Capitol Correspondence - 12.08.20

What to Expect from COVID-19 This Winter

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As part of its subscription to Politico Pro, ANCOR received this summary of a briefing on “the coronavirus pandemic, vaccine development and whether states are up to the task of distributing millions of COVID shots.” We are sharing it to help inform our members’ pandemic response plans to ensure the safety of their staff and the individuals with intellectual / developmental disabilities they support.

1) It’s going to be a long, dark winter.

The U.S. is now at about 275,000 Covid deaths, and it’s possible 50,000 more people will die in December. ‘Think of it this way: Roughly 2 percent of those who test positive die. And that’s held true for months even with the new treatments,’ Dan said.

Public health warnings against Thanksgiving travel were widely ignored, and the same could hold for Christmas and New Year’s. A key metric to watch will be hospitalizations. Some major health systems worried about being swamped with new cases are again shutting down all elective procedures to free up staff. Unlike in the spring, the prevalence of the virus means there are fewer U.S. health care workers traveling to help out in hot spots.

One source of light: The health system has learned how to more effectively treat hospitalized Covid patients and use therapeutics to reduce deaths. But that won’t matter if the medical system is overwhelmed.

2) Even states that had outbreaks under control are losing control.

California was Exhibit A for how to flatten the curve of cases early in the pandemic. But it’s now in the grip of a surge that’s shattering records for hospitalizations, with new daily cases exceeding the 20,000 mark.

Vicky noted Gov. Gavin Newsom is poised to announce new restrictions, but there are growing questions about just how many more levers the state can pull. State health officials are focusing on making sure they have enough ICU beds to take care of the sickest patients. The state’s surge, like other parts of the country, appears to be primarily driven by people letting their guards down and increasing community transmission to the point where the virus is widespread.

Vicky noted the Golden State still has lower case rates per 100,000 than most of the rest of the country.

3) Biden needs to take on vaccine skepticism.

Biden’s team is now meeting with federal health officials ahead of what will be one of the largest mass vaccination efforts in history. Rachel said it’s still an open question what exactly the president-elect would like to change. But experts think a robust, well-funded public education campaign led by the federal government is needed amid widespread public hesitancy to take either of the two vaccines that are expected to become widely available at the outset.

The public awareness effort could include advertisements on TV, social media campaigns, creating ambassadors of health and enlisting celebrities to tout the vaccines. And states say they desperately need more funding from the federal government. The Biden team could reprogram money for that — or put pressure on Congress to provide more aid.

4) States have big decisions to make about shots in the coming weeks.

Earlier this week, a CDC advisory panel recommended that health care workers and residents of long-term care facilities get the first doses of the coronavirus vaccines. But those recommendations are not binding, Rachel noted. While many states plan to follow these guidelines, they’re now grappling with what other top priority groups should go next. That will likely lead to a patchwork approach to vaccination among the states.

Teachers are likely to be among the next priority groups. The CDC advisers only voted on the very top tier, which they call ‘Phase 1a.’ But slides from the meeting show that they’re thinking about slotting teachers in a ‘Phase 1b.’

5) New federal spending for big Covid initiatives will be scarce.

Much of Biden’s ambition will be determined by the Senate runoffs in Georgia. Dan noted the incoming president is going to need a big package from Congress in the first 100 days of his presidency. But Senate Republicans may not go along willingly, especially if negotiations trickle into March, when there is wider distribution of a vaccine. That could spell trouble for some initiatives like Biden’s plan to hire 100,000 public health workers to trace Covid-19’s spread, despite widespread agreement it’s needed to finally end the crisis.

‘There’s a lot of ways to spin that if you’re negotiating on the Hill — you can say it’s money going directly to the states for their own program, it’s money to help people who may have lost jobs … but it’s going to be incredibly difficult,’ Dan said.”