Vaping, COVID, And The Biden Administration's Approach To Public Health : The NPR Politics Podcast The Biden administration says Americans now have access to the tools they need to protect themselves from COVID, as a new spike in cases begins. Deaths have remained low so far and the administration — recognizing the political realities — has not pushed for new restrictions.

Meanwhile, the Food and Drug Administration is moving ahead on a suite of initiatives aimed at reducing smoking and vaping — the latest, surprisingly apolitical chapter in a public health crusade that's notched hard-fought wins over many decades.

This episode: White House correspondent Tamara Keith, national political correspondent Mara Liasson, and health correspondent Allison Aubrey.

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Vaping, COVID, And The Biden Administration's Approach To Public Health

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AJ: Hi, this is A.J. (ph).

JEN: And this is Jen (ph).

AJ: We are currently standing inside a 900-year-old tree amongst the Avenue of the Giants.

JEN: This podcast was recorded at...

TAMARA KEITH, HOST:

2:21 p.m. on Wednesday, the 13 of July.

MARA LIASSON, BYLINE: Redwoods.

AJ: Things may have changed by the time you hear this.

JEN: But we'll still be looking for Bigfoot.

AJ AND JEN: Enjoy the show.

(SOUNDBITE OF THE BIGTOP ORCHESTRA'S "TEETER BOARD: FOLIES BERGERE (MARCH AND TWO-STEP)")

KEITH: (Laughter).

LIASSON: Very cool.

KEITH: Is that in northern Northern California, the Avenue of the Giants?

LIASSON: I think so.

ALLISON AUBREY, BYLINE: I think Humboldt County.

KEITH: Aha. Yes.

Hey there. It's the NPR POLITICS PODCAST. I'm Tamara Keith. I cover the White House.

LIASSON: I'm Mara Liasson, national political correspondent.

KEITH: And that familiar voice chiming in was Allison Aubrey, our tireless - or possibly very tired by this point - health correspondent. Hello, Allison.

AUBREY: (Laughter) Great to be here.

KEITH: So the White House held one of its regular - but not so regular as it was before - COVID briefings yesterday. And the news was, like, more advice, fewer restrictions?

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ASHISH JHA: We are at a point in the pandemic where most COVID-19 deaths are preventable. Our strategy to manage BA.5 relies on making sure Americans continue to have easy and convenient access to these tools. We're also going to communicate clearly about commonsense steps Americans can take to protect themselves. To that end, let me walk through a few key things every American should know.

KEITH: And Allison, we are hearing from the White House about COVID more now because there is a new omicron subvariant taking over. What is this one? - BA.5. And although it is now dominant, it's not clear how many cases there are, exactly.

AUBREY: That's right. Yeah, so BA.5 is hypertransmissible. It is the new dominant strain, but it is hard to know how many people are infected because everybody is using these rapid at-home tests, and they don't go to their doctor. Or if they do - in my case, I had COVID last month. I called my doctor. I said, hey, I just got a positive test, and they're like, you know, OK.

KEITH: Thanks. Great. Good for you.

AUBREY: I wanted it part of my record. But there is no system to sort of pass up the findings of these at-home tests. So increasingly, public health officials look to hospitalizations, which are up about 12% compared to about a week ago. The good news is deaths have stayed low, and I think that gives some reassurance that the impact of a BA.5 surge won't be on the scale that we saw last winter.

LIASSON: Does that mean that COVID is - get more and more transmissible and less and less lethal until it peters out into something like the common cold?

AUBREY: I think that we are on the path towards it becoming less lethal because of the tools that we have to fight it. That's what infectious disease folks will tell you if you talk to them. Like, yes, we know how to manage this better. But I don't think it's fair to say that it's petered out to something as innocuous as the common cold, as they are still treating people...

LIASSON: No, not yet, but is it on the path to doing that?

AUBREY: You know, well, that's the thing. Nobody can say with any clarity that absolutely that will happen at some point. A lot of the infectious disease experts I talk to say they have been so humbled by this virus because it throws so many curveballs, and it's still mutating like crazy. Something that's hopscotching around the world, as this virus has and still is mutating a lot, and so there's a lot of uncertainty about what future mutations will bring.

KEITH: So I think what stood out to me about this moment is that there is a surge of cases, and yet not a lot is changing. It's sort of like - sort of standard operating procedure, go about your life. I guess they are calling for people to wear masks in crowded spaces. I haven't seen a lot of people wearing masks in crowded spaces. Obviously, any idea of lockdown or even, you know, masks back on planes or anything like that seems pretty unlikely to happen. Is that just where things are, or is the Biden administration basically admitting defeat and, well, it's over in people's minds?

AUBREY: I think they're not admitting defeat as much as they're saying, hey, this is manageable enough that you are on your own now - I mean, without really saying it in those words. I think, you know, there are cities that are still kind of, you know, recommending masking. New York public health officials did so last Friday because of a rise in cases. In Los Angeles, there is active negotiation about whether a mask mandate goes back into effect. So some cities are still looking at that, but I think the de facto message kind of is, like, OK, we've given you all these tools, we've told you to get vaccinated, we told you to get boosted, better boosters are coming this fall - probably - so it's up to you.

KEITH: Allison, at this point, this strategy of basically saying, protect yourself if you want to protect yourself; otherwise, America has moved on - how do public health experts feel about the current state of things?

AUBREY: You know, there's a range of opinions within the infectious disease community, but I think what I hear from a lot of public health people is, look, the CDC set up this system whereby, if cases and hospitalizations and deaths started to rise again, that this would - could trigger or justify putting some restrictions back into place or mask mandates back into place. And right now, you know, it appears that reinfections are rising. It appears hospitalizations are rising, but deaths are not rising. And so this could change. We could see - if there's a bigger surge in the fall, we might start to see those conversations again because public health experts are not convinced that the best thing to do is just to say, eh, it's in your hands.

KEITH: Just to put this in a little bit of perspective, there was that New York Times/Siena poll that came out earlier this week that we were talking about for other reasons, but it also asked people about their top issues. And I think only 1% of the American public says that COVID is their top issue now, whereas, a year ago, that was a much higher number. So, you know, I just think that the country is in a different place.

AUBREY: For years and years, I've covered all of the things that kill us slowly - so like poor diet and smoking and all the other habits and choices people make - and I kind of am starting to feel like, oh, wow, yeah, this is becoming - COVID's now becoming the thing of like, oh, COVID. You know, COVID's always there. COVID's in the background. People might be singing a different tune in the fall if we have another big surge, but, yeah, we've just gotten to this point where people think it's over, and they think, eh, you know, if you get it, it's no big deal.

LIASSON: Allison, is there another model for dealing with this? I mean, we saw China try to do zero-COVID with pretty disastrous results. People weren't very happy there, and I don't even know if China succeeded. But is there another model for dealing with it, other than what's happened, this kind of haphazard muddling through that we have in the U.S.?

AUBREY: That's a really good question. I mean, I wish I could point to a place. You know, normally, when you're looking for instances of good behavior or a place that does it better, you know, you point to like Sweden and...

LIASSON: Denmark.

AUBREY: ...Norway. Like, oh, people there - Denmark - people there are healthier, you know? They all get education, and they have free health care. Honestly, like, the same thing happened in Europe. Like, people just stopped masking. And I don't know if I could point to a third way. I think the third way is this idea that if I sense that there's a risk out there and I don't want to be infected again, which I do, I'm going to keep masking.

KEITH: All right. Well, we are going to take a quick break. And when we get back, tobacco and vaping.

And we're back. And let's move on to an entirely different public health issue. The Food and Drug Administration is regulating nicotine and vaping products and doing sort of new and interesting things. Is that right, Allison?

AUBREY: Well, they're playing catch-up to regulate a whole suite of, like, nicotine and vaping products that have been out there for a while that haven't had regulation. So there was big news last month when FDA said, sorry, Juul, your products need to come off the market. That decision has been stayed or halted. The company is appealing it.

The other big thing happening is that currently, the most popular products among teenagers are no longer Juul. The most popular products are synthetic nicotine products that had escaped regulation before. These are products such as Puff Bar. In March, Congress said, hey, FDA, time to regulate those products, too. So the tobacco-control community is standing by saying, OK, what will you do now, FDA? It's on you.

KEITH: And is the FDA moving in the direction of doing something?

AUBREY: Well, actually, today is one deadline. Congress had told FDA that you need to look at all of these synthetic nicotine products that are on the market that remain popular with teenagers, and you need to tell each manufacturer that they need to apply for regulation.

Let me just back you up a little bit. The whole reason that we're in the situation that we are in right now is that about 10 years ago, when electronic cigarettes first came onto the market, the idea was that they were a great way to help cigarette smokers stop smoking. And so the FDA kind of let these products come on the market without any regulatory approval process at all.

Well, what happened over the last eight years, or starting about eight years ago, there was this huge surge in vaping among teenagers. And so it became this big epidemic, and these products weren't being regulated. So all of the tobacco-control companies - the American Cancer Society, the Lung Association, the Campaign for Tobacco-Free Kids - they all got together, and they sued the FDA. And they said, look; you need to do something about this because this plan of, you know, having vaping products around to help cigarette smokers quit, it didn't work out so well.

LIASSON: I understand there's also been talk of reducing the amount of nicotine in regular cigarettes.

AUBREY: That's right. They have announced that they will consider rulemaking to reduce the amount of nicotine in cigarettes to a point that it is not considered an addictive level. There are varying views about how effective this could be. There are some published studies to suggest that this could actually help prevent cravings. It could help reduce use for some people who don't move to other nicotine products. And it could also help people try to quit.

The American Cancer Society pointed me to one study of 800 smokers, and it found that people who tried these very low-nicotine cigarettes did actually reduce their dependence. They really did reduce cravings, and more of them tried to quit. So I would say the Biden administration sees this kind of effort as, you know, low-hanging fruit. In their big cancer moonshot proposal, they clearly named reducing tobacco use as a way of reducing deaths from cancer. This is something that will probably take years to happen and would probably be challenged in court by the tobacco industry if the rule is actually proposed.

LIASSON: And what's interesting is how, when every other thing, especially human behavior, has become politicized, there isn't a huge partisan split about tobacco or smoking. I mean, people seem to agree, at least in the numbers of people who've stopped smoking, that it's not a good idea, and it's not good for your health.

AUBREY: Yeah. I think the way this one breaks down is either you're pro-vaping or you're anti-vaping. And you're pro-vaping if you used to use cigarettes and now you vape because that's a form of risk reduction. The problem with that is that the community of people who were former cigarette smokers who became vapers is not as big, it doesn't seem, as the community of, you know, adolescents that was introduced to nicotine via these electronic cigarettes. And so that's really the problem.

I think the big picture here is there's still, like, almost a half million deaths a year from tobacco use. So, you know, any measure that you can take to reduce nicotine or limit access to all of these e-cigarettes is seen as a good action by the tobacco-control community.

KEITH: All right. Well, we are going to leave it there for now. Allison, thank you as always for sharing your reporting with our pod.

AUBREY: Oh, great to be here.

KEITH: I'm Tamara Keith. I cover the White House.

LIASSON: And I'm Mara Liasson, national political correspondent.

KEITH: And thank you for listening to the NPR POLITICS PODCAST.

(SOUNDBITE OF THE BIGTOP ORCHESTRA'S "TEETER BOARD: FOLIES BERGERE (MARCH AND TWO-STEP)")

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