Axios Vitals

A briefcase with a red cross on the front.

March 16, 2020

Good morning. Life is changing for all of us — fast. It's not easy. But remember that each one of us can contribute to mitigating the impact of this virus. Let's keep making decisions with our neighbor in mind, and remember that small acts of kindness can go a long way in this difficult time.

  • One thing you can do to help: Give blood. The American Red Cross is asking healthy, eligible people to donate blood to help avoid shortages. Find your location to donate here.

Today's word count is 1,040, or a 4-minute read.

1 big thing: Coronavirus testing problems are worse than you think

Illustration of full beaker casting exclamation point shadow.

Illustration: Eniola Odetunde/Axios

If the coronavirus outbreak in the U.S. gets really bad — if it stretches on longer than we anticipated, if huge numbers of people get sick, if the disruptions to daily life become even more severe — early flaws in the testing process will bear a lot of the blame, Axios' Sam Baker writes.

The big picture: You probably know that there were some early problems with testing, and that they're getting better — which they are.

  • But those early failures will help define the entire scope of this pandemic, and there's not much we can do now to reverse the damage.

Why it matters: Because we haven't been doing enough testing, we don't actually know how many people in the U.S. have the coronavirus. We know the official count is too low, and that the number of confirmed cases is likely to explode in the coming weeks as testing improves.

  • But that's not the only problem. The lack of testing hasn't just left us in the dark about how bad the situation is; it has also made that situation worse.

Widespread, accurate testing has been a key component of other countries' success in bringing their outbreaks under control.

  • When we can quickly and accurately diagnose one patient, we can immediately pinpoint who that person is most likely to have infected, then quarantine those people and test the ones who start to show symptoms, and repeat that process on down the line.
  • We can spot clusters of new cases, so that the public health system can react quickly and focus its resources.

But the U.S. has not been able to do those things on the scale we'd need. And so, experts say, the virus has probably been spreading undetected for weeks.

Go deeper.

2. Insurers aren't that worried about coronavirus

Health insurance companies are not concerned yet that the new coronavirus is going to drive up their medical claims and spending, Axios' Bob Herman reports.

The big picture: More people will need expensive hospitalizations to treat COVID-19, which has turned into a full-blown public health emergency.

  • But insurers view the outbreak as an "extension of the flu season," according to a Wall Street bank that spoke with insurance executives last week.

What they're saying: Barclays held its health care conference digitally last week, and several insurance executives reiterated their companies' profit projections for this year — relatively remarkable statements considering economists believe a recession is imminent.

  • "We're not expecting a material financial impact," said Matt Manders, a top Cigna executive.

Between the lines: A lot more cases and hospitalizations are coming. But those will be partially offset, from an actuarial perspective, by delays or cancellations of costly elective procedures like joint replacements — something that hospitals are starting to do.

  • "There is a net saving" when non-emergency procedures are eliminated, Anthem CFO John Gallina told Barclays analysts.

The bottom line: The coronavirus is throttling almost every business in America. Large insurers think they're mostly immune, and if medical claims start to rise uncontrollably, they will increase everyone's premiums next year.

  • "We would price for this for 2021 to the extent there's any meaningful impact," Humana CFO Brian Kane said. "I would imagine the industry will as well."

3. The latest in the U.S.

Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios
Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios

The CDC said in new guidelines Sunday that gatherings of 50 or more people should be postponed or canceled in order to curb the spread of the novel coronavirus.

A number of state governments on Sunday called for the closure of bars and restaurants, a drastic step to enforce "social distancing."

The Federal Reserve on Sunday cut its benchmark interest rate to almost zero and launched a $700 billion quantitative easing program in response to the expected economic downturn and stock market slump caused by the coronavirus.

At least 57,000 K-12 schools across the U.S. have closed or will close for weeks at a time due to the novel coronavirus, affecting at least 25 million students, Axios' Marisa Fernandez reports.

Nursing homes should not allow any visitors, the Centers for Medicare and Medicaid Services said in a new memo. There's one exception: "compassionate care situations, such as an end-of-life situation."

It took a stock market crash — and a Fox News star's intervention — to finally snap President Trump's delusional and possibly disastrous fixation with treating the coronavirus like just another winter flu, Axios' Jonathan Swan 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.
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 Italian government reported 368 new deaths from the coronavirus on Sunday, the largest 24-hour increase since the country confirmed its first case, according to AP.

Schools, bars and restaurants were ordered to close in Spain on Saturday, while citizens were told to stay at home unless absolutely necessary, Prime Minister Pedro Sánchez and health officials announced.

France and Israel moved on Saturday to close restaurants, cafes, movie theaters and clubs to promote social distancing amid the novel coronavirus pandemic.

The world once looked to the U.S. for leadership and aid in global health crises.

  • But the Trump administration has rejected global leadership in the fight against the coronavirus, and much of the initial domestic response was focused on shoring up the economy, Axios' Bethany Allen-Ebrahimian reports.

5. Parents' daunting new coronavirus reality

Data: Axios reporting; Chart: Danielle Alberti/Axios
Data: Axios reporting; Chart: Danielle Alberti/Axios

A new reality sets in today for many working parents: double duty as a remote employee and a home-school supervisor, Axios' Kim Hart reports.

The big picture: As schools and offices shut down because of the coronavirus outbreak, parents must figure out how to do two full-time jobs at once. It'll be a struggle even for privileged households, and could border on impossible for some working-class families.

Working from home with kids in tow is a lot to juggle, no matter what. And social distancing will make it even harder to redirect kids' short attention spans long enough to write an email.

  • Steve Silvestro, a pediatrician in Bethesda, Maryland, advises against most playdates, especially indoors or on playgrounds. Outdoor playdates with one or two friends are probably OK, for now, but not in crowded places.

Reality check: Playdate bans and juggling kids while working remotely are problems of the privileged. White-collar professionals often have the leeway to work from home, even without a crisis to force it.

Go deeper.

6. Hospitals cut back on routine care

Some hospitals in areas hit hard by the coronavirus are putting off surgeries that aren't urgent, WSJ reports.

Why it matters: This frees up space and staff to care for coronavirus patients, and also reduces patients' exposure to the virus.

  • Some hospitals are also asking primary care and psychiatry patients to use telemedicine.

The other side: Calling all non-coronavirus care "elective" right now can be misleading.

  • "Many patients, such as those with cancer or a need for cardiac surgery, will not be able to postpone medical interventions," leading hospital groups said in a statement last night, responding to the surgeon general's calls for postponing elective surgeries.