From the Capitol Hill front, the Hill reports that Senate continues to squabble over the must pass National Defense Authorization Act for the current federal fiscal year. Meanwhile Roll Call informs us that

Democrats and Republicans on Monday haggled over details of a stopgap spending bill that appears likely to run into late January at a minimum, with Republicans still trying to extend the duration into February or March.

Sources said House Appropriations Chair Rosa DeLauro, D-Conn., wants to file the temporary spending bill Tuesday with a goal of passing it in the House on Wednesday. That would presumably give the Senate enough time to clear it for President Joe Biden’s signature before the current stopgap funding law expires Friday.

Extending the continuing resolution into late January would represent a compromise between DeLauro, who previously was pushing for a shorter two-week CR, and senators from both parties who say more time is needed to wrap up work on fiscal 2022 appropriations bills.

Negotiations were ongoing, however, with Republicans arguing for more time. Senate Appropriations ranking member Richard C. Shelby told reporters Monday night that he prefers a stopgap through February or March. “I think it gives us more time to seriously sit down,” the Alabama Republican said.

From the Delta variant front, David Leonhard sagely writes in this New York Time column this morning

The public reaction to new Covid-19 variants has followed a familiar cycle. People tend to assume the worst about two different questions — whether the variant leads to faster transmission of the Covid virus and whether it causes more severe illness among infected people.

The first of those worries came true with the Alpha and Delta variants: Alpha was more contagious than the original version of the virus, and Delta was even more contagious than Alpha. But the second of the worries has largely not been borne out: With both Alpha and Delta, the percentage of Covid cases that led to hospitalization or death held fairly steady.

This pattern isn’t surprising, scientists say. Viruses often evolve in ways that help them flourish. Becoming more contagious allows a virus to do so; becoming more severe has the potential to do the opposite, because more of a virus’s hosts can die before they infect others.

It is too soon to know whether the Omicron variant will fit the pattern. But the very early evidence suggests that it may. Unfortunately, Omicron seems likely to be more contagious than Delta, including among vaccinated people. Fortunately, the evidence so far does not indicate that Omicron is causing more severe illness * * * .

The Boston Globe reports that

The Centers for Disease Control and Prevention [(CDC) today] broadened its recommendation for COVID-19 booster shots to include all adults because of the new Omicron variant. The agency had previously approved boosters for all adults, but only recommended them for those 50 years and older or living in long-term care settings.

“Everyone ages 18 and older should get a booster shot either when they are six months after their initial Pfizer or Moderna series or two months after their initial J&J vaccine,” CDC Director Dr. Rochelle Walensky said in a statement.

Healthcare Dive adds

Facing a coronavirus variant that experts fear could more easily evade vaccine protection, drugmakers raced last week to set in place plans to respond to omicron, the latest threat in the nearly two-year-old COVID-19 pandemic. 

BioNTech, which partnered with Pfizer to develop one of the world’s most effective coronavirus vaccines, is already working on a version of its shot tailored to omicron and expects adapting it could take as little as six weeks. Moderna and Johnson & Johnson, makers of two other vaccines for COVID-19, both said they would advance omicron-specific candidates, as did Maryland-based Novavax, which aims to soon ask for U.S. approval of its shot. 

On a related note, last Wednesday, the CDC released a health alert about increasing seasonal flu activity especially among young adults and in college and university settings.

On the Delta variant vaccine mandate front, the Biden Administration came to its senses today by announcing per Govexec that “it would delay until 2022 [a/k/a post holiday season] issuing suspensions and other serious penalties related to noncompliance with its mandate that the federal workforce be vaccinated against COVID-19.”

The White House Safer Federal Workforce Task Force updated guidance on its website to reflect the change, encouraging agencies to issue a letter of reprimand prior to more serious sanctions against noncompliant employees, as well as allowing for multiple rounds of suspensions before agencies move to fire them.

“Agencies may consider the length of the education and counseling period or following an initial brief suspension (14 days or less) with a longer second suspension (15 days or more), rather than moving from a first suspension to proposal of removal,” the task force wrote. “That said, consistency across government in enforcement of this government-wide vaccine policy is desired, and the executive order does not permit exceptions from the vaccination requirement except as required by law.”

Also Reuters reports that

A federal judge on Monday blocked in 10 states a Biden administration vaccine requirement, finding the agency that issued the rule mandating healthcare workers get vaccinated against the coronavirus likely exceeded its authority.

The ruling by U.S. District Judge Matthew Schelp in St. Louis prevents the U.S. Centers for Medicare and Medicaid Services (CMS) from enforcing its vaccine mandate for healthcare workers until the court can hear legal challenges brought by the 10 states. * * *

“Congress did not clearly authorize CMS to enact this politically and economically vast, federalism-altering, and boundary-pushing mandate, which Supreme Court precedent requires,” [Judge Schelp] wrote.

[Judge] Schelp’s ruling applied in the 10 states that brought the case: Missouri, Nebraska, Arkansas, Kansas, Iowa, Wyoming, Alaska, South Dakota, North Dakota and New Hampshire.

A Washington Post article reminded the FEHBlog of this New York Times squib posted on November 21

The article concludes

In Suffolk County, [on Long Island] Odette R. Hall, the chief medical examiner, is using the new mass spectrometer to dig through deaths, to figure out whether fentanyl or its analogues were to blame — or, she fears, whatever novel drug is coming next.

“Whatever is happening on the street,” Dr. Hall said, “is always going to be a step ahead.”

The Washington Post reports that

Forensic analysts have identified a new and highly potent family of synthetic opioids in the District’s illicit drug supply, a worrisome discovery in a city already struggling with a wave of fatal overdoses that shows no signs of abating. The opioids, found on used syringes examined by scientists at the D.C. Department of Forensic Sciences in September and October, are called protonitazene and isotonitazene, respectively. Experts estimate that each is at least several times more powerful than fentanyl, the synthetic opioid that has displaced heroin in many parts of the United States and is now responsible for the majority of the country’s drug overdoses, including those in the nation’s capital. * * *

It is unknown whether fentanyl testing strips — which alert users to the possibly higher potency of their drugs — pick up the presence of the nitazene family of substances. And more of the overdose antidote naloxone, commonly known as Narcan, may be needed to revive someone who has used the new drugs.

“For us, it is concerning,” [D.C. Public Health Lab chemist Alexandra] Evans said. “Naloxone should work, but because of the potency additional doses might be required.”