Welcome to POLITICO's West Wing Playbook, your guide to the people and power centers in the Biden administration. With help from Allie Bice. Send tips | Subscribe here | Email Alex | Email Max For the last several weeks, Americans across the country have struggled to access the new Covid-19 antiviral pill, Pfizer's Paxlovid. Eligibility was flexible but largely reserved for people "at high risk for progression to severe COVID-19," according to the Food and Drug Administration's emergency use authorization standards. That's why public health experts were surprised last night when the vice president's office revealed that the 57-year-old KAMALA HARRIS was taking the antiviral pill after she tested positive yesterday. Harris' office said she is asymptomatic. And her office didn't comment on whether she has any underlying health conditions that could make her more susceptible to a bad case of the disease. "Why," asked JONATHAN REINER, professor of medicine and surgery at George Washington University School of Medicine & Health Sciences, "would you give Paxlovid to someone without symptoms?" "Asymptomatic covid and no medical issues isn't an indication for Paxlovid," DONALD TRUMP's Surgeon General JEROME ADAMS tweeted.
West Wing Playbook asked the same thing about the medication and a White House official only replied that Harris "remains asymptomatic" and is "feeling good and has been in touch with staff." Harris' age does put her at higher risk for severe illness from infection, according to current CDC guidance . And Adams and other medical experts noted that world leaders are often granted top-of-the-line medication, if simply as a precautionary measure.
"I don't think it's unreasonable," said CELINE GOUNDER, an infectious disease specialist and epidemiologist who's also editor-at-large for public health at Kaiser Health News. She said the FDA's reference to "high risk" for progression to severe disease in its Paxlovid fact sheet suggests a patient can be asymptomatic at time of diagnosis and still be eligible for the drug. "We know that the way that presidents, or in this case vice presidents, are treated is not necessarily the way the average person is treated," added Gounder, who advised the Biden transition on Covid-19. "It's not just about what is best for that patient – it's about what's best for the nation." But medical ethicists argued that the moral rationalization for giving Harris the medication only underscores how unfair the system is. "It's what I make of the American health care system – better to be rich and connected," said ARTHUR CAPLAN, a New York University professor of medical ethics. Harris' speedy access to Paxlovid sharply contrasts with the rest of the country's ability to get it. The sheer logistics of finagling a prescription, and then finding the pills within days of symptom onset, has complicated the drug's rollout after it was first authorized in December. Only physicians, physician assistants and certain registered nurses — not pharmacists — can prescribe the drug. That means patients may have to visit a testing site, a doctor's office and, in the worst-case scenario, visit a participating pharmacy just to get the pills. The White House has tried to address this through its "test to treat" initiative, setting up one-stop shops for patients to get tested and access treatment on the spot. But a Department of Health and Human Services map of "test-to-treat" locations nationwide shows that many sites are concentrated in major metro areas, raising accessibility concerns in rural pockets of the country. The White House announced this week it's working with states to launch more sites with federal support and will allow thousands more pharmacies to directly order the medication. This is not the first time questions have been raised around the Covid protocols Harris has taken. The day after her communications director, JAMAL SIMMONS, tested positive in early April, a maskless Harris presided over the Senate vote to confirm KETANJI BROWN JACKSON . CDC guidelines state that those directly exposed to a "close contact" — which Simmons was — should wear a mask around other people for the next 10 days. But Harris' office stressed that "the Vice President presided over the Senate while practicing social distancing — with limited and brief interactions from her chair." At an event celebrating the confirmation the following day, Harris stayed unmasked and gave Brown a close hug. Press secretary JEN PSAKI said Harris "was socially distanced for 99.9 percent of the event," adding that "the Vice President has been wearing a mask inside." A White House social media video about Brown's confirmation released the following day, however, showed Harris maskless in the Oval Office standing over the president and next to first lady JILL BIDEN. Psaki subsequently argued that the VP still followed CDC guidance but conceded "there were moments when she was not wearing a mask inside, including in a photo. But she was wearing it 99.9 percent of the time." TEXT US — ARE YOU JOHN ANZALONE, a pollster on JOE BIDEN's 2020 campaign? We want to hear from you (we'll keep you anonymous). Or if you think we missed something in today's edition, let us know and we may include it tomorrow. Email us at westwingtips@politico.com or text/Signal/Wickr/WhatsApp Alex at 8183240098 or Max at 7143455427.
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