DCMedical News: Thursday, April 30, 2020
DCMedical News-DCMN
Washington, D.C.
Thursday, April 30, 2020
DCMedical News is published every day both the House and the Senate are in session and on pre-pandemic Regularly Scheduled Session days (see CQ calendar, below). DCMN will resume May 12.
THE BIG STORY IN HEALTH CARE
Coronavirus
Tracking by Johns Hopkins shows on 4-29 at 9:00 p.m. EST worldwide 3,189,017 confirmed cases; 227,247 deaths; 6,026,170 tests in the U.S. Total deaths in the U.S. (CDC, as of 4-29), 57,505, 25% of the world total.
Coronavirus News:
Aerosol Study: In Nature (here) Chinese researchers document aerosol-transmitted viral fragments found in more locations, over longer duration and in much smaller sizes than previously thought. They express a cautionary note for gathering and changing areas for health care workers: “We found that some medical staff areas initially had high concentrations of viral RNA with aerosol size distributions showing peaks in submicrometre and/or supermicrometre regions, but these levels were reduced to undetectable levels after implementation of rigorous sanitization procedures.”
Remdesivir: Medscape reports (here) “Hospitalized patients who had advanced COVID-19 with lung involvement and who received the antiviral agent remdesivir (Gilead Sciences) recovered faster than similar patients who received placebo, according to a preliminary data analysis from a US-led randomized, controlled trial. On the basis of as yet unpublished data, remdesivir ‘will be the standard of care’ for patients with COVID-19, said Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), during a press conference at the White House today. The randomized, placebo-controlled international trial was sponsored by NIAID, which is part of the National Institutes of Health, and enrolled 1063 patients. It began on February 21.” But a Chinese study published in The Lancet (here) was more cautious, although not in conflict with the NIAID findings: “In this study of adult patients admitted to hospital for severe COVID-19, remdesivir was not associated with statistically significant clinical benefits. However, the numerical reduction in time to clinical improvement in those treated earlier requires confirmation in larger studies.” Current NIH guidelines for the management of COVID-19 here.
The Economy: The Financial Times reports (here) that “The US economy shrank in the first quarter by its fastest rate since the 2008 financial crisis, ending the longest expansion on record as lockdowns aimed at curbing the coronavirus pandemic choked off economic activity.” Statista graphs the results, here.
The public: Bill Gates discusses the once-in-a-century pandemic challenge in the New England Journal of Medicine, here. A divided public: Ipsos finds (here) that “In a poll of more than 28,000 people conducted on April 16 to 19, a majority of respondents in eight out of 14 countries are against opening the economy if the virus is not fully under control. This sentiment is highest in developed economies of the United Kingdom and Canada (70%), followed by Mexico (65%), Spain and Australia (61%) and the United States (59%).” The Washington Post reports (here) that “Mass layoffs begin in cities and states amid coronavirus fallout, threatening education, sanitation, health and safety. Millions of municipal workers could find themselves out of a job or without pay, according to local leaders, who say programs would fall into disarray unless Washington intervenes.”
The Philadelphia Inquirer looks into testing (here) and finds “The Jefferson Health System has enough high-tech lab machines to process 10,000 diagnostic tests for the coronavirus every day. Instead, the Philadelphia-based network of 14 hospitals is doing only about 1,000 tests a day,” a consequence of “hospitals across the United States are grappling with a global shortage of testing chemicals and nasal swabs.” The American Society of Hospital Pharmacy (here) tracks other missing and shortage drugs, and attorneys, such as SheppardMullin (here) caution the adventurous buyer against violation of the Foreign Corrupt Practices Act.
Financial Calamity Stalks the Hospital Industry, Continued
Becker’s publishes (here) a 20-page list of 216 hospitals furloughing or laying off employees, to be updated daily.
USA Today finds (here) 100 or more hospitals which could close from the financial consequences of COVID-19. Also, “A USA TODAY Network analysis of financial reports submitted to the Centers for Medicare and Medicaid Services found that almost half of the counties with coronavirus cases are served by a hospital that reported a net loss in 2017.”
Roadmap for Resuming Elective Surgery after COVID-19 Pandemic by the American College of Surgeons, American Society of Anesthesiologists, Association of periOperative Registered Nurses and the American Hospital Association, here.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Physician Practices Decimated
The Medical Group Management Association (MGMA) reports (here) that “As patient volumes plummet amid the COVID-19 pandemic, nearly half of independent medical practices report they have had to furlough or lay off staff.” The survey found an average of 60% drop in volume and 55% drop in revenue.
Malpractice, Licensure and Other State Actions
Wilson Elser surveys (here) the States that have passed legislation or issued Executive Orders attempting to provide liability immunity in response to the COVID-19 health crisis. “Some states have relaxed licensing requirements for health care providers or supervision requirements for allied health care providers and emergency response providers to permit out-of-state health care providers to practice in their state. Some states also have modified statutes of limitation, extending the time frame for bringing lawsuits in certain civil matters.”
DRUGS & DEVICES
Can Investors do What Public Officials Cannot?
CQ and CQ Roll Call report (here) that an investor group with $4.3 trillion in assets that took on corporate responsibility for the opioid epidemic is now turning its attention to drug prices. Their view: “Generating revenue through drug price increases is unsustainable, while developing new treatments and expanding the market for products would be sustainable
over the long term.”
READINGS AND REFERENCES
“What We Don’t Know About the Coronavirus,” in The New Yorker, here.
Coronavirus Public Health Resources and References:
AMA resource page for physicians here. AMA guide to medical education and COVID-19, here. American Public Health Association information here. Association of American Medical Colleges Clinical Guidance Repository, here. CDC information page here. CMS (Centers for Medicare & Medicaid Services) Current Emergencies website, here. Council of State Governments, here. JAMA Network’s COVID-19 resource center here. Library of Congress Coronavirus Research Guide, (here) from the In Custodia Legis blog of the Library of Congress (LoC), with links to Congressional Research Service (CRS) reports. NIH information page here. National Library of Medicine Coronavirus page here, New England Journal of Medicine update here, New England Journal of Medicine Journal Watch here. The Lancet COVID-19 Resource Centre here and real-time dashboard to monitor clinical trials, here. State actions, Kaiser Family Foundation, here. The White House open research dataset (CORD-19) here. World Health Organization COVID-19 page here.
U.S. House of Representatives:
Members at https://www.house.gov/representatives
Committees and Members at https://www.house.gov/committees
U. S. Senate:
Committees and Members at https://www.senate.gov/committees
CQ 2020 Calendar of Regularly Scheduled Sessions, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
May 12, 13, 14, 15, 18, 19, 20, 21
June 1, 2, 3, 4, 9, 10, 11, 12, 15, 16, 17, 18, 23, 24, 25, 26
July 21, 22, 23, 24, 27, 28, 29, 30, 31
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.