Category Archives: Quarantine

We Work on the Front Lines of COVID-19. Here’s What Hospitals Should Do

Posted on by • Posted in Antibodies, Clinical Testing, Communication, Coronavirus, Crisis, Crisis Management, Discharge Planning, Emergency Preparedness, Health System, Hospital, Hospital Industry, Infection Control, Infectious Virus, Intensive Care (ICU), Oxygen, Pandemic, Personal Protective Equipment (PPE), Quarantine, Rehabilitation Care, Telemedicine, Ventilators • Leave a comment

https://www.medpagetoday.com/infectiousdisease/covid19/86185?xid=fb_o&trw=no&fbclid=IwAR3iM5LMZj3BxWisk3puZ2T3bOCeBaDS_xCRoTrnVaZYfj4-DZPmUfr01cw

We Work on the Front Lines of COVID-19. Here's What Hospitals ...

A game plan from ground zero.

It’s only a matter of time before all of us are directly affected by COVID-19. Proper preparation is the only way to ensure high-quality patient care and staff well-being in this challenging time. Having collectively spent time caring for patients at two different tertiary care facilities in New York on the medical floors and intensive care units, common themes are emerging that represent opportunities for hospitals in other parts of the country to start taking action before COVID-19 patients start filling up beds en masse.

Staffing

It takes a LOT of people to care for a COVID-19 onslaught; mapping out different staffing scenarios in the event you have 40 or 400 COVID patients is imperative. Staffing needs for COVID patients are higher than normal because of the patients’ complex medical needs — many require ICU level nursing and respiratory therapists — and because both clinical and non-clinical staff will inevitably become sick and need to be taken out of work. Staff should be screened for symptoms and high-risk contacts; those who are symptomatic should be proactively encouraged to stay home instead of showing up to work not feeling well and putting other care team members and patients at risk. This requires back-up staffing plans to fill in when your people become sick. Shutting down non-urgent and elective departments provides staffing redundancy to pull from when needed. All employees should be given advance notice about staffing plans so that potential role changes are clear.

Testing

Robust testing processes for both patients and your healthcare workforce are critical for success. Hospitals should be taking this time to obtain in-house rapid testing kits to avoid unnecessary patient isolation and conserve personal protective equipment (PPE) while waiting for test results.

Healthcare workers are understandably scared about contracting COVID-19 themselves and giving it to their family members. We recommend all staff members be tested for active infection so that those who are infected can be proactively quarantined.

Forward-thinking institutions should be prioritizing antibody testing for healthcare workers. While this testing is still in its infancy, it is quite likely that those with strong antibodies to COVID-19 possess some degree of immunity. Therefore, if you can identify which doctors, nurses, respiratory therapists, physical therapists, and janitorial staff have already developed an immune response to COVID-19, these staff members can take priority staffing infected units with the goal of reducing the number of new infections in healthcare workers and limiting exposure to those who have yet to contract the virus.

Communication

Each institution’s COVID-19 protocols and policies change rapidly as we learn more about the virus. How you communicate these ever-changing procedures with staff is critical. Most hospitals rely on daily email updates that are text-heavy; however, overwhelmed inboxes and less time with devices while wearing PPE limits the success of email as a sole communication channel.

Communication through graphics takes on new importance — signage noting changes in hospital geography, large pictures of donning and doffing instructions, phone numbers to call with equipment shortages, and clear instructions to staff about testing protocols, isolation, and removing patients from isolation need to be conveniently placed where staff can access information in real time without consulting their electronic devices. High-yield locations for just-in-time visual communication include outside patient rooms, nursing stations, break rooms, and elevators, so that the target information reaches its busy, hard-working audience successfully and repeatedly, minimizing confusion and augmenting clarity.

Limiting the Need to Enter the Room

Given ongoing PPE shortages, particularly around single-use gowns and N95 masks, minimizing the number of instances that staff, particularly nurses, need to enter the room is critical. This requires an adjustment from normal patient care. We recommend extension tubing to bring IV poles and medications outside the room. Tablets such as iPads can permit video calls with patients to check on non-urgent items. Centralized monitoring of oxygen saturations for all admitted patients can minimize the frequency of supplemental oxygen adjustment.

Similarly, given the increased risk of COVID-19 in diabetic patients, continuous blood glucose monitoring can minimize the need for frequent manual fingerstick measurements for patients receiving supplemental insulin.

Discharge Planning

Discharging patients to home or rehabilitation facilities presents novel challenges. A home discharge requires education, equipment, and follow-up. Education on home monitoring of vitals signs like oxygen saturation and blood pressure with instructions on critical values that should prompt patients to return to the hospital can expedite discharge and open hospital beds for other sick patients. Both patients and family members must also be educated on quarantine procedures to limit household transmission.

Many patients will have temporary oxygen requirements and we have seen home oxygen shortages in our areas. Coordinating a strategy with your outpatient clinicians, home oxygen suppliers, and insurance companies can facilitate getting patients home sooner on home oxygen and freeing up beds for sicker patients. Further, many patients are eager to go home earlier since hospital visitation limitations mean they’re sitting in bed alone away from family and the more a hospital can do to safely discharge patients home with appropriate supplies and follow-up will be beneficial to both patients and the hospital.

Hospitals must also be prepared to integrate these patients into their existing telehealth infrastructure, which has become the mainstay of ambulatory medicine in lieu of traditional office visits. For many patients, this will be a new way of accessing care. Prior to discharge, hospital staff should ensure patients have downloaded the necessary apps with login information and feel comfortable they will be able to follow up with their physician using technology following discharge.

There is a huge opportunity for hospitals that have not been caring for large numbers of COVID-19 patients to prepare ahead of time in a manner that optimizes patient care and minimizes risks to staff. Those of us on the early front lines have learned many of these lessons the hard way. An ounce of prevention is worth a pound of cure — we encourage all healthcare systems to take action before the storm comes.

 

 

 

 

US surpasses 1 million COVID-19 cases

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Emergency Preparedness, Health Policy, Infection Control, Infectious Virus, Mortality, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

https://thehill.com/policy/healthcare/494792-us-surpasses-1-million-covid-19-cases

Did the Trump Administration Overpromise 1 Million COVID-19 ...

More than a million people in the United States have tested positive for the coronavirus, a sobering milestone that experts say represents only the beginning of a months-long battle to end the pandemic.

The United States has now registered about a third of all confirmed cases of COVID-19 around the globe, according to data compiled by the Center for Systems Science and Engineering at Johns Hopkins University. More than 57,000 people have died in the United States, about a quarter of the known COVID-19 deaths around the globe.

The United States has now registered more confirmed cases than the next five countries suffering the largest outbreaks — Spain, Italy, France, Germany and the United Kingdom — combined.

Those numbers are partly a reflection of population, but there are troubling signs for the United States.

While those countries have reduced the pace of transmission and the growth in the number of new cases they are seeing on a daily basis, the United States has not similarly bent the curve.

Instead, it is stuck at a deadly plateau: In the last week, the U.S. has reported between 24,000 and 41,000 new cases a day, and between 1,200 and 2,600 deaths per day, according to The Covid Tracking Project, a group of researchers who keep tallies of case counts around the country.

Even as some states begin to relax orders that closed retail and service stores, experts warned the country is still at risk of a new rush of cases, and that the downslope of declining case counts will be much longer than the sudden surge the United States saw in April.

“We’re in the opening stages of this,” said Michael Osterholm, director of the Center for Infectious Disease Research and Prevention at the University of Minnesota. States “are not in the mountains, they’re in the foothills. The mountains are still to come.”

More than a quarter million residents of New York have tested positive for the virus, and commuter suburbs in New Jersey and Connecticut have reported tens of thousands of cases. More than 50,000 residents of Massachusetts have tested positive, and California, Illinois and Pennsylvania have all confirmed more than 40,000 cases.

There are growing signs that the virus is shifting into new, more rural territory. States like Arkansas, Kansas, Minnesota, Nebraska, New Mexico, Rhode Island, Tennessee and Virginia all recorded substantial growth in the number of new cases they had confirmed in the last few days.

That pattern of viral spread beginning in large urban cores and eventually making its way to rural areas is typical, experts said, given societal connections between urban areas, suburbs and more rural areas.

“Epidemiologists know that this pattern is a very expectable one, that rural areas are going to have lagged waves of cases. So we’ve been bracing for that,” said Nita Bharti, a biologist at the Center for Infectious Disease Dynamics at Penn State University. “What they’re experiencing now is what cities have been seeing. It’s the same, it’s just delayed, and we knew it would happen.”

About six months after the coronavirus outbreak was detected in Wuhan, China, and four months after the first case arrived on American shores, the United States still lags the world in testing capacity. States have bolstered their capacity in recent days, conducting more than 225,000 tests per day over four of the last five days, the capacity needed to ensure the virus can be brought under control lags substantially.

An analysis by Harvard researchers for the scientific publication STAT found more than half of states would have to significantly bolster their testing capacity in order to safely begin easing stay-at-home orders in May. The hardest-hit state, New York, will have to be able to test at least 100,000 more people every day than it is currently able to; New Jersey’s capacity would need to increase by 68,000 a day.

Smaller states and those that have yet to experience thousands of new cases — places like Mississippi, Idaho, Montana, Wyoming, Arizona and New Mexico — already have the testing capacity they need to identify and squelch any new viral hotspots. Even Washington state, the first state to confirm a positive case, has built its capacity to meet demand.

Public health experts say a robust testing program must be supplemented by armies of contact tracers who can track down those who are at risk of contracting the virus.

Already, Massachusetts has partnered with the nonprofit Partners In Health to deploy about 1,000 contact tracers across the state. Alaska has managed to trace the contacts of each of its 341 positive cases. New York City Mayor Bill de Blasio said Monday that the city would hire 1,000 contact tracers of its own, and former Mayor Mike Bloomberg has pledged $10 million to kick start a contact tracing program in the tri-state area.

On Monday, a bipartisan group of top public health experts led by President Trump‘s former FDA commissioner Scott Gottlieb and President Obama’s former Centers for Medicare and Medicaid Services administrator Andy Slavitt called on Congress to spend $46 billion to expand contact tracing capacity, including $12 billion to hire 180,000 new workers.

It is unclear how the outbreak in the United States compares with outbreaks in authoritarian countries like China, Russia and Iran, which do not report reliable numbers.

But even in the United States, where state and local governments are transparent about the data they collect, the actual number of cases and deaths are higher — likely significantly so. Early antibody tests in places like New York City and Miami show a significant number of people contract the virus without showing symptoms, and as studies show people who died inexplicably over the last several months tested positive for the virus.

 

 

 

COVID-19 vulnerability: A state-by-state analysis

Posted on by • Posted in Coronavirus, Crisis, Crisis Management, Health Policy, Infection Control, Infectious Virus, Pandemic, Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

https://www.beckershospitalreview.com/rankings-and-ratings/covid-19-vulnerability-a-state-by-state-analysis.html?utm_medium=email

To live and die in Dixie - Covid-19 is spreading to America's ...

Every state in the U.S. will be affected by COVID-19, but some are more vulnerable due to limited ability to mitigate and treat the virus, and to reduce its economic and social impacts, according to a COVID-19 vulnerability index created by the Surgo Foundation. 

The Surgo Foundation, a privately funded think tank, created an index that combines indicators specific to COVID-19 with the CDC’s social vulnerability index, which measures the expected negative impact of disasters of any type. The Surgo Foundation’s index takes into account factors that fall into one of several categories, including socioeconomic status, minority status, housing type, epidemiologic factors and health care system factors. Each state and the District of Columbia received a score in each category and an overall score, with a higher score indicating that the state is more vulnerable. Read more about the methodology here.

Here is each state’s ranking and composite score based on the vulnerability index: 

1. Mississippi: 1

2. Louisiana: 0.98

3. Arkansas: 0.96

4. Oklahoma: 0.94

5. Alabama: 0.92

6. West Virginia: 0.9

7. New Mexico: 0.88

8. Nevada: 0.86

9. North Carolina: 0.84

10. South Carolina: 0.82

11. Kentucky: 0.8

12. Hawaii: 0.78

13. Tennessee: 0.76

14. Missouri: 0.74

15. Kansas: 0.72

16. Indiana: 0.7

17. Georgia: 0.68

18. Oregon: 0.66

19. District of Columbia: 0.64

20. New York: 0.62

21. Alaska: 0.6

22. Delaware: 0.58

23. Michigan: 0.56

24. Arizona: 0.54

25. Illinois: 0.52

26. Iowa: 0.5

27. Texas: 0.48

28. New Jersey: 0.46

29. Idaho: 0.44

30. Maryland: 0.42

31. Ohio: 0.4

32. Massachusetts: 0.38

33. Nebraska: 0.36

34. Florida: 0.34

35. Washington: 0.32

36. Connecticut: 0.3

37. Pennsylvania: 0.28

38. Montana: 0.26

39. Rhode Island: 0.24

40. Virginia: 0.22

41. South Dakota: 0.2

42. Utah: 0.18

43. Wyoming: 0.16

44. California: 0.14

45. Minnesota: 0.12

46. Colorado: 0.1

47. Wisconsin: 0.08

48. North Dakota: 0.06

49. Maine: 0.04

50. Vermont: 0.02

51. New Hampshire: 0

 

 

 

Healthcare CFOs weigh-in on the challenges ahead

Posted on by • Posted in Capital Budget, Cash, Cash Reserves, Cash-Flow Improvements, CFO, Change, Change Management, Communication, Contact Tracing, Coronavirus, Cost Management, Cost Reduction, Crisis, Crisis Management, Cybersecurity, Economic Crisis, Economy, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employee Protections, Leadership, Leadership Cares, Leadership Flexibility, Mergers & Acquisitions, Net Income, Operating Expenses, Operating Income, Operating Margin, Operating Performance, Operating Revenue, Personal Protective Equipment (PPE), Quarantine, Recession, Remote Work, Sick Leave, Social Distancing, Supply Chain, Telemedicine, Uncertainty, Worker Protection • Leave a comment

https://www.pwc.com/us/en/library/covid-19/pwc-covid-19-cfo-pulse-survey.html

What CFOs think about the economic impact of COVID-19

How finance leaders see a return to work

Business perspectives on what it will take to shift from crisis mode are solidifying. US finance leaders are focused on shoring up financial positions, as US businesses head into a period of even more operational complexity while they orchestrate a safe return to the workplace. Back-to-work playbooks put workforce health first, as companies set course for a phased-in return to the workplace that will not be uniform across the US or internationally, findings from the survey show. Returning employees and customers are going to experience a work environment that will differ in marked ways as a result. Another change likely to endure post-crisis is the strong role corporate leaders have taken within their communities, placing a renewed emphasis on environmental, social and governance (ESG) efforts going forward.

The actions CFOs are taking show how US businesses continue to adjust to very difficult current conditions with an eye toward an evolving post-COVID world. The level of concern related to the crisis is holding steady. It is high but stabilizing, with 72% of respondents reporting that COVID-19 has the potential for “significant impact” to their business operations vs. 74% two weeks ago.

Key findings

Back-to-work playbooks reshape how jobs performed
49% say remote work is here to stay for some roles, as companies plan to alternate crews and reconfigure worksites.

Protecting people top of mind
77% plan to change safety measures like testing, while 50% expect higher demand for enhanced sick leave and other policy protections.

Substantive impacts expected in 2020 results
Half of all respondents (53%) are projecting a decline of at least 10% in company revenue and/or profit this year.

Cost pressures intensify
A third (32%) expect layoffs to occur, as CFOs continue to target costs, while 70% consider deferring or canceling planned investments.

Economic events shaping CFO response last week

This survey, our fourth since emergency lockdowns took effect in the US, reflects the views of 305 US finance leaders during the week of April 20. It was a week when oil futures traded below $0 as energy markets confronted downshifting global demand, Congress replenished emergency funding of $480 billion for small firms and healthcare systems, and everyone heard the call to get ready to go back to work as the US and Europe firmed up plans to ease quarantines.

Post-crisis world taking shape in plans to reboot the workplace

Health and safety are top priorities for leaders as they prepare to bring people back to on-site work. More than three-quarters (77%) are putting new safety measures in place, while others are taking steps to promote physical distancing, such as reconfiguring workspaces (65%). Findings also show where the virus may have longer-lasting impact on ways of working. Half (49%) of companies say they’re planning to make remote work a permanent option for roles that allow. That’s even higher (60%) among financial services organizations.

Takeaways

Among the small percentage of companies that are beginning to bring people back, returning to work will not mean a return to normal. Companies should consider how to help frontline managers lead with empathy, to communicate transparently and make decisions quickly so employees understand where they stand, have access to the resources available to them, and can share feedback to ensure they feel safe and get what they need. Tools such as workforce location tracking and contact tracing can help support employees with suspected or confirmed infections, while also helping to identify the level of risk exposure. Companies looking to make remote work a permanent option will need to enable leaders to manage a blended workforce of on-site and remote workers during the next 12 to 18 months.

Given that many people may be wary of returning to on-site work, there’s an opportunity for companies to create more targeted benefits to help make the transition easier. Paid sick leaves and worker protections, help with childcare, private transportation to and from work, or other benefits could help employees who may need extra flexibility or who want additional support as they prepare to come back.

Forecasting substantive impacts on 2020 performance

A majority of respondents (80%) continue to expect a decline in revenues and/or profits in 2020. Projections by sector vary, with consumer markets likely the hardest hit: one-third (32%) of CFOs expect a 25% or greater decline in revenues and/or profits this year, compared to 24% of respondents in all sectors.

Takeaways

Outlooks for financial results have held relatively steady in the survey over the last month, and are probably indicative of actual impact. Companies have had the time to evaluate the effects. CFO projections for declining revenue and profits coincide with a widening realization that the US economy is in recession. Since mid-March, jobless claims have soared past 26 million, and Congress passed relief packages of $2.5 trillion. CFOs are evaluating a wide range of scenarios that cover the health situation, the shape of the economic recovery, the spillover into the financial markets, and the resulting impacts on their business. This crisis is setting a new benchmark standard for “unknowable.”

Cost pressures intensifying

CFOs are considering additional ways to scale back on planned investment and/or other fixed costs amid volatility in demand. A third (32%) expect layoffs to occur in the next month, up from 26% two weeks ago. Protecting cash and liquidity positions is paramount. Financial impacts of COVID-19, including effects on liquidity and capital resources, remain the top concern of CFOs (71%). Over half (56%) say they are changing company financing plans, up from 46% two weeks ago.

Among other actions, 43% plan to adjust guidance, which is consistent with responses two weeks ago. This figure will likely increase as companies go through the earnings season over the next two to three weeks. Separately, 91% of respondents are planning to include a discussion of COVID-19 in external reporting. Depending on the type of company, this can mean inclusion in financial statements and/or in risk factors and MD&A results of operations, earnings release or MD&A liquidity sections.

Takeaways

Many CFOs have focused on how they can manage their cash pressures to ride out the crisis. Common approaches have included stop-gap measures, such as hiring freezes and tightening controls on discretionary costs to put an end to travel and events, or the use of contractors. Findings show that these types of cost actions are likely to continue, and they remain at the top of the CFO agenda.

Of those who say they’re considering deferring or canceling planned investments, 80% are considering facilities and general capital expenditures. At the same time, investment programs in areas that are considered important to future growth — including digital transformations, customer experience, or cybersecurity and privacy — are less likely to be targeted. CFOs will increasingly look for ways to prioritize costs in these areas, as businesses grow more confident in recovery prospects — even though current demand is subdued.

Priorities to de-risk supply chains

As companies continue to wade through mitigation efforts and start to think about recovery, many are planning changes to make their supply chains more resilient. Findings show CFOs prioritizing specific actions: 56% cite developing alternate options for sourcing, and 54% say better understanding the financial and operational health of their suppliers.

Takeaways

Findings confirm an emphasis on de-risking supply chains, as companies prioritize the health and reliability of their supplier base among changes they’re planning as a result of COVID-19. In particular, there is a focus on managing risk around supply elements, such as reducing structural vulnerability with other sourcing options.

Some companies are starting to invest in creating data-backed profiles of their supplier base so they know where and when to look for second sources. Others are increasing communication with suppliers to better understand financial health. For many, conducting deeper financial and health reviews of suppliers will become a regular part of their business reviews. Physical supply chain relocations will likely happen only as a last resort, given the costs involved. However, automation of certain elements of the supply chain — to eliminate time-consuming manual tracking efforts and check tariff structures, for example — will likely become more common as companies seek better data to make more informed decisions.

Strategies yet to change, but tech likely to drive M&A

The impact of the outbreak on mergers and acquisitions (M&A) strategies remains mixed. While 40% of respondents say their company’s M&A strategy is not being affected by COVID-19, compared with 34% two weeks ago, one in five say it’s too difficult to assess what changes, if any, will need to be made to strategy. CFOs within the technology, media and telecommunications industry stand out in particular. They are less likely to report decreasing appetite for M&A due to COVID-19, compared with peers in other sectors, and 55% say the crisis hasn’t changed their M&A strategy.

Takeaways

These findings highlight the fundamental strengths of the tech sector and suggest it will be among those driving M&A in the months ahead.  Tech giants, in particular, have large cash reserves. Moreover, demand for some tech products and services is strong as businesses return to work — 40% of CFOs say they will accelerate automation and new ways of working as they transition back. Additionally, technologies such as drones, artificial intelligence and robotics, will likely enjoy wider adoption in the post-COVID-19 environment. This leaves tech better-positioned to weather the pandemic’s economic fallout and to execute on inorganic growth strategies. M&A is likely to recover faster than the US economy, with tech among the cash and capital-rich sectors leading the charge. PwC studies show that a combination of factors has been driving a decoupling of deals from the broader economy.

Business recovery timeframes have extended

Organizations are realizing the business recovery from the impacts of the virus will take longer. The March measures of manufacturing and services activities show sharp drops. Demand is not only declining, it’s shifting. Moreover, even as some US states start to reopen, difficulties in setting up testing could keep some states in a holding pattern. As a result, for CFOs, the time required to return to “business as usual” the moment that COVID-19 ends continues to lengthen. Currently, 48% believe it will take at least three months to return to normal, up from 39% two weeks ago.

Takeaways

As reality sets in and companies understand the true impacts to their operations, CFO perceptions of the length of time to business recovery has extended. According to our analysis of how companies gauge their response to the crisis in PwC’s COVID-19 Navigator diagnostic tool, the expected impact of COVID-19 on businesses globally remains high, with consumer markets and manufacturing the most susceptible among industries. Put another way, businesses that are less reliant on a large, complex supply chain to deliver products, or are able to work relatively effectively while remote, are also likely to be among the least exposed.

Consumer-facing companies reconfigure physical sites as shutdowns start to lift

Companies in consumer-facing sectors continue to contend with both sides of the demand equation, as consumers sheltering in place focus single-mindedly on essential products to the exclusion of other offerings. Consumer markets (CM) CFOs are more likely to list a decrease in consumer confidence and spending as a top-three concern than they were two weeks ago (66% vs. 50%). For CM CFOs, consumer confidence trends translate almost directly to revenues, with 32% projecting an adverse impact on revenue and/or profit of at least 25% in 2020, compared with 24% of respondents across all industries.

In response, almost three-quarters of CM CFOs (73%) are considering deferring or canceling planned investments, targeting mostly general capital expenses, such as facilities. They also say technologies that can improve their understanding of changes in customer demand are a top-three priority as they plan changes to their supply chain strategies (41% vs. 30% for all sectors).

CM CFOs are planning workplace safety measures (86% vs. 77% for all sectors) and reconfiguring work sites to promote physical distancing as part of their transition back to on-site work (77% vs. 65% for all sectors). They recognize that consumers want the assurance of a safe physical environment above all else, especially because the majority of CM products and services require a physical component, despite the continuing shift to online.

Takeaways

Consumer-facing companies continue to be among the hardest hit, as the public health crisis keeps the majority of consumers confined to their homes for now. As they grapple with immediate challenges, CM companies are pulling back on capital investments. However, most are still planning to shore up their digital presence in response to accelerated online demand that could last well beyond the recovery period.

Health system pivots to new ways of working

What’s on the mind of financial leaders in the health industry? As they plan to bring more of their workforce back on-site, they are more likely than leaders in other industries to be leaning on technology to help them manage staffing uncertainties. Fifty-four percent of healthcare CFO respondents said they plan to accelerate automation and new ways of working, compared with an average of 40% across all industries.

Healthcare organizations are simultaneously solving two critical issues: uncertainty about demand and protecting their workforce. Health organization CFOs (70%) were more likely than executives from other industries (an average of 50%) to report that they expect higher demand for employee protections in the next month. Meanwhile, consumer anxiety over their own safety is driving up uncertainty about demand for healthcare and medical products. Forty-one percent of healthcare finance leaders listed tools to better understand customer demand as a top-three priority area when considering changes to their supply chain strategies, compared to 30% of financial leaders in all sectors. Fifty-one percent of healthcare finance leaders said they are making staffing changes as a result of slowed demand.

Takeaways

A survey conducted by PwC’s Health Research Institute in early April found that some consumers are delaying care and medications amid the pandemic. In this latest PwC survey of CFOs, healthcare leaders report uncertainty about how much of their business will return as the threat of the pandemic ebbs, making staffing decisions difficult.

As the nation continues to grapple with the pandemic, getting back to work is top of mind for US financial leaders overall, but this is an especially pressing issue for health leaders. They must plan for their own workforces, while dealing with an unfolding financial calamity — 81% expect their company’s revenue and/or profits to decline this year as a result of COVID-19. On par with other industries, they expect this decline, even though their organizations play central roles in addressing the human toll of the pandemic. One strategy is to use telehealth technology to virtually care for patients, thereby protecting patients and caregivers during the pandemic.

Financial firms see fewer layoffs, but slower recovery

Financial services (FS) CFOs are bracing for a longer road back to normal. About a third (35%) now think it could take six months to get back to business as usual, up sharply from 15% just two weeks ago. They’re also more optimistic about the bottom line. More than a quarter (27%) of FS survey respondents expect revenue and/or profits to fall by 10% or less. Across all industries, only 18% felt as confident.

Takeaways

Banks are playing a critical role in helping stabilize the economy, as they work on the front lines to distribute CARES Act provisions. Along with insurers and asset managers, they also rely heavily on workers with specialized technical and institutional knowledge. This may explain why FS CFOs expect fewer layoffs (15% vs. 32% overall) or furloughs (17% vs. 44% overall) over the next month. Now, they’re trying to focus on keeping workers healthy and safe.

Conversations are starting to shift toward when and how to transition back to physical offices. For some employees, work may look very different: More FS CFOs are considering making remote work a permanent option for roles that allow it (60% vs. 49% overall). To better protect their employees, they’re also looking to evaluate new tools to support workforce tracking and contact tracing (32% vs. 22% overall) as part of the return-to-work process.

Deeper insight into health of suppliers is top priority for industrial products

The industrial products (IP) sector is in full-throttle cost-cutting mode. Nearly all IP CFOs (96%) report considering cost containment measures, compared with 87% two weeks ago. Some of this comes in the form of layoffs: 49% of IP CFOs expect layoffs to occur vs. 36% two weeks ago. The longer the crisis lasts, the longer the impact on recovery times for their business. When asked how long it would take for their business to return to business as usual if the COVID-19 crisis were to end today, 15% of IP CFOs said less than one month, down from 25% two weeks ago.

Meanwhile, they’re closely examining challenged supply chains. When asked to list their top-three priority areas when planning changes to supply-chain strategies, 66% of IP CFOs identified understanding the financial and operational health of their suppliers, compared to 54% of CFOs across all industries. A majority (56%) also cited developing additional and alternate sourcing options as a priority. And the extent of the financial damage is sinking in: 65% of IP CFOs estimate 2020 revenues and/or profits will drop at least 10%.

Takeaways

IP CFOs are signaling they’re in the thick of the crisis, as they absorb historical lows in production, with March US industrial output plunging to levels not seen since the end of WWII. Continued cost actions are still in the cards.

IP finance leaders are looking ahead to get back to business, with some already bringing workers back on-site. Some are expecting changes to the workplace. Thirty-nine percent of IP CFOs are considering making remote work a permanent option for roles that allow, and 31% are considering accelerating automation and new ways of working. While these are still early days for US producers in returning to work, bringing millions of workers back into the fold may well usher in more change management than the industry now expects.

Tech, media and telecom well-positioned to power the recovery

Technology, media and telecommunications (TMT) companies are well-positioned for recovery from the initial blow of COVID-19. As they stabilize operations in response to the crisis, the percentage of TMT CFOs anticipating revenue and/or profit declines is down 19 percentage points from two weeks ago to 65%. The data suggest that TMT companies are preparing for a future in which virtual work options gain greater acceptance over traditional office settings. TMT companies are more likely to reduce their real estate footprint as they transition back to on-site work (38% compared to 26% for all sectors), and 55% say they’re planning to make remote work permanent for positions that allow.

Of those who said they’re considering deferring or canceling planned investments, TMT companies are less likely to reduce digital transformation investments (13%) than all sectors (22%). Their increased optimism about digital investment as they strategize for the future is further borne out by the data: Two weeks ago, of those who said they were deferring or canceling planned investment, TMT was on track to reduce digital investments at the same rate as other sectors (25%).

Takeaways

The resilience of TMT companies is evident in their approach to this crisis. Bolstered by robust liquidity, the majority of companies in the sector are looking ahead to a recovery they will power by using both organic growth and M&A. In the wake of a crisis that has accelerated more widespread virtual connectivity, look for new emerging-tech-enabled business models to take shape.

Where to focus next

COVID-19 has put businesses under enormous strain to drive new ways of working. When the pandemic began, many companies put their people’s health and safety at the center of their decision-making, and they appear to be doing the same as they prepare to ramp up business. With most firms expecting to bring people back on-site in phases, leaders will need to help employees adjust to a changed environment while still managing the well-being, engagement and productivity of all workers. Purpose-led communication will continue to be critical to keep people informed, and leaders should demonstrate empathy while helping employees adjust to what will likely be an extended transition period. 

 

 

Robots are playing many roles in the coronavirus crisis – and offering lessons for future disasters

Posted on by • Posted in Coronavirus, Crisis, Crisis Management, Front Lines, Healthcare Providers, Infection Control, Infectious Virus, Pandemic, Quarantine, Robots, Social Distancing, Telemedicine, Thermal Imaging • Leave a comment

https://theconversation.com/robots-are-playing-many-roles-in-the-coronavirus-crisis-and-offering-lessons-for-future-disasters-135527

Robots are playing many roles in the coronavirus crisis – and ...

A cylindrical robot rolls into a treatment room to allow health care workers to remotely take temperatures and measure blood pressure and oxygen saturation from patients hooked up to a ventilator. Another robot that looks like a pair of large fluorescent lights rotated vertically travels throughout a hospital disinfecting with ultraviolet light. Meanwhile a cart-like robot brings food to people quarantined in a 16-story hotel. Outside, quadcopter drones ferry test samples to laboratories and watch for violations of stay-at-home restrictions.

These are just a few of the two dozen ways robots have been used during the COVID-19 pandemic, from health care in and out of hospitals, automation of testing, supporting public safety and public works, to continuing daily work and life.

The lessons they’re teaching for the future are the same lessons learned at previous disasters but quickly forgotten as interest and funding faded. The best robots for a disaster are the robots, like those in these examples, that already exist in the health care and public safety sectors.

Research laboratories and startups are creating new robots, including one designed to allow health care workers to remotely take blood samples and perform mouth swabs. These prototypes are unlikely to make a difference now. However, the robots under development could make a difference in future disasters if momentum for robotics research continues.

Robots around the world

As roboticists at Texas A&M University and the Center for Robot-Assisted Search and Rescue, we examined over 120 press and social media reports from China, the U.S. and 19 other countries about how robots are being used during the COVID-19 pandemic. We found that ground and aerial robots are playing a notable role in almost every aspect of managing the crisis.

In hospitals, doctors and nurses, family members and even receptionists are using robots to interact in real time with patients from a safe distance. Specialized robots are disinfecting rooms and delivering meals or prescriptions, handling the hidden extra work associated with a surge in patients. Delivery robots are transporting infectious samples to laboratories for testing.

Outside of hospitals, public works and public safety departments are using robots to spray disinfectant throughout public spaces. Drones are providing thermal imagery to help identify infected citizens and enforce quarantines and social distancing restrictions. Robots are even rolling through crowds, broadcasting public service messages about the virus and social distancing.

At work and home, robots are assisting in surprising ways. Realtors are teleoperating robots to show properties from the safety of their own homes. Workers building a new hospital in China were able work through the night because drones carried lighting. In Japan, students used robots to walk the stage for graduation, and in Cyprus, a person used a drone to walk his dog without violating stay-at-home restrictions.

Helping workers, not replacing them

Every disaster is different, but the experience of using robots for the COVID-19 pandemic presents an opportunity to finally learn three lessons documented over the past 20 years. One important lesson is that during a disaster robots do not replace people. They either perform tasks that a person could not do or do safely, or take on tasks that free up responders to handle the increased workload.

The majority of robots being used in hospitals treating COVID-19 patients have not replaced health care professionals. These robots are teleoperated, enabling the health care workers to apply their expertise and compassion to sick and isolated patients remotely.

A robot uses pulses of ultraviolet light to disinfect a hospital room in Johannesburg, South Africa. MICHELE SPATARI/AFP via Getty Images

A small number of robots are autonomous, such as the popular UVD decontamination robots and meal and prescription carts. But the reports indicate that the robots are not displacing workers. Instead, the robots are helping the existing hospital staff cope with the surge in infectious patients. The decontamination robots disinfect better and faster than human cleaners, while the carts reduce the amount of time and personal protective equipment nurses and aides must spend on ancillary tasks.

Off-the-shelf over prototypes

The second lesson is the robots used during an emergency are usually already in common use before the disaster. Technologists often rush out well-intentioned prototypes, but during an emergency, responders – health care workers and search-and-rescue teams – are too busy and stressed to learn to use something new and unfamiliar. They typically can’t absorb the unanticipated tasks and procedures, like having to frequently reboot or change batteries, that usually accompany new technology.

Fortunately, responders adopt technologies that their peers have used extensively and shown to work. For example, decontamination robots were already in daily use at many locations for preventing hospital-acquired infections. Sometimes responders also adapt existing robots. For example, agricultural drones designed for spraying pesticides in open fields are being adapted for spraying disinfectants in crowded urban cityscapes in China and India.

Workers in Kunming City, Yunnan Province, China refill a drone with disinfectant. The city is using drones to spray disinfectant in some public areas. Xinhua News Agency/Yang Zongyou via Getty Images

A third lesson follows from the second. Repurposing existing robots is generally more effective than building specialized prototypes. Building a new, specialized robot for a task takes years. Imagine trying to build a new kind of automobile from scratch. Even if such a car could be quickly designed and manufactured, only a few cars would be produced at first and they would likely lack the reliability, ease of use and safety that comes from months or years of feedback from continuous use.

Alternatively, a faster and more scalable approach is to modify existing cars or trucks. This is how robots are being configured for COVID-19 applications. For example, responders began using the thermal cameras already on bomb squad robots and drones – common in most large cities – to detect infected citizens running a high fever. While the jury is still out on whether thermal imaging is effective, the point is that existing public safety robots were rapidly repurposed for public health.

Don’t stockpile robots

The broad use of robots for COVID-19 is a strong indication that the health care system needed more robots, just like it needed more of everyday items such as personal protective equipment and ventilators. But while storing caches of hospital supplies makes sense, storing a cache of specialized robots for use in a future emergency does not.

This was the strategy of the nuclear power industry, and it failed during the Fukushima Daiichi nuclear accident. The robots stored by the Japanese Atomic Energy Agency for an emergency were outdated, and the operators were rusty or no longer employed. Instead, the Tokyo Electric Power Company lost valuable time acquiring and deploying commercial off-the-shelf bomb squad robots, which were in routine use throughout the world. While the commercial robots were not perfect for dealing with a radiological emergency, they were good enough and cheap enough for dozens of robots to be used throughout the facility.

Robots in future pandemics

Hopefully, COVID-19 will accelerate the adoption of existing robots and their adaptation to new niches, but it might also lead to new robots. Laboratory and supply chain automation is emerging as an overlooked opportunity. Automating the slow COVID-19 test processing that relies on a small set of labs and specially trained workers would eliminate some of the delays currently being experienced in many parts of the U.S.

Automation is not particularly exciting, but just like the unglamorous disinfecting robots in use now, it is a valuable application. If government and industry have finally learned the lessons from previous disasters, more mundane robots will be ready to work side by side with the health care workers on the front lines when the next pandemic arrives.

 

 

 

 

Tentative steps toward recovering from a deadly pandemic

Posted on by • Posted in 2020 Election Issues, Center for Medicare and Medicaid Services (CMS), Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Dept of Health and Human Services (HHS), Economic Crisis, Economic Stimulus, Economy, Elective Procedures, Elective Surgery, Health Policy, Health System, Hospital, Hospital Industry, Infection Control, Infectious Virus, Medicare, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Safety Net Hospitals, Safety-Net Providers, Social Distancing, The CARES Act • Leave a comment

https://mailchi.mp/0d4b1a52108c/the-weekly-gist-april-24-2020?e=d1e747d2d8

Baby Steps – Selah Someonetotalkto's Blog

The death toll from the novel coronavirus continued to mount this week, with more than 50,000 deaths reported in the US, and over 900,000 confirmed cases nationwide. Globally, the disease has infected more than 2.7M people and killed nearly 200,000. On Tuesday, public health officials in California announced that two people who died in Santa Clara County in early February were victims of COVID-19, making them the earliest known fatalities in the US, and altering experts’ understanding of how long the disease has been spreading in the country. New modeling from researchers at Northeastern University this week suggested that the virus may have been spreading widely in several cities by early February, but went undetected because of restrictions on testing.

National attention has remained focused on the subject of testing, as states and localities scramble to secure enough testing supplies and equipment to allow them to understand community spread and identify new cases. President Trump signed an emergency $484B relief bill on Friday that will provide $25B to ramp up testing, give additional aid to businesses forced to shutter, and send hospitals $75B in additional emergency funding.

The new money for hospitals is in addition to $100B already approved by Congress for a “provider relief fund” as part of the CARES Act. Having already distributed $30B of the initial grant money to hospitals, the Department of Health and Human Services (HHS) was expected to pay out an additional $20B today, this time according to a formula based on the net patient revenue of each hospital, rather than the earlier approach based on Medicare billings. The shift is expected to address concerns among children’s hospitals, safety-net providers, and others who were disadvantaged by the Medicare-based approach. It is unclear how the newly approved $75B of additional funding will be allocated.

Meanwhile, states began to plan for the reopening of their economies, with most governors taking a measured approach in coordination with neighboring states. A handful of states moved to loosen stay-at-home restrictions in advance of meeting the Trump administration’s “gating” criteria, including Florida, which reopened some beaches for recreational use, Oklahoma, and Georgia, which controversially allowed gyms, bowling alleys, hair and nail salons, and tattoo parlors to reopen on Friday.

Many states began to put in place plans to restart elective surgeries, which had been curtailed by a patchwork of differing state and local directives. The Centers for Medicare and Medicaid Services (CMS) released guidelines this week to help local officials decide when and how to restart surgeries. Whether for healthcare services or other types of economic activity, states will (and should) be guided by the ability to conduct widespread testing, robust contact tracing, and isolation of those infected with the virus. Ensuring that ability will likely make the next phase of the pandemic a protracted and frustrating “dance” of fits and starts, likely to last into the summer months and beyond.

 

 

 

Cartoon – State of the Union

Posted on by • Posted in 2020 Election Issues, Cartoon, Communication, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy, Emergency Preparedness, False Hope, Health Policy, Infection Control, Infectious Virus, Leadership Culture, Leadership Decentralized, Mislead, Misleading, Mortality, Pandemic, Partisanship, Public Health, Public Safety, Quarantine, Social Distancing, State of the Union • Leave a comment

iroon.com: Cartoons

 

Governor Cuomo, Bloomberg Announce Unprecedented New York COVID-19 Coronavirus Contact Tracing Program

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

https://www.forbes.com/sites/brucelee/2020/04/23/governor-cuomo-bloomberg-announce-unprecedented-new-york-covid-19-coronavirus-contact-tracing-program/?utm_source=newsletter&utm_medium=email&utm_campaign=career&cid=5d2c97df953109375e4d8b68#129e09243cd1

Coronavirus: Why are there doubts over contact-tracing apps? - BBC ...

New York is not going to let the COVID-19 coronavirus spread without a trace. Make that multiple traces. In fact, make that many, many, many traces.

New York State Governor Andrew Cuomo and former New York City Mayor Mike Bloomberg announced the launch of a massive contact tracing program in an effort to better contain the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). How massive? How about larger-than-any-contact-tracing-effort-that’s-been-attempted-before-in-the-U.S. massive?

It is a sign of the times that Cuomo had to include a slide that said: “But we can’t be stupid.” After all, there are other people out there pushing to re-open businesses without at the same time providing a specific plan on how exactly to stop the virus when social distancing measures are relaxed.

Bloomberg Philanthropies, which was founded by Bloomberg, will contribute $10.5 million as well as technical support and assistance to the program. The Johns Hopkins Bloomberg School of Public Health will develop an online training program and certification process for those doing the contact tracing. Vital Strategies, via its Resolve to Save Lives initiative, will advise and assist the New York State Health Department staff in developing protocols and processes to help the whole contact tracing process.

Speaking of vital strategies, “test-trace-isolate” is quite a vital strategy to try to contain the COVID-19 coronavirus so that social distancing measures can be relaxed and things can re-open, at least to some degree. Contact tracing is the “trace” part of that strategy. I’ve described previously for Forbes how to do contact tracing. When you’ve identified a person (an index case) infected with the SARS-Cov2 via testing, contact tracing is determining and locating every person that index case may have had contact with that was close enough to transmit the virus. This way you can isolate or quarantine all of those contacts as quickly as possible so that they can’t spread the virus any further. Essentially testing, tracing, and isolating or quarantining aims to contain the virus, to box it in, to give it no people to spread to, to surround it by nothing but toilet paper, fluffy pillows, Netflix videos, and whatever else people have in their houses and apartments.

Without a vaccine or specific treatment versus the SARS-Cov2, the virus could have spread much more widely without social distancing measures in place, because supplements, gargling salt water, Medieval chants or whatever bogus prevention measures have been offered weren’t going to stop the virus. Premature re-opening could send all of those efforts down the metaphorical toilet bowl. “While we start our work to re-open our economy we must ensure we are doing it in a way that does no harm and does not undo all of the work and sacrifice it has taken to get here,” said Cuomo in statement. “One of the most critical pieces of getting to a new normal is to ramp up testing, but states have a second big task – to put together an army of people to trace each person who tested positive, find out who they contacted and then isolate those people.”

Think about it. If you re-open places and relax social distancing measures, it could take only a small number of people spreading the virus to then cause another surge in COVID-19 cases. Therefore, a good contact tracing program needs to be in place to catch potentially infectious people quickly. Implementing large scale and coordinated contact tracing programs has been one way that Germany, Singapore and South Korea have been able to better control the COVID-19 coronavirus and its impact than the U.S. and U.K. have.

“We’re all eager to begin loosening restrictions on our daily lives and our economy,” said Bloomberg in a statement. “But in order to do that as safely as possible, we first have to put in place systems to identify people who may have been exposed to the virus and support them as they isolate.”

Putting appropriate systems in place before making a decision? Hear that sound? It’s the sound of science walking back into the ongoing “re-open America” conversation and saying, “what the heck have you been doing to the house while I’ve been away.” Deciding to re-open anything without first putting proper systems in place to monitor and contain the virus would be like going to a dinner party when you aren’t wearing any clothes. It would leave you quite exposed and basically put your butt on the line.

Although the program is launching immediately, it will take some time to recruit and train hundreds or perhaps thousands of tracers. Potential recruits will come from a variety of places such as the State Department of Health, various state agencies, the State University of New York (SUNY), and the City University of New York (CUNY). Henning indicated that the timeline for getting things in place will be in the order of “a number of weeks.”

This program will coordinate with contact tracing efforts in New Jersey and Connecticut. After all, this virus doesn’t respect borders or need an E-ZPass to spread to neighboring states. As Henning noted, “New York state has already been talking extensively with New Jersey and other states.”

If you live outside this tri-state area, try to pay attention to what’s going on here. After all, contact tracing will have to occur in other parts of the country as well. Otherwise, the virus can keep circulating in different parts of the country, which means that it could at any time readily spread to the rest of the U.S. After all, the virus is like a very bad house guest. It doesn’t respect boundaries. And it is unlikely to just disappear without a trace.

 

 

The South is vulnerable to a coronavirus nightmare

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Coronavirus, Crisis, Crisis Management, Health Policy, Infection Control, Infectious Virus, Mortality, Pandemic, Partisanship, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Social Distancing, Vulnerable Populations • Leave a comment

https://www.axios.com/newsletters/axios-vitals-d53939d5-90fb-4aef-a87d-30cf2b0ceebf.html?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter_axiosvitals&stream=top

COVID-19 vulnerability index, by county

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The South is at risk of being devastated by the coronavirus.

Why it matters: Southern states tend to have at-risk populations and weak health care systems — and they’re the ones moving fastest to loosen social distancing rules. That puts them at risk for the worst-case coronavirus scenarios.

The big picture: To stop the spread of the coronavirus, there are really only two options: stringent social distancing, or stringent public health measures.

Driving the news: Several southern states including Georgia, Tennessee and South Carolina have recently announced that they’re starting to back off of social distancing.

  • Our national testing capacity is still nowhere near where experts say it needs to be, and only some communities have announced efforts to build up contact tracing.

Between the lines: The Surgo Foundation created a coronavirus community vulnerability index that takes into account factors like socioeconomic status, minority status, housing type, epidemiologic factors and health care system factors.

The bottom line: The South is already worse off in almost every way, partially due to policy choices made in these states. Its comparatively unhealthy population is vulnerable to more serious illness, and looser social distancing will enable the virus’ spread.