Trump out of isolation and back on trail

Trump out of isolation and back on trail

With Alice Miranda Ollstein, Carmen Paun and Susannah Luthi

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President Donald Trump is back on the campaign trail after his recent bout with coronavirus, with the White House physician maintaining that the president is no longer infectious.

The World Health Organization warned against the recent push for “herd immunity,” with the global health agency’s chief dismissing it as unethical.

— Johnson and Johnson is pausing its coronavirus vaccine trial, citing one participant’s unexplained illness.

WELCOME BACK TO TUESDAY PULSE — And greetings from the Midwest, where views of Trump and the pandemic are quite different than from inside the Beltway bubble. More on that below. Meanwhile, tips are always welcome to [email protected] and [email protected].

LET’S TALK ABOUT INEQUALITIES IN HEALTH CARE: We’re hosting an Oct. 29 virtual town hall on the policies and public health solutions needed to solve racial inequalities in the U.S. health care system – and we want your stories to help shape that conversation. Submit a 45-second video sharing your thoughts and we may feature it in our town hall and invite you to join our private Zoom discussion afterward to continue the conversation.

WHITE HOUSE MEMO: TRUMP IS NOT INFECTIOUS — The world’s most famous case of coronavirus has resolved, the White House’s top physician insisted on Monday, saying that the president had tested negative for Covid-19 on consecutive days.

The announcement came just hours before Trump held his first rally since his diagnosis was made public on Oct. 1. Trump did not wear a mask as he was boarding his flight to the rally in Florida, raising concern that he might infect staffers and journalists surrounding him.

— How SEAN CONLEY got to his diagnosis. In a memo to White House press secretary Kayleigh McEnany, the White House’s top doctor cited antigen tests from Abbott, along with laboratory data that included viral load, to determine that the president would not be able to spread the coronavirus to others.

“This comprehensive data, in concert with the CDC’s guidelines for removal of transmission-based precautions, have informed our medical team’s assessment that the President is not infectious to others,” Conley said in the memo.

The president subsequently boasted to rally-goers that he had “beat [the virus] and now they say you’re immune.” He has acknowledged experts’ uncertainty about the duration of immunity. But…

“I feel so powerful,” Trump said on Monday night. “I’ll walk into that audience. I’ll walk in there, I’ll kiss everyone in that audience. I’ll kiss the guys and the beautiful women.”

There’s still skepticism about Trump’s medical outcomes, particularly after his team’s lack of transparency about his health conditions. Several details still remain unclear, such as the results of Trump’s lung scan and the timing of his last negative test before the diagnosis. Conley hasn’t directly faced the media for more than a week.

Meanwhile, Trump has made several videos and given interviews where he’s praised his doctors for administering an experimental monoclonal antibody treatment from Regeneron, promising last week that the FDA will quickly authorize the treatment and that it could be a “cure” for Covid-19.

REGENERON‘s own CEO has played down the president’s outcome. Leonard Schleifer on Sunday said Trump’s treatment with the company’s experimental antibody cocktail is “a case of one,” but stressed ongoing clinical trials still need to show its efficacy.

“The president’s case is a case of one, and that’s what we call a case report, and it is evidence of what’s happening, but it’s kind of the weakest evidence that you can get,” Schleifer said in an interview on CBS’ “Face the Nation.”

Meanwhile: Reinfection remains possible. The Lancet on Monday reported on the first confirmed case of Covid-19 reinfection in the U.S., citing a 25-year-old Nevada man who tested positive six weeks apart earlier this year.

“The second infection was symptomatically more severe than the first,” the scientists write. It’s the fifth confirmed reinfection case worldwide.

WHO BOSS: ‘SCIENTIFICALLY AND ETHICALLY PROBLEMATIC’ TO TAKE SHORTCUT ON HERD IMMUNITY — That’s what World Health Organization director-general Tedros Adhanom Ghebreyesus warned in an eight-minute broadside against the idea on Monday, dismissing some calls to let the virus circulate unchecked among people, POLITICO’s Carmen Paun reports.

“Allowing a dangerous virus that we don’t fully understand to run free is simply unethical,” Tedros said, adding that herd immunity has never been used as a pandemic-response strategy. He also argued that leaders have safer options and proven tools to control the virus, singling out nations like Denmark and Germany for their use of digital technology to conduct contact tracing.

Meanwhile, Tedros didn’t mention the United States in his commentary on herd immunity, but there’s been a growing push in America to consider the idea even as cases surge above 50,000 new cases per day. HHS Secretary Alex Azar met last week with a trio of scientists who backed the approach, and the White House on Monday touted the scientists’ work in a call with reporters.

— Meanwhile: WHO to issue guidance on holding in-person elections safely, WHO emergencies boss Mike Ryan told reporters on Monday. “It’s possible to hold safe elections if proper measures are put in place,” he said.

But WHO experts danced around a question about Trump’s return to the campaign trail 11 days after the White House determined he was infected with the virus.

Ryan said he didn’t want to comment on specific individuals and deferred to U.S. public health criteria, but noted that WHO recommends that patients isolate for at least 10 days since the onset of symptoms, plus three days from the cessation of last symptoms. So by PULSE’s back-of-the-envelope math, Trump appears to be back on the campaign trail slightly ahead of WHO’s recommendation.

J&J PAUSES VACCINE TRIAL — Johnson & Johnson announced late Monday it is temporarily pausing recruitment and dosing of its coronavirus vaccine in clinical trials due to an “unexplained illness in a study participant.”

The independent drug safety monitoring board for J&J’s phase 3 ENSEMBLE trial is reviewing the unexpected event. The company did not disclose more information about the affected individual, POLITICO’s David Lim reports.

— It’s not unusual to pause clinical trials, although the Covid-19 vaccine race has raised the stakes and spotlight for participating companies.

AstraZeneca paused a Covid-19 vaccine trial last month after an unexpected outcome, and the trial remains on hold in the United States, although the company has since restarted the trial in multiple other countries.

HEALTH CARE WARS DOMINATE SCOTUS CONFIRMATION HEARINGDemocrats on Monday focused their remarks on the Affordable Care Act’s fate, a strategy expected to shape this week’s hearings in front of the Senate Judiciary Committee, POLITICO’s Alice Miranda Ollstein reports.

One after another, Democrats accused Republicans of attempting to rush Judge Amy Coney Barrett to the bench before the high court hears arguments about the constitutionality of Obamacare on Nov. 10, calling it an “end run” to nix the law after the GOP failed to repeal and replace it through legislation.

Democrats also took a multi-pronged approach to invoking the ACA, with some members displaying over-sized photos of constituents at risk of losing coverage if the courts strike the law’s protections for people with preexisting conditions. Meanwhile, Democrats cited a law review article by Barrett that criticized the Supreme Court for previously upholding the ACA, and a public statement she signed onto calling Obamacare’s birth control mandate “unacceptable,” as evidence she would vote to gut the law if confirmed.

— Republicans on the committee took a different view: the fate of the ACA is a non-issue, and is an effort to distract from Barrett’s confirmation.

“Every single member of the Senate agrees that pre-existing conditions can and should be protected,” said Sen. Ted Cruz (R-Tex.), although Alice notes that Cruz and other opponents of the ACA have yet to present a viable mechanism to do that — and all the GOP members have previously voted to repeal the law.

Sen. Chuck Grassley added that it’s “outrageous” to say the nominee would vote to eliminate the ACA. The Iowa Republican’s rationale: “As a mother of seven Judge Barrett clearly understands the importance of health care.”

What also got attention on Monday: Covid-19: Democrats slammed Senate GOP leaders for holding an indoor, in-person hearing after committee members Sens. Mike Lee and Thom Tillis tested positive for the virus following a White House event celebrating Barrett’s nomination.

Lee attended the hearing in person on Monday, citing a doctor’s note, but Tillis remains in quarantine and gave his opening statement via video. Meanwhile, committee chair Sen. Lindsey Graham insisted that the event was safe and cited copious efforts to make the hearing perhaps the single-most “CDC-compliant” room in the nation. Graham also defended his and Lee’s decision not to be tested in the days ahead of the hearing, arguing it wasn’t necessary.

Democrats were not reassured, Alice writes.

“The decision to hold this hearing now is reckless and places facilities workers, janitorial staff, and congressional aides, and Capitol Police at risk,” said Sen. Kamala Harris, who participated in the hearing via video.

Democrats also panned Republicans for prioritizing the confirmation hearings over passage of another coronavirus relief bill.

What got little attention: Roe v. Wade. While abortion rights may be the dominant issue for outside advocacy groups, the issue got little mention in the roughly five-hour-long opening day, Alice writes. Several Democrats did warn that Barrett has been open about her anti-abortion views and predict that the Supreme Court would likely overturn Roe with her on the bench.

KFF: INSURERS’ MEDICARE PROFITS HAVE JUMPED — Insurer profits on Medicare Advantage have grown 41 percent over last year, with plans grossing an additional $64 per member per month, according to a new Kaiser Family Foundation study.

Plans now gross about $222 per Medicare Advantage member per month, compared to just $138 per member per month in the individual market and $106 per member per month in the group market.

— Health plans are swimming in cash as the ongoing health crisis scares many people away from the doctor, POLITICO’s Susannah Luthi writes.

For instance, Susannah notes that workplace plans spent 78 cents for every premium dollar on health care, while Obamacare plans spent 72 cents. This means health plans will have to pay out rebates next year since their profits are capped by law – albeit through a system that critics suggest gives them a lot of leeway.

THOUGHTS ON COVID FROM THE RUST BELT AND MIDWESTPULSE has spent the past few days criss-crossing swing states like Ohio and Wisconsin, where a wide range of public health behaviors have been on display.

In a rural Pennsylvania park on Saturday, social distancing and masks were plentiful as hikers circled a lake. A few hours later near Cleveland, a trail was choked with people, with maybe half the crowd going mask-less as they gawked at a waterfall.

— PULSE was cautious about a visit to the University of Notre Dame, coming just days after the Indiana school’s president infamously tested positive for the virus after attending the White House’s celebration for Barrett, a former Notre Dame law professor.

But the Notre Dame campus, which re-opened two months ago even as other schools went virtual, seemed to be a model of mitigation during a few hours on campus. Students and others near-universally wore masks, there were few crowds and Notre Dame had set up fire-pits and tents that allowed for outdoor activities.

PULSE’s impression was very different on a trip to University of Wisconsin-Madison, which has had a staggered re-opening and recently ramped up masking requirements. Crowds of unmasked students wandered campus, even as the school and state grapple with a severe Covid-19 outbreak, and your author took a wide path to dodge one coughing woman when trying to get a snack from an ice cream parlor.

Meanwhile, politically tinged signs have been everywhere on this swing-state road trip, including a billboard in Southeastern Pennsylvania castigating “the media” as “the virus.” But another Covid-themed billboard down the road put the blame squarely on Trump, reading “200,000 Coronavirus Deaths. 13 Million+ Unemployed. VOTE HIM OUT.”

“A glimmer of unsubstantiated hope” that a drug called Actemra could be a coronavirus treatment set off a wave of unexpected consequences, John Fauber writes in the Milwaukee Journal Sentinel.

Sen. Gary Peters tells Elle magazine the story of his wife’s abortion, which the magazine says makes him the first sitting senator to publicly share a personal experience with the procedure.

As coronavirus cases surge in North Dakota, C.S. Hagen writes in the Inforum about why “partying in a pandemic is worth the risk” for some local students. (PULSE note: To be clear, this is not the messaging from public health experts.)

“We must do better”: Public health experts must improve their efforts to reach conservatives, Dartmouth’s Lindsey Leininger and the Univ. of Chicago’s Harold Pollack argue in the Washington Post.

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