May 14, 2020

Axios Vitals

Good morning.

Axios is hosting a live virtual event on Medicaid and mental health. Join Axios co-founder Mike Allen tomorrow at 12:30pm ET for a conversation with Rep. Lauren Underwood (D-Ill.) and former acting administrator of the Centers for Medicare and Medicaid Services Andy Slavitt.

Today's word count is 1,291, or a 5-minute read.

1 big thing: Bigger, wealthier cities lead on coronavirus recovery

Illustration: Sarah Grillo/Axios

Big cities have taken the biggest hit from the coronavirus, but they're now ahead of the curve in developing the public health infrastructure to manage the crisis in the future.

Why it matters: Communities that can conduct widespread testing and efficient contact tracing will be better able to keep more of their residents alive and reopen parts of their economies. So far, cities and states with large populations and ample resources are at the forefront.

New York City, the worst-hit city in America, is now emerging as a national leader in recovery.

  • New York Gov. Andrew Cuomo announced this week that nursing homes in the state must test staffers twice a week, and New York City is offering hotel rooms to help mildly symptomatic patients isolate without exposing members of their household, per the Washington Post.
  • Former Mayor Michael Bloomberg committed $10.5 million, along with technical and organizational assistance, to help New York build up a giant contact tracing program.

San Francisco is testing all essential workers through its partnership with Color, a health tech company, and other Bay Area companies.

The other side: Some smaller areas with fewer cases are also taking important steps. And tech companies say they can help close the gap between wealthy, well-resourced cities and more rural areas.

  • "One of the things that is most fluid is technology," Color CEO Othman Laraki told me. "It's really hard to move buildings. It's really hard to move equipment. But I think technology is a very big part of this."
  • North Dakota and South Dakota have launched a new contact tracing app.
2. The pandemic broke America

Illustration: Sarah Grillo/Axios

Eight weeks into this nation's greatest crisis since World War II, we seem no closer to a national strategy to reopen the nation, rebuild the economy and defeat the coronavirus, Axios editor-in-chief Nick Johnston reports.

Why it matters: America's ongoing cultural wars over everything have weakened our ability to respond to this pandemic. We may be our worst enemy.

  • The response is being hobbled by the same trends that have impacted so much of our lives: growing income inequality, the rise of misinformation, lack of trust in institutions, the rural/urban divide and and hyper-partisanship.

Without even a basic agreement on the danger of the pandemic and its toll, here's how we see the national response unfold:

  • The Centers for Disease Control and Prevention, the crown jewel of the globe's public health infrastructure, has been sidelined, its recommendations dismissed by the White House.
  • President Trump declares the U.S. has "prevailed on testing" at a time when health experts say we still need far more daily tests before the country can reopen safely.
  • Distribution of the promising coronavirus drug remdesivir was initially botched because of miscommunication between government agencies.
  • The virus is literally inside the White House. Aides have tested positive for coronavirus, leading to quarantines for some of the nation's top public health officials.
  • The No. 1 book on Amazon for a time was a book by an anti-vaxxer whose conspiracy-minded video about the pandemic spread widely across social media, leading to takedowns by platforms like YouTube and Facebook.

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. This graphic includes "probable deaths" that New York City began reporting on April 14.

Wisconsin's Supreme Court on Wednesday ruled against the state's stay-at-home order, saying the state's health department exceeded its authority.

Anti-vaccination movements could grow large enough to disrupt efforts to create public immunity when a vaccine is developed, according to new research, Axios' Bryan Walsh reports.

President Trump claimed on Wednesday that the novel coronavirus has "had very little impact on young people," and said that NIAD director Anthony Fauci's caution on reopening schools was "not an acceptable answer" while meeting with governors at the White House.

The CDC created detailed guidance on when and how to ease local coronavirus lockdown restrictions that includes a warning of future flareups, according to a document obtained by AP.

The U.S. has admitted two people seeking humanitarian protection at the southern border since March 21, amid new coronavirus restrictions from the Trump administration, according to U.S. Citizenship and Immigration Services data first obtained by the Washington Post and confirmed by Axios.

America's educators and students have a daunting year ahead as the coronavirus pandemic carries on. "Saturday school" and "summer school" used to evoke images of punishment for American kids, but they may need to become commonplace for everybody.

A top vaccine doctor who was ousted from his position in April is expected to testify today that the Trump administration was unprepared for the coronavirus, and that the U.S. could face the "darkest winter in modern history" if it doesn't develop a national coordinated response, according to prepared testimony first obtained by CNN.

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

A hospital in the epicenter of Italy's coronavirus outbreak has seen a 30-fold increase of children with severe inflammatory symptoms most often associated with Kawasaki-like disease, according to a study published Wednesday in the medical journal The Lancet.

Member states of the EU should only allow tourists in from countries that can prove their coronavirus outbreaks are under control, the European Commission said in guidance released Wednesday.

Australia and New Zealand are reopening their economies from coronavirus constraints and are on track to share a "COVID-safe travel zone" within weeks.

The Federal Bureau of Investigation (FBI) and Cybersecurity and Infrastructure Security Agency issued a joint alert on Wednesday warning that actors affiliated with the Chinese Communist Party are targeting U.S. institutions for data and intellectual property related to coronavirus research.

Brazilian President Jair Bolsonaro on Tuesday challenged state governors vowing to defy his push to reopen businesses to file lawsuits against his government as the country reported a record 881 people had died from the novel coronavirus in 24 hours

5. New world of digital coronavirus screening

Illustration: Sarah Grillo/Axios

Employers emerging from lockdown are looking to new COVID-19 screening tools to help workers get back on the job, Bryan reports.

Why it matters: Neither employees nor customers are likely to return to businesses if they fear infection, so there needs to be some way to separate the sick from the well. But many new screening services are untested, and could open the door to intrusive health surveillance.

Driving the news: Dozens of states have begun at least a limited form of reopening, but putting workers and customers back in offices and restaurants will raise the risk of new outbreaks unless the potentially infectious can be identified.

  • As a result, medical security is going to need to become a part of overall workplace security, says Mark Ein, chairman of Kastle Systems, the leading U.S. provider of commercial security.

What's happening: A number of companies are already rolling out new digital tools designed to identify possible COVID-19 cases at the point of entry for workplaces.

The catch: It's far from clear how effective any of these tools will be.

  • Beyond issues with effectiveness, these new services present challenges to autonomy and privacy.

Just as 9/11 led to more invasive security in airports and other vulnerable spaces, most indications are the pandemic will lead to more pervasive health surveillance abetted by new digital tools.

Go deeper.

6. Tech industry asks Pence for reopening guidance

A top tech trade group in a Wednesday letter to Vice President Mike Pence pushed the Trump administration to provide clear nationwide guidance on how companies should approach reopening during the coronavirus pandemic.

Why it matters: Conflicting guidance from federal, state and local authorities on how to safely get back to work is muddying an already daunting prospect, Axios' Margaret Harding McGill reports.

Details: Information Technology Industry Council president Jason Oxman is seeking a clear set of guidelines that address the following topics:

  • Assessing readiness: Creating a checklist of measures employers should consider taking before reopening that includes social distancing practices and cleaning protocols.
  • Health monitoring: Identifying effective COVID-19 screening methods that can be used in a workplace, as well as encouraging widespread testing as capacity increases.
  • Transmission mitigation: Techniques employers can use to reduce virus spread such as reconfiguring cubicles or workspaces, determining who is responsible for providing face coverings, and maintaining records on contact tracing.
  • Employee support: How to respond to employees whose immigration status is uncertain due to the pandemic or who must care for family members.

Go deeper: Reopening debate opens tech rift