Statement from Milken Institute Chairman Michael Milken
All of us at Milken Institute are working closely with leaders in industry, government, and medical research organizations to:
mitigate the spread of COVID-19;
expedite the discovery and rollout of tests/treatments/cures and;
consult with economic and policy leaders to provide information and expertise that can help companies and their employees weather the current conditions.
Across the Institute, we are focused on six areas: education, prevention, testing, treatment, cures, and financial assistance as we:
Activate our advisory boards and networks, and leverage our media relationships and social media platforms to disseminate accurate information.
Connect private industry, schools of public health, government agencies and policymakers to expedite advances in treatments and address diagnostic, staffing and device shortages.
Provide policy recommendations to support businesses as they lead virtual workforces, care for their employees and their employees' families, and access the capital they need to operate.
Over the next several weeks, we will be convening a series of conference calls for all supporters and friends of the Institute who are looking for perspective on the latest scientific thinking and market implications of the coronavirus outbreak. We will include content experts from a number of fields as well as internal thought leaders.
We will continue to leverage our extensive platform and working with our partners and supporters, private industry, government agencies, and other policymakers, to help resolve the many issues presented by COVID-19 as our nation addresses this unprecedented challenge.
A more specific review of the efforts underway at each of our Centers is detailed below.
The mission of FasterCures is to understand how industry and government are accelerating medical treatment. COVID-19 is testing biomedical research in ways we have rarely experienced, it is therefore critical to understand the progress being made towards solving this public health emergency.
COVID-19 Treatment and Vaccine Tracker
We have created a comprehensive online tracker that reviews the treatment and vaccine research currently in development that might help in the fight against COVID-19. Each row tracks a treatment or vaccine from discovery to clinical trial, accompanied by the name of the organization undertaking the research. This tool, collated from publicly available sources, is updated daily.
FasterCures Advisory Board Response Team
We have activated the FasterCures Advisory Board—which includes three former FDA commissioners and critical disease and biopharma experts: Scott Gottlieb, Peggy Hamburg, Mark McClennan, and David Baltimore—in our response to COVID-19. Alongside our other board members, they are leveraging their vast networks to develop critical solutions to the outbreak, with a focus on three areas:
Matching capital with promising science, to ensure no good idea goes unaddressed due to financial constraints;
Ramping-up manufacturing capacity, making sure approved therapies and vaccines get into the hands of doctors and patients as quickly as possible;
Ensuring regulators have sufficient resources to review promising diagnostics and therapeutics by recruiting subject matter experts from the academic community, which is also experiencing work-from-home orders and may have capacity.
Biopharmaceutical Vaccine and Cure Development Clearinghouse
More than 20 leading biopharmaceutical companies and business leaders serve on the FasterCures Business Council. We have reached out to this community to identify ways to speed the development of treatments and cures either through vaccine development or repurposing drugs. Companies are reaching out to share their efforts, and we are conducting regular calls to hear updates and address any immediate policy barriers that may impede progress towards a cure.
Disease Philanthropy Best Practice Community
Twenty-two of the most prominent disease foundations and philanthropies are members of the FasterCures Non-Profit Council. We have engaged this group to share their experiences with their patient populations in addressing COVID-19. Through this effort, FasterCures is gathering and will disseminate best practices to ensure that some of the most vulnerable patient groups have access to the critical information they need to avoid contracting COVID-19, and to obtain the best care should they contract it.
Older adults and those with underlying health conditions remain at greatest risk from COVID-19. The Milken Institute Center for the Future of Aging is promoting evidence-based solutions and highlighting issues of importance to lessen the negative impact of COVID-19 on older adults and other at risk populations.
Center for the Future of Aging Advisory Board Response Team
Members of the Center’s Academic and Policy Advisory Board and Business Council are leading authorities on aging, and include prominent academics, policy experts, and experienced business leaders. Our network has been actively discussing and developing recommendations on a wide range of issues, from the challenges facing older adults in health and long-term care facilities, to the impact of market fluctuations on retirement security.
The current crisis exposes a critical gap in how society has valued those who care for at-risk older adults across multiple care settings. In the US, our nation’s long-term care workers—those who provide direct care for aging adults disproportionately affected by COVID-19—are an indispensable part of our national emergency response. Yet this workforce is underpaid, overworked, and has one of the highest turnover rates among all US occupations.
Unlike other health care professionals, these front-line workers typically lack adequate health insurance and paid-sick-leave benefits; and one in six lives in poverty. Many long-term care workers hold multiple jobs in order to pay their own bills and support their families. As a result, they are at heightened risk of exposure to the coronavirus and, in turn, risk exposing many older adults and people with disabilities—especially those living in nursing homes and assisted living facilities. To learn more about ways to professionalize and expand the long-term care workforce, see “Age-Forward Cities for 2030”
In collaboration with the Milken Institute’s Innovative Finance team, Center for the Future of Aging will be creating a webpage with important facts and figures regarding the financing and delivery of long-term services and support, with several concrete ideas for solutions to address the gaps in funding and delivery system failures.
Social Isolation and Loneliness
Loneliness and social isolation are urgent health concerns. In the wake of the coronavirus pandemic, officials have called on us to practice social distancing to reduce exposure. Many homebound older adults will remain isolated for their own health and safety, and rely increasingly on telehealth and on-demand services for meal-delivery. How can we ensure the safety of those most vulnerable among us while mitigating the effects of prolonged isolation?
Our “Age-Forward Cities for 2030” report highlights community programs and technology that address social isolation. In addition, our report on “Reducing the Cost and Risk of Dementia: Recommendations to Improve Brain Health and Decrease Disparities” addresses the risk of social isolation and loneliness. This report highlights Dementia Friendly America, a national network seeking to ensure that communities across the US are equipped to support people living with dementia and their caregivers. Communities, care providers, and organizations will have to adapt and innovate during this time. Aging 2.0 is calling on everyone to submit innovations from around the world—or offers of help—that may be useful for those working with aging populations struggling with the COVID-19 pandemic.
Older Adults with Complex Care Needs
People living with dementia and other complex health conditions require an integrated approach to ensuring their needs are met, especially during a time of social distancing. Social engagement opportunities at memory cafes, senior centers, health clubs, and even within faith-based communities have been significantly cut back, if not eliminated altogether.
Even home-delivered services are at risk, as many home- and community-based organizations rely on older adults as volunteers. Now is the time to implement intergenerational solutions to address these concerns. Our partners, including AARP, the John A. Hartford Foundation, the Eisner Foundation, the SCAN Foundation, and the Annenberg Foundation are coming together to share best practices. Center for the Future of Aging Chairman Paul Irving contributed his expertise to a MarketWatch article. He shared that we must focus on the most vulnerable: “the older a disease-sufferer, the higher the risk.”
Local Responses to Protect Vulnerable Populations
Local public health responses are rapidly being developed and deployed, including measures focused on increasing social distancing and protecting the most vulnerable populations, including older adults experiencing homelessness. Paul Irving and Center Director Lauren Dunning are authoring an editorial on the impact of COVID-19 on older adults experiencing homelessness—for whom many of the recommended preventive measures, such as handwashing and social distancing, are out of reach—and the response of cities to meet their needs. Lauren Dunning also shared insights with Business Insider for an article on dining out, social distancing, and at-risk populations.
Older Workers and Finding Purpose During the Pandemic
An increasing number of older adults are continuing to work past the age of 65. This decision to delay retirement is often out of economic necessity, lack of retirement savings, and the sense of purpose that work brings. COVID-19 has forced many people into unemployment, especially older workers who are being told to self-isolate because of the risks of the disease to older adults. Paul Irving is discussing work and purpose during this pandemic with LAist and NextAvenue.
Epidemics and Pandemics as Transnational Issues: The Challenge of the Novel Coronavirus
Lauren Dunning coauthored an article for the Georgetown Journal of International Affairs about the challenge of COVID-19 transnationally. The outbreak is testing the global community, its governance structures, and its mechanisms for international collaboration. Many key data points critical to fully characterizing the disease epidemiology of COVID-19—including transmissibility, potential for asymptomatic spread, and risk factors for severe illness or death—are still emerging. As a result, a collective global response under strong World Health Organization (WHO) leadership, followed by subsequent nation-level implementation, is vital to ensuring the good of the many is not sacrificed for the good of the few.
Individuals and businesses in low- and moderate-income communities are disproportionately feeling the negative economic shock from the coronavirus. The Milken Institute Center for Financial Markets conducts research and outreach, and constructs programs designed to facilitate the smooth and efficient operation of financial markets, to help ensure that they are fair and available to those who need them.
Providing Access to Capital for Small Businesses in Economically Distressed Communities
Many small businesses did not survive the recession that followed the 2008 global financial crisis because they did not have access to the capital needed to pay their obligations (e.g. employee wages, supplier invoices, and debt payments). Already underserved, small businesses in low- and moderate-income (LMI) communities will disproportionately feel the negative economic shock from the coronavirus. Through the Center’s work on Opportunity Zones and Impact Banking, we have identified some initial policy recommendations, including:
Regulatory Relief: Amend some FDIC, Federal Reserve, and OCC regulatory standards to allow banks (with less than 5 billion USD in assets) that target LMI communities more flexibility—such as a wider range within key ratios they must maintain (i.e., liquidity, capital adequacy, and leverage)–to not only be in good standing, but also continue to provide capital as needed.
Balance Sheet Relief: Expand Treasury’s Minority Bank Deposit Program to increase deposits in MDIs and adjust the Small Business Administration Guarantee Program to cover 100% of targeted small business loans that target LMI communities to ensure continued capacity to provide access to capital.
Short-term Capital Support: Increase federal resources to enhance the Tier 1 Capital of banks that support underserved communities such as minority depository institutions (MDIs) and community development financial institutions (CDFI) funds.
Long-term Capital Support: Amend the 2017 Tax Cuts and Jobs Act to allow investments in MDIs and CDFIs to qualify for Opportunity Zone benefits. Because Qualified Opportunity Zone Businesses cannot have more than 5 percent of their assets in “nonqualified financial property” (as defined in paragraph (8) of 26 USC section 1397C(b)), CDFIs are excluded from eligibility for Qualified Opportunity Fund investments.
Education and Training: Increase appropriations to the U.S. Department of Commerce’s Minority Business Development Agency (MBDA) to allow for additional financial assistance in the form of grants to Minority Business Centers to provide education, training, and advising to minority-owned business that negatively affected by COVID-19 such as severe supply chain disruptions, staffing challenges, and sales declines.
Building A Safer, More Sustainable Housing Finance System
The Housing Finance Program team has been in close contact with policymakers across federal agencies as well as a wide range of housing finance stakeholders in a collaborative effort to identify and solve for the many economic issues arising from COVID-19. Millions of consumers – especially the financially insecure – will struggle with housing payments and face the life-changing, lasting repercussions of delinquency and default.
We are working to offer practical and effective solutions to help consumers, businesses, and the housing finance system weather this unprecedented crisis. We are particularly focused on ensuring that no homeowner is left out of proposed solutions; as we learned from the global financial crisis, the relief available to a borrower should not depend on who owns the borrower’s mortgage loan, but on what is fair and impactful for the borrower.
To that end, we are engaging on housing finance issues that include:
Relief, and the different methods to provide this relief, currently available to distressed consumers in the agency, government, and non-agency mortgage channels; and government or industry actions that can or must be taken to provide or enhance this relief.
Additional actions that government and industry could take, including potential government assistance to private entities, to ensure the liquidity and other support necessary to afford relief to homeowners and maintain industry and systemic safety and soundness throughout this crisis.
The role of key government agencies, including the Federal Housing Finance Agency (FHFA), the Department of Housing and Urban Development (HUD), and the Bureau of Consumer Financial Protection (CFPB), in addressing the impact of COVID-19 across the housing finance landscape.
Leveraging Financial Technology (FinTech)
The Center's FinTech program team explores how traditional financial services firms and alternative finance platforms can best leverage technology to provide the optimal amount and type of capital to small businesses and consumers in a quick, efficient, and responsible manner during the COVID-19 crisis.
The FinTech program team is working closely with our FinTech Advisory Committee – a group of outside experts that includes executives from FinTech firms, former senior government officials, academics, and thought leaders – to understand the impact of the pandemic on local economies and in what ways local, state, and federal officials should respond to best support the capital needs of those most affected by the current pandemic.
Building More Resilient Infrastructure Through Public-Private Partnerships
Given strong public and private interest in finding new approaches to fund and finance critical infrastructure needs, the Center created the Resilient Infrastructure Financing Initiative in 2019 to help accelerate innovative solutions for new infrastructure basics like broadband for remote work, energy-efficient hospitals, and clean water systems.
Since then, the Center for Financial Markets has been developing action-oriented research, trainings, and policy development to help communities learn how to better leverage public investment through public-private partnerships.
Even before the current crisis, the nation faced a multitrillion-dollar infrastructure funding and financing gap, due in part to the fact that state and local governments represent the largest economic sector that never recovered from the 2008-2009 economic recession. The gap will undoubtedly grow in the wake of new state and local fiscal strains from the current crisis. It is more important than ever to build a new paradigm and develop best practices to start to fill the infrastructure funding and financing gap.
Regional Economic Response Framework
Cities and counties cannot act to contain the spread of the virus nor limit its economic impact without explicit backing from state governments. If local and state leaders do not act together, it is difficult to predict the effectiveness of federal government intervention on its own.
The Milken Institute Center for Regional Economics is developing a collaborative regional response framework to share with federal, state, and local public officials that ensures they can meet their constituents’ specific needs. This framework will help expand local communities’ access to sources of state and federal emergency funding as well as organize contributions from philanthropic and private sector partners that address deficiencies in the existing response infrastructure.
Our Regional Response Framework engages state-level public officials in both the Executive and Legislative branches.
We are encouraging Governors’ Offices to design public service announcements to inform the public about available resources and coordinate regional responses, particularly at the county and city levels.
We are also advising on the deployment of state National Guard units and the utility of requests for federal assistance, such as coordination with FEMA to produce and distribute test kits.
Moreover, we are advising State Legislatures to consider and vote on funding proposals to provide key resources. These proposals include:
Regional medical response teams and fever clinics.
Direct subsidies to families with children in public schools to replace the value of school lunch programs.
Extension of paid leave to parents now responsible for childcare or caring for sick family members at home.
Specific relief for homeless populations.
Access to Capital for Small Business
Capital access is a core component of the Center’s research and programming agenda, and the particularly severe impact of this crisis on small businesses is guiding our actions in this area.
Small businesses employ approximately half of US workers, and two-thirds of net new job creation since the 2008-2009 financial crisis was initiated by small businesses. However, current projections indicate that more than 2.5 million small business jobs may be eliminated through economic contraction due to COVID-19.
Given that the size of the US economy is over $20 trillion, proposals for a recovery plan to provide $1-2 trillion may not be sufficient to minimize job losses and lay the foundation for recovery and sustainable growth. Our specific actions in response to this crisis fall into three areas:
Broad Stimulus Package
First, we are actively providing advice and feedback to federal and state public officials on the design and delivery of a broad stimulus package to help small businesses meet payroll and expenses.
From our point of view, comprehensive relief should be built on a foundation of low-interest loans and grants for immediate delivery. It should also include procurement opportunities to help sustain employment levels, regulatory streamlining to reduce administrative bottlenecks, tax incentives to encourage investment, and technical assistance to support human capital development.
Specific Assistance Programs
Second, given the decision by the US Small Business Administration to extend Economic Injury Disaster Loans upon requests from state governors, we are currently evaluating this and other proposals before the US Congress to provide specific assistance to small businesses.
In addition to studying the conditions for loan eligibility as a function of immediate needs in the community—particularly given the number of small businesses that may be losing access to other sources of credit—we are also evaluating proposals for payroll forgiveness, increased SBA loan limits, small business tax rebates, suspension of debt collection, and moratoriums on business evictions.
We are also engaging federal and state officials regarding proposals to expand unemployment insurance and sick leave.
Third, we are assisting businesses experiencing difficulties due to a lack of access to the capital required to retain their employees through the crisis, as well as to expand after it subsides.
Our main recommendations to small businesses include the following:
Use available lines of credit as soon as practicable to avoid potential problems with accessing cash flow due to further disruptions in the lending environment.
Reexamine long-term expenses and reduce, delay, or eliminate short-term non-essential operational costs as much as possible.
Reduce hours for nonessential personal (in lieu of laying off workers) to reduce downtime and ramp up full operations quickly once conditions improve.
Establish open lines of communication with creditors and suppliers to increase flexibility and provide more opportunities for adjustment.
The Milken Institute's Center for Public Health is focused on prevention and preparation efforts by connecting our networks and communities in an effort to slow the spread of the coronavirus.
Flatten the Curve
We are encouraging people to participate in aggressive handwashing and social distancing; and coordinating with our Advisory Board members, private and public sector partners, and schools of public health to support efforts to #flattenthecurve.
Schools of Public Health Ambassador Coalition
CPH is working to convene deans from Schools of Public Health to mobilize their communities to act as public health ambassadors. They will develop an ambassador toolkit to implement in their local communities to address needs to cope with the pandemic:
Continued education around adherence to public health best practices: hand washing, social distancing, and continued healthy habits (e.g., reducing stress, eating nutritious foods, and getting ample sleep).
Actions less intuitively related to disease spread, but rather, urgent upstream public health measures: organizing transportation, maintaining healthy living environments, safety.
Resources to help at-risk populations reduce exposure.
Perspectives on Coping with Coronavirus
The Center for Public Health is working to provide timely updates from medical and professional experts about the Coronavirus, including:
How to manage chronic disease while stay-at-home orders are in effect.
Recommendations to help people deal with isolation and loneliness.
Food procurement, emergency food distribution, and food safety during pandemic.
Philanthropic capital that is nimble, risk-tolerant, and informed by communities is critical to society’s response to a public health emergency like COVID-19. Philanthropy can not only bolster short-term mitigation—i.e. funding community resources, reducing the impact of lost wages on low-income individuals and families, facilitating the delivery of medical supplies—it can also drive systems change, advance scientific research into prevention, diagnosis, and treatment, and strengthen the nonprofit ecosystem to ensure efficient delivery of services.
The Center for Strategic Philanthropy will be launching resources to help social investors channel their philanthropy to address immediate and longer-term needs to rebuild communities, advance science, and drive long-term systemic change. As part of our advisory service, the Center for Strategic Philanthropy is also working with major donors as they increase their philanthropy and unlock more dollars to respond to the COVID-19 crisis.
Being nearest to the epicenter of the outbreak, our Asia Center, based in Singapore, has been galvanizing our prominent regional network and consulting with Asia Pacific’s top policy and business leaders to provide information and share best practices that can help companies and governments around the world.
We are building a depository of information on a) public health policies and measurements implemented by Asia Pacific government leaders to curb the spread of COVID-19, b) financial packages and economic policies designed by Asia Pacific governments to limit the economic damage of the coronavirus and c) philanthropic efforts to address both public health and financial challenges caused by COVID-19.
Our senior Asia Fellows have been sharing on-the-ground knowledge and insights with the media on the impact of Covid-19.