The Omicron variant of SARS-CoV-2 has surged in the United States in the past week and now accounts for 73% of new infections. The CDC showed a six-fold increase in Omicron infection in a single week. In the New York area, the Southeast and the Pacific Northwest, the variant is responsible for an estimated 90% of new infections, according to the Associated Press.
On Tuesday, amidst public criticism that the national response to the Omicron variant was underwhelming, President Joe Biden announced an accelerated coronavirus response. According to the announcement, the government will purchase and distribute 500 million rapid tests and distribute them to Americans for free. They will also create new federal vaccination and testing sites and send 1,000 medical professionals to assist in hospitals across the country, according to the New York Times. From President Biden:
I know you’re tired, really, and I know you’re frustrated. We all want this to be over but we’re still in it.
At a National Press Club briefing on Monday, National Institute of Allergy and Infectious Diseases (NIAID) Director Dr. Anthony Fauci, MD, said that control is the most likely path forward for COVID-19 in the U.S. — not eradication as many had hoped. Fauci said the only hope for control would be through vaccinations, boosters and mitigation strategies like masks in congregate settings, according to Medpage Today:
It’s not going to be eradication, and it’s likely not going to be elimination. it’s going to be a low, low level of infection that doesn’t interfere with our way of life, our economy, our ability to move around in society, our ability to do things in closed indoor spaces… Over time, we feel confident we will get this under control.
The surge in cases attributable to the rise of the Omicron variant comes at a time when hospitals across the country, especially in Arizona, the Midwest and Northeastern U.S., are reaching capacity. According to the New York Times, several hospital systems in Minnesota have released a joint message saying that employees are demoralized and “your access to health care is being seriously threatened,” Michigan currently has 4,700 virus patients hospitalized — more than have been reported during the state’s previous three surges.
In Saginaw, doctors and nurses said they have noticed colleagues struggling with the relentless nature of the pandemic — with fatigue, short tempers, post-traumatic stress and with frustration towards the unvaccinated,
On Wednesday, the Food and Drug Administration (FDA) approved the first oral antiviral for treatment of COVID-19. According to the FDA’s press release, the Pfizer tablet Paxlovid, is authorized for emergency use in mild-to-moderate COVID-19 in adults and pediatric patients 12 years and older. From Dr. Patrizia Cavazzoni, M.D., director of the FDA’s Center for Drug Evaluation and Research:
Today’s authorization introduces the first treatment for COVID-19 that is in the form of a pill that is taken orally — a major step forward in the fight against this global pandemic. This authorization provides a new tool to combat COVID-19 at a crucial time in the pandemic as new variants emerge and promises to make antiviral treatment more accessible to patients who are at high risk for progression to severed COVID-19.
Vaccine Mandates
President Joe Biden appealed to the U.S. Supreme Court (SCOTUS) to allow a federal mandate for healthcare workers to take effect nationwide. The rule, through the Centers for Medicare and Medicaid Services, would require all workers at any facility that receives funding through the Medicare or Medicaid programs to get vaccinated, is currently paused due to a challenge by separate groups of states led by Missouri and Louisiana. According to Bloomberg Law, the Supreme Court has thus far backed vaccine mandates and refused to order exemptions to New York’s healthcare worker vaccine mandates last week. From U.S. Solicitor General Elizabeth Prelogar:
Delaying the rule would cause serious, tangible harm to public health. If the rule remains stayed during this winter’s anticipated COVID-19 surge, hundreds and potentially thousands of patients may die at hospitals, nursing homes and other facilities participating in Medicare and Medicaid as the result of COVID-19 infections transmitted to them by staff.
According to the National Law Review, the Missouri and Louisiana Orders, as well as a third order in the state of Texas, block the federal government from implementing or enforcing the rule in 25 states. The original December 6 deadline for initial vaccination requirements has passed, leaving complications for if and when the stay on the rule is lifted. The CMS rule as written requires full compliance as of January 4.
The current CMS guidance remains in effect and deferment on enforcing the CMS vaccine requirements could be extended. Accordingly, barring new guidance or updates to existing guidance like the [memo to State Agency Survey Directors], how and when CMS plans to proceed with enforcement in the 25 states where that is now a possibility remains an open question.
Last Friday, the Sixth Circuit Court of Appeals lifted a stay on the employer vaccine mandate issued through the Occupational Safety and Health Administration (OSHA). The Emergency Temporary Standard (ETS) was issued on November 5, requiring employers with 100 or more workers to mandate that their employees must either get vaccinated against COVID-19 or submit to weekly tests for the virus. Shortly after the ETS was issued, the Fifth Circuit Court of Appeals granted a motion filed by employers and several state attorneys general to stay the mandate.
According to NPR, Judge Jane Stranch of the Sixth Circuit cited the Occupational Safety and Health Act’s language, noting that the agency has “long asserted its authority to protect workers against infectious diseases.”
The language of the OSHA Act plainly authorizes OSHA to act on it’s charge ‘to assure safe and healthful working conditions for the nation’s work force and to preserve the nation’s human resources.’
The decision was appealed to the Supreme Court by several business organizations and Republican-led states, according to CNBC. These include the National Retail Federation, the American Trucking Associations and the National Federation of Independent Businesses.
Federal Spending
According to a report published on Wednesday, U.S. healthcare spending hit $4.1 trillion last year or nearly 10% from 2020, double the normal growth rate. According to Associated Press this translates to healthcare accounting for $1 of every $5 in the economy. The federal government share of health spending increased by 35%.
The report, published in Health Affairs, also found that the number of uninsured people did not balloon with job losses but remained at around 30 million. Medicare rolls also grew more slowly in 2020, but that was largely due to deaths related to COVID-19. Health spending on the state and local levels decreased by about 3% in 2020 and the federal share of Medicaid spending was about 69%.
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