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Officials in Santa Clara County, Calif., announced late Tuesday that two residents there died of the coronavirus in early and mid-February, making them the earliest known victims of the pandemic in the United States. The new information may shift the timeline of the virus’s spread through the country weeks earlier than previously believed. The first report of a coronavirus-related death in the United States came on Feb. 29 in the Seattle area, although officials there later discovered that two people who had died Feb. 26 also had the virus. (Fuller and Baker, 4/22)

"The Medical Examiner-Coroner performed autopsies on two individuals who died at home on February 6, 2020 and February 17, 2020", Santa Clara County Public Health said in a statement. “Today, the Medical Examiner-Coroner received confirmation from the CDC that tissue samples from both cases are positive for SARS-CoV-2 (the virus that causes COVID-19)”, the statement added. (Singh, 4/22)

Dr. Jeff Smith, a physician who is the chief executive of Santa Clara County government, said earlier this month that data collected by the CDC, local health departments and others suggest it was “a lot longer than we first believed” — most likely since “back in December.” “This wasn’t recognized because we were having a severe flu season,” Smith said in an interview. “Symptoms are very much like the flu. If you got a mild case of COVID, you didn’t really notice. You didn’t even go to the doctor. The doctor maybe didn’t even do it because they presumed it was the flu.” (Hamilton, St. John and Lin, 4/21)

At least 28,000 more people have died during the coronavirus pandemic over the last month than the official Covid-19 death counts report, a review of mortality data in 11 countries shows — providing a clearer, if still incomplete, picture of the toll of the crisis. In the last month, far more people died in these countries than in previous years, The New York Times found. The totals include deaths from Covid-19 as well as those from other causes, likely including people who could not be treated as hospitals became overwhelmed. (Wu and McCann, 4/21)

Since the first confirmed case, the coronavirus has spread to all 50 states, claiming the lives of Americans coast to coast. This week, several Southern governors announced that they would ease restrictions on businesses. As governors in other parts of the country form coalitions to strategize lifting stay-at-home orders, a look at regional patterns reveals the challenges they will face as they try to combat the crisis. (Gamio, 4/22)

U.S. coronavirus deaths topped 45,000 on Tuesday doubling in a little over a week and rising by a near-record amount in a single day, according to a Reuters tally. The United States has by far the world’s largest number of confirmed coronavirus cases at over 810,000, almost four times as many as Spain, the country with the second-highest number. Globally, cases topped 2.5 million on Tuesday. U.S. deaths increased by more than 2,750 on Tuesday alone, just shy of a peak of 2,806 deaths in a single day on April 15. (Shumaker, 4/21)

A leading US model has upped its projected coronavirus death toll in August to 66,000 -- a 10% increase from its previous prediction. The change came as states began updating their number of deaths, adding residents of nursing homes who officials are now counting as presumptive positives, Dr. Chris Murray, the director of the Institute for Health Metrics and Evaluation at the University of Washington, said Tuesday. (Maxouris, 4/22)

A second wave of the coronavirus is expected to hit the United States next winter and could strike much harder than the first because it would likely arrive at the start of influenza season, the director of the Centers for Disease Control and Prevention warned on Tuesday. (4/21)

“We’re going to have the flu epidemic and the coronavirus epidemic at the same time,” he said. Having two simultaneous respiratory outbreaks would put unimaginable strain on the health-care system, he said. The first wave of covid-19, the disease caused by the coronavirus, has already killed more than 42,000 people across the country. It has overwhelmed hospitals and revealed gaping shortages in test kits, ventilators and protective equipment for health-care workers. (Sun, 4/21)

Infectious disease expert Michael Osterholm, who has been warning for a decade and a half about the possibility of a global pandemic, said the coronavirus we're fighting is at least as infectious as the one that killed an estimated 50 million people in the 1918 flu worldwide outbreak. He said we're only in the second inning of a nine-inning contest, with the possibility of as many as 800,000 deaths or more in the US over the next 18 months. (Bergen, 4/21)

Two new studies using antibody tests to assess how many people have been infected with the coronavirus have turned up numbers higher than some experts had expected. Both studies were performed in California: one among residents of Santa Clara County, south of San Francisco, and the other among residents of Los Angeles County. In both cases, the estimates of the number of people infected in those counties were far higher than the number of confirmed cases. (Kolata, 4/21)

In March, Andrew Atkeson, an economics professor at the University of California, Los Angeles, tried to assess the mortality rate from the new coronavirus based on what is known about its spread. Does it kill 1 percent of those infected, roughly the case fatality rate on the Diamond Princess cruise ship? Or might it be closer to 0.1 percent, the mortality rate in the United States from the common flu? If two-thirds of the population becomes infected, as would be needed to achieve what is known as “herd immunity,” the difference between those mortality rates would amount to two million deaths nationwide. (Porter, 4/21)

California public health officials have partially lifted restrictions on who should receive tests for the coronavirus, recommending for the first time that asymptomatic people living or working in high-risk settings such as nursing homes, prisons and even some households should now be considered a priority. The move makes California the first state to broaden restrictive federal guidelines and reflects increasing availability of testing, as major labs report sufficient supplies and excess capacity to run more procedures, according to the public health department. (Baumgaertner, 4/21)

A remote Northern California hamlet became one of the first places in the world Monday to attempt to comprehensively test all of its residents for Covid-19 and the antibodies believed to make one immune from infection. The community-wide free testing effort in Bolinas, California, is voluntary. The town is one of two communities taking part in the new study launched by the University of California, San Francisco with the aim of gaining a more complete understanding of how the virus invisibly spread during the initial shortfall of comprehensive nationwide testing. (Martin, 4/22)

As the coronavirus outbreak consumed the city of Wuhan in China, new cases of the virus began to spread out like sparks flung from a fire. Some landed thousands of miles away. By the middle of January, one had popped up in Chicago, another one near Phoenix. Two others came down in the Los Angeles area. Thanks to a little luck and a lot of containment, those flashes of the virus appear to have been snuffed out before they had a chance to take hold. (Baker and Fink, 4/22)

Governors in 17 states have committed to regional coordination to reopen their economies during the coronavirus outbreak — but none are in the South, where leaders are going it alone, just as they did in imposing restrictions. As questions about when and how to ease virus-control measures becomes increasingly politically charged, governors in the Deep South have resisted any appearance of synchronization, instead driving home their message that each state must make its own decision. (Deslatte and Collins, 4/22)

The decision by Gov. Brian Kemp to begin restarting Georgia’s economy drew swift rebukes on Tuesday from mayors, public health experts and some business owners, with skeptics arguing that the plan might amplify another wave of coronavirus outbreaks. “That could be setting us back,” Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, said in an interview on Tuesday, referring to Georgia and other states planning to reopen in coming days. “It certainly isn’t going to be helpful.” (Rojas and Fausset, 4/21)

South Carolina, Georgia, Texas, Tennessee and Florida have announced limited easing of business and recreational closures and social gatherings, to start between this week and the end of April. While some of those states have shown a fall in confirmed virus cases on some recent days, other days have presented increased numbers. None has charted the sustained, 14-day “downward trajectory” outlined in federal guidelines issued last week. (DeYoung, Berger and Mettler, 4/21)

Unlike their peers in New York, New Jersey and other Northeastern states that have been working cooperatively since last week to restart their economies, the six in the South have lagged on testing and social distancing measures. “If you put these states together, there is a perfect storm for a massive epidemic peak later on,” said Jill Roberts of the University of South Florida’s College of Public Health. “The Southeast region is not known for having the best health record. Diabetes and heart disease come to mind. I am very concerned about how our states will do it.” (Dixon, 4/21)

Many officials have warned that reopening too early without extensive testing could lead to a surge in new infections. Public-health experts have asked state leaders to heed reopening guidelines including a decline in infection rates for at least 14 days, a strong testing regime and adequate health-care capacity. Governors in the Northeast, Midwest and West Coast have formed regional pacts to coordinate reopening plans. The bipartisan National Governors Association was scheduled to release its own plan Wednesday to reopen the economy, and it offers a cautionary note among a number of recommendations. (Calfas, Campos-Flores and Bender, 4/21)

On Monday, Kemp made the controversial decision to restart the state’s economy by allowing some businesses to start up operations again. Kemp said that, along with barbershops, hair and nail salons, tattoo parlors, massage parlors, bowling alleys and fitness centers can open Friday. Restaurants, theaters and private social clubs will be allowed to open Monday. Reactions have been mixed. (Suggs, Kanell and Peters, 4/21)

The success of Gov. Brian Kemp’s hotly-debated decision to begin reopening Georgia’s economy rests on whether the state can detect novel coronavirus hotspots before they flare out of control, and reliably demonstrate that it’s safe to move about. The state Department of Public Health is rapidly increasing the number of testing sites and deploying the Georgia National Guard to help build up the state’s testing system. But whether enough tests, supplies and sites are available statewide to ease restrictions for the state’s 10.6 million residents — without a spike in new COVID-19 cases — depends on a testing infrastructure that is still a work in progress. (Mariano and Trubey, 4/22)

South Carolina Sen. Lindsey Graham, whose state is moving toward a more limited reopening, tweeted Tuesday: "I worry that our friends and neighbors in Georgia are going too fast too soon." "We respect Georgia's right to determine its own fate, but we are all in this together," Graham, a Republican, said. "What happens in Georgia will impact us in South Carolina." (Bradner, 4/21)

Since noon, Georgia surpassed 800 coronavirus-related deaths and 20,000 confirmed cases of COVID-19, according to the Georgia Department of Public Health. The DPH also announced 19 new deaths in the seven hours since its last update, bringing the state’s death toll to 818. Additionally, 285 more cases of COVID-19 were confirmed in that time frame, bringing the state’s total number of coronavirus cases to 20,166. (Prince and Hansen, 4/21)

As some Republican governors move to reopen parts of their states' shuttered economies, local Democratic leaders are pushing back — fearful that easing guidelines too early could wipe away the progress their cities have made in battling the novel coronavirus. Governors in a handful of states have begun unveiling plans to reopen beaches, retail stores, bowling alleys, hair salons and other "nonessential" businesses, following on President Donald Trump's release last week of a federal plan for reopening the U.S. economy. (Ward, 4/21)

One of Jay Timmons’s Facebook friends invited him last week to attend a “Reopen Virginia” rally in Richmond, a protest against the stay-at-home order issued amid the coronavirus by the state’s Democratic governor. Mr. Timmons unfriended the sender, then published a searing retort, criticizing the protesters and accusing them of putting manufacturing workers’ lives at risk by defying rules meant to limit the spread of the virus. Mr. Timmons’s post began with a single word in all capital letters: “IDIOTS.” (Tankersley, 4/21)

The Justice Department will consider taking legal action against governors who continue to impose stringent rules for dealing with the coronavirus that infringe on constitutional rights even after the crisis subsides in their states, Attorney General William Barr said. Blunt means to deal with the pandemic, such as stay-at-home orders and directives shutting down businesses, are justified up to a point, Barr said in an interview Tuesday on “The Hugh Hewitt Show.” Eventually, though, states should move to more targeted measures, Barr said. He cited the approach laid out by President Donald Trump. (Strohm, 4/21)

Attorney General Bill Barr, in a new interview on Tuesday, characterized some state 'stay-at-home' restrictions amid the pandemic as "disturbingly close to house arrest" and said the Justice Department will consider legal action if governors start to take restrictions on movement and civil liberties 'too far.' "These are unprecedented burdens on civil liberties right now. You know, the idea that you have to stay in your house is disturbingly close to house arrest," Barr told conservative radio host Hugh Hewitt. "I’m not saying it wasn’t justified. I’m not saying in some places it might still be justified." (Mallin, 4/21)

Wisconsin’s Republican-dominated legislature filed Tuesday for an injunction against the coronavirus-related lockdown ordered by the administration of Democratic Gov. Tony Evers. The move comes amid growing battles over efforts to slow the spread of the virus through restrictions on many business activities that are playing out in protests outside state capitols and tweets by President Trump. (Barrett, 4/21)

An informal coalition of influential conservative leaders and groups, some with close connections to the White House, has been quietly working to nurture protests and apply political and legal pressure to overturn state and local orders intended to stop the spread of the coronavirus. The groups have tapped their networks to drive up turnout at recent rallies in state capitals, dispatched their lawyers to file lawsuits, and paid for polling and research to undercut the arguments behind restrictions that have closed businesses and limited the movement of most Americans. (Vogel, Rutenberg and Lerer, 4/21)

While FreedomWorks and other conservative groups are pushing to amplify the protests, others have declined to get involved. For example, Americans for Prosperity, the flagship nonprofit of Charles Koch’s political network which helped organize the tea party movement a decade ago, is not involved this time, though the group is pushing for the country to reopen, said Tim Phillips, the group’s president. And David McIntosh, president of Club for Growth, a national network of 250,000 pro-growth, limited government Americans, said his group is focused on pushing Trump to slash regulations for businesses to boost the economy after it restarts. (Kumar, 4/21)

Republican politicians and individuals affiliated with President Donald Trump’s re-election campaign are organizing or promoting anti-lockdown protests across key electoral battleground states, despite the White House’s own cautious guidance on relaxing restrictions, interviews with two dozen people involved show. (Martina, Renshaw and Reid, 4/21)

America’s entrenched political divide is now playing out over matters of life and death. Republican governors, urged on by President Donald Trump, are taking the first steps toward reopening parts of their states’ economies in the midst of the coronavirus pandemic, and without adhering to the president’s own guidelines. Democratic governors are largely keeping strict stay-at-home orders and nonessential business closures in place, resisting small pockets of Trump-aligned protesters and public pressure from the president. (Pace, 4/22)

The fragile American consensus on battling the coronavirus is fracturing along bitter political fault lines, as early state openings threaten to undermine the nationwide effort to slow the pandemic. Divisions have emerged along a timeworn North vs. South divide, on ideological and geographical grounds nationally and within states, and on the level of respect accorded by political leaders to epidemiological science. (Collinson, 4/22)

The tension in America between the national government and states' rights is as old as the republic itself. That tension is about to play out in a starkly political way and on a grand scale over the next several weeks, as states consider how to reopen their states in the midst of the novel coronavirus pandemic. President Trump seems to be itching for states to reopen — frankly, faster than his own administration's guidelines recommend. (Montanaro and Wise, 4/22)

Reopening the U.S. economy is complicated by some troubling scientific questions about the new coronavirus that go beyond the logistics of whether enough tests are available. In an ideal world, we’d get vaccinated and then get back to normal. But, despite unprecedented efforts, no vaccine will be ready any time soon. “We’re all going to be wearing masks for a while,” Dr. Rochelle Walensky, infectious diseases chief at Massachusetts General Hospital, predicted during a podcast with the Journal of the American Medical Association. (Neergaard, 4/22)

Even with many former virus hotspots seeing a reduction in new deaths and hospitalizations, a flurry of cancellations of major events made it clear Wednesday that efforts to return to normal life could still be a long and dispiriting process. In just the past day, the U.S. scrapped the national spelling bee in June, Spain called off the Running of the Bulls in July, and Germany canceled Oktoberfest five months away. (Long and Brumback, 4/22)

Retailers are considering “sneeze guards” and ways to quarantine fitting room items. Restaurant owners are imagining a future with masked servers and temperature checks. Industries built on the personal touch are looking to eliminate physical contact. Businesses may be appealing to Congress for more aid, but they know key details about the economy’s reawakening won’t be hammered out in Washington. The states, counties and even cities are widely expected to decide when each business can open its doors and under what conditions. (Murphy, 4/22)

The District, Maryland and Virginia have been locked down since late March in an effort to limit the spread of the novel coronavirus. With the local economy in a tailspin and everyone eager to see life get back to some version of normal, area officials are watching for signs that the covid-19 “curve” is flattening, which they say would allow them to safely ease some restrictions. Because there hasn’t been widespread testing to determine how much the virus has spread, the tally of known coronavirus cases, up to 26,969 as of Tuesday, isn’t the most telling measurement, local officials say. (Olivo, 4/21)

Members of the Trump administration say there is sufficient coronavirus testing for states to move to the first phase of the White House's reopening plan. But many state and local officials and health care providers say testing is still far short of where it needs to be to consider lifting some social distancing restrictions. (Doubek, 4/21)

An overwhelming majority of Americans say that stay-at-home orders issued throughout the U.S. in response to the coronavirus outbreak should remain in place until health experts say it is safe to reopen, according to a new poll. The Reuters-Ipsos survey released Tuesday found that 72 percent of Americans support quarantine measures remaining in effect until "doctors and public health officials say it is safe." That includes 55 percent of Republicans, 88 percent of Democrats and 70 percent of independents. (Wise, 4/21)

President Trump and Gov. Andrew M. Cuomo, two New Yorkers who have alternately praised and quarreled with each other during the coronavirus pandemic that has ravaged their mutual home state, met in person on Tuesday to try to resolve differences over testing and financial relief. After weeks of talking by telephone and through the news media, Mr. Cuomo traveled to Washington to sit down with the president at the White House and press for more federal assistance to expand testing for the virus and to help financially devastated state and local governments. (Baker and McKinley, 4/21)

Setting aside their differences for at least an afternoon, President Donald Trump and New York Gov. Andrew Cuomo agreed in an Oval Office meeting to work to double coronavirus testing in the hard-hit state over the next few weeks. “We will work together to help them secure additional tests,” Trump said after Tuesday’s meeting. “And we hope that this model will work with the other states as well.” (Lemire, Villeneuve and Miller, 4/22)

"The federal government will work on the supply of tests and reagents from the national manufacturers," Cuomo said. State officials will work at the same time to expand field testing stations and lab capacity. Cuomo says New York will focus mostly on diagnostic tests to identify people contagious with the coronavirus, but will also conduct antibody tests to find those who have recovered from COVID-19. (Mann, 4/21)

After initially touting the work the federal government was doing to ensure more widespread access to testing, Mr. Trump has more recently said that testing is the responsibility of the states and that the administration can only play a supporting role. In an interview on MSNBC after the meeting concluded, Mr. Cuomo said it had been productive. He said he requested a meeting because he wanted to get the testing issue “ironed out.” New York has been the hardest-hit state in the country, with more than 256,000 cases—nearly a third of the cases nationwide. (Ballhaus and Vielkind, 4/21)

Businesses in different parts of New York state will reopen on separate schedules, Gov. Andrew Cuomo said Tuesday, as a growing number of upstate elected officials and employers made the case for a regional approach to easing restrictions aimed at slowing the spread of the coronavirus. The Democratic governor said officials in 10 existing economic development zones around the state would monitor local data and come up with a plan on exactly which stores and activities can reopen and when. (Vielkind, 4/21)

A Naval hospital ship that was dispatched to New York City to assist with a surge in coronavirus patients will return to Virginia soon so it can be routed elsewhere, President Trump said Tuesday. Trump met with New York Gov. Andrew Cuomo (D) on Tuesday afternoon at the White House, where the two discussed testing and funding for states. Trump said he also asked Cuomo about reallocating the USNS Comfort to another area of need. "I’ve asked Andrew if we could bring the Comfort back to its base in Virginia so that we could have it for other locations, and he said we would be able to do that," Trump said at a press briefing. (Samuels, 4/21)

New York City will create a strategic reserve of medical supplies and equipment to guard against future novel coronavirus outbreaks and other crises, Mayor Bill de Blasio said Tuesday. As part of the initiative, companies based in the city that can manufacture such goods will be supported. At a press conference, the mayor highlighted a type of ventilator developed during the current pandemic, the creation of which was spearheaded in part by Newlab, a Brooklyn-based technology hub that promotes entrepreneurship with 150-plus member companies. (Passy, 4/21)

New York City public health officials are moving patients suffering from COVID-19 into beds within a nursing home on Roosevelt Island that cares for hundreds of residents with a wide range of severe medical conditions, including dementia and other age-related ailments­­, paralysis, traumatic brain injury and profound developmental disabilities. (Thompson, 4/21)

With a spike in anti-Asian discrimination related to the coronavirus pandemic, New York City has formed a team to respond to the incidents. The New York City Commission on Human Rights announced Sunday that the coronavirus response team would handle reports of harassment and discrimination related to the outbreak, and that the team is made up of attorneys and members of the agency's law enforcement and community relations departments. (Holombe and Moghe, 4/22)

David Penepent walked into the back chapel of a funeral home in Queens on Thursday and surveyed a scene unthinkable before the coronavirus epidemic. Thirty people had been laid out in the chilled room, the bodies held in boxes made of cardboard and wood with “handle with extreme care” printed on the sides in bold, green letters. One by one, Mr. Penepent, an associate professor of mortuary science, and two of his students wheeled the bodies out on church trucks, first lining them up in the hallway, then bringing them to two vans parked out front. With the help of the home’s staff, they gently laid the boxes in the back of one of the vehicles, the first step in a long journey to a crematory outside the state. (Petri, 4/22)

Three men in Westchester, New York, are suing the World Health Organization contending it mishandled its response to the novel pandemic and engaged in a cover-up with China. Richard Kling and Steve Rotker of New Rochelle and Gennaro Purchia of Scarsdale, filed the suit in White Plains federal court Monday and claimed they suffered "injury, damage and loss" because of the outbreak and want the WHO to pay "incalculable" damages. Steven Blau, the attorney representing the plaintiffs, argued WHO didn't do enough to ensure the Chinese government was transparent of its COVID-19 safeguards. (Katersky and Pereira, 4/21)

As the number of deaths in nursing homes from COVID-19 surpassed 1,000 on Tuesday, the state announced it will pause a key component of its plan for testing residents of long-term care facilities. Secretary of Health and Human Services Marylou Sudders at a State House news conference said the state would temporarily stop shipping coronavirus test kits to nursing homes. Long-term care facilities appeared to be ill-equipped to collect the samples properly, officials said in subsequent statement. (Krantz, Crimaldi and Weisman, 4/21)

After more than a week of testing, Detroit officials say they are finding about a quarter of the residents and staff at the city’s nursing homes are infected with COVID-19, with about half of them asymptomatic. Detroit plans to publicly release detailed information on the impact the virus has had on individual nursing homes after testing at all the city's facilities is completed this week. (Anderson and Hall, 4/21)

At least 418 residents of long-term care and other group facilities in Wisconsin have tested positive for COVID-19, health officials reported Tuesday, without naming the facilities. The data came five days after the Journal Sentinel reported that many local health officials would not confirm whether any nursing homes or other long-term care facilities in their counties had coronavirus cases. (Chen and Linnane, 4/21)

The Nevada National Guard has stepped in to help combat the surge in cases of the new coronavirus at nursing homes and assisted living centers. ...Nursing homes and assisted living centers account for more than 16 percent of reported COVID-19 deaths in Nevada, according to state data. (Erickson, 4/21)

More than 21 percent of nursing homes in California now report cases of COVID-19, according to new lists state officials made public Monday, following a promise by the governor. The California Department of Social Services released some limited information about cases and deaths at adult and residential care facilities. Together, the lists -- among the most comprehensive in the nation -- still offer only a partial picture of institutional outbreaks of coronavirus. (Peterson, 4/21)

The Soldiers' Home in Holyoke reported its first positive case of the coronavirus on March 22. Four weeks later, 63 veterans have died; 52 of them had confirmed cases of COVID-19. Another 94 living residents and 81 employees have the virus, according to the state Executive Office of Health and Human Services. (Wasser, 4/21)

A new rule from the federal government that will require nursing homes to share news of coronavirus cases with residents and family members highlights the wide range of communicativeness residents and their families have encountered as the homes have become some of the most common sites of virus outbreaks. (Pendharkar, 4/22)

At least 65 residents and employees from two Sacramento County assisted-living facilities owned by the same company have tested positive for COVID-19, according to new state data released late Monday. Sunrise Assisted Living-Sacramento reported at least 25 residents and 23 employees infected with the new coronavirus. Similarly, Sunrise Assisted Living-Fair Oaks reported 16 infected residents and at least one employee with the disease. (Pohl, 4/21)

Long before the deadly coronavirus left thousands of Rhode Island residents ill and completely paralyzed the state’s economy in the process, legislative leaders were already predicting a difficult budget year. Back in January, the state was facing a $200 million shortfall for the fiscal year that begins July 1, and House Speaker Nicholas Mattiello and Senate President Dominick Ruggerio made it clear that they were unlikely to approve new spending. Yet they outright rebuffed one of Governor Gina Raimondo’s signature revenue-generating proposals: the legalization and taxing of marijuana. (McGowan, 4/22)

Rhode Island had its highest number of new cases of coronavirus in the previous 24 hours Tuesday, a sign of both more testing for the disease and the extent of its spread throughout the state. Another 394 Rhode Islanders have tested positive for COVID-19, the respiratory illness caused by the virus, bringing the total number of cases to 5,500, according to the state Department of Health. The state reported 16 new fatalities, bringing the state’s death toll to 171. Most of those who have died from the disease have been residents of nursing homes. (Milkovits, 4/21)

Texas Medical Center hospital systems Wednesday will begin phasing back more care of people with ailments not involving the coronavirus, a tacit acknowledgment they now feel equipped to handle COVID-19 and can’t overlook the community’s other health needs. The resumption of some such care follows Gov. Greg Abbott’s order last Friday relaxing restrictions he’d placed on non-urgent elective surgeries a month ago and that medical center hospitals, among others, had imposed on themselves a few days earlier. (Ackerman, 4/22)

A high school class that requires to students to use math and science skills in practical applications is helping frontline workers in the fight against the coronavirus. Manufacturing students at Gwinnett County’s Maxwell High School of Technology have developed an accessory to make the medical face shields worn by health care workers more comfortable. (Smith Broady, 4/21)

The coronavirus pandemic has put all other issues on the back burner. But still heating up — at an increasing pace — is the existential threat of climate change. Will Massachusetts' ambitious climate goals survive the virus crisis? In January, Gov. Charlie Baker announced that the commonwealth was adopting an ambitious new climate plan. Massachusetts would not just reduce emissions of carbon dioxide by 80% by mid-century, as state law required; instead, Baker committed to a goal of net zero emissions. (Gellerman, 4/22)

As Gov. Gavin Newsom prepares for a Wednesday press briefing in which he plans to detail the progress made with regard to “six key areas as part of our roadmap to recovery,” the governor said 60 more people who have tested positive for COVID-19 have died. Since the coronavirus pandemic began, data recorded by the California Department of Public Health shows 33,261 people have tested positive for COVID-19 and 1,268 people have now died. (Crowley, 4/21)

Kaiser Permanente, one of Northern California’s largest health care providers, is building a $14 million lab in Berkeley that will boost the system’s coronavirus testing capacity from about 1,200 tests a day to 5,000 by the time the lab opens in early June, Kaiser officials said. Kaiser is conducting one of the highest volumes of COVID-19 diagnostic testing in the region — it has 4.5 million members in Northern California — so its ability to increase testing will play a critical role in the state’s efforts to lift shelter-in-place restrictions. (Ho, 4/21)

Thousands of people lacking health insurance in Santa Clara County could soon access discounted or free care thanks to a newly-expanded county program. In an unanimous vote Tuesday, the Santa Clara County Board of Supervisors broadened the income requirements for the county’s stopgap insurance plan. The goal is to get health coverage for people in the “missing middle” during the pandemic and beyond, while also lessening the burden on local emergency rooms. (Kelliher, 4/21)

California and Sacramento again had some of the poorest air quality in the nation, its skies made worse by the effects of climate change and years of catastrophic wildfires, with worrying implications for those most at risk of developing COVID-19, officials say. The American Lung Association’s sobering State of the Air report released Tuesday examined data for 2016 through 2018. (Smith, 4/21)

Race and patterns of segregation are closely associated with the spread of coronavirus in Milwaukee County, according to a new report from the University of Wisconsin-Milwaukee. "Segregation has helped create concentrated disadvantage in certain areas of the city," said Joel Rast, one of the report's authors and director of UWM's Urban Studies Programs. (Luthern, 4/21)

Black residents of Louisiana are dying of coronavirus at vastly higher rates than people of other races and new data shows those dramatic disparities are occurring across the state, regardless of demographics of different communities. (Adelson, Rddad and Roberts, 4/21)

The Milwaukee Common Council on Tuesday unanimously approved allowing citations to be issued to people purposely violating the state's safer-at-home order, which is aimed at limiting the spread of the deadly coronavirus and which Gov. Tony Evers has extended until May 26. The measure approved by the council allows a middle ground in which police can issue citations, Nick DeSiato, chief of staff to Milwaukee Police Chief Alfonso Morales, said during a special meeting of the Common Council's Public Safety and Health Committee Tuesday. (Dirr, 4/21)

New Orleans police plan to set up checkpoints throughout Orleans Parish to "verbally provide information" about the current stay-at-home order related to the coronavirus pandemic. Police also will check that everyone is wearing seatbelts, the driver is licensed and the vehicle is registered and insured. (Kollath Wells, 4/21)

Plasma collected from the blood of people who have recovered from COVID-19 is now being used to treat patients in the Las Vegas Valley who are hospitalized with the disease. At least two area hospitals, St. Rose Dominican Hospital, Siena campus in Henderson and Southern Hills Hospital and Medical Center in the southwest valley, began to use the experimental treatment this week as part of a national study. (Hynes, 4/21)

Gov. Gretchen Whitmer’s administration on Tuesday abruptly canceled a no-bid contract to help track the spread of the coronavirus in Michigan, a day after announcing the hiring of a state Democratic consultant and a national firm that has worked for prominent Democratic causes. The reversal comes amid complaints that the governor tapped politically connected firms to collect health data on state residents and monitor sensitive medical information. It also comes as Whitmer’s profile is rising — she is considered a possible running mate for likely Democratic presidential nominee Joe Biden, and she has become the target of Republican attacks. (Viser and Dawsey, 4/21)

The Food and Drug Administration on Tuesday said it had granted emergency clearance to the first in-home test for the coronavirus, a nasal swab kit that will be sold by LabCorp. The agency said that LabCorp had submitted data showing the home test is as safe and accurate as a sample collection at a doctor’s office, hospital or other testing site. “With this action, there is now a convenient and reliable option for patient sample collection from the comfort and safety of their home,” Dr. Stephen M. Hahn, the F.D.A. commissioner, said in a statement. (Thomas and Singer, 4/21)

The test kit costs $119, and potential customers must complete a survey about their eligibility for testing before receiving one. LabCorp spokesman Mike Geller told CBS News that customers must pay up front for the test and "should contact their insurer to determine if their plan would reimburse them for expenses." The test's website says it will not be available in New York, New Jersey, Maryland and Rhode Island. Those states are excluded because they have regulations against patients initiating their own lab tests, Geller said. New York and New Jersey are the two states with the highest number of coronavirus cases and deaths. (Silverstein, 4/22)

The maker of a rapid coronavirus test widely used across the United States and distributed by the federal government has warned that its device can produce false negatives if a special solution is used to move or store patients' samples. Abbott Laboratories instructed health care providers last week not to use solutions known as "viral transport media" for samples tested on its ID NOW device, which runs one test at a time and can detect positive coronavirus cases in as little as five minutes and spit out negative results in 13 minutes. (Devine and Griffin, 4/22)

When it comes to battling the spread of the novel coronavirus, Kentucky and Rhode Island might look similar on paper. They’ve done comparable numbers of diagnostic tests and lost similar numbers of residents to the disease. But there’s one key difference. Kentucky has more than four times Rhode Island’s population, meaning it has tested 0.7 percent of its residents, compared with Rhode Island’s 3.7 percent, the highest per capita testing level in the United States. (Eilperin and Mooney, 4/21)

Congressional Republicans have strongly backed President Trump’s efforts to respond to the deadly coronavirus pandemic and its crippling impact on the economy, even as many of their home state officials have pushed for more to be done. But on the issue of testing, some Senate Republicans are looking for ways to get the federal government to play a bigger role despite Trump’s insistence it is an issue that governors should handle. (Kim and Olorunnipa, 4/21)

Testing is critical to controlling the coronavirus and eventually easing the restrictions that have halted daily life for most Americans. But there’s been confusion about what kinds of tests are available and what they actually measure. There are two main types in the United States. One is a diagnostic test to see if you have an active infection with the coronavirus, whether you have symptoms of COVID-19 or not. The other checks to see if you were previously exposed at some point and fought off an infection. (4/21)

When it comes to testing for COVID-19, there are two competing narratives. The Trump administration claims the U.S. has been doing well and has enough testing capacity. "By our best estimates, we have enough testing capacity today for every state in America to go to Phase 1," Vice President Pence said Monday night at a White House press briefing, referring to the administration's guidelines for gradually reopening the nation. (Aubrey, 4/22)

Iowa will nearly triple its ability to test for coronavirus infections, with the addition of an online screening system and drive-through testing sites, Gov. Kim Reynolds announced Tuesday. Iowa has hired a group of private companies to set up the new system, including a website, TestIowa.com, which launched Tuesday. The state has agreed to pay up to $26 million in federal money for the effort, according to a contract released Tuesday. Reynolds' spokesman said each test will cost $48.14. (Leys and Coltrain, 4/21)

President Trump said on Tuesday that he would order a temporary halt in issuing green cards to prevent people from immigrating to the United States, but he backed away from plans to suspend guest worker programs after business groups exploded in anger at the threat of losing access to foreign labor. Mr. Trump, whose administration has faced intense criticism in recent months for his handling of the coronavirus crisis, abruptly sought to change the subject Tuesday night by resuming his assault on immigration, which animated his 2016 campaign and became one of the defining issues of his presidency. (Shear, Kanno-Youngs and Dickerson, 4/21)

An administration official familiar with the plans, however, said the order will apply to foreigners seeking employment-based green cards and relatives of green card holders who are not citizens. Americans wishing to bring immediate family will still be able to do so, according to the official, who spoke on condition of anonymity before the plan was announced. About 1 million green cards were granted in the 2019 fiscal year, about half to spouses, children and parents of U.S. citizens. (Colvin, Spagat and Fox, 4/22)

The president has broad authority to restrict entry into the United States — a point the Supreme Court affirmed in upholding his controversial entry ban in 2018 — and that power is perhaps no greater than during a public health emergency. State Department officials said they are still waiting for guidance from the White House regarding what types of immigrant visas will be suspended. (Miroff, Sacchetti and Jan, 4/21)

The executive order wouldn’t impact immigrants already living in the U.S. or foreigners coming on temporary visas for work or travel. That category includes H-1B visas, which allow more than 85,000 high-skilled foreigners to come to the U.S. for at least three years to work. It also includes seasonal migrant workers who come to the U.S. annually to work on farms, where they make up about one-tenth of the agricultural workforce, and at other businesses such as resorts or county fairs. (Hackman and Ballhaus, 4/21)

The move angered conservatives who were hoping the president would go further. The Trump administration has already paused most routine visa processing and refugee cases during the coronavirus pandemic, meaning the president's executive order may be redundant for many already-stalled cases. Moreover, a majority of immigrants seeking green cards are already living in the U.S. (Kumar, 4/21)

Families that have waited years to be reunited, businesses that rely on foreign workers, universities that recruit international students with the promise of high-paying American jobs — all of their plans faced new uncertainty on Tuesday as the Trump administration announced new temporary restrictions on permanent residency in the United States. President Trump signaled that a 60-day ban on most green cards, which could be imposed as early as Wednesday, was intended to protect work opportunities for the millions of Americans who have lost their jobs in the coronavirus pandemic. (Dickerson and Jordan, 4/21)

Michigan Gov. Gretchen Whitmer said Tuesday that President Donald Trump’s plan to suspend immigration is distracting from efforts to combat the coronavirus pandemic and part of “inconsistent messages” that spread fear and put the public in “greater danger.” Trump’s pronouncements about freezing immigration are “scary” for immigrants, family members hoping to immigrate to the U.S., farmers who rely on seasonal migrant workers and Canadian nurses who work in Michigan, the Democratic governor said in an interview with The Associated Press. (Eggert and Burnett, 4/22)

Democrats and labor groups say companies should be forced to establish formal workplace coronavirus protections, a demand set to become a point of tension with Republicans and the Trump administration in the next round of stimulus talks. Rep. Bobby Scott (D., Va.), chairman of the House Education and Labor Committee, on Tuesday introduced a measure that would direct the Occupational Safety and Health Administration to order all companies to implement comprehensive plans to protect workers who continue in their jobs during the pandemic. (Hughes, 4/21)

Adam Ryan, a Target employee in Christiansburg, Va., has felt unsafe at work in recent weeks. He finds it difficult to follow the recommendation that he stay six feet away from others because the store is often crowded and customers linger closely while he restocks shelves. “People will get mad at me when I’m in the area and they want to grab something,” he said. “They just act like it’s business as usual.” Target has taken steps to address workers’ safety concerns, including providing masks, but Mr. Ryan feels that the company hasn’t gone far enough. (Scheiber, 4/22)

Nevada’s largest health care union slammed state officials Tuesday for not thoroughly investigating workplace safety complaints at hospitals. Service Employees International Union, Local 1107 board member Jody Domineck said it was “completely unacceptable” that the Nevada Occupational Safety and Health Administration was not performing work-site inspections for any of the more than two dozen complaints made against hospitals since the state’s coronavirus outbreak began in early March. (Davidson, 4/21)

A second Smithfield Foods worker has died from COVID-19 complications after a coronavirus outbreak at the Sioux Falls-based meatpacking plant erupted earlier this month. Craig Franken, 61, died on Sunday from COVID-19, according to his obituary. Franken started working at John Morrell and Company, now Smithfield Foods, after serving in the U.S. Army for three years in 1979. The obituary did not say what position Franken had at the plant. (Huber, 4/21)

California Attorney General Xavier Becerra and 19 other AGs are asking 3M to help prevent price hikes for respirator masks and other personal protective equipment that governments and health care providers are scrambling to acquire during the coronavirus pandemic. Led by Virginia Attorney General Mark Herring, officials from 19 states and the District of Columbia asked 3M CEO Michael Roman today to stop doing business with distributors that violate the company's policies prohibiting price gouging; create a database of 3M's inventory of N95 respirators for governments and health care providers; and disclose more information on how 3M is distributing its inventory and filling orders. (Kahn, 4/21)

Last month as the country struggled to defend itself from the coronavirus, some critics were asking where the Federal Emergency Management Agency was and why is wasn’t working overtime to assist a nation amid the pandemic. But after being brought late into the government's response and as states continue to sound the alarm, the federal agency says it has raced to catch up to the ever-growing demands and has mobilized quickly to get critical equipment to those who need it. (Folmer and Margolin, 4/21)

As pleas for protective masks continue amid the coronavirus pandemic, a Delaware supplier of medical equipment is disputing the legality of what he said were federal seizures of hundreds of thousands of N95 respirators. George Gianforcaro, owner of the small, Newark, Delaware-based Indutex USA, said the Federal Emergency Management Agency did not pay him when it took possession of two imported shipments of masks bound for customers across the United States. (Baker, 4/21)

White House senior adviser Jared Kushner in March launched an effort under the government’s emergency powers to enlist private-sector volunteers in the coronavirus pandemic response. As part of the project, eight junior analysts at New York-based Insight Partners, an investment fund, were assigned to work at Federal Emergency Management Agency headquarters to help source protective gear and test kits for medical workers from vendors. (Levy, 4/21)

For weeks into the coronavirus crisis, President Trump expressed support for China’s handling of the epidemic that first emerged in the city of Wuhan and the country’s “transparency” on the situation. Now that the death toll in the United States has soared, Trump and his aides have started to blame China, accusing it of not quickly sharing information that might have stemmed the pandemic. (Kessler, 4/22)

U.S. officials are drafting a plan to donate ventilators to African countries battling the novel coronavirus, an effort that comes as President Donald Trump boasts of how recently ramped-up production has made him the “king of ventilators. ”The still-preliminary plan, confirmed by two Trump administration officials, could save lives on a continent sorely lacking such machines and enhance America’s standing in the face of Chinese efforts to gain diplomatic dominance across Africa. (Toosi, 4/21)

Vice President Mike Pence visited a GE Healthcare manufacturing facility in Madison Tuesday to tout the production of ventilators and offer encouragement that the United States is robustly fighting the coronavirus pandemic.  "We are one team confronting the coronavirus epidemic, one nation working together," Pence said during a discussion with workers and management. He lauded the partnership between union machinists and GE Healthcare and said they "have saved lives all across America." (Glauber, 4/21)

Jamal Uddin’s coronavirus story began like many others: His health deteriorated, he was hospitalized, he tested positive for COVID-19, and he was treated. And the treatment appeared to be working, he was going to be taken off the ventilator -- until his potassium levels spiked. A sudden increase in potassium levels, a result of kidney damage, can be treated with a dialysis machine. But at the hospital in hard-hit New York City where Uddin was being treated, his family says every dialysis machine was already in use – a sign, experts say, of the growing connection between COVID-19 and kidney problems. (Dastmalchi, Bhatt and Bruggeman, 4/22)

States and hospitals aren't just counting on the federal government for personal protective equipment. They're wading into the import business themselves, sourcing their own supplies from China. (Kaste and Ruwitch, 4/21)

The global coronavirus crisis crashed into the United States in Washington state in January and quickly brought the richest and most powerful nation in the history of the world to its knees. And so far, the federal response has been too small in scope and short on creative solutions to meet the greatest challenge since World War II. The nation needs upward of 30 million tests per week to properly track the virus, health experts say. The country is testing only about 1 million a week now. It could take a public health army of more than 100,000 to track and trace those carrying the virus. There are only a few thousand so far. (White, 4/21)

By the time Dr. John Walsh raised the alarm in late March, his hospital in Joliet, Illinois, was almost out of ventilators. Sick prisoners from a nearby state prison kept arriving in the emergency room, requiring nine ventilators and overwhelming the private 480-bed AMITA Health St. Joseph Medical Center. Walsh went on television to plead for help with what he called a COVID-19 disaster. The U.S. Constitution requires prison systems to provide medical care for the people they incarcerate, the Supreme Court has said. And so states and the federal government hire doctors and nurses, or contract with healthcare companies, to treat sick prisoners. (Neff and Schwartzapfel, 4/16)

The Department of Justice has issued new guidelines to the federal prison system requiring that prisoners eligible for release to home confinement amid the coronavirus outbreak must have served at least 50% of their prison sentence, according to a Bureau of Prisons memo obtained by ABC News. The updated guidance was shared with federal prisons across the country Monday, according to sources familiar with it. Inside some facilities sources described to ABC News confusion over the department’s new guidelines, especially since some of the wheels were already in motion for some releases. (Barr, Faulders and Mallin, 4/21)

A federal judge in New York has slammed the federal Bureau of Prisons for what she contends are “illogical” and “Kafkaesque” quarantine policies that put inmates and the community at greater risk of contracting coronavirus. U.S. District Court Judge Alison Nathan, in a decision dated Sunday, excoriated federal officials over their practice of putting inmates considered or approved for early release into a pre-release quarantine before they are sent home. (Gerstein, 4/20)

When Quinsey Simpson relieved a colleague at New York City’s Rikers Island jail complex in early March, he had no idea his fellow correction officer was infected with the coronavirus. Before long, Officer Simpson had an unrelenting cough. When his chest began feeling tight, he went to the emergency room and was diagnosed with Covid-19, the disease caused by the virus. “We had the hope of him getting better, until he got on the respirator,” said Britton Alston, his friend and one-time co-worker. (Paul and Chapman, 4/22)

A prisoner who says he escaped custody over fears about contracting the coronavirus is now facing new charges after he turned himself in to authorities. The Justice Department announced that Richard Cephas of Wilmington, Del. was arrested Monday, over two weeks after authorities say he escaped from the custody of the Federal Bureau of Prisons (BOP) in Butner, N.C. He is now being charged over the escape. (Axelrod, 4/21)

Local community activists said Tuesday they would begin bailing defendants out of some of Texas’ largest county jails to protect them from dangerous conditions inside caused by the spread of the new coronavirus. In a news release, the Texas Organizing Project announced it would focus on bailing out people with low bonds in Harris County, Dallas County, Bexar County, and Fort Bend County. Harris County’s jail, with some 7,400 inmates, is the second largest county jail in the United States. (Barned-Smith, 4/21)

An anti-malarial drug President Trump has aggressively promoted to treat covid-19 had no benefit and was linked to higher rates of death for Veterans Affairs patients hospitalized with the novel coronavirus, according to a study, raising further questions about the safety and efficacy of a treatment that has seen widespread use in the pandemic. The study by VA and academic researchers analyzed outcomes of 368 male patients nationwide, with 97 receiving hydroxychloroquine, 113 receiving hydroxychloroquine in combination with the antibiotic azithromycin, and 158 not receiving any hydroxychloroquine. (Rowland, 4/21)

Hydroxychloroquine made no difference in the need for a breathing machine, either. Researchers did not track side effects, but noted a hint that hydroxychloroquine might have damaged other organs. The drug has long been known to have potentially serious side effects, including altering the heartbeat in a way that could lead to sudden death. (Marchione, 4/22)

The federal agency led by Dr. Anthony Fauci issued guidelines on Tuesday that stated there is no proven drug for treating coronavirus patients, a finding that essentially reinforces Dr. Fauci’s dissent from President Trump’s repeated promotion of certain drugs without evidence to support their use. The report echoed what frustrated doctors already know: Not enough is known about the highly infectious virus or how to combat it. (Grady, 4/21)

Coronavirus treatment guidelines issued by a government panel conclude there is not enough data on some of the most touted drugs — including hydroxychloroquine, which the panel said should not be used outside clinical trials when paired with antibiotics. The group, organized by the National Institutes of Health, includes physicians, statisticians and other experts from both government agencies and health organizations. (Owermohle, 4/21)

For the most part, the guidelines are agnostic about the use of experimental medications, pointing out that strong scientific evidence is lacking to make a firm conclusion one way or the other. But occasionally, there are recommendations explicitly against certain therapies. For example, the panel recommended against using Lopinavir/ritonavir or other HIV protease inhibitors because of negative clinical trial data. It also recommended against using interferon because it seemed to make patients with SARS and MERS worse. Those diseases are caused by a coronavirus related to the one causing COVID-19. (Palca, 4/21)

Given the hour — 4:30 a.m. in California, 7:30 a.m. in Boston — no one turned on their webcams. About 180 executives and venture capitalists from large biotech companies and small start-ups alike dialed in to a WebEx call Monday. All were hoping the group chat would help them make big decisions about how to proceed with research, how to raise money from investors — essentially, how to run a biotech company in the time of coronavirus. (Sheridan, 4/22)

Rick Bright, one of the nation’s leading vaccine development experts and the director of the Biomedical Advanced Research and Development Authority, is no longer leading the organization, officials told STAT. The shakeup at the agency, known as BARDA, couldn’t come at a more inopportune time for the office, which invests in drugs, devices, and other technologies that help address infectious disease outbreaks and which has been at the center of the government’s coronavirus pandemic response. (Florko, 4/21)

The director of the agency responsible for leading the charge on the production and purchase of vaccines in the Trump administration is no longer leading the agency as of Tuesday, CNN has confirmed. Dr. Rick Bright had led the Biomedical Advanced Research and Development Authority, which has been central to the response to the coronavirus outbreak, since 2016. An acting director has taken over in his position, though the reason behind Bright's sudden departure is still unclear. (Collins and Klein, 4/21)

The Senate approved a $484 billion coronavirus relief package on Tuesday that would revive a depleted loan program for distressed small businesses and provide funds for hospitals and coronavirus testing, breaking a partisan impasse over the latest infusion of federal money to address the public health and economic crisis brought on by the pandemic. The measure was the product of an intense round of negotiations between Democrats and the Trump administration that unfolded as the small-business loan program created by the $2.2 trillion stimulus law quickly ran out of funding, collapsing under a glut of applications from desperate companies struggling to stay afloat. (Cochrane and Tankersley, 4/21)

Most of the funding, $331 billion, would go to boost a small-business payroll loan program that ran out of money last week. There would be $100 billion for health care, with $75 billion to hospitals and $25 billion to boost testing for the virus, a key step in building the confidence required to reopen state economies. There is $60 billion for a small-business loans and grants. What started as a Trump administration effort with Republicans to bolster the government’s small-business Paycheck Protection Program quickly doubled in size, second only to the nearly $2 trillion coronavirus rescue package that became law last month. (Mascaro and Taylor, 4/22)

Republicans fended off money for state and local governments that Democrats wanted and also got more for small businesses than previously requested. Democrats, meanwhile, were able to deliver on more money for hospitals and testing that they'd requested. Democrats admitted defeat on their demands for $150 billion for states and local governments after McConnell and Mnuchin took a hard line against including that money. Schumer said he was "sorely disappointed" new food aid and more money requested by governors was not included in the package. (Everett and Caygle, 4/21)

The package, which lawmakers dubbed an interim emergency bill, also includes funding to ramp up the country’s testing for the new coronavirus, but doesn’t include funding sought by Democrats for hard-hit state and local budgets, which instead was pushed off to the next round of stimulus negotiations. Top Republicans signaled that concerns over the mounting debt would play a bigger role in talks about future stimulus aid, setting up a sharp divide with Democrats worried that Congress has done far from enough. (Peterson and Duehren, 4/21)

Trump signaled his approval of the deal on Twitter, saying, "I urge the Senate and House to pass the Paycheck Protection Program and Health Care Enhancement Act with additional funding for PPP, Hospitals, and Testing." The agreement also adds $60 billion for the Small Business Administration’s disaster relief fund, and farms and other agriculture enterprises would now be considered eligible. (Turner, Khan and Siegel, 4/21)

Democratic lawmakers say it should be just the beginning. Speaking on the Senate floor shortly before the legislation passed by voice vote, Senate Minority Leader Charles E. Schumer (D-N.Y.) said lawmakers needed to quickly begin work on another piece of legislation that would match the size and scope of last month’s $2 trillion Cares Act. “I’d remind my colleagues this is an interim measure,” Schumer said. “There’s plenty of hard-won provisions that we Democrats are pleased with, but it’s ultimately a building block. In the weeks ahead Congress must prepare another major bill similar in size and ambition to the Cares Act. The next bill must be big and bold and suited to the needs of a beleaguered nation.” (Werner and Kim, 4/21)

The House is expected to vote on Thursday on what would be the fourth coronavirus-response law. Taken together, the four measures amount to about $3 trillion in aid since last month to confront a crisis that has killed more than 43,000 Americans. (Cornwell and Zengerle, 4/21)

Senate Majority Leader Mitch McConnell is drawing a line: There will be no more attempts at long-distance legislating on the coronavirus. In a telephone interview Tuesday after passage of a $484 billion coronavirus relief bill, the Senate majority leader made clear that the full Senate must be in session before Congress begins its fifth installment of responding to the pandemic. And he signaled he is growing weary of quickly shoveling billions of dollars out the door even as the economy continues to crater. (Everett, 4/21)

Hospitals and health providers stand to get $75 billion under the coronavirus package passed by the Senate on Tuesday, funds aimed to help offset the costs from a surge in coronavirus cases and lost revenue due to the delaying of elective procedures. In hard-hit areas such as New York City, hospitals have been deluged with patients and had to spend above-market prices for personal protective equipment. Hospitals in some other parts of the country have escaped the surge in cases but have still had to put off nonemergency care that drives much of their revenue. “The need is really there,” said Tom Nickels, executive vice president of the American Hospital Association. (Armour, 4/21)

As Congress puts the finishing touches on a stimulus plan to include new funding to help hospitals survive the coronavirus pandemic, health-care facilities have yet to receive $70 billion of the emergency support allocated to them almost a month ago in the last stimulus package. The Department of Health and Human Services is facing criticism from both parties in Congress, not only for the delay, but also over a failure to provide more information about how the money will be divided up between hospitals and other providers. (Armour, 4/21)

The Senate on Tuesday passed a bill that gives $75 billion in new grants to providers, expands COVID-19 testing capacity, and replenishes small business assistance programs. The U.S. House of Representatives is expected to pass the bill as soon as Thursday. (Cohrs, 4/21)

Sen. Mike Lee (R-Utah) on Tuesday knocked Congress for taking a weeks-long recess amid the coronavirus pandemic that has roiled the economy. "Congress is in recess. This ... is simply unacceptable. If COVID-19 requires Congress to act then it requires Congress to convene," Lee said from the Senate floor Tuesday. (Carney, 4/21)

Democratic leaders plan to move this week to change the rules of the House of Representatives to allow lawmakers to cast votes remotely for the first time in its 231-year history, a major concession to the constraints created by the coronavirus pandemic. Representative Steny H. Hoyer, Democrat of Maryland and the majority leader, advised lawmakers on Tuesday that they were likely to vote on Thursday on the new rules, which would temporarily allow members to designate another lawmaker to cast votes for them by proxy if they are unable to travel to the Capitol themselves. (Fandos, 4/21)

Two days before learning that she would lose her job, Lissa Gilliam spent hundreds of dollars online on baby products. A 37-year-old expectant mother, Ms. Gilliam had planned to ask local parents in Seattle for used strollers and secondhand onesies in a bid to reduce waste. But as the coronavirus pandemic ravaged the area, new items delivered in boxes seemed a safer bet. (Hsu, 4/22)

The government is sending stimulus payments to dead people — and that’s not as surprising as it sounds. Though easy to mock, some say it’s hardly unusual when the IRS is trying to distribute payments to more than 150 million Americans. (Faler, 4/22)

President Trump joined mounting criticism of Harvard on Tuesday, saying the richest university in the country would pay back $8.6 million in relief money from a coronavirus stimulus package that the president himself signed last month. “Harvard’s going to pay back the money,” Mr. Trump said at his evening news briefing, adding, “They have one of the largest endowments anywhere in the country, maybe in the world, I guess, and they’re going to pay back that money.” (Hartocollis, 4/21)

Harvard University on Tuesday pushed back against President Trump's call for the institution to return funds it received from the $2.2 trillion coronavirus stimulus package, saying the money it accepted would go toward assisting students financially impacted by the coronavirus outbreak. The university emphasized in a statement that it received the money from a $14 billion fund established under the CARES Act, called the Higher Education Emergency Relief Fund, and not a separate program designed to help small businesses retain employees amid the pandemic. (Wise, 4/21)

The Trump Organization has asked the federal government to include it in any accommodations it may make for private tenants as the coronavirus pandemic has caused widespread layoffs and a falloff in revenue at the company, the president’s son Eric Trump said Tuesday. The discussions over the lease for President Trump’s D.C. hotel could pose a major test for how the Trump administration intends to treat the president’s private business as it navigates a perilous time for the hospitality industry. (Partlow and O'Connell, 4/21)

Damon West was hoping the government’s coronavirus rescue package for small-business owners would help replace the income he’s lost now that he can’t travel the country as a keynote speaker. But then he got a call from his accountant. A question on the application form asked whether, within the last five years, he had been convicted of or pleaded guilty or no contest to a felony or “been placed on any form of parole or probation.” Another asked whether anyone who owns at least 20% of the company was incarcerated, under indictment or on probation or parole. If so, they are ineligible. (Colvin, 4/22)

While many companies have laid off workers during the pandemic, several businesses in the region are still hiring, according to a new survey. Boston-based career management firm Keystone Partners found that 62% of businesses in New England are hiring during the coronavirus outbreak. (Enwemeka, 4/22)

Hospitals' median operating margins fell 150% to negative 8% in March, dropping 14 percentage points relative to last year, according to a new report from Kaufman Hall. A 20% decline in operating room minutes, in part, sunk revenue by 13% as providers postponed elective procedures like non-urgent heart surgeries and joint replacements to free capacity for coronavirus patients. (Kacik, 4/21)

The stranglehold COVID-19 put on HCA Healthcare's volumes starting March 15 has only worsened in April, with outpatient surgeries down 70% year-over-year so far. Leaders with the Nashville-based hospital chain said on an earnings call Tuesday they view the first quarter, which ended March 31, in two distinct phases: pre- and post-COVID-19. All key volume indicators were on the upswing from January 1 through March 15. After that, all bets were off. (Bannow, 4/21)

A federal appeals court ruled Monday that the CMS can include Medicare and commercial payments in a hospital's disproportionate-share payment limit calculation, a move that would lower supplemental payments to hospitals that care for low-income and uninsured people. The three-judge panel for the U.S. Court of Appeals for the Fifth Circuit found that the CMS acted within its rights when it created the 2017 rule, overturning a lower-court decision. (Brady, 4/21)

The CEOs of the largest publicly traded health insurers received more in total compensation in 2019 than they did the year before as nearly all of their companies grew profits and revenue. David Wichmann, the CEO of the most profitable health insurer UnitedHealth Group, made $18.9 million in total pay last year, a 4.3% increase over the year before, according to the company's annual proxy statement filed with the U.S. Securities and Exchange Commission. (Livingston, 4/21)

The economic and political impact of the coronavirus crisis is beginning to reverberate across the presidential battleground states, creating unforeseen red-state opportunities for Joe Biden but also offering promise for Donald Trump in several Democratic-leaning states where his prospects once seemed limited. Interviews with more than 30 political strategists, campaign advisers and officials in both parties paint a portrait of an expanded swing state electoral map, upended by the coronavirus pandemic and the economic dislocation it has caused. (Siders, 4/22)

Rising job losses, deaths and political tensions are putting new pressure on President Trump in key battleground states, creating uncertainty about his re-election prospects even as he projects an improved outlook on the coronavirus pandemic. While Mr. Trump’s national poll numbers hold steady and his base supporters remain loyal, the fast-moving virus could complicate his path in some of the states that delivered him to the White House in 2016, some fellow Republicans say. (Lucey and Leary, 4/22)

State health officials in Wisconsin said Tuesday that 19 people who have either voted in-person or worked at a polling site on election day have so far tested positive for COVID-19 after April 9, two days after the spring election, underscoring the risks of forging ahead with an in-person voting during the height of the widespread and deadly public health crisis. But a department spokesperson told ABC News that several of those people "reported other possible exposures as well." Officials are hesitant to link the new cases of the coronavirus directly to the election. (Karson, 4/21)

Health officials in Wisconsin said they have identified at least seven people who may have contracted the coronavirus from participating in the April 7 election, the first such cases following in-person voting that was held despite widespread concern about the public health risks. The infections involve six voters and one poll worker in Milwaukee, where difficulty finding poll workers forced the city to pare nearly 200 voting locations back to just five, and where voters — some in masks, some with no protection — were forced to wait in long lines for hours. (Richmond, 4/22)

The seven cases include six voters and one poll worker in Milwaukee, the state’s largest city, where nearly 200 voting locations were pared back to five and there were hours-long lines to cast ballots, the office of Milwaukee Health Commissioner Jeanette Kowalik confirmed. The number of election-related infections could grow as the 14-day incubation period ends on Wednesday, health officials said. (Becker, 4/21)

A federal lawsuit is seeking emergency changes to Georgia’s June 9 primary election — including another postponement and a switch to hand-marked paper ballots — because of the health risk from the coronavirus. The lawsuit, filed Monday by an election integrity group and five voters, said Georgia’s new voting touchscreens could spread the illness to voters at precincts. (Niesse, 4/21)

Rutgers University hopes to better understand and treat COVID-19 with the largest study of of healthcare workers who have been exposed to the virus. The study includes more than 800 employees of Rutgers University, University Hospital in Newark and Robert Wood Johnson University Hospital in New Brunswick, N.J., who will be tracked for six months. The goal is to determine how many of Rutgers' 7,000 healthcare employees might get infected by the 800 exposed. (Johnson, 4/21)

Kaiser Health News: Lost On The Frontline

For Jhoanna Mariel Buendia, her aunt was a constant ― if distant — presence. Araceli Buendia Ilagan emigrated from their hometown Baguio, in the Philippines, to the U.S. before Buendia was born, but she remained close to her family and communicated with them nearly every day. “She was one of the smartest people I ever knew,” Buendia, 27, said. Buendia Ilagan, who at one point looked into adopting her niece so she could join her and her husband the United States, encouraged Buendia to become a nurse, and talked her through grueling coursework in anatomy and physiology. Buendia is now a nurse in London. (4/22)

A nurse furiously pushes down on a man’s chest as five other staff in full protective gear surround the patient’s bed. Suddenly, one throws up his arms and steps backward. “OK, move! Everybody move!” are the instructions. Moments after they back away, the patient’s heart is shocked, his arm spasms and he shakes on the bed. Soon after, he is placed on a ventilator. He has been saved — for now. (Mahoney and Minchillo, 4/22)

The unknown effects of the novel coronavirus are worrisome for all but particularly agonizing for pregnant women, who fear the ravages of a severe respiratory illness could harm the development of their fetuses. But those same uncertainties are being cited by some employers as a reason to maintain the status quo in the workplace. While some hospitals — including Baystate Medical Center in Springfield and Massachusetts General Hospital in Boston — are giving pregnant health care workers the option of temporarily changing job responsibilities, Mercy Medical Center has made no such guarantees. (Ebbert, 4/21)

A group of state and nonprofit agencies Tuesday launched a new phone support service to provide emotional support to health care workers and first responders who are working on the frontlines responding to the coronavirus pandemic. Called the FrontLine WarmLine, the phone support service was launched to help Maine health care professionals and first responders deal with stress and anxiety related to tackling the COVID-19 pandemic. (Pendharkar, 4/21)

While hospitals strain to treat the surge of acutely ill COVID-19 patients, the crisis threatens the stability of the rest of the health care system. Elective surgeries and routine medical care are on hold. As a result, medical providers of all kinds are seeing drastic reductions in patient visits and crushing losses of revenue. At the same time, some continue to pay wages along with rent and other overhead costs. Many worry they’ll lose their skilled workers to hospitals. The combination raises the possibility that the non-hospital health system will be decimated, and many of the surviving providers will be ill-prepared to deal with the pent-up demand that emerges from this crisis. (Vestal and Ollove, 4/22)

Kaiser Health News: In The Middle Of The Country, A Hospital And Its Community Prepare For The Surge

Megan Kampling and her husband were only a few days into a spring break trip with their children when Kansas Gov. Laura Kelly shut down schools in an effort to slow the spread of the novel coronavirus. “We both just looked at each other and said, ‘What are we going to do?’” Kampling recalled. She works in the pharmacy department at Ascension Via Christi hospitals in Wichita and her husband is an officer with the Wichita Police Department, making them both essential workers who could not work remotely. (West, 4/22)

The Defense Department and the Veterans Affairs Department have launched a joint health information exchange designed to make it easier for the agencies to exchange patient data with one another, as well as with community providers. The DOD, VA and the Federal Electronic Health Record Modernization program office—the office that oversees the ongoing EHR implementations at both agencies—opened access to the HIE this past weekend. Providers from the agencies and private-sector providers treating their patients will be able to use the HIE to request access to health records of shared patients. (Cohen, 4/21)

HHS on Tuesday unveiled plans to delay enforcement of two recently released rules on interoperability and data blocking. The CMS said it will give providers an additional six months to comply with rules to improve data sharing. Meanwhile, the Office of the National Coordinator for Health Information Technology is giving vendors an additional three months to comply with its health IT certification program. (Cohen, 4/21)

Kaiser Health News: Coronavirus Fuels Explosive Growth In Telehealth ― And Concern About Fraud

On March 17, Medicare chief Seema Verma stepped to the podium at a White House coronavirus briefing and unveiled a “historic action” to promote virtual medical care, or telehealth. Verma temporarily lifted a variety of federal restrictions on the use of the service, which had been limited to rural areas. She praised telehealth, saying it could handle routine care for an older patient with diabetes without risking a visit to a medical office. (Schulte, 4/22)

As hospitals seek innovative solutions to treat the surge of COVID-19 patients with resources running thin, expanding ventilator supply has been central to the conversation. Research has shown that only a third of patients placed on a ventilator survive the experience. Now, some experts are wondering if ventilators could be contributing to the poor survival rate and whether ventilators are being overused. (Anoruo, 4/21)

They confront death daily, but the young doctors rarely pondered their own mortality until the coronavirus pandemic, when clinicians like them started dying. During an overnight lull last month, five Massachusetts General Hospital residents in their 20s and 30s recorded their health care proxies, naming who would make medical decisions for them if they became too sick to. (Martin, 4/20)

California has made progress in protecting the healthcare system from a dramatic spike of sick patients during the COVID-19 pandemic. But state public health officials are still planning for a “worst-case scenario,” quietly publishing a sobering set of detailed guidelines to answer the troubling ethical question of who lives and who dies should California face a new surge in the coronavirus outbreak, resulting in a shortage of ventilators and medical supplies. (Luna, 4/21)

Dr. Kathryn Hibbert's Covid-19 patient in the intensive care unit was not doing well. As his blood pressure plummeted, she tried to insert an intravenous line into an artery in his wrist. A blood clot clogged the tubing. Frustrated, Hibbert tried again with a new needle. A blood clot clogged up that line as well. (Cohen, 4/22)

With some states getting ready to lift their stay-at-home orders and relax their social distancing measures, it may seem that health officials have the coronavirus outbreak under control. But researchers say there’s still much they don’t know about the virus — and the answers to their questions could help determine when it will be safe for life to return to normal. The mysteries scientists are most eager to solve have shifted somewhat since this coronavirus began sickening people in Wuhan, China, in late 2019. (Khan, 4/21)

With a vaccine still months or years away, and no magic drug or miracle cure for the coronavirus, the cruel realities of this virus can hit families incredibly quickly. But with the scientific world working around the clock on potential lifesaving breakthroughs, there is hope. (Schlosberg and Hartung, 4/21)

As awareness of the coronavirus pandemic has spread throughout the United States, doctors who monitor activity at poison call centers have noticed an alarming trend: a significant increase in accidental exposures to household cleaners and disinfectants. A study released Monday by the Centers for Disease Control and Prevention shows that calls to poison hotlines this year for cases involving cleaners and disinfectants rose significantly compared with the same period over the previous two years, and charts a dramatic spike in March for both categories. (Waldstein, 4/21)

When Amy Belles first heard the coronavirus lockdown would close her son’s school in Ohio, it felt like the moment 14 years ago when he was first diagnosed with autism. “The wave just hit me, a feeling of uncertainty, anxiety, and that you’re dropped into this new world, and you have to figure it out and adapt,” she says. For people with autism, lockdowns have shattered the routines they rely on, deprived them of specialist education and therapy, and heightened already high levels of anxiety. (MacDonald, 4/21)

Skylar Herbert loved dressing up and performing. She adored going to kindergarten. She started reading at age 4. She liked "girly things" and bling. “She could take over a room,” her grandmother Leona Pannell Herbert said. About a month ago, Skylar started to complain of headaches. Within days, she was hospitalized in the Detroit suburbs, where she was diagnosed with covid-19, the disease caused by the novel coronavirus, and then with a rare form of meningitis. (Janes and Elmer, 4/21)

Strategies are needed to manage the unintended consequences for at-risk children of COVID-19–related school closings, social distancing, overwhelming numbers of distressing public health messages, and cancelation of non-urgent healthcare visits, according to a commentary in Pediatrics. Similarly, a second commentary in the same journal outlines recommendations for pediatricians to guide assessment and mitigation of the family violence likely to endanger many children during a prolonged quarantine. (Van Beusekom, 4/21)

An unplanned grand experiment is changing Earth. As people across the globe stay home to stop the spread of the new coronavirus, the air has cleaned up, albeit temporarily. Smog stopped choking New Delhi, one of the most polluted cities in the world, and India’s getting views of sights not visible in decades. (Borenstein, 4/22)

Doctors at some Los Angeles County hospitals say people are waiting too long to seek medical treatment -- including those infected with the coronavirus -- over fears of catching Covid-19, potentially leading to more detrimental effects to their health. Los Angeles County reported 1,491 new coronavirus cases on Monday, bringing the total to 13,816, Los Angeles Mayor Eric Garcetti said. (Elam and Holombe, 4/21)

Dr. Phil Cai is experiencing something no dentist ever expects: Patients, starved for human connections, are actually happy to arrive at his office. “It is kind of funny, people are actually eager to see the dentist,” he said. “Not for dental work but for social interaction.” Dr. Cai sees far fewer visitors at his McLean, Va., office, as stay-at-home orders restrict dental visits to emergencies. (Stoll, 4/22)

As forensic virologists search to uncover the origins of COVID-19, bats have been fingered as a likely source. Genetic analyses show the virus is very similar to one harbored by Chinese horseshoe bats, and researchers think it’s possible it jumped from those winged mammals to people. But some bat lovers and chiropterologists — scientists who study the flying mammals — are adamant there is no proof. Instead, they’re wringing their hands about the reverse: That people with COVID-19 could spread the disease to their furry, nocturnal housemates. They are particularly worried about already vulnerable North American bat populations, which are being wiped out by white-nose syndrome, a disease caused by a deadly fungus. (4/21)

The coronavirus was already a disaster for Meorina Mazza. In March, it sickened her brother, killed her cousin and prompted officials in Italy’s southern region of Calabria to quarantine her seaside town of San Lucido. But the lockdown also cut her off from her off-the-books shifts as a kitchen hand and made it harder to apply for welfare. Now she is relying on donations of flour to feed her daughters, but still has no money to pay her electricity bills. “We are really headed toward total desperation,” said Ms. Mazza, a 53-year-old mother of two. (Horowitz, 4/21)

The world is facing multiple famines of "biblical proportions" in just a matter of months, the UN has said, warning that the coronavirus pandemic will push an additional 130 million people to the brink of starvation. Famines could take hold in "about three dozen countries" in a worst-case scenario, the executive director of the World Food Programme (WFP) said in a stark address on Tuesday. Ten of those countries already have more than 1 million people on the verge of starvation, he said. (Picheta, 4/22)

Questions are swirling about the health of North Korea’s leader after U.S. news reports indicated Kim Jong Un is in poor health following a recent surgery. The South Korean government, though, said Kim appears to be handling state affairs as usual and that it has no information about his health. Still, Kim’s health is on the radar of U.S. intelligence, with national security adviser Robert O'Brien saying the U.S. intelligence apparatus is closely monitoring reports about North Korea’s leader. (Kheel and Beavers, 4/21)

They arrive 24 hours a day in the Mexican border city of Reynosa, groups of men, women and children deported by the United States. Each time, at the edge of the international bridge, Ricardo Calderón Macias and his team get ready. They put on masks and gloves. They prepare their thermometers and health forms. They wonder, sometimes aloud: Will anyone in this group test positive? (Sieff and Miroff, 4/21)

More than three dozen asset managers, pension funds, and insurers are urging the pharmaceutical industry to cooperate in the fight against Covid-19 by sharing research data and providing affordable worldwide access to medicines, diagnostics, and vaccines. In a letter to be sent to more than 15 large drug makers — including Roche (RHHBY), Gilead Sciences (GILD), and Johnson & Johnson (JNJ) — the investment firms argue that “financial considerations should take second place in the global challenge of getting the coronavirus under control as quickly as possible.” (Silverman, 4/17)

Selling drugs by mail order should feature high up any list of businesses likely to benefit from a pandemic. The U.S. has no big independent online-only pharmacies, but Europe has two for investors to choose between. Both Germany-based Shop Apotheke Europe SAE 0.45% and Switzerland’s Zur Rose saw a March surge in orders as consumers stockpiled medicine. Shop Apotheke this month reported first-quarter growth of 33%, ahead of last year’s rate, and upgraded its 2020 forecast. On Thursday, Zur Rose posted more muted numbers for the quarter, reflecting a slightly different business portfolio and strategy, but its growth also accelerated after stripping out acquisitions. (Wilmot, 4/16)

Even before the pandemic struck and drug makers were seen as potential saviors, the pharmaceutical industry had slightly improved its battered image among patient groups, according to a new survey. The survey found that 46% of patient advocacy groups thought that brand-name drug companies had developed an “excellent” or “good” reputation last year, up from 41% in 2018. That’s the best showing for pharma since the survey was started in 2011 by PatientView, a research firm that canvassed 1,850 patient groups from 95 countries between November 2019 and February 2020. (Silverman, 4/21)

Do they go with a Covid-19 question? Or one about aducanumab? Maybe a combination of both.O ne of biotech’s sell-side analysts — perhaps Geoff Porges from SVB Leerink, or J.P. Morgan’s Cory Kasimov, or Umer Raffat of Evercore ISI — will ask the first question of Biogen (BIIB) chief executive Michel Vounatsos when its first-quarter earnings call kicks off on Wednesday morning. There’s a lot to learn from Biogen on Wednesday, and biotech investors will be listening. (Feuerstein, 4/21)

Biotechnology offerings are one of the few bright spots in an otherwise dreary market for initial public offerings and could hold steady for the rest of the year, even as the pandemic keeps listings in other sectors shut. Biotech companies usually go public at the clinical trial stage without products or revenue. They tend to find long-term investors who are betting on whether these companies will ever have a successful product. Their businesses can survive volatility or a downturn in the economy. (Tse, 4/21)

On Tuesday, April 14th, Nicole Smith-Holt watched from the top balcony of the Minnesota state house as the legislature voted on the bill bearing her son’s name. A bill meant to prevent other Minnesotans from rationing their insulin and dying, like her son Alec did more than two years prior. (Florko, 4/20)

TScan Therapeutics announced a $30 million deal with Swiss pharma giant Novartis (NVS) to develop therapies to treat a type of kidney cancer. The Waltham, Mass., biopharmaceutical company is working to develop treatments that focus on T cells in the body’s immune system response. By harnessing information from T cells in recovering cancer patients, TScan aims to essentially reprogram the same cells in other patients. (Gardizy, 4/15)

Biotechnology startup Cerevance has secured $45 million to hunt for treatments for neurological diseases by studying samples of brain tissue gathered from deceased donors world-wide. (Gormley, 4/14)

The Minnesota Senate on Monday, April 20, approved a proposal to require prescription drug manufacturers to explain why they hiked prices of their drugs. The move aimed at preventing companies from increasing prices with little or no reason comes after more than a year of negotiation between a bipartisan coalition of state lawmakers, patient advocacy groups, doctors, pharmacists, drug manufacturers and others. The bill moves next to the Minnesota House of Representatives for consideration after the Senate approved it on a 63-2 vote. (Ferguson, 4/20)

The latest round of hype on Covid-19 drugs began Thursday afternoon when Stat News reported on a leaked video discussion about Gilead Sciences Inc’s remdesivir. A Chicago doctor who had tested it on severely ill patients suggested it was working — that most of those who were given the medicine recovered and were discharged. The market is reacting as if the drug were already a commercial hit: Gilead shares have been up as much as 12% in early trading. Investors should be clear about what this report is and isn’t, however. It is a promising anecdote that suggests the drug might be useful. It is also extremely limited information from a small portion of a trial taken out of context. In other words, it’s miles from providing proof that remdesivir cures Covid-19. The story is even further from being a reasonable basis for a multibillion-dollar stock move. (Max Nisen, 4/17)

Things have gone from bad to worse for Brian Helstien. For a decade, he’s been grappling with multiple myeloma, a form of blood cancer. Now he needs surgery for a leaky heart valve. But because his medical network, Kaiser Permanente, like all healthcare providers, is dealing with a tsunami of COVID-19 patients, the Laguna Woods resident has been informed his non-life-threatening ticker trouble is an “elective” procedure. (David Lazarus, 4/21)

Make no mistake: The only long-term solution to the Covid-19 pandemic is a safe and effective vaccine. The current focus on identifying effective treatments, while important, serve only as a temporary Band-Aid. We don’t know yet if hydroxychloroquine, remdesivir, or any of the other repurposed drugs currently being tested in a blitzkrieg of quickly designed clinical trials are going to work and save lives. It’s highly likely that most of them, if not all of them, will fail or be only marginally helpful. (Stewart Lyman, 4/21)

When I started working in the biopharma industry 20 or so years ago, I didn’t think I would need to become an expert in crisis management. Yet during the past decade, I have found myself leading the corporate response to three very different existential crises in three different regions. Despite the unique aspects of each situation, they share important commonalities that shed some light on actions and attitudes that can help guide and improve corporate leaders’ response to the coronavirus pandemic, in the United States and globally. (Mahesh Karande, 4/20)

The coronavirus pandemic contains an encouraging surprise. If we can take the right lessons from the crisis, we will find ourselves better prepared to tackle the health of our fevered planet. The first lesson is that our deepest well of practical hope is in science and the people who practice it. The front-line health care workers, public health experts, engineers, and scientists working on face shields, masks, ventilators, testing, contact tracing, therapeutic drugs, and a vaccine — with courage and ingenuity — are fighting the current wildfire with torrents of scientific knowledge. (L. Rafael Reif, 4/21)

Last month, a viral post attributed to Stanford University circulated on social media claiming that if you can hold your breath without coughing for more than 10 seconds, you most likely don’t have Covid-19, the disease caused by the new coronavirus. I initially believed it was credible and forwarded it to friends before I learned it was fake. I have studied influence campaigns for most of my career. How could I have been so foolish? And then I began to wonder about the impact that pandemic conspiracies like this one, labeled “infodemic” campaigns by the World Health Organization, will have on the American election in November. What sorts of lies, rumors and wild theories about the coronavirus will enshroud the Democratic and Republican campaigns, conventions, debates and Election Day? (Vera Zakem, 4/22)

When medical historians look back at the Covid-19 pandemic, they will reckon with how the United States, with its vast technological and scientific resources, stumbled so badly in the face of an emerging virus. They’ll wonder why the country responded so slowly, and why, in particular, it lacked adequate diagnostic tests for months after cases started to rise. But they will also be baffled at something else: that it took so long to study new medicines to determine if they worked — even as the novel coronavirus, SARS-CoV-2, was killing 2,000 Americans a day. Simply put, more people will die from Covid-19 because we cannot study drugs more quickly. (Herper, 4/22)

On March 1, the first case of COVID-19 was diagnosed in New York City at Mount Sinai. Over the next month, our health system would work at an unbelievable pace to double capacity to manage the dramatic spike in COVID-19-positive patients. Engineers and facilities personnel transformed lobbies and conference rooms into hospital rooms, we canceled scheduled surgeries and admissions, and hospital leadership partnered with a disaster relief organization to open a field hospital in New York's Central Park. (Brendan Carr, 4/21)

“Welcome to the Covid crew,” read the email we received in mid-March. With that quick introduction, we started work in the first medical ICU team focused on the care of patients with Covid-19 at Boston Medical Center, a safety net hospital. Little did we know that the next few weeks would be the most trying times of our medical careers to date, and possibly ever. (Iniya Rajendran and Stephanie Van Decker, 4/22)

The coronavirus thus far has hit hardest in urban areas, feeding a belief among many rural Americans that it isn’t their problem. Increasingly, though, it is. Even as larger cities start to see cases leveling off, infections are growing across the heartland, sometimes at even higher transmission rates than urban areas. As the virus moves out from the cities, rural America will face some unique problems, including older-than-average populations, lack of hospitals, lack of medical insurance — and a sense of complacency or tough-it-out self-reliance that too many rural-state political leaders have encouraged. (4/21)

I called my parents a few nights ago to tell them to be cautious when stepping out of the house, because they might be targets of verbal or even physical abuse. It felt so strange. Our roles had flipped. My plea mirrored the admonitions I received from them as a child growing up in Houston. The world, they cautioned, was hostile and it viewed us as strangers. So they warned me to stick close to my family. Close to my kind. The fact that the coronavirus seems to have originated in China has spawned a slew of anti-Asian hate crimes. (John Cho, 4/22)

I live and work in Colorado, a beautiful state that can look to an outsider like a year-round playground of sunshine and skiing. But my state has a big problem: suicide rates that are among the highest in the country. (Emmy Betz, 4/22)

Last Friday, Dr. Deborah Birx from the White House Coronavirus Task Force laid out the phased reopening of the country, with bullet points that there would be no visitation to nursing homes in Phases 1 or 2. No timetable is given for the phases other than a steady drop-off in cases. So it would be at least 14 days, twice over, once cases solidly recede.This means the elderly with daily living needs are going to go 60 days to 90 days or more without being able to see their family or friends.I was astonished that no one challenged this. (Lynn Berner, 4/22)

Across the United States, we are seeing alarming statistics about the disproportionate toll of COVID-19 on Latino and black people. In New York City, the New York Times tells us, coronavirus is twice as deadly for these minorities as for their white counterparts. In both Chicago and Louisiana, black patients account for 70% of coronavirus deaths, even though they make up roughly a third of the population. (Jossie Carreras Tartak and Hazar Khidir, 4/21)

The nation’s meatpacking industry must take a break. Packing plants around the country have become hot spots in the coronavirus crisis, in particular fueling dramatic increases in cases in the Heartland, as The World-Herald reported Tuesday. In the past 10 days, South Dakota, with a 266% increase in cases; Nebraska (155%); Iowa (129%); and North Dakota (117%), account for four of the top five states in case growth. The increases are linked to packing plants, where workers must be in close quarters and where, the numbers clearly show, operators and health officials are behind the curve and playing catch-up with mitigation measures. (4/21)

I woke up the other morning, as I imagine many others did, thinking about our current COVID-19 crisis, especially how it is impacting our food and farming sector. The magnitude and scale of the economic dislocation and disruption COVID-19 has already caused is shocking, and who knows what may be yet to come. The crisis has illustrated how fragile and brittle many parts of the food system are to this type of disruption. (Neil Hamilton, 4/21)

President Trump wants the U.S. economy to reopen soon and take off “like a rocket ship.” Yet now he plans to reduce the human capital necessary for a strong recovery by suspending even more immigration to the U.S. “In light of the attack from the Invisible Enemy, as well as the need to protect the jobs of our GREAT American Citizens, I will be signing an Executive Order to temporarily suspend immigration into the United States!” Mr. Trump tweeted Monday. On Tuesday he said it will last 60 days. The order’s details haven’t been disclosed, but this looks like a political distraction that could become a major restraint on economic growth if it lasts for any length of time. One question is why this is necessary even for public-health reasons. (4/21)

Gov. Andrew Cuomo of New York offered a blunt and troubling summary of America’s coronavirus predicament on Friday. To revive the economy, he said, “You have to develop a testing capacity that does not now exist.” There are promising signs that the spread of the virus is slowing, at least across large chunks of the United States. But that fragile victory has been won only by placing much of the nation in suspended animation, at great expense. Widespread testing is critical to allow a sustainable resumption of economic activity. (4/21)

President Trump has chosen his pandemic re-election strategy. He is set on unifying and reinvigorating the groups that were crucial to his 2016 victory: racially resentful whites, evangelical Christians, gun activists, anti-vaxxers and wealthy conservatives. Tying his re-election to the growing anti-lockdown movement, Trump is encouraging a resurgence of what Ed Kilgore, in New York magazine, calls “the angry anti-government strain of right-wing political activity that broke out in the tea-party movement” — a movement now focused on ending the virus-imposed restrictions on many aspects of American life. (Thomas B. Edsall, 4/22)

Gov. Brian Kemp’s order to begin reopening a state economy battered by the coronavirus is set to take effect Friday, the same day that Operation Gridlock, a Fox News-endorsed protest against shelter-in-place policies, intends to wrap its arms around the state Capitol. The vehicle-based parade– call it a white version of Freaknik -- now has an opportunity to become a victory celebration by a group of (presumed) voters whom Georgia Republicans will need in November. (Jim Galloway, 4/21)

How do you explain the utter idiocy of what we're seeing in the US? While the Covid-19 pandemic has ripped through country after country, the United States government stands out for seeming one of the least interested in actually fighting it -- particularly during the critical first few weeks of its spread. (Jill Filipovic, 4/21)

As COVID-19 cases worldwide soar past the 2 million mark, every health leader is calling for the same three things: increased testing, contact tracing and quarantining of those who’ve been exposed. Alongside their clear necessity for reducing disease spread, these steps are critical to our ability to reopen the economy and keep it open once we do. But one key question remains unanswered: Who is going to put this plan into action? (Jody Heymann and Aleta Sprague, 4/21)

The US Department of Health and Human Services recently announced that social workers need not see children being monitored in foster care in person, as required by federal law, but can instead use video conferences to reduce the risk of COVID-19. It’s more troubling that social workers are making increasing use of video conferences for children living with the parents who have subjected them to maltreatment, resulting in heightened danger for children. (Elizabeth Bartholet, 4/21)

The U.S. government is investigating whether the Covid-19 virus came from a government laboratory in Wuhan, China. The Chinese Communist Party denies the possibility. “There is no way this virus came from us,” claimed Yuan Zhiming over the weekend. Mr. Yuan is a top researcher at the Wuhan Institute of Virology, which studies some of the world’s deadliest pathogens. He is also secretary of the lab’s Communist Party committee. He accuses me of “deliberately trying to mislead people” for suggesting his laboratory as a possible origin for the pandemic. (U.S. Sen. Tom Cotton (R-Arkansas)

A year ago, when Mayor Eric Garcetti unveiled his budget for the 2019-20 year, Los Angeles was flush with cash from a strong economy and planning to spend big. The mayor wanted to spend the extra money to fix more sidewalks, fill more potholes and make city streets safer for pedestrians and cyclists. City workers were going to plant more trees and coat the streets in “cool pavement” to lower the amount of heat they radiated. And the city was increasing the amount of funding available to build homeless shelters and offer services to get people off the streets.Today? Amid a pandemic that has triggered an economic crisis, the city’s outlook couldn’t look more different. (4/21)