WEBVTT - When You Can't Go See the Doctor 0:00:07.600 --> 0:00:12.479 Welcome to Prognosis. I'm Laura Carlson. It's day twenty one 0:00:12.520 --> 0:00:17.119 since coronavirus was declared a global pandemic. Today, in a 0:00:17.239 --> 0:00:20.960 lockdown world, doctors need to help patients without seeing them 0:00:20.960 --> 0:00:23.840 in person. It's opening up a whole new chapter for 0:00:23.880 --> 0:00:29.440 companies who specialize in remote medicine. But first today's news. 0:00:41.520 --> 0:00:45.040 The White House and Congressional Democrats are preparing for a 0:00:45.080 --> 0:00:48.200 fourth round of economic stimulus to get the US through 0:00:48.200 --> 0:00:52.879 its coronavirus outbreak. This comes after Congress past a two 0:00:53.040 --> 0:00:57.520 trillion dollar bill last Friday. White House officials have compiled 0:00:57.560 --> 0:01:01.880 requests from government agencies totaling roughly six hundred billion dollars, 0:01:01.920 --> 0:01:05.520 according to people familiar with the matter. The proposals include 0:01:05.640 --> 0:01:09.080 more state aid, as well as financial assistance for mortgage 0:01:09.120 --> 0:01:12.880 markets and travel industries. Trump said in a tweet on 0:01:12.920 --> 0:01:16.520 Tuesday that timing is good for a massive infrastructure bill 0:01:16.840 --> 0:01:20.200 because interest rates are close to zero. Nancy Pelosi had 0:01:20.240 --> 0:01:23.320 said last week infrastructure should be part of the next 0:01:23.440 --> 0:01:27.360 stimulus bill. The economy is going to be hit even 0:01:27.440 --> 0:01:30.800 harder by this outbreak than expected, says Goldman Sachs. The 0:01:30.880 --> 0:01:33.800 firm came out with a report today saying GDP will 0:01:33.840 --> 0:01:37.039 shrink by over a third in the second quarter they 0:01:37.040 --> 0:01:42.720 had previously estimated and already staggering twent contraction. Goldman said 0:01:42.800 --> 0:01:46.280 unemployment would hit fift percent by the middle of the year. 0:01:47.080 --> 0:01:50.120 The good news. They also think the economy will come 0:01:50.200 --> 0:01:53.600 back faster than expected in the third quarter, predicting growth 0:01:53.840 --> 0:01:59.880 of Anthony Fauci, the US government's top infectious disease x 0:02:00.520 --> 0:02:04.240 said on CNN that he's starting to see glimmers that 0:02:04.360 --> 0:02:07.400 social distancing might be slowing the spread of the pathogen, 0:02:07.640 --> 0:02:11.280 but he warned that the situation is still very dangerous. 0:02:11.800 --> 0:02:15.440 You're starting to see that the daily increases are not 0:02:15.560 --> 0:02:19.240 in that steep incline. They're starting to be able to 0:02:19.400 --> 0:02:22.360 possibly flatten out. I mean again, you you look at 0:02:22.360 --> 0:02:25.600 it carefully, hope it's going in the right direction. But 0:02:25.720 --> 0:02:28.720 that's what we really are trying to attain. Despite that 0:02:28.800 --> 0:02:32.480 careful optimism, the numbers still look bad, both in the 0:02:32.600 --> 0:02:36.480 US and around the world. In Europe, most places are 0:02:36.520 --> 0:02:41.560 still seeing alarming numbers of cases and deaths. Spain suffered 0:02:41.560 --> 0:02:45.320 its deadliest day of the pandemic, and European governments doubled 0:02:45.360 --> 0:02:50.000 down on efforts to maintain rigid lockdowns amid tentative signs 0:02:50.040 --> 0:02:53.440 that the infection rate was slowing. Italy and the Netherlands 0:02:53.520 --> 0:02:57.440 are discussing prolonging measures to limit personal contact, and German 0:02:57.480 --> 0:03:01.280 officials warned that it's too soon to ease restrictions because 0:03:01.320 --> 0:03:13.440 things could still get worse. And now today's main story 0:03:14.120 --> 0:03:19.480 the doctors we can't see around the country and the world. 0:03:19.840 --> 0:03:22.840 More and more people are locked in their homes, but 0:03:23.240 --> 0:03:26.200 people still need to see the doctor. That has made 0:03:26.240 --> 0:03:30.800 telehealth companies businesses that let doctors treat patients remotely, the 0:03:30.840 --> 0:03:35.080 new stars of the COVID nineteen economy. And I'm not 0:03:35.200 --> 0:03:38.080 just talking about companies that offer an alternative to an 0:03:38.160 --> 0:03:41.400 urgent care clinic if you've got the flu. Companies that 0:03:41.560 --> 0:03:45.120 until now have mainly offered prescriptions for birth control or 0:03:45.240 --> 0:03:49.680 hair loss pills are pivoting to provide services related to 0:03:49.720 --> 0:03:53.640 the pandemic. Telehealth has been trying to become a mainstream 0:03:53.680 --> 0:03:57.920 alternative to brick and mortar doctor's offices for years. Bloomberg 0:03:57.960 --> 0:04:01.640 Health reporter Kristen V. Brown words that these companies hope 0:04:01.720 --> 0:04:07.720 this moment will be their chance. About two weeks ago, 0:04:08.080 --> 0:04:10.960 an email that struck me as really kind of funny 0:04:11.040 --> 0:04:15.520 landed in my inbox. Ne Rex, the San Francisco startup 0:04:15.600 --> 0:04:19.760 best known for selling birth control online, was launching their 0:04:19.839 --> 0:04:25.760 own coronavirus test. Ne Rex is one of a bunch 0:04:25.800 --> 0:04:29.360 of Silicon Valley funded healthcare startups that promised really fast, 0:04:29.880 --> 0:04:34.320 really cheap healthcare online. You basically text with a doctor 0:04:34.440 --> 0:04:36.800 and then a few days later your prescription shows up. 0:04:37.600 --> 0:04:40.800 Suffice it to say, addressing a global pandemic seemed like 0:04:41.120 --> 0:04:44.400 kind of a big leap from the pill. But with 0:04:44.440 --> 0:04:48.120 so many people encouraged to stay home, it seems like 0:04:48.200 --> 0:04:52.920 telehealth is finally poised to have its moment everybody wants in. 0:04:53.920 --> 0:04:57.599 Charles Jones is chairman and CEO of MPD Live. He 0:04:57.640 --> 0:05:01.440 says business has nearly doubled in re and weeks. People 0:05:01.440 --> 0:05:04.320 who were going to see their physician for regular medical 0:05:04.360 --> 0:05:07.240 needs are now coming to us. People who want to 0:05:07.240 --> 0:05:10.400 the emergency room are now coming to us. People who 0:05:10.440 --> 0:05:12.920 want to urgent care are now coming to us. It's 0:05:13.080 --> 0:05:18.359 not the virus itself, the quantities that we're seeing increases. 0:05:18.640 --> 0:05:22.400 It's people who I would judge want to avoid the 0:05:22.480 --> 0:05:30.720 contagion environments for for the virus. Telehealth is a young 0:05:30.839 --> 0:05:33.280 field that originally caught on is a way to bring 0:05:33.279 --> 0:05:36.840 healthcare to remote areas, but it's increasingly viewed as a 0:05:36.880 --> 0:05:41.360 way to also relieve pressure on the American healthcare system. Now, 0:05:41.760 --> 0:05:45.919 with the coronavirus straining every part of that system, companies 0:05:45.920 --> 0:05:49.680 like Ners think this might be telehealth moment to prove 0:05:49.720 --> 0:05:53.560 its worth. The argument for telehealth is that it allows 0:05:53.600 --> 0:05:56.600 people who say just have the flu, to not crowd 0:05:56.720 --> 0:06:00.400 urgent care centers and potentially get other people sick. It 0:06:00.440 --> 0:06:03.560 also lets doctors easily see hundreds of patients in a week. 0:06:04.200 --> 0:06:07.040 In many cases, doctors can figure out what's wrong and 0:06:07.080 --> 0:06:10.159 write a prescription without you ever having to leave your couch. 0:06:11.440 --> 0:06:15.799 In some cases, telehealth companies have actually even been overwhelmed 0:06:15.920 --> 0:06:19.400 by the sergeant business. Empty Live has been around for 0:06:19.440 --> 0:06:23.160 more than a decade, providing things like urgent care services online. 0:06:24.040 --> 0:06:27.720 A lot of companies, including Bloomberg, offer it as part 0:06:27.760 --> 0:06:31.600 of their health care plans. Charles says the coronavirus is 0:06:31.640 --> 0:06:34.680 going to have a long term impact that makes telehealth 0:06:34.720 --> 0:06:38.159 popular even after all of this is over. It isn't 0:06:38.160 --> 0:06:41.839 to say that medicine can't be what it used to be. 0:06:42.360 --> 0:06:46.479 It's to say medicine needs to be something different. It's 0:06:46.640 --> 0:06:50.239 just not going to be capable of handling all the demand. 0:06:50.440 --> 0:06:56.320 We also know that servicing health needs early tends to 0:06:56.360 --> 0:07:01.719 curtail the total cost of delivery and and speeds a 0:07:01.800 --> 0:07:05.640 patient to health sooner. So this is this is a 0:07:05.720 --> 0:07:09.400 perfect storm that will have consequences, but they might actually 0:07:09.440 --> 0:07:13.440 be really good for the industry. It's patients and for 0:07:13.520 --> 0:07:17.920 that matter, it's providers. Charles thinks it could even result 0:07:17.920 --> 0:07:22.680 in permanent changes to regulations. Already, the Trump administration has 0:07:22.720 --> 0:07:26.200 relaxed certain ones on an emergency basis to make virtual 0:07:26.280 --> 0:07:31.600 care more accessible, like expanding Medicare coverage. Some states have 0:07:31.680 --> 0:07:34.320 also made it easier for doctors to get licensed in 0:07:34.400 --> 0:07:37.760 order to allow them to see patients remotely. These kinds 0:07:37.760 --> 0:07:41.160 of regulatory hurdles have definitely been one thing standing in 0:07:41.160 --> 0:07:44.520 the way of industry growth. Telehealth is governed by a 0:07:44.720 --> 0:07:48.600 thicket of regulations. They're different in every state and often 0:07:48.680 --> 0:07:53.200 not very clear. It seemed like suddenly government and industry 0:07:53.480 --> 0:07:56.480 were on the same page. With so much more demand 0:07:56.520 --> 0:07:59.720 pouring in. Ner X wasn't the only venture backed company 0:07:59.760 --> 0:08:03.160 to think there might be a good opportunity here. Hymns, 0:08:03.400 --> 0:08:06.360 which is in the generic Viagra game, launched a primary 0:08:06.480 --> 0:08:09.880 care service to help relieve pressure on urgent care centers 0:08:09.960 --> 0:08:15.160 overwhelmed by COVID nineteen. One of its competitors, Roman launched 0:08:15.200 --> 0:08:19.320 an online symptom assessment tool, and everly Well, a company 0:08:19.400 --> 0:08:23.320 most well known for its food sensitivity tests, also announced 0:08:23.360 --> 0:08:28.120 plans for coronavirus tests. Chris Hall, a clinical advisor to direx, 0:08:28.320 --> 0:08:31.040 says the company's business model made it easy to meet 0:08:31.080 --> 0:08:35.680 the growing demand for test kits. I think as the 0:08:35.760 --> 0:08:40.560 initial outcry about the lack of testing became more and 0:08:40.679 --> 0:08:47.520 more pronounced, we realized that we had a solution for 0:08:47.559 --> 0:08:52.880 folks who were increasingly being asked to stay in their homes. So, 0:08:54.240 --> 0:08:57.160 just prior to the time when the shelter in place 0:08:57.200 --> 0:09:01.320 announcements in major cities uh AND and other public health 0:09:01.520 --> 0:09:07.080 announcements about the importance of social distancing, that's when we realize, Hey, 0:09:07.120 --> 0:09:10.440 if patients are going to be stuck at home, then 0:09:11.240 --> 0:09:14.760 why not facilitate getting them a test hit right where 0:09:14.760 --> 0:09:23.199 they are, which is at home. But it turns out 0:09:23.280 --> 0:09:26.480 that regulators still might not move quite as fast as 0:09:26.520 --> 0:09:30.560 Silicon Valley. One day after Nerk's launched its test, they 0:09:30.600 --> 0:09:33.520 were forced to pull it off the market. Regulators said 0:09:33.520 --> 0:09:37.040 they were concerned about how effective the tests were. They 0:09:37.080 --> 0:09:40.440 said that at home consumer test kits didn't get the 0:09:40.480 --> 0:09:44.960 same emergency exemptions that other ones do. To be honest, 0:09:45.280 --> 0:09:48.600 I wasn't all that surprised by this. Even as regulators 0:09:48.600 --> 0:09:51.760 have slowly embraced the idea that patients can receive certain 0:09:51.840 --> 0:09:54.760 kinds of medical treatment at home, startups like Nerk's have 0:09:54.800 --> 0:09:59.160 attracted some criticism. Some in the medical community think they're 0:09:59.160 --> 0:10:02.440 exploiting regular tory gray areas and making it perhaps too 0:10:02.480 --> 0:10:06.240 easy for customers to get their hands on prescriptions. Ner 0:10:06.400 --> 0:10:09.560 X already offers an at home HIV test, but with 0:10:09.600 --> 0:10:12.960 the home coronavirus test, it does seem like there could 0:10:12.960 --> 0:10:16.360 be a lot of things to potentially go wrong. With 0:10:16.400 --> 0:10:19.880 the disease already spreading at an alarming rate, a false 0:10:19.920 --> 0:10:24.760 negative test could have devastating consequences, But it seems likely 0:10:25.000 --> 0:10:28.520 that the FDA will approve and at home coronavirus tests 0:10:28.760 --> 0:10:32.000 and potentially soon. In the US, there is a huge 0:10:32.120 --> 0:10:34.800 shortage of tests and a need for people who aren't 0:10:34.880 --> 0:10:38.280 very sick to seek treatment at home. Chris Hall says 0:10:38.360 --> 0:10:41.719 that's a gap that telehealth was designed to fill. So 0:10:41.760 --> 0:10:44.960 the test will tell you something about the likelihood of 0:10:45.280 --> 0:10:49.200 your actually being infected with COVID nineteen, but much more 0:10:49.320 --> 0:10:51.920 is needed after that, And what our platform does is 0:10:51.960 --> 0:10:56.440 allows us to support people around things like testing and 0:10:56.480 --> 0:11:01.720 around things like provision of medications. So what's quite unique 0:11:01.720 --> 0:11:04.080 about our platform is that it's not a one off 0:11:04.120 --> 0:11:07.920 consultation with a medical provider. So they might think of 0:11:07.960 --> 0:11:09.760 a question that they have at three in the morning, 0:11:09.760 --> 0:11:12.680 they can put it in the platform and get an answer. 0:11:13.160 --> 0:11:15.679 Chris says that after all of this is over, there 0:11:15.679 --> 0:11:19.040 could be a real shift in how patients seek medical care. 0:11:19.679 --> 0:11:22.920 A big part is also just that old habits die hard. 0:11:23.559 --> 0:11:26.560 When you get sick, your first instinct isn't usually to 0:11:26.600 --> 0:11:29.800 try out some cool new website you read about. With 0:11:29.880 --> 0:11:34.120 the coronavirus, though we're now all forced to consider ways 0:11:34.240 --> 0:11:38.440 we can stay at home, we already are having dramatically 0:11:38.559 --> 0:11:42.720 increased access to our other service lines. Um so we're 0:11:42.720 --> 0:11:46.160 seeing upticks in the numbers of people who are actually 0:11:46.200 --> 0:11:49.839 seeking our birth control services and other services. I think 0:11:50.320 --> 0:11:56.160 as this COVID nineteen pandemic changes so many things fundamentally 0:11:56.200 --> 0:11:59.600 about all of our lives. It's also going to change 0:11:59.600 --> 0:12:04.000 the way people experience access to healthcare. So we want 0:12:04.400 --> 0:12:07.360 to have the opportunity to demonstrate to people that they 0:12:07.400 --> 0:12:10.880 can do so much of this from home, um that 0:12:11.000 --> 0:12:13.120 they can access that test from home, that they can 0:12:13.200 --> 0:12:18.400 have these ongoing connections with clinicians to get their questions 0:12:18.440 --> 0:12:21.960 answered no matter what they are um from home, and 0:12:22.000 --> 0:12:27.640 we think that's going to happen. Nor X says is 0:12:27.640 --> 0:12:31.200 working hard to bring its tests back on the market. 0:12:36.800 --> 0:12:47.520 And that's it for the Prognosis Daily Edition. For more 0:12:47.600 --> 0:12:50.560 on the coronavirus crisis from a hundred and twenty bureaus 0:12:50.600 --> 0:12:55.480 around the world, visit Bloomberg dot com slash coronavirus. If 0:12:55.520 --> 0:12:58.320 you appreciate the podcast, please take a moment to rate 0:12:58.400 --> 0:13:00.760 us and leave us a review on Apple Podcasts or 0:13:00.840 --> 0:13:05.640 Spotify to help more listeners find our global reporting. The 0:13:05.679 --> 0:13:09.880 Prognosis Daily Edition is hosted by me Laura Carlson. The 0:13:09.920 --> 0:13:14.120 show is produced by me Tophor Forheaz, Jordan Gaspore, and 0:13:14.240 --> 0:13:19.959 Magnus Henriksen. Reporting by Kristin V. Brown. Original music by 0:13:20.040 --> 0:13:24.720 Leo Sidrin Our Editors are Francesco Levi and Rick Shine. 0:13:25.480 --> 0:13:30.240 Francesco Levi is Bloomberg's head of podcasts. Thanks for listening.