The failed Newsom recall and the politics of public health

Good afternoon, readers.

Let me start off by saying this essay isn’t meant to be an overtly political space. But the reality is you just can’t have conversations about public health campaigns and medical policy without touching on partisan politics. The organizing values revealed by what we choose to prioritize in our collective health care decisions, and the best ways to realize those values, are issues stubbornly handcuffed to the stuffier business of data-driven science and academic debate, especially during a COVID pandemic that has sharply split the American people along ideological lines.

To that end, let’s talk about what happened in California earlier this week. The Golden State GOP failed spectacularly in its effort to recall Democratic Gov. Gavin Newsom, with Newsom not just surviving the ouster attempt but blowing it to smithereens in a 64% to 36% runaway victory against the recall with about three-quarters of votes tallied so far. Californians clearly didn’t think this was a choice moment to rock the administrative apple cart, and if you believe the Newsom team, the governor’s approach to handling the pandemic in the nation’s most populous state was central to that electoral calculus.

The New York Times has an excellent explication of what led to Tuesday’s moment, chronicling the shifting contours of the pandemic in California. What stands out is how, despite some personal and political brouhahas such as ignoring his own public safety advice in the outbreak’s early days, Californians have largely approved of Newsom’s handling of the pandemic, with about 60% of voters approving of his COVID-19 response. That’s led both the Newsom team and some political analysts to dub Tuesday’s election a “COVID referendum.” So what is it that helped Newsom win in that regard?

Part of it obviously has to do with the rank partisanship which has seeped into nearly every facet of the COVID pandemic response, with supporters of former President Donald Trump and many Republicans skeptical of or openly hostile toward lockdowns, masking mandates and vaccine requirements at indoor venues, and other measures nearly all prominent public health officials agree are necessary to contain the coronavirus. The nonprofit Kaiser Family Foundation (KFF) has been keeping tabs on this deepening red/blue public health divide: “As of September 13, 2021, 52.8% of people in counties that voted for Biden were fully vaccinated compared to 39.9% of Trump counties, a 12.9 percentage point difference. While the rate of vaccination coverage has slowed in both county groups, the gap has widened over time,” KFF wrote in a brief this week.

But Democrats vastly outnumber Republicans in California and Newsom has hewed to the advice of public health experts. The resulting, and compared with many other parts of the U.S robust, effect of those measures appears to have won the confidence of voters over time despite initial opposition to lockdowns when the electorate couldn’t see the fruits of the public health campaign manifest. That’s changed significantly since the spring, with COVID hospitalizations in California falling over the weeks leading up to the recall election, despite the continued threat of the Delta variant. In fact, the state is doing significantly better on that front compared to the national average.

All this is to say the California recall may have been the first such test of its kind, with public health and the coronavirus on the ballot right alongside Newsom and his political foes. Would it have played out the same way in a state with a far more Republican tilt? That’s a bit more of an open-ended “what if.”

Finally, I’d like to share an update with all of our amazing and dedicated Capsule readers (especially those of you who were around when we were still Brainstorm Health Daily after our launch five years ago). Next week will be my last at Fortune before moving on to a new endeavor. As such, I won’t be penning this newsletter after my final missive next Thursday, but suffice to say you’ll be left in more than capable hands. More to say on that, and some final thoughts, next week. In the meantime, read on for the day’s news.

Sy Mukherjee
sy.mukherjee@fortune.com
@the_sy_guy

DIGITAL HEALTH

Contact lenses for our screen-addicted eyes. A new era of contact lenses is set to tackle a very 21st century problem: How to deal with eyes that are constantly glued to screens. Quartz reports that eye care companies such as CooperVision are addressing this challenge and the underlying science necessary to adjust to the modern eye. For instance, people who look at screens for long periods of time tend to blink less frequently or only semi-blink in order to pay attention to their devices, which consequently reduces the amount of moisture in your eyes. (Quartz)

INDICATIONS

COVID vaccines for kids. The COVID immunization campaign has a pretty significant void left to fill: The nearly 50 million children in the U.S. who still don't qualify for a vaccine. As I lay out in this chronicling of when to expect at least a slice of those kids, aged 5-to-11, to be able to get a jab, vaccine availability may be just around the corner. Pfizer earlier this week provided more details on its COVID shots for children, including a potential filing for FDA emergency authorization by early October. That would mean that the first tranche of COVID vaccines for children could be available by Halloween, as former FDA chief and Pfizer board member Scott Gottlieb has predicted, with cascading studies opening up the shots to younger and young people. More on the nuances and special considerations for children's vaccines here. (Fortune)

The booster reckoning cometh. Speaking of COVID vaccines, a major FDA meeting is set for their future on Friday. A panel of experts which advises the FDA will discuss whether or not Pfizer's application for expanded use of its vaccine as a third booster dose passes the data smell test. And there's significant skepticism that's been telegraphed in documents released leading up to the meeting. That's not to say more limited use of boosters will be the ultimate conclusion reached by the FDA advisers (and the agency could overrule their advice if it wants to), but experts have pointed to ongoing real-world and clinical data showing the vaccines remain effective in preventing hospitalizations and deaths even without an imminent third dose of Pfizer or Moderna (Johnson & Johnson's one-shot variety is a whole different story). That may not be true in all cases, but it could very well be for most of the population. We'll know more soon enough.

THE BIG PICTURE

Intermountain Healthcare to merge with Colorado's SCL Health. The sprawling Intermountain Healthcare not-for-profit health system is joining forces with Colorado's faith-based (and similarly nonprofit) SCL Health, which has a $2.8 billion medical infrastructure across the state. The two systems have plenty of overlap in the communities they serve, which explains the rationale behind a deal that adds eight more hospitals and 160 doctors' clinics into the Intermountain fold. "SCL Health and Intermountain are pursuing our merger from positions of strength," said Lydia Jumonville, president and CEO of SCL Health. "We are two individually strong health systems that are seeking to increase care quality, accessibility and affordability. We will advance our missions and better serve the entire region together." (DesertNews)