Tuesday, December 21, 2021

Biden tries to teach to the Covid test

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Dec 21, 2021 View in browser
 
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By Renuka Rayasam

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Cars lineup at a drive-thru Covid-19 testing site at Tropical Park in Miami.

Cars lineup at a drive-thru Covid-19 testing site at Tropical Park in Miami. | Joe Raedle/Getty Images

HOLIDAY HOMEWORK — By the time the Biden administration makes 500 million at-home, rapid Covid tests available to the public, we will be deep into our post-holiday hangovers. The festivities will be over, and unvaccinated Omicron patients will be filling hospital beds.

And the number of tests — which adds up to not even two for every American — will barely make a dent in the country's overall testing infrastructure, especially given how quickly Omicron can spread.

"It's a speck in the ocean," said Eric Topol, director of the Scripps Research Translational Institute, who estimates that the country will actually need billions of tests in order to contain Covid spread.

The free Covid tests will help people make decisions about whether to gather more safely or attend school or work. Yet early studies show that an Omicron infection replicates about 70 times faster than Delta, so an infected person could show a negative test in the morning then be infectious by the time an evening party rolls around.

There are "worrisome signs" that, with Omicron, a symptomatic person could initially test negative, meaning they would need to test multiple times to make sure they are not infectious, said Michael Mina, a former Harvard epidemiologist who is chief science officer at eMed, a company promoting rapid at-home testing, on a call with reporters today.

The criticism about how often to test obscures bigger questions about what to do after the test, said Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Center for Health Security.

"Our problems are not just about technology," she said. "It's about the absence of a strategy."

Even if the administration were to blanket the country with billions of tests, there would still need to be updated guidance on how to react to test results, as well as better incentives to convince people to get tested, public health experts said.

On the first point, there are glimmers that new advice is on the way. The CDC is considering cutting isolation time down from 10 days for fully vaccinated individuals who test positive for Covid but don't show symptoms. The agency endorsed a new approach last week that keeps unvaccinated kids in schools through testing.

But on the second point, the country still has a long way to go.

For some people, a positive test doesn't mean just missing out on a party or canceling a flight. Those who miss work and lose out on pay after a positive test or who can't follow guidelines because they have nowhere to isolate probably aren't going to get tested. Even NFL players under the league's new guidelines may not report a sore throat for fear of getting a positive test and missing a game, said Asaf Bitton, executive director of Ariadne Labs and associate professor of health care policy at Harvard.

"A true pandemic response should include a way to incentivize someone to isolate," Mina said.

The country continues to underinvest in public health infrastructure that would help more Americans safely quarantine with paid time off and a place to go, Bitton said. The U.S. would rather invest in equipping hospital systems with the latest technology than simpler tools that help people from getting sick in the first place, he said.

"All of Covid — and this testing microcosm of Covid — show we invest in a sick care system," Bitton said.

At least one big incentive for rapid, at-home tests is coming later this week when the FDA is expected to approve the first pills to treat Covid, which need to be taken early in the illness.

"It is the most important thing we have seen since the vaccines to get us out of the pandemic," Topol said about the coming Covid therapies.

Welcome to POLITICO Nightly. It looks like many of you spent quite a bit of time reading POLITICO journalism this year: Chartbeat's Most Engaging Stories of 2021 included three POLITICO stories in its top 10 articles — including two of the top five — that readers spent the most time interacting with over the past 12 months. Reach out with news, tips and ideas at nightly@politico.com. Or contact tonight's author at rrayasam@politico.com, or on Twitter at @RenuRayasam.

A programming note: Nightly won't publish from Friday, Dec. 24 to Friday, Dec. 31. But don't fret: We'll be back and better than ever on Monday, Jan. 3.

 

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What'd I Miss?

— Education Department considers extending student loan relief: The Biden administration is considering extending the freeze on federal student loan payments amid the surge of Covid cases and pushback from Democrats who objected to sending student loan bills to tens of millions of Americans in the coming weeks. Education Department officials have for months publicly insisted that student loan payments would begin on Feb. 1 when the existing pandemic relief — which was extended several times by both the Trump and Biden administrations — is set to expire. But today, an Education Department official indicated that the restart of student loan payments could again be postponed.

— Democrats not yet ready to trim climate ambitions: Democrats aren't giving up yet on their hopes to go big on climate change — once they can figure out where Sen. Joe Manchin's red lines are . A day after the West Virginia senator abruptly repudiated their $1.7 trillion climate and social spending package, progressive Democrats were still holding out hope that Manchin might agree to a sweeping series of tax credits aimed at encouraging a transition to clean energy. But they don't know how close that might be to the House-passed reconciliation bill's $550 billion in overall climate and clean energy incentives — more than $300 billion of which was directed toward tax credits. And there are still unsettled questions on some of the finer details of the tax credits, most notably on providing extra credits for electric vehicles made by unionized labor, which Manchin said was "not American."

— NHL reportedly set to withdraw from Olympics after Covid surge: The NHL will withdraw from the Winter Olympics after the league's regular-season schedule was disrupted by coronavirus outbreaks , a person with direct knowledge of the decision told The Associated Press today. The NHL informed the NHLPA today that it was retaining its right to withdraw from Olympic participation because there was a material disruption to the season, the person said. The NHLPA was not going to dispute the decision.

 

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— Boston mayor lines up vaccine mandates despite pushback from city workers: Mayor Michelle Wu's sweeping new vaccine mandates for restaurants, gyms and city workers are drawing mixed reactions from businesses and public employees as local officials scramble to blunt the latest Covid-19 surge. Patrons and staff at certain indoor spaces — restaurants, bars and nightclubs; gyms and fitness centers; and entertainment venues such as theaters and sports arenas — will have to show proof of at least one vaccine dose by Jan. 15 and two by Feb. 15. Wu is also requiring all city employees to get vaccinated along the same timeline unless granted an exemption — a departure from the previous policy that gave workers the option of weekly testing.

— Biden Justice Department reverses on returning federal convicts on home detention to prison: Under intense pressure from criminal justice reform advocates, the Justice Department has reversed a Trump-era legal opinion that could have required several thousand federal convicts to return to prison from home confinement if the Biden administration declares an end to the pandemic-related national emergency. The new opinion from the Justice Department's Office of Legal Counsel meets demands from reformers and lawmakers that officials find a way to allow prisoners who've typically been living at home for a year or more under pandemic-related legal authorities to remain at home to serve out the remainder of their sentences.

— Fauci rebukes Fox News host: Fauci, the nation's top infectious disease expert, called on Fox News to fire host Jesse Watters for saying earlier this week that attendees of a conservative conference should "ambush" him with a "deadly" rhetorical "kill shot" question . "That's awful that he said that. And he's going to go, very likely, unaccountable," Fauci told CNN of Watters' remarks. "I mean, whatever network he's on is not going to do anything for him. I mean, that's crazy. The guy should be fired on the spot." Speaking on Monday at Turning Point USA's AmericaFest conference, Watters encouraged attendees to ask Fauci dubious questions about the National Institutes of Health allegedly funding "gain-of-function" research at the Wuhan Institute of Virology.

 

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AROUND THE WORLD

A Ukrainian soldier uses a hand-held periscope to view the positions of Russian-led forces in Zolote, Ukraine.

A Ukrainian soldier uses a hand-held periscope to view the positions of Russian-led forces in Zolote, Ukraine. | Brendan Hoffman/Getty Images

DOD REJECTS MOSCOW CLAIMS — The Pentagon is flatly rejecting Russian Defense Minister Sergei Shoigu's claim that American military contractors are smuggling chemicals into eastern Ukraine to incite a "provocation," Paul McLeary writes.

Shoigu's comments came during a meeting in Moscow today with the country's top military officials and President Vladimir Putin, who issued new threats against NATO if the alliance continues with unspecified "aggressive steps."

The suggestion that U.S. contractors were smuggling "tanks with unidentified chemical components" into Ukraine's Donetsk region was met with a swift response from the Pentagon, where spokesperson John Kirby said "those statements by Minister Shoigu are completely false."

The rhetoric coming out of Moscow has been increasingly aggressive, and it appears meant to portray a sense of helplessness in Russia in the face of NATO expansion. In recent months, Russia has massed about 100,000 troops, along with advanced artillery, logistics and support elements that could support a major thrust over the border into Ukraine.

 

STEP INSIDE THE WEST WING: What's really happening in West Wing offices? Find out who's up, who's down, and who really has the president's ear in our West Wing Playbook newsletter, the insider's guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won't find anywhere else, subscribe today.

 
 
Nightly Number

0.1 percent

The growth of the U.S. population in 2021, the slowest rate since the nation was founded in the 18th century, according to data from the U.S. Census Bureau . The Census Bureau attributed the slow population growth to the Covid-19 pandemic, though the country has been experiencing low birth rates and net migration for several years.

Parting Words

Shoppers visit the Dolphin Mall in Miami.

Shoppers visit the Dolphin Mall in Miami. | Joe Raedle/Getty Images

ECONOMY FACES COLD WINDS — Wall Street forecasters are dialing back their growth projections for next year as fading hopes for the president's sweeping economic agenda and heightened concerns about the new Covid variant have suddenly clouded the outlook, Kate Davidson writes.

The twin blows are coming on top of a fiscal drag that was already expected in 2022 as support from earlier economic-relief efforts has wound down. That creates even more challenges for Democrats in an election year in which they're struggling to maintain control of Congress.

"It can't be good for Democrats' chances in the midterms," Mark Zandi, chief economist at Moody's Analytics, said of the possibility that Biden will fail to get his signature policy proposals across the finish line. "On one level, the economy is going to be growing more weakly, particularly as we head into the election, because that's when fiscal headwinds are going to be blowing the hardest. It also makes it harder for Democrats to argue they're getting things done."

Those headwinds are also coming at a delicate time for the Federal Reserve as it moves to withdraw its massive aid to the economy to bring spiraling inflation under control. If overall growth slows markedly, the central bank would have much less of a cushion to raise interest rates without injuring the broader economy.

 

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