Monday, January 3, 2022

How Biden could have prepped for Omicron

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Jan 03, 2022 View in browser
 
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By Myah Ward

Stamford city workers hand out free at-home Covid-19 test kits in Stamford, Ct.

Stamford city workers hand out free at-home Covid-19 test kits in Stamford, Ct. | John Moore/Getty Images

WHAT WE DIDN'T DO IN 2021 Here we go again: The U.S. is breaking daily Covid case records. Tests are hard to come by. Some school districts have closed classrooms because of rampant spread. Everyone knows someone who has the virus.

Nightly asked public health experts what the Biden administration could or should have done differently to prepare for this moment. Read their edited responses below.

"The Biden administration should have explicitly articulated and adopted a harm reduction approach to Covid-19. Such a stance would help Americans learn how to risk-calculate their activities around what is a ubiquitous and unavoidable infection. Harm reduction could be accomplished much easier with wider availability of rapid home diagnostic tests — these technologies make it so much easier for people to gauge the risks of social interaction.

"The supply constraints we now face are not excusable, were completely predictable, and had been evident months ago. The country and the administration needs to explicitly come to terms with the fact that the post-pandemic world is not 2019 but a world in which Covid-19 is ever present but manageable due to the knowledge and tools — vaccines, monoclonal antibodies, antivirals and rapid tests — scientists and physicians have provided us." Amesh Adalja, senior scholar at the Johns Hopkins Institute for Health Security

"The biggest mistake the Biden administration made was to push a vaccines-only approach, rather than a 'vaccines-plus,' including rapid tests, improving indoor air quality, and distributing high-filtration masks ubiquitously, coupled with public indoor mask mandates for high-risk shared spaces.

"Vaccines-only suffers from a key weakness: variants. And we have now seen this play out with Omicron. We have wildfire spread as our current vaccines do not provide sterilizing immunity — meaning, people can and do still transmit the virus effectively.

"Rapid tests can stop public super-spreading by keeping very infectious people home. Better indoor air quality and ventilation/air filtration measures can pull infectious aerosols out of the air regardless of what variant they are carrying. And high-filtration masks can stop people who are contagious from exhaling as much virus in the air and prevent uninfected people from inhaling that virus-laden aerosol, regardless of variant.

"It feels like we are caught unprepared again. The CDC still won't address why respirators aren't being recommended or provided to the public despite a 2008 mask model by 3M that was meant exactly for a pandemic virus emergency. (I wear a relative of that model daily, and it's very comfortable.) By putting most eggs in the vaccine basket, we are where we are again." Abraar Karan, infectious disease fellow at Stanford University

"Overall the Biden administration has performed well in responding to the pandemic except for two major deficiencies. First, with no coherent plan to vaccinate the world, especially the Southern Hemisphere or the Global South, we've allowed new variants of concern to emerge. The most obvious is Omicron out of Africa. This never had to happen if the U.S. exerted leadership and got the G-7 to vaccinate globally by now. Hopefully our new recombinant protein Covid vaccine with Biological E in India will begin filling that gap. Second, the Biden admin still has not attempted to counter the anti-vaccine aggression from the far right, choosing instead softer targets like Facebook or other social media outlets. But it's not working." Peter Hotez , dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Texas Children's Hospital Center for Vaccine Development

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"It's easy to criticize from the outside but hard to do better when you understand the constraints from the inside. We're in a tough moment with Omicron both in the United States and globally. If anyone says they know what's coming next with Covid, they don't know what they're talking about. Hindsight is always 20/20; it's important not to underestimate how hard it is to get these decisions right. We learn more each day and need to continue to adapt our response based on data and information as it evolves.

"The major lapse, in my opinion, is CDC not speaking directly from Atlanta with Dr. Walensky and also subject matter experts to explain what we are learning when we learn it, and more detail about what is being recommended and why. The CDC has many of the world's leading experts on these topics and hearing directly from them can help increase public understanding.

"Because we have not globally expanded manufacturing of Moderna's mRNA technology, which was developed by NIH and paid for by the U.S. taxpayer, the U.S. and the world are at serious risk if future variants that escape vaccine-induced immunity and are more severe emerge.

"We've also underappreciated the benefit of masks at blunting the spread of Covid. The Biden administration could also be messaging about the effectiveness of different types of masks, while doing more to improve cost and quality control." Tom Frieden, former CDC director and president and CEO of Resolve to Save Lives, a global public health initiative

"There are two measures that should've been taken sooner to meet this moment in the pandemic. First, redefining the term 'fully vaccinated' to 'up-to-date' when booster doses became more of an apparent need to the general public back in November. This shift in just the terminology would've prompted more people to get booster doses knowing it's part of a vaccination regimen rather than an ad hoc dose that may or may not be needed. Second, increasing testing capability and making at-home rapid antigen test kits more widely available for public health surveillance purposes. Just like vending machines, we should've had Covid-19 testing much more accessible for the general public to pick one up as needed." Syra Madad, infectious disease epidemiologist at the Harvard Belfer Center

"I think not making bigger investments in rapid and point of care testing, and not making more of a push to open up vaccine patents and make vaccines available to everyone, anywhere in the world, for free were huge missed opportunities. Also, not pushing harder for the continuation of Covid-related benefits like the child tax credit, small business support and expanded unemployment have all contributed to the slow progress against Covid-19." Jon Zelner, epidemiologist at University of Michigan School of Public Health

"First, a winter surge is expected, so ensuring we had more testing available, targeted education, and vaccine initiatives in place should have been planned far earlier than Omicron. Accessible and affordable testing is critical and clearly an area the U.S. has struggled with. In the face of a novel variant of concern, that should have also been the impetus to ramp up testing and vaccination efforts, but it seemed a bit delayed. Lastly, changing CDC guidance with such a drastically shortened isolation period with little research behind it, during a surge and a highly transmissible variant is one that could have been avoided — we could have waited to make changes until after such challenging times without impacting trust in the CDC." Saskia Popescu, epidemiologist with George Mason University and the University of Arizona

What'd I Miss?

— FDA authorizes Covid boosters for teens 12-15: The Food and Drug Administration authorized Covid-19 booster shots today for adolescents ages 12 to 15, the latest step by the U.S. government to green-light more vaccine doses for younger Americans . Regulators shortened the timeframe between completion of the primary vaccination series with the Pfizer-BioNTech shot — the only one authorized for anyone 12 and older — and when someone can get a booster to at least five months, down from six months. The FDA cited lab studies suggesting boosters improve individuals' antibody response to the Omicron variant, as well as data of millions of Israeli citizens 16 and older who got boosters after at least five months, as justification for tightening the window.

— Schumer tries to jump-start Dems with rules change threat: Chuck Schumer is attempting a filibuster Hail Mary as Democrats' agenda on both elections reform and Biden's economic plans remains stalled at the beginning of a critical midterm election year . The Senate majority leader warned today that the Senate will debate and vote on changes to the chamber's rules by Jan. 17, Martin Luther King Jr. Day, unless Republicans get out of the way on elections reform. His threat seems inevitable, because Republicans are almost certain to block Democrats' next attempt to bring up their priority legislation.

— New York attorney general issued subpoenas to Ivanka, Don. Jr.: The New York attorney general's office has subpoenaed Ivanka Trump and Donald Trump Jr. as part of its ongoing investigation into the former president's business operation. The subpoenas were issued "in connection with an investigation into the valuation of properties owned or controlled by Donald J. Trump or the Trump Organization," according to the court document filed today.

— Longtime New Hampshire secretary of state retiring: Bill Gardner, the longtime New Hampshire secretary of state who has served as his state's chief elections official since 1976, announced today that he would be stepping down in the coming days. Gardner, a Democrat, has been a staunch defender of New Hampshire's place at the top of the presidential nominating calendar as the first state to hold its primary. Perhaps most memorably, he threatened to move the state's 2012 presidential primary to December of 2011 when Nevada tried to encroach on New Hampshire's spot at the top of the calendar that year.

— Capitol Police union douses private security proposal: The U.S. Capitol Police union is sharply criticizing a new proposal by department leadership to add private security contractors to protect the Capitol , calling the plan "a recipe for disaster." "We need to hire more officers — period. The last thing we need are private security contractors who are not trained to our standards," Gus Papathanasiou, the chair of the union, said in a statement first shared with POLITICO. "In law enforcement, we have to trust the men and women next to us. That trust enabled us, along with our partner agencies, to hold back the attackers on January 6th long enough to safely evacuate all Members of Congress and the Vice President."

 

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.

 
 
AROUND THE WORLD

Hungarian Prime Minister Viktor Orban

Hungarian Prime Minister Viktor Orban | Omar Marques/Getty Images

B-PEST — Former President Donald Trump endorsed Hungarian Prime Minister Viktor Orbán for reelection — throwing his support today behind a far-right, nationalist leader who has defied America's allies in Europe and moved to consolidate control over the media and judiciary.

"Viktor Orbán of Hungary truly loves his Country and wants safety for his people," Trump said in a statement. "He has done a powerful and wonderful job in protecting Hungary, stopping illegal immigration, creating jobs, trade, and should be allowed to continue to do so in the upcoming Election. He is a strong leader and respected by all. He has my Complete support and Endorsement for reelection as Prime Minister!"

Trump's endorsement of Orbán is not the first time the former president has backed the political campaign of a populist foreign leader accused of eroding democratic norms and embracing authoritarian governance. Last October, Trump announced his support for Brazilian President Jair Bolsonaro's reelection bid.

Biden, by contrast, has taken a tougher line against Orbán. Ahead of his virtual Summit for Democracy last month, Hungary was the only European Union member state to which the president did not extend an invitation.

Nightly Number

13 percent

The positivity rate for those tested for Covid-19 at the Capitol, according to the congressional attending physician today. The majority of the cases have been the Omicron variant.

Parting Words

KYIV NOT BINGE WATCHING — Ukraine's culture minister has complained to Netflix about the portrayal of a character from Kyiv in the hit show "Emily in Paris."

"We have a caricature image of a Ukrainian woman that is unacceptable. It is also insulting," Oleksandr Tkachenko wrote in a Telegram post. "Is this how Ukrainians are seen abroad? They steal, want to get everything for free, be afraid of deportation? That should not be the case."

The character in question is Petra, played by Daria Panchenko (who is from Ukraine), who fears deportation, shoplifts and is portrayed as having poor fashion sense, Thibault Spirlet writes. "Emily in Paris" is about an ambitious marketing executive from Chicago who unexpectedly lands a job at a Paris firm that handles luxury brands.

This is not the first time the show has come under fire for its clichéd and stereotypical depictions. "The berets. Croissants … Quote a cliché about France and the French: you will find it in 'Emily in Paris,'" wrote the website 20 Minutes when the show first appeared last year.

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