States begin questioning broad testing for kids

Jan 31, 2022

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With Ximena Bustillo and Daniel Lippman

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QUICK FIX

— Omicron has made broad school Covid testing untenable, and some states are forging ahead on narrower plans.

— Providers re-up complaints about staffing agencies as costs to hire nurses soar.

— USDA is hitting its vaccine stride after lagging rates in rural areas.

WELCOME TO MONDAY PULSE — The Wall Street Journal editorial board made a notable show of support for Biden's FDA nominee Robert Califf this weekend — after building reports that he doesn't have the votes. Send tips to sowermohle@politico.com.

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Driving the Day

STATES RETHINK BROAD COVID TESTINGFOR KIDS — State leaders and health experts, struggling to keep pace with the Omicron variant, are reconsidering their Covid-19 strategy for kids — favoring fewer tests and contact traces.

But that puts states at odds with the White House, where President Joe Biden and administration officials have promoted school "test to stay" programs , POLITICO's Juan Perez Jr. writes. The government said it would start delivering millions of rapid tests to schools this month as part of the program.

At the same time, the Centers for Disease Control and Prevention is telling states to narrow requests for rapid tests, focusing on places where quick tests would help students return to school immediately. So some state authorities are rethinking school testing and contract tracing entirely.

"Our testing infrastructure was not there; it was broken," Hilario "Larry" Chavez, superintendent of Santa Fe Public Schools, said of his decision to close New Mexico's capital city system for several days earlier this month.

While falling case counts are starting to bring East Coast states relief from the testing strain, schools elsewhere are still struggling with the Omicron surge, Juan writes. Curtailing school testing, cutting back contact tracing or rationing resources are now in play to free up staff and concentrate on the actively sick.

The debate unfolds as the White House encourages schools to layer testing programs atop proven protections: vaccinations, masks, social distancing and ventilation.

"Testing of asymptomatic individuals may put a lot of pressure, impose labor shortages and cause disruption in our schools. The main strategy, right now, should really be to manage our hospitals," Chavez said.

PROVIDERS COMPLAIN ABOUT STAFFING COSTS AMID SHORTAGE — Hospital and nursing home lobbies last week urged White House Covid-19 response coordinator Jeffrey Zients to fight high fees from nursing staff agencies — re-upping a request they've pushed for months.

What's happening: Nurses and other health care workers have left the industry in droves during the pandemic, many of them citing low pay, long hours and extreme stress. Providers increasingly rely on staffing agencies to provide contract staff to fill those gaps.

But the industry's largest trade groups, the American Hospital Association and the American Health Care Association and National Center for Assisted Living, argue those agencies are price gouging during a crisis.

The groups are "exploiting the severe shortage of health care personnel" during the pandemic "by charging uniformly high prices in a manner that suggests widespread coordination and abuse of market position," the lobbies wrote in a letter to Zients.

Those groups argue staffing agencies have inflated costs but pocket most of the fees. Lawmakers in November also sent a letter asking the White House and FTC to probe cost changes.

HOW USDA'S VACCINE COMPLIANCE STACKS UP — Agriculture Department staffers across all agencies were between 95 and 100 percent compliant with the federal vaccine mandates by the initial Nov. 8 deadline, according to data requested by POLITICO.

Started from the bottom: The agency previously ranked last among federal departments in compliance rate, which includes employees who have received the Covid-19 vaccine or have requested an accommodation, Ximena reports.

Why it matters: GOP congressional members have continued to raise concern over the potential decrease in work productivity because of the vaccine mandates, especially across the rural areas that the USDA serves. But the department hasn't removed any nonprobationary permanent employees who are noncompliant with the mandate.

"Instead, the department has made concerted efforts to reach out to individuals," a USDA spokesperson told POLITICO.

"Those who are requesting accommodations have simply been asked to put a mask on, to socially distance," Agriculture Secretary Tom Vilsack said during a hearing last month. "At the end of the day, the work is getting done."

Around the Agencies

SENATORS PRESS FDA FOR DEVICE UPDATES — Congressional health leaders on Friday called on the Food and Drug Administration and medical device industry to settle key guidance and fees for the industry.

The FDA is required to submit its final commitment letter on the Medical Device User Fee Amendments to Congress by Jan. 15. Other agreement letters — for prescription drugs, generics, and biosimilars — have been submitted.

"We respectfully request a briefing with FDA and industry representatives, no later than Wednesday, February 9, to update us on the progress made toward reaching an agreement and the expected timeline," Senate HELP leaders Sen. Patty Murray and Sen. Richard Burr , along with House Energy and Commerce Committee leaders Rep. Frank Pallone and Rep. Cathy McMorris Rodgers, wrote.

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Industry Intel

SPOTIFY SAYS CHANGES COMING AMID MISINFO CONTROVERSY — The music and podcast streaming app is adding content advisers to combat virus misinformation after a storm of criticism kicked off by Neil Young pulling his music from the service, The Associated Press reports.

Spotify CEO Daniel Ek, in a Sunday post , laid out new platform rules meant to stem a tide started by Young, who had his music removed Wednesday after Spotify declined to pull episodes of "The Joe Rogan Experience" criticized for spreading coronavirus misinformation. Joni Mitchell and Bruce Springsteen guitarist Nils Lofgren joined the call this weekend.

"Personally, there are plenty of individuals and views on Spotify that I disagree with strongly," wrote Ek. "It is important to me that we don't take on the position of being content censor while also making sure that there are rules in place and consequences for those who violate them."

Ek said that the advisories will link to Spotify's fact-based Covid-19 hub in what he described as a "new effort to combat misinformation" and roll out in the coming days. But he did not specifically reference Rogan or Young, the AP writes.

Names in the News

Marisa Aleguas is now special assistant in the office of the assistant secretary for public affairs for the Department of Health and Human Services. She most recently was scheduler and executive assistant for Rep. Mike Levin.

Daniel Harder is now director for government affairs and public policy at Biogen. He most recently was director for U.S. government and public affairs at EMD Serono.

Robert Daley joins the National Association of ACOs as a senior policy adviser. Daley previously spent five years as a legislative director at Polsinelli and worked for Sen. John Barrasso.

What We're Reading

A split-screen reality : People nationwide are returning to normal even as hospital pressure worsens. The point at which a pandemic ends is not a discrete event marked by a celebration in the streets," writes The Washington Post's Ariana Eunjung Cha.

Covid-19 struggles in the Mississippi Delta, plagued by hospital staff shortages and cost challenges, highlighting longtime problems besetting rural hospitals — and what's to come next for them, Bloomberg's Monte Reel writes.

Another call for masks off in schools: The New York Times' Michelle Goldberg, citing a recent article in The Atlantic making the same case, argues vaccinated school-age children shouldn't need masks as Covid severity wanes.

A message from PhRMA: