Growing Understanding Of Airborne Coronavirus Puts Focus On Air Conditioning

https://www.wgbh.org/news/local-news/2020/07/21/growing-understanding-of-airborne-coronavirus-puts-focus-on-air-conditioning

Restaurant Air Conditioning Experts - JDL Refrigeration

Scientists have come to realize the coronavirus isn’t just spread through close contact. The virus can float through the air and be inhaled by someone, even if they’re diligently practicing social distancing.

And as more people head back to work, start shopping in malls and doing other things in public, indoor spaces, the airborne virus is a real concern — especially as it gets hotter and we rely more on air conditioning.

Ed Nardell is an infectious disease expert at the Harvard T.H. Chan School of Public Health. Nardell said that when we exhale, most of the particles that come out are wet.

“Now they’re falling, falling, falling, and some will hit the ground and they won’t evaporate anymore. They’re settled,” Nardell said. “But others, before they hit the ground, start to evaporate. And pretty soon, they are airborne. And those can float on air currents indefinitely unless they’re vented out or inhaled.”

That could lead to infection. But Nardell said it’s unlikely that an HVAC system would suck up a virus particle from one room and deposit it out another vent. Nardell said there’s no evidence of that happening.

But AC is a problem, he said. “Mainly because it makes people go indoors.”

Outside, there’s infinite space to dilute the air you’re breathing.

“And then suddenly you’re inside and you are more likely to be less distant and you’re re-breathing air that other people have exhaled,” Nardell said.

Indoor AC units can spread the virus, Nardell said. The units create air currents that can blow the virus around a room. He said that problem was clear in the case of one restaurant in Wuhan, China, where researchers studied why so many people eating there became sick.

“Where apparently someone infected not only people at their own table, but at the next table and the table after that, which happened to be that in the direction of the airflow from a wall unit air conditioner,” he said.

Since not everyone has the option to stay outside, the American Society of Heating, Refrigerating and Air-Conditioning Engineers is figuring out ways to make indoor spaces safer.

Penn State professor William Bahnfleth chairs the society’s epidemic task force, which has been busy writing up guidance for people in the HVAC industry and building managers.

“It’s almost 400 pages of recommendations on how to protect different types of buildings from risk,” Bahnfleth said.

The key is to lower the concentration of possibly infected particles in the air, he said.

“One of the best ways to do that is simply to bring in a lot more outside air into a building, because that outside air replaces indoor air that may be contaminated, and that lowers the concentration,” Bahnfleth said.

That’s what they’re doing at the restaurant Coppersmith in South Boston, where they’re skipping the air conditioning and getting fresh air by leaving open big garage-style doors.

General Manager Sheila Senat said that customers seem happy with that choice. “I think they feel safer with the AC being off and the doors open,” she said.

But a lot of buildings don’t even have any windows that open. And most HVAC systems in those buildings keep recirculating cool air, because it’s more energy efficient.

Bahnfleth said now’s the time to sacrifice some of that energy efficiency and dial up how much air the system is taking in from outside.

“Another thing you can do is to use filters to remove the particles from the air that may contain viruses,” he said.

Filters are rated on what’s called the MERV scale, and the HVAC recommendations say most buildings should step it up to a level 13 filter to reduce particles carrying coronovirus.

So if you have to go back to work soon, Bahnfleth has some advice.

“You just have to ask, ‘What have you done?’” he said. “I have the same questions for my employer at the university. ‘What are you doing to make our classrooms safe?'”

Tamara Small of the commercial real estate development group NAIOP Massachusetts said she’s hearing building managers are stepping up filtration to the recommended MERV-13.

“It’s a balance to ensure that there is more ventilation, and definitely new air filters in every building are probably the most common responses we’ve seen,” she said.

There is one other technology that Ed Nardell of Harvard said could help reduce risk: Upper room germicidal UV. Basically, that means shining ultraviolet light at the ceiling level to kill any virus floating up there.

“I first encountered it in the eighties when we tried to deal with an outbreak of tuberculosis in a homeless shelter in Boston,” Nardell said.

It worked then, and Nardell said it could work now. The idea’s been around for almost 100 years, he said. But it’s rarely used in the U.S. these days.

Nardell’s working on research now to show how effective it could be at killing off the coronavirus.

In the meantime, the best we can do is to try to get some fresh air.

 

 

 

 

Six reasons to be optimistic amid COVID-19

Six reasons to be optimistic amid COVID-19

Being more optimistic lowers the risk of CVD and early death: JAMA

Although COVID-19 cases, hospitalizations, and deaths are rising, there is also some positive news on the horizon, according to Joseph Allen of Harvard T.H. Chan School of Public Health.

In a July 14, 2020 Washington Post op-ed, Allen, assistant professor of exposure assessment science and director of the Healthy Buildings program, wrote that progress is being made in treatments, testing, and vaccines, and that there’s growing agreement about ways to curb the spread of infection.

Among positive developments, Allen cited:

  • Therapeutic treatments, such as cloned antibodies, are showing to be effective both to treat and prevent COVID-19.
  • Rapid, low-cost saliva tests for COVID-19 are being developed and could be a game-changer.
  • Universal mask-wearing is catching on.
  • Consensus has emerged that airborne spread of the coronavirus is happening, and the World Health Organization and other organizations are now recommending the use of healthy building strategies such as higher ventilation, better filtration, and the use of air-cleaning devices.
  • Several studies suggest that past exposure to common-cold coronaviruses may help protect some people from COVID-19 infection.
  • Vaccine trials seem to be working and drug makers have said they may be able to deliver doses as early as October.

“For the first time in history, nearly every scientist in the world is focused on the same problem,” Allen wrote. “This is starting to pay real dividends.”

Read Joseph Allen’s Washington Post op-ed: Need some good news about covid-19? Here are six reasons for optimism.

 

 

 

 

Pinning hopes on vaccine is not the right coronavirus strategy, expert says

https://www.cnn.com/2020/07/22/health/us-coronavirus-wednesday/index.html

As cases continue to rise, Americans looking to a vaccine as the way out of the coronavirus pandemic should consider a more comprehensive approach, a leading medical expert told CNN on Wednesday.

“Pinning all our hopes on a vaccine that works immediately is not the right strategy,” Dr. William Haseltine, a former professor at Harvard University’s medical and public health schools, told CNN’s Wolf Blitzer.
Haseltine said a broad public health strategy is a better way to contain the spread of the virus along with the help of a vaccine and therapeutic drugs. Mandating masks will help but Haseltine said, “we need a lot more than masks to contain this epidemic that’s running through our country like a freight train.”
Haseltine recommended closing bars and other places where young people congregate at night and ban holding large meetings in the worst-hit regions. Life won’t get better until people make major changes to their behavior and public health services come forward with more resources, he said.
He said a vaccine is still six months away at the earliest and he warned not to underestimate a coronavirus. Haseltine, known for his work on fighting cancer and HIV/AIDS, said it won’t be easy to develop a vaccine.
“These are tricky viruses,” he said. “It’s not as simple as measles or mumps. It’s going to be a lot more complicated”.
Any Covid-19 vaccine that’s sponsored by the US government will be free or affordable for the American public, Health and Human Services Secretary Alex Azar told CNBC on Wednesday.
“For any vaccine that we have bought — so for instance the Pfizer vaccine — those hundred million doses would actually be acquired by the US government, then given for free to Americans,” Azar said.
He said the same would apply with the AstraZeneca and the Novovax vaccines.
“We will ensure that any vaccine that we’re involved in sponsoring is either free to the American people or is affordable,” Azar said.
And while some anti-mask protesters refuse to wear a piece of cloth to help save American lives, enormous signs of altruism have emerged.
More than 100,000 people have volunteered to participate in Covid-19 vaccine clinical trials, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
“I think we’ll be fine with regards to getting enough people,” Fauci said during a webinar Wednesday with the TB Alliance.

1 million more cases in two weeks

The US is heading in the wrong direction with Covid-19 numbers, and it’s doing so with astonishing speed.
Just after 1,000 people died in a single day, the country is about to reach 4 million Covid-19 cases.
To put that in perspective, the first reported case came on January 21. After 99 days, 1 million Americans became infected.
It took just 43 days after that to reach 2 million cases.
And 28 days later, on July 8, the US reached 3 million cases. The 4 millionth case could come just two weeks after that.
As of Wednesday night, more than 3.96 million people had been infected across the US, and more than 143,000 have died, according to data from Johns Hopkins University.
Some states are reporting record-breaking numbers of new cases. Johns Hopkins reported at least 68,706 new cases and 1,152 deaths in the US on Wednesday.
More governors are requiring masks, and dozens of hospitals are out of intensive care unit beds.
President Donald Trump said the United States has now conducted more than 50 million coronavirus tests. He told reporters at a White House briefing that people should wear masks, pay attention to social distancing and wash their hands. While hot spots like Florida and Texas have popped up, it’s all going to work out, he said.
“We’re all in this together,” he said.

Covid-19 a leading cause of death in L.A. County

California, the most populous state and the first to shut down months ago, appeared to have Covid-19 under control — only to suffer a massive resurgence and surpass New York with the most coronavirus cases in the nation.
This month, state Gov. Gavin Newsom shut down bars and indoor restaurant services again due to an influx of cases after reopening.
Covid-19 is set to become one of the leading causes of death in Los Angeles County, according to Barbara Ferrer, the county’s health director.
“It’s killing more people than Alzheimer’s disease, other kinds of heart disease, stroke and COPD,” Ferrer said, referring to chronic obstructive pulmonary disease, which causes airflow blockage and breathing issues.
Comparing Covid-19 to the flu, Ferrer said data shows Covid-19 killed twice as many people in six months as the flu did in eight months.

Where cases are surging

Some politicians, including the President, have insisted that much of the soaring case numbers are a reflection of increased testing.
But the surge is new cases has greatly outpaced the increase in testing, with troubling rates of transmission and test positivity in many states.
A CNN analysis of testing data from the Covid Tracking Project reveals the positive test rate — or the average number of positive test results out of 1,000 tests performed — has increased significantly in many of the current hotspots, including Florida, Arizona, Texas and Georgia.
Florida saw an average rate of 35 positive results per 1,000 tests during the month of May. But in June, that number nearly tripled to 105. So far in July, the average rate of test positivity has been 187 out of 1,000.
But Florida Gov. Ron DeSantis said the state is on the “right course” in the fight against the virus.
“I think we will continue to see improvements,” the governor said Tuesday. “We just have to, particularly Floridians, have to continue doing the basic things.”
Over the weekend, nearly 50 Florida hospitals said they were out of ICU beds. Statewide, the ICU bed availability had dwindled to 15.98% on Tuesday, down from about 18.1% on Monday.
And new data from the CDC also show infections could be more than 10 times higher than the number of reported cases in some parts of the US.

More mask mandates lead to decreased death projections

Researchers estimate the US will have 219,864 total Covid-19 deaths by November 1, according to the Institute for Health Metrics at the University of Washington.
That’s actually a decrease of about 5,000 deaths from the IHME’s previous forecast of 224,546 by that date.
The reasons for the slightly better forecast include more face masks mandates, more people wearing masks, and more people practicing social distancing, the researchers said.
“So a mandate is very important and helping, and a national mandate, of course, would do much better,” said Ali Mokdad, a professor of health metrics sciences at the IHME.
If Americans wore masks nationwide, the number of total deaths by November 1 would drop to 185,887, the researchers project. But if the mandates ease more, the US could have 231,012 deaths by November 1.
At least 41 states have some kind of mask requirement in place or planned. Starting Saturday, Minnesota will require people to wear masks inside businesses or indoor public settings. People who have conditions that make “it unreasonable for the individual to maintain a face covering are exempt from the order,” Gov. Tim Walz said.
Trump said Wednesday he would make a decision over the next day on whether to mandate masks on federal property.

Major testing delays make tracing almost useless

With the high transmission levels of the virus, traditional contact tracing has now become “impractical and difficult to do,” said California Health Secretary Dr. Mark Ghaly.
The state is working to refine strategies and continue to work with counties to build up their “tracing army,” but Ghaly warns that “even a very robust contact tracing program will have a hard time reaching out to every single case.”
Contact tracing is now harder all over the nation while testing results take days, Fauci said.
Quest Diagnostics, a leading commercial testing lab, said in a news release Monday that for some patients, testing results can take up to two weeks.
“The time frame from when you get a test to the time you get the results back is sometimes measured in a few days,” Fauci said Tuesday.
“If that’s the case, it kind of negates the purpose of the contract tracing because if you don’t know if that person gets the results back at a period of time that’s reasonable, 24 hours, 48 hours at the most … that kind of really mitigates against getting a good tracing and a good isolation.”

 

 

 

Maps Of The USA That Made Us Say “Whoa”

https://www.ranker.com/list/maps-mash-v1/mel-judson?format=slideshow&slide=1

The Red Area Features A Total Population Greater Than The Grey

Coronavirus cases could reach 150,000 a day this fall, widely followed Morgan Stanley analyst says

https://www.cnbc.com/2020/07/23/coronavirus-cases-could-reach-150000-a-day-this-fall-morgan-stanley-analyst-says.html

KEY POINTS
  • Morgan Stanley’s biotechnology analyst, Matthew Harrison, said 150,000 daily new U.S. coronavirus cases are possible in the fall without better control of the virus.
  • The analyst has gained a wide following on Wall Street for his success in predicting the course of the pandemic and government responses.
  • Harrison previously projected a “second wave” in the fall with daily new cases between 40,000 and 50,000 nationwide.
  • However, the recent hot spots — Arizona, Texas, Florida and California — have shown a high rate of infection, which led the analyst to adjust to a more pessimistic view on the pandemic.

The spread of the coronavirus could be elevated this fall with as many as 150,000 daily cases in the U.S., according to Morgan Stanley’s biotechnology analyst, Matthew Harrison.

“We update our scenarios to account for the higher sustained infection rate,” Harrison said in a note Thursday. “Our bull [most optimistic] case reflects similar virus control to Europe while our base [most likely] case assumes a near-term plateau followed by increased spread in the fall. [About] 150,000 daily new cases are possible without better control of the virus.”

Harrison previously projected a “second wave” in the autumn with daily new cases totaling between 40,000 and 50,000 nationwide. However, the recent emergence of hot spots — Arizona, Texas, Florida and California — has reflected a high rate of infection, which led the analyst to adjust to a more pessimistic view on the pandemic.

The analyst has gained a wide following on Wall Street for his success in predicting the course of the pandemic and government responses. For example, in April, Harrison warned that the reopening of the U.S. economy would be a slow and tedious process.

“Our assumption of a growing reproduction number, and consequently increasing daily cases, throughout the rest of the year is based on the fact that traditionally the spread of viruses is elevated in the fall compared to the summer primarily due to more people in enclosed spaces,” Harrison said.

A recent resurgence in new cases has forced a number of states to roll back their reopening plans, which weighed on the stock market that rallied massively in the second quarter on hopes for a fast economic recovery. 

Texas and Florida hit grim records earlier this week for daily coronavirus deaths based on a seven-day moving average.The virus has infected an average of 66,805 people per day in the U.S. over the past seven days, up more than 7% compared with a week ago, according to a CNBC analysis of data compiled by Johns Hopkins University.

On Wednesday, California reported a record spike in daily infections and passed New York as the U.S. state with the most confirmed infections since the pandemic began. 

To be sure, Harrison said his projection doesn’t take into account any pharmacological intervention such as vaccines or strict lockdown measures that could potentially dampen the infection rate.

There has been a slew of positive news on the vaccine front this week. The U.S. agreed to pay drugmaker Pfizer and German partner BioNTech nearly $2 billion for 100 million coronavirus vaccines if their candidate proves both safe and effective.

Meanwhile, another vaccine candidate from Oxford University and AstraZeneca showed a positive immune response in an early trial. Earlier this week, British pharmaceutical company Synairgen claimed that its new respiratory coronavirus treatment has reduced the number of hospitalized Covid-19 patients needing intensive care in a clinical trial.

Goldman Sachs biotech analyst Salveen Richter said the Covid-19 vaccine market will be similar to the flu vaccine market, which requires an annual or periodic vaccination. The analyst also cited data showing the global vaccine market will grow to at least $40 billion in 2023 from $35 billion in 2018.

 

 

Fauci on coronavirus: ‘I don’t really see us eradicating it’

https://thehill.com/policy/healthcare/public-global-health/508530-fauci-on-coronavirus-i-dont-really-see-us-eradicating?utm_source=Sailthru&utm_medium=email&utm_campaign=Issue:%202020-07-23%20Healthcare%20Dive%20%5Bissue:28659%5D&utm_term=Healthcare%20Dive

Anthony Fauci, the nation’s top infectious diseases expert, said Wednesday he doesn’t think COVID-19 will ever be fully eradicated but noted it can be controlled.

“I don’t see this disappearing the way SARS 1 did,” Fauci said during a livestreamed event hosted by the TB Alliance, a nonprofit focused on finding better tuberculosis treatments.

The SARS outbreak that started in 2003 lasted several months and mostly affected Asian countries before eventually vanishing. But in the process the disease sickened more than 8,000 people in 29 countries and claimed 774 lives.

Because COVID-19 is more contagious, it has had a far greater impact, with more than 15 million cases worldwide, including 618,000 deaths.

“It is so efficient in its ability to transmit from human to human that I think we ultimately will get control of it. I don’t really see us eradicating it,” Fauci said.

President Trump has repeatedly said the virus will eventually disappear, even though that is rare for most infectious diseases.

Fauci, who is a member of the White House coronavirus task force, recently responded to Trump’s characterization of him as “a little bit of an alarmist” on the pandemic by saying he prefers to think of himself as “a realist.”

During Wednesday’s interview, Fauci described ways that the U.S. can get the coronavirus under control.

“I think with a good combination of good public health measures, a degree of global herd immunity and a good vaccine, which I do hope and feel cautiously optimistic we will get, I think when you put all three of those together we will get very good control of this. Whether it’s this year or next year, I’m not certain,” he added.

“We’ll bring it down to such a low level that we will not be in the position we are right now for an extended period of time.”

 

 

 

Is telehealth as good as in-person care?

https://theconversation.com/is-telehealth-as-good-as-in-person-care-a-telehealth-researcher-explains-how-to-get-the-most-out-of-remote-health-care-142230

Is telehealth as good as in-person care? A telehealth researcher ...

COVID-19 has led to a boom in telehealth, with some health care facilities seeing an increase in its use by as much as 8,000%.

This shift happened quickly and unexpectedly and has left many people asking whether telehealth is really as good as in-person care.

Over the last decade, I’ve studied telehealth as a Ph.D. researcher while using it as a registered nurse and advanced practice nurse. Telehealth is the use of phone, video, internet and technology to perform health care, and when done right, it can be just as effective as in-person health care. But as many patients and health care professionals switch to telehealth for the first time, there will inevitably be a learning curve as people adapt to this new system.

So how does a patient or a provider make sure they are using telehealth in the right way? That is a question of the technology available, the patient’s medical situation and the risks of going – or not going – to a health care office.

Man holding phone with health data.

Telehealth technologies

There are three main types of telehealth: synchronous, asynchronous and remote monitoring. Knowing when to use each one – and having the right technology on hand – is critical to using telehealth wisely.

Synchronous telehealth is a live, two-way interaction, usually over video or phone. Health care providers generally prefer video conferencing over phone calls because aside from tasks that require physical touch, nearly anything that can be done in person can be done over video. But some things, like the taking of blood samples, for example, simply cannot be done over video.

Many of the limitations of video conferencing can be overcome with the second telehealth approach, remote patient monitoring. Patients can use devices at home to get objective data that is automatically uploaded to health care providers. Devices exist to measure blood pressure, temperature, heart rhythms and many other aspects of health. These devices are great for getting reliable data that can show trends over time. Researchers have shown that remote monitoring approaches are as effective as – and in some cases better than – in-person care for many chronic conditions.

Some remaining gaps can be filled with the third type, asynchronous telehealth. Patients and providers can use the internet to answer questions, describe symptoms, refill prescription refills, make appointments and for other general communication.

Unfortunately, not every provider or patient has the technology or the experience to use live video conferencing or remote monitoring equipment. But even having all the available telehealth technology does not mean that telehealth can solve every problem.

A father and son on a video call with a doctor.

Ongoing care and first evaluations

Generally, telehealth is right for patients who have ongoing conditions or who need an initial evaluation of a sudden illness.

Because telehealth makes it easier to have have frequent check-ins compared to in-person care, managing ongoing care for chronic illnesses like diabetesheart disease and lung disease can be as safe as or better than in-person care.

Research has shown that it can also be used effectively to diagnose and even treat new and short-term health issues as well. The tricky part is knowing which situations can be dealt with remotely.

Imagine you took a fall and want to get medical advice to make sure you didn’t break your arm. If you were to go to a hospital or clinic, almost always, the first health care professional you’d see is a primary care generalist, like me. That person will, if possible, diagnose the problem and give you basic medical advice: “You’ve got a large bruise, but nothing appears to be broken. Just rest, put some ice on it and take a pain reliever.” If I look at your arm and think you need more involved care, I would recommend the next steps you should take: “Your arm looks like it might be fractured. Let’s order you an X-ray.”

This first interaction can easily be done from home using telehealth. If a patient needs further care, they would simply leave home to get it after meeting with me via video. If they don’t need further care, then telehealth just saved a lot of time and hassle for the patient.

Research has shown that using telehealth for things like minor injuries, stomach pains and nausea provides the same level of care as in-person medicine and reduces unnecessary ambulance rides and hospital visits.

Some research has shown that telehealth is not as effective as in-person care at diagnosing the causes of sore throats and respiratory infections. Especially now during the coronavirus pandemic, in-person care might be necessary if you are having respiratory issues.

And finally, for obviously life-threatening situations like severe bleeding, chest pain or shortness of breath, patients should still go to hospitals and emergency rooms.

A woman asks a health care worker a question while staying socially distanced.

Balancing risk

With the right technology and in the right situations, telehealth is an incredibly effective tool. But the question of when to use telehealth must also take into account the risk and burden of getting care.

COVID-19 increases the risks of in-person care, so while you should obviously still go to a hospital if you think you may be having a heart attack, right now, it might be better to have a telehealth consultation about acne – even if you might prefer an in-person appointment.

Burden is another thing to consider. Time off work, travel, wait times and the many other inconveniences that go along with an in-person visit aren’t necessary simply to get refills for ongoing medication. But, if a provider needs to draw a patient’s blood to monitor the safety or effectiveness of a prescription medicine, the burden of an in-person visit to the lab is likely worth the increased risk.

Of course, not all health care can be done by telehealth, but a lot can, and research shows that in many cases, it’s just as good as in-person care. As the pandemic continues and other problems need addressing, think about the right telehealth fit for you, and talk to your health care team about the services offered, your risks and your preferences. You might find that that there are far fewer waiting rooms in your future.

 

 

 

 

New unemployment insurance claims rise for the first time since March

https://www.washingtonpost.com/business/2020/07/23/another-14-million-workers-filed-unemployment-benefits-last-week-pandemic-continues-weigh-labor-market/

 

Some 1.4 million workers filed for unemployment last week, the first increase in months, as the pandemic continues to weigh on the labor market

The number of new unemployment claims rose for the first time in months last week, to 1.4 million — a troubling sign for the labor market that’s weathering a new round of closures as the pandemic spreads.

For the week ending July 18, about 109,000 more jobless claims were filed compared to the week prior, according to the Department of Labor.

“What you’re seeing is that, as the economy slows, the pace of claims picks back up — which really puts at risk the monthly jobs report over the next few months,” said Joseph Brusuelas, the chief economist at RSM. “The July numbers are going to be tenuous, but it’s August that I’m worried about.”

The number of workers continually claiming unemployment insurance went down, however, a statistic that lags by a week, to 16.1 million workers for the week ending July 11, from 17.4 million for the week ending July 4.

In addition to the 1.4 million seeking unemployment nationwide last week, another 980,000 new Pandemic Unemployment Assistance claims were filed, the benefits offered to self-employed and gig workers.

The numbers come as millions of unemployed workers are about to exhaust stimulus payments from two federal benefits programs whose expiration economists have warned could have dire effects on the economy.

Brusuelas said the numbers are a sign that the burst of economic activity that marked the country’s reopening has waned, and that shrinking consumer demand remained a significant risk for businesses and the workers they employ across the country.

“We are going to see a much slower pace of growth the reset of the year,” he said. “While we still are retaining our call for a swoosh-shaped recovery, one has to acknowledge a w-shaped recovery is possible.”

The extra $600 a week in unemployment benefits that the federal government has offered to supplement more modest state unemployment benefits will end this week, as lawmakers wrangle over legislation that could extend it.

Including the new benefits available to gig workers and the self-employed, more than 53 million applications have been filed for some form of unemployment insurance during the pandemic.

 

 

Cartoon – Pandemic Management

Reflections on an Ad Industry at War With Itself | MediaVillage

Will Telemedicine Be the Blockbuster or Netflix of Healthcare?

https://www.medpagetoday.com/practicemanagement/telehealth/87662?xid=fb_o&trw=no&fbclid=IwAR1IRS5lgPjbTxkXuMS0fnFmvdkywSyf20YaJ-RElRIGCzU3_GY_W6rTwXw

Netflix Vs Blockbuster – The New DVD Viewing Experience

New approaches need to recognize patients’ wants and needs

One component of Blockbuster’s financial model was the late fees it charged to customers who did not return a video tape to the store in time. These fees accounted for up to 16% of its revenue. In 1997, Reed Hastings was one of the customers affected by these fees. After one late rental, he was charged a hefty $40 late fee. His frustration inspired him to help create a company that would have no late charges. This new company also had the audacious idea to send DVDs straight to the customer’s home for a flat monthly fee. The company that Reed Hastings co-founded was Netflix.

Over time, Netflix changed and adapted with new technology and shifting consumer preferences. It moved on from mailing DVDs to using a streaming platform. It developed an algorithm to help make personalized video recommendations to Netflix users. It started producing its own video content. Over time, the company planted itself firmly within many homes and routines. Conversely, Blockbuster adapted to new platforms too slowly and too late. After its peak in 2004, Blockbuster started losing market share and relevance. Today, there is only one Blockbuster store left, a curious tourist attraction in Bend, Oregon.

Markets and industries change all the time. Distinguishing these important changes from temporary fads is essential. History has many examples of companies and organizations that did not sense important changes, did not change their approach, and as a result, ended up obsolete and irrelevant. A similar shift is happening today in healthcare, but there is more at stake than a late fee. Like Netflix, the healthcare industry needs to shift and adapt to consumer preferences.

The COVID-19 pandemic has had an immediate impact on the health of our country and has also indelibly changed how patients interact with the healthcare system. Hospitals and providers around the country have had to quickly develop new strategies to connect with patients – to comply with social distancing guidelines, in an effort to slow down the spread of the virus. Consistent communication and accessibility is vital, especially given the disturbing trends in decreased preventive care visits and delayed emergency care. One solution is telehealth.

During this pandemic, we have seen that remote patient monitoring is valuable for patients with a wide variety of needs: certainly, those quarantined with coronavirus, but for healthy patients too – children in need of regularly scheduled well-child visits and adults who need routine care. Many patients have experienced telehealth for the first time and many have positive impressions, with nearly three quarters of patients who had a recent telehealth visit describing it as good or very good, according to a recent survey.

Even after the COVID-19 pandemic settles, these “temporary” approaches will permanently change patient attitudes towards technology and force healthcare providers to reexamine their approach to care. Telehealth will remain a convenient option and, in some cases, a necessary way to receive care. Embedding telehealth into standard practice of care enables providers to expand the access to people who otherwise might forgo care, and to people who may face barriers getting to a clinic, for example patients with inflexible job schedules or limited transportation.

Patients and providers are not the only people recognizing the benefits; government officials are too. While reimbursement rules were temporarily expanded to include telehealth, some states, such as Colorado and Idaho, are making COVID-19 telehealth expansions permanent.

There are many parallels to borrow from the Blockbuster example. As healthcare providers, we cannot be complacent and stick with old business models because they are what we are used to. We cannot wait for people to come to us. We cannot ignore these changing times and consumers’ changing preferences. In fact, if we adapt and provide care in ways that patients prefer, we could improve health outcomes.

The healthcare institutions that will grow and be successful during this time are those who are more like Netflix. Instead of waiting for patients to decide to seek healthcare when it may be too late (e.g., just like a Blockbuster “late fee”), we will actively reach out and remind our patients about the importance of timely healthcare services. Instead of ignoring changes in patient preferences and new technology, we will adapt quickly to new platforms for healthcare visits. Instead of waiting for patients to feel comfortable to return to a healthcare facility, we will show patients what our healthcare system is doing to ensure patient safety and protection from COVID-19. Most importantly, instead of being complacent, we will accept and develop new ways of providing care.

There was once a time that we thought that getting in a car, driving to a strip mall, and walking through aisles with thousands of video tapes was the only option to watch a movie at home. Now, many of us can get thousands of titles on our televisions, computers, and phones through several movie streaming platforms. The COVID-19 pandemic has forced healthcare systems to quickly adapt to new constraints; however, it may really be an opportunity to develop new models of care, to engage with our patients, and to make healthcare more accessible. As healthcare providers, we need to make the choice to be more like Netflix, and less like Blockbuster.