High numbers of Los Angeles patients complained about coughs as early as December, study says

https://www.washingtonpost.com/science/2020/09/10/los-angeles-patients-covid-coughing/?utm_campaign=wp_main&utm_medium=social&utm_source=facebook&fbclid=IwAR35fvTDN4Tq476ktGM0O8aIT3cvjVP1wP7I104tEQU3bRRgiLZs_nk6PYE

The number of patients complaining of coughs and respiratory illnesses surged at a sprawling Los Angeles medical system from late December through February, raising questions about whether the novel coronavirus was spreading earlier than thought, according to a study of electronic medical records.

The authors of the report, published Thursday in the Journal of Medical Internet Research, suggested that coronavirus infections may have caused this rise weeks before U.S. officials began warning the public about an outbreak. But the researchers cautioned that the results cannot prove that the pathogen reached California so soon, and other disease trackers expressed skepticism that the findings signaled an early arrival.

The debate about the findings underscores just how much remains to be known about the coronavirus, which has killed at least 187,000 people in the United States, according to a Washington Post analysis.

“This is consistent with the growing body of data that suggests that there’s been community spread much earlier than we had anticipated,” said study author Joann G. Elmore, a doctor and epidemiologist at the David Geffen School of Medicine at the University of California at Los Angeles.

The researchers examined six years of electronic health records, representing nearly 10 million patients, at the UCLA health system from July 2014 through February. That included patient visits to three UCLA hospitals and to nearly 200 associated outpatient clinics.

Health agencies have surveillance systems in place to detect the early signals of disease outbreaks, such as a rise in patients with fever checking into hospitals. But medical records were an under-tapped resource, Elmore said. “People weren’t paying attention to the outpatient setting,” she said.

The study authors searched outpatient and emergency department reports that used the word “cough,” and tallied the number of people hospitalized for acute respiratory failure.

That approach revealed an uptick in patients that began the week of Dec. 22 and remained elevated for 10 weeks. The number of extra people exceeded the researchers’ predictions by 50 percent, totaling about 1,000 more patients compared with the previous five flu seasons.

Influenza cannot be ruled out as a cause of the increase, Elmore said. “And, you know, we did see a bad bout of flu this year,” she said. But what gave her pause was the consistent, weeks-long trend found only in this most recent season and not others.

Some experts said they doubted that coronavirus infections were the likely cause of respiratory problems in California so far back in time. “The data countywide would suggest that it really began to spread in March,” said Brad Spellberg, chief medical officer at the Los Angeles County+USC Medical Center, who was not involved with the new research.

Although the virus may have infected a small number of people sooner than previously reported, Spellberg said he doubted that “meaningful transmission” occurred in December or January.

Using data from emergency departments that reported patients with flu-like illnesses, Spellberg and his colleagues observed two peaks in patients in December and February, as they reported in JAMA this spring.

Those increases were consistent with a severe flu season, Spellberg said. Los Angeles’s third spike in flu-like illnesses, this time caused by the coronavirus, came later.

What’s more, between March 2 and March 18, only 5 percent of 131 patients with flu-like illnesses tested positive for the coronavirus in the JAMA study. Spellberg said that if the virus had an earlier foothold in California, he would have expected that percentage to be higher. “You would have seen an explosion of cases,” he said.

Understanding how long the virus circulated within a population helps refine epidemiological models of transmission. Infectious-disease scientists and doctors in many pockets of the world are eager to uncover when the coronavirus first spread outside of China.

In late December 2019, Chinese health officials identified clusters of viral pneumonia in Wuhan. Researchers sequenced the culprit’s genome, describing the new coronavirus strain, in early January. The first officially reported U.S. case of coronavirus, a man who traveled home from Wuhan, occurred two weeks later.

A few observations indicate that the virus may have traveled farther, earlier, before it flared into a global pandemic. A study of Italian sewage revealed traces of the virus in December. When researchers retested a nasal swab from a man hospitalized near Paris dating to Dec. 27, they detected the coronavirus.

Genetic sequencing of coronavirus samples in New York suggests that the virus was spreading there by the end of January. In April, two autopsies in Santa Clara County, Calif., pushed back the first U.S. covid-19 deaths from late to early February.

Study author Judith Currier, a UCLA infectious-disease physician, said that when it comes to people who wonder whether they were exposed to the virus many months ago, she does not recommend “antibody testing for people who never had a symptomatic illness,” citing guidelines from the Centers for Disease Control and Prevention.

“If someone had a compatible clinical illness but never had testing for covid during that time, antibody testing could help to confirm,” she said. “Although we don’t know how long the antibodies last, so it would not be definitive.”

 

 

 

 

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

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.

 

 

 

The two sides of America’s coronavirus response

https://www.axios.com/us-coronavirus-vaccine-testing-science-b656e905-67d1-4836-863e-c91f739cfd1e.html

The two sides of America's coronavirus response - Axios

America’s bungled political and social response to the coronavirus exists side-by-side with a record-breaking push to create a vaccine with U.S. companies and scientists at the center.

Why it matters: America’s two-sided response serves as an X-ray of the country itself — still capable of world-beating feats at the high end, but increasingly struggling with what should be the simple business of governing itself.

What’s happening: An index published last week by FP Analytics, an independent research division of Foreign Policy, ranked the U.S. 31st out of 36 countries in its assessment of government responses to COVID-19.

  • That puts it below developed countries like New Zealand and Denmark, and also lower than nations with fewer resources like Ghana, Kenya and South Africa.
  • The index cited America’s limited emergency health care spending, insufficient testing and hospital beds and limited debt relief.

By the numbers: As my Axios colleague Jonathan Swan pointed out in an interview with President Trump, the U.S. has one of the worst per-capita death rates from COVID-19, at 50.29 per 100,000 population.

Yes, but: Work on a COVID-19 vaccine is progressing astonishingly fast, with the Cambridge-based biotech company Moderna and the National Institutes of Health announcing at the end of July that they had begun Phase 3 of the clinical trial.

  • Their efforts are part of a global rush to a vaccine, and while companies in the U.K. and China are jockeying for the lead, U.S. companies and the NIH’s resources and expertise have been key to the effort.
  • Anthony Fauci has said he expects “tens of millions” of doses to be available by early 2021, a little over a year after the novel coronavirus was discovered.
  • If that turns out to be the case, “the Covid-19 vaccine could take a place alongside the Apollo missions as one of history’s greatest scientific achievements,” epidemiologist Michael Kinch recently wrote in STAT.

So which is the real American response to COVID-19? The bungled testing policies, the politically driven rush to reopen, the tragic racial divide seen in the sick and the dead? Or the warp-speed work to develop a vaccine in a year when most past efforts took decades?

Be smart: It’s both.

The bottom line: It can often feel as if there are two Americas, and not even a virus that has spread around the world seems capable of bridging that gap.

 

 

 

 

Fauci has been an example of conscience and courage.

https://www.washingtonpost.com/opinions/fauci-has-been-an-example-of-conscience-and-courage-trump-has-been-nothing-but-weak/2020/07/13/7c9a7578-c52b-11ea-8ffe-372be8d82298_story.html?fbclid=IwAR0n0o67FMhhUjxqU11cfrd4daMkW0ZWZtIg–I1P3ioLPA7ka7Ew0XT_EA&utm_campaign=wp_main&utm_medium=social&utm_source=facebook

Opinion | Fauci has been an example of conscience and courage ...

When historians try to identify the most shameful documents from the Trump administration, a few are likely to stand out. For unconstitutional bigotry, it is hard to beat the initial executive order banning travel to the United States from Muslim countries. For cruelty and smallness, there is the “zero tolerance” directive to federal prosecutors that led to family separations at the border. For naked corruption, there is the transcript of the quid-pro-quo conversation between President Trump and the president of Ukraine.

But for rash, foolish irresponsibility, I’d nominate the opposition research paper recently circulated by the White House in an attempt to discredit the National Institute of Allergy and Infectious Diseases’ Anthony S. Fauci. As reported by The Post, the document recounted a number of instances — on community transmission, asymptomatic transmission and mask wearing in particular — where Fauci’s views have shifted over time. As far as I know, this official record is unique: A White House attack on the government’s leading infectious-disease specialist during a raging pandemic. It indicates an administration so far gone in rage, bitterness and paranoia that it can no longer be trusted to preserve American lives.

From a purely political standpoint, it is understandable that the administration would want to divert attention from its covid-19 record. Trump’s policy of reopening at any cost is exacting a mounting cost. Five months into the greatest health crisis of modern U.S. history, there are still serious problems with supply chains for protective equipment. There are still long wait times for testing results in many places. The contact tracing process in many communities remains (as one health expert described it to me) “a joke.” More than 132,000 Americans have died.

Rather than addressing these failures, Trump has chosen to sabotage a public official who admits their existence. Rather than confronting these problems, Trump wants to ensure his whole administration lies about them in unison. The president has surveyed America’s massive spike in new infections and thinks the most urgent matter is . . . message discipline.

It is true that a number of Fauci’s views on the novel coronavirus have evolved (though some of the administration’s charges against him are distorted). But attacking a scientist for making such shifts is to willfully misunderstand the role of science in the fight against disease. We do not trust public health officials during an emerging pandemic because they have fully formed scientific views from the beginning. We trust them because 1) they are making judgments based on the best available information and 2) they have no other motive than the health of the public. If, say, health officials were initially mistaken about the possibility of asymptomatic transmission, it is not failure when they change their views according to better data. It is the nature of the scientific method and the definition of their duty.

In the inch-deep world of politics, amending your view based on new information is a flip-flop. In epidemiology, it is known as, well, epidemiology.

Meanwhile, the president is failing according to both requirements of public trust. Trump is not making judgments based on the best available information. And he clearly has political goals that compete with (and often override) his commitment to public health. The president is hoping against hope that the public will forget about the virus until November, or at least about the federal role in fighting it. To apply a veneer of normalcy, he is holding public events that endanger his staff and his audience and is planning a Republican convention that will double as a petri dish.

It now seems likely that the most decisive moment of the American pandemic took place in mid-April when new cases began to stabilize around 25,000 a day. Even four or six more weeks of firm presidential leadership — urging the tough, sacrificial application of stay-at-home orders — might have reduced the burden of disease to more sustainable levels, as happened in Western Europe. And this would have relieved stress on systems of testing, tracing and treatment.

But Trump’s nerve failed him. Instead of holding firm, he began siding with populist demands for immediate opening, pressuring governors to take precipitous steps and encouraging skepticism about basic public health information and measures. This may well have been the defining moment of the Trump presidency. And he was weak, weak, weak.

It is typical for Trump to shift blame. But in this case, the president has selected his fall guy poorly. Fauci has been an example of conscience and courage in an administration that values neither. When Trump encourages a contrast to his own selfishness and cravenness, he only damages himself.

 

 

 

 

Why our “starved” public health system was unprepared for COVID-19

https://mailchi.mp/7d224399ddcb/the-weekly-gist-july-3-2020?e=d1e747d2d8

Exclusive: Health spending in Brazil states as small as USD 20 ...

The American public health system has long been considered one of the best in the world, but decades of underfunding have left states and counties woefully ill-equipped to handle the worst pandemic in a century.

An extensive analysis by Kaiser Health News and the Associated Press found that over the past ten years, per-capita spending by state and local public health departments has dropped by 16 and 18 percent, respectively, leaving our public health system “underfunded and under threat, unable to protect the nation’s health”.

Public health departments are mandated to provide a laundry list of critical functions, from restaurant inspections and water testing to immunizations. But over time, many of these functions have been privatized, and staff and budgets reduced. Both were cut further as state budgets tightened.

The federal government has extended $13B in emergency funding, but many local public health departments have still been forced to furlough workers during the pandemic. Citing comparisons to the funding extended during other crises like Zika and the H1N1 influenza, experts are concerned that baseline budgets will continue to decline.

Moreover, public health workers face unprecedented cultural challenges, and are often disrespected by political and clinical leaders. And as public health workers are putting themselves at risk of COVID exposure just to do their jobs, many face resentment and anger from angry citizens who blame them for the policies they are charged to enforce—with some local public health leaders even resigning due to threats and intimidation.

The current crisis has shown that we need a more expansive, and better coordinated public health infrastructure. Getting there will require not just more investment, but repairs to the foundation of this critical national asset.

 

 

 

HCA nurses issue 10-day strike notice at California hospital

https://www.healthcaredive.com/news/hca-nurses-issue-10-day-strike-notice-at-california-hospital/580359/

UPDATE: June 23, 2020: Riverside Community Hospital on Tuesday told Healthcare Dive the motivation behind the union’s strike notice “has very little to do with the best interest of their members and everything to do with contract negotiations.” The system said it has plans to ensure appropriate staffing and continued services for any type of event, including a strike.

Dive Brief:

  • Nurses at HCA Healthcare’s Riverside Community Hospital in south-central California issued a 10-day strike notice last week, citing a breakdown in discussions over safety and staffing, the union representing them said Monday.
  • The nurses plan to strike from Friday, June 26 through July 6, prior to starting contract negotiations with HCA on July 7.  The union plans to push for better staffing and safety measures, particularly hospital preparedness during states of emergency.
  • Neither HCA nor Riverside were available for comment, but the hospital told Becker’s Hospital Review it had hoped the union “would not resort to these tactics” during the COVID-19 pandemic and said it had not laid off or furloughed any employees due to the crisis.

Dive Insight:

The strike notice follows a recent job posting from the nation’s biggest for-profit chain seeking qualified nurses in the Los Angeles area in the event of a job action or work stoppage.

Nurses at Riverside Community Hospital pushed for an improved staffing agreement last year and got it — but the hospital recently ended that agreement, resulting in fewer RNs taking care of more patients amid a pandemic, according to the union.

Insufficient personal protective equipment, inadequate safety measures and recycling of single-use PPE is also putting nurses at increased risk of COVID-19 infection, the union alleges.

Scores of RNs at the hospital have fallen ill with COVID-19, according to a release, including deaths of an environmental services worker and a lab technician, that “have not caused RCH to improve staffing or increase PPE.”

PPE shortages have been a problem at all of the 27 hospitals SEIU Local 121 RN represents, the union says. But a member survey found HCA hospitals were particularly unprepared for shortages. Only 27% of local 121 RN members at HCA hospitals reported having access to N95 respirators in their unit, significantly lower than other hospitals surveyed, according to the union.

Nashville-based HCA has received the most among for-profits in Coronavirus Aid, Relief, and Economic Security Act funding so far, about $1 billion. The amount is about 2% of HCA’s total 2019 revenue.

The 184-hospital system said it has not had to furlough employees like other systems have, though some employees have been redeployed or seen their hours and pay decrease. HCA implemented a program providing seven weeks paid time off at 70% of base pay that was scheduled to expire May 16, but has been extended through this week.

A spokesperson with the country’s largest nurses union, National Nurses United, told Healthcare Dive the program isn’t technically a furlough because some HCA nurses participating said they must remain on call or work rotating shifts.

NNU has also recently fought with HCA over other pandemic-related labor issues. Nurses at 15 HCA hospitals protested in late May over contractually bargained wage increases the hospital says it can’t deliver due to financial strains, asking nurses to give up the increases or face layoffs.

Another dispute involves a last-minute change mandating in-person voting for nurses deciding whether to form a union at HCA’s Mission Hospital in Asheville, North Carolina, according to an NNU release.

SEIU Local 121 RN said HCA can “easily weather this storm financially, continue to provide profits for their shareholders, while at the same time support and protect nurses as they fight this disease and fight to save their community.”

 

 

 

 

Shutdowns prevented 60 million coronavirus infections in the U.S., study finds

https://www.washingtonpost.com/health/2020/06/08/shutdowns-prevented-60-million-coronavirus-infections-us-study-finds/?fbclid=IwAR3J402h_abt63p-JDNEEBrNwrZ_nRjQza8OKxtV9xmtt4n5Oky-droY_-c&utm_campaign=wp_main&utm_medium=social&utm_source=facebook

Shutdowns prevented 60 million coronavirus infections in the U.S. ...

Shutdown orders prevented about 60 million novel coronavirus infections in the United States and 285 million in China, according to a research study published Monday that examined how stay-at-home orders and other restrictions limited the spread of the contagion.

A separate study from epidemiologists at Imperial College London estimated the shutdowns saved about 3.1 million lives in 11 European countries, including 500,000 in the United Kingdom, and dropped infection rates by an average of 82 percent, sufficient to drive the contagion well below epidemic levels.

The two reports, published simultaneously Monday in the journal Nature, used completely different methods to reach similar conclusions. They suggest that the aggressive and unprecedented shutdowns, which caused massive economic disruptions and job losses, were effective at halting the exponential spread of the novel coronavirus.

“Without these policies employed, we would have lived through a very different April and May,” said Solomon Hsiang, director of the Global Policy Laboratory at the University of California at Berkeley, and the leader of the research team that surveyed how six countries — China, the United States, France, Italy, Iran and South Korea — responded to the pandemic.

He called the global response to covid-19, the disease caused by the virus, “an extraordinary moment in human history when the world had to come together,” and said the shutdowns and other mitigation measures resulted in “saving more lives in a shorter period of time than ever before.”

The two reports on the effectiveness of the shutdowns come with a clear warning that the pandemic, even if in retreat in some of the places hardest hit, is far from over. The overwhelming majority of people remain susceptible to the virus. Only about 3 percent to 4 percent of people in the countries being studied have been infected to date, said Samir Bhatt, senior author of the Imperial College London study.

“This is just the beginning of the epidemic: we’re very far from herd immunity,” Bhatt said Monday in an email. “The risk of a second wave happening if all interventions and precautions are abandoned is very real.”

In a teleconference with reporters later, Bhatt said economic activity could return to some degree so long as some interventions to limit viral spread remain in place: “We’re not saying the country needs to stay locked down forever.”

The Berkeley study used an “econometric” model to estimate how 1,717 interventions, such as stay-at-home orders, business closings and travel bans, altered the spread of the virus. The researchers looked at infection rates before and after the interventions were imposed. Some of these interventions were local, and some regional or national. The researchers concluded that the six countries collectively managed to avert 62 million test-confirmed infections.

Because most people who are infected never get tested, the actual number of infections that were averted is much higher — about 530 million in the six countries, the Berkeley researchers estimated.

Timing is crucial, the Berkeley study found. Small delays in implementing shutdowns can lead to “dramatically different health outcomes.” The report, while reviewing what worked and what made little difference, is clearly aimed at the many countries still early in their battle against the coronavirus.

“Societies around the world are weighing whether the health benefits of anti-contagion policies are worth their social and economic costs,” the Berkeley team wrote. The economic costs of shutdowns are highly visible — closed stores, huge job losses, empty streets, food lines. The health benefits of the shutdowns, however, are invisible, because they involve “infections that never occurred and deaths that did not happen,” Hsiang said.

That spurred the researchers to come up with their estimates of infections prevented. The Berkeley team did not produce an estimate of lives saved.

One striking finding: School closures did not show a significant effect, although the authors cautioned that their research on this was not conclusive and the effectiveness of school closures requires further study. Banning large gatherings had more of an effect in Iran and Italy than in the other countries.

In discussing their findings Monday with reporters in the teleconference, leaders of the two research teams said challenges exist in crafting their models and thus there are uncertainties in the final estimates.

Bhatt, for example, said the model used by his team is highly sensitive to assumptions about the infection fatality rate, estimates for which have varied among researchers and from one country to another. He said his team was heartened to see that its estimates for the number of people infected so far is generally consistent with antibody surveys that attempt to calculate the attack rate of the virus.

Ian Bolliger, one of the Berkeley researchers, acknowledged the difficulty in obtaining reliable numbers for coronavirus infections given the haphazard pattern of testing for the virus. Both research teams said the peer review process had made their findings more robust.

 

 

 

 

COVID-19 impact on hospitals worse than previously estimated

https://www.healthcarefinancenews.com/news/covid-19-impact-hospitals-worse-previously-estimated?mkt_tok=eyJpIjoiWTJOaU5EWTJOekZsWWpBMCIsInQiOiJEeUZmbVFWVEFmUUxiMElydWdrMmNzY2RtNEdMbmRmM3BFMUFiYTRDOTFBYktPVVJ3ZUFTbTVwR2VzZkNma2VLdUVTNWJ0cGxMNGZ3UjhHbWhDR3g2KzNLeTYrbHU1bCtOWFM1bzdIdXFyQmc2ZGFDNDA4NGNhbFZZT3R2c09wYSJ9

Coronavirus | MSF

Factors such as how many patients would need ICU treatment, average length of stay and fatality risk are straining hospital resources.

When it became evident that the COVID-19 pandemic would spread across the U.S., lawmakers, scientists and healthcare leaders sought to predict what the financial and operational impact on hospitals would be. In those early days, policymakers relied on data from China, where the pandemic originated.

Now, with the benefit of time, the early predictions seriously underestimated the coronavirus’ impacts. University of California Berkeley and Kaiser Permanente researchers have determined that certain factors — such as how many patients would need treatment in intensive care units, average length of stay and fatality risk — are much worse than previously anticipated, and put a much greater strain on hospital resources.

WHAT’S THE IMPACT

Looking primarily at California and Washington, data showed the incidents of COVID-19-related hospital ICU admissions totaled between 15.6 and 23.3 patients per 100,000 in northern and southern California, respectively, and 14.7 per 100,000 in Washington. This incidence increased with age, hitting 74 per 100,000 people in northern California, 90.4 per 100,000 in southern California, and 46.7 per 100,000 in Washington for those ages 80 and older. These numbers peaked in late March and early April.

Those numbers are greater than the initial forecast, especially when factoring in the virus itself. Modeling estimates based on Chinese data suggested that about 30% of coronavirus patients would require ICU care, but in the U.S., the probability of ICU admissions was 40.7%. Male patients are more likely to be admitted to the ICU than females, and also are more likely to die.

Length of stay was also higher than had been predicted. By April 9, the median length of stay was 9.3 days for survivors and 12.7 days for non-survivors. Among patients receiving intensive care, the median stay was 10.5 days, although some patients stayed in the ICU for roughly a month.

Long durations of hospital stay, in particular among non-survivors, indicates the potential for substantial healthcare burden associated with the management of patients with severe COVID-19 — including the need for ventilators, personal protective equipment including N95 masks, more ICU beds and the cancellation of elective surgeries.

The considerable length of stay among COVID patients suggests that unmitigated transmission of the virus could threaten hospital capacity as it has in hotspots such as New York and Italy. Social distancing measures have acted as a stop-gap in reducing transmission and protecting health systems, but the authors said hospitals would do well to ensure capacity in the coming months in a manner that’s responsive to changes in social distancing measures.

THE LARGER TREND

These challenges have placed a financial burden on hospitals that can’t be overstated. In fact, a Kaufman Hall report looking at April hospital financial performance showed that steep volume and revenue declines drove margin performance so low that it broke records.

Despite $50 billion in funding allocated through the CARES Act, operating EBITDA margins fell to -19%. They fell 174%, or 2,791 basis points, compared to the same period last year, and 118% compared to March. This shows a steady and dramatic decline, as EBITDA margins were as high as 6.5% in April.

 

 

How tariffs ravaged the COVID-19 medical supply chain

https://www.healthcaredive.com/news/coronavirus-tariffs-trade-medical-supply-chain/578861/

Trump's Tariffs Leave the U.S. Short on Vital Medical Supplies - WSJ

Months into the pandemic, the U.S. faces an ongoing shortage of PPE and some of it is still subject to tariffs.

Gojo Industries, which makes Purell, builds automated hand sanitizer dispensers in the U.S. The devices rely on an electronic input made in China. But in early March, the U.S. Trade Representative (USTR) turned down Gojo’s tariff exemption request for the specific part needed for its dispensers, just before President Donald Trump declared a national emergency due to COVID-19.

The government later reversed its decision and waived the tariff after a senator from Ohio, where Gojo Industries is based, pressured the USTR because of the product’s importance to public health.

But several months into the COVID-19 pandemic, many consumers still struggle to find public-health-related products, from hand sanitizer to wipes. There’s also a shortage of personal protective equiptment (PPE) in the United States, and some of it is still subject to tariffs, throwing a wrench into pandemic preparedness and response.

Health supply chain experts sound the warning bell

The healthcare industry warned the Trump administration long before COVID-19 that imposing tariffs on Chinese-produced essential healthcare products put the nation’s public health preparedness at risk.

In August 2018, Matt Rowan, president of the Health Industry Distributors Association (HIDA) told the U.S. Trade Representative (USTR) 301 Committee that products on the proposed list were widely used in healthcare settings and “are a critical component of our nation’s response to public health emergencies, such as Ebola.”

Tariffs on items like masks, medical gloves, isolation gowns and wet wipes would not only increase U.S. healthcare costs, but impact government and commercial suppliers supporting patients and providers during a medical crisis, the industry warned.

 

“We did not make up for the lack of imports from China by more imports from the rest of the world.”

Jennifer Hillman

Senior fellow for trade and international political economy, Council on Foreign Relations

 

Disrupting this supply chain would erode the industry’s ability to deliver quality outcomes, and “placing tariffs on these products would lead to product shortages and further exacerbate public health challenges during times of crisis. It would significantly limit the ability of all levels of government, as well as the commercial healthcare supply chain, to adequately support response efforts during emergency events,” Rowan said.

In spite of healthcare industry testimony, the U.S. slapped 15% to 25% tariffs on many of these essential healthcare items. That included 25% Section 301 tariffs on items like disposable medical headwear, hand sanitizers and pulse oximeters. It included 15% Section 301 tariffs on medical protective clothing, protective goggles, and Nitrile and sterile gloves.

In 2018, the American Action Forum estimated if import numbers remained consistent, medical supply costs would rise by $400 million.

“A good portion of the reason why we are in such a difficult position is imports of those products went way down once those tariffs were imposed on China,” Jennifer Hillman, senior fellow for trade and international political economy at the Council on Foreign Relations, told reporters on a press call. “Our traditional stockpiles, the amount that we had just in storage, by FEMA, by Veterans Affairs, by HHS, and by a lot of state and local hospitals, they decreased the amount of their imports and decreased their stockpiles because of the tariffs.”

Shefali Kapadia / Supply Chain Dive, data from World Trade Organization

In placing the tariffs, one Trump administration goal was for buyers to procure items from other countries or manufacture in the U.S. instead. And that happened, but not to the extent necessary to maintain the stockpiles.

“We did not make up for the lack of imports from China by more imports from the rest of the world,” Hillman said. China was the largest exporter of medical face masks globally, accounting for 25% of the world’s supply in 2019, according to the World Trade Organization (WTO).

The U.S. was the largest medical products importer during the last three years, with 19% of total world imports of these products in 2019, according to the WTO. Personal protective products (including face masks, hand sanitizer and protective eyewear) made up 10% of U.S. medical imports. Worldwide trade of products labeled “critical” and in severe shortage during the pandemic, included 1.7% of the total world trade for 2019, totaling $597 billion. The U.S. imported $5.2 billion in medical equipment in 2019.

The time-consuming exemption process

Trump refused a blanket exemption for medical products when COVID-19 hit, but did grant some exemptions retroactively to Sept. 1, 2019, through Sept. 1, 2020, on supplies like sterile drapes, disposable gowns, some face masks and disposable shoe covers. The government granted exemptions in executive orders on March 10, March 16 and March 17.

“They issued over 200 exclusions from the tariffs, with more than a hundred of these items are the ones that were needed for medical devices and to fight COVID,” said Hillman.

Still, $1.1 billion worth of healthcare imports that could be used for treating COVID-19 remain subject to the 25% tariffs, according to a report by Chad P. Brown, senior fellow at the Peterson Institute for International Economics. Tariffs from another $3.3 billion of critical healthcare product imports were lowered from 15% to 7.5%.

General Motors (GM), partnering with Ventec to produce ventilators under the Defense Production Act, needed to source more than 700 components for the new machines. While GM could obtain most from North America, it sourced components from a handful of categories from China, which fell under a 25% tariff. They included grommets, filter parts, compressor silencers and a power cord set. GM requested exclusions from the USTR for individual parts.

GM is producing ventilators in response to the pandemic. The company needed to source more than 700 component parts for the ventilators, many of which come from China and face 25% tariffs.
AJ Mast for General Motors

These types of requests are time-consuming, especially when efforts might be better spent on other priorities during this crisis, according to legislators. Senators on both sides of the aisle pointed this out in an April letter to U.S. Trade Representative Robert Lighthizer, saying “[companies] should not be subjected to the lengthy process of submitting tariff exemption requests for each individual input required to make products essential for addressing the ongoing pandemic.”

Tethered to China

Procuring from outside of China can alleviate the risk of single sourcing and increased costs from tariffs, but it’s not always possible due to availability of raw materials, FDA clearance or production capabilities,

In June 2019, Lara Simmons, Group President of Medline Industries, explained to the USTR why a manufacturer wasn’t easily able to source many of its healthcare products, like gloves, outside of China. She said 97% of vinyl gloves come from China.

“These products are not made in the United States and some of these products are effectively available only from China. Starting production in the U.S. or any third country would be a time-consuming expensive process due to the FDA regulatory procedure that is required for these products,” she said.

The process for FDA regulated Class I and Class II medical devices can take more than two years, she said, and includes development and installation of environmental controls, facility upgrades, equipment purchase, installation, process validation and multiple rounds of audits to ensure regulatory compliance and verification of the quality system effectiveness.

Personal protective products include face masks, hand soap, sanitizer and protective spectacles.
Shefali Kapadia / Supply Chain Dive, data from World Trade Organization

Even gloves used for hospital cleaning and industrial food prep are in short supply, sending buyers back to China in spite of high tariffs.

Minnesota-based Global Glove & Safety Manufacturing applied for a tariff exemption for unsupported gloves (rubber gloves without a fabric lining), which are subject to a 25% tariff. The company’s clients that traditionally use disposable supported gloves can’t keep those in stock and are now using unsupported gloves.

 

“Once stability is achieved in the marketplace, we won’t buy from China for unsupported gloves, especially because of the tariffs.”

Tanner Brehmer

Product development manager, Global Glove & Safety Manufacturing

Global Glove typically buys from producers in countries including Malaysia, Sri Lanka and Thailand, but due to lockdowns and limited production in those countries, it’s trying to source some from China. “It’s tough because nothing is really shipping and lead times are pushed out so far. We don’t know when we’ll get it from other countries,” Tanner Brehmer, the company’s product development manager, told Supply Chain Dive.

The 25% tariff on the gloves produced in China greatly increases the cost, yet China is one of the only countries producing these products at full speed, he said. So in spite of tariffs, his company may move some procurement back to China. “Once stability is achieved in the marketplace, we won’t buy from China for unsupported gloves, especially because of the tariffs,” Brehmer said.

A diversified future?

Lighthizer and the Trump administration has a long-term vision for the tariffs. “Indeed, if there is one lesson to be drawn from this crisis, it is that dependence on other countries as the source of key medical products has created a strategic vulnerability for the U.S. By encouraging diversification of supply chains and—better yet—more manufacturing in the U.S., President Trump’s economic and trade policies are helping to overcome that vulnerability,” Lighthizer wrote in the The Wall Street Journal.

As healthcare systems sourced PPE and other supplies to treat COVID-19, they often paid the tariffs if needed, even if that meant paying more for the products. Healthcare systems and the government also purchased from manufacturing companies converting their domestic factories to produce needed items for COVID-19 treatment.

 

“We need a more resilient supply chain, which means we need to have multiple sources of supply.”

Jennifer Hillman

Senior fellow for trade and international political economy, Council on Foreign Relations

 

Which of these production lines will continue when the acute need for PPE is over, is hard to know. However, healthcare systems are now more aware of the risk in relying on foreign sources for their supplies.

“We need a more resilient supply chain, which means we need to have multiple sources of supply rather than sole sources of supply, and we need to do a better job of creating stockpiles,” said Hillman. “Part of the reason why we’re in such a world of hurt is because of our stockpiles were allowed to be depleted, again, in response to these tariffs.”

 

 

 

266 hospitals furloughing workers in response to COVID-19

https://www.beckershospitalreview.com/finance/49-hospitals-furloughing-workers-in-response-to-covid-19.html

furlough - Fox21Online

Many U.S. hospitals and health systems have suspended elective procedures to save capacity, supplies and staff to treat COVID-19 patients.

As a result of suspending these nonemergent procedures, several systems have lost or expect to lose a large chunk of their annual revenue, forcing them to make cost reduction a top priority. 

Below is a breakdown of the hospitals that have furloughed staff in an effort to remain financially stable amid the COVID-19 pandemic. 

 

May 22-28

1. Emory Healthcare, an 11-hospital system based in Atlanta, has cut hours or furloughed 1,500 workers in an effort to help offset a revenue shortfall due to the COVID-19 pandemic.  The furloughs, slated to take effect June 1, will last until Aug. 31.

2. Citing volume and revenue declines from the COVID-19 pandemic, Dallas-based Baylor Scott & White Health said it would lay off 1,200 employees and furlough an unspecified portion of its workforce amid the COVID-19 pandemic. When announcing the workforce reductions, the health system said it spent $85 million to prepare and respond to the pandemic.

3. Lebanon, N.H.-based Dartmouth-Hitchcock Health said in its financial report released May 27 that although it reassigned as many staffers as possible to new roles, some employees were asked to choose between using paid time off or taking unpaid time off. The measure was due to a dip in volume from the COVID-19 pandemic.

4. Edward Elmhurst (Ill.) Health has furloughed a portion of its 8,000-person workforce due to the COVID-19 pandemic, according to ABC7 Chicago. It is unclear how many employees were furloughed.

5. Cadiz, Ky.-based Trigg County Hospital has furloughed a portion of its staff due to the financial hit from the COVID-19 pandemic, according to WJDZ Radio. The hospital will bring employees back when patient volume returns.

Note: In addition to new furloughs this week, two health systems announced plans to furlough additional staffers.

  • Seattle-based UW Medicine announced 4,000 additional furloughs on May 25, that affect union employees. The organization initially announced plans to furlough 1,500 staffers on May 18. Read more about the earlier furloughs here.

  • Additionally, New Bedford, Mass.-based Southcoast Health said it implemented a second round of furloughs in mid-May. It initially implemented furloughs for staff not actively involved in patient care in early April. It said it is working to absorb a deep revenue hit. Between the two rounds, more than 10 percent of Southcoast Health’s 7,500 employees were affected. Scroll to April 3 for more details on Southcost Health’s furloughs. 

May 14-21

1. Mount Sinai Medical Center in Miami Beach, Fla., told investors May 20 that it furloughed 775 employees and has permanently laid off 208 employees to help offset losses incurred from the COVID-19 pandemic. The furloughs reduced payroll by $3 million in April, and the layoffs are expected to save the system $11.1 million in payroll expenses this year.

2. Citing a financial hit from the COVID-19 pandemic, Marietta, Ga.-based Wellstar Health System has furloughed 1,070 workers through July 31. The furloughs affect about 4.4 percent of the health system’s workforce of 24,300. Wellstar said it is anticipating a $400 million to $600 million loss in 2020. The loss was mainly attributed to reduced patient volume. However, it also includes increased expenses for buying protective gear.

3. BJC HealthCare, a 15-hospital system in St. Louis, has furloughed 2,962 employees due to the COVID-19 pandemic. The health system said the furloughs are expected to last eight weeks, but some employees may be called back to work depending on patient volume.

4. UW Medicine will furlough 1,500 employees to help address an anticipated $500 million loss due to COVID-19, the Seattle-based organization said May 18. Affected employees will be furloughed for at least one week and up to eight weeks. During the furlough, employees will retain healthcare benefits.

5. The Erie County Medical Center in Buffalo, N.Y., has laid off 70 staffers and plans to implement furloughs to help offset losses caused by the COVID-19 pandemic. The hospital said it will first offer voluntary two- to six-week furloughs and then implement involuntary ones if its savings goals are not met.

6.  Lee Health, a system with more than 14,500 employees in Fort Myers, Fla., is offering voluntary buyouts and a voluntary summer leave program to help offset losses attributed to the COVID-19 pandemic. The summer sabbaticals are four to six weeks off from work during the summer. Employees who opt into the summer leave program can use vacation time if they have it or it will be unpaid.

7. Citing a patient volume drop from the COVID-19 pandemic, St. Luke’s Hospital in Chesterfield, Mo., will furlough a portion of its staff, according to KSDK. It is unclear how many employees will be affected and how long the furloughs will last. The hospital said it would bring employees back when patient volume increases.

8. Nurses in the delivery ward at Greater El Monte (Calif.) Community Hospital have been furloughed after the hospital suspended services due to low patient volume amid the pandemic, according to the Sun Gabriel Valley Tribune. 

May 13

1. Providence Oregon will implement staff furloughs and leadership pay cuts to help offset financial losses attributed to the COVID-19 pandemic, the Portland-based health system announced this week. The health system said its core leaders will take a one-week unpaid furlough between May 17 and July 31. In addition, caregivers will flex their hours during the same time period. The hours will be flexed based on patient volume.

May 12

1. Citing a revenue loss from the COVID-19 pandemic, Kentfield, Calif.-based MarinHealth Medical Center has furloughed 115 employees, according to the Marin Independent Journal. Affected employees will retain their healthcare benefits.

May 11

1. Peterborough, N.H.-based Monadnock Community Hospital has furloughed 20 percent of its workforce, or about 100 employees, according to The Keene Sentinel. The hospital said it lost $1.7 million in March and expects to lose $24 million by the end of September because of the COVID-19 pandemic.

2. Chesterfield, Mo.-based Mercy, which has hospitals in four states, said it plans to furlough workers and cut jobs due to the COVID-19 pandemic, according to St. Louis Post-Dispatch. While Mercy didn’t disclose the number of employees that will be furloughed, an email obtained by the Post-Dispatch said “thousands” would be affected.

3. Citing a financial toll from the COVID-19 pandemic, Harlingen, Texas-based Valley Baptist Medical Center plans to furlough an undisclosed number of employees for 90 days, according to The Valley Morning Star. 

4. Bristol (Conn.) Hospital has furloughed 103 employees and cut hours of about 200 staff members, according to the CT Mirror. The independent hospital said it expects to see a loss of $15 million to $18 million by September due to the COVID-19 pandemic.

Note: University of Rochester (N.Y.) Medical Center, which initially announced plans to furlough employees in April, announced May 8 that it would furlough 3,474 employees, or more than 19 percent of its workforce. Read more about the furlough here or under April 29.  

May 8

1. The University of Chicago Medical Center plans to furlough more than 800 employees, or about 8 percent of its workforce, due to a decline in operating revenue amid the COVID-19 pandemic, according to Crain’s Chicago Business. The academic medical center reported it saw a $70 million decline in operating revenue in March and April due to the suspension of elective procedures. Most furloughed employees are in nonclinical roles. The furloughs are expected to end by July 31.

2. Hyannis, Mass.-based Cape Cod Healthcare plans to furlough 600 of its 5,700 workers to help offset losses from the COVID-19 pandemic. Cape Cod Healthcare is projecting a $74 million loss by the end of the fiscal year, according to The Enterprise. Affected staff work in nonclinical and nursing roles. The furloughs will take effect May 10 and will last at least 30 days.

3. To help overcome the financial hit from the COVID-19 pandemic, Grand Rapids, Mich.-based Metro Health is offering its staff members a voluntary 12-week furlough program, according to MLive. The health system also plans to lay off some employees and implement other “staffing changes.” The furloughs, layoffs and other staffing adjustments are expected to affect less than 10 percent of the health system’s workforce of 3,059.

4. Citing financial challenges and a patient volume drop due to the COVID-19 pandemic, the University of Cincinnati Medical Center has furloughed staff to better align staffing levels with demand, according to NPR.  

5. Johns Hopkins Medicine in Baltimore has furloughed a portion of its staff during the pandemic, according to The Baltimore Sun. The hospital said the furloughs, as well as other cost-cutting measures, were necessary because it is “not immune to the broader economic impact of the pandemic.”

6. Auburndale, Mass.-based Atrius Health has furloughed some staff due to the patient volume drop amid the pandemic, according to a nurse who works at the system who spoke to NPR. 

May 7

1. MultiCare Health System plans to implement mandatory 17-shift furloughs for 6,000 employees to help offset losses from the COVID-19 pandemic, the Tacoma, Wash.-based organization said May 6. The furloughs, which will start next week and last through January, will mainly affect non-clinical employees. Affected employees will be able to retain healthcare benefits and have the option to use paid time off for the shifts to minimize the financial hit.

2. Iowa-based Mercy Iowa City is furloughing a portion of its staff and asking other employees to cut down hours to help offset a revenue loss caused by the COVID-19 pandemic, according to The Gazette. The hospital system said that about 7.5 percent of staff will be affected by the furloughs and reduction in hours. The cost-cutting measures are expected to last about 12 weeks. Mercy Iowa City employs 1,400.

3. Citing a patient volume drop due to the COVID-19 pandemic, Yankton, S.D.-based Avera Sacred Heart Hospital has furloughed a portion of its staff, according to WNAX Radio. The hospital said the furloughs have mainly affected employees not involved in direct patient care.

4. Pullman (Wash.) Regional Hospital has furloughed an undisclosed number of employees amid the COVID-19 pandemic, according to KREM. The organization has also capped overtime, limited paid time off and implemented pay cuts for executives to help offset the revenue loss from the pandemic.

May 6

1. Citing a projected financial loss exacerbated by the COVID-19 pandemic, Ann Arbor-based Michigan Medicine plans to furlough or lay off 1,400 full-time employees. The health system expects to record a financial loss of up to $230 million in the fiscal year ending June 30. The health system also expects losses to continue into the next fiscal year.

2. Due to the financial hit from the COVID-19 pandemic, Kaweah Delta Medical Center in Visalia, Calif., has furloughed an undisclosed number of staff, according to The Business Journal. The medical center has launched a relief fund to help employees who were furloughed. The Kaweah Delta Hospital Foundation will accept donations through July.

3. Warrenton, Va.-based Fauquier Hospital has furloughed 61 employees, or about 9 percent of its workforce, due to the COVID-19 pandemic, according to Fauquier Now. The furloughs were initially announced last month.

4. Birmingham, Ala.-based Brookwood Baptist Health has furloughed a portion of its staff due to patient volume declines amid the COVID-19 pandemic, according to WBRC. Furloughed employees still have access to their medical benefits.

5. Breckenridge, Texas-based Stephens Memorial Hospital has furloughed a portion of its staff to help offset a revenue loss attributed to the COVID-19 pandemic, according to the Breckenridge American. The hospital said it will start bringing back the furloughed workers because it was able to secure a loan from the Paycheck Protection Program.

May 5

1. Lawrence, Kan.-based LMH Health has furloughed 221 employees as it works to offset revenue shortfalls caused by the COVID-19 pandemic, according to The Lawrence Journal World. The hospital system said that 52 employees would be furloughed for one week, 77 for two weeks and 92 for more than two weeks. Affected employees will retain their health benefits.

2. Monongahela (Pa.) Valley Hospital, citing a loss in revenue due to the suspension of nonessential procedures, has furloughed 10 percent of its staff, according to CBS Pittsburgh. The furloughs affect about 100 staff members. Other staff members volunteered to take a leave of absence, according to the report.

3. Citing a financial hit from the COVID-19 pandemic, Princeton (W.Va.) Community Hospital has furloughed a portion of its staff, according to The Bluefield Daily Telegram. The hospital said the majority of furloughed employees worked in services that were closed or saw a drop in patient volume amid the pandemic.

May 4

1. Employees at Samaritan Healthcare of Moses Lake (Wash.) are taking voluntary furloughs to help cut expenses amid the COVID-19 pandemic, according to The Columbia Basin Herald. The hospital is facing a financial loss due to restrictions on performing elective procedures. The furloughs are expected to start by May 4.

2. Hurley Medical Center in Flint, Mich., is considering several cost-cutting measures, including voluntary and involuntary furloughs and reduced employee hours, to help offset COVID-19 financial losses, according to MLive.com. The medical center also is considering layoffs.

3. Citing a revenue drop of 40 percent due to the COVID-19 pandemic, Portland, Ore.-based Legacy Health System is requiring staff to take 10-day furloughs, according to Oregon Public Broadcasting. Employees can use paid time off during the furlough, but the health system said it expects some employees will have to take unpaid leave.

May 1

1. Minneapolis-based Children’s Minnesota plans to furlough 181 nurses to help offset the financial hit from the COVID-19 pandemic, according to The Star Tribune. Members of the Minnesota Nurses Association must still approve the furlough agreement. If the furloughs take place, they will affect 17 percent of nurses.

2. Providence, R.I.-based Care New England has furloughed a portion of its staff due to the COVID-19 pandemic, according to WJAR. The health system said that the furloughs affect workers in departments that have seen the greatest patient volume drop. Furloughs were voluntary and involuntary. They are being reassessed every two weeks.

3. Citing a decline in patient volume and a resulting revenue drop, Indiana (Pa.) Regional Medical Center has furloughed 200 employees, according to The Indiana Gazette. The furloughs are expected to last until May 31. Furloughed employees will still have access to health insurance and can apply for unemployment.

4. MU Health Care, based in Columbia, Mo., has furloughed staff at its medical school and plans to furlough additional healthcare workers at its hospitals due to the economic hit from the COVID-19 pandemic, according to KRCG TV. The health system will also end contracts for about 70 traveling nurses. In addition, the system will not fill the 300 open positions at MU Health Care.

5. Citing a financial hit and patient volume drop from the COVID-19 pandemic, North Mississippi Medical Center in Tupelo has furloughed a portion of its staff, according to WTVA. The hospital expects to begin calling back some of the first employees furloughed next week as nonemergent surgeries resume.

6. CHI St. Joseph in Lexington, Ky., said it has worked to align staffing levels with current volumes, according to KBTX.  Unnamed sources told the publication that hundreds of employees have been affected by furloughs amid the pandemic.

“We continue to look at every possible way to reduce costs and take advantage of resources available to our ministry, including federal funding recently approved by Congress. While those funds are welcomed, they will not be sufficient to address our financial challenges,” CHI St. Joseph told the publication.

April 30

1. Hospital Sisters Health Systems, a 15-hospital system in Springfield, Ill., will furlough a portion of its staff due to the COVID-19 pandemic, according to WAND TV. The health system said the furloughs were necessary to ensure it can remain financially stable. The furloughs were both voluntary and involuntary.

2. The Christ Hospital, based in Cincinnati, will furlough a portion of its staff that is not directly involved in patient care, according to WLWT. The furloughs, which will begin in May, will last 60 days. Affected employees can apply for unemployment and retain their healthcare benefits.

3. Citing a significant reduction in revenue due to the COVID-19 pandemic, Newburyport, Mass.-based Anna Jaques Hospital has furloughed 134 employees, according to the NewburyportNews.com. The unpaid furloughs affect about 10 percent of the hospital’s workforce.

4. Encompass Health, a Birmingham, Ala.-based operator of post-acute services, has implemented market-specific furloughs, according to Home Health Care News. The decision is to better align staffing with demand amid the COVID-19 pandemic, according to the report. It is unclear how many employees are affected.

5. Due to the patient volume drop amid the COVID-19 pandemic, some employees at San Francisco-based UCSF Benioff Children’s Hospitals have had their hours cut, according to The San Francisco Chronicle. One employee, Stephanie Lum Ho, a physical therapist who works at UCSF Benioff Children’s Hospital in Walnut Creek, Calif., said her hours were cut in half.

April 29

1. Stamford (Conn.) Health plans to furlough 375 employees to help offset a revenue loss from the COVID-19 pandemic, according to the Stamford Advocate. The health system said revenue was down $10 million in March, and that loss is expected to hit $27 million in April. The health system has 3,600 employees.

2. Citing a revenue loss of $85 million per month due to the COVID-19 pandemic, University of Virginia Health System in Charlottesville, plans to furlough a portion of its staff not involved in direct patient care. The furloughs will last up to three months. Affected employees can retain their health insurance benefits and can use their paid time off to help offset some of the pay loss. The health system also plans to reduce executive and physician compensation.

3. St. Joseph Mercy Health System in Livingston, Mich., has furloughed 50 staff members due to the COVID-19 pandemic, according to the Livingston Daily. The furloughs affected support staff from both of the health systems locations.

4. After exhausting other alternatives to shore up finances amid the pandemic, University of Rochester (N.Y.) Medical Center will begin furloughing employees in May, according to WXXI News.  The hospital system announced May 8 that it would furlough 3,474 employees, more than 19 percent of its 17,885-person workforce.

5. Citing a patient volume and revenue drop from the COVID-19 pandemic, Coshocton (Ohio) Regional Medical Center has furloughed a portion of its 320 employees, according to the Coshocton Tribune. The furloughs are expected to last until May 31.

6. Willis-Knighton Health System in Shreveport, La., has placed a portion of its staff on unpaid leave. Affected staff worked in areas where the health system found a lower or nonexistent demand for services. In a statement provided to Becker’s Hospital Review, Chief Administrative Officer Brian Crawford said the state’s directive to curb non-emergent procedures and the effects of the pandemic left about half of the services provided by Willis-Knighton significantly reduced or halted.

7. Henderson, Ky.-based Methodist Health plans to furlough 50 employees due to the COVID-19 pandemic, according to WEHT. The health system said patient volumes have been gravely affected by the state ban on non-emergent procedures.

April 28

1. To help minimize the financial hit from the COVID-19 pandemic, St. Louis-based SSM Health plans to furlough 2,000 employees. The furloughs, expected to last at least 13 weeks, will affect about 5 percent of the health system’s workforce. The health system said it also plans to place more workers on partial furlough or reduce their hours. Affected employees can apply for federal and state unemployment.

2. Bethel, Alaska-based Yukon-Kuskokwim Health will furlough, lay off or reduce hours of 300 workers to help offset a revenue loss attributed to the COVID-19 pandemic, according to Alaska Public Radio. The cuts and furloughs will occur across four categories: workers who are immediately laid off, workers who are furloughed, workers who volunteer for furlough and workers who have their hours cut by 50 percent. The health system employs about 1,400 people.

3. Citing a projected $100 million shortfall in revenue from March through June due to the pandemic, Rancho Mirage, Calif.-based Eisenhower Health has furloughed a portion of its staff, according to The Desert Sun. About 30 to 35 employees have been fully furloughed and others have been partially furloughed with reduced hours.

4. Washington, Ind.-based Daviess Community Hospital has furloughed a portion of its staff to help stabilize its financial position after a revenue loss caused by the COVID-19 pandemic, according to the Washington Times Herald. Affected employees can retain their benefits and have the opportunity to apply for unemployment. The furloughs will be reevaluated after 30 days.

5. University of Vermont Health System in Burlington has furloughed a few hundred employees due to the COVID-19 pandemic, according to NBC affiliate NECN. About 70 of the affected staffers were reassigned to different roles within the health system. The exact number of furloughed employees was not disclosed.

6. Citing a 40 percent reduction in patient volume and a resulting revenue drop, Memphis, Tenn.-based Methodist Le Bonheur Healthcare has furloughed a portion of its staff, according to the Daily Memphian. Some of the employees volunteered to take furloughs. Employees will still have health insurance benefits.

7. Palm Springs, Calif.-based Desert Regional Medical Center has furloughed an undisclosed number of employees because of a patient volume drop amid the COVID-19 pandemic, according to The Desert Sun.

8. Oceanside, Calif.-based Tri-City Medical Center has sent layoff or furlough notices to 24 nurses amid the COVID-19 pandemic, according to the Voice of San Diego.

April 27

1. Citing a revenue loss due to the COVID-19 pandemic, Jackson-based West Tennessee Healthcare has furloughed 1,100 individuals of its 7,000-person workforce. The health system said it lost $18 million in March due to the statewide ban on elective procedures that went into effect March 23. To comply with the order, the health system temporarily shut down some hospital departments as well as its outpatient surgery center.

2. Annapolis, Md.-based Anne Arundel Medical Center has furloughed 1,000 employees due to low patient volume and other financial challenges brought by the COVID-19 pandemic. All furloughed employees received 80 hours of pay and are able to retain their benefits through June 30. The medical center said it plans to redeploy some of the furloughed workers to support an anticipated COVID-19 surge.

3. Lexington, Ky.-based UK Healthcare has furloughed 1,500 employees to help offset a COVID-19-related revenue loss, according to Kentucky.com. The health system said it has seen a drop in the number of services offered after elective procedures were canceled statewide in March. The health system said earlier in April it planned to place some employees on unpaid leave after April 25 if the pandemic continued to affect operations.

4. St. Joseph Hospital in Nashua, N.H., has furloughed 300 employees due to the COVID-19 pandemic, according to WMUR. The furloughs affect about 20 percent of the hospital’s employees. In March, the hospital said it lost $3.6 million in revenue, a number expected to double by the end of April.

5. Citing a financial hit from the COVID-19 pandemic, Fresno, Calif.-based St. Agnes Medical Center has furloughed 175 employees, according to ABC affiliate KFSN. The hospital said it has seen a large drop in the number of elective surgeries and emergency room visits during the pandemic. Affected employees are able to retain healthcare benefits.

6. Pikeville (Ky.) Medical Center has furloughed more than 200 employees amid mounting financial pressure due to the COVID-19 pandemic, according to WCHS TV. The medical center said that the furloughs are necessary because it is predicting a “significant historical financial loss for April.” The furloughs took effect April 26.

7. In an effort to offset financial losses due to the COVID-19 pandemic, Cody (Wyo.) Regional Health said it is furloughing a portion of its nonclinical staff, according to The Cody Enterprise. The health system said the furloughs will last at least two months. Since the crisis began, Cody Regional Health’s revenue has been down 60 percent, according to the report.

8. Citing a decrease in patient volume and revenue, Mobile, Ala.-based Infirmary Health has furloughed a portion of its staff, according to NBC 15. Affected employees will retain their healthcare benefits.

9. Show Low, Ariz.-based Summit Healthcare, projecting a revenue decrease of 40 percent to 50 percent due to COVID-19, is asking employees to voluntarily take furloughs, according to the White Mountain Independent. The hospital system said that the state ban on elective surgeries has significantly reduced workloads and volumes. The voluntary furloughs would begin May 2 and last 90 days.

“Furloughing allows us to retain talent while providing limited benefits,” Summit Healthcare CEO Ron McArthur told the publication.

10. Dalles, Ore.-based Mid-Columbia Medical Center plans to furlough employees beginning May 3 in an effort to help offset losses attributed to the COVID-19 pandemic, according to The Dalles Chronicle. The furloughs will affect departments that are not seeing a high patient volume.

11. Due to a revenue loss from the COVID-19 pandemic, Stanford (Calif.) Health Care employees have the option to take a 20 percent pay cut, using paid time off, or taking a furlough, according to the San Francisco Chronicle. Employees must use one of those options between April 27 and July 4.

April 24

1. HealthPartners will furlough 2,600 workers in an effort to help offset the financial hit from the COVID-19 pandemic, the seven-hospital system in Bloomington, Minn., said April 23. The furloughs, made because the pandemic caused an “immediate and significant decrease in revenue,” affect about 10 percent of its workforce. The furloughs will take place in areas where the organization has stopped, slowed or deferred work temporarily.

2. Citing financial challenges due to the COVID-19 pandemic, Buffalo, N.Y.-based Catholic Health plans to furlough up to 1,200 employees, according to WKBW. The furloughs will affect management and non-management positions. They will begin April 26 and will be reevaluated after 30 days. Affected employees will retain health benefits and can apply for unemployment.

3. Kansas City, Mo.-based Children’s Mercy will furlough 575 employees for up to 60 days, according to KCTV 5. The furloughs will take effect April 26. Hospital officials said the furloughs are an effort to help offset fiscal losses attributed to the COVID-19 pandemic.

4. Mary Free Bed Rehabilitation Hospital in Grand Rapids, Mich., has furloughed 20 percent of its employees due to the COVID-19 pandemic, according to WOOD TV. The furloughs will affect about 400 staffers. Furloughed employees have access to health and life insurance through June 30.

5. Maryville, Tenn.-based Blount Memorial Hospital has furloughed 211 employees due to low patient volume amid the COVID-19 pandemic, according to The Daily Times. 

6. Citing a loss of $10 million per month due to the COVID-19 pandemic, Chicago-based Sinai Health System plans to lay off 24 nonclinical employees, furlough about 150 caregivers and cut hours for another 200 employees, according to Crain’s Chicago Business. The four-hospital system said it plans to call 200 furloughed employees back to work in 60 days.

7. After suffering a steep financial loss due to the COVID-19 pandemic, Bangor, Maine-based St. Joseph Healthcare has furloughed 100 of its 1,200 employees, according to The Bangor Daily News. St. Joseph said it ended March with an operating loss of $4 million and expects a bigger hit in April. The majority of affected staff volunteered to take a furlough.

8. Laurinburg, N.C.-based Scotland Health Care System will furlough nearly 70 employees through June 30, according to The Laurinburg Exchange. Most affected employees work in nonclinical roles, though some front-line staff were furloughed. The health system said the furloughs were necessary given the drop in patient volume and revenue caused by the COVID-19 pandemic.

9. Citing a slowdown in elective procedures and a resulting revenue drop, St. Paul, Minn.-based Regions Hospital plans to furlough about 30 employees, according to the Pioneer Press. The affected employees include nurses, physicians, lab techs and other emergency room staffers.

10. Winston-Salem, N.C.-based Wake Forest Baptist Health plans to furlough a portion of its leadership and administrative staff as early as next week, according to The Winston-Salem Journal. The furlough period would last 16 weeks. It is unclear how many employees will be affected.

April 23

1. Detroit-based Henry Ford Health System plans to furlough 2,800 staffers not directly involved in patient care due to financial damage from the COVID-19 pandemic. The six-hospital system recorded a $43 million loss in operating income in March due to the cancellation of elective procedures, temporary clinic closures and the additional expenses of acquiring personal protective gear. The health system expects bigger losses in April and May.

2. Citing a financial hit from the COVID-19 pandemic, Providence, R.I.-based Lifespan has furloughed about 1,100 employees, according to The Providence Journal. A hospital spokesperson said most of the furloughs were taken voluntarily, and some employees have been able to take vacation or sick leave to maintain pay. Affected employees can retain their benefits, such as health insurance.

3. Woodbury, N.J.-based Inspira Health has furloughed 219 employees due to the COVID-19 pandemic, according to the Philadelphia Business Journal. The list of furloughed employees will be reviewed every two weeks, the health system said. Inspira has about 6,000 employees.

4. Macomb, Ill.-based McDonough District Hospital plans to furlough 60 workers amid declining revenue from the COVID-19 pandemic, according to local radio station WGIL. The health system experienced a $1.2 million loss in net revenue in March, and expects April to have a much larger loss.

5. To address the financial impact and patient volume dip caused by the COVID-19 pandemic, Greenville, N.C.-based Vidant Health will furlough a portion of its workforce, according to ABC 12. The health system will start the furloughs April 26. The number of affected employees was not disclosed.

6. Olean, N.Y.-based Upper Allegheny Health System plans to start a voluntary furlough program in an effort to help offset some of the losses from the COVID-19 pandemic, according to Tap Into Greater Olean. The system projects it will incur a $25 million loss related to COVID-19 in 2020.

7. Due to the suspension of elective procedures and subsequent revenue drop, Grand Forks, N.D.-based Altru Health System plans to reduce the number staffing hours by 10 percent to 15 percent through furloughs and a system-required absence program, according to The Grand Forks Herald. The hospital system said it is facing a potential loss of $65 million this year due to the COVID-19 pandemic.

8. Cleveland-based University Hospital plans to cut the hours and pay of 4,100 employees not involved in patient care, according to Cleveland.com.  Salaried nonclinical staffers are required to take a one-week unpaid furlough every five weeks. Hourly nonclinical workers will have their hours cut by 20 percent each week. Affected employees can use paid time off and sick time during those unpaid weeks. Hospital staff will still receive benefits, like health insurance.

9. Citing the financial hit from COVID-19, Wausau, Wis.-based Aspirus Health plans to furlough a portion of its staff beginning May 1, according to a system press release. The furloughs will primarily affect employees who do not work directly in patient care.

“This is the most difficult decision our leadership team has ever made,” said Aspirus President and CEO Matthew Heywood. “These drastic actions are ones we hoped to avoid but must take to ensure we can continue to serve our communities throughout this pandemic and for generations after.”

10. To help protect the long-term financial health of the organization, Buffalo, N.Y.-based Kaleida Health is offering a temporary voluntary furlough program for its staff, the health system announced April 22 in a news release. The furlough program is a joint agreement with two unions that represent 8,000 Kaleida Health employees. Affected employees would be able to retain benefits, like health insurance.

Note: Rochester, Minn.-based Mayo Clinic said April 22 that 30,000 staff members will be affected by furloughs or cut hours. More information about the furloughs are listed under April  13, or you can click here

April 22

1. Southfield, Mich.-based Beaumont Health will permanently lay off 450 staff members, cut executive pay and furlough 2,475 workers due to the financial hit from the COVID-19 pandemic. Most of the 450 layoffs affect corporate staff or administrative employees. The furloughs affect staff not directly caring for patients and hospital administrative staff.

2. Philadelphia-based Tower Health has furloughed at least 1,000 employees due to the financial hit from the COVID-19 pandemic. The furloughs affect roughly 7 percent of the system’s 14,000-person workforce.The seven-hospital system said it has lost about 50 percent of its revenue due to the suspension of elective procedures and drop in outpatient volume.

3. Citing the suspension of elective procedures and a 50 percent reduction in revenue, Kalamazoo, Mich.-based Bronson Healthcare has furloughed hundreds, according to WWMT.   Furloughed employees will not be paid for at least four months, and they can not use paid time off. The number of furloughed employees was not disclosed.

4. Utica, N.Y.-based Mohawk Valley Health System will furlough about 20 percent of its workforce of 4,000 for up to four months, according to the Utica Observer-Dispatch. The health system said it is part of a cost-cutting plan to recover from lost revenue caused by the COVID-19 pandemic.

5. About 200 employees at Ithaca, N.Y.-based Cayuga Medical Center have volunteered to take a furlough, according to Ithaca.com. The hospital, which employs 1,500, has seen a 50 percent drop in patient volume. Employees that opt into the furlough program can retain health insurance, apply for unemployment benefits and will receive a stipend upon returning to work.

6. Hudson, N.Y.-based Columbia Memorial Hospital will furlough 125 workers due to a drop in patient volume and revenue caused by the COVID-19 pandemic, according to News 10, an ABC affiliate. Furloughed workers can keep their health insurance and apply for unemployment benefits.

7. St. Mary’s Health System in Lewiston, Maine, will furlough about 5 percent of its workforce to help offset losses attributed to the COVID-19 pandemic, according to the Sun Journal. The furloughs, which affect 77 staffers, will begin April 27 and last for 30 days.

8. Seventy-one employees from Bay Area Hospital in Coos Bay, Ore., opted to take voluntarily furloughs, according to KCBY. The employees will be furloughed for 45 days.

9. Rosemont, Ill.-based Pipeline Health, which operates Weiss Memorial Hospital in Chicago and West Suburban Medical Center in Oak Park, Ill., has furloughed an undisclosed number of its staff due to the COVID-19 pandemic, according to the Chicago Tribune. Those employees will keep their health insurance and can apply for unemployment.

10. Citing a revenue decline of 50 percent due to the COVID-19 pandemic, Dansville, N.Y.-based Noyes Health has furloughed a portion of its staff for one to two week on a rolling basis, according to The Livingston County News. Furloughed staff will retain health insurance benefits.

11. Madison, Wis.-based UW Health plans to furlough some staff due to the COVID-19 pandemic, according to the Wisconsin State Journal. UW Health CEO Alan Kaplan, MD, said UW Health saw a 62 percent decline in surgeries and patient volume, and as a result is expecting losses of $350 to $400 million between March 15 and June 30.

12. West Des Moines, Iowa-based UnityPoint Health said it will implement furloughs starting April 26, according to 25 News, an NBC affiliate.  Furloughs will affect employees in areas of the system that are not operating at capacity or experiencing closures.

13. Gottlieb Memorial Hospital in Melrose Park, Ill., has furloughed some staff in response to the COVID-19 pandemic, according to the Chicago Tribune. 

14. MacNeal Hospital in Berwyn, Ill., has furloughed some staff in response to the COVID-19 pandemic, according to the Chicago Tribune. 

April 21

1. Phoenix-based Banner Health plans to furlough 5 percent to 7 percent of its workforce in response to the COVID-19 pandemic. Some affected employees may be furloughed for just a few weeks. Affected employees will still have benefits, like health insurance.

2. Citing the suspension of elective procedures, Ogdensburg, N.Y.-based Claxton-Hepburn Medical Center has furloughed or cut pay for 170 workers, according to WWNY TV. The furloughed employees will not be paid.

3. Rochester, Minn.-based Olmsted Medical Center, which employs 1,300 people, plans to furlough a portion of its staff to offset the financial hit caused by the COVID-19 pandemic, according to ABC 6 News. The medical center is projecting a loss of nearly $25 million for April through June due to the suspension of elective procedures.

4. Myrtue Medical Center, a Harlan, Iowa-based hospital with 422 employees, has furloughed a portion of its workforce due to a revenue drop from the COVID-19 pandemic, according to HarlanOnline.com. The hospital said that the pandemic has caused a nearly 50 percent drop in procedures, visits and overall patient volumes.

5. Hutchinson (Kan.) Regional Healthcare System, experiencing financial strain from the COVID-19 pandemic, plans to furlough staff, according to The Hutchinson News. The system said the furloughs will affect employees at each of its facilities, but declined to discuss the number of employees that will be furloughed.

6. Poteau-based Eastern Oklahoma Medical Center, a 25-bed critical access hospital, has furloughed 52 employees, according to Erie News Now. The hospital said that suspending non-emergent procedures has caused a dip in patient volume and revenue.

7. Citing a revenue loss from the COVID-19 pandemic and suspension of elective procedures, Framingham, Mass.-based MetroWest Medical Center has furloughed an undisclosed number of nurses, according to The Milford Daily News.

April 20

1. Citing the financial burden caused by the COVID-19 pandemic, Carthage (N.Y.) Area Hospital has furloughed 20 percent of its staff, according to local news station WWNY TV. About 83 staff members are affected. Furloughed employees with health insurance can still receive those benefits.

2. Sioux Falls, Idaho-based Avera Health will furlough 650 workers due to the suspension of elective procedures and resulting revenue loss, according to The Grand Forks Herald. Avera will also cut pay for 1,500 employees. The health system has 19,000 employees across a five-state region.

3. St. Lawrence Health System, a three-hospital system in Potsdam, N.Y., plans to furlough at least 400 workers to help offset the revenue loss caused by the COVID-19 pandemic, according to North Country Now. Due to a drop in patient volume due to the suspension of elective procedures, the system is projecting a cash flow decrease of $10 million in the next 30 days. The health system’s website says it has more than 2,025 employees.

4. Rapid City, S.D.-based Monument Health will place 200 employees on furlough, according to KOTA TV. The health system said that it implemented furloughs to help preserve protective gear and save costs after suspending elective surgeries. The furloughs, which are effective April 25, affect 4 percent of Monument Health’s workforce.

5. In an effort to offset a revenue loss due to the COVID-19 pandemic, Niagara Falls (N.Y.) Memorial Hospital has furloughed 52 workers, according to WKBW.

6. Elizabethtown (N.Y.) Community Hospital has furloughed 25 staff members after experiencing a revenue cut of 50 percent due to the suspension of elective procedures during the COVID-19 pandemic, according to the Adirondack Daily Enterprise. 

7. Manatee Memorial Hospital, a safety-net facility in Bradenton, Fla., has furloughed a portion of its staff due to the COVID-19 pandemic, according to Bradenton.com. Affected employees will be able to retain health and life insurance. It is unclear how many staff members are affected or how long the furlough will last.

8. Tucson (Ariz.) Medical Center has furloughed some of its staff to help offset a revenue loss caused by the COVID-19 pandemic, according to Tucson.com. The health system said it is estimating a revenue loss of $20 million in April alone.

9. Tucson, Ariz.-based Carondelet Health Network has implemented furloughs across the system due to the COVID-19 pandemic, according to Tucson.com.

10. Gillette, Wyo.-based Campbell County Health has furloughed an undisclosed number of employees, according to The Gillette News Record. Affected employees are eligible to retain their health insurance and are expected to return to work within six to 12 weeks, according to the report.

April 17

1. Citing declines in revenue and patient volume due to the COVID-19 pandemic, Murray (Ky.) Calloway County Hospital plans to implement furloughs in all departments, according to local news station WPSD. The hospital said the reductions will affect about 15 percent to 30 percent of staff in each department, according to the report.

2. Lockport, N.Y.-based Eastern Niagara Hospital will furlough 60 employees in response to the suspension of elective procedures due to the pandemic, according to Buffalo, N.Y., ABC affiliate WKBW. The furloughs affect union and nonunion employees.

3. Lowville, N.Y.-based Lewis County Health System is temporarily placing 14 percent of its workforce on unpaid leave due to the COVID-19 pandemic, according to WWYN. The health system will ask for volunteers before furloughs will be mandated based on seniority. Furloughs are expected to last eight weeks.

4. Citing a financial hit from the suspension of elective procedures, Traverse City, Mich.-based Munson Healthcare is furloughing a portion of its staff, according to 9&10 News. Ed Ness, president and CEO of Munson Healthcare, told the CBS affiliate that the health system is projected to lose $7 million to $10 million a month.

5. Ann & Robert H. Lurie Children’s Hospital, based in Chicago, has furloughed about 20 percent of its staff through the end of April, according to the Chicago Tribune. Those staff members are still receiving pay and healthcare benefits. The hospital said it is losing about $10 million a week because it suspended elective surgeries and outpatient visits and is seeing a drop in inpatient visits.

6. Due to the COVID-19 pandemic, Maywood, Ill.-based Loyola Medicine has furloughed primarily nonclinical staff and reduced hours for other employees, according to the Chicago Tribune Furloughed workers are still receiving healthcare benefits.

“We hope to bring back as many furloughed employees as we can, when possible,” Loyola told the newspaper.

7. Citing a revenue drop from the COVID-19 pandemic, Somerset, Ky.-based Lake Cumberland Regional Hospital has 17 percent of its workforce on furlough, according to the Commonwealth Journal. Affected employees will continue to receive health insurance and 25 percent of their wages.

8. Aiken (S.C.) Regional Medical Centers will furlough 54 employees in an effort to offset revenue losses due to the COVID-19 pandemic, according to WJBF. Affected employees will be eligible for unemployment.

9. Due to the impact of the COVID-19 pandemic on its business operations, Boston-based Fenway Health will furlough a portion of its staff this week, according to The Rainbow Times.

“This is not something we are doing lightly. But Fenway Health is not immune to the economic forces affecting every health care system in the state in the midst of the COVID-19 crisis,” Fenway Health CEO Ellen LaPointe, told the publication. “These measures are temporary.”

10. El Paso, Texas-based Hospitals of Providence will furlough a portion of its staff to help offset a drop in patient volume, according to El Paso Times. Hospitals of Providence said that less than 3 percent of staff would be affected.

11. Jacksboro, Texas-based Faith Community Health System has furloughed, cut hours or reassigned about 75 percent of its staff due to the suspension of elective procedures, according to The Dallas Morning News.

“Where larger hospitals might have the ability to sustain that loss of revenue, rural hospitals just don’t. It has hit us faster and harder,” Faith Community CEO Frank Beaman told the publication.

April 16

1. Samaritan Medical Center in Watertown, N.Y., will furlough 10 percent of its 2,400 employee workforce due to a revenue loss stemming from the COVID-19 pandemic, according to NNY360. The medical center expects the furloughs to last about three months.

2. In an effort to ensure the long-term financial stability of the organization, DuBois, Pa.-based Penn Highlands Healthcare has furloughed or laid off 600 employees, according to The Progress News. About 60 percent of the 600 affected staff were furloughed. The health system has seen its revenue dip about 40 percent due to the suspension of elective procedures.

3. New Bedford, N.H.-based SolutionHealth, which includes Manchester, N.H.-based Elliot Hospital System and Nashua-based Southern New Hampshire Health, plans to furlough 650 staff members to offset a revenue hit from the COVID-19 pandemic, according to The Union Leader. 

4. Titus Regional Medical Center, a 108-bed facility in Mount Pleasant, Texas, has furloughed about 10 percent of its staff due to the COVID-19 pandemic, according to The Texas Tribune. It has about 800 employees. Titus said it expects the virus to cause a financial hit of $3.3 million, or about 14 days of cash.

5. Citing a financial hit from the COVID-19 pandemic, Chillicothe, Ohio-based Adena Health System has furloughed 500 staff members, according to WBNS, a CBS affiliate. The health system is projecting that it will have a deficit of more than $50 million through 2020 due to the suspension of elective procedures.

6. Akron, Ohio-based Summa Health is furloughing 360 employees in an effort to cut costs during the COVID-19 pandemic, according to The Beacon Journal. Summa Health has about 7,200 employees. The furloughs started this week. It is unclear when they will end.

7. Jupiter (Fla.) Medical Center has furloughed 50 workers in administrative and support positions due to the COVID-19 pandemic, according to The Palm Beach Post. The furloughs affect 2.7 percent of the hospital’s 1,883 employees and are expected to last through the peak of the pandemic.

8. Citing a patient volume and revenue loss from the COVID-19 pandemic, Paragould-based Arkansas Methodist Medical Center plans to furlough a portion of its staff starting April 20, according to local news station KAIT8. 

9. Dunn, N.C.-based Harnett Health has furloughed 80 staff members due to theCOVID-19 pandemic, according to My Daily Record. 

“We want to reassure our community that we are still here and able to provide care whenever they may need us,” Harnett Health President Cory Hess told the publication. “The restructuring is a direct result of having to temporarily shut down some of our services to reduce the spread of COVID-19.”

10. Citing a revenue dip due to the COVID-19 pandemic, Pocatello, Idaho-based Portneuf Medical Center will furlough and lay off a portion of its staff, according to the Idaho State Journal. It is unclear how many staff members were furloughed and laid off. The furloughs are expected to last 90 days, but some employees may be called back earlier.

“To balance the resources needed to care for our sickest patients against the economic impact of postponed visits and the decline in surgeries, we have made some difficult workforce decisions,” a spokesperson for Portneuf Medical Center told the publication.

11. San Francisco-based Dignity Health has furloughed a portion of its nonclinical staff, Laurie Harting, Dignity’s CEO for the Greater Sacramento region, told the Sacramento Business Journal. The number of affected employees was not disclosed.

12. While Sacramento-based Sutter Health has created a labor pool to redeploy and reassign employees, some who are unable to be reassigned have been furloughed, according to the Sacramento Business Journal. Sutter has offered these affected employees 80 hours of “disaster pay” to account for hours lost and is creating a relief fund for employees. It is unclear how many employees are receiving the disaster pay. The health system has not laid off employees.

April 15

1. Citing a decline in elective surgeries and other nonemergent procedures due to the COVID-19 pandemic, Dallas-based Tenet Healthcare has furloughed about 10 percent of its workforce of more than 113,000. Affected employees include those in administrative support roles, corporate office jobs and elective care. Earlier in April, Tenet said it planned to furlough 500 employees, but the health system said it had to raise the number of furloughs after the costly government-mandated suspension of elective procedures.

2. Citing the suspension of elective procedures, Detroit Medical Center is furloughing 480 employees who are not involved in treating COVID-19 patients or other critical patient care, according to Fox Detroit.

3. Lovelace Health System, based in Albuquerque, N.M., plans to furlough or cut hours of about 630 people, according to The Albuquerque Journal. The temporary workforce reduction affects about 15 percent of the health system’s 4,239 employees.

4. Citing a revenue drop of 60 percent due to the COVID-19 pandemic, Rutland City, Vt.-based Rutland Regional Health System has furloughed 150 employees, according to WCAX. The hospital has about 1,200 employees total.

5. Philadelphia-based Einstein Healthcare Network plans to move forward with furloughs due to a significant decline in physician practice and outpatient volume, according to WHYY. Health system officials said they project a $50 million to $60 million hit in 2020. Internal documents revealed that 70 percent of the health system’s expenses are staff related. Einstein Healthcare department heads were instructed to choose which employees to furlough this week.

6. Abbeville (S.C.) Area Medical Center has furloughed or cut hours of 75 employees for at least two months, according to the Index-Journal. Both clinical and nonclinical staff are affected.

“Like many hospital systems across the state and nation, the COVID-19 pandemic has created financial challenges for Abbeville Area Medical Center,” Dean Turner, Abbeville Area Medical Center’s CEO, told the publication. “This was a difficult decision but one that was necessary not only to ensure that our hospital can continue to serve patients, but also to ensure that our employees have jobs to come back to in the next six to eight weeks, if not sooner.”

7. Citing a financial toll from the COVID-19 pandemic, Roanoke, Va.-based Carilion Clinic plans to furlough a portion of its staff, CEO Nancy Agee announced in a video to employees. The number of affected employees has yet to be determined.

8. Jonesboro, Ark.-based St. Bernards Healthcare has furloughed 50 employees due to a significant decline in patient volume and revenue, according to Arkansas Business. The health system said that it is working to help furloughed staff “receive every benefit possible.”

9. In an effort to conserve cash and ensure the future financial stability of the organization, Sedalia, Mo.-based Bothwell Regional Health Center has furloughed 50 staff members, according to KSIS Radio. The COVID-19 pandemic has resulted in a 43 percent reduction in revenue, the hospital said.

10. Queensbury, N.Y.-based Hudson Headwaters Health Network has furloughed 50 employees due to the revenue hit from the COVID-19 pandemic, according to North Country Public Radio.

11. Decatur, Ill.-based HSHS St. Mary’s Hospital is asking employees to take voluntary furloughs due to a decline in patient volume from the COVID-19 pandemic, according to WCIA. 

12. Fayetteville, Ark.-based Washington Regional Medical Center is furloughing a portion of its staff to help offset revenue losses due to the COVID-19 pandemic, according to KNWA, a Fox affiliate. The number of furloughs has yet to be determined.

13. In an effort to offset some of the financial losses from the COVID-19 pandemic, Mount Clemens, Mich.-based McLaren Macomb Hospital plans to furlough up to 20 nurses, according to Detroit News. 

April 14

1. Kalispell (Mont.) Regional Healthcare will furlough 600 employees in an effort to help offset the financial hit from the COVID-19 pandemic, according to NBC Montana. The health system expects to incur a revenue loss of $16 million per month due to the suspension of elective procedures.

“The compounding effect of the loss of patient volumes, cancellation of elective surgeries, and the closure of entire service lines has had a tremendous financial impact on KRH,” Craig Lambrecht, MD, Kalispell Regional president and CEO, told the publication. “Cost cutting efforts have been underway but unfortunately those efforts alone cannot remedy the significance of these losses.”

2. UT Health East Texas in Tyler has furloughed or reduced hours of about 10 percent of its staff due to a decline in patient volume stemming from the COVID-19 pandemic, according to KLTV. The furloughs will last about 90 days, but some employees may be called back earlier. Employees will still have access to health insurance and paid time off benefits.

3. Manchester, N.H.-based Catholic Medical Center has furloughed 700 employees after canceling elective procedures to save staff and supplies for COVID-19 patients, according to The Union Leader. The hospital said it is losing about half of its typical monthly revenue. Furloughed workers can use paid time off.

4. Citing a revenue loss tied to the COVID-19 pandemic, Glens Falls (N.Y.) Hospital furloughed 337 workers, according to The Glens Falls Post-Star. Affected employees work in nonclinical roles.

5. Weymouth, Mass.-based South Shore Health has placed 219 employees on furlough in an effort to counter some of the financial strain caused by COVID-19, according to The Patriot Ledger. The health system has more than 5,600 employees. The health system said it is looking to reassign some of the workers to new roles.

6. Las Cruces, N.M.-based Memorial Medical Center has furloughed 125 employees, according to The Las Cruces Sun News. The furloughs affected nearly all departments and will last 60 days. The employees will earn partial pay and will still retain health benefits.

7. Minneapolis-based Allina Health said that employees in nonclinical and indirect patient care roles must take at least one mandatory furlough in a 30-day period, according to SW News Media. The mandatory unpaid furlough will be one week in duration. Employees can use paid time off to cover the mandatory furlough.

“Not unlike other health care systems in Minnesota and across the nation, these changes have created significant financial pressures for Allina Health,” the health system said in a news release.

8. Irving, Texas-based Christus Health implemented furloughs for a portion of its staff, according to KLTV. The health system said employees will retain their healthcare benefits and are allowed to take paid time off. The system didn’t disclose how many employees will be affected.

9. In an effort to help offset an expected revenue loss of $6 million per month, Derby, Conn.-based Griffin Hospital is furloughing 99 employees, according to The New Haven Register. The furloughed employees work in nonclinical roles.

10. Las Cruces, N.M.-based MountainView Regional Medical Center has placed 67 employees on furlough, according to The Las Cruces Sun News. The medical center has furloughed employees from departments where services have been suspended during the pandemic.

11. Nacogdoches (Texas) Memorial Hospital has furloughed a portion of its staff due to the COVID-19 pandemic, according to The Lufkin Daily News. The hospital said it has been stockpiling supplies for an anticipated surge in COVID-19 patients, which has “resulted in extraordinary expenses piling up at exactly the same time that we’ve intentionally driven volumes down by more than 50 percent.”

April 13

1. Citing a revenue drop due to the COVID-19 pandemic, Decatur (Ala.) Morgan Hospital is furloughing about 10 percent of its staff, 100 workers, according to The Decatur Daily. 

2. Springfield, Mo.-based CoxHealth has furloughed 283 employees due to the suspension of elective procedures, according to The Springfield News-Leader. The hospital said it is working to get some of the furloughed employees redeployed to other positions in the health system.

3. Canton, Ohio-based Aultman Health will furlough about 400 employees, according to The Canton Rep. The majority of furloughed employees work in nonclinical roles, low-volume service areas or can’t be redeployed to care settings.

4. Evangelical Community Hospital, based in Lewisburg, Pa., has placed 400 workers on a furlough, according to The Williamsport Sun-Gazette. The hospital employs about 1,900 workers.

“Furloughs were across the board,” Deanna Hollenbach, a Evangelical Community Hospital spokesperson, told The Sun-Gazette.

5. Danville, Ky.-based Ephraim McDowell Health plans to furlough 20 percent of its 1,700-employee workforce, according to The Advocate Messenger.  The hospital system said that it needed to “take immediate steps to ensure that we can sustain our operations after the COVID-19 crisis ends,” according to a statement obtained by the publication.

6. Starting April 13, Farmington, N.M.-based San Juan Regional Medical Center is furloughing a portion of its staff, according to The Farmington Daily Times. The furloughs will affect employees in elective care and in nonclinical roles.

7. Citing a revenue loss of 50 percent, Elmeria, N.Y.-based Arnot Health plans to furlough a portion of its staff to shore up finances, according to MyTwinTiers.com.  Affected employees will be notified by April 17.

“The subsequent reductions in patient revenue have made it impossible for Arnot Health to afford the cost of current staffing levels in all but the most essential areas at this time,” the hospital said in a news release.

8. Although Mayo Clinic previously said it would protect full pay and benefits through April 28, after that date the system now says it will furlough some staff and implement pay cuts to address significant reductions in revenues. The Rochester, Minn.-based system said it projects a $900 million shortfall, even with the furloughs and pay cuts.  On April 22, Mayo Clinic said the furloughs and reduced hours will impact about 30,000 staff members. The system also said it expects to incur $3 billion in losses due to the COVID-19 pandemic. The furloughs or reduced hours affect about 42 percent of Mayo Clinic’s 70,000 employees across its campuses in Arizona, Florida and Minnesota.

9. Anderson, S.C.-based AnMed Health will begin implementing furloughs April 19, according to WWYF. The furloughs are expected to last about three months. There was no specific number of furloughs announced, but officials said both clinical and nonclinical employees will be affected.

10. Spartanburg (S.C.) Regional Healthcare System has furloughed some of its staff, according to WWYF. The health system has set up a COVID-19 fund to support affected staff.

11. La Crosse, Wis.-based Gundersen Health System has furloughed some of its staff, according to The La Crosse Tribune. Gundersen officials said that its locations have experienced a 40 percent to 80 percent decrease in business operations in the last few weeks due to the suspension of nonemergent procedures and clinic visits.

“These are temporary actions,” Gundersen CEO Scott Rathgaber, MD, told the publication. “We plan to bring staff back to fully serve the needs of our patients and communities when our procedures and appointments can safely return to normal operations.”

12. Grays Harbor Community Hospital, based in Aberdeen, Wash., has implemented furloughs after the system saw a 45 percent drop in outpatient procedures due to the COVID-19 pandemic, according to KXRO. The hospital said it was also incurring more costs to procure equipment for staff. The furloughs will begin April 13 and last 90 days.

13. Citing millions of dollars in lost revenue due to the COVID-19 pandemic, Bennington-based Southwestern Vermont Health Care is furloughing a portion of its workforce, according to The Bennington Banner. The health system expects to furlough about 100 of its 1,400 workers and said it will reassess the furloughs every two weeks.

14. Putnam, Conn.-based Day Kimball Healthcare has furloughed workers due to a drop in patient volume and revenue, according to NBC Connecticut.

April 10

1. Allentown, Pa.-based Lehigh Valley Health Network has furloughed about 900 employees who work at its physician practices, according to The Morning Call. The email obtained by the publication stated that furloughed workers can return to work after in-person patient visits return to normal levels.

2. Halifax Health, based in Daytona Beach, Fla, has placed 300 staff members on a mandatory four-month furlough, according to The Daytona Beach News Journal. The news comes just nine days after the system asked for volunteers to take furloughs. The health system is also mandating that nonclinical staff not included in the furlough take one day off per week.

3. Citing financial pressure from the COVID-19 pandemic, Escondido, Calif.-based Palomar Health has issued temporary layoffs for 221 employees, according to NBC San Diego. The furloughs will last 21 days and may be extended. Palomar Health said it is facing a significant revenue decline and incurred more costs to procure equipment.

4. Citing a 60 percent reduction in revenue in the last two weeks due to the pandemic, Marshall, Mich.-based Oaklawn Hospital has temporarily laid off 200 employees, according to local news station WWMT. The temporary layoffs affect about 17 percent of its 1,150 employees.

5. More than half of the employees at Gold Beach, Ore.-based Curry Health Network will be furloughed, laid off or have hours cut, according to Oregon Live. The hospital network said that 192 employees will be affected. At the beginning of March the network employed 340. The system said the state’s ban on elective procedures to free up capacity and supplies for COVID-19 patients cut into its revenue stream, according to the report.

6. Baptist Health, an eight-hospital system based in Louisville, Ky., has implemented temporary unpaid furloughs for employees in jobs that do not support caregivers or are not critical to treating COVID-19 patients. The health system did not disclose the number of furloughed employees.

“Our intent is to return to normal operations as soon as possible, and begin calling back employees. This is just a temporary measure,” said Baptist Health CEO Gerard Colman.

7. Batesville, Ark.-based White River Health System has furloughed some employees for 30 days due to a decrease in patient volume, according to local news station KARK. It is unclear how many employees were placed on furlough, but they are expected to be temporary.

8. Citing volume declines of more than 50 percent due to the COVID-19 pandemic, Georgetown, S.C.-based Tidelands Health has furloughed an undisclosed number of staff, according to WPDE, an ABC affiliate.

9. Gardener, Mass.-based Heywood Healthcare has furloughed an undisclosed number of staff in units and facilities that were closed in preparation for a surge of coronavirus patients, according to The Gardener News. The first furlough will last four weeks and will mainly affect staff that work in outpatient settings.

“We are actually seeing a $5 million drop in overall revenue for our organization, so we are going to really work on staffing, and we are going to implement a variety of things today, including furloughs — both full furloughs for staff and partial furloughs — continuing to use low activity days, some very limited layoffs, reducing scheduled hours, changing our on-call arrangements, restructuring job positions, reducing the contracted services we have, as we try to tackle and lower our expenses,” Win Brown, president and CEO of Heywood Healthcare, told the publication.

10. Brewer, Maine -based Northern Light Health is asking its staff to volunteer to take furloughs, according to CentralMaine.com. The health system said it has no plans to conduct involuntary furloughs.

April 9

1. Citing severe patient volume disruptions caused by the COVID-19 pandemic, Johnson City, Tenn.-based Ballad Health plans to furlough at least 1,300 workers, cut pay for some senior leaders and suspend retirement contributions. Ballad is projecting a cash flow drop of $150 million in the next 90 days due to the suspension of elective procedures.

2. Lewiston-based Central Maine Healthcare will furlough 330 employees to help offset the revenue loss caused by the COVID-19 pandemic, according to Bangor Daily News. The furloughs affect about 10 percent of its workforce.

“Furloughs like this are one way that we can adjust and manage the balance sheet appropriately. It also allows us to do that without having to sacrifice jobs permanently, without having to end the provision of care,” Kate Carlisle, director of public relations and community affairs for Central Maine Healthcare, told the publication.

3. Oswego (N.Y.) Health will furlough 25 percent of its workforce next week, according to Syracuse.com. Health system officials said that it has been losing about $180,000 per day since the beginning of March due to the coronavirus pandemic. Oswego Health said the furloughs should last about 10 to 12 weeks.

4. Citing a revenue and patient volume dip caused by the COVID-19 pandemic, Hopkinsville, Ky.-based Jenny Stuart Health has furloughed 248 staff members, according to Kentucky New Era. The health system has about 1,000 employees.

“This is an incredibly difficult time for our health system, and this is not a decision we made lightly. I regret the immediate personal impact on these employees and their families,” Jennie Stuart Health CEO Eric Lee told the publication.

5. Marshfield (Wis.) Clinic will furlough employees who are not involved in preparing for the anticipated surge in COVID-19 patients, according to local news station WEAU.  The furloughs are expected to be temporary, and staff can be recalled at any point in time to help manage the surge, according to the report.

6. Due to the suspension of elective procedures, Ashtabula (Ohio) County Medical Center is furloughing a portion of its workforce, according to the Star Beacon. To reduce the number of employees affected by the furlough, the hospital is training some employees to support different clinical departments in anticipation of a surge of COVID-19 patients.

7. University of Kansas Health System St. Francis Campus in Topeka is laying off 29 employees and furloughing 235, according to The Topeka Capital Journal. The furloughs and layoffs are an effort to offset the financial impact of the COVID-19 pandemic. The furloughs affect about 17 percent of the hospital’s staff.

8. Holyoke, Colo.-based Melissa Memorial Hospital is placing 19 employees on furlough for about three months, according to The Holyoke Enterprise. Furloughed employees are expected to return to work on July 26. The hospital said the decision was made because revenue was down due to the suspension of elective procedures.

9. Mad River Community Hospital, a 78-bed hospital in Arcata, Calif., is placing some employees on a full or partial furlough, according to Lost Coast Outpost. Hospital officials said the move is “essential” to ensure its doors remain open after the pandemic.

10. Citing challenges due to the COVID-19 pandemic, Oklahoma City-based Integris Health plans to furlough employees not involved in direct patient care, according to News 9. The furloughs are expected to be temporary. Affected employees will still receive health insurance benefits.

11. Abilene (Texas) Regional Medical Center has placed a small number of employees on furlough, according to KTXS, an ABC affiliate. Affected employees work in areas where services have been curtailed or suspended due to the COVID-19 pandemic.

April 8

1. MUSC Health, an eight-hospital system based in Charleston, S.C., said it would temporarily lay off 900 employees, or 5 percent of its workforce, to offset the financial hit caused by the COVID-19 pandemic. The temporary layoffs, which do not affect nonclinical workers, were effective April 7.

2. Nonclinical employees at Peoria, Ill.-based OSF HealthCare will be subject to mandatory paid time off or will be furloughed, the health system said April 7. The health system said the furloughs are necessary to help offset a revenue loss caused by the COVID-19 pandemic.

“It is important for the communities OSF has been called to serve for more than 142 years that we stabilize our financial position and protect our culture so we can continue to serve those communities, and our Mission Partners and their families in Illinois and Michigan,” said Mike Allen, CFO of OSF HealthCare. “Our priority remains equipping our frontlines with the resources they need to ensure the continuation of essential care, while protecting those providing that care.”

3. Citing a revenue and patient volume reduction caused by the COVID-19 pandemic, Holyoke, Mass.-based Valley Health System has furloughed 225 employees, according to Western Mass News. The furloughs affect about 11 percent of its workforce.

4. Odessa (Texas) Regional Medical Center has furloughed 60 employees to help offset a revenue loss due to the COVID-19 pandemic, CBS 7 reports. Affected employees will still receive insurance and are expected to be called back to work.

5. Medical Center Hospital in Odessa, Texas, has furloughed 30 staff members after the facility was ordered to suspend the lucrative elective procedures to save resources and staff to treat COVID-19 patients, according to CBS 7. The hospital has reassigned hospital workers to different areas, but Medical Center Hospital CEO Russell Tippin told the publication that it has been difficult.

“We’re in such a regulated industry that it’s hard,” Mr. Tippin told CBS 7. “You can’t take a pharmacist and put them in radiology. And you can’t take a radiologist and put them in pharmacy.”

6. In an effort to ease the financial damage caused by the COVID-19 pandemic, Amarillo, Texas-based BSA Hospital plans to furlough some of its employees for up to 90 days, according to ABC 7 Amarillo. 

7. Magnolia (Ark.) Regional Medical Center has furloughed an undisclosed number of nonclinical staff, including administrative and clerical workers, according to The Magnolia Banner News. The furloughs are expected to last at least two months. Affected staff will remain on the MRMC roster and maintain insurance, according to the report.

8. Caribou, Maine-based Cary Medical Center has furloughed a number of employees due to a drop in patient volume and revenue as a result of preparing for a COVID-19 patient surge, according to The Bangor Daily News. A majority of the furloughs affect support staff for physicians, according to the report.

9. In response to the COVID-19 pandemic, Hartford, Conn.-based Trinity Health of New England plans to furlough an undisclosed number of employees, according to The Hartford Courant. The majority of the furloughs will affect nonclinical workers.

“This will enable us to focus our resources on the functions directly related to essential COVID-19 patient care needs that we anticipate, while protecting people and helping prevent the spread of the disease,” Trinity Health of New England said in a statement to The Hartford Courant. 

April 7

1. Tulsa, Okla.-based HillCrest HealthCare System will furlough 600 employees for up to 90 days, according to local news station KRMG. The furloughs affect about 9 percent of staff and are a result of a decline in routine and elective procedures due to the COVID-19 pandemic.

2. Thomas Health System in South Charleston, W.Va., plans to furlough “less than 500” employees starting this week, according to the West Virginia Gazette Mail. In announcing the furloughs, the health system cited the suspension of nonemergent procedures due to the COVID-19 pandemic.

3. Citing a decrease in patient volume and revenue due to the pandemic, Cookeville (Tenn.) Regional Medical Center has furloughed 400 employees, according to Fox 17 News. 

“The pandemic created by COVID-19 has had a devastating impact not only in our community and state but across our entire country and the world that has required each of us to make sacrifices,” the hospital said in a statement to Fox 17 News. 

4. Cape Fear Valley Health, based in Fayetteville, N.C., plans to furlough an additional 350 employees, according to The Fayetteville Observer. The health system had already furloughed about 300 employees on March 27. The health system said since the first round of furloughs, its inpatient occupancy has dropped to 60 percent.

5. Citing a revenue and patient volume drop from the COVID-19 pandemic, Washington Court House, Ohio-based Fayette County Memorial Hospital has furloughed 71 of its 352 employees, according to radio station WKKJ. The furloughs are expected to last for 30 days.

6. M Health Fairview, a 10-hospital system in Minneapolis, is asking physicians, nurse practitioners and physician assistants in some clinics to volunteer to take a week of unpaid leave as a furlough, according to The Star Tribune.The system is taking volunteers for one-week physician furloughs through May 3. Those who volunteer will still receive benefits.

7. Mountain Home, Ark.-based Baxter Regional Medical Center plans to furlough an undisclosed number of employees to ease the financial hit from a decrease in volume and increased costs to prepare for the COVID-19 pandemic, according to local news station KTLO.  The furloughs are expected to be temporary. The hospital will reevaluate if additional measures are needed or if employees can return after four weeks.

8. Joplin, Mo.-based Freeman Health System plans to furlough an undisclosed number of employees after suspending elective procedures to prepare for the anticipated surge in COVID-19 patients, according to FourStatesHomepage.com

9. Lawrence (La.) General Hospital has placed 160 staff members on a four-week furlough, according to The Eagle Tribune. Most of the furloughs, which are expected to be temporary, affect nonclinical workers. Lawrence General has about 2,000 employees.

10. Froedtert Health has furloughed some workers, according to local news station Fox 6, which spoke to furloughed nurses from the Wauwatosa, Wis.-based system on the condition of anonymity.

April 6

1. Huntington, W.Va.-based Mountain Health Network furloughed 550 employees and cut the hours of 450, according to local news station WSAZ. The furloughs are a result of the financial and resource strain prompted by the COVID-19 pandemic.

2. LRGHealthcare, based in Laconia, N.H., plans to furlough 600 employees for up to four months to cope with the financial effects of the COVID-19 pandemic, according to the Laconia Daily Sun. Affected employees will keep their medical insurance and can receive unemployment compensation.

3. Citing a 35 percent reduction in revenue due to the COVID-19 pandemic, Columbia, Tenn.-based Maury Regional Health will furlough 340 employees this week, according to The Columbia Daily Herald. Maury Regional Health employs more than 3,000.

“We are experiencing unprecedented events as the COVID-19 pandemic evolves. After much deliberation, we were forced to make the difficult decision to furlough employees in the face of declining volumes and revenue. We plan to begin calling back employees as patient volumes normalize,” Maury Regional CEO Alan Watson told the Daily Herald.

4. Franklin, Tenn.-based Williamson Medical Center will furlough 200 employees due to a loss in revenue attributed to the COVID-19 pandemic and government mandates to postpone elective procedures, according to The Tenneseean. The furloughs, which began taking place April 1, are expected to be temporary.

5. Coos Bay, Ore.-based North Bend Medical Center has furloughed 130 employees to prepare for the novel coronavirus pandemic, according to TheWorldLink.com. The medical center is still providing insurance to the furloughed workers.

6. Citing a $16 million revenue loss in March due to the postponement of elective procedures, Sarasota (Fla.) Memorial Hospital will furlough an undisclosed number of employees, according to local news station WUSF. The hospital, which has 6,400 employees, expects to lose even more revenue in April and May due to the COVID-19 pandemic.

7. Dayton, Ohio-based Premier Health will furlough an undisclosed number of employees due to an anticipated financial hit from Ohio’s interim ban on nonessential surgeries, according to The Dayton Business Journal. The furloughs will affect employees that are not providing patient care.

8. Due to a loss in revenue and patient volume, Conway (S.C.) Medical Center plans to furlough about 100 employees who are not frontline care providers, according to WMBF. The hospital said the mandate on suspending elective procedures caused the revenue and volume drop.

April 3

1. Burlington, Mass.-based Wellforce, which includes four community hospitals, one academic medical center and a children’s hospital, has furloughed 719 workers, according to the Boston Business Journal. The affected employees will be furloughed for at least 90 days to help the system deal with the drastic volume decrease from suspending elective procedures. In addition, 1,236 employees will have their hours and pay reduced, according to the report.

2. Southbridge, Mass.-based Harrington Healthcare has furloughed 131 employees across its network this week, according to MassLive. About 20 of the 131 affected employees were “partially furloughed,” meaning their hours were significantly reduced, according to the report. Chris Canniff, the company’s vice president of administration and human resources, said the provider has seen a 50 percent decline in patient volume amid the COVID-19 pandemic. Furloughed employees will not be paid for four weeks.

3. Seattle-based Virginia Mason Medical Center said it has seen a 30 percent decline in revenue since the COVID-19 pandemic started and Gov. Jay Inslee ordered hospitals to suspend elective procedures. As a result, the system is furloughing an undisclosed number of employees, according to local station K5 News. Most of the affected employees are in nonclinical roles.

“We rely substantially on outpatient revenue to ensure our financial viability,” wrote medical center executives in an internal memo to Virginia Mason leaders obtained by K5 News. “This is an unprecedented time and it calls for drastic measures.”

4. Citing drastic revenue decreases and increased expenses, Columbus, Ohio-based Mount Carmel Health System will furlough nonclinical staff, according to ABC 6. The health system said fewer than 500 employees will be affected. The system employs more than 10,000. In addition to the furloughs, the health system is implementing pay cuts for executives and physicians, according to the report.

5. Atlantic City, N.J.-based AtlantiCare has furloughed some of its workers due to the COVID-19 pandemic, according to NJ.com. In addition, the system has asked staff members, including nurses and physicians, to voluntarily take a furlough or a reduction in their hours, according to Press of Atlantic City. The staffing changes began taking place March 30. The changes are considered temporary, and affected employees will keep their benefits.

6. Citing a drop in patient revenue due to government mandates to help the COVID-19 pandemic, Dayton, Ohio-based Kettering Health Network is placing some of its employees on furlough, according to the Dayton Business Journal. 

7. New Bedford, Mass.-based Southcoast Health will furlough some staff not actively involved in patient care efforts because the health system is absorbing a deep revenue hit, according to Southcoast Today. The health system will pay a portion of furloughed employees’ insurance premiums through June 30.

April 2

1. Livonia, Mich.-based Trinity Health plans to furlough 2,500 employees. The system made the decision to help offset the financial hit from COVID-19. Most of the affected employees are in nonclinical roles.

2. Boston Medical Center is furloughing 700 staff members, or 10 percent of its workforce, due to financial losses from the COVID-19 pandemic. Kate Walsh, CEO of Boston Medical Center, told The Globe that the hospital has lost about $5 million in revenue per week, and that the furloughs will help save the system about $1 million per week.

3. Citing a revenue hit from the COVID-19 pandemic, Cincinnati-based Bon Secours Mercy Health will furlough 700 employees and freeze wages of all nonclinical personnel. The furloughs are expected to begin next week and last 30 to 90 days, depending on how long the pandemic lasts, according to Bon Secours Mercy Health CEO John Starcher. Bon Secours Mercy Health estimates it will see an operating loss of at least $100 million per month while the pandemic lasts.

4. Citing a severe disruption in services due to the COVID-19 pandemic, Duluth, Minn.-based Essentia Health has placed about 500 nonclinical staff on administrative leave.

5. Hartford-based Connecticut Children’s Medical Center is furloughing 400 employees across its system due to the expected financial hit from COVID-19, according to The Hartford Courant. The system said its patient volume has been cut in half due to halting elective procedures. Furloughed employees are mainly nonclinical workers, and are expected to return to work in early June, or when elective procedures can resume.

6. Clay County Medical Center, a 25-bed hospital in Clay Center, Kan., has furloughed 25 percent of its staff in response to the COVID-19 pandemic, according to The Clay Center Dispatch. It has about 300 employees, according to its website.

7. Williamson Medical Center in Franklin, Tenn., will temporarily furlough 200 employees to sustain its financial resources during the COVID-19 pandemic.

8. Dallas-based Steward Health Care is informing employees to expect furloughs at its facilities across the U.S. as the system works to overcome the “seismic shock” of the COVID-19 pandemic. The health system said it has started a temporary furlough program for some employees of its hospitals in nine states. Most affected staff work in nonclinical jobs.

9. Huntsville (Ala.) Hospital System, faced with expenses and a loss of revenue due to the novel coronavirus, has implemented a cost reduction plan that includes furloughs, according to AL.com. Huntsville Hospital said April 9 that it had to furlough or cut hours for 2,000 employees.

10. Syracuse, N.Y.-based St. Joseph Health plans to furlough an undisclosed number of workers as it prepares to deal with an “unprecedented fiscal fallout” from the COVID-19 pandemic, Syracuse.com reports. St. Joseph Health will also cut pay for senior management.

11. Baptist Health in Little Rock, Ark., has started furloughing an undisclosed number of employees this week to address an expected revenue loss from the pandemic.

12. Little Rock-based Arkansas Heart Hospital has furloughed workers due to the interruption of normal hospital operations.

March 27 to April 1

1. Citing the financial hit from the COVID-19 pandemic, Greenville, S.C.-based Prisma Health said it will furlough an undisclosed number of clinical, corporate and administrative workers. On April 9, Prisma Health executives told legislators that it was forced to furlough or cut hours for 3,900 of its 30,000 person workforce, according to The State.

2. Chattanooga, Tenn.-based Erlanger Health System said it is implementing a cost-reduction plan that includes furloughs and pay reductions for leadership. The moves were prompted by the COVID-19 pandemic. Administrative employees also are affected by the furlough.

3. Appalachian Regional Healthcare, a 13-hospital system in Lexington, Ky., will furlough about 500 employees due to a sharp reduction in business and revenue.  In addition to the financial aspect, Appalachian Regional said its decision was to protect employees not involved in direct patient care from contracting the novel virus and ensure that the health system has enough supplies to treat the anticipated surge of COVID-19 patients.

4. Cleveland-based St. Vincent Charity Medical Center has furloughed about 70 employees amid the COVID-19 pandemic. Affected employees include nurses, surgical assistants, clerical and other support staff.

5. Morehead, Ky.-based St. Claire HealthCare announced it will furlough 300 employees who are not involved in direct patient care to ensure it can sustain clinical operations during and after the COVID-19 pandemic.

6. Astoria, Ore.-based Columbia Memorial Hospital has furloughed 90 of its 740 employees after the facility scaled back nonemergent procedures to concentrate on the coronavirus.

7. Citing the spreading and unforgiving demands of the COVID-19 pandemic, Canton, Ohio-based Mercy Medical Center has furloughed workers. The move came shortly after the state ordered hospitals to suspend elective surgeries and procedures to free up capacity and supplies to treat COVID-19 patients.The number of staff affected was not disclosed.

8. Meadville (Pa.) Medical Centehas furloughed more than 225 employees to ensure the hospital’s financial stability. The hospital said the furlough is expected to last through April 5, but warned an extension is possible if the pandemic continues to affect business operations and revenue.

9. To help the system survive the economic challenges linked to the COVID-19 pandemic, Rockford, Ill.-based Mercyhealth has furloughed an undisclosed number of employees who are not providing direct patient care.

10. In response to the COVID-19 pandemic, Lewisburg, Pa.-based Evangelical Community Hospital has furloughed a “significant” number of employees who are not involved in direct patient care.