Axios Vitals

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March 15, 2022

Good morning.

Today's word count is 987, or a 4-minute read.

1 big thing: Partisanship undermines pandemic playbook

Illustration of a dead tree with surgical masks on the branches blowing in the wind.  
Illustration: Aïda Amer/Axios

Public health experts are already creating blueprints for the next pandemic, but it seems increasingly unlikely that policymakers or Americans themselves will have much of an appetite to follow those plans, Axios' Adriel Bettelheim reports.

Why it matters: The past two years have provided concrete examples of what works and what doesn't, but those lessons can only help if the U.S. is willing to apply them — whether in response to another new variant or an entirely new virus sometime in the future.

Where it stands: Congress can't agree on funding to ensure there are enough vaccines and therapeutics to adequately safeguard the U.S. against future waves of COVID-19, even though there are signs from Europe that another wave may be heading our way.

  • The struggle over supporting even the near-term pandemic response bodes poorly for the prospect of longer-term systemic changes that experts say are necessary.

Go deeper: COVID-19 yielded revolutionary vaccines and provided a real-time test for widespread testing and tracing, herd immunity strategies and government-led drug development.

  • Experts say the supply chain issues, difficulties administering vaccines on a mass scale and messaging challenges around a constantly evolving threat provided valuable lessons for future responses.

But the full-on government response — largely build around developing vaccines and minimizing the number of cases — has clashed with some Americans' perceptions of personal freedom, making schools and workplaces flashpoints for polarizing debates.

  • It will be a huge challenge to arrive at any public health consensus when states are split over measures like government mandates and polling shows rising distrust with the CDC and other authorities.

What we're watching: The Senate health committee today begins considering a pandemic preparedness bill.

Go deeper.

2. Children's health issues getting worse

Data: JAMA Pediatrics; Chart: Baidi Wang/Axios

Critical measures of children's health are moving in the wrong direction in the U.S., according to a new study published in JAMA Pediatrics.

What it found: The pandemic took a large toll on children's mental health and overall household stability, but several of these trends had been building for years.

Details: Levels of anxiety and depression among children increased between 2016 and 2020, while daily physical activity decreased. More parents and caregivers reported struggling to cope with parenting demands and dealing with mental health issues of their own.

  • More children were disconnected from the health system, as the proportion of uninsured children rose significantly and the proportion of children with adequate and continuous insurance declined.
  • Specifically between 2019 and 2020 — covering the first year of the pandemic — there was an increase in children with behavioral or conduct problems, as well as a spike in child care disruptions that affected parental employment.
  • Preventive medical visits also decreased, and there was a 32% increase in reports of unmet health care needs between 2019 and 2020.

The good news: There was a drop in household food insufficiency over the study period, including between 2019 and 2020.

  • Daily reading also become more common among young children during the first year of the pandemic, and the proportion of kids getting enough sleep held steady.

3. "Family glitch" fix on the horizon

The Biden administration is reviewing a regulation that experts expect would help close the Affordable Care Act's "family glitch," according to a notice filed last week.

Why it matters: The regulation could help as many as 5.1 million people get more affordable coverage by addressing an ACA loophole.

Details: The family glitch was created by a provision of the ACA that deals with premium subsidy eligibility — and that lowballs the cost of covering a family.

  • People who are eligible for "affordable" employer health insurance aren't eligible for premium assistance on the ACA marketplaces. Affordability is defined as the premium for a single beneficiary — the employee — being below a certain percentage of family income.
  • That doesn't account for the additional costs of adding dependents to the plan. But the affordability determination is applied to all members of the household, making them all ineligible for subsidies if the premium for just one person falls below the threshold.

What they're saying: "Fixing the ACA's family glitch may be the most consequential thing the Biden Administration could do without Congress to make health insurance more affordable," KFF's Larry Levitt tweeted yesterday.

  • Most of the people who fall into the glitch are children, per KFF estimates, and adult women are more likely to fall into it than adult men.

4. As masks lift, spirits rise

Data: Axios/Ipsos poll; Chart: Will Chase/Axios

Americans' emotional and physical health is bouncing back, along with record confidence about life returning to "normal" as mask mandates are abandoned, according to the latest installment of the Axios/Ipsos Coronavirus Index.

The big picture: Two years after the start of the pandemic, the nation is ready to move on, even as disinformation at home and a resurgence of cases in Europe driven by the B.A.2 variant point to challenges on the horizon, Axios' Margaret Talev reports.

  • 64% of survey respondents now favor federal, state and local governments lifting all COVID-19 restrictions, up 20 percentage points since early February.
  • Three in four say they'd go back to masking if infections increase again where they live.

By the numbers: 83% of respondents describe their physical health as good and 84% say their state of emotional well-being is good, the highest shares for both since May 2020.

But, but, but: Only one in three respondents were aware that more than 1,000 people in the U.S. each day are still dying from the virus.

  • Less than half knew that far more people have died from the virus than have experienced negative effects from the vaccine.

Go deeper.

5. Catch up quick

  • Some experts say the global COVID vaccination campaign needs to shift its focus to vaccinating the people most vulnerable to severe disease, NPR reports.
  • Merck's COVID treatment is being used more widely than expected, even though regulators have advised use of Pfizer's antiviral if possible, the Wall Street Journal reports.
  • A new malaria treatment for children has been approved in Australia, a promising development in the world's fight against the disease, per the NYT.