COVID-19 Update May 13, 2020

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Notes from Governor Cuomo’s COVID-19 Briefing

Data:

– Hospitalizations and intubations are down

– New COVID Cases is 416 as of yesterday, up from 401 May 11

– 166 deaths (122 in hospitals, 44 in nursing homes)

– “We’re just about where we are when we started this painful situation.”

Testing for Essential Workers:

– Antibody Test Results for essential workers are testing positive at lower rates

than other groups

– Downstate transit workers 14.2%

– Downstate healthcare workers 12.2%

– NYC General Population tested positive at 19.9%

Hospitals:

Elective surgeries to continue in 12 more counties

        – Albany, Cayuga, Chemung, Columbia, Clinton, Cortland, Montgomery,

          Orange, Otsego, Rensselaer, Schenectady, Warren

Reopening:

– Finger Lakes, Mohawk Valley, North County, and Southern Tier meet metrics

  for reopening

– The governor reiterated Dr. Fauci’s warning about reopening too soon

– Calibrate/control by monitoring diagnostic testing, antibody testing,

hospitalizations rate and capacity, infection rate

Children and COVID-19:

– DOH is investigating 102 cases of what may be rare COVID- related illness in

children with symptoms similar to Kawasaki disease or toxic shock like syndrome

– Illness has taken lives of 5-year-old boy, 7-year-old boy, and an 18-year-old girl

– 60% of children with symptoms tested positive for COVID-19 and 40% tested

positive for the antibodies (14% positive for both). 71% of cases end up in ICU.

– 14 other states (California, Connecticut, Delaware, Georgia, Illinois, Kentucky,

Louisiana, Massachusetts, Mississippi, New Jersey, Ohio, Pennsylvania, Utah,

Washington) Washington D.C, and Spain, France, England, Italy, and Switzerland

have reported cases as well

– Hospitals have been directed by DOH to prioritize COVID-19 testing for children

presenting symptoms

Federal Assistance:

– No corporate giveaways for layoffs

– Gov. Washington Op-Ed: “Make sure subsidies are tied to worker protections.”

– Americans First Law: No corporate bailout if workers will be laid off

– Will be introduced by congressional delegation

Q&A

Reopening:

– According to DeRosa, testing parameters came from Dr. Burke and the White

House task force and these parameters provide confidence in North Country

to have enough testing capacity to reopen

Testing:

– We will provide aid to ensure that testing can be done twice a week in nursing home facilities


Gov.: 12 More Counties Now Eligible to Resume Elective Surgeries
Ambulatory Surgical Centers in These 47 Counties Will Also Be Able to Resume Elective Surgeries

Amid the ongoing COVID-19 pandemic, Governor Andrew M. Cuomo today announced 12 more counties are now eligible to resume elective surgeries. The Governor previously announced that the state will allow elective outpatient treatments to resume in counties and hospitals without significant risk of COVID-19 surge in the near term, and a total of 47 counties can now resume elective surgeries:

Albany Genesee Putnam
Allegany Herkimer Rensselaer
Broome Jefferson Saratoga
Cattaraugus Lewis Schenectady
Cayuga Livingston Schoharie
Chautauqua Madison Schuyler
Chemung Monroe St. Lawrence
Chenango Montgomery Steuben
Clinton Niagara Sullivan
Columbia Oneida Tompkins
Cortland Onondaga Ulster
Delaware Ontario Warren
Dutchess Orange Wayne
Essex Orleans Wyoming
Franklin Oswego Yates
Fulton Otsego

Ambulatory surgical centers in these 47 counties will also be able to resume elective surgeries. Additionally, the State Department of Health clarified that these centers may continue providing certain diagnostic or screening procedures such as for cancer. Empire State Development Corporation also clarified that doctors’ visits continue to be permitted and remain open as essential businesses.


MSSNY Thanks Gov: Ambulatory Surgery Center Can Resume Elective Surgery
“We thank Governor Cuomo and the New York State Health Department for designating Ambulatory Surgery Centers as an additional clinical location that can resume performing elective surgery for patients in the 47 counties in which such surgeries are permitted.  We also appreciate the reminder to the public that physician offices have and remain open to deliver needed patient care. 

We of course still have much to do to continue to confront the Covid-19 pandemic and to work together to protect against a second surge of infections, but this action today will assist countless patients across New York State to receive urgently needed treatment that had been delayed to help prioritize health care resources towards those most immediately in need.

We look forward to continuing to work with the Governor and the NYS DOH on taking those steps which will enable the rest of New York’s health care system to more fully resume providing needed patient care.”


MSSNY Pres. Submits Testimony on Impact of COVID19 Crisis on NY Practices
May 13, 2020, Westbury, NY— Dr. Bonnie Litvack, MD, a Westchester radiologist and President of the Medical Society of the State of New York (MSSNY), today submitted testimony to the Joint Legislative Committee Hearing on Small Businesses, describing the impact of the COVID19 crisis on physician practices delivering patient care across the state of New York.

“Like many small businesses across the state, New York physicians have faced devastating consequences for their practices as a result of the coronavirus outbreak,” said Dr. Litvack. “Our first priority is, of course, to ensure that our patients, through the crisis and after, can continue to receive the care they need. However, physicians need to be assured that our practices can keep our doors open for patients now and in the future.”

To learn details about the impact, MSSNY conducted two surveys of its membership over the last month. Key takeaways from MSSNY’s most recent survey include:

  • 79% have seen a reduction of more than 50% in the volume of patients visiting their practices.
  • Nearly 3/4 had a greater than 50% drop in practice revenue.
  • More than a quarter had to lay off or furlough more than 50% of their staff, and 40% had to lay off or furlough at least 25% of their staff.

However, the bad news from the second survey was mixed with some modestly positive news that more physicians have received a small business Paycheck Protection Program loan. The CARES Act has provided some funding to help make up for some of the enormous deficits suffered by physician practices. However, it is not nearly enough to ensure the survival of many physician practices across the state.

Dr. Litvack’s testimony provided recommendations for how Congress and the New York State legislature can support physicians going forward including “advance” payments by commercial insurers to physicians and requiring health insurers to make bonus payments to their network physicians to account for the costs associated with additional Personal Protective Equipment (PPE) and the mark-up in price, that will be essential as practices begin to open up.

MSSNY also continues to work with the New York Congressional delegation to press for needed additional funding in future stimulus packages to help further offset the devastation to these practices. Physicians also need assurance that existing funding streams in previous stimulus packages will continue to be made available to community physicians so they may continue to provide patient care.

MSSNY will continue to urge the necessity of additional funding to New York State to prevent potentially devastating cuts.

“New York’s health care system, including physicians, shouldn’t have to face financial ruin, while working around the clock to save lives,” said Litvack. “New York has shouldered the brunt of this crisis and we desperately need fiscal attention.”


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CDC Guidance More Restrictive Than White House’s Plan
Advice from the top U.S. disease control experts on how to safely reopen businesses and institutions during the coronavirus pandemic was more detailed and restrictive than the plan released by the White House last month.

The guidance, which was shelved by Trump administration officials, also offered recommendations to help communities decide when to shut facilities down again during future flareups of COVID-19.

The Associated Press obtained a 63-page document that is more detailed than other, previously reported segments of the shelved guidance from the U.S. Centers for Disease Control and Prevention. It shows how the thinking of the CDC infection control experts differs from those in the White House managing the pandemic response.

The White House’s “Opening Up America Again” plan that was released April 17 included some of the CDC’s approach, but made clear that the onus for reopening decisions was solely on state governors and local officials.

By contrast, the organizational tool created by the CDC advocates for a coordinated national response to give community leaders step-by-step instructions to “help Americans re-enter civic life,” with the idea that there would be resurgences of the virus and lots of customization needed. The White House said last week that the document was a draft and not ready for release.

It contains the kinds of specifics that officials need to make informed decisions, some experts said.

From the start, CDC staffers working on the guidance were uncomfortable tying it specifically to reopening, and voiced their objections to the White House officials tasked with approving the guidance for release, according to a CDC official granted anonymity because they were not cleared to speak with the press.

The CDC’s detailed guidance was eventually shelved by the administration April 30, according to internal government emails and CDC sources who were granted anonymity because they were not cleared to speak to the press. After the AP reported about the burying of the guidance last week, the White House asked the CDC to revive parts of it, which were sent back for approval, according to emails and interviews.

On Tuesday, CDC Director Robert Redfield testified before a U.S. Senate committee that the recommendations would be released “soon.” He provided no further details.

The shelved CDC guide advises communities to avoid all nonessential travel in phases of reopening until the last one, when cases are at the lowest levels. Even then, the CDC is cautious and advises only a “consideration” of the resumption of nonessential travel after 42 continuous days of declining cases of COVID-19.

The White House plan, by contrast, recommends that communities “minimize” travel in Phase 1, and that in Phase 2, after 28 consecutive days of decline, “Non-essential travel can resume.”

As of Tuesday, CDC’s web page on travel guidance during the pandemic still linked to the White House plan. The stricter guidance is not there.

Another stark difference in the final White House plan and that designed by epidemiologists at the CDC is the latter’s acknowledgment that COVID-19 cases will likely surge after states reopen, and that local governments need to continuously monitor their communities closely.

(Modern Healthcare, May 13)


Registration Now Open Mental Health and COVID-19 for Health Professionals May 20, 2020 @ 7:30am Medical Matters CME Webinar

As health professionals, we are at great psychological risk simply by virtue of our “exposure” to the reality of COVID-19.  Registration is now open for MSSNY’s next Medical Matters webinar related to the COVID-19 pandemic, Medical Matters: Mental Health and COVID-19 for Health Professionals. Faculty for this program is Craig Katz, MD.

Registration is now open for this webinar 

Educational objectives:

  • Better understand the mental health risks posed by COVID-19 for physicians
  • Review the possible range of psychological and psychiatric responses to the pandemic
  • Discuss principles and interventions for helping ourselves, our families, and our colleagues

To view MSSNY’s other COVID-19 related programs, be sure to go here and view Medical Matters: Coronaviruses 2020: COVID-19 An Evolving Story recorded on March 18, 2020, Medical Matters: Psychosocial Dimensions of Infectious Outbreaks recorded on April 1, 2020 and Medical Matters: COVID-19 for Office-Based Physicians: How to Handle Surge and Psychological First Aid recorded on April 29, 2020.  You can also listen to MSSNY’s podcasts related to COVID-19 by going here.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.


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25 Hospitals Getting Biggest Slice of $12B Federal Bailout Fund
HHS has released new details on the latest payments to hospitals from the $175 billion in relief aid Congress allocated to cover expenses or lost revenues tied to the COVID-19 pandemic.

The first $50 billion in funding from the Coronavirus Aid, Relief and Economic Security Act was delivered to hospitals in April. HHS distributed $30 billion based on Medicare fee-for-service reimbursements and another $20 billion based on hospitals’ share of net patient revenue.

HHS announced May 1 that it is sending $12 billion to 395 hospitals that provided inpatient care for 100 or more COVID-19 patients through April 10. The agency said those hospitals accounted for 71 percent of COVID-19 inpatient admissions reported to HHS from 6,000 hospitals across the U.S.

HHS released new data May 8, sharing where the $12 billion in funding went. Below are the 25 hospitals that received the most funding.

  1. Long Island Jewish Medical Center (New Hyde Park, N.Y.): $277.7 million
  2. Holy Name Medical Center (Teaneck, N.J.): $213.4 million
  3. Tisch Hospital (New York City): $203.2 million
  4. Montefiore Hospital-Moses Campus (New York City): $156.7 million
  5. Columbia University Irving Medical Center (New York City): $152.7 million
  6. NewYork-Presbyterian Queens (New York City): $143.3 million
  7. Mount Sinai Medical Center (New York City): $140.8 million
  8. Sandra Atlas Bass Heart Hospital (Manhasset, N.Y.): $137.5 million
  9. Maimonides Medical Center (New York City): $131.5 million
  10. Weill Cornell Medical Center (New York City): $118.6 million
  11. New York City Health + Hospitals/Elmhurst: $111.3 million
  12. NYU Winthrop Hospital (Mineola, N.Y.): $108 million
  13. Hackensack (N.J.) University Medical Center: $98.1 million
  14. BronxCare Hospital Center-Fulton Campus (New York City): $91.5 million
  15. Staten Island University Hospital-South Campus (New York City): $91.4 million
  16. Ochsner Medical Center-West Bank Campus (Gretna, La.): $91.3 million
  17. Montefiore Hospital-Einstein Campus (New York City): $89.2 million
  18. St. Joseph’s University Medical Center (Paterson, N.J.): $88.2 million
  19. NewYork-Presbyterian Brooklyn Methodist Hospital (New York City): $87 million
  20. New York City Health + Hospitals/Bellevue: $86.7 million
  21. Stony Brook University Hospital (New York City): $83.3 million
  22. New York City Health + Hospitals/Kings County: $78.9 million
  23. New York-Presbyterian Allen Hospital (New York City): $76.9 million
  24. New York City Health + Hospitals/Lincoln: $76.1 million
  25. Jamaica Hospital Medical Center (New York City): $75.9 million
    (Becker’s Hospital CFO Report. May 11) 

Long Island CEOs Take Pay Cuts to Businesses Going
Dr. Raj Raina, president, CEO, and owner of Medical Associates, based in Hauppauge, has been taking care of patients — and his practice.

A primary care doctor who runs the six-site, multispecialty practice, he has kept Medical Associates’ doctors, nurses, and staff busy treating COVID-19 patients as he puts his own pay on pause. And he is not alone among doctors in private practice on Long Island who are making sacrifices to keep their doors open. “I personally have not taken a paycheck for the last couple of paychecks; I’m living off my savings,” Dr. Raina says, noting that his wife, a nurse, is receiving a paycheck for helping to run the COVID-19 test center at Jones Beach State Park. “Once they opened in Jones Beach, she was one of the first to be there. She’s a coleader there, scheduling patients.”

While healthcare providers and hospitals are on the front lines of the COVID-19 crisis, physicians without the resources of hospitals are facing financial and medical challenges, sometimes making financial sacrifices. “We’re living right now on income we produced in the past, hoping the government gives us some help,” Dr. Raina says, saying that his 79-person practice didn’t get help from the first tranche of funds. “It’s very hard in our industry to train people.”

Many physician practices face financial troubles, according to a survey by the Medical Society of the State of New York (MSSNY). The society says 83 percent of respondents saw patient volume drop by more than half, while 80 percent’s revenue fell by at least half since the COVID-19 outbreak. More than a quarter had to lay off or furlough more than half of their employees and about two thirds applied for forgivable loans, but most hadn’t received help before the first round of funding closed.“

Other healthcare providers, also considered essential, are taking steps to keep producing, as CEOs reduce or suspend their compensation or pay employees who are unable to work.

The federal government, meanwhile, made it easier for physicians to do virtual visits, increasing patient and provider safety, but Raina said that typically leads to $50 reimbursements.

“We’re mostly getting patients who have COVID-19 infection,” Dr. Raina says, adding that most are virtual visits. “Our revenue came mostly from stress tests, echocardiograms, and allergy tests.” Dr. Raina is still getting funds from previous work since insurer payments typically lag two months behind.

“I don’t want to lose employees,” Dr. Raina says. “They know what they’re doing. I would not want to start again. I’ve tried to keep everyone going. If I go through this year without a loss, I will think it is a good thing for me. I’m not sure that’s going to happen, though.”  Note: Dr. Raina is a MSSNY member. (LI Press May 11)


COVID-19: Risk Calculator / Choir Practice Super-Spreading Event
See some of the latest news on novel coronavirus disease (COVID-19):

Risk calculator: Researchers have developed a web-based risk calculator to estimate the probability that a COVID-19 patient will develop critical illness, defined as intensive care unit admission, invasive ventilation, or death. Reporting in JAMA Internal Medicine, the researchers examined the hospital records of nearly 1600 patients in China and assessed 72 potential risk factors. They found that the following 10 variables at admission were associated with increased risk for critical illness: chest radiographic abnormality, age, hemoptysis, dyspnea, unconsciousness, number of comorbidities, cancer history, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, and direct bilirubin. (Try the calculator at the second link below.)

Choir practice: Roughly 87% of 60 members of a Washington State choir became ill with confirmed or probable COVID-19 following a 2.5-hour practice that was also attended by a symptomatic person, according to an MMWR study. Two attendees died. The authors say that the act of singing may have contributed to viral transmission.

Risk score study in JAMA Internal Medicine
Web-based risk calculator
Choir study in MMWR
NEJM Journal Watch COVID-19 page
NEJM COVID-19 page
FO Report. May 11)


COVID-19 Map – Johns Hopkins Coronavirus Resource Center

COVID-19 Update May 12, 2020

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Notes from Governor Cuomo’s COVID-19 Briefing

Data:
– Hospitalizations and intubations are down
– Deaths 195 (142 in hospitals, 53 in nursing home)

Emerging Issue Among Youth:
– NYS DOH is investigating 100 cases of what may be COVID related illness
in children with symptoms similar to Kawasaki disease and toxic shock-like
syndrome
– Illness has taken lives of 5 year old boy, 7 year old boy, and 18 year old
girl
– Out of 100 cases, 5% of cases are found in those aged 1 or younger,
18% of cases are found in those aged 1-4, 29% is found in those aged 5-9,
28% in kids aged 10-14, 16% in those aged 15-19, and 4% in
those 20-21
– DOH is advising all hospitals to prioritize COVID-19 testing for children
presenting symptoms

Reopening:
– Heed Dr. Fauci’s warnings on risking an outbreak that cannot be controlled
– Learn from others’ mistakes (China, South Korea, Germany)
– Maintain regional management and citizen participation
–  Calibrate/control by monitoring diagnostic testing, antibody testing,
hospitalizations rate and capacity, infection rate
– – Finger Lakes, Mohawk Valley, and Southern Tier meet reopening criteria
– Status of regions will be updated daily and available to view at
forward.ny.gov/regional-monitoring-dashboard

Federal Assistance:
– This is time to pass a smart federal bill
– No time for handouts to corporations, political port, or partisanship
– Bill must fund state and local governments, working families, state testing
and tracing
– NY needs $61B in federal support or we will have to reduce spending
– Schools, local governments, and hospital spending will be cut by
20% each
– Federal bill must also respond to working families with:
– Landlord and renter assistance
– Payroll protection
– Funeral costs
– Repealing of SALT

– “No bailout boondoggles”

– Corporations have already forecasted next scam and will use pandemic
to enact layoffs and not rehire as many employees increasing corporate
profit and stock values on backs of American workers

Nursing Homes
– We now have more testing capacity, so nursing homes should be prioritized

– We will work with regions who do not have the testing capacity to do
two tests per week for staff


Dr. Fauci: Death Toll Higher than Reported
Dr. Anthony Fauci, the Trump administration’s top infectious disease expert, testified Tuesday that the consequence of reopening the country too early could be “really serious” if states don’t have the capability to respond to new coronavirus infections. The warning offered a stark contrast to the case made in recent weeks by President Trump, who has pushed to quickly restart the economy in spite of a mounting death toll and few signs that the months long pandemic is beginning the subside.

“My concern is that we will start to see little spikes that then turn into outbreaks,” Fauci told the Senate HELP Committee during a hearing on how to safely reopen the nation. “The consequences could be really serious.” The vast majority of states have yet to meet the most basic reopening benchmarks set out by the White House by last month, even as most move in stages toward lifting their social distancing guidelines.

That means that new outbreaks are likely as public life resumes, Fauci said, prolonging the coronavirus fight if states are not adequately prepared to respond. Already, more than 80,000 Americans have died from the disease — a figure that most public health experts agree likely undercounts the true toll. “There is no doubt even under the best of circumstances when you pull back on mitigation, you will see some cases appear,” he said.

Fauci added it’s almost certain the death toll is higher than recorded. He said that schools and businesses hoping to open their doors any time soon should not count on therapeutics or vaccines, saying that public safety hinges on the nation’s ability to regularly test Americans. “The idea of having treatments available or a vaccine to facilitate the reentry of students into the fall term would be something that would be a bit of a bridge too far,” he said. (Politico, May 11)


Please Join the NYS DOH in a COVID-19 Update Webinar

Thursday May 14th at 1-2PM for

COVID-19 update for healthcare providers.

To accommodate the large number of participants, find our webinar streaming via YouTube Live (and available for viewing immediately thereafter) on the NYSDOH COVID website for providers: 

For audio only, please dial in: 844-512-2950


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Registration Now Open Mental Health and COVID-19 for Health Professionals May 20, 2020 @ 7:30am Medical Matters CME Webinar
As health professionals, we are at great psychological risk simply by virtue of our “exposure” to the reality of COVID-19.  Registration is now open for MSSNY’s next Medical Matters webinar related to the COVID-19 pandemic, Medical Matters: Mental Health and COVID-19 for Health Professionals. Faculty for this program is Craig Katz, MD.

Registration is now open for this webinar

Educational objectives:

Better understand the mental health risks posed by COVID-19 for physicians
Review the possible range of psychological and psychiatric responses to the pandemic
Discuss principles and interventions for helping ourselves, our families, and our colleagues

To view MSSNY’s other COVID-19 related programs, be sure to go here and view Medical Matters: Coronaviruses 2020: COVID-19 An Evolving Story recorded on March 18, 2020, Medical Matters: Psychosocial Dimensions of Infectious Outbreaks recorded on April 1, 2020 and Medical Matters: COVID-19 for Office-Based Physicians: How to Handle Surge and Psychological First Aid recorded on April 29, 2020.  You can also listen to MSSNY’s podcasts related to COVID-19 by going here.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.


NYC’s Death Toll Worse than City and State Figures
New York City’s death toll from the coronavirus may be thousands of fatalities worse than the tally kept by the city and state, according to an analysis released Monday by the U.S. Centers for Disease Control and Prevention.

Some of those excess fatalities could be COVID-19 deaths that went uncounted because a person died at home, or without medical providers realizing they were infected, the researchers at New York City Department of Health and Mental Hygiene said. It might also represent a ripple effect of the health crisis, they wrote. Public fear over contracting the virus and the enormous strain on hospitals might have led to delays in people seeking or receiving lifesaving care for unrelated conditions like heart disease or diabetes.

“Tracking excess mortality is important to understanding the contribution to the death rate from both COVID-19 disease and the lack of availability of care for non-COVID conditions,” the report said.

The report underscored the challenges authorities face in quantifying the human toll of the crisis. Deaths caused by the coronavirus are believed to be undercounted worldwide, due in large part to limits in testing and the different ways countries count the dead.

Through Sunday, New York City had recorded nearly 14,800 deaths confirmed by a lab test and another nearly 5,200 probable deaths where no test was available, but doctors are sure enough to list the virus on the death certificate. In its analysis, the report released Monday said the 5,293 excess deaths were on top of both confirmed and probable fatalities.

Between March 11 and May 2, about 24,000 more people died in the city than researchers would ordinarily expect during that time period, the report said. That is about 5,300 more deaths than were blamed on the coronavirus in official tallies during those weeks. (AP News, March 11)


NY Rolling Out Training for Virus Detectives
New York is poised to launch a training plan for the huge corps of disease detectives it plans to deploy to track people who coronavirus. The effort, seen as a key to keeping the outbreak from flaring again once it is under control, is likely to involve hiring several thousand people who have no background in public health.

Because getting huge groups of people together in one place for a contact-tracing boot camp is not possible, the training is being done through a five- to six-hour online course launching Monday. “There’s all this discussion about using technology in some way. But fundamentally, this is a pretty human activity,” said Josh Sharfstein of the Johns Hopkins Bloomberg School of Public Health, which developed the course with Bloomberg Philanthropies, the charitable foundation of former Mayor Michael Bloomberg.

When someone becomes newly infected with the virus, the tracers will be tasked with figuring out everyone who might have had contact with that person, reaching out to them and advising them how to quarantine themselves until they know for certain they aren’t sick with the virus.

In the video training, actors portray how the tracing interviews—mostly conducted by phone or video chat—are supposed to go. Sharfstein said the training, to be offered on the Coursera website, will be available to anyone, not just those seeking to become contact tracers.

Bloomberg is putting up $10.5 million through his foundation to help the state roll out its tracing plan. Gov. Andrew Cuomo has made hiring at least 30 contact tracers per 100,000 residents requirement for any region of the state to reopen. (Crain’s, May 12)


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NIH to Test Remdesivir in Combo with Eli Lilly Arthritis Drug
The National Institutes of Health announced its sponsorship of a controlled clinical trial of the investigational antiviral drug remdesivir in combination with the anti-inflammatory drug baricitinib to treat COVID-19. The trial is NIH’s second iteration of its Adaptive COVID-19 Treatment Trial, launched Feb. 21.  It tested Gilead Sciences Inc.’s antiviral drug remdesivir in treating COVID-19. Analysis of the trial revealed patients who took remdesivir experienced significantly shorter recovery periods than patients who received placebos.

“ACTT 2 will examine if adding an anti-inflammatory agent to the remdesivir regimen can provide additional benefit for patients, including improving mortality outcomes,” said Anthony S. Fauci, MD, director of the NIH’s National Institute of Allergy and Infectious Diseases. The new trial will incorporate baricitinib, Eli Lilly’s anti-inflammatory drug commonly used to treat rheumatoid arthritis. Baricitinib is expected to inhibit cytokine signaling that causes lung inflammation and shortness of breath among COVID-19 patients.

Investigators will evaluate the recovery times of patients prescribed remdesivir with baricitinib versus those of patients prescribed remdesivir only. ACTT 2 is expected to enroll about 1,000 U.S. hospitalized adults with COVID-19 at 100 sites. (Becker’s Hospital Review, May 11)


COVID-19 Map – Johns Hopkins Coronavirus Resource Center