Axios Vitals

A briefcase with a red cross on the front.

December 02, 2020

Good morning.

💉 Situational awareness: The U.K. has become the first Western country to approve a coronavirus vaccine. Inoculations using the Pfizer and BioNTech vaccine are expected to start next week.

Today's word count is 879, or a 3-minute read.

1 big thing: Nursing homes getting pummeled by the pandemic

Data: AHCA/NCAL, The COVID Tracking Project; Chart: Naema Ahmed/Axios
Data: AHCA/NCAL, The COVID Tracking Project; Chart: Naema Ahmed/Axios

The U.S. has gotten no better at keeping the coronavirus out of nursing homes.

Why it matters: The number of nursing home cases has consistently tracked closely with the number of cases in the broader community — and that's very bad news as overall cases continue to skyrocket.

By the numbers: There were more than 16,000 confirmed nursing home cases during the week of Nov. 15., according to a report by the American Health Care Association and National Center for Assisted Living.

  • Nearly half of new nursing home cases that week were in the Midwest.
  • Cases nationally grew by more than 177% between mid-September and mid-November, mirroring the steady rise in caseloads overall.
  • Deaths are also rising, topping 2,000 that same week.

What they're saying: "Our worst fears have come true as COVID runs rampant among the general population, and long term care facilities are powerless to fully prevent it from entering due to its asymptomatic and pre-symptomatic spread," said Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living.

  • "This level of COVID nationwide puts serious strain on our workforce, supplies, and testing capacity."

The bottom line: We're not going to control the pandemic in the general population, which means the virus will continue to find its way into nursing homes.

  • The only bright spot on the horizon for nursing home residents is that a vaccine will soon be available, and they'll be among the first people to receive it.

2. CDC issues vaccine priority recomendations

Health care workers and nursing home residents should be at the front of the line to get coronavirus vaccines in the U.S. once they're cleared and available for public use, an independent CDC panel recommended in a 13-1 emergency vote on Tuesday, per CNBC.

Why it matters: Recent developments in COVID-19 vaccines have accelerated the timeline for distribution as vaccines developed by Pfizer and Moderna undergo the federal approval process. States are preparing to begin distributing as soon as two weeks from now, Axios' Shawna Chen writes.

The big picture: Health and Human Services Secretary Alex Azar told CNBC last month that roughly 40 million doses will be available by year's end. That’s enough to immunize about 20 million people, since Pfizer and Moderna’s vaccines must be taken in two doses about a month apart.

  • In the U.S., there are roughly 21 million health care workers and 3 million long-term care residents, per a presentation given during the CDC's Advisory Committee on Immunization Practices.
  • Most states and local jurisdictions will likely need around three weeks to vaccinate all health-care workers, Nancy Messonnier, director of the CDC's National Center for Immunization and Respiratory Diseases, told CNBC.

What to watch: CDC director Robert Redfield is anticipated to decide by Wednesday whether to accept the recommendation as the agency’s formal guidance to states.

  • But, but, but: Though states aren't bound to the CDC's guidance, they can provide a framework for planning, which many states adopt. The final call will be made by governors.

3. CDC to cut guidance on quarantine period

The CDC will soon shorten its guidance for quarantine periods following exposure to COVID-19, AP reported Tuesday and Axios confirmed.

Why it matters: Quarantine helps prevent the spread of the coronavirus, which can occur before a person knows they're sick or if they're infected without feeling any symptoms.

  • The current recommended period to stay home if exposed to the virus is 14 days. The CDC plans to amend this to 10 days, or seven with a negative test, an official told Axios' Jonathan Swan.
  • The CDC did not immediately respond to a request for comment.

4. An unprecedented drop in health spending

Reproduced from Peterson-KFF Health System Tracker; Chart: Axios Visuals
Reproduced from Peterson-KFF Health System Tracker; Chart: Axios Visuals

The coronavirus pandemic has caused national health care spending to go down this year — the first time that’s ever happened, KFF's Drew Altman writes in today's column.

The big picture: Any big recession depresses the use of health services because people have less money to spend. But this pandemic has also directly attacked the health system, causing people to defer or skip care for fear of becoming infected.

By the numbers: Year-to-date spending on health services is down about 2% from last year. Health spending for the calendar year may end up lower than it was in 2019.

  • In April, when the pandemic forced many facilities to temporarily close, spending on health services had fallen an eye-popping 32% on an annualized basis.
  • The largest drop-offs were in outpatient care. Telehealth visits increased dramatically but did not make up all of the difference.

Context: This is the first time expenditures for patient care have fallen year-over-year since data became available in the 1960s.

What's next: Spending and utilization have been recovering, but could fall again if the current spike in cases prompts either hospitals or patients to again hold off on elective care.

  • There has been a decline in cancer screenings and visits to manage chronic conditions, but it will take more research before we know precisely how this has affected outcomes.

Go deeper.

5. Catch up quick

Illustrated collage of a cut up coronavirus cell.

Illustration: Aïda Amer/Axios

Senate Majority Leader Mitch McConnell circulated a new framework for coronavirus stimulus legislation to Republican members on Tuesday that would establish a fresh round of funding for the small-business Paycheck Protection Program and implement widespread liability protections, according to a copy of the draft proposal obtained by Axios.

Americans have been working an average of 32 more minutes a day since the beginning of the pandemic, according to research from Atlassian, a big workplace software company that analyzed data on usage of its products across 65 countries, Axios' Erica Pandey writes.

80% of The Global Fund's AIDS and HIV programs around the world have been disrupted by the coronavirus pandemic, ONE Campaign president and CEO Gayle E. Smith said on Tuesday at an Axios virtual event.