May 26, 2020

Axios Vitals

Good morning. I hope you had a nice Memorial Day Weekend. My sister took the opportunity to remind me of the time when, after learning about germs in elementary school, I would listen outside of the bathroom to ensure my family members were all washing their hands.

  • So you can rest assured, dear Vitals readers, that my hand hygiene during these trying times has been impeccable.

Axios will host a live virtual event on the impact of the coronavirus on seniors in long-term care facilities. Join Axios co-founder Mike Allen Thursday, May 28, at 12:30pm ET for a discussion featuring Sen. Robert Casey, Jr. (D-Pa.) and Sen. Bill Cassidy (R-La.) 

Today's word count is 1,262, or a 5-minute read.

1 big thing: The coronavirus is making caring for seniors even harder

Illustration: Aïda Amer/Axios

Caring for older adults was already expensive, emotionally taxing and logistically difficult — and the coronavirus is only making it worse, Axios' Bob Herman reports.

Why it matters: People older than 65 have the highest risk of dying from the virus, and outbreaks have been rampant in long-term care facilities.

The big picture: Most seniors will need at least some long-term care, but the coronavirus has added even more complications to the tough decisions about how to obtain it.

  • Assisted-living and independent-living facilities cost an average of at least $4,000 a month, almost always paid out of pocket.
  • Nursing homes are generally more affordable, but people often have to burn through their savings, pensions and other assets on their way there.
  • Nursing homes also are cramped, understaffed and have poor track records with infection control to begin with — and they've been hotbeds for the spread of the coronavirus.
  • Home care is another option. If a professional worker isn't available, the task often depends on the charity of a friend or relative, and that's a dicier proposition when those friends or relatives could be carrying the virus — or unemployed, caring for children or otherwise just not able to help.

Where it stands: The pandemic has severely hindered operations across the industry.

  • And controlling outbreaks depends on facilities stocking up equipment for employees and conducting widespread testing — things the industry hasn't exactly been heralded for.

Between the lines: Seniors who want to avoid the virus-related risks could try to stay and get care at their homes, which more people have done in recent years. Adult children also may try to move their parents closer to their homes.

  • "But not all parents want to do that," said Toby Edelman, a senior policy attorney with the Center for Medicare Advocacy.
2. The final data for remdesivir is in

Remdesivir, officially branded as Veklury, does indeed work for patients hospitalized with COVID-19, according to expert reads of the data that were published in the New England Journal of Medicine.

Yes, but: The benefits remain rather limited, allowing patients to leave the hospital in 11 days vs. 15 days, Bob writes.

  • Remdesivir appeared to have no effect for the sickest patients who were on a ventilator or an ECMO machine.
  • The drug also did not lead to a statistically significant drop in deaths, just as the early readout suggested.

The bottom line: "These preliminary findings support the use of remdesivir for patients who are hospitalized with COVID-19 and require supplemental oxygen therapy," researchers wrote. "However, given high mortality despite the use of remdesivir, it is clear that treatment with an antiviral drug alone is not likely to be sufficient."

Our thought bubble, via Bob: Releasing highly anticipated data late on a Friday heading into a holiday weekend — even one that is hindered by quarantine — isn't quite the thing to do if you're really excited about something.

Go deeper: All eyes now fall on Gilead's price

3. The latest in the U.S.
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Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios. This graphic includes "probable deaths" that New York City began reporting on April 14.

Authorities urged Americans to maintain social distancing and wear masks to protect against the spread of the novel coronavirus amid reports of packed beaches and bars during the Memorial Day weekend.

The White House announced that beginning at 11:59pm ET on Thursday, President Trump would suspend entry of non-U.S. citizens who have been in Brazil in the past 14 days, in an effort to stop the imported spread of the coronavirus.

Charitable organizations around the U.S. are launching funds or redirecting their everyday efforts to address the needs of people affected by the coronavirus shutdown, Axios' Fadel Allassan reports.

The spread of the coronavirus has not slowed in 24 states, according to a new model by Imperial College London that forecasts infection spikes as more people travel and leave their homes in the coming weeks.

Lufthansa and Virgin Atlantic are among the many airlines opting to transition to hauling cargo — sometimes in empty passenger cabins — after the coronavirus pandemic gutted demand, the New York Times reports.

The coronavirus pandemic has pushed many people to buy groceries and supplies in bulk, but nearly 23.5 million Americans who live far from supermarkets don't have that option, Axios' Rashaan Ayesh writes.

White House coronavirus task force coordinator Deborah Birx said on ABC's "This Week" Sunday that social distancing is "absolutely critical" and that if Americans can't maintain at least six feet from other people while gathering outside, they "must wear a mask."

The FDA blocked 29 manufacturers, many of which are based in China, from selling coronavirus antibody tests in the U.S. on Friday.

A former employee at Florida's Health Department says that a top official told her to "manipulate" data to encourage public support for the state's reopening plan in rural counties, the Tampa Bay Times reports.

4. The latest worldwide
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Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Axios Visuals

The Italian government reported 300 new cases of the coronavirus on Monday, the lowest daily increase since Feb. 29.

Coronavirus testing is barely scratching the surface in much of the developing world, Axios' Dave Lawler reports.

Dominic Cummings, the top aide to British Prime Minister Boris Johnson, defended himself at a press conference Monday against allegations that he broke the U.K.'s coronavirus lockdown rules by traveling to his parents' home last month while exhibiting symptoms.

A 77-year-old woman with underlying health conditions has died from the coronavirus in Gaza, health authorities announced Saturday, per the New York Times.

Vox, the far-right party in Spain, protested the government's handling of the novel coronavirus in droves on Saturday. The protesters called for Prime Minister Pedro Sánchez to resign, per the New York Times.

5. WHO suspends hydroxychloroquine trial

The World Health Organization is temporarily pausing tests of the anti-malarial drug hydroxychloroquine as a coronavirus treatment in order to review safety concerns, the agency's director-general Tedros Adhanom Ghebreyesus said Monday.

Why it matters: The decision comes after a retrospective review published in The Lancet found that coronavirus patients who took hydroxychloroquine, or its related drug chloroquine, were more likely to die or develop an irregular heart rhythm that can lead to sudden cardiac death, compared to those who did nothing, my Axios colleagues write.

  • The medical journal's review consisted of 96,000 hospitalized patients diagnosed with the coronavirus in six continents, the largest analysis of medical records on the drug, between Dec. 20, 2019, and April 14, 2020.
  • Tedros said that an independent executive panel "agreed to review a comprehensive analysis and critical appraisal of all evidence available globally" regarding hydroxychloroquine in order to determine whether it should continue to be used in WHO's Solidarity Trial, a global effort to test experimental coronavirus treatments.

The big picture: President Trump has touted the drug as a potential “game-changer" and revealed last week that he had been taking it as a preventative against the coronavirus after consulting with the White House doctor.

  • This came even after the FDA warned that the unproven drug should only be taken in hospitals because of the risk of heart complications.
6. Employers navigate coronavirus testing

Many major employers are attempting to test their workers for the coronavirus in order to make returning to work safer, but the logistics of doing so are tricky, the Wall Street Journal reports.

The big picture: Widespread diagnostic testing is the only way to catch coronavirus cases before they become outbreaks, including in the workplace.

  • But the tests are expensive, results can take up to 72 hours, and the testing measures raise questions about worker privacy.

Between the lines: Companies are trying to figure out how often and who to test. Businesses that remained open over the last few months focused on symptomatic workers, but more companies now plan to test asymptomatic workers.

  • The lag time between when a worker takes a test and when the results come back is also difficult to navigate, as employees who don't know they're infected could easily spread the virus while awaiting their results.
  • Rapid diagnostic testing devices are generally not yet available to employers, as priority is being given to the health care system.

The bottom line: Until there's a vaccine for the coronavirus, going to work is going to remain a high-risk activity for most people. It's in both workers' and employers' best interest to mitigate that risk as much as possible.