Category Archives: Supply Chain

Operating margins plummet at US hospitals, Kaufman Hall says

Posted on by • Posted in Cash, Cash Reserves, Cash-Flow Improvements, Coronavirus, Crisis, Crisis Management, Elective Procedures, Elective Surgery, Employee Benefits, Employee Furlough, Employee Layoffs, Employee Pay Cuts, Employer-Based Health Insurance, Health Insurance Coverage Adequacy, Health Policy, Health System, Infection Control, Infectious Virus, Net Income, Operating Expenses, Operating Income, Operating Margin, Operating Performance, Operating Revenue, Out of Pocket Expenses, Pandemic, Paycheck Protection Program, Personal Protective Equipment (PPE), Supply Chain, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://www.healthcaredive.com/news/Kaufman-hospitals-operating-margin-decline/576491/

Third Quarter Investment Report: Moving Into Choppy Waters « CPEA ...

Dive Brief:

  • Operating margins at the nation’s hospitals have plummeted due to large-scale volume and revenue declines coupled with flat to rising expenses, according to a new report from Kaufman Hall.
  • Based on March data from more than 800 U.S. hospitals, average operating margins dropped 150% year over year, plunging non-profit hospitals, which historically operate on already thin margins, into troublesome territory.
  • The data paint a dire picture for U.S. hospitals. “These initial numbers only reflect the first two weeks of the COVID-19 response and likely indicate more negative results in the future,” Jim Blake, managing director at Kaufman Hall, said in a statement.

Dive Insight:

Hospitals depend heavily on elective surgeries for revenue, but had to cancel or postpone many of them starting last month in order to preserve coveted COVID-19 resources such as personal protective equipment, beds and staff.

Those measures have upended the financial health of the entire industry in a matter of just weeks, according to new data and analysis from Kaufman Hall.

“We anticipate April will be significantly worse, and at this point, no one knows how long hospitals will continue on their current path,” Blake said.

Despite the ongoing pandemic, patient volumes overall have plunged. During March, the median hospital occupancy rate was 53%, with operating room minutes down 20% year-over-year and emergency room visits down 15% year over year, according to the report.

At the same time, hospitals’ labor expenses were up 3% year over year, and non-labor expenses were up 1%. In order to rein in operating costs, some health systems have begun to furlough or lay off workers.

While non-profit systems are especially vulnerable given their razor-thin margins, major for-profit systems are also struggling financially.

HCA Healthcare, Community Health Systems and Tenet Healthcare have all pulled their 2020 guidance in response to the pandemic. In its first quarter report Tuesday, HCA attributed a steep decrease in volumes and 45% drop in profit to the pandemic.

And Jefferies analyst wrote in a note Tuesday they are reducing their volume and earnings expectations for those companies for this year and 2021 based on the pandemic. “Our belief is that high unemployment translates to reduced commercial insurance coverage and disposable income to fund co-pays/deductibles, which results in fewer physician visits and procedures,” they wrote.

Under these circumstances, the federal government has attempted to financially support struggling hospitals through ongoing coronavirus relief legislation.

First came accelerated Medicare payments based on reimbursement data, in the form of loans that providers will have to pay back.

Separately, the Coronavirus Aid, Relief, and Economic Security Act passed by Congress in March benchmarked $100 billion in funding to provide financial support to struggling hospitals.

A $30 billion first round was announced April 8 and given to providers based on historic Medicare payments. A second round of CARES act funding for systems in hot spots is next, although the timing is unclear.

On Tuesday the Senate approved a separate $484 billion aid package, the Paycheck Protection Program and Health Care Enhancement Act, that would send an additional $75 billion in emergency funds to hospitals. It also allocates $25 billion to expand testing for the virus across the country.

The White House expressed support for the package. It still needs House approval, which could happen as soon as this week.

The latest package comes in response to depleted funding for the Small Business Administration’s Paycheck Protection Program. Upon replenishing those funds, smaller health systems may be eligible for forgivable PPP loans used to meet payroll and other operating costs, but only if they have 500 or fewer employees.

 

 

 

 

New England Journal of Medicine publishes letter from doctor explaining how FBI and DHS almost grabbed the medical masks his hospital was buying

Posted on by • Posted in 2020 Election Issues, Coronavirus, Pandemic, Personal Protective Equipment (PPE), Physician, Physician Leadership, Supply Chain • Leave a comment

https://www.alternet.org/2020/04/new-england-journal-of-medicine-publishes-letter-from-doctor-explaining-how-fbi-and-dhs-almost-grabbed-the-medical-masks-his-hospital-was-buying/

New England Journal of Medicine publishes letter from doctor ...

The New England Journal of Medicine has begun a new series called “Covid-19 Notes,” which is focusing on the innovative responses to the dealing with the coronavirus. On Friday, the journal published a letter about acquiring N95 masks written by Dr. Andrew W. Artenstein, M.D., of Baystate Health in Springfield, Massachusetts. Here’s an excerpt from the letter:

As a chief physician executive, I rarely get involved in my health system’s supply-chain activities. The Covid-19 pandemic has changed that. Protecting our caregivers is essential so that these talented professionals can safely provide compassionate care to our patients. Yet we continue to be stymied by a lack of personal protective equipment (PPE), and the cavalry does not appear to be coming.

Our supply-chain group has worked around the clock to secure gowns, gloves, face masks, goggles, face shields, and N95 respirators. These employees have adapted to a new normal, exploring every lead, no matter how unusual. Deals, some bizarre and convoluted, and many involving large sums of money, have dissolved at the last minute when we were outbid or outmuscled, sometimes by the federal government. Then we got lucky, but getting the supplies was not easy. […]

Hours before our planned departure, we were told to expect only a quarter of our original order. We went anyway, since we desperately needed any supplies we could get. Upon arrival, we were jubilant to see pallets of KN95 respirators and face masks being unloaded. We opened several boxes, examined their contents, and hoped that this random sample would be representative of the entire shipment. Before we could send the funds by wire transfer, two Federal Bureau of Investigation agents arrived, showed their badges, and started questioning me. No, this shipment was not headed for resale or the black market. The agents checked my credentials, and I tried to convince them that the shipment of PPE was bound for hospitals. After receiving my assurances and hearing about our health system’s urgent needs, the agents let the boxes of equipment be released and loaded into the trucks. But I was soon shocked to learn that the Department of Homeland Security was still considering redirecting our PPE. Only some quick calls leading to intervention by our congressional representative prevented its seizure. I remained nervous and worried on the long drive back, feelings that did not abate until midnight, when I received the call that the PPE shipment was secured at our warehouse.

It would be nice to have federal leadership that doesn’t make acquiring essential medical equipment seem more like buying a heroin shipment.

https://www.nejm.org/doi/full/10.1056/NEJMc2010025?query=featured_coronavirus

 

 

 

 

Governors Reject Pence’s Claim on Virus Testing

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Core Values, Coronavirus, Crisis, Crisis Management, Health Policy, Infection Control, Infectious Virus, Mislead, Misleading, Pandemic, Public Health, Public Safety, Social Distancing, Supply Chain • Leave a comment

Coronavirus and Reopening: Governors Say They Lack Tests as Trump ...

Democratic and Republican governors bristled at claims from the Trump administration that the supply of tests was adequate to move firmly toward reopening the country.

Governors facing growing pressure to revive economies decimated by the coronavirus said on Sunday that a shortage of tests was among the most significant hurdles in the way of lifting restrictions in their states.

“We are fighting a biological war,” Gov. Ralph Northam of Virginia said on “State of the Union” on CNN. “We have been asked as governors to fight that war without the supplies we need.”

In interviews on Sunday morning talk shows, Mr. Northam was among the governors who said they needed the swabs and reagents required for the test, and urged federal officials to help them get those supplies.

The governors bristled at claims from the Trump administration that the supply of tests was adequate. On NBC’s “Meet the Press,” Vice President Mike Pence said “there is a sufficient capacity of testing across the country today for any state in America” to go to the first of three phases that the administration says are needed for the country to emerge from the coronavirus shutdown.

Mr. Northam, a Democrat, called Mr. Pence’s claim “delusional.” In Michigan, Gov. Gretchen ​Whitmer, also a Democrat, said the state could perform “double or triple” the number of tests it is doing now “if we had the swabs or reagents.” ​Gov. Larry Hogan​ of Maryland, a Republican, said that it was “absolutely false” to claim that governors were not acting aggressively enough to pursue as much testing as possible.

“It’s not accurate to say there’s plenty of testing out there, and the governors should just get it done,” Mr. Hogan ​said​ on “State of the Union​.​”​ “That’s just not being straightforward.”

The conflicting messages come as the debate over how and when to reopen the economy has intensified. President Trump on Saturday expressed his confidence in the nation’s testing capability and said some governors have “gotten carried away,” while state officials said they feared moving too early could cause the virus to flare again.

“As tough as this moment is,” Ms. Whitmer said in an interview with CNN, “it would be devastating to have a second wave.”

In a news conference on Sunday evening, Mr. Trump expressed his confidence in the federal response, including his administration’s relationship with governors and the capacity for testing.

Mr. Trump said the administration was preparing to use the Defense Production Act to compel one U.S. facility to increase production of test swabs by over 20 million per month. The announcement came after he defended his response to the accusations that there was an insufficient amount of testing to justify reopening the economy any time soon.

“You’ll have so many swabs you won’t know what to do with them,” Mr. Trump said.

Officials at every level have faced increasingly competing pressures, balancing maintaining stay-at-home orders against the exasperation and economic toll they are producing. On Saturday and Sunday, modest protests took place in several cities across the country, where demonstrators flouted social distancing rules as they demanded that restrictions be relaxed.

Yet there was also a widespread sense that much of the public understood the governors’ concerns and shared them. Nearly 60 percent of American voters said they were worried that measures would be relaxed too soon, causing deaths to rise, according to a new poll from NBC News and The Wall Street Journal.

Officials in various states said they had started staging plans for reopening their economies and were working in concert with neighboring states in determining when to lift restrictions.

In South Carolina, Gov. Henry McMaster said that he had spoken with the governors of other southeastern states, including Florida and Tennessee. “Told them South Carolina was ready,” Mr. McMaster, a Republican, said on Twitter on Saturday.

On Sunday, governors from across the Northeast, including New York, New Jersey, Connecticut and Pennsylvania, said they were creating a regional council focused on restoring the economy and addressing unemployment.

Still, many governors, including Andrew M. Cuomo of New York and Philip D. Murphy of New Jersey, said that testing still needed to be ramped up considerably before moving forward, and that they needed federal help to do so.

There are currently about 150,000 diagnostic tests conducted each day, according to the Covid Tracking Project. Researchers at Harvard estimated last week that in order to ease restrictions, the nation needed to at least triple that pace of testing.

Dr. Deborah Birx, the coronavirus response coordinator for the White House, also pushed back against criticism that not enough people were being tested, saying that not every community required high levels of testing and that tens of thousands of test results were probably not being reported.

“We need to predict community by community the testing that is needed,” Dr. Birx said Sunday on CBS’s “Face the Nation​.” “Each will have a different testing need, and that’s what we’re calculating now.”

On the ABC program “This Week,” Dr. Birx said she thought statistics on testing were incomplete: “When you look at the number of cases that have been diagnosed, you realize that there’s probably 30,000 to 50,000 additional tests being done that aren’t being reported right now.”

Shortages of supplies have restricted the pace of testing, according to commercial laboratories. Dr. Birx said that a team at Walter Reed National Military Medical Center was calling hundreds of labs around the country to determine exactly what supplies they need “to turn on full capacity, which we believe will double the number of tests that are available for Americans.”

In the news conference on Saturday, Mr. Trump said the criticism of the administration was driven by Democrats. “Unfortunately, some partisan voices are trying to politicize the issue of testing,” he said.

Yet, Gov. Jay Inslee of Washington noted that governors from both parties had been among those voicing frustration over a lack of federal support with testing. He also criticized what he saw as a discordant message from Mr. Trump, which, he argued, undermined governors’ stay-at-home orders and inspired “people to ignore things that actually can save their lives.”

“These orders actually are the law of these states,” Mr. Inslee, a Democrat, said in an interview with “This Week.” He added: “And, again, these are not just Democrats. These are Republican-led states as well. To have an American president to encourage people to violate the law, I can’t remember any time during my time in America where we have seen such a thing.”

Now, with states transitioning away from addressing the peak of the pandemic, governors stand to face a difficult landscape to navigate.

Governors across the political spectrum have stepped into the spotlight during the coronavirus crisis, holding daily news briefings and going back and forth with the president. But if they drew praise for taking quick action to protect public health, taking responsibility for when and how to reopen could prove far more politically perilous, said Ray Scheppach, a public policy professor at the University of Virginia and a former longtime executive director of the National Governors Association.

“That is one of the reasons you’re seeing groups of governors and states get together,” he said, noting the alliances made by clusters of governors around the country.

“Doing something with the surrounding states does give you a certain amount of political cover,” both with constituents and the White House, Professor Scheppach said. “They don’t want to get pushed around by this president and they are stronger in a group.”

Having claimed responsibility for reopening the country, governors are now offering hesitant timelines. Offering no date for reopening may leave people feeling despondent at a time when “people need more certainty as opposed to less,” Professor Scheppach said. But being too firm comes with the risk of having to push out deadlines and test the public’s patience.

“You can do it once,” he said, as Mr. Cuomo and others have done. “But you begin to lose if you do that two or three times.”

Governors said they had become acutely aware of the dilemmas they face.

In his appearance on CNN, Mr. Hogan was shown footage of a long line winding around a supermarket in a Maryland suburb of Washington where free food was being handed out. The video was an unsettling avatar of the economic damage wrought by the virus. He said he shared in the frustration over the economy, but he also noted that his state had not yet reached its peak in cases.

“My goal is to try to get us open as quickly as we possibly can,” he said, “but in a safe way.”

 

 

 

Cartoon – Sending Our Medical Warriors to Battle

Posted on by • Posted in Cartoon, Coronavirus, Crisis, Crisis Management, Employee Protections, Firefighters, First Responders, Front Lines, Health Policy, Healthcare Providers, Infection Control, Infectious Virus, Leadership, Leadership Cares, Management, Nurses, Pandemic, Personal Protective Equipment (PPE), Physician, Public Health, Public Safety, Supply Chain • Leave a comment

Marshall Ramsey: PPE | Mississippi Today

Beginning the long, winding journey back from coronavirus

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, Employer-Based Health Insurance, Health Insurance Coverage Adequacy, Health Policy, High Deductible Health Plans, Infection Control, Infectious Virus, Mortality, Out of Pocket Expenses, Pandemic, Personal Protective Equipment (PPE), Preexisting Conditions, Public Health, Public Safety, Social Distancing, Supply Chain, Test-Positivity Rate, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://mailchi.mp/39947afa50d2/the-weekly-gist-april-17-2020?e=d1e747d2d8

45cat - The Beatles - The Long And Winding Road / For You Blue ...

It was another brutal week in the coronavirus pandemic, with more than 2.1M cases and nearly 150,000 deaths worldwide. The US continued to be the hardest-hit country, reaching a daily record 4,591 deaths from COVID-19 on Thursday. The national death toll is now more than 35,000, though there are signs that the number of new cases in the US has begun to plateau, raising hopes that the worst days may be drawing to a close. Meanwhile, with strict stay-at-home measures continuing in most places across the country, the economic toll of the virus mounted. New unemployment claims rose by another 5.2M, bringing the estimated number of American jobs claimed by the virus to 22M, eliminating a decade’s worth of job growth, and raising the unemployment rate to an estimated 17 percent.

As the growth in new cases flattened, attention turned this week to plans to “reopen” the American economy. Despite insisting early in the week that he alone would decide when and how to reopen the country, President Trump yesterday unveiled a set of non-binding, “Opening Up America Again” guidelines for state and local officials to use in judging when to loosen restrictions. The guidelines suggest a three-stage, gated approach, gradually allowing individuals and employers to return to normal activities based on criteria including disease trends, hospital capacity, and the availability of robust testing. Progressing from one stage to the next is predicated on maintaining a downward trajectory in new cases—with any signs of a resurgence indicating a need to reimpose restrictions.

Missing from the White House plan are specific details about how states, cities, and healthcare providers are to procure and pay for the many millions of tests and extensive contact tracing that will need to be available to allow businesses, public transport systems, and other essential services to resume activity. By week’s end, about 3.5M coronavirus tests had been conducted nationally, but the daily number of tests conducted has plateaued, and the test-positivity rate is still troublingly high. Public health experts continue to warn that testing must ramp up significantly before any steps toward reopening can be considered, a difficult challenge given widespread reports of shortages of testing supplies and trained lab technicians. To bolster testing capacity, the Centers for Medicare and Medicaid Services (CMS) this week nearly doubled the amount it will pay laboratories to analyze tests using high-throughput equipment.

Three coalitions of states—in the Northeast, Midwest, and West Coast—were formed this week to coordinate regional efforts to reopen the economy. Among the issues they’ll need to address: interstate travel restrictions, coordinated purchasing of critical supplies, investments in contact tracing capabilities, and ongoing surveillance of the virus’ spread. With federal agencies taking a back seat to states (“You are going to call your own shots,” the President told governors on a call this week), it became clear that the road back from the coronavirus pandemic will be circuitous, with a patchwork of different timelines and approaches in different locations based on local conditions and resources.

In the words of William Gibson, “The future is here—it’s just not very evenly distributed.”

 

 

 

 

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

Posted on by • 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.”

 

 

 

 

 

 

Medical supply scramble continues

Posted on by • 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.

 

 

 

 

We can’t just flip the switch on the coronavirus

Posted on by • 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.

 

 

 

 

Cartoon – Reality Check

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Cartoon, April 9 | Cartoons | themountaineer.com

HP unveils advanced security for remote workers — and shows how to disinfect your laptop

Posted on by • Posted in Centers for Disease Control & Prevention (CDC), Crisis, Crisis Management, Cybersecurity, Data Security, Email, Infection Control, Infectious Virus, Information Security, Information Technology, Supply Chain • Leave a comment

https://www.venture-med.com/hp-unveils-advanced-security-for-remote-workers-and-shows-how-to-disinfect-your-laptop/

HP has unveiled advanced security for businesses and their remote workforces and disclosed an extensive guide to disinfecting your laptop and other computer equipment.

The new offerings include HP Pro Security Edition, HP Proactive Security, and HP Sure Click Enterprise. These are aimed at the security threats that evolve and disrupt business every day.

With the recent surge of remote workers — due to work-from-home rules forced upon us by COVID-19 — HP said we must all be aware of the increased risks of working from home. Over 80% of home office routers have been found to be vulnerable to potential cyberattacks.

Emails also pose a significant risk to organizations, with over 90% of PC infections originating from attachments and 96% of security  breaches not discovered until months later. There are 5 billion new threats per month, based on HP’s estimates.

“Our HP Pro Security Edition takes Sure Sense and Sure Click and bundles [them] with our system,” said Andy Rhodes, global head of commercial PCs, in a press briefing. “Endpoints are still an enormous risk — 90% of infections originate with emails. Every user is at risk here.”

HP Pro Security for small businesses.

With public health concerns over COVID-19 spreading worldwide, HP wants customers to have the information they need to effectively clean HP devices and maintain a healthy work environment.

The Centers for Disease Control and Prevention (CDC) recommends cleaning surfaces, followed by disinfection, as a best practice for the prevention of COVID-19 and other viral respiratory illnesses in households and community settings.

In fact, HP has issued its own whitepaper for cleaning your devices.

“We get asked [about] this every day,” said Rhodes. “If you use the wrong disinfectant, you can actually damage the product.”

A CDC-recommended disinfectant that is also within HP’s cleaning guidelines is an alcohol solution consisting of 70% isopropyl alcohol and 30% water.

The steps below use the CDC-recommended alcohol solution to clean high-touch, external surfaces on HP products:

  1. Wear disposable gloves made of latex (or nitrile gloves if you are latex-sensitive) when cleaning and disinfecting surfaces.
  2. Turn off the device and disconnect AC power (printers should be unplugged from the outlet). Remove batteries from items like wireless keyboards. Never clean a product while it is powered on or plugged in.
  3. Disconnect any external devices.
  4. Moisten a microfiber cloth with a mixture of 70% isopropyl alcohol and 30% water. Do not use fibrous materials, such as paper towels or toilet paper. The cloth should be moist, but not dripping wet. (Isopropyl alcohol is sold in most stores, usually in a 70% isopropyl alcohol/30% water solution. It may also be marketed as rubbing alcohol.)
  5. Do not spray any liquids directly onto your device.
  6. Gently wipe the moistened cloth on the surfaces to be cleaned. Do not allow any moisture to drip into areas like keyboards, display panels, or USB ports located on the printer control panels, as moisture entering the inside of an electronic product can cause extensive damage to the product.
  7. Start with the display or printer control panel (if applicable) and end with any flexible cables, like power, keyboard, and USB cables.
  8. When cleaning a display screen or printer control panel, carefully wipe in one direction, moving from the top of the display to the bottom.
  9. Ensure surfaces have completely air-dried before turning the device on after cleaning. No moisture should be visible on the surfaces of the product before it is powered on.
  10. After disinfecting, copier/scanner glass should be cleaned again using an office glass cleaner sprayed onto a clean rag to remove streaking. Streaking on the copier/scanner glass from the CDC-recommended cleaning solution could cause copy quality defects.
  11. Gloves should be discarded after each cleaning. Clean hands immediately after gloves are removed.