Axios Vitals

A briefcase with a red cross on the front.
December 22, 2021

Good morning, Vitals readers! Today's newsletter is 1,107 words, or a 4-minute read.

🍾 Programming note: This is our final newsletter of the year. We wish all of you a safe and healthy and happy holiday season. We'll see you in 2022!

1 big thing: Biden's COVID culpability

Illustration of aviator sunglasses with green COVID cells reflected in the lenses
Illustration: Annelise Capossela/Axios

In its never-ending race to stay ahead of the coronavirus, the Biden administration keeps falling behind, Axios' Caitlin Owens writes.

Why it matters: The U.S. is facing an overwhelming surge of cases driven by the Omicron variant less than six months after President Biden celebrated "Independence from COVID-⁠19," and experts say that the administration could have done more to better prepare the country.

  • Some experts say the administration's cardinal pandemic sin has been moving too slowly, while others say it's over-relying on vaccines.
  • But there's near-unanimous agreement that the administration should have made cheap, at-home rapid tests widely available months ago.

What they're saying: “There needs to be a commitment from the administration to make rapid, at-home tests available for every American to be able to test twice a week," said Leana Wen, an emergency physician and former Baltimore health commissioner. "500 million tests sounds like a lot, but it's not nearly enough."

The big picture: Omicron has rapidly replaced Delta as the dominant variant in the U.S., and some places — including New York City and D.C. — are already seeing signs of its exponential spread.

  • But only 30% of vaccinated Americans have received a booster shot after a messy rollout, COVID tests are in short supply right when Americans need them for the holidays, and hospitals are already stretched thin by Delta caseloads and worker burnout.
  • Most ominously, only 62% of Americans are fully vaccinated. And while most experts think that the high rates of lingering vaccination resistance aren't the administration's fault, they were foreseeable.

The other side: Biden himself pushed back yesterday at insinuations that he's moved too slowly, specifically on testing.

  • "What took so long is — it didn't take long at all," Biden told reporters. "What happened was the Omicron virus spread even more rapidly than anybody thought."
  • Even though rapid tests have been more widely available and much cheaper — in many European countries, they're still experiencing testing shortages given the explosion of Omicron cases.

“There are regulatory processes in which we have to work with in this country. That’s just the reality," a senior administration official tells Axios.

The latest: The White House announced yesterday that, beginning in January, it's making 500 million rapid tests available for Americans to order to their home via a federal website.

The bottom line: “Everything in this plan that he released today is what I want to see. I just wish we’d had it earlier,” said Megan Ranney, a professor at the Brown School of Public Health.

Go deeper.

2. Rethinking the COVID isolation period

Illustration: Aïda Amer/Axios

Health care experts believe the CDC needs to shorten the 10-day isolation period for fully vaccinated people who test positive for COVID-19 — or else hospitals will face more severe staff shortages, Axios' Bob Herman writes.

  • "Mandatory 10-day isolation is going to make things really difficult for essential services," tweeted Aaron Carroll, Indiana University's chief health officer.

Driving the news: The CDC has considered shortening the isolation period, according to the The New York Times, but no change has occurred yet. The CDC didn't respond to questions by deadline.

  • Given the quick spread of Omicron and the presumably shorter length of infectiousness for vaccinated people, several health care experts believe isolation doesn't need to surpass five days — especially if vaccinated people are returning multiple negative rapid tests.

The big picture: This is especially important for hospitals, which are already short-staffed and can't afford to have large swaths of providers out.

  • "If it turns out that every doctor and nurse who tests positive needs to stay away for 10 days, we could be emptied of health care providers pretty quickly," said Bob Wachter, chairman of the University of California, San Francisco Department of Medicine.

Read the rest.

3. 1 grim thing: Death rates rise

Data: CDC; Chart: Danielle Alberti/Axios

Death rates increased for each age group 15 years and older in 2020, according to the CDC's final 2020 death data released today, Axios' Danielle Alberti and I report.

Why it matters: The data reflects the impact of COVID-related illness last year, as well as increases in such other causes of death as unintentional injuries.

By the numbers: Life expectancy for the U.S. population in 2020 was 77 years, a decrease of 1.8 years from 2019.

4. Holiday health care reads

Illustration of a book shelf with a health plus made from negative space.
Illustration: Aïda Amer/Axios

I recently asked our Vitals readers for top health care reading recommendations, and, boy, did you deliver.

Why it matters: As we all, hopefully, take a few days of rest over the coming days, here's a collection of book recommendations to consider from other health care readers.

  • "Catastrophic Care," by David Goldhill. "My favorite idea from the book is about how health insurance has evolved into something completely different from insurance in other industries. You wouldn't use your auto insurance to pay for every oil change."

— Cyrus Attia, clinical lead at Ro

  • "This is Going to Hurt," by Adam Kay. He's a British comedy writer who used to be an A&E (emergency room) doctor, and these were his diaries he kept while he was a junior doctor in the NHS. It's mostly funny but also quite heartbreaking!"

— Dyan Flores, project manager, Health System Partnerships Operations at One Medical

  • "Sharing a great fiction read out this year that connects to mental health needs and self-care: "This Close to Okay," by Leesa Cross-Smith.

— Loran Smith, Humana

  • "Think Again," by Adam Grant. "The book illustrates the state of mind we should adopt in the healthcare industry if we really want to change."

 Susan Collins, global head of healthcare at Twilio

5. Catch up quick

  • FDA expected to authorize Pfizer and Merck COVID pills this week (Bloomberg)
  • Israel set to offer a fourth dose of COVID-19 vaccine to people over 60 (Reuters)
  • IU Health announces price freeze at first-ever hospital transparency meetings (The Indianapolis Star)
  • Pandemic poses short- and long-term risks to babies, especially boys (KHN)
  • A hospital offered a payment plan for baby's NICU stay — $45,843 a month for a year (NPR)
  • Private equity is gobbling up hospice chains and getting involved in the business of dying (Huffington Post)

6. Dog of the week (Bonus Edition)

Duck the dog.
Duck. Photo: Darlene Vanderbush

Meet Duck, a three-year-old black Lab who's quite calm for her breed.

  • Her loves are belly rubs, cuddling, and swimming in the lake at her aunt’s house in Maine, says her mom Darlene Vanderbush, the vice president of executive operations at the American Hospital Association.
  • Yes, we typically reserve our dogs of the week for Fridays. But we had to squeeze in one last adorable pup as a happy send-off in what has been a tough news week (month? year?) as we sign off for a few days.
  • A special thank you to all the front-line health care workers out there. See you in 2022! 🎉

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