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April 22, 2020

CDC director warns 2nd wave of Covid-19 could be worse than the 1st

Daily Briefing

    The Senate on Tuesday approved by voice vote a fourth economic stimulus package that includes $75 billion in grants for health care providers, as CDC Director Robert Redfield warned another wave of the new coronavirus could hit America even harder next winter.

    Tomorrow: Your 45-minute Covid-19 update

    US Covid-19 cases surpass 805K, death toll tops 40K

    As of Wednesday morning, U.S. officials had reported 805,772 cases of Covid-19, the disease caused by the new coronavirus, in the country—up from 780,536 cases as of Tuesday morning.

    Officials as of Wednesday morning also had reported 40,316 U.S. deaths linked to the new coronavirus—up from 37,818 deaths reported as of Tuesday morning.

    On Tuesday, U.S. public health officials announced that the results of autopsies performed on two residents of California's Santa Clara County who died at home on Feb. 6 and Feb. 17, respectively, suggest the earliest known U.S. death linked to the new coronavirus occurred much earlier than previously thought. U.S. officials previously had reported that the first U.S. death tied to the virus occurred in Washington on Feb. 29. According to Reuters, the findings could help public health officials better understand the new coronavirus' spread in the United States.

    CDC director warns US could face deadlier Covid-19 wave next winter

    The news comes as CDC Director Robert Redfield on Tuesday warned that the United States next winter could see another wave of Covid-19 cases that would be deadlier than the current wave because it would likely coincide with the beginning of the country's flu season.

    Experts have predicted that it's likely America will see a second and possibly third wave of Covid-19 cases and the severity of those waves will be determined by a number of different factors, including the potential to develop immunity to the new coronavirus, whether the virus' transmission becomes seasonal, adherence to social distancing measures, and more.

    Redfield on Tuesday told the Washington Post, "There's a possibility that the assault of the virus on our nation next winter will actually be even more difficult than the one we just went through" because "[w]e're going to have the flu epidemic and the coronavirus epidemic at the same time."

    According to Axios' "Vitals," the current wave of Covid-19 emerged toward the end of America's current flu season. However, if another wave of Covid-19 emerges at the start of America's next flu season, the country's health care system likely would be strained even more so than it's been in the past few weeks, Redfield said.

    Senate approves stimulus package with billions of dollars in health care funding

    Meanwhile, the Senate on Tuesday by voice vote approved a fourth legislative package intended to stimulate the economy and help Americans, health care providers, and businesses grappling with the epidemic.

    The $484 billion stimulus package includes billions of dollars in funding for health care providers and initiatives. For example, the package includes $75 billion in additional funding for grants available to providers under the Public Health and Social Services Emergency Fund. That funding builds on the $100 billion Congress had allocated for the fund in a separate stimulus package enacted late last month.

    The new package does not provide HHS with additional guidance on how to distribute the grant funds, even though some lawmakers and providers have raised concerns that, under HHS' current methodology, rural hospitals and providers in Covid-19 hotspots were at a disadvantage when the department distributed the first $30 billion in grants from the fund.

    The new package would allocate $25 billion for Covid-19 testing, which includes $11 billion designated for states. The package also would mandate that the Trump administration establish a national testing strategy to help states and local governments develop their testing plans. According to public health experts, a national testing strategy is critical to helping states safely reopen businesses and ease social distancing requirements.

    In addition, the stimulus package would allocate:

    • $6 billion for HHS' Office of Inspector General to use on oversight activities;
    • $1.8 billion for NIH;
    • $1 billion to cover the costs of testing uninsured Americans for the new coronavirus;
    • $1 billion for CDC;
    • $1 billion for the Biomedical Advanced Research and Development Authority;
    • $825 million for community health centers, rural health centers, and other health facilities; and
    • $22 million for FDA.

    The package also would allocate an additional $310 billion for the Paycheck Protection Program established under the stimulus bill enacted late last month, which aims to help small businesses prevent layoffs and rehire employees. That funding includes $60 billion designated for small businesses, $50 billion designated for Economic Injury Disaster Loans, $10 billion designated for Economic Industry Disaster Loans advance grants, and $2.1 billion designated for the Small Business Administration's administrative costs. Some hospitals and physician practices with fewer than 500 employees could qualify for forgivable loans under the program, but observers say they expect the program's funds will run out quickly and go to applicants with pending loan applications.

    The Federation of American Hospitals and the American Hospital Association (AHA) applauded the new package's additional funding for providers and the Payment Protection Program. "The efforts to secure additional funding are greatly appreciated by hospitals and health systems across the country who will now be able to continue their efforts on behalf of their patients and communities," AHA President and CEO Rick Pollack said.

    The House is expected to vote on the new package as soon as Thursday.

    Trump says executive order would pause approval of permanent residency applications

    Separately, President Trump on Tuesday provided additional details on a previously announced executive order that he said would temporarily suspend certain types of immigration to the United States in an effort to curb the new coronavirus' spread and reduce job competition in the U.S. economy.

    Trump said the executive order initially would place a 60-day pause on the issuance of new green cards, at which point his administration would evaluate whether to modify or extend the order. Trump said the order would apply only to immigrants seeking permanent residency in the United States, including job-based green cards and the family members of green card holders who are not U.S. citizens. The order would not apply to temporary workers.

    Trump did not provide details on whether the executive order would include exemptions, and he noted that the document is still being written (Singh, Reuters, 4/22; Cirruzzo, Inside Health Policy, 4/21 [subscription required]; Cohrs, Modern Healthcare, 4/21; King, FierceHealthcare, 4/21; Armour, Wall Street Journal, 4/21; Cochrane/Tankersley, New York Times, 4/21; Kight/Treene, Axios, 4/21; Colvin et al., Associated Press, 4/22; Sun, Washington Post, 4/21; Owens, "Vitals," Axios, 4/22; New York Times, 4/22). 

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