The Friday Breeze
Newsletter editor Brianna Labuskes, who reads everything on health care to compile our daily Morning Briefing, offers the best and most provocative stories for the weekend.
Hello! This pandemic is going to have ramifications that unfold for years to come that we won’t be able to predict. But my money is, for sure, on all of us leveling up on our germophobe meters. This New York Times cough simulation burned itself into my brain when I saw it, while I’m trying desperately to erase the knowledge that speaking alone creates enough droplets to lead to potential exposure. (I’m dragging you all down with me!)
All right, on to my attempts to summarize years-worth of news that was somehow crammed into one week. Buckle up!
President Donald Trump released a three-phase plan that leans heavily on the idea that reopening the country should not be based on a one-size-fits-all mentality. Hot spots would keep their shutdown measures in place, while areas in the country that haven’t been hit could start slowly getting back to normal.
The guidance was quickly dismissed by critics as “vague and inconsistent.” And considering that governors are the final authority on when shelter-in-place orders are lifted (which Trump acknowledged, after previously drawing an outcry over claims that he alone would make that decision), it may not make a huge impact on what happens next.
Trump also announced his panel of advisers who will help him reopen the country — something that came as a surprise to some of the people he named. One of the first bits of advice to come from the business leaders? The United States is woefully behind in the amount of testing it needs to do to reopen the country. Meanwhile, conversations between Trump and his panel don’t have to be made public because only “formal outside advisory committees” fall under the transparency law requirements.
As Josh Gerstein, from Politico, notes: Notably, the White House avoided the term “committee” in its announcement.
Speaking of testing, saliva tests based on the 23andMe model are being touted as the answer to the country’s testing woes. But I think I’ve heard that promise before.
The Friday Breeze
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WHO became a new target in Trump’s efforts to shift blame from his own administration’s missteps in the early days of the crisis. After a few days of speculation, Trump announced he wants to cut funding for the international organization, going against the State Department’s advice that the move would be “ceding ground” to China.
Predictably, since the country is in the midst of a pandemic, the decision drew swift condemnation from Trump’s critics and the medical community. And though WHO’s response may not have been pitch-perfect, experts say, the organization consistently treated the contagion as the threat it was far earlier than some nations did.
Although Trump’s decision was based on his criticism of WHO’s early response to the current crisis, the funding cuts would be felt far beyond the organization’s efforts to fight COVID-19.
As all that was going on, many people were wondering where the CDC — once the preeminent disease-fighting body — has been in this current fight. The agency won high praise for its work helping fight AIDS, Ebola and Zika, and played a major role in eradicating smallpox, as well as the near-elimination of polio. But funding cuts beneath the Trump administration have rendered it a “nonentity.”
In an ironic twist of fate, the pandemic could shape Trump’s health care legacy into one that looks a lot like his opponents’ dream scenario. The administration has greenlighted plans that pump billions of government money into the health care system to help offset costs, including a taxpayer-generated fund for hospitals to use to cover patients’ care. (Ahem, does that sound familiar?) Anxiety is rippling through some conservative circles that Trump might oversee historic new levels of federal health spending.
In contrast to all that, though, Trump’s continued disdain for the health law could also hamper the administration’s response to the crisis.
And hospitals say that $100 billion pot allocated in the $2.2 trillion stimulus package is not only taking far too long to distribute, but also is woefully inadequate.
Thursday marked another deadliest-day record, with the death count rising by 4,591 in the span of 24 hours. Meanwhile, New York this week started counting “probable” COVID-19-related deaths, which sent its totals soaring past 10,000. The change highlights one of the issues with getting an accurate count of the nation’s losses. Not only are COVID-19 cases widely considered undercounted because of a lack of tests, some states are counting them using different criteria (while remaining adamant that their strategy is best).
There’s also been a worrisome spike in at-home deaths, which makes some experts think we’re just seeing the tip of the iceberg in the death toll.
In a nod to the fact that the coronavirus knows no state boundaries, governors in different regions are forming partnerships to create plans to reopen their states in the coming months. The coalitions so far: the Northeastern corridor, the West Coast trio of Washington, Oregon and California, and seven Midwestern states.
While the partnerships are in their early days, it seems the plans will rely heavily on testing and a slow rollout that takes into account more vulnerable populations.
As the general shutdown effort enters its second month, though, tensions are simmering to a boiling point for some. Protesters, driven by economic and civil liberty concerns took to the streets this week to demand governors lift specific shutdown orders. But even as they voiced complaints, cases started to spike in the very states that hadn’t seen the need to shelter in place.
And those of us who have been social distancing laughed a little nervously (without humor) at a new study that suggests it could be needed until 2022. For what it’s worth, that seemed like a worst-case-scenario projection that didn’t account for a possible vaccine or increased capacity in hospitals.
It’s so rare these days that I get to talk about good news, but today is the day! There are hopeful signs coming out of a study on Gilead’s antiviral remdesivir, the drug that’s been a front-runner since the early days of the crisis. But, a warning: The good news comes with a huge helping of salt in that there was no control group used in the study, so the patients might have been getting better on their own.
Meanwhile, studies are going forward on a drug that calms the immune system, targeting the deadly “cytokine storms” that seem to be at the root of younger patients’ deaths. But fears remain that suppressing a patient’s immune system in the midst of a battle against the virus could backfire.
While the global science community has dropped everything to race for a cure, the scattershot, all-hands-on-deck method might actually be doing more harm than good, with researchers working at cross-purposes, duplicating efforts and failing to communicate outside of their realm.
Speaking of hopeful signs, there’s also a lot of movement with Moderna’s development of a vaccine. The company is set to get an infusion of cash and expand its trials with hopes that something can get pushed to the public far earlier than the original 12- to 18-month timeframe. Even Dr. Anthony Fauci (who has been on the extra-cautious side) has said that he thinks it might be possible to have a safe and effective vaccine as early as mid- to late winter.
In the meantime, some observers wonder if the general immune boost that comes with an old TB vaccine might help bridge the gap during the long wait for a coronavirus vaccine.
And, so far, the big names in the anti-vaccination movement have not changed their tunes, even as many in the country are looking to a vaccine as the one true exit strategy from the pandemic.
In a man-our-health-system-is-complicated moment, UnitedHealth Group is actually reporting an increase in profits during the pandemic. That’s because the extra coronavirus costs have been offset by the cancellations of other procedures.
Hospitals and states where the virus has not yet struck are growing ever more frustrated with FEMA “redirecting” (or “poaching,” for the more critically inclined) equipment it needs to brace for any potential surges. Over the past few weeks, the federal government’s response to equipment distribution has been blasted as somehow too chaotic and too controlling at the same time, which seems to be a real feat.
In another attempt to address some of the shortages in hot spots, the Trump administration announced a voluntary exchange program, in which hospitals in “cold spots” send their unused ventilators to places in need.
And all this demand is driving up costs across the board. A protective mask that used to cost $0.38 now rings up for $5.75. Isolation gowns went from $0.25 to $5. (You get the picture.)
If you expected quick, bipartisan action (haha!) out of Congress during these high-stakes times, you might have to take off the rose-colored glasses. The small-business fund allocated through the $2.2 trillion stimulus package ran out this week, and even in the face of overwhelming requests, Congress can’t seem to shake the shackles of partisan disputes.
Meanwhile, a staggering 22 million Americans have filed for unemployment in the past four weeks, sending the country into an economic nosedive that is drawing apt comparisons to the Great Depression. Images of lines of cars miles long might be our generation’s bread-line pictures, with food banks struggling to deal with the onslaught of needy Americans.
Experts say the stress from the pandemic revealed underlying vulnerabilities that suggest the booming economy might not have been all that strong to begin with. “We built an economy with no shock absorbers,” said Joseph Stiglitz, a Nobel Prize-winning economist.
Meanwhile, whatever details shake out about the reopening of the economy, one thing is certain: It will be fragile, partial and slow.
We know that health care workers represent a high number of coronavirus cases, but a new CDC report puts hard (though still undercounted) numbers on it: As of April 9, 9,282 health care professionals had contracted the virus and at least 27 had died from it.
On that note, KHN and The Guardian are documenting the lives of U.S. workers who succumbed during the crisis. If you have a story to share, please contact us here.
With each passing day, scientists are learning more about the coronavirus. Some news from this week includes a link between obesity and severe cases, as well as good news for asthma patients.
And as the coronavirus upends some ironclad medical traditions, doctors talk about what they wished they’d known about how the illness presents a month ago.
In an extremely grim snapshot of the devastation that’s hitting nursing homes across the country, an investigation following an anonymous tip found a makeshift morgue in one New Jersey facility that was housing 17 bodies.
I hate to leave you on that terrible note, so have a picture of three extremely adorable KHN dogs that will surely brighten your day, if only a little. Have a restful and safe weekend!
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