THE PROGNOSIS

Super Tuesday made this crystal-clear: The next president will be a septuagenarian. 

But voters shouldn’t worry about that, aging experts say.

The Democratic presidential primary now seems to be a contest between former vice president Joe Biden and Sen. Bernie Sanders (I-Vt.), after results from yesterday's 14 contests dramatically reversed his previously floundering bid.

“Biden powered to a dominating sweep of the South and surprisingly strong showings in New England and the Upper Midwest on Tuesday night, as he sought to seize control of the Democratic presidential race and overtake Sen. Bernie Sanders as the delegate leader,” The Post's Matt Viser and Chelsea Janes report.

Sanders is holding on to a lead in California, the biggest delegate award of any Super Tuesday state, and also carried Vermont, Colorado and Utah. But Biden seized a whopping nine states, threatening to erase Sanders's delegate advantage.

“The results set up a more vigorous fight ahead that presents the party with divergent choices, between a pragmatist vowing a return to normalcy and a populist promising a revolution," my colleagues write.

With this week's exit of former South Bend, Ind., mayor Pete Buttigieg and Sen. Amy Klobuchar (D-Minn.), the still-viable candidates are all … shall we say, seasoned.

Biden is 77. Sanders is 78. So is former New York City mayor Michael Bloomberg (who only won American Samoa last night and seems likely to reassess his campaign today). And President Trump, of course, is 73.

Concerns over the health of the senior citizen candidates have arisen throughout the campaign season. Biden critics have suggested his cognitive performance is lacking in debates. Sanders’s opponents made much of the heart attack he suffered last fall. And Democrats love to slam Trump’s lack of exercise and unhealthy eating habits.

Vox's Ezra Klein:

Yet all of these candidates are highly likely to survive through a first and even a second presidential term, according to an academic paper released last fall by the American Federation for Aging Research.

The paper’s authors made life expectancy projections for the candidates based on their age and gender, using data obtained by the Centers for Disease Control and the Census Bureau and published annually by the Social Security Administration.

Biden has a 79 percent chance of surviving through a first term and a 70 percent chance of surviving through a second term, per the projections. Trump’s chance of surviving through a second term is 85 percent.

Even Sanders is more likely than not to survive through a possible eight years in the White House. The researchers pegged that likelihood at 66 percent. Sanders’s chances of surviving through a first term? Seventy-seven percent, according to the researchers.

“The number of times you’ve traveled around the sun should not be a litmus test for being president of the United States,” S. Jay Olshansky, a professor at the University of Illinois at Chicago and an author of the study, told me.

But if those odds still don’t sound great – the researchers projected a one-third chance of Sanders not surviving a second term, after all – realize these are extremely conservative estimates for how long the candidates might actually live.

Here’s why: U.S. presidents live longer than the average person. Presidents are typically better-educated, wealthier and have access to top-notch medical care – all factors in an individual’s longevity.

Olshanksy said they’re part of a group of people he calls “super-agers,” who are able to function at a high cognitive level into their 70s and 80s.

Plus, the candidates have already shown they have higher-than-average stamina, by virtue of the fact they’ve been on the grueling campaign trail for months, giving continuous speeches and television appearances.

“They’re operating with very little sleep, they’re under extreme stress, and the fact they’re functioning as well as they are gives you an indication right there that these folks are special,” Olshansky said.

— Single-payer health care had a super Super Tuesday. 

Majorities of primary voters even in moderate states such as Virginia, North Carolina, Alabama and Tennessee said they support replacing private coverage with a single government plan, according to preliminary exit poll results reported by Scott Clement, Claudia Deane, Emily Guskin, Dan Keating and Jocelyn Kiley. Support for single-payer was particularly strong in Vermont and Maine – which both went for Sanders – where roughly 7 in 10 voters expressed support.

And voters in every single Super Tuesday primary said health care is the most important issue to them, among four issues tested. In Oklahoma and Maine, nearly half of voters named health care as their No. 1 issue. In California, which has one of the broadest health-care safety-net programs in the country, one-third of voters gave that response.

Nonetheless, Biden – who opposes Medicare-for-all and favors tweaks to the Affordable Care Act – did best among people whose top issue was health care, according to exit polls.

Drew Altman, president of the Kaiser Family Foundation:

AGENCY ALERT

— Experts are predicting the novel coronavirus could become a pandemic of historic proportions, on the scale of the 1957 influenza outbreak, our colleagues Joel Achenbach, Lenny Bernstein, Neena Satija and William Wan report. But there are still many unknowns, and that can hinder efforts to predict its trajectory.

“The ultimate impact of the new virus, officially named SARS-CoV-2, which causes the disease covid-19, depends on multiple factors that cannot be precisely calculated at present. They include how widely and quickly it spreads, its virulence (the degree to which is sickens and kills people), and the ability of health systems to handle illnesses.” 

Here's what we do know about the coronavirus. It has spread at surprising speed. Most cases are mild; about 16 percent of confirmed cases in China have resulted in serious illnesses. It has killed more than 3,000 people, the vast majority in central China. Most new coronavirus cases are now outside of China, with 72 countries reporting cases. The U.S. death toll stands at nine.

— The Trump administration is considering the use of a national disaster recovery reimbursement program to pay hospitals and doctors for treating uninsured coronavirus patients, the Wall Street Journal’s Stephanie Armour reports. 

The Centers for Medicare and Medicaid Services has been weighing whether to use the program, which would enable the federal government to pay providers about 110 percent of Medicare rates for treating such patients.

“The administration is focusing on the costs of caring for uninsured people because individuals otherwise would have coverage through Medicaid, employers, or through private insurance purchased on the individual market,” Stephanie writes.

Trump publicly suggested yesterday there would be government support for coverage related to the virus. He said his administration is “going to look at the uninsured because they have a big problem." “We're going to look at the uninsured people that, you know – this came out as a surprise to all of us,” he said. "It just happened. It shows what can happen in life. But we’re going to be looking at the uninsured and see if we can help them out.”

A telling quote, via the New York Times's Sarah Kliff:

The administration's move to consider paying for such coverage is changing how some Republicans talk about health care, HuffPost's Matt Fuller and Arthur Delaney report

Rep. Ted Yoho (R-Fla.) said this: “You can look at it as socialized medicine…But in the face of an outbreak, a pandemic, what’s your options?” 

Yoho said it would be a ”wise" move for the government even as he said he's “not OK with socialized medicine.” “Sometimes you have to do things that you have to do for your country, but as far as socialized medicine, no,” Yoho added. “Does this fall into that? Yeah, I guess you could throw it in there, but hopefully it’s not the long-term.”

— On Capitol Hill, an approximately $7.5 billion emergency spending bill stalled because of a dispute over the affordability of a vaccine that's not yet available. Government scientists say it could take at least a year for a coronavirus vaccine to be widely available.

“Negotiations continued, with members on both sides of the aisle expressing optimism about finalizing the legislation quickly, hopefully in time to move it through the House and Senate by week’s end,” The Post’s Erica Werner reports

“But hopes for releasing the bill Tuesday faded as negotiators squabbled over language Democrats want in the legislation that would ensure affordability of vaccines, such as by requiring reasonable prices and providing funding for the Health and Human Services Department to provide vaccines free."

— The Trump administration pledged late last night that every American can now be tested for the virus if a doctor determines it’s necessary, our colleagues Seung Min Kim, Maria Sacchetti and Brady Dennis report

“When I talked to some state officials, there was a sense that the tests would not be administered to people that were mildly symptomatic,” Vice President Pence told reporters in an off-camera White House briefing. “We’re issuing clear guidance that subject to doctors’ orders, any American can be tested.”

“Pence’s comments perplexed some public health officials, as physicians already have discretion to order testing," our colleagues write. “The announcement also raised questions about whether the government can rapidly accelerate the production of testing kits, as well as how much patients will ultimately have to pay for getting tested.”

— Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, spoke candidly about striking a balance between accurately informing the public, and not angering the boss – Trump. 

“You should never destroy your own credibility. And you don't want to go to war with a president,” Fauci told Politico’s Sarah Owermohle. “But you got to walk the fine balance of making sure you continue to tell the truth.”

— The White House is handling the rapidly expanding coronavirus as a public relations problem as much as a public health crisis, our colleagues Philip Rucker, Yasmeen Abutaleb and Ashley Parker report

“Officials are insisting on message discipline among government scientists and political aides alike, part of what they say is a responsible effort to try to calm jittery Americans and provide uniform and transparent information,” they write.

The delicate dance public health experts and government officials are engaged in is in part why Pence is seen as “uniquely equipped to lead the administration’s response — which involves not only traditional crisis management and bureaucratic streamlining, but also managing Trump’s shifting moods.”

— Food and Drug Administration commissioner Stephen Hahn said the U.S. could produce nearly a million coronavirus tests by the end of the week. But labs say they’re nowhere near reaching that mark, the New York Times reports.

“The figure includes orders for commercial tests that companies said were still weeks away from approval, and public health laboratories said their capacity doesn’t come close to that,” the New York Times’s Katie Thomas and Knvul Sheikh report. 

An HHS spokesperson told them Hahn was referring to tests being produced by an outside manufacturer, Integrated DNA Technologies, which are being sent to “a variety of academic, health care and commercial labs around the country in addition to the public health laboratories that are also receiving them."

—  As of Tuesday, the World Health Organization said the disease caused by the novel coronavirus has thus far killed about 3.4 percent of those diagnosed with the illness worldwide. That's higher than previous estimates. 

“By comparison, seasonal flu generally kills far fewer than 1 percent of those infected, said WHO Director General Tedros Adhanom Ghebreyesus. Earlier estimates had put the coronavirus death rate in a range of about 2 percent, but officials have been hamstrung by the difficulty in getting an accurate count of those who may have had mild illnesses and not sought treatment,” The Post reports

— There are some simple things individuals can do to combat the spread – but one isn't so easy: Wash your hands, don’t touch your face. 

The latter step is one of the hardest to follow, our Post colleague Reis Thebault points out. That’s in part because we’ve been “building the habits nearly all our lives.” 

“It’s very hard to change, because you don’t even know you’re doing it," said William Sawyer, an Ohio family doctor who founded a nonprofit that promotes hand hygiene.

Trump poked fun at Bloomberg:

— Another key to combating the spread of an illness: staying home. But in the United States, the dearth of paid sick leave will make this nearly impossible for many workers. About a quarter of workers in America have no such leave and more likely to work while ill, The Post’s Christopher Ingraham reports. 

— If you’re worried you may have symptoms associated with the novel illness – which are largely similar to the symptoms of a common cold or flu – here’s when you should see a doctor, as our colleague Marisa Iati reports. 

In case that's not enough coronavirus news, here's some more:

  • Trump pledged to donate part of his salary to the Department of Health and Human Services to help fight the spread, White House press secretary Stephanie Grisham tweeted.
  • Former FDA Commissioner Scott Gottlieb penned an op-ed in the Wall Street Journal about the strategies that will be necessary in quelling the spread.
  • Politico’s Dan Diamond reports a top FDA scientist was initially blocked from entering the CDC campuses in Atlanta, in a “sign of growing tension among the Trump administration's health agencies.” The official was sent to “expedite the development of lab tests for the novel coronavirus outbreak.”
  • Read about the baffling coronavirus roundtable Trump held this week where he bombarded drug companies with questions about a potential vaccine and variations of the question: “How fast can you get it done?” as The Post’s Aaron Blake reports.

AHH, OOF and OUCH

AHH: Today, the Supreme Court will consider a Louisiana abortion restriction – one of 89 such restrictions the state has passed since the court legalized abortion in 1973.

“A repopulated and more conservative Supreme Court on Wednesday will consider one of those Louisiana laws, and some politicians here wonder if it might be the breakthrough they’ve been waiting for in a decades-long effort to rid the state, and the nation, of abortion,” our Post colleague Robert Barnes reports. 

He adds: “It will be the first time the two justices selected by President Trump, Neil M. Gorsuch and Brett M. Kavanaugh, confront the merits of an abortion case. It marks a key moment for Chief Justice John G. Roberts Jr., who has never voted against an abortion restriction, in his new and pivotal role at the court’s center.” 

— Planned Parenthood Action Fund will launch a six-figure digital ad campaign today, timed with the beginning of oral arguments.

The ads target the president as well as Sens. Thom Tillis (R-N.C.) and Susan Collins (R-Maine). “Susan Collins turned her back on Mainers and voted to confirm Brett Kavanaugh to the Supreme Court,” one ad says. “… But now, the Supreme Court could dismantle access to safe, legal abortion.” 

“The Supreme Court isn’t considering a case that could upend abortion access by accident. It’s by design, and the president and Sens. Thom Tillis and Susan Collins share responsibility," Planned Parenthood vice president Jenny Lawson said in a statement to Health 202.

OOF: Drug companies are increasingly using social network sites like Facebook for advertising. That means Facebook users are seeing ads pushing prescriptions for depression, HIV and cancer. And it’s already a nearly billion-dollar business, our Post colleague NItasha Tiku reports in this deep dive. 

This growing use of social sites is revealing loopholes in the way data can be used to show users ads relevant to their personal health. And it’s fueled renewed concerns about privacy. Patient advocates worry that ad-targeting techniques, when applied to health data, could “cause embarrassment in front of friends and family or discrimination by employers, potentially even affecting insurance rates or service offerings.” 

“The ability of drug companies to reach people likely to have specific health conditions — a far cry from a magazine or TV ad — underscores how the nation’s health privacy law, the Health Insurance Portability and Accountability Act (HIPAA), has not kept up with the times. HIPAA, which safeguards personal health records, typically does not cover drug companies or social media networks,” Nitasha writes. 

A Facebook spokesman Joe Osborne told the Post: “Medical history is not used to inform the interest categories that we make available to advertisers, and we prohibit businesses from sending us sensitive health information…Our teams work with health related companies looking to reach their audiences on Facebook and we require them to act in accordance with the law.”

OUCH: Trump’s Justice Department is suing Mallinckrodt, charging that the generic drugmaker defrauded Medicaid out of “hundreds of millions” with its “meteoric” price spikes for its best selling medication, Acthar Gel. 

“Under federal law, drug makers are required to pay quarterly rebates to state Medicaid programs in exchange for coverage of their medicines,” Stat’s Ed Silverman reports. “These rebates include a provision that is designed to insulate the programs from price hikes that outpace inflation, and companies must pay rebates based on 1990 pricing or whenever a medicine was first marketed.” 

The lawsuit states Mallinckrodt “avoid(ed) paying hundreds of millions of dollars in rebates that should have insulated Medicaid from Acthar’s meteoric price rise prior to 2013… Instead, the taxpayers who fund Medicaid have absorbed the brunt of Acthar’s ever-increasing cost, in contravention of federal law and Congress’s intent in establishing the Medicaid rebate program.” 

— And here are a few more good reads:

TRUMP TEMPERATURE

The pharmaceutical industry’s push to combat the spreading coronavirus could deter the implementation of some drug- pricing policies from both the White House and Congress, according to Height Capital Markets.
Bloomberg
The Homeland Security secretary missed the mark with his estimate of the flu’s annual U.S. mortality rate.
Kaiser Health News

MEDICAL MISSIVES

A participant might commit months or years to a drug trial, only to see it vanish overnight.
New York Times

INDUSTRY RX

Two and a half years after the agreement was reached, both organizations were sued over allegations that patients could, in fact, be identified.
Stat

STATE SCAN

Democrats hope to block Susan Collins of Maine from a fifth term in the Senate in the wake of her support for Brett Kavanaugh and against impeachment.
Los Angeles Times

DAYBOOK

Today

  • The House Appropriations subcommittee on military construction, Veterans Affair and related agencies holds a hearing on the Veterans Affairs fiscal year 2021 budget request.
  • The House Homeland Security Committee holds a hearing on “Perspectives on the Response to a Pandemic Threat."
  • The House Appropriations subcommittee on the departments of Labor, Health and Human Services, Education and related agencies holds a hearing on the National Institutes of Health fiscal year 2021 budget request.

Coming Up

  • The House Science, Space and Technology Committee holds a hearing on “Understanding the Spread of Infectious Diseases and Mobilizing Innovative Solutions” on Thursday.
  • The House Appropriations subcommittee on defense holds a hearing on the Defense Health Program on Thursday.
  • The House Veterans’ Affairs subcommittee on technology modernization holds a hearing on the “Challenges with the Go-live of Electronic Health Record Modernization” on Thursday.

SUGAR RUSH