Apr 3, 2020

Axios Vitals

Good morning.

Do you know any health care workers — friends, family, or colleagues — who have exhibited heroic selflessness over the last few weeks? If so, please hit reply to this email and tell me their stories — I'd love to feature them.

  • If you can, please include their first name, a general description of their job (emergency room nurse, trauma surgeon, etc.) and the city that they live in.

Situational awareness: Vice President Mike Pence said yesterday that hospitals will be paid for caring for uninsured coronavirus patients.

Today's word count is 1,463, or a 6-minute read.

1 big thing: The push to multiply limited medical supplies

Illustration: Eniola Odetunde/Axios

Health care workers and the federal government are scrambling to stretch limited supplies of medical equipment.

Why it matters: We can't manufacture enough medical masks or ventilators in time to meet the enormous surge in demand that's expected to hit in mid-April. The next-best thing is trying to make what we have last as long as possible.

As it became clear that medical supply shortages would be a problem, the Centers for Disease Control and Prevention released strategies for stretching mask supplies, which included reusing masks or, in truly desperate times, using bandanas and scarves as substitutes.

  • The Trump administration has drastically loosened regulations on medical supplies, expanding the kinds of masks health care workers can use and speeding up the importation process for medical supplies.

What's next: States, hospitals and the federal government are trying to make existing supplies last while they desperately try to find more equipment.

  • The administration is airlifting in millions of masks, gloves and face shields, mostly from Asia.
  • And yesterday it announced that it's delivering hundreds of thousands of hoarded masks and gloves that were confiscated.

The administration announced yesterday that it's using additional authority under the Defense Production Act to speed up ventilator production.

  • But Politico reported yesterday that Federal Emergency Management Agency officials told the House Oversight Committee this week that there are only 9,500 ventilators in the Strategic National Stockpile, and only 3,200 more will become available by the week of April 13.

Doctors in New York are already thinking about how to decide which patients will receive limited ventilator supplies, the New York Times reports.

  • And then there's the bidding war: New York state is paying up to 15 times the normal price for medical equipment, amidst unprecedented demand, ProPublica reports.

Yes, but: All of this may be too late.

2. The rich pull up the drawbridges

Illustration: Aïda Amer/Axios

From hastily-chartered superyachts to fortresslike country estates, the wealthiest Americans have found places to ride out the pandemic far away from the masses, Axios' Jennifer Kingson reports.

Why it matters: The contrast between the rich vs. poor experience of coronavirus exposes class differences — in housing, access to health care, etc. — that are less obvious in normal times.

Where it stands: Even as elected officials tell us that the novel coronavirus does not discriminate — New York Gov. Andrew Cuomo called it "the great equalizer" — it's still true that the moneyed classes are walling themselves off and, on the whole, suffering less.

  • People with second (and third) homes have stampeded from hot spots like New York City to pastoral and less-afflicted areas — like the Hamptons, Cape Cod, Hilton Head and Palm Beach.
  • Thanks to "concierge medicine," where people pay hefty annual fees in exchange for near-unlimited access to their doctors, the rich have been getting faster access to COVID-19 tests, plus more attention when they're sick.

While the wealthy were among the first in the U.S. to contract the virus (as they're more apt to travel abroad), the brunt of the pandemic has hurt the working poor."

  • People who live in poverty are more likely to have underlying illnesses that make them more susceptible to coronavirus — asthma, heart disease, hypertension, diabetes.

Go deeper.

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

Roughly 3.5 million Americans likely lost their health insurance just in the past two weeks, according to an analysis of state and federal data from the Economic Policy Institute. That's over one-third of the people who have filed unemployment claims.

Treasury Secretary Steven Mnuchin said Thursday that oil companies are eligible for aid from new lending programs the Federal Reserve is setting up, but not direct loans from his department.

The Democratic National Committee said its July convention will be postponed until August because of the coronavirus.

Wisconsin's April 7 presidential primary will not be postponed, a federal judge ruled on Thursday, as 13 other states have delayed voting or made changes to promote social distancing to combat the spread of the novel coronavirus, the Washington Post reports.

Grocery delivery company Instacart says that beginning next week it will make free safety kits with face masks, hand sanitizer and a thermometer available to its shoppers and distribute masks to in-store workers amid the coronavirus outbreak.

Gay men, bisexual men and their female partners can now donate blood after a three-month waiting period, instead of the previously required 12-month span, the Food and Drug Administration announced Thursday.

Venture capital-backed startups will become eligible for $350 billion in small business loans guaranteed by the federal government, House Minority Leader Kevin McCarthy (R-Calif.) told the Axios Pro Rata Podcast on Thursday.

Google will begin to allow some advertisers to run ads across its platforms that address the coronavirus, according to a Google memo sent to clients and obtained by Axios.

4. The latest worldwide
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.

The coronavirus is spreading most widely in countries that should be among the best equipped to handle it. There's no reason to expect that to remain the case, Axios' Dave Lawler reports.

Policy responses to the global coronavirus crisis have been every-country-for-itself and — in the case of the U.S. and China — tinged with geopolitics. But the scientific work underway to understand the virus and develop a vaccine has been globalized on an unprecedented scale.

Israeli Prime Minister Benjamin Netanyahu re-entered self-quarantine on Thursday after his health minister, Yaakov Litzman, tested positive for coronavirus, according to the prime minister's office.

It's already hard to envision the world we lived in one month ago, Dave writes.

  • A WHO report from March 1 shows a total of 7,169 coronavirus cases outside of China, with just seven countries having recorded even a single fatality and the total death toll under 3,000, including China.
  • The global case-count has now topped 1 million.
5. Questions surrounding White House model

Leading experts don't know how the Trump administration got their numbers predicting between 100,000 and 240,000 American deaths from the coronavirus, the Washington Post reports.

  • There have also been debates among White House advisers about the accuracy of the estimate.

Between the lines: Any model is rife with uncertainty. But when we're talking about hundreds of thousands of deaths, there's some comfort to be had in knowing where those numbers come from.

  • But this just further underscores how much we don't know about the virus, and how much uncertainty there is about how all of this plays out.

Go deeper: What disease modeling could learn from weather forecasting

6. Dire prospects for health care's first quarter

The health care industry has been on a long run of financial prosperity, but early data points show the coronavirus is abruptly ending that run, Axios' Bob Herman reports.

The big picture: Health care is usually pretty recession-proof because people still need to see doctors and fill prescriptions when the economy tanks. 

  • But almost no business is immune to a pandemic that is severely curtailing almost all forms of consumption, including most health care services.

Driving the news: Walgreens and Tenet Healthcare yesterday previewed how bad things have been so far.

  • Sales at Walgreens stores shot up 26% in the first 21 days of March compared with the same time in 2019, as people stockpiled prescriptions, toiletries and any other product they could find. But sales then plummeted "at a mid-teens rate of decline" as people hunkered down at home. April will be worse.
  • Hospital and surgery center chain Tenet Healthcare withdrew its 2020 financial expectations and furloughed 500 people, as surgery volumes dried up. Tenet, through the new bailout package, also will be asking the federal government to advance the pay on $1.5 billion of Medicare revenue — which will have to be repaid later.

Go deeper: So much for health care’s profitable election year

7. Immigrants on the front lines
Data: New American Economy; Chart: Naema Ahmed/Axios

New data provided to Axios spells out just how outsized a role immigrants play on the high- and low-skilled ends of the economy keeping Americans alive and fed during the coronavirus crisis, Axios' Stef Kight reports.

By the numbers: Immigrants make up an estimated 17% of the overall U.S. workforce. But the analysis by New American Economy (NAE) shows they're more than one in four doctors, nearly half the nation's taxi drivers and chauffeurs and a clear majority of farm workers.

  • Reporting to work in hospitals, restaurant kitchens, cabs or the fields — for jobs deemed "essential" by the government — many documented and undocumented workers are putting themselves at higher risk of COVID-19 infections.

Be smart: The share of immigrants in some health care roles are higher in states that have been hit hardest by the virus.

  • More than a third of California nurses are immigrants, as well as 29% of nurses in New York and New Jersey, according to NAE data.

Between the lines: A large percentage of farm workers, who help maintain food supplies, are unauthorized immigrants, as the New York Times reported.

  • Immigrants make up a small percentage of delivery workers nationwide, but one-third of delivery workers in New York are unauthorized immigrants, NAE director of quantitative research Andrew Lim told Axios.
  • The $2 trillion aid package does not include assistance for unauthorized immigrants.
8. 1 Fauci thing
Data: Newswhip; Chart: Naema Ahmed/Axios

If you feel like you're suddenly spending a surprising amount of your days thinking and talking about Anthony Fauci, you're not alone. He's become the third-most talked about person online, according to data from NewsWhip provided to Axios.

Why it matters: Fauci, the director of the National Institutes of Health office that deals with infectious diseases, has quickly become a household name, and one of the few household names with (mostly) bipartisan credibility.

Go deeper.