August 19, 2020

Good morning.

Today's word count is 934, or a 4-minute read.

1 big thing: Slower mail could leave patients without drugs

Illustration: Sarah Grillo/Axios

Slowdowns in mail delivery could have serious consequences for the millions of Americans who get prescription drugs — in some cases, lifesaving treatments — through the mail, Axios' Bob Herman reports.

Why it matters: Treatments for cancer, multiple sclerosis, rheumatoid arthritis and other complex diseases increasingly are sent in the mail. And the coronavirus pandemic has spurred more people to get their routine prescriptions mailed to their homes, as a safer alternative to visiting a pharmacy.

Driving the news: Postmaster General Louis DeJoy said Tuesday that he would suspend the controversial operational changes that Democrats had widely criticized as a threat to timely mail-in voting this November.

  • House Speaker Nancy Pelosi said Democrats would still continue their oversight of the Postal Service — which has included questions for the pharmacy industry about possible delays, as well as concerns about delays for VA patients.

By the numbers: Americans received 313 million adjusted prescriptions through the mail in 2019, often for common, generic medications that treat things like high cholesterol and high blood pressure.

  • Even though that's only 5% of all prescriptions, mail orders represent roughly a quarter of all drug spending, according to health data firm IQVIA.

Consequently, the U.S. Postal Service has become a critical backbone of the country's medication infrastructure.

Where it stands: Even before Tuesday's announcement, the disruption to prescription deliveries seems to have been minimal.

  • In the latest Axios-Ipsos Coronavirus Index, just 5% of respondents said they had expected a drug delivery in the past week but either hadn't gotten it or had gotten it late. (14% were expecting a delivery and got it in time.)
  • But anecdotally, for the people who are experiencing delays, the worries are real.

2. People of color struggle to afford health care

People of color disproportionately lack stable health insurance and have more trouble affording health care than white Americans, a new survey from the Commonwealth Fund shows.

Why it matters: This is one of the long-standing inequalities the coronavirus pandemic has exacerbated, Axios' Marisa Fernandez writes.

By the numbers: Overall, 43% of working-age adults did not have stable health insurance coverage, according to the Commonwealth survey, which was conducted over the first six months of the year.

  • 45% of Black Americans reported having problems paying medical bills, compared to 35% of white Americans.
  • More than one-third of Latino adults, small business workers and people with low incomes were uninsured for at least part of the past year, the survey says.

Even 25% of adults with "adequate coverage" reported having trouble paying medical bills in the past year.

  • The number of Commonwealth considers to be underinsured has doubled in the last 10 years — 46% of privately insured adults now have a deductibles of $1,000 or more.

The bottom line: "Coverage inadequacy is compromising people's ability to get the care they need and leaving many with medical debt at a moment of widespread health and financial insecurity, and an uncertain future," said Sara Collins, the lead author of the report.

Go deeper: America's failed coronavirus response hurts people of color most

3. The latest in the U.S.

Data: The COVID Tracking Project; Note: Does not include probable deaths from New York City; Map: Andrew Witherspoon/Axios

Michigan State University will hold online-only classes for its fall semester, university President Samuel Stanley announced Tuesday, and the University of Notre Dame on Tuesday canceled in-person classes for at least two weeks, following a spike in coronavirus cases.

CNN's Anderson Cooper on Tuesday clashed with MyPillow CEO Michael Lindell, a Trump supporter, for promoting oleandrin, an unproven therapeutic treatment for the coronavirus.

Gov. Andrew Cuomo (D-N.Y.) is writing a book that reflects on his time mitigating the COVID-19 pandemic in New York, which was the global epicenter of the virus this spring, AP reports.

The coronavirus is already triggering early retirements. That's bad news for the American economy, experts tell Axios' Erica Pandey.

4. The latest worldwide

Our map wasn't updated last night because of data issues, but things still happened around the world yesterday:

The CDC has lifted its coronavirus warning against non-essential travel to Bermuda, as the island ramps up a scheme to attract foreign workers on year-long residencies and marks 57 days with no detected community spread, Axios' Rebecca Falconer reports.

Ireland increased its nationwide coronavirus restrictions in an attempt to stop a surge in cases. It reported 190 new cases on Tuesday, per Reuters.

France announced on Tuesday a new mandate for mask wearing in business spaces after the signs of a new wave of infection emerged over the summer months, the New York Times reports.

Germany reported Tuesday 1,693 new cases, the most since April 25. Chancellor Angela Merkel announced that the government will not be loosening coronavirus restrictions any more any time soon, Bloomberg reports.

World Health Organization Director-General Tedros Adhanom Ghebreyesus on Tuesday called on countries to join a pact to avoid "vaccine nationalism," according to NPR.

5. One in five college students aren't going back

Illustration: Eniola Odetunde/Axios

As the coronavirus pandemic pushes more and more universities to switch to remote learning — at least to start — 22% of college students across all four years are planning not to enroll this fall, according to a new College Reaction/Axios poll.

Why it matters: Scores of colleges were already approaching a financial cliff before the pandemic began. Steep drops in enrollment could push some over the edge, Erica writes.

Students are making alternative plans for the fall.

  • Of those not returning to school, most — 73% — are working full time. Around 4% are taking classes at a different university, and 2% are doing volunteer work.
  • Freshmen who are unwilling to sacrifice the experience of a normal first year of college appear to account for a big chunk of those who are planning not to enroll this fall. Harvard, which is going fully remote, says 20% of the students in its incoming freshman class are deferring.
  • Students also recognize the risk. 85% believe they are likely (or very likely) to be exposed to the coronavirus if they're on campus this fall.

Some colleges plan to welcome students back. And those kids are preparing for a very different college experience.