DCMedical News: Monday, February 7, 2022
DCMedical News is published every day both the House and the Senate are scheduled to be in session.
THE BIG STORY Monday, February 7, 2022
American and European Hospitals in the Pandemic, 2020 and 2022
The New York Times profiles city hospitals in 2020 (here), "More than 60,000 New York City residents tested positive for the coronavirus in a single day. Testing lines stretched for hours, and a quarantine hotel program doubled in size. Packed emergency rooms had too few nurses. Hospital morgues became so full that about 200 bodies had to be relocated by the city."
The Guardian profiles American hospitals in 2022 (here), noting "As Omicron peaks, the US healthcare system is left ‘broken beyond repair.' Despite Covid hospitalizations trending downward, 80% of hospitals across the country are under ‘high or extreme stress.'"
An ED physician in San Francisco told the paper, "Even though the odds of getting very sick with Omicron and the odds of getting sick once you are vaccinated and boosted are lower, the sheer number of infections means that there are still going to be a lot of sick people . . . Also, because of the threat of the virus, many people earlier in the pandemic were afraid or unable to seek care for their health issues. Now that delay is catching up with patients . . . A lot of patients hear that things are overwhelmed, but when faced with long wait times and an overwhelmed emergency department, it’s a lot different to see it for yourself when you are sick and seeking care than hearing about it,” he said.
The Los Angeles Times reports on stressed conditions in rural California hospitals, here. In Victorville, "The COVID-19 patients slumped in chairs in a hallway outside the emergency room of the Desert Valley Hospital . . . There were no gurneys for them, no beds and no rooms. Doctors and nurses dashed back and forth from the ER to treat them, dodging one another and medical equipment being wheeled about . . . But while the pandemic has been a series of ups and downs, the sheer longevity of it has become a nemesis of its own, making extended periods of relief an elusive commodity."
European hospitals have gone through similar phases (2020-2022), with similar consequences. Today's Financial Times reports (here) that "Footage of overwhelmed doctors treating patients in makeshift conditions in Italy’s Lombardy region in March 2020 was the first sign of the deadly threat posed by coronavirus in Europe. The sight of clinicians struggling to find beds in Madrid also foreshadowed the public health emergency ahead."
"Two years on, the situation has been transformed in both regions with vastly reduced hospital admissions thanks to vaccine rollouts and the disease’s evolution into the milder Omicron variant. However, public health systems now face different pressures. Health workers are contending with a large backlog of care postponed during earlier waves, a challenge compounded by staff absences caused by the highly infectious variant. As doctors and nurses are forced to self-isolate, absence levels of up to 20 per cent are being reported in hospitals across Europe."
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Nurses Not Found in Numbers Needed for American Hospitals, Help May Come From Immigration
A study by the University of California at San Francisco ("The Impact of the COVID-19 Pandemic on California’s Registered Nurse Workforce," here) found that "Many older RNs have left nursing, and a large number intend to retire or quit within the next two years. At the same time, unemployment among younger RNs increased and there were (small) decreases in new enrollments in RN education programs during the 2019-20 and 2020-21 academic years. . . . With a shortage of RNs likely underway now, employers need to redouble their efforts to retain RNs and develop career paths for newly-graduated RNs. They also need to rapidly develop and implement strategies to mitigate the potential harm of shortages over the next five years."
One strategy with new life: look overseas. ("Strained US hospitals seek foreign nurses amid visa windfall with double the number of visas available for eligible workers this year," AP, here.) "There’s an unusually high number of green cards available this year for foreign professionals, including nurses, who want to move to the United States — twice as many as just a few years ago. That’s because U.S. consulates shut down during the coronavirus pandemic weren’t issuing visas to relatives of American citizens, and, by law, these unused slots now get transferred to eligible workers."
HOSPITALS AND OTHER HEALTH CARE FACILITIES
Surgery Far Away From COVID Patients, in the Mall
The Wall Street Journal highlights (here) the transformation of vacant or ailing shopping malls into medical malls, providing hospital sponsors of such projects with alternative locations for elective surgery during the COVID-19 pandemic.
Notes the report, "The University of Rochester Medical Center’s $227 million project is part of the recent boom in mall-to-medical conversions. Malls have long been home to urgent-care facilities or doctor’s offices. But in recent years more property owners have started turning entire sections over to hospitals or clusters of medical tenants. Closed department stores and rising vacancies, which accelerated during the pandemic, mean landlords are increasingly desperate to fill big blocks of space. Medical tenants, along with schools and warehouses, offer a way to do that . . . mall owners are focusing their efforts to offset declining retail business with new offerings and services that can’t be easily replicated online. Many medical providers, meanwhile, have been looking to expand amid rising healthcare spending. Malls offer cheap real estate, ample parking, easy access to highways and plenty of nearby customers."
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Data Base on the Health of 270 Million Americans Changes Hands, From Watson to Private Equity
STAT (here) has an original report on the largest American health data base, MarketScan. "As a repository of sensitive patient information, the company’s databases churn silently behind the scenes of their medical care, scooping up their most guarded secrets: the diseases they have, the drugs they’re taking, the places their bodies are broken that they haven’t told anyone but their doctor. The family of databases that make up MarketScan now include the records of a stunning 270 million Americans, or 82% of the population."
"The vast reach of MarketScan, and its immense value, is unmistakable. Last month, a private equity firm announced that it would pay $1 billion to buy the databases from IBM. It was by far the most valuable asset left for IBM as the technology behemoth cast off its foundering Watson Health business . . . a former insurance executive named Ernie Ludy founded the company. His idea was to simply collect patients’ data and parcel it out to big companies that were seeking to control costs by getting a more granular view of their employees’ health care use. The biggest companies were looking for savings from the data, not new ways to make money."
READINGS & REFERENCES
The Workings of the Congressional Budget Office in Proposed Health Legislation
"How CBO Evaluates Health Care Proposals," a new publication, here.
Counties With Primary Care Deserts, by State
The Associated Press publishes (here) an assessment of primary care "deserts" with no health services and limited or no telehealth. From the Bipartisan Center, "In these rural, suburban, and even urban areas, individuals live without services essential to basic health maintenance. These can include pharmacies, primary care providers (PCPs), community health centers, emergency services, and hospitals. Telehealth offers a bridge for many people who would otherwise have to travel extensive distances for check-ups or visits with specialists; however, there is significant overlap between those living in medical deserts and those lacking the broadband speeds necessary to connect with that care."
Traditional measures of broadband coverage rely on reports from telecoms carriers to the Federal Communications Commission, "overstating the extent of broadband coverage across much of the U.S. The dataset from Microsoft is based on anonymized user data . . . While the FCC's data suggest 14.5 million people are unable to connect to the internet at broadband speeds, Microsoft's dataset found 120.4 million people lacked access to broadband speeds."
Select Coronavirus Public Health Resources and References may be found here.
2022 CQ Congressional Calendar here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
February 8, 9, 28
March 1, 2, 3, 7, 8, 9, 10, 15, 16, 17, 18, 28, 29, 30, 31
April 1, 4, 5, 6, 7, 26, 27, 28, 29
Notes to Fred Hyde, MD, JD, MBA, news@dcmedicalnews.org