Three takeaways from the monkeypox hearing

Monkeypox got top billing at yesterday’s hearing – but senators also pivoted to other health issues

Senators hauled top Biden health officials to Capitol Hill yesterday, demanding answers on the federal response to monkeypox during the chamber’s first hearing on the virus.

Lawmakers on the Senate’s health panel said they were disturbed that a virus traditionally confined overseas had spread so rapidly in the United States — and were worried it may permanently take root here. Both Republicans and Democrats accused the administration of frequent missteps, raising questions about whether the federal government can beef up its public health preparedness efforts in time for the next infectious-disease outbreak.

“For the next one, we’ve got to respond a hell of a lot faster than we did for covid — and we’ve got to do much better than we did on monkeypox,” said Sen. Richard Burr (N.C.), the panel’s top Republican. 

Here are three takeaways from me and my colleague Dan Diamond, who also watched the hearing:

1. Senators said they were frustrated by problems in the government’s monkeypox response, comparing them to mistakes made during the early days of covid. 

“To learn from this, we need to be clear-eyed about what went wrong,” Sen. Patty Murray (D-Wash.), the chair of the Senate HELP Committee, said in her opening statement, faulting stumbles in accessing monkeypox tests, distributing vaccines and reaching the most vulnerable patients as the virus spread through the gay community.

Burr was more critical, contending the health agencies ignored signs that a “perfect storm” was forming this spring for a potentially large outbreak. The virus — which generally spreads through close contact — has overwhelmingly affected men who have sex with men. It can cause agonizing pain, but is rarely fatal. 

Burr cited evidence of community transmission in the United States even before large groups gathered to celebrate Pride Month in June, often having sex or engaging in other close contact that jump-started infections.

“‘Disease control and prevention’ and ‘preparedness and response’ is literally in the name of two of your agencies,” Burr told the federal health officials. “Yet you did none of that.” 

2. Data issues are hampering the administration’s response. 

The Centers for Disease Control and Prevention still doesn’t have data on the total number of people hospitalized with monkeypox, Rochelle Walensky, the agency’s head, told lawmakers. The public health agency is also missing complete information on laboratory testing, demographic data and which people with monkeypox have been vaccinated.

It took until early September to secure every data agreement with state and local jurisdictions so that information on vaccinations could be shared with the CDC. Sen. Chris Murphy (D-Conn.) said Congress needs to figure out how to make such agreements more uniform, so the agency doesn’t spend weeks getting new agreements signed in the midst of an emergency. 

“If we can’t make informed decisions based on the best possible data coming into us, we’re not making the best decisions for the American people,” Walensky said. 

3. Yet, lawmakers acknowledged the monkeypox threat has partly receded, and they frequently pivoted to other priorities. 

Monkeypox cases have begun to fall in the last several weeks, though cases are still rising in some areas of the country, Walensky said. In the United States, there have been more than 22,000 confirmed infections of the virus. (Top administration officials are holding a press briefing this morning to give an update on the response.)

At times, the session felt less like the Senate’s first monkeypox hearing and more like the latest hearing on the nation’s covid response, featuring the same cast of characters.

Sen. Bill Cassidy (R-La.) pressed Walensky on why so many of her agency staff continue to work remotely and whether it’s hampering CDC’s planned reforms, an issue that Cassidy has raised across multiple hearings. Sen. Maggie Hassan (D-N.H.) pressed FDA Commissioner Robert Califf about his agency’s ongoing work on opioids, an issue that Hassan brought up in Califf’s confirmation hearing. 

And Sen. Rand Paul (R-Ky.) resumed his battles with Anthony Fauci, the government’s top infectious-disease expert, this time over whether children who were infected by covid also needed to be vaccinated.

Abortions are legal again in Ohio — for now

A judge temporarily blocked Ohio’s ban on abortions after fetal cardiac activity is detected, typically around six weeks into pregnancy, restoring legal access to the procedure. 

Hamilton County Judge Christian Jenkins issued the restraining order, which will block prosecutors from enforcing the law for the next 14 days, as part of a legal challenge the ACLU of Ohio and others brought on behalf of providers. Plaintiffs in the case argue the ban violates protections granted by the state’s constitution, and Jenkins signaled he may agree. 

“No great stretch is required to find that Ohio law recognizes a fundamental right to privacy, procreation, bodily integrity and freedom of choice in health care decision-making,” Jenkins wrote in the decision. Plaintiffs have asked the court to enter a preliminary injunction to block the law for the duration of the case. 

But in a bordering state, abortions will now be tightly restricted.

The first new abortion ban passed by a state legislature since the overturning of Roe v. Wade goes into effect today in Indiana. The law bans most abortions, and includes limited exceptions in cases of rape and incest before the 10th week of pregnancy, to protect the life and physical health of the patient, and in cases where a fetus is diagnosed with a lethal anomaly. 

The ban comes months after the state became a flash point in the national abortion debate when the story of a 10-year-old rape victim from Ohio traveled to Indiana for the procedure went viral in the weeks following the Supreme Court’s decision. 

Reproductive rights groups are currently challenging the ban in state court. A hearing in that case is scheduled for Sept. 19, four days after the law’s effective date, the Associated Press reports. 

Katie McHugh, abortion provider from Indiana:

And in West Virginia, most abortions have stopped.

On Tuesday morning, state residents could obtain abortions in the first 20 weeks of pregnancy. But later that day, the state legislature voted to ban nearly all abortions, and most procedures have already stopped even though the governor hasn’t signed the bill into law, Katie Shepherd and Dan Heyman report for The Post.

The state’s only abortion clinic announced on its website yesterday morning that it wouldn’t perform the procedure anymore.

Sen. Marco Rubio (R-Fla.) and Sen. Steve Daines (R-Mont.) joined Sen. Lindsey Graham (R-S.C.) yesterday as co-sponsors of his proposal to ban abortions after 15 weeks nationwide, The Post reports. But the legislation has met resistance from many congressional Republicans who argue the decision to restrict abortion access should be left to individual states.

Panel blasts governments’ covid response as ‘untrustworthy and ineffective’

A high-profile global panel of experts criticized the World Health Organization, the U.S. government and other countries for significant failures in coordinating a global response to covid-19, while creating a road map to stave off future pandemics, Dan writes.

The Lancet Covid-19 Commission released a 45-page editorial, where it accused many governments of being “untrustworthy and ineffective” as infections rose across the world, pointing to rich countries hoarding vaccines and faulting politicians — such as former president Donald Trump and Brazilian President Jair Bolsonaro — for playing down the virus’ risks.

The report doesn’t have any legal or regulatory weight. Yet its recommendations represent one of the most prominent attempts to find ways to bolster the world’s pandemic response and draw lessons learned from covid-19. 

For instance: The commission called for beefing up WHO’s financing and authority, while also urging the creation of a new global health board to help the agency make timely decisions. (WHO spokeswoman Margaret Harris said the panel had wrongly characterized “the speed and scope of WHO’s actions.”)

The report also pressed for more investigation into both the lab-leak and natural-origins theories of the virus, which comes after the panel’s chairman — Jeffrey Sachs — received backlash from some scientists after publicly embracing the “lab-leak theory.” They contended such advocacy could cloud the commission’s work.

CDC plans targeted surveillance of wastewater to hunt for polio virus

The CDC will begin conducting targeted testing of wastewater for the virus in communities at highest risk for the life-threatening illness, our colleague Lena H. Sun reports. 

The details: In selecting the sites for additional wastewater testing, the agency is weighing the community’s vaccination coverage, the extent of travel to and from countries where polio is still circulating, and whether the agency is already conducting wastewater surveillance for the coronavirus.

The announcement comes roughly two months after the first U.S. case of polio in nearly a decade was identified in an unvaccinated Rockland County, N.Y., man. The virus has since been detected in wastewater samples in counties near his residence, including New York City, but no additional cases of the potentially disabling disease have been reported. 

Some Biden officials expressed concern that there wasn’t more active preparation for a potential outbreak, Lena writes. White House leaders have been focused on gathering data to figure out the spread.

• Healthcare for Action, a new political action committee aiming to boost the number of Democratic health-care workers in Congress, is launching today. Its initial slate of endorsed candidates includes Annie Andrews in South Carolina’s 1st District race and Kermit Jones in California’s 3rd District.
• Pfizer has begun a late-stage trial of an mRNA-based flu shot, which is similar technology used in its coronavirus vaccine, Reuters reports.
• The House passed legislation aimed at modernizing the prior authorization for seniors with Medicare Advantage coverage.
• On the move: Melanie Fontes Rainer was officially sworn in as the new director of the federal health department’s Office for Civil Rights.

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Thanks for reading! See y’all tomorrow.