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Category: Health Policy

Patients & Vulnerable Populations Pandemically Left in the Dark

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By GRACE CORDOVANO PhD, BCPA

To be honest, the United States blew it on the mask front. From a public health, caregiver and patient safety, as well as community transmission standpoint, we are at least 3 months late to game. Anytime a brand new virus that humanity does not have any immunity to makes an appearance, is highly contagious, starts rapidly infecting people as well as the doctors and nurses caring for them, hospitalizing, and killing them in concerning numbers across the globe, we should enable every proactive safety measure at our disposal.

The first confirmed case of COVID-19 in the US was on January 20, 2020. The general public and the millions of people who are considered at high-risk for complications from COVID-19 were advised that wearing masks in public was unnecessary. Many individuals were shamed and called out for wearing masks in public, being directly blamed for personal protective equipment (PPE) shortages on the front-lines. Meanwhile, hundreds of millions of masks and PPE are exported out of the country by brokers daily. People out in public have been mocked for a spectrum of reasons, being criticized as to why masks were being worn, used to run errands, and for removing them incorrectly. On April 4, 2020, the Centers for Disease Control (CDC) recommended that the general public wear cloth face masks in public where social distancing may be difficult, such as at the grocery store or pharmacy, especially in areas where cases of the infection are high for active transmission.

There has been extensive media coverage of PPE shortages at hospitals on the front-lines of this pandemic. Protecting our doctors, nurses, and all caregivers and first-responders is of utmost priority as we work to fight against COVID-19. As a patient advocate, patient, and carepartner to 2 disabled adults, with multiple family members in the high-risk population, was the call-to-action for the public to wear masks delayed so as to not risk further depleting PPE needed for those directly caring for patients sick with COVID-19?

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Liberal Elite More Deadly Than Coronavirus

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By MIKE PAPPAS, MD

As the coronavirus pandemic spreads, millionaires and billionaires, who have been key to oppressing the working class, are trying to position themselves as everyday Americans. We need to understand them for what they are: beneficiaries and key supporters of the capitalist system that helped create this crisis.

My name is Mike. I’m a physician in NYC working on the front lines of the coronavirus pandemic. I’m also a socialist and member of Left Voice.

It was recently reported that a 17-year-old boy in Lancaster, California died suddenly, likely of coronavirus. The boy, who had no previous health conditions, was sick for only a few days. On Friday he was healthy and by Wednesday he was dead. On Wednesday, he went to urgent care as he was not feeling well, but since he had no health insurance, the urgent care center declined to treat him. He was directed to transfer to a nearby hospital, but en route, he went into cardiac arrest. He arrived at the nearby hospital, was revived, but died hours later.

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Sourcing Digital Health for COVID-19? Mount Sinai’s Medical Innovation Lead Has Advice | WTF Health

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By JESSICA DaMASSA, WTF HEALTH

As hospitals, health systems, and physician practices look to quickly scale up their digital health, telehealth, and remote monitoring offerings to adjust their delivery systems to the COVID-19 pandemic, what questions should they be asking health tech companies in order to make the right decisions? And, how can these health tech businesses, many of them startups, meet these ready customers half-way?

Ashish Atreja, Chief Innovation Officer for Medicine at Mount Sinai Health System (and also founder of digital health credentialing organization, Node.Health, and platform-builder Rx.Health) leans in with some critical advice at a time when health system sourcing, vetting, and contracting for digital health has never moved so fast.

“This COVID-19 solution you’re gonna bet on can be a catalyst for your entire digital health strategy and platform,” says Atreja, speaking as a health system innovator giving advice to others in similar roles. “There’s no pressure to bet on the right horse, but I think this is a moment of opportunity where you can see what is gonna give you long-term benefit.”

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“Essential Oncology”: The COVID Challenge

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By CHADI NABHAN MD, MBA, FACP

One harsh Chicago winter, I remember calling a patient to cancel his appointment because we had deemed it too risky for patients to come in for routine visits—a major snowstorm made us rethink all non-essential appointments. Mr. Z was scheduled for his 3-month follow-up for an aggressive brain lymphoma that was diagnosed the prior year, during which he endured several rounds of intense chemotherapy. His discontent in hearing that his appointment was canceled was palpable; he confessed that he was very much looking forward to the visit so that he could greet the nurses, front-desk staff, and ask me how I was doing. My carefully crafted script explaining that his visit was “non-essential” and “postponable” fell on deaf ears. I was unprepared to hear Mr. Z question: if this is his care, shouldn’t he be the one to decide what’s essential and what’s not?

This is a question we are all grappling with in the face of the COVID-19 pandemic. The healthcare industry is struggling to decide how to handle patient visits to doctor’s offices, hospitals, and imaging centers, among others. Elective surgeries are being canceled and advocates are arguing that non-essential outpatient and ER visits should be stopped. Ideas are flying left and right on how best to triage patients in need. Everyone has an opinion, including those who ironically consider themselves non-opinionated.

As an oncologist, these various views, sentiments, tweets, and posts give me pause. I understand the rationale to minimize patients’ exposure and thus prevent transmission. However, reconsidering what we should deem “essential” has made me reflect broadly on our method of providing care. Suddenly, physicians are becoming less concerned about (and constrained by) guidelines and requirements. Learning how to practice “essential oncology” may leave lasting changes in our field.  

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India’s COVID Conundrum: To Lockdown or Not to Lockdown

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By SOMALARAM VENKATESH, MD

 In “Asterix and the Roman Agent”, Julius Caesar deploys Tortuous Convolvulus to cause internal conflict among the Indomitable Gauls. Until then, the only fights the peaceful Gaulish village witnessed were between Unhygienix, the fishmonger and Fulliautomatix, the village smith. The Gauls always stood united against the Roman army and in spite of the occasional free-for-all, would always come together at the end for a boisterous feast. 

In the new millennium, India – like many other countries – has exhibited deep fault lines circumscribing hardened ideologies. It is that time in India’s history that Government’s economic and administrative actions are either inherently partisan, or projected to be divisive by its detractors. If SARS-Cov2 were to be an insidious single-stranded helical malware designed to sneakily break societal monoliths, there couldn’t have been a more opportune time for it than this. This pandemic has become an administrative nightmare. 

The first case of Corona Virus Disease (COVID-19) in India was detected on January 30th. After a lull for the next two weeks, stray reports of COVID-positive cases started from mid-February. A surreal calm descended across the country even as the COVID deaths climbed rapidly elsewhere in China, Italy & Iran. The nation went through a phase of wishful denial & unfounded bravado that tropical heat will protect Indians & that a younger, innately immune population will be somehow spared. 

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Understanding Covid19: How Data From People’s Daily Lives, Flu Outbreak Models Can Help | WTF Health

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By JESSICA DaMASSA, WTF HEALTH

In the face of Covid-19, health tech startup Evidation Health is leveraging their relationships with the 4-million people on their Achievement app, the “always on” stream of behavioral data these folks bring to the table via wearables, sensors, and surveys, and everything they’ve learned from years of studying and modeling flu outbreaks to examine the Covid-19 virus in the context of people’s everyday lives.

Evidation’s CEO, Deb Kilpatrick, and Sr. Data Scientist, Ernesto Ramirez, stop by to talk about their company’s efforts for large-scale, frequent symptom surveillance of Covid-19 to add new insights to our understanding of the pandemic and, possibly, even help with making predictions about its spread and severity.

The company is already publishing some of its findings in a weekly report called “Covid-19 Pulse” that is already gleaning insights from a 150,000+ person cohort asked to weigh-in specifically on what they’re doing and how their lives are changing as a result of the pandemic. What’s unique in Evidation’s spin is that they’re adding that critical data from “daily life” that is more or less missed by just looking at the data reported from those who’ve entered the hospital.

“Those folks that are presenting into the medical system — that’s not the full picture of what’s going on,” says Ramirez. “What we need to do is better understand, really, what’s going on at the community level to understand community spread, to understand surveillance efforts, to understand mitigation efforts that may or may not be having impact around the spread of Covid-19.”

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Trump Urges Insured COVID-19 Victims to Use For-Profit Medical Care

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By MICHAEL MILLENSON

(Foxnoxious News) WASHINGTON, April 1 –  President Trump today urged all insured Americans infected by the coronavirus to seek care only at for-profit facilities.

“American capitalism is the world’s greatest job-creating engine,” said the president in a prepared statement. “That’s why I urge all Americans who have both good health insurance and COVID-19 to get their care at for-profit hospitals and other wonderful, for-profit health care facilities.

The president expressed his compassion “for all the great companies whose share prices are suffering.” Americans who fall sick “can help make your life savings great again,” he said, by using investor-owned firms. In addition to hospitals, these include for-profit nursing homes, rehab facilities, home care and hospice, as well as funeral homes.

“If one million Americans get infected by COVID-19, that’s a terrific business opportunity,” the president declared.

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Immediate Changes Needed for Physicians to Stay in Business During the Pandemic

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Practices cannot survive the COVID-19 cash flow crisis

By JEFF LIVINGSTON, MD

Will doctors be able to keep their practices open during the worst pandemic in our lifetime? Our country needs every available doctor in the country to fight the challenges of Covid-19. Doctors working in independent practices face an immediate cash flow crisis threatening their ability to continue services.

The CARES Act was signed into law on Friday, March 27, 2020. The law offers much-needed help to the acute needs of hospitals and the medical supply chain. This aid will facilitate the production of critical supplies such as ventilators and PPE. The law failed to consider the needs of the doctors who will run the ventilators and wear the masks.

Cash flow crisis

Private-practice physician groups experienced an unprecedented reduction in in-office visits as they moved to provide a safe and secure environment for patients and staff. In compliance with CDC guidelines, practices suspended preventative care, nonurgent visits, nonemergent surgery, and office procedures.

These necessary practice changes help keep patients safe and slow the spread of Covid-19. The unintended consequence is an unreported and unrecognized cash flow crisis threatening the viability of physician practices.

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The Costs of Covid-19: What Health Plans & Employers Are Saying About Covering Care | WTF Health

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By JESSICA DaMASSA, WTF HEALTH

“[Employers’] top priority is getting their employees and their family members the appropriate care, but there are a lot of unknowns about how this is going to impact their actual total cost of care…”

As Covid-19 testing and treatment rise in U.S., many people — and their employers — may be starting to wonder: who is going to pay for this? How much is this going to cost?

Castlight Health’s CEO, Maeve O’Meara, talks to us about all-things healthcare cost, coverage and benefits administration, drawing from her position leading a company that focuses on helping people make sense of the health insurance benefits they receive through their employers or directly from health plans. 

What has employers and health plans most concerned? Making sure people are aware of changes to their plans so they know what’s covered (and what’s not), and when and where to go for care are the top of the list, according to Maeve.

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Pandemics Are the Mother of Invention

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By KIM BELLARD

If, as they say, necessity is the mother of invention, then you’d have to say that the COVID-19 pandemic is proving to be the mother of invention and innovation.  And, like Isaac Hayes sang about Shaft, it is a “bad mother…(shut your mouth).”

Many believe that the Allies won WWII in large part because of how industry in the U.S. geared up to produce fantastic amounts of weapons and other war materials.  It took some time for businesses to retool and get production lines flowing, during which the Axis powers made frightening advances, but once they did it was only a matter of time until the Allies would prevail.

Similarly, COVID-19 is making scary inroads around the world, while businesses are still gearing up to produce the number of ventilators, personal protective equipment (PPE), tests, and other badly needed supplies.  COVID-19 is currently outnumbering these efforts, but eventually we’ll get the necessary equipment in the needed amounts.  

Eventually.  

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