The public emergency isn’t over, and neither is the pandemic

From: POLITICO Pulse - Wednesday May 18,2022 02:01 pm
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By Krista Mahr and Sarah Owermohle

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QUICK FIX

The public health emergency continues as government officials grapple with what the end of a pandemic looks like.

Paxlovid prescriptions are up, reflecting broader access but also the ongoing case surge.

The Senate’s user fee proposal has landed, introducing potential changes for devices and dietary supplement regulations.

WELCOME TO WEDNESDAY PULSE This gives a whole new meaning to surprise billing. Send news, tips and surprise billing stories to kmahr@politico.com and sowermohle@politico.com.

 

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New data show that 35% of insured Americans spent more on out-of-pocket costs than they could afford in the past month. Read more about how insurance is leaving patients exposed to deepening inequities.

 
Driving the Day

In this March 5, 2019, file photo, California Attorney General Xavier Becerra speaks during a news conference in Sacramento, Calif.

HHS Secretary Xavier Becerra will extend the public health emergency past July. | Rich Pedroncelli, File/AP

IT AIN’T OVER ’TIL IT’S OVER The moment that the Covid-19 public health emergency could have ended came and went with little fanfare on Monday, an ambiguous milestone and perhaps a fitting marker to where we find ourselves as a nation two-plus years into this pandemic.

Monday was the date on which HHS Secretary Xavier Becerra would have had to keep his promise of giving 60 days’ notice before the emergency expired. But the deadline passed with no public announcement, signaling its likely extension through the fall, POLITICO’s Ben Leonard and Megan Messerly write.

That’s good news. The non-event was a relief to people worried about the chaotic transition its end would bring, from the data crunchers at the Centers for Disease Control and Prevention who could lose access to critical Covid-19 information from states when the emergency is over to some 15 million people who could lose their Medicaid coverage.

And yet actually, not-so-good news. In addition to those not-insignificant problems, Covid-19 cases are once again rising, with New York City raising its own Covid-19 risk level to “high” and recommending New Yorkers to wear a mask in any indoor public setting.

Nationwide, cases are up from their low of about 25,000 just a few weeks back to a current seven-day average of more than 91,000, with the highly transmissible Omicron subvariant BA.2.12.1 spreading. Experts widely agree those case numbers are an undercount because of reduced testing in the public and private sectors and the prevalence of at-home tests whose results people don’t typically report to public health authorities. A handful of states no longer publicly report testing data, according to this map from Johns Hopkins.

Hospitalizations are also up, and the White House has announced Americans are now eligible for a new round of free tests to be sent to their home, as it did during the winter Omicron surge.

When asked in a Wall Street Journal interview broadcast on Tuesday when the pandemic was going to end, CDC Director Rochelle Walensky told Americans to buckle up. “People are really looking for a date. How do I know today that it’s over?” she said. “I don’t think that date is going to come.”

Bonus factoid: The wedding industry is in trouble if she’s right. In 2020, pandemic marriage rates plunged to their lowest rates since 1963, according to the CDC.

BIDEN ADMIN TOUTS ANTIVIRAL USE Americans are increasingly taking Paxlovid and other Covid-19 treatments, according to new data released by the Health and Human Services Department on Tuesday.

The numbers: Doctors and pharmacists have ordered more than 2 million doses of Pfizer’s Paxlovid and dispensed nearly 669,000. That’s followed by 230,257 doses of Merck and Ridgeback’s Lagevrio, 76,103 of Eli Lilly’s monoclonal antibody Bebtelovimab and 253,454 of AstraZeneca’s monoclonal antibody cocktail Evusheld administered.

In a call with reporters, senior health officials partially credited the prescription rise to a boost in free and accessible testing helping Americans swiftly get results. Of course, as discussed above, the country is also in the midst of another case surge.

The officials said roughly 35,000 sites nationwide are equipped to administer Paxlovid, with more than 88 percent of people living within five miles of one of those sites.

But questions remain about who exactly is receiving treatments (clear data on the number of immunocompromised or high-need patients is unavailable) and whether their infection rebounds, particularly with the antiviral pill Paxlovid.

A senior health official said the agency is “very, very carefully” watching rebounds — and looking for signs that Paxlovid could suppress the virus to a point where someone tests negative, only for it to rear up again — and in talks with the FDA about whether Paxlovid guidance will need updating. “But in the meantime, we’ve still decided in consultation with our scientists that the 88 percent reduction in severe illness and death and hospitalization … makes it, still, a therapy that we continue to recommend folks take.”

DRAFT OF USER FEE BILL LANDS — The leaders of the Senate HELP Committee on Tuesday released bipartisan draft legislation to reauthorize the FDA’s medical product user fees for five years and overhaul how diagnostics, dietary supplements and cosmetics are regulated, POLITICO’s David Lim, Katherine Ellen Foley and Lauren Gardner report.

The Senate version of the must-pass package reauthorizes the FDA’s brand drug, generic drug, biosimilar and medical device user fee programs.

The draft bill would place new requirements on industry and the FDA to provide regular “sufficient detail” about future user fee negotiations to Congress and publish meeting minutes within 30 days. This provision is an apparent response to the medical device industry and the FDA failing to reach an agreement before the statutory deadline and a monthslong delay posting negotiation minutes.

The bill doesn’t contain provisions present in the House legislation that would tweak the FDA’s accelerated approval pathway or an FDA ask for expanded authority to enable the agency to require medical device firms to report shortages outside of a public health emergency.

 

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At the Agencies

ANNANDALE, VIRGINIA - NOVEMBER 04: A child receives the Pfizer BioNTech COVID-19 vaccination at the Fairfax County Government Center on November 04, 2021 in Annandale, Virginia. The federal government approved the coronavirus vaccine for children between the ages of 5 and 11 this week. (Photo by Chip Somodevilla/Getty Images)

HHS is bolstering parent outreach in an effort to get young children vaccinated. | Getty Images

HHS LEANS ON PARENT ORG WITH KIDS’ VACCINES — The health agency launches a campaign today with the National Parent Teacher Association aimed at encouraging parents to get their young children vaccinated.

The effort comes on the heels of the FDA’s Tuesday decision to grant emergency use authorization for a booster dose of the Pfizer-BioNTech Covid-19 vaccine in children ages 5–11. The CDC’s independent vaccine advisory committee will meet Thursday to discuss recommending the boosters for that age group. Children won't be able to receive them until the CDC formally endorses the shots, our Lauren Gardner notes.

The new PTA initiative is part of the HHS’s broader “We Can Do This” campaign, which has also targeted grassroots outreach among Black, Latino, Asian American, Pacific Islander, Native Hawaiian, and American Indian and Alaska Native communities.

HHS holds a Facebook Live event on children’s vaccinations tonight at 7 p.m. EDT with White House senior policy adviser Cameron Webb, the CDC’s Greta Massetti and the American Academy of Pediatrics’ Ilan Shapiro.

 

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Around the Nation

CALIFORNIA DEMS TURN TO BALLOT BATTLE ON ROEThe state’s ballot initiative system could become an engine to turn out motivated voters while — if it passes — enshrining abortion rights in the state’s constitution, POLITICO’s Jeremy B. White writes.

That action could transform the contours of midterm elections, expanding California Democrats’ margins in the statehouse and shoring up the national party's defense of its House majority. Control of Congress will hinge in part on a half-dozen California races where turnout could make the difference, Jeremy notes.

Incumbents are running on the issue: Within days of POLITICO reporting that the high court had voted provisionally to overturn Roe, California Democrats announced they aimed to place a measure on the November ballot that would explicitly include the right to abortion in the state’s constitution.

The effects of such an initiative could ripple beyond activating the party faithful. Californians of every party oppose overturning Roe, according to a recent statewide poll — that included more than three-quarters of independent voters, a swing bloc that comprises about a fifth of the state’s electorate. It could also animate young voters, who tend to vanish in midterm elections, by giving them an urgent reason to go to the polls.

Names in the News

Catharine Young is now assistant director for Cancer Moonshot engagement at the White House Office of Science and Technology Policy. She was senior science policy adviser in the office of the Assistant Secretary of Defense for Chemical Biological and Nuclear Warfare programs in the Obama administration, Daniel reports.

Dominique Duval-Diop is now U.S. deputy chief data scientist at the Office of Science and Technology Policy, Daniel also reports. She most recently was associate director of gender and social inclusion at the Millennium Challenge Corporation.

 

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.

 
 
What We're Reading

Conspiracy theorists flock to bird flu, frustrating farmers, The Associated Press’ David Klepper writes.

The federal government isn’t going to buy Covid-19 vaccines forever, STAT News’ Rachel Cohrs reminds us.

Spain’s coalition government wants to introduce state-paid leave for women with painful periods, Reuters reports.

 

A message from PhRMA:

According to data just released, insurance isn't working for too many patients. Despite paying premiums each month, Americans continue to face insurmountable affordability and access issues:

  • Roughly half (49%) of insured patients who take prescription medicines report facing insurance barriers like prior authorization and “fail first” when trying to access their medicines.
  • More than a third (35%) of insured Americans report spending more in out-of-pocket costs in the last 30 days than they could afford.
Americans need better coverage that puts patients first. Read more in PhRMA’s latest Patient Experience Survey.

 
 

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