Live updates on COVID-19: April 16-30

9:10 PM CT on 4/30/2020 

Half of primary care clinicians responding to a weekly survey conducted by the Primary Care Collaborative believe that it is unsafe to open the country right now. 

Another 37% said that the viability of re-opening the country depends on various factors, including the availability of COVID-19 testing and personal protective equipment and conditions in specific regions. Only 9% responded “yes” when asked about opening the country.

Eighty percent of survey respondents say they continue to limit well and chronic care visits at their practices for COVID-19-related reasons, suggesting pent-up demand for such services and pending population health challenges.

8:17 PM CT on 4/30/2020

(Crain's Detroit Business) The Detroit Pistons teamed with the Brooklyn Nets to do some good for the city of Detroit.

Joe Tsai, owner of the Nets and co-founder of e-commerce giant Alibaba, is donating 350,000 KN95 masks and 100,000 medical goggles to the city. Tsai said he called Pistons Vice Chairman Arn Tellem and asked if Tellem could coordinate distribution of the supplies.

"It came together very fast in a very short period of time," Tsai said, adding that the supplies should delivered by Monday.

The donation will help not only first responders and bus drivers, but also entrepreneurs who will need PPE to resume work in the coming weeks, Duggan said.

At the beginning of the month, the Pistons pitched in with a handful of other companies for a $350,000 grant to help feed the hungry during the coronavirus crisis.

7:12 PM CT on 4/30/2020

(AP) The Republican-led Michigan Legislature refused Thursday to extend the state's coronavirus emergency declaration and voted to authorize a lawsuit challenging Democratic Gov. Gretchen Whitmer's authority and actions to combat the pandemic.

The step came as hundreds of conservative activists, including some who were openly carrying rifles, returned to the Capitol to denounce her stay-at-home order.

Whitmer wanted lawmakers to extend her emergency declaration by 28 days. It expires late Thursday. She also believes she has other powers to respond to the crisis and does not need a legislatively-approved extension except to ensure that healthcare workers would continue to have special legal protections.

Whitmer’s stay-at-home measure will remain in effect through May 15. The coronavirus has infected more than 41,000 Michigan residents and contributed to the deaths of 3,789.

6:08 PM CT on 4/30/2020

A new independent commission will evaluate how nursing homes have responded to the COVID-19 outbreak and report its findings and recommendations to CMS, according to a press release Thursday.
CMS has tasked the commission with identifying how nursing homes can prioritize resident safety, quickly identify and mitigate the spread of COVID-19 and improve nursing home adherence to infection control policies.
“Additionally, the Commission will focus on identifying potentially innovative approaches to using nursing home data to allow for better coordination between federal surveyors, state and local entities, and nursing homes to address the current spread of COVID-19 in nursing homes,” CMS said in a statement.
Industry experts, patient advocates, clinicians, medical ethicists, administrators, public officials and others will serve on the commission.
The Trump administration expects it to convene in late May.

5:07 PM CT on 4/30/2020

Data Analyst Dan Adelman suggests in Health Affairs that the federal government organize a national effort for ventilators to be exchanged between states to take advantage of the variance in demand peaks. Adelman combined the federal government's pandemic forecasting model with estimates of ventilator availability to identify where equipment would go. 

3:08 PM CT on 4/30/20

The Medicaid and CHIP Payment and Access Commission is concerned the Coronavirus Aid, Relief and Economic Security Act isn’t providing enough financial assistance to providers caring for Medicaid beneficiaries.

In a letter to HHS Secretary Alex Azar, MACPAC argued that the agency’s recent change to the CARES Act distribution formula favors providers with more commercially insured patients, and HHS hasn’t been transparent about which providers have already received funds or the amount of future payments.

MACPAC is also concerned other types of providers--like dentists, home-care providers and non-hospital-based behavioral health providers--aren’t eligible for CARES Act funds.

This letter follows another written to CMS Administrator Seema Verma which expressed concern about the decision to distribute the first round of funding based on providers’ Medicare fee-for-service revenue.

“The Commission restates its concern that [CARES Act] funds are not providing sufficient assistance to healthcare providers focused on serving Medicaid beneficiaries, and that lack of attention to these providers may do permanent damage to the nation’s healthcare safety net,” wrote MACPAC.

2:09 PM CT on 4/30/20

(Crain’s Cleveland Business) Last week, Ohio shipped 4.1 million pieces of personal protection equipment to local emergency management agencies for distribution to hospitals, first responders, jails, nursing homes and other congregate-living facilities, Gov. Mike DeWine said in his daily news conference for Wednesday, April 29.

That PPE included 500,000 N95 face masks, 850,000 face shields, 750,000 surgical-type masks and two million nonmedical gloves provided through a coordinated effort by other Ohio agencies, including JobsOhio, the Ohio Department of Administrative Services and the Ohio Emergency Management Agency.

"We are competing in a volatile marketplace with other states and countries for this critical equipment," DeWine said, adding that Ohio will continue to obtain PPE, either by purchasing it or by finding private Ohio businesses to manufacture it.

1:52 PM CT on 4/30/20

Tampa General Hospital and 50 other hospitals across Southwest Florida are partnering to share data on the COVID-19 pandemic.

An interactive dashboard will give providers real-time information on patient case loads, bed availability and ventilator counts, according to a press release from Tampa General.

“This dashboard is critical in helping us potentially save lives. It gives us situational awareness of resources that are available across the region to take care of COVID-19 patients,” said Dr. Peter Chang, Tampa General’s vice president of care transitions. “It breaks down silos between competing hospitals for this collaborative community effort.”

SME Solutions Group and Qlik are the vendor partners on the project.

1:11 PM CT on 4/30/20

HHS Thursday granted $20 million to six organizations to boost telehealth access and infrastructure for providers and families in the fight against COVID-19.

The award recipients will use the funds to expand telehealth services for teens, young adults, maternal health and children and families with special needs. They’ll also address telehealth licensure and credentialing issues nationwide.

“Recipients will work with professional and state licensing boards and national compacts to develop a streamlined process for telehealth clinicians to obtain multi-state licensure,” HHS said.

Grantees include the American Academy of Pediatrics and the Federation of State Medical Boards of the United States.

The new funding comes from the Coronavirus Aid, Relief and Economic Security, or CARES, Act that Congress passed in March.

11:50 AM CT on 4/30/20

(AP) Gleaming new tent hospitals sit empty on two suburban New York college campuses, never having treated a single coronavirus patient. Convention centers that were turned into temporary hospitals in other cities went mostly unused. And a Navy hospital ship that offered help in Manhattan is soon to depart.

When virus infections slowed down or fell short of worst-case predictions, the globe was left dotted with dozens of barely used or unused field hospitals. Some public officials say that's a good problem to have — despite spending potentially billions of dollars to erect the care centers — because it's a sign the deadly disease was not nearly as cataclysmic as it might have been.

Many of the facilities will now be kept on standby for a possible second wave of infections. Some could even be repurposed as testing sites or recovery centers.

"It will count as a huge success for the whole country if we never have to use them," said Simon Stevens, the chief executive of the National Health Service in England, where sparsely used field hospitals have been criticized as costly, unnecessary "white elephants."

"But with further waves of coronavirus possible, it is important that we have these extra facilities in place and treating patients," Stevens said.

11:09 AM CT on 4/30/20

The Federal Communications Commission has approved funding for more than two dozen healthcare organizations as part of its COVID-19 Telehealth Program.

The FCC on April 13 opened applications for the program, which Congress allocated $200 million for as part of the CARES Act. Healthcare providers awarded funds from the COVID-19 Telehealth Program can use them to purchase telecommunications equipment, broadband connectivity and devices needed to provide telehealth services during the coronavirus outbreak.

So far, the FCC has distributed a collective $13.7 million from the COVID-19 Telehealth Program to 30 healthcare organizations. The agency said it will continue to evaluate applications and award funding on a rolling basis.

Here are the 13 latest providers to be awarded funding by the FCC:

Augusta (Ga.) University Medical Center: $113,744

Children's Hospital Colorado (Aurora): $807,090

Country Doctor Community Health Centers (Seattle): $392,770

Greene County General Hospital (Linton, Ind.): $60,480

The Institute for Family Health (New Paltz, N.Y.): $729,118

Lancaster (Pa.) Health Center: $75,710

Loudoun Community Health Center T/A HealthWorks for Northern Virginia (Leesburg, Va.): $93,380

Mayo Clinic (Rochester, Minn.): $1 million

McLaren Health Care Corp. (Grand Blanc, Mich.): $626,328

New York Psychotherapy and Counseling Center (Jamaica, N.Y.): $126,799

Parker Jewish Institute for Health Care and Rehabilitation (New Hyde Park, N.Y.): $97,965

Service Program for Older People (New York City): $26,180

Valley-Wide Health Systems (Alamosa, Colo.): $46,437

The FCC's announcement of 13 new awardees follows six providers it approved last week.

10:15 AM CT on 4/30/20

(AP) The nation’s top infectious diseases expert says he expects the U.S. Food and Drug Administration to quickly approve a new experimental drug that showed promising signs in treating patients with COVID-19.

Anthony Fauci tells NBC’s “Today” show Thursday that he anticipates the go-ahead for the emergency use of Remdesivir to happen “really quickly.”

He says he spoke with FDA Commissioner Stephen Hahn on Wednesday, and while Hahn had yet to make a final decision, “I would project that we’re going to be seeing that reasonably soon.” The drug was shown in a major study to shorten recovery time of hospitalized patients.

Fauci said the drug’s manufacturer has committed to scaling production of the drug as quickly as possible as the world hunts for an effective treatment and ultimately a vaccine.

Fauci has been working on a project to fast track the development of a vaccine by mass producing formulas that appear safe and effective before they’re fully vetted. The goal is to get hundreds of millions of doses to the public by January.

8:57 PM CT on 4/29/2020
(AP) Virginians will soon be able to have elective surgeries and dental checkups again, as Gov. Ralph Northam announced that nonessential medical procedures could resume Friday. The governor said pet owners could also resume taking their animals to the vet for nonemergencies.

The governor imposed a ban on nonemergency procedures last month in an effort to reserve capacity in the state’s health care system for coronavirus patients and personal protective equipment such as face masks for providers treating those patients.

Northam said at a news conference Wednesday that the state has avoided a surge in hospitalized patients like in Italy and New York and is in a much better spot in terms of having enough supplies and capacity than it was a few weeks ago.

“Together we took the right actions and they have been successful,” Northam said. “We slowed the spread of this virus.”

8:16 PM CT on 4/29/2020
The Illinois Health and Hospital Association, the American Nurses Association–Illinois, the Illinois Society for Advanced Practice Nursing and the Illinois State Medical Society wrote a friend of the court brief in support of Gov. Jay Pritzker's stay-at-home executive order, according to a news release from the organizations.

As a result of a lawsuit, the Clay County Circuit Court on April 27 issued a temporary restraining order preventing the administration from enforcing the extended stay-at-home order against the plaintiff.

“Frontline healthcare workers, including nurses, physicians, and many others, have placed their lives on the line to care for those infected with the coronavirus, and the people of Illinois have sacrificed to help curb the spread. The action taken by the circuit court risks making those sacrifices for nothing,” said ANA-Illinois President Elizabeth Aquino, in the release.

6:52 PM CT on 4/29/2020

(AP) COVID-19 has killed hundreds more Pennsylvania nursing home residents than was previously known, state health officials reported Wednesday, underscoring the threat at long-term care facilities that have struggled for weeks to contain the coronavirus.

The Department of Health reported 479 new COVID-19 deaths—339 at nursing and personal care homes—raising Pennsylvania's death toll to more than 2,100. Nursing homes account for 65% of those.

Nursing homes cite shortages of personal protective equipment and say they haven’t been able to do enough diagnostic testing to quickly identify and isolate patients and staff who have the virus. They say testing is critical because people can spread the virus without knowing they have it.

5:52 PM CT on 4/29/2020

(Crain's Detroit Business) Michigan Gov. Gretchen Whitmer wants a G.I. Bill-like college tuition program for frontline workers in the coroanvirus battle to further their education after the pandemic subsides.

Whitmer on Wednesday proposed a new free college tuition benefit for Michigan residents who have remained working in health care and nursing home facilities, supermarkets, public safety, transportation delivery, sanitation or manufacturing personal protection equipment.

The governor said she will seek the Legislature's approval for a "Futures for Frontliners" program to pay for the tuition for certificates, associate's degrees and possibly bachelor's degrees.

4:21 PM CT on 4/29/20

(Crain’s New York Business) The Medical Society of the State of New York applauded Gov. Andrew Cuomo's efforts to increase COVID-19 testing but said community physicians should be at the forefront.

The group expressed concern over a new executive order to allow pharmacies to become collection sites for tests.

"In particular, we are concerned that there has not been any specification for how such test results will be shared with the patient's primary physician or physicians to help explain to the patient what the results mean … as well as what the patient should do," Dr. Art Fougner, president of the medical society, said in a statement.

The group also questioned the lack of effort to involve community physicians in any statewide testing program and to help them obtain the supplies and personal protective equipment needed to provide COVID-19 tests.

"Not only are community physicians an integral part of New York's healthcare system, but many of them have been—unaware to many—working tirelessly to keep the surge of patients from becoming a tsunami, which would have overwhelmed our hospitals," Fougner said.

People trust community physicians, he said, adding that the medical society is urging Cuomo to enlist them to fully expand the state's testing capacity—which is critical to reopening businesses.

3:41 PM CT on 4/29/20

The University of Massachusetts Medical School has announced plans to furlough about 100 employees for up to six months to offset financial losses sparked by the coronavirus crisis.

It was “no longer sustainable” to pay all employees, spokeswoman Sarah Willey said in a statement Tuesday.

The furloughed workers account for about 2% of the Worcester school’s workforce of around 6,000 employees.

They could be brought back sooner than six months, and will still receive health care coverage and other benefits while they are furloughed, Willey said.

The school previously announced a hiring freeze and implemented wage and salary freezes.

3:05 PM CT on 4/29/20

The University of Iowa Carver College of Medicine and the David Geffen School of Medicine at UCLA have received a 3.7 million grant from the Centers for Disease Control and Prevention to study ways to reduce the risk of COVID-19 infection in emergency department workers.

The 12-week study will include 1,600 physicians, nurses, and other staff  in 20 academic healthcare institutions across the U.S. The goal is to determine which  practices and types of personal protective equipment are best suited to prevent the spread of the coronavirus.

“We don’t get many opportunities to gauge the risk of transmission during a global pandemic, so this study is somewhat unique,” says Dr. Nicholas Mohr, co-principal investigator of the study and vice chair for research in the Department of Emergency Medicine at the University of Iowa. “It is critical, however, to identify ways to reduce the risk of infection transmission to health care workers so that we can continue to take care of the people in our communities who need our help.”

1:49 PM CT on 4/29/20

Alternative methods of communication, like picture boards, gestures or computer-aided speech, could help COVID-19 patients on ventilators give details of their condition to their care teams.

Since speech-language pathologists and families may be restricted from seeing COVID-19 patients, the use of alternative communication methods may be even more valuable, according to the American Speech-Language-Hearing Association.

“It is essential that everyone have the ability to communicate at all times—and be provided an alternative method of communication if they cannot use speech,” said Theresa Rodgers, ASHA president. “Not only do people deserve to have their basic needs met, such as to communicate that they are in pain or request that a loved one is called, but patients may be more likely to have a serious adverse medical event if they cannot communicate with their healthcare providers.”

1:47 PM CT on 4/29/20

America’s Health Insurance Plans has released a set of principles for clinical care during the COVID-19 pandemic.

AHIP encourages providing alternative sites for care, including telemedicine and drive-through clinics for diagnostic testing, disseminating the most up-to-date information on COVID-19 best practices, prioritizing mental health and ensuring personal protective equipment is available to providers.

“Patients and public health safety must come first. These clinical principles underlie our commitment to ensuring patients and healthcare workers are safe and supported in the delivery of effective, efficient, and evidence-based care,” said AHIP CEO Matt Eyles.

12:53 PM CT on 4/29/20

(AP) An experimental drug has proved effective against the new coronavirus in a major study, shortening the time it takes for patients to recover by four days on average, U.S. government and company officials announced Wednesday.

Gilead Sciences' remdesivir is the first treatment to pass such a strict test against the virus, which has killed more than 218,000 people since it emerged late last year in China. Having a treatment could have a profound effect on the global pandemic, especially because health officials say any vaccine is likely a year or more away.

The study, run by the National Institutes of Health, tested remdesivir versus usual care in 1,063 hospitalized coronavirus patients around the world. At the White House, NIH's Dr. Anthony Fauci said the drug reduced the time it takes patients to recover by 31% — 11 days on average versus 15 days for those just given usual care.

He also said there was a trend toward fewer deaths among those on remdesivir, and that full results would soon be published in a medical journal.

"What it has proven is that a drug can block this virus," Fauci said. "This will be the standard of care."

A statement from the Food and Drug Administration says that the agency has been talking with California-based Gilead "regarding making remdesivir available to patients as quickly as possible, as appropriate."

Remdesivir is among many treatments being tested against the coronavirus but was the farthest along in study.

12:14 PM CT on 4/29/20

The Advanced Medical Association is urging the United States Trade Representative to consider more tariff exclusions for medical devices and supplies coming from China.

In a letter to USTR, AdvaMed requested tariff exclusions for equipment needed during the COVID-19 pandemic, including personal protective equipment, needles and syringes, ventilator components, dialysis machines and diagnostic testing supplies.

The association asks USTR to continue tariff exclusions indefinitely, or at least one year after the World Health Organization declares an end to the pandemic.

“We’re grateful that the administration made the positive decision last month to lift tariffs on some crucial medical equipment coming from China, including face masks, examination gloves and surgical drapes,” said AdvaMed CEO Scott Whitaker. “We appreciate USTR’s willingness to consider additional tariff relief, which will help encourage further imports from China of other mission-critical products, parts and components as together we continue to battle COVID-19.”

11:08 AM CT on 4/29/20

A group of cybersecurity firms are working together to provide free support to healthcare organizations, noting an increase in cyber attacks during the pandemic.

The Cyber Alliance to Defend our Healthcare has so far worked to assess provider networks, assist monitoring of core systems and offer surge capacity to security operations centers.

“As the COVID-19 outbreak accelerates worldwide, threat adversaries are taking advantage of popular fears about the disease to spread malware that provides them access to sensitive personal and corporate data. We must come together as one — through Collective Defense — to protect and defend global healthcare providers,” said General Keith Alexander, former Commander of the U.S. Cyber Command and current co-CEO of IronNet Cybersecurity. “They represent the front line of this crisis; as cybersecurity experts, we must work together behind the scenes to ensure reliability and continuity of service.”

9:42 AM CT on 4/29/2020

California's leaders and medical schools need to recruit more Latino physicians and medical students to help alleviate the physician shortage before another wave of COVID-19, a university group said.

The UCLA Latino Policy & Politics Initiative noted that Latinos are a large share of front-line workers, but not physicans in the state even though they are a plurality of California's population. The initiative called on medical schools to recruit and train "linguistically capable medical students" that would later practice in underserved communities.

“California has been grappling with a severe shortage of physicians long before the pandemic, and this crisis puts a spotlight on the impacts this has on the state’s most vulnerable communities,” said Laura Martinez, postdoctoral fellow at the David Geffen School of Medicine and the Center for the Study of Latino Health and Culture (CESLAC) at UCLA, said. “The COVID-19 pandemic highlights the urgency to act now to protect lives while building a healthcare foundation for the state’s future.” 

8:11 PM CT on 4/28/20

The Infectious Diseases Society of America Tuesday released a set of recommendations for when and how healthcare workers should use PPE when caring for patients with suspected or confirmed COVID-19.

"Evidence-based recommendations for what PPE to use in conventional, contingency and crisis standards of care are needed. Where evidence is lacking, the development of specific research questions can help direct funders and investigators," according to an executive summary on the IDSA website.

The recommendations address everything from gowns and masks to eye protection and shoe coverings.

6:40 PM CT on 4/28/20

(AP) Republican state leaders in Oklahoma and Utah are facing scrutiny for spending millions of dollars combined to purchase malaria drugs promoted by President Donald Trump to treat COVID-19 patients that many other states obtained for free and that doctors warned shouldn’t be used without more testing. 

While governments in at least 20 other states obtained more than 30 million doses of the drug through donations from the federal reserve or private companies, Oklahoma and Utah instead bought them from private pharmaceutical companies.

Oklahoma Gov. Kevin Stitt on Tuesday defended the state’s $2 million purchase, saying the drug was showing some promise. His health secretary attributed buying the 1.2 million hydroxychloroquine pills to something that happens in the “fog of war.” Utah Gov. Gary Herbert at first defended the state’s $800,000 purchase of 20,000 packets of hydroxychloroquine compounded with zinc, but has since ordered an investigation of a no-bid contract with a local company that had been promoting the drugs. Herbert, a Republican, also canceled an additional plan to spend $8 million more to buy 200,000 additional treatments from the same company. 

Oklahoma’s attorney general requested an investigative audit on Tuesday of its Department of Health over spending and warned the agency about retaliating against employees who report wrongful government activities under the state’s Whistleblower Act. A spokesman for Attorney General Mike Hunter declined to comment on whether the request was related to the $2 million spent on the drug.

4:13 PM CT on 4/28/20

Clinicians at three BJC Healthcare hospitals are using their N95 respirator masks up to 20 times by disinfecting them with vaporized hydrogen peroxide, according to a news release describing an article published online by the Journal of the American College of Surgeons.

The disinfection process, developed in conjunction with the Washington University School of Medicine, calls for masks to be used by the same clinician after cleaning, according to the news release.

The system is disinfecting 240 N95 masks a day and has the capability of disinfecting 1,500 masks daily, the release says.

2:44 PM CT on 4/28/20

The American Medical Association is issuing recommendations for stronger federal guidelines on coronavirus antibody testing, citing concerns about test performance, access and lab preparedness.

In a letter to Assistant Health Secretary Dr. Brett Giroir, the AMA recommended creating a national testing strategy, regularly consulting with laboratories, ensuring labs have adequate workforces and supplies of personal protective equipment, and providing more guidance to providers on the limitations of these tests, including the risk of false positives.

“As we anticipate the threat of COVID-19 may persist into the fall, the coming months represent a critical time for federal leadership to help ensure states are adequately resourced and prepared with critical strategies to manage what may be increased demand for testing services,” said AMA CEO Dr. James Madara. “The current outbreak has taught us what can occur if adequate diagnostic testing is not available in the early stages of a rapidly emerging and serious public health threat.”

1:51 PM CT on 4/28/20

(AP) Workers who had been exposed to the coronavirus at Washington state's largest psychiatric hospital were herded into a small building to be tested. Inside, few wore masks. They were given test kits by people without gloves and told to swirl a swab inside their noses.

The method was designed only for people showing symptoms, but the staffers said none of them did. Many told The Associated Press that the flawed testing process this month likely produced inaccurate results and exposed them to the virus again.

"I absolutely feel it was a misuse of the testing materials," said Dr. Lauren Smith, a forensic psychologist at the hospital. "In addition to that, the manner in which they did it put us all at risk."

Employees say it's another example of the state's failure to protect staff and patients at Western State Hospital. The 850-bed facility south of Seattle has been the target of multiple state and federal investigations, including one launched when a man accused of torturing a woman to death escaped. There's a pattern of violent attacks by patients and a failure to meet health and safety requirements.

The violations led the facility to lose its accreditation and federal funding, and staffers say mismanagement during the pandemic could cost lives. They fear a repeat of the Seattle-area nursing home that became the first U.S. cluster of COVID-19 deaths, with 43.

"I'm afraid this could become another tragedy similar to what happened at Life Care Center of Kirkland," said Justin Lee, a spokesman for the hospital employee union.

A 400-member nurses union is calling for top administrators at the Department of Social and Health Services, which oversees the hospital, to be removed over their handling of the outbreak.

Department Secretary Cheryl Strange said she's disappointed and has been working to address the union's concerns.

"There is always much work to do in a hospital this large, and we will continue our efforts to restore the faith of the membership," she said.

At least 29 workers at the psychiatric hospital have tested positive for the virus, while six patients have confirmed cases and one has died. Psychiatric hospitals in other states also have struggled with COVID-19, including a facility in Michigan where more than 100 patients and workers tested positive.

12:43 PM CT on 4/28/20

(AP) Republicans who control the Michigan Senate urged Gov. Gretchen Whitmer on Tuesday to lift her five-week-old ban on nonessential medical and dental procedures, saying the decision to resume should be left to hospitals and health providers.

The resolution, while symbolic, is the latest move by GOP lawmakers who are pushing the Democratic governor to ease restrictions she adopted to curb the spread of the coronavirus. The voice vote came as Whitmer asks the Legislature to this week extend an emergency declaration — the underpinning of her stay-at-home and other orders — by 28 days so health workers and others are immune from civil lawsuits.

Hospitals in the Detroit area, home to many of the state's 38,000 confirmed cases, have had to permanently or temporarily lay off employees to focus almost entirely on COVID-19 patients. Hospitals elsewhere in Michigan have made cuts, too, due to the cancellation of nonessential surgeries and other services. Many physicians have doing telemedicine appointments.

11:51 AM CT on 4/28/2020

The American Hospital Association, America’s Health Insurance Plans and the U.S. Chamber of Commerce on Tuesday asked leaders in Congress to bolster the private insurance market amid mass layoffs due to the COVID-19 pandemic. 

The insurance, hospital and business groups proposed that Congress provide employers with subsidies to maintain health benefits for employees, subsidize COBRA coverage for employees who were laid off, allow individuals to use health savings accounts to pay for premiums, open a special enrollment period for Affordable Care Act insurance marketplaces and increase premium subsidies for ACA marketplace plans.

Hospitals get higher payment rates from patients with private health insurance compared with those covered by Medicaid or without insurance. The groups also asked for Congress to create a separate funding source for uncompensated COVID-19 care, as HHS is currently pulling money from a $100 billion designated for provider relief.

Other signatories to the letter include the American Medical Association, the Blue Cross Blue Shield Association, the Children’s Hospital Association, the Association of American Medical Colleges, Federation of American Hospitals and the National Rural Health Association.

11:33 AM CT on 4/28/20

(AP) As states gear up to reopen, a poll finds a potential obstacle to controlling the coronavirus: nearly 1 in 10 adults say cost would keep them from seeking help if they thought they were infected.

The Gallup-West Health Healthcare Costs Survey out Tuesday finds that 9% of those age 18 and over would avoid seeking treatment because of concerns about the cost of care, even if they thought they were infected with the coronavirus.

A significantly higher number, 14%, would avoid seeking treatment because of pocketbook worries if they had fever and a dry cough, two widely publicized symptoms of COVID-19.

Although Congress and President Donald Trump have made coronavirus testing free to patients, and some insurers are waiving copays and deductibles for treatment within their networks, the survey suggests such messages may not be getting to the public.

The survey delivers "important and distressing information," said John Auerbach, head of the nonpartisan Trust for America's Health. "I hope that policy makers take note."

With so many reluctant to seek care, "it could pose problems in testing people," Auerbach added. "Without widespread testing, it will be problematic to lift the restrictions." Auerbach's group works with government at all levels to strengthen public health, and was not involved with the poll.

10:44 AM CT on 4/28/20

The National Action Alliance for Suicide Prevention is launching a national response with other organizations to address mental health needs during the pandemic.

According to a recent Gallup poll, 15% of Americans say their mental health is already suffering as a result of social distancing.

“Rates of suicide and overdoses were at historic levels before COVID-19 hit,” said former U.S. Rep. Patrick J. Kennedy, founder of The Kennedy Forum and private sector chair for the Action Alliance’s National Response. “This pandemic will fuel the fire of our country’s mental health crisis unless organizations unite in a call to action. There’s no more time for debate and discussion—we need all hands on deck to fast track the strategies we know will work.”

9:50 AM CT on 4/28/20

A clinical trial at Northwell Health has been testing famotidine, the active compound in the heartburn drug Pepcid, against coronavirus.

Famotidine seems to bind to a key enzyme in the virus that causes COVID-19, according to reports from China and molecular modeling. Northwell has been quiet about the clinical trial to avoid prematurely raising hopes before results are available, as well as to ensure the supply chain remains intact.

“If we talked about this to the wrong people or too soon, the drug supply would be gone,” Kevin Tracey, a former neurosurgeon in charge of the hospital system’s research, told Science.

8:32 AM CT on 4/28/2020

SSM Health will furlough 2,000 employees as it copes with the financial impact of the COVID-19 pandemic. The St. Louis-based health system expects to furlough 5% of its workforce for 13 weeks, but said that the staff could be brought back sooner. It will also reduce hours for additional employees.

The health system is also freezing executive pay, discretionary expenses and hiring for non-critical roles.

8:39 PM CT on 4/26/2020

(AP) China reported just three new coronavirus cases Monday, and no new deaths for the 12th day in a row.

A total of 723 people remain hospitalized and just under 1,000 were being kept in isolation and under monitoring for being suspected cases or for having tested positive for COVID-19 without showing symptoms.

Beijing added one additional postmortem death to its count, raising China’s overall death toll to 4,633 among 82,830 cases. Of the new cases, two were imported and one was detected in the province of Heilongjiang bordering Russia, according to the National Health Commission.

9:12 PM CT on 4/27/2020

(AP) Workers at 40 Chicago-area nursing homes announced they have set a May 8 strike date over wages as many of the facilities are treating patients suffering from the coronavirus.

Members of the Service Employees International Union, which represents more than 10,000 workers at 100 nursing homes, most in the Chicago area, are negotiating with the Illinois Association of Healthcare Facilities to replace a contract that expires April 30.

Shaba Andrich of the union’s nursing home division said many of the workers are making little more than Chicago’s minimum wage of $13 an hour while taking care of society’s most vulnerable members, adding they are seeking at least $15 an hour and hazard pay for working during the pandemic. The workers are also demanding improved staffing, better training and more personal protective equipment.

The strike threat comes a day after Illinois officials announced a jump to 625 deaths from the coronavirus of people who live or work at long-term care facilities. The Illinois Department of Public Health says the state has about 1,200 long-term care facilities. As of Friday, at least 278 facilities had 4,298 cases of residents and workers who tested positive for COVID-19.

The association representing nursing home operators say they have offered an 11% pay hike, stable employee health insurance contributions, earlier access to sick time during the pandemic and creation of a training fund, among other contract enhancements.

7:11 PM CT on 4/27/2020

(AP) Vice President Mike Pence has an appointment Tuesday at Minnesota’s Mayo Clinic to learn about a new coronavirus testing “moonshot” that has the famed clinic partnering with the state and its flagship university to quickly boost the state's capacity to 20,000 tests a day.

It’s an approach that leverages a health care infrastructure not all states can match. And it should help Minnesota become one of the most aggressive states at testing on the scale experts say is necessary to safely reopen the economy. Minnesota is one of several states that have quit waiting for the federal government for help.

Democratic Gov. Tim Walz unveiled the state's partnership with the University of Minnesota and Mayo last Wednesday, promising that every resident with symptoms of the coronavirus can get tested once the plan ramps up in the next few weeks.

“This is not a state that’s just going to get through COVID-19; this is a state that’s going to lead this nation and the world out of this,” Walz vowed of his ”moonshot."

Pence recognized Walz's efforts at a White House briefing Thursday, where he also praised Ohio Gov. Mike DeWine for an initiative to boost his state's testing capacity to 22,000 per day through a partnership with reagent manufacturer Thermo Fisher. The vice president also cited Iowa Gov. Kim Reynolds for a partnership with Utah-based startup Nomi Health aimed at increasing her state's lagging testing capacity by 3,000 per day from its current 1,000-2,000.

6:11 PM CT on 4/27/2020

AMGA, along with medical groups and independent practice associations, asked the federal government to support audio-only telehealth services, saying it would reduce burden on physicians.

In a letter to HHS Secretary Alex Azar and CMS Administrator Seema Verma, the groups praised the agencies for supporting telehealth during the COVID-19 pandemic. But they alleged the agency only considers services provided via live, audiovisual telecommunications for risk adjustment. Telephonic or audio-only visits don't count.

“Too many Americans lack the technology or broadband service necessary to receive care through video-based modalities,” said Dr. Jerry Penso, president and chief executive officer of AMGA. “Recognizing this need, clinicians have continued to provide care for these populations during the pandemic, using only audio-based services, including landline phones. This care should is vital to many patients who are unable to access audiovisual technology.”

The groups would like clarification that audio visits count for risk adjustment and care coordination.

5:21 PM CT on 4/27/2020

(AP) Four North Carolina nursing homes have each had at least 10 deaths of residents diagnosed with COVID-19, according to data released on Monday by state health officials.

The Department of Health and Human Services agreed to specifically identify more than 70 long-term facilities, rehabilitation centers or adult care homes where outbreaks have occurred and give updates on them twice weekly.

Before Monday, the department hadn't identified the specific facilities, with officials saying it could break confidentiality rules on patient information. The agency had only released the overall number of positive cases at these facilities and the counties where they were located. But some county health departments named the facilities anyway, leading to a fragmented picture of cases.

State DHHS Secretary Mandy Cohen said her department revisited the policy in the interest of standardizing information and avoiding a patchwork of rules across the state. Several media outlets had reported about the disparate release of the information.

“We've been trying to always strike the balance of transparency and getting good data to folks, protecting public health and protecting individual privacy,” Cohen said at a media briefing.

4:29 PM CT on 4/27/20

The U.S. recorded around 15,400 extra deaths in the first weeks of the COVID-19 pandemic, according to data analyzed in the Washington Post.

The excess deaths are nearly double the number attributed to the coronavirus--8,128--between March and April 4. These deaths may not have been due to COVID-19, but could result from Americans delaying care for fear of catching the virus as well as some natural variation in the numbers year to year.

The analysis suggests the data available during those early weeks didn’t capture the impact of the pandemic, just as states were making decisions on how to react. It could also show the death toll from the pandemic is much higher than has been reported.

“It’s really important to get the right numbers to inform policymakers so they can understand how the epidemic is evolving and how severe it is in different places,” Daniel Weinberger, a Yale professor of epidemiology and the leader of the research team, told the Washington Post.

3:22 PM CT on 4/27/20

Premier Health is working with local manufacturers near Dayton, Ohio, to address the shortage of isolation gowns during the COVID-19 pandemic.

Premier partnered with FastLane, a group of manufacturing and engineering consultants housed at the University of Dayton Research Institute, and Industry Products Company, an auto parts manufacturer.  Fastlane worked to find alternative materials, and IPC changed their production to make the gowns.

“Within days an alternative material was identified, prototypes were designed and approved, and a manufacturer began the process of retooling its production line,” said Lainie Dean, system vice president of strategy and business development at Premier.

2:48 PM CT on 4/27/20

(Crain's Detroit Business) As the coronavirus battle continues, Michigan has seen a slowdown in hospitalization rates due to COVID-19.

There's been a 32 percent decrease in hospitalized COVID-19 patients over the last 14 days, according to Michigan Department of Health and Human Services data as of Sunday.

As of Monday, the coronavirus had killed 3,407 Michigan residents while the number of confirmed cases rose by 432 over the past day to 38,210. The state reported 92 new deaths since Sunday. Michigan is the seventh state in terms of total cases, according to New York Times tracking data, and third for deaths.

However, there are signs of progress as the number of COVID-19 patients in critical care at hospitals is down 29 percent over the last 11 days and the number of patients on ventilators slid 33 percent over the past two weeks, according to state data. Hospital morgue availability has increased by 80 percent since April 13, the data show.

2:46 PM CT on 4/27/20

(Crain's New York Business) Nearly a quarter of New York City residents have had the coronavirus, according to a test survey of the population carried out across the state, Gov. Andrew Cuomo said Monday.

The state's second survey of city residents, conducted April 27, found that 24.7% tested positive for COVID-19 antibodies.

Statewide, New York tested 7,500 people, and almost 15% had the antibodies, which indicate the person had COVID-19.

The data suggest that about 2 million New York City residents have had the disease.

1:59 PM CT on 4/27/20

(AP) A hedge fund executive and philanthropist pledged Monday to match donations up to $1 million to Massachusetts General Hospital's efforts to fight the coronavirus.

The pledge by Donald Sussman — founder and chief investment officer of Connecticut-based Paloma Partners — will benefit the Boston hospital's Emergency Response Fund, established in 2013 in response to the Boston Marathon bombing.

“From doctors and nurses on the front lines to scientists working to develop test and therapies, there is an unprecedented need for philanthropy at this moment,” Sussman said in a statement released by the hospital.

The fund is currently being used to buy protective equipment, enhance telemedicine capabilities to provide care while preventing possible exposure to the virus, and helping subsidize child care costs for essential hospital employees.

“Donald Sussman’s generous gift will enable us to increase our capacity, expand vital research, and leverage the considerable resources and the expertise behind our hospital-wide efforts in ways that are real, measurable and long-lasting,” hospital President Dr. Peter Slavin said.

1:00 PM CT on 4/27/20

A collection of data tools created by MIT Sloan School of Management faculty aim to predict which counties could be overwhelmed by the virus and where front-line workers are needed.

The COVID-19 Policy Alliance collects data on a county level to help predict where outbreaks are occuring, especially in long-term care facilities. They also aim to determine where staff is needed and help connect workers looking for jobs with facilities that are hiring.

“The Alliance’s tools take real-time data to forecast the need for hospitals, ICU beds, and ventilators, down to the U.S. county level. These models help decision-makers allocate medical and other resources,” said  Professor Retsef Levi. “Our data makes it more likely that COVID and other patients will have the care available that they need.”

12:57 PM CT on 4/27/20

The American Medical Association has released a collection of online resources to promote health equity during the COVID-19 pandemic.

The resource center includes data on how COVID-19 has impacted marginalized communities, resources for non-English speakers, the pandemic’s effects on pregnant women and frequently asked questions for providers.

12:00 PM CT on 4/27/20

More than half of Americans age 70 and older have experienced a disruption in their healthcare during the first month of social distancing, according to a new survey from NORC at the University of Chicago.

The survey found 39% of older adults said they’d canceled non-essential medical treatment, and 32% said they’d forgone primary or preventative care. However, one in five said they’d had a telehealth appointment since the pandemic began, and about half of those adults said the appointment was about the same as an in-person visit.

“Telehealth is a lifeline for many who need clinical care during this pandemic,” said Terry Fulmer, president of The John A. Hartford Foundation. “Healthcare organizations have stepped up quickly to help older adults get their care needs met with this important technology. Comfort levels with telehealth vary, but we are seeing rapid uptake in both urgent and primary care delivery.”

11:07 AM CT on 4/27/20

IBM has launched a blockchain-based network to connect healthcare organizations and government agencies with suppliers who have started manufacturing medical equipment in response to COVID-19.

The network, called IBM Rapid Supplier Connect, provides inventory information for suppliers who have reoriented their businesses to produce masks, gowns and other equipment given the shortage of available medical supplies in the wake of the novel coronavirus outbreak, according to the IBM.

Blockchain describes a shared record of transactions. Ideally, it can enable participants in a group to securely share data with each other without a middleman and keep track of what was exchanged and when.

Northwell Health in New Hyde Park, N.Y., is one of the first hospital systems to join the network.

"It is through creating our own [group purchasing organizations] and supply chain, and joining forces with non-traditional suppliers that we have maintained an adequate stockpile of [personal protective equipment] and other equipment and supplies," Phyllis McCready, Northwell's chief procurement officer, said in a statement.

10:12 AM CT on 4/27/2020

University of Maryland School of Nursing approved an early-exit for students who were about to graduate, allowing them to enter the workforce and help combat the COVID-19 pandemic.

There are 98 Bachelor of Science in Nursing and 53 Clinical Nurse Leader master's students who qualify for early exit. They met GPA and academic program requirements, and can received a letter from the school for prospective employers.

8:53 AM CT on 4/27/2020

(AP) The city of Boston and Massachusetts General Hospital announced a partnership Sunday to test 1,000 asymptomatic city residents to evaluate community exposure to COVID-19 through antibody testing.

The federal Centers for Disease Control and Prevention estimates that nationally 25% of people infected with COVID-19 are asymptomatic, and may not know they are a carrier of the virus, or that they could be infecting others, according to a statement.

“Data from this testing in Boston will provide vital clues into the spread of the virus and will help us develop strategies to slow down or stop this invisible foe,” hospital President Dr. Peter Slavin said.

The city is randomly selecting participants in the hard hit neighborhoods of East Boston, Roslindale and Dorchester.

“The more we can expand our testing, the more we can learn how to use our medical resources more efficiently, and how we need to focus our current efforts to contain the virus,” Mayor Marty Walsh said.

7:26 AM CT on 4/27/2020

An Oxford University spin-off has asked 10 countries for x-rays of COVID-19 infected lungs, hoping the data can help them create a machine learning model that can predict patient outcomes.

Zegami wants to collect 10,000 COVID-19 lung x-rays, but only has 226 so far.

"As soon as we have enough x-rays it will be fully up and running and we hope ready to play a key role in supporting medical and technical professionals in their battle with this disease,” said Roger Noble, CEO and founder of Zegami.

7:43 PM CT on 4/26/2020

(AP) The Navy hospital ship sent to relieve stress on New York City hospitals at the height the pandemic is discharging or transferring its last 12 patients this weekend as it nears the end of its mission, according to Northwell Health, which provides operational assistance to the vessel.

The USNS Comfort, docked at a Manhattan pier since March 30, will soon leave for its homeport in Norfolk, Virginia, where it will restock and be readied for another possible assignment, Pentagon spokesman Jonathan Hoffman said. He did not provide a date for the ship’s departure.

As of Saturday, the 1,000-bed hospital ship had treated just 182 patients. There was just one patient left on the ship late Saturday evening.

6:04 PM CT on 4/26/2020

(AP) After two months of frantic response to the coronavirus, the White House is planning to shift President Donald Trump’s public focus to the burgeoning efforts aimed at easing the economic devastation caused by the pandemic.

Days after he publicly mused that scientists should explore the injection of toxic disinfectants as a potential virus cure, Trump has now rejected the utility of his daily task force briefings, where he has time and again clashed with scientific experts. Trump’s aides are aiming to move the president onto more familiar — and safer, they hope — ground: talking up the economy, in tighter controlled settings.

Some states have started to ease closure orders, and Trump is expected to begin to highlight his administration's work in helping businesses and employees. Aides said the president would hold more frequent roundtables with CEOs, business owners and beneficiaries of the trillions of dollars in federal aid already approved by Congress, and begin to outline what he hopes to see in a future recovery package.

4:21 PM CT on 4/26/2020

In a rush to get money to providers in desperate financial situations due to the COVID-19 pandemic, HHS sent some of providers’ $50 billion in general grant funds to facilities that have closed.

HHS’ first $30 billion grant distribution was sent automatically based on 2019 Medicare fee-for-service reimbursement. It is unclear exactly how much grant money from the Coronavirus Aid, Relief, and Economic Security Act's provider relief fund was erroneously sent out, and how much has been recovered. HHS said the department prioritized getting funds out quickly, and it is working to claw back improperly sent funds. Click here for more...

3:35 PM CT on 4/26/2020

The University of Maryland Medical System and Johns Hopkins Medicine Monday will open the 250-bed Baltimore Convention Center Field Hospital.
 
The facility is set up in the exhibit hall of the Baltimore Convention Center to care for COVID-19 positive patients.

“Opening this field hospital is a major victory in the fight against COVID-19 and one of our administration’s top priorities since day one of this crisis,” said Governor Larry Hogan.

2:33 PM CT on 4/26/2020

(AP) When a curfew goes into effect each night for one county in Hawaii, the mayor gets bored -- and posts videos on social media.

And his constituents? They’re entertained.

“Our Mayor is bettah than yours!!” one woman commented, responding to Kauai Mayor Derek Kawakami’s stiff but earnest version of the Renegade to the rap song “Lottery,” one of the most popular dances on social media.

In other videos, posted to his personal Facebook and Instagram accounts, he creates a mask out of a T-shirt and makes ice cream.

Even before Gov. David Ige issued a statewide stay-at-home order to curb the spread of the coronavirus, Kawakami set a 9 p.m. to 5 a.m. curfew for his county, which includes the islands of Kauai and Niihau.

The videos, the 42-year-old mayor explains on Facebook, are meant to “break the boredom together as a community.” And they seem to have succeeded.

1:48 PM CT on 4/26/2020

Six weeks into widespread self-quarantine, editors of academic journals have started noticing a trend: Women seem to be submitting fewer papers. This threatens to derail the careers of women in academia, said Leslie Gonzales, a professor of education administration at Michigan State University, to The Lilly.com.

A researcher compared data on preprint servers from January to April in 2020 to the same time period in previous years, noting “perhaps up to 50% more productivity loss among women.”

12:30 PM CT on 4/26/2020

(AP) With limited supplies of coronavirus tests available, the Pentagon is focusing first on testing those performing duties deemed most vital to national security. Atop the list are the men and women who operate the nation's nuclear forces, some counterterrorism forces, and the crew of a soon-to-deploy aircraft carrier.

Defense leaders hope to increase testing from the current rate of about 7,000 a day to 60,000 by June. This will enable them to test those showing symptoms as well as those who do not.

The current tight supply forced the Pentagon to take a phased approach, which includes testing sailors aboard the USS Nimitz, the Bremerton, Washington-based Navy carrier next in line to head to the Pacific. Officials hope to avoid a repeat of problems that plagued the virus-stricken USS Theodore Roosevelt. On Friday the Navy disclosed a virus outbreak aboard another ship at sea, the USS Kidd.

Despite President Donald Trump’s assertion that testing capacity is not an issue in the United States, Pentagon officials don’t expect to have enough tests for all service members until sometime this summer.

11:10 AM CT on 4/26/2020

10:28 AM CT on 4/26/2020

The San Antonio Express News reports a harrowing story of saving a patient's life when even medications and a ventilator weren’t enough. Doctors used an extracorporeal membrane oxygenation, or ECMO, which allowed the patient's lungs to rest as a machine took over the job of filtering oxygen into his blood.

9:21 AM CT on 4/26/2020

Vidant Heath in North Carolina sent state health officials the wrong COVID-19 test results Saturday. 

The state's Department of Health and Human Services said every test received from Vidant Health was counted as positive, increasing the total number of cases by 81. The corrected total is 8,542.

Vidant officials said the problem was a technical error not a problem with labwork. State officials said they had now updated the count.

Vidant Health announced last month that 191 staffers would be laid off.

8:37 PM CT on 4/25/20

HHS' early handling of the coronavirus pandemic is fueling speculation that Alex Azar may be on his way out as secretary.

Both the Wall Street Journal and Politico reported Saturday night that a short list of potential candidates is in the works and that it includes coronoavirus task for head Dr. Deborah Birx, CMS Administrator Seema Verma and HHS deputy Eric Hargan.

“The Department of Health and Human Services, under the leadership of Secretary Azar, continues to lead on a number of the President’s priorities,” HHS spokesman Judd Deere told the Wall Street Journal, which said it talked with six people familiar with the discussions. “Any speculation about personnel is irresponsible and a distraction from our whole-of-government response to COVID-19.”

Azar came under criticism early this week when reports emerged that in January, as COVID-19 was emerging in the Pacific Northwest, he place an Brian Harrison, an aide who had previously run a dog-breeding business for six years, in charge of the department's day-to-day COVID-19 response.

6:31 PM CT on 4/25/20

The U.S. should be able to double diagnostic testing for COVID-19 over the "next several weeks," Dr. Anthony Fauci said Saturday.

Speaking during a webcast of the National Academy of Sciences' annual meeting, Fauci estimated that the U.S. is conducting between 1.5 million and 2 million coronavirus tests per week.

"We probably should get up to twice that," said Fauci, who serves as the director of the National Institute of Allergy and Infectious Diseases. 

He also said that people should not become solely focused on testing.

"We don't want to get fixated on how many tests you need, but do you have enough tests to respond to the outbreaks that will inevitably occur as you try and ease your way back into the different phases," he said. "Testing is an important part of what we are doing, but it is not the only part. No doubt it is important to be able to do the identification, isolation and contract tracing."

The latest coronavirus relief package requires the Trump administration to develop a national plan for testing, but as Modern Healthcare's Steven Ross Johnson reports, but public health experts say cost barriers as well as states’ needs for resources must be addressed.

Fauci noted that the U.S. has more than 915,000 reported cases of COVID-19 and more than 51,000 deaths. While some localities are seeing a decline in reported cases, he cautioned that the numbers could be misleading since deaths usually lag by two or more weeks.

4:40 PM CT on 4/25/20

(AP) As the global death toll from the coronavirus surpassed 200,000 on Saturday, countries took cautious steps toward easing lockdowns imposed amid the pandemic, but fears of a surge in infections made even some outbreak-wounded businesses reluctant to reopen. 

The states of Georgia, Oklahoma and Alaska started loosening restrictions on businesses despite warnings from experts that such steps might be premature.

The worldwide death toll was over 202,000, according to a count by John Hopkins University from government figures. The actual death toll is believed to be far higher.

India reopened neighborhood stores that many of the country’s 1.3 billion people rely on for everything from beverages to mobile phone data cards. But the loosening didn’t apply to hundreds of quarantined towns and other places hit hardest by the outbreak that has killed at least 775 people in the country where many poor live in slums too crowded for social distancing.

Elsewhere in Asia, authorities reported no new deaths Saturday for the 10th straight day in China, where the virus originated. South Korea reported just 10 fresh cases, the eighth day in a row its daily increase was under 20. There were no new deaths for the second straight day.

2:22 PM CT on 4/25/20

(AP) A federal appeals court has ruled that Tennessee must continue allowing abortions amid a temporary ban on nonessential medical procedures during the COVID-19 outbreak.

The ruling follows a U.S. District judge's order last week that abortions could proceed during the pandemic.

The Sixth Circuit U.S. Court of Appeals, based in Cincinnati, issued its opinion Friday night. The justices wrote that courts must give governments flexibility to respond to a crisis.

“Affording flexibility, however, is not the same as abdicating responsibility, especially when well-established constitutional rights are at stake, as the right to an abortion most assuredly is,” the court wrote in the 33-page opinion.

Tennessee's attorney general had argued that abortions are not being singled out but treated like any other procedure that is not necessary to prevent death or serious bodily injury. Gov. Bill Lee issued an emergency order April 8 banning nonessential procedures for three weeks.

Several other states are grappling with similar issues. Judges in the past week have ruled to allow abortions to continue in Arkansas, Oklahoma, Ohio and Texas.

11:50 AM CT on 4/25/20

New York Gov. Andrew Cuomo Saturday said he will sign an executive order allowing independent pharmacies to conduct diagnostic coronavirus tests. 

"This will unlock a network of over 5,000 pharmacies as COVID-19 testing locations," he wrote in a tweet. 

The state currently conducts about 20,000 tests per day, but Cuomo wants to up that to 40,000. During his daily briefing, Cuomo also said he is expanding the criteria for a person to obtain a diagnostic test.

Antibody testing for healthcare workers is underway at four New York City hospitals. Next week, transit workers and state and city police will also receive antibody testing, the governor said.

The number of new coronavirus cases ticked down on Friday, with around 1,100 new cases, Cuomo said, adding, "Only in this crazy reality would 1,100 be relatively good news, right?"

10:31 AM CT on 4/25/20

(AP) As more states push to reopen their economies, many are falling short on one of the federal government’s essential criteria for doing so—having an efficient system to track people who have been physically near a person infected with the coronavius.

An Associated Press review found a patchwork of systems around the country for so-called contact tracing, with many states unable to keep up with caseloads and scrambling to hire and train enough people to handle the task for the months ahead. The effort is far less than what public health experts say is needed to guard against a resurgence of the virus.

The result is a wide array of strategies and little national coordination. With few exceptions, most states reviewed by AP are going it alone. Many other countries dealing with the pandemic are taking a national approach to testing.

As late as Friday, the website for the Centers for Disease Control and Prevention said detailed guidance on contact tracing for states was “forthcoming.”

“We’ll not ever control the whole country unless we have the same strategy,” said Dr. Cyrus Shahpar, a former CDC official. “Right now, that’s not what we’re doing.”

8:50 AM CT on 4/25/20

(AP) The World Health Organization is cautioning against the idea of “immunity passports." It says there is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected against a second infection.

The concept of “immunity passports” or “risk-free certificates” has been floated as a way of allowing people protected against reinfection to return to work.

But the Geneva-based U.N. health agency says in a scientific brief released Saturday that more research is needed. It says “at this point in the pandemic, there is not enough evidence about the effectiveness of antibody-mediated immunity to guarantee the accuracy of an ‘immunity passport’ or ‘risk-free certificate.’”

It argues that people who assume they are immune to reinfection may ignore public health advice, and such certificates could raise the risks of continued virus transmission.

WHO adds that tests for antibodies of the coronavirus also “need further validation to determine their accuracy and reliability.”

9:12 PM CT on 4/24/2020

(AP) At least 22 states and Washington, D.C., secured shipments of the drug, hydroxychloroquine, according to state and federal data.

But health experts worry that having the drug easily available at a time of heightened public fear could make it easier to misuse it. The U.S. Food and Drug Administration on Friday warned doctors against prescribing the drug, hydroxychloroquine, for treating the coronavirus outside of hospitals or research settings because of reports of serious side effects, including dangerous irregular heart rhythms and death among patients.

Oklahoma spent $2 million to buy the drugs, and Utah and Ohio have spent hundreds of thousands on purchases. The rest of the cities and states received free shipments from drug companies or the U.S. government over the last month. Ohio received a large donation from a local company.

Several states including New York, Connecticut, Oregon, Louisiana, North Carolina and Texas received donations of the medication from a private company based in New Jersey called Amneal Pharmaceutical. Florida was given 1 million doses from Israeli company Teva Pharmaceutical.

The Federal Emergency Management Agency said Friday it has sent out 14.4 million doses of hydroxychloroquine to 14 cities, including Washington, D.C., Philadelphia and Baltimore, from the federal government’s national stockpile, a source that also provided South Dakota and California with supplies. The U.S. government received a donation of 30 million doses from Swiss drugmaker Novartis on March 29 to build up the stockpile, which does not normally stock the drug.

8:14 PM CT on 4/24/2020

The Centers for Disease Control and Prevention on Friday added to the list of coronavirus symptoms. The number of symptoms has now tripled as the medical community learned more about the disease and how it spread.

• Fever
• Cough
• Shortness of breath or difficulty breathing
• Chills
• Repeated shaking with chills
• Muscle pain
• Headache
• Sore throat
• New loss of taste or smell

7:32 PM CT on 4/24/2020

(AP) Florida’s governor says his administration plans to let pharmacists administer tests for the new coronavirus to expand availability of testing for the general public.

Gov. Ron DeSantis says the state surgeon general would authorize pharmacists under emergency regulations, but he did not elaborate or say when this kind of testing might be rolled out.

Residents can seek testing through their doctors and private clinics, or go to one of the state’s seven drive-through and six walk-up sites — if they meet certain criteria. The conditions vary, with some sites focused on front-line responders, the elderly or people already showing some symptoms of COVID-19.

Pharmacy test sites would be part of efforts to expand testing to broader categories of people, including those with no symptoms but who believe they may have been exposed, DeSantis said.

6:25 PM CT on 4/24/2020

Fifty-five percent of U.S. adults say they watch President Donald Trump’s briefings on the coronavirus live at least sometimes, and 64% say they watch news coverage of them, according to a survey by Morning Consult.

Despite views on the press conferences falling along party affiliation, negative views outweigh positive ones among the general public.The most frequent words used to describe the conferences were “frustrating” and “misleading.” while “comforting” and “productive” are the lowest. Republicans tend to view the press conferences favorably, while 31% of GOP adults describe Trump’s appearances as “counterproductive” and 28% describe them as “frustrating.”

5:25 CT on 4/24/2020

Emory Healthcare has started using baby monitors to help ICU staffers communicate with one another as well as COVID-19 patients and their family members.

ICU staff found that high-efficiency particulate air filtration systems made COVID-19 patient rooms too noisy to effectively communicate with their peers outside the room.

“We had been writing on the ICU glass windows to communicate with colleagues inside and outside of ICU rooms, but baby monitors seemed like a great, simple way to improve communication,” says Tanya Snipes, a relief charge nurse at Emory Saint Joseph’s Hospital. “We place the unit that would normally be in a baby’s room in the ICU room, always keeping it turned on, and place the parent unit outside of the room. This allows staff to press a button and talk to those inside the room. Staff outside of the room can always hear what’s needed inside the room without entering, which helps in conserving PPE.”

The spouse of another care member also created battery packs to extend the lives of the baby monitors. They last approximately five days between charges.

3:29 PM CT on 4/24/20

The American Society of Anesthesiologists and American Society of Health-System Pharmacists are issuing guidelines to preserve supplies of medications during the COVID-19 pandemic, especially drugs needed to keep patients on ventilators.

The groups suggest maintaining infection control procedures to keep medications from being contaminated by the virus, as well as not discarding unopened drugs without considering how they could be disinfected. Providers could also follow guidelines to determine when drug use-by dates could be extended.

3:27 PM CT on 4/24/20

A new tool developed by researchers at Massachusetts General Hospital and Georgia Tech estimates how states will be impacted by the COVID-19 pandemic as social distancing restrictions are extended or lifted.

The model shows how lifting restrictions, extending stay-at-home orders or implementing lockdowns for different periods of time would affect new cases, numbers of deaths and strain on the healthcare system.

“Policy makers need to make decisions quickly—our analysis shows that even a week’s time can have a huge impact on the future trajectory of COVID-19. We developed the COVID-19 Simulator to inform such key decisions under this highly uncertain environment,” said lead investigator Jagpreet Chhatwal.

2:33 PM CT on 4/24/2020

In a new survey, more than seven in ten nurses say they're worried about their facilities being short-staffed during the COVID-19 pandemic, among other strains on the workforce.

The American Nurses Association polled 32,000 nurses. The results released Friday show more than half say they're short or out of personal protective equipment such as N95 masks, partial face shields and disposable gowns. Approximately 87% are very or somewhat afraid of going into work.

2:15 PM CT on 4/24/2020

(AP) New York reported its lowest number of daily COVID-19 deaths in weeks on Friday.

The state reported 422 deaths as of Thursday. That's the fewest since March 31, when it recorded 391 deaths. More than 16,000 people have died in the state from the outbreak.

“Again, this is at an unimaginable level, and it’s dropping somewhat. But it’s still devastating news,” Gov. Andrew Cuomo said at his daily briefing.

The total number of people hospitalized statewide continues to drop slowly, hitting 14,258, though the number of new patients coming into hospitals is basically flat at around 1,300, Cuomo said.

Though the overall trends provide some hope, the governor continued to stress that any gains could be lost quickly if social distancing restrictions are relaxed too quickly.

“How fast is the decline, how low is the decline?” Cuomo asked. “Again, the variable is what we do.”

12:41 PM CT on 4/24/2020

Office-based medical practices have been hard hit by the social distancing practices stemming from the COVID-19 pandemic, but there have been some variations based on regions.

According to Luma Health, practices in the West have seen a 44% increase in patient cancellations since mid-January, whereas Northeastern practices have seen a 100% increase. More than eight in ten providers say they have telehealth appointments available.

11:08 AM CT on 4/24/2020

(Crain's Chicago Business) Northwestern Memorial Hospital is among medical centers testing a rheumatoid arthritis drug as a possible treatment for severely or critically ill COVID-19 patients.

The Streeterville hospital is enrolling patients in a global clinical trial studying sarilumab, also known by the brand name Kevzara, Northwestern Medicine said today.

Severe cases of COVID-19 can cause a dangerous immune system response called cytokine storm, in which the body attacks itself rather than the virus. The trial aims to determine whether the injectable prescription medication, developed by Sanofi and Regeneron Pharmaceuticals, helps alleviate the overactive inflammatory responses in the lungs, according to a statement from the health system.

Northwestern is using diagnostic tests developed in-house to look for infection in patients receiving the drug, the statement says. The study will compare the response of people who get sarilumab to a smaller control group of patients taking a placebo.

“Very often with new diseases, people try multiple things at once, making it difficult to tell what, if anything, worked,” Dr. Richard Wunderink, Northwestern’s medical intensive care unit director, said in the statement. “Researchers in China gave a similar drug to a small number of people and observed what they thought were good effects. It is important to confirm—or not—these findings before we use this medication routinely. We also need to look to see if there are unexpected side effects of the drug in these patients.”

10:42 AM CT on 4/24/2020

(Crain's Cleveland Business) Cleveland Clinic is launching a center that aims to advance research on diseases including COVID-19.

The Center for Global and Emerging Pathogens, which has been in the planning stages for a year and a half, looks to broaden understanding of emerging pathogens (from Zika virus to SARS-CoV-2, which causes COVID-19) and expedite critically needed treatments and vaccines, according to a news release.

The new center, which will be largely supported by philanthropy, will include Cleveland Clinic's Lerner Research Institute in Cleveland and the Cleveland Clinic Florida Research and Innovation Center, a 107,000-square-foot building of laboratory and office space that is slated to open this summer in Port St. Lucie, Florida.

"Novel pathogens to which we have little or no immunity are a tremendous risk to global health," said Dr. Serpil Erzurum, chair of the Lerner Research Institute, in a prepared statement. "We have some of the world's top research experts in virology, immunology, genomics, population health and drug discovery coming together to form a team approach on infectious disease research."

9:57 AM CT on 4/24/2020

The parent company of Lysol disinfectant warned Friday that its products should not be used internally to treat COVID-19 after President Donald Trump wondered about the prospect during a White House briefing.

Trump noted Thursday that researchers were looking at the effects of disinfectants on the virus and wondered aloud if they could be injected into people, saying the virus “does a tremendous number on the lungs, so it would be interesting to check that.”

That prompted a strong warning from the maker of disinfectants Lysol and Dettol, which said it was issuing a statement to combat “recent speculation.”

“As a global leader in health and hygiene products, we must be clear that under no circumstance should our disinfectant products be administered into the human body (through injection, ingestion or any other route),” said the statement from Reckitt Benckiser.

The White House accused the media of misrepresenting Trump's comment.

“President Trump has repeatedly said that Americans should consult with medical doctors regarding coronavirus treatment, a point that he emphasized again during yesterday’s briefing," White House press secretary Kayleigh McEnany said in a statement Friday. "Leave it to the media to irresponsibly take President Trump out of context and run with negative headlines.”

Researchers are testing the effect of disinfectants on virus-laden saliva and respiratory fluids in the laboratory, said William Bryan, who leads the Science and Technology Directorate at the Department of Homeland Security. They kill the virus very quickly, he said.

8:45 AM CT on 4/24/2020

As nurses feel increased burden and burnout as they work through the COVID-19 pandemic, one company is looking to provide them with emotional support with their peers.

Trusted Health, which focuses on helping nurses build their careers, has launched an emotional support line in partnership with The Ohio State University College of Nursing. The line will be staffed by nurses and mental health specialists. They hope that the peer-to-peer program will set a precedent for similar initiatives in the future.

“As a nurses-first company, Trusted was founded on a simple idea: Nurses are the backbone of our healthcare system, and we must do more to support them,” said Dan Weberg, head of clinical innovation at Trusted. “The COVID-19 crisis has pushed this issue into the national consciousness, and we are committed to using this moment to advocate for and identify new ways to support the mental well-being of nurses not just on the frontlines, but everywhere.”

7:18 AM CT on 4/24/2020

HCA Healthcare said Friday that 172 of its affiliated hospitals will participate in a COVID-19 study on whether plasma from recovered patients can treat current victims. The health system is calling for qualified patients in 20 states to join the effort.

“As a learning healthcare system that serves communities across the country, we are proud to play a part in broader global public health initiatives, including this and other research, to identify effective COVID-19 treatments,” said Dr. Jonathan Perlin, chief medical officer at 
HCA Healthcare. “We’re encouraging the communities HCA Healthcare serves to join us in this important effort to help identify donors.”

Convalescent plasma has been used to treat similar coronavirus outbreaks, including SARS-1 and Middle East Respiratory Syndrome. Information on plasma donations can be found here.

8:47 PM CT on 4/23/2020

St. Luke's University Health Network has redeployed its occupational therapists to help workers at Pennsylvania essential businesses and manufacturers protect their health.

The OTs, nurses and medical assistants, who normally work in schools, are screening 6,000 employees per day at 15 businesses and hope to ramp up to 10,000 workers at 25 businesses.

“If we can identify a symptomatic employee prior to them entering the facility, we’ve mitigated a potential exposure to several hundred people,” said Kyra Dodson, St. Luke’s Worksite Injury Prevention Coordinator. “Our presence allows these essential businesses to operate in a safer manner and instills confidence in the employees.”  

7:16 PM CT on 4/23/2020

(AP) Hospitals, dentists' offices and other healthcare providers can resume attending to patients for non-urgent procedures on May 1, and Oregon is expecting “extremely large shipments” of protective masks and gowns, Gov. Kate Brown said Thursday.

However, health officials warned that Oregon, along with many other states, still lacks adequate testing capability to isolate and quash pockets of outbreaks of the coronavirus. Brown told reporters at a virtual news conference that around 8,000 tests are now being conducted weekly and that number will need to more than double.

“Testing is critical, and it's pretty clear we don't have enough, we need more,” Dr. Bruce Goldberg of the governor’s Medical Advisory Panel said. "We need to have robust contact tracing. And these are vital, vital pieces to allow us to continue to keep people safe and to start to approach some degree of normalcy.”

5:57 PM CT on 4/23/2020

Northwell Health on Thursday lit up Madison Square Garden's marquee in Manhattan that shows how many of its patients have recovered from COVID-19.

As of April 21, more than 6,600 patients at Northwell's 23 hospitals have beat the coronavirus. The "Hope Tracker" will run for several weeks. 

“COVID-19 is beatable and the Hope Tracker is another way to emphasize that recovery is happening here in New York,” said Ramon Soto, Northwell senior vice president and chief marketing and communications officer. “Recovery is an important storyline to the situation we continue to face. The pandemic has been tough on a lot of people in our communities. We need to continue to provide positive visuals and messages, and reassure them that we will persevere.”

5:12 PM CT on 4/23/2020

HHS extended the deadline for hospitals to provide the agency with information to help it decide how to pay out $10 billion to areas that have been hard-hit by COVID-19.

Hospitals have until 3 pm Eastern Time on April 25 to submit their taxpayer identification number, national provider identifier, the number of intensive care unit beds on April 10 and their number of COVID-19 admissions from January 1 to April 10.

“The extension will not delay the start of the distribution of these funds to high-impact areas, starting next week,” HHS said in a statement.

The additional funds come from the Coronavirus Aid, Relief, and. Economic Security, or CARES, Act.

4:47 PM CT on 4/23/2020

The majority of hospitals' planned surgeries have been canceled during the COVID-19 pandemic, and many providers are starting to calculate when and how they come back online for elective procedures.

LeanTaaS created a free calculator to model when hospitals could resume their normal caseloads. More than 100 health systems helped their data scientists create the tool.

3:22 PM CT on 4/23/2020

(Crain's Chicago Business) Layoffs, furloughs and reduced schedules are expected to save Sinai Health System an estimated $1.5 million as COVID-19 strains hospital finances.

The moves, which take effect Sunday, involve laying off 24 employees in non-clinical positions, furloughing about 150 caregivers and slashing hours for another 200 employees, the four-hospital chain announced today. It noted that furloughed workers could be reinstated within 60 days.

All hospitals are grappling with the financial realities of COVID-19, which has led them to cancel the elective surgeries and outpatient visits that help keep them afloat. But the pandemic is particularly hard on safety nets like Sinai that treat large numbers of poor and uninsured patients.

Cancellations and increased costs to treat COVID-19 patients have caused Sinai to lose $10 million a month, according to a statement.

“We need to act responsibly to protect Sinai’s financial stability,” CEO Karen Teitelbaum said in the statement. “This means difficult decisions about caregiver roles and assignments, including furloughs and layoffs. We are also limiting hiring activities to only essential positions, and developing plans for restarting certain services when possible again.”

2:06 PM CT on 4/23/2020

(AP) The Pennsylvania Department of Health slashed the state’s COVID-19 death toll on Thursday by 201, saying probable deaths it had previously included in the count were eliminated after further investigation.

The overall death toll now stands at 1,421, down from 1,622 reported a day earlier.

The number of deaths confirmed by a positive virus test actually rose overnight by 69, to 1,394. But Health Secretary Rachel Levine said Thursday that 270 probable deaths that had been added to the death toll in recent days have been removed after further investigation.

“This verification process is very intensive and under normal circumstances it can take months to complete,” she said. “We continue to refine the data that we are collecting to provide everyone this information in as near time as we possibly can. This is really difficult with thousands of reports each day.”

State health officials had recently changed the way they count COVID-19 deaths — now including probable deaths along with confirmed deaths — which resulted in a doubling of the state’s death toll in just four days. A probable death is one in which a coroner or medical examiner listed COVID-19 as the cause or contributing cause, but the deceased was not tested for the virus.

Officials have said they are trying to reconcile data provided by hospitals, healthcare systems, county and municipal health departments and long-term care living facilities with the department’s own records. Some county coroners have accused the state Department of Health of botching the numbers.

1:44 PM CT on 4/23/2020

HHS Thursday awarded almost $5 million to help poison control centers respond to an increase in calls for help since the COVID-19 pandemic began.

Poison control centers can use the money for education and outreach, training and to manage increased call volume resulting from COVID-19 related poisonings.

“Poison control centers are an easily accessible resource for Americans to protect their health, providing information about the risks of products they may be more likely to use to keep their households clean and loved ones safe during the pandemic,” HHS Secretary Alex Azar said.

Many people have attempted to prevent or cure the virus using household cleaners or disinfectants, which has led to a spike in exposure calls related to cleaners and disinfectants, according to the Centers for Disease Control and Prevention.

The funding was provided by the Coronavirus Aid, Relief, and Economic Security, or CARES, Act.

1:06 PM CT on 4/23/2020

(AP) Gov. Laura Kelly has suspended multiple regulations licensing medical professionals to make it easier for them to work in healthcare facilities and nursing homes.

The executive order Kelly issued Wednesday suspends requirements that doctors supervise physician assistants, advanced practice practical nurses and licensed practical nurses. The order also allows nurses with inactive or lapsed licenses to provide services and permits medical or nursing students to volunteer to work in healthcare facilities.

“Our healthcare facilities need as much flexibility as possible as we approach our projected peak infection rate in the coming days to ensure that hospitals do not become overwhelmed,” Kelly said during a news conference Wednesday.

The governor said the order is a “first step” and health care providers face “broader and more complex challenges.” She said she cannot address them with an executive order and called on the Legislature to consider rewriting licensing laws.

12:07 PM CT on 4/23/2020

HHS Thursday announced that the Centers for Disease Control and Prevention would award $631 million to help public health departments increase their COVID-19 testing and contact tracing capacities.

“This infusion of additional funding into the nation’s public health infrastructure will strengthen our capacity to implement tried and true containment measures,” said CDC Director Dr. Robert R. Redfield. “The ability to implement aggressive contact tracing, surveillance and testing will be fundamental to protecting vulnerable populations as the nation takes steps to reopen and Americans begin returning to their daily lives.”

The agency will take advantage of existing networks to help state and local jurisdictions secure funding.

The Coronavirus Aid, Relief, and Economic Security, or CARES, Act provided CDC with the additional funds.

11:52 AM CT on 4/23/20

(Crain's Cleveland Business) In his daily news conference on Wednesday, April 22, Gov. Mike DeWine said that Ohio Department of Health director Dr. Amy Acton would sign an order to begin relaxing her March 17 order that postponed all elective surgeries in order to keep hospital beds free for COVID-19 patients and preserve personal protective equipment.

The new order will encourage doctors, hospitals and outpatient surgery centers to reassess all postponed procedures and to reach out to those patients to determine their current health and how their quality of life has been affected by the postponement.

Both DeWine and Acton said they had become concerned by anecdotal reports of patients suffering due to cancellation of their surgeries. The new order also asks providers to begin moving forward with postponed diagnostic procedures. In all cases, patients must be informed of their options and the risks posed by COVID-19 infection so they can make informed decisions.

11:06 AM CT on 4/23/20

(Crain's Cleveland Business) Citing the financial impacts of the COVID-19 pandemic, University Hospitals announced plans to reduce hours and pay for about 4,100 caregivers not directly involved in patient care, according to a news release.

The 20% cut will be in place for an initial period of 10 weeks for salaried and hourly nonclinical staff throughout the health system. Executives, directors, nonclinical managers, department chairs and division chiefs will also see a pay reduction but will continue to work their regular schedules.

Ohio hospitals are seeing an estimated financial loss of $42 million daily, and spending $5 million per day on increased supply costs, according to the release. UH made the decision after weighing a detailed assessment of financial models, capital expenditures and other costs. Though the system is seeking resources available through FEMA and the Cares Act, any recoveries from these programs alone won't nearly make up for financial losses, according to the release.

Matching contributions to 403(b) and 401(k) plans are also suspended temporarily for all caregivers beginning the first pay in May, and planned merit pay adjustments are delayed until the end of the calendar year.

9:56 AM CT on 4/23/20

(AP) Arkansas will next week ease its ban on elective surgeries during the coronavirus pandemic and an announcement could also come on the lifting of restrictions on other businesses, Gov. Asa Hutchinson said Wednesday.

The state will allow hospitals and clinics to resume some elective surgeries starting Monday, Hutchinson said. The state had ordered healthcare providers to reschedule procedures that could be safely postponed.

"This will allow them to go back to business, it will allow everybody in Arkansas to have access to more routine procedures that have been put off for the last 45 days," Hutchinson said.

State Health Secretary Dr. Nathaniel Smith said the providers will have to meet certain conditions, including requiring patients to be tested for the virus 48 hours before the procedure. Smith said the ban is being lifted for procedures that don't require an overnight stay in the hospital.

It was not immediately clear whether the order would clear the way for the resumption of surgical abortions, which the state has halted.

9:25 PM CT on 4/22/20

(AP) President Donald Trump on Wednesday played down the possibility that the coronavirus could be worse this winter despite medical experts’ warnings that COVID-19 could combine with the flu to make a more complicated return to the United States.

Trump, who has been pushing for states to begin reopening their economies, batted down notions that COVID-19 could return in large waves, as has happened in previous pandemics. Health experts and members of the White House coronavirus task force have warned of a possible comeback for the virus next fall. 

“If it comes back, though, it won’t be coming back in the form that it was," he said during Wednesday's task force press briefing. "It will be coming back in smaller doses that we can contain. ... You could have some embers of corona ... (but) we will not go through what we went through for the last two months.”

Trump then turned to Dr. Deborah Birx, coordinator of the coronavirus task force, and asked, “Doctor, wouldn’t you say there’s a good chance that COVID will not come back?”

“We don’t know,” Birx responded.

Dr. Anthony Fauci, the nation’s top infectious disease expert, said later in the same briefing: “We will have coronavirus in the fall. I am convinced of that.”

8:33 PM CT on 4/22/20

(Crain's Chicago Business) AbbVie has shifted its operations to help Illinois test more people for COVID-19.

The Chicago-based drugmaker is donating about 40,000 units of viral transport media, or VTM, a week to the Illinois Department of Public Health, Crain’s has learned. The material is essential for COVID-19 testing since it maintains specimens until a laboratory can process them.

Gov. J.B. Pritzker has said that obtaining VTM, swabs and other raw materials needed to conduct tests has been particularly challenging. But he said last week that universities and vendors have committed to providing the materials needed to get Illinois closer to its goal of performing 10,000 tests a day.

AbbVie also has transformed one of its own labs to run tests for vulnerable patients, such as uninsured residents. 

7:25 PM CT on 4/22/20

(AP) California Gov. Gavin Newsom loosened the state’s stay-at-home order on Wednesday to let hospitals resume scheduled surgeries, the first step toward reopening the nation’s most populous state that has been shut down for more than a month because of the cronavirus pandemic.

Newsom gave no date for when businesses could reopen and people could return to work, saying that would depend on the state’s ability to build a more robust testing system “that is more inclusive.” So far, California has tested more than 465,000 people, or just over 1% of the state’s nearly 40 million residents.

Hospitals had stopped performing elective surgeries to make beds available for an expected surge of coronavirus patients. But an expected surge hasn’t happened.

Newsom said the number of coronavirus hospitalizations, including those in intensive care units, declined slightly. He said the modified order allows for surgeries that are “not an emergency but if left neglected for months and months could become an emergency.” Examples include surgeries for cancers, heart valves and chronic diseases. He said the order does not include purely cosmetic procedures, including plastic surgeries.

6:22 PM CT on 4/22/20

(AP) Former New York City Mayor Mike Bloomberg will help create a “tracing army” that will help find people infected with the coronavirus and get them into isolation, Gov. Andrew Cuomo announced Wednesday.

New York will coordinate the massive effort with neighboring New Jersey and Connecticut, accounting for the large number of people who commute into New York City for work. Wide-scale testing, tracing and isolation are considered crucial to taming the outbreak in the hard-hit region. 

“It all has to be coordinated. There is no tracing that can work with one jurisdiction,” Cuomo said at his daily briefing.

More than 257,000 people statewide have already tested positive for COVID-19 — a figure that likely undercounts infected residents by a substantial amount.

The state currently has just 225 tracers with almost 500 more in New York City and its suburbs, and their efforts to contain the virus by finding people who had contact with the sick fell apart quickly as huge numbers of people in the region fell ill.

4:48 PM CT on 4/22/20

National insurer Centene Corp. on Wednesday announced an initiative to help federally qualified health centers roll out telehealth services amid the COVID-19 pandemic.

Centene, which serves Medicaid, Medicare and Obamacare exchange members, said it will provide $5 million toward purchasing equipment and providing training and technical assistance to the health centers.

The initiative is part of a larger effort between Centene and the National Association of Community Health Centers to develop a national solution for implementing telehealth in Medicaid programs.

“In partnership with Centene, we envision a collaboration that identifies what health centers need in terms of technology, equipment, and assistance to address COVID-19 and builds a path forward for the sustainable integration of telehealth in community health care settings,” said Dr. Ron Yee, chief medical officer at the National Association of Community Health Centers.

4:47 PM CT on 4/22/20

(AP) In this era of dire medical need, hospitals and other parts of the health sector have seen incoming revenue erode to almost nothing.

Quest Diagnostics' testing volumes dropped more than 40% during the last two weeks of March, including COVID-19 testing. The company said in a regulatory filing that its cost-cutting measures include salary reductions for executives, suspension of its 401 (k) match, fewer hours for employees whose work has significantly declined and furloughs for employees with diminished work who expressed interest. Quest withdrew its full-year financial outlook.

Products made by Medtronic are essential in the fight against COVID-19, but that's just a sliver of what the company produces, and sales of those other goods have plummeted. Non-emergency procedures unrelated to the outbreak have come to a standstill.

Weekly revenue in the U.S. have tumbled 60% since the middle of March, when compared with last year. At the same time, spending at Medtronic is churning along with a vast need for its ventilators.

4:34 PM CT on 4/22/2020

The CMS on Tuesday issued additional blanket waivers for hospitals, psychiatric hospitals and critical access hospitals, including cancer centers and long-term care hospitals.

“Hospitals, psychiatric hospitals, and critical access hospitals to screen patients at a location offsite from the hospital’s campus to prevent the spread of COVID-19, so long as it is not inconsistent with a state’s emergency preparedness or pandemic plan,” the CMS said in its guidance.

The agency is also waiving several verbal order, reporting, facility, licensure and staffing requirements, among other changes.

3:35 PM CT on 4/22/2020
Ambulatory surgery centers and physical therapy providers will be among the hardest hit corporate healthcare segments tracked by Moody's Investors Service, the ratings agency said in a research report on COVID-19.

The governmental mandates limiting nonessential procedures will lead to an acute drop in patient volumes over the coming weeks.

Once the pandemic is over, the two provider types may snap back quickly. "The timing of a recovery is uncertain, but we believe that when the crisis subsides, these companies will be among the first to recoup lost volumes because there will be pent-up demand for routine, preventative and other deferrable care," Moody's wrote. Moody's also said dental care providers would be hit hard.

3:01 PM CT on 4/22/20

(Crain's New York Business) The Mount Sinai Laboratory is one of only a handful of labs to receive emergency authorization from the Food and Drug Administration to test whether patients have the antibodies to fight off the virus that causes COVID-19.

Testing for this type of immunity has been identified by New York Gov. Andrew Cuomo as key to reopening the state's economy and lifting restrictions on social interaction. Cuomo said Tuesday that the state was working with President Donald Trump to double the amount of diagnostic and antibody tests it does to 40,000 a day. He didn't set a timeline for achieving that goal.

Since validating and getting approval for the test, Mount Sinai had screened about 7,300 people as of Monday, health system officials told Crain's. The participants are individuals who have recovered from COVID-19 for at least two weeks and who might be candidates to donate plasma to severely ill patients. As of late last week, more than 600 people had been deemed eligible and committed to donate plasma through the New York Blood Center.

Mount Sinai began working on the test in January, developing a technique by which it could determine whether a person's immune system had interacted with the virus. The institution's researchers, led by microbiologist Florian Krammer, said the test can identify the presence of antibodies as soon as three days after symptoms appear.

Mount Sinai is working to make the test available to 200 research laboratories around the world.

2:26 PM CT on 4/22/20

(AP) The Iowa Department of Public Health is offering coronavirus testing for all employees of long-term care facilities in Tama County because of a rising number of cases in the region, Gov. Kim Reynolds said Wednesday.

The action followed a surge in cases at the National Beef plant in Tama, where 177 workers tested positive for COVID-19, the disease caused by the coronavirus. The eastern Iowa plant resumed production Monday after being closed for two weeks because the virus had spread among its workers.

Reynolds has frequently noted that a large percentage of those who have died from the virus live in long-term care facilities.

"By proactively conducting surveillance testing of long-term care facility employees in the area we do have the opportunity to isolate and identify positive cases early and potentially prevent exposing additional vulnerable residents," Reynolds said.

The testing will be done Wednesday and Thursday, and officials expect more than 200 people to participate.

2:24 PM CT on 4/22/20

(AP) Two testing facilities that New Jersey operates with the federal government are now taking state residents who show no coronavirus symptoms.

The Monmouth County Prosecutor's office said Wednesday that the centers in Monmouth and Bergen counties will no longer require state residents to have symptoms in order to get tested.

The state operates the drive-through facilities with the Federal Emergency Management Agency.

Beyond the two federally affiliated facilities, New Jersey has about 70 other testing centers across the state and conducts about 9,000 tests a day, according to Gov. Phil Murphy. Murphy said Tuesday he thinks the state needs to double the number of tests it does daily.

Murphy, a Democrat, has said the state would need to ramp up testing beyond just symptomatic people before reopening its economy.

1:28 PM CT on 4/22/20

(AP) Inspections are underway at a Kansas City, Kansas, rehabilitation facility where 25 people have died of COVID-19 and another 91 have contracted the disease.

The outbreak at the Riverbend Post Acute Rehabilitation started after a staff member who wasn't wearing appropriate personal protective equipment worked two shifts last month with a fever and cough before being diagnosed with COVID-19, according to a report that local health officials released last week.

State and federal inspectors are now looking into infection control measures that are being implemented at the facility, said Cara Sloan, a spokeswoman for the Kansas Department for Aging and Disability Services.

The deaths at Riverbend, which provides short-term rehabilitation for people recovering from medical issues as well as long-term care, account for nearly a quarter of Kansas' 107 deaths from COVID-19, the disease caused by the coronavirus. Wyandotte County, where the facility is based, is the hardest hit in the state, accounting for 433 of the state's 2,025 cases.

Eight of the sickened Riverbend residents remained hospitalized Tuesday, the Kansas City-Wyandotte County health agency said. Riverbend said on its website this week that there were signs of improvement, noting that 90% of the sickened residents were medically stable.

12:37 PM CT on 4/22/20

Tens of thousands of people are taking advantage of the emergency special enrollment periods that certain states launched in response to the COVID-19 pandemic.

More than 10,000 individuals in Colorado have so far signed up for Affordable Care Act exchange coverage through the state’s special enrollment period that ends April 30. Another 21,500 Marylanders enrolled in exchange or Medicaid coverage through a sign-up period ending June 15. And in Minnesota, 9,400 obtained exchange coverage during the state’s the now-closed enrollment period.

California’s insurance exchange has signed up 58,400 people. So far, D.C. and 11 of the 12 states that run their own ACA marketplaces have moved to allow uninsured people to enroll in coverage outside of the normal open enrollment period. The federal government, meanwhile, has refused to open up the HealthCare.gov exchange for the 38 states that use it.

11:28 AM CT on 4/22/20

The CMS has released a guide for healthcare leaders on managing their workforce during the COVID-19 pandemic.

The toolkit includes funding options, liability protections and training tools. It will also house best practices with updates on how those practices are working in the field.

“This new resource will help states apply all of these important changes on the ground in order to maximize their workforce to ensure care for patients,” said CMS Administrator Seema Verma.

10:42 AM CT on 4/22/20

(AP) Hawaii authorities on Tuesday reported a death associated with a cluster of coronavirus cases at Maui Memorial Medical Center while Honolulu's mayor extended his city's stay-at-home order through May 31.

The man who died was 65 or older and had an underlying health condition, the Hawaii COVID-19 Joint Information Center said. He had been at the hospital since late last year.

The COVID-19 cluster occurred after an infected employee went to work despite not feeling well. As of Monday, as many as 36 staff members and 20 patients have been confirmed as having the infection or shown symptoms, officials said.

The hospital hasn't had any new cases of COVID-19 since April 8, when the facility adopted universal use of face masks and daily symptom screenings for all employees, state Department of Health Director Bruce Anderson said. He said the cases at the hospital appear to be contained and controlled.

9:28 AM CT on 4/22/20

Researchers found the level of coronavirus in Paris sewage corresponded to the severity of the outbreak in the city, which could serve as a warning before patients show up at hospitals.

The pre-print study looked at wastewater across Paris for more than a month. Researchers saw higher levels of the virus several days before the city recorded its first coronavirus deaths, and concentration of the virus continued to increase as the number of patients with COVID-19 rose.

“We have a very clear curve that precedes the curve in numbers of clinical cases, and now with confinement, we see a flattening of that curve,” says Laurent Moulin, a study co-author, told Science.

7:18 AM CT on 4/22/2020

In an effort to curb post-traumatic stress disorder in healthcare workers treating COVID-19, a New York-based clinic is offering free group therapy to those individuals. 

Mindful Urgent Care said that all of its new patients say COVID-19 is affecting their mental health, and many of them are healthcare professionals. They have seen a 24% spike in visits since the pandemic began.

Healthcare workers treating coronavirus can obtain free, virtual group therapy from the clinic.

8:51 PM CT on 4/21/2020
(AP) A Navy hospital ship deployed to New York City to help fight the coronavirus outbreak is no longer needed, Gov. Andrew Cuomo said Tuesday, expressing confidence that stresses on the hospital system are easing.

Cuomo said after meeting with President Donald Trump that the USNS Comfort was helpful, but could now be sent elsewhere after being docked for weeks off of Manhattan.

At an evening press conference, Cuomo said having the ship had been worthwhile, even as the need for it didn't reach the levels that had been projected.

"I believe Comfort not only brought comfort but also saved lives," Cuomo said.

7:59 PM CT on 4/21/2020

The National Association of Free & Charitable Clinics will offeer video chat, SMS and secure text messaging to its members through an arrangement with Updox, which sells a telehealth and collaboration platform, according to an updox press release.

“An essential part of fighting this pandemic is keeping patients out of emergency departments, urgent cares and waiting rooms, particularly those who are in at-risk groups. On top of that, patients still need routine care, monitoring and regular check-ups. That makes a reliable, easily-accessible telehealth solution essential to care,” said Nicole Lamoureux, NAFC president and CEO.

NAFC supports 1,400 free and charitable clinics and charitable pharmacies in the United States that serve more than 2 million patients and 111,000 medical volunteers, according to the release.

7:08 PM CT on 4/21/2020

The American Nephrology Nurses Association launched an interactive map that identifies hotspots across the U.S. and allows nurses to answer facilities' calls for help, the organization said in a news release.

The map allows hospitals, facilities, and other organizations to submit information about their current needs for nephrology nursing staff, matching nurses with the facilities most in need.

"The tool works both ways. Nurses search the map by state to quickly identify and contact facilities with openings, and facilities also use the map to provide their name, location, type of health care professionals and specific practice areas they need to fill," said Lillian Pryor, president of ANNA.

5:46 PM CT on 4/21/2020

(AP) Gov. Ned Lamont said Tuesday that plans are underway to greatly ramp up COVID-19 testing across Connecticut as officials consider how and when to safely reopen the state and avoid a second wave of the disease.

The Democrat announced a new partnership between Hartford HealthCare and Quest Diagnostics, which will allow the health network to boost its testing capacity from about 500 tests per day to 2,000, with results available in 24 hours. In recent weeks, there's been an average of 2,600 tests a day being conducted across the entire state of Connecticut.

"Right now, we are only able to test people who are showing symptoms, so we're missing an awful lot of the folks out there," said Lamont, noting that about 40% of people who've been infected by the coronavirus don't show symptoms right away. "It's important that we be able to capture that if we're ever able to get back to work safely."

Jeffrey Flaks, president and CEO of Hartford HealthCare, said people will be able to call a hotline or go online to request a test. Initially, there are plans for five test centers, with more on the way. Hartford HealthCare also expects to have a mobile testing unit that can go to nursing homes, correctional facilities, homeless shelters and other places that are considered hot spots for COVID-19.

4:46 PM CT on 4/21/20

(AP) A malaria drug widely touted by President Donald Trump for treating the new coronavirus showed no benefit in a large analysis of its use in U.S. veterans hospitals. There were more deaths among those given hydroxychloroquine versus standard care, researchers reported.

The nationwide study was not a rigorous experiment. But with 368 patients, it's the largest look so far of hydroxychloroquine with or without the antibiotic azithromycin for COVID-19, which has killed more than 171,000 people as of Tuesday.

The study was posted on an online site for researchers and has not been reviewed by other scientists. Grants from the National Institutes of Health and the University of Virginia paid for the work.

Researchers analyzed medical records of 368 male veterans hospitalized with confirmed coronavirus infection at Veterans Health Administration medical centers who died or were discharged by April 11.

About 28% who were given hydroxychloroquine plus usual care died, versus 11% of those getting routine care alone. About 22% of those getting the drug plus azithromycin died too, but the difference between that group and usual care was not considered large enough to rule out other factors that could have affected survival.
Hydroxychloroquine made no difference in the need for a breathing machine, either.

Researchers did not track side effects, but noted a hint that hydroxychloroquine might have damaged other organs. The drug has long been known to have potentially serious side effects, including altering the heartbeat in a way that could lead to sudden death.

The NIH and others have more rigorous tests underway.

4:43 PM CT on 4/21/20

(Crain's Detroit Business) The U.S. Centers for Disease Control and Prevention has sent staff and expertise to Detroit to help deal with its coronavirus crisis in nursing homes.

CDC Director Robert Redfield, M.D., sent four clinicians Tuesday to the Detroit Health Department, Mayor Mike Duggan said Tuesday during a daily briefing on coronavirus response. He said he and Denise Fair, chief public health officer, requested help from the CDC.

The health protection agency's new involvement comes after the city began mass testing of all residents and staff at the 26 nursing homes in Detroit. It expects to finish the process by Thursday, using its five Abbott Laboratories rapid COVID-19 testing machines.

Duggan two weeks ago called nursing homes the "center of the battle" against the coronavirus. So far at least 124 Detroit nursing home residents have died due to COVID-19, Duggan said, though it's likely that figure is "dramatically understated."

The federal agency staff will be in Detroit for two weeks assisting with nursing home response led by the health department. The CDC will help city officials develop a strategy for testing and screening in nursing homes and skilled nursing facilities, as well as join meetings between the city and leaders of such facilities to address response, Fair said. They will assist with site visits, train health department trainers and provide infection prevention and control education for healthcare workers at the facilities.

4:07 PM CT on 4/21/2020

Franciscan Missionaries of Our Lady Health System's overall volumes have dropped 50% due to the COVID-19 pandemic, and the Louisiana health system expects it will lose $120 million in March and April.

"We have had to take steps to adjust to this new, if temporary, reality. While difficult, these actions are made to ensure the long-term sustainability of our health system and Sisters’ Mission beyond this pandemic. Our teams and our Board understand their responsibilities as well as preserving our collective future,” the system's President and CEO Dr. Richard R. Vath said in a statement.

FMOLHS has reduced some staff hours, cut executive salaries, postpone expenditures and evaluated its contract terms as it deals with the sudden revenue loss. Ultimately, Vath said caring for the community and responding to the COVID-19 pandemic are the system's top priorities.

3:00 PM CT on 4/21/20

(AP) U.S. health regulators on Tuesday OK'd the first coronavirus test that allows people to collect their own sample at home, a new approach that could help expand testing options in most states.

The test from LabCorp will initially only be available to healthcare workers and first responders under a doctor's orders. The sample will still have to be shipped for processing back to LabCorp, which operates diagnostic labs throughout the U.S.

Allowing people to self-swab at home would help reduce infection risks for front-line healthcare workers and help conserve protective gear.

For the home test, people are initially screened with an online questionnaire. If authorized by a physician, LabCorp will ship a testing kit to their home. The kit includes cotton swabs, a collection tube, an insulated pouch and box to ship the specimen back to LabCorp. To take a sample, a cotton swab is swirled in each nostril. The test results are posted online to a secure company website.

The company said it will make the test available in the coming weeks. Each kit will cost $119. The kits will not be available in Maryland, New Jersey, New York and Rhode Island. Those states have laws prohibiting testing with at-home kits.

2:50 PM CT on 4/21/20

(AP) Health officials in Wisconsin said they have identified at least seven people who appear to have contracted the coronavirus from participating in the April 7 election, the first such cases following in-person voting that was held despite widespread concern about the public health risks.

The cases involve six voters and one poll worker in Milwaukee, where difficulty finding poll workers forced the city to pare nearly 200 voting locations back to just five, and where voters — some in masks, some with no protection — were forced to wait in long lines for hours.

The conditions of the seven weren't immediately available. City health commissioner Jeanette Kowalik told the Milwaukee Journal Sentinel that she hopes to have more information later in the week. Kowalik's office didn't immediately respond to a question from The Associated Press asking how city health officials were able to trace the infections to the election.

The April 7 election, which included a presidential primary as well as a state Supreme Court race and local offices, took place after a legal struggle between Democrats and Republicans. A day before the election, Democratic Gov. Tony Evers ordered that it be delayed and shifted to all-mail voting, only to be overturned when Republican legislative leaders won an appeal in the state's conservative-controlled Supreme Court.

2:10 PM CT on 4/21/20

(Crain's New York Business) As the number of people admitted to city hospitals for COVID-19-like illnesses has fallen—from nearly 700 per day at the beginning of the month to a little more than 300—capacity could be less strained going forward.

At New York City Health and Hospitals officials have been "cautiously optimistic that we've hit the peak and are plateauing," said Dr. Eric Wei, an emergency department physician and the health system's chief quality officer.
The health system is seeing a decreasing number of patients showing up in its emergency departments, Wei said, comparing the trend to "an overnight plummet."

However, those who are still coming in are critically ill, high-acuity patients in respiratory distress, Wei said.
"We still do have a lot of patients in our intensive-care units who require ventilators to support their breathing," he said.

Elmhurst Hospital—the Queens facility that quickly became the epicenter of the COVID-19 outbreak—seems to be over its peak, Wei said. Now Queens Hospital in Jamaica and Coney Island Hospital are more stressed.

Elsewhere in the city, a spokeswoman for Mount Sinai said the health system is seeing a plateau in COVID-19 hospitalizations. It is experiencing a flattening in the number of deaths per day, she added, including a general decline since April 6.

"Based upon the trends we are seeing over the past eight days, we have enough beds to manage the pandemic," the spokeswoman said, "but not enough to return to normal operations."

NYU Langone Health said COVID-19 hospitalizations have dropped across all its facilities. It recently embarked upon expansion efforts to meet COVID-19 demand, even receiving expedited approval from the state Department of Health to grow the emergency department at its flagship hospital in Manhattan.

In recent weeks the health system opened spaces for emergency and inpatient care to help decrease overcrowding. And it expanded its number of ICU beds.

1:32 PM CT on 4/21/20

The American Academy of Orthopaedic Surgeons has published a list of clinical considerations for providers looking to resume elective surgeries during the COVID-19 pandemic.

The guidelines include prioritizing patient and staff safety, following CDC guidelines, making decisions based on local conditions like the availability of personal protective equipment and ventilators, and following local legal restrictions like stay-at-home-orders.

“CMS has once again offered a helpful, nationwide framework for entering this new phase of the pandemic, and we applaud the agency for recognizing the significant differences in disease incidence and prevalence in each state and locale,” said AAOS President Dr.  Joseph A. Bosco III. “Now as individuals across the country begin evaluating these recommendations and implementing them in their practices, the AAOS is offering additional detail for prioritizing the safety of our patients and members.”

12:59 PM CT on 4/21/2020

A team of drone companies has completed a series of tests to assess whether unmanned aerial systems can help hospitals transport lab samples and medical products during the COVID-19 pandemic.

Virginia's not-for-profit Center for Innovative Technology partnered with UPS Flight Forward—a UPS subsidiary focused on drone delivery—and drone companies DroneUp and Workhorse Group to assess processes and training necessary for safe drone deliveries, as well as looking into possible policy changes that could promote efficient deliveries via drones.

The Center for Innovative Technology, UPS Flight Forward, DroneUp and Workhorse Group completed three days of tests on a vacant campus in Virginia earlier this month. They plan to compile findings on the role drones could play in COVID-19 response into a report that's delivered to the White House.

"Drones can be an important way to deliver medical supplies while people stay home to adhere to our social distancing guidelines," Virginia Gov. Ralph Northam said in a statement. "I am encouraged to see so many private sector partners stepping up and thinking innovatively as we work together to combat COVID-19."

UPS Flight Forward has been targeting hospitals as possible customers for drone delivery since earning a first-of-its-kind federal certification to expand its drone delivery network last year.

12:27 PM CT on 4/21/2020

HHS will provide nearly $1 billion in grants for home-delivered meals, home-based care services, respite care and other supports for older adults and people with disabilities, according to a statement from the agency.

“The need for these services has increased as community measures to slow transmission of COVID-19 have closed locations where many people typically receive services and made it difficult for families to assist loved ones who live alone,” HHS said. “In addition, the adaptations necessary to provide these services in the current environment have increased costs to service providers.”

The funding comes from the Coronavirus Aid, Relief, and Economic Security, or CARES, Act that Congress passed last month.

11:54 AM CT on 4/21/20

Five more healthcare organizations have been awarded funds from the Federal Communications Commission's COVID-19 Telehealth Program.

The FCC on April 13 opened applications for the program, which Congress allocated $200 million for as part of the Coronavirus Aid, Relief, and Economic Security Act. Healthcare organizations awarded funds from the COVID-19 Telehealth Program use them to purchase telecommunications equipment, broadband connectivity and devices needed to provide telehealth services during the coronavirus outbreak.

"From implementing remote patient monitoring to helping low-income patients receive care in their communities, I am confident that the funding we approved today will help healthcare providers expand their telehealth efforts in New York, Michigan and elsewhere," FCC Chairman Pai said in an April 21 statement.

So far, the FCC has distributed a collective $6.94 million from the COVID-19 Telehealth Program to 11 healthcare organizations. The agency said it will continue to evaluate applications and award funding on a rolling basis.

Here are the five new healthcare organizations and the amount of funding awarded by the FCC:

1. Banyan Community Health Center (Coral Gables, Fla.): $958,270

2. Health Partners of Western Ohio (Lima, Ohio): $737,098

3. NYU Langone Health (New York City): $983,772

4. St. John's Well Child and Family Center (Los Angeles): $382,331

5. University of Michigan Hospital (Ann Arbor): $649,000

The FCC unveiled the first six healthcare organizations it approved for a collective $3.23 million in funding on April 16.

11:52 AM CT on 4/21/20

More than 300,000 Americans could die from COVID-19 if social distancing measures are lifted now, according to HHS documents obtained by the Center for Public Integrity.

The HHS documents being shared with other federal agencies estimate coronavirus cases and deaths would double every five and a half days, and about a third of Americans could show symptoms of the virus.

Florida, Maine, Puerto Rico, West Virginia, Vermont and Montana would have the highest numbers of deaths per capita in the "best guess" scenario outlined by the documents.

11:25 AM CT on 4/21/2020

Catholic Medical Center on Tuesday said it furlough 423 workers for 60 days, citing the COVID-19 pandemic's toll on its finances. Another 914 workers, or 29% of its workforce, will see reduced hours. Vice presidents and above will take a 15% paycut while executive directors will see a 5% cut.

The Manchester, N.H.-based provider said the virus has had a "dramatic and devastating financial impact," sparking an $11 million loss in March and a projected $60 million to $70 million year-to-date loss by June. The regional health system eliminated elective procedures and scaled back its outpatient work.

“I am so proud of how our staff has stepped up to meet the challenges of the COVID-19 pandemic,” CMC President and CEO Dr. Joseph Pepe said in a statement. “But the financial consequences of this response are astronomical, leading us to make these painful decisions. I recognize the added stress this will place on many of our valued employees and their families.  These steps are temporary, and I look forward to the day, hopefully sooner than we expect, when we are all working alongside each other again.”

10:53 AM CT on 4/21/20

The Infectious Diseases Society of America has created a guide on using antibody tests for the virus that causes COVID-19.

The ISDA is urging providers and policymakers to be cautious when using the tests as a sole means of diagnosis or when determining immunity to the virus.

"The current antibody testing landscape is varied and clinically unverified, and these tests should not be used as the sole test for diagnostic decisions," wrote the ISDA in its guide. "Further, until more evidence about protective immunity is available, serology results should not be used to make staffing decisions or decisions regarding the need for personal protective equipment."

10:40 AM CT on 4/21/20

The Ohio State University is launching a clinical trial using inhaled nitric oxide to prevent COVID-19 patients from needing a ventilator.

The treatment would be used on patients with mild or moderate COVID-19-related pneumonia who need oxygen but haven't yet been put on a ventilator. Inhaled nitric oxide works by dilating arteries in the lungs, allowing more oxygen to get into the blood stream. Older studies on the coronavirus that caused the SARS outbreak in 2003 and 2004 found the treatment could also suppress how the virus replicates.

“There’s a greater likelihood of death among COVID-19 patients with pneumonia who are placed on a ventilator,” said Dr. Sitaramesh Emani, principal investigator of the study. “If we can treat patients with inhaled nitric oxide before they become so ill that they require a ventilator, we believe we can improve patient outcomes and reserve ventilators and hospital resources for the sickest patients.”

10:01 AM CT on 4/21/20

(Crain's New York Business) As the Visiting Nurse Service of New York and other home healthcare providers assist overwhelmed hospitals during the COVID-19 outbreak, getting paid for certain services remains a challenge.

VNSNY is seeking Congress's assistance with reimbursement so it and other home health agencies can provide more telehealth services, which can help them take on high volumes of patients and reduce virus spread.

"The Centers for Medicare and Medicaid Services recently lifted certain regulatory burdens for home health agencies in the fight against COVID-19," VNSNY said in a statement provided to Crain's. "However, while virtually all other provider groups have been granted authority by CMS to perform and be reimbursed by Medicare for telehealth services the same as in-person visits, CMS lacks congressional authority to allow home health agencies to do the same."

Annie Miyazaki-Grant, chief compliance and privacy officer at VNSNY, said that traditional Medicare is not reimbursing for telehealth services.

"We are trying to negotiate a rate with our close to 30 managed-care payers, but this is a time-consuming and uncertain back-and-forth, and they are not mandated by CMS to pay an adequate rate," she said. "Medicaid, which is a fraction of our business, is reimbursing at a lower rate."

8:22 AM on 4/21/2020

Researchers have been working around the clock to understand COVID-19 and how it affects patients, as clinicians see symptoms ranging from fatigue and shortness of breath to gastrointestinal issues or loss of smell.

Science rounded up many of the papers studying how coronavirus kills patients and affects several of the body's systems.

8:48 PM CT on 4/20/2020

The New York State Nurses Association on Monday sued the state, Montefiore Medical Center and Westchester Medical Center, alleging their members weren't given adequate personal protective equipment and were forced to return to work earlier than advised.

Approximately 161 association nurses at the two health systems have tested positive for coronavirus.

“More than seven in ten of our nurses are reporting exposure to COVID-19 and most are still untested. These lawsuits were filed to protect our nurses, our patients and our communities from grossly inadequate and negligent protections,” NYSNA Executive Director Pat Kane said in a statement. “We cannot allow these dangerous practices to continue.”

7:17 PM CT on 4/20/2020

(AP) Five weeks after giving California Gov. Gavin Newsom broad power to spend up to $1 billion on coronavirus precautions, state lawmakers on Monday said they feared overreach by the governor's office and sought more answers on a contract to buy millions of protective masks.

“The emergency powers that were granted were with an understanding that this would be for a certain amount of discreet time,” said Democratic Assemblyman Phil Ting, chair of the budget oversight committee. There “definitely wasn’t the sense that there was a blank check or that we would just be notified after expenditures were already committed to.”

His comments came during a budget oversight hearing on the money Newsom has already spent and his administration's prediction it will spend $7 billion or more tackling the pandemic. Lawmakers called for Newsom to work with the legislature before spending money on relief measures, citing language from the coronavirus bill passed last month that gave Newsom new spending authority. They passed the bill March 16 before suspending their legislative session.

5:47 PM CT on 4/20/2020

The UCLA Center for Health Policy Research has created a dashboard to track COVID-19 and risk factors that could affect an infected individual, such as insurance status, chronic diseases and food insecurity.

The tool includes community profiles throughout California, which the center hopes will help drive policy decisions around the pandemic.

4:17 PM CT on 4/20/20

(AP) Indiana and Nebraska are taking steps to relax restrictions on hospitals performing elective surgeries.

Indiana Gov. Eric Holcomb said while he was extending the statewide stay-at-home order until May 1, hospitals would be allowed starting Tuesday to resume procedures to diagnose and treat medical conditions. A halt to elective procedures had been ordered last month to help preserve hospital equipment and protective gear if needed to treated people seriously ill with COVID-19 respiratory infections.

State officials have not reported shortages of hospital beds and equipment such as ventilators even as Indiana’s coronavirus death toll has topped 550 in little more than five weeks since the state’s first known death.

Dr. Kristina Box, the state health commissioner, has said she expected the coronavirus illness peak to arrive in late April for the Indianapolis area and the first weeks of May for rest of the state, which is the time period Holcomb has said he might start lifting some business and travel restrictions.

Box said Monday she wasn’t “100% convinced” has reached its illness peak and will continue reviewing the state’s caseload.

Nebraska Gov. Pete Ricketts said he will lift the state's ban on elective surgeries for hospitals that have at least 30% of their beds, intensive-care unit space and ventilators available. Hospitals must also have at least two weeks worth of personal protective equipment in stock for employees before can resume surgeries.

“We want to open these back up to be able to allow those folks who need to have those surgeries to be able to start scheduling those and start having those surgeries performed," Ricketts said. “It's also an important source or revenue for many hospitals, so in order to help sustain our hospitals and make sure they're available to take help care of our coronavirus patients, we want them to have a revenue source to be able to stay in business."

Nebraska is among a small handful of states without formal stay-home orders in place, although its restrictions are very similar and in some cases more strict than what other states have. Ricketts imposed the restrictions regionally before expanding them statewide, and the first ones that were put in place in the Omaha area are scheduled to expire April 30, but could be renewed.

The decision was based on the large amount of available bed space and equipment in many of the state’s hospitals, Ricketts said. In Omaha, for instance, hospitals still have 75% of all their ventilators and about half of their beds available, he said. Statewide, Nebraska currently has about 190 people hospitalized with the virus.

3:25 PM CT on 4/20/20

The American Medical Association is asking governors to adopt civil immunity protections for physicians during the COVID-19 pandemic.

In a letter to the National Governors Association, AMA CEO Dr. James Madara argues civil immunity would protect retired physicians responding to provider shortages, volunteers working outside their specialty and providers who are volunteering in COVID-19 hot spots from lawsuits.

The AMA argues physicians who aren't working directly with coronavirus patients also need protection when trying to determine which procedures should still be performed in light of directives urging hospitals and physicians to cancel elective surgeries.

3:07 PM CT on 4/20/20

(Crain's Detroit Business) After a week of blistering criticism, Beaumont Health is considering a plan to reopen Beaumont Hospital Wayne, one of the system's eight hospitals that it closed last week after seeing its COVID-19 admissions decline by 48 percent, Crain's has learned.

Over the past two weeks, Beaumont has issued press releases to announce that Beaumont Hospital Wayne, which it converted into a COVID-19 only hospital, would temporarily close operations. Officials said it could be reopened if a second surge of coronavirus patients require hospitalizations.

The announcements by Beaumont led to a round of criticisms by U.S. Reps. Debbie Dingell and Rashida Tlaib, Wayne Mayor John Rhaesa and state Rep. Kevin Coleman of Wayne and Westland.

But Crain's has learned that doctors and community leaders are talking with top Beaumont Health executives about ways to reopen the Wayne hospital. Two sources who asked for anonymity told Crain's that Beaumont plans to meet with Dingell once it has a firm plan.

2:34 PM CT on 4/20/20

The Substance Abuse and Mental Health Services Administration has begun distributing $110 million of emergency grant funding to improve access to mental healthcare and substance abuse treatment during the pandemic.

The grants will provide up to $2 million for state applicants and $500,000 for territory and tribal applicants for 16 months.

“Before the pandemic, there were nearly 58 million Americans living with mental and/or substance use disorders, according to our National Survey on Drug Use and Health," said Dr.  Elinore F. McCance-Katz, HHS assistant secretary for mental health and substance use and the head of SAMHSA. "The stressors and trauma of the COVID-19 pandemic exponentially increase the urgency of connecting individuals to treatment.”

2:05 PM CT on 4/20/2020

(AP) Massachusetts has become a hotspot of coronavirus infections, drawing the concern of federal officials and promises of aid from hard-hit New York as the state's death toll prepares to double in less than a week.

Deaths from COVID-19 are expected to surpass 2,000 this week in Massachusetts, where officials are scrambling to boost hospital capacity and trace new infections to curb the spread of the disease.

“We’re right in the middle of the surge now," Republican Gov. Charlie Baker said Sunday on CBS' “Face the Nation."

Vice President Mike Pence said the White House is closely watching the Boston area, and the coordinator of the federal coronavirus task force, Dr. Deborah Birx, said officials are “very much focused” on Massachusetts.

There were 146 new deaths reported in Massachusetts on Sunday, bringing the state's death toll to more than 1,700. More than 1,700 new cases were reported, for a total of more than 38,000 across the state. That compares with more than 14,000 deaths in New York state and over 35,000 nationally.

Massachusetts is hoping to bend the curve by using a group of “contact tracers” to alert people who may have come in contact with someone who tested positive for the virus so they can self-quarantine or be tested themselves.

1:07 PM CT on 4/20/20

(Crain's Detroit Business) Two members of Michigan's congressional delegation are questioning the head of Beaumont Health on the eight-hospital system's decision to temporarily shutter one of its facilities during the COVID-19 pandemic that has claimed more than 2,300 lives across the state.

In a letter dated last Thursday, U.S. Reps. Rashida Tlaib, D-Detroit, and Debbie Dingell, D-Dearborn, question Beaumont Health President and CEO John Fox on the move to temporarily cease operations at Beaumont Health Wayne, a 185-bed hospital had been essentially used the last few weeks as a COVID-19 ICU.

Tlaib and Dingell, whose congressional districts cover hard-hit Wayne County, say that they "have heard from numerous employees, families of patients, local elected officials and other critical stakeholders expressing concerns about this decision and the impact it will have on communities in western Wayne County and surrounding areas."

The lawmakers, among their 15 areas of inquiry into the matter, are asking Fox when and why the Southfield-based health system requested the state to issue it a certificate of need to close its emergency room and OB/GYN so it could only house COVID-19 patients, along with how staffing and duties were reconfigured at the Wayne hospital and its seven others as a result.

The letter also inquires about layoffs at the Beaumont Health Wayne; hospital system preparedness for a second wave of coronavirus cases; hazard pay for employees; financial performance figures; its cash on hand and investments at the end of Q4; and how much the health system has received so far under the federal Coronavirus Aid, Relief, and Economic Security Act, better known as the CARES Act.

Separately in a letter last Tuesday, the lawmakers said they were "alarmed" to learn of the closure.

In a statement last week, Beaumont Health said the few patients who were still at the Wayne hospital were discharged home or moved to other hospitals. It also said most of its staff was being moved to other sites within the health system, while others will be temporarily laid off.

The statement continued: "As the surge was expected to occur just a couple of weeks ago, Beaumont received approval from the state to designate Wayne as a COVID-19 only hospital. Fortunately, the surge was more moderated, likely due to aggressive social distancing, the stay at home order and other factors mitigating the spread of the disease."

"However, we are still operating under several executive orders that severely restrict the extent and type of care we can provide to our community. Until these executive orders are lifted and the disaster declaration has ended, we are not changing the COVID-19 only status of the Wayne hospital," Beaumont said. "This is in preparation for a second surge that could occur after the stay at home restrictions end. The pandemic remains very unpredictable."

12:57 PM CT on 4/20/20

Northwell Health is giving its front-line workers a $2,500 lump-sum payment and a week of paid time off.

The system estimates around 45,000 nurses, physicians, respiratory therapists, housekeepers and other workers are eligible for these benefits.

“Our dedicated staff’s response to the COVID-19 pandemic has been nothing short of heroic. Thanks to the courage and commitment of our front-line caregivers, we answered the call in service to the patients and communities who entrust us with their care,” said Michael Dowling, Northwell's CEO.

10:41 AM CT on 4/20/20

Dave King, former LabCorp CEO, is joining the American Clinical Laboratory Association as a special adviser.

King will support ACLA's response to the pandemic, including sharing information about supply needs and working with the White House Coronavirus Task Force.

“A fierce advocate for our industry, Dave’s depth of knowledge has been a great asset to our membership for over a decade,” said Julie Khani, president of ACLA. “As our nation confronts this unprecedented challenge, we are grateful to have his steady voice of reason and considerable expertise on our team.”

9:50 AM CT on 4/20/20

(AP) The Trump administration and Congress expect an agreement Monday on an aid package of up to $450 billion to boost a small-business loan program that has run out of money and add funds for hospitals and COVID-19 testing.

As talks continued, President Donald Trump said there’s a “good chance” of reaching a bipartisan agreement with Democrats.

“We are very close to a deal,” Trump said Sunday at the White House.

Along with the small business boost, Trump said the negotiators were looking at “helping our hospitals,” particularly hard-hit rural health care providers.

The Senate is scheduled for a pro forma session Monday, but no vote has been set.

The House announced it could meet as soon as Wednesday for a vote on the pending package, according to a schedule update from Majority Leader Steny Hoyer, D-Md.

9:13 AM CT on 4/20/2020

(AP) Tennessee is offering free child care to essential workers during the coronavirus pandemic.

The Tennessee Department of Human Services says the offer involves payment assistance and a network of temporary care locations to offer the free care through June 15.

The department will arrange payments for care with licensed programs once workers are approved for the initiative. Eligible workers can apply online.

Essential workers with school-aged children can also register at one of the temporary and emergency child care locations set up by the YMCA and the Boys & Girls Clubs in Tennessee. Parents seeking care at the temporary locations do not need to apply with the state first.

Eligible essential workers include employees of a health care entity, law enforcement, first responders, corrections officers, military, activated National Guard, human and social services workers, postal workers, transportation employees, restaurant workers or grocery workers.

7:02 PM CT on 4/19/2020

The American Hospital Association on Sunday said hospitals still need more funding to provide care and ensure they have adequate supplies for their workforce.

In a letter to House Minority Leader Kevin McCarthy (R-Calif.), the association thanked him for supporting additional hospital funding and said they still must be a priority as their finances take a hit from the pandemic.

"Hospitals and health systems are unique in that not only are they hurt from the slowdown of the economy and the loss of revenue from non-emergency medical procedures, but they are continuing to meet the needs of the public health emergency," association CEO Rick Pollack wrote.

4:55 PM CT on 4/19/2020

(AP) Florida released the names of 303 nursing homes where staff or patients have been tested positive for the coronavirus.

The seven-page list released Saturday evening names nursing homes and long-term care facilities in 45 of the state's 67 counties. Republican Gov. Ron DeSantis said while patient names won't be released, he thought it was important for families to know which facilities have had positive cases.

“I told the surgeon general from the beginning that we want to put as much information out as we can.” DeSantis told reporters before the list was released. “It is necessary for public health to release the names of the facilities where a resident or staff member has tested positive for COVID-19.”

Facilities already were required to notify all residents, staff and families once there is a positive test. However, the list doesn't provide context such as whether that patient recovered from the virus or what the outcome was.

“We have no reason to think that that wasn't done, we know it was done most of the time, but at the same time if you have one incident and a week from now they don't follow through with that, I don't want to be in a situation where the families don't know,” DeSantis said.

As of Saturday evening, there were 1,785 cases and 175 deaths among staff and residents in Florida's nursing homes and long-term care facilities, according to the state Department of Health. Overall, Florida has had about 26,000 cases and 764 deaths, according to numbers released Sunday.

The counties with the most facilities on the list include Miami-Dade with 54, Broward with 39 and Palm Beach with 36.

2:55 PM CT on 4/19/2020

(Crain's Detroit Business) It may be weeks before doctors know whether the measures they are taking now to treat thousands of COVID-19 patients are working.

Most doctors in metro Detroit say they believe a good number of patients are being helped to overcome the deadly disease.

In the meantime, doctors and nurses are doing what they can in hospital settings to care for very sick patients who continue to appear through hospital ER doors in various stages of respiratory distress. Read more at the link above.

12:52 PM CT on 4/19/2020

As New York sees its new cases of coronavirus drop, Gov. Andrew Cuomo said they will soon start "the most aggressive statewide antibody testing survey in the nation."

Cuomo believes his state, which has been experienced the most COVID-19 cases in the country, is past the peak as hospitalizations and deaths decrease. Now, they will test individuals for antibodies that would help them fight off a reinfection.

The testing could also show how many New Yorkers have been infected.

12:05 PM CT on 4/19/2020

(AP) The governor of Ohio is calling on the federal government to help provide crucial materials that would allow a dramatic increase in testing for coronavirus in his state.

Gov. Mike DeWine said Sunday on NBC's “Meet the Press" that Ohio hospitals doing the testing lack needed chemicals known as reagents, and help from the U.S. Food and Drug Administration is needed.

“I could probably double, maybe even triple testing in Ohio virtually overnight,” said DeWine, who called on the FDA to “prioritize companies that are putting a slightly different formula together for the extraction reagent kit."

“We have worldwide shortage of some of the materials that go into this, so we really need help," he said. “Anybody in the FDA is watching, this would really take our capacity up literally ... overnight.”

DeWine, a Republican, referred to his having sought help several weeks ago with an issue involving sterilization of masks, and he said President Trump “got that done." The FDA authorized a Columbus-based private research lab to deploy a system that can sanitize 160,000 face masks a day, after initially approving only 10,000 masks a day.

9:25 AM CT on 4/19/2020

(AP) Vice President Mike Pence says 150,000 coronavirus tests are now being conducted daily in the U.S. but suggested that governors and not the federal government were to blame for numbers not being higher.

Pence tells NBC’s “Meet the Press” that, “if states around the country will activate all of the laboratories that are available in their states, we could more than double that overnight.”

He said the nation has “sufficient testing today” for states to begin reopening their economies as part of the initial phases of guidelines the White House released this week.

Governors from both parties have said that while they do have more labs that could increase testing in many areas, they often are unable to do so because of federal delays.

Pence was also asked about President Donald Trump tweeting that Democratic governors in Minnesota, Michigan and Virginia should “liberate” their states — even though officials there are following many of the Trump administration’s own guidelines about slowing the spread of coronavirus.

Pence sidestepped those, saying, “This president wants to reopen the American economy as soon as we can safely and responsibly do it.”

8:43 AM CT on 4/19/2020

(AP) On most mornings, Somaya Farooqi and four other teen-age girls pile into her dad’s car and head to a mechanic’s workshop. They use back roads to skirt police checkpoints set up to enforce a lockdown in their city of Herat, one of Afghanistan’s hot spots of the coronavirus pandemic.

The members of Afghanistan’s prize-winning girls' robotics team say they’re on a life-saving mission — to build a breathing machine from used car parts and help their war-stricken country battle the virus.

“If we even save one life with our device, we will be proud,” said Farooqi, 17.

Afghanistan faces the pandemic nearly empty-handed. It has only 400 ventilators for a population of more than 36.6 million. So far, it has reported just over 900 coronavirus cases, including 30 deaths, but the actual number is suspected to be much higher since test kits are in short supply.

Herat province in western Afghanistan is one of the nation’s hot spots because of proximity to Iran, the region’s epicenter of the outbreak.

This has spurred Farooqi and her team members, ages 14 to 17, to help come up with a solution.

On a typical morning, Farooqi’s father collects the girls from their homes and drives them to the team's office in Herat, zigzagging through side streets to skirt checkpoints. From there, another car takes them to a mechanic’s workshop on the outskirts of the city.

In Herat, residents are only permitted to leave their homes for urgent needs. The robotics team has a limited number of special permits for cars.

So far, Farooqi’s father hasn’t been able to get one, but the girls are in a hurry. “We are concerned about security driving out of the city but there is no other option, we have to try to save people’s lives,” Farooqi said.

At the workshop, the team is experimenting with two different designs, including an open-source blueprint from the Massachusetts Institute of Technology. The parts being used include the motor of a Toyota windshield wiper, batteries and sets of bag valve masks, or manual oxygen pumps. A group of mechanics helps them build the frame of a ventilator.

The ventilator model, once completed, would then be sent to the Health Ministry for testing, initially on animals, said spokesman Wahid Mayar.

Farooqi, who was just 14 years old when she participated in the first World Robot Olympiad in the U.S., in 2017, said she and her team members hope to make a contribution.

“Afghans should be helping Afghanistan in this pandemic,” she said. “We should not wait for others.”

8:49 PM CT on 4/18/2020

Hospital for Special Surgery joined a national program testing convalescent plasma, a treatment that involves infusing patients with antibody-rich plasma donated by people who have recovered from the disease, the hospital said in a release.

"Based on very small case studies, convalescent plasma is one of the more promising therapies that are currently available," said Dr. Chad Craig an internal medicine specialist at HSS and primary investigator for the HSS site.

"To help patients at our hospital and other hospitals in New York, we are asking our community members and any New Yorkers who have recovered after testing positive for COVID-19 to donate plasma through the New York Blood Center."

7:32 PM CT on 4/18/2020
(AP) SSM Health system and Saint Louis University are trying to make it easier for retired nurses to return to caring for patients during the coronavirus pandemic as the number of confirmed cases and COVID-19-related deaths continue to rise in Missouri.

The nursing schools for Saint Louis University and the SSM Health system, which operates in Missouri, Illinois, Oklahoma and Wisconsin, have shortened a joint program for returning nurses to patient care from four weeks to two weeks, St. Louis Public Radio reported.

The program is offered in St. Louis and Oklahoma City, and afterward, returning nurses are paired with practicing nurses. Those who go through the program will have the option to continue working at SSM hospitals in those metropolitan areas when the pandemic ends.

6:05 PM CT on 4/18/2020

Rick Pollack, president and CEO of the American Hospital Association, wrote a letter of appreciation to President Donald Trump regarding the president's comments at a press briefing in which he recognized a need for additional funds for hospitals.

"The AHA appreciates the Administration’s efforts to provide funding to America’s hospitals and health systems to support nurses, doctors and staff on the front lines," Pollack according to a copy of the letter provided by the AHA.

"Many hospitals have already benefitted from the Medicare Accelerated Payment Program and we urge additional funding to be distributed from the CARES Act Provider Relief Fund."

3:33 PM CT on 4/18/2020
 
Chris Van Gorder, Scripps Health president and CEO, urged caution when considering the reopening of the state, in a response to reopen California events taking place in the state.

Van Gorder said personal protective equipment inventories may not yet have caught up with demand. "We are supportive of cautiously reopening the state – but only once the government assures that all in health care have the personal protective equipment necessary to protect the care-givers and medical equipment like ventilators and medications needed to care for the patients, as it is inevitable that we will see an uptick in patients," he said in the emailed statement.

"We understand that people very much want their lives to return to normal. But, if we reopen the state before we’re ready, many will lose their lives – including health care workers," he said.

1:55 PM CT on 4/18/2020
A group of clinicians at Massachusetts General Hospital in Boston is asking the public to donate cell phone chargers for COVID-19 patients to stay connected with loved ones while the hospital is not accepting visitors, according to WGBH.

Emily Swanson, a physician's assistant in the hospital, is on the Happiness Committee, which consists of MGH providers tryinng to improve the quality of life at the hospital, according to WGBH.

Swanson says they’re trying to help the patients, who arrived at the hospital without chargers for their cellphones. When their phone batteries run out, “They don't have their friends and their family visiting them and it just very isolating and lonely for these patients and their loved ones alike who are at home wanting to talk to them,” Swanson said.

"We went into rooms and asked them how long has your cell phone not been working,” Swanson said, “and for some of them it had been days.”

12:15 PM CT on 4/18/2020

(Crain's New York Business) As a steady number of New Yorkers continue to die or become admitted to hospitals due to coronavirus, Gov. Andrew Cuomo identified nursing homes as one of the biggest areas of concern.

On Friday, 36 out of the 540 New Yorkers who died lived in nursing homes, said Cuomo. The remaining 504 deaths were attributed to hospitals.

"Nursing homes are the single biggest fear in all of this," said Cuomo. "It's the feeding frenzy for this virus."  
The governor also reported that there were 2,000 new hospital admissions of patients in New York or new diagnoses due to coronavirus. But Cuomo noted that he believed the state is "past the plateau" in terms of cases.

"We're not at the peak," said Cuomo.

11:42 AM CT on 4/18/2020
(AP) The Trump administration's failure to test all but a small percentage of detained immigrants for the novel coronavirus may be helping it spread through the United States' sprawling system of detention centers and then to Central America and elsewhere aboard regular deportation flights, migrants' advocates said Friday.

The discovery of numerous COVID-19 cases among deportees on a flight that arrived this week prompted Guatemalan President Alejandro Giammattei to tell Guatemalans in a national address on Friday he was suspending such flights.

Just 400 detainees in the U.S. out of more than 32,000 have been tested so far, according to testimony that Matthew Albence, the acting director of U.S. Immigration and Customs Enforcement, gave Friday to a congressional committee. The House Committee on Oversight and Reform said that Albence "also confirmed that ICE does not routinely test detainees before deporting them."

More than 1,600 people deported from the United States to Guatemala over the last month were allowed to go home and into voluntary, unenforced quarantine. Fears are rising that it may have seeded the Central American nation with an untold number of undetected cases, increasing its vulnerability to the pandemic.

10:29 AM CT on 4/18/2020

(AP) As a clearer picture emerges of COVID-19's decidedly deadly toll on black Americans, leaders are demanding a reckoning of the systemic policies they say have made many African Americans far more vulnerable to the virus, including inequity in access to health care and economic opportunity.

A growing chorus of medical professionals, activists and political figures are pressuring the federal government to not just release comprehensive racial demographic data of the country's coronavirus victims, but also to outline clear strategies to blunt the devastation on African Americans and other communities of color.

On Friday, the Centers for Disease Control and Prevention released its first breakdown of COVID-19 case data by race, showing that 30% of patients whose race was known were black. The federal data was missing racial information for 75% of all cases, however, and did not include any demographic breakdown of deaths.

The latest Associated Press analysis of available state and local data shows that nearly one-third of those who have died are African American, with black people representing about 14% of the population in the areas covered in the analysis. Roughly half the states, representing less than a fifth of the nation's COVID-19 deaths, have yet to release demographic data on fatalities. In states that have, about a quarter of the death records are missing racial details.

9:33 AM CT on 4/18/2020

(AP) Elisheva Stern wasn't ready to say goodbye to her ailing father, who was succumbing to the coronavirus in an Israeli hospital.

But knowing countless others around the world are not given the chance to say their last farewells to sick relatives, she decided to enter the virus ward and be by her father's bedside, even if only for a brief moment, before he died.

Stern's father, Simha Benshai, 75, died at Tel Aviv's Sourasky Medical Center, which offers the next of kin of dying coronavirus patients the rare opportunity to say goodbye in person."None of us want to say bye to the people who we love. But I'm actually happy that they gave me the opportunity to say bye to my father," said Stern. "I was able to see him and to tell him I'm sorry and I love him."

The practice is in contrast to many hospitals around the world that don't allow final family visits as a precaution against spreading the highly contagious virus. That leaves patients to die alone and forces families to grieve from afar. Recognizing this peculiar tragedy wrought by the virus, Sourasky Medical Center officials opted to spare much-needed protective gear, take careful measures to ward off infection and offer grieving families a chance to say goodbye.

"The stories of patients dying alone are horrifying," said Roni Gamzu, the hospital's chief executive. "This is our moral duty as medical staff and as human beings. No one shall be allowed to die alone."

The hospital provides immediate next of kin who want to visit a patient with head-to-toe protective wear — gear in demand around the world and often reserved for health care workers — and allows them about 15 minutes to say good-bye.

8:17 PM CT on 4/17/2020

(AP) A large study of hospitalized COVID-19 patients in New York City found 1 in 3 were put on breathing machines. That's a rate more than 10 times higher than seen in China.

The study's authors say that of the patients studied, 36% were obese, which may have contributed to severe breathing problems and the need for ventilators.

Published online Friday in the New England Journal of Medicine, the report involves 393 patients admitted to two unidentified hospitals from March 5-27. Patients were aged 62 on average and 60% were men. Almost 40% were white but the report had no other racial breakdown. Overall, 6% were health care workers.

Cough, fever and shortness of breath were the main symptoms, but diarrhea, nausea and vomiting were also common.

Dr. Parag Goyal of Weill Cornell Medicine and the report authors say that compared with China, hospitalization for COVID-19 in the U.S. is generally limited to more severely ill patients, another likely reason for the greater use of ventilators.

The authors say 40 patients or 10% died and 260 were discharged from hospitals.

7:20 PM CT on 4/17/2020

Guidelines for treating COVID-19 and maintaining worker safety have changed over the course of the pandemic, and some groups are providing free training to those on the front lines.

Healthcare workers have taken more than 1.2 million coronavirus-related courses since the pandemic reached the U.S., according to HealthStream. The company is providing its courses on the virus free of charge, and some of them also include CE credits for individuals.

6:05 PM CT on 4/17/2020

(AP) Kansas plans to start using 3D printers to manufacture its own swabs to test for the novel coronavirus as officials look to improve the state's near-bottom national rank in testing before lifting a stay-at-home order.

Gov. Laura Kelly and her top public health administrator, Dr. Lee Norman, have complained for weeks that Kansas isn't a priority for testing supplies and personal protective equipment from the federal government or even private vendors, making it difficult to get them. The state's struggles have continued with the Democratic governor under increasing pressure from the Republican-controlled Legislature to lift restrictions hindering economic activity, with her stay-at-home order set to remain in place until May 3.

But Kelly said Friday that testing people both with and without symptoms is key. Norman said the state might not be able to loosen restrictions until later in May, a couple of weeks after the Kansas outbreak's expected late-April peak. Kelly's stay-at-home order took effect March 30 and is set to stay in place until May 3.

“Our ability to test and contact trace must be much more robust before we can safely proceed to open,” Kelly said during her daily coronavirus news conference at the Statehouse.

Kansas as of Friday had reported testing about 17,000 of its 2.9 million residents for coronavirus, or 5.8 for every 1,000 residents, according to The COVID Tracking Project, a website managed by journalists and analysts, with The Associated Press among the contributors to the data. That rate is the second-lowest among states, just behind Virginia's 5.75 per 1,000 residents and a little more than half of the national figure of 10.82 per 1,000 citizens.

5:45 PM CT on 4/17/2020

(AP) Health officials in northeastern North Dakota said Friday they're worried about having the ability to adequately respond to a cluster of coronavirus cases tied to a wind turbine facility, even as the overall number of positive tests in the state rose dramatically.

Fifteen workers at LM Wind Power facility in Grand Forks have tested positive for COVID-19, and officials were still waiting to find out the results of 424 additional tests that were conducted Thursday. Dr. Steven Weiser, president of Altru Health System, said about 2,500 people may have come in close contact with infected workers.

“We really can't make any projections, but it certainly has the opportunity to be a very substantial large number,” said Weiser, adding that it has “the ability to overwhelm our health care workers and our health care system.”

A record high of 46 new cases were confirmed statewide Friday, for a total of 97 cases in the last three days and 439 overall. There have been nine deaths in the state due to the coronavirus.

Later Friday, Gov. Doug Burgum said the state would continue charting its own course, a day after President Donald Trump rolled out “guidelines” for states to begin lifting restrictions imposed because of the coronavirus crisis.

3:14 PM CT on 4/17/20

The not-for-profit Partnership for Medicaid is calling for Congress to provide more funding for Medicaid providers in the next round of coronavirus relief.

In a letter to congressional leaders, the group asked for affected Medicaid providers to receive the remaining $70 billion from the Coronavirus Aid, Relief and Economic Security Act that was slated to go to healthcare providers.

They also urged Congress to increase the Federal Medical Assistance Percentage and maintain that increase beyond the national emergency caused by the pandemic.

"Medicaid providers are the safety net for individuals with low incomes and urgently require relief to maintain this critical role during this public health crisis and beyond," the group wrote in the letter.

3:00 PM CT on 4/17/20

(AP) U.S. hospitals are so desperate for sterile gowns to protect workers that some are resorting to having staff wear coveralls, Tyvek suits and ponchos. That’s according to a new survey from hospital consultant Premier Inc. illustrating how fighting a shortage of protective face masks can exacerbate another.

The survey finds companies that make personal protective equipment recently boosted manufacturing of N95 and surgical masks so much in response to pleas from hospital workers that now hospitals are having more trouble getting sterile gowns than masks. That’s because they’re often made from the same type of textiles.

Premier helps its 4,000 hospital members get medicines and supplies at discounts. It said 700 hospitals replied to the survey conducted April 11-15.

2:22 PM CT on 4/17/20

(AP) The mayor of Joliet said Friday that he has asked the governor to launch an investigation into the coronavirus-related deaths of 22 residents and a staff member at a nursing home in the northern Illinois city.

A spokeswoman for the facility, Symphony of Joliet, announced the deaths on Wednesday. The facility had reported a total of three deaths as recently as last week.

Joliet Mayor Bob O’Dekirk said that he had asked Gov. J.B. Pritzker's office late Thursday to initiate an investigation by the Illinois Department of Public Health and to "start untangling the mess of what happened inside that nursing home.”

“We don't have the answers right now, but we’re going to get the answers,” he said. “Certainly Joliet families (and) people who lost their loved ones inside the nursing home have a right to get those answers.”

Spokeswomen for the governor's office and nursing home, and officials from the health department didn't immediately reply to Friday emails seeking comment about the mayor's request.

Nursing homes in the U.S. and other countries have struggled to control outbreaks among their residents, whose age and existing medical conditions make them more vulnerable to serious illness and death as a result of becoming infected.

1:42 PM CT on 4/17/2020

(Crain's Detroit Business) Beaumont Health has announced to union employees at its three Downriver hospitals in Wayne, Trenton and Taylor that it is beginning layoffs along with redeploying other critical providers to its other four metro Detroit hospitals.

Crain's obtained an April 14 email from Beaumont sent to SEIU Healthcare Michigan, which represents several hundreds employees at Beaumont's three downriver hospitals in Wayne, Taylor and Trenton.

"Due to COVID-19, Beaumont Health plans to recalibrate services, resources and staffing across the system to best meet the needs for our patients, employees, physicians and the communities we serve," Patricia Leonard, Beaumont's director of labor relations, wrote in the emailed memo. "As a result, certain adjustments will be made to its staffing model at Beaumont Wayne as well as Beaumont Taylor and Beaumont Trenton due to a reduction in available work."

In response, Beaumont officials referred to a Wednesday memo on layoffs and temporary closure of the Wayne hospital. There was no immediate mention of the pending layoffs at Trenton and Taylor hospitals.

SEIU Michigan President Andrea Acevedo said Beaumont so far has laid off at least 80 workers at the Wayne hospital. The union is still hearing from affected workers.

11:31 AM CT on 4/17/20

(Crain's New York Business) Private labs across New York were ordered Friday to coordinate with the state's Department of Health to mandate coronavirus testing takes priority.

Gov. Andrew Cuomo said Friday he would issue an executive order that mandates all labs—public and private—in the state, who are tasked with carrying out coronavirus diagnostic tests, coordinate with the State's health department going forward.

There are 301 labs in New York licensed to perform virology testing, Cuomo said.

"How do we get 300 private labs and hospitals to become one system statewide to do testing for COVID? And how do we get them all coordinated? This is something that has never been done before and is going to be a tremendous undertaking," Cuomo said.

11:09 AM on 4/17/20

(AP) A Massachusetts hospital run by Tenet Healthcare plans to furlough some nurses as the coronavirus pandemic cuts into some services.

St. Vincent Hospital in Worcester said Thursday all the furloughs would be voluntary.

“Over the last several weeks up until late yesterday, we have been working diligently with the Massachusetts Nurses Association to come to an agreement on the best way to address the staffing challenges posed by the current environment," hospital spokeswoman Rhiana Sherwood said in a statement to The Telegram & Gazette. “Like numerous healthcare providers, we have been acutely impacted by the stay-at-home advisory and government orders canceling elective procedures, which have forced us to temporarily close hospital services and units where activity is limited."

David Schildmeier of the Massachusetts Nurses Association said he was disappointed with the furloughs.

St. Vincent Hospital nurses on the union negotiating committee on Wednesday unanimously rejected a proposal by Tenet Healthcare that would require nurses to work in areas of the hospital in which they did not have proper training or experience.

Sherwood said nurses would never be made to work in a role for which they were not appropriately trained.

10:31 AM CT on 4/17/2020

The National Institutes of Health on Friday said they are working to launch a public-private partnership that will focus on developing COVID-19 therapies and vaccines. 

The Accelerating COVID-19 Therapeutic Inventions and Vaccines partnership will include16 biopharmaceutical companies as well as government researchers from multiple agencies, including the Food and Drug Administration, HHS' Biomedical Advanced Research and Development Authority, and the Centers for Disease Control and Prevention.

HHS Secretary Alex Azar said in a statement that the partnership will reach "new levels of coordination" in their efforts to speed up COVID-19 treatment development.

"To save lives and bring life back to normal in the United States and around the world, we need COVID-19 vaccines and therapies on the market as soon as possible," he said.

10:14 AM CT on 4/17/2020

(AP) Workers at a Portland nursing home that has reported 14 coronavirus deaths failed to wash their hands, didn't use protective masks properly and weren’t trained on how to control the spread of infection, the state said Thursday.

Healthcare at Foster Creek has become the site of the largest known cluster of coronavirus cases and deaths in Oregon, with 50 confirmed cases among residents and staff, The Oregonian/OregonLive reported.

The Department of Human Services began a three-day inspection of the nursing home last week – the same day The Oregonian/OregonLive reported that 10 Foster Creek residents had died and about two weeks after the facility first reported coronavirus cases.

The nursing home “failed to ensure appropriate measures are in place to prevent the spread of COVID-19,” according to the inspection findings. “This failure presents an immediate risk to the health and safety of all residents.”

Many of the 22 problems state officials witnessed at Foster Creek violated basic principles of hygiene.

On Wednesday, the Department of Human Services ordered Foster Creek to train its staff, hire enough people and report its coronavirus and staffing numbers back to the agency every day.

“We do not want to see one more fatality,” DHS Director Fariborz Pakseresht said at at Thursday afternoon press conference. “Though we don’t really control the future.”

8:34 PM CT on 4/16/2020

President Donald Trump's plan to reopen the economy suggests the return of outpatient elective surgeries in the first of three phases. 

At the earliest, the guidelines suggest, some parts of the country could see a resumption in normal commerce and social gatherings after a month of evaluating whether easing up on restrictions has led to a resurgence in virus cases. In other parts of the country, or if virus cases pick up, it could be substantially longer.

Trump said governors would be responsible for deciding when it is safe to lift restrictions in their states.

"The term ‘elective surgeries’ implies they’re procedures patients choose to have, but in reality means surgeries or procedures that are ‘scheduled,’ are important to the patient’s health, and must often be performed," said Scott Whitaker, president and CEO of medical device trade association, AdvaMed. 

Oklahoma Gov. Kevin Stitt said the state would allow hospitals to resume elective surgeries next week.

The document also outlines "core state preparedness responsibilities," including having adequate testing and screening, the ability to supply enough protective gear and medical equipment and plans to surge intensive care beds, if needed.

7:19 PM CT on 4/16/2020

(AP) The federal government has approved Arkansas' plan to use Medicaid funds to pay bonuses to health workers at nursing homes and other long-term care facilities during the coronavirus pandemic.

Gov. Asa Hutchinson announced that the bonuses as health officials said the number of people in the state who had tested positive for the new coronavirus had increased to at least 1,569. One more person died from COVID-19, the illness caused by the coronavirus, bringing the state's total deaths to 33.

Officials said more that 26,000 non-physician direct-care workers at the facilities, including registered nurses and home health aides, will be eligible for the payments.

The governor said he'll ask a state panel to approve using some of the money Arkansas is receiving in federal coronavirus relief for similar bonuses for direct-care workers at hospitals and non-direct care workers at hospitals and nursing homes.

6:26 PM CT on 4/16/2020

(AP) — President Donald Trump and some of his officials are flirting with an outlier theory that the new coronavirus was set loose on the world by a Chinese lab that let it escape. Without the weight of evidence, they’re trying to blame China for sickness and death from COVID-19 in the United States.

“More and more, we’re hearing the story,” Trump says. Secretary of State Mike Pompeo adds: “The mere fact that we don’t know the answers — that China hasn’t shared the answers — I think is very, very telling.”

Experts overwhelmingly say analysis of the new coronavirus’ genome rules out the possibility that it was engineered by humans, as some conspiracy theories have suggested.

5:41 PM CT on 4/16/2020

The Society of American Gastrointestinal and Endoscopic Surgeons has updated guidance on members' response to the COVID19 crisis.

The recommendations include: what to do if deployed to the front line; resources for smoke and gas evacuation; surgical management of cancer patients; N-95 reuse strategies; and discussions from the global initiative, the Coronavirus Global Surgical Collaborative.

The group produces weekly “Notes from the Battlefield,” comprised from surgical leaders in affected countries.

SAGES warned that due to time constraints, the recommendations have not been reviewed using the usual standards.

4:50 PM CT on 4/16/2020

(AP) President Donald Trump gave governors a road map Thursday for recovering from the economic pain of the coronavirus pandemic, laying out a phased approach to restoring normal activity in places that have strong testing and are seeing a decrease in COVID-19 cases.

The new guidelines are aimed at easing restrictions in areas with low transmission of the coronavirus, while holding the line in harder-hit locations. They make clear that the return to normalcy will be a far longer process than Trump initially envisioned, with federal officials warning that some social distancing measures may need to remain in place through the end of the year to prevent a new outbreak.

Places with declining infections and strong testing would begin a three-phased gradual reopening of businesses and schools — each phase lasting at least 14 days — to ensure that infections don't accelerate again.

In phase one, for instance, the plan recommends strict social distancing for all people in public. Gatherings larger than 10 people are to be avoided and nonessential travel is discouraged.

In phase two, people are encouraged to maximize social distancing where possible and limit gatherings to no more than 50 people unless precautionary measures are taken. Travel could resume.

Phase three envisions a return to normalcy for most Americans, with a focus on identification and isolation of any new infections.

3:18 PM CT on 4/16/20

The Federal Communications Commission has approved the first set of funds awarded under its $200 million COVID-19 Telehealth Program.

The FCC on April 13 opened applications for the COVID-19 Telehealth Program, which Congress allocated $200 million for as part of the Coronavirus Aid, Relief, and Economic Security Act. As part of its first set of approvals, the FCC will give a collective $3.23 million in funding to help six healthcare organizations buy telecommunications, broadband connectivity and devices needed to provide telehealth services during the coronavirus outbreak.

The FCC said it will continue to evaluate applications and distribute funding on a rolling basis.

"Telehealth has emerged as a critical service for healthcare providers and patients alike during the coronavirus pandemic," FCC Chairman Pai said in a statement. "It promotes social distancing, protects the safety of healthcare professionals and patients, and frees up space in health care facilities for those who now need it most."

Here are the six healthcare organizations and the amount of funding awarded by the FCC:

• Grady Memorial Hospital (Atlanta): $727,747
• Hudson River HealthCare (Peekskill, N.Y.): $753,367
• Mount Sinai Health System (New York City): $312,500
• Neighborhood Health Care (Cleveland): $244,282
• Ochsner Clinic Foundation (New Orleans): $1 million
• UPMC Children's Hospital of Pittsburgh: $192,500

2:27 PM CT on 4/16/20

(Crain's Chicago Business) A coalition of seven Midwestern governors today announced they are working together to judge when best to start easing stay-at-home restrictions and reopen their states’ economies.

The move mirrors similar efforts on the West Coast and in the Northeast corridor.

As Crain’s has reported, Illinois Gov. J.B. Pritzker has been reaching out to his Midwest counterparts to coordinate efforts. Today, the coalition becomes official, with Michigan’s Gretchen Whitmer, Mike DeWine of Ohio, Wisconsin’s Tony Evers, Tim Walz of Minnesota, Eric Holcomb of Indiana and Kentucky’s Andy Beshear signing on to a multistate pact.

The governors said in a statement announcing the coalition: “We are doing everything we can to protect the people of our states and slow the spread of COVID-19, and we are eager to work together to mitigate the economic crisis this virus has caused in our region. Here in the Midwest, we are bound by our commitment to our people and the community. We recognize that our economies are all reliant on each other, and we must work together to safely reopen them so hardworking people can get back to work and businesses can get back on their feet.”

The statement says the states will “closely examine” at least four factors before reopening:

They include “sustained control” of the rate of new infections and hospitalizations; enhanced ability to test and trace; “sufficient health care capacity” to handle any resurgence,  and “best practices” for social distancing.

1:17 PM CT on 4/16/20

A new data tool created by the George Washington University Milken Institute School of Public Health could help policymakers determine which states are at risk of healthcare worker shortage during the COVID-19 pandemic.

The tool estimates which states will face shortages of respiratory therapists and intensivists who are trained to work with critically ill patients based on the severity of the outbreak and the availability of workers.

According to the model, New York, New Jersey, Connecticut, Massachusetts and Michigan wouldn't have enough respiratory therapists even with the lowest demand from the virus and no workforce attrition. Louisiana, New Jersey and New York are at risk of not having enough intensivists in the same low-demand scenario.

“This pandemic has put extraordinary pressure on our health workforce,” said Patricia Pittman, director of the Fitzhugh Mullan Institute for Health Workforce Equity, which is based at Milken Institute SPH. “Our interactive tool will help identify potential worker shortages during peaks in demand. Ultimately, the information gleaned from this model will pave the way toward solutions to anticipate and prevent problem by shoring up just-in-time capacity.”

1:01 PM CT on 4/16/20

Google, Facebook and Twitter have joined with the not-for-profit Center for Safe Internet Pharmacies to create an online platform with resources for people struggling with substance use disorder during COVID-19.

Due to social distancing restrictions, an increasing number of support group meetings have been suspended to prevent spreading the virus.

“COVID-19 may have paused our everyday lives, but unfortunately addiction and substance misuse disorders persist. More than half of Americans know someone impacted by opioid misuse alone,” said Marjorie Clifton, executive director of the Center for Safe Internet Pharmacies. “Those in recovery or looking for resources for a family member must find new ways to cope as they face the challenge of isolation.”

12:28 PM CT on 4/16/2020

L.A. Care Health Plan announced Thursday that it will provide almost $70 million in funds to support hospitals, primary care practices, safety net clinics during the COVID-19 pandemic.

The publicly operated Los Angeles insurer will speed $35 million in claims payments to hospitals and provide $21 million in advance incentive payments to primary care doctors and federally qualified health centers. It will also deliver $7 million in grants to more than 100 clinics and community organizations. Another $5.5 million in grants will be used to support vulnerable and homeless L.A. members.

“These funds are coming at a crucial time as safety-net health centers are directly caring for substantial increases in patients testing positive for and those ill with COVID-19,” said Al Ballesteros, president and CEO of JWCH Institute, a health center serving Los Angeles County.

11:48 AM CT on 4/16/2020

Pennsylvania agreed Thursday to change its pandemic guidelines after HHS’ Office for Civil Rights found that they discriminated against people with disabilities because they listed specific impairments that could lead providers to deprioritize patients’ access to care and ventilators.

The state agreed to remove criteria that led to automatic deprioritization based on disabilities, require individual patient assessments and to ensure “that no one is denied care based on stereotypes, assessments of quality of life, or judgments about a person’s “worth” based on the presence or absence of disabilities,” according to a statement from OCR.

“We must ensure that triage policies are free from discrimination both in their creation and their application, and we will remain vigilant in achieving that goal,” OCR Director Roger Severino said.

11:00 AM CT on 4/16/20

(AP) Two licensing boards that govern Maine doctors are warning that prescribing drugs touted by President Donald Trump for themselves or for family members is considered “unprofessional conduct.”

The boards also warned that the combination of one of two malaria drugs, chloroquine and hydroxychloroquine, along with the antibiotic azithromycin, should not be prescribed as a preventative measure for anyone.

A joint statement by the Board of Licensure in Medicine and the Board of Osteopathic Licensure said improper prescribing can harm the supply of drugs needed for COVID-19 patients "and may lead to improper use which can cause patient harm.”

The statement comes just days after the Maine Board of Pharmacy issued similar guidance to pharmacists, the Portland Press Herald reported.

For weeks, Trump and others have touted the benefits of the drugs to treat symptoms of COVID-19, the disease caused by the new coronavirus.

There have been anecdotal reports that the drugs are helpful, but there are also serious side effects, officials say.

9:56 AM CT on 4/16/2020

As shelter-in-place orders continue, many independent physician groups are worried they will run out of cash by the end of the summer. In an AMGA survey, 60% of the 82 respondents said they will deplete their cash reserves within two months.

Much of the lost revenue stems from cutting non-essential surgeries and social isolation orders. 

While the CARES Act includes funds to help cash-strapped providers, AMGA Consulting president Fred Horton said it amounts to about $10,000 per physician, which doesn't nearly cover independent physician groups' continuing expenses of $33,000 per physician per month.

"Even before paying physicians, the practice will lose $23,000 per physician in the first month relief is received," Horton said in a statement. "If no more relief is forthcoming, the losses will grow to $33,000 per physician per month, or about $20 million for a 200-member practice over a three-month period."