COVID-19 Update April 15, 2020


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April 15, 2020 Latest COVID-19 Statistics
10,834 – The number of people who have died of coronavirus in New York state, as of the morning of April 14.

11,568 statewide deaths as of Wednesday morning, including 752 more fatalities in the past day. Statewide and county-by-county totals haven’t yet been updated, which Gov. Andrew Cuomo suggested had to do with new reporting requirements from the Centers for Disease Control and Prevention. New York City, for example, added nearly 4,000 deaths to its total overnight by including “probable” deaths and not just confirmed deaths. As of Tuesday, New York City reported 10,367 deaths from the coronavirus. As of Wednesday, 18,335 New Yorkers were hospitalized with the coronavirus, and 5,205 were in intensive care units. For more numbers, including the latest statewide and borough-by-borough statistics, click here.


Gov. Cuomo’s Daily Press Conference Highlights

COVID-19 GENERAL:

– Gov reiterates that he’s not interested in retrospectives at this point.
– Gov did state that if he could, he’d go back to December/January.
– On NY specific, “There is no state that moved faster.” From time of
first case to total shut-down, NYS was the quickest –9-day period.

MASKS EXECUTIVE ORDER:

– Any situation in public where you cannot maintain social distancing (6
ft.): public transit, crowded streets
– Possibility for a civil penalty, local gov’ts would enforce, but doesn’t
want to get to a penalty, yet. If people don’t follow, there might be a
penalty in the future.  Looking for self-enforcement from public.
– Any coordination with the City?  Coordinate as much as possible with
local gov’ts and partner states.  Local gov’ts can have their own rules,
but they can’t conflict with the state.  If there’s a conflict, state laws
govern.
– Question on forceful removal from public transport if mask refused to be
worn. Gov states that we’re not there yet and transitioned into
compliance with stay at home initiative.  “How can you not wear a mask?”
given the facts.

TESTING:

– Coordination with the City?  DeRosa – City is looking to acquire swabs and
vials, etc.  Gov is looking to increase testing capacity in labs, all
aspects, hoping to reduce competition between purchasers and organize
efforts of gov’ts, and companies.
– How do we get the supply chain up – Fed Govt.

NOTES:

– State will begin reporting all categories of fatalities pursuant to new
CDC guidelines.  “Probable deaths” will be included.  State contacting
facilities to get updated numbers.
– State looking to get reports of COVID deaths outside of hospitals
and nursing homes.

In three days, New Yorkers will be required to wear a mask or face covering when going out in public and unable to maintain six feet of social distancing in order to halt the spread of the coronavirus pandemic, Gov. Andrew Cuomo on Wednesday said. For now, no fines will be issued for not wearing a mask, but local governments will be enforcing the order. 

Masks — either medical grade facemasks or cloth masks that can cover a nose and mouth — will be required to wear in crowded public areas like mass transit. 

Masks will be required in “any situation in public where you cannot maintain social distancing,” Cuomo said.


Interim Guidance on Executive Order 202.16 Requiring Face Coverings for Public
and Private Employees Interacting with the Public During the COVID-19 Outbreak


9,000+ Healthcare Workers Have Contracted COVID-19: 6 CDC Findings
More than 9,000 healthcare employees have contracted COVID-19 in the U.S., according to CDC data released April 14.

CDC researchers analyzed data on 315,531 laboratory-confirmed COVID-19 cases reported nationwide between Feb. 12 and April 9. The agency identified 9,282 cases known to involve healthcare professionals. The CDC noted this figure is likely underestimated, since healthcare employee status was only available for 16 percent of cases reported nationally.

Six report findings:

  1. The median age of sickened healthcare professionals was 42, and 73 percent were female.
  2. About 38 percent had at least one underlying health condition.
  3. Among healthcare professionals with available data on exposure, 55 percent said they only had contact with COVID-19 patients in healthcare settings.
  4. Ninety-two percent of healthcare professionals reported having fever, cough or shortness of breath. The remainder did not have these symptoms.
  5. A majority (90 percent) did not require hospitalization, but severe illness occurred among all age groups.
  6. The CDC received reports of 27 deaths among healthcare professionals during this time period, most commonly occurring in individuals 65 and older.
    Becker’s Hospital Review, April 15)

Practices Report 60% Average Decrease in Patient Volume
Practices report a 60% average decrease in patient volume and a 55% average decrease in revenue since the beginning of the public health emergency, an MGMA survey finds.

Ninety-seven percent of physician practices have experienced a negative financial impact from COVID-19, finds a new Medical Group Management Association survey.

The financial impact is both directly and indirectly related to the outbreak, the survey said. Specifically, practices report a 60% average decrease in patient volume and a 55% average decrease in revenue since the beginning of the public health emergency.

In addition, many practices have started furloughing and laying off employees, and more plan to do so as the weeks and months of crisis drag on, respondents said.

Because of the revenue and volume declines, 48% of respondents have temporarily furloughed staff, and 22% have permanently laid off staff. By May, those numbers are projected to increase to 60% for furloughs and 36% for layoffs, according to MGMA.


Clarification on Attestations for $100 billion CARES Act Health Care Provider Pool
Concerns were raised Friday when the initial HHS Emergency Fund grants were released that, in agreeing to the terms and conditions of the grants, physicians were being required to attest that they diagnose, treat, or test patients for COVID-19. The AMA brought these concerns to the Secretary’s office and HHS committed to posting some clarifying language. HHS has now modified some of the language to make its meaning clearer, as follows, stating that every patient is a possible case of COVID-19.

The website at https://www.hhs.gov/provider-relief/index.html now includes the following statement:

If you ceased operation as a result of the COVID-19 pandemic, you are still eligible to receive funds so long as you provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. Care does not have to be specific to treating COVID-19. HHS broadly views every patient as a possible case of COVID-19.

​Also, the second provision of the Terms and Conditions has been changed to no longer say providers attest to “currently” taking care of patients, just that they did so after 1/31/2020:

The Recipient certifies that it billed Medicare in 2019; provides or provided after January 31, 2020 diagnoses, testing, or care for individuals with possible or actual cases of COVID-19; is not currently terminated from participation in Medicare; is not currently excluded from participation in Medicare, Medicaid, and other Federal health care programs; and does not currently</a have Medicare billing privileges revoked. (American Medical Association)


CNN: Social Distancing in the US May Have To Be Endured Until 2022 if No Vaccine is Quickly Found, Scientists Predict
“Intermittent distancing may be required into 2022 unless critical care capacity is increased substantially or a treatment or vaccine becomes available,” they wrote in their report. “Even in the event of apparent elimination, SARS-CoV-2 surveillance should be maintained since a resurgence in contagion could be possible as late as 2024.” The Harvard team’s projections also indicate that the virus would come roaring back fairly quickly once restrictions were lifted. “If intermittent distancing is the approach that’s chosen, it may be necessary to do it for several years, which is obviously a very long time,” Dr. Marc Lipsitch, an author on the study and an epidemiology professor at the Harvard School of Public Health, told reporters. That’s according to researchers from the Harvard T.H. Chan School of Public Health, who published their findings in the journal Science on Tuesday.(CNN 4/15)


New York City’s Death Toll Jumps by More Than 3,700 After Officials Take into Account Probable Cases
“Behind every death is a friend, a family member, a loved one. We are focused on ensuring that every New Yorker who died because of COVID-19 gets counted,” said Health Commissioner Dr. Oxiris Barbot. The revised numbers hint at how much the country has likely under-counted deaths. The U.S. recorded its deadliest day on Tuesday

The US recorded its highest number of coronavirus deaths in a day after several days in which the death toll had fallen or was nearly flat. The daily death toll was 2,405 on Tuesday, according to Johns Hopkins University’s tally of cases, bringing the total number of US deaths to 26,033. At least 609,240 people have been infected with the virus in the US.


Trump’s Decision to Cut Off WHO Funding Draws Swift Push Back From AMA
“During the worst public health crisis in a century, halting funding to the World Health Organization is a dangerous step in the wrong direction that will not make defeating COVID-19 easier,” American Medical Association President Patrice Harris said.


New York AG Files Suit Against Dept. of Labor Paid Sick Leave Rule
Yesterday, New York Attorney General Tish James sued the Labor Department, alleging its rule governing emergency family leave and paid sick leave could have “devastating consequences for New York and its residents.”

The final rule, published earlier this month, implements the paid leave and paid sick leave provisions in the Families First Coronavirus Response Act, the second of two bills Congress passed last month to combat the coronavirus pandemic. The bill requires businesses that employ fewer than 500 people to offer employees up to two weeks’ sick leave at full pay and up to 10 weeks’ family leave at two-thirds’ pay to address the pandemic. Employers may offset the costs by suspending employee tax withholding.

DOL’s guidance placed certain restrictions on access to the temporary program, including a requirement that workers first receive a requirement that workers first receive a medical diagnosis or advice from a health care provider. “The paid sick leave and emergency family leave provisions of the FFCRA were enacted to protect public health and to provide economic security to working families,” James said in an emailed statement. “The Trump Administration’s rule makes it harder for New Yorkers and Americans throughout the country to claim these paid benefits, which unnecessarily puts more workers at risk of exposure to COVID-19.”

James also filed a motion for summary judgment in the same court, the U.S. District Court for the Southern District of New York. (Politico)


MLMIC Offers 24/7 Legal Hotline
Due to the minute by minute changes regarding COVID-19, MLMIC is keeping our insureds informed via email blasts, our website, blog, as well as through our social media accounts via Twitter and Linked In.

For those insureds who face challenges to their practice due to COVID-19, MLMIC is offering the following:

  • MLMIC’s toll free 24/7 Legal Hotline – (855) FAKS-LAW (1-855-325-7529) can help address many questions or concerns that may arise.
  • Our staff remains directly available via phone (800) ASK-MLMIC(1-800-275-6564) and every effort will be made to handle inquiries and answer questions regarding claims, coverages and policies on an immediate basis.
  • Blog:  Guidance on Using Telemedicine for Coronavirus – click here

COVID-19 WEBINAR

COVID-19 for Office-Based Physicians: How to Handle Surge & Psychological First Aid”
CME Webinar on April 29th – Registration Now Open

MSSNY announces a new webinar related to the COVID-19 pandemic, Medical Matters: COVID-19 for Office-Based Physicians: How to Handle Surge & Psychological First Aid on April 29th at 7:30am. Faculty for this program is William Valenti, MD and Craig Katz, MD.

Registration is now open for this webinar.

Educational objectives are:

  • Explore the role of office-based physicians during the COVID-19 pandemic
  • Describe surge preparedness procedures for infectious disease outbreaks
  • Identify wellness and resiliency strategies to use during infectious outbreaks

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 and Medical Matters: Psychosocial Dimensions of Infectious Outbreaks recorded on April 1, 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.