1 00:00:07,600 --> 00:00:12,479 Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day twenty one 2 00:00:12,520 --> 00:00:17,119 Speaker 1: since coronavirus was declared a global pandemic. Today, in a 3 00:00:17,239 --> 00:00:20,960 Speaker 1: lockdown world, doctors need to help patients without seeing them 4 00:00:20,960 --> 00:00:23,840 Speaker 1: in person. It's opening up a whole new chapter for 5 00:00:23,880 --> 00:00:29,440 Speaker 1: companies who specialize in remote medicine. But first today's news. 6 00:00:41,520 --> 00:00:45,040 Speaker 1: The White House and Congressional Democrats are preparing for a 7 00:00:45,080 --> 00:00:48,200 Speaker 1: fourth round of economic stimulus to get the US through 8 00:00:48,200 --> 00:00:52,879 Speaker 1: its coronavirus outbreak. This comes after Congress past a two 9 00:00:53,040 --> 00:00:57,520 Speaker 1: trillion dollar bill last Friday. White House officials have compiled 10 00:00:57,560 --> 00:01:01,880 Speaker 1: requests from government agencies totaling roughly six hundred billion dollars, 11 00:01:01,920 --> 00:01:05,520 Speaker 1: according to people familiar with the matter. The proposals include 12 00:01:05,640 --> 00:01:09,080 Speaker 1: more state aid, as well as financial assistance for mortgage 13 00:01:09,120 --> 00:01:12,880 Speaker 1: markets and travel industries. Trump said in a tweet on 14 00:01:12,920 --> 00:01:16,520 Speaker 1: Tuesday that timing is good for a massive infrastructure bill 15 00:01:16,840 --> 00:01:20,200 Speaker 1: because interest rates are close to zero. Nancy Pelosi had 16 00:01:20,240 --> 00:01:23,320 Speaker 1: said last week infrastructure should be part of the next 17 00:01:23,440 --> 00:01:27,360 Speaker 1: stimulus bill. The economy is going to be hit even 18 00:01:27,440 --> 00:01:30,800 Speaker 1: harder by this outbreak than expected, says Goldman Sachs. The 19 00:01:30,880 --> 00:01:33,800 Speaker 1: firm came out with a report today saying GDP will 20 00:01:33,840 --> 00:01:37,039 Speaker 1: shrink by over a third in the second quarter they 21 00:01:37,040 --> 00:01:42,720 Speaker 1: had previously estimated and already staggering twent contraction. Goldman said 22 00:01:42,800 --> 00:01:46,280 Speaker 1: unemployment would hit fift percent by the middle of the year. 23 00:01:47,080 --> 00:01:50,120 Speaker 1: The good news. They also think the economy will come 24 00:01:50,200 --> 00:01:53,600 Speaker 1: back faster than expected in the third quarter, predicting growth 25 00:01:53,840 --> 00:01:59,880 Speaker 1: of Anthony Fauci, the US government's top infectious disease x 26 00:02:00,520 --> 00:02:04,240 Speaker 1: said on CNN that he's starting to see glimmers that 27 00:02:04,360 --> 00:02:07,400 Speaker 1: social distancing might be slowing the spread of the pathogen, 28 00:02:07,640 --> 00:02:11,280 Speaker 1: but he warned that the situation is still very dangerous. 29 00:02:11,800 --> 00:02:15,440 Speaker 1: You're starting to see that the daily increases are not 30 00:02:15,560 --> 00:02:19,240 Speaker 1: in that steep incline. They're starting to be able to 31 00:02:19,400 --> 00:02:22,360 Speaker 1: possibly flatten out. I mean again, you you look at 32 00:02:22,360 --> 00:02:25,600 Speaker 1: it carefully, hope it's going in the right direction. But 33 00:02:25,720 --> 00:02:28,720 Speaker 1: that's what we really are trying to attain. Despite that 34 00:02:28,800 --> 00:02:32,480 Speaker 1: careful optimism, the numbers still look bad, both in the 35 00:02:32,600 --> 00:02:36,480 Speaker 1: US and around the world. In Europe, most places are 36 00:02:36,520 --> 00:02:41,560 Speaker 1: still seeing alarming numbers of cases and deaths. Spain suffered 37 00:02:41,560 --> 00:02:45,320 Speaker 1: its deadliest day of the pandemic, and European governments doubled 38 00:02:45,360 --> 00:02:50,000 Speaker 1: down on efforts to maintain rigid lockdowns amid tentative signs 39 00:02:50,040 --> 00:02:53,440 Speaker 1: that the infection rate was slowing. Italy and the Netherlands 40 00:02:53,520 --> 00:02:57,440 Speaker 1: are discussing prolonging measures to limit personal contact, and German 41 00:02:57,480 --> 00:03:01,280 Speaker 1: officials warned that it's too soon to ease restrictions because 42 00:03:01,320 --> 00:03:13,440 Speaker 1: things could still get worse. And now today's main story 43 00:03:14,120 --> 00:03:19,480 Speaker 1: the doctors we can't see around the country and the world. 44 00:03:19,840 --> 00:03:22,840 Speaker 1: More and more people are locked in their homes, but 45 00:03:23,240 --> 00:03:26,200 Speaker 1: people still need to see the doctor. That has made 46 00:03:26,240 --> 00:03:30,800 Speaker 1: telehealth companies businesses that let doctors treat patients remotely, the 47 00:03:30,840 --> 00:03:35,080 Speaker 1: new stars of the COVID nineteen economy. And I'm not 48 00:03:35,200 --> 00:03:38,080 Speaker 1: just talking about companies that offer an alternative to an 49 00:03:38,160 --> 00:03:41,400 Speaker 1: urgent care clinic if you've got the flu. Companies that 50 00:03:41,560 --> 00:03:45,120 Speaker 1: until now have mainly offered prescriptions for birth control or 51 00:03:45,240 --> 00:03:49,680 Speaker 1: hair loss pills are pivoting to provide services related to 52 00:03:49,720 --> 00:03:53,640 Speaker 1: the pandemic. Telehealth has been trying to become a mainstream 53 00:03:53,680 --> 00:03:57,920 Speaker 1: alternative to brick and mortar doctor's offices for years. Bloomberg 54 00:03:57,960 --> 00:04:01,640 Speaker 1: Health reporter Kristen V. Brown words that these companies hope 55 00:04:01,720 --> 00:04:07,720 Speaker 1: this moment will be their chance. About two weeks ago, 56 00:04:08,080 --> 00:04:10,960 Speaker 1: an email that struck me as really kind of funny 57 00:04:11,040 --> 00:04:15,520 Speaker 1: landed in my inbox. Ne Rex, the San Francisco startup 58 00:04:15,600 --> 00:04:19,760 Speaker 1: best known for selling birth control online, was launching their 59 00:04:19,839 --> 00:04:25,760 Speaker 1: own coronavirus test. Ne Rex is one of a bunch 60 00:04:25,800 --> 00:04:29,360 Speaker 1: of Silicon Valley funded healthcare startups that promised really fast, 61 00:04:29,880 --> 00:04:34,320 Speaker 1: really cheap healthcare online. You basically text with a doctor 62 00:04:34,440 --> 00:04:36,800 Speaker 1: and then a few days later your prescription shows up. 63 00:04:37,600 --> 00:04:40,800 Speaker 1: Suffice it to say, addressing a global pandemic seemed like 64 00:04:41,120 --> 00:04:44,400 Speaker 1: kind of a big leap from the pill. But with 65 00:04:44,440 --> 00:04:48,120 Speaker 1: so many people encouraged to stay home, it seems like 66 00:04:48,200 --> 00:04:52,920 Speaker 1: telehealth is finally poised to have its moment everybody wants in. 67 00:04:53,920 --> 00:04:57,599 Speaker 1: Charles Jones is chairman and CEO of MPD Live. He 68 00:04:57,640 --> 00:05:01,440 Speaker 1: says business has nearly doubled in re and weeks. People 69 00:05:01,440 --> 00:05:04,320 Speaker 1: who were going to see their physician for regular medical 70 00:05:04,360 --> 00:05:07,240 Speaker 1: needs are now coming to us. People who want to 71 00:05:07,240 --> 00:05:10,400 Speaker 1: the emergency room are now coming to us. People who 72 00:05:10,440 --> 00:05:12,920 Speaker 1: want to urgent care are now coming to us. It's 73 00:05:13,080 --> 00:05:18,359 Speaker 1: not the virus itself, the quantities that we're seeing increases. 74 00:05:18,640 --> 00:05:22,400 Speaker 1: It's people who I would judge want to avoid the 75 00:05:22,480 --> 00:05:30,720 Speaker 1: contagion environments for for the virus. Telehealth is a young 76 00:05:30,839 --> 00:05:33,280 Speaker 1: field that originally caught on is a way to bring 77 00:05:33,279 --> 00:05:36,840 Speaker 1: healthcare to remote areas, but it's increasingly viewed as a 78 00:05:36,880 --> 00:05:41,360 Speaker 1: way to also relieve pressure on the American healthcare system. Now, 79 00:05:41,760 --> 00:05:45,919 Speaker 1: with the coronavirus straining every part of that system, companies 80 00:05:45,920 --> 00:05:49,680 Speaker 1: like Ners think this might be telehealth moment to prove 81 00:05:49,720 --> 00:05:53,560 Speaker 1: its worth. The argument for telehealth is that it allows 82 00:05:53,600 --> 00:05:56,600 Speaker 1: people who say just have the flu, to not crowd 83 00:05:56,720 --> 00:06:00,400 Speaker 1: urgent care centers and potentially get other people sick. It 84 00:06:00,440 --> 00:06:03,560 Speaker 1: also lets doctors easily see hundreds of patients in a week. 85 00:06:04,200 --> 00:06:07,040 Speaker 1: In many cases, doctors can figure out what's wrong and 86 00:06:07,080 --> 00:06:10,159 Speaker 1: write a prescription without you ever having to leave your couch. 87 00:06:11,440 --> 00:06:15,799 Speaker 1: In some cases, telehealth companies have actually even been overwhelmed 88 00:06:15,920 --> 00:06:19,400 Speaker 1: by the sergeant business. Empty Live has been around for 89 00:06:19,440 --> 00:06:23,160 Speaker 1: more than a decade, providing things like urgent care services online. 90 00:06:24,040 --> 00:06:27,720 Speaker 1: A lot of companies, including Bloomberg, offer it as part 91 00:06:27,760 --> 00:06:31,600 Speaker 1: of their health care plans. Charles says the coronavirus is 92 00:06:31,640 --> 00:06:34,680 Speaker 1: going to have a long term impact that makes telehealth 93 00:06:34,720 --> 00:06:38,159 Speaker 1: popular even after all of this is over. It isn't 94 00:06:38,160 --> 00:06:41,839 Speaker 1: to say that medicine can't be what it used to be. 95 00:06:42,360 --> 00:06:46,479 Speaker 1: It's to say medicine needs to be something different. It's 96 00:06:46,640 --> 00:06:50,239 Speaker 1: just not going to be capable of handling all the demand. 97 00:06:50,440 --> 00:06:56,320 Speaker 1: We also know that servicing health needs early tends to 98 00:06:56,360 --> 00:07:01,719 Speaker 1: curtail the total cost of delivery and and speeds a 99 00:07:01,800 --> 00:07:05,640 Speaker 1: patient to health sooner. So this is this is a 100 00:07:05,720 --> 00:07:09,400 Speaker 1: perfect storm that will have consequences, but they might actually 101 00:07:09,440 --> 00:07:13,440 Speaker 1: be really good for the industry. It's patients and for 102 00:07:13,520 --> 00:07:17,920 Speaker 1: that matter, it's providers. Charles thinks it could even result 103 00:07:17,920 --> 00:07:22,680 Speaker 1: in permanent changes to regulations. Already, the Trump administration has 104 00:07:22,720 --> 00:07:26,200 Speaker 1: relaxed certain ones on an emergency basis to make virtual 105 00:07:26,280 --> 00:07:31,600 Speaker 1: care more accessible, like expanding Medicare coverage. Some states have 106 00:07:31,680 --> 00:07:34,320 Speaker 1: also made it easier for doctors to get licensed in 107 00:07:34,400 --> 00:07:37,760 Speaker 1: order to allow them to see patients remotely. These kinds 108 00:07:37,760 --> 00:07:41,160 Speaker 1: of regulatory hurdles have definitely been one thing standing in 109 00:07:41,160 --> 00:07:44,520 Speaker 1: the way of industry growth. Telehealth is governed by a 110 00:07:44,720 --> 00:07:48,600 Speaker 1: thicket of regulations. They're different in every state and often 111 00:07:48,680 --> 00:07:53,200 Speaker 1: not very clear. It seemed like suddenly government and industry 112 00:07:53,480 --> 00:07:56,480 Speaker 1: were on the same page. With so much more demand 113 00:07:56,520 --> 00:07:59,720 Speaker 1: pouring in. Ner X wasn't the only venture backed company 114 00:07:59,760 --> 00:08:03,160 Speaker 1: to think there might be a good opportunity here. Hymns, 115 00:08:03,400 --> 00:08:06,360 Speaker 1: which is in the generic Viagra game, launched a primary 116 00:08:06,480 --> 00:08:09,880 Speaker 1: care service to help relieve pressure on urgent care centers 117 00:08:09,960 --> 00:08:15,160 Speaker 1: overwhelmed by COVID nineteen. One of its competitors, Roman launched 118 00:08:15,200 --> 00:08:19,320 Speaker 1: an online symptom assessment tool, and everly Well, a company 119 00:08:19,400 --> 00:08:23,320 Speaker 1: most well known for its food sensitivity tests, also announced 120 00:08:23,360 --> 00:08:28,120 Speaker 1: plans for coronavirus tests. Chris Hall, a clinical advisor to direx, 121 00:08:28,320 --> 00:08:31,040 Speaker 1: says the company's business model made it easy to meet 122 00:08:31,080 --> 00:08:35,680 Speaker 1: the growing demand for test kits. I think as the 123 00:08:35,760 --> 00:08:40,560 Speaker 1: initial outcry about the lack of testing became more and 124 00:08:40,679 --> 00:08:47,520 Speaker 1: more pronounced, we realized that we had a solution for 125 00:08:47,559 --> 00:08:52,880 Speaker 1: folks who were increasingly being asked to stay in their homes. So, 126 00:08:54,240 --> 00:08:57,160 Speaker 1: just prior to the time when the shelter in place 127 00:08:57,200 --> 00:09:01,320 Speaker 1: announcements in major cities uh AND and other public health 128 00:09:01,520 --> 00:09:07,080 Speaker 1: announcements about the importance of social distancing, that's when we realize, Hey, 129 00:09:07,120 --> 00:09:10,440 Speaker 1: if patients are going to be stuck at home, then 130 00:09:11,240 --> 00:09:14,760 Speaker 1: why not facilitate getting them a test hit right where 131 00:09:14,760 --> 00:09:23,199 Speaker 1: they are, which is at home. But it turns out 132 00:09:23,280 --> 00:09:26,480 Speaker 1: that regulators still might not move quite as fast as 133 00:09:26,520 --> 00:09:30,560 Speaker 1: Silicon Valley. One day after Nerk's launched its test, they 134 00:09:30,600 --> 00:09:33,520 Speaker 1: were forced to pull it off the market. Regulators said 135 00:09:33,520 --> 00:09:37,040 Speaker 1: they were concerned about how effective the tests were. They 136 00:09:37,080 --> 00:09:40,440 Speaker 1: said that at home consumer test kits didn't get the 137 00:09:40,480 --> 00:09:44,960 Speaker 1: same emergency exemptions that other ones do. To be honest, 138 00:09:45,280 --> 00:09:48,600 Speaker 1: I wasn't all that surprised by this. Even as regulators 139 00:09:48,600 --> 00:09:51,760 Speaker 1: have slowly embraced the idea that patients can receive certain 140 00:09:51,840 --> 00:09:54,760 Speaker 1: kinds of medical treatment at home, startups like Nerk's have 141 00:09:54,800 --> 00:09:59,160 Speaker 1: attracted some criticism. Some in the medical community think they're 142 00:09:59,160 --> 00:10:02,440 Speaker 1: exploiting regular tory gray areas and making it perhaps too 143 00:10:02,480 --> 00:10:06,240 Speaker 1: easy for customers to get their hands on prescriptions. Ner 144 00:10:06,400 --> 00:10:09,560 Speaker 1: X already offers an at home HIV test, but with 145 00:10:09,600 --> 00:10:12,960 Speaker 1: the home coronavirus test, it does seem like there could 146 00:10:12,960 --> 00:10:16,360 Speaker 1: be a lot of things to potentially go wrong. With 147 00:10:16,400 --> 00:10:19,880 Speaker 1: the disease already spreading at an alarming rate, a false 148 00:10:19,920 --> 00:10:24,760 Speaker 1: negative test could have devastating consequences, But it seems likely 149 00:10:25,000 --> 00:10:28,520 Speaker 1: that the FDA will approve and at home coronavirus tests 150 00:10:28,760 --> 00:10:32,000 Speaker 1: and potentially soon. In the US, there is a huge 151 00:10:32,120 --> 00:10:34,800 Speaker 1: shortage of tests and a need for people who aren't 152 00:10:34,880 --> 00:10:38,280 Speaker 1: very sick to seek treatment at home. Chris Hall says 153 00:10:38,360 --> 00:10:41,719 Speaker 1: that's a gap that telehealth was designed to fill. So 154 00:10:41,760 --> 00:10:44,960 Speaker 1: the test will tell you something about the likelihood of 155 00:10:45,280 --> 00:10:49,200 Speaker 1: your actually being infected with COVID nineteen, but much more 156 00:10:49,320 --> 00:10:51,920 Speaker 1: is needed after that, And what our platform does is 157 00:10:51,960 --> 00:10:56,440 Speaker 1: allows us to support people around things like testing and 158 00:10:56,480 --> 00:11:01,720 Speaker 1: around things like provision of medications. So what's quite unique 159 00:11:01,720 --> 00:11:04,080 Speaker 1: about our platform is that it's not a one off 160 00:11:04,120 --> 00:11:07,920 Speaker 1: consultation with a medical provider. So they might think of 161 00:11:07,960 --> 00:11:09,760 Speaker 1: a question that they have at three in the morning, 162 00:11:09,760 --> 00:11:12,680 Speaker 1: they can put it in the platform and get an answer. 163 00:11:13,160 --> 00:11:15,679 Speaker 1: Chris says that after all of this is over, there 164 00:11:15,679 --> 00:11:19,040 Speaker 1: could be a real shift in how patients seek medical care. 165 00:11:19,679 --> 00:11:22,920 Speaker 1: A big part is also just that old habits die hard. 166 00:11:23,559 --> 00:11:26,560 Speaker 1: When you get sick, your first instinct isn't usually to 167 00:11:26,600 --> 00:11:29,800 Speaker 1: try out some cool new website you read about. With 168 00:11:29,880 --> 00:11:34,120 Speaker 1: the coronavirus, though we're now all forced to consider ways 169 00:11:34,240 --> 00:11:38,440 Speaker 1: we can stay at home, we already are having dramatically 170 00:11:38,559 --> 00:11:42,720 Speaker 1: increased access to our other service lines. Um so we're 171 00:11:42,720 --> 00:11:46,160 Speaker 1: seeing upticks in the numbers of people who are actually 172 00:11:46,200 --> 00:11:49,839 Speaker 1: seeking our birth control services and other services. I think 173 00:11:50,320 --> 00:11:56,160 Speaker 1: as this COVID nineteen pandemic changes so many things fundamentally 174 00:11:56,200 --> 00:11:59,600 Speaker 1: about all of our lives. It's also going to change 175 00:11:59,600 --> 00:12:04,000 Speaker 1: the way people experience access to healthcare. So we want 176 00:12:04,400 --> 00:12:07,360 Speaker 1: to have the opportunity to demonstrate to people that they 177 00:12:07,400 --> 00:12:10,880 Speaker 1: can do so much of this from home, um that 178 00:12:11,000 --> 00:12:13,120 Speaker 1: they can access that test from home, that they can 179 00:12:13,200 --> 00:12:18,400 Speaker 1: have these ongoing connections with clinicians to get their questions 180 00:12:18,440 --> 00:12:21,960 Speaker 1: answered no matter what they are um from home, and 181 00:12:22,000 --> 00:12:27,640 Speaker 1: we think that's going to happen. Nor X says is 182 00:12:27,640 --> 00:12:31,200 Speaker 1: working hard to bring its tests back on the market. 183 00:12:36,800 --> 00:12:47,520 Speaker 1: And that's it for the Prognosis Daily Edition. For more 184 00:12:47,600 --> 00:12:50,560 Speaker 1: on the coronavirus crisis from a hundred and twenty bureaus 185 00:12:50,600 --> 00:12:55,480 Speaker 1: around the world, visit Bloomberg dot com slash coronavirus. If 186 00:12:55,520 --> 00:12:58,320 Speaker 1: you appreciate the podcast, please take a moment to rate 187 00:12:58,400 --> 00:13:00,760 Speaker 1: us and leave us a review on Apple Podcasts or 188 00:13:00,840 --> 00:13:05,640 Speaker 1: Spotify to help more listeners find our global reporting. The 189 00:13:05,679 --> 00:13:09,880 Speaker 1: Prognosis Daily Edition is hosted by me Laura Carlson. The 190 00:13:09,920 --> 00:13:14,120 Speaker 1: show is produced by me Tophor Forheaz, Jordan Gaspore, and 191 00:13:14,240 --> 00:13:19,959 Speaker 1: Magnus Henriksen. Reporting by Kristin V. Brown. Original music by 192 00:13:20,040 --> 00:13:24,720 Speaker 1: Leo Sidrin Our Editors are Francesco Levi and Rick Shine. 193 00:13:25,480 --> 00:13:30,240 Speaker 1: Francesco Levi is Bloomberg's head of podcasts. Thanks for listening.