 Welcome to Tuesday's Overnight Health Care. The White House could try to revive action on drug pricing, pharma execs were optimistic about a safe COVID-19 vaccine in the next six months, Senate Republicans previewed their coronavirus relief bill, and the CDC has new data showing a much higher number of infections than reported. We’ll start with the return of President Trump’s briefings on coronavirus: Trump says coronavirus will 'get worse before it gets better' President Trump said Tuesday that the novel coronavirus outbreak in the United States would “get worse before it gets better” amid surges in cases in parts of the country. “It will probably, unfortunately, get worse before it gets better,” Trump, reading from prepared remarks, told reporters at a White House briefing. Trump went on to implore Americans to wear masks, physically distance and wash their hands, and urged young Americans to avoid bars. “We’re asking everybody that when you are not able to socially distance, wear a mask,” he said. “Whether you like the mask or not, they have an impact. They’ll have an effect, and we need everything we can get.” Read more here.
Be on guard for some drug pricing action this week: White House considering executive orders The White House is considering one or more executive orders aimed at lowering drug prices that could come as soon as this week, prompting pushback from some GOP lawmakers and the powerful pharmaceutical industry. One idea under discussion, sources say, is to link some U.S. drug prices to the lower prices paid overseas, an idea that is opposed by many Republicans, who see it as a price control that violates free-market principles. The politics: This comes a little more than three months from the election, on an issue that is key to voters. Democrats have been pounding Republicans on the issue of health care, pointing to a President Trump-backed lawsuit to overturn the Affordable Care Act, and executive action on drug prices could be a way for Trump to try to counter on the issue. The intra-party drama: Some congressional Republicans have been calling the White House in recent days to raise objections to the proposal, sources say, an effort spurred on by the pharmaceutical industry, which is rallying to try to stop the idea. Another idea in the mix is bringing back the “rebate rule,” which bans discounts drug companies pay to pharmacy benefit managers in a bid to simplify the system. Read more here. CDC: US coronavirus infections likely 10 times higher than reported Infections of the coronavirus in the U.S. may be up to 10 times what is currently known, according to Centers for Disease Control and Prevention (CDC) data published in JAMA Internal Medicine. The estimate is based on detection of antibodies in the population. Testing indicates the number of people with antibodies is between two and 13 times the approximately 3.8 million recorded cases of the virus in the U.S., according to the CDC’s research. An analysis of blood samples from 10 geographic regions, including Washington state, Utah, New York and South Florida, found that New York City has the highest proportion of antibodies within the population, with 24 percent. May and June data indicates that 2.8 percent of Missourians have antibodies, while 3.6 percent of Philadelphia residents have them. Read more here. CDC updates isolation guidelines The CDC also updated its guidance on self isolation: if you are symptomatic with COVID-19, you should isolate at home for 10 days after symptoms begin, and for 24 hours after your fever has broken. People with more severe to critical illness, or severe immunocompromise, likely remain infectious no longer than 20 days after symptom onset, the agency said. Asymptomatic patients should isolate for 10 days from the date of the first positive test. The new guidelines were previewed last week, when the agency said it would recommend people do not need to have two negative tests in order to end isolation. Multiple studies have found evidence that recovered patients will continue to "shed" viral RNA for up to three months, but none have shown those patients can transmit the virus to others. Isolation rules are for people who test positive. The CDC continues to recommend a 14-day quarantine period for people who come into contact with someone who tested positive. Context: The update comes as the U.S. testing system is strained to the brink, because so many states are seeing surges of coronavirus cases. Results can take as long as two weeks to return, which makes the tests effectively useless. Read more here. Some details from McConnell on the GOP response bill: Senate Majority Leader Mitch McConnell (R-Ky.) on Tuesday provided a broad outline for what to expect in the forthcoming Republican coronavirus relief proposal, including help for schools, small businesses and testing. McConnell, speaking from the Senate floor, indicated that he would soon be unveiling the Republican proposal after swapping ideas with the administration in recent weeks. "The majority will be laying down another historic proposal very soon," McConnell said. Elements: - $105 billion for schools
- Another round of small business loans and reimbursing business for coronavirus expenses
- Another round of stimulus checks
- Funding for testing and vaccines
- Liability protection for businesses
Read more here.
Pharma execs say FDA will not lower standards for coronavirus vaccine Drug company executives on Tuesday painted a mostly rosy picture of the timeline for developing and getting a coronavirus vaccine approved Four out of five executives said they hoped to have some sort of regulatory approval by this fall, but cautioned that there are many uncertainties. “We would hope in the fall or towards the end of the year we have data that we could submit to the Food and Drug Administration for them to make a determination on whether to approve it,” said Stephen Hoge, president of Moderna. “We would also hope at that point to have millions of doses of vaccines available,” Hoge said. High standards remain: The executives also sought to reassure House Democrats that the federal government is not lowering its approval standards, and any coronavirus vaccine that gains approval will be safe. Executives from Moderna, Janssen, Merck, AstraZeneca and Pfizer told lawmakers during an Energy and Commerce subcommittee hearing Tuesday that despite the unprecedented speed, any vaccine candidate will be safe. Read more here. The Hill event The coronavirus pandemic is presenting new challenges for the 34 million Americans living with diabetes. On Thursday, July 23, The Hill Virtually Live hosts "Diabetes and the COVID Threat" to discuss effective diabetes care during the time of COVID-19. Reps. Diana DeGette (D-CO) and Tom Reed (R-NY), co-chairs of the Congressional Caucus on Diabetes and a panel of health experts join The Hill's Steve Clemons. RSVP today. What we’re reading Tension, infighting roil Trump White House as coronavirus strategy sputters (Reuters) The deputy HHS secretary’s wife has been lobbying the agency (STAT) How deadly is COVID-19? Researchers are getting closer to an answer (The Wall Street Journal) State by state After bending the curve, California is poised to take over New York for the most Covid-19 cases (CNN) The virus found a crowded Houston neighborhood, sparing one nearby (New York Times) Coronavirus cases are way up in nursing homes in hard-hit states (Axios) Op-eds in The Hill As COVID-19 crisis continues, suicide risk for veterans likely to grow News media stoke COVID-19 anxieties; yawned during 1968 pandemic Are we prepared for the next health crisis? Maybe | 
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