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The Health 202

A newsletter briefing on the health-care policy debate in Washington.

Experts express cautious optimism about the latest covid variant

The Health 202

A newsletter briefing on the health-care policy debate in Washington.

Happy spring Wednesday, where today’s weather gets an 8/10 from the Capital Weather Gang. 

Today’s edition: More Americans died in 2021 than ever before, largely due to covid-19. The Biden administration criticizes Oklahoma’s new restrictive abortion law. But first …

Ashish Jha says Americans don't need to be “excessively concerned” about BA.2

Coronavirus cases are beginning to rise after a post-omicron lull.

But newly-appointed White House coronavirus czar Ashish Jha said he's “not overly concerned right now,” in one of his first TV interviews in his new role.

  • “We've got to watch this very carefully. Obviously, I never like to see infections rising … but I don't think this is a moment where we have to be excessively concerned,” Jha, who most recently served as the dean of Brown University’s School of Public Health, said on NBC News’s “Today” show.

Infections are increasing again in the Northeast, which recorded at least 126 new cases per 100,000 people last week, double the rate one month ago. But that’s a far cry from where they were in mid-January — and experts aren’t predicting a repeat of the winter’s massive surge, at least according to early signs, our colleagues Frances Stead Sellers, Fenit Nirappil, Joel Achenbach and Dan Keating report. 

Spring 2022 feels like a different moment in the pandemic, which is now in its third year. Statewide mask mandates are gone, and Americans are beginning to resume their normal lives. Cases, deaths and hospitalizations are relatively low even amid a spike in infections, but the proliferation of home tests makes it harder to know just how many people are infected.

The Health 202 talked to half a dozen epidemiologists and virus forecasters yesterday to get the latest on the virus, the indicators to watch and mask mandates.

Will there be another surge?

It’s always tricky terrain predicting the virus. But experts have some reason for optimism even as the more transmissible BA.2 subvariant takes hold, pointing to promising recoveries in Britain and other European countries that often indicate the pandemic’s next course in the United States, our health team colleagues note. 

  • “I think the key will be watching the next two weeks or so — the holiday week, we're in the middle of it,” David Rubin, who tracks coronavirus trends for PolicyLab at Children’s Hospital of Philadelphia, told The Health 202. “Any peaks that might occur would be within the next one or two weeks.”

Several experts have also said a rise in infections was generally expected after the relaxation of public health measures such as mask mandates. And they point to immunity in the population after omicron infected millions of Americans.

  • “It is difficult to predict what will happen here with BA.2, but I think cases will continue to increase for a while, but hopefully we will not see a concomitant rise [in] hospitalizations due to large swaths of our population having some degree of immunity,” per Monica Gandhi, an infectious-disease specialist and professor of medicine at the University of California, San Francisco.

What are the indicators to watch?

There is broad consensus among health experts: Official case counts are no longer an accurate snapshot of the pandemic. That’s because of the proliferation of at-home tests, many of which aren’t reported to the government.

But health experts differ on which indicators they’re most focused on to predict the virus’s path. For instance: Gandhi said while tracking cases is important, she’s most focused on hospitalizations. Others — like Natalie Dean, an assistant professor of biostatistics at Emory University — pointed to metrics such as test positivity rate and wastewater surveillance.

For the Centers for Disease Control and Prevention’s part, the agency now incorporates data showing the strain on the health-care system into its metrics for mask-wearing recommendations. That’s in addition to the number of new coronavirus cases per 100,000 people in the past week.

So, will states and cities put mask mandates back in place?

Thus far, Philadelphia is the only major city to reactivate its mask mandate. Such a mandate isn’t recommended in the region by the CDC’s standards. Yet local officials defended their decision, saying they wanted to act before any spike in hospitalizations. 

Many blue states dropped their mask mandates over the past two months — and at the time, there was no unified metric for lifting such a restriction. As of now, no mayors or governors have suggested that they plan to copy Philadelphia and reimpose a mask-wearing requirement.


The U.S. death toll reached a grim milestone in 2021

Last year the number of Americans who died hit a record high, largely fueled by the coronavirus and climbing rates of drug overdoses, the Associated Press reports. 

By-the-numbers: Last year, there were 3.465 million deaths — an increase of about 80,000 more than 2020’s record-setting total, according to CDC data.

  • Experts told the AP that new variants, vaccine hesitancy and reluctance to take precautions such as indoor mask-wearing likely pushed the death toll to new heights in the pandemic’s second year.

Provisional data also suggests that the United States is on track to see at least 105,000 overdose deaths in 2021, up from 93,000 the year prior.

A growing portion of those deaths were among adolescents ages 14 to 18, whose overdose rates nearly doubled from 2019 to 2020, according to new research published in JAMA yesterday.

  • Yet drug use among teenagers dropped during the pandemic. Experts said the spike in deaths is probably related to the growing presence of fentanyl, a synthetic opioid that was involved in the majority of adolescent overdose deaths in 2021.
  • “Drug use is becoming more dangerous, not more common,” among adolescents, Joseph Friedman, a UCLA addiction researcher and lead author of the study, told STAT. 

Meanwhile … STD rates remained high during pandemic’s first year, CDC says

Rates of syphilis and gonorrhea spiked during the first year of the pandemic, officials said yesterday, as the coronavirus disrupted routine medical checkups and forced screening clinics to close, our colleague Katie Shepherd reports. 

  • The CDC’s annual report identified 2.4 million STD cases across the United States in 2020, down slightly from 2.6 million in 2019.
  • Chlamydia was the only disease for which rates dropped, but researchers said that's probably a result of reduced testing rather than a true decrease in cases.

Of note: Congenital syphilis, which affects newborns who contract the disease from their mother, hit a new high of 2,148 cases in 2020 — an increase of 235 percent since 2016.

  • Rates of the disease — which can cause lifelong health issues for infected infants, miscarriages or stillbirths — reached near-historic lows in the early 2000s amid ramped-up education and prevention initiatives, according to Kaiser Health News.
  • But by 2020, all but three states — Maine, New Hampshire and Vermont — reported cases of congenital syphilis.

Céline Gounder, infectious-disease specialist and editor-at-large for public health at Kaiser Health News:

Reproductive wars

White House calls Oklahoma abortion law an ‘attack on women’s rights’

The Biden administration weighed in on an Oklahoma bill signed by Gov. Kevin Stitt (R) on Tuesday that makes it illegal to perform an abortion, with limited exceptions, calling it the country’s most restrictive law regulating the procedure. 

Key context: The law makes performing an abortion in the state a felony punishable by up to 10 years in prison and a $100,000 fine, starting this summer if not blocked by the courts.

  • “Make no mistake: The actions today in Oklahoma are part of a disturbing national trend attacking women’s rights,” White House press secretary Jen Psaki said in a statement.
  • The Biden administration called on Congress to pass the Women’s Health Protection Act, which would codify abortion rights in federal law even if the Supreme Court moves to weaken or overturn Roe v. Wade’s decades-old protections. The bill passed the House last year, but failed a procedural vote in the Senate this year.

A call, a text, an apology: How an abortion arrest shook up a Texas town

The Post has a deep dive out this morning on how the arrest and since-dropped murder charge against a 26-year-old woman stoked widespread outrage and confusion over the weekend. 

Their key finding: “Interviews with several people in the South Texas community who closely following the situation, as well as statements from leaders in the Texas antiabortion movement, suggest this was not part of a broader antiabortion strategy, but instead a hasty error by a first-term Democratic district attorney.”

Oklahoma Gov. Kevin Stitt: 

White House prescriptions

Biden calls Russia’s war in Ukraine a ‘genocide’

President Biden on Tuesday referred to Russia as committing “genocide” in Ukraine, an escalation of the president’s rhetoric, The Post’s Tyler Pager reports. 

  • The comment came during an event in Iowa, where Biden decried food and gas prices rising in the United States because “a dictator declares war and commits genocide a half a world away.”
  • Biden later told reporters he’d intentionally used the word because “it’s become clearer and clearer that Putin is just trying to wipe out even the idea of being Ukrainian.” However, he added that he would let lawyers decide whether Russia’s actions officially meet the definition.

As of Sunday, the U.N. Office of the High Commissioner for Human Rights has confirmed 4,232 civilian casualties across Ukraine since the start of the Russian invasion, but it said in a statement that the true figure is almost certainly higher.

More from Ukrainian President Volodymyr Zelensky: 

In other health news

  • The world has surpassed a half-billion known coronavirus infections, though experts said cases are probably far higher as many go undetected or unreported, a gap made worse as leaders worldwide scale back official testing, the New York Times reports.
  • The international advocacy organization Human Rights Watch says that the country’s sky-high insulin prices are contributing to “human rights abuses” by violating the needs of diabetics who cannot afford medication, per Stat.
  • All children 8 and older should be screened for anxiety amid a growing mental health crisis among minors, the U.S. Preventive Services Task Force recommended in new draft guidelines.
  • On tap today: The Biden administration is slated to announce $43 million in grants in 22 states to rural health care providers, per Kaiser Health News.

Sugar rush

Thanks for reading! See y'all tomorrow.