Administration officials are divided over whether to fight for travel mask mandate

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Apr 20, 2022 View in browser   By Krista Mahr and Sarah Owermohle Presented by Editor's Note: POLITICO Pulse is a free version of POLITICO Pro Health Care's morning newsletter, which is delivered to our subscribers each morning at 6 a.m. The POLITICO Pro platform combines the news you need with tools you can use to take action on the day's biggest stories. Act on the news with POLITICO Pro. QUICK FIX — The Biden administration punted a major appeal decision to public health officials amid divides over whether to fight for masks. — CDC launches a disease forecasting center, hoping to improve the U.S. response to future outbreaks and win back Americans' trust. — Unvaccinated kids were hospitalized twice as often for Covid-19 during Omicron, highlighting the need to boost vaccine uptake in children. WELCOME TO WEDNESDAY PULSE — An inspirational read before we get into the bad stuff. Send news and tips to sowermohle@politico.com and kmahr@politico.com.   A message from PhRMA: 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 The transportation mask mandate hangs in limbo as federal officials mull an appeal. | Scott Olson/Getty Images THE MASK MANDATE'S FUTURE IS (STILL) UNCERTAIN — The Justice Department says it will appeal a federal judge's decision striking down a mask mandate for public transportation with one big "if" — the Centers for Disease Control and Prevention must deem the mandate necessary for public health. That might seem a given for the public health agency, but officials are divided over whether to fight for a requirement that was already ending in early May and is fast losing political support. Detractors also expressed concerns about the fallout if the government were to lose an appeal, Sarah reports with POLITICO's Adam Cancryn, Erin Banco and David Lim. The Justice Department ultimately punted to CDC after hours of deliberation. That puts a testy decision with public health officials while consensus grows among White House and public health officials that an appeal would be impractical, two people with knowledge of the deliberations told POLITICO. Biden officials are cautiously optimistic about coronavirus trends: Despite roughly 35,000 new cases a day, up 40 percent from earlier in the month, hospitalizations have remained flat during that period. Still, Biden officials and people familiar with the matter say there's internal anxiety over whether whittled-down mitigation measures are premature in the face of new subvariants and several case surges, including one among Washington, D.C., elites. "There's no question we're at a crossroads," said one senior administration official granted anonymity to speak freely on internal deliberations. "No one knows yet whether hospitalizations are going to rise; that's what everyone is waiting to see." And there's anxiety about tools left to combat the pandemic. Congress has yet to clear new funding to continue buying vaccines, treatments and tests. In recent days, White House Covid-19 response coordinator Ashish Jha has also stressed the need to find ways to accelerate the distribution of antiviral pills, privately lamenting that doctors are still being too cautious in prescribing them, according to a person familiar with the matter. What's next: State and local health officials are proceeding with a patchwork of masking policies that public health experts worry will leave Americans confused and more frustrated. Already, policies within cities vary about whether to wear masks on planes, trains and automobiles that serve as public buses, as our transportation colleagues Tanya Snyder, Oriana Pawlyk and Alex Daugherty report. "Leaving this decision in place is dangerous," said Wendy Parmet, faculty co-director at the Center for Health Policy and Law at Northeastern University. "Whatever you think about mask mandates, this decision isn't saying that mask mandates are a bad idea. … This is a decision that says CDC cannot impose mandates — no matter what. So imagine the next variant that has a 50 percent mortality rate and the vaccines don't work." CDC LOOKS INTO THE FUTURE — The Centers for Disease Control and Prevention launched a new center on Tuesday that will try to improve the government's ability to predict and respond to future infectious disease outbreaks, Krista writes. The CDC compares the Center for Forecasting and Outbreak Analytics to the National Weather Service. They say the new team will use data to "model and forecast disease spread and severity;" work with federal, state and local officials to develop a response; and inform authorities and the public about its findings so people can decide how to respond. The CFA would provide transparent information about disease outbreaks to the American public, whose faith in the agency's ability to manage Covid-19 has been dwindling, said CDC officials. White House Covid czar Ashish Jha cast the rollout as a chance for the government to reset its improvised pandemic response. "The response from our leadership — our public health leadership — has been to scramble, to pull together evidence and try to make the best decisions we can," Jha said during a White House summit on pandemic preparedness Tuesday. "And I would argue we've done a pretty good job. But it's also been really clear that is no way to run a response to a pandemic. "That's what this center begins to do, both for this pandemic and for future ones." OMICRON HIT UNVACCINATED KIDS HARDER — A new study published in the CDC's Morbidity and Mortality Weekly Report found that hospitalization rates among unvaccinated children ages 5 to 11 during the Omicron wave were twice as high as vaccinated kids. About 20 percent of kids who were hospitalized were admitted to an intensive care unit. Researchers found that Black and Hispanic unvaccinated children comprised half of the hospitalized kids. Diabetes and obesity were associated with increased risk for severe Covid-19, and a third of the children admitted to hospitals had underlying neurologic disorders. Why it matters: Vaccine uptake in 5- to 11-year-olds has been extremely slow. Nearly 70 percent of children haven't received even one dose of the vaccine after it was approved for use in the age group in November. The disproportionate impact on Black and Hispanic children also throws into sharp focus the need for federal, state and local public health officials to improve outreach and vaccine access for communities of color even two years into the pandemic.   A message from PhRMA:   Coronavirus MODERNA'S FIRST BIVALENT BOOSTER WORKS BETTER —  Moderna said Tuesday that its first bivalent coronavirus booster candidate — based on the original strain as well as the Beta variant — increased antibody responses against multiple variants including Omicron, better than its current booster, POLITICO's Sarah-Taïssir Bencharif reports. The update from the U.S. biotech company comes as vaccine makers seek to respond to the continuing evolution of the SARS-CoV-2 virus, which has reduced the efficacy of their original formulas. The results show that the first revamped booster candidate, at the 50-microgram dose, generated higher antibody responses than Moderna's current booster shot, even when additional variants weren't included in the booster jab. Compared with Moderna's current booster, a dose of the bivalent vaccine increased the levels of antibodies that protect against Omicron 2.20-fold after one month and 2.15-fold after six months.   SUBSCRIBE TO NATIONAL SECURITY DAILY : Keep up with the latest critical developments from Ukraine and across Europe in our daily newsletter, National Security Daily. The Russian invasion of Ukraine could disrupt the established world order and result in a refugee crisis, increased cyberattacks, rising energy costs and additional disruption to global supply chains. Go inside the top national security and foreign-policymaking shops for insight on the global threats faced by the U.S. and its allies and what actions world leaders are taking to address them. Subscribe today.     Around the Nation CALIFORNIA CRACKDOWN ON COVID-19 MISINFORMATION — A bill that could discipline California doctors for spreading Covid-19 misinformation was passed by a key policy committee on Tuesday, POLITICO's Victoria Colliver reports. The California Medical Association, which is sponsoring the bill by Assemblymember Evan Low (D-Campbell), argues that pandemic-related misinformation has undermined public health efforts such as masking and vaccinations. Critics of the bill say it infringes upon free speech and doctors' ability to help patients make personal medical decisions. A proposed New Jersey bill would mandate that sex education courses be uploaded online for public review. | Seth Wenig/AP Photo GOPAL TO INTRODUCE NEW JERSEY SEX ED BILL — New Jersey Senate Education Chair Vin Gopal (D-Monmouth) plans to introduce legislation to "bring clarity for all parents and guardians regarding their child's health and sex education curriculum," POLITICO's Carly Sitrin reports. In a statement provided to POLITICO, Gopal said the bill would mandate all school curricula be uploaded to local board of education websites two weeks before the start of the school year, require school districts implementing sexual education a public opportunity to review the lessons and give parents the chance to opt out of the classes. Gopal's measure comes amid a predominantly right-wing uproar in New Jersey over age-appropriate sex education in schools.   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.     Mental Health THE LONG LEGACY OF FAMILY SEPARATION — Most parents forcibly separated from their children at the southern U.S. border by the U.S. government under the Trump-era "Zero Tolerance" immigration policy suffer long-term psychological effects, according to a new report from the advocacy group Physicians for Human Rights. Most of the parents interviewed for the report said they were given incomplete or no information about why they were being separated from their children, where their children were being taken or when they would see them again. Years later, parents said they continued to experience "disturbances in sleep, nightmares, loss of appetite, loss of interest, fear for the future, constant worry, hopelessness, and loss of the ability to concentrate." Most were diagnosed with post-traumatic stress disorder. The report recommends the U.S. government provide redress to families separated at the U.S. border under the policy, which ended in January 2021 after separating more than 3,000 children from their families. Names in the News Courtney Williams is now senior manager of congressional relations at the American Society for Radiation Oncology. She most recently was a health insurance specialist at the Centers for Medicare and Medicaid Services. Jennifer S. Lee joins the Alliance of Community Health Plans as its chief medical officer. Previously, Lee led the successful implementation of Medicaid expansion for the Commonwealth of Virginia as Medicaid director. What We're Reading Myanmar's health system has been in a tailspin since its coup in 2021, The New York Times' Richard Paddock reports, and dozens of doctors have been killed. Rural treatment options are scarce for the increasing number of eating disorders that emerged during the pandemic, Kaiser Health News' Carly Graf reports. The Biden administration may delay the repeal of Title 42 amid concern over an influx of migrants, Axios' Hans Nichols and Jonathan Swan report.   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.     Follow us on Twitter Tucker Doherty @tucker_doherty Dan Goldberg @dancgoldberg Erin Banco @ErinBanco Katherine Ellen Foley @katherineefoley Lauren Gardner @Gardner_LM Ben Leonard @_BenLeonard_ Rachael Levy @rachael_levy David Lim @davidalim Megan Messerly @meganmesserly Alice Miranda Ollstein @aliceollstein Sarah Owermohle @owermohle Carmen Paun @carmenpaun Megan R. Wilson @misswilson   Follow us

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