W.H.O., Now Trump’s Scapegoat, Warned About Coronavirus Early and Often

Posted on April 16, 2020 by henrykotula • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Coronavirus, Crisis, Crisis Management, Denial, Emergency Preparedness, Health Policy, Pandemic, Public Health, Public Safety, Scapegoat, Social Distancing, World Health Organization (WHO) • Leave a comment

The World Health Organization, always cautious, acted more forcefully and faster than many national governments. But President Trump has decided to cut off U.S. funding to the organization.

On Jan. 22, two days after Chinese officials first publicized the serious threat posed by the new virus ravaging the city of Wuhan, the chief of the World Health Organization held the first of what would be months of almost daily media briefings, sounding the alarm, telling the world to take the outbreak seriously.

But with its officials divided, the W.H.O., still seeing no evidence of sustained spread of the virus outside of China, declined the next day to declare a global public health emergency. A week later, the organization reversed course and made the declaration.

Those early days of the epidemic illustrated the strengths and weaknesses of the W.H.O., an arm of the United Nations that is now under fire by President Trump, who on Tuesday ordered a cutoff of American funding to the organization.

With limited, constantly shifting information to go on, the W.H.O. showed an early, consistent determination to treat the new contagion like the threat it would become, and to persuade others to do the same. At the same time, the organization repeatedly praised China, acting and speaking with a political caution born of being an arm of the United Nations, with few resources of its own, unable to do its work without international cooperation.

Mr. Trump, deflecting criticism that his own handling of the crisis left the United States unprepared, accused the W.H.O. of mismanaging it, called the organization “very China-centric” and said it had “pushed China’s misinformation.”

But a close look at the record shows that the W.H.O. acted with greater foresight and speed than many national governments, and more than it had shown in previous epidemics. And while it made mistakes, there is little evidence that the W.H.O. is responsible for the disasters that have unfolded in Europe and then the United States.

The W.H.O. needs the support of its international members to accomplish anything — it has no authority over any territory, it cannot go anywhere uninvited, and it relies on member countries for its funding. All it can offer is expertise and coordination — and even most of that is borrowed from charities and member nations.

The W.H.O. has drawn criticism as being too close to Beijing — a charge that grew louder as the agency repeatedly praised China for cooperation and transparency that others said were lacking. China’s harsh approach to containing the virus drew some early criticism from human rights activists, but it proved effective and has since been adopted by many other countries.

A crucial turning point in the pandemic came on Jan. 20, after China’s central government sent the country’s most famous epidemiologist, Zhong Nanshan, to Wuhan to investigate the new coronavirus racing through that city of 11 million people. Dr. Zhong delivered a startling message on national television: Local officials had covered up the seriousness of the outbreak, the contagion spread quickly between people, doctors were dying and everyone should avoid the city.

Dr. Zhong, an eccentric 83-year-old who led the fight against the SARS outbreak of 2002 and 2003, was one of few people in China with enough standing to effectively call Wuhan’s mayor, Zhou Xianwang, a rising official in the Communist Party, a liar.

Mr. Zhou, eager to see no disruption in his plans for a local party congress from Jan. 11 to 17 and a potluck dinner for 40,000 families on Jan. 18, appears to have had his police and local health officials close the seafood market, threaten doctors and assure the public that there was little or no transmission.

Less than three days after Dr. Zhong’s warning was broadcast, China locked down the city, preventing anyone from entering or leaving and imposing strict rules on movement within it — conditions it would later extend far behind Wuhan, encompassing tens of millions of people.

The national government reacted in force, punishing local officials, declaring that anyone who hid the epidemic would be “forever nailed to history’s pillar of shame,” and deploying tens of thousands of soldiers, medical workers and contact tracers.

It was the day of the lockdown that the W.H.O. at first declined to declare a global emergency, its officials split and expressing concern about identifying a particular country as a threat, and about the impact of such a declaration on people in China. Such caution is a standard — if often frustrating — fact of life for United Nations agencies, which operate by consensus and have usually avoided even a hint of criticizing nations directly.

Despite Dr. Zhong’s warning about human-to-human transmission, Tedros Adhanom Ghebreyesus, the W.H.O.’s director-general, said there was not yet any evidence of sustained transmission outside China.

“That doesn’t mean it won’t happen,” Dr. Tedros said.

“Make no mistake,” he added. “This is an emergency in China, but it has not yet become a global health emergency. It may yet become one.”

The W.H.O. was still trying to persuade China to allow a team of its experts to visit and investigate, which did not occur until more than three weeks later. And the threat to the rest of the world on Jan. 23 was not yet clear — only about 800 cases and 25 deaths had been reported, with only a handful of infections and no deaths reported outside China.

“In retrospect, we all wonder if something else could have been done to prevent the spread we saw internationally early on, and if W.H.O. could have been more aggressive sooner as an impartial judge of the China effort,” said Dr. Peter Rabinowitz, co-director of the MetaCenter for Pandemic Preparedness and Global Health Security at the University of Washington.

Amir Attaran, a public health and law professor at the University of Ottawa, said, “Clearly a decision was taken by Dr. Tedros and the organization to bite their tongues, and to coax China out of its shell, which was partially successful.”

“That in no way supports Trump’s accusation,” he added. “The president is scapegoating, dishonestly.”

Indeed, significant shortcomings in the administration’s response arose from a failure to follow W.H.O. advice.

The Centers for Disease Control and Prevention bungled the rollout of diagnostic tests in the United States, even as the W.H.O. was urging every nation to implement widespread testing. And the White House was slow to endorse stay-home restrictions and other forms of social distancing, even after the W.H.O. advised these measures were working in China.

It is impossible to know whether the nations of the world would have acted sooner if the W.H.O. had called the epidemic a global emergency, a declaration with great public relations weight, a week earlier than it did.

But day after day, Dr. Tedros, in his rambling style, was delivering less formal warnings, telling countries to contain the virus while it was still possible, to do testing and contact tracing, and isolate those who might be infected. “We have a window of opportunity to stop this virus,” he often said, “but that window is rapidly closing.”

In fact, the organization had already taken steps to address the coronavirus, even before Dr. Zhong’s awful revelation, drawing attention to the mysterious outbreak.

On Jan. 12, Chinese scientists published the genome of the virus, and the W.H.O. asked a team in Berlin to use that information to develop a diagnostic test. Just four days later, they produced a test and the W.H.O. posted online a blueprint that any laboratory around the world could use to duplicate it.

On Jan. 21, China shared materials for its test with the W.H.O., providing another template for others to use.

Some countries and research institutions followed the German blueprint, while others, like the C.D.C., insisted on producing their own tests. But a flaw in the initial C.D.C. test, and the agency’s slowness in approving testing by labs other than its own, contributed to weeks of delay in widespread testing in the United States.

In late January, Mr. Trump praised China’s efforts. Now, officials in his administration accuse China of concealing the extent of the epidemic, even after the crackdown on Wuhan, and the W.H.O. of being complicit in the deception. They say that lulled the West into taking the virus less seriously than it should have.

Larry Gostin, director of the W.H.O.’s Center on Global Health Law, said the organization relied too heavily on the initial assertions out of Wuhan that there was little or no human transmission of the virus.

“The charitable way to look at this is that W.H.O. simply had no means to verify what was happening on the ground,” he said. “The less charitable way to view it is that the W.H.O. didn’t do enough to independently verify what China was saying, and took China at face value.”

The W.H.O. was initially wary of China’s internal travel restrictions, but endorsed the strategy after it showed signs of working.

“Right now, the strategic and tactical approach in China is the correct one,” Dr. Michael Ryan, the W.H.O.’s chief of emergency response, said on Feb. 18. “You can argue whether these measures are excessive or restrictive on people, but there is an awful lot at stake here in terms of public health — not only the public health of China but of all people in the world.”

A W.H.O. team — including two Americans, from the C.D.C. and the National Institutes of Health — did visit China in mid-February for more than a week, and its leaders said they were given wide latitude to travel, visit facilities and talk with people.

Whether or not China’s central government intentionally misstated the scale of the crisis, incomplete reporting has been seen in every other hard-hit country. France, Italy and Britain have all acknowledged seriously undercounting cases and deaths among people who were never hospitalized, particularly people in nursing and retirement homes.

New York City this week reported 3,700 deaths it had not previously counted, in people who were never tested. The United States generally leaves it to local coroners whether to test bodies for the virus, and many lack the capacity to do so.

In the early going, China was operating in a fog, unsure of what it was dealing with, while its resources in and around Wuhan were overwhelmed. People died or recovered at home without ever being treated or tested. Official figures excluded, then included, then excluded again people who had symptoms but had never been tested.

On Jan. 31 — a day after the W.H.O.’s emergency declaration — President Trump moved to restrict travel from China, and he has since boasted that he took action before other heads of state, which was crucial in protecting the United States. In fact, airlines had already canceled the great majority of flights from China, and other countries cut off travel from China at around the same time Mr. Trump did.

The first known case in the United States was confirmed on Jan. 20, after a man who was infected but not yet sick traveled five days earlier from Wuhan to the Seattle area, where the first serious American outbreak would occur.

The W.H.O. said repeatedly that it did not endorse international travel bans, which it said are ineffectual and can do serious economic harm, but it did not specifically criticize the United States, China or other countries that took that step.

Experts say it was China’s internal travel restrictions, more severe than those in the West, that had the greatest effect, delaying the epidemic’s spread by weeks and allowing China’s government to get ahead of the outbreak.

The W.H.O. later conceded that China had done the right thing. Brutal as they were, China’s tactics apparently worked. Some cities were allowed to reopen in March, and Wuhan did on April 8.

The Trump administration has not been alone in criticizing the W.H.O. Some public health experts and officials of other countries, including Japan’s finance minister, have also said the organization was too deferential to China.

The W.H.O. has altered some of its guidance over time — a predictable complication in dealing with a new pathogen, but one that has spurred criticism. But at times, the agency also gave what appeared to be conflicting messages, leading to confusion.

In late February, before the situation in Italy had turned from worrisome to catastrophic, Prime Minister Giuseppe Conte and other government officials, citing W.H.O. recommendations, said the regional governments of Lombardy and Veneto were doing excessive testing.

“We have more people infected because we made more swabs,” Mr. Conte said.

In fact, the W.H.O. had not said to limit testing, though it had said some testing was a higher priority. It was — and still is — calling for more testing in the context of tracing and checking people who had been in contact with infected patients, but few Western countries have done extensive contact tracing.

But the organization took pains not to criticize individual countries — including those that did insufficient testing.

On March 16, Dr. Tedros wrote on Twitter, “We have a simple message for all countries: test, test, test.” Three days later, a W.H.O. spokeswoman said that there was “no ‘one size fits all’ with testing,” and that “each country should consider its strategy based on the evolution of the outbreak.”

The organization was criticized for not initially calling the contagion a pandemic, meaning an epidemic spanning the globe. The term has no official significance within the W.H.O., and officials insisted that using it would not change anything, but Dr. Tedros began to do so on March 11, explaining that he made the change to draw attention because too many countries were not taking the group’s warnings seriously enough.

Testing Falls Woefully Short as Trump Seeks an End to Stay-at-Home Orders

Posted on April 16, 2020 by henrykotula • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Coronavirus, Crisis, Crisis Management, Health Policy, Infection Control, Infectious Virus, Pandemic, Public Health, Public Safety, Supply Chain, Truth • Leave a comment

Coronavirus Testing Falls Woefully Short as Trump Seeks to Reopen ...

As President Trump pushes to reopen the economy, most of the country is not conducting nearly enough testing to track the path and penetration of the coronavirus in a way that would allow Americans to safely return to work, public health officials and political leaders say.

Although capacity has improved in recent weeks, supply shortages remain crippling, and many regions are still restricting tests to people who meet specific criteria. Antibody tests, which reveal whether someone has ever been infected with the coronavirus, are just starting to be rolled out, and most have not been vetted by the Food and Drug Administration.

Concerns intensified on Wednesday as Senate Democrats released a $30 billion plan for building up what they called “fast, free testing in every community,” saying they would push to include it in the next pandemic relief package. Business leaders, who participated in the first conference call of Mr. Trump’s advisory council on restarting the economy, warned that it would not rebound until people felt safe to re-emerge, which would require more screening.

And Gov. Andrew M. Cuomo of New York reiterated his call for federal assistance to ramp up testing, both for the virus and for antibodies.

“The more testing, the more open the economy. But there’s not enough national capacity to do this,” Mr. Cuomo, a Democrat, said at his daily briefing in Albany. “We can’t do it yet. That is the unvarnished truth.”

As the governor spoke, a PowerPoint slide behind him said, “WE NEED FEDERAL SUPPORT.”

At his own briefing later in the day, Mr. Trump boasted of having “the most expansive testing system anywhere in the world” and said that some states could even reopen before May 1, the date his task force had tentatively set. Twenty-nine states, he added, “are in good shape.”

From the beginning of the coronavirus crisis, lapses by the federal government have compromised efforts to detect the pathogen in patients and communities. A diagnostic test developed by the Centers for Disease Control and Prevention proved to be flawed. The F.D.A. failed to speed approval for commercial labs to make tests widely available. All of that means that the U.S. has been far behind in combating the virus.

Whether in New York City, with its densely packed 8.4 million residents, or Nebraska, with fewer than two million spread across mostly rural expanses, widespread diagnostic and antibody testing will be crucial for determining a number of factors: How many in a community are infected but asymptomatic? Who has the protective antibodies that might allow them to go about their lives without fear? Are workplaces and schools safe?

“It is great that we are flattening the curve,” said Dr. Mark McClellan, director of the Margolis Center for Health Policy at Duke University, who worked in the George W. Bush administration and is advising state and federal policymakers on the virus response.

“But for this next phase, where we are really aiming to detect and stamp out smaller outbreaks before they get so big, testing is critical for that,” he said. “So we have to plan ahead now for much larger capacity.”

By the end of May, he added, “we will maybe be up to two million tests a week, but we are definitely not at that level now.”

Nationally, an average of 145,000 people have been tested for the virus each day over the past week, according to the Covid Tracking Project, which reported a total of nearly 3.1 million tests across the United States as of Tuesday night.

State health officials and medical providers around the country say they are unable to test as many people as they would like. Many of them say the biggest challenge is getting not the diagnostic tests themselves but the supplies to process them, including chemical reagents, swabs and pipettes. Manufacturers are facing a huge global demand as every country fights the pandemic, with many attempting the widest-scale testing they have ever undertaken.

“We’re at a really critical juncture and the supply chain has not yet caught up,” Scott Becker, chief executive of the Association of Public Health Laboratories, said on Wednesday.

Yet even as people waited hours for drive-through testing in California, Florida, New Jersey and elsewhere, some laboratories reported having ample capacity.

Two weeks ago, officials at University of California San Diego Health rushed to scale up testing, setting up a second laboratory devoted only to Covid-19. “You know the saying, ‘If you build it, they will come’?” said Dr. David T. Pride, director of the molecular microbiology laboratory there. “We built it and nobody has come. ” He said confusion over which laboratories were accepting tests, and “convoluted” systems connecting providers to labs, meant his facilities were running about 200 to 300 tests per day when they could handle 1,000.

Quest Diagnostics, one of the nation’s biggest testing laboratories, said on Wednesday that it could now process more tests than it was receiving, and that it was reaching out to state health departments, doctors and nursing homes. After dealing with backlogs for weeks, the company said it was returning results in less than two days for ordinary patients, and in less than one day for priority patients.

In Nebraska, as of Wednesday afternoon, 11,757 people had been screened for Covid-19, and of those, 901 were positive, according to state health data.

Peter C. Iwen, director of the Nebraska Public Health Laboratory, said that chemicals and equipment needed to run the tests were going to places like New Orleans and New York. “We’re trying to compete with those people, and we’re just not getting the reagents sent to us,” he said in an interview with the Omaha television station KETV.

The nonprofit Community Health of South Florida is operating three drive-through sites in the Miami area and the Florida Keys, where it has provided free testing to 1,300 people.

Tiffani Helberg, the group’s vice president for communications, said a tight supply of testing swabs as well as staffing numbers meant the nonprofit was not screening as many people as it would like.

“Is it a struggle every day? Absolutely,” she said.

The lack of testing is hitting minority communities especially hard, according to Dr. James E.K. Hildreth, president and chief executive of Meharry Medical College in Nashville, one of the nation’s largest historically black medical schools.

“Testing should be a priority for vulnerable populations — that would be prisons, nursing homes, assisted living facilities and, last but not least, minorities and disadvantaged communities,” said Dr. Hildreth, an infectious disease expert. “Because in those communities, we know there are many individuals with underlying conditions, and they are more likely to get severe disease and die.”

But even as short supplies are limiting who can get tests, some laboratories say they have extra capacity.

The American Clinical Laboratory Association, a trade group representing large diagnostic companies like LabCorp and Quest, has recently reported a dip in the daily testing volumes of its members. On Monday, its members processed 43,000 tests, the lowest number since March 20. At one point in early April, members were processing more than 100,000 a day.

“They are reaching out to providers to make sure they know that we have more testing capacity,” said Julie Khani, president of the lab association.

But even as testing for active coronavirus infections is struggling to meet demand, public health officials and major laboratories say they are gearing up for the next wave: antibody testing. A well-designed antibody test will detect whether someone has been exposed to the virus and generated an immune response, and whether the person may be protected from further illness.

“Antibody testing is not a cure-all,” Gov. Doug Ducey of Arizona, a Republican, said on Tuesday as he announced a partnership with the University of Arizona to provide antibody tests for 250,000 health care workers and emergency responders. “But learning more about it is an important step to identifying community exposure, helping us make decisions about how we protect our citizens and getting us to the other side of this pandemic more quickly.”

Most of the available antibody tests can say only whether someone has antibodies, not how many they have or how powerful they are at fighting the virus. Many of the tests are also flawed and signal the presence of antibodies even when there are none. The F.D.A. has granted emergency approval to three companies to begin selling the tests, but dozens more have entered the market after the agency loosened the guidelines in March.

“We have to to make sure it’s an accurate test with good specificity,” said Dr. Rachel Levine, Pennsylvania’s health secretary. “And we really need to know that antibodies are truly protective and how long-lasting they are.”

Dr. Jon R. Cohen, the executive chairman of BioReference Laboratories, which is processing tests at drive-through sites in New York and New Jersey and other locations around the country, said he was still evaluating different antibody tests but planned to begin offering them soon. Other large laboratories said the same.

“It’s a huge factor, we believe, in terms of people regaining confidence and jump-starting the economy,” he said. “To me, it’s an absolute moral imperative.”

Quest Diagnostics furloughing 4,000 employees

Posted on April 15, 2020 by henrykotula • Posted in Clinical Testing, Coronavirus, Crisis, Crisis Management, Diagnostic Testing, Employee Furlough, Employee Layoffs, Employee Pay Cuts, Infection Control, Infectious Virus, Pandemic • Leave a comment

https://www.beckershospitalreview.com/supply-chain/quest-diagnostics-furloughing-4-000-employees.html?utm_medium=email

Quest Diagnostics is a monopoly, schemed with insurers, California ...

Quest Diagnostics, the commercial lab that has performed about 800,000 COVID-19 tests, is furloughing more than 4,000 employees, which is about 9 percent of its workforce, CBS News reports.

Demand for COVID-19 testing has only partially offset a sharp drop in business for the company, according to CEO Steve Rusckowski.

The Secaucus, N.J.-based company has so far performed about 800,000 COVID-19 tests, making up about 40 percent of all testing done by commercial labs in the U.S. The company can process 45,000 diagnostic tests per day.

But, Quest saw its overall testing volumes drop by more than 40 percent in the last two weeks of March, CBS News reported.

In addition to the furloughs, members of the company’s executive board are all taking 25 percent pay cuts for the next 12 weeks and other employees’ salaries are being cut between 5 percent and 20 percent.

Quest has also suspended 401(k) matching for its employees and is dismissing temporary contract workers.

The company said its cost-cutting efforts won’t impact COVID-19 testing.

Read the full article here.

Medical supply scramble continues

Posted on April 15, 2020 by henrykotula • Posted in 2020 Election Issues, American Medical Association (AMA), Coronavirus, Crisis, Crisis Management, Emergency Preparedness, Health Policy, Infection Control, Infectious Virus, Intensive Care (ICU), Pandemic, Personal Protective Equipment (PPE), Prescription Drugs, Supply Chain, Ventilators • Leave a comment

https://www.axios.com/newsletters/axios-vitals-fb6b1c68-afc1-4b2b-9096-de20fd0b10a7.html?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter_axiosvitals&stream=top

What's Really To Blame For Drug Shortages

The U.S. is still scrambling to get health care workers the personal protective equipment, ventilators and lab testing materials that they need.

Between the lines: President Trump has repeatedly said that governors are responsible for obtaining supplies for their states, but industry groups are asking the federal government to play a larger role.

The American Medical Association asked FEMA to create a national system to acquire and distribute personal protective equipment, in light of ongoing shortages.
David Skorton, president and CEO of the Association of American Medical Colleges, wrote a letter to coronavirus task force coordinator Deborah Birx asking for more federal help with diagnostic testing supply shortages.

Meanwhile, the private sector is shifting into gear on its own and in partnership with the government.

The Trump administration and 20 major health care systems launched a new ventilator loan program that will allow hospitals to ship unused machines to areas where they are needed most to fight the coronavirus pandemic, Axios’ Joann Muller reports.
General Motors started manufacturing ventilators on Tuesday under a $489.4 million federal contract. But it will take until August to produce all 30,000 the government ordered under the Defense Production Act.
Space-focused organizations around the U.S. are now looking to manufacture ventilators and other much-needed health equipment to aid the pandemic relief effort, Axios’ Miriam Kramer reports.

1 scary stat: Prescription drugs needed by patients on ventilators are being filled only 53% of the time so far in April, as demand has skyrocketed, according to Vizient, a health care purchasing group.

California governor unveils roadmap for relaxing coronavirus lockdowns

Posted on April 15, 2020 by henrykotula • Posted in 2020 Election Issues, Coronavirus, Crisis, Crisis Management, Data, Economic Crisis, Economy, Health Policy, Infection Control, Infectious Virus, Leadership, Pandemic, Public Health, Public Safety • Leave a comment

https://www.axios.com/california-newsom-coronavirus-restrictions-3195f1b4-cbf8-4205-aeda-500d1e965486.html

California governor unveils roadmap for relaxing coronavirus ...

California Gov. Gavin Newsom released a roadmap on Tuesday that will guide how he will make the decision to relax the stay-at-home policies his state implemented to combat the spread of the coronavirus.

The big picture: While there is no timeline for modifying the stay-at-home order, Newsom’s office said California would use a “gradual, science-based and data-driven framework” to determine when it would be safe to do so. Newsom indicated efforts to flatten the curve in California “have yielded positive results.”

California had 24,421 confirmed cases of COVID-19 as of Tuesday afternoon, per the LA Times.
On Monday, Newsom announced California would create a task force with Oregon and Washington to coordinate the reopening of the regional economy. Northeastern states have announced a similar plan.

Details: Newsom said California would use six indicators to determine when to relax social distancing measures:

“The ability to monitor and protect our communities through testing, contact tracing, isolating, and supporting those who are positive or exposed.”
“The ability to prevent infection in people who are at risk for more severe COVID-19.”
“The ability of the hospital and health systems to handle surges.”
“The ability to develop therapeutics to meet the demand.”
“The ability for businesses, schools, and child care facilities to support physical distancing.”
“The ability to determine when to reinstitute certain measures, such as the stay-at-home orders, if necessary.”

Newsom’s roadmap also notes that life will be different even after stay-at-home orders are eased. For example, restaurants will likely reopen with fewer tables and face coverings will be more common in public.

What he’s saying: “While Californians have stepped up in a big way to flatten the curve and buy us time to prepare to fight the virus, at some point in the future we will need to modify our stay-at-home order,” Newsom said.

“As we contemplate reopening parts of our state, we must be guided by science and data, and we must understand that things will look different than before.”
“There is no light switch here. Think of it as a dimmer. It will toggle between less restrictive and more restrictive.”

We can’t just flip the switch on the coronavirus

Posted on April 15, 2020 by henrykotula • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy, Employee Protections, Expectations, Food and Drug Administration (FDA), Front Lines, Health Insurance Coverage Adequacy, Health Policy, Health System, Healthcare Providers, High Deductible Health Plans, High Drug Prices, High Premiums, High Prices, Hospital, Hospital Industry, Infection Control, Infectious Virus, Medicaid, Out of Network, Out of Pocket Expenses, Out-of-Network, Pandemic, Public Health, Public Safety, Supply Chain, Surprise Bills, Uncompensated Care, Underinsured, Unemployment, Unemployment Insurance, Uninsured, Vaccination, Vaccine, Worker Rights • Leave a comment

https://www.axios.com/coronavirus-slow-recovery-econony-deaths-27e8d258-754e-4883-bebe-a2e95564e3b6.html

The end of the coronavirus lockdown won't be like flipping a ...

It feels like some big, terrible switch got flipped when the coronavirus upended our lives — so it’s natural to want to simply flip it back. But that is not how the return to normalcy will go.

The big picture: Even as the number of illnesses and deaths in the U.S. start to fall, and we start to think about leaving the house again, the way forward will likely be slow and uneven. This may feel like it all happened suddenly, but it won’t end that way.

What’s next: Nationally, the number of coronavirus deaths in the U.S. is projected to hit its peak within the next few days. But many big cities will see their own peaks significantly later — for them, the worst is yet to come.

The White House is eyeing May 1 as the time to begin gradually reopening the economy. But that also will not be a single nationwide undertaking, and it will be a halting process even in the places where it can start to happen soon.
“In principle it sounds very nice, and everyone wants to return to normalcy. I think in reality it has to be incredibly carefully managed,” said Claire Standley, an infectious-disease expert at Georgetown University.

The future will come in waves — waves of recovery, waves of more bad news, and waves of returning to some semblance of normal life.

“It’s going to be a gradual evolution back to something that approximates our normal lives,” former Food and Drug Administration Commissioner Scott Gottlieb said.

What the post-lockdown world will look like:

Some types of businesses will likely be able to open before others, and only at partial capacity.
Stores may continue to only allow a certain number of customers through the door at once, or restaurants may be able to reopen but with far fewer tables available at once.
Some workplaces will likely bring employees back into the office only a few days a week and will stagger shifts to segregate groups of workers from each other, so that one new infection won’t get the whole company sick.
Large gatherings may need to stay on ice.

And there will be more waves of infection, even in areas that have passed their peaks.

“Everything doesn’t just go down to zero” once a city or region gets through its initial crush of cases, said Janet Baseman, a professor of epidemiology at the University of Washington.
This is happening now in Singapore, which controlled its initial outbreak more effectively than almost any other country in the world but is now seeing the daily number of new cases climb back up.

This is all but inevitable in the U.S., too, especially as travel begins to pick back up. Some places may need to shut down again, or at least tighten back up, if these new flare-ups are bad enough.

Part of the reason to lock down schools, businesses and workplaces is to prevent an outbreak from overwhelming the local health care system. If new cases start to pile up too quickly, leaders may need to pump the brakes.
“If you go back to normal too fast, then cases start to go up quickly, and then we end up back where we started,” Baseman said.
The good news, though, is that hospitals should have far more supplies by the fall, thanks to the coming surge in manufacturing for items like masks and ventilators.

What we’re watching: We’ll still need a lot more diagnostic testing to make this process work. Public health officials need to be able to identify people who might be spreading the virus before they begin to feel sick, and then identify the people they may have infected.

Most of the U.S. does not seem prepared for that undertaking, at least on any significant scale.
Another kind of test — serology tests, which identify people who have already had the virus and may be immune to it — will also help. We can’t test everyone, but identifying potential immunity could be important in knowing who can safely return to work in high-risk fields like health care.

The real turning point won’t come until there’s a proven, widely available treatment or, even better, a widely available vaccine.

A vaccine is still about a year away, even at a breakneck pace and if everything goes right. A treatment isn’t likely to be available until the fall, at the earliest.
In the meantime, all we can do is try to manage a slow recovery, using a less aggressive version of the same tools that are in place today.

The bottom line: “I’m not going back to Disneyland, I’m not going to take a cruise again, until we have a very aggressive testing system or we have very effective therapeutics or a vaccine,” Gottlieb said.

Bill Gates, in rebuke of Trump, calls WHO funding cut during pandemic ‘as dangerous as it sounds’

Posted on April 15, 2020 by henrykotula • Posted in 2020 Election Issues, American Medical Association (AMA), Clinical Testing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy, Emergency Preparedness, Health Policy, Infection Control, Infectious Virus, Mortality, Pandemic, World Health Organization (WHO) • Leave a comment

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Bill Gates: Trump halting funding to World Health Organization ...

Microsoft co-founder Bill Gates criticized President Trump’s decision to suspend funding to the World Health Organization as “dangerous,” saying the payments should continue particularly during the global coronavirus pandemic.

“Halting funding for the World Health Organization during a world health crisis is as dangerous as it sounds,” Gates tweeted early Wednesday. “Their work is slowing the spread of COVID-19 and if that work is stopped no other organization can replace them. The world needs @WHO now more than ever.”

The United States, the organization’s largest donor, has committed to provide the WHO with $893 million during its current two-year funding period, a State Department spokesperson told The Washington Post.

The Bill & Melinda Gates Foundation, the family’s giant philanthropy, is the next biggest donor to WHO after the U.S., accounting for close to 10 percent of the United Nations agency’s funding.

As The Washington Post’s Anne Gearan reported, the president said on Tuesday that the halt in U.S. funding would continue for a period of 60 to 90 days “while a review is conducted to assess the World Health Organization’s role and severely mismanaging and covering up the spread of the coronavirus.”

“We have not been treated properly,” Trump said at the Tuesday news briefing. He added, “The WHO pushed China’s misinformation about the virus.”

It remains unclear whether the United States will cut off money to the main international organization, or if Trump is setting conditions for a resumption of U.S. payments at a later date, The Post reported.

The announcement looms as a potentially devastating blow to the agency during the coronavirus pandemic, as the United States’ donations make up nearly 15 percent of all voluntary donations given worldwide.

The criticism from Gates, whose foundation has committed up to $100 million as part of the global response to the pandemic, comes as Trump has attempted to deflect blame for the administration’s failure to respond vigorously and early to the deadly novel coronavirus.

Also defending the WHO was U.N. Secretary General António Guterres, who, while not naming Trump, said it was “not the time to reduce the resources for the operations of the World Health Organization or any other humanitarian organization in the fight against the virus.”

“Now is the time for unity and for the international community to work together in solidarity to stop this virus and its shattering consequences,” he said.

Others, such as the American Medical Association, called Trump’s announcement to cut WHO funding “a dangerous step in the wrong direction.”

“Cutting funding to the WHO — rather than focusing on solutions — is a dangerous move at a precarious moment for the world,” the organization said in a statement. “The AMA is deeply concerned by this decision and its wide-ranging ramifications, and we strongly urge the President to reconsider.”

While some of Trump’s conservative allies are focusing on the WHO as complicit in a Chinese coverup of the outbreak, others have urged the president to hold off on moving forward on suspending funding.

“If the president wants to genuinely hold the WHO accountable, counter Chinese efforts to shift blame for COVID-19, and reform the WHO to better respond to the next pandemic, he should not cut funding — at least not yet,” wrote Brett D. Schaefer, an expert at the conservative Heritage Foundation and member of the U.N.’s Committee on Contributions.

It isn’t the first time that Gates has questioned the country’s response to the pandemic. In a TED interview last month, Gates, while not mentioning Trump by name, suggested the push to relax social distancing to reopen the country was reckless.

“There really is no middle ground, and it’s very tough to say to people: ‘Hey, keep going to restaurants, go buy new houses, ignore that pile of bodies over in the corner. We want you to keep spending because there’s maybe a politician who thinks GDP growth is all that counts,’” Gates said. “It’s very irresponsible for somebody to suggest that we can have the best of both worlds.”

In a March 31 op-ed for The Post, Gates emphasized that while the U.S. lost valuable time in getting out ahead of its response, there was still a path forward for recovery through decisions made by “science, data and the experience of medical professionals.”

“There’s no question the United States missed the opportunity to get ahead of the novel coronavirus. But the window for making important decisions hasn’t closed,” Gates wrote. “The choices we and our leaders make now will have an enormous impact on how soon case numbers start to go down, how long the economy remains shut down and how many Americans will have to bury a loved one because of covid-19.”

COVID-19 fatality rates vary widely, leaving questions for scientists

Posted on April 14, 2020 by henrykotula • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Coronavirus, Denial, Infection Control, Infectious Virus, Mortality, Pandemic, Public Health, Public Safety, Social Distancing • Leave a comment

COVID-19 fatality rates vary widely, leaving questions for scientists

The COVID-19 outbreak that has infected more than half a million Americans is killing people or causing them to become seriously ill at vastly different rates in different states, baffling scientists who are still learning about the coronavirus that causes the illness.

The virus so far has killed at least 23,529 people in the United States, a case fatality rate of just over 4 percent.

But the true mortality rate of COVID-19 is almost certainly much lower. Studies have showed that many infected with the virus show no symptoms, or nothing worse than a common cold, suggesting that the actual number of people who have contracted the virus is much larger than the 579,390 who had tested positive as of Tuesday morning.

The worst outcomes have come in states with the highest number of cases. Experts said that is likely a function of state rules that govern who is eligible to get one of the limited number of tests available: Only those who are sickest, and thus most likely to die from the disease, are tested, while those who are likely to make a speedy recovery are sent home to convalesce.

“In lots of places that are hard hit, what they have to do is limit testing to those who have symptoms, and sometimes pretty severe symptoms,” said Amira Roess, an epidemiologist and global health expert at George Mason University’s College of Health and Human Services.

“Different states are having to make testing decisions. They’re having to change their testing policies as they move through the epidemic.”

In Michigan, where 25,635 people have tested positive, the case fatality rate stands at 6.3 percent, the highest level in the country. New York, the epicenter of the outbreak in the United States, has recorded 10,056 deaths out of 195,031 cases, a fatality rate of 5.1 percent. And in Washington, where an early outbreak claimed dozens of lives at a nursing home, the case fatality rate stands at 5 percent.

Connecticut and New Jersey also have high case fatality rates amid outbreaks that are concentrated in the New York City suburbs.

Other states near the top of the list have large numbers of residents who suffer from the underlying conditions that seem to exacerbate the coronavirus. Kentucky, Oklahoma and Indiana all have relatively high case fatality rates, even though their number of confirmed cases is lower than in other states; they are among the states with higher-than-average obesity, diabetes and smoking rates.

“If you’re having a large number of elderly or people with underlying conditions getting infected, then you’re going to have a higher case fatality rate,” Roess said.

On the other end of the spectrum are smaller rural states that have seen relatively few cases so far, and where geography or population density have created a sort of built-in social distancing.

Wyoming on Monday became the last state in the union to report a death from the coronavirus. It has only reported 275 confirmed cases. Utah and South Dakota both have case fatality rates under 1 percent, though the number of cases in South Dakota has risen rapidly for such a small state in recent weeks.

West Virginia, Montana, Hawaii and Idaho all have case counts under 2 percent. So does North Carolina, a larger state but one with a substantial rural population.

The United States is trending better than the global average case fatality rate, according to data compiled by the European Centers for Disease Control. Worldwide, COVID-19 has killed a little more than 6 percent of confirmed cases. The rates are much higher in places like Italy and Spain, where health systems were overwhelmed by a huge explosion of cases in early March and where fatality rates stand north of 10 percent.

But the United States is faring worse than places like Germany and South Korea, where aggressive testing regimes have identified more people with the coronavirus — and therefore, more people who show few if any symptoms and are most likely to recover. The case fatality rate in Germany is about 2.4 percent, while it stands at just 2.1 percent in South Korea.

In Iceland, where huge teams of contact tracers have fanned out across Reykjavik and the country’s rural communities in what may be the world’s most ambitious testing regime, the case fatality rate stands at 0.5 percentage points.

Case fatality rates in countries like China and Iran are unclear, as scientists raise questions about the accuracy and transparency of the data those nations have made public.

Epidemiologists say they will earn a better understanding of the true toll of COVID-19 once they are able to do broader studies, randomized tests — like a public opinion poll, but with blood samples — to see just how many people in society at large have been infected by the virus, including the asymptomatic cases who might never know anything is wrong with them.

“We don’t have infection rates. We haven’t done a very simple test in epidemiology, which is to try to randomly sample a population in an overall area,” said Jennifer Prah Ruger, director of the Health Equity and Policy Lab at the University of Pennsylvania. “We don’t know how many people have been infected, have already recovered.”

Case fatality rates can change over time, and experts said they are already seeing a difference in states that promoted or enforced social distancing policies early on. The fast start to the outbreak in Washington state meant the fatality rate there was among the highest in the world in its earliest days — at one point in early March, nearly a third of the confirmed COVID-19 patients had died.

But as the state enforced distancing rules, and as the virus spread outside of the nursing home at its epicenter, the case fatality rate has dropped steadily. California, too, acted aggressively to ban large gatherings and encourage people to work from home, efforts that have paid off.

“The early social distancing has had a huge effect on mortality, which is what we’re really trying to do. We may be closer to being able to come out of shelter in place than other locations,” said George Rutherford, an epidemiologist at the University of California-San Francisco.

In states that waited longer to implement strict measures, the fatality rate may be on the rise — and the number of cases is growing quickly. Southern states like Florida, Alabama and Georgia have seen their case counts rising in recent days, after governors in those states were slow to take steps like closing beaches, restaurants and bars.

“They’ve come to the party late in terms of social distancing, and there may still be a price to be paid,” Rutherford said.

Hospitals will need a Bailout

Posted on April 14, 2020 by henrykotula • Posted in 2020 Election Issues, Cash, Cash Reserves, Cash-Flow Improvements, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Stimulus, Economy, Health Policy, Health System, Hospital, Hospital Bailout, Hospital Bankruptcy, Hospital Closure, Hospital Industry, Operating Expenses, Operating Income, Operating Margin, Operating Performance, Operating Revenue, Pandemic • Leave a comment

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We Tracked the Last Time the Government Bailed Out the… — ProPublica

The CEO of Kaleida Health in Buffalo, N.Y., said hospitals will likely need a bailout due to COVID-19, according to local news station WGRZ.

Kaleida Health President and CEO Jody Lomeo highlighted parallels between hospitals and U.S. automakers during the Great Recession.

“I would think there’s gonna have to be some reimbursement on some level and we’ve seen some of that already with the [recent federal] stimulus bill. We’re gonna need support,” he told WGRZ. He added that his health system “can survive for a couple of months; after that I would be really nervous.”

While federal stimulus funds have begun flowing to hospitals nationwide, hospital CEOs are blasting HHS’ decision to distribute the first $30 billion in emergency funding based on Medicare fee-for-service revenue. HHS said April 10 it would allocate money to hospitals and providers based on their historical share of revenue from the Medicare program, rather than the burden caused by the coronavirus or number of uninsured patients treated.

105 hospitals furloughing workers in response to COVID-19

Posted on April 14, 2020 by henrykotula • Posted in Coronavirus, Crisis, Crisis Management, Employee, Employee Furlough, Health System, Hospital, Hospital Industry, Pandemic • Leave a comment

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Benefits Continuation During a Furlough or Reduction in Hours ...

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

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

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

April 14

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

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

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

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

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

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

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

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

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

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

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

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

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

April 13

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

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

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

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

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

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

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

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

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

8. Although Mayo Clinic previously said it would protect full pay and benefits through April 28, after that date the system now says it will furlough some staff and implement pay cuts to address significant reductions in revenues. The Rochester, Minn.-based system said it projects a $900 million shortfall, even with the furloughs and pay cuts.

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

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

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

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

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

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

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

April 10

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

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

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

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

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

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

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

7. Lexington, Ky.-based UK HealthCare said it plans to place some employees on unpaid leave after April 25 if the pandemic continues to affect operations, according to WKYT. Direct care providers will not be affected by the furloughs.

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

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

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

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

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

April 9

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

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

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

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

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

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

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

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

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

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

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

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

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

April 8

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

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

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

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

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

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

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

6. Citing financial difficulties caused by the COVID-19 pandemic, Chillicothe, Ohio-based Adena Health System plans to furlough nonclinical workers in the coming weeks, according to a video from Adena CEO Jeff Graham.

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

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

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

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

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

April 7

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

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

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

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

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

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

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

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

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

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

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

April 6

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

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

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

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

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

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

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

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

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

April 3

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

2. Citing financial uncertainty due to the COVID-19 pandemic, Dallas-based Tenet Healthcare will furlough 500 workers. Affected employees are full-time staff not involved in clinical care. They will not receive pay, but will have health insurance.

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

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

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

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

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

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

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

April 2

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

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

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

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

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

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

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

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

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

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

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

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

March 27 to April 1

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

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

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

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

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

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

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

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

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

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

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HENRY KOTULA

A Healthcare Leadership Blog

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