POLITICO NIGHTLY: How bad will the jobs number be?

By Victoria Guida and Renuka Rayasam Presented by Matt Wuerker 20 PERCENT UNEMPLOYMENT? — As protests continue throughout the country over police brutality toward black Americans, it’s worth remembering that we’re still in the middle of a severe recession. The monthly jobs numbers for May, which will be released Friday, are expected to show we’ve reached 20 percent unemployment, and that’s falling particularly hard on minorities. Fewer than half of black adults are now employed, according to Labor Department data. Brace yourself for more jobless claims in the weekly report Thursday morning. Economists are expecting the federal government to announce that around 1.8 million new people filed for unemployment insurance last week. That’s part of a steady improvement since late March, when weekly claims soared as high as 6.8 million. But it’s still a distressingly high number — in February, the numbers were in the 200,000s. Before the pandemic, the weekly record was under 700,000, in 1982. There’s some hopeful news coming out of the payroll data from ADP, which said 2.76 million private sector jobs were lost in May, compared with expectations of around 9 million. One possibility is that those numbers have been helped by the Paycheck Protection Program — the government-backed loans designed to help small businesses keep workers on payroll. But it’s hard to know whether the ADP numbers are actually showing us the full picture. “The ADP number will miss furloughs: employees who are formally kept on but set at zero hours … so ADP may be underestimating the pain we see on Friday,” said Ernie Tedeschi, a policy economist at the financial research firm Evercore ISI. “It could be that PPP firms are choosing to furlough their employees as a lower-risk strategy. If so, those furloughs would show up as employment in ADP but nonemployment on Jobs Day.” The upshot: Things are bad, but it’s hard to know how bad. “Even if the official number on Friday is ‘better’ than expected, it's probably still going to miss a lot of disruption in the labor market,” Tedeschi said. “I'm not sure the true pain in May was much better than the true pain in April.” All of the awful elements plaguing us right now — the pandemic, the economy, police brutality, looting — have the potential to feed into one another, particularly if mass gatherings in the streets lead to a new outbreak of the coronavirus. That would extend and worsen the economic pain, not to mention the horrible health toll of the disease. Some small businesses are suffering from property damage, but the big economic concerns from the protests and clashes with police over the past week are driven by public health, not broken windows. Welcome to POLITICO Nightly: Coronavirus Special Edition. In a sign of the times, LeBron James criticized Drew Brees today for saying he disagrees with players who kneel during the national anthem to protest police brutality. Reach out with tips: rrayasam@politico.com or on Twitter at @renurayasam.   A message from PhRMA: In these unprecedented times, many Americans may find it harder to afford their medicines this month. PhRMA member companies are dedicated to helping patients access resources when they need them most. Our Medicine Assistance Tool was built to connect patients with resources that may help lower out-of-pocket costs.   First In Nightly VACCINE POLITICS — Peter Marks spent nearly a decade at the Food and Drug Administration, most recently overseeing the office that approves vaccines and gene therapies, health care reporter Sarah Owermohle writes. The cancer specialist quit last month, just days after joining President Donald Trump’s Operation Warp Speed, a venture that partners the government with private companies in the vaccine race. After a clash during a tense meeting with White House coronavirus coordinator Deborah Birx about how the government was prioritizing potential vaccines, he returned to his old FDA job full-time, according to three people familiar with the event. Marks’ abrupt switch was the latest sign of the FDA’s struggle to fend off outside political pressure, particularly from the White House, during the desperate search for a coronavirus cure. The unprecedented effort by the White House to intercede at an agency that’s supposed to make independent judgments based on medical science is raising alarms among health experts inside and outside the administration. POLITICO spoke with six current or former senior HHS officials and three other people familiar with the White House coronavirus response. Several expressed concerns that FDA Commissioner Stephen Hahn, confirmed to his role just a month before the coronavirus reached the U.S., has not been a strong enough voice for an agency charged with regulating drugs and vaccines. Some acknowledged friction between FDA officials and White House and coronavirus task force members. “You just know that they are just under enormous pressure. But look what happened to Rick [Bright]. Look what happens to anyone else who has resisted pressure,” one former health official said. Actor John Boyega speaks during a Black Lives Matter protest today in London’s Hyde Park. | Getty Images From the Health Desk HOW TO FIX NURSING HOMES — A recent federal report found that a quarter of Covid-19 deaths — 26,000 in all — were from nursing homes. And that’s probably an undercount. Executive health care editor Joanne Kenen talked with David Grabowski, a professor of health care policy at Harvard Medical School and one of the leading U.S. experts in long term care, about what’s happened in nursing homes and what has to change. The conversation has been edited. When we hear about tragedies in nursing homes, we tend to automatically think about poor quality horror story homes, where people just don’t get decent care. Is that what’s happening with the coronavirus? There are good nursing homes and bad nursing homes — and the bad get lots of attention in this country. When they are bad, they can be really bad. But it turns out that Covid is all over the country — in five-star facilities and one-star facilities, with strong infection control records and with poor infection control records. It turns out that it’s related to where the facility is. The policy answers we typically have — regulation, oversight and punishment — aren’t the solution. We need to test the staff who are bringing Covid in, the silent spreaders. We need meticulous infection control and more PPE. Few states have that in place. I’ve been saying this since March and people tell me “You were ahead on this,” and I say, “No, I think our government is behind on this.” What else do we have to do to prevent, or at least minimize, the coronavirus in nursing homes? The workforce is incredibly fragile right now — emotionally, physically, financially. They need hazard pay, sick leave. Many are earning around minimum wage, and they are thinking, “I didn’t sign up for this.” If a second wave comes, they are exhausted, they have been working long hours and it’s time to pay them a rate commensurate with what they are providing. You’ve noted that we spend a lot of time talking about, and arguing about, health care in this country — but not about nursing homes and long term care. Will the pandemic change that? Many of us view it as a family issue, but it’s a massive policy issue. When we have such poor infrastructure, low payments, lack of regulation or quality oversight — we see outcomes like this. I’m hopeful this pandemic will see us down a path of real reform. The way we set up Medicare and Medicaid, we left long-term care under Medicaid, and that left it up to each state. It’s time to federalize the long-term care portion of Medicaid. Start to pay a uniform — and higher — rate across the states. That’s the first step. ANOTHER COST OF COVID — Mounting unemployment is setting the stage for yet another crisis: Tens of millions of people have already lost health coverage because of pandemic-related job losses, according to two recent studies from the Urban Institute and the Kaiser Family Foundation . Some people who lose their jobs may qualify for government programs, especially in the 36 states, plus D.C., that expanded Medicaid to working-age adults. Others may qualify for subsidies to help them buy health coverage on Obamacare exchanges. But up to 27 million adults and children may be left without any sort of coverage. The rise in the uninsured is both a financial crisis and a health one. It threatens already-strained state budgets and cash-strapped providers. And it means that more people will go without care. For people with chronic conditions like diabetes or asthma, that puts them at higher risk for dying from Covid. Nowhere is the situation more dire than in Texas . The state has the highest number (5 million) and share (nearly 18 percent) of uninsured residents in the country. The studies say that an additional 1 million Texans could lose insurance, which would blow up the state’s cobbled-together health care safety net. (Texas is one of the 14 states that have not expanded Medicaid under the Affordable Care Act.) People who don’t have insurance often wind up getting more expensive, last-minute care in emergency rooms. About 55 percent of the patients at Houston’s Harris Health System, the county’s safety net health care provider, do not have insurance coverage. Harris County has the highest uninsured rate within Texas, and more than 200 people there have died from Covid. Harris Health is now seeing a large number of its patients, disproportionately racial minorities, suffering from coronavirus, said Esmaeil Porsa, president and CEO at Harris Health System. Adding people with untreated chronic conditions when a second virus wave hits could lead to more deaths, he said. “I’m worried about us being inundated,” Porsa said. Because Texas isn’t taking steps to cover the newly uninsured, more people will needlessly die from the virus, he said. “We are kind of artificially increasing the total number of patients who are going to be afflicted with Covid-19. That’s what worries me.”   FOR NEWS AND CONTEXT YOU NEED IN 15 MINUTES OR LESS, LISTEN IN: The coronavirus death count passed a grim milestone in the U.S. as a growing number of regions reopen parts of their economies. Unemployment claims continue to pile up as the virus continues to spread. POLITICO Dispatch is a short, daily podcast that keeps you up to date on the most important news affecting your life. Subscribe and listen today.     Talking to the Experts How concerned are you about the president’s suggestion that he’s going to activate the U.S. military and use it for law enforcement purposes, both in D.C. and potentially in cities and states around the country? “In the case of a real disaster — like hurricanes or floods — communities have welcomed military assistance. But this is something of a far different nature. We’re at a very delicate point. In particular cities and other jurisdictions, so many departments have worked very hard to build community trust. I know many, many chiefs who have worked diligently at this for a long period of time. And we’re at a point where no events are “local” anymore because of social media and communication. What happened in Minneapolis, it’s as if it happened next door — as has been clear in the last week. Whatever trust has been built is on shaky ground now, and sending our military to suddenly be on the ground in many communities — unless it were desperately needed — would be a tragic mistake.” — Laurie O. Robinson, co-chair of the Obama-era President’s Task Force on 21st Century Policing, as told to POLITICO Magazine’s Zach Stanton in an interview     Ask The Audience With so many crises gripping the nation, what worries you the most right now and why? Is it coronavirus, the economy, racial injustice, policing, protests, the 2020 election or something else? Please write us and we’ll include some answers in our Friday edition. The Global Fight SWEDEN’S DR. NO-LOCKDOWN — Sweden’s top public health official, state epidemiologist Anders Tegnell, said the country’s distinct approach to containing the coronavirus — most schools, restaurants and other businesses remained open — was mostly right, Charlie Duxbury writes. But when he said that the nation had room to improve , Tengell galvanized critics, who swooped in with attacks. Neighboring countries imposed a rapid lockdown, but Sweden instead allowed a slow spread of the virus while protecting vulnerable groups, especially the elderly. As the death rate has mounted, particularly among the elderly in care homes, concern about Sweden’s approach has grown. The number of deaths per million in Sweden, at 450, is below the worst-hit countries in Europe, including the U.K. and Spain, but it has now spiked to 10 times that of Norway and eight times that of Finland. “It cannot go on like this,” said Lena Einhorn, an author, virologist and high-profile critic of the Swedish approach. “If you look at the curves, Sweden is the only one among the high-death countries, with the possible exception of the U.S., which is staying high.” CHINA DOES NOT CONTROL WHO, NORWAY SAYS — The prime minister of Norway rejected Trump’s claim that the World Health Organization is controlled by China, and criticized his May 29 decision to leave the organization, Ryan Heath writes. Norwegian Prime Minister Erna Solberg is the first world leader to publicly criticize Trump on the move. Speaking during a POLITICO virtual interview, Solberg said Trump’s decision was “the wrong answer” to concerns about WHO, adding, “I hope we can get the U.S. back.” Solberg agreed with Trump that China likely withheld information from WHO in the initial stages of coronavirus spread, but said “I don’t think China controls the World Health Organization.” She called on other countries to help fill the funding gap that would be created if the U.S. ends up leaving — after a one-year notice period — in 2021. “Norway alone cannot fill that gap,” Solberg said, though the country is the world’s biggest per capita aid donor. Is gender a factor in successful Covid-19 leadership? Asked why countries led by women — including Taiwan, New Zealand, Finland, Iceland and Germany — were faring better in combating the coronavirus than countries led by men, Solberg said it probably reflects less on female leaders, and more on the populations that elected them. Those countries have “a little bit less testosterone and power politics” and a greater willingness to cooperate via communal politics, she said. THE WORLD WATCHES — Other countries are closely watching U.S. demonstrations over police violence — and how the Trump administration is responding. Nahal Toosi and Ryan Heath explain in the latest episode of POLITICO Dispatch what that means for international relations and America’s status on the world stage. “This is giving adversaries a cudgel to hit America with,” Nahal said. Listen to the latest POLITICO Dispatch podcast   Protect Yourself and Others From Coronavirus: Even if you don’t have symptoms, you could spread the coronavirus. Practice these physical distancing and hygiene tips to keep yourself and your loved ones safe: Stay 6 feet away from others in public; wash your hands often for 20+ seconds; disinfect frequently touched surfaces like cellphones and light switches; and wear a cloth face covering when out in public. Together, we can slow the spread. Visit coronavirus.gov to learn more.     Nightly Number 65 percent The proportion of Republicans nationwide who believe the country is headed in the right direction, according to a new POLITICO/Morning Consult poll . This contrasts with 23 percent of independents, 9 percent of Democrats and 31 percent overall. Parting Words A NEW GOLDEN AGE? Matt Wuerker interviews Washington Post cartoonist Ann Telnaes about the evolving nature of editorial cartooning in the latest episode of Punchlines. They debate if memes should be considered political cartoons, and whether we are on the precipice of a different era political satire.   A message from PhRMA: America’s biopharmaceutical researchers work every day in the lab to find treatments and cures for patients. But patients must be able to access these discoveries. We built MAT, our Medicine Assistance Tool, to match patients with resources that may help with out-of-pocket medicine costs. 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