From the Delta variant mandate front, Federal News Network reports that

The federal government is at 96.5% compliance with the Biden administration’s COVID-19 vaccination mandate for employees and contractors, including civilian and military personnel.

Monday was the deadline to get vaccinated, and as of yesterday, the U.S. Agency for International Development, the departments of Commerce, Transportation, the Office of Personnel Management and the Small Business Administration all have at least 99% compliance with the mandate among employees. That includes the percentage of agency employees covered by a vaccination requirement with at least one dose of a COVID-19 vaccination, or a pending or approved exception or extension. Again, that’s for compliance — when it comes to actual vaccination or employees with at least one dose of a COVID vaccine, the compliance rates hovered between 86.1% and 97.8%.

That’s good news.

In Delta variant testing news, David Leonhardt in the New York Times Mornings column brings us a handy guide rapid COVID tests which are will work hand in glove with the Merck early COVID treatment pill that the Food and Drug Administration will consider for emergency use authorization next week.

The Covid tests that you take in a doctor’s office or testing center are usually PCR tests, which are designed to identify whether you have any amount of the Covid virus. They can sometimes come back positive even if you had the virus weeks earlier and have not been infectious for a long time.

The rapid tests — also known as antigen tests — are designed to tell whether you are infectious. That’s why they are such a powerful public-health tool. They can prevent somebody with the virus from spreading it to others.

“For too long, people thought of testing as an extra and not the core, and it needs to be thought of as the core,” Mara Aspinall, a professor at Arizona State University and former biotechnology executive, told Kaiser Health News.

The most widely available antigen test seems to be BinaxNOW, from Abbott. You should also feel comfortable using QuickVue, Ellume and Flowflex, among others. If you search for one of these tests online and a website points you to a different brand, do some research. Others can be very expensive.

Both CVS and Walgreens have search engines that let you find tests for sale near you. I recommend calling the store to confirm it still has them in stock — and then immediately going to buy it. A store may limit you to buying one test pack at a time. * * *

The F.D.A. approved three more tests this week, and the Biden administration continues to spend more to expand their availability.

By Christmas and New Year, tests should be easier to find than they are this week.

Fingers crossed.

In other news

• Govexec reports that

After months of speculation, President Biden on Wednesday announced his intent to nominate the acting director of the Office of Management and Budget—currently Deputy Director Shalanda Young—to become the permanent leader. He also announced his pick to replace Young as deputy director. 

Young, a veteran of the House Appropriations Committee, has been serving as acting OMB director since the end of March when she was confirmed as deputy director, which followed the withdrawal of Neera Tanden’s nomination for the top job. Lawmakers from both parties immediately called on the administration to tap Young for the director role. 

Nani Coloretti, who the president will formally nominate as OMB deputy director, is currently a senior vice president at the Urban Institute. She has previously served in senior roles at the Housing and Urban Development and Treasury departments and Consumer Financial Protection Bureau. * * *

OMB’s role in advancing the administration’s priorities is critical. It manages the federal budget process, regulatory matters, procurement and management of the federal workforce (as demonstrated in the outline of the president’s management agenda released last week), including the return to office process and implementation of the coronavirus vaccine mandate.

Young is currently on maternity leave, so Jason Miller, OMB deputy director for management, is handling the day-to-day responsibilities. While the clock ran out earlier this month for some acting positions under the 1998 Federal Vacancies Reform Act, there is no time limit for acting OMB directors. 

• Healthcare Dive provides an overview of third quarter financial reports from non-profit healthcare facilities, such as the Cleveland Clinic.

Nonprofit giant Cleveland Clinic posted operating revenue of $3.1 billion in the third quarter, up 13% year over year as net patient revenue swelled on an influx of patient activity. The Ohio academic medical center’s topline was also helped by higher outpatient pharmacy revenue, as utilization of outpatient and specialty drugs increased.

However, pandemic pressures weighed heavily on nonprofits in the quarter ended Sept. 30, as spending drove down operating incomes for systems like Providence Health, CommonSpirit and Kaiser Permanente, which shelled out more on overtime and staffing agencies, pharmaceuticals and medical supplies to respond to increased volumes.

The trend was common but not universal: Minnesota-based Mayo Clinic is an outlier, reporting a robust operating margin of 8% as revenue growth kept well above costs.

Cleveland Clinic operates 19 hospitals and a number of outpatient and ambulatory surgery centers, along with physician offices. Its network is most concentrated in northeast Ohio and Florida, though the system also operates centers in Toronto, Las Vegas and Abu Dhabi.

Have a wonderful Thanksgiving holiday.