First Edition: April 22, 2020

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)

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)

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 New York Times: 28,000 Missing Deaths: Tracking The True Toll Of The Coronavirus Crisis
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)

The New York Times: State By State: Comparing Coronavirus Death Rates Across U.S.
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)

Reuters: U.S. Coronavirus Deaths Top 45,000, Doubling In Little Over A Week: Reuters Tally
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)

CNN: US Coronavirus: America Could See A Higher Summer Death Toll And CDC Warns Of A Possibly Worse Coronavirus Outbreak In Winter 
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)

Reuters: CDC Chief Warns Second COVID-19 Wave May Be Worse, Arriving With Flu Season
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)

The New York Times: Santa Clara County Coronavirus Death Is First Known In U.S.
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)

Reuters: First U.S. Coronavirus Death Occurred In Early February In California
"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)

The New York Times: How Many Coronavirus Infections? Rewards For Testing May Provide An Answer
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)

The New York Times: Coronavirus Infections May Not Be Uncommon, Tests Suggest
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)

The New York Times: From 1 To 1,000s: Solving The Mysteries Of Coronavirus With Genetic Fingerprints
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)

The Associated Press: Southern States Largely Go It Alone In Reopening Decisions
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 New York Times: ‘I Am Beyond Disturbed’: Internal Dissent As States Reopen Despite Virus
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)

The Washington Post: Governors Chart Different Paths As They Respond To The Coronavirus
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)

Politico: Southern Governors Create A Covid-19 Coalition And Experts Fear A 'Perfect Storm'
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)

The Wall Street Journal: Some States Look To Reopen, But Others Want More Testing First
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)

Politico: Coronavirus Lockdowns Pit Republican Governors Against Democratic Mayors
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)

The Associated Press: Big Unknowns About Virus Complicate Getting Back To Normal
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)

Politico: All Reopening Is Local, Forcing Companies To Navigate Patchwork Of Laws
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 New York Times: The Quiet Hand Of Conservative Groups In The Anti-Lockdown Protests
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)

Reuters: How Trump Allies Have Organized And Promoted Anti-Lockdown Protests
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)

Bloomberg: Barr Threatens Legal Action Against Governors Over Lockdowns
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)

The Associated Press: Analysis: Pandemic Fallout Tracks Nation's Political Divide
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 Associated Press: Fresh Cancellations Show Reopening From Virus Will Be Tough
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)

The New York Times: Trump And Cuomo Put Aside Disputes During White House Meeting 
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)

The Associated Press: Trump Says He'll Help New York's Cuomo Boost Virus Testing
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 Wall Street Journal: New York To Ease Coronavirus Rules By Region To Reopen State Economy 
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)

The Associated Press: Michigan Governor: Trump's Messaging Causes 'Greater Danger'
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)

The Wall Street Journal: Wisconsin Legislature Files Suit Over Governor’s Lockdown Order
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)

Politico: The Government Is All In On Coronavirus: How It’s Still Not Enough
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)

The Wall Street Journal: Volunteers In Coronavirus Response Ruffle Some At FEMA
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)

Politico: Becerra, 19 Other AGs Ask 3M To Help Prevent Price Gouging
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)

The New York Times: F.D.A. Authorizes First In-Home Test For Coronavirus
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 Washington Post: Kentucky And Rhode Island Have Different Coronavirus Testing Rates
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)

The Washington Post: Senate Republicans Want Federal Government To Play Bigger Role In Coronavirus Testing
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)

Los Angeles Times: California Coronavirus Tests To Cover Some Asymptomatic People
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)

The Washington Post: Hydroxychloroquine Shows No Benefit For Coronavirus Patients In VA Study
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)

The Associated Press: More Deaths, No Benefit From Malaria Drug In VA Virus Study
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 New York Times: New U.S. Treatment Guidelines For Covid-19 Don’t See Much Progress
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)

Politico: NIH Panel Issues First Guidance On Coronavirus Drugs
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)

Stat: Biotech Execs Gather Virtually To Share Best Practices Amid Coronavirus
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)

Stat: Director Of Key U.S. Vaccine Agency Leaves Role Suddenly Amid Coronavirus
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)

Politico: How The Coronavirus Crisis Is Remaking The Swing State Map
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)

The Associated Press: Officials: 7 Virus Cases May Be Related To In-Person Voting
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)

Reuters: Seven Confirmed COVID-19 Cases Linked To Wisconsin's April Elections
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)

The Wall Street Journal: Trump Administration Slow To Distribute Coronavirus Aid To Hospitals
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 Wall Street Journal: Hospitals Secure More Aid In Latest Coronavirus Bill
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)

The New York Times: Senate Approves Aid For Small-Business Loan Program, Hospitals And Testing
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)

The Associated Press: Congress Set To Pass $483B Virus Aid As Trump Eyes Next Deal
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)

Reuters: $500 Billion Coronavirus Aid Package Passes U.S. Senate, Headed To House
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)

Politico: McConnell Slams Brakes On Next Round Of Coronavirus Aid
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)

The New York Times: House Readies Historic Changes To Allow Remote Voting During Pandemic
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)

The New York Times: Trump Says Harvard Must Pay Back Relief Money He Signed Into Law
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)

The Associated Press: Criminal Records Keep Small-Business Owners From Aid Program
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)

The New York Times: Food, Rent, Health Insurance? Tough Choices in Pandemic Economy
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 New York Times: OSHA Leaves It To Employers To Monitor Coronavirus At Work
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)

The New York Times: Trump Blocks Green Cards During Coronavirus
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)

The Associated Press: Trump Bars New Immigration Green Cards, Not Temporary Visas
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)