News : Capitol chaos to spark Covid spread? — Biden's vaccine goal challenge

Monday, January 11, 2021

Capitol chaos to spark Covid spread? — Biden's vaccine goal challenge — Hospitals blast feds on syringes

Jan 11, 2021

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By Dan Diamond and Adam Cancryn

Presented by

With Carmen Paun, Susannah Luthi and Rachel Roubein

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Quick Fix

— The fallout from last week's riots at the Capitol continues, as officials worry about potential Covid-19 spread and Blue Cross Blue Shield halts donations to some lawmakers.

— President-elect Joe Biden's team is facing a steep challenge in fulfilling its goal of 100 million Covid-19 shots in 100 days.

— Hospitals are blaming the federal government for syringes that they say have led to waste of some Covid-19 vaccine.

WELCOME BACK TO MONDAY PULSE — And welcome to Washington this week… Bill Belichick? Amid the chaos, the New England Patriots coach is set to get the Medal of Freedom from President Donald Trump this week, POLITICO's Meridith McGraw scooped.

Perhaps someone took Trump's summons for "American patriots" literally, not figuratively. Tips to 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

A COVID BREAKOUT LOOMING ON THE HILL? — That's what many staff and lawmakers have feared, after crowding together for safety as a pro-Trump mob stormed the hill. The Capitol's attending physician warned on Sunday there's reason to worry.

"Many members of the House community were in protective isolation in [a] room located in a large committee hearing space," physician Brian Monahan said in a statement. "During this time, individuals may have been exposed to another occupant with coronavirus infection."

— A potential inciting incident: Punchbowl News on Friday obtained video of maskless Republican lawmakers — including Reps. Marjorie Greene (R-Ga.), Markwayne Mullin (R-Okla.), Andy Biggs (R-Ariz.), Scott Perry (R-Pa.) and Michael Cloud (R-Texas) — rebuffing Rep. Lisa Blunt Rochester (D-Del.) as she offered them masks in the safe room.

"While I was disappointed in my colleagues who refused to wear a mask, I was encouraged by those who did," Blunt Rochester said in a statement. "My goal, in the midst of what I feared was a super spreader event, was to make the room at least a little safer."

BLUE CROSS BLUE SHIELD FREEZES DONATIONS TO HOLDOUT LAWMAKERS — The lobbying group on Friday suspended all campaign giving to GOP lawmakers who voted to reject election results last week, citing the "violent, shocking assault" on the U.S. Capitol, POLITICO's Susannah Luthi writes.

— In their words: "BCBSA will suspend contributions to those lawmakers who voted to undermine our democracy," Kim Keck, the association's CEO, said in a statement. "We will continue to support lawmakers and candidates in both political parties who will work with us to build a stronger, healthier nation."

— The move is significant: The association's PAC has spent nearly $2.7 million on federal candidates since the 2010 election cycle, according to an analysis from the Center for Responsive Politics, with the GOP getting about twice as much campaign cash (about $1.9 million) from the association than Democrats (about $780,000).

— It's unclear whether other major health care groups will follow suit. America's Health Insurance Plans, the nation's largest health insurance lobby, told Susannah that it didn't have any comment on Sunday. Meanwhile, the American Medical Association, the American Hospital Association, the Pharmaceutical Research and Manufacturers Association and United HealthGroup didn't immediately respond to requests for comment.

ADMIT IT. YOU DON'T MISS TRUMP's MISINFORMATION — Twitter abruptly banned the president on Friday, citing his efforts to rally supporters after last week's violent attack on the Capitol and sparking debate over whether the ban was appropriate. But Trump's reckless tweets during the pandemic should've been grounds to strip him of access months ago, given Twitter's stated policy of stopping users from spreading Covid misinformation.

— Take Trump's actions on July 27-28. In one retweeting spree, the president repeatedly promoted debunked claims about hydroxychloroquine as a Covid-19 treatment, including the theories of a doctor who separately alleged that demons are to blame for illness and alien DNA is part of medical treatment, while attacking infectious-disease expert Tony Fauci. Trump had more than 84 million Twitter followers at the time.

BIDEN TEAM FEELS THE HEAT OVER 100M VACCINATIONS VOW — President-elect Joe Biden has grown frustrated with the team in charge of plotting his coronavirus response, amid rising concerns that his administration will fall short of its promise of 100 million vaccinations in the first 100 days, according to people familiar with the conversations, POLITICO's Adam Cancryn and Tyler Pager report.

The president-elect has repeatedly vented about not having sufficient logistical and operational details, Adam and Tyler write, tensions that have surfaced as Biden's advisers plan a dramatic scale-up of vaccinations next week, when the new administration inherits Trump's troubled vaccine rollout that has fallen well short of its initial targets.

Biden has expressed criticism on multiple occasions to groups of transition officials — including one confrontation where Biden conveyed to Covid coordinator Jeff Zients and his deputy, Natalie Quillian, that their team was underperforming, Adam and Tyler report.

— The challenge: the U.S. has conducted around 7 million vaccinations over its first three weeks, well below the million-a-day rate Biden will need to hit. While some Biden advisers insist it's possible to make good on the 100-million vow, others are privately worried that the federal response is already so chaotic that it will take a herculean effort to pull it off.

— A Biden spokesman defended the team's work, calling Zients the "right person for the job."

"The President-elect has full confidence in the plan he and his team are putting forward to get that done," T.J. Ducklo said.

HOSPITALS SAY SYRINGES SUPPLIED BY FEDS WASTE PRECIOUS VACCINE DOSES — Hospitals are throwing out untold shots of Pfizer's coronavirus vaccine because the federal government is giving some of the facilities syringes that can only extract five doses from vials that often contain more, POLITICO's Rachel Roubein and Susannah Luthi report.

Pharmacists discovered quickly that the standard five-dose vials of the vaccine from Pfizer and its German partner BioNTech often contained enough shots for six or seven people. Regulators rushed to allow those "overfill doses" to maximize the reach of the scarce coronavirus vaccines.

— But some syringes distributed by Operation Warp Speed, the federal Covid-19 vaccine program, aren't efficient enough to extract a sixth dose, according to hospital lobbyists. They say the issue appears to stem from supply chain problems that have troubled the nation's pandemic response from the start.

Federal officials acknowledged to POLITICO they are aware of the syringe problem, though did not comment on whether it stemmed from supply chain issues. "Operation Warp Speed is quickly evaluating options to reconfigure the accompanying ancillary supply kits to accommodate the potential additional doses," according to an HHS spokesperson.

HAPPENING THURSDAY - THE COVID-19 VACCINE ROLLOUT: What are the logistical challenges facing the coronavirus immunization campaign? Who is overseeing the process and working to overcome obstacles to ensure that vulnerable groups have access to the vaccine? Join POLITICO for a virtual discussion on the outgoing Trump administration's plan to prioritize lower-income, rural, and communities of color for vaccine distribution and what the Biden administration can do to streamline plans and fill in any gaps. REGISTER HERE.

Coronavirus

WHO PROMISES UPDATE ON CHINA MISSION DATES THIS WEEK — World Health Organization director-general Tedros Adhanom Ghebreyesus pledged on Friday that reporters would get an update this week on the international mission into the origins of Covid-19, POLITICO "Global Pulse" author Carmen Paun reports. Two experts had begun travel to China last week before WHO discovered that China had not finished all procedures for the mission, forcing the experts to return home, WHO emergencies chief Mike Ryan said. Other experts hadn't yet been granted a visa last week.

Pressed on why China didn't allow the experts in, Foreign Ministry Spokesperson Hua Chunying suggested that local outbreaks of the virus in China were occupying officials' time, Carmen writes. A Chinese health official this weekend insisted that the nation is "enthusiastic, open and supportive" about the WHO's visit, the South China Morning Post reports.

Inside the Humphrey Building

CMS MOVES TO MAKE IT HARDER TO ERASE CONSERVATIVE MEDICAID CHANGES — The agency is laying out a new, nine-month process for killing Medicaid waivers that's likely to complicate efforts by the incoming Biden team to quickly overturn conservative revisions to the safety-net program, Rachel writes.

CMS Administrator Seema Verma is asking states to sign an agreement "as soon as possible" to lock in a lengthy process if the agency decides to terminate, amend or withdraw a state's Medicaid experiment in the future, according to communications reviewed by POLITICO. Multiple Medicaid advocates viewed the letter as an attempt to make it harder to erase controversial policies approved by the Trump administration. CMS didn't respond to a request for comment.

"It really amounts to nothing more than a power grab," said Joe Weissfeld, the Medicaid initiatives director at Families USA, a consumer advocacy group. "It is just an added bureaucratic layer that is seemingly attempting to again constrain an incoming administration."

MEANWHILE...the effort comes as the Trump administration, in its waning days, approved the first-ever Medicaid block grant in Tennessee, a long-sought conservative overhaul of the safety-net program.

"A terrific development," Avik Roy, the president of the Foundation for Research on Equal Opportunity, wrote in a Twitter thread. "Rest assured your favorite drug lobby, which purports to be all about free markets and against socialism, will be up in arms about CMS's move, which gives states the flexibility *not* to be forced to pay for the industry's products."

But the plan likely tees up a legal challenge from Medicaid advocates, who have panned the move, and Biden may look to roll it back.

"There's no time like the present," tweeted the Tennessee Justice Center, a non-profit public interest law and advocacy firm. "We must act to #stoptheblock with everything we've got - keeping in mind that healthcare cuts for nursing home residents, those in need of mental health assistance and care for kids with disabilities hang in the balance."

CALDER LYNCH EXITS — The acting CMS chief of staff departed on Friday, a move that the Trump appointee had planned before last week's chaos at the Capitol, according to an official with knowledge of his thinking.

Lynch was a top ally of CMS chief Verma and was tapped as Medicaid director in January 2020, serving in that role for much of the pandemic. He extolled the team's work on Covid-19 in a goodbye email to Medicaid staff obtained by PULSE, touting "hundreds of approvals of waivers and emergency flexibilities, a veritable trove of guidance [and] a playbook that captured our best lessons to strengthen our resiliency for future emergencies," among other initiatives.

Lynch also criticized the pro-Trump rioters who stormed the Capitol and the "rhetoric" that egged them on, though he did not mention Trump by name. "Political disagreements or competing policy views on how we achieve our goals is a normal and healthy part of this process. What we witnessed this week, and divisive rhetoric that fueled these actions, is not," he wrote.

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.

Names in the News

JENNIFER SULLIVAN ON 2021 GOALS FOR INDIANA — Sullivan, an emergency physician who this weekend marked her four-year anniversary as the state's Family and Social Services Administration secretary, told PULSE that top priorities include evaluating race equity policies, having just hired a new chief health equity officer, as well as better integrating social drivers of health in care delivery, long-term care reforms, strengthening the mental health network and expanding community health workers and paramedicine. "We have a huge agenda this year," Sullivan allowed.

AUSTIN FRAKT named editor-in-chief of Health Services Research. Frakt, a New York Times contributor and the director of the VA's Partnered Evidence-based Policy Resource Center, will now oversee the flagship journal of the Health Research & Educational Trust.

KEEP UP WITH THE FIRST 100 DAYS OF THE BIDEN ADMINISTRATION WITH TRANSITION PLAYBOOK: It was a dark week in American history, and a new administration will have to pick up the pieces. Transition Playbook brings you inside the last days of this crucial transfer of power, tracking the latest from President-elect Biden and his growing administration. Written for political insiders, this scoop-filled newsletter breaks big news and analyzes 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.

What We're Reading

"We lost to SARS-CoV-2 in 2020. We can defeat B-117 in 2021," MIT's Kevin Esvelt and Harvard's Marc Lipsitch argue in Stat.

A seeming success story: The vaccine rollout is going smoothly in Connecticut, WSJ's Joseph De Avila writes.

The post-holiday surge in coronavirus means that Northern California providers are seeing more COVID-19 patients with no underlying health conditions, Tatiana Sanchez writes for the San Francisco Chronicle.

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