With Megan R. Wilson

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– President Joe Biden is running out of new ways to kick off his vaccination campaign, especially in the face of growing resistance from the GOP.

– Senate avoided government shutdown after reaching deal authorizing an amendment vote on funding for Biden’s employer vaccine needs.

– New York has confirmed five Omicron cases, in a sign the new variant is already widespread in the United States

WELCOME TO FRIDAY PULSE – where despite Gen Z’s best efforts, Tears of Joy will remain the best emoji for at least a year longer. (We have a soft spot for the upside down smiley, which describes this weird year in healthcare so much.)

Send tips and your favorite emoji to [email protected] and [email protected].

NEW COVID PLAN, EVEN COVID PROBLEMSJoe Biden’s presidency rests on whatever he can to fend off the pandemic. But in the face of rising cases, falling approval rates and entrenched GOP opposition, Biden may be running out of new options to defeat Covid-19.

In its new nine-point plan, the White House pledged to redouble federal immunization efforts, expand testing, and conduct a series of public education campaigns – all initiatives that could strengthen the defenses of the country on the fringes.

What it lacks, however, are the kinds of drastic measures which health experts say are critical to ending the pandemic – and that would also cause the biggest political backlash, according to the Jonathan Lemire report from Adam and POLITICO.

The Biden administration has avoided imposing vaccines for domestic travel, stricter public health measures or forced quarantines. The warrants he is trying to put in place are frozen in court. And in the hardest-hit parts of the country, GOP governors have thwarted the government’s best efforts to impose basic protections.

This hostile environment has reduced the White House’s Covid-19 toolbox, even as he faces perhaps the most pressing threat since the summer’s Delta wave. Health officials have already found several cases of Omicron in the United States, and it could be at least a week before a final verdict is rendered on the severity of the variant.

Biden, meanwhile, preaches unity, launching its new plan for the winter in part on the promise that it will not include new mandates. “This is a time when we can put the division behind us, I hope,” he said on Thursday.

Yet few in the administration expected this new plan to result in a dramatic increase in the vaccination rate. Rather, authorities have turned their attention lately to strengthening the ranks of those already vaccinated – urging people to get boosters and vaccinate their children in hopes of at least tackling Covid-19 to a standstill for another season.

THE CONGRESS AVOIDS A TO CLOSEThe Senate on Thursday night approved a bipartisan deal to keep government open until mid-February, after negotiators struck a deal on a vaccine-related amendment vote in return for GOP support, Caitlin Emma reports, Jennifer Scholtes and Sarah Ferris of POLITICO.

The path to the 69-28 vote was based on demands from a group of conservatives for consideration of a funding amendment to Biden’s immunization requirements for big business. The faction, led by Sen. Mike Lee (R-Utah), had decided to shut down the government entirely if funding for the new vaccine rules was maintained.

But they ultimately went with an amendment stripping the money for the demands, which fell to the floor by a 48-50 margin.

Biparty funding deal concluded after days of dysfunction inside Capitol Hill, as House and Senate lawmakers sought a deal they could speed up to Biden’s office. The House finally passed its measure Thursday morning, entering final negotiations on the Senate side.

The process represents a taste of much more controversial fundraising battles to come. Congress has yet to agree on a full-year spending measure that could for the first time include Biden’s priorities. They also face potential cuts to Medicare and other assistance programs that are expected to take effect next year.

FIVE OMICRON CASE IN NY – The number of confirmed cases of Omicron in the United States is growing as more states detect the new variant, including five infections discovered in New York on Thursday, reports Shannon Young of POLITICO.

Gov. Kathy Hochul said at least one infected person had recently traveled from South Africa and told New Yorkers they should assume the variant is already spreading at the community level. Officials across the country have stressed that Omicron’s rise to power is expected once it begins to appear in the world.

It will be several more days before scientists can determine whether Omicron is more contagious or virulent than previous strains of Covid-19.

“We are not in March 2020,” Hochul said. “People shouldn’t panic that this is going to be a repeat of what happened before.”

Hawaii, Minnesota and Colorado also identified cases of Omicron on Thursday.

FIRST IN PULSE: DRUGS ON THE ATTACK – PhRMA launches nationwide seven-figure advertising campaign on TV, radio and the Internet, arguing that pharmacy benefit managers should pass discounts they negotiate with drug makers directly to consumers, reports Megan R. Wilson of POLITICO.

It’s part of a civil war in the healthcare industry unfolding as Democrats finalize their $ 1.7 trillion social spending program. The pharmaceutical industry has so far borne the brunt of the plan’s prescription drug proposals. But they have stepped up their efforts to present PBMs as one of the main culprits of rising drug costs.

PBMs argued that the industry is efficient at cutting costs and that drugmakers are unfairly trying to blame it.

GERMANY REVEALS ITS NOT VACCINATED – The German government is imposing severe restrictions on those who are not vaccinated against Covid-19, denying them access to certain stores and limiting the size of gatherings, reports Laurenz Gehrke of POLITICO Europe.

Chancellor Angela Merkel called the new measures an “act of national solidarity”, arguing that the nation must reduce its infection rates. Just over 68% of Germans are currently vaccinated.

The restrictions include a limit to private gatherings that allows a maximum of two unvaccinated people from a household to be present. Non-essential stores will be open only to people vaccinated or cured of Covid-19.

OKLAHOMA PROSECUTION ON THE VAX MANDATE – The state attorney general is challenging Biden’s vaccine requirements for federal employees and the National Guard after the administration denied Oklahoma’s request for an exemption from tenure.

The costume is just the latest tough federal efforts to demand the Covid-19 vaccine; new rules covering large companies and healthcare workers are also being held up in court.

Oklahoma Governor Kevin Stitt previously asked Defense Secretary Lloyd Austin to let his state’s National Guard bypass the warrant. But Austin responded that all members of his department’s service branches must comply with the vaccination order or risk being kicked out of custody.

Members of the Army National Guard have until June 30, 2022 to be fully immunized.

DC NOTICE MASKS ONCE AGAIN – Just weeks after stepping down from his indoor mask tenure, Washington, DC, is advising people to start covering their faces again – but without making it a requirement.

DC Health has issued an advisory on indoor masks as more cases of Omicron are found in the United States, citing the new variant and “substantial community spread” of Covid-19 in the district.

Mayor Muriel Bowser broke with the Biden administration in late November when she chose to drop the mask mandate even as the CDC continued to encourage masking inside. The White House has never relaxed its own masking policy.

Torey mack is the new Quality and Solutions Manager at the Children’s Hospital Association. Mack was previously Deputy Assistant Administrator of the Bureau of Health Workforce at HRSA.

For the Washington Post, William Wan recounts the struggles families face when a loved one is lost to Covid-19.

About 3,800 Rhode Island state employees will receive a $ 3,000 bonus if they get vaccinated against Covid-19, under a new union contract signed with the state, reports Patrick Anderson of the Providence Journal.

Pfizer has yet to begin clinical trials for boosters in adolescents, even as the Biden administration speeds up initial vaccinations for 12 to 15 year olds, reports Sophie Putka of MedPage Today.