Tuesday, December 1, 2020

Scott Atlas resigns — CDC committee meets on vax priority — National Guard covid funding could be extended

Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
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By Dan Diamond and Adam Cancryn

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With Carmen Paun, Sarah Owermohle and Alice Miranda Ollstein

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Quick Fix

— Scott Atlas is leaving the White House, four months after the controversial physician emerged as a top coronavirus adviser to President Donald Trump.

— A CDC committee is holding an emergency meeting today on vaccine prioritization, an effort to speed the process even before FDA signs off.

— The National Guard's covid funding could be extended, administration officials told governors on Monday.

WELCOME TO DECEMBER PULSE — And you may ask yourselves, how did we get here?

In PULSE's case — hiding in our apartments as the days went by. If you've got tips, same as it ever was: find ddiamond@politico.com and acancryn@politico.com.

 

A message from PhRMA:

Today, there are several promising vaccine candidates in stage three clinical trials. These trials have tens of thousands of participants, from every walk of life. From development to robust clinical trials, and throughout manufacturing, these vaccine candidates follow the same rigorous process of other vaccines that have saved millions of lives. More.

 


Driving the Day

TRUMP TO FIND COVID PATH WITHOUT ATLAS — The controversial physician resigned from his White House post on Monday, four months after he became Trump's hand-picked coronavirus adviser, despite a lack of infectious disease experience.

In his exit, the embattled radiologist pitched himself as a champion for public health. "I worked hard with a singular focus—to save lives and help Americans through this pandemic," Atlas wrote in his resignation letter to Trump, which he posted on Twitter , adding that he "always relied on the latest science and evidence, without any political consideration or influence."

But that's not how administration medical officials and public health experts saw it, spending months denouncing Atlas — a fellow at Stanford's conservative Hoover Institution — for downplaying the threat the virus posed and misleading Trump to win the president's favor.

Senior medical experts also battled with Atlas after he appeared to advocate the concept of "herd immunity" — the controversial theory that the United States can quickly and safely achieve widespread immunity to the coronavirus by allowing it to spread unfettered among healthy people.

How we got here: Atlas was brought in by the White House as a special government employee after praising Trump's response during a series of Fox News appearances this summer and saying that coronavirus concerns were overblown. The president swiftly turned to Atlas for guidance, while Deborah Birx, an infectious disease expert tapped in February to be the White House's coronavirus coordinator, was increasingly marginalized.

But Atlas' 130-day detail will run out this week — although some SGEs stay for much longer, an administration official noted to POLITICO.

The reaction from many within the administration: relief and frustration. There's "really nothing left for him to advise on," said a senior administration official who's been in meetings with Atlas. The arrival of Covid-19 vaccines means that herd immunity is likely coming the traditional way, the official said — through widespread vaccination, rather than the approach advocated by Atlas.

Meanwhile, Trump's interest in "an alternate reality" on the coronavirus outbreak has waned in recent days, the senior official said, with the president increasingly focused on contesting the election results. "Both sides seemed to reach the end of their utility to each other," the senior official said.

The reaction from Palo Alto: exuberant. About 100 Stanford faculty who denounced Atlas in September cheered his White House exit on Monday.

Atlas' resignation "is long overdue and underscores the triumph of science and truth over falsehoods and misinformation," the faculty said in a joint statement. "His actions have undermined and threatened public health even as countless lives have been lost to COVID-19."

— The reality: Atlas' departure is coming too late to have much of an effect. While Atlas's rhetoric and actions were widely condemned through the fall, he had the president's ear at a crucial time — and Trump's strategy on coronavirus appears to be set through Inauguration Day.

TODAY: CDC COMMITTEE MEETS ON WHO SHOULD GET SHOTS FIRST —  The Advisory Committee for Immunization Practices is set to convene at 2 p.m. and vote on the initial priority order, an effort to speed the process even before the FDA's scheduled advisory committee to authorize a vaccine next week. See today's agenda and watch the livestream.

COVID VACCINES AS SOON AS MID-DECEMBER — Vaccine distribution could begin within days of an Dec. 10 expert panel discussion of Pfizer's shot, federal officials told state governors in a Monday call, according to notes of the call obtained by POLITICO.

Administration officials "strongly believe" the vaccine distribution process could begin the week of Dec. 14, Vice President Mike Pence reportedly told the governors. That would be a record turnaround for FDA review, POLITICO's Sarah Owermohle notes, especially because this will be the first coronavirus vaccine before the agency's advisory committee. Officials promise that distribution will begin within 24 hours of FDA's green light.

Altogether, it's a striking contrast with the agency's usual process, with FDA Commissioner Stephen Hahn noting on the call that it usually takes the FDA four months or more after the submission of an application.

But vaccines will initially be limited: Between Pfizer and Moderna, just 40 million doses are expected to be available this year, Sarah notes. Governors asked about their allocation with some, like Maine Governor Janet Mills, saying they were getting one-third less than originally expected. Officials said that state census records contributed to the allocations, which are not yet public.

"The calvary is coming," Pence reportedly told the governors, while acknowledging that cases are rising nationwide. "Our country has never been more prepared to combat this virus," the vice president added.

The vaccines can't come soon enough: The U.S. is nearing 200,000 new coronavirus cases a day.

— And the frustration inside the administration is building: FDA's HAHN was called in for a West Wing meeting this morning, where White House Chief of Staff Mark Meadows will grill the commissioner on why the agency hasn't moved faster to approve a vaccine, Jonathan Swan reported at Axios.

Hahn also will face scrutiny for spending time in the Outer Banks of North Carolina, Swan writes — a decision that an FDA spokesperson characterized to Axios as quarantining in a remote location, after an exposure to coronavirus at the FDA's campus.

"Everyone was just blindsided that he had a possible exposure to covid — if that's true," a senior FDA official told PULSE.

PENCE PROMISES GOVS HE'LL ASK TRUMP ABOUT GUARD'S COVID FUNDINGPence on Monday also told the governors he would personally speak to Trump about extending federal support for the National Guard's coronavirus relief work past the current Dec. 31 expiration date, POLITICO's Alice Miranda Ollstein reports.

Pressed by governors like Louisiana's John Bel Edwards and Massachusetts' Charlie Baker, Pence said that the extension is "under active consideration" and "heading to the President's desk for a decision," and he twice promised that he would "personally raise this issue with President Trump today," according to notes from one of the states on the call.

Pence's office declined to comment when Alice asked if he did in fact speak to Trump about the extension and when a decision is expected.

Most states are depending on National Guard members to run covid testing sites, deliver supplies to overwhelmed hospitals, stock food banks, sanitize nursing homes and carry out other vital tasks, Alice notes. While President-Elect Joe Biden recently promised to authorize an extension as soon as he's sworn in, many state leaders fear a gap in funding between Dec. 31 and Biden's late January inauguration, which they say could cripple their ability to manage the virus amid an expected post-holiday surge. The Trump administration earlier this year required most states to pick up 25 percent of the cost of deploying thousands of soldiers and airmen to respond to the public health emergency.

 

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Inside the Humphrey Building

ALEX AZAR: COMBATING HIV REMAINS PRIORITY AMID COVID —  Today is World AIDS Day, and the health secretary tells PULSE that the Trump administration's goal of ending HIV transmission in the United States by 2030 remains doable.

"In 2020, we awarded the first funds to start the implementation of our End the HIV Epidemic initiative in the 57 jurisdictions that account for more than half of new HIV infections in the U.S. each year," Azar said in a statement, touting the government's plan . "By engaging closely with communities most affected by HIV, we can bring this terrible epidemic in America to an end in America within the decade and continue helping more countries around the world bring their epidemics under control."

Azar also praised the "remarkable and courageous" efforts by HIV doctors, advocates and patients to fight the disease even as the Covid-19 pandemic has introduced new risks.

... Trump's ambitious goal to curb HIV transmission, announced last year, was panned by administration critics who said it wasn't consistent with the president's efforts to undermine Obamacare, roll back protections for LGBTQ patients and take other steps that undermined public health. Infectious-disease expert Tony Fauci, who helped shape the HIV plan, told POLITICO at the time that he understood the skepticism but believed the target was achievable.

"The program was driven by people who have a deep commitment to working with the appropriate communities to get this done," Fauci said on POLITICO's Pulse Check podcast last year.

Public Health

STRAWBERRY-FLAVORED HIV DRUG FOR KIDS TO BE ROLLED OUT IN SIX COUNTRIES — UNITAID announced that an HIV treatment designed for children will become available in six African countries in the first half of 2021 at the price of $36 per year per person, POLITICO's Carmen Paun tells PULSE.

The price for the HIV treatment dolutegravir, in a 10 mg formulation, was reduced from $400 per year per person after an agreement between UNITAID, the Clinton Health Initiative and generic manufacturers Viatris and Macleods.

 

TRACK THE TRANSITION: President-elect Biden has started to form a Cabinet and announce his senior White House staff. The appointments and staffing decisions made in the coming days send clear-cut signals about Biden's priorities. Transition Playbook is the definitive guide to one of the most consequential transfers of power in American history. Written for political insiders, it tracks the appointments, people, and the emerging power centers of the new administration. Track the transition and the first 100 days of the incoming Biden administration. Subscribe today.

 
 
Names in the News

Longtime McKinsey hand VIVIAN RIEFBERG joins Darden faculty. Riefberg, who spent 31 years at McKinsey and co-led the firm's U.S. health care practice before retiring this summer as a senior partner, is now a professor of practice at the University of Virginia's Darden School of Business. Riefberg is also on the board of Johns Hopkins Medicine and Signify Health, among other roles.

S.K. BOWEN joins Rep. Brett Guthrie's press team. Bowen will be the Kentucky Republican's new communications director. She was previously press secretary for the House Energy and Commerce Committee Republicans.

ROSALYNN CARTER INSTITUTE tweaks its name. The institute founded by the former first lady is now the Rosalynn Carter Institute for Caregivers – rather than its previous title, "for Caregiving" – in order to strengthen its mission and "better champion the needs of caregivers," it said in a blog post.

 

A message from PhRMA:

America's biopharmaceutical companies are making great progress against a common enemy – COVID-19. They're learning from successful vaccines for other diseases, developing new treatments and collaborating like never before.

Today, there are several promising vaccine candidates in stage three clinical trials. These trials have tens of thousands of participants, from every walk of life. From development to robust clinical trials, and throughout manufacturing, these vaccine candidates follow the same rigorous process of other vaccines that have saved millions of lives.

America's biopharmaceutical companies are working day and night until they defeat COVID-19. Because science is how we get back to normal.

 
What We're Reading

A popular coronavirus testing site in Los Angeles is set to shut down today — with scheduled appointments canceled — in order to film a remake of "She's All That," Dominic Patten reports for Deadline.

A Michigan couple died this month from Covid after making a decision to relax their guard, their daughter told the Washington Post's Meryl Kornfield.

At tiny, rural hospitals, exhausted health workers are treating their friends and family, Jeff Roberson and Jim Salter report for the AP.

 

NEXT WEEK - 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.

 
 
 

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