Category Archives: Evidence-Based Plan

2020 Health Care Legislative Guide

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https://unitedstatesofcare.org/resources/2020-health-care-legislative-guide/

Pennsylvania 2020 Health Care Legislative Guide - United States of Care

ABOUT THE UNITES STATES OF CARE

United States of Care is a nonpartisan nonprofit working to ensure every person in America has access to
quality, affordable health care regardless of health status, social need or income. USofCare works with elected
officials and other state partners across the country by connecting with our extensive health care expert
network and other state leaders; providing technical policy assistance; and providing strategic communications
and political support. Contact USofCare at help@usofcare.org

Health care remains one of the most important problems facing America.

Voters are concerned about access to and the cost for health care and insurance.

Health Care During the COVID Pandemic
The COVID-19 pandemic has illuminated the need for effective solutions that address both the immediate
challenges and the long-term gaps in our health care systems to ensure people can access quality health care
they can afford. Americans are feeling a mix of emotions related to the pandemic, and those emotions are
overwhelmingly negative.*

In addition, the pandemic has illuminated deficiencies of our health care system.

People feel that the U.S. was caught unprepared to handle the pandemic and our losses have
been greater than those of other countries.

People blame government for the inadequate pandemic response, not health care systems.

Health Care During the COVID Pandemic

The COVID-19 pandemic has illuminated the need for effective solutions that address both the immediate challenges and the long-term gaps in our health care systems to ensure people can access quality health care they can afford. In the wake of COVID, policymakers have a critical opportunity to enact solutions to meet their constituents’ short- and long-term health care needs. The 2020 Health Care Legislative Candidate Guide provides candidates with public opinion data, state-specific health care information, key messages and ideas for your health care platform.

Key Messages for Candidates:

  • Acknowledge the moment: “Our country is at a pivotal moment. The pandemic, economic recession, and national discussion on race have created a renewed call for action. They have also magnified the critical problems that exist in our health care system.”
  • Take an active stance: “It is long past time to examine our systems and address gaps that have existed for decades. We must find solutions and common ground to build a health care system that serves everyone.”
  • Commit to prioritizing people’s needs: “I will put people’s health care needs first and I’m already formalizing the ways I gather input and work with community and business leaders to put effective solutions in place.”
  • Commit to addressing disparities and finding common ground: “The health care system, as it’s currently structured, isn’t working for far too many. I will work to address the lack of fairness and shared needs to build a health care system that works for all of us.”

Click to access USC_Generic_CandidateEducationGuide.pdf

 

 

Promising State Policies to Respond to People’s Health Care Needs

In the wake of COVID, policymakers have a critical opportunity to enact solutions to meet their constituents’
short- and long-term health care needs. Shared needs and expectations are emerging in response to the
pandemic, including the desire for solutions that:

Ensure individuals are able to provide for themselves and their loved ones, especially those worried about
the financial impact of the pandemic.

• Protect against high out-of-pocket costs.
• Expand access to telehealth services for people who prefer it to improve access to care.
• Extend Medicaid coverage for new moms to remove financial barriers to care to support healthier moms
and babies.

Ensure a reliable health care system that is fully resourced to support essential workers and available when
it is needed, both now and after the pandemic.

• Ensure safe workplaces for front-line health care workers and essential workers and increase the capacity to
maintain a quality health care workforce.
• Support hospitals and other health care providers, particularly those in rural or distressed areas.
• Expand mental health services and community workforce to meet increased need.

Ensure a health care system that cares for everyone, including people who are vulnerable and those who
were already struggling before the pandemic hit.

• Adopt an integrated approach to people’s overall health by coordinating people’s physical health, behavioral health
and social service needs.
• Establish coordinated data collection to quickly address needs and gaps in care, especially in vulnerable
communities.

Provide accurate information and clear recommendations on the virus and how to stay healthy and safe.
• Build and maintain capacity for detailed and effective testing and surveillance of the virus.
• Resource and implement contact tracing by utilizing existing programs in state health departments, pursuing
public-private partnerships, or app-based solutions while also ensuring strong privacy protections.

 

BY THE NUMBERS

The pandemic is showing different impacts for people across the country
that point to larger challenges individuals and families are grappling.

A disproportionate number of those infected by COVID-19 are Black, Indigenous, and people of color. According to recent CDC data, 31.4% of cases and 17% of deaths are among Latino residents and 19.9% of cases and 22.4% of deaths were among Black residents.ix They make up 18.5% and 13.4% of the total population, respectively.

Seniors are at greatest risk. According to a CDC estimate on August 1, 2020, 80% of COVID-19 deaths were among patients ages 65 and older. In 2018, only 16% of Americans were in this age range.

Access to health care in rural areas has only become more challenging during the pandemic and will likely have lasting impacts on rural communities.

The economic fallout of the pandemic has caused nearly 27 million Americans to lose their employer-based health insurance. An estimated 12.7 million would be eligible for Medicaid; 8.4 million could qualify for subsidies on exchanges; leaving 5.7 million who would need to cover the cost of health insurance policies (COBRA policies averaged $7,188 for a single person to $20,576 for a family of four) or remain uninsured.

 

History tells us trying to stop diseases like COVID-19 at the border is a failed strategy

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Culture, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Failed, Failed Repeatedly, Failure, False Hope, False Narrative, Germ Theory, Health Policy, Individualism, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Misinformation, Misinterpret, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Partisanship, Public Health, Public Opinion, Public Perception, Public Safety, Public Schools, Public Trust, Quarantine, School Reopening, Scientists, Social Distancing • Leave a comment

https://theconversation.com/history-tells-us-trying-to-stop-diseases-like-covid-19-at-the-border-is-a-failed-strategy-145016?utm_medium=email&utm_campaign=Latest%20from%20The%20Conversation%20for%20August%2028%202020%20-%201715916573&utm_content=Latest%20from%20The%20Conversation%20for%20August%2028%202020%20-%201715916573+Version+A+CID_8719e3ecf842bc9762e48ce42f2ba6ad&utm_source=campaign_monitor_us&utm_term=History%20tells%20us%20trying%20to%20stop%20diseases%20like%20COVID-19%20at%20the%20border%20is%20a%20failed%20strategy

History tells us trying to stop diseases like COVID-19 at the border is a failed strategy

To explain why the coronavirus pandemic is much worse in the U.S. than anywhere else in the world, commentators have blamed the federal government’s mismanaged response and the lack of leadership from the Trump White House.

Others have pointed to our culture of individualism, the decentralized nature of our public health, and our polarized politics.

All valid explanations, but there’s another reason, much older, for the failed response: our approach to fighting infectious disease, inherited from the 19th century, has become overly focused on keeping disease out of the country through border controls.

As a professor of medical sociology, I’ve studied the response to infectious disease and public health policy. In my new book, “Diseased States,” I examine how the early experience of outbreaks in Britain and the United States shaped their current disease control systems. I believe that America’s preoccupation with border controls has hurt our nation’s ability to manage the devastation produced by a domestically occurring outbreak of disease.

Germ theory and the military

Though outbreaks of yellow fever, smallpox, and cholera occurred throughout the 19th century, the federal government didn’t take the fight against infectious disease seriously until the yellow fever outbreak of 1878. During that same year, President Rutherford B. Hayes signed the National Quarantine Act, the first federal disease control legislation.

By the early 20th century, a distinctly American approach to disease control had evolved: “New Public Health.” It was markedly different from the older European concept of public health, which emphasized sanitation and social conditions. Instead, U.S. health officials were fascinated by the newly popular “germ theory,” which theorized that microorganisms, too small to be seen by the naked eye, caused disease. The U.S. became focused on isolating the infectious. The typhoid carrier Mary Mallon, known as “Typhoid Mary,” was isolated on New York’s Brother Island for 23 years of her life.

Originally, the military managed disease control. After the yellow fever outbreak, the U.S. Marine Hospital Service (MHS) was charged with operating maritime quarantine stations countrywide. In 1912, the MHS became the U.S. Public Health Service; to this day, that includes the Public Health Service Commissioned Corps led by the surgeon general. Even the Centers for Disease Control and Prevention started as a military organization during World War II, as the Malaria Control in War Areas program. Connecting the military to disease control promoted the notion that an attack of infectious disease was like an invasion of a foreign enemy.

Germ theory and military management put the U.S. system of disease control down a path in which it prioritized border controls and quarantine throughout the 20th century. During the 1918 influenza pandemic, New York City held all incoming ships at quarantine stations and forcibly removed sick passengers into isolation to a local hospital. Other states followed suit. In Minnesota, the city of Minneapolis isolated all flu patients in a special ward of the city hospital and then denied them visitors. During the 1980s, the Immigration and Naturalization Service denied HIV-positive persons from entering the country and tested over three million potential immigrants for HIV.

Defending the nation from the external threat of disease generally meant stopping the potentially infectious from ever entering the country and isolating those who were able to gain entry.

Our mistakes

This continues to be our predominant strategy in the 21st century. One of President Trump’s first coronavirus actions was to enforce a travel ban on China and then to limit travel from Europe.

His actions were nothing new. In 2014, during the Ebola outbreak, California, New York and New Jersey created laws to forcibly quarantine health care workers returning from west Africa. New Jersey put this into practice when it isolated U.S. nurse Kaci Hickox after she returned from Sierra Leone, where she was treating Ebola patients.

In 2007, responding to pandemic influenza, the Department of Homeland Security and the CDC developed a “do not board” list to stop potentially infected people from traveling to the U.S.

When such actions stop outbreaks from occurring, they are obviously sound public policy. But when a global outbreak is so large that it’s impossible to keep out, then border controls and quarantine are no longer useful.

This is what has happened with the coronavirus. With today’s globalization, international travel, and an increasing number of pandemics, attempting to keep infectious disease from ever entering the country looks more and more like a futile effort.

Moreover, the U.S. preoccupation with border controls means we did not invest as much as we should have in limiting the internal spread of COVID-19. Unlike countries that mounted an effective response, the U.S. has lagged behind in testing, contact tracing, and the development of a robust health care system able to handle a surge of infected patients. The longstanding focus on stopping an outbreak from ever occurring left us more vulnerable when it inevitably did.

For decades, the U.S. has been underfunding public health. When “swine flu” struck the country in 2009, the CDC said 159 million doses of flu shots were needed to cover “high risk” groups, particularly health care workers and pregnant women. We only produced 32 million doses. And in a pronouncement that now looks prescient, a Robert Wood Johnson Foundation report said if the swine flu outbreak had been any worse, U.S. health departments would have been overwhelmed. By the time Ebola appeared in 2014, the situation was no better. Once again, multiple government reports slammed our response to the outbreak.

Many causes exist for the U.S.‘s failed response to this crisis. But part of the problem lies with our past battles with disease. By emphasizing border controls and quarantine, the U.S. has disregarded more practical strategies of disease control. We can’t change the past, but by learning from it, we can develop more effective ways of dealing with future outbreaks.

 

 

 

 

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

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

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

 

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

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

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

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

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

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

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

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

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

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

On that day alone.

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

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

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

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

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

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

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

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

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

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

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

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

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

 

 

 

Cartoon – Covid Facts Don’t Matter

Posted on by • Posted in 2020 Election Issues, Cartoon, Coronavirus, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expert, Expert Opinion, Fact-Denying Populism, Facts, False Hope, False Narrative, Infection Control, Infection Control Plan, Infectious Virus, Misinformation, Misinterpret, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Partisanship, Public Health, Public Opinion, Public Perception, Public Safety, Public Schools, Public Trust, Quarantine, School Reopening, Scientists, Social Distancing, Wishful Thinking • Leave a comment

Facts Don't Matter (cncartoons033663-514) | Speak Up For Success

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

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

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

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

TOPLINE

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

 

KEY FACTS

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

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

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

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

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

 

BIG NUMBER

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

 

SURPRISING FACT

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

 

KEY BACKGROUND

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

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

 

 

 

 

New unemployment claims top 1 million. Again.

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

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

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

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

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

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

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

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

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

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

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

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

 

 

 

 

Notre Dame cancels in-person classes after surge of COVID-19 cases

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Infection Control, Infection Control Plan, Infectious Virus, Mortality, National Strategy, Pandemic, Public Health, Public Opinion, Public Perception, Public Safety, Public Trust, School Reopening, Scientists • Leave a comment

https://www.axios.com/notre-dame-cancels-classes-coronavirus-a7bd3249-f757-44a9-baf8-fb4de0bbefa3.html?stream=health-care&utm_source=alert&utm_medium=email&utm_campaign=alerts_healthcare

The University of Notre Dame announced Tuesday that it is canceling in-person classes for at least two weeks following a spike in coronavirus cases.

Why it matters: Notre Dame is the second prominent university to announce this week that it would revert back to remote learning, following the the University of North Carolina at Chapel Hill on Tuesday. The reversals underscore the challenges facing colleges and universities as more students are set return to campus.

Between the lines: As was the case with UNC, most of the COVID-19 infections at Notre Dame have been linked to off-campus parties.

  • The nearly 12,000 students that returned to Notre Dame were all tested before arriving on campus on Aug. 10, and just 33 tested positive, according to the Journal.
  • Through Monday, 147 of the 927 students who had shown symptoms tested positive for the virus — a sharp uptick in the positivity rate.

What they’re saying: “Our contact-tracing analysis indicates that most infections are coming from off-campus gatherings,” said University of Notre Dame President Rev. John Jenkins. “Students infected at those gathering passed it on to others, who in turn have passed the virus on to others, resulting in the positive cases we have seen.”

  • “For your sake and the sake of our community and for continuing our semester on campus, please observe health protocols and avoid behavior that puts yourself or others at risk,” Jenkins added.

 

 

 

 

Medicaid Is Essential for Workers

Posted on by • Posted in 2020 Election Issues, Coronavirus, Employer-Based Health Insurance, Essential Health Benefits, Essential Workers, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Front Lines, Health Insurance Coverage Adequacy, Health Policy, Medicaid, Medicaid Expansion, Mortality, Outcomes, Pandemic, Public Health, Public Safety • Leave a comment

Medicaid Is Essential for Workers as COVID-19 Spreads

Earlier this year, when public schools in Kansas City, Missouri, shut down in-person instruction because of the COVID-19 pandemic, Nika Cotton quit her job in social work to start her own business. She has two young children — ages 8 and 10 — and no one to watch them if she were to continue working a traditional job.

It was a big decision, made weightier by the loss of her employer-sponsored health insurance. But on August 5, Cotton awoke to the news that Missouri voters had narrowly approved the expansion of the state’s Medicaid program via ballot initiative, making it the second politically right-leaning state to do so during the pandemic. The expansion opens Medicaid eligibility to individuals and families with incomes up to 138% of the federal poverty guidelines, which are $12,760 for an individual and $21,720 for a family of three, allowing Cotton’s family of three to qualify.

“It takes a lot of stress off of my shoulders with having to think about how I’m going to take care of myself, how I’m going to be able to go and see a doctor and get the health care I need while I’m starting my business,” she told Alex Smith of KCUR, the NPR affiliate in Kansas City.

Nearly 1,264,000 voters weighed in on the measure, with 53% voting for it and 47% against it. Missouri’s Republican governor Mike Parson opposed it, arguing that the state could not afford the coverage expansion — even though the federal government pays 90% of the costs and a fiscal analysis (PDF) by the Center for Health Economics and Policy at Washington University estimated that the state would save $39 million if it implemented Medicaid expansion in 2020.

The ballot measure requires the state to expand Medicaid by July 2021, and an estimated 230,000 residents with low incomes will become eligible for affordable health coverage.

Voters Signal Support

In late June, Oklahoma voters also approved Medicaid expansion by ballot measure, eking out a victory by less than one percentage point.

“It is difficult to ignore that these ballot initiatives passed in right-leaning states in the middle of the coronavirus pandemic, when millions of Americans have lost their jobs and, with them, their employer-sponsored health insurance,” Dylan Scott wrote in Vox. “This is partly a coincidence — the signatures were collected to put the Medicaid expansion questions on the ballot long before COVID-19 ever arrived in the US — but the relatively narrow margins made me wonder if the pandemic and its economic and medical consequences proved decisive.”

Earlier this year, Scott spoke to Cynthia Cox, MPH, director of the Peterson-Kaiser Health System Tracker, about the potential impact of the pandemic on health care politics. “Many of the biggest coverage expansions both in the US and in similar countries happened in the context of wars and social upheavals, as well as financial crises,” Cox said. “One theory is that those circumstances redefine social solidarity, thus expanding views of the role of government.”

Between February and May, Missouri’s Medicaid program saw enrollment rise nearly 9%, one of the largest increases nationwide during the pandemic, Rachel Roubein reported in Politico. During that same period, Oklahoma’s Medicaid program saw enrollment increase by about 6%.

States that implemented Medicaid expansion are better positioned to respond to COVID-19, according to a report by the Center on Budget and Policy Priorities (CBPP). These states entered the health crisis and resulting economic downturn with lower uninsured rates, which is important for public health “because people who are uninsured may forgo testing or treatment for COVID-19 due to concerns that they cannot afford it, endangering their health while slowing detection of the virus’ spread,” the authors wrote.

CBPP and KFF estimate that 3.6 to 4.4 million uninsured adults would become eligible for Medicaid coverage if the 12 states that have not yet expanded the program did so. Those states are Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, and Wyoming.

Coverage for Frontline Essential Workers

Medicaid is particularly important for frontline essential workers — such as those working in grocery stores, meat processing plants, and nursing homes — during the pandemic. Their jobs require them to report in person, increasing their risk of getting sick with the coronavirus as they interact with coworkers and, in many cases, with customers and patients. Essential workers are often paid low wages and not offered employer-sponsored health insurance or can’t afford the premiums for it.

About 5 million essential workers nationwide get health coverage through Medicaid, “including nearly 1.8 million people working in frontline health care services and 1.6 million in other frontline essential services including transportation, waste management, and child care,” Matt Broaddus, senior research analyst at CBPP, wrote on the center’s blog.

In California, over 950,000 essential workers are enrolled in Medi-Cal, the state’s Medicaid program. People of color are overrepresented in many categories of essential jobs. According to a UC Berkeley Labor Center analysis of the 15 largest frontline essential occupations, Latinx workers are overrepresented in agriculture, construction, and food preparation, among other occupations. Asian workers are overrepresented among registered nurses and personal care aides; and Black workers are overrepresented among personal care aides, laborers and material movers, and office clerks.

In addition to low-wage workers, Medi-Cal continues to bridge the coverage gap for other key populations amid the COVID-19 crisis, which is magnifying historical health inequities. (Medi-Cal covers nearly 40% of the state’s children, half of Californians with disabilities, and over one million seniors. For a refresher on the program, see CHCF’s Medi-Cal Explained series.)

Medicaid Saves Lives

Research has shown time and time again the varied benefits of Medicaid expansion: lower mortality rates among older adults with low incomes, declines in infant mortality, reductions in racial disparities in the care of cancer patients, and fewer personal bankruptcies, just to name a few.

Even though Missouri’s Medicaid expansion won’t take effect for another year, Nika Cotton remains excited. “It’s better late than never,” she said. “The fact that it’s coming is better than nothing” — perhaps a takeaway for the remaining 12 states.

 

 

 

 

Cartoon – What does your mask say about you?

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Jim Morrissey: What does your coronavirus mask say about you ...

U.S. doing a lot less coronavirus testing

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

https://www.axios.com/newsletters/axios-vitals-32689a40-e409-4547-8468-b03dc589c082.html

The two sides of America's coronavirus response - Axios

The U.S. is cutting back on coronavirus testing. Nationally, the number of tests performed each day is about 17% lower than it was at the end of July, and testing is also declining in hard-hit states.

Why it matters: This big reduction in testing has helped clear away delays that undermined the response to the pandemic. But doing fewer tests can also undermine the response to the pandemic.

By the numbers: At the end of July, America was doing more than 800,000 tests a day. This week, it’s hovered around 715,000.

  • Even as states with particularly bad outbreaks pull back on their testing, the proportion of tests coming back positive is still high — which would normally be an indication that they need to be doing more tests.
  • In Texas, 19% of tests are coming back positive, according to Nephron Research. In Florida, the rate of positive tests is 18%, and in Nevada, 17%.

Yes, but: Experts have said reducing the demand for testing may be the best way to alleviate long delays, which made tests all but useless. And that appears to be working.

Driving the news: The Department of Health and Human Services estimated this week that nearly 90% of all tests are being completed within three days — a big improvement from turnaround times that had been stretching well over a week.

  • Quest Diagnostics says its expected turnaround time is now 2–3 days, and less for priority patients. LabCorp announced a similar turnaround time last week.

The bottom line: The U.S. is averaging 50,000 new cases a day, and that high caseload is ultimately why the demand for testing is more than the system can handle.

  • We can’t get our caseload under control without fast, widespread testing, but we can’t achieve fast, widespread testing with such a high caseload.