Friday, October 1, 2021

The pill that could change the Covid fight

Presented by the American Cancer Society Cancer Action Network: Tomorrow's conversation, tonight. Know where the news is going next.
Oct 01, 2021 View in browser
 
POLITICO Nightly logo

By Renuka Rayasam

Presented by the American Cancer Society Cancer Action Network

With help from Kathryn A. Wolfe

Merck corporate headquarters in Kenilworth, N.J.

Merck corporate headquarters in Kenilworth, N.J. | Seth Wenig, File/AP Photo

HOME REMEDY The arsenal in the fight against Covid just gained a new weapon.

Merck announced today that Covid patients might soon get a way to treat the virus at home, with a pill. The drugmaker said it is seeking FDA authorization for its experimental, antiviral drug molnupiravir, which works by keeping the virus from replicating.

Another Covid treatment is big enough news on its own — the virus is still killing nearly 2,000 people a day in the U.S. But the potential approval of a Covid treatment pill is even more exciting considering that monoclonal antibodies, the only other effective outpatient Covid treatment, is kind of a pain to get.

To get the antibodies, a doctor often has to fill out a bunch of paperwork and then find the patient a spot at an infusion center. The antibody treatment, which mimics naturally produced antibodies and targets Covid's spike protein, requires a 25-minute intravenous infusion plus an hour of post-treatment waiting. The treatment, which former President Donald Trump received after testing positive for Covid last year, also costs about $2,100 a dose.

Merck's molnupiravir, by contrast, would require patients to get a pack of pills they take at home. So far the Merck drug seems to be less effective than monoclonal antibodies, but it could free up space at infusion centers and hospitals for the sickest patients. More important, the pills would reach patients in the U.S. and around the world who might not have access to monoclonal antibodies at all.

"It's a big deal," said Thomas Holland, an infectious disease specialist at Duke University. Holland downplayed the logistical hassles of prescribing monoclonal antibodies — Duke built a system to make the process easier — but agreed that prescribing and taking a pill is way easier than dealing with an intravenous infusion.

Fast testing will be critical to molnupiravir's effectiveness , if approved, said Robert Shafer, an infectious disease specialist at Stanford University. In trials, patients received the Merck drug within five days of testing positive. Antivirals generally work better the earlier they are taken, Shafer said.

"One day can make a difference," he said. That's why some doctors will prescribe Tamiflu and a flu test at the same time for certain people who have symptoms — patients start on the drugs before the test comes back positive.

Because molnupiravir is so new and won't be fully approved for a while, doctors won't use it on patients that don't have a positive Covid test, Shafer said.

Merck tested the drug in patients with at least one Covid risk factor such as being older or obese. And that's likely the group that doctors will use it on for now.

Merck is also testing molnupiravir as a prophylactic in patients who were exposed to Covid , before they have a positive test to see if the drug can keep people from preventing Covid. Over time, Shafer hopes, it could even be studied to see if it will keep people from developing long Covid.

There's still at least one other risk to an easier Covid treatment — the chance that people will refuse vaccines and opt for a pill to treat their symptoms.

"It's reasonable to worry about that," Holland said. "But the better thing is not to have Covid in the first place."

Welcome to POLITICO Nightly. Reach out with news, tips and ideas for us at nightly@politico.com. Or contact tonight's author at rrayasam@politico.com and on Twitter at @RenuRayasam.

 

A message from the American Cancer Society Cancer Action Network:

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides lifesaving cancer screenings in low-income communities, but fewer than 2 in 10 eligible individuals received breast or cervical cancer screenings through this critical safety net program. Lawmakers must take action to end this divide in access to cancer prevention, early detection and treatment. Increased funding for the NBCCEDP will help more individuals get the cancer care they need—and help end this alarming divide.

 
On the Hill

THE SILENT SHUTDOWN — Transportation editor Kathryn A. Wolfe emails us:

It's the shutdown you never heard about (unless you read POLITICO).

Plenty of lawmakers breathed obvious sighs of relief once Congress decided to delink the debt limit from a bill to keep the government open and running. That bill was cleared Thursday, ending the possibility that federal workers would be furloughed.

Except about 3,700 of them at the Transportation Department just were.

Why? Because those few thousand workers aren't paid out of yearly appropriations. Instead, they're paid out of a trust fund that's fueled by mostly gasoline taxes, the authorization for which expired at midnight today, when the House punted voting on the $550 billion infrastructure bill everybody's been talking about. That bill contains the authorization for money to be expended from the trust fund account, and unless it gets authorized, people who are paid out of it have to stay out of work as of today.

If the shutdown is short — and there are indications that it could be resolved as early as tonight — the impacts are probably minimal. Outside of the furloughs, a short shutdown would not greatly affect states' ability to make plans for projects based on money from the trust fund, for example. But it's an object lesson in congressional dysfunction that a shutdown nobody wanted happened because the Democratic leadership insisted that they had the votes to move the bill forward even when they didn't, making the small step of moving even a short-term patch tantamount to admitting defeat on their big priority.

 

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What'd I Miss?

— Infrastructure vote 'ain't going to happen' until agreement on larger plan, Biden says: President Joe Biden pushed for Democrats to support a total cost of between $1.9 trillion and $2.3 trillion for the party's broader spending bill in a caucus meeting today, according to multiple sources in the room. It's the latest twist in last-minute drive to get progressives to vote for a bipartisan infrastructure bill and salvage his legislative agenda, as House Democrats continue feuding over the path forward for a pair of key bills.

— Justice Kavanaugh tests positive for Covid-19: Supreme Court Justice Brett Kavanaugh has tested positive for Covid-19, the court said in a news release today. Kavanaugh learned of his test results Thursday evening after being tested earlier in the day as part of the court's "regular testing protocols" ahead of fellow Justice Amy Coney Barrett's formal investiture ceremony today, the Court said.

— California to mandate student vaccines once FDA gives formal approval: Gov. Gavin Newsom announced today that California will mandate student vaccines for Covid-19 once federal officials fully approve the immunizations , becoming the first state to declare that requirement, though it likely will not take effect until next school year. Under the plan, California will add Covid-19 vaccines to its list of immunizations required for school attendance in the first academic term after the Food and Drug Administration approves the shots for students in a given age band, split between grades 7-12 and K-6. The governor's office estimates that middle- and high-schoolers will need to get vaccinated before the 2022-23 school year starts.

— Pence plans return trip to Iowa in November: Former Vice President Mike Pence is headed to Iowa next month as he ramps up his national travel schedule ahead of a potential 2024 White House bid. Pence will appear at the University of Iowa on Nov. 1 to speak at an event hosted by the Young American Foundation. Pence has been active with the conservative organization since Trump's administration ended in January.

— Feds, Texas square off in court over novel abortion law: The Justice Department asked a federal court today to block a Texas law that relies on an unusual, private enforcement mechanism to try to limit the availability of abortion in the state . During a three-hour hearing held by video before Austin-based U.S. District Court Judge Robert Pitman, lawyers battled over a lawsuit the Biden administration filed last month to try to neutralize the Texas anti-abortion measure, known as Senate Bill 8.

 

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Ask The Audience

Nightly asked you: Has the Delta variant led you to change you or your family's Thanksgiving or holiday plans? Your select, lightly edited responses are below:

"No! We live in a part of California where people are responsible — got vaccinated, wear masks — so we have a very low Covid rate here. We will be gathering with vaccinated friends and family." Nancy Foster, retired, Pasadena, Calif.

"Not yet … but we will see how it progresses. Right now, it seems like cases are waning, but as this pandemic seems to have told us, nothing is off the table." — Lauren Winterhalder, account executive, Washington, D.C.

"Definitely. Even though I am vaccinated, I will not risk traveling now with all of the people who have not been vaccinated. People do not want to wear masks. (How difficult is that?) Without everyone uniting to combat Covid, this will just continue to evolve." — Christine Wilk-McFadden, retired, Pittston, Pa.

"Mostly all the family is vaccinated, but not all. Holidays are stressful enough of their own accord. I am of the mindset that procrastinating holiday decisions is where I am today." — Ann Brandon, retired, Fort Collins, Colo.

"We are not going to visit any family or friends, and will just hang out at our home." — Bill Sadler, public health, Los Angeles

"Absolutely not. We gather as a large family group for Thanksgiving, and we had already required vaccinations and masking for everyone." — Beth Jacobs, retired, Chicago

 

BECOME A GLOBAL INSIDER: The world is more connected than ever. It has never been more essential to identify, unpack and analyze important news, trends and decisions shaping our future — and we've got you covered! Every Monday, Wednesday and Friday, Global Insider author Ryan Heath navigates the global news maze and connects you to power players and events changing our world. Don't miss out on this influential global community. Subscribe now.

 
 
Nightly Number

91

The age of Pat Robertson, who announced he was stepping down as the long-running host of the "700 Club." Robertson, who turned a tiny Virginia television station into a global religious broadcasting network, said in a statement that he hosted the network's flagship program for the last time today, and that his son Gordon Robertson will take over the weekday show starting on Monday.

PUNCHLINES

REDRAWING THE POLITICAL MAPIn a week highlighting congressional dysfunction, Matt Wuerker's Weekend Wrap of the latest in political satire and cartoons has plenty on the action on the Hill, in addition to takes on border security and climate change.

Matt Wuerker's Punchlines Weekend Wrap video on political satire and cartoons

Parting Words

"Imagine relearning how to groom yourself in your mid-40s. People talk about running for office or running for president as an act of leadership. I'm not so sure about that. I actually think that in many respects running for president requires qualities that would make you a terrible leader."

— Andrew Yang, in an article coming this weekend in POLITICO Magazine

Andrew Yang speaks to POLITICO after the Democratic Debate on Dec. 19, 2019 in Los Angeles.

Andrew Yang speaks to POLITICO after the Democratic Debate on Dec. 19, 2019 in Los Angeles. | Stephen Voss for POLITICO

 

A message from the American Cancer Society Cancer Action Network:

For every person who has cervical cancer detected early through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), nine others don't have the chance. We must end this divide.

The NBCCEDP provides lifesaving cancer screenings in low-income communities and to uninsured and underinsured Americans, but fewer than 2 in 10 eligible people received breast or cervical cancer screenings through this critical safety net program. Increased funding for the NBCCEDP can help ensure more people get the care they need from the program and may even save states money on treatment costs when cancer is detected at earlier stages.

Tell Congress to take action and prioritize health. Tell Congress to increase funding for the NBCCEDP.

 

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