Category Archives: Crisis Management

Six months ago, Trump said that coronavirus cases would soon go to zero. They … didn’t.

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Blame, Centers for Disease Control & Prevention (CDC), Clinical Testing, Coronavirus, Credibility, Crisis, Crisis Management, Emergency Preparedness, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expert, Expert Opinion, Failed, Failed Repeatedly, Failure, False Hope, False Narrative, Honesty, Integrity, Misinformation, Misinterpret, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Public Health, Public Opinion, Public Perception, Public Safety, Public Schools, Public Trust, Quarantine, School Reopening, Scientists, Social Distancing, Wishful Thinking • Leave a comment

https://www.washingtonpost.com/politics/2020/08/26/six-months-ago-trump-said-that-coronavirus-cases-would-soon-go-zero-they-didnt/?utm_campaign=wp_main&utm_medium=social&utm_source=facebook&fbclid=IwAR2-yqYYel73YR3zJXfqtn25DXNEA8Yi1qc0L0RQ3PNP-NqUJ299PFNdeWc

 

But with new constraints on testing, Trump may get his wish eventually.

It was exactly six months ago Wednesday when the spread of the coronavirus in the United States had become too significant for President Trump to wave away. He and several members of the team planning the administration’s response held a news briefing designed to inform the public about the virus and, more important, to allay concerns.

This was the briefing in which Trump made one of his most wildly incorrect assertions about what the country could expect.

“The level that we’ve had in our country is very low,” Trump said, referring to new confirmed infections, “and those people are getting better, or we think that in almost all cases they’re better, or getting. We have a total of 15. We took in some from Japan — you heard about that — because they’re American citizens, and they’re in quarantine.”

That part was generally true. At the time, there had been only a smattering of confirmed cases, with the addition of passengers from the cruise ship Diamond Princess pushing the confirmed total to more than 50.

“So, again,” he added later, “when you have 15 people, and the 15 within a couple of days is going to be down to close to zero, that’s a pretty good job we’ve done.”

It was a brash prediction and seemingly an off-the-cuff one. Trump’s point was less about what was going to happen than arguing that his administration had done a good job. But by linking those two things, he made it simple for observers to use his assertion that the number of cases would fade as a baseline for measuring everything that followed.

Over time, more cases from the period before Feb. 26 would be discovered, including two early deaths in California from covid-19, the disease caused by the virus. There were actually almost 200 cases that would eventually be confirmed by the time Trump was saying the country would go from 15 to zero.

The experts standing behind Trump would have known that Trump’s claims were inaccurate. As the briefing was underway, The Washington Post reported a confirmed case of “community spread” — a documented infection that couldn’t be traced to international travel. In other words, it was uncontained: The virus was moving from person to person without impediment or detection.

Although about 200 cases in that period eventually would be confirmed, even that number was far lower than the reality. Researchers can use documented cases to estimate the number of cases that weren’t being detected and that also weren’t later confirmed through testing. For example, an estimate produced by data scientist Youyang Gu puts the likely number of new infections on Feb. 26 somewhere in the range of 13,000 to 25,000.

On that day alone.

Within a month, the country would go from Trump’s 15 cases to nearly 88,000 cases. By April 26, the total was nearly a million. By May 26, 1.7 million. The most recent total is north of 5.7 million.

That steady increase is in part a function of Trump repeating the same mistake over and over, portraying the pandemic as ending or functionally ended. As cases faded a bit in May and June, he pushed for a return to normal economic activity, triggering a new surge in confirmed cases. That second increase has been fading for about a month, happily, but the country is still adding 33 percent more confirmed new cases each day than it did at the peak in April.

That’s confirmed cases, a metric that relies on testing. Gu’s estimates of the actual spread of the virus put the country about 40 percent below the peak in daily new cases, which was reached in early July.

Trump, of course, blames testing for revealing the scale of the pandemic in the first place. He has a point, in a way: Had the United States never managed to solve its problems with testing, something that took weeks, there wouldn’t have been millions of confirmed cases. There would still have been millions of cases or, perhaps, tens of millions of cases. We just wouldn’t have known how many there were.

It has been about two months since Trump held a political rally in Tulsa, contributing to a new surge of cases in the city. There, he made a tongue-in-cheek reference to asking his team to slow down on testing, because it was pushing the number of confirmed cases higher. As they say, though, each joke contains a grain of truth, and it was clear that Trump, in fact, would be happy to see the number of tests drop so that the number of confirmed cases did as well.

Data compiled by the COVID Tracking Project show that he has gotten his wish, to a degree. Over the past month, the number of tests being completed each day in the United States has dropped by nearly one-fifth.

Part of this is a function of interference from natural disasters, with storms in Florida and fires in California limiting testing capacity. Part of it, too, is probably a function of the drop in the number of cases coming back positive. Fewer new cases means fewer people feeling sick and seeking tests to confirm an infection. The drop in the percent of tests coming back positive reinforces that trend.

But, increasingly, part of it will stem from the administration de-emphasizing testing. New guidance published by the Centers for Disease Control and Prevention suggested that those who had been in contact with an infected person no longer needed to be tested, particularly when asymptomatic.

This, too, has been something Trump has talked about a lot, complaining that people without symptoms were being tested and confirmed as positive — and added to the total number of infections.

“Many of those cases are young people that would heal in a day,” Trump said in an interview on July 19. “They have the sniffles and we put it down as a test.”

The reason it’s important to track asymptomatic cases, of course, is that those people can still infect others. To defeat the pandemic, we need to contain it, and the new CDC approach runs the significant risk of leaving large holes in that containment effort. But, with the presidential election only about 70 days away, it will mean fewer confirmed cases.

The irony of Trump’s complaints about the virus from the outset is that the United States’ confirmed infection totals already have been minimized because of limited testing. The reason Trump was able to claim that there were only 15 cases six months ago was that the administration had spent the month since the first confirmed case in the country unable to put together a robust testing regimen that would allow the virus to be constrained. South Korea, where such a regimen was quickly implemented, actually did see its virus numbers drop to near zero.

In other words, Trump’s prediction was not only wrong, it was wrong in large part because Trump’s team hadn’t done what would have been needed to make it come true. Trump portrays himself as an unwitting victim of the pandemic, but his comment six months ago Wednesday is a good reminder that he can put a lot of the blame for his position on himself.

 

 

 

Billions in Hospital Virus Aid Rested on Compliance With Private Vendor

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Coronavirus, Crisis, Crisis Management, Data, Data Consistency, Data Control, Data Gathering, Data Governance, Data Integrity, Data Management, Data Transparency, Dept of Health and Human Services (HHS), Economic Crisis, Economic Stimulus, Ethics, Health Policy, Health System, Hospital, Hospital Industry, Pandemic, The CARES Act, Transparency, Trust, Truth • Leave a comment

Billions in Hospital Virus Aid Rested on Compliance With Private ...

The Department of Health and Human Services told hospitals in April that reporting to the vendor, TeleTracking Technologies, was a “prerequisite to payment.”

The Trump administration tied billions of dollars in badly needed coronavirus medical funding this spring to hospitals’ cooperation with a private vendor collecting data for a new Covid-19 database that bypassed the Centers for Disease Control and Prevention.

The highly unusual demand, aimed at hospitals in coronavirus hot spots using funds passed by Congress with no preconditions, alarmed some hospital administrators and even some federal health officials.

The office of the health secretary, Alex M. Azar II, laid out the requirement in an April 21 email obtained by The New York Times that instructed hospitals to make a one-time report of their Covid-19 admissions and intensive care unit beds to TeleTracking Technologies, a company in Pittsburgh whose $10.2 million, five-month government contract has drawn scrutiny on Capitol Hill.

“Please be aware that submitting this data will inform the decision-making on targeted Relief Fund payments and is a prerequisite to payment,” the message read.

The financial condition, which has not been previously reported, applied to money from a $100 billion “coronavirus provider relief fund” established by Congress as part of the $2.2 trillion Coronavirus Aid, Relief and Economic Security Act, or CARES Act, signed by President Trump on March 27. Two days later, the administration instructed hospitals to make daily reports to the C.D.C., only to change course.

“Another data reporting ask,” a regional official in the health department informed colleagues in an email exchange obtained by The Times, adding: “It comes with $$ incentive. We really need a consolidated message on the reporting/data requests, this is past ridiculous.”

A colleague replied, “Another wrinkle. What a mess.”

The disclosure of the demand in April is the most striking example to surface of the department’s efforts to expand the role of private companies in health data collection, a practice that critics say infringes on what has long been a central mission of the C.D.C. Last month, the federal health department moved beyond financial incentives and abruptly ordered hospitals to send daily coronavirus reports to TeleTracking, not the C.D.C., raising concerns about transparency and reliability of the data.

Officials at the Department of Health and Human Services say that the moves were necessary to improve and streamline data collection in a crisis, and that the one-time reports collected in April by TeleTracking were not available from any other source.

“The national health system has not been challenged in this way in any time in recent history,” Caitlin Oakley, a department spokeswoman, said in a statement, adding that TeleTracking offered a “standardized national hospital capacity tracking system which provided more real-time, better informed data to make decisions from.”

But critics remain alarmed.

“In the middle of a pandemic, the Trump administration is using funds meant to support hospitals as a tool to coerce them to use an unproven, untrusted and deeply flawed system that sidelines public health experts,” Senator Patty Murray of Washington, the ranking Democrat on the Senate Health Committee, said in a statement.

In a statement, TeleTracking said it has three decades of experience providing health care systems “with actionable data and unprecedented visibility to make better, faster decisions.”

Still, public health experts and hospital executives are puzzled as to why the health agency chose such a difficult time to employ an untested private vendor rather than improve the C.D.C.’s National Healthcare Safety Network, a decades-old disease tracking system that was deeply familiar to hospitals and state health departments.

The N.H.S.N., as it is known, had built up trust over decades of working with hospitals and state health departments. Administrators were reluctant to make the switch.

“People — especially in public health and clinical health — are very protective of their data, so that trust factor is certainly an issue,” said Patina Zarcone, the director of informatics for the Association of Public Health Laboratories. “The fear of having their data leaked or misused or used for a purpose that they weren’t aware of or agreed to — I think that’s the biggest rub.”

Ms. Oakley said the C.D.C.’s system was “not designed for use in a disaster response” and could not adapt quickly in a crisis. Allies of the C.D.C. say withholding taxpayer dollars from the CARES Act in lieu of cooperation was an inappropriate effort to push hospitals into a system they were reluctant to use.

“It’s an absolutely enormous lever,” said William Schaffner, an infectious disease expert at Vanderbilt University. “It’s a compulsion to oblige institutions to report to this TeleTracking system because they knew if it weren’t tied to money, it wouldn’t happen.”

The Pittsburgh company has no obvious ties to the Trump administration. Rather, the push appears to be part of a broader privatization. The Health and Human Services Department has also asked the Minnesota-based manufacturer 3M “to create, and continuously update, a nationwide clinical data set on Covid-19 treatment,” according to documents obtained by The Times.

The effort is separate from the TeleTracking data collection. Tim Post, a company spokesman, said that because 3M already operates hospital information systems, it is “uniquely positioned,” with the permission of its clients, to submit information to the health department to help officials study disease patterns and recommend treatment options.

Some experts say this kind of cooperation with the private sector is long overdue. But the push also appears to be driven at least in part by an intensifying rift between the C.D.C., based in Atlanta, and officials at the White House and Department of Health and Human Services, the parent agency of the disease control centers.

Dr. Deborah L. Birx, the White House coronavirus response coordinator, and Mark Meadows, the president’s chief of staff, have taken a dim view of the C.D.C. and believe its reporting systems were inadequate. In a recent interview, Michael Caputo, the spokesman for Mr. Azar, accused the C.D.C. of having “a tantrum.”

Accurate hospital data — including information about coronavirus caseloads, deaths, bed capacity and personal protective equipment — is essential to tracking the pandemic and guiding government decisions about how to distribute scarce resources, like ventilators and the drug remdesivir, the only approved treatment for hospitalized Covid-19 patients.

The health agency has set up a new database, H.H.S. Protect, to collect and analyze Covid-19 data from a range of sources. TeleTracking feeds hospital data to that system.

But the public rollout of H.H.S. Protect has been rocky. The nonpartisan Covid Tracking Project identified big disparities between hospital data reported by states and the federal government and deemed the federal data “unreliable.”

The tension dates to March, when the novel coronavirus was making its first surge in the United States

On March 29, Vice President Mike Pence, charged by Mr. Trump with overseeing the federal response, informed hospital administrators that the C.D.C. was setting up a “Covid-19 Module,” and asked them to file daily reports which, he said, were “necessary in monitoring the spread of severe Covid-19 illness and death as well as the impact to hospitals.”

But around that time, TeleTracking submitted a proposal for data collection to the Trump administration, through an initiative, ASPR Next, created to promote innovation. On April 10, TeleTracking was awarded its contract.

The health department’s spokeswoman said the intent was to complement the C.D.C., not compete with it. Like the C.D.C.’s network, TeleTracking’s system requires manual reporting on a daily basis. But in June, Ms. Murray demanded the administration provide more information about what she called a “multimillion-dollar contract” for a “duplicative health data system.”

Some hospital officials also objected to the change.

“We have been directing our hospitals to N.H.S.N.,” Jackie Gatz, a vice president of the Missouri Hospital Association, wrote to a regional health and human services official in an email obtained by The Times, “and now this email with a much greater carrot — CARES Act distributions — is routing them to TeleTracking.”

When the order was delivered, flaws had already emerged in the new system.

“H.H.S. has acknowledged long wait times for those calling for technical support, and indicated that TeleTracking recently added 100 staff to respond to call center requests,” the American Hospital Association wrote to its members in a “special bulletin” on April 23. “They also are directing hospitals to leave a message if they are unable to reach someone live.”

At the time, hospitals had the option of making their daily coronavirus reports to TeleTracking or the C.D.C. Few were using the new database.

In June, the administration again used a stick to demand that hospitals report to TeleTracking, this time in order to obtain remdesivir. By July, with Dr. Birx pushing to bolster hospital compliance, the administration instructed hospitals to stop filing daily reports to the C.D.C. and to send them to TeleTracking instead.

One official at a major academic hospital, who spoke on the condition of anonymity for fear of angering officials in Washington, said the switch left her “unable to sleep at night.”

“Ethically, it felt like they had taken a very trusted institution in the C.D.C. and all of that trust built up with many public health people,” she said, then “moved it onto a politically and financially motivated portion of this response.”

Health and human services officials say the government now has a much more complete picture of hospital bed capacity, with more than 90 percent of hospitals reporting. But Dr. Janis M. Orlowski, the chief health officer for the Association of American Medical Colleges, who worked with Dr. Birx and the administration to bolster hospital reporting, said that she was “stunned” by the switch and that the increase in reporting came because of efforts by her group and others, not the TeleTracking system.

Dr. Orlowski said the data and maps now published on the administration’s H.H.S. Protect data hub are “just not as sophisticated as the C.D.C.”

The switch also generated pushback inside the C.D.C., where officials have refused to analyze and publish TeleTracking data, saying they could not be assured of its quality and had continuing questions about its accuracy, according to a senior federal health official.

Administration officials say the C.D.C. is working with a little-known office in the executive branch — the United States Digital Service — to build a “modernized automation process” in which data will continue to flow directly to the Department of Health and Human Services. But the project is in its infancy, one senior federal health official said.

Critics say that if the department believed the C.D.C.’s health network had problems, those should have been fixed.

“We have a public health system that depends upon communication from hospitals to state health departments to the C.D.C.,” said Dr. Schaffner, the Vanderbilt University infectious disease expert. “It’s very well established. Can it be improved? Of course. But to cut out the public health infrastructure and report to a private firm essential public health data is misguided in the extreme.”

 

 

 

The kids are not all right

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Childcare, Children's Health, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Deferred Healthcare, Economic Crisis, Infection Control, Infection Control Plan, Infectious Virus, Mortality, National Strategy, Pandemic, Primary Care, Public Health, Public Opinion, Public Perception, Public Safety, Public Schools, Public Trust, Quarantine, School Reopening, Scientists, Social Distancing, Vaccination • Leave a comment

https://mailchi.mp/0e13b5a09ec5/the-weekly-gist-august-21-2020?e=d1e747d2d8

Many children heading back to school—in whichever form that that may take this fall—have skipped their annual visit to the pediatrician. The graphic above highlights the sluggish rebound in pediatric ambulatory volume. While adult primary care visits have mostly bounced back, pediatric visits are still 26 percent below pre-COVID levels.

The drop in visits early in the pandemic also impacted immunizations, with 2.5M regular childhood vaccinations missed in the US during the first quarter of 2020—and early data suggests those seem to be rebounding at a similarly anemic rate.

This lack of pediatric routine care is particularly worrisome as COVID-19 cases in children are climbing, with a 90 percent increase from July to August. Though most of the nation’s largest public school districts have opted to begin the school year with online learning, some districts have already returned to in-person classes, and, unsurprisingly, new cases are already being reported.

While COVID-19 is normally neither severe nor fatal in children, infections among school-age kids put others at risk. According to the Kaiser Family Foundation, nearly a quarter of teachers (1.5M) are considered high-risk and almost six percent of seniors (3.3M) live with school-aged children.

Without the traditional back-to-school push for well-child visits, sports physicals, and immunization updates, healthcare providers must think creatively about how to give children with the care they need, whether through personalized communication from pediatricians that assuages parental concerns about office safety, or through more innovative means such as drive-thru vaccination services.

 

 

 

Why Most Voters Oppose Schools Reopening

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Stimulus, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, National Strategy, Pandemic, Public Health, Public Opinion, Public Perception, Public Safety, Public Schools, Public Trust, Quarantine, School Reopening, Scientists, Social Distancing • Leave a comment

https://www.forbes.com/sites/williamhaseltine/2020/08/21/why-most-voters-oppose-schools-reopening/#2df43b5b1822

Why Most Voters Oppose Schools Reopening

Even as test rates hover around six to seven percent and tens of thousands of new Covid-19 cases are being reported daily, school districts across the country will continue with plans to resume operations in the coming weeks. The latest survey data shows, however, that most Americans oppose reopening K-12 education in their states.

Parents have reason to be concerned that sending their children to school could bring the virus into their homes, as well as spike positivity rates in their communities. From July 30th to August 13th, over 75,000 new child Covid-19 cases were reported, according to the American Academy of Pediatrics. The outcome would be disastrous were even one asymptomatic carrier to attend classes in the coming weeks.

A recent survey conducted by the Financial Times-Peterson Foundation US Economic Monitor revealed that six in ten voters oppose reopening K-12 schools in their states, while as many as 81 percent urge the prioritization of health among students and faculty over the economy. Were children to get sick at school, not only would their health be endangered, but so would the health of their families. There would be no economy without healthy parents, which is why the vast majority of Americans urge the safety of American students over the state of the economy.

One of the more prudent concerns about the resumption of K-12 education is the social nature of a student’s daily life. School districts are assuring parents that they have put preventative measures in place, such as social distancing and classroom hybridization. But to assume students will have no interaction at all seems ludicrous. Children and teens have been out of the traditional school setting for over five months and they will be ready to interact with others. 

Despite the urge shared by parents and children alike to return to normal, the average voter realizes that the pandemic in the United States is far from over. Parents want their children to stay healthy for many reasons—to ensure the physical health and wellbeing of the family, to ensure the economic livelihood of the family, and to avoid the unknown long term health risks associated with Covid-19. Around 65 percent of voters believe social distancing requirements and non essential business restrictions should be in place for at least another three months—a sacrifice many are willing to make for the sake of their families and children.

Such statistics also show that people recognize there will be several more months of abnormality and want decision makers to take action accordingly, even if it means deprioritizing the economy. Families and individuals have been economically crippled by the pandemic and the US government’s lack of public assistance. The official unemployment rate still hovers around ten percent according to the Bureau of Labor Statistics. Low income families are struggling and eviction rates are sure to spike as rent moratoriums expire. These families have enough to worry about without the added pressure of sending their children back to school at this time.

The reopening of K-12 school districts in the coming weeks presents medical and economic challenges for families in the pandemic era, especially those already disadvantaged or experiencing hardship. Societal immunity is a long way off; as thirty five percent of voters said they would not be likely to get a COVID-19 vaccine were one approved and available by the end of the year, meaning children of those thirty five percent would also be unlikely to get vaccinated. With the inability to ensure the health and safety of students and the unknown economic future to come, schools are better off staying online for the time being.

 

 

 

 

The Science Behind Campus Coronavirus Outbreaks

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, National Strategy, Pandemic, Public Health, Public Opinion, Public Perception, Public Safety, Public Schools, Public Trust, Quarantine, Respect, Responsibility, School Reopening, Scientists, Social Distancing, Virtual Work, Virtual Workforce • Leave a comment

https://www.forbes.com/sites/johndrake/2020/08/21/the-science-of-campus-outbreaks/#4c5704ae6893

LSU frat parties become coronavirus 'superspreader events ...

Colleges And Universities Reverting To Online Instruction

On August 17, seven days after the start of in-person classes, the University of North Carolina at Chapel Hill announced that, due to a dramatic increase in Covid-19 on campus, all undergraduate classes would be held online for the remainder of the fall. Ithaca College and Michigan State pulled the plug on August 18. Two days later, N.C. State joined the club. More may follow. (The Chronicle of Higher Education maintains a live update feed.) In fact, only a minority of colleges and universities are still attempting fall instruction fully or primarily in person (about 25% at this writing).

Only time will tell if these rapid course changes were warranted and, of course, the answer may not be the same everywhere. Each institution is unique with respect to size, culture, infrastructure to provide online learning, and ability to cope with transmission.

What We Know About Infectious Diseases On College Campuses

In thinking about Covid-19 transmission on campus, it may be useful to know something about the science of epidemics among college students in general. There is a small scientific literature on disease outbreaks on campus. Campuses are special for several reasons. News photos of students lounging on green quads, engaged in late night study groups, or partying into the wee hours reminds us that if college is known for anything other than studying and college sports, it might be the unique gregariousness that attaches to what many people call the “college experience.”

Although outbreaks of infectious diseases on college campuses are routinely reported, there is little evidence that they are more explosive than in the general population. Outbreaks of directly transmitted diseases like measles, mumps, and whooping cough occur with some regularity and are typically contained through isolation and other public health measures. But, no study has been done to systematically examine how the campus environment differs from community-based transmission. 

Influenza is a particularly interesting case because, like Covid-19, it is a respiratory disease transmitted directly through close contact and also has a short incubation period. The basic reproduction number (R0) is a measure of the explosiveness of an epidemic, with anything over R0 = 1 indicating the possibility of sustained transmission.

In 2014, CDC and academic scientists compiled a list of all estimates of R0 for influenza. While most estimates for the 2009 pandemic were between 1 and 2, estimates from some schools (not necessarily colleges or universities) were noticeably higher (2.3 for a school in Japan and 3.3 for a school in the United States), although other cases (Iran and the United Kingdom) were similar to the rest of the population.

Perhaps more importantly, a study in Pullman, Washington (home to Washington State University) estimated R0 of the 2009 pandemic flu to be around 6, which is two to four times larger than most other estimates. So there is some evidence that campus contagions may be more prone to outbreak than other places.

Since Covid-19 is typically much less severe in young adults than in older adults, another question that seems particularly important now is whether transmission among students remains primarily within the student population or readily spreads to the rest of the community. 

In a measles outbreak at a university in China, the fraction of staff who were infected was not statistically different from the fraction of students. The total number of staff infected — three — was small, however, and it seems unlikely that this is the usual pattern.

A study of the 2009 influenza pandemic at the University of Delaware found that the risk of infection for people older than 30 was roughly half the risk of those that were 18 to 29.

An even more interesting aspect of the University of Delaware study is the association with student activities. Reports of influenza-like illness among students at a nearby emergency health center remained stable for almost a month after spring break. But cases increased almost five-fold following “Greek week”. In the final analysis, belonging to a fraternity or sorority doubled a student’s chances of being infected.

What’s Happening Now

This is concerning now as cases of Covid-19 are rising among college students nationwide. College leaders such as Penn State president Eric Barron, University of Kansas chancellor Douglas Girod, and University of Tennessee chancellor Donde Plowman have reproached students, especially fraternities and sororities, for ignoring guidance to avoid large gatherings.

Yesterday, J. Michael Haynie, Vice Chancellor for Strategic Initiatives and Innovation publicly excoriated students at Syracuse University for “selfishly jeopardizing” the possibility of in-person instruction this fall. “Make no mistake,” he wrote, “there was not a single student who gathered on the Quad last night who did not know and understand that it was wrong to do so.”

The science of Covid-19 tells us that students are vulnerable, just like everyone else. Although the evidence is somewhat thin, what there is points only in one direction: because of their specific social structure, college campuses are especially prone to outbreaks of infectious diseases. As in the rest of society, the only way to slow down the Covid-19 pandemic on college campuses is to reduce the rate of infectious contacts. There is too much value in the college experience to reduce it to partying, and it should not be squandered altogether for the sake of the party experience.

 

 

 

 

Sutter posts $857M loss in H1 on investment, operational declines

Posted on by • Posted in Antitrust, Cash, Cash Management, Cash Reserves, Coronavirus, Credit Quality, Credit Ratings, Crisis, Crisis Management, Economic Crisis, Economic Stimulus, Health System, Hospital, Hospital Industry, Lawsuit Settlement, Liquidity, Market Outlook, Market Trends, Market Uncertainty, Net Income, Nonoperating Income, Operating Expense Reduction, Operating Expenses, Operating Income, Operating Margin, Operating Performance, Operating Revenue, Pandemic, The CARES Act • Leave a comment

https://www.healthcaredive.com/news/sutter-posts-857m-loss-in-h1-on-investment-operational-declines/583910/?utm_source=Sailthru&utm_medium=email&utm_campaign=Issue:%202020-08-21%20Healthcare%20Dive%20%5Bissue:29231%5D&utm_term=Healthcare%20Dive

California's Sutter Health reaps rewards from investments in ...

Dive Brief:

  • Sutter Health had a staggering loss of $857 million in the first half of the year as the Northern California health was bruised by the pandemic. That’s almost a $1.4 billion drop in income compared to the first half of last year, a plummet Sutter management largely blamed on investment and operational losses in its latest financial filing posted Thursday.
  • The virus shuttered operations for a period of time, driving Sutter’s revenue down 8% to $6.1 billion during the first half of the year. Expenses climbed nearly 2%, contributing to an operating loss of $557 million.
  • Still, the nonprofit noted it did experience a significant rebound in its investments in the second quarter after weathering the devastating effects of the first quarter.

Dive Insight:

Sutter joins other major nonprofit health systems in posting net losses for the first half of the year despite receiving hundreds of millions in federal grants to help offset headwinds brought on by the pandemic.

Recently, both Renton, Washington-based Providence and Arizona-based Banner Health posted losses for the first half of the year — $538 million and $267 million, respectively. Dampened revenue and downturns in investments contributed to their losses.

The federal government has funneled billions of dollars to providers across the country in an attempt to help them weather the downturn in patient volumes. Sutter noted in its filing that it’s received $400 million in federal relief funds so far, though that wasn’t enough to push the health system back into the black. Sutter operates 29 hospitals and enjoys a large presence in Northern California.

Sutter reported fewer admissions and emergency room visits in the second quarter compared to the prior-year period, down about 10% and 19%, respectively.

The pandemic was quick to wreak havoc on Sutter’s finances during the first quarter, in which the system reported an operating loss of $236 million and a net loss of almost $1.1 billion.

The coronavirus is also serving as a drag on its ratings. In April, two of the three big ratings agencies downgraded Sutter Health’s rating.

In part, Moody’s attributed the downgrade to Sutter’s weaker profitability profile. In its rationale, Moody’s said, “Following a second year of weaker results, margins in 2020 are likely to remain under pressure due to COVID-19 related disruptions, ongoing performance challenges at some of Sutter’s facilities, and continued reimbursement pressure.”

Also weighing on Moody’s rating is the $575 million settlement expected to be paid this year to resolve antitrust issues. Last year, the health system averted a trial over antitrust concerns after agreeing to a settlement with California regulators. Sutter agreed it would end any contracts that require all of its facilities to be in-network or none of them and cap out-of-network charges, among other stipulations.

 

 

 

 

Florida Hits 10,000 Coronavirus Deaths—The Fifth State To Reach That Mark

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, National Strategy, Pandemic, Positivity Rate, Public Health, Public Opinion, Public Perception, Public Safety, Public Schools, Public Trust, Quarantine, School Reopening, Scientists, Social Distancing • Leave a comment

https://www.forbes.com/sites/nicholasreimann/2020/08/20/florida-hits-10000-coronavirus-deaths-the-fifth-state-to-reach-that-mark/#29e05eb438f3

Florida Hits 10,000 Coronavirus Deaths—The Fifth State To Reach ...

TOPLINE

Over 10,000 Floridians have now died of coronavirus, marking a grim milestone that comes weeks after the state led the record U.S. coronavirus case surge earlier this summer.

 

KEY FACTS

10,049 Florida residents have died of coronavirus, according to the state, reaching that mark after adding 117 deaths Thursday.

Florida is the fifth state in the U.S. to record over 10,000 deaths, joining New York and New Jersey, where most deaths happened during the spring coronavirus surge, along with California and Texas, where most deaths occurred during the summer.

Florida has been the nation’s recent coronavirus epicenter, but the pandemic’s spread seems to have slowed there over the past few weeks, even as deaths, which lag behind other statistics, have been at record highs in the state.

New cases have recently reached their lowest daily increases in two months, and hospitalizations have trended downward since late July.

The testing positivity rate, seen as one of the first indicators of increased coronavirus spread, dropped below 10% Thursday—the first time the state has been below that threshold since June 21, and less than half the 20.71% positivity rate the state had at its highest point on July 8.

 

BIG NUMBER

23.8%. Gov. Ron DeSantis said that’s what the positivity rate was Thursday for antibody testing at state-run drive-through sites. That number suggests a massive amount of Floridians, much higher than the record-setting confirmed case counts, were infected with coronavirus this summer.

 

SURPRISING FACT

There are five U.S. states that have over 10,000 deaths. That’s a number that only 14 countries around the world have hit, according to Johns Hopkins University. The U.S. continues to have by far the most coronavirus deaths of any country and could reach 175,000 deaths before the weekend.

 

KEY BACKGROUND

The U.S. as a whole is on a downward trend when it comes to coronavirus metrics, which seems to be influenced by large states, like Florida, having a reduction in coronavirus spread.

States like California, Texas and Florida, the nation’s three most populated, were all setting records when the U.S. had its highest confirmed coronavirus spike earlier this summer. They now seem to be pushing the country in the other direction.

 

 

 

 

South Korea Warns Covid-19 Back In ‘Full Swing’ After Week-Long Case Spike

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Economy Reopening, False Hope, False Narrative, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, National Strategy, Pandemic, Public Health, Public Opinion, Public Perception, Public Schools, Public Trust, Quarantine, School Reopening, Scientists, Social Distancing • Leave a comment

https://www.forbes.com/sites/alisondurkee/2020/08/20/south-korea-warns-covid-19-back-in-full-swing-after-week-long-case-spike

South Korea Warns Covid-19 Back In 'Full Swing' After Week-Long ...

TOPLINE

South Korea officials warned Thursday that the country is in a “grave situation” after Covid-19 cases rose by triple digits for a week straight, as one of the countries most hailed for its success in containing the coronavirus sees a new resurgence of the virus linked to a far-right church and anti-government protest.

 

KEY FACTS

South Korea added 288 Covid-19 cases Thursday—slightly down from 297 cases Wednesday, the highest number observed in the country since March 8.

“Consider the COVID-19 pandemic now to be in full-swing,” Korea Centers for Disease Control and Prevention deputy director Kwon Jun-wook said, warning that the country could experience similar sustained outbreaks to the U.S. and Europe without aggressive contact tracing.

The new case spikes are largely tied to Sarang Jeil Church, which has been linked to 676 recent cases, and a large anti-government rally held in Seoul Saturday in which many church members participated.

The outbreak is the second time a church has been linked to a large outbreak in the country—5,200 cases in February and March were linked to the Shincheonji Church of Jesus—but officials warn this one has the potential to be worse, and the New York Times notes anti-government sentiment among the church’s members may make efforts to contain the virus more difficult.

South Korean President Moon Jae-in has shut down churches in the country in response to the new outbreak, sparking a broader controversy as conservatives accuse the government of infringing on religious freedoms.

South Korea has been hailed for its effective response to the coronavirus, and was previously able to curb the Shincheonji church outbreak through widespread testing, self-isolation orders and contact tracing.

 

CRUCIAL QUOTE

“We are standing on the cusp of the nationwide outbreak,” Kwon said at a briefing Thursday. “The wider capital region should brace for a massive wave of the outbreak.”

 

BIG NUMBER

16,346: The total number of Covid-19 cases in South Korea since the start of the pandemic, as reported by Johns Hopkins University.

 

KEY BACKGROUND

South Korea is one of many countries to see a worrying resurgence of Covid-19 in recent weeks, as Europe and countries that had successfully contained the virus see new spikes.

Spain and Italy posted new Covid-19 case number highs Wednesday, while France reported Wednesday that it had recorded new Covid-19 cases at the highest rate since May.

Germany reported its highest case count since April on Thursday, with 1,707 new cases.

Outside of Europe, India experienced its highest daily total yet of new Covid-19 cases Thursday—69,672 cases, also the fourth highest daily total reported globally—while Japan reported that more than a third of its 59,213 cases have been recorded since the start of August alone.

New Zealand, one of the countries that had most successfully contained the virus, went back into lockdown last week after seeing Covid-19 spread through community transmission for the first time in 102 days; the outbreak has so far resulted in 80 new cases.

 

 

 

 

New unemployment claims top 1 million. Again.

Posted on by • Posted in 2020 Election Issues, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Stimulus, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employer-Based Health Insurance, Essential Health Benefits, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Infection Control, Infection Control Plan, Infectious Virus, Job, Job Loss, Job Market, Job Search, Job Security, Leadership Decentralized, Mixed Message, Mortality, National Strategy, Pandemic, Public Health, Public Opinion, Public Perception, Public Safety, Public Schools, Quarantine, School Reopening, Scientists, Social Distancing, Underinsured, Unemployment, Unemployment Insurance, Uninsured, Wishful Thinking • Leave a comment

https://www.washingtonpost.com/business/2020/08/20/august-unemployment-claims/?wpmk=1&wpisrc=al_business__alert-economy&utm_source=alert&utm_medium=email&utm_campaign=wp_news_alert_revere&location=alert&pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJjb29raWVuYW1lIjoid3BfY3J0aWQiLCJpc3MiOiJDYXJ0YSIsImNvb2tpZXZhbHVlIjoiNWI2M2EzNDJhZGU0ZTI3Nzk1NTBjYTFiIiwidGFnIjoid3BfbmV3c19hbGVydF9yZXZlcmUiLCJ1cmwiOiJodHRwczovL3d3dy53YXNoaW5ndG9ucG9zdC5jb20vYnVzaW5lc3MvMjAyMC8wOC8yMC9hdWd1c3QtdW5lbXBsb3ltZW50LWNsYWltcy8_d3Btaz0xJndwaXNyYz1hbF9idXNpbmVzc19fYWxlcnQtZWNvbm9teSZ1dG1fc291cmNlPWFsZXJ0JnV0bV9tZWRpdW09ZW1haWwmdXRtX2NhbXBhaWduPXdwX25ld3NfYWxlcnRfcmV2ZXJlJmxvY2F0aW9uPWFsZXJ0In0.ns8VggWJk95qb-c_2926acWIaHxyFIBXSRn76O7Lrf0

The number of people applying for the first time for unemployment insurance ticked up last week to 1.1 million, from 970,000 the week before, a sign that job losses continue to plague the labor market five months into the coronavirus pandemic.

The weekly jobless claims had sunk slowly in recent months but have remained well above historical highs, averaging about 1.18 million a week for the last four weeks. Economists had predicted last week’s figure to approach the numbers from the previous week, which had fallen below 1 million for the first time in about five months.

Instead, the initial claims and new claims for Pandemic Unemployment Assistance, the program available to gig and self-employed workers, both went up. About 543,000 new claims were filed for PUA for the week that ended on Aug. 15, up from 488,000 the week before.

“The fact that the claims are so high this far into the crisis is concerning,” said AnnElizabeth Konkel, an economist at the job site Indeed. “Yet the depths of the damage remain to be seen. I would definitely call it a canary raising alarms in the economic coal mine.”

Data shows the number of job postings slowly recovering in recent weeks, compared with postings from the year prior. However, last week, postings took a turn for the worse. They had been running about 18 percent below normal and fell to 20.3 percent below normal last week.

“The longer we go into this crisis, the longer people that have been temporarily laid off may not get called back,” Konkel said. “Businesses can only ride out this crisis for so long.”

More than 28 million people were receiving some form of unemployment benefits as of Aug. 1, the most recent week for that statistic, about equal to the previous week.

Job loss from the pandemic remains a singular crisis, without comparison in modern times. The country’s unemployment rate, last calculated in July, was 10.2 percent, and economists have warned that it could go up in August as the virus continues to alter life around the country.

The extra $600 in unemployment benefits that many workers credit with keeping them afloat expired at the end of July. And funds from the $660 billion PPP program, which gave grants and loans to companies to keep workers on payroll, have been running out for many recipients.

Companies announcing layoffs in recent days include Wieland Copper Products, in North Carolina, a Mohegan Sun casino in Wilkes-Barre, Pa., Amsterdam Printing & Litho, a printing company in Upstate, N.Y., and Ohio sales and marketing company Maritz. School districts and local governments are also beginning to experience deep cuts: New York Mayor Bill de Blasio (D) warned last week that as many as 22,000 city workers faced possible layoffs in the fall.