Jun 3, 2020

Axios Vitals

Good morning.

Today's word count is 967, or a 4-minute read.

1 big thing: Coronavirus hospitalizations keep falling
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Data: COVID Tracking ProjectHarvard Global Health Institute; Note: Alabama, Florida, Hawaii, Idaho, Kansas, Nebraska, Tennessee and Puerto Rico have not reported hospitalizations consistently; Chart: Andrew Witherspoon/Axios

The number of people hospitalized with COVID-19 continues to decline, particularly in New York and other northeastern states that were among the hardest hit by the virus, Axios' Bob Herman and Andrew Witherspoon report.

Yes, but: Some states are still recording stagnant or rising hospitalization rates.

By the numbers: Roughly 34,000 people diagnosed or being evaluated for COVID-19 were in the hospital at the beginning of June — down from 40,000 in the middle of May, according to state data compiled by the COVID Tracking Project.

  • Seven states — Alabama, Florida, Hawaii, Idaho, Kansas, Nebraska and Tennessee — still don't report the number of people hospitalized with COVID-19.

Between the lines: Hospitalizations help show where coronavirus outbreaks have been severe, but they are a lagging indicator of an area's actual infection rate and could underestimate the spread if people die in their homes or before making it to the hospital.

The good news: Hospitalizations have steadily decreased in the biggest coronavirus hotspots: New York, New Jersey, Massachusetts, Connecticut, Illinois and Louisiana.

The bad news: Plenty of states — including Washington, Arizona, North Carolina and Arkansas — still are reporting upticks in the number of hospital beds filled by seriously ill people.

The bottom line: Public health experts are worried that states reopening businesses and people easing up on social distancing guidelines — now paired with nationwide protests over racism and police brutality — will make it harder to temper the outbreak.

2. Private equity benefits from HHS provider loans

Private equity companies have borrowed at least $1.5 billion from the federal government through programs intended to provide emergency funding to struggling health care companies during the coronavirus pandemic, Bloomberg reports.

Between the lines: Some of the hospitals, clinics and treatment centers benefiting from the Medicare loans — which could plausibly end up being forgiven — are owned by the richest investment firms.

Details: Some of the firms that have received such loans are swimming in cash.

  • KKR, which has received $60 million via subsidiaries of KKR-owned companies, has more than $58 billion of cash to invest.
  • Apollo Global Management started the year with about $46 billion, but its health care facilities received at least $500 million in loans.
  • Steward Health Care System, owned by Cerberus Capital Management, received at least $400 million. Cerberus was attempting last month to grow one of its investing funds to $750 million. Steward physicians announced yesterday that they are buying the company from Cerberus.

The big picture: The HHS programs making the loans were expanded by Congress earlier this year to help health care companies financially slammed by the pandemic, as elective care skid to a halt.

  • CMS administrator Seema Verma told Bloomberg that the agency's goal was to get the money out quickly. "We don't look into ownership, what we look into is are they Medicare-enrolled providers," Verma said.
  • KKR has been in the political spotlight for months for its role in the surprise billing debate.

Go deeper: Private equity's slow creep into doctors' offices

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.

Infectious disease experts doubt that the coronavirus will slow its spread during the summer, National Institutes of Health director Francis Collins wrote in a Tuesday blog post.

HHS has allocated only about $77 billion of the $175 billion in emergency aid for health providers that has been approved by Congress, Politico reports.

The College Board said it will "pause" on offering at-home SAT tests this year, since it cannot guarantee that all students have access to "three hours of uninterrupted, video-quality internet."

North Carolina Gov. Roy Cooper said Republicans should plan for a "scaled-down convention with fewer people, social distancing and face coverings" given the impact of the pandemic. As a result, the Republican National Committee is searching for a new host city.

About 7 in 10 Americans would get a coronavirus vaccine if it was free and available to everyone, a Washington Post-ABC News poll found.

4. Mental health screenings rise during pandemic

The advocacy group Mental Health America says it's seen a big increase in anxiety and depression since the coronavirus pandemic began, Axios' Marisa Fernandez reports.

Why it matters: The pandemic and ensuing lockdown have triggered increased loneliness and isolation while also making in-person help harder to access.

By the numbers: More than 211,000 people took one of Mental Health America's anonymous online screenings in May. Almost four times more people used those online tools in May than in January.

  • Roughly 88,000 of those screenings showed signs of anxiety or depression, the group said. More than 21,000 reported thinking about suicide or self-harm.

Between the lines: This is just an anecdotal data source, but there are plenty of other signs the pandemic and ensuing lockdown have taken a toll on people.

  • The Food and Drug Administration announced shortages of the antidepressant Zoloft. Prescriptions in the U.S. hit an all-time record in March, Bloomberg reports.

If you have any thoughts of self-harm or suicide, please pick up the phone right now and call the National Suicide Prevention Hotline at 1-800-273-8255.

5. Concerns about at-home coronavirus testing

The latest wave of coronavirus testing concerns has arrived, this time about new at-home tests that are hitting the market, the Wall Street Journal reports.

Between the lines: Experts are worried about the accuracy of the tests and about limitations on who can access them.

The big picture: The Food and Drug Administration has so far given emergency authorization to six at-home collection kits, which still must be sent to a lab.

  • These tests, in theory, expand testing access to people who can't easily leave their homes and to those who would be at-risk in a doctor's office around other patients. They also add to the total number of available tests.
  • They're appealing to employers who want to test their workers and universities that want to test faculty and students.

Yes, but: The tests aren't foolproof, and can produce varying rates of false negatives depending on where the sample is collected from.

  • They are also dependent on lab capacity to process them.
  • And for some people, the tests' price tag could be prohibitive if it isn't fully covered by insurance or if they're uninsured.