Mar 25, 2020

Axios Vitals

Good morning.

Today's word count is 1,456, or a 5-minute read.

1 big thing: We keep underestimating the coronavirus

Illustration: Eniola Odetunde/Axios

The U.S. keeps reacting too late to the novel coronavirus, prolonging its economic pain and multiplying its toll on Americans' health.

Why it matters: The spread and impact of the coronavirus may be unfathomable, but it's not unpredictable. And yet the U.S. has failed to respond accordingly over and over again.

First, it happened with testing — a delay that allowed the virus to spread undetected.

  • Then we were caught flat-footed by the surge in demand for medical supplies in emerging hotspots.
  • And the Trump administration declined to issue a national shelter-in-place order. The resulting patchwork across the country left enough economic hubs closed to crash the economy, but enough places up and running to allow the virus to continue to spread rampantly.

Between the lines: Proactive containment and mitigation steps would have required extraordinary political and economic capital, especially if they had come early in the process, when many Americans didn't grasp the full weight of this challenge.

  • But making decisions based on today's information — without an understanding of how much worse tomorrow will be — is also politically and economically risky, and carries the extra cost of more deaths.

Now, even as testing and hospital capacity remain limited, President Trump is eager for an economic recovery — even though, by all estimates, the outbreak is only going to get worse.

The bottom line: When I asked one senior Health and Human Services official how all of this keeps happening, the official said it's at least partially due to disconnects — between Trump and his administration; between the government and the private sector, and between the U.S. and the rest of the world.

  • "At the end of the day, the virus has slipped through all those cracks that exist between all of these entities," the official said.
2. America's Wuhan: New York

Illustration: Eniola Odetunde/Axios

New York's fight against the coronavirus is also the nation's fight, as the state — and the city in particular — emerges as ground zero for the disease, with "astronomical numbers" of cases, to quote Gov. Andrew Cuomo.

Why it matters: The Empire State has 5% of the world's COVID-19 cases and about 50% of the nation's. Its success — or failure — in fighting the virus, safeguarding citizens and treating the afflicted will tell us a lot about what can succeed in the rest of the U.S., Axios' Jennifer Kingson reports.

  • It's a national travel hub, so it will likely be the catalyst of many outbreaks elsewhere.

Cuomo is treating New York like an American Wuhan, trying to shut it down and stop the spread.

  • Unlike Wuhan, there is no spinning the reality — he is using his public mic as a blunt instrument to crush any happy talk about quick ends or easy fixes.

By the numbers: New York has 25,000 cases of the novel coronavirus, vs. 2,800 in California, 2,200 in Washington state and 1,200 in Florida, Cuomo said.

  • The apex of the epidemic in New York isn't expected for 14 to 21 days.

"What happens in New York, we can expect to see in other cities around the world, but maybe not at the same scale," Denis Nash, an epidemiologist at City University of New York's school of public health, told Axios.

Go deeper.

3. The latest in the U.S.
Expand chart
Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios

President Trump said at a Fox News town hall Tuesday that he would "love" to have the country "opened up, and just raring to go" by Easter, or April 12, despite warnings from public health officials that easing social distancing restrictions too soon could cause the number of coronavirus cases to skyrocket.

  • Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, then said at a coronavirus briefing Tuesday evening that President Trump's target date of Easter to ease social distancing is "really very flexible."
  • 2020 Democratic front-runner Joe Biden harshly criticized the idea of lifting restrictions by Easter, saying on CNN that the president should "stop talking and start listening to the medical experts."

New York City Mayor Bill de Blasio told a news conference Tuesday he plans to release from Rikers Island some 300 nonviolent inmates who are over 70 years old as a measure against the novel coronavirus pandemic.

The USS Theodore Roosevelt reported three cases of sailors contracting COVID-19 Tuesday, Navy officials said at a briefing — marking the first U.S. sailors to test positive aboard a Navy ship while at sea.

A minor died from the novel coronavirus in Los Angeles County, California, the county's health department said Tuesday, although it later said that "there may be an alternate explanation" for the death of a California teenager whose "early tests indicated a positive result for COVID-19."

The trade groups representing hospitals, doctors and nurses called on the public today to stay at home to slow the spread of the new coronavirus.

Up to 5,000 students will be allowed to return to Liberty University's campus this week, as the Lynchburg, Virginia, college bucks the national trend of school closures.

4. The latest worldwide
Data: The Center for Systems Science and Engineering at Johns Hopkins, the CDC, and China's Health Ministry. Note: China numbers are for the mainland only and U.S. numbers include repatriated citizens and confirmed plus presumptive cases from the CDC.

More than 740 new deaths from the coronavirus were reported in Italy over the course of nine hours on Tuesday.

India's Prime Minister Narendra Modi announced on Tuesday that the entire country will be locked down for three weeks beginning at midnight in an effort to stop the spread of the coronavirus.

Despite their proximity to China, Hong Kong and Singapore have managed to keep COVID-19 infections and death extraordinarily low.

  • But the single most important factor may be something the U.S. can't replicate: the experience of the SARS outbreak in 2003, Axios' Bryan Walsh reports.

The Chinese Communist Party has spent the past week publicly pushing conspiracy theories intended to cast doubt on the origins of the coronavirus, and thus deflect criticism over China's early mishandling of the epidemic.

  • The strategy is a clear departure from Beijing's previous disinformation tactics and signals its increasingly aggressive approach to managing its image internationally, Axios' Bethany Allen-Ebrahimian reports.
5. America's incomplete coronavirus shutdown
Data: Axios reporting; Map: Danielle Alberti/Axios

If President Trump follows through on his statements that he wants to "open" the U.S. up again, an already patchwork shield of state "stay at home" orders could look like even more of a patchwork, Axios' David Nather reports.

The big picture: Just 17 states have ordered people to stay at home, and most of those are states with Democratic governors. Only Ohio, Indiana, Massachusetts and West Virginia have Republican governors.

  • If Trump declares it's time to start getting back to normal, those GOP governors could face pressure to start easing their own social restrictions, too.
  • That doesn't mean they'll do it, but the political pressure will intensify every time Trump talks about the importance of restarting the economy. And it could become even less likely that other Republican governors will impose stay-at-home orders of their own.

Between the lines: Some Republican governors, like Greg Abbott of Texas, have resisted calls to issue statewide stay-at-home orders, leaving it to cities and counties to issue their own restrictions.

  • Not all Democratic governors have ordered statewide restrictions, either. Pennsylvania Gov. Tom Wolf, for example, issued a stay-at-home order for people in the hardest-hit areas, but not for the whole state.
  • There are 26 Republican governors and 24 Democratic governors — and seven Republicans are up for re-election, compared to four Democrats.

The bottom line: The "mitigation strategy" of social distancing urged by health experts has been uneven throughout the U.S. — and it's likely to get more uneven.

6. The race to develop a coronavirus treatment

Scientists around the world have started dozens of clinical trials, on more than 100 drugs, in the hunt to find a product that could attack the new coronavirus. More data will be coming soon, Axios' Bob Herman reports.

The big picture: Expectations need to be tempered. A vaccine is likely a long way off, and failures are inevitable. But some experimental treatments, while they still require more research, are showing promise.

Where it stands: There are more than 100 coronavirus drugs and vaccines in development worldwide, according to Umer Raffat, an analyst at Evercore ISI who has been tracking progress. 

  • The coronavirus has become the pharmaceutical world's top priority, but safety and efficacy haven't been proven anywhere yet.

Read about the drugs that are worth paying particular attention to.

7. American manufacturing vs. the coronavirus

Illustration: Aïda Amer/Axios

America's new goalpost: Build tens of thousands of ventilators and assemble and reuse billions of face masks in the next few weeks to ward off some of the worst-case scenarios from the coronavirus pandemic, Axios' Joann Muller, Bob Herman and Erica Pandey report.

Why it matters: We need to give medical professionals, first responders and essential personnel (like grocery store staff) every possible tool to treat the ill and avoid getting sick.

The first wave of need is right now: New York has 7,000 ventilators and needs 30,000 — and America's essential personnel need an estimated 3.5 billion N95 masks.

  • Gov. Andrew Cuomo has been pleading with the Trump administration for help. He is asking it to either use the Defense Production Act for ventilator production or to tap the federal stockpile to provide 20,000 machines. Vice President Mike Pence said today that 4,000 more are on the way.
  • Cuomo says he needs the ventilator stockpile during the next few weeks, then promises he'll pass them to other parts of the country as their own outbreaks peak.

The second wave is coming fast: As outbreaks grow in other states, manufacturers will be needed to dramatically expand the national capacity.