About the public’s health
US sees five deadliest days since Covid-19 pandemic's start in last two weeks: “In just less than two weeks, the US recorded its five deadliest days since the Covid-19 pandemic's start -- with more than 4,000 virus-related deaths reported Thursday.
The nation's total Covid-19 death toll has now climbed to more than 365,300, according to data from Johns Hopkins University. And another nearly 115,000 people could lose their lives over the next four weeks, according to projections from the University of Washington's Institute for Health Metrics and Evaluation.”
Pfizer vaccine appears to neutralize a key mutation of Covid variants found in UK, South Africa: “The research, published Thursday on preprint server bioRxiv and not yet peer-reviewed, suggested the Pfizer-BioNTech vaccine worked to neutralize the so-called N501Y mutation.
The N501Y mutation has been reported in the more infectious variants. It is altering an amino acid within six key residues in the receptor-binding domain — a key part of the spike protein that the virus uses to gain entry into cells within the body.”
Biden says he will release all available coronavirus vaccine before second doses are administered: “President-elect Joe Biden announced Friday that he plans to release all available coronavirus vaccine after he takes office. The move breaks with the Trump administration, which has favored holding half the vaccine in reserve to ensure people receive their second doses. It would greatly expand the number of Americans who could soon get their first shot, but risks depleting reserves needed for follow-up shots.”
FDA warns new coronavirus variant could trigger false negatives among gold-standard tests: “The FDA is alerting healthcare professionals that mutations in the novel coronavirus’s genetic code—such as the type powering the fast-spreading variant identified in the U.K.—can trigger false negative results in gold-standard COVID-19 tests.
Accuracy can suffer if the alterations occur within the specific region of the virus’s RNA used by molecular diagnostics to line up a positive result, which may vary product to product, the agency said.
While FDA staff said they believe these risks are low, the agency listed three currently authorized tests—Thermo Fisher’s TaqPath combo kit, Mesa Biotech’s hand-held Accula test and Applied DNA Sciences’ Linea assay—that may be compromised by genetic variants.”
California hospitals prepping for grim COVID-19 choices: “California hospitals struggling with a skyrocketing coronavirus surge are trying to prepare for the possibility that they may have to ration care for lack of staff and beds — and hoping they don't have to make that choice.
The state avoided surging cases for months, but now the virus is raging out of control there and across the nation in the wake of Thanksgiving holiday gatherings that authorities say vastly spread infections. Only Arizona tops California in cases per resident.
The state this week ordered hospitals in the hardest-hit areas to delay many elective surgeries in order to free up space.”
UPDATED Coronavirus tracker: 86% of mild COVID-19 cases include loss of smell, study finds: “A new study of 2,500 patients in 18 European hospitals with COVID-19 finds that loss of smell is a symptom 86% of the time for mild cases of the virus.
Sense of smell typically reappeared within 18 to 21 days, according to the study in the Journal of Internal Medicine, though about 5% of those studies had not recovered their sense of smell six months out from recovery.”
Post-infection coronavirus immunity usually robust after 8 months, study shows: “The human body typically retains a robust immune response to the coronavirus for at least eight months after an infection, and potentially much longer, researchers said in a study published in the journal Science. About 90 percent of the patients studied showed lingering, stable immunity, the study found.”
Labcorp to help CDC track COVID-19 mutations as new strain spreads in U.S.: “The Centers for Disease Control and Prevention has tapped Labcorp to help conduct a large-scale genomic study tracking new mutations in the COVID-19 virus—after a fast-spreading variant, first identified in the U.K., has recently surfaced on U.S. shores.
The public health agency plans to collect random samples from across the country, to provide a baseline that will enable national and state-level surveillance programs to hone in on emerging cases.
With the addition of Labcorp’s facilities, the CDC said it aims to more than double the number of genomic samples sequenced per week.”
U.S. DEPARTMENT OF LABOR’S OSHA ANNOUNCES $3,930,381 IN CORONAVIRUS VIOLATIONS: “Since the start of the coronavirus pandemic through Dec. 31, 2020, the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has issued citations arising from 300 inspections for violations relating to coronavirus, resulting in proposed penalties totaling $3,930,381.
OSHA inspections have resulted in the agency citing employers for violations, including failures to:
Implement a written respiratory protection program;
Provide a medical evaluation, respirator fit test, training on the proper use of a respirator and personal protective equipment;
Report an injury, illness or fatality;
Record an injury or illness on OSHA recordkeeping forms; and
Comply with the General Duty Clause of the Occupational Safety and Health Act of 1970”
Arthritis drugs found to reduce risk of death in severe Covid-19 cases: “The immunosuppressants tocilizumab and sarilumab, were found to reduce stays in intensive care by at least seven days on average, according to data released by the UK government-backed Remap-cap study, conducted by researchers at Imperial College London and Utrecht university in the Netherlands…
These are the first immune-modulating drugs found to have an effect on outcomes of hospitalised Covid-19 patients, adding to positive results from the cheap and plentiful steroid dexamethasone.”
The Best Evidence for How to Overcome COVID Vaccine Fears: This article is an excellent review of the headline’s topic. It identifies more reluctant groups and explains strategies to increase immunization rates. For example: “Research shows that {the intervention]… with the biggest proved impact… is to make the desired action—in this case, vaccination—the default. A 2010 study at Rutgers University showed that informing people that a dose of flu vaccine was waiting for them at a specified time and place (although the appointment could be changed) boosted their vaccination rate by 36 percent, compared with a control group that was e-mailed a Web link to schedule their own appointment. In other words, opt out works better than opt in.”
About health insurance
The Affordable Care Act Reduced Income Inequality In The US: “We found that the ACA reduced income inequality and that the decrease was much larger in states that expanded Medicaid than in states that did not. We also decomposed the effect of the ACA on inequality by race/ethnicity, age, and family educational attainment. The ACA reduced inequality both across groups and within these groups. With efforts to repeal the ACA—specifically, California v. Texas—having shifted from Congress to the courts, it remains important to consider the consequences of fully repealing the ACA, which would likely reverse reduced inequality observed under the law.”
How 3 Major Payers Extended Temporary COVID-19 Benefits into 2021: The article provides information on what Aetna, BC/BS companies and Cigna are doing.
Health Care Company Indicted for Labor Market Collusion: “A federal grand jury returned a two-count indictment charging Surgical Care Affiliates LLC and its related entity (collectively SCA), which own and operate outpatient medical care centers across the country, for agreeing with competitors not to solicit senior-level employees, the Department of Justice announced today. These are the Antitrust Division’s first charges in this ongoing investigation into employee allocation agreements.”
SCA is a division of Optum, part of UnitedHealth Group.
Illinois Is the Nation's First State to Extend Health Coverage to Undocumented Seniors: “Healthy Illinois pushed state lawmakers to offer health benefits to all low-income immigrants. But the legislature opted instead for a smaller program that covers people 65 and older who are undocumented or have been legal permanent residents, also known as green card holders, for less than five years. (These groups don't typically qualify for government health insurance.) Participants must have an income at or below the federal poverty level, which is $12,670 for an individual or $17,240 for a couple. It covers services like hospital and doctor visits, prescription drugs, and dental and vision care (though not stays in nursing facilities), at no cost to the patient.
The new policy continues a trend of expanding government health coverage to undocumented immigrants.”
Other countries (like France) cover undocumented residents in order to deliver optimum public health.
Hospitals Lose Fight Over Uncompensated Care Reimbursements:”The Affordable Care Act bars hospitals from challenging HHS Secretary Alex M. Azar II’s calculation of adjustments to Medicare reimbursements for uncompensated care provided to low-income Americans, a federal court in Washington said.
The Health and Human Services Department’s Provider Reimbursement Review Board lacked jurisdiction to consider the hospitals’ objections to their payments, and thus properly dismissed their request for review, the U.S. District Court for the District of Columbia said Thursday.”
Physician Fee Schedule Update: The “Consolidated Appropriations Act, 2021 modified the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (MPFS):
Provided a 3.75% increase in MPFS payments for CY 2021
Suspended the 2% payment adjustment (sequestration) through March 31, 2021
Reinstated the 1.0 floor on the work Geographic Practice Cost Index through CY 2023
Delayed implementation of the inherent complexity add-on code for evaluation and management services (G2211) until CY 2024
CMS has recalculated the MPFS payment rates and conversion factor to reflect these changes. The revised MPFS conversion factor for CY 2021 is 34.8931.”
Telehealth Claim Lines Increase 3,060 Percent Nationally When Comparing October 2019 to October 2020: “Telehealth claim lines increased 3,060 percent nationally from October 2019 to October 2020, rising from 0.18 percent of medical claim lines in October 2019 to 5.61 percent in October 2020, according to new data from FAIR Health's Monthly Telehealth Regional Tracker. From month to month, coinciding with a surge in COVID-19 cases in October, the telehealth share of medical claim lines rose 10.6 percent nationally, from 5.07 percent in September 2020 to 5.61 percent in October 2020. The data represent the privately insured population, excluding Medicare and Medicaid.
Trends in the four US census regions (Midwest, Northeast, South and West) were similar to those in the nation as a whole. In each region, there were large percent increases in volume of claim lines from October 2019 to October 2020, and smaller increases from September 2020 to October 2020.”