 Welcome to Wednesday’s Overnight Health Care. Pfizer could become the recipient of the largest amount of funding from Operation Warp Speed, Former FDA Commissioner Scott Gottlieb said the U.S. could hit 300,000 COVID-19 deaths by the end of the year, and Anthony Fauci says he doesn’t think COVID-19 will ever really go away. Let’s start with the Pfizer news: Pfizer lands nearly $2b from Trump administration for COVID vaccine The Trump administration will give nearly $2 billion to Pfizer and German company BioNTech in order to deliver 100 million doses of a potential coronavirus vaccine. The deal announced on Wednesday is the largest yet for Operation Warp Speed, the Trump administration's push to have a coronavirus vaccine widely available by early next year. The program has already poured billions of dollars into several different companies, including Moderna, AstraZeneca and Johnson & Johnson. The government will be guaranteed 100 million doses for $1.95 billion, or about $20 a dose, if the vaccine is given regulatory clearance, and will be able to acquire up to 500 million more doses. Patients will not pay for the drug at the point of care. The company is set to begin a phase 3 large-scale clinical trial as early as this month. If successful, Pfizer and the German company BioNTech expect to be ready to seek Emergency Use Authorization from the Food and Drug Administration as early as October. The companies expect to manufacture globally up to 100 million doses by the end of 2020. Early trial results of the companies' most advanced vaccine candidate were positive and showed the development of neutralizing antibodies. A much larger study of the safety and efficacy could begin as early as this month. What's different: The contract with Pfizer was different than the agreements with other companies. Pfizer is being paid for the doses and distribution only, not the manufacturing and development of a vaccine. They will also only be paid if the vaccine works and is given some sort of regulatory approval or clearance. Read more here. FEMA head: 'We have a ways to go' on having enough PPE The head of the Federal Emergency Management Agency (FEMA) told Congress on Wednesday the country has “a ways to go” on getting enough protective equipment for health workers fighting coronavirus, though he said the situation has been improving. “I want to be clear: We have a ways to go on making sure we have enough PPE,” Administrator Pete Gaynor said at a congressional hearing, referring to personal protective equipment. “This is not as simple as just throwing a light switch and we just magically make more.” Gaynor testified that many states are reporting they now have stockpiles of equipment that could last 60 or 90 days or more. As cases rise, Gaynor acknowledged there would be more stress on the system. “Now there may be shortages, micro-shortages across the country based on COVID-19 cases, increased hospitalizations,” he said, adding hospitals should work with state emergency response officials and FEMA to acquire more PPE if they cannot from their normal supplier. Read more here.
A depressing thought: Gottlieb says US could hit 300K COVID-19 deaths by end of year Former Food and Drug Administration (FDA) Commissioner Scott Gottlieb signaled Wednesday that the U.S. could reach 300,000 COVID-19 deaths by the end of 2020 if the country's death rate doesn't improve. "Right now, we have close to 1,000 casualties a day, so if we don’t change that trajectory, you could do the math and see where we are towards the end of the year," Gottlieb, who served as President Trump's FDA chief, told CNBC's "Squawk Box." Where we are now: More than 142,000 people in the U.S. have died from the coronavirus, the most of any country in the world, according to data compiled by Johns Hopkins University. Read more here. Fauci on coronavirus: 'I don't really see us eradicating it' Anthony Fauci, the nation’s top infectious diseases expert, said Wednesday he doesn’t think COVID-19 will ever be fully eradicated, but noted it can be controlled. “I don’t see this disappearing the way SARS 1 did,” Fauci said during a live streamed event hosted by the TB Alliance, a nonprofit focused on finding better tuberculosis treatments. The SARS outbreak that started in 2003 lasted several months and mostly affected Asian countries before eventually vanishing. But in the process the disease sickened more than 8,000 people in 29 countries and claimed 774 lives. Because COVID-19 is more contagious, it has had a far greater impact, with more than 15 million cases worldwide, including 618,000 deaths. “It is so efficient in its ability to transmit from human to human that I think we ultimately will get control of it. I don’t really see us eradicating it,” Fauci said. Read more here. Testing delays once again hamper COVID-19 response Surging COVID-19 outbreaks in several states are straining testing capacity across the country as people wait several days or even weeks to get their results back, causing another setback to the U.S. response to the months-long pandemic. Lengthy turnaround times are undermining the fight against the coronavirus, experts say, making efforts to trace contacts of confirmed cases almost pointless. That, in turn, potentially leads to more infections that threaten to strain testing capacity further. “The concern is it's just starting to spiral out of control,” said Marcus Plescia, chief medical officer at the Association of State and Territorial Health Officials. While public health officials say people should be self-isolating while they wait for their test results, there’s little data to indicate how often that’s happening. Longer turnaround times run the risk of making it less likely someone will self-isolate, especially if they’re not experiencing any symptoms. “It really undermines our infection control,” Plescia said. “Somebody who has COVID but has less typical symptoms or doesn't feel that bad, they may feel like it’s probably not COVID, and they'll be going out in public. And if it turns out they really do have COVID, they could have infected significant numbers of people.” Read more here. On a more light-hearted note: Democratic lawmakers launch 'Mean Girls'-inspired initiative to promote face masks Democratic lawmakers launched an initiative Wednesday to promote the use of face masks amid the ongoing coronavirus pandemic inspired by the movie “Mean Girls.” “Excited to launch the #OnWednesdaysWeWearPink masks campaign today. I encourage all my colleagues to participate and support wearing masks to help prevent the spread of #COVID19. It's going to be so fetch!” Rep. Suzan DelBene (D-Wash.), who is leading the initiative, tweeted Wednesday. Dozens of Democratic lawmakers shared their own photos donning a pink mask or supporting the initiative on Wednesday, with some making their own jokes about the hit 2004 film. “We all need to take responsibility for protecting our communities from COVID-19. The best action you can take yourself? #WearAMask. #OnWednesdaysWeWearPink,” House Speaker Nancy Pelosi tweeted Wednesday. Read more here.
The Hill event Diabetes & The COVID Threat. 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 Trump keeps boasting about passing a cognitive test — but it doesn’t mean what he thinks it does (The Washington Post) It's not just dexamethasone: Other steroids may be used to treat critically ill COVID-19 patients, study says (USA Today) After falling for months, Covid-19 hospitalizations in the US are nearing April's peak (CNN) Social distancing Canadians eye new sight at Niagara Falls: crowds of Americans (Reuters) White House privately warns 11 cities must "take aggressive action" State by state Idaho appears to have failed Stage 4 for a third time — and for a new reason this time (Idaho Statesman) Some Iowa districts want out of governor's in-person instruction order. But how to do that remains unclear. (Des Moines Register) Trump was maskless in the lobby of his D.C. hotel. The city plans to investigate. (Washington Post) Medicaid mystery: millions of enrollees haven’t materialized (California Healthline) The Hill op-eds Eating disorders cost US $65 billion a year: Here's what agencies can do | 
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