Pence Blocks Fauci, Birx from Appearing on CNN after Network Stops Airing Full White House Coronavirus Briefings

https://news.yahoo.com/pence-blocks-fauci-birx-appearing-163022678.html

Anthony Fauci and Deborah Birx are diving into social media to ...

Vice President Mike Pence has blocked Drs. Anthony Fauci and Deborah Birx, as well as other top U.S. health officials, from appearing on CNN following the network’s decision to not air the White House coronavirus press briefings in full.

“When you guys cover the briefings with the health officials then you can expect them back on your air,” a spokesman for the vice president told CNN.

Trump and the White House Coronavirus Task Force, led by Pence, have been giving daily briefings to the press for several weeks after rising numbers of Americans have been infected. A CNN executive said that the network has sometimes cut away from the briefings after Trump speaks, and turns to a panel to fact-check the president. However, the network usually broadcasts only the president’s question-and-answer session.

Fauci and Birx regularly appear at the briefings to give updates on the status of the coronavirus epidemic within the U.S. Fauci has also appeared on CNN virtual townhalls on the coronavirus for the past five weeks, but will not be present this Thursday.

The New York Times, another outlet that has been a target of the Trump administration’s ire, stopped airing the briefings on its website entirely.

“We stopped doing that because they were like campaign rallies,” Elisabeth Bumiller, the paper’s Washington bureau chief, told the Washington Post. “The health experts often have interesting information, so we’re very interested in that, but the president himself often does not.”

 

State-by-state breakdown of 354 rural hospitals at high risk of closing

https://www.beckershospitalreview.com/finance/state-by-state-breakdown-of-354-rural-hospitals-at-high-risk-of-closing.html?utm_medium=email

What Rural Hospital Closures Mean for EMS Professionals

Twenty-five percent of the 1,430 rural hospitals in the U.S. are at high risk of closing unless their finances improve, according to an annual analysis from Guidehouse, a consulting firm. 

The 354 rural hospitals at high risk of closing are spread across 40 states and represent more than 222,000 annual discharges. According to the analysis, 287 of these hospitals — 81 percent — are considered highly essential to the health and economic wellbeing of their communities.

Several factors are putting rural hospitals at risk of closing, according to the analysis, which looked at operating margin, days cash on hand, debt-to-capitalization ratio, current ratio and inpatient census to determine the financial viability of rural hospitals. Declining inpatient volume, clinician shortages, payer mix degradation and revenue cycle management challenges are among the factors driving the rural hospital crisis.

The Guidehouse study analyzed the financial viability of rural hospitals prior to the COVID-19 pandemic, and the authors noted that the rural hospital crisis could significantly worsen due to the pandemic or any downturn in the economy. 

Here are the number and percentage of rural hospitals at high risk of closing in each state based on the analysis:

Tennessee
Rural hospitals at high risk of closing: 19 (68 percent)

Alabama
Rural hospitals at high risk of closing: 18 (60 percent)

Oklahoma
Rural hospitals at high risk of closing: 28 (60 percent)

Arkansas
Rural hospitals at high risk of closing: 18 (53 percent)

Mississippi
Rural hospitals at high risk of closing: 25 (50 percent)

West Virginia
Rural hospitals at high risk of closing: 9 (50 percent)

South Carolina
Rural hospitals at high risk of closing: 4 (44 percent)

Georgia
Rural hospitals at high risk of closing: 14 (41 percent)

Kentucky
Rural hospitals at high risk of closing: 18 (40 percent)

Louisiana
Rural hospitals at high risk of closing: 11 (37 percent)

Maine
Rural hospitals at high risk of closing: 7 (33 percent)

Indiana
Rural hospitals at high risk of closing: 8 (31 percent)

Kansas
Rural hospitals at high risk of closing: 26 (31 percent)

New Mexico
Rural hospitals at high risk of closing: 3 (30 percent)

Michigan
Rural hospitals at high risk of closing: 13 (29 percent)

Missouri
Rural hospitals at high risk of closing: 10 (26 percent)

Virginia
Rural hospitals at high risk of closing: 5 (25 percent)

Oregon
Rural hospitals at high risk of closing: 4 (24 percent)

California
Rural hospitals at high risk of closing: 6 (23 percent)

North Carolina
Rural hospitals at high risk of closing: 6 (23 percent)

Florida
Rural hospitals at high risk of closing: 2 (22 percent)

North Dakota
Rural hospitals at high risk of closing: 7 (21 percent)

Ohio
Rural hospitals at high risk of closing: 6 (20 percent)

Vermont
Rural hospitals at high risk of closing: 2 (20 percent)

Idaho
Rural hospitals at high risk of closing: 4 (19 percent)

Pennsylvania
Rural hospitals at high risk of closing: 4 (19 percent)

Washington
Rural hospitals at high risk of closing: 5 (18 percent)

Wyoming
Rural hospitals at high risk of closing: 3 (18 percent)

Texas
Rural hospitals at high risk of closing: 14 (16 percent)

Colorado
Rural hospitals at high risk of closing: 4 (14 percent)

Illinois
Rural hospitals at high risk of closing: 7 (14 percent)

Montana
Rural hospitals at high risk of closing: 7 (14 percent)

Nebraska
Rural hospitals at high risk of closing: 8 (13 percent)

New York
Rural hospitals at high risk of closing: 4 (13 percent)

Iowa
Rural hospitals at high risk of closing: 9 (12 percent)

Minnesota
Rural hospitals at high risk of closing: 8 (11 percent)

Alaska
Rural hospitals at high risk of closing: 1 (10 percent)

Arizona
Rural hospitals at high risk of closing: 1 (10 percent)

New Hampshire
Rural hospitals at high risk of closing: 1 (9 percent)

Wisconsin
Rural hospitals at high risk of closing: 5 (9 percent)

 

 

 

What Will U.S. Labor Protections Look Like After Coronavirus?

https://hbr.org/2020/04/what-will-u-s-labor-protections-look-like-after-coronavirus?utm_medium=social&utm_source=facebook&utm_campaign=hbr&fbclid=IwAR1fNFaJM-Tz1jCoBQ3bTVJG5zdbuqcExQOujKz87J34csjOhRLm8C2Dxjo

As I was writing the draft of this article, I was checking my symptoms and awaiting the results of a test I underwent for Covid-19. This virus has upended my life, as it has for every last one of us, no matter where we fall on the socio-economic scale.

But the consequences fall more heavily on those at the bottom end of the wage distribution. That includes those risking their health as they sell us groceries, check our vitals, and sanitize our hospitals. Easily lost amid the chaos, however, is how this crisis may be an opportunity to improve employee protections — and not temporarily but permanently.

During bull markets, employers and policymakers often paint the hardships befalling low-wage workers as stemming from those workers’ personal failures. But when markets crash, we learn how these workers’ troubles were indicative of persistent, system-wide weaknesses.

As Warren Buffett wrote of the insurance failures exposed by 1993’s Hurricane Andrew, “It’s only when the tide goes out that you learn who’s been swimming naked.” Pundits cite Buffet to refer to firms that appear healthy during bull markets, only to get eaten alive during downturns. This month, however, the markets exposed a new group of skinny dippers: a government and an economic system that fail workers, and employers who haven’t or can’t fill this gap in public policy.

In response to the novel coronavirus, the stock market has been mostly in a free fall since late February. The low-wage service sector is facing widespread layoffs. And the tumbling markets have uncovered other deep inequalities among workers, who fall into two groups: those with access to employment protections like affordable healthcare, remote work accommodations, paid time off, and job security — and those without.

This second group, which includes the working class, often lack healthcare or face high out-of-pocket expenses. There are nearly 24 million uninsured working-age adults in the United States. Those with only a high school diploma or who did not complete high school are the least likely to be insured. Moreover, racial and ethnic minority groups face significant barriers to “good jobs.” They form 60% of the uninsured population but only 40% of the total population.

A quarter of all U.S. workers have no access to paid sick leave. Work-from-home options are slim, but many can’t afford not to work. Among workers at the bottom 10th of the earnings distribution, only 31% have paid sick leave. For comparison, 94% of the top 10% of earners have paid sick leave.

While many professionals enjoy protections that can help them ride out the pandemic with their livelihoods and family’s health intact, workers in the low-wage service sector have few options or resources to stay home to care for themselves, let alone their loved ones. And that burden to provide care largely falls on women. The workers lacking healthcare and paid sick leave are also the most vulnerable to layoffs and lost hours. The fate of service workers in travel and food services indicate what’s to come. Similarly, gig economy workers, migrant laborers, and those in the informal economy are particularly vulnerable.

How did we get here? Since the late 1970s, executives have prioritized boosting dividends for shareholders over protecting their employees, whose work has been outsourced, digitized, and downsized. In our book, Divested: Inequality in the Age of Finance, Ken-Hou Lin and I show how this shift in corporate governance undermined workers’ bargaining power. Although insurance coverage increased from the Affordable Care Act, overall working conditions, protections, and pay have diminished.

A more robust safety net would help to mitigate the consequences for workers today as it shores up the economy against future downturns. For years, U.S. policymakers have considered universal healthcare impractical because of its large scope and high startup costs. But as new unemployment claims surge to historical levels and Americans face the medical precarity of a pandemic, this crisis has laid bare the underlying problem of linking healthcare to employment.

Sick leave and universal healthcare would ease the stressors workers face and ensure the sick have time to recover, making them more productive when they return to work. Without the costs of insuring workers, employers could pay more. An income boost would generate more spending and stimulate the economy.

Broader protections would also support the self-employed, contract workers, and prospective entrepreneurs. The United States has lower rates of self-employment (6.3%) than countries with universal healthcare (e.g., Spain has 16%), and a lower share of employment at small businesses than any OECD country except Russia. Reducing the reliance on big businesses would free workers to find jobs that better fit their skills, creating a more nimble and innovative economy.

The current moment provides an opportunity to make lasting changes to the status quo and improve conditions for all workers. As sociologists have theorized, crises and crashes expose cracks in the systems upholding inequality. And history provides a clue for how crises can provide opportunities to transform society in ways that reduce inequality. After the Great Crash of 1929, unemployment spiked, reaching 25% by 1933. In less than three years, Franklin D. Roosevelt’s New Deal reduced unemployment to 9%.The New Deal achieved this feat through a vast and broad range of public works and conservation projects.

The New Deal transformed American society — from erecting iconic buildings and statues, to saving the whooping crane, to developing the rural United States, to planting a billion trees. New Deal workers built and renovated 2,500 hospitals, 45,000 schools, and 700,000 miles of roads. The New Deal hired 60% of the unemployed, including 50,000 teachers and 3,000 writers and artists, such as Jackson Pollock and Willem de Kooning. The New Deal modernized, preserved, and employed the country, while reducing inequality between the haves and have-nots.

Facing a similar economic threat in the wake of the pandemic, we have a comparable once-in-a-century opportunity to make lasting changes that address the pressing problems of today, from inequality to climate change.

In today’s crisis, we could double down on the “trickle-down” approach of the 2008 financial crisis: stimulus to the banks, corporations, and their investors combined with tax cuts and temporary wage support as a short-term Band-Aid for immiserated workers. But Lin and I find that this approach left many workers flailing and worsened inequality, because the banks deposited, rather than invested, the stimulus funding and corporations borrowed the money to buy back their stocks, enriching top executives and shareholders.

Last week, the president signed into law a sweeping $2 trillion plan that combines money for states, loans for distressed businesses, and tax relief, paid leave, unemployment benefits, and cash for most citizens. But this plan only gives workers temporary benefits. Although the bill has stricter oversight and restricts buybacks, it is unlikely to reduce inequality unless it addresses the structural conditions making some workers more vulnerable.

While a New Deal approach may be infeasible amid a contagious virus, we can and should enact permanent policies protecting all workers. Sick leave and healthcare should be universal rights. We could adopt a “flexicurity” labor policy modeled on the Danish one. The Danes provide both flexibility for employers to hire and fire workers as needed and security for workers through generous benefits and retraining opportunities during unemployment.

Meanwhile, in my household, after 2.5 weeks of symptoms—from a dry cough to a tight chest to a low fever—my test results came back negative. Thanks to the healthcare and insurance provided by my employer, I will continue to do the work I care about.

While I am on the mend, the workers who sell our groceries, serve us food, clean our workplaces, and drive us to the doctor also need to take care. In this pandemic, they are risking their health and lives. And they deserve the same level of care as the people they serve: access to both preventative medicine and comprehensive treatment, and time to take a break, recover, and care for their loved ones. The coronavirus is our chance to extend these protections during times of crisis and far into the future.

 

 

The Most Appalling COVID-19 Lie

https://www.medpagetoday.com/infectiousdisease/covid19/85741?xid=nl_mpt_investigative2020-04-08&eun=g885344d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=InvestigativeMD_040820&utm_term=NL_Gen_Int_InvestigateMD_Active

The Most Appalling COVID-19 Lie | MedPage Today

— Doctor breaks down the worst fallacy

Please forgive the basic nature of this video. I’ve enjoyed spending some time with my family finally after my quarantine expired. I wasn’t planning on making a video this weekend, but everybody’s in bed now and I felt that this was important.

I have done a few interviews recently and I’ve been asked the same question every time, which is what is the worst piece of misinformation you’ve heard about coronavirus. The first time I answered I said one of those conspiracy theories that we’ve all heard, but I quickly realized actually that isn’t the most damaging misconception about the current virus at all. The most harmful perception about COVID-19 is that it’s a disease that only affects the very old or the infirm.

The Intensive Care National Audit and Research Centre is a body that collects information from all the intensive care units in the U.K. and they’ve been publishing data about the COVID-19 patients here. I briefly mentioned one of their results in a previous video and I’ve been posting updates on Twitter. The most recent, which is about the first 775 patients admitted with COVID-19 to intensive care units in the U.K., came out a couple of days ago. I put it up on Twitter and it got quite a lot of attention, and so I felt it was useful to talk about that here as well.

The European Society of Intensive Care Medicine (ESICM) has published some preliminary results — I don’t have the full data set yet — for an even bigger group of patients — I think something like 1,800 patients. But from what I have seen, the results are very comparable.

The first headline is that the average age of patients admitted is 60 years old. Now, that doesn’t mean the average age of people getting coronavirus is 60. It’s just that out of the patients admitted to intensive care units with COVID-19 in the U.K., the average age — both mean and median — is around 60. The reason I say it like that is because admissions to ITU [intensive treatment unit] are prioritized for those that have the best chance of survival.

The right-hand column is quite useful here. It shows results for admissions to ITU over the last couple of years in the U.K. for patients with non-COVID viral pneumonia to act as a comparator. We can see immediately that in comparison to the usual viral pneumonia admissions, COVID admissions have a better baseline in that 91% are fully independent compared to 73% normally and fewer have pre-existing comorbidities or medical problems.

You can also see they are much more likely to be mechanically ventilated — i.e., intubated on a breathing machine, a ventilator — which is reflective of the profound hypoxia or low oxygen levels that we’re seeing in COVID-19 and the guidance that these patients deteriorate fast, and so doctors should intubate early.

An interesting pattern that’s emerged from every country’s cohorts is that men are more affected by this than women; 70% of severe infections requiring ITU are male, and perhaps most sobering is that out of all the patients admitted to ITU so far in the U.K., almost half have died — 48%. Comparing that with the usual admissions we see in ICU for viral pneumonia, like say influenza, only 22% of those died. If it needs to be repeated again, this is not “just like the flu.”

If you look at just 16- to 49-year-olds, although numbers are low at the moment, a quarter of them admitted to ITU have died. It remains true that 80% of people that get COVID-19 will have a self-limiting illness, the way I did, that does not require hospital admission. Your risk goes up with increasing age and the pre-existence of medical conditions.

However, overall one in five people that get this will have a severe infection, perhaps requiring hospital admission. Out of that, a quarter will require admission to intensive care. As these figures show, the average age for that subgroup is only 60, and half of those patients die.

Something that’s not captured in these figures is that death is just one marker. If you spend a week on a ventilator and 2 weeks in the hospital overall and then go home alive, that’s hardly what I’d call a mild infection. As I’ve said before, the main risk for most of us is not from the virus itself, but the effect that it’ll have on how healthcare functions in our respective countries.

On the subjects of healthcare, we’ve now seen three doctors here in the U.K., several in America, and 51 in Italy lose their lives directly because of COVID-19 — many or perhaps even most of whom were fit and well beforehand. To my sisters and brothers in healthcare, especially those going into battle like this without the appropriate armor — which is something that I just cannot believe is happening in developed countries, it shouldn’t be happening — I salute you.

That’s it. That’s the video. This isn’t aimed at any particular age group nor political affiliation. I find it remarkable I even have to say that second point because somehow this has become a partisan issue, which again I can’t understand.

Perhaps, if this does have an intended audience, it’s the middle-aged politicians who maybe also think that they’re too young for this disease and promote this appalling fallacy that COVID-19 is only killing patients who would have died sooner or later otherwise. Just stop f**king around.

 

 

 

 

Fauci: ‘Looks like’ US deaths will be lower than original projection

https://thehill.com/homenews/coronavirus-report/491779-fauci-looks-like-us-deaths-will-be-lower-than-original-projection?userid=12325

Fauci: 'Looks like' US deaths will be lower than original ...

Dr. Anthony Fauci said Wednesday morning that he thinks the number of U.S. deaths from coronavirus will end up being less than the original projection of 100,000 to 200,000. 

Fauci, the government’s top infectious disease expert, attributed the drop to the success of social distancing measures that have directed people to stay home and closed many businesses.

“Although one of the original models projected 100- to 200,000 deaths, as we’re getting more data and seeing the positive effect of mitigation, those numbers are going to be downgraded,” Fauci said on Fox News. “I don’t know exactly what the numbers are going to be, but right now it looks like it’s going to be less than the original projection.”

By the end of March, the White House was projecting 100,000 to 240,000 deaths as America’s best-case scenario for the pandemic.

Centers for Disease Control and Prevention Director Robert Redfield made similar comments on Tuesday, saying he expected the number of deaths to be “much lower” than what was predicted by the models.

A closely watched University of Washington model is now projecting about 60,000 deaths in the U.S. 

Despite some hopeful signs, Fauci emphasized that now is not the time to ease up on social distancing measures, the best way to keep improving the outlook. 

“We’re going to start to see the beginning of a turnaround, so we need to keep pushing on the mitigation strategies because there’s no doubt that that’s having a positive impact,” he said.

“Now’s not the time to pull back at all,” he added. “It’s a time to intensify.”

President Trump has been eager to reopen the economy, and Fauci said planning for that is underway at the White House, where late Tuesday night there was a meeting on the subject in the Roosevelt Room.

“If in fact we are successful it makes sense to at least plan what a reentry into normality would look like,” Fauci said. “That doesn’t mean we’re going to do it right now, but it means we need to be prepared to ease into that. And there’s a lot of activity going on.”

 

 

 

 

Trump considering suspending funding to WHO

https://thehill.com/homenews/administration/491671-trump-considering-suspending-funding-to-who?utm_source=&utm_medium=email&utm_campaign=28856

WHO declares the outbreak of the new coronavirus is a pandemic ...

President Trump said Tuesday that he would consider placing a hold on funding for the World Health Organization (WHO), expressing grievances with its handling of the novel coronavirus.

“They missed the call. They could have called it months earlier. They would have known, and they should have known, and they probably did know,” Trump told reporters at a White House press briefing, suggesting the WHO failed to sufficiently warn the global community about the virus.

“We’re going to be looking into that very carefully, and we’re going to put a hold on money spent to the WHO,” Trump continued. “We’re going to put a very powerful hold on it, and we’re going to see. It’s a great thing if it works, but when they call every shot wrong, that’s not good.”

Pressed later by a reporter on whether it was a good idea to put a hold on funding during a global pandemic, the president clarified that he was considering suspending funding to the WHO.

“I’m not going to say I’m going to do it,” Trump said. “We will look at ending funding.”

The United States is the largest contributor to the WHO’s budget. The president’s fiscal 2021 budget request proposed slashing funding to the WHO, a body of the United Nations responsible for international public health, from $122 million to about $58 million.

The president said the WHO seemed to be “very biased towards China” and accused the organization of disagreeing with his travel restriction on flights coming in from China. He suggested the organization was blind to the extent of the outbreak in Wuhan, the capital of China’s Hubei province, where the virus originated.

The WHO said in early February that widespread travel bans that interfere with international travel and trade were not necessary to prevent the spread of COVID-19, days after the Trump administration announced it would restrict travel coming into the U.S. from China. It did not take particular issue with the president’s travel restriction.

“They actually criticized and disagreed with my travel ban at the time I did it, and they were wrong. They’ve been wrong about a lot of things. They had a lot of information early, and they didn’t — they seemed to be very China-centric. We have to look into it,” Trump told reporters.

When a reporter asked Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, to answer a question on the WHO, Trump interjected before he answered, saying Fauci “respects the WHO, and I think that’s good.”

“But they did give us some pretty bad play-calling,” Trump said.

The remarks, expanding on a critical tweet he sent earlier Tuesday, come amid growing criticism among conservatives of the WHO’s handling of the coronavirus outbreak. Some have accused the organization of leaving other nations unprepared for the virus.

Sen. Martha McSally (R-Ariz.) last week called on WHO Director-General Tedros Adhanom Ghebreyesus to resign, after reports emerged that the U.S. intelligence community had concluded China underreported its count of coronavirus cases. McSally accused the WHO of helping China conceal the extent of the outbreak.

Trump has faced criticism for at first downplaying the threat from the coronavirus, and his administration has been scrutinized for early delays in testing that hampered the overall response. Trump has often pointed to his early action restricting travel from China as a sign his administration was quick to confront the outbreak.

Ezekiel Emanuel, a special adviser to the director general of the WHO, was critical of Trump’s remarks on the coronavirus at the end of February, saying he found much of what Trump said at his first press briefing on the domestic virus outbreak to be “incoherent.”

 

 

 

 

Trump says IG report finding hospital shortages is ‘just wrong’

https://thehill.com/policy/healthcare/491454-trump-says-ig-report-finding-hospital-shortages-is-just-wrong?utm_source=&utm_medium=email&utm_campaign=28856

Hospital Experiences Responding to the COVID-19 Pandemic: Results ...

President Trump on Monday claimed that an inspector general report finding “severe” shortages of supplies at hospitals to fight the novel coronavirus is “just wrong.”

Trump did not provide evidence for why the conclusions of the 34-page report are wrong.

He implied that he is mistrustful of inspectors general more broadly. He recently fired the inspector general of the intelligence community, which has drawn outrage from Democrats.

“Did I hear the word inspector general?” Trump said in response to the reporter’s question about the findings.

“It’s just wrong,” Trump said of the report.

The inspector general report, released earlier Monday, was based on a survey of 323 randomly selected hospitals across the country.

It found “severe” shortages of tests and wait times as long as seven days for hospitals. It also found “widespread” shortfalls of protective equipment such as masks for health workers, something that doctors and nurses have also noted for weeks.

“The level of anxiety among staff is like nothing I’ve ever seen,” one hospital administrator said in the report.

Brett Giroir, an assistant secretary of Health and Human Services, noted that the report’s survey of hospitals was conducted March 23 to March 27. He said testing had improved since then and that it was “quite a long time ago.”

Trump asked who the inspector general of the Department of Health and Human Services is.

“Where did he come from, the inspector general?” Trump said, adding, “What’s his name?”

The office is currently led by Christi Grimm, the principal deputy inspector general.

According to her online biography, Grimm joined the inspector general’s office in 1999. 
Trump said the U.S. has now done more testing than any other country. “We are doing an incredible job on testing,” he said.
He also berated the reporter asking the question, saying testing has been a success.
“You should say, ‘Congratulations. Great job’ instead of being so horrid,” Trump said.
The American Hospital Association (AHA) on Monday said the inspector general report was accurate.

The report “accurately captures the crisis that hospitals and health systems, physicians and nurses on the front lines face of not having enough personal protective equipment (PPE), medical supplies and equipment in their fight against COVID-19,” the AHA said.

https://oig.hhs.gov/oei/reports/oei-06-20-00300.pdf?utm_source=&utm_medium=email&utm_campaign=28856