Lessons for the next one

Presented by Kaiser Permanente

With Daniel Lippman, Carmen Paun and Megan R. Wilson

Driving the day

IF ONE THING IS CERTAIN — As the Covid-19 public health emergency enters its final weeks, Washington is still gripped by debate over how the pandemic started and what the Trump and Biden administrations got wrong. But one thing most can agree on: This won’t be the last time we face off with a deadly pathogen, and we’d better be ready.

That’s the premise of a new report released by the Covid Crisis Group, headed by Philip Zelikow, former executive director of the 9/11 Commission. The group of 34 experts was assembled in 2021 to lay the groundwork for a future Covid commission that never came to be. So they released their findings today, offering a series of lessons about what went wrong — and occasionally right — in America’s pandemic response.

A few highlights:

— When 19th century infrastructure met a 21st century virus: America’s public health infrastructure was built on a 19th century design, researchers wrote, focused on the state and local response to outbreaks. The CDC, founded as a research center early in the 20th century, was neither conceived nor updated to manage a national health emergency. The modern health care system evolved separately and with more resources from the nation’s public health infrastructure, and both public health and the health care system were detached from the bio-pharma complex, which ultimately made the drugs that saved Americans’ lives.

— Policy failure created the pandemic partisan divide, not the other way around: Red and blue states had surprisingly similar approaches to lockdowns and reopenings early in the pandemic, upending the narrative that there were distinct “red” and “blue” pandemic responses. Instead, researchers said, it was a series of federal policy failures that created the toxic political environment that has come to define many people’s feelings about Covid and the government’s response.

— Health security is national security: The report hails Operation Warp Speed as a major success in the pandemic response, partly due to researchers already being familiar with coronaviruses and the mRNA vaccine platform already being so advanced. The program helped invest, manufacture and distribute vaccines, and its leadership was granted unusual autonomy by the Trump administration, researchers wrote.

The “America first” vaccine approach, on the other hand ... Turns out that wasn’t a great approach to vaccine distribution in a global pandemic.

WELCOME TO TUESDAY PULSE — For the Pulse-reader runners out there: Finding the right sports bra might improve your running performance by 7 percent, researchers suggest. So spend the extra 20 bucks and get a good one. Send your other splurge-worthy sports-gear tips and news to [email protected] and [email protected].

TODAY ON OUR PULSE CHECK PODCAST, host Ben Leonard talks with Megan Messerly, who explains how bans on gender-affirming care in red states are impacting doctors who provide such care to transgender adolescents in blue states and threatening health care access for their trans youth patients.

In Congress

E&C LAUNCHES PROBE INTO NIH COMMS MONEY — The House Committee on Energy and Commerce announced it’s investigating how the NIH has been spending its communication dollars.

The committee seeks information about a contract awarded to 10 public relations and consulting firms in 2018, which is due to expire in December. In 2021, the NIH requested that the ceiling for the potential contract amount be raised from $500 million to $1 billion, citing the unprecedented need for communication services because of the pandemic.

Citing past concerns over how federal health agencies managed media consulting contracts and the size of contracts, an E&C committee spokesperson said the goal of the new probe is to “determine how the NIH uses contract public relations firms and whether these are an appropriate use of taxpayer dollars.”

The committee has sent letters to all 10 firms asking for information about their work for NIH: BETAH Associates, BLH Technologies, CSR, Incorporated, Fors Marsh Group, Hager Sharp, Hendall, Inc., IQ Solutions, Lumina Corps, Palladian Partners and Scientific Consulting Group.

The firms either declined to comment or did not respond to Pulse’s request for comment. NIH did not respond to Pulse’s request for comment.

HOUSE GOP ASKS CHINA FOR COOPERATION ON COVID ORIGINS — Republican members of the House Select Subcommittee on the Coronavirus Pandemic, led by chair Brad Wenstrup (R-Ohio), asked the Chinese embassy in the U.S. to make available five Chinese scientists for transcribed interviews on how the pandemic started, Carmen reports.

The scientists Republicans want to talk with include the former head of China’s CDC George F. Gao and Shi Zhengli, the director of the Wuhan Institute of Virology lab.

House Republicans and some experts believe a leak of SARS-CoV-2 from that lab may have started the pandemic, although there is no conclusive evidence to support their claims. There’s also no conclusive evidence that the pandemic started from a natural spillover of the virus from animals to people.

The Republicans’ request comes in response to a letter from the Chinese embassy in Washington protesting a subcommittee hearing last week on the intelligence regarding Covid’s origins in China.

Lobby Watch

‘BIG PHARMA’ IS BIG MAD — PhRMA is striking back against a seven-figure advertising blitz from America’s Health Insurance Plans, the leading industry group for insurers, following a first-in-Pulse report from Megan on Monday. The campaign blasts drugmakers as the source of the high cost of medicine, arguing that pharmacy benefit managers and insurers help keep costs down by negotiating discounts with drugmakers.

PhRMA, meanwhile, has spent millions of its own dollars on advertising that slams insurers and pharmacy benefit managers for their role in the drug ecosystem — and it looks like it’s just getting started.

“With PBMs facing increasing scrutiny on Capitol Hill, AHIP is hitting the airwaves to deflect any responsibility for the high cost of medicine many people face,” wrote Robby Zirkelbach, PhRMA’s head of public affairs, in an email Monday. “Insurance companies use PBMs to determine what patients pay at the pharmacy and what medicines are covered,” he adds, noting that PBMs have been facing scrutiny on the state and federal level for their business practices.

Abortion

JUDGE MULLS IDAHO AG ORDER — A federal judge in Idaho signaled Monday that he’s leaning toward issuing an order aimed at blocking the use of that state’s strict abortion ban to prosecute doctors who refer patients to other states to terminate a pregnancy, POLITICO’s Josh Gerstein reports.

U.S. District Court Judge B. Lynn Winmill didn’t rule on the request from two Idaho doctors and several Planned Parenthood organizations who said their First Amendment rights were in danger as a result of a letter from Idaho Attorney General Raul Labrador last month that indicated out-of-state referrals would violate the law.

A deputy to Labrador repeatedly noted that the AG has formally withdrawn the opinion, but a lawyer representing the doctors and family-planning groups said Labrador was being cagey by not disavowing the letter’s legal conclusion.

Winmill appeared to share the concern that Labrador’s withdrawal of the March opinion wouldn’t assuage worries expressed by doctors and Idaho’s largest health provider, St. Luke’s Health System.

In the States

‘REVISIONS AND REFINEMENTS’ — Florida Surgeon General Joseph Ladapo personally altered a state-driven study about Covid-19 vaccines last year to suggest that some doses pose a significantly higher health risk for young men than had been established by the broader medical community, POLITICO’s Arek Sarkissian reports.

Ladapo’s changes, released as part of a public records request, presented the risks of cardiac death to be more severe than in previous versions of the study. He later used the final document in October to bolster disputed claims that Pfizer-BioNTech and Moderna vaccines were dangerous to young men.

What Ladapo says: In a statement to POLITICO, Ladapo said revisions and refinements are a normal part of assessing surveillance data and he has the appropriate expertise and training to make those decisions.

Names in the News

Behavioral telehealth provider Brightline has made two new hires: Myra Altman is the firm’s new chief clinical officer, and Amy Chen is its new chief marketing officer.

Adrienne Mendenhall is now a director at Crowell & Moring International. She previously was global business development lead at Access Health International. Sejal Mistry and A. Vigneswari are also joining the firm’s Singapore office as a director and a consultant, respectively.

What We're Reading

KFF has published an excerpt from Alison Young’s new book, “Pandora’s Gamble: Lab Leaks, Pandemics, and a World at Risk,” that describes a spill of unsterilized laboratory wastewater from an Army facility in Maryland in 2018.

The Washington Post reports on how Alzheimer’s patients are starting to push back against the early stages of the disease.

NPR reports that a growing number of urinary tract infections could be attributed to the nation’s food supply.