Mar 12, 2020

Axios Vitals

By Caitlin Owens
Caitlin Owens

Good morning. Welcome to another day of news breaking way faster than I can keep up with.

📺 This week on "Axios on HBO" — An exclusive: DNC chair Tom Perez said on Monday he's "not contemplating" an online convention despite the spread of the novel coronavirus (clip). Watch the full interview Sunday at 6pm ET/PT on all HBO platforms.

Today's word count is 1,150, or a 4-minute read.

1 big thing: Trump suspends travel from Europe

Photo: Doug Mills-Pool/Getty Images

President Trump announced from the Oval Office last night that all travel from Europe — excluding the U.K. — will be suspended for 30 days, beginning Friday. There will be an exemptions for Americans who undergo screening upon their return.

Why it matters: The move is stunning and will likely be a blow to the economy, but it won't stop the novel coronavirus outbreak from spreading in the U.S.

  • The virus is already here, and public health officials warn that our top priority needs to be slowing its inevitable spread through American communities.

Trump also announced plans for economic stimulus, including:

  • Low interest loans for small businesses via the Small Business Administration
  • Deferring tax payments for affected businesses and individuals
  • Calling on Congress to cut payroll taxes

Behind the scenes: These options were considered in the task force yesterday and presented to the president today, a senior administration official told Axios' Jonathan Swan.

  • The source said multiple senior health officials in the administration supported the travel ban from Europe given the recent spikes, especially in Italy.
  • Swan asked whether Trump had second thoughts about the economic effects of this.
  • "All of us do," the official said. "Of course. But it's a matter of what's best in the long term."

Flashback: Administration officials previously — and recently — had considered trying to shut down travel from Italy, but backed off that idea in part because health officials were cool to it.

2. Coronavirus testing is still a huge problem

Coronavirus cases in the U.S. are rapidly increasing, but too many people still can't get tested.

Between the lines: The Centers for Disease Control and Prevention's failed diagnostic test may be the original sin of our initial response to COVID-19, and we're still learning about the effects of allowing the virus to spread undetected.

The big picture: A lot of labs are now making tests, and testing capacity is steadily increasing.

  • But some areas have the ability to get results in hours, while others must wait days, as the Wall Street Journal reports. That's because some patients are receiving care closer to the testing facility than others.
  • States, counties and providers all have different criteria for who should be tested, and some of these criteria are still very limited — meaning that some patients with signs of the coronavirus aren't getting tested.
  • Some providers don't have enough protective gear, and so aren't testing patients in order to avoid infecting health care workers.

What's more, shortages of testing supplies may threaten our testing capacity in the near future.

  • As Politico reported Monday, there may be shortages in RNA-extraction kits that are a necessary component of the tests.
  • The New York Times reported yesterday that labs are also facing potential shortages of key chemical ingredients and having trouble obtaining other testing materials.

The bottom line: "What's most important now is there is still a significant shortage of reagents, and laboratories are really scrambling to get access to the reagents," Karen Carroll, director of the Division of Medical Microbiology at John Hopkins, told me. "That's the crisis we're all facing right now."

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

The NBA has suspended games until further notice, and it announced a player had tested positive for the virus.

  • The NCAA men's and women's basketball tournaments will be played without fans, NCAA president Mark Emmert announced in a statement Wednesday.

The spread of the coronavirus has triggered emergency responses from cities of all sizes, as officials grapple with everything from how to pay sick workers and run city operations remotely to whether to cancel major events and close schools, Axios' Kim Hart reports.

  • Seattle and San Francisco banned large events, and Seattle also closed public schools.

Congress' in-house doctor told Capitol Hill staffers at a close-door meeting this week that he expects 70–150 million people in the U.S. — roughly a third of the country — to contract the coronavirus, two sources briefed on the meeting tell Axios.

As the coronavirus pushes more human activities online, it's forcing a reckoning with the often-invisible digital divide, Axios' Margaret Harding McGill reports.

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.

The World Health Organization announced Wednesday that it classified the novel coronavirus outbreak as a pandemic.

  • The big picture: Cases continue to exponentially rise in Spain, Germany and France, while Italy is on complete lockdown.

Italian Prime Minister Giuseppe Conte, said Wednesday that the country's retailers and businesses, other than pharmacies and grocers that sell "essential items," will close, AP reports.

National security adviser Robert O’Brien claimed Wednesday that an initial cover-up of the coronavirus in China "cost the world community two months" and exacerbated the global outbreak, Axios' Dave Lawler reports.

  • Why it matters: In the face of a global crisis, the world's two most powerful countries are pointing fingers at one another.

As China begins to get its coronavirus outbreak under control, authorities are going on the offensive to rewrite the narrative that the global epidemic is Beijing's fault, Axios' Bethany Allen-Ebrahimian writes.

5. Hospitals' next steps for coronavirus influx

Hospitals are dusting off their pandemic preparedness plans in anticipation of overcrowded waiting rooms and supply shortages as the coronavirus outbreak continues to spread, Axios' Marisa Fernandez reports.

The big picture: Hospitals are preparing for tens of millions of cases and millions of hospitalizations from COVID-19.

By the numbers: In a survey of 6,500 nurses from the National Nurses United...

  • 19% report their employer has a policy to address employees with suspected or known exposure to novel coronavirus. 43% don't know.
  • 44% report their employer has provided them information about novel coronavirus.
  • 30% say their employer has sufficient PPE stock on hand to protect staff if there is a rapid surge in patients with possible coronavirus infections.

What they're doing: Hospitals and clinicians are exploring ways to delay an inevitable influx of patients by pushing in-home care, and possibly limiting elective surgeries.

  • EvergreenHealth hospital in Kirkland, Washington, has been rationing supplies like goggles and overworking staff across all departments while caring for nearly 70 patients, the New York Times reports.
  • Massachusetts General Hospital doctors are pushing for pop-up clinics and more testing, the Washington Post reports.
  • Johns Hopkins University is looking to turn entire medical units into a respiratory isolation unit for patients.

A leaked slide from an American Hospital Association presentation in February shows the hospital system is expecting an impact 10 times more severe than flu season. That could include:

  • 4.8 million hospitalizations
  • 96 million cases overall
  • 480,000 deaths

Go deeper: Full coronavirus coverage

6. Coronavirus cost relief in high-deductible plans

The IRS yesterday firmed up employers' ability to offer their employees coronavirus testing and treatment without cost-sharing, even if those employees haven't met their deductibles.

Why it matters: People in these kinds of plans usually have to spend thousands of dollars out of pocket before coverage kicks in, but the coronavirus outbreak is forcing the industry to change plan designs so people are encouraged to seek testing and treatment, regardless of cost, Axios' Bob Herman reports.

Yes, but: The IRS is not requiring employers to exempt coronavirus testing and treatment from the deductible, and people who are in self-insured plans still may be on the hook for some costs. A lot depends on what employers actually do.

7. CMS announces new insulin policy

The Centers for Medicare & Medicaid Services announced yesterday that it's launching a new voluntary model that would allow seniors to buy insulin with no more than a $35 monthly copay.

Why it matters: Medicare beneficiaries who rely on insulin and are enrolled in a participating plan would save an average of $446 a year in out-of-pocket costs.

The bottom line: This move may not target the overall price of insulin, but it could meaningfully lower what seniors pay themselves for it.

Caitlin Owens