Decoding what Biden health officials told Congress about Omicron

Senators on Tuesday demanded clear answers from the Biden administration health officials on the state of the resurging pandemic and the government’s short- and long-term plans for combating it. They mostly got jargon.

In contrast to previous oversight hearings on the Biden administration’s Covid-19 response, Democrats on the Health, Education, Labor and Pensions Committee raised sharp questions and complaints about widespread “confusion and frustration” around who should isolate and for how long after a Covid exposure or diagnosis, or where and when to get tested.

“We want the Biden team to take advantage of the opportunity to speak directly to those frustrations and anxieties,” a senior Democratic aide told POLITICO heading into the hearing.

The answers may not assuage their fears. Here’s what was said, and the takeaways:

The question: What is current CDC guidance on quarantine and isolation?

What they said: Centers for Disease Control Director Rochelle Walensky spent several minutes walking lawmakers through her agency’s recently-amended guidelines for Covid infections, which critics have called confusing and contradictory,

“If they are exposed and completely boosted, they do not need to stay home, but they should get a test at day five,” Walensky said. “So by five days after your symptoms — if you’re feeling better, if your fever is better, if your cough and sore throat are better, then on day six you can go out, but you have to wear a mask and you have to wear a mask reliably.”

When HELP Committee Chair Patty Murray (D-Wash.) interrupted to ask for more clarity on what to do between days five and 10, Walensky replied: “You shouldn’t go visit grandma. You shouldn’t get on an airplane.”

Sen. Mitt Romney (R-Utah) later told the officials that many Americans — himself included — don’t even understand what it means to be “exposed.” Biden Chief Medical Adviser Anthony Fauci explained it means 15 or more minutes in close contact with someone known to be infected.

The takeaway: Confusion still reigns. People five days into a Covid infection shouldn’t “go visit grandma,” but if they’re a health care worker, they are cleared to treat grandmas in a hospital. The lack of a testing component to reenter society also reflects the administration’s current scramble to address a severe shortage of reliable tests, leaving the CDC asking individuals to make decisions based on a subjective evaluation of their own symptoms.

The question: How did CDC arrive at those guidelines? Was it a public health or an economic decision?

What they said: Walensky acknowledged that the CDC changed its quarantine and isolation guidance based both on new research about when Covid-positive people are most infectious as well as “the real-world circumstances we currently face” with a decimated workforce.

In particular, she said she has heard from hospitals around the country that “they had plenty of beds, but they didn’t have staff to staff them” and that preventing closures of schools and pharmacies were other top priorities.

The takeaway: Walensky is arguing that even the economic imperative to get more people back to work faster has a health component. If hospitals don’t have enough workers, for example, they could be forced to turn patients away or delay elective procedures.

Yet the acknowledgment that the guidance change wasn’t based purely on science leaves a perception that the government is willing to put workers’ health behind economic interests.

The question: Why are there still test shortages? When will they be resolved?

What they said: Assistant Health Secretary Dawn O’Connell testified that when the Omicron varient began sweeping across South Africa and Europe in the fall and early winter, the Biden administration “immediately reached out to our manufacturers to understand any supply constraints they had and to evaluate their surge capacity.”

Beyond daily follow-up meetings, she said the administration has used the Defense Production Act a dozen times to help free up testing supplies, expand manufacturing capacity and make sure the U.S. gets first priority. And she said it’s working to fulfill Biden’s recent promise to provide free rapid at-home tests to those that want them, but added the $3 billion invested in the work so far is “not enough.” Just 10 percent of the 500 million promised tests have been purchased so far.

The takeaway: They’re on the case.

The administration is dealing with supply chain hiccups and a testing workforce that is itself sidelined by Covid and other challenges. But lawmakers faulted the administration Tuesday for failing to prepare for the current surge months ago, when demand for testing was lower.

And while the health officials stressed Tuesday that keeping schools open is a priority this winter, the testing shortage has left schools scrambling to obtain enough to track infections and decide who goes to the classroom and who stays home.

The question: Why is CDC data on vaccination rates still spotty and inaccurate? When will the agency get it right?

What they said: Sen. Maggie Hassan (D-N.H.) pressed Walensky on why the CDC can’t distinguish between booster shots and first vaccine doses, which has led to incorrect data on vaccination rates in her state and elsewhere.

Walensky responded that “CDC is the compiler of the data and we rely on state immunization services to provide CDC the data at the state level.” She added that when people don’t bring their vaccine card to their booster shot appointment, the shot is marked down as their first dose instead of their third.

Walensky couldn’t say when the issue will be resolved, but she noted the agency is working with every state to “reconcile” data gaps.

The takeaway: CDC says the blame really rests with states and Americans who don’t accurately keep records.

Yet vaccination rates are far from the only area where the federal government has struggled to pull together and make available accurate data on the state of the pandemic. As Walensky noted, data trickles up from underfunded state and local health departments — many of which still operate on manual data entry, fax machines and other outdated technologies.

The problem extends beyond vaccination rates to challenges tracking new variants, collecting information on racial disparities in Covid-19 infections and more — forcing the government to turn to international data to make domestic policy decisions as the pandemic drags on.

The question: Why does the CDC find it “really encouraging” that people with underlying health conditions are dying of Covid?

What they said: Sen. Bob Casey (D-Pa.) expressed concern about remarks Walensky made on Good Morning America on Friday that the CDC found it “really encouraging” that the majority of deaths from people infected with Omicron are happening to people with other medical conditions.

Walensky said the comment was “taken out of context” and that she was referencing a recent study that demonstrated the currently available vaccines are doing a great job protecting most people from Omicron.

“The study was a cohort of 1.2 million people who were vaccinated, and 36 people passed — demonstrating the remarkable effectiveness of our vaccines. But no less tragic are those 36 people who passed because of Covid-19, and many of them had comorbidities.”

She added that the agency is taking additional steps to help people with disabilities.

The takeaway: Walensky still has a messaging problem. While vaccines are holding strong against the new variants and preventing millions of hospitalizations and deaths, people with disabilities, parents of children too young to be vaccinated and other vulnerable groups still feel that the government is not doing enough, or taking their needs into account when crafting policy and guidance.

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