It’s far from certain we’ll see a pandemic response overhaul

House and Senate Democrats have released their covid response probes

Democratic congressional investigators are calling for significant investments and large-scale changes to the country’s efforts to better prepare for the next pandemic. But some advocates and health experts are skeptical the nation will take those steps.

Two sweeping reports from Democrats in Congress faulted years of poor planning, chronic underfunding and the Trump administration’s leadership for the inability to curb the coronavirus pandemic at the outset. Both offered a spate of recommendations aimed at bolstering the nation’s defenses, such as increasing public health funding, clarifying federal agencies’ roles during an emergency, and beefing up the nation’s stockpile of medical and protective supplies.

But the United States doesn’t appear likely to drastically change its ways after the worst pandemic in a century. Partisan bickering has stalled more covid aid for roughly nine months. A pair of key senators are lobbying hard for their bipartisan plan to tackle future pandemics to pass before the end of the year — a package that’s viewed as a down payment on what’s needed. Prospects for sweeping bipartisan legislation next year are dim amid a split Congress and a pandemic that polarized the country.

This comes after years of warnings from oversight agencies and experts that the country was ill-equipped to tackle a major public health threat.

• “We’re going to be kicking ourselves again,” said Ezekiel Emanuel, a bioethicist at the University of Pennsylvania who coordinated a road map for living with covid that was released earlier this year.

The details: Congressional committees are releasing their probes into the federal government’s pandemic response in the last weeks of the lame-duck session. 

On Friday, Democrats on the House select subcommittee on the coronavirus crisis released their sweeping final report, which included 30 recommendations aimed at strengthening the nation’s pandemic response. The panel will hold a hearing Wednesday on preparing for the next health emergency, as well as convene a business meeting to formally adopt the report.

In the Senate, Democratic staff on the chamber’s chief oversight panel released their own 241-page investigation and recommendations on Thursday. (It’s routine for both parties to launch their own investigations, particularly when they’re in the majority. House Republicans are already pledging to probe the Biden administration’s response when they get the committee gavels next year.)

Among the recommendations:

• The Senate report asked Congress and the executive branch to clarify the roles of the Department of Homeland Security and the Department of Health and Human Services during public health emergencies. This includes reevaluating policy directives and planning documents to clearly delineate both departments’ responsibilities.
• The House’s report recommended examining ways to protect the public health workforce, such as establishing a national reporting system for incidents of violence against public health officials.
• Both reports contained a significant number of overlapping recommendations. This includes boosting federal funding for public health for multiple years, clarifying the role of the Strategic National Stockpile and modernizing the country’s antiquated data and surveillance systems.

The most immediate: The leaders of the Senate health committee — Sens. Patty Murray (D-Wash.) and Richard Burr (R-N.C.) — are pushing congressional leaders to include their plan to overhaul the country’s pandemic strategy in any year-end package. The legislation has particular significance for Burr, who’s retiring and wants to further cement his legacy on pandemic preparedness.

A Senate GOP aide said there were “really good conversations” occurring on trying to get the bill attached to a potential spending package during the lame-duck session. In a floor speech last week, Murray stumped for the legislation, saying it “represents meaningful, bipartisan progress,” while also acknowledging that “there is more to do to strengthen our public health system.”

But getting the measure into any broader package is still precarious. Even if it makes it in, some experts remain skeptical of the country’s ability to quickly beef up pandemic preparedness, outlining a number of hurdles to doing so.

• “To solve it, you really have to start thinking about infectious disease in a proactive manner, you can’t just be reactive,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “For whatever reason, Congress is incentivized to be reactive.”

For one, a sustained boost in funding for public health doesn’t appear imminent. Some, like Emanuel, have called for a massive infusion of funds, roughly $100 billion, to manage future coronavirus variants and pandemics. Congress has fought over spending a fraction of that amount on covid aid since March. 

Another notable barrier: The country is fiercely divided over the pandemic and what happened, and that’s fueled a distrust in science that has become a top concern of Francis Collins, the former National Institutes of Health director.

“We have to tackle it somehow,” said J. Stephen Morrison, senior vice president at the Center for Strategic and International Studies. “The formula for restoring trust and confidence, there is no proven cookbook recipe for this. There’s no short, quick answers for that.” 

⏰ The congressional clock is ticking

The stopgap bill funding the government expires Friday, meaning lawmakers may need to pass at least a one-week resolution to keep the lights on. While a government shutdown is not expected, the big question is whether key lawmakers hammer out a top-line number for a sweeping year-end spending deal to fund the government through the end of September. 

Such a broader package is key to passing any new health policies before the next Congress. Providers are lobbying hard to stave off cuts to their pay. Republicans want to unwind pandemic-era Medicaid rules, while Democrats are pushing for policies aimed at ensuring new moms and children have health coverage. And a deadline for funding the U.S. territories’ Medicaid programs is fast approaching. 

Negotiations between the two parties didn’t lead to an agreement on a top-line number over the weekend, but there was enough traction for Democrats to back off a plan to release their own partisan spending package today, a move aimed at strong-arming Republicans, our pals at The Early 202 report this morning. 

Washington faltered as fentanyl gripped America

Presidents from both parties failed to take action amid the rise of fentanyl, which is now the leading cause of death for Americans ages 18 to 49, The Post’s Nick Miroff, Scott Higham, Steven Rich, Salwan Georges and Erin Patrick O’Connor report in an investigation out this morning. 

“During the past seven years, as soaring quantities of fentanyl flooded into the United States, strategic blunders and cascading mistakes by successive U.S. administrations allowed the most lethal drug crisis in American history to become significantly worse, a Washington Post investigation has found,” they write. 

The Drug Enforcement Administration had a series of missteps as it confronted its biggest challenge in its 50-year history. The agency was slow to respond as Mexican cartels began supplanting Chinese producers, which created a massive illicit pharmaceutical industry that has created huge supplies of the potent drug. The agency says it’s now taking direct aim at cartels and acknowledged it was initially too focused on heroin.

Meanwhile, the Department of Homeland Security failed to ramp up its scanning and inspection technology at official crossings. The White House Office of National Drug Control Policy spent years fending off its elimination. 

Court: HHS can’t force religious hospitals, doctors to provide gender-transition care

A federal appeals court ruled Friday that the Biden administration can’t require hospitals and medical professionals to provide gender-transition services under an Affordable Care Act provision barring sex discrimination in health care, Reuters reports. 

The judges unanimously affirmed a permanent injunction blocking the rule. It remains unclear whether HHS will appeal the decision.

The details: The three-judge panel of the U.S. Court of Appeals for the 8th Circuit upheld a lower court’s decision that the Obama-era rule infringes on the religious freedoms of the plaintiffs, which consist of several Catholic organizations including the Catholic Medical Association. 

The ruling echoes one by the New Orleans-based 5th Circuit in August, which found that the agency lacks the authority to punish Christian medical groups for refusing to provide services, procedures or products they object to based on their religious beliefs. 

Key context: The Affordable Care Act prohibits sex discrimination by health-care providers who receive federal funding, and the HHS rule interpreted that ban as extending to discrimination based on gender identity, Reuters’s Daniel Wiessner writes. 

Medical groups and experts reacted with frustration as Twitter owner Elon Musk tweeted this over the weekend:

Peter Hotez of Texas Childrens’:

Some Democrats responded as well. Sen. Amy Klobuchar (D-Minn.): 

And journalists Bari Weiss and Matt Taibbi reported over the weekend on select internal files from Twitter, provided by Musk, which confirmed the social medial platform disproportionally targeted users who advanced more conservative viewpoints or challenged mainstream thinking about aspects of the pandemic. From Weiss, founder of the new media company The Free Press:

• Prominent American soccer writer Grant Wahl died Friday while covering the World Cup in Qatar. He was the husband of Céline Gounder, an infectious disease specialist and Kaiser Health News editor-at-large, who also served on President Biden’s covid-19 advisory board during the presidential transition. 
• Juul Labs will pay more than $1.7 billion to settle thousands of lawsuits accusing the e-cigarette manufacturer of being a main driver behind the nation’s youth vaping epidemic, the Wall Street Journal reports. 
• New York City health officials issued an advisory on Friday urging residents to wear masks in public indoor settings and crowded outdoor areas due to high levels of coronavirus, flu and RSV cases. 
• After relaxing its stringent coronavirus policies, some online pharmacies across China have run out of critical drugs and medical supplies, like antigen test kits, prompting authorities to crack down on hoarding, Reuters reports. 

📅 It’s another busy week in Washington. 

Tuesday: A Senate Agriculture, Nutrition and Forestry subcommittee is meeting to examine efforts and opportunities to use food as medicine; the House Veterans’ Affairs Committee is holding a hearing to review the Department of Veterans Affairs’ pandemic response.  

Wednesday: A House Veterans’ Affairs subcommittee is gathering to review the VA’s family caregiver assistance program; the House select subcommittee on the coronavirus crisis is meeting to discuss lessons from the pandemic and how to prepare for the next public health emergency. 

Thursday: The Senate Special Committee on Aging is holding a hearing to examine promoting healthy and affordable food for older adults.

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Thanks for reading! See y’all tomorrow.