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Small gatherings are becoming a growing source of Covid-19 spread, a leading health expert said, as at least 36 states are now reporting increased cases of the virus and hospitalizations are on the rise nationwide. "In the public square, we're seeing a higher degree of vigilance and mitigation steps in many jurisdictions," US Centers for Disease Control and Prevention Director Dr. Robert Redfield said during a call with the nation's governors on Tuesday. Audio of the call was obtained by CNN. (Maxouris, 10/14)

U.S. coronavirus cases are rising again, driven by rapid transmission in Midwestern states and sparking fears that a forewarned wave of infections this fall and winter has begun. For almost a month, new U.S. cases have been trending upward. Since Saturday, more than 20 states have hit a new high in their seven-day average of case counts, and more than half of those states set records again on Tuesday, according to data tracked by The Washington Post. (Wan and Dupree, 10/13)

North Dakota looks poised to become the No. 1 state in the nation by cumulative Covid-19 cases per capita, having surged past Florida and Mississippi with Louisiana just ahead. South Dakota, Utah, Wisconsin and Montana are also quickly adding cases. (Levin, 10/13)

During this pandemic, people in the United States are currently dying at rates unparalleled elsewhere in the world. A new report in the Journal of the American Medical Association finds that over the last 5 months per capita deaths in the U.S., both from COVID-19 and other causes have been far greater than in 18 other high-income countries. "It's shocking. It's horrible," says Dr. Ezekiel J. Emanuel, a professor of health policy and medical ethics at the University of Pennsylvania and one of the authors of the study. (Beaubien, 10/13)

In updates from the states —

Coronavirus cases are rising in Michigan and COVID-19 hospitalizations have spiked 80% in recent weeks, climbing in all regions of the state, health officials warned Tuesday. "It is very possible that this is the beginning of a second wave," said Dr. Joneigh Khaldun, the chief medical executive and chief deputy director for health for the Michigan Department of Health and Human Services. (Shamus, 10/13)

Declaring Utah’s continuing surge of coronavirus cases “unacceptable,” Gov. Gary Herbert announced the state will abandon its previous color codes for a new strategy that ties restrictions to local case numbers and testing rates. Masks will be required in several of Utah’s counties under the statewide order. (Alberty, 10/13)

It could be two weeks until there is news on a paused trial of Eli Lilly’s closely watched monoclonal antibody treatment for Covid-19. The National Institutes of Health said late Tuesday that it paused the trial because one of the two groups in the study — one had received the antibody, the other a placebo — was doing better than the other. Both groups also received remdesivir, a Covid-19 treatment from Gilead Sciences. (Garde and Herper, 10/13)

U.S. drug inspectors uncovered serious quality control problems at an Eli Lilly and Co pharmaceutical plant that is ramping up to manufacture one of two promising COVID-19 drugs touted by President Trump as “a cure” for the disease, according to government documents and three sources familiar with the matter. The Lilly antibody therapy, which is experimental and not yet approved by regulators as safe and effective, is similar to a drug from Regeneron Pharmaceuticals that was given to the president during his bout with COVID-19. Trump, who credits the Regeneron drug with speeding his recovery, has called for both therapies to become available immediately on an emergency basis, raising expectations among some scientists and policy experts that the administration will imminently release an Emergency Use Authorization (EUA) for the drug. (Levine and Taylor, 10/13)

Also —

Johnson & Johnson hopes to know within days whether it can resume testing its Covid-19 vaccine, as the health-products company battles the virus on several fronts. An independent committee is investigating the unexplained illness of a study volunteer that prompted a pause in clinical trials of the company’s experimental Covid-19 vaccine, J&J Chief Financial Officer Joseph Wolk said in an interview Tuesday. The illness is “still under investigation and we’re going to let that process play out,” Mr. Wolk said. The company is hopeful that the pause will only last a few days, he said. (Loftus, 10/13)

Here is what we know about drugs and vaccines: If tested in rigorous clinical trials and shown to be safe and effective, they make the world a healthier place. Here is another thing we know about drugs and vaccines: They are not easy to develop. (Garde, 10/13)

Recent pauses to two large-scale COVID-19 vaccine trials and a treatment study should reassure people — not frighten them — vaccine experts said, though it is a reminder of the messiness of science. “This is an indication that the system is working as it was designed to work to protect human subjects in clinical trials,” Lawrence Gostin, a public health and legal expert at Georgetown and Johns Hopkins universities, said Tuesday. “It demonstrates that the ethical guard rails on vaccine trials are working.” (Weintraub and Weise, 10/13)

Supreme Court nominee Amy Coney Barrett returns to Capitol Hill for a third day of confirmation hearings as senators dig deeper into the conservative judge’s outlook on abortion, health care and a potentially disputed presidential election — the Democrats running out of time to stop Republicans pushing her quick confirmation. Wednesday’s session is set to be Barrett’s last before the Senate Judiciary Committee. She has been batting away questions in long and lively exchanges, insisting she would bring no personal agenda to the court but decide cases “as they come.” (Mascaro, Sherman and Kellman, 10/14)

On the subject of the Affordable Care Act —

As senators on Tuesday grilled Judge Amy Coney Barrett over her views on the Affordable Care Act during the second day of Supreme Court confirmation hearings, Barrett repeatedly said she had no goal to repeal the healthcare law. Democrats have made Barrett's criticism of an opinion Chief Justice John Roberts wrote upholding the ACA a key tenet of their argument against Barrett's nomination, saying that her confirmation before oral arguments in a case that could determine the fate of the ACA on Nov. 10 could mean invalidation of the entire statute, including protections for patients with preexisting conditions. (Cohrs, 10/13)

Judge Amy Coney Barrett on Tuesday said a pending challenge to the Affordable Care Act (ACA), which the Supreme Court will consider on Nov. 10, is not affected by past rulings by the court upholding the health care law. Barrett said Chief Justice John Roberts’s landmark ruling in National Federation of Independent Business v. Sebelius, which upheld the Affordable Care Act in a 5-4 decision, does not protect the law from being struck down over the issue now pending before the high court. (Bolton, 10/13)

Supreme Court nominee Amy Coney Barrett said she did not strike down the Affordable Care Act (ACA) but did find its individual mandate unconstitutional in a recent moot court case, while stressing her actions in the moot court case did not actually reflect how she might rule on ObamaCare if confirmed to the high court. Barrett, currently a judge on the U.S. Court of Appeals for the Seventh Circuit, has faced withering criticism from Democrats who say she will vote to overturn the signature Obama-era health care law in an upcoming case regarding the ACA that the high court will hear on Nov. 10, one week after the election. (Axelrod, 10/13)

Barrett said the job of the justices is to decide whether the law can still stand without a tax mandate — by “severing” it from the rest of the law — or whether that’s legally impossible. She said she would consider the real-world consequences of her decision and what she thought Congress intended those consequences to be when Republicans fundamentally changed how the mandate works. “I’m not hostile to the ACA,” she said. (Phillips, 10/13)

On the subject of abortion —

Supreme Court nominee Amy Coney Barrett said Tuesday that she did not consider Roe v. Wade, the landmark ruling establishing a woman’s right to an abortion, as a superprecedent, meaning a decision so widely accepted that it is invulnerable to serious legal challenges that could see it overturned. Barrett said during the second day of her Supreme Court confirmation hearing that she defined superprecedent as cases that are “so well settled that no political actors” or other people are “seriously pushing for its overruling.” (Hellmann, 10/13)

Amy Coney Barrett has been something of a stone wall in her Supreme Court confirmation hearings. She has resolutely declined to weigh in on anything that might come before the court. But she has also demurred on whether a president can unilaterally delay an election (it’s pretty clear President Trump can’t) and whether voter intimidation is a federal crime (it is). But after hours of pulling teeth, Sen. Amy Klobuchar (D-Minn.) might have moved the needle a bit. (Blake, 10/13)

Sen. Kamala Harris (D-Calif.) told Amy Coney Barrett [Tuesday] that her nomination to the Supreme Court poses a serious threat to abortion rights, signaling that women’s reproductive freedom will emerge as a significant issue in the final weeks of the 2020 campaign. “Anti-choice activists and politicians have been working for decades to pass laws and file lawsuits designed to overturn Roe and the precedents that followed. The threat to choice is real,” Harris said during her 30 minutes of question time at Barrett’s second day of confirmation hearings. (Bolton, 10/13)

And regarding the presidential election —

Judge Amy Coney Barrett flatly refused on Tuesday to pledge that she would recuse herself if a dispute over the Nov. 3 election came before the Supreme Court, insisting that despite her nomination by President Trump, she would not “allow myself to be used as a pawn to decide this election for the American people.” ... “I have not made any commitments or deals or anything like that,” she told the Senate Judiciary Committee on her second day of confirmation hearings. “I’m not here on a mission to destroy the Affordable Care Act. I’m just here to apply the law and adhere to the rule of law.” (Fandos, 10/13)

The Supreme Court on Tuesday rejected South Carolina’s request to reinstate its blockade on Medicaid funding to Planned Parenthood and other abortion providers, a move that could indicate the court’s conservative majority may be selective about abortion cases as a new member is expected to soon join its ranks. The case is one the first major reproductive rights challenges the court has considered since the death of Justice Ruth Bader Ginsburg last month, and its rejection was announced on the second day of Senate hearings for President Donald Trump's nominee to the court, Amy Coney Barrett. Both sides of the abortion debate have been closely watching how aggressive the court’s conservatives will move to roll back abortion access with Barrett seemingly on track for confirmation later this month. (Ollstein, 10/13)

The U.S. Supreme Court on Tuesday rejected a years-long effort by South Carolina leaders to cut off public funding for two Planned Parenthood clinics that provide abortions in the Palmetto State. The country’s highest court declined to consider an appeal in which Gov. Henry McMaster sought to remove two Planned Parenthood clinics — one in Charleston and one in Columbia — from the state’s Medicaid network. The high court, in essence, upheld previous rulings that prevent South Carolina from shutting off government reimbursements to Planned Parenthood clinics that treat Medicaid patients, the health insurance program for the poor. (Wilks, 10/13)

The high court’s rejection means that last year’s ruling from the 4th Circuit Court of Appeals will remain in effect, prohibiting the state from terminating Planned Parenthood as a Medicaid provider. While it takes four justices to approve a petition, the court doesn’t publish the vote totals and it declined to hear the case without comment. (Hellman, 10/13)

In other news about Planned Parenthood —

Reproductive health care nonprofit Planned Parenthood corrected comments made by Senator Ted Cruz during Amy Coney Barrett's Supreme Court confirmation hearings, where he referred to birth control pills as "abortion inducing drugs." The Texas senator referred to birth control as such when discussing assumed threats on religious freedom, referencing the Supreme Court case of The Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania. "It also extends to religious liberty. The Little Sisters of the Poor, our Catholic Convent of nuns, who take oaths of poverty, who devote their lives to caring for the sick, caring for the needy, caring for the elderly, and the Obama administration litigated against the little sisters of the poor, seeking to fine them in order to force them to pay for abortion-inducing drugs among others," he said during his lengthy address at the hearings. (Crowley, 10/13)

Twitter users are sharing their positive experiences of using non-profit Planned Parenthood for services other than abortion, amid a reignited debate about reproductive rights in the U.S. The hashtag gained traction on Twitter the same day that Planned Parenthood, which provides reproductive healthcare, corrected Senator Ted Cruz after he wrongly referred to birth control as "abortion inducing drugs." (Gander, 10/14)

Also —

Michigan Senator Gary Peters, a Democrat, and one who tends to steer clear of national headlines, made history Monday when he shared his family’s personal experience with abortion in an interview with Elle Magazine. Less than a month before a pivotal election, Peters is the first sitting senator in the US to publicly break the silence on such a highly contended and politicized issue. (Bowker, 10/13)

The White House has embraced a declaration by a group of scientists arguing that authorities should allow the coronavirus to spread among young healthy people while protecting the elderly and the vulnerable — an approach that would rely on arriving at “herd immunity” through infections rather than a vaccine. Many experts say “herd immunity” — the point at which a disease stops spreading because nearly everyone in a population has contracted it — is still very far-off. Leading experts have concluded, using different scientific methods, that about 85 to 90 percent of the American population is still susceptible to the coronavirus. (10/14)

Maverick scientists who call for allowing the coronavirus to spread freely at “natural” rates among healthy young people while keeping most aspects of the economy up and running have found an audience inside the White House and at least one state capitol. The scientists met last week with Health and Human Services Secretary Alex Azar and Scott Atlas, a neuroradiologist who has emerged as an influential adviser to President Trump on the pandemic. (Achenbach, 10/13)

The head of the World Health Organization warned against the idea that herd immunity might be a realistic strategy to stop the pandemic, dismissing such proposals as “simply unethical.” At a media briefing on Monday, WHO Director-General Tedros Adhanom Ghebreyesus said health officials typically aim to achieve herd immunity by vaccination. Tedros noted that to obtain herd immunity from a highly infectious disease such as measles, for example, about 95% of the population must be immunized. (10/12)

Coronavirus task force member Dr. Scott Atlas and Sen. Rand Paul have misleadingly suggested that much of the U.S. population has immunity to the coronavirus due to previous exposure to similar viruses. But scientists say any possible protection is theoretical — and can’t be relied upon to control the pandemic. (McDonald, 10/13)

Social Security recipients will get a modest 1.3% cost-of living-increase in 2021, but that might be small comfort amid worries about the coronavirus and its consequences for older people. The increase amounts to $20 a month for the average retired worker, according to estimates released Tuesday by the Social Security Administration. That’s a little less than this year’s 1.6% cost-of-living adjustment, or COLA. ... The economic fallout from the virus has reduced tax collections for Social Security and Medicare, likely worsening their long-term financial condition. (Alonso-Zaldivar and Taylor, 10/13)

AARP Chief Executive Jo Ann Jenkins called the cost-of-living adjustment “modest,” but said the increase was crucial given the coronavirus pandemic’s health and economic consequences. Medicare’s trustees in April projected the standard 2021 monthly premium for Medicare Part B, which covers doctor visits and other types of outpatient care, would increase by $8.70 to $153.30 from $144.60 this year. The trustees, citing uncertainty around the Covid-19 outbreak, didn’t factor any potential impacts from the pandemic into their projections. However, such a rise in Part B standard premiums would consume about 43% of the increase in the average monthly Social Security retirement benefit. (Omeokwe, 10/13)

Federal retirement benefits will be increased by 1.3 percent in January, the same as the upcoming increase in Social Security benefits that was announced Tuesday. The cost-of-living adjustment, or COLA, will go to almost all of the nearly 2.2 million federal retirees plus about 500,000 survivor beneficiaries. The figure is about average for the past 10 years, when the boosts have ranged from zero to 3.6 percent; a 1.6 percent increase was paid at the start of this year. (Yoder, 10/13)

And Trump's drug-discount cards may not arrive before the election —

President Trump’s plan to send 33 million Medicare beneficiaries a card that can be used to help pay for as much as $200 in prescription drug costs won’t be completed until after the election, according to a person familiar with the plan. The cards will be mailed in phases, with some likely going out later in October but most not until after the Nov. 3 presidential election, the person said. The Centers for Medicare and Medicaid Services is spending an estimated $20 million for administrative costs to print and send letters to Medicare beneficiaries informing them that they will be getting cards, the person said. (Armour, 10/13)

Top-ranking Democrats want an independent watchdog to expedite a review of the Trump administration's plans to send $200 Medicare prescription drug discount cards to seniors. The lawmakers said they don't think the administration has the legislative authority to enact the plan, and they're concerned it is an improper attempt to influence the election. (Weixel, 10/13)

The wife of Labor Secretary Eugene Scalia tested positive for coronavirus on Tuesday afternoon, the department told its employees in a Tuesday night email. Trish Scalia “is experiencing mild symptoms but doing well,” the Labor Department wrote, adding that Secretary Scalia had tested negative and experienced no symptoms of the virus. The agency didn’t specify whether Trish Scalia would self-isolate, but did say, “The Secretary and Mrs. Scalia will follow the advice of health professionals for Trish’s recovery and the health of those around them.” Secretary Scalia, his wife and his mother sat in the second row for the late-September introduction of Supreme Court nominee Amy Coney Barrett at the White House. (Bermel, 10/13)

New Jersey Gov Phil Murphy said Tuesday that state and local health officers have not identified any outbreaks of coronavirus linked to attendance at a fundraiser earlier this month at President Donald Trump’s golf club in Bedminster. “We’re not aware of any outbreaks and the federal response was extremely disappointing,” Murphy told reporters after an unrelated press conference with Sen. Bob Menendez, Rep. Tom Malinowski (both D-N.J.) and state legislative leaders in Somerset County, about 20 miles from Trump National Golf Club Bedminster. (Sutton, 10/13)

The day after President Trump made his dramatic return from the hospital, taking off his mask in an “Evita”-style moment outside the White House residence before walking inside, the office of first lady Melania Trump, who was also sick with the coronavirus, released an incredibly detailed statement on the precautions it had taken since March to protect the members of the staff — the butlers, housekeepers, florists, chefs — working in the executive residence. The timing of the statement, about the care she is taking to prevent the spread of the virus while her infectious husband returned to the White House, was its own kind of statement. It seemed to be her way of answering an outcry of concern over the safety of the residence staff. This first lady with what can at times seem like an antagonistic relationship with the press, who rarely gives interviews or deviates from her prepared remarks at public appearances, was following her own playbook. (Yuan, 10/13)

Hospitalizations, virus spread and deaths continued at high levels Tuesday in Iowa on the eve of a campaign rally by President Donald Trump, where Gov. Kim Reynolds and thousands of other Trump supporters will likely defy the governor’s own emergency proclamation to keep distance between people in public places. Iowa remains under a public health emergency declared by Reynolds on March 17. It requires that organizers of mass gatherings “must ensure at least six feet of physical distance between each group or individual attending alone.” (Pitt, 10/13)

Minnesota health officials said Monday that they have connected more than two dozen coronavirus cases to Trump and Biden campaign events in the state... Minnesota on Tuesday reported 1,537 new cases, the highest single-day figure since the beginning of the pandemic, according to The New York Times. (Budryk, 10/13)

In other presidential campaign news —

Joseph R. Biden Jr. turned his attention on Tuesday to older Americans, making a case in South Florida that seniors were paying the price for the president’s poor handling of the coronavirus pandemic. “The only senior that Donald Trump cares about — the only senior — is senior Donald Trump,” Mr. Biden said in a speech at a community center in Pembroke Pines, a city in the vote-rich Democratic stronghold of Broward County. ... He went on to say that Mr. Trump’s “reckless personal conduct since his diagnosis is unconscionable.” (Mazzei and Kaplan, 10/14)

Last week, President Trump tweeted out a video where he makes a direct appeal to seniors, calling them “my favorite people in the world!” That affectionate tone was nowhere to be found in his latest broadside against his Democratic opponent, former vice president Joe Biden. Trump on Tuesday night shared a meme of Biden Photoshopped in a wheelchair inside what appears to be a nursing home, implicitly mocking him as elderly and disabled. (Elfrink, 10/14)

KHN and Politifact: Pence Said Biden Copied Trump’s Pandemic Response Plan. Pants On Fire!
During last week’s vice presidential debate, moderator Susan Page, USA Today’s Washington bureau chief, asked Vice President Mike Pence about the U.S. COVID-19 death toll. Pence replied by touting the Trump administration’s actions to combat the pandemic, such as restrictions on travel from China, steps to expand testing and efforts to accelerate the production of a vaccine. Pence also took a jab at Democratic presidential nominee Joe Biden, a strong critic of the Trump pandemic response. “The reality is, when you look at the Biden plan, it reads an awful lot like what President Trump and I and our task force have been doing every step of the way,” said Pence. “And, quite frankly, when I look at their plan,” he added, “it looks a little bit like plagiarism, which is something Joe Biden knows a little bit about.” (Knight, 10/14)

And updates on state races —

Democratic U.S. Sen. Mark Warner of Virginia and his Republican opponent, Daniel Gade, sparred over how best to respond to the coronavirus and other health care issues Tuesday in their third and final debate. The televised event, sponsored by the AARP, focused heavily on the pandemic as well as issues important to seniors, like prescription drug prices and the Affordable Care Act. Warner, a former governor, cast himself as a trusted problem solver. (Suderman, 10/14)

Candidates in two closely contested suburban Atlanta U.S. House districts continued to clash Tuesday over their views on health care, the pandemic response and the size of government. Those disagreements were aired in two debates sponsored by the Atlanta Press Club. One was between 6th Congressional District incumbent Lucy McBath, a Democrat, and Republican Karen Handel, the woman McBath unseated in a narrow 2018 victory. Slightly less sharp was a debate between candidates in the neighboring 7th District, where Democrat Carolyn Bourdeaux is trying to claim an open seat after falling just short of beating Republican incumbent Rob Woodall in 2018. With Woodall stepping down, Republican Rich McCormick is trying to hold the seat for his party. (Amy, 10/13)

Running for office as a mom with children under 18 was hard enough before the pandemic. Now it means spending a lot of time at home, but that time is away from their families, trying to look out for their children’s mental health, as well as their own, and feeling that “mom guilt” that they still aren’t doing enough — even while they are running to build a better future for their children. (Thompson, 10/14)

President Trump’s long-fraught relationship with Anthony S. Fauci, the nation’s top infectious-disease specialist, ruptured again this week in an ugly public dispute just as U.S. coronavirus cases have ticked past 50,000 per day and with three weeks left in a campaign dominated by the government’s response to the pandemic. Trump on Tuesday responded to Fauci’s warnings that the president’s decision to resume campaign rallies this week was “very troublesome” by mocking him in a tweet that unfavorably compared his medical guidance to his errant ceremonial first pitch at a Washington Nationals game in July. (Nakamura, Dawsey and Abutaleb, 10/13)

The president’s tweet appeared to be a reference to skepticism Dr. Fauci expressed about masks in March, a position he later reversed. Mr. Trump didn’t wear a mask in public until this summer and has often mocked their usage. The president’s latest criticism of Dr. Fauci, whom he has regularly attacked for months, came a day after the doctor called for the Trump campaign to take down the ad featuring his comments. “To take a completely out-of-context statement…I thought it was really very disappointing,” Dr. Fauci said on CNN on Monday. He said it would be “outrageous” if the campaign uses his comments in future ads. (Ballhaus, 10/13)

Also —

Health officials have struggled to convey the seriousness of Covid-19 to many Americans. President Trump’s rapid recovery from the disease, while welcome by all, makes the challenge even more difficult, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases acknowledged. Trump’s quick bounce-back from his infection will likely underscore the mistaken belief some people have that the disease does not present significant health risks, Fauci said in an interview with STAT. (Branswell, 10/13)

President Donald Trump took to Twitter on Tuesday to urge the California Republican Party to “fight on” in its move to collect ballots in unofficial “drop boxes’’ around the state, in defiance of legal threats from state officials. Trump’s comments come a day after top California officials sent the state party a cease-and-desist notice, ordering them to remove the unofficial ballot drop boxes. The appearance of the boxes prompted Gov. Gavin Newsom to accuse California Republicans of “willing to lie, cheat and threaten our democracy all for the sake of gaining power.” (Marinucci, 10/14)

From lawsuits by the Trump campaign to a decree from the governor of Texas — to the sudden appearance of boxes falsely labeled “official” in California — Republicans are intensifying efforts to eliminate the use of drop boxes to collect absentee ballots, or using them in ways that undermine confidence in their security. (Thrush and Corasaniti, 10/13)

Also —

Early voting in Texas began Tuesday with crowds of excited voters waiting in line for several hours in some places to cast their ballots, even as new legal developments sowed confusion and threatened to restrict options for voting ahead of Election Day. As they have in other states, long lines formed outside voting locations as socially distanced voters sometimes turned up hours before early in-person voting began Tuesday morning. Many brought folding chairs, lunches and umbrellas to wait their turn. (Ye Hee Lee, Gardner and Martin, 10/14)

Virginia’s online voter registration portal crashed on the final day it was available when roadside utility workers cut the wrong cable. Texans waited in long lines on the first day of early voting in their state’s biggest cities, and in one county in the Houston suburbs, a programming error took down all of the voting machines for much of the morning. On Georgia’s second day of early voting, long lines again built up at polling places in the Atlanta suburbs. The hurdles to early voting on Tuesday resulted from a combination of intense voter interest that stressed the capacity of overwhelmed local elections officials and the sort of messiness that has long been common in American elections and which is now under a microscope as concerns over voter suppression and the unprecedented dynamics of voting during a pandemic collide. (Epstein, Saul and Fernandez, 10/13)

Senate Majority Leader Mitch McConnell (R-Ky.) announced on Tuesday that the Senate will take up a narrow economic relief bill when it comes back in session next week. President Trump immediately undermined the move, writing on Twitter: “STIMULUS! Go big or go home!!!”The clashing messages were a stark display of GOP disunity just three weeks before the November election, as Senate Republicans balk at a $1.8 trillion relief package Treasury Secretary Steven Mnuchin has offered to House Speaker Nancy Pelosi (D-Calif.). Trump, though, has suggested Republicans should agree to an even bigger deal than what Democrats have offered. (Stein and Werner, 10/13)

“When the full Senate returns on October 19th, our first order of business will be voting again on targeted relief for American workers, including new funding for the PPP," McConnell said in a statement, referring to the Paycheck Protection Program. McConnell, during a stop in Kentucky on Tuesday, said the bill would be "highly targeted" and authorize around $500 billion. The bill, he noted, would include money for schools, hospitals and protections from coronavirus-related lawsuits. (Carney, 10/13)

With President Donald Trump and his top aides urging the GOP to address the issue and replenish the Paycheck Protection Program for small businesses, McConnell (R-Ky.) is daring Democrats to block it again. “Republicans do not agree that nothing is better than something for working families. The American people need Democrats to stop blocking bipartisan funding and let us replenish the PPP before more Americans lose their jobs needlessly,” McConnell said in a statement. (Everett and Ferris, 10/13)

Also —

Speaker Nancy Pelosi (D-Calif.) on Tuesday defended holding out for a more expansive COVID-19 economic relief package than the current proposal offered by the Trump administration in an unusually contentious interview with CNN's Wolf Blitzer, telling the news anchor that "you really don't know what you're talking about" and calling him an "apologist" for Republicans. Pelosi and the Trump administration have been trying to negotiate a pandemic relief package for months to no avail, with Democrats currently pushing for a price tag of $2.2 trillion — down from their initial proposal of $3.4 trillion this spring — and the Trump administration most recently offering a $1.8 trillion proposal. (Marcos, 10/13)

Speaker Nancy Pelosi (D-Calif.) on Tuesday shot down entreaties from some Democrats to cut a $1.8 trillion deal with the White House on coronavirus relief, arguing that President Trump's pleas for Congress to "go big" have given her leverage to hold out for more aid. "I appreciate the, shall we say, a couple people saying, ‘Take it, take it, take it,’" Pelosi said in a phone conference with Democrats, according to source on the call. "Take it? Take it? Even the president is saying, ‘Go big or go home.’" (Lillis, 10/13)

Drugmaker Pfizer has plans to start testing its experimental coronavirus vaccine in children as young as 12, and parents have already expressed interest in enrolling their kids, the researcher leading the trial told CNN Tuesday. It will be the first coronavirus vaccine trial to include children in the United States. A team at Cincinnati Children's Hospital will begin vaccinating teenagers aged 16 and 17 this week, and will move to enroll 12-to 15-year-olds later, said Dr. Robert Frenck, director of the Vaccine Research Center at the hospital. (Fox, 10/13)

The FDA is resisting Trump administration pressure to rebrand the emergency authorization of a Covid-19 vaccine as a “pre-licensure,” over worries that it would appear the agency is politicizing its scientific determinations, according to four senior administration officials with knowledge of the debate. FDA Commissioner Stephen Hahn rejected attempts to alter the terminology tied to its closely watched regulatory process in recent weeks, frustrating health department officials who contend the agency is holding coronavirus vaccines to a far higher standard than normal for an emergency authorization – and that its description should reflect that, the officials said. (Cancryn, 10/13)

In updates on testing and tracing —

The U.S. government is investing $481 million in startup Cue Health Inc. to expand manufacturing of its rapid, point-of-care Covid-19 test, the U.S. Department of Health and Human Services and the Department of Defense said on Tuesday. As part of the deal, Cue Health plans to ramp up production from several thousands of tests daily to about 100,000 of the assays each day by March. The vast majority of that production will go to the government, which is acquiring about 6 million of the single-use tests and 30,000 associated instruments. (Court, 10/13)

The United States has more than 50,000 contact tracers for the first time since the coronavirus pandemic hit, according to a survey of states conducted by the Johns Hopkins Center for Health Security in collaboration with NPR. The total number of contact tracers reported in all U.S. states and territories was 53,116. That's four times the number of contact tracers states reported to NPR in its initial survey in late April, but still falls far short of the more than 100,000 public health experts have been calling for since the pandemic began, seven months ago. (Simmons-Duffin, 10/14)

Seven months into the coronavirus pandemic, we’re a far cry from the early days when getting a test was nearly impossible. Now, people have a lot more options, with major coronavirus testing initiatives and more places to get tested. But there are also a wide variety of tests available, ranging from highly reliable to not-so-much. From rapid testing to deep nasal swabs, antibodies to antigens, it can be confusing to sort out. (Vainshtein, 10/12)

Johnson & Johnson announced on Tuesday that it is adding $1 billion to its contribution to the all-in settlement deal struck last year that would resolve opioid lawsuits against the company. The settlement is part of the $48 billion framework that four states announced one year ago in which Johnson & Johnson and four other companies agreed to provide $22 billion in cash and $26 billion worth of a generic opioid addiction treatment, product distribution and data tracking measures. (Williams, 10/13)

Also —

Wright, like most marijuana growers nationwide, doesn’t have crop insurance. Because federal law defines marijuana as an illegal, dangerous drug, neither federal agencies nor conventional banks and major insurance companies will work with marijuana businesses even if they are legal under state law. Producers and industry supporters now are pushing for changes to federal relief law and seeking state disaster aid. (Quinton, 10/14)

At the peak of the Covid-19 wave that swept through New York City in the spring, with hospitals overwhelmed and more than 700 new virus deaths being reported each day, researchers there scrambled to build artificial intelligence models that could help doctors get a handle on the crisis. Now, results are coming in on how well those models work. The data suggest that these tools may hold promise to help to combat an expected resurgence of cases this winter, though they are far from perfect at predicting a patient’s trajectory. (Robbins, 10/14)

A federal judge in California on Tuesday denied bids by Theranos Inc. founder Elizabeth Holmes and former top executive Ramesh “Sunny” Balwani to dismiss the criminal charges they face in connection with the disgraced blood-testing startup. Ms. Holmes, 36 years old, is set to go to trial March 9 on charges she and Mr. Balwani defrauded investors out of hundreds of millions of dollars and deceived patients by lying about the reliability of Theranos blood tests. Mr. Balwani will face trial separately at a later date. (Davis O'Brien, 10/13)

A Japanese supercomputer showed that humidity can have a large effect on the dispersion of virus particles, pointing to heightened coronavirus contagion risks in dry, indoor conditions during the winter months. The finding suggests that the use of humidifiers may help limit infections during times when window ventilation is not possible, according to a study released on Tuesday by research giant Riken and Kobe University. ... The study also indicated that clear face shields are not as effective as masks in preventing the spread of aerosols. Other findings showed that diners are more at risk from people to their side compared to across the table, and the number of singers in choruses should be limited and spaced out. (Swift, 10/14)

The first SARS-CoV-2 infections in US animals were confirmed in large cats at the Bronx Zoo in March during the height of the local COVID-19 outbreak. An American Society for Microbiology study today details the genomic characteristics of viruses that infected zookeepers, four tigers, and three African lions, supporting a human-to-animal transmission pathway. SARS-CoV-2—the virus that causes COVID-19—has a suspected zoonotic origin, meaning it arose in animals. Genome sequencing of SARS-CoV-2 shows a close relationship with bat coronaviruses. Natural SARS-CoV-2 infections in animals have been reported in dogs, cats, and farmed mink, and in ferrets and fruit bats in the lab. (10/13)

The novel coronavirus has created an opportunity for businesses that purport to offer high-end products with enhanced protections against infection — from $250 face masks to $20,000 private jet flights and $200,000 home ventilation systems. Luxury car makers could be the next to capitalize. At a time when there’s more focus than ever on what people are breathing in — read: a deadly virus, wildfire smoke — well-heeled buyers could be enticed by cars with advanced air filtration systems and other devices designed to protect against a variety of dangerous particulates, including some pathogens. (Miller and Mitchell, 10/13)

Also —

The Centers for Disease Control and Prevention has said for months that people with pre-existing conditions are at a higher risk of severe illness from the coronavirus, which causes COVID-19. However, a study recently published in the peer-reviewed journal PLOS ONE reveals that certain pre-existing conditions can mean people who have them are up to three times more at risk of death resulting from COVID-19. (Willis, 10/13)

A study late last week found that convalescent plasma (CP) treatment did not significantly reduce mortality, but improved hospital discharge rates for patients 65 and older. The study in Clinical Infectious Diseases is one of the first to analyze clinical outcomes for closely matched cohorts of CP and control patients. In convalescent plasma treatment, plasma collected from individuals who have recovered from an infection is transfused into currently infected patients to provide passive immunity. CP treatment has a long history of application for other types of infections and is in clinical use to treat COVID-19 patients. Preliminary safety data for COVID-19 CP treatment is reassuring, but the efficacy is still unclear and remains the focus of multiple ongoing randomized controlled trials. (10/12)

Two separate studies late last week in Science Immunology document the persistence of SARS-CoV-2 antibodies in COVID-19 patients at least 3 months after symptom onset. Both studies suggest that longer-lasting immunoglobulin G (IgG) antibodies may hold promise as a tool to evaluate viral immune response. One study also demonstrates a correlation between blood and saliva antibody levels, suggesting that saliva could serve as an easier-to-collect alternative to blood testing. (Kuebelbeck Paulsen, 10/12)  

Reports of reinfection with the coronavirus evoke a nightmarish future: Repeat bouts of illness, impotent vaccines, unrelenting lockdowns — a pandemic without an end. A case study published on Monday, about a 25-year-old man in Nevada, has stoked those fears anew. The man, who was not named, became sicker the second time that he was infected with the virus, a pattern the immune system is supposed to prevent. But these cases make the news precisely because they are rare, experts said: More than 38 million people worldwide have been infected with the coronavirus, and as of Monday, fewer than five of those cases have been confirmed by scientists to be reinfections. (Mandavilli, 10/13)

Electronic health record vendors on Tuesday got their first look at the questionnaire users will use to evaluate their software products for an HHS comparison program. As part of a voluntary survey, clinicians, pharmacists and hospital information technology staff can answer 28 questions evaluating EHR products for an HHS program that will compare the software systems. The questionnaire asks users to evaluate the EHR systems' interoperability, usability, privacy and other factors. (Cohen, 10/13)

The last time Brittni DuPuy-German saw her trusted gynecologist, she once again explained that the stabbing, mystery pain in her abdomen had not gone away. It first appeared two years earlier, after she said her doctor, Javaid Perwaiz, surgically tied her tubes. To fix it, he had proposed more surgery — three additional procedures in nine months that she said included a hysterectomy when she was 29. But the pain persisted. (Mettler and Schmidt, 10/13)

Also —

In a move that sets up an intellectual property battle between telemedicine’s two most powerful companies, Teladoc has sued its rival Amwell for allegedly infringing on its patents. Teladoc’s complaint, filed on Monday in federal court in Delaware, seeks to recoup damages and to block Amwell from continuing to market the products that it believes infringe on its patents. (Robbins, 10/13)

Funding from the Harold Alfond Foundation will help the University of New England move the College of Osteopathic Medicine from the main campus in Biddeford to a 100,000-square-foot building in Portland, the university announced Tuesday. The $30 million grant also will be used to accelerate high-growth undergraduate and graduate programs to meet student demand and workforce needs in areas like aquaculture, entrepreneurship, criminal justice and sports media communication, among others, officials said. (10/13)

Novant Health opened a new, seven-story building on the corner of Queens Road and Fourth Street this week — complete with the health system’s largest wellness facility. The $166 million building combines all outpatient cardiac and cancer specialists, treatment services and support programs into one location, according to Novant. (Smoot, 10/13)

Facebook announced Tuesday that it will ban advertisements that discourage people from getting vaccines, another tightening of the platform’s rules on a subject it had previously avoided. Any ads that paint vaccines as unsafe, useless or harmful will no longer be allowed. (Mills Rodrigo, 10/13)

Your ears are not deceiving you: Songbirds in San Francisco have changed the way they sing this year, and in unexpected ways. Throughout the shutdown San Franciscans reported an unusual amount of birdsong ringing through the city streets, and a scientific study has now shown that birds have indeed changed their singing habits. ... Scientists discovered that while the songbirds of San Francisco increased the frequency of song, they did so at a lower volume than usual, as there was less noise to compete with. However, to residents' ears this resulted in a perceived increase in birdsong volume. (Chamings, 10/12)

KHN: Making Money Off Masks, COVID-Spawned Chain Store Aims To Become Obsolete
Darcy Velasquez, 42, and her mother, Roberta Truax, were walking recently in the Park Meadows mall about 15 miles south of downtown Denver, looking for Christmas gifts for Velasquez’s two children, when they spotted a store with a display of rhinestone-studded masks. It’s an immutable truth of fashion: Sparkles can go a long way with a 9-year-old. The store is called COVID-19 Essentials. And it may well be the country’s first retail chain dedicated solely to an infectious disease. (Hawryluk, 10/14)

In sports news —

Cristiano Ronaldo, one of soccer’s biggest stars and among the world’s most famous athletes, has tested positive for the coronavirus, Portugal’s soccer federation announced Tuesday. The federation’s statement said Ronaldo was not displaying symptoms of Covid-19, and that he had entered isolation, away from the rest of Portugal’s players. Those players continued their preparations for a match against Sweden on Wednesday in Lisbon. (Mather and Panja, 10/13)

Stephen Curry is launching a series of long-form interviews focused on the global pandemic and voting ahead of November’s election, the most recent move by an NBA star into civic engagement. The first video, released Tuesday on Curry’s YouTube channel, is a 20-minute conversation with Bill Gates in which they talk about the economic fallout from the novel coronavirus. Future conversations include a discussion with Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, about how society will emerge safely from the pandemic. Another is with Stacey Abrams, a voting rights activist and former Democratic Senate candidate in Georgia, about voter suppression and registration. Several others are in the works, Curry said. (Strauss, 10/13)

In school news —

Brigham Young University-Idaho warned on Monday about accounts of college students “intentionally” trying to contract COVID-19 in order to make money by donating plasma with antibodies. The Idaho university issued a statement saying officials were “deeply troubled” by the alleged behavior and “is actively seeking evidence of such conduct among our student body.” (Coleman, 10/13)

Howard University and up to nine other schools will receive millions of dollars from the Bill & Melinda Gates Foundation to support campus coronavirus testing facilities and expand screening for thousands of students at historically Black colleges and universities, the foundation announced Tuesday. The foundation’s three-year, $15 million donation will equip as many as 10 schools to be testing hubs that process tests for the novel coronavirus that are administered at other HBCUs in their regions. (Lumpkin, 10/13)

In obituaries —

Conchata Ferrell, the award-winning theater actress who became a television star as the gruff housekeeper of a toxic Malibu bachelor on the sitcom “Two and a Half Men,” died on Monday in Los Angeles. She was 77.The death, in Sherman Oaks Hospital, was confirmed by her daughter, Samantha Anderson. Ms. Ferrell was hospitalized in December for a kidney infection, which spread to her bloodstream. In May, a heart attack put her in intensive care for four weeks. She was then moved to long-term care, remaining on a respirator and on dialysis until her death. (Gates, 10/13)

Languishing in a tiny hotel room, their three young children buzzed around them on two beds pushed together. A pile of donated toys sat on the floor near a baby stroller that doubles as a cart to fetch groceries. Cockroaches lurked on the inside of an open cabinet near a mini refrigerator. “We’re not complaining about it. It’s a place to live,” said Skyla M. Thomas, 20. “But at the same time, it’s disgusting.” (Lamothe, 10/13)

KHN: As Californians Get Older And Less Mobile, Fires Get Hotter And Faster
Late on the night of Sept. 27, a bumper-to-bumper caravan of fleeing cars, horse trailers, RVs and overstuffed pickup trucks snaked east on Highway 12, the flames of the Glass Fire glowing orange in their rearview mirrors. With her cat, Bodhi, in his carrier in the back seat, 80-year-old Diana Dimas, who doesn’t see well at night, kept her eyes glued to the rear lights of her neighbor’s Toyota. She and Magdalena Mulay had met a few years before at a bingo night in their sprawling retirement community on the outskirts of Santa Rosa. Both Libras, each with two marriages behind her, the two women soon became the sort of friends who finish each other’s sentences. (Scheier, 10/14)

And states cope with COVID surges —

New Mexico plans to renew several coronavirus restrictions on Friday, and officials warned of more to come if COVID-19 cases continue to rise in the state. New Mexico Gov. Michelle Lujan Grisham (D) announced the new rules, which will include restricting indoor dining and limiting mass gatherings, on Tuesday, saying that the virus is “booming” in the state. (Coleman, 10/13)

South Dakota Gov. Kristi Noem on Tuesday blamed South Dakota’s recent surge in coronavirus cases on an increase in testing, even as the state saw a new high in the number of people hospitalized by the virus. There are currently no open general-care hospital beds in the southeastern part of the state, which contains the two largest hospitals, according to the Department of Health. Hospitals are dealing with both an increase in COVID-19 patients and people needing other medical care. The hospitals in Sioux Falls do have about 41% of their Intensive Care Units available. (10/13)

As COVID-19 infections and hospitalizations increase in North Carolina, the state’s top health official and representatives from hospitality and retail industries pushed for renewed efforts to slow the spread of the virus. COVID-19 hospitalizations have topped more than 1,000 patients since Oct. 6, and new daily cases this month have reached levels not seen since a July peak. (Bonner, Sessoms and Jackson, 10/13)

The good news: Ohio has avoided a spike in COVID-19 cases that could have overwhelmed hospitals. Those hospitals now have plans in place to address a surge in patients. The bad news: Ohio's fight against the novel coronavirus is likely just halfway done. Residents can expect mask requirements and social distancing to continue for months. (Balmert and Borchardt, 10/13)

Vermont locked itself down early and reopened gradually. Washington state paid workers who couldn't do their jobs while quarantined. And Louisiana zeroed in on students who were most at-risk of falling behind and prioritized help for them first. When President Donald Trump decided to delegate the pandemic response to the states, he gave them a chance to call their own shots. Some states acted aggressively to contain COVID-19, others far less so. We wondered with all those decisions put in states’ hands, which ones have done the best job so far? (Doherty, Guida, Quilantan and Wanneh, 10/14)

The first known death from a coronavirus reinfection has been reported in the Netherlands. A paper accepted for publication in the journal Clinical Infectious Diseases details the death of an 89-year-old Dutch woman who has become the first known person to die after contracting COVID-19 twice. (Guzman, 10/13)

European Union countries on Tuesday approved a series of guidelines including a “traffic-light” system aimed at facilitating free movement across the bloc and avoiding further travel disruption during the coronavirus pandemic. ... The criteria used to define the colored zones — green, orange and red — are the number of newly notified cases per 100,000 in the past 14 days as well as the testing rate and the test positivity rate in the past week. Member states agreed that they should not restrict free movement of people traveling from or to green areas, but national EU governments will continue to set their own restrictions such as quarantines or mandatory testing upon arrival for people coming from orange or red zones. (Petrequin, 10/13)

The World Bank has approved $12 billion in financing to help developing countries buy and distribute coronavirus vaccines, tests, and treatments, aiming to support the vaccination of up to 1 billion people. The $12 billion “envelope” is part of a wider World Bank Group package of up to $160 billion to help developing countries fight the COVID-19 pandemic, the bank said in a statement late Tuesday. (10/14)

Makerita Iosefo Vaʻa hasn’t been home for nearly eight months — the longest she’s ever been away from American Samoa. ... Vaʻa left the U.S. territory in the Pacific in February with her husband for medical treatment. They planned to fly home in March from San Francisco but decided to postpone after hearing a security worker at the airport had contracted the virus. Since then, they haven’t been able to leave because American Samoa Gov. Lolo Matalasi Moliga closed the territory on March 13 to protect those on the islands from COVID-19 — and it hasn’t reported any cases. (Sagapolutele and Sinco Kelleher, 10/14)

A Medicare administrative contractor has sent a cease-and-desist letter to a well-known diagnostic reimbursement expert containing lab test pricing and coding information that reveals instances where CMS may be overpaying for certain molecular tests. Palmetto GBA sent the letter to Bruce Quinn, asking him to delete information from a public blog and his own files. Palmetto's lawyer asserts that the information was included in a document, known as a master edit file (MEF), that is the contractor's intellectual property. (Ray, 10/13)

Also —

For a long time, drug makers have been the most hated industry in America. Companies are blamed for gouging prices on lifesaving drugs and enriching themselves through the opioid crisis, among other sins. Now, with pharmaceutical companies racing to find vaccines to end the coronavirus pandemic, the industry is hoping to redeem itself in the public’s mind. (Drucker, Gelles and Thomas, 10/13)

The cost of prescription drugs has taken center stage in congressional races all over Texas. In battles from Austin to San Antonio to Houston, candidates are insisting they are committed to tackling the high price of prescription drugs while they claim their opponents can’t be trusted on the issue. (Wallace, 10/12)

Last year, Pfizer posted a billboard outside its midtown Manhattan headquarters showing a larger-than-life patient smiling at his partner. “Dedicated to the brave of heart,” it read. The patient, Walter Feigenson, 72, of Portland, Ore., says he was paid roughly $1,000 for taking part in the launch of tafamidis—sold by Pfizer (ticker: PFE) under the names Vyndaqel and Vyndamax—a $225,000-a-year treatment for a potentially fatal heart condition. The price, which makes tafamidis the most expensive cardiovascular drug ever launched in the U.S., is “unconscionable” and “completely unjustified,” Feigenson said in an interview with Barron’s. (Lalse, 10/12)

The rising costs of prescription drugs and health care could be a potent campaign issue for older voters in Utah ahead of the November elections. And according to a new survey, Utahns age 45 and above expressed support for a number of progressive policies to boost pay and reduce the influence of money in politics. The survey from AARP Utah found 75% of Utahns either “strongly” or “somewhat” support raising the state’s minimum wage to $12/hour over a three-year period. Just 23% were opposed. (Schott, 10/10)

Americans are struggling to pay for their prescription drugs, which are getting more expensive every year. Since 2014, the cost of prescription drugs has risen 33 percent—faster than any other medical service. This means many Americans, especially seniors living on a fixed income, must spend a greater share of their income each year just to keep taking their medication. No wonder one-in-five seniors say they have a hard time paying for their prescription drugs. The coronavirus pandemic has only made matters worse. Millions of workers have lost their job or taken a pay cut due to the virus. And many people still aren’t able to set up appointments with their doctors, so they’re forced to navigate our confusing health care system on their own. (Sen. Tom Cotton, R-Ark., 10/13)

As the Trump administration asks the Supreme Court to dismantle the Affordable Care Act, the president has made lowering prescription drug costs the core focus of his own plan to improve the American health care system. Responding to a question from moderator Chris Wallace during last week’s presidential debate about how the administration would replace ObamaCare, Trump shifted gears to repeat his claim that his administration’s policies will bring down drug prices 80 percent to 90 percent. (Varun Vaidya, 10/6)

Also —

The federal government spends a lot of money on prescription drugs. Medicare Part D, the program to help seniors pay for their prescription drugs, provides benefits to 45 million people and its budget for the upcoming fiscal year will exceed $90 billion.  The program itself does not negotiate drug prices with pharmaceutical companies. Instead, the government partners with pharmacy benefit managers (PBMs) to leverage its market power and reduce drug prices for seniors in Part D.  Insurance companies, unions, large employers, and state governments also engage PBMs in similar arrangements. By representing such a wide swath of the purchasers of prescription drugs, PBMs can use their purchasing power to negotiate lower prices from pharmaceutical companies. (Ike Brannon, 10/7)

In searching for answers to why drug costs are high, we only need look at problems our own government has created. One of the biggest culprits distorting prices is the once obscure “340B Drug Pricing Program.” Created in 1992, it requires drugmakers to offer steep discounts to certain safety net clinics and hospitals to help them “stretch scarce federal resources.” The original intent was to reduce drug costs for uninsured and vulnerable patients by passing the discounts along to them. (Grace-Marie Turner, 10/7)

Finding an effective price transparency approach is one of the most difficult and expensive tasks in front of healthcare providers today. It seems we are all reacting to what the government, payers and employers want, instead of realizing these are our prices and messages to manage. As a 16-year-old cashier at Kmart, I saw the power of pricing firsthand with the retailer's pledge to match the lowest prices of its competitors. You can also see the absurdity of not being upfront about consumer pricing in the YouTube video "If Air Travel Worked Like Health Care." Shortly after becoming a vice president of revenue cycle almost a decade ago, I had a memorable conversation with our system CFO who asked my opinion of price transparency. I blurted out, "It would be too complicated for us to publish our prices." He looked at me and asked: "Then don't you think you should do something about that?" (Jenni Alvey, 10/13)

Events have moved faster than I thought possible. I have become cautiously optimistic. Experts are saying, with genuine confidence, that the pandemic in the United States will be over far sooner than they expected, possibly by the middle of next year. That is still some time off. Experts warn that this autumn and winter may be grim; indoor dining, in-classroom schooling, contact sports, jet travel and family holiday dinners may all drive up infections, hospitalizations and deaths. Cases are rising in most states, and some hospitals already face being overwhelmed. (Donald G. McNeil Jr., 10/12)

The truth is that using lockdowns to halt the spread of the coronavirus was never a good idea. If they have any utility at all, it is short term: to help ensure that hospitals aren’t overwhelmed in the early stages of the pandemic. But the long-term shutdowns of schools and businesses, and the insistence that people stay indoors — which almost every state imposed at one point or another — were examples of terribly misguided public policy. It is likely that when the history of this pandemic is told, lockdowns will be viewed as one of the worst mistakes the world made. (Joe Nocera, 10/13)

Many of the businesses that are closing will never come back, and some of the lives that are being upended will probably stay upside down forever. But even before you consider the long-term effects, this is all pure loss; there’s no cosmic refund office where we can all demand our lost year back. So it’s quite legitimate for President Trump and his supporters to ask whether staying in our houses and waiting for a vaccine isn’t actually making us worse off — especially the large number of “us” who can’t do professional office jobs from home. And because the nature of infectious disease means such decisions have to be made collectively, we should have that conversation, rather than attempt to forestall it with a wall of outrage, as much of the professional class has been doing for the past seven months. (Megan McArdle, 10/13)

Did President Trump return to work too soon after coming down with Covid-19? The Centers for Disease Control and Prevention in August updated its guidelines for health-care workers recovering from the disease. The CDC recommends that for those with mild to moderate illness, returning to work is permissible when “at least 10 days have passed since symptoms first appeared and at least 24 hours have passed since last fever without the use of fever-reducing medications and symptoms (e.g., cough, shortness of breath) have improved.” The CDC also notes that “a test-based strategy is no longer recommended because, in the majority of cases, it results in excluding from work health care professionals who continue to shed detectable SARS-COV-2 RNA but are no longer infectious.” No one would deny that doctors, nurses and support staff are essential workers, but it’s obviously unwise to return to a hospital or medical office if you are still contagious with Covid. Few would deny, either, that the president is an essential worker. (Marc Siegel, 10/13)

In September, the Co-Immunity Project of the University of Louisville conducted an extensive survey of the spread of coronavirus infection throughout Jefferson County. Unlike other initiatives and facilities that test only those suspecting an infection, the Co-Immunity Project invited participants from different parts of the county to ensure that individuals of different age, race and sex, and those living in different neighborhoods are proportionally represented. The project investigators measured the level of antibodies in the blood, which is a sign that an individual may have been exposed to the virus in the past few months. After testing nearly 2,000 individuals, the study found that nearly 4.4% of the population of the county, or approximately 34,000 people may have been exposed to the virus. Given that only 17,500 cases had been reported in the county till September, the findings of the Co-Immunity Project suggest that nearly half of the individuals who have the virus are not getting tested. In addition, the study found that the rate of infection was 10% to 12% in west Louisville, compared with 2% to 4% in other parts of the county. (Aruni Bhatnagar and Ben Chandler, 10/13)

Strikingly large shares of Black Americans say they would be reluctant to get a coronavirus vaccine — even if it was free and had been deemed safe by scientists, according to a new nationwide survey from �鶹Ů�� and The Undefeated. Why it matters: The findings reflect well-founded distrust of government and health care institutions, and they underscore the need for credible outreach efforts when a vaccine is distributed. Otherwise, distribution could fail to effectively reach the Black community, which has been disproportionately affected by coronavirus. (Drew Altman, 10/14)

The confusing array of ways to measure the coronavirus pandemic — with some indicators going up while others go down and asterisks attached to many measures — makes it difficult to feel certain on any given day about whether things are getting better, worse or neither. But there’s no doubt that Ohio has a lot of virus-fighting left to do. Monday’s headline figure was as simple as it was grim: The number of confirmed COVID-19 deaths in Ohio topped 5,000. That puts the state squarely in the middle of the pack for deaths per 100,000 people, at 24th. And, less than seven months into the pandemic in the U.S., it puts COVID-19 on a course to kill nearly as many Ohioans in a year as lung cancer, colorectal cancer and breast cancer combined. (10/14)

It was a great relief to learn that Missouri did not, in fact, see a one-day jump of 5,000 new coronavirus infections on Saturday, as the state’s new online pandemic data dashboard briefly reported. The Missouri Department of Health and Senior Services subsequently admitted that a technical error on its database coughed up the erroneous number. (10/13)

We have entered the age of megafires. Since 1970, yearly fire seasons in California have grown by 78 days. The amount of land burned annually across the Western U.S. has doubled since 1980. Last week, the August Complex fire in Northern California set a record for the state, burning more than 1 million acres. That record will probably not stand for long. These extreme fires are caused by two main factors: fire suppression and climate change. The dangerous consequences of fire suppression are now widely acknowledged. But the role of climate change on wildfires — more heat, less rainfall and lower humidity in fire-prone regions — is either being minimized or pushed from the frame. (Jordan Thomas, 10/14)

As our nation continues to confront the ramifications of a global pandemic, the stigma around mental health and addiction seems to be dissipating. People are talking, opening up to friends and family, and finally realizing it’s OK to not be OK. This type of awareness is a major step forward for a nation that saw nearly 72,000 overdose deaths in 2019 and more than 48,000 deaths from suicide in 2018. (Darrell Steinberg and Patrick J. Kennedy, 10/14)

Before deciding to take a photogenic, early-evening helicopter ride from Walter Reed National Military Medical Center back to the White House, President Trump toyed with an even more dramatic idea. He discussed wearing a Superman T-shirt under his dress clothes, coming out of the hospital looking exhausted, and then tearing off his outer shirt to reveal himself as the ever-strong Superman. Made-for-tweeting publicity stunts that are rejected can still teach us something: In this case, it is about the power of costumes and the narratives they bring with them. (George J. Annas, 10/14)

Welcome to the Trump-DeSantis horror show in Central Florida. It can make you sick and kill you, but Floriduh dunces love these COVID deniers. Supporters see President Trump’s narcissism and couldn’t-care-less attitude as a sign of strength. They see the governor’s reckless behavior — mingling with crowds without wearing a mask, high-fiving people, then wiping his nose in the middle of a pandemic — as anything but what it is, dangerous. It’s gross, and grotesque, too. (Fabiola Santiago, 10/13)

In a normal political world, a president who deliberately endangers thousands of his own supporters for his personal benefit would face a massive public backlash. But as President Donald Trump and his enablers remind us weekly now, we’re no longer in a normal political world. Trump’s decision to hit the road this week with live, crowded, mostly maskless rallies — while refusing to divulge complete information about his own coronavirus testing status — is a mind-boggling act of self-centered hubris. (10/13)

If someone had asked you a year ago what you thought of people who wear masks after Halloween, the chances are your reaction would have been negative. What kind of person covers his face in public? Armed robbers do that sort of thing. So do Klansmen and radical Wahhabis. The rest of us don't do that. In fact, until recently, wearing a mask in public was illegal in many places. The assumption was if you're hiding who you are, you're up to something bad. It made people nervous. By our nature, we want to see each other. We need to see each other. Looking at another person's face is the beginning of connection. Eliminating that connection dehumanizes us. That used to be obvious. (Tucker Carlson, 10/13)

Recently hospitalized with the virus, Trump was onstage at a Monday campaign event in Florida. Masks were optional, even though coronavirus cases are surging in the state. It was an epidemiologist’s worst nightmare come to life. But for Trump, it was time to celebrate. He did a little dance to “Macho Man” by Village People, a song his campaign might consider researching more carefully. The president looked absurdly triumphant. The more than 215,000 Americans who died of COVID-19 so far this year could not be reached for comment, though I can’t imagine they were thrilled about the unsavory man dancing on their graves. Senate Majority Leader McConnell was debating his opponent, Democrat Amy McGrath, in Kentucky on Monday. When McGrath criticized McConnell’s handling of the pandemic, he smiled. Then he started laughing as she spoke, because a virus that has crippled the economy and left millions of Americans unemployed is, apparently, hilarious. (Rex Huppke, 10/14)

The Senate confirmation hearings for Amy Coney Barrett may lack for political drama, but they are still instructive. They are revealing the deep fault lines over the Supreme Court, and how Democrats view it as a mini-legislature to achieve policy goals, rather than a real judicial body. Democrats are asking very little about the actual law or Judge Barrett’s jurisprudential thinking. Instead, one after another, Democrats have used their time to focus on a parade of policy horribles if she is confirmed. And for emotional effect, they brought along photo displays of children and women who would supposedly be her victims on health care, abortion, gun violence and more. (10/13)

Judge Amy Coney Barrett wasn’t inclined to opine on anything — not on whether in vitro fertilization is “tantamount to manslaughter,” not on whether she might support re-criminalizing homosexuality and certainly not on whether she’d invalidate Obamacare or Roe v. Wade. But the most chilling moment of her Supreme Court confirmation testimony Tuesday came when she said she would “need to hear arguments” about whether President Trump can postpone the election. (Dana Milbank, 10/13)