Category Archives: Health Policy

CMS suspends advance payments to providers, is reevaluating accelerated payments for hospitals

Posted on by • Posted in 2020 Election Issues, Cash, Cash Reserves, Cash-Flow Improvements, Center for Medicare and Medicaid Services (CMS), Coronavirus, Crisis, Crisis Management, Dept of Health and Human Services (HHS), Economic Crisis, Economic Stimulus, Health Policy, Health System, Hospital, Hospital Industry, Medicare, Paycheck Protection Program, Physician, Physician Practice Management, Supply Chain, The CARES Act • Leave a comment

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CMS suspends advance payments to providers, is reevaluating ...

The Trump administration is suspending a program that offered advanced payments to providers and reevaluating another program that offered accelerated payments to health systems after doling out about $100 billion. 

The Centers for Medicare & Medicaid Services (CMS) announced over the weekend it is immediately suspending its Advance Payment Program to Medicare Part B suppliers such as doctors, non-physician practitioners and durable medical equipment suppliers.

The agency is reevaluating the amounts that will be paid under its Accelerated Payment Program, which have been made available to fee-for-service Medicare providers such as hospitals in light of the $100 billion already sent to providers through the program.

CMS had expanded the loan programs to ensure providers and suppliers had resources needed to combat COVID-19 as many began furloughing or laying off workers due to sharp revenue drops from elective care amid the COVID-19 response.

CMS approved more than 24,000 applications under the program and advanced more than $40 billion to Part B suppliers in the last several weeks. It approved 21,000 applications for accelerated payments, totaling nearly $60 billion in payments to hospitals.

Prior to COVID-19, the agency had only approved just over 100 of such requests.

The advanced and accelerated payments are not grants, but instead payments that are required to be paid back within one year, officials said.  

In a release, CMS officials said the actions are also being taken “in light of the $175 billion recently appropriated for healthcare provider relief payments,” the agency said, referring to $100 billion allocated in the CARES Act as well as $75 billion allocated to providers through the Paycheck Protection Program and Health Care Enhancement Act.

The Department of Health and Human Services is distributing that money through the Provider Relief Fund. Those funds will be used to support healthcare-related expenses or lost revenue attributable to the COVID-19 pandemic and to ensure uninsured Americans can get treatment for COVID-19, officials said.

Among the recipients of the funding, HCA Healthcare said it benefited from about $4 billion in accelerated Medicare payments provided under the CARES Act, saying that money will be repaid over an eight-month period beginning in August. HCA also received about $700 million of funds from the first phase of the public health and social services emergency fund.

Those two pieces of economic assistance have had the greatest impact in stabilizing the health system’s financials amid challenges presented by COVID-19, HCA officials said during a recent conference call with analysts.

 

 

 

The only way to get back to normal this summer is to test everyone in the United States, Nobel Prize-winning economist says

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Employee Furlough, Employee Layoffs, Employee Pay Cuts, Health Policy, Infection Control, Infectious Virus, Pandemic, Public Health, Public Safety, Social Distancing, Unemployment, Unemployment Insurance • Leave a comment

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Coronavirus tests should be as cheap as a 'morning latte' to ...

Paul Romer estimates that testing every American would cost $100 billion, a hefty sum but less than the $2 trillion Congress has spent so far.

Nobel Prize-winning economist Paul Romer says a return to nearly normal life is possible this summer if the United States does wide-scale testing for the coronavirus.

Romer is calling on the U.S. government to test everyone in the nation once every two weeks and isolate people who test positive for the deadly coronavirus. He estimates that doing so would cost $100 billion, a hefty sum but far less than the $2 trillion Congress has spent so far and less than the cost of keeping the economy partly closed for months to come.

“I’m on the optimistic end of how quickly we can scale testing up,” said Romer, who won the 2018 Nobel Prize for economics. “I do think there’s a way most people could feel safe returning to what feels like normal life this summer if we do this wide-scale testing.”

So far, the nation has tested about 5 million people — or less than 2 percent of the population. Last week, Congress approved an additional $25 billion for testing as part of the latest funding bill, which Romer calls a good start but not enough.

Restarting the U.S. economy isn’t just about government officials clearing certain businesses to reopen. People have to feel safe enough to venture out. Romer says that will happen only when nearly everyone in the country is getting tested on a regular basis and people who are sick are being quarantined.

“It’s totally in our control to fix this,” Romer said in a phone interview. “We should be spending $100 billion on the testing. We should just get it going. It’s just not that hard.”

He advises starting with screening all health-care and front-line workers in the next month and then scaling up the testing to the rest of the nation this summer by using university labs to process tests.

Romer says massive testing is the only viable option for the nation. Otherwise, the economy will limp along, leaving millions of people unemployed and forcing small businesses to shut forever. It could take years to recover from that kind of pain. On the flip side, reopening much of the nation too soon could cause deaths to skyrocket again.

Top White House officials voiced support for more testing over the weekend. Treasury Secretary Steven Mnuchin said on Fox News Sunday that the Trump administration would “balance” reopening the economy with “more testing” to “monitor this very, very carefully.”

Deborah Birx, the White House’s coronavirus task force coordinator, said Sunday that more testing would be needed and that “social distancing will be with us through the summer.“

As Congress and the White House debate another round of economic relief, it’s unclear how much more money will be allocated for testing. Evidence from China and Germany, which have begun to reopen much of their economies, shows that people remain reluctant to go out and spend again. Subways in China remain half full, big public spaces such as casinos remain nearly empty and economic activity is still way off from normal.

Although some have balked at the cost of testing every American, Romer points out that the United States is losing at least $500 billion a month from the Great Lockdown. His estimate is more modest than some other economists such as St. Louis Federal Reserve President Jim Bullard, who says the nation is losing $25 billion a day right now. Bullard has also endorsed universal testing as the only way to fix the nation’s health — and economic — problems.

“Every month of delay makes the recovery slower — and take longer,” Romer said.

Romer won the Nobel Prize for modeling the U.S. and global economies. A former chief economist at the World Bank, he has built a career thinking through big international problems and what to do about them. But the coronavirus fight is also personal for him. He has a daughter who is an intensive care physician in Philadelphia.

 

 

 

In worst-case scenario, COVID-19 coronavirus could cost the U.S. billions in medical expenses

Posted on by • Posted in Cash, Cash Reserves, Cash-Flow Improvements, Coronavirus, Crisis, Crisis Management, Economic Crisis, Elective Procedures, Elective Surgery, Health Policy, Health System, Herd Immunity, Hospital, Hospital Bed Shortage, Hospital Industry, Intensive Care (ICU), Net Income, Operating Expenses, Operating Income, Operating Margin, Operating Performance, Operating Revenue, Pandemic, Ventilators • Leave a comment

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In worst-case scenario, COVID-19 coronavirus could cost the U.S. ...

If 20% of the US population were to become infected with COVID-19, it would result in an average of $163.4 billion in direct medical costs.

One of the major concerns about the COVID-19 coronavirus pandemic has been the burden that cases will place on the healthcare system. A new study published April 23 in the journal Health Affairs found that the spread of the virus could cost hundreds of billions of dollars in direct medical expenses alone and require resources such as hospital beds and ventilators that may exceed what is currently available.

The findings demonstrate how these costs and resources can be cut substantially if the spread of COVID-19 coronavirus can be reduced to different degrees.

The study was led by the Public Health Informatics, Computational and Operations Research team at the City University of New York Graduate School of Public Health and Health Policy, along with the Infectious Disease Clinical Outcomes Research Unit at the Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center and Torrance Memorial Medical Center.

The team developed a computer simulation model of the entire U.S. that could then simulate what would happen if different proportions of the population end up getting infected with the COVID-19 coronavirus. In the model, each infected person would develop different symptoms over time and, depending upon the severity of those symptoms, visit clinics, emergency departments or hospitals.

The resources each patient would require – such as healthcare personnel time, medication, hospital beds and ventilators – would then be based on the health status of each patient. The model then tracks the resources involved, the associated costs and the outcomes for each patient.

For example, if 20% of the U.S. population were to become infected with the COVID-19 coronavirus, there would be an average of 11.2 million hospitalizations and 1.6 million ventilators used, costing an average of $163.4 billion in direct medical costs during the course of the infection.

The study shows the factors that could push this amount up to 13.4 million hospitalizations and 2.3 million ventilators used, costing an average of $214.5 billion. If 50% of the U.S. population were to get infected with COVID-19, there would be 27.9 million hospitalizations, 4.1 million ventilators used and 156.2 million hospital bed days accrued, costing an average of $408.8 billion in direct medical costs during the course of the infection.

This increases to 44.6 million hospitalizations, 6.5 million ventilators used and 249.5 million hospital bed days (general ward plus ICU bed days) incurred, costing an average of $654 billion during the course of the infection if 80% of the U.S. population were to get infected. The significant difference in medical costs when various proportions of the population get infected show the value of any strategies that could reduce infections and, conversely, the potential cost of simply letting the virus run its course – the “herd immunity” approach.

Simply put, allowing people to get infected until herd immunity thresholds are met would come at a tremendous cost, and even if social-distancing measures were relaxed and the country “opened up” too early, the healthcare system, as well as the broader economy, would come close to buckling under the weight of the additional costs.

WHAT’S THE IMPACT?

The study shows how costly the coronavirus is compared to other common infectious diseases. For example, a single symptomatic COVID-19 infection costs an average of $3,045 in direct medical costs during the course of the infection alone. This is four times higher than a symptomatic influenza case and 5.5 times higher than a symptomatic pertussis case. Factoring in the costs from longer lasting effects of the infection such as lung damage and other organ damage increased the average cost to $3,994.

Importantly, for a sizable proportion of those who get infected, healthcare costs don’t end when the active infection ends, and costs will likely stay high even after the bulk of the pandemic has passed.

A continuing concern is that the U.S. healthcare system will become overloaded with the surge of COVID-19 coronavirus cases and will subsequently not have enough person-power, ventilators and hospital beds to accommodate the influx of patients. The study shows that even when only 20% of the population gets infected, the current number of available ventilators and ICU beds will not be sufficient.

According to the Society of Critical Care Medicine, there are approximately 96,596 ICU beds and 62,000 full-featured mechanical ventilators in the U.S., substantially lower than what would be needed when only 20% of the population gets infected.

THE LARGER TREND

Data released this week by Kaufman Hall illustrates the extent to which U.S. hospitals are already suffering financially due to the coronavirus.

Looking at earnings before interest, taxes, depreciation and amortization, hospitals’ operating margins fell more than 100% in March, dropping a full 13 percentage points relative to last year. Compared to most months, that’s a much greater change. Operating EBITDA margin was up just 1% in March 2019, for example, and down 1% in February of this year.

These margins likely fell even further across broader health systems, which often include substantial physician and ambulatory operations outside of the hospital, Kaufman Hall found. Overall, operating margins fell 170% below budget for the month.

 

 

 

“Immunity passports” in the context of COVID-19

Posted on by • Posted in Antibodies, Clinical Research, Coronavirus, Crisis, Crisis Management, Health Policy, Immunity, Infection Control, Infectious Virus, Pandemic, Public Health, Public Safety, Social Distancing, World Health Organization (WHO) • Leave a comment

https://www.who.int/news-room/commentaries/detail/immunity-passports-in-the-context-of-covid-19

Charu Kaushic (@CKaushic) | Twitter

Scientific Brief

WHO has published guidance on adjusting public health and social measures for the next phase of the COVID-19 response.1 Some governments have suggested that the detection of antibodies to the SARS-CoV-2, the virus that causes COVID-19, could serve as the basis for an “immunity passport” or “risk-free certificate” that would enable individuals to travel or to return to work assuming that they are protected against re-infection. There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection.

 

The measurement of antibodies specific to COVID-19

The development of immunity to a pathogen through natural infection is a multi-step process that typically takes place over 1-2 weeks. The body responds to a viral infection immediately with a non-specific innate response in which macrophages, neutrophils, and dendritic cells slow the progress of virus and may even prevent it from causing symptoms. This non-specific response is followed by an adaptive response where the body makes antibodies that specifically bind to the virus. These antibodies are proteins called immunoglobulins. The body also makes T-cells that recognize and eliminate other cells infected with the virus. This is called cellular immunity. This combined adaptive response may clear the virus from the body, and if the response is strong enough, may prevent progression to severe illness or re-infection by the same virus. This process is often measured by the presence of antibodies in blood.

WHO continues to review the evidence on antibody responses to SARS-CoV-2 infection.2-17 Most of these studies show that people who have recovered from infection have antibodies to the virus. However, some of these people have very low levels of neutralizing antibodies in their blood,4 suggesting that cellular immunity may also be critical for recovery. As of 24 April 2020, no study has evaluated whether the presence of antibodies to SARS-CoV-2 confers immunity to subsequent infection by this virus in humans.

Laboratory tests that detect antibodies to SARS-CoV-2 in people, including rapid immunodiagnostic tests, need further validation to determine their accuracy and reliability. Inaccurate immunodiagnostic tests may falsely categorize people in two ways. The first is that they may falsely label people who have been infected as negative, and the second is that people who have not been infected are falsely labelled as positive. Both errors have serious consequences and will affect control efforts. These tests also need to accurately distinguish between past infections from SARS-CoV-2 and those caused by the known set of six human coronaviruses. Four of these viruses cause the common cold and circulate widely. The remaining two are the viruses that cause Middle East Respiratory Syndrome and Severe Acute Respiratory Syndrome. People infected by any one of these viruses may produce antibodies that cross-react with antibodies produced in response to infection with SARS-CoV-2.

Many countries are now testing for SARS-CoV-2 antibodies at the population level or in specific groups, such as health workers, close contacts of known cases, or within households.21 WHO supports these studies, as they are critical for understanding the extent of – and risk factors associated with – infection.  These studies will provide data on the percentage of people with detectable COVID-19 antibodies, but most are not designed to determine whether those people are immune to secondary infections.

 

Other considerations

At this point in the pandemic, there is not enough evidence about the effectiveness of antibody-mediated immunity to guarantee the accuracy of an “immunity passport” or “risk-free certificate.” People who assume that they are immune to a second infection because they have received a positive test result may ignore public health advice. The use of such certificates may therefore increase the risks of continued transmission. As new evidence becomes available, WHO will update this scientific brief.

 

 

 

 

Hospitals that have disclosed bailout funds

Posted on by • Posted in 2020 Election Issues, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Stimulus, Federal Bailout Funding, Health Policy, Health System, Hospital, Hospital Bailout, Hospital Bailout Funding, Hospital Industry, Oversight, Pandemic • Leave a comment

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Hospitals Need Cash. Health Insurers Have It.

More than $1.2 billion in federal bailout funds have been disclosed by hospitals and health systems thus far, including $150 million that was sent to Mayo Clinic, according to a review of financial documents by Axios’ Bob Herman.

Why it matters: Hospitals do not have to repay these taxpayer funds, which are supposed to offset the lost revenue and higher costs associated with handling the coronavirus outbreak. But there is no central location to track where the money is flowing.

The big picture: Hospitals and other health care providers can receive coronavirus funds through two primary sources:

Where it stands: Axios has found 11 hospital organizations — ranging from small community hospitals to large, multistate systems — that have disclosed bailout funding and Medicare loans through municipal bondholder documents or public filings, and compiled them into a database.

  • Some of the largest bailout payments disclosed so far have gone to HCA Healthcare ($700 million), Mayo Clinic ($150 million), Mercy ($101.7 million) and NYU Langone Health ($73.1 million).
  • $50 billion of the first $100 billion in bailout funds is “allocated proportional to providers’ share of 2018 net patient revenue,” according to HHS, and therefore likely favors systems that are bigger and/or charge higher prices.
  • Medicare has sent $100 billion as loans as of April 24, $7 billion of which has been disclosed to these 11 hospital systems.

Go deeper: The hospital bailout funding database

 

 

 

 

 

Covid-19 Testing is increasing, but still not good enough

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The Daily Shot: So Far, About 5% of Small Businesses Received ...

The good news is that the number of daily coronavirus tests is going up again. The bad news is that it’s still not nearly enough for the country to safely reopen.

Why it matters: If we don’t know who has the virus, we can’t stop it from spreading without resorting to stringent social distancing measures.

Driving the news: On Saturday, Anthony Fauci said that the U.S. is testing roughly 1.5 million to 2 million people a week, but “we probably should get up to twice that as we get into the next several weeks, and I think we will.”

  • Deborah Birx, the White House coronavirus task force coordinator, said yesterday that “we have to realize that we have to have a breakthrough innovation in testing.” She said we’ll need tests that can detect antigen, or the part of a pathogen that triggers an immune response.

Between the lines: Testing has been hampered by shortages of supplies like swabs and test kits. There has also been a lack of coordination between labs with excess testing capacity and communities struggling to meet testing demand.

What we’re watching: Some major cities and states — including New York and California — have begun to expand testing beyond the sickest patients, which is a good sign.

 

 

 

 

The pandemic didn’t come out of nowhere. The U.S. ignored the warnings.

Posted on by • Posted in 2020 Election Issues, Coronavirus, Crisis, Crisis Management, Denial, Economic Crisis, Emergency Preparedness, Health Policy, Infection Control, Infectious Virus, Leadership Decentralized, Mislead, Misleading, Mortality, National Security, National Security Risk, Pandemic, Partisanship, Public Health, Public Safety, Scientists • Leave a comment

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The pandemic didn't come out of nowhere. The U.S. ignored the ...

“CAME OUT of nowhere,” President Trump said March 6 of the coronavirus pandemic. “I just think this is something . . . that you can never really think is going to happen.” A few weeks later, he added, “I would view it as something that just surprised the whole world.” Mr. Trump also said, “Nobody knew there would be a pandemic or epidemic of this proportion.”

Of course, no one can pinpoint the exact moment that lightning will strike. But a global pandemic? Experts have predicted it, warned about the preparedness gaps and urged action. Again and again and again.

Just look at 2019. In January, the U.S. intelligence community issued its annual global threat assessment. It declared, “We assess that the United States and the world will remain vulnerable to the next flu pandemic or large-scale outbreak of a contagious disease that could lead to massive rates of death and disability, severely affect the world economy, strain international resources, and increase calls on the United States for support. . . . The growing proximity of humans and animals has increased the risk of disease transmission. The number of outbreaks has increased in part because pathogens originally found in animals have spread to human populations.”

In September, the Johns Hopkins Center for Health Security issued a report titled “Preparedness for a High-Impact Respiratory Pathogen Pandemic.” The report found that if such a pathogen emerged, “it would likely have significant public health, economic, social, and political consequences. . . . The combined possibilities of short incubation periods and asymptomatic spread can result in very small windows for interrupting transmission, making such an outbreak difficult to contain.” The report pointed to “large national and international readiness gaps.”

In October, the Nuclear Threat Initiative, working with the Johns Hopkins center and the Economist Intelligence Unit, published its latest Global Health Security Index, examining open-source information about the state of health security across 195 nations, and scoring them. The report warned, “No country is fully prepared for epidemics or pandemics, and every country has important gaps to address.” The report found that “Fewer than 5 percent of countries scored in the highest tier for their ability to rapidly respond to and mitigate the spread of an epidemic.”

In November, the Center for Strategic and International Studies published a study by its Commission on Strengthening America’s Health Security. It warned, “The American people are far from safe. To the contrary, the United States remains woefully ill-prepared to respond to global health security threats. This kind of vulnerability should not be acceptable to anyone. At the extreme, it is a matter of life and death. . . . Outbreaks proliferate that can spread swiftly across the globe and become pandemics, disrupting supply chains, trade, transport, and ultimately entire societies and economies.” The report recommended: “Restore health security leadership at the White House National Security Council.”

Came out of nowhere? Not even close. The question that must be addressed in future postmortems is why all this expertise and warning was ignored.

 

 

 

 

U.S. coronavirus updates

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Coronavirus outbreak is level of public pain we haven't seen in ...

 

The pandemic is a long way from over, and its impact on our daily lives, information ecosystem, politics, cities and health care will last even longer.

The big picture: The novel coronavirus has infected more than 939,000 people and killed over 54,000 in the U.S., Johns Hopkins data shows. More than 105,000 Americans have recovered from the virus as of Sunday.

Lockdown measures: Demonstrators gathered in Florida, Texas and Louisiana Saturday to protest stay-at-home orders designed to protect against the spread of COVID-19, following a week of similar rallies across the U.S.

  • 16 states have released formal reopening plans, Vice President Mike Pence said at Thursday’s White House briefing. Several Southern states including South Carolina have already begun reopening their economies.
  • Alaska, Oklahoma and Georgia reopened some non-essential businesses Friday. President Trump said Wednesday he “strongly” disagrees with Georgia Gov. Brian Kemp on the move.
  • California’s stay-at-home orders and business restrictions will remain in place, Gov. Gavin Newsom made clear at a Wednesday news briefing. But some local authorities reopened beaches in Southern California Saturday.
  • New York recorded its third-straight day of fewer coronavirus deaths Friday. Still, Gov. Andrew Cuomo said he’s not willing to reopen the state, citing CDC guidance that states need two weeks of flat or declining numbers.

Catch up quick: Deborah Birx said Sunday that it “bothers” her that the news cycle is still focused on Trump’s comments about disinfectants possibly treating coronavirus, arguing that “we’re missing the bigger pieces” about how Americans can defeat the virus.

  • Anthony Fauci said Saturday the U.S. is testing roughly 1.5 million to 2 million people a week. “We probably should get up to twice that as we get into the next several weeks, and I think we will,” he said.
  • The number of sailors aboard the USS Kidd to test positive for the coronavirus has risen from 18 Friday to 33, the U.S. Navy said Saturday. It’s the second major COVID-19 outbreak on a U.S. naval vessel, after the USS Theodore Roosevelt, where a total of 833 crew members tested positive, per the Navy’s latest statement.
  • The first person known to have the coronavirus when they died was killed by a heart attack “due to COVID-19 infection” on Feb. 6, autopsy results obtained by the San Francisco Chronicle on Saturday show.
  • Some young coronavirus patients are having severe strokes.
  • Trump tweeted Saturday that White House press conferences are “not worth the time & effort.” As first reported by Axios, Trump plans to pare back his coronavirus briefings.
  • The South is at risk of being devastated by the coronavirus, as states tend to have at-risk populations and weak health care systems.
  • New York Gov. Andrew Cuomo said Friday Trump was right to criticize the World Health Organization’s handling of the global outbreak.
  • Trump signed legislation Friday for $484 billion in more aid to small businesses and hospitals.
  • The House voted along party lines on Thursday to establish a select committee to oversee the federal government’s response to the crisis.
  • Unemployment: Another 4.4 million Americans filed last week. More than 26 million jobless filings have been made in five weeks due to the pandemic.

 

 

 

 

World coronavirus updates

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Coronavirus brings clearer skies but darker world to 50th Earth ...

Children in Spain were allowed to go outside on Sunday for the first time since a nationwide lockdown aimed at slowing the spread of the novel coronavirus began six weeks ago.

By the numbers: The coronavirus has infected over 2.9 million people and killed over 200,000, Johns Hopkins data shows. More than 829,000 people have recovered from COVID-19. The U.S. has reported the most cases in the world (more than 940,000 from 5.1 million tests), followed by Spain (over 223,000).

What’s happening: Australian Health Minister Greg Hunt announced a new coronavirus tracing app on Sunday that the government hopes at least 50 percent of the population will use. A top health official said the app is “only for one purpose, to help contact tracing,” as he sought to reassure Australians on privacy issues.

  • China reported 11 new cases and no deaths on Sunday. It’s been 10 days since the country reported any deaths. China’s reported infections and deaths have been treated with suspicion by foreign leaders and the CIA.
  • Argentina is extending a nationwide shelter-in-place order that was due to expire Sunday until May 10, President Alberto Fernandez said on Saturday, per Reuters. The country has confirmed over 3,700 cases, according to Johns Hopkins.
  • Spain will gradually ease nationwide stay-at-home restrictions starting May 2 if coronavirus cases continue to decline, Prime Minister Pedro Sánchez said Saturday.
  • British Prime Minister Boris Johnson plans to return to work on Monday after recovering from the coronavirus.
  • The World Health Organization said Saturday there is “no evidence” that people who recover from COVID-19 and have antibodies are protected from a second infection.
  • India announced it will be easing lockdown measures for its 1.3 billion people in the areas outside of hotspots — providing some relief for locally owned businesses and daily wage workers.
  • The director of Israel’s foreign intelligence agency, Mossad, said in a briefing to health care officials on Thursday that Iran and its regional allies are intentionally underreporting cases and deaths from the coronavirus.
  • Brazil and Ecuador are becoming coronavirus epicenters in Latin America, as prolonged lapses in tracking and testing have led to severely undercounted death tolls, the Washington Post and the N.Y. Times report.
  • New Zealand’s level 4 lockdown measures requiring non-essential workers to stay home have been extended to 11:59 p.m next Monday, when the country moves into a still-strict level 3. NZ reported just three cases on Thursday.
  • Pakistan has decided to keep mosques open during the fasting month of Ramadan, which began Thursday, as cases continue to climb, AP reports.

The big picture: The world faces its gravest challenge in decades, but geopolitical tensions won’t wait until it’s over. Trump’s threat on Wednesday to “destroy” Iranian boats that harass U.S. ships comes amid arrests of Hong Kong pro-democracy activists and clashes in Afghanistan that could further undermine peace there.

Between the lines: Policy responses to the crisis have been every-country-for-itself and — in the case of the U.S. and China — tinged with geopolitical rivalry.

  • But the scientific work under way to understand the virus and develop a vaccine has been globalized on an unprecedented scale.

Coronavirus symptoms: Fever, cough, shortness of breath.

 

 

U.S. with 1/3 of Confirmed Coronavirus Cases with Less Than 2% of Population Tested

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Coronavirus outbreak affecting some Durham high school students ...

By the numbers: The coronavirus has infected over 2.9 million people and killed over 200,000, Johns Hopkins data shows. More than 829,000 people have recovered from COVID-19. The U.S. has reported the most cases in the world (more than 940,000 from 5.1 million tests), followed by Spain (over 223,000).