Author Archives: henrykotula

Identifying “triple-threat” counties at higher risk of COVID outbreaks

Posted on by • Posted in Clinical Testing, Contact Tracing, Coronavirus, Correctional Facilities, Crisis, Crisis Management, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Meatpacking Plants, Mortality, Nursing Home, Pandemic, Public Health, Public Safety, Quarantine, Social Determinants of Health, Social Distancing, Superspreader Facilities • Leave a comment

https://mailchi.mp/9f24c0f1da9a/the-weekly-gist-june-5-2020?e=d1e747d2d8

“Superspreader facilities”—nursing homes, correctional facilities, and meatpacking plants—have become major COVID hotspots across the US. Many counties are dealing with a large outbreak in one type of tightly-packed facility or another.

Case in point: the outbreak at Cook County Jail in Chicago, which now accounts for a whopping 15.7 percent of all COVID cases in the state of Illinois. Some places, like Colorado’s Weld County, are managing outbreaks across all three types of superspreader facilities.

The graphic above highlights the nearly 260 counties that we’ve termed “triple-threat counties”: those which have all three types of superspreader facilities. The counties are mapped using our Gist Healthcare COVID-19 Risk Factor Index, which identifies particularly vulnerable populations using chronic disease, demographic, and acute care access variables.

The top 10 “triple-threat counties” by risk index score are all in more rural areas of the country with limited acute care access and more vulnerable populations—places where a COVID outbreak is likely to be particularly devastating. Seven of the 10 have a high percentage of African-American or Hispanic/Latino residents, groups with a an outsized burden of COVID-19 illness and death. These risk factors are intersectional; for example, food processing plants employ twice as many Hispanic workers as the national average, and a disproportionate share of long-term care workers are black.

[Click here for more information and interactive data from our analysis of the risk impact of these superspreader facilities.]

 

 

 

 

66% of counties with most COVID-19 cases lack infectious disease physician

Posted on by • Posted in Access, Access & Quality of Healthcare, Coronavirus, Health Policy, Infection Control, Infection Control Plan, Infectious Disease Physician, Infectious Virus, Physician, Public Health, Telemedicine • Leave a comment

https://www.beckershospitalreview.com/infection-control/66-of-counties-with-most-covid-19-cases-lack-infectious-disease-physician.html?utm_medium=email

About 208 million Americans are living in counties with no or very few infectious disease physicians, and many of these areas have been hit hardest by COVID-19, according to a study published in Annals of Internal Medicine.

Researchers determined the density of infectious disease physicians in every U.S. county using 2017 Medicare Provider Utilization and Payment Data. They also used aggregated data from the CDC and local public health agencies to plot the rate of confirmed COVID-19 cases in each county as of May 12.

Four study findings:

1. Of the 3,142 total counties in the U.S., 79.5 percent did not have a single infectious disease physician.

2. Among 785 counties with the highest burden of COVID-19 cases, 66 percent did not have an infectious disease physician working in the county.

3. About 9.9 percent of counties had an infectious disease physician density below the national average of 1.76 physicians per 100,000 population.

4. Only 10.5 percent of counties had an infectious disease physician density above the national average.

“The deficits in our [infectious disease] physician workforce today have left us poorly prepared for the unprecedented demand ahead,” study authors said, highlighting telemedicine as a key strategy for expanding access to this speciality.

To view the full study, click here.

 

 

 

 

Chart of the Day: The Dire State of State Tax Revenues

Posted on by • Posted in 2020 Election Issues, Economic Crisis, Economic Stimulus, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employee Protections, Health Insurance Coverage Adequacy, Health Policy, Health System, Hospital, Hospital Industry, Job, Job Market, Job Search, Job Security, Market Outlook, Medicaid, State Budgets, Uncompensated Care, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://www.thefiscaltimes.com/2020/06/02/Chart-Day-Dire-State-State-Tax-Revenues

Chart of the Day: The Dire State of State Tax Revenues | The ...

Lucy Dadayan of the Urban-Brookings Tax Policy Center breaks down the good, the bad and the ugly of the fiscal crisis facing states as the coronavirus pandemic crushes revenues and raises costs.

“Prior to the onset of the COVID-19 pandemic, most states were generating solid revenue growth. And many built up robust rainy day funds. But the pandemic has largely wiped out earlier revenue gains and most states now anticipate substantial revenue shortfalls for the current fiscal year and for fiscal year 2021,” she writes.

The good: Preliminary April tax revenue data show a steep drop in estimated and final annual tax payments as the tax-filing deadline got pushed back from April 15 to July 15. But taxes withheld from paychecks grew in 17 states compared to April 2019. “Tax withholding is usually a better indicator of the current strength of the economy and of the path for personal income tax revenue because it comes largely from current wages,” Dadayen explains. On the other hand, 16 states reported declines of less than 10%, while five states posted double-digits drops, so the bright spots are limited.

The bad: “Declines in sales tax revenues have been fast, steep, and widespread across the states,” Dadayen writes. How steep? April sales tax revenues fell by 16% across 42 states for which the Tax Policy Center has complete data. Twenty-three states reported double-digit declines, while just five states reported year-over-year growth. And since the April data mostly reflect March sales, the May numbers are likely to be even worse.

The ugly: For the fiscal year so far, total state tax revenue has fallen sharply — and next year is expected to be worse. “With two months remaining in the fiscal year for 46 states, total state tax revenues are now down about $57 billion, compared to last year,” Dadayen writes.

After the sharp pandemic-related plunge in April, tax revenues have fallen in 34 states compared to 2019 and risen in 12. (New York, the state hit hardest by the virus, is surprisingly among those dozen, but Dadayen says that’s only because its fiscal year 2020 ended in March, so April’s devastation isn’t reflected in the data. The state reported that net taxes and fees collected in April, the first month of its new fiscal year, fell by 69% compared with April 2019.)

Chart of the Day: The Dire State of State Tax Revenues | The ...

 

 

 

A Third of Unemployment Benefits Haven’t Been Paid Out: Report

Posted on by • Posted in 2020 Election Issues, Coronavirus, Crisis, Crisis Management, Dept of Labor, Economic Crisis, Economic Stimulus, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employee Protections, Employer-Based Health Insurance, Health Insurance Coverage Adequacy, Health Policy, Job, Job Market, Job Search, Job Security, Market Outlook, Pandemic, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://www.thefiscaltimes.com/2020/06/02/Third-Unemployment-Benefits-Haven-t-Been-Paid-Out-Report

A Third of Unemployment Benefits Haven't Been Paid Out: Report

The U.S. Treasury paid out $146 billion in jobless benefits in the three months ending in May as tens of millions of Americans lost their jobs due to the coronavirus pandemic. Although the number is massive – larger than all of the unemployment benefits provided during the depths of the Great Recession in 2009 – it’s smaller than it should have been, according to a new analysis by Bloomberg News. Crunching the numbers on weekly unemployment filings and average claim size, Bloomberg found that total jobless benefits should have come to roughly $214 billion during that time.

“The estimated gap of some $67 billion shows how emergency efforts to boost payments, and deliver them via creaking state-level systems, are lagging the needs of a jobs crisis that’s seen more than 40 million people file for unemployment as the economy shut down,” Bloomberg’s Shawn Donnan and Catarina Saraiva wrote Tuesday.

A tough calculation: Although it’s hard to put a precise number on the shortfall – the Labor Department pushed back against the method used by Bloomberg to develop its estimate – there is general agreement that there are many people who still haven’t received the unemployment assistance they are entitled to. “There’s a lot more money that should have gone out that has not gone out,” said Jay Shambaugh, an economist at the Brookings Institution who has been studying the issue.

And Bloomberg says its analysis likely provides a conservative estimate of the shortfall. Some states are still working through backlogs of unemployment claims – Texas alone is waiting to verify nearly 650,000 cases – and more than 7 million people are still owed retroactive benefits under the Pandemic Unemployment Assistance program for independent contractors.

Why it matters: In addition to the unnecessary suffering the delays are causing, the shortfall is reducing the positive economic effect that unemployment benefits are intended to provide. “On paper the U.S. strategy is very generous,” Ernie Tedeschi, a former U.S. Treasury economist now at Evercore ISI, told Bloomberg. “But that generosity on paper is meaningless if it doesn’t translate into actual money in people’s pockets when they need it.”

Diane Swonk, chief economist at the accounting firm Grant Thornton, said she is worried that lawmakers are experiencing “fiscal fatigue” as the crisis wears on, risking a falloff in aid that could prolong the recession. “We’re really talking about an economy that is going to be operating at a fraction of its capacity for a long period of time,” she told Bloomberg.

 

 

 

 

Unemployment Claims Top 42 Million

Posted on by • Posted in 2020 Election Issues, Economic Crisis, Economic Stimulus, Economy Reopening, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employee Protections, Employer-Based Health Insurance, Health Insurance Coverage Adequacy, Job, Job Market, Job Search, Job Security, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://www.thefiscaltimes.com/2020/06/04/Unemployment-Claims-Top-42-Million

Unemployment Claims Top 42 Million

About 1.9 million people filed for unemployment benefits last week, the Department of Labor announced Thursday, bringing the total for initial claims over the last 11 weeks to 42.6 million.

Continuing claims rose by 649,000 over the previous week, for a total of 21.5 million. Adding independent contractors, the number of people receiving unemployment benefits comes to roughly 30 million.

The good news: Initial jobless claims for state benefits continue to fall. Torsten Slok, chief economist at Deutsche Bank Securities, said the job market appears to have bottomed out and is “crawling out of the hole now,” adding that we “have the worst behind us.”
Earlier this week, Mark Zandi, chief economist at Moody’s Analytics, said he thinks the coronavirus recession is technically over, with growth resuming this month. “This Covid recession will go down as the shortest and arguably the most severe in history,” Zandi told The Washington Post.

The bad news: The unemployment numbers are still shockingly high, and the economy is in bad shape by any measure. “Even as states reopen, claims in the millions are an indicator that the economic pain of the Covid-19 crisis is still acute,” Daniel Zhao, senior economist at Glassdoor, told CNBC.

Recovery is expected to be slow and painful. Economist Ed Yardeni said Thursday in a note to clients that he expects it to take more than two years to recover all of the lost jobs, with a return to the February 2020 employment peak not coming until October 2022.

The even worse news: The official unemployment numbers are almost certainly underestimating the damage.

In addition to the state unemployment filings, there were about 623,000 newly reported claims from independent contractors, who are eligible to receive federal aid temporarily under the Pandemic Unemployment Assistance program. But at least half a million filings for pandemic relief payments have yet to show up in the official data, Bloomberg reported Thursday, due to lags in the system. And the weekly unemployment reports tell us nothing about the people who may still be working but are earning far less than they were just a few months ago.

Up next: On Friday the Labor Department will release its employment numbers for May. Economists surveyed by Dow Jones project 8.3 million job losses and an unemployment rate of 20.5%.