Is the new Omicron subvariant cause for concern?

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

Jan 06, 2023 View in browser   By Daniel Payne and Krista Mahr Presented by With Carmen Paun Driving the Day Health experts say that XBB.1.5 is more transmissible than other Covid strains and encourage people to take precautions like masking up. | Spencer Platt/Getty Images EARLY SIGNS FROM XBB.1.5 — With the most transmissible variant of Covid-19 causing more cases across the U.S., public health officials are considering the possible impacts of the new strain. Pulse spoke with two infectious disease experts about what XBB.1.5 means for the country and how we got here. The variant doesn't seem to be driving up hospitalizations and deaths — but the risk to individuals is real. Though Covid hospitalizations appear to be on the rise nationwide, experts don't project this Omicron subvariant alone to cause a spike — forecasts from early data suggest they'll remain fairly steady, Céline Gounder, an infectious disease specialist and senior fellow at the Kaiser Family Foundation, said. Holiday travel, social gatherings and colder weather are factors in the rising hospitalization rate. "This may be more transmissible, but it's not necessarily translating into more hospitalizations and deaths in the population at large," she added. The prediction matches the data from Singapore, where a related subvariant recently became dominant but didn't result in a spike in hospitalizations and deaths — though that country's vaccination rate is higher than that of the U.S. But some individuals — particularly people who are older or pregnant or have weakened immune systems — are at heightened risk from the virus, regardless of larger population trends. "I'm a bit concerned with it just because it's coupled with the extremely low booster rates of those over 65," Katelyn Jetelina, epidemiologist and professor at the University of Texas Health Science Center, said. "Our most vulnerable aren't as protected." And Covid remains a concern to the population as a whole, health experts have continued to emphasize. From long Covid to the ongoing disease threats of the flu and respiratory syncytial disease, risks remain. And that's why Gounder and Jetelina, among other health experts, continue to highlight the importance of vaccination, masking and testing in stopping the virus. It matters that this variant is more transmissible than others, but overstating the risk could have downsides. "We have to be careful about not overplaying the risk every time there's a new variant because I think you are going to see fatigue — we already see fatigue," Gounder said of the public's attention to the pandemic. "So you have to be judicious about when you say this is truly a threat versus not." A subvariant like this isn't surprising, and more of the same is likely to come, both experts said. "This virus continues to do what viruses do," said Jetelina. "We're going to continue to see this." Viral strains that are better at infecting people than earlier versions will eventually become dominant in the population — until a more contagious variant enters the scene. "Big picture, that's exactly what you expect: that the virus that is more transmissible has an evolutionary advantage over other variants and will come to dominate in the population," Gounder said. WELCOME TO FRIDAY PULSE. We made it … at least to another day of House Speaker votes. Stuck on the Hill today for vote number 12 (or beyond)? We want to hear about it — and about your health policy expectations for 2023. Drop us a line at dpayne@politico.com and kmahr@politico.com. TODAY ON OUR PULSE CHECK PODCAST, Lauren Gardner talks with Daniel about the results of a survey from the Substance Abuse and Mental Health Services Administration, which shows that 1 in 3 Americans had a substance abuse disorder or mental illness in 2021. Plus, Ben Leonard talks with Amy Abernethy, president of Verily's clinical research business and the former No. 2 at the FDA, about barriers to improving trials, the new Advanced Research Projects Agency for Health and more. Listen to today's Pulse Check podcast   A message from PhRMA: Costly out-of-pocket expenses tied to deductible and coinsurance requirements are a leading concern for patients with commercial insurance. These harmful practices put in place by insurers and pharmacy benefit managers (PBMs) are even causing patients to abandon their medicines. New IQVIA data break down how insurers and their PBMs are impacting how patients access and afford their medicines.   Abortion The Idaho Supreme Court ruled to uphold the state's abortion restrictions. | Sarah A. Miller/Idaho Statesman via AP IDAHO UPHOLDS ABORTION RESTRICTIONS — The Idaho Supreme Court upheld a near-total ban on abortion, saying there's no implicit right to the procedure in the state's constitution, POLITICO's Megan Messerly reports. The decision comes just hours after the South Carolina Supreme Court released its opinion striking down the state's six-week abortion ban under a privacy clause in the state's constitution, allowing abortion to remain legal in the state until 20 weeks of pregnancy — more on that below. Idaho has no right to privacy in its constitution, and the state's 3-2 ruling will prohibit abortion in most cases — except if necessary to save the pregnant person's life or in cases of rape and incest. SOUTH CAROLINA RULES ABORTION PROTECTED — Hours before the Idaho ruling was released, the South Carolina Supreme Court struck down the state's six-week abortion ban, ruling the privacy rights in the state constitution protect abortion access, POLITICO's Megan Messerly reports. Abortion will remain legal until 20 weeks of pregnancy because of the 3-2 decision, representing a setback for Republican lawmakers who hoped to ban the procedure after conception. The majority opinion noted the state could limit a person's right to privacy but added "any such limitation must be reasonable" and "afford a woman sufficient time to determine she is pregnant and take reasonable steps to terminate that pregnancy." The court determined six weeks was not a reasonable amount of time. The South Carolina Supreme Court is the first state high court to find a state-level constitutional right to abortion since the fall of Roe v. Wade — although other states have similar challenges pending. Global Health CHINA PUSHES BACK AGAINST LACK OF COVID TRANSPARENCY — The Chinese embassy in the U.S. responded to international accusations about its lack of transparency on Covid-19 data in a briefing with reporters in Washington, D.C., on Thursday. The embassy's spokesperson Liu Pengyu claimed that China "has always shared its information and data responsibly with the international community," Carmen and POLITICO's Phelim Kine report. The World Health Organization's emergencies boss Mike Ryan said Wednesday that, while China has shared some data about the virus variants circulating in the country, it's not enough and understates the wave's impact. On the same day, State Department spokesperson Ned Price said the lack of transparency from China on epidemiological and viral genomic sequencing data has compounded U.S. concerns about the potential of a new variant emerging in China. So far, the data China presented to WHO experts show no new variant there, but much more data is needed to get a complete picture, the WHO said. China's explanation: The authorities stopped testing citizens en masse after moving away from its "Zero Covid" policy, which makes it difficult to know the exact number of cases, Liu said, noting that the U.S. and other countries have similar difficulties estimating the exact number of cases. He added more information on case fatality rates is being collected and will be shared in the future. Why it matters: The Omicron-triggered wave of infections and deaths in China after its switch from Zero Covid is fueling renewed mistrust toward the country, with many Western nations imposing testing requirements over the last week for people traveling from China.   A message from PhRMA:   At the Agencies STAYING THE COURSE — The FDA rejected demands from the left and the right on abortion pill regulations, POLITICO's Alice Miranda Ollstein reports. The agency denied two petitions related to mifepristone — one of two pills used to terminate a pregnancy — declining to loosen or tighten the rules for who can get the drugs as well as when and how. One rejected demand, from anti-abortion group Students for Life, asked the FDA to prohibit most telehealth prescriptions of the medication, essentially reverting to a 2011 restriction on the drug. The FDA also turned down a demand from the American College of Obstetricians and Gynecologists, which asked the agency to make the pills easier for miscarriage patients to obtain. The decisions come just after the agency expanded access, allowing the drug to be picked up at local pharmacies. HEALTH TECH PATIENT PORTAL DISPARITY — White patients are more likely to know about and use online patient portals than are Black and Hispanic patients, POLITICO's Ben Leonard reports. White patients are at least 10 percentage points more likely than Black and Hispanic patients to be offered access to an online patient portal that provides test results or other medical information. Most patients — including white people in the study — didn't access a portal at all. "Differences in access were likely driven by disparities in being offered a portal," ONC economist Chelsea Richwine wrote in a blog post Thursday. "Our findings point to the important role of health care providers in increasing access to [electronic health information] by offering portals and encouraging their use." The differences come as health organizations try to close the digital divide as they adopt new technologies for sharing and storing patient information.   A message from PhRMA: Every day, patients at the pharmacy counter discover their commercial insurance coverage does not provide the level of access and affordability they need. New data from a study by IQVIA reveal the harmful practices of insurers and their pharmacy benefit managers (PBMs) can lead to significantly higher out-of-pocket costs for medicines — causing some patients to abandon their medicines completely. Learn more.   Public Health A CERVICAL SCREENING GAP — Nearly 1 in 10 women have never been tested for cancerous or precancerous cells in their cervix, raising their cancer risk, according to a new survey. POLITICO's Ruth Reader reports the new Harris Poll data, which surveyed 872 women ages 18 to 64, found more than 70 percent of respondents have delayed Pap tests. And most women said they didn't know how often to get screened. The American Cancer Society recommends that women ages 25-65 get a test for human papillomavirus, or HPV, the leading cause of cervical cancer, every five years and a screening for potential cervical cancer every three years. Black and Hispanic women were less likely to get screened than white women, the report found. Around 4,000 American women die from cervical cancer annually, though the disease is largely preventable by vaccination and screening. Names in the News Brian Reich is now chief speechwriter at the U.S. Dept. of Health and Human Services. He most recently served as senior vice president of branding and marketing at Murmuration, a progressive political data and strategy operation in New York. What We're Reading Rising noise levels are harming the mind and body, Kaiser Health News reports. Global Covid surveillance is an even bigger concern than the rising cases in China, The Economist argues.   Follow us on Twitter Dan Goldberg @dancgoldberg Katherine Ellen Foley @katherineefoley Lauren Gardner @Gardner_LM Ben Leonard @_BenLeonard_ David Lim @davidalim Krista Mahr @kristamahr Megan Messerly @meganmesserly Alice Miranda Ollstein @aliceollstein Carmen Paun @carmenpaun Megan R. Wilson @misswilson Daniel Payne @_daniel_payne Ruth Reader @RuthReader   Follow us

To change your alert settings, please log in at https://www.politico.com/_login?base=https%3A%2F%2Fwww.politico.com/settings This email was sent to rouf@idiot.cloudns.cc by: POLITICO, LLC 1000 Wilson Blvd. Arlington, VA, 22209, USA Please click here and follow the steps to unsubscribe.