Overnight Health Care: US braces for COVID-19 ‘slow burn’ | Packed crowds spark pandemic alarms as states reopen | White House announces move to cap insulin costs for seniors

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Welcome to Tuesday’s Overnight Health Care.

The U.S. is on the verge of passing 100,000 deaths from COVID-19. But as states continue to lift restrictions, experts are concerned that people are not going to be following guidelines for physical distancing, particularly in outdoor public spaces.

In non-COVID news, the White House has a plan to cap insulin costs for seniors.   

We’ll start with some coronavirus news, and a look at where we go from here:

US braces for COVID-19 ‘slow burn’

The coronavirus outbreak in the United States is not likely to get significantly better any time soon. Instead, get ready for a slow burn followed by a possible spike in the fall and winter. 

As the country passes the grim milestone of 100,000 deaths, experts say the pace of harm might be slower in the coming months, but there is unlikely to be a steep drop-off in the virus. There even could be some significant upticks as restrictions on businesses and movement are eased around the country. 

Risk looms even higher in the fall and winter, as experts expect a new spike in cases of the virus as the weather gets colder, combined with the added damage from flu season. 

Counter-acting forces: Warmer weather could help, but reopening will push cases higher. 

William Schaffner, an infectious disease expert at Vanderbilt University, said the net effect of these opposing forces is not yet clear but “I would be surprised if there were a substantial decrease” in cases.

Read more here

Packed crowds spark pandemic alarms as states reopen

You’ve probably seen the photos of crowded partiers at the Lake of the Ozarks or other locations over the holiday weekend. Experts are alarmed too, not just people on social media. 

“I am concerned that there are people who think this is the all clear, and I think what we really need to be doing is defining a new normal,” President TrumpDonald John TrumpMulvaney: ‘We’ve overreacted a little bit’ to coronavirus Former CBS News president: Most major cable news outlets ‘unrelentingly liberal’ in ‘fear and loathing’ of Trump An old man like me should be made more vulnerable to death by COVID-19 MORE‘s former Food and Drug Administrator Scott Gottlieb said on CNBC Tuesday. 

Memo Cedeno Laurent, a research associate at the department of environmental health at the Harvard T.H. Chan School of Public Health, said the reopenings should not be a call for people to drop their guards.

Any setting where people are in close contact without masks, even outdoors, raises the potential for COVID-19 transmission, he said. 

Read more here.

White House announces deal to cap insulin costs for seniors

Most seniors on Medicare plans will pay no more than $35 for a month’s worth of insulin under a new agreement reached by insurers, drug manufacturers and the Trump administration. 

More than 1,750 Medicare Part D drug plans and Medicare Advantage plans will cap the cost of insulin copays at $35, saving enrollees an average of $446 per year, according to the Centers for Medicare & Medicaid Services (CMS). 

CMS expects plans that cover the new benefit will be available in all 50 states, Washington, D.C., and Puerto Rico, with open enrollment beginning Oct. 15 and ending Dec. 7. 

The politics: The announcement Tuesday comes as polls show support for President Trump is slipping among seniors as anxiety over COVID-19 and Trump’s handling of the crisis grows. COVID-19 is disproportionately killing seniors, particularly those living in nursing homes. Polls also have shown high drug costs are a top issue for voters in 2020.

Read more here

DC reopening could start Friday

Washington, D.C., Mayor Muriel Bowser (D) said Tuesday that the city is on track for its gradual reopening, despite a spike in the number of coronavirus cases on Saturday. 

The mayor reported at her daily press conference that 109 new cases were recorded by the city on Memorial Day, a decrease from Sunday’s 115 new cases and Saturday’s 144 new cases. D.C. has documented a total of 8,334 positive cases, according to the city’s health department.

The increase in new cases on Saturday was “outside the expected ups and downs,” Bowser added.

“This morning, we reported that we are now at 13 days of sustained decline, which means that if the trend holds we will be able to report 14 days of decline tomorrow,” she said.

Bowser said the city could still begin its reopening on schedule on Friday, which she will announce Wednesday. 

Read more here

Our colleague Reid Wilson dives into the numbers: Virus center moving from Northeast to Midwest

The United States confirmed 156,795 new coronavirus cases last week. Put that into some perspective: That means we had more new cases in the space of seven days than any country other than Brazil, Russia, the United Kingdom, Spain, Italy, France, Germany and Turkey have confirmed — in total.

The statistics show the outbreak is still a Northeastern phenomenon, but it’s moving more to the Midwest. The 12 Midwestern states make up about 21 percent of the nation’s population, but they accounted for 27 percent of the new cases last week. The nine Northeastern states make up 17 percent of the country’s population, and almost 24 percent of the new cases last week — still high, but a number that has come down substantially as case counts in New York, New Jersey, Connecticut and Massachusetts fall from their daunting peaks.

Southern states confirmed 42,554 new cases last week, and case counts are growing week over week in Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, South Carolina and Tennessee. But the 13 Southern states make up 35 percent of the nation’s population and 27 percent of new cases.

The Mid-Atlantic continues to be troubling. Maryland and West Virginia showed week-over-week case increases, and Virginia has lagged far behind in testing capacity, raising questions about just how many cases the Commonwealth have been missed. Those three states plus Washington, D.C., and Delaware account for just 3 percent of the population, but 6.6 percent of the new cases.

Western states are doing best, despite a spike in California. States that touch the Pacific have 16 percent of the population, and just 10 percent of new cases.

Some good news: Alaska has gone 19 days without recording a single COVID 19-related death. Hawaii’s streak is at 22 days, and Montana’s is at 26 days. Vermont has gone a little more than a week without a single death.

New York is still experiencing more new cases than any other state, 11,309 last week. But that’s a really positive trajectory, sitting at about 1/6th the number of weekly new cases the state was confirming at its peak in early April.

What we’re reading

Fears of coronavirus second wave prompt flu push at U.S. pharmacies, drugmakers (Reuters)

Dow soars 530 points on big hopes for a vaccine and the economy’s reopening (CNN)

Boris Johnson’s chief adviser Dominic Cummings says he ‘doesn’t regret’ 260-mile lockdown trip (CNN)

Hunger program’s slow start leaves millions of children waiting (New York Times)

State by state

New York Governor Andrew CuomoOvernight Health Care: US braces for COVID-19 'slow burn' | Packed crowds spark pandemic alarms as states reopen | White House announces move to cap insulin costs for seniors 1Andrew CuomoCuomo rings bell as NYSE reopens to big gains The Hill’s Morning Report – Presented by Facebook – US death toll nears 100,000 as country grapples with reopening Watch Live: New York Gov. Andrew Cuomo gives coronavirus update MORE says “you’re going to see pain” as economy reopens (CBS News)

Parson moving Medicaid expansion vote to August (St. Louis Post-Dispatch)

Coronavirus in Illinois: First week-over-week drop in deaths reported (WGN

Op-eds in The Hill

Right-sizing American health care: A potential silver lining to COVID-19

Is defunding the WHO really just a backdoor attack on sexual and reproductive health?

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