With Carmen Paun
Programming note: We’ll be off Monday for Martin Luther King Jr. Day but will be back in your inboxes on Tuesday.
THE CDC IN ‘PERIL’— A long list of D.C. lawmakers, public health experts and think tanks have lately been offering advice to the Centers for Disease Control and Prevention, the embattled public health agency that has recently embarked on a process of self-reformation.
A working group formed by the Center for Strategic and International Studies, a nonprofit research policy center, released a report Thursday that examines what it calls the CDC’s “moment of peril.” The report, authored by the group’s co-chairs, J. Stephen Morrison, senior vice president and director of CSIS’ Global Health Policy Center, and Tom Inglesby, director of the Johns Hopkins’ Center for Health Security at the Bloomberg School of Public Health, outlines steps the CDC can take to turn around what critics say is a declining ability to effectively protect Americans’ health.
Krista talked to Inglesby this week about the report, “Building the CDC the Country Needs.” The interview has been edited for length and clarity.
You say throughout the report that the CDC has entered a moment of “peril.” What do you mean by that?
The peril is that public perceptions of CDC changed a lot over the course of the pandemic. The CDC has always enjoyed public and bipartisan support. If that goes away, then overall political public policy support for the critical mission of CDC is at risk. And the country can’t afford to have a CDC that is anything but strong and fast and scientifically sound.
Does the CDC’s current standing among the public and among politicians directly translate into a national security threat?
The CDC is the national institution that we rely on to provide guidance in crisis, to provide technical assistance to laboratories, to provide messages to the public about how to reduce their risks of contracting a contagious disease. That’s important in natural epidemics but important in some kind of deliberate biological event. We’ve seen the connection between pandemics and our national well-being. In a severe pandemic, that crisis can affect our economy. It can affect our educational system. It can affect basic societal functions.
How can the agency rehabilitate itself as an independent voice that can give its own advice?
It is logical for there to be a lot of organization and connection between the White House and CDC in a crisis because CDC is working in a larger federal family. But it’s also very important for CDC to have a clear, scientific independent voice. And I think you’ve seen more of that in the last six months. I think you saw that during monkeypox.
One point you made in the paper was that the CDC needs a greater presence in Washington. Why?
You know how Washington works. There’s a lot of interaction between the federal agencies and the White House and OMB. You need to be present in those interactions there. The process is not one and done. The process is always. They do have a Washington office and people in Washington. They do not have the number of senior experienced policymakers that other agencies have in Washington. They have to rely on fewer people on the move from the CDC… It’s just a big disadvantage.
WELCOME TO FRIDAY PULSE — Doctors in Ukraine removed an unexploded grenade from inside a young soldier’s chest, managing to complete the procedure without setting off the explosive. Incredibly, it’s not the first time unexploded ordnance has been removed during surgery. Send your news and tips to [email protected] and [email protected].
Today on our Pulse Check podcast, Ben Leonard talks with Ruth Reader about the impact the end of the Covid-19 public health emergency might have on access to drugs used to treat substance use disorders and mental illnesses.
KINDERGARTEN VACCINATION RATES PLUMMET — Vaccination coverage among kindergarteners fell to a 10-year low last school year, according to CDC officials discussing a new report released Thursday.
In the 2021–2022 school year, national vaccination coverage among kindergarteners dropped to 93 percent, down 1 percent from the previous year, the report found. Coverage for MMR, DTaP, polio and varicella vaccines declined in most states. About 3.9 percent of children — or 250,000 kids — had not been vaccinated against measles, officials told reporters during a call.
Why it’s happening: CDC officials attributed the continuing drop to a variety of factors, ranging from missed routine pediatrician visits during the pandemic, lockdowns, schools having to focus on remote learning instead of enforcing vaccination requirements and misinformation and vaccine hesitancy about the Covid-19 vaccine spilling over into other vaccines.
The good news (and some more bad news): While researchers saw an increase in children attending school for the first time without any vaccination documentation, they didn’t see a marked increase in the number of nonmedical exemptions requested by parents. In other words, some parents might still just be behind in getting back on track instead of intentionally declining to vaccinate their kids.
A separate CDC report released Thursday found that vaccination coverage overall was higher among young children up to 24 months born in 2018 and 2019. However, vaccination rates declined among kids living below the poverty line and in rural areas.
PHE’S END COULD COMPLICATE MENTAL HEALTH, OPIOID DISORDER CARE — Pandemic waivers that have allowed individuals with substance use disorders and mental illness to receive virtual care, including prescription medications, could soon end if the Biden administration terminates the Covid public health emergency in April, POLITICO’s Ben Leonard writes.
Congress has extended many other exemptions that have applied during the PHE — such as expanded Medicare and high-deductible health plan telehealth access and hospital-at-home care — through the end of 2024.
The Biden administration has said in its policy agenda that it expects to issue a proposed rule this month to facilitate virtual prescribing of buprenorphine — a drug used to treat opioid use disorder — and a separate regulation generally allowing access to controlled substances by telemedicine.
But the DEA is concerned that some telehealth providers abused pandemic waivers by overprescribing drugs. The agency is reportedly investigating two firms, Cerebral and Done, for allegedly overprescribing controlled substances used to treat attention-deficit hyperactivity disorder.
U.S. ENDS SCREENING FOR EBOLA AT AIRPORTS — Travelers who have been in Uganda over the past 21 days no longer need to be screened for any potential symptoms of Ebola upon entering the U.S. the CDC said. The Ugandan government and the World Health Organization declared the outbreak officially over on Wednesday after 42 days of no new reported cases.
The U.S. began screening passengers who had traveled to the country in October, a few weeks after the declaration of an outbreak of the Sudan strain of Ebola. While no cases made their way into the U.S. or other countries, at least 55 people died and 164 were infected with the virus in Uganda.
CALIFORNIA SUES OVER INSULIN PRICES — California filed a lawsuit Thursday against the largest makers of insulin and major pharmacy benefit managers, accusing them of illegally hiking the price of insulin in violation of state law, POLITICO’s Ramon Castanos reports.
The suit names Eli Lilly, Novo Nordisk and Sanofi — the three companies that produce 90 percent of the insulin in the world. It also targets CVS Caremark, Express Scripts and OptumRx, pharmacy benefit managers that Attorney General Rob Bonta says handle about 80 percent of prescription claims.
FENTANYL DRIVES RECORD OVERDOSE DEATHS IN NYC — New York City saw its highest rate of overdose deaths in 2021 since reporting began just over two decades ago, POLITICO’s Maya Kaufman reports.
Overdose deaths rose 27 percent in 2021 to nearly 2,700 New Yorkers, or a rate of 39.4 deaths per 100,000 residents when adjusted for age, according to provisional data released Thursday by the New York City Department of Health and Mental Hygiene. Fentanyl was detected in 80 percent of the deaths.
Director of the Maine Center for Disease Control and Prevention Nirav D. Shah has been tapped as the CDC’s new principal deputy director. Shah previously served as president of the Association of State and Territorial Health Officials between March 2021 and September 2022.
Wanyoike Kang’ethe is now a senior principal scientist with Altria’s regulatory affairs department. He previously was toxicology branch chief with the FDA’s Center for Tobacco Products’ Office of Science.
Our colleagues at Power Switch dive into the Great Gas Stove Debate burning up Washington, D.C.
U.S. cancer rates have dropped 30 percent since 1991, the BBC reports.
