay reopening for a few weeks.” He said the decision will fall to governors. (Binkley, 7/23)

President Donald Trump is still demanding schools reopen, even after nixing his Republican National Convention keynote events in Florida next month. The president argued Thursday that "a permanent shutdown was never the strategy, which would ultimately lead to greater mortality and irreversible harm." The prosperity of the U.S. economy hinges on children returning to school in person this fall, he contended, noting that the Council of Economic Advisers has estimated more than 5 million parents won't be able to go back to work if their kids don't return to campus. (Quilantan and Miranda Ollstein, 7/23)

San Francisco officials are readying an unprecedented educational assistance program for the fall meant to help up to 6,000 children with their distance-learning needs, as parents and students confront the reality of starting the school year without classrooms during the COVID-19 pandemic. Starting in September, dozens of recreation facilities, libraries and community centers across the city will be transformed into “learning hubs,” spaces where young students who may struggle with remote instruction can go each day to access their digital classwork and the social interactions that virtual schooling cannot provide. (Fracassa, 7/23)

Alka Tripathy-Lang’s 5-year-old son is supposed to start kindergarten this fall, but her district in suburban Phoenix has already delayed its start and announced that classes, when they do start, will be online for at least the first couple of weeks. What those lessons will look like is unclear, as are details about how much parental involvement will be required, and how or when the school is going to implement the dual immersion Mandarin program her son is supposed to begin. Tripathy-Lang’s current plan is to start him in an online-only option, but if it’s not working, she’ll pull him out to be home with her 3-year-old, who she and her husband have already decided not to send to preschool this year. (Sohn, 7/23)

This weekend, as a heat wave bakes huge swaths of the country under triple-digit heat indexes, some fear that the collision of Covid-19 and extreme heat could be a dangerous combination. Extreme heat can threaten anyone, but many of the same groups who are at greatest risk of serious illness from the coronavirus are also the most vulnerable groups to heat exposure. (Kann, 7/24)

A first-of-its-kind analysis, conducted in collaboration with researchers at Microsoft, paints a detailed picture of how people do — or don’t — engage with virtual mental health tools, a step toward expanding the use of digital therapeutics. Lackluster engagement has long been a thorn in the health tech industry’s side: As mental health tools proliferate, their uptake and long-term use remain relatively low. That problem has taken on new urgency as the pandemic shunts patients from in-person to online treatment. (Isselbacher, 7/24)

Kaiser Health News and USA Today: Less-Lethal Weapons Blind, Maim And Kill. Victims Say Enough Is Enough.
There’s a gap in Scott Olsen’s memory for the night of Oct. 25, 2011. The Iraq War vet remembers leaving his tech job in the San Francisco Bay Area and taking a BART train to join an Occupy Oakland protest against economic and social inequality. He remembers standing near protesters who faced off with Oakland police officers bristling with riot gear. He remembers being carried away by other protesters. But not the moment when a “bean bag” round fired from an officer’s 12-gauge shotgun crashed into the left side of his head, fracturing his skull and inflicting a near-fatal brain injury that forced him to relearn how to talk. (Slack, Wagner, Hancock, McCoy, 7/24)

Nearly 60% of the parents of about 4.3 million US children don't intend to have them vaccinated against the highly infectious and sexually transmitted human papillomavirus (HPV), according to survey results published earlier this week in The Lancet Public Health. Researchers at the University of Texas at Houston analyzed the data of parents of 82,297 children 13 to 17 years old from the 2017-18 National Immunization Study. They found even higher vaccine hesitancy rates (higher than 65%) in Idaho, Kansas, Michigan, Montana, Nebraska, North Dakota, Oklahoma, and Utah. (7/23)

To the untrained eye, play can seem aimless, repetitive, wild or foolish. But play can offer a window into the developing mind. Piaget viewed certain kinds of play as milestones, signs that a child had reached a new stage of development. Studies conducted over the past few decades suggest play serves a more crucial role. Play can help kids learn, plan and even persevere in the face of adversity. (Willyard, 7/21)

A new analysis from the Metropolitan Area Planning Council (MAPC) finds that people of color in the Greater Boston area are more likely to live near a major roadway that exposes them to high levels of vehicular air pollution. The findings are especially relevant now, since air pollution can cause or exacerbate the underlying health issues that increase the likelihood of dying from COVID-19. (Wasser, 7/23)

Once the epicenter of the coronavirus pandemic in the U.S., New York City has been attempting a gradual return to normal. But six weeks and four phases of reopening since the lockdown lifted, the city remains a profoundly changed place. Activity is picking back up in parts of the city, but New York’s reopening is taking shape differently across boroughs—driven largely by income and race. (Tartar, Kao, Murray, Lin, Popina and Reznik, 7/24)

Thefts that took place at Walmart pharmacies during civil unrest in May may have compromised some patient information, according to notice published in the classified advertisement section of several local newspapers Thursday. After George Floyd died in May while under police restraint, peaceful protests and looting dotted the country and sparked calls for police reform and to address racism in various areas, including in the healthcare industry. Some healthcare businesses were affected by the looting, including some Walmart locations. (Cohen, 7/23)

Nearly 25 years ago, President Bill Clinton vowed to “end welfare as we know it,” and Congress bought in, passing landmark legislation designed to help millions of low-income Americans find work and get off the rolls for good. In the early years, the new Temporary Assistance for Needy Families program, known as TANF, which states also must fund, did just that. But over time, instead of focusing on helping low-income people get jobs, TANF has devolved into a kind of candy store that many states are raiding to plug budget holes and pay for programs that have little to do with moving poor people into the workforce, a Stateline investigation has found. (Bergal, 7/24)

Kaiser Health News and PolitiFact: With DACA Ruling, Did Supreme Court Grant Trump New Powers To Reshape Health Care? 
President Donald Trump came into office vowing to repeal and replace Obamacare. While he successfully neutralized the health care law’s requirement that everyone carry insurance, the law remains in effect. When Fox News host Chris Wallace noted that Trump has yet to put forward a replacement plan, Trump told him to stay tuned. “We’re signing a health care plan within two weeks, a full and complete health care plan that the Supreme Court decision on DACA gave me the right to do,” Trump said July 19 on “Fox News Sunday.” (Greenberg, 7/24)

Kaiser Health News: Technology Divide Between Senior ‘Haves’ And ‘Have-Nots’ Roils Pandemic Response 
Family gatherings on Zoom and FaceTime. Online orders from grocery stores and pharmacies. Telehealth appointments with physicians. These have been lifesavers for many older adults staying at home during the coronavirus pandemic. But an unprecedented shift to virtual interactions has a downside: Large numbers of seniors are unable to participate. (Graham, 7/24)

The Occupational Safety and Health Administration is failing to do its job properly, according to a lawsuit filed Thursday by three meatpacking workers, who say the agency’s inaction has left them in danger. The lawsuit accuses OSHA of leaving the workers in imminent danger due to what they say are hazardous working conditions at the factory where they work, run by Maid-Rite Specialty Foods in Pennsylvania, in the midst of the coronavirus pandemic. (Rosenberg, 7/23)

In other news —

North Dakota’s Republican governor on Thursday blasted an anti-LGBTQ resolution that was passed by hundreds of his party’s delegates, calling it insulting and divisive. The resolution — one of dozens of party policy statements in a passed by this spring by mail-in ballot — states that many “LGBT practices are unhealthy and dangerous, sometimes endangering or shortening life and sometimes infecting society at large.” Gov. Doug Burgum issued a statement Thursday denouncing the resolution. (MacPherson, 7/23)

Nearly a month after a federal judge ruled the Trump administration must release migrant children "with all deliberate speed" from Immigration and Customs Enforcement detention centers because of COVID-19, 346 parents and children are detained in facilities with outbreaks and court filings show releases remain rare. When U.S. District Judge Dolly Gee ordered the release of children detained with their parents in late June, she was explicit in her reasoning. The ICE facilities, she said, were "‘on fire’ and there is no more time for half measures." (Soboroff, 7/23)

Amid concerns over the spread of the coronavirus, a federal judge has now ordered the state to set aside space for isolation and quarantine in its prisons. The order is the latest result of a long string of court motions filed by prison reform advocates in recent months that have criticized the California Department of Corrections and Rehabilitation for its handling of the coronavirus pandemic. Under the ruling, signed by U.S. District Court for the Northern District of California Judge Jon Tigar on Wednesday, the state must come up with a plan to vacate at least 100 beds in each prison across California in the next month. (Kristoffersen, 7/23)

After only communicating with loved ones through emails, phone calls and letters during the coronavirus pandemic, people incarcerated at some Michigan prisons will have the option for video visitation as the state institutes a pilot program slated to get underway in about three months.  The Department of Corrections on Thursday said it is launching video calls at seven of its 29 prisons. The department halted in-person visits in prisons March 13 because of COVID-19. (Jackson, 7/23)

A San Francisco city official is introducing a resolution to condemn the city’s public hospital for naming itself after Mark Zuckerberg — the latest escalation of a five-year quest, led mostly by nurses and other health care workers, to disassociate the institution from the controversial Facebook founder. The resolution, introduced late Thursday by San Francisco supervisor Gordan Mar, wouldn’t strip the hospital of the Zuckerberg name, bestowed on the hospital after he and his wife, pediatrician Priscilla Chan, donated $75 million to the institution in 2015. (Ortolano, 7/24)

Reps. Diana DeGette (D-Colo.) and Tom Reed (R-N.Y.) said Thursday that Congress’ expansion of telemedicine during the coronavirus pandemic is likely to become permanent. Virtual health visits have seen rapid growth in popularity during the pandemic as patients seek to avoid hospitals. Congress passed the CARES Act in late March, which dedicated funds for telehealth expansion and strengthened access to telehealth for Medicare recipients. (Bikales, 7/23)

Iowa-based Blue Cross and Blue Shield insurer Wellmark has named Cory Harris, the company's president and chief operating officer, as its next CEO starting in 2021. Harris will succeed Wellmark chairman and CEO John Forsyth, who is retiring at the end of this year after 24 years with the insurance company. Wellmark's board of directors tapped Harris as part of a comprehensive succession planning process, according to the company. (Livingston, 7/23)

Also —

The Trump administration has renewed the public health emergency for the coronavirus, ensuring that critical resources to fight the pandemic can continue while much of the country battles rising caseloads. The news will come as relief to health care groups who worried that President Donald Trump would let the emergency declaration lapse when it was set to expire July 25, despite previous assurances from top administration officials it would be renewed. (Roubein, 7/23)

The mayor of Anchorage is limiting gathering sizes and the number of people allowed in bars, restaurants and entertainment venues in response to rising coronavirus cases. The order, by Mayor Ethan Berkowitz, takes effect Friday and says that due to a “resurgence” in cases there is a need for increased restrictions on public interactions “to preserve health and save lives in our community.” (Bohrer, 7/23)

Arizona Gov. Doug Ducey (R) on Thursday extended his executive order closing water parks, theaters, bars and gyms a further two weeks. Ducey also declined to postpone the school reopening target date, but directed the state’s Department of Health Services to create data benchmarks for in-person classes by Aug. 17. (Budryk, 7/23)

Washington Gov. Jay Inslee said Thursday he is tightening restrictions throughout the state in restaurants and bars, for weddings and funerals, and at gyms in a further effort to stem a surge in COVID-19 cases. “I care about businesses opening and people getting back to work, but public health and economic activity go hand in hand,” Inslee said. “If we let this virus get even more out of control, it will have devastating effects on our health and on our economy.” (Baumann, 7/24)

During the final four weeks of the 2020 legislative session, California lawmakers vulnerable to the worst of COVID-19 will be allowed to submit proxy or remote votes on bills at the cost of losing their daily pay if they select that option. (Wiley, 7/23)

Gov. Brad Little announced Thursday that Idaho would remain in Stage 4 of the state’s reopening plan, and he opted not to implement further restrictions or open the economy more as COVID-19 cases rise. This will become the state’s fourth go at making it through Stage 4 restrictions. (Scholl, 7/23)

Dallas County reported 12 more coronavirus deaths Thursday, a day after officials announced a single-day record of 30. The county also reported 648 new cases of the virus, the third straight day with fewer than 1,000 new cases after 18 consecutive days of at least 1,000. (Jones and Branham, 7/23)

In news from the Midwest and Northeast —

As in many of the world’s cities in pandemic shutdown, the Cincinnati area breathed cleaner air this spring. But as soon as people got their vehicles back on the road with the economic reopening, the bad air came back. Major pollutants of the region’s air dropped up to 20% from March 23 to June 30 compared to the same period in the previous three years, says a fact sheet and chart from the Southwest Ohio Air Quality Agency. (Saker, 7/23)

Residents in six central and southern Illinois counties, including the state capital’s home, filed lawsuits Thursday against Gov. J.B. Pritzker’s restrictions on social interaction prompted by the coronavirus pandemic. The actions taken in Bond, Clay, Clinton, Edgar, Richland and Sangamon counties seek court orders declaring there is no public health emergency as defined by Pritzker’s Public Health Department. Springfield, the state capital, is in Sangamon County. (7/24)

At least 10 people who were at a party attended by area restaurant workers earlier this month in Chatham have tested positive for the coronavirus, prompting some local eateries to temporarily close or scale back service and authorities to launch a public health campaign to identify everyone the partygoers have been in contact with. (Andersen and Berg)

In nursing home news —

A southern Illinois judge on Thursday extended a temporary restraining order barring a nursing home from executing its closure plan until it has fulfilled all its obligations to residents. When Aperion Care Cairo announced its intention to close last week, families complained to Alexander County officials they felt rushed to select alternative placement for loved ones. (7/23)

A Massachusetts home where nearly 80 aging veterans sicked with the coronavirus have died was denied emergency aid as leadership and staff frantically worked to protect the residents, an attorney for the ousted superintendent said Thursday. The attorney said state officials initially refused in March to send National Guard aid even as the home was dealing with dire staffing shortages. The lawyer for former Holyoke Soldiers’ Home Superintendent Bennett Walsh called him a “good and honorable man” who “would never do anything intentional to harm the vets.” (Durkin Richer, 7/23)

Nearly three years after Hurricane Maria tore through Puerto Rico, tens of thousands of homes remain badly damaged, many people face a hurricane season under fading blue tarp roofs and the island’s first major program to repair and rebuild houses hasn’t completed a single one. Maria hit more than 786,000 homes on Sept. 20, 2017, causing minor damage to some homes and sweeping others from their foundations. A federally funded program administered by local officials carried out relatively small repairs to some 108,000 homes the next year, while churches and nonprofits patched up thousands with private funds. (Coto, 7/24)

As countries figure out how to deal with the coronavirus pandemic, some have closed their borders to outside travel. Sometimes that’s a blanket ban on visitors, while for others the bans are origin country-specific. The United States is among countries targeted for bans due to increasing coronavirus cases. So where can Americans travel? While the State Department has a Global Level 4 Health Advisory to warn citizens to avoid all international travel until further notice, these are the Caribbean destinations technically open for U.S. tourists. (Compton, 7/23)

And in foreign news on COVID --

Mexico’s anti-monopoly commission said Thursday it is looking into possible price-fixing or monopolistic practices in the market for medical oxygen, after pharmacies reported a spike in prices and difficulties in getting tanks and refills. Prices for oxygen tanks in Mexico have reportedly tripled since the pandemic hit Mexico in March, and Mexico continues to post record levels of infection. On Thursday, the Health Department said there were 8,438 newly confirmed cases for the previous 24 hours, bringing the country’s case total to 370,712. Confirmed deaths rose by 718 to 41,908. (7/24)

In May, Benjamin Netanyahu was riding high. He had just started his fifth term as Israel's prime minister after surviving a string of near-death elections, had co-opted his main rival into a unity government and was enjoying a surge in popularity after successfully leading the country through the initial onslaught of the coronavirus. Just two months later, with Israel suffering a second wave of infections, the prime minister finds himself enduring a hot summer of collapsing poll numbers, swelling protests and dissenting lawmakers. (Hendrix, 7/23)

If all had gone according to plan, Tokyo would awake tomorrow to the opening day of the 2020 Summer Olympics. Instead, the city is grappling with a spike in coronavirus infections, with 366 new cases reported Thursday, a daily record. The rescheduled Summer Games are set for a year from Thursday. Japan marked the moment with a 15-minute ceremony held in Tokyo’s newly built Olympic Stadium, absent an audience. (Berger, 7/23)

In news from across the pond —

The number of overseas visitors to Britain halved in March, the first month in which COVID-19 seriously affected travel, and there was a similar fall in British people going abroad, official figures showed on Friday. The number of visits to Britain dropped to 1.4 million, 54% fewer than in March 2019, while the number of Britons travelling overseas fell by 50% to 3.2 million, Britain’s Office for National Statistics said. (7/24)

British Prime Minister Boris Johnson said on Friday that opponents of vaccination, so called anti-vaxxers, were “nuts”. “There’s all these anti-vaxxers now,” Johnson told medical workers at a doctor’s surgery in London. “They are nuts, they are nuts.” (7/24)

Earlier this month, the EU extended a travel ban for U.S. residents, deeming America’s pandemic response inadequate. While it wasn’t binding, most member states followed the advice. But Ireland stayed open. It didn’t make quarantine mandatory like Slovenia or demand a negative Covid-19 test as Croatia did. While visitors are told to restrict their movements for two weeks, there’s no legal requirement to do so. Under pressure to justify the approach, Irish Prime Minister Micheal Martin told lawmakers this week that mandatory quarantine would be harsh and do little to control the spread of the virus, and the government is still discouraging non-essential travel to the country. (Doyle, 7/23)

When Peggy Frank returned to her mail route following three months of medical leave, Los Angeles was in the middle of a scorching heat wave. The 63-year-old letter carrier had slipped on a patch of wet leaves and broken her ankle in March, and she spent the spring at home in a walking boot. Although the injury still bothered her, Frank had been cleared to go back to work. She was just two years away from retirement when she climbed back into her U.S. Postal Service truck on July 6, 2018.The temperature had topped out in the high 80s in the first days of the month, but then it shot up dramatically after the July 4 holiday, putting Southern California under an extreme heat advisory. On July 5, the highs surpassed 100 degrees. (Jamieson, 7/15)

There’s a fire up north, the woman says, the Kincade Fire. It flickered into existence on the nighttime horizon, a shapeless brightness billowing into the sky. Now the wind’s whipping it south toward Santa Rosa. Evacuations are under way, and she worries her home will burn. Allison Chapman listens in silence. She’s modeling for a makeup demo when the woman walks into the studio, where Allison studied after moving south a couple of years ago, at 18. She knows this woman from back home in Northern California, knows how close this woman lives to her grandparents, knows that if the fire is threatening this woman’s home, it’s threatening theirs, too. She feels the panic coming on.It begins, usually, with a quickening of the heart and a tightening of the chest. Then comes a rush of cold, which is ironic, in a way, because her fear is fire. Her mind jumps backwards first—to the flames tearing across the mountainside on a late-summer evening in 2015, to the dark smoke rising from the woods around her house, to the toy wagon wheels discovered weeks later amid the wreckage—then springs forward and explodes like a shotgun shell into a million imagined tragedies. She shivers. (Stern, 7/20)

In Mid-City, a refrigerator stands on the sidewalk outside Little Amsterdam coffee shop. This is no ordinary sidewalk fridge — dank and empty, waiting to be picked up by sanitation services — but a community fridge: cold, clean and well-stocked with food. Behind its frosty glass door is a wheel of Cacique queso fresco, a carton of eggs, squash, kale, Lunchables and half a gallon of milk. On its side, there’s a mural of a young man eating an apple, the words “Eat to Live” etched into his curly cropped hair. (James, 7/14)

One Tuesday this past May, Justice Ruth Bader Ginsburg announced she was spending the night at the hospital. The announcement sent the usual shivers down the spines of liberals across America, who, given Ginsburg’s advanced age and serial bouts with cancer, are stricken with fear each time word comes that she is facing yet another health scare while Republicans are in a position to name or control the Senate‘s approval of her successor. (Gerstein, 7/19)

Longer Looks at families and parenting —

The Black Lives Matter movement has changed the country and shifted conversations about police, social justice and structural racism. Nowhere is the impact as great as it is for Black families, especially those with children. NPR spoke with five couples about how their family conversations have changed and how they try to support and inform their children in the face of police violence and racism. The parents spoke about how painful it is to have these issues rupture the innocence of childhood, and the importance of having these discussion proactively. They say they try to model a measured optimism about the future, teaching their kids "to stand up and speak out", as one mother, Dr. Rhea Roper Nedd puts it. (Neighmond, 7/19)

It’s easy to get the impression that the majority of Americans are spending their days at home, isolated with their nuclear family. The idea of the family as the main source of care and refuge has dominated both media coverage and public-health messaging since the beginning of the coronavirus pandemic.If doctors, politicians, and reporters think of the family as the default source of care in our lives, that’s likely because Americans have idealized the two-parents-plus-kids household since the mid-20th century. But this fixation on the nuclear family overlooks the diversity of U.S. living arrangements, as David Brooks pointed out in a recent cover story for The Atlantic. In fact, as of 2017, only 20 percent of American households were composed of two parents with children. The rest were single parents living with their children (7 percent), childless cohabiting couples (25 percent), adult roommates (20 percent), and people who live alone (28 percent). (Len Catron, 7/18)

Talking with young children about their bodies and sexuality paves the way for open communication as they get older, said Tanya Coakley, Ph.D., a professor at the University of North Carolina at Greensboro who has studied how parents communicate with their children about sex, with a focus on African-American fathers and sons. (Marder, 7/16)

It didn’t take long. We are only just now approaching the end of the beginning of the pandemic, and already the futurists are confidently sketching out the “new normal”—a world in which every sector of life, from workplaces to the way we shake hands, will be transformed. One of these sectors is higher education. As colleges and universities debate how, or whether, to hold classes in the fall, prophecies about their longer-term future are sprouting like mushrooms after a good rain. We’re told that the schools that have been focused on harvesting tuition dollars from the wealthy will collapse in the recession, or that, on the contrary, schools will use the opportunities of viral disruption to become more learning-centered and sophisticated about online offerings. Business school professors and technologists declare that college as we know it is over. (Roth, 7/18)

Before it reopens next month, Colby College will require all students coming to its campus in Maine to be tested for the novel coronavirus. But that’s just the beginning of its pandemic safety plan. The private liberal arts school will require everyone on campus, from nearly 2,000 students to the college president, to swab their lower nasal cavities three times a week at the start of the semester. Then they’ll do it twice weekly until the term ends. A laboratory in Massachusetts will deliver results within 24 hours to the school in the riverfront town of Waterville. (Anderson, 7/20)

Longer Looks at COVID-19 —

"We tried our best to be polite about it. I’d frame it to customers like they were doing us this big favor: 'Would you please consider wearing a mask?' 'May we offer you a free mask?' 'We sure do appreciate your cooperation.' ... We found out how much they cared. It became clear real quick." (Saslow, 7/18)

When Google and Apple announced plans in April for free software to help alert people of their possible exposure to the coronavirus, the companies promoted it as “privacy preserving” and said it would not track users’ locations. Encouraged by those guarantees, Germany, Switzerland and other countries used the code to develop national virus alert apps that have been downloaded more than 20 million times. But for the apps to work on smartphones with Google’s Android operating system — the most popular in the world — users must first turn on the device location setting, which enables GPS and may allow Google to determine their locations. (Singer, 7/20)

They were the most depressing headlines I’d read all year. And that’s saying a lot. "Immunity to COVID-19 Could Be Lost in Months,” The Guardian declared last week, drawing on a new study from the United Kingdom. Forbes grimly accelerated the timeline: “Study: Immunity to Coronavirus May Fade Away Within Weeks.” And the San Francisco Chronicle took things to a truly dark place: “With Coronavirus Antibodies Fading Fast, Vaccine Hopes Fade, Too.” Terrified, I read the study that launched a thousand headlines—and did not come away much less terrified. Researchers at King’s College London had tested more than 90 people with COVID-19 repeatedly from March to June. Several weeks after infection, their blood was swimming with antibodies, which are virus-fighting proteins. But two months later, many of these antibodies had disappeared. (Thompson, 7/20)

Breathe. We do it roughly 25,000 times a day, but until recently few of us gave much thought to this automatic bodily function. “If there’s some good to come out of Covid, it’s that people are paying more attention to how they’re breathing,” said James Nestor, author of “Breath: The New Science of a Lost Art,” which explores how we breathe, how that’s changed and how to do it properly. “You can’t be truly healthy unless you’re breathing correctly.” How we breathe affects us at a cellular level. Research shows changing the way we breathe can influence weight, athletic performance, allergies, asthma, snoring, mood, stress, focus and so much more. You can learn to breathe better and these exercises can help. (DiNardo, 7/18)

The sweep of Covid-19 across the globe has raised a fundamental question about medical ethics: Do physicians, nurses, EMTs, and other health care workers have moral and legal obligations to risk their health and lives to treat patients during a pandemic? It’s an important question, given the toll that Covid-19 is taking on medical professionals. (Alan Kadish and John Loike, 7/24)

The Centers for Disease Control and Prevention opened branch offices in Bentonville, Ark., and Seattle this month. Not officially. But with the president trying to distance himself from responsibility for the coronavirus crisis, and Southern governors amplifying the damage with their flawed reopening strategies, the nation’s retailers have become the first line of defense against the pandemic. (Bill Saporito, 7/24)

Who says you can’t teach an old president new tricks? After months of refusing to wear a face mask in public and making fun of people who did, President Trump is suddenly a big fan. This is quite the reversal from a man who suggested that people who wear masks were doing so as a political statement against him, which of course is more important that protecting oneself from a deadly infection. (Mariel Garza, 7/23)

He’s also missing a huge political opportunity. Imagine how differently things would have played out at his Tulsa, Okla., rally if, instead of removing signs from seats asking participants to social distance, his campaign had left up the signs and handed out MAGA masks to everyone who entered. Rather than fending off criticism about how the rally was a third empty, the arena would have been filled to its socially distanced capacity with a sea of Trump supporters wearing MAGA masks. (Marc A. Thiessen, 7/23)

Although Donald Trump keeps boasting that we’ve had the best coronavirus response in the world, and some credulous supporters may actually believe him, my guess is that many people are aware that our handling of the virus has fallen tragically short compared with, say, that of Germany. It may not seem surprising, however, that German discipline and competence have paid off (although we used to think that we were better prepared than anyone else to deal with a pandemic). But how can America be doing so much worse than Italy? (Paul Krugman, 7/23)

President Donald Trump says the country is doing great in a pandemic that just infected its four millionth US victim and is killing 1,000 people a day. But his claim is based on a brazen confidence trick, requiring Americans to ignore his responsibility for the spike in the southern and western states as he claims credit for the success of northeastern states that suppressed the disease after not heeding his advice to reopen before the virus was under control. (Stephen Collinson, 7/24)

A lot has been said about how cancer doesn’t stop for COVID-19, and now we’re seeing the first estimates of what that might mean. A National Cancer Institute model, examining just breast cancer and colorectal cancer, predicts in excess of 10,000 deaths in the U.S. over the next 10 years due to pandemic-related delays in diagnosis and care. The modeling suggests most of this increase will be felt quickly – in the next two years.  These worrisome trends are on the minds of oncologists across the country, especially as confirmed COVID-19 cases continue to increase nationwide, including at home in Tennessee.  (Dr. Jeff Patton, 7/24)

The events that turned an everyday trip into the "miracle on the Hudson" don't have a direct parallel in the healthcare policy arena. Unlike that fabled flight, warning lights signaling the financial unsustainability of Medicare, and by extension that of the American healthcare system, have been flashing for years. The Medicare Hospital Insurance (HI) Trust Fund has long been in jeopardy. In late 2019, the Medicare board of trustees, in its annual report to Congress, projected that the HI Trust Fund would become insolvent in 2026. But COVID-19 could be the black swan event that takes it down even sooner, all in an environment of massive federal deficit and debt. (Joseph J. Fifer, 7/24)

When the last COVID-19 restrictions have been lifted, the last schools reopened, the last phase passed through, we will [be left] to sort out a new landscape in the world. Economic power will have shifted. Security concerns will have changed dramatically. A great reckoning of sovereign debt may be in order as the world rebalances after the pandemic. The United States will be in position to emerge from this in even stronger position than before if the help it extends the rest of the world — rebuilding economies, supplying medicines and vaccines, feeding the hungry — is handled effectively. (Brian McNicoll, 7/23)

Though scientists are working tirelessly to create a COVID-19 vaccine, there is growing concern that many people may refuse to take it once one becomes available. According to recent polls,  only half of Americans said they would get a vaccine, and another quarter were on the fence. Some of the communities most at risk from COVID-19 are also the most resistant: Black people account for nearly one-quarter of U.S. COVID-19 deaths, yet 40 percent surveyed said they would refuse a vaccine. Twenty-three percent of Hispanics surveyed said they don’t plan to get vaccinated. Given this current climate, some have called for mandatory COVID-19 vaccinations for all Americans, including a New York State Bar Association task force. (Y. Tony Yang and Dorit Rubinstein Reiss, 7/23)

Viruses like SARS-CoV-2 can circle the globe with astonishing speed by taking advantage of human networks. The global medical research community couldn’t immediately contain it because it had no comparable network for defense — but we are moving quickly to create one. Employing adaptive clinical trials will help. (Andy Plump and David Reese, 7/23)

This week, Congress will decimate the economy, in an unfortunately literal sense: It will cut unemployment-insurance payments to more than 25 million people, more than one in 10 American adults. When it does, the coronavirus recession, already historic in its severity, will become far, far worse. (Annie Lowrey, 7/24)

On a scale of 0 to 10, how painful is the cost of your health care?” That’s a question all physicians should ask their patients, and one that has become increasingly more relevant in everyday patient care due to the relentlessly rising costs of health care and prescription drugs. These are now compounded by the economic devastation of the Covid-19 pandemic. (Ted M. Burns, A. Gordon Smith and Jason L. Crowell, 7/23)

Thirty years ago this Sunday, President George H.W. Bush signed the Americans with Disabilities Act. The anniversary takes place at a dark moment.  We have never had a president as hostile to people with disabilities as President Donald Trump. (John J. Pitney Jr., 7/24)

I never thought I’d begin a column by praising Kim Kardashian West, but I do so today. Arguably the world’s most famous-for-being-famous celebrity, Kardashian West performed a valuable public service this week by talking openly about the helplessness family members can feel when trying to cope with a loved one’s mental illness. (Eugene Robinson, 7/23)

Take the presumptive Democratic presidential nominee’s appearance Monday as Joy Reid’s inaugural guest on her new MSNBC show. Ms. Reid began by encouraging Mr. Biden to pummel President Trump on the coronavirus, which he did with gusto. “There’s no leadership,” Mr. Biden thundered. “He has no idea what to do. Rather than challenge him on that, Ms. Reid asked Mr. Biden what he would do differently as president. His answer sounded good initially but doesn’t amount to much. (Karl Rove, 7/23)

Mr. Trump’s bragging about his test results may simply be part of his strategy to cast presumptive Democratic nominee Joe Biden as “not all there.” But it’s hard to fathom why the Trump campaign thinks this is a shrewd gambit. (Jonah Goldberg, 7/24)

Unfortunately, there is a further financial strain looming on the horizon, and this one is entirely preventable. As it stands today, the Centers for Medicare and Medicaid Services plans to cut reimbursements for surgeons for certain procedures starting in January. While this rule was misguided before the COVID-19 pandemic, it is untenable in this environment. (John Calhoon, 7/23)

The U.S. health care system has long neglected minority mental health. It continues to do so during this time of coronavirus-wrought isolation, economic hardship, and social unrest. Paying homage to he-roes and she-roes in the long struggle for equal rights in mental health care offers hope. (Annelle Primm, Courtney Lang and Keris Jan Myrick, 7/24)