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Brian Lehrer: Brian Lehrer on WNYC and as the BA.2 Omicron subvariant spreads, did you see they had a million cases in a day in the UK over the weekend. COVID spending in this country is at a standstill. We were just talking about it with Congressman Pallone, Republicans in the Senate in particular have been reluctant to approve $15 billion in COVID pandemic aid and the Biden administration has warned that the consequences of holding back that money could be dire.

For the next few minutes, we'll talk about what's at stake for health without this funding, the politics of the stand still and the threat of BA.2. With me now is Alice Miranda Ollstein, healthcare reporter for Politico. Hi, Alice, thanks for coming on WNYC today.

Alice Miranda Ollstein: Good morning. Glad to be here.

Brian Lehrer: First, what do we know about COVID BA.2? Are you following this, I know you're more following the politics of healthcare, but do you have any background to give us on what makes it more contagious? The thing about the original omicron was that it was more contagious than the earlier variants of COVID. Now, this is a more contagious variant of omicron so, what are we facing in the US as far as you're here?

Alice Miranda Ollstein: I think we're seeing exactly what we've seen throughout the entire pandemic, which is that as long as there is somewhere in the world, a significant number of unvaccinated people, the virus will continue to circulate and continue to evolve. Those evolutions are not good for humans [chuckles] and so we have to keep evolving with the virus and increase our protections.

This is coming at a time when, basically all across the US we've been dropping precautions, dropping mask mandates, going back to work, gathering indoors more, and that increases the risk as well. For now, officials are saying that it does not appear that the new variants evades vaccines any better than the previous omicron variant so that is good news, of course. Again, this is just going to keep happening until we achieve a level of global immunity. It's not just about the United States, although there is a significant number of unvaccinated people here as well.

Brian Lehrer: Tell me if I have this right, starting today, hospitals and doctor's offices will not be reimbursed for testing or treating patients who don't have insurance, nor will they starting early April, be reimbursed for the vaccines they provide. This funding stalemate in Congress is having practical effects starting today?

Alice Miranda Ollstein: That's right. Those aren't the only things that are happening now. The Biden administration is saying that they need to be able to plan ahead and make orders and purchases of things like COVID antiviral pills, potential additional boosters, a fourth shot. Although it's not yet clear how much of the public is going to be recommended to have that but you need to order these things in advance and you need to stockpile these things in advance, because if you only start doing that when another wave is underway, as we've seen over and over, it is too late.

Not only as you mentioned, have these funds for the uninsured run out, the government is also delaying and making those important purchases for the future because of the funding stalemate.

Brian Lehrer: The Biden administration went on the record earlier this month with a number, $22 billion needed to continue to fight the pandemic but you write in your Politico article that top appropriators in Washington say the white house didn't do enough to win over Republicans in Congress and actually secure those fines. Does the reporting support that assertion?

Alice Miranda Ollstein: There is just, as we see in Washington all the time, it's devolved into a lot of blame and finger-pointing, meanwhile, nothing is getting done and so the COVID funding was going to be approved as part of the overall 2022 omnibus spending bill recently. Democrats objected to it being included in the house because it would have been paid for by cutting aid to States. Now, the scramble is underway to find an alternate source of funding. Meanwhile, the White House, and some members of Congress say, "This is an emergency, we shouldn't have to offset or cut other funding in order to pay for this. We don't do that for many other things, including military funding, why do we need to do it here?" Republicans are insisting that it all be paid for through other sources as opposed to new dollars going out.

Brian Lehrer: What would happen today to a person who gets diagnosed with COVID and is in one of the risk groups where they say they should get the COVID pill, for example, but they can't afford it. Yesterday that person's treatment would have been covered, today, if I'm understanding you correctly, it would not be covered. What's that person to do?

Alice Miranda Ollstein: It depends. What's run out is the reimbursement for the medical providers and so some medical providers could eat the cost themselves and continue to provide that care. There could be at state or municipal funds that they tap, there could be private foundations that are supporting this but of course, so much access to healthcare in the US it's going to depend on where people live. The most marginalized people who have had the worst access to care throughout the entire pandemic are again getting slammed here.

Brian Lehrer: I don't have your article in front of me, but do I remember correctly that you wrote something to the effect of, "Republicans in Congress voted to declare the pandemic over."?

Alice Miranda Ollstein: [chuckles] Yes, multiple times. These were Senate resolutions that aren't becoming law because they have no chance of passing the house in the White House would veto even if it did, but it does send a strong message that makes it clear why they don't want to spend tens of billions more dollars on an emergency they don't believe we should continue treating as an emergency, so it's tough.

It's a tough message for Democrats as well because the Biden administration has both tried to tout all of the progress that has been made on the pandemic. How much lower cases are, how the economy is recovering, but at the same time, say, "Hey, but we still need tens of billions more dollars to continue this fight, otherwise we're leaving ourselves vulnerable to future surges."

Of course, it's true, it's a message that makes sense but it's also a tough message when you're trying to project confidence and recovery and things are better.

Brian Lehrer: You reported that one of the Republican's objections, at least what they're saying their objection is, is that there's been so much money and there has been so much money allocated to COVID relief of various kinds and that it hasn't all been spent or hasn't all been accounted for and they want that accounting before they appropriate more money. Can you put some details on that?

Alice Miranda Ollstein: The White House has been for months, providing Capitol Hill with details about how the money has been spent. You're right, it's been trillions of dollars over the past few years and not all of it has gone strictly to COVID care, COVID testing, COVID vaccinations, it's also been a lot of economic aid propping up, state and local governments propping up hospitals that have been losing funding because people aren't going in for their regular surgeries, et cetera.

They have been providing information to Congress and to the press about how that money has been spent, or it has been allocated. It has been bookmarked for certain purposes. There are now some tough choices ahead. Like I said, Democrats refuse to approve the new COVID funding if it was going to be cut out of funding for their states.

What was interesting was, Biden administration officials were on Capitol Hill last week to brief senators about this conundrum. Some democratic senators emerging from that briefing told me, "Look, if Republicans are going to insist on offsets and cuts, they may not like what is proposed next." I'm curious if that is a reference to perhaps disaster aid for certain states that have experienced natural disasters, if that's funding for veterans, it's really no good choices here.

Brian Lehrer: A cynic or a political analyst might say maybe the same thing, that Republican might be undermining the Biden administration's pandemic response because it's a midterm election year to gain leverage that can fuel a red wave in November. I know you're not a congressional reporter, you're a healthcare reporter but have there been signs in the Republican's pandemic approach lately as to what their COVID message might be for the November elections?

Alice Miranda Ollstein: Of course, they have consistently been opposed to the kind of pandemic precautions we've seen imposed and lifted and imposed and lifted and are now mostly lifted, the vaccine mandates, the mask mandates, the restrictions on businesses. They have consistently fought Democrats on those issues and have made political hay about them, of course. I fully expect that will continue and some of these messaging votes, like I mentioned, about wanting to declare the pandemic emergency over tie right into that.

I think that there is an awareness, that there is a lot of pandemic fatigue among the public, and not a lot of appetite to continue in an emergency posture. It's evidence that Republicans see that to their advantage.

Brian Lehrer: We'll see if that gets them in trouble, though, with respect to this or if they can hang it on lack of accounting for the funding that's previously been allocated. I don't think there are many Republicans who are against voluntary vaccination and I don't think there are many Republicans who are against testing and I don't think there are many Republicans who are against treatment for people seeking treatment. That's different than the mandates and the lockdowns all of which seem to be going by the boards more or less. Politically, we'll see what happens with this in November, if it really doesn't get funded anymore.

Let's take a phone call. We mentioned the spike in the UK with the Omicron BA.2 and they're usually few weeks ahead of us. Maybe it's a preview of what's to come here. It's already begun to increase here. Tom in New Canaan, you're on WNYC. Hi, there. You wanted to ask a question about the UK, right?

Tom: Yes, Brian. Thank you for your program. From what I understand, the reinfection rates are very worrying and troubling. In Great Britain, their data is really top-notch. I also have concerns about the CDC. There was a New York Times article a few weeks ago about how the CDC was sitting on data. They were concerned it might be misinterpreted. I just have real questions about whether the data is really getting properly analyzed and whether they may be sitting on data that should be released.

Brian Lehrer: Do we know anything about that, CDC compared to how they release data in the UK? Is there something to report on, Alice?

Alice Miranda Ollstein: Not specifically, but the attention on how the CDC collects and also disseminates data is top of mind here. Funding will also impact or funding running out will also impact the ability to do the basic disease surveillance that identifies outbreaks and can surge resources to clamp down on them. Things like additional testing, contact tracing. There's a lot of concern that I'm hearing that the lack of funding will hamper that kind of basic data collection and analysis as well.

Brian Lehrer: Last thing before you go, forth shots, Pfizer and Moderna are both seeking approval for a fourth COVID vaccine dose. The Washington Post and others reported over the weekend that the FDA will likely authorize a second booster for anyone 50 years old and older as soon as tomorrow. Can you confirm that at Politico? Even if not, assuming those reports are correct, why 50? Why not 65 which we've heard earlier?

Alice Miranda Ollstein: There is a lot of debate currently about continuing to authorize additional boosters and whether it should be just for the elderly, just for the immunocompromised or for the entire population. There's also a lot of disagreement about whether it makes sense to continue boosting relatively protected people within the US when so many millions of people around the world have not even had their first dose.

This isn't just a question of altruism or ethics. It's a question of epidemiology because no matter how much we boost ourselves here in the US if there are, as I said, continue to be pockets of people around the world who aren't vaccinated the virus will continue to circulate and continue to evolve. There are a lot of people saying we can't boost ourselves out of this problem. We have to get first shots to more of the globe.

That said, of course, we don't want to have more people dying here in the US. We are already on the cusp of having a million deaths, and so there is a strong desire to protect the vulnerable. I fully expect fourth boosters as has already happened in some other countries. We expect to be available.

Brian Lehrer: Which brings us back to the funding question that we started with. Is it a zero-sum game if the FDA authorizes fourth doses or second boosters for large swaths of the US population? Does that mean there's less money to vaccinate people in more unvaccinated countries?

Alice Miranda Ollstein: It depends on how much Congress is willing to spend. I think the current impasse we are seeing over an amount of funding that everyone including the Biden administration and Democratic leaders agree is not enough. The $22.5 billion they're asking for is only going to fund all of these programs for a little bit longer and then they're going to have to come back and ask for more.

That said, the country has shown itself more than able to spend big, spend generously when it wants to. We've seen that, of course, on the defense front and many other fronts, and so if the country wanted to, it could come up with the funding both to vaccinate the world and to protect people here at home. It's about political will.

Brian Lehrer: Last question, because COVID spending has dried up and we'll see if Congress reauthorizes another dose of that or not. Can the US even get enough vaccine doses to roll out a second booster or a fourth dose if it chooses to?

Alice Miranda Ollstein: Again, it's more about whether it's recommended just for immunocompromised people, just for people over a certain age, or for the entire population. The government has said without more funding it would not be able to provide them for free for the entire population. Again, like so much healthcare in the US, it will come down to what people can afford and what insurance programs are willing to cover as well.

Brian Lehrer: We thank Alice Miranda Ollstein, healthcare reporter for Politico, for bringing us up-to-date on Omicron BA.2, fourth doses, second boosters, and the stalemate in Congress over COVID funding. Alice, thanks so much.

Alice Miranda Ollstein: Great to be here.

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