POLITICO NIGHTLY: Covid's war on women

By Ryan Heath and Renuka Rayasam

Presented by

COVID'S WAR ON WOMEN — During this plague year, there is almost never good news, only degrees of bad news. Even so, the pandemic has been different (and worse) for girls and women. It's true that more men are dying than women from Covid-19 around the world — but that's not exactly cause for celebration. Another ambivalent data point: More workplace risk is falling on women, who are more likely to be considered essential workers. The upside to that is still having a job, but at what price? Sweden's Foreign Minister Ann Linde pointed out today in a POLITICO interview that "70 percent of those working in health care and elderly care are women." More of the daily grind tends to fall, on average, on women: From the increased cleaning and chores that come with more time spent in the home, which falls disproportionately to so many female household members, to the extra education and childcare work created through closures of school and day care, where men have also been known, on average, to skimp. The real-life examples are heartbreaking: Alice Jorge, a woman living with a disability in Belgium who needs support from her sister and a visiting nurse, was recently asked to choose between keeping her Covid-19 positive caregiver or going without professional care. Three women bound to suffer no matter what choices they took. Domestic violence is up sharply: A new research report by a consortium that includes Johns Hopkins University confirms this: 31 million additional cases of gender-based violence can be expected globally if lockdowns last for an average of six months. Travel to shelters may be restricted, and a simple phone call to a helpline can itself trigger new violence. Support services are overwhelmed with requests: from a 47 percent increase in calls to Spain's national hotline to a 113 percent spike at U.N.-supported hotlines in Ukraine. We can expect 7 million unplanned pregnancies in 144 low- and middle-income countries, thanks in part to restricted access to contraception, not to mention the 2 million female genital mutilations and countless child marriages projected to increase by the United Nations' population agency. "The pandemic is deepening inequality," UNFPA Executive Director Natalia Kanem said, slamming the "Swiss cheese of a safety net" she sees in most countries. Kanem speaks of childbirth horror stories: pregnant women unable to access caesarian procedures (many of which are unplanned) or blood pressure medication because of redeployed health care resources, or "the woman gets to the clinic (and) the midwife isn't there," because they're also redeployed or sick. Up to two-thirds of maternal and neonatal deaths globally occur because of the absence of properly trained midwives in better times. During World War II, women on the U.S. homefront — think Rosie the Riveter — entered the workforce out of a call to sacrifice for the common good. During this pandemic, women are being called back — but this time to the frontlines. Welcome to POLITICO Nightly: Coronavirus Special Edition. Of course Matthew McConaughey's mask says "just keep livin." Reach out with tips: rrayasam@politico.com or on Twitter at @renurayasam.

A message from PhRMA: In these unprecedented times, America's biopharmaceutical companies are coming together to achieve one shared goal: beating COVID-19. We are sharing learnings from clinical trials in real time with governments and other companies to advance the development of additional therapies. Explore our efforts.

First In Nightly

THE COVID DOCTRINE — For much of the nation's 100 days at war with the coronavirus, Donald Trump has been a commander in chief in search of an exit strategy, Adam Cancryn writes. The president has promised the virus will simply disappear, touted unproven treatments as miracle cures and fantasized about a near future of economic resurgence and rapid return to normalcy. Yet as the White House shifts its focus away from the public health response and toward rebuilding an economy ravaged by the pandemic, there remains little clear sense — even within his own administration — of how close the U.S. is to victory, and what "winning' the war even looks like.

WILL ILLINOIS' LATEST STAY-AT-HOME ORDER STAY IN EFFECT? Illinois Gov. J.B. Pritzker's latest stay-at-home order faces a court challenge from downstate conservatives. What would lifting it mean for the state's efforts to contain the coronavirus pandemic? Join Shia Kapos and Natasha Korecki tomorrow at 11 a.m. CST for a virtual discussion on the likely outcome, Pritzker's relationship with the White House, how Covid-19 could impact turnout in the election, and a look at Joe Biden's efforts to campaign and raise money from Chicago megadonors at a time when the virus has him physically sidelined. Have questions? They'll answer as many as they can. REGISTER HERE TO PARTICIPATE.

From the Health Desk

PINS AND NEEDLES — Our executive health editor Joanne Kenen emails: There's some good news on the vaccine front — including word that the country is getting a new vaccine leader. Peter Marks has emerged as the Trump administration's unofficial vaccine czar (minus the cross and pearls) at the FDA, filling in the gap created by the abrupt ouster of Rick Bright from the Biomedical Advanced Research and Development Authority. Marks will advise BARDA and other agencies on vaccine and gene therapy approval, health care reporter Sarah Owermohle reports. News of Marks' growing involvement comes amid a spate of heartening — though still, we can't emphasize enough, very preliminary — news about vaccine development, here and abroad. Oxford has a candidate vaccine that's safe in humans; it's still testing whether it can create a strong enough immune response to combat the coronavirus. Three other companies have announced accelerations of clinical trials, though widespread availability in the best possible scenario is still months away. Even if we get a vaccine, Joanne writes, big questions have to be answered. Who gets it second? First responders will get it first. But how are we going to define a first responder? Anyone who works at a hospital? Only doctors and nurses? Doctors in the community? Police? Firefighters? The military? But then who gets it second? The elderly and immune compromised because they are vulnerable? The young and healthy because they transmit it? Essential workers because they're essential? The well-connected? And who decides? It's possible several vaccines will come on the market at around the same time in different countries, so there could be multiple answers to this question. But this is going to be a huge bioethical knot, colliding with geopolitics. There's no guarantee that a U.S. company will get to market first — and if the World Health Organization has a role in vaccine allocation, we can anticipate some obvious conflicts. How effective is it? If we get a good but not great vaccine — like the seasonal flu shots — it will still reduce transmission, but it won't wipe out the virus completely. We'll still have to deal with Covid-19, though on a more manageable scale. Who pays for it? Even if insurers, governments or, in countries other than our own, national health systems pay for immunization, the costs can be passed on indirectly through higher taxes or higher premiums. How much does it cost? Some of the companies say they don't plan to make a profit, but vaccines are expensive. In the U.S., Trump has largely shunned national approaches, leaving states to fend for themselves as they try to acquire lab testing supplies, protective gear, ventilators and other essential pandemic-fighting goods. A similarly fragmented approach could make vaccine acquisition more expensive and complicated. How do we make enough of it? One of BARDA's roles is to help ramp up production, and they've started addressing this. But to make 7 billion vaccines, enough for everyone around the globe, will require commitment, creativity and cooperation that the world hasn't been very good at of late. How fast will poor countries get access? Good question. Will the anti-vaxxers take it? We'll see. Best guess is that some will, and some won't, because not everybody who opposes vaccines does so for the same reasons or with the same intensity. Some people who don't want their child to get a measles shot may weigh the costs and the benefits differently for a coronavirus vaccine. Amid rising fears of bioterrorism after 9/11, a poll found deep but not overwhelming support for a smallpox vaccination campaign. But that was a hypothetical threat. This one is all too real. A SMALL BREAKTHROUGH — More than three decades ago, researchers made their first big breakthrough against HIV, when they showed that the drug AZT could slow the progression of the virus. It's a moment that Anthony Fauci compared to today's results about the drug remdesivir, which a clinical trial showed could help Covid patients recover more quickly. Fauci's reference to AZT was a bit like a secret code, Sarah Owermohle tells us. He was suggesting that the remdesivir results were a breakthrough, but a modest one. AZT is the shorthand for azidothymidine, a drug that won FDA approval in March 1987, when HIV patients were desperate for any treatment — even one with rough side effects that was dogged by questions about whether it actually extended life. It took another decade before the development of drugs that turned HIV from a death sentence into a chronic condition. HIV and Covid-19 are complex, but distinctly different, viruses, and drug development times are a lot faster now than they were in the 1980s and '90s. But Fauci's implication was clear: Remdesivir could be a good first step in fighting Covid, but probably isn't a miracle drug.

On The Economy

A SICK ECONOMY — The U.S. economy shrank at a 4.8 percent annual rate last quarter as the pandemic shut down much of the country. A huge percentage of the decline came from the health care industry, with a halt in elective procedures harming profits.

CLAIMS DENIED — As businesses in Georgia, Texas and other states throw open their doors, many employees are scared that their employers aren't taking proper health precautions. Yet if they refuse offers to return to their jobs they'll be ineligible for unemployment, reporter Megan Cassella tells us. Trump has declared meatpacking plants essential businesses even as they spawn outbreaks across the country. Frontline health workers are having trouble getting masks, gloves, gowns and other protection equipment, so what hope do nail salons and restaurants have of getting the gear they need? But for now, Covid fears aren't a valid reason not to go back to work. Some states are trying to take steps so that workers who feel unsafe aren't forced to choose a paycheck over their health. Colorado and New York are looking at how to give workers more flexibility. In Georgia, the state labor agency is encouraging employers to negotiate back-to-work plans with employees so that if a business partially reopens, workers who feel unsafe can continue to collect unemployment. In Texas, advocates are asking the workforce commission to add "voluntarily leaving work due to COVID-19" as a valid reason to claim assistance. But other states, like South Carolina and Tennessee, are telling workers they will lose unemployment aid the same week they turn down an offer. Even in boom times, states reject a high share of unemployment claims. We'll probably learn Thursday that another 3.5 million people filed for unemployment assistance last week. That's on top of the 26 million who've already lost their jobs in the past five weeks.

Ask The Audience

Our question for readers this week: Seeing any interesting, fun or meaningful signs related to the coronavirus? Snap a photo sometime this week and send it to Renu at rrayasam@politico.com, and we'll share the best ones on Friday.

PUNCHLINES

GRAND OLD PACHYDERM — Matt Wuerker dives into an old question on partisan symbols in the latest edition of Punchlines: Why is the elephant the symbol of the Republican Party?

The Global Fight

MASS HYSTERIA — Italian politicians clash with the Catholic clergy at their own peril, and Prime Minister Giuseppe Conte has risked doing just that by keeping churches closed because of coronavirus. The prime minister's decision to extend the ban on all religious ceremonies until further notice, except for funerals, has infuriated religious officials. When the lockdown started, most priests quietly accepted the need to suspend services and found alternative ways to connect with their flocks, such as holding ceremonies by video or taking confession by the roadside. But now that other places are gradually reopening, the clergy don't see why they should be last on the list.

TOMORROW - CAN VIRTUAL CARE FILL A GAP FOR WOMEN'S HEALTH IN THE AGE OF COVID-19? Telemedicine and remote care have boomed in in recent weeks. Join Women Rule Editorial Director Anna Palmer tomorrow at 4 p.m. EDT for a virtual conversation with Carolyn Witte , CEO and co-founder of Tia, a membership-driven women's health care platform and clinic. How can women better prioritize their health? Can virtual care can fill a gap in women's health care during the current crisis? How will this pandemic transform women's health care in both the near and long-term future? Have questions? Submit yours by tweeting it to @POLITICOLive using #AskPOLITICO. REGISTER HERE TO PARTICIPATE.

Nightly Number

82,000 The number of job losses forecast in the bus industry, according to a report released last week by the American Bus Association. The industry could see losses of up to $14 billion. Many of the 3,000 private bus companies in the U.S. are small, serving a range of uses from taking kids to school, sporting events and field trips, ferrying seniors on weekend getaways and connecting small towns with major destinations. (h/t transportation reporter Tanya Snyder)

Portuguese army chief of staff Gen. José Nunes da Fonseca attends a briefing of school workers on disinfection procedures. | Armando Franca/AP Photo Parting Words DEEP FRIED STATE — Belgium, the North Sea homeland of moules frites and mayonnaise, is the world's biggest exporter of frozen fries, but it has been hammered by the pandemic's trade slowdown. The Belgian potato industry has warned that more than 750,000 tons of potatoes could be thrown away — more than 40 percent of the harvest. And though Belgium's potato industry has urged patriots to take a high-calorie hit for the team by heading down to their local friteries twice a week to help reduce the spud surplus, it's increasingly clear that 11 million Belgians won't be able to handle the deep-fried mission alone. With restaurants and bars closed, and large summer events canceled, fries won't be as ubiquitous as they often are this summer. "Our entire sector is facing a big crisis. We don't just invite all Belgians to eat more fries, but the entire world," said Ward Claerbout from Agristo, a potato processing company in the west of Belgium. Correction: Tuesday's edition of POLITICO Nightly incorrectly stated which tracks Iowa will open without spectators. The state will reopen certain race tracks without spectators but not horse and dog tracks. We regret the error.   A message from PhRMA: In these unprecedented times, America's biopharmaceutical companies are coming together to achieve one shared goal: beating COVID-19. The investments we've made have prepared us to act swiftly: · Working to protect our workforce and the communities where we live and work, having employees work from home whenever possible and keeping our salesforces out of hospitals and physicians' offices · Remaining steadfast in our commitment to research and develop new medicines to prevent, treat and cure disease in all its forms, not just COVID-19 We all have unique roles to play and are confident that together we can be successful. And we won't rest until we are. Explore our efforts.   Did someone forward this email to you? Sign up here.   Follow us on Twitter Renuka Rayasam @renurayasam   Follow us

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