COVID-19 Update April 30, 2019

New York State COVID-19 Stats

NYSDOH COVID-19 Tracker – NY.gov


Notes from Governor Cuomo’s COVID-19 Briefing:

  • Hospitalizations and new cases are down.-306 new deaths yesterday – 287 in hospitals / 19 in nursing homes.
  • DATA:– Gov stressed two points about reopening:- Closely monitor the rate of transmission, keep it below 1.1.- Maintain 30% or more available hospital capacity.- The state has collaborated with the federal government to increase testing to 30,000 tests per day. The goal is 40,000.
  • TRANSIT:– NYC Subway conditions have rapidly deteriorated as a result of corvid-19.- MTA employees and NYPD officers are sick, so there are less people available to maintain the subway.- There are less people to provide outreach for homeless people.- The MTA has been cleaning the trains and buses every 72 hours.- Unfortunately, the virus can remain on surfaces for days.- Gov said that trains and buses should be disinfected every 24- The scale of work is unprecedented, but it must be done.

    – The MTA will also disinfect the Metro North and LIRR without

    service disruptions.

    – Overall ridership is down 92%.

    – The slowest hours are from 1:00 a.m. to 5:00 a.m.

  • TRACING:
    – When you get a positive case of COVID-19, you must trace by identifying who they have been in contact within the last 14 days.- Yesterday, there were 4,681 positive cases.- There are too many people to contact at once.- The state needs help tracing people- The state will collaborate with city and county health departments to find tracers- The state is also collaborating with former NYC Mayor- Bloomberg: we must use contact tracing as we relax socialdistancing protocols.

    – He announced partnerships with Johns Hopkins University,

    Vital Strategies, and Resolve to Save Lives, staffing

    organizations, and SUNY/CUNY.

    – These organizations will help with tracing training,

    recruitment, guidance, and app development.

    – Guidelines will be publicly available to provide a model for

    others and spread best practices.

    – There must be 30 contact tracers for every 100,000 cases.

    – Statewide, we will need about 6,000 tracers

    – There will be a tri-state collaboration for contact tracing.

    Q&A:
    CHILDREN:
    – Zucker: COVID-19 infects the lining of blood vessels and lungs.
    – Some kids are having strange, adverse effects to this.
    – Camps are set to open at the end of May.
    – Gov says that the federal government is not providing
    enough funding for schools, rental assistance, etc.


Physicians Offices Should Continue to Submit Requests for PPE through Local Office of Emergency Management (OEM)
Physicians’ offices should continue to submit requests for Personal Protection Equipment (PPE) through their local Office of Emergency Management. Physicians generally need to call the local Department of Health first.  Upon providing their license number and practice address they will be given the private OEM phone number or website address for requesting PPE supplies.   Physicians will need to provide information to the local OEM regarding the amount of PPE needed, license number, and practice location.  In some cases, we have been able to eliminate one step.  IT’S OFTEN A TWO-STEP PROCESS TO REQUEST PPE.

  • Here are contacts for this region:
  • In NYC, EMAIL the OEM directlysupplyrequest@oem.nyc.gov   Make sure you include doctor’s name, complete contact information, and the request.
  • In Nassau, you can go directly to the OEM website (OEM phone number is 516 573-9600)
  • In Suffolk, you can go directly to this website.
  • In Westchester, call the DOH at 1-866-588-0195, Option 2.  A DOH expert will take the request and provide the next step for reaching the OEM

New York State continues to fulfill requests for PPE and provides supplies to the local OEM when there is a request. If your practice is unable to obtain PPE through vendors and local Offices of Emergency Management fail, please let MSSNY know.  MSSNY will need the information that was provided to the local OEM so that we can provide that information back to the state.  MSSNY is in continuous contact with the NYS Department of Health to help address such situations.

For general guidance on the use of PPE in healthcare settings, please refer to CDC guidance entitled “Healthcare Supply of Personal Protective Equipment”.

MSSNY is engaging our county societies statewide to assess the level of difficulty physicians may be encountering in obtaining PPE, to determine if problems being reported are local in nature, or more widespread.

2)  Guidance on steps to take in reopening physician practices is being finalized and will be circulated shortly. 

3)  We are engaged with the Dept of Health and the OPMC on legal changes needed to support confidential peer-to-peer support for physicians during the pandemic and beyond.  Meetings are occurring this week.


HHS: FAQs Posted Regarding Second Tranche
The Department of Health and Human Services (HHS) has posted new Frequently Asked Questions regarding the second tranche of disbursement of the CARES Act Provider Relief Fund. Regarding second Tranche Please note there is conflicting information about whether a provider who has not previously received money from the first round of funding can apply for this round.  The AMA is trying to clarify this and other questions with HHS.


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Paycheck Protection Program (PPP) Update
Have you applied for the PPP small business forgivable loan program yet?  According to SBA.gov as of 5:00 PM yesterday more than 960,000 loans had been approved totaling greater than $90 billion. The total number of lenders involved in processing these transactions has been 5,300 so far. Last week Congress approved an additional $310 billion for the program.

Yesterday, the SBA notified borrowers and lenders that certain provisions would be put in place to favor lending from smaller institutions. The text of the notice:

Paycheck Protection Program (PPP) Lending Operations Update – Wednesday, April 29, 2020

SBA and Treasury value all lenders and their small business customers.

To ensure access to the PPP loan program for the smallest lenders and their small business customers, starting at 4 p.m. yesterday EDT through 11:59 p.m. EDT, SBA systems will only accept loans from lending institutions with asset sizes less than $1 billion.

Please note, lending institutions with asset sizes less than $1 billion will still be able to submit PPP loans outside of this time frame. Please also note that lenders with asset sizes greater than $1 billion will be able to submit loans outside of today’s 4:00 PM -11:59 PM EDT reserved processing time.

Today this reserved processing time applies to April 29, 2020. SBA and Treasury will evaluate whether to create a similar reserved time again in the future.

SBA and Treasury continue to monitor loan system performance and will continue to provide frequent updates to the lending community.


Governor Issues Executive Order to Resume Elective Surgery in 35 Counties, but Only in Hospitals
The Governor issued an Executive Order on April 29 to lift the prohibition on elective surgery in 35 upstate counties based upon meeting certain criteria, but only for hospitals in those counties.  There was an arbitrary exclusion of Ambulatory Surgery Centers and Office-Based surgery locations in these counties from resuming elective surgery.  With many patients facing significant health care issues including pain that require surgical intervention, there is no good reason to exclude these care facilities from the resumption of these elective procedures.  For the benefit of patients, physicians are urged to contact the Governor to lift this restriction by sending a letter from here.

The counties in which hospitals are now eligible are: Allegany, Broome, Cattaraugus, Chautauqua, Chenango, Delaware, Dutchess, Essex, Franklin, Fulton, Genesee, Herkimer, Jefferson, Lewis, Livingston, Madison, Monroe, Niagara, Oneida, Onondaga, Ontario, Orleans, Oswego, Putnam, Saratoga, Schoharie, Schuyler, St. Lawrence, Steuben, Sullivan, Tompkins, Ulster, Wayne, Wyoming and Yates.


NIH Announces $1.5 billion, ‘Shark Tank’-like Initiative to Accelerate Covid-19 testing
The NIH yesterday announced a $1.5 billion initiative aimed at speeding up the availability of diagnostics for Covid-19. The hope is that this endeavor will lead to “millions of tests” being deployed per week by late summer or fall. The initiative will rely on a “national Covid-19 testing challenge,” in which researchers and inventors across the country will compete for a share of $500 million in a “Shark Tank”-style competition to move their proposed inventions forward. The National Institute of Biomedical Imaging and Bioengineering’s director Bruce Tromberg tells STAT’s Lev Facher that the agency, which will be coordinating the initiative, expects to select roughly five winners who will be paired with manufacturers who will mass-produce the new diagnostics.


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NIH: Critical Study of COVID-19 Drug Shows Patients Respond to Treatment
Preliminary data released yesterday from a closely watched, government-run trial of Gilead’s remdesivir showed it was effective in Covid-19 patients. Those who were given remdesivir recovered four days faster than those who were given placebo. The decrease in mortality rate compared to placebo was not statistically significant. Anthony Fauci, the director of NIAID, which is conducting the study, said the data are a “very important proof of concept,” but cautioned they were not a “knockout.”

The preliminary results come after days of conflicting results on remdesivir’s efficacy against Covid-19: While early results from Gilead’s separate trial of the drug in severe Covid-19 patients showed promise, data from a trial in China showed no added benefit. NIAID’s trial results are critical because the drug was tested in a large number of patients and neither the patients nor physicians knew who was getting the drug, which controlled for any unconscious biases. And following NIAID’s preliminary data, the FDA is exploring an emergency use authorization for remdesivir, according to The Wall Street Journal.