 Welcome to Wednesday's Overnight Health Care. The Tokyo Olympics may be ground zero for COVID outbreaks, but the lemurs at the Duke Lemur Center in North Carolina are getting ready for their own event. If you have any tips, email us at nweixel@thehill.com psullivan@thehill.com jcoleman@thehill.com Follow us on Twitter at @NateWeixel, @PeterSullivan4, and @JustineColeman8. Today: State attorneys general announced a $26 billion settlement with opioid distributors and Johnson & Johnson. Life expectancy dropped as a result of COVID-19, and a federal judge blocked Arkansas from implementing a law banning gender-affirming care for young people. We'll start with opioids: Drug companies reach tentative $26 billion national opioid settlement A bipartisan coalition of state attorneys general on Wednesday announced a $26 billion settlement with Johnson & Johnson and three of the country's largest drug distributors regarding their roles in the U.S. opioid epidemic. If approved, the three major drug distributors — Cardinal Health, McKesson, and AmerisourceBergen — would pay $21 billion over 18 years, a tiny percentage of their annual revenue. The companies also would not admit any wrongdoing. Distributors were accused of ignoring red flags that billions of opioid pills were being illegally diverted onto the black market, and subsequently into communities. As part of the deal: Johnson & Johnson, which once manufactured and marketed opioids, will pay up to $5 billion over nine years, with up to $3.7 billion paid during the first three years. The company also agreed to exit the opioid business. The agreement would resolve the claims of both states and local governments across the country, including the nearly 4,000 that have filed lawsuits in federal and state courts. However, none of the money will go to individual families, or people who suffer from opioid addiction. The substantial majority of the money is to be spent on opioid treatment and prevention, according to the attorneys general that negotiated the deal. What's next: States will have 30 days to sign on to the deal, and North Carolina Attorney General Josh Stein (D) told reporters during a press conference he expects at least 40 states to agree. But Washington State Attorney General Bob Ferguson (D) already rejected the settlement, saying it is "not nearly good enough" and that he was ready to continue to litigate in court. West Virginia Attorney General Patrick Morrisey (R) already voiced his objections, and has said he will not support any settlement that distributes money based on population, rather than impact of the opioid crisis. Read more here. COVID-19 deaths push drop in life expectancy U.S. life expectancy fell by 1 1/2 years in 2020, largely driven by the COVID-19 pandemic, according to new data released by the Centers for Disease Control and Prevention (CDC). The drop in life expectancy at birth, from 78.8 years in 2019 to 77.3 years in 2020, was in part caused by the increase in mortality from the COVID-19 pandemic, the CDC noted. The data found that the coronavirus was responsible for 73.8 percent of the overall decline in life expectancy. Approximately 3.3 million Americans died in 2020, according to the CDC, 375,000 of whom died as a result of COVID-19. Drug overdoses and an increase in homicides also played a role in U.S. life expectancy falling. The decline would have been even greater were it not for the offsetting effects of decreases in mortality due to cancer, chronic lower respiratory diseases, heart disease, and suicide. Disparities: Hispanic Americans have longer life expectancy than white or Black Americans, but had the largest decline in 2020. The drop in life expectancy was larger among Black Americans and Hispanic Americans, who saw decreases of 2.9 years and 3 years, respectively. COVID-19 was responsible for 90 percent of the decline in life expectancy among Hispanics, 68 percent among white people, and 59 among Black Americans. The reduction in life expectancy for Black Americans was the largest one-year drop seen since the mid-1930s, amid the Great Depression, according to The Associated Press. The CDC has not monitored Hispanic Americans' life expectancy as long, but the one-year drop recorded in 2020 was reportedly the largest ever seen. Read more here. WHO chief: Virus risk inevitable at Olympics The chief of the World Health Organization (WHO) said on Wednesday that the risk of COVID-19 spreading at the Olympics is inevitable as tens of thousands gather for the global competition. WHO Director-General Tedros Adhanom Ghebreyesus said during a keynote speech at an International Olympics Committee (IOC) meeting that cases at the Olympics should be expected and what matters is how organizers respond to infections. "The mark of success in the coming fortnight is not zero cases, and I know that some cases have already been detected," he said. "The mark of success is making sure that any cases are identified, isolated, traced and cared for as quickly as possible, and onward transmission is interrupted." Almost 80 cases have been connected to the Olympics, including 33 among international visitors, as of Wednesday — two days before the opening ceremony. Tedros praised the IOC for having "done your best" to reduce transmission with COVID-19 safety measures, saying the Olympics' success could show "a demonstration of what is possible with the right plans and the right measures." But the director-general also issued a stark warning to the world, calling the pandemic "a test" that "the world is failing." "The pandemic will end when the world chooses to end it," he said. "It's in our hands." Read more here. Federal judge blocks Arkansas transgender youth treatment ban A federal judge on Wednesday temporarily blocked the Arkansas law that bans gender-affirming care for transgender youth as part of the state's legal battle with the American Civil Liberties Union (ACLU). U.S. District Judge James Moody granted a preliminary injunction for the law that punishes physicians for giving gender confirming treatment to minors and recommending other providers for such care. Moody, an Obama appointee to the U.S. District Court for the Eastern District of Arkansas, also denied the state's motion to dismiss the ACLU's lawsuit. Holly Dickson, the executive director of ACLU Arkansas, praised the temporary injunction in a statement, saying it "sends a clear message to states across the country that gender-affirming care is life-saving care, and we won't let politicians in Arkansas — or anywhere else — take it away." Background: The law, which was set to go into effect July 28, passed earlier this year after the Republican-led Arkansas legislature overrode a veto from Gov. Asa Hutchinson (R). What's next: Arkansas Attorney General Leslie Rutledge (R) announced that the state will appeal the ruling. "I will aggressively defend Arkansas's law which strongly limits permanent, life-altering sex changes to adolescents," she said in a statement. "I will not sit idly by while radical groups such as the ACLU use our children as pawns for their own social agenda." Read more here. Johnson & Johnson projects $2.5 billion from vaccine sales globally Johnson & Johnson on Wednesday said that it anticipates $2.5 billion in annual sales of its COVID-19 vaccine, even as the company faces questions about the vaccine's effectiveness with the delta variant. The forecasted sales are a small fraction of the sales expected from the other two authorized vaccines; Pfizer and Moderna have forecast $26 billion and $19.2 billion in annual sales of their vaccines, respectively. Global sales of J&J's COVID-19 vaccine in the quarter were only $164 million. Background: The single-dose vaccine was expected to be a major tool for helping inoculate the world, especially in hard-to-reach areas, but it has struggled to gain a foothold. The company has been plagued by production problems at its only U.S. facility, and use of the vaccine was paused for nearly two weeks while health officials examined rare but serious cases of blood clots. Follows: The company's financial announcement comes a day after a new study showed the vaccine may be less effective in battling the delta and lambda coronavirus variants than other shots. Read more here. What we're reading Cash shortage threatens White House global vaccine effort (Politico) Conservative media offers mixed messages on COVID-19 vaccine (The Associated Press) U.S. isn't prepared to track Covid variants as delta mutation spreads (Bloomberg) State by state 'I'm sorry, but it's too late' Alabama doctor on treating unvaccinated, dying COVID patients (Alabama Local News) State: Unvaccinated Cape Cod nursing home employees must take rapid tests before shifts (Cape Cod Times) 'A form of brainwashing': why Trump voters are refusing to get a vaccine (Financial Times) The delta variant thrives in a state of political and public health discord (Kaiser Health News) Op-eds in The Hill COVID-19 misinformation is a public health hazard — we need to start treating it as such Why 'misinformation' is the wrong label with vaccine hesitancy Texas Democrats pull worst publicity stunt — ever | 
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