Politics. The politicization of a coronavirus pandemic continues to be a vexing problem for the Biden administration. The latest skirmish is over vaccine hesitancy in certain parts of the U.S. and who bears the blame. The White House has fixed it on social media platforms like Facebook. General readership publications have identified political affiliation as a driver with Republicans rejecting vaccination more than Democrats.
The map produced by the Centers for Disease Control and Prevention seems to be saying something different.
Assuming social media platforms have been, as one would expect, trafficking in the most outrageous material and assuming their active users are uniformly dispersed across the U.S., it seems that vaccine hesitancy would be more evenly distributed across the U.S. Instead, there are significant pockets of hesitancy and acceptance.
The people of Nebraska are probably as prone to use social media as those of Wyoming but their desired to take the COVID-19 vaccine is significantly higher. Similarly, notwithstanding Sen. Joe Manchin, West Virginia is decidedly Republican but has a remarkable record of vaccination, especially given the logistical demands imposed by its rural character.
Certainly, there is a lot of bad information floating around and political viewpoints are having an effect, but the reality may be a combination of factors; accessibility, political leadership, education and above all, experience with the virus are determinant. The vaccination rates in urban areas that were significantly affected are quite high, as you would expect. In more rural and suburban areas where hospitalization and deaths occurring at lower levels and often fewer public health restrictions imposed, the rates are lower.
Fair or not, how one feels personally about the threat of COVID-19 to themselves or their family depends in part on how it affected their life in 2020. Taking that a step forward, the urgency necessary to take the time to get vaccinated may not be there for everyone.
That presents a political problem. International perception that the virus is not under control in the U.S. could mean travel restrictions endure. Domestically, Biden’s desire at some point to declare absolute victory against the virus will be stymied by periodic flare ups. The crisis will continue to be exploited by whoever finds it useful at the local, state or federal level.
We expect the White House to eventually recognize that the COVID-19 vaccination rates in certain densely populated areas are at or approaching levels common in long tenured childhood program. For those most at risk the rates exceed any other commonly administered vaccine. The vaccinations and their administration are a stellar achievement for the public health system.
Biden’s job now is to get it off the front page while quietly working to finish the job.
Policy. It was always going to be a token gesture, a way to demonstrate to the world that the Biden administration was an emphatic departure from the Trump-era’s signature isolationism and protectionism. As expected, the negotiations over suspending intellectual property protections for COVID-19 vaccines and therapeutics have stalled. One world-ism has its limits.
As of last week, the state of play appears to be this: India and South Africa, both of which introduced the resolution at the WTO have spent most of the last months reiterating their position that the TRIPS waiver include anything “in relation to prevention, containment or treatment of COVID-19.” Given the number of systems of the human body often affected by COVID, their demands cover a lot of pharmaceutical and device products.
The European Union, Switzerland and the United Kingdom all oppose the resolution as written and have made attempts to encourage sponsors to narrow the scope to vaccines alone. There has also been a push to require mandatory licensing. The U.S. continues to make supportive comments knowing full well the effort is going nowhere.
Had this WTO resolution been introduced in another era, in the aftermath of World War II for example, it might have reached fruition of some sort. As it stands, theft of intellectual property has become the default industrial strategy of some nations. Much of the resistance has emerged, in part, due to a suspicion on the part some negotiators that a TRIPS waiver is just the opportunity a few members need to become contenders in the pharmaceutical industry.
Given the WTO’s spotty record on enforcing IP protections, the outcome – US/EU/UK shipments of vaccines and/or localized manufacturing in the developed world– seems easy to predict. (MRNA, PFE, JNJ)
Power. Add political risk for U.S. companies operating abroad to the things we have not seen in a while such as inflation, PLBY, labor shortages. In the postwar power scuffles that ultimately divided the world into spheres of influence, arrests, harassment and property seizures where risks for U.S. companies operating abroad. The oil industry, for obvious reasons, was a frequent target.
On Friday the U.S. Departments of State, Treasury, Commerce and Homeland Security issued a joint business advisory warning U.S. companies about the “be aware of potential reputational, regulatory, financial, and, in certain instances, legal risks associated with their Hong Kong operations” due to the advancing influence of Beijing. It is not the outcome anyone would have expected when China was admitted to the WTO 20 years ago.
The advisory cites four areas of concern: risk for businesses following the imposition of the National Security Law; data privacy risks; risks regarding transparency and access to critical business information; and risks for businesses with exposure to sanctioned Hong Kong or PRC entities or individuals.
Risks related to data, as the new oil, are particularly relevant to health care. The U.S. Military, State and parts of the intelligence community have warned its employees and their families away from genetic testing. The concern has been that genetic information made freely available could compromise the identities of sensitive employees. Other concerns being raised include compromise of electronic health records that could affect program integrity efforts against fraudulent billing.
For the past several years, all these quietly considered concerns have been brushed away as typical of the alarmist nature of the intelligence community. State, Commerce, Treasury and Homeland Security’s advisory makes these risks difficult to ignore. Watch for more Q and K disclosure. (ILMN, ME, CLOV)
Have a great rest of your weekend.
Emily Evans
Managing Director – Health Policy
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