May 7, 2020

Axios Vitals

Good morning.

Today's word count is 1,259, or a 5-minute read.

1 big thing: The U.S. coronavirus recovery is way behind Europe
Data: The Center for Systems Science and Engineering at Johns Hopkins; Chart: Naema Ahmed/Axios

Other countries — even some hit hard by the coronavirus — are beating back their outbreaks more successfully than the U.S., Axios' Dave Lawler and I report.

Why it matters: The number of new cases every day is holding steady in the U.S., but it's not going down — a key benchmark many other countries achieved before loosening their lockdowns and social distancing measures.

In some of Europe's hardest-hit countries, case counts seemed to skyrocket uncontrollably even amid some of the world's strictest lockdowns.

  • Italy and Spain followed a similar pattern. New cases climbed over about a month from under 100 per day to terrifying peaks of roughly 8,000 per day in Spain and 6,000 per day in Italy.
  • The fall was nearly as sharp. Within two weeks of the peak, the rates of daily recorded cases had been halved. They've continued to fall since.

America's daily rate climbed faster and higher (due in part to its larger population), but appears to have peaked at around 30,000 new cases per day in the first week of April.

  • But rather than falling, the rate stagnated. Outside of New York (which has bent its curve) the rate is actually continuing to climb.

Between the lines: The U.S. didn't lock down as tightly as some of those countries, and made a host of mistakes early in the response.

  • Italy and Spain issued strict nationwide lockdowns that forced most people to remain inside except to shop for necessities. Spain didn't allow children outside at all.
  • "Our economic shutdown ... wasn't as broad as some of the other countries', so there was more opportunity for the virus to spread," said Amesh Adalja, a senior scholar at the John Hopkins Center for Health Security.

The big picture: "It seems that this is a controllable pandemic without it having to run its natural course," says Columbia University economist Jeffrey Sachs.

2. The high stakes of pricing a coronavirus drug

Now that the federal government is allowing the emergency use of remdesivir for coronavirus patients, and as the world awaits final clinical data on the drug's effectiveness, a giant question looms: What will the price be?

Why it matters: Gilead's pricing decision is important on its own, but it also will set the bar for how all coronavirus treatments that come after remdesivir will be priced, Axios' Bob Herman reports.

Where it stands: Gilead CEO Daniel O'Day has punted all questions related to remdesivir's price thus far.

The intrigue: We have some ballpark pricing thresholds to consider based on a new report from the Institute for Clinical and Economic Review, an organization that analyzes drug prices.

  • $10 per treatment: This assumes a "nonprofit" model where Gilead would only attempt to recover the basic costs of making remdesivir. Even $10 per 10-day treatment, or $1 a day, is above cost, according to researchers and consumer advocates.
  • $390 per treatment: So far, the science suggests remdesivir helps on the margins — it may get patients out of the hospital a few days quicker, but does not reduce the chance of death. A drug with that level of efficacy, if it's not being given away, should land at this price, ICER says.
  • $4,460 per treatment: This large jump in price assumes clinical trial data would show the drug saves lives.

The bottom line: Drug prices have taken a backseat to the pandemic, but remdesivir is about to make the issue very relevant again.

3. The latest in the U.S.
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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.

Senate Intelligence Chairman Richard Burr's (R-N.C.) brother-in-law, Gerald Fauth, dumped up to $280,000 in shares on the same day as the senator, according to documents published by ProPublica on Wednesday.

Children in the U.S. are currently experiencing food insecurity that is "unprecedented in modern times," Lauren Bauer of the Brookings Institution's Hamilton Project wrote on Wednesday.

Far from being the unifying force other catastrophes have been, the COVID-19 pandemic is tearing a divided America — and world — further apart, Axios' Bryan Walsh reports.

President Trump has complained to advisers about the way coronavirus deaths are being calculated, suggesting the real numbers are actually lower — and a number of his senior aides share this view, according to sources with direct knowledge, Axios' Jonathan Swan and Sam Baker report.

Trump tweeted Wednesday that the White House's coronavirus task force will continue "indefinitely" but move to focus on "safety & opening up our country."

Irate business owners are finding out the hard way that their insurance policies don't cover coronavirus — and they're suing, Axios' Jennifer Kingson writes.

California saw a spike in confirmed coronavirus cases of 2,603 on Wednesday as Gov. Gavin Newsom (D) reported that the state has conducted 100,000 tests over the course of three days.

A fifth of Wendy's 1,043 fast-food restaurants have run out of meat, an analysis by the financial firm Stephens found, per the New York Times.

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

Andela, a tech staffing platform focused on training and connecting African developers with U.S. companies, today confirmed to TechCrunch that it has laid off more than 11% of its staff, or 135 employees. Among its investors are Google Ventures and the Chan Zuckerberg Initiative.

The U.S. is bullish on the possibility that the coronavirus outbreak started with a lab accident in China. But U.S. allies say that's unlikely, Axios' Bethany Allen-Ebrahimian reports.

A growing number of reports indicate Chinese officials pushed their counterparts in Europe to make positive statements about China in order to receive shipments of medical supplies to fight the novel coronavirus, Bethany writes.

5. HHS wanted to "flood" states with chloroquine

The whistleblower complaint filed by former Health and Human Services official Rick Bright includes email chains that illuminate the administration's push to use chloroquine — an unproven drug that President Trump has repeatedly touted, Axios' Orion Rummler and I report.

In a March 17 email, HHS official Joe Hamel described chloroquine as "not a blockbuster drug for this fight, but a good drug."

  • Chris Houchens, an official in Bright's former office, known as BARDA, warned of "safety liabilities associated with the drug," but also said "the potential benefit outweighs the risk, especially when we have few/no options."

The Food and Drug Administration has only signed off on emergency use of hydroxychloroquine in hospitals, but Assistant Secretary of Health Brett Giroir said on April 5 it "needs to go to pharmacies as well," according to emails included in the complaint.

  • "The drug is approved and therefore can be prescribed as per doctor’s orders. That is a FINAL ANSWER," he wrote, saying that the FDA's emergency authorization "matters not."
  • Giroir and other HHS officials discussed an effort "to flood NY and NJ with treatment courses" of hydroxychloroquine in an email chain on April 4, citing a "WH call."

The other side: HHS declined to respond to any specifics in the complaint.

6. 1 happy-ish thing

Illustration: Eniola Odetunde/Axios

The dramatic need caused by the pandemic and the accompanying economic devastation is being partially met by innovative approaches to philanthropy, Bryan writes.

Why it matters: The COVID-19 pandemic could lead to human misery on a scale we haven't seen for decades. Smarter and more generous volunteering and giving could help prevent the worst outcome while demonstrating the unity that is desperately needed.

What's happening: According to the nonprofit Candid, nearly $10 billion in large charitable gifts around the world has so far been donated in response to the pandemic, with much of it originating in the U.S. That's far more than was given for catastrophes like Hurricane Sandy.

  • But as great as the giving has been, the need is even greater. More than 30 million Americans have filed unemployment claims, while globally, the number of starving people could double because of the pandemic.

Be smart: There will always be a limit in what even the most generous private philanthropy can do — the size of Washington's initial stimulus package was more than 200 times bigger than those large charitable gifts.

  • But charity can make a difference at the margins, especially if ordinary people get involved helping their neighbors.

The bottom line: We may be politically divided, but Americans can still be counted on to give their money and time to neighbors in need.