Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.
Five Supreme Court justices signaled Tuesday that they are not likely to strike down the entire Affordable Care Act, even if the court strikes down the “individual mandate” that now has no enforcement anyway.
One of the four issues the Supreme Court is considering is whether Congress invalidated the entire Affordable Care Act when in 2017, it zeroed out the penalty for failing to obtain health insurance. The court ruled that the penalty was a tax, and the U.S. Court of Appeals for the 5th Circuit later ruled that since it no longer “produces at least some revenue” for the federal government, it was not constitutional.
Look at these statements from two justices on the conservative side of the court:
Justice Brett Kavanaugh: “It does seem fairly clear that the proper remedy would be to sever the mandate provision and leave the rest of the law in place.”
Chief Justice John Roberts: “Congress left the rest of the law intact when it lowered the penalty to zero.”
After the hearing, President-elect Joe Biden said, “Americans are more united on this issue today than divided. … This does not need to be a partisan issue, it is a human issue.” He said if the court struck down the act, women could be charged more for health care than men, people with common conditions such as high blood pressure or asthma could be denied care and seniors would likely see higher drug prices.
Biden said, beginning Jan. 20, his administration would “protect your health care like I would protect my own family.”
If the court nullified the Affordable Care Act, one serious question might be if having been exposed to the coronavirus counts as a preexisting condition that insurance companies could consider before providing insurance.
The Urban Institute calculated what it says would happen if the Supreme Court struck down the act:
An additional 21.1 million people will be uninsured, a 69 percent increase nationally.
Medicaid/CHIP coverage (acute care for the nonelderly) will decline by 22 percent nationally, or 15.5 million people.
The number of people with individually purchased (nongroup) insurance will fall by 7.6 million.
The Urban Institute also says hospitals, which are already struggling with finances during the pandemic, would see significant financial losses without the Affordable Care Act:
Relative to current levels, hospital revenues will be hardest hit in:
California ($10.4 billion decrease)
Florida ($3.8 billion decrease)
Louisiana ($1.7 billion decrease)
Kentucky ($1.7 billion decrease)
New Mexico ($1.1 billion decrease)
Arkansas ($836 million decrease)
Idaho ($600 million decrease)
Montana ($503 million decrease)
Because of the 69 percent increase in uninsurance, the demand for uncompensated care will rise by 74 percent, or $58 billion.
The winter spike has begun
“We have legitimate reason to be very, very concerned about our health system at a national level.” That’s how Lauren Sauer, an assistant professor of emergency medicine at Johns Hopkins University who studies hospital surge capacity, summed up where we are right now.
When the pandemic began to spread in the U.S., surges in hospitalizations created emergencies, mostly in the Northeast and Southern states. Now, it is far more widespread.
The charts are more than just concerning. A recent study draws a direct link between hospitalizations — especially intensive care unit hospitalizations — and the number of COVID-19 related deaths that follow a week or so later. The study found that a 1% increase of COVID-19 patients in a state’s intensive care beds leads to about 2.8 additional deaths over the next seven days.
In El Paso, the county judge says his community will need at least four more refrigerator trailers to store bodies of people who have died from COVID-19. That is in addition to the four already filling now. El Paso expects at least 20 deaths per day for the next two or three weeks, according to KFOX. The county officials said some of the mobile morgue trucks will be moved to funeral homes that are overflowing.
While officials haven’t pinpointed a single cause for the recent surge in cases, El Paso Mayor Dee Margo said in late October that many infections have been attributed to community spread and residents letting their guard down.
A previous analysis by local officials of more than 2,000 cases over two weeks in October found that “37% of our positives were from visiting large big-box stores, 22.5% were restaurants, and 19% were travel to Mexico,” the mayor had said.
About 10% were attributed to parties and reunions, 7.5% were from gyms and 4% were due to large gatherings.
Senate proposes no pay raise for federal employees, budget clock ticking
The 2021 appropriations bill that Senate Republicans released this week includes a pay freeze for civilian employees. President Donald Trump proposed a 1% raise. Now, Congress has four weeks to settle that and a million other budget issues before the current budget expires Dec. 11.
The lame-duck Congress must pass either a second temporary stopgap agreement or a complete omnibus spending package to avoid a government shutdown next month. (See the bills released this week.) The federal government employs around 2 million civilians (not including the U.S. Postal Service or the military).
Airlines are adding flights
Even while COVID-19 cases are exploding in parts of America, airlines are adding flights, lots of flights, in anticipation of an increase in travel in a couple of weeks.
United Airlines is adding 1,400 flights for Thanksgiving week. JetBlue is also adding flights that week. United says it expects Thanksgiving week will be the busiest it has seen since the pandemic began.
By comparison, however, the Transportation Security Administration has only screened about a third of the number of travelers this quarter compared to a year ago.
Will movie theaters survive?
When Pfizer announced it may have a successful vaccine on the way, movie theaters saw their first glimmer of hope in months. Wall Street jacked up stocks for theater companies but, keep in mind, it may be late next year before most people are vaccinated.
“We have not heard good news for a while, and this is unqualified good news,” says Rich Gelfond, CEO of Imax Entertainment. “This is potentially a game changer. It gives us greater clarity about when and how this pandemic may end.”
Variety added some context to ballast that quote:
Box office revenues have plummeted since COVID-19 first started spreading in the United States last winter. While cinemas in 48 states have reopened, many are still digging out from a very deep hole after being closed for much of the spring and summer and theaters in Los Angeles and in New York City remain shut. Some are teetering on the verge of insolvency, with the National Association of Theatre Owners (NATO) predicting that as many as 70% of small to mid-sized theaters are facing bankruptcy by early next year without some kind of federal assistance. That kind of lifeline may be hard to secure given that stimulus talks have largely broken down and Congress is now entering a lame duck session when legislation tends to grind to a halt.
The bigger question may be whether the movie companies are willing to release their top-dollar films like “F9,” “Black Widow,” and “No Time to Die” — all sequels to popular films that have moved into 2021 — if they don’t know that theaters can sell enough seats and people will actually attend.
One-fourth of COVID-19 cases are in colleges, and students are heading home soon
You probably have seen the images of Notre Dame students rushing the football field this weekend after upsetting No. 1 Clemson. Notre Dame President Rev. John I. Jenkins chastised students for violating the school policies on gatherings and the school is requiring students to all get tested for COVID-19. The school sent a text to students with a “get tested or else” message:
Because we are now even more concerned about the potential for contagion to your home communities as you prepare to travel home at the end of the semester, the University will place a registration hold on the record of any student who fails to appear for testing when asked to do so. A registration hold would mean you are unable to matriculate or register for classes next semester or receive a transcript.
Furthermore, you may not leave the South Bend area until you receive the results of your exit test. Again, should we discover that you have left the area, we will place a registration hold on your record.
Notre Dame’s final exams begin next week, then students start heading home. Experts say there is potential that those students will bring the virus home with them. Universities have been virus epicenters, along with jails and prisons and nursing homes. Notre Dame has recorded more than 1,200 cases.
Colleges and universities have been doing a lot to try to manage COVID-19 cases, but last week a New York Times survey found we crossed the threshold of a quarter of a million cases that can be attributed to colleges — and that number is likely underreported. Roll over the Times’ tracking map to see the data that Times researchers have gathered school by school. You will see that states with big recent upticks in cases among the general population have seen those numbers mount in the school population as well.
College populations added 38,000 new cases over the last two weeks.
National Geographic dives into the story at the other end of the pool. It profiles some colleges that have had almost no COVID-19 cases to find out how they have been able to escape infections. NatGeo says at least 74 of the 1,588 schools that report COVID-19 data have recorded no cases:
The NatGeo story includes some interesting insights about why it is so difficult to control the virus on campuses. Universities spend a lot of energy trying to connect students to become a community quickly after they arrive on campus, but those close-knit communities cause big problems in a pandemic:
Superspreader events, like fraternity parties, might include only a few dozen students, but they can have an outsized domino effect. In society at large, superspreader events can spark infections in communities. As few as 10 percent of infected people are responsible for spreading 80 percent of cases. In colleges, that effect is amplified by a formerly positive trait: the interconnectedness of campus life.
Almost all students are connected by a shared classmate, says Kim Weeden, a social science professor at Cornell University. At a mid-size school like Cornell, 92 percent of the student body is connected by three degrees of separation or fewer, according to a study by Weeden and Benjamin Cornwell, the chair of sociology at Cornell.
The schools that have been most successful have several things in common. They have significant health infrastructure, clearly told students how to stay safe and what to do if they suspected they might have been infected and communicated strong messages about expected behavior.
The times in which we live
Lines of cars snaked around empty parking lots as people in DuPage County, Ill., just west of Chicago, waited for COVID-19 tests Monday.
The COVID-19 death toll in Illinois has crossed 10,000, and the preliminary seven-day statewide test positivity from Nov. 1 to Nov. 7 is 12%. pic.twitter.com/2e8ZsEIDra
— CBS Evening News (@CBSEveningNews) November 10, 2020
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