The president of the Federal Reserve Bank of Minneapolis said Sunday that the “worst is yet to come” after a record of 20 million people lost their jobs amid furloughs and layoffs sparked by the coronavirus pandemic in April.
“I mean the worst is yet to come on the job front, unfortunately,” Neel Kashkari said on ABC’s “This Week.”
“We may be in an environment of gradual relaxing and then having to clamp back down again around the country as the virus continues to spread,” he added. “To solve the economy, we must solve the virus. Let’s never lose sight of that fact.”
Kashkari also contradicted White House economic adviser Larry Kudlow’s prediction for a financially strong half of 2020 and full 2021 when ABC’s George Stephanopoulos asked if that was realistic.
“You know, I wish it were,” he responded. “What I’ve learned in the last few months, unfortunately, this is more likely to be a slow, more gradual recovery.”
The Minneapolis Fed president said a “robust economy” would require a breakthrough in vaccines, testing and therapies.
“I don’t know when we’re going to have that confidence,” he said, adding, “and ultimately, the American people are going to decide how long the shutdown is.”
The Department of Labor reported last week that the unemployment rate had reached 14.7 percent, which is the highest since the U.S. began tracking in 1948. More than 33 million people have applied for unemployment claims since mid-March.
Speaking earlier Sunday on “This Week,” Kudlow acknowledged that “very difficult” unemployment numbers could likely be reported in May. But he added that there is a “glimmer of hope” within the unemployment data, with 80 percent of the claims involving those who were furloughed or going through temporary layoffs.
Columbia University infectious diseases expert Jeffrey Shaman predicted Sunday that the U.S. will see a growth in coronavirus cases in coming weeks as some states loosen restrictions.
Shaman said on NBC’s “Meet the Press” that Trump administration officials have not taken full advantage of the past eight weeks of near-total lockdowns, saying that the period would have “benefitted enormously from consistent messaging” from the White House.
“We do need to start picking ourselves up where we are” he said, pointing to countries that appear to have successfully contained the spread of the virus, such as South Korea, Germany and New Zealand.
“They did this because they tested so aggressively and they used contact tracing and they were able to quarantine people who were becoming infectious,” he said. “Once you’ve done that, then you’re in this position of strength where reopening the economy is not going to lead necessarily to the rebound in cases that I’m expecting, given this patchwork response that we have right now and the reopenings taking place in some states.”
“What I think we’re probably going to see over coming weeks, probably towards the end of the month, is we’re just going to start to see a growth in cases,” he added. “It’s not going to happen over the next week or two, it’s going to come in with a lag. That built-in delay means any changes we do to social distancing because of reopening, we’re not going to realize for a couple of weeks that we’re already into some period of growth.”
Multiple states have moved to reopen portions of their economy shuttered by state-at-home orders imposed to prevent the spread of coronavirus.
The Labor Department reported last week that a record 20 million Americans lost their jobs in April amid the pandemic.
White House adviser Kevin Hassett said Sunday the U.S. unemployment rate could reach 20 percent in May.
“I think just looking at the flow of initial claims, it looks like we’re probably going to get close to 20 percent in the next report,” Hassett said on CNN’s “State of the Union.”
He made similar comments on CBS’s “Face the Nation,” saying the low point could reach 20 percent around May or June.
Hassett said on CNN the unemployment rates depend on whether the virus “has really abated” and if economies are “really going again.”
“I would guess middle of summer is when we’re going to start to go into the transition phase,” he said, adding that he hopes there will be “very strong” growth in the third and fourth quarters.
The unemployment in April rate rose to 14.7 percent from 4.4 percent in March, according to the latest jobs report released by the Bureau of Labor Statistics on Friday.
The U.S. lost 20.5 million jobs in April amid the coronavirus pandemic, breaking the record for the largest one-month increase in the unemployment rate.
State governments are building armies of contact tracers in a new phase of the battle against the coronavirus pandemic, returning to a fundamental practice in public health that can at once wrestle the virus under control and put hundreds of thousands of newly jobless people back to work.
California is already conducting contact tracing in 22 counties, and it eventually plans to field a force of 10,000 state employees, who will be given basic training by University of California health experts.
Massachusetts and Ohio have partnered with Partners in Health, a global health nonprofit originally established to support programs in Haiti, to field teams of contact tracers. Maryland will partner with the University of Chicago and NORC, formerly the National Opinion Research Center, to quadruple its contact tracing capacity.
Washington, West Virginia, Iowa, North Dakota and Rhode Island are using their National Guards to trace contacts of those who have been infected with the coronavirus. In Kansas, 400 people have volunteered to trace contacts; in Utah, 1,200 state employees have raised their hands.
Contact tracing is a pillar of basic public health, a critical element in battling infectious disease around the globe. The goal is to identify those who have been infected with a virus and those with whom the infected person has come into contact.
If those contacts then come down with the virus, they can be quickly isolated so they do not spread it further. They can also be treated, making it less likely they develop the most severe symptoms.
The practice works even in areas where health systems are thin at best and nonexistent at worst.
Tracking down those who had the Ebola virus in Guinea, Liberia and Sierra Leone, three of the poorest nations on Earth, was critical to ending the world’s largest outbreak of the deadly hemorrhagic fever in 2015. World Health Organization trackers and health officials in Congo have tracked as many as 25,000 people at a time during an Ebola outbreak that is still simmering in an eastern province, even as they face the threat of what is an almost active war zone.
“Our ability to suppress transmission relates to our ability to detect the virus,” Maria Van Kerkhove, the American who leads the World Health Organization’s technical team studying the coronavirus, told reporters last week.
The focus on contact tracing comes as public health experts warn that the coronavirus will not end as a threat to humankind until so many people have become infected that the virus has nowhere else to turn — a terrifying prospect that conjures images of overwhelmed health systems and death on a mass scale — or until scientists develop and distribute an effective vaccine to billions of people across the globe.
There are more than 100 vaccines in some stage of testing, though determining their effectiveness is still months away, and production at a mass scale is months beyond that. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and the country’s most well-known infectious disease expert, has estimated that a vaccine could be as close as 18 months away, though he has acknowledged that would blow the old record for speedy development out of the water.
“We have to fundamentally do everything possible to get a safe and effective vaccine as quickly as possible. At the same time, we have to assume that it’s not around the corner,” said Tom Frieden, former director of the Centers for Disease Control and Prevention who now runs Resolve to Save Lives, a global health nonprofit.
In the meantime, the federal government has largely left it up to the states to build their contact tracing capacity.
Sen. Elizabeth Warren (D-Mass.) and Rep. Andy Levin (D-Mich.) have proposed adding a massive nationwide federal contact tracing program to the next round of coronavirus-related relief funding. In a nod to the New Deal-style scale such a program would require, they call the program the Coronavirus Containment Corps.
“Establishing a nationwide contact tracing program is the only way we can truly know the progress we’ve made in containing the virus, and how far we have left to go before we can transition back to normal life,” Levin said in a statement.
But contact tracing can work only if the number of new cases the United States confirms every day begins to bend down to a manageable number. The number of cases confirmed in the United States has grown by at least 25,000 on all but two of the first eight days of May.
And tracing will become an effective tool only when those who are conducting the tracing have the ability to test people broadly and to get the results of those tests back quickly. The Food and Drug Administration said Friday it had approved both the first diagnostic test that could be conducted using home-collected saliva samples and the first antigen test, a type of test that delivers results much faster than others on the market.
The lack of available tests at the earliest stages of the coronavirus outbreak has hidden the true extent of the virus’s spread around the United States. While some countries have the capacity to test huge percentages of their population on a given day, the United States is still testing only about 250,000 people per day, a level far short of the capacity necessary to conduct widespread contact tracing.
“Right from the start there has been a tremendous undercounting of cases, and that had to do with our now infamous slow testing rollout,” said Paul Sax, clinical director of the division of infectious diseases at Brigham and Women’s Hospital in Boston.
President Trump has touted the raw number of tests performed — he rightly claims that the United States conducts more tests on a given day than any other country. But on a per capita basis, the United States is testing fewer of its residents than countries such as the United Kingdom, Italy and Estonia.
Until that changes, public health experts worry the United States will be stuck at a dangerous plateau.
“We’re doing deeply inadequate testing and functionally no tracing,” said Jeremy Konyndyk, a former head of the Office of Foreign Disaster Assistance at the U.S. Agency for International Development and now a senior fellow at the Center for Global Development. “We’re not going to half-ass our way out of a pandemic, and that’s where we are, and that’s why we’re stuck.”
https://mailchi.mp/aa7806a422dd/the-weekly-gist-may-8-2020?e=d1e747d2d8
As we talk this week with leaders of health systems that have restarted non-emergent surgeries, they report that volume has been slower to return than anticipated. A typical data point: a Midwestern system opened up half of its outpatient surgery capacity two weeks ago, but by the end of this week saw just 15 percent of that capacity being utilized.
Most surgeons are ready to operate, but patients are still reticent to come into a healthcare setting. Many providers are facing more sobering forecasts and expecting that volume may not return to pre-COVID levels until 2021. They’re also anticipating challenges in filling the summer surgery schedule. Patients expecting to have procedures in June or July should be seeing their doctor now, and undergoing screening exams and other diagnostic testing—the months-long surgery “pipeline” has almost evaporated.
And looming over everything are worries about a COVID-19 resurgence forcing another shutdown. Taken together, the outlook seems grim, but one chief strategy officer told us it’s motivation to act quickly: “We have to do as much as we can, as fast as we can, until we can’t.” With a future resurgence and shutdown likely, hospitals and doctors must quickly recruit patients and make them feel comfortable, while finding ways to expedite diagnostics and testing amid operational challenges. And they must deliver as much care as they can while it’s safe to do so. That’s critical for providers’ finances, but even more important for the thousands of patients facing delayed diagnoses, postponed treatments, and prolonged pain as the pandemic continues.
https://mailchi.mp/aa7806a422dd/the-weekly-gist-may-8-2020?e=d1e747d2d8
As non-essential businesses begin to reopen, there’s no guarantee that merely opening the doors will make customers return. A recent Morning Consult poll provides an assessment of the impact of COVID-19 on consumer confidence: fewer than one in five US adults are currently comfortable doing (formerly) everyday activities like eating at a restaurant or going to a shopping mall.
The graphic below provides similar data for healthcare. Consumers’ willingness to visit healthcare providers in person for non-COVID care is only slightly better, at 21 percent. Which providers might see patients return most quickly?
Consumers say they are about twice as likely to visit their primary care doctor’s office than other healthcare facilities, including hospitals, specialists, and walk-in clinics. And when it comes to scheduling a routine in-office visit, nearly half say they will wait two to six months, with almost one in ten not comfortable going to a doctor’s office in person for a year or more.
Healthcare facilities face an uphill battle in bringing back patients—many of whom have ongoing chronic diseases that necessitate care now. Reaching patients through telemedicine and providing concrete messages about how they can safely see their doctor will be critical to staving off a tide of disease exacerbations that will mount as fear delays much-needed care.
HENRY KOTULA 