May 20, 2020

Axios Vitals

Good morning.

Today's word count is 921, or a 3-minute read.

1 big thing: Many counties have no coronavirus test sites

Illustration: Aïda Amer/Axios

More than half of U.S. counties don't have a single coronavirus testing site, according to a recent report by Castlight, a health software company.

Why it matters: That leaves a wide swath of the country — particularly rural areas — vulnerable to undetected coronavirus outbreaks, especially as lockdown measures ease. Asking people to travel long distances to get a coronavirus test is both unrealistic and potentially dangerous.

By the numbers: 54% of all counties don’t have a testing site.

  • Among counties with 50,000 or more people, 38% don't have any testing sites.
  • Among rural counties with fewer than 10,000 residents, 68% don't have any.
  • And even among counties that do have testing sites, 58% don't have the capacity to meet minimum recommended testing levels, which Castlight defined as 1% of their population every week.

In Texas, for example, big cities have enough testing capacity to meet Castlight's thresholds, but there's a cluster of 26 counties — and 315,000 residents — in the middle of the state with no testing access.

The big picture: Commitment from retailers like CVS, Walgreens and Walmart to open new testing sites could help close some of these gaps.

  • CVS recently announced that it plans to have opened up to 1,000 self-swab testing sites around the country by the end of May.
  • These sites will primarily be located at pharmacies with drive-through capabilities, although in a handful of cases, the company is establishing parking lot test sites.

Some cities, including New Orleans, Nashville and Seattle, have set up mobile testing in order to reach communities without adequate testing access.

The bottom line: There's no geographic barrier that prevents the coronavirus from spreading to counties without the ability to test for it, especially in states that are reopening while their caseloads are still high.

2. Airlines pack in customers

Illustration: Sarah Grillo/Axios

As restaurants, department stores and other local businesses grapple with operating at half occupancy (or less) to comply with social distancing guidelines, airlines are packing customers to near capacity on a reduced number of flights, Axios' Dion Rabouin reports.

Why it matters: The practice shows how a lack of a national policy allows certain companies — like airlines — to continue to put Americans at risk for exposure to COVID-19 while other companies miss out on revenue by adhering to local regulations.

  • "If you look back at SARS in 2003, this issue of planes being a spreader of the virus has been well-known," Paul Tharp, an attorney specializing in negligence and liability at North Carolina's Arnold & Smith law firm, tells Axios.
  • Unless Congress passes rules shielding the airlines from liability — as Senate Republicans have discussed — they could face a complicated legal situation, Tharp adds.

How it works: In March, most airlines reduced the number of flights they offered by as much as 80% through the end of May, and as travel demand has picked up, they've simply loaded new passengers onto the few remaining scheduled flights.

  • They could reinstate laid-off pilots and restart flights in order to accommodate newly increased demand, but have chosen not to.
  • "Airlines have very significant flexibility to adapt their route networks even during this extraordinary period," a Department of Transportation spokesperson tells Axios.

Go deeper.

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.

A federal judge ruled on Tuesday that Texas must give all of its 16 million voters the option of casting mail ballots amid coronavirus concerns.

Making sure we can safely return to work and public life post-coronavirus will require new rules, new equipment — and even whole new jobs, Axios' Erica Pandey reports.

Asked about the FDA's warning about the use of hydroxychloroquine for coronavirus patients, Trump responded by attacking a non-peer reviewed study released last month that found an increased risk of death associated with patients who were only treated with the antimalarial drug — calling it a "false study."

One takeaway from Tuesday's Senate coronavirus bailout hearing: The Treasury Department and Federal Reserve both think the worst could be yet to come for America's economy, Axios' Courtenay Brown writes.

35 of the 92 people (38%) who attended services at a rural Arkansas church March 6–11 tested positive for the coronavirus, ultimately killing three, according to a case study released Tuesday by the CDC.

The Lancet medical journal issued a statement Tuesday responding to a letter President Trump sent to the World Health Organization about the coronavirus, calling his citation of its studies "factually incorrect."

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

Nonessential traffic between the U.S. and Canada will be restricted for another 30 days, due to the coronavirus pandemic, Canadian Prime Minister Justin Trudeau said at a press conference on Tuesday.

Brazil's daily death toll hit a new record yesterday, at 1,179, Reuters reports. As of this week, Brazil has the third-highest number of confirmed infections, behind Russia and the U.S.

The World Health Organization's other member nations ignored demands made by President Trump earlier this week, but decided instead to examine the organization's response to the coronavirus pandemic, per NYT.

5. FEMA has been another coronavirus lifeline

As of May 15, the Federal Emergency Management Agency has dished out $6.1 billion to help the health care industry weather the coronavirus outbreak, an agency spokesperson told Axios' Bob Herman.

The bottom line: FEMA is most often on the ground after natural disasters. Now, it's a vital resource for health care systems during a catastrophic public health disaster.

The big picture: The federal $2.2 trillion stimulus package added $45 billion to FEMA's disaster relief fund. And of the $6.1 billion that has been allocated thus far, a majority has gone to either directly subsidizing providers' costs or putting people on the ground.

  • $2.4 billion was used for "medical personnel, mortuary and ambulance services," FEMA's spokesperson said.
  • Another $1.5 billion went to hospitals and other providers for personal protective equipment, other medical supplies and drugs.
  • $489 million has been routed to hospitals for other expenses outside of protective gear and supplies. Hospitals can apply for these funds.
  • Roughly $1.3 billion has been to support the National Guard.