The Health 202: The U.S. poised to surpass 200,000 coronavirus deaths well before the election

“I really do believe we are rounding the corner, and the vaccines are right there,” Trump insisted at a White House news conference yesterday. 

The president noted that daily deaths are declining in the United States after a summertime surge. But he ignored the fact that the nation’s daily death toll is still far higher than in European countries, where cases are slowly starting to rise again. 

The United States is averaging about 800 deaths per day and ranks 12th in the world for covid-19 deaths per capita.

Brian Klaas, of the Johns Hopkins Bloomberg School of Public Health:

“Spain is being heavily impacted, France, and 400 percent in Italy,” Trump said. “We’re hopefully beyond our spike. … We’ll see, but we’re doing very well all over our country.”

That’s according to an average of 32 different projections merged by researchers at the University of Massachusetts at Amherst and used by the Centers for Disease Control and Prevention. The Covid-19 Forecast Hub projects four weeks into the future, drawing upon models from universities and analytics firms around the country. 

If the predictions hold, it would bring the death toll to about 209,000 with weeks left before Election Day. 

The country has moved past a second surge over the summer. Daily new infections have been declining since the beginning of August, and daily deaths have been slowly declining over the past three weeks. 

Not only is the weather about to turn colder, driving more people indoors, but many students and teachers have also returned to classrooms.

‘A widely cited model from the University of Washington’s Institute for Health Metrics and Evaluation projects 258,708 deaths by Nov. 3 — although experts have questioned the model’s accuracy, saying it may not be taking into account better covid-19 treatments that have lowered death rates.

Regardless, the pandemic’s persistent presence in American life — and Trump’s shortcomings in addressing it — are giving Democratic presidential nominee Joe Biden an easy campaign message.

According to a new book by Woodward, Trump told Woodward that he thought the coronavirus was far more deadly than what he had been communicating publicly. The ad uses audio of a phone call between the two:

Biden running mate Kamala Harris remarked on Woodward’s reporting during a campaign stop in Miami yesterday afternoon.

“We continue to have examples of the fact that this is an individual who is not concerned about the well-being of the American people, and is frankly engaged in a reckless disregard for the lives and the health and well-being of the American people,” Harris said. “I find it so outrageous.”

But the two viruses are difficult to compare. The H1N1 virus was more infectious than the coronavirus — infecting an estimated 60 million Americans — but far less deadly, killing only 12,500.

The president spent some of his news conference criticizing the Obama administration’s approach to the swine flu and predicting the current pandemic would have turned out worse under a Biden administration.

“Biden’s record demonstrates if he had been in charge of this pandemic, countless more Americans would have died,” Trump said.

Trump also spent the past 48 hours punching back against the Woodward book:

“Democrats blocked a pared-down GOP coronavirus relief bill in a bitterly disputed Senate vote Thursday, leaving the two parties without a clear path forward to approve new economic stimulus before the November elections,” Erica Werner, Seung Min Kim and Tony Romm report.

A 52-to-47 vote fell short of the 60 votes needed for the bill to advance, as Democrats and one Republican, Sen. Rand Paul (R-Ky.), voted against the relief package, which would have brought approximately $300 billion in new spending.

The bill would have authorized new funding for small businesses, coronavirus testing and $300 a week enhanced unemployment benefits, but it fell far short of the $3.4 trillion bill that House Democrats passed in May. It also contained provisions, such as liability protections for businesses and tax credits for children to attend private schools, that Democrats dismissed as unacceptable.

“Democrats contended that the Senate GOP legislation, written without any Democratic input, was designed to fail and intended only to give Republicans cover for inaction. Republicans argued that Democrats were refusing to agree to any new relief because they didn’t want to help President Trump or bolster the fragile economic recovery ahead of the election,” my colleagues write.

While Democratic leaders have said that they hope for a new round of negotiations, there is no sign of that happening.

Senate Minority Leader Charles E. Schumer (D-N.Y.):

Senate Majority Leader Mitch McConnell (R-Ky.):

The fine against Smithfield Packaged Meats in Sioux Falls, S.D., is the first coronavirus-related fine issued against a meatpacking plant, Politico reports.

Advocates for workplace safety have been pushing the Occupational Safety and Health Administration to take a stronger stance to protect food workers during the coronavirus pandemic. A July report from the CDC found more than 16,000 meat and poultry facility workers have contracted the virus and at least 86 have died.

While OSHA issued recommendations for protecting workers — including face shields and social distancing — it did not mandate those measures. 

The fine against Smithfield, for one violation of the general duty clause, which requires employers to keep workplaces free of recognized hazards that can cause death or serious harm, struck many as little more than a slap on the wrist.

HuffPost labor reporter Dave Jamieson:

“Congress passed laws requiring insurers to pay for tests, and the Trump administration created a program to cover the bills of the uninsured. Cities and states set up no-cost testing sites,” the New York Times’s Sarah Kliff reports. “Patients, whether with or without insurance, are beginning to find holes in those new coverage programs.”

The Times reviewed dozens of medical bills in which patients were charged unexpected fees or denied claims. One New York woman got tested after she saw an ad promoting free coronavirus testing. She was charged $2,718 for her test.

In some cases, these tests appear to violate federal laws, as insurers applied co-pays or deductibles for the tests or denied coverage for care related to it. Other cases may occur because doctors or hospitals make errors in the billing code. Sometimes patients may receive care that the insurance company deems unrelated to the test, often without the patient knowing that their doctors have ordered extra testing or that they could face additional charges.

While only a small percentage of patients receive surprise bills after a coronavirus test, the number of people affected could be huge.

“About 2.4 percent of coronavirus tests billed to insurers leave the patient responsible for some portion of payment, according to the health data firm Castlight. With 77 million tests performed so far, it could add up to hundreds of thousands of Americans who receive unexpected bills,” Kliff reports.

Erin Fuse Brown, a professor at Georgia State University College of Law specializing in health law, reacted to the story:

“Internal emails obtained by Reveal from The Center for Investigative Reporting provide a behind-the-scenes look at the frustration that built up over months within the New Mexico Department of Health as officials with ICE or its contractors failed to test detainees exposed to the virus — or turned down vital testing assistance,” Reveal’s Patrick Michels and Laura C. Morel write. 

ICE ignored repeated calls and messages from top health and corrections officials in the state who sought to discuss conditions at immigration detention centers in the state, Michels and Morel report.

Both Kathy Kunkel, the secretary of the New Mexico Department of Health, and Tafoya Lucero, the state’s corrections secretary, were repeatedly stonewalled by the federal immigration agency as they sought to increase testing and halt transfers in and out of the Otero County Processing Center, a privately run immigration detention facility in the state, in an effort to prevent outbreaks of the virus. The facility ended up one of the hardest hit in the country, with at least 150 detainees contracting the virus.

“We sent 500 tests. They don’t answer calls,” Kunkel said in one message to a medical officer at the Department of Homeland Security, asking for help in getting the agency to respond.

“Dozens of nursing homes and hospitals ignored official guidelines to separate COVID patients from those without the coronavirus, in some places fueling its spread and leaving staff unprepared and infected or, in some cases, dead,” Kaiser Health News’s Christina Jewett reports.

The CDC has advised nursing homes and hospitals to isolate covid-19 patients to protect other residents and staff members, but an investigation by KHN based on interviews and public records found that many facilities were failing to follow this guidance.

As recently as July, a National Nurses United survey of more than 21,000 nurses found that about one-third work in facilities without a dedicated coronavirus unit. Hospitals have received less regulatory scrutiny than nursing homes, and the guidelines not to mix patients do not carry the force of law.

The result is that patients and health-care workers are becoming infected and dying. Hospitals filed at least 48,000 reports this summer to federal health regulators in which a patient came into the hospital without the coronavirus but tested positive 14 days later, although Christina noted that number might reflect some cases being counted twice.

• A new poll from the Kaiser Family Foundation finds that trust in the nation’s public health institutions has declined. The public’s confidence in both the CDC and in leading coronavirus expert Anthony Fauci has dropped since April. Meanwhile, nearly two-thirds of Americans say that they are worried the Food and Drug Administration will rush a vaccine approval, Stat News reports.
• U.S. researchers have started two clinical trials to determine whether blood thinners can help stop dangerous blood clotting that has caused strokes and heart attacks in covid-19 patients. Many doctors have already been using blood thinners with their patients, but the trial will try to provide additional information on the effectiveness of various treatment options, Anna Edney of Bloomberg News reports.
• Education Secretary Betsy DeVos has dropped a rule that would have sent a larger share of coronavirus relief funds to private schools than Congress intended after a federal judge ruled that it violated the law. Lawmakers said the money was meant to be distributed based on the number of low-income students in schools, but DeVos pushed to send money to private schools based on the total number of students enrolled, Valerie Strauss reports.

• A new CDC report finds that adults with positive coronavirus tests were more than twice as likely to report having recently dined in a restaurant compared with those with negative tests.
• The pause of the AstraZeneca vaccine trial announced earlier this week occurred after a woman who had received the experimental vaccine developed severe neurological symptoms, consistent with transverse myelitis, a rare inflammation of the spinal cord, the Associated Press’s Maria Cheng reports.