COVID-19 Update May 29, 2020
Grow Through What You Go Through: Telehealth Coverage MUST Be Permanent
Finally, the re-opening phase has begun for most of New York. However, for history not to repeat itself with we must reflect on those things that helped New York to get to this position. Toward the top of the list would be the swift adoption by New York physicians of telehealth models.
In mid-March through strong advocacy, the barriers to telehealth in federal, commercial, and state-sponsored insurance programs were knocked down. With persistence, even coverage for 20th century telehealth, the telephone conversation, was accomplished.
As we enter a new phase in confronting the pandemic, and preventing against a second surge, this expanded coverage for telehealth must be continued across the health insurance coverage spectrum. This is a needed tool to care for those that are ill without putting staff and other patients at risk and to see and connect with those that cannot, will not or are afraid to come out of their homes and into our offices or hospitals.
This week, the NYS legislature took a step in a positive direction and passed A.10404-A/S.8416) which expands Medicaid and CHIP coverage for telehealth to include “audio-only” services. However, much work remains. We are urging DFS to continue to require coverage by state-regulated commercial health insurance plans. Nationally, we are working with the AMA to urge CMS to make telehealth “flexibilities” permanent and to curtail commercial insurance companies from cutting telehealth coverage or subjecting it to cost sharing.
Rolling back telehealth coverage will be detrimental to patient care. We must hold our state and our nation leaders to the goal of building back smarter and growing through this experience. Permanent expansion of telehealth coverage fits that bill.
NY State DOH Pain/Opioid Course Deadline Extended Until Oct
Due to the impact of Novel Coronavirus – COVID-19 in NYS, prescribers who were due to attest or re-attest between June 30, 2020 and September 30, 2020, now have until October 1, 2020 to complete the required coursework or training and attest or re-attest.
Course is free to all MSSNY members and is available here.
The News of New York Wants Your Submissions for How You Are Faring During Quarantine!
Hello, ALL MSSNY Physicians:
Do you have a COVID-19 story to tell? This question is directed at all physicians, not just physicians who work in hospitals. Many physicians were furloughed because their patients were quarantined or afraid to go out of their homes. Many physicians have not had this much free time since college.
Did you do find interesting diversions? Were you preoccupied with worry about the future of your practice? Did you sign up for telehealth—if yes, how is the learning curve?
If possible, send photos. If you submit and do not want your name printed, tell us.
Submissions will be published in the News of New York.
Notes from Governor Cuomo’s COVID-19 Daily Briefing:
– Hospitalizations and intubations are down
– 152 new COVID cases as of yesterday
– 67 deaths yesterday (46 in hospitals, 21 in nursing homes)
– NY was hit the hardest, but we’re reopening smarter
– We test more than other states and must continue to test and trace
– A new dashboard is available showing the severity of the virus, measures
being taken in each region, and other information
– 5 regions will now begin entering Phase 2
– All office-based jobs:
– Professional services
– Administrative support
– Information Technology
– In-store shopping
– Rental, repair, and cleaning
– Barbershops and hair salons (limited services)
– Motor vehicle leasing, rental, and sales
– Real estate services
– Building and property management
– Leasing, rental, and sales services
– NYC is on track to meet reopening metrics by June 8
– Must work on the following:
– Hospital capacity remains below 70% and establishing PPE stockpile
– Testing/contact tracing being
– MTA preparing for reopening
– 400K workers will be returning to work in Phase 1
Virtual Appearance from Mayor de Blasio:
– De Blasio noted that NYC aims to be below 15% of positive COVID tests, only 5%
– A hotline will be utilized for business owners to have questions answered
– In response to a question regarding public transit, the Governor stated that the
public transportation system will be operating and would not be open if it was
– Mujica reiterated the executive order requiring masks on public transportation and
NY Businesses Can Refuse Entry to People Not Wearing a Face Covering
Under a New Executive Order, Gov. Andrew Cuomo said May 29. “People Have A Right To Jeopardize Their Own Health (I Don’t Recommend It),” Mr. Cuomo Tweeted May 29. “People Don’t Have A Right to Jeopardize Other People’s Health.” Another Tweet From The Day Before Reads, “No Mask – No Entry.”
Only 49% Of Americans Would Get COVID-19 Vaccine, Survey Shows
Only about half of Americans say that if a vaccine against the new coronavirus becomes available, they would get vaccinated, a new poll shows.
The survey was conducted May 14-18 by the Associated Press and NORC Center for Public Affairs Research at the University of Chicago, and it includes responses from 1,056 adults nationwide. Twenty percent of Americans anticipate that a COVID-19 vaccine will become available to the public before the end of the year, but if it does, only 49 percent say they plan to get it, while 20 percent say they do not plan to get vaccinated. About 31 percent said they are unsure.
Of the 20 percent of Americans who said they will not get the vaccine, most (70 percent) cited concern about its potential side effects. Another 42 percent cited concern about getting infected with the coronavirus from the vaccine. Among the 49 percent who said they will get vaccinated, wanting to protect themselves (93 percent) and their families (88 percent) were the top reasons for wanting to get vaccinated.
Clinical Leaders Most Concerned about Second Wave of COVID-19
Clinical leaders are most concerned about the possibility of a COVID-19 outbreak or second wave when it comes to resuming deferred procedures, according to a survey released by Deloitte May 27.
The Deloitte Center for Health Solutions asked 50 clinical leaders at health systems, hospitals and ambulatory surgery centers about their biggest concerns around COVID-19’s effect on deferred services. The survey was conducted during the first two weeks of May.
Deloitte found clinical leaders estimated that their elective procedure volume in April represented only 16 percent of what they normally see and returning to pre-COVID-19 volumes could take between two and six months.
While 82 percent of respondents said the possibility of an outbreak or second wave topped their list of worries around resuming elective procedures, 54 percent said low patient demand also was a big concern. Half were worried about medications, equipment, or testing.
Read the full survey results here. (Becker’s Hospital Review Leadership & Management May 28)
Blood Oxygen Levels, Inflammation Make Covid-19 Turn Critical: NYU Study Researchers at NYU Langone Health have found a pair of factors more strongly associated with critical illness from Covid-19 than the commonly cited risks of advanced age and comorbidities. Patients with inflammation and low levels of blood oxygen were most likely to have the worst outcomes, the researchers found.
The study, published in the medical journal BMJ, followed more than 5,200 patients in the city who tested positive for Covid-19 between March 1 and April 8. Slightly more than half of the patients were hospitalized. Nearly 70% of hospitalized patients were discharged, and more than 24% died or were discharged to hospice.
Risk factors for developing critical illness—besides age—include heart failure, chronic kidney disease, a body mass index greater than 40 and being male.
However, a blood oxygen level below 88% upon admission and markers of inflammation in the body were more strongly associated with critical illness than age and comorbidities, NYU said. One such marker included a substance produced by the liver in response to inflammation.
Some 53% of hospitalized patients were younger than 65.
Other findings included that the risk of critical illness and death among hospitalized patients decreased over the study period, NYU Langone said.
The findings show that physicians’ increasing familiarity with the disease might improve outcomes, even without a vaccine or proven drugs for treatment, the researchers wrote. (May 27 Crain’s Health Pulse)
House Passes Small Business Loan Tweaks That Would Help Healthcare Providers
The House legislation’s payroll tax deferral would also be a help to providers that employ highly compensated physicians, Willey said. Proskauer Rose partner Rick Zall said the extension of the time frame from eight to 24 weeks to spend PPP funds would be especially useful to physician practices that had to nearly or completely shut down due to the pandemic. “They are looking at the PPP as a bridge to be able to maintain staff and reopen promptly,” Zall said. (Modern Healthcare, 5/28)
COVID-19 Patients with Cancer: 13% of 928 Died
The AP (5/28) reports on two studies that concluded people with cancer who developed COVID-19 were more likely to die than people without cancer who developed COVID-19. Researchers found in one study published in The Lancet and which will be presented at the American Society of Clinical Oncology online conference that “half of 928 current and former cancer patients with COVID-19 were hospitalized and 13% died.” In the other study, which was also published in The Lancet, researchers in the UK found that a 28 percent mortality rate out “of 800 patients with various types of cancer and COVID-19.”
U.S. Adults Still Afraid to Go to A Hospital Over Covid-19 Fears
A new survey reinforces the fact that many Americans’ fears of contracting Covid-19 at a hospital are keeping them from seeking essential care. The new survey, conducted by the Society for Cardiovascular Angiography & Intervention, included responses from around 1,000 U.S. adults over the age of 30.
It found that 36% of respondents view going to the hospital as risky behavior, which is higher than the number who view going to a salon as risky (27%) and those who would reconsider going to the beach (16%). Asked further about going to a hospital, 61% said they felt they were somewhat or very likely to acquire Covid-19 there. Half of respondents said they were more afraid of contracting the infection than they were of experiencing a heart attack or stroke, while nearly 60% said the same about a family member.
Asymptomatic Patients With SARS-CoV-2 Shed Virus for About Eight Days, Compared With 19 Days for Those Who Have Symptoms, Study Shows
NBC News (5/27) reports, “New estimates of the number of asymptomatic people with the coronavirus suggest that ‘silent’ COVID-19 is much more prevalent than once thought – but these individuals may not spread the virus for as long as symptomatic patients do, a study from China suggests.” The report published in JAMA Network Open found “the asymptomatic patients were more likely to be women, and more likely to be younger, in their 20s, 30s and early 40s.” Furthermore, “the researchers found the asymptomatic individuals shed the virus for about eight days, compared with 19 days among those who did have symptoms.”
Support Health Equity Initiatives Through The David and Donna Marie Meza Health Equity Fund
The David and Donna Marie Meza Health Equity Fund, was established by Thomas Madejski, MD and Sandra Madejski to support health equity initiatives through the AMA Foundation. Support from this fund is focused on the AMA’s Center for Health Equity and the Foundation’s Community Health Program.
Eligible initiatives must demonstrate a commitment to addressing health disparities and promoting health equity in diverse, economically disadvantaged environments. Preference shall be given to initiatives that support health literacy and self-management.
You can make a tax-deductible donation in direct support of this fund using the form here.