HEALTH CARE BRIEFING: Trump Silent on Virus Surge as Cases Rise

President Donald Trump has stayed silent as the U.S. coronavirus outbreak rages anew, a leadership vacuum that leaves governors and health authorities to grapple with record numbers of new cases and hospitalizations.

Trump hasn’t spoken publicly in a week, as the virus surges across the country and sets records for hospitalizations and daily new cases. He’ll receive a briefing Friday on vaccine development, but has otherwise focused his public comments this week on circulating debunked allegations of voter fraud and criticizing Fox News on Twitter.

The president could help by asking Americans directly to wear masks, encouraging Republican governors to do more to slow the spread, publicly backing health officials or even directing his staff to jointly coordinate with President-elect Joe Biden’s transition team, to ensure a smooth handoff, health experts say. Trump has instead been absent. He’s discouraged masks and social distancing and is blocking the start of Biden’s transition while refusing to concede defeat, compounding the federal inaction.

“I find it really just unbelievable that the federal government has just thrown in the towel on this and is doing nothing,” said Ashish Jha, dean of the Brown School of Public Health. He expects Biden to inherit an even more dire picture.

“We are in the worst shape that we have been in, in the pandemic. Things are awful and they are going to get much, much worse,” he said.

The US recorded 145,000 cases yesterday, second only to the 152,000 a day earlier, roughly double the figures from just two weeks earlier. Deaths have been trending upward as well with nearly 2,000 on Wednesday alone. Read more from Josh Wingrove and Emma Court.

Governors Face Pandemic Alone With Trump Distracted: With a Covid-19 vaccine months away and a distracted, lame-duck president, governors are stirring as America’s first line of defense against the pandemic’s winter onslaught. The pending departure of Trump, who has scoffed at the disease’s potency, could provide cover for stricter new measures. The Republican leaders of Nebraska, Maryland, Utah, Ohio and Iowa tightened their virus restrictions for their states this week, and Democrats warned residents of difficult months ahead. Many have little choice but to act, as the virus sets daily records and reality sets in among constituents. Read more from Emma Court and Margaret Newkirk.

  • Still, one thing the latest Covid-19 surge has laid bare: No part of America is totally safe, no matter how restrictive the policies or how compliant the residents. Take Illinois: Since May, it has required face masks in public statewide, at times shuttered indoor dining, and banned large gatherings. Yet it recently hit a series of daily case records and in the past week had more new Covid-19 cases than any other state. Colorado and Michigan have also been restrictive, yet they too face some of America’s most dire streaks of infections. Shruti Date Singh and Jonathan Levin have more.

Klain Pick Boosts Biden’s Virus Response Coordination: The former Ebola czar who will be running Biden’s White House has a knack for getting government agencies to cooperate while digging out from economic crises, colleagues said. Biden’s decision to tap Ron Klain, a District insider who led the nation’s Ebola response in 2014 and 2015, as his chief of staff will be key, as the administration likely will be responsible for rolling out a vaccine nationwide and could be dealing with more surges in cases. Read more from Jacquie Lee and Jeannie Baumann.

Trump Loyalists Hit With Another Wave of Virus: A new wave of people in Trump’s orbit, including longtime adviser Corey Lewandowski and Republican lobbyist Jeff Miller, have tested positive for the coronavirus after attending an election-night party at the White House. It’s unclear if either of them contracted the disease while at the White House. Billionaire shipping magnates Elizabeth and Richard Uihlein, who are among the president’s biggest donors, also tested positive for the virus. Read more from Jennifer Jacobs and Anders Melin.

Happening on the Hill

White House Leaves Stimulus to Congress: The Trump administration is stepping back from discussions on a new coronavirus stimulus package and instead leaving it to Senate Majority Leader Mitch McConnell (R-Ky.) to revive long-stalled talks with House Speaker Nancy Pelosi (D-Calif.), two people familiar with the matter said. While the White House probably would consult with Republicans on details of a Covid-19 relief bill, it’s now unlikely to take the lead on talks, the people said.

With Trump officials retreating, Biden yesterday spoke with Pelosi and Senate Minority Leader Chuck Schumer (D-N.Y.) about the “urgent need” for further resources to deal with the pandemic, including aid to state and local governments, before the end of the year, according to a joint statement. The statement didn’t put a price tag on a bill, but Pelosi and Schumer yesterday reiterated their support for the $2.4 trillion measure proposed earlier this year. Read more from Saleha Mohsin, Laura Litvan and Erik Wasson.

  • Democratic leaders said that the next stimulus package also should include funds to support Biden’s vision for a federal coronavirus response. Pelosi told reporters that Biden has a “mandate” to enact his Covid-19 response and that the election was “more a referendum on who can handle Covid well.” Biden’s team has said it wants tens of billions of dollars to distribute an eventual Covid-19 vaccine, double the number of tests, and create an army of contact tracers.
  • Republican leaders have been supportive of including funds for vaccine distribution in a stimulus package, but are pushing for a lower topline figure than are Democrats. McConnell has pitched around $500 billion in aid measures, significantly lower than Democrats’ offer of more than $2 trillion. “That’s not a place I think we’re willing to go,” McConnell said yesterday of Pelosi’s proposal, Alex Ruoff reports.

Senate Clears Virus Education Program Legislation: The Senate last night by unanimous consent cleared H.R. 8472, which passed the House in October. The bill revises the application processing data for local education agencies in the Impact Aid Program due to Covid-19 disruptions, and also directs the Department of Education to use pre-pandemic data when allocating funds to states under the Migrant Education Program.

Dems Demand ICE Stop Deporting Medical Witnesses: House Homeland Security Chair Bennie Thompson (D-Miss.) and Oversight and Reform Chairwoman Carolyn Maloney (D-N.Y.), as well as members of their committees, demanded Immigration and Customs Enforcement halt any deportations of witnesses or victims in an ongoing investigation into alleged forced hysterectomies and medical maltreatment at a facility in Georgia. The allegations are being investigated by several congressional committees and the departments of Homeland Security and Justice. Read the letter here.

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More on the Pandemic

Fauci Says End to Pandemic is in Sight: Even as Covid-19 rages, the virus won’t be a pandemic for “a lot longer” thanks to rapid progress in vaccine development, according to Anthony Fauci, the top U.S. infectious diseases expert. The disease could nonetheless circulate for years, and people need to recommit to inexpensive public health measures like wearing masks, washing hands and social distancing as cases surge, the director of the U.S. National Institute of Allergy and Infectious Diseases said at an event yesterday. Read more from Tim Loh.

FDA Considers Exclusive License to Patent for Coronavirus Tests: The FDA is considering granting an exclusive license for a government-owned patent on equipment to detect the novel coronavirus to the U.S. unit of a Chinese testing company, according to a Federal Register notice. The U.S. government would receive royalties on the patent under the license, which may be granted by Nov. 30. Read more from Susan Decker and Ian Lopez.

Remarkable Vaccine Results Leave a Lot of Questions Unanswered: When Pfizer and BioNTech reported their successful coronavirus vaccine trial results on Nov. 9, the news sparked optimism around the globe that there was finally light at the end of the long, dark tunnel. Investors rushed to bid up stocks—not just those of vaccine makers, but of a wide swath of ordinary companies expected to benefit once the pandemic moves into the rearview mirror. Yet there are still many hurdles before vaccines get into widespread use and Covid-19 is history.

Questions about production, distribution, and, most important, the capability of the shot itself still need to be answered. Pfizer’s late-stage trial started less than four months ago, and how long the vaccine will confer protection is unknown. “The key question still centers upon time,” says Michael Kinch, a drug development expert and associate vice chancellor at Washington University in St. Louis. “Will time tell us that the protection remains useful for the larger population?” Read more from James Paton and Robert Langreth.

Turmoil Hits Cyber Agency That Shifted Focus on Health Care: Key officials at the U.S. Cybersecurity and Infrastructure Security Agency are stepping down or expecting to get fired from their roles as Trump continues to question the results of the Nov. 3 election, saying he was the victim of a fraudulent voting process. Bryan Ware, assistant director for cybersecurity at CISA, resigned yesterday, along with Valerie Boyd, the assistant secretary for international affairs at the Department of Homeland Security, which oversees CISA, according to two other people. Read more from Shaun Courtney and Alyza Sebenius.

Ware said in the interview with Bloomberg Government that DHS focused on critical infrastructure early on in the pandemic, including pharmaceutical companies working on vaccines and treatments. “Very early this year when we saw the pandemic coming this way, we really leaned into protection for hospitals and clinics and critical manufacturers of PPE equipment,” he said in an interview, Shaun Courtney reports.

“And then as Warp Speed became a thing, we were already working with the pharmaceutical companies and doing things in a different way than we had before,“ he said. “I think this is one of those cases where it wasn’t systemically important critical infrastructure really last year, it absolutely is this year. We were able to pivot a lot of our programs.”

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What Else to Know

Obamacare Enrollment Posts Strong First Week: In the first week of Obamacare enrollment for 2021, more than 800,000 people signed up for health plans on the federal HealthCare.gov platform, the Centers for Medicare & Medicaid Services announced yesterday.

The CMS said that 818,365 people selected a plan in the 36 states using the federal exchange from Nov. 1-7, including 174,344 new people enrolling in coverage and 645,021 renewals. With national elections taking place during the period, as well as arguments before the U.S. Supreme Court over whether the Affordable Care Act is constitutional, “enrollment during the first week was strong,” Get America Covered co-founder Joshua Peck wrote. Get America Covered had projected enrollment the first week would be between 875,000 and 1,050,000 people. Read more from Sara Hansard.

Obamacare Skirmishes Await Regardless of Supreme Court Ruling: The fight over Obamacare will likely continue even if the U.S. Supreme Court upholds the constitutionality of the country’s signature health-care law for a second time. Despite its newly strengthened conservative majority, the court signaled Nov. 10 it’s inclined to let the Affordable Care Act live on with or without the individual mandate that requires everyone to buy health insurance. That ruling won’t stop opponents from trying to tear down the law, but it could deter another broadside legal attack, some health law scholars say. Read more from Lydia Wheeler.

Fetal Tissue Studies See Promise in Biden: A ban on fetal tissue research could be easily undone by the incoming Biden administration, but what happens to research grants in the meantime is unclear. Biden has promised to undo a wide range of Trump’s policies, primarily through executive orders. While the fetal tissue research policy didn’t come via executive order, it is a Trump-era research policy ripe for change once the Biden White House installs a new health secretary.

“As general matter, there’s often a lot of flexibility around any action that’s been taken by an HHS policy,” said Valerie H. Bonham, a Ropes & Gray attorney who served as a senior adviser at the NIH and a senior attorney in the Health and Human Services Office of the General Counsel. Since the decision to establish the policy was driven entirely within the administration, it can be undone in the same manner. Read more from Jeannie Baumann.

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With assistance from Alex Ruoff and Shaun Courtney

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

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