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Today in health care, monkeypox was declared a public health emergency in the U.S., while the Senate prepares to move forward on its sweeping health and climate package this weekend

Welcome to Overnight Health Care, where we’re following the latest moves on policy and news affecting your health. For The Hill, we’re Peter Sullivan, Nathaniel Weixel and Joseph Choi. Someone forward you this newsletter? Subscribe here.

White House: Monkeypox a public health emergency 

The Biden administration on Thursday officially declared monkeypox a public health emergency, a move that’s aimed at freeing up emergency funding and improving distribution of vaccines and treatments. 

• “We are prepared to take our response to the next level in addressing this virus, and we urge every American to take monkeypox seriously and to take responsibility to help us tackle this virus,” Health and Human Services Secretary Xavier Becerra said during a briefing. 

The announcement comes amid intense criticism that the Biden administration failed to recognize the severity of the outbreak, leading to shortages of vaccine doses and diagnostic tests even as demand has soared. 

The nation has already purchased most of the global supply of Jynneos, the only monkeypox vaccine licensed in the U.S., but much of it is stored frozen in bulk substance. It needs to undergo a process called “fill and finish” to put the vaccine into usable vials to be shipped and then administered. 

Where it helps: A public health emergency won’t ease the shortages of vaccines, but it could expedite the approval process for new treatments and provide more flexibility for federal agencies to respond to the outbreak. 

• “This public health emergency will allow us to explore additional strategies to get vaccines and treatments work quickly out to the impacted communities. And it will allow us to get more data from jurisdictions so we can effectively track and attack this outbreak,” said Robert Fenton, the administration’s newly-appointed national coordinator for the monkeypox response. 

Read more here. 

‘Paxlovid rebound’ raises questions 

President Biden testing positive for COVID-19 again days after completing a course of Paxlovid has raised the question of whether the length of the antiviral treatment should be reconsidered. 

Just days after he completed a five-day round of Pfizer’s COVID-19 antiviral treatment, Biden’s physician, Kevin O’Connor, said in a letter on Saturday that the president had tested positive once again. As of Wednesday, Biden is still testing positive for COVID-19. 

This phenomenon has come to be known as “Paxlovid rebound,” when a person tests positive for the coronavirus again even after initially testing negative following a round of treatment with the antiviral. 

Reasons to look into this: 

• Some experts have called for studies into extending Paxlovid treatments to be prioritized, as early research has suggested that Paxlovid rebound could occur due to insufficient exposure to the drug. Researchers from the University of California, San Diego School of Medicine said last month that the drug may not be reaching enough infected cells in the allotted time. 
• People who experience cases of antiviral rebound are still at risk of transmitting COVID-19 to other people. Michael Charness, a researcher from the Veterans Administration Medical Center in Boston, recently told CNN that he and his colleagues had observed at least two instances of people infecting others after their symptoms reoccurred. Both cases involved people who tested positive again after taking Paxlovid. 

“I’m actually still flabbergasted that we have not set up a clinical trial to figure this out. It’s an easy thing to do,” Robert Wachter, chair of the Department of Medicine at the University of California, San Francisco, told The Hill. 

“Wouldn’t cost that much to be able to accumulate enough patients in a week or two and follow them for a few weeks so we could have an answer,” Wachter said, adding that the data needed to potentially extend the length of a round of Paxlovid could have been collected already if trials had been started just a few months ago. 

Read more here. 

SENATE SETS UP FIRST VOTE SATURDAY ON SCHUMER-MANCHIN DEAL 

It’s looking like it will be a long weekend in the Senate.  

Senate Majority Leader Charles Schumer (D-N.Y.) announced that the Senate will begin consideration of a $740 billion budget reconciliation package that would lower drug prices and tackle climate change on Saturday afternoon, setting up a weekend of around-the-clock votes. 

“For the information of Senators, the Senate will next convene on Saturday at noon. The next vote will be at 12:30 p.m. on Saturday, on a motion to discharge a nomination. We expect to vote on the motion to proceed to the reconciliation legislation on Saturday afternoon,” Schumer announced on the floor.   

Next steps: If a majority of senators vote to proceed to the legislation, they will then debate for up to 20 hours before holding an open-ended series of votes, known as a vote-a-rama, before a final up-or-down vote, which is now expected Sunday or perhaps early Monday morning. 

The Sinema question: Sen. Kyrsten Sinema (D-Ariz.) is still negotiating to make changes to the legislation, according to people familiar with the discussion, but it appears Schumer is optimistic he can strike a deal with her before the package comes to final vote on the floor.   

Read more here. 

DESANTIS SUSPENDS STATE ATTORNEY 

Florida Gov. Ron DeSantis (R) suspended Hillsborough County State Attorney Andrew Warren on Thursday for “neglect of duty” after the prosecutor refused to enforce bans on abortion and transgender surgery. 

“When you flagrantly violate your oath of office, when you make yourself above the law, you have violated your duty, you have neglected your duty and you are displaying a lack of competence to be able to perform those duties,” DeSantis said at a news conference in the county sheriff’s office. 

“And so today we are suspending State Attorney Andrew Warren effective immediately.” 

Warren, a Democrat, was first elected in 2016, when he defeated the Republican incumbent, and has been an outspoken voice for criminal justice reform. 

DeSantis cited Warren’s signing of a letter saying that he would not enforce “prohibitions on sex change operations for minors” and another saying that he would not enforce “any laws related to protecting the right to life” as evidence that the state attorney had shirked his duty as a public prosecutor. 

“It’s not for him to put himself above that and say that he’s not going to enforce the laws,” DeSantis said, accusing Warren of acting like he had “veto power” over the state legislature. 

Read more here. 

Kansas allows abortion rights advocates to be optimistic

Kansas voters are giving abortion rights advocates and Democrats reason to be hopeful. When Tuesday night’s votes came in, it looked like they confirmed what the groups have been saying all along: Americans broadly support abortion rights. 

Nearly 60 percent of voters in the Sunflower State rejected a state constitutional amendment on Tuesday that would have given the state legislature more power to regulate access to abortion, marking the first time Americans were asked to weigh in on abortion rights after the Supreme Court overturned Roe v. Wade. 

“In the first election since [the ruling] where abortion was front and center, the people of a state that hasn’t voted for a Democrat for President since 1964 emphatically endorsed a right to abortion. This should send shockwaves through politics at every level,” David Cohen, a law professor at Drexel University’s Thomas R. Kline School of Law, said in an email following the Kansas vote. 

Where to watch next: 

• In Kentucky, residents will be asked to weigh in on a state constitutional amendment that says, “Nothing in this Constitution shall be construed to secure or protect a right to abortion or require the funding of abortion.” 
• In Michigan, residents will vote on a ballot measure that would amend the state constitution, protecting the right to make choices on reproductive issues such as contraception and abortion. 
• Over in Montana, there’s also a ballot measure that would require that infants born following an abortion attempt be provided medical care. 

Read more here. 

WHAT WE’RE READING

• Patients seeking novel weight loss drugs find a ‘wild west’ of online prescribers (Stat)  
• How the 2022 midterms strategy could change after the Kansas abortion vote (NPR)  
• The Three COVID Developments I’m Still Holding Out Hope For (The Atlantic)

STATE BY STATE

• West Virginia Medicaid must cover gender-affirming surgeries, judge rules (Axios)  
• Indiana lawmakers vote to keep exceptions from abortion ban (Associated Press) 
• Whitmer to Supreme Court: Monday abortion rights ‘fire drill’ requires immediate action (Detroit News)  

THE HILL OP-ED

We need a national action plan to contain monkeypox now 

That’s it for today, thanks for reading. Check out The Hill’s Health Care page for the latest news and coverage. See you tomorrow.

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