IMPAQ Health News
From our experts to your inbox. Every two weeks.
This edition of IMPAQ Health News highlights stories on the racial and ethnic disparities of COVID-19, testing and contact tracing efforts, and growing mental health concerns as a result of the pandemic. Be sure to read original COVID-19 analysis from IMPAQ health policy experts, including a new blog post examining how CMS is addressing the opioid epidemic during the pandemic .
How can we serve the immediate needs of marginalized communities facing COVID-19, while also tackling decades of disinvestment and neglect? Join IMPAQ President Dr. Adaeze Enekwechi as she leads a conversation with nationally recognized experts from a public health system, technology company, health and social justice advocacy group, and safety net insurance provider, to learn how they are pivoting their efforts during the COVID-19 crisis. Speakers will share lessons learned and actionable advice for others working to address health inequity.
Government Response
With encouragement from the White House, most states across the nation have begun to reopen  businesses and relax stay-at-home mandates. These changes come as the unemployment rate rises to 14.7 percent , the highest since the Great Depression.  As concerns mount over reopening too quickly and the increasing likelihood of a second wave of infections , early talks of using antibody tests to measure immunity are losing traction as experts admit there are still many unknowns. The FDA is now requiring companies to validate their testing accuracy after claims of fraudulent antibody tests. The White House has also launched a new collaborative project titled “Operation Warp Speed” to develop and distribute a vaccine as early as November 2020. Currently, 14 potential vaccines are undergoing testing. In Congress, House Democrats are preparing to vote on the Heroes Act , the fifth stimulus package that is set to cost over $3 trillion and allocate funds to local governments, social services, and directly to Americans, among other provisions.
Here are some resources for following the latest COVID-19 news:
  • Kaiser Family Foundation developed a dashboard to track confirmed COVID-19 cases and deaths by race/ethnicity in the United States. 

  • Opportunity Insights created a tracker of the economic impacts of COVID-19 policies on counties, cities, states, and the nation as a whole.

  • The New York Times is tracking how states are reopening as many roll back stay-at-home orders and open select businesses.

  • STAT News created a guide for coronavirus treatment and vaccine progress. Early results of Remdesivir, an antiviral medication, show promise of improving recovery time in patients.

  • Johns Hopkins developed a frequently updated worldwide map of confirmed COVID-19 cases and deaths.
CMS has released a number of   press releases  detailing actions they are taking to address the COVID-19 outbreak. The most significant CMS updates since IMPAQ’s last newsletter include:  
COVID-19 Amplifies Racial & Ethnic Health Inequities across the Country
Social and economic factors contribute to high rates of COVID-19 infections in the Latino community. The highest risk pool are lower-income jobs that cannot be done from home, such as seasonal harvesting. The state of Oregon has mandated social distancing measures on farms to protect the predominantly-Latino migrant farm workers in anticipation of the fall picking season, although farmers warn of the difficulty of implementing these measures. The New York Times (5/7)
Zip code data across 12 states shows higher infection rates in localities that have more non-white or lower-income populations, with noticeable differences in areas only a few blocks apart. USA Today (5/3)
The CARES Act allotted $8 billion to tribal groups, but has only begun to release $4.8 billion in payments. The remaining 40 percent of payments is yet to be determined, pending resolution of a legal challenge made by Alaska Native corporations. Health disparities have increased the vulnerability of native populations to COVID-19; the Navajo Nation has the third highest infection rate behind New York and New Jersey. Reuters (5/5)
Health inequities and medical mistrust that predate COVID-19 have positioned Black Americans as a vulnerable population during this pandemic. Community leaders are looking to communicate about COVID-19 through less traditional methods, such as music radio shows and faith leaders, to reach community members. NPR (5/8)
COVID-19 Testing & Contact Tracing
Globally, government officials have expressed an interest in granting “immunity passports,” or documentation proving that someone had COVID-19. The WHO has advised against this approach . Many commercially available antibody tests can only confirm previous infection and it is still unknown if a person with antibodies is immune from COVID-19 reinfection. The Verge (5/7)
Apple and Google collaborated to build software to ease communication between their smartphone devices for apps to boost contact tracing capabilities. However, for these voluntary opt-in apps to be effective, nearly 60 percent of the target population needs to download the app amid concerns over privacy. Wall Street Journal (5/9)

  • Although the technology exists, public health officials are turning toward manual contact tracing efforts. This WIRED article takes a deeper look at the nature of contact tracing and the limitations of technology. (5/8)
Original projections that the United States would need to conduct between 500,000–600,000 daily tests have increased to 900,000, as the data shows the outbreak is more widespread than previously believed. Only nine states meet the new testing target and many states that have begun to reopen, like Georgia and Colorado, do not meet this standard. Forbes (5/7)
COVID-19 & the Mental Health Crisis
A preliminary study found that mental distress across all adult age groups has seen a significant spike when compared to 2018 data. The largest change was seen in young adults ages 18 to 29 and those living with children under 18. Time (5/7)
Dr. Vivek Murthy, in conversation with The Hill’s Steve Clemons, discusses loneliness during the pandemic and lessons learned from his time as the Surgeon General. Dr. Murthy advises individuals struggling with physical distancing to hold short, focused conversations rather than longer, distracted talks and to find ways to be of service to others. The Hill (5/6)
Beyond the Headlines
Shrinking state budgets and expected increases in Medicaid enrollment are putting economic pressure on state officials. Adjustments to benefits and provider payments are expected if the economic downturn is prolonged. Congress provided states with increased funding from the $2.2 trillion CARES Act and House Democrats are planning to allocate more funds in the new Heroes Act , but it may not be enough to meet the increased need. Politico (5/5)

  • NASHP highlights some of the innovative measures state-based health insurance exchanges are implementing to address increased need. (5/11)
Close working conditions and lower temperatures are both factors for how the virus is able to spread easily through meatpacking plants. In the United States, socioeconomic factors of the workers also play a role, like crowded housing situations, use of public transportation, and lack of health care. WIRED (5/7)
A survey , co-led by the Hamilton Project, found that food insecurity for mothers with children under the age of 12 is now at more than 40 percent, an increase from 15.1 percent reported in 2018. While 17.4 percent of mothers responded that they currently cannot afford to feed their children due to the pandemic, 3.4 percent of this group responded that this was often the case. Forbes (5/7)
Spotlight on IMPAQ
On May 5, 2020, IMPAQ signed an agreement to be acquired by the American Institutes for Research (AIR). To learn more, view the press release on AIR's website .
Substance use disorders remain a public health emergency. How has the COVID-19 pandemic put patients at further risk, and what steps is CMS taking to increase access to care? IMPAQ researchers Lovely Davilmar and Karin Johnson share answers in the latest post on the IMPAQ blog.
Feel-Good News Stories
Below are a few feel-good stories to remind us that no matter what, people always find a way to help one another, even in times of crisis.
  • Over 170 years ago, the Choctaw people sent the Irish $170 of relief during the Great Irish Potato Famine of 1847. Now, the Irish are returning the favor to Native American communities. The Guardian (5/9)

  • Kroger pledges to donate 200,000 gallons of milk to food banks. CBS (5/6)

  • An online children’s book is now available that explains the science behind COVID-19. Read Kelly Stays Home, for kids big and small!
Additional Eye-Catching Headlines
President Trump says his administration is still proceeding with a lawsuit to effectively end the ACA. The Supreme Court is set to begin arguments later in the year and a decision is not likely to be made until 2021. Washington Post (5/6)
After exiting a majority of state marketplaces in 2017, UnitedHealthcare announced it will offer exchange plans in Maryland in 2021 and that participation in other state exchanges is possible. Modern Healthcare (5/12)
CMS announced a set of final rules to govern Qualified Health Plans (QHPs) available through the Federal Exchange. The Final Payment Notice includes a one-week extension to the QHP certification and rate review timelines, changes to promote affordable insurance coverage, and improvements to program integrity, among other provisions. CMS (5/7)
In a new proposed rule, CMS is seeking to collect price median negotiated charges between hospitals and Medicare Advantage plans and third-party payers for inpatient services. This move follows the Trump Administration’s push for greater price transparency from the health care and pharmaceutical industry. Politico (5/11)
Graphic of the Week
The American Foundation for Suicide Presentation shares tips to improve mental health during the pandemic. Find more resources available here .
Upcoming Events, Trainings, Tools, & Webinars
This is the first of two online learning events highlighting select sessions from the 2020 Sharing Knowledge to Build a Culture of Health Conference, held this past March. This session will provide a grounding in what is meant by racism and its intersection with health, and provide historical and contemporary examples of how racial injustice shapes health inequities. Register here .
Clinical, infrastructure, and policy changes that must be made to reopen the primary care system, prepare for a second wave, and more will be discussed. This is the second webinar of a three-part series. Register here .
Join the Robert Wood Johnson Foundation as they discuss the policies, programs and budgets being implemented across the globe that place the well-being of people and the planet at the center of all decisions. Register here .
NOTE: The information, analyses, and opinions expressed in the articles, publications, or comments contained therein are those of the authors and should not be considered verified or endorsed by IMPAQ or any of our partners or clients.