Leana Wen stands by her return-to-normal position

Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.

Apr 22, 2022 View in browser   By Sarah Owermohle and Krista Mahr Presented by With help from Megan R. Wilson 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 — Leana Wen tells Pulse why she thinks the country should get back to normal, even as Covid-19 cases are rising. — Health lobbying spending got off to a big start in 2022, with PhRMA leading the pack in the first quarter. — Public health experts worry the CDC's mask policy puts people at increased risk, with an estimated 23 million Americans already suffering from long Covid. WELCOME TO FRIDAY PULSE — Sorry to open with this, but it seems worth noting that roughly 234,000 Covid-19 deaths could have been prevented with vaccination since June 2021, according to KFF's latest calculations. Send brighter 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 Leana Wen talks to Pulse about her views on public messaging and the pandemic. | Julio Cortez/AP Photo WHAT CHANGED FOR LEANA WEN — The George Washington University public health professor, Washington Post columnist and former Baltimore health commissioner has become one of the most prominent voices advancing a controversial take: It is time to return to normal and has been for a while. It wasn't always like this. When the Biden administration announced vaccine requirements for U.S. employers, Wen argued they should have gone further. She's lamented rapid returns to schools and the coronavirus risks for children. Roughly 35,000 new cases a day are still being reported, though hospitalization rates remain flat. The youngest kids remain unvaccinated and are unlikely to see shots before June. New vaccination rates have stagnated. So, what changed? Public sentiment and her own risk calculus, Wen told Pulse. She and her husband wanted their two young children, one born during the pandemic, to experience life with peers and playdates. "That is where most Americans are and, frankly, where they have been throughout the pandemic, which is that they want to find the best way to navigate their lives." In other words, "public health depends on public trust," and the public is tired, Wen said. Wen insists she didn't pivot, pointing to an April 2021 column in which she urged vaccinated people to return to normal. Within a month of that column, the Delta variant hit, causing a hospitalization surge and the first of several waves of breakthrough cases. Wen maintains it wasn't her take that was wrong but the government's messaging — Biden officials should've never assumed the vaccine would stamp out all infections. Critics argue this isn't her call. People who are immunocompromised, particularly, say that increasingly relaxed public health guidance leaves their safety out of the equation — and they could still die from this virus. "It's true," Wen told Pulse. "I think it could both be true that the majority of individuals, if they are vaccinated and boosted, should be able to resume pre-pandemic normal, [and] we have to do a lot more when it comes to protecting the most vulnerable," including more accessible treatment. That stance — that most should move on even if others can't — has infuriated many doctors and public health experts, especially since some treatments aren't yet widely available. The simmering frustration boiled over this week when New York-based doctor and Health Justice director Oni Blackstock tweeted at Wen that her approach is "harmful and ableist" and beseeched her to consider her impact on public opinion. Blackstock later tweeted that Wen blocked her. Wen's 189,000-strong Twitter following, regular CNN appearances and previous reputation for divisiveness — she was abruptly ousted as Planned Parenthood head in 2019 — have made her a lightning rod on this issue even as administration officials endorse relaxed measures. Wen also has some direct lines into the White House as part of a group of health experts who have received private briefings on Covid policy throughout the pandemic. Twitter battles parallel anxiety in the Biden administration about how to message risk and responsibility in the pandemic's current phase when thousands are still dying but mask mandates have ended and social norms like conventions and concerts are back. Despite once supporting federal mandates, Wen now realizes they were never going to change some people's decision to mask or not. "We live in this very individualistic society where the incentive to do good for society may not be as strong as the incentive to have something personally," she told Pulse. "We should have said to people from the beginning: 'If you're vaccinated, you can take off your mask, you can go back to doing whatever you would like, understanding that there is still risk.' "That would have been the strongest incentive for vaccinations, and we lost them early on." THE FIRST LOBBYING NUMBERS OF THE YEAR ARE IN — K Street had until Thursday to submit lobbying filings for the first quarter of 2022, which runs from January through March — and the health sector set its year off with a bang, Megan reports. Seventy-five health care companies and associations spent $500,000 or more on lobbying in Q1 — and 44 of them increased their advocacy outlays by 10 percent or more from the same period in 2021, according to a POLITICO analysis of disclosures sent to the Senate. The top three health spenders remained the same — key industry groups for drugmakers, hospitals and doctors — but America's Health Insurance Plans, which represents insurers, spent $4.7 million on lobbying. That's a 20 percent boost over last year's first-quarter figure and the highest amount the group has ever spent on lobbying in any quarter. (A spokesperson didn't immediately respond to a request to comment on the figure.) LONG COVID AND THE GREAT UNMASKING — Critics of the Centers for Disease Control and Prevention's Covid-19 risk assessment are increasingly worried that the agency's approach to masking recommendations is putting Americans at unnecessary risk for long Covid, POLITICO's Rachael Levy reports. Basing federal mask guidance on hospitalization rates and capacity instead of case numbers exposes more people to the virus and the chance of ending up with a long-term condition, like the 23 million Americans the government estimates already have long Covid. That puts vulnerable people at increased risk and means young and healthy people could face long-term health effects that could jeopardize their ability to work, potentially exacerbating the labor shortage. "You cannot say you care about long Covid and then put out guidance that only cares about hospitalizations," Lakshmi Ganapathi, a pediatric infectious disease doctor at Harvard Medical School, told Rachael. "They're mutually incompatible."   A message from PhRMA:   Public Health Kindergarten vaccination rates have dropped during the pandemic. | Michael Loccisano/Getty Images KINDERGARTEN VACCINATIONS DROP — Vaccination rates for kindergartners across the U.S. fell in the 2021–2021 school year, according to new CDC data, in keeping with the national decline in immunization since the pandemic's start, Krista reports. Rates for three key state-required vaccines for public and private schools — chickenpox; measles; and diphtheria, tetanus and whooping cough — dropped 1 percent across the nation to approximately 94 percent coverage, a worrying development when it comes to contagious and dangerous diseases. Equally concerning, CDC doctors say, is what we don't know. In the 2020–2021 school year, kindergarten enrollment dropped by about 10 percent nationwide as parents delayed starting school during the pandemic. That means — in addition to the 35,000 kindergarten-age children that the CDC knows from its survey weren't up to date on their vaccines — nearly half a million more children were off the grid when it comes to knowing whether they were immunized.   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 HHS, WHITE HOUSE HOST VACCINE SUMMIT —  HHS Secretary Xavier Becerra and the White House host a summit today where doctors and community leaders will talk about the best ways to boost America's stagnating Covid-19 vaccination rates. The summit will focus in particular on improving vaccination rates in children ages 5–11, which are still very low; addressing vaccine misinformation targeted at pregnant people and nursing mothers; and getting young adults vaccinated and boosted. "Doctors and public health officials are aligned on the importance of every parent and pregnant person getting vaccinated — for their health and the health of their family," said Cameron Webb, senior policy adviser for Covid-19 equity on the White House Covid-19 response team. "The administration is committed to working with trusted local leaders, advocates, public health experts and doctors to make sure we're reaching every community with this important message and answering questions." WHITE HOUSE INVITES BIZ LEADERS TO TALK COVID AID — The White House is gathering companies and philanthropies for a private roundtable next week to discuss how to ensure developing countries have access to Covid-19 medical countermeasures, POLITICO's David Lim reports. White House Covid-19 response coordinator Ashish Jha and national security adviser Jake Sullivan are slated to speak at the virtual meeting on Tuesday, which will focus on how to distribute more vaccines and expand access and use of Covid-19 tests and treatments globally, according to an invitation obtained by POLITICO. The White House is asking the invited executives to come prepared with "concrete solutions" that enable sustained test and treatment production. The meeting comes weeks ahead of the administration's second Global Covid-19 Summit on May 12.   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.     Names in the News The American Telemedicine Association announced five new directors are joining its board: Mujadala Abdul-Majid, Meta; Tania Elliott, Ascension; Julian Harris, ConcertoCare; Nathaniel Lacktman, Foley & Lardner; and Darshak Sanghavi, Babylon. What We're Reading The story of a psychedelics therapist allegedly preying on a Holocaust survivor highlights the vulnerabilities of the elderly in experimental therapy, reports STAT's Olivia Goldhill. Flying from Baltimore to London sans mask. A Washington Post staff writer gives the blow by blow of her trip this week.   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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