President Joe Biden wearing a mask. Photo: Flickr / Department of Defense

The new vaccine rules.

Plus, a question about Ivermectin.
Isaac Saul Sep 13, 2021
I’m Isaac Saul, and this is Tangle: an independent, ad-free, subscriber-supported politics newsletter that summarizes the best arguments from across the political spectrum — then “my take.”

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Today’s read: 12 minutes.

We’re covering the Biden administration’s new vaccine rules and answering a reader question about a potential Covid-19 treatment.

President Joe Biden wearing a mask. Photo: Flickr / Department of Defense

Podcast launch!

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Quick hits.

  1. House Democrats are expected to propose raising the corporate tax rate from 21 percent to 26.5 percent, and a 3-percentage point surtax on individual income above $5 million. (The plan)
  2. The FBI released a newly declassified document on its investigation into the 9/11 attacks detailing contacts between the hijackers and several Saudi officials. (The release)
  3. Sen. Joe Manchin (D-WV) once again said he won’t vote for Biden’s $3.5 trillion spending plan in its current form, proposing the cost be slashed by $2 trillion. (The nix)
  4. Secretary of State Antony Blinken will testify twice before Congress this week on the withdrawal from Afghanistan. (The grilling)
  5. North Korea said it fired new long-range cruise missiles in a test over the weekend. (The test)
Our “Quick hits” section is presented in partnership with Ground News, an app and website that rates the political bias in news coverage.

Today’s topic.

Vaccine mandates. On Thursday, President Joe Biden announced a new slate of federal vaccine requirements that could impact as many as 100 million Americans. The new rules impose different mandates for both private and federal employees. All employers with more than 100 workers (which covers roughly 80 million Americans) will be required to either test their employees for the virus weekly or mandate vaccination. Employers violating the new rules could face penalties of up to $14,000 per violation. Employers must provide paid time off to employees to be vaccinated.

Meanwhile, with limited exceptions, all federal employees and contractors must be fully vaccinated, with no option to opt into weekly testing instead, which will impact about four million workers. Another 17 million health care workers in hospitals and clinics that receive Medicare or Medicaid funds reimbursements will also need to be vaccinated. The Occupational Safety and Health Administration (OSHA) will be tasked with implementing and enforcing the mandate, operating under a broad authority it was granted in the 1970s to create an emergency temporary standard to protect employees from “grave danger from exposure to substances or agents determined to be toxic or physically harmful or from new hazards.”

Biden also announced he would double federal fines for airline passengers who refuse to wear masks, send additional federal support to schools trying to reopen, and call on large entertainment venues to require vaccinations or proof of negative test for entry. The Department of Health and Human Services will also require vaccinations in head start programs and schools run by the Department of Defense and Bureau of Indian Education, impacting another 300,000 employees.

“What more is there to wait for? What more is there to see?” Biden said on Thursday. “We’ve been patient, but our patience is wearing thin.”

Two months ago, Biden declared the United States’ “independence” from Covid-19. He also said he would not issue vaccine mandates, and his administration said it was not the role of the federal government to do so. Instead, the administration spent weeks trying to compel Americans to go get the shot. But as those efforts have stalled, the rapid spread of the Delta variant has torn through the country, overwhelming some hospitals in areas with low vaccination rates. While about 75 percent — or 208 million Americans — have at least one Covid-19 vaccine dose, we’re still averaging about 1,500 Covid-19 deaths a day, the most since last winter. The CDC says 99 percent of hospital admissions are among those who are not fully vaccinated.

About 62 percent of Americans support vaccine mandates in the workplace, according to a USA Today and Ipsos poll. 83 percent of unvaccinated Americans say they do not plan to get the vaccine shots. More than 39 million Americans have been infected with Covid-19, and over 660,000 have died.

Below, we’ll take a look at some reactions from the right and left, then my take.


What the left is saying.

The left supports the mandate, arguing that this moment justifies it.

The Washington Post editorial board said the plan will “almost certainly run into logistical and legal hurdles” but is justifiable “at a time of national emergency.”

“The delta variant is running rampant, every single day, on average, taking more than 1,000 lives, putting more than 11,000 people in hospital beds and causing more than 130,000 new infections,” the board wrote. “The death toll from this pandemic now exceeds all the U.S. military combat deaths in all wars in the 20th century. It just makes no sense to go on being savaged by a virus when an effective tool to fight it is widely available and free. Every possible method should be used to reach the estimated 80 million unvaccinated eligible Americans: persuasion, incentives and, yes, coercion. The summer surge in infections may be easing, and it may take the government weeks to implement Mr. Biden’s plan. But any progress toward getting an additional 20 or 40 million Americans vaccinated will be worth the effort, as will a rollout of boosters that could substantially add to vaccine immunity.

“In his more muscular approach, Mr. Biden plans to have the Occupational Safety and Health Administration compel employers to impose the vaccine mandate on their employees,” the board added. “It is the same logic as government mandating construction workers to wear a hard hat. It is the same reasoning as public schools requiring students to be vaccinated against measles and other contagious diseases. Legally, Mr. Biden’s expansive use of executive power is sure to be challenged in the courts. In normal times, we would not want to see such power used for less pressing needs. But the emergency is real.”

In The New York Times, two ACLU lawyers argued that vaccine mandates do not violate civil liberties.

“While the permissibility of requiring vaccines for particular diseases depends on several factors, when it comes to Covid-19, all considerations point in the same direction,” they wrote. “The disease is highly transmissible, serious and often lethal; the vaccines are safe and effective; and crucially there is no equally effective alternative available to protect public health. In fact, far from compromising civil liberties, vaccine mandates actually further civil liberties. They protect the most vulnerable among us, including people with disabilities and fragile immune systems, children too young to be vaccinated and communities of color hit hard by the disease.

“While vaccine mandates are not always permissible, they rarely run afoul of civil liberties when they involve highly infectious and devastating diseases like Covid-19,” they said. “Although this disease is novel, vaccine mandates are not. Schools, health care facilities, the U.S. military and many other institutions have long required vaccination for contagious diseases like mumps and measles that pose far less risk than the coronavirus does today. (And just to be clear, no one is proposing forcible injections or criminal penalties.)… While limited exceptions are necessary, most people can be required to be vaccinated. Any vaccination mandate should have exceptions for those for whom the vaccine is medically contraindicated, such as people who have allergies to it.”

In Slate, Ben Mathis-Lilley said Biden was “going nuclear.”

“If you’re going to have to put up with the political opposition calling you the Hitler of vaccines regardless, President Joe Biden appears to have reasoned, you might as well also get the benefit of curtailing the pandemic by putting vaccine requirements in place,” Mathis-Lilley said. “The public health rationale for these requirements is strong: Only 64 percent of American adults are fully vaccinated, which has manifestly not been enough to stop COVID-19 from spreading. Biden may also have concluded, like more and more state-level Democrats, that the delta variant has made the U.S. public as a whole less interested in tolerating the danger presented by unvaccinated individuals—and that a crucial portion of that public blames Democrats for delta, despite the party’s pro-vaccine position, simply because it’s in power at the national level.”


What the right is saying.

The right opposes the mandate, saying it’s federal overreach.

The Wall Street Journal editorial board said the mandate was “overkill in a free country.”

“Many large businesses already require vaccinations or regular testing, and some have offered workers financial incentives to get inoculated. A few have been more forceful. Yet many businesses have been reluctant to mandate shots because they respect individual conscience or worry some employees will quit. Workers have been hard to hire amid the incentives Democrats have created not to work. Mr. Biden thinks that’s not his problem. Employers understandably have concerns about compliance and enforcement. Are they supposed to pay for unvaccinated workers’ weekly testing, and what kind of proof of testing or vaccination must they require? Will franchisees and corporations be liable as joint employers? Nobody knows.

“Mr. Biden may be reading polls that show vaccine mandates are popular, at least among Democrats. He promised last fall to ‘kill the virus,’ and declared victory too soon in June,” the board added. “He’s now trying to blame the virus surge on everyone else in angry, accusatory rhetoric.”

In The New York Times, Robby Soave said the mandate was a “big mistake.”

“The president’s plan is certainly well intentioned,” Soave wrote. “The vaccines are the only tried-and-true strategy for defeating Covid; government officials should both encourage vaccination and make it easier to get vaccinated,” Soave wrote in The New York Times. But forcing vaccines on a minority contingent of unwilling people is a huge error that risks shredding the social fabric of a country already being pulled apart by political tribalism.

“The president should not — and most likely does not — have the power to unilaterally compel millions of private-sector workers to get vaccinated or risk losing their jobs: Mr. Biden is presiding over a vast expansion of federal authority, one that Democrats will certainly come to regret the next time a Republican takes power,” Soave said. “Moreover, the mechanism of enforcement — a presidential decree smuggled into law by the Department of Labor and its Occupational Safety and Health Administration — is fundamentally undemocratic. Congress is supposed to make new laws, not an unaccountable bureaucratic agency.”

In The New York Post, John Podhoretz said Biden’s announcement was “bizarrely incoherent.”

“He told the American people without qualification that fully vaccinated people are at incredibly low risk: ‘Only 1 out of every 160,000 fully vaccinated Americans was hospitalized for COVID per day.’ Then he promised to shield them against the evil people who are threatening their very lives: ‘We’re going to protect the vaccinated from unvaccinated co-workers.’ But Joe, you just said the vaccinated were already protected!” Podhoretz wrote. “The danger in what Biden himself called an ‘epidemic of the unvaccinated’ is to the unvaccinated. That is what all the data show. Ninety-nine percent of the hospitalizations and more than 99 percent of the deaths from the Delta variant are among the unvaccinated.

“What’s happening with the Delta variant is terrible, and Biden spent a lot of the speech importuning the unvaccinated to get the shot,” Podhoretz added. “They should. If they don’t, they’re incredibly stupid, and yes, this means you. But it’s not a crime to be stupid, or to be a foolish parent. People do self-destructive things all the time.”


My take.

At the end of July, I wrote about vaccine mandates and conceded that I wasn’t really sure where I landed. I also said that a vaccine mandate “will not (and shouldn’t) come from the federal government.” That presumption, based largely on the Biden administration’s own professed belief that a mandate from the government wouldn’t be that helpful, was apparently wrong.

There are two separate questions here that I think should be addressed. The first is whether the vaccine mandate will be “good” for the public at large. The second is whether the federal government does or should have the authority to do what Biden is doing.

To the first question, my answer is yes. The data on vaccination protecting Americans from serious illness is by now incontrovertible. While Biden’s convoluted argument that vaccines keep us safe and that the unvaccinated are endangering the vaccinated might spin heads, it’s also ridiculous to presume that people remaining unvaccinated only impacts them. Even if outbreaks of Covid-19 aren’t going to kill the vaccinated, they can overwhelm hospitals, shut down schools, cost the public massive amounts of money, endanger people who (for whatever reason) can’t get vaccinated, and impose all sorts of other serious burdens on the public at large.

At the very least, Biden’s announcement is probably going to spur some employers to move swiftly to avoid punishment, and hopefully we’ll see a bump in vaccination rates — which is a win. I would have preferred the Biden administration to also address the millions of Americans who have already had Covid-19, and thus have natural immunity, but the more we understand this virus the more it looks like vaccination plus natural immunity is about the best protection you can have. So, even for the millions who have gotten Covid-19, getting vaccinated is still a very good idea that is going to make you and the people around you safer.

The second question is a lot more complicated. A lot of people magically became experts in the 1905 Supreme Court decision in Jacobson v. Massachusetts overnight, in which the court ruled against a man named Henning Jacobson who wanted to refuse vaccination for smallpox. Effectively, the court told Jacobson that one man’s liberty cannot deprive his neighbors of their liberties, too.

But the legal terms of that debate were different. For starters, Jacobson was fighting a law, while Biden has enacted an executive order without any Congressional authority. The real question is whether OSHA has the authority to punish private businesses using its emergency temporary standard powers, a prospect that looks much less certain. Under the same authority, OSHA has struggled to regulate even asbestos or Benzene, which makes me skeptical it will be able to collect $14,000 fines from companies for dodging a vaccine mandate. This order will also be coming before a federal court system — including SCOTUS — that has a clear ideological lean and may be much less receptive than the courts we had over 100 years ago.

It’s also true, though, that describing this simply as a “vaccine mandate” or some kind of authoritarian takeover is overkill of its own. For the vast majority of Americans, there is still going to be a choice, though it’s binary: get tested regularly and repeatedly, or get vaccinated. Rapid and frequent testing seems like it could be a less burdensome and better mitigation strategy to me than mask mandates and social distancing, and I’m glad to see that as an option here. Getting tested won’t prevent you from getting Covid-19, though, so if you’re refusing the vaccine it’s the least you can do. Simply put, a lot of people seem to be refusing to get tested regularly, won’t get vaccinated, won’t wear masks and won’t social distance, at which point I really don’t know where to meet you.

The real burden of all this will fall onto the employers who, while now being able to say that it’s not their mandate, will still have to navigate a giant logistical hurdle, but until OSHA writes and releases its rule we won’t have clarity on what exactly that burden is. For now, I’m both hopeful that this encourages more vaccination and skeptical that the Biden administration can enforce this mandate without overstepping its authority.


Your questions, answered.

Q: What is going on with Ivermectin? How did this become such a thing on the right? And is it actually a thing? Or is the left media blowing it out of proportion?

— Greg D, Boston, Massachusetts

Tangle: For those of you who don’t know, Ivermectin is the latest drug to be heralded as a miracle treatment (and perhaps even preventative measure) for Covid-19. It’s mostly been in the headlines because the animal version of the drug, which is an anti-parasitic, can be bought over-the-counter and some people actually appear to be taking it to treat themselves (or in an attempt to prevent Covid-19 without getting the vaccine).

The CDC and FDA have both advised against using the drug for Covid-19. The National Institutes of Health (NIH) has said there is not enough evidence for or against it yet.

So, a few things: no, I don’t think that many people are using Ivermectin, though it’s impossible to know for sure. It’s also unfair to pretend the drug is only a horse medication. It is, yes. But the human version won a Nobel Prize in 2015 for success in treating parasitic diseases. It’s very safe if it’s prescribed by your doctor, and it is being used experimentally in Latin America and some places in Europe to treat Covid-19.

That being said, we need more info. One of the most popular studies touting Ivermectin was retracted for glaring discrepancies in the data and ethical concerns regarding plagiarism. We have very little in the way of peer-reviewed medical research on its efficacy against Covid-19. Long story short: Ivermectin hasn’t aced a trial in humans, so if your hesitancy about the vaccine is that it’s “unproven”, it’d be a bizarre contradiction to go take a drug that is literally unproven. That being said, it looks like some better data is on the way, and I’m hopeful the results are promising. The more cheap, widely available and safe drugs to treat Covid-19 the better. Just don’t take advice from a politics newsletter — ask your doctor.

Want to ask a question? Simply reply to this email and write in or fill out this form.


A story that matters.

College students are using a lot more cannabis and a lot less booze, according to a new study. The “Monitoring the Future” study, funded by the National Institute on Drug Abuse (NIDA), has been tracking drug and alcohol use among 19-22 year olds since 1980. 44 percent of college students reported using cannabis in 2020, an increase from 28 percent in 2015. Daily or near daily use rose from 5 percent to 8 percent. At the same time, alcohol use dropped from 62 percent in 2019 to 56 percent, with the percentage reporting that they had been drunk in the last month dropping from 35 percent to 28 percent. Binge drinking also dropped markedly. The Washington Post has the story.


Numbers.

  • 64%. The estimated percentage of hospital staff who have been vaccinated at facilities that receive Medicare or Medicaid reimbursement.
  • 75 days. The amount of time federal workers have to get themselves vaccinated.
  • 97,666. The number of Americans hospitalized with Covid-19 on Saturday.
  • 11 times. How much more likely people unvaccinated from Covid-19 are to die from the virus than those who are vaccinated.
  • 10,000. The number of pharmacies in America that will offer free testing under Biden’s new Covid-19 plan.

Thank you.

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Have a nice day.

Researchers in Arkansas believe they have found the cause of long-haul Covid-19 symptoms. The University of Arkansas for Medical Sciences (UAMS) team believes an antibody that appears weeks after the initial infection “attacks and disrupts a key regulator of the immune system.” Around 30 percent of patients with the virus deal with lingering symptoms like fatigue and shortness of breath, and if their hypothesis is correct the researchers believe they can develop effective treatments for so-called long-haulers. “If our next steps confirm that this antibody is the cause of long COVID symptoms, there are medications that should work to treat them,” John Arthur, M.D., Ph.D., professor and chief of the Division of Nephrology at UAMS said. “If we get to that phase of research, the next step would be to test these drugs and hopefully relieve people of the symptoms they're having.” (The good news)

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Isaac Saul

I'm a politics reporter who grew up in Buck County, PA — one of the most politically divisive counties in America. I'm trying to fix the way we consume political news.

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