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The Health 202

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

Schools race to improve indoor air quality as coronavirus cases climb

The Health 202

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

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Good morning from your Health 202 researcher McKenzie. The Post wants to hear from more practitioners and patients about how their experiences in reproductive health have been affected by the Dobbs decision. Here’s how you can share your story

Today’s edition: Senate Democrats will attempt to pass legislation increasing funding for the federal family planning program later this week. The Supreme Court is letting Indiana enforce its parental consent law for abortions. But first …

Schools race to improve indoor air quality as coronavirus cases climb

The federal government gave schools billions for coronavirus mitigation over the past two years. Only recently, though, are most using those dollars for what has turned out to be a critical measure: keeping indoor air clean. 

School officials reluctant to reinstate mask-wearing requirements when students return to the classroom this fall are rushing to improve indoor air quality to combat what one expert called the “worst version” of the virus: omicron subvariant BA. 5, which has shown a remarkable ability to evade immunity and reinfect Americans. 

The science has been evident for more than a year that ventilation is key to slowing the spread of the virus, we've detailed how the Centers for Disease Control and Prevention was slow to emphasize this in its recommendations.

But according to conversations with eight school officials as well as experts across the country, indoor air cleaning efforts have just begun — and they’re running up against strained supply chains, spiking costs and labor shortages that might have been avoidable had the control measure been emphasized by public health officials earlier in the pandemic.

ALLOCATING FUNDS 

Schools were a flash point during the pandemic, as some districts continued to offer only virtual education for months as administrators grappled over how to stymie the virus’s spread — a lengthy process that extended the negative effects of remote schooling, like learning loss, for many students

There are several reasons schools shied away from in-person instruction for so long. But education advocates say there’s something that could have helped a return to the classroom: spending more of the federal government’s $190 billion on ventilation systems to clean the air breathed by students and teachers. 

The benefits of doing so stretch far beyond controlling covid-19. Study after study proves that cleaner indoor air leads to better student health, higher attendance rates and even improved academic performance

But when schools received an influx of funds in the early days of the pandemic, most districts neglected to use the money to make investments in their ventilation systems, according to Anisa Heming, director of the Center for Green Schools at the U.S. Green Building Council

“They dismissed the importance of those measures because there wasn’t a lot of emphasis on them from the federal government,” Heming said. “It was a real missed opportunity.”

Instead, that first batch of funding was spent mostly on short-term control measures like sanitizing supplies and personal protective equipment. But as more money flowed down the pipeline and the science about the virus's airborne transmission became clearer, school officials said they were left mostly on their own to figure out the most effective way to clean their indoor air. 

“It was problematic to not have clear leadership and guidance from top levels of government,” said Angelina Cruz, president of Racine Educators United in Wisconsin. “It definitely led to a lot of confusion.”

  • School districts across the country are facing similar challenges in deciding which technology to invest in. An investigation by Kaiser Health News this spring found that more than 2,000 schools have spent millions on defunct or ineffective air-quality products.

And while many schools have recently pivoted their response to emphasize ventilation, Heming said mixed — and often contradictorymessaging from the federal government throughout the pandemic has led some districts to continue investing in virus control measures that scientists have since deemed ineffective, like installing plexiglass barriers around desks and constant surface cleaning

At this point in the pandemic, cleaning the air is still “one of the smartest investments” schools could make, Georgia Lagoudas, senior adviser for biotechnology and bio-economy at the White House’s Office of Science and Technology Policy, said in a statement. “It’s really important that school leaders understand this money is still available and the guidance has become more clear on how to make indoor air upgrades.”

The CDC did not respond to requests for comment. 

Marwa Zaatari, member of the American Society of Heating, Refrigerating and Air-Conditioning Engineers' Epidemic Task Force:

SHORING UP SCHOOLS 

The country faces a mammoth challenge in addressing its indoor air quality problems. Among schools alone, about 36,000 nationwide need to update their HVAC systems to have healthy air, according to a 2020 report by the Government Accountability Office

As a result, a majority of schools report air cleaning efforts as one of their top priorities, but an analysis released last month from the CDC found that fewer than 40 percent have replaced or upgraded their HVAC systems since the start of the pandemic.

That’s largely because of three factors: supply chain delays, labor shortages and increased need, according to Phyllis Jordan, associate director of FutureEd, a think tank at Georgetown University that tracks how pandemic relief dollars are spent. 

“Since everybody at the same time is trying to do this work, it’s going to make the contractors who do it in much higher demand,” Jordan said. “That’s going to both slow down the process and make it more expensive.” 

That puts schools in a precarious situation. Districts must either use or dedicate the federal relief dollars before September 2024, a deadline more than half of schools nationwide said will be “an obstacle” to meet. 

Joseph Allen, director of Harvard's Healthy Building Program:

On the Hill

On tap this week: Federal family planning funding to be in the spotlight

Democratic Sens. Patty Murray (Wash.) and Tina Smith (Minn.) are slated to introduce legislation today aimed at nearly doubling funding for the Title X family planning program, which directs grants for birth control, reproductive health and preventive services for low-income women. 

On Thursday, the pair will head to the Senate floor to seek to pass the legislation by unanimous consent — part of Democrats’ efforts to keep a spotlight on reproductive care after the Supreme Court overturned Roe v. Wade. Last week, Republicans in the Senate stymied Democrats’ attempt to pass legislation aimed at protecting patients' right to travel to obtain an abortion.

According to a Senate aide, the Title X legislation would:

  • Provide $500 million annually for Title X services for the next decade.
  • Provide $50 million per year for clinic construction and other renovations for the next decade.

White House prescriptions

Fauci to retire by the end of Biden’s term

Anthony S. Fauci has served as the face of the coronavirus pandemic response for more than two years. He has been in government for more than a half-century, and has advised seven presidents — and President Biden will be his last, our colleagues Yasmeen Abutaleb and Dan Diamond report. 

Fauci confirmed to The Post his plans to retire by the end of Biden’s term, a decision first reported by Politico. In subsequent interviews with other media outlets, the 81-year-old suggested that his plans were not fully settled. 

Fauci, who also serves as Biden’s chief medical adviser, joined the National Institute of Allergy and Infectious Diseases in 1968 and has been the head of that agency for decades. He has tackled an array of public health crises, such as HIV/AIDS, the 2001 anthrax attacks, Ebola and Zika. 

But he has become a political lightning rod for his advice on the coronavirus. His support for covid mitigation measures — such as shutdowns in early 2020, as well as mask and vaccine mandates — have made him a boogeyman of sorts for Republican lawmakers who opposed such efforts to control the virus.

Reproductive wars

Indiana to begin enforcing parental consent abortion law for minors

The Supreme Court issued an order yesterday allowing Indiana to begin enforcing a state abortion law that places rules around a minor's access to the procedure. 

Passed in 2017, the law requires that people younger than 18 receive parental consent before getting an abortion, unless a court finds that the notification isn’t in the best interest of the minor. The rule was blocked shortly after it was enacted, when lower courts ruled that it ran afoul of the Supreme Court precedent. 

After Roe v. Wade was overturned, state officials asked the U.S. Court of Appeals for the 7th Circuit to lift the injunction on the law. But the court said it wouldn’t offer a ruling until the Supreme Court transmits its opinion repealing the constitutional right to abortion, which is set to happen around July 25. 

Eager to move forward on enforcing the law, Indiana officials last week filed an emergency application asking the court to speed up the process. The high court granted the state’s request and transmitted its judgment quickly

More abortion news from across the country:

  • In Louisiana: A federal judge temporarily extended an order blocking the state’s trigger law from going into effect. But the judge didn’t grant a preliminary injunction that would keep abortion available until a district court determines whether Louisiana's near-total abortion ban, with no exceptions for rape or incest, violates the state constitution, The Post’s Katie Shepherd writes.
  • In West Virginia: The state’s lone abortion clinic resumed operations “immediately” yesterday after a federal judge blocked officials from enforcing a 19th-century law that prohibited the procedure, per our colleague Caroline Kitchener.

More from Caroline:

In other health news

  • On tap today: Independent advisers to the CDC will vote on whether to recommend the Novavax coronavirus vaccine. The panel is expected to vote in favor of the shot, which the FDA authorized for use last week.
  • The CDC has stopped reporting coronavirus levels for cruise ships, our colleagues Amanda Finnegan and Gabe Hiatt write.
  • D.C. has more cases of monkeypox per capita than any state, prompting public health officials to launch an aggressive vaccination campaign aimed at stopping the spread within the most at-risk communities, The Post’s Jenna Portnoy reports.

Health reads

What extreme heat does to the human body (By Ruby Mellen and William Neff | The Washington Post)

Biden’s FTC has blocked 4 hospital mergers and is poised to thwart more consolidation attempts (By Harris Meyer | Kaiser Health News)

Health care's high rollers: As the pandemic raged, CEOs' earnings surged (By Bob Herman, Kate Sheridan, J. Emory Parker, Adam Feuerstein and Mohana Ravindranath | Stat)

Sugar rush

Thanks for reading! See y'all tomorrow.

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