THE PROGNOSIS

Here’s something else Congress could do to fight the coronavirus: Renew funds for the nation’s community health centers, the likely first stop for many low-income Americans if they suspect they have the virus.

Lawmakers already approved a $8.3 billion emergency funding package last week to support the coronavirus response. But now they’re facing a May 22 deadline, when nearly 1,400 community health centers that serve 1 in 12 Americans many on Medicaid or uninsured risk losing their federal funding stream.

It’s these centers that will be best positioned in many areas of the country to order tests for the most economically vulnerable individuals suspected of having contracted the virus. Once tests are made more available to laboratories — as government officials promised would be the case this week — providers will be able to evaluate a patient’s symptoms and order a lab test if needed, particularly if they are elderly or have a chronic health condition. 

Indeed, tests are supposed to be on their way to labs around the country, after troubling technical problems that hamstrung the whole process. 

Anthony Fauci, director of the infectious disease division at the National Institutes of Health, has said around 4 million coronavirus tests will be available by the end of this week, and two of the country’s largest commercial labs have announced they’re ready to begin testing: LabCorp said its test has been available since Thursday, while Quest Diagnostics said it planned to start testing as of yesterday.

But the health centers aren’t yet able to order coronavirus tests, Ron Yee, chief medical officer for the National Association of Community Health Centers (NACHC), told me yesterday. The billing codes are not yet in place on electronic medical records, so medical professionals haven’t been ordering them yet. Yee said he has been regularly checking in with community health centers on the situation.

“It’s going to be a real game-changer if we can really get this worked out,” Yee said. “Centers are placed where there are people.”

But some are skeptical that it will all get “worked out” very quickly. Per Andy Slavitt, former administrator of the Centers for Medicare and Medicaid Services:

Scott Gottlieb, former head of the Food and Drug Administration under Trump:

Nick Bagley, a health law professor at the University of Michigan:

Now there are hopes the coronavirus outbreak might boost the chances of lawmakers focusing on the May 22 funding “cliff” for the community health centers as they feel heavy pressure from health advocates and the broader public to expand testing quickly.

Funding uncertainty is nothing new for community health centers — but it’s a big bummer for them. Congress has often dragged its feet on re-upping their funding and finding a way to pay for it (this was a big issue back in 2018, for example). 

Ever since the centers’ funding ran out last September, Congress has authorized more dollars only on a short-term basis. Ever since then, the NACHC has been urging Congress to guarantee funding renewal. 

Administrators of these centers are already dealing with funding uncertainty — and now new demands presented by the outbreak make it all a lot to juggle, said the NACHC’s national strategy officer, Steve Carey.

“It’s just too much of a burden they shouldn’t have to endure,” Carey told me yesterday.

The issue is making its way into the 2020 campaign. Yesterday, former vice president Joe Biden applauded the achievements of community health centers at a campaign stop in Grand Rapids, Mich., which holds its primary elections today. But Biden notably didn’t mention the coronavirus during his speech.

Members of Congress and White House officials are talking about little else at the moment. It was hard not to yesterday, as the stock market plunged, Italy and Israel announced new extreme quarantine measures, infections reached 113,000 worldwide and the director of the World Health Organization called the threat of a pandemic “very real.”

“The coronavirus outbreak fanned new fears of a worldwide recession on Monday, as well as an all-out oil price war, sending stock markets spiraling down to new record lows not seen since the financial crisis,” The Post’s Heather Long, Thomas Heath, Will Englund and Taylor Telford report.

“The U.S. tally of known infections of covid-19, has passed 500 spanning across 30 states,” they write. “The growing outbreak has wreaked havoc on the travel and tourism and manufacturing supply chains on everything from cars to smartphones. Americans are increasingly staying at home, choking off the spending that normally fuels the U.S. economy, and setting off alarms that a recession could be underway.”

In other coronavirus developments:

– President Trump said he is seeking measures to provide immediate federal aid to workers and a number of business groups, The Post’s Jeff Stein, Seung Min Kim, Mike DeBonis and Erica Werner report. The president said he'll ask Congress to cut payroll taxes and provide relief to hourly workers suffering from the economic fallout of the coronavirus. He added he was seeking assistance to the airline, hotel and cruise industries, which are all suffering as Americans rapidly cancel travel plans.

“We are going to take care of and have been taking care of the American public and the American economy,” Trump said. 

“Trump’s comments made clear that the White House is considering a huge and expensive government response,” my colleagues write. “Reducing the payroll tax by a single percentage point would cut between $55 billion and $75 billion in revenue, according to a recent projection from the Committee for a Responsible Federal Budget.”

But leading Democrats quickly dismissed Trump's proposals, insisting they're working on their own plan that could include paid sick leave.

House Speaker Nancy Pelosi (D-Calif.) and Senate Minority Leader Chuck Schumer (D-N.Y.) say they're pursuing legislation to provide free coronavirus testing for all Americans, paid leave for those affected by the epidemic, expanded food subsidies and an expansion of the federal unemployment insurance program.

Six members of Congress have announced they are quarantining themselves due to contact with confirmed carriers of the pathogen, DeBonis reports.

“None of the six — members of both parties and both chambers — reported any symptoms of respiratory illness in their public statements, but their proximity to confirmed cases highlighted the risks to members of Congress and their aides as the coronavirus outbreak expands to pandemic proportions,” Mike writes.

Five of the six lawmakers — Sen. Ted Cruz (R-Tex.) and Reps. Douglas A. Collins (R-Ga.), Matt Gaetz (Fla.), Paul A. Gosar (R-Ariz.) and Mark Meadows (R-N.C.) — attended last month’s Conservative Political Action Conference, which has confirmed two attendees were infected. Meadows is the new White House chief of staff.

The sixth lawmaker, Rep. Julia Brownley (D-Calif.), said Monday she met with a person in Washington last week who has since tested positive for the virus and would be “working remotely” as a result.

“Out of an abundance of absolute caution, my D.C. staff and I are self-monitoring and maintaining social distancing practices,” she said.

The Hill's Scott Wong:

Sen. Ted Cruz (R-Tex.) poked fun at himself:

— Trump correctly noted yesterday that the coronavirus has caused far fewer deaths than the seasonal flu.

– Trump is ignoring the upward trend in coronavirus cases, while downplaying the deadliness of the disease, The Post’s Philip Bump writes. The president’s varied statements and claims make it hard to understand the virus’s true risk.

The president is also using coronavirus as an chance to tout his efforts to expand the border wall with Mexico:

— Yesterday, federal officials announced a crackdown against companies selling products claiming to prevent, treat or cure covid-19, the disease caused by the new coronavirus, The Post’s Laurie McGinley reports, including teas, essential oils and colloidal silver.

“The Food and Drug Administration and the Federal Trade Commission sent warning letters to seven companies accusing them of marketing illegal, unapproved drugs and making deceptive or scientifically unsupported claims,” Laurie writes. “It was the first time the agencies took such action involving products being touted for the coronavirus.”

— Biden and Sen. Bernie Sanders (I-Vt.) both slammed Trump over his coronavirus response while campaigning in Michigan. While Biden said he wishes Trump “would just be quiet,” Sanders asserted that essential decisions and statements are being made “based on tweets that have no scientific basis.”

“Donald Trump does not have a natural ability to understand the coronavirus, and his reckless statements are confusing people in this country and all over the world,” Sanders said.

Both men are continuing to campaign throughout the virus outbreak, saying they’re “listening” to guidance from the Centers for Disease Control and Prevention.

Scott Bixby, national reporter for the Daily Beast:

CNN’s Sarah Mucha: 

— Just over half of Americans have confidence in the federal government to handle the response to the spread of the coronavirus, according to Quinnipiac polling analyzed by Bump. “That confidence varies widely by party, with Republicans overwhelmingly confident in the government and most Democrats more skeptical,” he writes.

— Some hospitals have dwindling supplies of respirator masks, unable to get new shipments from Chinese manufacturers facing an explosion of new orders, the New York Times's Abby Goodnough reports.

— Our colleagues want to hear from you: Have you tried to get tested for the coronavirus and been turned away? You can share your experience with The Post here.

Post data reporter Christopher Ingraham:

AHH, OOF and OUCH

AHH: The second person to be declared cured of HIV revealed his identity in an interview with the New York Times. 

Adam Castillejo, 40, said he wants to be an “ambassador of hope,” one year after scientists announced he had been cured of the virus that causes AIDS “after receiving a bone-marrow transplant for his lymphoma,” the New York Times’s Apoorva Mandavilli reports. “The donor carried a mutation that impeded the ability of H.I.V. to enter cells, so the transplant essentially replaced Mr. Castillejo’s immune system with one resistant to the virus.” 

It was a novel and case-specific approach, she adds. It was “intended to cure his cancer and is not a practical option for the widespread curing of H.I.V. because of the risks involved.”

His decision to publicize his identity came recently, in part because his doctors are now more sure that he is virus-free. 

“I don’t want people to think, ‘Oh, you’ve been chosen,’ ” he said. “No, it just happened. I was in the right place, probably at the right time, when it happened.”

OOF: Even if Sanders wins the Democratic nomination, what happens down-ballot could indicate the political viability of his signature Medicare-for-all proposal.

“No legislation to advance or achieve universal health care has succeeded over the past 70 years without Democrats not only controlling all three branches of government, but also having a supermajority in the Senate,” the New York Times’s Abby Goodnough and Reed Abelson report. “At this point, Mr. Sanders’s plan has nowhere near that support.” 

Even the public option alternative touted by Biden is a political challenge, as insurers and hospitals rally against it. “Industry groups that are already mobilizing against Medicare for all could also doom public option legislation, as they did in 2010, when supporters of the Affordable Care Act had to drop a relatively modest public option provision to get the law passed,” Abby and Reed report. 

Of course there’s always a chance opinions shift, but thus far “many Democratic lawmakers have expressed trepidation that a legislative showdown over Medicare for all would make it impossible to advance other important initiatives, including on climate change and immigration.” 

OUCH: Before Attorney General Chris Carr (R) announced Georgia and 38 other states would investigate Juul Labs and whether the firm marketed its nicotine-heavy products to youths, a team of Juul representatives had met with Carr and his staff. 

“They delivered a 17-page presentation laden with information about the public health potential of Juul’s combustion-free vaping devices for adult smokers and the company’s ‘commitment to ending youth use,’ a pledge that included more rigorous retail and online sales controls,” the Associated Press’s Matthew Perrone and Richard Lardner report. “Juul had access, but it did not pay off.” 

The company met numerous times with state AGs but failed to prevent legal action, according to documents, internal emails, meeting minutes and company records that reveal an influence campaign. Nine states have already sued Juul, and amid the 39-state probe, other suits are possible. 

“In an emailed response to written questions, a Juul spokesman declined to say how many state attorneys general company representatives have met with,” Matthew and Richard add. “Juul, the spokesman said, is working to earn ‘the trust of society by working cooperatively with attorneys general, regulators’ and other officials to combat teen vaping and to steer adult smokers away from cigarettes.”

— And here are a few more good reads:

TRUMP TEMPERATURE

The new interoperability rules are meant to fuel broader efforts to use patient data to develop new software tools and services.
Stat

INDUSTRY RX

“We agree Descovy has a different, albeit improved safety profile ... but how much more should we be willing to pay?” asked one study author.
Stat

STATE SCAN

Pure Oasis is also among the few retail stores in the country owned and operated by people of color, who experts say have struggled to break into the industry. Massachusetts’ ballot initiative was the first to insert specific language aimed at encouraging people of color and others harmed by the war on drugs to participate in the new industry.
Associated Press

OPIOID OPTICS

The ACLU filed a wrongful death lawsuit against the city of Springfield, MA.
ABC News

MEDICAL MISSIVES

REPRODUCTIVE WARS

Two Utah bills addressing abortion — one an outright ban and the other requiring doctors to show women their ultrasound before performing the abortion — received favorable recommendations in committees Monday.
Deseret News

DAYBOOK

Today

  • The House Appropriations subcommittee on the departments of Labor, Health and Human Services, Education and related agencies holds a hearing on the Centers for Disease Control and Prevention’s budget request for fiscal year 2021.
  • The House Oversight and Reform subcommittee on national security holds a hearing on the coronavirus outbreak response.
  • The House Homeland Security subcommittee on emergency preparedness, response and recovery holds a hearing on “Community Perspectives on Coronavirus Preparedness and Response.”

Coming Up

  • The House Oversight and Reform Committee holds a hearing on coronavirus preparedness and response on Wednesday.
  • The House Appropriations subcommittee on agriculture, rural development, the Food and Drug Administration and related agencies holds a hearing on the FDA budget request for fiscal year 2021 on Wednesday.
  • The House Ways and Means subcommittee on worker and family support holds a hearing on “Combatting Child Poverty in America” on Wednesday.

SUGAR RUSH