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Morning Briefing

Summaries of health policy coverage from major news organizations

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Wednesday, Mar 18 2020

吃瓜不打烊 Original Stories 4

  • As Coronavirus Testing Gears Up, Specialized Swabs Running Out
  • Amid Pandemic, Programs Struggle To Reach Vulnerable Seniors Living At Home
  • Is The Bay Area鈥檚 鈥楿nprecedented鈥 Lockdown The First Of Many?
  • Near Trump鈥檚 Florida Home, Drive-Thru COVID-19 Testing Gets Off To Rocky Start

Federal Response 4

  • Trump Administration Calls For 'Big' Stimulus Package, Including $1,000 Checks To Every American
  • Trump Now Mobilizing Federal Government To React To Crisis, But Key Agency Resources Are Still Untapped
  • FDA Slashes Regulations For Tests In Desperate Effort To Meet Demand, But Admits There's A Trade-Off With Accuracy
  • A Timeline Of Trump's Shifting Rhetoric: President's Claims That He Always Took Pandemic Seriously Proven False

Capitol Watch 1

  • McConnell Vows Senate Will Work At 'Warp Speed' And Won't Leave Washington Until Deal Is Passed

Preparedness 2

  • The Daunting Math When It Comes To Ventilators And ICU Beds: A Look At What Places Are Strained Most For Resources
  • Protective Gear Shortages Endanger Health Workers On Front Lines: 'Guard Your Mask With Your Life, Because It Is Your Life'

From The States 3

  • Governors Become Generals Of Coronavirus Crisis As Federal Government Dawdled
  • All 50 States Have Confirmed Cases; U.S. Death Toll Surpasses 100
  • 'This Is Really About Saving Lives': California's Stringent Measures To Protect State Might Set Example For Other States

Economic Toll 2

  • There Is No Good Choice For Leaders When Potential To Save Lives Comes With Devastating Side-Effect Of Wrecked Economy
  • Big Reason To Halt Shipments Of Big Screens: Amazon Prioritizes Groceries, Necessities, Limits Some Orders

Elections 1

  • Amid Coronavirus Upheaval, Biden Sweeps Tuesday's Elections; Switching To Vote-By-Mail Not As Easy As It Sounds

Science And Innovations 3

  • Scientists Work Around The Clock At Incredible Speeds To Map Virus, Find Treatments And Develop Vaccines
  • Despite The Narrative, Young People Can Get Severely Ill From Coronavirus
  • Science Vs. Myths: New Study Outlines How Long Coronavirus Lives On Various Surfaces, In The Air

Health IT 2

  • Surveillance Tools Have Untold Potential To Help Locate Infectious Vectors, But They Could Erode Privacy Protections
  • Telemedicine For Seniors Gets Boost In Effort To Keep Most Vulnerable At Home, Out Of Hospitals

Government Policy 1

  • Trump Considering Capitalizing On Crisis By Completely Blocking All Illegal Border Crossings From Mexico

Global Watch 1

  • 'Devastatingly Dangerous Spiral': Editors Condemn China's Decision To Expel U.S. Journalists After Trump Imposed Limits

Public Health 1

  • Concerns Inside Prisons: 'Staff Are Starting To Get Fearful', Inmates Argue For Release

Prescription Drug Watch 2

  • Drug Coverage Is Shrinking, Leaving Vulnerable Patients In A Lurch. What's Going On?
  • Perspectives: The Social Contract That Keeps The Pharmaceutical Industry Functioning Is In Total Disrepair

Editorials And Opinions 2

  • Different Takes: Pros, Cons Of Stronger Government Responses During COVID-19
  • Viewpoints: Self-Quarantine Is Essential During Pandemic, But Will Rush Limbaugh's Followers Comply?; Lessons On How U.S. Hospitals Can Avoid Italy's Crisis

From 吃瓜不打烊 - Latest Stories:

吃瓜不打烊 Original Stories

As Coronavirus Testing Gears Up, Specialized Swabs Running Out

Nationwide, testing for coronavirus is ramping up. But the supply of specialty swabs needed to collect potential coronavirus specimens can鈥檛 keep up with demand, creating a bottleneck in testing capabilities. So two top manufacturers are working with U.S. and Italian governments to increase production. ( Lauren Weber and Christina Jewett , 3/17 )

Amid Pandemic, Programs Struggle To Reach Vulnerable Seniors Living At Home

Older adults are at serious risk during this pandemic and have been advised to avoid contact with others. Yet many still need essential services, and programs are scrambling to adapt. ( Judith Graham , 3/18 )

Is The Bay Area鈥檚 鈥楿nprecedented鈥 Lockdown The First Of Many?

About 7 million people across the San Francisco Bay Area began to 鈥渟helter in place鈥 Tuesday to limit the spread of the new coronavirus. Although public health officials acknowledged the orders were drastic, they also agreed they were necessary. ( Jenny Gold and Rachel Bluth , 3/17 )

Near Trump鈥檚 Florida Home, Drive-Thru COVID-19 Testing Gets Off To Rocky Start

Just 5 miles from Mar-a-Lago, the POTUS鈥 outpost, Florida residents find that the president鈥檚 pledge to make testing accessible hasn鈥檛 materialized. ( Phil Galewitz , 3/17 )

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Summaries Of The News:

Federal Response

Trump Administration Calls For 'Big' Stimulus Package, Including $1,000 Checks To Every American

The idea of sending checks to Americans isn't new: During the Great Recession, the federal government sent about every adult a $300 to $600 check. Economists concluded that it was one of the most effective measures deployed to blunt the impact. Meanwhile, Treasury Secretary Steve Mnuchin warns of a grim economic future, including a 20% jobless rate, if lawmakers don't act.

The Trump administration called on Tuesday for urgent action to speed $1 trillion into the economy, including sending $250 billion worth of checks to millions of Americans, as the government prepared its most powerful tools to fight the coronavirus pandemic and an almost certain recession. The Federal Reserve took the rare step of unleashing its emergency lending powers and President Trump called on Congress to quickly approve the sweeping economic stimulus package. Mr. Trump dispatched his Treasury secretary to Capitol Hill to begin hammering it out as large sections of the economy shut down and companies began laying off workers. (Rappeport, Cochrane and Fandos, 3/17)

President Donald Trump and Treasury Secretary Steven Mnuchin on Tuesday proposed mailing out checks of up to $1,000 to American adults to quickly pump hundreds of billions of dollars into the U.S. economy at a time when airlines are slashing flights and officials are shuttering restaurants, sports arenas and other public venues. Though details remained unclear, Washington could turn to the playbook it deployed in February 2008, when the Great Recession was just taking hold. The Economic Stimulus Act of 2008 provided payments averaging $600 per person, injecting more than $100 billion into the economy within a matter of months. (Sullivan, 3/17)

The idea took off Monday when Sen. Mitt Romney (R-Utah) called for every American adult to receive a $1,000 check 鈥渋mmediately鈥 to help tide people over until other government aid can arrive. By Tuesday, there was bipartisan support for the idea, including from President Trump. The White House even suggested the amount could be over $1,000, an acknowledgment of how big the economic crisis is becoming. (Long, 3/17)

Mnuchin indicated that the president鈥檚 preference for a payroll tax holiday 鈥 a six- to eight-month process 鈥 would take too long to put money into Americans鈥 pockets. 鈥淭he president has instructed me we have to do this now. So this is now,鈥 Mnuchin said. 鈥淭his is stuff that needs to be done now. The president has instructed me that this is no fault to American workers. For medical reasons, we are shutting down parts of this economy, and we are going to use all the tools we have.鈥 (McCaskill, 3/17)

"We have put a proposal on the table that would inject 1 trillion dollars into the economy," Treasury Secretary Steven Mnuchin said on Capitol Hill after meeting with Senate Republicans to discuss the White House's plan. "This is a combination of loans. This is a combination of direct checks to individuals. This is a combination of liquidity for small businesses," Mnuchin continued. (Egan, 3/17)

After a savage drop at the start of the week, the stock market rose as Trump and aides sketched out elements of the economic rescue package at a briefing. Economists doubted that would be enough to stop millions of jobs losses, even if in the short term. Bigger than the $700 billion 2008 bank bailout or the nearly $800 billion 2009 recovery act, the White House proposal aims to provide a massive tax cut for wage-earners, $50 billion for the airline industry and $250 billion for small businesses. Two people familiar with he package described it to The Associated Press on the condition of anonymity because they weren鈥檛 authorized to speak publicly. The amount that would be sent out in checks Americans is not yet disclosed. (Mascaro and Miller, 3/17)

The details of the administration鈥檚 $1 trillion proposal are still being finalized and the top-line figure could change, officials said. The administration anticipates spending as much as $500 billion on direct cash payments across two $250 billion tranches, the first of which officials hope to deliver quickly. The package also includes roughly $50 billion in assistance for the airline industry, which has been hit hard by the outbreak, and up to $500 billion to boost small businesses and for other needs. (Restuccia, Duehren and Wise, 3/17)

News of the stimulus planning sent the Dow Jones industrial average up more than 1,000 points Tuesday as it recovered some of its losses from Monday. However, reservations expressed by Democrats on Tuesday over various aspects of the package suggested that it could take some time to arrive at a bipartisan agreement that could pass both chambers of Congress. The scramble for a deal comes while the coronavirus pandemic has upended everyday life for many Americans. (Werner, Stein and DeBonis, 3/17)

Treasury Secretary Steven Mnuchin raised the possibility with Republican senators that U.S. unemployment could rise to 20% without government intervention because of the impact of the coronavirus, according to people familiar with the matter. (Wingrove, Mohsin and Jacobs, 3/18)

A Treasury Department official added that Mnuchin "used some mathematical examples to illustrate potential risk if there were no intervention, but because they are doing the right things and proposing additional action, that would not be the case." (Diamond, 3/17)

President Donald Trump said progress was being made against the fast-spreading pathogen and predicted the U.S. economy would 鈥渃ome roaring back鈥 when it slows. 鈥淚t鈥檚 going to pop,鈥 said Trump, who is seeking re-election on Nov. 3. The Republican president鈥檚 tone on the pandemic has changed sharply over the past few days. After initially playing down the threat and focusing on the stock market, his administration has begun pushing for urgent action to stem the disease鈥檚 economic and human toll. The White House on Tuesday urged Americans to avoid groups larger than 10. (Chiacu and Allen, 3/17)

The White House Office of Management and Budget submitted an emergency funding request to Congress late Tuesday for an additional $45.8 billion -- a sweeping request for new funds and statutory authority across the federal government to address the growing coronavirus pandemic. The request came on the same day the Trump administration presented a $1 trillion stimulus proposal on Capitol Hill. (Mattingly and LeBlanc, 3/18)

The Fed in the morning announced it would reopen the so-called Commercial Paper Funding Facility to underwrite the short-term loans that companies often use to pay for their operations, a key financial market backstop first set up 2007 to 2009. At day鈥檚 end it extended its reach as the economy鈥檚 lender of last resort to the two dozen Wall Street primary dealers who are critical to the functioning of bond and other financial markets. By letting those companies pledge municipal bonds, corporate debt and equity securities as collateral for 90-day Fed loans, the Fed aimed to keep credit flowing to parts the economy that may face an unfolding nationwide cash crunch. (Schenider and Dunsmuir, 3/17)

Suddenly, it seems like everyone wants Uncle Sam to send Americans checks. In just the last two days, the idea that the federal government should simply give people money to help them through the coronavirus pandemic has been endorsed throughout the political spectrum鈥攂y Democratic senators like Sherrod Brown and Michael Bennet, Republican senators like Mitt Romney and Tom Cotton, just about every economist who worked for President Barack Obama, and finally, this afternoon, by President Donald Trump. There鈥檚 a #ChecksChecksChecks hashtag on Twitter. The concept of Money For All has gone, well, viral, and legislation is surely coming soon. (Grunwald, 3/17)

Behind聽a聽flurry of activity in Washington Tuesday was an increasingly urgent problem for聽a nation grappling with the novel coronavirus pandemic: the growing risk that millions of businesses and households won鈥檛 be able to pay their everyday bills鈥攔ent, payroll, utilities鈥攁s business activity grinds to an unprecedented halt. The Federal Reserve聽launched a program聽to provide short-term loans to businesses in commercial paper markets, while White House officials and lawmakers scrambled for ideas to get funds into the private sector, and the Treasury postponed one of the biggest bills coming due for anyone:聽individual income taxes. (Hilsenrath and Timiraos, 3/17)

For Republicans, this time is different. Senior GOP lawmakers are moving quickly to inject as much as $1 trillion into the economy to save a slew of industries and millions of jobs from the devastation of the fast-spreading coronavirus. They鈥檙e even talking about handing out $1,000 checks to Americans 鈥 an idea first pushed by a Democratic presidential candidate. (Zanona and Levine, 3/18)

The Trump administration says individuals and businesses will be allowed to delay paying their 2019 tax bills for 90 days past the usual April 15 deadline. The extension announced Tuesday is an effort to inject up to $300 billion into the economy at a time when the coronavirus appears on the verge of causing a recession. (Crutsinger, 3/17)

The IRS, using authority under President Trump鈥檚 national-emergency declaration, will waive interest and penalties as well, Treasury Secretary Steven Mnuchin said at the White House on Tuesday. The delay is available to people who owe $1 million or less and corporations that owe $10 million or less, he said. (Rubin, Saunders and Restuccia, 3/17)

U.S. stock futures fell by the maximum allowed and international indexes tumbled, as the financial turmoil sparked by the novel coronavirus continued to roil markets. Shortly after European markets opened Wednesday, futures tied to the Dow Jones Industrial Average were down 3.9% and those tied to the S&P 500 were 3.7% lower. The Stoxx Europe 600 fell 3.3%, while the U.K.鈥檚 FTSE 100 slid 3.6% and Germany鈥檚 DAX index dropped 4.2%. (Yu and Isaac, 3/18)

Trump Now Mobilizing Federal Government To React To Crisis, But Key Agency Resources Are Still Untapped

Although the military and some other agencies are ramping up efforts to address the crisis, many government resources are awaiting orders. Hospital ships are at port; the VA, which is legally designated as the backup health care system in national emergencies, awaits requests for help; and HHS' system of of emergency doctors and nurses has yet to be deployed.

The mayor of Seattle wanted 鈥渕ass tents鈥 from the federal government to rapidly build shelters to house people in quarantine. The state of New York pleaded for help from the Army Corps of Engineers to quickly build hospitals. Oregon鈥檚 governor repeatedly pressed the Department of Health and Human Services for hundreds of thousands of respirators, gowns and gloves, face shields or goggles. After so many pleas, President Trump moved on Tuesday to begin enlisting much of his government in what the White House had called for weeks a 鈥渨hole of government鈥 approach to the rampaging coronavirus. (Lipton, Kanno-Youngs and Cooper, 3/17)

The Pentagon on Tuesday laid out how the U.S. military would support the medical response to the coronavirus, from using its stockpile of respirator masks to potentially building field hospitals and perhaps even deploying Navy hospital ships to reduce the stress on U.S. emergency rooms. The moves illustrate the massive government effort that will be required to deal with the fast-spreading pandemic, with the number of cases topping 5,800 in the United States and the death toll approaching 100. (Ali and Stewart, 3/17)

The Pentagon is already helping combat the coronavirus outbreak in the United States and is considering ways to do more. But the military faces limits. Its health care system is geared more toward handling combat casualties than infectious diseases. And there are logistical and legal concerns about expanding the military鈥檚 role in civilian affairs, such as tasking it with enforcing quarantines. Defense officials also want to be careful not to do anything to weaken its ability to defend the nation. (Burns and Baldor, 3/17)

The administration is considering mobilizing the National Guard and Reserve at the federal level to help combat the coronavirus, Defense Secretary Mark Esper announced Tuesday, while also preparing hospital ships to relieve stress on civilian facilities. Esper briefed Vice President Mike Pence and other members of the coronavirus task force on Monday on ways the Defense Department can help deal with the crisis, he told reporters. (Seligman, 3/17)

The U.S. Naval Ship Comfort and its sister ship, the USNS Mercy, are being prepared to be sent to potential hot spots in the U.S. if the number of coronavirus cases begins to overwhelm local hospitals, officials said. There hasn鈥檛 yet been a formal request for use of the ships, Mr. Esper said. The Pentagon is offering up the capabilities and equipment as federal, state and local officials have grown increasingly anxious about the nation鈥檚 capacity to deal with the growing number of coronavirus cases across the nation, particularly in New York and Washington state, both of which have high numbers of infections. The Health and Human Services department made the requests in recent days, Mr. Esper said. (Youssef and Lubold, 3/17)

A quartet of House lawmakers from New York is asking President Trump to deploy a Navy hospital ship to New York City to treat noncoronavirus patients as hospitals become slammed with patients suffering from the virus. 鈥淲e write to ask that you immediately ready the naval hospital ship USNS Comfort, currently being refitted in Norfolk, VA for deployment to New York City in support of our city鈥檚 fight against the novel coronavirus pandemic,鈥 the lawmakers wrote to Trump and Chief of Naval Operations Adm. Michael Gilday. (Kheel, 3/17)

As President Donald Trump imposes sweeping entry restrictions in a bid to stop the spread of the coronavirus 鈥 and considers still more 鈥 he's relying on an agency to help implement them that has been hollowed out at the top ranks in a revolving door of leadership, potentially hampering his administration's response to the crisis. It has been nearly a year since the Department of Homeland Security has had a Senate-confirmed leader. Acting Homeland Security Secretary Chad Wolf, the fourth person to lead the agency in three years, has been on the job less than six months. (Pettypiece, 3/18)

FDA Slashes Regulations For Tests In Desperate Effort To Meet Demand, But Admits There's A Trade-Off With Accuracy

Frustration has been growing over the country's inability to properly test Americans to get an accurate count on just how bad the outbreak is. Meanwhile, rumors that the U.S. turned down tests offered by WHO are false -- WHO does not sell tests to wealthy countries, which usually prefer to make their own.

The Trump administration is slashing regulations governing test development in a bid to ramp up screening for the coronavirus amid nationwide frustration with the slow pace of the effort. The unprecedented steps by the Food and Drug Administration could boost testing capacity at some U.S. labs, but also complicate efforts to assure the accuracy of tests and track who receives them.More than eight weeks after the first U.S. case of COVID-19 was detected, the U.S. still struggles to conduct mass screening and provide definitive figures on the number of people tested. (Perrone, 3/17)

A federal agency鈥檚 decision to allow lab companies to release coronavirus tests without prior government approval should help ease the shortage of test kits, but at the potential cost of compromised results, medical experts said Tuesday. 鈥淚t鈥檚 a pretty good idea to allow for companies to get tests out in a national emergency,鈥 said Paul Fey, research medical director at the University of Nebraska Medical Center. But he added that 鈥渢hese tests may not perform as well.鈥 (Burton and Terlep, 3/17)

In response to a dire shortage of tests for detecting the novel coronavirus, the FDA gave states new powers to authorize labs to develop their own diagnostics, and it also approved new tests that will be distributed by LabCorp (LH) and Hologic (HOLX), STAT says.聽The agency will allow states to take responsibility for tests developed and used by laboratories within their borders, a step that is similar to what the FDA last week granted to the New York State Department of Health. The labs will not have to pursue an emergency clearance that is normally required. (Silverman, 3/17)

A small commercial laboratory in Georgia has been selling do-it-yourself coronavirus testing kits, despite the fact that the Food and Drug Administration has not approved at-home testing for people worried they may have been infected in the global pandemic. A physician at the health clinic working with the Georgia lab said there is no time to waste on federal bureaucracy. 鈥淲e鈥檙e behind the eight ball. We need to start testing more people,鈥 said David Williams, the chief executive of Southside Medical Center in Atlanta. (Johnson, McGinley, Eilperin and Brown, 3/17)

At a time when the Trump administration is facing intense criticism for its failure to make coronavirus tests available to millions of nervous Americans, remarks by a federal health official on Tuesday appeared to suggest that the World Health Organization鈥檚 diagnostic tests were wildly inaccurate. In a somewhat rambling answer to a question related to W.H.O. tests, Dr. Deborah Birx, the White House coronavirus response coordinator, said: 鈥淚t doesn鈥檛 help to put out a test where 50 percent or 47 percent were false positives. Imagine what that would mean to the American people. Imagine what that would mean to tell someone they were positive when they weren鈥檛.鈥 (McNeil, 3/17)

No discussions occurred between WHO and the CDC about providing tests to the United States, WHO spokesperson Tarik Jasarevic told CNN on Tuesday, and WHO did not offer coronavirus tests to the CDC. The United States, Jasarevic confirmed, doesn't ordinarily rely on WHO for tests because the US typically has the capacity to manufacture its own diagnostics. (Azad, 3/18)

A major issue in the U.S. government鈥檚 response to the outbreak of a novel coronavirus has been the availability of tests for people who believe they may have covid-19. The administration has been under fire for its failure to quickly expand testing for coronavirus across the United States. A still-unspecified manufacturing problem caused the Centers for Disease Control and Prevention (CDC) to distribute flawed tests to state and local health departments. The lack of tests, compared with countries such as South Korea that have tested tens of thousands of people, has meant the spread of the virus in the United States may have been hidden in the early weeks of the outbreak. (Kessler, 3/18)

Any other place, any other time, the three white tents set against the Long Island Sound in the middle of a public park, with a line of vehicles waiting to get in, could have easily been the scene of a wedding or a garden party. But the appearance of the people underneath the tents 鈥 in silver hazmat suits, face shields and masks 鈥 told a different story. (Nir, 3/17)

Kaiser Health News: As Coronavirus Testing Gears Up, Specialized Swabs Running Out

The two top makers of the highly specialized swabs used to test patients for the novel coronavirus are straining to keep up with the demand, even as both the Italian and U.S. governments are working with them to increase production, including at a key manufacturing site in the midst of Italy鈥檚 outbreak. The nasopharyngeal swabs required for the coronavirus tests are quite different from your standard Q-tips 鈥 and the exploding need for them has created a bottleneck in the soaring demand for diagnoses. (Weber and Jewett, 3/17)

Kaiser Health News: Near Trump鈥檚 Florida Home, Drive-Thru COVID-19 Testing Gets Off To Rocky Start

A much-needed drive-thru coronavirus testing site opened here Monday, just a few miles from the Mar-a-Lago Club, home to the country鈥檚 most high-profile COVID-19 exposure. A week ago, President Donald Trump and a few top aides hosted a festive dinner with Brazilian officials, some later found to be ill with the novel coronavirus. Despite repeated assertions from White House officials that tests will soon be available to anyone who wants them, residents here found the reality much different. (Galewitz, 3/17)

After more than 30 years in advertising, Loretta and Roddy celebrated their retirement with a trip. They left their home in Orlando, Fla., for the Philippines on Feb. 4. At one point, they traveled to Thailand. They had layovers in Seoul on the way to the Philippines and the way back to the U.S. On March 8, they flew into Los Angeles International Airport. They planned to stay at Roddy鈥檚 sister鈥檚 house in Walnut for two nights and then fly back to Florida on March 10. (Wigglesworth, 3/17)

Almost a dozen calls with five health care providers over five hours. Two hours of hold music. Two hours in a hospital. Four days of anxiously checking an online portal for results. And lots of confusion. That鈥檚 the winding path through bureaucracy that took me from placing my first phone call last Wednesday to getting my positive coronavirus test results on Monday night. Five days in limbo. (Herrera, 3/18)

A Timeline Of Trump's Shifting Rhetoric: President's Claims That He Always Took Pandemic Seriously Proven False

When asked in January if he was worried about a pandemic, President Donald Trump said, 鈥淣o, not at all. We have it totally under control. It鈥檚 one person coming in from China, and we have it under control. It鈥檚 going to be just fine.鈥 This week he claimed he knew it was going to be a pandemic before it was called a pandemic. Meanwhile, a recent poll finds that many Americans don't trust his response to the crisis.

For weeks, President Trump has minimized the coronavirus, mocked concern about it and treated the risk from it cavalierly. On Tuesday he took to the White House podium and made a remarkable assertion: He knew it was a pandemic all along. 鈥淭his is a pandemic,鈥 Mr. Trump told reporters. 鈥淚 felt it was a pandemic long before it was called a pandemic.鈥 This is what Mr. Trump has actually said over the past two months: On Jan. 22, asked by a CNBC reporter whether there were 鈥渨orries about a pandemic,鈥 the president replied: 鈥淣o, not at all. We have it totally under control. It鈥檚 one person coming in from China, and we have it under control. It鈥檚 going to be just fine.鈥 (Rogers, 3/17)

As the virus continues to spread across the United States, the nation is reeling, with schools closed, sporting and cultural events shut down, and an economy in danger of lapsing into recession. An examination of how the Trump administration responded to the coronavirus outbreak that was first documented in December reveals a story of missed opportunities, mismanagement and a president who resisted the advice of experts urging a more aggressive response. (Dilanian, Martinez, Enright, McCausland and Muccari, 3/17)

Referring the virus as the "enemy" and the fight as a "war," Trump said, "One day we'll be standing up here and say, 'Well, we won.' And we're going to say that, as sure as you're sitting there, we're going to win. And I think we're going to win faster than people think, I hope," adding,"If we do this right, our country -- and the world, frankly -- but our country can be rolling again pretty quickly. Pretty quickly." (Cathey, 3/17)

Few Americans trust President Donald Trump when it comes to the coronavirus pandemic, according to a new survey, and fewer than half of respondents believe the federal government is taking sufficient steps to combat the public health crisis. (Forgey, 3/17)

Capitol Watch

McConnell Vows Senate Will Work At 'Warp Speed' And Won't Leave Washington Until Deal Is Passed

There's reportedly a high-level of interest among Republicans to support the administration's proposal to send checks to Americans to help stimulate the economy. The Senate will also take up, and expects to OK, a House-passed, $100 billion coronavirus stimulus bill referred to as "Phase 2." Senate GOP aides said the bill could be through the chamber as early as Wednesday. Meanwhile, as industries scramble to get emergency money, Democrats try to stave off Congress writing business blank checks.

Senate Majority Leader Mitch McConnell said the Senate will work at "warp speed" to craft a massive new stimulus package to help Americans deal with the economic fallout from the coronavirus crisis, vowing that senators "will not leave" Washington until it's done. And Senate Majority Whip John Thune (R-S.D.) said Tuesday there is a "high level of interest" among Republicans for a Trump administration proposal to send as many as two $1,000 checks directly to individual Americans to help respond to the economic slowdown, a move that could cost an estimated $500 billion, according to GOP sources. (Bresnahan, Levine, Caygle and Sherman, 3/17)

Senate Majority Leader Mitch McConnell (R-Ky.) said Republicans will work out a deal among themselves聽on a third聽coronavirus聽funding package before negotiating with Democrats.聽McConnell has established three working task forces with Senate Republicans to field ideas and work with the Treasury Department on the upcoming bill, which is expected to touch on workers, small businesses and industries affected by the pandemic. (Carney, 3/17)

Senate Majority Leader Mitch McConnell said the Senate would move at "warp speed" to pass coronavirus legislation Tuesday, but Sen. Rand Paul, his fellow Kentucky Republican, put a damper on those plans, two leadership sources told NBC News. Senators were heading toward a vote Tuesday on the package 鈥 which would include provisions for free coronavirus testing, secure paid emergency leave, enhance unemployment insurance, strengthen food security initiatives and increase federal Medicaid funding to states 鈥 but they had to slam on the brakes because of an amendment Paul proposed. (Tsirkin and Gregorian, 3/17)

Compromises in the legislation set to pass the Senate this week have ripped holes in that net, exposing millions of workers to financial risks that could push them to continue reporting to work 鈥 even on the front lines of the pandemic 鈥 and accelerate the infection rate nationwide. Democrats in Congress now say they will attempt to patch those holes by expanding a government-funded paid-leave benefit and making unemployment payments more generous for workers laid off as the economy rapidly shutters under government orders seeking to curb the virus. But that push will almost certainly have to wait for the next phase of the congressional response, an increasingly expensive fight that could meet resistance from business groups worried that the program could drive small companies out of existence by allowing critical workers to stay at home. (Tankersley and Cochrane, 3/17)

Last-minute negotiations between Democratic leaders and the White House have downsized the scope of a paid leave program for workers affected by the coronavirus outbreak, angering some Democrats who see it as a major concession to the White House. The House on Monday night approved a slate of last-minute 鈥渢echnical鈥 corrections to a sweeping aid package, paving the way for swift adoption by the Senate. But several Democrats and progressive advocates say changes pushed by the White House are actually significant revisions to the bill鈥檚 paid leave program, undermining one of their top priorities in the package. (Ferris, Cancryn and Caygle, 3/17)

Amid public pressure from New York's governor, Senate Minority Leader Chuck Schumer is positioning himself as a legislative champion for New York providers in the COVID-19 crisis. But he may be overstating his involvement, sources say. New York has the highest number of confirmed cases of COVID-19 in the country. The state's Democratic Gov. Andrew Cuomo is pressuring the New York congressional delegation, including Schumer (D), to deliver resources back home. The first two aid packages Congress is considering have included little direct support to providers, and Cuomo said that funding will not meet the needs of his state's providers. (Cohrs, 3/17)

When Treasury Secretary Steven Mnuchin rushed to the Capitol on Tuesday to pitch Senate Republicans on a $1 trillion coronavirus relief package, the chamber had already moved into crisis mode as lawmakers confronted a growing sense of urgency to act before much of the nation shuts down. Senate Democrats abandoned their weekly policy luncheon for a teleconference, while about four dozen Republicans, joined by Mr. Mnuchin, practiced social distancing by moving their lunch from their usual room in the Capitol that seats 80 to one across the street that seats 200. Instead of 10 senators at each table, there were five. The buffet line was dispensed with; gloved servers dished out tuna, egg salad and chicken. (Edmondson and Stolberg, 3/18)

Congressional leaders are resisting calls to let lawmakers vote remotely, a dispute pitting the scourge of the coronavirus against two centuries of tradition that underscores Washington鈥檚 struggle to adapt to recommendations that evolve daily about how to handle the pandemic. Advocates of the voting change cite the health perils of air travel at a time when health experts want people to avoid crowds. They argue that as infections spread, it may become all but impossible for many lawmakers to journey to the Capitol because of the growing risk of getting the virus. (Fram and Daly, 3/18)

Democrats are pushing to place conditions on a $50 billion airline bailout the White House presented to Congress Tuesday, hoping to leverage protections for frontline employees such as flight attendants, gate agents and more 鈥 not just CEOs. The Trump administration is planning to move forward with an airline bailout as part of a massive economic stimulus package that Congress will start weighing this week. Treasury Secretary Steven Mnuchin was on Capitol Hill Tuesday at Senate Republicans鈥 weekly lunch to discuss specifics. (Mintz, 3/17)

As Washington rushes to aid airlines and other sectors crushed by the pandemic crisis, politicians face the challenge of saving the economy without unleashing the backlash that accompanied the last such rescue operation in 2008. Economists and policy makers say the massive bank and auto bailouts of that time were vital in preventing the Great Financial Crisis from turning into a 21st century Great Depression. (Schlesinger and Hilsenrath, 3/17)

New York City鈥檚 public transportation system, the largest in North America, is seeking a $4 billion federal bailout as the coronavirus pandemic has triggered an extraordinary free fall in ridership and left transit officials facing what is likely to be the worst economic crisis in decades. In a letter on Tuesday to New York鈥檚 Congressional delegation, the Metropolitan Transportation Authority 鈥 which runs the subway, buses and two commuter rails 鈥 said ridership had plunged 60 percent on the subway and 49 percent on buses on Monday compared with the same day last year. (Goldbaum, 3/17)

The U.S. hotel industry asked the Trump administration for a $150 billion bailout Tuesday, joining the growing ranks of businesses appealing to the federal government to stave off insolvency after getting hammered by the fallout of the coronavirus. In a White House meeting with Mr. Trump and Vice President Mike Pence, hotel industry groups requested a massive cash infusion鈥$100 billion to retain workers and $50 billion to service debt鈥攁s they warned that half the hotels in the country could close this year. (Mann and Sider, 3/17)

U.S. hotel companies are seeking $150 billion in direct aid for their workers for what they say is an unprecedented fall-off in demand because of the new coronavirus. CEOs of Marriott, Hilton, Hyatt and other chains met Tuesday with President Donald Trump to describe the impact and seek help. (Durbin, 3/17)

Some Democratic state lawmakers, like their congressional counterparts, are redoubling their efforts to pass paid leave legislation, arguing that the spread of the novel coronavirus proves that workers must be able to stay home without losing pay when they鈥檙e sick, quarantined or caring for a family member. (Quinton, 3/18)

Preparedness

The Daunting Math When It Comes To Ventilators And ICU Beds: A Look At What Places Are Strained Most For Resources

It's difficult to determine the exact numbers for how much the health system will be taxed, especially now that states are taking measures to slow the spread. But one resounding message is that many hospitals are braced to be overwhelmed. The New York Times offers a look at what areas in the country are the most vulnerable.

A new Harvard analysis shows that many parts of the United States will have far too few hospital beds if the new coronavirus continues to spread widely and if nothing is done to expand capacity. In 40 percent of markets around the country, hospitals would not be able to make enough room for all the patients who became ill with Covid-19, even if they could empty their beds of other patients. That statistic assumes that 40 percent of adults become infected with the virus over 12 months, a scenario described as 鈥渕oderate鈥 by the team behind the calculations. (Sanger-Katz, Kliff and Parlapiano, 3/17)

The largest national hospital organization is pleading with Americans to abide by precautions to prevent the spread of the coronavirus, warning it's the only way to avoid running out of ventilators or otherwise overwhelming the health care system. "There are limited supplies of ventilators and hospital beds, which is why hospitals and public health officials all across the country are urging the public to follow the guidance of the CDC and other public health leaders on social distancing and other actions," Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association, which represents nearly 5,000 hospitals and other health care organizations, said in a statement to NBC News. (Chuck, 3/17)

Hospitals are rushing to rent more ventilators from medical-equipment suppliers. And manufacturers are ramping up production. But whether they can turn out enough of the machines at a time when countries around the world are clamoring for them, too, is unclear. 鈥淭he real issue is how to rapidly increase ventilator production when your need exceeds the supply,鈥 Dr. Lewis Kaplan, president of the critical care society, said Tuesday. 鈥淔or that I don鈥檛 have a very good answer.鈥 (Tanner and Johnson, 3/17)

Medstar Washington Hospital Center in Washington D.C. is in full-on preparation mode. On a recent visit the staff had already marked out the parking lot 鈥 painting green rectangles to mark the places where tents are starting to be set up to screen arriving patients for COVID-19. In a medical building on the hospital grounds, the director for emergency management, Craig DeAtley, opens the door to a room crammed with supplies. (Simmons-Duffin and Aizenman, 3/17)

Providers have compiled a laundry list of requests for lawmakers to help hospitals and healthcare workers prepare for a surge in COVID-19 patients .Congress is beginning negotiations on its third major legislative package to respond to the COVID-19 pandemic. It appears the bill will originate in the Senate, where leaders on both sides have said they want to provide support to frontline healthcare workers. (Cohrs, 3/17)

Beginning Tuesday, staff at Indiana University Health Physicians are calling patients with scheduled appointments for routine care to come in at a later date, many being scheduled six weeks out. The decision is one of many IU Health Physicians has made over the last 10 days to mitigate the spread of the novel coronavirus and protect its workforce, which consists of 200 primary-care and 1,700 specialty physicians spread across over 150 ambulatory locations in Indiana. (Castellucci and Meyer, 3/17)

The Greater New York Hospital Association is asking New York City鈥檚 large companies and financial institutions to share their stockpiles of face masks as local hospitals grapple with dwindling supplies. New York City had reported 814 confirmed cases of novel coronavirus as of Tuesday afternoon, and state and federal authorities have already begun dipping into government stockpiles to distribute masks and other medical equipment. (King, 3/17)

As the number of Washington-area residents testing positive for the novel coronavirus climbs, hospitals are racing to enact a two-pronged strategy 鈥 expand testing capability and free up beds 鈥 in preparation for what could be a months-long response to the global pandemic. Montgomery County hospitals are installing treatment and triage tents. Kaiser Permanente set up five drive-through testing sites in Maryland and Virginia for patients who have a prescription, and Virginia Hospital Center in Arlington and a health-care system in Hampton Roads, Va., are testing people via drive-through if they meet certain criteria. (Portnoy, Chason and Swenson, 3/17)

One doctor described the machines as being like "gold." Ventilators have quickly become the most sought-after medical device in the world because of their ability to help save the lives of some of the sickest coronavirus patients. What worries experts is that it's increasingly clear many countries 鈥 including the United States and much of Europe 鈥 have nowhere near enough of them to keep pace with a pandemic killing exponentially more people every day. (Smith, 3/17)

The American Red Cross said they're now facing a "severe blood shortage," as blood drives across the country continue to be cancelled as concerns over the novel coronavirus pandemic grow. "Right now, the Red Cross is distributing blood donations faster than they are coming in," Paul Sullivan, senior vice president of the American Red Cross, told ABC News. (Schnell, 3//17)

Protective Gear Shortages Endanger Health Workers On Front Lines: 'Guard Your Mask With Your Life, Because It Is Your Life'

Health providers are among the most vulnerable workers to contract the coronavirus. But even as hospitals try to take measures to protect their staff during the crisis, shortages of masks and other protective gear threaten those efforts.

As the U.S. combats the spread of the novel coronavirus, health care experts continue to debate how to best protect America鈥檚 protectors during a time when they are needed most. With masks and other supplies dwindling, public health experts are now balancing the need to keep healthcare workers on the front lines against the need to protect medical staff from becoming patients themselves. (David, 3/18)

Two doctors in Washington state, which leads the U.S. in coronavirus deaths, have tested positive for the disease as hospitals scramble to make due with a shortage of masks and other equipment needed to keep them from getting sick. In the area of Seattle that's been hardest-hit, some nurses in emergency departments are washing and reusing surgical masks, gloves and gowns. They may work on a patient for hours or more before learning they tested positive for COVID-19. (3/17)

Dozens of health-care workers have fallen ill with covid-19, and more are quarantined after exposure to the virus, an expected but worrisome development as the U.S. health system girds for an anticipated surge in infections. From hotspots such as the Kirkland, Wash., nursing home where nearly four dozen staffers tested positive for the coronavirus, to outbreaks in Massachusetts, Pennsylvania, California and elsewhere, the virus is picking off doctors, nurses and others needed in the rapidly expanding crisis. (Bernstein, Boburg, Sacchetti and Brown, 3/17)

Administrators at the Renton, Wash., headquarters of the Providence health system are in conference rooms assembling makeshift face shields from vinyl, elastic and two-sided tape because supplies are drying up. Nurses from Brigham and Women鈥檚 Hospital in Boston, preparing for a potential shortage, have pleaded with friends on Facebook for any goggles and other gear they might have lying around. Providence plans next to make its own masks, with possible help from a uniform manufacturer. 鈥淚鈥檓 reusing my mask from yesterday,鈥 said Calvin Sun, an emergency-room doctor in New York City. 鈥淲e really have no choice.鈥 (Evans and Safdar, 3/18)

The Cambridge Health Alliance is accepting mask donations from the public at its Greater Boston hospitals amid the coronavirus pandemic, as frontline health providers nationwide struggle with a shortage of protective gear. (Andersen, 3/17)

Meanwhile, it's not just health workers who are exposed 鈥

As the aviation industry struggles to offset the economic impact of the novel coronavirus, those representing employees on the frontline believe not enough is being done to protect their health. The Transportation Security Administration (TSA) has confirmed that eight of their officers have tested positive for COVID-19. This number has doubled within the last four days as the virus continues to spread in the U.S. and more testing becomes available. (Kaji, Maile and Benitez, 3/17)

From The States

Governors Become Generals Of Coronavirus Crisis As Federal Government Dawdled

While President Donald Trump downplayed the seriousness of the outbreak, governors were thrust into the spotlight as they tried to manage the crisis in their states. 鈥淥ur leaders in the federal government at every level ought to be thinking of this moment as December 8, 1941,鈥 said Washington Gov. Jay Inslee, whose state was one of the first hit by the pandemic. He said states should be calling for 鈥渢he same federal response we had the morning after Pearl Harbor.鈥 Meanwhile, about half of Americans support stringent measures to curb the outbreak, and New York City leaders warn that a "shelter in place" order may be coming eventually. Media outlets look at how other states are dealing with the crisis, as well.

One day after President Trump told the nation鈥檚 governors on a conference call that he had been 鈥渨atching a lot of you on television鈥 dealing with the coronavirus, he proved it Tuesday morning by angrily tweeting at Michigan鈥檚 governor for saying on MSNBC that 鈥渢he federal government did not take this seriously early enough.鈥 But Mr. Trump鈥檚 name-calling 鈥 he referred to Gretchen Whitmer only as 鈥淔ailing Michigan Governor,鈥 and said she needed to 鈥渨ork harder鈥 鈥 soon backfired. (Martin and Burns, 3/17)

As the nation struggles to reconcile itself to a new and spreading peril, it also struggles with a patchwork of rules that vary dizzyingly from place to place: For now, your life and lockdown in the shadow of COVID-19 depends on where you live. In some places, many ordinary Americans are making public health choices, searching their own conscience and deciding for themselves what risk they鈥檙e willing to endure. In others, government has made at least some of those decisions. (Galofaro, 3/17)

Mark Estee spent his Tuesday laying off 100 cooks, waiters and dishwashers, having been forced by city decree in Reno, Nev., to close two restaurants that had been thriving just days ago. Less than an hour down the road, in Nevada鈥檚 Carson Valley, the threat of coronavirus had inspired no such restrictions. Estee鈥檚 three other restaurants were preparing to serve dinner, a hearty mix of pasta, burgers and beer. (Witte, Zezima, Cha and Craig, 3/17)

Roughly half of all Americans want the U.S. government to act more aggressively to slow the spread of the coronavirus, such as banning large public gatherings and shutting down all overseas flights, according to a Reuters/Ipsos poll released on Tuesday. (Kahn, 3/17)

New York Gov. Andrew Cuomo and New York City鈥檚 mayor delivered conflicting messages Tuesday on whether city residents could be forced to shelter in place because of the rapid spread of the new coronavirus. Mayor Bill de Blasio said at an afternoon news conference that New York City residents should be prepared for such a possibility and that a decision could be made in conjunction with the state in the following 48 hours. (Berger, 3/17)

New York City, a colossus of 8.6 million people and an economic engine for the country, ground to a shocking halt on Tuesday because of the coronavirus outbreak and the restrictions on public life put in place to stem its spread. The city鈥檚 mayor signaled that the shutdown could go even further with the possibility of an order to 鈥渟helter in place鈥 鈥 a decision he said 鈥渟hould be made in the next 48 hours.鈥 (Newman, 3/17)

New York Attorney General Letitia James has temporarily suspended medical and student debt referred to her office amid the coronavirus crisis. The collection of medical and student debt referred to the attorney general's office will be halted for at least a 30-day period, through April 15, according to a statement released by New York Gov. Andrew Cuomo and James on Tuesday. Not all student debt will be halted, just that which has been referred to the AG office for delinquency from state institutions. (Jacobo, 3/17)

New York鈥檚 total number of coronavirus cases is up to 923 with 10 deaths as of Tuesday, Mayor Bill de Blasio (D) said. 鈥淭he number鈥檚 gone up literally over a hundred cases in the course of the day. We鈥檙e at 923 cases at this hour tonight, 10 people who have passed away,鈥 de Blasio said on MSNBC Tuesday evening. It鈥檚 unbelievable how rapidly this crisis is growing right now.鈥 (Budryk, 3/17)

An employee at Sing Sing Correctional Facility in Ossining, New York, has tested positive for the coronavirus, NBC News has confirmed. Two other people, neither outwardly showing symptoms, have been tested, and those results are pending, according to the state Corrections Department. (Liautaud, 3/17)

Gambling will grind to a halt by Wednesday in casino-mecca Las Vegas, a city known for glitzy and sometimes reckless fun, as the governor of Nevada issued a sweeping statewide order aimed to stop the spread of the new coronavirus. Democrat Steve Sisolak ordered a monthlong freeze on gambling, shutting down everything from the famous casino resorts to slot machines found in convenience stores, cutting off an industry that fuels the state鈥檚 tourism and hospitality-powered economy. (Price and Sonner, 3/18)

First the schools closed, then the babysitter canceled. Jaime Fitch, 40, a manager at the University of Washington School of Medicine, woke up on Monday to learn that her children鈥檚 caretaker 鈥 and her family鈥檚 best source of backup child care 鈥 had some symptoms of Covid-19, but not enough to get tested. Her mother-in-law, who has babysat in the past, was recently in a car accident and had a broken sternum. And Fitch鈥檚 husband, who is the director of marketing and operations at a start-up, needed to work, too. (Caron, 3/17)

The buses on Melissa Paulen鈥檚 commute to work at the University of Washington Medical Center have been nearly empty for almost a week. The halls of the hospital are almost empty as well, as visitors have been tightly restricted, and nonessential staff are working from home. 鈥淚t鈥檚 a ghost town,鈥 Ms. Paulen, a 37-year-old gynecologist, said of the city. 鈥淚t feels kind of eerie.鈥 (Lovett, 3/18)

By last Wednesday, the tickle in Alison McGrath Howard鈥檚 throat had turned into chills, though not severe enough to keep her from seeing six patients who came to her Northwest Washington office for psychotherapy. Twenty-four hours later, while walking her dog, Howard felt dizzy and fatigued. She anxiously catalogued her recent activities: grocery shopping, hanging with her two teenagers, going to her book club and attending a conference in Manhattan with 1,100 therapists from around the world. (Schwartzman, 3/17)

Maryland and Virginia reported dramatic spikes in their cases of the novel coronavirus Tuesday, as Virginia Gov. Ralph Northam banned gatherings of 10 or more people in restaurants, gyms and theaters, and Gov. Larry Hogan postponed Maryland鈥檚 April 28 primary election. With nearly every local county and jurisdiction now affected by the coronavirus, the region鈥檚 total had climbed to 162 by Tuesday evening. (Olivo, Chason and Schneider, 3/17)

Thelma Sanderlin, 88, has become accustomed to visitors. She has no husband or children, and no living siblings, but at least twice a month, a volunteer arrives at her apartment in the District to give her a break from the isolation that can jeopardize the health of older adults. 鈥淚 just like to have company sometimes,鈥 Sanderlin said. 鈥淭hey鈥檙e young people, you see. They listen to my aches and pains.鈥 (Contrera and Shapira, 3/17)

As states confirm more cases of the new coronavirus disease, local health officials are requesting that people who have tested positive and those who've come in close contact with them isolate themselves at home for 14 days. Many states have laws that give health department directors the authority to enforce a quarantine on individuals who pose a threat to public health. And if people defy a court-ordered quarantine, they could face fines and criminal charges. (Chen, 3/18)

When local health officers issued simultaneous orders on March 16 for all residents of seven counties in the San Francisco Bay area to "shelter at their place of residence," Arnab Mukherjea thought it was "a bit draconian" for him as well as his wife and two young children. "Let's be honest, this is pain, but a little bit of pain right now may be worth it," said the California State University, East Bay professor of health sciences and resident of Contra Costa county, one of the jurisdictions affected by the stay-at-home edicts. (Welna, 3/17)

Two scientists studying the spread of the coronavirus say the number of infected residents in Massachusetts could be at least five times the number the state is reporting and possibly much higher, with one estimate ranging up to 6,500. The official tally reported by the state rose to 218 on Tuesday, but that number does not account for large numbers of infected people who have not been tested, particularly those who are not yet symptomatic or have only mild symptoms. (Martin, 3/17)

City officials have established a temporary medical clinic outside a South End homeless shelter and said they鈥檙e prepared to create other pop-up, makeshift clinics across the city to quarantine homeless people showing signs of COVID-19 infection. Two tents built in recent days at the Southampton Street Shelter will be used to isolate homeless residents who show symptoms or have been exposed to the virus, city officials told The Boston Globe late Tuesday afternoon. Each tent can accommodate around 20 people. (Coleman, 3/17)

The group that delivers Meals on Wheels in Boston is stepping up to meet increased demand from homebound seniors, even as it scrambles to set up 鈥済rab-and-go鈥 sites across the city for older residents who formerly gathered for free lunches at churches, senior centers, and other sites that have closed. Meals on Wheels is seeing an uptick in requests for home-delivered meals as seniors try to comply with social-distancing guidelines during the coronavirus crisis, said Valerie Frias, chief executive of Ethos, a Jamaica Plain nonprofit that runs the state鈥檚 largest Meals on Wheels program. (Weisman, 3/17)

Just as students and parents are adjusting to being out of school for the next few weeks, people with disabilities around Massachusetts are coming to terms with the cancellation of day programs, community activities and new precautions at group homes. (Young, 3/17)

Gov. Greg Abbott on Tuesday announced he activated the state's National Guard to help with the state's response to coronavirus but said deployment is not yet necessary. This means members, with the exception of first responders and health professionals, are now being called to active duty, but they have not yet been given an assignment. Texas joins more than 20 other states in making the move, including California, Florida and Arizona, according to the National Governors Association. (Goldenstein, 3/17)

The governor of Washington signed legislation on Tuesday approving $200 million in emergency funds intended to slow the spread of the coronavirus in one of the hardest-hit U.S. states. (Whitcomb, 3/17)

All 50 States Have Confirmed Cases; U.S. Death Toll Surpasses 100

West Virginia was the last state to announce a confirmed case. According to the Johns Hopkins database, there are now 5,894 confirmed cases of coronavirus in the country, although many experts expect the actual number is far larger due to under-testing. The majority of people who have died were in their 60s, 70s, 80s and 90s. The youngest were in their early or mid-50s. Meanwhile, researchers scramble to model an accurate prediction for the worst-case scenarios.

All 50 U.S. states now have confirmed cases of the new coronavirus as West Virginia鈥檚 governor announced the first positive test in his state on Tuesday evening. Gov. Jim Justice said the person with the virus is in the state鈥檚 Eastern Panhandle, a region close to Washington, D.C., though he didn鈥檛 disclose the county where it was reported.Justice used a televised address to announce new restrictions, ordering bars, restaurants and casinos to close with the except of carry-out food services. He did not address delivery services. (Raby, 3/17)

Those known deaths, all from the past three weeks, come as the number of diagnoses has surged into the thousands as the virus has spread and as testing has expanded significantly. On Tuesday evening, West Virginia became the 50th state to report its first case. (Yourish, Harmon, Collins, McCann and Wu, 3/18)

Coronavirus has killed from coast to coast. It devastated a nursing home in Washington state and crept into the heartland. Across the United States, more than 100 people infected with the highly contagious new virus have now died 鈥 a toll that experts expect to rise quickly. This country鈥檚 first fatal cases offer a preview of the challenges ahead, as Americans battle a disease that has killed thousands of people worldwide. The Washington Post has tracked every known U.S. death and has analyzed data provided by state and local health officials, families of the victims, and the Centers for Disease Control and Prevention. (Thebault, Hauslohner and Dupree, 3/17)

Public health experts believe the initial and ongoing testing problems mean that unknown numbers of cases have gone undetected, and they say the death toll will only continue to rise. The virus has only tightened its grip on the country and its economy since it first arrived on America鈥檚 shores 鈥 with local officials closing schools, bars and restaurants, postponing elections and in extreme cases ordering citywide lockdowns in an effort to prevent transmission despite warnings from public health experts that social distancing measures alone are not enough to slow the rate of infection. (Oprysko, 3/17)

Dozens of people from their 50s to their 90s have died in the United States after contracting the novel coronavirus and the death toll continues rising. At least 112 people have died since the first US case of the coronavirus was reported in January and the virus has spread to all states, the District of Columbia and some territories. While the majority were treated at hospitals, a woman in Washington died at home. (Chavez, Watts and Mack, 3/18)

Epidemiologists are teaming up with data scientists to stem the spread of the novel coronavirus by tapping big data, machine learning and other digital tools. The goal is to get real-time forecasts and other critical information to front-line health-care workers and public policy makers as the outbreak unfolds. Known as outbreak analytics, the approach attempts to go beyond confirmed cases and fatalities to gauge the total number of people who are likely to be infected by a virus鈥攚hether or not they show any symptoms. (Loten, 3/17)

Immediately after Boris Johnson completed his Monday evening news conference, which saw a somber prime minister encourage his fellow citizens to avoid "all nonessential contact with others," his aides hustled reporters into a second, off-camera briefing. That session presented jaw-dropping numbers from some of Britain鈥檚 top modelers of infectious disease, who predicted the deadly course of the coronavirus could quickly kill hundreds of thousands in both the United Kingdom and the United States, as surges of sick and dying patients overwhelmed hospitals and critical care units. (Booth, 3/17)

The number of confirmed coronavirus infections shot toward 200,000, more than doubling in a span of two weeks, despite an escalation in global travel restrictions and the imposition of home quarantines in many parts of the world. There were 198,152 confirmed cases of the disease known as Covid-19 early on Wednesday, with infections outside of mainland China鈥攚here the epidemic began鈥攏ow above 117,000, according to data compiled by Johns Hopkins University. Deaths globally also more than doubled over the past two weeks to 7,954. (Craymer, 3/18)

'This Is Really About Saving Lives': California's Stringent Measures To Protect State Might Set Example For Other States

While the line is blurred between what's essential and non-essential, many people are trying to follow guidelines to shelter-in-place in the first state issuing such drastic orders.

The double-length buses that snake through downtown San Francisco past the offices of Google and Facebook were empty. The teller at a Citibank in the city had seen three customers all morning, and the manager of a deserted sandwich shop a few blocks away decided to shut down for the rest of the week after selling only a handful of bagels. The most ambitious experiment in America to stop the spread of the coronavirus 鈥 shelter-in-place orders for almost every resident 鈥 was underway for seven million people living around the San Francisco Bay on Tuesday. (Fuller, Nicas and Conger, 3/17)

More than 8 million Californians are living under shelter-in-place orders 鈥 the nation鈥檚 most stringent public health measures yet 鈥 as state and local governments rush to address the coronavirus pandemic. At least 10 counties in the Bay Area and Central California and the city of Palm Springs have directed all residents to stay at home as much as possible, with Sonoma, San Benito and Monterey counties deciding Tuesday to join the order implemented a day earlier by San Francisco, Santa Clara, San Mateo, Alameda, Contra Costa, Marin and Santa Cruz counties. In Ventura County, health officials Tuesday announced a shelter-in-place order that applied only to older residents. (Shalby, Lin, Vives, Blume and Cosgrove, 3/17)

The Los Angeles City Council voted Tuesday to temporarily stop enforcing a law requiring tents to come down during daytime hours, saying the change is needed to limit the spread of the novel coronavirus. Councilmen Mike Bonin, Marqueece Harris-Dawson and Gil Cedillo said the city must 鈥渦rgently reevaluate鈥 its policies for dealing with homeless encampments, given the virus threat. (Zahniiser, Reyes and Smith, 3/17)

Hair stylists canceled clients. Gardeners and construction crews showed up to work. A dog grooming business deemed itself essential and kept its door open. Some liquor stores closed. Others didn鈥檛. All the time, cases of the coronavirus kept creeping upward. During the first day of a 鈥渟helter-in-place鈥 order in seven Bay Area counties Tuesday, compliance was generally strong but uneven in places, with some businesses uncertain whether they required to close. (Rust, Dolan and Lin, 3/17)

On any given weekday, as clocks approach lunch hour, the streets of San Francisco's Nob Hill neighborhood are bustling with pedestrians strutting to the clanging bells of iconic cable cars packed with wide-eyed tourists. But as Ree Ree Li, 25, peeked out her apartment window on Tuesday, she described a desolate scene punctuated by eerie silence. (Hutchinson, 3/17)

California schools will likely be closed for the remainder of the school year amid the coronavirus pandemic, Gov. Gavin Newsom (D) said Tuesday. 鈥淚 don鈥檛 want to mislead you,鈥 Newsom told a group of parents and educators in a press conference Tuesday afternoon. Schools responsible for about 85 percent of California students have shuttered in response to the pandemic, according to聽the Los Angeles Times. (Budryk, 3/17)

As students across the country adjust to learning outside of their classrooms, some states are preparing for the disruption to last the rest of the school year as the coronavirus outbreak continues. Florida has canceled all tests for the year, Kansas has decided to keep schools closed, Arizona plans to announce the suspension of makeup days and California said parents should be prepared for their state to be next. (Holcombe, 3/18)

In San Francisco, where a legally mandated lockdown went into effect Tuesday, police patrols were light. But citizens mostly appeared to be complying with the edict, which says residents may only venture outside for groceries or medical appointments. Walks and other exercise are also allowed, but not in groups. (Calfas, Carlton and Schechner, 3/17)

Kaiser Health News: Is The Bay Area鈥檚 鈥楿nprecedented鈥 Lockdown The First Of Many?

Life came to a grinding halt for millions of San Francisco Bay Area residents as the most stringent isolation orders in the country took effect Tuesday. To stem the spread of the new coronavirus, roughly 7 million people in seven counties were instructed to 鈥渟helter in place鈥 and were prohibited from leaving their homes except for 鈥渆ssential鈥 activities such as purchasing food, medicine and other necessities. Most businesses closed, with the exception of grocery stores, pharmacies, restaurants (for takeout and delivery only), hospitals, gas stations, banks and a handful of others. (Gold and Bluth, 3/17)

Economic Toll

There Is No Good Choice For Leaders When Potential To Save Lives Comes With Devastating Side-Effect Of Wrecked Economy

The U.S. and governments around the world are taking extreme measures to stop the spread of the virus. But as a result the economy is tanking. 鈥淓verything else will come back,鈥 President Donald Trump said. 鈥淟ives won鈥檛 come back.鈥 But the economic health of a country is deeply tied to the physical health of its people, and the long-term stress could play out for years in the future. Meanwhile, media outlets take a look at some of the industries that have been hard-hit, including hotels, restaurants, gig jobs and small businesses.

No one knows how long it will last or how much it will hurt. But the U.S. economy is either sliding into a recession for the first time since 2009 or is already in one 鈥 a sudden victim of the coronavirus outbreak. The vast changes deemed necessary to defeat the virus 鈥 people and companies no longer engaging with each other 鈥 are bringing everyday business to a halt and likely delivering a death blow to the longest economic expansion on record. (Wiseman, 3/18)

The coronavirus pandemic has confronted governments around the globe with the ultimate bad choice: Wreck your economy or lose millions of lives. While some initially hesitated, leaders and legislators in the United States and worldwide increasingly have decided they have to accept the severe economic pain. 鈥淓verything else will come back,鈥 President Trump said Tuesday even as the economic downturn and global turmoil deepened. 鈥淟ives won鈥檛 come back.鈥 (Lauter, 3/18)

Employers are slashing jobs at a furious pace across the nation due to mass shutdowns over the coronavirus, slamming state unemployment offices with a crush of filers facing sudden crises. Long before official government data is expected to reveal the depths of the economic shock inflicted by the coronavirus, reports from state officials and businesses around the country indicate the gathering of a massive wave of unemployment on a scale unseen since the Great Recession. (Rainey, 3/17)

However events unfold, one thing is becoming clear: As the effects of the coronavirus pandemic hit the job market, the damage looks likely to be much deeper and longer lasting than seemed possible even a week ago. Marriott International, the hotel operator, said Tuesday that it would begin furloughing tens of thousands of employees worldwide. Restaurants, coffee shops, gyms and other small businesses have begun laying off workers outright. On Monday, a flood of inquiries from newly jobless New Yorkers crashed the website for the state鈥檚 unemployment insurance system. (Casselman, Maheshwari and Yaffe-Bellany, 3/17)

Luis Rivera and his family have run their neighborhood rotisserie chicken joint in downtown New York City for nearly five decades, staying open through everything from 9/11 to Superstorm Sandy, but he said he's never seen anything like the coronavirus pandemic. Rivera is among a handful of small business owners -- many of whom already operate on razor-thin margins -- who say they are entering times of unprecedented uncertainty. Despite pledges from the government and private sector, many say they still don't know how they will possibly pull through. (Thorbecke, 3/18)

It was just after 11 a.m. last Wednesday when Jaime Maldonado, 51, pulled his rented Nissan into a parking lot outside San Francisco International Airport. He figured he had a long wait ahead of him 鈥 about two hours 鈥 before Lyft would ping him to pick up a passenger. Occasionally, jets roared overhead 鈥 but not many, which meant not enough passengers for Mr. Maldonado, who said that before the coronavirus outbreak, he spent just 20 to 40 minutes waiting outside the airport before getting a customer. (Conger, Satariano and Isaac, 3/18)

The coronavirus pandemic is devastating global travel, causing business to evaporate and forcing companies to slash payroll in what鈥檚 shaping up to be the biggest test the modern travel industry has ever faced. Longer term, the crisis could permanently reshape attitudes toward travel, fundamentally changing the landscape for hotels, airlines and cruise companies, and the millions of smaller businesses that make up the industry. (Karmin, Sayre and Paris, 3/17)

Marriott International Inc., MAR -12.94% the world鈥檚 largest hotel company with nearly 1.4 million rooms world-wide, said it is starting to furlough what it expects will be tens of thousands of employees as it ramps up hotel closings across the globe. The company began shutting down some of its managed properties last week, a Marriott spokeswoman said. (Karmin, 3/17)

The United Auto Workers and Detroit car companies reached agreements on coronavirus-mitigation efforts that for now will avoid a two-week shutdown of U.S. factories. The UAW had been pressing General Motors Co., Ford Motor Co. and Fiat Chrysler Automobiles NV to idle their plants to protect workers from the virus. The union said late Tuesday that company executives had agreed to partial shutdowns of plants to allow for cleaning between shifts and longer periods for shift changeovers, along with other measures to minimize worker contact. (Colias and Foldy, 3/17)

Most white-collar auto industry employees by Fiat Chrysler, Ford and General Motors are working from home this week, but Detroit鈥檚 Big 3 have formed a task force with the United Auto Workers Union to see if there鈥檚 a way also to protect hourly workers from the coronavirus without shutting down their U.S. parts and assembly lines. With schools closed, major sports leagues suspending their seasons, large gatherings being canceled and the travel industry in freefall, automotive analysts are downgrading their 2020 sales forecasts. (Eisenstein, 3/17)

Three of America鈥檚聽largest automakers聽have agreed to institute a rotating partial shutdown of production facilities amid the coronavirus outbreak, the United Auto Workers (UAW) union said. The union聽announced聽it had reached a deal with General Motors, Ford Motor and Fiat Chrysler for the companies to 鈥渞eview and implement鈥 a rotating partial shutdown of facilities, deep cleaning of facilities and other measures to prevent the spread of the virus among workers. (Axelrod, 3/17)

Nationwide spending on ride-hailing services Uber Technologies Inc. UBER -6.80% and Lyft Inc. LYFT -2.41% plunged in the U.S. in the past two weeks as large numbers of Americans started working from home, avoided travel, and curtailed social gatherings in an effort to contain the spread of the novel coronavirus. U.S. consumers spent 21% less on Uber rides in the seven days through March 16 compared with the seven days prior, according to data from market research-firm Edison Trends. It based its analysis partly on credit and debit card transactions. Spending on Lyft rides declined 19% over the same period, the data showed. (Rana, 3/18)

Even in a crisis that could dwarf 9-11, airline bailouts are a bitter pill for taxpayers to swallow. But they are also depressing for financially robust carriers dreaming of a more profitable European market. On Tuesday, the International Air Transport Association said global airlines would need $200 billion to avoid mass bankruptcies, as countries close their borders to international travelers due to the Covid-19 pandemic. (Sindreu, 3/18)

The rumor unsettled Deborah Santamaria. A fellow janitor at 555 California Street, a 52-story office tower in San Francisco鈥檚 financial district, told her he heard that a floor of the building was being closed because a worker had contracted the novel coronavirus. At 63, Ms. Santamaria counted herself among those most vulnerable to a virus that had killed thousands worldwide and was rapidly spreading across the United States. (Eligon and Bowles, 3/18)

Several state unemployment-benefits sites are malfunctioning amid a rise in claims from Americans who are out of work because of the novel coronavirus. New York, Oregon and Kentucky are among the states whose websites to register for unemployment benefits have experienced problems this week tied to unusually high traffic. Kentucky normally processes 2,000 jobless claims a week but received more than 9,000 claims on Tuesday alone. (Chaney and Omeokwe, 3/17)

Sweeping rounds of layoffs have started to hit D.C.-area businesses in a wide range of sectors. The economic plunge has been widely felt, hitting the wedding industry,聽food and hospitality services, arts organizations, wellness companies, and many others. (Williams and Lefrak, 3/17)

Big Reason To Halt Shipments Of Big Screens: Amazon Prioritizes Groceries, Necessities, Limits Some Orders

Amazon announced a three-week pause of shipments of things like electronics and toys in order to get people groceries, baby products, pet supplies, health and household products and personal care items like shampoo.

Amazon is moving to meet a surge in demand for household staples and medical supplies by pulling back on stocking items like consumer electronics and toys. In emails early Tuesday, Amazon told the sellers and vendors that supply the products on its website that it would not accept some shipments into its warehouses for three weeks. That includes halting purchase orders from brands that sell directly to the company and stopping shipments from the third-party sellers that offer goods on its marketplace. (Weise, 3/17)

The company said it would place the highest priority on products in six broad categories: baby products; health and household goods; beauty and personal care; groceries; industrial and scientific products; and pet supplies. Amazon announced Monday it would hire an additional 100,000 workers in its U.S. warehouses to help handle increased demand.The news comes as several U.S. states and European countries have closed bars, restaurants, movie theaters, gyms and other businesses where people come into close contact in an effort to stem the spread of coronavirus. (Nylen, 3/17)

Among the products that can be shipped to Amazon include canned beans, diapers, dog food, disinfecting wipes, medical supplies and various household goods. Items like jeans, phone cases and other non-essentials will not be allowed. 鈥淚t鈥檚 pretty disruptive,鈥 says Greg Mercer, the CEO of Jungle Scout, a software platform for Amazon sellers that predicts sales data. (Pisani, 3/17)

The white-tablecloth restaurants and the dive bars are closed. The ample buffets that feed America鈥檚 tech work force and Las Vegas gamblers have been shut down, along with millions of school cafeterias. On Monday, McDonald鈥檚 joined other fast-food companies and closed its restaurants except for delivery and drive-through. Almost overnight, Americans have had to rethink one of the most elemental parts of their daily lives: food. (Severson and Moskin, 3/17)

Workers were affixing small black-and-white signs to the stone patio outside Zaytinya on Tuesday morning, each one exactly six feet from the next.聽 The signs indicated where customers for one of ThinkFoodGroup鈥檚 new community kitchens should stand while waiting for meals outside a restaurant that would be, under normal circumstances, packed with lunchtime diners. But Zaytinya was closed, one of hundreds of restaurants and bars across the city affected by the D.C. government鈥檚 order on Monday to stop all dine-in service. (Carman, 3/17)

Elections

Amid Coronavirus Upheaval, Biden Sweeps Tuesday's Elections; Switching To Vote-By-Mail Not As Easy As It Sounds

Former Vice President Joe Biden emerged the presumptive nominee after victories on Tuesday. During his victory speech, Biden said of the outbreak, 鈥淭his is the moment for each of us to see and believe the best in every one of us.鈥 Meanwhile, there's a growing call for voting to be switched from in-person to a mailed ballot, but there are risks involved with that system as well.

Joe Biden won all three primaries held Tuesday on a day filled with anxious voting, building a lead in the Democratic presidential nomination race that appears increasingly difficult for Bernie Sanders to overcome. The two-man race lurched forward against major disruptions triggered by the coronavirus pandemic as the first balloting was held鈥攊n Florida, Illinois and Arizona鈥攕ince the crisis engulfed the nation. (McCormick and Thomas, 3/17)

Biden鈥檚 speech to the nation provided a striking coda to a complicated primary day. As he moved ever closer to becoming the Democratic nominee, he stood alone in front of a camera without a cheering crowd 鈥 symbolizing the example Americans have been asked to follow by isolating themselves from others in the midst of the novel-coronavirus outbreak. 鈥淭ackling this pandemic is a national emergency that is akin to fighting a war,鈥 Biden said. 鈥淭his is the moment for each of us to see and believe the best in every one of us.鈥 (Scherer, Linskey and Sullivan, 3/17)

The Democratic presidential race passed a point of no return Tuesday, with former vice president Joe Biden firmly in control of his party鈥檚 nomination over Sen. Bernie Sanders (I-Vt.). But politics more broadly entered into the unknown as the spreading coronavirus continued to radically disrupt the political life of the country. This combination of certainty and uncertainty was highlighted on a day when three states 鈥 Arizona, Florida and Illinois 鈥 held primaries and another 鈥 Ohio 鈥 that was scheduled to do so abruptly shut down its polling places for reasons of health safety. (Balz, 3/17)

For many voters going to the polls Tuesday in three states, the trip was their first time out of their homes since they started practicing social distancing to deal with the coronavirus pandemic. Some were successful in casting their ballots鈥攚ith hand sanitizer at the ready, while others had trouble even locating an operating polling site. (Parti and Campo-Folres, 3/17)

Despite escalating concerns about the coronavirus outbreak that has shut down large public gatherings across the country, Edison Research estimated Democratic turnout in Florida at 1.85 million - more than the 1.7 million who voted in 2016 and 1.75 million in 2008. (Whitesides and Gibson, 3/17)

The candidates canceled their rallies and stopped door-to-door outreach to voters. Then the debate that was supposed to highlight Arizona鈥檚 emergence as a national battleground was moved from a concert venue in Phoenix to an empty television studio in the nation鈥檚 capital. Arizona鈥檚 moment in the presidential political spotlight disappeared as the nation mobilized to confront the coronavirus outbreak, leaving an anticlimactic election that didn鈥檛 feel much like an election. (Cooper, 3/18)

Ohio called off its state鈥檚 primary just hours before polls were set to open as the federal government urged Americans not to gather in groups of 10 or more and asked older people to stay home entirely. Democratic National Committee Chairman Tom Perez blasted Ohio鈥檚 unprecedented move for breeding 鈥渕ore chaos and confusion.鈥 He sought to head off more states from taking similar actions, urging those with upcoming primaries to expand vote-by-mail and absentee balloting, as well as polling station hours, so that efforts to stop the spread of the coronavirus don鈥檛 further derail his party鈥檚 contest for the right to face President Donald Trump in November. (Jaffe and Weissert, 3/17)

Voting rights groups and the head of the Democratic National Committee want the states with remaining primary elections to offer voting by mail as a way to ensure that voters can safely cast their ballots amid the coronavirus outbreak. A quick and easy fix? Not always. (Mulvihill, 3/18)

Already, the pandemic has forced Louisiana, Georgia, Maryland, Kentucky and Ohio to postpone their presidential primaries until later in the spring, while reportedly contributing to lower than average turnout in Tuesday鈥檚 primaries in Illinois and Florida. It has also inspired some lawmakers and activists to call for much broader use of mail-in voting, a way for Americans to cast their ballots despite the lockdowns, quarantines and limitations on crowds taking hold across the country. (Zetter, 3/17)

It鈥檚 the zombie primary now. For all practical purposes, the Democratic nominating contest was over after Joe Biden won Michigan and Washington last week, then stretched his delegate lead by sweeping Florida, Illinois and Arizona on Tuesday night. Bernie Sanders has almost no chance of catching him.Yet because of the coronavirus, the presidential campaign is suspended in time. Rallies are off. Campaign workers, like many other people, are sheltering in place. On Tuesday, Maryland became the fifth state to postpone its election, and more states are expected to follow.The postponements have left an unexpected opening for Sanders to soldier on, even as his prospects fade. The pandemic, which first sapped the primary of life, is now extending it. (Siders, 3/18)

Science And Innovations

Scientists Work Around The Clock At Incredible Speeds To Map Virus, Find Treatments And Develop Vaccines

Researchers from around the globe are working at an unprecedented pace to try to get ahead of the fast-moving virus. So far, scientists have mapped the human proteins that the coronavirus interacts with and identified existing drugs that may prove effective against it. But a blood shortage could throw a wrench in the progress. Meanwhile, China has given the go-ahead for researchers to start human trials on a vaccine.

Working at a breakneck pace, a team of hundreds of scientists has identified 50 drugs that may be effective treatments for people infected with the coronavirus. Many scientists are seeking drugs that attack the virus itself. But the Quantitative Biosciences Institute Coronavirus Research Group, based at the University of California, San Francisco, is testing an unusual new approach. The researchers are looking for drugs that shield proteins in our own cells that the coronavirus depends on to thrive and reproduce. (Zimmer, 3/17)

Pharmaceutical companies and research facilities are working to find new, successful treatments for those infected with coronavirus. But clinical trials and FDA approval can take time, so while new drugs are being developed, companies are seeing if older drugs can be repurposed. Here鈥檚 a list of some of the options being explored and why they might be useful in blunting the effects of coronavirus. (Siegel, 3/17)

China has given the go-ahead for researchers to begin human safety tests of an experimental coronavirus vaccine in the race to develop a shot against the COVID-19 epidemic that has killed more than 7,000 people worldwide. Researchers at China鈥檚 Academy of Military Medical Sciences, - affiliated to the Chinese People鈥檚 Liberation Army (PLA) -received approval to launch early-stage clinical trials of the potential vaccine starting this week, the ruling Communist Party鈥檚 People鈥檚 Daily reported on Tuesday. (3/17)

To cure the sick, drug researchers first need the blood of the healthy. Scientists trying to develop treatments for the new coronavirus have struggled to get a hold of recovered patients鈥 blood samples, which contain the building blocks needed to create new medicines. More than 180,000 people globally have been infected by the new coronavirus, but blood samples from recovered patients have been in short supply, say pharmaceutical executives, academic researchers and U.S. public health officials. (Walker, 3/17)

Australian researchers said on Tuesday they have mapped the immune responses from one of country鈥檚 first coronavirus patients, findings the health minister said were an important step in developing a vaccine and treatment. The coronavirus has infected more than 168,000 people worldwide and killed at least 6,610, according to the World Health Organization (WHO). While the bulk of those infected experience only mild symptoms, it is severe or critical in 20% of patients. The virus mortality rate is about 3.4%, the WHO has estimated. (Packham, 3/17)

The health minister of France, Olivier V茅ran, has issued a blunt warning about painkillers taken by people ill with the coronavirus: Stay away from drugs like ibuprofen and aspirin. Take acetaminophen instead, he advised in a tweet on Saturday. So-called nonsteroidal anti-inflammatories like ibuprofen worsened symptoms of the illness caused by the coronavirus, he said. ... The advice left many medical experts scratching their heads. The coronavirus is a new pathogen, and little is known about the disease it causes, called Covid-19, or how patients respond to common medications. (Kolata, 3/17)

Despite The Narrative, Young People Can Get Severely Ill From Coronavirus

A new study looks at how age plays a role in the outbreak. While the study shows that the illness is less severe in kids, there are nuances that aren't considered in the broader narrative around the illness. Meanwhile, the older generations struggle to cope with the outbreak.

The spread of the coronavirus through a Seattle-area nursing home seemed to underscore a key point about the disease: Older and sicker individuals are most at risk. And while it is true that nursing home residents are particularly vulnerable to serious complications from the illness, younger and middle-age adults, those in their 30s, 40s and 50s, are far from immune from catching the virus. (Edwards, 3/17)

The coronavirus raging around the globe has tended to tread gently with children, who account for the smallest percentage of the tens of thousands of infections identified so far. Now, the largest study to date of children and the virus has found that while most develop mild or moderate symptoms, a small percentage 鈥 especially babies and preschoolers 鈥 can become seriously ill. The study, published online in the journal Pediatrics, looked at more than 2,000 ill children across China, where the pandemic began. (Belluck, 3/17)

The study provides confirmation that coronavirus infections are in fact generally less severe in kids, with more than 90 percent having mild to moderate disease or even being asymptomatic. But it contains worrisome information about one subset 鈥 infants 鈥 and suggests that children may be a critical factor in the disease鈥檚 rapid spread. The first thing to know is that children are getting infected across all age groups and genders. Among the patients studied, half were from Hubei Province, the epicenter of the outbreak, while the others were from bordering areas. They ranged in age from newborns to 18 with the median age being 7 years. (Cha, 3/17)

At the Stanley M. Isaacs Neighborhood Center on Manhattan鈥檚 Upper East Side on Monday morning, a trickle of older New Yorkers, some pushing walkers or riding in mobility scooters, arrived to bad news. All group activities were canceled. Lunch was strictly to go. A worker wearing a plaid shirt and a surgical mask handed a meal to a woman, then urged her to move along. 鈥淵ou can鈥檛 hang out at the center today.鈥 (Leland, 3/18)

As the federal government imposes strict new rules to prevent the spread of coronavirus, America鈥檚 nursing homes are trying to get creative to combat fears about what could come next. That means 鈥渉allway bingo鈥 in Beaver Dam, Kentucky; video conferences with family at The Villages in Rockville, Maryland; and a fresh supply of puzzles and coloring books at the Avoyelles Manor nursing home in Plaucheville, Louisiana. (Mosk and Romero, 3/18)

Kaiser Health News: As Coronavirus Surges, Programs Struggle To Reach Vulnerable Seniors Living At Home

Close down group meals for seniors. Cancel social gatherings. The directive, from the Illinois Department on Aging, sent shock waves through senior service organizations late last week.Overnight, Area Agencies on Aging had to figure out how to help people in their homes instead of at sites where they mingle and get various types of assistance. (Graham, 3/18)

The Social Security Administration operates a vast network of more than 1,200 offices around the country that help thousands of Americans every day with applications for retirement, disability and Medicare benefits. No more. Starting Tuesday, Social Security鈥檚 field office network will be closed to the public in most situations until further notice because of the coronavirus public health crisis, administration officials said. Offices that hear disability insurance appeals also are closed. (Miller, 3/17)

Science Vs. Myths: New Study Outlines How Long Coronavirus Lives On Various Surfaces, In The Air

Published in the New England Journal of Medicine, the study says coronavirus can live for three days on some surfaces. It survives longest on plastic and steel. Other research news is on how long social distancing might be necessary, how long the pandemic can last and the importance of taking walks.

The coronavirus can live for three days on some surfaces, like plastic and steel, new research suggests. Experts say the risk of consumers getting infected from touching those materials is still low, although they offered additional warnings about how long the virus survives in air, which may have important implications for medical workers. The new study, published Tuesday in the New England Journal of Medicine, also suggests that the virus disintegrates over the course of a day on cardboard, lessening the worry among consumers that deliveries will spread the virus during this period of staying and working from home. (Mandavilli, 3/17)

In terms of half-life, the research team found that it takes about 66 minutes for half the virus particles to lose function if they are in an aerosol droplet. That means that after another hour and six minutes, three quarters of the virus particles will be essentially inactivated but 25% will still be viable. (Emery, 3/17)

Life in America 鈥 and in many countries around the world 鈥 is changing drastically. We鈥檙e physically distanced from our favorite people, we鈥檙e avoiding our favorite public places, and many are financially strained or out of work. The response to the Covid-19 pandemic is infiltrating every aspect of life, and we鈥檙e already longing for it to end. But this fight may not end for months or a year or even more. (Resnick, 3/17)

A plan developed by the federal government to combat the coronavirus reportedly projects the pandemic will last 18 months or more and could feature multiple 鈥渨aves,鈥 The New York Times reported. 鈥淪hortages of products may occur, impacting health care, emergency services, and other elements of critical infrastructure,鈥 the plan warns, according to the Times. 鈥淭his includes potentially critical shortages of diagnostics, medical supplies (including PPE [personal protective equipment] and pharmaceuticals), and staffing in some locations.鈥 (Budryk, 3/17)

The United States is facing a grim dilemma: either effectively shut down society for months to prevent transmission of the coronavirus, or see health care systems overwhelmed by people needing treatment for severe infections. That's the conclusion of a influential new analysis by a well-respected group at Imperial College London that does computer simulations of outbreaks. (Greenfieldboyce, 3/17)

By now, you've heard the advice that to slow the spread of coronavirus in the U.S., we need to practice social distancing. But if you're confused as to what that looks like in practice, we've got some answers. On Monday, the White House announced new guidelines for the next two weeks, urging Americans to avoid gathering in groups of more than 10 people, to avoid discretionary travel, shopping trips, or social visits, and not to go out to restaurants or bars. (Godoy and Aubrey, 3/17)

Millions around the world are heeding the extraordinary pleas for keeping social distance to combat the coronavirus by avoiding landmarks, resorts and other large gathering places. That's the unmistakable takeaway from a series of satellite images released Tuesday of highly trafficked locations from New York's Central Park to Milan鈥檚 Cathedral and Moscow鈥檚 Red Squares. (Feldscher, 3/17)

As the coronavirus continues to spread across the globe, confusion and misconceptions about what can protect you are becoming as contagious as the virus. We spoke to doctors and experts in infectious diseases about whether there鈥檚 any truth to these common claims. (Blum, 3/17)

In a bygone era 鈥 last week, in other words 鈥 the best way to cut through New York City stress was, for many, a stroll to the nearest restaurant, bar or maybe (for the virtuous or vain) the gym. Not anymore. With Mayor de Blasio鈥檚 closure of the city鈥檚 restaurants (except for takeout), bars and gyms, which took effect this morning at 9 a.m., along with schools, movie theaters and any other place where people congregate, the stroll, it seems, is all that鈥檚 left. (Williams, 3/17)

A Baton Rouge hotel front-desk manager with chills, body aches and walking pneumonia. A New Orleans casino cocktail server with a sore throat and a respiratory infection. Mothers caring for children with burning fevers. All have worried they may be spreading the novel coronavirus to others while being turned down for testing under strict criteria over recent weeks. (Stole, 3/16)

As the new coronavirus shuts down countries around the world, the impact can be seen from space. A satellite that detects traces of human activity 鈥 tailpipe emissions from cars and trucks, fossil fuel burned in power plants and other industrial activities 鈥 shows striking reductions in pollution across China and Italy since the outbreak first started. (Popovich, 3/17)

The coronavirus pandemic is becoming a brutal psychological test. This is a dreadful moment with a potentially deadly pathogen on the loose. This public health crisis can take a mental toll on people, especially those struggling with anxiety, depression and other conditions. One common emotion that might not be immediately obvious: grief. (Achenbach, 3/17)

Two hours. That鈥檚 all the time medical teams in Singapore are given to uncover the first details of how patients contracted the coronavirus and which people they might infect. Did they travel abroad? Do they have a link to one of the five clusters of contagion identified across the city-state? Did they cough on someone in the street? Who are their friends and family, their drinking buddies and partners in prayer? As Western nations struggle with the wildfire spread of the coronavirus, Singapore鈥檚 strategy, of moving rapidly to track down and test suspected cases, provides a model for keeping the epidemic at bay, even if it can鈥檛 completely stamp out infections. (Beech, 3/17)

Singapore, a tiny city-state of less than 6 million people, had one of the earliest and biggest clusters of cases of the coronavirus in early February, before it began its rapid, inexorable expansion around the globe. Within weeks, the country鈥檚 tally of infections with the highly contagious virus that causes COVID-19 was overtaken by skyrocketing caseloads in South Korea, several European countries and the U.S. (Toh and Kurtenbach, 3/18)

Efforts to stop the spread of the new coronavirus have people stuck at home and consuming news that may be confusing and alarming. Here, some terms used repeatedly by public officials and health-care experts to describe the situation as well as what those terms mean. Containment: Usually used at the start of an outbreak, it refers to actions taken to track the spread of a disease within a community by investigating travel histories and close contacts, and then issuing quarantines of sick individuals to stop its spread. (Camero, 3/17)

Health IT

Surveillance Tools Have Untold Potential To Help Locate Infectious Vectors, But They Could Erode Privacy Protections

In the midst of a crisis, when tensions are running high, tech and government officials are struggling to find a balance between deploying technology and keeping patients鈥 data safe. Meanwhile, will the internet be able to bear the extra strain of so many people working from home? And Facebook's algorithm is flagging coronavirus posts even when they're not spam.

As the country scrambles to control the rapidly spreading coronavirus, government agencies are putting in place or considering a range of tracking and surveillance technologies that test the limits of personal privacy. The technologies include everything from geolocation tracking that can monitor the locations of people through their phones to facial-recognition systems that can analyze photos to determine who might have come into contact with individuals who later tested positive for the virus, according to people familiar with the matter. (Grind, McMillan and Wilde Mathews, 3/17)

As the federal government shifts into an all-hands-on-deck fight to battle coronavirus, President Trump and his White House have increasingly called on tech companies to lend a hand. The companies are in conversations with government about to leverage their might and reach; the Trump White House held a conference call last week to talk about what they can do to help, from helping analyze scholarly research to pulling down misinformation on the virus. For the tech giants, this plea represents a huge opportunity to get back in the public鈥檚 good graces, as an industry whose image has taken a beating is being asked, even urged, to step up in a moment of national emergency. (Scola, 3/18)

As soon as Konrad Iturbe started working from home, he ran into problems. Sitting in his shared apartment in a northern suburb of Barcelona, the 20-year-old app developer saw his internet speeds fall off a cliff soon after the country entered a two-week shutdown on Saturday because of the coronavirus pandemic. (Scott, Cerulus and Delcker, 3/17)

Facebook said a bug in its anti-spam system temporarily blocked the publication of links to news stories about the coronavirus. Guy Rosen, Facebook鈥檚 vice president of integrity, said on Twitter Tuesday that the company was working on a fix for the problem. Users complained that links to news stories about school closings and other information related to the virus outbreak were blocked by the company鈥檚 automated system. (3/18)

The United States, already dealing with the coronavirus pandemic, is also being targeted for cyberattacks and foreign disinformation campaigns, as federal officials feared. Multiple sources confirmed to ABC News in recent days that both the efforts that slowed computer systems at the Health and Human Services Department Sunday night and the weekend rash of bogus text messages warning a national quarantine is imminent were the products of foreign actors or components of foreign governments or entities connected to them. (Dukakis, Meek, Levine, Barr and Margolin, 3/17)

Telemedicine For Seniors Gets Boost In Effort To Keep Most Vulnerable At Home, Out Of Hospitals

Medicare's administrator Seema Verma said the move will help prevent the spread of illness, but critics say telehealth is limited, especially in rural areas, and seniors who don't know how to use devices might be imperiled if family members get close in order to teach them.

Medicare said Tuesday it will immediately expand coverage for telemedicine nationwide to help seniors with health problems stay home to avoid the coronavirus. The new option will allow millions of older people to take care of ongoing medical problems as well as new concerns, while heeding public health advice to stay home during the outbreak. (Alonso-Zaldivar, 3/17)

The Trump administration on Monday announced that it will expand telehealth services for Medicare beneficiaries and cut back on HIPAA enforcement, the latest move to combat the coronavirus pandemic.Medicare will pay doctors and hospitals for a broad range of telehealth services on a temporary basis, effective March 6. The program will pay for office and hospital telehealth visits and include a wide range of providers including nurse practitioners, clinical psychologists and social workers. Telehealth visits will be reimbursed for the same amount as in-person visits. (Brady, 3/17)

The Trump administration expanded access to telemedicine in Medicare, a move that could relieve crowding at hospitals but strain companies facing a surge in demand from the coronavirus pandemic. Medicare patients will now have greater ability to seek treatment from their providers through remote means, such as videoconferencing on Skype or Apple Inc.鈥檚 FaceTime. The changes announced on Tuesday apply to the 44 million people who are on Medicare, a federal program for seniors and the disabled. (Armour and McKinnon, 3/17)

The coronavirus pandemic has opened the door for Medicare patients to have access to telehealth, the Centers for Medicare and Medicaid Services (CMS) said Tuesday. But what is that, exactly? Telehealth connects patients to healthcare providers through videoconferencing, electronic consultations and virtual communications, in lieu of in-person consultations, according to the American Hospital Association. In 2019, 76% of US hospitals used the technology. (Holcombe, 3/18)

Telehealth services are sagging under the weight of an unprecedented surge in patients as hospitals scramble to shift routine care online in response to the coronavirus pandemic. The crisis is stressing major telehealth providers鈥 technical infrastructure and the supply of physicians prepared to deliver care virtually. (Brodwin and Ross, 3/17)

Over the past week, President Trump and his administration have made statements and taken other actions that show they increasingly recognize the magnitude of the coronavirus pandemic 鈥 and are counting on health tech, and especially telemedicine, to help save the country. But can the technology meet the demands of this extraordinary moment? How the health tech community performs in this crisis could instantly and dramatically advance the industry 鈥 and shape how medical care gets delivered for years to come. (Robbins, 3/18)

Government Policy

Trump Considering Capitalizing On Crisis By Completely Blocking All Illegal Border Crossings From Mexico

The administration said the nation cannot risk allowing the coronavirus to spread through detention facilities and among Border Patrol agents. Meanwhile, the U.S. and Canada are eyeing a mutual agreement to end all non-essential travel over the border.

The Trump administration is considering a plan to turn back all people who cross the border illegally from Mexico, two administration officials said Tuesday, using powers they say the president has during pandemics like the coronavirus outbreak to mount what would be one of the most aggressive attempts to curtail illegal immigration. The plan is under consideration and no final decisions have been made, according to the officials, who spoke to The Associated Press on the condition of anonymity because the plan hasn鈥檛 been announced. (Spagat and Long, 3/18)

Under the plan, the administration would keep ports of entry open to U.S. citizens, permanent residents and foreigners with legal permission to enter the country. Foreigners covered by President Trump鈥檚 existing travel restrictions on China and Europe are already not permitted to enter at either of the U.S.鈥檚 land borders. Migrants crossing the southern border between legal ports of entry, including those claiming asylum, would be swiftly returned to Mexico by the U.S. Border Patrol. (Hackman and Caldwell, 3/17)

Agents will have to check migrants鈥 information, including criminal records, in the field. Equipment to help them perform those checks was already being distributed Tuesday, Judd said. Judd, who is close to the Trump administration, added that the new policy could take effect as soon as Tuesday night. 鈥淭his will greatly limit the potential for spread of the coronavirus,鈥 he said. 鈥淭he administration was looking at ways to minimize exposure.鈥 (O'Toole and Hennessy-Fiske, 3/17)

The administration officials said the ports of entry would remain open to American citizens, green-card holders and foreigners with proper documentation. Some foreigners would be blocked, including Europeans currently subject to earlier travel restrictions imposed by the administration. The points of entry will also be open to commercial traffic. (3/17)

The administration is pushing to use the coronavirus pandemic to accomplish some of the tough immigration restrictions that hardliners have struggled to put into practice since President Donald Trump took office, including blocking entry to asylum seekers, according to US officials briefed on the plans. A plan to turn back all migrants seeking asylum would have its most immediate effect on the US-Mexico border. It has run into opposition from several government agencies, in part because of concerns that it would violate US and international law, including treaties on how to deal with refugees and victims of torture. (Perez, Sands and Alvarez, 3/17)

The United States and Canada are聽working聽on a plan to bar non-essential travel between the two countries, according to multiple reports late Tuesday. A Canadian government official told The Associated Press聽that the two countries were working out the details of the聽new restrictions ahead of an expected announcement. The Canadian Broadcasting Corporation (CBC) reported that the plan聽could be announced as early as Wednesday.聽(Byrnes, 3/18)

The United States and Canada are preparing to issue a joint statement in the next 24-48 hours to suspend non-essential travel between the two countries, a Trump administration official tells CNN. The agreement is not yet finalized and officials are still working to define "non-essential travel," but the official stressed that the new restrictions will ensure that business and trade between the two countries can continue. (Diamond, 3/18)

And in other news 鈥

President Donald Trump鈥檚 increasingly urgent campaign to attack the coronavirus outbreak is having a notably meager impact in the immigration courts, where dramatic moves could undercut his signature policy of getting tough on undocumented immigrants and asylum seekers. As state and federal courts around the country scale back sharply due to the pandemic, most immigration courts have pressed on with only minor adjustments, prompting growing outrage from immigration judges, lawyers for immigrants facing deportation and even the attorneys who serve as prosecutors. (Gerstein, 3/17)

Global Watch

'Devastatingly Dangerous Spiral': Editors Condemn China's Decision To Expel U.S. Journalists After Trump Imposed Limits

China announced it would expel American journalists and demand they hand back their press cards, announcing the decisions 鈥渁re entirely necessary and reciprocal countermeasures ... in response to the unreasonable oppression the Chinese media organizations experience in the U.S.鈥 The news organizations have also reported in the past year on other issues deemed extremely sensitive by Chinese officials,

In a sharp escalation of tensions between the two superpowers, China announced on Tuesday that it would expel American journalists working for The New York Times, The Wall Street Journal and The Washington Post. It also demanded that those outlets, as well as the Voice of America and Time magazine, provide the Chinese government with detailed information about their operations. The announcement, made by China鈥檚 Ministry of Foreign Affairs, came weeks after the Trump administration limited to 100 the number of Chinese citizens who can work in the United States for five state-run Chinese news organizations that are widely considered propaganda outlets. (Tracy, Wong and Jakes, 3/17)

China withdrew the press credentials of American journalists at three U.S. newspapers on Wednesday, intensifying a bitter fight between the world鈥檚 top two economies over the spread of coronavirus and press freedoms. (Munroe, Pamuk and Coster, 3/17)

Badly strained ties between the United States and China are deteriorating further with the two sides hurling harsh accusations and bitter name-calling over responsibility for the spread of the novel coronavirus. The global pandemic is just one in a series of irritants that has rocked the relationship between Washington and Beijing since the Trump administration began to step up long-simmering confrontations on issues ranging from territory to trade to high-tech telecommunications. (3/18)

Public Health

Concerns Inside Prisons: 'Staff Are Starting To Get Fearful', Inmates Argue For Release

Prisons are taking steps to stem the flow of infection, according to a The New York Times report, as prisoners and guards fall sick.

Packed into a crowded federal prison complex with not enough masks, soap or hand sanitizer, and the sole doctor out sick, corrections workers in Tallahassee, Fla., were worried. Then on Monday, a new inmate arrived and was immediately put into quarantine. And on Tuesday, a bus with almost a dozen inmates from a U.S. Immigration and Customs Enforcement detention center showed up. They were scheduled for quarantine, too. And all had elevated temperatures. (Ivory, 3/17)

Coronavirus has become a 鈥済et out of jail鈥 card for hundreds of low-level inmates across the country, and even hard-timers are seeking their freedom with the argument that it鈥檚 not a matter of if but when the deadly illness sweeps through tightly packed populations behind bars. Among those pleading for compassionate release or home detention are the former head of the Cali drug cartel, President Donald Trump鈥檚 former personal attorney Michael Cohen, Ponzi schemer Bernard Madoff and dozens of inmates at New York City鈥檚 Rikers Island, part of a jail system that lost an employee to the virus this week. (Mustian and Goodman, 3/18)

Prescription Drug Watch

Drug Coverage Is Shrinking, Leaving Vulnerable Patients In A Lurch. What's Going On?

Read about the biggest pharmaceutical development and pricing stories from the past week in KHN's Prescription Drug Watch roundup.

It took years for Leslie Miller to find the prescription drug that worked for her. But in December, she got a letter from her insurer that the medicine would no longer be covered by her insurance plan starting January 1. "My heart started racing immediately," says Miller, a graduate teaching assistant in the University of Oklahoma's sociology department. "I've had this happen before and it's scary." (Lupkin, 3/16)

If your doctor wants to prescribe an extremely expensive drug, expect your insurer to look hard first at whether it works before agreeing to pay. Health insurers are hunting for more ways to tame rising costs. Aside from looking at prescription drugs, they're also covering meal deliveries and even some housing costs to keep people healthy and out of expensive emergency rooms. (Murphy, 3/15)

Republicans impatient to vote on legislation to lower the price of prescription drugs deployed a new tactic this week to win Senate Majority Leader Mitch McConnell鈥檚 support: tie it to the coronavirus. The Kentucky Republican is 鈥渙bviously considering鈥 the recommendation to fast-track a long-stalled legislative proposal that would, among other things, improve affordability of eventual treatments for COVID-19, said Sen. Bill Cassidy, R-La., a physician who supports the legislation. (Dumain, 3/13)

As the new coronavirus spreads illness, death, and catastrophe around the world, virtually no economic sector has been spared from harm. Yet amid the mayhem from the global pandemic, one industry is not only surviving, it is profiting handsomely. 鈥淧harmaceutical companies view Covid-19 as a once-in-a-lifetime business opportunity,鈥 said Gerald Posner, author of 鈥淧harma: Greed, Lies, and the Poisoning of America.鈥 The world needs pharmaceutical products, of course. For the new coronavirus outbreak, in particular, we need treatments and vaccines and, in the U.S., tests. Dozens of companies are now vying to make them. (Lerner, 3/13)

The novel coronavirus is putting pharma's complicated global supply chain under strain, no question. What's up in the air is just how supplies could聽be affected鈥撯揳nd unfortunately, analysts just can't be sure.聽Why? Lack of transparency, for one thing. A dearth of information is making it hard on pharma watchers who'd like to diagnose the growing impact聽COVID-19 has had on individual companies' struggles, SVB Leerink analyst Ami Fadia wrote in a note to investors Monday. (Blaneknship, 3/16)

Sometimes the most beautiful images are ones that can鈥檛 be seen with the naked eye. Take the hot pink grid of microscopic capsules or the sea of shimmering bubbles (below). Not only are they visually arresting images, but they reveal the inner workings of human physiology and bioscience on the microscopic scale. (3/18)

Regulators in Finland threatened to fine Novartis (NVS) for violating laws governing the distribution of prescription medicines through pharmacies and state-owned hospitals. The Finnish Medicine Agency took the drug maker to task for allowing the Aimovig migraine drug to be made available at a reduced price to patients through hospitals on an outpatient basis, instead of through pharmacies. Another violation involved an attempt to limit patients who would have been eligible for the medicine at a reduced price, although further details were not disclosed. (Silverman, 3/16)

An experimental pill from Merck significantly reduced the frequency of chronic coughing compared to a placebo, achieving the main goal of twin, Phase 3 clinical trials, the drug maker said Tuesday. Merck has described its chronic cough drug, gefapixant, as one of the most important medicines in its research pipeline. The positive results will also likely bolster the prospects of Bellus Health, a small Canadian drug maker developing a similar drug for chronic cough. (Feuerstein, 3/17)

This was supposed to be the microbiome鈥檚 breakthrough year 鈥 and pandemic or not, it looks like it still might be. Three companies 鈥 Finch Therapeutics, Seres Therapeutics, and Rebiotix 鈥 said earlier this year that they expected to announce results from pivotal clinical trials for recurrent C. difficile treatments sometime this summer. (Sheridan, 3/18)

In a setback to Mallinckrodt (MNK), a federal court judge upheld a move by the Centers for Medicare and Medicaid Services to reset a benchmark used for calculating rebates the company must pay to Medicaid for its most important drug, a decision that could cost it $650 million and escalates a heated battle between the drug maker and the federal government. At issue is the amount of money the company owes CMS for its controversial Acthar Gel treatment, which is used primarily to treat infantile spasms and has been a poster child for the high cost of medicines. Over the past five-plus years, the wholesale price rose 20% and a vial now costs around $39,000, making the drug a large expense for public and private payers. (Silverman, 3/16)

We think we know generic drug companies. They challenge patents held by brand firms. They litigate vigorously to overturn those patents. And they often win these challenges.But what about 鈥済eneric鈥 companies that play both sides, earning revenue from generic and brand drugs? Do they have less incentive to do what generic firms should be doing? (Carrier, Lemley and Miller, 3/17)

Perspectives: The Social Contract That Keeps The Pharmaceutical Industry Functioning Is In Total Disrepair

Read recent commentaries about drug-cost issues.

The biopharmaceutical industry is under unprecedented assault by the public and politicians. Hostility over launch prices for new drugs and post-launch price increases is broad and bipartisan, reflected in increasingly draconian legislative proposals and aggressive rebate payer negotiations. The net price of drugs 鈥 that鈥檚 the list price minus rebates and other reductions 鈥 is being squeezed, and the pressure won鈥檛 let up. (James C. Robinson, 3/13)

As the coronavirus crisis has unfolded, we鈥檝e seen a聽a flood of announcements from drug companies touting potential聽treatments for the still incurable disease. Many have come from biotechnology companies that have never successfully developed a drug, let alone purpose-built one for an outbreak.聽Regeneron Pharmaceuticals Inc.'s announcement Tuesday聽that its development efforts are ahead of schedule 鈥斅爏o much so that it聽聽may be able to start human trials in early summer 鈥斅爄s an exception that should provoke measured optimism. (Max Nisen, 3/17)

The World Health Organization has declared the novel coronavirus a global pandemic, with more than 118,000 confirmed cases worldwide. As countries brace for the worst, people around the world are looking to the United States for a drug that can prevent or cure the disease. The world is right to put its hope in American scientists. Our country leads the world in drug development and has the best shot at delivering a rapid medical breakthrough. (Sally Pipes, 3/17)

After contracting a virus as a baby, 14-year-old Kaden was diagnosed with Type 1 diabetes.鈥淛ust to keep our buddy alive, it鈥檚 pretty expensive. And it doesn鈥檛 need to be. It shouldn鈥檛 have to be this way,鈥 said Laura Finch, Kaden鈥檚 mom. But families like the Finches are getting a little help from Utah legislators, with Tuesday鈥檚 unanimous Senate passage of a bill to make insulin more accessible. (Imlay, 3/10)

Editorials And Opinions

Different Takes: Pros, Cons Of Stronger Government Responses During COVID-19

Opinion writers weigh in on government's response during the pandemic.

The alarming reality is, however, that we are at grave risk of running out of these protective items. Hospitals across the country can鈥檛 get enough of the basic supplies they need as they test and care for a steadily growing number of patients who show up with symptoms that could indicate COVID-19. How could this happen? Why don鈥檛 we have the tools necessary to wage this war effectively? (Edward J. Markey and Peter L. Slavin, 3/17)

Ten or 20 years from now, by the time the current crisis has hardened into a cautionary tale about the dangers of governmental incompetence, I imagine we鈥檒l look back on Donald Trump鈥檚 Rose Garden news conference of Friday, March 13, as the moment that finally shattered the world鈥檚 faith in America. What broke me, at least, was the spectacular smallness on display 鈥 how, in the span of about an hour that afternoon, the illusion of American can-do greatness shriveled like a frightened turtle right before our eyes. (Fahad Manjoo, 3/18)

The emergence of Covid-19 and its worldwide spread has some of the United States鈥 top leaders 鈥 at least those without public health or infectious disease expertise 鈥 succumbing to speculation and calling for action based on political hunches. If policymakers really want to effectively control the spread of the virus, they need to rely on expertise and thoughtful deliberation, especially when it comes to addressing complex and nuanced questions of allocating scarce resources, ordering quarantine and isolation, and controlling infection. (Susie A. Han and Valerie Gutmann, 3/17)

The other day, a new neighbor overheard us complaining about how slowly western governments were imposing drastic social distancing to help slow the spread of COVID-19. He entered the conversation, saying, "It's not as if life as we know it is ending." He seemed a little anxious as he said it, contradicting his words. He was wrong, of course. Life as we know it is ending for now, and the sooner people's mental understanding of this catches up with their gut understanding, the sooner people will demand and support stronger government responses. (Peter M. Sandman and John Lanard, 3/17)

Before the coronavirus crisis hit, I was toying with writing a book about 21st-century political parties, but in light of this global epidemic it鈥檚 obvious that whatever nonfiction book you鈥檙e working on now, put it down. There is the world B.C. 鈥 Before Corona 鈥 and the world A.C. 鈥 After Corona. We have not even begun to fully grasp what the A.C. world will look like, but here are some trends I鈥檓 watching. (Thomas L. Friedman, 3/17)

As the federal and state governments grapple with the potential effects of the Covid-19 pandemic across the nation, there has been an increasing call for mobilizing the military to contribute to the pandemic response. In a New York Times opinion piece, New York Governor Andrew Cuomo suggested that the Army Corps of Engineers should be called into service to assist to "retrofit and refit existing facilities" to serve as temporary medical centers. (Mark Hertling, 3/18)

Last week, Atlantic writer Yascha Mounk called on America to 鈥渃ancel everything.鈥 At the time, this seemed radical. This week, approximately 17,000 years later in covid-19 time, it is conventional wisdom. As Treasury Secretary Steven Mnuchin stepped up to the lectern on Tuesday to announce that the government would be looking for a way to send checks to every American in the next week or so, I thought of my own parallel proposal to Mounk鈥檚: subsidize everything. (Megan McArdle, 3/17)

There is a lot to like in the House coronavirus stimulus package, but Representative Joseph P. Kennedy III tells me it鈥檚 just a down payment on helping Americans deal with and recover from the pandemic鈥檚 economic pain. The House proposal features free coronavirus testing for everyone who needs one, including the uninsured; paid emergency leave consisting of 14 days sick time and up to three months of family and medical leave; enhanced unemployment insurance; strengthened programs for student meals, senior nutrition, and food banks; and increased federal funds for Medicaid as states face bigger health care bills. (Shirley Leung, 3/13)

The United States has never experienced anything quite like the economic disjuncture caused by the spread of the new coronavirus. Airports and malls are empty. Restaurants and movie theaters are closed. The collapse is happening so fast it isn鈥檛 visible yet in standard data like the unemployment rate, but startling facts are piling up. OpenTable, a restaurant reservation website, reported 56 percent fewer people ate at its member restaurants on Monday compared with the same day last year. In a poll, almost one fifth of the respondents said they were working fewer hours or had lost their jobs. (3/18)

The last few weeks have been a whirlwind for the financial markets and the economy, capped off by the president giving a number of speeches and conferences during which he tried to calm Americans and reassure businesses. Although the coronavirus crisis is expected to have a finite duration, similar to other outbreaks, its rippling effects may have lasting impacts on the economy and public policy. Here are some reasons why. (Joseph Minarik, 3/16)

CBS White House correspondent Weijia Jiang tweeted Tuesday that "this morning a White House official referred to the #Coronavirus as the 'Kung-Flu' to my face. Makes me wonder what they're calling it behind my back." For members of the Asian American and Pacific Islander (AAPI) community, this type of ignorance and racism is hardly new. It never ceases to amaze me how comfortable people feel espousing racially charged tropes about Asian Americans. It's the kind of brazenness that stems from labeling us the "model minority." (Kurt Bardella, 3/18)

If the Food and Drug Administration slows or halts ongoing drug reviews due to the coronavirus, payout of the Bristol Myers Squibb contingent value rights might be in jeopardy. Recall, as part of the Bristol acquisition, Celgene shareholders were promised a $9 per share payout if three of the company鈥檚 drugs secure FDA approval within a specific timeline. If any of the three drugs miss their respective approval deadline, the CVR does not pay out.聽(Adam Feuerstein, 3/17)

The search for treatments and vaccines to curb transmission of the new coronavirus is in overdrive. Fortunately, there are a number of promising candidates thanks to the U.S. government鈥檚 investment in biomedical research and development. Since the 2003 SARS outbreak, the United States has spent nearly $700 million of taxpayer money on coronavirus research 鈥 more than any other country 鈥 through the National Institutes of Health. Yet the question right now for Americans 鈥 thousands of whom are forced to ration their insulin and face astronomical bills for live-saving drugs 鈥 is not only when these treatments and vaccines will become available, but at what price. (Mariana Mazzucato and Azzi Momenghalibaf, 3/18)

Underfunded health infrastructure, the lack of an adequate safety net, and inattention to public health capacity and infrastructure has made this situation so much worse. Even the best presidential response would be hamstrung by a larger set of institutional shortcomings that make America more vulnerable to a pandemic than other developed nations. (Michael Cohen 3/13)

After the terrorist attacks of Sept. 11, 2001, we were exhorted to defiance. I remember it well. Don鈥檛 let the terrorists win, we were told. Don鈥檛 let them steal your joys or disrupt your routines 鈥 at least not too much. Be wary, yes, and be patient with extra-long security lines where they didn鈥檛 previously exist. If you see something, say something. But otherwise, resume normal life. Venture out. Revel. (Frank Bruni, 3/17)

Viewpoints: Self-Quarantine Is Essential During Pandemic, But Will Rush Limbaugh's Followers Comply?; Lessons On How U.S. Hospitals Can Avoid Italy's Crisis

Editorial pages weigh in on these issues surrounding COVID-19.

In 1918, a new respiratory virus invaded the human population and killed between 50 million and 100 million people 鈥 adjusted for population, that would equal 220 million to 430 million people today. Late last year another new respiratory virus invaded the human population, and the reality of a pandemic is now upon us. Although clearly a serious threat to human health, it does not appear to be as deadly as the 1918 influenza pandemic. But it is far more lethal than 2009鈥檚 H1N1 (swine flu) pandemic, and the coronavirus does not resemble SARS, MERS or Ebola, all of which can be easily contained. (John M. Barry, 3/17)

Behold, the perils of the Pinocchio presidency.For three years, President Trump told his supporters that the federal government perpetrates hoaxes and frauds, that the media produces fake news and that nothing is on the level except for his tweets. He did the same with the novel coronavirus, portraying it as an ordinary flu that would 鈥渄isappear鈥 and accusing Democrats of a hoax and the media of exaggerating. Belatedly, Trump has begun to speak the truth about the virus, which by some estimates could kill more than 2 million Americans without attempts to control it. After an abrupt change of tone Monday afternoon, Trump continued to say the right things, using the same word on Tuesday that former vice president Joe Biden and French President Emmanuel Macron have used: war. (Dana Millbank, 3/17)

I didn鈥檛 even notice the balloons at first. With our laser focus on coronavirus, on our protocols and procedures, our carts of isolation gowns and our fears about mask shortages, it is easy to see only pandemic these days. But as we stood outside the cancer patient鈥檚 room on our rounds one recent morning, I finally took note. Three 鈥淔eel Better Soon鈥 balloons. They were the kind you might buy at the gift shop, colorful and festive. He had been in the hospital for weeks and they were shrunken by now, wilting. (Daniela J. Lamas, 3/17)

China locked down Hubei province in late January in a last-ditch attempt to slow the novel coronavirus epidemic. But hospital admissions for Covid-19 continued to rise for another four weeks. At the epidemic鈥檚 peak, nearly 20,000 patients were hospitalized, more than 10,000 in severe or critical condition. There are lessons here for the U.S. A rapidly escalating outbreak in a large American city would severely burden an area鈥檚 health system. Americans are doing things to try to avert this outcome: working from home, cutting down on social interactions. That will slow down chains of spread. But if two more large cities suffer rapid epidemic spread at the same time, the health system will be overwhelmed. There are steps American hospitals and policy makers can take now to increase capacity to deal with a crisis. (Luciana Borio and former FDA commissioner Scott Gottlieb, 3/17)

The current coronavirus disease, Covid-19, has been called a once-in-a-century pandemic. But it may also be a once-in-a-century evidence fiasco. At a time when everyone needs better information, from disease modelers and governments to people quarantined or just social distancing, we lack reliable evidence on how many people have been infected with SARS-CoV-2 or who continue to become infected. Better information is needed to guide decisions and actions of monumental significance and to monitor their impact. (John P. A. Ioannidis, 3/17)

The number of confirmed Covid-19 cases in Massachusetts is not an accurate reflection of the number of people who are actually sick because delays in testing have left symptomatic patients with nowhere to turn 鈥 except back into their communities, possibly spreading germs. (Jennifer Crystal, 3/17)

Chaos, disorganization and cluelessness describe the current state of COVID-19 testing in the United States. Doctors, hospitals and state labs give patients needing tests the runaround, each pointing to the other as the place to get tested. Some people self-quarantine for days awaiting their results, only to be told the lab misplaced or bungled the test. As of March 11, the U.S. trailed most of the developed world in tests administered, with per capita numbers virtually the same as Vietnam's. (Jeffrey A. Singer, 3/18)

The people buying every gun available in this country apparently are preparing for total anarchy. Fear and panic is driving the gun-buying frenzy. But fear of what? It can鈥檛 be that Americans are arming themselves to protect their stash of toilet paper. Whatever the reason, gun聽sales are up everywhere but particularly in states like California, New York and Washington that have been hit hardest by coronavirus, according to The聽Los Angeles Times. Ammo.com also reports that revenue from sales on its website increased聽309% from Feb. 23 through March 15, compared to same time a month before. (Elvia Diaz, 3/17)

In the last few days, most Americans, even President Trump, have come to terms with the need for social distancing. Though they feel fine, they are staying home and developing new routines 鈥 killing time baking, binge-watching, figuring out how to home-school their kids. It took far too long for Americans to accept how serious the coronavirus is. Now that we鈥檝e finally taken the necessary measures in many places to close schools, offices, restaurants and other businesses, people are asking: How soon will it all be over? Two weeks? Four weeks? When can we go back to normal? (Ezekiel J. Emanuel, Susan Ellenberg and Michael Levy, 3/17)

What if we were told that the best way to slow the spread of the coronavirus pandemic was to smoke 15 cigarettes a day? What would you do? Loneliness, we know from the research, can be as bad for your health as smoking. It鈥檚 more predictive of mortality than obesity. And loneliness itself was a pandemic long before covid-19 got its name. (Amanda Ripley, 3/17)

If, like me, you've been receiving emails from most every organization you're involved with saying that classes, lectures, services, and other planned events are now being conducted online amid the coronavirus crisis, you've almost certainly noticed a trend. With so many of us already connecting with our communities through social media and smartphones, we have already taken big steps away from physical proximity as the core of our human intimacy. What we are now witnessing is a quantum leap toward the virtualization of our lives. (Jamie Metzl, 3/17)

Wash your hands. Practice social distancing. This often repeated and important public health messaging is critically important as the nation seeks to contain COVID-19. Recently, CDC officials encouraged people to have a 2-week stock of their medications. Unfortunately, for people taking medications for opioid use disorder, this simply may not be possible 鈥 without critical federal intervention.聽(Caleb Banta-Green, Regina LaBelle and Dr. Yngvild Olsen, 3/17)

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