On Sept. 13, Nicki Minaj tweeted that she wasn’t vaccinated against COVID-19, and that if she does get vaccinated, it won’t be until she feels like she’s “done enough research.”
About 20 minutes later, the Trinidadian-born rapper tweeted again about the vaccine and offered some insight into why, perhaps, she’s wary of it.
“My cousin in Trinidad won’t get the vaccine cuz his friend got it & became impotent,” she said. “His testicles became swollen. His friend was weeks away from getting married, now the girl called off the wedding. So just pray on it & make sure you’re comfortable with ur decision, not bullied.”
Back in May, we looked into misinformation about how the COVID-19 vaccine affects sperm production. In short, research from the University of Miami was being misrepresented to claim that the vaccines affected sperm production. In reality, the researchers had been looking at the effects of COVID-19, not vaccines against the disease.
At the time, Dr. Daniel Nassau, who worked on that study as a fellow and investigator with lead author Dr. Ranjith Ramasamy, told us that researchers at the university’s Miller School of Medicine were separately investigating how mRNA vaccines may affect fertility.
“We do not think the vaccine will affect male fertility,” he told PolitiFact, but researchers were still waiting for the results of the study to be published.
That research is now online on the Journal of the American Medical Association website. After recruiting 45 healthy men between the ages of 18 and 50 with no underlying fertility issues, researchers collected semen samples before they received their first COVID-19 vaccine dose and approximately 70 days after they received their second dose.
“We found that there were no negative impacts of the vaccine on male fertility,” Nassau said.
In fact, the research showed “statistically significant increases in all sperm parameters,” though that change was within normal variations and could be because of how long the men were abstaining from sex before the second sample was taken.
The research only looks at a small number of men and “is an imperfect predictor of fertility potential,” according to the work published on JAMA’s site.
Still, Nassau told us, “there are no reports about vaccine causing erectile function or orchitis,” an inflammation of one or both testicles.
However, he said, data has suggested that a COVID-19 infection itself may be a risk factor for impotence and male infertility, and it has been found to cause orchitis in up to 22% of men.
As for Minaj’s claim, “I saw the tweet,” Nassau said. “I am certain what she is describing is not related to a COVID-19 vaccine.”
Booster shots are a key piece of President Joe Biden’s plan to beat the COVID-19 pandemic. Speaking at the White House, Biden said boosters are “likely to provide the highest level of protection yet.”
There has been some confusion about boosters. In August, the administration got ahead of the Food and Drug Administration approval process, setting a booster rollout for Sept. 20. That’s still the goal, but the White House dialed back that plan a bit, saying the administration would be “prepared” by that date, pending a full vetting by regulators.
“The decision of which booster shots to give, when to start them, and who will give them will be left completely to the scientists at the FDA and the Centers for Disease Control,” Biden said Sept. 9.
Until that happens, here’s what we know about the basics of boosters.
Why are boosters needed?
It’s often the case that the antibodies someone gets through vaccination will begin to decline, diminishing their protection against a disease. There’s growing evidence that this is taking place with vaccines against COVID-19. The numbers are preliminary, but an August study in New York found that vaccine effectiveness dropped from 92% in early May to 80% in late July.
Public health leaders voice particular concern about the more infectious delta variant. While all three vaccines approved for use in the U.S. do a good job of keeping people out of the hospital and preventing deaths, the delta variant produces so much virus so quickly, that even vaccinated people can get ill.
The CDC’s website says “with the delta variant, public health experts are starting to see reduced protection against mild and moderate disease.”
A CDC study of nursing home residents reported that among people who got the Moderna or Pfizer vaccines, effectiveness went from 75% before delta to 52% after delta.
Will boosters work?
Again, the numbers are preliminary, but some initial research is promising.
In Israel, which has high rates of vaccination, people over 60 who had been fully vaccinated with Pfizer for at least five months were given a third dose. Researchers saw a 10-fold reduction in the risk of infection and severe disease.
At a September press briefing, leading U.S. epidemiologist Dr. Anthony Fauci said this and other reports out of Israel “support, very strongly, the rationale for such an approach.”
The concept of boosters is well established. They are part of the normal vaccination schedule for diseases such as tetanus and a number of childhood diseases.
“These vaccine series, as we call them, are recommended because you need the extra doses to get longer lasting protective immunity,” Yale infectious-disease specialist Dr. Albert Shaw told a Yale Medicine reporter in August.
Who should get a booster and when?
The CDC says: “The goal is for people to start receiving a COVID-19 booster shot beginning in the fall, with individuals being eligible starting eight months after they received their second dose of an mRNA vaccine (either Pfizer-BioNTech or Moderna).”
That applies to people without any special conditions. The eight-month wait is based on how long the initial protection is expected to be robust. The actual eligibility criteria will be set by the government when, as is expected, a round of booster shots are approved.
This is aimed at people receiving active cancer treatment, transplant recipients taking immunosuppressant drugs, and others whose immune systems are specifically at risk.
Technically, the additional dose available for these candidates is not a booster. But given that it is a third shot, it’s easy to see why many people wouldn’t see the distinction. The difference is the timing. Unlike the booster for otherwise healthy people which could have an eight-month wait, the government recommends the additional dose as soon as one month after completing the initial two-shot series.
When boosters open up for the general population, the CDC says the first in line to receive it will be those who were first for the initial doses: healthcare providers, residents of long-term care facilities and other older adults.
Where do boosters stand in the approval process?
Pfizer and Moderna were the first to submit data to regulators, and their vaccines are the furthest along in the vetting process run by the FDA and the CDC’s Advisory Committee on Immunization Practices.
The Pfizer review is on track to meet the Sept. 20 target, with Moderna not far behind, Fauci said in a Sept. 5 interview with CBS News.
“It is conceivable that we will only have one of them out, but the other will likely follow soon thereafter,” Fauci said.
The FDA is also looking at data from Johnson & Johnson, but it is unclear when it will make a decision.
Is a booster the same as the initial vaccination?
For now, yes. In the future, Pfizer and Moderna, with their mRNA approach, could adjust their vaccines fairly quickly to account for new variants or other issues. But for now, any booster will have the same ingredients, dosages and storage requirements as the initial shots.
Will there be enough vaccine boosters for Americans who want them?
Biden said there would be plenty of boosters.
“We’ve bought enough … booster shots, and the distribution system is ready to administer them,” he said Sept. 9.
Given the potential eight-month wait, only those who were fully vaccinated by mid-January would be eligible for boosters by Sept. 20. That’s a small fraction of the 163 million people who have received both shots of Pfizer or Moderna so far.
But there is a debate over whether the U.S. should push boosters at a time when millions of people worldwide haven’t received even a first shot. The World Health Organization has called for a moratorium on boosters until the end of the year.
Is it safe to switch from Pfizer to Moderna, or vice versa, for the booster shot? And what are the Johnson & Johnson options?
The National Institutes of Health has clinical trials underway to answer these questions. One study will give the Moderna booster to participants who received any of the three approved vaccines.
When the FDA cleared the way for immunocompromised people to get an additional dose, it spoke of matching it with the initial vaccine a person received. Any booster guidelines are expected to hold to that.
People who got the Johnson & Johnson shot face a different choice.
Unlike the other two vaccines, Johnson & Johnson is a single-shot regimen, and uses a different approach to building a person’s resistance to the disease. Ongoing studies are looking at the effect of giving a Pfizer or Moderna booster to a Johnson & Johnson recipient. San Francisco General Hospital has begun to give those boosters to people who got the Johnson & Johnson vaccine.
Will boosters, like the COVID-19 vaccines, be free?
Yes, Biden said so.
Rapid at-home COVID-19 tests are flying off store shelves across the nation and are largely sold out online as the delta variant complicates a return to school, work and travel routines.
For Americans looking for swift answers, the cheapest over-the-counter COVID test is the Abbott Laboratories BinaxNOW two-pack for $23.99. Close behind are Quidel’s QuickVue tests, at $15 a pop. Yet supplies are dwindling. After a surge in demand, CVS is limiting the number of tests people can buy, and Amazon and Walgreen’s website were sold out as of Friday afternoon.
President Joe Biden said Thursday he would invoke the Defense Production Act to make 280 million rapid COVID tests available. The administration struck a deal with Walmart, Amazon and Kroger for them to sell tests for “up to 35 percent less” than current retail prices for three months. For those on Medicaid, the at-home tests will be fully covered, Biden said.
An increased supply should help to lower prices. As schools open and much of the country languishes without pandemic-related restrictions, epidemiologists say widespread rapid-test screening — along with vaccination and mask-wearing — is critical to controlling the delta variant’s spread. Yet shortages, little competition and sticky high prices mean routine rapid testing remains out of reach for most Americans, even if prices drop 35%.
Consumers elsewhere have much cheaper — or free — options. In Germany, grocery stores are selling rapid COVID tests for under $1 per test. In India, they’re about $3.50. The United Kingdom provides 14 tests per person free of charge. Canada is doling out free rapid tests to businesses.
Michael Mina, assistant professor of epidemiology at Harvard University, lauded Biden’s announcement on Twitter while saying he “had some reservations” about its scale and noted that 280 million tests represent “less than one test per person over the course of a year.”
Rep. Kim Schrier (D-Wash.) for months has advocated for rapid testing at a lower cost. “In an ideal world, a test would either be free or cost less than a dollar so that people could take one a few times a week to every day,” she said in the days before Biden’s announcement.
Biden’s initiative “is a great start” for broader rapid testing, Schrier said Friday. “But there is a lot more to be done, and that must be done quickly, to use this really important tool to combat this virus.”
A nationwide survey released in February by the Harvard T.H. Chan School of Public Health and Hart Research found that 79% of adults would regularly test themselves at home if rapid tests cost a dollar. But only a third would do so if the cost was $25.
Billions in taxpayer dollars have been invested in these products. Abbott Laboratories, for instance, cashed in on hundreds of millions in federal contracts and gave its shareholders fat payouts last year, increasing its quarterly dividend by 25%. Even so, according to a New York Times investigation, as demand for rapid tests cratered in early summer, Abbott destroyed its supplies and laid off workers who had been making them.
More than a year ago, Abbott said the company would sell its BinaxNOW in bulk for $5 a test to health care providers, but that option is not available over the counter to the public. Even with the anticipated price decrease, a two-pack will be more than $15. Abbott did not comment further.
Schrier said in spring that test prices were high because “big companies are buying up all the supplies.” Also, “their profit is far higher making 1,000 $30 tests than 30,000 $1 tests” — in other words, they can make the same amount of money for many fewer tests.
In March, the Biden administration allocated $10 billion as part of the American Rescue Plan Act to perform COVID testing in schools, leaving the rollout largely to states. This followed $760 million spent by the Trump administration to buy 150 million of Abbott’s rapid-response antigen tests, many of which went to schools. The rollout has been mixed, with states like Missouri mired in logistical challenges.
In late August, Schrier wrote a letter asking four federal agencies to update their distribution plans. She also urged the government to increase spending on rapid testing, saying “time is of the essence” as children returned to school.
Antigen tests can give real-time information to people exposed to COVID-19, said Dr. Dara Kass, an associate professor of emergency medicine at Columbia University Medical Center. Waiting for lab results from polymerase chain reaction (PCR) tests can take days, and many states — particularly in the hard-hit South — are seeing appointments fill up days in advance. At-home collection kits for PCR tests can cost over $100.
Rapid tests take under 15 minutes to detect COVID by pinpointing proteins, called antigens. The tests are similar to a pregnancy test, with one or two lines displayed, depending on the result.
The Centers for Disease Control and Prevention recommends that fully vaccinated people exposed to COVID wear a mask indoors for two weeks and get tested three to five days after exposure. The unvaccinated should quarantine for 14 days. But that leaves gray area for those vaccinated people hoping to attend classes or go about their lives, Kass said.
“Rapid tests give information,” she added, “that allows somebody to engage in society safely.” People can follow up with a PCR test, which is more sensitive, for confirmation of a diagnosis.
In Massachusetts, for example, a “Test and Stay” strategy for students exposed to COVID allows them to remain in school: Students take BinaxNOW tests five days in a row following close contact with an infected person.
More than 30 antigen tests have been developed in the U.S. — though just six companies have FDA authorization for over-the-counter use. No rapid COVID-19 tests have full FDA approval. Two rapid molecular options, made by Lucira Health and Cue Health, also have emergency use authorization (EUA).
“Unfortunately, many submissions are incomplete or contain insufficient information for FDA to determine that they meet the statutory criteria,” FDA spokesperson James McKinney said.
The agency has taken a stricter stance than its European counterparts. In June, the FDA warned Americans to stop using Innova Medical Group’s rapid antigen test, stating that the agency had “significant concerns that the performance of the test has not been adequately established.” Yet in the U.K., which has contracts worth billions with the California company, the regulatory agency OK’d the product.
In Germany, regulators have given special authorization to dozens of antigen tests.
“As long as these tests are regulated as medical devices, the FDA has to regulate them not as critical public health tools, but as medical tools, with all of the onerous clinical trials that slow everything down 100-fold,” Mina said on Twitter.
With only a handful of rapid tests on the market, it is harder for companies that have not yet received FDA authorization to catch up and, in turn, drive the prices down, said Michael Greeley, co-founder and general partner at Flare Capital Partners, a venture capital firm focused on health care technology. “If we’re talking about people testing their kids every day going to school,” he added, “for many families, the current costs are a real burden.”
Broad adoption of rapid testing seems premature, he said, even with a mass purchase of tests by the U.S. government: “We can’t even get people to floss, so the idea that people are now going to start rapid testing as their standard operating procedure is a flawed assumption.”
Regardless, companies can’t keep up with demand.
Ellume said it saw a 900% spike in the use of its tests over the past month. Its at-home rapid test costs up to $38.99. On Walmart’s website, it was listed for $26.10 Friday but was out of stock.
The Australian manufacturer received $232 million from the U.S. Defense Department in February to scale up production, after the FDA authorized its at-home use late last year. But the federal Health Care Enhancement Act, which furnished the funding, does not impose pricing restrictions. Ellume said it will begin production at a Frederick, Maryland, plant this fall. For now, it is shipping tests from Australia.
This summer, Lucira Health stopped selling its about $50 molecular rapid test online to focus on larger clients, including San Francisco’s Chase Center, home to the Golden State Warriors, and the Olympics, Dan George, Lucira’s chief financial officer, said during a recent earnings call.
The company is still losing money as it ramps up production but hopes to return to selling directly on its website and Amazon later this year.
In the days leading up to the California recall election, former President Donald Trump alleged without evidence that the California recall election was rigged on behalf of Gov. Gavin Newsom, echoing falsehoods from the 2020 election.
About a week before the Sept. 14 election, Trump told Newsmax that the election was “probably rigged.” He went further with a Sept. 13 statement from his Save America PAC:
“Does anybody really believe the California recall election isn’t rigged? Millions and millions of mail-in ballots will make this just another giant election scam, no different, but less blatant, than the 2020 Presidential Election Scam!”
Some of Trump’s allies had been laying the groundwork before Election Day to suggest that a rigged election is the only path for Newsom to win.
On Fox News’ “Outnumbered,” Tomi Lahren said about a week before the election, “The only thing that will save Gavin Newsom is voter fraud.”
Larry Elder, the top GOP candidate in the California recall election, had a link on his website — days before the Sept. 14 election — inviting the public to report potential fraud and demand a legislative review of pro-Newsom results.
The website, stopcafraud.com, asks citizens to sign a petition demanding a special session of the California Legislature “to investigate and ameliorate the twisted results of this 2021 Recall Election of Governor Gavin Newsom.”
The website makes a series of allegations suggesting voter fraud without providing any evidence. We emailed Elder’s campaign but did not receive a response. We also did not receive a response from Trump’s PAC about his renewed claims of election rigging.
Unlike Trump’s baseless claims about the 2020 election, these claims about the recall election ignore the political reality in California: Newsom could win because Democrats nearly outnumber Republicans two-to-one. The last Republican to win the governor’s seat was Arnold Schwarzenegger, who was re-elected in 2006.
But even if we set aside that California is a blue state, it’s difficult to imagine a scenario where it would be logistically possible to rig a statewide election in which more than 8 million have already cast ballots.
“It’s very difficult to rig any election, really, especially in California but even nationwide,” said Donna Johnston, Sutter County Registrar of Voters and president of the California Association of Clerks and Election Officials. “We are all decentralized. Elections are run from local jurisdictions and information is fed to the state.”
Rigging an election would require convincing elections officials across the state — Democrats, Republicans, minor parties and those without a party preference — to team up to secretly break the law and risk landing in jail.
There are tens of thousands of election officials across the state who are involved in the various steps of the election, including mailing ballots, receiving ballots and working at in-person voting sites.
The day before the election, Johnston said, “We are not seeing any evidence that it’s rigged.”
The state sent all active voters a mail ballot. A minority of voters have chosen to vote in person.
As of Sept. 12, counties reported more than 8 million votes cast by mail and more than 143,000 votes cast in person.
“To date, we haven’t sent any recall-related potential voter fraud cases to the Attorney General’s office,” said Jenna Dresner, a spokesperson for the California Secretary of State.
Experts have told us that voting by mail presents a higher risk of fraud than in person voting. But election after election shows that voter fraud is rare among the millions of ballots cast. A nationwide canvas of state election officials by Bloomberg news published in July about the November election found roughly 200 fraud prosecutions. The conservative Heritage Foundation says it has found 1,333 proven instances of voter fraud nationwide, over decades.
When it exists, voter fraud tends to happen on the local level. Earlier this year a judge ordered a new election for a position in a small Mississippi city after ruling that 78% of the 84 absentee ballots cast for that seat contained irregularities.
In California in August, police found a man passed out in a vehicle in the city of Torrance with 300 ballots, drugs and driver’s licenses and credit cards in other peoples’ names. Officials said replacement ballots would be sent to the voters. The police department wrote in a Facebook post that the incident was under investigation and that it was “not tied to any additional thefts of election ballots.”
We found no evidence of a rigged election. But if the goal of those who make such allegations is to draw attention, they have had some success.
Zignal Labs analyzed trends across social media in relation to the California recall between June 1 and Sept. 10 and found that the word “fraud” garnered about 145,000 mentions, while “rigged” or “rigging” drove about 60,000 mentions. Other phrases or words that drew tens of thousands of mentions included “cheat,” “cheating” or “stealing ballots.”
The narratives captured all conversation surrounding the topic, which means that not all of the mentions were accusations about fraud. But Zignal Labs found that general narratives around voter fraud, a rigged election, ballot stealing and cheating spiked in the month before the election.
Congress is considering how much of President Joe Biden’s public investment agenda to implement — but in an unusually confusing fashion.
In August, the Senate passed a roughly $1 trillion infrastructure bill backed by Biden, winning the support of all Senate Democrats as well as 19 Republicans. The infrastructure bill now needs to be approved by the House before being sent to Biden’s desk.
But Democrats are also pursuing a second measure, known as a “reconciliation” bill, that includes many of the parts of Biden’s tax and spending proposals that attracted little or no buy-in from Republicans. Many in the GOP argue that the national debt is too large for this type of spending, and that it could contribute to already higher-than-normal rates of inflation.
Undeterred by such opposition, the House is currently hammering out the language for a measure that will add up to $3.5 trillion in spending or tax cuts over 10 years. It might include such provisions as clean energy incentives, housing, child care subsidies, and the expansion of Medicare to include dental, hearing and vision benefits.
The House is expected to vote on the reconciliation measure around the same time it votes on the infrastructure bill. But due to the Democrats’ slim majorities — and the party’s need to satisfy its ideologically broad range of members — the timing and sequence of those votes has been subject to considerable debate.
Here’s a rundown on what to expect as these two key pieces of Biden’s agenda move forward in September.
What is reconciliation?
Reconciliation is a process for passing a certain type of fiscal legislation with just a simple majority of 51 Senate votes — rather than the 60 that would be needed to overcome a filibuster.
The idea behind budget reconciliation is to use a two-step process for federal budgeting. The first step is to pass a blueprint called a budget resolution that gives an outline of budgetary goals. Both chambers finished this first step in August, without Republican support.
The second step is to pass a bill to “reconcile” those broad goals with a more detailed implementing legislation. Both chambers must pass identical versions of the legislation. The agreed-upon bill would then head to the White House for Biden’s signature.
Why did the Democrats structure the legislation this way?
Biden pursued this two-track solution because he wanted one bipartisan package and one package that only Democrats supported.
On the one hand, Biden framed his run for president as someone who would reach out to Republicans and try to collaborate on common goals. That’s why he pushed for a bipartisan bill consisting of elements that could attract support from many Republican lawmakers, including investments in roads, waterways, electrical infrastructure and broadband.
At the same time, Biden also ran for president seeking initiatives that receive strong support from rank-and-file Democrats, and especially those in the more progressive wing of his party. Those include investments in health care, clean energy and housing and child care.
By using the reconciliation process, which can only be attempted once every fiscal year, Biden had to throw a lot of different initiatives into one large reconciliation bill.
“By putting all of his eggs in two baskets, Biden upped the ante but also created more (opportunities) for building majority coalitions in the two houses,” said Steven S. Smith, a political scientist at Washington University in St. Louis “The aggregate cost targets are large and create problems of their own, but he was trying to exploit his momentum and the mood of the country by keeping a focus on just two legislative vehicles.”
What does Biden want to pass through Congress?
Some of Biden’s policy priorities were included in the bipartisan infrastructure bill, mainly “hard” infrastructure investments in transportation and energy systems. But some spending Biden wanted didn’t make it into that bill — such as money for upgrading veterans’ hospitals, American manufacturing competitiveness, and job training — and these have been combined with “softer” human infrastructure initiatives proposed in Biden’s American Families Plan for possible inclusion in the reconciliation bill now being put together.
Some of the proposals that might be included in the bill are
universal preschool for 3- and 4-year-olds;
two years of free community college;
a national paid family and medical leave program;
extensions of the child tax credit, the earned income tax credit, and the child and dependent care tax credit;
adding dental, vision and hearing benefits to Medicare;
allowing Medicare officials to negotiate drug prices; and
investments to support reductions in carbon emissions to address climate change.
To partly pay for such outlays, the bill might include an increase in the top tax rate to 39.6% and an end to certain capital gains tax breaks.
But these are goals. None of these are certain to be in the reconciliation bill currently being negotiated, and some could be cut back in scope or duration.
How large could the reconciliation bill be?
While the budget resolution permits an increase of $1.75 trillion, House Democrats have been discussing a measure that includes up to $3.5 trillion in new outlays. The reason that figure is higher is that it would be partially paid for through tax increases that reduce the net cost to the $1.75 trillion cap set by the budget resolution.
While the broad outlines of Biden’s proposal are known, the specific elements of the reconciliation bill are not known as of early September. House Democratic leaders are working behind closed doors with committee chairs and other key lawmakers to find something that can gain near-universal support within the progressive House Democratic caucus, while also keeping in mind what more centrist Senate Democrats would be able to support.
Sen. Joe Manchin, D-W.Va., arrives at the Senate on Aug. 10, 2021. (AP)
How united are Democrats?
Progress on hammering out the details of a reconciliation bill has been hampered by internal sparring among Democrats.
The Democrats’ narrow margins in the House mean that factions within the caucus potentially have a lot of leverage to shape the final bill. The two most important factions so far have been progressives and centrists.
Progressives, including Rep. Alexandria Ocasio-Cortez, D-N.Y., see even the maximum $3.5 trillion amount as a downward concession from what they were initially seeking. Meanwhile, centrist Democrats, including those who could face tough reelection bids in 2022, are wary of spending that much and are seeking to shrink the reconciliation bill’s bottom line.
This intra-party conflict forced House Speaker Nancy Pelosi, D-Calif., to draw on her legislative experience just to secure passage of the budget resolution that needed to precede any reconciliation bill. Progressives want to vote on the reconciliation bill first, before the bipartisan infrastructure bill; centrists want to do the opposite.
Ultimately, a “rule” governing a floor vote on the budget had to be debated and renegotiated three separate times in about 24 hours before progressives and centrists would agree to proceed to the vote. Centrists settled for an agreement from Democratic leaders to hold a vote on the infrastructure bill no later than Sept. 27.
Democrats “need virtually unanimous support” to pass the reconciliation bill, said Marc Goldwein, senior vice president at the Committee for a Responsible Federal Budget. “They need enough policies to make people satisfied. It’s a delicate tightrope.”
And that’s just for House consideration. Over in the Senate, the challenges are equally steep.
Democratic Sen. Joe Manchin of West Virginia, whose state strongly backed Donald Trump for president in 2016 and 2020, has said he won’t support a reconciliation bill as big as $3.5 trillion. Other Democrats may join him.
Since every Democratic vote in the Senate will be needed to pass the reconciliation bill, Manchin’s opposition, and the possible opposition of others, means that a reconciliation measure with a chance of making it to Biden’s desk may have to end up well below $3.5 trillion in spending.
“There is zero chance of a reconciliation bill getting a party-line vote in the Senate and the House without major concessions to moderate Democrats on the price tag and how it’s paid for,” said Donald R. Wolfensberger, director of the Congress Project at the Woodrow Wilson International Center for Scholars.
What could be done to trim the reconciliation bill?
Democrats could cut specific spending programs entirely, or they could cut a whole lot of initiatives by the same percentage, perhaps by authorizing programs for a shorter period of time. They could also propose more tax increases on high-income taxpayers or corporations than they were initially considering. These options are likely part of the closed-door negotiations now under way.
Of course, cutting the reach of the bill risks losing the support of progressive Democrats, and that would torpedo the entire effort unless Democrats can pick up enough moderate Republicans to balance out the progressive losses.
How serious are the centrists and progressives about derailing the process if they don’t get their way?
Experts said it’s certainly possible that either centrists or progressives would tank the bill if they can’t get everything they want, though such a course would be risky since the Democrats are at risk of losing their slim majorities in the 2022 midterm elections.
“It may be too early to be talking about a snowball’s chance in Hades, but the intraparty heat in the Democratic caucuses has already set off the pre-melt warning sirens,” Wolfensberger said.
Goldwein said that while the factions’ positioning is deeply felt, he added that there’s a good chance that Democrats want to get to yes. “I think the leadership and the administration will lead them to a deal,” he said.
Question: Did the Supreme Court overturn Roe vs. Wade?
Answer: As a legal matter, no. But its decision to let a Texas law banning most abortions to take effect effectively voids the Roe decision in Texas for now, and some legal experts say it may be a signal of the court’s thinking in future cases that could test Roe.
On Sept. 1, the Supreme Court declined to block SB 8, a controversial Texas law that would effectively ban abortion in the state for women after the sixth week of pregnancy.
The 5-4 decision caused an outcry among abortion rights advocates and sparked panic among Texans seeking the procedure. Three of four San Antonio abortion providers stopped allowing the procedure altogether. On Sept. 9, the Justice Department sued Texas in federal court to block SB 8, the Biden administration’s first significant step to intervene on the ban.
The complexities of the law and the murkiness of the decision had people asking whether the court had overturned Roe v. Wade, the landmark 1973 Supreme Court ruling that recognizes the constitutional right to an abortion.
From a strictly legal perspective, the answer is no. Roe v. Wade remains in force. But legal experts say the Sept. 1 ruling does put the future of Roe squarely in doubt by allowing a ban in Texas that defies decades of precedent affirming a woman’s right to an abortion and that contains language that makes it tough to challenge in court.
“There’s no way that a law like this should be in effect if there’s still a right to choose an abortion,” said Mary Ziegler, a law professor at Florida State University.
What did the court decide?
SB 8 bars abortions in Texas once the baby’s heartbeat can be detected on a fetal monitor. That’s usually at about six weeks’ gestation, and well before most women know they’re pregnant. The law makes no exceptions in cases of rape or incest, making it far more restrictive than the standard established by Roe. It also contains an unusual provision that deputizes private citizens, rather than public officials, to enforce the law through litigation.
Under certain circumstances, the Supreme Court can prevent a law from taking effect, at least temporarily, while its constitutionality is being litigated. The justices typically consider a range of factors, including whether there is a fair chance that the court will eventually deem the law unconstitutional and whether the law is likely to cause permanent harm if it goes into effect.
In the case before the court, Whole Woman’s Health v. Jackson, the plaintiffs, a group of abortion providers, sought the court’s emergency intervention to block SB 8 from taking effect on grounds that it would cause harm to women seeking abortions and deprive them of their rights.
The court rejected the request.
The court’s conservative majority didn’t reference Roe v. Wade in the single-paragraph opinion explaining their decision. Instead, they focused on procedural questions raised by the enforcement provisions in the law and the plaintiffs’ challenge, such as which party they were eligible to sue in seeking their injunction.
Why is the court’s decision significant?
The decision signals a potential departure from decades of court precedent on abortion.
Since the landmark Supreme Court abortion cases Roe v. Wade in 1973 and Planned Parenthood v. Casey in 1992, the courts have blocked laws that prohibit abortions before a fetus becomes viable — around the 23rd week of pregnancy. In 2020, for example, a federal court permanently blocked a Georgia abortion bill that, like the Texas law, would have banned abortions after the point at which a fetal heartbeat shows up on an ultrasound, about six weeks into pregnancy.
The Texas law “clearly violates Roe and Casey,” said Carol Sanger, a professor at Columbia Law School and the author of About Abortion: Terminating Pregnancy in Twenty-First-Century America. “No one thinks viability is achieved at six weeks.”
Nevertheless, the majority of the Supreme Court allowed SB 8 to take effect, saying that the plaintiffs’ request for an injunction raised “complex and novel” procedural questions that they hadn’t satisfactorily addressed in their petition.
Those questions surround the law’s novel enforcement mechanism. SB 8 doesn’t make abortion a crime punishable by local or state government; instead, it empowers private actors to sue anyone accused of “aiding or abetting” an abortion after an ultrasound can pick up a fetal heartbeat. Successful plaintiffs would receive $10,000 and reimbursement of legal costs. Successful defendants wouldn’t be reimbursed.
Typically, plaintiffs challenge the constitutionality of specific laws by suing the state officials charged with enforcing them. However, since SB 8 gives private citizens, rather than the state, enforcement power, abortion providers don’t have a clear defendant to sue to stop the law from taking effect.
To get around the problem, Texas abortion providers sued a judge who would theoretically preside over the private lawsuits meant to enforce the ban, arguing that he would be using state power to carry out the law. The court’s conservative majority, however, wrote that they were still unsure whether they had the authority to block the bill, given its unique enforcement mechanism, and opted to deny the injunction.
In essence, Justice Sonia Sotomayor argued in her dissent, “the state’s gambit worked.”
“This is untenable,” she wrote. “It cannot be the case that a state can evade federal judicial scrutiny by outsourcing the enforcement of unconstitutional laws to its citizenry.”
So what is the status of Roe v. Wade?
The majority emphasized in their ruling that they weren’t taking a position on the underlying substance of the Texas measure and that the bill could be challenged as unconstitutional in a future case.
So Roe v. Wade is still the law of the land. The Supreme Court’s ruling “did not overturn Roe v. Wade as a matter of law,” Sanger said.
However, it’s also important to note that the court’s decision practically renders Roe moot in Texas, as almost all women in the state now lack the ability to legally have an abortion. In addition, the court has opened the door for other states to try to circumvent Roe’s protections by adopting the language of the Texas law.
“The effect of the law is more or less the same as what you’d expect if the court actually overturned Roe,” said Ziegler. “The people who are saying that SB 8 functionally overturned Roe are pointing out that if Roe were gone, policy in Texas would look pretty much the same … with some adjustments on the margins.”
The court’s decision is also being interpreted as a signal of what it plans to do with future cases. This fall, the Supreme Court is scheduled to hear arguments in Dobbs v. Jackson Women’s Health Organization, a case on whether a Mississippi ban on abortions after 15 weeks is constitutional. With a 6-3 conservative majority on the Supreme Court, abortion rights activists are worried that the justices could use the case to dramatically change the standard established by Casey or reject the constitutional right to an abortion altogether.
“I think it’s premature to say that (the Supreme Court’s decision) is exactly the same thing as reversing Roe,” Ziegler said. “It’s more a pretty powerful signal that that’s probably the direction we’re headed.”
A stopped clock is right twice a day, but is a clock that’s an hour behind evidence that the president of the United States used an old photo to pretend he was engaged in foreign policy?
Some on social media are claiming it does, but we’ve found no such evidence.
On Aug. 14, the verified White House Twitter account tweeted a photo of President Joe Biden sitting alone in a suit jacket at a table on a video conference call at Camp David.
“This morning, the President and Vice President held a video conference with the national security team to discuss the ongoing efforts to draw down our civilian footprint in Afghanistan,” the tweet said. “In addition, the President and Vice President were briefed on the earthquake in Haiti.”
The next day, the White House tweeted another photo of Biden sitting alone on a video conference call at Camp David. In this photo, Biden is wearing a polo shirt.
“This morning, the President and Vice President met with their national security team and senior officials to hear updates on the draw down of our civilian personnel in Afghanistan, evacuations of SIV applicants and other Afghan allies, and the ongoing security situation in Kabul,” the tweet said.
Both images show digital clocks meant to reflect the time in other cities. In the first, it looks like it’s 11:03 a.m. in Washington D.C., 16:03 — 4:03 p.m. — in London and 19:03 or 7:33 p.m. in Moscow. In the second image, it looks like it’s 26 minutes later in both cities.
The time difference between Washington D.C. and London is five hours. But the time difference between London and Moscow is only two hours right now, not three, as it appears in the images.
“Real question,” tweeted Boris Epshteyn, a former adviser to Donald Trump. “Why is Moscow time wrong in this photo?”
Some people on social media offered their own ideas.
Donald Trump Jr., the former president’s son, tweeted: “Having spent time at Camp David where everyone is a total professional I would find it hard to believe that a clock would be off by a minute let alone by an hour. If this is a photo taken at a prior time to make it seem like Joe is working the admin has some explaining to do.”
“Is this a stock photo?” another account asked.
The White House didn’t respond to PolitiFact’s requests for comment about the clock in the photos.
But, as Newsweek reported, Moscow is sometimes three hours ahead of London. However, the United Kingdom is currently on British Summer Time, a period when the clocks are turned ahead an hour so that there’s more daylight in the evenings and less in the mornings.
We found no evidence the photo was staged, and claims that say so ignore a more likely scenario – that the clock was not updated for British Summer Time.
According to Biden’s public schedule, he arrived at Camp David on Aug. 13 and was there on Aug. 14 and 15, when the White House shared those photos. He was still there on Aug. 16 but flew back to DC to make a national address regarding Afghanistan before returning again to the Maryland property that evening.
Biden has made several other trips to Camp David since becoming president, including in February, March, April, May, June and July.
When the clocks go back on Oct. 31, London will again be three hours behind Moscow, which in 2014 stopped observing daylight savings time.
As the numbers of new COVID-19 cases rise in Florida, Gov. Ron DeSantis has claimed that the ongoing spike is to be expected — that it’s part of a seasonal pattern.
“We have a summer season here, just like last year. It started a little later this year. So you’re going to have higher prevalence for the rest of July, probably into August. And then it goes back and goes the different waves,” DeSantis said July 21. “If you’re vaccinated, those waves are not going to impact you in any significant way, and I think that’s the important message for people.”
He said something similar about seasonality a couple of days before that.
“Obviously in July, which I told people months ago, we would see higher prevalence because this is a seasonal virus, and this is the seasonal pattern that it follows in the Sun Belt states, particularly in Florida,” DeSantis said July 19.
Weekly data reported by the state’s health department shows that new cases have steadily increased in Florida all season: Nearly 12,000 cases were reported in a week in early June, more than 23,000 cases in a week at the beginning of July, and by early August, more than 151,000 were reported in a week.
Critics argue that it’s the governor’s policies that are fueling Florida’s rising cases. He’s banned local governments from setting pandemic restrictions, opposed vaccine mandates and opposed requiring masking indoors.
Is DeSantis right that Florida is seeing a seasonal increase in COVID-19?
Some experts said there appears to be a seasonal component to COVID-19, but not the way DeSantis describes it. They said that data suggests that cases, deaths and other epidemiological variables rise during winter, not during summer.
Respiratory viruses, like the influenza, peak in winter, said Jill Roberts, an associate professor at the University of South Florida’s college of public health.
“Despite our hot weather and Floridians often retreating to AC in summer, influenza continues to display winter seasonality in Florida (not summer),” she said.
Even if there is a seasonal component to COVID-19, experts said, one should not dismiss the importance of masking, social distancing and vaccination in mitigating the spread and the severity of COVID-19. People who are fully vaccinated against COVID-19 can still get infected with the coronavirus, but the Centers for Disease Control and Prevention says evidence shows that people who are vaccinated will likely have less severe illness.
Delta variant plays a significant role in transmission
The delta variant of the coronavirus that causes COVID-19 is currently spreading worldwide and has caused outbreaks regardless of the season, Roberts said.
“It is the increased transmissibility of this strain that is causing the cases, irrespective of the weather,” she said.
In the absence of community immunity, seasonality has little to no impact on spread of respiratory viruses — it can happen year-round, Roberts said.
DeSantis’ stance on COVID-19 seasonality
DeSantis doesn’t dispute that COVID-19 can spread year-round, said spokesperson Christina Pushaw. But she said that a seasonal pattern is the “root cause” of the current spike in Florida, while the delta variant has been an accelerant and population immunity from previous infection or vaccination has been an impediment.
“There is some speculation that COVID infections rise as people spend more time indoors in summer in the South, because of the extreme heat at this time of year,” she said. “We know COVID spreads much more easily indoors than outdoors. That may also be a reason why we see such serious spikes in northern states in the winter/spring, as in Michigan a few months ago, despite that state’s mandates and restrictions.”
But behavior “is not the only or even the main factor influencing COVID prevalence,” Pushaw argued. DeSantis “looks at the empirical evidence, which shows that COVID prevalence rises and falls in different regions at different times of year, in ways that cannot be explained by ‘behavior,’” she said.
Studies on COVID-19 seasonality
One study on the seasonality of COVID-19, cited by Pushaw as backup for DeSantis’ statements, highlighted five countries of different climates and latitudes: Canada, Germany, India, Ethiopia and Chile.
In Canada, Germany and Chile, COVID-19 incidence peaked in their respective winter months. While in India and Ethiopia, COVID-19 appeared to have peaked during the summer, “specifically at the time of the monsoons when the specific humidity was at its highest.”
The researchers suggested that air drying capacity and ultraviolet radiation, “unlike temperature and humidity, are likely environmental determinants of COVID-19 spread and its seasonality.” They said COVID-19 spread appears lowest at high temperatures, and peak spread happens at somewhat average temperatures, “and the relationship is altogether inconsistent.”
Researchers said they did not consider the effects of climate control such as heating and air conditioning, “which may also influence the seasonality” of viral respiratory diseases.
Their findings didn’t entirely align with DeSantis’ argument. Overall, researchers said that the spread of COVID-19 cannot be described by environmental factors alone.
“The spread of COVID-19 is largely shaped by several factors like population density, social distancing, international travel routes, school closures, event cancellations, mask mandates and hygiene,” said the study, published in May.
Another study cited by Pushaw was published in January and was co-authored by Gustavo Caetano-Anollés, a professor of bioinformatics at the University of Illinois.
Caetano-Anollés told PolitiFact that their study showed a seasonal component to COVID-19 and that additional analysis supported those findings. But it shouldn’t be used to support a claim of a summer spike in Florida, he said, because their data shows that cases go up in colder temperatures, not as it gets hotter.
Caetano-Anollés said he was unaware of a study testing the hypothesis that cases go up due to summer crowding.
In Florida and the U.S. in general, human behaviors “are more important drivers than environment and physiology” and the virus’ winter seasonality will not improve conditions, he said.
“Seasonality expresses during an entire yearly cycle, not during some few months of that cycle,” Caetano-Anollés said. “Being seasonal will have little effect on a raging Florida pandemic.”
Unless vaccination rates increase and preemptive measures are imposed, cases and deaths will continue to soar, he said.
When will COVID-19 cases decrease in Florida?
Experts did not offer a specific timeline. But cases should decrease “as this wave burns itself out” by infecting the maximum number of people, Roberts said.
“This is absolutely not the route of immunity that is desired as it will and is resulting in unnecessary hospitalizations, deaths, and burden to the health care and laboratory systems,” she said.
The Biden administration announced plans to offer boosters to all U.S. adults as soon as next month, saying that recent data, including some made available only in the past few days, played a role in that decision.
“If you wait for something bad to happen before you respond to it, you find yourselves considerably behind,” Dr. Anthony Fauci said during a White House briefing on Aug. 18. “You want to stay ahead of the virus.”
White House officials emphasized that the rollout of boosters was pending review of evidence by officials at the Food and Drug Administration as well as the advisory committee to the Centers for Disease Control and Prevention.
The rollout would begin the week of Sept. 20. U.S. residents 18 and older who received the Moderna or Pfizer-BioNTech vaccines would be eligible for a third shot eight months after their second dose. The timing would mean that health care workers, long-term care residents and older residents would be first in line for boosters.
“If you are fully vaccinated, you still have a high degree of protection from the worst outcomes — we are not recommending you go out and get a booster today,” U.S. Surgeon General Vivek Murthy said. Johnson & Johnson vaccines were not distributed until March and a plan for those booster shots will come later, officials said.
Political and corporate pressure to offer a booster to U.S. citizens has been mounting over the summer months, as the highly contagious delta variant has spread nationally and filled hospital beds. On Wednesday, Biden officials offered slides filled with charts of recent data, talked about antibody response, and noted that research showing waning vaccine strength in Israel played a key role in their decision as did a study from Mayo Clinic that is not yet peer-reviewed.
“Stick to the advice from the CDC and the FDA, because they are doing their very best to ensure maximum protection and safety,” said Dr. Cody Meissner, a specialist in pediatric infectious diseases who sits on the FDA’s vaccine advisory panel. “People have to be very careful about statements that come from Big Pharma. They have a very different goal.”
Dr. Sadiya Khan, an epidemiologist and cardiologist at Northwestern University’s Feinberg School of Medicine, said that taking any medication has risks and that adding an additional dose of vaccine might cause unnecessary side effects. “What we need is data,” she said.
There was no discussion Wednesday of any potential side effects of a third dose.
So what do we know about whether healthy, fully vaccinated people should get a booster? Here are answers to seven key questions.
1. What evidence are vaccine makers giving federal regulators to support the idea that an additional shot is needed?
It’s unclear how the booster may be authorized by regulators. On Tuesday, FDA spokesperson Abby Capobianco said federal agencies are reviewing laboratory and clinical trial data as well as data from the real world. Some data will come from specific pharmaceutical companies, but the agency’s analysis “does not rely on those data exclusively,” she said.
The companies, for their part, are racing to produce data. On Monday, Pfizer and BioNTech submitted initial but promising results from a phase 1 study of the safety and immune response from a booster dose given at least six months after the second dose. Late-stage trial results that evaluate the effectiveness of a third dose are “expected shortly,” Pfizer spokesperson Jerica Pitts confirmed this week.
Moderna President Stephen Hoge said during his company’s earnings call this month that a third dose is “likely to be necessary” this fall because of the highly contagious delta variant. Moderna spokesperson Ray Jordan said Tuesday the company is in talks with regulators but hasn’t provided an estimated timeline.
Johnson & Johnson, whose vaccine is administered in a single shot, hopes to share results soon from a late-stage clinical trial studying the safety and efficacy of a two-dose regimen in 30,000 adults. The study is looking at “potential incremental benefits” with a second dose, company spokesperson Richard Ferreira wrote in a Tuesday email.
2. Why might healthy people not need a booster yet?
Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and an adviser to the National Institutes of Health and FDA, said current federal guidance does not recommend a booster and there’s no “science-based” reason to get an additional shot at this time — even after receiving the J&J vaccine.
The current mRNA vaccines work by inducing a certain level of neutralizing, virus-specific antibodies with the first dose. Then the second dose brings on an exponential increase in the measurable level of specific neutralizing antibodies — and, more important, there’s evidence that the second dose of mRNA vaccine also gives cellular immunity, Offit said.
“That predicts relatively longer-term protection against severe critical disease,” he said. A single dose of the J&J vaccine — which uses a different technology, called an adenovirus vector — has been shown to provide the equivalent response to the second dose of an mRNA vaccine, he said.
3. How do the three vaccines authorized in the U.S. compare?
A recent preprint — a paper that has not been peer-reviewed — from the Mayo Clinic suggests that the Moderna vaccine may be more protective against the delta variant than the Pfizer-BioNTech vaccine. However, that research is based on examining the vaccination history of thousands of people who got covid, rather than a direct comparison of the vaccines, said Dr. Catherine Blish, a specialist in infectious diseases at Stanford Medicine.
“I would be hesitant to alter any practices or change behavior in any way based on that data,” she said.
The Moderna and Pfizer-BioNTech vaccines are administered differently, which could factor into how much mRNA the body receives to code into protein, said Dr. Monica Gandhi, a specialist in infectious diseases at the University of California-San Francisco. Moderna’s dosing is two shots of 100 micrograms delivered four weeks apart, while the Pfizer-BioNTech vaccine’s two 30-microgram doses are delivered three weeks apart.
At the end of July, Pfizer and BioNTech announced findings that four to six months after a second dose their vaccine’s efficacy dropped from a peak of 96% to about 84%. With its own data of fading efficacy, the Israeli government launched a vaccination campaign this month encouraging more than 1 million residents over age 50 to get a third shot.
As for J&J’s one-shot vaccine, there’s no evidence that recipients are being hospitalized with breakthrough infections at a higher rate than if they had received other vaccines, said Dr. Amesh Adalja, a specialist in infectious diseases at Johns Hopkins Center for Health Security.
4. Could a booster harm a healthy, fully vaccinated person?
It’s unclear. Offit said he believes a booster is safe and may well become important — but “it’s just not where we should be in this country right now.” The best defense against delta and other variants, he said, is to first vaccinate as many people as possible.
Others, though, said the available research signaled that caution is warranted. During a media briefing reported by Reuters last month, Jay Butler, the CDC’s deputy director for infectious diseases, said the agency was “keenly interested in knowing whether or not a third dose may be associated with any higher risk of adverse reactions, particularly some of those more severe — although very rare — side effects.”
The CDC did not respond to questions this week about its stance on potential risks. There have been reports of blood clots and allergic reactions after regular dosing. Khan, at Northwestern, said she is also concerned about reports of myocarditis, inflammation of the heart — which is more common after the second shot than the first. She said it’s not clear that the benefit of taking a booster would outweigh the risk for young, healthy people.
5. Would a booster limit a vaccinated person’s ability to spread the virus?
Dr. William Moss, a professor of epidemiology at Johns Hopkins’ Bloomberg School of Public Health, explained that the immune protection conferred by vaccines operates along a spectrum, from severely limiting initial virus replication to preventing widespread virus dissemination and replication within our bodies.
“Booster doses, by increasing antibody levels and enhancing other components of our immune responses, make it more likely virus replication will be rapidly prevented,” Moss said. “This then makes it less likely a vaccinated individual will be able to transmit the virus.”
Moss also said there are potential benefits to combinations of vaccines like those being administered in San Francisco and some European countries. German Chancellor Angela Merkel boosted her adenovirus-vectored AstraZeneca shot with Moderna in June.
Another possible step for pharmaceutical companies is to reformulate their covid vaccines to more closely match newer variants. Pfizer has announced it could do so within 100 days of the discovery of a variant.
Hopefully, the regulatory process could be expedited for such reformulated vaccines, said Moss, who works within Johns Hopkins’ International Vaccine Access Center.
6. Would we have to pay for the booster dose, or would it be free, like the previous shots?
It will be free regardless of immigration or health insurance status, according to White House officials. No identification or insurance will be required.
In July, White House press secretary Jen Psaki announced that the federal government bought an additional 200 million doses of the Pfizer-BioNTech vaccine for inoculating children under 12 and for possible boosters.
7. Is there a future in which we take an annual covid shot?
Dr. Vincent Rajkumar, a hematologist at the Mayo Clinic who studies cancers involving the immune system, said a year ago he believed immune responses to covid may be similar to those of the measles, which create “a very long memory that protects us.”
Then covid mutated. “India changed everything for me,” he said, referring to its massive second wave after delta was discovered. Many of those who were infected had already had covid, he said.
Rajkumar now believes “we might need annual boosters — and it would be nice if such boosters can be combined with the flu vaccine.”