HEALTH CARE BRIEFING: Biden’s School-Reopening Plans at Risk

The coronavirus pandemic is erupting anew in youth sports across the U.S., prompting fresh warnings from President Joe Biden’s health advisers and adding a headwind to his push to reopen classrooms.

Several states have faced recent outbreaks linked to sporting events and to a variant of the virus from the U.K. called B.1.1.7. Michigan is an epicenter both of the latest surge and the U.K. variant, which is regarded as more transmissible than the original strain of the virus and may be deadlier.

Elementary, middle and high schools have driven the outbreak in Michigan more than any other setting, largely through sports such as basketball and wrestling, according to data compiled by the state.

Despite rising vaccinations, what had been a dramatic decline in U.S. cases has stalled as new variants take hold and overtake the original virus — and as pandemic-weary Americans clamor to return to normal life. A new surge in cases threatens Biden’s hopes to get more classrooms reopened — a political vulnerability Republicans have sought to exploit by blaming teachers’ unions and Democrats for keeping children at home.

“We remain focused on and committed to our objective of reopening schools five days a week,” White House Press Secretary Jen Psaki said yesterday. Read more from Josh Wingrove.

Happening on the Hill

Public Health Leaders to Talk Vaccines: House Select Coronavirus Crisis Chair Jim Clyburn (D-S.C.) will hold a hearing next Thursday with U.S. Centers for Disease Control and Prevention Director Rochelle Walensky, National Institute of Allergy and Infectious Diseases Director Anthony Fauci, and David Kessler, head science officer for the White House’s Covid-19 response, Clyburn said in a statement. The hearing will explore the Biden administration’s “progress in accelerating vaccine access” and the “crucial importance of adhering to public health measures,” the statement says.

Substance Abuse Amid Pandemic: Energy and Commerce Chair Frank Pallone, Jr. (D-N.J.) and Health Subcommittee Chair Anna Eshoo (D-Calif.) announced that the subcommittee will hold a hearing next Wednesday on substance abuse with White House Office of National Drug Control Policy acting Director Regina LaBelle. The hearing comes as overdose deaths surged in 2020, likely in part as a result of the shutdowns prompted by the spread of Covid-19. The White House hasn’t yet named a permanent head for ONDCP. Read the hearing announcement here.

EEOC Pressed for Vaccine Incentive Guidance: A pair of Republican lawmakers asked the U.S. Equal Employment Opportunity Commission to offer insight on the murky legal area of vaccine incentives, perks offered by employers to encourage workers to receive a Covid-19 shot. Employers seeking to protect employees by increasing vaccinations through incentive programs need assurances it “does not violate important labor laws such as the Americans with Disabilities Act,” they said. Read more from Paige Smith.

The Coronavirus Pandemic

Biden Opens Shots to Community Health Centers: Biden will offer Covid-19 vaccines to all of the nation’s community health centers, adding 2,500 delivery sites in a program aimed at closing the racial gap in inoculations. Another 520 will be eligible, increasing the total to about 1,470 across the U.S., an official familiar with the plans said.

The 520 new health centers operate over 2,500 delivery sites. So far, about 70% of community health center vaccinations have been for racial minorities. Community health centers typically serve at-risk communities, including Americans living in poverty. “By adding to the number of community health centers participating in this program,” said HHS Secretary Xavier Becerra yesterday, “we will help make sure shots are getting to those who need them most.” Josh Wingrove has more.

Pfizer Shot May Be Offered to Kids by May: Pfizer’s Covid-19 vaccine could be expanded to children as young as 12 years old as soon as May and Moderna’s vaccine may be available by this summer, Walensky said on ABC Instagram Live. “By May or mid May maybe we’ll be able to have a vaccine from Pfizer that will be able to do down to 12 and Moderna will soon follow because those studies are happening right now,” Walensky said. The data on 5-year-olds and younger will likely need to wait through the end of 2021, she said, Jeannie Baumann reports.

U.K. to Avoid AstraZeneca Shots for Young People: Two drug regulators issued a warning about AstraZeneca’s Covid-19 vaccine, acknowledging a link to a rare type of blood clots and prompting the U.K. to restrict the shot’s use in younger adults. The U.K. is now advising that those under the age of 30 be offered an alternative vaccine if one is available, the Medicines and Healthcare Products Regulatory Agency said. Naomi Kresge and Emily Ashton have more.

• Meanwhile, the NIH is starting a clinical trial to determine whether people who are highly allergic or have a mast cell disorder are at increased risk for an immediate and systemic allergic reaction to the Moderna or Pfizer-BioNTech Covid-19 vaccines. Investigators will examine the biological mechanism behind such reactions and whether a genetic pattern or other factors can predict who is at most risk, Malak Saleh reports.
• Related: AstraZeneca’s Vaccine Drama Risks Prolonging the Pandemic

B.1.1.7 Variant Most Common Strain in U.S.: The B.1.1.7 variant of the coronavirus that was first found in the U.K. has overtaken the original strain of the virus in the U.S. and is now the nation’s most common form, Walensky said at a briefing yesterday. The strain had overtaken other mutations that have emerged as well. B.1.1.7 is more easily transmitted and appears to also be more harmful. Read more from Josh Wingrove.

Covid-19 Boosts Risks for Mental Disorders: A third of Covid-19 survivors were diagnosed with a neurological or psychiatric condition six months after infection, according to the first large-scale analysis to compare risks to other illnesses, including influenza. The University of Oxford study analyzed health records of 236,379 Covid-19 patients infected in 2020, a report published in The Lancet Psychiatry journal says. Read more from Fiona Rutherford.

Small Business Owners Surveyed on Vaccine: Less than a fifth of small business owners plan to require their workers to get a Covid-19 vaccine or pay their workers to get vaccinated, according to a new survey released Tuesday, Alex Ruoff reports.

Business owners prefer to offer educational materials or time off to get vaccinated over a bonus or mandate, according to the survey of more than 3,000 business owners from March by Reimagine Main Street, a collection of business groups and companies. Business groups say getting the workforce vaccinated will be key for their success and employers can play a big role in educating their workers on the safety of the Covid-19 vaccines.

More Headlines:

• White House Says Americans Need to ‘Do Their Job’ in Vaccine Push
• Mexican Foreign Minister Plans Trip to U.S. to Secure Vaccine Doses
• California Eyes Total Reopening as ‘Vacciland’ After Hard Lockdown
• Carnival Cruise Bookings Surge Even as Industry Remains Sidelined

What Else to Know

Biden to Release 2022 U.S. Budget Outline Friday: Biden will release his preliminary spending requests for 2022 tomorrow, the White House said, the first step before Congress negotiates the government’s budget for the fiscal year starting in October.

Biden’s spending request will also only deal with about a quarter of the annual federal budget — discretionary spending set annually by Congress — leaving out entitlements like Medicare, Medicaid, Obamacare and Social Security. And the document won’t include the infrastructure and jobs plan the president unveiled last week in Pittsburgh.

His first full budget proposal, including tax, entitlements and debt figures, is expected later in the year. Read more from Justin Sink and Erik Wasson.

More White House News:

• White House Approves Inpatient Rehab Facilities Pay Rule Proposal
• White House Clears HHS Release of Medicare Hospice Pay Proposal

Biden’s ACA Signup Period Draws a Half-Million Enrollees: More than a half-million people have signed up for Obamacare coverage since the Biden administration reopened the federal marketplace in February, the Department of Health and Human Services said. The number of enrollees from Feb. 15 through March 31 marks a “substantial” increase from 2020 and 2019, when 209,000 and 171,000 people signed up, an HHS fact sheet says. Sara Hansard has more.

• Related: Laid-Off Employees Get Relief to Keep Job-Related Health Coverage

Employers Pressed to Ensure Hospitals Disclose Rates: Companies that cover employees’ health coverage face greater responsibility for monitoring pricing now that hospitals in their networks must comply with a new rule requiring that negotiated rates be disclosed. The rule, which took effect Jan. 1, requires hospitals to post the rates they’ve negotiated with insurers on their websites. The rule may thus enable employers to get payment information that they could use to push their insurers to negotiate better rates with hospitals, helping ensure that employers are paying hospitals the best rates. Read more from Sara Hansard.

Ex-Trump Aide Launches Health-Care Investment Firm: Adam Boehler, a former official in the Trump administration involved in the early pandemic response, has started a health-care investment firm with two private equity partners. His Nashville-based firm Rubicon Founders will create companies and help fund purchases of existing firms, said Boehler, a former chief executive officer of the U.S. International Development Finance Corporation. Read more from Jennifer Jacobs.

Corporate Leaders Decry Anti-LGBTQ Legislation: Top executives from four of the largest food companies came together to condemn the growing number of anti-LGBTQ bills under consideration in U.S. state legislatures, including those that target transgender people and particularly children. In an open letter published in USA Today, business leaders of Danone, Mars, Nestle, and Unilever blasted the bills as dangerous and called on corporations to take action. Read more from Carolina Gonzalez.

More Headlines:

• Medicaid Work Requirement Waivers Pulled in Michigan, Wisconsin
• Medicare Payment Bump Proposed for Psychiatric, Rehab Facilities
• FDA Approves Bausch + Lomb Clearvisc Ophthalmic Surgery Device
• Eleven States Join DOL Fight to Undo Data-for-Insurance Ruling

With assistance from Alex Ruoff

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