COVID-19 Update May 18, 2020


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From the Governor’s Office Today 

  • Westchester and Suffolk Counties are Now Eligible to Resume Elective Surgeries and Ambulatory Care including in ambulatory care settings such as ASCs and Office based surgery locations.
  • Confirms 2,419 Additional Coronavirus Cases in New York State – Bringing Statewide Total to 348,232; New Cases in 52 Counties
  • Calls on U.S. Senate to Pass Coronavirus Relief Bill

Gov.: Over 700 locations Where New Yorkers Can Get Diagnostic Testing

  1. New Yorkers can visit a new website — health.ny.gov/find-test-site-near-you — and enter their address to view a list and a map view of the nearest testing sites. The state has also partnered with Google Maps to display testing site results. New Yorkers can search “COVID testing near me” on Google Maps to easily find the nearest testing sites. Please remember you must always schedule an appointment to get a COVID-19 diagnostic test by calling 1-888-364-3065 or your healthcare provider.
  2. New York State is partnering with CVS to bring testing to more than 60 CVS pharmacies across the state. Each site will be able to conduct 50 or more tests per day.
  3. The number of total COVID hospitalizations continues to drop. Total hospitalizations fell to 5,897, from 6,220 the day before. The number of new COVID hospitalizations also dropped to 374, from 400 the day before. Tragically, we lost 139 New Yorkers to the virus yesterday.
    4. A reminder that there are mental health resources available to those who need it. The past few months have been hard for everyone. If you need emotional support, call the New York State Emotional Support Hotline at 1-844-863-9314 to schedule a free appointment with a mental health professional. New Yorkers can access additional mental health resources at headspace.com/ny.

Webinar: Re-Opening Your Medical Practice in the COVID-19 Era on May 26 12 Noon – 1 PM
As physicians are now considering re-opening their practices, they need to appreciate that they cannot simply “go back to normal”.  With furloughs, layoffs, severe limitations of medical services, decreased revenues and office closures, physicians need to consider strategies to maximize the success of their practices going forward.  These include financial analysis and planning, how to best protect and treat patients and employees, and what needs to be done to ensure that their practices operate efficiently, safely and profitably.  Topics addressed will include:

What you need to consider before re-opening?

  • What financial issues must be considered to better prepare your practice to move forward?
  • How can you ensure your practice operates appropriately as it relate to patients?
  • Is there a continued role for telehealth?
  • What will the new practice culture look like going forward?
  • What reasonable accommodations and workplace safety precautions should be made for employees?
  • What are potential discrimination issues that can arise, including, for example, from a phased re-opening, or gradual return of employees from furlough?
  • Given that employees have had a furlough period, and there may be a backlog of work, can/should employers make changes to or limit their PTO policies for the remainder of the year?
  • How do we handle/resolve employment contract breach issues?
  • Is there liability to the practices for exposing employees or employees’ family to Coronavirus? Wrongful reopening?

Click Here to Register

Presented by:
Barry B. Cepelewicz, M.D., Esq.
Partner/Director
Garfunkel Wild, P.C. 

Roy W. Breitenbach, Esq.
Partner/Director
Garfunkel Wild, P.C.


Study Shows How Long Speech-Generated Droplets Can Stay in Air
A research team comprised of scientists from the National Institute of Health and the University of Pennsylvania have found that the coronavirus can stay airborne for anywhere between eight and 14 minutes after conversation.

Previously, scientists have researched how cough or sneeze generated droplets carried the virus. They used the phrase “stay healthy” for 25 seconds into an open end of a cardboard box. The inside was lit with lasers that could measure the droplet spray the speaker produced. Researchers admitted that the controlled setting, a stagnant air environment, could vary greatly from well ventilated room. (Modern Healthcare 5/18)


Majority Want Stay-At-Home Orders Lifted Within Month
More than six in 10 providers want stay-at-home restrictions to be lifted in the next month or sooner, according to a new survey. CHG Healthcare surveyed 1,200 physicians, physician assistants and nurse practitioners about their workloads, COVID-19 restrictions and anxiety levels. While 60% said they are still working full-time or part-time, 74% of those said their hours have been reduced. Nearly three out of four providers want elective care to start back up in the next month. (Modern Healthcare 5/14)


Right Ventricular Dilation Could Indicate High-Risk COVID-19 Cases
Right ventricular dilation, where the right side of the heart enlarges and doesn’t function correctly, may indicate worse outcomes in hospitalized COVID-19 patients, according to a study in the Journal of the American College of Cardiology: Cardiovascular Imaging. Researchers analyzed records of 105 patients and found right ventricular dilation was the only factor that significantly correlated with increased mortality.

Though the reason for the correlation is unknown, researchers say there could be multiple factors, including possible clots, lung damage, low blood oxygen level or heart damage. “Echocardiography is a readily available bedside tool that yields essential diagnostic and prognostic information in these patients,” said Dr. Edgar Argulian, an author of the study. “Clinicians can use bedside echocardiography as a readily available tool to identify patients with COVID-19 infection at the highest risk of adverse hospital outcomes.” (Modern Healthcare 5/18)


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State Health Officials Sending Thousands of Test Kits to Nursing Homes
State health officials are sending thousands of test kits to nursing homes and are securing new lab capacity to help the facilities meet new staff testing requirements, Gov. Andrew Cuomo said Monday during his daily briefing. The governor said his administration is connecting nursing homes and adult care facilities with private labs that have reserved at least 35,000 tests per day to help them comply with new regulations requiring all staff to be tested twice a week. It is also sending 320,000 test kits to nursing homes and adult care facilities across the state, he said.

Cuomo, who has faced criticism over his handling of Covid-19 in nursing homes as well as his new staff testing requirement , stressed that while facility operators “are not happy” about the policy, it’s needed to reduce the spread of the virus. The governor added that many testing sites across the state are being underutilized and have the capacity to perform these tests.

Covid-19 has killed or is presumed to have killed more than 5,000 nursing home and adult care residents in New York. (Politico, May 18)


Clinic Pushes Inhaled Stem Cell Tx, Delivered to Your Door: Taking Advantage of COVID-19 Fears
In the age of social distancing, one stem cell clinic has decided to make its products — which it strongly suggests can prevent COVID-19 — available for home delivery. No injections are required: instead, a nebulizer allows patients to inhale exosomes directly into their lungs, according to a YouTube video posted by the Los Angeles-based Novus Center that has since been taken down (though a text-only version persists on Google Cache).

“This procedure was invented during the coronavirus outbreak so patients could get the full benefit of exosome vapor to repair their lungs, strengthen their immune systems, and interrupt ‘virus multiplication’ WITHOUT risking a trip to their local clinic or hospital (where they could end up catching COVID-19),” the text below the video reads.

Stem cell companies have been using the coronavirus pandemic to push their dubious products in many ways, according to a new paper by Turner about to be published in Cell: Stem Cell (it’s currently posted as a “pre-proof” on the journal’s website).

Clinics in ColoradoPennsylvaniaDelawareArizona, and Florida are all selling stem cell or exosome treatments that they claim can boost immunity, enhance lung health, and inhibit viral replication — making strong suggestions about a place in COVID-19 prevention. The Arizona clinic even cites a South China Morning Post article about a 65-year-old woman in China who had COVID-19 but was healed thanks to stem cells.

Other players in the direct-to-consumer stem cell industry have seized on coronavirus-related opportunities for promoting their products. Biobanks have urged healthy clients to store their own stem cells for future use if they develop COVID-19, Turner reported, though the YouTube and Facebook posts he cited have since been removed.

Two organizations that promote stem cells — the American Academy of Stem Cell Physicians and the American Society for Interventional Pain Physicians — have issued public messaging about stem cells, which Turner says “risks spreading the misrepresentation that a substantial body of evidence already supports the safe and efficacious use of stem cell products in the care of individuals with COVID-19.”

Regulators have started to warn stem cell companies playing to coronavirus fears; starting in April, the FDA has sent warning letters to Dynamic Stem Cell Therapy, the Stem Cell Center of New JerseyKimera Labs, and Sparrow Health & Performance. The Federal Trade Commission issued warning letters to Absolute Health ClinicAmerican Medical Aesthetics, the Center for Regenerative Cell MedicineStemedix, and Vidaful Medicine.

The FDA has long been trying to get a handle on unapproved stem cell therapies. In 2017, the agency issued guidance on regenerative medicine products, with a November 2020 deadline for full compliance. It has since sent numerous warning letters to companies, though many continue to push therapies ahead of the fall deadline. (Medpage, May 15)


 

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COVID-19 Map – Johns Hopkins Coronavirus Resource Center

COVID-19 Update May 15, 2020

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Got PPE?
As physicians we like order and consistency but much in our current reality has been chaotic. Particularly frustrating has been the shortage of essential medical supplies that has plagued us from nearly the first day following the WHO pandemic declaration.  As an organization and a profession, we spoke out early and often about the lack of adequate PPE and the threat it conferred on the health and safety of our doctors, staff and patients in our Emergency Rooms and ICUs.  Thank goodness the crisis has eased in our hospitals and that they are preparing for a possible future surge by re-stocking emergency closets.

In the meantime, our community doctors remain in crisis mode struggling to procure PPE to keep open/reopen their offices.  Our MSSNY was told that local Offices of Emergency Management (OEM) would aid our doctors but sadly, many county warehouses were empty and lists of OEM sources led to dead ends.  This week brings new PPE concerns with the FDA and CDC warning that dozens of tested KN95 masks were defective with some filtering as few as 20% of particles.

The email we sent this week about physician PPE needs yielded about 1000 responses in the first 24 hours.  Clearly, the situation is dire.  Your MSSNY is actively working on a plan to address the PPE acquisition challenges you are facing.  Our physicians are essential to a safe and successful re-opening of New York.  This cannot happen without a reliable supply of protective equipment for our offices.

“Not being heard is no reason for silence.” –Victor Hugo, French novelist.

We will not be silent. Physician offices must GET PPE.

Bonnie Litvack, MD
MSSNY President


Are You Stressed Out from COVID-19? MSSNY Help Line is Live for You!
The Medical Society of the State of New York announced today that it has established a help line NYS physicians that have been experiencing COVID 19 related stress.  The MSSNY helpline is staffed by psychiatrists that will provide one-time support for those in need.

The helpline number is: 518-292-0140

Physicians can call this number 24/7 and will get an answering service who will ask for the individuals name and contact information.   There will be a return call to the individual within an hour of the call being received.

The MSSNY helpline is part of the MSSNY Peer to Peer (P2P) support program which is currently in development by MSSNY.  MSSNY is seek volunteer peer supporters for this program and additional information will be forthcoming within the next several weeks.  Additional information on how to become a volunteer peer support may be obtained by contacting Cayla Lauder at clauder@mssny.org or Pat Clancy at pclancy@mssny.org.


Gov. Cuomo Issues Criteria for Physicians Defining COVID-19 related Inflammatory Illness
Today, Gov. Cuomo has issued the first in the nation criteria for Health Care Professionals defining COVID-19-Related Inflammatory Illness in Children


Notes from Governor Cuomo’s COVID-19 Briefing
Data:

– Hospitalizations and intubations are down

– New COVID Cases 431 as of yesterday, up from 420 May 12

– 132 deaths yesterday

– “We’re where we are when this first started.”

– “Our Curve is down, and the curve in the rest of the nation is up.”

Reopening:

– 5/10 regions will open

– NY on PAUSE is extended to May 28 for regions that do not open today

– If a region hits benchmark between now and then, they can reopen

Phase 1 Reopening

– Retail Business Owner

– Curbside pickup

– In store pickup when curbside is not possible

– Masks must be worn by employees and customers (unless under two

years of age or for medical reasons) and hand sanitizer

will be available

Beaches for Memorial Day

– Agreement has been made with New York, New Jersey, Connecticut, Delaware

to open beaches for Memorial Day

– State and local beaches may open Friday before Memorial Day weekend on

the following conditions:

– No more than 50% capacity with controlled exists/ entrances

– No group activities

– Enforce social distancing measures

– No concessions

– City/town/county beaches can open under same conditions

– Must fully enforce minimum rules and may add additional

Conditions

Q&A

– According to DeRosa, BioReference Lab Core and Quest have been partnered and

30K tests a day are being saved for nursing homes

Reopening:

– Businesses that open today have signed a compliance agreement. If there is a

violation, they can be closed on that basis.

Finances:

– According to Mujica, the Comptroller report coming out today states revenues

are down 14%. He continued noting that the federal government has been

working on a bill that will provide funds to the state.


MSSNY Leglisative Podcast for this Week


Re-Opening Your Medical Practice in the COVID-19 Era on May 26, 12 Noon-1PM
As physicians are now considering re-opening their practices, they need to appreciate that they cannot simply “go back to normal”.  With furloughs, layoffs, severe limitations of medical services, decreased revenues and office closures, physicians need to consider strategies to maximize the success of their practices going forward.

These include financial analysis and planning, how to best protect and treat patients and employees, and what needs to be done to ensure that their practices operate efficiently, safely and profitably.  Topics addressed will include:

What you need to consider before re-opening?

  • What financial issues must be considered to better prepare your practice to move forward?
  • How can you ensure your practice operates appropriately as it relates to patients?
  • Is there a continued role for telehealth?
  • What will the new practice culture look like going forward?
  • What reasonable accommodations and workplace safety precautions should be made for employees?
  • What are potential discrimination issues that can arise, including, for example, from a phased re-opening, or gradual return of employees from furlough?
  • Given that employees have had a furlough period, and there may be a backlog of work, can/should employers make changes to or limit their PTO policies for the remainder of the year?
  • How do we handle/resolve employment contract breach issues?
  • Is there liability to the practices for exposing employees or employees’ family to Coronavirus? Wrongful reopening?

Register in advance for this webinar.

Presented by:

Barry B. Cepelewicz, M.D., Esq.
Partner/Director
Garfunkel Wild, P.C. 

Roy W. Breitenbach, Esq.
Partner/Director
Garfunkel Wild, P.C.


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There Are Limits to Coronavirus Antibody Testing, AMA Warns
Physicians and the general public should be cautious about the use of antibody testing for identifying previous COVID-19 infections, and they should especially be cautious of using the tests to determine if a person is immune to the new coronavirus, the American Medical Association warned.

Per a new guidance released by the association May 14, while antibody tests may play a key role in identifying the overall prevalence of COVID-19 in the U.S. population, including among those who do not show symptoms, the testing has inherent limitations.

The limitations include antibody tests currently on the market showing a significant number of false positive results. These tests may also identify antibodies for other coronaviruses, such as those that cause the common cold.

Also, a vast majority of more than 120 tests on the market have not been authorized by the FDA, and the association urges physicians to note the regulatory status of all available coronavirus antibody tests. Thus, the association recommends that “currently available antibody tests not be used as the sole basis of diagnosing COVID-19, and not be offered to individuals as a method of determining immune status.”

The test should not be used to support >decisions on returning to work or ending physical distancing, the association said.


Anyone in NYC with Coronavirus Symptoms Eligible for Testing
Any New Yorker with symptoms of the coronavirus will now be eligible to get tested for Covid-19. The new rules come after weeks where the city refused to test patients unless they were sick enough to be hospitalized. A limited number of vulnerable people, like the elderly in hard-hit neighborhoods, and frontline workers were also deemed eligible.

But now, the city is moving to set up a widespread program to test New Yorkers for the disease and hunt down people they have been in contact with. In the coming months, the effort will be crucial for the city’s plans to gradually lift stay-home restrictions and reopen its economy.

Under the new rules, anyone with a fever, cough, shortness of breath and symptoms like loss of smell and taste can get tested. Anyone who has been in close contact with a confirmed Covid-19 patient is also eligible for testing. Workers in nursing homes, homeless shelters and adult care facilities are eligible as well, regardless of whether they have symptoms.

The city is opening a dozen new testing sites over the next two weeks and will have a total of 23 publicly run sites. Though the eligibility criteria have broadened, there is no guarantee there will be enough tests available to meet demand. Appointments have filled up fast at available sites.

Officials are aiming to do 20,000 tests a day by late May. Next week, test sites will open at the Highbridge Recreation Center in Washington Heights and in Midwood, Brooklyn.

The city has moved its contact tracing program out of the Health Department and into the public hospital system, a move that sparked controversy.

Meanwhile, the number of children suffering from an inflammatory syndrome linked to Covid-19 spiked again on Thursday, reaching 100 confirmed cases.

The city has launched a PSA campaign to warn parents about the disease.

The number of people newly hospitalized for Covid-19, the number of ICU patients in public hospitals, and the share of patients testing positive all declined in the latest data Thursday.

The virus has killed 20,406 people in the city, and there are now 186,293 confirmed cases.


“Practical Considerations in Reopening Your Medical Practice”
By Andrew L. Zwerling

The outbreak of the COVID-19 virus and the response to it, including governmental orders that closed in whole or in part medical practices that performed elective procedures, created a difficult landscape for medical practices to navigate in the effort to remain viable, let alone operationally functional.  As the government slowly lifts stay-at-home orders and bans on elective procedures in New York State, the reopening of medical practices creates its own set of issues and burdens for medical practices to consider and handle.  Lapses in doing so correctly may lead to potentially punishing outcomes.

A threshold issue of significance is ensuring adherence to safety protocols that must be implemented either because they are required by the government or because the failure to implement them may expose a medical practice to future liability should an employee become ill from the COVID-19 virus.

For example, may an employer ask an employee if he or she had COVID-19 or was exposed to anyone who had it or has symptoms of COVID-19?  May an employer require an employee to have his or her temperature taken or submit to a COVID-19 test as a condition of re-entering the workplace?  May an employer require an employee with COVID-19 symptoms to stay home?  May an employer require employees to wear masks and/or gloves?  If so, who should bear the cost?  How does a medical practice social distancing with respect to staff and patients?  Should patients be screened prior to or after their arrival for appointments? What new and different cleaning and sanitation protocols must be implemented in response to COVID-19?  These questions and others should be answered before a medical practice reopens.

A host of employment law issues are also implicated in the reopening. For example, if an employer reduces an employee’s hours and wages does that reduction violate the terms of an employment contract?  If an employer reduces the wages of an exempt employee will that reduction fall below required thresholds and thereby undermine the exempt status of that employee?  If, to compensate for staffing shortages, an exempt employee performs the tasks of a non-exempt employee will that functional change convert the employee to non-exempt status?  If an employer reduces an employee’s salary because he or she is working fewer hours what steps must the employer take – for example, providing the employee with a “Rate of Pay Change” form – in order to avoid costly violations of the New York State Labor Law?

Although the issues related to reopening are many and may seem daunting, they are all susceptible to resolution if an employer conducts the proper due diligence and consults with the legal experts who can assist in providing the requisite guidance.

[1] Andrew L. Zwerling is a Partner-Director at Garfunkel Wild P.C. with over 38 years as a trial and appellate lawyer in State and Federal courts, including his successful argument before the United States Supreme Court.  A member of his firm’s Employment Law Practice Group, he has been advising clients how to respond to COVID-19 issues affecting their practices and businesses.  He may be reached at 516-393-2581 and by email at azwerling@garfunkelwild.com.  


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

Register now for MSSNY’s next webinar related to the COVID-19 pandemic, Medical Matters:: Mental Health and COVID-19 for Health Professionals.  Just like we need to take extra precautions to protect ourselves from the risk of being infected by COVID-19, we also need to be concerned about psychological risks for health professionals. Faculty for this program is Craig Katz, MD.

Click here to register for this webinar

To view the companion pieces to this webinar, be sure to go to https://cme.mssny.org 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.

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. 


Study Puts U.S. Covid-19 Infection Fatality Rate At 1.3%

KEY TAKEAWAYS

The researchers looked at 116 counties in 33 states and found 40,835 confirmed cases and 1,620 confirmed deaths through April 20. Asymptomatic COVID-19 patients who recovered with no symptoms were not counted in the data, which could have skewed results. The researchers also said they could not estimate age-adjusted IFR-S because the data is not available.

COVID-19 kills 1.3% of symptomatic people and could kill 500,000 Americans in the coming months if as many people contract the highly-contagious virus this year as contracted the seasonal flu last year, according to a caveat-laden estimate published Thursday in Health Affairs.

“After modeling the available national data on cumulative deaths and detected COVID-19 cases in the United States, the IFR-S (Infection Fatality Rate – Symptomatic) from COVID-19 was estimated to be 1.3%,” said the researchers, led by Anirban Basu, Stergachis Family endowed director and professor in the Department of Pharmacy, CHOICE Institute, University of Washington, Seattle.

“This estimated rate is substantially higher than the approximate IFR-S of seasonal influenza, which is about 0.1% (34,200 deaths among 35.5 million patients who got sick with influenza).”


FBI: Hackers Breaking into COVID-19 Research Organizations
China-linked hackers are breaking into American organizations carrying out research into COVID-19, U.S. officials said on Wednesday, warning both scientists and public health officials to be on the lookout for cyber theft. In a joint statement, the Federal Bureau of Investigation and the Department of Homeland Security said the FBI was investigating digital break-ins at U.S. organizations by China-linked “cyber actors” that it had monitored “attempting to identify and illicitly obtain valuable intellectual property (IP) and public health data related to vaccines, treatments, and testing from networks and personnel affiliated with COVID-19-related research.”

The statement offered no further details on the identities of the targets or the hackers. The Chinese Embassy in Washington did not immediately respond to a request for comment. China routinely denies longstanding American allegations of cyberespionage. Coronavirus-related research and data have emerged as a key intelligence priority for hackers of all stripes. Last week Reuters reported that Iran-linked cyberspies had targeted staff at U.S. drugmaker Gilead Sciences Inc., whose antiviral drug remdesivir is the only treatment so far proven to help COVID-19 patients. In March and April, Reuters reported on advanced hackers’ attempts to break into the World Health Organization as the pandemic spread across the globe. (Reuters)


Sanofi: If Successful, Americans Has First to Access Vaccine
Sanofi, the French drug company working with the U.S. Department of Health and Human Services (HHS) to develop a coronavirus vaccine, indicated that Americans will be the first to gain access to the vaccine should the company be successful.

“The U.S. government has the right to the largest pre-order because it’s invested in taking the risk,” Sanofi CEO Paul Hudson told Bloomberg.

HHS announced in February that its Biomedical Advanced Research and Development Authority (BARDA) will provide “expertise and reallocated funds” to Sanofi to develop the vaccine. Hudson said the U.S. expects “that if we’ve helped you manufacture the doses at risk, we expect to get the doses first.”

BARDA has given $30 million to Sanofi so far, according to Bloomberg.

Sanofi also partnered with British pharmaceutical company GlaxoSmithKline on the project and says it could make 600 million doses annually, though Hudson aims to double that projection.

Hudson warned that European countries could be left behind if they do not put in more resources toward vaccine development. “I’ve been campaigning in Europe to say the U.S. will get vaccines first,” Hudson told Bloomberg from his home in Paris. “That’s how it will be because they’ve invested to try and protect their population, to restart their economy.”

The Trump administration is pushing to speed up the development of vaccines through a program dubbed “Operation Warp Speed,” seeking to have millions of doses ready by January, an ambitious timeline that would be significantly faster than any previous vaccine development. Hudson told Bloomberg that Sanofi plans to begin human trials in the second half of this year and aim to have a vaccine available by the second half of 2021.

On Tuesday. the American biotechnology company Moderna announced that the Food and Drug Administration has given them fast-track designation, which is designed to expedite the development of treatments for life-threatening diseases such as COVID-19. (The Hill, May 13)


MSSNY Now Has More Than 50 Podcasts Available
Did you know you can now listen to all of MSSNY’s podcasts at Spotify, iTunes, I Heart Radio or Google Podcast?  Just search “MSSNY” and you will be able to listen to the MSSNY weekly update and messages from the new MSSNY president, Bonnie Litvack, MD.  You will also find podcasts on COVID-19, immunizations, emergency preparedness and veterans matters.  You can also access all of MSSNY’s podcasts by clicking here.


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Nassau County Webinar
DATE: May 21, 2020
Time: 7pm

Zoom Webinar Link 

Guest Speaker
Dr. David A. Hirschwerk
Attending-Infectious Diseases
Executive Vice Chair-Dept. of Medicine
North Shore University Hospital/LIJ Medical Center


 

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COVID-19 Map – Johns Hopkins Coronavirus Resource Center

MSSNY Applauds Senators Schumer and Gillibrand for Advancing the HEROES Act


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release

MSSNY Applauds Senators Schumer and Gillibrand for Advancing the HEROES Act


May 15, 2020, Westbury, NY
—MSSNY is grateful to Senator Schumer, Senator Gillibrand and the many members of New York’s Congressional delegation for advancing the HEROES Act to provide significant new resources for our health care system and our state and local governments to help in on our ongoing efforts to confront the myriad of issues caused by the COVID19 crisis.  While we continue to seek improvements to the legislation, it contains several important components that are absolutely essential for the next Congressional stimulus package.

The “Heroes Act” prioritizes essential needs of states, physicians, and other health care providers who are on the front lines fighting the COVID-19 pandemic. This is not only a public health crisis, but also an economic one, especially here in New York where we have been hit the hardest by the virus.  For example, MSSNY’s most recent survey of its physician members noted that:

  • 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.

While the survey noted that a significant number of responding physicians received a small business Paycheck Protection Program (PPP) loan, many others noted the difficulty in accessing the health care provider relief pool, which has been overwhelmingly allocated to hospitals not community physicians. Overall, the survey demonstrated that the CARES Act enacted by Congress in March and supplemented in April has helped to offset some of these enormous deficits effecting patient access to care and tens of thousands of jobs, but it has been nowhere near enough to ensure the survival of many physician practices across the state.

In addition to extending and improving important financial lifeline programs such as the PPP and the Medicare Advance payment program, the HEROES Act acknowledges that the economic fallout from COVID-19 increases the need for shoring up important programs such as Medicaid, which provide support to families who need it during these unprecedented times. Expanding access to comprehensive healthcare coverage ensures that New Yorkers get the care they need through this crisis.  It also helps to prevent against devastating cuts that may be imposed that will adversely impact patient access to care.

MSSNY will also continue to work with the New York Congressional delegation to improve other aspects of the legislation to better ensure grant funding is prioritized to hard-hit community physicians, and to provide desperately needed medical student loan relief to front line physicians, residents and students (as has recently been proposed by Representative Carolyn Maloney).

As we begin the recovery process and work to prevent against a second “surge” of infection, the HEROES Act contains several positive provisions to get the country back on track and meet future challenges that the virus will present going forward.

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About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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MSSNY Thanks Gov: Ambulatory Surgery Center Can Resume Elective Surgery


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release
May 13, 2020

MSSNY Thanks Gov: Ambulatory Surgery Center Can Resume Elective Surgery

Statement Attributable to:
Bonnie Litvack, M.D.
President, Medical Society of the State of New York

“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.”

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About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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COVID-19 Update May 14, 2020

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Notes from Governor Cuomo’s COVID-19 Briefing

Data:
– Hospitalizations and intubations are down
– New COVID Cases 420 as of yesterday
– 157 deaths (121 in hospitals, 36 in nursing homes)

Reopening:
– Not a matter of if we reopen, but when and how
– Check the data on a daily basis; Transparency is key
– NYS will post daily dashboard of relevant local information
– Build Back Better in areas of education, telecommuting, telemedicine, public
transit, and public health

Local Government Management:
– Manage compliance among business and individuals for reopening procedures
– React immediately if numbers change

Federal Assistance:
– We still need federal help to fund schools, hospitals, local governments,
police officers, and firefighters
– President Trump expedited $3.9B to the MTA
– Cap on SALT increases federal taxes on NYers by $12B-$15B
– D.C. must not delay, exclude special interests and not provide corporate
bailouts; If corporation accepts federal funds, they should rehire same amount
of workers

Re-Imagine:
– This experience has taught us we need to make medical equipment in the U.S.
– Initial $3M in grants to businesses to mfg. medical  supplies/equipment in NY

Contact Empire State Development to grow or start medical supply business: www.esd.ny.gov

COVID-Related Illness in Children:
– DOH is investigating 110 cases of what may be rare COVID- related illness in
children with symptoms similar to atypical Kawasaki disease
or toxic shock like syndrome
– Illness has taken lives of 5 year-old boy, 7 year-old boy, and 18 year-old girl
– NYS and DOH are leading national effort to understand and combat new syndrome
– So far, 16 other states, Washington D.C., and six European countries have
reported cases
– While this illness is rare, seek care if child has prolonged fever (more
than five days), abdominal pain, diarrhea, vomiting, bloodshot eyes, skin rash
– NYS issued first-in-the-nation criteria to healthcare professionals defining
this syndrome

Q&A
Reopening:
– Business will reopen while abiding by reopening guidelines for particular regions
which will be enforced by local government.
– According to DeRosa, there will be regional control meetings to ensure regions
are adhering to guidelines
– Social acceptability continues to be left up to individuals
– Religious institutions should adhere to guidelines for large gatherings and
remember the situation in New Rochelle
– There is federal legislation pending regarding liability for businesses that
tests positive for COVID
– Regions will be able to open at 12:01 a.m., so Friday can be a day of business


MSSNY President Submits Testimony on the Impact of the COVID19 Crisis on NY Physician 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 Dr. Litvack. “New York has shouldered the brunt of this crisis and we desperately need fiscal attention.”


5,300 Excess Deaths in New York City May Be Tied to Pandemic, CDC Says
Officials have identified 5,293 excess deaths in New York City that may have been caused by COVID-19 but weren’t included in the official death toll, according to the CDC’s Morbidity and Mortality Weekly Report published May 11.

From March 11 to May 2, a total of 32,107 deaths were reported to the New York City Department of Health and Mental Hygiene. Of those deaths, about 24,172 were found to be in excess of the expected seasonal baseline. Of the 24,172 deaths, 57 percent (13,831) were lab-confirmed COVID-19 deaths and 21 percent (5,048) were probable COVID-19 deaths, leaving 22 percent of deaths (5,293) without an identified cause.

The 5,293 excess deaths may be directly or indirectly due to the pandemic. The deaths could include deaths among people with COVID-19 “who did not access diagnostic testing, tested falsely negative, or became infected after testing negative, died outside of a health care setting, or for whom Covid-19 was not suspected by a health care provider as a cause of death,” according to the CDC. Fear related to the virus could also prompt some to delay seeking or obtaining lifesaving care.

Other findings suggest the true number of national cases and deaths is also likely much higher than reported. (May 13 Becker’s Hospital Review)


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Mount Sinai Health System Launches Center for COVID-19 Recovery
New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease.

The Center for Post-COVID Care, opened May 13, will help patients hospitalized for COVID-19 transition from the hospital to their homes. The center is also open to patients who were never hospitalized but need help during their recovery.

At the center, patients will be offered a personalized treatment plan that will include input from several specialties, including primary care, pulmonary medicine, cardiology, infectious disease and physiatry, as well as social workers and pharmacists. The center will also focus on evaluating the long-term effects of the disease, which are largely unknown. Mount Sinai will create a COVID-19 registry and collect information on sociodemographics, behaviors, underlying conditions, mental health conditions and medications from patients with the disease.

“This center will provide a unique opportunity to follow this population and systematically evaluate the long-term impact of COVID-19,” said Dennis S. Charney, MD, president for academic affairs at Mount Sinai Health System. (Becker’s Hospital Review, 5/15)


MedPage Today: 4.91% of 763 (86% Physicians) Had/Have COVID-19
Of 763 respondents in a MedPage Today survey — 86% of whom were physicians — 4.91% reported they had or currently have COVID-19. The findings come from an ongoing MedPage Today poll conducted every 2 weeks to monitor challenges U.S. healthcare workers face during the COVID-19 pandemic. The most recent survey took place from April 29 to May 3 and was distributed by email and posted on the MedPage Today site.

COVID-19 continues to waylay healthcare workers, the latest findings revealed. Nationally, 20% of respondents said 1% to 5% of their facility’s healthcare workers were out due to COVID-19 illness or exposure. About one in ten put COVID-19 absenteeism at 6% to 10%, and 6% said the virus sidelined 11% or more of their workforce.

The survey also showed:

  • COVID-19 testing still is severely lacking, but trending toward improvement

The majority of respondents, 56%, still rated their access to COVID-19 testing as     fair or poor, representing an improvement from the 67% fair-to-poor rating of 2 weeks ago. “It is still very difficult. We still predominately test if you are being admitted or, now, if you need an elective surgery or admission to a skilled nursing facility. Outpatient is still chaos,” wrote an infectious disease specialist. “Only admitted patients get tested,” noted a cardiologist in New York City. “The hospital is not routinely testing staff workers who want testing,” another New York physician said.

  • About 70% of hospitals lack access to all COVID-19 treatments, including experimental therapies

Only 31% of respondents said their facility could access all therapies including experimental treatments; the same percentage was reported 2 weeks ago. “I cannot get remdesivir yet. Convalescent plasma limited,” one critical care physician wrote. “Stopped using hydroxychloroquine after data was suggesting harm but we had access to it when it was being given more regularly,” an infectious disease specialist noted. “Gilead drug [remdesivir] or IL-6 inhibitors” were not available, a Chicago anesthesiologist wrote, while an Atlanta critical care doctor reported access to “most treatments, including tocilizumab.” 

  • Personal protective equipment (PPE) continues to be a problem

About half (49%) of respondents said their access to PPE was fair or poor, similar to the 51% who said so 2 weeks ago. “We have PPE, but we need to save and reuse our N95 mask,” an emergency medicine doctor in Cleveland remarked. “No N95 is provided unless you can do a mask exchange to have it cleaned and reused,” a nurse practitioner in West Virginia said. “N95 masks and face shields are available only for COVID-confirmed patients,” a cardiologist in northern California noted. “Everything is locked down,” another physician stated. “In order to see a patient in consultation, you have to ask an administrator for an N95 mask. They are available, but barriers are high.”

Most respondents (86%) in this survey were doctors; 4% were nurses, 4% were nurse practitioners, and 3% were physician assistants. Nearly two-thirds (65%) currently worked in a hospital. Specialties included emergency medicine (6%), critical care/ICU (6%), anesthesiology (6%), cardiology (6%), infectious disease (3%), neurology (2%), and pulmonology (2%), among others.

About a quarter of respondents practiced in New York City (17%) or northern New Jersey (8%). Another 10% worked in Los Angeles, 6% in Chicago, 5% in Boston, 4% in Detroit, and 3% in Miami.

A limitation of this poll is that identities of respondents and their locations, license status, and individual responses were not verified independently. Click here for MedPage Today COVID-19 survey results in more detail. (Updated May 12, 2020)


WHO Official: COVID-19 May Never Be Eradicated
A top World Health Organization official said during a May 12 news briefing. “This virus may become just another endemic virus in our communities, and the virus may never go away,” said Mike Ryan, MD, executive director of WHO’s emergencies program. He said HIV has not gone away, but effective therapies and prevention measures have allowed people with HIV to live long, healthy lives. He clarified that he was not comparing the two diseases but emphasized that COVID-19 could be managed if an effective vaccine was globally distributed. (Becker’s Hospital Review, 5/14)


 

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COVID-19 Map – Johns Hopkins Coronavirus Resource Center


 

 

MSSNY President Submits Testimony on the Impact of the COVID19 Crisis on NY Physician Practices


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release

MSSNY President Submits Testimony on the Impact of the COVID19 Crisis on NY Physician 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 Dr. Litvack. “New York has shouldered the brunt of this crisis and we desperately need fiscal attention.”

# # #

About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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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

COVID-19 Update May 11, 2020


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Gov. Cuomo’s Press Conference Today, May 11

Data:

– Total hospitalizations 7,226 as of yesterday

– Net intubations is down

– Lives lost 161 (112 in hospitals, 49 in nursing homes)

– New hospitalizations 488 as of yesterday

Reopening:

– Regions can reopen when numbers show decline in accordance with CDC guidelines

and there is testing/tracing plan in place

– Regions must meet 7 metrics

– 14 day decline in hospitalizations OR under 15 new hospitalizations

(3-day average)

– 14 day decline in hospitalized deaths OR under 5 new (3-day average)

– New hospitalizations – under 2 per1 00K residents (3 day rolling average)

– Share of total beds available (threshold of 30%)

– Share of ICU beds available (threshold of 30%)

– 30 per 1k residents tested monthly (7-day average of new tests per day)

– 30 contact tracers per 100k residents or to meet current infection rate

– Southern tier, Mohawk Valley, and Finger Lakes Regions meet metrics for reopening

Phased Reopening of Businesses:

– Businesses will reopen on a risk vs. reward basis

– Businesses will have to consider:

– Adjusted workplace hours and shift design

– Social distancing

– Non-essential travel restrictions

– Wearing masks if in frequent contact with others

– Strict cleaning and sanitation standards

– Continuous health screenings

– Continuous tracing, tracking, and reporting

– Liability for maintaining processes 

Local Officials:

– Testing – tracing in place

– Monitor infection rate with hospitals

– Communicate with other local governments

– Regional Control room of healthcare professionals and other necessary

personnel to monitor the situation across regions 

Regional Control Rooms:

– Announcing members of regional control rooms to monitor regional metrics today

Looking Back:

– Virus attacked us from Europe in January and February and no one knew

– Projected hospitalizations were 120K


Please join the NYS Department of Health at a COVID-19 Update
Thursday May 14th at 1-2PM for a 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


FDA Approves First Coronavirus Diagnostic Test That Uses CRISPR Technology
The Food and Drug Administration on Thursday authorized the first test to detect the coronavirus using CRISPR technology.

The test, manufactured by genetic engineering company Sherlock Biosciences, provides results in approximately one hour. The test kit works by programming a CRISPR molecule to detect the presence of a genetic signature specific to SARS-CoV-2 in a nasal swab, nasopharyngeal swab, oropharyngeal swab, or broncho-alveolar lavage (BAL) specimen. When the signature is found, the CRISPR enzyme releases a detectable signal. The test is designed for use in high-volume CLIA laboratories and hospitals.

Sherlock is working to rapidly scale the production of the test kit and said it will share plans for distribution and availability in the coming weeks.

“While it has only been a little over a year since the launch of Sherlock Biosciences, today we have made history with the very first FDA-authorized use of CRISPR technology, which will be used to rapidly identify the virus that causes COVID-19,” Sherlock Bio Cofounder, President, and CEO Rahul Dhanda said in a statement. “We are committed to providing this initial wave of testing kits to physicians, laboratory experts, and researchers worldwide to enable them to assist frontline workers leading the charge against this pandemic.”

The company said it is also developing an instrument-free, handheld test that would provide rapid detection of the SARS-CoV-2 virus in a format like an at-home pregnancy test. May 8 Modern Healthcare

This story first appeared in our sister publication, Genomeweb.


Map Shows Communities Vulnerable to Severe Cases of COVID-19
An interactive map created by Experian shows which populations are most at-risk of developing severe cases of COVID-19.The map uses data on the community’s health, such as rates of pre-existing conditions like chronic lung disease or severe asthma, demographic information and social factors like population density and use of public transit to determine a community’s risk.


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Estimated Volume Losses for 30 Service Lines
Across all service lines, COVID-19 pushed the number of unique patients who sought hospital care down by an average of 54.5 percent, according to a year-over-year analysis from Strata Decision Technology.

For the analysis, data scientists examined more than 2 million patient visits and procedures from 51 healthcare delivery systems in 40 states. The 228 hospitals represented in the study had varying rates of COVID-19 cases.

Here are the estimated volume losses for 30 service lines for a two-week period in late March-April 2020 compared to the same period a year prior:

Ophthalmology: 81 percent
Spine: 76 percent
Gynecology: 75 percent
Orthopedics: 74 percent
Ear, nose and throat: 72 percent
Endocrine: 68 percent
Dermatology: 67 percent
Gastroenterology: 67 percent
Rheumatology: 66 percent
Neurosciences: 66 percent
General medicine: 64 percent
Urology: 62 percent
Genetics: 60 percent
Vascular: 59 percent
Hepatology: 58 percent
Cardiology: 57 percent
Pulmonology: 56 percent
Breast health: 55 percent
General surgery: 54 percent
Nephrology: 52 percent
Hematology: 49 percent
Allergy and immunology: 48 percent
Behavioral health: 45 percent
Burns and wounds: 44 percent
Cancer: 37 percent
Obstetrics: 30 percent
Infectious disease: 23 percent
Neonatology: 20 percent
Not assigned: 4 percent
Normal newborn: 2 percent
View the full report here. (May 11)


Physicians Rethinking Use of Ventilators for Some COVID-19 Patients
Some COVID-19 patients come to the hospital with low blood oxygen levels — levels that should have them gasping for air — but instead, these patients are awake and talking, resulting in some physicians rethinking the use of ventilators for them, according to The Wall Street Journal.

It is unclear why certain COVID-19 patients are unaffected by low blood oxygen levels and able to tolerate them, but some physicians are now holding off invasive mechanical ventilation for these patients.

Initially during the pandemic, physicians would rush to intubate these patients sooner, afraid of their sudden and swift deterioration. But recently, physicians at Stony Brook (N.Y.) Hospital and Ochsner Medical Center-West Bank Campus in Gretna, La., have put these patients on ventilators less often and are instead using other machines, such as CPAP machines, BiPAP machines or high-flow nasal cannulas.

Scott Weingart, MD, chief of emergency critical care in the department of emergency medicine at Stony Brook Hospital told the Journal about a 42-year-old COVID-19 patient with dangerously low blood oxygen levels, who was able to sit up and talk. Dr. Weingart and his team used a high-flow nasal cannula to increase the patient’s blood oxygen levels and placed the patient on his stomach, called “prone positioning,” which can boost oxygen levels. The patient was discharged without being placed on a ventilator.

The hospitals eschewing the use of ventilators in favor of CPAP and BiPAP machines are also careful to use filters on the masks and keep patients in specially ventilated rooms since these devices could release the virus into the air, they told the Journal.

Ventilators have played a key role in COVID-19 patient care during the pandemic, and as a result, demand for the machines soared. But their use comes with several risks. Studies have shown that many COVID-19 patients placed on ventilators die. A recent study published in the Journal of the American Medical Association showed that of 320 New York state patients who received invasive mechanical ventilation, 88.1 percent died. (Becker’s Hospital Review, May 11)


Northwell Health Surpasses 10,200 COVID-19 Patient Discharges
Northwell Health has discharged 10,210 COVID-19 patients as of May 11, surpassing the threshold of 10,000 patient discharges, the health system told Becker’s Hospital Review.

The state’s largest health system said the milestone comes more than two months after its hospitals saw the first COVID-19 cases and more than 30 days after Northwell experienced the surge’s peak.

“Based on the data we’ve seen, Northwell has treated more COVID-19 patients than any other health system in the nation,” Northwell President and CEO Michael Dowling said in a news release. “Our success is a reflection of the selfless work of both front-line staff and behind-the-scenes innovation that has enabled us to respond to an unprecedented influx of patients.”

Northwell said it has treated more than 41,000 COVID-19 patients since the beginning of the pandemic. This included about 13,000 hospitalized patients on Long Island, in New York City and Westchester County, as well as those seen in emergency departments, urgent care centers and physician offices. (Becker’s Hospital Review, May 11)


 

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COVID-19 Map – Johns Hopkins Coronavirus Resource Center

Frank Dowling, MD Re-elected Secretary of the Medical Society of the State of New York


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release

Frank Dowling, MD Re-elected Secretary
of the Medical Society of the State of New York

MSSNY is the State’s Primary Professional Organization for Physicians

Westbury, NY—May 8, 2020— Frank Dowling, MD was re-elected Secretary of the Medical Society of the State of New York (MSSNY) on May 7.

A graduate of Harvard College, Dr. Dowling received both their medical degree and their residency training from SUNY at Stony Brook School of Medicine.  Since 2004, they have served as Clinical Associate Professor of Psychiatry at SUNY Stony Brook School of Medicine. Prior to that appointment, they were Clinical Assistant Professor from 1993-2004.

Board certified in both Psychiatry and Addiction Medicine, Dr. Dowling has an outpatient private practice in Garden City and Islandia that focuses on treating victims of trauma and disaster, emergency responders and healthcare professionals and their families. They also treat patients with co-occurring substance use and psychiatric disorders. In addition to their private practice, Dr. Dowling serves as Medical Advisor to the Police Organization Providing Peer Assistance (POPPA), an independent, confidential, non-departmental voluntary assistance program for the NYPD.

An active member of MSSNY, Dr. Dowling has served as Commissioner for Science and Public Health, co-chair of the Addiction and Psychiatric Medicine Committee, chair of the Task Force on Alcohol and Health and vice chair of the Committee on Bioterror and Emergency Preparedness. In addition, they serve on the Advisory Committee and as faculty for the Veteran’s Mental Health Training Initiative, a collaborative effort by MSSNY, NYSPA and NASW-NY to train NY practitioners to assist warriors and veterans with post-traumatic stress and TBI.  

When the ISTOP law was under consideration in Albany, Dr. Dowling—working with MSSNY staff—was instrumental in helping a MSSNY led coalition obtain the right for a designee to assist a physician with mandated PMP lookups.  They currently serve on the AMA’s LGBTQ Advisory Committee and Opioid Task Force and on MSSNY’s Committee on Physician Wellness and Resilience. They previously worked with the MSSNY/OASAS Planning Committee that developed a 3 hour CME program on pain management and opioid abuse, which is available free to MSSNY members to meet the New York State mandated CME requirement.

As a member of the New York Delegation to the American Medical Association (AMA), Dr. Dowling has collaborated with others to update AMA policies in several public health areas, including psychiatric and substance use disorders, access to care issues, preservation pf medically necessary care for patients with chronic pain, LGBTQ health issues and societal and healthcare inequities.

Dr. Dowling received the American Psychiatric Association’s Bruno Limo Award in 2003 for “outstanding contributions to the care and understanding of victims of disaster” for their work with emergency services personnel after the World Trade Center attacks in 2001. In addition, Dr. Dowling received a Long Island Healthcare Heroes Award from Long Island Business News for their work in support of veterans and others with chronic psychiatric illnesses. In 2015, they were awarded MSSNY’s Charles D. Sherman Award for their support of medical students.  They are a co-author of Disaster Psychiatry: Readiness, Evaluation, and Treatment, a textbook intended to prepare psychiatrists and other mental health professionals to respond to disasters and mass casualty events.

Dr. Dowling lives in Oakdale, NY with their spouse Theresa, children Frank, Finn and Charlie Robin.

# # #

About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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