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But the government can do little at this stage to address a glaring weakness in the U.S. health system. America has relatively few hospital beds, and hospitals probably have too few ventilators. And in case of a large outbreak of the virus, they could find it hard to handle a surge of patients, as is the case now in Italy.
According to a recent study from Johns Hopkins , U.S. hospitals have 160,000 ventilators — 62,000 full-featured ventilators, and 98,000 more basic ones that can be used in an emergency. There are an unknown number in the national stockpile; one critical care surgeon with knowledge of the industry told us it's probably only about 20,000.
That may not be anywhere near enough. COVID-19 is a brand new disease, and a lot of the estimates are based on long-ago flu pandemics. But reputable projections for how much ventilator capacity we may need range from a manageable 64,000 if it's like the 1957 flu — to around 740,000 if it's more like the 1918 "Spanish flu."
And while the infusion of more money thanks to Trump's emergency declaration will help, it's not clear whether it will happen soon enough . The president only said his order would increase the powers of the Department of Health and Human Services, the lead agency thus far in the administration's coronavirus response. Under his order, HHS will be able to waive certain Medicare, Medicaid or Children's Health Insurance Program requirements in an effort to bypass time-consuming regulations.
This crisis is exposing other shortcomings in the U.S. system — To save lives, hospitals need critical care beds, isolation facilities, triage areas — and doctors, nurses, respiratory therapists and a throng of support personnel. According to a World Bank report, Japan for instance had 13.4 beds per 1,000 and US at 2.9 per 1,000. (Italy is just a bit higher than the U.S at 3.4.)
Hospitals can add beds to meet a surge — turning an ambulatory unit into an acute care division, for instance. But if the caseload keeps building, it may not be enough. Some states, like New York, are already looking for sites for temporary hospitals.
"The fears that the United States could become like Italy — that's the worst case scenario that people worry about," Elaine Batchlor, CEO of Martin Luther King Community Hospital, which serves mostly poor patients in South Los Angeles told us. She's already making plans to house more patients, including possibly triage tents.
Here's what to watch for over the weekend:
The case load: The virus has been spreading fast. Will the pace flatten at all? This (and testing capacity) is the single most important thing to track. We've been relying on a Johns Hopkins website to track the spread but it's temporarily offline. The New York Times has a good map.
Social distancing: Getting people to change their behavior — to change social norms — usually takes years. Now, we've got days. But hunkering down, avoiding crowds, telecommuting are the best tool we have to reduce transmission. Canceling the NBA season, turning out the lights on Broadway or closing the National Zoo got people's attention. We'll see whether it makes a dent.
Testing capacity: Trump promised yet again that tests would be available very soon to anyone who needs one. (He's right that the "worried well" should skip it!) Several private sector partners joined him at the press conference. Commercial labs like Quest and LabCorps and pharmacy chains will have drop in, or even drive-by, testing sites. Google is developing a website that will help people determine whether they need to get tested — or can safely stay home and nurse an old-fashioned cold.
Look for more from POLITICO's Executive Health Care Editor Joanne Kenen on POLITICO on Saturday.
Speaking of testing, POLITICO's Adam Cancryn and Adrienne Hurst dive into the missteps and next moves made thus far in coronavirus testing in the latest edition of POLITICO Dispatch, a new podcast from POLITICO's newsroom.
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Welcome to POLITICO Nightly: Coronavirus Special Edition, a nightly intelligence brief from our global newsroom on the impact of the coronavirus on politics and policy, the economy and global health. Reach out: rrayasam@politico.com and @renurayasam.
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HIGHER SPIRITS — Americans are starting to feel less panic about the threat of virus, according to Elucd's National Coronavirus Preparedness Tracker. The daily survey of about 450 American adults, provided exclusively to POLITICO, showed a 20-point one-day drop in the number of people who said they feel "very worried" about the possibility of serious harm to themselves or a loved one and a 10-point increase in people who say they are confident the economy will recover.
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DOWN TO THE WIRE — Even with a crisis this big and urgent, House Democrats and the White House have struggled to cut a deal aimed at buoying affected Americans. After days of frantic negotiating and frequent phone calls, House leaders raced to pass a bill before they recess Friday as fear of the virus spread grips the Capitol and the nation. Treasury Secretary Steve Mnuchin and House Speaker Nancy Pelosi exchanged 20 phone calls on Thursday. And on Friday after almost tanking the negotiations several times, Trump finally tweeted his support for the bill, which will include paid sick leave provisions, free food for poor kids whose schools closed and free testing.
The House is set to vote on the bill Friday night. The Senate, which canceled its recess next week, could vote as soon as Monday.
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Question of the day: What's the best thing the federal government can do with the power of its purse right now? (Responses have been edited for length and clarity.)
"This crisis is brought upon by a virus, not any dumb action. My advice has been to have a federal payroll tax holiday. There's a great incentive for people to not stop working and costs to firms have been reduced a great deal. ... Free markets are most essential in times of crisis. That is when you take your hands off the wheel and let markets steer. However, it is in times of crisis that most governments do something stupid. ... Whenever people make decisions when they are either panicked or drunk, the consequences are rarely attractive. ... When I was with Reagan in '87 my motto was... don't just stand there, undo something." — Arthur Laffer, economist who has advised Presidents Ronald Reagan and Donald Trump
"There is one very large difference between virus economics and regular business cycle economics, which is with virus economics the most important thing you can do for the economy is slow the spread of the virus. ... The best [thing] to do [after that] would be to start by having the federal government entice states to cut their sales taxes. At a moment of fear the large amount of money you are sending to people as an income tax cut, they aren't going to spend." — Austan Goolsbee, chairman of the Council of Economic Advisors in the Obama administration.
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Passengers walk through Terminal C of Logan Airport in Boston. | Getty Images
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| From The Transportation Desk |
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TRAVEL BUGS — Travel bans , conference cancellations, lockdowns — they could all be for nothing if front line airport security workers don't step up screening measures, POLITICO Transportation Editor Kathryn Wolfe tells us. Wolfe and her team have been tracking reports from travelers who say customs and security agents aren't checking their travel history or whether they show virus symptoms when they pass through American airports. Travelers aren't even getting information about what to do if they show symptoms later on.
Is it a security screening hole that front-line workers fail to follow orders — or that federal officials haven't coordinated a response at all?
The logistics of stepping up screening are complicated. Some airports in Asia, for example, require people to pass through temperature scanners to flag whether they have fevers. Any measures likely would add to travel times and may require more airport staff. Wolfe also points out that there's no bulletproof response — people can evade travel bans and lie about symptoms. Still additional screening measures could help slow the virus spread.
"I would also say there's not a perfect system," she said.
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VIRAL VOTING — Election Day turnout is a massive wild card with a nationwide shutdown. One thing to watch, POLITICO's Zach Montellaro tells us, is turnout in states that see a lot of voting on Election Day, as opposed to heavily early and mail-in voting states. Will voters stay home to try to minimize their risk?
Louisiana isn't risking it. It became the first state to postpone its primary, kicking its April 4 primary to late June. The state, somewhere in the middle of the pack in delegates allocated in the race, likely was not going to be a linchpin in either of the remaining candidates' electoral strategies. And Wyoming Democrats also canceled in-person caucusing, opting for mail-in balloting only.
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Patterson Clark/POLITICO
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HOW TO GOVERN WHEN QUARANTINED — You'd never know Justin Trudeau was self-isolating, POLITICO's Ryan Heath notes. The Canadian prime minister conducted TV and radio interviews from his house and announced a raft of aggressive containment measures — including closing some airports to international flights and closing Parliament until April 20 — in a live address to the nation.
Earlier today he tweeted a picture of himself at his desk, captioned: "Busy day ahead, working from home. Meetings with my cabinet, the country's premiers, national Indigenous leaders, and more." Canada's public health officer Dr. Theresa Tam led the charge advising Canadians how to respond to the risks they face.
And in Bucharest, Romania's caretaker PM Ludovic Orban was asked by Romanian President Klaus Iohannis to try to form a new government by phone, despite being in isolation. Orban lost a confidence vote in Parliament last month. |
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People across the country are stocking up on toilet paper, canned goods — and cannabis products. Kyle Kazan, CEO of California cannabis company Glass House Group, said his company has seen retail marijuana sales grow 4.1 percent in the past week. Demand for the company's marijuana deliveries grew 50 percent in Santa Barbara and 24 percent in Los Angeles. "There's a whole new normal coming in the next week or two," Kazan told POLITICO's Mona Zhang. "I see a recession coming and I'm happy to be in cannabis," said Kazan, who pointed to vice industries like alcohol doing well during recessions.
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