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With David Lim
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Quick Fix
— Six months and 3 million coronavirus cases into the pandemic, public health forecasters warn that the crisis is bound to worsen in the weeks to come.
— The pandemic has continued to disproportionately harm communities of color, even as its epicenter shifts out of cities and into conservative states.
— The White House’s push to reopen schools this fall is its latest attempt to move the country past an ever-present national public health emergency.
WELCOME TO THURSDAY PULSE — where “scream inside your heart” is the 2020 theme we didn’t know we needed.
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THE VACCINE RACE: The world is waiting on a coronavirus vaccine. We're tracking the global competition, the research and development, the rollout plan and how effective the vaccine will be. Check out our full coverage here.
Driving the Day
3 MILLION AND WORSENING — The United States blew past 3 million coronavirus infections during another record day for new cases on Wednesday, and public health forecasters say the next several months could bring even worse news.
The nation is likely to reach the 4 million mark within weeks as outbreaks across several regions mushroom, putting America on pace for 200,000 deaths by Election Day, POLITICO’s Dan Goldberg and Adam Cancryn report.
— It’s a clear signal that containment efforts have failed. The pandemic has outlasted leaders’ patience and political will, swamping any hopes of a summer lull and making it increasingly difficult to prepare for another resurgence in the fall.
That’s deeply disappointed public health experts who envisioned the U.S. uniting against the virus — and instead watched its scattershot response drive further division.
— The irony: The tools for fighting the coronavirus remain the same. Testing, contact tracing and social distancing have been the only proven strategies for curbing the virus’ spread for the last six months — and will be the only path out of the pandemic for the foreseeable future.
But states still face testing backlogs, tracing operations have effectively collapsed, and the nation lost its distancing discipline as the Trump administration and some states pushed to swiftly reopen the economy. That's put the U.S. on pace for more misery even as much of the rest of the world has brought the disease under control.
— The White House’s take: Learn to live with it. “As the President has said, the cure cannot be worse than the disease,” White House spokesperson Judd Deere emailed. “The United States will not be shut down again.”
MINORITIES ARE BEARING THE BRUNT OF THE COVID DISASTER — Even as virus hotspots have shifted from coastal big cities to conservative states, it’s Black, Latino and Native Americans who remain the hardest hit by the disease, POLITICO’s Laura Barrón López, Elena Schneider and Alice Miranda Ollstein report.
Communities of color have suffered from Covid-19 at greater rates across urban and rural areas alike, analyses of county and state data show. And they’ve faced additional barriers to care as well — like lack of access to tests and higher uninsurance rates.
— Arizona is a case study. Latinos make up just under one-third of the population in Maricopa County, but account for half of all infections and 39 percent of hospitalizations.
And in Florida, 59 percent of Latinos and 70 percent of Black people live in census tracts more vulnerable to coronavirus — a major overrepresentation compared with their percentage of the state’s total population.
— Minorities in Democratic-led states are still disproportionately impacted too. That’s been especially apparent in California, where sprawling Los Angeles County has become a massive hotspot. In one of the county communities with the highest percentage of Black residents, the rate of infections per 100,000 was 22 times greater in late June than in early April.
FIRST IN PULSE: NEW LEGISLATION TARGETS SOCIAL DETERMINANTS — Five House Democrats are introducing legislation today that would encourage the use of population health tools to study how policy changes affect health equity. Reps. T.J. Cox, David Trone, Terri Sewell, Julia Brownley and Eliot Engel are backing the bill.
White House
TRUMP’S NEW PANDEMIC FIXATION: OPENING SCHOOLS — The White House’s push to fill up classrooms this fall over teachers’ and some district’s objections represents a fresh attempt to move the country past a still-raging pandemic that’s dented Trump’s political standing, POLITICO’s Anita Kumar and Nicole Gaudiano report.
“It’s about moving forward,” one outside Trump adviser said.
— The issue is heaping more political pressure on the CDC. Two months after the White House clamped down on the agency over reopening guidelines for religious institutions, Trump is bucking the CDC again over its guidance for schools — tweeting Wednesday morning he disagreed with its advice.
The CDC later that day said it would issue new guidance, with Director Robert Redfield telling reporters “the goal is to get schools reopened.”
Redfield later insisted he and Trump were “totally aligned,” but then would not comment on the president’s tweet.
— Yet there’s still no workable plan for ensuring safe repenings. Schools in many areas lack the tools and funding to protect students and teachers, and on Wednesday coronavirus coordinator Deborah Birx appeared to cast doubt on a key administration assertion: That schools are safe because children are at low risk of infection.
“I think it really comes to the evidence base of, what do we have as far as testing and children,” she said. “The portion that has been the lowest-tested portion is the under 10-year-olds. So we’re putting into place other ways to get testing results from them … and try to really figure this out.”
2020 Watch
WHAT’S ON THE BIDEN-SANDERS TASK FORCE’S HEALTH WISH LIST — The health coalition led by Rep. Pramila Jayapal and former Surgeon General Vivek Murthy is recommending a series of health priorities that straddle the divide between moderate and progressive Democrats.
— Medicare expansion and a public option. The task force isn’t calling for “Medicare for All,” opting instead for lowering Medicare’s eligibility age to 60 and tacking on a public option.
Notably, the public option would be administered by the government — not private insurers. And at least one option would come with no deductible. The group is also backing a series of provisions making Obamacare more generous.
— A sweeping drug pricing overhaul. The policy recommendations track closely with the drug pricing bill the House passed last year, H.R. 3 (116), though the task force remained vague on a key intraparty flashpoint: How many and which drugs would be subject to price negotiations.
— A ban on surprise billing. They also sidestepped weighing in on the fight that’s paralyzed every “surprise” medical billing effort to date: How hospitals and insurers should resolve pay disputes.
Coronavirus
FDA’S MARKS CASTS DOUBT ON COVID ‘CHALLENGE TRIALS’ — Senior FDA official Peter Marks rebuffed suggestions the agency could intentionally infect people with coronavirus to test possible vaccines, saying the approach would create “ethical heartburn.”
Marks’ main objection is that there’s no easy way to treat infected patients, POLITICO’s Sarah Owermohle reports. “If something bad happens, you don’t have a perfect fix for it,” he said.
— House lawmakers have pushed the “challenge trial” strategy. That includes former HHS chief Donna Shalala, who floated the idea in April. World Health Organization guidance has also green-lighted ethical versions of the trials.
— But Marks stressed that the FDA needs to balance safety and speed. The agency will need the public to trust that the development process was sound for any vaccine to be widely adopted.
Eye on FDA
FDA POSTS INTERIM ESSURE STUDY RESULTS — Women implanted with Essure, a permanent birth control device, tended to have an increased likelihood of chronic lower abdominal and/or pelvic pain and abnormal uterine bleeding compared to those who had laparoscopic tubal ligation, according to interim results from an FDA-required postmarket study released Wednesday.
“They basically confirmed that the concerns we and other consumer groups had about the device,” Public Citizen’s Mike Carome told POLITICO's David Lim.
Terri Cornelison, the director of FDA’s device center Health of Women Program, said the agency is working with manufacturer Bayer to add an additional interim analysis one year after patients’ permanent birth control procedure to more closely monitor outcomes.
— U.S. sales of the device were discontinued in December 2018 and it has not been available for implantation since December 2019. But adverse event reports tied to Essure have continued after it was withdrawn, according to medical device safety expert Madris Tomes.
“The device doesn't always migrate and perforate organs immediately,” Tomes said. “It can take years for the problems to compound and for the patient to realize that it's the device causing the problems.”
What We're Reading
A growing number of Houston-area residents are dying at home, echoing what happened in New York in the pandemic’s early days, Mike Hixenbaugh and ProPublica’s Charles Ornstein report.
Stat’s Helen Branswell profiles Maria Van Kerkhove, the head of the World Health Organization’s emerging disease unit and a leader of its rocky Covid-19 response.
An Arizona teacher has already died from Covid-19, underscoring the risks facing school employees in the hard-hit state, the Arizona Republic’s Lily Altavena reports.
Churches are emerging as a major source of new coronavirus outbreaks, The New York Times’ Kate Conger, Jack Healy and Lucy Tompkins report.
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