Overnight Health Care — Biden officials weigh vax mandate for travel

View in your browser OVERNIGHT POLICY: Health Care Biden officials weigh vax mandate for travel © Getty Images Welcome to Wednesday's Overnight Health Care, where we’re following the latest moves on policy and news affecting your health. Subscribe here: thehill.com/newsletter-signup. If Chicago is any indication, D.C. Public Schools' effort to make all staff and students test negative is going to be ... challenging, to say the least.  The Biden administration is also tip-toeing around a domestic travel vaccine mandate. For The Hill, I'm Nathaniel Weixel (nweixel@thehill.com). Write with tips and feedback, and follow me on Twitter @NateWeixel. Let’s get started. Domestic travel mandate back in spotlight © Istock The debate over requiring COVID-19 vaccines for domestic travel is back in the spotlight this week, despite pushback from the business community and the potential for strong backlash if the Biden administration imposes such a mandate. The White House said that a potential mandate is not off the table, and the uptick in COVID-19 cases brought on by the highly transmissible omicron variant has raised questions over whether a requirement is another way to keep Americans safe. President Biden’s chief medical adviser, Anthony Fauci, said on Wednesday that the administration is discussing a mandate, but pointed to the safety of the mask requirement in place for all U.S. transportation networks. “When you're dealing with domestic flights, you want to keep people safe on domestic flights. And as I said, right now, we feel that the masking requirement and the degree of filtration on a plane is sufficient to keep people safe,” Fauci told reporters during a White House COVID-19 response team briefing. “If there's a need to do more beyond this masking, mainly having a vaccine issue, we will seriously consider that as new information arises.” Airline lobby: Airlines and other business groups oppose a vaccine and testing requirement for domestic air travel. Delta Air Lines on Wednesday reiterated their position that the health protections on airlines enable safe travel, pointing to the hospital grade filtration systems and masking onboard aircraft and inside airports. The administration is already facing criticism for new guidelines that halved the isolation time for people who are asymptomatic or showing improved symptoms, which came after pressure from the airline industry.  Read more here. Fauci: Omicron not as severe for vaccinated © Julia Nikhinson Early data show the omicron variant of the coronavirus appears to be less severe than the delta strain among people who are vaccinated, Anthony Fauci said Wednesday. Citing international studies and some initial data from U.S. hospitals, Fauci said people who are vaccinated and boosted are also less likely to be hospitalized. And despite a surge in infections over the past month, hospitalizations have not increased nearly as quickly. "We know now, incontrovertibly, that this is a highly, highly transmissible virus. We know that from the numbers we're seeing," Fauci told reporters during a White House briefing. However, he said, "all indications point to a lesser severity of omicron versus delta." The numbers: Omicron is now the dominant strain of coronavirus, but delta is still prominent. Cases were already rising steadily this fall because of the delta variant, but the emergence of omicron in the past month has led to a near vertical spike. The U.S. on Tuesday broke a record for most single-day COVID-19 infections, with 441,278 cases. That surpassed the previous daily record by close to 150,000. On Wednesday, the Centers for Disease Control and Prevention reported another 431,567 infections. The seven-day average of cases hit a record 277,241, an increase of more than 60 percent over the past week.  Positive signs? Fauci on Wednesday said there's been a 126 percent increase in cases over the past two weeks, but only an 11 percent increase in hospitalizations. While hospitalizations and deaths are a lagging indicator, the "disparity between cases and hospitalizations strongly suggest there will be a lower hospitalization to case ratio," Fauci said. Fauci noted that omicron has some ability to evade immunity, particularly against infection. But for people who are vaccinated, they remain protected against severe illness. Read more here. WHO CHIEF ISSUES WARNING TO WEALTHY NATIONS The World Health Organization's (WHO) chief on Wednesday urged wealthier nations not to prioritize coronavirus booster shots amid a "tsunami of cases" driven by the new omicron variant. WHO Director-General Tedros Adhanom Ghebreyesus during a news conference pressed wealthy nations to spread their share of vaccines with other countries, arguing the coronavirus will continue to evolve and the pandemic will worsen "if we don't improve our collective response." "Delta and omicron are twin threats that are driving up cases to record numbers," he said. "I'm highly concerned that omicron being more transmissible [and] circulating at the same time as delta is leading to a tsunami of cases." Tedros has repeatedly knocked wealthier nations for prioritizing boosters or third shots of the vaccine, saying last week that "no country can boost its way out of the pandemic." Developing countries continue to struggle to vaccinate their populations. Low- and middle-income nations have an average 20 percent vaccination rate, compared to 80 percent in wealthier countries, according to a September update from Covax, a collaborative initiative to share vaccines with the world. Read more here. DC PUBLIC SCHOOLS TO REQUIRE NEGATIVE TEST Washington, D.C., Public Schools will require a negative COVID-19 test for all students and staff before they will be allowed to return to schools after the holiday break.  Mayor Muriel Bowser (D) and D.C. Public Schools (DCPS) Chancellor Lewis Ferebee announced on Wednesday that to ensure safety amid the ongoing COVID-19 surge, DCPS will require all students and staff to provide proof of a negative COVID-19 test result before they return to school on Jan. 5.  DCPS added that it will make free rapid antigen tests available on Monday, Jan. 3, and Tuesday, Jan. 4.  Previously, school officials said testing to return was “highly encouraged" but not required. Officials are asking parents to keep children at home regardless of their test results if they are showing any symptoms or if they are required to quarantine because they are unvaccinated and have been identified as a close contact of an individual who tested positive for COVID-19. Read more here. CDC head: Agency sought balanced guidance © Julia Nikhinson Federal health officials said the recommendation to shorten the isolation period for people with asymptomatic COVID-19 was aimed at striking a balance between making sure essential services can continue to function and how long people can reasonably be expected to stay isolated. Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky said Wednesday the agency was concerned that people are not isolating at all. As infections due to the omicron variant surge, she said the goal was to have a policy that people would follow. The new guidelines, which cut the 10-day period to five days for people who are asymptomatic, "really had a lot to do with what we thought people would be able to tolerate," Walensky said during an interview on CNN's "New Day." "We have seen relatively low rates of isolation for all of this pandemic. Some science has demonstrated less than a third of people are isolating when they need to. And so we really want to make sure that we had guidance in this moment where we were going to have a lot of disease that could be adhered to, that people were willing to adhere to," Walensky added. Business calculations: The sheer number of expected infections could hobble businesses if large swaths of employees miss work, and Walensky said many people would not even want to isolate if they tested positive but experienced mild symptoms. Given what is known about omicron, she said the agency felt a change was needed. "Our guidance was conservative before. It had said 10 days of isolation. But in the context of the fact that we were going to have so many more cases, many of those would be asymptomatic or mildly symptomatic, people would feel well enough to be at work. They would not necessarily tolerate being home and they may not comply with being home," Walensky said.  Read more here. WHAT WE’RE READING Who invented Covid-19 vaccines? Drugmakers battle over patents (Wall Street Journal) 3 big questions about the Biden administration’s Covid response in 2022 (Stat) How errors, inaction sent a deadly COVID variant around the world (Bloomberg) How the insurance lobby got Congress to love Medicare Advantage (Modern Healthcare) STATE BY STATE 22,000 unvaccinated state workers need weekly COVID tests (Albany Times Union) Florida opposes federal government over monoclonal antibodies — again (Tampa Bay Times) After year of virtually no cases, seasonal flu is back in Minnesota (Star Tribune) OP-EDS IN THE HILL The COVID-19 endgame may be here Growing use of at-home tests could lead to an undercount of omicron cases Biden should push for a stronger biodefense to protect Americans That's it for today, thanks for reading. Check out The Hill's health care page for the latest news and coverage. See you Thursday. 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