Covid origins in spotlight, as feds cut funding to virus hunters

Today’s edition: A key senator is pushing to expand dental coverage to millions of Americans. Overdose deaths dropped slightly last year, but experts say the toll remains unacceptably high. But first …

The EcoHealth saga continues

What did the deputy director of the National Institutes of Health know, and when did he know it?

Top NIH official Lawrence Tabak is set to face off this morning with the House panel probing the coronavirus response. Expect lawmakers to focus on the agency’s oversight and funding of EcoHealth Alliance, a nonprofit organization that worked with the Wuhan Institute of Virology before the pandemic.

EcoHealth was thrown back into the spotlight Wednesday, after the Department of Health and Human Services said it was suspending funding to the organization and moving to debar the New York-based nonprofit from receiving additional funds, citing evidence EcoHealth had failed to monitor and report on risky virus experiments in China.

EcoHealth has said it is appealing the decision, but the news was hailed on Capitol Hill. Both Republicans and Democrats had called on HHS to review the organization’s funding and its NIH grants; GOP leaders have gone further and called for a criminal probe.

“Our investigation into EcoHealth and Dr. Daszak’s actions is not over,” Rep. Brad Wenstrup (R-Ohio), who chairs the House Select Subcommittee on the Coronavirus Pandemic, plans to say to Tabak today, in remarks shared with The Health 202. “This issue has highlighted broader concerns with the NIH — especially that it is up to the grantee to oversee themselves. That is a recipe for waste, fraud, abuse and deception.”

Years of questions

EcoHealth has been at the center of questions about SARS-CoV-2’s origins since the pandemic’s earliest days, given the organization’s ties to Wuhan, China — the epicenter of the outbreak — and its work to research and experiment with coronaviruses. Then-President Donald Trump publicly said his administration was looking into EcoHealth’s work, and Tabak was among the officials in April 2020 who moved to abruptly halt NIH funding to the organization. (It was later restored.)

The House coronavirus panel also recently grilled Peter Daszak, EcoHealth’s president, on his conflicting statements and outstanding questions, including why his organization waited nearly two years to submit a required report about the results of its research and activities leading up to the pandemic.

EcoHealth has repeatedly denied accusations that it played any role in the pandemic, and its defenders have said it’s been wrongly scapegoated. There’s no existing evidence EcoHealth, the Wuhan Institute of Virology or another organization had SARS-CoV-2 in its possession before the pandemic.

Federal and congressional officials also cautioned that the HHS decision to cut funding to EcoHealth shouldn’t be interpreted as a smoking gun about the virus’s origins or a possible lab leak. Officials on Wednesday told me the theory that the pandemic began naturally — when a virus spread from animals to humans — continues to be favored by several government agencies and many scientists.

But at minimum, federal officials had grown increasingly uneasy about EcoHealth’s work and safeguards, they said. “HHS wanted to be out of the EcoHealth business,” one official told me.

What Tabak will be pushed on today

Republicans’ line of attack was previewed in a letter to NIH last week, in which Wenstrup laid out Daszak’s claims and compared them with other officials’ statements under oath.

“The Select Subcommittee is eager to uncover the true sequence of events and has identified multiple occasions where Dr. Daszak directly contradicts NIH’s or NIAID’s assertions,” Wenstrup wrote. Republicans have hinted that they could refer Daszak to the Justice Department on perjury grounds.

Expect GOP lawmakers to probe Tabak’s conversations with Anthony S. Fauci, his longtime colleague at NIH and the center of persistent Republican attacks over his pandemic recommendations, his agency’s funding of EcoHealth and other issues. Fauci, who retired from government at the end of 2022, is set to testify in front of the panel in June.

Democrats, meanwhile, have tried to draw a line between what they characterized as bad actions by EcoHealth and Daszak, and the more sweeping charge that the organization helped spark the pandemic.

“While the Select Subcommittee’s probe has uncovered efforts by Dr. Peter Daszak to mislead his funders at the National Institutes of Health and the National Institute of Allergy and Infectious Diseases, it has not substantiated any allegations that federal grant funding for EcoHealth Alliance created the COVID-19 pandemic,” Rep. Raul Ruiz (D-Calif.), the top Democrat on the House coronavirus panel, plans to say in remarks today previewed with The Health 202.

Data point

Overdose deaths dropped slightly in 2023, but remain staggeringly high

Overdose deaths have surpassed 100,000 for the third consecutive year, a reminder that the nation remains mired in an intractable epidemic fueled by the potent street drug fentanyl, our colleague David Ovalle reports. 

By the numbers: An estimated 107,543 people died in 2023, a slight decrease from the previous year, according to provisional data from the CDC. Of these deaths, an estimated 74,702 were attributed to synthetic opioids such as fentanyl.

• The agency described it as the first annual decrease in deaths since 2018, although experts cautioned that the numbers could rise in ensuing years and that the toll remains unacceptably high.

The politics: The CDC yesterday pointed to the decrease as a sign that federal efforts to help prevent deaths and treat addiction in states are paying off. It could boost Biden as he seeks reelection and Republicans rip him over border security and the flow of fentanyl synthesized by Mexican criminal groups.

On the Hill

Sanders mounts another push for expanded dental coverage

On tap today: The Senate Health, Education, Labor and Pensions Committee will hold a hearing on dental care accessibility and affordability, a topic long championed by Chair Bernie Sanders (I-Vt.). 

Sanders is also set to introduce a comprehensive bill aimed at extending dental insurance to all Medicare, Medicaid and Veterans Affairs beneficiaries. The legislation, outlined in a one-pager shared with The Health 202, also seeks to establish new access points for dental services, enhance the oral health workforce, improve education and authorize additional federal funding for oral health research. 

We’re expecting the independent firebrand to draw from his constituents’ experiences in navigating dental care challenges during the hearing, following a request this month that garnered over 1,000 responses, as noted by a source familiar with the senator's plans.

Why it matters: An estimated 68.5 million U.S. adults lacked dental insurance in 2023, according to the nonprofit CareQuest Institute for Oral Health. That’s more than 2.5 times the roughly 26 million Americans of all ages who lack health insurance.

The Centers for Disease Control and Prevention estimates that untreated dental disease costs the United States more than $45 billion in lost productivity annually, and it’s linked to a long list of serious health problems, including diabetes and heart disease.

Sen. Bernie Sanders (I-Vt.):

In other news from the upper chamber …

New this a.m.: Sens. Edward J. Markey (D-Mass.) and Sanders are urging HHS to be prepared to offer support and regulatory flexibility to prevent any loss of care after Steward Health Care’s bankruptcy filing, according to a letter sent to Secretary Xavier Becerra that was shared with The Health 202.  

The Senate rejected a GOP-led attempt to claw back billions of dollars in unspent coronavirus relief funds in a party-line vote yesterday. President Biden had already pledged to veto the bill, safeguarding Treasury Department guidance that gave states and municipalities more time to spend the money. 

And across the Capitol …

On our radar: The House Energy and Commerce Committee unveiled legislation to extend pandemic-era Medicare telehealth flexibilities for the next two years, which is up for a consideration today during a health subcommittee mark up. Among the other 22 bills on the agenda are proposals that seek to remove barriers for living organ donors, preserve access to treatments for rare disease patients and tackle fraud in Medicare and Medicaid. 

The House passed a bipartisan bill that would direct the Federal Aviation Administration to update aircraft emergency medical kits to include overdose reversal medication. It now heads to Biden’s desk. 

The House Committee on Oversight and Accountability voted to advance a bipartisan bill that would prohibit U.S. businesses that receive federal funding from purchasing equipment or contracting services from a list of designated foreign “companies of concern,” currently all of which are Chinese-owned biotechnology firms. 

Rep. Brad Wenstrup (R-Ohio):

In other health news

• More self-collection test kit news. Yesterday, we told you about the Food and Drug Administration moving to expand screening for potentially lethal cervical cancer by allowing women to collect test samples themselves. In addition to the test by Becton, Dickinson and Company, the FDA also signed off on self-collection for an HPV test manufactured by Roche, our colleague Rachel Roubein writes. 
• The Centers for Medicare and Medicaid Services has abandoned its proposal to revise how drugmakers calculate the “best price” they must offer Medicaid, saying it will gather additional information before proceeding with any changes. 
• A first-of-its-kind service program will train hundreds of young adults to help their peers access mental health care and other support. The Youth Mental Health Corps is set to launch in Colorado, Michigan, Minnesota and Texas this fall, Maya Goldman reports for Axios. 

Health reads

Months after Maui fires, residents report troubling health problems (By Brianna Sacks | The Washington Post)

Most states receive D’s, F’s in maternal mental health report card (By Alejandra O’connell-Domenech | The Hill)

North Carolina lawmakers push bill to ban most public mask wearing, citing crime (By Makiya Seminera | The Associated Press)

Sugar rush

Thanks for reading! See you tomorrow.