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Overnight Health Care: VA problems raise worries about prescriptions during mail slowdown | School reopenings with COVID-19 offer preview of chaotic fall | Fauci undergoes surgery for vocal cord polyp

Overnight Health Care: VA problems raise worries about prescriptions during mail slowdown | School reopenings with COVID-19 offer preview of chaotic fall | Fauci undergoes surgery for vocal cord polyp
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Welcome to Thursday’s Overnight Health Care. 

Lawmakers are investigating how postal service delays impact prescription medication delivery. Another senator tested positive for COVID-19, and Dr. Fauci underwent surgery for a vocal cord polyp and his doctors have advised him to limit his talking for a while.

We'll start with the postal service: 

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VA problems raise worries about prescriptions during mail slowdown

Concern is growing among Democrats and advocacy groups that slowdowns in the mail could leave millions of people without access to needed medications. 

The Department of Veterans Affairs (VA), which fills about 80 percent of its prescriptions by mail, has already reported problems, and has been forced to use alternative methods of shipping prescriptions in certain areas of the country.

While only about 5 percent of all prescription drugs are delivered in the mail, pharmacies and pharmacy benefit managers are increasingly using the mail to fill prescriptions for the most expensive drugs. The coronavirus pandemic has increased those numbers, as people opt for a safer option than visiting pharmacies in person.

The backstory: The postal delays stem from changes instituted by Postmaster General Louis DeJoyLouis DeJoyJudge orders Postal Service to restore high-speed mail sorting machines Watchdog rips operational changes at USPS Voting rights group files suit against Trump, administration officials alleging voter intimidation MORE, a longtime supporter and fundraiser for President TrumpDonald John TrumpGiuliani goes off on Fox Business host after she compares him to Christopher Steele Trump looks to shore up support in Nebraska NYT: Trump had 7 million in debt mostly tied to Chicago project forgiven MORE, who took over the role in June. 

Where it's a problem:  With veterans. According to the group Disabled American Veterans, medications from the VA have been delayed by an average of 25 percent over the past year.

In an email to the organization reviewed by The Hill, VA officials said they detected “hot spots” with delivery delays in Detroit as well as parts of New York and New Jersey, and “proactively converted from USPS to United Parcel Service (UPS) 2nd day air for those areas until service levels could be returned.”

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Where it isn't: Major commercial pharmacies and pharmacy groups said they are either monitoring the issue, or have not been impacted — yet. 

Read more here 

But Democrats want answers, and multiple lawmakers in the House and Senate have launched investigations into whether medications are being delayed. 

Senators open investigation into prescription delays through Postal Service

Sens. Elizabeth WarrenElizabeth WarrenOvernight Defense: Dems want hearing on DOD role on coronavirus vaccine | US and India sign data-sharing pact | American citizen kidnapped in Niger Conservative operatives Wohl, Burkman charged in Ohio over false robocalls Senate Democrats want hearing on Pentagon vaccine effort MORE (D-Mass.) and Bob CaseyRobert (Bob) Patrick CaseySenate Democrats hold talkathon to protest Barrett's Supreme Court nomination Two Loeffler staffers test positive for COVID-19 Healthcare, retirement security seen as top issues for older voters, lawmakers say MORE (D-Pa.) on Thursday announced an investigation into delays in mail-order drug prescriptions, which they attributed to “sabotage” of the United States Postal Service by the Trump administration.

"Millions of Americans with diabetes, high blood pressure and heart disease, asthma, and other chronic conditions, illnesses or health care needs rely on the USPS for delivery of their prescription drugs and are at grave risks if President Trump's efforts to degrade the mail service results in delays and disruptions," they wrote.

The senators wrote to the five major pharmacies and pharmacy benefit managers to request information on the number of mail-in prescriptions they have filled each month of 2020.

In the House: The Energy and Commerce Committee this week launched an investigation into how the Postal Service’s organizational and operational changes are impacting the delivery of prescription drugs.

And last week, bipartisan members of the House Veterans Affairs Committee and Transportation and Infrastructure Committee wrote to VA Secretary Robert WilkieRobert Leon WilkieHillicon Valley: Department of Justice sues Google | House Republicans push for tech bias hearing | Biden drawing more Twitter engagement for first time House Republicans push VA for details on recent data breach Overnight Defense: National Guard says no federal requests for election security help | Dems accuse VA head of misusing resources | Army official links COVID-19 to troop suicides MORE and DeJoy asking for information about how the VA delivers medications and urging them rectify the delayed deliveries.

Read more on the Senate investigation here

School reopenings with COVID-19 offer preview of chaotic fall

Thousands of students and teachers across the country are quarantining just days into the new school year, highlighting the challenges of resuming in-person instruction during a pandemic.

While many schools aren’t scheduled to reopen until later this month or September, those that have are offering a preview of the chaos that awaits districts this fall, particularly in hot spots in the South and Midwest where the virus is spreading uncontrollably.

In Georgia’s Cherokee County School District, where students are not required to wear masks, nearly 2,200 students — mostly high schoolers — are quarantining after coming into contact with one of 116 students or 25 teachers and staff members with COVID-19. Another 53 teachers and staff members are also quarantining.

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Those numbers are expected to increase with more test results. In the meantime, three of the district’s six high schools have moved classes online, at least until September.

Why it matters: Experts have warned for weeks that it will be extremely difficult to safely reopen schools in hot spots, but some districts are still charging ahead — some willingly, others after some prodding from state and national leaders. The situation in Georgia is just one example of what could happen in the fall when more schools open, despite the country not having COVID under control.

Read more here. 

Fauci undergoes surgery for vocal cord polyp

Anthony FauciAnthony FauciConservative operatives Wohl, Burkman charged in Ohio over false robocalls 68 percent of Americans say they know someone diagnosed with COVID-19: poll The Hill's 12:30 Report - Presented by Facebook - One week out, where the Trump, Biden race stands MORE, the country’s leading infectious diseases expert, underwent surgery to have a polyp removed from his vocal cord on Thursday morning.

Fauci, who heads the National Institute of Allergy and Infectious Diseases and has been helping to lead the federal government’s response to the ongoing pandemic, confirmed the news to CNN.

Sanjay Gupta, CNN's chief medical correspondent, said on Twitter that Fauci texted him shortly after the surgery to let him "know he was doing ok."

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Fauci told the Washington Post by text message that doctors have told him to rest, avoid speaking “for a few days,” and then limit the time he spends on interviews and other speaking arrangements for a week or two after that.

Read more here

Sen. Bill CassidyWilliam (Bill) Morgan CassidyTwo Loeffler staffers test positive for COVID-19 Michigan Republican isolating after positive coronavirus test GOP Rep. Mike Bost tests positive for COVID-19 MORE tests positive for coronavirus

Sen. Bill Cassidy (R-La.) said on Thursday that he has tested positive for the coronavirus, becoming the second senator known to do so.

"I am strictly following the direction of our medical experts and strongly encourage others to do the same," he said in a statement.

Cassidy got a coronavirus test on Thursday after being informed on Wednesday night that he had been exposed to an individual with COVID-19. His office said he was following Centers for Disease Control and Prevention guidelines including quarantining for 14 days and notifying individuals he has been in contact with.

Cassidy is just the second senator to test positive, but roughly a dozen House members have also tested positive. The lower chamber implemented new voting procedures to try to prevent members from crowding on the floor and proxy voting to give more members flexibility with traveling to Washington. 

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Read more here.

COVID-19 fatality rates fall as treatments improve

The percentage of those infected with the coronavirus who die of COVID-19 is falling in most states, a sign that the battle against the virus is entering a new phase.

Across the nation, that percentage — known as the case fatality rate — has been on the decline for weeks, and in some states for months. It is a hopeful indicator, but one that health experts caution is layered with uncertainty.

In Arizona, about 5 percent of those who tested positive for the coronavirus by the end of May died. The case fatality rate now is about half that figure. In California, the rate stood at 4 percent in late May, and is now 1.6 percent. In April, 7.5 percent of those who tested positive in Minnesota died, a rate that has fallen to 2.7 percent, according to The Hill’s analysis of state data.

Health experts pointed to several reasons for the decline: Doctors are learning about better methods of treating those who are ill. Those who contract the virus are now more likely to be younger, rather than older people who are most at risk of dying. And more widespread testing is identifying cases among those who show few or no symptoms.

Read more here

Also at thehill.com:  

Russia says it will test coronavirus vaccine on 40,000 people 

Jobless claims again rise to over 1 million 

VIRTUAL EVENT ANNOUNCEMENT: COVID-19: THE WAY FORWARD — WEDNESDAY, AUGUST 26TH AT 1PM EDT

As election day approaches, the COVID-19 pandemic remains an ever-present threat.  On the sidelines of the 2020 Republican Convention, The Hill will host a discussion with policymakers and hospital and medical school leaders about lessons learned from the coronavirus pandemic, the importance of research and innovation in battling healthcare crises, and the value of a resilient and responsive health care ecosystem. Rep. Michael BurgessMichael Clifton BurgessRace heats up for top GOP post on powerful Energy and Commerce Committee Hillicon Valley: House votes to condemn QAnon | Americans worried about foreign election interference | DHS confirms request to tap protester phones House approves measure condemning QAnon, but 17 Republicans vote against it MORE, M.D. (R-Texas) joins The Hill's Steve Clemons.

RSVP for event reminders.

What we’re reading

Bolstered testing and daily briefings: inside Biden’s COVID-19 plan (STAT)

Meatpacking companies dismissed years of warnings but now say nobody could have prepared for COVID-19 (ProPublica)

COVID plans put to test as firefighters crowd camps for peak wildfire season (Kaiser Health News)

Trump admin limits FDA review of some coronavirus tests (Politico)

State by state

Texas positivity rate, Abbott’s key metric in fight against COVID, proven to be unreliable (Houston Chronicle

Covid cases are linked to the Sturgis Motorcycle Rally, but the full impact may never be known (Washington Post) 

Op-eds in The Hill

Health care price transparency would bring relief from pandemic worries