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Life expectancy in the US dropped a full year in the first half of 2020, according to a report published Thursday by the US Centers for Disease Control and Prevention's National Center for Health Statistics. Experts say that Covid-19 was a significant factor contributing to the decline. (McPhillips, 2/18)

Life expectancy at birth for the total U.S. population was 77.8 years – a decline of 1 year from 78.8 in 2019. For males, the life expectancy at birth was 75.1 – a decline of 1.2 years from 2019. For females, life expectancy declined to 80.5 years, a 0.9 year decrease from 2019. Deaths from COVID-19 are the main factor in the overall drop in U.S. life expectancy between January and June 2020, the CDC says. But it's not the only one: a surge in drug overdose deaths are a part of the decline, too. (Wamsley, 2/18)

Life expectancy for Black populations declined the most from 2019 – by 2.7 years, to 72 years – its lowest level since 2001. Latinos experienced the second-biggest decline, falling 1.9 years since 2019 to a life expectancy of 79.9 years, lower than when it was first recorded in 2006. (Rodriguez, 2/18)

“This is a huge decline,” said Robert Anderson, who oversees the numbers for the CDC. “You have to go back to World War II, the 1940s, to find a decline like this.” Other health experts say it shows the profound impact of COVID-19, not just on deaths directly due to infection but also from heart disease, cancer and other conditions. (Marchione, 2/18)

“It’s pretty jolting,” said Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, who is compiling the same data for all of 2020. “This is a huge impact.” Life expectancy at birth, considered a reliable barometer of a nation’s health, has risen steadily in the United States since the middle of the 20th century, with small annual decreases in recent years caused mainly by “deaths of despair” — drug overdoses, alcoholism and suicide. Flat and modestly declining life expectancy from 2015 to 2017 caused considerable concern among public health experts after decades of progress against heart disease, cancer and other maladies. (Bernstein, 2/18)

Newly reported coronavirus cases in the U.S. remained under 80,000 for the fourth day in a row, while hospitalizations fell to their lowest level since Nov. 10. The U.S. reported more than 68,000 new cases for Wednesday, according to data compiled by Johns Hopkins University that was published early Thursday. The data may update later. Wednesday’s total was slightly higher than the 62,398 new cases reported the previous day but sharply lower than the daily tally of more than 94,000 a week earlier. (Hall, 2/17)

In its weekly snapshot of the pandemic yesterday, the World Health Organization (WHO) said cases and deaths continue to drop, mainly driven by steep declines in the two highest-burden countries, the United States and the United Kingdom. Also, the B117 virus variant has now been detected in 94 countries spanning all six WHO regions, with local transmission occurring in 47. (Schnirring, 2/17)

California’s coronavirus numbers continue to show signs of improvement. The percentage of coronavirus tests that came back positive over the past seven days — a closely watched indicator for reopening the economy — has dropped to 3.5%. That’s down from over 11% a month ago. Hospitalizations for coronavirus patients have dropped 38% over 14 days, and the rate of infection in the state has fallen to 0.65 — meaning each infected person infects fewer than one other person. “That’s the lowest I’ve seen it,” California Department of Public Health Director Dr. Tomás Aragón said at a meeting of a state vaccine advisory committee on Wednesday. “That’s really good news.” (Vaziri, 2/17)

In related news about the spread and treatment of coronavirus —

In early December, Miguel Fernandez lay unconscious in the intensive care unit at a Los Angeles area hospital. A mechanical ventilator pumped oxygen into his lungs, which had been ravaged by COVID-19. The 53-year-old was dying. The best, and likely only, chance of Miguel surviving was a therapy called extracorporeal membrane oxygenation, better known as ECMO. It would allow his lungs to rest while a machine infused his blood with the oxygen he needed. But PIH Health Whittier Hospital, where he had been admitted, didn’t have any ECMO machines or the highly trained staff needed to run them. Only a handful of hospitals in southern California did, and they were overrun with COVID-19 cases. (Armstrong and Allen, 2/18)

Pregnant women in Washington state were infected with COVID-19 at a 70% higher rate than others of similar ages, with nonwhite women shouldering a disproportionate burden, according to a study published yesterday in the American Journal of Obstetrics & Gynecology. Noting that population-based estimates of coronavirus infections in pregnancy are unreliable due to incomplete recording of pregnancy status or inclusion of only hospitalized patients, a team led by researchers from the University of Washington in Seattle analyzed data from 240 pregnant COVID-19 patients at 35 healthcare systems, capturing 61% of the state's annual births, from Mar 1 to Jun 30, 2020. (Van Beusekom, 2/17)

Computed tomography, magnetic resonance imaging (MRI), and ultrasound scans should be used to help diagnose and treat COVID-19 symptoms, according to a review published today in Skeletal Radiology. While COVID-19 infection is most known for its respiratory ailments, musculoskeletal symptoms such as muscle pain and inflammation, peripheral neuropathy, joint pain, and clotting issues can cause short- or long-term issues, the researchers write. (2/17)

As Southern California last month reeled from a COVID-19 surge that overwhelmed hospitals, bottlenecked ambulance systems and killed thousands, a physician hosted a conference in Culver City. Peter Diamandis, who is also an engineer, executive and scientist, believed he could create an “immunity bubble” and safely host a scaled-down version of his pricey annual tech conference. Instead, the conference became a superspreader event that infected 24 people, including Diamandis, with the novel coronavirus. (Logan, 2/17)

One million counterfeit N95 masks were seized by federal agents on Wednesday as part of a sweeping fraud investigation stemming from the global coronavirus pandemic, the head of the Department of Homeland Security announced. The seizure brought the total number of knockoff masks that have been confiscated in recent weeks to more than 11 million, Alejandro N. Mayorkas, the homeland security secretary, said during a news conference. (Vigdor, 2/17)

The fake masks closely resemble N95 masks produced by Minnesota-based company 3M. The counterfeit products have been sold to states "from coast to coast" with officials expected to seize more phony N95s in the "coming weeks," Alejandro Mayorkas, the U.S. Secretary of Homeland Security, said during a briefing Wednesday. ... The phony masks are not tested to see whether they meet strict N95 standards and could put frontline medical workers at risk if they are used while treating patients with COVID-19.  (Farber, 2/17)

In other news about masks —

Florida authorities have arrested two men who allegedly pretended to be U.S. Marshals to avoid wearing masks. Walter Wayne Brown Jr. and Gary Brummett were arrested on Feb. 11 for impersonating a federal officer after a hotel employee became suspicious and called the cops, the South Florida Sun Sentinel reported. (Lonas, 2/17)

Americans may soon be able to choose between two clearly labeled levels of face mask protection while browsing store shelves. The new national mask standard outlines minimum fit, design, performance and testing requirements for face masks and would require user instructions, package labeling and a permanent tag on the product. (Enriquez, 2/17)

Quicker and easier spreading variants of the coronavirus are making some wonder if they should upgrade their mask, or double up with ones they already own. What is better, an N95 mask or two blue surgical masks? We consulted health experts, as well as the latest masking guidance from the Centers for Disease Control and Prevention, to lay out the most effective masking strategies. (Dickinson, 2/17)

The U.S. attorney in Brooklyn and the FBI have begun a preliminary investigation into the way New York Gov. Andrew Cuomo’s administration handled data about Covid-19 nursing home deaths. After early praise for his leadership when his state became the U.S. epicenter of the pandemic, the governor is now dealing with accusations of underreporting nursing home deaths. (Dienst and Valiquette, 2/17)

State records released last week show that the death toll for long-term-care facilities is more than 15,000. That is about 50% higher than earlier reports, which didn’t include more than 5,600 facility residents who died in hospitals. Melissa DeRosa, Mr. Cuomo’s top aide, told state lawmakers last week that the state Health Department held back the fuller tally because of its fear that it would be politicized by the administration of then-President Donald Trump. (Vielkind, 2/18)

The Democratic leaders of the New York State Senate are moving to strip Gov. Andrew M. Cuomo of unilateral emergency powers granted during the pandemic, setting up a remarkable rebuke for the governor from members of his own party. The Senate’s measures, which could be voted on as soon as next week, underscore the deepening division between Mr. Cuomo and state lawmakers since the governor admitted to intentionally withholding critical data on virus-related deaths from the Legislature. (McKinley and Ferre-Sadurni, 2/17)

Fallout over New York Gov. Andrew M. Cuomo’s handling of nursing home coronavirus data worsened Wednesday as a critical state legislator — a fellow Democrat — accused the governor of threatening to “destroy” him during an angry call. New York Assemblyman Ron Kim said the governor ordered him in a call last Thursday to backtrack in defense of a top Cuomo aide whose leaked comments on nursing home data sparked a bipartisan furor. An adviser to Cuomo (D) said Wednesday that Kim was “lying” about the conversation. The governor also lashed out at Kim during a news conference, saying the lawmaker has a “long and hostile relationship” with his office. (Knowles and Barrett, 2/18)

The federal government is sending generators, water and blankets to Texas and is preparing to ship in diesel, as well, to help with backup power amid the massive outages that accompanied the recent cold snap, the White House announced on Wednesday. A Federal Emergency Management Agency spokesperson said the agency has sent 60 “very large” generators to the state to help keep hospitals and other crucial infrastructure online. The spokesperson could not say where the generators had been sent. The agency has also sent “millions of liters of water” and “tens of thousands” of blankets, she said. (Wermund, 2/17)

Austin-area hospitals are facing widespread water issues after severe weather this week. St. David’s South Austin Medical Center said it lost water pressure from the city Wednesday, creating a series of problems. “Water feeds the facility’s boiler, so as a result, it is also losing heat,” David Huffstutler, CEO of St. David’s HealthCare, said in a statement. (Lopez, 2/17)

Millions of Houstonians awoke Wednesday to a notice from the city that their water was unsafe to drink unless boiled, an impossible task for many residents who continued to suffer power outages from the winter storm. A large chunk of Houston households had already lost water pressure altogether or had seen their pipes freeze, preventing access to the city’s water system. The crisis extended to key facilities, depriving hospitals and the Harris County Jail of running water. Houston Methodist canceled most non-urgent surgeries and procedures due to the water shortage and may do so again Thursday, a spokeswoman said. (Scherer, 2/17)

And now Texans are running out of food. From farm to table, freezing temperatures and power outages are disrupting the food supply chain that people rely on every day. Across the state, people are using up supplies they had stockpiled and losing more as items start to spoil in dark refrigerators. Some are storing their remaining rations in coolers outside, and trips to the grocery store often do little to replenish pantries. (Agnew and Aguilar, 2/17)

The American Red Cross on Wednesday urged those in the few areas spared by serious wintry conditions to donate blood amid sweeping cancellations. "Record-breaking cold and severe winter weather across most of the U.S. has forced the cancellation of American Red Cross blood drives in approximately 30 states — impacting approximately 16,000 blood, platelet and convalescent plasma donations this month," Jessa Merrill, spokesperson for the American Red Cross, said in an emailed statement. "The Red Cross is urging healthy individuals in unaffected areas, especially those with type O blood, to give now." (Rivas, 2/17)

Vaccination disruptions are widespread —

Severe winter weather across the country has delayed the arrival of 200,000 doses of the Moderna COVID-19 vaccine to Florida, according to a local report. The doses, which were initially expected on Tuesday, should now arrive Thursday, said Samantha Bequer, a spokeswoman for the Florida Division of Emergency Management, to the Naples Daily News. But even if the shipment does arrive Thursday, vaccine distribution will still likely be delayed, she warned. "The state has been working closely with providers and has advised they begin to plan for delays in their vaccine delivery," she told the paper. (Farber, 2/17)

One public health expert said the delays were unacceptable. “Having vaccine centers take snow days is just going to back things up more than they already are,” said Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security. “The virus doesn’t take snow days.” Adalja said people in charge of vaccination efforts must find ways to be more resilient to weather, “just like mailmen can deliver the mail through sleet or snow.” He suggested clinics use better contingency plans. The goal, he said, must be “a continuous assembly line of vaccines going into people’s arms.” (Naishadham and Noveck, 2/17)

After an unprecedented winter storm cut off power to the freezers storing vaccines in Harris County, Texas, thousands of doses were at risk of expiring within hours. Alan Hoffman, an internist at Houston Methodist Hospital, received a phone call Monday morning from Methodist executive Roberta Schwartz asking how quickly could they get shots in arms? It was a race against the clock. (Silberman, 2/17)

The Pfizer-BioNTech Covid-19 vaccine loses some potency against the coronavirus variant that first appeared in South Africa, researchers reported Wednesday, based on lab experiments. What the findings mean for how well the vaccine will protect real people from the variant, called B.1.351, is hard to tell. But clinical data from three other vaccines — those from AstraZeneca, Novavax, and Johnson & Johnson — have already shown the shots are not as powerful at blocking symptomatic Covid-19 cases caused by B.1.351 as by other forms of the virus. (Joseph, 2/17)

All of the blood samples from vaccinated patients still showed significant levels of neutralizing antibody against the South Africa variant, the researchers said. The study was conducted by Pfizer, BioNTech and researchers at the University of Texas Medical Branch at Galveston and published in the New England Journal of Medicine. ... What the lab data means in practice remains to be seen. “It is unclear what effect a reduction in neutralization by approximately two-thirds would have” on protection from Covid-19 caused by the South Africa variant, the Pfizer study concluded. (Kresge and Langreth, 2/17)

Because there is no established benchmark yet to determine what level of antibodies are needed to protect against the virus, it is unclear whether that two-thirds reduction will render the vaccine ineffective against the variant spreading around the world. However, UTMB professor and study co-author Pei-Yong Shi said he believes the Pfizer vaccine will likely be protective against the variant. “We don’t know what the minimum neutralizing number is. We don’t have that cutoff line,” he said, adding that he suspects the immune response observed is likely to be significantly above where it needs to be to provide protection. (Erman, 2/17)

In related news about the variants —

Covid-19 variants are threatening to cause another surge of infections, health officials warned Wednesday, and it's now more important than ever for Americans to continue practicing safety measures that work against the spread of the virus. (Maxouris, 2/18)

One-third of US military service members eligible to receive a Covid-19 vaccination have opted not to, defense officials said Monday as they announced the Department of Defense is nearing 1 million vaccinations delivered. Cautioning that it's still "very early data," Maj. Gen. Jeff Taliaferro, vice director of operations for the Joint Chiefs of Staff, told the House Armed Services Committee Wednesday, "The vaccine is the right thing to do, it's clearly safe for service members." (Kaufman and Liebermann, 2/17)

To get out of ninth-grade science period one recent Friday, the King twins had an excuse that is so very 2021.Alexandra and Isabelle, 14, had to miss class — including a test — because they were participating in an actual science experiment: a clinical trial of Moderna’s Covid-19 vaccine to evaluate whether the shot is effective and safe in children ages 12 through 17. (Hoffman, 2/16)

People experiencing homelessness are especially vulnerable to disease and often live in close quarters. Reaching them for COVID-19 vaccination is crucial, public health officials say, yet also presents some unique challenges. Addresses and phone numbers change constantly. Few of the people affected have reliable Internet access. Also, the pandemic put a halt to many mobile clinics and other outreach efforts to homeless encampments; in the meantime, patients scattered or avoided the clinic for fear of infection. (Noguchi, 2/17)

Mark Shepherd got off the phone with the public health department and began reaching out to members of the Henderson County Rescue Squad. It was early January. The volunteers, all emergency medical professionals, were needed at The Laurels of Hendersonville, an assisted living facility about 20 miles outside Asheville. (Critchfield, 2/18)

For a decade, Jennifer Crow has taken care of her elderly parents, who have multiple sclerosis. After her father had a stroke in December, the family got serious in its conversations with a retirement community — and learned that one service it offered was Covid-19 vaccination. (Kwon, 2/18)

Also —

A waitress [was] fired on Monday after, she said, she resisted getting vaccinated out of concern that doing so could hurt her chances of becoming pregnant. Over the weekend, the restaurant, the Red Hook Tavern, required that its employees get vaccinated and then terminated the waitress, Bonnie Jacobson, when she asked for time to study the vaccine’s possible effects on fertility. (Haag, 2/17)

Fran Goldman had spent weeks glued to her tablet and on the phone with her local health department before she was finally able to schedule a coronavirus vaccine appointment last weekend. So when the 90-year-old woke up on Sunday to find 10 inches of snow covering the unplowed Seattle roads, she realized she only had two options: Rescheduling her shot or trekking by foot for three miles. She chose the latter. (Salcedo, 2/17)

Almost three-quarters of Americans said they are confident the COVID-19 vaccine will be widely available in their state by the end of the summer, according to a poll released Wednesday. (Coleman, 2/17)

KHN: In Search Of The Shot
Too little covid vaccine and too great a demand: That’s what KHN readers from around the country detail in their often exasperating quest to snag a shot, although they are often clearly eligible under their local guidelines and priority system. Public health officials say the supply is growing and will meet demand in several months, but, for now, readers’ experiences show how access is limited. Some savvy readers report no problem getting in line for the vaccine, but others say that balky application processes and lack of information have stymied their efforts. Their unedited reports are a good snapshot of the mixed situation around the country. (2/17)

Florida Gov. Ron DeSantis (R) on Wednesday threatened to divert coronavirus vaccines from communities that criticize his distribution efforts. DeSantis made the remarks at a news conference amid criticism that he arranged for seniors in two wealthy neighborhoods to be given priority vaccine access, The South Florida Sun-Sentinel reported. (Gstalter, 2/17)

Florida's Republican Gov. Ron DeSantis has threatened to move a pop-up vaccination clinic that his state has set up in an affluent community in Manatee County after he was confronted with allegations of political favoritism and preference for the wealthy at a news conference Wednesday. (Toropin, 2/17)

More than 100,000 Pennsylvanians could be forced to wait days or weeks longer for their coronavirus shots after mistakes made by vaccine providers and possible miscommunication from the state led to a massive shortage of doses, officials said Wednesday. State health officials said they discovered only last weekend that some providers had been improperly using doses of the two-part Moderna vaccine, giving out their supply of second shots as first doses instead. They said the misuse of second shots had been going on for weeks, though they could not explain exactly why or how it happened, or why it went undetected. (McDaniel and McCarthy, 2/17)

Iowa is backing out of a plan to use Microsoft Corp. software for registering patients and scheduling Covid-19 vaccinations, the latest challenge to the software giant’s efforts to make money helping states overwhelmed with residents looking for shots. Iowa Governor Kim Reynolds announced the change of heart at a news conference Wednesday, saying state officials concluded it would be too hard to combine existing scheduling systems and were trying to avoid disruptions. The state will instead focus on bolstering its current systems. Just last week, New Jersey Governor Phil Murphy and members of his administration complained about significant glitches in that state’s Microsoft-built vaccination scheduling system. (Bass and Joyce, 2/18)

If there is a path that leads to an equitable distribution of potential life-saving doses of COVID-19 vaccines in California, it almost inevitably will end at the doorstep of the state’s battered community clinic system. Plagued by financial woes, fighting at times to keep the doors open, these clinics remain the primary point of contact for millions of low income and uninsured patients across the state. But the early returns on California’s vaccination rollout present a vivid study in contrast: The state’s better off residents are commanding a disproportionate share of the doses. And as a recent letter from the clinics’ statewide organization to Gov. Gavin Newsom makes clear, that won’t change until the clinics themselves are fully incorporated in the vaccination effort. (Kreidler, 2/17)

Maine will introduce a new set of performance measures to scrutinize COVID-19 vaccine providers more closely when it comes to how quickly they are giving shots in a move that could change where doses are sent across the state. The state has not yet determined the set of metrics, a Maine Department of Health and Human Services spokesperson said, but a Tuesday memo to providers indicated they will be used to help clinics improve performance or lead the state to send vaccines elsewhere. (Andrews, 2/18)

Gov. Asa Hutchinson said Tuesday that the state next week will receive its biggest increase so far in its weekly allocation of coronavirus vaccine from the federal government. Hutchinson also announced that the state Department of Health has revised its rules so that indoor events with up to 100 people can once again be held without submitting a plan to the department for approval. (Davis, 2/17)

The Vaccine Equity Now! Coalition is composed of 11 local and statewide organizations, including the New England Area Conference of the NAACP, the American Civil Liberties Union of Massachusetts, and La Colaborativa in Chelsea. The group issued a set of five demands. It called for a state investment of $10 million in trusted local organizations for outreach and engagement in communities of color; immediate implementation of the administration’s promise to set aside 20 percent of the doses to supplement vaccine allocations in the most affected communities; and the establishment and monitoring of clear goals to ensure equity in vaccine distribution. (Pan and Finucane, 2/17)

Anthony Fauci said Wednesday that vaccinating all teachers against Covid-19 before reopening schools is "non-workable," wading into an issue that has taken center stage for the Biden administration amid the ongoing pandemic. "If you are going to say that every single teacher needs to be vaccinated before you get back to school, I believe quite frankly that’s a non-workable situation," Fauci told "CBS This Morning." (Leonard, 2/17)

White House press secretary Jen Psaki said Wednesday that vaccinating teachers is not a requirement for reopening schools for in-person learning. “Neither the president nor the vice president believe that it is a requirement,” Psaki said at a briefing when asked whether teachers need to be vaccinated before they return to school. (Chalfant, 2/17)

Asked about the guidance Wednesday on NBC’s “Today” show, Vice President [Kamala] Harris declined to explicitly endorse it. “Teachers should be a priority,” she said several times. When pressed about teacher vaccinations in particular, she hedged, saying the CDC recommendations “are exactly that: recommendations.” Later, she added: “We’re all really clear. Teachers should be a priority. Teachers should be a priority. Teachers are critical to our children’s development, they should be able to teach at a safe place and be able to expand the minds of our children.” (Wootson Jr. and Meckler, 2/17)

President Joe Biden is in a political firestorm over how and when to get more schools open amid the coronavirus pandemic, with Republicans seizing on confusion surrounding Biden’s goal to reopen a majority of schools within his first 100 days to paint the president as beholden to teachers’ unions at the expense of American families. His administration in recent weeks has sent muddled and at times contradictory messages about Biden’s goal. On Tuesday night, the president said his 100-day goal was to have most elementary schools open five days a week, seeming to conflict with his own press secretary, who had said last week that schools would be considered “open” if they held in-person classes even one day a week. (Jaffe, 2/18)

Also —

You might get a vaccine shot in June. Or July. Hopefully by fall. And children are definitely returning to school soon, maybe. As for when things return to normal? Let's not talk about that yet. (Flaherty, 2/7)

In its opening days, the Biden administration set a new rule to allow Dr. Anthony Fauci to make more mainstream media appearances, after being effectively muzzled during the waning months of the Trump administration. “It's great to see Dr. Fauci on @Maddow — and anywhere else where he wants to speak his mind,” White House chief of staff Ron Klain tweeted on Jan. 22.The Biden administration is finding out the hard way, however, that the doctor does not really do White House talking points. On Wednesday, Fauci went decidedly off-message on the question of vaccines for school teachers, leading to a muddle of messaging. (Thompson, Meyer and Cancryn, 2/17)

The administration says it will spend $650 million to expand testing for K-8 schools and settings where people congregate such as homeless shelters, via new "hubs" created by the Department of Health and Human Services and the Department of Defense. Regional coordinating centers will work to increase testing capacity, partnering with labs and universities to collect specimens, perform tests and report results to public health agencies. The plan could mean an additional 25 million tests per month, and it's intended to aid President Biden's effort to open schools for in-person learning. (Wamsley, 2/17)

The White House announced Wednesday a multipronged effort to bolster the United States’ ability to test for Covid-19 in schools and homeless shelters, increase domestic manufacturing of testing supplies such as pipette tips, and boost genomic sequencing efforts needed to understand the spread of virus variants. Biden testing coordinator Carole Johnson described the $1.6 billion for testing as a “pilot” that will serve as a bridge until Congress passes its massive $1.9 trillion Covid-19 relief bill. (Lim, 2/17)

The Biden administration announced Wednesday that it is investing roughly $200 million in an effort to triple the country's genomic sequencing, the process crucial to tracking the spread of new, more contagious variants of the virus. The move is one of three actions officials announced Wednesday aimed at boosting testing. (Sullivan, 2/17)

By month’s end, the United States will pay off the arrears it owes to the World Health Organization as well as its current year obligations, the State Department announced Wednesday. In remarks to the U.N. Security Council, Secretary of State Antony Blinken said the United States would provide more than $200 million “in assessed and current obligations to the WHO” as a “key step” toward complying with U.S. financial obligations as a member country. (Oswald, 2/17)

Also —

Nearly a year after scientists showed that the coronavirus can be inhaled in tiny droplets called aerosols that linger indoors in stagnant air, more than a dozen experts are calling on the Biden administration to take immediate action to limit airborne transmission of the virus in high-risk settings like meatpacking plants and prisons. The 13 experts — including several who advised President Biden during the transition — urged the administration to mandate a combination of masks and environmental measures, like better ventilation, to blunt the risks in various workplaces. (Mandavilli, 2/17)

President Biden has selected Chiquita Brooks-LaSure to lead the Centers for Medicare and Medicaid Services, filling a major role in his health-care leadership team, according to four people who spoke on the condition of anonymity because they were not authorized to discuss the decision. Brooks-LaSure served in the Obama administration as a senior CMS official who helped implement the Affordable Care Act’s coverage expansion and insurance-market reforms. She also worked on Capitol Hill as a Democratic staff member for the House Ways and Means Committee, building ties with then-Rep. Xavier Becerra, Biden’s choice to lead the Health and Human Services department and who sat on the committee at the time. (Diamond and Goldstein, 2/17)

If confirmed by the Senate, Chiquita Brooks-LaSure would be the first Black woman to head CMS, which has under its umbrella Medicare, Medicaid, children’s health insurance and the Affordable Care Act, better known as “Obamacare.” The programs cover more than 130 million people, from newborns to nursing home residents. Brooks-LaSure has a long track record in government, having held health policy jobs at the White House, in Congress, and at CMS during the Obama administration. Most recently she led the Biden transition’s “landing team” for the Department of Health and Human Services, laying the groundwork for the new administration. Before her return to government service, Brooks-LaSure was a managing director at the Manatt Health consultancy. (Alonso-Zaldivar, 2/18)

Brooks-LaSure would inherit those lawsuits, most notably a Supreme Court case set to be argued in March challenging the agency’s new policy of denying health coverage to unemployed Medicaid beneficiaries. The Supreme Court is still scheduled to hear the case on March 29, although the Biden administration took action last week to begin reversing the policy, which could moot the lawsuit before it’s argued. That’s far from the agency’s only lawsuit: CMS is currently facing two other challenges from hospitals alone, and is also fending off lawsuits from drug makers and seniors’ groups. (Florko and Facher, 2/17)

In other Medicare news —

An oncologist group has lost a bid to reinstate its legal challenge to the ongoing, automatic 2% cut in Medicare reimbursement that began in 2013 for intravenous cancer treatments and other drugs administered by healthcare providers. Circuit Judge Gregory Katsas, writing on behalf of a unanimous panel of the U.S. Court of Appeals for the D.C. Circuit, said neither the Balanced Budget Act, which caused the cut, nor federal Medicare statutes gave federal courts jurisdiction over the Community Oncology Alliance Inc’s lawsuit. (Pierson, 2/16)

HHS needs to overhaul its approach to value-based payment to ensure widespread practice transformation and rein in Medicare spending, according to a report by the Leonard Davis Institute of Health Economics at the University of Pennsylvania released Wednesday. Experts said the agency needs a new strategy because providers and payers have been too slow to adopt value-based payment, especially arrangements that require providers to take on significant financial risk. In addition, most existing initiatives don't systematically lower healthcare spending or improve quality. According to the report, CMS must develop a clear vision for the future of value-based payment, simplify and align its models across payers and mandate participation in advanced payment models whenever possible. The agency should also make it easier for providers to take part in voluntary models, commit to longer-term contracts and make fee-for-service reimbursement less attractive for providers when mandatory participation isn't possible. (Brady, 2/17)

Two Democratic senators released their version of a public option health care plan Wednesday, setting the stage for this year’s debate over how best to expand coverage to the millions of people who are uninsured. The proposal from Sens. Michael Bennet (Colo.) and Tim Kaine (Va.) would create a government-run health care plan on the Affordable Care Act (ACA) exchanges to compete with plans offered by private insurers with the hope of driving down costs. (Hellmann, 2/17)

While the eyes of the nation were on an impeachment trial, Democratic-led committees were quietly advancing President Joe Biden's $1.9 trillion Covid-19 relief bill, hoping to deliver a bill to his desk by their self-imposed mid-March deadline. Democrats approved pieces of the bill in late-night sessions last week, ignoring widespread opposition from Republicans. Party leaders are eyeing House passage by the end of next week, aides said. (Kapur, 2/18)

Even as President Biden and congressional Democrats work to pass their $1.9 trillion coronavirus relief bill, they’re bracing for the next big legislative scramble, over another massive spending bill that’s already drawing intense lobbying and threatening Democratic unity. Biden’s next package could be far pricier than the coronavirus bill. Although plans remain fluid, it’s expected to center on a major infrastructure investment, while also tackling other priorities such as clean energy, domestic manufacturing, and child and elder care. However, as the next must-pass bill in a divided Congress, where legislative opportunities will be scarce, it has unleashed a torrent of other demands, as advocates for issues from climate change to immigration push to get included. (Werner, Stein and Grandoni, 2/17)

On Feb. 11, the House Ways and Means Committee approved a plan to subsidize coverage in 2021 and 2022 for higher-income people who don't qualify for ACA subsidies currently, boost contributions to lower-income people who already qualify for financial help and max out allowances for anyone collecting unemployment benefits in 2021. The committee also aims to block the Internal Revenue Service from clawing back money from people who underestimated their 2020 income and received too much in ACA subsidies, and subsidize premium costs for COBRA coverage for some workers. The Congressional Budget Office and Joint Committee on Taxation estimate these moves will reduce the number of people without insurance by 800,000 in 2021, 1.3 million in 2022 and 400,000 in 2023. But they will come at a cost of more than $54 billion over the next decade. (Tepper, 2/17)

In related news about President Biden's push for covid relief —

A new internal White House memo gives a behind-the-scenes look into the administration's strategy to up the pressure on Republicans to get on board with President Joe Biden’s costly COVID relief proposal, arguing GOP opposition to his American Rescue Plan is damaging the GOP and that "this is not a moment in the country when obstructionism is rewarded." (Nagle, 2/17)

Young adults have historically had high uninsured rates because they are less likely to have full-time jobs that offer insurance and can’t afford a plan on their own. Those who are healthy and use medical services infrequently might not see the value in buying insurance. But between 2011 and 2018, the uninsured rate among adults age 19 and 25 fell by nearly half — from 30% to 16% — as many gained coverage under Medicaid or through the ACA marketplaces, with help from income-based tax credits, according to the Urban Institute report. The ACA also made more young adults eligible to stay on their parents’ insurance by raising the age to 26, though that’s no help if parents are among the pandemic unemployed. (Gantz, 2/18)

Difficulties with access to voting reported by disabled Americans fell significantly between 2012 and 2020, according to research published Wednesday by the U.S. Election Assistance Commission (EAC). The EAC report found about 1 in 9 disabled respondents reported voting difficulties in 2020, compared to more than a quarter of non-disabled Americans. (Budryk, 2/17)

The coronavirus pandemic has led to a rise in stress, anxiety and depression, leading to a staggering increase in mental health disorders. Now, experts are warning that our mental health can also impact our heart health, particularly for women. Last month, the American Heart Association released a scientific statement highlighting the strong link between heart health, mental health and overall wellbeing. (2/18)

Today, hospitals in Massachusetts and elsewhere explicitly allow a pregnant person to have one partner accompany her when she is admitted for labor and delivery. But a few hospitals, including the Brigham, Tufts Medical Center, and Baystate Health, deem it unsafe for visitors to come into the triage area, where women go to assess their labor. The practice has prompted a petition, started by two childbirth and lactation specialists, which has been signed by more than 1,000 people. It calls on Governor Charlie Baker to order hospitals to “stop the separation of birthing families.” (Freyer, 2/17)

Grocery giant Kroger plans to close two stores in Seattle after the city passed a $4-an-hour hazard pay mandate for grocery workers, drawing sharp rebukes from local officials and worker advocates who point to the company’s booming sales as the pandemic continues to claim more than 2,000 lives a day. Kroger, which recorded one of its more profitable years due to strong demand during the pandemic, blamed the closures on the city’s new mandate, saying it would raise costs at the two Quality Food Centers (QFC), which were already underperforming. (Rosenberg, 2/17)

In obituaries —

Rush Limbaugh, the talk titan who made right-wing radio financially viable in American media and himself a Republican kingmaker years before Fox News, died Wednesday after he revealed in 2020 that his lung cancer was terminal. He was 70. His death was confirmed by his wife, Kathryn, at the beginning of Limbaugh's radio show, from which he's been absent for almost two weeks. (Puente, 2/17)

The American Medical Association has removed a public display of its founder and taken his name off of one of its most prestigious annual awards as the organization seeks to reconcile its past discriminatory practices as part of its efforts to address systemic racism as a public health threat. In an opinion editorial posted to its website on Wednesday, American Medical Association CEO Dr. James Madara called the moving of a bust and display of Dr. Nathan Davis from public view at its Chicago headquarters to its archives a necessary step toward reconciling the AMA's past actions of discrimination. Women and Black doctors were barred from joining its ranks until the 1960s. (Ross Johnson, 2/17)

What happens when pandemic fighters are at risk themselves with preexisting medical conditions? (Kreidler, 2/12)

KHN: ‘I Wanted To Go In There And Help’: Nursing Schools See Enrollment Bump Amid Pandemic 
Last December, Mirande Gross graduated from Bellarmine University in Louisville, Kentucky, with a bachelor’s degree in communications. But Gross has changed her mind and is heading back to school in May for a one-year accelerated nursing degree program. The pandemic that has sickened more than 27 million people in the United States and killed nearly 500,000 helped convince her she wanted to become a nurse. “I was excited about working during the pandemic,” Gross, 22, said. “It didn’t scare me away.” (Andrews, 2/18)

KHN: Montana’s Health Policy MVP Takes Her Playbook On The Road 
Marilyn Bartlett might be the closest thing health policy has to a folk hero. A certified public accountant who barely tops 5 feet, Bartlett bears zero resemblance to Paul Bunyan. But she did take an ax to Montana’s hospital prices in 2016, stopping the state’s employee health plan from bleeding money. “Marilyn is not a physically imposing person,” said Montana Board of Investments Executive Director Dan Villa, who worked closely with Bartlett in state government. “She is a blend of your favorite aunt, an accounting savant and a little bit of July Fourth fireworks.” (Gorenstein and Walker, 2/18)

The Department of Housing and Urban Development has for years neglected to enforce its own environmental regulations, resulting in lead poisoning of children in at least one public housing development and potentially jeopardizing residents’ health in thousands of other federally subsidized apartments near contaminated sites, according to an inspector general report obtained by The Washington Post. The agency’s watchdog reviewed HUD’s efforts to identify and mitigate health risks to residents of public housing near toxic waste dumps after the East Chicago, Ind., apartment complex, where tenants had been living with lead contamination for more than four decades, was deemed uninhabitable in 2016. (Jan, 2/17)

In news about health insurance coverage in New Mexico and Kentucky —

Through May 15, New Mexico’s Health Insurance Exchange, beWellnm, is offering an open enrollment period for uninsured New Mexicans. The three-month reopening of the Affordable Care Act, or ACA, is also an opportunity for those who have lost job-based insurance during the pandemic to enroll in the marketplace and find affordable coverage. “BeWellnm encourages all uninsured New Mexicans to begin the enrollment process as soon as possible because of the limited amount of time to find comprehensive, affordable health insurance options,” said Maureen Manring, spokeswoman for beWellnm. More than 56,000 New Mexicans qualify for significant premium reductions, she said. (Nathanson, 2/17)

Gov. Andy Beshear has joined in urging Kentuckians who lack health insurance to take advantage of new opportunities now available to sign up for coverage. The sign-up window for government insurance markets runs through May 15. President Joe Biden ordered those markets that ended their annual enrollment periods in December to reopen. Beshear, who calls health care a basic human right, said the coronavirus pandemic has underscored how “expanded health care in Kentucky has helped us to have fewer deaths than most states.” (2/18)

In other news from Utah, New Mexico and California —

An effort to bar transgender girls from competing in female K-12 sports continued to make headway in the Utah Legislature, gaining passage through the House on a largely party-line vote. Opponents of the bill — titled “preserving sports for female students” — warned that it would further stigmatize youth who are already vulnerable and at higher risk for suicide. They said it would draw a legal challenge that Utah would likely lose. And they said it could undermine Utah’s prospects for hosting future sports tournaments and even the Olympics, given the probability that event organizers would choose to boycott the state. (Rodgers, 2/17)

Saturday, as the chill of a polar vortex descended outside, the state House Judiciary Committee took testimony via Zoom on a bill that if passed could allow terminally ill patients to die in a way less cold, less cruel. When it was over, the committee voted 7-3 to send House Bill 47 to the floor. Then it’s the Senate’s turn to do what it will with the Elizabeth Whitefield End of Life Options Act, which Gov. Michelle Lujan Grisham has signaled she will sign. It’s the third time the bill, modeled after similar laws in other states, has come before the Legislature, including 2017 when Whitefield, her voice raspy between gasps from a trach tube, testified about the dire need to give those like her facing a painful, certain death from a terminal illness the legal, physician-approved option to end their lives in peace, with a modicum of dignity and at a time of their choosing. (Gutierrez Krueger, 2/17)

KHN: California Aims To Address The ‘Urgent’ Needs Of Older Residents. But Will Its Plan Work?
Even as the pandemic derailed some of Gov. Gavin Newsom’s biggest health care proposals, such as lowering prescription drug costs, it crystallized another: the pressing need to address California’s rapidly aging population. Already nine months into their work when Newsom issued the nation’s first statewide stay-at-home order last March, members of a state task force on aging watched as the coronavirus disproportionately sickened and killed older people, and left many isolated in nursing homes, assisted living facilities and their own homes. (Young, 2/18)

In news from West Virginia, Washington, D.C., and Vermont —

Meeting in person for the first time in months, Charleston City Council voted Tuesday to move forward in surveying city first responders on their opinions of harm reduction in the community. The resolution passed with an amendment removing language that requested agencies uncertified by the state to pause needle distributions in Charleston while the council continued deliberating legislation that could outright ban such programs. The City Council meeting came five days after officials from the federal Centers for Disease Control and Prevention presented to the Kanawha-Charleston Health Department’s HIV task force, calling the county’s HIV crisis “the most concerning” in the nation. (Coyne, 2/17)

After an especially bloody year of shootings in the District, Mayor Muriel E. Bowser on Wednesday formally declared gun violence to be a public health crisis in the city and announced a new “whole-government” approach to combating the scourge, emphasizing more than just police work and prosecutions. With an initial investment of $15 million and more money to come, said Bowser (D), the city is establishing a “gun violence prevention emergency operations center,” to be staffed by the D.C. government’s “best and brightest” in the fields of education, job training, mental health counseling, housing and other services. (Duggan, 2/17)

Gov. Phil Scott signed a proclamation on Wednesday naming it “Recovery Day” in Vermont, which he called one small way to help reduce the stigma associated with mental illness and substance use disorder. “More importantly, highlighting this day also sends a message to those who are struggling that there is hope,” Scott said in a written statement. “To those who need support, please know that help and services are available, and there are many of us who care about you. Recovery is possible, and we want to do all we can to help you get there.” (2/17)

The limited supply of doses of the vaccines has forced State Department leaders to make difficult and unenviable decisions, and created humbling experiences for U.S. diplomats representing the world’s wealthiest country. Managing the shortage is an early challenge for Secretary of State Antony Blinken, who has pledged to restore “morale and trust” at the department. At least 13 foreign governments offered to inoculate U.S. officials serving abroad with their own supplies of U.S.-made Moderna and Pfizer vaccines — a gesture the State Department has already accepted, said senior U.S. officials. The department is evaluating offers from at least eight other countries that are willing to do the same. (Hudson, 2/17)

Just weeks ago, the European Union was clamoring for AstraZeneca Plc’s Covid-19 vaccine. Now, fewer than one-tenth of the doses delivered to Germany have been administered in the initial days of the roll-out, and some health-care workers say they’re concerned about side effects. Germany isn’t alone: Some French health workers are also pushing to get shots from Moderna Inc., Pfizer Inc. and BioNTech SE instead. Their reluctance comes after a clash last month over whether EU countries would get their fair share of AstraZeneca’s shipments as deliveries slowed. (Kresge, Loh and Rogers, 2/17)

Indonesia is requiring those eligible for the Covid-19 vaccine to take the shots as the country seeks ways to quicken its inoculation program to curb Southeast Asia’s largest outbreak. The government can punish those who refuse the vaccine by stopping or delaying social assistance programs and administrative services as well as impose fines, according to a revised presidential rule. The actual form of the sanctions are left to local governments to decide. (Aditya and Jiao, 2/18)

Cracking a joke about his fear of needles, South African President Cyril Ramaphosa on Wednesday became one of the first people to receive a COVID-19 vaccination in the country that has by far the highest confirmed virus caseload in Africa. “Can I close my eyes?” Ramaphosa bantered as a health worker injected him with the Johnson & Johnson vaccine in a live broadcast on South African television. ... The first phase of vaccinating the country’s health care workers will now begin as an observational study because the J&J shots are not yet authorized for general use here or anywhere in the world. (Imray and Magome, 2/17)

Tanzania’s president recently rejected any need for coronavirus vaccines, instead promoting herbal cures. He claims the nation of 60 million has been “covid-free” since he presided over three days of national prayer in June. Mark Mwandosya, a former minister in the president’s ruling party, knows that is not true. Over the past month, Mwandosya has turned his social media feeds into a stream of mini-obituaries. Fifteen of his family members and close friends have died. As he rattled off their names, he said he could not prove any of them had coronavirus, because the government has limited testing almost entirely to travelers. But the stories all go the same way. (Ombuor and Bearak, 2/17)

Vaccine supplies are running out. The number of daily deaths has reached a record high. A new variant that health officials say is three times as transmissible as the original coronavirus is spreading throughout the country. Some are calling for more lockdowns. But people can’t bring themselves to stop partying. Brazilians, a famously jovial and festive people, have struggled with restrictions on gatherings since the start of the pandemic. But the challenge has never been more clear than this week, when Rio de Janeiro filled with revelers to celebrate the annual bacchanal of Carnival — despite the fact that Carnival was canceled. (McCoy, 2/17)

Also —

Facebook Inc.’s move to block the sharing of articles from Australian news media has swept up government information outlets, nonprofit charities and even political satire pages. The pages for the Queensland and South Australia health services were among those affected, preventing them from serving Covid-19 information days ahead of a national vaccination program rollout. Australians were also prevented from accessing Foodbank Australia, Women’s Legal Shelter, the sites of some politicians and emergency service departments as well as the Australia Council of Trade Unions. Even wildlife-preservation group WWF Australia was caught up in the sweeping measure. (McKay and Scott, 2/18)

To describe presentation, hospital course, and predictors of bad outcome in multisystem inflammatory syndrome in children (MIS-C). Retrospective data review of a case series of children meeting the published definition for MIS-C who were discharged or died between March 1, 2020, and June 15, 2020, from 33 participating European, Asian, and American hospitals. Data were collected through a Web-based survey and included clinical, laboratory, electrocardiographic, and echocardiographic findings and treatment management. (Bautista-Rodriguez et al, 2/1)

World Health Organization expert groups recommended mortality trials of four repurposed antiviral drugs — remdesivir, hydroxychloroquine, lopinavir, and interferon beta-1a — in patients hospitalized with coronavirus disease 2019 (Covid-19). We randomly assigned inpatients with Covid-19 equally between one of the trial drug regimens that was locally available and open control (up to five options, four active and the local standard of care). The intention-to-treat primary analyses examined in-hospital mortality in the four pairwise comparisons of each trial drug and its control (drug available but patient assigned to the same care without that drug). Rate ratios for death were calculated with stratification according to age and status regarding mechanical ventilation at trial entry. (WHO Solidarity Trial Consortium, 2/11)

Also —

The results of a National Institutes of Health-funded phase 2 study indicate the new tuberculosis (TB) drugs delamanid and bedaquiline, when combined, have only a modest effect on the electrical activity of the heart, US, South African, and Peruvian researchers reported last week in the Lancet Infectious Diseases. In the phase 2 randomized controlled trial, patients in South Africa and Peru with multidrug-resistant or rifampicin-resistant TB were randomized 1:1:1 to receive bedaquiline, delamanid, or both for 24 weeks. The two new drugs are considered critical components of a shorter, less toxic regimen for multidrug-resistant and rifampicin-resistant TB, but the cardiac and microbiologic safety of combining the two has not been well-established. (2/15)

Pediatric patients who develop hemolytic uremic syndrome (HUS)—a rare kidney failure that follows an Escherichia coli infection—are at risk for severe acute neurologic symptoms (ANS), according to a study based on almost 4,000 US patients. The findings were published today in Pediatrics. The study was the largest to date to describe ANS following HUS, and showed a strong correlation between increased multiple neurological symptoms and mortality. The authors used the Pediatric Health Information System database to identify HUS-related inpatient visits between 2004 and 2018. (2/15)

The Centers for Disease Control and Prevention (CDC) says that it has identified nine US cases of extensively drug-resistant (XDR) typhoid fever that aren't linked to travel. The news came in a Health Advisory issued late last week by the CDC, which said that, as of Jan 14, it has received 71 reports of XDR typhoid infections in the United States dating back to 2018, when surveillance for the pathogen began. Of the 67 patients with a travel history, 58 reported travel to Pakistan in the 30 days before their illness began. Nine patients from six states reported no travel to Pakistan or any other country. (Dall, 2/15)

A big tempest is brewing in a big teapot over President Biden’s $1.9 trillion coronavirus relief plan. Republican objections are to be expected. But some of the objections come from nominally Democratic economists, led by former Treasury Secretary Lawrence Summers. This is a surprise. The Biden plan isn’t perfect. But with today’s enormous uncertainties, no one can possibly know what the “right” plan really is. (Alan S. Blinder, 2/17)

Vaccine shortages and precious doses wasted. Unnavigable systems for making appointments. A stark racial and economic divide in the distribution of shots. Scary virus mutants that may render vaccines ineffective. Protesters disrupting vaccination sites.It may seem at times that the high hopes for the COVID-19 vaccination rollout have fizzled since December, when the U.S. Food and Drug Administration gave emergency authorization to the first vaccine. But step back for a moment and chew on this little factoid: In just two months, the U.S. has managed to administer 55 million shots — more than any other country — even during a chaotic time of plague and contentious presidential transition. (2/17)

Media reports describe the inarguable, if inconvenient, circumstances that follow us into the second year of the Covid-19 pandemic: In addition to hundreds of thousands of Americans killed by the disease, thousands of those who have “recovered” develop long Covid, a syndrome marked by symptoms such as cough, head and body aches, fatigue, loss of taste and smell, and “brain fog” that can linger — or disappear and reappear — for months after the main symptoms of Covid-19 fade away. It can occur even in those with initially mild cases of Covid-19. (Jennifer Olsen, 2/18)

Imagine a highly contagious virus circulating in the community. Many infected children have fever and some general misery but recover without incident. Rarely, devastating complications occur, leading to hospitalization, severe illness, and occasional deaths. Susceptible adults fare worse, with higher rates of poor outcomes. Would you want your child vaccinated against this disease? You guessed we were talking about measles, right? As the first SARS-CoV-2 vaccines are rolled out to the highest-risk groups, the current stage of the Covid-19 pandemic is pregnant with possibility. (Perri Klass, 2/18)

Given the lack of highly effective therapies against COVID-19, except perhaps for corticosteroids, it is important to remain open-minded to emerging results from rigorously conducted studies of vitamin D (despite smaller sample sizes and important limitations of some studies). However, taken together with existing randomized clinical trials of vitamin D administration in hospitalized patients with respiratory infection and critical illness, the results reported by Murai et al do not support routine administration of vitamin D in hospitalized patients with moderate to severe COVID-19. (David E. Leaf and Adit A. Ginde, 2/17)

My mother, Joan Morris, died of Covid-19, which she contracted at a Brooklyn, N.Y., nursing home. She arrived there Jan. 24, 2020. She came down with Covid symptoms the week of April 5. She was sent to the hospital on April 10, was diagnosed with Covid on April 11, and died on April 17. Last month the state acknowledged that 12,743 people died of Covid contracted in nursing homes because they were inexplicably put in harm’s way by the admission of new residents who were Covid-positive. My mother’s death was entirely preventable. (Kieran E. Morris, 2/17)

In Los Angeles, you can once again dine outdoors at a restaurant. Stores are open and freeways are buzzing. Construction sites are crowded on weekdays as are the beaches on sunny weekends. But our region’s dozens of university campuses remain closed with plans for remote education at least through summer — and continued uncertainty about the shape of fall. Nearly all university teaching throughout Southern California has been conducted remotely since March. This decision has promoted the safety of students, faculty, staff and the broader L.A. community, but it also comes at a cost. As we look ahead, the fall semester and higher education remain in jeopardy, despite the arrival of the COVID-19 vaccine. (Jennifer Mnookin and Eileen Strempel, 1/18)

Three weeks ago, Julia Gray, a florist, delivered a bright bouquet of flowers to a customer in Queens — spring colors, by request. Judging by the accompanying card, which the sender had carefully dictated to Ms. Gray by telephone, a familial falling out had taken place. The flowers were sent as an apology. “It was this young woman, sending flowers to her aunt,” Ms. Gray said. “She hadn’t seen her family for a year and a half.” When Ms. Gray told the recipient the flowers were from her niece, her face lit up. “People are realizing that time is of the essence,” Ms. Gray said. “You can’t hold a grudge.” (Carly Lewis, 2/17)