 Welcome to Wednesday’s Overnight Health Care. Senate Minority Leader Mitch McConnell is running pro-vaccine ads across Kentucky, using money from his reelection campaign. If you have any tips, email us at nweixel@thehill.com, psullivan@thehill.com and jcoleman@thehill.com. Follow us on Twitter at @NateWeixel, @PeterSullivan4, and @JustineColeman8 Today: President Biden is expected to unveil a mandate for federal government employees and contractors to get vaccinated or get regular COVID-19 tests. Republican governors speak out against the CDC’s updated mask guidance, and Pfizer released data showing a third dose of its vaccine “strongly” improves immune response to the delta strain. We’ll start with anticipated vaccine mandate: Biden expected to announce vaccine requirement for federal workers this week President Biden is expected to announce Thursday that federal government employees and contractors must get a COVID-19 vaccine or they will be subject to frequent testing for the virus, a source familiar with the plans confirmed to The Hill. Biden will outline the new protocols for federal workers during a speech Thursday in which he plans to detail efforts to get more Americans vaccinated as cases around the country are on the rise. White House principal deputy press secretary Karine Jean-Pierre told reporters Wednesday that no decision has been finalized, but a system where federal employees must get the vaccine or submit to strict safety protocols is under "strong consideration." The president on Tuesday acknowledged his administration is considering making it mandatory for federal workers to get the coronavirus vaccine. "That is under consideration right now, but if you’re not vaccinated, you’re not nearly as smart as I thought you were," Biden said during a visit to the Office of the Director of National Intelligence. Multiple outlets reported the White House announcement will likely be similar to what New York City Mayor Bill de Blasio announced Monday, which is that city workers will be required to be vaccinated by mid-September or submit to weekly testing. Follows: The Department of Veterans Affairs (VA) on Monday announced it would require its front-line health care workers to be vaccinated against COVID-19, making it the first federal agency to institute a mandate for coronavirus vaccinations. Read more here. Related: White House instructs agencies to mandate masks indoors in DC Aftermath to updated CDC guidance: Republican governors revolt against CDC mask guidance Republican governors are rejecting new mask recommendations the CDC issued Tuesday, casting the health guidance as a step back amid a push to vaccinate millions of Americans that is already struggling in their states. In statements and public comments, governors said their states would not return to the mask orders issued in 2020, including several leaders in states at the epicenter of the delta wave. In Texas: “Gov. Abbott has been clear that the time for government mandating of masks is over — now is the time for personal responsibility,” Texas Gov. Greg Abbott’s (R) office said in a statement Tuesday. “Every Texan has the right to choose whether they will wear a mask, or have their children wear masks.” In Nebraska: “The CDC’s new guidance suggesting that vaccinated people wear masks indoors flies in the face of the public health goals that should guide the agency’s decision making,” Gov. Pete Ricketts (R) said in a statement. “The State of Nebraska will not be adopting their mask guidance.” In Iowa: Gov. Kim Reynolds (R) called the new guidance “not grounded in reality or common sense.” “I’m concerned that this guidance will be used as a vehicle to mandate masks in states and schools across the country, something I do not support,” she said. Read more here. Where do the CDC’s new recommendations apply? Here's where you should wear a mask indoors The CDC’s update for many fully vaccinated Americans to wear masks indoors came amid an alarming rise on COVID-19 cases across the country that suggests the highly contagious delta variant is surging. The guidance itself advised fully vaccinated people in counties with “substantial” and “high” COVID-19 transmission to wear masks in public indoor settings. About 63 percent of counties are now a high or substantial transmission area, but the South is at the center of the new surge. The South is painted mostly red for high transmission in the CDC's county guidance, with the entirety of Louisiana, Arkansas and Florida considered to have high COVID-19 transmission. The new masking recommendations apply in all but two counties in Missouri, Mississippi and Alabama. The South also has almost all of the counties dealing with the highest average daily case count per population. The top 40 counties with the most COVID-19 cases per capita are all located in the South and Missouri, according to data from The New York Times. Read more here. Ford reacts, again requires masks at plants in Missouri, Florida The Ford Motor Company said it will again require all employees and visitors to wear masks at its facilities in Missouri and Florida, two states where new coronavirus cases are spiking. The Michigan-based automaker will also require employees be vaccinated against the coronavirus before traveling internationally "due to the potential of increased exposure to COVID-19," spokesperson Kelli Felker told The Detroit News. "Ford continues to strongly encourage all team members who are medically able to be vaccinated," Felker said in a statement. Ford's announcement comes as federal health officials warn of the dangers of the quickly spreading delta variant of the coronavirus that sparked the CDC to recommend fully vaccinated Americans in some areas of the country to mask up in indoor public settings. All counties in Florida and most in Missouri are considered high transmission areas, activating the new CDC guidance. Read more here. Pfizer says third vaccine shot 'strongly' boosts immune response against delta variant Pfizer said Wednesday that a third dose of its COVID-19 vaccine "strongly" boosts the immune response against the delta variant. The company posted slides ahead of an earnings call, with data showing that antibody levels were five times higher after a third dose among people aged 18 to 55 against the delta variant, and 11 times higher among 65- to 85-year-olds. Booster debate: Pfizer made waves earlier this month when it said it would be applying for Food and Drug Administration (FDA) authorization for a third dose of its vaccine. Still, it is not fully clear yet when and if a booster dose will be needed. It is possible booster shots will only be needed for more vulnerable people like the elderly or those with compromised immune systems. Experts also point out that antibody levels are not the only measure of protection and that there are other parts of the immune system that are activated against the coronavirus too. Some have noted Pfizer also has a financial incentive to sell more doses of its vaccine to use as boosters. Read more here. Related: Pfizer data shows vaccine effectiveness drops to 84 percent after six months What we’re reading Unraveling the mysterious mutations that make delta the most transmissible Covid virus yet (Kaiser Health News) ‘There is a real cost’: As Covid shows, barring bedside visitors from ICU deprives patients of the best care (Stat News) Schools Brace for a Chaotic Reopening With Delta Raging (Bloomberg Businessweek) State watch ‘We can’t keep these levels up’: Oklahoma health leaders warn of grim COVID trajectory (The Oklahoman) Mask order fights brew in Kansas City, St. Louis area (The Associated Press) New York opioid trial opens with emails joking about epidemic (The Wall Street Journal) Op-eds in The Hill Why in the world are White House reporters being told to mask up again? | 
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