Another Covid Christmas — with RSV and flu, too

By Daniel Payne and Krista Mahr

With Megan Messerly

Health experts warn the public that if their vaccinations aren't up to date, we could be in for a post-holiday flu, RSV and Covid surge. | Jeff Roberson/AP Photo

GHOSTS OF HOLIDAY SEASONS PAST — State health officials are concerned that a unique mix of viral outbreaks could make for a hard holiday season, Megan reports .

Public health experts are urging people to get vaccinated against the flu and Covid-19 before gathering with friends and family for the holidays.

Even though some experts think this winter’s Covid surge could be mild compared with the last two, flu, Covid and respiratory syncytial virus outbreaks — along with existing staffing shortages — could stretch facilities beyond their capacities, leaders worry.

It highlights an ongoing effort from health leaders to get Americans vaccinated and remind them of the health system’s limits.

“Most of the population — unfortunately — has forgotten about Covid-19 and moved on. As a result, we’re seeing a rise in cases and a rise in hospitalizations, and that worries me,” said Ali Mokdad, professor of global health at the Institute for Health Metrics and Evaluation at the University of Washington told POLITICO. “Right now, with the rise of flu, RSV and Covid, our health professionals are exhausted.”

For some providers, this winter doesn’t seem that different from the pandemic’s early days when health systems were overwhelmed by the new virus.

Now, Mississippi is down to 65 ICU beds and transferring some patients to other states, though Tennessee and Alabama have stopped accepting out-of-state transfers. Hospital networks are asking the federal government for additional resources, and Oregon Gov. Kate Brown signed an executive order Wednesday in response to outbreaks.

Much of the U.S. seems to have moved on from measures intended to protect public health, but the mix of rising infections could continue to press health workers through the winter.

Health experts are hopeful a growing immunity will protect people — particularly those who are older or have compromised immune systems and would be at heightened risk.

“It’s not just the challenge of Covid-19; it’s influenza and RSV stacked on top of Covid that’s presenting a challenge to our health care system,” Rachel Herlihy, Colorado’s state epidemiologist, said.

WELCOME TO MONDAY PULSE, where we learned that being optimistic about an outcome could actually change it — at least when it comes to placebos in cannabinoid pain relief trials .

We’re hoping the same positive outlook could work for how long Congress will be negotiating a year-end deal. Know anything about how that’s coming along? Drop us a line at dpayne@politico.com and kmahr@politico.com .

TODAY ON OUR PULSE CHECK PODCAST , Megan Messerly talks with Lauren Gardner about the introduction next year of biosimilars that will compete with the arthritis medication Humira, the best-selling drug in America, once it goes off-patent.

A message from PhRMA:

Costly out-of-pocket expenses tied to deductible and coinsurance requirements are a leading concern for patients with commercial insurance. These harmful practices put in place by insurers and pharmacy benefit managers (PBMs) are even causing patients to abandon their medicines. New IQVIA data break down how insurers and their PBMs are impacting how patients access and afford their medicines.

Washington is gearing up to help undocumented residents enroll in the state's health care exchange. | Eric Gay/AP Photo

WASHINGTON STATE TO OFFER HEALTH INSURANCE TO UNDOCUMENTED IMMIGRANTS — Federal health officials have granted Washington state’s request to waive certain Affordable Care Act requirements, an action that will allow undocumented residents to purchase plans on the state’s health insurance exchange starting in 2024. The move is expected to benefit an estimated 100,000 Washingtonians who are uninsured because of their immigration status, Megan reports.

While undocumented residents don’t qualify for federal subsidies to purchase plans on the exchange, they’ll be able to take advantage of state subsidies to do so. The state allocated $50 million for the upcoming plan year to subsidize health coverage for people with incomes at or below 250 percent of the federal poverty level. An additional $5 million will become available next year.

The context: Washington’s waiver application comes after a similar move by Colorado , which passed a law in 2021 to allow undocumented residents making up to 138 percent of the federal poverty level to purchase health coverage on the state’s health insurance exchange starting this year.

Colorado has set aside about $58 million to subsidize coverage for low-income undocumented people, and 5,700 undocumented immigrants have already enrolled for health insurance this year through the program, known as OmniSalud, The Denver Post reports . While the state’s health insurance exchange runs OmniSalud, it is operated separately and doesn’t share enrollees’ personal information with the federal government.

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GOING PUBLIC — Amid conversations about how to handle looming Medicare cuts, a significant number of lawmakers in the House and Senate have voiced their support for stopping the cuts.

A bipartisan group of 135 representatives and 48 senators have publicly acknowledged the need to stop the payment reductions, according to a list from the Surgical Care Coalition .

The list comes after provider groups intensified their lobbying campaign last week.

It also comes as lawmakers wait for top-line budget numbers to begin addressing concerns about paying for forgone cuts.

ADD IT TO THE WISHLIST — Sen. Patty Murray (D-Wash.) is urging that the PREVENT Pandemics Act be added to a year-end package.

Murray, who leads the HELP committee, has long emphasized the need to address pandemic preparedness, pointing to the bipartisan bill as a solution in a year-end package.

But the bill, like many year-end items, risks being lost in the race to make a deal before the deadline.

REPORT RIPS GOVERNMENT’S COVID RESPONSE — House Democrats on the Select Subcommittee on the Coronavirus Crisis released their final report Friday, pointing out failures in the country’s structures, leadership and information-sharing that contributed to more than 1 million Covid deaths in the U.S., POLITICO’s Alice Miranda Ollstein reports .

The report, 200-plus pages long, comes at the end of two years of investigations into the Trump administration’s handling of the pandemic.

It makes 30 recommendations, including replenishing the Strategic National Stockpile, passing legislation to improve long Covid research and treatment and enacting universal paid sick and family leave for U.S. workers.

But don’t expect swift action on every item: Partisan fighting looks like it will stand in the way of a new path forward, with Republicans uninterested in funding the Biden administration’s $10 billion ask to fight Covid.

More reports may be on the way in the next Congress as Republicans ready themselves for their turn to extensively investigate the country’s handling of the pandemic.

A message from PhRMA:

ANOTHER CDC ENDORSEMENT — The CDC formally recommended Covid-19 vaccines that have been updated to target two Omicron subvariants for children as young as 6 months old, POLITICO’s Lauren Gardner reports.

The endorsement late last week came a day after the FDA authorized the new formula's emergency use for young children.

It also comes amid renewed stress on the health system from Covid-19, the flu and RSV.

JOIN THURSDAY FOR A CONVERSATION ON FAMILY CARE IN AMERICA : Family caregivers are among our most overlooked and under-supported groups in the United States. The Biden Administration’s new national strategy for supporting family caregivers outlines nearly 350 actions the federal government is committed to taking. Who will deliver this strategy? How should different stakeholders divide the work? Join POLITICO on Dec. 15 to explore how federal action can improve the lives of those giving and receiving family care across America. REGISTER HERE .

LOOKING FOR TRANSPARENCY — European Union health officials are looking for additional information about the group’s largest Covid vaccine contract — one that European Commission President Ursula von der Leyen took a personal role in negotiating, POLITICO’s Carlo Martuscelli and Sarah-Taïssir Bencharif report .

“What was promised? We would really like to know,” said Pierre Cartuyvels, deputy permanent representative for Belgium, about the multibillion-euro contract with BioNTech/Pfizer.

The comment, made during a meeting of EU health officials in Brussels on Friday, was picked up by Irish Health Minister Stephen Donnelly, who said the lack of transparency around the contract negotiations could provide “fuel for misrepresentation,” even if the result is “demonstrably prudent and justified.”

It’s a deal that’s already come under intense scrutiny, with auditors noting a lack of information about the deal shared with them.

Anthony Fauci writes for The New York Times’ opinion section about his hopes for the next generation of scientists.

The Atlantic’s Michael Schuman reports on the next phases of China’s pandemic affecting Xi Jinping.

The Washington Post’s Erin Blakemore writes about how AI and robots could make diagnosing urinary tract infections faster.

A message from PhRMA:

Every day, patients at the pharmacy counter discover their commercial insurance coverage does not provide the level of access and affordability they need. New data from a study by IQVIA reveal the harmful practices of insurers and their pharmacy benefit managers (PBMs) can lead to significantly higher out-of-pocket costs for medicines — causing some patients to abandon their medicines completely.  Learn more.

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