MSSNY eNews: July 8, 2020 – Testing Capacity: Went from 400 maximum Per Day to Current 57,000

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Gov. Cuomo’s Press Briefing Today
– Gov. stated school re-openings still being examined, finalized guidance will be provided on July 13th

– Schools will submit reopening plans by July 31st

– State will announce decision on school re-openings between Aug. 1-7

– Gov. said all County Fairs cancelled until further notice

– Malls can begin re-opening in Phase IV on July 10th, provided air filtration system is in place

FEDERAL RESPONSE:

– Gov. stated school re-openings are not determined by the President and are a state decision

– Gov. said projections now show an additional 15,000 deaths nationwide by October

– Projections suggest an additional 45,000 deaths nationwide without use of masks

Q&A:

– Gov. said plans will be submitted, alterations made accordingly, and then will be either accepted or declined

– Follow-up: if based on today’s data would a decision to reopen be made?

Gov. stated decision cannot be made based upon current data, will be made first        week in August

– Gov. said decision may differ based upon region and infection rates

– Gov. stated we are “better than we hoped to be” currently, but infection rate can change before August

– Asked about President’s tweet about cutting off aid to states. Gov. stated President’s claim is “not constitutional”

– Jim Malatras, Director of State Operations, added that a commission is discussing reopening with labor relations, superintendents, school transportation to make a determination

– Asked about backlog in federal laboratories in testing. Gov. stated national laboratories are getting overwhelmed, and provide back-up testing for NYS, but they process only 30% of NY’s testing

– Cuomo aide DeRosa added that NY has network of 215 labs, turn-around time is 2-3 days for tests, patients can opt to utilize these labs instead

– Gov. reiterated need to change relationship between police and communities

– Follow-up on increased backlog in labs and if can state increase capacity

– Gov. responded that he does not believe there is any avenue to increasing testing further. Gov noted capacity went from 400 maximum per day at beginning of pandemic to current 57,000

– Asked how private schools will handle reopening. Malatras said private and charter schools will also submit plans. Public schools often provide transportation to private schools, he expects public schools to work with private schools on plans. Malatras stated when collaboration is not occurring, the state will assist in facilitating cooperation

– Asked about air filtration in HVAC systems in schools. Gov. stated this is also being looked at. It depends on the type of HVAC system a school has and if it can utilize the right type of filter.

MSSNY Raises Concerns about Lag Time in Covid-19 Lab Tests
MSSNY has reached out to the New York State Health Department to raise concerns brought by some physicians that certain labs processing Covid-19 tests in some parts of the State, including one of the national lab companies, are reporting that it will take them over a week to complete and report testing results.

What makes this particularly challenging for patients is that NYSDOH protocols for elective surgery require a negative Covid-19 test to be received within 5 days of the procedure.  This means that some patients in need of medical care may not be able to receive the care they need.

An article in today’s New York Daily News noted “some test results are taking a week or longer to reach patients”.  During the Governor’s press briefing today, he noted that national laboratories are getting overwhelmed, but they process only 30% of New York’s testing.  The Governor’s chief of staff also added that, as New York has a network of 215 labs performing tests with the typical turn-around time of 2-3 days for tests, patients could opt to use these other labs instead.

MSSNY will continue to keep members alerted as to the status of our efforts to ensure testing results will be returned promptly.

Health Advisory: Revised Protocols for Personnel in Healthcare and Other Direct Care Settings to Return to Work Following COVID-19 Exposure or Infection American Academy of Pediatrics, American Academy of Family Physicians, American College of Physicians and American Medical Association

TO: All Healthcare Settings, except Nursing Homes, including but not limited to Hospitals, Adult Care Facilities (ACFs), End Stage Renal Disease (ESRD) Facilities, Emergency Medical Services (EMS), Home Care, Outpatient Clinics, and Private Practices

Revised Interim Guidance: Protocol for COVID-19 Testing Applicable to All Health Care Providers and Local Health Departments.

State Says 1 in 4 Nursing Home Workers Were Infected with COVID-19
A State Department of Health analysis examining how Covid-19 spread within nursing homes concluded that the disease spread from staff members at those facilities to vulnerable patients. The report found that 37,500 nursing home workers, about 1 in 4 statewide, were infected with Covid-19 between March and early June, and more than one-third of nursing home residents had the virus during that time.

The state sought to investigate the factors leading to the deaths of about 6,400 nursing home residents from either confirmed or suspected cases of Covid-19. The report also looked at whether the Cuomo administration’s March 25 directive to nursing homes to accept Covid-19 positive patients contributed to fatalities.

A survey conducted by the state showed about 6,300 Covid-positive patients were admitted to 310 skilled-nursing facilities across the state from March 25 to May 8. Of those homes, 252 already had a patient with suspected or confirmed Covid-19 before one was transferred from a hospital.

The report said the timing of the peak in nursing home deaths on April 8 supports its theory that transmission from staff was the main driver as the highest number of staffers reported symptoms on March 16. That timeline aligns with findings that most patients who die from the disease do so in 18 to 25 days on average.

Meanwhile, the highest number of transfers from hospitals to nursing homes occurred on April 14, which was after the peak in nursing home mortality, according to the report.

The department said it suspects visitors to nursing homes, who were allowed to enter facilities until March 13, might also have transmitted the virus but doesn’t have data to support the assumption.

It said investigations by the department and the state Attorney General into whether nursing homes accepted patients they were unable to care for are ongoing.

“The data shows that the nursing home residents got COVID from the staff, and presumably, also from those who visited them,” said Dr. Howard Zucker, the state health commissioner. “Unfortunately, we did not understand the disease early on, we did not realize how widespread it was within our community, and therefore, it was able to be introduced into a vulnerable population.” (Crain’s, 7/7)

NY Nurses Union Files Unfair Labor Charges, Seeks Data on Infected Workers
A union representing 42,000 nurses in New York state is urging several hospitals to provide COVID-19 data on healthcare workers, according to The Wall Street Journal. The New York State Nurses Association filed labor charges July 7 with the National Labor Relations Board regional offices, seeking this information from hospitals in New York City-based Mount Sinai and New York-Presbyterian health systems, the newspaper reports. Labor charges also were filed against Interfaith Medical Center, Kingsbrook Jewish Medical Center and Wyckoff Heights Medical Center, all in New York City.

By filing the labor charges, the union said it seeks to get a clearer picture of how many healthcare workers in New York City have been infected with COVID-19 since early March and prepare for a potential second wave, according to the Journal. Numbers it wants include how many union nurses reported COVID-19 symptoms, received tests, and tested positive. It also wants to know how many union workers have been off work sick for any amount of time during the pandemic.

In a separate labor charge filed July 7, the union seeks data on nurse infections from Valhalla, N.Y.-based Westchester Medical Center. But the newspaper said obtaining such information may be challenging partially due to testing shortages early during the pandemic.

The union estimates at least 22 New York State Nurses Association members have died of COVID-19, and data provided to the union shows more than 2,000 New York City healthcare workers have been sickened or had to leave work at two hospital systems for reasons related to the pandemic. A spokesperson for Westchester Medical Center, told the Journal in an email: “Our staff has tested positive for COVID-19 at a level consistent with or lower than community spread.” The spokesperson added that “our practices (and these statistics) have been shared with NYSNA repeatedly, both informally and formally.”

A spokesperson for Interfaith Medical Center told the newspaper the hospital expects to comply with the union’s request for information. Mount Sinai, New York-Presbyterian and the other hospitals didn’t immediately provide comment to the publication. This is not the first time the union has taken legal action during the pandemic. The union also filed three lawsuits against the state and two hospitals in April, alleging they failed to provide adequate protection for healthcare workers treating COVID-19 patients. (Becker’s Hospital Review, July 8)

Statement on Official Withdrawal of U.S. from the World Health Organization
The following statement is attributable to AAP President Sally Goza, MD, FAAP, AAFP President Gary L. LeRoy, M.D., AMA President Susan R. Bailey, M.D., and ACP President, Jacqueline W. Fincher, MD, FACP

“The Trump administration’s official withdrawal from the World Health Organization (WHO) puts the health of our country at grave risk. As leading medical organizations, representing hundreds of thousands of physicians, we join in strong opposition to this decision, which is a major setback to science, public health, and global coordination efforts needed to defeat COVID-19.

“The WHO plays a leading role in protecting, supporting, and promoting public health in the United States and around the world. The agency has been on the frontlines of every global child health challenge over the last seven decades, successfully eradicating smallpox, vaccinating billions against measles, and cutting preventable child deaths by more than half since 1990. Withdrawing from the WHO puts these investments at risk and leaves the United States without a seat at the table – at a time when our leadership is most desperately needed.

“As our nation and the rest of the world face a global health pandemic, a worldwide, coordinated response is more vital than ever. This dangerous withdrawal not only impacts the global response against COVID-19, but also undermines efforts to address other major public health threats. The American Academy of Pediatrics, American Academy of Family Physicians, American College of Physicians and American Medical Association strongly oppose this short-sighted decision. We call on Congress to reject the Administration’s withdrawal from the WHO and make every effort to preserve the United States’ relationship with this valued global institution. Now is the time to invest in global health, rather than turn back.”

HHS and DOD Agreement with Regeneron for Anti-Viral Antibody Treatment
On Tuesday, July 6, HHS) and the Department of Defense (DOD) announced an agreement with Regeneron, Inc. for the commercial-scale manufacturing of the company’s COVID-19 investigational anti-viral antibody treatment, REGN-COV2.

The federal government will own the doses created through this agreement. Regeneron “estimates between 70,000 and 300,000 treatment doses could be available from this project, with the initial doses ready as early as end of summer and completed this fall.” This manufacturing project will take place at the same time as clinical trials.

HHS Secretary Alex Azar stated, “This agreement with Regeneron is the first of a number of Operation Warp Speed awards to support potential therapeutics all the way through to manufacturing, allowing faster distribution if trials are successful.”

Additional information can be found in the linked press release.

Poll: Majority Report Being Concerned About Lack of Social Distancing
The Hill  reports, “A majority of Americans for the first time said in a new survey that they are concerned about a lack of social distancing in their area, according to Gallup.” This “survey, taken from June 22-28, found that 54 percent of respondents said they are now concerned.” Gallup noted “the level of concern reached a low of 41 percent in late May and percentages hovered in the 40s most of April and May. Gallup surveyed a random sample of 3,454 adults who are part of its panel for the poll. Its results have a 3-point margin of error for individual samples, with a higher margin of error for subgroups.”

HHS Provider Relief Fund Update
After the initial CARES ACT distribution of 30 billion dollars, several member physicians advised MSSNY that they did not receive their HHSPAYMENT by direct deposit.  Regina McNally, VP of the Division of Socio-medical Economics reached out to her contact at the Department of Health and Human Services (DHHS) asking for an investigation.

Based on continued activity, DHHS recently advised that they are working with Acumen and UHG, the Department’s administrators for this payment activity, to fill any gaps in the General Distribution payments including those experienced by MSSNY members.  DHHS is planning on generating payments this week. 

PPP Application Deadline Extended
The President signed a bill over the holiday weekend that gives small businesses and nonprofits additional time to apply for Paycheck Protection Program (PPP) relief loans. Applicants now have until August 8, 2020 to submit their applications to a participating financial institution. Under the CARES Act, the PPP application period closed on June 30. That deadline passed with more than $130 billion of PPP funds still unused. This 5-week extension will allow more borrowers to receive low-interest, potentially forgivable loans up to $10 million to recover from COVID-19 losses.

When passing the bill, the House called on the Small Business Administration to continue to clarify confusing guidance, ensure PPP funds are reaching underserved businesses, and release more data on how PPP funds are being used. In addition to the deadline extension, the PPP Flexibility Act was signed into law last month gives borrowers more time to use PPP funds and rehire their employees to qualify for loan forgiveness.

Fair Health: Telehealth Claims Increased Nationally by 8000%
Manhattan-based Fair Health said that telehealth claim lines increased more than 8,000% nationally over the course of a year, from 0.15% of medical claim lines in April 2019 to 13% this past April, according to its recently launched telehealth tracking tool. The data represent the privately insured population, excluding Medicare and Medicaid. Telehealth claim lines rose even more in the Northeast, increasing 26,000% from 0.07% in April 2019 to nearly 20% in April 2020. (Crain’s’ 7/7)

The NYS Department of Health invites you to participate in a webcast:

Supporting Healthcare Provider Well-being in COVID and Beyond on Thursday, July 9^th, 2020 at 1-2 PM 

Find our webinar streaming via YouTube Live (and available for viewing immediately thereafter) on the NYSDOH COVID website for providers: For audio only, please dial in: 844-512-2950 and  Access code: 2395356

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