Mar 31, 2020

Axios Vitals

Good morning. Let's all remember to thank the health care workers in our lives this week.

Today's word count is 1,104, or a 4-minute read.

1 big thing: The outbreak won't peak in every state at once
Data: IHME COVID-19 health service utilization forecasting team; Cartogram: Andrew Witherspoon/Axios

Although the coronavirus is expected to peak in the U.S. in two weeks, many states will see their individual peaks well after that, according to a model by the University of Washington's Institute for Health Metrics and Evaluation.

Why it matters: States like Virginia and Maryland have more time to prepare for their systems to be maximally strained — if they make good use of that time.

States' coronavirus peaks are defined as the point at which there is the most demand for resources, namely hospital beds and ventilators.

  • This is also the point at which the most health care workers will be needed to care for coronavirus patients.

Some experts warn that states expected to face the hardest hit later in the year aren't using their lead time well.

  • "The states that are going to be affected last need to start husbanding resources now, because the feds could get tapped out ... by some of these early states, particularly New York, which has absorbed a lot of federal resources," former Food and Drug Administration commissioner Scott Gottlieb told me.
  • Even though they may not be seeing a huge number of cases now, states like Texas and Florida should stop doing elective surgeries now in order to preserve personal protective equipment — like masks, gowns and gloves — for their health care workers, Gottlieb added.

The bottom line: Coronavirus outbreaks, both globally and in the U.S., have seemed manageable until it's too late. For states that so far aren't hit hard, there's no such thing as over-preparing.

2. CMS gives hospitals huge new flexibilities

The Centers for Medicare and Medicaid Services yesterday issued new temporary rules that will allow hospitals to expand their capacity during the coronavirus epidemic.

Between the lines: These new flexibilities are designed to allow health care workers to treat more patients than the system is built for, and to help separate patients with the coronavirus from those without it.

Details: The rules allow facilities ranging from ambulatory surgical centers to convention centers to be repurposed to respond to the pandemic.

  • Ambulatory centers can, for example, be used to provide cancer or trauma care that would normally be performed in hospitals, thus protecting these patients from coronavirus exposure.
  • Non-hospital sites can be used to treat or quarantine patients, allowing hospitals to convert buildings like hotels or gymnasiums into care sites.
  • Hospitals and labs can test for the coronavirus in patients' homes or in community-based settings outside of hospitals, and hospital emergency departments can test and screen patients for COVID-19 at drive-through or off-campus sites.
  • Hospitals are also given new flexibilities that will allow them to rapidly expand their workforce.
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 Pentagon on Monday announced the death of a member of the New Jersey National Guard who tested positive for the coronavirus.

28 states are in or entering lockdown, with Maryland, D.C. and Virginia joining those ranks yesterday. Those states include roughly three-quarters of the American people, the New York Times notes.

Ford and GE Healthcare announced plans on Monday to build a simplified ventilator design licensed from a Florida medical technology company, with the goal of producing 50,000 machines by early July, and up to 30,000 a month thereafter, to fight the coronavirus.

Rep. Nydia Velázquez (D-N.Y.) announced Monday that she was diagnosed with "presumed" coronavirus just days after she was on the House floor and attended Speaker Nancy Pelosi's signing ceremony for the stimulus bill last week.

Florida's Hillsborough County Sheriff Chad Chronister issued a warrant for the arrest of megachurch pastor Rodney Howard-Browne on Monday after he refused to cancel his packed services and obey coronavirus social distancing orders.

Navy hospital ship USNS Comfort docked Monday in New York as it prepares to begin assisting the medical needs of the city's citizens due to the strain on the health care system from the coronavirus pandemic.

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 coronavirus is providing cover to autocrats, dictators, and even some democratically-elected leaders who were already looking for reasons to undermine the independent media, Axios' Sara Fischer reports.

Data from Earth-gazing satellites is key for scientists hoping to understand and track disease outbreaks including the unfolding coronavirus pandemic, Axios' Miriam Kramer writes.

India's three-week lockdown is the largest ever attempted, and it sparked South Asia's greatest migration since partition in 1947. While the economic effects could be devastating, the public health crisis it's intended to fend off could be more destructive still.

Israeli Prime Minister Benjamin Netanyahu's office said Monday that he would enter self-isolation after an aide tested positive for the coronavirus.

Spain and Italy extended lockdown deadlines on Monday, as Italy became the second country in the world to surpass 100,000 confirmed coronavirus cases.

Hungary's parliament passed a law Monday to allow Prime Minister Viktor Orbán almost unlimited power, for an indefinite period, to fight the coronavirus outbreak.

5. Why Trump changed his mind about Easter

Scenes out of New York, including bleak hospital images played on Fox News, struck a nerve with President Trump and caused him to drop his aspiration of reopening America by Easter, senior administration officials tell Axios's Jonathan Swan.

  • Treasury Secretary Steven Mnuchin also played a key role, according to two sources familiar with the conversations.

Between the lines: By the time the president's medical advisers showed him modeling on Sunday of predicted deaths, emotional and economic factors had been bearing on him for days.

The distancing extension became, in Trump's mind, less risky than rolling back the guidance, even though he remained fixated on the economy and the stock market, according to another source who spoke with Trump.

  • The source said Trump had already signaled to the market that he's willing to spend whatever it takes to keep the economy afloat. And he's already signaled strongly that he doesn’t like the idea of an extended shutdown.
  • "Better to overextend now and reopen sooner than people expect," the source said. "The fact he;s already signaled he doesn't like it and [the stimulus] act passed seems enough for the market."

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6. Kids' daily screen time surges
Data: Super Awesome ; Chart: Axios Visuals

With almost all U.S. states closing schools until at least the end of the month, most children ages 6-12 say they are spending at least 50% more time in front of screens daily, according to new data from SuperAwesome, a kids technology company.

Why it matters: Parents were already struggling to limit screen time for kids when they were in school, let alone trying to pull them away from their devices while they are forced to stay home away from their friends, peers and regular activities, Sara reports.

Driving the news: In the U.S., a majority of children ages 6–12 say they use screen devices either a lot more (at least 50% more), twice as much, or for what feels like "most of the day" during the coronavirus pandemic.

The bottom line: For many parents who are forced to simultaneously balance child supervision and working at home, screen time limits have effectively been out of the picture.

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