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National

Detroit Mayor Mike Duggan announced on Friday that the city will start making diagnostic tests available to all employees of “essential” businesses, and to city employees performing essential services.

Why it matters: It’s the first program of its kind, and a model for other cities to follow. And it’s a reminder that testing remains the limiting factor in every facet of our response to the coronavirus.

You may be tired of hearing about testing. You may think it has become an almost myopic focus in a multifaceted crisis. But there is simply no way to work around it, or to put that problem to the side and focus on something else. All roads lead back to testing.

Between the lines: Detroit’s plan to test people who aren’t experiencing symptoms, even if it's just a small group, is critical.

Many parts of the country, though, simply don’t have the capacity to test anyone who isn't feeling sick. That will never be good enough.

Although more rapid tests are becoming available, turnaround times of up to a week increase the risk that people will spread the virus without knowing it.

If you test someone too soon after they’ve contracted COVID-19, they won’t have enough of the virus in their system, resulting in a false negative — which means some infected workers may slip through the cracks even with widespread testing.

Our thought bubble: Every incremental step that brings more people out into the world creates some level of additional risk. We don’t have a vaccine and we can’t stay inside forever, so all we can do is try to find a level of risk that’s manageable.

The only way to manage that risk is to stay on top of the virus’ spread, and the only way to do that is with testing. And so the limitations in testing will always, necessarily, restrict everything else we try to do.

It all comes back to testing

We don’t have a vaccine and can’t stay inside forever — all we can do is find a level of risk that’s manageable.

Health Care

Deep Dive — Coronavirus 6

Public health

Coronavirus

The U.S. health system faces critical questions about cost, access and equity. Technological advances and new discoveries about diseases like cancer and Alzheimer’s are transforming patient care and reshaping public health.

Health

Widespread social distancing has forced Americans to get creative with how they connect to one another, including romantically.

The big picture: The dating industry was poised to take a hit amid the coronavirus outbreak as potential suitors are generally unable to meet in-person. Platform Match, which also owns Tinder and OkCupid, has seen stocks tumble 25%. But daters are turning to digital courtship through video chats and virtual activities as an alternative.

The dating app Bumble saw increased user engagement as Americans adjusted to social distancing last month.

The platform reports a 26% spike in messages sent during the week ending March 27 compared to the week ending March 13. Trump declared COVID-19 a national emergency on March 13.

The app is also allowing users to add a badge to their profiles signaling they're open to virtual dating, and to filter out users who are not.

Web-based first dates are becoming the new normal, with platforms seeing a dramatic increase in users turning to calls and video chats.

Bumble has seen an 84% increase in users using the app's voice call and video chat tools.

OkCupid has experienced a 180% increase in mentions of FaceTime, Skype and Zoom on profiles and the platform has seen an 83% increase in users going on virtual dates in April compared to March.

A new dating app called “Quarantine Together” launched last month, with a built-in video chat option and periodic reminders to wash your hands. 

Coffee meets Bagel has introduced virtual speed dating, with 10- to 15-minute video calls moderated by a company representative.

Between the lines: The dating industry argues that digital-first dates could become the standard beyond the COVID-19 outbreak.

The founder of the dating site "The League" told Axios in December: "In-person first dates will definitely be replaced by digital dates, as the stakes are lower and with video chatting you can figure out whether or not you click within the first few minutes."

OkCupid surveyed its users on their virtual-date preferences, finding that 31% favor a game or activity, 29% want digital dinner and drinks, 25% want a simple video chat and 15% would opt for remotely watching a TV show or movie together. 

The bottom line... Hinge told its users: 

"We're lucky to live in a time where we can have video chat dates, phone call dates & connect virtually in an infinite number of ways. Stay home, date from home & we’ll get through this together."

Date from home: Romance in the age of the coronavirus

People may have to stay at home, but they're still dating.

Illustration of heart wearing a face mask

Technology

Deep Dive: Future of Dating

Business

Top stories & latest news on the Federal Reserve, real-time data, plus the biggest shifts happening in the U.S. and global economy.

Economy

After a record economic expansion, the coronavirus pandemic sent the U.S. economy into a recession as unemployment soared to staggering heights. The country now faces urgent questions about how much stimulus is needed for reeling consumers and businesses, and what a recovery might look like.

Economy & Business

Some U.S. mayors and governors are bracing for new pressures to reopen their economies too soon, and fear second surges of coronavirus infections would only force fresh clampdowns.

What they're saying: "That would be like releasing someone from prison, and then saying, 'Sorry, you need to come back to serve more time,'" Paul TenHaken, the mayor of  Sioux Falls, S.D., tells Axios.

Some red-state governors say they plan to relax stay-at-home orders and other social distancing measures sooner rather than later, which could create or heighten conflicts with the mayors of some of their largest cities.

“I'm very concerned about any type of pressure — political or otherwise — to make hasty decisions based on the economy as opposed to the science,“ Tampa, Fla., Mayor Jane Castor told Axios. 

She pushed for a sheltering-in-place order for her city long before Florida Gov. Ron DeSantis issued one statewide, and DeSantis has already relaxed some of those restrictions in the days since President Trump released his plan to begin reopening the economy.

The big picture: Governors and mayors will have to walk a political tightrope as they navigate one of the most devastating and durable emergencies in U.S. history.

Trump's guidelines make clear that states' decisions are up to governors, but as some states move forward, there are concerns that his words could add political pressure to move quickly. Already, Trump has tweeted criticisms of Democratic governors' continuation of their shelter-in-place orders. 

That pressure could also lead to tensions between mayors and governors.

“I would fight any battle that would protect my citizens. But there are certain legal boundaries that I have," Castor said when asked whether she would disregard orders from DeSantis.

In Sioux Falls, TenHaken issued a "safer at home" order in his city, which has a high share of the state's rising number of COVID-19 cases. But South Dakota Governor Kristi Noem has refused to enact a state-wide order. TenHaken and Noem are both Republicans.

TenHaken said the decision, which he's still wrestling with, is especially difficult in a red state, and has spurred questions about infringing on civil liberties. 

Texas Gov. Greg Abbott announced executive orders on Friday that will allow state parks and some businesses to open back up in phases, although schools will remained closed through the end of the school year. 

Steve Adler, the Democratic mayor of Austin, said he think’s Abbott’s reopening plans seem “reasonable,” but that he is eager to see “what are we doing to help mitigate and minimize that risk and measure what it is that's happening in our community.” 

Adler said he doesn’t think Abbott has been clear enough on that. 

"And, if for whatever reason, he or the president or anybody was putting the community in danger that I was elected to represent, then I’d have to do everything I can to try to protect it," Adler added.

"With this being an election year, you've got to be fearful that we don't do things that are good or bad for the political climate of one person or party, as opposed to what's best for the American people," said Louisiana Lieutenant Governor Billy Nungesser, a Republican.

Former Chicago Mayor Rahm Emanuel tells Axios every mayor of a big city clashes with their governor at some point.

"Look, anywhere you go in a state, a city in a major metropolitan area is going to be a big engine," he said. "And there's going to be tension. I mean, you see it playing out either in politics, personality, or more importantly resources — and that's fine. It happens when this virus isn't happening, and it comes in distress."

Between the lines: Some governors are seeking to minimize political pressures and patchwork health risks by banding together. Governors have formed Midwest, Northeastern states and Western state coalitions — deciding to coordinate their reopening efforts. 

7 East Coast governors also extended their shelter-in-place orders through May 15. 

The bottom line: 66% of Americans are more concerned that state governments will lift restrictions on public activity too quickly, according to a new Pew Research survey. Only 32% are more concerned that they will not lift them soon enough. 

The state-level coronavirus dilemma

Governors and mayors brace for pressure to reopen — and possibly clamp down again if cases rise.

Illustration of Texas capitol building surrounded by question marks and exclamation marks

Politics

2024 will be an election year like no other, as President Biden seeks re-election amid economic uncertainty, two wars and questions about his age. His likely foe, former President Trump, faces felony charges and vows revenge on his political enemies. Meanwhile, Americans generally are dissatisfied with those choices and are divided over immigration, race, education and more.

Politics & Policy

Capital

Axios Capital

We're fighting the greatest public-health crisis in a century, and we barely understand our enemy. We cannot afford to stay in lockdown until a cure or vaccine arrives — but anybody trying to reopen our cities needs information that is frustratingly difficult to find.

The big picture. The single biggest obstacle to reopening the economy is a lack of visibility: We don't know the scope of the pandemic itself, or its economic fallout, or how its trajectory will change as we embark upon an ad-hoc effort to reopen the economy.

Where it stands: The Trump administration's plan for reopening the American economy explicitly calls for "up-to-date data" — but very few state or local leaders will actually have strong data on which to base their decision-making.

We don't know how many people the coronavirus has killed, or how many people have had it.

The official tally of over 37,000 deaths is too low, because it's based on people who died after testing positive for the coronavirus, but we don't know how low. 

We don't know how many Americans have lost their jobs because of the coronavirus shutdown.

The official tally is 22 million new applications for unemployment benefits. But millions more haven't been able to make it through the application process, or haven't tried.

The biggest employers will be able to rehire their legions of workers, but the bigger concern is the businesses that will never be able to reopen. We don't know how many of them there will be.

We don’t know when we'll have a treatment, whether summer will tame the spread, or whether the virus could return in the fall even stronger. We don't know whether we're immune once we've had it, or for how long.

We don't know whether tech will allow us to trace it, or whether enough Americans would sign up for that, even if it does. 

We don’t know when it’ll be safe to fly, go to a game, or pack into a school or a church. 

Be smart: It’s shocking and a bit scary how much we do not know, despite how much we now do know.

The fog of coronavirus

Bad information is making any attempt at a coronavirus recovery harder.

Illustration of various people in a fog

Future

Axios Future

The World Health Organization made mistakes in its initial response to COVID-19, but as it comes under criticism, it's important to remember the world still needs the agency.

Why it matters: President Trump's decision this week to withhold money from the agency could damage its efforts to fight the next pandemic and other health threats. For all its problems, the WHO remains the only global institution charged with combating the global threat of infectious disease.

Background: Despite its grand name and purpose — to "keep the world safe" — the actual scope of the WHO is limited by both its budget and the political realities of international governance.

With a biennial budget of $6.3 billion, the WHO has about as much cash to spend as a large urban hospital system in the U.S., and significantly less than the U.S. Centers for Disease Control and Prevention.

Like all UN agencies, the WHO is not independent in any real sense from its member countries.

In the case of its early response to COVID-19, this meant the agency was ultimately dependent on the Chinese government. It wasn't until mid-February — weeks after the outbreak began in Wuhan — that a WHO team was permitted to enter China to begin investigations.

Early on, many WHO officials appeared to underplay the potential global threat posed by the novel coronavirus.

What they're saying: In a press conference the day after Trump's attacks, WHO Director-General Tedros Adhanom Ghebreyesus told reporters the agency's performance would eventually be reviewed, as it was after previous outbreaks, but "for now, our focus — my focus — is on stopping this virus and saving lives."

What's next: Without a revolution in how national governments treat international governance, the WHO will likely continue operating under inherent limitations. But there are steps the agency could take to improve global disease response in particular.

The WHO could be more transparent about what it can and what it can't do, and what it knows and what it doesn't know. While it may not be realistic for the WHO to publicly criticize a government like China for holding back information, it could make it clearer to the rest of the world what it isn't being told about an outbreak.

In an increasingly politically divided world, the need for a global broker of some kind on infectious disease will only grow. Geopolitics may still be driven by nation-states, but as we've learned with COVID-19, viruses do not respect borders.

Defunding the WHO is like voting to "de-fund fire depart in the middle of a fire, on the grounds they ought to have got to the fire sooner," Lawrence Gostin, the director of the O'Neill Institute for National and Global Health Law at Georgetown University, tweeted on Thursday.

While the focus with COVID-19 has been on the U.S. and China, the biggest losers in a world without the WHO would be poor countries that are much more dependent on the UN agency for assistance. And the next pandemic is just as likely to come from one of them.

The bottom line: An imperfect WHO is still better than a nonexistent one, and policymakers can make the best use of the agency if they fully understand what it can and cannot do.

Go deeper: The U.S. gives far more money to the WHO than China does

Making the most of an imperfect WHO

It's important to remember the world still needs the agency.

Illustration of Trump with money and the WHO logo in the background

Photo Illustration: Eniola Odetunde/Axios. Photo: Noam Galai/Getty Images

World Health Organization (WHO)

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Axios

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