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News brief: omicron variant, spending bill stalls, abortion pill decision

STEVE INSKEEP, HOST:

How much could the omicron variant disrupt American life this winter?

A MARTINEZ, HOST:

Well, that depends on many factors, from the virus itself to the way people respond, but some scientific projections do not look good. A consortium of experts made computer models of what the near future could be, and NPR got a first look.

INSKEEP: Yeah. NPR health correspondent Rob Stein got it in particular. Rob, good morning.

ROB STEIN, BYLINE: Good morning, Steve.

INSKEEP: I want to remind people three months ago, you shared with us scientific scenarios that showed possible steady improvement through the winter. There was lots of reason for optimism three months ago. It seems pretty clear we're on a different trajectory now.

STEIN: Yeah, absolutely. That was before the omicron variant emerged. And, you know, there's still lots of mysteries about omicron. But several teams of scientists are using computer models to project possible scenarios for the CDC, and the first one to be made public comes from the UT COVID-19 Modeling Consortium. Lauren Ancel Meyers at the University of Texas at Austin runs the consortium.

LAUREN ANCEL MEYERS: We are modeling the emergence of the omicron variant in the United States under 16 different scenarios that cover a range of how quickly it spreads, how easily it evades immunity and how quickly we're able to roll out booster shots.

STEIN: Right. But she says that there are a range of possibilities ranging from the omicron variant sparking just, you know, kind of just intensifying the current delta wave to maybe causing something that is very much a significant turn for the worse.

INSKEEP: How much worse could it get?

STEIN: Yeah. So it could get pretty bad. You know, according to the most pessimistic scenario, things could get worse than last winter's horrific surge. We're talking about a wave that would peak around the end of January, with more than half a million people catching the virus every day. That's more than double last winter's peak and nearly 30,000 people being hospitalized with COVID-19 and well over 3,000 people dying every day in the following weeks. Here's Meyers again.

MEYERS: The most pessimistic scenarios are scary, and we need to sort of equip ourselves to make changes. Change policies encourage more cautionary behavior if and when we start to see hospitalizations ticking up in this country.

STEIN: But Meyers stresses that the most dire scenarios assume the very worst, you know, that we do nothing, even as the numbers soar, that the omicron variant is amazingly good at evading our immune systems and that omicron makes people sicker than delta. And so far, evidence suggests omicron may cause milder illness. But, you know, that remains the biggest and probably most consequential open question.

INSKEEP: OK. So there is some evidence to suggest we might not be headed for the worst scenario. So what's a more optimistic scenario?

STEIN: Yeah, that's far less frightening. Under the most optimistic scenario, the omicron wave peaks around the middle of January and never gets nearly that bad. Cases would be about double what they are now, leading to a few thousand more hospitalizations and a few hundred more deaths every day than now. Here's Meyers yet again.

MEYERS: It's just sort of a little bump. It's not a catastrophic surge that overwhelms our hospitals and leads to record numbers of deaths.

STEIN: But that scenario assumes things like omicron isn't quite as good at sneaking around our immune systems, it doesn't make people any sicker than delta, more people get boosted. But the bottom line is the U.S. has to take omicron very seriously. Even the most optimistic scenario still isn't pretty. You know, hospitals are already struggling to keep up in many parts of the country, and millions of people are still totally vulnerable because they haven't gotten vaccinated yet.

INSKEEP: Well, for those who choose to get vaccinated, let's talk about how people can stay safest. For those who are getting vaccinated, what is the CDC now saying about the options among vaccines?

STEIN: Yeah. So the CDC last night recommended that COVID vaccines other than the Johnson & Johnson vaccine should be preferred. That's because of increasing evidence that the J&J shots can trigger a rare blood clot, now causing dozens of cases and at least nine deaths in the U.S. last year.

INSKEEP: NPR's Rob Stein, thanks.

STEIN: You bet, Steve.

(SOUNDBITE OF MUSIC)

INSKEEP: President Biden will not be signing his domestic agenda into law this Christmas.

MARTINEZ: No. Democrats had been hoping to pass a budget plan before they took off for the holidays - that will not happen - while 50 Democrats are needed to get the bill through the Senate and one is still negotiating. West Virginia Senator Joe Manchin has been pushing to keep the costs down.

INSKEEP: Let's bring in NPR's Deirdre Walsh, who covers Congress. Good morning.

DEIRDRE WALSH, BYLINE: Good morning, Steve.

INSKEEP: OK. So, wow, we're talking about Joe Manchin resisting this bill. It's almost like - I don't know - we've done this story a hundred times before. But how bad is this latest setback for Democrats?

WALSH: I mean, the bill is not dead, but it's definitely a big setback for Democrats and the president. Senate Majority Leader Chuck Schumer has been talking for weeks about - saying that there would be a vote by Christmas, but he needs all 50 Democrats to pass this, and he's just not there yet. In a statement last night, President Biden said he talked to both Schumer and House Speaker Nancy Pelosi about his talks with Manchin, and he said, quote, "we will advance this work together over the days and weeks ahead. Leader Schumer and I are determined to see this bill successfully on the floor as early as possible." But the word weeks in that statement shows you that these issues between Biden and Manchin are still pretty significant, and it's going to take some time.

INSKEEP: I feel that, in a way, the more progressive Democrats and Manchin have had the same conversation over and over again. Manchin says, you're trying to squeeze too much into this bill, make some choices, and more progressive lawmakers say, how about if we squeeze too much into this bill or squeeze everything into this bill? It's not too much from their perspective. But they just seem to be repeating the same points about the cost and scope of the bill.

WALSH: They have, and they've just been sort of at crossways for months. I mean, Manchin has also cited inflation concerns as a big factor in terms of sort of putting the brakes on this effort. You know, the president had said the package will help bring down costs. On policy, Manchin's mainly focused on the child tax credit. He says he's concerned about how much that would cost and what it would mean if it gets extended for more than the one year that's in this current bill. He also has been saying for some time he has worries about energy and climate change provisions. So these are big items that are going to have to be reworked.

INSKEEP: Regardless of what Senator Manchin wants, it appears that Democrats are not going to be getting immigration into this bill.

WALSH: That's right. It's been a rough week for Senate Democrats. The Senate parliamentarian ruled yesterday that they can't include a provision in this package that would give work permits to undocumented immigrants who've been in the United States since 2011. That would have meant they would not be deported. Top Senate Democrats released a statement last night saying they disagreed with the decision, and they're still going to try other ways to get a path to citizenship. But this is the third time they've been rejected from trying to get broad immigration policies in this package.

INSKEEP: I feel obliged to bring up something else here. Democrats are now turning back to the question of voting rights. And unlike the budget bill, voting rights is the kind of legislation where they need to get past a filibuster, meaning they need 10 Republicans to do anything. So what's happening there?

WALSH: They're definitely trying again. They're sort of pivoting to this topic as they, you know, had some shaky progress on the spending bill. Advocates met with President Biden and Vice President Harris yesterday, and they say they want to move something soon. They say that there's a real urgency about acting as states are making changes to voting laws across the country. But as you said, Republicans have blocked it, so they're talking about potentially a carve out to get around that Senate filibuster.

INSKEEP: NPR's Deirdre Walsh, thanks so much.

WALSH: Thank you.

(SOUNDBITE OF MUSIC)

INSKEEP: Access to abortion pills will get a little easier.

MARTINEZ: Food and Drug Administration says it's permanently doing away with a rule that reproductive rights advocates have described as burdensome and medically unnecessary. The move comes as the Supreme Court weighs whether to overturn Roe v. Wade in the coming months.

INSKEEP: NPR's Sarah McCammon joins us now. Sarah, good morning.

SARAH MCCAMMON, BYLINE: Good morning.

INSKEEP: Can't people already get abortion pills in the mail?

MCCAMMON: They can. But the FDA is making what was just a temporary pandemic policy permanent. So this policy was put in place in response to the pandemic. And I need to explain that this abortion drug, mifepristone, which is used in combination with another drug to induce abortions up to about 10 weeks, in the past, it's required patients to go to a hospital or clinic to pick up the pills. But that was suspended during the pandemic. There was some legal back and forth for a while last year. The Trump administration was forced through some litigation to suspend that rule, fought that to the Supreme Court, which allowed the rule to be reinstated. Then the Biden administration came in and again suspended the rule. But now, Steve, the FDA is saying that will be permanent. Patients won't have to go to a clinic to get this drug.

INSKEEP: They would do some kind of telemedicine with the doctor. Is that what the option is?

MCCAMMON: Right. For states where that is legal, it opens up the opportunity for doctors to speak to patients remotely and assess their readiness for this kind of treatment. About 40% of people who are seeking abortions in the U.S. choose medication abortion as opposed to a surgical procedure at a clinic. So this is an increasingly popular option. I talked yesterday with Dr. Julie Amaon. She's medical director for a group called Just the Pill that provides medication abortion and uses telemedicine. She said she'd hope the FDA would go even further in relaxing these rules because there are layers of rules for mifepristone, the abortion drug. But she said she's still pleased with this decision.

JULIE AMAON: I mean, I think the FDA should look at repealing all of the medically unnecessary restrictions that their REMS puts up for mifepristone. But this is a wonderful start. The fact that beyond the pandemic, patients can still get these safe medications delivered where it's convenient to them, that's huge.

INSKEEP: This feels like something that could potentially transform the abortion debate across the country, Sarah, because we are looking at the prospect, at least, of a state-by-state battle over abortion rights focused on abortion clinics. And this turns abortion into something that can happen anywhere.

MCCAMMON: Right. Abortion rights advocates hope that this will make abortion more accessible, particularly in states with more liberal abortion laws because those states, even now, Steve, are absorbing states from - patients from states with more restrictive laws. Now, groups opposed to abortion rights are also concerned about this, and they are working at the state level to tighten up laws around medication abortion in addition to surgical abortion, of course. Catherine Glenn Foster is with Americans United for Life, a group that's promoting model legislation focused on limiting how the medication is prescribed.

CATHERINE GLENN FOSTER: Roe v. Wade looks set to be reversed in June. That's my hope. But the fight is going to continue until either our constitution is rightly understood to protect all human life from abortion as a simple matter of justice, or until every state does so in its state law.

MCCAMMON: The state of Texas just approved a law that restricts medication abortion, and activists are asking more states to do so in the coming months.

INSKEEP: NPR's Sarah McCammon, thanks for your insights, really appreciate it.

MCCAMMON: Thank you. Transcript provided by NPR, Copyright NPR.

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