The president’s comments at a recent rally are false and contribute to the spread of misinformation, they say.
Hospital groups are pushing back against President Trump’s claims this week that doctors are over-reporting COVID-19 deaths for financial gain. Trump made the comments at a Wisconsin rally on Saturday.
“You know some countries they report differently,” Trump is quoted as saying in Newsweek. “If somebody’s sick with a heart problem, and they die of COVID they say they die of a heart problem. If somebody’s terminally ill with cancer and they have COVID, we report them. And you know doctors get more money and hospitals get more money. Think of this incentive. … We’re going to start looking at things.”
WHAT’S THE IMPACT
Hospitals and health systems are eligible to receive higher payments for complex coronavirus-related treatment under the Coronavirus Aid, Relief and Economic Security Act, under which they receive a Medicare add-on payment of 20%. However, American Hospital Association President and CEO Rick Pollack refuted Trump’s claims.
Asked to respond, the AHA referred to a viewpoint article written by Pollack in September, in which he sought to dispel what he called certain “myths.”
“Hospitals do not receive extra funds when patients die from COVID-19,” Pollack said. “They are not over-reporting COVID-19 cases. And they are not making money on treating COVID-19.
“The truth is,hospitals and health systems are in their worst financial shape in decades due to the coronavirus. In some cases, the situation is truly dire. An AHA report estimates total losses for our nation’s hospitals and health systems of least $323 billion in 2020. There is no windfall here.”
Pollack also noted that healthcare organizations adhere to strict coding guidelines and use the COVID-19 code for Medicare claims only for confirmed cases. Inappropriate coding can result in criminal penalties and exclusion from the Medicare program altogether.
In a more recent and direct response to the president’s latest comments, American Medical Association President Dr. Susan Bailey bemoaned that physicians are being pulled into a public battle over the legitimacy and motivation behind their work.
“The assault on public health and the undermining of efforts to defeat COVID-19 began with unfounded suspicions about the science and evidence of this novel coronavirus and how it spreads,” Bailey said on Tuesday. “It grew with speculation about harmful and unproven treatments for COVID-19, false claims that masks were a source of infections, and by misleading suggestions that increased testing alone explains why case counts are surging.
“It expanded again with inaccurate, dangerous statements about children being ‘almost immune’ from the most serious effects of COVID-19, a reckless plan of ‘focused protection’ and naturally acquired ‘herd immunity’ as a pathway out of this pandemic, and most recently with wild and highly offensive claims that physicians are inflating the number of COVID-19 cases and deaths to increase our incomes.”
Bailey said that many public health officials have been threatened and intimidated, prompting some to quit or retire, and decried the “campaign of misinformation” as a betrayal of public trust that threatens the work being done to treat and contain the virus.
“Our AMA will always stand on the side of patients and physicians, of science and evidence, and of free and honest conversations that build the trust that is so crucial to our work,” she said. “We will not hesitate to call out political intimidation and fear-driven rhetoric that undermines this trust or that interferes with our ability to deliver the very best care to patients.”
The American College of Emergency Physicians also issued a statement, calling Trump’s assertions “reckless” and “false.”
“To imply that emergency physicians would inflate the number of deaths from this pandemic to gain financially is offensive, especially as many are actually under unprecedented financial strain as they continue to bear the brunt of COVID-19,” ACEP wrote. “These baseless claims not only do a disservice to our health care heroes but promulgate the dangerous wave of misinformation which continues to hinder our nation’s efforts to get the pandemic under control and allow our nation to return to normalcy.”
THE LARGER TREND
The numbers of COVID-19 cases continue to bring grim news, especially in the U.S., which struggled early in the pandemic to secure testing capacity and necessary personal protective equipment for frontline healthcare workers.
As of Wednesday morning, the Johns Hopkins University coronavirus tracker showed more than 8.7 million confirmed cases of the virus in the U.S., with the death toll climbing to over 226,000. Both lead the world. Second on the list is India (7,990,322 cases, 120,010 deaths), while Brazil comes in third (5,439,641 cases, 157,946 deaths).
In Thursday’s second and final Presidential debate, former Vice President Joe Biden warned that a “dark winter” lies ahead in the coronavirus pandemic, and with cases, hospitalizations, and deaths on the rise across the country, it now appears that we are headed into a “third wave” of infections that may prove worse than both the initial onset of COVID on the coasts and the summertime spike in the Sun Belt.
Yesterday more than 71,600 new cases were reported nationwide, nearing a late-July record. Thirteen states hit record-high hospitalizations this week, measured by weekly averages, most in the Midwest and Mountain West. Several Northeastern states, which had previously brought the spread of the virus under control, also experienced substantial increases in infections, leading schools in Boston to suspend all in-person instruction. Of particular concern is hospital capacity, which is already being strained in the more rural areas now being hit by COVID cases. With infection spikes more geographically widespread than in earlier waves, fewer medical workers are available to lend support to hospitals in other states, leading to concerns about hospital staffing as admissions rise.
As hospitalizations increase, so too will demand for therapeutics to help shorten the course and moderate the impact of COVID. This week, Gilead Sciences’ antiviral drug remdesivir, previously available under an Emergency Use Authorization (EUA) from the federal government, became the first drug to win full approval from the Food and Drug Administration (FDA) to treat patients hospitalized with COVID-19. The approval was based on clinical studies that showed that remdesivir can reduce recovery time, and also includes use for pediatric COVID patients under the age of 11.
Meanwhile, the FDA cleared AstraZeneca to resume US clinical trials of its coronavirus vaccine, which had been suspended for a month following an adverse patient event. It’s widely expected that one or more drug companies will submit their vaccine candidates for EUA sometime next month, although new polling data released this week indicates that the American public is growing more skeptical in their willingness to take an early vaccine against the virus, with only 58 percent of respondents saying they would get the shot when it first becomes available, down from 69 percent in August. (Only 43 percent of Black respondents say they would get the vaccine, compared to 59 percent of Whites—a racial divide that reveals deep distrust based on the history of inequities in the US healthcare system.)
In many respects, the coming month will surely prove to be a pandemic turning point, revealing the magnitude of the next wave of COVID, the direction of US public health policy, the prospects for reliable therapeutics, and the timing of a safe and effective vaccine. We’ll soon know whether we are, indeed, headed for a winter of darkness.
President Trump repeated baseless claims at the final presidential debate that the coronavirus “will go away” and that the U.S. is “rounding the turn,” while Joe Biden argued that any president that has allowed 220,000 Americans to die on his watch should not be re-elected.
Why it matters: The U.S. is now averaging about 59,000 new coronavirus infections a day, and added another 73,000 cases on Thursday, according to the Covid Tracking Project. The country recorded 1,038 deaths due to the virus Thursday, the highest since late September.
What they’re saying: “More and more people are getting better,” Trump said. We have a problem that’s a worldwide problem. This is a worldwide problem. But I’ve been congratulated by the heads of many countries on what we’ve been able to do … It will go away and as I say, we’re rounding the turn. We’re rounding the corner. It’s going away.”
Trump later disputed warnings by public health officials in his administration that the virus would see a resurgence in the winter, claiming: “We’re not going to have a dark winter at all. We’re opening up our country.”
Biden responded: “Anyone responsible for that many deaths should not remain as president of the United States of America.”
“What I would do is make sure we have everyone encouraged to wear a mask all the time. I would make sure we move in the direction of rapid testing, investing in rapid testing.”
“I would make sure that we set up national standards as to how to open up schools and open up businesses so they can be safe and give them the wherewithal, the financial resources, to be able to do that.”
The bottom line:Biden and Trump are living in two different pandemic realities, but Biden’s is the only one supported by health experts.
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HENRY KOTULA 