DCMedical News: Thursday, September 24, 2020
DCMedical News-DCMN
Washington, D.C.
Thursday, September 24, 2020
DCMedical News is published every day both the House and the Senate are scheduled to be in session this year. Subscription information and archives here.
THE BIG STORY IN HEALTH CARE
The Presidential and Other Campaign(s)
The Kaiser Family Foundation reports (here) on health care issue polling on issues in the Presidential campaign, including the ACA, the Supreme Court, pre-existent conditions and Biden v. Trump approaches to the ACA.
Coronavirus
Tracking: By Johns Hopkins (here) shows on 9-23 at 8:00 p.m. EST worldwide 31,759,233 confirmed COVID-19 cases; 973,904 deaths worldwide; 201,861 U.S. deaths (21%).
Science and Public Health: Coronavirus mutating (Washington Post report here, research report from Houston here). “A virologist at the National Institute of Allergy and Infectious Diseases reviewed the new study and said the findings point to the strong possibility that the virus, as it has moved through the population, has become more transmissible, and that this ‘may have implications for our ability to control it.’” MMWR reports (here) on younger people and COVID-19, as follows: “Nationwide, the median age of COVID-19 cases declined from 46 years in May to 37 years in July and 38 in August. Similar patterns were seen for COVID-19–like illness-related ED visits and positive SARS-CoV-2 RT-PCR test results in all U.S. Census regions. During June–August, COVID-19 incidence was highest in persons aged 20–29 years, who accounted for >20% of all confirmed cases.”
Medicine: A profile in JAMA (here) of COVID-19 “long haulers.” “The longer the pandemic drags on, the more obvious it becomes that for some patients, COVID-19 is like the unwelcome houseguest who won’t pack up and leave.” Droplets or aerosols? Modern Healthcare reports (here) that a “battle is raging inside hospitals,” those suspecting aerosol transmission of the virus arguing for higher levels of infection control and worker protection.
Vaccines: The New York Times reports on the Johnson & Johnson vaccine: J&J is the fourth company to enter a Phase 3 trial (Sanofi and Novavax also coming along). It will only require one shot instead of two, and does not need to be kept at sub-zero temperatures. In another story, The Times reported that “President Trump said Wednesday that the White House ‘may or may not’ approve new Food and Drug Administration guidelines requiring outside experts to weigh in before the agency approves a coronavirus vaccine, and said the plan ‘sounds like a political move,’ undercutting government scientists who had said the opposite just hours earlier” [to a Senate Committee, CQ report here].
Government: CMS Administrator Verma held a “stakeholder” call with providers, revealing that during the pandemic “Rates for vaccinations, primary, preventive and mental health services among children in Medicaid and CHIP have steeply declined.” A report to accompany the call (here) notes that 40 million children are covered by Medicaid and the Children’s Health Insurance Program, or CHIP; that the agency saw 22 percent fewer vaccinations for children under 2 years old between March and May compared to the same time period last year; and that child screening services from March to May dropped 44 percent from the same period last year. The Wall Street Journal reports (here) that a vaccine approved through Emergency Use Authorization would not be paid for by Medicare.
The Hill reports (here) on a “beaten down” CDC. “I have never seen morale this low. It’s just, people are beaten down. People are beaten down partially by a public who not only distrusts us but who actually think we want to infringe on their civil liberties . . . The other factor is the active undermining by senior members of our own administration.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Hospitals, Recessions and the Pandemic
An essay in the New England Journal of Medicine (here) asks “Are U.S. Hospitals Still ‘Recession Proof’?” while Strata Decision Technology (report here) analyzed six-month data from 275 U.S. hospitals, finding that outpatient visit volumes have recovered more strongly than inpatient volumes; inpatient volume remains down 5%; medical services have rebounded more than surgical services; and high-margin inpatient procedures and surgeries and still down 19%.
National Action Plan on Patient Safety
TJC reports, “The National Steering Committee for Patient Safety (NSC) — convened by the Institute for Healthcare Improvement (IHI) — has released a National Action Plan that aims to provide health systems with renewed momentum and clearer direction for eliminating preventable medical harm.” Action plan here, self-assessment tool here, resources here.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Medicaid Expansion and Surgery
An essay in JAMA Surgery (here) reports that “Medicaid expansion has had a significant impact on insurance coverage, access to care, quality of care, and financial risk protection among surgical populations. These gains were derived from extending health insurance to more than 13 million low-income adults in 36 states and the District of Columbia.”
Public Charge Rule Returns
Modern Healthcare reports (here) that “The Trump administration on Tuesday reinstated its so-called ‘public charge’ rule for green card applicants after a federal appeals court allowed the Department of Homeland Security's U.S. Citizenship and Immigration Services agency to move forward with it,” retroactive to February 24. The rule is intended to prevent persons who may need public services from immigrating to the U.S.
MACPAC (Virtual) Meeting Agenda
The advisory group on Medicaid and CHIP meets today (the 24th) and tomorrow (the 25th), agenda here.
READINGS & REFERENCES
Select Coronavirus Public Health Resources and References (alphabetical):
AMA resource page for physicians here. AMA guide to medical education and COVID-19, here.
CDC information page for professionals here, Morbidity and Mortality Weekly Reports on Coronavirus, here.
CMS (Centers for Medicare & Medicaid Services) Current Emergencies website, here.
Council of State Governments, here.
The Guardian and Kaiser Health Network, report on health professionals dead from COVID-19, here.
JAMA Network’s COVID-19 resource center 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.
Reproduction rate (rt), website https://rt.live/ tracks the highest and lowest COVID-19 reproduction.
State actions, Kaiser Family Foundation, here.
UC Hastings College of Law’s “The Source” (on health care prices and competition) 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
September 25, 30
October 1, 2
November 16, 17, 18, 19, 20
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.