eMSSNY eNews June 26, 2020 – Peer to Peer Support Goes Live July 6

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MSSNY Peer to Peer (P2P) Goes Live: We’re Here for You
Starting Monday, July 6, 2020, the Medical Society of the State of New York will offer physicians, residents, and medical students the opportunity to talk with a peer about their life stressors.  MSSNY’s Physician Wellness and Resiliency Committee has launched the long-awaited MSSNY Peer to Peer (P2P) program. We hope that colleagues will reach out to peer supporters to discuss daily stressors such as work, school, family, or financial issues.  With the advent of COVID-19 pandemic, there may also be some additional stress in our colleagues’ lives.

The P2P program is an opportunity for our colleagues to have a one-time confidential discussion with a peer supporter.  The peer supporter is a trained professional who can share experiences, listen without judgment, and can validate your feelings and provide you with Support, Empathy and Perspective.  Peer supporters can also provide information on specific organizations that can support you and will provide you with positive coping skills.  They can also help connect you to professionals should you need more focused assistance.

Any physician, resident, or medical student who wishes to chat with a peer supporter, may contact the Medical Society of the State of New York in the following ways:

• Email your request to P2P@mssny.org to be connected with a peer supporter.
• Or you can call MSSNY at (518) 465-8085, ext. 321 and request that you be connected with a peer supporter. The line is answered by MSSNY staff during regular business hours (Monday – Friday, 8:30-5 p.m.) After 5 p.m., the call will be answered by a live answering service that will take down your contact information and MSSNY staff will subsequently follow-up with you.
• All calls and emails will remain strictly confidential.

It is well documented that physicians, residents, and medical students have enormous stressors that can range from the emotions arising in the context of patient care to the demanding environment in which we practice medicine.   Now, with the COVID-19 pandemic added into the mix, those stressors may be exacerbated.

Please know that whatever your situation, you are not alone.  MSSNY P2P is here to help.  Our trained peer supporters are ready, willing, and able to take time to talk with you.  Please reach out to us. We truly care about you and the difficult issues that you face.

The words “Be Well” apply to all of us.

Bonnie Litvack, MD
MSSNY President

NYS DOH COVID-19 Tracker

Daily US Cases Hit New High; White House Reconvenes Task Force
The U.S. reported more than 41,000 new COVID-19 cases June 25, the nation’s highest count since the pandemic began, according to data from Johns Hopkins University. The count surpassed previous records of 36,880 cases June 24 and 36,739 cases confirmed April 24, according to The New York Times.

At least 20 million Americans may have had COVID-19, according to a new CDC estimate cited by NBC News. The estimate is based on an analysis of blood samples from patients nationwide. “Our best estimate right now is that for every case that’s reported, there actually are 10 other infections,” CDC Director Robert Redfield, MD, said June 25.

The coronavirus task force is set to reconvene today for its first briefing since April 27, White House officials told The New York Times. Task force members are expected to share new data from areas seeing a surge in cases.

On Wednesday, the State tested 67,642 people. Of those tested, 749, or 1.1%, were positive.

Nationwide, Coronavirus Cases up 30% Compared to Beginning of June
There are 26 states seeing daily COVID cases increase over the past week. New York State is one of the exceptions. The travel advisory is now in effect for people arriving to New York, New Jersey and Connecticut from hotspot states.

US Aim: ‘Take Flu Off The Table’ In Preparation For Second Wave of Coronavirus
Drugmakers are making millions of extra flu shots this year in preparation for a possible second wave of COVID-19 during the annual flu season, and in a rare move, the CDC has bought 7 million doses directly from them. The CDC usually buys about 500,000 doses of the flu shot to distribute to states but has spent $100 million to buy 7 million doses and has given $140 million to immunization programs across the U.S. to boost adult flu vaccination. Drugmakers are planning to boost production by about 10 percent to make 189 million doses this year, up from 170 million last year. Public health experts are expecting an “unprecedented” number of people to get a flu shot this year, according to the Post.

Experts have said lowering the number of people who catch the flu could free up critical hospital space to handle a potential second wave of COVID-19. Health officials are especially concerned about people at higher risk for both COVID-19 and the flu, the Post reported, such as residents and employees at long-term care facilities, African Americans, Hispanics, and people with comorbidities. Read the full article here.

Hospitalized COVID-19 Patients May Be More Prone to Major Organs Clotting
Modern Healthcare (6/25) reports, “Hospitalized COVID-19 patients may be more likely to develop clotting in their major organs, which researchers say may explain why some with the virus suffer heart attacks despite having no prior coronary damage.” According to findings published in the Lancet, “a series of 18 autopsies performed on NYU Winthrop Hospital patients who tested positive for COVID-19 discovered abnormal clotting and deposits of cells and proteins that cause clots in small blood vessels in their hearts, kidneys, lungs and livers.” Moreover, “clotting was also found in the heart veins rather than arteries, causing heart muscle damage.”

Five Regions of New York Are on Track to Enter Phase 4 of Reopening Today
The metrics in the Finger Lakes, Central New York, Southern Tier, Mohawk Valley, and the North Country continue trending in the right direction. Phase 4 permits indoor religious gatherings at 33% of capacity and allows low-risk indoor and outdoor arts and entertainment, film and TV production and professional sports without fans. Read more about Phase 4 here.

• Social gatherings of up to 50 people will be allowed as part of Phase Currently, gatherings of up to 25 people are permitted in regions that are in Phase 3.
• A note on malls, movie theaters and gyms. These industries are unusually risky from a health standpoint. The State is undertaking further study to ensure they make informed decisions before reopening these businesses.

The total number of COVID hospitalizations continues to decline. Total hospitalizations fell to 1,071, from 1,104 the previous day. Sadly, 17 people in New York died due to COVID-19 (June 24)

On June 23, the State tested 51,144 people. Only 581, or 1%, were positive.

MSSNY’s Weekly Podcast

WHO Outlines COVID-19 Vaccine Distribution Plan
The World Health Organization has laid out a proposal for the distribution of  COVID-19 vaccines and said over 4 billion doses will be needed to vaccinate the world’s priority populations, Politico reported. In a document presented to WHO member countries June 18, the organization said the allocation framework’s goal should be to reduce COVID-19 deaths and to protect health systems.

The WHO said three groups should be prioritized to receive vaccines: healthcare workers, adults over 65 and adults with comorbidities including cancer, cardiovascular disease, and obesity. All countries should receive an initial shipment of vaccines, but the formula for how many vaccines each country will receive can change to reflect the prioritization of a specific region or a shifting risk assessment of a country’s vulnerability and COVID-19 threat, according to Politico. Read the full article here.

Physicians, Do You Use Telemedicine?
CMS has asked MSSNY for a listing of physicians who do Telemedicine. They have heard from a numbers of community health care groups for seniors that some patients are hesitant about calling their physicians about needed appointments since they are fearful of having to go to the doctor’s office.

CMS is asking for MSSNY’s assistance for two reasons:

• The first is to alert patients in communities where physicians can provide virtual care during this pandemic.
• Second, regarding forward thinking, it would be helpful for CMS to know which and how many physicians can provide telemedicine. This information would be useful in making the argument of continuing the expanded telemedicine coverage in a post pandemic future.

If you can provide telemedicine, please provide MSSNY with your name, address, specialty, phone and NPI number. This information will be added to MSSNY’s website and shared with your county societies.  CMS would also help in disseminating the information to the patient community. Send info to rmcnally@mssny.org

Monday June 29, 2020 @ 7:30am Medical Matters CME Webinar Registration Now Open Questions & Answers Surrounding the COVID-19 Pandemic
Be sure to register now for MSSNY’s next webinar related to the COVID-19 pandemic.  Medical Matters: Questions & Answers Surrounding the COVID-19 Pandemic on Monday June 29^th at 7:30am. Faculty for this program is William Valenti, MD, Arthur Cooper, MD, Marcus Friedrich, MD and Elizabeth Dufort, MD.

Educational objectives:

• Identify frequently asked questions surrounding the COVID-19 pandemic

• Examine the dynamic circumstances encompassing COVID-19

Click here to register

To view the companion pieces to this webinar, be sure to go here or go to the MSSNY podcast site and listen to the COVID-19 related podcasts available 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.

CMS Rule Promotes Payer Drug Price Negotiations Based on Clinical Outcomes
CMS issued a proposed rule June 17 that would make it easier for Medicaid to make payment models based on a drug’s clinical value.

Current regulations make it hard for drugmakers to report payments under value-based arrangements to the agency. The regulations hinder payers and drugmakers from designing new payment arrangements based on the value a drug provides to a patient and leads to prices based on the quantity of drugs sold rather than the quality of the drug, CMS said.

“CMS’s rules for ensuring that Medicaid receives the lowest price available for prescription drugs have not been updated in thirty years and are blocking the opportunity for markets to create innovative payment models,” said CMS Administrator Seema Verma. “By modernizing our rules, we are creating opportunities for drug manufacturers to have skin in the game through payment arrangements that challenge them to put their money where their mouth is.”

The new proposed rule seeks to modernize regulations to encourage innovation and encourage states, private payers and drugmakers to pay for prescription drugs based on clinical outcomes. Basing payment on clinical outcomes could foster innovation and reduce overall healthcare spending and hospital visits, CMS said.

Read the full news release here.

CMS Announces Relief for Clinicians Participating in the Quality Payment Program in 2020
In response to the 2019 Coronavirus (COVID-19) public health emergency, CMS) is announcing flexibilities for clinicians participating in the Quality Payment Program (QPP) Merit-based Incentive Payment System (MIPS) in 2020:

• Clinicians significantly impacted by the public health emergency may submit an Extreme & Uncontrollable Circumstances Application to reweight any or all of the MIPS performance categories. Those requesting relief via the application will need to provide a justification of how their practice has been significantly impacted by the public health emergency.
• Reminder: In April, CMS added a new COVID-19 clinical trials improvement activity. There are two ways MIPS eligible clinicians or groups can receive credit for this new improvement activity:
  • A clinician may participate in a COVID-19 clinical trial and have those data entered into a data platform for that study; or
  • A clinician participating in the care of COVID-19 patients may submit clinical COVID-19 patient data to a clinical data registry for purposes of future study.

For More Information

• Visit the QPP COVID-19 Response webpage or review the COVID-19 Fact Sheet to learn more about changes to the Quality Payment Program in response to the COVID-19 pandemic.

Veterans Matters Podcasts
Check out MSSNY’s Veterans Matters podcast series on Veterans’ healthcare topics including PTSD in Returning Veterans, TBI in Returning Veterans, Substance Use in Veterans, Suicide in Veterans, The Special Mental Health Needs of Women Veterans and Military Culture: Everything Physicians Need to Know about Veterans as Patients.

Click here to listen to Part 1 of PTSD in Returning Veterans with Dr. Frank Dowling.

Click here to listen to Part 2 of PTSD in Returning Veterans with Dr. Frank Dowling.

Click here to listen to TBI in Returning Veterans with Dr. David Podwall.

Click here to listen to Substance Use Disorders with Dr. Thomas Madejski.

Click here to listen to Suicide in Veterans podcast with Dr. Jack McIntyre.

Click here to listen to The Special Mental Health Needs of Women Veterans with Dr. Malene Ingram, Colonel, U.S. Army Reserves and Retired Chief Master Sergeant, U.S. Air Force, Marcelle Leis.

Click here to listen to Military Culture: Everything Physicians Need to Know about Veterans as Patients with Retired Lieutenant Colonel, U.S. Army, Lance Allen Wang and Retired Chief Master Sergeant, U.S. Air Force, Marcelle Leis.

MSSNY Helpline for Physicians Experiencing COVID-19 Related Stress 518-292-0140