 Welcome to Wednesday's Overnight Health Care. The CDC shortened its recommendation for a precautionary quarantine period, as the agency's director warned that this winter could be the most dire time in public health history. The White House coronavirus task force had a similarly urgent warning. Meanwhile, the administration announced more details of its vaccination allocation plan. We'll start with the White House task force: White House warns COVID-19 cases at dire levels, says patient care could be compromised While President Trump himself remains largely quiet on coronavirus, the White House task force is issuing increasingly urgent warnings. “We are in a very dangerous place due to the current, extremely high COVID baseline and limited hospital capacity; a further post-Thanksgiving surge will compromise COVID patient care, as well as medical care overall,” reads the White House report sent to states and obtained by The Hill. Some further messages from the report: - If you are over 65 or have underlying health conditions, you should not go indoors where there are unmasked people, and should get groceries and medications delivered. If you are under 40 and gathered for Thanksgiving, assume you have the virus and isolate.
- “Restricting indoor dining and limiting and/or closing areas of congregation without masking” is needed and has proven successful in areas that have done so.
- Use of rapid antigen tests needs to be expanded and it is important that asymptomatic people are tested as well, given that many people without symptoms still spread the virus.
“All states and all counties must flatten the curve now in order to sustain the health system for both COVID and non-COVID emergencies,” the report states. Read more here.
CDC director: Winter could be 'most difficult time in the public health history of this nation' In a surprisingly candid appearance with the U.S. Chamber of Commerce, CDC Director Robert Redfield warned that the country is facing a potentially devastating winter unless a large percentage of Americans change their behavior. The U.S. could see another 200,000 coronavirus deaths in the next three months if people don't take mitigation measures such as mask-wearing and physical distancing seriously, Redfield said. "The reality is December and January and February are going to be rough times. I actually believe they're going to be the most difficult time in the public health history of this nation," largely because of the stress to the health system. "I do think, unfortunately, before we see February, we could be close to 450,000 Americans dead from this virus," Redfield said. The path forward: Redfield made a point to say the country is not defenseless, and the death toll is not a "fait accompli." But people need to do the bare minimum of wearing a mask, maintaining physical distance, and avoiding crowds, especially indoors. "The truth is, mitigation works," Redfield said. "The challenge with this virus is, it's not going to work if half of us do what we need to do. It's not even going to work, probably if three quarters of us do what we need to do. This virus really is going to require all of us to really be vigilant." Parting swipe at Trump? Redfield said one of his main disappointments from his time as CDC director is the lack of a consistent message about the benefits of wearing a mask. He criticized that fact that it's been turned into a political statement, but never directly acknowledged that President Trump and others in the administration played a major part in that. "When you really want to get everybody on board, you’ve got to have clear, unified, reinforced messaging,” Redfield said. “The fact that we were still arguing in the summer about whether masks work,’’ he said, “was a problem.” Read more here. Aside from masks, CDC is taking steps to make a preventive quarantine more palatable CDC says preventive coronavirus quarantines can be shortened from 14 days You don’t necessarily need to quarantine for 14 days anymore after exposure to coronavirus. The Centers for Disease Control and Prevention (CDC) on Wednesday said its recommended quarantine time after someone is exposed to the coronavirus can be shortened to seven days with a negative test result, and 10 days without a test, if they do not have symptoms. CDC officials said that people ideally would still quarantine for the full 14 days, but that in an effort to boost compliance with quarantining and after "extensive modeling," they determined there was a low risk of people continuing to spread the virus in the final days of a quarantine. "Reducing the length of quarantine may make it easier for people to take this critical public health step," said Henry Walke, the CDC's COVID-19 incident manager. Also rethink those holiday travel plans: In addition, the CDC is continuing the recommendation it made before Thanksgiving that people not travel for the holidays. But if people do decide to travel, the CDC is recommending that people get tested 1 to 3 days before travel and 3 to 5 days afterward. Read more here. Meanwhile at the White House, it’s holiday parties White House press secretary Kayleigh McEnany on Wednesday shrugged off concerns about holding in-person holiday parties as the nation is riven by a surge in coronavirus cases and public health agencies urge Americans to forgo such gatherings. "If you can loot businesses, burn down buildings, engage in protest, you can also go to a Christmas party," McEnany said at a White House briefing. "You can celebrate the holiday of Christmas, and you can do it responsibly," she added. The Washington Post reported that the White House is planning at least 25 separate holiday parties over the coming weeks, each of which will include more than 50 guests. The White House has already been the site of multiple coronavirus outbreaks that infected President Trump, McEnany and other top aides. Flashback: Last month, U.S. Surgeon General Jerome Adams warned against large indoor holiday celebrations when asked about the White House’s plans to hold parties. “We want everyone to understand that these holiday celebrations can be super-spreader events, so we want them to be smart and we want them to be as small as possible,” Adams said on ABC’s “Good Morning America,” urging the public to follow Centers for Disease Control and Prevention guidelines. “These apply to the White House, they apply to the American people, they apply to everyone.” Read more here. US plans to immunize 100 million people by end of February The U.S. is hoping to give a COVID-19 vaccine to 100 million people by the end of February, the head of the administration's Operation Warp Speed told reporters Wednesday. Moncef Slaoui said that number essentially represents all the nation's frontline health workers, the elderly, and people with underlying conditions. Slaoui said he is basing that number on the number of vaccines that could be available from both Moderna and Pfizer/BioNTech. If Johnson & Johson's vaccine is authorized before then, there is potential for even more people to be vaccinated, he said. Slaoui said that based on how quickly the coronavirus is spreading, he expects the company to release late-stage trial data in January. According to Slaoui, the companies have manufactured and stockpiled enough doses so the government can send 40 million doses to states in December, 60 million doses in January and 100 million doses by the end of February. More allocations: According to Warp Speed CEO Gen. Gustave Perna, the government plans to ship out 6.4 million doses of the Pfizer vaccine within 24 hours of it getting the green light from the Food and Drug Administration. Officials plan to send 12.5 million doses of the Moderna vaccine in the same period. No vaccine has been authorized in the U.S. yet, but states have a Friday to deadline to submit their distribution plans to the Trump administration. An emergency authorization could come as early as next week. It's not a race. But the U.S. will not have first access to a COVID vaccine. UK becomes first nation to approve COVID-19 vaccine British officials on Wednesday cleared Pfizer’s COVID-19 vaccine for emergency use, making the United Kingdom the first country to do so. The U.K.’s Medicines and Healthcare Products Regulatory Agency cleared the vaccine for use after reviewing data that shows it is 95 percent effective, The Associated Press reported. “Help is on its way,″ Health Secretary Matt Hancock told the BBC. “We now have a vaccine. We’re the first country in the world to have one formally clinically authorized but, between now and then, we’ve got to hold on, we’ve got to hold our resolve.” Hancock said the first 800,000 doses of the vaccine would likely be received in the next few days and estimated the pandemic situation would begin turning around in spring of 2021 with its introduction. Read more here.
What we’re reading Why was the UK first to authorize a coronavirus vaccine? (CNN.com) Where COVID is on the menu: failed contact tracing leaves diners in the dark (Kaiser Health News) Moderna plans to begin testing its coronavirus vaccine in children (New York Times) Starbucks offers free coffee to health care workers, first responders as coronavirus cases rise (USA Today) State by state Officials outline plans for coronavirus vaccine distribution in Washington region (Washington Post) California shuts down to curb coronavirus surge. Will it work? (San Francisco Chronicle) Virginia County Votes To Reject Gov. Northam's Coronavirus Restrictions (NPR) The Hill op-eds Four guiding principles to extinguish the public health wildfire Protecting child health now and in the future | 
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