Two injured in shooting at clinic near Vancouver’s PeaceHealth Southwest Medical Center

https://www.kgw.com/article/news/crime/peacehealth-southwest-on-lockdown-after-report-of-shooting-nearby/283-f56b3c79-0032-49ac-9bf7-b83683ba9d37

2 people injured in shooting near PeaceHealth Southwest Medical Center in  Vancouver | | kptv.com

Two people were injured in a shooting at a medical facility near PeaceHealth Southwest Medical Center in Vancouver on Tuesday afternoon. 

Both were immediately taken to the nearby PeaceHealth emergency room for treatment, according to a hospital spokesperson.

The victims’ conditions and identities were not released. But there is no longer any danger to the public, said PeaceHealth spokesperson Randy Querin.

Police were called to the shooting just before 1 p.m. at 505 NE 87th Ave. Security officers put the nearby PeaceHealth campus into modified lockdown, with most entrances closed.

“I heard shots,” said Gaye Lynn Cook who was in the building for an eye appointment. “We were told to go down the hall and hide in the rooms.”

Just after 2:30 p.m., Querin said, “The situation is now safely contained, and both the 505 building and PeaceHealth Southwest Medical Center are all clear, no longer in lockdown.”

Querin said facilities inside the 505 Building include a vision center, oncology clinic, maternal fetal medicine, family medicine and a sleep disorders clinic.

No more snow days in the clinic

https://mailchi.mp/e38b070b8787/the-weekly-gist-december-18-2020?e=d1e747d2d8

Snow Days and Health Care…No Such Thing. | The CureTalks Blog

It turns out it’s not just the kids who aren’t getting snow days this year. This week, we spoke with an executive at a health system hit hard by Wednesday’s Nor’easter, and asked how the system was faring with the expected 18 inches of snowfall. He replied that the medical group was as busy as usual.

With all the work this spring to expand telemedicine capabilitiesclinic staff were able to reach out to patients the day before the storm, and proactively convert a majority of scheduled in-person clinic visits to telemedicine. “Normally we would’ve been closed, and most appointments rescheduled for weeks down the road,” he told us. Instead, they were able to keep most of those visits in their scheduled time slot.

Now that we have a systemwide process for telemedicine, I don’t think we’ll have a reason for the clinic to take a snow day again.” It’s a clear win-win for the system and patients: patient care seamlessly goes on. It’s easy to see the many use cases for the ability to toggle between in-person and virtual visits. A parent is stuck at home with a sick kid, and can’t make her endocrinologist appointment? Moved to virtual! A patient has an unexpected business trip taking him out of town? Don’t cancel, let’s do that follow-up visit via telemedicine.

We’ve been worried about the slowdown in progress made on telemedicine as patients switched back to in-person visits across the summer and fall. The ability to continue patient care during a record-breaking snowstorm is a perfect illustration of why it’s critical not to “backslide” with virtual care: meeting patients where they are, regardless of circumstances, is an essential part of building long-term loyalty and care continuity.

Los Angeles hospitals brace for care rationing

Rising Covid cases means Americans may face health care rationing. Here's  how they view that.

Several hospitals in Los Angeles County are preparing for the possibility of restrategizing care delivery in the coming weeks amid growing COVID-19 hospitalizations, according to the Los Angeles Times.

Los Angeles County reported 6,018 COVID-19 hospitalizations Dec. 20 — a 2.5 percent increase from the day prior — with 1,198 patients in ICUs, according to the state’s data dashboard. Statewide, 17,750 patients are hospitalized with COVID-19, 3,710 of them in ICUs. 

The LA Times obtained a document recently circulated among physicians at the four county-run hospitals that outlines resource allocation in crisis situations. The guidelines call for physicians to save as many patients as possible versus trying everything to save a patient, meaning those less likely to survive will not receive the level of care they would have otherwise. L.A. County Health Services Director Christina Ghaly, MD, told the LA Times that the guidelines were not in place as of Friday night.

California activated its “mass fatality” program last week, which coordinates mutual aid across several government agencies when more deaths take place in a period of time than can be handled by local coroner or medical emergency personnel, NPR reports. 

Nearly all of the state is under stay-at-home orders, with residents prohibited from gathering with anyone outside their immediate household.

“I have yet to see any clear signals that things are slowing down, and I’m very concerned about the next two months,” Timothy Brewer, MD, an epidemiologist with UCLA Health, told the LA Times. He said UCLA Health is scheduling several infectious disease specialists to be on call at any time, and the biggest issue is that hospitals may quickly run out of providers who can administer ICU-level care.

Congress agrees on $900B COVID-19 relief package, $1.4 trillion funding deal: 7 things to know

Mixed reaction as Congress seals agreement on $900 billion COVID relief  bill - 6abc Philadelphia

Congressional leaders have reached an agreement on a $900 billion COVID-19 relief package and $1.4 trillion government funding deal with several healthcare provisions, according to Senate Majority Leader Mitch McConnell, R-Ky., and Minority Leader Chuck Schumer, D-N.Y.

Here are seven things to know about the relief aid and funding deal:

1. Congressional leaders have yet to release text of the COVID-19 legislation, but have shared a few key details on the measure, according to CNBC. Becker’s breaks down the information that has been released thus far. 

2. The COVID-19 package includes $20 billion for the purchase of vaccines, about $9 billion for vaccine distribution and about $22 billion to help states with testing, tracing and other COVID-19 mitigation programs, according to Politico.

3. Lawmakers are also expected to include a provision changing how providers can use their relief grants. In particular, the bill is expected to allow hospitals to calculate lost revenue by comparing budgeted revenue for 2020. Hospitals have said this tweak will allow them to keep more funding. 

4. The agreement also allocates $284 billion for a new round of Paycheck Protection Program loans

5. The COVID-19 relief bill also provides $600 stimulus checks to Americans earning up to $75,000 per year and $600 for their children, according to NBC. It also provides a supplemental $300 per week in unemployment benefits.

6. The year-end spending bill includes a measure to ban surprise billing. Under the measure, hospitals and physicians would be banned from charging patients out-of-network costs their insurers would not cover. Instead, patients would only be required to pay their in-network cost-sharing amount when they see an out-of-network provider, according to The Hill. The agreement gives insurers 30 days to negotiate a payment on the outstanding bill. After that period, they can enter into arbitration to gain higher reimbursement. 

7. Lawmakers plan to pass the relief bill and federal spending bill Dec. 21

A tall order: Rolling out the COVID-19 vaccine to all

https://mailchi.mp/e38b070b8787/the-weekly-gist-december-18-2020?e=d1e747d2d8

As the first Americans receive COVID vaccines, supplies remain limited even for the highest-risk populations. And with doses now in the pipeline, states are facing more intense questions about how they will prioritize vaccine delivery across demographic and at-risk groups. The graphic above shows an estimated vaccination timeline, based on the Centers for Disease Control and Prevention’s (CDC) recommended schedule. It illustrates the relative size of different populations in each allocation phase, along with the likely difficulty of targeting them and verifying eligibility. The first phase is divided into three waves (1a, 1b, 1c) for at-risk populations and essential workers, while the second phase includes the rest of the adult population, as well as children (though pediatric clinical trials are still in early stages).
 
Unsurprisingly, the CDC recommends that those most at risk for infection and severe disease—healthcare workers and nursing home residents—receive the 20M doses available by year’s end. While most states are generally adhering to the initial recommendations on priority groups for phase 1a set by the CDC’s Advisory Committee on Immunization Practices (ACIP), several have made adjustments. At least three are including law enforcement personnel in phase 1a, and others are further categorizing healthcare workers into high-, medium-, and low-risk groups. This weekend, ACIP will reconvene to create its official recommendations for phases 1b and 1c, which include the much larger populations of adults over age 65, and those with high-risk medical conditions.

Beyond eligibility guidelines, larger questions loom. How would someone “verify” that they have a high-risk condition? Who will reach out to older Americans to let them know they are eligible, and where to access the vaccine? As vaccine rollout continues, providers should anticipate the role they will likely play in managing patients “in the queue”, documenting eligible conditions and establishing regular information channels to keep people informed about the current status of vaccine planning and access.

It will be darkest before dawn

https://mailchi.mp/e38b070b8787/the-weekly-gist-december-18-2020?e=d1e747d2d8

It's Always Darkest Before The Dawn – Peter Scott

But first, we have a difficult period to get through. This week again saw record-breaking numbers of cases, hospitalizations, and deaths from COVID-19, with Thursday alone bringing more than 238,000 new cases—and a staggering 3,293 fatalities.

Nearly 115,000 Americans are currently hospitalized with COVID, a rise of 16 percent from just two weeks ago, and in many places a precarious capacity situation has turned perilous. Conditions have worsened precipitously in California, with only Tennessee, Oklahoma, and Rhode Island registering more daily COVID cases per 100,000 population than the Golden State, although cases are still on the rise across 80 percent of states and territories.

 Intensive care availability in Southern California hit zero, with ICU volume there expected to double or triple by this time next month. The same stresses are playing out in dozens of markets across the country, leading to a staffing sustainability crisis that can’t be solved through paying overtime, cancelling vacations or looking to travel nurses to fill the gaps in a now nationwide crisis. With the Christmas and New Year’s holidays still ahead, experts predict COVID cases won’t peak until sometime in mid-January, with a peak in hospitalizations and deaths following several weeks after.

Several states and cities tightened restrictions on gatherings and issued new stay-at-home orders, in an effort to keep new cases at a level that allows hospitals to manage through the next several weeks and maintain care quality and access for COVID and non-COVID patients alike. The coming weeks will require every American to take greater precautions than at any time during the course of this pandemic.

Oregon suspends license of physician who discouraged mask-wearing

Oregon suspends license of physician who discouraged mask-wearing

An Oregon physician who publicly spoke out against wearing a mask to slow the spread of COVID-19 has had his medical license suspended, according to The Washington Post.

In a written order Dec. 4, the Oregon Medical Board suspended the license of Steven A. LaTulippe, MD, a family medicine physician at South View Medical Arts in Dallas, Ore. The board alleges Dr. LaTulippe engaged in “conduct that is contrary to medical ethics and does or might constitute a danger to the health or safety of the public.” 

It also accuses him of “gross negligence.”

Specific acts cited in the letter include the physician’s alleged advice to a Medicaid patient. According to the board, the patient contacted Dr. LaTulippe’s medical clinic in July for guidance on COVID-19 and was told asymptomatic people should not be tested, that wearing masks does not prevent virus transmission, and the patient was told not to self-isolate because exposure to others would provide COVID-19 immunity.

The board said the patient seeking the guidance from Dr. LaTulippe’s clinic was terminated as a patient after questioning the appropriateness of the guidance.

The board also contends workers in Dr. LaTulippe’s clinic refuse to wear masks at work and urge people who enter the clinic wearing masks to remove them.

Dr. LaTulippe “regularly tells his patients that masks are ineffective in preventing the spread of COVID-19 and should not be worn”; “directs patients to a YouTube video providing false information about mask-wearing” ; and “regularly advises, particularly for his elderly and pediatric patients, that it is ‘very dangerous’ to wear masks because masks exacerbate [chronic obstructive pulmonary disease] and asthma and cause or contribute to multiple serious health conditions,” according to the board.

The Post could not immediately reach Dr. LaTulippe for comment Dec. 5.

In a recent interview, Dr. LaTulippe told NBC News he believes there is “bad science behind” wearing masks.

“I have absolutely zero problems with infectivity, and I have completely successful treatments, so I ask, ‘What is the problem?’ Why would I be demonized if I know what I’m doing?” he told the news network.

The CDC has advocated wearing masks to combat COVID-19. 

U.S. Hits Highest 1-Day Toll From Coronavirus With 3,054 Deaths

https://www.npr.org/sections/coronavirus-live-updates/2020/12/09/944844088/u-s-hits-highest-one-day-death-toll-from-coronavirus-with-3-054?fbclid=IwAR0mP-0McBNWX43iXLzLWIJyQmI8dR73ChPEg98YtDAS6F1DI_36ZOpjnA4

4 bar charts showing key COVID-19 metrics for the US over time. Today, states reported 1.8M tests, 210k cases, 106,668 currently hospitalized (record), and 3,054 deaths (record).

The coronavirus pandemic pushed the U.S. past another dire milestone Wednesday, the highest daily death toll to date, even while the mortality rate has decreased as health experts learn more about the disease.

The Covid Tracking Project, which tracks state-level coronavirus data, reported 3,054 COVID-19 related deaths — a significant jump from the previous single-day record of 2,769 on May 7.

The spread of the disease has shattered another record with 106,688 COVID-19 patients in U.S. hospitals. And overall, states reported 1.8 million tests and 210,000 cases. According to the group, the spike represents more than a 10% increase in cases over the last 7 days.

Additionally, California nearly topped its single-day case record at 30,851. It is the second highest case count since December 6, the organization reported.

Chart showing COVID-19 deaths over time by day. Deaths hit a record high today (Dec 9) at 3,054.

The staggering spike in fatalities and infections has overwhelmed hospitals and intensive care units across the nation, an increase attributed by many experts to people relaxing their precautions at Thanksgiving.

Hospital workforce tracker: layoffs, furloughs and pay cuts

https://www.healthcaredive.com/news/hospital-workforce-tracker-layoffs-furloughs-and-pay-cuts/576890/

Hospital workforce tracker: layoffs, furloughs and pay cuts | News Break

Many hospitals are temporarily or permanently reducing the size of their workforce as they grapple with depleted revenues and the thorny question of when they can return to normal operating capacity. Here’s a tracker to follow the latest updates.

Hospitals across the country, financially battered as they face the dual challenges of sick COVID-19 patients and a precipitous decline in patient volume, are struggling to balance quickly shifting staffing needs. While some face and others brace for intense demand, many have announced furloughs of specialists and others that work in elective surgeries that have been drastically scaled back.

Thousands of healthcare workers at hospitals big and small have been asked not to return to work, and it’s still unclear how soon non-essential services will return. While some governors announce plans to reopen businesses, others have extended stay-at-home orders.

Most recent data from the U.S Bureau of Labor doesn’t cover the second half of March or early April, but during the first half of March, the healthcare industry shed 43,000 jobs — reversing a decade of growth in the sector. According to BLS data, the industry added 49,000 jobs in March 2019.

“Even our emergency room has seen a significant drop in patients coming in,” Sue Philips, an ICU nurse at Palomar Pomerado Health in Northern San Diego, told Healthcare Dive.

Phillips is a spokesperson with National Nurses United, the country’s largest nurses union. Palomar Health, which runs three medical centers in northern San Diego County, recently instituted 21-day temporary layoffs of 221 employees.

On April 28, Palomar announced that most of those layoffs were becoming permanent. The system laid off 5% of its workforce, eliminating 317 positions. Fifty of those employees were clinical RNs, mostly in part-time positions, and the rest spread across the organization ranging from clerical staff to technicians.

Due to a 50% decrease in patient volumes, Palomar lost $10 million in revenue in March alone, according to a statement. In April the system said it stands to lose $20 million or more.

“I’m an ICU nurse, so my job is pretty much protected,” Phillips said. “But you didn’t think you were expendable until you became expendable, and that’s a hard pill for nurses and caregivers to swallow.”

Congress has attempted to financially support struggling hospitals through ongoing coronavirus relief legislation, approving some $175 billion thus far. But without knowing what will come next, hospitals are attempting to remain nimble while reining in one of their most costly expenses — paying employees.

The following information is based on publicly reported data, along with interviews with hospital representatives and union members.

It’s not an exhaustive list, but features nonprofit and for-profit hospital systems that reported revenue above $10 billion in 2019. It also takes a look at smaller, more regionally based systems that have announced similar cutbacks.

Click on link above to use the dropdown to find a company.

As healthcare job growth slows, some look to restructure long-term operations

Healthcare job losses reached staggering levels amid stay-at-home orders and the widespread cancellation of elective procedures when the COVID-19 pandemic first hit this spring. Dentists and ambulatory services were particularly hard hit.

While the industry has since recovered many of the 1.3 million jobs lost this April, it’s still 527,000 short from February levels, and monthly gains have slowed since, according to the latest data from the Bureau of Labor Statistics.

At the same time, some of the major hospitals that issued furloughs or layoffs early in the pandemic are now further reducing the size of their workforce.

The stagnation will likely continue, as companies “don’t hire as many people, then lay some people off to also try and save money, because worse times may be ahead,” said Erica Groshen, former BLS commissioner and senior labor economics adviser at Cornell’s School of Industrial and Labor Relations.

One example is Dallas-based Baylor Scott & White, which laid off 3% of its workforce, or 1,200 employees in May. It’s now laying off a third of its corporate finance staff, though some impacted employees are being offered positions with a third-party vendor, the system said in a Monday statement.

Providence Health & Services laid off 183 employees in mostly administrative roles as a result of transitioning work to a third-party vendor, while five employees were laid off “as a result of business need,” according to a WARN notice letter the system sent to an Oregon state agency Nov. 16. It previously issued an unknown number of furloughs across its 51-hospital system.

And Utah-based Intermountain Health said it would cut 250 business-related jobs by offering 750 employees voluntary separation packages on Oct. 13.

The moves come even while hospitals are stretched to the brink from the highest surge of coronavirus cases the country has yet seen. In the past few weeks, many have halted elective procedures and paid steep rates for temporary nursing staff, further straining finances.

And other healthcare establishments, such as some doctor’s offices and medical labs, are still struggling to get reluctant patients back in.

A recent Labor Department survey covering the onset of the pandemic through September found among all healthcare businesses, 64% experienced a decrease in demand while only 13% experienced an increase in demand.

In November, healthcare businesses overall added 46,000 jobs in — fewer than the 58,000 jobs added in October; 53,000 in September; and 75,000 in August, according to BLS data.

Hospitals added about 4,000 jobs in November and are about 100,000 jobs short from February.