This Week in Coronavirus: July 17 to July 23

At almost 27 weeks since the first coronavirus case appeared in the United States, we have reached 4 million cumulative cases — only 15 days after crossing 3 million. While cases are climbing at increasing rates and the economy continues to suffer, the debate around the safety and feasibility of reopening schools for in-person instruction continued this week, as state and local officials released their decisions around in-person or online learning and the Centers for Disease Control and Prevention released its own guidance on reopening schools.

Amidst these developments, we released our latest poll, which found that parents overwhelmingly prefer that schools wait to restart in-person classes to reduce infection risk (60%) rather than open sooner so parents can work and students can return to the classroom (34%). Parents of color (76%) are even more likely than white parents (51%) to prefer that schools wait to return to in-person classes.

Increasing federal funding to state and local governments to help schools reopen safely was among the public’s top priorities for Congress, with 55% saying it should be a top priority.

But as Congress finalizes negotiations around the next coronavirus stimulus package, 72% of the public say increasing federal funding to limit the spread of coronavirus — including testing, contract tracing and personal protective equipment (PPE) — should be a top priority for Congress. It’s the highest-ranked priority in the poll, and the only one seen as a top priority by a majority of Democrats, Republicans, and independents.

The media and President Trump in his latest coronavirus briefings largely focused on the share of cases attributed to a younger population in the most recent resurgences in hotspot states, but our analysis highlights how continued community transmission has implications beyond increased cases. As of July 23, we identified 36 states that are now coronavirus hotspots — based on cases and positivity rates increasing, or meeting specific thresholds. That means approximately 73.5% of the U.S. population is now living in a hotspot.

Long-term care (LTC) facility deaths in these hotspot states as of July 23 have risen at six times the rate as LTC deaths in non-hotspot states. Long-term care cases in Texas and Florida have increased by approximately 50% in two weeks. Adults 65 and older account for 16% of the US population but 80% of COVID-19 deaths in the US. Nearly half of all COVID-19 deaths have been in long-term care facilities.

Here are the latest coronavirus stats from KFF’s tracking resources:

Global Cases and Deaths: Total cases worldwide reached 15.5 million between July 16 and July 23 – with an increase of approximately 1.7 million new confirmed cases. There were also approximately 43,600 new confirmed deaths worldwide between July 16 and July 23, bringing the total to 633,394 confirmed deaths.

U.S. Cases and Deaths: Total confirmed cases in the U.S. passed 4 million this week. There was an approximate increase of 463,000 confirmed cases between July 16 and July 23. Approximately 5,900 confirmed deaths in the past week brought the total to over 144,000 confirmed deaths in the U.S.

U.S. Tests: There have been over 48 million total COVID-19 tests with results in the U.S. In the past 7 days, 1.7% of the total U.S. population was tested.

Race/Ethnicity Data: As of this week, Black individuals made up a higher share of cases/deaths compared to their share of the population in 30 of 49 states reporting cases and 34 of 44 states reporting deaths. In 7 states (MI, TN, MO, IL, WI, KS, and NH), the share of COVID-19 related deaths among Black people was at least two times higher than their share of the total population.

Hispanic individuals made up a higher share of cases compared to their share of the total population in 35 of 45 states reporting cases and 10 of 44 states reporting deaths. In 8 states  (NE, VA, WI, AR, IA, MN, TN, and SD), Hispanic peoples’ share of cases was more than 3 times their share of the population. COVID-19 continues to have a sharp, disproportionate impact on American Indian/Alaska Native as well as Asian people in some states.

State Reports of Long-Term Care Facility Cases and Deaths Related to COVID-19 (Includes Washington D.C.)

  • Data Reporting Status: 47 states are reporting COVID-19 data in long-term care facilities, 4 states are not reporting
  • Long-term care facilities with known cases: 13,411 (across 44 states)
  • Cases in long-term care facilities: 322,505 (across 43 states) 
  • Deaths in long-term care facilities: 59,506 (in 42 states)
  • Long-term care facility cases as a share of total state cases: 10% (across 43 states)
  • Long-term care facility deaths as a share of total state deaths: 44% (across 42 states)
  • Texas, South Carolina, Utah, and Florida reported a >20% increase in LTC deaths over the last 14 days. Texas reports the highest increase — a 64% increase in LTC deaths between July 9 and July 23
  • The states that have historically had the highest deaths in LTC facilities overall (NY, NJ, MA, PA, and IL) all saw less than a 3% increase in LTC deaths over 14 days. These states are not classified as hotspots. There is evidence to suggest that LTC deaths are rising in hotspot states (such as in TX, SC, UT, FL) at a faster pace than in non-hotspot states (NY, NJ, MA, PA, and IL).
State Social Distancing Actions (includes Washington D.C.)
  • Status of reopening: Proceeding in 21 states, paused in 8 states, new restrictions in 15 states, reopened in 7 states
  • Stay At Home Order: Original stay at home order in 1 state, stay at home order eased or lifted in 44 states, no action in 6 states
  • Mandatory Quarantine for Travelers: Original traveler quarantine mandate in place in 9 states, new traveler quarantine mandate in place in 3 states, traveler quarantine mandate eased or lifted in 16 states, no action in 23 states
  • Non-Essential Business Closures: Some or all non-essential businesses permitted to reopen (some with reduced capacity) in 43 states, new business closures or limits in 3 states, no action in 5 states
  • Large Gatherings Ban: Original gathering ban/limit in place in 5 states, gathering/ban limit expanded or lifted in 38 states, new gathering/ban limit in place in 7 states, no action in 1 state
  • Restaurant Limits: Restaurants reopened to dine-in service in 45 states, newly closed to dine-in service in 1 state, new capacity limits in 4 states, no action in 1 state
  • Bar Closures: Closed in 9 states, reopened in 30 states, newly closed in 9 states, new service limits in 3 states
  • Face Covering Requirement: Required for general public in 31 states, required for certain employees in 11 states, allows local officials to require them for general public in 4 states, no action in 6 states
  • Primary Election Postponement: Postponement in 15 states, no postponement in 36 states
  • Emergency Declaration: There are emergency declarations in all 51 states.

State COVID-19 Health Policy Actions (Includes Washington D.C.)

  • Waive Cost Sharing for COVID-19 Treatment: 3 states require, state-insurer agreement in 3 states; no action in 45 states
  • Free Cost Vaccine When Available: 9 states require, state-insurer agreement in 1 state, no action in 41 states
  • States Requires Waiver of Prior Authorization Requirements: For COVID-19 testing only in 5 states, for COVID-19 testing and treatment in 6 states, no action in 40 states
  • Early Prescription Refills: State requires in 16 states, expired requirements in 2 states, no action in 33 states
  • Premium Payment Grace Period: Grace period extended for all policies in 2 states, grace period extended for COVID-19 diagnosis/impacts only in 4 states, expired in 10 states, no action in 35 states
  • Marketplace Special Enrollment Period: Marketplace special enrollment period still active in 5 states, ended in 7 states, no special enrollment period in 39 states
  • Paid Sick Leave: 13 states enacted, 2 proposed, no action in 36 states

State Actions on Telehealth (Includes Washington D.C.)
38 states overall have taken mandatory action expanding access to telehealth services through private insurers, including:

  • New Requirements for Coverage of Telehealth Services: Parity with in-person services in 6 states, broad coverage of telehealth services in 6 states, limited coverage of telehealth services in 6 states, no action in 33 states
  • Waiving or Limiting Cost-Sharing for Telehealth Services: Waived for COVID-19 services only in 7 states, waived or limited for all services in 8 states, expired in 1 state, no action in 35 states
  • Reimbursement Parity for Telehealth and In-Person Services: Required for all services in 17 states, no action in 34 states
  • Require Expanded Options for Delivery of Telehealth Services: Yes in 35 states, for behavioral health services only in 1 state, no action in 14 states
  • Approved Section 1115 Waivers to Address COVID-19: 5 states (HI, NC, NH, WA) have approved waivers
  • Approved Section 1135 Waivers: All states have approved waivers
  • Approved 1915 (c) Appendix K Waivers: 50 states have approved waivers except Idaho
  • Approved State Plan Amendments (SPAs): 47 states have temporary changes approved under Medicaid or CHIP disaster relief SPAs, 1 state has an approved traditional SPA
  • Other State-Reported Medicaid Administrative Actions: All states report taking other administrative actions in their Medicaid programs to address COVID-19

The latest KFF COVID-19 resources:

The latest KHN COVID-19 stories:

  • As Long Waits for Results Render COVID Tests ‘Useless,’ States Seek Workarounds (KHN, Daily Beast)
  • Employers Require COVID Liability Waivers as Conflict Mounts Over Workplace Safety (CHL, Fortune)
  • KHN’s ‘What The Health?’: Trump Twists on Virus Response (KHN)
  • Lost on the Frontline (KHN, The Guardian)
  • COVID Runs Amok in 3 Detroit-Area Jails, Killing At Least 2 Doctors (KHN, The Guardian)
  • With DACA Ruling, Did Supreme Court Grant Trump New Powers To Reshape Health Care? (KHN, PolitiFact)
  • Adjunct Professors: Jobs Are Low on Pay and Health Benefits With High COVID Risk (KHN, US News)
  • Technology Divide Between Senior ‘Haves’ and ‘Have-Nots’ Roils Pandemic Response (KHN, CNN)
  • Essential and in Danger: Coronavirus Sickens, Even Kills Public Health Workers (KHNAP)
  • For COVID Tests, the Question of Who Pays Comes Down to Interpretation (KHNNBC News)
  • Medicaid Mystery: Millions of Enrollees Haven’t Materialized (CHLLos Angeles Times)
  • Administration Eases Rules to Give Laid-Off Workers More Time to Sign Up for COBRA (KHNNPR)
  • NIH Project Homes In on COVID Racial Disparities (KHN)
  • Scientists Want to Know More About Using UV Light to Fight COVID-19 Spread (KHNNPR)
  • Pandemic-Inspired Food Labeling Raises Alarms for Those With Food Allergies (KHNWashington Post)
  • Bingeing on Doom: Expert on the ‘Black Death’ Attracts Cult Following (KHNLos Angeles Times)
  • Behind The Byline: ‘Reporting From a Distance’ (KHN)
  • Watch: COVID Patients and Families Battle to Get Benefits (KHN)