The New York Times: What 5 Coronavirus Models Say The Next Month Will Look Like
In the last few weeks, we’ve all become a little more familiar with epidemiological models. These calculations, which make estimates about how many people are likely to get sick, need a hospital bed or die from coronavirus, are guiding public policy — and our expectations about what the future holds. But if you look at the models, they don’t really agree. (Bui, Katz, Parlapiano and Sanger-Katz, 4/22)

NPR: Trump Didn't See It Coming: Coronavirus Deaths Increased Tenfold This Month
A month ago, President Trump went on Fox and downplayed the potential lethality of the novel coronavirus and compared it to the seasonal flu."We've had horrible flus," Trump said March 24. "I mean, think of it: we average 36,000 people. Death. Death. I'm not talking about cases, I'm talking about death — 36,000 deaths a year. People die — 36 [thousand] — from the flu. But we've never closed down the country for the flu. So you say to yourself, 'What is this all about?'" (Montanaro and Moore, 4/23)

The Wall Street Journal: Mortality Rates Tell True Tale Of Coronavirus’s Effect
Governments considering reopening economies frozen by restrictions to limit the spread of the new coronavirus are struggling to determine how deadly it is. With tests for the virus still in short supply, many analysts are looking to the blunter measure of total deaths. By comparing mortality statistics for this year with those from the same period in past years, a rough measure of the pandemic’s impact emerges. In parts of the U.S. and Europe that have been hit hard, weekly fatalities from all causes are up by more than 25%, and in some places almost 80%. (Michaels, 4/22)

The New York Times: Santa Clara County: First Known U.S. Coronavirus Death Occurred On Feb. 6
Weeks before there was evidence that the coronavirus was spreading in U.S. communities, Patricia Dowd, a 57-year-old auditor at a Silicon Valley semiconductor manufacturer, developed flulike symptoms and abruptly died in her San Jose kitchen, triggering a search for what had killed her. Flu tests were negative. The coroner was baffled. It appeared that she had suffered a massive heart attack. But tissue samples from Ms. Dowd, who died on Feb. 6, have now shown that she was infected with the coronavirus — a startling discovery that has rewritten the timeline of the virus’s early spread in the United States and suggests that the optimistic assumptions that drove federal policies over the early weeks of the outbreak were misplaced. (Fuller, Baker, Hubler and Fink, 4/22)

The Wall Street Journal: First Coronavirus Deaths In U.S. Came Earlier Than Authorities Thought
“The one thing that you can take from this is how we’ve likely missed a number of cases,” Dr. Chiu said. He and other scientists still believe, however, that the virus was introduced to the U.S. in January. It isn’t known when the people who died in Santa Clara were infected. On Jan. 31, 10 days after the first confirmed U.S. infection surfaced, the Trump administration imposed restrictions on people traveling to the U.S. from the Chinese province where the coronavirus originated. (Elinson, Rana and Kamp, 4/22)

Los Angeles Times: First Known Coronavirus Fatality In The U.S. Was In Bay Area
A mystery clouded the death of Patricia Dowd in early February. The San Jose woman was a seemingly healthy 57-year-old who exercised routinely, watched her diet and took no medication. She had flu-like symptoms for a few days, then appeared to recover, a family member said. Then she was found dead Feb. 6, and the initial culprit appeared to be a heart attack. This week, authorities confirmed to Dowd’s family that she tested positive for the novel coronavirus, making her the first such documented fatality in the nation. (Hamilton and St. John, 4/22)

The Hill: California Governor Orders Autopsies Back To December To Find Out How Long Coronavirus Has Been In The State
California Gov. Gavin Newsom (D) ordered medical examiners and coroners across the state to review autopsies dating back to December to “help guide a deeper understanding of when this pandemic really started to impact Californians.” “When this occurred is important forensic information, profoundly significant in understanding the epidemiology of this disease, all of those things are brought to bear with more clarity and light,” Newsom at a daily press briefing Wednesday. “Not only because of this specific announcement, but I imagine subsequent announcements that may be made by similar efforts all across the state of California.” (Moreno, 4/22)

The New York Times: Hidden Outbreaks Spread Through U.S. Cities Far Earlier Than Americans Knew, Estimates Say
By the time New York City confirmed its first case of the coronavirus on March 1, thousands of infections were already silently spreading through the city, a hidden explosion of a disease that many still viewed as a remote threat as the city awaited the first signs of spring. Hidden outbreaks were also spreading almost completely undetected in Boston, San Francisco, Chicago and Seattle, long before testing showed that each city had a major problem, according to a model of the spread of the disease by researchers at Northeastern University who shared their results with The New York Times. (Carey and Glanz, 4/23)

Boston Globe: Official Toll Of Massachusetts Coronavirus Deaths Likely Undercounted, A Review Shows 
The number of people killed by coronavirus in Massachusetts in the early days of the pandemic is likely much higher than reflected by the official death toll, according to a Globe analysis of preliminary state death records from March. Total deaths in Massachusetts soared by 11 percent last month over the March average for the last 20 years, a statistically significant increase that far exceeded the expected swings from year to year.(Ryan, Lazar and Datar, 4/22)

The New York Times: Covid-19 Arrived In Seattle. Where It Went From There Stunned The Scientists.
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 New York Times: Trump’s Scientists Push Back On His Claim That Virus May Not Return This Fall
In February, President Trump told the public that the coronavirus should “go away” by April. In March, he said that the virus may “wash” away by summer. On Wednesday, Mr. Trump told the American public that the virus “won’t be coming back in the form that it was” this fall or winter. He then mused that it might not come back at all. The scientists flanking him at a White House briefing explicitly said otherwise. “There will be coronavirus in the fall,” Dr. Anthony S. Fauci, the federal government’s top infectious disease expert, said as Mr. Trump looked on. (Rogers, 4/22)

The Associated Press: Despite Warnings, Trump Downplays Threat Of Virus Returning
“It’s not going to be what we’ve gone through, in any way, shape or form,” Trump said flatly. He continued: “If it comes back, though, it won’t be coming back in the form that it was. It will be coming back in smaller doses that we can contain. ... You could have some embers of corona ... (but) we will not go through what we went through for the last two months.” Trump then turned to Dr. Deborah Birx, coordinator of the coronavirus task force, and asked, “Doctor, wouldn’t you say there’s a good chance that COVID will not come back?” “We don’t know,” Birx responded. (Lemire and Miller, 4/23)

The New York Times: The Fear Of Coronavirus And Flu Colliding In The Fall 
Could the United States face two epidemics at the same time next fall, flu and the coronavirus? That frightening idea was raised by Dr. Robert Redfield, the director of the Centers for Disease Control and Prevention, during an interview on Tuesday with The Washington Post. He suggested that a new surge in coronavirus cases could coincide with the next flu season, causing an even more difficult crisis than the one the nation is facing now. (Grady, 4/22)

Politico: Trump Downplays Risk Of Coronavirus Rebound
Redfield repeated his warnings that if the two viruses are circulating at the same time it could make it harder for the health care system to respond, though he downplayed the potential severity of the situation. “It doesn't mean it's going to be more, as some people have said, or worse, it's just going to be more difficult because we have to distinguish between the two,” Redfield said, adding that what he wanted to articulate was that more Americans should get the flu vaccine. (Ehley, 4/22)

The Wall Street Journal: Pence Says Coronavirus Could Be Largely Past By Early June
Vice President Mike Pence said the White House hopes the coronavirus epidemic can be “largely in the past” by early June. Mr. Pence didn’t make a firm prediction about when the U.S. economy can be fully reopened. But he said “the trend lines continue to be encouraging,” including in some of the country’s most hard-hit cities, and offered a generally ambitious timeline for revival of normal activities. (Seib, 4/22)

The Hill: Fauci: Best Way To Reopen Economy Is To Avoid A Rebound Of Virus 
Anthony Fauci, the nation's top infectious diseases expert, warned state officials Wednesday that the coronavirus could rebound if they moved too quickly in reopening their economies. "The one way not to reopen the economy is to have a rebound that we can't take care of," Fauci said at a White House news briefing. (Sullivan, 4/22)

The Wall Street Journal: U.S., WHO Diverge On Coronavirus Outlook
The U.S. and the World Health Organization offered divergent messages on the coronavirus pandemic, as Vice President Mike Pence expressed optimism that it could be largely over in the country by early June, while the WHO’s chief warned that most of the world remains susceptible and epidemics can easily reignite. The total number of confirmed infections across 185 countries and regions globally topped 2.63 million on Thursday with more than 183,400 deaths, according to data from Johns Hopkins University. The U.S. has about one-third of all confirmed cases world-wide, with over 842,600 infections and a death toll exceeding 46,700, according to Johns Hopkins. (Ping, 4/23)

The New York Times: The Cold Calculations America’s Leaders Will Have To Make Before Reopening
How many deaths are acceptable to reopen the country before the coronavirus is completely eradicated? “One is too many,” President Trump insists, a politically safe formulation that any leader would instinctively articulate. But that is not the reality of Mr. Trump’s reopen-soon approach. Nor for that matter will it be the bottom line for even those governors who want to go slower. Until there is a vaccine or a cure for the coronavirus, the macabre truth is that any plan to begin restoring public life invariably means trading away some lives. (Baker, 4/22)

The Washington Post: Reopening States Quickly Could Lead To More Coronavirus Cases And Deaths, Experts Warn
As several states — including South Carolina, Tennessee and Florida — rush to reopen businesses, the sudden relaxation of restrictions will supply new targets for the coronavirus that has kept the United States largely closed down, according to experts, math models and the basic rules that govern infectious diseases. “The math is unfortunately pretty simple. It’s not a matter of whether infections will increase but by how much,” said Jeffrey Shaman, a leading epidemiologist at Columbia University. Closing America was hard. But it came with one simple instruction: Everyone stay at home. (Wan, Johnson and Achenbach, 4/22)

Reuters: More U.S. States Make Plans To Reopen; California Holds Firm
More states in the U.S. South and Midwest signaled readiness on Wednesday to reopen their economies in hopes the worst of the coronavirus pandemic had passed, but California’s governor held firm to sweeping stay-at-home orders and business closures. (McKay and O'Brien, 4/22)

CNN: Some States Are Retracing Their Coronavirus Timelines After The Discovery Of Earlier Deaths 
California and Indiana are retracing their coronavirus timelines after discovering that the highly infectious disease started killing people earlier than previously reported. Gov. Gavin Newsom has asked coroners to review California cases dating to December after autopsies revealed two people in the state died of coronavirus in early and mid-February -- up to three weeks before the first known US death from the virus at the time. (Karimi, 4/23)

Los Angeles Times: 'Second Wave' Of Coronavirus In California Could Be Worse
Even as California continues to bend the coronavirus curve, a rise in the number of COVID-19 cases and deaths as well as concerns about a second wave of the outbreak are reasons to stay vigilant, officials say. California has recorded more than 37,000 cases, adding nearly 2,000 on Tuesday alone. Part of the increase in new cases this week is the result of a lag in labs reporting test results and releasing bulk numbers. More than 1,400 people have died across the state. (4/22)

NPR: Montana Governor Announces Phased Reopening Plan
Saying his state has flattened the curve of coronavirus spread, Montana Gov. Steve Bullock on Wednesday released a plan outlining how churches, businesses and schools can open their doors again over the next three weeks. But significantly for this tourism-dependent state, a 14-day quarantine for out-of-state visitors remains, with an exemption for those visiting for work. (Ouellet, 4/22)

Politico: Governors Release New Plan For Reopening — And Suggest Few States Are Ready
A new road map from the nation’s governors for reopening the economy urges a cautious approach, saying the White House must dramatically ramp up testing and help states bolster other public health measures before social distancing can be safely pulled back. The plan from the National Governors Association and state health officials suggests a wide-scale reopening of the country isn’t imminent, even as President Donald Trump roots on Southern states that are dialing down restrictions despite warnings from health experts. (Roubein, Goldberg and Ehley, 4/22)

Detroit Free Press: Gov. Whitmer: Some Form Of Stay Home Order Will Exist For A While
An extension of the state's stay-at-home order beyond May 1 will probably be needed, Gov. Gretchen Whitmer said during her Wednesday update on the coronavirus, especially for populations that are particularly vulnerable to the virus. "We are going to have to look at the process of re-engaging sectors of our economy," she said. "There will need to be an extension of some sort. We know that even when we get to a stable moment, that people who are compromised and vulnerable to COVID-19 are still going to need to stay home. (Gray and Spangler, 4/22)

The Associated Press: Mayor Called Reckless For Urging Vegas To Test Reopening
Nevada officials condemned comments Wednesday by Las Vegas Mayor Carolyn Goodman after she called for casinos and other nonessential businesses to reopen and suggested the city could serve as a test case to measure the impact during the coronavirus pandemic. One local official called her comments “reckless and dangerous” and another described them as an “embarrassment.” Goodman, during a 25-minute interview with Anderson Cooper on CNN, said she wants everything back open, including casinos, restaurants and small businesses, and a return of conventions. (Price, 4/23)

The Associated Press: US States Represent Patchwork As They Mull Economic Restarts
More governors are reopening their economies by the day around the country, creating a patchwork of stay-home orders and other business restrictions amid the coronavirus pandemic. Some states are moving faster to reopen, like Georgia, Oklahoma and Montana, where the governor on Wednesday gave the green light to schools to open back up in early May. Other states such as New Hampshire are considering extensions. (4/23)

CNN: While Some Politicians Rush To 'Reopen' States, Corporate America Is Bracing For A Long-Term Slowdown 
To understand what the coming months will be like, try to tune out the politicians. There are way too many mixed messages coming from mayors, governors and presidential advisers. Tune into public health experts and CEOs instead. Yes, CEOs: I think we're seeing a repeat of mid-March, when corporate leaders moved more swiftly than political leaders to shut down key sectors of American society. Now, in late April, we're seeing companies act much more realistically than elected officials like Georgia governor Brian Kemp and Las Vegas mayor Carolyn Goodman. (Stelter, 4/23)

New Orleans Times-Picayune: How And When Should Louisiana Reopen? Urban League Weighs In With Recommendations
Temperature checks in all public buildings, masks for everyone and hazard pay for front-line employees are just some measures one civil rights organization is recommending Louisiana take before reopening parts of the state after coronavirus-induced closures. The Urban League of Louisiana, which aides underserved communities, said Wednesday those steps and others will help ensure that African-Americans and poor people aren't unduly threatened by reopenings, which if done too quickly or without enough preparation could cause infections to spike again. (Williams, 4/22)

The Washington Post: Inside The Conservative Network Backing The Anti-Quarantine Protests 
The ads on Facebook sounded populist and passionate: “The people are rising up against these insane shutdowns,” they said. “We’re fighting back to demand that our elected officials reopen America.” But the posts, funded by an initiative called Convention of States, were not the product of a grass-roots uprising alone. Instead, they represented one salvo in a wide-ranging and well-financed conservative campaign to undermine restrictions that medical experts say are necessary to contain the coronavirus — but that protesters call overkill and whose economic fallout could damage President Trump’s political prospects. (Stanley-Becker and Romm, 4/22)

Politico: The Koch Network, Avatar Of The Tea Party, Rejects Shutdown Protests
The libertarian-leaning Koch political network, founded by brothers Charles and David Koch, rose to prominence by funding the tea party protests a decade ago, when taxpayers outraged by an economic stimulus bill and President Barack Obama’s health care plans embraced combative tactics in town halls and protests — and remade politics for years to come. Now, as another recession looms and concerns about government overreach and civil liberties are causing some conservatives to take to the streets, the Koch network is explicitly rejecting the in-person protests. (Severns, 4/22)

The Hill: Despite Protests, Americans Overwhelmingly Favor Stay-At-Home Orders: Poll 
The vast majority of Americans said they support restrictions put in place to mitigate the spread of the coronavirus, according to a new poll, despite several crowded protests breaking out across the country against the prevention measures. Eight in 10 Americans said they support measures that include requiring Americans to stay at home and limit social gatherings to 10 people or fewer, according to an AP-Norc poll released Wednesday. (Klar, 4/22)

ABC News: Coronavirus Misinformation Is Widespread, According To New Report That Calls It An 'Infodemic' 
A new report from network analysis firm Graphika concludes that Twitter is awash with novel coronavirus-related misinformation, some of which is being promoted by far right, anti-vaccination and pro-Kremlin online communities. "You have this kind of convergence of health conspiracies, political conspiracies and technology conspiracies, which I think is particularly concerning," said Melanie Smith of Graphika, an artificial intelligence film that studies online communities. (Gallagher and Bell, 4/23)

KQED: Facebook (Sort Of) Reacts To Right Wing Use Of Its Platform To Politicize Public Health 
Social media platforms have been systemically deleting pandemic-related disinformation, and Facebook, like the others, is keen to publicize a variety of efforts designed to boost credible information and suppress false information on its various properties, including Instagram and WhatsApp, during the coronavirus pandemic. But Facebook and Twitter are caught in what has evolved into a politicized battle over public health. (Myrow, 4/22)

The New York Times: Trump Criticizes Georgia Governor For Decision To Reopen State
President Trump on Wednesday criticized the decision of a political ally, Gov. Brian Kemp of Georgia, to allow many businesses to reopen this week, saying the move was premature given the number of coronavirus cases in the state. “I want him to do what he thinks is right, but I disagree with him on what he is doing,” Mr. Trump said at a White House briefing. “I think it’s too soon.” (Rojas, 4/22)

Politico: Trump Says He Told Kemp: ‘I Totally Disagree’ With Move To Reopen Georgia
Trump on Wednesday asserted that Kemp’s rolled-back restrictions were “in violation” of the first step of his administration’s phased plan to return to normal and revive the economic standstill. At the same time, Trump indicated he was not so opposed to Kemp’s decision that he would ask the federal government to step in. (Oprysko, 4/22)

CNN: Trump Says He 'Strongly' Disagreed With Move To Reopen Georgia -- Contradicting Source Who Said He Agreed With It
He suggested he would intervene if he saw "something totally egregious." "I love those people. They're great. They've been strong, resolute, but at the same time, he must do what he thinks is right. I want him to do what he thinks is right, but I disagree with him on what he's doing but I want to let the governors do (what they want)," the President said. "Now, if I see something totally egregious, totally out of line, I'll do (something)," Trump said, but did not provide specifics on what he would do. (Holmes, Collins and Bradner, 4/23)

The Wall Street Journal: In Georgia, A Divided View On Gov. Kemp’s Plan To Reopen Businesses
Georgia Gov. Brian Kemp’s order allowing some nonessential businesses to reopen as soon as Friday is being met with skepticism by many residents and business owners here, while some outside the metro area welcomed the effort to restart the stalled economy. Georgia’s rollback of restrictions was the broadest yet in the South, where governors are testing how far and how quickly to relax stay-at-home orders that were put in place to curb the spread of the coronavirus. (McWhirter and Bauerlein, 4/22)

The Associated Press: White House Shifts From Raising Alarms To Reopening Country
It’s a defining question for a cloistered nation — and a political imperative for Trump, whose reelection likely rides on the pace of an economic rebound. Can the country move beyond a crippling fear of the virus and return to some modified version of its old routines, doing what’s possible to mitigate the risk of COVID-19, but acknowledging it may be a fact of life for years to come? (Miller, 4/23)

Atlanta Journal-Constitution: Georgia Workers May Have To Choose Between Paycheck And Safety
Despite the governor’s decision to lift some restrictions on businesses, the right to receive unemployment benefits for most jobless Georgians has not changed, according to the state Department of Labor. However, the move did change the calculation for employers – and that could put some workers in a tough spot, forced to choose between their sense of safety and their need for a paycheck. (Kanell, 4/22)

Atlanta Journal-Constitution: Coronavirus Testing Expands In North Georgia Counties
The District 2 Public Health office in Gainesville, covering 13 counties north of Atlanta including Forsyth and Hall counties, announced ramped-up specimen collection for persons suspected of being infected with the COVID-19 virus. New guidelines, according to a District 2 announcement, allow tests for hospitalized patients; and people showing symptoms who are health care workers, first responders or critical infrastructure workers; persons 65 and older, in long-term care or with underlying medical conditions; and their household members, care givers or others in close contact. (Ibata, 4/23)

The Washington Post: With 15 New Covid-19 Deaths In Hard-Hit D.C., Bowser Urges More Testing
D.C. Mayor Muriel E. Bowser expressed alarm Wednesday about the harsh impact of the novel coronavirus on the poor, sick and elderly in the nation’s capital, as officials reported 15 new fatalities — including several people who died without being hospitalized. Ten of the dead were from wards 5, 7 and 8, the poorest and most heavily African American parts of the city, mirroring a national trend in which blacks have been disproportionately affected. Nine of the dead were older than 80; one was a 100-year-old woman and another a 98-year-old woman. (Olivo, Nirappil and Cox, 4/22)

The Hill: Judge Rejects Attempt By Three California Churches To Hold Services Despite Stay-At-Home Order 
A Los Angeles judge denied a request by three southern California churches to continue holding in-person services during the coronavirus pandemic. In his ruling Wednesday, U.S. District Judge Jesus Bernal denied the request for a temporary restraining order against Gov. Gavin Newsom (D) by Shield of Faith Family Church, Word of Life Ministries International and Church Unlimited. Bernal rejected the argument that Newsom’s stay-at-home orders violated their first amendment rights to freedom of religion and freedom of assembly, The Associated Press reported. (Budryk, 4/22)

KQED: Newsom Coronavirus Briefing Goes Deep On Testing; Calif. ‘Not Prepared’ To Open Up Yet
Gov. Gavin Newsom said today that at least 465,327 Californians have been tested for this coronavirus so far, but he acknowledged that the state’s testing capacity is still coming online and remains inadequate to lift a statewide stay-at-home order and other social distancing restrictions. (Stark, 4/22)

Los Angeles Times: Coronavirus Could Be Leveling Off In L.A. County, New Forecast Says
Los Angeles County health officials offered slightly rosier projections Wednesday about the trajectory of the virus in Los Angeles county, but cautioned that the improved outlook was contingent on residents continuing to practice physical distancing. Presenting a new update to the county’s coronavirus model, Dr. Christina Ghaly, the county’s health services director, said that while COVID-19 cases are not yet decreasing here, “it is leveling out, which is a good thing.” (Mason, 4/22)

KQED: Here's Why California's Immigrant Communities Need Coronavirus Information In Their Own Languages 
Flores-Haro is the associate director of the Mixteco/Indígena Community Organizing Project (MICOP), home of Radio Indígena — a community radio station in Oxnard. In a state where more than 40% of people speak a language other than English at home, MICOP is one of numerous community groups filling in the gaps as public health officials work to inform people about COVID-19 in a language they understand. (Hall, 4/22)

Boston Globe: Pockets Of Resistance Emerge To Coronavirus Retail Closures In Mass. 
Among the state’s 250,000-plus registered businesses, state officials say, the scale is relatively small. The state’s Department of Labor Standards said it’s issued cease-and-desist orders to 123 companies, shuttering more than 350 locations statewide since the order was issued four weeks ago. Another 50 or so remain “under investigation,” according to the department. (Stout, 4/22)

Houston Chronicle: Hidalgo Orders Harris County Residents To Wear Masks In Public, Draws Fire From Police Unions, GOP 
Harris County Judge Lina Hidalgo on Wednesday ordered residents to cover their faces in public starting next week, the latest effort by local governments to slow the spread of the novel coronavirus. The new rules, which require residents 10 and older to cover their nose and mouth when outside the home, take effect Monday and last 30 days. Acceptable garments include a homemade mask, scarf, bandana or handkerchief. Medical masks or N-95 respirators are not recommended as they are most needed by first responders and health workers. (Despart, 4/22)

San Francisco Chronicle: Alameda County Moves Hundreds Of Homeless To Hotels Amid Fear Of Coronavirus Outbreak 
After 96 people tested positive for the coronavirus at San Francisco’s largest shelter this month, alarmed Alameda County officials hurried to empty out shelters and move people into hotel rooms to prevent a similar outbreak. Since the San Francisco outbreak on April 10, Alameda County transferred at least 346 homeless people from shelters into two Oakland hotels. But before the outbreak across the bay, the county had moved only 70 people into the hotels since mid-March, prompting criticism from homeless advocates that Alameda County acted too slowly to protect vulnerable people from the coronavirus. (Ravani, 4/22)

Detroit Free Press: Detroit To Begin COVID Testing At Other Senior Facilities
Detroit plans to turn its attention to skilled nursing facilities and assisted living homes after it finishes testing for COVID-19 in the city's nursing homes. Living quarters in these settings are similar to nursing homes, and place residents and staff at a greater risk for contracting the virus, Denise Fair, chief public health officer at the Detroit Health Department, said Wednesday. (Hall, 4/22)

Cincinnati Enquirer: Coronavirus In Kentucky: Beshear Announces Testing Open To Public
Kentucky Gov. Andy Beshear announced at his Wednesday press conference that the new state total for confirmed coronavirus cases in the state is at 3,373. He also announced 14 new deaths, bringing the statewide total deaths to 185. Beshear believes the state has begun to plateau in confirmed cases.  (Key and Mazade, 4/22)

Milwaukee Journal Sentinel: Wisconsin Cases Spike As Golf Courses Reopen, Madison Protests Planned
Wisconsin saw its biggest one-day increase in positive COVID-19 cases Wednesday, likely fueled by an outbreak at a meatpacking plant in Green Bay. The increase came even as the stay-at-home order loosened a bit with word that some golf courses would be opening in the Milwaukee area later this week. On Wednesday, the state reported 225 new cases, bringing the total to 4,845 cases. The previous highest one-day total was 199 on April 1. (Diedrich, 4/22)

Bangor Daily News: Maine Hospital System Has More Critical Care Beds And Ventilators Free Now Than Before Pandemic
Many Maine hospitals have more critical care beds and ventilators available right now than before the coronavirus pandemic began, positioning medical providers to be able to handle an increase in critically ill patients if a surge occurs, a top hospital administrator said Wednesday. (Rhoda, 4/22)

Albuquerque Journal: Closed Hospital Fixed Up To Treat COVID-19 Patients
Albuquerque-based Weil Construction and local subcontractors completed the work in 14 days under the supervision of the Corps. Weil Construction owner Chris Weil told the Journal it was not an easy task because of the aging infrastructure. The hospital on Gibson SE closed in 2007.“We had 150 workers on the project,” Weil said. “We were running 24/7.” (Turner, 4/22)

Indianapolis Star: Coronavirus Stimulus: Indiana Colleges Don't Know How To Spend It
Indiana colleges and universities are set to receive to roughly $200 million from the federal government’s coronavirus relief package – a welcome boost as higher education institutions and their students face unprecedented challenges, both academic and financial. The only problem: Most schools say they’re not sure yet how to spend it. (Herron, 4/23)

Las Vegas Review-Journal: Acts Of Kindness Continue In Las Vegas
Amid the COVID-19 pandemic, individuals, families and businesses in Las Vegas are stepping up to offer relief to people in the community who are in need of food, services and support. Here are stories about people who are leading with kindness and proving the community is #VegasStrong. (Karel and Hynes, 4/22)

The Wall Street Journal: Coronavirus Deaths In U.S. Nursing, Long-Term Care Facilities Top 10,000
The number of U.S. coronavirus-linked deaths in long-term care facilities including nursing homes has eclipsed 10,000, as nursing-home owners said they are still struggling to access the testing they need to detect and curb outbreaks. A growing number of state health departments are reporting data, including fatalities, linked to facilities that primarily house older people who often are in frail health and particularly vulnerable to infection from the new coronavirus. (Kamp and Wilde Mathews, 4/22)

WBUR: In New York Nursing Homes, Death Comes To Facilities With More People Of Color 
There's one thing that distinguishes the nursing homes in New York that have reported patient deaths from COVID-19. According to an NPR analysis, they are far more likely to be made up of people of color. NPR looked at 78 nursing homes in New York in which six or more residents have died of COVID-19. In one facility, 55 people have died as of April 20. Ten others report 30 or more deaths. (Shapiro, Jingnan and Benincasa, 4/22)

New Orleans Times-Picayune: Coronavirus Death Toll In Louisiana Adult Residential Care Facilities Nears 500; More Than 2,400 Total Cases 
Deaths from coronavirus in adult residential health care facilities, including nursing homes, rose to 464 Wednesday, an increase of 61 deaths from Monday, the last time the state reported on the impact the virus has had on those in such homes. There are now 2,402 confirmed cases in 205 facilities, the state reported Wednesday. But that total comes from an expanded pool of homes, unlike before, when the tally was focused on nursing homes. Now, according to the Louisiana Department of Health update, the totals include nursing homes, assisted living facilities, inpatient psychiatric/behavioral health and drug treatment facilities. (Roberts III, 4/22)

Indianapolis Star: Coronavirus Kills Two Nursing Home Workers In Indianapolis
State regulators are investigating the coronavirus-related deaths of two employees of the same Indianapolis nursing home. The Indiana Occupational Safety and Health Administration is pursuing a safety compliance inspection at Wildwood Health Care, 7301 E. 16th St., after the deaths of two employees were reported to the state last week, agency spokeswoman Stephanie McFarland confirmed to IndyStar on Wednesday. (Hopkins, 4/22)

Politico: Inside America’s Unending Testing Snafu
It’s hard to tell from watching President Donald Trump and members of his Coronavirus Task Force just how many people can be tested for coronavirus in the U.S. and whether there’s enough testing capacity to reopen the economy. Task force officials have been citing the millions of swabs and test tubes now in production as manufacturers ramp up capacity. They handed out lists of labs in each state to governors this week, suggesting that states just haven’t been asking labs to do the work. But doubling the number of tests conducted from the current 1 million per week, as the White House recommends, is far more complicated than that. (Lim and Ehley, 4/22)

The Washington Post: States Could Increase Coronavirus Testing This Week With At-Home Kits, FDA Commissioner Says 
States could increase their testing capabilities as soon as this week, including the use of at-home testing kits, the head of the Food and Drug Administration said Wednesday. The FDA this week gave the green light to the first coronavirus test that allows patients to collect nasal samples at home. LabCorp, a North Carolina-based company, had said on Tuesday that it was given an emergency-use authorization for its Pixel home collection kit. (Beachum and McGinley, 4/22)

The Wall Street Journal: New York Preps For Large-Scale Testing Program To Combat Coronavirus Spread
New York state will launch massive testing programs as it prepares to relax restrictions on businesses that were implemented in response to the novel coronavirus crisis, officials said Wednesday. Former New York City Mayor Michael Bloomberg will provide more than $10 million to design and help set up a tracing program that would allow governments to track down whom infected people have come into contact with in New York City, as well as neighboring counties and states, New York Gov. Andrew Cuomo said. (Vielkind, 4/22)

NPR: Washington State Builds Coronavirus Contact Tracing Brigade
If life is going to return to anything like normal in the next few months, experts say we're going to need a lot more "contact tracers." Those are the public health workers who get in touch with someone who's tested positive for a disease, to find out who else he or she might have been in contact with. It's a long-standing practice for illnesses such as tuberculosis and AIDS, and now, as states re-open, it'll be a crucial tool for keeping a lid on the coronavirus. (Kaste, 4/22)

The Hill: Newsom Wants To Train 10,000 Contact Tracers In California
California Gov. Gavin Newsom (D) said Wednesday that the state is planning to train up to 10,000 contact tracers amid the coronavirus pandemic. Expanding contact tracing and testing is one of six indicators Newsom said last week would drive the state’s decision to gradually modify portions of the stay-at-home order. (Klar, 4/22)

Stateline: Some States Want To Track Your Phone–If You're OK With That 
When Rhode Island Gov. Gina Raimondo, a Democrat, suggested recently that the state might use residents’ cellphone data to trace the spread of the coronavirus, opponents on both the left and right were aghast. The American Civil Liberties Union raised the specter of an intrusive government prying into people’s personal lives. Republican state lawmakers drafted a letter imploring the governor “not to attempt to track personally-identifiable cellular phone location data, absent specific user consent or a judicial warrant.” (Povich, 4/23)

CIDRAP: Scientists Use Serology To Connect Dots On COVID-19 Clusters
Serologic testing helped scientists establish connections between two people with COVID-19 from Wuhan, China, to three clusters in Singapore, according to a study yesterday in The Lancet Infectious Diseases. Also, a study today in The Journal of Infectious Diseases found that four of eight COVID-19 cases in three family clusters in China were asymptomatic or had only mild symptoms. (Van Beusekom, 4/22)

The Wall Street Journal: Health Chief’s Early Missteps Set Back Coronavirus Response
On Jan. 29, Health and Human Services Secretary Alex Azar told President Trump the coronavirus epidemic was under control. The U.S. government had never mounted a better interagency response to a crisis, Mr. Azar told the president in a meeting held eight days after the U.S. announced its first case, according to administration officials. At the time, the administration’s focus was on containing the virus. (Ballhaus and Armour, 4/22)

Reuters: Special Report: Former Labradoodle Breeder Tapped To Lead U.S. Pandemic Task Force
On January 21, the day the first U.S. case of coronavirus was reported, the secretary of the Department of Health and Human Services appeared on Fox News to report the latest on the disease as it ravaged China. Alex Azar, a 52-year-old lawyer and former drug industry executive, assured Americans the U.S. government was prepared. ... Azar’s initial comments misfired on two fronts. Like many U.S. officials, from President Donald Trump on down, he underestimated the pandemic’s severity. He also overestimated his agency’s preparedness. (Roston and Taylor, 4/22)

ProPublica/WNYC: How Jared Kushner Is Tackling The White House’s Coronavirus Response — Without Any Evident Experience
On April 2, Jared Kushner uncharacteristically took to the podium to speak at the White House’s daily coronavirus briefing. He’d been given the task, he said, of assisting Vice President Mike Pence’s Coronavirus Task Force with supply chain issues. “The president,” Kushner said, “wanted us to make sure we think outside the box, make sure we’re finding all the best thinkers in the country, making sure we’re getting all the best ideas, and that we’re doing everything possible to make sure that we can keep Americans safe.” That very day, he said, President Donald Trump told him that “he was hearing from friends of his in New York that the New York public hospital system was running low on critical supply.” (Bernstein, 4/22)

The New York Times: ‘Sadness’ And Disbelief From A World Missing American Leadership
As images of America’s overwhelmed hospital wards and snaking jobless lines have flickered across the world, people on the European side of the Atlantic are looking at the richest and most powerful nation in the world with disbelief. “When people see these pictures of New York City they say, ‘How can this happen? How is this possible?’” said Henrik Enderlein, president of the Berlin-based Hertie School, a university focused on public policy. “We are all stunned. Look at the jobless lines. Twenty-two million,” he added. “I feel a desperate sadness,” said Timothy Garton Ash, a professor of European history at Oxford University and a lifelong and ardent Atlanticist. (Bennhold, 4/23)

Stat: An Ousted Vaccine Agency Director Alleges Trump Is Politicizing Science
Rick Bright, the U.S. official who was ousted this week from a post atop an agency charged with developing vaccines, has decided to put the Trump administration on trial. The charge: politicizing science. (Florko, 4/22)

The Associated Press: Expert Claims Reprisal For Opposing Virus Drug Trump Touted
The head of a government agency combating the coronavirus pandemic alleged Wednesday that he was ousted for opposing politically connected efforts to promote a malaria drug that President Donald Trump touted without proof as a remedy for COVID-19. Rick Bright, former director of the Biomedical Advanced Research and Development Authority, said in a statement that he was summarily removed from his job on Tuesday and reassigned to a lesser role. His lawyers, Debra Katz and Lisa Banks, called it “retaliation plain and simple.” (Alonso-Zaldivar, 4/23)

Reuters: U.S. Official Says He Was Ousted For Urging Caution On Trump-Touted Coronavirus Drug
“While I am prepared to look at all options and to think ‘outside the box’ for effective treatments, I rightly resisted efforts to provide an unproven drug on demand to the American public,” Bright said in the statement, reported by multiple U.S. media outlets on Wednesday. Bright said the U.S. government has promoted the medicines as a “panacea” even though they “clearly lack scientific merit.” (Wolfe, 4/22)

NPR: Federal Scientist Says He Was Removed For Resisting Unproven Coronavirus Treatments
Bright said his career in vaccine development has prepared him for a crisis like this one. "To this point, I have led the government's efforts to invest in the best science available to combat the COVID-19 pandemic," he said. "Unfortunately, this resulted in clashes with HHS political leadership, including criticism for my proactive efforts to invest early in vaccines and supplies critical to saving American lives. I also resisted efforts to fund potentially dangerous drugs promoted by those with political connections." (Swasey, 4/22)

The Wall Street Journal: HHS Official Says He Was Ousted Over Coronavirus Drug Dispute
In a comment late Wednesday evening, HHS spokeswoman Caitlin Oakley pushed back on Dr. Bright’s assertion that he opposed the use of hydroxychloroquine. “It was Dr. Bright who requested an Emergency Use Authorization (EUA) from the FDA for donations of chloroquine that Bayer and Sandoz recently made to the Strategic National Stockpile for use on Covid-19 patients,” she said. “The EUA is what made the donated product available for use in combating Covid-19.” Mr. Trump, asked at Wednesday’s briefing about Dr. Bright’s claim he was pushed out in part due to his opposition to hydroxychloroquine, said, “I’ve never heard of him.” (Ballhaus and Armour, 4/22)

The Hill: Democratic Senator Calls For Investigation Into Reassignment Of Key HHS Official 
Sen. Ed Markey (D-Mass.) on Wednesday called for an investigation into the removal of the former director of the federal office that will be at the forefront of developing a COVID-19 cure. Markey’s push for an investigation came after Rick Bright, the former director of the Biomedical Advanced Research and Development Authority (BARDA), said he was forced out of the position for prioritizing science over promoting unproven treatments President Trump had repeatedly pushed as potential cures without evidence. (Klar, 4/22)

CNN: Trump Disregards Science As Coronavirus Response Is Overtaken By Chaos 
Alarming new signs are emerging that the Trump administration is shunting science aside in the battle against coronavirus. In Wednesday's most stunning development, a top administration official working on a vaccine claimed he was ousted after resisting efforts to push unproven drugs promoted by President Donald Trump and his conservative media cheerleaders as "game changer" treatments. (Collinson, 4/23)

The Washington Post: Under Trump, Coronavirus Scientists Can Speak — As Long As They Mostly Toe The Line
Robert Redfield, director of the Centers for Disease Control and Prevention, issued a candid warning Tuesday in a Washington Post interview: A simultaneous flu and coronavirus outbreak next fall and winter “will actually be even more difficult than the one we just went through,” adding that calls and protests to “liberate” states from stay-at-home orders — as President Trump has tweeted — were “not helpful.” The next morning, Trump cracked down with a Twitter edict: Redfield had been totally misquoted in a cable news story summarizing the interview, he claimed, and would be putting out a statement shortly. (Parker, Dawsey, Abutaleb and Sun, 4/22)

Reuters: Pompeo: U.S. Calls On China To Permanently Close Wildlife Wet Markets
U.S. Secretary of State Mike Pompeo said that the United States has called on China to permanently close its wildlife wet markets, citing links between those markets and zoonotic diseases. The new coronavirus is believed to have emerged in a market in the central Chinese city of Wuhan late last year. It has spread around the world killing over 180,000 people and infecting over 2.6 million, Reuters calculations show. (4/23)

NPR: U.S. Pressures China To Close Wet Markets Thought To Be Source Of COVID-19
Although some of the markets sell wild animals, the vast majority of them do not. Such markets are common not only in China, but throughout Asia and parts of the Middle East. "Given the strong link between illegal wildlife sold in wet markets and zoonotic diseases, the United States has called on the People's Republic of China to permanently close its wildlife wet markets and all markets that sell illegal wildlife. I call on all ASEAN governments to do the same," Pompeo said in the statement. (Neuman, 4/23)

The New York Times: Executive Order Halting New Green Cards Includes Exceptions
President Trump signed an executive order on Wednesday temporarily blocking the issuance of green cards to those outside the United States, but the measure includes numerous exemptions, like those for overseas spouses and young children of American citizens. The order, which will be in place for at least 60 days, will affect thousands of parents, adult children and siblings of citizens seeking to immigrate to the United States. (Kanno-Youngs, 4/22)

The Associated Press: Trump Signs Immigration Order Featuring Numerous Exemptions
President Donald Trump claimed Wednesday that he had signed an executive order “temporarily suspending immigration into the United States.” But experts say the order will merely delay the issuance of green cards for a minority of applicants. Trump said his move was necessary to help Americans find work in an economy ravaged by the coronavirus. “This will ensure that unemployed Americans of all backgrounds will be first in line for jobs as our economy reopens,” he said. (Colvin and Spagat, 4/23)

Reuters: Trump Order Temporarily Limits U.S. Immigration During Coronavirus Crisis
Some critics saw Republican Trump’s announcement as a move to take advantage of the coronavirus crisis to implement a long-sought policy goal of barring more immigrants in line with his “America first” platform. “In order to protect our great American workers I have just signed an executive order temporarily suspending immigration into the United States. This will ensure that unemployed Americans of all backgrounds will be first in line for jobs as our economy reopens,” Trump said at his daily news conference about the coronavirus at the White House. (Hesson, Holland and Mason, 4/22)

The Washington Post: Trump Signs Order Pausing Immigration For 60 Days, With Exceptions
Trump said his order will shield Americans from the virus while also protecting American jobs at a time of excessively high unemployment and economic uncertainty. It will put a halt on employment-based immigration visas as well as the family-based categories for parents and siblings, which the president has often derided as “chain migration.” (Miroff, Sacchetti and Hernandez, 4/22)

Meanwhile —

Politico: How Democratic Governors And Mayors Are Bucking Trump On Stimulus Benefits For Immigrants
California Gov. Gavin Newsom said last week that undocumented immigrants, who comprise about a tenth of California’s workforce, will be able to draw on a $125 million public-private fund. Minneapolis is offering $5 million in assistance to tenants and small businesses, regardless of their immigration status. Chicago Mayor Lori Lightfoot recently extended the city’s coronavirus-relief benefit programs, including aid for housing and for small businesses, to undocumented immigrants. New Jersey Gov. Phil Murphy says a fund for immigrants is “something we want to look at.” (Rainey and Landergan, 4/22)

The Wall Street Journal: Confusion Hampers Coronavirus-Driven Inmate Releases
The Justice Department said Wednesday that federal prison officials could consider inmates for early release even if they haven’t yet served half of their sentences, clarifying a shifting policy that has sown confusion across the nation’s prisons and courts in recent days. Dozens of inmates who had been granted early release as part of an effort to stem the spread of the coronavirus were told this week they hadn’t served enough time to qualify, according to prisoners and court filings. Inmates, prosecutors and federal judges demanded prison officials explain their rules and criteria for releasing inmates during the pandemic. (Gurman and O'Brien, 4/22)

Politico: Judge Orders Transfer Or Release For Some Inmates At Virus-Wracked Ohio Federal Prison
A judge has ordered the release or transfer of hundreds of elderly and vulnerable inmates at a federal prison in Ohio that has seen a particularly deadly and widespread outbreak of the coronavirus. Although federal courts have been flooded in recent days with release and resentencing requests in individual cases, the ruling Wednesday from U.S. District Court Judge James Gwin appeared to be the first that could lead to a group release of federal convicts as a result of the ongoing Covid-19 pandemic. (Gerstein, 4/22)

Houston Chronicle: Federal Appeals Court Halts Ruling Mandating Masks, Soap, Testing Protocol At Geriatric Texas Prison
A federal appeals court has halted a judge's ruling that inmates at a geriatric prison outside Houston should have expanded access to masks and soap and a plan for testing for COVID-19. A three-judge panel from the 5th U.S. Circuit Court of Appeals critiqued the injunction by a veteran Houston judge , saying his order last week “regulates in minute detail the cleaning intervals for common areas, the types of bleach-based disinfectants the prison must use, the alcohol content of hand sanitizer that inmates must receive, mask requirements for inmates, and inmates’ access to tissues” surpassing CDC guidelines. (Banks, 4/22)

Des Moines Register: Cases Of COVID-19 In Iowa's Prison System Triples; Union Leader Issues Warning
Ten more prisoners in Iowa were reported Wednesday as having tested positive for coronavirus, tripling the number of known infections in the state's prison system. The announcement prompted the leader of the largest employee union that represents state employees to call for comprehensive testing within the prison system. Iowa could be on the cusp of a far more serious outbreak like one in Ohio, where a single facility has more than 1,800 confirmed cases, he warned. (Davis, 4/22)

Indianapolis Star: Lawyer For Imprisoned Noblesville CEO Warns That A Coronavirus Outbreak Could Kill Him
A former Indiana pharmaceutical executive who was sentenced last year for conspiracy and adulterating drugs says he is at high risk of becoming severely ill or dying from the novel coronavirus and wants to be released from federal prison, according to court documents. Attorneys for Paul Elmer filed an emergency motion April 1 asking U.S. Southern District Judge James Sweeney to enter an order releasing the 69-year-old to home detention at his home in Florida. A memo filed in support of the motion says Elmer suffers from medical conditions that make him severely susceptible to the COVID-19 virus. (Hill, 4/23)

New Orleans Times-Picayune: Plaintiffs In St. Tammany Jail Suit Denied Emergency Steps As Coronavirus Cases Climb 
A federal judge has denied a request by three men seeking to force the St. Tammany Parish Jail to immediately enact social distancing rules in holding cells aimed at preventing the spread of the coronavirus among immates at the facility. (Pagones, 4/22)

The Washington Post: Trump Administration Says It Will Pay Hospitals For Treating Uninsured Covid-19 Patients
The Trump administration confirmed Wednesday that the government will devote an unspecified amount of federal aid to help hospitals cope with the expense of treating covid-19 patients who are uninsured. Health and Human Services Secretary Alex Azar announced the payments for patients without health coverage as part of several strands of funding the government will distribute from a federal relief package to hospitals and other health-care facilities and practitioners overwhelmed financially by the coronavirus pandemic. (Goldstein, 4/22)

The Wall Street Journal: Trump Administration Unveils Plan To Distribute Coronavirus Aid To Hospitals
The disbursal will include $20 billion more for providers based on their recent revenues and $10 billion for hospitals in areas hard-hit by the virus, as well as $10 billion for the roughly 2,000 rural hospitals and health clinics. More funding is coming: The Senate on Tuesday passed a new package with as much as $75 billion in fresh aid for hospitals and providers. Hospitals, especially those in areas hit hard by the pandemic, are straining under the influx of patients with Covid-19, the disease caused by the virus, and the financial demands of emergency procurement of supplies such as personal protective equipment. Facilities in less stressed areas, meantime, are seeing revenues hammered by elective surgery delays and a decline in patients, who are afraid of contracting the virus in health-care facilities. (Armour, 4/22)

The Hill: Trump Administration Offers Plan For Hospital Funds To Coronavirus Hot Spots, Uninsured Patients
"It will be a significant infusion of money for high impact areas," Azar said during a call with reporters. Hospitals in those hard-hit areas have until April 23 at midnight to apply for the funding. Hospitals in New York, which have seen the highest number of COVID-19 cases, will receive about $4.4 billion, Senate Minority Leader Charles Schumer (D-N.Y.) said. (Weixel, 4/22)

Modern Healthcare: COVID-19 Hotspots, Rural Hospitals To Score Half Of $40B CARES Grants
HHS officials Wednesday said the department will distribute $40 billion in federal grant funds with carveouts for providers in COVID-19 hotspots and rural areas, and will reimburse providers for uncompensated COVID-19 care. Roughly $20 billion will go out providers generally based on 2018 net patient revenue from cost reports. HHS Secretary Alex Azar said the funds would be distributed for about half of providers on Friday. A portal will open up this week for providers to enter or confirm their revenue numbers. (Cohrs, 4/22)

Modern Healthcare: COVID-19 Could Cause Medicare Reserves To Run Out Before 2026
The team in charge of monitoring Medicare's solvency kept its projection that the Part A trust fund's reserves will run out in 2026, although the COVID-19 pandemic could speed that up. That prediction is unchanged from the trustees' past two annual reports to Congress. Medicare covered about 62 million Americans last year. The 2020 report has an elephant in the room: It doesn't factor in the effects of COVID-19 on Medicare spending. Senior administration officials acknowledged the global pandemic will "no question" have a negative effect on the reserve funds of both Medicare and Social Security. (Bannow and Brady, 4/22)

Modern Healthcare: Independent Free-Standing EDs Get Temporary Approval To Bill Medicare, Medicaid
The CMS issued guidance this week allowing independently owned freestanding emergency departments to temporarily participate in Medicare and Medicaid. The guidance is a way to expand capacity for hospital services as providers see an influx of patients with COVID-19, the agency said in a press release. (Castellucci, 4/22)

Houston Chronicle: Texas’ Freestanding ERs To Get Medicaid Funding 
Texas’ freestanding emergency rooms will temporarily be eligible to receive federal reimbursement to care for Medicare and Medicaid recipients under guidance issued Tuesday by the Trump administration. The move is aimed at easing some of the burden on hospitals, which in other parts of the country have been overwhelmed by patients seeking treatment for COVID-19, the diseases caused by the coronavirus. (Wu, 4/22)

Modern Healthcare: CMS Approves First Emergency Medicaid Demonstration Waiver
The CMS on Tuesday approved a Medicaid Section 1115 emergency waiver for Washington state, making it the first state to get approval. Under the waiver, Washington will be able to target Medicaid services to areas hit hard by COVID-19 rather than deliver services evenly across the state. The state can also differentiate and target specific populations affected by the virus and "triage access to long-term services and supports based on highest need," the CMS wrote in its approval letter. (Brady, 4/22)

Sacramento Bee: People Met With High Hospital Bills After COVID-19 Treatment 
Many people are being met with surprise bills from coronavirus treatment that cost thousands or tens of thousands of dollars, as patients battle with their insurers. “I could have chosen not to do all this, and put countless others at risk,” said Andrew Cencini, who told Kaiser Health News he was tested for COVID-19 in a New York emergency room. “But I was trying to do the right thing.” (Stunson, 4/22)

The Washington Post: Almost 90 Percent Of Coronavirus Patients On Ventilators Died In Large U.S. Study
Throughout March, as the pandemic gained momentum in the United States, much of the preparations focused on the breathing machines that were supposed to save everyone’s lives. New York State Gov. Andrew M. Cuomo (D) and President Trump sparred over how many ventilators the state was short. DIYers brainstormed modifications to treat more patients. And ethicists agonized over how to allocate them fairly if we run out. (Cha, 4/22)

CNN: Nearly All Covid-19 Patients Put On Ventilators In New York's Largest Health System Died, Study Finds 
Nearly all coronavirus patients who needed ventilators in New York's largest health system to help them breathe died, a study found. Overall, about 20% of Covid-19 patients treated at Northwell Health died, and 88% of those placed on ventilators died, according to the study. (Fox, 4/22)

Reuters: Special Report: As Virus Advances, Doctors Rethink Rush To Ventilate
Reuters interviewed 30 doctors and medical professionals in countries including China, Italy, Spain, Germany and the United States, who have experience of dealing with COVID-19 patients. Nearly all agreed that ventilators are vitally important and have helped save lives. At the same time, many highlighted the risks from using the most invasive types of them - mechanical ventilators - too early or too frequently, or from non-specialists using them without proper training in overwhelmed hospitals. Medical procedures have evolved in the pandemic as doctors better understand the disease, including the types of drugs used in treatments. The shift around ventilators has potentially far-reaching implications as countries and companies ramp up production of the devices. (Aloisi, Beasley, Borter, Escritt and Kelland, 4/23)

Meanwhile —

Stat: Catheter Shortage Boosts Work, And Risk, For Respiratory Therapists 
They had bolstered their ranks with everyone available. They’d hired traveling respiratory therapists, to stop in at Massachusetts General Hospital before moving on, riding the tides of coronavirus from one packed ICU to the next. They’d borrowed others from the smoking cessation program, which had itself largely ceased. They’d brought in students with limited state licenses, to pick up whatever tasks their training had covered so far. (Boodman, 4/23)

The Washington Post: Blood-Clotting Complication Is Killing Coronavirus Patients, Doctors Say
Craig Coopersmith was up early that morning as usual and typed his daily inquiry into his phone. “Good morning, Team Covid,” he wrote, asking for updates from the ICU team leaders working across 10 hospitals in the Emory University health system in Atlanta. One doctor replied that one of his patients had a strange blood problem. Despite being put on anticoagulants, the patient was still developing clots. A second said she’d seen something similar. And a third. Soon, every person on the text chat had reported the same thing. (Cha, 4/22)

CNN: Covid-19 Causes Sudden Strokes In Young Adults, Doctors Say 
The new coronavirus appears to be causing sudden strokes in adults in their 30s and 40s who are not otherwise terribly ill, doctors reported Wednesday. They said patients may be unwilling to call 911 because they have heard hospitals are overwhelmed by coronavirus cases. There's growing evidence that Covid-19 infection can cause the blood to clot in unusual ways, and stroke would be an expected consequence of that. (Fox, 4/22)

Reuters: Alarmed As COVID Patients' Blood Thickened, New York Doctors Try New Treatments 
Signs of blood thickening and clotting were being detected in different organs by doctors from different specialties. This would turn out to be one of the alarming ways the virus ravages the body, as doctors there and elsewhere were starting to realize. At Mount Sinai, nephrologists noticed kidney dialysis catheters getting plugged with clots. Pulmonologists monitoring COVID-19 patients on mechanical ventilators could see portions of lungs were oddly bloodless. Neurosurgeons confronted a surge in their usual caseload of strokes due to blood clots, the age of victims skewing younger, with at least half testing positive for the virus. (Allen, 4/22)

CNN: Seniors With Covid-19 Show Unusual Symptoms, Doctors Say 
Older adults with Covid-19, the illness caused by the coronavirus, have several "atypical" symptoms, complicating efforts to ensure they get timely and appropriate treatment, according to physicians. Covid-19 is typically signaled by three symptoms: a fever, an insistent cough and shortness of breath. But older adults — the age group most at risk of severe complications or death from this condition ― may have none of these characteristics. (Graham, 4/23)

Stat: Competing Covid-19 Efforts Could Hamper Progress, Experts Warn
As many of the most forward-thinking tech and biopharma behemoths — from Apple and Google to Gilead and MIT — rush in to use their savvy and expertise to help fight Covid-19, some of their independent efforts risk undermining their common goals. For all the know-how and good intentions of these institutions, responding to a global pandemic is far different than operating in the private sector. In interviews with STAT, several researchers and technology experts said that instead of collaborating and seeding innovation, some groups are effectively duplicating each other’s work or competing for limited resources — which could stymie progress in the pandemic response, the experts warned. (Brodwin and Robbins, 4/23)

Sacramento Bee: Rancho Cordova CA Biotech Firm Close On Coronavirus Therapy 
Scientists in the Sacramento area believe they have developed a way to keep the new coronavirus from finding the doorknob that it typically turns to enter human lung cells. Chris Xu, the CEO of Rancho Cordova-based ThermoGenesis, said the biopharmaceutical treatment could go to market within two months. (Anderson, 4/22)

The New York Times: Fox News Stars Trumpeted A Malaria Drug, Until They Didn’t
For a month’s stretch, the Fox News star Laura Ingraham relentlessly promoted the malaria drug hydroxychloroquine to her nearly four million nightly viewers. The drug was “a game changer” in the fight against the coronavirus, the conservative anchor declared. She booked recovered patients to describe their “miracle turnaround” — “like Lazarus, up from the grave,” as Ms. Ingraham put it. Anyone who questioned the drug’s efficacy, she said, was “in total denial.” (Grynbaum, 4/22)

The Washington Post: Fox News Hosts Go Mum On Hydroxychloroquine, The Covid-19 Drug They Spent Weeks Promoting
At the height of Fox News’s coverage of a would-be treatment for the novel coronavirus, the network’s medical correspondent, Marc Siegel, offered a remarkable testimonial during Tucker Carlson’s show. Siegel said his 96-year-old father, suffering from symptoms of the virus and fearing he would die, made a full recovery thanks to the drug, hydroxychloroquine, and a course of antibiotics. “He got up the next day and was fine,” Siegel told an astonished Carlson. (Farhi and Izadi, 4/22)

Politico: New Jersey Lawmaker Bangs The Drum For Hydroxychloroquine
President Donald Trump’s push to put hydroxychloroquine at the forefront of his administration’s coronavirus strategy may be quieting down, but one of his biggest proxies in New Jersey is keeping up the fight. “Not only do I read the stories, I read the studies,” state Sen. Joseph Pennacchio, who is co-chairman of Trump’s 2020 campaign in New Jersey, told POLITICO on Wednesday. “The internet is a wonderful place,” he added, saying he’s discussed the issue with physicians. (Sutton, 4/23)

CNN: Hydroxychloroquine Study: New York Researcher Says Preliminary Results Are Ready, But State Hasn't Released Them 
In what's described as the largest study of its kind, New York researchers have submitted to the state health department preliminary results of their work looking at hydroxychloroquine, the drug President Trump has touted as a "game changer" in the fight against coronavirus. "We have reviewed several hundred medical records of Covid patients at this point in over 20 hospitals and done a preliminary analysis," David Holtgrave, the lead researcher, said Wednesday. Doctors and patients anxiously await the results of studies like this one to guide them toward the most effective therapies for Covid-19. (Cohen, 4/22)

The New York Times: Video: ‘What Do You Have To Lose?’ How Trump Has Promoted Malaria Drug
President Trump has pushed a malaria drug, hydroxychloroquine, as a treatment for coronavirus patients. A recent study found that patients taking it had higher death rates compared with those who did not. (4/22)

The New York Times: Risky Strategy Has Produced Wins For Democrats In Fights Over Pandemic Aid
In January 2018, Senate Democrats took a politically risky stand, shutting down the government to insist on protections for hundreds of thousands of undocumented immigrants. Gleeful Republicans saw the obstruction strategy as a huge blunder and pounded the Democrats, who caved after only a few days of sharp attacks and cut a deal to reopen. Times — and circumstances — have changed. Democrats have now blocked two consecutive coronavirus rescue packages pushed by Republicans and withstood withering criticism to win concessions — and hundreds of billions of dollars — they said were vital, including in the bill that passed the Senate on Tuesday and is slated to clear the House on Thursday. (Hulse, 4/23)

The Associated Press: House Expected To Send 4th Coronavirus Aid Bill To Trump
The House is reassembling to send President Donald Trump a fourth bipartisan bill to help businesses crippled by the coronavirus, an almost $500 billion measure that many lawmakers are already looking beyond. Anchoring the latest bill is a request by the administration to replenish a fund to help small- and medium-size businesses with payroll, rent and other expenses. (Taylor, 4/23)

The Washington Post: Republican Leaders Want Congress Back In Person, Contrary To Public Health Advice
Top Republican leaders said Wednesday they want Congress to return to business as usual amid the coronavirus pandemic — in effect bringing hundreds of lawmakers, aides and support staff back to Capitol Hill despite the warnings of public health officials that reopening parts of the country too soon could cause a spike in the deadly disease. The calls from prominent members of both the House and Senate echo rhetoric from conservative activists and some GOP governors who have advocated loosening social distancing guidelines after weeks of lockdowns and the disease’s devastating toll on the economy. (DeBonis and Kane, 4/22)

Politico: Pelosi Scraps Proxy Voting Plan After GOP Outcry
Speaker Nancy Pelosi is backing off a plan to muscle through a major rules change to the way House lawmakers vote during the coronavirus pandemic, and has announced a bipartisan task force to further study the issue before taking any action. Pelosi announced the sudden change of plans during a call with her leadership team Wednesday morning, saying she would no longer push to change House rules this week to allow members to vote by proxy after vocal Republican opposition. (Caygle, Bresnahan and Ferris, 4/22)

The Associated Press: Banks: New $310B For Small Businesses Likely Already Used Up
The more than $300 billion set aside to replenish the emergency loan program for small businesses impacted by the coronavirus pandemic is likely already all spoken for, banking industry groups said Wednesday. The initial $349 billion set aside for the Paycheck Protection Program ran out on April 16, after being available for less than two weeks. The Senate has approved an additional $310 billion for the program, which the House of Representatives is expected to vote in favor of later this week. (Sweet and Rosenberg, 4/22)

The Wall Street Journal: More Coronavirus Aid To Small Businesses Is Coming, But It Might Not Be Enough
Combined, the two tranches of money totaling $670 billion (including administrative costs) are designed to provide paychecks for the roughly 60 million workers in the small-business sector for about two months, a Treasury Department spokesman said. Small businesses are generally defined as companies with 500 or fewer employees, but special exemptions were made for certain sectors, including restaurants and hotel chains, triggering controversy. (Omeokwe, 4/23)

The New York Times: Banks Gave Richest Clients ‘Concierge Treatment’ For Pandemic Aid
The federal government’s $349 billion aid program for small businesses devastated by the coronavirus pandemic was advertised as first-come, first-served. As many business owners found out, it was anything but. That’s because some of the nation’s biggest banks, including JPMorgan Chase, Citibank and U.S. Bank, prioritized the applications of their wealthiest clients before turning to other loan seekers, according to half a dozen bank employees and financial industry executives who spoke on the condition of anonymity because they were not authorized to discuss the banks’ operations. (Flitter and Cowley, 4/22)

The Washington Post: How A Family-Owned Nebraska Bank Became A Leader On Coronavirus Loans
Ryan Wittmann was wrapping up his first full week of working from home when he noticed an instant message from his boss: “I think I’ve got a project for you.” It was Friday, March 27, in Lincoln, Neb., and Wittmann and hundreds of his colleagues were getting the hang of running Union Bank & Trust from their makeshift home offices. Wittmann was working at a card table in his basement. Others had commandeered space in their kitchens and laundry rooms. (Whalen and Merle, 4/22)

The New York Times: Harvard Won't Take Coronavirus Stimulus Money After Trump's Criticism
Harvard University announced Wednesday that it would not accept $8.6 million in taxpayer money that the university was set to receive as part of an emergency relief package for higher education, whose losses have been mounting during the coronavirus pandemic. The school’s decision came a day after President Trump criticized Harvard for receiving federal relief funds despite its large endowment, valued at $41 billion before the pandemic. “Harvard’s going to pay back the money,” he declared. (Hartocollis, 4/22)

The New York Times: ‘Staying Nimble’: How Small Businesses Can, And Do, Shift Gears
The first week after Cristina McCarter closed her Memphis food tour company, a casualty of the pandemic, she had only tears. “It was a lot of emotions,” she said. “It was like going back to when I first started and everyone said I was crazy to give up my job to be an entrepreneur. I was like, this is what my granddaddy was talking about.” But then, she had an idea. As Ms. McCarter saw restaurants in town reopen to serve takeout, she realized she could take her business, City Tasting Tours, virtual. (Haimerl, 4/23)

The Hill: Coronavirus Oversight Lags As Trillions In Relief Head Out The Door 
Democrats are struggling to monitor the Trump administration's handling of coronavirus relief funding at a time when Congress is poised to provide an additional $500 billion in emergency aid and watchdogs warn of massive fraud and abuse. While party leaders have demanded strict accounting of the trillions of dollars Congress has approved to address the pandemic, they’ve faced hurdles setting up oversight mechanisms, even as the massive outlays start flowing out the door. (Wong and Lillis, 4/22)

The Hill: Trump On Coronavirus Response Debt: 'We Had No Choice' 
President Trump said Wednesday that the U.S. “had no choice” but to pour trillions of dollars into fighting the coronavirus and its steep economic toll as Republican lawmakers raise concerns about its impact on the national debt. Trump said during a White House briefing Wednesday night that while he was worried about the climbing national debt, the unprecedented nature of the COVID-19 pandemic required a response of similar magnitude from Washington, D.C. (Lane, 4/22)

And McConnell says states who need more funding should consider other options beyond federal aid —

The New York Times: McConnell Says States Should Consider Bankruptcy, Rebuffing Calls For Aid
Senator Mitch McConnell took a hard line on Wednesday against giving cash-short states more federal aid in future emergency pandemic relief legislation, saying that those suffering steep shortfalls amid the coronavirus crisis should instead consider bankruptcy. “I think this whole business of additional assistance for state and local governments needs to be thoroughly evaluated,” Mr. McConnell, Republican of Kentucky and the majority leader, said in an interview with the conservative radio host Hugh Hewitt. “There’s not going to be any desire on the Republican side to bail out state pensions by borrowing money from future generations.” (Hulse, 4/22)

The Wall Street Journal: McConnell Supports Giving States Bankruptcy Access
On a syndicated talk radio show, Mr. McConnell, a Republican from Kentucky, floated the idea of opening bankruptcy as a potential option for states that have struggled with pension debt even before the public health crisis caused by the new coronavirus. The pandemic has battered local economies, causing steep declines in sales taxes, transit fees and other sources of municipal revenue. Bankruptcy protection “saves some cities, and there’s no good reason for it not to be available” to states, Mr. McConnell said. (Ferek and Gillers, 4/22)

The Hill: State Governments Face Financial Abyss With Coronavirus
State governments are staring at budget shortfalls that will substantially exceed what they faced during the great recession, even before the full scope of the economic damage caused by the coronavirus pandemic is known. Budget analysts, governors and legislative leaders around the country are already holding regular meetings to assess the damage, watching in real time as their revenue estimates fall short of worst-case scenarios mapped for a recession. (Wilson, 4/22)

The Associated Press: 26 Million Have Sought US Jobless Aid Since Virus Hit
More than 4.4 million laid-off workers applied for U.S. unemployment benefits last week as job cuts escalated across an economy that remains all but shut down, the government said Thursday. Roughly 26 million people have now filed for jobless aid in the five weeks since the coronavirus outbreak began forcing millions of employers to close their doors. About one in six American workers have now lost their jobs since mid-March, by far the worst string of layoffs on record. Economists have forecast that the unemployment rate for April could go as high as 20%. (Rugaber, 4/23)

Reuters: Record U.S. Jobless Claims Wipe Out Post-Great Recession Employment Gains
Though weekly jobless filings remain very high, last week’s data marked the third straight weekly decline, raising hopes that the worst may be over. Weekly claims appeared to have peaked at a record 6.867 million in the week ended March 28. Nonetheless, the report adds to a growing pile of increasingly bleak economic data. It also comes amid rising protests against nationwide lockdowns to control the spread of COVID-19, the potentially lethal respiratory illness caused by the virus. (Mutikani, 4/23)

Marketplace: Jobless Claims Jump Another 4.4 Million — 26 Million Americans Have Lost Their Jobs To The Coronavirus
The unfathomable spike in unemployment has likely pushed the jobless rate to between 15% and 20%, economists estimate. The only other time in American history when unemployment was that high was in the early stages of the Great Depression almost a century ago. (Bartash, 4/23)

The Wall Street Journal: Another 4.4 Million Americans Sought Unemployment Benefits Last Week 
“These unbelievable numbers are masking a lot of the true demand, and that’s what we’re going to continue to see play out over the next month,” said Maria Flynn, president of Jobs for the Future, a workforce development nonprofit. ... The number of workers receiving unemployment insurance continues to rise as states process applications. (Chaney and Guilford, 4/23)

CNN: Unemployment Benefits: Another 4.4 Million Americans Filed For Unemployment Benefits Last Week
Not all of those claims will result in benefits being paid. Some will be rejected because workers did not meet eligibility requirements. Even so, numbers at that level reflect a devastating blow to workers, indicating roughly 16.2% of the US labor force is suffering from layoffs, furloughs or reduced hours during the coronavirus pandemic. Early studies have shown lower-income workers are particularly affected by job losses, and minorities, specifically black and Hispanic families, are expected to bear the brunt of the economic cost of this crisis. (Tappe, 4/23)

Bloomberg: U.S. Jobless Claims At 4.43 Million In Labor Rout’s Fifth Week
Most states continued to see initial claims decline on an unadjusted basis -- a sign that layoffs could be slowing a bit. While several states reported declines in layoffs for the prior week, it’s unclear to what extent the figures reflect Americans still losing their jobs by the millions each week, or if people are getting through on jammed websites and phone lines to apply for benefits after weeks of attempts. (Pickert, 4/23)

Reuters: Americans Too Scared To Go To Work Risk Losing Unemployment Aid, Experts Say
U.S. workers who refuse to return to their jobs because they are worried about catching the coronavirus should not count on getting unemployment benefits, state officials and labor law experts say. Workers in a handful of U.S. states will face this situation this week, as state officials hope to revive economies paralyzed by shutdowns related to the epidemic. (Sullivan, 4/23)

The Wall Street Journal: Millions Of U.S. Workers Continue To Seek Unemployment Help Amid Coronavirus
Millions of Americans likely filed for unemployment benefits last week, reflecting the depth of the jobs crisis triggered more than a month ago by the coronavirus pandemic. About 5.2 million Americans applied for jobless benefits in the week that ended April 11, bringing the one-month total to more than 22 million. Economists expect a similar number filed in the most recent week that ended April 18. Claims, which are laid-off workers’ applications for unemployment insurance payments, are expected to have remained historically high last week. (Chaney and Guilford, 4/23)

The New York Times: The $600 Unemployment Booster Shot, State By State
Before the coronavirus, people receiving unemployment benefits in most states got, on average, less than half their weekly salaries. Now, as millions file claims, many are poised to receive more money than they would have typically earned in their jobs, thanks to the additional $600 a week set aside in the federal stimulus package for the unemployed. (4/23)

Las Vegas Review-Journal: DETR’s Added Call Center ‘Waste’ Of Money, Frustrated Jobless Say 
Las Vegas resident John Kim said he was “ecstatic” when he heard the state would set up a new call center to address questions on unemployment insurance claims. The former New Life Adult Day Health Care Center employee hadn’t been to work since March 20 and has yet to see any money from the unemployment program, despite filing his initial claim nearly a month ago. He hoped the new phone lines would allow him to finally have questions answered and get his claim sorted out.But the operator on the new phone line wasn’t able to explain to Kim why his payments weren’t going through or how long he would have to wait until he would see any of the money. The operator could only answer “general questions” on the filing process. (Schulz, 4/22)

Cincinnati Enquirer: Coronavirus In Ohio: Ohio Has Lost A Million Jobs During Pandemic
Ohio Gov. Mike DeWine and Lt. Gov. Jon Husted made the economic case Wednesday for allowing some businesses to resume operations next week. Husted said Ohio has lost 1 million jobs since the COVID-19 pandemic hit the state last month. At the beginning of March, there were 5.6 million Ohioans working. The biggest problem then, Husted said, was employers couldn't find enough workers. (Borchardt, 4/22)

The Wall Street Journal: VA Didn’t Publicly Acknowledge Shortages, Top Officials Say
The Department of Veterans Affairs was slow to publicly disclose the extent of mask shortages the department faced, as it dealt with an onslaught of coronavirus cases, top VA officials said this week. Secretary Robert Wilkie and the department’s official in charge of hospitals said the U.S. medical system has been inundated with Covid-19 cases since March, straining resources at the VA and all health systems nationwide. And yet, for weeks the VA told the public, employees and veterans that the department faced no problems and wasn’t rationing equipment. (Kesling, 4/22)

The Associated Press: VA Medical Facilities Struggle To Cope With Coronavirus
As she treated patient after patient infected with the coronavirus at a Veterans Affairs medical center in New York City, Heather Espinal saw stark warning signs. So many nurses had called in sick, she said, that the Bronx facility was woefully understaffed. It lacked specially equipped rooms for infected patients, she said, and didn’t have enough masks, gloves and other protective gear to guard against the spread of the highly contagious disease. (Casey and Yen, 4/23)

The Associated Press: Stopping Virus A Huge Challenge At Crowded US Meat Plants
Daily reports of giant meat-processing plants closing because workers tested positive for the coronavirus have called into question whether slaughterhouses can remain virus-free. According to experts, the answer may be no. Given that the plants employ thousands of people who often work side by side carving meat, social distancing is all but impossible. (Funk, 4/23)

The Associated Press: Tyson Foods Idles Largest Pork Plant As Virus Slams Industry
Tyson Foods suspended operations Wednesday at an Iowa plant that is critical to the nation’s pork supply but was blamed for fueling a massive coronavirus outbreak in the region. The Arkansas-based company said the closure of the plant in Waterloo would deny a vital market to hog farmers and further disrupt U.S. meat supply. Tyson had kept the facility, its largest pork plant, open in recent days over the objections of alarmed local officials. (Foley, 4/23)

CNN: Tyson Will Close Its Biggest Pork Plant After Workers Call Out Sick With Coronavirus 
Tyson Foods is closing its largest pork plant as a growing number of workers become ill from coronavirus infections. The plant, located in Waterloo, Iowa, had already slowed production because many of its 2,800 workers had been calling out sick. The Black Hawk County health department linked the Tyson plant to 182 of the county's 374 Covid-19 cases. Last week, Waterloo Mayor Quentin Hart called for the Tyson facility to be shut down. (Alcorn, 4/22)

The New York Times: Tight-Knit Company Towns Reel As Coronavirus Rolls Through
As soon as she heard about a cluster of coronavirus cases at the Tyson pork processing plant on the edge of Columbus Junction, Iowa, Cindy Johnston felt a ripple effect through her small community along the Iowa River. Ms. Johnston, who manages a Dairy Sweet burgers and ice cream shack, sent home four teenage employees because their parents work at the Tyson plant. Parents of other teenage workers were too afraid of potential infection to let their children report to work at Dairy Sweet. Then, she learned of the death of an employee at the Tyson plant; it was the father of a classmate of her son. (Searcy, 4/22)

Kaiser Health News: Biden Says OSHA Isn’t Doing Enough To Protect Workers’ From COVID-19
During an April 15 virtual town hall meeting with front-line workers, former Vice President Joe Biden, the Democrats’ presumptive nominee for the White House, was asked by a meat processing worker what he would do to protect workers like her from COVID-19. “We lost a co-worker at my plant because there is no regulation to protect meat chain employees,” said Safaa Elzakzoky, who is also a member of the United Food and Commercial Workers International Union. “We can’t work safely and get people the meat that they need to eat. So what would you do to protect a worker like my friend who just died?” (Knight, 4/23)

The New York Times: Vaccine Rates Drop Dangerously As Parents Avoid Doctor’s Visits
As parents around the country cancel well-child checkups to avoid coronavirus exposure, public health experts fear they are inadvertently sowing the seeds of another health crisis. Immunizations are dropping at a dangerous rate, putting millions of children at risk for measles, whooping cough and other life-threatening illnesses. “The last thing we want as the collateral damage of Covid-19 are outbreaks of vaccine-preventable diseases, which we will almost certainly see if there continues to be a drop in vaccine uptake,” said Dr. Sean T. O’Leary, a member of the American Academy of Pediatrics’ committee on infectious diseases. (Hoffman, 4/23)

The Washington Post: Coronavirus Patients Die Alone In Hospitals. This Family Chose Death At Home.
When it came time for the conversation about whether Carmelo Marchese should go to the hospital, his daughter didn’t tell him about her fears — that he’d be taken away in an ambulance and never see his family again. She didn’t mention the images on the news, of black body bags piling up outside hospitals, nor the images in her mind, of her father in one of those bags. She just told him what she thought was most necessary. That northern Italy’s hospitals were overloaded. That a 93-year-old, weakened already with fever, wouldn’t be prioritized. That his odds might be no worse at home. (Harlan, Pitrelli and Panella, 4/22)

Kaiser Health News: The Other COVID Risks: How Race, Income, ZIP Code Influence Who Lives Or Dies
It started with a headache in late March. Then came the body aches. At first, Shalondra Rollins’ doctor thought it was the flu. By April 7, three days after she was finally diagnosed with COVID-19, the 38-year-old teaching assistant told her mom she was feeling winded. Within an hour, she was in an ambulance, conscious but struggling to breathe, bound for a hospital in Jackson, Mississippi. (Szabo and Recht, 4/22)

Stat: Covid Phobia Keeping People With Heart Symptoms Away From ERs 
Stayc Simpson’s blood pressure readings are all over the place. Her heart rate is fluctuating wildly. After struggling with heart failure and coronary artery disease for 15 years, undergoing a double bypass, and living with an implanted pacemaker and defibrillator, she knows her numbers aren’t good. (McFarling, 4/23)

The New York Times: As Leaders Urge Face Masks, Their Behavior Muffles The Message
When Vice President Mike Pence descended onto the tarmac in Colorado Springs last Saturday, his first appearance outside the White House grounds in over a month, he was greeted by the Democratic governor of Colorado, Jared Polis, who was wearing a face mask emblazoned with images from his state flag. Mr. Pence tapped elbows with Mr. Polis, rather than offering a hand, but he kept his face uncovered, a decision in line with President Trump’s position: Mr. Trump said this month that he would not follow guidelines from his own Centers for Disease Control and Prevention and wear a face mask. (Karni and Astor, 4/22)

Boston Globe: Fighting Coronavirus With Sewing Machines, Volunteers Make Over 14,000 Face Masks And Counting 
During an average April, Boston designer David Josef would be up to his eyebrows in tulle, lace, and satin, fitting anxious brides and their mothers for their upcoming nuptials in elaborate frocks. This year his output is slightly less elaborate. The fabric is cotton, the sewing patterns are rectangular, and demand is through the roof. He’s turned his Waltham fashion studio into a small factory where he turns out hundreds of face masks a week. (Muther, 4/22)

The New York Times: Two Cats Are First U.S. Pets To Test Positive For Coronavirus
The first pets in the United States, two cats from New York State, have tested positive for the virus that is causing the worldwide pandemic, the Agriculture Department and the Centers for Disease Control announced Wednesday. The cats, from different parts of the state, are showing only mild symptoms and are expected to be fine. (Gorman, 4/22)

WBUR: Climate Change Worsens Effects Of Global Outbreaks Like Coronavirus, Expert Says
Today marks the 50th anniversary of Earth Day, a day traditionally dedicated to protecting the environment. This year, experts are grappling with a global coronavirus pandemic along with worsening climate change, and some believe the two problems are linked. (Mullins, 4/22)

WBUR: 'Crisis Schooling': Educators, Families Balance Learning And Wellbeing Amid Closures 
During the pandemic, parents like Pries are prioritizing emotional well-being over school work. For most Massachusetts schools, meeting kids' social and emotional needs is also a top priority. Many are under enormous stress to serve all of the needs of their community, from rigorous academic material, to mental health support and a source for food. And they're doing this all while faced with the new reality that schools across the state will be closed for the rest of the year. (Jung, 4/23)

The Wall Street Journal: Hospitals Aim To Resume Procedures Postponed By Coronavirus
Hospitals, clinics and surgery centers are moving tentatively to resume surgeries and other procedures that were halted when the coronavirus pandemic reached the U.S., a shift that could help stanch the sector’s financial losses but presents new risks to infection control and public health. (Evans and Gold, 4/22)

San Francisco Chronicle: Gov. Newsom Says California Hospitals Can Begin Scheduling Essential Surgeries After Halt Due To Coronavirus 
Gov. Gavin Newsom took his first small step toward loosening a month-old statewide stay-at-home order Wednesday, allowing hospitals to begin scheduling some elective surgeries again. But he cautioned that California would not be ready to end restrictions on other sectors of the economy without a massive increase in testing to track the spread of the coronavirus, despite growing pressure for him to provide a timeline for a broader reopening of the state. His comments came on a day California recorded the most deaths in a 24-hour-period: 118, according to data collected by The Chronicle from the state’s 58 counties. (Koseff, 4/22)

Houston Chronicle: Houston Hospitals To Start Phasing Back More Non-COVID-19 Care 
Most Texas Medical Center hospital systems Wednesday will begin phasing in 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)

Texas Tribune: Texas Abortions Resume After A Short Ban During The Coronavirus Pandemic
A ban on nearly all abortions in Texas during the coronavirus pandemic appears to be over, as clinics began offering the procedure again Wednesday and state lawyers ceded in a legal filing that there is no longer any "case or controversy." The near-total ban has been the subject of weeks of litigation — starting in late March when Gov. Greg Abbott postponed all surgeries not “immediately medically necessary” to preserve medical resources for coronavirus patients. Attorney General Ken Paxton said the ban extended to abortions, and the politically conservative 5th U.S. Circuit Court of Appeals largely sided with state officials. (Najmabadi, 4/22)

The New York Times: Texas Allows Abortions To Resume During Coronavirus Pandemic
During the weeks of legal wrangling that went all of the way to the Supreme Court, Texas had argued that abortion was like any other elective surgery, and should be delayed to preserve the personal protective equipment needed by medical workers exposed to the virus. Lawyers for abortion clinics said the state was using the pandemic to advance its own political agenda, and took the state to court. Abortion access in Texas swung wildly for a month, with clinics canceling dozens of appointments and rescheduling them days later, as the case bounced through the court system. (Tavernise, 4/22)

The Hill: Abortion Services Resume As Texas Loosens Restrictions On Elective Medical Procedures 
Abortion services appear to have resumed in Texas after Gov. Gregg Abbott (R) issued an order last week that took effect Wednesday allowing elective procedures to resume amid the coronavirus pandemic. The news comes after Abbot issued an executive order late last month that banned abortions as part of a general halt to all elective medical procedures amid the coronavirus pandemic. (Klar, 4/22)

The Guardian: Arkansas Can Enforce Surgical Abortion Ban Amid Pandemic, Federal Court Rules
A federal appeals court has allowed Arkansas to enforce a ban on most surgical abortions, as part of a state directive aimed at postponing medical procedures not deemed urgent during the coronavirus outbreak. The ruling from the eighth US circuit court of appeals in St Louis, Missouri, lifted a federal judge’s order which had allowed abortions to continue. The new ruling does not affect abortion induced through medication in the early stages of pregnancy, which is still allowed. (Glenza, 4/22)

Modern Healthcare: Front-Line Workers Face Pay Cuts Amid COVID-19 Crunch
Of all clinicians who expect compensation decreases, half expect their pay to decrease by more than 25%, according to Bain & Co.'s April 8-13 survey of more than 300 physicians and nurses, 60% of which are frontline hospitalists and emergency, intensive case and infectious disease providers and 40% are primary care doctors and other specialists. As hospitals lose revenue from canceled elective surgeries to protect patients and preserve supplies, additional pay cuts are likely in the coming months, which could spur closures or consolidation, analysts said. (Kacik, 4/22)

Boston Globe: Medical Workers Return To Work After Recovering From Coronavirus. But Are They Immune? No One Knows For Sure 
Lauren Detmer, a front-line worker at Massachusetts General Hospital, returned to a hero’s welcome after being isolated at home for three weeks with COVID-19. Forty of her colleagues in green scrubs and blue masks lined a hospital hallway at 7:30 a.m. and, when she rounded the corner, erupted into applause. But Detmer also finds herself in the center of a coronavirus medical puzzle: Are those who’ve recovered immune from future infections? Is COVID-19 like many other infectious diseases in that way? (Kowalczyk and McCluskey, 4/22)

San Francisco Chronicle: UCSF Sends Doctor And Nurses To Largest Native American Reservation, Hard-Hit By Coronavirus 
UCSF sent 21 health care workers - seven doctors and 14 nurses - Wednesday to treat patients in the Navajo Nation hard-hit by the coronavirus. UCSF-trained doctors working on the largest Native American reservation in the U.S. asked San Francisco colleagues for help as the outbreak strains the health care system. Navajo Nation, where around 175,000 people live spread over 27,500 square miles in New Mexico and Arizona, has recorded 1,206 COVID-19 cases and 48 deaths. By comparison, San Francisco, which has a population eight times as large in a much smaller area, has only 21 deaths. (Moench, 4/22)

Kaiser Health News: OSHA Probing Health Worker Deaths But Urges Inspectors To Spare The Penalties
The Occupational Safety and Health Administration has in recent weeks launched investigations into deaths of workers at 34 health care employers across the U.S., federal records show, but former agency officials warn that the agency has already signaled it will only cite and fine the most flagrant violators. The investigations come as health care workers have aired complaints on social media and to lawmakers about a lack of personal protective equipment, pressure to work while sick, and retaliation for voicing safety concerns as they have cared for more than 826,000 patients stricken by the coronavirus. (Jewett and Luthra, 4/22)

'Lost On The Frontline': Know of a health-care worker who died of COVID-19? KHN and The Guardian are documenting the lives of U.S. workers who succumbed during the crisis. These are the front-line health workers who risk their lives to care for the sick and keep our facilities running. Please share their stories here.

Boston Globe: These Nurses Hold Their Patients’ Hands And Erect A Critical Bridge To Loved Ones Now Heartbreakingly Out Of Reach 
For the COVID-19 patients they care for each day, 7 a.m. to 7 p.m. inside the intensive care unit at BMC, they have become essential lifelines to beloved grandfathers, to mothers and fathers worshipped by worried children. They have seen the desperation in family members’ eyes. They have heard the voices breaking with emotion. They have kids of their own, and the fear they see is palpable. And it’s close. So amid the widening pandemic, they wondered how to bridge that terrifying gap between their patients in their beds and their frightened families now so sadly out of reach. (Farragher, 4/22)

Modern Healthcare: Henry Ford Furloughing 2,800 Employees Due To COVD-19 Financial Fallout
Temporary furloughs of at least 2,800 employees have begun at Henry Ford Health System, a six-hospital integrated system based in Detroit that has been hit hard by the COVID-19 pandemic. Top executives at Henry Ford also have agreed to contribute 10% to 25% of their salaries to two employee relief funds, said officials in a statement Wednesday evening. (Greene, 4/22)

The Wall Street Journal: A Day In The Life Of A Doctor Treating Homeless People In The Age Of Coronavirus
At 10 a.m. on a recent day, Dr. Thomas Huggett squared his shoulders and waded into a crowd of homeless people at a dimly lighted shelter on this city’s West Side. Most were elderly or suffered from a variety of ailments that made them particularly vulnerable to Covid-19, the disease caused by the new coronavirus. His only protection was a thin surgical mask as he delivered an unusual pitch he has been making almost daily at different shelters. (Barrett, 4/23)

San Francisco Chronicle: Librarians In San Mateo County Use 3D Printers To Make Equipment For Health Care Workers
San Mateo County library staff are using the system’s 3D printers to make protective equipment for health care workers while branches are closed due to the coronavirus pandemic. About a dozen library staffers are using the system’s 17 3D printers to produce face shields and ear savers that will be given to the county to distribute to medical facilities, spokesperson Katie Woods said. (Kawahara, 4/22)

Cincinnati Enquirer: Coronavirus: OD Victims Charged With Violating Stay-At-Home Order.
Addiction experts who help those who use drugs question the effectiveness of citing a drug overdose victim with violating the state order. And they say the policy can be a setback during a years-long, no-end-in-sight opioid epidemic. (DeMio and Knight, 4/22)

Kaiser Health News: Coronavirus Crisis Opens Access To Online Opioid Addiction Treatment
Opioid addiction isn’t taking a break during the coronavirus pandemic. But the U.S. response to the viral crisis is making addiction treatment easier to get. Under the national emergency declared by the Trump administration in March, the government has suspended a federal law that required patients to have an in-person visit with a physician before they could be prescribed drugs that help quell withdrawal symptoms, such as Suboxone. (Galewitz, 4/23)

The New York Times: ‘Instead Of Coronavirus, The Hunger Will Kill Us.’ A Global Food Crisis Looms.
In the largest slum in Kenya’s capital, people desperate to eat set off a stampede during a recent giveaway of flour and cooking oil, leaving scores injured and two people dead. In India, thousands of workers are lining up twice a day for bread and fried vegetables to keep hunger at bay. And across Colombia, poor households are hanging red clothing and flags from their windows and balconies as a sign that they are hungry. (Dahir, 4/22)

The New York Times: Oil Collapse And Covid-19 Create Toxic Geopolitical Stew 
Iraq cannot afford to pay millions of workers and pensioners. Mexico’s grand plans to develop the country have been thrown into disarray. Ecuador is cutting government salaries, and Venezuela is on life support. Nigeria is seeking a nearly $7 billion emergency loan. The coronavirus pandemic and the collapse in oil prices it has caused have created a monstrous calamity for countries heavily reliant on oil production for their economic survival, and forced others to change policies that no longer make economic sense. (Gladstone, 4/22)

The New York Times: ‘This Government Is Lucky’: Coronavirus Quiets Global Protest Movements
Tear gas no longer chokes Hong Kong’s skyscrapers, while protesters’ tents in downtown Beirut have been dismantled. In Delhi, the odd plastic fork and tattered blanket are all that remain of the sit-in that once throttled one of the city’s busiest highways. Around the globe, the coronavirus pandemic has stilled the anti-establishment protests that erupted last year, bringing months of marches, rallies and riots to a sudden halt. Now, like everything else in the world, the protests face the unanswerable question of what happens next. (Wang, Abi-Habib and Yee, 4/23)

The Associated Press: North Korean Silence On Kim’s Health Bolsters Speculation
With North Korea saying nothing so far about outside media reports that leader Kim Jong Un may be unwell, there’s renewed worry about who’s next in line to run a nuclear-armed country that’s been ruled by the same family for seven decades. Questions about Kim’s health flared after he skipped an April 15 commemoration of the 108th birthday of his grandfather, North Korea founder Kim Il Sung. It’s North Korea’s most important event, and Kim, 36, hadn’t missed it since inheriting power from his father in late 2011. (4/22)

The Associated Press: 'We Are In Prison': France Opens Nursing Homes, Exposes Pain
For her first authorized visit in more than six weeks with her 80-year-old mother, Sabrina Deliry prepared a selection of their favorite tunes, among them Edith Piaf’s “La Vie en Rose.” Later, at the Paris nursing home where the mother has been agonizing in the solitude of her room, feeling imprisoned and miserable without the sun on her cheeks, the breeze in her hair or her daughter’s tender hugs, they listened to the French songbird together. (Leicester, 4/23)

The New York Times: Daily Aspirin Tied To Lower Risk Of Various Digestive Cancers
Regular aspirin use has been associated with a reduced risk for colorectal cancer. Now a review of studies has found that it may reduce the risk for several other digestive tract cancers as well. Researchers pooled data from 113 studies and found that daily aspirin use among people aged 40 to 75 was associated with a 27 percent reduction in the risk for colorectal cancer, a 36 percent reduction in stomach cancer, a 33 percent reduction in esophageal cancer, a 38 percent reduction in liver and gallbladder cancer, and a 22 percent reduction in pancreatic cancer. (Bakalar, 4/21)

CIDRAP: Sepsis Study Highlights Risks Of Overly Broad Antibiotic Treatment
A large new study of patients with sepsis has found that broad-spectrum antibiotics are frequently administered to patients not infected with antibiotic-resistant pathogens, and are associated with higher mortality in these patients. The study, published last week in JAMA Network Open, looked at data on more than 17,000 culture-positive community-onset sepsis patients in US hospitals and found that more than two-thirds received antibiotics targeting drug-resistant organisms like methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa.  Yet only in one in eight sepsis patients had resistant gram-positive or gram-negative organisms, respectively. Treatment with unnecessary broad-spectrum antibiotics was associated with a 22% increase in mortality. (Dall, 4/21)

JAMA Internal Medicine: Evaluation Of Medical Surveillance And Incidence Of Post-September 11, 2001, Thyroid Cancer In World Trade Center–Exposed Firefighters And Emergency Medical Service Workers
In this cohort study of 14 987 male Fire Department of the City of New York rescue/recovery workers, the overall age-adjusted incidence rate of thyroid cancer among the Fire Department of the City of New York World Trade Center–exposed cohort was significantly greater than the rate among demographically similar, non–World Trade Center–exposed men. This difference may be explained by the high rate of asymptomatic cancers detected among individuals from the Fire Department of the City of New York; in addition, the Fire Department of the City of New York found no thyroid cancer–specific deaths or metastatic disease. (Colbeth et al, 4/20)

Commonwealth Fund: New Survey Finds Americans Suffering Health Coverage Insecurity Along With Job Losses
More than 22 million people in the U.S. have filed unemployment claims since the beginning of the coronavirus economic shutdown in March. Since most people get health insurance through their own jobs or through a spouse or parent’s job, the question is: Just how many people in the U.S. have lost their insurance as a result of the pandemic? (Collins et al, 4/21)

The New York Times: C-Section Births May Increase Risk For Diabetes
Women born by cesarean section are at increased risk for Type 2 diabetes, according to a new study. The report, in JAMA Network Open, included 33,226 women born between 1946 and 1964, and followed for up to 25 years. More than a third were obese, and 6 percent had a diagnosis of Type 2 diabetes. Compared with women born vaginally, those born by C-section had an 11 percent increased relative risk for obesity and a 46 percent increased risk for diabetes. (Bakalar, 4/20)

The Washington Post: Georgia Leads The Race To Become America’s No. 1 Death Destination 
Whether you’re going to heaven or hell, the old joke goes, you’ll have to change planes in Atlanta. But Georgia Gov. Brian Kemp is proposing to offer a new nonstop service to the Great Beyond: He has a bold plan to turn his state into the place to die.Kemp, a Republican and an ally of President Trump, just called for the reopening within days of his state’s gyms, fitness centers, bowling alleys, body-art studios, barbers, nail salons, cosmetologists, aestheticians, beauty schools, massage therapists, theaters, private social clubs and dine-in restaurants. (4/21)

Atlanta Journal Constitution: When It Comes To His Pandemic Decision, Brian Kemp Is Who He Said...
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)

Dallas Morning News: The Success Of Gov. Abbott’s Plan To Reopen The Texas Economy Rests With What We Do In Our Cities And Counties
The decision to shut down the Texas economy was a tough call. Getting back to business safely is becoming an equally difficult decision. On Tuesday, Colleyville Mayor Richard Newton announced plans to relax stay-at-home orders and Dallas County Commissioners voted to extend Dallas County’s stay-at-home order until May 15, both acting before the expiration of the governor’s statewide shelter in place order at the end of April. It is essential that state and local officials work together and that timetables for reopening the Texas economy not devolve into a clash over local and state control. By law, Abbott has the legal last word over cities and counties, and he plans soon to issue a new executive order to reopen the economy and replace his statewide order to shelter in place with a phased-in process. (4/23)

Cincinnati Enquirer: DeWine's Stay-At-Home Order Is Unenforceable
At least 22 people in Hamilton County have been criminally charged with violating the stay-at-home order issued by Ohio Gov. Mike DeWine in response to the COVID-19 pandemic, according to news reports. However, enforcement of the governor's order via criminal charges would violate the constitutional principle enshrined in the 14th Amendment that persons not be deprived of liberty "without due process of law." (Michael Mannheimer, 4/22)

The New York Times: Who’s Behind The ‘Reopen’ Protests?
I first became aware of the political influence of Charles and David Koch in 2009 when I started looking into who was behind the protests at health care town halls. The Tea Party, formed after America elected its first black president, used a series of health care town halls to spur angry Republicans to oppose the Affordable Care Act as a socialist takeover of American medicine. Little matter that it was modeled on a plan devised by Mitt Romney, a Republican, when he was the governor of Massachusetts. (Lisa Graves, 4/22)

San Francisco Chronicle: Close Off Some Streets — For The Health Of The Public 
Oaklanders can now use the slow roads of the pandemic era to get some social distance from each other as they walk, run, cycle and roll — free from worry about being hit by a vehicle. Residents of San Francisco, San Jose and all other cities in the Bay Area deserve the opportunity to do the same. With streets suddenly empty — and with all of us now, more than ever, needing a bit of space — other mayors should follow Mayor Schaaf’s lead and show that, once again, the Bay Area is ahead of the curve in protecting the public’s health. (Robert Ogilvie, Harold Goldstein and Mary A. Pittman, 4/22)

Boston Globe: Boston’s Post-Pandemic Recovery Must Be Equitable
With coronavirus cases and fatalities surging to a peak this week, Boston is at a turning point. Our health care system is under strain as nurses, first responders, and doctors rush to save lives — with limited hospital beds, ventilators, and personal protective equipment. We are also in an economic free-fall that threatens to deepen inequities for the very communities who are overrepresented in infections and fatalities. (Michelle Wu, Julia Mejia, and Ricardo Arroyo, 4/22)

The New York Times: Covid-19 Threatens Global Safety Net
Having rampaged through the wealthier Northern Hemisphere, the coronavirus is expected to strike next in the poorer South, where many countries are far less equipped to cope with the medical and economic ravages. Fortunately, there are international organizations such as the International Monetary Fund and the World Health Organization to help with just such a contingency. Unfortunately, the Trump administration is hampering the work of these critically needed agencies. (4/22)

The Hill: COVID-19 Public Health Orders Should Not Target Asylum Seekers
The recent move to expel 10,000 asylum seekers from U.S. Customs and Border Patrol (CBP) facilities at the U.S.-Mexico border is no act of generosity. These individuals, families and children have left violence and poverty behind them and furtively travelled thousands of miles seeking safety and opportunity in the U.S. For them, there is no way forward, and no way back. (Orit Abrahim and Dr. Paul Spiegel, 4/22)

The Wall Street Journal: A Coronavirus Vaccine: Faster, Please
Covid-19 cases, hospitalizations and deaths are leveling off in hot spots like Seattle and New York. New infections should soon begin to decline, and many parts of the country will be able to start a phased return to “normal.” Yet without a vaccine, normality will look very different than it did before the pandemic. The medical community and the public are hungry for news about vaccines, but accounts of progress have been exaggerated. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and senior member of the White House coronavirus task force, has put into perspective the overly optimistic predictions of a vaccine available within the target of 12 to 18 months: “A vaccine that you make and start testing in a year is not a vaccine that’s deployable.” There is a world of difference between testing a vaccine candidate and millions of people lining up for a shot. Clearly, there is a sense of urgency. What, then, is standing in the way of the rapid deployment of a vaccine? (Henry I. Miller, 4/22)

The Washington Post: 7 Things The Administration Is Getting Wrong About Testing
Over the past week, members of the Trump administration have issued justifications for why the United States does not need mass covid-19 testing. Here’s what they get wrong:We don’t need mass testing to reopen the country. Actually, we do. Reopening depends on our ability to transition from population-wide mitigation — which is what social distancing does — to individual-level containment. That means we must identify each individual with covid-19 and then trace and quarantine their contacts. This requires mass testing. In addition, one of the White House’s guidelines for reopening the country is a downward trend in infections. We can’t know that the numbers are going down unless we have an accurate daily count, which can only be obtained through widespread testing. (Leana S. Wen, 4/22)

Los Angeles Times: This California Town Has The Coronavirus Testing Program We Need 
It’s galling that celebrities, professional athletes and politicians without symptoms were able to use their connections and wealth to score COVID-19 tests early in the pandemic, when physicians and hospitals didn’t have enough to go around for the sick patients who probably did have the disease. For that reason, some people might feel irritated with one Northern California community that launched a large-scale, self-funded effort Monday to test all of its residents, sick or not. But don’t hate Bolinas, the unincorporated west Marin County seaside community in question. This is a case not of rich people bogarting a scarce supply of tests, but of a historically civic-minded community (whose residents are not all wealthy, by the way) leveraging its resources to do us all a favor. (4/23)

The Hill: The Troubling Realities Of Slow COVID-19 Testing 
Many Americans are already aware that, in the initial weeks of the COVID-19 crisis, our nation failed to test broadly. The implications of this grave error will only become clearer with time. Meanwhile, some public officials seem to believe that the country’s testing problems have since been resolved. On the contrary, COVID-19 testing remains a significant and troubling bottleneck. (Dr. Maggie Salinger and Dr. Kathleen Pollard, 4/22)

Boston Globe: Uncomfortably Numb. 
The numbers are numbing. Every day, the grim tallies rise. Not along a steady incline, which would be bad enough, but by jarring, exponential leaps unthinkable just a few weeks ago. After a certain point, do most of us fully register the lives behind the statistics? Ted Monette, Barbara Levine, Fred Harris, Julio Quintanilla, Larry Rasky. Can the will to remember outlast the fear of the moment? Or do we detach, in the interests of self-preservation — or of something darker? (Yvonne Abraham, 4/22)

Atlanta Journal Constitution: Thinking Of The Vulnerable Amid COVID-19
These past few weeks have been unprecedented times for all Americans. The fear and unknowns generated from this novel coronavirus have left many feeling scared, isolated, and alone. With new information and guidelines continually being produced by the CDC, WHO and other health organizations, it is difficult to feel stable physically, mentally, and emotionally. But not all of us have borne this burden equally. In fact, just like many things in America, the impact of this event has fallen hardest on populations that are often afterthoughts in our society: the homeless, the poor, the elderly, the undocumented, asylum seekers, and prisoners. (Marshall Waller, 4/22)

The Washington Post: To Help Immigrants Who Won’t Get Stimulus Checks, An Online Effort Asks People To Give Up Their Own
The emails that have appeared lately in Brandon Wu’s inbox contain words such as “afraid” and “worried” and “please.” They are from and on behalf of immigrants. One tells of an undocumented immigrant from Brazil who has worked for more than 15 years in the country and is now unemployed because of the pandemic. Another describes a 9-year-old girl who has seen both her parents lose their jobs and worry about how they’re going to pay May’s rent. “I’m running out of money and i don’t know what can i do,” reads one of the emails. People are suddenly turning to Wu, a 38-year-old D.C. resident, for help because his name appears on a GoFundMe campaign that aims to do for Washington-area immigrants and their families what the federal government is not: get economic stimulus money to them. (Theresa Vargas, 4/22)

The Wall Street Journal: Lockdown Is A Stress Test For Relationships
The Covid lockdown has been a harsh experience for one of my patients, a young professional woman. Isolated with her family in their second home, outside New York City, she has gotten in touch with her resentment of and dissatisfaction toward her husband. The stress of being confined together has made her aware that he is consumed with his work, has difficulty connecting emotionally, is uninterested in physical intimacy, and is an unreliable father to their two children. She might have come to many of these conclusions eventually, but the pressure of being together 24/7 at least accelerated the process. Being alone together has become a stress test for marriages and other intimate relationships. (Erica Komisar, 4/22)

The Washington Post: Covid-19 Is Posing Serious Questions About Cancer Treatment. There Are No Easy Answers. 
As covid-19 continues its assault on New York, the medical community has redeployed its forces to buffer health-care workers on the front lines. Half of my co-fellows, who were caring for cancer patients at our New York hospital just days ago, have been deployed to support our heroic intensive care, emergency room and medicine colleagues treating patients infected with the disease. Those of us remaining have assumed their clinical responsibilities, sharing the enlarged burden of patient care both in and out of the hospital. We are facing serious, unresolved questions about how to practice oncology in the covid-19 world. (Bobak Parang, 4/22)

CNN: Loneliness Is A Petri Dish For Depression...But You're Not Alone
2020 wasn't supposed to be like this. It was going to be, I told myself, the year I rebooted my life. Less stress and a clearer mind, a better attitude and bigger dreams. Back -- shudder -- to dating. This was finally going to be the year, as Dolly Levi would say, when I rejoined the human race. (Jack Gray, 4/22)

Boston Globe: Massachusetts’ Untapped Pool Of Foreign Health Care Professionals 
Long before the coronavirus pandemic hit, there was already a critical need for medical personnel in underserved communities — and overly burdensome requirements for foreign-trained medical professionals who could be filling the gaps. Now states like Massachusetts, New Jersey, and New York are taking emergency measures to ease the strain put on front-line health care workers during the crisis. (4/22)

CNN: Denver Opened Up In 1918 Pandemic To Deadly Results 
Politicians were feeling pressure during the pandemic. Businesses were agitating to reopen and deaths were going down, especially far away from the coastal cities that it had hit worst, first. It seemed time to declare "mission accomplished" and get the economy humming again -- especially with an election looming. It was 1918 and Denver Mayor William Fitz Randolph Mills bowed to business leaders and decided to back off social distancing. (John Avlon, 4/22)