For the unvaccinated, Biden bets billions on Covid treatments as another surge threatens

WASHINGTON — After a year of relentless efforts to vaccinate Americans, President Joe Biden is spending almost $10 billion on new and experimental Covid-19 treatments that will largely help those he hasn't been able to convince.

It is the latest sign that administration officials see the pandemic as being far from over, that the incidents of breakthrough cases will continue to present problems and that for the unvaccinated, many who don't trust or like Biden, they aren't giving up.

This week alone, the Biden administration inked a $5.25 billion deal with Pfizer for its experimental pill to treat Covid infections and agreed to pay $1 billion for a monoclonal antibody treatment from GlaxoSmithKline. That comes on top of multibillion-dollar deals earlier this month with Merck and Eli Lilly for their Covid medicines.

Spending billions of dollars on pills to treat Covid infections is far from where Biden anticipated he would be less than six months ago when he called on Americans to "declare our independence from the virus" during the "summer of freedom."

The treatments, which have been shown in studies to reduce the risk of hospitalizations and deaths, would provide the greatest benefit to the 1 in 5 Americans who have not been vaccinated and are at greatest risk for severe illness. But with vaccine immunity reportedly waning and just a fraction of those eligible for a booster having got the additional shot, the drugs could increasingly be needed by the vaccinated.

Video: Will vaccines, boosters and a promising pill put COVID behind us?

“Our vaccines are safe and highly effective, but even assuming we’re able to get vaccination rates up and boosters to those at highest risk of severe disease, Covid is there to stay,” said Dr. Celine Gounder, an infectious disease expert at New York University who advised the Biden transition.

How the pandemic plays out over the coming months carries significant political consequences for the White House and Democrats in Congress who have been trying to shift voters’ focus to the recently passed infrastructure bill. White House officials have attributed Biden’s sagging approval rating to Covid fatigue among the public and blamed rising inflation on the economic disruption created by the pandemic.

With tens of millions of Americans continuing to refuse to get vaccinated, the pills give Biden one more tool in preventing the pandemic from returning to a point where hospitals are overwhelmed, schools are closed and people avoid travel and dining out, public health officials have said.

While administration officials say their focus still remains on increasing vaccination rates, the deals with Pfizer and Merck will provide enough treatments for 15 million people by the end of next year if their drugs are cleared by the Food and Drug Administration, a move expected by the end of the year.

The $10 billion committed this month for the treatments comes on top of the $22.5 billion the United States has spent on vaccines from Pfizer, Moderna and Johnson & Johnson.

Biden specifically directed his staff to order twice as much of the Pfizer drug as they had planned after seeing how effective it was in study results released last week, upping the order to cover 10 million people by the end of 2022, according to a person familiar with the conversation.

“This is positive news," the president said in a statement Thursday announcing the Pfizer deal. "This treatment could prove to be another critical tool in our arsenal that will accelerate our path out of the pandemic. But vaccines remain our strongest tool.”

Administration officials have said they expect to see an increase in cases in the colder months as people head indoors and gather for the holidays.

And in addition to urging people to get vaccinated, the administration now must also transmit a message about boosters. So far, just 36 percent of seniors have got their booster shots, many of whom were the first to get vaccinated and are now the most vulnerable for severe breakthrough infections.

Even before Americans hit the road for the holidays, cases are on the rise and hospitals are reaching capacity. States in the Northeast are being hit particularly hard, including in heavily vaccinated states such as Vermont and New Hampshire, where cases have risen by 60 percent and 56 percent respectively.

While the unvaccinated are significantly more likely to be hospitalized or die, the drugs will likely provide a benefit to those who are vaccinated as well. CDC Director Dr. Rochelle Walensky said Wednesday that a decline in vaccine effectiveness among the elderly and residents of long-term care facilities is driving up hospitalization and emergency room visits among vaccinated seniors.

“Although the highest risk are those people who are unvaccinated, we are seeing an increase in emergency department visits among adults 65 and older, which are now again higher than they are for younger age groups,” she told reporters.

At the same time, a growing number of cities, including Washington, D.C., are lifting their mask mandates.

Despite the multibillion-dollar investment on the Covid treatments, the medicines come with challenges. Similar to the influenza treatment Tamiflu, the drugs need to be given within the first few days of the onset of symptoms meaning people would need to quickly get test results and receive a prescription for the drugs from their doctor.

The GlaxoSmithKline and the Eli Lilly treatments, while also highly effective, are delivered through IVs, so patients will have to go to a hospital or infusion center to receive them.

Pfizer’s treatment will cost $529 per patient and Merck’s will cost $700 — much less than if a patient is hospitalized but pricier than the vaccines, which cost the U.S. government around $20 to $30 each.

Ultimately, Biden’s chief medical adviser, Dr. Anthony Fauci, said the way to stop the pandemic is to stop the spread of the virus — something best achieved with the vaccines.

“Although antivirals are promising, we must be sure to get our population vaccinated,” Fauci said last week. “Antivirals, as good as they are, are not our first line of defense against Covid-19, because we all know it's much, much more important to prevent an infection than it is to treat.”