 Welcome to Monday’s Overnight Health Care. The anonymous messaging app Yik Yak is back after a four-year hiatus – just as college students are returning to campus. 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: Both D.C. and New York State announced vaccine mandates for health workers. The Dallas Independent School District decided to keep its mask requirement despite the Texas Supreme Court siding with the governor’s ban, and Pfizer submitted its initial data to the FDA backing a booster shot. We’ll start with the delta strain: How the delta variant took over the US The delta variant has overtaken the U.S. in a matter of weeks as it spreads around the world in what President Biden’s chief medical adviser Anthony Fauci called a “global outbreak” of the strain. The highly contagious variant of COVID-19 is considered at least two times more contagious than the previously dominant alpha strain, and experts say the increased transmissibility has likely fueled the surge in COVID-19 cases, hospitalizations and deaths nationwide. But much is still unknown about delta as scientists scramble to better understand the strain. Here’s what we know about the delta strain and how it blunted earlier momentum in the fight against the coronavirus. More transmissible: A study from the United Kingdom in May suggested the delta strain could be 60 percent more transmissible than the alpha variant, which was already more contagious than the original strain. Higher viral load: A study from China indicated that the strain’s viral load could be more than 1,000 times higher than the original strain, meaning it’s more likely an infected person can “shed” the virus and pass it along to someone nearby. Vaccines still effective: But studies have found that at least five vaccines, including all three used in the U.S., are effective against the delta variant in lab and real-world settings, Fauci said last week. “The only reason our case numbers are lower now than they were back in December is because half of our population has been fully vaccinated,” David Dowdy, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, said. Still more to learn: “A big thing is we still don't know how much of what we're seeing is due to the virus versus due to behavior,” Dowdy said. “That makes a big difference because things that are due to the virus, we can't really change as a society.” Read more here. DC requires health care workers to get vaccine by Sept. 30 D.C. will require health care workers in the nation’s capital to get at least one dose of the COVID-19 vaccine by the end of next month, officials announced Monday. All health care workers will have to get at least the first dose of the Pfizer or Moderna vaccines or the single dose of the Johnson & Johnson by Sept. 30, LaQuandra Nesbitt, the director of the D.C. Department of Health, said during a briefing. The requirement applies not only to all licensed, certified and registered health employees, but also all emergency medical services providers, including paramedics and emergency medical technicians, and all unlicensed health care workers, including patient care technicians, personal care aides and environmental services staff. “It is necessary for us to ensure that we’re creating safe environments in our health care facilities and in … any places where people receive health care to help disrupt the spread of COVID-19 and to make sure we can prevent outbreaks in these environments,” Nesbitt said. Read more here. And another one: New York orders health care workers to be vaccinated Outgoing Gov. Andrew Cuomo (D) announced Monday that health care employees, including staff at hospitals and long-term care facilities, will have to start their vaccination process by Sept. 27. The state’s Department of Health will mandate hospitals and long-term care facilities, including nursing homes and adult care settings, to create and enforce policies requiring vaccinations for their workers. The policies will include “limited exceptions” for religious and medical reasons. “We must now act again to stop the spread,” Cuomo said in a statement. “Our healthcare heroes led the battle against the virus, and now we need them to lead the battle between the variant and the vaccine.” By the numbers: A portion of the health care workers in the state still remain unvaccinated, as the governor’s office reports 75 percent of hospital workers, 75 percent of adult care facility workers and 68 percent of nursing home workers have gotten their COVID-19 shots. “The data and science tell us that getting more people vaccinated as quickly as possible is the best way to keep people safe, prevent further mutations, and enable us to resume our daily routines,” New York State Health Commissioner Howard Zucker said in the release. “This mandate will both help close the vaccination gap and reduce the spread of the Delta variant.” Side note: The governor also announced the state would supply immunocompromised residents with a third dose 28 days after their second dose, following the CDC’s advisory committee’s recommendation Friday. Read more here. Texas school masking wars: Dallas school district maintains mask mandate despite state Supreme Court ruling The Dallas Independent School District in Texas will maintain its mask mandate for students despite a Texas Supreme Court ruling that upheld Gov. Greg Abbott's (R) ban on such measures. Superintendent Michael Hinojosa said on Sunday, “Until there’s an official order of the court that applies to the Dallas Independent School District, we will continue to have the mask mandate," according to The Dallas Morning News. Thousands of Dallas-area students are expected to return to school this week amid the unclear mask policies after the Texas Supreme Court on Sunday blocked temporary restraining orders that had allowed local entities to issue mask mandates. The restraining orders from district judges temporarily allowed Texas's four most populous counties — Harris, Dallas, Bexar and Travis — to enforce mask mandates. Flashback: Speaking to The Hill last week, Hinojosa called on Abbott to allow local elected officials to make mask decisions for their own communities. "Just let us get through this ugly period, and then go back and put your order back in place. And just allow us in local communities to make decisions that are in our best interest," Hinojosa said. Read more here. Pfizer submits initial data to FDA on booster dose Pfizer and BioNTech on Monday said they submitted early-stage clinical trial data to the Food and Drug Administration in support of their application for authorization of a booster dose of their coronavirus vaccine. The companies said a booster dose of their vaccine generated “significantly higher neutralizing antibodies” against the original coronavirus strain as well as the beta and delta variants. “The data we’ve seen to date suggest a third dose of our vaccine elicits antibody levels that significantly exceed those seen after the two-dose primary schedule," Pfizer CEO Albert Bourla said in a statement. Participants in the trial received a third shot of the two-dose vaccine about eight to nine months after receiving their second shot. The companies said the results show a booster dose given within 6 to 12 months after the primary vaccination schedule may help maintain a high level of protection Caveat: The companies do not yet have the late stage data to confirm those results. Bourla said results "are expected shortly" and will be submitted to the FDA and other regulatory authorities worldwide. But Pfizer did not begin its global phase 3 study until July 1, with an estimated completion date of October 2022. The FDA usually requires phase 3 studies before granting approval. What we’re reading Covid vaccines produced in Africa are being exported to Europe (The New York Times) Inside America’s Covid-reporting breakdown (Politico) In rural America, twisting arms to take a Covid vaccine first takes trust (Kaiser Health News) Scientists unlock clues to determining how safe vaccinated people are from Covid-19 (Stat News) State by state Second field hospital staged in UMMC garage as COVID-19 continues surge across Mississippi (Clarion Ledger) ‘No plans’ to reinstate Nebraska’s COVID-19 dashboard, state health department says (WOWT) Tennessee tops 1-month COVID hospitalization high in 2 weeks (The Associated Press) Op-eds in The Hill COVID-19: We will all need a booster shot — but some sooner than others Both the politicians and the experts flubbed COVID-19 response | 
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