Sep 10, 2021

Axios Vitals

😎Happy Friday, Vitals readers! Today's newsletter is 1,181 words, or a 4-minute read.

  • Join me and Axios' Caitlin Owens today at 12:30pm ET for a Vitals "Check-Up" event on the state of COVID-19 vaccinations, featuring former FDA commissioner Scott Gottlieb and Walgreens chief medical officer Kevin Ban. Register.
1 big thing: Biden embraces "sticks" with workplace vaccine mandates

Illustration: Sarah Grillo/Axios

President Biden sought to reframe the issue of vaccines as a workplace safety issue as he announced plans Thursday to require employers with 100 or more workers to mandate COVID shots for workers.

Why it matters: The vaccine mandates unveiled as part of Biden's six-pronged COVID-19 response plan extend to federal workers and much of the health care workforce. They could impact about 100 million workers.

Between the lines: "By asking people to be vaccinated before they return back to work, by acting as an employer, as a large federal employer, what they were doing was creating safe work spaces," said Ashish K. Jha, dean of Brown University's School of Public Health.

  • The extension of vaccine mandates to health organizations that get federal funding is aimed at further extending those safe spaces for patients, particularly the immunocompromised, he said.

The new rule for employers, to be developed by the Department of Labor's Occupational Safety and Health Administration (OSHA), is "a very big deal," Devjani Mishra, a leader of employment law firm Littler Mendelson's COVID-19 task force.

  • "There's going to be a lot to unpack. A lot of it will deal with specifically what OSHA ends up putting in this standard, what their timeline is going to be, what they plan to achieve and what they are required to achieve under this plan," Mishra said.
  • It raises questions about costs and administrative burdens relating to the testing option, as well as requirements that employees be offered paid time off for vaccination, she said.
  • Republicans have vowed to fight the plan to mandate COVID-19 vaccination or testing for more than 80 million private sector employees.

What to watch: Vaccine exemptions may end up being a bigger deal than employers, and the feds, are anticipating. Larger than expected numbers have already been seeking — or even purchasing "proof" online of — such religious and medical exemptions to vaccine mandates.

Go deeper: Our thought bubbles on Biden's COVID mandates

2. Democrats' health care plans are taking shape

Illustration: Aïda Amer/Axios

Democrats' ambitious health plans are slowly transitioning from bullet point proposals to more fleshed-out policies, Axios' Caitlin Owens reports.

Yes, but: Some of these proposals put the House and Senate in conflict with one another, emphasizing just how far Democrats still have to go.

Driving the news: One House committee with health care jurisdiction began considering legislation yesterday, while a second released its portion of the reconciliation package.

There were also multiple news nuggets on the drug pricing front yesterday:

  • The Biden administration released its drug pricing plan, throwing its support not only behind allowing Medicare to negotiate drug prices, but also behind making those negotiated prices available to employers and the commercial market.
  • That's a major — albeit exceptionally controversial — piece of the House drug pricing bill.
  • But the Senate is still working on its own version of a Medicare negotiation plan. It's been reported that, unlike the House approach of tying U.S. drug prices to what other countries pay, the Senate is interested in some kind of domestic benchmark price.
  • Senators are considering tying what Medicare pays for drugs to what other government programs like the VA pay, STAT reported yesterday.

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3. Fauci: We don't need new vaccines yet

While some have raised concerns that it may be time to look at updating the vaccines to better match variants such as Delta — and most recently, Mu — NIAID director Anthony Fauci tells Axios' Eileen Drage O'Reilly that's not yet needed.

Why it matters: Sounding the alarm, Fauci says widespread vaccination is a priority to fight the coronavirus and cut down on the rate of new infections — which is currently 10 times higher than where it needs to be.

What he's saying: The current vaccines "do very well against the Delta variant," Fauci said.

  • "Even though the vaccine wasn't specifically [designed] against Delta, there's enough cross-protection against the different variants once you get the antibody level high enough," he says.

What's happening: The WHO recently labeled Mu (B.1.621 and first discovered in Colombia) a variant of interest as preliminary data indicated it may better elude immunity from prior infection or vaccination.

  • Mu may "indicate potential properties of immune escape, as it has some of these hallmarks of being able to get around that existing vaccine protection, but it doesn't mean that's what we're seeing play out in real life," says Anne Rimoin, an epidemiologist and director of the UCLA Center for Global and Immigrant Health.

Go deeper: How the Delta variant dominates Mu

4. A grim comparison

Delkhah Shahin checks on a 34-year-old, unvaccinated COVID-19 patient at Providence Cedars-Sinai Tarzana Medical Center in Tarzana, Calif. Sept. 2. Photo: Apu Gomes/AFP-Getty Images

This weekend, we commemorate the 20th anniversary of the Sept. 11, 2001 attacks which killed nearly 3,000 people. But we've lost track of the fact that at least that many will die of COVID-19 within the span of two days.

The big picture: 9/11 was a shocking attack that sparked massive domestic foreign policy changes and conflict in two countries. While the pandemic has certainly led to enormous change, the daily drumbeat of hundreds of COVID deaths in America isn't garnering the attention it once did.

We saw this phenomenon with each surge of this pandemic before vaccines had a chance to be widely distributed yet at the end of 2020.

  • "In fact, the more who die, sometimes the less we care," psychologist Paul Slovic told the Washington Post in December.
  • "Statistics are human beings with tears dried off," Slovic said. "And that's dangerous because we need tears to motivate us."

Between the lines: Now deaths are on the rise again, with about 1,500 COVID deaths a day in the U.S.

  • The bulk of patients who end up seriously ill or dead from COVID are unvaccinated — many by choice. Meanwhile, those killed or seriously injured on 9/11 had no choice.

Our thought bubble: But people are still dying every day from COVID-19 — a lot of people.

  • As we take time this weekend to absorb the massive loss the nation experienced on a single day two decades ago, it'd be valuable to use this moment to also consider the enormity of the daily losses America is suffering from COVID.
5. Catch up quick
  • The FDA said Thursday it will delay its decision on top-seller Juul, but thousands of other electronic cigarettes will be ordered off the U.S. market. (Axios)
  • The uptake for Aduhelm, the controversially approved Alzheimer's drug, has been a lot slower than expected, Biogen CEO Michel Vounatsos said Thursday. (Axios)
  • France will offer free contraception for women up to the age of 25 starting next year, French Health Minister Olivier Véran announced Thursday. (Axios)
6. Dog of the week

Mia. Photo: Lorrie Ernst

Meet Mia, a rescue puggle who lives in Sarasota, Florida, with Lorrie and Al Ernst.

  • She has been a great companion for her "under employed stand up comedian" for dad and "a joy and comfort for mom" who works as wound and ostomy nurse at the Blake Medical Center burn and trauma program.
  • "This has been especially true with recent tragic unnecessary COVID surge!" Lorrie said. Good job, Mia!

Think you've got the cutest pup in health care? Send their photos and tell me a bit about them — and you — so I can share them and bring smiles to our readers. (Note: Please be sure your shots are horizontal.)