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Who gets to be first in line for a COVID-19 vaccine? U.S. health authorities hope by late next month to have some draft guidance on how to ration initial doses, but it’s a vexing decision.“Not everybody’s going to like the answer,” Dr. Francis Collins, director of the National Institutes of Health, recently told one of the advisory groups the government asked to help decide. “There will be many people who feel that they should have been at the top of the list.”Traditionally, first in line for a scarce vaccine are health workers and the people most vulnerable to the targeted infection.But Collins tossed new ideas into the mix: Consider geography and give priority to people where an outbreak is hitting hardest.And don’t forget volunteers in the final stage of vaccine testing who get dummy shots, the comparison group needed to tell if the real shots truly work.“We owe them ... some special priority,” Collins said.Huge studies this summer aim to prove which of several experimental COVID-19 vaccines are safe and effective. Moderna Inc. and Pfizer Inc. began tests last week that eventually will include 30,000 volunteers each; in the next few months, equally large calls for volunteers will go out to test shots made by AstraZeneca, Johnson & Johnson and Novavax. And some vaccines made in China are in smaller late-stage studies in other countries.For all the promises of the U.S. stockpiling millions of doses, the hard truth: Even if a vaccine is declared safe and effective by year’s end, there won’t be enough for everyone who wants it right away -- especially as most potential vaccines require two doses.It’s a global dilemma. The World Health Organization is grappling with the same who-goes-first question as it tries to ensure vaccines are fairly distributed to poor countries -- decisions made even harder as wealthy nations corner the market for the first doses.In the U.S., the Advisory Committee on Immunization Practices, a group established by the Centers for Disease Control and Prevention, is supposed to recommend who to vaccinate and when -- advice that the government almost always follows.But a COVID-19 vaccine decision is so tricky that this time around, ethicists and vaccine experts from the National Academy of Medicine, chartered by Congress to advise the government, are being asked to weigh in, too.Setting priorities will require “creative, moral common sense,” said Bill Foege, who devised the vaccination strategy that led to global eradication of smallpox. Foege is co-leading the academy’s deliberations, calling it “both this opportunity and this burden.”With vaccine misinformation abounding and fears that politics might intrude, CDC Director Robert Redfield said the public must see vaccine allocation as “equitable, fair and transparent.”How to decide? The CDC’s opening suggestion: First vaccinate 12 million of the most critical health, national security and other essential workers. Next would be 110 million people at high risk from the coronavirus -- those over 65 who live in long-term care facilities, or those of any age who are in poor health -- or who also are deemed essential workers. The general population would come later.CDC’s vaccine advisers wanted to know who’s really essential. “I wouldn’t consider myself a critical health care worker,” admitted Dr. Peter Szilagyi, a pediatrician at the University of California, Los Angeles.Indeed, the risks for health workers today are far different than in the pandemic’s early days. Now, health workers in COVID-19 treatment units often are the best protected; others may be more at risk, committee members noted.Beyond the health and security fields, does “essential” mean poultry plant workers or schoolteachers? And what if the vaccine doesn’t work as well among vulnerable populations as among younger, healthier people? It’s a real worry, given that older people’s immune systems don’t rev up as well to flu vaccine.With Black, Latino and Native American populations disproportionately hit by the coronavirus, failing to address that diversity means “whatever comes out of our group will be looked at very suspiciously,” said ACIP chairman Dr. Jose Romero, Arkansas’ interim health secretary.Consider the urban poor who live in crowded conditions, have less access to health care and can’t work from home like more privileged Americans, added Dr. Sharon Frey of St. Louis University.And it may be worth vaccinating entire families rather than trying to single out just one high-risk person in a household, said Dr. Henry Bernstein of Northwell Health.Whoever gets to go first, a mass vaccination campaign while people are supposed to be keeping their distance is a tall order. During the 2009 swine flu pandemic, families waited in long lines in parking lots and at health departments when their turn came up, crowding that authorities know they must avoid this time around.Operation Warp Speed, the Trump administration’s effort to speed vaccine manufacturing and distribution, is working out how to rapidly transport the right number of doses to wherever vaccinations are set to occur.Drive-through vaccinations, pop-up clinics and other innovative ideas are all on the table, said CDC’s Dr. Nancy Messonnier.As soon as a vaccine is declared effective, “we want to be able the next day, frankly, to start these programs,” Messonnier said. “It’s a long road.”___The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. 5581

White House press secretary Kayleigh McEnany says President Donald Trump is “not even at that point yet” when it comes to conceding to President-elect Joe Biden.McEnany tells Fox Business News on Friday that Trump believes he will be president and have a second term.When told it would look sad if he did not attend the inauguration on Jan. 20, McEnany said, “I think the president will attend his own inauguration. He would have to be there in fact.”McEnany continued to raise unsubstantiated allegations of voter fraud and maintained that “when every legal vote is counted” Trump would win.There is no evidence of widespread fraud in the 2020 election despite her claims. Election officials from both political parties have stated publicly that the election went well, and international observers confirmed there were no serious irregularities.White House economic adviser Peter Navarro offered a similar assessment. "We're moving forward here at the White House under the assumption that there will be a second Trump term," Navarro said. Biden is projected to win at least 290 Electoral College votes, and could pick up 16 more in Georgia, where a hand recount is underway. Biden leads the state by 12,000 votes. 1223

We've seen headlines for weeks about Hertz selling off its fleet after filing for Chapter 11 bankruptcy. In reality, it isn't just Hertz and it didn't just start.“You should not expect, or the market should not expect, all of a sudden this influx of rental supply to hit the market because rental companies have been right sizing their fleets since at least mid-March,” said Larry Dixon, Senior Director of Valuation Services at J.D. Power.As COVID-19 forces car rentals and auctions to shut down, the rental companies started selling more to dealers who weren't able to replenish their used car supply. Now that auctions have opened, demand is up and so are auction prices.So far for retail, what we pay is stable. At the same time, new car sales are down. So, there are fewer trade-ins. That means better deals.“Dealers are going to be more likely to be more aggressive with a trade-in offer to a consumer, particularly for highly desirable late model vehicles, think that 2 to 5-year-old used vehicle,” said Dixon.As far as rental cars being a good buy, they are well-maintained and kept clean. The negatives are they have higher miles. But that can also be a positive in the price.A dealer doesn't have to disclose if a car was a rental. You can find out on your own with a vehicle history report. 1309

Where you stand in the moment matters. In this moment, leadership, decency, constitutional norms matter. Character matters. Our vote matters. The president we choose matters. I stand with @JoeBiden because America matters. #Vote https://t.co/TGR08YQ3gd— Michael Steele (@MichaelSteele) October 20, 2020 310

With no new stimulus bill, many Americans are approaching a financial cliff. Their unemployment benef