Jul 7, 2020

Axios Vitals

Caitlin Owens

Good morning.

Today's word count is 1,082, or a 4-minute read.

1 big thing: Hospitals, doctors are major recipients of PPP loans

Illustration: Eniola Odetunde/Axios

Small hospitals, physician clinics, surgery centers, dental offices and other health care businesses were among the most common recipients of loans under the Paycheck Protection Program, according to data released by the federal government on Monday.

The big picture: Medical facilities had to halt routine procedures in the early days of the coronavirus pandemic as a way to prevent spread of infection and keep hospital beds open, Axios' Bob Herman reports.

  • PPP loans saved some, but certainly not all, of the jobs that are dependent on those routine procedures.

Between the lines: The health care industry is benefiting from two major sources of federal bailouts tied to the pandemic.

  • The main pot of money is $175 billion in no-strings-attached grants. A lot of those funds have flowed to large hospitals and medical providers that charge high prices.
  • Health care also is the largest recipient of PPP loans. Most of the loans have gone toward dentists, independent medical providers and rural hospitals that have not benefited as much from the main bailout funding.

The intrigue: Some health care organizations are dipping into both sources of money.

  • Sutter Health — a large hospital system in California that has $6 billion in cash and investments and is on the hook for a $575 million settlement tied to allegations of anticompetitive behavior — has received $205 million in federal bailout funds.
  • Two of Sutter's physician practices, Sutter East Bay Medical Group and Gould Medical Group, also each received at least $5 million in PPP loans, according to the new federal data.
  • A Sutter spokesperson said those groups are independent contractors whose finances "are wholly separate from those of Sutter Health."
2. There is no new normal
Data: Axios/Ipsos poll; Chart: Andrew Witherspoon/Axios

The longer the coronavirus pandemic lasts, the farther we're moving apart, according to Axios' analysis of nearly four months of data from the Axios-Ipsos Coronavirus Index.

Why it matters: Ever since life in the U.S. as we knew it came to a screeching halt, we've been trying to get our heads around what a "new normal" will look like, Axios' Margaret Talev writes.

  • But so far, the politicization of the virus — and our socioeconomic differences — are working against any notion of national unity in impact or response.

The big picture: Partisanship is the main driver of behavior when it comes to concern about the virus, or use of face masks to contain the spread.

  • Race and ethnicity are major predictors both of employment status and whether you know someone who's tested positive for — or died from — the virus.
  • Younger, working-class, Republican men take the pandemic the least seriously, the data shows.

What they're saying: "We know that America has failed to contain the coronavirus pandemic, and we can't get past partisanship," says pollster Chris Jackson, senior vice president for Ipsos Public Affairs.

  • Jackson saw a jarring pattern that's become clearer over time: the people least likely to wear masks also are the most likely to be interacting with others.
  • Just 38% of lax mask wearers practiced social distancing, compared with 62% of those who always wear masks.

Go deeper.

3. The latest in the U.S.
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Data: The COVID Tracking Project; Map: Andrew Witherspoon/Axios

The main trade groups representing hospitals, nurses and doctors issued a public letter yesterday that urges "the American public to take the simple steps we know will help stop the spread of the virus: wearing a face mask, maintaining physical distancing, and washing hands."

Miami-Dade County Mayor Carlos Gimenez announced Monday that he would sign an emergency order to again close many businesses, including indoor dining at restaurants, party venues, gyms and fitness centers, effective Wednesday.

Atlanta Mayor Keisha Lance Bottoms said on Monday that she has tested positive for the coronavirus after displaying no symptoms.

Foreign college students could be forced to leave the U.S. or transfer schools if their universities move classes entirely online this fall, according to guidance released by Immigration and Customs Enforcement on Monday.

Sen. Chuck Grassley (R-Iowa) told reporters Monday that he will not attend the Republican National Convention in Jacksonville, Florida, this August due to coronavirus concerns, the Des Moines Register reports.

West Virginia Gov. Jim Justice signed an executive order on Monday making face coverings mandatory in all public and privately owned buildings, effective Tuesday.

New York Gov. Andrew Cuomo accused President Trump at a press briefing Monday of "enabling the virus" by refusing to admit the U.S. is experiencing a real surge of COVID-19 cases.

4. How Guayaquil saved itself
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Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Axios Visuals

Guayaquil, Ecuador, offered the world some of the grimmest images to date from the pandemic: bodies lying in the streets as the health system buckled under a sudden influx of cases, Axios' Dave Lawler writes.

  • Flashback: "On April 4, at the height of the pandemic, 778 people died in Guayas, the province where Guayaquil is located, about 10 times the province’s normal daily death rate," per WSJ.
  • Flash forward: “In June, the province had about 60 deaths a day, with just a handful attributed to COVID-19.”

How it happened: The government, aided by a 32-year-old urban planner named Hector Hugo, used data to "pinpoint which neighborhoods were the hardest hit and where the virus would likely spread next," per the Journal.

  • Teams were then dispatched to find sick people before they turned up at the hospital.

Why it matters: "Guayaquil is the first large city in the developing world to be hit hard by COVID-19 and manage a turnaround."

5. Trump's big swing voter ACA risk
Data: KFF; Graphic: Axios Visuals

President Trump's decision to ask the Supreme Court to throw out the Affordable Care Act may alienate the independent voters who can swing the presidential election. That could be especially important in battleground states, the Kaiser Family Foundation's Drew Altman writes in today's column.

The big picture: Many of the ACA's benefits are hugely popular with independents — even beyond protections for people with pre-existing conditions, which gets the most attention.

By the numbers: KFF polling asked independent voters whether they would want certain ACA policies to remain in place even if the ACA were thrown out.

  • 93% of independent voters want insurance companies to continue to be prohibited from setting lifetime limits on coverage.
  • 82% want to retain subsidies to help people pay for insurance.
  • 80% want young adults to keep the option of staying on their parent's plans.
  • And 90% of independents want to see protections for people with pre-existing conditions continue if the court throws out the ACA.

President Trump has offered no plan to replace any of these consumer protections if the Supreme Court grants his wish and strikes down the versions that exist now.

What to watch: Going after popular ACA consumer protections may even create some vulnerability within Trump’s base.

  • 79% of Republicans support getting rid of the ACA. But if Republicans think that might result in losing protections for pre-existing conditions, support for overturning the ACA drops to 45%.
Caitlin Owens

Editor's note: The fifth story in yesterday's Vitals was corrected to show Alabama broke its record of daily infections with 1,725 cases on July 2 (not with 298 new cases last Sunday).