September 20, 2021

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Overnight Health Care: Biden signs health care executive actions to ‘undo the damage’ caused by Trump | COVID-19 cases drop, but variants point to dangers ahead | Novavax vaccine almost 90 percent effective in trial, but not against South Africa variant

8 min read

Welcome to Thursday’s Overnight Health Care.

President Biden announced new steps to expand access to health care and to reverse some of the Trump administration’s anti-abortion measures. Novavax reported mixed results in its early trial analysis, previewing some potential dangers about new coronavirus variants. And the state AG says New York undercounted nursing home deaths.

We’ll start with Biden:

Biden signs health care executive actions to ‘undo the damage’ caused by Trump

President Biden on Thursday signed two executive actions focused on health care, describing the directives as a necessary effort to “undo the damage” done by former President TrumpDonald Trump’QAnon Shaman’ willing to testify in impeachment trial, lawyer says Boebert clashes with Parkland survivor on Twitter: ‘Give your keyboard a rest, child’ Overnight Defense: FEMA asks Pentagon to help with vaccinations | US says Taliban has ‘not met their commitments’ | Army investigating Fort Hood chaplain MORE.

Biden signed an order directing federal agencies to open a special enrollment period for the Affordable Care Act (ACA) exchanges from Feb. 15 to May 15 in response to the coronavirus pandemic and to review existing policies put in place under the Trump administration that limited access to health care.

Biden made protecting the ACA a key part of his presidential campaign as he and other Democrats accused Trump of sabotaging the health care law. 

Open enrollment: The executive order directs the Department of Health and Human Services (HHS) to open a special enrollment period from Feb. 15 through May 15, something the Trump administration refused to do, despite the pandemic. HHS will likely launch new advertising and outreach activities to go along with the special enrollment period — efforts that were essentially ended by the Trump administration. 

Medicaid: Federal agencies are directed to review other policies from the prior administration that could “limit” access to health care, including Medicaid work requirements and policies that “undermine” the ACA or protections for people with preexisting conditions or make it more difficult to enroll in federal health programs. 

Abortion funding: Biden told agencies to review the Trump administration’s controversial changes to the Title X family planning program, which provides contraception and other health services to low-income women and men. The changes required family planning providers participating in the program to stop providing or promoting abortions to remain eligible for funding. 

‘Global gag rule:’ Biden also signed a presidential memorandum rescinding the Mexico City policy which requires that foreign groups receiving family planning aid from the U.S. government agree not to provide or promote abortions, even with funding from other sources.

Read more here

COVID-19 cases drop, but variants point to dangers ahead 

The number of Americans testing positive for the coronavirus has dropped substantially from an early January zenith, easing the strain on hospitals across the nation that faced danger over the winter holidays.

But new and more transmissible strains of the coronavirus are circulating more widely across the world, and public health experts caution that, even with the beginnings of mass vaccination programs, Americans must be more vigilant than ever in protecting themselves and reducing the spread.

The pace of infections has followed a steady and disturbing pattern in the year since the virus was first identified in the United States: Cases rise alarmingly, first in core epicenters and then across the nation, followed by a plateau and a slight decline, before the cycle begins again. 

What worries epidemiologists and health experts is that the declines have so far stalled at successively higher baselines, leading to larger spikes when infections begin accelerating anew.

New strains: The pattern is likely to accelerate once again as two more transmissible strains — one known in the scientific literature as B.1.1.7 and first identified in the United Kingdom, the second known as B.1.351 and first identified in South Africa — begins spreading faster. The Centers for Disease Control and Prevention (CDC) estimates those strains will become dominant in the United States in the coming weeks. On Thursday, the CDC said it had identified the first two strains of the South African variant in South Carolina.

Read more here.

Foreshadowing some of the dangers from the new variants, Novavax announced early results of its vaccine trial with a major caveat:

Novavax vaccine almost 90 percent effective in trial, but not against South Africa variant

Novavax’s COVID-19 vaccine has been found to be almost 90 percent effective in a clinical trial in the United Kingdom, the company said Thursday, but was far less effective in a separate trial in South Africa given the variant prevalent there.

Efficacy was strong in the UK trial, at 89.3 percent, the company said. 

But in a separate, smaller trial in South Africa, where a more contagious variant of the virus known as  B.1.351.has taken hold, efficacy fell sharply to 49.4 percent, though it was somewhat higher, at 60 percent, among participants who did not have HIV.

That news is problematic for the U.S.,where the more contagious variant was found in South Carolina just hours before the announcement. Even more problematic, the U.S. is so far behind much of the world in genetic sequencing, we don’t know how widespread this new variant is.

The South Africa trial had just 4,400 volunteers, but the results were enough for the company to say it will be working on a booster specifically for that variant. 

Read more here.

Meanwhile, Pfizer says its vaccine won’t be impacted as much.

Study finds Pfizer vaccine effective against mutations in new COVID-19 variants

A Pfizer study released Wednesday determined that the mutations in the COVID-19 variants originally found in the United Kingdom and South Africa have “small effects” on the effectiveness of the company’s vaccine developed with BioNTech.

The preliminary research, conducted by Pfizer and University of Texas Medical Branch scientists, concluded that the results showed no need for an additional vaccine for the variants.

“While these findings do not indicate the need for a new vaccine to address the emerging variants, the Companies are prepared to respond if a variant of SARS-CoV-2 demonstrates evidence of escaping immunity by the COVID-19 vaccine,” Pfizer and BioNTech said in a release.

The study said the vaccine was slightly less effective on mutations for the variant first found in South Africa compared to other mutations. 

“The Companies believe the small differences in viral neutralization observed in these studies are unlikely to lead to a significant reduction in the effectiveness of the vaccine,” the companies said.

Read more here.

State AG says New York massively undercounted nursing home COVID-19 deaths

The administration of New York Gov. Andrew CuomoAndrew CuomoOvernight Health Care: Biden signs health care executive actions to ‘undo the damage’ caused by Trump | COVID-19 cases drop, but variants point to dangers ahead | Novavax vaccine almost 90 percent effective in trial, but not against South Africa variant State AG says New York massively undercounted nursing home COVID-19 deaths COVID-19 hospitalizations decreasing as states begin lifting restrictions MORE (D) undercounted the number of COVID-19 deaths in nursing homes by as much as 50 percent, according to a new report from the state attorney general.

The 76-page report from Attorney General Letitia James (D) is based on preliminary findings from an investigation that began in March into nursing home policies that caused abuse and neglect and put the lives of patients and staff in danger.

The state has reported about 8,600 nursing home deaths tied to the coronavirus since the pandemic began. Overall COVID-19 deaths in the Empire State exceed 40,000.

Cuomo has been dogged by accusations of obscuring the true death toll in nursing homes across the state at the height of the pandemic last spring.

New York only counted residents who died on nursing home property, rather than any who were transferred to hospitals. But according to the report, most of the deaths occurred in hospitals.

Read more here.

GOP seizes on CDC research to press Biden on schools

School reopening has become the latest partisan battlefield of the pandemic. 

The Biden administration is coming under pressure from Republicans to support the reopening of schools after the Centers for Disease Control and Prevention (CDC) published new research that says that schools can operate safely despite COVID-19.

The CDC researchers on Tuesday wrote that there is “little evidence” of widespread coronavirus transmission in schools when proper precautions are followed.

Teachers unions in several places across the country, however, are resisting the push to return to in-person instruction, arguing it is not safe. 

Experts stress that the picture is nuanced, and schools should not be thrown open without care and precautions. But they say repeated evidence from around the country shows that schools can open safely under the right conditions. 

That puts the new Biden administration in a tough political spot given support from teachers unions for the Democratic Party. And the GOP is seizing on the issue, arguing that schools should be reopened.

Point of contention: Teachers unions are pushing to keep schools closed until it can be completely safe, and have drawn criticism for what some see as unreasonable demands.  

Big picture: Schools may not be areas of spread, but they are reflective of the larger communities. If the virus is raging in a community, there’s a much higher likelihood of infection outside the school and it being brought in.  

Read more here.

The Hill event

Friday 1/29 beginning at 12:30 PM ET | Reset 2021: A New American Start

The inauguration of President Biden and Vice President Harris marks a new era in Washington. As with any presidential transition, priorities and goals will be recalibrated. The administration has outlined a broad policy framework with proposals focused on improving infrastructure and expanding universal access to broadband, revitalizing immigration, supporting environmental sustainability, providing meaningful support to those harmed by the COVID-19 pandemic, and, of course, reviving the economy. Looking ahead to the first 100 days, what steps will be used to drive economic recovery and environmental sustainability and to address immigration? Reps. Peter DeFazioPeter Anthony DeFazioOn The Money: Economy shrank 3.5 percent in 2020 | Lawmakers rip Robinhood’s decision on GameStop | Budget rules, politics threaten per hour minimum wage Overnight Health Care: Biden signs health care executive actions to ‘undo the damage’ caused by Trump | COVID-19 cases drop, but variants point to dangers ahead | Novavax vaccine almost 90 percent effective in trial, but not against South Africa variant The Hill’s Morning Report – Dems question trial; January becomes deadliest pandemic month MORE, Stacey PlaskettStacey PlaskettOn The Money: Economy shrank 3.5 percent in 2020 | Lawmakers rip Robinhood’s decision on GameStop | Budget rules, politics threaten per hour minimum wage Overnight Health Care: Biden signs health care executive actions to ‘undo the damage’ caused by Trump | COVID-19 cases drop, but variants point to dangers ahead | Novavax vaccine almost 90 percent effective in trial, but not against South Africa variant The Hill’s Morning Report – Dems question trial; January becomes deadliest pandemic month MORE, David SchweikertDavid SchweikertOn The Money: Economy shrank 3.5 percent in 2020 | Lawmakers rip Robinhood’s decision on GameStop | Budget rules, politics threaten per hour minimum wage Overnight Health Care: Biden signs health care executive actions to ‘undo the damage’ caused by Trump | COVID-19 cases drop, but variants point to dangers ahead | Novavax vaccine almost 90 percent effective in trial, but not against South Africa variant The Hill’s Morning Report – Dems question trial; January becomes deadliest pandemic month MORE and Ted Detuch, USCC’s Tom Donohue, Kevin Hassett, UnidosUS’s Janet Murguía and more. RSVP today for one session or both. (https://reset2021.splashthat.com/) 

What we’re reading

New COVID cases plunge 25 percent or more as behavior changes (Kaiser Health News

Time to double mask or upgrade masks as coronavirus variants emerge, experts say (The Washington Post

US drug prices more than twice as high than in 32 countries (STAT)

State by state

This doctor became the face of Ohio’s coronavirus response. Some Democrats want to make her a senator (Buzzfeed)

At Colorado’s rural edges, vaccines help assisted living homes crack open the doors (Kaiser Health News)

$44 billion vaccine system from CDC gets few takers among states (Bloomberg

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