HEALTH CARE BRIEFING: Trump Aide Floats ‘Herd Immunity’ Approach

Public skepticism about coronavirus vaccines and enthusiasm on the right for herd immunity are colliding as the country’s outbreak is worsening, developments that could dash hopes for containing Covid-19 in the months ahead.

Herd immunity aims instead to expose more people to the coronavirus, to build protection broadly in the population. It’s been roundly denounced by mainstream experts, who say it promises still more illness and death. Still, the concept has surfaced in White House circles, due to the mounting influence of President Donald Trump’s medical advisor, Scott Atlas. And it was endorsed this month by a group of academics in a treatise titled the Great Barrington Declaration.

Officially, just about 220,000 Americans have died from the coronavirus. But the Centers for Disease Control and Prevention estimated yesterday that the number of dead overall—from all causes—was about 300,000 higher than was expected in a typical year. Many are likely to have died from virus cases that went uncounted.

Meanwhile, the predicted fall surge in infections is materializing, with new cases on the rise since early September, especially in Midwestern states. The U.S. recorded about 69,500 new infections daily last week, rivaling peak numbers this summer, and almost 60,000 additional cases yesterday, according to Johns Hopkins University data compiled by Bloomberg.

On a conference call last week that the White House organized in an apparent effort to draw attention to the Great Barrington statement, two administration officials said it amounted to an endorsement of Trump’s policies.

Trump adviser Atlas, a neuroradiologist affiliated with Stanford University’s conservative Hoover Institution who lacks an epidemiology background, said in a statement that the document emphasized protecting the vulnerable while reopening schools and society, and that “those specific policies are aligned with the president.” The Trump administration has sent thousands of rapid tests to nursing homes, while pushing for schools to reopen.

Atlas has repeatedly publicly said it’s preferable to expose young, healthy people to the virus, but has said he hasn’t ever encouraged Trump to adopt a herd immunity strategy specifically. Meanwhile, mainstream public-health leaders have condemned a herd immunity approach as ethically contemptible. Read more from Emma Court.

More on the Pandemic

Pelosi, Mnuchin Make Another Run at Stimulus McConnell Opposes: Treasury Secretary Steven Mnuchin and Speaker Nancy Pelosi (D-Calif.) will try today to bridge remaining gaps in their talks over comprehensive coronavirus relief, blowing past Pelosi’s self-imposed deadline yesterday amid signs of progress toward a pre-election deal.

But Senate Majority Leader Mitch McConnell (R-Ky.), who is pressing ahead with his own, more targeted plan, warned the White House against agreeing to anything akin to Pelosi’s more sweeping proposal. The speaker agreed to continue talking beyond her original Tuesday cut-off, saying an agreement with the Trump administration needs to be done by the weekend to get a bill passed by the end of next week, ahead of Election Day Nov. 3. Read more from Billy House and Erik Wasson.

‘Red Zone’ States Reach All-Time High: The number of “Red Zone states,” where Covid-19 cases were increasing significantly, has reached an all-time high, according to newly released documents from the White House Coronavirus Task Force. As of Oct. 13, the White House has flagged 31 states as being in the red zone, the most since the executive branch began issuing reports to states in June. The documents, sent to governors offices but not widely distributed, were made public by the House Select Subcommittee on the Coronavirus Crisis yesterday. Read the subcommittee’s report here.

Lilly Covid Drug Plant Flagged Again by FDA for Quality Issues: U.S. drug-safety inspectors have found continuing quality-control problems problems at a New Jersey plant Eli Lilly & Co. is using to help produce its Covid-19 antibody therapy, posing a potential obstacle to the company meeting its goal of producing 1 million doses by year-end.

In an Oct. 2 memo, Food and Drug Administration compliance officers wrote that findings from an inspection of the facility in July and August “support a major failure of quality assurance.” They noted that Lilly planned to make its antibody therapy at the plant and said the inspection group “feelsit is still imperative that FDA take action.” Read more from Anna Edney.

U.K. Prepares First Tests to Purposefully Infect People: The first trials to deliberately infect people with the coronavirus to accelerate the development of vaccines could occur in the U.K. next year as part of an agreement reached by the government. Britain signed a contract with Open Orphan and its London-based unit hVivo that paves the way for human challenge trials, the company said. The plan is to manufacture SARS-Cov-2 and conduct human clinical trials to determine how much of the pathogen to expose volunteers to in the study.

The agreement is a turning point in a contentious ethical debate on whether to conduct such studies, which could help researchers combat the novel virus but expose healthy volunteers to potential risks. Read more from James Paton.

Tracking Shot’s Safety Strains Health IT Networks: Electronic health data systems that still can’t fully talk to one another will create challenges flagging side effects of any vaccine once it reaches the market. Surveillance systems to monitor everything from vaccines to cough drops have been in place for decades, and the CDC said it plans to beef up what it does for Covid-19. But finding long-term safety data on a shot that will likely be authorized for some segments of the population after a few months will require changing the culture of patients and providers who aren’t used to reporting side effects, drug safety experts said. Read more from Jeannie Baumann.

DeVos Rejects Role for Tracking Covid-19 in Schools: Education Secretary Betsy DeVos said yesterday she doesn’t see a role for her department in tracking coronavirus cases in schools. Instead, DeVos said school leaders can rely on data compiled by the Centers for Disease Control and Prevention as well as state governments. “The data is there for anybody who wants to search for it and look for it,” DeVos said, Andrew Kreighbaum reports.

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What Else to Know

Democrats Question Legality of Trump Drug Card: House Energy and Commerce Chairman Frank Pallone (D-N.J.), House Ways and Means Chairman Richard Neal (D-Mass.), and Senate Finance ranking member Ron Wyden (D-Ore.) want Health and Human Services Secretary Alex Azar to answer their questions about the legality of the Trump administration’s plans to send $200 cards to millions of Medicare beneficiaries “in an apparent attempt to buy votes ahead of Election Day using $7.9 billion in taxpayer funds,” according to a statement. Read the letter here.

Republicans Tout ACA as Thriving Under Trump: Republicans are trying to sell the Trump administration as the single best steward of Obamacare, despite the increasing number of uninsured people and the push to upend the health law. House Republicans and the Trump campaign say premiums for plans on the Affordable Care Act’s individual marketplace are falling and Americans now have more insurance options. The push to tout accomplishments around the ACA show how the politics of the once-unpopular health law have changed over the past four years. Read more from Alex Ruoff.

Medicare Head Verma to Campaign for Trump: Centers for Medicare and Medicaid Services Administrator Seema Verma will campaign for Trump tomorrow in North Carolina, an unusual appearance for a relatively obscure administration official. Verma is set to appear at the state Republican Party office in Raleigh as a special guest during a “Prime Timers for Trump” event geared toward seniors, the Trump campaign said yesterday. Read more from Jordan Fabian.

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Colorado Dispensaries Fail to Skirt Subpoenas in IRS Audit Fight

ThermoGenesis Soars as FDA Extends Test Kit’s Expiration Date

Xeris Pharma Climbs After Getting FDA Fast-Track for Diazepam

Biogen Drug to Get Approval Despite Flaws, JPMorgan Poll Says

Justice Department Presses to Curtail Purdue Pharma Bankruptcy Probe(DJ)

Health Ministry Faces Crackdown From N.Y. Insurance Regulator

With assistance from Alex Ruoff and Andrew Kreighbaum

To contact the reporter on this story: Brandon Lee in Washington at blee@bgov.com

To contact the editors responsible for this story: Zachary Sherwood at zsherwood@bgov.com; Giuseppe Macri at gmacri@bgov.com; Michaela Ross at mross@bgov.com