Washington Policy Analyst Ed Mills and Healthcare Policy Analyst Chris Meekins share their expectations for what may unfold over the next two weeks.
We fully expect some travel restrictions. They will likely start at limited airports in areas where the outbreak is most prevalent, but could then move nationwide. This will likely happen in different waves with some air travel, then all air travel, then mass transit, then ride sharing, then possibly even some auto (though we think that is unlikely right now).
What we are seeing in France may come here in areas of community spread. The closure applies to restaurants, cafes, cinemas and nightclubs as well as nonessential businesses. Things are escalating quickly and will continue to do so. We believe businesses will basically be paused by midweek in community transmission areas. In fact, we may not be that far away from a national pause/roughly two-week timeout. People are not acting responsibly, so we believe the government will be forced to act drastically.
From the first diagnosed case in the U.S. on January 21, it took 53 days to do 20,000 tests in the U.S. Testing remains a challenge, but progress has been made this week. Testing capacity now exceeds 30,000 per day, though tests performed continue to not reach anywhere near that many. Additional companies are ramping up capacity and we should have a 50,000 to 75,000 per-day capacity by the end of the week.
The key now is processing the tests. The government outlined a plan to create a new website and drive-thru testing in community transmission areas, but that is still probably days away. Testing is getting there, but with the virus doubling right now at a minimum of every seven days, each day of testing lost is a day that more people get sick.
The White House, with the use of an emergency declaration on Friday, will give the federal government access to $50 billion in disaster funds, which is aimed at supporting testing and other efforts to combat COVID-19 (including expanded eligibility for federal programs and waiving certain regulatory hurdles). The president further announced the purchase of oil for the national Strategic Petroleum Reserve (SPR) – the mirror image of previous policy (as recently as February) to sell down some volumes from the SPR. The SPR currently has capacity for an additional 80 million barrels, though there is no clarity yet vis-a-vis how much will be purchased and over what time frame. Interest on federal government-backed student loans were also frozen as part of this announcement.
The federal government will likely mobilize both the National Disaster Medical System (which has already been engaged with quarantines and repatriation) and the Department of Defense to assist with medical surge capacity in areas most impacted.
The NDMS is composed of teams of doctors, nurses, paramedics and other providers from around the country who respond when disaster strikes. As it does during hurricanes, teams usually set up triage units outside of hospitals. As patients arrive at the hospitals they go to the NDMS facility first and then, if the patient is deemed serious enough and the hospital has capacity, the patient goes inside. If the hospital does not have capacity, a federal medical station (think pop-up basic hospital) from the Strategic National Stockpile will be set up for patients. If the patient does not need additional care, he or she is sent home.
DOD will use military doctors, nurses and other providers to assist in the medical needs of the nation if called upon. This would likely include setting up what are usually referred to as "combat hospitals" in areas most impacted. Hospitals will be expected to handle the situation and if they get in trouble, the federal government will then come in to provide assistance.
The government is continuing to watch and monitor clinical trials that are ongoing. Nearly 30 clinical trials for potential therapeutics should report results by the end of April. If any of the products that are already approved for other uses show promise, the products will likely be put to use right away.
The public messaging is likely to continue to ramp up with a goal of scaring the public into taking appropriate public health mitigation measures. Catchy phrases like “six feet apart, not six feet under” will likely continue to make the rounds. If the messaging is not effective, we expect the government entities to take more mandatory actions like those outlined above.
All expressions of opinion reflect the judgment of Raymond James & Associates, Inc., and are subject to change. There is no assurance any of the trends mentioned will continue or that any of the forecasts mentioned will occur. Economic and market conditions are subject to change.