Overnight Health Care: CDC expands definition of 'close contact' after COVID-19 report | GOP coronavirus bill blocked in Senate | OxyContin maker agrees to $8B settlement with Trump administration

Overnight Health Care: CDC expands definition of 'close contact' after COVID-19 report | GOP coronavirus bill blocked in Senate | OxyContin maker agrees to $8B settlement with Trump administration
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Welcome to Wednesday's Overnight Health Care.

It was a big day at the CDC. The agency held a press briefing for the first time since August, and also expanded the definition of a "close contact" of someone infected with COVID-19. Senate Democrats holding out for a bigger deal blocked a whittled-down coronavirus relief bill, and OxyContin maker Purdue Pharma will plead guilty in a deal with the Justice Department.

We'll start with the CDC:


CDC expands definition of close contact after spread from 'multiple brief encounters'

More people are now going to be “close contacts” of those infected with coronavirus under new CDC guidelines. 

The CDC on Wednesday expanded its definition of “close contact,” now saying that multiple brief encounters can also lead to transmission of the virus. 

The previous definition of close contact, which is used for determining who should quarantine, was being within 6 feet of an infected person for at least 15 minutes. 

The new standard now defines close contact as being within 6 feet of an infected person for at least 15 minutes over a 24-hour period, making clear that multiple separate encounters that add up to more than 15 minutes also count. 

The change comes after the CDC and Vermont health officials published a report finding that a prison employee in Vermont contracted the virus after “multiple brief encounters” with inmates who later tested positive. The 22 encounters added up to 17 minutes over an eight-hour shift, the report said.

Some of the inmates were not wearing masks, the CDC said, reinforcing the importance of mask wearing. 


Read more here.

CDC: 75 percent of US seeing increases in COVID-19 cases in 'critical phase' of pandemic

The number of COVID-19 cases is increasing in 75 percent of the country, as the U.S. Approaches a “critical phase” of the pandemic, Centers for Disease Control and Prevention officials said Wednesday.

“Unfortunately we're seeing a distressing trend here in the United States,” Jay Butler, the CDC’s deputy director for infectious diseases, said at a rare media briefing at the agency's headquarters in Atlanta.

The briefing was initially only open to local media, but the Department of Health and Human Services eventually allowed national press to cover the event as well. 

The U.S. has confirmed more than 8.1 million cases of COVID-19, though the official number is likely much higher. 

Why it matters: Experts had warned all year the U.S. would likely see a surge in cases in the fall and winter as the cold weather forces people to spend more time indoors.

It appears that surge is here, with the U.S. confirming nearly 60,000 cases a day, nearing the record high set this summer during the wave in the south. 

“I recognize that we are all getting tired of the impact that COVID-19 has had on our lives — we get tired of wearing masks but it continues to be as important as it's ever been, and I would say it's more important than ever, as we move into the fall season,” Butler said, noting that people will likely be gathering over the holidays. 

Read more here.

Another day in the swirling coronavirus negotiations: The GOP coronavirus bill was blocked in the Senate as a deal remains elusive 

Senate Democrats blocked a scaled-down, GOP-only $500 billion coronavirus bill Wednesday, as talks continue on a bipartisan deal between House Speaker Nancy PelosiNancy PelosiSpending deal clears obstacle in shutdown fight Ocasio-Cortez, Cruz trade jabs over COVID-19 relief: People 'going hungry as you tweet from' vacation Rep. Rick Allen tests positive for COVID-19 MORE (D-Calif.) and the White House.

Senators voted 51-44 to end debate on the Republican proposal, falling short of the 60 needed to overcome the procedural hurdle.

The GOP bill was widely expected to fall short—and is less than a third of the latest offer made by the White House. But Senate Republican leadership was eager to force Democrats to go on the record on coronavirus relief as the number of cases per day is on the rise and the November election is less than two weeks away.


“The overwhelming bulk of it is programs that Democrats claim they support. Well, it turns out there’s a special perk to being a United States senator. When you actually support something, you get to vote for it. ... When you actually want an outcome, you vote it. Strangely enough, that’s not what seems to be happening,” McConnell said on Wednesday ahead of the vote.

Democrats blasted the GOP bill as a “stunt,” aimed at allowing vulnerable GOP senators to vote for a bill as they fight to hold onto the majority in November.

Read more here.

OxyContin maker agrees to $8B settlement with Trump administration

Purdue Pharma, the company that manufactures the powerful opioid OxyContin, will plead guilty to three federal charges as part of a larger $8 billion settlement arrangement, the Justice Department said Wednesday.

OxyContin is widely blamed for starting the country’s opioid crisis that's killed more than 400,000 Americans over the past two decades.

Deputy Attorney General Jeffrey Rosen said Purdue has agreed to plead guilty in federal court in New Jersey to conspiracy to defraud the United States and two counts of conspiracy to violate anti-kickback laws.


The settlement includes a criminal fine of more than $3.5 billion, criminal forfeiture of $2 billion and a civil settlement of $2.8 billion.

The criminal plea does not preclude the potential for criminal charges in the future against any executive or member of the Sackler family, who own Purdue Pharma.

The reality: The $8 billion figure is headline grabbing, but Purdue will not pay anywhere close to that amount. The company filed for Chapter 11 protection last year, and has many creditors looking to extract payment.

The politics: The announcement, less than two weeks before Election Day, will allow President TrumpDonald John TrumpMinnesota certifies Biden victory Trump tells allies he plans to pardon Michael Flynn: report Republican John James concedes in Michigan Senate race MORE to claim a major victory in combating the opioid epidemic, something he campaigned heavily on ahead of the 2016 election. But the deal was not embraced by all parties, as Democratic lawmakers and state attorneys general criticized what they said was a politically-motivated settlement. 

What's next: The Justice Department settlement means the company will be dissolved, and become a government owned "public benefit company." Purdue, along with other manufacturers, distributors, and pharmacies is still facing litigation from more than 2,000 cities, counties, Native tribes and other groups. But by declaring bankruptcy, Purdue is attempting to shield itself from the litigation. 

Read more here.  

Coming Thursday: FDA Vaccine advisory committee meeting


The Food and Drug Administration will convene a panel of outside experts on Thursday, the first in what is expected to be a series of meetings on a coronavirus vaccine. There will not be a specific vaccine discussed at this particular meeting, but the committee— known as the Vaccines and Related Biological Products Advisory Committee— will meet in the future every time a vaccine manufacturer applies for emergency FDA authorization.

The meeting will allow FDA officials to get guidance from the outside experts. This particular meeting will discuss the types of studies that should be conducted to assess the safety and efficacy of a vaccine, including in populations like pregnant women and the elderly.

The meeting is open to the public and will be streamed on YouTube, an acknowledgement in just how much interest the vaccine development process has garnered. As the process has grown more political, polls have shown public confidence in a vaccine has fallen. The dry, clinical discussions of the advisory board can show the public that a coronavirus vaccine will be subject to the same rigors as any other vaccine, despite pressure from the White House.  


What we’re reading

For Latino voters, health care is a top issue as Obamacare gains reverse under Trump (NBC News)

How the FDA stood up to the president (The New York Times)

Do masks on plane flights really cut your risk of catching COVID-19? (NPR

Oxford developed Covid vaccine, then scholars clashed over money (Wall Street Journal)

State by state

Ohio’s four-phase plan to distribute coronavirus vaccine prioritizes health care workers and first responders (cleveland.com)

Indiana's health commissioner got coronavirus. She says it's proof masks, distancing work. (Indianapolis Star)

Two more Illinois regions put under COVID-19 restrictions (Journal Star

The Hill op-eds

Tear gas during the COVID-19 crisis can be deadly — ban it 

Trump's health care plan 

COVID-19 vaccine distribution — challenges and perhaps opportunities