National

The U.S. faces a range of health care flashpoints — unaffordable drugs, opioids, vaping — as we debate whether to adopt universal care. For now, the Affordable Care Act is the law of the land, but Republicans want to issue it a final death blow.

Health

New York City officials issued an advisory Monday "strongly" recommending that people mask up indoors regardless of vaccination status to curb the spread of the newly-discovered Omicron variant. 

Why it matters: Dave Chokshi, commissioner of the New York City Department of Health and Mental Hygiene, announced the advisory in response to concerns of the new strain's potential implications. 

The advisory recommends city residents wear a mask "at all times when indoors and in a public setting," but stops short of reinstituting a mask requirement. 

Mayor Bill de Blasio also said that while there are currently no reported cases of the variant in New York City, "it is very likely there will be."

What they're saying: We "still have a lot to learn about the Omicron variant, but its emergence lends urgency to the importance of the precautions we've all become familiar with," Chokshi said in a press conference. 

"Cases have been rising, including among our youngest New Yorkers in recent weeks," he added.

"Our understanding of Omicron will advance and we'll be able to adjust our public health strategies accordingly."

NYC urges masks indoors "at all times" regardless of vaccination status

Mayor Bill de Blasio said that while there are currently no known cases of the variant in the city, "it is very likely there will be."

People wearing masks walking in Times Square.

New York City

Coronavirus

President Biden has made the COVID-19 crisis and a post-Trump return to national unity and traditional democratic ideals his top priorities. From vaccinations to stimulus to schools, Biden is seeking bipartisan compromise while showing a willingness to use executive authority and bare Democratic majorities in the U.S. House and Senate to implement his policies. Republican leaders are navigating deep party divisions over if and how to move beyond former President Trump.

Politics & Policy

A federal court in Missouri has blocked the Biden administration from enforcing a coronavirus vaccine mandate for health care workers at federally funded facilities in 10 states.

Why it matters: Monday's decision is the first victory for opponents of the rule, which requires health care workers to get vaccinated by Jan. 4, 2022. The case is one of four lawsuits challenging the Centers for Medicare & Medicaid Services' (CMS) rule and argues that the mandate will exacerbate staffing shortages. 

What he's saying: The mandate exceeds the agency's authority, U.S. District Judge Matthew Schelp wrote in the opinion.

"The nature and breadth of the CMS mandate requires clear authorization from Congress—and Congress has provided none," he said.

Along with its "political significance," the cost of compliance with the mandate — around $1.38 billion in the first year — represents the "heavy hand of the federal government," he added.

"[E]ven if Congress’s statutory language was susceptible to CMS’s exceedingly broad reading — which it is most likely not — Congress did not clearly authorize CMS to enact the this politically and economically vast, federalism-altering, and boundary-pushing mandate, which Supreme Court precedent requires."

Missouri, Nebraska, Arkansas, Kansas, Iowa, Wyoming, Alaska, South Dakota, North Dakota and New Hampshire are not subject to the mandate as the case moves forward, so long as the preliminary injunction remains in place.

Worth noting: Courts have generally upheld COVID vaccine mandates in recent months, with the Supreme Court declining to block enforcement of Maine's requirement for health workers.

The Biden administration's vaccine mandate for large companies has, however, faced some pushback.

What to watch: If the administration appeals the injunction, it would go to the Eighth Circuit. Over half of U.S. states are involved in one of the four legal challenges, according to Bloomberg Law. 

"We're obviously going to abide by the law and fight any efforts in court or otherwise to prevent local authorities, officials, leaders in the health care industry and other industries from protecting their workforces," Press Secretary Jen Psaki said in a White House briefing on Monday. 

Go deeper: Republican-led states begin legal fight over Biden vaccine mandate

Federal court blocks Biden's vaccine mandate for health workers in 10 states

The ruling is the first victory for opponents of the rule, which requires health workers to get vaccinated by Jan. 4.

Photo of Joe Biden speaking from a podium

President Biden delivers remarks on the Omicron COVID-19 variant following a meeting with his COVID-19 response team. Photo: Anna Moneymaker via Getty Images

Coronavirus vaccines

Public health

The Centers for Disease Control and Prevention (CDC) on Monday strengthened its previous recommendation for booster shots, saying that everyone 18 and older "should" receive a booster dose. 

Why it matters: Last month, CDC director Rochelle Walensky accepted a key advisory committee's recommendation that adults "may" get the shot. The slight, but strengthened, change in wording comes amid the emergence of the Omicron coronavirus variant.

The big picture:  Public health experts later criticized the language of the original recommendation for characterizing boosters as a "luxury" for the general population and not a necessity, Axios' Tina Reed writes. 

What they're saying: "The recent emergence of the Omicron variant ... further emphasizes the importance of vaccination, boosters, and prevention efforts needed to protect against COVID-19," Walensky said in a statement. 

"I strongly encourage the 47 million adults who are not yet vaccinated to get vaccinated as soon as possible," she added. 

To "stop the spread of COVID-19 we need to follow the prevention strategies we know work."

Go deeper: Experts criticize CDC's language on COVID vaccine boosters

CDC strengthens COVID booster recommendation

The CDC now says all adults over 18 "should" receive a booster dose, whereas previously they said adults "may" get the shot.

Rochelle Walensky. Photo: Chip Somodevilla/Getty Images

President Biden on Monday said that the new coronavirus variant, Omicron, is "a cause for concern, not a cause for panic."

Driving the news: Biden said later this week the administration will be releasing a strategy on how "we're going to fight COVID this winter. Not with shutdowns or lockdowns, but with more widespread vaccinations, boosters, testing and more."

Biden urged Americans to get vaccinated and get booster shots if they are eligible.

Biden said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, believes the current vaccines "provide at least some protection against the new variant and the boosters strengthen that protection significantly."

The big picture: Biden said it is "hopefully unlikely" that updated vaccinations or boosters are required, but added that his administration is already working with officials at Pfizer, Moderna, and Johnson & Johnson to develop contingency plans for updated versions "if needed."

"I will also direct the FDA and the CDC to use the fastest process available without cutting any corners for safety to get such vaccines approved and on the market if needed."

What we know: Omicron was first detected in South Africa and appears to be more transmissible than other coronavirus variants, according to South African scientists and health officials.

The World Health Organization said it is still uncertain how transmissible the variant is, how effective vaccines are against it, or whether it causes more severe illnesses and a higher risk of death.

What we're watching: On Sunday, the Canadian government announced it had detected the first two Omicron cases in North America.

It has also been detected in the U.K. and other European countries, as well as in Israel, Hong Kong and Australia.

Catch up quick: Shortly after South African officials identified the new variant, the Biden administration announced new travel restrictions for South Africa, Botswana, Zimbabwe, Namibia, Lesotho, Eswatini, Mozambique and Malawi.

Officials said the restrictions are being implemented "out of an abundance of caution," adding that this step was recommended by U.S. government medical experts and the COVID-19 response team.

Biden: Fight against Omicron won't include "shutdowns or lockdowns"

Biden pushed boosters, mask use as concerns over the Omicron variant grow.

Joe Biden

Daily TSA screenings

The Transportation Security Administration screened 2,451,300 people at airports across the U.S. on Sunday, making it the busiest day for air travel since the beginning of the pandemic. 

Driving the news: Nearly 20.9 million passengers passed through TSA checkpoints from Nov. 19 through Nov. 28,  more than double the number of air travelers screened during the same period last year, TSA said. 

The agency had previously said it expected to screen about 20 million air travelers during the Thanksgiving holiday period. 

Flashback: The busiest air travel day in TSA history was on the Sunday after Thanksgiving in 2019, when nearly 2.9 million people were screened.

TSA: Sunday marked busiest day for air travel since start of pandemic

TSA screened more than 2.4 million passengers at airports across the U.S.

Transportation Security Administration (TSA)

Passengers walk through security checkpoint lines in Orlando's international airport. 

Transportation

After a record economic expansion, the coronavirus pandemic sent the U.S. economy into a recession as unemployment soared to staggering heights. The country now faces urgent questions about how much stimulus is needed for reeling consumers and businesses, and what a recovery might look like.

Economy & Business

The World Health Organization said Monday in a new risk assessment that it believes the COVID-19 Omicron variant poses a "very high" risk to the globe because it may be more transmissible than other strains of the virus.

Why it matters: Though the WHO acknowledged there are still many uncertainties associated with the variant, the agency said it believes the likelihood of potential further spread of Omicron around the world is "high."

The health agency warned that the variant could potentially drive future COVID-19 surges that strain health care systems, especially in countries with low vaccination rates.

It's still uncertain how transmissible the variant is, how effective vaccines are against it or whether it causes more severe illnesses and a higher risk of death.

Scientists and health officials in South Africa, where Omicron was first detected, said the new variant appears to be more transmissible than others but added that observed cases have so far been mild.

What they're saying: "The overall global risk related to the new [variant of concern] Omicron is assessed as very high," the WHO said.

"Increasing cases, regardless of a change in severity, may pose overwhelming demands on health care systems and may lead to increased morbidity and mortality," it added.

"The impact on vulnerable populations would be substantial, particularly in countries with low vaccination coverage."

Currently, no deaths associated with the Omicron variant have been reported, the WHO said.

The big picture: Despite Omicron's designation as a variant of concern, the WHO has criticized travel bans on southern African nations by the U.S. and European and Asian countries, saying they may "slightly" reduce the spread of COVID-19 but will "place a heavy burden on lives and livelihoods."

Go deeper: First North American Omicron cases identified in Canada

WHO says Omicron poses "very high" risk

The health agency warned that the variant could drive future COVID-19 surges.

World Health Organization Director-General Tedros Adhanom Ghebreyesus speaking in Geneva in October.

World Health Organization Director-General Tedros Adhanom Ghebreyesus speaking in Geneva in October. Photo: Fabrice Coffrini/AFP via Getty Images

Omicron variant COVID

China is becoming the most formidable rival America has faced, and the risk of confrontation with Russia, North Korea or Iran still looms. Authoritarians are rising, the chaotic Afghanistan exit revealed the limits of U.S. power, and the pandemic, climate change and other critical challenges continue to pose grave threats.

World

Axios Vitals

An Ohio man appears to have been cured of his Type 1 diabetes after participating in an early-stage clinical trial of a stem cell treatment by Vertex Pharmaceuticals, the New York Times reports.

Why it matters: If ultimately successful, the development could offer hope to millions of Americans who suffer the life-altering symptoms of the disease.

In June, Brian Shelton, 64, got an infusion of cells grown from stem cells that mimicked the insulin-producing pancreas cells his body lacked.

"We've been looking for something like this to happen literally for decades," said Irl Hirsch, a diabetes expert at the University of Washington who was not involved in the research, per the New York Times.

But, but, but: The results are still early and have not yet been published in a peer-reviewed journal. Experts say they want to see the study replicated, see if there are unanticipated adverse events and if the treatment will last a lifetime, per the New York Times.

Patient possibly cured of Type 1 diabetes

The development could offer hope to millions of Americans who suffer from the disease.

A photo illustration showing the Vertex logo on a smartphone.

Photo illustration: Pavlo Gonchar/SOPA Images/LightRocket via Getty Images

Diabetes

Axios Media Trends

Box office ticket sales over the Thanksgiving holiday show that consumer confidence in moviegoing is slowly improving but not enough to bring the struggling theater industry back to pre-pandemic levels anytime soon, if ever. 

Why it matters: "We may have to temper expectations a bit" for next year, said Comscore senior media analyst Paul Dergarabedian.

While some analysts initially predicted the domestic box office would hit $10 billion next year, Dergarabedian said that "may be somewhat optimistic."

Dergarabedian expects this year's domestic box office total to be about $4 billion, which would be down nearly $7 billion from 2019. 

Driving the news: Box office ticket sales for the five-day Thanksgiving holiday were down around 46% from 2019, Comscore estimates. 

Domestic ticket sales from Wednesday to Sunday were about $140 million, compared to $263 million in 2019 and $315 million in 2018. 

Disney's "Encanto" was the clear holiday weekend winner, bringing in $40 million over the five-day weekend, followed by MGM's "House of Gucci," which brought in $21 million. 

By comparison, Disney's "Frozen 2," the top Thanksgiving title in 2019, brought in $123.7 million over the five-day holiday. 

Be smart: Thanksgiving tends to be a modest moviegoing period compared to other holidays, but this year it served as an important indicator for how consumers are feeling about moviegoing ahead of the holiday season. 

The last week of the year between Christmas and the New Year tends to be the busiest time for the box office each year. 

This year's Thanksgiving totals "gives us a really nice boost of momentum heading into the holiday season," Dergarabedian said. 

Sony's "Spider-Man: No Way Home," which debuts in theaters exclusively on Dec. 17, "could be the first $100 million opener of the pandemic era in North America," he added. 

The big picture: Analysts were expecting a fuller box office recovery in 2022, but fears of the new COVID-19 Omicron variant could derail progress. 

Theater stocks sunk Friday amid fears that another wave could continue to impact studio production and moviegoing next year. 

"There is not enough information yet around this ... but the main question here is how this virus is working with the vaccination," Cineworld CEO Mooky Greidinger told CNBC on Friday.  

Dergarabedian noted that "Encanto" and other children's movies out right now like "Clifford the Big Red Dog" are benefitting from vaccines being eligible to children ages 5-11. 

What to watch: While studios are still trying to figure out their release strategies moving forward, shortened theatrical windows and more simultaneous at-home releases are expected as the streaming industry becomes more competitive. 

Thanksgiving box office shows theaters have long road to recovery

Analysts expect this year's domestic box office total to be about $4 billion — down nearly $7B from 2019.

Movies

The emergence of the Omicron variant is bringing new urgency to global vaccination efforts.

Why it matters: New variants can emerge anywhere, and can spread everywhere. Getting doses to the developing world — and getting those doses into people's arms — is essential, and that effort has so far been lagging.

What they're saying: "We will only prevent variants from emerging if we are able to protect all of the world's population, not just the wealthy parts. The world needs to work together to ensure equitable access to vaccines, now," said Seth Berkley, CEO of the Gavi vaccine alliance.

But, but, but: Some countries — including South Africa, where scientists first identified the omicron variant — have enough doses, but are facing distribution challenges, said Scott Gottlieb, who was FDA commissioner under the Trump administration and is on Pfizer's board.

"South Africa has told J&J and Pfizer — the two countries that are distributing vaccine there — to throttle shipments or stop shipments because they have an excess of vaccines," Gottlieb said on CBS News' "Face the Nation." "Of the 30 million doses Pfizer sent to South Africa, only 19 million have been used to date."

What to watch: Health officials across the globe are still racing to figure out whether the Omicron variant makes people sicker, whether it is more transmissible than prior COVID strains, and whether it evades protection from the vaccines.  

Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, told ABC's George Stephanopoulos on "This Week" that U.S. officials will meet with colleagues from South Africa to try to determine the severity of the cases caused by the variant.

The world's major manufacturers of COVID-19 vaccines, including Moderna, Pfizer and Johnson & Johnson, said they are working to adapt their shots to Omicron, CNBC reported.

"We should know about the ability of the current vaccine to provide protection in the next couple of weeks," Moderna's chief medical officer Paul Burton said on the BBC's "Andrew Marr Show."

Omicron adds urgency to vaccinating world

The world is scrambling to respond to reports of a concerning new variant in the developing world.

Photo: Phill Magakoe/AFP via Getty Images

Anthony Fauci

A bipartisan group of U.S. House members chided the Biden administration for repealing a rule that would have required Medicare to pay for any medical device deemed a "breakthrough" by the FDA.

The big picture: Medical device manufacturers really wanted the rule enacted, in part, because it would have led to higher sales. Now many members of Congress who receive sizable campaign donations from the industry want the federal government to revive the rule.

The state of play: The Centers for Medicare & Medicaid Services officially repealed the rule this month.

The agency said that although the FDA reviews breakthrough devices for safety and effectiveness, "there is often limited evidence regarding whether the device is clinically beneficial to Medicare patients."

"Although we continue to be in favor of increasing access to new technologies, we are also mindful that sometimes those devices have unknown or unexpected risks," the repeal notice said.

Driving the news: 61 House Democrats and Republicans said in a letter that CMS' decision to ax the rule "may delay future innovative medical devices and diagnostic tools," and the agency should "retain the crucial components" in a future rule.

Between the lines: The medical device industry's trade group, AdvaMed, gave at least $1,000 since 2018 to nearly half of the lawmakers who signed the letter, according to data within OpenSecrets, which tracks lobbying spending.

House Democrats Angie Craig of Minnesota, Suzan DelBene of Washington and Scott Peters of California signed the letter and are among the biggest recipients of campaign cash from AdvaMed, as well as other medical device companies.

Republicans who signed the letter and who have accepted funds from AdvaMed and other device firms include Reps. Michael Burgess of Texas, Brett Guthrie of Kentucky and Jackie Walorski of Indiana.

What they're saying: "A bipartisan letter signed by 61 members of Congress who support immediate coverage under Medicare for suffering seniors in need of FDA-approved breakthrough medical technologies practically writes itself," AdvaMed CEO Scott Whitaker said in a statement.

The push to revive an industry-backed medical device rule

31 of 61 lawmakers who signed the letter took money from AdvaMed.

Surgeons and technicians in blue protective gear stand around a patient on an operating room table.

Doctors and technicians perform a surgery. Photo: Melina Mara/The Washington Post via Getty Images

Medical devices

Health care costs

The first two cases of the new Omicron variant have been detected in North America, the Canadian government announced Sunday evening.

Driving the news: The World Health Organization has named Omicron a "variant of concern," but cautioned earlier on Sunday that it is not yet clear whether it's more transmissible than other strains of COVID-19. 

The new strain has also been detected in several European countries, Israel and Hong Kong and Australia.

State of play: The two people in Canada who tested positive had recently traveled from Nigeria, per the statement from Ottawa Public Health.

France's Ministry of Health announced in a statement on Sunday evening that it has detected eight possible cases of the variant. Testing is underway to confirm their diagnosis. 

Botswana's Health Minister Edwin Dikoloti announced Sunday that the country has identified 15 more cases of the Omicron variant, Reuters reports.

Health officials in Australia announced on Sunday that they detected two cases of the variant in travelers from southern Africa, the first such cases identified on the continent. 

Both people who tested positive were asymptomatic and fully vaccinated, Australian health officials said in a statement. 

The Netherlands also reported that they had identified cases of the variant among 13 passengers who arrived from southern Africa, per the National Institute for Health. 

The big picture: Many countries have begun restricting or banning travel from nations in southern Africa in an effort to curb the spread of the variant.  

Australia imposed new security measures just a day before the variant was identified, barring anyone who is not a citizen or permanent resident from entering after having traveled to south African countries. 

The Netherlands have also imposed restrictions on travel to and from southern Africa, and the country has also announced other measures such as an evening lockdown, according to the New York Times. 

Meanwhile, the Japanese government on Monday joined Israel and Morocco in closing its borders to all foreign visitors as a precaution against the Omicron variant, per the NYT.

Fauci: Omicron variant will "inevitably" be found in U.S.

NIH director: "No reason to panic" yet about Omicron variant

U.S. to restrict air travel from 8 countries over new COVID variant concerns

Editor's note: This story has been updated with new details throughout.

First North American Omicron cases identified in Canada

The new strain has also been detected in several European countries, the United Kingdom, Australia, Israel and Hong Kong.

COVID-19 testing at Toronto Pearson International Airport 

COVID-19 testing personnel at Toronto Pearson International Airport in September. Photo: Steve Russell/Toronto Star via Getty Images

The World Health Organization called on countries Sunday not to impose travel bans on southern African nations amid concerns over the COVID-19 Omicron variant.

Why it matters: The U.S. and countries in Europe and the Asia-Pacific announced travel restrictions in response to Omicron, which was first detected in South Africa. It's since been identified in several European countries, Canada, Israel, Australia and Hong Kong. The WHO noted in a statement that only two southern African nations have detected the new strain.

What they're saying: "Travel restrictions may play a role in slightly reducing the spread of COVID-19 but place a heavy burden on lives and livelihoods," the WHO said.

"If restrictions are implemented, they should not be unnecessarily invasive or intrusive, and should be scientifically based, according to the International Health Regulations, which is a legally binding instrument of international law recognized by over 190 nations."

Matshidiso Moeti, the WHO's regional director for Africa, said in a statement that the "speed and transparency of the South African and Botswana governments in informing the world of the new variant is to be commended."

"With the Omicron variant now detected in several regions of the world, putting in place travel bans that target Africa attacks global solidarity," Moeti added. "COVID-19 constantly exploits our divisions. We will only get the better of the virus if we work together for solutions."

Representatives for the White House did not immediately respond to Axios' request for comment.

Go deeper: South Africa says it's being "punished" for detecting new COVID variant

WHO warns against travel bans on southern African countries

The WHO noted that only 2 southern African nations have detected the new variant.

The WHO's Dr. Matshidiso Rebecca Moeti attends The Access Challenge UHC Conference 2018 at Westin Times Square on September 24, 2018 in New York City.

Matshidiso Moeti, World Health Organization regional director for Africa. Photo: Sylvain Gaboury/Patrick McMullan via Getty Images

Sections

Axios Local

Axios gets you smarter, faster with news & information that matters.

About

Subscribe

Monday's health stories