| Good morning, this is McKenzie, The Health 202 researcher, writing today's top. Welcome to Monday's newsletter, where we're trying to avoid getting stuck behind the "People's Convoy" slowing down the Beltway. Today's edition: The White House must go even further on its new pandemic response, say some former Biden advisers. Senate Republicans are signaling they will slow efforts to fund the federal government and increase coronavirus aid. But first … | Humanitarian groups scramble to deliver lifesaving aid to Ukrainians under siege |  An employee of Doctors Without Borders prepares boxes of supplies for the first shipment of medical equipment for teams in Poland and Moldova to be sent to Ukraine. (Philippe Lopez/AFP/Getty Images) | | | Leaders from Ukraine and Russia had struck a deal to allow safe passages for the evacuation of civilians and the transportation of lifesaving medical supplies. But over the weekend, the agreement quickly crumbled. Ukrainian officials have since accused Russian forces of violating the cease-fire agreement along routes designated as humanitarian corridors and slammed Russia for proposing evacuation routes only to Russia and Belarus instead of European Union countries. Groups on the ground are left scrambling to get supplies around Russian tankers and restricted airspace to deliver assistance directly to those who need it the most. | - Ukrainian officials said two rescue efforts to evacuate residents of the southern city of Mariupol through designated humanitarian corridors were thwarted over the weekend when Russian forces continued to shell the area, breaking the cease-fire agreement and trapping more than 200,000 individuals under fire. The city is now in its sixth day without water, power or sanitation.
- Officials coordinating humanitarian efforts described two distinct problems: treating life-threatening injuries of those on the front lines and continuing care for Ukrainians with preexisting conditions.
| | We spoke with Kate White, the emergency manager for Ukraine at Doctors Without Borders, and Jarno Habicht, the World Health Organization representative to Ukraine and head of the WHO Country Office in Ukraine, about organizing the ongoing relief efforts. H202: What is your team on the ground seeing in Ukraine's hospitals, clinics and emergency medical centers? | - Habicht: "In many instances, provisions of health care have moved from buildings to underground shelters. Women are giving birth in bunkers and other safe places as health care comes under attack. Health workers are going over and above the call of duty, saving lives while risking their own."
| | Key context: On Sunday, WHO director general Tedros Adhanom Ghebreyesus confirmed that there have been several attacks on health-care facilities in Ukraine resulting in multiple deaths in violation of international humanitarian law. | - The WHO has recorded six deaths and 12 injuries, of which seven are health workers, as a result of several attacks on medical buildings since Russian forces began invading Ukraine. Some health-care facilities were assaulted using heavy weapons, which include tanks, missiles or bombs.
| - White: "Teams that are closer to border areas are seeing a lot of congestion in terms of people trying to move and escape the conflict. People have spent days traveling, at times being displaced multiple times. … And so by the time they get to the western areas, they are tired, they are dehydrated, they are exhausted, they've had family separation, they don't know where all the members of their family are. There's just a lot of uncertainty about what comes next."
| | Tedros Adhanom Ghebreyesus, WHO director general |  | | | | | H202: What health-related supplies and assistance are most needed to keep the health-care system running in Ukraine? | - Habicht: "All medical supplies will become critical. … We will need oxygen for trauma cases in intensive care units, but there's also a need for basic trauma supplies, as well as regular medicines so people who have chronic diseases, like diabetes or hypertension, can be treated. We will need basic vaccines, vaccines for childhood diseases like measles or polio."
| | The dollars: Countries have given billions of dollars in humanitarian aid to Ukraine to provide basic provisions and shore up its fledgling health-care system amid an emerging medical crisis. The United States pledged nearly $54 million in humanitarian aid to Ukraine late last month, which will help provide drinking water, emergency health care and shelter for individuals affected by the conflict, according to Secretary of State Antony Blinken. | | On tap this week: Congress is contending with the Biden administration's request for $10 billion in additional aid to Ukraine, which could get caught up in broader funding disagreements. H202: What different scenarios are you planning for as the conflict evolves? | - White: "We're looking at ensuring continuity of care for those underlying health issues — that they're still able to get access to health care and medications — as well as reinforcing and supporting the immediate lifesaving needs of the population in terms of trauma and emergency care."
- "In a way, some of those are linked because we know that Ukraine has, for example, a significant burden of disease in terms of diabetes. If you no longer have access to insulin, then relatively quickly, you're going to turn into an acute case, but you may not get priority in the system."
| | H202: What are some of those challenges you're facing in distributing aid? White said some of Doctors Without Borders's usual routes to deliver supplies are being disrupted or cut off due to fighting, and because air travel is restricted over Ukraine, her teams rely on troops to respect those traveling on the ground to offer humanitarian assistance. Habicht said WHO workers are experiencing similar challenges in dispersing aid and donated medical supplies. Habicht: "WHO had pre-positioned supplies in Ukraine, but some of these are now inaccessible due to military operations. … In Poland, we are setting up a logistics base to urgently get medical supplies and equipment into Ukraine. Equipment will arrive by plane [in Poland], including trauma kits and health kits, for onward transfer to Ukraine by land, for which a safe corridor is vital." | | António Guterres, secretary general of the United Nations: |  | | | | | |  | From our reporters' notebooks | | | Getting to the 'next normal': Six former Biden covid advisers and nearly 50 other outside experts are jointly calling on the White House to ramp up efforts to fight long covid, improve indoor air quality, ensure workplace safety and pursue other measures they say are necessary to combat coronavirus and the risk of other infectious diseases. The group's plan, posted this morning at covidroadmap.org, calls for broadening the fight against covid-19 to include all respiratory viruses, our colleague Dan Diamond writes to us. The experts also say that the virus is not yet "endemic," and that it's too soon to let down the nation's guard. | - "We're not there yet," Ezekiel Emanuel, a University of Pennsylvania bioethicist who coordinated the effort, said in an interview with Dan. He also warned that a White House proposal for $22.5 billion in new funding for the domestic and global coronavirus response fell far short of the actual need.
- "This is a classic situation of where we tend to underinvest, and we tend to move on, and we tend to forget. And that would be a huge mistake," Emanuel said, calling for $100 billion in additional covid funding across the next year, followed by about $15 billion per year.
| | |  | On the Hill | | On tap this week: Funding wars over spending bill, coronavirus aid |  Some Senate Republicans are threatening to slow efforts to fund federal agencies ahead of a critical Friday deadline. (Justin Sullivan/Getty Images) | | | Senate Republicans are signaling they could slow-walk a still-forming deal to fund the government over concerns about vaccine mandates and excessive spending, The Post's Tony Romm reports. The early warnings were delivered in two letters to Senate Majority Leader Chuck Schumer (D-N.Y.) as lawmakers face a Friday deadline to fund the government. The partisan division comes as the Biden administration is seeking $22.5 billion to restock key public health programs as a protection against future variants. The request is "urgent," White House press secretary Jen Psaki said Friday, as she outlined what the administration says is at stake without more dollars. | - For instance: By May, the current supply of monoclonal antibodies — a coronavirus treatment — will be out of stock. By September, the administration anticipates its supply of oral antivirals could run out if more pills aren't purchased now. And within weeks, the testing capacity could drop without more investments soon, per Psaki.
| | |  | Coronavirus | | What's next for Biden's 'test to treat' coronavirus plan |  President Biden announced a new "test to treat" initiative during last week's State of the Union address. (Jabin Botsford/The Washington Post) | | | Starting this week: Consumers can soon walk into a clinic or a pharmacy, get tested for the coronavirus and get a free course of antiviral pills under President Biden's new "test to treat" plan. But many puzzle pieces — including having enough supply of rapid tests and take-home drugs — must fall into place for the program to ramp up quickly, our colleague Katie Shepherd reports. Some doctors have heralded the one-stop approach as a potential breakthrough. But the American Medical Association was strongly critical of the effort Friday afternoon, arguing that prescribing decisions should be made under the guidance and supervision of doctors with expertise in dealing with complex medications. White House officials countered that the program is primarily focused on helping the quarter of Americans who don't have a regular doctor quickly access the lifesaving drugs. And they expressed confidence that they have enough pills and test kits to launch the program in hundreds of pharmacies, as well as community health centers and long-term care facilities, this week. | | |  | In other health news | | - Two new studies suggest the number of abortions among Texas women fell by around 10 percent after a near-total ban went into effect — far less than previous estimates. That's because many traveled to a nearby state or ordered abortion pills online, the New York Times reports.
- The nation's largest pediatric hospital announced it stopped gender-transition therapies after Texas Gov. Greg Abbott (R) ordered such care be treated as child abuse, per the Associated Press.
- The "People's Convoy," a group of hundreds of drivers protesting pandemic restrictions, is aiming to loop around the Capital Beltway once today and occupy two lanes of traffic while driving the minimum legal speed limit, The Post's Ellie Silverman and Karina Elwood report.
| | Ellie Silverman, The Post |  | | | | | |  | Daybook | | | Today: The Post will host a discussion on racial health disparities with Health and Human Services Secretary Xavier Becerra and Santa Ana, Calif., Mayor Vicente Sarmiento. Thursday: The Post hosts an event with Albert Bourla, the chairman and CEO of Pfizer, on his new book on the race to create the coronavirus vaccine. | | |  | Health reads | | By Heather Haddon and Stephen Council l The Wall Street Journal ● Read more » | | | | | |  | Sugar rush | | | Thanks for reading! See y'all tomorrow. | |
