January 31, 2022

Welcome to the week, Vitals readers. Today's newsletter is 784 words or a 3-minute read.

  • 🎙️ Listen in: The Axios Today podcast caught up with an 81-year-old retired nurse and grief counselor who's now an ordained Episcopalian chaplain to speak to her about ministering to nursing home residents two years into the pandemic.
  • Plus, podcast host Niala Boodhoo discusses the latest Spotify controversy over COVID misinformation with Axios' Sara Fischer.

1 big thing: The Omicron Olympics face the ultimate test

Photo illustration: Brendan Lynch/Axios

Health experts are worried the Beijing Olympics face the perfect conditions for a COVID outbreak, due to the lightning-fast spread of Omicron, vaccines' weakened protection against it, and, ultimately, a mentality that the games must go on in spite of the risks.

Why it matters: These Games boast a "closed-loop system" that has been called the strictest ever created for a global sporting event. But China's protocols seem more focused on keeping COVID from escaping the loop than protecting those inside it, critics say.

  • The rules even direct locals not to help should an Olympics vehicle get in an accident.

"China is trying to protect China, not the athletes," Annie Sparrow, a professor at the Icahn School of Medicine at Mount Sinai Hospital, told Axios.

The state of play: Omicron is still spreading fast, and now there are new warnings of an even more contagious version of the variant.

  • "The trillion-dollar question is: Can they beat Omicron?" Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told Axios.
  • "At least, in theory, they've laid out a plan that won't stop COVID from beginning in the Games, but it could and should greatly limit transmission. Then again, we're up against Omicron and I'm not sure how effective anybody could be against that virus."

The other side: "The public health measures in place within the closed-loop — physical distancing, hand hygiene, wearing a mask, good ventilation, etc. — all those public health measures work," McCloskey told reporters during a Jan. 23 news conference.

  • "If people stick to the rules, we will not see Omicron spreading within the loop and we won't see Omicron spread out of that loop," McCloskey said.

Go deeper.

2. ACA enrollment soars, and faces perilous fall

Illustration: Shoshana Gordon/Axios

Democrats are touting record Affordable Care Act enrollment, but a lot of those gains will be wiped away next year unless Congress takes action, Axios' Caitlin Owens and Bob Herman write.

Why it matters: Millions of Americans have taken advantage of the enhanced ACA subsidies Congress passed into law last year, with many enrolling in health insurance for the first time.

  • But under the status quo, that more generous coverage is going to expire at the end of 2022 — and people will be notified right before the midterm elections.

State of play: An extension of the enhanced subsidies was included in Democrats' Build Back Better legislative package. But that's stalled in the Senate, and it's unclear which pieces — if any — will make it into law.

  • What they're saying: "President Biden has successfully reinvigorated the ACA, as he promised to do," said KFF's Larry Levitt. "But, that success will be sustained only if the extra premium help continues."

Read the rest.

3. Little kids' vaccine timeline could change

The timeline for getting Pfizer's COVID vaccines to kids under 5 could move to early March, Pfizer board member and former FDA commissioner Scott Gottlieb told CBS News Sunday.

Why it matters: Getting vaccines approved for the youngest children would not only be a relief for worried parents, but could help protect against disruptive school and daycare closures.

Driving the news: Previously, Gottlieb said vaccines could get out by late March at the very earliest, depending on regulatory approval.

What he's saying: "Previously, we had data showing that the childhood vaccine for six months to four years wasn't as protective against infection as the adult vaccine. That's the reason they pushed it out," Gottlieb said.

  • "But now, if the goal of the vaccine is to get baseline immunity into the kids to prevent bad outcomes and you're really not using the vaccine as a tool to prevent infection in the first place, two doses could do that," he said. "I think that may be why federal health officials are rethinking this."

4. More workplaces cover fertility treatments

Illustration: Sarah Grillo/Axios

Employers are beefing up benefits packages to lure workers in a tight labor market, and many are adding pricey fertility benefits — such as in-vitro fertilization and egg freezing — to their offerings, Axios' Erica Pandey writes.

  • By the numbers: 11% of U.S. employers with 500 employees or more covered egg freezing in 2020, compared with just 5% in 2015, according to the Mercer study. When looking just at firms with 20,000 employees or more, the 2020 share is 19%.

5. While you were weekending

Illustration: Aïda Amer/Axios

  • Antimicrobial resistance was already a major problem. But it's possible the pandemic made the issue of superbugs even worse. (National Geographic)
  • University of Utah Health has begun phase 2 clinical trials for a promising new contraceptive — for men. (Deseret News)
  • OSHA is pursuing new COVID safety rules for health care workers. (Washington Post)

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