Axios Vitals

Nearly half of Americans said that either they or someone in their household has skipped or delayed needed medical care because of the coronavirus, according to new polling by the Kaiser Family Foundation.

Why it matters: Shutting down elective medical care may have been necessary, particularly in coronavirus hotspots, but will have lasting effects on some patients.

By the numbers: Of the 48% of Americans who said someone in their household has delayed care, 68% expect to get the postponed care within the next three months, and almost all expect to eventually get the care.

• But of those who postponed care, 11% told KFF that they or their family member's condition worsened as a result.
• A separate survey by the American Cancer Society found that, among cancer patients in active treatment, 79% reported care delays — including 17% who reported delays to cancer therapy like chemotherapy, radiation or hormone therapy.

The big picture: Cancer patients pose a particularly wrenching illustration of the coronavirus catch-22: They are particularly vulnerable to the virus, and putting them in the same facility as coronavirus patients without stringent safeguards is dangerous. But delaying care can also be dangerous.

Between the lines: Not all delays are attributable to decisions made by governments or the health care system, especially as states reopen. Some patients are just too scared of catching the coronavirus to seek medical care.

• "Even as the number of [coronavirus] cases declines in many places, patients with cancer, heart disease and strokes, among others, are delaying or forgoing critical procedures that could keep them alive," NYT reported earlier this week.
• "And as the virus reignites in pockets of the country, people are ignoring symptoms altogether, afraid to set foot in emergency rooms or even doctors’' offices."

Go deeper: Spine and joint procedures have taken a dive during the pandemic

A wave of cyber-spying around COVID-19 medical research is once more demonstrating the perils of treating cybersecurity as a separate, walled-off realm, Axios Codebook author Zach Dorfman of the Aspen Institute writes.

Driving the news: U.S. officials recently announced an uptick in Chinese-government affiliated hackers targeting medical research and other facilities in the U.S. for data on a potential COVID-19 cure or effective treatments to combat the virus.

• Additionally, "more than a dozen countries have redeployed military and intelligence hackers to glean whatever they can about other nations’ virus responses," reports the New York Times.
• According to a recent FBI bulletin, "nation-state cyber actors are targeting COVID-19-related research as many foreign governments seek to accelerate their own R&D processes and clinical trials."
• Since February, suspected foreign government hackers have compromised the systems of a "healthcare-related" company, a "U.S. research entity," and have targeted other medical, pharmaceutical, and academic institutions, says the Bureau.

Of course the world's spies are trying to purloin vaccine research: Nothing is more valuable right now, anywhere on the planet.

• The country that's first with a vaccine will, in theory, benefit immensely. Elections may be won or lost because of it. Industries and entire economies hang in the balance. Social stability may depend on vaccine access.
• There are also subtler benefits of a vaccine: the soft power accrued to whoever develops and shares it internationally, as well as the potential profits from what should be a global, compulsory, vaccination campaign.

Go deeper.

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Americans are experiencing an increase in anxiety and depression amid the coronavirus pandemic, according to a U.S. Census Bureau survey cited by the Washington Post.

Coronavirus antibody tests are still relatively unreliable, and it's unclear if people who get the virus are immune to getting it again, the Centers for Disease Control and Prevention cautioned on Tuesday.

The CDC also released new guidance over Memorial Day weekend outlining when Americans can stop self-isolating after contracting the novel coronavirus.

20 House Republicans planned to file a lawsuit late Tuesday against Speaker Nancy Pelosi in an effort to block the chamber's new proxy voting system amid the coronavirus pandemic, three congressional sources told Axios.

The number of daily new coronavirus cases and deaths reported in New York was the lowest since the state started its lockdown in March, Gov. Andrew Cuomo said Tuesday, calling Memorial Day a "pivot point" for New York.

Notre Dame University President John Jenkins wrote in a New York Times op-ed Tuesday that science alone "cannot provide the answer" regarding the school's decision to bring students back to campus for its fall semester.

Russian President Vladimir Putin ordered his defense minister to start planning the country's annual military parade on Tuesday, saying that the event would take place on June 24, the Wall Street Journal reports.

Legal measures arbitrarily targeting "fake news" are picking up global steam, Axios' Sara Fischer reports. The ACLU has filed a lawsuit on behalf of two Puerto Rican journalists who fear that two recent "fake news" laws will be used to punish them for their reporting on the coronavirus crisis.

As states open up, businesses are starting to call their employees back to work, but many don’t feel safe going back, Axios' Erica Pandey reports.

Why it matters: This is poised to be the next big challenge in the American economy: workers may be forced to choose between their health and their livelihood.

• "It's a very big problem," says Andrew Stettner, an expert on worker protections at the Century Foundation. "A lot of people don't feel safe. They're anxious, and businesses are starting to reopen, and I think employer behavior will be all over the place."

The big picture: Under the CARES Act, those who have been urged to quarantine by medical professionals and can show documentation can refuse work and keep receiving unemployment benefits.

But this is a time during which anyone can reasonably feel unsafe returning to work. And it gets a lot more complicated to stay home and keep getting unemployment insurance if a worker cannot provide that doctor's note, says Michele Evermore of the National Employment Law Project.

• And if people are not high-risk themselves, but still feel unsafe returning to work in the public because they're living with someone who is at risk, protections are essentially non-existent, and employers may be able to compel them to come back, experts say. "You can go back, or you can lose your job," Stettner says.

Go deeper.

New research suggests that the coronavirus outbreak in Washington state was likely started by someone who came to the U.S. in mid-February, not by the first confirmed infection in the country, STAT reports.

Why it matters: The research indicates that the U.S. could have been more successful in mitigating community spread of the virus had it acted sooner.

• Some scientists had originally thought that the outbreak was tied to the first coronavirus patient in the U.S., who traveled from Wuhan to Washington state on Jan. 15.
• If that had been the case, there would have been little more that could have been done to stop the spread, especially because public health officials had traced his contacts and quarantined them.
• The upside of the new research is that these efforts were probably successful.

Yes, but: It also means that there was a weeks-long gap between when the virus was first detected in the U.S. and when it began spreading rampantly — a gap that the U.S. failed to take advantage of.

• "Our finding ... is sobering, since it demonstrates that the window of opportunity to block sustained transmission of the virus stretched all the way until" mid-February, the authors wrote in the paper, which has not yet been peer-reviewed.

The bottom line: "Everything is sort of lining up in the direction that if we're serious about it, we can control this thing," Samuel Scarpino, an assistant professor at Northeastern University's Network Science Institute, told STAT. "We're just not being serious about it."