 Welcome to Thursday's Overnight Health Care. The spike in COVID-19 cases is putting a massive strain on the nation's hospitals as the country reached a record number of new infections this week. Meanwhile, House Democrats released documents showing how HHS tried to craft its celebrity campaign to "defeat despair," and two people who attended Trump's rally in North Carolina last week have since tested positive for COVID-19. We'll start with hospitalizations: Winter COVID-19 wave poses threat to nation's hospitals It’s looking like it’s going to be a tough winter. And at hospitals that means a surge in coronavirus patients. Some signs of strain on hospitals already: - In El Paso, Texas, authorities are setting up a field hospital at the convention center to help deal with the surge in hospitalizations.
- In Utah, the head of the state hospital association told The Salt Lake Tribune that hospitals are on a trajectory to have to start rationing care soon.
- Kootenai Health, a hospital in Idaho, warned in a statement last week that it was 99 percent full, and that many hospitals in the area were not accepting patients to be transferred because they are also at capacity.
Overall numbers: Hospitalizations nationally have risen to about 45,000 people, up from around 30,000 at the beginning of the month. Those numbers are still rising, according to the COVID Tracking Project. Big picture: France and Germany announced partial lockdowns on Wednesday, a sign of the worsening situation there. Such drastic measures are not expected on a national level in the United States, though experts expect many states and localities will have to implement at least targeted measures such as closing bars and indoor dining as the situation worsens. Read more here. Related: US sets weekly record with over 500,000 new COVID-19 cases Two people who attended Trump's North Carolina rally test positive for COVID-19 Two people who attended President Trump's rally at an airport in Gaston County, N.C., last week have tested positive for COVID-19, the county health department said Thursday. The Gaston County Department of Health and Human Services said the cases are not thought to be an indication of spread from the rally, but rather two independent cases among individuals who were in attendance. One of the people infected was a local television reporter, who tweeted that he was wearing a mask the entire time "but due to Secret Service protocols, there were several times when social distancing wasn't possible." Contact tracing is underway, and other places these individuals have been and other close contacts to them are being notified directly by public health staff. However, the county said it is making a broader announcement "because of the large number of potential contacts from the rally, and the inability to alert them directly." Read more here. Documents show 'political' nature of Trump COVID-19 ad campaign, lawmakers say A Trump administration official suggested that the theme of a roughly $250 million taxpayer-funded ad campaign to “defeat despair” around coronavirus could be “Helping the President will Help the Country,” according to documents obtained by the House Oversight and Reform Committee. House Democrats said in a letter to Health and Human Services (HHS) Secretary Alex Azar released Thursday that the suggestion from Michael Caputo, the top HHS spokesperson, who has since taken a leave of absence, showed the inappropriately political nature of the ad campaign. “Of course, it is completely inappropriate to frame a taxpayer-funded ad campaign around ‘helping’ President Trump in the weeks and days before the election,” wrote the Democratic lawmakers. Notes from a contractor on the meeting with Caputo indicate he thought the theme “would appeal to [Trump’s] base in terms of wearing a mask, vaccine – Do Your Part...” Background: The ad campaign, which was to feature public service announcements from celebrities around defeating coronavirus, was already controversial, given suspicions that it was really a way to use taxpayer money to boost the president’s reelection campaign. Read more here. A potentially significant move on the non-COVID front: New Trump policy will force insurers to disclose prices up front Health insurers will be required to publicly post, in advance, the prices for the most common services and procedures under a rule finalized by the Trump administration on Thursday. The final rule is an effort to inject transparency into the opaque health care sector, and it comes less than a week before the culmination of a campaign in which President Trump has been hammered on health care by Democratic nominee Joe Biden for his efforts to overturn ObamaCare and his handling of the coronavirus pandemic. Patients will eventually have access to new information about cost, including an estimate of their cost-sharing liability, through an internet-based, self-service tool. Currently, this is information that patients typically receive only after they get those services, through an explanation of benefits form. The Department of Health and Human Services (HHS) said the goal is to bring greater competition to the private health care industry. "We want every American to be able to work with their doctor to decide on the healthcare that makes sense for them, and those conversations can’t take place in a shadowy system where prices are hidden," HHS Secretary Alex Azar said. Read more here. Moderna says it's on track to report initial COVID-19 vaccine results next month Moderna is on track to report initial results from its coronavirus vaccine trial next month, company executives said Thursday. The company is one of the front-runners to produce a vaccine for COVID-19. During an earnings call, Chief Medical Officer Tal Zaks said the trial is operating as planned, and an independent data-monitoring committee is expected to conduct an interim review in November. The first review from the board will come after the trial reports that 53 cases of COVID-19 have been diagnosed among its sample, and the second interim analysis will come at 106 cases. The company will need to show the vaccine has at least a 74 percent efficacy rate at the first review, and a 57 percent efficacy rate at the second. CEO Stéphane Bancel said the company is preparing to distribute the vaccine globally and is scaling up for the launch. It has already received $1.1 billion in deposits from governments in advance of vaccine delivery. Read more here. What we’re reading Attacks on Obamacare threaten coverage gains among minorities (Politico) Sewage testing shows a country flush with coronavirus cases (CNN) Hospital bills for uninsured COVID patients are covered, but no one tells them (Kaiser Health News) States say they lack federal funds to distribute coronavirus vaccine as CDC tells them to be ready by Nov. 15 (Washington Post) State by state Florida groups fear loss of health insurance for many ahead of oral arguments in Obamacare lawsuit (WUWF) New York wedding and birthday party lead to 56 Covid cases, nearly 300 in quarantine (NBC News) N.J.'s coronavirus 2nd wave ‘is coming in now’ as new cases, hospitalizations surge, Murphy says (NJ.com) The Hill op-eds Listening to experts isn't perfect, but ignoring them is far worse Save America's independent family doctors Science supports new dietary guidelines limiting alcohol consumption | 
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