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Coronavirus May Add Billions to the Nation's Health Care Bill - The New York Times - 0 views

www.nytimes.com/...surance-premium-increases.html health-care health cost pandemic treatment
shared by Javier E on 29 Mar 20 - No Cached
  • Insurance premiums could spike as much as 40 percent next year, a new analysis warns, as employers and insurers confront the projected tens of billions of dollars in additional costs of treating coronavirus patients.
  • Mr. Lee’s organization estimated the total cost to the commercial insurance market, which represents the coverage currently offered to 170 million workers and individuals through private health plans.
  • Depending on how many people need care, insurers, employers and individuals could face anywhere from $34 billion to $251 billion in additional expenses from the testing and treatment of Covid-1
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  • At the high end, the virus would add 20 percent or more to current costs of roughly $1.2 trillion a year.
  • Insurers and employers are already prodding Congress to consider helping them pay for the crisis by setting up a special reinsurance program that would cover the most expensive medical claims
  • While insurers have enjoyed strong profits in recent years, they say the cost of the pandemic could be overwhelming, especially to employers and workers already struggling to pay for coverage.
  • Employers and others have launched a new group, the Alliance to Fight for Health Care, that includes many of the same parties that worked together to defeat the enactment of the so-called Cadillac tax on high-cost employer plans
  • Mr. Lee warned that insurers are likely to seek rates that are double their additional costs from the virus. If their costs go up 20 percent, Mr. Lee says rates could jump as much as 40 percent in 2021.
  • He thinks his clients in New York, which is being particularly hard hit by the virus, could see additional costs of 4 to 5 percent. In other areas, if there are many fewer cases, costs could be less.
  • Rate increase requests still might be difficult for some states and consumers to swallow. The nation’s largest insurers, which include giant for-profit companies like Anthem, CVS Health and UnitedHealth, reported billions of dollars in profits last year, and analysts say these companies have abundant capital to absorb any losses because of the pandemic
  • Since the enactment of the Affordable Care Act, health care inflation has remained in the single digits.
  • Increases in medical costs of 3 to 4 percent “would be manageable by most insurers,” concluded a recent analysts at S&P Global Ratings
  • If costs were to go up by 10 to 12 percent, the analysts say the stress on the companies would be greater, with insurers reporting losses and forced to use their capital reserves to pay claims.
  • But some actuaries are predicting costs are likely to be much lower. One actuary said insurers have told him that they have no plans to raise rates sharply because the do not think the pandemic will change their predictions about ongoing medical expenses once it has run its course.
  • other actuaries are coming up with estimates that are lower because they have different assumptions about how many people might be hospitalized and whether that would be offset by the declines in medical care for other illnesses or surgeries as people stay home and elective procedures are postponed indefinitely
  • “These increased costs could mean that many of the 170 million Americans in the commercial market may lose their coverage and go without needed care as we battle a global health crisis,”
  • Another big unknown is whether people will be able to get treatment for Covid-19 or other illnesses, in spite of needing care.
  • If patients can’t get care, overall costs could be much lower than they would otherwise be,
  • Even then, how much the private sector will pay is unclear, especially if the government starts setting up hospital beds and temporary hospitals in various regions, and supplying staff to treat patients.
  • Another unknown factor is how much it will cost to treat those coronavirus patients who are hospitalized. “Everybody is still guessing what a coronavirus hospitalization stay looks like,”
  • While there are some estimates hovering around $20,000 for a hospital stay based on a typical pneumonia case, his group is estimating that the average could be closer to $72,000 for severe cases
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USNS Comfort Hospital Ship Was Supposed to Aid New York. It Has 3 Patients. - The New Y... - 0 views

www.nytimes.com/...-coronavirus-usns-comfort.html navy Covid-19 patients nyc pandemic trump crisis policy
shared by Javier E on 03 Apr 20 - No Cached
  • Only 20 patients had been transferred to the ship, officials said, even as New York hospitals struggled to find space for the thousands infected with the coronavirus. Another Navy hospital ship, the U.S.N.S. Mercy, docked in Los Angeles, has had a total of 15 patients, officials said.
  • Across the city, hospitals are overrun. Patients have died in hallways before they could even be hooked up to one of the few available ventilators in New York. Doctors and nurses, who have had to use the same protective gear again and again, are getting sick. So many people are dying that the city is running low on body bags.
  • At the same time, there is not a high volume of noncoronavirus patients. Because most New Yorkers have isolated themselves in their homes, there are fewer injuries from car accidents, gun shots and construction accidents that would require an emergency room visit.
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  • Ultimately, Mr. Dowling and others said, if the Comfort refuses to take Covid patients, there are few patients to send.
  • The solution, he and others said, was to open the Comfort to patients with Covid-19.
  • Asked about Mr. Dowling’s criticisms, the Defense Department referred to Mr. Trump’s statements about the Comfort at his daily briefing. The president said only that the ship was not accepting patients with the coronavirus.
  • Late Thursday, Governor Andrew M. Cuomo of New York reached an agreement with Mr. Trump to bring Covid patients to the Javits Convention Center in Manhattan, another alternative site operated by the military, with 2,500 hospital beds.
  • There was no word about doing the same with the U.S.N.S. Comfort.
  • Capt. Patrick Amersbach, the commanding officer of the medical personnel aboard the Comfort, said at a news conference that, for now, his orders were to accept only patients who had tested negative for the virus. If ordered to accept coronavirus patients, he said, the ship could be reconfigured to make that happen.
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America, Learn From New York - The Atlantic - 0 views

www.theatlantic.com/...608875 medical response pandemic
shared by Javier E on 29 Mar 20 - No Cached
  • even for my senior attendings, it is the worst they have ever seen. Here, the curve is not flat. We are overwhelmed
  • There was a time for testing in New York, and we missed it. China warned Italy. Italy warned us. We didn’t listen. Now the onus is on the rest of America to listen to New York.
  • Many of my patients clearly haven’t received the message to stay home unless they’re in immediate need of professional medical assistance.
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  • If they didn’t have the coronavirus before coming to our hospital, they probably do now. So much for gatherings of 10 people or fewer.
  • Meanwhile, my colleagues tend to patients in the critical-care bay with dipping oxygen levels, patients who can barely speak and may need breathing tubes.
  • Earlier in the month, we were told that positive-pressure oxygen masks, such as CPAP machines, were risky, as they would aerosolize the virus, increasing health-care workers’ risk of infection
  • But in recent days, running dangerously low on ventilators, we have attempted using CPAP machines to stave off the need for medically induced comas.
  • Nevertheless, we need to perform an alarming number of of intubations. Our ventilators are almost all in use, and the ICUs are at capacity.
  • On Wednesday, I greeted a patient I had discharged only one week prior. When I saw his name pop up on the board, my heart sank. He is just shy of 50, with hardly any past medical history, and he had seemed fine. Now he was gasping for air. His chest X-ray was no relief—COVID-19 for sure. I needed to admit him to the hospital, and set him up with oxygen, heart monitoring, and a bed.
  • My colleagues and I discuss this pandemic with a sardonic sense of helplessness. Some of us are getting sick. Our reality alters by the moment. Every day, we change our triage system. Each day could be the day that the masks run out. There is much we think but are too afraid to say to one another.
  • I do not want to see you in my hospital. I do not want you to go to any hospital in the United States. I do not want you to leave your home, except for essential food and supplies. I do not want you to get tested for the coronavirus, unless you need to be admitted to a hospital.
  • If you have mild symptoms, assume that you have the coronavirus. Stay home, wash your hands, call your doctor. Don’t come to the emergency department just because of a fever or cough. Receiving a test won’t change our recommendation that you remain in self-isolation. We don’t want you to expose yourself to those who definitely do have the virus.
  • Social distancing, while still crucial, came too late in New York to prevent a crisis. Maybe, just maybe, extreme measures can prevent this from happening in other cities around the country.
  • the hospital received one piece of good news yesterday. A coronavirus patient was successfully taken off a ventilator after two weeks, a first for our Medical ICU and a victory for the staff and, of course, the patient.
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Coronavirus fatality rate remains unknown as officials plan to reopen the economy - The... - 0 views

www.washingtonpost.com/...a-a3ee-13e1ae0a3571_story.html fatality rate pandemic Covid-19
shared by Javier E on 18 Apr 20 - No Cached
  • a fundamental question about the coronavirus pandemic remains unanswered: Just how deadly is this disease?
  • In Germany, fewer than three out of every 100 people with confirmed infections have died. In Italy the rate is almost five times higher, according to official figures.
  • Singapore, renowned for its careful testing, contact tracing and isolation of patients, saw only 10 deaths out of 4,427 cases through April 16. That yields a strikingly low case fatality rate of 0.2 percent, about twice the rate of seasonal influenza.
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  • No one knows exactly how many people died from influenza in 1918; estimates range from 15 million to 100 million globally. Historians estimate that the virus killed about 675,000 people in the United States across three waves of the pandemic
  • confirmed cases. But in this global crisis, both the numerator and the denominator are fuzzy.
  • the rising rate may reflect the disease’s gradual progression, combined with discoveries of additional deaths.
  • The disease is far more likely to cause severe outcomes in older people, with the oldest cohorts the most vulnerable. That said, in every age group — even 85-plus — most people who contract the disease will recover.
  • One scholarly estimate finds that the 1918-1920 pandemic killed 218 out of every 100,000 people living in the world at that time
  • In Spain, the death toll already stands at 41 out of 100,000 people; in Belgium the number is 45. In New York state, it is 63, and that number rises even higher if you consider the “probable” death toll in New York City.
  • So is the coronavirus as deadly? “This depends on how long this continues,”
  • The “virulence” of the virus — its ability to cause illness — has been steadily coming into focus.
  • But more than a month later, the WHO number has gone even higher: On April 16, the WHO showed a global fatality rate of 6.6 percent among confirmed cases.
  • Preliminary research indicates that the virus is not mutating significantly as it spreads, and so there is no evidence that some countries are dealing with a more virulent strain of SARS-CoV-2.
  • the median age of patients in Italy is 63 or 64 years; the median age of patients in Germany is 47. The mortality is much lower [in Germany] because they avoided having the older population affected.”
  • “If, in fact, the case fatality rate is higher than the 1918 flu, then this one has the potential to kill even more people,
  • “We saw it everyday. African Americans have three times the rate of chronic kidney disease that Caucasians have, and 25 percent higher heart disease. They’ve got higher rates of diabetes, hypertension and asthma,” Duggan said. “I fully expect that when people are hit hard and they are on a ventilator to breathe and their body needs to fight the infection, that people who already have compromised hearts or kidneys or lungs are that much more in jeopardy.”
  • Also critical is the nature, and robustness, of the national health system. For instance, Japan, where the current case fatality rate is 1.6 percent, and Singapore are reporting extremely high rates of hospitalization for coronavirus patients, at 80 percent and higher, figures that are unheard of in the United States. But this probably helps improve treatment and also reduces disease spread by isolating patients. The result is fewer deaths.
  • Several of the countries with low fatality rates — Germany, South Korea, Norway — have very high rates of coronavirus testing. This gave them a better look at the disease within their borders.
  • San Francisco General Hospital, noted that the hospital nearly tripled the capacity of its intensive care unit by adding doctors, nurses and technicians while the city adopted social distancing measures shortly ahead of New York.
  • “We were ready for a surge that never happened,” Balmes said. “They’re every bit as good as we are in intensive care in New York, but the system was overwhelmed. We did physical distancing just a few days earlier than New York, but it was a few days to the good.”
  • in a news conference that the global case fatality rate was 3.4 percent. That was treated as a revelation about the innate deadliness of the disease, but in fact was simply the WHO’s crude mortality ratio for confirmed covid-19 cases up to that point in time.
  • The other major factor in mortality is chronic disease. Most people hospitalized with severe cases of covid-19 have chronic health conditions such as diabetes, lung disease and heart disease. Where there is a high percentage of noncommunicable diseases like high blood pressure, the coronavirus will also be more deadly
  • A new study from researchers at Stanford, not yet peer-reviewed, looked for coronavirus antibodies in a sample population in Santa Clara County, Calif., and concluded that the actual infection rate in the county by early April was 50 to 85 times greater than the rate of confirmed cases.
  • “The story of this virus is turning out to be more about its contagiousness and less about its case fatality rate,” said David Rubin, director of PolicyLab at Children’s Hospital of Philadelphia and a University of Pennsylvania professor of pediatrics. “It’s less fatal than we thought, but it’s more contagious.”
  • Where extensive testing has been done, estimates for the case fatality rate are often below 1 percent, The Post has found, suggesting these countries are getting closer to a rate that takes into account all infections
  • In Iceland, which has tested over 10 percent of the population, vastly more than other countries, the fatality rate is just 0.5 percent.
  • Harvard epidemiologist Marc Lipsitch has written that he and most experts suspect the fatality rate is about 1 to 2 percent for symptomatic cases. A 1 percent fatality rate is 10 times the average fatality rate for seasonal flu.
  • “It’s probably about an order of magnitude higher for covid-19,” said Viboud, the NIH epidemiologist. “It’s more severe in terms of mortality than the pandemics we’ve seen since 1918.”
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A Collapse Foretold: How Brazil's Covid-19 Outbreak Overwhelmed Hospitals - The New Yor... - 0 views

www.nytimes.com/...virus-brazil-bolsonaro.html
shared by rerobinson03 on 28 Mar 21 - No Cached
  • The virus has killed more than 300,000 people in Brazil, its spread aided by a highly contagious variant, political infighting and distrust of science.
  • More than a year into the pandemic, deaths in Brazil are at their peak and highly contagious variants of the coronavirus are sweeping the nation, enabled by political dysfunction, widespread complacency and conspiracy theories. The country, whose leader, President Jair Bolsonaro, has played down the threat of the virus, is now reporting more new cases and deaths per day than any other country in the world.
  • At Hospital Restinga e Extremo Sul, one of the main medical facilities in Porto Alegre, the emergency room has become a crammed Covid ward where many patients received care in chairs, for lack of a free bed. Last week, the military built a tent field hospital outside the main entrance, but hospital officials said the additional bed space is of little use for a medical staff stretched beyond its limit.
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  • President Bolsonaro, who continues to promote ineffective and potentially dangerous drugs to treat the disease, has also said lockdowns are untenable in a country where so many people live in poverty. While several Brazilian states have ordered business shutdowns in recent weeks, there have been no strict lockdowns.Some of the president’s supporters in Porto Alegre have protested business shutdowns in recent days, organizing caravans that stop outside of hospitals and blast their horns while inside Covid wards overflow.
  • Epidemiologists say Brazil could have avoided additional lockdowns if the government had promoted the use of masks and social distancing and aggressively negotiated access to the vaccines being developed last year.
  • uch conspiracy theories about Covid-19 vaccines have spread widely on social media, including on WhatsApp and Facebook. A recent public opinion poll by the firm IPEC found that 46 percent of respondents believed at least one widely disseminated falsehood about vaccines.Mistrust of vaccines and science is new in Brazil and a dangerous feature of the Bolsonaro era, said Dr. Miguel Nicolelis, a Brazilian neurologist at Duke University who led a coronavirus task force in the country’s northeast last year.
  • The mistrust and the denials — and the caravans of Bolsonaro supporters blasting their horns outside hospitals to protest pandemic restrictions — are crushing for medical professionals who have lost colleagues to the virus and to suicide in recent months, said Claudia Franco, the president of the nurses union in Rio Grande do Sul.
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Prince Philip, Duke of Edinburgh, dead at 99 - CNN - 0 views

www.cnn.com/...index.html Politics
shared by martinelligi on 09 Apr 21 - No Cached
  • Prince Philip, the lifelong companion of Britain's Queen Elizabeth II, has died, Buckingham Palace announced Friday.
  • The duke had been admitted to the King Edward VII Hospital in London hospital on February 17 after feeling unwell.
  • On March 1, he was transferred to St. Bartholomew's Hospital, also in London, where doctors continued to treat the infection as well as undertake testing for a pre-existing heart condition.
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  • The Queen will need to sign off on any plans before they are confirmed, and it is not yet known whether this has already happened.
  • In December 2019, he was taken to hospital as a "precautionary measure" for what Buckingham Palace described as a "pre-existing" condition. He had previously been admitted to hospital on multiple occasions for a variety of reasons, including for a hip replacement and for treatment for bladder infections.
  • The duke was known for off-the-cuff remarks that often displayed a quick wit but occasionally missed the mark, sometimes in spectacular fashion.
  • Philip, also known by his official title of the Duke of Edinburgh, was the longest-serving British consort.
  • Prince Philip, the lifelong companion of Britain's Queen Elizabeth II, has died, Buckingham Palace announced Friday. He was 99.
  • Philip, also known by his official title of the Duke of Edinburgh, was the longest-serving British consort. He married the then Princess Elizabeth in 1947 after a courtship that charmed a country still reeling from the ravages of World War II.
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Cash, Breakfasts and Firings: An All-Out Push to Vaccinate Wary Medical Workers - The N... - 0 views

www.nytimes.com/...e-hospitals-nursing-homes.html
shared by anonymous on 14 Jan 21 - No Cached
  • Anxious about taking a new vaccine and scarred by a history of being mistreated, many frontline workers at hospitals and nursing homes are balking at getting inoculated against Covid-19.
  • Those opposing forces have spawned an unusual situation: In addition to educating their workers about the benefits of the Covid-19 vaccines, a growing number of employers are dangling incentives like cash, extra time off and even Waffle House gift cards for those who get inoculated, while in at least a few cases saying they will fire those who refuse.
  • “For us, this was not a tough decision,” said Lynne Katzmann, Juniper’s chief executive. “Our goal is to do everything possible to protect our residents and our team members and their families.”
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  • “This is a population of people who have been historically ignored, abused and mistreated,” said Dr. Mike Wasserman, a geriatrician and former president of the California Association of Long Term Care Medicine. “It is laziness on the part of anyone to force these folks to take a vaccine. I believe that we need to be putting all of our energy into respecting, honoring and valuing the work they do and educating them on the benefits to them and the folks they take care of in getting vaccinated.”
  • At Jackson Health System in Miami, a survey of about 5,900 employees found that only half wanted to get a vaccine immediately, a hospital spokeswoman said.
  • Henry Ford Health System, which runs six hospitals in Michigan, said that as of Wednesday morning, about 22 percent of its 33,000 employees had declined to be vaccinated.
  • At Houston Methodist, a hospital system in Texas with 26,000 employees, workers who take the vaccine will be eligible for a $500 bonus. “Vaccination is not mandatory for our employees yet (but will be eventually),” Dr. Marc Boom, the hospital’s chief executive, wrote in an email to employees last month.
  • Both have been found to be safe and highly effective. So why are so many hospital and long-term care workers reluctant to get inoculated?
  • Underlying the hesitancy is a lack of trust in authorities — the federal government, politicians, even their employers — that have failed for the past year to get the virus under control.
  • “We are left behind in the dust — no one sticks up for us,”
  • Another concern about forcing workers to get vaccinated is that it could prompt hesitant employees to resign. That’s a particular worry in long-term care, where the pandemic has exacerbated a shortage of certified nursing assistants.
  • Gov. Mike DeWine of Ohio said last month that roughly 60 percent of nursing home staff members offered the vaccine in his state had declined it.
  • At Norton Healthcare, a health system in Louisville, Ky., workers who refuse the vaccine and then catch Covid-19 will generally no longer be able to take advantage of the paid medical leave that Norton has been offering to infected employees since early in the pandemic.
  • At Juniper — which has 20 senior living communities in New Jersey, Pennsylvania and Colorado — officials have tried to educate workers about the safety and benefits of Covid-19 vaccines, including hosting a webinar with a registered nurse who was enrolled in a clinical trial of the Moderna vaccine. Officials told staff last month that vaccines would be mandatory.
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Los Angeles County ambulance crews told not to transport Covid-19 patients with little ... - 0 views

www.cnn.com/...index.html Politics US Covid19 California LA Hospitals
shared by yehbru on 05 Jan 21 - No Cached
  • In a little more than a month, the county doubled its number of infections, climbing from about 400,000 cases on November 30 to more than 800,000 cases on January 2, health officials said Monday.
  • With no hospital beds available, ambulance crews in the county were given guidance not to transport patients with little chance of survival. And the patients who are transported often have to wait hours before a bed is available.
  • And a person is dying of the virus every 15 minutes, Los Angeles County Director of Public Health Barbara Ferrer said.
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  • But Los Angeles hospitals are now at capacity and many medical facilities don't have the space to take in patients who do not have a chance of survival, the agency said. Patients whose hearts have stopped despite efforts of resuscitation, the county EMS said, should no longer be transported to hospitals.
  • "We're likely to experience the worst conditions in January that we've faced the entire pandemic, and that's hard to imagine."
  • "Given the acute need to conserve oxygen, effective immediately, EMS should only administer supplemental oxygen to patients with oxygen saturation below 90%," EMS said in a memo to ambulance crews Monday.
  • "We are waiting two to four hours minimum to a hospital and now we are having to drive even further... then wait another three hours," EMT Jimmy Webb told CNN affiliate KCAL.
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Colonoscopies Explain Why U.S. Leads the World in Health Expenditures - NYTimes.com - 0 views

www.nytimes.com/...ld-in-health-expenditures.html health medical costs us comparative international economics health care
shared by Javier E on 02 Jun 13 - No Cached
  • In many other developed countries, a basic colonoscopy costs just a few hundred dollars and certainly well under $1,000. That chasm in price helps explain why the United States is far and away the world leader in medical spending, even though numerous studies have concluded that Americans do not get better care.
  • Whether directly from their wallets or through insurance policies, Americans pay more for almost every interaction with the medical system. They are typically prescribed more expensive procedures and tests than people in other countries, no matter if those nations operate a private or national health system. A list of drug, scan and procedure prices compiled by the International Federation of Health Plans, a global network of health insurers, found that the United States came out the most costly in all 21 categories — and often by a huge margin.
  • “The U.S. just pays providers of health care much more for everything,” said Tom Sackville, chief executive of the health plans federation and a former British health minister.
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  • Largely an office procedure when widespread screening was first recommended, colonoscopies have moved into surgery centers — which were created as a step down from costly hospital care but are now often a lucrative step up from doctors’ examining rooms — where they are billed like a quasi operation.
  • The high price paid for colonoscopies mostly results not from top-notch patient care, according to interviews with health care experts and economists, but from business plans seeking to maximize revenue; haggling between hospitals and insurers that have no relation to the actual costs of performing the procedure; and lobbying, marketing and turf battles among specialists that increase patient fees.
  • While several cheaper and less invasive tests to screen for colon cancer are recommended as equally effective by the federal government’s expert panel on preventive care — and are commonly used in other countries — colonoscopy has become the go-to procedure in the United States. “We’ve defaulted to by far the most expensive option, without much if any data to support it,”
  • Hospitals, drug companies, device makers, physicians and other providers can benefit by charging inflated prices, favoring the most costly treatment options and curbing competition that could give patients more, and cheaper, choices. And almost every interaction can be an opportunity to send multiple, often opaque bills with long lists of charges: $100 for the ice pack applied for 10 minutes after a physical therapy session, or $30,000 for the artificial joint implanted in surgery.
  • The United States spends about 18 percent of its gross domestic product on health care, nearly twice as much as most other developed countries. The Congressional Budget Office has said that if medical costs continue to grow unabated, “total spending on health care would eventually account for all of the country’s economic output.”
  • The more than $35,000 annually that Ms. Yapalater and her employer collectively pay in premiums — her share is $15,000 — for her family’s Oxford Freedom Plan would be more than sufficient to cover their medical needs in most other countries. She and her husband, Jeff, 63, a sales and marketing consultant, have three children in their 20s with good jobs. Everyone in the family exercises, and none has had a serious illness.
  • A major factor behind the high costs is that the United States, unique among industrialized nations, does not generally regulate or intervene in medical pricing, aside from setting payment rates for Medicare and Medicaid, the government programs for older people and the poor. Many other countries deliver health care on a private fee-for-service basis, as does much of the American health care system, but they set rates as if health care were a public utility or negotiate fees with providers and insurers nationwide, for example.
  • “In the U.S., we like to consider health care a free market,” said Dr. David Blumenthal, president of the Commonwealth Fund and a former adviser to President Obama. ”But it is a very weird market, riddled with market failures.”
  • Consumers, the patients, do not see prices until after a service is provided, if they see them at all. And there is little quality data on hospitals and doctors to help determine good value, aside from surveys conducted by popular Web sites and magazines. Patients with insurance pay a tiny fraction of the bill, providing scant disincentive for spending.
  • Even doctors often do not know the costs of the tests and procedures they prescribe. When Dr. Michael Collins, an internist in East Hartford, Conn., called the hospital that he is affiliated with to price lab tests and a colonoscopy, he could not get an answer. “It’s impossible for me to think about cost,” he said
  • Instead, payments are often determined in countless negotiations between a doctor, hospital or pharmacy, and an insurer, with the result often depending on their relative negotiating power. Insurers have limited incentive to bargain forcefully, since they can raise premiums to cover costs.
  • “People think it’s like other purchases: that if you pay more you get a better car. But in medicine, it’s not like that.”
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United States Records Its Worst Week Yet for Virus Cases - The New York Times - 0 views

www.nytimes.com/...us-covid-case-record.html
shared by lmunch on 30 Oct 20 - No Cached
  • The country reported a record of more than 500,000 new coronavirus cases in the past week.
  • Almost a third saw a record in the past week.
  • In the Upper Midwest and Mountain West, records are being smashed almost daily, and in some counties as much as 5 percent of the population has tested positive for the virus to date.
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  • Hospitalization data, which the Covid Tracking Project collects at the state level, shows that the number of people hospitalized with the coronavirus reached record highs in almost half of states in recent weeks.
  • Recent studies have provided some hope that improved treatment has led to a better survival rate among those ill enough to be hospitalized. But experts worry that the 46 percent increase in hospitalizations compared with a month ago could overwhelm hospital capacity — especially in rural areas with limited health resources — and roll back improvements in survival rates.
  • In the past month, about a third of U.S. counties hit a daily record of more deaths than any other time during the pandemic.
  • The recent surge in cases has not yet brought a similar surge in reported deaths, which can lag cases by up to several weeks. But already deaths are increasing in about half of states.
  • The daily death toll is lower than it was at its peak, but on average, about 800 people who contracted the coronavirus are dying each day
  • The outlook for the pandemic continues to worsen, and many areas of the United States are experiencing their worst weeks yet.
  • It’s not just a few areas driving the surge, as was the case early on. Half of U.S. counties saw new cases peak during the past month.
  • And in some less populous places, a record number is not necessarily a very high one. Orleans County, Vt., for example, saw eight cases in the past week — a record for the rural county of about 27,000 people on the Canadian border, but hardly a severe outbreak.
  • Taylor County, Fla., a Gulf Coast county of similar size, had 32 cases in the past week, four times as many as Orleans but far fewer than the record 600 new cases it had during the first week of August.
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Think a 'mild' case of Covid-19 doesn't sound so bad? Think again | Adrienne Matei | Op... - 0 views

www.theguardian.com/...rus-covid-19-mild-symptoms-who Covid-19 effects
shared by Javier E on 06 Jul 20 - No Cached
  • Doctors now know that Covid-19 not only affects the lungs and blood, but kidneys, liver and brain – the last potentially resulting in chronic fatigue and depression, among other symptoms. Although the virus is not yet old enough for long-term effects on those organs to be well understood, they may manifest regardless of whether a patient ever required hospitalization, hindering their recovery process.
  • For a Dutch report published earlier this month (an excerpt is translated here) researchers surveyed 1,622 Covid-19 patients with an average age of 53, who reported a number of enduring symptoms, including intense fatigue (88%) persistent shortness of breath (75%) and chest pressure (45%). Ninety-one per cent of the patients weren’t hospitalized, suggesting they suffered these side-effects despite their cases of Covid-19 qualifying as “mild”
  • After being diagnosed with Covid-19, 26-year-old Fiona Lowenstein experienced a long, difficult and nonlinear recovery first-hand. Lowenstein became sick on 17 March, and was briefly hospitalized for fever, cough and shortness of breath. Doctors advised she return to the hospital if those symptoms worsened – but something else happened instead. “I experienced this whole slew of new symptoms: sinus pain, sore throat, really severe gastrointestinal issues,” she told me. “I was having diarrhea every time I ate. I lost a lot of weight, which made me weak, a lot of fatigue, headaches, loss of sense of smell …”
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  • By the time she felt mostly better, it was mid-May, although some of her symptoms still routinely re-emerge, she says.
  • “To me, and I think most people, the definition of ‘mild’, passed down from the WHO and other authorities, meant any case that didn’t require hospitalization at all, that anyone who wasn’t hospitalized was just going to have a small cold and could take care of it at home,”
  • “From my point of view, this has been a really harmful narrative and absolutely has misinformed the public. It both prohibits people from taking relevant information into account when deciding their personal risk levels, and it prevents the long-haulers from getting the help they need.”
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Fauci Warns Of 'Surge Upon A Surge' As Coronavirus Hospitalizations Increase : Coronavi... - 0 views

www.npr.org/...italizations-hit-yet-another-h surge pandemic
shared by martinelligi on 29 Nov 20 - No Cached
  • The number of hospitalizations from the coronavirus set yet another record on Saturday, as cases continue to surge and public health officials warn of a worsening outlook with the holiday season just weeks away.
  • Across the country, medical personnel are now bracing for what they fear will be a new wave of infections after millions of Americans ignored the advice of public health experts and traveled for the Thanksgiving holiday. Already, hospital resources are being stretched thin, with many institutions reporting a dire shortage of beds and personnel to handle the influx of new patients.
  • The rising hospitalization numbers reflect an overall rise in infections. The U.S. hit another tragic milestone Friday, when over 200,000 daily cases were reported for the first time. More than 13 million people have been infected in the U.S. since the pandemic began, and nearly 267,000 have died, according to data from Johns Hopkins University.
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How Iowa Mishandled the Coronavirus Pandemic - The Atlantic - 0 views

www.theatlantic.com/...617252 pandemic iowa response
shared by Javier E on 05 Dec 20 - No Cached
  • Iowa Is What Happens When Government Does Nothing The story of the coronavirus in the state is one of government inaction in the name of freedom and personal responsibility. Elaine Godfrey December 3, 2020
  • The story of the coronavirus in this state is one of government inaction in the name of freedom and personal responsibility.
  • Iowa is what happens when a government does basically nothing to stop the spread of a deadly virus.
  • ...13 more annotations...
  • “In a lot of ways, Iowa is serving as the control group of what not to do,”
  • Perencevich and other public-health experts predict that the state’s lax political leadership will result in a “super peak” over the holidays, and thousands of preventable deaths in the weeks to come. “We know the storm’s coming,” Perencevich said. “You can see it on the horizon.”
  • Joe English, a 37-year-old respiratory therapist, spends every day traveling between hospital units, hooking up seriously ill COVID-19 patients to ventilators or ECMO machines. When there’s nothing left to be done, English is the one who turns off those machines; he’s done so at least 50 times in the past few months. “What I’m seeing [among health-care workers] is just frustration, desperation,” English told me. “People have been acting like we’ve been fighting a war for months.”
  • There is a name for this feeling, says Kevin Doerschug, the director of the hospital’s medical ICU: moral distress, or the sense of loss and helplessness associated with health-care workers navigating limitations in space, treatment, and personnel
  • A recent New York Times analysis clearly showed that states with the tightest COVID-19 restrictions have managed to keep cases per capita lower than states with few restrictions.
  • What makes all of this suffering and death exponentially more painful is the simple fact that much of it was preventable
  • Democrats in Iowa believe that Reynolds’s inaction has always been about politics. Early on, she’d assumed an important role making sure that Trump would win Iowa in the November election, State Senator Joe Bolkcom, who represents Iowa City, told me. “She did that by making people feel comfortable” about going out to eat, going to bars, and going back to school. “She mimicked Trump’s posture” to get him elected. Ultimately, Reynolds was successful in her efforts: Trump won Iowa by 8 points. But Iowans lost much more.
  • Iowa’s problem is not that residents don’t want to do the right thing, or that they have some kind of unique disregard for the health of their neighbors. Instead, they looked to elected leaders they trust to tell them how to navigate this crisis, and those leaders, including Trump and Reynolds, told them they didn’t need to do much at all.
  • Which means that not only are health-care professionals tasked with saving sick Iowans’ lives, but it’s also fallen on them to communicate the truth about the pandemic.
  • The crisis in Iowa’s hospitals could be improved in a matter of weeks if Iowans started wearing a mask whenever they leave the house and stopped spending time indoors with people outside their households.
  • Without state leadership on board, none of those changes will happen. “The endgame of uncontrolled spread is a choice between massive death and suffering and overflowing hospitals, or shutting things down,” he said. “This is the equivalent [of] choosing between death or amputation—when you could have had an earlier surgery, which would have been painful but would have prevented this scenario from developing in the first place.”
  • Reynolds needs to order bars closed and restaurants to move to takeout only, at least until the surge is over, public-health experts told me. Reynolds and other state leaders could frame mask wearing and self-isolation as a matter of patriotic duty. “We need to make the right thing to do the easy thing to do,” T
  • right now, Iowa is on a disastrous path. Experts expect to see a spike in COVID-19 cases in the state roughly one week from now, two weeks after the Thanksgiving holiday. That spike will likely precede a surge in hospitalizations and, eventually, a wave of new deaths—maybe as many as 80 a day, Perencevich, the infectious-disease doctor, estimates. Add Christmas and New Year’s to the mix, and Iowans can expect to see nothing less than a tsunami
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US Coronavirus: Daily deaths from Covid-19 just exceeded the deaths from 9/11 on this b... - 0 views

www.cnn.com/...index.html covid
shared by katherineharron on 10 Dec 20 - No Cached
  • The United States should be celebrating a day of great hope today, as a Covid-19 vaccine could get authorized for emergency use very soon.
  • Vaccine advisers for the US Food and Drug Administration are meeting Thursday to discuss the Pfizer/BioNTech vaccine.
  • That's more deaths than those suffered in the 9/11 attacks.
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  • A new composite forecast from the US Centers for Disease Control and Prevention projects a total of 332,000 to 362,000 Covid-19 deaths by January 2.
  • Covid-19 hospitalizations also reached a new record high of 106,688 on Wednesday, according to the COVID Tracking Project.
  • more than 221,000 new infections were reported in just one da
  • "We are in a totally unprecedented health crisis in this country,"
  • Health care workers are exhausted. Hospitals are totally full."
  • "Unfortunately, with the volume of new cases that we are seeing and the implications it has on hospital utilization, during a period of widespread, community transmission, activities such as eating, drinking and smoking in close proximity to others, should not continue."
  • If the FDA grants emergency use authorization in the coming days, the first Americans outside of clinical trials could start getting inoculated this month.
  • in the coming months it's crucial that Americans stay vigilant and follow safety guidelines, like wearing face masks, social distancing and hunkering down in their social bubbles.
  • But the country will likely not see any meaningful impact until well into 2021 -- and that's if enough people get vaccinated, said Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases.
  • "Let's say we get 75%, 80% of the population vaccinated. I believe if we do it efficiently enough over the second quarter of 2021, by the time we get to the end of the summer ... we may actually have enough herd immunity protecting our society that as we get to the end of 2021, we could approach very much, some degree of normality that is close to where we were before,"
  • "We want to make sure that the vaccines are actually administered, and we're afraid that won't happen," Paul Ostrowski, who is leading supply, production and distribution for Operation Warp Speed, told "Good Morning America" Wednesday.
  • "Baltimore City has not had to implement such severe restrictions since the very earliest days of the pandemic and the implementation of the stay-at-home order," the city's health department tweeted.
  • The daily death toll from Covid-19 reached a record high of 3,124 Wednesday, according to Johns Hopkins University.
  • Indiana's Republican Gov. Eric Holcomb ordered hospitals to postpone or reschedule non-emergency procedures done in an inpatient hospital setting from December 16 through January 3 to preserve hospital capacity.
  • In Alabama, Republican Gov. Kay Ivey announced Wednesday she's extending the state's Safer at Home order, which includes a statewide mask mandate for another six weeks.
  • About 53% of respondents said they would get the vaccine promptly -- up from 51% before Thanksgiving and 38% in early October.
  • The first emergency use authorization for a vaccine is expected soon, and about 20 million people could likely get vaccinated in the next few weeks, Secretary of Health and Human Services Alex Azar said Wednesday.
  • In the UK, "thousands" of people were already vaccinated Tuesday, the first day of the Pfizer/BioNTech vaccine rollout there, according to the National Health Service (NHS).
  • The FDA will not "cut any corners" when deciding whether to authorize the vaccine, Azar said, saying he was sure what happened in the UK would be "something the FDA looks at."
  • "For now, we need to double down on the steps that can keep us all safe."
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Senegal President sacks health minister after hospital fire that killed eleven babies -... - 0 views

www.cnn.com/...index.html
shared by criscimagnael on 01 Jun 22 - No Cached
  • Senegalese President Macky Sall has fired his health minister as the country mourns eleven babies killed by a fire at the neonatal ward of a hospital in the western city of Tivaouane.
  • Sarr was attending the World Health Assembly conference in Geneva during the time of the fire at the Mame Abdou Aziz Sy Dabakh Hospital, which occurred late Wednesday. He cut short his trip and returned to Senegal Thursday, the health ministry said.
  • Before his dismissal, Sarr told local radio station RFM that the blaze which engulfed the Tivaouane hospital's newborn unit was caused by an electrical short circuit.
  • ...5 more annotations...
  • The reported death in April of a pregnant woman who was refused a cesarean by three midwives also sparked outrage in the country.
  • Four babies were killed in the Linguere hospital fire, the health ministry said last April.
  • 'Hospitals now places of death'
  • Too much negligence, indifference, casualness!... Hasn't going to the hospital become a risk today?"
  • "11 babies. How could this happen? How could they leave those babies in the fire? Why didn't they evacuate them when the fire started? Were emergency services alerted in time? Were there no emergency fire extinguishers on these premises...? No, but that is unacceptable!"
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Katie Duke struggles to navigate advocating for nurses and working as one - The Washing... - 0 views

www.washingtonpost.com/...uke-instagram-nursing-pandemic nurse experience culture crisis pandemic
shared by Javier E on 25 Feb 23 - No Cached
  • Nurses don’t dispute that patients deserve compassion and respect, but many feel that their roles are misunderstood and their expertise undervalued; as Duke repeatedly told me, people don’t respect nurses like they do doctors. As a result, nurses are leaving hospitals in droves. And they’re establishing new careers, not just in health care but as creatives and entrepreneurs.
  • Duke argues that nurses are especially fed up and burned out. And yet, as caretakers, nobody expects them to put their physical and emotional well-being first. But that’s starting to change. Once a lone voice, Duke is now a representative one.
  • Nurses make up the nation’s largest body of health-care workers, with three times as many RNs as physicians
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  • They also died of covid at higher rates than other health-care workers, and they experience high rates of burnout, “an occupational syndrome characterized by a high degree of emotional exhaustion and depersonalization, and a low sense of personal accomplishment at work,” according to the World Health Organization
  • high stress and anxiety are the “antecedents” to burnout. But you know you’ve hit the nadir when you become emotionally detached from your work. “It’s almost like a loss of meaning,” she said.
  • In April 2020, Miller said the public was “exalting nurses as these superheroes and angels,” while nurses themselves were tweeting about “the horrible working conditions, enormous amount of death without any break … being mentally and completely worn down and exhausted.”
  • Miller said nurses are experiencing “collective trauma,” a conclusion she reached by studying their social media usage through the pandemic
  • Before the pandemic, between a third and half of nurses and physicians already reported symptoms of burnout. A covid impact study published in March 2022 by the American Nurses Foundation found this number had risen to 60 percent among acute-care nurses. “Reports of feeling betrayed, undervalued, and unsupported have risen,
  • Miller and Groves also found a fivefold increase in references to quitting between the 2020 study and the 2021 study. “Our profession will never be the same,” Miller told me. “If you talked to any nurse who worked bedside through the pandemic, that’s what they’ll tell you.” From this, she says, has grown a desire to be heard. “We feel emboldened. We’re not as willing to be silent anymore.”
  • then, in late February 2013, Duke was abruptly fired. She’d posted a photo on Instagram showing an ER where hospital staff had just saved the life of a man hit by a subway train. It looked like a hurricane had blown through. There were no people in the photo, but Duke titled the post, “Man vs. 6 train.” She told me she wanted to showcase “the amazing things doctors and nurses do to save lives … the f---ing real deal.”
  • Duke says her superiors called her an “amazing nurse and team member” before they told her that “it was time to move on.” Her director handed her a printout of the Instagram post. According to Duke, he acknowledged that she hadn’t violated HIPAA or any hospital policies but said she’d been insensitive and unprofessional. She was escorted out of the building by security. When the episode aired, it showed Duke crying on the sidewalk outside the hospital.
  • She’d reposted the photo, with permission, from a male doctor’s Instagram account. He faced no repercussions. She now admits her caption was rather “cold” — especially compared with the doctor’s, “After the trauma.” In hindsight, she said, she might have been more sensitive. Maybe not even posted the photo at all. And yet this frustrates her. Why shouldn’t the public see nursing culture for what it really is? Man vs. 6 Train. “That’s ER speak,” she told me. “We say ‘head injury in room five.’ We don’t say ‘Mr. Smith in room five. We talk and think by mechanism of injury.”
  • But this is at odds with the romanticized image of the nurturing nurse — which hospitals often want to project. In some cases, nurses are explicitly told not to be forthright with their patients. “I know nurses in oncology who are not allowed to say to a patient and their family, ‘This will be the fourth clinical trial, but we all know your family member is dying,”
  • “The most frequent question is, ‘Katie, I have to get out of the hospital, but I don’t know what else to do.’” Her advice: “You have to create your own definition of what being a nursing professional means to you.” She has a ready list of alternative jobs, including “med spa” owner, educational consultant and YouTuber.
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Once-wealthy Syrian doctor works in exile to treat refugees, dreams of healing his coun... - 0 views

www.washingtonpost.com/...3-a0b9-249bbb34602c_story.html
shared by Maria Delzi on 17 Jan 14 - No Cached
  • REYHANLI, Turkey — When the wounded arrived at the Red Crescent hospital in Idlib at the start of the Syrian uprising — opponents of President Bashar al-Assad who had been shot or beaten by government troops — military police ordered the doctors to just let them die.
  • Ammar Martini and his colleagues refused.
  • “This I could not do,” said Martini, a successful surgeon from an affluent family. “I treat all people, of any origin. They are human, and I am a doctor.”
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  • “They beat me. They did terrifying things,” he said quietly in a recent interview. “I don’t want to remember that day.”
  • Martini is, in some ways, typical: mostly apolitical but firmly opposed to Assad’s regime and to the Islamist groups that are vying with other armed opposition groups for control of rebel-held areas.
  • Now, he lives alone in makeshift quarters in the offices of the aid organization he helped found in this Turkish border town. He heads the group’s relief operations in northern Syria and the Turkish border regions, overseeing the delivery of medical care to hundreds of thousands of Syrian refugees.
  • Martini is deeply skeptical of peace talks scheduled for this month in Geneva, which are supposed to facilitate negotiations between Assad’s government and rebel groups.
  • “We must keep working. Whether the time is long or short, this regime will fall,” Martini said. “Then we must rebuild our country.”
  • . Then he crossed the border into Jordan, which aid agencies say shelters more than 563,000 refugees.
  • When he left Syria, Martini said, he lost everything. The government seized all nine of his houses, along with his bank accounts, a clinical laboratory and 2,000 olive trees. The loss of the olive grove seems to have stung particularly; Idlib is known for its production of the bitter fruit.
  • In Jordan, the doctor briefly treated patients in the Zaatari refugee camp. Then he fled the difficult conditions to join his wife and youngest child in the United Arab Emirates. His older children escaped Syria, too, and are studying medicine in the United States.
  • At first, the effort paid for treatment for Syrians in Turkish hospitals. Operations were soon expanded to include the building of a 144-bed medical unit in the city of Antakya, near the Syrian border. Then hostility from Antakya’s Alawites — many of whom support Assad, who is also Alawite — prompted Orient to move the facility to Reyhanli. Alawites are members of a Shiite-affiliated sect.
  • Orient’s medical ventures expanded into rebel-held areas of Syria, where it now runs 12 hospitals and several rehabilitation centers and employs more than 400 doctors. Facilities in Turkey include a day clinic, a school for displaced Syrians and a sewing workshop that trains and provides work for many Syrian women.
  • It is an unusual arrangement for an organization of Orient Humanitarian Relief’s size — staff members said Orient programs and facilities helped nearly 400,000 people last year. But the setup offers a strategic advantage. A member of an aid organization working with Orient said it is able to move faster than any of its peers, making quick decisions unhampered by complicated bureaucracies and approval processes.
  • The many doctors and surgeons in the Martini clan are scattered across Europe and the United States. One uncle founded Martini Hospital in the Syrian city of Aleppo, where fighting between rebels and government forces has been sustained and brutal. Ammar Martini worked at that hospital, now heavily damaged, for 10 years.
  • When his father died recently in Syria, Martini was not able to return home to attend the funeral.
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As Health Care Shifts, U.S. Doctors Switch to Salaried Jobs - NYTimes.com - 0 views

www.nytimes.com/...ad-to-cheaper-health-care.html health care medical system doctor incentives
shared by Javier E on 13 Feb 14 - No Cached
  • Health economists are nearly unanimous that the United States should move away from fee-for-service payments to doctors, the traditional system where private physicians are paid for each procedure and test, because it drives up the nation’s $2.7 trillion health care bill by rewarding overuse
  • “In many places, the trend will almost certainly lead to more expensive care in the short run,”
  • When hospitals gather the right mix of salaried front-line doctors and specialists under one roof, it can yield cost-efficient and coordinated patient care, like the Kaiser system in California
  • ...5 more annotations...
  • many of the new salaried arrangements have evolved from hospitals looking for new revenues, and could have the opposite effect. For example, when doctors’ practices are bought by a hospital, a colonoscopy or stress test performed in the office can suddenly cost far more because a hospital “facility fee” is tacked on. Likewise, Mr. Smith said, many doctors on salary are offered bonuses tied to how much billing they generate, which could encourage physicians to order more X-rays and tests.
  • “From the hospital end there’s a big feeding frenzy, a lot of bidding going on to bring in doctors,” Mr. Mechanic said. “And physicians are going in so they don’t have to worry
  • The base salaries of physicians who become employees are still related to the income they can generate, ranging from under $200,000 for primary care doctors to $575,000 in cardiology to $663,000 in neurosurgery,
  • Dr. Jacowitz said that the economics drove the choice and that the only other option would have been to bring in more revenue by practicing bad medicine — ordering more heart tests on patients who did not need them
  • “The question now is how to shift the compensation from a focus on volume to a focus on quality,” said Mr. Smith of Merritt Hawkins. He said that 35 percent of the jobs he recruits for currently have such incentives, “but it’s pennies, not enough to really influence behavior.”
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Health Care's Road to Ruin - NYTimes.com - 0 views

www.nytimes.com/...health-cares-road-to-ruin.html health care costs analysis
shared by Javier E on 28 Dec 13 - No Cached
  • Even supporters see Obamacare as a first step on a long quest to bring Americans affordable medicine, with further adjustments, interventions and expansions needed.
  • There are plenty of interesting ideas being floated to help repair the system, many of which are being used in other countries, where health care spending is often about half of that in the United States.
  • But the nation is fundamentally handicapped in its quest for cheaper health care: All other developed countries rely on a large degree of direct government intervention, negotiation or rate-setting to achieve lower-priced medical treatment for all citizens. That is not politically acceptable here.
  • ...7 more annotations...
  • With that political backdrop, Obamacare deals only indirectly with high prices. By regulating and mandating insurance plans, it seeks to create a better, more competitive market that will make care from doctors and hospitals cheaper.
  • With half a billion dollars spent by medical lobbyists each year, according to the Washington-based Center for Responsive Politics, our fragmented profit-driven system is effectively insulated from many of the forces that control spending elsewhere
  • And so American patients are stuck with bills and treatment dilemmas that seem increasingly Kafkaesque.
  • Many health economists say we must move away from the so-called fee-for-service model, where doctors and hospitals bill every event, every pill, every procedure, even hourly rental of the operating room.
  • Given that national or even regional rate-setting is out of the question, most health economists argue that the nation needs a new type of payment model, one where doctors and hospitals earn more by keeping patients healthy with preventive care rather than by prescribing expensive tests.
  • The Affordable Care Act generally requires patients to be responsible for more of their bills — copays and deductibles — so they will become more price-savvy medical consumers. But the deck is stacked against them in a system where doctors and hospitals are not required or expected to provide upfront pricing. Why not?
  • And policy makers need to address two of the biggest drivers of our inflated national health care bill: the astronomical price of hospitalizations and particularly end-of-life care.
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WHO Reviews 'Available' Evidence On Coronavirus Transmission Through Air : NPR - 0 views

www.npr.org/...virus-transmission-through-air
shared by nrashkind on 29 Mar 20 - No Cached
  • The World Health Organization says the virus that causes COVID-19 doesn't seem to linger in the air or be capable of spreading through the air over distances more than about three feet.
  • But at least one expert in virus transmission said it's way too soon to know that.
  • "I think the WHO is being irresponsible in giving out that information. This misinformation is dangerous," says Dr. Donald Milton, an infectious disease aerobiologist at the University of Maryland School of Public Health.
  • ...28 more annotations...
  • "The epidemiologists say if it's 'close contact' then it's not airborne. That's baloney," he says.
  • Of course, the world is struggling with a shortage of the most protective medical masks and gear.
  • What's more, one study of hospital rooms of patients with COVID-19 found that "swabs taken from the air exhaust outlets tested positive, suggesting that small virus-laden droplets may be displaced by airflows and deposited on equipment such as vents." Another study in Wuhan hospitals f
  • "The U.S. CDC has it exactly right,"
  • When epidemiologists are working in the field, trying to understand an outbreak of an unknown pathogen, it's not possible for them to know exactly what's going on as a pathogen is spread from person to person, Milton says. "Epidemiologists cannot tell the difference between droplet transmission and short-range aerosol transmission."
  • For the average person not working in a hospital, Milton says the recommendation to stay 6 feet away from others sounds reasonable.
  • People shouldn't cram into cars with the windows rolled up, he says, and officials need to keep crowding down in mass transit vehicles like trains and buses.
  • With coronavirus cases continuing to climb and hospitals facing the prospect of having to decide how to allocate limited staff and resources, the Department of Health and Human Services is reminding states and health care providers that civil rights laws still apply in a pandemic.
  • States are preparing for a situation when there's not enough care to go around by issuing "crisis of care" standards.
  • But disability groups are worried that those standards will allow rationing decisions that exclude the elderly or people with disabilities.
  • On Saturday, the HHS Office for Civil Rights put out guidance saying states, hospitals and doctors cannot put people with disabilities or older people at the back of the line for care.
  • Severino said his office has opened or is about to open investigations of complaints in multiple states. He did not say which states could be the focus of investigation, but in the last several days, disability groups in four states — Alabama, Kansas, Tennessee and Washington — have filed complaints.
  • In Kansas and Tennessee, disability groups and people with disabilities say state guidelines would allow doctors to deny care to some people with traumatic brain injuries or people who use home ventilators to help them breathe.
  • The ventilator issue is coming up in New York, which may soon be the first place where there are not enough ventilators to meet the demand of patients. Gov. Andrew Cuomo said the state will need double its current amount in about three weeks.
  • Severino said Saturday that his office was concerned about complaints of possible ventilator reallocation, an issue that had been raised in New York and Kansas.
  • The PREP Act provides immunity to tort liability claims for manufacturers or drug companies that are asked to scale up quick responses to a disaster such as a nuclear attack or a pandemic.
  • Severino said his office would investigate civil rights violations and it would be up to another office at HHS, the general counsel's office, to make waivers under the PREP Act.
  • Some disability advocates have worried whether that exception could be used to trump civil rights laws that protect people with disabilities from treatment decisions.
  • He was 98 years old.
  • The Reverend Joseph Lowery, co-founder of the Southern Christian Leadership Conference, died Friday, according to a statement by the Joseph & Evelyn Lowery Institute for Justice and Human Rights.
  • The statement said Lowery died peacefully at home Friday night, surrounded by his daughters.
  • Known affectionately as the "Dean" of the Civil Rights Movement, Lowery was a part of pivotal moments in the nation's history
  • At an appearance on the national mall in 2013, at the age of 91, he led the crowd in the chant "Fired Up? Ready to go?" The event marked 50 years since the 1963 March on Washington, which Lowery attended as a contemporary of the Rev. Martin Luther King, Jr. At that 50th anniversary appearance, he warned that hard-fought gains were under attack.
  • Joseph Echols Lowery was born in Huntsville, Alabama in 1921. He was the son of a teacher and a shopkeeper. The young Lowery experienced firsthand the brutalities of the Jim Crow South and would spend his life fighting for racial justice.
  • One of the first protests he organized was as a young Methodist minister in Mobile, Alabama in the early 1950s. It was aimed at desegregating city buses.
  • From there, Lowery helped coordinate the 1955 Montgomery bus boycott, the non-violent movement that desegregated the city's public transportation and led to the formation of the Southern Christian Leadership Conference.
  • Four decades later, at a gathering of civil rights foot soldiers in Montgomery, Lowery reflected on that accomplishment, noting that the number of black elected officials in the country had gone from less than 300 in 1965 to nearly 10,000 by 2005.
  • "It changed the face of the nation," said Lowery.
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