CDC gets more reports of hepatitis cases after issuing health alert

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Apr 26, 2022 View in browser   By Krista Mahr and Sarah Owermohle Presented by With help from David Lim 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 U.S. is one of 10 countries where reports of acute hepatitis in children surfaced, and no one is sure why. — A court has ordered Title 42 to continue, while public health advocates are urging Congress to stop it. — Global health officials are worried the West is giving up on the fight against Covid-19, even as they disagree on how to wage the war. WELCOME TO TUESDAY PULSE — Former coronavirus response coordinator Deborah Birx told ABC in a new interview that, as she sat through Trump's disinfectant moment, she wanted it "to be 'The Twilight Zone' and all go away." She was not alone. Send news and tips to kmahr@politico.com and sowermohle@politico.com.   A message from PhRMA: Nearly half of insured Americans who take prescription medicines encounter barriers that delay or limit their access to medicines. In a new report, learn more about the abusive insurance practices that can stand between patients and the care they need.   Driving the Day The CDC is investigating a cluster of hepatitis cases in children. | Ron Harris/AP Photo 169 KIDS AND COUNTING — The Centers for Disease Control and Prevention is evaluating new reports of hepatitis cases it received after issuing a nationwide health alert last week warning of a cluster of nine children with hepatitis and an adenovirus infection. The U.S. is one of 10 countries that have reported acute hepatitis cases of unknown origin in young children, according to the World Health Organization. So far, at least 169 cases have been reported, mostly in the United Kingdom. Ten percent required liver transplants, and one child has died. The CDC is working with Alabama, where the nine U.S. cases were reported, to investigate the cluster. None of the children, who ranged from ages 1 to 6, had a current Covid-19 infection, and all were otherwise healthy. Five were admitted to a children's hospital with significant liver injury, the cause of which is unclear. The CDC has ruled out the usual suspects of viral hepatitis — hepatitis A, B and C — and believes the cause may be linked to an adenovirus. The WHO also said an adenovirus might be a possibility but noted in an April 23 statement that "it is not yet clear if there has been an increase in hepatitis cases, or an increase in awareness of hepatitis cases that occur at the expected rate but go undetected." North Carolina is also investigating two cases in young children, its health officials told STAT . The CDC didn't specify the number of new case reports it had received since sending the alert but said in a statement to POLITICO that it "is working with state health departments to see if there are additional U.S. cases, and what may be causing these cases." COURT TO ORDER TITLE 42 TO CONTINUE —  A Louisiana judge said he plans to issue a temporary restraining order against the Biden administration from ending Title 42, the Trump-era policy that kept migrants out of the country in the name of public health. The CDC had said it will end the controversial order on May 23, saying it was no longer needed to protect the health of Americans during the pandemic. The decision was widely criticized by Democrats and Republicans alike for reasons ranging from concerns over the rising number of Covid-19 cases to a surge in drug and human trafficking that looser border restrictions might create. Missouri Attorney General Eric Schmitt, who is running for the Senate, tweeted on Monday that his office "just obtained a temporary restraining order to keep Title 42 in place" after filing a lawsuit with the AGs of Louisiana and Arizona to keep the administration from ending the policy. Since then, 18 more states joined in asking the court for a restraining order against the administration. "This is a huge victory for border security, but the fight continues on," Schmitt wrote. It's the second CDC policy to get tied up by courts in a week after a Florida judge issued an injunction ending the agency's mask mandate on public transportation, prompting widespread concerns about the agency's authority. Earlier this month, Republican lawmakers were demanding a vote on keeping Title 42 in place as a condition for passing Covid-19 aid. How the judge's decision Monday will affect that dynamic is unclear. But in a letter sent to Congress early today, dozens of public health organizations and immigration advocacy groups urged lawmakers not to sign on to any bill that would reverse the CDC decision to end the order. "Congress should address this pandemic by expanding access to vaccines and preventative measures, not by furthering anti-immigrant policies," they wrote. "If the nation desires a robust and healthy debate about immigration reforms, it should be considered within its own context, not entangled with urgently needed COVID-19 funding." CONCERNS MOUNT OVER GLOBAL COVID FIGHT — The world is increasingly worried that the U.S. and European countries are turning away from the global fight against the pandemic, POLITICO's Erin Banco reports from Ghana. As Western governments relax public health guidelines like mask mandates and drop Covid-19 financing from budgets, countries like Ghana are still trying to ramp up primary vaccinations. Millions worldwide remain unvaccinated, and some global health officials, including from the WHO, worry those governments' decisions to move on at home will affect efforts to change that. "The vaccines remain incredibly important in getting those who are most at risk in all countries because they continue to save lives," Maria Van Kerkhove, the Covid-19 technical lead at the WHO, told reporters this month. "But they can only save lives among the people who receive them." Other health advocates argue that Covid-19 should no longer be viewed as a health emergency because there's enough baseline immunity through prior infection and vaccination to manage hospitalizations. The diverging strategies have led to a global health community at odds over how to handle the next step in the Covid-19 fight. And that reality has left people in African countries grasping for clues about whether additional funding or help is coming.   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.     Coronavirus BIDEN ADMIN: DOCTORS SHOULD PRESCRIBE PAXLOVID TO ALL ELIGIBLE — The Biden administration is launching a fresh push today to get health care providers to prescribe Covid-19 antivirals to all patients eligible to receive them. Under the plan, first reported by David and POLITICO's Adam Cancryn on Friday , all pharmacies in the federal antiviral pharmacy program will be allowed to order antivirals from the federal government. The administration expects the number of locations where people can obtain antiviral treatment to soon grow from about 20,000 sites to more than 30,000 — eventually reaching 40,000 places "over the coming weeks." Antibiotics and steroids aren't effective against Covid-19 and shouldn't be prescribed to treat the infection, the CDC warns. | Joe Raedle/Getty Images CDC: STOP PRESCRIBING ANTIBIOTICS, STEROIDS FOR COVID — On Monday, the CDC issued a health advisory warning doctors against prescribing antibiotics or steroids to nonhospitalized Covid-19 patients with mild to moderate cases. Agency data suggests those drugs have increasingly been used to treat Covid outpatients, and a CDC-funded study recently found that 30 percent of outpatient Covid visits among Medicare beneficiaries were linked to an antibiotic prescription during the pandemic's first year. A senior administration official declined to say how many health care providers are inappropriately prescribing antibiotics or steroids to Covid-19 patients when asked on a press call Monday night. SPEAKING OF THAT MASK MANDATE — As we've noted here before, most Americans seem to think putting a mask on before traveling with a bunch of strangers in an airless bus, train or airplane isn't a bad idea. Our colleague Alex Daugherty over at Weekly Transportation pulled together five polls that show sustained support for the CDC order. A Harris Poll conducted from April 1 to 3, a Morning Consult/POLITICO survey from April 15 to 17, an AP-NORC poll from April 14 to 18, a daily YouGov poll on April 18 and a Premise poll from April 15 to 17 all show continued support for the mandate, though the polls' methodologies, wording of questions, sample size and timing were different. Support for travel mask mandates polled between 56 percent and 62 percent in all five.   A message from PhRMA:   In Congress FIRST IN PULSE: HASSAN TO PRESS FDA ON MCKINSEY — Sen. Maggie Hassan (D-N.H.) intends to ask FDA officials about what action the agency has taken against the consulting firm McKinsey & Company at a hearing today. Hassan has previously called for an investigation into McKinsey's failure to disclose potential conflicts of interest when the company was working with the FDA on issues related to opioids at the same time it was working for opioid companies, including Purdue Pharma. "It's undeniable that McKinsey played a role in fueling the opioid crisis, and the recent revelations that they were consulting for the FDA while at the same time working on behalf of opioid manufacturers is deeply disturbing," Hassan said in a statement provided to Pulse. "We must get to the bottom of this and understand how the FDA allowed these potential conflicts of interest to go undetected for years."   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 The Los Angeles Times investigates how Reynolds American has hired Black lobbyists and consultants to stoke fears among Black communities about bans on menthol cigarettes as the company seeks to keep its grip on the market. An investigation from Buzzfeed News reports on what happened after the private equity giant KKR bought hundreds of homes for people with disabilities: "Conditions grew so dire that nurses and caretakers quit in droves, a state prohibited the company from accepting new residents, and some of the most vulnerable people in its care suffered and died." NPR dives into the role misinformation played in one woman's death from Covid-19.   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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