Please see below for updates on federal legislation and easing of restrictions in related to COVID- 19. Updates are sent every Monday, Wednesday, and Friday evening. This email will be followed by our daily COVID Compilation memo.

Iowa Today, the Iowa Department of Public Health (IDPH) has been notified of 349 additional positive cases for a total of 5,868 positive cases. There have been an additional 1,668 negative tests for a total of 32,282 negative tests to date. According to IDPH, an additional 9 deaths were also reported (totaling 127), 300 are currently hospitalized, and 2,021 Iowans have recovered. At this time, 1 in 82 Iowans have already been tested.

Gov. Reynolds signed a new proclamation continuing the State Public Health Emergency Declaration until May 27, 2020. The proclamation loosens social distancing measures in 77 Iowa counties effective Friday, May 1 and continues other restrictions until 11:50 p.m. on Friday, May 15, 2020. Watch the governor’s news conference here. In the 77 counties, the proclamation permits restaurants, fitness centers, malls, libraries, race tracks, and certain other retail establishments to reopen in a limited fashion with public health measures in place. In addition, the proclamation lifts the restriction on religious and spiritual gatherings so long as churches and other gathering hosts implement reasonable public health measures. All other regulatory relief previously provided to affected Iowans is also extended until Wednesday, May 27, 2020.

The full proclamation is online in its entirety: https://www.homelandsecurity.iowa.gov/documents/disasters/proclamations/2020/PROC_2020_44_C OVID-19_April27.pdf

Federal Legislation Supplemental IV – CARES 2.0. / Phase 4 Timeline: Attention has turned to the next bill, termed “CARES 2.0” by some and “COVID 4” by others. The House is still scheduled to return on May 4, but a bill likely won’t be ready for a vote until mid- or late-May. There have been rumblings that Speaker Pelosi may unveil the next coronavirus supplemental as early as later this week, but as some committees have yet to pass legislative text on to leadership, next week is more likely. House Democrats still see Phase 4 as the next step in supplementals with a vote in May, followed by an infrastructure-focused bill in June.

Process/Politics: It’s likely that House Democrats will take the lead on drafting the next bill. However, as far as negotiations with Republicans goes, finding common ground on this bill may be more difficult than earlier supplementals. Republicans have said they want to slow down and see how the spending so far has been used before moving forward. Additionally, there continues to be a push for remote voting. The New Democrat Coalition sent letter today supporting remote voting. If House leadership agrees to proxy voting, the process could move quicker.

Policy: Phase 4 will likely be a large package, totally at least $1 trillion. The bill Speaker Pelosi introduces will likely heavily mirror many of the priorities reflected in the “Take Responsibility for Workers and Families Act”, which House Dems released prior to Senate passage of CARES. Text here, summary here, and one pager here. Ways and Means has been working on provisions to provide another round of stimulus checks, more unemployment assistance, and tax incentives to help address supply chain issues.

Highlights from the Democratic “Take Responsibility for Workers and Families Act”, some of which were implemented in CARES include:  $150 billion for hospitals, CHCs, government medical systems, including $80 billion in low- interest loans to hospitals;  $1,500 to individuals in direct cash payment, up to $7,500 for family of five;  Expansion of Earned Income Tax Credit, Child Tax Credit;  Expands paid sick days and family medical leave (extends to 12/31/2021, paid sick leave required regardless of size of the company);  Health extenders extended to end of the fiscal year;  $500+ billion grants and interest-free loans (some forgivable) for small businesses, additional $184 billion for low-interest disaster loans;  $200 billion state stabilization fund, $15 billion in Community Development Block Grant for local governments;  $60 billion for schools/universities ($50 billion for states’ school funding and $10 billion for higher education);  $10 billion in grants to airports, $40 billion in grants to airlines and ground support contractors ($21 billion in loans), $100 million in grants to maintain service to small communities.  Housing support, including $100 billion for emergency rental assistance to low-income renters at risk of homelessness, $32 billion for state housing agencies, and $1.1 billion for HUD multi- family housing programs;  $25 billion for public transportation to ensure continued operations;  Over $250 million for investments in telemedicine (ReConnect, Distance Learning and Telemedicine), $2 billion for broadband hotspots/devices to for distance learning, and $1 billion for the expansion of broadband access to low-income Americans.

Last week, the President called for aid to state and local governments, infrastructure investment, a payroll tax cut, and tax breaks for restaurants, sports, and entertainment interests. Some Republican members have said they want a more economic stimulus and recovery-focused bill, with funding for infrastructure like broadband, roads, and bridges. Republicans have also voiced concern around energy industry losses and its implication for the broader economy.

Earlier today, the Republican Study Committee released a 37-point proposal outlining plans for combatting COVID-19 and facilitating economic recovery. Highlights include:  Offset future COVID-19-related deficits and implement a “spending control” mechanism such as tying spending to annual revenues or potential GDP;  Sanction Chinese officials, end visas for Chinese government officials, prohibit distribution of China Daily, pressure the Chinese government to allow the CDC access to China, and direct a Congressional probe of the World Health Organization and its relationship with China;  Further expand telemedicine services, relax restrictions of drone deliveries for medical purposes;  Remove barriers to production of drugs, ingredients, and medical devices and allow businesses to instantly expense investments in R&D and physical capital;  Direct the FDA to fast-track any COVID-19 related drug or device approved in an allied country;  Waive certain federal hiring requirements and alter the GS wage scale to give greater compensation to those with in need skills;  Give all federal agencies access to death data, require sharing of death data by states, to ensure benefits are not distributed to deceased individuals;  Streamline certain federal permitting processes related to NEPA and endangered species’ habitats.  Ensure gig workers are treated as independent contractors and not as employees;  Allow investments in workers’ education to be tax deductible;  Allow employers to offer alternatives to overtime and pay above what is specified in a union contract;  Relax public housing voucher requirements;  Allow students in short-term career and technical education to be eligible for Pell Grants;  Allow 529 Accounts for homeschooling funds;  Remove CARES Act language that prohibits providers who receive funding from HUD’s Emergency Solutions Grants (ESG) program to require participants to use certain support services.

Passed Legislation

New information and guidance regarding passed legislation:  4/27 – Outline of the Provider Relief Fund with additions from COVID 3.5 here.  4/26 – CMS suspended the Advance Payments Program, to the surprise of Democrats, who were actively negotiating with the department officials on modifying the program. For providers who have already applied for the program, the announcement doesn’t affect them. Press release here.  4/24 – SBA released updated data on Economic Injury Disaster Loans here and EIDL Advance here.  4/24 – SBA released an interim final rule on requirements for Promissory Notes, Authorizations, Affiliation, and Eligibility. Interim Final Rule here. Additional eligibility criteria and requirements for certain loans here.  4/24 – SBA issued a procedural guidance on participation sales here.  Treasury released an interim final rule for the Paycheck Protection Program on how lenders will calculate loan amounts for employers with seasonal employees. Rule here.

Supplemental 3.5 – Interim Emergency Coronavirus Relief, formally titled “Paycheck Protection Program and Health Care Enhancement Act” (HR 266) The President signed the bill into law on April 24. Text here. Section by section here. Summary of hospital and testing provisions here. DPCC one pager here. Senate Democrats summary of health provisions. Overview of commitments regarding health funding and Medicare advance payments the Administration made as part of negotiations.

Highlights include:  $310 billion total for PPP with $250 billion unrestricted and a $60 billion set aside for smaller institutions: o $30 billion for assets less than $10 billion; o $30 billion for assets between $10 billion and $50 billion.  $50 billion for EIDL loans;  $10 billion for EIDL Advance grants;  $2.1 billion for SBA administrative expenses.  The bill also clarifies agriculture enterprises are eligible for PPP (they were eligible for 7(a) in the past, but they weren’t eligible for EIDL because they received disaster relief from USDA in the past).  The bill did not expand PPP eligibility to 501(c)(6)s and 501(c)(7)s, but lawmakers have brought up the issue with Secretary Mnuchin, specifically regarding local and regional chambers of commerce. Treasury is currently looking into is whether they have enough regulatory authority to expand eligibility or if that requires a legislative fix.  $75B for hospitals and providers (summary of hospital and testing provisions here);  $25 billion for testing, broken into the following categories: o $11 billion for states, localities, territories, and tribes to develop, purchase, administer, process, and analyze COVID-19 tests, scale-up laboratory capacity, trace contracts, and support employer testing. . $2 billion for states using the Public Health Emergency Preparedness grant formula; . $4.5 billion provided to hotspot areas; . $750 million for tribes, tribal organizations, and urban Indian health organizations in coordination with IHS. o $1 billion for the CDC for surveillance, epidemiology, laboratory capacity, contact tracing, public health data, and analytics infrastructure modernization; o $1.8 billion to NIH for testing and associated technologies and for partnerships to research and implement the activities; . (Note: This bill will roughly double the amount that Congress has appropriated for NIH for COVID-19 purposes so far.) o $ 1 billion for BARDA for advanced research, development, manufacturing, production and purchase of COVID-19 tests and related supplies; o $22 million for the FDA for diagnostic activities; o $825 million for Community Health Centers and rural health clinics; o $1 billion to cover costs of testing for the uninsured; o $6 million for the HHS Office of Inspector General.

Supplemental III – Coronavirus Aid, Relief, and Economic Security (CARES) Act After a unanimous vote by the Senate, the House passed the bill on March 27 and the President signed the bill into law shortly after. Final text here. Democratic summary here. Republican section by section here.

Small Business Loans  4/24 – Data on Economic Injury Disaster Loans here, EIDL Advance here.  4/23 – The Treasury Department asked all publicly traded companies that received funds under the program to return the funds within two weeks.  The Treasury Department released an interim final rule on the small business provisions in the bill. See here for a memo Cornerstone put together on the interim final rule.  Treasury FAQs on the Paycheck Protection Program o Top-line overview of the program here o Lender information here, Borrower information here, borrower application here o PPP FAQ here (as of 4/23)

Individual and Business Tax Relief  IRS guidance on deferral of payroll taxes here  House Ways and Means factsheet on Economic Impact Rebate portal here  IRS’s FAQ page on individual economic relief here.  Treasury Guidance on Employee Retention Tax Credit here  Treasury FAQ on Employee Retention Tax Credit here

Public Health Systems, Education, and Healthcare  4/23 – As part of negotiations on 3.5, the Administration made commitments on how the next $60 billion in the health relief fund will be distributed. HHS has committed that it will send out an additional $60 billion dollars in the coming weeks, much of it coming within the next 10 days. That funding will be distributed as follows: o $10 billion for hotspots, which will be for the top 100 counties with Covid-19 cases to date. Payments are expected to be distributed by next Wednesday, April 29. The funding will be based on total ICU beds and Covid-19 patient admissions, cumulatively for the period from January 1 to April 10. An additional weighting factor, using Medicaid DSH status, will provide a greater proportion of this funding to those that treat underserved patients. o $10 billion in additional hotspot funding, expected to go out in the next 45 days. o $10 billion for rural health care. o $400 million for Native American health care systems. Payments are expected to be distributed on Friday, April 24. o $20 billion to reconcile the inequities from the initial $30 billion, which was based on Medicare fee-for-service payments and left out providers that rely heavily on non-FFS payers. When combined with the initial $30 billion, this total will be calculated based on the provider’s portion of 2018 net patient revenue. Of this total, $9.3 billion will be released by Friday, and the remaining $10.7 billion will require providers to submit an application attesting to their revenue. Those payments will go out weekly on a rolling basis. o $10 billion to cover the cost of providing treatment for the uninsured. Applications will be accepted within 10 days, with payments going out within 30 days.  4/22 – CARES Act Provider Relief Fund overview here. State by state breakdown of first payment here.  4/23 – As part of negotiations on 3.5, the Administration made commitments on changes to Medicare advance payment policies. The administration committed that, by the end of this week, Secretary Mnuchin and Chief of Staff Meadows will release a letter stating that they will: o Use their administrative authority to reduce the interest rate down from what is currently 10.25 percent to a rate that is more in line with a traditional federal interest rate. o Use their administrative authority to extend the repayment period beyond 12 months. o Work with Congress and support legislation in Corona 4 that will place the liability for these payments in Treasury’s General Revenue fund, rather than the Medicare Hospital Insurance and Supplemental Medical Insurance Trust Funds. The expansion of these programs must not adversely affect Medicare’s solvency or result in premium increases for seniors.  4/9 – Secretary DeVos indicated that she would be moving to "immediately distribute" the $6 billion in CARES for emergency financial aid grants to college students. The grants can be used by college students for technology, course materials, food, housing, and healthcare. DeVos distributed the funding to colleges, which are meant to then distribute the aid among students. The Department did not issue guidance on how colleges are to structure the program, but colleges will be required to sign a form certifying that the funds were used in accordance with the law. See here for the specific allocations for each college.

Economic Stabilization  3/30 – The Treasury Department released guidance on payroll support to airline industry employees, and on loans to the airline industry and businesses critical to national security. Guidance for payroll support here. Guidance on procedures and minimum requirements for loans here. Treasury press release here.  4/10 – Treasury Q&A on Loans to Air Carriers and Eligible Businesses and National Security Businesses here. Loan application here.

State, Local, and Tribal Government Funding  4/13 – Treasury launched its web portal for payments to state, local, and tribal governments. Treasury announced that eligible government entities must provide required information by Friday, April 17 to receive payment within the 30-day window allowed under CARES and those that miss that deadline may not receive funding. Submission page here. Some highlights from the announcement below: o Funds are only allowed to be used for expenses which: . Are necessary expenses during the coronavirus emergency; . Were not accounted in the most recent budget (as of March 27, 2020); . Were incurred between 3/1/2020 – 12/30/2020. o Eligible local governments are those below the state level (county, municipality etc.) with a population higher than 500,000. See here for data sources and the distribution methodology. See here for a list of eligible local government units. o Amounts paid to governments will be based on population and the amounts allocated to states will be reduced by the total amount provided to local governments in the state. o Payments to Tribal Governments will be determined by the Treasury Secretary in consultation with the Interior Secretary and Tribes. While consultation has been completed, more than a dozen tribes have sued the Treasury Department over its guidance identifying Alaska Native Corporations (ANCs) as eligible entities for the fund. On Wednesday, Secretary Mnuchin said that the department would not be releasing funding until Tuesday, April 28 – two days after the deadline outlined in the CARES Act.  4/22 – Treasury issued guidance on the state/local/tribal governments fund here o The guidance further defines what expenses qualify as “necessary expenditures” and provides examples as well as examples of ineligible expenses.

Supplemental II – Families First Coronavirus Response Act (HR 6201) The Senate passed the House bill on March 18 and the President signed the bill into law that evening. Bill text here. Factsheet here. Bill section by section here. A summary of paid leave provisions, incorporating changes made by technical correction, is here.

Supplemental I – Coronavirus Supplemental Signed by the President March 6. Text here, summary here.

Congress Session: Earlier today, Leader McConnell confirmed that the Senate will return next week on May 4. Leader Hoyer said on a call with House Democrats that the House would also return May 4, but mostly for committee work and minimal floor activity. D.C. is currently under a stay-at-home order, and and have similar orders in place. Speaker Pelosi has advised members to keep their schedule flexible and said that the House may meet during weeks previously scheduled as District Work Periods.

Appropriations/NDAA: While timing continues to be unclear, House Appropriations Committee (HAC) will likely stick to the original subcommittee order of markups, just shifting everything back by 2-3 weeks. The first markups were slated to begin April 22. SAC has given subcommittees direction to stick with the original plan of marking up all of the bills in June.

This year’s NDAA has been “indefinitely postponed”. Reps. and Thornberry (HASC Chair and RM) sent a letter to the committee members saying that they will schedule the date of the markup once the House schedule for the next few months becomes clear. SASC Chairman Inhofe has said he aims to writing the FY21 NDAA by the end of May but is flexible considering the circumstances.

Remote voting: After pushback from Republicans, Speaker Pelosi pulled a proxy voting proposal, and instead tasked a bipartisan group to review proposals for proxy voting and procedures to reopen the House. The group includes Majority Leader Hoyer, Minority Leader McCarthy, Chairman McGovern (Rules), Ranking Member Cole (Rules), Chairwoman Lofgren (House Admin), and Ranking Member Davis (House Admin). There continues to be a push for remote voting. The New Democrat Coalition sent letter today supporting remote voting. The resolution proposed by Chairman McGovern here and includes protocols for proxy floor voting, and remote committee hearings and markups. Rules Majority proxy voting FAQ here. Leader McConnell, as of right now, is not supportive of any form of remote voting.

Other Floor Action: The House has issued guidance indicated that Floor materials are to be submitted through a secure email address instead of dropped off at the Speaker’s Lobby or Cloakrooms. Members are still allowed to drop off materials in person. Speaker’s Dear Colleague on the guidance here.

Hearings and Meetings: Next week when the House is back, there will be in-person committee hearings and markups, but member attendance will be staggered and scheduled in large committee rooms to ensure members practice social distancing measures. Leader Hoyer has been working with Leader McCarthy to develop an official remote working plan. Under current rules, the House does not allow virtual hearings. Chairman McGovern’s proxy voting proposal would also allow remote hearings and markups.

The Senate Rules Committee Democrats released a one-pager guidance on “paper hearings”, which stated “paper hearings” are not official hearings. The Senate Sergeant at Arms is exploring technology that would allow for remote hearings, though Leader McConnell remains opposed to any form of remote voting. The Senate has advised offices to avoid using the video conferencing app Zoom over data security concerns. The Senate has not yet officially banned the application though.

Members of Congress in Quarantine or Treatment (new additions in bold) Tested Positive (1): Rep. Neal Dunn (R-FL) Currently Self-Quarantined (0): Recovered (6): Sen. Rand Paul (R-KY), Rep. Joe Cunningham (D-SC), Rep. Ben McAdams (D-UT), Rep. Mario Diaz-Balart (R-FL), Rep. Mike Kelly (R-PA), Rep. Nydia Velazquez (D-NY) Completed Quarantine (37): Sen. Ted Cruz (R-TX), Rep. Mark Meadows (R-NC), Sen. Lindsay Graham (R- SC), Rep. (D-VA), Rep. (D-KS), Rep. Doug Collins (R-GA), Rep. Paul Gosar (R-AZ), Sen. Cory Gardner (R-CO), Sen. Rick Scott (R-FL), Rep. Matt Gaetz (R-FL), Rep. (D-CO), Rep. (D-CA), Rep. Ben Ray Luján (D-NM), Rep. Gwen Moore (D-WI), Rep. (D- FL), Rep. John Yarmuth (D-KY), Rep. (D-CA), Rep. Vincente Gonzalez (D-TX), Rep. Drew Ferguson (R-GA), Rep. David Schweikert (R-AZ), Rep. (D-NY), Rep. David Price (D-NC), Rep. Ann Wagner (R-MO), Rep. (D-NY), Rep. Matt Cartwright (D-PA), Rep. Tom Cole (R- OK), Rep. Steve Scalise (R-LA), Rep. Frederica Wilson (D-FL), Rep. Andy Kim (D-NJ), Rep. (D- OK), Sen. Mike Lee (R-UT), Sen. Mitt Romney (R-UT), Rep. Katie Porter (D-CA), Rep. (D- MA), Rep. (D-TX), Rep. (D-NJ), Rep. Ayanna Pressley (D-MA), Rep. (D-NJ)

Washington, D.C.

 The White House released the Opening Up America Again Testing Overview and Testing Blueprint to facilitate state development and implementation of the testing plans and rapid response programs described in the President’s Opening Up America Again Guidelines. The blueprint describes a partnership between federal, state, local, and tribal governments, and the private sector. The overview and blueprint do not specify how states will be able to test at least 2 percent of their populations every month, which is what administration officials had promised.  President Trump signed the interim emergency relief fund package last week, which replenishes the SBA Paycheck Protection Program (PPP), and includes funding for hospitals, testing, and disaster loan programs. You can view the bill text here and a section by section summary here. With Congress set to return next Monday, May 4th, discussion of a fourth COVID supplemental funding package has continued. For a more thorough update on the federal legislative landscape, please refer to the COVID-19 Legislative Update from Sierra Fuller which is published every Monday, Wednesday, and Friday. If you do not already receive that update and would like to subscribe, please email [email protected].  The CDC has been busy uploading new guidance and updated resources for COVID-19 on their dashboard. On Sunday, the agency posted an interim guidance document for meat and poultry processing workers and employers. Today, there is more information about contact tracing, new symptoms associated with COVID-19, and a toolkit for transportation partners to inform road travelers.  Yesterday, CMS announced that it is reevaluating the amounts that will be paid under its Accelerated Payment Program (AAP) and suspending its Advance Payment Program to Part B suppliers effective immediately. Since expanding the AAP programs on March 28th, CMS approved over 21,000 applications totaling $59.6 billion in payments to Part A providers, which includes hospitals. For Part B suppliers, including doctors, non-physician practitioners, and durable medical equipment suppliers, CMS approved almost 24,000 applications advancing $40.4 billion in payments.  USDA Sec. Sonny Perdue announced that and Virginia have been approved to operate Pandemic Electronic Benefit Transfer (EBT), authorized by the Families First Coronavirus Response Act (FFCRA), which provides assistance to families of children eligible for free or reduced-price meals dealing with school closures.  The USDA Agricultural Marketing Services posted to the federal register the availability of $3 billion in funds for the purchase and distribution of fresh produce and dairy and meat products for Americans facing challenges due to the COVID-19 national emergency.  The FDA provided an update today on the availability of alcohol-based hand sanitizer and said more than 1,500 additional manufacturers have registered with the agency to produce hand sanitizer. At the same time, the agency is addressing safety concerns related to products being sold that are not in line with the FDA’s policy and others being marketed with unproven claims.  On April 29th from 12:15 pm - 1:15 pm ET, the FDA will host a virtual Town Hall for clinical laboratories and commercial manufacturers that are developing or have developed diagnostic tests for SARS-CoV-2. The purpose of this Town Hall is to help answer technical questions about the development and validation of tests for SARS-CoV-2.  The FDA is hosting a webinar on April 30th at 1:00 pm about ET “Conducting Clinical Trials During the COVID-19 Public Health Emergency.”  Education Sec. Betsy DeVos announced today that more than $300 million in discretionary grant funds will be available for states to use to create adaptable, innovative learning opportunities for K-12 and postsecondary learners in response to COVID-19. The grants will be funded through the Education Stabilization Fund (ESF), authorized by the Coronavirus Aid, Relief, and Economic Security (CARES) Act.  The Executive Office of the President posted a proclamation about the suspension of entry of immigrants who present a risk to the U.S. labor market during the economic recovery following COVID-19.

Updates from the States

 Out of the cases under investigation detected by U.S. surveillance, there are total cases: 957,875 and 53,922 deaths The CDC data closes out the day before reporting.  President Trump suggested on a call with governors today that some should make an effort to reopen their public schools before the end of the academic year. Montana, which has among the fewest cases and deaths, will give schools the option to reopen starting May 7th.  Gov. (D) and Gov. Steve Sisolak (D) announced their states will be joining , , and in the Western States Pact – a working group of Western state governors who have a shared plan for modifying stay-at-home orders.  The Mississippi Department of Corrections (MDOC) has provided masks to all inmates (approximately 18,500 total) and correctional staff amid the coronavirus pandemic. To date, four inmates within MDOC have tested positive for COVID-19 and 21 have tested negative.  Gov. Murphy (D) said Monday that he would need to see four things before he would consider reopening businesses and schools: a prolonged decline in hospitalization and infection rates, expanded testing, more contact tracing and places for those who were sick with the virus to remain in isolation.  Updates on Lockdowns/Reopening: o Gov. Polis signed an executive order outlining the new “safer at home” level for the state’s response which includes some new benchmarks for reopening. Starting today, retail businesses can open for curbside delivery, starting Friday, personal services can open if they are implementing best practices, and on May 4th, offices can reopen at a 50 percent reduced in-person staffing capacity (but are still encouraged to allow employees to telecommute). Child care facilities can also expand or reopen if they are following Safer at Home requirements. o Gov. Greg Abbott (R) announced the reopening of the state’s businesses in phases starting Friday and said he was allowing the stay-at-home order to expire on April 30th. o Gov. Andrew Cuomo (D) outlined a multi-phase plan, based on regional analysis and determinations, to re-open New York. This will only be implemented once the region experiences a 14-day decline in the hospitalization rate. o Montana Gov. Steve Bullock (D) allowed retail businesses to become operational today or after if they adhere to requirements to limit capacity and maintain strict physical distancing. Restaurants, bars, breweries, and distilleries can begin providing some in- establishment services on May 4th. o Gov. Bill Lee (R) allowed restaurants and retailers to reopen at 50 percent capacity in the vast majority of counties. o Oklahoma Gov. Kevin Stitt (R) will allow restaurants, movie theaters, sporting venues, and gyms to reopen May 1st if they maintain "strict social distancing and sanitation protocols." Bars, schools, and sporting events, however, will still be closed. o In , Gov. Tim Walz (D) said he will allow some businesses to reopen beginning Monday. o Gov. David Ige (D) has opened beaches for exercising, but said people cannot loiter on the beach and must maintain social distance. Elective surgeries are also allowed to take place as long as there is enough capacity. o Louisiana Gov. John Bel Edwards (D) is extending the state's current stay-at-home order through May 15th, keeping bars, dine-in restaurants and barber shops closed for two additional weeks before starting a phased reopening of the economy on May 16th.  Useful state data: o The NYT is now tracking which states are reopening and which are still shut down. o These charts show cumulative coronavirus cases and deaths for metropolitan areas over time. o Use Johns Hopkins University’s COVID-19 U.S. map as a resource for media, policymakers and communities to view a collection of critical public health data in one online destination and better understand and track the COVID-19 pandemic in populations both large and small across the country. o NASHP has developed a COVID-19 State Action Center which serves as a state-level policy dashboard. o This site from the Kaiser Family Foundation provides state-level information on cases/deaths, social distancing measures, health policy actions, and more. o This resource from Bloomberg Law is a database of State Quarantine and Public Health Laws related to the COVID-19 response. o This series of maps shows how states are responding to COVID-19, and this tracker, created and maintained by MultiState Associates, has an up-to-date list of executive orders and various travel restrictions. o Finally, this site offers COVID-19 projections assuming full social distancing and can be broken down by state. Military/Defense

 There are now 47 confirmed COVID-19 cases among sailors aboard the destroyer USS Kidd, the second Navy ship with a COVID-19 outbreak. The destroyer, which only saw its first confirmed COVID-19 case on April 23rd, is expected to port in San Diego this week to conduct deep cleaning.  The USNS Mercy offloaded its last remaining patients this weekend as it prepares to leave Manhattan for its homeport in Norfolk, Virginia. As of Saturday, the 1,000-bed hospital ship had treated just 182 patients.  VA officials say five million masks ordered by the Veterans Health Administration to protect staff at VA hospitals were taken by FEMA for the Strategic National Stockpile. After an appeal from VA Secretary Robert Wilkie to FEMA, the agency provided the VA with 500,000 masks last week. o The number of veterans and healthcare workers diagnosed with COVID-19 at VA hospitals and clinics continues to surge. Over the weekend, cases among veterans topped 6,900 while cases among VA employees reached 1,900. 435 VA patients have died from the virus.  The U.S. Military Academy at West Point, New York will test and “soft quarantine” all cadets returning to graduate in June. President Trump is slated to serve as the commencement speaker.  Some states, including New York, Virginia, and , have begun to scale back construction of Army Corps of Engineers makeshift hospitals as already-built Army Corps hospitals see low occupancy rates and social distancing measures lower estimates of hospital overload.  Joint Chiefs Chairman Gen. Mark Milley wants a “full-blown investigation” into the USS Theodore Roosevelt incident, which will likely delay a final decision by Defense Secretary Esper on whether to restore Capt. Crozier as commander of his former carrier.

International Affairs

 More than a million Australians have downloaded a coronavirus contact tracing app within hours of it being released by the government. The COVIDSafe smartphone app uses a Bluetooth wireless signal to exchange a "digital handshake" with another user when they come within five feet. The app then logs this contact and encrypts it.  Users will be notified if they have had more than 15 minutes of close contact with another user who tests positive.  Canadian Prime Minister Justin Trudeau announced a new rent subsidy program which would provide financial resources to property owners and businesses to cover rent payments. The program would pay 50 percent of the rent for three months to the building owners, but it requires them to reduce the rent cost and refrain from evicting tenants. The businesses themselves would be required to cover the remaining rent.  National and local health officials in South Korea published a case study of a COVID-19 outbreak at a call center. The cluster of COVID-19 cases was originally reported in early March, in a “commercial-residential mixed-use building,” and the outbreak resulted in 97 confirmed cases at the time of the investigation.  Paraguay President Mario Abdo Benitez announced Monday that in-person classes will remain closed through December. Benitez said that although there is “scientific evidence suggesting children are less vulnerable to the virus,” the government has a “constitutional obligation” to care for the health of its citizens.  Nigeria's President Muhammadu Buhari has extended the country’s coronavirus lockdown in three major states —Abuja, Lagos and Ogun — for another week until May 4th.  UK Prime Minister Boris Johnson returned to work, several weeks after being diagnosed with and hospitalized for COVID-19. He addressed the country from 10 Downing Street, thanking first responders and citizens for their dedication, support, and cooperation. He emphasized that, while the economic and other hardships resulting from social distancing are difficult, the UK must resist the urge to resume normal activities too soon.  As serological testing capacity increases worldwide, countries and businesses are developing plans to implement broader testing programs and evaluating mechanisms to use the available data. One particular tool that has been mentioned by health and elected officials in multiple countries is “immunity passports/certificates” that could enable those with antibodies to SARS- CoV-2 to resume normal activities; however, this concept presents a myriad of technical, social, ethical, and legal challenges. The WHO published a statement regarding the use of serological tests for this purpose. The WHO notes that there is not currently sufficient evidence to determine whether individuals who have been previously infected with SARS-CoV-2 are immune to future infections.  Kremlin spokesperson Dmitry Peskov said Russian President Vladimir Putin would meet tomorrow with regional governors to discuss the spread of COVID-19 around the country. On a conference call, Peskov was asked when Russians could expect their self-isolation orders to end, and he responded that it was too early for predictions.  The Russian military reported 2,090 cases of the coronavirus among its personnel, cadets and civilian employees, according to the country's defense ministry.  A village in India’s southern state of Kerala is distributing 10,000 umbrellas to residents to help maintain social distancing. The idea is to stand next to one another with open umbrellas to maintain a distance of at least a meter.  Global Cases: 2,878,196 (the U.S. now accounts for nearly 1/3 of global cases) Total Deaths: 198,668

Lifestyle and Economy

 As online shopping has increased, demand for Amazon delivery folks has skyrocketed. Amazon hired 175,000 more workers over the last two months to keep up with orders.  Food delivery apps like Grubhub, DoorDash, and UberEats have said they would suspend some or all of the commissions they take on orders to help restaurants continue to offer takeout. Restaurants have said other fees still apply.  Apple is pushing back the production ramp-up of its flagship iPhones coming later this year by about a month. Apple’s annual product refresh fuels the majority of iPhone sales for an entire year, making new phones the linchpin of a business segment that accounts for more than half of the company’s total revenue.  Stocks rose Monday, with investors betting that stimulus measures and the easing of coronavirus-lockdown measures around the world could help kick-start economic activity. The Dow increased 1.5 percent and the S&P 500 followed suit.  Apple, Amazon, Facebook, and other U.S. companies are scheduled to report their Q1 results in the next few days. The reports are likely to provide insights on how leaders of the biggest American businesses view prospects for the rest of the year, though the pandemic still makes these forecasts less reliable than in previous quarters.  WIRED recently published “An Oral History of the Day Everything Changed,” which documents prominent Americans looking back at when they realized COVID-19 was a big deal.  Demand for in-home care has increased as older adults shelter in place. The uptick in need is stretching thin an already burdened caregiver network.  Forbes is keeping a running list of all major international airline COVID-19-related change and cancellation policies.  The New York Times has started its own tracker of cases in the U.S. to fill in the gaps left by agency data.  Lists of canceled conferences and events can be found here (music), here (tech), here (general), and here (sports/entertainment).

Helpful Articles/Media

 Daily WHO Situation Report (4/25) (4/26) (4/27)  Here is last week’s COVIDView from CDC, a weekly summary and interpretation of key indicators that have been adapted to track the COVID-19 pandemic in the U.S.  From Dr. Tom Frieden: How to reopen society as soon and safely as possible  Putting A Stake Through The Heart of Public Health’s Eeyore Complex  The Other COVID Risks: How Race, Income, ZIP Code Influence Who Lives Or Dies  Vaping, Opioid Addiction Accelerate Coronavirus Risks, Says NIDA Director  Examining the social impact of COVID-19  The Implications of COVID-19 for Mental Health and Substance Use  COVID-19 exacerbating inequalities in the US  COVID-19 in the USA: a question of time  COVID-19 Outbreak Associated with Air Conditioning in Restaurant, Guangzhou, China, 2020  The characteristics of household transmission of COVID-19  The SARS-CoV-2 receptor-binding domain elicits a potent neutralizing response without antibody-dependent enhancement  Symptom Screening at Illness Onset of Health Care Personnel With SARS-CoV-2 Infection in King County, Washington  Finding Effective Treatments for COVID-19: Scientific Integrity and Public Confidence in a Time of Crisis  Covid-19 is rapidly becoming America’s leading cause of death  Antibiotic treatment for COVID-19 complications could fuel resistant bacteria  Rapid coronavirus test, commonly used in U.S., may miss infections in some situations  Food And Beverage Companies Evolve, Innovate And Contribute Amid COVID-19 Crisis  Visualizing Speech-Generated Oral Fluid Droplets with Laser Light Scattering  Coronavirus Vaccine Prospects  The NIH Office of Portfolio Analysis (OPA) has developed a comprehensive, expert-curated portfolio of COVID-19 publications and preprints. The portfolio includes peer-reviewed articles from PubMed and preprints from medRxiv, bioRxiv, ChemRxiv, and arXiv. It is updated daily with the latest available data and enables users to explore and analyze the rapidly growing set of advances in COVID-19 research.  ‘We need an army’: Hiring of coronavirus trackers seen as key to curbing disease spread  Suicide Mortality and Coronavirus Disease 2019—A Perfect Storm?  FEMA’s How to Help website.  Safety at the Time of the COVID-19 Pandemic: How to Keep our Oncology Patients and Healthcare Workers Safe  The effective use of telemedicine to save lives and maintain structure in a health care system  Projecting hospital utilization during the COVID-19 outbreaks in the U.S.  Johns Hopkins data capture.  Other tracking data here.

Common Acronyms

Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), National Institutes of Health (NIH), Personal Protective Equipment (PPE), Department of Health and Human Services (HHS), Department of Defense (DoD), Department of Homeland Security (DHS), U.S. Department of Agriculture (USDA), Central Command (CENTCOM), Department of Housing and Urban Development (HUD), Centers for Medicare and Medicaid Services (CMS), Transportation Security Administration (TSA), Department of Veterans Affairs (VA), Assistant Secretary for Preparedness and Response (ASPR), Biomedical Advanced Research and Development Authority (BARDA), U.S. Trade Representative (USTR)

Statistics

State reopening plans, New York Times, 4.27.20

Map updated 4.26.20

(data from WHO daily situation reports)

For more information, visit CDC’s Novel Coronavirus 2019 website

David R. Adelman Principal & Director | Government Affairs