May 19, 2020

Good morning.

  • Thank you to everyone who sent kind emails about Paco, my foster dog. I am happy to report that he has found a forever home, although sad to report that he is no longer helping with Vitals.

Today's word count is 986, or a 4-minute read.

1 big thing: The hospital procedures taking a pandemic dive

Adapted from Strata Decision Technology; Chart: Naema Ahmed/Axios

Hospitals and outpatient offices have canceled elective procedures and surgeries en masse to prepare for the coronavirus, but some treatments have been more "elective" than others, Axios' Bob Herman reports.

The big picture: Health care services have fallen across the board. The most pronounced drops have come in eye, spine and joint replacement surgeries.

By the numbers: Volumes this year for pretty much every hospital service have plummeted by at least 33% when compared with the same six-week stretch in 2019, according to a new analysis by hospital software firm Strata Decision Technology, which looked at procedure volume data at 51 hospital systems.

  • This includes major drops in lucrative, high-volume hospital specialties such as spine (45%), orthopedics (43%) and cardiology (35%).
  • Outpatient specialties that have quicker procedures, like those in ophthalmology (50%) and dermatology (44%), have fallen the most.
  • Cancer procedures have declined less than most others (18%), given the necessity of care.

Between the lines: Some specific procedures within these specialties have fallen even more than the averages show.

  • For example, within orthopedics, hospitals have almost completely stopped knee replacement surgeries in April, and they've dropped in total by more than 68% when comparing the same six-week periods in 2019 and 2020.
  • Hip replacements are down 52%.

The big picture: Hospitals and outpatient offices are starting to resume some of these operations depending on their states' coronavirus cases and hospitalizations, but the volumes likely won't return quickly, as people fear the risks of catching the coronavirus in a health care setting.

Go deeper: Coronavirus is obliterating outpatient care

2. Old-fashioned contact tracing is most popular

Data: Axios/Ipsos survey; Chart: Danielle Alberti/Axios

A large majority of Americans say they're likely to cooperate with contact tracing and isolation efforts — as long as that doesn't involve handing over their cell phone location data, according to the latest installment of the Axios-Ipsos Coronavirus Index.

Why it matters: Basing contact tracing efforts around voluntary cell phone programs is only effective if people are willing to use those programs — which Americans generally aren't, as we reported last week.

  • But they seem much more willing to tell health officials who they have come into contact with after testing positive for the coronavirus, and to self-isolate if they are on an infected person's list of contacts.
  • That's good news. Stopping the virus' spread is dependent on figuring out who has it, who those people may have given it to, and preventing those people from spreading it even further.

The bottom line: One of the benefits of using cell phone programs for contact tracing is that they relieve some of the human workload. But this polling suggests that traditional contact tracing will be more effective — which experts say could require upwards of 100,000 workers.

Go deeper: Why contact tracing may fall apart

3. The latest in the U.S.

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.

A county judge in Oregon on Monday tossed out Gov. Kate Brown's stay-at-home executive order because it was not approved by the legislature within 28 days.

Healthy patients who received the first doses of Moderna's coronavirus vaccine appeared to have generated antibody responses to the virus, according to early phase one trial data released by the company Monday.

Uber CEO Dara Khosrowshahi said Monday in an email to employees that the company is cutting about 3,000 more jobs and closing or consolidating 45 offices to soften the economic blow from the coronavirus pandemic, the Wall Street Journal reports.

A coalition of tech companies has signed a pledge to find ways to support working parents at their firms through the coronavirus crisis, thereby setting examples for other employers.

4. Tourist hotspots hope summer travel heats up

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

Tourist hotspots around the world face a daunting challenge: how to bring in much-needed visitors while keeping COVID-19 out, Axios' Dave Lawler reports.

Why it matters: As the summer season heats up in the Northern Hemisphere, that’s a multitrillion-dollar question.

Few places on Earth are more dependent on international arrivals than Aruba, where tourism accounted for 86% of GDP in 2018.

  • Live videos showed sunny if blustery weather on beaches there yesterday afternoon, but they were entirely devoid of people.

Zoom out: Most Caribbean islands have seen relatively few cases of COVID-19, meaning the main concern is keeping infections out.

Summer holidays are sacrosanct in Europe, and Brussels has joined national governments in issuing assurances that they will not be sacrificed to COVID-19.

  • Europe is home to three of the world's five most-visited countries (France, Spain and Italy) and an outsized proportion of international travelers.
  • "Our message is we will have a tourist season this summer," EU economic affairs commissioner Paolo Gentiloni said last week, "even if it's with security measures and limitations."

And in the U.S., the COVID-19 recession will likely hit tourism-reliant states like Hawaii and Nevada worst of all, Axios' Courtenay Brown reports.

Go deeper.

5. Trump says he's taking hydroxychloroquine

President Trump said yesterday that he's been taking hydroxychloroquine, an antimalarial drug, and a zinc supplement for over a week as a preventative measure against the coronavirus.

Why it matters: The FDA issued a warning last month that the unproven drug should only be taken in hospitals because of the risk of heart complications, Bob notes.

  • There's no substantiated evidence that taking hydroxychloroquine prevents COVID-19 infections. It's being studied as a potential preventative measure for health care workers with high risk of exposure to coronavirus patients.

The big picture: Rick Bright, the former head of a key government vaccine agency, testified last week that he believes he was ousted from his position because of his resistance to promoting hydroxychloroquine, which has long been touted by Trump and his allies in conservative media.

My thought bubble: Trump's personal use of the drug is questionable on its own. But it will almost certainly affect other people as well.

  • After Trump began touting the drug, demand for hydroxychloroquine spiked so much that patients who rely on it to treat other conditions were at risk of shortages.
  • That was before we knew that the drug could be dangerous. If Trump inspires others to follow his lead, it could have fatal consequences.