Top Stories

  • Hospital administrators are warning that their facilities face shortages of vital medical equipment such as testing kits and thermometers amid the coronavirus pandemic, and they expressed concerns that they lack the ability to keep their workers treating COVID-19 patients safe, according to a report released this morning by the Health and Human Services Department’s Office of Inspector General. The report, based on interviews with administrators from 324 hospitals and networks, also found that facilities are receiving equipment that expired years ago, and officials said conflicting guidance from local, state and federal governments on how to use personal protective gear and other issues has resulted in “a greater sense of confusion, fear and distrust among staff that they can rely on hospital procedures to protect them.” (NBC News)
  • Surgeon General Jerome Adams said COVID-19 cases are expected to accelerate this week, adding that “this is going to be the hardest and the saddest week of most Americans’ lives” while likening the loss of life to events like Pearl Harbor and 9/11. Other Trump administration health officials, including National Institute of Allergy and Infectious Diseases Director Anthony Fauci, echoed similar remarks, though Fauci also said that mitigation efforts in effect could begin to flatten the curve of cases “within a week, maybe a little bit more.” (Politico)
  • The White House said it is using the Defense Production Act to prohibit the export of surgical masks and gloves in an attempt to stock up on personal protective equipment and prevent hoarding, price gouging and profiteering from “war profiteers.” President Donald Trump said the order will not interfere with long-term PPE deals with other countries. (The Hill)

Chart Review

Events Calendar (All Times Local)

04/06/2020
Rep. Diana DeGette (D-Colo.) participates in a Silicon Flatirons webcast conference on the 21st Century Cures Act 4:00 pm
04/07/2020
Politico webcast on how the Trump administration is balancing public health concerns with economic concerns 9:00 am
Kellyanne Conway participates in a Meridian International Center webinar on the short and long-term economic impacts of COVID-19 11:00 am
Asia Society webcast: “Following the Curve: From China to America, A Dialogue with Leading COVID-19 Medical Experts.” 7:30 pm
04/08/2020
Politico webcast on major moments in New Jersey related to COVID-19 9:00 am
04/09/2020
Transforming Access to Care through a Digital Front Door 1:00 pm
04/10/2020
Politico webcast to discuss the latest global trends and developments on the pandemic 11:00 am
American Bar Association webcast: “Public Health Measures in Response to COVID-19.” 1:00 pm
View full calendar

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Coronavirus

Fauci says it’s likely coronavirus will be seasonal
Justine Coleman, The Hill

National Institute of Allergy and Infectious Diseases Director Anthony Fauci said Sunday that it is likely the coronavirus will become a seasonal occurrence.

People should wear cloth face coverings in public, CDC recommends, to reduce spread of coronavirus
Adam Taylor et al., The Washington Post

President Trump on Friday announced the Centers for Disease Control and Prevention recommends that everyone wear a simple, cloth face covering while out in public. The debate about whether the public should wear masks came after increasing evidence that infected people without symptoms can spread the coronavirus.

Ignoring Expert Opinion, Trump Again Promotes Use of Hydroxychloroquine
Michael Crowley et al., The New York Times

President Trump doubled down Sunday on his push for the use of an anti-malarial drug against the coronavirus, issuing medical advice that goes well beyond scant evidence of the drug’s effectiveness as well as the advice of doctors and public health experts.

U.S. ‘wasted’ months before preparing for virus pandemic
Michael Biesecker, The Associated Press

After the first alarms sounded in early January that an outbreak of a novel coronavirus in China might ignite a global pandemic, the Trump administration squandered nearly two months that could have been used to bolster the federal stockpile of critically needed medical supplies and equipment. A review of federal purchasing contracts by The Associated Press shows federal agencies largely waited until mid-March to begin placing bulk orders of N95 respirator masks, mechanical ventilators and other equipment needed by front-line health care workers.

Another Thing to Fear Out There: Coronavirus Scammers
Sharon LaFraniere and Chris Hamby, The New York Times

Federal, state and local law enforcement authorities are reporting an explosion of such scams as fraudsters move to capitalize on public panic over the fast-moving pandemic and the flood of federal money making its way to most Americans to help address the economic fallout.

In Congress, Doctors Are Pressing for a More Aggressive Coronavirus Response
Sheryl Gay Stolberg, The New York Times

There were just 160 documented cases of the coronavirus in the United States when Representative Raul Ruiz, Democrat of California, told Vice President Mike Pence in a closed-door meeting that President Trump needed to “think about declaring a national emergency.” It took nine more days for Mr. Trump to do so.

Mysterious Heart Damage, Not Just Lung Troubles, Befalling COVID-19 Patients
Markian Hawryluk, Kaiser Health News

While the focus of the COVID-19 pandemic has been on respiratory problems and securing enough ventilators, doctors on the front lines are grappling with a new medical mystery. In addition to lung damage, many COVID-19 patients are also developing heart problems — and dying of cardiac arrest.

This tiny federal agency was built to respond to a crisis like coronavirus. Now that it’s here, is BARDA ready?
Nicholas Florko, Stat News

Lawmakers were so confident that BARDA could help scientists develop a coronavirus vaccine, therapy, or even a diagnostic test that Congress has showered the agency with a $3.5 billion boost in funding, more than tripling its total budget. But consultants and experts in biotech and in academia told STAT they had serious concerns about BARDA’s preparedness to absorb the massive new workload it will take to identify targets for a coronavirus vaccine or therapy.

Coronavirus: Boris Johnson ‘still in charge’ despite hospital admission
BBC News

Prime Minister Boris Johnson is “still very much in charge of the government” despite spending the night in hospital with coronavirus, Housing Secretary Robert Jenrick has said. The PM was taken to a London hospital on Sunday evening with “persistent symptoms” – including a temperature – for a series of routine tests.

He Led a Top Navy Ship. Now He Sits in Quarantine, Fired and Infected.
Eric Schmitt and John Ismay, The New York Times

For days, he fended off fears that the contagion would spread unchecked through his crew. Then last week, the captain of the aircraft carrier Theodore Roosevelt, who had appealed to his superiors for help, was fired. By Sunday, friends said, he had come down with the coronavirus himself.

Payers

How Trump surprised his own team by ruling out Obamacare
Adam Cancryn et al., Politico

As the coronavirus ran rampant and record jobless numbers piled up, the nation’s health insurers last week readied for a major announcement: The Trump administration was reopening Obamacare enrollment to millions of newly uninsured Americans. It was an announcement that never came.

Providers

Health care workers vs. the coronavirus
Caitlin Owens, Axios

Health care workers are at an especially high risk of catching the coronavirus, because of their prolonged exposure to patients who have it. Making matters worse, the U.S. doesn’t have enough of the protective equipment, like masks and gloves, that keeps them safe.

With worst to come, 3 in 4 hospitals already facing COVID-19
Ricardo Alonso-Zaldivar, The Associated Press

Three out of four U.S. hospitals surveyed are already treating patients with confirmed or suspected COVID-19, according to a federal report that finds hospitals expect to be overwhelmed as cases rocket toward their projected peak.

Coronavirus Crisis Puts Bankrupt Hospitals Back in Demand
Peg Brickley, The Wall Street Journal

From small-town Vermont to Los Angeles, local governments are commandeering shut-down hospitals to add space amid the coronavirus pandemic—a trend that could revamp the market for health-care facilities.

Pharma, Biotech and Devices

Ford and GM are undertaking a warlike effort to produce ventilators. It may fall short and come too late.
Reed Albergotti and Faiz Siddiqui, The Washington Post

Ford and General Motors both announced in late March that they would build the medical machines after shutting down car production and sending workers home, a historic redeployment of their factories and workers. But the relatively late start of both companies means the bulk of their production will come online in May, possibly missing the peak load of cases expected by most U.S. health officials in mid-April.

States Try Reducing Malaria-Drug Hoarding Amid Unproven Coronavirus Benefit
Jared S. Hopkins, The Wall Street Journal

States across the U.S. are taking steps to prevent hoarding of decades-old antimalarial drugs for treatment of the new coronavirus, an effort to preserve supplies for other patients who rely on the medicines to remedy ailments such as lupus and arthritis.

FDA Commissioner Says China Not Creating Drug Shortages in U.S.
Naomi Nix, Bloomberg

FDA Commissioner Stephen Hahn said there’s no evidence that any drug is in short supply because China or another country is blocking critical ingredients from flowing into the U.S. market.

The Quest for a Pandemic Pill
Matthew Hutson, The New Yorker

Could bacteria do us in? Outbreaks of plague have wreaked havoc throughout history, but the development of effective antibiotics in the past century “took bacteria off the table as a global biological risk for the most part,” Amesh Adalja, a physician at Johns Hopkins and the report’s project director, told me.

Health IT

Enlisting tech to fight coronavirus sparks surveillance fears
Niv Elis and Maggie Miller, The Hill

The portable supercomputers people carry around in their pockets may hold the key to stemming the coronavirus pandemic, some public health experts say.

Digital health startups scored a critical cash infusion at the start of this year
Erin Brodwin, Stat News

As much of the world prepares for the possibility of a coronavirus-driven recession, a new report suggests that some digital health startups scored a critical infusion of cash just in the nick of time.

Opinions, Editorials and Perspectives

Pharmacists Overlooked as a Relief Resource for COVID-19
Ashley Garling, Morning Consult

Shelter-in-place orders are becoming increasingly more stringent across the country, and the need for health care access is greater than ever. However, if you’ve kept up with recent news reports, you may find that the Coronavirus Aid, Relief and Economic Security Act did not include expanding pharmacists’ ability to provide additional patient care. 

Bet Big on Treatments for Coronavirus
Scott Gottlieb, The Wall Street Journal

Some imagine that the coronavirus will run its tragic course in the spring, with the direst results avoided by intense social-distancing and other mitigation efforts, and then our lives can more or less return to normal in the summer. But that isn’t realistic.

‘You’re basically right next to the nuclear reactor.’
Cory Deburghgraeve, The Washington Post

I could be the last person some of these patients ever see, or the last voice they hear. A lot of people will never come off the ventilator.

Research Reports

Quality Adjusted Life Years (QALY): The Threat to Older Americans
William S. Smith, Pioneer Institute

The Quality-Adjusted Life Year (QALY) cost-effectiveness methodology employed most notably in the U.S. by the Institute for Clinical and Economic Review (ICER) and in the United Kingdom by The National Institute for Health and Care Excellence (NICE) represents an inherently discriminatory threat to senior citizens’ access to high-quality medicines. The threat that the QALY poses to older Americans deserves considerable attention because some observers argue that, were a new U.S. President to implement a “Medicare for All” health plan, cost pressures would inevitably lead federal policy makers to adopt the use of QALYs when making decisions on how to ration healthcare.

General

What Happens If You’re Seriously Ill and It’s Not From Covid-19?
Danielle Bochove and Emma Court, Bloomberg

With the Covid-19 pandemic demanding an unprecedented amount of medical resources and personnel, care for other conditions, even life-threatening ones, is being put on hold. In many places across North America, everything except emergency surgeries have been canceled, and in-person care has been delayed for all but the most worrisome cases.

Stocks Jump With U.S. Futures on Easing Virus Toll: Markets Wrap
Sam Potter, Bloomberg

Stocks jumped in Europe and Asia alongside U.S. equity futures after the reported death tolls in some of the world’s coronavirus hot spots showed signs of easing over the weekend. The dollar edged higher and Treasuries fell.

Morning Consult