By Shawn Zeller, Daniel Payne and Erin Schumaker

Biden doffed his face covering to award the Medal of Honor to Larry Taylor on Tuesday. | AP

After first lady Jill Biden came down with Covid on Labor Day, White House press secretary Karine Jean-Pierre said the president would follow the Centers for Disease Control and Prevention’s advice for the close contacts of infected people.

That’s to wear a mask for 10 days and take extra precautions around people at high risk from the disease.

But even as an August uptick in cases has created many close contacts, and some schools and businesses have required mask wearing to comply with the CDC guidance, most people aren’t, including President Joe Biden.

“They keep telling me, because it has to be 10 days or something, I gotta keep wearing it,” Biden joked, mask in hand, in front of a room full of people awaiting his comments on ports and supply chains on Wednesday. “Don’t tell them I didn’t have it when I walked in.”

A day earlier, Biden, who’s eligible to receive his sixth Covid shot when an updated booster becomes available this month, removed his face covering to speak at a Medal of Honor ceremony and never put it back on — even as he stood inches away from 81-year-old honoree Larry Taylor, reports POLITICO’s Adam Cancryn.

The debate continues: The Cochrane Library assessment of randomized control trials on masking earlier this year “did not show a clear reduction in respiratory viral infection,” but most public health agencies continue to recommend them under certain circumstances.

On Saturday, former White House Covid adviser Anthony Fauci defended government policy in an interview with CNN.

“When you are talking about the effect on the epidemic or the pandemic as a whole, the data are less strong," he said, "but when you talk about ... someone protecting themselves or protecting themselves from spreading it to others, there’s no doubt that there are many studies that show that there is an advantage.”

Mandates are now exceedingly rare, with even the last holdouts, hospitals and cancer centers, dropping them with the end of the public health emergency in May or soon thereafter.

Other public health authorities, such as the World Health Organization, continue to advise that close contacts of infected people wear masks, while the European CDC recommends them for people with symptoms. Britain’s National Health Service says to consider wearing them in crowds.

Experts’ reproach: Biden’s nonchalance has alarmed some public health experts who had once cheered on his Covid response for adopting a mantra of “follow the science,” and now worry that the president is undermining his own public health messaging amid an uptick of cases.

“It’s unfortunate,” Michael Osterholm, an epidemiologist and former Covid adviser to the Biden transition, told Cancryn. “Because as we begin to see the number of deaths rise in the country, Covid is still with us.”

Black Canyon of the Gunnison | Shawn Zeller

This is where we explore the ideas and innovators shaping health care.

Tech firms are collecting more health care data on apps and smart devices that fall outside the protections of HIPAA, the federal health privacy law.

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Today on our Pulse Check podcast, host Katherine Ellen Foley talks with POLITICO reporter Megan R. Wilson about the debate surrounding Congress' efforts to regulate pharmacy benefit managers, the pharmaceutical middlemen that negotiate drug prices between manufacturers, insurers and government health providers.

Scientists are still trying to unravel long Covid's mysteries. | AP

Patients with rheumatic diseases who also have antibodies to a pre-Covid coronavirus may be more susceptible to long Covid, says new research.

How so? Up to 45 percent of patients with rheumatic diseases, such as arthritis and lupus, experienced long Covid symptoms at least 28 days after infection, and those with lingering symptoms were more likely to have antibodies to the coronavirus that causes the common cold.

That’s according to research by rheumatologists from Brigham and Women’s Hospital and Massachusetts General Hospital plus immunology and virology experts from the Ragon Institute of Mass General, the Massachusetts Institute of Technology and Harvard.

What’s next? They say the finding could reveal a marker of long Covid and might help to understand the condition’s causes, which could lead to new treatments.

“We may be able to develop biomarkers that help us understand who is at high risk for developing long COVID and strategically enroll individuals into clinical trials to either prevent long COVID or develop therapies to treat it,” said Dr. Zachary Wallace, a rheumatologist at Mass General and co-author of the study, in a statement.

The study is in Science Translational Medicine.

Federal funding still favors heating needs over cooling. | FREDERIC J. BROWN/AFP/Getty Images

Nearly a third of states haven’t tapped federal funding to help people with low incomes pay for air-conditioning, despite growing concerns about the health risks of heat waves, according to an analysis of government records by POLITICO’s Thomas Frank.

Congress created the Low Income Home Energy Assistance Program in 1977 in response to soaring heating costs after the OPEC oil embargo.

In the 1980s, Congress allowed LIHEAP funds to pay for cooling assistance, too. But almost every state, even those in the South and Midwest, continues to spend most of its money on heating bills, the records show.

“The programs haven’t caught up with the change in climate,” said Mark Wolfe, executive director of the National Energy Assistance Directors Association. “We’re now at a period where not only are we having expensive winters, but we’re also having record-breaking heat.”

Some states with hot summers alongside cold winters continue to spend their aid almost exclusively on heating assistance:

— Pennsylvania has the nation’s fourth-highest vulnerability to heat waves, behind Missouri, Illinois and Texas, according to a Federal Emergency Management Agency risk index. But the Keystone State didn’t spend any of the $4.6 billion it got from LIHEAP between fiscal 2004 and 2021 to help residents pay cooling costs.

— Illinois, with the second-highest vulnerability to heat waves, spent only 2 percent of the $3.4 billion it got from LIHEAP between 2001 and 2021 on cooling.

And the program still heavily favors heating in the allocation of funds:

— Vermont has less than half the population of Hawaii. But in 2021, Vermont received nearly five times as much LIHEAP money — $53 million compared with $11 million.

— Connecticut, with 3.6 million residents, got $177 million in 2021. Florida, with 22.2 million people, got roughly the same — $183 million. Connecticut spent nothing on cooling assistance. Florida spent more than 60 percent of its LIHEAP money to help residents stay cool.

“It’s a resource issue,” said Katrina Metzler, executive director of the National Energy and Utility Affordability Coalition. “As the climate changes, the need is growing faster than the funds are growing.”

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