The emergency isn’t over

Mar 14, 2022

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QUICK FIX

— We're not quite back to normal, even as masks come off.

— National efforts to track virus spread in wastewater have stalled with skeptical or slow-moving states.

— Congress' Covid funding drop is already playing out as health officials asses whether to slash virus research.

WELCOME TO MONDAY PULSE — D.C. residents are showing their support for Ukraine with a sugar fix. Send news, tips and bakery recommendations to kmahr@politico.com and sowermohle@politico.com.

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ICYMI: A majority of Americans reject so-called government "negotiation" once they learn it could restrict access and choice and chill the innovation of new treatments and cures. The survey also shows a majority find health care coverage costs unreasonable and a top priority health care issue for policymakers to address today.

Driving The Day

READY OR NOT — In two long years that have let off a volley of scary, confounding moments, millions of Americans find themselves in yet another. Omicron is fading. Concerts are packed. Officials urge us to move on, shed our masks and get back to normal.

And yet, there's that number — the number that tells us we're nowhere near what anyone would have called normal two years ago. On March 11, the number was 1,487 : That's how many Americans are dying every day from Covid-19, while the country moves on.

And then there's the latest from Pfizer's CEO, who got out ahead of the FDA on Sunday and said another Covid-19 booster shot would be needed, a message that will inevitably cause some boosted Americans to wonder exactly how well they're protected today.

Advocates for some of those most vulnerable to Covid-19 — people living with chronic conditions and the immunocompromised — have raised concerns with the Biden Administration about the rush to ditch Covid-19 restrictions and have been left frustrated, POLITICO's Rachael Levy writes.

"The pandemic is not over," Elena Hung, co-founder of Little Lobbyists, an advocacy group for chronically ill and disabled children, said. "What the CDC is doing is leaving out immunocompromised and disabled people."

Then, of course, there are the kids. Parents are staring into uncharted territory as schools lift mask mandates with no vaccine for children under 5 and a new study showing the Pfizer vaccine offered only middling protection against Omicron infection to kids 11 and younger.

This week in Washington, public schools, like others across the country, will lift their mask mandate. Unsurprisingly, there are strong feelings. And so we parents, like so many families with vulnerable members across the nation, start the week braced to leap into the great unknown — again.

SEWAGE OVERSIGHT FALTERS WITH STATES — Wastewater surveillance gained popularity during the pandemic as some state and local health officials showed they could detect the coronavirus in their community's sewage systems before residents developed symptoms.

But there's a big problem with nationalizing surveillance, POLITICO's Katherine Ellen Foley and Megan Messerly report: Few states are on board.

The landscape: Roughly 18 months into the wastewater effort, only a dozen states routinely submit data to a federal program. Even among those participating, several have only clusters of collection sites in major population centers. Others are unsure how large their programs will be, while some don't plan to participate.

Why it matters: Surveillance can help public health officials more quickly identify and respond to clusters of coronavirus or other viruses. But lackluster participation leaves gaping holes in what public officials intend to be a comprehensive early-warning system, according to Katherine's and Megan's interviews with state health officials and wastewater experts across 17 states.

What are the issues? Some areas have grappled with privacy concerns and logistical challenges like how to coordinate dozens of treatment plants routinely submitting sewage samples to a handful of labs.

The federal government paid LuminUltra, a private commercial lab, more than $6 million to assist states that couldn't monitor sewage on their own, but the company struggled to build trust with local operators.

NIH GRAPPLES WITH COVID FUNDING CUTS — Scientists at the National Institutes of Health are scrambling to decide whether all its coronavirus research and development can continue after Congress dropped new funding from its sweeping budget bill, Sarah scooped Friday.

The stakes: There are immediate implications for government trials on Covid-19 therapies, tests and vaccines that run out of funds as soon as this month, according to an internal email obtained by POLITICO.

"We would like to understand which March activities can be delayed, de-scoped, paused, etc. and what the consequences are of choosing this option," Health and Human Services Department program analyst Thomas Libert wrote.

The budget crunch comes after House Democrats cut $15.6 billion in coronavirus relief spending from the omnibus bill earlier this week amid caucus complaints that their states' assistance would decline to pay for the new relief spending.

What's next: Libert warned that top officials assume there would be no new coronavirus funding in the 2023 fiscal year and that "agencies should be prepared to use base funding to continue any COVID activities" in the next year: "No new activities should be funded at this time.

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Public Health

IN THE SHADOW OF COVID-19, STD RATES SPIKE — Americans' rates of sexually transmitted diseases got worse during the pandemic's isolation, POLITICO's, Alice Miranda Ollstein writes.

After a dip early in the pandemic, gonorrhea and syphilis reached new highs by the end of 2020, as sexual health clinics across the country closed or cut back on hours and services. Disease contract tracers were diverted to Covid-19, and a surge in addiction and mental health problems led to riskier behavior.

Many public health experts expect the 2021 STD numbers, once they come out, will only be worse, prompting them and government officials to warn that without intervention, millions of Americans could face severe consequences.

REST UP, BARACK — Former President Barack Obama announced Sunday on social media that he had tested positive for the virus but was basically feeling fine.

He added that his wife, Michelle Obama, had tested negative and used the announcement to encourage Americans to get vaccinated and not become complacent as the nation's case numbers take a steep dive. As of Saturday, 216,587,984 Americans were fully vaccinated, or 65.2 percent of the population, according to CDC data.

AROUND THE NATION

'CRACK 2.0' — The extension of a Trump-era order cracking down on fentanyl copycats is reigniting what advocates call another war on drugs, writes POLITICO's Renuka Rayasam.

On Thursday, Congress reauthorized for the sixth time a 2018 emergency order to make it easier to prosecute people for selling fentanyl analogs, or drugs chemically similar to the highly addictive synthetic opioid.

President Joe Biden wants to make it permanent, a move civil rights groups, public health researchers and criminal justice reform experts argue would embolden federal law enforcement authorities and disproportionately affect low-income defendants of color.

IN TEXAS, A WIN FOR GENDER-AFFIRMING CARE — A Texas judge ordered a statewide halt to a Feb. 22 directive from Republican Gov. Greg Abbott that calls for abuse investigations into the use of gender-affirming care for transgender children, POLITICO's Juan Perez Jr. writes.

The judge ruled Abbott's directive, which called for inquiries into parents and medical providers who allegedly violate the law, was unconstitutional.

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At the border

CDC CHIPS AWAY AT TITLE 42 — The CDC formally ended its Title 42 order as it applies to unaccompanied minors on Friday, leaving the controversial order in place for adults and families.

The administration had already temporarily stopped expelling children arriving alone at the U.S. border in the name of the coronavirus public health emergency. A Texas court's March 4 ruling would have forced the agency to resume the practice.

The CDC said it made the decision after "considering current public health conditions and recent developments, that expulsion of unaccompanied noncitizen children is not warranted to protect the public health."

It's a step in the right direction for immigration advocates who have been calling for the Biden Administration to end the policy that started under Trump.

But — and it's a big one — the order still applies to adults and families arriving at the border, a fact that has become increasingly contentious as Covid-19 cases drop and the CDC now says 98 percent of the country no longer needs to mask indoors.

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Names in the News

Emergent BioSolutions announced that, on April 1, Coleen Glessner will join as executive vice president on global quality, ethics and compliance and Bill Hartzel will lead compliance and contract development and manufacturing. Glessner most recently was chief quality officer for Alexion Pharmaceuticals, and Hartzel was chief commercial officer for Woodstock Sterile Solutions.

What We're Reading

Trust in public health agencies hasdeteriorated during the pandemic as politics pull at frustrations, leaving officials in a tenuous place to rebuild public trust, James Hamblin writes in The New York Times' opinion pages.

"My son's life depends on this ": The Washington Post's Siobhán O'Grady, Kostiantyn Khudov and Claire Parker delve into the desperate search for insulin and other medicines in Ukraine.

EcoHealth Alliance's Peter Daszak, who found his nonprofit in the crosshairs of early questions about coronavirus origins,sat down with The Intercept's Sharon Lerner and Mara Hvistendahl to defend EcoHealth's research and talk viral threats.

A message from PhRMA:

According to a new poll , voters overwhelmingly support policies that would lower out-of-pocket costs and bring greater transparency and accountability to the health insurance system.

We need to make the cost of medicine more predictable and affordable. Government price setting is the wrong way. The right way means covering more medicines from day one, making out-of-pocket costs more predictable and sharing negotiated savings with patients at the pharmacy counter.

Learn more.