COVID-19 Policy Update #493
Tuesday 5/9
Top Three
Under 5s: Frustrated by the lack of information for vaccines for under 5s, Rep. James E. Clyburn summoned the FDA to the Hill today for a briefing and shared out what he learned:
The FDA's Peter Marks told Congress that although the adult vaccines had to meet a 50% threshold for efficacy against Covid-19 infections, that same standard will not need to be met for the vaccines for the youngest group of children. “If these vaccines seem to be mirroring efficacy in adults and just seem to be less effective against Omicron like they are for adults, we will probably still authorize.”
If FDA is able to complete its reviews of the Moderna or Pfizer pediatric vaccines faster than anticipated, then the agency would move up the meetings of the Vaccines and Related Biological Products Advisory Committee (VRBPAC), currently scheduled in June 2022.
FDA won’t wait for Pfizer to review Moderna.
"Dr. Marks also said that the emergence of new variants—including Delta and Omicron—has made the process of reviewing vaccines more complex and time consuming. He acknowledged that it “was a little simpler for the original submissions in late 2020 when we didn’t have the variants and tons of immunogenicity data to go through,” which has made review and authorization of the vaccines for young kids “reasonably complicated.”
Lessons Not Learned: The Disaster of Covid-19 School Closures: Via Alasdair Munro, Senior Clinical Research Fellow in Paediatric Infectious Diseases.
"Much has been made of planning based on pandemic influenza and it’s influence on Covid-19 policy. This is particularly true of school closures as a non-pharmaceutical intervention, as it has long been considered a reasonable measure in the short term to help curb transmission (although it has it’s own controversies). This is because children are recognised to play an important role in the transmission of flu. They are more susceptible to infection and spread the virus more easily, including between households."
"Given this uncertainty, temporary school closures were arguably forgivable in the first instance."
"It became apparent surprisingly quickly that children had not played a key role in the initial transmission of the SARS-CoV-2 virus, and were not superspreaders in the way they are thought to be with influenza. By the spring of 2020 many European countries had prioritised the reopening of schools, and none of them experienced an early resurgence in cases of Covid-19 nor a rise severe illness."
"Early and robust investment in upgrading ventilation systems would have paid off in the longer term as well as bringing short term benefits. Reducing class density by appropriating unused buildings and inviting volunteers to provide additional staffing in a “nightingale schools” effort was never on the cards. The use of facemasks remains controversial, and however they were implemented large numbers of people would be left unhappy. Sadly, we have no high quality evidence to guide precisely how effective they are in this setting."
"There is no question that prolonged school closures are one of, if not the single most harmful non-pharmaceutical intervention at a population level."
"It is vital that schools are considered essential infrastructure for any future pandemic planning."
Hundreds of Suicidal Teens Sleep in Emergency Rooms. Every Night: Via NYT
"At the E.R., a doctor examined her and explained to her parents that she was not safe to go home."
"Indeed, 15 other adolescents — all in precarious mental condition — were already housed in the hospital’s emergency department, sleeping in exam rooms night after night, waiting for an opening. The average wait for a spot in a treatment program was 10 days."
"The girl, being identified by her middle initial, G, to protect her privacy, spent the first week of her wait in a “psych-safe” room in the emergency department. She grew “catatonic,” her mother recalled. “In this process of boarding we broke her worse than ever.”
"Nationally, the number of residential treatment facilities for people under the age of 18 fell to 592 in 2020 from 848 in 2012, a 30% decline."
"Absent that option, emergency rooms have taken up the slack. A recent study of 88 pediatric hospitals around the country found that 87 of them regularly board children and adolescents overnight in the E.R. On average, any given hospital saw four boarders per day, with an average stay of 48 hours."
Colorado is struggling with the same shortage of services that has hit hospitals nationwide. "A major cause, Ms. Baskfield said, was the low reimbursement rates paid by Medicaid, the state insurance program. From 2006 to 2021, the daily Medicaid rate in Colorado allotted roughly $400 for a therapeutic residential bed — “less than some families spend to send their kids for a night to sleepaway camp,” Ms. Baskfield said. The low rates also accounted for some of the quality issues, she said; it was hard to hire experienced staff. (In the past year, Colorado has raised its reimbursement to $750 per day by using money from the American Rescue Plan, but new beds have yet to open, and that source of money is temporary.)"
Federal
White House Warns of COVID-19 Surge in Fall: Without a substantial infusion of cash from Congress, the United States could see another 100 million COVID-19 cases come fall, the White House warned today.
Washington Post: “Several experts agreed that a major wave this fall and winter is possible given waning immunity from vaccines and infections, loosened restrictions and the rise of variants better able to escape immune protections.”
White House Covid Coordinator: Dr. Ashish Jha provides an update through a Twitter thread.
Affordable Connectivity Program: The White House said 20 internet service providers have agreed to offer $30 high-speed internet plans to low-income families, effectively giving free service to households that qualify for a federal subsidy under the Affordable connectivity Program.
"The Affordable Connectivity Program (ACP) provides a $30 monthly discount on internet service from participating providers for low-income households, such as those that receive federal assistance through SNAP or Medicaid."
"The 20 ISP companies cover more than 80% of the U.S. population, but they are a fraction of the more than 1,000 providers participating in the ACP."
Great to see Propel is helping their 5 million households sign up for the benefit.
New signup website: www.getinternet.gov
HHS: The Health Resources and Services Administration (HRSA) awarded nearly $25 million to HRSA-funded health centers to improve and strengthen access to school-based health services.
Bipartisan Innovation Act Heads to Conference: The Senate completed the last series of votes needed to go to conference with the House legislation aiming to improve U.S. competition with China.
The vote on a series on nonbinding motions to instruct, which guide Senators as they enter negotiations with the House on the bill, included a motion related to the College Transparency Act, offered by Senator Bill Cassidy (R-LA) which would require colleges to collect and submit data on student completion, enrollment, transfer, and persistence to USED and other federal agencies.
Conferees: Senate Democrats, Senate Republicans, House Democrats, and House Republicans.
Related: More than four dozen former national security leaders are calling on Congress to exempt international advanced technical degree holders from green card caps in a bid to maintain U.S. science and tech leadership, especially over China, according Axios.
Covid-19 Research
Boosters: New study, "Our results suggest the Omicron sub-lineages threaten the neutralization efficacy of current vaccines and antibody therapeutics, highlighting the importance of vaccine boosters."
We Parents of Unvaccinated Children Need More Guidance: Via Nita Farahany in the Washington Post.
"We parents of young children who can’t be vaccinated feel abandoned at this late stage of the pandemic. Federal officials, it seems, have decided to leave it up to us to figure how to navigate coronavirus risks for our children. This lack of information has bred distrust in parents while putting public health agencies in an unenviable Catch-22 as they prepare to — finally, hopefully — vaccinate children under 5."
"I’m a bioethicist who, stuck in parental limbo, has become a fervent amateur epidemiology researcher, devouring information to better decipher the risks to our youngest child. But like other parents, I’m exhausted from the effort and confused by the data that’s out there, and believe public health agencies, not me, should be doing the work of summarizing the most salient findings, and explaining how to act on them."
"Everyone has their own risk calculus, but we shouldn’t be forced to wing it in this way. My family’s approach seems reasonable, but there’s just no way to know. All of us need timely information to make choices to best protect our children, and parents of young children especially need this information, given that we are still waiting for vaccines. Unfortunately, federal health officials are letting us down — still."
BillG on School Closures: "It's pretty clear, because young people don't get sick from the disease very often, that we probably, if we knew everything we know today, we would have shut schools down a lot less than we did during this pandemic."
State
Arizona: New report / press release from A for Arizona, "Transportation Modernization & Innovation Grants to Eliminate Access Barriers" which touches on everything from needed policy flexibility to "micro transit needs" to grants to families.
Illinois: CPS expands access to remote learning program.
Massachusetts: "The closely watched Boston-area COVID-19 wastewater data is climbing once again after it briefly started falling in April. The north-of-Boston COVID wastewater average has jumped 38% in the last week, and the south-of-Boston average has increased 25%."
Oregon: Portland schools will end pooled testing but recommend masking.
International
South Africa: Daily coronavirus test positivity rate neared a record, rising above 30% on Saturday for the first time in almost five months as two sublineages of the omicron variant spread rapidly ahead of the nation’s winter season.
Economic Recovery
Baby Formula Shortage Worsens: Nearly 40% of popular baby formula brands were sold out at retailers across the U.S. during the week starting April 24, USA Today reports.
"In six U.S. states, more than 50% of formula was out of stock as of late April. Parents in Iowa, South Dakota, and North Dakota are grappling with severe shortages of 50%-51%, according to Datasembly. Out-of-stock levels are even higher in Missouri (52%), Texas (53%), and Tennessee (54%). At the same time, between 40%-50% of baby formula products were out of stock in 26 states."
Inflation:
The FT wonders, "Has US inflation finally started to slow?"
"Economists polled by Bloomberg forecast that US consumer prices rose at a pace of 8.1% year on year compared with 8.5% in March. Inflation at that level would remain close to four-decade highs but would represent the first slowdown in pace since August 2021."
CNBC reports, "Inflation expectations over the next year fell to a median 6.3%, a 0.3 percentage-point decrease from the record high in March, according to data going back to June 2013. On a three-year basis, expectations rose 0.2 percentage point to 3.9%, which itself is 0.3 percentage point off the record."
Minneapolis Fed President Neel Kashkari said Monday he’s confident inflation will come back to the central bank’s 2% target. He said he underestimated how persistent price increases would be, adding rate increases to tame inflation will hurt low-income people.
The NYT has an interesting personal inflation rate calculator.
Global Recession is Coming: Via IIF's Economist, "the two biggest export economies in the world - Germany (blue) & China (black) - are seeing their new export orders in the manufacturing PMIs fall sharply. That's deteriorating global demand as we teeter towards recession."
Resources
Teachers Believe Whole Child Learning Gives Students The Skills Needed To Succeed: Gradient Learning has released results from a national survey, indicating that 91% of teachers believe students perform better when schools prioritize whole child learning.
88% said they believe schools need to adopt a broader definition of student success to include both academic and non- academic skills
62% shared that students are more comfortable asking for help with a whole child approach
Nearly two-thirds report their students take more ownership of their learning as a direct result of adopting a whole child approach
How to Build a More Diverse, Inclusive, and Effective Policy Sector: Via The Next100.
Child Tax Credit Recipients Experienced a Larger Decline in Food Insecurity: Via the Tax Policy Center.
Find Out What Is In $80 Billion of ESSER III Spending Plans: Burbio webinar on Tuesday, May 10 at 3:00pm ET.
Teens Share Mental Health Problems That Were Exacerbated by COVID: 60 Minutes segment worth your time. Full segment here.
Beating the Odds: Rich Strike, an 80-1 longshot, pulled off the second-biggest upset in the Kentucky Derby's 148-year history. Overhead view is even more impressive.
U2's Bono Gives 'Freedom' Concert in Kyiv Metro: “The sound of Sunday Bloody Sunday blasted out of a subway station in central Kyiv, Ukraine, on Sunday as Bono and The Edge took to a makeshift stage in a makeshift bomb shelter and performed a surprise 40-minute concert to a backdrop of air-raid sirens and war,” the Irish Times reports.