Saturday, August 29, 2020

POLITICO NIGHTLY: How to treat Covid, for now




 
POLITICO Nightly: Coronavirus Special Edition

BY JOANNE KENENLAUREN MORELLO AND RENUKA RAYASAM

With help from Myah Ward

COVID RX — “We developed a wide array of effective treatments,” President Donald Trump said Thursday in his 70-minute speech on the White House lawn that, along with fireworks and an opera singer, closed out the Republican National Convention. He repeated his optimistic forecast that a vaccine would be ready this year thanks to “America’s scientific genius.” (Some of the leading candidates are from scientific geniuses in places like China, Germany and the U.K., but let’s put that aside.)

Trump boasted that his policies are based squarely on “the science, the facts and the data.” But science and facts don’t always come out on top in this administration. Just today, FDA Commissioner Stephen Hahn fired his top spokesperson after just two weeks on the job, after Hahn publicly overstated the benefits of one Covid treatment.

In truth, we have not developed a wide array of effective treatments. Not one new coronavirus drug has even gone through the full FDA approval process. Some treatments have been given emergency authorizations by the FDA. There are promising therapeutics in the pipeline. Other good ideas have failed (as have a few bad ones).

So what treatments do we have? A rundown:

Remdesivir is the drug you probably hear most about. A large study run by the National Institutes of Health has shown it helps severely ill, hospitalized Covid-19 patients recover more quickly. Just today, the FDA OK’d its use for other hospitalized patients, even if they aren’t that ill.

But it’s not yet clear whether it prevents deaths. The findings on whether it improves survival aren’t statistically significant. We don’t know if it saves people who might have otherwise died, just that it helps some people get better faster — and recovering faster from a disease that can do a lot of damage to vital organs is a good thing. But those might be people who would have lived anyway. We just don’t know.

Though the drug is still being studied, on its own and in combination with other medicines like beta interferon, it is considered the standard of care for hospitalized Covid patients, at least until something better comes along. But it’s hard to manufacture and is in short supply.

Dexamethasone, a safe and inexpensive steroid that’s been around for a long time, has recently been proven to be quite effective for patients receiving breathing assistance, either through oxygen or a ventilator. It is not recommended for — and could harm — patients who don't need at least supplemental oxygen. Available and affordable, it too is now going into wide use.

Convalescent plasma — derived from antibody-rich blood donated by people who have recovered from the virus — received an emergency-use authorization from the FDA last weekend. But it was highly controversial — both because it came after public pressure on the agency from Trump and because the data is still pretty thin. This is the one the FDA’s Hahn botched the stats on when he talked about it in public. He later apologized, also in public. Despite Trump’s effusive assertions, it is by no means certain that “thousands and thousands” of lives will be saved by convalescent plasma.

The plasma is safe. It’s been used in medicine for more than a century. But there aren’t yet high-quality studies showing that it works on the coronavirus, and if so, when in the course of the disease to administer it and in what amounts. It will be even harder to get those answers now, because patients can get it without entering a clinical trial and the risk of getting a placebo.

As far as drugs still in development, keep your eye on monoclonal antibodies — lab-produced versions of proteins that the immune system uses to fight off a virus. The research on two promising drugs is still underway. We mostly hear about the government’s Operation Warp Speed funding for vaccines, but the initiative is focused on this potential treatment, too. Monoclonal antibodies could turn out to be a treatment or a preventive measure, possibly a bridge to a vaccine or to help while vaccine supplies are limited.

Hydroxycholoroquine — don’t get us started. The malaria and lupus drug has been thoroughly discredited as a Covid-19 treatment and the FDA has withdrawn its emergency-use authorization, But some people in Trump’s circle still have faith. The president didn’t mention it in his speech Thursday but he did mention it favorably in one of the videos aired on the first night of the convention. “It's a shame what they did to that one,” he said.

And that’s about it. Other drugs are being used to help Covid-19 patients fight off symptoms and survive, but there aren’t yet well-established protocols. Doctors deploy drugs to fight immune system crises called cytokine storms, to treat the kidney failure the coronavirus can bring on, to support patients with dangerous pneumonia.

There is a lot of improvisational medicine, with doctors using their knowledge and experience to try things that might help. But again, not a lot of data, and some of the drugs that look promising are falling flat. The New York Times Magazine a few weeks ago had a really good article about the tensions between research doctors, who want to be methodical and precise, and the doctors in intensive-care units, who want to throw everything they have to try to help their patients.

A final thought: There may not be one Covid cure. Anthony Fauci and others have noted, we may end up with a cocktail or cocktails of drugs, as we do in fighting HIV/AIDS and many cancers.

Welcome to POLITICO Nightly: Coronavirus Special Edition. How German chancellor Angela Merkel ends her press conferences these days: by reaching for a zip-loc bag in her pants pocket that stores her mask. Reach out rrayasam@politico.com or on Twitter at @renurayasam.

 

POLITICO'S "FUTURE PULSE" - THE COLLISION OF HEALTH CARE AND TECHNOLOGY : As the school year begins, campuses will be laboratories for the future of mental health care and contact tracing in the era of Covid-19. Can technology help ease students' anxiety? The health care system that emerges from this crisis will be fundamentally different, and technology will play a significant role in shaping it. Future Pulse spotlights the politics, policies and technologies driving long-term change on the most personal issue for voters: Their health. SUBSCRIBE NOW.

 
 
FIRST IN NIGHTLY

THE POST-PANDEMIC CONVENTIONS — POLITICO Magazine asked a group of political scientists, strategists, observers, activists and historians to think about the ways in which the parties might have landed on convention innovations that will remain with us after the pandemic has passed. Did these virtual conventions offer a new way forward — and how could they change politics, for better or worse, in the future? A few of the answers, or read them all:

“Political conventions evolved to fit the television schedule but hadn't evolved for the viewer experience — until now. This pandemic forced organizers to truly think about the audience at home. The roll call vote definitely got the makeover it deserved. Not only did it meaningfully showcase our diverse and beautiful country, many Democrats I know joked that it made returning to the old roll call, with delegates swarming to the mic and camera on the convention floor, which evokes so many unpleasant flashbacks, an untenable way to nominate someone moving forward.” — Atima Omara, founder and principal strategist of Omara Strategy Group, elected DNC representative from Virginia

“This year’s party conventions aren’t geared toward persuading voters to change their minds. Instead the conventions are looking to persuade voters to vote. Those same political science studies that found persuasion campaigns don’t work also found that turnout tactics do make a real difference. From now on, party conventions will almost certainly be geared — not toward a traditional polling bounce — but toward increasing likeability for the candidate, building enthusiasm for the campaign, and convincing their own voters on the importance of not letting the other side win.” — Sarah Isgur, former Republican campaign operative and spokesperson for the Department of Justice, CNN political analyst, staff writer at The Dispatch

AROUND THE NATION

CALIFORNIA SLOWS ITS ROLL — California’s Democratic Gov. Gavin Newsom overhauled and slowed his state’s economic reopening today by allowing for different levels of operation as California's coronavirus situation steadily improves following a summer surge, Jeremy B. White and Victoria Colliver write.

The new framework creates four tiers that condition in-person learning and business activity only on daily case numbers and test positivity rates — a system that Newsom touted as creating a uniform standard rather than a county-by-county patchwork. Most counties currently fall into the most stringent tier, which would prohibit in-classroom instruction and indoor dining. Two of California's most populous counties — San Diego and Orange — have clamored for the ability to reopen more businesses.

PUNCHLINES

‘ISN’T THE LIVING SUPPOSED TO BE EASY?’ In his Weekend Wrap edition of Punchlines, Matt Wuerker takes us through the week that was in cartoons and satire, including the RNC, recovery from Hurricane Laura, the continued nationwide protests for racial justice, and the pandemic.

Nightly video player of Punchlines Week End Wrap

ASK THE AUDIENCE

Nightly asked you: What is your favorite memory from previous editions of the RNC or DNC? Below are some of your lightly edited responses.

“DNC 2004, my first convention and I was in charge of Senate Minority Leader Tom Daschle’s suite. Former Senator and astronaut John Glenn walked in. He looked old but his steel blue eyes projected superhuman strength and assurance. He kindly chatted with everyone, huddled with Tom a bit, and then posed for a picture with me — John on one side, Tom the other. Obama 2008 was historic, but I’ll never forget meeting this American hero.” — Ami Copeland, executive vice president, Resolute Public Affairs, Chicago

“When Bill Clinton came on the floor of the convention at Madison Square Garden on the third night in 1992, which no nominee had done since JFK in 1960, he went to two places in the front row of delegates — the Arkansas delegation, where his mom was, and the New Hampshire delegation, where I was lucky enough to say hi and congrats as a Granite State supporter.” — Terry Shumaker, former ambassador to Trinidad and Tobago, Concord, N.H.

“In reference to the ’88 VP debate, at the ’92 RNC Ronald Reagan said: ‘This fellow they’ve nominated says he is the new Thomas Jefferson. Well, let me tell you something. I knew Thomas Jefferson. He was a friend of mine. And, governor, you’re no Thomas Jefferson.’” — William Fisher, student, New York City

“My favorite? Well … not my favorite … but certainly one that I remember: Standing around a computer monitor in the Fox News press area with a bunch of Fox colleagues where we were all jointly reading the Drudge Report that Roger Ailes was out at Fox. It was a shock to the hundreds of Fox employees at the convention. Our press area became like a petting zoo — everyone was staring at us.”

GRETA VAN SUSTEREN, JOURNALIST, WASHINGTON, D.C.

“1984: Jesse Jackson tells the DNC, ‘I’d rather have Roosevelt in a wheelchair than Reagan on a horse!’ Jackson’s applause line underscored the fact that the greatest president of the 20th century was a person with a disability, and it galvanized my lifelong commitment to the disability rights movement.” — Mark Willis, writer, Yellow Springs, Ohio

“I threw a load on at the 2000 RNC in Philadelphia courtesy of the open bar at the RNC’s luxury suite in the hall. Standing in the common area in a circle that included Bob Dole, James Carville, Tom Ridge, Larry King and Ed Rendell, I obnoxiously started poking Rendell in the chest, reminding him that it was his job to get Al Gore elected. He turned to my wife: ‘Keep your eye on him.’” — Chuck Moore, business analyst, Ambler, Pa.

“In 1980, I was a twentysomething just arrived in Washington and just broken up with my boyfriend who took his TV with him. I bought a junky used TV just to watch the conventions. Ted Kennedy’s speech was astonishing and thrilling. A decade later, I had the honor to work for him as a health policy staffer and he never failed to astonish me with his drive, his vision and his incredibly hard work.” — Marsha Simon, health policy consultant, Washington, D.C.

“In 1936 and 1940 I listened to two Republican conventions with my father. Our best moment was the roll call of the states. We sat close to the radio, pencils ready to tally each state’s vote. How thrilling to hear ‘Alabama casts X-number votes for Alf Landon/Wendell Willkie’ on through Wyoming! The pride of being the chair of one of the 48 showed in their voices. We were proud, too.” — Jeanne Fuchs, retired, Fort Myers, Fla.

COVID-2020

VOTING BEYOND THE ARC — The National Basketball Association will work with local election officials to turn its arenas into polling places for November's presidential election, the league and its players’ union announced today in a joint statement. As part of an agreement with the National Basketball Players Association, the NBA will convert franchise-owned-and-operated arenas into voting facilities targeted at communities particularly vulnerable to the coronavirus pandemic.

NIGHTLY NUMBER

4

The number of people at the Republican National Convention’s events in Charlotte, N.C., who have tested positive for Covid-19, authorities in Mecklenburg County announced today.

THE GLOBAL FIGHT

People pass by as Japan's Prime Minister, Shinzo Abe, is displayed on a giant television screen during a press conference in which he announced his resignation in Tokyo.

People in Tokyo pass by as Japan’s Prime Minister, Shinzo Abe, is displayed on a giant television screen during a press conference in which he announced his resignation. | Getty Images

TOKYO DRIFTS — Officially, Shinzo Abe — a Trump ally and Japan’s longest-serving prime minister — resigned today for health reasons. But while Abe has long lived with an inflammatory bowel condition, it’s also true that sagging popularity over his pandemic handling turned him into a lame duck leader through 2020. Ryan Heath emails:

Headlines like “Where is Shinzo Abe?” became increasingly common as Japan experienced a spike in infections through August. The country has recorded just 1,226 deaths from Covid-19: fewer than the U.S. recorded on Wednesday alone. But the number of cases soared from less than 100 a day in June to an average of more than 1,000 a day in August.

Abe’s failure to beat the virus — as Japan’s east Asian neighbors and rivals China, Vietnam, South Korea and Taiwan have largely done — delivered too much frustration and disappointment for the Japanese public, which had been expected to host the world in July for the 2020 Olympics, now delayed until summer 2021.

Abe’s approval ratings never recovered from a nosedive after the pandemic hit Japan in February. By August just 20 percent approved of the government’s pandemic handling, with 61 percent opposed. Morning Consult's latest foreign leader tracking showed a 32 percent approval rating for Abe, as of Thursday.

In some ways it was a familiar tale: Abe didn’t lock the country down quickly and then, desperate to protect his cherished economic reputation, he encouraged domestic tourism, which sent the virus ricocheting around the country.

In the end, Abe fell on his sword, an act timed almost to the hour of his friend giving a defiant RNC acceptance speech that accepted no coronavirus fault. “I cannot continue being prime minister if I do not have the confidence that I can carry out the job entrusted to me by the people," Abe, 65, said at a news conference.

PARTING WORDS

A BLUEPRINT FOR BLM — Forty-eight years after the first National Black Political Convention, a group of Black Lives Matter organizers is looking to the 1972 Gary, Ind., convention as a model for how they can take the energy and ideas of their protest movement into the halls of political power, Jesús Rodríguez writes. Today, the Movement for Black Lives — a coalition of organizations founded in 2014 in response to the shooting of Michael Brown in Ferguson, Mo. — aims to engage tens of thousands of Black voters in an online Black National Convention of its own.

The Black Lives Matter movement has resisted coalescing around a single leader or a hierarchy. Instead, organizers see the convention as an acknowledgment that protest is but one way to push for police and other reforms, and that electoral politics needs to play a role as well. While a handful of Black Lives Matter activists have won political office, the United States has only three Black senators and zero Black governors.

With protests ongoing in several cities after the police shooting of Jacob Blake in Wisconsin, and pro athletes in multiple leagues striking to draw attention to racial injustice, Maya King explores what’s next for BLM in the latest POLITICO Dispatch.

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Renuka Rayasam @renurayasam

 

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