Houston ICUs at 97 Percent Capacity as Texas Coronavirus Cases Break Records

https://www.newsweek.com/houston-icus-90-percent-capacity-texas-coronavirus-cases-break-records-1513077

Coronavirus Briefing: What Happened Today - The New York Times

Almost all intensive care unit beds at Houston hospitals were occupied on Wednesday as Texas reported a record number of statewide patient admissions related to the novel coronavirus.

During a City Council meeting Wednesday morning, Houston Mayor Sylvester Turner said 97 percent of the city’s ICU beds were filled. A report from the Texas Medical Center (TMC) said 27 percent of those beds were occupied by COVID-19 patients.

According to data published earlier this week by the TMC, a network of health care and research institutions based in Houston, 90 percent of the city’s ICU beds were filled as of Monday. Virus patients accounted for more than one-quarter of those occupancies.

The TMC’s latest report incorporated ICU admission numbers from seven affiliate hospitals in the Houston area: CHI St. Luke’s Health, Harris Health System, Houston Methodist, MD Anderson Cancer Center, Memorial Hermann, Texas Children’s Hospital and University of Texas Medical Branch. The hospitals can collectively admit 1,330 ICU patients at regular capacity, when 70 to 80 percent of total beds are typically occupied, according to the TMC.

The TMC’s Monday report noted that an additional 373 beds could become available under its “sustainable surge” plan, a procedure that would indefinitely increase ICU capacities as needed during the pandemic. Another 504 beds could be added to Houston ICUs under an emergency “unsustainable surge” plan, which the TMC would implement to address a “significant, temporary” influx of patients, according to its report.

Houston’s heightened ICU admissions were reported as cases and hospitalizations related to the coronavirus are spiking throughout Texas. Ongoing data released by the Texas Department of State Health Services show that of all the state’s regions, the Houston area is one of the hardest hit in terms of virus incidence and hospital admissions. The latest DSHS data estimated that 179 ICU beds were available at medical facilities located in the Greater Houston area as of Tuesday afternoon.

The number of patients hospitalized with the virus peaked in Texas on Tuesday, as the DSHS confirmed more than 4,000 current admissions. The state has set new records for hospitalizations related to COVID-19 every day since June 12, when 2,166 patients were reported.

On Monday, the Houston Health Department said hospitalizations due to the virus had increased 177 percent throughout the surrounding county since May 31. It also noted a 64 percent increase in ICU patients who had tested positive for the virus.

Texas also saw its highest daily increase in virus cases on Wednesday, with 5,489 new diagnoses confirmed. The latest single-day record surpassed its previous high of 4,430 new cases reported last Saturday. Cumulative diagnosis data reflected in graphics published by the DSHS show a sharp upturn in cases reported statewide since the start of June, when about 64,800 total cases were confirmed. As of Tuesday afternoon, the number had risen to more than 120,300. The DSHS estimated that roughly 47,400 of those cases remain active.

Businesses in Texas started to reopen at the beginning of May. Although Texas Governor Greg Abbott has not required residents to wear face masks in the state’s public spaces during the reopening process, he did encourage people to do so earlier this week in response to increasing case counts and hospitalizations.

“Wearing a mask will help us to keep Texas open. Not taking action to slow the spread will cause COVID to spread even worse, risking people’s lives and ultimately leading to the closure of more businesses,” he said during a news conference on Monday.

 

 

Coronavirus live updates: New York activates quarantine for travelers from hotspots as Florida shatters daily record

https://www.cnbc.com/2020/06/24/coronavirus-live-updates.html?utm_source=&utm_medium=email&utm_campaign=30961

Chart of daily new coronavirus cases in the United States through June 23, 2020.

The coronavirus continues to surge in states around the country, mostly in the South and West. Testifying before members of Congress on Tuesday, White House health adviser Dr. Anthony Fauci said parts of the U.S. are beginning to see a “disturbing surge” and described the overall situation as a “mixed bag” across different regions and states.

  • Global cases: More than 9.29 million
  • Global deaths: At least 478,289
  • U.S. cases: More than 2.34 million
  • U.S. deaths: At least 121,279

The data above was compiled by Johns Hopkins University.

California reports more than 7,000 cases, biggest daily jump so far

3:30 p.m. ET — California reported an additional 7,149 Covid-19 cases since Tuesday, a 69% increase in two days, bringing the state’s total to 190,222 cases, according to the state’s health department.

While the daily case numbers are growing, Gov. Gavin Newsom said that the state performed a record number of tests in the last 24 hours. However, the percent of tests coming back positive has slightly increased in the last two weeks, sitting at 5.1% on a 14-day average, he said.

Hospitalizations from Covid-19 in California have also increased 29% in the last 14 days, totaling 4,095 as of Tuesday, Newsom said.

“We cannot continue to do what we have done over the last number of weeks. Many of us understandably developed a little cabin fever, some I would argue developed a little amnesia, others have frankly taken down their guard,” Newsom said at press briefing. —Noah Higgins-Dunn

The pandemic still hasn’t peaked in the Americas, WHO says

2:30 p.m. ET — Coronavirus outbreaks in the Americas, which include North, South and Central America, haven’t reached their peaks yet, the World Health Organization warned.

Over a third of the new cases reported Tuesday were from five countries in the Americas, according to WHO data. The U.S. reported the most cases and is the worst-hit country in the world with more than 2.3 million cases and at least 121,279 deaths as of Wednesday.

The comment by the WHO came a day after Dr. Anthony Fauci, the United States’ leading infectious disease expert, expressed concern a “disturbing surge” in coronavirus infections as states continue to reopen.

One WHO official said that parts of the Americas had not “reached a low enough level of transmission “with which we can achieve a successful exit of successful and social distancing measures.” —Berkeley Lovelace Jr.

The entrance to the Magic Kingdom at Disney World is seen on the first day of closure as theme parks in the Orlando area suspend operations for two weeks in an effort to curb the spread of the coronavirus (COVID-19). Paul Hennessy/SOPA Images/LightRocket via Getty Images)

1:04 p.m. ET — More than 7,000 people have signed an online petition urging Disney and local government officials to reconsider the reopening of Disney World next month.

The petition comes as coronavirus cases in the state are rapidly rising.

It is difficult to determine how many of the signees of the online petition are actually Walt Disney employees or if the petition is union-backed. There is no mention in the petition itself of any affiliation with an employee union.

“The safety and well being of our cast members and guests are at the forefront of our planning, and we are in active dialogue with our unions on the extensive health and safety protocols, following guidance from public health experts, which we plan to implement as we move toward our proposed, phased reopening,” Disney said in a statement to CNBC. —Sarah Whitten

Florida shatters record for new cases in a day

People wait for a health assessment check-in before entering Jackson Memorial Hospital, as Miami-Dade County eases some of the lockdown measures put in place during the coronavirus disease (COVID-19) outbreak, in Miami, Florida, U.S., June 18, 2020.

12:15 p.m. ET — The Florida Department of Health reported 5,508 new coronavirus cases, surpassing the previous record single-day increase of 4,049 new cases reported on Saturday.

Florida is among a handful of states that includes Arizona and Texas that are experiencing expanding outbreaks of the virus.

As cases continue to rise by the thousands every day in Florida, the percent of total tests coming back positive has also risen. On Wednesday, the state reported that 15.91% of all tests came back positive, up from 10.82%. That increase indicates that the surge in new cases is not due solely to ramped up testing. —Will Feuer

NY, NJ and CT impose quarantine on travelers from hotspot states

11:51 a.m. ET — The governors of New York, New Jersey and Connecticut jointly announced a 14-day quarantine for travelers entering the states from coronavirus hotspots.

The Northeastern bloc of states has successfully combated their own outbreaks, having brought peak infection rates down considerably, and are now worried about visitors reintroducing high transmission rates.

“We worked very hard to get the viral transmission rate down. We don’t want to see it go up because a lot of people come into this region and they can literally bring the infection with them,” New York Gov. Andrew Cuomo said at a press conference with New Jersey Gov. Phil Murphy and Connecticut Gov. Ned Lamont.

The hotspot states included in the advisory so far are: Alabama, Arizona, Arkansas, Florida, North Carolina, South Carolina, Texas, Utah and Washington. —Sara Salinas

New York City Marathon canceled

Lelisa Desisa of Ethiopia crosses the finish line to win the Men's Division during the 2018 TCS New York City Marathon in New York on November 4, 2018.

10:29 a.m. ET — The 2020 TCS New York City Marathon has been canceled amid the ongoing coronavirus pandemic, according to an announcement from the race’s organizers. Scheduled for Nov. 1, the event was supposed to commemorate the 50th running of the marathon.

New York Road Runners, which organizes the race, said the decision was made from a health perspective in partnership with the New York City Mayor’s Office.

“While the marathon is an iconic and beloved event in our city, I applaud New York Road Runners for putting the health and safety of both spectators and runners first,” said Mayor Bill de Blasio in a statement.

NYRR said runners will receive a full refund of their entry fee or complimentary entry for 2021, 2022 or 2023. They will also be invited to participate in a virtual marathon event taking place from Oct. 17 to Nov. 1.

The New York City race is the world’s largest marathon and counted 53,640 finishers in 2019, according to NYRR. —Hannah Miller

More states are reporting increases in new Covid-19 cases as U.S. 7-day average continues to grow

A patient is wheeled into Houston Methodist Hospital as storm clouds gather over the Texas Medical Center, amid the global outbreak of the coronavirus disease (COVID-19), in Houston, Texas, U.S., June 22, 2020.

0:11 a.m. ET — As of Tuesday, the seven-day average of daily new Covid-19 cases in the U.S. increased by more than 32% compared to one week ago, according to a CNBC analysis of data compiled by Johns Hopkins University.

Cases are growing by 5% or more in 30 states across the country, including Arizona, Texas, Montana and Idaho. Since Monday, four more states have seen growth in their 7-day average of daily new cases.

Texas health officials reported an all-time high of 5,489 new cases on Tuesday, surpassing 5,000 cases in a single day. The state has also been seeing record spikes in hospitalizations in recent weeks. As of Tuesday, there are 3,335 people currently hospitalized in Texas based on a 7-day moving average, which is a 49% increase compared with a week ago, according to Covid Tracking Project data.

California also broke its record for daily number of positive cases on Tuesday, adding 6,712 new cases, according to Johns Hopkins data. The state surpassed 6,000 new cases for the first time on Monday. —Jasmine Kim

IMF slashes forecasts for U.S. economy, GDP

9:47 a.m. ET — The International Monetary Fund slashed its economic estimates for global GDP and the U.S. economy amid the ongoing coronavirus pandemic, and warned that governments’ debt levels will continue to soar as they combat the crisis.

The IMF forecast a contraction of 4.9% in global GDP and estimated that the U.S. economy will contract by 8% in 2020, CNBC’s Silvia Amaro reports. The new estimates were downward revisions from what the IMF forecast in April.

The Washington-based institution said the new figures were due to expectations that social-distancing measures will likely remain in place during the second half of 2020, hurting productivity and supply chains.

The Fund also downgraded its 2020 estimates for the euro zone and its GDP forecast for 2021. —Hannah Miller

The U.S. will eclipse its first peak, Dr. Scott Gottlieb says

8:20 a.m. ET — Daily new cases of coronavirus will surpass the country’s first peak in April, former Food and Drug Administration Commissioner Dr. Scott Gottlieb told CNBC.

“We’re going to eclipse the totals in April, so we’ll eclipse 37,000 diagnosed infections a day,” he said on CNBC’s “Squawk Box.” “But in April we were only diagnosing 1 in 10 to 1 in 20 infections, so those 37,000 infections represented probably half a million infections at the peak.“

Since April, the U.S. has significantly ramped up the country’s capacity to test broadly for the virus, including among asymptomatic and pre-symptomatic patients. That means even though confirmed cases will likely peak again, the underlying outbreak probably isn’t as large as it was in April, Gottlieb said.

“The total number of deaths is falling because the total infection burden in the country is a lot lower now than it was in April,” he said. —Will Feuer

Most recent 1 million cases were reported in just a week, WHO says

Chart of global daily new coronavirus cases by region

8:08 am ET — The pandemic is still accelerating, with the most recent 1 million cases being reported in one week, World Health Organization Director-General Tedros Adhanom Ghebreyesus said, according to Reuters.

During a virtual conference on vaccine development and access across the continent, Tedros added that every country in Africa has now developed laboratory capacity to conduct diagnostic testing for the virus.

The virus has sickened more than 9.27 million people around the world and killed at least 477,807 people. There is still no U.S.-approved treatment or vaccine for the disease. —Will Feuer

India reports record single-day spike in cases

Health workers wearing Personal Protective Equipment (PPE) carry the body of a person who who died due to the coronavirus disease (COVID-19), at a crematorium in New Delhi, India, June 24, 2020.

7:12 a.m. ET — India has reported its highest spike of new cases of infections since the virus took hold in the country of more than 1.3 billion people, according to The Associated Press. 

In 24 hours, the country reported 15,968 new cases and 465 deaths, the AP reported. That means the virus has now infected more than 456,183 people in India, killing at least 14,476, according to data compiled by Johns Hopkins University.

Maharashtra, New Delhi and Tamil Nadu are the hardest-hit states, making up almost 60% of all confirmed cases in the country. New Delhi, in particular, is emerging as a cause for concern in the federal government, the AP reported, due to poor contact tracing infrastructure and limited hospital capacity.

India has the fourth worst coronavirus outbreak in the world, based on total number of confirmed cases, behind only the U.S., Brazil and Russia. —Will Feuer

The EU is discussing reopening its borders, but US citizens could remain barred

A general view of almost desert Pantheon square during Italy's lockdown due to Covid-19 pandemic.

6:51 a.m. ET — The European Union is discussing how to reopen its external borders as the region looks to revive its economies, but visitors from the U.S., and elsewhere, could be barred from entering the bloc for now.

Thirty European countries decided to close their external borders back in March to contain the spread of Covid-19, but that measure is due to be lifted on Tuesday. Representatives of the EU governments are discussing the criteria to lift the travel restrictions from abroad, and at the moment, the main requirement is the coronavirus infection rate in the country of origin.

This means that countries with high rates, such as the United States and Brazil, could remain barred from entering European nations, at least for some time. —Silvia Amaro

 

 

 

 

Coronavirus spike won’t end elective surgeries, Milwaukee hospital execs say

https://www.beckershospitalreview.com/hospital-management-administration/coronavirus-spike-won-t-end-elective-surgeries-milwaukee-hospital-execs-say.html?utm_medium=email

Medical Technology News - COVID-19 Risk in Elective Surgery Reboot

Healthcare executives in the Milwaukee area say they plan to continue offering elective care even if COVID-19 hospitalizations spike, according to the Milwaukee Business Journal

Many public health experts expect a second wave of COVID-19 infections to hit by the end of the year. But the healthcare executives said that hospitals won’t need to implement strict elective care cancellation procedures as they did in March and April because more is known about the virus.

“We know COVID now,” Jeff Bahr, MD, chief Aurora Medical Group officer for Advocate Aurora Health, told the Business Journal. “I accept that there might be another peak. The name of the game right now is to be able to continue to serve patients and continue despite another bump or spike.”

Dr. Bahr added that Advocate Aurora Health executives plan to continue “with minimal interruption” to elective surgical procedures. 

Spokespeople for ProHealth Care, Froedtert Health, the Medical College of Wisconsin and Children’s Wisconsin also told the Business Journal that their organizations plan to continue some or all elective surgeries even if there is a second surge in COVID-19 cases.

Medical College of Wisconsin President and CEO John Raymond Sr., MD, told the Business Journal that “Even with a second wave or surge of COVID-19 cases, I do not believe that we will need to return to the stringent restrictions that were imposed on elective procedures and routine clinical care in March and April of this year.”

ProHealth Care and Children’s Hospital of Wisconsin officials said that they plan to offer elective care amid  a spike, but the amount of that care will depend on several factors, including whether there’s enough protective gear for staff. 

Health systems across the U.S. canceled elective procedures in mid-March in an effort to prepare for a spike in COVID-19 cases. As a result of the cancellations of the more lucrative services, health systems saw steep revenue drops. Throughout the last month, hospitals have started to resume elective services.  

 

 

WHO Reports Largest Single-Day Spike In Coronavirus Cases

https://talkingpointsmemo.com/news/who-reports-largest-single-day-spike-in-coronavirus-cases

WHO reports largest single-day increase in coronavirus cases

The World Health Organization on Sunday reported the largest single-day increase in coronavirus cases by its count, at more than 183,000 new cases in the latest 24 hours.

The UN health agency said Brazil led the way with 54,771 cases tallied and the U.S. next at 36,617. Over 15,400 came in in India.

Experts said rising case counts can reflect multiple factors including more widespread testing as well as broader infection.

Overall in the pandemic, WHO reported 8,708,008 cases — 183,020 in the last 24 hours — with 461,715 deaths worldwide, with a daily increase of 4,743.

More than two-thirds of those new deaths were reported in the Americas.

In Spain, officials ended a national state of emergency after three months of lockdown, allowing its 47 million residents to freely travel around the country for the first time since March 14. The country also dropped a 14-day quarantine for visitors from Britain and the 26 European countries that allow visa-free travel.

But there was only a trickle of travelers at Madrid-Barajas Airport, which on a normal June day would be bustling.

“This freedom that we now have, not having to justify our journey to see our family and friends, this was something that we were really looking forward to,” Pedro Delgado, 23, said after arriving from Spain’s Canary Islands.

Spanish Prime Minister Pedro Sánchez urged people to take maximum precautions: “The virus can return and it can hit us again in a second wave, and we have to do whatever we can to avoid that at all cost.”

At a campaign rally in Tulsa, Oklahoma, Trump said Saturday the U.S. has tested 25 million people, but the “bad part” is that it found more cases.

“When you do testing to that extent, you’re going to find more people, you’re going to find more cases,” Trump said. “So I said to my people, ‘Slow the testing down, please.’″

White House trade adviser Peter Navarro said on CNN that Trump was being “tongue-in-cheek” and made the comment in a “light mood.”

Democratic rival Joe Biden’s campaign accused Trump of “putting politics ahead of the safety and economic well-being of the American people.”

The U.S. has the world’s highest number of reported infections, over 2.2 million, and the highest death toll, at about 120,000, according to Johns Hopkins. Health officials say robust testing is vital for tracking outbreaks and keeping the virus in check.

In England, lockdown restrictions prevented druids, pagans and party-goers on Sunday from watching the sun rise at the ancient circle of Stonehenge to mark the summer solstice, the longest day of the year in the Northern Hemisphere. English Heritage, which runs the site, livestreamed it instead. A few people gathered outside the fence.

“You can’t cancel the sunrise,” druid Arthur Pendragon told the BBC.

The number of confirmed virus cases is still growing rapidly not only in the U.S. but in Brazil, South Africa and other countries, especially in Latin America.

Brazil’s Health Ministry said the total number of cases had risen by more than 50,000 in a day. President Jair Bolsonaro has been downplaying the risks even as his country has seen nearly 50,000 fatalities, the second-highest death toll in the world.

South Africa reported a one-day high of almost 5,000 new cases on Saturday and 46 deaths. Despite the increase, President Cyril Ramaphosa announced a further loosening of one of the world’s strictest lockdowns. Casinos, beauty salons and sit-down restaurant service will reopen.

In the United States, the virus appears to be spreading across the West and South. Arizona reported over 3,100 new infections, just short of Friday’s record, and 26 deaths. Nevada also reported a new high of 445 cases.

In Europe, a single meatpacking plant in Germany has had over 1,000 cases, so the regional government issued a quarantine for all 6,500 workers, managers and family members.

In Asia, China and South Korea reported new coronavirus cases Sunday in outbreaks that threatened to set back their recoveries.

Chinese authorities recorded 25 new confirmed cases — 22 in Beijing. In the past week, Beijing tightened travel controls by requiring anyone who wants to leave the Chinese capital, a city of 20 million people, to show proof they tested negative for the virus.

In South Korea, nearly 200 infections have been traced to employees at a door-to-door sales company in Seoul, and at least 70 other infections are tied to a table tennis club there. But South Korean officials are reluctant to enforce stronger social distancing to avoid hurting the economy.

 

 

 

 

 

Nebraska governor says he’ll withhold federal money from counties that require masks

https://www.latimes.com/world-nation/story/2020-06-18/nebraska-governor-mask-requirement-will-cost-counties-money

Nebraska governor: Mask rules will cost counties money meant to ...

Nebraska’s governor told local governments they will not receive any federal money to help fight the effects of the coronavirus pandemic if they require people to wear masks in public buildings.

The mandate from Republican Gov. Pete Ricketts seems at odds with his usual message, often delivered at his regular news conferences to address the COVID-19 outbreak, encouraging people to wear masks to slow the spread of the virus, the Omaha World-Herald reported.

Ricketts stands by that advice, his spokesman Taylor Gage said. Local governments can encourage mask-wearing in courthouses and other county government buildings, he said, but the governor “does not believe that failure to wear a mask should be the basis for denying taxpayers’ services.”

“Counties are not prohibited from requiring masks, but if they want CARES Act money, they have to be fully open, and that means they cannot deny service for not wearing a mask,” Gage said.

The mandate is drawing objections from county officials, who say it runs counter to Nebraska’s long-held bent toward local control and the advice of public health officials.

In Lincoln, officials planned to require all visitors to wear masks when entering the City-County Building, but those rules were dropped when officials learned that doing so would cost Lancaster County any chance at the $100 million that has been allotted to Nebraska counties as part of the federal economic rescue law.

“We’d like to have a little bit more ability to call the shots in our courthouse, but we realize that he has the right to set the rules,” said Deb Schorr, a longtime Lancaster County Board member.

Dakota County Assessor Jeff Curry said the order could have dire consequences in his county, which is home to a Tyson Foods meatpacking plant and has been one of the hardest-hit counties in the nation for the virus.

Curry said he was hoping that a mask requirement could be in place for the courthouse through July 1.

Nebraska continues to pull back on restrictions meant to slow the spread of the virus, even as more cases are recorded. On Wednesday, the state saw nearly 200 news cases of the virus reported, bringing Nebraska’s total to 17,226, according to the state’s online virus tracker. Nebraska has seen a total to 234 deaths related to the COVID-19 virus.

 

 

 

This Single Factor Could Force Another Coronavirus Shutdown, Goldman Sachs Says

https://www.forbes.com/sites/sarahhansen/2020/06/23/this-single-factor-could-force-another-coronavirus-shutdown-goldman-sachs-says/?utm_source=newsletter&utm_medium=email&utm_campaign=news&utm_campaign=news&cdlcid=#4a09f8fb3f92

This Single Factor Could Force Another Coronavirus Shutdown ...

TOPLINE

With new coronavirus cases rising in 26 states, according to data from Johns Hopkins, and the national conversation turning to whether those states rushed to reopen their economies too quickly, new analysis from Goldman Sachs suggests that in the coming weeks, hospital capacity (rather than case numbers) is the factor most likely to prompt another lockdown.

KEY FACTS

Goldman’s experts say hospital data is a more reliable picture of the spread of the virus nationwide than positive test results, which fluctuate with changes in testing trends. 

The analysts noted, however, that “there is probably a high hurdle for states to reinstate lockdowns.”

As new cases continue to rise across the country, Goldman’s analysts also tracked which states currently meet federal reopening criteria based on four factors: symptoms, cases, testing and hospitalizations and fatalities. 

Only Arizona and Alabama fail in all four categories, the analysts say; symptoms and cases are on the rise, positive test rates are high, and hospitals are nearing their maximum capacities. 

On the other hand, 19 states meet all four criteria for reopening, including several former hot spots like New York and New Jersey, and the vast majority of states meet at least three out of the four criteria.

KEY BACKGROUND

Along with Alabama and Arizona, California, Texas, and Florida have also seen sharp upticks in infections in recent days. Florida reported a record increase in new cases on four out of the six days between June 15 and 20, for instance. The number of confirmed cases since the pandemic started has now swelled to over 100,000, and Gov. Ron DeSantis said the uptick is “clearly” the result of a failure to follow social distancing guidelines. With cases on the rise, some places—like Arizona—are forging ahead with reopening plans while others—in MaineOregon, and Kansas, for instance—are tightening up restrictions again. 

 

 

 

Fauci: US seeing ‘disturbing’ new surge of infections

https://thehill.com/policy/healthcare/504087-fauci-country-seeing-disturbing-new-urge-of-infections?userid=12325

Fauci: US seeing 'disturbing' new surge of infections | TheHill

Anthony Fauci, the administration’s top infectious disease doctor, told a House panel on Tuesday that the country’s response to the COVID-19 pandemic has been a “mixed bag,” adding that a new increase in cases is “disturbing.”

“In some respects, we’ve done very well,” Fauci said during an Energy and Commerce Committee hearing, specifically praising the way New York has been containing the worst outbreak in the country to date.

“However, in other areas of the country, we are now seeing a disturbing surge of infections that looks like it’s a combination, but one of the things is an increase in community spread. And that’s something I’m really quite concerned about,” Fauci said.

There are now about 30,000 new cases per day in the United States. The number of new cases had leveled off at about 20,000, and stayed there for weeks before rising this past weekend.

The rise in the U.S. comes as the Trump administration has sought to paint a rosier picture of the U.S. outlook. Both President Trump and Vice President Pence have inaccurately tried to attribute the increase in cases to more tests being performed.

The new spike in the U.S. is being driven in part by worsening outbreaks across the South and Southwest, including in Arizona, Texas, Florida and the Carolinas, even as the situation has greatly improved in once hard-hit states in the Northeast like New York and Massachusetts.

Many of the states now being hit hard were on the more aggressive side in reopening their economies.  

“Right now, the next couple of weeks are going to be critical in our ability to address those surgings in Florida, in Texas, in Arizona, and in other states,” Fauci said on Tuesday.

 

 

 

 

5 health systems cutting physician salaries

https://www.beckershospitalreview.com/compensation-issues/5-health-systems-cutting-physician-salaries.html?utm_medium=email

Pay Cuts, Furloughs, Redeployment for Doctors and Hospital Staff ...

To help offset revenue losses attributed to the COVID-19 pandemic, many hospitals have implemented pay cuts for staff, including physicians.

Below are five hospitals or health systems that have announced pay cuts for clinicians, reported by Becker’s Hospital Review in the last month.

1. ThedaCare physicians, advanced practice clinicians take pay cuts
ThedaCare physicians and advanced practice clinicians will take a 10 percent pay cut to help reduce the Appleton, Wis.-based health system’s financial hit due to the COVID-19 pandemic.

2. Providence to cut salaries of 1,200 providers
Renton, Wash.-based Providence plans to reduce the salaries of 1,200 high-paid medical providers in its Oregon division to help offset losses from the COVID-19 pandemic. Providence told Becker’s Hospital Review that the decision to cut salaries was made by local leadership and is limited to Oregon-based providers.

3. Cleveland’s University Hospitals to cut all physician, clinical leader pay
University Hospitals, based in Cleveland, said it will temporarily cut pay for all physicians and clinical leaders in the organization to help offset losses driven by the pandemic.

4. Sentara executives, physicians take pay cuts
Senior leaders, executives and physicians at Norfolk, Va.-based Sentara Healthcare are taking pay cuts to help address an anticipated $778 million shortfall against projected revenue due to COVID-19, the organization confirmed to Becker’s Hospital Review.

5. Loyola Medicine CEO, physicians take pay cuts amid pandemic
Leadership and faculty physicians at Maywood, Ill.-based Loyola Medicine will take three-month pay cuts in response to the COVID-19 pandemic, CEO Shawn Vincent said in an interview with Becker’s Hospital Review.

 

 

 

 

Moody’s: Patient volume recovered a bit in May, but providers face long road to recovery

https://www.fiercehealthcare.com/hospitals/moody-s-patient-volume-recovering-may-but-providers-face-long-road-to-recovery?mkt_tok=eyJpIjoiWmpjeVlXVTRZV0l5T1RndyIsInQiOiJLWWxjamNKK2lkZmNjcXV4dm0rdjZNS2lOanZtYTFoenViQjMzWnF0RGNlY1pkcjVGcFwvZFY4VjFaUUlZaFRBT1NRMGE5eWhGK1ZmR01ZSWVZWGMxOHRzTkptZVZXZmc5UnNvM3pVM2VIWDh6VllldFc3OGNZTTMxTDJrXC8wbzN1In0%3D&mrkid=959610

Moody's: Patient volume recovered a bit in May, but providers face ...

Patient volumes at hospitals, doctors’ and dentists’ offices recovered slightly in May but lagged well behind pre-pandemic levels, according to a new analysis from Moody’s Investors Service.

In all, the ratings agency estimated total surgeries at rated for-profit hospitals declined by 55% to 70% in April compared with the same period in 2019. States required hospitals to cancel or delay elective procedures, which are vital to hospitals’ bottom lines.

“Patients that had been under the care of physicians before the pandemic will return first in order to address known health needs,” officials from the ratings agency said in a statement. “Physicians and surgeons will be motivated to extend office or surgical hours in order to accommodate these patients.”

Those declines narrowed to 20% to 40% in May when compared to 2019.

Emergency room and urgent care volumes were still down 35% to 50% in May.

“This could reflect the prevalence of working-from-home arrangements and people generally staying home, which is leading to a decrease in automobile and other accidents outside the home,” the analysis said. “Weak ER volumes also suggest that many people remain apprehensive to enter a hospital, particularly for lower acuity care.”

The good news:  The analysis estimated it is unlikely there will be a return to the nationwide decline of volume experienced in late March and April because healthcare facilities are more prepared for COVID-19.

For instance, hospitals have enough personal protective equipment for staff and have expanded testing, the analysis said.

For-profit hospitals also have “unusually strong liquidity to help them weather the effects of the revenue loss associated with canceled or postponed procedures,” Moody’s added. “That is largely due to the CARES Act and other government financial relief programs that have caused hospital cash balances to swell.”

However, the bill for one of those sources of relief is coming due soon.

Hospitals and other providers will have to start repaying Medicare for advance payments starting this summer. The Centers for Medicare & Medicaid Services doled out more than $100 billion in advance payments to providers before suspending the program in late April.

Hospital group Federation of American Hospitals asked Congress to change the repayment terms for such advance payments, including giving providers at least a year to start repaying the loans.

Another risk for providers is the change in payer mix as people lose jobs and commercial coverage, shifting them onto Medicaid or the Affordable Care Act’s (ACA’s) insurance exchanges.

“This will lead to rising bad debt expense and a higher percentage of revenue generated from Medicaid or [ACA] insurance exchange products, which typically pay considerably lower rates than commercial insurance,” Moody’s said.

 

 

 

Coronavirus Doesn’t Recognize Man-Made Borders

Coronavirus Doesn’t Recognize Man-Made Borders

Coronavirus Doesn't Recognize Man-Made Borders - California Health ...

From El Centro Regional Medical Center, the largest hospital in California’s Imperial County, it takes just 30 minutes to drive to Mexicali, the capital of the Mexican state of Baja California. The international boundary that separates Mexicali from Imperial County is a bridge between nations. Every day, thousands of people cross that border for work or school. An estimated 275,000 US citizens and green card holders live in Baja California. El Centro Regional Medical Center has 60 employees who reside in Mexicali and commute across the border, CEO Adolphe Edward told Julie Small of KQED.

Now these inextricably linked places have become two of the most concerning COVID-19 hot spots in the US and Mexico. While Imperial County is one of California’s most sparsely populated counties, it has the state’s highest per capita infection rate — 836 per 100,000according to the California Department of Public Health. This rate is more than four times greater than Los Angeles County’s, which is second-highest on that list. Imperial County has 4,800 confirmed positive cases and 64 deaths, and its southern neighbor Mexicali has 4,245 infections and 717 deaths.

The COVID-19 crisis on the border is straining the local health care system. El Centro Regional Medical Center has 161 beds, including 20 in its intensive care unit (ICU). About half of all its inpatients have COVID-19, Gustavo Solis reported in the Los Angeles Times, and the facility no longer has any available ventilators.

When Mexicali’s hospitals reached capacity in late May, administrators alerted El Centro that they would be diverting American patients to the medical center. “They said, ‘Hey, our hospitals are full, you’re about to get the surge,’” Judy Cruz, director of El Centro’s emergency department, recounted to Rebecca Plevin in the Palm Springs Desert Sun.

By the first week of June, El Centro was so overburdened that “a patient was being transferred from the hospital in El Centro every two to three hours, compared to 17 in an entire month before the COVID-19 pandemic,” Miriam Jordan reported in the New York Times.

Border Hospitals Filled to Capacity

Since April, hospitals in neighboring San Diego and Riverside Counties have been accepting patient transfers to alleviate the caseload at the lone hospital in El Centro, but the health emergency has escalated and now those counties need relief. “We froze all transfers from Imperial County [on June 9] just to make sure that we have enough room if we do have more cases here in San Diego County,” Chris Van Gorder, CEO of Scripps Health, told Paul Sisson in the San Diego Union-Tribune. El Centro patients are now being airlifted as far as San Francisco and Sacramento.

According to the US Census Bureau, nearly 85% of Imperial County residents are Latino, and statewide, Latinos bear a disproportionate burden of COVID-19. The California Department of Public Health reports that Latinos make up 39% of California’s population but 57% of confirmed COVID-19 cases.

Nonessential travel between the US and Mexico has been restricted since March 21, with the measure recently extended until July 21. However, jobs in Southern California, such as in agricultural fields and packing houses, require regular movement between the two countries. “I’m always afraid that people are imagining this rush on the border,” Andrea Bowers, a spokesperson for the Imperial County Public Health Department, told Small. “It’s just folks living their everyday life.”

These jobs, some of which are considered essential because of their role in the food supply chain, may have contributed to the COVID-19 crisis on the border. Agricultural workers often lack access to adequate personal protective equipment and are unable to practice physical distancing. They also are exposed to air pollution, pesticides, heat, and more — long-term exposures that can cause the underlying health conditions that raise the risk of death for COVID-19 patients.

Comite Civico del Valle, a nonprofit focused on environmental health and civic engagement in Imperial Valley, set up 40 air pollution monitors throughout the county and found that levels of tiny, dangerous particulates violated federal limits, Solis reported.

“I can tell you there’s hypertension, there’s poor air pollution, there’s cancers, there’s asthma, there’s diabetes, there’s countless things people here are exposed to,” David Olmedo, an environmental health activist with Comite Civico del Valle, told Solis.

Fear of New Surges

With summer socializing in full swing, health experts worry that COVID-19 spikes will follow. Imperial County saw surges after Mother’s Day and Memorial Day, probably because of lapsed physical distancing and mask use at social events.

Latinos in California are adhering to recommended public health behaviors to slow the spread of the virus. CHCF’s recent COVID-19 tracking poll with Ipsos asked Californians about their compliance with recommended behaviors. Eighty-four percent of Californians, including 87% of Latinos, say they routinely wear a mask in public spaces all or most of the time. Seventy-two percent of Californians, including 73% of Latinos, say they avoid unnecessary trips out of the home most or all of the time, and 90% of Californians, including 91% of Latinos, say they stay at least six feet away from others in public spaces all or most of the time.

A Push to Reopen Anyway

Most counties in California have met the state’s readiness criteria for entering the “Expanded Stage 2” phase of reopening. Imperial County has not. In the past two weeks, more than 20% of all COVID-19 tests in the county came back positive, the Sacramento Bee reported. The state requires counties to have a seven-day testing positivity rate of no more than 8% to enter Expanded Stage 2.

Still, the Imperial County Board of Supervisors is pushing Governor Gavin Newsom for local control over its reopening timetable. The county has a high poverty rate — 24% compared with the statewide average of 13% — and “bills are stacking up,” Luis Pancarte, chairman of the board, said on a recent press call.

He worries that because neighboring areas like Riverside and San Diego have opened some businesses with physical distancing measures in place, Imperial County residents will travel to patronize restaurants and stores. This movement could increase transmission of the new coronavirus, just as reopening Imperial County too soon could as well.

More than 1,350 residents have signed a petition asking Newsom to ignore the Board of Supervisor’s request, Solis reported. The residents called on the supervisors to focus instead on getting the infection rate down and expanding economic relief for workers and businesses.

Cruz, who has been working around the clock to handle the county’s COVID-19 crisis, agrees with the petitioners. The surges after Mother’s Day and Memorial Day made her “really concerned about unlocking and letting people go back to normal,” she told Plevin. “It’s going to be just like those little gatherings that happened [on holidays], but on a bigger scale.”