May 8, 2020

Axios Vitals

Good morning.

Today's word count is 1,393, or a 5-minute read.

  • Axios is giving each of its employees a mental health day for the months of April and May, and mine is today. That means Vitals alumnus Sam Baker will be spamming your inbox with Monday's edition — enjoy what I anticipate will be a much funnier introduction than what I write.
1 big thing: Coronavirus' double whammy on vulnerable populations
Adapted from KFF; Chart: Axios Visuals

Minorities and low-income people are more likely to become seriously ill if infected with the coronavirus, according to a new Kaiser Family Foundation analysis.

Why it matters: These populations are also less likely to be able to social distance, or have been hit hardest economically by doing so. The coronavirus may be a national problem, but its impact is most devastating to the people who were already worse off.

Adapted from KFF; Chart: Axios Visuals

The big picture: Even before the virus hit, minorities suffered from worse health outcomes, in part because they're more likely to be low-income — which is also correlated with higher rates of chronic conditions.

  • People with underlying health conditions — like heart disease, chronic obstructive pulmonary disease (COPD), uncontrolled asthma, diabetes or obesity — are more vulnerable to severe illness from the novel coronavirus.
  • Health care and socioeconomic disparities also exacerbate Native Americans' and black Americans' risk.
  • And "even though the shares of Hispanic and Native Hawaiian or Pacific Islander nonelderly adults at higher risk for serious illness if infected are similar to that of White adults, these groups face disparities in other health, social, and economic factors that may contribute to barriers to health care associated with coronavirus," KFF adds.

Between the lines: People with low-income jobs deemed essential — like grocery store workers, home health aides or delivery drivers — are also at higher risk of contracting the virus.

  • Those in other low-income jobs, like in retail or restaurants, are more likely to be out of work right now or working fewer hours.
  • As the fight between businesses and workers heats up in states reopening sooner than public health experts advise, low-income workers have less of an option to quit if they feel unsafe.

Go deeper: Coronavirus hits people of color harder, and its economic impact is unequal, too

2. Trump officials' coronavirus drug dysfunction

A complete breakdown in communication and coordination within the Trump administration has undermined the distribution of a promising treatment, according to senior officials with direct knowledge of the discussions.

Why it matters: The drug, remdesivir, hasn't made it to some of the high-priority hospitals where it's most needed, and administration officials have responded by shifting blame and avoiding responsibility, sources told Axios' Jonathan Swan.

Where it stands: Gilead Sciences, the company that makes remdesivir, donated hundreds of thousands of doses to the federal government after the Food and Drug Administration authorized it as an emergency treatment for coronavirus patients.

  • More than 32,000 doses of remdesivir were shipped and delivered on Tuesday to Indiana, Massachusetts, New Jersey, New York, Rhode Island, Tennessee and Virginia.
  • But many of these doses went to "less impacted counties," an administration official said.

"Some went to the wrong places, some went to the right places," said one senior official. "We don't know who gave the order. And no one is claiming responsibility."

What they're saying: "An initial allocation of the drug remdesivir was made to seven states on Tuesday, and — after consultation with health experts — HHS will be managing distribution of the next tranche of the treatment to 16 states tonight and tomorrow, based on urgent need," Devin O'Malley, a spokesman for the White House Coronavirus Task Force, told Axios last night.

Read the scoop.

3. The latest in the U.S.
Expand chart
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.

California on Thursday projected a $54.3 billion deficit in its state budget as a result of the economic damage caused by the novel coronavirus, Gov. Gavin Newsom's administration said.

The U.S. military is considering making a hospitalization for coronavirus a "disqualifying" condition for new recruits, reports Fox News.

Police departments throughout the U.S. have seen crime rates fall since the coronavirus pandemic, but shootings in some cities have surged despite stay-at-home orders, Axios' Marisa Fernandez reports.

The White House confirmed on Thursday that a member of the U.S. Navy who serves as one of President Trump's personal valets has tested positive for coronavirus, CNN reports.

The White House coronavirus task force asked the CDC to revise a 17-page report that detailed specific guidelines for how local leaders should begin reopening cities and businesses, but never received a revised copy, sources familiar with the documents tell Axios' Alayna Treene.

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

The Trump administration's ongoing offensive over China's handling of the coronavirus pandemic now centers on one question, Axios' Dave Lawler writes: Who was "patient zero?"

The coronavirus crisis highlights why the security of supply of key minerals used in renewable power and electric vehicles can't be taken for granted, International Energy Agency analysts say in a new commentary.

Black people in England and Wales are roughly twice as likely to die from the novel coronavirus than white people, the U.K.'s Office for National Statistics reported in new data released Thursday.

5. Coping with the pandemic's mental health toll

Illustration: Aïda Amer/Axios

As COVID-19 continues to strain health systems around the country, local leaders are trying to address the mental health needs of people in their communities, Axios' Kim Hart reports.

Why it matters: Unlike the physical maladies the pandemic causes, its psychological toll is often invisible, and stress tends to have a cumulative effect that may not be apparent until months after the trauma of this period.

Between the lines: Stress becomes traumatic when people face uncontrollable and unpredictable events that are continually changing and require constant adaptation.

  • Ironically, the very mandates that officials are making to protect communities from COVID-19, such as continued social distancing, are creating new challenges and sources of stress.

What's happening: Mayors and local public health officials have launched initiatives to support their communities' most vulnerable residents — and are openly talking about their own struggles.

  • In Coral Springs, Florida, Mayor Scott Brook launched the nonprofit Mental Wellness Networking Alliance in the wake of the Parkland school shooting. It's now shifted to weekly virtual meetings held via Zoom and Facebook Live.
  • In Lincoln, Nebraska, during daily press briefings, Mayor Leirion Gaylor Baird shares her own family's experience with the added strain, as well her own self-care routine, including daily runs, per the Lincoln Journal Star.
  • In Topeka, Kansas, Mayor Michelle De La Isla instituted a "warmline" system (as opposed to a hotline) to connect volunteers with lonely residents who need to talk to someone. She's read books to children via Facebook.

Go deeper.

6. Bankrupt hospitals sue feds

Small hospitals going through bankruptcy are suing the Small Business Administration, arguing it is unlawful for the federal government to deny them loans under the Paycheck Protection Program, Axios' Bob Herman reports.

Why it matters: Allowing bankrupt hospitals access to PPP loans could keep their doors open, and could force the federal government to reverse its stance and allow other bankrupt firms to get PPP loans.

Driving the news: Faith Community Health System, a small rural hospital in Texas that filed for bankruptcy in February, sued the SBA Thursday.

  • The hospital wants to apply for a $2.4 million PPP loan to pay staff and remain open while it goes through bankruptcy and handles the coronavirus pandemic.
  • However, the SBA says bankrupt companies will not be approved for the bailout money because of their "high risk."
  • Faith Community argues the government agency doesn't have the authority to exclude bankrupt firms from PPP funding because the law doesn't spell out those eligibility requirements.

The big picture: Courts are starting to take hospitals' side.

  • A bankruptcy judge in Maine said the funding was a "grant of aid necessitated by a public health crisis," and that two hospitals that sued the federal government are entitled to PPP loans.
  • A separate bankrupt hospital in Vermont also should be eligible for PPP funds, a judge ruled this week.

The bottom line: Rural hospitals have been in dire straits for years, and for those that are on the precipice of or are going through bankruptcy, they may be eligible for this bailout funding despite SBA exclusions.

7. States face economic death spiral
Data: Lucy Dadayan/The Urban Institute; Chart: Andrew Witherspoon/Axios

Early numbers show how significantly the coronavirus is devastating states' revenue streams — and could force choices between raising taxes or gutting services and laying off public employees, Axios' Stef Kight reports.

Why it matters: Even as some states move toward reopening, the economic ramifications of having shut down will haunt them far into the future.

  • When states can reopen, and how quickly industries are able to bounce back, could either worsen or improve projections.

By the numbers: The Urban Institute has been compiling lost revenue data as states make it publicly available. So far, there are figures for about one in four states that compare this April's state income and sales tax revenue collections against those from April 2019.

  • The data shows collections dropping between 20% and more than 50%, depending on the state, senior researcher Lucy Dadayan tells Axios — and those figures could get worse as new data comes in.

The big picture: Democratic-leaning cities have seen the highest case and death rates. But red and blue states alike are facing serious budget shortfalls.

Go deeper.