“We've been flooded with thousands of reader questions on coronavirus. We're answering them. - USA TODAY” plus 1 more

“We've been flooded with thousands of reader questions on coronavirus. We're answering them. - USA TODAY” plus 1 more


We've been flooded with thousands of reader questions on coronavirus. We're answering them. - USA TODAY

Posted: 27 Mar 2020 04:45 PM PDT

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An epidemiologist answers the biggest questions she's getting about coronavirus. Wochit

As the coronavirus pandemic continues to shut down daily life across the globe, thousands of our readers across the nation have asked us questions about COVID-19.

And we're answering them.

For basic facts about the virus – what it is, how it spreads and where it's located – you can get caught up by reading our in-depth explainer here. We've also debunked some viral coronavirus myths

But you're curious and continue to ask important questions via our newsletter, Coronavirus Watch. (Not a newsletter subscriber? Sign up for it here!)

So below, you can find answers to questions such as: Is it OK to be outside? How old are people who are dying in the U.S.? Is it safe to get carry-out food?

If you don't see an answer you're looking for, check out our first batch of answers, addressing things like: Can testing show if someone has had coronavirus and then recovered? Can someone get the coronavirus more than once?

What else would you like to know? Ask us by filling out the form you can find here.

Will families who receive food stamps be eligible for the stimulus check?

– Renda from Miami, Florida

Yes, families who receive food stamps are eligible to receive a stimulus check!

Trump in March signed the largest economic stimulus package in U.S. history. The $2 trillion stimulus plan includes one-time payments of $1,200 per adult and $500 per child, $367 billion for small businesses, $500 billion for loans to larger industries, $100 billion for hospitals and the health care system, and $600 more per week in unemployment benefits for those out of work. 

Here's how you can calculate the amount of stimulus money your household can expect.

Is the virus a DNA molecule protected by a thin layer of fat that will disintegrate if that fat layer is removed outside your body?

– Rita in Las Vegas, Nevada

SARS-CoV-2 particles are spherical bundles of genetic material (RNA) surrounded by a fatty outer layer (lipids) with proteins called spikes protruding from the surface. These spikes latch onto receptor proteins on human cells in the lungs and other tissues and change the structure of those human cells, allowing the viral genes to enter the host cell to be copied, producing more viruses.

Viruses need a host to "survive," and the fat layer breaks down when it is out on its own in the environment. Preliminary research suggests that the virus is stable outside the body for different periods of time, depending on the climate and surface. You can "kill" the virus using soap, extreme heat and ultraviolet light, and each attacks a different part of this virus structure. Soap breaks up the fatty outer layer. Heat breaks up the protein spikes. And UV light breaks up the genes inside.

Has anyone with preexisting conditions gotten the coronavirus and survived?

– Dee from Arlington, Texas

Yes, many people have. While the risk for serious disease and death from COVID-19 is higher in people who are older or who have certain preexisting conditions, thousands have survived.

Data from the CDC published Tuesday found that, as of March 28, the U.S. reported 2,692 patients who had one or more underlying health conditions. Of those patients, 173 died. This limited data suggests that thousands of people who have one or more underlying health conditions have not died.

Moreover, a February WHO study of more than 70,000 coronavirus patients in China found that people with preexisting conditions had higher fatality rates than those without preexisting conditions: 13.2% for those with cardiovascular disease, 9.2% for diabetes, 8.4% for hypertension, 8.0% for chronic respiratory disease, and 7.6% for cancer. However, those figures suggest that large percentages of people with preexisting conditions survived.

Can coronavirus be transmittedthrough secondhand smoke?

– David from Columbus, Georgia

"It's not the main mode of transmission. There's probably some component of airborne, but I don't think secondhand smoke would be a compounding factor," said Tania Elliott, clinical instructor of infectious diseases at NYU Langone.

If the smoke irritates your lungs and causes you to cough, that poses a greater risk of transmission since the virus is thought to mainly spread through respiratory droplets when someone coughs or sneezes, Elliot said.

Smokers are likely to be more vulnerable to COVID-19 as the act of smoking means that fingers and possibly dirty cigarettes are in contact with lips, according to the WHO. Smokers may also already have lung disease or reduced lung capacity which would greatly increase risk of serious illness, the WHO says.

While data is still evolving about how long the virus may remain alive, a recent study found that viable virus could be detected up to three hours later in the air.

Is cross-country road travel advisable to destinations outside of COVID-19 'hot spots'?

– Roland from Albuquerque, New Mexico

The White House is asking Americans to stay home as much as possible to slow the spread of the virus, and some states and local governments have issued "stay home" and "shelter-in-place" orders.

"I don't think now's the time to do it," Elliott said. "If you have a house somewhere else, that's fine. But I wouldn't recommend being in hotels or crowded public settings. If you want take a road trip and go camping, there's risk associated with that."

Can you catch the virus from people who've died?

– Nikki from Albany, Georgia

The main way the virus is thought to spread is through respiratory droplets produced when an infected person coughs or sneezes, and this is not a concern after death, according to the CDC. But people should consider not touching the body of someone who has died of COVID-19, the CDC says.

There is no known risk associated with being in the same room at a funeral or visitation service with the body of someone who died of COVID-19, the CDC says. Kissing, washing and shrouding should be avoided before, during and after the body has been prepared, if possible. But holding the hand or hugging after the body has been prepared for viewing may pose less of a risk, the CDC says.

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What is the value of testing for the coronavirus if there is currently no treatment?

– Linda from Brevard County, Florida

There is value to getting tested because there are many reasons why someone would seek medical care for their symptoms, and ruling out the coronavirus is helpful in seeking other causes, said Jason Christie, chief of pulmonary medicine at Penn Medicine.

"The biggest problem is we don't have a quick and reliable test right now. Without that, we have to be smart and ration the testing to those people that need them most. So don't go out and get tested right now unless you're sick," Christie said.

Testing also helps health officials figure out how prevalent and contagious a virus is.

Is it safe to get groceries during senior shopping hour?

– Pamela from Wellsville, Pennsylvania

Acknowledging that older adults and persons with underlying health conditions are more susceptible to COVID-19, a growing number of stores are dedicating time or opening earlier for senior shoppers and other at-risk groups.

But Elliott says she doesn't advise it. "That gives a false sense of security," she said. "By encouraging older people with chronic diseases to go out at a dedicated time, you're still exposing them to a bunch of other people, and if one person in that crowd is infected, then the virus will spread."

Elliott said she'd rather see stores limiting the number of people who can enter during a given time period so that there are fewer people in the store. She also encourages healthy people to do the shopping.

Can the virus be transmitted through the mail? Should I stop sending greeting cards?

– Pam from Seven Lakes, North Carolina

The chances of transmission through your mail is very low, Elliott says. "Parts of the virus can fall on surfaces and survive on surfaces for up to 72 hours. But you have to have pretty good conditions for that to happen. So the likelihood would be very small, even with no precautions," she said.

Elliott advises people to put their mail down on a plastic plate instead of directly on a counter top or table, to use a letter opener, and to wash hands thoroughly after touching the mail.

Research on how long a virus may live on surfaces is evolving. The CDC has said there is likely very low risk of transmission of COVID-19 from products or packaging that are shipped over a period of days or weeks "because of poor survivability of these coronaviruses on surfaces."

recent study found that viable virus could be detected up to three hours later in the air, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel. But a subsequent report from the CDC found that genetic material from the virus can live on surfaces for more than two weeks.

Are plastic grocery bags considered the plastic that you have to wait hours to touch?

– Elizabeth from Greenfield, Indiana

You should take precaution with any containers, Elliott says. "The plastic grocery bags I'd throw out right away, wash your hands and then clean your food. Chances (of infection) are low," she said. "But better yet, bring your own bags! It's better for the environment anyway."

They keep saying stay isolated for two weeks. But what happens after the two weeks?

– Al from Topeka, Kansas

Officials suggest self-quarantining for two weeks if you've had exposure to somebody with the virus and might be infected. It's a way to monitor if symptoms develop and, at the same time, avoid any possible spread to others. Since the incubation period for the virus is up to 14 days, you're "cleared" for the virus after two weeks, Elliott said.

After that, you still need to practice social distancing.

Is it advantageous for a younger healthy person to get the coronavirus to build immunity to it?

– Danny from Sundance, Wyoming

No, for several reasons, says Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine.

While a protective antibody is generated in those who are infected, scientists are not yet sure whether that immunity will last for a short period of time, for years or for life. Some say the possibility of reinfection is very likely.

Moreover, a new federal health report says Americans of all ages have faced serious health complications amid the outbreak. Data from the CDC show that among the roughly 12% of COVID-19 cases in the U.S. known to need hospitalizations, about 1 in 5 were among people ages 20 to 44. Anywhere from 14% to 21% of adults ages 20 to 44 with COVID-19 have been hospitalized, the CDC data estimates. Two to 4% of cases led to ICU admissions, and less than 1% were fatal.

Finally, it's important to avoid getting and spreading the virus. While the young may not be the most at risk, they're carrying the disease to those who are more vulnerable, such as older people and those with underlying conditions. Dr. Deborah Birx, a member of the White House coronavirus task force, on Wednesday urged "the millennial generation" to take special precautions. "You have the potential to spread it," she said.

Does getting pneumonia shots given to elderly people help if you get this virus?

– Linda from Hendersonville, Tennessee

Vaccines against pneumonia, such as pneumococcal vaccine and Haemophilus influenzae type B vaccine, do not provide protection against the new coronavirus, according to the World Health Organization. The vaccines simply guard against those specific bacterial infections.

The COVID-19 virus can, in fact, cause pneumonia, but the vaccines cannot prevent this pneumonia.

I see people in my neighborhood out running, riding bikes and walking their dogs. Is that OK?

– Patti from Carmel, Indiana

Yes, that's OK! Just be sure to maintain distance from other people. The CDC recommends a distance of about 6 feet. Even in states and counties where residents are being asked to stay home or "shelter in place," it's still fine to go for a run, hike or do other outdoor activities, as long as proper social distancing is observed.

Just don't be like Chicago, where city officials closed trails and parks after crowds of hundreds of people were seen congregating along the city's lakefront.

Remember: The White House recommends that you should avoid social gatherings involving more than 10 people, as well as all non-essential travel, shopping trips and social visits.

Social distancing: Why it's so important to stopping the spread of coronavirus 

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Are there any projections to estimate the spread of COVID-19 and a timeline of its passing?

– Dennis from Las Vegas

Yes, there are many projections, but scientists say they all hinge on how people behave. That's why it's essential to social distance and do what you can to prevent spread.

A conservative USA TODAY analysis based on data from the American Hospital Association, U.S. Census, CDC and WHO estimates that 23.8 million Americans could contract COVID-19, leaving almost six seriously ill patients for every existing hospital bed. Another analysis finds that America's trajectory of community spread is trending toward Italy's, where circumstances are dire.

One researcher at the Global Center for Health Security estimated last month that as many as 96 million Americans could be infected. The U.S. population on March 27 is estimated at 329 million.

The Johns Hopkins Center for Health Security estimated that 38 million Americans will need medical care for COVID-19. The CDC's worst-case-scenario is that about 160 million to 210 million Americans will be infected by December. Under this forecast, 21 million people would need hospitalization and 200,000 to 1.7 million could die by the end of the year.

Outside the U.S., leaked British documents projected that a coronavirus outbreak could rage until spring 2021. German Chancellor Angela Merkel said 60% to 70% of her country's population could eventually become infected.

USA TODAY analysis: America's coronavirus 'curve' may be at its most dangerous point

Is it safe to get carry-out food?

– Debby from Omena, Michigan

The CDC and WHO have not issued formal guidance on carry-out food.

While the CDC says that there is no evidence to support transmission associated with food, a person may get COVID-19 by touching a surface or object that has the virus on it and then touching their own face. The virus can, for example, survive on cardboard up to 24 hours, according to a recent study.

The issue of carry-out food also raises concerns about the risk couriers are facing by interacting with customers during their shifts. That's why some companies are now offering "contactless" delivery options that help people maintain social distancing by allowing couriers to ring the doorbell and leave the package outside.

Study finds: Coronavirus can live in the air for hours and on surfaces for days

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How soon after exposure can you test positive?

– Pam from Easton, Maryland

There's no specific data on this question yet, according to Gregory Poland, director of the Mayo Clinic's Vaccine Research Group. However, we do know that someone infected with the virus may begin showing symptoms anywhere between one and 14 days after catching the virus, most commonly around five days, according to the WHO.

"The peak viral shedding occurs during the first five days after the onset of symptoms. My guess is that within a few days of being exposed, these patients are beginning to shed virus," Poland said.

A recent report from the CDC studying an outbreak at a care home in Washington State found that among 23 residents who tested positive for the virus, 13 were asymptomatic. Within a week, 10 of those 13 developed symptoms, with onset at 3 days.

Do the symptoms for COVID-19 come together or can you have separate symptoms showing up at different times?

– Carlos from Los Angeles

The most common symptoms are fever, tiredness and dry cough, according to the WHO. Shortness of breath is also among the most common symptoms, according to the CDC. In most cases where symptoms present, those symptoms come together, Hotez said.

"Usually it presents with fever and cough, or fever, cough, and shortness of breath," he said. "It might present with one of those symptoms first, but then it rapidly progresses to the others."

Some patients also have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. Some people do not have symptoms at all.

New York neurosurgeon is warning people against looking out for fever as the first tell-tale symptom of the virus. His symptoms began with a little bit of congestion and only later progressed to a fever, body aches and chills.

More on testing: Coronavirus test swabs aren't your standard Q-tips, and they're running out as testing ramps up

How do you actually die from the coronavirus? What happens?

– Catherine from Carson City, Nevada

In some cases, the virus ultimately damages tiny air sacs in the lungs, restricting oxygen to the bloodstream and depriving other major organs – including the liver, kidney and brain – of oxygen.

Severe cases of coronavirus: Some result in brain damage, inability to walk

In a small number of severe cases, that can develop into acute respiratory distress syndrome (ARDS), which requires a patient be placed on a ventilator to supply oxygen.  However, if too much of the lung is damaged and not enough oxygen is supplied to the rest of the body, respiratory failure could lead to organ failure and death.

Here's what that looks like inside the body.

What is the age range of U.S. deaths from COVID-19?

– Becky from Bentonville, Arkansas

In the U.S., ages range from an infant less than one year old to people in their 90s, according to state and local health departments.

The Illinois Department of Public Health said Saturday that an infant coronavirus patient younger than one year old in Chicago had died. An investigation was underway to determine the cause of death. "There has never before been a death associated with COVID-19 in an infant," department Director Dr. Ngozi Ezike said.

This week health officials also reported that a 17-year-old teen in New Orleans died after contracting the virus. And a 2-month-old in Nashville who tested positive for the virus could be the youngest patient in the nation, officials say.

However, this range is not conclusive because health officials have not released the specific ages of several other patients, and new deaths are being reported each day.

If a person is sick with the coronavirus and gets tested for the flu, would the flu test be positive?

– Antonio from Patchogue, New York

No, the presence of the coronavirus would not turn a flu test positive. However, it's possible to have both the coronavirus and the flu at the same time. In that case, the flu test would be positive.

The opposite is also true: Presence of the flu would not result in a positive coronavirus test. It's important to note that, even if someone tests negative for the coronavirus, they still may be infected with the coronavirus.

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I was told I should be tested if I could not easily inhale a large breath and hold it for at least 10 seconds. Is this good advice?

–Ted from Scottsdale, Arizona

No. While shortness of breath is among the most common symptoms of the virus, according to the CDC, that diagnosis does not necessarily involve holding a large breath for 10 seconds. Medically known as dyspnea, shortness of breath is often described as "an intense tightening in the chest, air hunger, difficulty breathing, breathlessness or a feeling of suffocation," according to the Mayo Clinic.

If you think you may be sick, call your doctor and follow CDC guidance.

Can masks be reused by an infected person or used only once?

– Debra from Dayton, Ohio

The longer a mask is used and the more damp it becomes, the less effective it is, Poland said. "But it is definitely better than the alternative of no mask!"

Contributing: Adrianna Rodriguez, Dalvin Brown, Marco della Cava, Jayme Fraser and Matt Wynn

Follow Grace Hauck on Twitter @grace_hauck

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Coronavirus outbreak: Live updates on COVID-19 - ModernHealthcare.com

Posted: 16 Mar 2020 12:00 AM PDT

7:50 PM CT on 3/31/2020

The American Hospital Association wants HHS to immediately send billions of dollars to hospitals under the stimulus package signed by President Donald Trump last week.

The department should direct Medicare Administrative Contractors "distribute funds to every hospital in the U.S. at the rate of $25,000 per bed, and $30,000 per bed for 'hot spots,' " the trade group wrote in a letter Tuesday to HHS Secretary Alex Azar and CMS Administrator Seema Verma.

That would come to about $23 billion, not "including the additional funding for hot spots," according to the AHA, which said that MACs have the information needed to make the per-hospital calculations.

The stimulus package--known as the CARES Act--allocated $100 billion to hospitals to respond to the COVID-19 pandemic. HHS has not said yet how the funds will be dispersed. 


4:58 PM CT on 3/31/2020

Even though the federal government has waived several regulations and reporting requirements during the COVID-19 pandemic, HHS' Office of Civil Rights on Saturday reinforced that civil rights laws remain in effect during the COVID-19 pandemic.

"The fact that they issued the bulletin serves as a reminder that practices should . . . make sure that they're adhering to those rules in the event that there is stepped up enforcement," said Mollie Gelburd, associate director of government affairs for the Medical Group Management Association.

People often rely on their instincts when they're under stress and making quick decisions. Providers, especially in times of crisis, need to be aware of their biases because they can often lead to misleading assumptions that affect the standard of care that patients receive, said Dr. David Acosta, chief diversity and inclusion officer for the Association of American Medical Colleges.

"The vulnerable communities out there are the ones that are probably going to . . . be impacted the most by the pandemic," he said. "From an ethics and moral standpoint, (providers) should treat everybody with humanity and dignity. Everybody has a right to be treated."

But many patients don't understand their rights, even though hospitals are supposed to disclose them. Increasing public awareness of patient rights could improve the quality of care that patients receive and foster better communication between providers and patients.


4:05 PM CT on 3/31/20

Boston Medical Center Health System has furloughed around 10% of its workforce, citing staff safety and financial concerns in the midst of the coronavirus outbreak.

According to a statement by the health system, furloughed employees will remain in active status with the expectation of returning to work. They can also use vacation and sick time.

The executive team's pay will also be cut for the next three months. In a message to staff, the system said the decision to cut back on elective surgeries and ambulatory services meant "immediate and major reduction in clinical revenue."


2:26 PM CT on 3/31/20

Drugs needed for patients using ventilators are at risk of shortage due to increased demand during the COVID-19 pandemic, according to Vizient data.

Vizient found 13 medications at risk of going into shortage in three drug classes: Sedatives and anesthetics, analgesics, and neuromuscular blockers.

"What we are seeing now is some products that are in a shortage and others that are in a very tight market," said Dan Kistner, group senior vice president of pharmacy solutions at Vizient. "The data show that orders placed are not being completely filled and it is spiralling toward a major shortage of the medications necessary for patients who require a ventilator."


12:45 PM CT on 3/31/20

(AP) Dr. Anthony Fauci said the White House coronavirus task force is looking into the idea of recommending broader, community-wide use of masks to deter the spread of the new coronavirus.

Fauci said the task force first wants to make sure that such a move wouldn't take away from the supply of masks available to health care workers.

"But once we get in a situation where we have enough masks, I believe there will be some very serious consideration about more broadening this recommendation of using masks," Fauci said in a CNN interview Tuesday. "We're not there yet, but I think we're close to coming to some determination."

He said wearing a mask may prevent an infected person from spreading the virus.

Fauci is the director National Institute of Allergy and Infectious Diseases and a leader of the U.S. response to the pandemic.

President Donald Trump said Monday he could see broader use of masks on a temporary basis.

"I mean, you know, we want our country back. We're not going to be wearing masks forever, but it could be for a short period of time," Trump said.

The World Health Organization on Monday reiterated its advice that the general population doesn't need to wear masks unless they're sick. Since the epidemic began in China, the WHO has said masks are for the sick and people caring for them.


12:23 PM CT on 3/31/2020

The Federal Communication Commission received $200 million from Congress to support telehealth during the COVID-19 pandemic and recently unveiled its plans for the money.

FCC Chairman Ajit Pai wants to help healthcare providers purchase broadband and other devices that will support their expanded use of telehealth services, which will help contain the coronavirus by keeping individuals out of doctors' offices and other facilities where they could contract the virus.

Pai also wants to give providers $100 million in universal service support over the next three years to help pay for telehealth in patients' homes or other locations as part of the Connected Care Pilot Program.


11:28 AM CT on 3/31/2020

While Northwell Health hasn't run out of ventilators yet during the coronavirus pandemic, the New York-based health system is thinking ahead on how to treat more patients when resources are scarce.

A Northwell team led by Dr. Hugh Cassiere, the medical director at North Shore University Hospital, found a way to convert BiPAP machines, which are usually used for sleep apnea or COPD, into ventilators that could assist a COVID-19 patient. Northwell Health is also 3D printing an adapter it needs to make this conversion work, and it plans on sharing the design with other providers to ease any shortages.

"Our hospitals are at the US epicenter of the coronavirus epidemic, and some of our COVID-19 patients require intensive care unit therapy and mechanical ventilators within minutes of being hospitalized," Cassiere said. "I knew we could develop a way to repurpose and convert these machines to save hundreds of lives."


10:30 AM CT on 3/31/20

The New Jersey Hospital Association is tracking status updates on federal and state waivers sought by the NJHA in response to the COVID-19 pandemic.


9:43 AM CT on 3/31/2020

While the U.S. as a whole is expected to hit peak coronavirus resource use on April 15, many states will reach the apex weeks after. 

Assuming residents continue to follow social distancing recommendations, the University of Washington's Institute for Health Metrics and Evaluation predicted when each state will hit peak resource use in an interactive graphic. California is projected to hit its peak on April 27; Florida's estimate is May 3; Missouri is May 18. Vermont will need the most resources on April 7, the earliest of the projections.


6:38 PM CT on 3/30/2020

Researchers have created an artificial intelligence tool that may help physicians predict which patients will develop severe lung disease, even if they initially have a mild case of the novel coronavirus.

In a study published in Computers, Materials & Continua, NYU and Chinese researchers used data from a small group of COVID-19 patients in two Chinese hospitals.They found that patients with mildly elevated liver enzymes and body aches were most likely to develop acute respiratory distress syndrome.

"Given the increasing caseload, there is an urgent need to augment clinical skills in order to identify from among the many mild cases the few that will progress to critical illness," the paper said.

Those two identifies were 70% to 80% accurate in predicting severe COVID-19 cases, according to the researchers.


5:58 PM CT on 3/30/2020

The U.S. is now handling roughly 100,000 COVID-19 test samples a day, HHS Secretary Alex Azar said during a press briefing Monday in the Rose Garden. 

He noted that the FDA has approved about 20 different emergency testing options. 

Azar's comments followed an opening statement by President Donald Trump who said that the U.S. has now completed more than 1 million tests, which he claimed was more than any other country.

Breaking the 1 million barrier comes two weeks after the administration had cleared the way for more private labs to conduct tests. During a March 15 press conference, Vice President Mike Pence claimed that 1.9 million tests would start flowing that week into the healthcare system.

The administration also unveiled several new regulatory relief efforts aimed at easing hospital capacity.


4:00 PM CT on 3/30/2020

UPMC said Monday it will ensure that all of its staff members will continue to be paid at their current rate for normally scheduled hours through May 9, 2020, even if they are assigned to alterative work during their regular hours.

That's as the Pittsburgh, Penn.-based academic health system adjusts to the ever-evolving staffing needs amid the COVID-19 pandemic. UPMC is redeploying staff members to help in other areas of the health system as needs arise. Others are being asked not to report to work, yet they may be called back on short notice, the health system said. Regardless, all UPMC staff will continue to receive their pay through May 9.

UPMC CEO Jeffrey Romoff in a statement thanked his organization's staff.

"This pay protection program is our commitment to our valued staff," he said.


3:56 PM CT on 3/30/2020

Blue Cross of Idaho said it will begin providing advance payments to independent physicians who need financial support during the COVID-19 pandemic.

The Blues insurer said it will make advance payments to the providers once per month in April, May and June, and will recover the interest-free payments during the fourth quarter of 2020. Interested physician groups may opt into the program, which is focused on primary care clinicians, behavioral health practitioners, and a few other non-surgical specialties.

"Idaho is fortunate to have a dedicated group of independent providers who are passionate about their communities and the health of each of their patients," Drew Hobby, Blue Cross of Idaho's senior vice president for healthcare economics. "We have created a program to provide cashflow relief to independent providers we know are integral to the Idaho healthcare ecosystem."


2:50 PM CT on 3/30/2020

The CMS on Monday issued emergency Medicaid waivers to Montana, Texas, Vermont and West Virginia, bringing the total number of states to receive Medicaid 1135 waivers to 38.

The waivers allow state Medicaid programs to sidestep prior authorization requirements and provisionally enroll out-of-state providers, among other things, in response to the COVID-19 pandemic.


2:40 PM CT on 3/30/2020

(Crain's Chicago Business) Gov. J.B. Pritzker announced Monday that an Illinois baby who tested positive for the coronavirus died, as did a state employee at the Department of Human Services.

The baby was under a year old and lived in Cook County, according to the state.

"I know how difficult this news can be ... upon hearing it, I admit I was immediately shaken," Pritzker said. The news comes as the state marks one week since Pritzker's stay-at-home order went into effect, and Illinois logged its largest jump in fatalities—13 in one day.  

"There has never before been a death associated with COVID-19 in an infant. A full investigation is underway to determine the cause of death," Illinois Department of Public Health Director Dr. Ngozi Ezike said in a statement.


1:37 PM CT on 3/30/2020

Stanford Health and supply chain risk management company Resilinc will launch a trading platform for hospital supplies next month, the companies said Monday.

In partnership with UPS and Premier, the companies have created a cloud-based platform where hospitals can identify and exchange critical medical supplies if they find inventory imbalances. Stanford and Resilinc hope the platform will help reduce medical supply shortages, especially during the coronavirus pandemic.

The exchange, which will launch in mid-April, will also allow distributors and procurement organizations to donate medical supplies and match them to health systems or other organizations in need.


1:28 PM CT on 3/30/2020

As COVID-19 cases rise, ambulatory surgical centers in California are preparing to help with the surge and care for patients in their facilities.

California has more than 750 ASCs, which have ventilators, qualified staff and additional medical supplies to care for coronavirus patients. They have been canceling procedures and preparing to take on this patient care role, according to the California Ambulatory Surgery Association.

"We are here, in communities across the state, ready to help. ASCs want to be part of the solution as the entire healthcare industry must rise to meet this enormous challenge," said Michelle George, President of the California Ambulatory Surgery Association. "We have valuable resources to lend to this crisis – whether it is staff, space, equipment, supplies, or other capabilities. ASCs are coordinating with the public health teams on local and regional levels to identify how their facilities can be ustilized most effectively on a case by case basis."

ASCs are also requesting waivers in California to care for coronavirus patients and alleviate the burden on hospitals, or provide other types of care such as birthing and delivery, infusions or urgent care.


12:23 PM CT on 3/30/2020

HHS on Monday announced that it's working with Janssen Research & Development and Moderna Therapeutics to develop and, hopefully, manufacture a COVID-19 vaccine.

"The Phase 1 clinical trial is set to begin no later than fall of 2020 with the goal of making COVID-19 vaccine available for emergency use in the United States in early 2021," HHS said in a statement.

Janssen Research & Development is owned by Johnson & Johnson.


11:04 AM CT on 3/30/2020

Cigna and Humana are the latest health insurers to announce that they will eliminate out-of-pocket costs for COVID-19 treatment. 

Louisville-based Humana said it would waive all medical costs related to coronavirus treatment, including inpatient hospital admissions, for its Medicaid, Medicare Advantage and fully insured commercial members. Humana will waive cost-sharing indefinitely whether treatment is delivered virtually, in a doctor's office or hospital, and regardless of whether the provider is in-network or out-of-network. 

Cigna, meanwhile, pledged to waive members' costs for COVID-19 treatments that are covered under Medicare or other state regulations through May 31. The policy applies to fully insured individuals, families and employer groups and Medicare Advantage members. Self-insured employers will have a chance to opt out. Cigna said it would reimburse providers at in-network or Medicare rates.

Last week, CVS Health announced that it would waive cost-sharing for inpatient hospital admissions related to COVID-19 treatment for certain Aetna plan members. An inpatient hospital admission for coronavirus could cost more than $20,000 for commercially insured individuals, according to a Kaiser Family Foundation analysis.


10:58 AM CT on 3/30/2020

Northwell Health has implemented a new on-site process for breaking down medical waste, including waste from COVID-19 laboratory testing.

Northwell is using a system from Irish biotechnology company Technopath Clinical Diagnostics that shreds and disinfects infectious waste, killing bacteria, spores and pathogens. The resulting waste—which Northwell describes as "confetti-like" in a news release—is subsequently categorized as regular trash. It installed the system in October 2019.

It's poised to play a role in Northwell's COVID-19 response, since the New York system's laboratory is able to test for more than 1,600 possible coronavirus samples daily.

"For the past several weeks, Northwell has continued to take on the health and safety challenges posed by COVID-19," Michael Dowling, Northwell's president and CEO, said in a statement. "This new technology allows us to remove the unknown risk exposure when disposing of medical waste while avoiding the need for the costly and carbon-inefficient transportation and disposal by third-party handlers."

Northwell said it was waiting on regulatory approval before completing validation of the system. That approval was fast-tracked after an executive order New York Gov. Andrew Cuomo signed March 13, according to the health system.


10:20 AM CT on 3/30/20

The American Institute of Architects is creating a task force to inform governments and healthcare providers on adapting existing buildings into temporary facilities to house COVID-19 patients.

The task force will release a report in early April on how to assess which spaces are suitable for patient care.

"This is a race against time for healthcare facilities to meet bed surge capacity needs," said Kirsten Waltz, president of the AIA Academy of Architecture for Health. "This task force will help inform best practices for quickly assessing building inventory and identifying locations that are most appropriate to be adapted for this crisis."


9:00 PM CT on 3/29/2020

(AP) Before the Olympics were postponed, Japan looked like it had coronavirus infections contained, even as they spread in neighboring countries. Now that the games have been pushed to next year, Tokyo's cases are spiking, and the city's governor is requesting that people stay home, even hinting at a possible lockdown.

The sudden rise in the number of virus cases in Tokyo and the government's strong actions immediately after the Olympic postponement have raised questions in parliament and among citizens about whether Japan understated the extent of the outbreak and delayed enforcement of social distancing measures while clinging to hopes that the games would start on July 24 as scheduled.

Experts have found a rise of untraceable cases mushrooming in Tokyo, Osaka and other urban areas — signs of an explosive increase in infections. Prime Minister Shinzo Abe said Saturday that Japan is now on the brink of a huge jump in cases as it becomes increasingly difficult to trace and keep clusters under control.


7:21 PM CT on 3/29/2020

Researchers at the Massachusetts Institute of Technology have released over 24,000 peer-reviewed journals and papers from non-peer-reviewed sources in the Covid-19 Open Research Dataset.

The research covers represents the most extensive collection of scientific literature related to the ongoing pandemic and will continue to update in real time as more research is released, according to a press release.


6:28 PM CT on 3/29/2020

(AP) New York state's death toll from the coronavirus outbreak surged Sunday above 1,000, less than a month after the first case was detected in the state.

New York City reported in the evening that its toll had risen to 776. The total number of statewide deaths isn't expected to be released until Monday, but with at least 250 additional deaths recorded outside the city as of Sunday morning, the state's total fatalities was at least 1,026.

The virus and the disease it causes, COVID-19, has torn through New York with frightening speed.


5:35 PM CT on 3/29/2020

(AP) Italy reported more than 750 new deaths Sunday, bringing the country's total to nearly 10,800 - vastly more than any other country. But the number of new infections showed signs of narrowing again. Officials said more than 5,200 new cases were recorded in the last 24 hours, the lowest number in four days, for a total of almost 98,000 infections.


4:29 PM CST on 3/29/2020

Northwell Health and the University of South Florida Health are producing a 3D printed nasal swab to address shortages.

According to a press release, the teams worked together for just over a week to develop a nasal swab prototype and test it in the USF Health and Northwell Health labs. The swabs were tested by clinicians at Northwell Health, USF Health and Tampa General Hospital. Now that clinical validation is complete, 3D printers at USF Health and Northwell Health will produce the swabs and provide them to their patients.

The partnership should result in the production of "thousands of swabs a day" according to the release.


3:50 PM CT on 3/29/2020

2:26 PM CT on 3/29/2020

The FDA is warning industry stakeholders to alert patients and consumers that chloroquine phosphate Intended for fish should not be used as treatment for COVID-19.

According to an alert, the FDA's Center for Veterinary Medicine has reported that some consumers may mistake chloroquine phosphate used to treat disease in aquarium fish for the FDA-approved drugs used to treat malaria and certain other conditions in humans.

Last week, a man died after he reportedly took chloroquine used to treat their fish in an attempt to prevent COVID-19.


1:25 PM CT on 3/29/2020

1:32 PM CT on 3/29/2020

The Service Employees International Union's United Healthcare Workers West told Buzzfeed it has found a supplier to provide 39 million masks and another who could make 20 million masks per week. The union also found another supplier who can deliver millions of face shields, according to Buzzfeed.

SEIU-UHW spokesperson Steve Trossman declined to name the largest supplier, but it has warehouses in Pennsylvania and Georgia.

SEIU represents 2 million healthcare workers across the country—including hospital, home care, and nursing home workers. The union is focusing mainly on providing the supplies to hospitals, both unionized and non-unionized, in New York and California for now, but it hopes to expand its reach as it continues to search for suppliers, according to Buzzfeed.


12:30 PM CT on 3/29/2020

Apple has released an app that offers a series of questions to determine if someone should seek care for COVID-19 symptoms. The tech giant partnered with the White House, HHS and the Centers for Disease Control and Prevention on the app and website. 

Both provide CDC recommendations on distancing and self-isolating, how to closely monitor symptoms, recommendations on testing, and when to contact a medical provider, according to a press release.

Users can download the app for free from Apple's app store.


11:31 AM CT on 3/29/2020

(AP) — As President Donald Trump looks for ways to restore normalcy in parts of the U.S., Dr. Anthony Fauci, speaking on CNN's "State of the Union" on Sunday, says the country could experience more than 100,000 deaths and millions of infections from the coronavirus pandemic.

The federal government is weighing rolling back guidelines on social distancing in areas that have not been as hard-hit by the outbreak. 

About 125,000 cases of COVID-19 in the U.S. had been recorded as of Sunday morning, with over 2,100 dead. It is certain that many more have the disease but their cases have not been reported.

One in three Americans remain under state or local government orders to stay at home to slow the spread of the virus.

Dr. Deborah Birx, head of the White House coronavirus task force, said parts of the country with few cases so far must prepare for what's to come. "No state, no metro area, will be spared," she said on NBC's "Meet the Press."

Fauci said he would only support the rollback in lesser-impacted areas if more testing is in place to monitor those areas. He said "it's a little iffy there" right now.


10:41 AM CT on 3/28/2020 

Because the U.S. is so far behind testing for COVID-19, President Donald Trump, Congress, the U.S. Food and Drug Administration, the Centers for Disease Control, the National Institutes of Health, should make data-sharing a condition of clinical research funding and product clearance and approval, according to experts in a Health Affairs.

A group that includes renowned Yale Medicine researcher Harlan Krumholz say medical journals should help by mandating data-sharing associated with publications on therapeutics, vaccines, and diagnostics. Companies can show their commitment to public health by voluntarily agreeing to share data at the time when products are approved, they said.  

The shortage in testing is critical in identifying where the virus is spreading and has prevented providers from targeting where care and interventions are needed most, they continued.   


09:28 AM CT on 3/29/2020

The Society for Post-Acute and Long-Term Care Medicine and the American Health Care Association are urging hospitals not to send COVID-19 patients to nursing homes and assisted living facilities as the solution to overcrowding.

A recent New York State advisory called for nursing homes to accept all patients discharged from hospitals regardless of their COVID-19 status. 

"This is a short-term and short-sighted solution that will only add to the surge in COVID-19 patients that require hospital care," since elderly people over the age of 80 with chronic diseases are most at risk of hospitalization—and they constitute the majority of nursing home residents today, the statement read.

AMDA Executive Director Christopher E. Laxton asked that patients instead be sent to hotels and conference centers for isolation, like Chicago has done.


8:34 AM CT on 3/29/2020

Mount Sinai Health System in New York will begin treating critically ill patients by transfering into them the antibodies from patients who have recovered from COVID-19. The process, called plasmapheresis, was used successfully in China, with some patients improving within 24 hours, according to a press release.

Mount Sinai is collaborating with the state's blood center and is receiving guidance from the U.S. Food and Drug Administration to begin implementing the treatment later this week.

In addition to its widespread use in plasmapheresis, antibodies will provide experts with an accurate infection rate so they can track the trajectory of the disease.Mount Sinai hopes the test will help identify healthcare workers who are already immune to the diseas. The system last week lost a nursing manager, Kious Kelly, to the disease. 


8:28 PM CT on 3/28/2020

The Trump administration late Saturday issued a travel advisory for New York, New Jersey and Connecticut. Earlier in the day, President Donald Trump said he was considering a full quarantine for the region.

Trump announced he reached the decision after consulting with the White House coronavirus task force and the governors of the three states.

The advisory "urges residents of New York, New Jersey, and Connecticut to refrain from non-essential domestic travel for 14 days effective immediately." It does not apply to employees of such "critical" industries as trucking, public health professionals, financial services, and food supply. 

New York Gov. Andrew Cuomo, who has criticized the federal government's response as his state became the country's virus epicenter, said roping off states would amount to "a federal declaration of war."


6:17 PM CT on 3/28/2020

In a move aimed at protecting first responders, anyone calling 911 in South Carolina will be asked if they are symptomatic for COVID-19.

The new executive order issued Saturday by Gov. Henry McMaster requires that 911 emergency dispatchers ask anyone requesting calls for service whether they or anyone at their location has tested positive or is symptomatic for COVID-19.

The move came as the state announced two new COVID-19 deaths, bringing its total to 15. The total number of cases rose by 121 Saturday to 660, reaching 40 of the state's 46 counties, according to the South Carolina Department of Health and Environmental Control.


3:39 PM CT on 3/28/2020

The Centers for Disease Control and Prevention Saturday issued a health advisory warning against the use of chloroquine phosphate without a prescription. 

Using it without "supervision of a healthcare provider, can cause serious health consequences, including death," the CDC warned. "Clinicians and public health officials should discourage the public from misusing non-pharmaceutical chloroquine phosphate (a chemical used in home aquariums). Clinicians should advise patients and the public that chloroquine, and the related compound hydroxychloroquine, should be used only under the supervision of a healthcare provider as prescribed medications."

A man in Arizona died earlier this week after self administering the compound.

Chloroquine is an antimalarial drug that the Trump administration suggested may be able to treat coronavirus. However, the U.S. Food and Drug Administration has not approved it for that purpose.


1:17 PM CT pm 3/28/2020

President Donald Trump floated the idea of a quarantine as early as Saturday affecting residents of New York, New Jersey and Connecticut for a short time to stop the spread of coronavirus from reaching states with fewer infections.

Trump told reporters at the White House that he had spoken with Republican Gov. Ron DeSantis of Florida, among others, and that "a lot of the states that are infected but don't have a big problem, they've asked me if I'll look at it so we're going to look at it."

But Gov. Andrew Cuomo, D-N.Y., who has criticized the federal government's response as his state became the country's virus epicenter, said the issue had not come up in a conversation he had with Trump earlier Saturday. "I don't even know what that means," he said at a briefing in New York. " I don't know how that could be legally enforceable, and from a medical point of view, I don't know what you would be accomplishing. ... I don't like the sound of it."

The federal government is empowered under the law to take measures to prevent the spread of communicable diseases between states, but it's not clear that means Trump can order state residents to stay put.


12:22 PM CT on 3/28/2020

HHS' Office of Civil Rights Saturday reminded providers not to discriminate when providing care during the COVID-19 pandemic. In particular, OCR noted that people with disabilities "should not be denied medical care on the basis of stereotypes, assessments of quality of life, or judgments about a person's relative 'worth' based on the presence or absence of disabilities."

The bulletin comes on the heels of complaints filed by advocacy groups, including a March 23 letter from Disability Rights Washington which alleged that a "rationing scheme being put in place in Washington State" discriminates against people with disabilities.

"HHS is committed to leaving no one behind during an emergency, and this guidance is designed to help health care providers meet that goal," said Roger Severino, OCR director. "Persons with disabilities, with limited English skills, or needing religious accommodations should not be put at the end of the line for health services during emergencies. Our civil rights laws protect the equal dignity of every human life from ruthless utilitarianism."


11:40 AM CT on 3/28/2020

The number of confirmed coronavirus infections worldwide topped 600,000 on Saturday as new cases stacked up quickly in Europe and the United States and officials dug in for a long fight against the pandemic.

The latest landmark came only two days after the world passed half a million infections, according to a tally by John Hopkins University, showing that much work remains to be done to slow the spread of the virus. It showed more than 615,000 cases and over 28,000 deaths.

While the U.S. now leads the world in reported infections—with more than 105,000 cases—five countries exceed its roughly 1,700 deaths: Italy, Spain, China, Iran and France.

Americans braced for worsening conditions elsewhere, with worrisome infection numbers being reported in New Orleans, Chicago and Detroit.

Virus cases have been rising rapidly in some American cities such as Detroit, where poverty and poor health have been problems for years. Mayor Mike Duggan pointed to aggressive testing as a reason behind the quickly growing numbers.


10:38 AM CT on 3/28/2020

HHS' Office of Inspector General pulled together its oversight work on infectious disease preparedness

"OIG's oversight of HHS preparedness for and response to emerging infectious diseases in the past identified areas of strength and weakness in the Department's efforts. These insights, along with OIG's recommendations, provide useful guidance for improving HHS efforts to protect the public from the threat of infectious diseases," the watchdog agency noted on its website. 


9:32 AM CT on 3/28/2020

President Donald Trump will send off a naval hospital ship Saturday before it heads to New York City, as he aims to highlight the federal response to the coronavirus pandemic.

The USNS Comfort, a 1,000-bed hospital ship, had been undergoing planned maintenance, but was rushed back into service to aid the city which is now the epicenter of the nation's outbreak. It is scheduled to arrive Monday at a Manhattan pier a week after its sister ship, the USNS Mercy arrived in Los Angeles to preform similar duty on the West Coast.

The president acknowledged that making the 140-mile trip to Naval Station Norfolk wasn't necessary, but said he was doing it to recognize the work of sailors and medical professionals who worked to get the ship out of maintenance more than a week ahead of schedule.

"I think it's a good thing when I go over there and I say 'thank you,'" Trump told reporters Friday. He added he wanted to make the trip to show "spirit for the country."


11:02 PM CT on 03/27/2020

The Food and Drug Administration gave emergency use authorization to an Abbott molecular point-of-care test for detecting COVID-19, delivering positive results in as little as five minutes and negative results in 13 minutes.

Abbott says "it can be used in more non-traditional places where people can have their results in a matter of minutes, The company is increasing production to deliver 50,000 of the COVID-19 tests per day, beginning next week, to the U.S. healthcare system.


10:02 PM CT on 03/27/2020

Henry Ford Health System, Ascension Michigan, Beaumont, Detroit Medical Center and Wayne State University are banding together to bring large-scale COVID-19 drug trials to southeast Michigan, the organizations announced.

"The whole idea is we want to collaborate in the region, apply for the new trials and be part of discovering best practices and treatments for COVID-19," said Henry Ford Health System interventional cardiologist Dr. William "Bill" O'Neill, in the release.

"We're going to be very competitive.  We want to figure out how to optimally treat these patients, to establish protocols and systems so we can all do things effectively and, very importantly, to quickly track outcomes," O'Neill said.

They are seeking National Institutes of Health approval to bring two COVID-19 trials to Michigan: Moderna's COVID-19 vaccine and Takeda's hyperimmune globulin.


8:08 PM CT on 03/27/2020

In the fight to stop the new coronavirus, Henry Ford Health System is putting athletic trainers to work a number of ways, accoring to a news release.

That includes: COVID-19 health screenings for employees, incoming patients and essential visitors, and communicating new visitor policy; assisting in emergency rooms and walk-in clinics; and transporting patients to isolation wings ensuring safety protocols are followed.

"I admire the dedication and willingness of our athletic trainers to quickly shift their focus from their normal daily operations to the unique patient and staffing needs that have arisen during the COVID-19 pandemic," said Dr. Robert Albers, part of the Sports Medicine Primary Care physicians team at Henry Ford.


7:47 PM CT on 03/27/2020

The International Hospital Federation asked that people take public health recommendations seriously for the sake of healthcare workers.

"We believe the best way to demonstrate solidarity with healthcare professionals, particularly those in hospitals, is to follow public recommendations for limiting and slowing down the transmission of COVID-19," the federation wrote in a news release.

"Each of us has a role to play: adopting responsible social behaviors to break the transmission chain of the virus. It is critical that people displaying coronavirus symptoms follow recommendations from their national or local health authorities," the federation wrote.


5:57 PM CT on 03/27/2020

A coalition of healthcare stakeholders praised Congress for passing legislation that broadens access to medical records of patients with substance use disorders as part of the Coronavirus Aid, Relief and Economic Security Act.

Called the Partnership to Amend 42 CFR Part 2, its chairwoman, Maeghan Gilmore, said in a statement that the group "applauds Congress for their decisive action and leadership in addressing substance use disorders."

Gilmore, director, government affairs, Association for Behavioral Health and Wellness,, also said the law "will bolster the ability of providers and organizations to deliver safe, high-quality, coordinated care and treatment in addition to improving patient safety and outcomes across the care delivery spectrum­­--this will save lives."

American Hospital Association, Alliance of Community Health Plans and Academy of Managed Care Pharmacy were among the other organizations supporting the legislation.


4:32 PM CT on 3/27/2020

Some health insurers are allowing employees with medical training to temporarily leave their regular roles to volunteer at hospitals and other healthcare facilities during the COVID-19 pandemic.

CareFirst Blue Cross and Blue Shield said it will allow its employees who are licensed nurses or behavioral health providers to leave for 30-day period to support patient care in Maryland, D.C. and Northern Virginia. The employees' day-to-day responsibilities would be waived and they would continue to be receive regular pay during their time volunteering.

National insurer Anthem said its employees with medical training would be permitted to take up to 80 hours of paid leave to deliver care and relieve medical staff in hospitals and other care centers. Interest in volunteering has been strong among its employees, an Anthem spokeswoman said.


4:10 PM CT on 3/27/20

President Donald Trump on Friday signed a massive COVID-19 economic relief package with billions of dollars for providers.

The House of Representatives passed the bill earlier Friday without taking a recorded vote, and the Senate passed it 96-0 late Wednesday. The package is Congress' largest-ever relief package and came together quickly as lawmakers scrambled to get out of the Capitol due to health concerns.

The package includes several funding streams for providers including a $100 billion provider emergency fund, suspending the Medicare sequester, an inpatient hospital add-on payment for treating COVID-19 patients, $1.3 billion for community health centers, and expanding advance Medicare payments to hospitals.

Lawmakers have said they plan to pass further COVID-19 relief legislation, but are not scheduled to return to the Capitol until the week of April 20.


2:24 PM CT on 3/27/2020

(GenomeWeb) The National Institutes of Health and the Centers for Disease Control and Prevention stand to receive billions of dollars in new funding under a $2.2 trillion economic stimulus package aimed at bolstering the economy against the effects of the COVID-19 pandemic.

The Coronavirus Aid, Relief, and Economic Security, or CARES, Act would provide the NIH with $945.4 million in new funding. Specifically, the National Institute of Allergy and Infectious Diseases would get an additional $706 million, while the National Heart, Lung, and Blood Institute would receive an additional $103.4 million.

The National Institute of Biomedical Imaging and Bioengineering would receive an extra $60 million; the National Library of Medicine stands to receive an added $10 million; the National Center for Advancing Translational Sciences would get an additional $36 million; and the NIH's Office of the Director would receive an extra $30 million.

The NIH's current budget totals $41.46 billion.

The CDC, meanwhile, would receive a $4.3 billion infusion under the spending package, including $1.5 billion for grants and cooperative agreements with state and local governments.

CARES Act funding for the NIH and CDC would be earmarked for preventing, preparing for, and responding to coronavirus domestically and internationally, and would be available to the agencies through Sept. 30, 2024.


2:17 PM CT on 3/27/2020

In the last week, more primary care physicians are seeing the toll of the COVID-19 pandemic on their work.

In a survey of PCPs by the Larry Green Center last week, 49% of physicians said their practice has seen a "severe" impact from coronavirus, which doubled last week's response (27%). 

In addition, 43% of practices said they don't have the capabilities to test patients for COVID-19.


1:01 PM CT on 3/27/2020

The CMS on Friday approved emergency Medicaid waivers for Connecticut, Delaware, Minnesota, Pennsylvania and Wyoming.

"These approvals provide states new flexibilities to focus their resources to provide the best possible care for their Medicaid beneficiaries in response to the coronavirus outbreak," the CMS said in a statement.

States can make a number of temporary changes to their Medicaid programs when the CMS grants them a Section 1135 waiver like fast-tracking enrollment for out-of-state providers, delaying Medicaid hearings and suspending prior authorization requirements.

The Trump administration has approved the waivers for 34 states.


10:35 AM CT on 3/27/2020

Infection prevention officials today implored government officials to articulate a clear plan for how, when and where personal protective equipment from the Strategic National Stockpile will be distributed to the nation's hospitals.

"We need clarity," Katrina Crist, CEO of the Association for Professionals in Infection Control and Epidemiology, said during a press call Friday morning. "When will the supplies be coming. When and where?"

Ann Marie Pettis, director of infection prevention for University of Rochester Medicine in upstate New York, and APIC 2020 president-elect, added that spread of PPE across the state has been inconsistent, saying, "Our supply chain people are scrambling 24/7." She noted that dentists in the region have donated masks to hospitals since dental procedures are on hold until the pandemic ends. 

Nearly half of APIC members responding to a new survey—49%—said they do not have enough face shields and 31% said they were almost or completely out of masks. Additionally, 48% said they were out of or nearly out of respirators.

In a separate, but related announcement Friday, the American Hospital Association launched the "100 million mask challenge," an effort to attain PPE for physicians, nurses and caregivers. It builds on an effort by Renton, Wash.-based Providence which earlier this month was able to get masks from across the northwest. That effort included working with a local furniture manufacturer and others to produce some PPE.


10:18 AM CT on 3/27/20

Dozens of organizations are urging American Hospital Association CEO Rick Pollack to condemn disciplinary action for healthcare providers talking about coronavirus caseloads and supply shortages.

"Trying to gag nurses and doctors, those on the front lines fighting this disease, is reprehensible and will only lead to more deaths," said Dr. Michael Carome, director of the left-leaning Public Citizen's Health Research Group. "Such actions may be commonplace within authoritarian regimes, but they are not acceptable in the U.S."


9:25 AM CT on 3/27/20

The National Association of Freestanding Emergency Centers is asking the CMS to provide Medicare and Medicaid reimbursement to freestanding ERs during the COVID-19 pandemic.

"During this time, all resources should be available to patients, including FECs, especially given that many of those facilities may have key healthcare resources (e.g., respirators, isolation rooms) to assist in caring for the patient overflow from hospital emergency departments," wrote Brad Shields, executive director of the NAFEC, in a letter to HHS Secretary Alex Azar.

According to the letter, there are more than 1,550 beds in 200 freestanding ERs in the the state of Texas alone that could serve as COVID-19 testing centers, offer inpatient and outpatient care, and provide post-op care to patients in need of emergency surgery.


8:42 PM CT on 3/26/2020

Cincinnati-based health system TriHealth's senior leaders will take a 20% pay cut in light of the coronavirus pandemic.

The Cincinnati Enquirer reported that the health system will also close several offices, reassign some employees and lay off others.

In an email to staff obtained by the Enquirer, TriHealth Chief Executive Officer Mark Clement said the provider needed to make changes to address the loss of elective surgeries, paying quarantined staff and other challenges associated with COVID-19.

"This affects all TriHealth team members, including senior leaders, who are taking a 20% pay reduction throughout this hopefully once-in-a-lifetime pandemic," he wrote.


8:35 PM CT on 3/26/2020

More than half of surveyed healthcare workers expose to the coronavirus experienced signs of depression than their peers who had not treated patients in the pandemic, according to a study published in JAMA.

Of the 1,257 healthcare workers in China who responded, 50.4% experiened signs of depression and 44.6% reported anxiety. Seven out of ten experienced distress, and a third suffered from insomnia.

All of those symptoms were reported at higher rates than other healthcare workers, researchers said.


7:19 PM CT on 3/26/2020

Hospitals have voiced concern that they won't be paid enough to cover the costs of treating coronavirus patients. The American Medical Association on Thursday gave providers new coding advice for the pandemic.

The guidance includes 11 scenarios for COVID-19 coding including telehealth and office visits.

"Equipping a healthcare workforce to accurately code medical procedures streamlines communication across the health system, reducing administrative and rework costs at a time when resources are stretched by the COVID-19 pandemic," AMA President Dr. Patrice A. Harris said in a statement.


6:28 PM CT on 3/26/2020

Epidemiologists are increasingly able to create better models of the coronavirus because they've collected more and better data from China, South Korea and Italy, according to Dr. Deborah Birx, White House coronavirus response coordinator.

 "The predictions of the models don't match the reality on the ground," Birx said. "Italy should have close to 400,000 deaths. They're not close to achieving that." Italy has reported 8,215 deaths.

Early models predicted as many as 500,000 deaths in the U.K. and 2.2 million deaths in the U.S., but Birx pointed out that the same research team recently lowered their U.K. estimate to 20,000 deaths.

It suggests that "we're only measuring the tip of the iceberg of the symptomatic cases ... or we have the transmission completely wrong," Birx said.


4:27 PM CT on 3/26/20

A group of eight physician and hospital groups are urging the CMS to send periodic interim payments to healthcare providers to lessen the financial impact of the COVID-19 pandemic.

"Healthcare facilities are responding to the crisis by training additional staff, increasing staffing levels, constructing or retrofitting facilities and expanding telehealth capabilities," wrote the groups in a letter. "Additionally, hospitals following CMS' recommendations to postpone elective surgeries, and non-essential surgical and other medical procedures will see significant decreases in revenue."

The letter says some hospitals are experiencing up to a 40% decrease in services, while physicians and other clinicians are  seeing cancellation rates more than double.


2:21 PM CT on 3/26/2020

While some hospitals have come up with creative ways to share ventilators and other scarce equipment to treat coronavirus patients, the American Society of Anesthesiologists warned these practices could do more harm than good.

According to ASA, ventilator needs are very specific to each patient and must be monitored closely. If a ventilator is shared by multiple patients, that could put their lives at risk.

Instead, the organization suggested repurposing anesthesia machines to work as ventilators. Freestanding ambulatory surgery centers and procedure rooms in physicians' offices may have additional machines that hospitals could use. It also encouraged using manual ventilation rather than sharing ventilators between patients.


2:06 PM CT on 3/26/2020

The Society for Post-Acute and Long-Term Care Medicine on Thursday came out urging their fellow healthcare organizations to create a surge capacity plan for COVID-19 patients. The organization criticized the New York State Department of Health for saying nursing homes must accept COVID-19 patients who have been discharged from the hospital, calling the advisory "ill advised."

"There is a clear need to balance the issues of patient safety, surge management, and conflicting guidelines and public policy around hospital-SNF transfers," the society said. "We find the New York State advisory to be over-reaching, not consistent with science, unenforceable, and beyond all, not in the least consistent with patient safety principles."

Instead, the group wants a cooperative approach with all healthcare professionals that will consider the welfare of other patients who have not been infected.


1:56 PM CT on 3/26/2020

Peoria, Ill.-based OSF Healthcare has turned to an artificial intelligence tool to help it move triage out of the emergency department in the wake of the coronavirus outbreak.

Using a tool from StoCastic, OSF will identify which patients have a high risk of hospitalization before triaging them over the phone. The move should help prevent overcrowding in emergency departments at OSF's 14 facilities.

If a patient is at low risk of hospitalization, healthcare workers will come to their home for testing and follow-up care.


12:00 PM CT on 3/26/20

Researchers are trying to figure out which clinical trials should continue and which should be stopped in the middle of the COVID-19 crisis.

During a meeting of the NIH Collaboratory Grand Rounds on March 20, Dr. Adrian F. Hernandez, vice dean for clinical research at Duke University School of Medicine, said there are nearly 20,000 clinical research studies recruiting participants in the U.S.

"You have participants joining a study to contribute something around their health problem, who now have other issues to worry about. What do you do with this major disruption where data could be adversely affected by COVID-19?" Hernandez said.

The U.S. Food and Drug Administration issued guidance for researchers, suggesting they have back-up plans to ensure the safety of participants, and keep data on missing information caused by changed schedules, missed appointments and patient dropouts.

Hernandez said Duke is dividing clinical trials into three tiers: essential studies with possible direct benefits to participants, studies with moderate potential benefit in the longer term and those without potential direct benefits.

"You can see there are all sorts of ethical issues to consider," Hernandez said. "Some organizations are allowing access to essential studies that have the clearest direct potential benefit that would be considered life-saving, while other studies suspend enrollment and do as much work virtually as possible."


11:17 AM CT on 3/26/2020

The University of Wisconsin Hospital and Clinics anticipates the COVID-19 pandemic could drop its net patient revenue by $200 million to $300 million if it receives no assistance or insurance recoveries.

In a bondholder filing, the health system said it can't predict the direct impact on its finances.

Based on its budgeted operating income for the fiscal year ended June 30, 2020, the system could have operating losses between $80 million and $180 million. The estimate could change drastically depending on how the coronavirus spreads, the filing said.


10:52 AM CT on 3/26/2020

Airbnb on Thursday said it would provide free or subsidized housing for up to 100,000 COVID-19 doctors and first responders to give them shelter closer to their work during the pandemic.

The vacation rental site said it would waive all fees for stays that are arranged through its coronavirus-related initiative, and it is also partnering with the International Federation of the Red Cross and other not-for-profits to help relief workers.

Airbnb will also accept donations from the public to potentially expand the initiative.


10:18 AM CT on 3/26/20

Some states, like Florida and California, are allowing doctors to practice without being licensed in their state in the midst of the COVID-19 crisis.

The Federation of State Medical Boards has also said it will help verify credentials of healthcare workers who want to practice in states hit hardest by the pandemic.

"Likely the most novel, necessary and widespread impact of the waiving of licensure requirements will be aiding physicians in practicing telehealth video visits, as now authorized by Medicare and (hopefully) commercial insurers," Dr. Gregory A. Hood, an internist in Lexington, Kentucky, told Medscape.


9:32 PM CT on 3/25/2020

Piedmont Healthcare is disputing that the death of a 42-year-old nurse employed by the Atlanta-based system was caused by COVID-19.

Diedre Wilkes, 42, did not have any underlying health issues and reportedly worked as a local health care worker, according to the Newnan Times Herald.

The paper went on to report that a Piedmont spokesperson said the death was "inconclusive," but that the system had contacted employees and patients who may have had contact with the Wilkes.


8:32 PM CT on 3/25/2020

The American Clinical Laboratory Association released a statement Wednesday evening expressing  disappointment that the Coronavirus Aid, Relief, and Economic Security Act did not include funding to support "free testing" for all Americans.

"Our members remain in an untenable situation, absorbing growing, uncompensated costs for testing specimens with no assurance that they will be appropriately or fairly reimbursed for all the tests they are performing, said ACLA President Julie Khani.

However, as part of this third stimulus package, the statement continued, most Medicare lab rates will freeze for one year. According to ACLA, labs have sustained significant year-over-year cuts to Medicare reimbursement for common lab tests, which will average about 30% when fully implemented.


7:37 PM CT on 3/25/2020

The nonpartisan think tank, the Milken Institute has launched a tool that tracks the development of treatments and vaccines for COVID-19.

The tracker was developed and is maintained by FasterCures, a center of the Milken Institute, with an Advisory Council comprised of a Nobel Laureate researcher, former FDA chiefs, and industry leaders, according to a press release.

The tracker is compiled from publicly available sources and will include FDA-approved drugs, as well as basic information about the focus of each clinical trial.


6:41 PM CT on 03/25/2020

President Trump on Wednesday argued that his administration's reluctance to use the Defense Production Act to increase the availability of critical medical supplies and equipment is a clever negotiating tactic. "It's a great point of leverage," Trump said.
Hundreds of companies have volunteered to produce masks, gloves, gowns and ventilators, according to Vice President Mike Pence. The Trump administration is vetting 70 of them to see if they can effectively repurpose their manufacturing capacity.
Earlier this week, FEMA Administrator Peter Gaynor had said his agency would use the Defense Production Act to secure coronavirus test kits, but the agency reversed course after Trump said it wasn't necessary to use the wartime power. The agency later said it found test kits on the commercial market.
State officials, policy experts and provider groups have repeatedly petitioned the Trump administration to use its authority to boost medical supplies and equipment, but administration officials have been reluctant to do it.


4:45 PM CT on 3/25/20

William Rinehart, senior research fellow at the Center for Growth and Opportunity at Utah State University, created a timeline to document the major regulatory actions in response to COVID-19.


4:33 PM CT on 3/25/2020

The American Medical Association, American Pharmacists Association, and American Society of Health-System Pharmacists today called on clinicians to halt inappropriate ordering, prescribing or dispensing of medications to treat COVID-19. 

"We are aware that some physicians and others are prophylactically prescribing medications currently identified as potential treatments for COVID-19 (e.g., chloroquine or hydroxychloroquine, azithromycin) for themselves, their families, or their colleagues; and that some pharmacies and hospitals have been purchasing excessive amounts of these medications in anticipation of potentially using them for COVID-19 prevention and treatment. We strongly oppose these actions," the groups wrote in a joint statement.

The groups said they support state and federal requirements that prescriptions be written "only for legitimate medical purpose." 

Additionally, they warned hospitals and individual clinicians that "no medication has been FDA-approved for use in COVID-19 patients, and there is no incontrovertible evidence to support off-label use of medications for COVID-19. Stockpiling these medications—or depleting supplies with excessive, anticipatory orders—can have grave consequences for patients with conditions such as lupus or rheumatoid arthritis if the drugs are not available in the community."


2:15 PM CT on 3/25/20

A Yale New Haven Health affiliate said it will draw $100 million through a taxable revolving credit agreement, citing the effects of the coronavirus pandemic.

According to a bond filing, the withdrawal is part of the health system's liquidity review, and it is predicting "significant actual and expected effects of the COVID-19 pandemic" on its resources.

As of Feb. 29, Yale New Haven had 188 days cash on hand and as of March 20, the system had $770 million in cash and short-term treasuries, the system said.


12:27 PM on 3/25/2020

(Crain's New York Business) Calling the state's total shutdown a "blunt instrument," Governor Andrew Cuomo said Tuesday that he is refining his public health strategies during the health crisis to get New Yorkers back to work.

Lower risk people and individuals who have had COVID-19 -- and therefore have built up resistance to it -- could end isolation measures before vulnerable populations, Cuomo said, adding that this would be a way to get the economy started again after its near-total shutdown. 

"The younger people go back to work. Let the recovered people go back to work," Cuomo said. "And then ramp up the economy with those individuals." 

One of the first steps in Cuomo's more nimble policy would be to test people to find if they have already had, and are therefore immune, to coronavirus. The governor said New York was looking into a way to test blood for the antibodies that would show up if that were the case.


11:55 AM on 03/25/2020

Ochsner Health System in New Orleans is taking steps to address coronavirus at its facilities, including adding beds to its ICUs and launching designated urgent care centers for COVID-19 patients.

The health system also used 3D printing to help create face shields for its workers.

Ochsner also created a predictive model to help plan for a surge of COVID-19 patients.


9:18 AM CT on 3/25/2020

The American Medical Association called on the State Department to open visa processing at embassies and consulates to allow international residents and physicians into the U.S. Residency programs start in July, and foreign students could bolster the healthcare workforce's ranks as it continues to cope with the coronavirus pandemic.

"Prior to the COVID-19 pandemic, the U.S. was already facing a serious shortage of physicians largely due to the growth and aging of the population and the impending retirement of many physicians," the letter said. "Non-U.S. citizen (international medical graduates) play a critical role in providing healthcare to many Americans, especially in areas of the country with higher rates of poverty and chronic disease."


8:15 AM CT on 3/25/2020

Federal Emergency Management Agency Administrator Peter Gaynor said Tuesday that the Trump administration will use the Defense Production Act to obtain 60,000 COVID-19 test kits and 500 million masks, but the agency ultimately did not use the authority to compel production.

"At the last minute we were able to procure the test kits from the private market without invoking the DPA," FEMA spokeswoman Lizzie Litzow said.

Gaynor had said earlier Tuesday that he intended to use the administration's authority to ramp up production.

President Donald Trump has so far been reticent to use the authority he invoked to prioritize government contracts for acquiring medical supplies, even though governors, the American Hospital Association and the American Medical Association are pressuring Trump to invoke his authority to ramp up production of supplies in shortage.

The governors of New York and Illinois have called upon the Trump administration to use the Defense Production Act to ensure states are not competing against each other for scarce supplies.


11:04 PM CT on 3/24/2020

Texas Gov. Greg Abbott signed an executive order Tuesday mandating that hospitals report their bed capacity to the state on a daily basis. That data will then be shared with the CDC. 

"Every public or private entity that is utilizing an FDA-approved test, including an emergency use authorization test, for human diagnostic purposes of COVID-19," will also have to report results--positive and negative--to the state.

During a press conference Tuesday, Abbott said 715 people had tested positive for COVID-19.


9:53 PM CT on 3/24/2020

The Wayne State University Physician Group, Wayne State University Health Sciences and ACCESS resumed drive-through testing for police officers, firefighters, medics and health care workers with COVID-19 symptoms (fever, cough, shortness of breath, sore throat).

The groups had paused testing "to determine the impact of the stay-at-home order on our voluntary staff, adjust our schedule accordingly and proceed with a plan that is compliant with the stay-at-home order," said Dr. Charles Shanley, president and CEO of WSUPG and vice dean for clinical affairs at Wayne State School of Medicine. "We are eager to resume our important mission of protecting those who protect our community."


9:35 PM CT on 3/24/2020

Washington's insurance commissioner issued an emergency order Tuesday that directs health insurers to further expand coverage during the COVID-19 pandemic and allows extra time for health plan members to pay their premiums.

Insurance Commissioner Mike Kreidler directed state-regulated health plans to cover additional methods for providing telehealth, including telephone and video chat tools such as FaceTime, Facebook Messenger video chat, Google Hangout video, Skype and GoToMeeting.

He also ordered insurers to cover without cost-sharing medically necessary tests for the flu and other viral respiratory illnesses billed during a provider visit for COVID-19, and directed them to speed up patient discharges from the hospital by waiving or expediting prior authorization for home health care or long-term care facility services.


7:57 PM CT on 3/24/2020

The CMS on Tuesday issued guidance for insurers that offer coverage on federal- and state-based exchanges, announcing that the agency will use its discretion to allow qualified health plans to postpone payment deadlines until the COVID-19 national emergency ends.

Both initial binder payments and ongoing premium payments are covered by the guidance. A binder payment is the first payment by a member to a plan to secure coverage.

The agency also made available two FAQs to address common concerns related to prescription drugs and coronavirus, and the use of telehealth services through commercial coverage.


6:12 PM CT on 3/24/2020

HHS on Tuesday announced $250 million in grants to make meals available to older adults through home-delivery services like Meals on Wheels.

"The need for these services, particularly home-delivered and packaged meals, has increased as community measures to slow transmission of COVID-19 have closed meal sites and have left many family caregivers unable to assist their older loved ones," HHS said in a statement.

Congress freed up additional funding for nutritional service programs when it passed its second relief package last week. More than 2.4 million people receive meals from the programs each year.


5:52 PM CT on 3/24/2020

As it deals with a surge in COVID-19 cases, Beaumont Health today said it is screening all hospital staff for the virus before their shifts.

The eight-hospital system, which serves southeastern Michigan, had 450 confirmed COVID-19 patients and another 185 awaiting test results admitted to its hospitals as of March 24. 

"Given the way our healthcare system and others have needed to convert to primarily COVID-19 screening diagnosis and treatment in the past few weeks, we will soon be looking at the need for coordinating the care of acute COVID-19 patients across the region and beyond," said CEO John Fox. "All health system in Michigan need to work together to help care for these patients. I am very please with the commitment all the hospital systems have expressed to work together to respond to the pandemic." 


4:29 PM CT on 3/24/2020

(AP) — The Dow Jones Industrial Average surged to its best day since 1933 as Congress and the White House neared a deal on Tuesday to inject nearly $2 trillion of aid into an economy ravaged by the coronavirus.

The Dow burst 11.4% higher, while the more closely followed S&P 500 index leapt 9.4% as a wave of buying around the world interrupted what has been a brutal month of nearly nonstop selling. Despite the gains, investors were far from saying markets have hit bottom. Rallies nearly as big as this have punctuated the last few weeks, and none lasted more than a day.

Both Democrats and Republicans said Tuesday they're close to agreeing on a massive economic rescue package, which will include payments to U.S. households and aid for small businesses and the travel industry, among other things. A vote in the Senate could come later Tuesday or Wednesday.


3:55 PM CT on 3/24/2020

Arizona Gov. Doug Ducey has ordered state regulators to exempt all Arizona certified registered nurse anesthetists from federal regulations that require CRNAs to work under direct supervision of a surgeon or anesthesiologist when treating Medicare and Medicaid patients.

With today's executive order from Governor Ducey, Arizona joins 17 other states in increasing access to medical care by allowing CRNAs to put their advanced training to use, according to the Goldwater Institute, a conservative and libertarian public policy think tank that applauded the move.

CRNAs have advanced training in anesthesia that allows them to care for patients, freeing doctors to treat other medical conditions.


3:48 PM CT on 3/24/2020

The CMS on Tuesday issued guidance to states about how they can secure and use additional Medicaid funding approved by Congress' second major COVID-19 relief package.

The state and federal governments jointly fund state Medicaid programs. Congress approved a temporary 6.2% increase in the Federal Medical Assistance Percentage, or FMAP, to increase federal Medicaid funding during the coronavirus pandemic.

Congress hopes the measure will guard against cuts to provider reimbursements, which are under pressure from increases in uncompensated care and new limitations on more profitable surgeries and procedures.

The agency's guidance addresses when increasing funding will be available, which costs are eligible for extra matching funds, documentation requirements and other state concerns.


3:04 PM CT on 3/24/2020

HHS Office for Civil Rights on Tuesday provided first responders with guidance on how to disclose protected health information and stay in compliance with HIPAA through the COVID-19 pandemic.

While HIPAA-covered entities should minimize the amount of patient PHI that is disclosed, OCR acknowledged that they may need to provide more information to first responders if patients may have COVID-19. First responders would need additional personal protective equipment for those calls. 

"Our nation needs our first responders like never before and we must do all we can to assure their safety while they assure the safety of others," OCR Director Roger Severino said in a statement.


2:57 PM CT on 3/24/2020

HHS' Office of the Assistant Secretary for Preparedness and Response on Tuesday said it would give healthcare providers $100 million to prepare for the onslaught of COVID-19 patients during the pandemic. The money will support the National Special Pathogen System, which was set up to combat Ebola.

"We cannot beat the COVID-19 pandemic without getting America's healthcare workers the training and resources they need to respond to this novel threat, and these funds secured from Congress by President Trump will help make that happen," HHS Secretary Alex Azar said in a statement.


1:45 PM CT on 3/24/2020

Virginia Commonwealth University researchers began two clinical trials this week on a possible treatment for COVID-19. Gilead Science's antiviral remdesivir has been used experimentally to treat Ebola and earlier this year was used on a Seattle man with COVID-19. The drug is designed to slow the infection of healthy cells in a patient's body. Remdesivir is not approved anywhere globally and has not been demonstrated to be safe or effective for any use.

The first randomized, controlled tests in the U.S. began in February. VCU is one of only a few institutions in the U.S. to conduct the clinical trials. 
Researchers say the trials are a chance not only to provide access to remdesivir, but also to generate data on the investigational drug's safety and effectiveness.
 


1:35 PM CT on 3/24/2020

(GenomeWeb) The U.S. Food and Drug Administration has issued a safety alert that notes evidence that SARS-CoV-2, the virus behind the ongoing pandemic, can be found in the stool of infected individuals. For instance, researchers from China report in an article accepted at the journal Gastroenterology that viral RNA could be detected within the stool of about half the patients tested and other researchers similarly report in the Journal of the American Medical Association that about 30% of patients tested had viral RNA in their stool, while another team found viral RNA within the stool of an asymptomatic child, as they note at Emerging Infectious Diseases.

Because of this, the FDA says there is a chance that the virus could be transmitted via stool, though it notes that the risk of such transmission is unknown. It advises any stool donated for the procedure after the beginning of December be subject to additional screening. In particular, it says that donors should be asked questions to uncover any potential COVID-19 exposure and that they or their samples should be tested for SARS-CoV-2, if possible. The agency also says that informed consent forms should be changed to include information about potential SARS-CoV-2 transmission through fecal microbiota transplants.


12:01 PM CT on 3/24/2020

Stay home. 

That's the unified message coming from the American Hospital Association, American Medical Association and American Nurses Association.

"We are honored to serve and put our lives on the front line to protect and save as many lives as possible. But we need your help," the three groups said in an "open letter to the American public." The groups noted that social distancing and staying at home are key to slowing the spread of COVID-19 and ensuring that physicians and nurses have enough equipment and time to care for those who need it the most.

"That's why we're urging the public to #StayHome as we reach the critical stages of our national response to COVID-19. Of course, those with urgent medical needs, including pregnant women, should seek care as needed. Everyone else should #StayHome," they wrote. 


10:10 AM CT on 3/24/2020

The Pharmaceutical Care Management Association, a trade group representing pharmacy benefit managers, has issued recommendations to protect the supply chain of prescription drugs.

The group suggests PBMs work with local, state and federal governments to ensure patients have access to drugs, and governments should issue guidance on social distancing, whether drugs are appropriate for clinical use and the need to prevent future shortages.

PBMs should also plan several options for patients to access prescription drugs, including home delivery and having extra supply on hand, while balancing the need to avoid shortages.


9:22 PM CT on 3/23/2020

(AP) South Korea has reported 76 new cases of the coronavirus and nine more deaths, bringing its totals to 9,037 infections and 120 deaths.

South Korea's Centers for Disease Control and Prevention said Tuesday that so far 171 infections have been linked to people entering the country from abroad. Authorities have stepped up border controls to prevent the virus from re-entering amid broadening outbreaks in Europe, North America and beyond.

Around 7,700 of the country's cases are from the southeast city of Daegu and the neighboring areas, where thousands of infections were linked to a secretive church sect. More than 740 people tested positive in the populous Seoul metropolitan area, home to about half of South Korea's 51 million population.


8:07 PM CT on 3/23/2020

(AP) The Federal Reserve is unleashing its boldest effort yet to protect the U.S. economy from the coronavirus by helping companies and governments pay their bills and survive a devastating crisis.

With lending in Treasury and mortgage markets threatening to shut down, the Fed announced an aggressive set of programs Monday to try to smooth out those markets. To do so, it committed to buy as much government-backed debt as it deems necessary. And for the first time ever, the Fed said it plans to buy corporate debt, too.

Its intervention is intended to ensure that households, companies, banks and governments can get the loans they need at a time when their own revenue is fast drying up as the economy stalls.


7:30 PM CT on 3/23/2020

America's Health Insurance Plans on Monday released a statement that took a stronger stance on waiving prior authorization in light of the COVID-19 crisis. AHIP's statement encouraged hospitals to transfer and discharge patients to the "safest, clinically appropriate setting of care."

"That means inpatient hospitals can transfer patients that are COVID positive or suspected or are treated in regions with capacity challenges without advanced approval to any alternate post‐acute care facilities that are safe, medically appropriate and readily available (e.g., Home Health, Long Term Acute Care Hospitals, Skilled Nursing Facilities, and others) until this crisis is resolved," the statement continued, adding that facilities simply needed to notify the insurer the following business day.

The lobbying group can not compel members to follow its directives but when AHIP ​​​​​​made a statement about waiving cost sharing for tests, individual insurers put out press releases saying they were going to do that.


6:38 PM CT on 3/23/2020

(AP) Britain, Germany and Italy are evaluating powerful and invasive tools for what epidemiologists call contact-tracing, the mapping of personal interactions that could spread the virus. These apps would use real-time phone data to pinpoint virus carriers and people they might have infected.

That worries privacy advocates, who fear such ubiquitous surveillance could be abused without careful oversight, with potentially dire consequences for civil liberties.

The new tools would mark a substantial departure from existing European disease-surveillance efforts, which have focused on tracking people's movements with aggregated phone location data designed not to identify individuals. Italian police also began mobilizing drones on Monday to enforce restrictions on citizens' movements.


5:13 PM CT on 3/23/2020

Scientists at the University of Arizona created 1,600 COVID-19 specimen collection kits over the weekend, and they're rushing to make more as providers run low on tests.

UArizona said Monday that they have materials to make 7,000 kits this week. Swabs and the medium for their collection have been scarce, sparking a shortage of tests and the occasional closure of COVID-19 testing sites. UArizona Health Sciences Biorepository was able to manufacture the media with a formula from the Centers for Disease Control and Prevention.

"Fortunately, our personnel at the biorepository have several decades of experience in creating biospecimen collection kits for use in FDA-approved analyses and clinical applications," said Biorepository Director David Harris. Harris helped create cord blood stem cell collection kits that most hospitals have today.


5:02 PM CT on 3/23/2020

Florida Gov. Ron DeSantis said Monday he is issuing an executive order mandating that anyone arriving on a flight from New York City and the surrounding area submit to self-quarantine for two weeks.

DeSantis said in an address from his Tallahassee office that more than 100 such flights arrive daily in the state and he believes each contains at least one person infected with the new coronavirus.

He said he has been in contact with federal officials about curtailing such flights, but has not yet received a response. He said people will be screened when they arrived and told they must self-quarantine. He said those travelers will not be allowed to stay with family or friends, because that is one way the virus is spread.

He did not say specifically how the self-quarantine would be enforced, but said "it is actually a criminal offense if you violate the quarantine order." Florida law says it is a second-degree misdemeanor to violate a quarantine order that could result in a 60-day jail sentence.


4:45 PM CT on 3/23/2020

A loss of smell or taste might be an early sign of infection with the pandemic virus, say medical experts who cite reports from several countries.

It might even serve as a useful screening tool, they say.

The idea of a virus infection reducing sense of smell is not new. Respiratory viral infection is a common cause of loss of smell, because inflammation can interfere with airflow and the ability to detect odors. The sense of smell usually returns when the infection resolves, but in a small percentage of cases, smell loss can persist after other symptoms disappear. In some cases, it is permanent.

Now, there's "good evidence" from South Korea, China and Italy for loss or impairment of smell in infected people, says a joint statement from the presidents of the British Rhinological Society and of ENT UK, a British group that represents ear, nose and throat doctors. In South Korea, some 30% of people who tested positive for the virus have cited loss of smell as their major complaint in otherwise mild cases, they wrote.

A similar proposal was published Sunday by the American Academy of Otolaryngology-Head and Neck Surgery. It noted "rapidly accumulating" anecdotal evidence from around the world that the pandemic virus can cause not only loss of smell but also a diminished sense of taste. So the appearance of those symptoms in people without another explanation should alert doctors to the possibility of a COVID-19 infection, the group said.


4:04 PM CT on 3/23/2020

The Federal Communications Commission has issued a ruling that allows hospitals and healthcare providers to conduct robocalls related to health and safety risks from COVID-19.

Under the Telephone Consumer Protection Act, companies are subject to fines that could potentially be billions of dollars in statutory damages if they use automated outreach by call or text.


1:56 PM CT on 3/23/20

LGBTQ people are more vulnerable to the economic and health risks caused by the COVID-19 pandemic, according to a research brief by the Human Rights Campaign. 

One in five said they hadn't seen a doctor when they needed because they couldn't afford it, and 17% of LGBTQ people lack health insurance. They're also more likely to smoke and have asthma.

They're more vulnerable to the economic impacts of the pandemic as well. LGBTQ individuals are more likely to work in restaurants, where pay is already low. One in five LGBTQ people live in poverty, and 40% of homeless youth identify as LGBTQ.


12:05 PM CT on 3/23/2020

Dr. Zeke Emanuel and several other experts write in NEJM that COVID-19 has already sparked medical resource rationing. Ultimately, providers need to consider four values as they allocate resources and treat patients: maximizing benefits, treating equally, promoting and rewarding instrumental value and giving priority to those worst off.

While coronavirus is a pandemic at this point, the authors note that clinicians need to apply the same resource allocation principles to those infected with the virus and other patients in their facilities. 


11:55 AM CT on 3/23/2020

Hospitals are running low on personal protective equipment and changing their guidelines in an effort to conserve those supplies. JAMA is looking for ideas to help providers conserve their inventory, keep the workforce safe and find new streamlines for PPE. They're asking readers to comment with suggestions.


10:15 AM CT on 3/23/2020

The FDA will allow providers to repurpose ventilators certified for use in another setting for coronavirus treatment in hospitals. For instance, ventilators normally used for ambulance transportation can be used for long-term hospital care, the agency said.

The FDA also offers recommendations for ventilator alternatives, including the use of continuous positive airway pressure, or CPAP, devices typically used to treat sleep apnea. Healthcare facilities may also use ventilators beyond their indicated shelf life to boost ventilator availability.

Suppliers can make changes to FDA-cleared devices without having to go through the usual approval process or use alternative manufacturing facilities like automotive plants to make their products. The agency is also asking both foreign and domestic manufacturers to contact it about getting emergency use authorization, or EUA, to distribute their ventilators in the U.S.


8:46 PM CT on 3/22/2020

7:56 PM CT on 3/22/2020

(AP) China's National Health Commission on Monday reported 39 new cases of COVID-19, all of which it says are "imported" infections in recent arrivals from overseas.

For more than a week, the majority of mainland China's reported cases have been found in people coming from other countries, while community transmission inside the country has dwindled, according to the National Health Commission.

Seeking to prevent a resurgence of the virus, which first emerged late last year in central China, the government is imposing a strict quarantine on individuals entering the country.

Beginning Monday, all flights into Beijing will be diverted to one of 12 airports in other cities. Passengers must pass a health inspection in one of those cities before flying onward to the Chinese capital. They must then quarantine themselves in a hotel for 14 days at their own expense.


6:09 PM CT on 3/23/2020

In a 2007 study published by Clinical Microbiology Reviews.scientists warned that a penchant for eating exotic mammals in southern China was a "time bomb" waiting to happen.

Lack of hygienic environments and crowded, wet markets selling wild game plus the common presence of coronaviruses in China was a "time bomb" for a dangerous virus outbreak. 

"The small reemergence of SARS in late 2003 after the resumption of the wildlife market in southern China and the recent discovery of a very similar virus in horseshoe bats, bat SARS-CoV, suggested that SARS can return if conditions are fit for the introduction, mutation, amplification, and transmission of this dangerous virus," the authors said.


5:31 PM CT on 3/22/2020

4:37 PM CT on 3/22/2020

(AP) The White House is urging commercial labs to prioritize the testing of hospital patients as they work to clear a backlog of tests for the coronavirus.

Vice President Mike Pence says HHS will issue formal guidance Monday, but that the federal government is encouraging all labs to "prioritize inpatient testing."

Pence says the government hopes to have the backlog of existing tests — a milestone the White House hoped to reach on Monday — cleared by the middle of the week.

The White House is encouraging those without symptoms against seeking testing, warning it depletes already scarce supplies of personal protective equipment for healthcare providers.


3:02 PM CT on 3/22/2020

(AP) — Kansas residents will be able to get medicine without an in-person visit to the doctor during the coronavirus crisis under a new executive order that Gov. Laura Kelly announced Sunday.

Doctors can now prescribe medicine without an in-person visit, including out-of-state doctors.

"Expanding the use of telemedicine for nonemergency-related assessments like routine checkups and prescribing medication frees up additional time, resources and physical space in our hospitals and clinics," Kelly said.

The second order eases motor carrier rules and regulations such as weight restrictions. Kelly said the goal is to allow for quicker delivery of resources to address the pandemic.

Fifty-five cases of COVID-19, the disease caused by the virus, are now confirmed in Kansas. They include two deaths.


2:23 PM CT on 3/22/2020

The CMS created a checklist to make it easier for states to receive federal waivers to respond to COVID-19. The agency said it was releasing four tools that give states access to "emergency administrative relief, make temporary modifications to Medicaid eligibility and benefit requirements, relax rules to ensure that individuals with disabilities and the elderly can be effectively served in their homes, and modify payment rules to support health care providers impacted by the outbreak."

"The Trump Administration is marshaling all its support behind states battling the coronavirus," said Administrator Seema Verma. "CMS is making it easier and faster for state Medicaid agencies to get the regulatory relief and additional support they need to respond as rapidly and effectively as possible to protect their most vulnerable residents from this disease."


12:49 PM CT on 3/22/2020

(AP) The number of deaths of people with the coronavirus in Italy jumped 651 to 5,476 in the last 24 hours, while new infections rose by 10% to over 59,000.

The head of Italy's Civil Protection Agency, Angelo Borrelli, noted that the increases had narrowed from recent days, adding ''we hope that this trend can be confirmed in the coming days. We should not lower our guard.''


11:02 AM CST on 3/22/2020

(AP) Just two weeks ago, the government delivered a blockbuster employment report: A healthy gain of 273,000 of jobs in February. A 3.5% unemployment rate, a 50-year low.

What's more, public confidence was up. Consumers were spending. Incomes were rising. Layoffs were rare.

In just a couple of weeks, it's all ended with the shutdown of most business activity nationwide, and a destructive recession seems inevitable. Goldman Sachs expects the economy to shrink at a sickening 24% annual rate in the April-June quarter. That would be, by far, the worst quarterly drop on record. Just days before, Goldman had projected a 5% annual drop in that period.

This week, economists say the government could report that up to 3 million people applied for unemployment benefits last week, which would easily set a record. IHS Markit predicts 7 million job losses from April to June and for unemployment to shoot to 8.8% by late this year. Other economists see joblessness going much higher than that.


8:26 PM CT on 3/21/2020

HanesBrands on Saturday confirmed that it is contracting with the U.S. government to produce cotton masks for use when N95 masks are not required or available. 

The company plans to ramp up manufacturing to 1.5 million masks per week, and it is sharing its FDA-approved product specifications with several other manufacturers that plan to collectively produce between 5 and 6 million masks per week, according to a statement by HanesBrands. Ramp-up to full capacity will take "a few weeks," a company spokesman said.

FDA declined to comment on the approval.

HHS approached HanesBrands with a request for masks and the company developed the specifications and samples, a HanesBrands spokesman said. The timeline from preliminary discussions with federal officials to approval and startup of production took less than a week. A company spokesman said Hanes was not compelled to production under the Defense Production Act. 


2:18 PM CT on 03/21/2020

After several days of back-and-forth, President Donald Trump on Saturday said that he has not used the Defense Production Act to compel private companies to ramp up production of medical equipment because companies have volunteered to help.

"We have so many things being made right now by so many, they've just stepped up. In fact, Mike Pence and I were just discussing that before, we've never seen anything like it where they are just volunteering," Trump said.

Trump signed an executive order last week invoking the Defense Production act, but his statements indicate his administration has not yet made use of the powers. Providers including the American Medical Association have implored the president to use the authority to a greater extent.

"The American Medical Association continues to press the Administration to leverage every tool at its disposal, including fully employing production and distribution mechanisms of the Defense Production Act. While the President signed an Executive Order earlier in the week that would allow him to exercise this authority, it is unclear to what degree that authority is being utilized," the AMA said in a statement Friday.


11:42 AM on 03/21/2020

New York state officials are considering establishing temporary hospitals on college campuses and in New York City's main convention center in preparation for a possible onslaught of coronavirus patients, Gov. Andrew Cuomo said Saturday. Cuomo said the government is seeking to increase hospital bed capacity by 50 percent—up to 25,000 more beds.

Officials have also identified 2 million protective masks to send to hot spots.The state is reviewing four possible locations for temporary hospitals, which would be operated by the Army Corps of Engineers. The governor also said 1 million N-95 masks are being sent to New York City on Saturday, with another 500,000 masks going to Long Island. He is also trying to find a supplier for more gowns, and clothing companies are converting to make masks. New York has seen about 10,400 coronavirus cases, and about 1,600 people hospitalized.

"Everything that can be done is being done," he said, adding, 'We are literally scouring the globe looking for medical supplies."


9:25 AM CT on 3/21/2020

(Crain's Cleveland BusinessUniversity Hospitals in Ohio is among the first in the country to secure clinical trials to test an investigational antiviral drug against patients who have COVID-19, a disease caused by a new coronavirus, according to a news release.

UH has two trials, one of which will focus on COVID-19 patients with moderate illness, and the other of which will focus on patients with more severe illness who may require care in intensive care units (ICUs). The trials will provide the investigational antiviral drug remdesivir to hospitalized adults with a pneumonia due to the novel coronavirus.

"This is some promising news in the midst of this COVID-19 situation," said Dr. Daniel Simon, chief clinical and scientific officer and president of UH Cleveland Medical, in a prepared statement. "Our UH research team has worked closely with the manufacturer, Gilead, in recent days to secure the studies. We are grateful to be one of the first sites in the U.S. to participate in these clinical trials. Both trials are now approved by the U.S. Food and Drug Administration (FDA) and our Institutional Review Board, and we are expecting shipment of the experimental drug remdesivir in the next couple of days."


9:45 PM CST on 3/20/2020
 
The Centers for Disease Control and Prevention, through HHS, is providing $80 million to tribes, tribal organizations, and Urban Indian Organizations to battle COVID-19.

"Our nation's tribal health leaders are on the front lines of the COVID-19 outbreak and these additional resources will help increase public health capacity for Indian Country," said CDC Director Robert Redfield.  "This virus presents new challenges and our nation's public health infrastructure must have the flexibility to implement public health measures to respond aggressively to the outbreak and to protect all Americans."


8:01 PM CT on 03/20/2020

(AP) First, some of the coronavirus tests didn't work. Then there weren't enough to go around. Now, just as the federal government tries to ramp up nationwide screening, laboratory workers are warning of a new roadblock: dire shortages of testing supplies.

The shortages are the latest stumble in a botched effort to track the spread of coronavirus that has left the U.S. weeks behind many other developed countries. Dwindling supplies include both chemical components and basic swabs needed to collect patient samples.

There are "acute, serious shortages across the board" for supplies needed to do the tests, said Eric Blank, of the Association of Public Health Laboratories, which represents state and local health labs.

Late Friday, Blank's group and two other public health organizations recommended that testing be scaled back due to "real, immediate, wide-scale shortages." The groups said only patients with COVID-19 symptoms who are elderly, have high-risk medical conditions or are medical staff should be tested.


7:42 PM CT 03/20/2020

(AP) Gov. Pete Ricketts asked lawmakers Friday for $58.6 million in emergency state funding to help pay for medical and cleaning supplies, tests, employee overtime and other expenses needed to respond to the new coronavirus pandemic as the number of Nebraska cases rose to 37.

Ricketts was expected to present the new budget request to legislators Friday afternoon. Lawmakers are tentatively planning to return to the Capitol on Monday to consider the package. Speaker of the Legislature Jim Scheer said Friday evening he hadn't yet scheduled the session because he was still polling lawmakers to see if there was enough consensus to pass the governor's proposal.

"We want to make sure we've got the resources necessary," Ricketts said at a Capitol news conference.
Ricketts said the money would come from the state's emergency fund, which is designed for budget crunches and one-time expenses. The biggest chunks of money would pay for lab equipment, protective gear for local health departments and a surge of employees needed in the state's public health facilities and veterans' homes.
The announcement came as eight more cases of COVID-19 were identified in the state, including the first case in Lincoln.


5:55 PM CT on 3/20/2020

LeadingAge Ohio, a not-for-profit representing more than 400 long-term care organizations, wants to help displaced workers in the Buckeye State find new jobs in post-acute care and related services during the coronavirus pandemic.

The organization launched an email address, [email protected], where individuals seeking work can send their information and seek employment in the healthcare industry. Ohio has shut down senior centers and adult day cares, and more service workers are needed to fill the gaps.

"Long-term care and post-acute care represent the frontlines in the fight against this disease," said Kathryn Brod, president and CEO of LeadingAge Ohio, in a statement.

Available jobs could include food service, housekeeping or transportation for facilities.


4:02 PM CT on 03/20/2020

(AP) At a time of isolation, people in many European cities hit hard by the new coronavirus are taking at least a minute each night to come together in gratitude.

They stand at open windows or on balconies in Rome, Madrid, Paris, Athens and Amsterdam, singing, cheering and applauding even though they know their intended audience is too busy to listen.

The adulation is for the doctors, nurses and other health care workers putting themselves at risk on the front lines of the pandemic that is forcing most residents to stay home.

"We're clapping tonight out of respect and to say thank you to all the health care workers in the Netherlands who are protecting us against this horrible coronavirus," King Willem-Alexander said while observing the ritual Tuesday night with his family at Palace Huis ten Bosch in The Hague.


3:39 PM CT on 3/20/2020

A group that represents more than 1,000 safety-net hospitals asked HHS for more regulatory flexibility and financial help to respond to the coronavirus pandemic. 340B Health asked HHS Secretary Alex Azar to hold off on a survey of 340B hospitals' drug acquisition costs and to pause the "nearly 30% Medicare Part B payment reduction to 340B hospitals," among other measures, arguing that both moves would help providers respond to the crisis thanks by freeing up staff and increasing funding.

HHS and hospitals that participate in the 340B drug discount program have been fighting over the Trump administration's cuts to the program in 2018, both in and out of court.


3:00 PM CT on 3/20/2020

A physician at Chicago-based Sinai Health system has tested positive for COVID-19, becoming the latest in a growing list of healthcare professionals who have fallen ill or been forced isolate due to the virus.

The physician, whose name has not been disclosed, was sent home from work at Mount Sinai Hospital on Monday after developing respiratory symptoms while at work, according to the safety-net provider. A subsequent test confirmed the physician had contracted COVID-19.

Sinai Health Spokesman Dan Regan said an investigation has yet to determine where the physician contracted the virus. 

The individual reportedly followed proper procedures for use of personal protective equipment while at work. Regan said the health system was working to identify any staff and patients the doctor might have come in contact with to notify them and coordinate any appropriate testing for potential COVID-19 infection.

The case marks Sinai Health's the first confirmed infection of COVID-19 among either staff or patients since the start of the outbreak last December. But the case highlights growing concern over the safety of healthcare professionals on the front line of combating the effects of a pandemic that has infected more than 15,000 as of Friday, resulting in more than 200 deaths.


2:47 PM CT on 03/20/2020

(AP) — Seven national organizations representing patients with serious medical conditions criticized Oklahoma Gov. Kevin Stitt on Friday for rolling out his Medicaid expansion plan during the coronavirus pandemic. The organizations, including the American Heart Association and The Leukemia & Lymphoma Society, released a statement calling for the state to withdraw its application immediately.

"Starting the 30-day public comment period on SoonerCare 2.0, which if implemented in its current form could trigger grave consequences for Oklahomans, while families worry about their lives and livelihoods is completely inappropriate," the statement read.

A spokesman for the governor didn't immediately respond to a request for comment.

Stitt wants to take advantage of a block-grant-style Medicaid expansion offered by the Trump administration that would give states more control over Medicaid in exchange for a limit on how much the feds kick in. One requirement Stitt wants to impose would make recipients pay premiums and either work or volunteer in the community.

Stitt has touted his plan, which he's dubbed SoonerCare 2.0, as an alternative to a citizen-led Medicaid expansion that has qualified for a public vote this year. If approved, that plan would put Medicaid expansion in the Oklahoma Constitution to prevent lawmakers from tinkering with it.


1:19 PM CT on 3/20/2020

HHS Secretary Alex Azar on Friday applauded the Trump administration's decision to limit non-essential travel between the U.S., Canada and Mexico, arguing that "illegal immigrants" impair the ability of the U.S. health system to respond to the coronavirus pandemic.

"When held a border facilities, these migrants were spreading the virus to other migrants, to CBP agents and border healthcare workers, and even the United States population as a whole," Azar said. "That's why the president and his administration are taking these important steps to keep Americans and our immigration system safe from these health risks."

The move was also supported by Dr. Anthony Fauci, U.S. Coronavirus Task Force member and director of the NIH's National Institute of Allergy and Infectious Diseases, and other administration officials.

1:03 PM CT on 3/20/20

Staff at Henry Ford Health system are creating their own personal protective equipment using everyday items like nylon jersey fabric, elastic bands, Velcro, tongue depressors and air filter material.

"There is a critical shortage of the personal protective equipment our healthcare providers need. In response to that, staff from across Henry Ford are creating homemade eye protection and face masks that are washable, do not degrade if placed into a bleach cleaning solution, and can be reused, within reason," said Dr. Scott Dulchavsky, CEO of the Henry Ford Innovation Institute.

Former Sen. Claire McCaskill reports her daughter-in-law's hospital has created sewing stations to create supplies:

12:13 PM CT on 3/20/2020

President Trump said Friday that the Defense Production Act, which allows the president to compel U.S. companies to produce goods and services, went into effect Thursday night, even though he previously said that he was reserving it for a worst-case scenario. A day earlier, the president had told governors that they were responsible for making sure that their states had enough supplies.

"We are helping the states a lot," Trump said during a press conference.

The National Response Coordinator Center, part of the Federal Emergency Management Agency, is now in its "highest level of activation," Trump said.

Senate Minority Leader Chuck Schumer's (D-NY) office alleged that he had urged Trump to "immediately invoke the Defense Production Act to get ventilators & other important medical equipment to those who need it," less than an hour before Trump announced that he had done it the night before.


11:53 am CT on 3/20/20

Dr. Aaron Bernstein, interim director of the Center for Climate, Health, and the Global Environment at the Harvard T.H. Chan School of Public Health, answers common questions about the role of climate and climate change in the transmission of the COVID-19. Read the full interview here.

Does climate change affect the transmission of coronavirus?
We don't have direct evidence that climate change is influencing the spread of COVID-19, but we do know that climate change alters how we relate to other species on Earth and that matters to our health and our risk for infections.

As the planet heats up, animals big and small, on land and in the sea, are headed to the poles to get out of the heat. That means animals are coming into contact with other animals they normally wouldn't, and that creates an opportunity for pathogens to get into new hosts.

Does air pollution increase the risk of getting coronavirus? Does it make symptoms worse?
Given what we know now, it is likely that people who are exposed to more air pollution and who smoke are going to fare worse if infected with COVID-19 than those who are breathing cleaner air, and who don't smoke. Air pollution is strongly associated with people's risk of getting pneumonia and other respiratory infections and with getting sicker when they do get pneumonia. A study done on SARS, a virus closely related to COVID, found that people who breathed dirtier air were about twice as likely to die from the infection.

Will warmer weather slow the spread of coronavirus?
We don't yet have a sense of what the changing weather will mean for COVID-19 and so we shouldn't rely upon warmer weather to curtail transmissions. We need to do everything we can right now to slow the spread of this disease, and that means we need to follow the advice that public health experts are telling us and practice social distancing and good hand hygiene, among other actions.


9:57 AM CT on 3/20/2020

Amazon Web Services—the cloud computing arms of Seattle tech giant Amazon—said it has committed $20 million toward its new effort to accelerate diagnostic research related to the coronavirus pandemic.

The effort, dubbed the AWS Diagnostic Development Initiative, is designed to support research institutions, startups and businesses using the company's computing and analytics tools to develop new diagnostic tests. AWS will provide funding through a "combination of AWS in-kind credits and technical support," wrote Teresa Carlson, vice president of worldwide public sector at AWS, in a blog post announcing the program.

The AWS Diagnostic Development Initiative's emphasis will initially focus on helping organizations develop tools that support same-day detection of COVID-19, but AWS said it will also consider projects tackling other infectious diseases. The AWS Diagnostic Development Initiative has established a technical advisory group of health policy experts and scientists to continue to inform the program's goals, according to Carlson.

So far, AWS said 35 organizations are participating in the AWS Diagnostic Development Initiative.


9:53 AM CT on 3/20/2020

The National Whistleblower Center wrote to Attorney General William Barr on Friday calling for the Trump administration to be transparent about its coronavirus-related spending.

Congress has fast tracked several bills to address the COVID-19 pandemic, with one piece of legislation allocating $8.3 billion to combat the virus and another earmarking $100 billion for sick leave and other measures to alleviate pressures on workers.

But the process' fast pace could also open the door to wrongdoing, the group said.

"In light of the gargantuan scope and rapid pace of this federal spending, we should anticipate that rogues and profiteers will leap at the opportunity to divert large amounts of coronavirus funding for their own purposes," said John Kostyack, NWC's executive director. "The only way to stop this, and ensure that coronavirus funds go to those in need, is to enlist whistleblowers to help the government prosecute the wrongdoers to the fullest extent of the law."


9:16 AM CT on 3/20/2020

The federal government postponed Americans' tax deadline from April 15 to July 15, citing the coronavirus epidemic.

Individuals and businesses will not be penalized for filing their taxes after the usual deadline, according to Treasury Secretary Steven Mnuchin.

"I encourage all taxpayers who may have tax refunds to file now to get your money," Mnuchin tweeted Thursday morning.


9:14 PM CT on 3/19/2020

California's Democratic Governor Gavin Newsom on Thursday ordered all residents to stay at home to stem the growth of the coronavirus pandemic.The nearly 40 million residents should only travel for essential purposes. Previously, several San Francisco Bay Area counties were under similar orders.

Newsom said 56% of the state's population could contract COVID-19 over the next eight weeks. 


8:41 PM CT on 3/19/2020

The CMS on Thursday gave Washington state the green light to modify its Medicaid rules as it responds to coronavirus. It's the second state to receive a Section 1135 waiver after Florida.

Under the changes, Washington will allow providers to bill Medicaid even if they aren't enrolled with another state Medicaid agency or Medicare. Normally these healthcare providers would have to undergo screening, site visits and licensing requirements.

The state will also forgo prior authorization requirements as long as COVID-19 is a national emergency.

"I recognize that Governor (Jay) Inslee and his team are working around the clock to respond to the escalating crisis in Washington State," CMS Administrator Seema Verma said in a statement. "We are committed to stripping away any red tape that gets in the way of states or providers effectively managing this public health emergency."


8:27 PM CT on 3/19/2020

Georgia Fojtase, President Emeritus at Henry Ford Allegiance Health is making notes on her "lessons from 2020" and inviting others to consider creating their own letter to the future.

"Harvesting what we learn through this crisis provides perspective and builds resilience for futures which are always filled with the unexpected," Fojtase said.


7:40 PM CT on 3/19/2020 

In a research letter published in JAMA on Thursday, doctors at the University of Washington revealed what they called "the first description of critically ill patients infected with COVID-19 in the U.S.," describing them as having a high rate of acute respiratory distress syndrome and a high risk of death.

The research shows "poor short-term outcomes among patients requiring mechanical ventilation."
A total of 21 cases, ranging in age from 43 to 92, with 52% of them male were admitted to the ICU at Evergreen Hospital between February 20, 2020, and March 5, 2020, were included. Evergreen Hospital is a 318-bed public hospital with a 20-bed ICU serving approximately 850 000 residents of King and Snohomish counties in Washington State.

Comorbidities were identified in 18 cases, with chronic kidney disease and congestive heart failure being the most common.


6:13 PM CT on 3/19/2020

An assessment of the country's hospital bed capacity indicates that the healthcare system could be overwhelmed dealing with COVID-19 patients, according to a new report from the Urban Institute.

An analysis of American Hospital Association data from 2018 indicates that almost two-thirds of the country's 728,000 medical and surgical hospital beds were occupied on a typical day.

In addition, occupancy rates vary widely by county, prompting the institute to create an interactive county-level map for stakeholders to analyze their community.

The report was funded by the Robert Wood Johnson Foundation.


4:40 PM CT on 3/19/2020

Michigan-based Beaumont Health is encouraging hospitals to share data on testing and patient admissions. Once a day, the following numbers/statistics will be available on Beaumont's website 
•    Total number of patients tested by Beaumont for COVID-19.
•    Number of patients who test positive for COVID-19.
•    Number of patients who test negative for COVID-19.
•    Number of patients with pending COVID-19 test results. Beaumont has shifted mainly to COVID-19 testing within its own labs, but will still use some outside national labs.
•    Number of patients tested for COVID-19 currently in a Beaumont hospital. 
•    Number of patients tested for COVID-19 and sent home.

Beaumont Health also launched a free online COVID-19 risk assessment tool yesterday, March 18. It allows patients to answer a series of questions about their symptoms and help them determine whether to stay home or seek medical attention. Within the first 24 hours, more than 27,500 people visited the site and clicked on the risk assessment tool, according to Beaumont.


3:27 PM CT on 3/19/2020

(AP) In a nearly empty Statehouse with especially worried members voting from the balcony, the South Carolina House approved $45 million Thursday for state health officials to fight the new coronavirus.

House Speaker Jay Lucas then called in Senate President Harvey Peeler and they took the unheard of step to ratify the bill immediately and walk it personally to the governor's office, where Gov. Henry McMaster was waiting to sign it.

The three men joined by other lawmakers, standing several feet apart, as they showed off the bill. Then all the lawmakers left, without any idea when the General Assembly might return as legislators go home to isolate themselves as best they can from COVID-19. Sixty cases had been reported in the state as of Wednesday afternoon.


3:10 PM CT on 3/19/2020

The Illinois Health and Hospital Association issued a plea to the leaders of associations for the construction industry, dentists, veterinarians and other groups to donate face masks to hospitals in the state. Illinois' 200-plus hospital need both face masks and N-95 masks to protect healthcare workers caring for COVID-19 patients.

"Hospitals all over the state are in jeopardy of potentially running out of critically needed protective medical supplies," said Illinois Health and Hospital Association President and CEO A.J. Wilhelmi, in a news release.


2:31 PM CT on 3/19/2020

CVS Health said it has opened a COVID-19 testing site in a CVS Pharmacy parking lot in Shrewsbury, Mass., in partnership with the federal government and Massachusetts Gov. Charlie Baker's administration.

The testing will initially focus on first responders and healthcare workers who potentially have been exposed to coronavirus, and it will not administer tests on a walk-up or drive-up basis, according to a company announcement. The site will serve as a model for testing and inform the opening of other sites, it said.

President Donald Trump last week announced a partnership with major U.S. retailers CVS, Target, Walgreens and Walmart to expand COVID-19 testing. The retailers agreed to donate portions of their parking lots for drive-thru testing sites.


2:11 PM CT on 3/19/2020

While the vast majority of Americans are following hand washing guidelines and other recommendations to curb the spread of coronavirus, their worries about the pandemic have increased.

An AP-NORC poll shows two-thirds of Americans are at least somewhat concerned that a family member will contract the virus, compared to 45% in February. But 88% report they are washing their hands more frequently and 68% are avoiding crowds.

COVID-19 is also drastically changing travel behaviors. Almost 60% of Americans will avoid domestic travel and 87% say they don't plan on traveling internationally for now.


1:42 PM CT on 3/19/2020

The Rockefeller Foundation on Thursday said it would commit $20 million to assist workers and invest in public health to combat the coronavirus pandemic. With 40% of Americans having less than $400 saved for emergencies and many losing their jobs or hours of work due to COVID-19 precautions, the foundation hopes to provide "immediate relief." 

On the healthcare front, the foundation will invest in data-science tools to track coronavirus' spread and predict the direction of the pandemic, as well as work with other organizations on a response tool.


1:18 PM CT on 3/19/2020

Senate Majority Leader Mitch McConnell (R-Ky.) said Thursday that funding for frontline medical supplies, hospitals and community health centers will be one of his top priorities in Congress' upcoming COVID-19 economic stimulus plan. Lawmakers are still negotiating what measures will be included in the bill, which is Congress' third major legislative effort in response to COVID-19. 

"Our proposal will go even further to remove barriers to care, speed innovation, fund the hospitals and health centers that will treat patients and expand health care workers' access to the tools they need, including respirator masks," McConnell said on the Senate floor.

Senate Minority Leader Chuck Schumer (D-N.Y.) has also called for increased funding for hospitals and healthcare workers, and called his request a "Marshall Plan for our hospitals" in an appearance on CNN on Wednesday.

McConnell said that Congress will also consider a fourth bill addressing the Trump administration's request for $48 billion to help government agencies combating COVID-19. The request includes $3.4 billion to help the Centers for Disease Control and Prevention expand lab capacity and response efforts and $5.2 billion for HHS to develop vaccines, treatments and diagnostics, bolster stockpile supplies and conduct pandemic forecasting. $3 billion would be placed in and "unanticipated needs" account.

"Immediately after we pass this legislation, Congress must begin a bipartisan, bicameral appropriations process to address the administration's new supplemental funding request so we can keep funding healthcare and other priorities," McConnell said.


1:05 PM CT on 3/19/2020

Intermountain Healthcare subsidiary HealthCare Partners Nevada released a home health monitoring app for COVID-19 for high-risk senior patients. Users will be able to input if they have a cough, temperature or shortness of breath to keep track of their symptoms. HealthCare Partners had a similar digital health plaform for influenza in 2019.


12:55 PM CT on 3/19/2020

A French official suggested that ibuprofen might actually worsen a COVAD-19 infection, but it's all speculation at this point. According to Live Science, a letter published by Lancet started it all, though experts say proof will be needed before ibuprofen is taken off the approved list for infected patients. "There is currently no scientific evidence establishing a link between ibuprofen and worsening of COVID‑19," the European Medicines Agency, wrote in a statement on March 18, according to Live Science.


10:40 AM CT on 3/19/2020

Norfolk, Va.-based Sentara Healthcare has restarted its drive-thru coronavirus testing at two locations, shortly after halting the program due to low supplies. Sentara Princess Anne Hospital and Sentara Williamsburg Regional Hospital will both accept patients. Sentara Edinburgh's drive-thru testing facility remains closed.

Sentara said operations are open on a day-by-day basis depending on supply levels.


10:05 AM CT on 3/19/2020

Law firm Seyfarth conducted a flash survey of its clients to gauge how coronavirus is affecting employer behavior. Of the 550 respondents, approximately 85% actively encouraged employees to work from home. 

But other actions may place undue burden on the healthcare industry. Nearly 70% of respondents required employees who were returning to work to get a medical sign-off. The government has warned that could put too much pressure on medical offices that are already dealing with a swell of demand.


9:07 PM CST on 3/18/2020

BEIJING (AP) — Factories in China, struggling to reopen after the coronavirus shut down the economy, face a new threat from U.S. anti-disease controls that might disrupt the flow of microchips and other components they need.

The shock threatens to set back the ruling Communist Party's efforts to revive the world's second-largest economy after it declared victory over the outbreak. It would add to pressures on global business activity as Western countries close workplaces, limit travel and tell consumers to stay home.

China is a major global supplier of disposable medical devices like syringes and gloves, as well as surgical equipment. Over the past decade the country has also exported higher-tech therapeutic and diagnostic products like joint implants and MRI machines.

Sales of Chinese orthopedic implantable devices grew by 189% to $555 million from 2011 to 2016, according to a 2018 analysis by the U.S. International Trade Commission. Over the same period, exports of diagnostic equipment increased by 37% to $1.4 billion.


7:07 PM CT on 3/18/2020

The CMS on Wednesday updated its COVID-19 FAQ for state Medicaid and Children's Health Insurance Program agencies. The additions address several issues related to benefit, financing, managed care and waiver flexibilities.

Many of the updates focus on the recent expansion of telehealth services by the CMS and state amendments to their Medicaid 1115 demonstration waivers to address the public health crisis.


6:59 PM CT on 3/18/2020

WASHINGTON (AP) — By a sweeping bipartisan tally, the Senate on Wednesday approved a $100 billion-plus bill to boost testing for the coronavirus and guarantee paid sick leave for millions of workers hit by it — and President Donald Trump quickly signed it. But lawmakers and the White House had already turned their focus to the administration's far bigger $1 trillion plan to stabilize the economy as the pandemic threatens financial ruin for individuals and businesses.

Details on Trump's economic rescue plan remain sparse — and it's sure to grow with lawmaker add-ons — but its centerpiece is to dedicate $500 billion to start issuing direct payments to Americans by early next month. It would also funnel cash to businesses to help keep workers on payroll as widespread sectors of the $21 trillion U.S. economy all but shut down.

In a memorandum, the Treasury Department proposed two $250 billion cash infusions to individuals: a first set of checks issued starting April 6, with a second wave in mid-May. The amounts would depend on income and family size.

The Treasury plan, which requires approval by Congress, also recommends $50 billion to stabilize the airlines, $150 billion to issue loan guarantees to other struggling sectors, and $300 billion for small businesses. The plan appears to anticipate that many of the loans would not be repaid.


6:08 PM CT on 3/18/2020

More than a dozen healthcare trade associations, some often at odds with each other, have written to Vice President Mike Pence and congressional leaders.

"This is an unprecedented demonstration of partnership and collaboration in the health care industry. And it is happening now, because we unanimously agree that by the private market and government coming together as one, we can effectively protect and care for the American people," the letter written by America's Health Insurance Plans, the American Hospital Association, the Federation of American Hospitals, HIMSS and the Pharmaceutical Research and Manufacturers of America, stated.  

Leaders in the private sector say the following actions are needed to ensure care for communities in peril: 

  • We must ensure a stable, continuous supply of needed medical supplies for clinical labs and technicians, health care providers and health care facilities.
  • We must strengthen provider capacity and drive patients to appropriate alternative sites of care.
  • We must ensure continued access to critical medications and avoid supply-chain disruptions. 

"This moment challenges all of us.  And we will do everything possible to ensure that the private sector and government collaborate and cooperate on behalf of the American people. We will deliver by working together," the letter concludes.


4:10 PM CT on 3/18/2020

North Carolina is seeking permission from the CMS to temporarily waive certain Medicaid requirements so the state and healthcare providers can better address patient needs during the coronavirus pandemic.

The state health department said Wednesday it requested an 1135 waiver to streamline provider enrollment, waive facility access and length of stay limits, and allow alternative settings to deliver care, such as providing services at home. It further asked for authority to modify Medicaid benefits and cost-sharing, cover housing and provide healthy meals to families who don't have access.

Section 1135 waivers allow HHS to set aside administrative requirements to increase access to medical services when the president declares a national emergency. On Tuesday, Florida became the first state to receive CMS approval for its 1135 waiver request.


3:30 PM CT on 3/18/2020

In a letter to CMS Administrator Seema Verma, provider groups are calling on the agency to remove financial penalties and reporting requirements part of value-based payment contracts as a result of the COVID-19 outbreak. 

The letter, sent by the National Association of ACOs, the American College of Physicians and others, urges the CMS to forgo penalizing clinicians in the 2020 performance year should they have losses in value-based payment arrangements. Providers are concerned the novel coronavirus will drive up Medicare beneficiary spending, which will affect benchmarks used to determine savings and losses in advanced alternative payment models. 

The letter states providers need assurance that they won't be accountable for losses or the agency risks turning off providers from entering value-based payment contracts in the future. The authors also urge the CMS to remove quality reporting obligations baked into value-based arrangements and extend reporting deadlines for participants in the Merit-based Incentive Payment System. The outbreak has made it difficult for providers to do preventive care required of these programs, according to the associations.  


2:24 PM CT on 3/18/2020

HHS' Health Resources and Services Administration on Wednesday said it would survey HRSA-funded health centers to better understand how they're addressing the coronavirus pandemic. The agency is particularly interested in whether they're testing people in their communities for the virus.

"Our health centers can provide us with an on-the-ground-perspective on the response to the COVID-19 pandemic and what stresses our healthcare system is experiencing as a result," HHS Secretary Alex Azar said. "Health centers are on the frontlines of providing accessible, affordable care in many of our communities, and play a vital role in our response efforts."

The government-funded health centers deliver primary care services to about 28 million people.


1:27 PM CT on 3/18/2020

Workers at the private call center contractor Maximus are urging the company take immediate steps to ensure safe workplaces, including full access to paid sick leave. Maximus employs about 10,000 workers in 11 call centers across the country who handle Medicare and Affordable Care Act federally facilitated marketplace inquires under a federal contract with the CMS. According to the union Communications Workers of America, Maximus' emergency attendance policy issued in response to COVID-19 counts excused COVID-19 absences as an unscheduled absence worth 8 hours. Employees who miss more than 64 hours in a 12-month period face termination.

Call center employees work in close conditions that can lead to outbreaks, according to CWA.

The CWA is calling on Maximus to grant employees full access to paid sick leave and waive penalties associated with its use, among other demands.

Maximus said they have implemented "significantly more flexibility" for employee leave.


12:56 PM CST on 3/18/2020

Senate Minority Leader Chuck Schumer (D-N.Y.) is prioritizing hospital funding in his requests for Congress' third economic stimulus package. Lawmakers have started negotiations on the bill, but the timeline for passage remains unclear.

In a letter to colleagues sent Tuesday, he called for a "massive new investment program" to help hospitals pay for non-reimbursable costs, a program to address cash-flow issues, expanding the healthcare workforce through disaster relief programs, investing in the National Strategic Stockpile, funding vaccine purchasing, ensuring affordable treatment for COVID-19, funding Centers for Disease Control and Prevention labs and providing support for mental health services. 

American Hospital Association Executive Vice President Tom Nickels issued a new letter to congressional leaders asking for direct payments to hospitals for infrastructure, equipment and supplies, tax relief to offset uncompensated care costs, the ability to advance refund tax-exempt municipal bonds, and increasing the limit for small borrowers from $10 million to $30 million. 


12:03 PM CT on 3/18/2020

Diarrhea may play a role in earlier diagnosis of COVID-19, according to a new study published out of China in the Journal of Gastroenterology. Digestive symptoms are common in COVID-19, and are the chief complaint in nearly half of patients being assessed at hospitals, but may indicate a more serious case than those with just respiratory symptoms and signs, according to the American College of Gastroenterology.

"In this study, COVID-19 patients with digestive symptoms have a worse clinical outcome and higher risk of mortality compared to those without digestive symptoms, emphasizing the importance of including symptoms like diarrhea to suspect COVID-19 early in the disease course before respiratory symptoms develop," said Dr. Brennan Spiegel, co-editor-in-chief of the journal. "This may lead to earlier diagnosis of COVID-19, which can lead to earlier treatment and more expeditious quarantine to minimize transmission from people who otherwise remain undiagnosed." 


10:26 AM CT on 3/18/2020

The coronavirus pandemic is affecting regularly scheduled care for Americans, but some treatment must go on. Seattle Cancer Care Alliance encouraged its peers to reschedule well visits, consider lower thresholds for blood transfusions and move some inpatient treatments to outpatient. Their full recommendations are available in a free, peer-reviewed article for the Journal of the National Comprehensive Cancer Network.


9:12 AM CST on 3/18/2020

TORONTO (AP) — The U.S. and Canada have agreed to temporarily close their shared border to nonessential travel, President Donald Trump announced Wednesday as the two nations work to stem the spread of the coronavirus pandemic.

Both countries are eager to choke off the spread of the virus but also maintain their vital economic relationship. Canada relies on the U.S. for 75% of its exports.


9:08 AM CST on 3/18/2020

The Ambulatory Surgery Center Association advised its members that they should proceed with some surgeries, depending on the prognosis of a patient. Under the new guidelines, procedures may need to happen during the COVID-19 pandemic if a patient's morbidity would be significantly worse without the surgery at this time. Those cases could include situations with acute trauma or infection, possible malignancy or uncontrollable pain. 

The association also recognized ASCs may have to cease operations if a staff member falls ill with coronavirus or the facility runs low on personal protective equipment.


8:30 AM CST on 3/18/2020

CommonSpirit Health said Wednesday that it won't send patients bills for any COVID-19 testing or treatment while it works on a solution with insurers and government officials. 

"The last thing our patients should worry about if they experience symptoms characteristic of this coronavirus is the cost of seeking care," said Lloyd H. Dean, CEO of CommonSpirit Health, said in a statement. "While we cannot yet know how COVID-19 will spread in the days and weeks ahead, our care sites will remain available to our communities."

The health system, which has hospitals and clinics in 21 states, encouraged individuals to call their providers if they're experiencing possible coronavirus symptoms.


6:55 PM CST on 3/17/2020

In the area of Seattle that's been hardest-hit, some nurses in emergency departments are washing and reusing surgical masks, gloves and gowns. They may work on a patient for hours or more before learning they tested positive for COVID-19.

"I've got a two-day supply of masks, so we're trying to be conservative," said Dr. Stephen Anderson, an emergency physician at the MultiCare Auburn Medical Center in suburban Seattle. "You get one in the morning. You clean it and reuse it.


5:47 PM CST on 3/17/2020

The CMS issued guidance to all Programs of All-Inclusive Care for the Elderly (PACE) Organizations to protect from the Coronavirus pandemic. PACE organizations serve older adults who often have serious chronic medical conditions and therefore are at higher risk of serious illness from the virus.

The CMS reminded organizations that they must provide diagnostic laboratory tests to identify COVID-19.

"This responsibility extends to the home setting, including for participants with symptoms that may be attributable to COVID-19 and who therefore should not attend the PACE center in order to mitigate the risk of infecting other participants and/or personnel."


4:52 PM CST on 3/17/2020

4:21 PM CST on 3/17/2020

HHS Secretary Alex Azar waived select HIPAA sanctions and penalties for hospitals that have instituted disaster protocols in the wake of the COVID-19 outbreak. The waiver applies for up to 72 hours from when a hospital implements its disaster protocol or through when President Donald Trump's nationwide emergency or Azar's public health emergency declarations are terminated.

The waiver applies to just five HIPAA provisions, including a requirement to obtain a patient's agreement before speaking with family members involved in their care and a requirement to distribute a notice of privacy practices.

HHS waived the same HIPAA sanctions and penalties after the Puerto Rico earthquakes in January, Hurricane Dorian in September 2019 and Tropical Storm Barry in July 2019, among other public health emergencies.


3:40 PM CST on 3/17/2020

Senate health committee Chair Lamar Alexander (R-Tenn.) and House Energy & Commerce Chair Frank Pallone (D-N.J.) are pushing for legislation banning surprise medical bills to be included in Congress' third bill responding to the COVID-19 pandemic, according to several sources familiar with the efforts. Some individuals will likely incur out-of-network costs related to COVID-19. 

Hospitals and provider groups oppose Alexander and Pallone's bill, which combines a median benchmark payment and arbitration approach to banning surprise medical bills. Neither office immediately responded to a request for comment.

3:28 PM CST on 3/17/2020

With numerous businesses ordered temporarily closed, the Ohio Department of Job and Family Services said it had received 48,640 unemployment insurance benefit applications online in just two days this week, compared to typical filings of a few hundred. Restaurants are among the hardest-hit businesses because of restrictions on dining in. The Ohio Restaurant Association says Ohio has about 22,500 food service locations with 585,000 total employees. It urged people to consider takeout and pickup options. Ohio's investor-owned utilities suspended disconnections for customers with past-due bills.


2:52 PM CST on 3/17/2020

New York City Mayor Bill de Blasio said residents should be prepared for the possibility of a "shelter in place" order within days. State officials scrambled to bring more hospital beds online as the number of confirmed cases in the state rose above 1,300. There were 264 hospitalizations and 12 deaths.

Gov. Andrew Cuomo said Tuesday that demand for hospital beds in New York state could outstrip current capacity by tens of thousands when cases of the coronavirus reaches an expected peak in 45 days. Officials are also scrambling to increase the number of hospital beds in New York from 53,000, with 3,000 ICU beds.

Cuomo said the at the current rate of spread, the state would need 55,000 to 110,000 hospital beds and 18,600 to 37,200 ICU beds.

"The numbers are daunting," he said.

Cuomo said the state also will need more ventilators to help patients breathe.


2:14 PM CST on 3/17/2020

Beaumont Health has joined several other hospitals in processing a limited number of COVID-19 tests in its own laboratory. 

"We're proud to have developed a mechanism to process tests within our health system. It typically takes months to do this and we did it several days," said Dr. Barbara Ducatman, chief of Pathology and Laboratory Medicine for Beaumont Health. "However, we must conserve our testing supplies. That's why we're only processing our own tests for certain patients who meet COVID-19 testing criteria and are admitted to our hospitals or are receiving treatment in one of our emergency centers."


1:28 PM CST on 3/17/2020

The Trump administration has expanded telehealth services to rein in the spread of COVID-19. Officials think that increased use of telehealth services will reduce seniors' exposure to the virus and preserve system capacity by reducing the number of people visiting medical facilities for treatment. 
Here are four key takeaways from the changes.

  • The CMS will pay providers to deliver a wide range of telehealth services to all Medicare beneficiaries starting March 6, even if those services don't address COVID-19.
  • If providers deliver telehealth services to their patients "in good faith," HHS' Office of Civil Rights won't go after them for HIPAA violations.
  • Doctors can use their personal phones and other devices to provide telehealth services.
  • Expanded telehealth coverage will last until the national emergency ends.

12:48 PM CST on 3/17/2020

Italy, the second hardest-hit nation after China in the world's coronavirus pandemic, has one-third of the world's total deaths. Italy on Tuesday added more than 3,500 new positive cases, bringing its total to 31,506. In addition, another 345 people with the virus have died, bringing Italy's total deaths to 2,503.

Italy, which has the world's second-oldest population after Japan, has been blindsided by the virus that appears to be much more deadly for the elderly and the infirm. The doctors Without Borders charity says Italy lacks key medical equipment like protective gloves or masks.

"Nearly 1,700 healthcare workers, or 8% of the total COVID-19 cases in Italy have been infected whilst tirelessly caring for the rising number of severely ill patients who require long-term hospitalization," the group said.


11:40 AM CST on 3/17/2020

The Trump administration is urging U.S. construction companies to donate their inventories of safety masks to hospitals and forgo new orders as the nation battles the coronavirus pandemic.

Vice President Mike Pence said the single-use N95 masks, which are designed to filter 95% of airborne particles and commonly used in the construction industry, are "perfectly acceptable" for hospital use.


11:03 AM on 3/17/20

Many are trying to understand the healthcare capacity across the U.S. Here's an estimate of ICU and specialty ICU beds per 10,000 population, by state. 

10:12 AM CST on 3/17/2020

According to a survey from group purchasing organization Premier, about 30% of senior living respondents reported they have no inventory of N95 masks and 68% said they had limited to no ability to access additional masks. Nearly 60% of respondents also indicated limited to no ability to access gowns. Approximately 65% have limited to no ability to obtain disinfecting products such as wipes, spray and hand sanitizer. Nearly 70% reported limited to no ability to acquire face shields and other facial protective equipment. 


8:37 PM CST on 3/16/2020

"Although demand for pharmaceutical products is non-discretionary and not traditionally sensitive to economic slowdowns, S&P Ratings expect the disruptive nature of the COVID-19 pandemic to moderately influence the performance of some pharmaceutical companies. That impact, will be mild compared to disruptions in certain other sectors," the credit ratings agency said.
 

7:25 PM CST on 3/16/2020

The U.S. House of Representatives on Monday evening passed for the second time a bill to mitigate the economic impact of COVID-19 after technical corrections were made to the measure.

The bill initially passed in a 363-40 vote on Saturday morning, but due to a technicality that could not be fixed administratively, it had to be brought back to the floor.


7:08 PM CST on 3/16/2020

America's Physician Groups and group purchasing organization Premier sent a joint letter to HHS Secretary Alex Azar and CMS Administrator Seema Verma in which they urged HHS to provide guidance on financial and quality mitigation policies for all quality programs and value-based arrangements in response to the challenges brought about by COVID-19.

3:15 PM CST on 3/16/2020

As COVID-19 changes the landscape of healthcare, critical-access hospitals will be more affected than larger acute-care hospitals.

Critical-access hospitals have lower occupancy rates but also fewer beds overall, and some have no intensive-care beds. 

Here's a look at average full-time employees, occupancy rates, ICU and other beds for CAH versus acute-care hospitals.


 

3:00 PM CST on 3/16/2020

The American Hospital Association, Federation of American Hospitals and the American Academy of Medical Colleges on Sunday asked lawmakers to suspend Medicare sequestration cuts, which reduce payments for most benefits by 2%. The groups argue that Medicare payments fall below the cost of care. "This action alone will provide immediate, significant relief across-the-board, and will signal continued Congressional support for the hard work that lies ahead for all of us," the hospital groups said.


1:47 PM CST on 3/16/2020

A bipartisan group of medical professionals that includes Andy Slavitt and Dr. Leana Wen, have penned an open letter calling on Americans to "#StayHome, Save Lives." The letter explains that this will come to communities in waves and will be a marathon, not a sprint, and gives people concrete actions they can take.


3/16/2020

Read Scripps Health CEO Chris Van Gorder's memo to employees and physicians on COVID-19.


3/16/2020

Data scientists at Penn Medicine have put together a tool to understand the best and worst-case scenarios surrounding hospital capacity planning around COVID-19.

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