 Welcome to Wednesday’s Overnight Health Care. The Senate is heading out of town until after Thanksgiving, with no COVID relief deal. Meanwhile, the U.S. has reached another grim milestone, with more than 250,000 people dead from COVID-19. Let’s start there: US reaches grim milestone of 250,000 coronavirus deaths More than a quarter-million Americans have died from complications of COVID-19, the disease caused by a coronavirus that is tearing massive holes in states across the nation, as health experts warn the death toll could double in the coming months. NBC News reported the death toll crossed the 250,000 mark on Wednesday. Other counts maintained by Johns Hopkins University and The New York Times were slightly below that figure. The United States continues to be the epicenter of the pandemic, accounting for a hugely disproportionate share of cases and deaths even as the virus begins spreading more widely in European countries. Virtually every indicator in the U.S. is flashing bright red alarms: The country has recorded more than 100,000 new cases on every day since the Nov. 3 election. More than 73,000 Americans are being treated in hospitals, an all-time high. Of those, 14,000 are in intensive care units. The number of tests conducted on a given day is rising, but so too is the percentage of those tests that come back positive, a sign that the virus is spreading faster than testing is expanding. Further warning signs ahead of holiday gatherings: “This is a disaster waiting to happen,” said Kelli Drenner, a public health expert at the University of Houston. “People are letting their guard down, expanding their bubbles.” Read more here. Even more good news on the vaccine front: Pfizer says vaccine shows 95 percent efficacy Pfizer on Wednesday announced that final data on its coronavirus vaccine candidate showed it to be 95 percent effective. Looks for an application to FDA soon: The company said it would be applying for FDA emergency authorization “within days.” Pfizer said that the vaccine candidate, developed with German company BioNTech, is 95 percent effective “against COVID-19 beginning 28 days after the first dose.” The company last week said that interim data revealed its vaccine to be over 90 percent effective, but it added more specifics on Wednesday. It also said on Wednesday that it had the two months of safety data necessary to apply for an emergency use authorization from the FDA. Caveat: While good news, the vaccines are not expected to be widely available to the general public until at least the spring, meaning there are still several tough months ahead. Read more here. The next challenge: getting those vaccines out to states Federal health officials on Wednesday expressed confidence that every state will have access to at least some doses of a COVID-19 vaccine for distribution within 24 hours after authorization. "Every jurisdiction will have access immediately upon the initial push of the vaccine," Gen. Gustave Perna, chief operating officer of the Trump administration's Operation Warp Speed, said during a call with reporters. Perna said after the initial push there will be weekly distributions as more doses become available. Health and Human Services Secretary Alex Azar said between the two vaccines from Pfizer and Moderna, and pending FDA authorization, the country expects to have 40 million doses available by the end of the year, enough to vaccinate about 20 million people. Right now, the United States is averaging more than 1 million new infections per week. Read more here. Coronavirus relief at a standstill with no leadership-level talks Negotiations between congressional leaders on a fifth coronavirus relief bill are at a standstill, further dimming the prospects for an end-of-year deal even as cases climb across the country. Senate Majority Leader Mitch McConnell (R-Ky.) and Senate Minority Leader Charles Schumer (D-N.Y.) on the Senate floor Wednesday traded blame for the lack of progress. “I heard the Republican leader this morning give the same long, tired speech that pretends as if Democrats haven’t been trying to negotiate with our colleagues, that we haven’t been trying over and over again to get our Republican colleagues to talk with us,” Schumer said. Schumer and House Speaker Nancy Pelosi (D-Calif.) sent McConnell a letter this week urging him to restart negotiations on a fifth coronavirus package. McConnell told reporters during a weekly press conference that he was not having any behind-the-scenes talks with Democratic leadership about coronavirus relief, though he and Pelosi spoke last week on funding the government. Why it matters: The Senate is about to take off for Thanksgiving break without reaching a COVID deal. Read more here. Meanwhile, Senate Democrats introduce bill to shore up PPE supply Senate Democrats on Wednesday introduced a bill that would shore up the supply of protective equipment for health care workers as the U.S. faces another surge of COVID-19 cases. The bill would appropriate $10 billion for the government to purchase large quantities of masks, gloves, gowns and face shields, Schumer told reporters Wednesday. The bill would also create a $1 billion grant program to help small businesses “retool” their facilities to manufacture protective equipment on a larger scale. Democrats introduced the bill as COVID-19 cases surge nationwide in the largest wave of the pandemic. While shortages of protective equipment are not as widespread today as they were at the beginning of the pandemic, they still persist and are likely to get worse as cases continue to rise. "We must do everything in our power to avoid a repeat of the widespread shortages," Schumer said. Why it matters: Shortages are likely to worsen as cases continue to surge across with the U.S. with no end in sight. Read more here. New York City schools to shut down amid rise in coronavirus cases New York City public schools will close starting Thursday amid a rise in COVID-19 cases, Mayor Bill de Blasio (D) announced. The move is a setback for the city, which still has one of the lowest rates of infection in the country. Officials have worried about a new wave of cases as the number of infections tick upwards in New York and across the country. “We must fight back the second wave of COVID-19,” de Blasio tweeted Wednesday when announcing the closure, which will affect all public school buildings. Officials had previously said schools would close again if the percentage of tests coming back positive in New York City reached 3 percent. Why it matters: Many public health experts were critical of the move, noting that bars and restaurants remain open in NYC but are a greater contributor to the spread of COVID than schools. Read more here. What we’re reading The last children of down syndrome (The Atlantic) Health systems are using AI to predict severe Covid-19 cases. But limited data could produce unreliable results (Stat) How the out-of-control pandemic is speeding the hunt for vaccines (The New York Times) State by state Over 900 Mayo staff have gotten COVID-19 in past two weeks (Twin Cities) Some resist California's new coronavirus restrictions (Associated Press) El Paso is fighting the coronavirus and state resistance as officials desperately try to keep up with sick and dying Texans (Texas Tribune) The Hill op-eds Mask-wearing mandate should include a major public health educational campaign Haste makes COVID-19 waste — good science takes time Contraception has changed the game, but concerns over access linger | 
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