The Pandemic Has Been a Death Knell for Some Hospitals
For all of the hardships that hospitals have endured this year—horrific losses of life, a shortage of beds and personal protective equipment (PPE), staffers burned out from working overtime—the financial struggles are not immediately obvious.
“In most industries, if there's a line of customers out your door, it means business is good,” says my colleague Emily Barone, who specializes in data reporting. But she kept noticing news stories about U.S. hospital closures in recent months. “I thought it a bit strange,” she says, “so I wanted to explore why hospitals were suffering financially.”
What she found was perhaps counterintuitive. Hospitals across the country took a financial blow when the pandemic hit—many paused lucrative elective surgeries, while those slammed with coronavirus patients faced costs related to PPE, labor and treating the disease itself. But while well-off hospitals have been able to weather the storm (and in some cases even prosper), the pandemic could force many to close, especially those in rural counties that were struggling even before the outbreak.
The problem is in part tied to how the U.S. healthcare system works. Rural hospitals are more likely to treat patients on government programs like Medicare and Medicaid (or who don’t have insurance at all), who bring in less money than those on more expensive private insurance. “If a hospital is efficient, it can make money on Medicare, but it usually breaks even,” Nancy Kane, adjunct professor in the department of health policy and management at the Harvard T.H. Chan School of Public Health, told Emily. “The secret to financial success is having privately insured people.”
Understaffed and overwhelmed by the costs of caring for coronavirus patients, 15 rural medical facilities have shuttered this year so far, leaving nearby residents without easily accessible care. That’s especially alarming given that the U.S. is facing a third wave of COVID-19 that, so far, is mostly concentrated in rural states, while flu season is also getting underway.
“In the most rural parts of the country, there is a much higher risk that a hospital closure will leave a health-care void in the community, which is a disconcerting thought in normal times, and a terrifying one in a pandemic,” Emily says.
More than 40.7 million people around the world had been diagnosed with COVID-19 as of 1 a.m. E.T. today, and more than 1.1 million people have died. Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
On Oct. 20, there were 387,768 new cases and 6,585 new deaths confirmed globally. Here's how the world as a whole is currently trending:
Here is every country with over 500,000 confirmed cases:
Two new studies from England and the U.S. found that a smaller share of hospitalized COVID-19 patients are dying than earlier in the pandemic. The improvements are apparent across all ages, racial groups and even in people with underlying conditions, NPR reports. Several factors are likely driving down the death rate, including new drugs and therapies, mask-wearing (which may reduce how much virus a person receives) and keeping hospitals below their maximum capacity.
The Czech Republic was once a model country for handling the coronavirus—it was among the first to mandate masks, and until recently had comparatively low numbers of cases and deaths. But soon after it ended the mask mandate and other rules, cases began to skyrocket; the country has now reported nearly 194,000 positive tests. Czech leaders have since reinstituted the mask mandate and limited travel across the country through Nov. 3 in an effort to stop the spread, CNN reports.
After being closed to foreign tourists for about half a year, Thailand opened its borders to a group of visitors from China this week, the New York Timesreports. The travelers were directed to quarantine for two weeks at a Bangkok hotel. Thailand hopes to soon allow visitors from other countries where the virus is also well controlled, like Australia, New Zealand, Japan and South Korea. Restarting tourism is essential to Thailand’s economy, which shrank by 12% in the second quarter of 2020.
The Situation in the U.S.
The U.S. had recorded more than 8.2 million coronavirus cases as of 1 a.m. E.T. today. More than 221,000 people have died. Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
On Oct. 20, there were 60,315 new cases and 933 new deaths confirmed in the U.S. Here's how the country as a whole is currently trending:
As coronavirus cases rise across the U.S., the decision of whether to pass another federal stimulus package looms large. As negotiations between congressional Republicans and Democrats continue, Senate Majority Leader Mitch McConnell yesterday privately warned the White House against green-lighting the Democrats' $2 trillion stimulus deal before the election, the AP reports. U.S. President Donald Trump wants a deal to happen soon, so that he can put his name on another round of payments to Americans before Election Day.
All Boston public schools will go remote starting tomorrow as cases rise across the city, officials there have announced. “We have said all along that we will only provide in-person learning for students if the data and public health guidance supports it, and this new data shows that we are trending in the wrong direction,” Boston Mayor Marty Walsh said in a statement. Boston’s seven-day average positive test rate is 5.7%; in-person learning for most students will resume only after that figure falls below 4% for two straight weeks. Students with special needs, those experiencing homelessness and other vulnerable groups that had previously been allowed to return to school in person will be the most affected by the decision.
All numbers unless otherwise specified are from the Johns Hopkins University Center for Systems Science and Engineering, and are accurate as of October 21, 1 a.m. E.T. To see larger, interactive versions of these maps and charts, click here.
WHAT ELSE YOU SHOULD KNOW
The Ethical Quandary of Intentionally Infecting People
After U.K. researchers announced plans yesterday to purposefully infect volunteers with the virus in an effort to test various vaccines, my colleague Alice Park dug into the ethical controversies surrounding the so-called “challenge trials”—and their potential promise. Read more here.
Remembering Julie Davis, a Teacher Who Died of COVID-19
It started with a headache for Julie Davis, a 49-year-old third-grade teacher in North Carolina. But COVID-19 claimed her life 10 days later. "She loved with her entire heart…she would go out of her way for anyone," Davis’s daughter told TIME. Read more here.
Could Obesity Thwart a Vaccine?
Given that obesity hampers the immune system, researchers are increasingly concerned that a coronavirus vaccine may be less effective in people suffering from the condition. But obesity is also a risk factor for severe COVID-19, meaning some of those who are most vulnerable could receive less protection, Nature reports. Read more here.
The Virus Can Kill Your Sense of Smell. That’s More Devastating Than It Sounds
In a story for Vogue, one writer recounts what it was like to lose her ability to smell—the most “underappreciated and misunderstood” of the senses— after contracting COVID-19, and how her life changed when it returned. Read more here.
Thanks for reading. We hope you find the Coronavirus Brief newsletter to be a helpful tool to navigate this very complex situation, and welcome feedback at coronavirus.brief@time.com.
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Today's newsletter was written by Mandy Oaklander and edited by Alex Fitzpatrick.
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