MSSNYeNews: February 5, 2021 – Stressing about Increased Physician Stress


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Colleagues:

Yesterday, the New York Times published an article titled A Parallel Pandemic Hits Health Care Workers: Trauma and Exhaustion.

Physician demoralization was a problem long before COVID-19, but the pandemic has significantly exacerbated the issue taking it from a problem to an acute crisis that must be addressed.  The nationwide shortage of PPE, public and even political disregard for mask-wearing and social distancing, added home responsibilities for our children’s academic/remote learning needs, stress over remotely caring for aging parents, guilt over inadvertently infecting loved ones, death and acute and chronic illness enveloping our families and our practices are just some of the emotional and physical burdens that are crushing our collective psyche as we work long hours, often for less pay.

In January, our MSSNY convened a meeting on physician wellness with the goal of bringing together those committed to the endeavor so we could pool resources, share ideas, and break down silos.  The meeting included representatives from MSSNY, NYSDOH, Northwell Health, Bassett Healthcare, Catholic Health Services of LI, NYACP, GNYHA, NYSAFP and HANYS.  We heard about novel approaches to physician engagement through affinity groups, recharge rooms to decrease stress and increase mindfulness, and statewide seminars. MSSNY shared information about our Peer-to-Peer program which provides physicians, residents, and medical students the opportunity to talk with a peer about their life stressors.

We explained that this is a confidential discussion with a peer supporter who is trained to share experiences, listen without judgment, and validate feelings as well as offer further support, provide positive coping skills, or connect physicians to professionals for more focused assistance (P2P@MSSNY.org 1-844-P2P-PEER).  We also shared updates on the Practice Transformation Initiative which is a 5-step process aimed at providing guidance to health system leaders on how to create conditions where joy, purpose, and meaning are possible for physicians and care teams by finding strategies to optimize practice efficiencies, reduce burn out, and improve physician well-being.

The NY Times article was spot on and I hope it has been read and digested by not only all of us but also our Governor and our legislators. We will be sharing it with the entire Legislature. For us, it validates our feelings and lets us know we are not alone in our experiences.  For our elected officials this should be a wake-up call and should be kept in mind in the current budget cycle and the current legislative cycle. With a Medscape survey reporting that two-thirds of American doctors are grappling with intense burnout during the pandemic, our NYS budget should include increased funding for the Committee on Physician Health (CPH)—not the unfathomable and potentially dangerous 20% cut that is currently proposed. The proposed “OPMC Modernization” should be struck.  Removing physicians’ due process rights will only add to moral injury and burn out.

In the Medscape survey, 2/3 of respondents reported a drop in income and 1/4 reported that they had left the practice of medicine. Our State can’t afford to lose any more physicians to early retirement, career changes or suicide.  This is not the time to impose increased financial burdens on physicians by requiring them to pay 50% of the excess malpractice fund. Don’t Balance the Budget on the Backs of Physicians. This fund exists due to the long-standing dysfunctional malpractice adjudication system in NYS and our state’s failure to address the root problem by enacting malpractice reform.

The NY Times article raises the question of whether our government has done enough. We need a commitment from our elected officials that they will stand with MSSNY and promote policies and laws that support physician wellness and resilience and oppose those that add to demoralization and endanger the health and well being of our physician hero workforce.

Please make it a point to join with us in our Annual Physician Advocacy Day on March 2 – this year virtual – to help ensure your state legislators make this commitment.  This is the link to register.

Bonnie Litvack, MD
MSSNY President


Notes from Governor Cuomo’s Briefing:

COVID:

– Day 342
– Statewide Positivity rate 4.31%
– 203,627 Test results reported
– 153 deaths
– 7,937 Hospitalizations, down 30
– 1,516 ICU patients, up 10
– 1,000 Intubations, up 14
– Lowest daily positivity rate since Nov. 28th
– Lowest daily hospitalization rate since Jan 1st

Hospitalizations by Region:
– Finger Lakes: 483 (0.04%)
– Western NY:  377 (0.03%)
– Southern Tier: 232 (0.04%)
– Mid-Hudson: 919 (0.04%)
– Central New York: 182 (0.02%)
– Mohawk Valley:  199 (0.04%)
– Capital Region: 374 (0.03%)
– NYC: 3,598 (0.04%)
– Long Island:  1,382 (0.05%)
– North Country: 91(0.02%)

Positivity by Region:

– Finger Lakes: 3.30%
– Western NY: 4.69%
– Southern Tier: 1.68%
– Mid-Hudson: 5.54%
– Central New York: 2.82%
– Mohawk Valley: 3.63%
– Capital Region: 3.92%
– NYC: 5.08%
– Long Island: 5.56%
– North Country: 5.36%

– Manhattan: 3.36%
– Bronx: 6.67%
– Queens: 5.15%
– Staten Island: %
– Brooklyn 5.37%

– Gov. said NYS needs support from the federal government in order to
rebuild and recover economically

COVID Vaccine:

– 2,237,678 total doses administered
– 99.02% of allocated first doses administered
– Vaccine supply is now week-to-week
– Gov. said Vaccine hesitancy is a major obstacle stemming from concern about
side effects and distrust of the healthcare system
– 39% of New Yorkers are hesitant to take the vaccine
– Gov. described differentials by race in acceptance of vaccine within eligible groups
– Gov. said two challenges in reaching the Black community include access and acceptance
– NYS is making efforts to add mass vaccination sites in high positivity areas in Black
and Latino communities and committing to more outreach
– Yankee Stadium vaccine site opening today for Bronx residents

– 75% of hospital workers vaccinated but there are still uneven levels of vaccinations
among hospitals
– Gov. said hospitals have one more week to vaccinate their last workers
– Gov. said the state is reallocating the majority of the 1a subgroup allocation to local
health departments to vaccinate people with comorbidities beginning February 15th.
– NYS is working with the CDC to establish a comorbidities list for eligibility
– Gov. said FDA and CDC recommends not to use second dose allocations as first doses
– Johnson and Johnson filed for emergency use authorization

COVID- Variants:

– 15 new variants of interest in NYS
– 59 total UK strain cases in NYS
– UK strain is up to 70% more transmittable

UK Strain Cases by County:

– Niagara County: 1 Case
– Allegany County: 1 Case
– Tompkins County: 4 Cases
– NYC: 18 Cases
– Nassau County: 8 Cases
– Suffolk: 6 Cases
– Westchester: 4 Cases
– Ulster County: 1 Case
– Onondoga County: 1 Case
– Jefferson County: 1 Case
– Essex County: 1 Case
– Warren County: 6 Cases
– Saratoga County: 7 Cases



Capital Update


MSSNY Weekly Podcast


Join Us for MSSNY’s Virtual Lobby Day on March 2
Please plan to put aside Tuesday, March 2 for MSSNY’s Annual Physician Advocacy Day – this time Virtual!  To register, click here: Webinar Registration

The format will follow previous years formats, where assembled physicians and allies will hear from legislative leaders and MSSNY physician leaders in the morning (this year via Zoom) from 8 AM-11 AM, and then have virtual visits with their respective legislators in the afternoon (organized by their county medical societies).

With the Governor and the State Legislature needing to create tens of billions of savings to the state budget, any number of healthcare programs of interest to physicians could be on the table, not to mention concerns with the numerous problematic proposals that have already been advanced in the proposed Executive Budget including:

  • Significantly reducing physician due process when a complaint has been filed against them to the OPMC;
  • Forcing the 17,000 physicians insured through the Excess Medical Malpractice Insurance Program to bear 50% of these policies, resulting in the imposition of thousands of dollars of new costs;
  • Inappropriately expanding scope of practice for various non-physicians including pharmacists and nurse practitioners;
  • Handing insurance companies enormous new powers to limit physicians providing telehealth services to their patients

As well as voicing your support for a number of proposals including:

  • Expanding the supply of PPE
  • Regulation of Pharmacy Benefit Managers(PBMs)
  • Reducing the interest on court judgments to bring down exorbitant liability costs

Please plan to join hundreds of colleagues from around the State on March 2!


New York Times Story Captures Depth of Physicians’ Struggles During COVID While 2021 Executive Budget Proposal Fails to Address Provider Needs
A New York Times article this week (Click Here) detailed the significant impact on the medical profession in New York and across the country as a result of the pandemic.   The article notes that, since March, 3,373 healthcare workers have died from COVID19, with physicians among the top three health professions impacted and a number of studies suggest that medical professionals made up 10-20% of the deaths in the early days of the pandemic. Moreover, New York State leads the nation in deaths among healthcare professionals [1] [2]

The article notes a recent survey by Medscape which showed that 2/3 of American physicians are grappling with intense burnout from the ongoing crisis, and dramatic drops in income, with many considering early retirement, or leaving the field altogether. A quarter of respondents said their experiences with COVID had led them to exit the medical field and another survey found that 8% of physicians in the United States had closed their doors since the start of the crisis, which translates into 16,000 fewer private practices of community physicians and an inevitable decline in the quality of care.[3] [4]

Instead of proposals to help confront these challenges and protect patient access to care, physicians practicing in New York are facing significant additional challenges from the litany of adverse proposals in proposed Executive budget for FY 2022, which includes a proposal for a restructuring of the state Excess Medical Malpractice Program to require physicians to bear 50% of the cost for their medical malpractice insurance. For many physicians this equates to thousands, or tens of thousands, of dollars of new costs at a time when patient visits & revenues have dropped dramatically.

The Budget proposal also includes an unreasonable bypass of due process for physicians through the Office of Professional Medical Conduct (OPMC), a misguided expansion of Telehealth coverage that may actually harm physician practices, and huge cuts in the funding for the Committee for Physicians’ Health (CPH), among others.  The CPH program is designed to assist physicians who may be struggling with mental health issues, including stress.   An American Medical Association study on the mental health impacts and COVID-19 has shown that 52% of physicians are stressed and over 16% feel “burnout” since the pandemic began.

MSSNY is urging that all of these misguided proposals be rejected as the Legislature finalizes its State Budget for 2021-22.

To help physicians in confronting the events of the last year, last July, the Medical Society of the State of New York launched the Peer 2 Peer (P2P) program.   This program offers physicians, residents and medical students an opportunity to talk with a peer about some of life stressors.  MSSNY’s program is to assist their colleagues who are need of help in dealing with work and family stressor and with the advent of the COVID-19 pandemic, some of the emotional issues related to this event have been difficult to overcome.   Physicians, residents and students can reach out 24/7 to either 1-844-P2P-PEER (1-844-727-7337) or by email at p2p@mssny.org  to be connected to a peer.
(CARY, CLANCY)


Please Urge Your Legislators to Oppose Huge New Costs for Excess Liability Insurance
Please urge your legislators to reject an enormously adverse Executive Budget proposal that would require the over 16,000 physicians enrolled in the Excess Medical Malpractice Insurance program to bear 50% of the cost of these policies.   You can send a letter and/or tweet them from here.

This incredibly short-sighted proposal would thrust over $50 million of new costs on the backs of our community-based physicians who served on the front lines of responding to the pandemic.  For some physicians, particularly in Long Island and New York City, this could add up to tens of thousands of dollars per physician.  This new cost imposition would hit these practices at a time when many of these practices are already facing huge losses resulting from the substantial reduction in the number of patients receiving care during the pandemic.

MSSNY has joined with 16 other specialty medical societies in a letter to the entire State Legislature that expresses our strong objection to this proposal (Click Here).  Among the key points in the letter is that a recent AMA survey reported that during the pandemic the average number of in-person visits to physician offices dropped nearly in half.  As a result, physicians averaged a 32% drop in revenue since February, with about one in five doctors seeing revenue drop by 50% or more, while nearly 1/3 saw a 25%-49% decrease.

The bottom line is that the new costs this proposal would impose are simply not assumable by physicians, meaning that many physicians will face no choice but to forgo receiving this additional coverage.

[1] Click Here
[2] Click Here
[3] Click Here
[4] Click Here

It is important to remember that the Excess Insurance program exists because of New York’s disproportionately high medical liability insurance costs as compared to all other states.  The real solution to this problem is comprehensive medical liability reform, but in its absence, this program is absolutely essential to provide needed assurance to physicians that they will not risk losing everything they have worked for every time they treat a patient.  Please contact your legislators today to oppose this new cost imposition: Click Here. (AUSTER                                                                              


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Urge Your Senators and Assemblymembers to Reject Proposal to Disregard Important Physician Due Process Protections
Please urge your legislators to oppose an Executive Budget proposal that that would significantly reduce due process protections for physicians against whom a complaint has been filed with the Office of Professional Medical Conduct (OPMC), including making information public about a complaint even if no professional misconduct is found and greatly lessening the burden for imposing an interim suspension prior to the conclusion of disciplinary proceedings.   You can send a letter and/or tweet to your local legislators from here: Click Here.

MSSNY has joined with 15 other specialty medical societies in a letter to the State Legislature expressing its strong opposition to this proposal (Click Here). While New York’s physicians share the goal of assuring the State has ample power to protect the public when the conduct of a particular health care provider places patients at risk, the Commissioner already has authority to take summary action prior to the conclusion of a disciplinary hearing in the absence of a finding of misconduct.  Moreover, this proposal is stunning in light of the enormous sacrifices made by many in the medical profession over the last year, serving on the front lines in responding to the pandemic.  The proposal was rejected by the Legislature last year when it was proposed in the Executive Budget and we are urging them to reject it again.

The group letter reminds the Legislature that, while the medical community is always ready to work to address gaps in our disciplinary system to protect patient safety, this proposal is far too broad.  Most complaints to OPMC of alleged misconduct do not become actual findings of misconduct. Indeed, most complaints to OPMC do not even get so far as advancing to a formal Investigation Committee review.  According to the 2018 OPMC Annual report, while over 9,000 complaints were received by OPMC, and 8,782 complaints closed, only 210 cases resulted in the filing of actual charges. This is 2% of filed complaints that ended in actual charges.  Of greatest concern is that information released to the public, even if there is no action ultimately taken, can remain available through Google searches forever, potentially unfairly destroying a physician’s professional reputation.

Please urge your legislators to reject this grossly unfair proposal. (AUSTER)


Please Oppose Proposals That Facilitate Uncoordinated Siloed Care to be Provided by Pharmacists
Please contact your legislators to urge that they oppose several components of the Executive Budget that could upend the patient-centered medical home model and threaten patient safety by greatly expanding the scope of services provided to patients by pharmacists without coordination with patient care physicians.  You can send a letter from here: Click Here.  Please let them know these proposals would greatly enhance the power of corporate giants such as CVS and Walmart to control various aspects of patient care delivery not in coordination with but to the exclusion of community-based primary care and specialty care physicians that typically manage the care of their patients.

Specifically, these Budget proposals would 1) permit pharmacists to order various lab tests without any physician oversight and without any requirement to coordinate with the patient’s physician for follow-up care; 2) greatly expand the physician-pharmacist Collaborative Drug Therapy Program to enable pharmacists to adjust the medications provided to entire classes of patients rather than individual patients and 3) permit pharmacists the power to administer any vaccination approved by the federal Advisory Commission on Immunization Practices (ACIP), including those which may be added in the future, thereby removing the discretion of the State Legislature to make these decisions.  Some of these proposals have been rejected by the Legislature in previous Budget cycles.

All of these programs together could incentivize the development of health care silos at the expense of the patient-centered medical home model we have worked so hard to develop in New York.   It would also marginalize community-based primary care and specialty care physicians’ ability to continue to be able to manage their patients’ ongoing care needs.    Please urge your legislators to reject these measures as they finalize the State Budget for 2021-22. (AUSTER)


 

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AMA to Conduct Webinar on Mental Health and Substance Use Disorder Parity on Feb. 9
Click Here on February 9, 2021 at 2:00 PM ET on mental health and substance use disorder parity. Experts from the American Psychiatric Association, The Kennedy Forum, the Commonwealth of Pennsylvania and State of Illinois will discuss state and federal laws, including model legislation and actions taken to better enforce state parity laws.

The AMA has also developed a resource new resource that focuses on positive efforts being taken in states to help increase access to evidence-based treatment for substance use disorders, help patients with pain and support broad harm reduction efforts.  That resource can be found at: Click here

Further information on Ending the Opioid Epidemic can be found at the AMA’s microsite dedicated to ending the epidemic.          (CLANCY)


Medical Society of the State of New York (MSSNY) Teams Up With Specialty Societies to Raise Concerns with Executive Proposal to Expand Access Telehealth Coverage                                                                                                One of MSSNY’s top issues for the 2021 legislative session is securing policies to continue to expand access and coverage for Telehealth services for all New Yorkers. However, MSSNY has serious concerns about the plan included in the Executive Budget proposal for FY 2022 and teamed up recently with many of the state’s specialty societies in a letter to lawmakers expressing our concerns. To read the letter: Click Here

Among the medical societies’ primary concerns is the proposal does not include provisions to ensure providers receive payment for video, and audio-only Telehealth visits, that is on par with payments for in-office appointments. The groups’ letter also flagged the need to ensure that New York community-based physicians are not excluded from health plans’ network of physicians that provide Telehealth services and that all Telehealth policies included in private commercial insurance plans apply to public health insurance plans like Medicaid and the state health insurance Marketplace.

Prior to the onset of the COVID19 crisis, some physicians across the state had integrated Telemedicine into their practices, but the pandemic forced physicians, and other health care providers, to quickly increase their capacity to provide care remotely. A May 2020 MSSNY survey showed that 83% of the physician respondents had incorporated telemedicine into their practice, with nearly half the respondents noting that they were treating at least 25% of their patients remotely. Moreover, telehealth claim lines increased 2,938 percent nationally from November 2019 to November 2020, rising from 0.20 percent of medical claim lines in November 2019 to 6.01 percent in November 2020, according to new data announced this week from FAIR Health’s Click Here   (CARY)


Registration Now Open
Medical Matters: COVID Vaccine Update February 17, 2021 @ 7:30am
Learn more about the COVID-19 vaccine on February 17th @ 7:30am.  Registration is now open for the next Medical Matters webinar: COVID Vaccine Update.  The discussion will include the types of vaccine in development, distribution priorities and barriers surrounding vaccine administration.  Dr. William Valenti will serve as faculty.  Click here to register.

Educational Objectives:

  • Recognize the types of COVID-19 vaccine in development;
  • Discuss priorities for vaccine distribution; and
  • Identify barriers to COVID-19 immunization

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 each 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.       (HOFFMAN)


 

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MSSNY Podcasts Keep You Informed and Current
The MSSNY podcast website has reached a new milestone, 7,500 listens!  In addition to MSSNY’s weekly Update podcasts, there are numerous informative podcasts available on topics ranging from COVID-19 to emergency preparedness to vaccines.  Each podcast offers insight from medical experts on topics they are extensively well versed on.  Go here and choose one or many to listen to.       (HOFFMAN)     


 

eNews
Superbowl Advice from Dr. Fauci: “Lay Low and Cool It”
Dr. Anthony Fauci said families should not hold house parties but instead limit Super Bowl celebrations to those who live in their household. “As difficult as that is, at least this time around, just lay low and cool it,” he said on ABC’s Good Morning America. (Feb. 4)

Majority of COVID-19 Infected Have Antibodies for More than Six Months
Majority of people previously infected with COVID have high level of antibodies for at least six months, study indicates reports that almost all people “previously infected with COVID-19 have high levels of antibodies for at least six months that are likely to protect them from reinfection with the disease, results of a major U.K. study. Scientists “said the study, which measured levels of previous COVID-19 infection in populations across Britain, as well as how long antibodies persisted in those infected, should provide some reassurance that swift cases of reinfection will be rare.”
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Some Physicians Stop Testing For COVID-19, Citing Low Reimbursements
The New York Times (2/3 ) reports, “Across the country, some doctors are seeing reimbursement rates so low” for COVID-19 testing “that they do not cover the cost of the test supplies, jeopardizing access to a tool experts see as crucial to stopping the virus’s spread.” The Times adds, “Across the country, multiple doctors identified UnitedHealthcare and certain state Medicaid plans as the ones that routinely pay test rates that do not cover
the cost of supplies.”


Community-Based Physicians Seek More Vaccine Doses
The Medical Society of New York on Wednesday urged state officials to send more vaccine doses to community-based doctors so they can begin to immunize their patients.

The push from the organization comes as New York has opened pop-up sites for vaccine distribution as well as mass distribution sites at public colleges and university campuses and is opening a site at Yankee Stadium in the Bronx on Friday.

This week, Gov. Andrew Cuomo announced expanded eligibility to include restaurant workers, people in developmentally disabled facilities, and taxi drivers. Those doses will be administered through local public health departments.

The Medical Society in a statement said its members would be able to ensure communities of color are not left out of vaccine distribution, an increasingly key concern for health officials in New York. At the same time, doctors are already familiar with administering flu shots and have the ability to track who has received a shot through patient databases.

“MSSNY has long advocated for physician involvement as a COVID-19 immunizer, and many community-based private practices have already signed up to do so,” said Dr. Bonnie Litvack, the group’s president. “These individuals practice in a wide range of communities, including those that serve the Black/Brown/LatinX/Asian patient population and in the rural, urban, and suburban communities.”

Cuomo has said New York has the capacity to administer more doses than it currently receives each week from the federal government. In addition to the pop-up locations and mass distribution sites, the state has identified thousands of distribution locations for vaccine administration, including doctor’s offices and pharmacies.

But demand is outrunning supply in many areas of the state.

“We hear every day from physicians who are asking when they will be getting vaccines,” Litvack said. “Patients are requesting immunization from their physician rather than going to a POD or a pharmacy where they believe they risk greater exposure to COVID-19. Many of these physicians care for the state’s most vulnerable— seniors, those with significant co-morbidities, individuals of color, and those who speak different languages.” (Spectrum 1 NY News, Feb. 4)

Tenet Must Pay Whistleblowing Cardiologists $10M, Court Rules
Dallas-based Tenet Healthcare must pay two cardiologists who filed a False Claims Act lawsuit $10 million and reinstate their medical staff privileges for one year, a Michigan federal court ruled Feb. 1, according to Bloomberg Law.

In December, Amir Kaki, MD, and Mahir Elder, MD, who were fired from their leadership positions at Tenet’s Detroit Medical Center in October 2018, were awarded $10.6 million. The arbitration award also included reinstatement of their medical staff privileges.
The physicians, who originally brought suit in 2019 alleging violations of the False Claims Act, claimed they were ousted from their leadership positions for reporting problems affecting patient care. The court ordered the parties to arbitrate the federal claims, and the arbitrator found that Tenet acted with malice when the physicians were fired from their leadership positions and later had their staff privileges revoked, according to the Detroit Free Press.

Tenet, Detroit Medical Center, and the other named defendants tried to get the arbitrator’s award vacated in federal court. The defendants brought three main challenges to the award, and the court stated that only one — whether the arbitrator exceeded her powers — was a legitimate potential ground for vacating the award. Arthur Tarnow, a district judge for the Eastern District of Michigan, ultimately concluded that the defendants’ arguments were without merit.

The defendants are appealing the court’s order to the U.S. Court of Appeals for the Sixth Circuit. (Becker’s ‘Hospital Review, Law and Regulator Issues, Feb. 3)


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Oxford Finds COVID-19 Shot 76% Effective for 3 Months After Single Dose
Oxford University and AstraZeneca’s COVID-19 vaccine showed in a study it had 76% efficacy against symptomatic infection for three months after a single dose, which increased if the second shot is delayed, backing Britain’s vaccine rollout policy.
The findings of the paper, published ahead of peer-review by Preprints with The Lancet, supported Britain’s decision to extend the interval between initial and booster doses of the shot to 12 weeks, Oxford said on Tuesday.

However, the new study did not address concerns about a lack of data on efficacy among the oldest, whom the British government have given highest priority in its vaccine rollout.
Andrew Pollard, Chief Investigator of the Oxford Vaccine Trial, said the data showed the 12-week interval between doses was “the optimal approach to roll out, and reassures us that people are protected from 22 days after a single dose”.

Britain has decided to vaccinate as many people as possible as quickly as possible by lengthening the amount of time between initial shots and booster shots to tackle the COVID-19 pandemic.

AstraZeneca’s research chief has said 8-12 weeks between doses seems to be the “sweet spot” for efficacy, contrasting with U.S. drugmaker Pfizer, which has warned that the vaccine it has developed with Germany’s BioNTech was not trialled with such an interval.
The results for the AstraZeneca/Oxford vaccine, gathered from trials in Britain, Brazil, and South Africa, showed that immune responses were boosted with a longer interval to the second dose among participants aged 18 to 55 years.

“Vaccine efficacy after a single standard dose of vaccine from day 22 to day 90 post vaccination was 76%, and modeled analysis indicated that protection did not wane during this initial 3-month period,” Oxford academics said in the preprint.

The paper said that vaccine efficacy was 82.4% with 12 or more weeks to the second dose, compared to 54.9% for those where the booster was given under 6 weeks after the first dose.

The longest interval between doses for those aged 56 and over was between 6-8 weeks, so there was no data for the efficacy of a 12-week dosing gap in that cohort.
Europe’s medicine regulator has flagged that there is not enough data to determine how well the vaccine will work in people aged over 55, but Britain has expressed confidence the vaccine works in all age groups.

The study said that no-one out of the 12,408 people vaccinated with a single dose of the vaccine was hospitalized with COVID-19 from 22 days after immunization.
Oxford also said data seemed to suggest the vaccine reduced transmission of infections, with a 67% reduction in positive swabs among those vaccinated in the British arm of the trial.

SOURCE: https://bit.ly/3apMSyt Preprints with The Lancet, online February 1, 2021.


NY Supreme Court Rules in Favor of Empire Center for Nursing Home Info
The Empire Center today won a court ruling requiring the prompt release of full coronavirus death tolls in New York nursing homes. The decision by state Supreme Court Justice Kimberly O’Connor requires the Health Department to provide the requested records within five business days and compensate the Empire Center and its legal counsel for their litigation expenses. The center was represented in the case by the Government Justice Center.

The Empire Center requested the records under the Freedom of Information Law on Aug. 3. The Health Department had postponed responding three times, mostly recently until March 22—a delay of more than seven months.

Justice O’Connor addressed the delays in her ruling: “DOH does not, in the Court’s opinion, offer an adequate explanation as to why it has not responded to that request within its estimated time period or to date… The Court is not persuaded that the respondent’s estimated date for responding to Empire Center’s FOIL request is reasonable under the circumstances of the request.”

The state has been collecting comprehensive infection and mortality data from nursing homes throughout the pandemic but sharing only a partial death toll with the public. Its reports exclude residents who were transferred to hospitals before dying, a practice used by no other state.

Last week, in response to a critical report on nursing homes from the state attorney general’s office, Health Commissioner Howard Zucker revealed that almost 4,000 nursing home residents had succumbed to COVID-19 in hospitals, boosting the total nursing home toll to almost 13,000.

That one-day total represents a tiny fraction of the data the Department is now obliged to release, which would include the number of deaths in each facility on each day since the start of the pandemic.

For more background on Empire Center vs. New York State Department of Health, go to empirecenter.org/nursinghomes.


Study: Biggest Spreaders of Coronavirus in U.S. are Adults Aged 20 to 49,
reports that research “suggests that the biggest spreaders of coronavirus in the U.S. are adults aged 20 to 49.” CNN adds, “Children accounted for very little spread, the researchers said, as did older adults.” Investigators came to this conclusion after using “cell phone location data covering more than 10 million people and publicly available information on the spread of the virus to calculate which age groups were most responsible for the spread of the virus across most of the U.S.” The study was published in Science.

Top 10 Preventable Medication Errors from Last Year
Prescribing extended-release opioids to patients who are not educated about the addictive drugs’ effects was the top preventable medication error in 2020, according to the Institute for Safe Medication Practices.
The Institute for Safe Medication Practices on Jan. 27 released its list of the top 10 medication errors from 2020, selecting errors and hazards that have not only been consistently reported, but also can be avoided or minimized through operational improvements.
The 10 preventable medication errors:
1. Prescribing, dispensing, and administering extended-release opioids to patients who are opioid-naïve.
2. Not using smart infusion pumps with dose error reduction systems in perioperative settings
3. Oxytocin errors
4. Hazards resulting from infusion pumps being positioned outside of COVID-19 patients’ rooms
5. COVID-19 vaccine errors
6. Use of the “syringe pull-back” verification method during pharmacy sterile compounding
7. Combining or manipulating commercially available sterile products outside a pharmacy
8. Medication loss in the tubing when administering small-volume infusions with a primary administration set
9. Intraspinal injection errors with tranexamic acid

10. Use of error-prone abbreviations, symbols, or dose designations


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