With help from Daniel Lippman
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— Biden officials are considering what Covid-19 death metric the country must reach to declare the pandemic under control.
— The CDC is analyzing long Covid mortality, part of a broader quest to understand the evolving disease.
— Monkeypox cases are expected to rise, as the CDC warns that the rare virus may now be passing person to person in the U.S.
WELCOME TO MONDAY PULSE — On social media, even the new Gerber baby is a target, as the contest becomes the latest staging ground for angsty parents. Send news and tips to [email protected] and [email protected].
HOW MANY COVID DEATHS ARE OK? Recently, Biden administration officials have been privately mulling the number of daily Covid-19 deaths at which the virus could be considered to be under control, POLITICO’s Rachael Levy reports.
The number of 200 daily deaths or fewer was kicked around in discussions across the administration until it was ultimately decided not to formally incorporate it into pandemic planning, sources said.
Fewer than 200 people dead a day would translate to about 73,000 deaths a year, slightly more than what the U.S. experiences during a bad flu season.
The discussions, though described as purely “exploratory,” underscore the delicate balance the administration walks between trying to minimize Covid-19’s harm and encouraging Americans to live with it, even as the CDC expects deaths to rise in the weeks ahead as cases are forecast to surge nationwide.
On June 3, the average daily number of Covid-19 deaths was 414. At no point since the pandemic’s first weeks have fewer than 200 Americans died a day at a sustained rate.
WHILE WE’RE ON THE SUBJECT … The Centers for Disease Control and Prevention is analyzing more than 100 deaths that could be attributed to long Covid, reports POLITICO’s Erin Banco.
The CDC’s National Center for Health Statistics is reviewing death certificates from across the country from 2020 and 2021 that cite long Covid or similar terminology, such as “post Covid.”
It’s unclear whether the people who died had underlying health issues and whether long Covid was the cause of their deaths or a contributing factor. The center is expected to release preliminary data from the review shortly.
Why it matters: Doctors and public health officials are scrambling to assess the risk that long Covid poses to Americans — and the world. A recent CDC study found that as many as one-fifth of adults infected with Covid-19 had at least one lingering health problem, meaning that millions of Americans are potentially impacted.
The condition’s severity ranges greatly, from minor symptoms that improve within weeks or months to severely debilitating health problems that dramatically affect patients’ lives.
What the research says: Few studies have examined the relationship between long Covid and mortality. A study of European cancer patients, published in The Lancet in November 2021, found that about 15 percent of those who survived Covid-19 had long Covid symptoms and their survival outcomes were significantly worse.
MONKEYPOX AND COMMUNITY SPREAD — Health officials warn that monkeypox may be spreading person to person in the U.S. and that cases are expected to rise as the government calls on doctors to stay vigilant for symptoms of the rare disease.
The CDC reports 24 confirmed cases in 12 states, Krista writes.
“I want to emphasize that this could be happening in other parts of the United States,” said Jennifer McQuiston, the incident manager for CDC’s monkeypox response, on Friday. “There could be community-level transmission that is happening, and that’s why we want to really increase our surveillance efforts.”
The CDC says the risk to Americans’ public health remains low in the unusual global outbreak. Monkeypox is rarely seen outside West and Central Africa, where it is endemic. Since May, more than 900 cases have been reported in nonendemic countries in Europe, North America and South America and in Australia.
So far, no deaths have been reported in those regions, unlike in the Democratic Republic of Congo where the disease is endemic and 1,200 cases and 58 deaths have been reported since the beginning of the year.
The World Health Organization has characterized the risk to global public health as “moderate” and said it suspects the virus was spreading between individuals in Europe weeks before it was reported in early May.
FIRST IN PULSE — The American Medical Association’s CEO James Madara sent a letter on Sunday to House Speaker Nancy Pelosi and House Minority Leader Kevin McCarthy to oppose a bill that would allow nurse practitioners and physician assistants “to diagnose, prescribe, treat, and certify an injury and extent of disability” for purposes of compensating federal workers under the Federal Employees’ Compensation Act.
Current law says only doctors can make such determinations. In a letter shared first with Pulse, Madara writes that the skill sets of NPs and PAs “are not interchangeable with that of fully educated and trained physicians” and by removing doctors from the process, H.R. 6087 (117) jeopardizes the care of federal workers.
The organization’s head cites concerns with the standardization of NP and PA programs and particularly with the increased prevalence of online learning, which means students have less in-person instruction and hands-on training than they do with in-person learning.
SPECIAL OLYMPICS BOWS TO FLORIDA VAX PRESSURE — The Special Olympics reversed its Covid-19 vaccine mandate for upcoming competitions in Orlando after Florida threatened event organizers with a $27.5 million fine, POLITICO’s Arek Sarkissian reports.
The Special Olympics, which kicked off on Sunday and are expected to attract 4,000 athletes, issued a statement saying it will lift its mandate as directed by state officials on May 27 “based upon the Florida Department of Health’s interpretation of Florida law.”
The day before, the Florida Department of Health sent a letter to Special Olympics International threatening the fine. The letter states the Special Olympics had asked 5,500 people to provide proof of vaccination to gain access into the 2022 USA Special Olympics Games, which violates a state ban on requiring proof of vaccination.
FDA RAISES CONCERNS OVER NOVAVAX VACCINE — FDA reviewers have signaled concerns that Novavax’s Covid-19 vaccine could be associated with an increased risk of heart inflammation, POLITICO’s Lauren Gardner reports.
On Tuesday, an external advisory panel will consider Novavax’s application for emergency use authorization for its two-dose primary series in people 18 and older.
In its briefing document, Novavax said the vaccine has 90 percent efficacy against mild, moderate and severe disease and has a “positive benefit-risk profile.” The company also said that observed cases of inflammation of the heart muscle, called myocarditis, and its lining, called pericarditis, were within expected incidences of myocarditis in the general population without any vaccine administered.
The FDA was concerned enough with the recorded cases to ask Novavax to mark the two heart conditions as an “important identified risk” — something the company hasn’t yet agreed to do, the agency said in papers released ahead of the Tuesday meeting.
IN DEFENSE OF ACCELERATED APPROVAL — A new analysis from the Partnership to Fight Chronic Disease says that drugs approved under the FDA’s accelerated approval program don’t drive up Medicaid spending.
In light of efforts to limit coverage of drugs approved via the accelerated pathway, the study estimated the impact that accelerated approved drugs had on Medicaid spending growth nationally and state by state between 2007 and 2020.
On both levels, it found those drugs accounted for about 1 percent or less of annual Medicaid spending yearly, and in 2020, they “consumed well less than one dollar for every one hundred dollars of total Medicaid spending, and similarly contributed a minimal amount to Medicaid spending growth” in all states.
Beth Cameron, the former National Security Council senior director for global health security and biodefense, has been appointed as senior adviser for global health security at the U.S. Agency for International Development.
Tim Manning has left the White House, where he was Covid-19 supply coordinator. He is returning to academia and the private sector.
Natasha Silva is now senior director of federal government relations at the National Multiple Sclerosis Society. She previously was legislative director for Rep. Bill Keating (D-Mass.) and is a Stephen Lynch alum.
Chelsea Conaboy reports for POLITICO Magazine how a Dutch doctor may become America’s most controversial abortion provider.
The Associated Press reports on the unsung work of the country’s youngest Covid-19 caregiver.