COVID-19 Update – April 14, 2020

April 14, 2020 Latest COVID-19 Statistics
By the Numbers:

· New York reported 10,834 statewide deaths as of Tuesday morning, including 778 more fatalities in the past day. As of Tuesday, New York reported 202,208 confirmed cases, including 110,465 cases in New York City alone. As of Tuesday, the state reported 7,905 deaths of New York City residents. As of Tuesday, 18,697 New Yorkers were hospitalized with the coronavirus. As of Friday, 4,903 of those hospitalized were in intensive care units. For more numbers, including the latest statewide and borough-by-borough statistics, click here.

· Johns Hopkins Corona Virus Map 

Notes from Governor Cuomo’s COVID-19 Briefing:

-Total hospitalizations is basically flat, “technically” down. Governor
believes we are at the apex.
– Net change in hospitalizations is down. The 3-day average is
also down.
– Net change in ICU admissions is down.
– New COVID hospitalizations down. However, 1,600 new COVID cases came in
yesterday. The Governor reiterated that though volume is still high,
net changes reflect discharges as well as new entries.
– Total hospitalizations by region has remained relatively flat. Hot spots
have been isolated and traced as they pop up.
– Deaths since April 13: 778. This is higher than recent numbers but
reflects a current flattening of the curve. Total deaths: 10,834.
– Celebrated changes made to projected infection rates through distancing
– REOPENING: Seven states have joined the multi-state council for reopening
(DE, MA, PA, CT, NJ, NY, RI).
– President has said he has “total authority” on reopening, but the
Governor disagrees. He says the Federal government was created by states
thus states should hold more power over the Federal government.
– Comment on the President’s briefing last night: Says the President is
“clearly unhappy” with Governors and is “spoiling for a fight.” The Governor
hopes to stray from political division and will be walking away from said
fight. Says a fight is not worth the risk of a second wave.

Q & A

– When asked on whether his staff is preparing to battle with the President,
Governor Cuomo again said he was not interested in fighting with him.
The Governor said he will fight for New Yorkers if it comes to it
but he doesn’t believe such actions will be necessary.


– The Governor explained that only a handful of private companies produce
tests, thus creating competition between states. He argued FEMA should hold
control over testing to stray from multi-state competition and issue them
on a need basis.
– DOH Commissioner Dr. Zucker said the state is looking for tests with over 95% accuracy. He
also said the DOH is looking into false positive issues.
– When asked how many antibody tests could be done, Zucker said 2k tests
will be held daily next week. Additionally, he said DOH was working with
private sector companies and hospitals to develop 100k tests per day.

MSSNY Survey: Please Complete to Gauge Financial Impact of Outbreak and Availability of Relief
The $2 trillion CARES Act became law on Friday, March 27th and was the third stimulus relief package approved by the federal government in less than two months. Among the issues the bill addresses are the impact on small businesses, as well as the healthcare system, and includes $350 billion in forgivable loans and grants, and advanced payments from Medicare.

These resources are already available, but it is unclear how much physicians know about them and whether they are benefiting. Moreover, as MSSNY continues its aggressive advocacy to ensure physicians can obtain needed financial assistance during this crisis, we need information from our members as to the impact on their practice.

To get an idea if funds are getting into the hands of New York physicians, MSSNY’s Governmental Affairs team distributed a survey on Monday, April 13, to all members and other partners, with questions ranging from how aware physicians are of the financial assistance available through the federal government, difficulty in applying for assistance and whether or not physicians are having to layoff, or furlough, staff. For those MSSNY members who may not have taken the survey, please go to this link.

We will keep you updated on our final survey findings and how we plan to use this information, going forward.


MLMIC Announces Coverage Continuation without Requiring New Premium
As part of our ongoing support of the medical community as it takes on COVID-19, any retired physician returning to volunteer and aide in the COVID-19 efforts who was last insured by MLMIC prior to their retirement will have access to professional liability coverage without requiring any new premium. The same policy benefits and coverages will be provided as when the volunteering physician was actively practicing medicine and last insured with MLMIC.

Retired physicians who were last insured by MLMIC and choose to volunteer should simply call (800) ASK-MLMIC or go click here.

Opportunity to Request Relief from Medical Liability Costs
Physicians are reminded that, pursuant to a recent Governor’s Executive Order, that they are able to request a 60-day “grace period” for paying their medical liability insurance premiums based if they are experiencing “financial hardship”.  Moreover, medical liability insurance companies including MLMIC have provided the opportunity for physicians to request alterations in their premiums.

For example, MLMIC’s website notes that “to alleviate some of the adverse impact caused by COVID-19, premium installment due dates and potential policy cancellations due to non-payment of premium can be adjusted if your practice is encountering a demonstrated financial hardship due to COVID-19. To discuss these forms of potential accommodation, please contact us at (800) ASK-MLMIC (1-800-275-6564).”

Hospital CEOs Blast Distributing Stimulus Funds Based on Medicare Revenue
Hospital CEOs are blasting HHS’ decision to distribute the first $30 billion in emergency funding based on Medicare fee-for-service revenue, according to Kaiser Health News.

HHS said April 10 it would allocate money to hospitals and providers based on their historical share of revenue from the Medicare program, rather than the burden caused by the coronavirus or number of uninsured patients treated.

Kenneth Raske, CEO of the Greater New York Hospital Association, wrote in a memo to association members that the method is “woefully insufficient to address the financial challenges facing hospitals at this time, especially those located in ‘hot spot’ areas such as the New York City region.”

Another CEO, Carlos Migoya of Jackson Health, said that the way the bailout money is being distributed “could jeopardize the very existence” of the hospital. Jackson Health is a safety-net hospital in Miami, one of the harder-hit cities in the U.S.

America’s Essential Hospitals represent more than 300 safety-net hospitals in the U.S., which care for large numbers of uninsured and Medicaid patients.

An HHS spokesperson told Kaiser Health News the agency decided to use Medicare revenue as the basis of distribution because it “allowed us to make initial payments to providers as quickly as possible.”

The $30 billion is part of $100 billion in emergency stimulus funding earmarked for hospitals from the Coronavirus Aid, Relief, and Economic Security Act. (Becker’s Hospital Review, April 14)

Deadline for Cycle VII DANY Grant Applications Extended
Doctors Across New York is a state funded initiative enacted in 2008 to help train and place physicians in underserved communities in a variety of settings and specialties to care for New York’s diverse population.

Due to the COVID-19 epidemic in New York State and the response required by physicians, the deadline for Cycle VII applications has been extended to June 4th, 2020. Applications must be received by 4:00 PM on that day. For more information, visit the NYS Grants Gateway website.

CMS COVID-19 Office Hours—Tonight, April 14
Physicians are invited to join CMS “Office Hours” on COVID-19, Tuesday, April 14th from 5:00 – 6:00 PM EST, the next in a series of opportunities for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:

  • Increase Hospital Capacity – CMS Hospitals Without Walls;
  • Rapidly Expand the Healthcare Workforce;
  • Put Patients Over Paperwork; and
  • Further Promote Telehealth in Medicare

Dial-in details below. Conference lines are limited, so you are highly encouraged you to join via audio webcast, either on your computer or smartphone web browser.

Toll-Free Attendee Dial In: 833-614-0820
Event Plus Passcode: 2395745

Audio Webcast link

Early Results of Remdesivir for COVID-19 Published
Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

About two-thirds of novel coronavirus disease (COVID-19) patients given the antiviral remdesivir on a compassionate-use basis showed signs of clinical improvement, according to a small, industry-conducted study in the New England Journal of Medicine. However, the study had no control arm.

Researchers studied 61 patients hospitalized with confirmed SARS-CoV-2 infection who required oxygen support or had an oxygen saturation level of 94% or less. At baseline, 57% of patients were receiving mechanical ventilation, and 8% were receiving extracorporeal membrane oxygenation. Patients were given up to 10 days of remdesivir. Eight patients were excluded from the final analysis, largely because of missing data.

During a median of 18 days of follow-up, 68% of the 53 remaining patients had an improvement in oxygen support requirements. After finishing treatment, 13% overall had died. Some 60% reported adverse events, including elevated hepatic enzymes, diarrhea, rash, renal impairment, and hypotension.

The authors write: “Although data from several ongoing randomized, controlled trials will soon provide more informative evidence regarding the safety and efficacy of remdesivir for Covid-19, the outcomes observed in this compassionate-use program are the best currently available data.”

NEJM article; NEJM Journal Watch COVID-19 page