Coronavirus confronts Congress: Cruz, Gosar self-quarantine and members grow antsy Presented by

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Quick Fix

— Two lawmakers say they’re self-quarantining because they were possibly exposed to the novel coronavirus at CPAC.

— The coronavirus continues to spread, with more than 500 confirmed cases and more than 20 deaths in the United States, and officials are more aggressively warning about the outbreak — and trading blame for missteps.

— The Trump administration’s interoperability rules are imminent, with senior leaders set to roll them out today.

A message from PhRMA: Today, there are several promising vaccine candidates in stage three clinical trials. These trials have tens of thousands of participants, from every walk of life. From development to robust clinical trials, and throughout manufacturing, these vaccine candidates follow the same rigorous process of other vaccines that have saved millions of lives. More.

WELCOME BACK TO MONDAY PULSE — Where quarantined kids in China, stuck at home as the coronavirus outbreak raged, teamed up and were nearly able to downvote their homework app off the app store, Wang Xiuying writes in the London Review of Books. (Scroll down for the mention, although the whole report from Wuhan is worth a read.)

If you're reading this newsletter, PULSE considers it an upvote. Tips to [email protected] and [email protected].

Driving the Day

TED CRUZ, PAUL GOSAR ARE IN LOCKDOWN — The two Republican lawmakers say they’re in voluntary self-quarantine after being exposed to a person at the Conservative Political Action Conference who later become symptomatic with coronavirus and is now hospitalized in New Jersey. Neither Cruz nor Gosar says he’s developed symptoms.

Cruz has been among the Senate’s most aggressive members on the virus. He called for a China travel ban in January, has consistently raised questions about U.S. preparedness and held a subcommittee hearing just five days ago on how global travel could fuel the spread of the virus.

Meanwhile, Gosar has been more skeptical of the response to the outbreak, decrying last week’s emergency supplemental that he said allocated “$9,625,000 per patient,” citing the approximately 80 cases flagged by CDC at the time.

— Officials also reported the first confirmed case in D.C., the rector of Christ Church Georgetown, who oversaw services for hundreds of worshipers.

There are now nine confirmed cases in the greater Washington region, as of PULSE press time.

— What PULSE is watching: The steady creep of employers urging that workers go remote, and whether the government follows suit as some lawmakers and officials grow antsy.

Members may even push House Speaker Nancy Pelosi (D-Calif.) on Monday afternoon to consider that Congress go on recess, NBC's Kasie Hunt and Alex Moe report.

OFFICIALS’ WARNINGS GROW MORE SERIOUS — New CDC guidance recommends that the public, especially those with underlying health conditions, defer any cruise ship travel. And while there are no plans to impose lockdowns, “anything is possible,” top government scientist Tony Fauci said on “Fox News Sunday,” part of a broader messaging campaign to brace Americans for potential virus-related disruptions. POLITICO’s Darius Tahir and Brianna Ehley have more.

— It’s possible that officials wanted to go even further. An Associated Press story said that the White House overruled health officials’ plan to recommend that elderly and physically fragile Americans avoid air travel, but a spokesperson for Vice President Mike Pence called the story “complete fiction” and Fauci said that “no one overruled anybody” when asked about the report on Fox News.

— What PULSE is watching, Part 2: Confirmed case counts will likely shoot up this week as more testing comes online. How health officials respond remains to be seen.

AS CORONAVIRUS SPREADS, WHO BEARS THE BLAME? — There are now more than 500 confirmed cases in the United States, according to a tracker maintained by Johns Hopkins. The virus is clearly not “contained,” despite what White House officials like Kellyanne Conway and Larry Kudlow claimed in recent weeks.

So what went wrong? “The slowness of the testing regimen ... was the first, and most sweeping, of many failures,” writes POLITICO’s Joanne Kenen in an extensive tick-tock. But neither the CDC nor the White House coronavirus task force has admitted who made the decision to forgo a viable World Health Organization coronavirus test that could’ve sped up results.

Blame for the disjointed U.S. response has largely been apportioned among the following three leaders:

— ROBERT REDFIELD, the CDC chief, whose agency stumbled at rolling out coronavirus tests and made other missteps, like supporting a decision to keep hundreds of Americans aboard a coronavirus-stricken cruise ship off the coast of Japan.

But Redfield has defenders in the White House, who argue that the CDC chief was pushing further preparedness measures but was stymied by his boss…

— ALEX AZAR, the HHS secretary, who didn’t appear to have a testing backup plan and also cut some of his deputies out of the process. White House officials claim that Azar’s approach to the outbreak was too narrow, and the frustration helped lead to Pence taking over the response almost two weeks ago.

However, a Sunday New York Times story detailed some of Azar’s efforts to lead an aggressive response to the outbreak, but he occasionally faced skepticism from White House aides and his own boss…

— DONALD TRUMP, whose mismanagement has affected the entire response, from refusing to grapple with bad news to undermining his own team’s plans, POLITICO’s Dan Diamond reports.

For instance, Pence and HHS officials on Friday had settled on a plan to evacuate thousands of passengers from another coronavirus-stricken cruise ship, but the president balked because of what it would do to “the numbers” of U.S. cases — a debate that he later referenced at a press conference at CDC. Trump ultimately said that Pence could make the final call.

— Time is growing short to make tough decisions to mitigate the virus’ spread. “New York, Boston, Seattle, Chicago, D.C. — all seem to have community spread,” a former official who’s briefed Trump in the past told PULSE. “What you do at this moment will make more of a difference than anything for a long time.”

MEANWHILE: WHAT WAS TRUMP EVEN TALKING ABOUT? — The president’s wide-ranging press conference at CDC on Friday was filled with multiple asides and misinformation. The president veered into discussing Fox News ratings, attacked Washington Gov. Jay Inslee, mused about becoming a scientist and appeared to compare the CDC’s fumbled response to his own impeachment.

White House officials have grown frustrated trying to keep Trump on message about coronavirus, NBC News reported on Sunday night.

Inside the Humphrey Building

AZAR’s LONG DAY — The HHS secretary spent all of Friday accompanying Trump, one day after a POLITICO report — disputed by the White House — that Azar’s been minimized as Pence took over the response.

AZAR’s GOOD NIGHT — Trump announced on Friday night that acting Chief of Staff Mick Mulvaney would be replaced by Rep. Mark Meadows (R-N.C.), the prominent co-founder of the influential House Freedom Caucus.

The news was hailed by Azar’s allies: Mulvaney had been one of Azar’s sharpest critics in the White House, with the two men battling for more than a year on numerous policies, while Meadows and Azar have productively worked together in the past.

MEANWHILE: SEEMA VERMA GETS BUSY ON CORONAVIRUS — Since being added to the task force a week ago, the CMS chief has announced new actions on nursing homes and infection control, created relevant billing codes and taken additional steps to explain what providers can do. According to Verma’s supporters, the flurry of actions is why she should’ve been included on the task force when it was first formed more than a month ago.

JEROME ADAMS IN HOT WATER OVER TRUMP CLAIM — The surgeon general was widely panned on social media for telling CNN’s Jake Tapper that the president, about 30 years his senior, is “healthier” than him, with critics saying it’s the latest example of officials being sycophantic. But PULSE watched the entire clip and notes the context: Adams was responding to a question about whether Trump, Sen. Bernie Sanders or former Vice President Joe Biden were at higher risk for coronavirus, and he appeared to be attempting to convey that age wasn’t the only risk factor.

Adams later walked back the statement on Twitter, saying he could have framed the comparison better.

INTEROPERABILITY RULES ARE IMMINENT — The Office of Management and Budget has cleared the pair of rules, intended to ease data-sharing, and PULSE expects the rollout to happen today.

— As proposed, the rules required providers and insurers to make data available by standardized application programming interface, or API; required hospitals to inform primary care physicians about admissions, discharges and transfers; defined information blocking; and allowed doctors and researchers to share EHR screenshots to disseminate information on software with poor design.

— The rules have divided the health IT community, POLITICO’s Darius Tahir writes. Industry giant Epic has invested money and resources into a public campaign against them. Privacy hawks worry that allowing third-party apps to access patient data could allow medical information to seep online and be used for advertising and marketing purposes.

Names in the News

ALLAN COUKELL heads to CivicaRx. Coukell, who’s served as senior director of health programs at Pew Charitable Trusts, will lead the public policy team for the nonprofit generic drug company founded by hospitals in an effort to combat drug shortages and bring down costs.

A message from PhRMA: America’s biopharmaceutical companies are making great progress against a common enemy – COVID-19. They’re learning from successful vaccines for other diseases, developing new treatments and collaborating like never before. Today, there are several promising vaccine candidates in stage three clinical trials. These trials have tens of thousands of participants, from every walk of life. From development to robust clinical trials, and throughout manufacturing, these vaccine candidates follow the same rigorous process of other vaccines that have saved millions of lives. America’s biopharmaceutical companies are working day and night until they defeat COVID-19. Because science is how we get back to normal.

What We're Reading

Hospitals are bracing for millions of Americans to potentially be hospitalized as part of the coronavirus outbreak, Lydia Ramsey reports for Business Insider.

New York’s attorney general ordered televangelist Jim Bakker to stop selling his unproven coronavirus cure, WaPo’s Julie Zausmer writes.

Pilots worldwide are complaining of unsafe cabin fumes — but regulators aren’t convinced of the need for action, POLITICO’s Saim Saeed, Daniel Lippman and Brianna Gurciullo report.

Follow us on Twitter Joanne Kenen @joannekenen



Adriel Bettelheim @abettel



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Dan Diamond @ddiamond



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