Axios Vitals

A briefcase with a red cross on the front.

June 22, 2020

Good morning. I'll be filling in for most of this week while Caitlin takes some time off.

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Today's Smart Brevity count: 846 words, or a 3-minute read.

1 big thing: Deaths aren't spiking — yet

Data: The COVID Tracking Project; Chart: Naema Ahmed/Axios
Data: The COVID Tracking Project; Chart: Naema Ahmed/Axios

The number of coronavirus cases in the U.S. is on the rise again, but the number of daily deaths is still dropping from the mid-April peak.

Between the lines: This is likely in part because younger people, for now, are accounting for a larger share of new infections, Caitlin reports.

What they're saying: The falling number of new deaths are "among other things a reflection of improvements in medical care, and more diagnosed cases occurring in milder disease and younger patients as older individuals protect themselves better," former FDA commissioner Scott Gottlieb recently tweeted.

Yes, but: Young people don't exist in social silos; they visit older family members and interact with older or sicker coworkers. That means that as these more vulnerable groups get the virus, the death rate may shoot back up.

  • "The death rate always lags several weeks behind the infection rate," top infectious disease expert Anthony Fauci told Caitlin.
  • The high number of cases in young people is "not surprising," Fauci added, as younger people are more likely to engage in riskier behaviors right now. "They get infected first, then they come home, and then they infect the older people. The older people get the complications, and then they go to the hospitals."

Details: Officials in southern states are becoming alarmed about the number of cases in young adults, the New York Times reports. Outbreaks in these states are being tied to bars and frat parties.

2. Pandemic "patient dumping" at nursing homes

Illustration of a pattern of rocking chairs, with one emanating a bright color.

Illustration: Aïda Amer/Axios

Well, this one will make you mad: As the coronavirus pandemic rages on, nursing homes have been ramping up their practice of evicting the poorest residents — often without helping them find a safe place to go, the New York Times reports.

The big picture: "Patient dumping" has long been an issue in nursing homes, and the pandemic has turned up the volume. The facilities can now get a $600 per day bonus for taking in coronavirus patients, which strengthens the financial incentive to boot less-profitable residents.

  • And since the coronavirus has frozen visitation, it's also easier to get away with right now.

Details: Nursing homes are often evicting residents who are on Medicaid into homeless shelters or other potentially unsafe conditions, in many cases without giving the advance notice required by law, per NYT.

  • Some of those evicted patients then don't have anyone to help them recover from surgery, manage their medications or otherwise take on the tasks that a nursing home is supposed to perform.
  • The Times documents one dementia patient who was evicted into an unlicensed boarding house, only to wander away and end up on the streets.

The other side: Nursing homes denied evicting residents in order to secure higher reimbursements, including from coronavirus patients.

3. Bad signs from around the world

Protesters in Brazil wearing masks to protect themselves from the coronavirus

Protesters in Brazil wearing masks to protect themselves from the coronavirus. Photo: ndressa Anholete/Getty Images

Sunday set a record — the biggest-single day increase in new cases worldwide, according to the World Health Organization.

  • More than 183,000 cases were reported in just 24 hours. Brazil was the biggest contributor to that surge, with almost 55,000 new cases, followed by the U.S. with roughly 37,000, per AP.

And in Germany, which has so far been considered a relative success story, the virus seems to be getting more infectious, Reuters reports.

  • The country had been seeing a reproduction rate hovering around 1 — meaning that each infected person was likely to infect one other person. But that number spiked to 2.88 over the past week, per Reuters.

Why it matters: When there's coronavirus anywhere, there's coronavirus everywhere. The world does not have this under control, and the U.S. does not have this under control.

4. The highest-risk workers

Illustration of gloved hand holding briefcase

Illustration: Eniola Odetunde/Axios

An estimated 25–30 million people are caught in the middle of the coronavirus economy — they're unable to work from home but also face a high risk of severe infection.

Why it matters: The impossible choice between lives and livelihoods falls mainly to lower-wage workers in service industries, Kaiser Family Foundation president Drew Altman writes in his latest column.

By the numbers: According to Bureau of Labor Statistics data published before the pandemic hit, slightly more than two-thirds of American workers cannot work virtually.

  • There are 38 million workers who are at risk of severe illness due to COVID-19 because of underlying health conditions.
  • Another 12 million high-risk adults are not working, but live with someone who is.
  • That means roughly 25 to 30 million high risk workers cannot work virtually.
  • The number may be an under-estimate because pre-existing conditions are more prevalent among lower-income people, who are less likely to be able to work at home.

Between the lines: If you work for any number of public-facing small businesses, your boss will need you back at work for the business to function, but interaction with customers will likely increase your risk of infection.

  • Many of these same workers also will rely on public transportation to get to work.

What's next: The Trump administration is considering a back-to-work bonus, which could put more money in vulnerable workers’ pockets while also making them feel more pressure to return to work as soon as possible,

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5. Catch up quick

Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios.
Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios.
  • Johns Hopkins' Tom Inglesby said on Fox News that states experiencing big case spikes need to "use the tools that we know work," but don't need to go back into lockdown.
  • White House aides said President Trump was joking when he said during his rally Saturday night that he had asked U.S. officials to slow down coronavirus testing.
  • China suspended imports from a U.S. meatpacking plant because of a coronavirus outbreak (NPR).