The Health 202: Genetic tracing could show how coronavirus spread through White House

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White House spokesman Judd Deere said tracing has been done for people who had contact with Trump. But it’s the kind recommended by the Centers for Disease Control and Prevention, which involves merely tracking people who were nearby those known to be infected.

“Contact tracing has been done by the White House Medical Unit consistent with CDC guidelines,” Deere said, though The Post has reported many of the hundreds of people potentially exposed to the president found out via media reports of his diagnosis.

Coding coronavirus samples would give a clear picture of whether recent White House events were so-called “superspreaders.”

This is an approach researchers have tried around the country.

They’ve watched the virus accumulate a catalogue of mutations as it moved through Zip codes in the Houston area. They’ve used genetic sequencing to trace how the virus spread outward from a conference in Boston, infecting people from Alaska to Senegal to Luxembourg.

And as detailed by my colleagues Sarah Kaplan, Desmond Butler, Juliet Eilperin, Chris Mooney and Luis Velarde, tumor geneticist Paraic Kenny sequenced samples taken from people in the small town of Postville, Iowa. By looking at variants in their genetic coding, he was able to identify a cluster of cases that all originated from one meatpacking plant.

“Infectious particles swabbed from a patient’s nose carry small but distinctive differences in its genome that can be used, like a molecular bar code, to track where the virus came from and how it had been transmitted,” my colleagues write. “By reading the virus’s RNA, Kenny could unveil how cases were connected to one another, exposing the secret spread of the disease.”

Genetic tracing could play a critical role in seeing how the virus spread – and even whether Trump himself played a role in spreading it. 

They include senior policy adviser Stephen Miller, who tested positive along with several others who helped Trump prepare for last week’s debate. Former New Jersey Gov. Chris Christie, who checked himself into the hospital after testing positive, has said masks were not worn while prepping the president. 

NBC News’s Kelly O’Donnell:

A Coast Guard aide is also infected. Jennifer Jacobs, senior White House reporter for Bloomberg News:

Others who have contracted the virus also include assistant press secretary Jalen Drummond, who attended a Sept. 26 Rose Garden event where Trump announced Amy Coney Barrett as his Supreme Court nominee. While others who attended that event – including Republican Sens. Mike Lee and Thom Tillis – later tested positive, several White House press aides are also infected. 

From the New York Times’s Maggie Haberman:

The Rose Garden event has prompted speculation it may have turned into a so-called “superspreader event” where the virus was transmitted to many people. While that’s less likely to happen outdoors, part of the event was held indoors — and many guests were not wearing masks and were pictured hugging, shaking hands and talking closely together. And during the time they were outside, they were seated close to one another. 

The White House could do genetic tracing for those attendees, as well as people who attended a ceremony one day later in the East Room of the White House. That event, which recognized the families of deceased service members, was attended by Trump, Vice President Pence, Defense Secretary Mark Esper, and top generals and admirals.

Now some of them are isolating after Adm. Charles W. Ray, the vice commandant of the Coast Guard, tested positive for the virus on Monday, the service announced yesterday. Attendees were tested before the event, but most attendees didn’t wear masks or maintain social distancing, according to White House photographs.

Pence will likely face questions at tonight’s vice presidential debate about the White House-connected outbreaks.

The vice president, who leads Trump’s coronavirus task force, will debate Joe Biden’s running mate Sen. Kamala Harris (D-Calif.) in Salt Lake City.

“Pence’s challenge is to explain what happened in the last few days and defend it,a Trump campaign source told my colleague Jacqueline Alemany in today’s Power Up.

And Trump is apparently determined to attend the second presidential debate next week, even though it’s unclear whether he’ll still be infectious at that point. The president returned on Monday from the hospital to treat his own case of covid-19, and his doctors said yesterday the president is now symptom-free.

The president has continued to project an image of being fully in charge and able to conduct all of his regular activities, but his response after being sick has frustrated some, The Post’s Amy Goldstein and Frances Stead Sellers write.

“Some outside health experts…said Trump’s determination to attend the Oct. 15 debate is part of a pattern of recklessness that has defined his response to the pandemic, with the president and his aides not wearing masks or observing social distancing,” they write. “At least 19 people on his staff or his campaign, or who attended recent White House events, have tested positive for the virus in the past week.”

Ahh, oof and ouch

AHH: The White House has cleared the FDA’s stricter standards for vaccine approval.

Trump had previously called the guidelines “political” and indicated that the White House might not approve them. Even after the FDA provided the White House with additional information, the guidelines remained stalled.

“On Tuesday, tired of the delay, the FDA circumvented the White House by publishing the criteria online as part of a briefing package for a meeting with its vaccine advisory committee that is scheduled for Oct. 22,” my colleagues write. 

An official told The Washington Post that the White House approved the guidelines shortly after the standards were published. The new guidelines will require drugmakers to follow participants for at least two months after their last shot is administered, a prospect that all but guarantees a vaccine will not be approved before the election.

Albert Bourla, the chief executive of Pfizer, one of the companies at the forefront of the race for a vaccine, declared his support for the FDA on Tuesday.

OOF: Trump ordered an end to pandemic relief talks, upending hope for a pre-election stimulus.

In a series of tweets posted less than 24 hours after he was released from the hospital, Trump accused House Speaker Nancy Pelosi (D-Calif.) of negotiating in bad faith and said that he had ordered Treasury Secretary Steven Mnuchin to end talks over a proposed economic relief package, Erica Werner and Jeff Stein report.

“I have instructed my representatives to stop negotiating until after the election when, immediately after I win, we will pass a major Stimulus Bill that focuses on hard-working Americans and Small Business,” Trump wrote.

“Barring another unexpected development, Trump’s declaration kills any near-term chance of new aid for millions of Americans who remain out work and at risk of eviction. Pelosi and Mnuchin spoke shortly after Trump’s tweets and Mnuchin informed Pelosi that the negotiations were indeed over, according to Pelosi’s spokesman,” Erica and Jeff write.

Pelosi and Mnuchin had been in talks over the past week in an effort to reach a compromise stimulus package. While progress was slow, talks appeared to be moving forward, spurred initially by encouragement from the president. As recently as Saturday the president tweeted that country “wants and needs stimulus.”

The news that new stimulus funding is not forthcoming could harm an already fragile recovery. The United States has recovered barely half of the jobs lost in March and April, and Federal Reserve Chair Jerome H. Powell warned on Tuesday that more money is needed for economic recovery.

OUCH: Facebook removed a Trump post calling the coronavirus less deadly than the flu.

“Flu season is coming up! Many people every year, sometimes over 100,000, and despite the Vaccine, die from the Flu. Are we going to close down our Country? No, we have learned to live with it, just like we are learning to live with Covid, in most populations far less lethal!!!” Trump’s tweet and now-deleted Facebook post reads.

Facebook removed the president’s post for violating its policies restricting misinformation about the coronavirus. Twitter did not remove the post but hid it under a notice that the post violated the platform’s policies, Rachel Lerman reports.

The estimated number of annual deaths from the flu has ranged from 12,000 to 61,000 since 2010. The coronavirus, meanwhile, has killed at least 210,000 Americans this year and probably would have killed more if not for a nationwide effort to limit its spread. 

Trump lashed out at the social media companies after they censored his posts, calling for the repeal of Section 230, a law that shields tech companies from liability for what third parties post on their sites. 

More on coronavirus

Federal vaccine expert turned whistleblower Rick Bright resigned from government.

“Bright, who headed the powerful Biomedical Advanced Research and Development Authority, was abruptly reassigned in April to a lesser position at the National Institutes of Health,” Stat News’s Nicholas Florko writes. “Bright has alleged he was moved after raising concerns about the Trump administration’s response to Covid-19 and nepotism within the Department of Health and Human Services.”

In May, Bright filed a whistleblower complaint against HHS in which he said he was pressured to allow for the distribution of hydroxychloroquine, an unproven covid-19 treatment championed by Trump. On Tuesday, Bright amended his complaint to include his decision to resign. The amended complaint said that, since being reassigned, the former pandemic preparedness leader had only been given one assignment to complete.

“Dr. Bright has been assigned no meaningful work since September 4, 2020, when he completed the one assignment given to him at NIH,” the amended complaint states. “He has been idle for weeks … The federal government is paying Dr. Bright, one of the nation’s leading experts in pandemic preparedness and response, and an internationally recognized expert in vaccine and diagnostic development, to sit on his hands during a global pandemic that has, to date, killed one million people globally and over 210,000 people within the United States.”

The Trump campaign vows to forge ahead with debates, while the Biden campaign expresses reservations over health risks.

Trump said he intends to participate in next week’s presidential debate on Oct. 15 in Miami. But with at least 11 positive virus cases linked to last Tuesday’s debate, the prospect of a nominee showing up for an in-person debate only 10 days after leaving the hospital has some worried.

Biden indicated that he would not debate if Trump still had covid-19. In remarks to reporters on Tuesday, he said he would follow recommendations from doctors and the Cleveland Clinic. The Centers for Disease Control has said people with mild to moderate cases of covid-19 remain infectious for no longer than 10 days after symptoms start, but the time can be doubled for those with severe cases, the New York Times’s Sydney Ember reports.

Biden’s running mate, Sen. Kamala Harris (D-Calif.) will face off with Pence in a debate tonight. After disagreement over public health precautions, the two camps have agreed to debate at a distance of 12 feet with plexiglass barriers.

Kamala’s healthcare record

Harris took on the drug and hospital industry as California attorney general.

With health care expected to be a central concern in today’s vice-presidential debate, the Times reviewed Harris’s record opposing mergers between large health-care groups and anticompetitive behavior by hospital systems and drugmakers.

“As the California attorney general from 2011 to 2017, Ms. Harris used her powers to protect consumers and to prosecute fraud or antitrust violations in pursuit of health care industry players she accused of maximizing profits at the expense of patients,” the Times’s Reed Abelson reports.

Harris led state attorneys general in opposition to a merger between a large hospital group and a large physician practice, she joined a Justice Department lawsuit that stopped health insurers Anthem and Cigna from joining, and she challenged drugmakers who paid off competitors to delay the introduction of generic alternatives to brand-name drugs. 

Harris’s record has gained plaudits from many consumer protection advocates, who cite a body of research linking mergers and acquisitions to higher health-care costs. Her efforts have also attracted criticism. Last year an editorial in the Wall Street Journal linked Harris’s decision to block a hospital sale to the hospital chain’s subsequent bankruptcy.  

Elsewhere in health care

  • During an NBC town hall on Monday, Biden said he would pass legislation to make Roe v. Wade the law of the land if the Supreme Court overturns it. The comment came in response to a voter who asked Biden what he would do to protect abortion rights if Barrett, Trump’s nominee to the Supreme Court, is confirmed. Trump hit back on Twitter falsely accusing Biden of supporting late-term abortions “right up until the time of birth, and beyond.” While Biden has changed his stances on several abortion issues — including federal funding for abortion — he has not explicitly supported legalization of late-term abortions and has previously said he opposes them, Forbes’s Tommy Beer reports.

  • The Supreme Court heard arguments on Tuesday in a case that could determine the extent to which states can regulate prescription drug benefit companies. The case, Rutledge v. Pharmaceutical Care Management Association, addresses a 2015 Arkansas law that blocked pharmacy benefit managers from marking up profits or underpaying pharmacies. The Supreme Court decision, which will weigh whether federal law preempts state law regulating PBM payments, could affect 40 states that regulate PBMs in some form, Roll Call reports.

Sugar rush

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