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The Supreme Court on Monday ruled the federal government owes health insurers massive payments from an Obamacare program shielding them from financial risks after the companies accused Washington of reneging on its funding promises. The 8-1 decision could open the floodgates for federal cash to the insurance industry. Insurers who accused the government of a “bait and switch” claimed they’re owed $12 billion from the Affordable Care Act program. (Luthi, 4/27)

Justice Sonia Sotomayor, writing for the majority in the 8-to-1 ruling, said the court’s decision vindicated “a principle as old as the nation itself: The government should honor its obligations.” The health care law had promised the insurers that they would be protected, she wrote, and it did not matter that Congress later failed to appropriate money to cover the insurers’ shortfalls. The Affordable Care Act established so-called risk corridors meant to help insurance companies cope with the risks they took when they decided to participate in the law’s marketplaces without knowing who would sign up for coverage. (Liptak, 4/27)

The law, as enacted, promised to limit profits and losses for insurance companies in the first three years of the Obamacare program. Some companies made more money than allowed by the formula, and had to pay some back to the government, and other companies lost money and were owed money by the government under the formula. But in 2014, the first year that the ACA's plan was in place, the Republican-controlled Congress reneged on the promise to appropriate money for the companies that had lost money. It did the same for the next two years as well, adding to appropriation bills a rider that barred the government from fulfilling the promise in the statute. After President Trump was elected, his administration supported the GOP-led refusal to pay. (Totenberg, 4/27)

Because insurers took considerable risks when they agreed to participate in Obamacare's marketplaces, the original 2010 law included limits on the amount of losses they could incur. But when the bill came due to cover some of those losses several years later, the government refused to pay. (Wolf, 4/27)

The decision clears insurers to seek roughly $12 billion under the program. Early on, Obama administration officials believed the now-expired program could remain budget-neutral by balancing insurance company profits and losses during the first few years of the exchanges, from 2014 to 2016. But those hopes missed the mark, especially after changes in implementing regulations initially altered the pool of consumers seeking insurance coverage. Fewer healthy people participated in the exchanges than anticipated, leading to larger financial losses than many insurers expected. (Kendall, 4/27)

The Supreme Court concluded that the insurers can sue the federal government to collect unpaid risk-corridor funds in the U.S. Court of Federal Claims. Justice Samuel Alito was the lone dissenter. He argued that federal law did not give insurers the right to sue for damages if they were to recover payments. "Under the court's decision, billions of taxpayer dollars will be turned over to insurance companies that bet unsuccessfully on the success of the program in question. This money will have to be paid even though Congress has pointedly declined to appropriate money for that purpose," Alito wrote. (Livingston, 4/27)

The U.S. death toll from the coronavirus outbreak could exceed 74,000 by August, according to the University of Washington’s predictive model, often cited by White House officials and state public health authorities. Late on Monday, the university’s Institute for Health Metrics and Evaluation (IHME) model raised its projected U.S. death toll to 74,073 by Aug. 4, up from nearly 67,000 predicted a week ago, and 60,000 predicted two weeks ago. (4/28)

President Donald Trump on Monday acknowledged more Americans would die of the coronavirus than he has recently predicted, now saying that the nationwide toll is likely to be between 60,000 and 70,000. (Ollstein, 4/27)

More than 27,000 New Yorkers have died since the start of the novel coronavirus outbreak in March — 20,900 more than would be expected over this period and thousands more than have been captured by official coronavirus death statistics. (Katz and Sanger-Katz, 4/27)

The excess deaths — the number beyond what would normally be expected for that time of year — occurred during March and through April 4, a time when 8,128 coronavirus deaths were reported. The excess deaths are not necessarily attributable directly to covid-19, the disease caused by the coronavirus. They could include people who died because of the epidemic but not from the disease, such as those who were afraid to seek medical treatment for unrelated illnesses, as well as some number of deaths that are part of the ordinary variation in the death rate. The count is also affected by increases or decreases in other categories of deaths, such as suicides, homicides and motor vehicle accidents. (Brown, Ba Tran, Reinhard and Ulmanu, 4/27)

The percentage of people who die after testing positive for the coronavirus is rising even as thousands of new U.S. cases are identified each day, a troubling preview of the weeks and months that lie ahead. Epidemiologists and experts say increased case fatality rates are a natural function of a deadly virus running its course: The people who succumb today were probably infected as long as a month ago, when the number of cases began accelerating. (Wilson, 4/27)

The number of coronavirus deaths in Los Angeles County doubled in the last week amid new evidence that the poor are being hardest hit, according to the county health department. As of Sunday, the county had recorded 916 deaths and nearly 20,000 confirmed cases of COVID-19. (Wigglesworth, 4/27)

The public’s thirst for information about the coronavirus has sharply elevated the profiles of academic and government research institutions that analyze data about the virus. The COVID-19 tracker developed by Johns Hopkins University became a near-constant image on cable news, showing new cases glowing red in hotspots around the world.But there are other sources that go beyond recording new cases, deaths and mapping them around the world. These sources take data about the virus and forecast the future. But they each do it in different ways and it’s important to understand the differences. (Thieme, 4/24)

Governors across the country forged ahead Monday with plans to reopen their economies, even as the nation hit a grim milestone of 50,000 deaths from the coronavirus and public health experts warned against lifting stay-at-home orders too quickly. Numerous states, including some of the largest, began the process of lifting shelter orders in what could be a pivotal stage in the U.S. response to the pandemic. Texas, with its population of nearly 30 million, made one of the most expansive moves toward reopening when Gov. Greg Abbott announced that retail stores, restaurants, movie theaters and malls would be allowed to reopen with limited capacity on Friday. (Healy, Fernandez and Baker, 4/27)

Everyone wants to know: When, oh when, will it go back to normal? As some governors across the United States begin to ease restrictions imposed to stop the spread of the coronavirus, hopes are soaring that life as Americans knew it might be returning. But plans emerging in many states indicate that “normal” is still a long way off. White House adviser Dr. Deborah Birx says social distancing will be with Americans through the summer. (DiLorenzo, 4/28)

Georgia, at the vanguard of states testing the safety of reopening the U.S. economy in the midst of the coronavirus outbreak, permitted restaurant dining for the first time in a month on Monday while governors in regions with fewer cases also eased restrictions. (McKay, 4/27)

Traffic got a little busier along Main Street, but otherwise, it was hard to tell that coronavirus restrictions were ending in the tiny Montana town of Roundup. That’s because it’s largely business as usual in the town of 1,800 people. Nonessential stores could reopen as a statewide shutdown ended this week, but most shops in Roundup — the pharmacy, the hardware store, two small grocers — were essential and never closed. (Brown and Hanson, 4/28)

Restaurants opened up to dine-in patrons in at least three states Monday and the governor of Texas allowed movie theaters, malls and eateries to start letting customers trickle into their establishments later this week. Across the country, an ever-changing patchwork of loosening stay-home orders and business restrictions took shape Monday. (Snow, 4/27)

After weeks of closures and social-distancing orders in the U.S., states from Mississippi to Tennessee to Colorado began to permit some businesses to reopen Monday, welcoming customers back and letting some employees return to work. Over the weekend, some businesses had resumed in Georgia, Oklahoma, Alaska, Texas and South Carolina, with social-distancing measures in place. Retail stores, restaurants, malls, movie theaters, museums and libraries in Texas will be allowed to open Friday at 25% capacity, Republican Gov. Greg Abbott said Monday. He will allow a stay-home order now in place to expire Thursday. (Calfas, Findell and Purnell, 4/27)

Many Ohioans will return to work next month, but work will look different with mandatory facial coverings or masks and lots of space between employees. Gov. Mike DeWine announced a three-phase plan to reopen some businesses that have been closed because of concerns about spreading the novel coronavirus. That plan includes restarting delayed medical procedures, a return to office work, reopening manufacturing plants and eventually allowing retail shops to reopen. (Balmert and Borchardt, 4/27)

For 40 years, Mike DeWine rose steadily if blandly up the ladder of Ohio politics, finally landing his dream job as governor. He took office last year as a familiar figure in the state, not because of any indelible political identify, but because, at 72, he had been around forever. But the coronavirus crisis has made Mr. DeWine something that decades in elected offices never did: a household name. A Republican, he took early and bold actions to lock down his state, even as the head of his party, President Trump, dismissed the threat of the pandemic. (Gabriel, 4/28)

Hard-hit New York edged toward lifting restrictions meant to limit the spread of the deadly novel coronavirus on Monday despite a shortage of testing, joining other U.S. states and some countries in Europe eyeing a gradual reopening, while the Trump administration said the federal government will only be a “last resort” source of critical virus tests. (Gearan and Wagner, 4/27)

Restaurants across Tennessee are able to welcome dine-in customers Monday for the first time in nearly a month as the state eases restrictions put in place to help stem the spread of the coronavirus. The step toward some semblance of normalcy comes a day after the state reported its highest single-day jump in newly confirmed COVID-19 cases, 478, which officials say represents a 5.2% increase from the previous day. (Booker, 4/27)

The commissioners of rural Franklin County, some 200 miles inland from Seattle, spelled out their defiance of Gov. Jay Inslee’s stay-at-home order on a piece of paper in blue ink. It passed unanimously last week. “Franklin County is now open for Business!!!” commissioner Clint Didier wrote on Facebook with a photo of the motion, which called the order unconstitutional. Two days later, after Mr. Inslee’s office threatened legal action, the commissioners rescinded the motion. (Parti and Elinson, 4/28)

Gov. Gavin Newsom chided Californians who flocked to beaches over the weekend, saying they could delay an otherwise imminent start to reopening the economy. “We can’t see images like we saw, particularly on Saturday, in Newport Beach and elsewhere,” Newsom told reporters, adding that coronavirus “doesn't go home because it's a beautiful sunny day around our coasts.” (White, 4/27)

Mayor Eric Garcetti seemed optimistic that social distancing measures were proving effective and said he believed “the curve really is beginning to flatten,” even suggesting that easing restrictions under the city’s safer-at-home order could be weeks away. Testing capabilities were continuing to increase, according to Garcetti, who said asymptomatic essential workers including delivery, ride-hail and taxi drivers, as well as journalists, will now be able to be tested for the virus. (Queally and Shalby, 4/27)

A leading coronavirus model has upped its predicted death toll again, this time projecting 74,000 Americans will lose their lives to the virus by August. The projection was adjusted due to longer peaks in some states and signs that people are becoming more active again, according to Dr. Chris Murray, the director of the University of Washington's Institute for Help Metrics and Evaluation. The model had previously forecasted 60,000 deaths from Covid-19. (Maxouris, 4/28)

For more than a month, governors in a vast majority of states have urged people to stay indoors and away from one another, critical measures needed to slow the spread of the coronavirus. But as the lockdowns drag on, the weather gets warmer and some states move to reopen, researchers at the University of Maryland have found that more people across the country are going outside, that they are doing so more frequently and that they are traveling longer distances. (Zaveri, 4/27)

Republican governors are facing a new challenge as they fight to stop the spread of coronavirus: pressure from their own right flanks. While the biggest protests calling for an end to stay-at-home orders and business restrictions have hit Democratic governors, conservative activists and groups are intensifying pressure on GOP governors they say are being too deliberative as their economies stagger and jobless rates spiral — part of a hyperaggressive effort on the right to reshape the debate over the financial ravages of Covid-19. (Cadelago, 4/27)

More U.S. states and countries around the world began exiting coronavirus-related lockdowns, while the head of the World Health Organization warned that infections could be undercounted in some regions because of limits to testing capacity. Total confirmed coronavirus cases rose by roughly 20% over the past week to more than three million globally, while the death toll passed 211,000, according to data from Johns Hopkins University. (Xie, 4/28)

Efforts to quickly restart economic activity risk further dividing Americans into two major groups along socioeconomic lines: one that has the power to control its exposure to the coronavirus outbreak and another that is forced to choose between potential sickness or financial devastation. It is a pick-your-poison fact of the crisis: The pandemic recession has knocked millions of the most economically vulnerable Americans out of work. Rushing to reopen their employers could offer them a financial lifeline, but at a potentially steep cost to their health. (Tankersley, 4/27)

As companies start planning their reopening in the coming weeks, business groups are pushing Congress to limit liability from potential lawsuits filed by workers and customers infected by the coronavirus. They appear to have the White House’s ear. President Donald Trump has floated shielding businesses from lawsuits. (D'Innocenzio and Tucker, 4/27)

Health officials in six Bay Area counties and the city of Berkeley said Monday that orders to shelter in place to curb the spread of the novel coronavirus will be extended through the month of May. In a joint statement, officials in Alameda, Contra Costa, Marin, San Francisco, San Mateo and Santa Clara counties and Berkeley, which has its own health department, said a new round of health orders would “largely” keep current restrictions in place, but would also “include limited easing of specific restrictions for a small number of lower-risk activities.” (Fracassa, 4/27)

Gov. Jim Justice on Monday unveiled a six-week plan to reopen West Virginia in phases, each contingent upon three consecutive days of daily positive COVID-19 test rates of 3% or less. “We’re going to begin our comeback,” Justice said at his daily COVID-19 briefing Monday. The governor stressed that the reopening plan will not mark a return to normalcy but to a new normal until an effective treatment or vaccine is developed for COVID-19. (Kabler, 4/27)

Michigan's top doctor said that while the state's coronavirus curve is flattening,  some parts of the state are still seeing too many deaths, others are seeing a rise in cases and some intensive care units are still at capacity. That means Michigan's  economy needs to open up slowly, not all at once, said Dr. Joneigh Khaldun the state’s chief deputy for health, stressing social distancing remains key to beating this virus. (Baldas, 4/28)

Deaths are declining and aid for struggling  Detroiters is increasing, Mayor Mike Duggan announced Monday. "We are trending down," the mayor said during his daily briefing. Duggan said 127 Detroiters died between April 19 and April 25, the lowest one-week toll since the coronavirus began killing Detroiters in March. The highest weekly toll was 246, between April 5 and April 11.  (Elrick, 4/27)

In less than two weeks, Rhode Islanders may be able to gather in slightly larger numbers, have access to restaurant dine-in seating, have a few more options for child care, be able to visit some parks and beaches, and even go to the dentist. They’re all part of Phase One of the state’s new plan to start easing restrictions on some businesses and social gatherings on Saturday, May 9 announced Monday by Governor Gina M. Raimondo. (Fitzpatrick, 4/27)

Rhode Island gives the appearance of a state where the coronavirus is a fire raging, the average number of daily infections more than quadrupling since the start of this month. The reality is more complicated and encouraging, as state health workers have tested more residents per capita in Rhode Island than in any other state, leading them to discover many infections that might have gone overlooked elsewhere. (Powell, 4/28)

The laboratory reporting error that created a hiccup in COVID-19 data in Massachusetts at the end of last week was the result of a computer system changeover that delayed when test results were sent to some states but there was no delay getting results to patients, the company said. The Department of Public Health's daily coronavirus data update was delayed a couple of hours Friday "due to a national laboratory reporting issue" and when the numbers were released, they came with a significant disclaimer from DPH that it had received a backlog of almost 10,000 test results from Quest that week. (Young, 4/27)

Massachusetts residents have done a relatively good job in social distancing, according to a ranking by researchers from the University of Maryland. The researchers say Massachusetts has consistently been near the top of its class in their social distancing index, a measure where 0 means there is no social distancing and 100 means everybody is staying at home and no visitors are entering their counties. (Finucane, 4/27)

Every public college in California plans to continue remote learning at least through the summer session to stem the coronavirus outbreak, except one. The Cal Maritime Academy in Vallejo could start face-to-face classes in late May.In addition, the small campus nestled up against the Carquinez Bridge hopes to continue its annual summer training cruise, sending about 350 students and staff on a 62-day trip despite a 100-day ban on commercial cruises issued by the Centers for Disease Control and Prevention. The trip, part of a graduation requirement for cadets, could leave as soon as June despite virus outbreaks aboard cruise ships and naval vessels making international headlines. (Gafni, 4/27)

Many of the scenarios for easing the societal restrictions coronavirus has imposed hinge on greatly increasing testing for the virus. But up until now, testing has been limited to those at greatest risk. That could soon change. Last week, State Health Commissioner Dr. Kris Box opened the door to expanding testing, recommending that anyone with symptoms be tested. (Rudavsky, 4/28)

An executive order allowing hospitals, veterinarians, dentists and other health care providers to resume elective or non-emergency medical procedures has gone into effect. Gov. Eric Holcomb on Friday signed Executive Order 20-24 allowing these facilities to reopen for elective procedures starting 11:59 p.m. Sunday as long as they have sufficient quantities of personal protective equipment, or PPE. (Mack, 4/27)

Individuals with HIV face a greater threat of incurring flu-related complications, according to the Centers for Disease Control and Prevention.In a similar vein, people with "poorly controlled HIV or AIDS" could be more susceptible to illness stemming from COVID-19, the official name of the disease related to the coronavirus that first started to affect people at the end of 2019, though the agency indicated a lack of information about people living with HIV and risk of the disease. (Syed, 4/27)

There have now been 1,023 confirmed coronavirus cases across all of Maine’s counties, according to the Maine Center for Disease Control and Prevention. That’s up from 1,015 on Sunday. The statewide death toll stands at 51. The latest death involved a man in his 70s from Kennebec County. (Burns, 4/27)

The state is looking to update My Maine Connection — the platform people use to apply for MaineCare, the Supplemental Nutrition Assistance Program and the Temporary Assistance for Needy Families program — to make it more user-friendly. The upgrades will include allowing applicants to upload documents into the system and the ability to check on the status of their applications, according to DHHS spokesperson Jackie Farwell. The portal would also allow people to apply for Affordable Care Act health insurance plans when Maine’s state-based marketplace goes online. (Andrews, 4/27)

A new grant program will help Atlanta child care providers who serve low-income families stay afloat amid the coronavirus pandemic. The program will award grants of up to $20,000 to eligible applicants to pay for basic expenses and other costs as they struggle with declining revenues.  (McCray, 4/27)

The coronavirus outbreak is sparking a debate over paid sick leave in Houston, the largest U.S. city without a law requiring businesses to provide paid time off for workers who fall ill. Labor leaders say the COVID-19 pandemic has bolstered their argument for a paid leave mandate, arguing such a policy would slow community spread of the disease here. (Scherer, 4/27)

Gulf Coast chemical companies, including those slowed by the oil crash, are responding to the humanitarian needs of the global COVID-19 pandemic and keeping plants running. The companies are boosting production of the chemicals used in the manufacturing of personal protective equipment used by medical personnel, increasing global production of chemicals used to make hand sanitizer — in some cases manufacturing the product themselves — as well as lending expertise and materials for PPE manufacturing. (Magill, 4/27)

The White House is finalizing expanded guidelines to allow the phased reopening of schools and camps, child-care programs, certain workplaces, houses of worship, restaurants and mass transit, according to documents under review by administration officials. Members of the White House coronavirus task force and other officials received the guidelines late last week, according to senior administration officials who spoke on the condition of anonymity because the guidelines have not been officially released. (Sun and Dawsey, 4/27)

On Monday, for instance, the president met with retail executives and spoke with governors about the coronavirus response and “economic revival,” a subject that has cropped up on several of his daily schedules in the past few weeks, replacing “mitigation” and “containment” of the new coronavirus. With a slimmed-down public schedule, Trump has spent much of April meeting — virtually or otherwise — with business groups, including his reopening council of more than 200 people. (Oprysko, 4/27)

Atty. Gen. William Barr on Monday ordered federal prosecutors across the U.S. to identify coronavirus-related restrictions from state and local governments “that could be violating the constitutional rights and civil liberties of individual citizens.” The memo to U.S. attorneys directs the head of the Justice Department’s civil rights division and the U.S. attorney for the Eastern District of Michigan to coordinate the department’s efforts to monitor state and local policies and take action if needed. (4/27)

President Donald Trump says states should “seriously consider” reopening their public schools before the end of the academic year, even though dozens already have said it would be unsafe for students to return until the summer or fall. Trump made the comments Monday in a call with governors discussing how to reopen their economies, among other topics. (Binkley, 4/28)

From the White House podium to harried homes, pressure is building to reopen the nation’s schools. But the next iteration of American education will look far different from the classrooms students and teachers abruptly departed last month. Many overwhelmed school systems remain focused on running remote education that was set up on the fly. Others, though, are deep into planning for what they see coming: an in-between scenario in which schools are open but children are spread out in places where they are normally packed together. (Meckler, Strauss and Balingit, 4/27)

President Trump, under growing pressure to expand coronavirus testing as states move to reopen their economies, unveiled a new plan on Monday to ramp up the federal government’s help to states, but his proposal runs far short of what most public health experts say is necessary. Mr. Trump’s announcement in the Rose Garden came after weeks of him insisting, inaccurately, that the nation’s testing capability “is fully sufficient to begin opening up the country,” as he said on April 18. Numerous public health experts say that is untrue, and Mr. Trump’s plan may do little to fix it. (Stolberg, 4/27)

The White House released new guidelines aimed at answering criticism that America’s coronavirus testing has been too slow, and President Donald Trump tried to pivot toward a focus on “reopening” the nation. Still, there were doubts from public health experts that the White House’s new testing targets were sufficient. (Miller, Colvin and Lemire, 4/28)

Pressure mounted Monday on the White House and Congress to develop a national strategy to test Americans for exposure to the novel coronavirus, as health and economic experts said the current patchwork of testing efforts is insufficient to allow the economy to reopen safely. Governors, congressional leaders and public health officials have pressed for a robust testing plan from the federal government, insisting that frequent and widespread testing is crucial to ending the stay-at-home orders that have idled businesses across much of the country. (DeBonis, Mooney and Eilperin, 4/27)

“We’re deploying the full power and strength of the federal government to help states, cities, to help local governments get this horrible plague over with,” Mr. Trump said in a Rose Garden press conference, in which he was joined by several executives. Adm. Brett Giroir, the administration official overseeing coronavirus testing efforts, said the federal government would be able to supply every state with the supplies and tests they need to “dramatically increase” the number of tests. (Bender and Abbott, 4/27)

The rosy assessments of progress appear to contrast with the reality in the states, as fears mount that early openings in some regions could cause a spike in infections -- and with business sparse in shops and restaurants that have already opened up, for instance, in Georgia on Monday. The President dodged a question over whether he bore any responsibility for the deaths of more Americans than those who perished in Vietnam in a pandemic that he denied was ever coming to US shores. Despite weeks of prior warning that the virus would spread around the world, the President blamed China for not keeping it confined to its territory, thereby absolving himself of a buck stops moment. (Collinson, 4/28)

The 2-million-tests-per-week pledge would represent a dramatic testing capacity increase for the U.S., where roughly 5.4 million coronavirus tests have been conducted to date. Yet it also represents the low end of what many public health officials estimate the country will require to safely reopen, according to an analysis conducted by STAT and leading public health officials. Other leading researchers have estimated that for most Americans to safely return to work, testing capacity might need to reach between 3 and 4 million per week. (Facher, 4/27)

Several national retailers, including CVS Health, Kroger Health and Walmart, announced they would significantly expand coronavirus testing efforts in May. The United States has run about 5.5 million coronavirus tests after a slow start caused by the botched rollout of CDC's diagnostic test. But the number of tests analyzed has risen dramatically in recent days: More than 1.5 million samples have been processed in the past week alone, according to The COVID Tracking Project. (Lim and Tahir, 4/27)

But those and other major retailers have made only modest progress in the 45 days since Trump first announced the federal partnership, predicting Americans would be able to easily access drive-thru testing sites in parking lots across the country. "The goal is for individuals to be able to drive up and be swabbed without having to leave your car," Trump said in his March 13 remarks in the Rose Garden. Since that time, the participating retail giants -- who boast a combined 28,903 store locations across the country -- have launched 69 drive-thru testing sites. (Rubin and Mosk, 4/28)

Senate Minority Leader Charles Schumer (D-N.Y.) said on Monday that Republicans should "immediately" start oversight of the government's coronavirus response and related legislation, including holding public hearings. “Now that Leader McConnell has decided the Senate will reconvene next week, he should instruct his Committee Chairs to immediately begin vigorous and desperately needed oversight of the Trump administration’s response to the COVID-19 pandemic and its implementation of the CARES Act," Schumer said in a statement. (Carney, 4/27)

Testing is the key that will unlock normalization for millions of Americans. It's the doorway between the disaster response mode of the pandemic and confidence about returning to work, school and life. And it's also still apparently weeks or more away from scaling to a level that will make a big difference for most people in most places. (Ewing and Moore, 4/28)

Vice President Mike Pence has an appointment Tuesday at Minnesota’s Mayo Clinic to learn about a new coronavirus testing “moonshot” that has the famed clinic partnering with the state and its flagship university to quickly boost the state’s capacity to 20,000 tests a day. It’s an approach that leverages a health care infrastructure not all states can match. And it should help Minnesota become one of the most aggressive states at testing on the scale experts say is necessary to safely reopen the economy. Minnesota is one of several states that have quit waiting for the federal government for help. (Karnowski, 4/27)

A source familiar with the vice president's plans confirmed that Pence and Trump staffers are meeting regularly to talk about lessons they have learned from the Pence trips, such as new security and health protocols. NPR accompanied Pence on his first two trips. There were several new safety protocols evident. For example, at Andrews Air Force Base, masked officers in camouflage took the temperatures of passengers traveling with Pence and made sure no one showed symptoms of the virus. (Ordonez, 4/28)

U.S. intelligence agencies issued warnings about the novel coronavirus in more than a dozen classified briefings prepared for President Trump in January and February, months during which he continued to play down the threat, according to current and former U.S. officials. The repeated warnings were conveyed in issues of the President’s Daily Brief, a sensitive report that is produced before dawn each day and designed to call the president’s attention to the most significant global developments and security threats. (Miller and Naskashima, 4/27)

The president declined to form a White House task force on the issue until late February, about a month after the initial warnings began, according to the Post. White House deputy spokesman Hogan Gidley fired back at the Post's report in a statement to the newspaper, denying that the president was slow to react. (Bowden, 4/27)

President Trump’s public statements about using disinfectants to potentially treat the coronavirus have put him in the company of pseudoscientists and purveyors of phony elixirs who promote and sell industrial bleach as a “miracle cure” for autism, malaria and a long list of medical conditions. The president’s comments, at a White House briefing last week, have already prompted widespread incredulity, warnings from health experts and a spike in calls to poison control centers around the country. The makers of Clorox and Lysol urged Americans not to inject or ingest their products. (Jacobs, 4/27)

Like an SOS distress signal emanating from deep within the White House, the daily coronavirus briefing was on, then off, and then on again. Monday morning’s whiplash — a news conference scheduled, canceled, and rescheduled all over the course of five hours — was a stark reminder of the challenges of trying to restrain a president who doesn’t want to be controlled. (Parker, 4/27)

Days after President Trump announced he would freeze U.S. funding to the World Health Organization, China made a very different statement: a $30 million pledge to the group. Trump and his allies argue the WHO’s response to the novel coronavirus has been ineffectual and “China-centric” — and some outside the administration agree. (Rauhala, 4/27)

In the worldwide race for a vaccine to stop the coronavirus, the laboratory sprinting fastest is at Oxford University. Most other teams have had to start with small clinical trials of a few hundred participants to demonstrate safety. But scientists at the university’s Jenner Institute had a head start on a vaccine, having proved in previous trials that similar inoculations — including one last year against an earlier coronavirus — were harmless to humans. That has enabled them to leap ahead and schedule tests of their new coronavirus vaccine involving more than 6,000 people by the end of next month, hoping to show not only that it is safe, but also that it works. (Kirkpatrick, 4/27)

Drug companies are racing to develop a coronavirus vaccine at breakneck speed, but they’re quickly encountering challenges with clinical trials, production capacity and governmental approval. The world is pinning its hopes on a vaccine to prevent COVID-19, the disease caused by the coronavirus. Public health experts say that until a vaccine is successfully deployed, it will be difficult to completely lift the social distancing restrictions that have devastated the global economy. (Weixel, 4/27)

A dozen of America’s top scientists and a collection of billionaires and industry titans say they have the answer to the coronavirus pandemic, and they found a backdoor to deliver their plan to the White House. The eclectic group is led by a 33-year-old physician-turned-venture capitalist, Tom Cahill, who lives far from the public eye in a one-bedroom rental near Boston’s Fenway Park. He owns just one suit, but he has enough lofty connections to influence government decisions in the war against Covid-19. These scientists and their backers describe their work as a lockdown-era Manhattan Project, a nod to the World War II group of scientists who helped develop the atomic bomb. (Copeland, 4/27)

Doctors around the world, trying to save seriously ill coronavirus patients, have been dosing them with rheumatoid arthritis drugs that can squelch immune responses. The theory was that many were dying because their immune systems went into overdrive, creating a fatal storm that attacked their lungs. But now, preliminary results on treatments with one of these drugs, sarilumab, marketed as Kevzara and made by Regeneron and Sanofi, indicate that it does not help patients who are hospitalized but not using ventilators. (Kolata, 4/27)

The study will continue, however, for an even sicker set of hospitalized Covid-19 patients who require the help of ventilators or other high-flow oxygen support, the companies said. In the second, sicker group of patients, the drug showed a relatively small potential benefit over placebo—substances with no actual pharmaceutical effect—though that will need to be confirmed in the ongoing study, the companies said. Results are expected in June. “There’s still hope it might help, but more modest than people hoped,” Regeneron Chief Scientific Officer George D. Yancopoulos said. “It doesn’t look like the magic panacea that everyone would’ve wanted for the pandemic.” (Walker, 4/27)

Kevzara was not expected to directly block the coronavirus, SARS-CoV-2, that is causing a global pandemic. But it was hoped that the drug would help ease the immune system’s overreaction to the virus — a “cytokine storm” that causes inflammation and fluid buildup in the lungs of many of the sickest patients — potentially helping to keep patients off of ventilators or saving their lives. Early data from a 21-patient study in China using Actemra had appeared promising. (Herper, 4/27)

For weeks, the world has been eagerly awaiting clinical trial results for one experimental drug, remdesivir, to treat Covid-19. On some days, the entire stock market has moved up and down based on limited amounts of data about the therapy from Gilead Sciences. The signals, so far, have been contradictory. (Herper and Feuerstein, 4/27)

Medical researchers are doing detective work to see if the novel coronavirus was in New York before March, undertaking studies of flu swabs and deaths that could challenge the official timeline of the infection’s arrival in the state. Pathologists at Manhattan’s Weill Cornell Medicine are looking at the remains of roughly 20 bodies that were permitted to be autopsied. These patients died at the hospital in February and March, and researchers are trying to determine whether one of those deaths may have been due to Covid-19, the disease caused by the new coronavirus, said Alain Borczuk, vice chairman and director of anatomic pathology. (West and Chapman, 4/27)

On March 7, the rector of a Georgetown church became patient zero, the first known coronavirus case in the District, causing a flurry of concern for people who had been in recent contact with him. By then, it had been three weeks since Woodley Park resident Kathy Hughes started feeling ill. On Feb. 16, a day after returning from a ski trip in northern Italy, the 54-year-old education researcher woke with a fever, chills, a headache and exhaustion. (Bahrampour, 4/27)

States are eager to open up and get people back to work, but how do they do that without risking new coronavirus flare ups? Public health leaders widely agree that communities need to ramp up capacity to test, trace and isolate. The idea behind this public health mantra is simple: Keep the virus in check by having teams of public health workers — epidemiologists, nurses, trained citizens — identify new positive cases, track down their contacts and help both the sick person and those who were exposed isolate themselves. (Simmons-Duffin, 4/28)

When Alaska's first COVID-19 case was discovered in March, the director of the state's public health laboratory began scrambling to find enough technicians and microbiologists to confront the emerging pandemic. State public health labs are the nation's first line of defense against an infectious disease because they handle the early diagnostic tests. But labs in Alaska and several other states were left short staffed after years of state budget cuts and inconsistent federal funding, according to an APM Reports analysis. (Scheck and Hing, 4/28)

The Centers for Disease Control and Prevention has expanded its list of possible symptoms of the coronavirus, a step that reflects the broad variation and unpredictability in the way the illness can affect individual patients. Echoing the observations of doctors treating thousands of patients in the pandemic, the federal health agency changed its website to cite the following symptoms as possible indicators of Covid-19, the infection caused by the coronavirus. (Belluck, 4/27)

“You don’t want to list 20-something symptoms, especially if half the population has those symptoms,” Ramirez said. “You’re trying to balance targeting the right people to come in for testing, so it must be specific.” The additions confirm what patients and doctors have been reporting anecdotally for weeks. In particular, the loss of taste or smell has been known to appear in patients since at least mid-March when a British group of ear, nose and throat doctors published a statement amid growing concern that it could be an early sign someone is infected but otherwise asymptomatic. (Fritz, Brice-Saddler and Judkis, 4/27)

Dr. John Swartzberg, an infectious disease specialist at UC Berkeley’s School of Public Health, said it is not surprising that the CDC would update its list of symptoms as more information about the virus became available. “It’s what they should be doing,” he said. “This is a brand-new disease and we are learning enormous amounts about it,” Swartzerg added, “including its clinical manifestations.” (Netburn, 4/27)

Doctors are learning more about COVID-19’s newest and oddest skin manifestation, dubbed COVID toes, as the Centers for Disease Control and Prevention adds to the growing list of symptoms associated with the coronavirus. The American Academy of Dermatology has compiled a registry of skin manifestations associated with COVID-19. About half of the more than 300 total cases on the dermatological registry consist of COVID toes. (Rodriguez, 4/27)

Dr. Sunny Jha, a University of Southern California anesthesiologist, recently treated a man in his 60s who tested positive for COVID-19. Since the disease is known to attack the lungs, Jha tested the man's oxygen levels, though the man said he didn't have any breathing problems or any other sign of low oxygen. But the reading came back at 88%, a concerning far cry from the healthy mid- or upper-90s Jha was expecting from someone who didn't show any outward breathing issues. (Abdelmalek and Bhatt, 4/28)

Throughout the nearly five months the world has been fighting covid-19, one of the most comforting — and baffling — aspects of the coronavirus has been its effect on children. Most children who are infected with the coronavirus remain asymptomatic or experience mild illness. But there’s new evidence the disease may be associated with surprising complications in a small number of children. (Cha and Janes, 4/27)

Some children in the United Kingdom with no underlying health conditions have died from a rare inflammatory syndrome which researchers believe to be linked to COVID-19, Health Secretary Matt Hancock said on Tuesday. (4/28)

A small but rising number of children are becoming ill with a rare syndrome that could be linked to coronavirus, with reported cases showing symptoms of abdominal pain, gastrointestinal symptoms and cardiac inflammation, UK health care bosses and pediatrics specialists have warned. On Sunday, the Paediatric Intensive Care Society UK (PICS) tweeted an "urgent alert" from the National Health Service England about a small rise in the number of cases of critically ill children presenting "overlapping features of toxic shock syndrome and atypical Kawasaki disease with blood parameters" -- with some of the children testing positive for Covid-19. (Woodyatt and Howard, 4/27)

Mitch McConnell is open to cutting a deal to provide reeling states and cities with relief during the pandemic-fueled recession. But it will come at a price. In an interview on Monday, the Senate majority leader said it’s “highly likely” the next coronavirus response bill will aid local governments whose budgets have been decimated by lockdowns and now face spiraling deficits. But to unlock that money, McConnell said he will "insist" Congress limit the liabilities of health care workers, business owners and employees from lawsuits as they reopen in the coming weeks and months. (Everett, 4/27)

Congress is plunging ahead on a new coronavirus relief package, but deepening partisan divide and uncertainty in the schedule could stall the federal response to the health crisis and deteriorating U.S. economy. Leaders of both parties announced the House and Senate will return May 4, despite objections from their ranks. Senior lawmakers were told in a briefing by the Capitol physician Monday that they may not be able to convene full House sessions, with staffing, for at least a year amid the ongoing crisis. Negotiations are set to resume Tuesday on proxy voting proposals. (Mascaro, 4/28)

President Trump said he is skeptical of providing funding for states in the next round of coronavirus relief legislation, throwing into doubt the administration’s support for hundreds of billions of dollars sought by Democratic leaders and state governors of both parties. “Why should the people and taxpayers of America be bailing out poorly run states (like Illinois, as example) and cities, in all cases Democrat run and managed when most of the other states aren’t looking for bailout help?” Mr. Trump tweeted Monday. “I am open to discussing anything, but just asking?” (Andrews and Lucey, 4/27)

Elaborating on Trump’s position in an interview on Fox News, White House economic adviser Kevin Hassett said, “I think that the president has said that he is not eager to go around bailing people out, but he’s willing to negotiate.” The president’s social media post inflamed an already fierce debate over further federal assistance to states expending vast financial resources to battle a highly infectious outbreak while exacerbating perilous budget gaps. (Forgey and Gronewold, 4/27)

Lawmakers and state officials say the Trump administration is unreasonably restricting how local governments can spend federal aid as they struggle to stay afloat during the pandemic and Republicans raise doubts about providing added financial relief to hard-pressed communities. The officials say new Treasury Department rules that prohibit local governments from using their share of $150 billion provided last month for “revenue replacement” are impractical. (Hulse, 4/27)

The House and Senate will return on Monday, May 4 after an extended recess to prevent the spread of the coronavirus, even as the pandemic continues to ravage Washington. The plan is already receiving pushback from some lawmakers, including a vocal group of House Democrats who railed against the “dangerous” idea in a call with Speaker Nancy Pelosi Monday. (Caygle and Everett, 4/27)

In his 15 years in the Senate, Richard Burr, a North Carolina Republican, has been one of the health care industry’s staunchest friends. Serving on the health care and finance committees, Burr advocated to end the tax on medical device makers, one of the industry’s most-detested aspects of the 2010 Affordable Care Act. He pushed the Food and Drug Administration to speed up its approval process. (Faturechi and Willis, 4/27)

The U.S. government reopened the pipeline for small-business loans and grants Monday, triggering a fresh chorus of complaints from lenders and borrowers about delays and glitches plaguing the approval process. The Small Business Administration’s electronic loan portal was overwhelmed by demand shortly after it opened Monday morning, according to banking industry groups, that say the process was also stymied by last-minute changes in guidance on how to submit applications. (Hayashi, 4/27)

Despite early glitches and overwhelming demand, the Small Business Administration processed more than 100,000 Paycheck Protection Program loans by more than 4,000 lenders as of 3:30 p.m. Eastern time. Some participating lenders reported trouble accessing the SBA application website. Twice as many users were trying to access the application website Monday compared with at any time during the first round of the program, SBA administrator Jovita Carranza said. (Haberkorn, 4/27)

Roughly half of all U.S. workers stand to earn more in unemployment benefits than they did at their jobs before the coronavirus pandemic shut down wide swaths of the U.S. economy, and employers say the government relief is complicating plans to reopen businesses. The package of coronavirus stimulus laws Congress passed and President Trump signed in March included a $600 boost to weekly unemployment benefits through July 31. (Morath, 4/28)

A judge has ruled in favor of tribal nations in their bid to keep Alaska Native corporations from getting a share of $8 billion in coronavirus relief funding — at least for now. In a decision issued late Monday, U.S. District Judge Amit Mehta in Washington, D.C., said the U.S. Treasury Department could begin disbursing funding to 574 federally recognized tribes to respond to the coronavirus but not to the corporations. (Fonseca, 4/28)

Coronavirus has campaigns rushing to put voting by mail at the center of their general election strategies — and some Republicans worry they’ve already fallen behind, as President Donald Trump dismisses the method and drives doubt about mail voting among the GOP base. Multimillion dollar programs urging mail voting in November are already coming together, as both parties envision a social-distancing election featuring a spike in absentee ballots, according to interviews with more than a dozen campaign strategists, party committees and outside groups. (Schneider and Arkin, 4/28)

The first major test of an almost completely vote-by-mail election during a pandemic is about to unfold in Ohio, offering lessons to other states about how to conduct one of the most basic acts of democracy amid a health crisis. The process hasn’t been smooth as state officials have navigated election laws and the need to protect citizens and poll workers from the coronavirus. Ohio’s in-person primary was delayed just hours before polls were supposed to open last month, prompting legal challenges and confusion. (Weissert and Carry Smyth, 4/28)

Sen. Bernie Sanders’s campaign excoriated New York election officials Monday for canceling the state’s Democratic presidential primary, opening a new rift in a party trying to mend its divisions following a competitive fight for the nomination. Although Sanders (I-Vt.) has suspended his campaign and endorsed former vice president Joe Biden, he has expressed a desire to remain on ballots in states with upcoming nominating contests. He hopes to continue amassing delegates to the party’s national convention to gain influence over the platform and other decisions. (Sullivan, 4/27)

The Covid-19 pandemic is changing a lot of things, fast—and one of them is American politics. Everything from campaigning to the way we vote is suddenly up in the air. And that’s on top of a primary season that was already one of the strangest in memory. What does it mean for President Donald Trump, for Joe Biden’s chances in November, and for the country? Should Biden hide, or come out swinging—and which VP choice would give the Republicans the most to worry about? (Alberta, 4/28)

Joe Biden’s U.S. presidential campaign and his Democratic Party allies have gone on an all-out offensive against President Donald Trump’s coronavirus response, betting it will be a winning issue with American voters in November. (Hunnicutt, 4/27)

Republicans are trying to pull off a high-wire act over the next three months: Reopen the economy enough to get most jobless Americans back to work and off the public dole, while resisting another giant stimulus package. If they fail, they’ll face a coronavirus cliff — an even deeper collapse in spending and sky-high unemployment in the months before Election Day. That could both damage President Donald Trump’s reelection prospects and put the party’s Senate majority at serious risk. (White, 4/28)

Earlier this month, the Senate Republican campaign arm circulated a memo with shocking advice to GOP candidates on responding to coronavirus: “Don’t defend Trump, other than the China Travel Ban — attack China.” The Trump campaign was furious. (Isenstadt, 4/27)

Trump has repeated this fiery claim dozens of times in campaign rallies, speeches and tweets. The wording never changes. The verb is always “rip.” The womb is always mentioned. He never leaves out the “moment of birth.” We keep adding it to our database of everything false or misleading from Trump, but the claim is so visceral and deceptive that it deserves its own fact check. (Rizzo, 4/28)

As states gear up to reopen, a poll finds a potential obstacle to controlling coronavirus: nearly 1 in 10 adults say cost would keep them from seeking help if they thought they were infected. The Gallup-West Health Healthcare Costs Survey out Tuesday finds that 9% of those age 18 and over would avoid seeking treatment because of concerns about the cost of care, even if they thought they were infected with the coronavirus. (Alonso-Zaldivar, 4/28)

Kaiser Health News: Health Insurers Prosper As COVID-19 Deflates Demand For Elective Treatments

As doctors and consumers are forced to put most nonemergency procedures on hold, many health insurers foresee strong profits. So why is the industry looking to Congress for help? Insurers say that while that falloff in claims for non-COVID care is offsetting for now many insurers’ costs associated with the pandemic, the future is far more fraught. (Appleby and Findlay, 4/28)

Providers can request reimbursement through a new web portal starting May 6 if they have treated or tested an uninsured patient for COVID-19, HHS said on Monday.HHS will reimburse providers at Medicare rates for services dating back to February 4 if funding is available. Providers can claim reimbursement after they confirm the patient is uninsured, and if they agree not to balance bill the patient. (Brady, 4/27)

CMS suddenly suspended advance Medicare payments for physician practices on Sunday, and some groups are concerned that other federal funding streams are uncertain. Physician groups including primary-care practices have been hard-hit by a dropoff in revenue from nonessential procedures. Many have already received some support from federal relief programs, but it's unclear how much more physician-owned practices will receive from a $175 billion provider grant fund and small business assistance programs. (Cohrs, 4/27)

Kaiser Health News: Amid Coronavirus Distress, Wealthy Hospitals Hoard Millions

Inova Health System, with campuses in some of the wealthiest suburbs of Washington, D.C., and Truman Medical Centers, a safety-net hospital in downtown Kansas City, Missouri, have little in common. But, today, they are confronting the same financial plague: mass cancellations of nonessential surgeries that are their biggest moneymakers while bracing for an expensive onslaught of coronavirus patients. (Rau, 4/28)

Health systems are reassessing their real estate portfolios as they prepare for a post-COVID-19 environment that will likely feature more home-based care and remote working arrangements. Hospitals have been acquiring physician practices and merging with other providers, boosting the already significant amount of square footage they manage. But as the pandemic reshapes care delivery, health systems will likely reconfigure and pare down their brick-and-mortar space, real estate experts said. (Kacik, 4/28)

Each night at dusk, in an otherwise desolate Times Square, hundreds of nurses in blue scrubs gather to board buses that take them to hospitals across New York City. Of the thousands of nurses who have come from other states to shore up New York’s hospitals, more than 4,000 are staying in Midtown Manhattan. During the day, many rest at their hotels, amid darkened Broadway marquees, quiet streets and boarded up shops. At night, they face crowded hospital corridors, panicked patients and strained intensive care units. (Gross, 4/28)

A top emergency room doctor at a Manhattan hospital that treated many coronavirus patients died by suicide on Sunday, her father and the police said. Dr. Lorna M. Breen, the medical director of the emergency department at NewYork-Presbyterian Allen Hospital, died in Charlottesville, Va., where she was staying with family, her father said in an interview. Tyler Hawn, a spokesman for the Charlottesville Police Department, said in an email that officers on Sunday responded to a call seeking medical assistance. (Watkins, Rothfeld, Rashbaum and Rosenthal, 4/27)

Workers who had been exposed to the coronavirus at Washington state’s largest psychiatric hospital were herded into a small building to be tested. Inside, few wore masks. They were given test kits by people without gloves and told to swirl a swab inside their noses. The method was designed only for people showing symptoms, but the staffers said none of them did. Many told The Associated Press that the flawed testing process this month likely produced inaccurate results and exposed them to the virus again. (Bellisle, 4/28)

The senior nurse went on national television to make a plea on behalf of her fellow health care workers: Please stop assaulting us. Nurses working under her auspices had been viciously attacked around Mexico at least 21 times, accused of spreading the coronavirus. Many were no longer wearing their uniforms as they traveled to or from work for fear of being hurt, said the official, Fabiana Zepeda Arias, chief of nursing programs for Mexico’s Social Security Institute. (Semple, 4/27)

Debbie Accad, 72, a clinical nursing coordinator for the Detroit VA Medical Center, died from complications of the coronavirus on March 30. Celia Yap-Banago, 69, a “fireball” of a nurse who worked for 40 years at a hospital in Kansas City, died last week... As the coronavirus pandemic takes a devastating toll on health care workers, death notices published in recent weeks starkly show that it is hitting Filipino Americans — who make up an outsized portion of the nation’s nursing workforce — especially hard. (McFarling, 4/28)

People have donated millions of dollars to help hospitals get crucial protective equipment that is being sold at a huge markup because of global demand associated with the coronavirus. But even for those that have the money, the competition to get the gear can be brutal. To help ease the burden on purchasing teams at the region’s medical centers, a hastily assembled team of Harvard Business School students has joined the fray ― pulling overnight shifts from their apartments and working contacts in China, where much of the needed equipment is made. (Rosen, 4/27)

Kaiser Health News: Widely Used Surgical Masks Are Putting Health Care Workers At Serious Risk

With medical supplies in high demand, federal authorities say health workers can wear surgical masks for protection while treating COVID-19 patients — but growing evidence suggests the practice is putting workers in jeopardy. The Centers for Disease Control and Prevention recently said lower-grade surgical masks are “an acceptable alternative” to N95 masks unless workers are performing an intubation or another procedure on a COVID patient that could unleash a high volume of virus particles. (Jewett and Luthra, 4/28)

Facing criticism for their slow response to the public health crisis in senior housing, state officials Monday ordered testing at all long-term care sites and announced an additional $130 million in new funding for Massachusetts nursing homes and rest homes struggling to contain the coronavirus. The new emergency funding, which will help facilities cover staffing costs and bankroll infection control measures and personal protective equipment, is an acknowledgement that long-term care sites have emerged as hot spots for COVID-19 in Massachusetts. (Weisman, 4/27)

At the start of an eighth week living under a state of emergency, Gov. Charlie Baker said Monday the data might be starting to show that the coronavirus's spread has "plateaued" as he committed an additional $130 million to support efforts to fight COVID-19 in nursing homes, where the toll of the pandemic has been particularly harsh. (Murphy, 4/27)

In late March, when the first resident of the Soldiers’ Home in Holyoke died from the coronavirus, 226 residents lived at the elder care facility. Just over a month later, nearly 30 percent of them have died in one of the nation’s deadliest outbreaks, and another 83 have tested positive. With 67 deaths linked to the coronavirus, the facility has a greater reported death toll than any other nursing home in New England, New York or New Jersey, or the long-term care facility in Kirkland, Wash., the initial epicenter of the US outbreak, according to a Globe review of cases. (Krueger, 4/27)

Although cancer centers have kept up essential treatments and surgeries for patients during the COVID-19 pandemic, routine preventive screenings such as mammograms and colonoscopies were by and large put off. Now as states look to ease stay-at-home restrictions, leaders at cancer centers are anticipating their clinics will see an influx of new cancer diagnoses and potentially worse prognoses. (Castellucci, 4/27)

Bruce’s diagnosis has come at a particularly fraught time for cancer patients, who often have weakened immune systems as a result of their treatments or cancers, and who may be more likely to become seriously ill from COVID-19, the disease caused by the coronavirus. Now, hospitals have delayed all sorts of non-emergency services to preserve their resources and to prevent the virus from spreading among vulnerable patients, leading to delays in some care for cancer patients. While it might make medical sense to delay or adjust treatments during the pandemic, those changes have still added to the stress, isolation and uncertainty already felt by patients such as Bruce. (Eichacker, 4/28)

Routine medical tests critical for detecting and monitoring cancer and other conditions plummeted in the United States since mid-March, as the coronavirus spread and public officials urged residents to stay home, according to a new report by Komodo Health. (Respaut and Nelson, 4/28)

She never thought her husband’s punishment for selling drugs would be a death sentence. But as the new coronavirus rips through the U.S. prison system and into the facility where he is serving eight years, she fears it could be. The 24-year-old inmate suffers from severe asthma at the medium-security South Carolina prison. He has tried and failed to get released to home confinement, while his wife on the outside watches high-profile inmates go free. (Balsamo and Long, 4/28)

In Arizona, a woman behind bars at the Perryville women's prison reports hearing coughing echoing through the warehouse-style dorms all night.In New Jersey, an immigrant detainee being held in the Essex County jail has been put on quarantine cleaning duty even though he's been sick. He fears he's spreading the coronavirus. And at the Etowah County jail in Alabama, Karim Golding, an immigrant detainee who's fighting deportation to Jamaica, says he's been feeling short of breath and worries he got coronavirus from the guards or new detainees coming in and out. (Jenkins and Katz, 4/28)

In the midst of the coronavirus outbreak and a recent Nevada Supreme Court decision, criminal defense attorneys have begun to flood the Las Vegas justice system with requests for new bail hearings. They are asking for clients to be given a chance at freedom in a shuttered community, even those facing the most serious criminal charges. In some cases, judges have significantly reduced the amount of money needed for suspects to get out of jail. (Ferrara, 4/27)

A federal judge on Monday required U.S. Immigration and Customs Enforcement to individually justify the detention of parents held longer than 20 days at family detention centers amid the coronavirus outbreak, expanding on a ruling that had earlier applied only to children. U.S. District Judge James E. Boasberg of the District of Columbia said in a teleconference hearing that he doubted he had jurisdiction to order emergency releases from ICE’s family detention facilities as sought by immigrant advocates who filed a class-action suit on March 31 arguing that the facilities lack hygiene and social distancing standards to prevent coronavirus spread. (Hsu, 4/27)

Immigrant advocates say migrants held in jails and prisons in California who are eligible for release are instead being shipped to dangerously overcrowded federal detention centers overseen by U.S. Immigration and Customs Enforcement. They are urging the state Supreme Court to step in.“ICE’s abject failure to protect the lives of people in its custody from the deadly COVID-19 is inviting a calamity,” advocacy groups said in a lawsuit filed Friday. They asked the court to issue an order by next Monday prohibiting county jails and state prisons in California from transferring any inmates to ICE detention during the coronavirus pandemic. (Egelko, 4/27)

In a letter to Amazon obtained by NPR, the office of New York's top lawyer Letitia James says the company may have also broken the state's whistleblower laws for firing a warehouse worker who helped organize a protest in Staten Island. "While we continue to investigate, the information so far available to us raises concerns that Amazon's health and safety measures taken in response to the COVID-19 pandemic are so inadequate that they may violate several provisions of the Occupational Safety and Health Act" and other federal and state guidelines, James's staff wrote in the letter, dated April 22. (Selyukh, 4/27)

Amazon has been under pressure for the safety of its hundreds of thousands of workers who are packing and shipping products to millions of homebound Americans in the pandemic. The company has rolled out various safety measures at its warehouses across the country, such as temperature checks and mandatory masks, but it has faced protests at several facilities from employees who have said they feel unsafe. As of early April, workers at more than 50 of its warehouses in the United States had contracted the coronavirus. The case that Ms. James’s office has been looking into involves Christopher Smalls, an employee in Amazon’s Staten Island warehouse. In late March, Mr. Smalls agitated for more worker protections at the facility as co-workers began getting sick. On March 28, Amazon put Mr. Smalls on quarantine for being in contact with a worker who had contracted the coronavirus. (Weise, 4/27)

Since the coronavirus outbreak began, dozens of workers from the three major airports in the New York City area have been infected, and at least 17 have died, union officials said. Those still on the job are afraid they could be next. Most of the workers earn less than $20 an hour and do not have health insurance, because the cost of the coverage was more than they could afford on their salaries, they say. (McGeehan, 4/28)

Truck drivers and warehouse workers at Cort Furniture Rental in New Jersey had spent months trying to unionize in the hopes of securing higher wages and better benefits. By early this year, they thought they were on the cusp of success. But when the coronavirus arrived, Cort, which is owned by Warren Buffett’s Berkshire Hathaway, laid off its truck drivers and replaced them with contractors, workers said. The union-organizing plans were dashed. (Silver-Greenberg and Abrams, 4/28)

Face masks are becoming a must-have travel accessory for those still flying during the coronavirus pandemic. JetBlue Airways Corp. will require customers to wear masks starting May 4. “This is the new flying etiquette,” Joanna Geraghty, JetBlue’s president and chief operating officer said in a statement. (Sider, 4/27)

As demand for air travel reaches historic lows amid the COVID-19 pandemic, passenger Erin Strine was shocked to board a nearly full American Airlines flight from New York to Charlotte on Saturday. Strine observed many passengers were sitting side by side and not wearing masks. She posted a video to Twitter, which as of Monday evening, has been viewed almost two million times - -strengthening union calls for more protection and more aggressive policies on social distancing. (Benitez, Maile and Kaji, 4/28)

For millions of people around the world dealing with the coronavirus pandemic, sleep brings no relief. The horrors of COVID-19, and the surreal and frightening ways it has upended daily life, are infecting dreams and exposing feelings of fear, loss, isolation and grief that transcend culture, language and national boundaries. (Flaccus, 4/28)

With tens of thousands of schools in dozens of states now shuttered through the remainder of the school year because of the coronavirus pandemic, an estimated 55 million students will be home from school for double the length of their normal summer vacations, if not longer. Now some experts are warning that one of the likely health consequences for many housebound children will be an increase in the unhealthy levels of weight gain typically seen during summer breaks. (O'Connor, 4/28)

In March, at the start of the pandemic, the U.S. Centers for Disease Control and Prevention issued guidelines instructing cities that, unless housing units are available, “do not clear encampments during community spread of COVID-19. Clearing encampments can cause people to disperse throughout the community,” which “increases the potential for disease spread.” But across the country, from California to Washington to Minnesota to New York, cities are still conducting sweeps, city officials acknowledged, saying they must address health and safety problems. (Wiltz, 4/28)

The spread of COVID-19 has dramatically altered the way Americans both live and die. We asked our viewers to share their stories about losing loved ones during the pandemic, whether to COVID-19 or to something else. (Nawaz, Fritz and Wellford, 4/27)

More than half of residents of a Seattle-area nursing home had no symptoms when they tested positive for COVID-19 and had probably already spread the disease, according to a study published late last week in the New England Journal of Medicine (NEJM). Also, a study in Emerging Infectious Diseases (EID) found that all five household contacts of a mildly symptomatic doctor in Wuhan, China infected with the novel coronavirus had the disease but no symptoms. (Van Beusekom, 4/27)

In India, the incessant beep-beep of cars has disappeared. In New York, Harlem’s heart has stopped beating. In the suburbs of Detroit, the chatter of neighbors is muffled. In Toronto, the trains no longer whistle, and in Marseille, every day sounds like a holiday. All around the world, the silence rolls in and out like fog. It hangs in the air — there but not there. Impenetrable and fragile, weightless and smothering. (Givhan, 4/28)

More than 300 children are treated for poisoning each day in emergency departments across the United States, according to the US Centers for Disease Control and Prevention. On average, two of those kids will die. As Americans spend more time at home trying to safeguard their families against Covid-19, accidental poisonings are on the rise. And some experts believe the spike is due to the very same cleaning products parents are using to protect their families from infection. (Smith, 4/28)

American companies making crucial goods like ventilators, face masks and military equipment are unable to get parts and materials they need because the Mexican government has shuttered hundreds of factories and is refusing to reopen them during the pandemic. Canada and the United States have deemed many manufacturers of parts and materials essential and kept them open during the coronavirus outbreak. But Mexican President Andrés Manuel López Obrador is only allowing companies to operate if they’re directly involved in critical industries such as health care, food production or energy — and not if they supply materials to companies involved in those industries. (Rodriguez, 4/27)

A global pandemic had begun in a hospital in Oklahoma City. Doctors soon diagnosed smallpox, a virulent, deadly and disfiguring infection that had disappeared from the planet two decades before. What would the president do? This was the scenario that a cast of Washington power players sought to tackle over two days at Andrews Air Force Base in June 2001. The exercise, code-named Dark Winter, has passed into Washington lore as the first high-profile alarm of the dire consequences of a pandemic. (Harris and Palmer, 4/28)

Trina Bird has driven to the same Ford Motor Co. factory in Ypsilanti, Mich., for 26 years to work. Early on the morning of April 17, she sat in her compact car gripped by something she’d never experienced before. “When I pulled into the parking lot, I was like ‘oh no, I’m not doing it,’” she said. Ms. Bird was returning to the plant after a roughly four-week layoff to make machines for people suffering from Covid-19. A couple of friends had expressed concern about her safety, and those comments echoed as she spent time alone as the sun came up. (Stoll, 4/28)

Authorities on Monday accused two California men of trying to sell millions of nonexistent medical masks to buyers during the coronavirus pandemic. Donald Allen, 62, and Manuel Revolorio, 37, were arrested and charged with alleged conspiracy to commit wire fraud. The pair attempted to influence a buyer to send them more than $4 million to secure masks that they did not actually have, according to a release from the Department of Justice (DOJ). (Coleman, 4/27)

The nightmare of doctors in overwhelmed Italian hospitals being forced to ration ventilators, choosing who would live and who would die, has been an ever-present fear since before the coronavirus hit the United States. Avoiding that bleak scenario has made getting more ventilators a national priority. But as physicians have learned more about COVID-19, the disease caused by the virus, they are finding that less-invasive and less-risky therapies may be as effective and can help some patients heal faster. As a result, doctors are becoming more conservative about putting severely ill patients on ventilators. (Shastri and Boulton, 4/27)

After prodding from state lawmakers, Gov. Gavin Newsom’s administration debuted a website Monday to let people track the shipment of coronavirus-related personal protective equipment across California. The website shows how the state has distributed scarce supplies by county, such as face masks, gloves and gowns, to protect health care workers and others from the coronavirus pandemic. (Gardiner, 4/27)

Ashley Dale was grateful she could end her pregnancy at home. As her 3-year-old daughter played nearby, she spoke by video from her living room in Hawaii with Dr. Bliss Kaneshiro, an obstetrician-gynecologist, who was a 200-mile plane ride away in Honolulu. The doctor explained that two medicines that would be mailed to Ms. Dale would halt her pregnancy and cause a miscarriage. (Belluck, 4/28)

Telemedicine has been around for more than two decades, but its adoption among Americans has been relatively low. The coronavirus pandemic is quickly changing that. With millions of people around the country forced to stay home in lockdown and worried about potentially exposing themselves to the virus, many of them are turning to telemedicine companies' virtual consultation services. (Iyengar, 4/27)

Kaiser Health News: Telehealth Will Be Free, No Copays, They Said. But Angry Patients Are Getting Billed.

Karen Taylor had been coughing for weeks when she decided to see a doctor in early April. COVID-19 cases had just exceeded 5,000 in Texas, where she lives. Cigna, her health insurer, said it would waive out-of-pocket costs for “telehealth” patients seeking coronavirus screening through video conferences. So Taylor, a sales manager, talked with her physician on an internet video call. The doctor’s office charged her $70. She protested. But “they said, ‘No, it goes toward your deductible and you’ve got to pay the whole $70,’” she said. (Hancock, 4/27)

Claims that the coronavirus pandemic originated in a laboratory in the Chinese city of Wuhan have no basis in fact, the head of the lab told Reuters, adding that there were still no conclusive answers as to where the disease started. (Stanway, 4/28)

Surfers in New Zealand hit the waves at dawn, builders returned to construction sites and baristas fired up their espresso machines as the nation eased a strict lockdown Tuesday amid hopeful signs the coronavirus has been all but vanquished Down Under — at least for now. But elsewhere, Brazil was emerging as a potential new hot spot for infections, and fresh doubts were raised over whether Japan would be able to host the already postponed Olympic Games next year. (Perry and Biller, 4/28)

Reports of infected medical workers are emerging almost daily as Russia copes with the virus. Last week alone, more than 200 doctors in Moscow and St. Petersburg were reported to have it, with some turning to social media to make their plight known. It’s unclear how many Russian doctors and nurses overall have been infected. The Health Ministry did not respond to requests for comment but news reports from a dozen regions in the past two weeks suggest at least 450 medical workers have had COVID-19, with 11 doctors and five nurses dying. (Litvinova, 4/28)

An anticorruption unit of the Organization for Economic Cooperation and Development has warned countries to be on guard for potential bribery, particularly in the health care sector, as they tackle the coronavirus pandemic. The OECD Working Group on Bribery in International Business Transactions said last week that the economic fallout and human suffering from the pandemic can create conditions “ripe for corruption” and that bribery and corruption could undermine how countries respond to the crisis. (Sun, 4/27)

The medical community in Japan is moving toward a consensus that holding next year’s Tokyo Olympics may hinge on finding a coronavirus vaccine. Japan Medical Association president Yoshitake Yokokura said in a video media conference on Tuesday that the Olympics were possible only if the infections were under control, not only in Japan, but globally. (Wade, 4/28)

The Olympics could be canceled if the Covid-19 pandemic continues into next year, according to the Tokyo 2020 president. The Games are scheduled to start from July 23, 2021, having already been postponed a year amid the virus outbreak. This would be the strongest statement on canceling the Olympics and Paralympics from organizers, who have routinely said they are focusing on plans to hold the Games. (Wakatsuki, Yee and Ramsay, 4/28)

El Salvador’s government launched a crackdown on jailed gang members after 60 people were killed over the weekend, ending months of remarkable calm in the Central American country. Photos released by the office of President Nayib Bukele showed hundreds of inmates stripped to their shorts and jammed together on prison floors as their cells were searched. Some wore face masks, but most had little protection against the possible spread of the coronavirus. (Sheridan and Brigida, 4/27)

The Trump administration appears to be doubling down on a destructive campaign against the World Health Organization, a United Nations agency, threatening to starve it of funds and support from the United States in the throes of a global pandemic. Not only is this strategy misguided and potentially harmful to millions of people, it is also based on skewed claims about the agency’s role, notably by Secretary of State Mike Pompeo. (4/27)

The strongest critics of the Trump’s administration’s handling of the coronavirus pandemic point to its flat-footedness and the consequences of time lost. But the full account looks worse. Over the last five days of February, President Trump and senior officials did something more sinister: They engaged in a cover-up. A look at this window of time gives insight into how several members of the president’s team were willing to manipulate Americans even when so many lives were at stake. (Ryan Goodman and Danielle Schulkin, 4/28)

When the announcement came from the White House on Monday morning that there would be no briefing, there was a sigh of relief. And not just from weary fact-checkers and health care professionals, but from members of President Donald Trump's own political party who have been forced to at worst defend and at best explain his failure to prepare for, manage and communicate on the worst public health crisis in a century. (Jen Psaki, 4/27)

The Founding Fathers gave us the government we need to effectively manage the consequences of COVID-19 and its threat to our economy. It is federal and each level — national, state and local— has an essential role to play... The wisdom of the Founding Fathers has always served us well. Let’s keep in mind their three principles of federal policymaking and assignment of responsibilities. (Robert P. Inman and Daniel L. Rubinfeld, 4/27)

Our initiative, Resolve to Save Lives, released a brief Monday on how to prioritize testing for COVID-19 in the United States. It’s time for plain talk on testing. Plain fact one: We have nowhere near enough tests, and it’s not clear how many week or months away we are from having them. Facts are stubborn things, and so is math. (Tom Frieden and Cyrus Shahpar, 4/27)

Public health experts fear that a disastrous spike in COVID-19 cases in many low- and middle-income countries may be looming. Across Africa and Southeast Asia, for example, there are currently around 75,000 confirmed cases, far fewer than the nearly one million cases in the US. The difference between containment and widespread outbreak of COVID-19 may depend on our response to another global crisis: water insecurity. (Joshua D. Miller and Sera L. Young, 4/27)

Millions of people visit ClinicalTrials.gov each year to find a trial that they or a loved one might be eligible to join. It’s the largest public database of clinical studies in the world, listing more than 300,000 trials in the U.S. and around the world. But as patients, families, and advocacy groups all say, ClinicalTrials.gov is not an easy website to use. (Jamie Webb and Alison Bateman-House, 4/28)

On March 22, President Trump famously tweeted that “we cannot let the cure be worse than the problem itself.” While many rushed to critique Trump’s tweet based on the perception that he was trivializing the severity of the coronavirus pandemic, he was simply saying that we should look at net benefits: Weigh the costs and the benefits associated with policy prescriptions. Now, over two months into the national quarantine, we are at a fundamental fork in the road. Do we continue with the quarantine, as some experts have suggested, or do we begin to reopen the economy with caution and testing, as other experts have suggested? (Christos A. Makridis, 4/27)

The Friday op ed "Yielding freedom to the government is risky" by Erin Kokemiller decries “the government’s regulation of liberty during this pandemic.” Ms. Kokemiller rails against all the current compulsory orders that close businesses, restrict travel and public gatherings, and require in-home lockdowns in larger cities, arguing that these measures will lead to a learned dependence on an increasingly controlling government (much like Soviet-style communism, to my mind) to the detriment of America’s sacrosanct regard for individual personal liberty. The government, through its imposition of burdensome mandates, Ms. Kokemiller contends, “can’t legislate common sense.” Instead, all that is accomplished is to throw “personal responsibility and individual freedom out the window.” On only one point do I agree with Ms. Kokemiller: “You can’t legislate common sense.” Yet, this is precisely the very reason that government at all levels in this country has implemented numerous restrictions, some more severe than others, on our freedom to behave and to live our lives as each of us would choose because, frankly, as a people, we are generally lacking in common sense. We need the restrictions in order to save us from ourselves. (Steven Pokorny, 4/27)

The coronavirus pandemic has hit nursing homes especially hard. In the New York City borough of Queens, at least 760 seniors have died in nursing homes. In New Jersey 17 bodies were discovered in a nursing home’s morgue. In Rochester, N.Y., a nursing-home owner failed to report to authorities the names of at least seven people who died, as required by federal regulations. In Washington state, where the virus first landed, 43 patients died in one nursing home alone. The Journal reported last week that in New York state 3,505 nursing-home residents had perished, nearly one-fourth of total deaths from the virus. Visitors have been prohibited, which protects patients but also prevents the outside world from knowing what’s going on. In Hornell, N.Y., a nurse was fired after refusing to share personal protective equipment with other staffers. (Andrew Stein, 4/27)

More than a fifth of the 55,000 known covid-19 deaths in the United States have occurred at nursing homes and other elder-care facilities. Federal and state governments have largely turned a blind eye, often making no effort to test residents or staffs and leaving relatives, surrounding communities and the public in the dark.In at least a half-dozen states — most notably Maryland, Virginia, Michigan, Pennsylvania, Texas and Louisiana — officials have refused to make public the names of facilities wracked by the virus, even as residents and employees there are dying. The states’ nominal reason for their secrecy, privacy protections for institutions, is akin to refusing to identify an airline whose plane has crashed. (4/27)

It was clear almost from the outset that the elderly and frail were in the greatest danger from Covid-19. And it was clear to anyone familiar with American nursing homes that these facilities would not be up to the task of protecting their older and infirm residents.As of Thursday, Covid-19 has killed over 10,000 residents and staff members in long-term-care facilities in 23 states that report fatality data, about 27 percent of the Covid-19 deaths in those states, according to the Kaiser Family Foundation. The weaknesses in patient care and oversight at nursing homes that made those deaths more likely were longstanding, widespread and well known. (Richard Mollot, 4/28)

Being uninsured is more than just a source of personal anxiety. In a time of pandemic, being uninsured is a threat to public health. According to media accounts, some Americans who are uninsured or underinsured are afraid to seek testing and treatment for COVID-19, because they worry about the financial impact of testing and treatment. When they avoid these medical interventions, they can unknowingly hasten the spread of coronavirus.That is why our two organizations—the Association for Community Affiliated Plans and the Alliance of Community Health Plans—last month asked the Trump administration to establish a special enrollment period during the COVID-19 national emergency, opening individual market coverage to anyone who needs it. And absent action by the administration we urge Congress to take this simple, consequential step to help flatten and bend the curve of the deadly virus nationwide. (Margaret Murray and Ceci Connolly, 4/27)

We are being told to do a lot of things these days: Wash your hands. Don’t touch your face. Wear a mask outside. Stock the house with two weeks of food. Dust off your will. And make sure to complete your advance directive and talk to the people who matter in your life about your wishes for end-of-life care. (Anna Gosline, 4/28)

Few of us want to consider suffering a serious medical emergency and the potential end of our lives, as well as what type of medical care we’ll need and want at that point. Sadly, the COVID-19 pandemic has drawn attention to such situations and the importance of making decisions before you and your family may be forced to make difficult choices. (4/25)

Throughout history, disease outbreaks and dangerously fake cures have gone hand in hand. But thanks to breakthroughs in medical science, the public became better enlightened on such quackery and better informed about how to protect themselves from it.Now, however, comes Donald Trump, a president who would turn back the clock to the Dark Ages. With his insane ramblings last week about curing COVID-19 by ingesting or injecting disinfectant or by zapping the body with ultraviolet light, Trump revealed his nonexistent knowledge of medicine and health. And showed beyond a doubt that he’s incapable of leading the fight against the coronavirus. (4/28)

In late March, the United Kingdom issued new guidance authorizing physicians to provide medication abortion pills to those wishing to end their pregnancies during the COVID-19 pandemic. The change was immediately embraced by the public and by British abortion providers who know home use is a safe and effective way to experience an early abortion. (Susan F. Wood and Cynthia Pearson, 4/27)

The disruption in routine can also lead to behavior changes. For younger children, that can mean less sleep, more tantrums, and bed-wetting. For older children, it can manifest in feelings of sadness, anxiety, and hopelessness. With studies showing the mental health of U.S. teens and young adults dramatically declining over the past decade, it’s important that we continue to check in with our children to talk about how they’re doing and what they’re experiencing.With children and adolescents now home from child care and schools, the only person outside the household who has eyes on them may be their doctor. That is why well-child visits must continue for all children and youth, even in areas where the visit must be done through telemedicine. (Sara "Sally" Goza and Dr. Patrice Harris, 4/28)

Covid-19 continues to awkwardly expose the weird morality of American capitalism, where it's OK for companies to swarm for government help while individual families and small businesses struggle. Consider the strange case of Tyson Foods. The meat giant warned in a full-page ad published Sunday in The New York Times, Washington Post and Arkansas Democrat-Gazette that the food supply is in jeopardy, not because of a lack of food, but because of the safety concerns that have shut down its plants. (Zachary B. Wolf, 4/28)

Only four major sporting events — if you count the Westminster Kennel Club dog show as sport — have never been interrupted by civil strife, including the Great Depression, the 1918 flu pandemic and both world wars. Both the dog show and the Rose Bowl have already been staged this year. That leaves the 2020 Kentucky Derby and the Boston Marathon, both rescheduled for September.In their long histories, the derby and the marathon have had date changes, so their uninterrupted records won’t require asterisks if they take place as planned. They will survive the coronavirus pandemic and go on as before, perhaps with even more celebration and resilience. And with the help of spectator sports, so will we. (Larry Olmsted, 4/28)