COVID Update April 6, 2020

Latest COVID-19 Statistics
The state reported 130,689 confirmed cases and 4,758 deaths as of Monday morning, including 72,181 cases in New York City, 15,616 in Nassau County, 14,294 in Westchester County, 13,487 in Suffolk County, 5,703 in Rockland County, 3,397 in Orange County, 1,189 in Dutchess County, 1,023 in Erie County, 574 in Monroe County and 372 in Ulster County.

As of Monday morning, New York City reported 2,475 deaths (here is the breakdown of deaths by borough) and 22,276 confirmed cases in Queens, 18,215 in Brooklyn, 13,397 in the Bronx, 9,624 in Manhattan, and 3,780 in Staten Island. More numbers can be found here. City & State (April 6)

NYS DOH Tracker

Latest National COVID-19 Statistics
More than 10,000 people have now died from COVID-19 in the U.S., as the pandemic’s horrible toll hit another milestone. The U.S. is reporting more COVID-19 cases than any country in the world, with nearly 350,000 people testing positive for the coronavirus, according to a COVID-19 dashboard created by the Johns Hopkins Whiting School of Engineering, which reports coronavirus numbers in near real time.

Gov. Cuomo: Clips from Press Conference

   – Federal gov’t might increase hydroxychloroquine and zithromax supply
and the State can then lift the 14-day limit on the drugs.
– Anecdotal evidence suggests the treatments have been positive.
– Governor has not heard reports of NYC plans to temporarily bury COVID
victims in City Parks. NY Post reported it earlier this morning.
– State is releasing 802 ventilators to the downstate area.  Surge and
-Flex program is focused on needs, and not wants.
– In response to reports of Orthodox Jewish communities continuing to
gather in large numbers for wedding and funerals, Gov stated that the
social distancing rule should be enforced:  “None of us has the right to
be reckless.”
– On ventilator usage, Governor stated that the state is currently
utilizing all back-up plans. Governor states that the hospital system
is “over-capacity.”
– State of California, in addition to Washington released ventilators.
No specifics given.
– At close of presser, Gov stated that we are not currently in need of
ventilators, which contrasts the statement that the state is currently
employing contingency plans due to ventilator usage.

Notes from the Governor’s briefing:
– Number of deaths effectively flat for past two days.
– Total hospitalizations, ICU admittance, intubations are all down.
– State looking at whether or not we’re in the apex, and if we’ll deal
with a peak or a plateau of case numbers.
– Dataset over past few weeks charts a lower bed count than earlier
models projected.  Malatras credits the social distancing actions with
putting downward pressure on the number of needed beds.
– Governor states that social distancing is working
– If we’re plateauing, we’re doing so at a high-level, and the
healthcare system is “red-line” stress.
– Surge and Flex program (inter-hospital / hospital system coordination)
continues, move 802 ventilators.
– Javits Center coming up to functionality now – relief for
– USNS Comfort: Governor requesting that the ship be used for COVID
use.  Non-COVID cases declined.  Gov wants it as relief valve for
downstate hospital system.  Gov calling President this afternoon.
– Federal Beds: Northwell Health will help manage, and US Military
personnel are staffing.

-Governor extending NY Pause until April 29.
– Governor is increasing maximum fine for violations of State social
distancing protocol.
– $500 maximum increased to $1,000.  “Not about the money, it’s
about the compliance.”
– State setting up COVID-19 First Responders Fund – help with costs
associated with continuing to work through the pandemic: Childcare…
– DOH will run the fund.
– Governor thanked Blackstone for a $10M donation.
– Headspace app will partner with NY to provide free services.

NYS COVID-19 Volunteer and Donation Assistance Program
Please use the following form to offer any donated goods, services, or space for use in New York’s response to the COVID-19 public health emergency.

All health care professionals offering their medical services should complete a separate survey found here. Anyone offering to sell goods should complete a separate procurement form found here. For offers of donated goods, services, or spaces, please click the next button at the bottom of this page to continue.

The U.S. COVID-19 case count is the highest in the world, with 337,971 cases as of 10:30 a.m. CDT April 6. Nationwide, 9,654 Americans have died from the virus, while 17,582 have recovered.

Worldwide, 1,289,380 COVID-19 cases and 70,590 deaths have been reported, while 270,372 people have recovered from the illness as of 10:30 a.m. CDT April 6.

New Video Available on Medicare Coverage and Payment of Virtual Services
CMS released a video providing answers to common questions about the Medicare telehealth services benefit. CMS is expanding this benefit on a temporary and emergency basis under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act. Video

Survey: 73% of US Physicians Can’t Easily Test for COVID-19
About 73 percent of U.S. physicians reported being unable to test patients for COVID-19 quickly and easily, according to a recent Doximity survey. Researchers analyzed data from a survey sent to Doximity members, an online professional network consisting of about 70 percent of U.S. physicians. The survey, sent to registered physicians via email between March 21 and March 24, was completed by 2,615 physicians.

Medical Practices Shift to Telemedicine as COVID-19 Closes Offices
Now that patients have been cautioned to stay away from the hospital and the doctor’s office unless it’s essential during the current pandemic, health care providers are turning to virtual visits as a way to keep their offices up and running. But independent doctors and smaller practices have been on their own to find affordable options that could keep them connected to patients—and earning money.

The expansion of telemedicine could be a lifeline for smaller medical practices as they face looming rent, payroll and utility bills while the stream of patients seeking routine care is cut off.

“The first priority is taking care of patients,” said Dr. Inderpal Chhabra, a primary care doctor at the office Lefferts Medical Associates in New Hyde Park, Queens. “At the end of the day, we’re small-business owners also and have responsibility for our employees.”

In mid-March Chhabra realized he would have to close his office. He had treated several patients he suspected would test positive for Covid-19 and was worried that the respiratory disease might spread to his staff and other patients if he kept the doors open.

He wanted to continue providing treatment but hadn’t used telemedicine software in the past. He began researching options and chatting with several hundred doctors in a WhatsApp forum. He settled on Rochester-based company, which has designed a telehealth tool that doesn’t require patients to download an app.

“I’m just talking to a patient as if they’re in my own office,” Chhabra said. Chhabra said he pays Doxy $29 a month.

There are some medical services that only can be provided in person, however. Chhabra can’t take a patient’s blood pressure, check their lungs or do a full physical remotely, for example. He has had patients use their own blood-pressure cuff during a video visit to get that reading.

Chhabra still isn’t clear how he will be paid for the virtual visits. He said he is billing private insurance companies for them but won’t know whether they approve payment for about 60 to 90 days.

Medicare and Medicaid have said they will pay for telemedicine.

During the Covid-19 emergency, Medicare will pay for virtual office visits, mental health counseling and preventive screenings. The federal government is also allowing doctors to use their license across state lines, which makes physicians able to treat patients remotely in more places.

Dr. Arthur Fougner, president of the Medical Society of the State of New York and an OB/GYN at Northwell Health, said the society’s members have reported using telemedicine companies including Doxy and DrFirst. But, he said, the relaxed regulations also allow doctors to use regular consumer apps, such as Skype, FaceTime and WhatsApp, to conduct the calls.

The federal Office for Civil Rights at the U.S. Department of Health and Human Services, which enforces violations of the health privacy law, said it would not impose financial penalties for HIPAA violations if telehealth services were provided in good faith during the Covid-19 emergency.

“You’re putting social distancing ahead of any kind of legal issue,” Fougner said. “We need to keep people at home.” Crain’s Health Plus.

Gov Cuomo on TV