Jan 30, 2020

Axios Vitals

Good morning.

Situational awareness: The Trump administration is expected to release its Medicaid block grant program today, per Politico.

Today's word count is 808, or a 3-minute read.

1 big thing: What's next with the coronavirus

Passengers arriving in Los Angeles on a flight from Asia wear protective masks. Photo: Mark Ralston/AFP via Getty Images

The U.S. should be preparing for the worst as the Chinese coronavirus spreads, and somebody at the White House needs to be in charge of coordinating that effort, public health experts tell Axios' Sam Baker.

The big picture: The virus may never become a crisis here, but experts say the responsible thing right now is to plan for the worst and hope that those plans aren't needed.

The catch: The National Security Council official who would have been in charge of leading the response to a pandemic left in 2018, and now no one is around to do the job.

  • "They need to put someone at the White House in charge," Ron Klain, who served as then-President Obama's "Ebola czar," said this week on Axios' Pro Rata podcast.

Where it stands: There have only been five confirmed cases of the coronavirus in the U.S., and there are still big unanswered questions about it. The primary goal so far has been to contain the virus.

  • But keeping a lid on the coronavirus may simply be impossible.
  • "Global & national planning efforts should now be aimed at possibility that [the virus] cannot be contained," Tom Inglesby, an infectious-disease expert at Johns Hopkins University, wrote on Twitter.

What's next: Experts say there are a handful of priorities at this stage.

  • Hospitals need to stock up on protective equipment, to the extent they can find more supplies.
  • The federal government also needs to be ready to step in, if a large number of cases start to crop up in concentrated areas.

The bottom line: "Don't tell the public that everything's going to be OK, but at the same time, tell the public we're going to get through this," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Go deeper.

2. Tech responds to the coronavirus outbreak

Illustration: Aïda Amer/Axios

The largest tech companies are responding to the Wuhan coronavirus outbreak in two main ways: limiting employee travel to China and trying to make sure their users have access to accurate health information, Axios' Ina Fried reports.

Why it matters: Like the virus itself, the spread of misinformation is hard to slow.

On the content front, Google, Facebook and Twitter are all taking steps to promote verified information.

  • Facebook has been giving ad credits to the World Health Organization and Philippines Department of Health to share information. It is also returning dedicated information modules when users search for terms related to the outbreak.
  • YouTube is returning text results when people search for "coronavirus" and other terms, reminding users that the situation is rapidly changing while also aiming to point to authoritative video results. Google is also trying to put extra focus on verified information in search results, including showing information that has been fact-checked where possible.
  • Twitter has adjusted its results to point to authoritative, local-language information when people search for virus-related terms.

At the same time, Bloomberg reports that false information is spreading fast. The Daily Beast reports that TikTok videos show teens pretending to have the disease.

Go deeper: The new age of global pandemic risk

3. The U.S. suicide rate is exceptionally high
Expand chart
Reproduced from The Commonwealth Fund; Chart: Axios Visuals

The U.S. has the highest suicide rate among wealthy nations, according to a new report by the Commonwealth Fund.

Between the lines: That's potentially because of our high rates of mental illness, inadequate mental health screening, low investments in social services and the cost of mental health care, the researchers said.

Go deeper: Mental health coverage is getting worse

4. Democrats happy with whatever health plan
Expand chart
Data: Kaiser Family Foundation survey of 1,212 U.S. adults conducted Jan. 16–22, 2020. Margin of error ±3 percentage points; Chart: Axios Visuals

While Democratic presidential candidates are deeply divided between Medicare for All and a public insurance option, Democratic voters seem to be cool with either one, according to a new Kaiser Family Foundation poll.

The big picture: Sizeable majorities of both Democrats and independents in the Kaiser poll said they approve of a single national health insurance system, and larger majorities said they like the idea of a public program competing alongside private insurance, Sam writes.

Between the lines: Big majorities expect their taxes to go up under either plan, but still seem ready to accept that trade-off.

Sam's thought bubble: Consider these results in the context of Sen. Bernie Sanders' rise in 2020 polling.

  • Neither Sanders nor Medicare for All has actually won anything yet — not an argument within the Democratic Party, much less a broader political argument up against the full force of industry and GOP attacks, much less an actual legislative victory.
  • And they may not end up winning any of those fights. But the first step would be to build a sufficiently large and enthusiastic base of Democrats, and if you were part of that effort, you'd have to be pretty happy about the way this is going right now.
5. Zolgensma's lucrative fourth quarter

Novartis said yesterday that Zolgensma — the gene therapy that's the most expensive drug in the world — brought in $186 million in the fourth quarter of 2019, STAT reports.

Why it matters: It suggests that the drug's enormous price tag isn't blocking patients from accessing it, although the costs are ultimately borne through premiums and by taxpayers.

By the numbers: About 200 patients have been treated with Zolgensma since it launched in June, Novartis said.

  • The company said it has reimbursement agreements that cover 97% of commercially-insured patients and 50% of Medicaid patients.