Monday, November 23, 2020

Herd immunity by May? — Biden plans to put CDC at center — Trump admin rolls out oversight of organ transplants

Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
Nov 23, 2020 View in browser
 
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By Dan Diamond and Adam Cancryn

With Rachel Roubein and Alice Miranda Ollstein

PROGRAMMING NOTE: Morning PULSE will not publish on Thursday, Nov. 26 and Friday, Nov. 27. We'll be back on our normal schedule on Monday, Nov. 30.

Editor's Note: POLITICO Pulse is a free version of POLITICO Pro Health Care's morning newsletter, which is delivered to our subscribers each morning at 6 a.m. The POLITICO Pro platform combines the news you need with tools you can use to take action on the day's biggest stories. Act on the news with POLITICO Pro.

Quick Fix

— Scientists are optimistic about the fast rollout of coronavirus vaccines and possible herd immunity next year, even as cases surge.

— President-elect Joe Biden plans to put the CDC at the center of his planned Covid-19 response.

— The Trump administration finalized new oversight of organ transplants, which advocates say will boost patient care and access.

WELCOME BACK TO MONDAY PULSE — Where we're watching Biden's planned Tuesday announcement of "multiple" Cabinet picks. Will we get an HHS secretary among them?

Place your bets and send other tips to ddiamond@politico.com and acancryn@politico.com.

Driving the Day

SIGNS OF OPTIMISM ON COVID — Moncef Slaoui, Operation Warp Speed's clinical adviser, signaled on Sunday that Americans could start getting vaccinated for Covid-19 within a day or two of the FDA's advisory committee meeting scheduled for Dec. 10.

"Our plan is to be able to ship vaccines to the immunization sites within 24 hours from the approval, so I would expect maybe on day two after approval on the 11th or the 12th of December," Slaoui said on CNN.

— Herd immunity could be reached by May, Slaoui also predicted, estimating that's when about 70 percent of the U.S. population would get shots.

The vaccines should be "an incentive to have us double down even more with public health measures until we get the full component of the help that's on its way," said infectious-disease expert Tony Fauci on NBC's "Meet the Press."

— Meanwhile: FDA authorized Regeneron's experimental antibody treatment on Saturday, saying that it could be used for mild and moderate cases of Covid-19. President Donald Trump received the treatment in October.

SIGNS OF PESSIMISM AND CONCERN — Coronavirus cases have accelerated, with an average of more than 170,000 new confirmed cases per day across the past week. That's more than double the rate a month ago, and hospitalizations and deaths are surging too.

It's also created new pressures on hospitals and health workers from coast to coast, with some Utah doctors saying that care is being effectively rationed, Erin Alberty writes in the Salt Lake City Tribune.

"There are no beds anywhere," one Minnesota doctor told the Star Tribune's Jeremy Olson.

HOW BIDEN's COVID RESPONSE WILL CENTER THE CDCThe president-elect is planning to restore regular media briefings and elevate long-sidelined career CDC officials when his administration takes control of the Covid-19 response, POLITICO's Alice Miranda Ollstein and Adam Cancryn report.

The moves are aimed at sending an immediate message that the Biden administration is prioritizing science over politics in its pandemic efforts — and heading off resistance to public health restrictions and mass vaccination efforts.

— Two to watch: NANCY MESSONNIER and ANNE SCHUCHAT. The top CDC officials were sidelined by Trump and his deputies after their warnings about the severity of the crisis angered the White House. Both are likely to re-emerge under Biden and play prominent roles in guiding the response.

Biden transition officials have also spent significant time plotting how to restore trust and morale at the CDC, with a person close to the president-elect calling the challenge "job one."

— The incoming administration views messaging as critical to curbing the pandemic. Biden will confront a series of policy and logistical challenges, but the simpler question of how to rally a fatigued and divided nation has dominated discussions.

In building his pandemic team, Biden has sought candidates who are good communicators and boast deep credibility with the health community and broader public. Once in office, the Biden administration is likely to enlist a slate of career health officials and political appointees to reinforce the government's message and build trust in particular in communities of color hit hardest by the pandemic.

— What the FEDERATION OF AMERICAN HOSPITALS is urging Biden: The organization for investor-owned hospitals wants the president-elect to extend the public health emergency and its accompanying waivers, in a letter shared first with PULSE.

"All of the waivers, while too numerous to list here, have been critical for allowing hospitals to prepare for patient surge and care for patients throughout the PHE, while also protecting them from risk of exposure to COVID-19," FAH chief Chip Kahn urges, also calling for other policies to improve coronavirus mitigation and help hospitals.

CLYBURN BACKING VIN GUPTA FOR SURGEON GENERAL — Rep. Jim Clyburn, the No. 3 House Democrat and a close Biden ally, has recommended Gupta for surgeon general or another high-level post, he confirmed to PULSE.

A lung specialist, Gupta is currently an affiliate assistant professor at the University of Washington's Institute for Health Metrics and Evaluation, and had advised the Biden team.

"Vin is someone that I'm very supportive of," Clyburn said. "I know him and I've worked with him and he would be outstanding."

Gupta also spent recent months as a medical contributor for NBC and MSNBC — a visible role that comes as Biden officials seek candidates with the communication skills and credibility to steer the nation through the pandemic.

Clyburn cautioned that he's not part of the transition, and doesn't have any final say on personnel decisions. But another person familiar with the process said Gupta has spoken with other high-level Biden advisers about a spot in the administration in recent weeks.

Gupta declined to comment.

TODAY: $50M VACCINE EDUCATION CAMPAIGN LAUNCHED BY COVID COLLABORATIVE, AD COUNCIL — The campaign, which its organizers bill as unprecedented, will promote awareness of the upcoming vaccines and attempt to reach marginalized communities. The effort also will release a toolkit devised with the National Governors Association and others.

— The COVID Collaborative boasts a bipartisan mix of advisers, including Joe Grogan, who served as Trump's domestic policy chief before leaving the White House this year, and Trump's former FDA commissioner Scott Gottlieb. Other advisers include Obama officials like former HHS Secretary Kathleen Sebelius, CDC Director Tom Frieden and Peggy Hamburg, as well as academics like Georgetown's Rebecca Katz, Johns Hopkins' Tom Inglesby and Brown's Ashish Jha.

The Ad Council, meanwhile, is the communications industry's not-for-profit consortium that has spent decades partnering with the government on public health campaigns.

"Widespread adoption of the COVID-19 vaccine is our generation's 'moonshot' and will represent one of the largest public health interventions in our nation's history," Lisa Sherman, the head of the Ad Council, said in a statement.

— The campaign comes even as the Trump administration's own planned $300 million-plus coronavirus surge awareness campaign, mired in months of scrutiny, has yet to produce a single ad. An official at the Ad Council told PULSE that the Trump administration still hasn't reached out to coordinate about that campaign.

 

KEEP UP WITH THE PEOPLE AND POLITICS DRIVING GLOBAL HEALTH: The global pandemic has revealed just how critical it is to keep up with the politics, policy, and people driving global health. Will America reclaim its leadership on the worldwide health stage with the new Biden administration in 2021? What impact could the president-elect's presidency have on global vaccine access and the international response to the pandemic? Our Global Pulse newsletter connects leaders, policymakers, and advocates to the politics impacting our global health. Join the conversation and subscribe today.

 
 


Inside the Humphrey Building

ORGAN TRANSPLANT RULES MOVE FORWARD — HHS on Friday night signed off on final rules that would impose new oversight on organ procurement organizations, winning applause from lawmakers like Sen. Ron Wyden (D-Ore.), Sen. Todd Young (R-Ind.) and the Congressional Kidney Caucus. The effort, which also has been widely championed by researchers and patient advocates, is among the Trump administration's most popular health initiatives.

"These bipartisan reforms are a win for patients and their families," said Greg Segal, co-founder of Organize, praising the new accountability measures, calling on the Biden administration to "enforce these reforms as urgently and quickly as possible."

DRUG, STARK RULES ALSO UNVEILED — As POLITICO reported last week, HHS on Friday issued a slew of final rules: a "most favored nation" plan that linked some government payments to an international index, new regulations effectively eliminating rebates from seniors' drug plans as well as anti-fraud laws. It's not clear if the Biden administration would continue with the drug rules, which also are expected to face legal challenges.

— A tribute to DAN BEST. An eagle-eyed reader pointed out to PULSE that the first letter of each paragraph in the press release on the rebate rule, when read in reverse, spelled out the name of the former HHS senior adviser, who passed away in 2018 after working on the effort.

An HHS spokesperson confirmed that the lettering was intentional.

Around the Nation

THE THANKSGIVING TRAVEL DEBATE — The CDC and epidemiologists say don't go, as Covid-19 continues to spike and travel ups the risk of spreading the virus. Many Americans say they're hitting the road anyway.

— The New York Times fronted its Sunday review section with Farhad Manjoo's op-ed about his realization that his immediate circle is larger than 100 people as he weighed whether to travel hundreds of miles to see his parents this week.

The essay underwent quiet edits after it was much criticized — deservedly so, PULSE thinks — for Manjoo's surprising conclusion that "for family, it's worth it" to travel for the holidays.

"Manjoo decides that what he's learned doesn't matter. He thinks his family and their contacts are special after all," Tim Carmody wrote at Kottke.org, in another look at the moral calculations about Thanksgiving travel.

— Meanwhile: TSA did more than 2 million traveler screenings at airports on Friday and Saturday combined, the highest two-day total since mid-March.

HOW THOUSANDS OF SCARCE COVID SHOTS COULD GO TO WASTE — The Trump administration is hoping to begin delivering millions of doses of a coronavirus vaccine in December. But the short shelf life of Pfizer's shots and uncertainty over how to get them to the right people once vials are cracked open could mean thousands go to waste, POLITICO's Dan Goldberg, Rachel Roubein and David Lim report.

It's one of many worries hanging over the vaccine rollout in the coming months, with pharmacies worried about inefficiency, and cash-strapped state and local health departments warning they need more federal funding and direction.

— Pfizer's requirements are complex. The vaccine must be kept in ultra-cold conditions and will be shipped in specially designed pizza-shaped boxes that hold a minimum of 975 doses in 195 glass vials. Once a vial is thawed and diluted to make five shots, health workers will be in a true "use it or lose it" situation: If there aren't enough people ready for the shots within six hours, the vaccine spoils, slowing efforts to stamp out hot spots and save lives.

— The view from the Trump administration: Gen. Gustave Perna – the chief operating officer of Operation Warp Speed, the Trump administration initiative charged with bringing a vaccine to market – said CVS and Walgreens know how to do this and that his team has worked with states to "make sure that no vaccine is wasted."

 

DON'T MISS THE MILKEN INSTITUTE FUTURE OF HEALTH SUMMIT 2020: POLITICO will feature a special edition Future Pulse newsletter at the Milken Institute Future of Health Summit. The newsletter takes readers inside one of the most influential gatherings of global health industry leaders and innovators determined to confront and conquer the most significant health challenges. Covid-19 has exposed weaknesses across our health systems, particularly in the treatment of our most vulnerable communities, driving the focus of the 2020 conference on the converging crises of public health, economic insecurity, and social justice. Sign up today to receive exclusive coverage from December 7–9.

 
 


In Congress

NEW CAPITOL HILL PUSH TO EXTEND NATIONAL GUARD'S COVID FUNDING — With federal funding for the National Guard's coronavirus relief work set to expire at the end of the year, Rep. Cheri Bustos (D-Ill.) is leading a new Capitol Hill effort to pressure Trump to extend the funding at least until Biden takes office.

"Forcing governors to sit and wait over a three-week delay between your Administration and the next will inflict unnecessary, easily avoidable suffering," Bustos writes to Trump in a letter first shared with POLITICO's Alice Miranda Ollstein.

Bustos, who recently contracted Covid-19, asks for the mission to be extended and for the Trump administration to drop cost-sharing it imposed on most states earlier this year, which charged them 25 percent of the cost of the Guard's deployment. Nearly every governor is depending on soldiers and airmen for many key pieces of the pandemic response.


In the Courts

APPEALS COURT LETS TENNESSEE's ABORTION 'REASON BAN' TAKE EFFECT — A three-judge panel at the 6th Circuit Court of Appeals ruled 2-1 on Friday that the state could begin enforcing its ban on abortions that are sought based on the race, sex or Down syndrome diagnosis of the fetus, Alice reports. The law had been frozen by lower courts since it was enacted in July.

The judges in the majority, appointed by President George H.W. Bush and Trump, argued that the state should be able to ban doctors from terminating a pregnancy when they "know" it's for a particular reason.

Judge Eric Clay, a Clinton appointee, dissented, saying the law "threatens to prevent physicians from engaging in even brief discussions about the woman's personal considerations without fear of prosecution."

The groups challenging the law, led by the Center for Reproductive Rights, immediately went back to the lower district court seeking a temporary restraining order, but have not yet received a response.

— Trend watch: More than a dozen states have passed reason-based abortion bans, most of which have been blocked by courts, and the Supreme Court could take up the issue in its next term.

Names in the News

GREG D'ANGELO DEPARTS WHITE HOUSE — D'Angelo, who had been the top health official for the Office of Management Budget since March 2019, stepped down on Friday after a very busy few days for the budget office, which signed off on multiple HHS rules. He previously had worked on the Senate Budget Committee and at the Heritage Foundation.

MEAGHAN ROSE SMITH named as executive director of the Biosimilars Forum. Smith, who previously served as a top Obama HHS communications official and worked for Sen. Brian Schatz, will lead the organization that advocates for development and access to biosimilars. Smith most recently led the health care practice at SKDKnickerbocker.

What We're Reading

"As a matter of public health and moral decency": writing in USA Today, former CDC Director Rich Besser demands Congress move forward with a Covid-19 aid package.

A maskless Trump supporter was charged with assault after video captured him breathing on protesters outside of the president's golf club in Virginia, NBC4 reports.

A team of New York Times reporters dive into the frantic race between Pfizer and Moderna to develop a Covid-19 vaccine.

"I lost my mom to COVID-19," just five days after she entered the hospital , Crosscut reporter Emily McCarty writes. "Don't let the holidays steal yours."

 

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