Category Archives: Communication

We Work on the Front Lines of COVID-19. Here’s What Hospitals Should Do

Posted on by • Posted in Antibodies, Clinical Testing, Communication, Coronavirus, Crisis, Crisis Management, Discharge Planning, Emergency Preparedness, Health System, Hospital, Hospital Industry, Infection Control, Infectious Virus, Intensive Care (ICU), Oxygen, Pandemic, Personal Protective Equipment (PPE), Quarantine, Rehabilitation Care, Telemedicine, Ventilators • Leave a comment

https://www.medpagetoday.com/infectiousdisease/covid19/86185?xid=fb_o&trw=no&fbclid=IwAR3iM5LMZj3BxWisk3puZ2T3bOCeBaDS_xCRoTrnVaZYfj4-DZPmUfr01cw

We Work on the Front Lines of COVID-19. Here's What Hospitals ...

A game plan from ground zero.

It’s only a matter of time before all of us are directly affected by COVID-19. Proper preparation is the only way to ensure high-quality patient care and staff well-being in this challenging time. Having collectively spent time caring for patients at two different tertiary care facilities in New York on the medical floors and intensive care units, common themes are emerging that represent opportunities for hospitals in other parts of the country to start taking action before COVID-19 patients start filling up beds en masse.

Staffing

It takes a LOT of people to care for a COVID-19 onslaught; mapping out different staffing scenarios in the event you have 40 or 400 COVID patients is imperative. Staffing needs for COVID patients are higher than normal because of the patients’ complex medical needs — many require ICU level nursing and respiratory therapists — and because both clinical and non-clinical staff will inevitably become sick and need to be taken out of work. Staff should be screened for symptoms and high-risk contacts; those who are symptomatic should be proactively encouraged to stay home instead of showing up to work not feeling well and putting other care team members and patients at risk. This requires back-up staffing plans to fill in when your people become sick. Shutting down non-urgent and elective departments provides staffing redundancy to pull from when needed. All employees should be given advance notice about staffing plans so that potential role changes are clear.

Testing

Robust testing processes for both patients and your healthcare workforce are critical for success. Hospitals should be taking this time to obtain in-house rapid testing kits to avoid unnecessary patient isolation and conserve personal protective equipment (PPE) while waiting for test results.

Healthcare workers are understandably scared about contracting COVID-19 themselves and giving it to their family members. We recommend all staff members be tested for active infection so that those who are infected can be proactively quarantined.

Forward-thinking institutions should be prioritizing antibody testing for healthcare workers. While this testing is still in its infancy, it is quite likely that those with strong antibodies to COVID-19 possess some degree of immunity. Therefore, if you can identify which doctors, nurses, respiratory therapists, physical therapists, and janitorial staff have already developed an immune response to COVID-19, these staff members can take priority staffing infected units with the goal of reducing the number of new infections in healthcare workers and limiting exposure to those who have yet to contract the virus.

Communication

Each institution’s COVID-19 protocols and policies change rapidly as we learn more about the virus. How you communicate these ever-changing procedures with staff is critical. Most hospitals rely on daily email updates that are text-heavy; however, overwhelmed inboxes and less time with devices while wearing PPE limits the success of email as a sole communication channel.

Communication through graphics takes on new importance — signage noting changes in hospital geography, large pictures of donning and doffing instructions, phone numbers to call with equipment shortages, and clear instructions to staff about testing protocols, isolation, and removing patients from isolation need to be conveniently placed where staff can access information in real time without consulting their electronic devices. High-yield locations for just-in-time visual communication include outside patient rooms, nursing stations, break rooms, and elevators, so that the target information reaches its busy, hard-working audience successfully and repeatedly, minimizing confusion and augmenting clarity.

Limiting the Need to Enter the Room

Given ongoing PPE shortages, particularly around single-use gowns and N95 masks, minimizing the number of instances that staff, particularly nurses, need to enter the room is critical. This requires an adjustment from normal patient care. We recommend extension tubing to bring IV poles and medications outside the room. Tablets such as iPads can permit video calls with patients to check on non-urgent items. Centralized monitoring of oxygen saturations for all admitted patients can minimize the frequency of supplemental oxygen adjustment.

Similarly, given the increased risk of COVID-19 in diabetic patients, continuous blood glucose monitoring can minimize the need for frequent manual fingerstick measurements for patients receiving supplemental insulin.

Discharge Planning

Discharging patients to home or rehabilitation facilities presents novel challenges. A home discharge requires education, equipment, and follow-up. Education on home monitoring of vitals signs like oxygen saturation and blood pressure with instructions on critical values that should prompt patients to return to the hospital can expedite discharge and open hospital beds for other sick patients. Both patients and family members must also be educated on quarantine procedures to limit household transmission.

Many patients will have temporary oxygen requirements and we have seen home oxygen shortages in our areas. Coordinating a strategy with your outpatient clinicians, home oxygen suppliers, and insurance companies can facilitate getting patients home sooner on home oxygen and freeing up beds for sicker patients. Further, many patients are eager to go home earlier since hospital visitation limitations mean they’re sitting in bed alone away from family and the more a hospital can do to safely discharge patients home with appropriate supplies and follow-up will be beneficial to both patients and the hospital.

Hospitals must also be prepared to integrate these patients into their existing telehealth infrastructure, which has become the mainstay of ambulatory medicine in lieu of traditional office visits. For many patients, this will be a new way of accessing care. Prior to discharge, hospital staff should ensure patients have downloaded the necessary apps with login information and feel comfortable they will be able to follow up with their physician using technology following discharge.

There is a huge opportunity for hospitals that have not been caring for large numbers of COVID-19 patients to prepare ahead of time in a manner that optimizes patient care and minimizes risks to staff. Those of us on the early front lines have learned many of these lessons the hard way. An ounce of prevention is worth a pound of cure — we encourage all healthcare systems to take action before the storm comes.

 

 

 

 

Healthcare CFOs weigh-in on the challenges ahead

Posted on by • Posted in Capital Budget, Cash, Cash Reserves, Cash-Flow Improvements, CFO, Change, Change Management, Communication, Contact Tracing, Coronavirus, Cost Management, Cost Reduction, Crisis, Crisis Management, Cybersecurity, Economic Crisis, Economy, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employee Protections, Leadership, Leadership Cares, Leadership Flexibility, Mergers & Acquisitions, Net Income, Operating Expenses, Operating Income, Operating Margin, Operating Performance, Operating Revenue, Personal Protective Equipment (PPE), Quarantine, Recession, Remote Work, Sick Leave, Social Distancing, Supply Chain, Telemedicine, Uncertainty, Worker Protection • Leave a comment

https://www.pwc.com/us/en/library/covid-19/pwc-covid-19-cfo-pulse-survey.html

What CFOs think about the economic impact of COVID-19

How finance leaders see a return to work

Business perspectives on what it will take to shift from crisis mode are solidifying. US finance leaders are focused on shoring up financial positions, as US businesses head into a period of even more operational complexity while they orchestrate a safe return to the workplace. Back-to-work playbooks put workforce health first, as companies set course for a phased-in return to the workplace that will not be uniform across the US or internationally, findings from the survey show. Returning employees and customers are going to experience a work environment that will differ in marked ways as a result. Another change likely to endure post-crisis is the strong role corporate leaders have taken within their communities, placing a renewed emphasis on environmental, social and governance (ESG) efforts going forward.

The actions CFOs are taking show how US businesses continue to adjust to very difficult current conditions with an eye toward an evolving post-COVID world. The level of concern related to the crisis is holding steady. It is high but stabilizing, with 72% of respondents reporting that COVID-19 has the potential for “significant impact” to their business operations vs. 74% two weeks ago.

Key findings

Back-to-work playbooks reshape how jobs performed
49% say remote work is here to stay for some roles, as companies plan to alternate crews and reconfigure worksites.

Protecting people top of mind
77% plan to change safety measures like testing, while 50% expect higher demand for enhanced sick leave and other policy protections.

Substantive impacts expected in 2020 results
Half of all respondents (53%) are projecting a decline of at least 10% in company revenue and/or profit this year.

Cost pressures intensify
A third (32%) expect layoffs to occur, as CFOs continue to target costs, while 70% consider deferring or canceling planned investments.

Economic events shaping CFO response last week

This survey, our fourth since emergency lockdowns took effect in the US, reflects the views of 305 US finance leaders during the week of April 20. It was a week when oil futures traded below $0 as energy markets confronted downshifting global demand, Congress replenished emergency funding of $480 billion for small firms and healthcare systems, and everyone heard the call to get ready to go back to work as the US and Europe firmed up plans to ease quarantines.

Post-crisis world taking shape in plans to reboot the workplace

Health and safety are top priorities for leaders as they prepare to bring people back to on-site work. More than three-quarters (77%) are putting new safety measures in place, while others are taking steps to promote physical distancing, such as reconfiguring workspaces (65%). Findings also show where the virus may have longer-lasting impact on ways of working. Half (49%) of companies say they’re planning to make remote work a permanent option for roles that allow. That’s even higher (60%) among financial services organizations.

Takeaways

Among the small percentage of companies that are beginning to bring people back, returning to work will not mean a return to normal. Companies should consider how to help frontline managers lead with empathy, to communicate transparently and make decisions quickly so employees understand where they stand, have access to the resources available to them, and can share feedback to ensure they feel safe and get what they need. Tools such as workforce location tracking and contact tracing can help support employees with suspected or confirmed infections, while also helping to identify the level of risk exposure. Companies looking to make remote work a permanent option will need to enable leaders to manage a blended workforce of on-site and remote workers during the next 12 to 18 months.

Given that many people may be wary of returning to on-site work, there’s an opportunity for companies to create more targeted benefits to help make the transition easier. Paid sick leaves and worker protections, help with childcare, private transportation to and from work, or other benefits could help employees who may need extra flexibility or who want additional support as they prepare to come back.

Forecasting substantive impacts on 2020 performance

A majority of respondents (80%) continue to expect a decline in revenues and/or profits in 2020. Projections by sector vary, with consumer markets likely the hardest hit: one-third (32%) of CFOs expect a 25% or greater decline in revenues and/or profits this year, compared to 24% of respondents in all sectors.

Takeaways

Outlooks for financial results have held relatively steady in the survey over the last month, and are probably indicative of actual impact. Companies have had the time to evaluate the effects. CFO projections for declining revenue and profits coincide with a widening realization that the US economy is in recession. Since mid-March, jobless claims have soared past 26 million, and Congress passed relief packages of $2.5 trillion. CFOs are evaluating a wide range of scenarios that cover the health situation, the shape of the economic recovery, the spillover into the financial markets, and the resulting impacts on their business. This crisis is setting a new benchmark standard for “unknowable.”

Cost pressures intensifying

CFOs are considering additional ways to scale back on planned investment and/or other fixed costs amid volatility in demand. A third (32%) expect layoffs to occur in the next month, up from 26% two weeks ago. Protecting cash and liquidity positions is paramount. Financial impacts of COVID-19, including effects on liquidity and capital resources, remain the top concern of CFOs (71%). Over half (56%) say they are changing company financing plans, up from 46% two weeks ago.

Among other actions, 43% plan to adjust guidance, which is consistent with responses two weeks ago. This figure will likely increase as companies go through the earnings season over the next two to three weeks. Separately, 91% of respondents are planning to include a discussion of COVID-19 in external reporting. Depending on the type of company, this can mean inclusion in financial statements and/or in risk factors and MD&A results of operations, earnings release or MD&A liquidity sections.

Takeaways

Many CFOs have focused on how they can manage their cash pressures to ride out the crisis. Common approaches have included stop-gap measures, such as hiring freezes and tightening controls on discretionary costs to put an end to travel and events, or the use of contractors. Findings show that these types of cost actions are likely to continue, and they remain at the top of the CFO agenda.

Of those who say they’re considering deferring or canceling planned investments, 80% are considering facilities and general capital expenditures. At the same time, investment programs in areas that are considered important to future growth — including digital transformations, customer experience, or cybersecurity and privacy — are less likely to be targeted. CFOs will increasingly look for ways to prioritize costs in these areas, as businesses grow more confident in recovery prospects — even though current demand is subdued.

Priorities to de-risk supply chains

As companies continue to wade through mitigation efforts and start to think about recovery, many are planning changes to make their supply chains more resilient. Findings show CFOs prioritizing specific actions: 56% cite developing alternate options for sourcing, and 54% say better understanding the financial and operational health of their suppliers.

Takeaways

Findings confirm an emphasis on de-risking supply chains, as companies prioritize the health and reliability of their supplier base among changes they’re planning as a result of COVID-19. In particular, there is a focus on managing risk around supply elements, such as reducing structural vulnerability with other sourcing options.

Some companies are starting to invest in creating data-backed profiles of their supplier base so they know where and when to look for second sources. Others are increasing communication with suppliers to better understand financial health. For many, conducting deeper financial and health reviews of suppliers will become a regular part of their business reviews. Physical supply chain relocations will likely happen only as a last resort, given the costs involved. However, automation of certain elements of the supply chain — to eliminate time-consuming manual tracking efforts and check tariff structures, for example — will likely become more common as companies seek better data to make more informed decisions.

Strategies yet to change, but tech likely to drive M&A

The impact of the outbreak on mergers and acquisitions (M&A) strategies remains mixed. While 40% of respondents say their company’s M&A strategy is not being affected by COVID-19, compared with 34% two weeks ago, one in five say it’s too difficult to assess what changes, if any, will need to be made to strategy. CFOs within the technology, media and telecommunications industry stand out in particular. They are less likely to report decreasing appetite for M&A due to COVID-19, compared with peers in other sectors, and 55% say the crisis hasn’t changed their M&A strategy.

Takeaways

These findings highlight the fundamental strengths of the tech sector and suggest it will be among those driving M&A in the months ahead.  Tech giants, in particular, have large cash reserves. Moreover, demand for some tech products and services is strong as businesses return to work — 40% of CFOs say they will accelerate automation and new ways of working as they transition back. Additionally, technologies such as drones, artificial intelligence and robotics, will likely enjoy wider adoption in the post-COVID-19 environment. This leaves tech better-positioned to weather the pandemic’s economic fallout and to execute on inorganic growth strategies. M&A is likely to recover faster than the US economy, with tech among the cash and capital-rich sectors leading the charge. PwC studies show that a combination of factors has been driving a decoupling of deals from the broader economy.

Business recovery timeframes have extended

Organizations are realizing the business recovery from the impacts of the virus will take longer. The March measures of manufacturing and services activities show sharp drops. Demand is not only declining, it’s shifting. Moreover, even as some US states start to reopen, difficulties in setting up testing could keep some states in a holding pattern. As a result, for CFOs, the time required to return to “business as usual” the moment that COVID-19 ends continues to lengthen. Currently, 48% believe it will take at least three months to return to normal, up from 39% two weeks ago.

Takeaways

As reality sets in and companies understand the true impacts to their operations, CFO perceptions of the length of time to business recovery has extended. According to our analysis of how companies gauge their response to the crisis in PwC’s COVID-19 Navigator diagnostic tool, the expected impact of COVID-19 on businesses globally remains high, with consumer markets and manufacturing the most susceptible among industries. Put another way, businesses that are less reliant on a large, complex supply chain to deliver products, or are able to work relatively effectively while remote, are also likely to be among the least exposed.

Consumer-facing companies reconfigure physical sites as shutdowns start to lift

Companies in consumer-facing sectors continue to contend with both sides of the demand equation, as consumers sheltering in place focus single-mindedly on essential products to the exclusion of other offerings. Consumer markets (CM) CFOs are more likely to list a decrease in consumer confidence and spending as a top-three concern than they were two weeks ago (66% vs. 50%). For CM CFOs, consumer confidence trends translate almost directly to revenues, with 32% projecting an adverse impact on revenue and/or profit of at least 25% in 2020, compared with 24% of respondents across all industries.

In response, almost three-quarters of CM CFOs (73%) are considering deferring or canceling planned investments, targeting mostly general capital expenses, such as facilities. They also say technologies that can improve their understanding of changes in customer demand are a top-three priority as they plan changes to their supply chain strategies (41% vs. 30% for all sectors).

CM CFOs are planning workplace safety measures (86% vs. 77% for all sectors) and reconfiguring work sites to promote physical distancing as part of their transition back to on-site work (77% vs. 65% for all sectors). They recognize that consumers want the assurance of a safe physical environment above all else, especially because the majority of CM products and services require a physical component, despite the continuing shift to online.

Takeaways

Consumer-facing companies continue to be among the hardest hit, as the public health crisis keeps the majority of consumers confined to their homes for now. As they grapple with immediate challenges, CM companies are pulling back on capital investments. However, most are still planning to shore up their digital presence in response to accelerated online demand that could last well beyond the recovery period.

Health system pivots to new ways of working

What’s on the mind of financial leaders in the health industry? As they plan to bring more of their workforce back on-site, they are more likely than leaders in other industries to be leaning on technology to help them manage staffing uncertainties. Fifty-four percent of healthcare CFO respondents said they plan to accelerate automation and new ways of working, compared with an average of 40% across all industries.

Healthcare organizations are simultaneously solving two critical issues: uncertainty about demand and protecting their workforce. Health organization CFOs (70%) were more likely than executives from other industries (an average of 50%) to report that they expect higher demand for employee protections in the next month. Meanwhile, consumer anxiety over their own safety is driving up uncertainty about demand for healthcare and medical products. Forty-one percent of healthcare finance leaders listed tools to better understand customer demand as a top-three priority area when considering changes to their supply chain strategies, compared to 30% of financial leaders in all sectors. Fifty-one percent of healthcare finance leaders said they are making staffing changes as a result of slowed demand.

Takeaways

A survey conducted by PwC’s Health Research Institute in early April found that some consumers are delaying care and medications amid the pandemic. In this latest PwC survey of CFOs, healthcare leaders report uncertainty about how much of their business will return as the threat of the pandemic ebbs, making staffing decisions difficult.

As the nation continues to grapple with the pandemic, getting back to work is top of mind for US financial leaders overall, but this is an especially pressing issue for health leaders. They must plan for their own workforces, while dealing with an unfolding financial calamity — 81% expect their company’s revenue and/or profits to decline this year as a result of COVID-19. On par with other industries, they expect this decline, even though their organizations play central roles in addressing the human toll of the pandemic. One strategy is to use telehealth technology to virtually care for patients, thereby protecting patients and caregivers during the pandemic.

Financial firms see fewer layoffs, but slower recovery

Financial services (FS) CFOs are bracing for a longer road back to normal. About a third (35%) now think it could take six months to get back to business as usual, up sharply from 15% just two weeks ago. They’re also more optimistic about the bottom line. More than a quarter (27%) of FS survey respondents expect revenue and/or profits to fall by 10% or less. Across all industries, only 18% felt as confident.

Takeaways

Banks are playing a critical role in helping stabilize the economy, as they work on the front lines to distribute CARES Act provisions. Along with insurers and asset managers, they also rely heavily on workers with specialized technical and institutional knowledge. This may explain why FS CFOs expect fewer layoffs (15% vs. 32% overall) or furloughs (17% vs. 44% overall) over the next month. Now, they’re trying to focus on keeping workers healthy and safe.

Conversations are starting to shift toward when and how to transition back to physical offices. For some employees, work may look very different: More FS CFOs are considering making remote work a permanent option for roles that allow it (60% vs. 49% overall). To better protect their employees, they’re also looking to evaluate new tools to support workforce tracking and contact tracing (32% vs. 22% overall) as part of the return-to-work process.

Deeper insight into health of suppliers is top priority for industrial products

The industrial products (IP) sector is in full-throttle cost-cutting mode. Nearly all IP CFOs (96%) report considering cost containment measures, compared with 87% two weeks ago. Some of this comes in the form of layoffs: 49% of IP CFOs expect layoffs to occur vs. 36% two weeks ago. The longer the crisis lasts, the longer the impact on recovery times for their business. When asked how long it would take for their business to return to business as usual if the COVID-19 crisis were to end today, 15% of IP CFOs said less than one month, down from 25% two weeks ago.

Meanwhile, they’re closely examining challenged supply chains. When asked to list their top-three priority areas when planning changes to supply-chain strategies, 66% of IP CFOs identified understanding the financial and operational health of their suppliers, compared to 54% of CFOs across all industries. A majority (56%) also cited developing additional and alternate sourcing options as a priority. And the extent of the financial damage is sinking in: 65% of IP CFOs estimate 2020 revenues and/or profits will drop at least 10%.

Takeaways

IP CFOs are signaling they’re in the thick of the crisis, as they absorb historical lows in production, with March US industrial output plunging to levels not seen since the end of WWII. Continued cost actions are still in the cards.

IP finance leaders are looking ahead to get back to business, with some already bringing workers back on-site. Some are expecting changes to the workplace. Thirty-nine percent of IP CFOs are considering making remote work a permanent option for roles that allow, and 31% are considering accelerating automation and new ways of working. While these are still early days for US producers in returning to work, bringing millions of workers back into the fold may well usher in more change management than the industry now expects.

Tech, media and telecom well-positioned to power the recovery

Technology, media and telecommunications (TMT) companies are well-positioned for recovery from the initial blow of COVID-19. As they stabilize operations in response to the crisis, the percentage of TMT CFOs anticipating revenue and/or profit declines is down 19 percentage points from two weeks ago to 65%. The data suggest that TMT companies are preparing for a future in which virtual work options gain greater acceptance over traditional office settings. TMT companies are more likely to reduce their real estate footprint as they transition back to on-site work (38% compared to 26% for all sectors), and 55% say they’re planning to make remote work permanent for positions that allow.

Of those who said they’re considering deferring or canceling planned investments, TMT companies are less likely to reduce digital transformation investments (13%) than all sectors (22%). Their increased optimism about digital investment as they strategize for the future is further borne out by the data: Two weeks ago, of those who said they were deferring or canceling planned investment, TMT was on track to reduce digital investments at the same rate as other sectors (25%).

Takeaways

The resilience of TMT companies is evident in their approach to this crisis. Bolstered by robust liquidity, the majority of companies in the sector are looking ahead to a recovery they will power by using both organic growth and M&A. In the wake of a crisis that has accelerated more widespread virtual connectivity, look for new emerging-tech-enabled business models to take shape.

Where to focus next

COVID-19 has put businesses under enormous strain to drive new ways of working. When the pandemic began, many companies put their people’s health and safety at the center of their decision-making, and they appear to be doing the same as they prepare to ramp up business. With most firms expecting to bring people back on-site in phases, leaders will need to help employees adjust to a changed environment while still managing the well-being, engagement and productivity of all workers. Purpose-led communication will continue to be critical to keep people informed, and leaders should demonstrate empathy while helping employees adjust to what will likely be an extended transition period. 

 

 

“I’ll take my chances with breast cancer”

Posted on by • Posted in Communication, Coronavirus, Diagnostic Testing, Fear, Health System, Hospital, Hospital Industry, Infection Control, Infectious Virus, Marketing, Mortality, Office Visit, Outpatient Care, Pandemic, Public Health, Public Safety • Leave a comment

https://mailchi.mp/0d4b1a52108c/the-weekly-gist-april-24-2020?e=d1e747d2d8

Local Health Officials Prepared for Coronavirus - Social Security ...

It’s entirely understandable that consumers would be reticent to visit in-person care settings right now. Given that doctors’ offices and urgent care facilities are where sick people congregate, a patient might well assume their chances of contracting COVID-19 would be higher there than in almost any other public space. But a story we heard this week from a health system chief strategy officer (CSO) reveals just how frightened patients may be to return.

Last week the system began to reach out to patients who had positive screening mammograms in February, before elective procedures and tests were cancelled, and who now needed to return for more detailed diagnostic images. A full 75 percent of these patients were unwilling to schedule a diagnostic mammogram within the next month, with one patient even saying, “I’ll take my chances with breast cancer over COVID!”.

Women with a concerning mammogram finding are typically among the most motivated patients in seeking follow-up care. If a majority of them are unwilling to pursue in-person follow-up, the same will likely be true of scores of patients with other possible cancers, heart disease, and other serious conditions. As fear delays needed care, patients are likely to end up much sicker, with more advanced disease, when they do return. With rigorous attention to symptom and temperature screening, visiting a doctor’s office should be less risky than going to the grocery store—but providers will have to publicly communicate the steps they are taking to keep patients safe before many will be willing to come in the door.

 

 

 

 

Cartoon – State of the Union

Posted on by • Posted in 2020 Election Issues, Cartoon, Communication, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy, Emergency Preparedness, False Hope, Health Policy, Infection Control, Infectious Virus, Leadership Culture, Leadership Decentralized, Mislead, Misleading, Mortality, Pandemic, Partisanship, Public Health, Public Safety, Quarantine, Social Distancing, State of the Union • Leave a comment

iroon.com: Cartoons

 

The High Stakes of Low Scientific Standards

Posted on by • Posted in 2020 Election Issues, Communication, Coronavirus, Crisis, Crisis Management, False Hope, Health Policy, Hydroxychloroquine, Infection Control, Infectious Virus, Misinformation, Mislead, Misleading, Pandemic, Public Health, Public Safety, Scientists, Social Distancing, Wishful Thinking • Leave a comment

https://www.axios.com/coronavirus-pandemic-science-problems-e6e619b8-c1a8-4e06-97d9-c328d4d0400e.html

The Lucky Seven States Already Pursuing Gambling Legislation In 2018

In the midst of this pandemic, science is suffering from low standards for some research, a new study argues.

The big picture: Science — which is slow, methodical and redundant — isn’t necessarily made for the immediacy and acute public interest brought on by a health crisis.

  • Scientists rely on peer review and back and forth exchange that leads to a more polished final study. But a health crisis like the current pandemic, or the Ebola outbreak, creates a sense of urgency that can be antithetical to the scientific process.

What’s happening: A new study out today in the journal Science warns many of the clinical trials and studies first published about treatments and other issues involving the current pandemic were designed poorly or had other issues that affected their outcomes.

  • Studies that have yet to go through peer-review — like a recent, flawed study of the use of hydroxychloroquine to treat coronavirus — have found their way into news stories thanks to pre-print services, leading to problematic reporting and real-time peer review through Twitter.
  • More than 18 clinical trials testing hydroxychloroquine to treat the novel coronavirus have enrolled more than 75,000 patients in North America.
  • “This massive commitment concentrates resources on nearly identical clinical hypotheses, creates competition for recruitment, and neglects opportunities to test other clinical hypotheses,” the study says.
  • Early, flawed work has potentially increased the risk that later results may have gotten false positives and more media attention than they deserved, the new study says.

Yes, but: While the pandemic is exacerbating these problems with misinformation and lax research standards, it isn’t the cause of them.

  • “Some of the problems that we’re seeing right now are actually not that exceptional compared to the problems that we have under normal conditions as well, just that maybe they’re a little bit more amplified and have a little more visibility,” Jonathan Kimmelman, director of the Biomedical Ethics Unit at McGill University and one of the authors of the new paper, told Axios.
  • These kinds of issues cropped up during previous health crises, and while the authors of the new study argue that some of those problems around information sharing and standards of research have improved, there’s still a long way to go.

What’s next: Many of these issues around varying standards of research and communication could be remedied through better communication among researchers and the agencies funding their work.

  • Instead of having a number of fragmented studies competing for resources and looking for effective treatments, the researchers say it would make more sense to bring them under one umbrella, allowing them to coordinate.
  • “You could reduce variation, and you might get answers more quickly,” Alex John London, the director of the Center for Ethics and Policy at Carnegie Mellon and one of the authors of the new study, told Axios.
  • The authors are also calling on clinicians to resist performing their own small studies, instead opting to join up with larger trials.
  • They also say agencies need to help build those larger studies and avoid making statements to the public about unvalidated treatments that may or may not work, instead opting to elevate larger studies in their various stages to the public.

 

 

 

 

 

Melinda Gates: This is not a once-in-a-century pandemic.

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Research Funding, Clinical Testing, Clinical Trial Recruitment, Clinical Trials, Communication, Coronavirus, Crisis, Crisis Management, Emergency Preparedness, Food and Drug Administration (FDA), Health Policy, Herd Immunity, Infection Control, Infectious Virus, Intensive Care (ICU), Leadership, Leadership Cares, Leadership Trust, Mortality, National Strategy, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Social Distancing, Vaccination, Vaccine • Leave a comment

https://www.businessinsider.com/melinda-gates-coronavirus-interview-vaccine-timeline-2020-4?linkId=87026774

Melinda Gates

‘We will absolutely have more of these.’ The billionaire philanthropist predicts a timeline for going back to normal.

  • Business Insider spoke with Melinda Gates about COVID-19, the prospect and timeline of making an effective vaccine, and how the world will be permanently changed by the coronavirus.
  • Gates said it would likely take about 18 months for a vaccine to become widely available, and that it should first go to healthcare workers to help them keep others safe.
  • She said this pandemic was not a once-in-a-century situation, like the Spanish flu. Because the world is now a global community, we’re likely to see other pandemics in our lifetimes, Gates said.
  • Even after things get back to normal, “our psyches are going to permanently changed … I hope we change to realize that we’re a global community.”

Melinda Gates is the cochair of the Bill & Melinda Gates Foundation, which has donated more than $45 billion to tackle some of the world’s toughest problems, including vaccination research and combating pandemics, from coronavirus to Ebola.

Gates and her husband have long been concerned about a pandemic and have warned that we need to be more prepared at a global level.

In a wide-ranging interview with Gates on Thursday afternoon, she gave her thoughts on the coronavirus pandemic, the inequality of it all, and how the world can go back to semi-normal. The highlights:

  • The world needs a vaccine delivered at mass scale to go back to “normal.” A realistic timeline is about 18 months, the same time it took to create an Ebola vaccine.
  • It is possible we won’t be able to find an effective vaccine for coronavirus, although Gates thinks that is highly unlikely.
  • The idea of herd immunity solving coronavirus is far-fetched. Gates said that would require more than half the population to get coronavirus (which isn’t anywhere close to happening) and a lot of death along the way.
  • To effectively roll out a vaccine, Gates believes you need to first give it to health workers, then to high-risk groups, then distribute it equitably to different countries and communities. The vaccine also has to cost very little with a fund to cover it for everyone. What the US is doing right now, pitting states against each other for supplies and allowing wealthy individuals to access tests first, would be disastrous for a vaccine rollout.
  • To prepare for the second wave of coronavirus this fall, or even a next pandemic, we need mass testing from the get-go, voluntary data sharing from people so that we can trace who has been tested and where they have been, and vaccine stockpiles so that you can distribute those as soon as you see signs of an outbreak.
  • Gates said there would “absolutely” be more pandemics in our lifetime. Coronavirus is not a once-in-a-century occurrence like the Spanish flu.
  • If you want to help vulnerable, poor communities survive coronavirus, Gates recommends giving to the WHO COVID Solidarity Fund, United Way, or America’s Food Fund.

We need a vaccine to be widely distributed before the world will start to feel normal again. Gates says we won’t get that for at least 18 months.

Alyson Shontell: How is it going in the Gates household?

Melinda Gates: Like all other families, it’s been a complete change of life for all of us. But we are also incredibly privileged, and we know that, and our kids know that. But yes, life has changed drastically. The kids are studying online. Bill and I are doing all of our meetings via video teleconference. I’m a terrible cook, so I’m heating things up a lot more, and everybody’s trying to pitch in to do what needs to get done in terms of things around the house.

And the other thing I would just say is every night, we’ve had this tradition for a long time of saying grace before meals. And what that looks like is that we all go around and say something we’re thankful for. Pretty much every night what comes up from the kids and us is we’re thankful for our health and for the fact that we’re not going hungry and the fact that we can still do our work and the kids can still learn. It’s kind of amazing.

Shontell: We heard Dr. Fauci say earlier this week that things probably won’t return to normal until we have a vaccine. What do you think is a realistic timeline for a wide distribution of a vaccine? Is anything faster than 18 months really safe?

Gates: I think it’s likely 18 months. Just from everything we know from working with our partners for many, many years on vaccines, you have to test the compounds. Then, you have to go into preclinical trials, then full-scale trials. And even though I’m sure the FDA will fast-track some of these vaccine trials like they did with Ebola, still by the time you get it through the trials safety- and efficacy-wise, then you have to manufacture the vaccine and manufacture at scale. I think it really is 18 months.

The good news that I’m seeing on that front, though, is so many scientists are coming forward, and I’m seeing CEOs come forward and say, “I have this platform we can use.” Pharmaceutical companies are coming together already to say, “How do we build up the manufacturing capacity so it’s there when we get a vaccine and we can basically just run it through the manufacturing process?” I’m seeing lots of good things come forward, but it’s a process that needs to run its full course, because you don’t want to put something in someone’s body that is harmful.

Shontell: Right. It seems like, in addition to creating something we’ve never had before, you do really have to do these human tests in a way that’s safe so that you’re not creating a vaccine that maybe cures coronavirus but gives you something else.

Gates: I’d add also that we need to know who it’s safe to give the vaccine to and in what dosages. We know COVID-19 is affecting people who are particularly vulnerable health-wise if they have diabetes, or a heart condition, or they have asthma. You have to make sure that, safety-wise, you’re not giving somebody a vaccine that’s going to affect their heart. So yeah, there are lots of issues there that have to be tested.

It’s possible we won’t be able to create a coronavirus vaccine, although Gates thinks that’s highly unlikely. Also, herd immunity is not the solution.

Shontell: If at the end of this 18-month period, or however long it is, we do feel like we’ve got a vaccine, what do you think that vaccine will actually look like? Is it possible that we actually won’t be able to create a vaccine at all? Could that be one scenario?

Gates: Well, it’s possible. We have to look at how far science has come even in the last five years. And the number of compounds we have, there’s something like 14,000 compounds that we, with our partners alone, have. And there are many, many, many others testing compounds that we’re looking at to see, “Is this promising?” Could that one be promising? And we have high throughput screening now of compounds. I really think we’re going to find a vaccine.

We found a vaccine for Ebola, right? And we did that in about an 18-month time frame, and that was hard. When I see the scientific community all coming together the way they are around the globe and sharing data and sharing information, we’re going to get a vaccine.

Shontell: OK, so you’d say that it’s a high likelihood.

Gates: High likelihood.

Shontell: That’s very, very good to know.

Gates: The other thing to think about is, in the meantime, there’s another whole strand of work going on, which is the therapeutics accelerator. Through the accelerator, we’re trying to find medicines so that if you get COVID-19, hopefully we can boost your immune system or tamp down the effect of the disease on you. So again, hopefully, we’ll come up with some medicines that will also help so people don’t get as sick as they’re getting and landing in the ICU, which is what’s truly tragic.

Shontell: Is there anything to this idea of herd immunity? Could we be closer than we think on that, or is that far-fetched thinking?

Gates: That’s still very far-fetched today. You don’t get herd immunity until you have a huge percent of your population that has had the disease. We know that from all the diseases in the past that humans have had. So no, we’re still a long way from herd immunity. And you can’t count on that because a lot of people are going to die in the meantime if you let the experiment run and you just let the disease run its course in communities. Sure, we could get herd immunity and we will get so much death. That’s why it’s so important to remind people the only tools we have today are physical distancing, handwashing, and wearing masks in public. We have to go with what we know works.

How to distribute a coronavirus vaccine to the masses: 1. Make it cheap and buy it for everyone. 2. Give it to healthcare workers. 3. Give it to the highest-risk people. 4. Come up with an equitable way for everyone else to get it (the US is screwing that up right now).

Shontell: Once we have a vaccine, what do you think is the best way to distribute it to the masses? Who should get it first? How would we do it on such a big scale?

Gates: We have to make sure that the vaccine is very low priced and that there’s a fund for buying it for everyone, whether you’re in a low-, middle-, or a high-income country. And that’s doable. We’ve done that with the Vaccine Alliance that exists today. That’s been in existence since 1990, so we know how to do that piece.

But we also have to distribute very carefully. The very first people that need to get this vaccine are healthcare workers, because if you can keep them safe, they can help keep others safe. Then you need to distribute it to the people who are the very most vulnerable. That is, they have underlying health conditions, some of the ones that we’ve talked about before. And from there, you then make it distributed completely equitably across society.

And even the United States is going to have to really work at that. COVID-19 is exposing all the inequities we have in our healthcare system. And so we need to look at, OK, does Mississippi get this vaccine at the same time California gets it and New York gets it? We can’t do this game that we’re playing right now where you have 50 different states competing for resources for masks and PPE, that makes zero sense. You need a national strategy that will equitably distribute this vaccine and we first look at the vulnerable populations.

Shontell: To touch on that point, as you mentioned, there are so many inequalities coming to light with this pandemic, from who has been able to get initial testing on to how it’s affecting different genders in different ways, to more African Americans in the US dying of this than other races. When you think about it, social distancing, stocking up on food, and handwashing are all privileges that some of the poorest communities don’t have.

You’ve done a lot of work on equality efforts, and you’ve said it’s the best way to fix everything in society is to level the playing field. How do we start leveling the playing field so the next time it’s better for everybody? How do we help the people who are in the poorest, most vulnerable communities right now?

Gates: We have to start by remembering that COVID-19 anywhere is COVID-19 everywhere. And if we keep that front and center in our minds, then we will start to think really deeply about these most vulnerable populations.

The thing that keeps me up at night — because I’ve traveled to Africa so many times and been in so many townships and slums — is if you are a person living in those conditions, you can’t begin to handwashing or social distance. In those situations, we need to start with food. People need to be able to feed themselves. And then if they feel like they have COVID symptoms, then they don’t have to go out of the house looking for food.

When I think forward about how we would do this, right now, we have to focus on the pandemic today right in front of us. We have to take the tools we have and try and distribute them as equitably as we possibly can. That means a national response that is thought out and strategic. So you start there.

When you plan for the future, you start to plan it out the way we did for other diseases that came into the world. You would create a vaccine stockpile. We’ve actually been quite involved with that for cholera, which we don’t get much in the United States anymore, but you get in a lot of places in the developing world or in refugee camps. And when there’s a stockpile of vaccine, then when you see an outbreak or a vulnerable population get it, it’s already basically paid for and you ship the vaccines out.

We have to have not a national stockpile of vaccines but an international stockpile of vaccines for something like COVID. We can predict some of these types of disease outbreaks; we just haven’t been planning it. We plan for things like an earthquake or a fire. We need to plan for disease. We are a global community. People travel. We’ve just learned that New York mostly got infected from people coming back from Europe. We have to plan for these things as a global community in the future.

How to be ready for the 2nd wave to hit this fall: Are you ready to give up your personal data and get tracked?

Shontell: Clearly, we were caught flat-footed and unprepared here in the US especially. There’s talk of a second wave of coronavirus potentially hitting in the fall. What are the things we need to do to plan for it? What has to be done by the end of the summer to put us all in a much better shape for it? And then I’m curious what we need to have in place to prevent something like this moving forward, if that’s even possible.

Gates: In terms of what we need to do to prepare ourselves this fall, first of all, all the way through this, we need to listen to the medical experts and the science experts. They know what’s real. We need to do the disease modeling to see where the outbreaks are going. We need to plan resources appropriately and share them in the United States with all the states in an equitable way.

And then we need to do massive testing. We have to have testing at wide scale so that you can get a test and you can know if you’re positive. And if you’re positive, then you self-isolate. Unless you get further disease, you then get telemedicine. You figure out if you need to go to the health system. And you have different tiers of the health system, places people can go for oxygen versus people who go to the ICU.

We can do that, kind of. You can do that triage of people if you have a test. To be frank, we also need to be able to share all that testing data so that eventually the US would be a place like South Korea, where I can literally prove on my phone “I took a test this morning — I’m COVID-free” or “Guess what? I had COVID before and I tested for antibodies in my system. I can be out in society working maybe now.” You could literally have a code on your phone that says, “Tested this morning” or “See? I have a COVID antibody.”

And so we can start to see who can be in society versus who needs to self-isolate. But without testing and contact tracing and some way of being able to prove to one another we’re safe, you can’t plan for a full eventual reopening of society. We need to do get that up and running at scale at a national level.

Preparing for the next epidemic is a whole different conversation. You’d have tests available from the get-go. You would have fought through the civil-liberties issues of people sharing their health information willingly or not willingly. Am I willing to share my health data so that you know if I got it?

Early on, people with COVID had symptoms we didn’t know to track. If we had known that from the get-go because they were able to share their information into a national database voluntarily, we would have known to tell people, “Look for these symptoms. Self-isolate just in case you have it.” We have to be able to start thinking through those types of systems as a country so that we’re prepared for whatever comes next.

Whose job is it to solve a pandemic, the elite’s or the government’s?

Shontell: Yes to all of that. Edelman put out on their annual Trust Barometer in January. They found that trust in media is really low right now. Trust in the government is really low too. But trust in business leaders is the highest group, and people seem to put the most faith in business leaders to solve some of society’s biggest problems.

You and Bill have done a tremendous amount with the foundation. You’re seeing Mark Zuckerberg giving a ton of money toward this. Sheryl Sandberg is doing the same. Jack Dorsey just pledged a big chunk of net worth to help fight COVID. Lots of people are stepping up. Bezos as well.

Is it the responsibility of business leaders to do this versus the government? Is this something we should come to expect? How do you kind of view the responsibility of the people who are in positions of the most privilege as we tackle something as wide-scale is this?

Gates: What I’m seeing is people stepping up. I sometimes wish people could see the number of emails we’re receiving daily at the foundation, not just Bill and me, but our scientists and our head of global health. We’re seeing CEOs come forward. We’re seeing philanthropists come forward. We’re seeing people who have knowledge and data saying, “Should we look at this? What should we do?” I am seeing the best of humanity come out right now in some of these leaders who are stepping forward and doing the right thing.

“Is this the responsibility of business?” was your question. It’s the responsibility of all of us. Business won’t be able to solve this. There’s no way business or philanthropy can solve this alone. It takes the government. It’s government who puts out huge amounts of money into our healthcare system to take care of everybody, to take care of the most vulnerable. It’s philanthropy and business and nonprofits coming together with government to have a national response. That is the only way we’re going to be able to care for all Americans.

But what I see is amazing scientists like Dr. Fauci stepping up and giving all the right messages. Those are the people we should be listening to, and I am seeing so many people come together behind the scenes to try and do the right thing. While the vulnerable is what keeps me up at night, one of the things that keeps me encouraged when I wake up in the morning is seeing so many people doing the right thing.

This is not just a once-in-a-century pandemic. ‘We are absolutely going to have more of these.’

Shontell: Is this a once-in-a-century pandemic like the Spanish flu, or do we need to expect to face more pandemics like this moving forward?

Gates: This is not a once-in-a-century pandemic. We are absolutely going to have more of these. This thing is highly infectious, COVID-19. But it is not nearly as infectious as measles. And we dealt with measles in the world. We know how to deal with measles. We’re going to see more, so we need to plan for them. And we haven’t planned for them as a global community.

Shontell: Why do you think we’ll see more pandemics?

Gates: We’ll see more because of all kinds of reasons, but mainly because we’re a global community and we travel and we spread disease.

Alyson: To end on a positive note, we are going to get through this, right? It will be hard, but we will get through this. I’m curious from your estimation: What timeline are we looking at for life to feel normal again? Or are we in a new normal, and are there things that we should expect to be permanently changed?

No one really knows when things will feel normal again. But be prepared for some permanent changes, including to your psyche.

Gates: I definitely think there are going to be things that are permanently changed. Our psyches are going to be permanently changed. We are learning some things about how to do more meetings online. We’re learning how to take care of each other online. People are reaching out to the elderly in their homes and doing video calls and sending emails or dropping a meal off. What’s going to change is our psyche, and I hope we change to realize that we’re a global community.

To the question of when does society reopen in what we think of as our normal form, nobody really knows the answer to that. It really is when we get a vaccine at scale.

Will we get, over time, probably some partial reopenings of society where you can do certain smaller group things or be out walking with one friend or two friends? I think we will start to see some partial reopenings.

We have to follow the data, though, of how is that working in Wuhan right now? How did it work in South Korea? How does it work in Germany? The places that are kind of ahead of us on both their response and when they got the disease? And then, we’ll start to be able to see, OK, where can we open up pockets of society over time? For right now, we need to be physically distant from one another.

Shontell: If the average person wants to give to help a vulnerable person or community, what’s the best way to do that other than social distancing? Is there some cause to give to or something that’s most helpful?

Gates: Yes. You could go globally. You could go to the WHO COVID Solidarity Fund. Locally, you could go to United Way. America’s Food Fund is another place you can go. I would give also to local domestic-violence organizations. We see domestic violence on the rise for many, many people, particularly women. Any of those would be amazing places to go and to give, even if you only give $10 — $10 or $100, it all makes a difference.

Shontell: I’m leaving this conversation very hopeful. Thank you for all efforts you and Bill and the foundation are doing in helping fight this. You were early to realizing the problems of pandemics, and we are grateful that you’re on it.

Gates: Thanks, Alyson. Be safe. Be well.

 

 

 

Fauci at center of conservative storm

Posted on by • Posted in 2020 Election Issues, Communication, Coronavirus, Credibility, Crisis, Crisis Management, Denial, Emergency Preparedness, Failure, Health Policy, Honesty, Indecision, Infection Control, Infectious Virus, Integrity, Misleading, Pandemic, Public Health, Public Safety, Social Distancing, Transparency, Trust, Truth, World Health Organization (WHO) • Leave a comment

Fauci at center of conservative storm

Health Official condemns Senator Ron Johnson's false equivalency ...

Criticism of Anthony Fauci from the right has picked up in recent days, with some conservatives calling for Trump to dump the infectious disease expert after he made comments about how imposing social distancing rules earlier could have slowed the spread of the novel coronavirus in the United States.

Fauci has become a national name with his regular presence at the daily coronavirus task force briefings and in other media appearances, and poll numbers show he’s trusted by a majority of Americans. It would set off a political storm if Trump were to sideline him in the middle of a pandemic.

Yet the criticism of Fauci by two conservative lawmakers in a Saturday op-ed and Trump’s own retweet of a conservative’s call to “#FireFauci” were unmistakable signs that the public health official is coming under pressure from some on the right to be loyal to the president. 

Tensions between Fauci and Trump have been evident at times in recent weeks. The doctor put his head in his hand at one March briefing where the president quipped about the “Deep State Department,” and Trump stepped in at a briefing this month before Fauci could give his opinion on hydroxychloroquine.

The president had publicly praised Fauci as “extraordinary” and dismissed speculation about a rift between the two, joking on Friday that Fauci is so popular he could run against Rep. Alexandria Ocasio-Cortez (D-N.Y.) and “win easily.” For the most part Fauci has seemed to successfully walk the line between contradicting Trump without outright criticizing him. 

But Trump’s tweet on Sunday marked a shift and coincided with a fresh groundswell of conservative push-back toward the doctor as Trump comes under intense criticism for his slow response to the virus.

Some of the more pointed criticism of Fauci came after he said on CNN Sunday that more lives could have been saved if stay-at-home measures were implemented earlier than mid-March.

The comments irked Trump allies who viewed them as revisionist history given how Fauci’s own public statements evolved throughout January and February as scientists learned more about the virus and it spread through the U.S.

Jason Miller, a former Trump adviser who now hosts a radio show focused on the pandemic, said Fauci must be careful with how he talks about the crisis, but also described “finger pointing” as media chatter seeking to pull the administration apart.

“This talk of potential removal from the team is unnecessary media chatter trying to draw a divide where one doesn’t exist,” Miller said.

“I think what this is about is about the accuracy with which Dr. Fauci is communicating with both the president and the American people,” he added. “It’s critical as the lead scientist and health expert advising the president on the coronavirus pandemic that he be spot on with his details. I think the recent finger pointing and revisionist history whether intentional or accidental doesn’t help anybody.”

One source close to the administration said, while some inside would like to see Fauci gone, most recognize there is more value to keeping him on.

“I don’t sense there’s a monolithic view,” the person said. “There are some who dislike him and want him out of the [administration] but I think most recognize it’s better for him to be in the tent than outside of it.” 

Fauci’s CNN remarks followed a New York Times article detailing how Trump ignored early warnings about the virus and initially resisted recommendations to implement social distancing recommendations, reporting that Trump has dismissed as “fake.”

One of Trump’s many tweets Sunday night defending his response quoted a former GOP congressional candidate who said it was “time to #FireFauci,” citing his Feb. 29 comments that there was not yet a need for Americans to alter their day-to-day lives.

Fauci has been clear that his realm of expertise is public health, and he has suggested at times that social distancing guidelines will be needed for weeks or months to limit the spread of the virus.

Others inside and outside the administration are advocating that it take steps to open up the economy soon, and emphasizing that health experts can’t be the only voices involved in the decision.

“Anthony Fauci should be deferring to the President when answering questions about timing of economic reopening,” Fox News host Laura Ingraham tweeted on Sunday.

Reps. Andy Biggs (R-Ariz.) and Ken Buck (R-Colo.) penned an op-ed in the Washington Examiner over the weekend arguing that Fauci should not be a primary voice speaking on the coronavirus outbreak after the public health official late last month described social distancing as an “inconvenient” from societal and economic standpoint.

The criticism of Fauci comes amid a concerted effort among Trump and his supporters to shift blame away from the White House for its handling of the coronavirus, which has infected more than 557,000 people in the U.S. and killed more than 22,000 in the country. The president has at various points blamed governors for failing to prepare for the pandemic, deflected criticism toward the World Health Organization (WHO) and accused Democrats of using impeachment as a distraction.

Fauci, director of the National Institute of Allergy and Infectious Diseases since 1984, has been a ubiquitous presence during the coronavirus outbreak, appearing on political talk shows, sports podcasts and Instagram live chats.

He has emerged as something of a beacon for liberals in particular for his willingness to gently correct Trump on matters like a timetable for a vaccine and the efficacy of hydroxychloroquine, an anti-malaria drug the president has touted as a potential treatment for the coronavirus.

But his prominence has made him a target of criticism, so much so that he was given added security at the end of March.

One feature of Trump’s presidency has been his distrust of long-time government officials, particularly those who have served in previous administrations. Another has been Trump’s tendency to tire of aides and advisers who garner more of a spotlight than he does, putting Fauci in a precarious position even at a time when his expertise is most relevant.

Trump would have difficulty firing Fauci, who is not a political appointee, without cause. Attempting to do so would cause a firestorm among even some Republicans who have urged the president to listen to his health experts.

But one former administration official suggested Fauci could see his influence reduced. The official likened it to the way Health and Human Services (HHS) Secretary Alex Azar has been diminished after he warned Trump in January and February about the threat of a pandemic but was dismissed as too alarmist.

“What happens when somebody repeatedly tells the president something he doesn’t want to hear?” said the former administration official, who requested anonymity to speak candidly. “He won’t fire [Fauci], but he’ll just sideline him.”

But doing so could risk damaging public confidence in the administration’s response to the virus. 

A Monmouth University poll released last week found that 35 percent of Americans named Fauci when asked who they trust the most among public officials who discuss the outbreak on television, whereas 20 percent named Trump. 

“Regardless of the issue, [Trump is] not always his most disciplined messenger,” said GOP strategist Doug Heye. “The more that he’s able to rely on the expertise of scientists, the more credibility that it gives him in this entire process.”

 

 

 

 

The Costly Toll of Not Shutting Down Spring Break Earlier

Posted on by • Posted in 2020 Election Issues, Blame, Centers for Disease Control & Prevention (CDC), Communication, Coronavirus, Crisis, Crisis Management, Denial, Excuses, Health Policy, Infection Control, Infectious Virus, Mislead, Misleading, Pandemic, Public Health, Public Safety, Trust, Truth, Uncertainty, World Health Organization (WHO) • Leave a comment

https://www.yahoo.com/news/costly-toll-not-shutting-down-161107861.html

The Costly Toll of Florida Not Shutting Down Spring Break During ...

You could find Beatriz Diaz at this spring’s Winter Party Festival in Miami Beach, giving out hand sanitizer.

It was early March. She knew the coronavirus was beginning to make its way around the world, but she figured if she kept her hands clean and avoided sweaty people, she would be safe.

“I was thinking, ‘OK, well, hold on, the government did not cancel it, so it should be fine,’” she said.

Within days, reports started popping up on Facebook about a DJ and several partygoers who were suddenly terribly ill. By the end of the month, two people who attended the festival had died.

As of last week, 38 people had reported that they were symptomatic or had tested positive for the coronavirus in the weeks following the event, according to the organizer, the National LGBTQ Task Force. Diaz was among them.

Weeks before Florida ordered people to stay at home, the coronavirus was well into its insidious spread in the state, infecting residents and visitors who days earlier had danced at beach parties and reveled in theme parks. Only now, as people have gotten sick and recovered from — or succumbed to — COVID-19, the disease caused by the coronavirus, has the costly toll of keeping Florida open during the spring break season started to become apparent.

Gov. Ron DeSantis, a Republican, has blamed travelers from New York, Europe and other places for seeding the virus in the state. But the reverse was also true: People got sick in Florida and took the infection back home.

The exact number of people who returned from leisure trips to Florida with the coronavirus may never be known. Cases as far away as California and Massachusetts have been linked to the Winter Party Festival, a beachside dance party and fundraiser for the LGBTQ community held March 4-10. Another California man died after going to Orlando for a conference and then to a packed Disney World. Two people went to Disney and later got relatives sick in Florida and Georgia.

Slow action by Florida’s governor left local leaders scrambling to make their own closure decisions during one of the busiest and most profitable times of the year for a state with an $86 billion tourism economy. The result was that rules were often in conflict, with one city canceling a major event while a neighboring city allowed another event to continue.

The governor, who did not order people to stay home until April 1, has said the state supported local governments that ordered event cancellations and beach closures but that it was not his role to step in first.

“Let’s have tailored approaches, surgical approaches, that are going to work best for those regions,” DeSantis said at a news conference March 24. “These blunt measures — you wouldn’t want to do them on a community where the virus hasn’t spread.”

With little testing available, local officials made decisions blindly. Data that suggested looming trouble, such as rising fever readings from internet-connected thermometers, were ignored, a spokeswoman for Kinsa Health, the company that produces the thermometers, has said.

Only later did the effects become apparent.

Florida has confirmed more than 17,500 coronavirus cases and nearly 400 deaths, with the epidemic still expanding in the state.

A video by data analytics and visualization company Tectonix showed how cellphones that were on one Fort Lauderdale beach at the beginning of March spread across the country — up the Eastern Seaboard and further West — over the next two weeks.

“At the time, there was still this debate: Should we close public beaches? Should we shut down these big public events?” said Mike DiMarco, the company’s chief marketing officer. “When you actually see it visually on a map like that, it brings a ton of awareness to what that really looks like.”

The first festivalgoer to die was Israel Carrera, a 40-year-old Lyft and Uber driver who spent several days in the hospital in Miami Beach before his death March 26. His boyfriend, who also attended, got mildly sick and is now making plans to deliver Carrera’s ashes to his surviving family in Cuba.

Ron Rich, a 65-year-old festival volunteer, died over the weekend of March 28.

The decision to hold the festival five weeks ago came at a different point in the crisis, before a single person had tested positive in Miami-Dade County, said Rea Carey, executive director of the National LGBTQ Task Force. The event ended the day before the World Health Organization declared the virus a pandemic.

“It points to what we didn’t know at the time,” she said. “If we had had the information that is available now, the information that has become available after Winter Party as this pandemic has played out, we would have made a different decision.”

Photos of the festival show hundreds of people crammed in front of a stage under neon lights, dancing, hugging and practicing little social distancing.

Diaz, 42, got a fever March 15. The next day her girlfriend was also sick. By the time Diaz was confirmed positive for COVID-19, she had been grocery shopping, gone to the pharmacy and spent time with her employer’s 80-year-old father and 14-year-old daughter.

“I understand that was my choice to be there; I take full responsibility for that,” Diaz, who lives in Wilton Manors, Florida, said of the Winter Party Festival, which drew about 5,500 people and has been a fixture in the LGBTQ community for more than 25 years.

“I am really upset for the way it was handled,” she said.

Loc Nguyen, a software developer, felt exhausted from the time he returned home to Los Angeles from the festival March 9. He went to work the next day but had to call in sick after that, feeling shortness of breath and such terrible shivers that he wrapped himself in three winter jackets to go to the doctor.

“You’re coughing and gasping for air,” Nguyen said. “You are scared. You can’t breathe.”

His friend who went to the festival with him also tested positive. A third friend got sick but was unable to get a test.

Nguyen knew the risk of attending but said he did not want to lose the money he had spent on tickets. He did not blame organizers for holding the festival and pointed to mixed messages from local officials.

“If one city closes and one city is open, it’s not consistent,” he said. “And therefore you can’t stop this pandemic.”

On March 6, the city of Miami, which is separate from Miami Beach, canceled the Ultra Music Festival, a marquee electronic dance music event that draws tens of thousands of people. Other local leaders criticized the action as too drastic: The Centers for Disease Control and Prevention was not yet recommending mass closures. Florida announced its first confirmed coronavirus case March 1, but it was in the Tampa area.

“We should live our lives normally,” with public health safeguards in place, Mayor Carlos Gimenez of Miami-Dade County said March 5.

By March 12, he had reversed course and canceled the Miami Open tennis tournament and the county youth fair. The fairgrounds now house a field hospital.

“We did what we thought — and I’m sure all cities did what they thought — was the right thing to do at the right time,” Gimenez said last week. “It’s called novel coronavirus for a reason. We don’t really know how it acts.”

Mayor Francis Suarez of Miami, one of the first elected officials in the country to test positive for the coronavirus, said other jurisdictions’ decisions to keep events going proved costly.

“That ended up as a national embarrassment, when you saw what happened with the spring breakers and what happened unfortunately, tragically, with the music festival,” he said, referring to the Winter Party.

Further north, near Orlando, people streamed into the six Disney World theme parks before they closed March 15. Courtney Sheard recalled that the weather was beautiful and that a new ride at Hollywood Studios, Mickey & Minnie’s Runaway Railway, was especially crowded.

After she got back home to Naples, Florida, on March 12, she awoke with a terrible headache and a sore throat. Her 3-year-old daughter, Journey, ran a fever and vomited.

By the time she received a positive test result, Sheard, 30, had been around her sister, her sister’s children, a friend, her parents, beachgoers and diners at a Bonefish Grill.

When Sheard learned that Jeffrey Ghazarian, 34, had died March 19 in California after visiting the theme park, she figured that the coronavirus had been circulating in Disney while he, and then she, were there.

“Think of all the people from around the world, from around the country, that were in Disney and then went home,” she said.

Officials at Walt Disney World did not respond to a request for comment.

Mayor Jerry Demings of Orange County, home to Orlando, said local officials had insufficient guidance to act consistently to slow the spread.

“We were left to our own devices to come up with strategies ourselves because of the lack of direction from the federal government and governor’s office,” he said.

Nicholas Hickman started feeling ill three or four days after returning home to Ringgold, Georgia, on March 11. He had spent five days at Disney with friends who were on spring break. They were also celebrating Hickman’s 20th birthday.

Back home, Hickman came down with a fever, chills and chest pains but struggled to get tested because no one else in his county had received a coronavirus diagnosis.

Hickman has since recovered, but only after getting his mother, and likely his father, sick. He does not blame Disney for his infection.

“If we would have been told not to go to Disney and just avoid going, we would not have gone,” he said. “There’s no way we would have gone.”

 

 

 

 

Fauci: US could have ‘saved lives’ if social-distancing restrictions were enforced earlier

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Communication, Coronavirus, Crisis, Crisis Management, Economy, Failure, False Hope, Health Policy, Inaction, Indecision, Infection Control, Infectious Virus, Misleading, Social Distancing, Trust, Truth, Wall Street • Leave a comment

https://thehill.com/homenews/administration/492411-fauci-us-could-have-saved-lives-if-social-distancing-restrictions

Top doc Fauci admits lives could have been saved if US had shut ...

Anthony Fauci, the U.S. government’s top infectious disease expert, said Sunday that the U.S. would have saved lives had the country enforced firm social-distancing requirements as early as February, but noted that those recommendations were met with pushback at the time.

Speaking on CNN’s “State of The Union,” Fauci addressed a New York Times report that said he and other health experts concluded on Feb. 21 that the Trump administration would need to issue aggressive mitigation measures in order to slow the spread of COVID-19, the disease caused by the novel coronavirus. 

“As I have said many times, we look at it from a pure health standpoint,” Fauci said. “We make a recommendation. Often, the recommendation is taken. Sometimes, it’s not. It is what it is. We are where we are right now.”

Fauci added that “you could logically say, that if you had a process that was ongoing, and you started mitigation earlier, you could have saved lives.”

“Obviously, no one is going to deny that. But what goes into those kinds of decisions is complicated,” he said. “I mean, obviously, if we had, right from the very beginning, shut everything down, it may have been a little bit different. But there was a lot of pushback about shutting things down back then.”

The National Security Council reportedly received intelligence reports in January warning that the COVID-19 outbreak would spread to the U.S. By the third week of February, Dr. Robert Kadlec, the top disaster response official at the Health and Human Services Department (HHS), convened a meeting on whether officials should lock down the country to prevent an outbreak. The group determined that mitigation measures such as school and business closures were necessary despite the devastating economic implications, The Times noted.

The White House issued social-distancing guidelines, including recommendations against gatherings of more than 10 people, in mid-March. President Trump later that month extended those guidelines through the end of April.

The U.S. has reported more than 530,000 confirmed COVID-19 cases and roughly 20,600 deaths caused by it as of Sunday morning, according to a Johns Hopkins University database. 

Asked whether the statistics were a direct cause of the late start on mitigation measures, Fauci said that “it isn’t as simple as that.” While earlier mitigation efforts would have had an impact, Fauci noted that “where we are right now is the result of a number of factors,” including the size of the country and the heterogeneity of the country.

“I think it’s a little bit unfair to compare us to South Korea, where they had an outbreak in Daegu, and they had the capability of immediately, essentially, shutting it off completely in a way that we may not have been able to do in this country,” he said. “So, obviously it would have been nice if we had a better head start, but I don’t think you could say that we are where we are right now because of one factor.”

The Trump administration has faced continued scrutiny over its handling of the outbreak, as state and federal officials raise alarms over testing and medical equipment shortages.

The president on Feb. 28 predicted that the disease would disappear like a “miracle.” Asked about those comments last week, Trump said that “the cases really didn’t build up for a while” and that he was trying to avoid stirring panic. 

 

 

 

 

Trump suggests doctors complain about lack of coronavirus equipment in order to get on TV

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Communication, Coronavirus, Crisis, Crisis Management, Employer-Based Health Insurance, Health Insurance Coverage Adequacy, Health Policy, High Deductible Health Plans, Infection Control, Infectious Virus, Medicare for All, Mislead, Misleading, Out of Pocket Expenses, Pandemic, Personal Protective Equipment (PPE), Physician, Surprise Bills, Trust, Truth, Underinsured, Unemployment, Unemployment Insurance, Uninsured, World Health Organization (WHO) • Leave a comment

https://www.yahoo.com/news/trump-suggests-doctors-complain-lack-141500695.html

PPE Shortage Endangering Health Workers Worldwide - GineersNow

Donald Trump has implied doctors and elected officials say they do not have enough personal protective equipment (PPE) and other materials to get on television amid the coronavirus crisis.

The US president had a row with Jim Acosta, CNN’s chief White House correspondent, over the shortage of PPE, which includes essential gear such as hand sanitiser, gloves, aprons, and face masks, during his coronavirus press briefing.

Acosta said: “We hear from a lot of people who see these briefings as sort of ‘happy talk’ briefings. And some of the officials don’t paint as rosy a picture of what is happening around the country. If you look at some of these questions – do we have enough masks? No. Do we have enough tests? No. Do we have enough PPE? No.”

Mr Trump interjected: “Why would you say that? The answer is yes. I think the answer is yes.”

Acosta referred to doctors and other medical officials who have vented their frustrations about the dearth of essential equipment on CNN.

The president hit back: “A lot of it is fake news.”

Acosta said: “Doctors and medical officers come on our air and say ‘we don’t have enough tests, we don’t have enough masks’.”

Mr Trump chipped in: “Well yeah, depending on your air they are always going to say that because otherwise, you are not going to put them on.”

The spat comes as doctors and healthcare workers across America are battling against a shortage of face masks which safeguard them against coronavirus – sparking fears doctors will not be able to provide life-saving care if they fall ill.

America has become the first country in the world to record more than 2,000 people dying from coronavirus in one day alone, according to Johns Hopkins University figures.

People who contract coronavirus in the US are at greater risk than those in the UK or Canada due to America not having a national health service.

Americans are at risk of running up bills for coronavirus treatment which force them to fork out tens of thousands of dollars. The situation is exacerbated by the fact many have lost their healthcare insurance due to job losses linked to the pandemic.