Category Archives: 2020 Election Issues

Moody’s: US healthcare system rebounds from COVID-19 in May, but a bumpy road lies ahead

Posted on by • Posted in 2020 Election Issues, Cash, Cash Reserves, Coronavirus, Credit Quality, Credit Ratings, Economic Crisis, Economic Recovery, Economy, Economy Reopening, Elective Procedures, Elective Surgery, Emergency Care, Health Insurance Coverage Adequacy, Health System, High Deductible Health Plans, High Drug Prices, High Prices, Hospital, Hospital Industry, Linear Path, Liquidity, Market Outlook, Market Uncertainty, Medical Device, Out of Pocket Expenses, Personal Protective Equipment (PPE), Robot-Assisted Surgery, Robotic Process Automation, Supply Chain • Leave a comment

https://www.healthcaredive.com/news/moodys-us-healthcare-system-rebounds-from-covid-19-in-may-but-a-bumpy-ro/580152/

Banks rating downgrade: Moody's changes outlook on Indian banks to ...

Dive Brief:

  • A Moody’s Investors Service report on Thursday suggests that the U.S. healthcare industry is on the rebound from COVID-19, but recovery will likely to slow and uneven. Moreover, the report expressed concerns that regional flareups of coronavirus could majorly set back the return to normal volumes.
  • Investment firm Jefferies affirmed those worries in hospital traffic data shared Friday, noting “a sharp reversal” in hotspot state Arizona. Analysts tracked “record lows” in Arizona’s hospital traffic last week, down from what was thought to be the trough in April and sagging below May recovery amid a significant uptick in COVID-19 cases and protests.
  • “Whether states can continue their recovery even as cases increase, as we’ve seen in [Texas] and others, or if the recent reversals in [Arizona, Illinois,] etc. become more widespread is a trend to watch in coming weeks,” Jefferies analysts wrote.

Dive Insight:

Large sections of the healthcare sector all but shut down during the spring as the coronavirus led to nationwide shelter-in-place orders. However, as states and municipalities slowly reopen, so are the doors for hospitals, ambulatory surgical centers, clinics and other integral components of healthcare delivery.

As a result, Moody’s reported “considerable sequential improvement” during May. For example, while for-profit hospitals saw surgery volumes drop as much as 70% in April compared to the same period in 2019, May volumes were down about 20% to 40% compared to last year’s. Hospital-operated ambulatory surgical centers saw an 80% to 90% drop in April volumes, but only a 30% to 40% drop in May.

However, Moody’s noted that the “path to normalized volumes are not linear.” It also pointed out that emergency room care volumes, which dropped as much as 60% in April, have yet to really rebound, as they still appeared depressed as much as 50% in May.

“This could reflect the prevalence of working-from-home arrangements and people generally staying home, which is leading to a decrease in automobile and other accidents outside the home. Weak ER volumes also suggest that many people remain apprehensive to enter a hospital, particularly for lower acuity care,” the Moody’s report said.

The firm also noted that “the shape of recovery will vary by state, region and service line, reinforcing the importance of diversification for credit quality among healthcare service providers.”

However, Moody’s believes that the darkest days of March and April are behind much of the healthcare sector. It noted that most providers have stockpiled appropriate personal protective equipment and have reconfigured their offices, waiting rooms and other infrastructure to protect the health of both patients and employees.

Traffic data from 3,300 U.S. hospitals, tracked by Jefferies via mobile device pings, indicates that compared to January 2019 levels, national traffic lows of 43.7% in mid-April improved to 63.3% by early June.

But state-by-state analysis reveals some parts of the country are trending backwards. Arizona fell to a new low of 28.5% last week after hitting 51.5% on May 20. The analysts also reported Illinois hit its own new low on June 7.

While Moody’s did express some concern about regional outbreaks, it concluded that the precautions already taken “make it less likely that the U.S. would once again shut down all non-elective care across the nation if there is a second wave of coronavirus infections.”

Moody’s did express some concerns about hospital finances, but noted that for-profit hospitals “have unusually strong liquidity” due to payouts from the CARES Act and other government-sponsored financial relief programs.

Medical device firms should be prepared for a long and uneven recovery, according to Moody’s. The dental and orthopaedic sectors “will see a greater than average impact from consumers’ inability to pay for procedures or their unwillingness to engage with the healthcare system.” Moody’s forecast “a gradual, uneven pace of recovery,” with pre-tax earnings to decline as much as 30% in 2020 compared to 2019, while revenues will shrink around 10%. It expects that earnings will rebound in 2021 to 2019 levels.

Companies that operate in discretionary sectors will be hit harder as they rely on patients able to meet large deductibles or co-payments or to pay for related procedures entirely on their own. Moody’s noted that a large number of these procedures are performed in acute care hospitals with the assistance of robotics, but hospitals may be more conservative in their robotics investments given new budget constraints.

 

 

 

Trump says Covid-19 is ‘dying out.’ Experts fear his dismissiveness could prolong the crisis

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Economic Crisis, Economy Reopening, False Hope, False Narrative, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mislead, Misleading, Mixed Message, Mortality, National Strategy, Pandemic, Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Transparency, Trust, Truth • Leave a comment

Trump says Covid-19 is ‘dying out.’ Experts fear his dismissiveness could prolong the crisis

The Trump Administration Paid Millions for Test Tubes — and Got ...

The White House is taking a new position on the coronavirus pandemic: a daily count of 750 deaths is a testament to the federal government’s successful pandemic response.

On Wednesday, when U.S. health officials reported nearly 27,000 new Covid-19 cases, President Trump said in a television interview that the virus was “dying out.” He brushed off concerns about an upcoming rally in Tulsa, Okla., because the number of cases there is “very miniscule,” despite the state’s surging infection rate. In a Wall Street Journal interview Wednesday, Trump argued coronavirus testing was “overrated” because it reveals large numbers of new Covid-19 cases, which in turn “makes us look bad,” and suggested that some Americans who wear masks do so not only to guard against the virus, but perhaps to display their anti-Trump animus.

But a range of public health experts told STAT that this messaging not only diverts attention from a pandemic that has already caused 120,000 U.S. deaths, but has more practical implications: It could make it difficult for local governments to enlist the public in the mitigation measures necessary to reduce the continued spread of the virus.

“The science behind how people process public warnings in a crisis supports this: You have to have people speaking with one voice,” said Monica Schoch-Spana, a medical anthropologist at the Johns Hopkins Center for Health Security. “You need a chorus.”

Conflicting directives can make it more difficult for recommendations coming from state and local leaders to have an impact, said Sara Bleich, a professor of public health policy at Harvard’s T.H. Chan School of Public Health.

“It sends a mixed message, which is confusing, particularly because while many people will get infected, most will not get severely sick, so it’s easy to say this won’t happen to me,” she said. “And it’s that sort of attitude that will keep us in this situation for a very long time.”

While the president has for weeks, if not months, underplayed the pandemic, his sharp and repeated remarks this week represent a remarkable attempt from the leader of American government to effectively declare the U.S. Covid-19 epidemic over.

The president’s rhetoric comes at a time that his coronavirus task force, which once conducted daily briefings, has not addressed the public since May. The president’s resumption of campaign rallies flouts federal guidance that encourages mask use (Trump’s campaign will hand out masks and hand sanitizer at the rally, but has not said it will require attendees to use them) and discourages large indoor gatherings. And the president has repeatedly claimed, misleadingly, that persistently high U.S. case totals are simply the result of increased testing.

Health experts say that political leaders preaching caution and modeling proper behavior — such as wearing a mask and demonstrating proper hand hygiene — can send a powerful signal to people that these steps can not only protect them, but their communities. They say that, essentially, national and state leaders need to walk the walk in a situation when individual behavior, like staying home when sick and cooperating with contact tracing, can make a large impact in curbing contagion.

Trump’s counterproductive behavior, Schoch-Spana said, extends far beyond the consistently dismissive tone he has taken toward the health risks of Covid-19. With few exceptions, the president has refused to wear a mask in public, and has insisted on continuing in-person briefings and White House events that effectively defy federal health guidance about gathering indoors in large groups.

“It’s not just words, it’s actions,” she said. “So when you have the nation’s top executive refusing to wear a mask, holding meetings where people are shoulder to shoulder, where he’s signing executive orders — that is also a form of communication.”

Experts also say continued federal commitments to combating the virus are crucial as the public grows tired of abatement measures. Instead, Trump has only elevated his monthslong campaign of downplaying the virus.

And Vice President Mike Pence, in a Wall Street Journal op-ed, framed the declines in cases and deaths since April as “testament to the leadership of President Trump” — even as hundreds of Americans are still dying every day and cases are not dropping further.

Rep. Donna Shalala (D-Fla.), who served as health secretary during the Clinton administration, said she hoped Americans would listen to public health guidance from local officials, not Trump and Pence.

“The president of the United States is dangerous to the health of the people of my district, because he’s giving out misinformation and false hope,” she said. “For those that believe him, they’re putting themselves and their families at risk.”

Public health experts have raised a number of issues with the administration’s messaging.

For one, a plateau of cases and deaths should not be celebrated, they say. While some countries in Europe and Asia have not only flattened their curve but driven them down, that hasn’t happened in the United States. Daily cases and deaths dipped from the peak in April, but have averaged about 20,000 and 800, respectively, for weeks.

Beyond those numbers representing real people getting sick and dying, there are other problems with sustained high levels of spread. The more cases there are, the more difficult it is for the surveillance system, including contact tracing, to keep up. It’s also more likely that some of the cases will spiral into explosive spread; 20,000 cases can turn into 40,000 a lot faster than one case can turn into 20,000.

Plus, a failure to suppress spread now could lead to more prolonged disruptions to daily life. If transmission rates come fall are still what they are now in certain communities, that makes it harder to reopen schools, for example.

Experts also point to evidence suggesting that the daily case and death numbers won’t stay flat for long. While new cases in the Northeast and Midwest are declining, a number of states in the West and South — Arizona, Texas, Florida, California, and Oregon among them — have reported record number of new cases this week. What worries public health officials is that, without measures to stem those increases, those outbreaks could keep growing. Those thousands of new cases also signal that, in a week or two, some portion of those people will show up in the hospital, and, about a week after that, a number of them will be dead, even as clinicians have learned more about treating severe Covid-19.

Some states in the South and West are already reporting record hospitalizations from Covid-19.

The White House’s shrug has been echoed by some governors, who insist, like Pence and Trump, that increased testing explains away the rise in cases. That is certainly one reason; testing has become more widespread, so states are capturing a more accurate reading of their true case burden.

But experts say increased testing can only account for some of the data states are reporting. Other metrics — including rising hospitalizations, filling ICUs, and the increasing rate of tests that are positive for the virus — signal broader spread.

Until Wednesday, leaders of Texas and Arizona also bristled at efforts from city and county officials to institute mask requirements, but acceded to growing pressure even as they have not ordered statewide mandates.

Cameron Wolfe, an infectious disease expert at Duke University, said he was seeing a growing “fatigue” among the public to keep up with precautionary steps like physical distancing and mask wearing. People letting down their guard was coinciding with an increase of cases in states, including North Carolina.

He said medical experts and health workers needed to model proper behavior to show others that the coronavirus epidemic was still something that required action. But, he added, “that also comes from political leaders buying into this.”

Federal and state authorities, he said, need to be “taking this to heart. That has not yet happened. That needs to change if we’re going to get people to buy into this.”

 

 

 

 

Mask-wearing becomes political even as some governors ease resistance

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Freedom, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Motivation, National Strategy, Pandemic, Partisanship, Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

Mask-wearing becomes political even as some governors ease resistance

More US states mandate wearing masks | The Canberra Times ...

Some state and local leaders are softening their resistance to issuing public masking requirements as emerging research shows face coverings can slow the spread of COVID-19, even as others are doubling down on their opposition.

The debate over whether to require face coverings in public has become increasingly politicized in recent weeks, even as COVID-19 cases have increased in the Sun Belt and some other parts of the country as lockdowns across the country have greatly eased.

Governors in southern, conservative states have been reluctant to issue statewide mandates on public mask-wearing, and in some cases have prevented local governments from taking stronger actions. 

“We want to make sure that individual liberty is not infringed upon by government and hence government cannot require individuals to wear a mask,” Texas Gov. Greg Abbott (R) said Wednesday in an interview with Waco television station KWTX.

Abbott, who frequently recommends mask-wearing, has resisted calls from local leaders to require it, and has also prohibited them from enforcing local orders with civil or criminal penalties on individuals.

However, two Texas counties on Wednesday announced businesses must impose a mask rule on staff and customers or face fines of up to $1,000, which Abbott said would be allowed under his executive order.

“Businesses … they’ve always had the opportunity and the ability, just like they can require people to wear shoes and shirts, these businesses can require people to wear face masks if they come into their businesses. Now local officials are just now realizing that that was authorized,” he said.

Texas has experienced a rapid increase in COVID-19 cases that experts say is likely related to the state’s decision to lift lockdown measures ahead of Memorial Day. The state reported 3,129 new COVID-19 cases Wednesday, its largest single-day increase. Nearly 2,800 people were hospitalized with COVID-19 as of Wednesday, a new high for the state.

In Arizona, which has also seen a surge in cases, Gov. Doug Ducey (R) on Wednesday again resisted calls to issue a statewide masking requirement, but in a reversal, said he would allow local governments to take their own actions. Larger cities including Phoenix and Tucson plan to do so.

“Every Arizonan should wear a face mask,” he said at a Wednesday press conference. “This is an issue of personal responsibility, and we’re asking Arizonans to make responsible decisions to protect the most vulnerable in our communities.” 

While a number of coastal states and cities led by Democrats have strict mask requirements when in public settings such as grocery stores, where staying six feet away from others may not be possible, some Republicans appear to see it as a restriction on freedom and have emphasized individual responsibility.

Trump has almost exclusively declined to wear a mask, and has criticized his political rival Joe Biden, the Democratic candidate for president, for wearing one. 

“I see Biden. It’s like his whole face is covered,” Trump said in an interview published Thursday in The Wall Street Journal. “It’s like he put a knapsack over his face. He probably likes it that way. He feels good that way because he does. He seems to feel good in a mask, you know, feels better than he does without the mask, which is a strange situation.”

The debate of whether to wear masks has sparked division on Capitol Hill, where two Republicans this week refused to follow a new directive from House Speaker Nancy Pelosi (D-Calif.) 

“I consider masks much more effective at spreading panic and much less effective at stopping a virus,” said Rep. Tom McClintock (R-Calif.), during a hearing yesterday. He later put on a mask. 

Polls have shown Democrats are more likely to wear masks in public than Republicans; a Gallup poll conducted in April found 75 percent of Democrats have worn a mask in public, compared to half of Republicans.

However, emerging evidence shows face coverings can slow the transmission of COVID-19. A study published in Health Affairs this week found that mandated use of face masks in public was associated with a reduction in the daily COVID-19 growth rate in 15 states and Washington, D.C., compared to states that did not have such requirements.

Governors of other states experiencing outbreaks, including Henry McMaster (R) of South Carolina, have recommended but don’t require people to wear face masks in public. City council members in Columbia, S.C., however, are reportedly considering a requirement for the state’s largest city.

Alabama Gov. Kay Ivey (R) hasn’t issued a statewide mask requirement for the public, but employees of certain businesses are required to wear them while working.

In Montgomery, Ala., which has the largest COVID-19 outbreak in the state, Mayor Steven Reed (D) issued an executive order Wednesday requiring face coverings be worn in public after a similar ordinance failed to pass the city’s council.

Florida Gov. Ron DeSantis (R) has also resisted a statewide mask requirement, though localities can require their use in public. On Tuesday, he encouraged people to wear masks when social distancing isn’t possible but said it would not be a requirement.

“In terms of forcing that under penalty of criminal law, we’re not going to be doing that. I think it would be applied unevenly and I just don’t think it would end up working,” DeSantis said at a press conference.

The state is also seeing an increase in cases, which DeSantis ties to increased testing. However, public health experts note that the percentage of tests coming back positive is also increasing, a sign of ongoing community transmission. 

In Nebraska, where the rate of COVID-19 transmission has been declining, Gov. Pete Ricketts (R) encourages the use of masks in public but has threatened to withhold federal relief funding from localities that require their use in government buildings.

“The governor encourages people to wear a mask but does not believe that failure to wear a mask should be the basis for denying taxpayers’ services,” spokesman Taylor Gage told the Omaha World-Herald.

Not all Republican governors have resisted masking mandates. Maryland Gov. Larry Hogan and Massachusetts Gov. Charlie Baker were early to issue wide-ranging mask requirements in their states.

Meanwhile, Democratic governors are mandating mask requirements or say they are seriously considering it. 

As cases continue to climb in North Carolina, Gov. Roy Cooper (D) said this state leaders are considering making mask-wearing in public settings mandatory but has not done so yet.

Oregon Gov. Kate Brown (D) announced Wednesday that people living in seven of the state’s counties will have to wear masks in public beginning June 24 as the state sees an increase in cases.

Democratic governors of states hit hard early in the pandemic including New York, Washington and New Jersey have required the use of face coverings in public for several weeks.

California Gov. Gavin Newsom (D) issued a statewide mask order Thursday amid an increase in COVID-19 cases in his state.

“Science shows that face coverings and masks work,” Newsom said Thursday. “They are critical to keeping those who are around you safe, keeping businesses open and restarting our economy.” 

 

 

 

 

In countries keeping the coronavirus at bay, experts watch U.S. case numbers with alarm

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, National Strategy, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Trust, Truth • Leave a comment

https://www.washingtonpost.com/world/2020/06/19/countries-keeping-coronavirus-bay-experts-watch-us-case-numbers-with-alarm/?utm_campaign=wp_post_most&utm_medium=email&utm_source=newsletter&wpisrc=nl_most

Experts abroad watch U.S. coronavirus case numbers with alarm ...

As coronavirus cases surge in states across the South and West of the United States, health experts in countries with falling case numbers are watching with a growing sense of alarm and disbelief, with many wondering why virus-stricken U.S. states continue to reopen and why the advice of scientists is often ignored.

“It really does feel like the U.S. has given up,” said Siouxsie Wiles, an infectious-diseases specialist at the University of Auckland in New Zealand — a country that has confirmed only three new cases over the last three weeks and where citizens have now largely returned to their pre-coronavirus routines.

“I can’t imagine what it must be like having to go to work knowing it’s unsafe,” Wiles said of the U.S.-wide economic reopening. “It’s hard to see how this ends. There are just going to be more and more people infected, and more and more deaths. It’s heartbreaking.”

China’s actions over the past week stand in stark contrast to those of the United States. In the wake of a new cluster of more than 150 new cases that emerged in Beijing, authorities sealed off neighborhoods, launched a mass testing campaign and imposed travel restrictions.

Meanwhile, President Trump maintains that the United States will not shut down a second time, although a surge in cases has convinced governors in some states, including Arizona, to walk back their opposition to mandatory face coverings in public.

Commentators and experts in Europe, where cases have continued to decline, voiced concerns over the state of the U.S. response. A headline on the website of Germany’s public broadcaster read: “Has the U.S. given up its fight against coronavirus?” Switzerland’s conservative Neue Zürcher Zeitung newspaper concluded, “U.S. increasingly accepts rising covid-19 numbers.”

“The only thing one can say with certainty: There’s nothing surprising about this development,” a journalist wrote in the paper, referring to crowded U.S. beaches and pools during Memorial Day weekend in May.

Some European health experts fear that the rising U.S. caseloads are rooted in a White House response that has at times deviated from the conclusions of leading scientists.

“Many scientists appeared to have reached an adequate assessment of the situation early on [in the United States], but this didn’t translate into a political action plan,” said Thomas Gerlinger, a professor of health sciences at the University of Bielefeld in Germany. For instance, it took a long time for the United States to ramp up testing capacity.

Whereas the U.S. response to the crisis has at times appeared disconnected from American scientists’ publicly available findings, U.S. researchers’ conclusions informed the actions of foreign governments.

“A large portion of [Germany’s] measures that proved effective was based on studies by leading U.S. research institutes,” said Karl Lauterbach, a Harvard-educated epidemiologist who is a member of the German parliament for the Social Democrats, who are part of the coalition government. Lauterbach advised the German parliament and the government during the pandemic.

Despite its far older population, Germany has confirmed fewer than 9,000 coronavirus-linked deaths, compared to almost 120,000 in the United States. (Germany has about one-fourth of the United States’ population.)

Lauterbach cited in particular the work of Marc Lipsitch, a professor of epidemiology at Harvard University, whose research with colleagues recently suggested that forms of social distancing may have to remain in place into 2022. Lipsitch’s work, Lauterbach said, helped him to convince German Vice Chancellor Olaf Scholz that the pandemic will be “the new normal” for the time being, and it impacted German officials’ thinking on how long their strategy should be in place.

Regarding the effectiveness of face masks, Lauterbach added, “we almost entirely relied on U.S. studies.” Germany was among the first major European countries to make face masks mandatory on public transport and in supermarkets.

Lipsitch said Thursday that he was not previously aware of the impact of his research on German decision-making, but added that he has spoken to representatives of several other foreign governments in recent weeks, including Israeli Prime Minister Benjamin Netanyahu and officials or advisers from Canada, New Zealand and South Korea.

Even though Lipsitch cautioned it was impossible for him to say how or if his conversations influenced foreign governments’ thinking, he credited the overall European response as “science-based and a sincere effort to find out what experts in the field believe is a range of possible scenarios and consequences of decisions.”

Lipsitch said he presented some of his research to a White House group in the early stages of the U.S. outbreak but said the Trump administration’s response to the pandemic did not reflect his conclusions. “I think they have cherry-picked models that at each point looked the most rosy, and fundamentally not engaged with the magnitude of the problem,” he said.

The White House has defended its approach as science-based. After a study by Imperial College London predicted 510,000 deaths in Britain and 2.2 million in the United States if the pandemic remained fully uncontrolled, for instance, the Trump administration indicated that it was taking the research into account.

“If we didn’t act quickly and smartly, we would have had, in my opinion and in the opinion of others, anywhere from 10 to 20 and maybe even 25 times the number of deaths,” Trump said two months later,

But European researchers dispute that the U.S. government’s reliance on scientists to inform decision-making comes anywhere near the degree to which many European policymakers have relied on researchers.

After consulting U.S. research and German studies, for instance, German leaders agreed to make reopening dependent on case numbers, meaning restrictions snap back or reopening gets put on hold if the case numbers in a given region exceed a certain threshold.

Meanwhile, several U.S. states have reopened despite rising case numbers.

“I don’t understand that logic,” said Reinhard Busse, a health management professor a the Technical University of Berlin.

Lauterbach said that while most Germans disapproved of Trump before the pandemic, even his staunchest critics in Germany were surprised by how even respected U.S. institutions including the Centers for Disease Control and Prevention (CDC) struggled to respond to the crisis.

The CDC, for instance, initially botched the rollout of test kits in the early stages of the outbreak.

“Like many other aspects of our country, the CDC’s ability to function well is being severely handicapped by the interference coming from the White House,” said Harvard epidemiologist Lipsitch. “All of us in public health very much hope that this is not a permanent condition of the CDC.”

Some observers fear the damage will be difficult to reverse. “I’ve always thought of the CDC as a reliable and trusted source of information,” said Wiles, the New Zealand specialist. “Not anymore.”

 

 

 

Cartoon – Coronavirus Leadership

Posted on by • Posted in 2020 Election Issues, Absenteeism, Accountability, Cartoon, Coronavirus, Coronavirus Treatment, Credibility, Crisis, Crisis Management, Economic Crisis, Economic Stimulus, Economy Reopening, False Hope, False Narrative, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, Pandemic, Public Health, Public Safety, Quarantine, Responsibility, Social Distancing, Transparency, Trust, Truth, Wishful Thinking • Leave a comment

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Coronavirus Layoffs Keep Coming as Jobless Claims Top 45 Million

Posted on by • Posted in 2020 Election Issues, Coronavirus, Crisis, Crisis Management, Deferred Healthcare, Economic Crisis, Economic Recovery, Economic Stimulus, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employer-Based Health Insurance, Health Insurance Coverage Adequacy, Infection Control, Infection Control Plan, Infectious Virus, Pandemic, Public Health, Public Safety, Quarantine, Social Distancing, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

http://www.thefiscaltimes.com

About 1.5 million people filed for state unemployment benefits last week, the Department of Labor announced Thursday, bringing the 13-week total for first-time claims to more than 45 million. Another 760,000 filed new claims for Pandemic Unemployment Assistance, a temporary program for workers such as independent contractors who ordinarily do not qualify for unemployment payments.

While new jobless claims continue to decline, falling for the 11th straight week, the numbers remain startlingly high relative to previous recessions, and some economists have expressed concerns that the labor market is not healing as rapidly as they had hoped.

“It’s not clear why claims are still so high,” said Ian Shepherdson, chief economist at Pantheon Macroeconomics, in a note to clients. “[I]s it the initial shock still working its way up through businesses away from the consumer-facing jobs lost in the first wave, or is it businesses which thought they could survive now throwing in the towel, or both? Either way, these are disappointing numbers and serve to emphasize that a full recovery is going to take a long time.”

 

Federal Reserve – Semiannual Monetary Policy Report to the Congress

Posted on by • Posted in 2020 Election Issues, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Economic Stimulus, Fiscal Policy, Gross Domestic Product (GDP), Job, Job Growth, Job Market, Mission, Monetary Policy, Paycheck Protection Program, Responsibility, The CARES Act, Transparency • Leave a comment

https://www.federalreserve.gov/newsevents/testimony/powell20200616a.htm

Federal Reserve Board - Structure of the Federal Reserve System

Chair Powell submitted identical remarks to the Committee on Financial Services, U.S. House of Representatives, Washington, D.C., on June 17, 2020.

Chairman Crapo, Ranking Member Brown, and other members of the Committee, thank you for the opportunity to present the Federal Reserve’s semiannual Monetary Policy Report.

Our country continues to face a difficult and challenging time, as the pandemic is causing tremendous hardship here in the United States and around the world. The coronavirus outbreak is, first and foremost, a public health crisis. The most important response has come from our health-care workers. On behalf of the Federal Reserve, I want to express our sincere gratitude to these dedicated individuals who put themselves at risk, day after day, in service to others and to our nation.

Current Economic Situation and Outlook
Beginning in mid-March, economic activity fell at an unprecedented speed in response to the outbreak of the virus and the measures taken to control its spread. Even after the unexpectedly positive May employment report, nearly 20 million jobs have been lost on net since February, and the reported unemployment rate has risen about 10 percentage points, to 13.3 percent. The decline in real gross domestic product (GDP) this quarter is likely to be the most severe on record. The burden of the downturn has not fallen equally on all Americans. Instead, those least able to withstand the downturn have been affected most. As discussed in the June Monetary Policy Report, low-income households have experienced, by far, the sharpest drop in employment, while job losses of African Americans, Hispanics, and women have been greater than that of other groups. If not contained and reversed, the downturn could further widen gaps in economic well-being that the long expansion had made some progress in closing.

Recently, some indicators have pointed to a stabilization, and in some areas a modest rebound, in economic activity. With an easing of restrictions on mobility and commerce and the extension of federal loans and grants, some businesses are opening up, while stimulus checks and unemployment benefits are supporting household incomes and spending. As a result, employment moved higher in May. That said, the levels of output and employment remain far below their pre-pandemic levels, and significant uncertainty remains about the timing and strength of the recovery. Much of that economic uncertainty comes from uncertainty about the path of the disease and the effects of measures to contain it. Until the public is confident that the disease is contained, a full recovery is unlikely.

Moreover, the longer the downturn lasts, the greater the potential for longer-term damage from permanent job loss and business closures. Long periods of unemployment can erode workers’ skills and hurt their future job prospects. Persistent unemployment can also negate the gains made by many disadvantaged Americans during the long expansion and described to us at our Fed Listens events. The pandemic is presenting acute risks to small businesses, as discussed in the Monetary Policy Report. If a small or medium-sized business becomes insolvent because the economy recovers too slowly, we lose more than just that business. These businesses are the heart of our economy and often embody the work of generations.

With weak demand and large price declines for some goods and services—such as apparel, gasoline, air travel, and hotels—consumer price inflation has dropped noticeably in recent months. But indicators of longer-term inflation expectations have been fairly steady. As output stabilizes and the recovery moves ahead, inflation should stabilize and then gradually move back up over time closer to our symmetric 2 percent objective. Inflation is nonetheless likely to remain below our objective for some time.

Monetary Policy and Federal Reserve Actions to Support the Flow of Credit
The Federal Reserve’s response to this extraordinary period is guided by our mandate to promote maximum employment and stable prices for the American people, along with our responsibilities to promote the stability of the financial system. We are committed to using our full range of tools to support the economy in this challenging time.

In March, we quickly lowered our policy interest rate to near zero, reflecting the effects of COVID-19 on economic activity, employment, and inflation, and the heightened risks to the outlook. We expect to maintain interest rates at this level until we are confident that the economy has weathered recent events and is on track to achieve our maximum-employment and price-stability goals.

We have also been taking broad and forceful actions to support the flow of credit in the economy. Since March, we have been purchasing sizable quantities of Treasury securities and agency mortgage-backed securities in order to support the smooth functioning of these markets, which are vital to the flow of credit in the economy. As described in the June Monetary Policy Report, these purchases have helped restore orderly market conditions and have fostered more accommodative financial conditions. As market functioning has improved since the strains experienced in March, we have gradually reduced the pace of these purchases. To sustain smooth market functioning and thereby foster the effective transmission of monetary policy to broader financial conditions, we will increase our holdings of Treasury securities and agency mortgage-backed securities over coming months at least at the current pace. We will closely monitor developments and are prepared to adjust our plans as appropriate to support our goals.

To provide stability to the financial system and support the flow of credit to households, businesses, and state and local governments, the Federal Reserve, with the approval of the Secretary of the Treasury, established 11 credit and liquidity facilities under section 13(3) of the Federal Reserve Act. The June Monetary Policy Report provides details on these facilities, which fall into two categories: stabilizing short-term funding markets and providing more-direct support for credit across the economy.

To help stabilize short-term funding markets, the Federal Reserve set up the Commercial Paper Funding Facility and the Money Market Liquidity Facility to stem rapid outflows from prime money market funds. The Fed also established the Primary Dealer Credit Facility, which provides loans against good collateral to primary dealers that are critical intermediaries in short-term funding markets.

To more directly support the flow of credit to households, businesses, and state and local governments, the Federal Reserve established a number of facilities. To support the small business sector, we established the Paycheck Protection Program Liquidity Facility to bolster the effectiveness of the Coronavirus Aid, Relief, and Economic Security Act’s (CARES Act) Paycheck Protection Program. Our Main Street Lending Program, which we are in the process of launching, supports lending to both small and midsized businesses. The Term Asset-Backed Securities Loan Facility supports lending to both businesses and consumers. To support the employment and spending of investment-grade businesses, we established two corporate credit facilities. And to help U.S. state and local governments manage cash flow pressures and serve their communities, we set up the Municipal Liquidity Facility.

The tools that the Federal Reserve is using under its 13(3) authority are appropriately reserved for times of emergency. When this crisis is behind us, we will put them away. The June Monetary Policy Report reviews the implications of these tools for the Federal Reserve’s balance sheet.

Many of these facilities have been supported by funding from the CARES Act. We will be disclosing, on a monthly basis, names and details of participants in each such facility; amounts borrowed and interest rate charged; and overall costs, revenues, and fees for each facility. We embrace our responsibility to the American people to be as transparent as possible, and we appreciate that the need for transparency is heightened when we are called upon to use our emergency powers.

We recognize that our actions are only part of a broader public-sector response. Congress’s passage of the CARES Act was critical in enabling the Federal Reserve and the Treasury Department to establish many of the lending programs. The CARES Act and other legislation provide direct help to people, businesses, and communities. This direct support can make a critical difference not just in helping families and businesses in a time of need, but also in limiting long-lasting damage to our economy.

I want to end by acknowledging the tragic events that have again put a spotlight on the pain of racial injustice in this country. The Federal Reserve serves the entire nation. We operate in, and are part of, many of the communities across the country where Americans are grappling with and expressing themselves on issues of racial equality. I speak for my colleagues throughout the Federal Reserve System when I say, there is no place at the Federal Reserve for racism and there should be no place for it in our society. Everyone deserves the opportunity to participate fully in our society and in our economy.

We understand that the work of the Federal Reserve touches communities, families, and businesses across the country. Everything we do is in service to our public mission. We are committed to using our full range of tools to support the economy and to help assure that the recovery from this difficult period will be as robust as possible.

Thank you. I am happy to take your questions.

 

 

 

 

Supreme Court’s LGBTQ ruling may sideline Trump’s health care rules

Posted on by • Posted in 2020 Election Issues, Dept of Health and Human Services (HHS), Discrimination, Health Policy, Health System, Hospital, Hospital Industry, Nondiscrimination, Supreme Court • Leave a comment

https://www.axios.com/supreme-court-lgbtq-trump-health-care-e1328769-3e2f-4dc8-986d-f167de65191e.html

Supreme Court's LGBTQ ruling may sideline Trump's health care ...

The Supreme Court’s historic ruling on LGBTQ nondiscrimination could sideline the Trump administration’s new policies on health care and adoption.

Why it matters: The ruling’s ripple effects will be felt immediately, and could ultimately derail regulations the administration had finalized just days ago.

The big picture: Federal civil rights law prohibits discrimination on the basis of sex, and the Supreme Court said Monday that “sex” includes sexual orientation and gender identity.

  • Monday’s case was specifically about employment, but the same legal interpretation will likely carry over to other areas, most notably health care — and that could cause problems for some of the Trump administration’s policies.

Between the lines: Just a few days before the Supreme Court’s ruling, the Department of Health and Human Services rolled back Obama-era rules that banned health care providers from denying care to trans patients.

  • That was based on the Trump administration’s interpretation of what constitutes “sex” discrimination — that it only encompasses biological traits defined at birth. That is, broadly, the same interpretation the high court rejected on Monday.

What’s next: The court’s ruling does not automatically invalidate the health care rules, but would make them much harder to defend in court. And if the administration doesn’t withdraw the rules, those lawsuits are coming.

  • “The court here today clearly articulated that discrimination based on sexual orientation, discrimination based on gender identity, are forms of sex discrimination,” said Alphonso David, president of the Human Rights Campaign.
  • “So, we are expecting the administration to rescind their rule immediately,” he said. “If they don’t, we are prepared to continue to use all of our resources, including litigation, to sue them and make sure that the rule is never implemented,”

HHS declined to answer questions about the regulations in light of Monday’s ruling.

Federal adoption guidelines could also be affected by the court’s decision.

  • The Trump administration has been working on rules that would make it easier for adoption and foster agencies to refuse to work with same-sex couples. Those rules would also face lawsuits if and when they’re finalized.
  • The specific legal foundations at issue there are somewhat different, but now that the Supreme Court has said civil-rights law prohibits discrimination on the basis of sexual identity and gender identity, any policy allowing such discrimination is going to face a steeper climb in the courts.

The bottom line: It may take a while for some of these issues to work their way through the courts, but the Supreme Court’s ruling Monday will make many forms of LGBTQ discrimination harder to defend, and in the scheme of things, that will likely happen pretty quickly.

 

 

 

 

Axios-Ipsos poll: Americans fear a second wave

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Expectations, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Mortality, Pandemic, Partisanship, Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

https://www.axios.com/axios-ipsos-coronavirus-index-second-wave-87c327c2-42bb-43a5-80b2-5f2f513a24b2.html

Axios-Ipsos poll: Americans fear a second wave - Axios

Eight in 10 Americans are worried about a second wave of the coronavirus, with large majorities saying they’ll resume social distancing, dial back shopping and keep their kids out of school if it happens, in Week 13 of the Axios-Ipsos Coronavirus Index.

Why it matters: Businesses and schools around the country are trying to assess how quickly and fully they should reopen based in part on what Americans will demand and tolerate. These findings underscore the challenges in predicting how they should proceed.

  • But getting Americans to swallow a second round of 14-day self-quarantining could be tougher than getting them to go back to social distancing, with one in three saying they likely won’t do it.
  • The biggest factor is partisan identification, with 81% of Democrats but only 49% of Republicans saying they’ll self-quarantine if a second wave hits.

The big picture: The latest installment of our national weekly survey shows a renewed sense of risk following reports of new hospitalizations since states began lifting stay-at-home orders — but quarantine fatigue is still driving people to take their chances.

  • People’s assessment of large or moderate risk grew last week for each of these categories: returning to their normal workplace, dining out, retail shopping, going to the hair salon or participating in protests.
  • But the share of those going out to eat rose from 31% to 41%. Those visiting friends or relatives rose from 56% to 60%. Those getting their hair done rose from 26% to 31%. Those attending demonstrations rose from 11% to 14%.

What they’re saying: “People are starting to be concerned about it again,” said pollster Chris Jackson, senior vice president for Ipsos Public Affairs. “We’re not yet seeing changes in the patterns of their behavior yet, though.”

  • “Their behaviors are not really catching up to their concern level.”

By the numbers: 81% say they’re concerned about a second wave — including those who are extremely (30%), very (26%) or somewhat (24%) concerned.

  • 64% of those surveyed say returning to their normal pre-coronavirus life represents a large or moderate risk, up from 57% a week ago.
  • The share of people extremely or very concerned about getting sick rose from 32% to 40% last week. Those fearing U.S. economic collapse rose from 48% to 54%.
  • There also were upticks in people’s concerns about job security and the government’s response to the outbreak.
  • Americans’ ability to afford household goods also decreased.
  • One in 10 surveyed say they’ve been collecting unemployment benefits in recent weeks.
  • 35% of Americans now know someone who’s tested positive, a new high for the survey.

Between the lines: The survey suggests an evolving understanding of the racial disparities in the pandemic.

  • The share of those saying they are extremely or very concerned that the coronavirus is doing greater damage to people of color rose from 36% to 42%.
  • The share of those extremely or very concerned that official responses are biased against certain groups also rose from 36% to 42%.

 

 

 

 

How could reopenings, protests affect coronavirus infections?

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economy Reopening, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Mortality, Pandemic, Personal Protective Equipment (PPE), Protest, Public Health, Public Safety, Quarantine, Social Distancing, Uncertainty • Leave a comment

https://www.politifact.com/article/2020/jun/09/how-could-reopenings-protests-affect-coronavirus-i/?fbclid=IwAR1tC4zpfVBq56fc2XDuOyKswBzwjPsXbe8CN4sv1yfCV-856_Qy2OXe298

Two women peer into a clothing store to see if it is open in Brooklyn, N.Y., on June 8, 2020, after New York reopened some retail stores. (AP)

IF YOUR TIME IS SHORT

• Since April, the numbers of new cases and deaths from the coronavirus have been falling nationally, although the number of cases ticked slightly upward in the first week of June, a few weeks after many states ended their stay-at-home orders.

• The spread of the virus has varied significantly from state to state. Some states, especially those with longer-lasting stay-at-home orders, have seen cases fall since April. Others, including many that ended their closures earlier, have seen increases.

• Scientists expect to see a rise in coronavirus cases in the coming weeks due to continued reopenings and the racial justice protests. However, it’s unclear how large those increases will be.

With most states reopening for business after shutting down for the novel coronavirus, some states are seeing an increase in infections. And with protest marches bringing together large numbers of people, some scientists worry that infections could rise further.

However, scientists say that there’s lots of uncertainty about whether, and how much, the coronavirus will spread following the lifting of stay-at-home orders and the emergence of protest marches for racial justice.

We looked at the most recent data and interviewed several researchers to explain what we’re seeing already, and what might happen in the future.

What are the overall trends for coronavirus cases and deaths?

Nationally, both cases and deaths have generally been falling since April, although cases saw a small uptick in early June.

Here’s a chart showing the number of new coronavirus cases confirmed each day since the outbreak began in late February. The blue bars show the number of new cases per day, while the orange line shows the seven-day rolling average, which smooths out technical differences in the daily reporting.

The pattern for coronavirus deaths has been similar, with a fairly consistent decline since mid-April.
Researchers said the spring stay-at-home orders are likely the main reason for the declining trend.

“The social distancing that resulted from the closures slowed cases,” said Tara C. Smith, a professor of epidemiology at Kent State University.

Smith cited a recent study that estimated that the shutdowns prevented an additional 4.8 million confirmed coronavirus cases in the U.S., and about 60 million infections in all. (The 60 million figure includes people who didn’t know they were infected and did not confirm their infection with a test.) So far, there have been roughly 2 million confirmed coronavirus cases.

The decline in cases has been driven by significant improvements in the hardest-hit area: the tri-state region of New York, New Jersey and Connecticut. Each of those states has seen the number of new cases decline consistently since April, as can be seen in this chart:

How has the timing of reopenings affected new-case patterns?

The national numbers mask considerable differences among the states in new caseloads.

Beyond New York, New Jersey and Connecticut, several other large states have seen declining caseloads over time.

Here’s a chart showing the patterns for Pennsylvania, Illinois, Ohio, Michigan and Virginia, all of which have seen declines in new cases in recent weeks:

But other states have seen increases in recent weeks. Here’s a look at the upward trends in California, Texas, Florida, Georgia, North Carolina and Arizona:

One notable difference between the states with rising and falling numbers of new cases is the date they lifted their stay-at-home orders.

Almost every state in our chart that’s seeing rising numbers of new cases reopened between April 30 and May 22. (The one exception is California, which is a mystery to the experts we asked.)

By contrast, the states in our charts with falling numbers of new cases opened no earlier than May 28.

Experts said there are too many variables to conclude that reopening will inevitably produce rising new case counts. For instance, the virus’ spread may be proceeding differently in urban areas than in the rest of the state, something that the state-level data wouldn’t capture.

Also, the data we used are not adjusted for the number of tests being conducted. The more tests that are done, the more positive cases will be found, everything else being equal.

That said, if there is a connection between reopening and a rise in new cases, the states that delayed their openings may see their new case loads rise in the coming weeks.

“Until we have a vaccine for prevention, our ‘people’ interventions are what stand between us and the virus spreading,” said Nicole Gatto, an associate professor in the School of Community and Global Health at Claremont Graduate University. “Reopening efforts and mixing of people again will reintroduce the potential for viral transmission.”

What impact could the recent protest marches have on the virus’ spread?

For now, the impact of the protests on new caseloads is not showing up in the data. Any impact would become evident only in the next few weeks, as participants get tested and the results are tabulated.

Some aspects of the protests could promote the spread, experts said.

“The protests have ingredients which we have been making efforts to avoid these last three months: large gatherings of people in close proximity to each other not always wearing protective face coverings,” Gatto said. “Add in tear gas, and the recipe becomes worse.”

People who were arrested at protests and had to spend time in jail could also be at higher risk for infection, scientists said.

The best-case scenario, scientists said, is that the marches’ outdoor locations and the precautions taken by participants will cut down on the spread.

“Outdoor gatherings may present less transmission risk, especially when everyone is wearing a mask,” said Forrest W. Crawford, a biostatistician at Yale University.

While emphasizing the uncertainties, Smith said she was surprised by the relatively modest impact of the state reopenings on the virus’ spread so far. So there may be reason for cautious optimism.

“I’m expecting cases to grow over the next two weeks, but it’s really tough to say if it will be a spike or a less dramatic increase,” she said.