Apr 9, 2020

Axios Vitals

Good morning. Happy Thursday. Hope you're all staying safe and sane.

Today's word count is 1,340, or a 5-minute read.

1 big thing: Hospitals' coronavirus cash is coming

Illustration: Rebecca Zisser/Axios

The federal government is sending $64 billion to hospitals, post-acute facilities and other medical providers to help cope with the coronavirus fallout, Axios' Bob Herman reports.

Yes, but: Even though more funding is coming, safety net and rural hospitals fear they are getting a raw deal from the way some of the money is being distributed.

The big picture: Hospitals and other providers requested funding to offset higher labor and supply costs as well as lost revenue from elective surgeries and procedures that had to be halted. Those federal funds, part of the most recent stimulus package, are now flowing.

Where it stands: The federal government is doling out $30 billion in no-strings-attached bailouts, out of the $100 billion that was authorized, but some facilities that treat vulnerable patients are worried about the way that money is being distributed.

  • The government's funding mechanism is "going to widen the disparities" between safety-net providers and large hospital systems that already have large cash reserves, said Beth Feldpush, a top executive at America's Essential Hospitals.
  • Hospitals' and other providers' share of that $30 billion will be based on their historical Medicare revenue. That's a good deal for hospices, home health companies and dialysis facilities, which primarily treat Medicare patients, according to an analysis from Spencer Perlman, an analyst at Veda Partners.
  • But safety net and rural hospitals, some of which are in coronavirus hotspots right now, typically treat a lot of uninsured and Medicaid patients and worry they won't be getting paid proportionally.

Hospitals have also tapped a separate $34 billion pot, which will be administered as "advance payments" from Medicare — essentially loans. Hospitals can request up to six months of advance payments, and have to repay it within a year before interest starts to accrue.

2. The Trump administration's fizzled face mask plan

Top Trump administration officials had been developing a plan to give cloth masks to huge numbers of Americans, but the idea lost traction amid heavy internal skepticism, my colleague Jonathan Swan and I reported yesterday.

The big picture: The scale of this undertaking would have been extraordinary, mobilizing an enormous public-private partnership to deliver protective cloth masks to millions of people — in one iteration of the idea, maybe even to every American.

Details: Administration officials had considered a partnership in which Hanes and Fruit of the Loom manufactured millions of cloth face masks and the U.S. Postal Service would have helped deliver them.

  • Robert Kadlec, the assistant secretary for Preparedness and Response at the Department of Health and Human Services, was the key driver of the idea and had vocal support from Deputy National Security Adviser Matthew Pottinger.

Kadlec has argued for a partnership among Hanes, Fruit of the Loom and the Postal Service. He wanted to publicly announce the proposal in conjunction with the then-upcoming federal guidance encouraging people to wear masks.

Where it stands: Hanes has already announced that it's retooling its factories to make masks for health care workers to help alleviate shortages. But Kadlec's idea for a bigger partnership has been tabled.

Several senior officials opposed the idea, questioning its practicality.

  • "It's not clear they have thought through the costs, the logistics of how this would work, or whether this is a wise idea in the first place," one senior official said.
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

Chicago's Cook County jail is the largest-known source of coronavirus infections in the U.S., the New York Times reports. The White House has identified Chicago's metro area as a risk for exponential growth of the virus.

New Jersey Gov. Phil Murphy (D) signed an executive order on Wednesday to postpone the state's primary election until July 7, and New York Gov. Andrew Cuomo (D) signed an order for all voters to use absentee ballots in the state's June 23 election.

A rare bipartisan group of lawmakers is calling on global health organizations to permanently ban the buying and selling of live wildlife, which is likely the root cause of the novel coronavirus outbreak.

Amid the coronavirus pandemic, nearly one-third of apartment renters in the U.S. didn't make their April payments, according to numbers from the National Multifamily Housing Council and a group of real-estate data providers.

The U.S. is starting to see "glimmers of hope" when it comes to the coronavirus pandemic, despite recent increases in the rate of reported deaths due to the illness, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Fox News.

Fauci on Wednesday called conspiracy theories suggesting the novel coronavirus death toll is inflated because sick people are dying with the virus — not because of it — "nothing but distractions."

The coronavirus is spreading in rural America, with more than two-thirds of the country's rural counties reporting confirmed cases and one in 10 reporting at least one death, the New York Times reports.

4. The latest worldwide
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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.

Air travel — and the jet fuel powering it — are plummeting alongside most other parts of our modern economy as vast swaths of the world shut down to fight the coronavirus.

China's handling of the coronavirus has favorably highlighted the capability and transparency of Taiwan, which, like China, is also seeking to assist other countries in fighting the pandemic, Axios' Bethany Allen-Ebrahimian writes.

  • Many Indians are angry at China and the World Health Organization for their perceived mishandling of the coronavirus. The efficiency and transparency of Taiwan's response to the epidemic, in contrast, has made it a topic of renewed sympathy and interest in India.

In the depths of an economic crisis, with few well-equipped hospitals and spotty access to running water and electricity in some places, Venezuela will struggle to cope with its coronavirus outbreak without international aid.

  • While the U.S. is attempting to oust Nicolás Maduro's government, and most in the region and around the world treat Maduro as a pariah, China is extending a helping hand, Bethany reports with Axios' Dave Lawler.
5. We shouldn't count on weather to save us

The coronavirus isn't likely to significantly slow down when summer arrives, although plenty of uncertainties remain, a National Academies of Sciences panel told the White House on Tuesday, per the Washington Post.

Why it matters: That puts extra weight on getting mitigation measures — like testing, contact tracing and quarantining — right whenever we begin to lift social distancing policies.

Between the lines: Experts have hoped that the virus would die down during the warm summer months, giving us time to be better prepared for it in the fall. But there hasn't been any concrete evidence that that'll be the case, meaning we shouldn't have been counting on it anyway.

6. The pandemic and pollution

COVID-19 is underscoring the connection between air pollution and dire outcomes from respiratory diseases, Axios' Bryan Walsh reports.

Why it matters: Old-fashioned air pollution is almost certainly the single biggest environmental health threat, contributing to the deaths of some 7 million people a year according to the WHO, making it comparable to deaths from smoking.

  • How deadly COVID-19 might be is a function of a number of variables, from the age of a patient to viral load to how overwhelmed a hospital system might be. But a growing body of research is a reminder of the hidden health consequences of living with serious air pollution.

Driving the news: A new study by researchers at Harvard T.H. Chan School of Public Health examined more than 3,000 counties in the U.S. and found that higher levels of the small particulate matter known as PM2.5 were associated with higher rates of death from COVID-19.

  • Some of the results were startling: A person who had lived for decades in areas with high levels of PM2.5 was 15% more likely to die from COVID-19.

Other early studies have shown a similar relationship in countries hit hard by COVID-19.

Flashback: In 2003, researchers found that SARS patients in the most polluted parts of China were twice as likely to die from the virus as those living in low pollution areas.

Go deeper.

7. The coronavirus pandemic threatens low-wage jobs
Data: LaborCUBE; McKinsey Global Institute analysis; Chart: Axios Visuals

As many as one-third of U.S. jobs may be vulnerable as a result of the coronavirus pandemic, and it will disproportionately displace low-income workers that do not have the financial cushion to absorb the economic blow, Axios' Kim Hart reports.

Why it matters: The dire economic ramifications of the national shut-down stand to devastate those that can least afford it. Nearly 10 million Americans have filed for unemployment claims in recent weeks.

The latest: According to an analysis by McKinsey Global Institute, up to 86% of the vulnerable jobs paid less than $40,000 a year, and almost all (98%) of at-risk jobs paid less than the national living wage for a family of four ($68,808).

  • Almost 40% of the vulnerable jobs are in small firms with fewer than 100 employees, which are less equipped than big companies to weather the storm.

Go deeper.