Category Archives: Pandemic

Fitch Q2 outlook for nonprofit hospitals: ‘worst on record’

Posted on by • Posted in 2020 Election Issues, Cash, Cash Reserves, Cash-Flow Improvements, Clinical Testing, Contact Tracing, Coronavirus, Credit Quality, Credit Ratings, Crisis, Crisis Management, Demand, Economic Crisis, Economic Stimulus, Elective Procedures, Elective Surgery, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employer-Based Health Insurance, Essential Workers, Financially Distressed, Health Insurance Coverage Adequacy, Health Policy, Health System, High Deductible Health Plans, High Drug Prices, High Premiums, High Prices, Hospital, Hospital Industry, Infection Control Plan, Infectious Virus, Market Outlook, Mortality, National Strategy, Net Income, Operating Expenses, Operating Income, Operating Margin, Operating Performance, Operating Revenue, Out of Pocket Expenses, Pandemic, Preexisting Conditions, Public Health, Public Safety, Quarantine, Social Distancing, Surprise Bills, Uncertainty, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://www.healthcaredive.com/news/fitch-analysts-hospital-worries-FY-2020/577875/

Nicklaus Children's Health System Receives A+ Rating from Fitch ...

From the Mayo Clinic to Kaiser Permanente, nonprofit hospitals are posting massive losses as the coronavirus pandemic upends their traditional way of doing business.

Fitch Ratings analysts predict a grimmer second quarter: “the worst on record for most,” Kevin Holloran, senior director for Fitch, said during a Tuesday webinar.​

Over the past month, Fitch has revised its nonprofit hospital sector outlook from stable to negative. It has yet to change its ratings outlook to negative, though the possibility wasn’t ruled out.

Some have already seen the effects. Mayo estimates up to $3 billion in revenue losses from the onset of the pandemic until late April — given the system is operating “well below” normal capacity. It also announced employee furloughs and pay cuts, as several other hospitals have done.

Data released Tuesday from health cost nonprofit FAIR Health show how steep declines have been for larger hospitals in particular. The report looked at process claims for private insurance plans submitted by more than 60 payers for both nonprofit and for-profit hospitals.

Facilities with more than 250 beds saw average per-facility revenues based on estimated in-network amounts decline from $4.5 million in the first quarter of 2019 to $4.2 million in the first quarter of 2020. The gap was less pronounced in hospitals with 101 to 250 beds and not evident at all in those with 100 beds or fewer.

Funding from federal relief packages has helped offset losses at those larger hospitals to some degree.

Analysts from the ratings agency said those grants could help fill in around 30% to 50% of lost revenues, but won’t solve the issue on their own.

They also warned another surge of COVID-19 cases could happen as hospitals attempt to recover from the steep losses they felt during the first half of the year.

Anthony Fauci, the nation’s top infectious disease expert, warned lawmakers this week that the U.S. doesn’t have the necessary testing and surveillance infrastructure in place to prep for a fall resurgence of the coronavirus, a second wave that’s “entirely conceivable and possible.”

“If some areas, cities, states or what have you, jump over these various checkpoints and prematurely open up … we will start to see little spikes that may turn into outbreaks,” he told a Senate panel.

That could again overwhelm the healthcare system and financially devastate some on the way to recovery.

“Another extended time period without elective procedures would be very difficult for the sector to absorb,” Holloran said, suggesting if another wave occurs, such procedures should be evaluated on a case-by-case basis, not a state-by-state basis.

Hospitals in certain states and markets are better positioned to return to somewhat normal volumes later this year, analysts said, such as those with high growth and other wealth or income indicators. College towns and state capitols will fare best, they said.

Early reports of patients rescheduling postponed elective procedures provide some hope for returning to normal volumes.

“Initial expectations in reopened states have been a bit more positive than expected due to pent up demand,” Holloran said. But he cautioned there’s still a “real, honest fear about returning to a hospital.”

Moody’s Investors Service said this week nonprofit hospitals should expect the see the financial effects of the pandemic into next year and assistance from the federal government is unlikely to fully compensate them.

How quickly facilities are able to ramp up elective procedures will depend on geography, access to rapid testing, supply chains and patient fears about returning to a hospital, among other factors, the ratings agency said.

“There is considerable uncertainty regarding the willingness of patients — especially older patients and those considered high risk — to return to the health system for elective services,” according to the report. “Testing could also play an important role in establishing trust that it is safe to seek medical care, especially for nonemergency and elective services, before a vaccine is widely available.”

Hospitals have avoided major cash flow difficulties thanks to financial aid from the federal government, but will begin to face those issues as they repay Medicare advances. And the overall U.S. economy will be a key factor for hospitals as well, as job losses weaken the payer mix and drive down patient volumes and increase bad debt, Moody’s said.

Like other businesses, hospitals will have to adapt new safety protocols that will further strain resources and slow productivity, according to the report.​

Another trend brought by the pandemic is a drop in ER volumes. Patients are still going to emergency rooms, FAIR Health data show, but most often for respiratory illnesses. Admissions for pelvic pain and head injuries, among others declined in March.

“Hospitals may also be losing revenue from a widespread decrease in the number of patients visiting emergency rooms for non-COVID-19 care,” according to the report. “Many patients who would have otherwise gone to the ER have stayed away, presumably out of fear of catching COVID-19.”

 

 

 

New Coronavirus Vaccine Candidate Shows Promise In Early, Limited Trial

Posted on by • Posted in Clinical Research, Clinical Trials, Coronavirus, Food and Drug Administration (FDA), Pandemic, Vaccination, Vaccine, Vaccine RNA • Leave a comment

https://www.npr.org/sections/coronavirus-live-updates/2020/05/18/857997341/new-coronavirus-vaccine-candidate-shows-promise-in-early-limited-trial

Moderna's coronavirus vaccine shows promise in first human trial ...

A vaccine manufacturer is reporting preliminary data suggesting its COVID-19 vaccine is safe, and appears to be eliciting in test subjects the kind of immune response capable of preventing disease.

Moderna, Inc., of Cambridge, Mass., developed the vaccine in collaboration with the National Institute of Allergy and Infectious Diseases. The results reported Monday come from an initial analysis of a Phase I study primarily designed to see if the vaccine is safe.

The company reports no serious side-effects; however, modest side-effects included redness at the injection site, headache, fever and flu-like symptoms, although none of these lasted more than a day.

The first 45 volunteers for the vaccine trial were divided into three groups, with each group getting a different dose of the vaccine. All groups got an initial shot, followed by a booster shot a month later.

In addition to safety, the company also looked at the vaccine’s ability to induce antibodies to the coronavirus — what’s known as its immunogenicity. It did, for all subjects at all dose levels. In addition, eight of the subjects were tested for the presence of neutralizing antibodies that prevent the virus from infecting cells in the laboratory. All eight did.

The Food and Drug Administration has given Moderna the green light to begin a Phase II study expected to enroll an additional 600 volunteers — half older than 55 — to provide additional immunogenicity data. The company hopes by July to begin a Phase III study, aimed at showing that the vaccine can actually prevent disease.

The Moderna vaccine is made using messenger RNA, or mRNA, a molecule containing the genetic instructions to make a protein on the coronavirus surface that is recognized by our immune systems. Although mRNA vaccines have been studied for several years, so far none has been licensed by the FDA.

The advantage of mRNA vaccines over more traditional vaccines is they can be made quickly. The company says it was just 63 days from the time Chinese scientists revealed the genetic sequence to the time a vaccine was injected into the first volunteer.

Moderna’s is one of about a dozen COVID-19 vaccine candidates that have begun studies in humans.

 

 

 

OSHA Probing Health Worker Deaths But Urges Inspectors To Spare The Penalties

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Employee Protections, Mortality, Occupational Safety and Health Administration (OSHA), Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Worker Protection, Worker Rights • Leave a comment

https://khn.org/news/osha-probing-health-worker-deaths-but-urges-inspectors-to-spare-the-penalties/

OSHA Probing Health Worker Deaths But Urges Inspectors To Spare ...

The Occupational Safety and Health Administration has in recent weeks launched investigations into deaths of workers at 34 health care employers across the U.S., federal records show, but former agency officials warn that the agency has already signaled it will only cite and fine the most flagrant violators.

The investigations come as health care workers have aired complaints on social media and to lawmakers about a lack of personal protective equipment, pressure to work while sick, and retaliation for voicing safety concerns as they have cared for more than 826,000 patients stricken by the coronavirus.

Despite those concerns, the nation’s top worker safety agency is not viewed as an advocate likely to rush to workers’ aid. President Donald Trump tapped a Labor Department leader who has represented corporations railing against the very agency he leads.

“It’s a worker safety crisis of monstrous proportions and OSHA is nowhere to be found,” said David Michaels, an epidemiologist and George Washington University professor who was assistant secretary of Labor and ran OSHA from 2009 to 2017.

Employers are required to report a work-related death to OSHA or face fines for failing to do so. Yet former OSHA leaders say the agency has not openly reminded hospitals and nursing homes to file such reports in recent weeks.

Last week, the Centers for Disease Control and Prevention reported that more than 9,200 health workers had been infected with the coronavirus, a number the agency concedes is a vast undercount. The estimate was based on a set of lab-generated reports in which only 16% included the patient’s profession. The agency said the true number is probably closer to 11% of all known cases.

Federal records show the OSHA fatality investigations ― searchable here — involve hospitals, an emergency medical service agency, a jail health department and nursing homes. Its investigations can be prompted by the complaint of a worker, a former worker or even an OSHA official who sees a news report about a workplace death. They can be conducted by phone and fax or involve an on-site inspection.

One fatality investigation launched April 7 focuses on Marion Regional Nursing home in Hamilton, Alabama, where nurse Rose Harrison, 60, worked before she died of COVID-19, her daughter Amanda Williams said.

Williams said her mother was not given a mask when caring for a patient on March 25 ― 10 days after the county’s first coronavirus case — who later tested positive for the virus. Williams said her mother felt pressured to keep going to work even as she was coughing, fatigued and running a low-grade fever.

“She kept telling me ‘Amanda, I have to work, I have to get my house paid off,’” Williams said, noting her mother said she was urged to work unless her temperature reached 100.4.

Williams said that she drove her mother to the hospital on April 3 and that Harrison was unhappy she’d spent the week working. Harrison went on a ventilator the following day, fully expecting to recover. She died April 6.

“When your mother dies mad, you’re pretty much mad,” Williams, one of Harrison’s three daughters, said. “I think if proper steps were taken from the beginning, this would have been different.”

North Mississippi Health Services, which owns the nursing home, and the home’s administrator did not reply to calls or emails.

An April 13 OSHA memo said the agency would prioritize death investigations involving health care workers and first responders. It said “formal complaints alleging unprotected exposures to COVID-19 … may warrant an on-site inspection.”

Michaels, the former Labor Department official, said a subsequent OSHA memo suggested that officials are unlikely to penalize all but the most careless employers.

The memo about employers’ “good faith” efforts said a citation may be issued “where the employer cannot demonstrate any efforts to comply.”

Michaels said that “any efforts” to comply with work safety rules could amount to making even one phone call to try to buy masks for workers.

Federal OSHA officials did not respond to a request for comment.

Democrats criticized Trump last year when he tapped Eugene Scalia, who spent years of his legal career defending major corporations, to head the Labor Department.

Scalia fought OSHA on behalf of SeaWorld after it was cited over the death of a woman training killer whales, The New York Times reported. Scalia’s team argued the work-safety agency was not meant to regulate the training of killer whales. He also argued that SeaWorld had adequate safety measures in place, but ultimately lost the case.

Sen. Bernie Sanders, alluding to Scalia’s record of defending firms like Chevron and Goldman Sachs, called the appointment “obscene.”

Since March 27, the ongoing fatality investigations have been mostly categorized as “partial” investigations, which initially focus on one area of noncompliance. Four are labeled “complete,” meaning they cover a wide range of hospital operations.

One of the “complete” investigations is listed at Coral Gables Hospital in South Florida, where respiratory therapist Jorge Mateo, 82, worked before he died of coronavirus complications, his daughter said.

The hospital reported the death, according to a statement from Shelly Weiss Friedberg of Tenet Healthcare, which owns the hospital. She said Mateo was with the hospital for four decades and “the loss of Jorge Mateo is felt throughout our entire community.”

A subsequent investigation — also labeled as “complete” ― was opened April 10 at Palmetto General Hospital, in South Florida.

There, 33-year-old Danielle Dicenso worked for a staffing agency as an ICU nurse, treating coronavirus patients. Dicenso died after developing COVID-19 symptoms, including fever and a cough, according to reports in the Miami Herald. The Palm Beach County medical examiner has not yet determined a cause of death, a spokesperson told Kaiser Health News.

Her husband, David Dicenso, told local news station WSVN she had not been given a protective mask and was “very scared of going to work.”

Weiss Friedberg, of Tenet, which also owns Palmetto, said in an email that “nurses are provided appropriate personal protective equipment (PPE) in compliance with Centers for Disease Control (CDC) guidelines.”

The latest guidelines say staff can wear a face mask if no N95 respirator is available when performing routine care with COVID-19 patients. For higher-risk procedures, such as intubation, workers must receive N95 masks.

OSHA opened an inspection at St. Catherine of Siena Medical Center, a Long Island hospital, on April 11. Federal officials had learned from a local news story about a patient care assistant dying of COVID-19, hospital leadership confirmed.

The hospital has no record of that employee having any interaction with COVID patients, said James O’Connor, its executive vice president. The hospital tests employees for COVID-19 only if they have had confirmed exposure to someone who tested positive and if they develop symptoms.

O’Connor said all employees who are in contact with suspected COVID-19 patients get the full suite of PPE; they are told to clean their N95 masks after each shift, he said, and to change masks entirely every three shifts.

That can mean workers wear the same equipment for multiple days.

Early research suggests that N95s can be sanitized and reused up to three times. But that paper has not yet undergone peer review. In an affidavit the New York State Nurses Association filed regarding another state hospital, the union argued that it has “yet to be adequately proven that disposable respirators can be effectively decontaminated” without putting the wearer at risk.

As recently as April 16, the local nurses union told Newsday that St. Catherine workers on Long Island are being told to share PPE.

While OSHA does have a “general duty” clause urging employers to keep workers safe and a standard for respiratory protection, it has no written rule on protecting workers from airborne disease, said Debbie Berkowitz, a former OSHA chief of staff and director of the National Employment Law Project’s worker safety and health program.

As OSHA and the Centers for Disease Control and Prevention downgrade their requirements week by week, workers are left with the choice in some places to wear a bandana in situations that had called for a properly fitted N95 mask, which can filter out particles as small as 0.1 microns.

“OSHA has really completely abandoned their mandate to protect workers,” Berkowitz said, “and every worker is on their own.”

 

 

 

 

States brace for ‘nearly certain’ Medicaid budget shortfalls amid COVID-19

Posted on by • Posted in 2020 Election Issues, ACA, Coronavirus, Crisis, Crisis Management, Employer-Based Health Insurance, Essential Health Benefits, Health Insurance Coverage Adequacy, Health Policy, Health System, Hospital, Hospital Industry, Medicaid, Medicaid Block Grants, Medicaid Childrens Health Insurance Program (CHIP), Medicaid Expansion, Out of Pocket Expenses, Pandemic, Preexisting Conditions, Uncompensated Care, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://www.healthcaredive.com/news/states-brace-for-nearly-certain-medicaid-budget-shortfalls-amid-covid-19/578120/

Coronavirus updates: Virus reaches all 50 states, stock futures fall

Dive Brief:

  • Most states with budget projections expect Medicaid shortfalls due to rising spending as more people lose jobs and enroll into the safety net insurance for low-income Americans due to the COVID-19 pandemic, according to a new Kaiser Family Foundation survey.
  • Almost all states with enrollment projections and more than half with spending projections expect program growth to surpass pre-pandemic estimates. Nearly all states anticipate growth will accelerate even more in the 2021 fiscal year, KFF found. As a result of that growth, 17 of 19 states with budget projections report a shortfall is “nearly certain” or “likely” for the upcoming fiscal year.
  • The survey comes as Congress once again considers raising the federal match rate for Medicaid in the $3 trillion Health and Economic Recovery Omnibus Emergency Solutions Act, passed by the House of Representatives on Friday.​

Dive Insight:

Medicaid is often the top line spending item in state budgets, sending states scrambling for ways to reduce spend in the safety net health insurance program, including controversial block grants for funding.

At the start of the 2020 fiscal year, states anticipated modest Medicaid spending growth, and flat enrollment growth due to the strong economy. That forecast quickly shifted as the coronavirus spread in the U.S., which lost some 21 million jobs in April as businesses shutter their doors in compliance with stay-at-home orders, sending the unemployment rate to 15%.  

Because the U.S. generally couples coverage to employment, skyrocketing job loss could make an estimated 17 million people newly eligible for Medicaid and 6 million eligible for subsidies in the Affordable Care Act marketplaces by January 2021.

Medicaid officials from 38 states shared their budget projections with KFF for the survey. States that did not respond were still gathering data about the coronavirus or didn’t have updated enrollment or spending projections for the 2020 or 2021 fiscal years, KFF researchers Robin Rudowitz and Elizabeth Hinton said.

Thirty-two of 34 states with enrollment projections think enrollment will exceed initial projections in 2020, and 30 of 31 states anticipate that growth in 2021 will outpace the current fiscal year.

States are more mixed on spending projections. Over half of states with projections, 18 of 32, expect 2020 Medicaid spending to exceed pre-pandemic estimates. Eight states anticipate no change, and the remaining six project slightly lowered spending due to lower healthcare utilization as non-essential services have largely ground to a halt.

State Medicaid officials are more in lockstep when it comes to 2021 spending projections. Nearly all states with projections — 29 of 30 — think Medicaid spending rates in 2021 will increase over 2020.

Without greater support from the federal government, the survey hints states will face significant spending cuts for Medicaid for the upcoming fiscal year, which begins July 1 for most states. Multiple groups, including the National Governors Association and the National Association of State Medicaid Directors, have called for a higher federal match rate.

One of the first legislative packages designed to mitigate the fallout of COVID-19, the Families First Coronavirus Response Act passed March 18, authorized a 6.2 percentage point increase in the rate for Medicaid if states meet certain requirements. States can’t increase premiums or restrict eligibility standards and must cover COVID-19 testing and treatment without cost-sharing.

The HEROES Act passed by Democrats in the House on Friday would increase the match rate by 14 percentage points from July 1, 2020, through June 30, 2021, along with benchmarking an additional $100 billion for providers.

However, Senate Majority Leader Mitch McConnell, R-Ky., and President Donald Trump have said they’re in no rush to pass another round of legislation adding to the more than $3 trillion Congress has approved so far.

 

 

 

 

Jay Powell warns US recovery could take until end of 2021

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Economic Stimulus, Economy Reopening, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employee Protections, Employer-Based Health Insurance, False Hope, Health Insurance Coverage Adequacy, Health Policy, Infection Control, Infection Control Plan, Job, Job Market, Job Search, Job Security, Pandemic, Public Health, Public Safety, Quarantine, Social Distancing, Underinsured, Unemployment, Unemployment Insurance, Uninsured, Vaccination, Vaccine, Wishful Thinking • Leave a comment

https://www.ft.com/content/2ed602f1-ed11-4221-8d0b-ef85018c96ea

Fed Makes Second Emergency Rate Cut to Zero Due To Coronavirus ...

Fed chair says economy may not fully bounce back until virus vaccine is available.

Federal Reserve chair Jay Powell has warned that a full US economic recovery may take until the end of next year and require the development of a Covid-19 vaccine.

“For the economy to fully recover, people will have to be fully confident. And that may have to await the arrival of a vaccine,” Mr Powell told CBS News on Sunday. A full revival would happen, he said, but “it may take a while . . . it could stretch through the end of next year, we really don’t know”.

He added: “Assuming there is not a second wave of the coronavirus, I think you will see the economy recover steadily through the second half of this year.”

Mr Powell told CBS it was likely there would be a “couple more months” of net job losses, with the unemployment rate climbing to as high as 20-25 per cent. But he said it was “good news” that the “overwhelming” majority of those claiming unemployment benefits report themselves as having been laid off temporarily, meaning they are expecting to go back to their old jobs.

Oil prices and stocks in Asia rose on Monday despite the gloomy outlook. West Texas Intermediate, the US crude benchmark, climbed 4.4 per cent to take it above $30 a barrel for the first time in two months. Brent crude, the international benchmark, rose 3.6 per cent to $33.67 a barrel. Japan’s Topix was up 0.4 per cent and China’s CSI 300 index of Shanghai- and Shenzhen-listed stocks added 0.6 per cent.

Donald Trump, US president, said last week that he hoped to have a vaccine ready by the end of 2020. But public health experts, including Anthony Fauci, the head of the US National Institute of Allergy and Infectious Diseases, and Rick Bright, the recently ousted head of the US Biomedical Advanced Research and Development Authority, have warned that the process is likely to take longer.

Dr Fauci, a high-profile member of Mr Trump’s coronavirus task force, has said he expects the search for a vaccine to take at least a year to 18 months. But Dr Bright has said that was too optimistic.

Some world leaders have also raised doubts about the immediate prospects for a vaccine. Giuseppe Conte, prime minister of Italy, said at the weekend that his country could “not afford” to wait for a vaccine, while Boris Johnson, UK prime minister, warned that a vaccine “might not come to fruition” at all.

Mr Powell said that while lawmakers had “done a great deal and done it very quickly”, Congress and the Fed may need to do more “to avoid longer-run damage to the economy”.

The Fed chair said fiscal policies that “help businesses avoid avoidable insolvencies and that do the same for individuals” would position the US economy for a strong recovery post-crisis.

Mr Powell also reiterated his position against using negative interest rates, something Mr Trump has called for. The Fed chair told CBS that the Federal Open Market Committee had eschewed negative interest rates after the last financial crisis in favour of “other tools” such as forward guidance and quantitative easing.

The US Congress has already approved nearly $3tn of economic relief measures intended to support struggling businesses and individuals, but there is growing consensus in Washington that more fiscal stimulus will be needed — even if Democrats and Republicans are divided over how to dole out federal funds.

Late on Friday, the Democrat-controlled House of Representatives passed Nancy Pelosi’s plan for $3tn in new stimulus spending.

Mr Trump has repeatedly called for the next stimulus to include a cut to payroll taxes — deductions for entitlements such as social security and Medicare. Last week, Larry Kudlow, the top White House economic adviser, suggested that lower corporate taxes and looser business regulation should be part of any future relief package.

The Trump administration has taken a more bullish stance on the US economic recovery than Mr Powell, with White House officials repeatedly insisting that the economy will bounce back before the end of the year.

Mr Powell told CBS it was a “reasonable expectation that there will be growth in the second half of the year” but “we won’t get back to where we were by the end of the year”.

 

 

 

 

 

AFL-CIO sues feds over coronavirus workplace safety

Posted on by • Posted in 2020 Election Issues, American Federation of Labor and Congress of Industrial Organizations (AFL-CIO), Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, District Court of Appeals, Employee Protections, Essential Workers, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Job, Job Security, Labor Union, Lawsuit, Occupational Safety and Health Administration (OSHA), Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Social Distancing, Worker Protection, Worker Rights, Workflow Environment • Leave a comment

https://www.axios.com/afl-cio-sues-feds-over-coronavirus-workplace-safety-6de76122-2c75-4f84-92e5-21048c08b44b.html

AFL-CIO sues feds over coronavirus workplace safety - Axios

With states reopening for business and millions of people heading back to work, the nation’s largest labor organization is demanding the federal government do more to protect workers from contracting the coronavirus on the job.

What’s happening: The AFL-CIO, a collection of 55 unions representing 12.5 million workers, says it is suing the federal agency in charge of workplace safety to compel them to create a set of emergency temporary standards for infectious diseases.

Driving the news: The lawsuit against the U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) is expected to be filed on Monday in the U.S. Court of Appeals in Washington, D.C.

  • Citing an urgent threat to “essential” workers and those being called back to work as government-imposed lockdowns are lifted, the AFL-CIO is asking the court to force OSHA to act within 30 days.
  • It wants a rule that would require each employer to evaluate its workplace for the risk of airborne disease transmission and to develop a comprehensive infection control plan that could include social distancing measures, masks and other personal protective equipment and employee training.

The agency has issued guidance, in collaboration with the Centers for Disease Control and Prevention, to protect workers in multiple industries — including dentist offices, nursing homes, manufacturing, meat processing, airlines and retail.

  • But the unions complain these are only recommendations, not requirements, and that mandatory rules should be imposed.
  • OSHA has been considering an infectious disease standard for more than a decade, they note, and has drafted a proposed standard.

U.S. Labor Secretary Eugene Scalia, in a letter to AFL-CIO President Richard Trumka, said employers are already taking steps to protect workers, and that OSHA’s industry-tailored guidelines provide more flexibility than a formal rule for all employers.

Yes, but: OSHA has received more than 3,800 safety complaints related to COVID-19 as of May 4, but it had already close to about 2,200 of them without issuing a single citation, according to the AFL-CIO.

What they’re saying: “It’s truly a sad day in America when working people must sue the organization tasked with protecting our health and safety,” Trumka said.

  • “But we’ve been left no choice. Millions are infected and nearly 90,000 have died, so it’s beyond urgent that action is taken to protect workers who risk our lives daily to respond to this public health emergency.
  • “If the Trump administration refuses to act, we must compel them to.”
  • OSHA could not immediately be reached for comment on the lawsuit.

 

 

 

 

Most states still aren’t doing enough coronavirus testing

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Health Policy, Infection Control, Infectious Virus, Leadership Decentralized, Mortality, Pandemic, Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

https://www.axios.com/coronavirus-testing-states-still-behind-629973cb-d8ad-4f36-a6fa-d59959fe84a3.html

 

Most states still aren't doing enough coronavirus testing - Axios

 

Most states still aren’t doing enough coronavirus testing, especially those that have suffered from larger outbreaks, according to recent testing targets calculated by the Harvard Global Health Institute.

Between the lines: It’s much harder to contain the virus once a lot of people have it — which is why we needed strong social distancing in the first place. But knowing who is infected is the foundation of containment going forward, and most states are still behind.

The big picture: Nationally, the U.S. needs to be doing about 900,000 tests a day, according to the Harvard estimate, which was released earlier this month.

  • But not all states need to be doing the same amount of tests. The goal Harvard suggested for each state — the number of tests they should have done on May 15 — was calculated based on the size of its outbreak as of early May.
  • That means that New York needs to be doing a much larger number of tests each day than Wyoming, even after accounting for the states’ huge population discrepancy.

Why it matters: Most states have already begun reopening to some extent, even without key public health tools — like testing and contact tracing — fully built up.

  • That increases the chance that the virus will spread undetected as people begin interacting with one another again.
  • And these premature measures may just increase the number of tests a state needs, especially because the estimates were based on the assumption states would remain closed until May 15.
  • “The moment you relax, the number of cases will start climbing. And therefore, the number of tests you need to keep your society, your state from having large outbreaks will also start climbing,” Harvard’s Ashish Jha warned.

 

If the White House is struggling, how will ordinary businesses fare? 

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy, Economy Reopening, Emergency Preparedness, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employee Protections, Food and Drug Administration (FDA), Health Policy, Infection Control, Infectious Virus, Job, Job Market, Job Search, Job Security, Leadership Decentralized, Mortality, Pandemic, Public Health, Public Safety, Quarantine, Social Distancing • 1 Comment

https://mailchi.mp/f4f55b3dcfb3/the-weekly-gist-may-15-2020?e=d1e747d2d8

The RAOI Advisory Opinion: A Transformative Moment or a Bump in ...

In a week that saw reopening activity pick up across the country, drawing even more attention to the need for sufficient testing to give employers and workers confidence in returning to work, a new study from researchers at New York University (NYU) suggested that a widely-hailed rapid testing machine from Abbott Labs may be unreliable.

The Abbott ID NOW COVID-19 test produced false negatives a third of the time using nasopharyngeal swabs, and 48 percent of the time with less-invasive “dry nasal swabs”, according to the study, which has not yet undergone peer review. The five-minute, point-of-care test received emergency use authorization from the Food and Drug Administration (FDA) in late March and has been touted as a “great test” by President Trump, whose White House relies on it to test the President and those around him.

On Thursday, the FDA issued a warning about the potential for false negative results using the Abbott test. The company disputes the findings and sent a list of questions to the NYU researchers for clarification. Meanwhile, two White House staffers—an aide to the President and the Vice President’s press secretary—tested positive for coronavirus, causing the White House to mandate masks for all employees starting this week.

The uncertainty around test results, and the ensuing concern about safety at the White House, provides a foretaste of the difficult road ahead for thousands of employers nationwide as stay-at-home orders are lifted, and companies consider when and how to reopen workplaces.

If the White House is struggling, how will ordinary businesses fare?

US coronavirus update: 1.46M cases, 87K+ confirmed deaths, 10.2M total tests conducted.

 

 

 

 

Quantifying the massive blow to hospital volumes

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Even after hearing dozens of reports from health systems about how steep their COVID-related volume losses have been, we were still floored by this analysis from healthcare analytics firm Strata Decision Technology, documenting a 55 percent drop in patients seeking hospital care across the country.

The report, which analyzed data from 228 hospitals in 51 health systems across 40 states, found that no clinical service line was immune from steep volume losses. The graphic below shows volume loss by service line in March-April 2020 compared to the same period in 2019.

Unsurprisingly, ophthalmology, gynecology, ortho/spine and ENT—all specialties with a high portion of elective cases, and heavily dependent on procedures—saw volume declines of greater than 70 percent. But even obstetrics and neonatology (which we expected to be “pandemic proof”) and infectious disease (which we thought might be busier in the throes of COVID-19) saw losses of 20-30 percent.

Looking at specific procedures, complex elective surgeries like spinal fusion and hip and knee replacements were almost completely obliterated. Precipitous declines in encounters for chronic diseases like coronary heart disease and diabetes (down 75 and 67 percent, respectively) and cancer screenings (a 55 percent decline in breast health and a 37 percent decline in cancer care overall) point to the likelihood of worrisome disease exacerbations, and a future full of more complex patients.

The volume losses, plus a 114 percent rise in uninsured patients, led to average two-week losses of $26.5M per health system across the study’s cohort. Strata will continue to track and publish volume changes, but this early snapshot paints a bleak picture of staggering financial hits, and “lost” patient care that will carry lasting ramifications for the health of communities nationwide.

 

 

 

 

Putting a pillar of the community in jeopardy

Posted on by • Posted in 2020 Election Issues, Cash, Cash Reserves, Community, Community Hospital, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy, Economy Reopening, Elective Procedures, Elective Surgery, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employee Protections, Financially Distressed, Health Policy, Hospital, Hospital Industry, Leadership, Pandemic, Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

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Pillars of the Community - New York Improv Teams

It’s easy to become numb to the numbers we’re bombarded with on a daily basis—case counts, deaths, financial losses, unemployment claims, bailout funding. An article from the Washington Post this week put a very human face on how the coronavirus crisis is playing out on the ground, profiling the experience of 115-bed Griffin Hospital in Derby, CT.

We first got to know Griffin, and its CEO Patrick Charmel, years ago in the course of work for our former employer. It’s a remarkable, fiercely independent organization—recognized as the flagship hospital of the “Planetree” patient-centered care model, and a decade-long fixture on Fortune’s list of Top 100 Best Companies to Work For. But the COVID-19 wave hit Griffin hard, as it did much of Connecticut.

With the high cost of caring for COVID patients, and lost revenue from cancelled procedures, Griffin has had to make hard decisions about furloughing and redeploying staff—incredibly difficult for a small facility that has been a pillar of the community for a century. Charmel has been able to secure some relief in the form of advance payment from Medicare, but his efforts to lobby for a share of the state’s allocation of CARES Act grant funding for hospitals proved unsuccessful, and so the future of the hospital—or at least its continued viability as an independent organization—is in jeopardy.

In the words of Griffin’s chief financial officer, “This could be devastating for us.” As the recovery begins, and questions begin to be asked about the billions of dollars of “bailouts” paid to “greedy hospitals”—an easy narrative for the media to latch onto—it’s worth remembering what’s happening to Griffin Hospital, and to hundreds of other similar organizations across the country.

Countless communities rely on these hospitals, and their survival is worth safeguarding.