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April 10, 2020

US may be flattening Covid-19 curve—but it's not time to ease social distancing, Fauci says

Daily Briefing

    On Thursday, federal officials said the United States appears to be flattening the curve of the country's new coronavirus epidemic, and CMS took additional action to ease provider regulations to expand the country's capacity to provide care to infected patients.

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    US Covid-19 cases exceed 450K, death toll tops 16K

    As of Friday morning, U.S. officials had reported 463,619 cases of Covid-19, the disease caused by the new coronavirus, in the country—up from 429,264 cases as of Thursday morning.

    Officials as of Friday morning also had reported 16,695 U.S. deaths linked to the new coronavirus—up from 14,820 deaths reported as of Thursday morning. The U.S. death toll from the new coronavirus is now the second highest worldwide, behind Italy.

    The rise in the U.S. death toll comes as New York Gov. Andrew Cuomo (D) announced that the state—which is the epicenter of the United States' epidemic—reported 799 new deaths linked to the virus on Wednesday, marking the third consecutive day the state reported a record high one-day death toll. New York has reported a total of 7,067 deaths tied to the new coronavirus so far.

    However, Cuomo also said New York had its lowest level of new hospitalizations on Wednesday since the state's Covid-19 outbreak first began, signaling that the state might be passing its peak of new cases.

    US may be flattening the curve, Fauci says

    Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, during an interview on NBC's "TODAY" on Thursday said he thinks the United States as a whole is beginning to "flatten the curve" of the Covid-19 epidemic. He added that he is "cautiously optimistic" the United States may begin to see " that curve not only flatten, but coming down."

    Fauci also said the U.S. death toll from the new coronavirus could be closer to 60,000, which is lower than the 100,000 to 240,000 deaths the White House had previously projected, and credited the lower estimate to social distancing measures in place throughout the country. "The real data are telling us that it is highly likely that we're having a definite positive effect by this mitigation thin[g] that we're doing—this physical separation—so I believe we are gonna see a downturn."

    But Fauci said the possible progress the country has made on fighting the epidemic so far doesn't mean it's time for Americans to stop following social distancing guidelines. "We've got to continue to redouble our efforts at the mitigation of physical separation in order to keep those numbers down and hopefully even get them lower than what you've heard recently," he said.

    CMS eases provider regulations to expand capacity

    As the numbers of U.S. Covid-19 cases and deaths continue to rise, hospitals have reported provider shortages, and CMS on Thursday announced it is suspending several federal rules to help hospitals to boost their staff.

    CMS said the rule waivers represent an expansion of the flexibilities the agency announced last month to allow hospitals to increase their capacity to respond to the Covid-19 epidemic. CMS said the new waivers apply to physicians, nurses, and other clinicians. The waivers reduce supervision and certification requirements to allow hospitals to hire practitioners more quickly and to allow clinicians to perform at the top of their license once they are hired, the agency said.

    In addition, the new waivers allow physicians to practice across state lines if necessary to provide care to patients at rural hospitals remotely via phone, radio, or online communications. The waivers also allow nurse practitioners to conduct certain medical exams on Medicare patients at skilled nursing facilities and allows occupational therapists from home health agencies to conduct initial assessments on some homebound patients, which could free up home-health nurses for more direct patient care. Further, the waivers relieve hospice nurses of hospice aide in-service training requirements to allow them to spend more time with patients.

    "It's all hands on deck during this crisis," said CMS Administrator Seema Verma. "All frontline medical professionals need to be able to work at the highest level they were trained for. CMS is making sure there are no regulatory obstacles to increasing the medical workforce to handle the patient surge during the [Covid-19] pandemic."

    Separately, White House spokesperson Judd Deere in a statement on Thursday said hospitals receiving grants under the recent $2 trillion stimulus bill must agree not to send Covid-19 patients so-called "surprise" medical bills for care related to the new coronavirus. To receive the grants, hospitals must certify they will not charge patients for care from out-of-network providers more than they would have charged the patient if they had received in-network care. The surprise billing protections will apply to patients enrolled in government, employer, and self-purchased health plans.

    US unemployment claims soar, as 4th coronavirus relief package stalls over health care funding

    Meanwhile, the Department of Labor (DOL) on Thursday announced that 6.6 million Americans filed unemployment claims last week—down slightly from the record 6.87 million claims filed the previous week. In total, nearly 17 million Americans have filed for unemployment since the global Covid-19 pandemic began to cause volatility in global stock markets and forced several countries to shut down businesses and implement strict lockdowns aimed at containing the new coronavirus' spread.

    Amid the rise in unemployment claims, federal policymakers are seeking to enact a fourth legislative package aimed at stimulating the United States' economy and providing relief to Americans and businesses. However, Senate Democrats and Republicans on Thursday failed to reach an agreement on the latest legislation. Senate Republicans in the bill had proposed to include an additional $250 billion for a small business loan program established in the $2 trillion stimulus bill enacted last month, but Senate Democrats objected to the proposal.

    Senate Democrats on Thursday released a separate proposal for a $500 billion relief bill. That proposal would allocate $250 billion to the small business loan program, but 50% of the funds would be designated for credit unions and small banks to help serve businesses owned by minorities, veterans, and women. The proposal also calls for $100 billion in additional funding for hospitals and providers and requiring HHS and other agencies to submit reports to Congress every 30 days on testing allocation and supplies. The proposal also calls for $150 billion in funding for state, local, and tribal governments (New York Times, 4/10; Strumpf/Schechner, Wall Street Journal, 4/10; Layne/Kelly, Reuters, 4/9; Shabad, NBC News, 4/9; Keemahill, USA Today, 4/9; Caspani, Reuters, 4/9; Brady, Modern Healthcare, 4/9; CMS release, 4/9; Alonso-Zaldivar, Associated Press, 4/10; Brown, Axios, 4/9; Chaney/Harrison, Wall Street Journal, 4/9; Everett/Caygle, Politico, 4/9;  Cohrs, Modern Healthcare, 4/9; Werner/DeBonis, Washington Post, 4/9; Bolton, The Hill, 4/9).

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