Feb 27, 2020

Axios Vitals

Good morning. It's still only Thursday, which is incredible. Happy Thursday.

Today's word count is 865, or a 3-minute read.

1 big thing: What the coronavirus means for Trump's presidency

Photo illustration: Eniola Odetunde/Axios; Photo: Chris Graythen/Getty Images

A poor response to the novel coronavirus could be politically devastating for President Trump, and so far his administration has given the strong impression that it's still scrambling as the risk of a pandemic mounts, Axios' Sam Baker and Alayna Treene report.

Why it matters: There's only so much any president can do to stop a virus from spreading, and for now the coronavirus is still very much under control within the U.S. But if things get bad as the year goes on, and if the administration seems to be caught off guard, that spells trouble for public confidence in Trump.

Case in point: Last night's coronavirus press conference was all over the map.

  • Trump initially and consistently downplayed the likelihood of a widespread outbreak within the U.S., even though public-health officials, including the CDC, believe such an outbreak to be pretty likely.
  • Trump was surprised at how deadly the annual flu virus is, but accurately emphasized public health officials' advice to treat the coronavirus like the flu.
  • A new U.S. case — one that may have been transmitted locally, a key indicator of a potential pandemic — was confirmed while Trump was speaking.

What we're hearing: Sources familiar with the decision tell Axios that the call to put Vice President Mike Pence in charge was made just yesterday.

  • It had loosely been a subject of discussion among staff, but it was unclear how many — if any — officials knew beforehand that Trump was going to announce it at the press conference.

"This is such a s--tshow. Thank goodness the markets are closed," a former HHS official who's close to the White House said during the briefing.

2. Colorado's lessons for Democrats

Colorado lawmakers are preparing to vote on the state's public option proposal, providing an example of what happens when politicians take on the health care industry, Bloomberg reports.

Why it matters: Democrats by and large want to do the same thing on a national scale, but promising more affordable coverage for everyone is a lot easier than actually passing legislation to make it happen.

Details: Colorado's public option would be run by private insurers, although it would more tightly limit insurers' profits and administrative costs. Insurers don't like the additional regulation.

  • The proposal lowers premiums in the individual market by lowering what hospitals are paid — so the state's hospital industry is fiercely opposing it, too.

The intrigue: A local affiliate of the Partnership for America's Health Care Future Action — the group opposing Medicare for All nationally — paid for a mailer that warned Coloradans that the proposal would raise costs and lead to hospital closures.

  • Expect that exact same messaging if Democrats seize power in the 2020 elections — except on a much, much larger scale.

Go deeper: Blue states' watered-down health reforms

3. Hospitals prepare for coronavirus uptick

An Italian health worker. Photo: Stefano Guidi/Getty Images

Many U.S. hospitals have been stocking extra supplies and refreshing disaster preparation plans over the past month in the event the coronavirus became more prominent domestically, Axios' Bob Herman reports.

The big picture: The Centers for Disease Control and Prevention warned this week that this infectious disease could spread more in the U.S., and hospitals have anticipated such scenarios.

Where it stands: The American Hospital Association told its members last week that they "should be prepared for the possible arrival of patients with COVID-19," directing them to use a CDC checklist for coronavirus patients and monitor protective equipment needs.

  • Shruti Gohil, an infectious disease doctor at the University of California, Irvine, said her hospital system and others always have emergency plans for these types of outbreaks and disasters. Their planning ramped up in January after more cases began coming out of China.
  • A spokesperson with the University of California, San Francisco health system, which has already treated patients who had the coronavirus, said it has 40 airborne infection isolation rooms and can "adapt additional rooms" if needed.
  • Most large regional systems, like UPMC, are working with local and state public health departments on how to screen for potential patients, a UPMC spokesperson said.

The bottom line: Hospitals handled Ebola and Zika in recent years, and have already recorded a busy flu season.

  • Occupancy statistics show hospitals have enough beds to treat coronavirus patients, although preparedness varies by hospital and is more likely to be regimented in urban facilities.
4. New scrutiny of drug and device supply chain

The spotlight that the coronavirus has shone on our reliance on China for American drugs and medical devices has already prompted lawmakers to act.

Driving the news: Sens. Marco Rubio and Josh Hawley both plan to introduce bills aimed at safeguarding the supply chain.

Details: Rubio's bill would require drugmakers to report to the Food and Drug Administration the volume of their drug's ingredients derived from each source, which would give the FDA a clearer picture of how reliant drugs are on Chinese products.

  • The bill also would create federal financing guarantees to American businesses producing critical medical supplies, pharmaceuticals and equipment in the U.S.
  • And it would temporarily increase the tax deduction for business capital expenditures on medical equipment and facilities related to the coronavirus.

Hawley's legislation would require medical device manufacturers to report predicted shortages to the FDA, and would give the FDA additional authorities in the event of an expected shortage.

  • It also would give the FDA more authority to request information from drug and device makers about their manufacturing capacity.

The bottom line: Old fears about our medical supplies' dependence on China have been given new urgency.

5. First supervised drug injection site to open

The nation's first supervised drug-use site is set to open in Philadelphia next week, after a federal judge ruled on Tuesday in favor of the nonprofit that plans to open it, the Wall Street Journal reports.

Yes, but: The Justice Department — which brought the lawsuit against the nonprofit — said it's appealing the decision.

Context: Advocates of such sites say that they help prevent deadly overdoses while potentially helping connect users with treatment.

  • Federal law enforcement officials have said that they think such sites are illegal.