 Welcome to Wednesday's Overnight Health Care. It was a big day at the CDC. The agency held a press briefing for the first time since August, and also expanded the definition of a "close contact" of someone infected with COVID-19. Senate Democrats holding out for a bigger deal blocked a whittled-down coronavirus relief bill, and OxyContin maker Purdue Pharma will plead guilty in a deal with the Justice Department. We'll start with the CDC: CDC expands definition of close contact after spread from 'multiple brief encounters' More people are now going to be “close contacts” of those infected with coronavirus under new CDC guidelines. The CDC on Wednesday expanded its definition of “close contact,” now saying that multiple brief encounters can also lead to transmission of the virus. The previous definition of close contact, which is used for determining who should quarantine, was being within 6 feet of an infected person for at least 15 minutes. The new standard now defines close contact as being within 6 feet of an infected person for at least 15 minutes over a 24-hour period, making clear that multiple separate encounters that add up to more than 15 minutes also count. The change comes after the CDC and Vermont health officials published a report finding that a prison employee in Vermont contracted the virus after “multiple brief encounters” with inmates who later tested positive. The 22 encounters added up to 17 minutes over an eight-hour shift, the report said. Some of the inmates were not wearing masks, the CDC said, reinforcing the importance of mask wearing. Read more here.
 
CDC: 75 percent of US seeing increases in COVID-19 cases in 'critical phase' of pandemic The number of COVID-19 cases is increasing in 75 percent of the country, as the U.S. Approaches a “critical phase” of the pandemic, Centers for Disease Control and Prevention officials said Wednesday. “Unfortunately we're seeing a distressing trend here in the United States,” Jay Butler, the CDC’s deputy director for infectious diseases, said at a rare media briefing at the agency's headquarters in Atlanta. The briefing was initially only open to local media, but the Department of Health and Human Services eventually allowed national press to cover the event as well. The U.S. has confirmed more than 8.1 million cases of COVID-19, though the official number is likely much higher. Why it matters: Experts had warned all year the U.S. would likely see a surge in cases in the fall and winter as the cold weather forces people to spend more time indoors. It appears that surge is here, with the U.S. confirming nearly 60,000 cases a day, nearing the record high set this summer during the wave in the south. “I recognize that we are all getting tired of the impact that COVID-19 has had on our lives — we get tired of wearing masks but it continues to be as important as it's ever been, and I would say it's more important than ever, as we move into the fall season,” Butler said, noting that people will likely be gathering over the holidays. Read more here. Another day in the swirling coronavirus negotiations: The GOP coronavirus bill was blocked in the Senate as a deal remains elusive Senate Democrats blocked a scaled-down, GOP-only $500 billion coronavirus bill Wednesday, as talks continue on a bipartisan deal between House Speaker Nancy Pelosi (D-Calif.) and the White House. Senators voted 51-44 to end debate on the Republican proposal, falling short of the 60 needed to overcome the procedural hurdle. The GOP bill was widely expected to fall short—and is less than a third of the latest offer made by the White House. But Senate Republican leadership was eager to force Democrats to go on the record on coronavirus relief as the number of cases per day is on the rise and the November election is less than two weeks away. “The overwhelming bulk of it is programs that Democrats claim they support. Well, it turns out there’s a special perk to being a United States senator. When you actually support something, you get to vote for it. ... When you actually want an outcome, you vote it. Strangely enough, that’s not what seems to be happening,” McConnell said on Wednesday ahead of the vote. Democrats blasted the GOP bill as a “stunt,” aimed at allowing vulnerable GOP senators to vote for a bill as they fight to hold onto the majority in November. Read more here. OxyContin maker agrees to $8B settlement with Trump administration Purdue Pharma, the company that manufactures the powerful opioid OxyContin, will plead guilty to three federal charges as part of a larger $8 billion settlement arrangement, the Justice Department said Wednesday. OxyContin is widely blamed for starting the country’s opioid crisis that's killed more than 400,000 Americans over the past two decades. Deputy Attorney General Jeffrey Rosen said Purdue has agreed to plead guilty in federal court in New Jersey to conspiracy to defraud the United States and two counts of conspiracy to violate anti-kickback laws. The settlement includes a criminal fine of more than $3.5 billion, criminal forfeiture of $2 billion and a civil settlement of $2.8 billion. The criminal plea does not preclude the potential for criminal charges in the future against any executive or member of the Sackler family, who own Purdue Pharma. The reality: The $8 billion figure is headline grabbing, but Purdue will not pay anywhere close to that amount. The company filed for Chapter 11 protection last year, and has many creditors looking to extract payment. The politics: The announcement, less than two weeks before Election Day, will allow President Trump to claim a major victory in combating the opioid epidemic, something he campaigned heavily on ahead of the 2016 election. But the deal was not embraced by all parties, as Democratic lawmakers and state attorneys general criticized what they said was a politically-motivated settlement. What's next: The Justice Department settlement means the company will be dissolved, and become a government owned "public benefit company." Purdue, along with other manufacturers, distributors, and pharmacies is still facing litigation from more than 2,000 cities, counties, Native tribes and other groups. But by declaring bankruptcy, Purdue is attempting to shield itself from the litigation. Read more here. | 
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