STATES STRUGGLE MONTHS AFTER BIDEN COVID SURGE — States such as Alabama and Louisiana still are struggling with unsustainable Covid-19 caseloads that are stretching their funding, months after President Joe Biden in early July promised to send federal response teams to help struggling states. What happened: The federal officials Biden promised arrived only after Delta had already begun to take hold, Erin Banco writes. And state officials said the personnel sent to help track and prevent the spread of the variant, including CDC experts, couldn't fix the systemic problems public health departments faced in investigating outbreaks. The federal deployments also were limited to a handful of states in the Midwest and South experiencing the most severe outbreaks, forcing officials to work with outside contractors to quickly hire more doctors and nurses at local hospitals. States that didn't get staffing help received supplemental funding — but couldn't find enough doctors and health workers to fill gaps at hospitals. “When you have Hurricane Ida and then you have 50 states that are all having surge and you're doing that in the midst of having health care shortages throughout the country, then it really becomes hard to get resources into your state,” said Umair Shah, the secretary of health at the Washington State Department of Health, adding that states were “in essence competing with all the other states.” The current landscape: The administration to date has sent 1,500 federal personnel to respond to the Delta surge, including physicians, nurses, paramedics, EMTs and public health experts, according to the White House. As of last week, 917 are on the ground — the majority are clinical personnel supporting patient care. The teams “indubitably have helped to save lives and accelerate the nation’s recovery efforts,” a White House spokesperson told Politico. A senior administration official told Erin that HHS public health and medical personnel are currently supporting efforts on the ground in Arizona, Oklahoma, Kentucky, Wyoming and Tennessee. But it is unclear how many individuals have been sent to those states and whether they are specifically helping with hospital staffing. And a recent burst of cases in Alaska — the highest spike in the U.S. since the pandemic began — sparked HHS to dispatch another team. FDA PANEL BEGRUDGINGLY BACKS MORE BOOSTERS — The expert panel’s unanimous votes in favor of Moderna and Johnson & Johnson booster doses — especially the J&J vote — may have surprised some people. But the clean vote belied several scientists’ frustration. Both days, experts on the FDA’s Vaccines and Related Biological Products Advisory Committee questioned the broad need for boosters and voiced concern about offering an extra shot to young adults and teens because of myocarditis risk. After each vote, multiple scientists piped up to say that while they voted “yes,” the data were thin and they are still unconvinced on boosting everyone. J&J especially had a tough grilling when committee members questioned why they would make a sweeping recommendation based on data for so few people. Agency officials like vaccine chief Peter Marks admitted they don’t have all the answers, including how long protection lasts. What happens now: The next major hurdle is how to navigate mixing vaccine brands, especially as J&J recipients (like your authors) contend with recent data showing that we’d benefit more from a messenger RNA shot like Pfizer’s or Moderna’s. FDA doesn’t generally recommend mixing vaccines like this and might not make a move unless J&J applies for it. Amanda Cohn, the CDC’s representative to the panel, suggested including flexible language in a future emergency use authorization or in the vaccines’ fact sheets allowing people to make decisions based on their circumstances. The CDC’s Advisory Committee on Immunizations Practices meets Thursday to discuss Covid-19 vaccines. A cutoff age could also come up in that meeting, since FDA’s panel suggested limiting boosters to people as young as 30 or even 40 years old to minimize myocarditis risk more pronounced in younger people. But is all that going to further complicate vaccine messaging and administration? “No shit,” one senior Biden administration official told Pulse. | 
