Axios

President Trump said Saturday that the money that's being spent on Affordable Care Act subsidies now should be sent directly to consumers — a position that's likely to complicate the government shutdown deadlock even more.

Why it matters: Trump's statement in a Truth Social post puts further pressure on Republicans to reject Democratic demands to extend the enhanced ACA tax credits as a condition for voting to end the shutdown.

Pockets of the country are seeing COVID activity ahead of the winter months.

The big picture: COVID-19 cases boomed in the summer, and many health experts are seeing another bump — mostly through common variants that have surged this year.

• Though the United States has declared the public health emergency over, the spread of COVID-19 has continued to impact the country and its workforce — leading to an increase in work absences and exits.

Driving the news: Global cases are on the rise, surging by 30,000 over the last week or so, per data shared on the World Health Organization's COVID dashboard.

• Researchers told Scientific American that the number of infections is likely higher than that given the slowdown in testing worldwide.

Reality check: COVID-19 cases are generally down compared to the high levels seen in 2024 or the peak of the pandemic. But that doesn't mean cases are gone completely.

Here's what to know about the state of COVID ahead of winter.

Where COVID cases are surging

Generally, the viral activity of COVID in the United States is at a "moderate" level, according to the Centers for Disease Control and Prevention's monitoring of wastewater levels.

• Wastewater levels typically detect viruses spreading from one person to another throughout a community, the CDC says.
• "It can also detect infections without symptoms. If you see increased wastewater viral activity levels, it might indicate that there is a higher risk of infection," per the CDC.

Zoom in: The Northeast has the highest wastewater activity in the U.S., the CDC says. Connecticut has a "very high" level of activity, while Massachusetts, Rhode Island and New York have "high" levels.

• Elsewhere, Nevada and Utah have "very high" viral activity.
• Most of the Western U.S. has "high" levels of activity, too.

Yes, but: Vermont, another Northeastern state, has "low" activity. Similarly, Michigan and Missouri have "very low" activity, per the CDC data.

What new COVID variants are spreading

Context: The XFG variant — also known as the Stratus variant — is leading all others with 85% share of cases, according to CDC data running through the end of September.

• The NB.1.8.1 variant — otherwise known as Nimbus — has about 7% of the share.
• Both of those variants are descendants of the Omicron strain.

Flashback: The XFG Stratus variant started making headlines last January, and it was soon monitored by the WHO. The variant didn't make much noise in the U.S. through the first half of the year, but soon began to surge throughout the late summer months.

Common COVID symptoms for Stratus, Nimbus

Threat level: The Stratus and Nimbus variants have similar common COVID symptoms compared to previous variants, including:

• Fever
• Cough
• Runny nose
• Chills
• Congestion

Yes, but: The Nimbus variant causes a "razor blade" sore throat, per multiple reports.

When are you no longer contagious with COVID?

The CDC says those infected with a respiratory virus should use precautions for five days to reduce risk.

• "After this 5-day period, you are typically much less likely to be contagious," the CDC says.
• For COVID, the CDC recommends taking a test to know if you're still infected and can spread the virus.

Generally, the CDC says you can go back to normal activity after at least 24 hours and you feel better or no longer have a fever.

COVID vaccine rules for winter 2025

Zoom out: The CDC approved a set of recommendations from Robert F. Kennedy Jr.'s vaccine advisers in October — including changes to how people get COVID-19 vaccines.

• This includes a recommendation that older Americans consult with a health provider before getting vaccinated.
• Experts generally see the COVID vaccine as safe and effective, especially for those at risk for serious illness.

Go deeper: A guide to the new COVID vaccine recommendations

Colleges are throwing more and more money at kids to get them to choose their schools.

Why it matters: That grant money is going to families who need it the least, a new analysis of government data finds.

Recent breakthroughs in therapies and diagnostics are creating real hope in Alzheimer's disease care — especially for treating early symptomatic stages of the disease. But despite this progress, major healthcare system and awareness gaps still risk leaving too many people behind.

We sat down with Laura Steele, Senior Vice President of U.S. Neuroscience at Lilly, to unpack how scientific progress has produced innovations that can improve detection and diagnosis for people with Alzheimer's disease. She also discussed what health care providers and policymakers must do to unlock the full value of these innovations.

Metsera is belle of the metabolic ball, the subject of an intense bidding war between drug giants Novo and Pfizer.

The big picture: Normally, such a takeover target would sit back and wait for the highest number. But this situation is anything but normal.

A growing number of Senate Republicans are indicating they're open to a deal on extending the Affordable Care Act premium subsidies.

Why it matters: A clear path forward on the ACA issue would solve one corner of the Senate's puzzle to end the government shutdown.

Seven people at Joint Base Andrews fell ill after a "suspicious package" containing "negative sentiments" towards President Trump and his actions was sent to the Maryland military facility, the U.S. military said Friday.

The latest: "There were no specific threats towards the President or other government officials" in the package that was sent Thursday, but the statement from the 316th Wing of the U.S. Air Force at the base said "emergency responders evacuated the building and connecting building and established a cordon around the area" as a precaution.