Jun 24, 2020

Axios Vitals

Good morning. If you've got some free time at 11am Eastern, tune in here for a conversation I'll be moderating with FDA commissioner Stephen Hahn.

Today's word count: 850, or a 3-minute read.

1 big thing: Optimism about a vaccine

Go Nats. Photo: Kevin Dietsch-Pool/Getty Images

You want a coronavirus vaccine. I want a coronavirus vaccine. The economy wants a coronavirus vaccine. We all want a coronavirus vaccine. And maybe we really will get one in record time.

"I believe it will be when, and not if," Anthony Fauci, the director of the NIH's infectious diseases center, told a House panel yesterday.

  • Fauci reiterated the ambitious timeline he's laid out before — human trials for one potential vaccine will begin this month, others will follow soon, and a product could be available to the public by the end of the year or early 2021. That would be record-breaking speed.
  • It's possible, he said, because of the willingness to accept the financial risk of scaling up manufacturing for products that may not work, just to be ready for the one that does.

That raises the question: Who gets it first?

  • "We can assume that a country is gong to try to control a vaccine that's developed in its country, and give it to its citizens first," medical ethicist and health policy expert Zeke Emanuel said yesterday on the "Axios Re:Cap" podcast.
  • That could be good news for the U.S., which has a stake in several American companies' vaccine candidates.
  • But if, for example, China gets there first, it could "months or years" before anyone else gets a crack at that product, Emanuel said.

"We need a different approach other than, 'Me, me, me, me, me; my country, my country,' because that's not going to be wise either — for restarting the economy; for travel, for example, and for not having the coronavirus come back and infect the country," he said.

🎧 Go deeper: Listen to the interview.

2. Pessimism about everything else

Illustration: Aïda Amer/Axios

We really need that coronavirus vaccine to come through — because we're not doing so great on anything else.

The big picture: It's getting worse. What we're seeing across the South and Southwest is not simply the result of more testing. All indications are that it is the result of a worsening outbreak.

  • Infections are rising nationwide. In several states, they're breaking one-day records.
  • Hospitalizations are also up — seven states have hit a record number of COVID-19 hospitalizations this week, per the Washington Post.
  • Deaths are so far not following this upward trend. But they are, obviously, one of the outcomes after a person tests positive and gets sick. So there's every reason to believe death numbers will rise again. And over 120,000 people have already died.

The EU may ban travelers from the U.S., along with Brazil and Russia, after it reopens its borders, because we are simply too high-risk.

And progress does not seem to be forthcoming.

  • The Trump administration has at least considered lifting the federal emergency declaration for the virus, part of which is set to expire next month, the L.A. Times reports.
  • Local health officials also told Talking Points Memo that the federal government will soon stop paying for testing sites in several hard-hit states, including Texas.

The bottom line: We may think we're through with the pandemic. But the pandemic isn't through with us.

3. Court: Hospitals must disclose their prices

Illustration: Aïda Amer/Axios

A federal judge yesterday upheld the Trump administration's rules requiring hospitals to publicly disclose the prices they've negotiated with insurers — information that both hospitals and insurers would very much prefer to keep secret.

  • The American Hospital Association sued to block the rules, arguing that they exceeded the administration's legal authority and infringed on hospitals' First Amendment rights.
  • The court rejected both arguments.

"The publication of charges will allow the agency to further its interest of informing patients about the cost of care, which will in turn advance its other interest — bringing down the cost of health care," Judge Carl Nichols wrote in his ruling.

Experts and economists aren't so sure that's correct. There's at least an argument that price transparency can backfire, causing prices to rise, but it has been a core element of the Trump administration's efforts to lower health care prices.

  • And the difficulty — in many cases, the impossibility — of finding out in advance how much hospital care will cost is often maddening for patients.

What's next: The AHA will appeal this ruling to the D.C. Circuit Court of Appeals, and says it will seek expedited review. The disclosure are rules are set to take effect in January.

4. Catch up quick
Expand chart
Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios.
  • Texas Gov. Greg Abbott urged Texans to stay home, and expanded local government's power to limit crowds, as the state hit a record 5,000 new cases in one day (Dallas Morning News).
  • Washington Gov. Jay Inslee issued a statewide order yesterday requiring residents to wear masks in public (Seattle Times)
  • Sanofi is speeding up its work on a coronavirus vaccine, hoping to catch up with its competitors and get a successful product to market early next year (NYT).
  • A Brazilian judge ordered President Jair Bolsonaro to wear a mask (CNN).
5. Deforestation may lead to more outbreaks

Photo: Florian Gaertner/Photothek via Getty Images

Axios' Marisa Fernandez flags something I didn't know about infectious diseases: Some scientists believe deforestation is creating more outbreaks.

How it works: Any number of pathogens live in forest ecosystems, and destroying those ecosystems can cause those pathogens to spill over into humans.

  • "Once you have a deforestation event then you get spillover and you don’t know whether that’s because we're losing biodiversity that otherwise would kind of help dilute that pathogen, or if it's humans coming into the area and increasing their risky behaviors," Christina Faust, postdoctoral scholar Center for Infectious Disease Dynamics at Penn State University, told NPR.

Thanks for reading. If you made it this far and you have any good tips, OR if you caught the "Magnolia" reference in this newsletter, shoot me an email at baker@axios.com.