Jun 4, 2020

Axios Vitals

Good morning.

Today's word count is 864, or a 3-minute read.

1 big thing: Coronavirus cases spike in Arizona, Oregon and Texas
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Data: The COVID Tracking Project, state health departments; Map: Andrew Witherspoon, Sara Wise, Naema Ahmed/Axios

Texas, Arizona and Oregon saw significant spikes last week in new coronavirus infections, while cases also continued to climb in a handful of states where steady increases have become the norm, Axios' Andrew Witherspoon and Sam Baker report.

Why it matters: Nationwide, new cases have plateaued over the past week. To get through this crisis and safely continue getting back out into the world, we need them to go down — a lot.

Between the lines: Improved testing can cause the number of confirmed cases in a particular state to rise, even if that state's outbreak isn't getting that much worse.

  • At least in Texas, however, the spike in recorded cases does seem to reflect an actual increase in new infections — not just better testing.
  • Testing in Texas increased by 36% over the past week, while the number of confirmed infections rose by 51%.
  • Texas also saw an increase in the percentage of all coronavirus tests that came back positive. In a state where testing is improving and the underlying outbreak isn't getting worse, you'd expect the share of positive tests to go down.

The big picture: Axios is tracking each state's caseload week by week, using a seven-day average. The disparities between states, and these sudden spikes in places that had been making progress, underline just how tentative the country's progress against the virus has been.

2. Where the CDC went wrong

The Centers for Disease Control and Prevention mishandled the novel coronavirus pandemic, sowing mistrust among health experts and the public, according to a sweeping report by the New York Times.

Why it matters: It's been reported that a faster and more organized response from the federal government could have saved thousands of lives, Axios' Marisa Fernandez writes.

The big picture: The Times' review of thousands of emails, in addition to interviews with more than 100 state and federal officials, public health experts, CDC employees and medical workers, paint a picture of confusion and mistakes.

What went wrong, according to the NYT:

  • Bad data: The agency's outdated systems collected inaccurate testing data and incomplete demographic information.
  • Staffing: The CDC's Division of Viral Diseases wasn't at full strength.
  • Political pressure: CDC director Robert Redfield had to juggle varying demands and wishes from President Trump, who has lashed out at the agency.
  • Unclear guidance: CDC's guidelines have left elected officials and the public confused about the reopening process, in part because of caveats and changes designed to appease the White House.
3. Catch up on the latest
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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.

The Senate unanimously passed a bill on Wednesday to loosen some of the rules that small businesses must follow when applying for Paycheck Protection Program loans.

Hydroxychloroquine, a drug that treats malaria and lupus, did not prevent people from getting COVID-19 if they were exposed to the virus, according to data from a randomized, placebo-controlled clinical trial published in the New England Journal of Medicine.

The World Health Organization will resume its hydroxychloroquine trial after its safety committee found "there are no reasons to modify the trial protocol," WHO director-general Tedros Adhanom Ghebreyesus said at a press briefing Wednesday.

At least 50% of inpatient hospital beds are currently occupied in the majority of states, the Centers for Disease Control and Prevention said in updated data on Wednesday.

Florida Gov. Ron DeSantis said Wednesday that bars and clubs will be allowed to reopen on Friday, as the state continues to scale-down restrictions it put in place because of the coronavirus, WCTV reports.

4. Wall Street predicts colossal remdesivir sales

Gilead's intravenous coronavirus drug remdesivir could fetch $6.7 billion in revenue in 2021 with a 19% profit margin, assuming the company prices each treatment at $5,000, according to new forecasts from Geoffrey Porges, a highly read pharmaceutical analyst at Wall Street firm SVB Leerink.

Why it matters: That kind of price tag would make remdesivir a blockbuster, but it's far from being a blockbuster treatment, Axios' Bob Herman writes.

  • That price would also be above what independent researchers suggest is a fair price.

What they're saying: Gilead will start charging for the drug, to be sold as Veklury, after its donated supply runs out, which is expected to occur as soon as this month. Gilead did not provide an updated timeline for when a price would be disclosed.

5. Telemedicine leads on coronavirus innovation

Illustration: Sarah Grillo/Axios

The use of telemedicine has exploded during the COVID-19 pandemic, and experts see the changes remaining even after the coronavirus, Axios' Bryan Walsh reports.

Why it matters: Given its heavily regulated and fragmented nature, health care tends to be slow to adopt innovation. But the pandemic has shown Americans the advantages of communicating with doctors remotely — and health insurance companies are paying attention.

What's new: According to FAIR Health's Monthly Telehealth Regional Tracker, which draws from 31 billion private health care claim records, telemedicine claim lines increased an astounding 4,347% year-over-year in March.

Telemedicine services have been available for years, but health concerns around the pandemic combined with the fact that most doctor's offices and hospitals were effectively off-limits to non-COVID-19 patients have led millions of Americans to use their smartphone to access remote care for the first time.

  • The stock price of the leading telemedicine company Teladoc has risen by more than 30% since the beginning of March.

Telemedicine is only one aspect of the sclerotic health care sector that has been shaken up by the COVID-19 pandemic.

  • Wearable devices like the Apple Watch are being used in academic studies to predict when COVID-19 cases might occur.
  • Jeff Semenchuk, chief innovation officer at Blue Shield of California, says the pandemic has pushed his company to digitize health care whenever possible. That includes efforts to make electronic patient health records more easily accessible and to simplify the laborious process of payment claims.