Overnight Health Care — Presented by PCMA —US now leads world in known coronavirus cases | Unemployment claims soar by over 3 million | House to vote on stimulus Friday | Ventilator shortage sets off scramble

Overnight Health Care — Presented by PCMA —US now leads world in known coronavirus cases | Unemployment claims soar by over 3 million | House to vote on stimulus Friday | Ventilator shortage sets off scramble
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Welcome to Thursday's Overnight Health Care. The United States surpassed China and Italy Thursday afternoon to become the country with the most confirmed cases of the coronavirus. And a top CDC official warned that New York's coronavirus outbreak is just a preview of what is to come in an exclusive interview with The Hill. 

Let's start with a sad milestone...



U.S. now leads the world in known coronavirus cases

The United States now has the most known coronavirus cases of any country in the world, passing Italy and China.

The U.S. had 82,404 cases as of Thursday evening, according to data from Johns Hopkins University, vaulting to the top spot amid ramped up testing.

The milestone is a foreboding distinction for the United States, setting off alarms that the epidemic continues to get worse in the country.

Experts have raised warnings that the U.S. trajectory is continuing to climb. The U.S. had more than 14,000 new cases on Wednesday, according to a New York Times tracker, and the number of new cases announced each day continues to climb.

Why it matters: The health care system is already showing signs of strain from the surge of coronavirus cases. And it appears that the rise of cases is unrelenting, tweeted Ashish Jha, director of the Harvard Global Health Institute. "A sign that we had many more un-identified cases while we couldn't test... and a lot of community transmission still. Long way to go turn this around."

Read more here.




Exclusive: Top CDC official warns New York's coronavirus outbreak is just a preview

In an exclusive interview, Dr. Anne Schuchat, the principal deputy director of the Centers for Disease Control and Prevention (CDC), said her agency is seeing early signs that the number of cases in other cities are already beginning to spike. While New York City is home to almost half the cases in the country at the moment, other cities are seeing their case counts rising at alarming rates.

"We're looking at our flu syndromic data, our respiratory illness that presents at emergency departments. Across the country there's a number of areas that are escalating. The numbers in New York are so large that they show up, but we're looking at increases over time and we're really seeing some in a number of places. It would be surprising to me based on what I've seen about how this virus spreads if it were not going to increase in many other parts of the country," Schuchat said.

Read more from The Hill's Reid Wilson here.


Severe ventilator shortage sparks desperate scramble

One of the most needed supplies as the coronavirus crisis spreads: ventilators, which are literally life or death for some seriously ill people. It's not clear how or even if the need can be met. 

  • New York Gov. Andrew Cuomo (D) said Wednesday his state needs 30,000 ventilators in as soon as 14 days when the peak of the epidemic is expected to hit, yet it only has 11,000 currently. 
  • Louisiana Gov. John Bel Edwards (D) said Wednesday that New Orleans could run out of ventilators as soon as next week, and that he needs several thousand more.

The company that makes them has increased production from the 100 ventilators a week it produces in normal times to 225 a week for ventilators used for the most seriously ill patients. It is hoping to eventually get to 500 a week. 

Daunting numbers: There are about 160,000 ventilators in the United States, according to the Society of Critical Care Medicine (SCCM), and about 60,000 of those are the most advanced kind used for the most seriously ill patients. 

Read more here



More on supplies...

Democrats ask Trump for evidence that medical supplies are available

House Democrats, highly skeptical of President TrumpDonald TrumpTrump lawyers to Supreme Court: Jan. 6 committee 'will not be harmed by delay' Two House Democrats announce they won't seek reelection DiCaprio on climate change: 'Vote for people that are sane' MORE's claim that medical equipment needed to treat patients with coronavirus is in ready supply, are asking the administration for evidence to back it up.

Behind Rep. Norma TorresNorma Judith TorresDemocrats eager to fill power vacuum after Pelosi exit House passes giant social policy and climate measure State Democrat group teams up with federal lawmakers to elect down-ballot candidates MORE (D-Calif.), dozens of lawmakers are pressing the administration to provide proof that hospitals, nursing homes and other medical providers have ample access to equipment like respirators, ventilators, gloves and goggles, as the president and members of his administration have recently asserted.

In a letter to Trump delivered Thursday, 45 Democrats cite numerous cases of hospitals lacking not only test kits, but also the most basic personal protective equipment, or PPE, like medical masks and gowns. Those reports run counter to Trump's claims that the administration is keeping up with the providers' supply needs, and getting "tremendous reviews" in the process.

"Your Administration claims to be resolving shortages of critical medical supplies, yet we have not seen evidence to corroborate those claims," the Democrats wrote in their letter, obtained by The Hill. "In contrast, first responders on the front lines of this crisis are urgently warning that their needs for these medical supplies are rapidly outstripping available supply."

Read more here



And hospitals are being pushed to the limit

Hospitals in areas of the United States hit hard by the coronavirus pandemic are being pushed to their limits as cases skyrocket and they quickly run out of capacity to treat patients.

States are rushing to build temporary facilities to stay ahead of the surge in new patients. Officials scouring for more beds have turned to convention centers, field hospitals and even soccer fields.

New York, with over 37,000 cases, is building an overflow hospital at a Manhattan convention center to handle non-COVID-19 cases. Temporary hospitals are also being set up at two state colleges and a convention center in Westchester, and the state is scouting even more sites.

New York Gov. Andrew Cuomo (D) said Wednesday that the hospitalization rate was "heading in the right direction" even as one hospital saw 13 patients die in a 24-hour period. 

But on Thursday, he acknowledged that hospitals will not be able to keep up unless they find more space, and said the state will need upwards of 140,000 beds, including 40,000 for intensive-care patients.


Read more here.


Over at the White House...

Trump outlines plan to classify counties by risk level for coronavirus 

President Trump on Thursday outlined plans for his administration to classify each county across the United States based on its risk for an outbreak of coronavirus and use that information to create targeted guidelines.

In a letter to the nation's governors, Trump spoke optimistically about expanded testing capabilities that would allow officials to identify which areas of the country are grappling with outbreaks and where the virus is spreading.

Based on that surveillance testing data, federal agencies would determine if a specific county is high-risk, medium-risk or low-risk for the virus. The administration is simultaneously working on new guidelines for social distancing that would apply to an area depending on its classification, Trump wrote.

Takeaway: The plan is likely part of Trump's controversial push to see if he can reopen the country by Easter. More on the blowback to that below.

Read more here.


Trump set for clash with governors over reopening economy

President Trump's aggressive timeline for reopening the economy could set the White House on a collision course with governors and mayors who seem intent on maintaining social distancing policies beyond the president's Easter target date if necessary. 

Trump's proposal on Tuesday to ease restrictions by mid-April came as a number of state and local governments have moved in the opposite direction, heeding the advice of public health officials to implement stay-at-home orders and close nonessential businesses to stem the rising number of coronavirus infections.

"You can't put a time frame on saving people's lives," Maryland Gov. Larry Hogan (R), who chairs the National Governors Association, said Wednesday. "We're going to make decisions based on the scientists and the facts."

Trump's pronouncement came as Congress is close to passing a deal to inject roughly $2 trillion into the economy to stave off a deep recession and get the economy up and running following widespread disruption from the global pandemic. 

"I would love to have the country opened up and just raring to go by Easter," Trump said Tuesday during a Fox News town hall at the White House, later describing his April 12 target date as a "beautiful timeline." 

Read more here


On the economic front... 

Unemployment claims surge to 3.3 million

More than 3 million Americans applied for unemployment benefits last week as a devastating wave of layoffs and business closures due to the coronavirus pandemic intensifies, according to data released by the Labor Department on Thursday.

Weekly claims for unemployment insurance rose to 3,283,000 between March 15 and 22, spiking from the 281,000 applications for jobless benefits filed between March 8 and 14.

The staggering rise in jobless claims comes as businesses across the U.S. shutter in a desperate bid to slow the progress of the coronavirus pandemic. Restaurants, bars, retailers, entertainment venues and nonessential businesses across the country have been closed for at least weeks, forcing millions of Americans employed in those industries into joblessness as the coronavirus spreads.

Read more here.


Trump says jobs will come back 'very quickly'

President Trump on Thursday said the sharp rise in unemployment claims was "fully expected" and predicted the economy would quickly rebound once the United States overcomes the coronavirus outbreak.

Trump told reporters at a White House briefing that he was not surprised by the Labor Department's report.

"I heard it could be 6 million, it could be 7 million," Trump said at a briefing on the coronavirus Thursday evening. "It's a lot of jobs. But I think we'll come back very strong."

"Every day we stay out it gets harder to bring it back very quickly and our people don't want to stay out," Trump continued.

Read more here.


But the pressure is on... Trump faces race against clock to get coronavirus aid out the door

Congress's $2.2 trillion "phase three" economic rescue package came together in record time, but economists, workers and businesses alike are worried about how quickly relief can get out the door.

Disbursing hundreds of billions of dollars to Americans and businesses large and small in a matter of weeks comes with significant logistical challenges. With each passing day of lost income and revenue, the odds of a sharper downturn increase.

"The longer it takes, the more severe and longer-lasting the downturn will be. And that's really the nightmare scenario here," said labor economist Josh Wright, a former researcher at the Federal Reserve and chief economist at the recruiting software firm iCIMS.

Read more here.


Read more: But there was some good news on Wall Street, where stocks recovered 20 percent of their value after a three-day surge. More here.


More from the administration

EPA suspends enforcement of environmental laws amid coronavirus

State Department says 50K stranded Americans requesting help to return home

White House identifies Chicago, Detroit areas as emerging coronavirus hot spots

Trudeau calls for keeping US-Canada border demilitarized



Pharmacy benefit managers (PBMs) are committed to making sure that the patients we serve can access needed medications safely. Learn more.


Over in Congress... 

Pelosi vows quick House passage of Senate stimulus Friday

Speaker Nancy PelosiNancy PelosiTwo-thirds of Americans support banning lawmakers from trading stocks: poll The Hill's Morning Report - Presented by Facebook - Voting rights week for Democrats (again) Watch: Lawmakers, activists, family members call for voting rights legislation on MLK day MORE (D-Calif.) said Thursday that the House will move quickly on Friday to approve the Senate's massive, $2 trillion coronavirus relief package through the lower chamber and on to President Trump, who has vowed to sign it immediately.

While a number of House lawmakers -- conservatives and liberals alike -- are grumbling about both the process and content of the mammoth stimulus bill, Pelosi predicted smooth sailing through the lower chamber with broad support from both parties.

"I feel certain that we will have a strong bipartisan vote," she told reporters in the Capitol.

Read more here.


And lawmakers are already looking ahead to the next bill

Lawmakers are quickly shifting their attention to a "phase four" coronavirus bill as the economic, health and social effects of the pandemic unfold across the U.S.

Congress is set to pass a $2.2 trillion stimulus package -- the largest in the nation's history -- as soon as Friday as lawmakers try to ward off a deep recession sparked by the outbreak.

But leadership and rank-and-file members in both chambers argue that even with the wide-reaching spending package, which includes help for individuals, small businesses and hard-hit industries, more legislation will be needed.

Senate Minority Leader Charles SchumerChuck SchumerThe Hill's Morning Report - Presented by Facebook - Voting rights week for Democrats (again) Kelly takes under-the-radar approach in Arizona Senate race Hundreds attend mass funeral for victims of Bronx apartment building fire MORE (D-N.Y.) said the "odds are high" Congress will need to do more.

Read more here.


Read more: One Republican, House Minority Leader Kevin McCarthyKevin McCarthyOvernight Defense & National Security — Texas hostage situation rattles nation The Hill's Morning Report - Presented by Facebook - Democrats see victory in a voting rights defeat Former acting Defense secretary under Trump met with Jan. 6 committee: report MORE (Calif.) on Thursday though tried to pump the brakes on talk of another stimulus package. More on that here.


More from Congress

More questions and answers about the coronavirus checks

How the business loan program would work in the $2T coronavirus package

Lobbying blitz yields wins for airlines, corporations, banks, unions

House members given safety measures to follow while voting on coronavirus bill

C-SPAN to air video statements from lawmakers on coronavirus response bill

Hoyer says House expects to pass coronavirus bill on Friday

Schumer: Senate should 'explore' remote voting if coronavirus sparks lengthy break

Schumer waves off Cuomo criticism that he didn't deliver for New York with coronavirus stimulus


In the states...

Coronavirus reignites fight over abortion rights

The fight over abortion rights is getting tangled up in the battle against the coronavirus, with conservative states moving to restrict access to the procedure by classifying it as nonessential. 

Officials in Texas, Mississippi and Ohio argue abortion is an elective procedure that should be halted so masks and gloves, which are in short supply, can be preserved for health workers on the front lines of the pandemic. 

"The truth is abortion, for the most part, is an elective procedure that can be done later," Texas Attorney General Ken Paxton (R) said Wednesday during a live interview on Facebook with a conservative advocacy group. 

But abortion rights advocates argue the procedure is essential and time-sensitive, and clinics are following guidelines to conserve personal protective equipment.

"We certainly understand governors' desires to limit nonessential health care right now in the middle of a pandemic," said the Very Reverend Katherine Ragsdale, president and CEO of the National Abortion Federation, a professional association for abortion providers. 

"However, abortion is essential health care. It's not something that can be put off indefinitely like a knee replacement or something," she added.  Read more here


States brace for massive budget gaps in coronavirus recession

State governments have spent a decade stockpiling billions of dollars in reserve funds for the next economic downturn, scarred by the steep cuts they were forced to make in the midst of the last recession.

Now, with the coronavirus grinding the global economy to a virtual halt, those billions could be gone in a matter of months.

State and local experts say the coming months will be a bloodbath for governments that are required by law to maintain balanced budgets. They will be forced to choose between steep and painful cuts to social programs that are already underfunded or tax hikes at a time when millions of people will be unemployed.

"States are very limited in the options available to them," said Jeff Chapman, director of the state fiscal health project at The Pew Charitable Trusts. "States have to balance their budgets, so when revenue falls precipitously like it is now they're going to have to either raise taxes or cut spending. And both of those options are bad for the economy."

More here.


More in The Hill

New York AG calls on states not to restrict abortion access amid pandemic

Biden releases plan to boost economy amid coronavirus pandemic

Mnuchin indicates federal government could take stakes in airlines for government grants

New Jersey reports nearly 2,500 new coronavirus cases in one day

Trump to travel to see naval hospital ship deploy to NYC


What We're Reading

Who lives and who dies? With ventilators limited amid coronavirus, doctor might face hard choices (Los Angeles Times)

Internal emails show how chaos at the CDC slowed the early response to coronavirus (ProPublica)

Politicians jockeying for Covid-19 tests find proximity to Trump is the fastest route (Washington Post)


State by State

Massachusetts medical schools to graduate students early to fight coronavirus pandemic (Boston Herald)

New York mandates nursing homes take Covid-19 patients discharged from hospitals (Wall Street Journal)

Ivey says 'right now is not the time' for Alabama-wide shelter-in-place order (Montgomery Advertiser)


The Hill op-eds

Defense Production Act urgently needed for critical medical gear 

How mass incarceration will lead to mass infection -- and how to avoid it 

From opioids to coronavirus -- Medicaid is a crisis response program