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The Trump administration on Wednesday asked Congress for $500 billion to cover two separate waves of direct payments to American taxpayers in the next several weeks and another $300 billion to help small businesses meet payroll, outlining a sweeping $1 trillion economic stabilization package to respond to the coronavirus pandemic. The package, outlined in a document obtained by The New York Times, also calls for $50 billion for secured loans for the airline industry and another $150 billion for secured loans or loan guarantees for other sectors of the economy that have been devastated by the global economic shutdown as the virus spreads. (Cochrane and Fandos, 3/18)

Details on Trump’s economic rescue plan remain sparse — and it’s sure to grow with lawmaker add-ons — but its centerpiece is to dedicate $500 billion to start issuing direct payments to Americans by early next month. It would also funnel cash to businesses to help keep workers on payroll as widespread sectors of the $21 trillion U.S. economy all but shut down. In a memorandum, the Treasury Department proposed two $250 billion cash infusions to individuals: a first set of checks issued starting April 6, with a second wave in mid-May. The amounts would depend on income and family size. (Taylor and Mascaro, 3/19)

The White House is vetting these proposals with Senate GOP leaders before engaging more fully with Democrats, so the package is certain to evolve in coming days. Democrats, meanwhile, are eyeing their own priorities, largely aiming to shore up safety-net programs and the public health infrastructure, as well as send money directly to American taxpayers, while shunning corporate bailouts. Rep. Maxine Waters (D-Calif.) proposed on Wednesday having the Federal Reserve send $2,000 to every American adult and $1,000 to every American child until the crisis ends. (Werner, Stein and DeBonis, 3/18)

The Federal Reserve announced late Wednesday that it will establish an emergency lending facility to help unclog a short-term credit market that has been disrupted by the viral outbreak. The Fed said it will lend money to banks that purchase financial assets from money market mutual funds, including short-term IOUs known as commercial paper. By facilitating the purchase of commercial paper, which is issued by large businesses and banks, the Fed hopes to spur more lending to firms that are seeking to raise cash as their revenues plummet amid the spread of the coronavirus. (Rugaber, 3/19)

Over a frenetic two weeks, as the coronavirus has upended American capitalism and changed every aspect of life, the Federal Reserve has taken drastic steps to keep money flowing throughout the financial system. It has cut interest rates to near-zero, introduced a huge bond-buying program, revamped a crisis-era emergency lending program to calm the market big businesses use to raise cash, and enacted major backstops in an attempt to restore order to Wall Street’s volatile inner workings. (Smialek and Tankersley, 3/19)

By establishing the Money Market Mutual Fund Liquidity Facility, the Fed is reprising another weapon from its 2008 arsenal. During the financial crisis of a dozen years ago, there was great concern that these money market mutual funds would not be able to make investors whole. In recent weeks, investors have been rushing to pull money out of the market, leading to concerns that a wide range of assets could face a run. The Fed has now launched seven emergency actions this week, with the money market liquidity facility announcement occurring at 11:30 p.m. (Long, 3/18)

The stark news came in shortly after noon on Wednesday: The Dow Jones Industrial Average dropped almost 10%, wiping out all the gains logged since President Donald Trump took office, thanks to investors craving more government spending to offset the impact from the coronavirus. As the freefall commenced, the President was at the White House podium, leading the now-daily coronavirus task force briefing on the latest measures being taken to mitigate the public health crisis. (Salama and Harwood, 3/19)

Stock markets were largely subdued Thursday after days of massive volatility, as investors digested new financial support measures, including the European Central Bank’s promise to funnel $817 billion into financial markets. Market sentiment appeared fragile as investors rushed to convert holdings to cash, bracing for a prolonged coronavirus-induced recession. ... The futures for the Dow were down 1.5% and those for the S&P 500 were 1.4% lower. (Kurtenbach, 3/19)

U.S. stock futures dropped on Thursday, deepening the market turmoil even as the Federal Reserve and European Central Bank introduced fresh measures to protect the global economy from the impact of the coronavirus pandemic. Futures tied to the S&P 500 index wavered between gains and losses before edging down over 1%. A closely watched measure of turbulence in U.S. stocks, the Cboe Volatility Index, climbed close to historic highs. (Ostroff and Yu, 3/19)

The New York Stock Exchange said Wednesday it will temporarily close its historic trading floor and move fully to electronic trading after two people tested positive for coronavirus infection at screenings it had set up this week. All-electronic trading will begin on March 23 at the open, the exchange said. The facilities to be closed are the NYSE equities trading floor and NYSE American Options trading floor in New York, and NYSE Arca Options trading floor in San Francisco. (Li, 3/18)

The coronavirus pandemic is about to test the bounds of how much debt the U.S. government can bear. Even before the crisis hit, the U.S. was on track to increase its budget deficit to nearly $1 trillion in the fiscal year that ends Sept. 30. It was already up to $625 billion in the five months since the current fiscal year began Oct. 1. (Hilsenrath, 3/18)

The financial shock from the coronavirus pandemic threatens the housing security of millions of Americans, prompting federal, state and local officials — and even judges and the police — to move quickly to ward off foreclosures and evictions. On Wednesday, the federal agency overseeing Fannie Mae and Freddie Mac, the giant government-run finance firms that back the mortgages of 28 million homeowners, ordered a suspension of foreclosures and foreclosure-related evictions for at least two months. The move is meant to keep people in their homes and avoid a housing squeeze like the one that followed the mortgage-fueled financial crisis of 2008. (Dougherty, Goldstein and Flitter, 3/18)

A week ago, the big question in Washington was: Which industries will be bailed out of their losses because of coronavirus? This week, the question is: Which industries won’t? With stunning speed, it has become clear that many mainstays of American industry are facing potentially existential risks from their looming financial losses, and that Congress and the Trump administration are determined to prevent widespread bankruptcies and corporate collapse. (Irwin, 3/19)

Describing himself as a “wartime president” fighting an invisible enemy, President Donald Trump on Wednesday invoked rarely used emergency powers to marshal critical medical supplies against the coronavirus pandemic. Trump also signed an aid package — which the Senate approved earlier Wednesday — that will guarantee sick leave to workers who fall ill. (Lemire and Colvin, 3/18)

President Trump announced Wednesday that he will invoke the Defense Production Act (DPA), which would allow the administration to force American industry to manufacture medical supplies that are in short supply in the fight against the coronavirus pandemic. Hospitals, health workers and state and local officials have said they are quickly running out of personal protective equipment (PPE), like masks, gowns and gloves, that are crucial to keeping doctors and nurses on the front lines of the pandemic safe. (Hellmann, 3/18)

Trump said his administration aimed to ramp up production for ventilators, “millions” of masks, and “certain pieces of equipment,” though he did not specify what the government’s specific needs were, or what quantity of supplies the White House hoped could be produced. Trump also said he would deploy two Navy hospital ships to American cities hard-hit by cases of coronavirus and the respiratory disease it causes, known as Covid-19. One, the USS Mercy, will be deployed to New York, Trump said. The president said his administration would soon decide where on the West Coast to deploy the other ship, the USS Comfort, which is based in San Diego. (Facher, 3/18)

The Defense Department said Wednesday it was preparing two Navy hospital ships for deployments, including one slated to go to New York to boost the state’s medical capacity amid fears that the virus could become overwhelming should it spread among the millions of people who live in and around New York City. The Pentagon also said this week it would be making 5 million masks and 2,000 ventilators available for use by health workers.The measures aim to ramp up what state and local officials have described as Washington’s frustratingly slow and disjointed early response to the epidemic, which they have said was plagued by inadequate testing and an ignorance about the prospect of widespread shortages in medical equipment and facilities. (Olorunnipa, Miroff and Lamothe, 3/19)

The CMS will publish detailed recommendations about how to conserve personal protective equipment by limiting non-essential, elective medical and surgical procedures. "We believe that these recommendations will help surgeons, patients and hospitals prioritize what is essential while leaving the ultimate decision in the hands of state and local health officials and those clinicians who have direct responsibility to their patients," CMS Administrator Seema Verma said. (Brady, 3/18)

The White House, after weeks of reluctance to disrupt the gears of government, has now instructed federal agencies to adjust their operations to focus on “mission-critical” services to contain the coronavirus by limiting face-to-face interactions. In a memo late Tuesday, acting budget director Russell Vought told department heads that they should “postpone or significantly curtail” operations that cannot be carried out through telework or that require in-person interaction with the public. (Rein, Kindy and Yoder, 3/18)

The DPA was inspired by laws from 1941 and 1942 that gave the White House the ability to tell private companies what to make for the good of the country. Think, for example, of how Ford Motor Company made nearly 300,000 vehicles — including tanks — for World War II. As the Cold War heated up in the late 1940s and the Korean War began in June 1950, President Harry Truman’s administration thought it should codify those powers into law. With Congress’s help, the DPA was signed into law in September 1950. It’s been amended and altered over the years, but the general thrust remains the same. Specifically, the DPA allows the federal government to skip the line, so to speak, when it makes requests of private industries. But Trump can’t just go to a company and say “produce this.” He delegates those requests to federal agencies, and the one that does the vast majority of the ordering is the Defense Department. (Ward, 3/18)

As the globe confronts the coronavirus pandemic, one urgent problem is the shortage of key pieces of equipment, including high-quality masks, test kits and—perhaps most important of all—ventilators. It seems hundreds of thousands of lives might be saved, if only manufacturers could quickly ramp up the production of such equipment, perhaps by a factor of 100 or 1,000, within a few weeks. The United States has done something similar, on a nationwide scale, once before—eight decades ago during the emergency of World War II. At that time, there was a desperate need to radically accelerate the output of items such as ships, tanks and bombers. With decisive government action, including taking a little bit of control from corporations, this effort was hugely successful. (Wilson, 3/19)

The spread of the novel coronavirus has prompted the Food and Drug Administration to temporarily postpone all routine inspections of manufacturing facilities in the U.S. The agency has also directed most employees to begin teleworking. The move, which comes one week after foreign inspections were suspended for several weeks, will halt inspections the agency typically conducts every few years based on risk analyses. (Silverman, 3/18)

In late January, South Korean health officials summoned representatives from more than 20 medical companies from their lunar New Year celebrations to a conference room tucked inside Seoul’s busy train station. One of the country’s top infectious disease officials delivered an urgent message: South Korea needed an effective test immediately to detect the novel coronavirus, then running rampant in China. He promised the companies swift regulatory approval. Though there were only four known cases in South Korea at that point, “we were very nervous. We believed that it could develop into a pandemic,” one attendee, Lee Sang-won, an infectious diseases expert at the Korea Centers for Disease Control and Prevention, told Reuters. (Terhune, Levine, Jin and Lee, 3/18)

When cases of the new coronavirus began emerging several weeks ago in California, Washington state and other pockets of the country, U.S. public-health officials worried this might be The Big One, emails and interviews show. The testing program they rolled out to combat it, though, was a small one.Limited testing has blinded Americans to the scale of the outbreak so far, impeding the nation’s ability to fight the virus through isolating the sick and their contacts, public-health officials say. As of early Wednesday, about 6,500 people in the U.S. had tested positive, data compiled by Johns Hopkins University show, but the Centers for Disease Control and Prevention had reported only about 32,000 tests conducted at its facilities and other public-health labs. (Weaver, McKay and Abbott, 3/18)

Politicians, celebrities, social media influencers and even N.B.A. teams have been tested for the new coronavirus. But as that list of rich, famous and powerful people grows by the day, so do questions about whether they are getting access to testing that is denied to other Americans. Some of these high-profile people say they are feeling ill and had good reason to be tested. Others argue that those who were found to be infected and then isolated themselves provided a good example to the public. (Twohey, Eder and Stein, 3/18)

Asked about the issue Wednesday, President Donald Trump said the well-to-do and well-connected shouldn’t get priority for coronavirus tests. But the wealthy former reality star conceded that the rich and famous sometimes get perks. “Perhaps that’s been the story of life,” Trump said during a briefing at the White House. “That does happen on occasion. And I’ve noticed where some people have been tested fairly quickly.” (Biesecker, Smith and Reynolds, 3/19)

As the Trump administration scrambles to make more coronavirus tests available, demand for testing still outstrips availability. Most experts are pushing for making more testing available even faster, but some also question some of the steps the government is taking to try to make that happen.More than 71,000 tests have been done so far in the U.S., according to the Covid Tracking Project, and thousands more are being conducted each week by federal and state labs, hospitals and private companies, officials say. (Stein, 3/18)

A lack of critical COVID-19 tests is forcing some drive-through testing sites to temporarily shut down.Both Sentara Healthcare and M Health Fairview announced they have suspended drive-through testing sites to preserve their limited supply of testing supplies. Norfolk, Va.-based Sentara announced Wednesday it would temporarily close its drive-through locations beginning at 2 p.m. (Bannow, 3/18)

The number of coronavirus cases in the United States keeps jumping each day by the hundreds, pushing health care officials and political leaders to take steps to keep the pandemic from overwhelming the system. The battle is to get equipment and beds to doctors and nurses and to stem the economic fallout by taking measures to provide financial relief. (Yan, Maxouris and Almasy, 3/19)

The wait for coronavirus test results in Massachusetts can last as long as a week, a delay that exacerbates equipment shortages, frustrates worried patients and families, and hamstrings front line health care workers’ efforts to combat the growing pandemic. Faster test results can help determine which patients need to be treated by medical staff in protective gear. (Ryan and Lazar, 3/18)

President Trump on Wednesday defended his increasingly frequent practice of calling the coronavirus the “Chinese Virus,” ignoring a growing chorus of criticism that it is racist and anti-Chinese. “It’s not racist at all,” Mr. Trump said, explaining his rationale. “It comes from China, that’s why.” But the term has angered Chinese officials and a wide range of critics, and China experts say labeling the virus that way will only ratchet up tensions between the two countries, while resulting in the kind of xenophobia that American leaders should discourage. (Rogers, Jakes and Swanson, 3/18)

Among the hate crimes reported in major cities with Chinese communities: An Asian man in a Brooklyn subway car who was yelled at and sprayed with Febreze air freshener. In Los Angeles, a 16-year-old boy of Asian descent said other students had bullied him and accused him of carrying the virus. Even before cities began shutting down all restaurants to stop the spread of the virus, Chinese restaurant owners were already experiencing steep declines in business because of racial stigma. (Riechmann and Tang, 3/18)

Centers for Disease Control and Prevention chief Robert Redfield agreed last week with a member of Congress that it was “absolutely wrong and inappropriate” to call the illness the “Chinese coronavirus." Rep. Judy Chu (D-Calif.), chairwoman of the Congressional Asian Pacific American Caucus, told The Fix last week that the president needs to do away with language that stigmatizes Asian Americans. “He needs to make sure that everyone in this country is safe and secure and that we follow the guidelines of the World Health Organization and cannot create greater stigma and use the official term or covid-19. He seems to not be very concerned that there are these acts of xenophobia and scapegoating against Asian Americans.” (Scott, 3/18)

From the start of the coronavirus outbreak, statements from the presidential pulpit have been far out of step with those of health experts and many inside the administration. President Trump contradicted some officials while they were standing right next to him. Here is a sampling of what Mr. Trump has said compared with statements made by prominent officials. (Qiu, Marsh and Huang, 3/18)

Only days into the start of the 2020 census, the Census Bureau said Wednesday that it is suspending its field operations for two weeks while it searches for ways to protect its workers from exposure to the coronavirus. The immediate impact of the suspension, beyond a delay in a scheduled count of the nation’s homeless and a break in training census-takers, was not clear. But experts who had been briefed on the move said the bureau was racing to adjust to government warnings about the scope and consequences of the virus’s spread, which seemed to grow more dire by the day. (Wines, 3/18)

As the country continues to bunker down in response to the spread of COVID-19, the bureau's director, Steven Dillingham, says it is making the change "to help protect the health and safety of the American public, Census Bureau employees, and everyone going through the hiring process for temporary census taker positions." For the next couple of weeks, the bureau is also reducing the number of on-site workers at its two centers in Phoenix and Jeffersonville, Ind., for processing paper census forms, the bureau says in a separate statement on its website. (Wang, 3/18)

Postal carriers say they are being pressed into service against medical advice and with insufficient protection against the novel coronavirus. Two mail carriers told ProPublica they have been pressured to stay on their routes despite showing symptoms of COVID-19. One of the workers, in Denver, says he had to keep delivering mail for days while he awaited a doctor’s note. He says the route includes many locations where there are elderly and immunocompromised residents. (Jameel, 3/18)

The U.S. Senate overwhelmingly passed legislation on Wednesday providing billions of dollars to limit the damage from the coronavirus pandemic through free testing, paid sick leave and expanded safety-net spending. President Donald Trump signed the bill into law, and Congress and the White House are discussing additional stimulus measures that could cost more than $1 trillion. Lawmakers in the Republican-led Senate largely set aside their ideological divisions, passing the legislation by a bipartisan vote of 90-8, with all “no” votes coming from Republicans. The Democratic-controlled House of Representatives also passed the bill by an overwhelming bipartisan margin last Saturday. (Cowan and Morgan, 3/18)

President Donald Trump has signed Congress' second major COVID-19 relief package which includes an increase in state Medicaid funding that hospitals liked and a requirement that insurers do not charge cost-sharing for services related to coronavirus testing. Here's a rundown of the major provisions of the Families First Coronavirus Response Act relevant to the healthcare industry. The Senate passed the bill 90-8, and President Trump immediately signed it. (Cohrs, 3/18)

“The [Families First Coronavirus Response Act] makes emergency supplemental appropriations and other changes to law to help the Nation respond to the coronavirus outbreak,” Trump said in a statement Wednesday evening announcing he had signed the bill. (Chalfant, 3/18)

The bill would provide free coronavirus testing for those who need it. The Trump administration has struggled to make such tests available. The legislation would require private healthcare insurers to pay for all testing costs for beneficiaries with medical coverage. It also would cover testing costs for people who receive health care through government-run programs such as Medicare and Medicaid. It provides $1 billion to the National Disaster Medical System, a coordinated healthcare system and partnership involving several federal agencies, to cover costs for people without medical insurance. (Sullivan, 3/18)

Meanwhile, Senate Republicans were inching closer on Wednesday to unveiling their proposal for a third, even larger stimulus package to address the epidemic, which is likely to include some of Treasury's ideas. The Senate’s approval Wednesday of the House-passed coronavirus bill, known as “phase two,” comes as Republican senators are expected to begin negotiations with Democrats on a trillion-dollar “phase three” stimulus package as early as Wednesday night. Senate Majority Leader Mitch McConnell backed the House bill, which grants paid sick leave to hourly employees and expands unemployment insurance. “It is a well-intentioned bipartisan product assembled by House Democrats and President Trump’s team that tries to stand up and expand some new relief measures for American workers,” McConnell (R-Ky.) said of the House bill, which House lawmakers passed early Saturday and later approved technical corrections on Monday. (Levine and Desiderio, 3/18)

In remarks Wednesday morning, Senate Minority Leader Chuck Schumer (D., N.Y.) criticized the prospect of a one-time cash grant to Americans. He has laid out his own $750 billion stimulus plan that includes expanding unemployment insurance and a moratorium on evictions and foreclosures. Mr. Schumer also warned against putting a focus on economic stimulus to the exclusion of other priorities, and said other issues needed to be addressed, like increasing the supply of masks, hospital beds and ventilators. “Now, a few of my Republican colleagues have proposed a one-time cash payment of $1,000. But my fellow Americans, this is not a time for small thinking. This is not a time for small measures. This is a time to be bold, to be aggressive,” he said. (Hughes, Davidson and Duehren, 3/18)

Senate GOP negotiators are eyeing income thresholds of $75,000 for individuals and $150,000 for couples for the direct payments President Trump has proposed to ease the economic impact of the coronavirus. Republican senators say they want to model direct payments on the stimulus checks former President George W. Bush sent out in 2008 during the financial crisis. Twelve years ago, the rebates were reduced for individual incomes above $75,000 and joint incomes above $150,000. (Bolton, 3/18)

A $1 trillion federal stimulus. Bailouts for crippled industries. Cash payments to every American. Soaring deficits into the indefinite future. No, it’s not the Obama-era response to the Great Recession; it’s the Republicans’ plan to brace the plummeting economy amid sinking markets and mass layoffs resulting from the global coronavirus pandemic. (Lillis and Wong, 3/18)

House Democrats are drafting a new stimulus bill to address the coronavirus pandemic — legislation designed as their counter-offer to a trillion-dollar package currently being assembled in the Republican-controlled Senate. On a private call Wednesday, Speaker Nancy Pelosi directed her leadership team and committee chairs to begin further efforts to address the looming economic disaster caused by the growing coronavirus crisis. (Caygle, Bresnahan and Ferris, 3/18)

The scale of the problem is unlike anything Washington has faced before: The financial crisis, which sent unemployment skyrocketing to 10 percent, centered on foreclosures and the banking sector while this crisis is springing from dozens of places at once, as restaurants and movie theaters shut down, factories close and airplanes, public trains and buses run nearly empty of passengers. (Tankersley and Casselman, 3/18)

The fast-moving coronavirus upending every facet of American life is testing whether Washington, a capital city fractured by years of bitter partisanship and inaction, can still do big things. Not since the Great Recession of 2008, and before that the 9/11 attacks, has the federal government attempted to mount such an ambitious response to an emergency, and so quickly. The country’s once-revered, now often maligned institutions — from the White House to Congress to the Federal Reserve — are being summoned into action to shoulder the lift. (Mascaro and Taylor, 3/19)

As the concerns over the spread of coronavirus continue to grow, a number of House lawmakers are working to tamp down panic and put response plans into action back in their home districts. Lawmakers recently passed two emergency coronavirus relief packages and are working on a third, but outside of the steps being taken in the Capitol, members said they’ve been working with local officials to ensure individuals have access to the proper information and resources needed to combat the virus as efficiently as possible. (Brufke, 3/18)

Two members of the U.S. House of Representatives, Mario Diaz-Balart of Florida and Ben McAdams of Utah, said on Wednesday they had tested positive for the coronavirus, becoming the first members of Congress known to have contracted the respiratory illness. (3/18)

Rep. Ben McAdams (D-Utah) announced Wednesday he tested positive for the coronavirus after developing symptoms on Saturday. McAdams, 45, is the second lawmaker to test positive for COVID-19. Rep. Mario Diaz-Balart (R-Fla.), 58, announced his diagnosis shortly before the Utah Democrat. (Brufke, 3/18)

The White House is temporarily stopping top officials engaged in the response to the coronavirus pandemic from giving testimony in hearings on Capitol Hill. "While the Trump Administration continues its whole-of-government approach to stopping the spread of COVID-19, it is counter-productive to have the very individuals involved in response efforts appearing at Congressional hearings," deputy White House press secretary Judd Deere said in a statement. "We are committed to working with Congress to offer testimony at the appropriate time." (Samuels, 3/18)

Republican Sen. Ron Johnson cast doubt on the severity of federally issued guidance aimed at staunching the spread of the novel coronavirus, urging people to consider the economic drawbacks of the recommendations as health officials plead with the American public to heed them. "I'm not denying what a nasty disease COVID-19 can be, and how it's obviously devastating to somewhere between 1 and 3.4 percent of the population," Johnson, a Wisconsin Republican, told the Milwaukee Journal Sentinel on Tuesday. "But that means 97 to 99 percent will get through this and develop immunities and will be able to move beyond this." (Kelly, 3/19)

As President Trump cast the nation’s battle against the coronavirus as war, one high-ranking Republican senator seemed to play down the gravity of the pandemic, saying the number of Americans who might die would be 3.4 percent of the population at most. Sen. Ron Johnson (R-Wis.), chairman of the Senate Homeland Security and Governmental Affairs Committee, called covid-19 a “nasty disease” that is devastating to those who contract it. (Itkowitz, 3/18)

Sen. Richard J. Durbin sat in a leadership meeting Monday night in the same room he was in the morning of Sept. 11, 2001, with the location and today’s environment reminding him of that fateful day. “Looking down the Mall, as the white black smoke came across from the Pentagon. I remember it well,” the Illinois Democrat said in an interview Tuesday. (Kane, 3/18)

As the United States braces for an onslaught of coronavirus cases, hospitals and governments are confronting a grim reality: There are not nearly enough lifesaving ventilator machines to go around, and there is no way to solve the problem before the disease reaches full throttle. Desperate hospitals say they can’t find anywhere to buy the medical devices, which help patients breathe and can be the difference between life and death for those facing the most dire respiratory effects of the coronavirus. (Kliff, Satariano, Silver-Greenberg and Kulish, 3/18)

The FDA is so desperate for information about shortages in coronavirus testing supplies that it is turning to an unlikely source of information: Twitter. Wading into the Wild West of social media for help during a global pandemic may seem unsophisticated for an agency charged with regulating the nation’s drugs and medical devices. But thanks to a decades-old law, the FDA cannot require device manufacturers to report shortages in the same way it can for drugmakers. (Lim, 3/18)

Just as the nation’s ability to test for coronavirus is expanding, hospitals and clinics say another obstacle is looming: shortages of testing swabs and protective gear for health care workers. At the UCSF Health — a San Francisco hospital system at the heart of one of the nation’s coronavirus outbreaks — officials said they would have to stop testing patients in about five days because they will run out of nasopharyngeal swabs, which are inserted into the nasal passage of patients to get samples for testing. Other hospitals elsewhere in the country were ending their practice of using a second swab to test for the flu in an effort to preserve their supply. (Thomas, 3/18)

Even as commercial laboratories have ramped up coronavirus testing, frontline medical workers across the country are reporting a new, dire problem: A shortage of related materials needed to conduct the tests. Medical officials at several state health departments, hospitals and labs have told CNN they need more testing swabs, reagents, pipettes and other material needed to conduct the Covid-19 tests. (Kuznia, Devine and Griffin, 3/18)

A critical lack of testing kits. A shortage of ventilators. Not enough ICU beds. America’s struggle to deal with the spread of the highly infectious new virus Covid-19 is bad enough, with the number of confirmed cases surging, hospitals begging for help and entire cities going on lockdown. But it’s also exposed just how unprepared the U.S. is for a threat many would-be Cassandras have been warning about for years: a targeted biological attack. (Bertrand and Lippman, 3/19)

The Trump administration has yet to complete a comprehensive assessment, despite weeks of discussion about using the act to help prevent the medical system from being overrun, according to current and former administration officials. Even Trump said on Wednesday that he's in no hurry to order the supplies. In an executive order issued Wednesday afternoon, Trump granted authority primarily to Health and Human Services Secretary Alex Azar to determine “the proper nationwide priorities” and to allocate all necessary health and medical resources and services. Azar will work with Commerce Secretary Wilbur Ross and the heads of other agencies as appropriate, the order says. (Bender and Cassella, 3/18)

Hospitals are struggling to find enough doctors, nurses and other health care workers to care for mounting numbers of critically ill coronavirus patients. The staffing problems are on top of the equipment problems — the lack of ICU beds, ventilators, and masks and other protective equipment needed to prevent the healers from becoming patients. (Roubein and Kenen, 3/18)

Just a month ago — back when hardly anyone in the United States had tested positive for the coronavirus, back when the federal government spoke hopefully about keeping the virus from spreading in American cities, back when the mass cancellation of school and work and basketball seemed unimaginable — a small hospital ward in Omaha was at the center of the country’s effort to quash the illness. Nebraska Medicine’s Biocontainment Unit is where the federal government sends people with the most fearsome pathogens. In 2014, its doctors and nurses treated Americans who contracted Ebola in Liberia and Sierra Leone. (Smith, 3/18)

New York City is working with the hospitality industry to possibly convert entire hotels into hospitals for patients without the novel coronavirus, in an effort to increase capacity at medical facilities as the outbreak grows. The city’s emergency management commissioner, Deanne Criswell, said in an interview Wednesday that hotels could be vital as New York City needs more beds to treat those with Covid-19. (Honan, 3/18)

New York City Mayor Bill de Blasio (D) is calling on President Trump to deploy the U.S. military to New York in an effort to fight the rapidly spreading coronavirus outbreak. “President Trump has to mobilize the United States military to fully act in the coronavirus situation,” de Blasio said Wednesday on CNN’s “Anderson Cooper 360.” (Klar, 3/18)

The catastrophic potential is painful to consider: State models show that 60,000 homeless people could be hit by the novel coronavirus, with up to 20% of them needing hospitalization. That would mean California would need 12,000 hospital beds just for those living on the streets — a formidable task for a state that is already struggling to find extra capacity to manage the pandemic before it’s too late and hospitals become overwhelmed by too many patients. (Chabria, 3/18)

The American Red Cross and the medical facilities it supplies are experiencing a massive blood shortage as an “unprecedented” number of blood drives have been canceled regionally and across the country, as workplaces and schools have closed due to the coronavirus outbreak. The shortage means local hospitals are working to conserve the blood supplies they do have. (Orso, 3/18)

Stephanie Bandyk is on the front lines of the Covid-19 pandemic: A registered nurse who works in the intensive care unit of Seattle’s Swedish Hospital, she has helped treat some of the earliest patients infected with the novel coronavirus in the U.S. She has been working overnight shifts, from 7 p.m. to 7:30 a.m. in the state hardest hit by the new disease. There have been more than 1,000 cases of Covid-19 reported in Washington state, and at least 52 deaths. (Keshavan, 3/18)

It is a grim sentiment shared by thousands of health care workers on the front line of a pandemic that is expected to deluge the nation’s hospitals with new patients in the coming weeks. The people treating them understand what that means. They have read the stories from Italy, about doctors dying. They have heard of the findings from Wuhan, China, where nearly 1 in 5 health workers who caught the virus ended up in severe or critical condition. In the United States, where everyday activities have almost skidded to a halt, the virus has upended the lives of doctors and nurses more than anyone else. (Cox, Miller and Jamison, 3/18)

Kaiser Health News: A View From The Front Lines Of California’s COVID-19 Battle

On Tuesday, Dr. Jeanne Noble devoted time between patient visits to hanging clear 2-gallon plastic bags at each of her colleagues’ workstations. Noble is a professor of emergency medicine and director of the UC-San Francisco medical center response to the novel coronavirus that has permeated California and reached into every U.S. state. The bags were there to hold personal protective equipment ¬— the masks, face shields, gowns and other items that health care providers rely on every day to protect themselves from the viruses shed by patients, largely through coughs and sneezes. (Barry-Jester, 3/18)

The Coronavirus Preparedness and Response Supplemental Appropriations Act, which became law March 6, only invests $10 million for “training” of first responders, money they will have to share with hospital employees and other health care workers. “I think we know how to put our protective gear on,” said Gary Ludwig, chief of the Champaign Fire Department in Illinois, calling that part of the bill “ridiculous.” “They don’t need to teach us that,” said Ludwig, who is also president of the International Association of Fire Chiefs. “We need more stuff, is what we need.” (Allen, Sapien and Sanders, 3/18)

A second D.C. firefighter has tested positive for the novel coronavirus, and officials are tracing that person’s contacts with colleagues and community members, the fire department announced Wednesday night. In total, 73 city firefighters, paramedics and emergency medical technicians have self-quarantined after exposure or potential exposure to the virus, according to the president of the firefighters union. (Hermann, 3/18)

The closure of schools and daycares across Massachusetts has forced many parents to reorganize their lives around child care. For doctors and other people on the front lines of the fight against the coronavirus, there’s an additional concern: how to protect their families from being infected. (Rios and Mullins, 3/18)

California’s nearly $50-billion agricultural industry is bracing for a potential labor shortfall that could hinder efforts to maintain the nation’s fresh produce supply amid the widening coronavirus outbreak. The immediate concern centers on a backlog in the recruitment of foreign guest workers because of the virus-related shutdown of consul offices processing agricultural H2-A visas in Mexico. (Mohan, 3/18)

Don’t be fooled by the barren grocery store shelves: There’s plenty more food on the way. Meat, dairy and produce groups as well as federal regulators say the U.S. has an ample amount of products in cold storage to handle the unexpected demand for food and household products from Americans. (McCrimmon and Boudreau, 3/18)

Amazon.com Inc (AMZN.O) on Thursday said it was closing a small New York warehouse temporarily after one of its associates tested positive for the coronavirus, a move that highlights the operational risk it faces as the disease spreads. The company said it has sent associates home from the delivery station with full pay as it sanitizes the facility, its first in the United States known to have a case of the virus. (Dastin, 3/19)

The World Health Organization said Wednesday that it would launch a multiarm, multicountry clinical trial for potential coronavirus therapies, part of an aggressive effort to jumpstart the global search for drugs to treat Covid-19. Four drugs or drug combinations already licensed and used for other illnesses will be tested, said WHO Director-General Tedros Adhanom Ghebreyesus. Ten countries have already indicated they will take part in the trial. (Branswell, 3/18)

Antiviral drugs that had held promise as a potential treatment for the coronavirus did not work in one of the first major studies in seriously ill patients, researchers from China reported on Wednesday. “No benefit was observed,” the researchers wrote in The New England Journal of Medicine. The study tested Kaletra, a combination of two antiviral medicines, lopinavir and ritonavir, that are normally used to treat H.I.V. (Grady, 3/18)

The White House considered issuing an executive order greatly expanding the use of investigational drugs against the new coronavirus, but met with objections from Food and Drug Administration scientists who warned it could pose unneeded risks to patients, according to a senior government official. The idea to expand testing of drugs and other medical therapies was strongly opposed by the FDA’s senior scientists this week, the official said, and represented the most notable conflict between the FDA and the White House in recent memory. (Burton, 3/18)

Dr. Anthony Fauci, one of the faces of the Trump administration's coronavirus response, is pushing back against warnings that an anti-inflammatory drug like ibuprofen could worsen the effects of the infection. Fauci, director of the National Institute of Allergy and Infectious Diseases, said Wednesday that the suggestion was a "little bit urban legend" and that there was no "solid evidence" to support the theory after France's health minister urged people to avoid the drug. (Wise, 3/18)

But most infectious disease experts say there's no good scientific evidence at this point to support that claim. The furor was sparked by a tweet by the French health minister, Olivier Véran, over the weekend. He warned people not to take non-steroidal anti-inflammatory drugs, or NSAIDS — a category of pain relievers and fever reducers that includes ibuprofen — because some French COVID-19 patients had experienced serious side effects. The warning was also included in a bulletin from the French health ministry, which counseled that patients should instead use acetaminophen, the generic name for Tylenol. (Godoy, 3/18)

As more regional governments consider ordering residents to largely stay inside their homes to try to slow the spread of the coronavirus, drug industry trade groups are pushing to ensure such orders make exceptions to allow the employees of biotech and pharma companies to travel to and from work. The first “shelter-in-place” orders in the U.S. have come over the past few days in the Bay Area and other parts of Northern California. (Robbins and Sheridan, 3/18)

Nearly one-third of clinical trial sites expect the novel coronavirus will have a “big or extremely big” impact on their ability to recruit patients for new trials or keep patients already enrolled in existing studies compliant with scheduling, a new survey finds. In addition, 39% of 170 clinical trial sites surveyed in the U.S. believe patients will be much less or somewhat less likely to enroll in new clinical research trials. And 25% of the sites expect patients currently enrolled in a trial to be much less or somewhat less willing to continue their participation. (Silverman, 3/18)

Employers are cutting shifts, suspending work and starting to lay off workers as the new coronavirus devastates business across the country. Companies from restaurant operators to wedding caterers have started to let workers go as they ratchet down operations. Many firms have moved cautiously to date, furloughing employees and moving workers to part-time status. But for many companies, economists say, layoffs are likely next. (Maidenberg, Cutter and Feintzeig, 3/18)

The new coronavirus pandemic has triggered a wave of U.S. workers filing for state jobless benefits, with states across the nation receiving a sharp rise in applications as businesses shut down and out-of-work Americans hunt for a payment lifeline. Ohio’s three-day total for jobless claims through Tuesday was 78,000, compared with about 3,000 for the same period last week. Connecticut filers have submitted more than 30,000 new claims since Monday, compared with just 2,500 all last week. (Chaney and Omeokwe, 3/18)

As the coronavirus pandemic shuts down business across the county, a surge in newly laid off workers is crashing states' unemployment websites. (Ivanova, 3/18)

A wave of laid-off workers, mostly from restaurants and bars that together form the nation’s largest private employer, overwhelmed state unemployment systems as states relaxed rules on coronavirus-related unemployment insurance. Northeastern and New England states were the first to see websites jammed by new jobless claims, as more governors opted to close restaurants and other public gathering places. (Henderson, 3/18)

As governments and communities struggle to figure out the best way to deal with the novel coronavirus, a major concern is how to balance the risk to lives versus the risk to livelihoods. In short, how do we balance the public health versus economic consequences of this pandemic? The answer comes from a widely used economic tool, and it is telling us that extreme measures are warranted. (Jacobson and Chang, 3/18)

The Macy’s in Manhattan’s Herald Square opened its doors to customers at 10 a.m. on Tuesday, as planned. Dozens of employees staffed the cash registers, cosmetics counter and shoe department. Many were frightened. Three days before, the company said that a worker at the store had tested positive for the coronavirus. But other workers were still being asked to commute to a job that required close interaction with the public. (Maheshwari and Corkery, 3/18)

The good news: The federal government is allowing states to expand eligibility for unemployment benefits because of the impact of COVID-19. If your employer had to temporarily shut down operations because of coronavirus, you can file. The same is true of employees who are currently being quarantined, but expect to return to work after. “In this emergency, I would not discourage anyone from trying to apply for benefits, even if they wouldn’t have applied before,” Michele Evermore, senior policy analyst for the National Employment Law Project, tells CNBC. (Leonhardt, 3/18)

In a powerful sign that casualties of the coronavirus outbreak include even the country’s strongest cultural institutions, the Metropolitan Museum of Art is projecting a total shortfall of close to $100 million for the near future and expects to be closed until July, according to a letter the museum sent to its department heads on Wednesday. “This is an extraordinarily challenging time for us all,” said the letter, signed by the Met’s top executives, Daniel H. Weiss, the president and chief executive, and Max Hollein, the director. “As staff members of The Met we all have a profound responsibility to protect and preserve the treasured institution we inherited.” (Pogrebin, 3/18)

With fear of infection rising among factory workers, and few customers shopping for cars, several automakers on Wednesday decided to idle their plants in the United States, Canada and Mexico for at least a week. The decisions will put tens of thousands of people out of work and add to the coronavirus outbreak’s growing economic toll. The country’s largest automakers — General Motors, Ford Motor and Fiat Chrysler — decided to close plants after the United Auto Workers union pressured them to do so to protect workers. That pressure intensified after it was revealed on Wednesday that a worker at a Ford truck plant in Dearborn, Mich., had tested positive for the virus. (Boudette, 3/18)

The number of confirmed cases of the new coronavirus worldwide surpassed 200,000 for the first time Wednesday and the damage being seeded in the global economy is growing more clear by the day. Furloughs and job cuts, from dog walkers to oilfield workers, have begun. Governments around the world are pushing drastic countermeasures to help workers, particularly those who live paycheck to paycheck. (3/18)

It started last Tuesday, a sudden decline in the number of haircuts. By Saturday, the salon owner, Zach Edwards, was sitting in his office looking nervously at a line of empty barber chairs. “I’m really, really worried,” said Mr. Edwards, of his shop, Emerson Joseph, a male grooming salon in downtown Charlotte, N.C. “We had customers all week saying, ‘Can you cut it a little shorter? I don’t know when I’ll be back.’” (Tavernise, 3/18)

Since World War II, there have been 12 bear markets and 12 recessions, but not every bear market has preceded a downturn in the economy. (Russel and Grocer, 3/18)

Some businesses for days played down the health threat of the new coronavirus or directed employees to continue coming into offices as federal and local health authorities have called for flexible work arrangements to slow the spread of the disease. Closely held Hill Restaurant Group recently said it wouldn’t close its seven eateries in the Washington, D.C., area before reversing course. Ad agency holding company Omnicom Group Inc. OMC -5.85% and technology firm MicroStrategy Inc. MSTR -15.69% maintained—until this week—that most employees should come into work. (Needleman and Haggin, 3/18)

Walmart cut its store operating hours for the second time in a week Wednesday, in addition to making other store changes amid continued concerns over the coronavirus pandemic.Walmart stores in the U.S. will be open from 7 a.m. until 8:30 p.m. beginning Thursday. The move will “further help associates restock the shelves for customers while continuing to clean and sanitize the store,” Dacona Smith, Executive Vice President and Chief Operating Officer of Walmart U.S., said in a Wednesday statement. (Pitofsky, 3/18)

Gov. Andrew M. Cuomo of New York provided new numbers on Wednesday that showed 2,382 people in the state had tested positive for the coronavirus, an increase of more than 1,000 since Tuesday. Mayor Bill de Blasio said later in the day that 1,871 people in New York City had tested positive, compared with 814 on Tuesday. Mr. Cuomo attributed much of the jump to an increase in testing. Of the 14,597 people to be tested so far, nearly 5,000 were tested on Tuesday. (3/18)

Health officials expressed growing alarm on Wednesday that the coronavirus is spreading quickly in tightly knit Hasidic Jewish communities in Brooklyn, saying that they are investigating a spike in confirmed cases in recent days. More than 100 people have recently tested positive for the coronavirus in Borough Park and Williamsburg, two Brooklyn neighborhoods with sizable Hasidic Jewish populations — all of them tested at two urgent care centers that have been crowded with anxious patients, according to an urgent care center employee. (Stack and Schweber, 3/18)

New York Gov. Andrew Cuomo tightened restrictions on businesses Wednesday, telling them to allow employees to telecommute or otherwise keep half their workforce home at any one time, as governors across the tri-state area grappled with increased coronavirus cases. Grocery stores, pharmacies, shipping companies and other essential services would be exempt from the rule Mr. Cuomo imposed through executive order to help curb the transmission of the virus. (Berger and Vielkind, 3/18)

New York City is nearly unrecognizable as the coronavirus outbreak has driven crowds from the streets. With 532 new cases on Wednesday, there are now at least 1,871 cases of coronavirus in New York City and 11 deaths, Mayor Bill de Blasio's office confirmed to CNN. (Holcombe, 3/19)

In New York’s State Capitol, lawmakers voted one at a time or in small groups in nearly empty chambers. In Boston, legislators postponed public hearings, promising to take virtual testimony on bills. State lawmakers in Mississippi, California and Nebraska gaveled out, holding hope of returning once the crisis passes. (McKinley and Ferre-Sadurni, 3/18)

A passenger who flew out of John F. Kennedy International Airport to Rochester, New York, over the weekend had coronavirus and was contagious, the Monroe County Health Department tweeted Wednesday night. The Delta Air Lines flight left JFK at 4:05 p.m. on Saturday and landed in Rochester at 5:55 p.m., according to the tweet. (Holcombe, 3/19)

With nearly 9 million Californians living under orders to stay home as much as possible, state and county leaders are preparing for what could be next in the coronavirus pandemic. Gov. Gavin Newsom on Wednesday evening said the state has asked the Department of Defense to deploy the Navy’s Mercy hospital ship and two mobile hospitals to California to help care for the expected surge in hospitalizations of residents stricken by the novel coronavirus. (Lin, Shalby, Blume and Fry, 3/18)

Los Angeles will convert 42 of its recreation centers into temporary shelters for homeless residents, providing 6,000 new beds in an effort aimed at slowing the spread of the novel coronavirus, Mayor Eric Garcetti said Wednesday. The city is looking in the initiative’s first phase to open 1,600 shelter beds at 13 recreation centers by Monday, with beds provided by the American Red Cross, Garcetti said. (Zahniser, Nelson and Smith, 3/18)

Gov. Gavin Newsom said Wednesday that the state has asked the Department of Defense to deploy the Navy’s Mercy hospital ship and two mobile hospitals to California to help care for the expected surge in hospitalizations of residents stricken by the novel coronavirus. (Willon, 3/18)

A group of homeless and housing-insecure Angelenos seized more vacant, publicly owned homes in El Sereno on Wednesday, arguing that government officials have failed to provide the shelter that’s necessary for them to remain healthy during the coronavirus pandemic. The occupation followed a similar takeover Saturday, when two families and a man moved into one of the neighborhood’s dozens of empty homes — all owned by Caltrans. The state agency bought them years ago as part of a now-failed plan to extend the 710 Freeway. (Dillon, 3/18)

Texas is a big state with a proud small-government philosophy. And that’s being tested by the Covid-19 pandemic. Strict bans on public gatherings to curtail the virus' reach and widespread testing and treatment run counter to the politics of top Texas officials. Instead they're calling on local officials to lead the response. As governors in states including New York and California have imposed statewide measures such as closing schools and limiting commerce, Texas leaders have been reluctant to set restrictions conservative voters might consider draconian and business leaders oppose. They’ve also opposed steps to expand health insurance coverage. (Rayasam, 3/18)

Rep. Debbie Wasserman Schultz, on a call with fellow lawmakers and Florida state officials, accused Gov. Ron DeSantis of failing to acknowledge the coronavirus is spreading in the state even among people who haven’t traveled overseas. In a recording of the briefing obtained by POLITICO, Wasserman Schultz tried without success to get state Surgeon General Scott Rivkees, a DeSantis appointee, to commit to informing the public about community spread in Florida. (Dixon, 3/18)

A New Jersey mother died from coronavirus without knowing that her two children also got infected and died shortly before she did, The New York Times reported. Grace Fusco, 73, died Wednesday and was unaware of the deaths of her oldest son and daughter from Covid-19, the disease caused by coronavirus. (Karimi and Frehse, 3/19)

As the coronavirus death toll rises and quarantine forces Americans into lockdowns, details on patients killed by the virus are slowly trickling in. Here's what we know about some of the 145 people who've died since the first US case of the virus was reported in January. Coronavirus has spread to all states, the District of Columbia and some territories. (Karimi, 3/19)

Maryland announced its first coronavirus fatality Wednesday night as the number of patients in the greater Washington area passed 200 and medical facilities worked to expand testing capacity and add hospital beds. The man who died was a Prince George’s County resident in his 60s who had an underlying medical condition, officials said. (Simon, Swenson, Chason and Portnoy, 3/18)

Most national parks are open as a refuge for Americans tired of being stuck at home during a global pandemic, but despite now being free to visit, people may find it more difficult than normal to enjoy them as parks close visitor centers, shuttles, lodges and restaurants to fight the spread of the coronavirus. (McCombs and Anderson, 3/19)

Grace Fusco — mother of 11, grandmother of 27 — would sit in the same pew at church each Sunday, surrounded by nearly a dozen members of her sprawling Italian-American family. Sunday dinners drew an even larger crowd to her home in central New Jersey. Now, her close-knit clan is united anew by unspeakable grief: Mrs. Fusco, 73, died on Wednesday night after contracting the coronavirus — hours after her son died from the virus and five days after her daughter’s death, a relative said. (Tully, 3/18)

Shauntrice Murry sat in a prison hospital bed the other night, alone and fearing death. Pain kept the 45-year-old inmate awake, as did the ringing memory of her doctor’s words from days earlier: We’ve done all we can. The doctor said to call in family for goodbyes, but the Georgia Department of Corrections cancelled all visitation amid concerns over the spread of coronavirus. Since her diagnosis, she’d lost a third of her body weight (down to 101 pounds) and could no longer walk to the bathroom without a fellow inmate holding her steady. Now in her darkened cell, with pain pulsing through her body, Murry called out her savior’s name: Jesus. Jesus. Jesus. (Blau and Sharpe, 3/18)

Ogrod’s next scheduled court date on this matter, March 27, has been postponed at least until June. Now, both his defense team and the district attorney have filed emergency motions for Ogrod’s release and transportation to a hospital — citing symptoms of possible coronavirus, including a 106-degree fever, cough, and difficulty breathing. (Melamed, 3/18)

A top deputy at the Massachusetts Department of Correction issued an agency-wide directive on Tuesday that halted all employee discipline and lifted the suspensions of prison guards and other workers because of the coronavirus outbreak. But a day later, amid growing public backlash, Correction Department Commissioner Carol Mici rescinded the eyebrow-raising order in her own memo. Mici said the earlier directive was unauthorized, distributed without her knowledge, and that the prison system’s disciplinary procedure should remained unchanged. (Rocheleau, 3/18)

Maine Governor Janet Mills on Wednesday ordered that bars and restaurants in the state close to dine-in customers amid the ongoing coronavirus pandemic. The order, Mills’s office said in a statement, takes effect at 6 p.m. Wednesday, and will last until midnight on Mar. 31. Take-out, delivery and drive-thru service can continue, according to Mills’s office. She also barred gatherings of more than 10 people until further notice. (Andersen, 3/18)

As the number of coronavirus cases continued to spike in Massachusetts, Governor Charlie Baker on Wednesday ordered most early education and child care centers in the state to close beginning Monday. Baker’s announcement came as the state Department of Public Health reported 256 confirmed cases of the infectious disease, a 17 percent increase since Tuesday. Department officials also said that 1,168 Massachusetts residents remained in quarantine as potential coronavirus carriers. (MacQuarrie and Ebbert, 3/18)

Tufts University is preparing some of its undergraduate dormitories in case they are needed by hospitals as isolation rooms for patients with mild coronavirus symptoms. Middlebury College in Vermont has drained its ice-hockey rink, on the chance that the local hospital needs space to conduct offsite virus testing or for storage. (Fernandes, 3/18)

In an effort to curb the spread of the coronavirus, funeral directors across Pennsylvania are being urged to postpone funerals, cancel public viewings, and limit attendance at services to 10. Over the weekend, the Pennsylvania Funeral Directors Association encouraged funeral homes to consider limiting services to immediate family and moving public memorials to a later date. (Simon, 3/18)

The state can issue expedited child care licenses in order to expand access and help health care providers find care for their children, under an executive order signed by Gov. Gretchen Whitmer Wednesday night. The order also allows employers, like hospitals, to operate a disaster relief child care center for their employees. And it allows both public and nonpublic school facilities to be used for the purposes of maintaining a disaster relief child care center focused on providing services for health care workers, who have faced added challenges finding daycare when Whitmer ordered schools closed. (Moran and Gray, 3/18)

Detroit buses are back on schedule as of 3 a.m. Wednesday morning after a major shortage of bus drivers forced the city to cancel bus service Tuesday. New sanitization and safety protocols were put into place after Detroit Mayor Mike Duggan heard concerns about the spread of novel coronavirus from Detroit Department of Transportation employees. (Parvez, 3/18)

At least two Republican-led states want to temporarily ease their Medicaid waiver requirements and make it easier for residents to get and keep coverage under Medicaid and the Children's Health Insurance Program during the coronavirus pandemic. On Tuesday, Arizona and Iowa sent requests to the CMS so they can make temporary changes to their Medicaid programs, including eliminating premiums and pausing disenrollments. (Meyer, 3/18)

Gov. Kevin Stitt’s plan to customize Medicaid expansion in Oklahoma seeks to impose work or community-engagement requirements on thousands of low-income Oklahomans and charge them monthly premiums for health care services. Directed by Stitt, the Oklahoma Health Care Authority is seeking approval for a Healthy Adult Opportunity waiver — offered by the Trump administration to let states tailor their Medicaid expansion plans. (Forman, 3/19)

Minnesota lawmakers have approved more than $220 million to tackle the coronavirus. Washington state is tapping $175 million in reserves to test for the virus and treat patients. And Philadelphia’s city council is considering holding a teleconferenced public hearing so $85 million can be freed up to help combat the pandemic. States and cities across the U.S. are scrambling to quickly draw millions of dollars from their reserves to help cover coronavirus-related expenses such as testing and unemployment insurance, while also bracing for steep tax-revenue declines. (Calvert and Kamp, 3/19)

As tribes across the country take steps to fight the spread of the coronavirus, they’re doing so mindful that the virus has proven especially dangerous to the elderly, a venerated group in many Native communities. In her address, Gobin urged Tulalip members to look after the needs of Elders “so they don’t have to be in the public, because they are the most at-risk.” (Brown, 3/19)

Staff members who worked while sick at multiple long-term care facilities contributed to the spread of COVID-19 among vulnerable elderly in the Seattle area, federal health officials said Wednesday. Thirty-five coronavirus deaths have been linked to Life Care Center in Kirkland. A report Wednesday from the U.S. Centers for Disease Control and Prevention provided the most detailed account to date of what drove the outbreak still raging in the Seattle area where authorities closed down restaurants, bars, health clubs, movie theaters and other gathering spots this week. (Johnson and Stobbe, 3/18)

Staff members at the Seattle-area nursing home overrun by COVID-19 spread the coronavirus to other facilities where they worked, an investigation led by the U.S. Centers for Disease Control and Prevention has found. The report published Wednesday said that as of March 9, the CDC confirmed 129 COVID-19 cases among people linked to Life Care Center of Kirkland. These comprise 81 residents, 34 staff members and 14 visitors. (Read, 3/18)

A national organization that represents nursing homes and assisted-living facilities said Wednesday that there already are sporadic shortages of protective equipment for staff and that 20% of facilities say they could run out of masks and gowns next week. Another 20% would run out the week after that, according to the American Health Care Association. The group is calling for people who do not currently need protective equipment to share their inventories with medical providers, and lauded dentists in Ohio for doing so. (Burling, 3/18)

Nineteen long-term care facilities in Florida have either a suspected or confirmed case of the coronavirus, including two confirmed cases in Duval and Broward counties. Agency for Health Care Administration Secretary Mary Mayhew said she could not divulge the name or addresses of the nursing facilities, citing patient privacy requirements. She said she would look into providing more information in aggregate. (Glorioso, 3/18)

An additional 128 people have tested positive for the coronavirus in Illinois, including 20 more individuals living or working at a nursing home in a southwestern suburb of Chicago, state officials announced Wednesday. The additional results bring the state’s total to 288 cases in 17 counties, according to the Illinois Department of Public Health. The patients have ranged in age from 9 to 91, and one person has died — a Chicago woman in her 60s. (Foody, 3/18)

With their doors closed, their reopening dates in flux and their promised “distance learning” offerings in doubt, the nation’s school administrators are pleading with the federal government for guidance to respond to the worsening coronavirus outbreak. More than half the states have shut down all their schools for two to six weeks, and some state leaders have begun to predict that their schools will remain closed for the remainder of the year. But so far, instructions from the federal government have been contradictory and inconclusive. The Centers for Disease Control and Prevention first recommended hygiene. Then it advised against gatherings of more than 50 people, hours before President Trump lowered that to 10 for the next two weeks, with a vague call for home schooling where possible. (Green, 3/18)

The Centers for Disease Control and Prevention on Tuesday abruptly canceled an online briefing with school superintendents, and their association called on the agency and the White House to clarify federal guidance for schools struggling amid the coronavirus outbreak. Daniel A. Domenech, executive director of AASA, The School Superintendents Association, told POLITICO that superintendents are feeling "total confusion" with the conflicting statements issued earlier by the CDC and then on Monday from the White House. (Gaudiano, 3/17)

Closing schools to combat the spread of the coronavirus is having a sweeping impact on an annual rite of spring: the standardized tests that are dreaded by millions of students and teachers alike. Several states have canceled standardized testing for this academic year as they face school closures that could last weeks or months. The tests were scheduled to begin in early April in many states. (Vertuno, 3/19)

One man wore plastic gloves and a face mask as he pulled up in a pickup to receive school-packed meals for his children. A woman with a preschooler at her side took her boxed meals through her car window and quickly drove away. Another woman said she was grateful to hear that the district was giving out milk. She couldn’t find any the last time she went to a local market. (Blume and Xia, 3/18)

When America is at war, voters prefer not to swap presidents in the middle of battle. James Madison sailed to reelection after launching the War of 1812. Abraham Lincoln delivered his second inaugural address a month before the Confederacy surrendered at Appomattox. In the shadow of World War II, Franklin D. Roosevelt notched a third term. And the year after deploying troops to Iraq, George W. Bush defeated a war veteran, Democrat John Kerry. What if the enemy is invisible? Not a foreign country, or the perpetrators of a brazen terrorist attack, but a lethal disease that forces Americans to shelter in place indefinitely as their health, jobs and wages hang in the balance? (Orr and Seligman, 3/19)

The coronavirus crisis is rapidly changing President Trump’s re-election strategy, forcing him into the position of leading the nation through a sprawling, complex emergency while undermining his greatest asset: a strong economy. Mr. Trump this week has taken steps to demonstrate more command, appearing at daily news conferences and taking a solemn outlook, while his campaign weighs how to contend with battered financial markets and rising unemployment. (Leary and Bender, 3/19)

Trump’s ability to enact his plan and weather the turbulence could have an enormous impact on his political fate and determine whether he is remembered as this era’s Herbert Hoover, who was president at the onset of the Great Depression, or its Franklin Roosevelt, his successor who guided the nation out of economic and geopolitical turmoil. “This is Trump’s World War II,” said Stephen Moore, a Heritage Foundation fellow and an informal Trump economic adviser. “It’s really critical to not only whether he is reelected but how he will be judged by history.” (Costa and Rucker, 3/18)

A president who shaped his first three years in office trying to sell Americans on obscure corporate tax provisions, minute details of tariffs and the rollback of mind-numbing regulations has a new approach: Keep it simple. Facing the most sudden economic crisis to hit any modern American leader, President Donald Trump is now pushing to send Americans four-figure checks, establish broad corporate bailout programs and lend billions of dollars to small businesses so they can keep paying their bills. (Cook and Levine, 3/19)

President Donald Trump’s top political advisers in recent weeks envisioned unleashing a massive advertising campaign against Joe Biden to define him for the general election before he had a chance to recover from the primary. Then the novel coronavirus arrived. (ISenstadt and Korecki, 3/19)

A group of Democratic senators led by Sens. Amy Klobuchar (D-Minn.) and Ron Wyden (D-Ore.) introduced legislation on Wednesday to promote mail-in and early voting to decrease the spread of the coronavirus. The Natural Disaster and Emergency Ballot Act (NDEBA) would ensure voters have 20 days of early voting in all states, require that all mail-in ballots submitted during 21 days leading to an election be counted, and ensure that all voters have the option to request absentee ballots. (Miller, 3/18)

The primary day turnout wave that swept over Democratic presidential contests in recent weeks crashed on Tuesday as concerns about the coronavirus outbreak kept anxious voters in Florida, Illinois and Arizona away from the polls. Turnout in Florida’s Democratic presidential primary saw a marginal increase — about 2 percent — over 2016 levels, rising from about 1.71 million to 1.74 million. But the gains appeared to come from increased early voting, while actual in-person turnout dropped from about 820,000 four years ago to 630,000 on Tuesday. (Greenwood, 3/18)

Marie Newman didn't get to have the big election night party she'd been planning at her beloved local brewery. With a growing coronavirus pandemic halting most large gatherings across the country, she celebrated her Democratic primary victory over Rep. Dan Lipinski of Illinois on Tuesday night with a virtual party on Facebook Live. Lipinski, an eight-term incumbent, called her Wednesday afternoon to congratulate her, then held a news conference where he offered a lukewarm concession and committed to working with her. (Pathe, 3/18)

American adults of all ages — not just those in their 70s, 80s and 90s — are being seriously sickened by the coronavirus, according to a report on nearly 2,500 of the first recorded cases in the United States. The report, issued Wednesday by the Centers for Disease Control and Prevention, found that — as in other countries — the oldest patients had the greatest likelihood of dying and of being hospitalized. But of the 508 patients known to have been hospitalized, 38 percent were notably younger — between 20 and 54. And nearly half of the 121 patients who were admitted to intensive care units were adults under 65, the C.D.C. reported. (Belluck, 3/18)

Most public health messaging so far has stressed that people who are older, whose immune systems are weakened, and who have underlying diseases are at higher risk of becoming critical cases. But during a briefing, Deborah Birx, the official, cited preliminary data from Europe to caution the public that younger adults can get very sick as well. “There are concerning reports coming out of France and Italy about some young people getting seriously ill, and very seriously ill in the ICUs,” said Birx, a physician and ambassador. (Joseph, 3/18)

In general, the U.S. experience largely mimics China’s, with the risk for serious disease and death from Covid-19 rising with age. But in an important qualification, an analysis by the Centers for Disease Control and Prevention reported on Wednesday underlines a message that infectious disease experts have been emphasizing: Millennials are not invincible. The new data show that up to one-fifth of infected people ages 20-44 have been hospitalized, including 2%-4% who required treatment in an intensive care unit. (Begley, 3/18)

Eighty percent of deaths associated with the coronavirus in the United States were in adults aged 65 and older, according to an analysis released Wednesday by the Centers for Disease Control and Prevention (CDC). “The risk for serious disease and death in COVID-19 cases among persons in the United States increases with age,” the CDC said. “Social distancing is recommended for all ages to slow the spread of the virus, protect the health care system, and help protect vulnerable older adults.” (Hellmann, 3/18)

Although severe illness and death from COVID-19 infection can occur in people of any age, 80% of US deaths so far have been in those 65 years and older, with the worst outcomes in people 85 and older, according to an analysis in today's Morbidity and Mortality Weekly Report from the US Centers for Disease Control and Prevention (CDC). In another report in the same journal, experts analyzing the highly publicized novel coronavirus outbreak in a Washington state long-term care facility said that the virus can quickly spread in residents, workers, and visitors and that "substantial morbidity and mortality might be averted if all long-term care facilities take steps now to prevent exposure of their residents to COVID-19." (Beusekom, 3/18)

At the Florida community of The Villages, the retirement capital of America and the place with the nation’s highest concentration of older people, only 33 people have been tested for the coronavirus. In the Florida Keys, swamped with young spring breakers and travelers from around the world, just 16 people had been tested by Monday night. Ten of Florida’s 67 counties have tested no one at all. A disease that is deadly to the elderly and easily spread by the young has left Florida especially vulnerable. (Mazzei, Robles and Burch, 3/18)

Since a novel coronavirus first made its presence known in China, public health officials around the world have had one fervent hope: That people who are infected but not sick would pass the virus to others only rarely. That would give these silent spreaders no more than a bit part in driving a global outbreak. That hope is in danger of being dashed. (Healy, 3/17)

As people in San Francisco shelter in place and New York City was warned to prepare for a similar measure, some 40 people met in New Mexico for an Alcoholics Anonymous meeting on Wednesday amid White House pleas to avoid groups as the country battles coronavirus. Officials are telling Americans they must practice social distancing and avoid groups of more than 10 people to slow the spread of the pandemic. But in many places, especially outside large centers, people are defying the message. Among the reasons: The urgency has been slow to become apparent; they do not believe in the steps; or their livelihoods depend on ignoring the guidance. (Hay and Resnick-Ault, 3/18)

Not even a pandemic could prevent Brady Sluder from partying in Miami for spring break. An Ohio native, Sluder had been planning the getaway for about three months, according to Reuters, when Florida Gov. Ron DeSantis (R) ordered all the state’s bars and nightclubs to shut down for 30 days to reduce the spread of the novel coronavirus. It unfolded as the Centers for Disease Control and Prevention urged a nationwide halt to gatherings of more than 50 people for the next eight weeks. (Bella, 3/19)

Consider the wild tiger. It consorts with fellow tigers only to mate or, if female, to briefly raise cubs. Otherwise, the tiger roams solo. Tigers are great at social distancing. We are not tigers. Amid a novel coronavirus pandemic, some of us have defied public health officials’ exhortations and headed to bars to be with other members of our species. More of us have stared into the weeks to come and wondered how we will cope without basketball games, book groups, worship services, yoga classes and dinners with friends. (Brulliard, 3/17)

The Trump administration plans to emphasize social distancing as the primary method to contain the new coronavirus, a shift away from its recent focus on widespread testing as a containment tool. Top White House officials have recently started saying testing will prioritize seniors aged 65 and older, front-line health care workers and patients hospitalized with symptoms amid a dwindling national supply of testing chemicals and ingredients. State health departments in Utah and Minnesota have said they must limit who gets tested, and a senior Trump administration official said most people will face a long wait for testing if they aren’t in the prioritized categories. (Armour, 3/19)

Kaiser Health News: Take A Deep Breath: Making Risk-Based Decisions In The Coronavirus Era 

Just last week, it seemed OK to have lunch out or maybe meet up with friends for a game of pickup soccer. Now, in the fast-moving world of the coronavirus response, that’s no longer the case. More and better social distancing is required. But what’s still acceptable? We reached out to public health experts, who, admittedly, vary in their recommendations. But their main message remains: The better individuals are now at social distancing to slow transmission of the virus, the better off we’ll all be eventually. (Appleby, 3/18)

Just a few weeks ago, China was overwhelmed by the coronavirus pandemic that began in Wuhan. Since then, it has drastically reduced the number of new cases, what is known as flattening the curve. (Lai and Collins, 3/19)

How long will this last? Scientists say there isn’t a simple answer. “In many ways, this situation is unprecedented – we’re trying to take some actions to curb the spread and timing of this pandemic,” said Stephen Morse, a disease researcher at Columbia University in New York. Yes, there have been past disease outbreaks that scientists can draw some lessons from but, in those cases, the disease was largely allowed to run its course. “So those models don’t precisely apply,” Morse said. (Larson and Smith, 3/19)

Nearly two months since the first US coronavirus case, the federal government is now preparing for a pandemic that could last up to 18 months or longer and "include multiple waves of illness," a report obtained by CNN shows. Hospitals have already sounded the alarm on quickly vanishing supplies as the outbreak in the US shows no signs of slowing -- in just 24 hours, cases soared by more than 40%. (Maxouris, 3/19)

Political leaders around the country are beginning to warn their constituents that the major disruptions to their everyday lives caused by the spreading coronavirus will last far beyond the temporary shutdowns that are so far in place. The states and cities that have ordered schools and businesses closed have set two- or three-week limits, in hopes of stemming the spread of the virus. But public officials are increasingly warning that the closures are likely to last far longer. (Wilson, 3/18)

There is no known cure for the new coronavirus.Scientists are scrambling to find treatments and vaccines for the virus, which causes the illness Covid-19, and health care professionals are working to stop the spread of misinformation. It’s a tough battle. On social media, memes have become efficient vectors of bad advice, often with urgent instructions or dystopian graphics. One, misstating the benefits of gargling salty water, shows the virus as a cluster of green burrs infecting the throat of a glowing blue man. (Fortin, 3/18)

As the worldwide spread of COVID-19 has spiraled into a pandemic, national health organizations are warning that some members of the LGBTQ community may be “particularly vulnerable” to the effects of the virus.While LGBTQ individuals have not been found to be more susceptible to contracting COVID-19, some health habits within the community, including significantly higher rates of smoking than the general population, have raised concern among health professionals. (Eadens, 3/18)

“Life is one thing after another,” Dr. Harriet Lerner, a psychologist and author, said. “And just because the universe has already sent us one big stress, it doesn’t mean we won’t be hit with others. ”Dr. Lerner has spent much of her career researching the effects of anxiety and fear on individuals, families and larger systems. She has also managed anxiety in her own life (documented in her best seller “The Dance of Fear”). That makes her the perfect person to help us tackle the rise in panic accompanying Covid-19, the disease caused by the novel coronavirus. (Sethi, 3/18)

Viruses didn’t become ubiquitous by being wimps: From the rhinoviruses that cause the common cold to the new coronavirus that has spread across the world, they are able to survive on surfaces far away from the living cells that they need in order to reproduce. How long they can lurk before a living organism comes along to infect depends on the kind of surface and the properties of the virus: The Covid-19 virus, according to a new study, sticks around on plastic surfaces for up to three days, but for a shorter period on metals. (Begley, 3/19)

Left unchecked, the coronavirus that causes COVID-19 could infect billions of people. By one estimate, up to 70% of the world’s population may contract the disease. That means there’s an excellent chance that, sooner or later, you will be one of them. The World Health Organization said 14% of people known to have COVID-19 develop symptoms severe enough to require hospitalization and oxygen support. But calculating the odds of survival in the early stages of the pandemic is imprecise. (Pierson, 3/19)

In the outpouring of social media messages about the coronavirus pandemic, the collective mood is grim, experts found. Manlio De Domenico, a scientist at Italy’s Bruno Kessler Foundation’s Center for Information and Communication Technology, has tracked online rumors and bots that spread false news. He and his colleagues recently analyzed more than 121,407,000 tweets, half of which were tagged to a location, and more than 22 million Web pages to describe the messages people — and robots — have been sending during the outbreak. (Buarino, 3/17)

The world has changed a lot in the last few weeks. We’re here to help. (3/18)

Conversations that dominated the health policy discourse only a few weeks ago have been suspended as we scramble to contain Covid-19. The overall cost of health care in the United States was a first-order concern before the virus struck. Now, most people are focused on the critically important but narrower issue of the price tag of Covid-19 testing and treatment. (Broffman, 3/19)

A company that uses internet-connected thermometers to predict the spread of the flu says it is tracking the coronavirus in real time — something that had been impossible, given the lack of testing for the disease. Kinsa Health has sold or given away more than a million smart thermometers to households in which two million people reside, and thus can record fevers almost as soon as consumers experience them. (McNeil, 3/18)

The coronavirus is forcing big changes to the way Facebook operates and stretching the company to its limits, according to CEO Mark Zuckerberg. Facebook must continue to tackle an urgent and potentially dangerous form of misinformation around the virus while it simultaneously tries to figure out how much work its content moderators can do remotely at home and faces an unprecedented surge in usage that has the company scrambling just to keep its services running. (Iyengar, 3/18)

China on Thursday reported no new local infections for the first time since the coronavirus crisis began three months ago, reaching a milestone in its battle with the deadly outbreak that has upended daily life and economic activity around the world. As governments in Italy, the United States and elsewhere grapple with the pandemic, China has hailed its success as evidence of what can be achieved when a vast, top-down bureaucracy that brooks no dissent is mobilized in pursuit of a single target. (Hernandez, 3/18)

The news offered a rare glimmer of hope for the rest of the world as it battles the virus, and perhaps a lesson in the strict measures needed to halt its spread. It came as President Donald Trump likened the fight to “a war” and invoked emergency powers that allow him to compel manufacturers to deal with the pandemic. Wuhan was where the outbreak first took hold and thousands once lay sick or dying in hurriedly constructed hospitals. But Chinese authorities said Thursday that all 34 new cases recorded over the previous day had been imported from abroad. (Moritsugu and Perry, 3/19)

China’s leader, Xi Jinping, pledged to send more medical experts to Italy this week, on the same day Beijing sent 2,000 rapid diagnostic tests to the Philippines. Serbia’s president pleaded for assistance not from the country’s neighbors in Europe, which restricted the export of needed medical equipment, but from China. “European solidarity does not exist,” the Serbian leader, Aleksandar Vucic, said when he announced a state of emergency in televised remarks. “That was a fairy tale on paper. I believe in my brother and friend Xi Jinping, and I believe in Chinese help.” (Myers and Rubin, 3/18)

When authorities in Wuhan announced on Dec. 31 that they had detected a cluster of viral pneumonia in the Chinese city, with 27 cases linked to a seafood market, they said the disease was preventable and controllable, with "no obvious signs of human-to-human transmission." But in wealthy places on China's periphery — Hong Kong, Taiwan and South Korea — a rapid response swung into action. (Mahtani and Denyer, 3/18)

The I.O.C., which has insisted the Games will be held as scheduled beginning in late July in Tokyo, provided the guidance during a two-hour conference call Wednesday morning with 200 athlete representatives from around the world and half a dozen I.O.C. officials, including Thomas Bach, the president. Rather than reassuring the athletes, the call left a number of them flummoxed. (Keh and Panja, 3/18)

Regional Olympic officials are rallying around the IOC and have backed its stance on opening the Tokyo Games as scheduled, as direct criticism from gold medalist athletes built amid the coronavirus outbreak. Leaders of continental Olympic groups praised the IOC after a conference call Wednesday to update them on coronavirus issues four months before the opening ceremony in Tokyo on July 24. (Dunbar, 3/18)

In this cohort study of 9388 individuals, a significant number of children were classified as having an intermediate cardiovascular health score by 8 years of age. Many of these children experienced more rapid declines in cardiovascular health, had greater carotid intima-media thickness, and were more likely to have high carotid intima-media thickness by middle age. (Allen et al, 3/11)

A new study shows that white, college-educated, high-income Texans who live in cities or suburbs are less likely than others to vaccinate their children, putting students at 5% of public, 28% of private, and 22% of charter K-8 schools in the state's metro areas at high risk for vaccine-preventable diseases such as measles. In the study, published yesterday in PLOS Medicine, researchers at the University of Texas at Austin mined public records to evaluate conscientious vaccination exemptions (CVEs) for 318 private, 818 public, and 60 charter schools in Texas from the 2012-13 through 2017-18 school years.Using regression analysis, the investigators related the exemptions to percentages at the school and county to 115 socioeconomic and demographic factors through the US Census Bureau and the Texas Education Agency. (3/11)

Eating fish when pregnant — but not too much — is linked to better metabolic health in children, researchers report. For a study in JAMA Network Open, scientists recorded fish consumption and blood mercury levels in 805 women with singleton pregnancies and then followed their children’s metabolic health for an average of eight years. (Bakalar, 3/18)

The prices of physicians’ services for 38 million beneficiaries in the traditional Medicare program are set by the federal government. The process begins with a set of relative value units (RVUs) determined by a Resource Utilization Committee (RUC) composed of physicians representing different specialties whose job is to report the amount of time or work units required to perform a wide variety of patient care tasks. Those work units, combined with practice cost and liability insurance, constitute RVUs. The RVUs are converted to dollars using a multiplier set each year by the Centers for Medicare and Medicaid Services (CMS). This price-setting process is important because private Medicare Advantage (MA) plans and commercial insurers often build their pricing systems, although not necessarily their multipliers, on traditional Medicare’s RVU system. We refer to this system as “administrative pricing.” (Dowd, Feldman and Coulam, 3/18)

Nearly one-quarter of likely voters said they are very or moderately worried about their ability to afford their health care in the next 12 months. Those most worried were Democrats, voters leaning Democratic, Hispanics, and people earning less than $50,000 a year. But nearly one of five Republicans also said they’re very or moderately worried about paying for their care. (2/27)

People with a common heart rhythm problem who are physically active may live longer than more sedentary counterparts, a recent study suggests. Among 1,100 adults with atrial fibrillation, or AFib, those who got regular exercise were about 45 percent less likely to die of any cause, or of cardiovascular causes specifically, over a seven- to nine-year study period compared to those who got little physical activity. These results suggest that moderate exercise like brisk walking for 30 minutes most days of the week could help people with AFib live longer, Duke University cardiologist Christopher Granger said. (3/10)

A study examining the clinical and molecular epidemiology of carbapenem-resistant Enterobacterales (CRE) in US hospital patients indicates there is greater diversity in CRE than previously thought, a finding that could have implications for how hospitals treat and control the pathogens. The study, published late last week in The Lancet Infectious Diseases, looked at clinical and whole-genome sequencing data on a cohort of patients at 49 US hospitals in 15 states who were colonized or infected with CRE according to Center for Disease Control and Prevention (CDC) 2015 CRE guidelines. (Dall, 3/9)

Flu surveillance case definitions miss many hospitalized patients 65 years and older who have laboratory-confirmed infection—especially those who are frail, according to a prospective cohort study in today's Infection Control & Hospital Epidemiology. Researchers from the Canadian Immunization Research Network and Serious Outcomes Surveillance (SOS) Network determined that standard influenza-like illness (ILI) and severe acute respiratory illness (SARI) case definitions are biased toward detecting infection in people younger than 65 and thus do not characterize the true burden of the flu. (3/9)

In a recent and controversial First Opinion, epidemiologist and statistician John Ioannidis argues that we lack good data on many aspects of the Covid-19 epidemic, and seems to suggest that we should not take drastic actions to curtail the spread of the virus until the data are more certain. He is absolutely right on the first point. The U.S. has done fewer tests per capita so far than almost any rich country in the world. And many critical details of the epidemiology — including the absolute number of cases, the role of children in transmission, the role of presymptomatic transmission, and the risk of dying from infection with SARS-CoV-2 — remain uncertain. (Marc Lipsitch, 3/18)

Out of every major crisis comes a saying. After the terrorist attacks of September 11, 2001—now 9/11—it was “This changes everything.” During World War II the British said, “Keep Calm and Carry On”—good advice then and now. For the coronavirus pandemic of 2020, it looks like America’s version will be “Flatten the curve.” Given what we’re up against, “flatten the curve” sounds like a useful rule of thumb—not only for the health-care system but for the economy, politics and even our social and psychological well-being. (Daniel Henninger, 3/18)

When the novel coronavirus infection advances through the body in more severe cases, the lungs begin to fill with fluid and breathing becomes difficult. In a hospital intensive care unit, life-saving ventilators can help a patient survive by pumping oxygen into the impaired lungs. But what if thousands more people need hospital beds and ventilators than are available? That is the nightmare scenario facing the United States and other nations in the pandemic. In Italy, doctors are having to make painful choices about which patients get treatment. (3/18)

The coronavirus outbreak may have you feeling scared, frustrated and powerless. In stressful times, there’s a tendency to panic and, say, buy up all the pasta and bottled water. But we’re all in this together, and it’s far better for all involved if we choose to help our fellow humans rather than rip the last roll of toilet paper from their hands. There are many ways to do so. Here are a few ideas: Continue to pay ... (3/19)

Typically when I am on a conference call and my 5-year-old son is home, I do everything I can to minimize his potential disruptions. Snack, check.Bathroom, check. And, let’s be honest, iPad, check. I pray the office door will not open and trigger me to split my brain to respond to his request as quickly as possible while also staying focused on my colleagues’ discussion. Tuesday was different. Instead of living in fear of his distractions, I invited him to pop into my video call to wish my colleagues a happy St. Patrick’s Day. I thought it would help to lighten the mood as we all shelter in place in response to the coronavirus. (Courtney Masterson, 3/19)

"Rescheduled, date TBA," say the notes above a string of upcoming events listed on the Hoyt Sherman Place website."Postponed ... Postponed ... Postponed ... Cancelled," it says next to scheduled shows on the Iowa Events Center homepage.The St. Patrick's Day Parade didn't happen, the Des Moines Book Festival is off and the Iowa Legislature is on hiatus. The State Historical Museum and the Botanical Garden join shuttered schools, churches, and public libraries. Locked-up storefronts, empty workplaces and vacated bars and restaurants round out the picture. A pandemic plays out quietly. (Rekha Basu, 3/17)

The United States can and should “go big” to fight the coronavirus. It has done so before, at extraordinary speed and scale. It has tools like the Defense Production Act to help do it again. And it can be transformative: The industrial mobilization during World War II had a military purpose but lasting economic and social effects, helping build the foundation for a remarkable era of postwar prosperity. To get it right, we must understand how it worked, where it fell short and what the nation needs to mobilize again. (Margaret O'Mara, 3/18)

Probably for most of us, the coronavirus crisis will soon enough—Six months? A year?—recede in our minds and come to seem like a hallucinatory moment. Maybe it will be like a hurricane that forced everyone to rush inland and then only glanced the coast. Or maybe it will be like a hurricane that really does hit. Even then, human nature being what it is, most people will clean up and move on. Yet no matter how the coronavirus pandemic passes, or how quickly, there is likely in these strange housebound weeks a new political epoch being born. (John F. Harris, 3/18)

So our question for today is: What is the appropriate attitude toward Donald Trump in a time of national crisis? A) Rally around the president. B) Tell your friends about the pandemic response team he dismantled. C) Put your head down and watch 200 repeats of “Modern Family.” Come on, get your head up. I know this is tough. It’s definitely a time for Americans to come together. On the other hand, complaining about Trump is sort of … our way of life. (Collins, 3/18)

During national crises, we count on presidents to rise to the occasion, to mobilize and galvanize, and to lift us from our fears. Think of the fireside chats that Franklin Roosevelt held during the Great Depression and World War Two, the promise by John Kennedy to land Americans on the moon despite the staggering risk, and the stirring address that Ronald Reagan gave the country after the Space Shuttle Challenger disaster. These moments have tested and measured our ability to do bold things. So it is worth enshrining the actions of Donald Trump since the outbreak of the coronavirus. (Steve Israel, 3/18)

China is promoting a propaganda narrative that its authoritarian system is uniquely capable of curbing the coronavirus, in contrast to the chaotic response of Europe and the United States. Nevermind that the virus began in Wuhan and spread because Communist Party officials suppressed whistle-blowers. Beijing’s new storyline stresses that its draconian lockdown of tens of millions of its people (and ability to build new 1,000-bed hospitals in 10 days) was able to control the virus, even as new cases are soaring in America. (Trudy Rubin, 3/18)

It may soon be time for the U.S. to take an unprecedented step and waive the costs of treatment for the new coronavirus, for everyone. Where it stands: Insurers have already waived the cost of testing for many patients. But if hospitals are deluged with coronavirus cases, as expected, it may also be time to look at the substantially higher cost of treatment. (Drew Altman, 3/19)

The United States is facing what could become the most serious economic crisis since the Great Depression of the 1930s. We must therefore take immediate, large-scale, once-in-a-century action to protect our public health and our economy. (Rep. Don Beyer (D-VA), 3/18)

Like Zombies emerging from the mist, leaders of the much-maligned Deep State are shedding their anonymity as coronavirus fear grips the nation. But instead of seeking retaliation against a president who has mocked and belittled them for political expediency, the scientists and doctors and researchers and diplomats now moving to the fore are trying to save Donald Trump from himself — and just might save his presidency. The spreading contagion is teaching Trump a bitter lesson: When you’re confronting what some pathologists warn could become the worst health crisis in a century, you need experts on your side. (James Rosen, 3/18)

[T]he United States has failed to adopt necessary measures that have, in other countries, stemmed the tide of an epidemic that threatens to kill over one million Americans. Such severe measures, like the nationwide lockdown imposed in France, are unpalatable in a fiercely individualistic country in which, as Tocqueville observed nearly two centuries ago, commerce is king. (Jerome Karabel, 3/18)

The coronavirus emergency is fast transforming into one of the gravest political and societal challenges of the modern age -- and America's leaders are only just beginning to understand the gargantuan task before them. The longer-term realities are setting in for Americans amid calls for a World War II-style national mobilization to fight the pandemic. And the deeply concerned politicians charged with fighting it are comparing the historic significance of the crisis to the 1918 influenza calamity, the Great Depression and 9/11. (Stephen Collinson, 3/18)

Writing from Italy, where the coronavirus pandemic is at its strongest, I am fully committed to taking the most draconian steps necessary to keep people physically separated until the virus dies out for lack of new hosts. My op-ed last week made clear how strongly I believe that we have to take bold, strong measures on both the public health and the economic fronts. I strongly supported the $8.3 billion bill for coronavirus actions – and I support the bill now in the Senate that will send emergency relief to many American businesses and American workers. ... Today, though, I want to suggest that President Trump create a planning team to think beyond the immediate crisis. (Newt Gingrich, 3/19)

Our way of life in this country has survived wars, economic depressions, and yes, worldwide pandemics. In colonial times, Americans overcame smallpox and yellow fever. In the 19th century, we weathered horrific outbreaks of cholera and scarlet fever. In the 20th century, there was the Spanish flu, typhoid fever, polio, measles, and human immunodeficiency virus, which all caused enormous human suffering but failed to break the spirit of Americans. (Jenna Ellis, 3/18)

The social distancing required to limit the spread of the novel coronavirus that causes COVID-19 is having a devastating impact on our globalized and consumption-based, service-oriented economy. Across the nation, businesses large and small are closing to minimize contact between people. Over the long term, we will need to make significant investments to aid recovery, but in the near term, we need to provide direct relief to all Americans. (Andrew Foster, 3/18)

With the nation on the brink of total shutdown, the stock market wiping out years of accumulated wealth and millions of Americans worried about losing their jobs, I’ve lost all patience with the spitefulness of the political class. Maybe it’s asking too much, but in times of crisis I expect leaders to lead, not fight. I’d like to know that guiding the nation through its gravest threat since 9/11 is a higher priority than toting the partisan flag. I want those who have been chosen to lead to realize their constituents are frightened and uncertain of the future, and getting them safely through this dark hour demands that they present a united front. Mostly, I’m looking for them to tell America that together we can defeat this challenge, as we’ve defeated all others that have come before. That’s not the course taken Tuesday by Gov. Gretchen Whitmer and President Donald Trump, who were at each other’s throats as if it were still 2019. (Nolan Finley, 3/18)

As North Carolina races to slow the coronavirus outbreak, Lt. Gov. Dan Forest is trying to upend the effort by disputing Gov. Cooper’s authority to order that bars and restaurants shut down. Here’s a COVID-19 order just for Dan Forest: Hush. In a news release Tuesday afternoon, Forest said Cooper lacked the authority to order bars to close and restaurants to shut down their dining rooms. Earlier in the day, Cooper had issued the order, which allowed for restaurant takeout and delivery, starting at 5 p.m. Forest, a Republican, is running to unseat Cooper, a Democrat, in November’s election. (3/18)