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Must-Reads Of The Week From Brianna Labuskes

Hello! We have once again reached Friday, and I’ll do my best to give you a snapshot of the biggest health news from the week. But, first, I must dispel some bad advice that I’ve seen: Everyone wants to see your pet on those video conferences! Don’t hide them away in this time of need! Show us the doggos, the cats, and the … whatever this is. (A porcupine, I think?) Also make sure you’re following DogsOfKFF on Twitter for some of the best content on that social media platform.

All right, onto the news.

As predicted, the United States has surpassed China in the number of confirmed coronavirus cases, with nearly 93,000 to China’s nearly 82,000, as of 1 p.m. ET Friday. According to Johns Hopkins’ tracker, we also have surpassed 1,300 recorded deaths. (Worldwide, we’re at more than 566,000 and over 25,000 deaths.) Meanwhile, all that data comes with an asterisk in that most experts believe there are far more cases going unrecorded either because of testing flaws or overwhelmed state health departments that can’t keep up. Either way, not exactly something we want to be first in.

Meanwhile, the House came back to Washington to approve the $2.2 trillion stimulus package the Senate managed to send through this week (more on that in a second), despite concerns over lawmakers’ safety. There had been (dim but existent) hope earlier in the week that the House might be able to pass the legislation by unanimous consent. But that seemed too easy to be true, and it was. Concerns that a voice vote would be derailed by objections from a libertarian Kentucky lawmaker went unrealized, and the House passed the legislation Friday afternoon. The bill now goes to President Donald Trump, who is expected to sign it.

So what exactly is in that legislation?

— Direct payments of $1,200 to millions of Americans, including those earning up to $75,000, and an additional $500 per child

— $100 billion for grants to hospitals, public and nonprofit health organizations and Medicare and Medicaid suppliers, including a 20% bump in Medicare payments for treating patients with the virus

— $221 billion in a variety of tax benefits for businesses, including allowing businesses to defer payroll taxes, which finance Medicare and Social Security, for the rest of the year

— More than $25 billion in new money for food assistance programs, like SNAP

— Expanded jobless aid, providing an additional 13 weeks and a four-month enhancement of benefits, and extending the payments for the first time to freelancers and gig workers

— $377 billion in federally guaranteed loans to small businesses and the establishment of a $500 billion government lending program for distressed companies

— Millions in aid for states to begin offering early voting or voting by mail

— A rule that blocks foreclosures and evictions during the crisis on properties where the federal government backs the mortgage

— The suspension of federal student loan payments for six months and waives the interest

Predictably, some sectors (like cruise ships) were unhappy with being left out, but for once some people were pleased — for example, the hospital industry, which got the $100 billion it asked for.

For those of you, like me, who love a good tick-tock, here are a few inside looks at how Senate leaders and White House advisers struck a quick, expansive deal in a Washington that typically seems incapable of compromise.

The New York Times: As Coronavirus Spread, Largest Stimulus in History United a Polarized Senate

Politico: Inside the 10 Days to Rescue the Economy

The Washington Post: The Dealmaker’s Dealmaker: Mnuchin Steps In as Trump’s Negotiator, but President’s Doubts Linger With Economy in Crisis

The urgency of the legislation was underscored by an astronomical jump in jobless claims this week. Nearly 3.3. million Americans applied for benefits, up from 200,000 during pre-outbreak days. The “widespread carnage,” as one economist put it, is expected to get worse. While the stimulus package is expected to help mitigate some of the devastation, many have said it should be looked at as just the beginning.

It seemed strangely appropriate this week that the health law turned 10 amid a pandemic — the legislation’s journey to here has been anything but smooth, why should this anniversary be? But one ripple effect of the pandemic and economic fallout might actually be a boost to the health law, which is likely to serve as a crucial safety net for many Americans who possibly lost their employer-sponsored coverage in the past few weeks. States have already started reopening their marketplaces, and the federal government is being urged to follow suit.

Trump chafed this week at the drastic measures states are putting in place to try to curb the outbreak, raising eyebrows when he said he’d like to see church pews full by Easter. Public health experts have warned that lifting the social-distancing measures would result in a surge of cases that slam an already stretched-thin hospital system. But for Trump, who has tied his reputation to the well-being of the stock market, the economic toll seems too much. (The rhetoric also started a truly bizarre push from conservatives for older Americans to sacrifice themselves for the good of the country.)

The president’s most recent proposal to kick-start parts of the country is identifying places by risk level and applying strategies to match. But experts, like Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, warn that even “cool spots” that aren’t seeing many cases might be in for a surge coming down the pike.

Meanwhile, Gov. Andrew Cuomo has said that New York’s experience presages America’s future. But some say that’s not necessarily accurate. Leading specialists say that while it is likely that devastation similar to New York’s will emerge in other places, there’s hope that in lower-density areas, where there are fewer factors like mass transit to exacerbate the spread, the outcome might be different.

Realistically, though, Americans will need to eventually think about returning to normalcy. Are there exit strategies from this complete lockdown that would work effectively? Here’s the problem: All the experts say success relies on extreme, aggressive and widespread testing to isolate the sick before they can give it to anyone. This has not exactly been America’s strong suit in recent weeks.

There are two storylines that have taken hold to demonstrate how much this pandemic will strain the hospital system, the first being the lack of ventilators available. States and hospitals have been pleading with the federal government to invoke war powers to jump-start the manufacturing process on the equipment. This comes as doctors are being forced to split ventilators between patients (a risky practice), planning to make the tough ethical decisions to ration care, creating policies to not resuscitate, searching for alternative treatments despite the dangers they might pose, and being warned that morgues are reaching capacity.

But Trump, who had been set to announce a partnership with GM to produce up to 80,000 ventilators, balked this week at the $1 billion price tag that came with it. “I don’t believe you need 40,000 or 30,000 ventilators,” he said, in a reference to New York, where Gov. Andrew Cuomo has appealed for federal help in obtaining them. “You go into major hospitals sometimes, and they’ll have two ventilators. And now all of a sudden they’re saying, ‘Can we order 30,000 ventilators?’”

The second notable thread throughout the country is a lack of personal protective equipment for health care workers on the front lines of the epidemic. There might be a long medical tradition of accepting elevated risk in the middle of a crisis, but many health care workers are frustrated that they’re being put in that position. Some are resorting to using hand-sewn masks, which do little to protect them and trash bags for surgical gowns. But others are drawing a line in the sand.

Meanwhile, something that might get missed with everyone’s attention directed at the coasts: Atlanta’s mayor is warning that its hospitals are at capacity.

Gilead, whose antiviral drug is getting a lot of buzz, was granted orphan drug status for the treatment because there are fewer than 200,000 cases of COVID-19 in the States right now. The designation would have granted Gilead lucrative perks, like the ability to keep generic competitors from the marketplace. But the news was meant with rage-filled incredulity from, uh, pretty much everyone, and so the company rescinded the request. As one expert said: “I think it’s embarrassing to take something that’s potentially the most widespread disease in the history of the pharmaceutical industry and claim it’s a rare disease.”

Meanwhile, an antimalarial drug is getting tons of attention after Trump touted it as a possible game changer. But a new, more carefully constructed study that finds it did little to help patients in China shows why people shouldn’t be looking for a quick, miracle cure. Researchers say this doesn’t disprove that the drug works but is a good check on expectations, especially when people are trying to self-medicate with the drug — resulting in shortages for those who need it for other illnesses and fatal consequences for others.

On the good-news front (there is some!), Moderna said there could be a vaccine ready for the fall for health care workers under emergency use authorization, ahead of the wider release that’s not expected to come for about a year.

And another treatment that some scientists are hopeful about is the practice of injecting recovered patients’ blood into new patients. The strategy is at least a century old but has scattershot results. “It’s not exactly a shot in the dark, but it’s not tried and true,” says one scientist. Still, in this era, people are willing to try what they can.

And here are some other interesting stories to get you through the weekend.

Federal Response:

Politico: Trump Team Failed to Follow NSC’s Pandemic Playbook

Politico: Those Who Intentionally Spread Coronavirus Could Be Charged As Terrorists

The New York Times: As Coronavirus Surveillance Escalates, Personal Privacy Plummets

2020 Elections:

The New York Times: Joe Biden, Struggling for Visibility, Faults Trump’s Response to Coronavirus

The New York Times: Is All of 2020 Postponed?

From The States:

Stateline: One Governor’s Actions Highlight the Strengths — and Shortcomings — of State-Led Interventions

The New York Times: Governors Tell Outsiders From ‘Hot Zone’ to Stay Away as Virus Divides States

NBC News: Entire Senior Home in New Jersey, 94 People, Presumed to Have Coronavirus

Science And Innovation:

The New York Times: The Virus Can Be Stopped, But Only With Harsh Steps, Experts Say

The New York Times: Warmer Weather May Slow, But Not Halt Coronavirus

The Washington Post: What Research on Coronavirus Structure Can Tell Us About How to Kill It

The Washington Post: The Science of Why Coronavirus Is So Hard to Stop

Reuters: Smokers Likely to Be More at Risk From Coronavirus: EU Agency

Public Health:

ProPublica: Domestic Violence and Child Abuse Will Rise During Quarantines. So Will Neglect of At-Risk People, Social Workers Say.

NBC News: Anti-Abortion Groups Seek Halt to Abortions During Coronavirus Pandemic

Politico: New York’s Health Care Workforce Braces for Influx of Retirees, Inexperienced Staffers

That’s it from me! Have a safe and healthy weekend!





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