| Helloo good morning. Today is the last day of February, let the March Madness begin. Got tips? rachel.roubein@washpost.com. Was this forwarded to you? Sign up here. Today's edition: President Biden is planning to defend health-care spending again today, this time focusing on Obamacare and Medicaid. The Food and Drug Administration's neuroscience chief at the center of the Aduhelm controversy is leaving. But first … | A little-known scientific team helped determine new assessment on the virus's origins |  Chinese virologist Shi Zhengli, left, inside the P4 laboratory in Wuhan, China, in February 2017. (Johannes Eisele/AFP) | | | The theory that covid-19 started with a lab accident has received a modest boost from findings by a little-known scientific team within the Department of Energy. The analysis by experts from the U.S. national laboratory complex included members of a team known as the Z-Division, which since the 1960s has conducted highly secretive and technically challenging investigations of emerging security threats, The Post's Joby Warrick, Ellen Nakashima and Shane Harris reported last night. The fierce debate over the origins of the pandemic came roaring back into the media spotlight Sunday. The Wall Street Journal reported that the Energy Department, initially undecided about the virus's origins, now concludes with "low confidence" that a lab leak most likely triggered the worst pandemic in a century. But even within the administration, federal agencies are divided over which theories they lean toward, with more favoring the natural transmission hypothesis. This comes as House Republicans have pledged multiple probes into the origins of covid-19 with their newfound majority. | - "There is not a consensus right now in the U.S. government about exactly how covid started," John Kirby, spokesman for the National Security Council, told reporters yesterday. "That work is still ongoing."
| | The Post's Ben Pauker: |  | | | | | There are two main theories under debate. | | | | | | | BCBSA's Affordability Solutions can cut health care costs by $767 billion over the next 10 years by improving competition, lowering drug costs and prioritizing high-quality care. Learn more. | | | |  | | | | | One is a natural origin of the pandemic, which has long been a favored theory among scientists since past human infections with novel coronaviruses have started that way. Essentially, this theory holds that the virus was transmitted from an animal to a human, perhaps at a market in the Chinese city of Wuhan. The other is the "lab leak" theory, where there was some kind of laboratory accident at the nearby Wuhan Institute of Virology and which was a notion originally dismissed in most mainstream media outlets, including The Post. The administration's split: It's not clear what specific evidence prompted the Energy Department to view the lab leak as the most probable theory. In addition to DOE, the FBI backs the lab-leak theory, though with "moderate confidence." Four other agencies and a national intelligence panel believe with "low confidence" that the virus emerged through natural transmission, the WSJ reported. Meanwhile, the CIA and another agency that officials didn't name remain undecided, lacking enough compelling evidence to support one conclusion over the other. The overall view from the latest U.S. intelligence assessment — that there isn't a definitive conclusion on covid-19's origin — hasn't changed much since the release of an earlier version of the report by the Biden administration in 2021, our colleagues note. But there is some consensus: The agencies don't believe the virus was man-made or developed as a bioweapon. | | The Post's Philip Bump: |  | | | | | This debate over the origins of the virus has led to differing conclusions that include knowledge gaps. Over the summer, the journal Science published two papers that stated the coronavirus pandemic began in separate viral spillovers. The papers underwent five months of peer review and revisions, and the authors acknowledged there are many unknowns that require further investigation, like which animals were involved, The Post's Joel Achenbach reported at the time. In October, Senate Republican staffers released a report laying out their argument that the "most likely" origin of the pandemic was some kind of "research-related incident" in China. Yet, the document didn't rule out a market origin, Joel and Dan Diamond wrote last year. | | And yesterday, top House Republicans overseeing pandemic probes announced they were expanding their investigation into the virus's origins, sending letters to top officials at the Energy Department, State Department and FBI. (The FBI confirmed it received the letter, and declined to comment further. The other two departments didn't immediately respond to a request for comment.) Multiple experts said determining the origins of the virus was important for preventing future pandemics. For one, the findings could help shape public policy, such as tightening oversight of certain laboratories and ways of preventing natural spillovers from infected animals. | - "It's not that I personally am invested in one or the other," said David Relman, a professor of microbiology and immunology at Stanford Medicine, "I just think that knowing more will motivate us in a way that the current kind of uncertainty that we have does not."
| | But will there ever be definitive evidence? Gerald Parker, the associate dean for Global One Health at Texas A&M University, says he's not sure there will be. Instead, he thinks there will be "a lot of circumstantial evidence one way or the other." | | |  | Daybook | | | On tap today: President Biden is expected to mount a vigorous defense of his health-care policies at an event in Virginia Beach as he ramps up criticism of Republican proposals that he argues could threaten Obamacare and Medicaid, our colleague Matt Viser reports. While GOP lawmakers have largely backed away from any discussion of cuts to Social Security and Medicare in recent weeks, they're still committed to balancing the budget — which could require cuts to other large government programs. With Republicans largely refraining from offering details of where exactly those cuts would come from, Biden is attempting to focus on another area of spending lawmakers have targeted in the past, but, because of its popularity, might be politically problematic to cut. White House officials yesterday didn't say explicitly whether cuts to the Affordable Care Act or Medicaid are off the table in those discussions. Biden's own budget proposal will be released on March 9, in which administration officials said he will outline plans to build on Obamacare and bolster the safety net program. | | More from Biden: |  | | | | | |  | Agency alert | | FDA's neuroscience chief to leave agency |  Billy Dunn is leaving his post leading the FDA's neuroscience team after an 18-year career. (iStock) | | | Our colleague Laurie McGinley sends us this dispatch: | | Billy Dunn, the Food and Drug Administration official who oversaw the regulation of drugs for neurological conditions and was at the center of the controversy over Aduhelm, a drug for Alzheimer's disease, is leaving the agency, the FDA said Monday. His departure was announced in an email to FDA staff by Peter Stein, head of the agency's Office of New Drugs. Stein said he regretted to announce that Dunn was leaving the agency to pursue other opportunities. Dunn became a lightning rod for criticism of the FDA's accelerated approval of Aduhelm, which had a history of confusing clinical trial data. Its approval set off a furor among doctors and led to Medicare's refusal to cover the drug for people who were not in clinical trials. Stat reported that Dunn had developed an overly close relationship to Biogen, one of the drug's developers, and he faced harsh criticism from congressional investigators. But the FDA has said that Dunn did nothing wrong, and Alzheimer's and ALS groups praised his willingness to be flexible on applying FDA regulatory rules to deadly diseases. | HHS reshuffles civil rights office as complaints skyrocket | | The federal health department is reorganizing its civil rights division in an effort to cut down on a growing backlog of complaints lodged with the agency amid a lack of resources and overstretched staff. The Department of Health and Human Services announced yesterday that it will create three new divisions within the Office for Civil Rights with staff that focus on each of the following: policy, strategic planning and enforcement. The office will keep a division dedicated to investigating health privacy complaints, which will have a focus on a recent rise in cybersecurity breaches. Key context: The office is tasked with investigating complaints filed by patients against health-care workers, insurers and government agencies when they think their civil rights or privacy have been violated. The office's caseload has increased by nearly 70 percent over the last five years, with over 51,000 complaints filed last year. | | |  | State scan | | Mississippi may vote on year-long Medicaid coverage for new moms | | Yesterday a top GOP leader in the Mississippi state house said he won't block a vote on a bill letting women have a full year of Medicaid coverage after giving birth, the Associated Press reports. House Speaker Philip Gunn made the comments after the state's governor Tate Reeves gave his backing to the legislation after initially opposing it. Twenty-eight states have expanded Medicaid coverage for women a full year after birth. More GOP-led states are now considering such proposals after the Supreme Court overturned Roe v. Wade last summer, as we've reported. "Reeves is seeking reelection, and Democrats have hammered his unwillingness to allow a year of postpartum Medicaid coverage," the AP writes. "Reeves said Sunday that more babies will be born because the U.S. Supreme Court upended abortion rights nationwide last year with a case from Mississippi. He said longer Medicaid coverage after birth is 'part of our new pro-life agenda.'" | | |  | In other health news | | - A spokesman for Sen. John Fetterman (D-Pa.) said yesterday that the freshman lawmaker is "doing well" and "remains on a path to recovery" after checking himself into a hospital to receive treatment for clinical depression two weeks ago, The Post's Amy B Wang and Colby Itkowitz report.
- Rep. Joaquin Castro (D-Tex.) is recovering after undergoing surgery to remove slow-growing tumors from his gastrointestinal tract following a cancer diagnosis last summer, his office announced yesterday.
- A proposed federal rule seeking to protect health-care workers from violent patients would cost employers $1.2 billion annually, according to new estimates released yesterday by the Occupational Safety and Health Administration.
| | |  | Health reads | | | By Caroline Chen, Irena Hwang and Al Shaw, with additional reporting by Lisa Song and Robin Fields | ProPublica ● Read more » | | | | | |  | Sugar rush | | | Thanks for reading! See y'all tomorrow. | |
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