HEALTH CARE BRIEFING: Trump Battles In-House Outbreak

By Brandon Lee

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President Donald Trump faces a tricky proposition this week, as he tries to convince Americans it’s safe to return to work and social life while combating a coronavirus scare moving closer than ever to his own office.

Vice President Mike Pence has been self-isolating from the White House following his press secretary Katie Miller’s diagnosis of Covid-19 on Friday, said three people familiar with the situation. A spokesman said he’d be back at the White House today.

Miller’s infection brought the virus into Trump’s inner circle, as she’s married to one of his closest advisers, Stephen Miller, known best as the architect of much of his immigration crackdown.

Pence didn’t attend a meeting at the White House on Saturday with Trump and top military officials. Neither did two members of the Joint Chiefs of Staff who’ve had their own brushes with coronavirus, Chief of Naval Operations Michael Gilday and the chief of the National Guard Bureau, Air Force General Joseph Lengyel.

Gilday has had contact with an infected family member. Lengyel tested positive on Saturday, and later tested negative, a Defense Department spokesman said. He’ll be tested again today.

A rapid-test screening at the White House ahead of Trump’s meeting with military leaders in the Cabinet Room caught Lengyel’s positive status, one person familiar with the matter said.

Trump has ratcheted up his efforts to urge Americans to reopen businesses and resume a more normal social life, as widespread social distancing practices continue to exact unprecedented damage on the U.S. economy — once his favorite argument for re-election. Read more from Jennifer Jacobs.

Sen. Alexander to Self Quarantine: Sen. Lamar Alexander (R-Tenn.) will self-quarantine in Tennessee for 14 days after a staff member tested positive for Covid-19, his chief of staff David Cleary says in a statement. The staffer tested positive yesterday, and Alexander last tested negative May 7. Alexander has no symptoms.

  • Alexander, chairman of the Senate Health, Education, Labor and Pensions Committee, is due to lead the panel’s virtual hearing tomorrow on the virus response, which includes testimony from National Institute of Allergy and Infectious Diseases Director Anthony Fauci and Centers for Disease Control and Prevention Director Robert Redfield.

Redfield and FDA Commissioner Stephen Hahn are also now quarantining after coming into contact with the White House staff member who tested positive for the coronavirus. Fauci, will start a “modified quarantine,” during which he’ll primarily work from home and wear a mask continually for 14 days, he told CNN on Saturday, Jennifer A. Dlouhy reports.

Congressional Virus Efforts

New Funding for Testing, Tracing Sought: House Democrats want to provide more funds for Covid-19 testing and surveillance to aid efforts to restart the U.S. economy, House Energy and Commerce Chairman Frank Pallone (D-N.J.) said during a teleconference briefing. The House does “intend to do more” in terms of funding testing and contact tracing programs, he said.

At the briefing, Andy Slavitt, a former acting administrator of the Centers for Medicare & Medicaid Services, outlined his $46.5 billion plan to reopen the economy and expand the contact tracing workforce. Slavitt warned that the Covid-19 pandemic is still growing in much of the country and the public health infrastructure needs to expand. “We’re heading to 100,000 American lives lost, and we’re not appreciably slowing,” he said. Read more from Alex Ruoff.

GOP Finds Deficit-Scold Voice Again, Adding Snag to Talks on Aid: The flood of pandemic-relief spending from Washington has rekindled deficit concerns among Republican lawmakers, one of several hurdles facing the next round of stimulus many economists say is needed to pull the U.S. out of its downward spiral.

After backing almost $3 trillion to offset the economic impact of the coronavirus pandemic, Senate Majority Leader Mitch McConnell (R-Ky.) and other Republicans now have begun raising alarms about the deficit and characterizing a new relief package as an if, not when, proposition. Trump is also tapping the brakes on the idea of swift action on any new aid package, saying he’s in “no rush” for a new stimulus even after Friday’s Labor Department report showing an unprecedented 20 million jobs were lost in April. Read more from Steven T. Dennis.

Democrats Push to Restore WHO Funding: Democrats on the Senate Foreign Relations Committee are offering legislation that would restore U.S. funding for the World Health Organization and appropriate $9 billion to support international efforts to fight the pandemic. The move comes as Trump and his administration claim that the agency was complicit in the spread of the virus by accepting initial claims from China about the severity of the outbreak. He then temporarily suspended U.S. payments to the WHO.

The legislation would require the immediate restoration of funds to the WHO and would re-establish a position for global health emergencies on the staff of the National Security Council. The legislation also aims to keep sanctions from affecting humanitarian relief and medical equipment delivery efforts to North Korea, Iran, and Venezuela. Read more from Daniel Flatley.

  • Meanwhile, the Department of State said Friday that China has stepped up a campaign to shift blame for the outbreak by using fake internet accounts to promote conspiracies on the source of the virus as Beijing adopts Russian-style disinformation tactics. Experts at the department’s Global Engagement Center have found evidence of a campaign linked to the ruling Communist Party in which accounts run by Chinese officials and other officials gained hundreds of followers a day. Nick Wadhams has more.

Virus Research Integrity: The House Energy and Commerce Health Subcommittee plans a hearing Thursday on scientific integrity in the Covid-19 response. The panel has asked Rick Bright, the former Biomedical Advanced Research and Development Authority director who was reassigned, to testify. Bright said he was ousted over his concerns regarding a drug pushed by the Trump administration to treat the coronavirus and clashed repeatedly with his superiors over other issues related to the pandemic, according to a complaint he filed last Tuesday.

Letters & Legislation:

  • Senate HELP ranking member Patty Murray (D-Wash.) on Friday asked HHS’s assistant secretary of preparedness Robert Kadlec for “corrected paperwork” regarding potential conflicts of interest, citing news reports he failed to disclose connections to companies with business directly relevant to his position at the department. Murray and five other Democrats requested a briefing and his “assurances that all decisions made at ASPR are driven by public health” before May 19. Read the letter here.
  • Sens. Chris Murphy (D-Conn.) and Tammy Baldwin (D-Wis.) on Friday led 8 Senate Democrats in urging the Trump administration to cover Covid-19 treatment expenses for Americans enrolled in short-term health insurance plans, sometimes referred to as “skinny plans,” and “junk plans” by critics. The plans, backed by the Trump administration as a cheap alternative to coverage on the Affordable Care Act marketplace, don’t cover some expenses as required by the ACA, Murphy and Baldwin say. Read the letter here.
  • House Energy and Commerce Health Subcommittee ranking member Michael Burgess (R-Texas) on Friday sent a letter to Chairwoman Anna Eshoo (D-CA) to call for a hearing on the Strategic National Stockpile. “The committee has a responsibility to actively examine through hearings how to improve efforts to fight COVID-19,” Burgess said in a statement. Burgess wants the hearing to investigate concerns related to the distribution of SNS supplies amid concerns of shortages of personal protective equipment at hospitals. Read the letter here.

Testing & the Path to Reopening

White House Looks Abroad for Reopening Ideas: The Trump administration has cited success stories in South Korea and Austria as it calls for Americans to return to work — but those countries moved faster than the U.S. to combat the pandemic and have been more cautious in reopening their economies. And a third country U.S. officials once regarded as a model, Singapore, is now struggling with a resurgence of the outbreak.

Secretary of State Michael Pompeo and White House economic adviser Kevin Hassett have said in the past two weeks that the Trump administration is monitoring those three nations as it plans for the U.S. to reopen. But they offer flawed comparisons at best, given the much larger size of the U.S. and its outbreak, as well as measures taken to curb the virus. Read more from Josh Wingrove, Boris Groendahl and Kanga Kong.

  • As businesses across the U.S. begin reopening amid the crisis, they’re following a patchwork of state, local and industry guidance on how to do it safely. What they’re not following are official and detailed recommendations from the nation’s top public health agency, the U.S. Centers for Disease Control and Prevention because the Trump administration hasn’t released them. State health departments in places such as Georgia, Alabama, North Carolina and Ohio, where some businesses have been reopening, have published their own guidelines. Margaret Newkirk and Emma Kinery have more.

Quidel’s Antigen Test Approved: The FDA approved a new antigen test that could help rapidly screen people infected with Covid-19. The emergency use authorization, the first ever for a Covid-19 antigen test, was granted late Friday to San Diego-based Quidel, the company and the FDA said. The move could be a breakthrough in screening for the coronavirus, coming as state and local governments ease their lockdown orders and businesses begin reopening across the U.S. Health professionals argue that swift screening is key to temper new outbreaks. Jennifer A. Dlouhy and Katerina Petroff have more.

Former FDA Commissioner Scott Gottlieb yesterday called the new Quidel test a “game changer.” He told CBS yesterday that each test will probably cost about $5, with results available within minutes. Gottlieb, now a special partner at New Enterprise Associates, a venture capital firm that invests in the health-care and biotech sectors, said “doctors now have about 40,000 of these Sophia machines already installed in their offices” where they’re used to test for strep throat and flu. Read more from Dlouhy.

FDA Approves Test Using At-Home Collection: The FDA Friday approved the first diagnostic test with the option of home-collected saliva samples for Covid-19 testing. The FDA issued the emergency use authorization to Rutgers Clinical Genomics Laboratory. The authorization for the molecular test permits testing of a saliva sample collected from the patient using a designated self-collection kit. Read more from Robert Lavelle.

More Headlines:

Research, Treatment & Coordination

HHS Said Debated Wider Use for Malaria Drug: A request from HHS Secretary Alex Azar to make an established malaria treatment available for Covid-19 patients set off an internal debate about how to authorize the drug’s use for that purpose, a complaint filed by a recent administration official said. The FDA ultimately gave hydroxychloroquine an “emergency use authorization” letting doctors in hospitals, under certain conditions, prescribe the drug for patients with the virus’ respiratory disease. Read more from Shira Stein and Jeannie Baumann.

  • Novartis expects to present results from a U.S. study of hydroxychloroquine in July, as well as for two other drugs being tested for Covid-19 effectiveness — Ilaris and Jakavi, CEO Vas Narasimhan told Swiss newspaper Schweiz am Wochenende. Novartis is ready to ramp up production of hydroxychloroquine, Narasimhan said in the interview. Still, existing studies of the drug didn’t meet the highest standard of clinical research and the company is focused on delivering reliable data regarding Covid-19 usability, he said. Read more from Jan Dahinten.

U.S. Ships Remdesivir to States: The federal government is sending Gilead Science’s remdesivir to Connecticut, Illinois, Iowa, Maryland, Michigan and New Jersey after doctors raised questions about the federal allocation of the drug to treat patients. State health agencies, rather than the federal government, will distribute doses to the hospitals, the HHS said Saturday. Illinois and New Jersey each get more than 100 cases. Read more from Steve Geimann.

  • The White House on Friday said it will have Deborah Birx, a member of the coronavirus task force, help oversee distribution of Gilead’s Covid-19 drug following questions about the opaque process for getting the therapy to U.S hospitals. “She is going to be working and consulting as to where this drug should go,” White House spokeswoman Kayleigh McEnany said at a briefing Friday. “She really has the best grasp as to how that should be distributed.” Read more from Michelle Fay Cortez.

Coronavirus-Related Patents to Be Fast-Tracked: Small businesses working on coronavirus-related drugs or treatments can get patents in as few as six months under a new program announced by the U.S. Patent and Trademark Office. “Independent inventors and small businesses are often the difference makers when it comes to cutting-edge innovation and the growth of our economy,” patent office Director Andrei Iancu said in a statement. “They are also in most need of assistance as we fight this pandemic.” Susan Decker has more.

Majority Black Counties See Triple the Covid Death Rate: It has become increasingly clear that black Americans are dying at alarmingly high rates of Covid-19. But absent national statistics, the picture remains incomplete. Piecemeal data trickling out of cities and states have shown disproportionate death rates among African Americans, with an analysis of available state-provided figures by APM Research Lab putting the black death rate at 2.6 times higher than that of whites.

A look at countrywide data adds another troubling statistic to the growing pile of evidence that the virus is ravaging black communities. Counties with the highest proportion of black residents are also seeing the highest death rates. The larger the share of black residents, the worse the health outcomes get. Read more from Jeff Green and Jackie Gu.

Sleuthing at Funeral Parlors to Track Nursing Homes’ True Toll: Connecticut is swabbing corpses at funeral homes. Maryland is testing all nursing-home residents and staff, symptomatic or not. Coast to coast, governors have intensified efforts to get accurate death counts at the facilities as investigations suggest far more devastation than initially recorded. In New York and New Jersey, tallies of deaths from the novel coronavirus surged in recent days after the states began disclosing more data on nursing-home residents. On Sunday, New York Governor Andrew Cuomo added a requirement that all positive test results for staff must be reported to the state health department by the next day.

Nursing homes account for at least a third of the nation’s 76,000 Covid-19 fatalities, and in 14 states they’re more than half the total, according to Kaiser Family Foundation data from Thursday. Those numbers, though, are woefully incomplete because 18 states aren’t disclosing such data and those that are provide varying levels of information. Read more from Elise Young and Keshia Clukey.

More Headlines:

What Else to Know

Dental Industry Sees Less Federal Aid: Dental practices accounted for more than a third of the 1.4 million health-care industry job losses in April, according to the Bureau of Labor Statistics. Dental practices lost 503,000 jobs in April, according to BLS data. Before the coronavirus pandemic, the health-care industry had been a cornerstone for growth in the economy, adding jobs steadily even through recent recessions. The coronavirus spread shut down much of the industry, with dental practices and physicians offices shedding a combined 746,000 jobs in April alone. Read more from Alex Ruoff.

GAO Faults Government on Scientist Recruitment: The FDA and NIH haven’t been able to recruit top scientists under an authority provided in a landmark biomedical innovation law because they are still waiting for guidance on how many people they can hire, according to a Government Accountability Office report released Friday, Jeannie Baumann reports.

More Headlines:

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

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

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