 Welcome to Monday's Overnight Health Care. Moderna announced positive initial data from its vaccine trial, giving public health officials and experts more optimism. Meanwhile, COVID-19 is still surging exponentially and more states and cities have reimposed restrictions. We'll start with Moderna: Moderna says coronavirus vaccine is 94.5 percent effective Moderna announced Monday morning that a preliminary analysis of its coronavirus vaccine candidate showed it was 94.5 percent effective at preventing illness, including severe cases. The announcement comes one week after Pfizer and its German partner BioNTech announced their vaccine was over 90 percent effective, meaning there are now two vaccine candidates with very high levels of efficacy in interim analyses of clinical trial data The Moderna vaccine is similar to the one from Pfizer/BionNTech, in that both are developed using mRNA instead of a live virus. The method is experimental, but experts said the fact that two separate candidates had results of over 90 percent efficacy is a cause for optimism. "The light at the end of the tunnel just got even brighter," tweeted Atul Gawande, a coronavirus adviser to President-elect Joe Biden, in reaction to Moderna's announcement. "We may now have multiple, very effective vaccines distributing widely in spring and summer. Now we must pull together to get everyone we can through that tunnel alive and with jobs intact." Leg up: Moderna's vaccine is slightly more effective than Pfizer's, plus the data shared shows it also prevents severe illness, which is unknown about Pfizer. Most of all, storage and distribution ought to be easier because the vaccine doesn't need the ultra cold storage that the Pfizer/BioNTech one requires. The hard part: The coming months are still likely to be brutal, before the vaccine is widely available, as coronavirus cases and hospitalizations continue to rise heading into winter. Widespread vaccination likely won't be available until 2021, although initial doses may be injected into high priority groups as early as next month. Biden has emphasized this point in multiple speeches, making it clear that public health measures like wearing masks and keeping physically distant are the best tools available. Read more here On distributing the vaccine, Biden would like some cooperation from Trump: President-elect Joe Biden warned Monday that “more people may die” from COVID-19 if the Trump administration does not begin to engage in a smooth transition of power. “More people may die if we don’t coordinate,” Biden told reporters following a speech on his economic plan in Wilmington, Del., emphasizing the pressing need for his transition team to gain access to the Trump administration’s plan for distributing a future vaccine for the coronavirus. “A vaccine is important. It’s of little use until you are vaccinated. So how do we get the vaccine, how do we get over 300 million Americans vaccinated? What is the game plan? It is a huge, huge, huge undertaking to get it done,” Biden said. “If we have to wait until Jan. 20 to start that planning, it puts us behind over a month, month and a half. And so, it’s important that it be done, that there be coordination now. Now or as rapidly as we can get that done,” he continued. Anthony Fauci, the top U.S. infectious diseases expert and a member of the White House coronavirus task force, also said Sunday that “it would be better” if government health experts could begin engaging with Biden’s team. Read more here. Trump officials preparing to move forward with major step to lower Medicare drug prices Many last-minute Trump administration moves are likely to be strongly opposed by Democrats, but probably not this one… The Trump administration is preparing to move forward with a major proposal to lower drug prices and rulemaking could come as soon as this week, according to people familiar with the effort. The move, fiercely opposed by the pharmaceutical industry, would implement President Trump’s “most favored nation” proposal and lower certain Medicare drug prices to match prices in other wealthy countries. Trump issued an executive order in September calling for steps to that effect, but it was unclear whether the administration would still go forward with implementing the proposal, especially given the election and a coming change in administration. Sources said that while plans can always change at the last minute, the administration is preparing to take the regulatory steps to implement the idea as soon as this week and that it is likely to take the form of an interim final rule, meaning it will skip some of the steps in the regulatory process and go forward faster. The coming backlash: Trump’s actions would be sure to set off a backlash from drug companies, possibly including lawsuits to try to stop the rule. Many congressional Republicans also oppose the proposal, warning that it veers from traditional GOP free-market principles and instead constitutes “price controls.” Read more here. California pulling 'emergency brake' to slow record surge of COVID cases California is pulling the "emergency brake" and tightening restrictions for 94 percent of the state's residents amid a record-breaking increase in coronavirus cases. Gov. Gavin Newsom (D) on Monday said 41 of the state's 58 counties will be put into the most restrictive "purple" tier because of widespread virus transmission, effective tomorrow. This means indoor dining, gyms, movie theaters and houses of worship will be closed. Counties will be reassessed multiple times during the course of a week, and they will be unable to move forward until the numbers improve and the state deems it safe. Newsom said the state will no longer wait until each Tuesday to impose new restrictions on counties. Daily cases have doubled in the state over the last 10 days, the fastest increase California has seen since the beginning of the pandemic. The state's positivity rate over the past seven days is 4.6 percent. While much lower than the national average, Newsom said that rate is far too high. Just two weeks ago, the state's positivity rate was 3.2 percent. If left unchecked, Newsom said the spread could quickly overwhelm the state's health care system and lead to "catastrophic outcomes." Read more here. Related: Philadelphia announces new restrictions as coronavirus cases surge New Jersey limits indoor, outdoor gatherings ahead of Thanksgiving as COVID-19 surges Trump adviser in hot water for saying Michigan should ‘rise up’ against COVID restrictions Scott Atlas, a top medical adviser to President Trump, called on Michiganders to “rise up” after Gov. Gretchen Whitmer (D) announced new restrictions amid a surge in coronavirus cases. "The only way this stops is if people rise up," Atlas tweeted Sunday after Whitmer’s office announced a three-week return to remote learning for high schools and college students, as well as a reimposed ban on dine-in service at restaurants. "You get what you accept. #FreedomMatters #StepUp," Atlas added. The language echoed Trump's calls to "LIBERATE MICHIGAN." Whitmer, reportedly the target of a kidnapping plot earlier this year by a far-right militia group that objected to her COVID restrictions, reacted to the tweets Sunday evening, telling CNN’s Wolf Blitzer: “We know that the White House likes to single us out here in Michigan, me out in particular. I'm not going to be bullied into not following reputable scientists and medical professionals." About three hours later, Atlas tweeted that he would never "endorse or incite violence." Atlas has become Trump's top source of information on the coronavirus pandemic, despite being a neuroradiologist without any training in infectious diseases. Atlas is a proponent of "herd immunity," which involves letting supposedly healthier people get infected with COVID until there is widespread immunity. Experts say this is impossible and would result in millions of deaths. Read more here. Meanwhile, Fauci distances himself from Trump adviser Atlas: 'I totally disagree with the stand he takes' Anthony Fauci, the nation’s top infectious diseases expert, once again distanced himself from a doctor advising the president on COVID-19, saying he “totally disagrees” with Scott Atlas. Atlas has taken to Twitter in recent days to rail against closures of some businesses and high schools in Michigan in response to COVID-19. “I don't want to say anything against Dr. Atlas as a person, but I totally disagree with the stand he takes. I just do, period,” Fauci said Monday on NBC's "Today." Atlas has repeatedly criticized closures and restrictions that are aimed at slowing the spread of the coronavirus, arguing they are harmful for the economy and mental health. Read more here. What we’re reading: Doctors are calling it quits under stress of the pandemic (The New York Times) A lack of transparency is undermining pandemic policy (Wired) On COVID-19, two vaccines offer more answers about the road ahead (STAT) State by state: Why do some Ohioans find it hard to get Medicaid? Survey says it’s a glitchy online form (The Columbus Dispatch) Milwaukee Considers Raising Fine To $20K For COVID-19 Violators (Wisconsin Public Radio) As Texas universities prepare to send thousands of students home for the holidays, few are requiring COVID-19 safety precautions (Texas Tribune) | 
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