| Good Wednesday morning, where today we want to know, how busted is your bracket? Send us the details with tips at rachel.roubein@washpost.com. 🚨 Today's edition: Moderna says its coronavirus vaccine for young children is safe, though effectiveness is a complicated picture. There's a bipartisan effort to get an insulin bill to the Senate floor. But first … | Rahul Gupta promises a drug control strategy "soon" |  Rahul Gupta, director of the Office of National Drug Control Policy, says his office will release a drug control strategy soon. (Photo by Philip Scott Andrews for The Washington Post) | | | President Biden's drug czar says an inaugural drug control strategy – a road map of how the White House plans to tackle the nation's growing addiction crisis – is in "the advanced stages of being finalized." | - "We are working diligently to make sure that we get it out as quickly as possible because of the urgency that we have placed and the president has placed on this issue," Rahul Gupta, the director of the Office of National Drug Control Policy (ONDCP), said in an interview last week.
| | One of the primary functions of ONDCP is to develop and oversee the implementation of the National Drug Control Strategy, which every administration is required to submit to Congress after its first full year in office. The Biden administration informed Capitol Hill that it would miss the Feb. 7 deadline to deliver the document, prompting a bipartisan pair of lawmakers to implore federal officials to quickly finish their work. In the interview, Gupta said the strategy would be released soon, though declined to specify a firm date. An ONDCP spokesperson said the administration continues to implement the drug policy priorities it identified last year in the meantime. | - The Biden administration isn't the first to miss the deadline. Former president Donald Trump didn't release such a document until 2019, and he reportedly ran the drug office with "skepticism, ambivalence and a lack of focus," our colleagues Kim Bellware and Robert O'Harrow Jr. wrote in October 2020.
| | The upcoming release comes as the U.S. drug epidemic hit a new, grim record last year. Drug-related deaths topped 100,000 within a 12-month period — a ballooning crisis that's caught the attention of both Congress and the White House. Biden mentioned "beat[ing] the opioid epidemic" as a top priority in his State of the Union address. | | | | | | | 1,000 Americans slip from mild to moderate Alzheimer's disease every day. There's no time to waste. Medicare must cover FDA-approved treatments now. | | | |  | | | | | Yet the effort comes after a conservative uproar over "crack pipes," which some anti-addiction advocates fear could further inflame tensions over policies they contend are increasingly mainstream and key to saving lives. The upcoming strategy As required by Congress, the administration released its first-year drug policy priorities by April 1. The 11-page document was the first to use the term "harm reduction" — which refers to policies aimed at curbing deaths and infectious diseases, rather than just achieving abstinence. | - On harm reduction, the administration zeroed in on three main policies. They included increasing availability of the opioid overdose reversal drug, naloxone; promoting syringe service programs; and boosting test strips to detect the powerful synthetic fentanyl.
- Other planks of the first-year priorities include reducing the supply of illicit drugs and expanding medication for opioid addiction.
| | Next up is the broader drug control strategy: The document essentially takes the initial policy priorities issued last year and builds them out, said Regina LaBelle, who served as Biden's acting ONDCP director until the fall. Expect the slate of harm reduction measures to likely be featured. "This is the first time you're going to be seeing a lot of comprehensive, evidence-based solutions that are going to herald an era of United States drug control policy that's going to look at addressing the issues that plague us today," Gupta said. But some Republicans have long been wary of certain harm reduction measures. Over the summer, several syringe exchange programs closed in Republican-led areas, which could indicate a new backlash to the programs, Politico's Dan Goldberg reported. | | Crafting the strategy is "a little bit like herding cats," said Michael Botticelli, who ran the White House drug policy office under former president Barack Obama. He said it takes time to develop, particularly at the outset of a new administration, requiring ONDCP to consult with multiple agencies and receive interagency sign-off. Then the drug policy office is essentially in charge of oversight. For instance, to ensure federal agencies were meeting their goals, they were required to send in quarterly reports to ONDCP when Botticelli served as the office's director. | - "It's [a] really important role for ONDCP to ensure not only that they're publishing the strategy, but that they're implementing a pretty rigorous process to ensure implementation, and there's measurement and evaluation behind that to monitor it," Botticelli said.
| | |  | Coronavirus | | Moderna says its covid-19 vaccine is safe for young children, babies | | Yet the effectiveness of the shot is a mixed picture due to the challenges presented by the highly transmissible omicron variant, our colleague Carolyn Y. Johnson reports this morning.The shot met the main criteria that the company and regulators had defined for success, which is generating immune defenses equivalent to those that protected young adults before omicron emerged, per a news release from Moderna. | - "But in the face of omicron, the immune defenses mustered by two doses in adults were less robust, particularly in preventing infections — and the same pattern was seen in children, with vaccine efficacy of about 40 percent," Carolyn writes.
| | The vaccine maker plans to submit the data on children 6 months to 5 years old to the Food and Drug Administration in the coming weeks. Quickly spreading BA.2 variant arrives in U.S. amid loosening restrictions | | Here's where BA.2 is spreading around the globe:  | | | The recently emerged BA.2 version of the coronavirus accounts for about a third of new infections nationally, but disease experts said that the variant could take over as the dominant strain in a matter of weeks, our colleague Joel Achenbach reports. Catch up quick: | - In some areas of the country, as much as 70 percent of new cases are being attributed to the transmissive variant that has fueled a surge across Europe in recent weeks, according to an estimate from the genomics company Helix.
- There is no evidence that BA.2 evades immunity protections from vaccines or prior infection, and early data on the subvariant suggest it doesn't make patients sicker than the earlier omicron strain.
| | Where we're at: Administration officials say expanded access to coronavirus vaccines, testing and treatments have allowed the country to return closer to normal. But they argue that a holdup in new funding could jeopardize efforts to respond to new variants. What we're watching: A substantial wave from BA.2 would be the sixth since the virus arrived in early 2020, but it would be the first to occur under new CDC metrics that relaxed public health measures like indoor masking while cases are low. | - And if cases rise like public health experts predict, whether the agency's new guidelines would trigger local officials to reinstate such policies remains unclear.
| | Speaking with our colleague Yasmeen Abutaleb at a Post Live event Tuesday, the nation's top infectious disease expert, Anthony Fauci, said he thought health officials would have a "tough time" trying to convince Americans to mask up again, if needbe. | - "I don't think there's much stomach for people to all of a sudden turn around, even if there is an uptick," Fauci said.
- But those who are at high-risk of severe disease should follow the CDC's guidelines, even if local leaders refuse to reimpose mitigation measures, Fauci said.
| | Anthony Fauci on BA.2:  | | | | | White House press secretary Jen Psaki tested positive for the coronavirus for a second time and will not attend a planned trip to Europe this week with Biden, The Post's Amy B Wang and Matt Viser report. Former secretary of state Hillary Clinton also tweeted yesterday that she tested positive for the coronavirus and was experiencing mild symptoms. | | |  | Readers help us | | | The Post is looking to speak with families with a child currently struggling with suicide. Your story can help us understand this difficult issue. We recognize this is a sensitive topic and respect your privacy. We won't publish any part of your response without contacting you first and getting your permission. Here's how to share your story with us. | | |  | Health policy watch | | Coming soon: Potential congressional movement on insulin pricing | | Sens. Susan Collins (R-Maine) and Jeanne Shaheen (D-N.H.) are working on a bipartisan effort on insulin pricing, which could consist of measures to drive down the drug's list price and protect the uninsured from high costs. The plan is to incorporate a bill from Sen. Raphael Warnock (D-Ga.) to place a $35 monthly cap on insulin into broader, insulin-focused legislation, Senate Majority Leader Chuck Schumer (D-N.Y.) announced yesterday. | - Flashback: Last year, Democrats included the $35 monthly cap in their now-stalled sweeping social spending bill.
- The politics: Curbing the cost of the lifesaving treatment is politically popular — and affordable insulin was one of Biden's top plugs for his economic package. Schumer wants to put it to a vote on the Senate floor ASAP after Easter recess.
| The law Biden once called a BFD turns 12 | | First in The Health 202: On the Affordable Care Act's 12th anniversary, President Biden will call out Sen. Ron Johnson (R-Wis.), though not by name, and tout his administration's efforts to build on Obamacare. In a forthcoming statement shared with The Health 202, Biden will pledge that Democrats will protect the health law, particularly after "a Republican senator shared his plan to repeal the ACA." | - Earlier this month, Johnson appeared to suggest he wanted Republicans to repeal and replace the health law if the GOP won the White House and Congress in 2024. He later claimed his comments were taken out of context.
- Since Biden took office, Democrats have taken a number of steps they say is aimed at strengthening the health law, like expanding Obamacare's financial aid and opening a lengthy special enrollment period. But other measures — like the party's legislation to continue those subsidies and expand Medicaid to 2.2 million people — have languished on Capitol Hill.
| | |  | Reproductive wars | | Ketanji Brown Jackson: Roe is 'settled law' |  Supreme Court nominee Ketanji Brown Jackson testifies on the second day of her confirmation hearing on Capitol Hill on Tuesday. (Demetrius Freeman/The Washington Post) | | | Biden's Supreme Court nominee Ketanji Brown Jackson says two landmark abortion decisions are "settled law," The Post's Mariana Alfaro reports. Under questioning from Sen. Dianne Feinstein (D-Calif.), Jackson was asked whether she agrees with Justices Brett M. Kavanaugh's assessment that Roe v. Wade is settled precedent and Justice Amy Coney Barrett's claim that she has "no agenda to try to overrule Casey." | - "I do agree with both Justice Kavanaugh and Justice Barrett on this issue," Jackson said. "Roe and Casey are the settled law of the Supreme Court concerning the right to terminate a woman's pregnancy."
| | Feinstein's questioning comes as the high court seems inclined to uphold Mississippi's 15-week ban on abortion, which would undermine Roe v. Wade's nearly half-century old protections. The decision is expected this summer, before Jackson would be seated on the bench, if confirmed. | | The GOP-controlled Oklahoma House approved a Texas-style measure Tuesday to ban all abortions unless necessary for saving the pregnant person's life, The Post's Caroline Kitchener reports. The bill, if passed by the Senate and signed into law, would go into effect immediately after the governor signs it. | | More from Caroline: |  | | | | | |  | Sugar rush | | | Thanks for reading! See y'all tomorrow. | |
