Jun 16, 2020

Axios Vitals

By Caitlin Owens
Caitlin Owens

Good morning.

  • The Axios Pro Rata podcast is now Axios Re:Cap — a 10-minute podcast that unpacks the day's biggest stories with a business lens — hosted by Dan Primack. In the first episode, Jalen Rose, ESPN commentator and former NBA player, digs into his efforts to increase African-American voter turnout, and whether or not players should return to the court. Tune in.

Today's word count is 1,030, or a 4-minute read.

1 big thing: LGBTQ ruling may sideline Trumps' health care rules

Illustration: Sarah Grillo/Axios

The Supreme Court's historic ruling on LGBTQ nondiscrimination could sideline the Trump administration's new policies on health care and adoption, Axios' Sam Baker and Alayna Treene report.

Why it matters: The ruling's ripple effects will be felt immediately, and could ultimately derail regulations the administration had finalized just days ago.

The big picture: Federal civil rights law prohibits discrimination on the basis of sex, and the Supreme Court said Monday that "sex" includes sexual orientation and gender identity.

  • Monday's case was specifically about employment, but the same legal interpretation will likely carry over to other areas, most notably health care — and that could cause problems for some of the Trump administration's policies.

Between the lines: Just a few days before the Supreme Court's ruling, the Department of Health and Human Services rolled back Obama-era rules that banned health care providers from denying care to trans patients.

  • That was based on the Trump administration's interpretation of what constitutes "sex" discrimination — that it only encompasses biological traits defined at birth. That is, broadly, the same interpretation the high court rejected on Monday.

What's next: The court's ruling does not automatically invalidate the health care rules, but would make them much harder to defend in court. And if the administration doesn't withdraw the rules, those lawsuits are coming.

HHS declined to answer questions about the regulations in light of Monday's ruling.

  • The Trump administration has been working on rules that would make it easier for adoption and foster agencies to refuse to work with same-sex couples. Those rules would also face lawsuits if and when they're finalized.
2. Americans fear a second wave
Data: Ipsos/Axios survey; Note: ±3.3% margin of error. This survey defined self-quarantine as staying at home and avoiding contact with others for 14 days and social distancing as staying at home and avoiding others as much as possible; Chart: Naema Ahmed/Axios

Eight in 10 Americans are worried about a second wave of the coronavirus, with large majorities saying they'll resume social distancing, dial back shopping and keep their kids out of school if it happens, in Week 13 of the Axios-Ipsos Coronavirus Index.

Why it matters: Businesses and schools around the country are trying to assess how quickly and fully they should reopen based in part on what Americans will demand and tolerate, Axios' Margaret Talev writes. These findings underscore the challenges in predicting how they should proceed.

  • But getting Americans to swallow a second round of 14-day self-quarantining could be tougher than getting them to go back to social distancing, with one in three saying they likely won't do it.
  • The biggest factor is partisan identification, with 81% of Democrats but only 49% of Republicans saying they'll self-quarantine if a second wave hits.

The big picture: The latest installment of our national weekly survey shows a renewed sense of risk following reports of new hospitalizations since states began lifting stay-at-home orders — but quarantine fatigue is still driving people to take their chances.

Go deeper.

3. The latest in the U.S.
Expand chart
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.

The FDA ended Monday its emergency use authorizations for two controversial drugs, hydroxychloroquine and chloroquine, as a potential coronavirus treatment.

President Trump's campaign will require temperature checks and will distribute face masks and hand sanitizer to each person attending his rally in Tulsa, Oklahoma, on Saturday, a spokesperson said Monday.

Hawaii's strict coronavirus restrictions appear to be working as COVID-19 case numbers remain low, the Los Angeles Times reports. The state reported eight new cases on Monday, taking the total to 736. The death toll from the virus stands at 17.

West Virginia Gov. Jim Justice said Monday that 28 members of the Graystone Baptist Church in Greenbrier County tested positive for the coronavirus, ABC affiliate WCHS-TV reports.

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

The number of novel coronavirus cases surpassed 8 million worldwide on Monday evening, per Johns Hopkins.

The Americas are now firmly established as the pandemic's epicenter, Axios' Dave Lawler writes. One-half of coronavirus deaths reported in the past 24 hours occurred in Brazil (892), the U.S. (646) or Mexico (424). Chile (222) and Peru (190) were also among the countries recording the most deaths.

Countries have begun to reopen their borders in Europe. But as shops across England resumed business, the World Health Organization warned the U.K. is still in a "very active phase of the pandemic," per the Guardian.

5. Why we didn't run out of hospital beds

As the coronavirus really began to take hold in the U.S. earlier this year, experts warned that hospitals would soon be overrun with patients. But health systems never ran out of beds, even in New York City.

Between the lines: The hospitalization rate was much lower than predicted, ProPublica's Charles Ornstein reports.

  • Data from Wuhan, China, suggested that about 20% of known coronavirus cases required hospitalization. The Centers for Disease Control and Prevention estimated that for every person who died of the virus, more than 11 would be hospitalized. The real number is around four hospitalizations per death.
  • State hospitalization rates vary from 6% to more than 20%, according to the COVID Tracking Project.
  • In New York City, where around 20% of the adult population had coronavirus antibodies by mid-April, that translates to a hospitalization rate of about 2%, Nathaniel Hupert, an associate professor at Weill Cornell Medicine and co-director of the Cornell Institute for Disease and Disaster Preparedness, told ProPublica.

Hospitals also were good at increasing their number of beds. And the number of non-coronavirus patients was drastically reduced, both because elective care was postponed and some patients with other emergencies stayed home.

What we're watching: There were plenty of lessons learned from the first wave of the pandemic that can be applied going forward, particularly as the situation worsens in some states.

6. Walmart buys medication delivery tech firm

Walmart has acquired CareZone, an app-based company that helps coordinate the delivery of medications, Axios' Bob Herman reports. CNBC reported the deal was worth around $200 million.

Why it matters: Walmart now has the technology to mail prescription drugs to homes or arrange more pickups at its own pharmacies, which makes the retail giant more competitive in the multi-billion-dollar business of drug delivery.

Between the lines: CareZone essentially operates as an Uber for prescription medications. It acts as an agent, through an app, to get drugs for its 3.6 million users.

  • Walmart's massive footprint could grow the app as well as its lucrative pharmacy business.
  • "The world has moved to home delivery," CareZone CEO Jonathan Schwartz said.

The big picture: Pharmacy benefit managers control a lot of the mail-order business, but that is changing now, with Amazon buying PillPack in 2018 and Walmart buying CareZone.

Worth noting: Express Scripts and CareZone are still locked in a legal battle, with Express Scripts alleging CareZone doesn't have proper licensure, and CareZone alleging Express Scripts is engaging in anticompetitive behavior. The case is slated to go to trial when the courts reopen.

Go deeper: People are filling more prescriptions by mail amid coronavirus crisis

Caitlin Owens