Live updates on COVID-19: May 16-31

8:45 PM CT on 5/31/2020

While HHS has vowed that it wouldn't shell out COVID-19 relief to providers that balance bill coronavirus patients, some are receiving eyewatering invoices.

One patient in Colorado received an $840,000 itemized statement for his hospitalization, according to Denver's ABC affiliate. Robert Dennis, a high school teacher, was intubated for two weeks at Sky Ridge Medical Center due to COVID-19. His wife, Suzanne, told the station that they expect to receive more bills for her own emergency department visits for COVID-19, as well as Robert's rehabilitation care.

4:56 PM CT on 5/31/2020

(AP) The U.S. has sent to Brazil more than 2 million doses of a malaria drug touted by President Donald Trump as potentially protecting against and treating the coronavirus, even though scientific evidence has not backed up those uses.

No large, rigorous scientific studies have found the drug, hydroxychloroquine, safe or effective for preventing or treating COVID-19, and some smaller studies have indicated worse outcomes from those taking the drug.

Brazil, now Latin America’s hardest-hit country, continues to see a surge in virus cases, and last week Trump announced that the U.S. was restricting travel from the country to prevent travelers from spreading the virus in the U.S.

In a joint statement with the Brazilian government on Sunday, the White House said the doses of hydroxychloroquine had been sent to Brazil as a prophylactic for front-line health workers and as a therapeutic for those who may come down with the virus. The White House said it was also delivering 1,000 ventilators to Brazil.

Trump revealed in May that he took a two-week course of the drug to protect against the coronavirus, despite warnings from his own government that it should only be administered for COVID-19 in a hospital or research setting due to potentially fatal side effects.

Trump’s announcement that he was taking the drug was criticized by medical experts who warned that his actions could encourage others to take the drug outside of a medical setting.

Trump said he decided to take hydroxychloroquine after two White House staffers tested positive for the disease.

3:37 PM CT on 5/31/2020

(AP) Health experts fear that silent carriers of the virus could unwittingly infect others at protests where people are packed cheek to jowl, many without masks, many chanting, singing or shouting. The virus is dispersed by microscopic droplets in the air when people cough, sneeze, sing or talk.

“There’s no question that, when you put hundreds or thousands of people together in close proximity, when we have got this virus all over the streets ... it’s not healthy," Maryland Gov. Larry Hogan said Sunday on CNN’s “State of the Union.”

"Two weeks from now across America, we’re going to find out whether or not this gives us a spike and drives the numbers back up again or not.”

The U.S. has seen over 1.7 million infections and nearly 104,000 deaths in the pandemic, which has disproportionately affected racial minorities in a nation that does not have universal health care.

Washington Mayor Muriel Bowser said Sunday she was very concerned that the protests in the nation’s capital and elsewhere could provide fertile ground for a new series of outbreaks. Many of the protesters were wearing masks, but there were no attempts at social distancing.

“We’ve been working very hard in these last eight to 10 weeks to not have any mass gatherings,” she said. “As a nation, we have to be concerned about a rebound.”

1:55 PM CT on 5/31/2020

(AP) Officials across the U.S. South are still scrambling to adjust their hurricane plans to the coronavirus. The big unknown: Where will people fleeing storms go?

The Associated Press surveyed more than 70 counties and states from Texas to Virginia, with more than 60% of coastal counties saying as of late May that they're still solidifying plans for public hurricane shelters. They're also altering preparations for dealing with the sick and elderly, protective equipment and cleanup costs.

In Georgia’s McIntosh County, south of Savannah, Emergency Management Agency Director Ty Poppell said evacuations during the pandemic would be a “nightmare.” He worried about social distancing at shelters and on buses used to get people out.

“I’d love to be able to tell you we’ve got that answered right now,” Poppell said. “It’s a work in progress.”

Hurricane season officially starts Monday, though Tropical Storms Arthur and Bertha arrived early. Forecasters are expecting a busier-than-normal season.

12:11 PM CT on 5/31/2020

Stay-at-home orders in four states helped slow COVID-19 infection rates, according to a new article in JAMA.

Researchers reviewed hospitalization data from four states that issued stay-at-home orders for residents, and found the growth rate ultimately slowed within days of the median effective date. For example, Minnesota's hospitalization rates dropped outside the 95% prediction band on April 13, after a stay-at-home order went into effect on March 28.

The analysis noted that job loss, health insurance loss and general pandemic awareness may have also led to decreased hospital utilization.

11:13 AM CT on 5/31/2020

(Crain's New York Business) New York City is on track to begin phase 1 of reopening its economy on June 8, Gov. Andrew Cuomo said Friday. 

"We will stay on track by focusing on the hot spots, we want to focus on them next week, be ready to open" Cuomo said during his daily press briefing in Albany. "We will meet the need where it is greatest."

The governor reminded New Yorkers that this step is only the first of many to come.

"You have to remember this is only phase 1, you don’t go from zero to 60 miles per hour," Cuomo said. "You start to open gradually and watch how the system operates. And if you have to adjust, you adjust."

Phase 1 will allow regions to resume construction, manufacturing, agriculture, wholesale trade and limited retail operations. Phase 2 will open real estate and professional services. Restaurants and arts institutions will be at tail end of the reopening phases; they will have to wait until phases 3 and 4.

The governor said the biggest challenge would be the hot spots. The ZIP codes with twice the infection rate and the largest area of deaths are concerning, Cuomo said.

8:10 AM CT on 5/31/2020

(AP) India has recorded more than 8,000 new cases of the coronavirus in a single day for the first time as the infection tally surged to 182,143.

The death toll climbed to 5,164 after 193 fatalities were recorded in the last 24 hours, according to the health ministry data. This week has been the deadliest in India, with cases of infections and deaths reaching a new high almost every day.

Overall, more than 60% of the country’s virus fatalities have been reported from only two states — Maharashtra, the financial hub of India, and Gujarat, the home state of Prime Minister Narendra Modi. The new cases of infections are also largely concentrated in six Indian states, including the national capital New Delhi.

Public health experts have criticized the Modi government’s handling of the outbreak. A joint statement by the Indian Public Health Association, Indian Association of Preventive and Social Medicine and Indian Association of Epidemiologists, which was submitted to Modi’s office on May 25, said it was “unrealistic” to eliminate the virus at a time when “community transmission is already well-established.”

8:32 PM CT on 5/30/20

(AP) Arizona health officials on Saturday again reported a large number of additional COVID-19 cases.

The Department of Health Services reported 790 additional cases with 18 additional deaths as of Saturday, increasing the total number of cases statewide to 19,255 and the total number of deaths to 903. The department on Friday had reported 702 additional cases and 28 additional deaths.

The number of people hospitalized because of COVID-19 also continues to rise, with 975 as of Saturday, up from 931 as of Friday. Hospitalizations hovered around 700 people a month ago.

Gov. Doug Ducey has said Arizona's health care system can care for any virus patients and has enough hospital beds and ventilators available.

6:55 PM CT on 5/30/20

(AP) Healthcare workers rallied Saturday in New London, Conn., to protest what they called a shortage of personal protective equipment and pay tribute to a nurse's aide who died earlier this month after contracting the coronavirus.

Gov. Ned Lamont, Lt. Gov. Susan Bysiewicz and U.S. Rep. Joe Courtney, D-Conn., joined workers for Lawrence + Memorial Hospital and the Visiting Nurses Association of Southeastern Connecticut for the rally.
Union leaders said nurses, aides and other health care workers are risking their lives caring for COVID-19 patients while lacking sufficient protective gear such as masks and gowns to keep them safe.

"Our #HealthcareHeroes are fighting 24 hours a day to save lives, all while putting their own lives at risk," Courtney said in a Twitter posting. "Losing even just one of these workers due to improper protections cannot be tolerated. Congress must act to ensure OSHA implements a new & enforceable safety standard."

5:20 PM CT on 5/30/20

(AP) City officials in Boston are concerned that many Asian American residents may not be getting tested for the new coronavirus.

Boston's Chinatown zip code, where half the residents are of Asian descent, is one of city neighborhoods with the lowest percentage of positive coronavirus cases, Marty Martinez, the city's chief of Health and Human Services told the Boston Globe. Only 13% of those tested were positive, compared to the citywide cumulative percentage of 26%.

Asian Americans and Pacific Islanders make up just less than 10% of Boston's population but account for only 4% of confirmed COVID-19 cases and 6% of deaths, according the newspaper. At the same time, black residents, who comprise 25% of the city's population, account for 38% of COVID-19 infections and 35% of deaths, in cases where the race and ethnicity is known. Latinos make up nearly 20% of the Boston population and account for 25% of cases and 11% of deaths.

Paul Watanabe, a political science professor and director of the Institute for Asian American Studies at the University of Massachusetts Boston who is on the mayor's COVID-19 Health Inequities Task Force, thinks the numbers, though incomplete, show a low level of testing among Boston's Asian American population. The percentage of deaths may indicate that those Asian Americans with COVID-19 are getting tested late.

3:40 PM CT on 5/30/20

(AP) The massive protests sweeping across U.S. cities following the police killing of a handcuffed black man in Minnesota have elevated fears of a new surge in cases of the coronavirus.

Images showing thousands of screaming, unmasked protesters have sent shudders through the health community, which worries its calls for social distancing during the demonstrations are unlikely to be heard. Leaders appealing for calm in places where crowds smashed storefronts and destroyed police cars in recent nights also have been handing out masks and warning protesters they were putting themselves at risk.

Minnesota's governor said Saturday that too many protesters weren't socially distancing or wearing masks after heeding the call earlier in the week. But many seemed undeterred."It's not OK that in the middle of a pandemic we have to be out here risking our lives," Spence Ingram said Friday after marching with other protesters to the state Capitol in Atlanta. "But I have to protest for my life and fight for my life all the time."

Ingram, 25, who was wearing a mask, said she has asthma and was worried about contracting the virus. But she said as a black woman, she always felt that her life was under threat from police and she needed to protest that.

2:35 PM CT on 5/30/20

(Crain's Cleveland Business) In mid-March, nursing and medical students' clinical experiences with direct patient care were quickly put on hold, leaving schools scrambling to find new ways to continue to train medical professionals.

They got creative, expanding virtual options for classroom learning and finding other, safer experiences for students, including helping to answer COVID-19 hotline calls or consulting with patients via video or phone call. "The decision to remove medical students from the hospital was a difficult and painful one," said Steven Ricanati, interim vice dean of medical education and associate dean for student affairs at the Case Western Reserve University School of Medicine.

But university and hospital leaders agree that pausing these experiences was the right call for everyone's safety. The schools wanted to ensure there were appropriate patients for their students to work with, safety guidelines in place and a sufficient supply of personal protective equipment so students could learn without depleting hospitals' PPE resources or their faculty's attention, Ricanati said.

Now that the economy is reopening, the anticipated dramatic surge didn't happen and all have had time to put appropriate safety measures in place, many nursing and medical students will return to clinical sites Monday, June 1.

12:55 PM CT on 5/30/20

(GenomeWeb) Tangen Biosciences said on Friday that it has signed an exclusive agreement under which its GeneSpark point-of-care instrument will be distributed as part of LabWare's portable disease surveillance kit for SARS-CoV-2.

According to Tangen, the suitcase-sized kit includes a mobile hot spot and a tablet computer connected to a cloud-based laboratory information management system (LIMS) software portal. The kit is designed to help gather patient demographic and clinical information, document field collection of respiratory swabs for SARS-CoV-2 testing, accession samples, and disseminate data to public health agencies.

The addition of the GeneSpark molecular diagnostic instrument will allow high-priority patient specimens to be tested immediately, with patient details and test results transferred to public health labs and the US Centers for Disease Control and Prevention via LabWare's LIMS in under 30 minutes.

Additional terms of the deal were not disclosed.

11:35 AM CT on 5/30/20

(AP) The European Union on Saturday urged President Donald Trump to rethink his decision to terminate the U.S. relationship with the World Health Organization as spiking infection rates in India and elsewhere reinforced that the pandemic is far from contained.

Trump on Friday charged that the WHO didn't respond adequately to the pandemic and accused the U.N. agency of being under China's "total control."

The U.S. is the largest source of financial support for the WHO, and its exit is expected to significantly weaken the organization. Trump said the U.S. would be "redirecting" the money to "other worldwide and deserving urgent global public health needs," without providing specifics.

The U.S. has been worst hit by the outbreak, with more than 1.7 million cases and almost 103,000 deaths.

9:49 AM CT on 5/30/20

(AP) Washington Gov. Jay Inslee on Friday announced he would not extend the state's COVID-19 stay-at-home order beyond Sunday and would allow counties more flexibility to apply to advance through the current four-phase reopening plan using updated benchmarks that some larger counties had been seeking.

The stay-at-home order — in place since March 23 — was set to expire Sunday night. With the addition of two more counties Thursday, 26 of the state's 39 counties are currently approved for Phase 2, which allows restaurants and taverns to reopen at half capacity with limited table sizes, hair and nail salons and barber shops to resume business, and retail stores to reopen for in-store purchases at 30% capacity. It also allows additional outdoor recreation and gatherings with no more than five people outside of a person's household.

Starting Monday, counties can apply to move to the next phase or to add new business activity, with the applications assessed on several targets, including whether the counties have had fewer than 25 new cases per 100,000 residents over a two-week period.

Their application also will be measured on the reproductive rate of the virus in the county, hospital bed capacity, and number of outbreaks in workplaces and nursing homes. The counties also have to submit testing data and target number of confirmed cases and contacts reached in contact-tracing investigations. The guidance offered by the governor's office said that the applications will be considered as a whole, and that not meeting one target won't necessarily prevent the state from approving the county's application.More than 21,000 people in Washington state have tested positive for the coronavirus and at least 1,111 have died.

9:09 PM CT on 5/29/20

(AP) California plans to have 10,000 workers trained by July 1 to contact trace coronavirus cases, Gov. Gavin Newsom announced in a news conference on Friday.

The first phase commitment of 10,000 workers will be able to track 3,600 new cases per day, Newsom said.

Newsom noted the importance of contact tracing as the state reopens because it will meet the substantial needs of the counties that are reopening.

The state’s testing capacity has substantially increased from 2,000 to 50,000 tests every day. There has been an increase in the number of positive cases due to the increase in testing capacity, Newsom explained.  

The contact tracing workforce is being developed in partnership with the University of California Los Angeles and the University of California San Francisco.

8:29 PM CT on 5/29/20

It will be here before we know it--flu season. And health officials should be taking steps now to get ready for the covergence of the flu and COVID-19, Dr. Benjamin Singer writes in an editorial published Friday in the journal Science Advances.

A Northwestern Medicine pulmonologist who treats COVID-19 patients, Singer spelled out steps health officials can take to prepare:

• If COVID-19 cases spike in the fall, put tight social distancing measures back in place to mitigate the spread of both viruses.
• There will likely be an increase in flu vaccines while one is being developed for COVID-19. 
• There has to be "widespread availability of rapid diagnostics for COVID-19 and other respiratory pathogens because co-infection with another respiratory pathogen, including the flu, occurred in more than 20% of COVID-19-positive patients who presented with a respiratory viral syndrome early in the pandemic."
• It'll be critical to address health disparities given the disproportionate impact COVID-19 had on people of color. "Increase vaccination rates, deploy rapid diagnostics and expand other health care services for vulnerable populations, including communities of color, the poor and older adults," Singer argued.

"Even in non-pandemic years, the flu and other causes of pneumonia represent the eighth-leading cause of death in the United States, and respiratory viruses are the most commonly identified pathogens among hospitalized patients with community-acquired pneumonia," Singer said.

6:54 PM CT on 5/29/20

The American Medical Association Friday said that access to personal protective equipment and other supplies continues to be a challenge for non-hospital based physicians. 

"We want to ensure that the extreme shortages faced by front-line providers during the initial COVID-19 surges will not recur," AMA Executive Vice President and CEO Dr. James Madara wrote to Vice President Mike Pence. "Equally important, we want to ensure that this challenge does not spread to non-hospital physician practices as these practices begin to reopen for elective procedures and non-urgent care."

As states reopen their economies, bans on elective procedures and office visits will also lift. As that happens, Madara said it is "essential that physicians and their staff institute proper infection control procedures in their practices."

He called on the administration to work with the AMA to provide "additional assistance to these non-hospital physicians in securing PPE, disinfectants, and sanitizers." Assistance could include developing points of contacts in states, providing lists of suppliers and manufacturers, and creating a federal clearinghouse of informational resources.

5:30 PM CT on 5/29/20

(AP) The federal agency that oversees workplace safety said Friday that it had issued its first citation in the U.S. related to the coronavirus outbreak: against a Georgia nursing home that delayed reporting the hospitalization of six infected workers.

The Occupation Safety and Health Administration announced the citation the day after Democrats at a congressional subcommittee hearing in Washington accused the agency of being largely invisible during the pandemic and failing to protect workers at meatpacking plants and health care facilities with high infection rates.

The citation, dated May 18, states that Winder Nursing Inc., which operates a nursing home in Winder, Georgia, failed to report to OSHA within 24 hours the work-related hospitalizations of six employees. OSHA said the workers were hospitalized around April 19, but the agency wasn't notified until May 5.

The citation does not mention the coronavirus. An OSHA spokeswoman, Megan Sweeney, confirmed Friday that all six of the workers were infected with COVID-19.

OSHA proposed a $6,500 fine for the nursing home for a single violation that the agency concluded was “other than serious,” according to the citation.

Katy Callaway, the nursing home's administrator, said Friday that she had not yet received the OSHA citation. She declined to comment further.

Sweeney said OSHA has received more than 4,500 coronavirus-related complaints but this is the first citation the agency has issued in response. She said the agency investigates every complaint.

4:24 PM CT on 5/29/20

(AP) The University of Mississippi Medical Center has laid off 250 employees to offset financial losses due to the coronavirus pandemic.

Hospital leaders said the facility is projecting more than a $100 million deficit through September.

The hospital outlined the reductions in a memo sent to employees Wednesday, news outlets reported. Other steps put in place to counter the financial situation include salary reductions, restrictions on hiring and travel and other capital budget cuts.

Dr. LouAnn Woodward, vice chancellor for health affairs, said the hospital has never faced this type of challenge in all of its 65 years.

"It will take guts, grit and fortitude to pull through to the other side," she said. "Today's action is an example of how very tough decisions with difficult consequences will be required. However, I am confident we can, and we will, weather this storm and emerge stronger than ever."

2:58 PM CT on 5/29/20

House GOP Doctors Caucus Co-Chair Phil Roe (R-Tenn.) and Rep. Lou Correa (D-Calif.) introduced legislation that would protect healthcare providers from legal liability during the COVID-19 pandemic as long as they act in good faith and follow government guidelines.

The Coronavirus Provider Protection Act would protect healthcare providers from liability for suspending elective in-person visits, staffing shortages requiring physicians to work outside their practice area, equipment shortages and delayed or inaccurate diagnoses due to inadequate testing supplies. Senate Republicans have said they want liability protections for businesses included in the next round of COVID-19 response legislation.

“While our bill does provide protections to providers who engaged in good-faith attempts to care for patients in accordance with state and local regulations, this bill does not provide protections to physicians who engaged in gross negligence or willful misconduct,” Roe said in a statement.

The American Medical Association supports the bill.

2:57 PM CT on 5/29/20

(AP) President Donald Trump said Friday that the U.S. will be terminating its relationship with the World Health Organization, saying it had failed to adequately respond to the coronavirus because China has "total control" over the global organization.

He said Chinese officials "ignored" their reporting obligations to the WHO and pressured the WHO to mislead the world when the virus was first discovered.

He noted that the U.S. contributes about $450 million to the world body while China provides about $40 million.

The U.S. is the largest source of financial support to the WHO and its exit is expected to significantly weaken the organization. Trump said the U.S. would be "redirecting" the money to "other worldwide and deserving urgent global public health needs," without providing specifics.

1:36 PM CT on 5/29/20

(AP) Employers must provide agricultural workers with face masks, more hand-washing stations and more frequently disinfect work surfaces under new coronavirus rules established Thursday by Washington Gov. Jay Inslee.

Also Thursday, Secretary of Health John Wiesman signed an order for all residents and staff in nursing homes to be tested for COVID-19 by June 12, and all residents and staff in assisted living facilities with a memory care unit to be tested by June 26. The state will provide test kits and personal protective equipment for administering tests to every facility at no cost.

The nation's first deadly coronavirus outbreak was at a Seattle-area nursing home where more than 40 people died. In early May the state's COVID-19 response team said at that time more than 60% of the coronavirus deaths in Washington were linked to long-term care facilities and more than 250 such locations had reported at least one COVID-19 case.

12:42 PM CT on 5/29/20

Google's philanthropy arm, Google.org, has awarded the Satcher Health Leadership Institute at Morehouse School of Medicine a $1 million grant to study to study reasons why black, Latino and other minority populations so far have been disproportionately affected by COVID-19.

The Satcher Health Leadership Institute will use the funding to create a database with information about COVID-19 cases, hospitalizations and deaths in the U.S., as well as breaking down those cases by race, ethnicity, gender, socioeconomic status and other demographic factors.

A team of Google engineers and data scientists will work on the project full-time over the next six months to help create the database, as well as a public-facing and interactive component called the COVID-19 Health Equity Map.

The project will ideally help to inform policymakers target resources and support to those populations.

"This partnership goes beyond showing disparate impact of the virus," Daniel E. Dawes, principal investigator of the grant award and director of Satcher Health Leadership Institute, said in a statement. "By looking at the social and political determinants of COVID-19 outcomes, we can inform resource allocation and management, jurisdictions' response and mitigation strategies, testing, contact tracing, and overall implications for health equity for vulnerable populations."

11:35 AM CT on 5/29/20

The Federal Communications Commission to date has approved a collective $68.22 million in funding for 185 healthcare organizations as part of its COVID-19 Telehealth Program, 34.11% of the funding Congress allocated the FCC for the program.

Congress under the CARES Act authorized $200 million for the FCC to set up the COVID-19 Telehealth Program.

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.

Healthcare organizations receive funding after submitting an invoice and supporting documentation for eligible services, as a form of reimbursement. That means the $68.22 million in funding the agency has announced to date, while approved, has not necessarily been distributed to designated healthcare organizations yet.  

In its latest set of approvals May 28, the FCC committed $18.22 million in funding to 53 healthcare organizations. It's eighth set of COVID-19 Telehealth Program applications the agency has approved since it opened the program in April.

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

To view the FCC's running tally of funding recipients, click here.

10:46 AM CT on 5/29/20

(AP) Sen. Tim Kaine of Virginia says he and his wife have tested positive after taking coronavirus antibody tests.

Kaine said in a statement Thursday that he and his wife, Anne Holton, were tested for antibodies this month after their health providers thought it possible they'd had mild cases of virus earlier this year. Kaine said he initially thought he was suffering from remnants of an earlier bout with the flu and a high pollen count.

Kaine said he and Holton worked remotely and isolated themselves from others and were symptom free by mid-April. Holton is the interim president of George Mason University.

Antibody tests are different from the nasal swab tests currently used to diagnose active infections. Instead, the tests look for blood proteins called antibodies, which the body produces days or weeks after fighting an infection. An antibody test might show if you had COVID-19 in the recent past, which most experts think gives people some protection.

At least eight federal lawmakers have tested positive for active infections.

9:49 AM CT on 5/29/20

(AP) Wading into a politically charged issue, Senate Majority Leader Mitch McConnell on Thursday preached the importance of wearing masks in public as the nation's economy reopens from the "cataclysmic" damage inflicted by the coronavirus pandemic.

During a tour of hospitals this week in his home state of Kentucky, the Republican leader has stressed wearing masks in public and following social distancing guidelines.

"There should be no stigma attached to wearing a mask," McConnell said during an appearance in Owensboro. "And even among age groups that are least likely to either contract this disease or die from it, you could be a carrier. So I think what we all need to do is say, 'OK, I'm going to take responsibility not only for myself but for others.'"

McConnell, who is in his late 70s and is in the midst of his own reelection campaign, has worn masks at his appearances. On Thursday, he stuffed the face covering into his coat jacket to speak. He donned it again afterward.

His mask-wearing is in stark contrast to the unwillingness of a key political ally to do so. President Donald Trump has refused to wear face coverings, and polls find that conservative Americans are more likely to forgo them. McConnell did not mention the president while touting the use of masks.

Kentucky Gov. Andy Beshear has repeatedly stressed the use of masks as people increasingly venture out as the economy gradually gets rebooted.

"This is not a battle between political parties or ideologies," the Democratic governor said recently. "It's plain, basic public health guidance that's out there from the CDC and from everywhere else. It's the same guidance on the federal and on the state level. And it's just smart, right?"

9:04 PM CT on 5/28/2020

Kaiser Permanente is extending its waiver for most member out-of-pocket costs for inpatient and outpatient COVID-19 services through December 31, 2020. This waiver was originally implemented on April 1 and originally was set to expire on May 31.

"This move aims to alleviate any stress about paying for care, as well as any hesitancy to seek needed care. The path forward through this pandemic must include identifying, treating and tracing as many cases of COVID-19 as possible as we work to suppress this virus,” said Greg Adams, chairman and CEO of Kaiser Permanente.
 
Kaiser Permanente's elimination of member out-of-pocket costs applies to all fully insured benefit plans, in all markets. This waiver does not automatically apply to self-funded customers who directly administer health benefits to their employees and non-urgent or emergent out-of-network claims for tiered benefit product customers. Kaiser Permanente has encouraged self-funded customers to adopt this change, according to a press release.

Kaiser Permanente suspended all terminations for non-payment of premium or out of pocket expenses from March 15 through May 31. In May, Kaiser Permanente further extended the suspension of terminations for non-payment through June 30 for KP Individuals and Family and Small Group members.

8:17 PM CT on 5/28/2020

(AP) North Carolina's governor said Thursday that his administration hasn't received the written safety plan for the upcoming Republican National Convention requested by his health secretary in response to President Donald Trump's demands for a full-scale event.

Gov. Roy Cooper, a Democrat, said during a media briefing that RNC organizers have yet to turn over written plans for how they envision safely holding the convention in Charlotte in August amid the COVID-19 pandemic. Top GOP officials countered in a letter that they need more guidance and assurances from Cooper.

North Carolina Health and Human Services Secretary Mandy Cohen sent a letter Monday to the top RNC organizer asking for the written plans after Trump demanded in a tweet that North Carolina guarantee a full-scale, in-person convention will be held. Cooper and Cohen say that they had discussed various scenarios with convention organizers but want their plan in writing.

“We’re ready to hold the RNC convention in North Carolina in a safe way. And for weeks and months, the health experts in our office have had conversations with the people organizing the RNC about how to have it in a safe way,” he said.

But despite the request Monday, Cooper said: “We've yet to see” a written safety plan from RNC organizers.

7:12 PM CT on 5/28/2020

(AP) South Korea on Thursday reported its biggest jump in coronavirus cases in more than 50 days, a resurgence that health officials warn is getting harder to track and risks erasing some of the nation’s hard-won gains.

The Korea Centers for Disease Control and Prevention said 67 of the 79 new cases reported were from the Seoul metropolitan area, where about half of South Korea’s 51 million people live.

Following an emergency meeting, the government decided to shut public facilities such as parks, museums and state-run theaters in the metropolitan area over the next two weeks to slow the spread of the virus.

“The two weeks from now will be crucial in containing infections,” said Health Minister Park Neung-hoo, who called for residents in the metropolitan area to avoid unnecessary gatherings and urged companies to keep sick employees off work.

At least 82 infections so far have been linked to workers at a massive warehouse operated by local e-commerce giant Coupang. Health authorities plan to finish testing more than 4,000 workers and visitors to the warehouse later Thursday.

Hundreds of other infections have been linked to nightclubs and other entertainment venues, which saw huge crowds in early May after officials relaxed social distancing guidelines.

6:20 PM CT on 5/28/20

A blog in Health Affairs offers a silver lining to the challenges facing individuals with opioid use disorder. COVID-19 and associated social distancing strategies have reversed the downward trend of overdoses that began in 2018. Cities and states across the country are reporting up to 50% increases in overdose deaths.     

"To prevent the COVID-19 pandemic from supercharging the opioid epidemic, it is important to seek continued opportunities to integrate lower-barrier medication treatment offered through telemedicine with other forms of social support, such as self-help groups," the authors write.

5:28 PM CT on 5/28/20

(AP) The U.N. chief on Thursday warned the largest gathering of world leaders since the coronavirus pandemic began that it will cause “unimaginable devastation and suffering around the world,” with historic levels of hunger and famine and up to 1.6 billion people unable to earn a living unless action is taken now.

Secretary-General Antonio Guterres also told the high-level meeting on measures to help low- and middle-income countries that fallout from the crisis could lead to “a loss of $8.5 trillion in global output — the sharpest contraction since the Great Depression of the 1930s.”

He called for immediate collective action in six critical areas: enhancing global financial liquidity; providing debt relief; engaging private creditors; promoting external finance; plugging leaks in tax evasion, money laundering and corruption; and adopting a recovery that tackles inequalities, injustices and climate change.

Nearly 50 world leaders spoke by video at the event along with economic experts, including the heads of the International Monetary Fund and the World Bank. But there were noticeable absences, among them the leaders of the world’s two largest economies — the United States and China, which are engaged in escalating tensions over the pandemic and a host of other issues.

China’s U.N. Mission said it didn’t participate “due to a scheduling conflict” and submitted a written statement. The U.S. Mission did not respond to requests for a reason why it did not speak. Guterres told reporters later that neither country could participate at a high level, but “there is a commitment from both the United States and China to be involved in this process which we very much welcome.”

4:08 PM CT on 5/28/20

(Crain’s Cleveland Business) Gov. Mike DeWine announced that 14, 10-person Congregate Care Unified Response Teams will begin this week to test all staff working in Ohio's 960 long-term care facilities for the coronavirus.

Residents will also be tested based on assessments of their likely exposure by team clinicians. Dr. Amy Acton, director of the Ohio Department of Health, reported that 63% of all COVID-19 related deaths statewide have been linked to nursing homes.

The teams, consisting of professionals from the ODH and local health departments, will begin by focusing on about 200 of the state's facilities that already have a history of at least one confirmed COVID-19 case, with a goal of eventually testing every facility in Ohio as quickly as possible. Medically trained members of the Ohio National Guard will assist in taking test samples.

Contact tracing will be implemented for anyone who tests positive for the virus.

"This will help nursing home administrators understand the status of the virus in their facilities and will help isolate the virus and help keep it from infecting their community," DeWine said.

3:00 PM CT 5/28/20

Federally recognized tribes and other tribal organizations in 20 states will receive $15 million for COVID-19 preparedness, prevention and response, HHS said in a statement Thursday.

Tribes can use the funds to offer overtime and hazard pay to their workforces and secure access to personal protective equipment. They may also build telehealth infrastructure, improve testing capacity, buy mobile clinics or vehicles to transport COVID-19 patients and provide “culturally-informed educational resources and information to promote behaviors that slow the spread of the virus,” HHS said.

Under a program created for rural tribes by Congress in the CARES Act, tribes can receive up to $300,000 from HHS to address the COVID-19 pandemic.

1:56 PM CT on 5/28/20

Premier is partnering with Hikma Pharmaceuticals to provide supplies of two drugs that are necessary for COVID-19 patients, amiodarone and sterile water.

Amiodarone is used for late onset cardiac arrest and ventricular arrhythmia, complications that can arise from COVID-19. Sterile water is used to prepare many injectable drugs, including remdesivir, the Gilead medication that has so far shown to speed COVID-19 recovery.

Amiodarone isn’t on the Food and Drug Administration’s shortage list, but Premier purchasing data shows the drug is backordered. Sterile water is on the American Society of Health-System Pharmacists’ list of drugs in shortage.

“When it comes to the COVID-19 response, we can’t afford to delay action until drugs roll onto the FDA shortage list,” said Premier President Michael J. Alkire. “By that time, patient care is already compromised.”

12:46 PM CT on 5/28/20

(AP) The leader of South Carolina's health agency announced Wednesday that he is stepping down after a health scare to spend more time with his family as the state continues to fight the coronavirus.

Rick Toomey's decision to leave the Department of Health and Environmental Control came less than 15 months after he took over the agency. DHEC's board had spent 17 months looking for its new director before choosing Toomey, who was a board member.

Toomey, 65, spent two weeks on leave starting in late March because of high blood pressure. Toomey said that health scare played a part in his decision to leave, along with wanting to spend more time in his Beaufort home, where his new grandson also lives.

"It is a difficult decision," Toomey said at an emergency board meeting Wednesday. "I have grown to love, to admire the effort of the individuals who make up DHEC."

The board then voted to make agency attorney Marshall Taylor the interim director after Toomey leaves June 10.

Nearly every board member praised Toomey for his leadership.

"I really wished we could have had you a little bit longer. Your leadership during this crisis in South Carolina has been incredible," board member Seema Shrivastava-Patel said.
 

Toomey was president of Beaufort Memorial Hospital from 2007 to 2016 before Gov. Henry McMaster appointed him to the DHEC board in February 2018.

Toomey said it was hard to leave in the middle of the COVID-19 pandemic, but he felt like the agency reaching its goal of testing 2% of the state's population — or about 110,000 people — in May along with South Carolina's reopening committee, Accelerate SC, planning to finish its work Thursday made the timing work.

11:53 AM CT on 5/28/20

An experimental stem cell therapy is being tested to determine whether it can help hospitalized COVID-19 patients on ventilators breathe.

The drug, remestemcel-L, will be used to treat patients with moderate to severe acute respiratory distress syndrome. Remestemcel-L was developed to treat inflammatory conditions, and some COVID-19 patients suffer an extreme immune response causing fatal levels of inflammation.

“This stem cell therapy is a potential new therapy in our treatment arsenal to battle COVID-19,” said Dr. Sunjay Kaushal, professor of surgery at the University of Maryland School of Medicine. “There is an urgent need to find new life-saving therapies for our sickest COVID-19 patients who are suffering from ARDS and require ventilators. We are eager to see whether remestemcel-L can reduce mortality in these patients.”

10:49 AM CT on 5/28/20

(AP) CVS Health is opening 10 new drive-thru coronavirus testing sites at pharmacies in Rhode Island on Friday as part of its commitment to open 1,000 such sites nationwide.

The new sites will utilize self-swab tests that won't require people to get out of their vehicles, according to the Woonsocket-based company. No testing will be done in the stores.

Patients, who must first make an appointment online, will be given a test kit and instructions at the drive-thru window. A qualified CVS employee will observe the test to ensure it is done properly. Tests will be sent to a third-party lab for processing, with results available in about three days.

9:41 AM CT on 5/28/20

(AP) The U.S. surpassed a jarring milestone Wednesday in the coronavirus pandemic: 100,000 deaths.

That number is the best estimate and most assuredly an undercount. But it represents the stark reality that more Americans have died  from the virus than from the Vietnam and Korean wars combined.

"It's a striking reminder of how dangerous this virus can be," said Josh Michaud, associate director of global health policy with the Kaiser Family Foundation in Washington.

The once-unthinkable toll appears to be just the beginning of untold misery in the months ahead as Las Vegas casinos and Walt Disney World make plans to reopen, crowds of unmasked Americans swarm beaches and public health officials predict a resurgence by fall.

Dr. Anthony Fauci, the nation's top infectious disease expert, issued a stern warning after watching video of Memorial Day crowds gathered at a pool party in Missouri.

"We have a situation in which you see that type of crowding with no mask and people interacting. That's not prudent, and that's inviting a situation that could get out of control," he said during an interview Wednesday on CNN. "Don't start leapfrogging some of the recommendations in the guidelines because that's really tempting fate and asking for trouble."

Worldwide, the virus has infected more than 5.6 million people and killed over 350,000, with the U.S. having the most confirmed cases and deaths by far, according to a tally by Johns Hopkins University. Europe has recorded about 170,000 deaths, while the U.S. reached more than 100,000 in less than four months.

8:45 PM CT on 5/27/20

Hal Wolf, CEO of the Healthcare Information and Management Systems Society, has responded to a recent petition from companies that had planned to exhibit at the group's 2020 trade show.

A group of 25 exhibitors led by workforce management solutions provider Softworks penned a letter to Wolf last week to request that HIMSS provide full refunds for payments the companies had made for space in the now-canceled conference's exhibition hall. HIMSS canceled the conference just days before the March event was slated to start as COVID-19 related shutdowns began.

Wolf in a letter responding to the petition reaffirmed that HIMSS won't issue refunds, but will offer partial credit toward the fees for its annual conferences in 2021 and 2022. "The non-refund provision of the force majeure clause in our contract reflects the reality that non-profits like HIMSS have fewer financial tools available when a black-swan event like COVID-19 forces a cancellation," Wolf wrote in the letter, obtained by Modern Healthcare.

A force majeure clause is designed to excuse an entity—in this case, HIMSS—from its contractual obligations when circumstances arise beyond its control.

For more, click here.

8:05 PM CT on 5/27/20

(AP) Tennessee will soon stop providing the names and addresses of COVID-19 patients to first responders, after initially arguing that doing so would protect those on the front line.

Gov. Bill Lee's administration decided on the change this week, conceding that the data may have created a false sense of security to those responding to emergency calls. The data sharing will stop at the end of the month.

The announcement follows an Associated Press review that found public officials in at least two-thirds of states are sharing the addresses of people who tested positive with first responders. A small handful of those states, including Tennessee at the time, also shared the patients' names.

Supporters argue that the information is vital to helping them take extra precautions to avoid contracting and spreading the coronavirus. Yet civil liberty and community activists have expressed repeated concerns of potential profiling in African American and Hispanic communities that already have an uneasy relationship with law enforcement.

6:50 PM CT on 5/27/20

A large group of associations representing drug stores, pharmacists, insurers and other supply chain stakeholder released policy principles for ensuring access to drugs during the pandemic.

The principles call for such things as: "the private and public sectors (working) together to sustain access to care for patients and help to mitigate disruptions and shortages," according to a press release.

Another principle addresses reliance on overseas drug production: "We should avoid measures that could trigger protectionist responses and instead deepen relationships with international trading partners to promote resiliency and diversity of the global pharmaceutical supply chain. Specifically, the U.S. Government should avoid adopting policies that may have an unintended impact on the U.S. pharmaceutical supply, including requirements to buy only drugs, or a percentage of drugs, manufactured in the United States."

Among the signers are America's Health Insurance Plans, PhRMA and Blue Cross Blue Shield Association.

5:25 PM CT on 5/27/20

The American Medical Group Association said on Wednesday that many of its members have not received some of the $50 billion in general provider relief grants HHS has distributed from the Coronavirus Aid, Relief, and Economic Security Act weeks after hospitals got the money.

“We are concerned that most of our members have not received a second payment from the $50 billion general allocation fund, despite providing the required financial documentation,” AMGA President and CEO Jerry Penso wrote in a letter to HHS Secretary Alex Azar.

Funds in the second wave of general provider grants were automatically sent to hospitals, but providers that do not file Medicare cost reports had to submit financial information to HHS through an online portal. AMGA said that HHS had said providers could expect payment 10 days after submission, but that the “vast majority” of its medical group members have not received funds more than four weeks later.

HHS did not immediately respond to a request for comment on the letter.

4:16 PM CT on 5/27/20

(AP) Intensive care units in Chile's hospitals are nearly at capacity amid a flood of coronavirus patients, authorities said Tuesday, and doctors are having to make wrenching choices over which patients should get available beds.

Health officials said 95% of the country's 2,400 ICU beds are occupied even after a doubling of capacity from the levels in March. They announced plans to add 400 more critical care beds in the coming days.

"This is an extraordinarily difficult time," Health Minister Jaime Mañalich said.

A nation of 18 million people, Chile has the third most coronavirus cases in the region, after Brazil and Peru, with an average of 4,000 new infections reported daily. About 15% of the cases require hospitalization.

That is forcing Chilean physicians to face a dilemma that previously confronted doctors in hard-hit nations like Italy and Spain: Which patient with coronavirus should be given the last available bed?
 

Khaty Barriga, mayor of the populous commune of Maipú, said there was only one respirator free for use Tuesday at the El Carmen de Maipú hospital.

His area is part of the Santiago metropolitan region, which has had more than 80% of the nearly 78,000 coronavirus cases and just over 800 deaths recorded in Chile.

Dr. Claudia Vega, head of the hospital's ICU, had said Monday in a television interview that "right now I am choosing which bed is going to be vacated and choose the right person, which is the right one."

"May God enlighten me in this," she said.

The Chilean Society of Intensive Medicine, which consults with hundreds of hospitals and clinics daily, said the occupancy of critical care beds in the greater Santiago area stood at 97%. A report from the University of Chile said the increase in new cases "suggests a possible complete saturation of the system this week."

The Santiago region is home to 8 million people, who have been under mandatory orders for isolation at home for 11 days. Except for a 10 p.m.-5 a.m. curfew, residents are allowed to obtain permission online to venture outside to perform necessary tasks, such as grocery shopping and taking pets for brief walks.

3:04 PM CT on 5/27/20

Statewide stay-at-home orders correlate with fewer people than expected being hospitalized for COVID-19, according to research published in JAMA.

Using data collected from Colorado, Minnesota, Ohio and Virginia, researchers calculated the projected growth in hospitalizations just before the order was issued and compared it to the actual number of hospitalizations in each state.

By April 13, five days after a 12-day incubation period, researchers projected 988 people would have been hospitalized in Minnesota, but actual hospitalizations were 361. In Colorado, projected hospitalizations were 8,637, but actual hospitalizations were 1,632.

“What we found is that about 12 days after the stay-at-home order was implemented, the growth in hospitalizations began to deviate favorably from the initial, projected trajectory,” said Soumya Sen, the study’s lead author. “In all the states we examined, growth in the total number of patients being hospitalized due to COVID-19 symptoms appeared to slow down from the initial, exponential trend.”

1:45 PM CT on 5/27/20

Wellmark Blue Cross and Blue Shield will extend coronavirus-related coverage changes like no cost-sharing for COVID-19 tests and increased access to telehealth through August 31.

The changes were originally supposed to expire June 16. The updates included waiving cost-sharing for inpatient COVID-19 treatment with an in-network provider, allowing more flexibility with prescription drugs and working with employers to keep furloughed workers enrolled in insurance coverage.

12:41 PM CT on 5/27/20

(Crain’s Detroit Business) The state of Michigan provided grants to five companies to solve mobility issues from the COVID-19 outbreak.

Troy-based Penske Vehicle Services, Roseville-based RCO Engineering, New Hudson-based Pratt Miller, Grand Haven-based engineering firm GSHP and Palo Alto, Calif.-based autonomous logistics firm Gatik received a total of $286,000 to create a host of technologies and create new jobs during the pandemic, the state said in a news release.

• Penske Vehicle Services is manufacturing clear vinyl partitions for public transit to prevent coronavirus transmission from drivers and passengers. Penske used the $28,000 grant to boost manufacturing to fill a "small" contract with a ride-sharing service. The state declined to name the service provider.
• RCO Engineering also received $28,000 to manufacture partitions for public transit. The city of Detroit is providing vehicles to RCO.
• Pratt Miller created a robotic vehicle to disinfect the Gerald R. Ford International Airport in Grand Rapids. The Large area autonomous Disinfecting robotic vehicle's "electrostatic technology spray disinfectant into the air and adheres to surfaces for maximum virus protection, while the autonomous platform monitors and guarantees coverage through the use of sensors and data analysis." The vehicle will begin work at the airport next month, the state said in the release. The state provided a $50,000 grant toward the project.
• GHSP developed an automated disinfectant sprayer technology for shared shuttle services. The sprayer will sense when occupants have left the vehicle and disinfect the air and high-touch surfaces. GHSP received an $80,000 grant for the technology development, which will be integrated into May Mobility's autonomous shuttle fleet as part of the Grand Rapids Autonomous Vehicle Initiative. The project is expected to be integrated into emergency vehicle applications in the future.
• Gatik is working with "one of the state's largest retailers" to deploy autonomous delivery vehicles on fixed routes in Grand Rapids and Rochester. The company received a $100,000 grant from the state. The retailer was not identified.

11:25 AM CT on 5/27/20

Quest Diagnostics will offer a suite of COVID-19 testing services as employees return to work.

Services include event hosting with temperature checks and respiratory and blood specimen collection, online questionnaires to direct workers to the appropriate test based on symptoms and exposure, and flu vaccine services that could incorporate a COVID-19 vaccine when available.

"Some jobs are higher risk than others, and we plan to prioritize testing access for organizations that employ healthcare workers, first responders and others whose health and safety are critical to our nation's response to COVID-19," said Dr. Jay Wohlgemuth, head of Quest's Employer Population Health business. 

10:31 AM CT on 5/27/20

(AP) A Mississippi judge ruled Tuesday that the state Health Department must respond to a newspaper's public records request about long-term care facilities where outbreaks of the new coronavirus have occurred.

Hinds County Chancery Judge Tiffany Grove granted an emergency injunction in favor of Hattiesburg Publishing Inc., which owns the Pine Belt News.

Grove wrote that the Health Department has seven days to either provide information what the newspaper is requesting or cite a specific exemption in the state Public Records Act for denying the information.

The judge wrote that "the public interest is served by maintaining transparency and public access to public information when the appropriate requests for such information are made."

The publishing company filed a lawsuit May 12 against the Health Department, saying that the department had improperly denied the newspaper's request for the names of Forrest County nursing homes where at least one case of COVID-19 had been found. The lawsuit said the department spokeswoman did not provide a specific reason for not releasing the information and said her action violated the state's public records law.

Other news organizations have sought the names of nursing homes where coronavirus cases have been found.

The state health officer, Dr. Thomas Dobbs, said in response to questions at a May 13 news conference that the Health Department will not release the names of long-term care facilities where residents or employees test positive for COVID-19, just as it does not release the names of facilities where other diseases such as tuberculosis are found.

"Ever since I've been at the Department of Health, we've recognized the real potential danger of identifying nursing homes in outbreaks," Dobbs said. "In other states, we've seen adverse events where people are identified and stigmatized and even the centers were stigmatized. If a center gets stigmatized, there's difficulty finding staff, and then there is a possibility of undermining the integrity of the care."

In a news release Tuesday, Pine Belt News publisher David Gustafson praised Grove's ruling.

"Unfortunately, we live in a day and age when secrecy in government generates suspicion and mistrust on the part of our citizenry and I'm proud to lead a news organization that isn't afraid to ask the tough questions and seek the answers that our readers deserve," Gustafson said.

9:20 AM CT on 5/27/20

(AP) Some residents in a Kentucky nursing home were evacuated to area hospitals after nearly 60 residents and employees tested positive for the novel coronavirus.

The plan to evacuate residents who tested positive for the virus was told to families over the weekend after Nazareth Home's Clifton Campus in Louisville discovered on Friday that about 40 residents and approximately 20 staff members had tested positive for the virus, news outlets reported.

Diane Curtis, a communication director of Nazareth Home Ministries, told the Courier Journal the nursing home requested the testing after some residents began to show symptoms of the coronavirus last week. Many of those who tested positive did not show symptoms.

Rosemary Moore, one of the residents who tested positive for the virus, was brought to a hospital Monday night. "I don't know if she's going to make it, and it's heart wrenching," Diane Streicher, Moore's daughter, told WHAS-TV.

The evacuations began after it was "apparent the facility was going to have a very tough time providing enough staff to the residents that they had in that facility," state Health and Family Services Secretary Eric Friedlander said in a news conference Tuesday.

The testing at the nursing home was done as part of the state's long-term care task force that has tested thousands for the virus in facilities across Kentucky.

Nazareth Home's second location will receive testing on June 1.

9:09 PM CT on 5/26/20

(AP) Missouri's state health director on Tuesday confirmed that the state has been lumping together different coronavirus test results in a way that can be misleading, despite saying otherwise multiple times last week.

The agency has been combining the results of viral tests, which detect active cases of the virus essentially from the onset of infection, with antibody tests. Antibody tests check for proteins that develop a week or more after infection and show whether a person has been exposed at some point in the past.

Mixing the results makes it difficult to understand how the virus is spreading, and Missouri health Director Randall Williams himself has previously said the two tests should not be conflated. It can give the false impression that the rate of positive test results is declining.

The Centers for Disease Control and Prevention and several other states have admitted to combining the results, but Missouri's state health department denied doing so when asked by reporters multiple times last week.

Viral test results should be reported separately, public health experts say. That allows for tracking of how many people have confirmed active infections, the percentage of people testing positive and how those numbers change over time — all crucial for guiding public policy.

8:17 PM CT on 5/26/20

(Crain's Detroit Business) Michigan Gov. Gretchen Whitmer on Tuesday ordered that people who leave their home for work or those who have coronavirus symptoms can be tested without needing a doctor's note.

It was the state's latest move to expand COVID-19 testing, which is seen as a critical to slowing the virus, particularly as the governor loosens stay-at-home restrictions. Previously, many people needed an order from a health care provider, although people don't need a note or symptoms to be tested at a site at the old state fairgrounds in Detroit.

Those who have been exposed to a person with the coronavirus and people in nursing homes, prisons and other congregate settings are also eligible for testing.

Executive Order 2020-104 expands the types of medical personnel who can order a test, and creates a new category of community testing sites that offer testing to anyone with reason to be tested without an advance order, and without charging an out-of-pocket cost to any Michigan resident.

The governor also announced a new online dashboard that illustrates COVID-19 risks and trends in Michigan at MIstartmap.info.

7:37 PM CT on 5/26/20

Although it was not slated until late November, RSNA 2020 is joining the long list of major trade shows that's going virtual.

The Radiological Society of North American made the announcement today on its website, saying, "With a mission that focuses on health and patient care, the primary consideration for RSNA is the health and safety of attendees, presenters, exhibitors, staff, and by extension, the global community. Therefore, we concluded it would be impossible to safely conduct RSNA 2020 in person and have decided to hold RSNA 2020: Human Insight/Visionary Medicine as an exclusively virtual event."

RSNA regularly brings more close to 52,000 attendees to Chicago for its annual meeting. It's meeting is scheduled for Nov. 29-Dec. 5. RSNA President James Borgstede noted that the meeting has only been cancelled two other times during the last century, in 1943 and 1945, because of World War II.

6:42 PM CT on 5/26/20

(AP) First came a high fever, drenching sweats and muscle aches. Then, almost a month later, a weird numbness that spread down the right side of her body. Darlene Gildersleeve thought she had recovered from COVID-19. Doctors said she just needed rest. And for several days, no one suspected her worsening symptoms were related — until a May 4 video call, when her physician heard her slurred speech and consulted a specialist.

“You’ve had two strokes,’’ a neurologist told her at the hospital. The Hopkinton, New Hampshire, mother of three is only 43.

Blood clots that can cause strokes, heart attacks and dangerous blockages in the legs and lungs are increasingly being found in COVID-19 patients, including some children. Even tiny clots that can damage tissue throughout the body have been seen in hospitalized patients and in autopsies, confounding doctors’ understanding of what was once considered mainly a respiratory infection.

Doctors and scientists at dozens of hospitals and universities around the globe are seeking answers while trying to measure virus patients’ risks for clots and testing drugs to treat or prevent them.

Gildersleeve said health authorities “need to put out an urgent warning about strokes” and coronavirus. Not knowing the possible link “made me doubt myself” when symptoms appeared, she said.

5:28 PM CT on 5/26/20

HHS on Tuesday submitted a three-page report to Congress fulfilling a statutory requirement to update lawmakers on how the department is sending out $175 billion set aside to aid healthcare providers during the COVID-19 pandemic.

The data was categorized by disbursement by state and totals were current through April 30, which means it only represents $39.3 billion of the more than $77 billion the department has sent providers so far. HHS has publicly released provider-level data on the grants that was current through May 13, though that dataset is still incomplete.

The Coronavirus Aid, Relief, and Economic Security Act--know as the CARES Act--required HHS to report to the House and Senate appropriations committees obligations of provider relief funds, including the state summary, within 60 days of the law being enacted.

Two prominent House Democrats, Energy & Commerce Chair Frank Pallone (N.J.) and Ways & Means Chair Richard Neal (Mass.) criticized HHS and CMS on May 7 for a lack of transparency into the distribution methods and recipients of provider relief grants, and said they plan to call HHS Secretary Alex Azar and CMS Administrator Seema Verma to testify on the issue.

4:11 PM CT on 5/26/20

(Crain’s Chicago Business) The city of Chicago is setting aside $56 million in federal and state grants to help train and certify a 600-person COVID-19 contact tracing workforce.

A request for proposals, released today, seeks an organization to head up the effort. That organization would be required to distribute 85 percent of contact tracing funding to groups that primarily serve people in areas with high economic hardship. Those areas have also been some of the hardest hit by COVID-19.

“These neighborhood-based organizations are responsible for recruiting, hiring and supporting a workforce of 600 contact tracers, supervisors, and referral coordinators to support an operation that has the capacity to trace 4,500 new contacts per day,” the city said in a news release. Contact tracers would earn $20 per hour, and supervisors would earn $24 per hour.

"We already have a significant core of people who do contact tracing as a matter of course," Lightfoot told reporters today, in addition to the work being done by healthcare providers like Howard Brown Health, Rush University Medical Center and the Sinai Urban Health Institute. The city is expanding its base "exponentially" through this RFP, with hopes for the new 600-strong workforce to be in place by August.

3:13 PM CT on 5/26/20

A reconstruction of a COVID-19 outbreak at St. Augustine’s Hospital in Durban, South Africa, demonstrates how the coronavirus spread throughout the facility, infecting 119 people between March 9 and April 30.

The study hypothesizes there was a single case of COVID-19 introduced in the emergency department, which spread to another patient who was admitted to the cardiac intensive care unit with a possible stroke. From there, the virus spread throughout the hospital, involving at least five different departments.

“This outbreak highlights how easily and rapidly SARS-CoV-2 can spread through a hospital, exposing weaknesses in respiratory virus infection prevention and control,” said the study. “It underlines that personal protective equipment is only one component of a comprehensive approach to IPC and does not replace the need for good IPC systems and practices.”

2:24 PM CT on 5/26/20

(AP) A Detroit-area hospital network has less than 100 COVID-19 patients for the first time in more than two months.

Henry Ford Health System, which has five acute-care hospitals, said it had 96 patients Tuesday morning. The peak was 752 COVID-19 patients on April 7.

Beaumont Health has been under 300 patients since May 20.

Meanwhile, retail shops around Michigan reopened with restrictions on the number of people who can be inside. People also can make an appointment to visit auto dealers.

The Michigan Retailers Association created signs that businesses can print and display. They highlight the importance of masks, hand sanitizer and customers limiting their touching to what they might buy.

Restaurants and bars remain closed to dine-in customers, except in northern Michigan. Casinos, gyms, barber shops and hair salons also are closed.

"We look forward to working with the governor to accelerate the opening process. Every day retailers are closed is another day we'll lose more stores," said Bill Hallan, president of the Michigan Retailers Association.

1:30 PM CT on 5/26/20

Asymptomatic pregnant women admitted to hospitals for labor and delivery may be less likely to be infected with COVID-19 than previously thought, according to a study published as a letter in JAMA.

The study found less than 3% of asymptomatic pregnant women admitted to three Yale New Haven Health hospitals in April tested positive for COVID-19. An earlier study conducted in New York City had found 13.5% of these patients tested positive for the coronavirus.

These findings might mean providers in labor and delivery units could conserve more personal protective equipment, and they could encourage pregnant women to go to hospitals instead of choosing a home birth.

“Our report provides reassuring information on infection rates and appropriate hospital responses outside of highly endemic areas,” said corresponding author Dr. Katherine H. Campbell. “Not only have we provided insight into the nature of a positive test, we’ve highlighted how a comprehensive testing program can reduce the use of personal protective equipment among labor and delivery staff without increasing their risk of exposure.”

12:31 PM CT on 5/26/20

(Crain’s Cleveland Business) University Hospitals is working with technology company TensorMark to make returning to work, restaurants and entertainment safer via the use of artificial intelligence and computer vision/facial recognition technology.

Through the strategic initiative, the technology will allow consenting consumers to leverage their personal COVID-19 test results and create a real-time platform that employers, retailers and sports/concert venues can use to validate those results, according to a news release. Only permission-based consumer information will be included in the databank in compliance with UH guidelines, as well as privacy laws like The Health Insurance Portability and Accountability Act (HIPAA).

"TensorMark's technology can be deployed via a wearable (e.g., VUZIX Blade), smartphone or mounted device at the entrance of a certified location to validate an individual via facial recognition," explained Andrew Jacobson, president of TensorMark, in a prepared statement. "Based on such validation, locations are able to take a number of different actions, from fast-tracking an individual for entrance to automatically unlocking and opening doors."

Both organizations' goal is to help ensure a safer, healthier environment outside of the home and increase confidence in the safety of participating locations.

Employers can test their staff and use the technology as the "stamp of approval" by stating the employer is "TMCertified," according to the release, which also notes that the technology will be "incredibly valuable" for the hospitality industry.

"Working with TensorMark allows us to design an identity solution built around consumers' preferences to safely, securely and efficiently validate a person's recent results," said Robert Eardley, UH chief information officer, in a prepared statement.

11:32 AM CT on 5/26/20

(AP) A U.S. biotechnology company began injecting a coronavirus vaccine candidate into people in Australia on Tuesday with hopes of releasing a proven vaccine this year.

Novavax will inject 131 volunteers in the first phase of the trial testing the safety of the vaccine and looking for signs of its effectiveness, the company's research chief Dr. Gregory Glenn said.

About a dozen experimental vaccines against the coronavirus are in early stages of testing or poised to start, mostly in China, the U.S. and Europe. It's not clear that any will prove safe and effective. But many work in different ways, and are made with different technologies, increasing the odds that at least one approach might succeed.

"We are in parallel making doses, making vaccines in anticipation that we'll be able to show it's working and be able to start deploying it by the end of this year," Glenn told a virtual news conference in Melbourne from Novavax headquarters in Maryland.

Animal testing suggested the vaccine is effective in low doses. Novavax could manufacture at least 100 million doses this year and 1.5 billion in 2021, he said.

Manufacture of the vaccine, named NVX-CoV2373, was being scaled up with $388 million invested by Norway-based Coalition for Epidemic Preparedness Innovations since March, Glenn said.

The results of the first phase of clinical trials in Melbourne and Brisbane are expected to be known in July, Novavax said. Thousands of candidates in several countries would then become involved in a second phase.

10:29 AM CT on 5/26/20

Premier Inc. and 15 health systems are partnering to buy a minority stake in Prestige Ameritech, a domestic manufacturer of personal protective equipment like N95 respirators and surgical masks.

The goal is to alleviate providers’ dependence on foreign supplies of PPE, which have been in shortage during the COVID-19 pandemic.

“Our supply chain team has been scouring the globe to ensure our team members on the front lines have the PPE they need. It’s clear that overreliance on foreign manufacturers has been a driving cause of the issues care providers across the country have faced these past two months,” said Jim Skogsbergh, CEO of Advocate Aurora Health.

9:34 AM CT on 5/26/20

(AP) As Brazil and India struggle with surging coronavirus cases, a top health expert is warning that the world is still in the very middle of the outbreak, dampening hopes for a speedy global economic rebound and renewed international travel.

"Right now, we're not in the second wave. We're right in the middle of the first wave globally," said Dr. Mike Ryan, the World Health Organization's executive director.

"We're still very much in a phase where the disease is actually on the way up," Ryan said, pointing to South America, South Asia and other parts of the world.

India, with a population of over 1.3 billion, saw a record single-day jump in new cases for the seventh straight day. It reported 6,535 new infections Tuesday, raising its total to over 145,000, including close to 4,200 deaths.

The virus has taken hold in some of the country's poorest, most densely populated areas, underscoring the challenges authorities face in trying to contain a virus for which no vaccine or cure has yet to be developed.

In Brazil, where President Jair Bosonaro has raged against state and local leaders enforcing stay-at-home measures, WHO warned that before reopening the economy, authorities must have enough testing in place to control the spread of the virus.

Brazil has 375,000 coronavirus infections — second only to the 1.6 million cases in the U.S. — and has counted over 23,000 deaths, but many fear Brazil's true toll is much higher.

Ryan said Brazil's "intense" transmission rates means it should keep some stay-at-home measures in place, regardless of the damage to the economy.

"You must continue to do everything you can," he said.

But Sao Paulo Gov. João Doria has ruled out a full lockdown in Brazil's largest state economy and plans to start loosening restrictions on June 1.

A U.S. travel ban was set to take effect Tuesday for foreigners coming from Brazil.

7:11 PM CT on 5/25/2020

COVID-19 may be less lethal as time goes on, according to data from two Italian provinces. A pre-print study looking at the Ferrara and Pescara provinces in Italy determined that COVID-19's case fatality rate dropped from 10.8% in March to 6% in April. 

The researchers saw significant drops in fatality rates among the elderly (30% to 8.4%), patients with cardiovascular disease (31.5% to 12.1%), COPD (29.7% to 11.4%) and renal disease (32.3% to 11.5%) in the same period.

The improved rate might mean that treatment for COVID-19 improved over that time period.

5:23 PM CT on 5/25/2020

Acknowleding that "we all failed" at projecting COVID-19 case numbers, New York Gov. Andrew Cuomo Monday said it is too early to tell if the state's staged re-opening is working.

"Now, people can speculate, people can guess, I think next week, I think two weeks, I think a month,” Cuomo said during is daily press briefing. “I’m out of that business, because we all failed at that business. All the early national experts, here’s my projection, here’s my projection model, they were all all wrong, they were all wrong.”

Cuomo reaffirmed that regions of the state will be able to reopen as the hit certain benchmarks that measure hospitalizations, testing and deaths.

3:07 PM CT on 5/25/2020

Novavax Monday announced that it will begin enrolling people in a trial for its experimental COVID-19 vaccine. 

The Maryland-based company will enroll 130 healthy people between the ages of 18 - 59 at two sites in Australia. Results are expected in early July, according to a statement on the company's website.

“Administering our vaccine in the first participants of this clinical trial is a significant achievement, bringing us one step closer toward addressing the fundamental need for a vaccine in the fight against the global COVID‑19 pandemic,” said Stanley Erck, president and CEO of Novavax. “We look forward to sharing the clinical results in July and, if promising, quickly initiating the Phase 2 portion of the trial.”

3:07 PM CT on 5/25/2020

Countries seeing declines in their COVID-19 cases may soon face an "immediate second peak," according to Dr. Mike Ryan, executive director of World Health Organization's health emergencies program.

Ryan said that epidemics often come in waves. And he pointed out that cases are increasing in such areas as Central and South America, South Asia and Africa,

"When we speak about a second wave classically what we often mean is there will be a first wave of the disease by itself, and then it recurs months later. And that may be a reality for many countries in a number of months' time," Ryan said, according to Reuters.

Ryan urged leaders in Europe and North America "continue to put in place the public health and social measures, the surveillance measures, the testing measures and a comprehensive strategy to ensure that we continue on a downwards trajectory and we don't have an immediate second peak," Reuters reported.

1:52 PM CT on 5/25/2020

Four top congressional Democrats Monday panned the Trump administration's COVID-19 testing plan. 

“After six months and nearly 100,000 lives lost, the Trump administration still does not have a serious plan for increasing testing to stop the spread of the virus," House Speaker Nancy Pelosi, Senate Minority Leader Chuck Schumer, Senate Health, Education, Labor, and Pensions committee ranking member Patty Murray and House Energy and Commerce committee chair Frank Pallone said in a joint statement Monday. "“In this document, the Trump administration again attempts to paint a rosy picture about testing while experts continue to warn the country is far short of what we need.  We still need clear explanations for how targets were set, how they will be met and what will be done if they are not."

The Trump administration May 24 released its COVID-19 strategic testing plan, which was mandated by the Paycheck Protection Program and Health Care Enhancement Act.

To a large degree, the plan puts the onous on states to take the lead. "The Federal government is supporting and encouraging States, territories, and tribes to build a multi-layered approach that incorporates and fully leverages all components of the testing ecosystem," the plan notes. "States must assure provisions are in place to meet future surge capacity testing needs including POC or other rapid result testing for local outbreaks."

12:56 PM CT on 5/25/2020

(AP) The World Health Organization said Monday that it will temporarily drop hydroxychloroquine — the anti-malarial drug U.S. President Trump says he is taking — from its global study into experimental COVID-19 treatments, saying that its experts need to review all available evidence to date.

In a press briefing, WHO director-general Tedros Adhanom Ghebreyesus said that in light of a paper published last week in the Lancet that showed people taking hydroxychloroquine were at higher risk of death and heart problems, there would be “a temporary pause” on the hydroxychloroquine arm of its global clinical trial.

“This concern relates to the use of hydroxychloroquine and chloroquine in COVID-19,” Tedros said, adding that the drugs are approved treatments for people with malaria or autoimmune diseases. Other treatments in the trial, including the experimental drug remdesivir and an HIV combination therapy, are still being tested.

Tedros said the executive group behind WHO's global “Solidarity” trial met on Saturday and decided to conduct a comprehensive review of all available data on hydroxychloroquine and that its use in the trial would be suspended for now.

Dr. Michael Ryan, WHO's emergencies chief, said there was no indication of any safety problems with hydroxychloroquine in the WHO trial to date, but that statisticians would now analyze the information.

“We're just acting on an abundance of caution based on the recent results of all the studies to to ensure that we can continue safely with that arm of the trial,” he said. WHO said it expected to have more details within the next two weeks.

Last week, Trump announced he was taking hydroxychloroquine although he has not tested positive for COVID-19. His own administration has warned the drug can have deadly side effects, and both the European Medicines Agency and the U.S. Food and Drug Administration warned health professionals last month that the drug should not be used to treat COVID-19 outside of hospital or research settings due to numerous serious side effects that in some cases can be fatal.

Hydroxychloroquine and chloroquine are approved for treating lupus and rheumatoid arthritis and for preventing and treating malaria, but no large rigorous tests have found them safe or effective for preventing or treating COVID-19.

11:29 AM CT on 5/25/2020

10:19 AM CT on 5/25/2020

(AP) States are spending billions of dollars stocking up on medical supplies such as masks and breathing machines during the coronavirus pandemic. But more than two months into the buying binge, many aren't sharing details about how much they’re spending, what they’re getting for their money or which companies they’re paying.

An Associated Press survey of all 50 states found a hodgepodge of public information about the purchase of masks, gloves, gowns and other hard-to-get equipment for medical and emergency workers.

Illinois has one of the most detailed tracking websites, showing the date, vendor, purpose, quantity and price of each purchase. In most states, it's not that easy. Some provided similar information only after the AP pointed to laws requiring the release of government documents.

The public can see only a piece of the procurement puzzle in many states — maybe an estimate of the total spent on supplies, but not the names of the providers or the price of each item, which could show whether the state got a good deal or was ripped off.

Those details are important because many states set aside purchasing safeguards amid a scramble for supplies among health care providers, states, the U.S. government and other countries. Instead of seeking competitive bids and vetting them for months, states have closed emergency deals in days with businesses claiming to have access to supplies. In some cases, states have prepaid to ensure orders aren't diverted elsewhere.

Some states say technological barriers prevent them from posting more information. Others provided no explanation for why they aren't doing so.

Transparency advocates say they're troubled by the difficulty in getting details about government spending, especially during a crisis that's shaken the economy and sickened about 1.6 million in the U.S.

9:32 AM CT on 5/25/2020

(AP) Many laid-off workers who lost health insurance in the coronavirus shutdown soon face the first deadlines to qualify for fallback coverage under the Affordable Care Act.

Taxpayer-subsidized health insurance is available for a modest cost — sometimes even free — across the country, but industry officials and independent researchers say few people seem to know how to find it. For those who lost their health insurance as layoffs mounted at the end of March, a 60-day “special enrollment” period for individual coverage under the ACA closes next week in most states.

The nonpartisan Kaiser Family Foundation estimates that nearly 27 million workers and family members had lost job-based health coverage as of the start of this month, a number now likely higher with unemployment claims rising.

In a counter-intuitive finding, Kaiser's study also estimated that nearly 8 in 10 of the newly uninsured would likely qualify for some sort of coverage under the ACA.

There are several options, not easy to sort through. Some have application deadlines; others do not. And the Trump administration, which still plans to ask the Supreme Court later this summer to declare “Obamacare” unconstitutional, is doing little to promote the health law's coverage. People who lose workplace insurance generally have 60 days from when their coverage ended to apply for an ACA plan. Most states that run their own health insurance marketplaces have provided an extended sign-up period for people who lost coverage in the pandemic. The federal marketplace, serving most of the country, has not.

In states that expanded Medicaid, low-income adults can qualify for free or very low cost coverage. There is no sign-up deadline. The Kaiser foundation estimates that nearly 13 million people who lost job-based insurance are eligible for Medicaid. But that option is not available in most Southern states, as well as some in the Midwest and Plains, because they have not expanded Medicaid.

Laid-off workers should be able to get their children covered even if the adults in the family cannot help. The federal-state Children's Health Insurance Program and Medicaid cover kids in families with incomes well above the poverty level.

People can continue their employer coverage under COBRA, but they have to pay 102% of the premium — too much for most who are out of work. If there's another coronavirus bill from Congress, it might include subsidies for COBRA coverage.

Government statistics on people losing —and finding— health insurance coverage in the coronavirus contraction won't be available for months.

9:31 PM CT on 5/24/2020

Nursing homes have born the brunt of the COVID-19 pandemic, accounting for approximately 25% of the virus' death toll in the U.S and up to 50% in Europe. In a viewpoint for JAMA, two professors suggested value-based care could help give nursing homes the long-term support to better treat their residents.

David Grabowski, a healthcare policy professor at Harvard Medical School, and Vincent Mor, a health services and policy professor at Brown University, acknowledged that nursing homes need immediate support from federal and state governments to ramp up testing and provide PPE to their staff and residents. But when the crisis subsides, nursing homes will still need additional support, they wrote. That could come from integrated pay models.

Onlly a few nursing homes currently participate in care models, primarily the Medicare Advantage Institutional Special Needs Plans and nursing-home led Accountable Care Organizations.

"Only by addressing the clinical workforce caring for this population can fundamental changes be realized," Grabowski and Mor wrote. "Nursing homes will have to attract healthcare professionals who want long-term relationships with their frail patients."

6:28 PM CT on 5/24/2020

(AP) As Texas continues to reopen during the coronavirus pandemic, health officials said Sunday that there were 839 new cases of the virus reported in the state for a total of 55,348.

The true numbers are likely higher because many people have not been tested, and studies suggest people can be infected and not feel sick.

The Texas Department of State Health Services said Sunday that the number of deaths in Texas increased by 13, for a total of 1,519 deaths.

Gov. Greg Abbott has been reopening the state’s economic activity in phases.

Bars, breweries and tasting rooms were allowed to reopen Friday at 25 percent capacity and with other social distancing measures in place. Rodeos, bingo halls and aquariums also can reopen. Restaurants, which were allowed to reopen May 1 at 25 percent customer capacity, can now run at 50 percent.

The new standards don’t apply yet in El Paso and Amarillo, which have seen a recent increase in coronavirus cases.

3:19 PM CT on 5/24/2020

(AP) White House coronavirus task force coordinator Deborah Birx says she’s “very concerned” that people going outdoors for the Memorial Day weekend aren’t maintaining 6 feet of social distancing.

She was responding to reports showing people crowding at beaches.

Noting that people with no symptoms could unwittingly spread the coronavirus, Birx said people need to wear masks in public if they don’t socially distance because “you don’t know who’s infected.”

As states loosen stay-at-home orders, Birx also declined to say whether the country may need to close down again if the U.S. is hit by a second wave of infections in the fall. President Donald Trump insisted last week “we are not closing” again.

On Sunday, Birx said: “We’re trying to understand during this period of coming out of the closure: How do we maintain openness and safety? And I think that’s what we’re going to be learning through May, June and July.”

She spoke on “Fox News Sunday” and ABC’s “This Week.”

12:39 PM CT on 5/24/2020

A new report suggests that rising tempatures may correlate with lower COVID-19 transmission rates. In a study published in Science of the Total Environment, researchers looked at case data from Feb. 27 to April 1 in Brazil state capitals affected by the virus.

For every 1 degree Celsius change between 16.8 degress Celsius (62 degrees Fahrenheit) and 27.4 degrees Celsius (81 degrees Fahrenheit), researches saw a 4.9% decrease in daily cumulative confirmed cases. There was no significant change above 81 degrees Fahrenheit.

10:12 AM CT on 5/24/2020

(AP) State health officials say civil penalties totaling more than $93,000 have been assessed against nursing care facilities in Pennsylvania amid hundreds of complaint investigations during the coronavirus pandemic.

The Pennsylvania Department of Health said Saturday that nursing home surveyors have conducted more than 1,470 inspections of nursing homes since the beginning of February. There have been more than 900 complaint investigations, and 10 sanctions were finalized, the department said.

“We know that congregate care settings, like nursing homes, have been challenged by the COVID-19 pandemic,” said health secretary, Dr. Rachel Levine. “That is why we remain committed to protecting the health and well-being of our most vulnerable Pennsylvanians by continuing to hold nursing home operators accountable, as necessary, to ensure they are providing safe care. If you see something at a nursing home that doesn’t seem right, we encourage you to speak up.”

Last year, the department conducted 5,381 inspections of 3,637 nursing homes, including 3,285 complaint investigations, the department said. A total of 213 sanctions were finalized against nursing care facilities and civil penalties totaled more than $2.5 million dollars, the department said.

Sanctions can result in civil penalties, admission prohibitions, license revocation or the facility being placed under a provisional license, which can require more inspections than normal, among other things, officials said.

8:10 PM CT on 5/23/20

The paper will list the names of 1,000 Americans who died from COVID-19. As of Saturday night, the Johns Hopkins Coronavirus Resource Center reported 97,000 deaths in the U.S.

6:28 PM CT on 5/23/20

(AP)  A woman who raised questions about Florida’s COVID-19 data after being ousted as the data’s curator had been reprimanded several times for violating Health Department policy, including for posting political commentary about the information, state records show.

Rebekah Jones’ comments over the past week and a half in emails to researchers, interviews with a handful of media outlets, and blog posts have sought to sow doubt about the credibility of the data now that she is no longer in that role.

State health officials strenuously deny any issue with the information’s accuracy as Republican Gov. Ron DeSantis seeks to make a data-driven case for a step-by-step reopening of the state’s battered economy following safer-at-home orders.

Jones has not alleged any tampering with data on deaths, hospital symptom surveillance, hospitalizations for COVID-19, numbers of new confirmed cases, or overall testing rates. She has, however, suggested Health Department managers wanted her to manipulate information to paint a rosier picture and that she pushed back.

5:13 PM CT on 5/23/20

(AP) The Oregon Supreme Court is giving a rural judge until Tuesday to toss out his ruling that found the governor's coronavirus restrictions are invalid.

If the judge declines to do so, justices said Saturday that Baker County Circuit Judge Matthew Shirtcliff must explain why and give the state and churches who sued over the stay-at-home directives an opportunity to make further arguments.

Shirtcliff ruled Monday that Gov. Kate Brown had exceeded her authority by shutting down in-person religious services to slow the spread of the novel coronavirus. The lawsuit was brought by 10 churches around Oregon and later was joined by several local elected officials and business owners.

Shirtcliff’s broad ruling also invalidated many of the other provisions of Brown’s stay-at-home order, including a ban on public gatherings and a ban on non-essential businesses and sit-down service in bars and restaurants.

The Supreme Court quickly stayed Shirtcliff’s order, keeping Brown’s directives in place.

4:04 PM CT on 5/23/20

Lobbying efforts have thus far failed to convince Tenn. Gov. Bill Lee to extend an executive order that loosened restrictions on advanced practice nurses.

The order, which lapsed on May 18, cleared the way for nurse practitioners to write prescriptions without consulting a physician, waived a requirement for chart review and waived a requirement that a supervising physician visit remote sites every 30 days, among other things. 

Nursing groups have pushed the governor to extend the executive order. More permanent changes would require a legislative fix. 

Tennessee was one of 21 states to temporarily suspend scope-of-practice requirements in an effort to expand access to care during the coronavirus pandemic, according to the American Association of Nurse Practitioners. 

And as Modern Healthcare reported last month, the pandemic is sure to spark more debate on making these changes permanent. 

2:27 PM CT on 5/23/20

North Carolina health officials Saturday said the state saw 1,107 positive COVID-19 cases, the state's highest single-day total.

"Please practice the 3 Ws–wear a face covering, wait 6 ft apart & wash hands frequently. We need to work together to protect our families, friends & neighbors," officials said in a tweet. 

The spike in cases comes as the state moves into its so-call phase two of re-opening the economy. 

North Carolina has a total of 22,725 confirmed cases, according to NCDHHS. 

12:49 PM CT on 5/23/20

Dr. Anthony Fauci had a special message for Johns Hopkins University class of 2020: "We need your talent, your energy, your resolve, and your character to get through this difficult time. In the next phase of your lives, whatever professional path you choose, all of you directly or indirectly will be doing your part, together with the rest of us, to come out from under the shadow of this pandemic."

Fauci, head of the National Institute of Allergy and Infectious Diseases, went on to tell the graduates that they'll "be confronted with changes, and it's how you adapt to those changes that may determine your success."

Fauci received an honorary degree from Jonhs Hopkins five years ago.

11:30 AM CT on 5/23/20

A highly-anticipated study on the use of remdesivir to treat COVID-19 patients showed mixed results.

While the experimental drug, developed by Gilead Sciences, shortened the recovery time for patients, researchers found that it had some limitations. 

"These preliminary findings support the use of remdesivir for patients who are hospitalized with COVID-19 and require supplemental oxygen therapy," they wrote in the New England Journal of Medicine. "However, given high mortality despite the use of remdesivir, it is clear that treatment with an antiviral drug alone is not likely to be sufficient. Future strategies should evaluate antiviral agents in combination with other therapeutic approaches or combinations of antiviral agents to continue to improve patient outcomes in COVID-19."

The study, which was funded by the National Institute of Allergy and Infectious Diseases, found that patients getting remdesivir recovered in a median of 11 days; those taking a placebo recovered in 15 days. Mortality was also slighltly better for those taking the drug--7.1% compared to 11.9%.

9:30 AM CT on 5/23/20

(Crain's Cleveland Business) With support from the MetroHealth Foundation, the MetroHealth System is giving 4,000 nonunion frontline staff, including nurses and support workers, a 2.25% raise for the last 12 biweekly pay periods of the year beginning June 28.

The one-time grant will help offer additional financial support to assist the Cleveland safety-net health system in covering the cost of the proposed salary increase for the second half of the year, according to a news release. The funding will not dilute funds the foundation has raised for the system's $100 million Transformation Campaign.

"The MetroHealth employees are the most valuable assets of the institution," said Brian M. O'Neill, chair of The MetroHealth Foundation Board of Directors, in a prepared statement. "They are essential to the high-quality care that MetroHealth provides to the community, regardless of their ability to pay, during this historic health crisis."

The 2.25% wage increase will be awarded to frontline staff, excluding union members, who already received contractual increases in 2020 under their collective bargaining agreements, according to the release. It also excludes executives, researchers and providers.

9:00 PM CT on 5/22/20

(AP) Louisiana is getting the only drug approved to treat COVID-19, Gov. John Bel Edwards said Friday.

A new shipment of remdesivir means the state will have received enough of the drug to treat about 1,200 patients, according to data Edwards presented during a news conference livestreamed from Baton Rouge. He said the first shipment was May 14. The drug is being sent to all hospitals that have at least five patients infected with the novel coronavirus — currently 47 facilities.

Edwards said other hospitals can request the drug if they feel a patient would benefit. The U.S. Food and Drug Administration has approved emergency use of remdesivir for severely ill people.

Edwards said Louisiana is on the way to meeting its goal of testing 200,000 people this month. "We're about 56,000 short with nine days to go," he said.

8:11 PM CT on 5/22/20

(Crain's Detroit Business) Henry Ford Health System in Detroit is taking full advantage of Gov. Gretchen Whitmer's new order that allows resumption of health care services after May 29 by scheduling more than 7,000 surgeries and procedures through June.

The University of Michigan Health System has a backlog of about 12,000 surgeries or procedures, Trinity Health has 10,000 postponed surgeries and Beaumont Health has another 8,500 surgeries that were delayed along with several hundreds cardiac catheterizations and more than 9,500 imaging procedures, officials said.

In late March, as the numbers of COVID-19 deaths and positive cases were doubling each day, Whitmer issued an executive order that restricted many nonessential surgeries and elective procedures, including routine physician, dental and mental health visits, to prevent the coronavirus spread.

7:34 PM CT on 5/22/20

(AP) Nebraska public health officials are watching for signs of strain on Omaha's hospitals because they've received a steady increase in coronavirus patients, but the state's top medical official said Friday that he isn't worried yet about the caseload as Gov. Pete Ricketts moves to further ease safety restrictions.

Nebraska Chief Medical Officer Dr. Gary Anthone said that based on his conversations with Omaha-area hospital officials, he doesn't believe the hospitals are at risk of being overrun with COVID-19 patients."So far, nobody feels really overwhelmed. ... I can't predict the future, but I'm not worried about it right now," he said at a news conference with Ricketts.

His comments came after a University of Nebraska Medical Center infectious diseases expert said she's concerned about the number of hospitalizations in the Omaha area, even though hospitals statewide still have plenty of capacity.

6:28 PM CT on 5/22/20

(AP) California Gov. Gavin Newsom said Friday that the state is building a "field medical station" with up to 125 beds to aid a farming region along the Mexican border that has witnessed a surge in coronavirus cases.

As many parts of the state eased restrictions, Newsom said Imperial County, with a population of 175,000 people in the state's southeastern corner, "continues to be of concern."

It is unclear what caused the surge in coronavirus patients. But Adolphe Edward, chief executive officer of El Centro Regional Medical Center, is among those who believe that U.S. citizens who live in Mexicali, Mexico, play a major part. Edward told the El Centro City Council Friday that the temporary facility at the Imperial Valley College gymnasium was expected to open Monday to receive transfers from local hospitals, with state and federal support.

5:55 PM CT on 5/22/20
(GenomeWeb) More than 70 Nobel laureates have called on Francis Collins, the director of the US National Institutes of Health, and Alex Azar, HHS secretary, to review a recent decision to stop funding a coronavirus grant, ScienceInsider reports. It notes that 31 scientific societies have likewise sent a letter to Collins urging him to reconsider that decision.

Last month, NIH informed EcoHealth Alliance it was ending its grant for a project the alliance sponsored that was studying how coronaviruses may spread from bats to people. The grant had come to the attention of President Donald Trump, as EcoHealth Alliance researchers have worked closely with scientists at the Wuhan Institute of Virology. At a press conference, President Trump had said the grant would be shut down.

"We believe that this action sets a dangerous precedent by interfering in the conduct of science and jeopardizes public trust in the process of awarding federal funds for research," the Nobel laureates write in their letter, which was posted to Twitter by Steven Salzberg. "Now is precisely the time when we need to support this kind of research if we aim to control the pandemic and prevent subsequent ones."

4:15 PM CT on 5/22/20

The Indian Health Service and tribal providers will receive $500 million in relief payments from HHS, the agency said Friday.

“This funding provides vital support to these healthcare facilities, which in some cases may be the only healthcare facility within a day’s traveling distance for those served,” HHS said in a statement.

According to the agency, more than 230 facilities in the Indian health system are the only provider for both IHS and non-IHS beneficiaries in their area. They have been disproportionately affected by the COVID-19 pandemic and related increases in labor costs and the demand for personal protective equipment.

The extra money comes from the Provider Relief Fund paid for by Congress under the CARES Act and the Paycheck Protection Program and Health Care Enhancement Act.

3:05 PM CT on 5/22/20

Essentia Health will lay off 900 workers to offset nearly $100 million in pandemic-related losses since the beginning of March.

The Duluth, Minn.-based health system said the layoffs will affect 6% of its workforce. Essentia has also placed 850 employees on administrative leave until July 31 with the intention of bringing them back to work as needed.

“Despite our best efforts, the many cost-reduction measures we’ve taken over the last several weeks are not sufficient to preserve our mission and the health of the organization,” said Essentia Health CEO Dr. David C. Herman. “This has prompted our leadership team to carefully consider the most difficult decision we’ve faced since I joined Essentia five years ago and move forward with permanent layoffs.”

2:01 PM CT on 5/22/20

The virus that causes COVID-19 uses a receptor known as ACE2 to enter the body. Children have lower levels of ACE2 gene expression than adults, which may explain why they’re less likely to become infected or die from the coronavirus, according to a study published in JAMA.

“ACE2 is known to be present in our airway, kidneys, heart and gut. In our study, we took this knowledge a step further, finding that there are low levels of ACE2 expression in the nasal passages of younger children, and this ACE2 level increases with age into adulthood,” said lead author Dr. Supinda Bunyavanich. “This might explain why children have been largely spared in the pandemic.”

1:04 PM CT on 5/22/20

(AP) More than 4,300 recovering coronavirus patients were sent to New York's already vulnerable nursing homes under a controversial state directive that was ultimately scrapped amid criticisms it was accelerating the nation's deadliest outbreaks, according to a count by The Associated Press.

AP compiled its own tally to find out how many COVID-19 patients were discharged from hospitals to nursing homes under the March 25 directive after New York's Health Department declined to release its internal survey conducted two weeks ago. It says it is still verifying data that was incomplete.

Whatever the full number, nursing home administrators, residents' advocates and relatives say it has added up to a big and indefensible problem for facilities that even Gov. Andrew Cuomo — the main proponent of the policy — called "the optimum feeding ground for this virus."

"It was the single dumbest decision anyone could make if they wanted to kill people," Daniel Arbeeny said of the directive, which prompted him to pull his 88-year-old father out of a Brooklyn nursing home where more than 50 people have died. His father later died of COVID-19 at home.

"This isn't rocket science," Arbeeny said. "We knew the most vulnerable -- the elderly and compromised -- are in nursing homes and rehab centers."

Told of the AP's tally, the Health Department said late Thursday it "can't comment on data we haven't had a chance to review, particularly while we're still validating our own comprehensive survey of nursing homes admission and readmission data in the middle of responding to this global pandemic."

Cuomo, a Democrat, on May 10 reversed the directive, which had been intended to help free up hospital beds for the sickest patients as cases surged. But he continued to defend it this week, saying he didn't believe it contributed to the more than 5,800 nursing and adult care facility deaths in New York — more than in any other state — and that homes should have spoken up if it was a problem.

"Any nursing home could just say, 'I can't handle a COVID person in my facility,'" he said, although the March 25 order didn't specify how homes could refuse, saying that "no resident shall be denied re-admission or admission to the (nursing home) solely based" on confirmed or suspected COVID-19.

Over a month later, on April 29, the Health Department clarified that homes should not take any new residents if they were unable to meet their needs, including a checklist of standards for coronavirus care and prevention.

12:19 PM CT on 5/22/20

In an opinion piece for the Washington Post, HHS Secretary Alex Azar argued the economic damage brought by COVID-19 lockdowns has damaged Americans’ health, and the country needs to reopen.

Increased unemployment correlates to opioid abuse and risk of suicide, Azar wrote. The healthcare sector has also taken serious financial hits due to the delay of lucrative elective procedures, while many American delay necessary care for fear of going to providers where COVID-19 may spread.

“We cannot allow the virus to impose intolerable costs in terms of drug, suicide and alcohol deaths; forgone healthcare; and more lost jobs,” Azar wrote. “Under the president’s leadership, we can safely reopen our country, protecting every American’s overall health and well-being today and in the years ahead.”

10:42 AM CT on 5/22/20

(AP) British researchers testing an experimental vaccine against the new coronavirus are moving into advanced studies and aim to immunize more than 10,000 people to determine if the shot works.

Last month, scientists at Oxford University began vaccinating more than 1,000 volunteers in a preliminary study designed to test the shot's safety. Those results aren't in yet but on Friday, the scientists announced they're expanding to 10,260 people across Britain, including older people and children.

If all goes smoothly, "it's possible as early as the autumn or toward the end of the year, you could have results that allowed use of the vaccine on a wider scale," predicted Andrew Pollard, head of the Oxford Vaccine Group.

But Pollard acknowledged there were still many challenges ahead, including how long it will take to prove the vaccine works — particularly since transmission has dropped significantly in Britain — and any potential manufacturing complications.

The Oxford shot is one of about a dozen experimental vaccines in early stages of human testing or poised to start, mostly in China, the U.S. and Europe. Scientists have never created vaccines from scratch this fast and it's far from clear that any of the candidates will ultimately prove safe and effective.

9:36 AM CT on 5/22/20

(AP) New York City is offering free coronavirus testing at nursing homes amid growing scrutiny of outbreaks that have killed more of their residents in New York than in any other state.

It's the latest in a series of steps that city and state officials have taken in recent weeks to institute widespread testing in nursing homes after some administrators said they couldn't get access to tests as the virus swept through. Earlier this month, the state ordered twice-weekly testing for all care home staffers — a requirement that administrators said could be overwhelming — and the White House last week recommended a round of testing for all nursing home residents and staffers.

Now, “we will make sure that all nursing homes have the testing capacity they need in New York City,” Mayor Bill de Blasio said at a news briefing Wednesday.

Starting next week, the city will provide test kits and pay to process them for any of the 169 nursing homes citywide if they request the help, said de Blasio, a Democrat.

Meanwhile, the city will supply more nurses, aides and other staffers to fill in for quarantined nursing home workers — the goal is 600 temporary staffers, up from 240 so far — and make 10 epidemiologist-led “outbreak response teams” available to help nursing homes and other adult care facilities get on top of any burgeoning flare-ups of the COVID-19 virus.

Nursing home industry groups and a residents' advocate commended the city's testing initiative, though it didn't resolve all their concerns about staffing and the costs of testing.

“Immediate steps need to be taken to help residents, triage those who are suffering and stop nursing homes with inadequate staffing from taking in more residents,” said Richard Mollot, the executive director of the Long Term Care Community Coalition, a residents' advocacy group.

9:12 PM CT on 5/21/2020

(AP) President Donald Trump said Thursday "we're not closing our country" if the U.S. goes through a second wave of the coronavirus. It comes as more than 94,000 people in the U.S. have died from COVID-19, but nearly 39 million Americans have lost their jobs in the effort to stop the virus.

The president, touring a Ford plant in Michigan, indicated that decisions made early on to promote social distancing have worked to keep the death toll from being much higher than it is now.

"We've called it right, and now I want it open," Trump said.

But he said he thinks governors, some of whom have imposed tougher restrictions than others, need to now relax those measures.

Experts, including White House coronavirus task force member Dr. Anthony Fauci, have warned about the potential for a second wave of the disease if restrictions are pulled back too quickly. Additionally, there is concern the wave could happen at the same time the seasonal flu ramps up in the fall and winter. 

8:18 PM CT on 5/21/2020

(AP) Data on coronavirus infections that was a key driver in Georgia Gov. Brian Kemp’s aggressive push to reopen the state was flawed and may have distorted perceptions of progress against the virus.

Georgia Department of Public Health spokeswoman Nancy Nydam said in an emailed statement Thursday that the department included antibody tests when calculating the total number of tests conducted “since early April,” using the same methodology as the Centers for Disease Control and Prevention. She said about 57,000 of the 407,000 total tests reported to the state have been antibody tests.

The inclusion of antibody tests in state testing data was first reported by the Columbus Ledger-Enquirer.
Antibody tests look for the presence of a protein that the body makes in reaction to the virus, while other, more common tests, called viral tests, look for the virus itself.

Conflating the two tests can create confusion about the current impact of the virus, said Dr. Richard Rothenberg, an infectious disease expert at Georgia State University. That’s because antibody tests tell you whether a person had the coronavirus in the past, not whether the person was infected at the time of the test.

Combining them can create “a false impression of what is happening now,” he said. He also noted that antibody tests made up about 15% of the total tests reported to the state — a figure that he said would make a “substantial impact” on the perception of the outbreak.

7:32 PM CT on 5/21/20

(KY3) A limousine company in Springfield Miss. is manufacturing what they're calling a medical grade first-call vehicle, according to local news reports.

The vans is lined with stainless steel rather than carpet, allowing it to be cleaned and disinfected much faster. The vans are also equipped with ventilators that have U-V lights to further kill any germs that could potentially get medical examiners sick.

The company said it has sold several of the vans across the country.

6:23 PM CT on 5/21/20

Research published in Health Affairs Thursday shows that evidence is mounting that racial and ethnic minorities and socioeconomically disadvantaged groups are bearing a disproportionate burden of illness and death during the pandemic.

The study looked at COVID-19 patients at Sutter Health, a large integrated health care system in northern California, to measure potential disparities.

Sutter’s integrated electronic health record identified adults with suspected and confirmed COVID-19, and assessed risk of hospitalization, adjusting for known risk factors, such as race/ethnicity, sex, age, health, and socioeconomic variables. In 1,052 confirmed cases of COVID-19 from January 1–April 8, 2020, researchers found that compared with non-Hispanic white patients, African Americans had 2.7 times the odds of hospitalization, after adjusting for age, sex, comorbidities, and income.

5:33 PM CT on 5/21/20

(AP) Pandemic politics shadowed President Donald Trump’s trip to Michigan to highlight lifesaving medical devices, with the president and officials from the electoral battleground state clashing over federal aid, mail-in ballots and face masks.

The president did not wear a face covering Thursday despite a warning from the state’s top law enforcement officer that a refusal to do so might lead to a ban on Trump's return.

Trump visited Ypsilanti, outside Detroit, to tour a Ford Motor Co. factory that had been repurposed to manufacture ventilators, the medical breathing machines governors begged for during the height of the COVID-19 pandemic.

The visit came as the number of Americans applying for unemployment benefits in the two months since the coronavirus took hold in the U.S. hit nearly 39 million even as states gradually let people go back to work after nationwide business shutdowns triggered by the outbreak. The Labor Department says more than 2.4 million people filed for jobless aid last week alone.

The continuing trend of heavy job cuts reflects an economy that is sinking into the worst recession since the Great Depression. The National Association of Realtors reports that sales of existing homes plunged 17.8% in April, the largest one-month decline since a 22.5% fall in July 2010.

4:29 PM CT on 5/21/20

(Crain’s New York Business) SUNY Downstate Health Sciences University in Brooklyn, N.Y., has established a dedicated outpatient clinic that is providing ongoing care for discharged COVID-19 patients.

The clinic opened May 7 at University Hospital of Brooklyn. Follow-up care is especially important given that nearly 90% of COVID-19 patients treated at SUNY Downstate have had at least two comorbidities, and 30% have had three. The vast majority of patients have been people of color, and many don't have an established relationship with a primary care physician, said Dr. Mafuzur Rahman, vice chair of medicine at SUNY Downstate.

"These patients are dischargeable because they don't have to be in the hospital, but they're in no condition to resume normal life," Rahman said.

There is constantly changing information about how COVID-19 affects different parts of the body beyond the lungs, Rahman said. That has included gastrointestinal symptoms, headaches, strokelike symptoms, heart attacks, nerve damage and multisystem inflammatory syndrome in children.

The clinic plans to follow up with patients on symptoms that may develop once they've left the hospital, Rahman said. And because COVID-19 has no standard of care, the clinic will monitor patients for any serious side effects from medications used to treat the disease while they were in the hospital.

3:20 PM CT on 5/21/20

(AP) Strong concern about a second wave of coronavirus infections is reinforcing widespread opposition among Americans to reopening public places, a new poll finds, even as many state leaders step up efforts to return to life before the pandemic.

Yet support for public health restrictions imposed to control the virus's spread is no longer overwhelming. It has been eroded over the past month by a widening partisan divide, with Democrats more cautious and Republicans less anxious as President Donald Trump urges states to "open up our country," according to the new survey from The Associated Press-NORC Center for Public Affairs Research.

The poll finds that 83% of Americans are at least somewhat concerned that lifting restrictions in their area will lead to additional infections, with 54% saying they are very or extremely concerned that such steps will result in a spike of COVID-19 cases.

"Oh, I'd like to get my hair and nails done. It's one of those little pleasures you take for granted," said Kathy Bishop, a 59-year-old billing specialist who had pneumonia two years ago. "But I'm just going to suck it up. It's not worth the risk."

Bishop lives in the western suburbs of Columbus, Ohio, a state where Republican Gov. Mike DeWine is among the state chief executives leading a gradual reopening of businesses such as salons, barbershops, restaurants and bars. But even after nine weeks spent at home, Bishop is among the solid majority of Americans who support rigorous criteria for economic reopening that goes beyond wearing masks in public places and continued social distancing.

About 8 in 10 Americans say that it's essential to reopening for people to return to self-quarantine if they are exposed to the virus. Roughly 6 in 10 also say having widespread testing for the coronavirus in their area is essential to reestablishing public activities, along with requiring people to keep 6 feet (1.8 meters) apart in most places and to wear face masks when they're near others outside their homes.

Nearly as telling as the public's appetite for rigorous precaution: Close to half say it is essential that a vaccine be available before public life resumes. A third say that's important but not essential.

Taken together, the findings suggest that while some Americans are anxious to get back to business as usual, most don't see the country returning anytime soon to what once was considered normal. Instead, Americans largely envision a protracted period of physical distancing, covered faces and intermittent quarantines ahead, perhaps until a vaccine is available.

1:49 PM CT on 5/21/20

(AP) Washington has trained more than 2,100 people to work as contact tracers during the coronavirus outbreak, people who will call every person who tests positive for COVID-19 to find out who they have had close contact with.

They then call the contacts to urge them to get tested and quarantine for 14 days, seeking to stop the spread of the virus.

About 630 employees of local and state health departments are working on the assignment, The Seattle Times reported. The state has also trained 723 members of the National Guard and 769 employees of the state Department of Licensing to help out.

"Case investigations and contact tracing are key pieces of the effort to keep Washington residents safe," state Health Secretary John Wiesman said. "Both have been critical tools to suppress the virus in other parts of the world."

Of the more than 2,100 trained contact tracers, about 700 are currently active, the Health Department said. Local officials are spread around the state, while about 50 National Guard personnel are making calls at well-spaced work stations from that Health Department office building.

The goal, which the state has not yet reached, is to contact each person who tests positive within 24 hours, and call each of their close contacts within 48 hours. Tracers will not tell the contacts who the infected person is or who gave the tracer their phone number. Officials stress the entire process is voluntary.

"We do try to influence people in positive ways to participate in public health interventions, but if they don't want to talk to us, that's their prerogative," Maria Courogen, the state's branch director for disease contamination said.

12:48 PM CT on 5/21/20

Six Los Angeles County health systems have launched a campaign urging patients to go to providers if they need care during the COVID-19 pandemic.

Cedars-Sinai Health System,  Dignity Health, Providence, UCLA Health, Keck Medicine of USC and Kaiser Permanente say there could be a "silent sub-epidemic" of health issues arising from people avoiding providers, like delaying calling 911 for heart attack or stroke symptoms, or falling behind on a child’s vaccination schedule.

"There is concern that patients with serious conditions are putting off critical treatments," says Tom Jackiewicz, CEO of Keck Medicine of USC. “We know that seeking immediate care for heart attacks and strokes can be life-saving and may minimize long-term effects. Our hospitals and healthcare providers are ready and open to serve your needs."

11:45 AM CT on 5/21/20

(Crain’s Detroit Business) Lower health claim payouts because of the COVID-19 pandemic have led Blue Cross Blue Shield of Michigan, Blue Care Network and Health Alliance Plan of Michigan to cut premium rates and further extend no-cost benefit coverage to members.

Blue Cross and Blue Care Network will return more than $100 million to many fully insured customers this year, the company announced Wednesday. The refunds are in addition to $494 million that Blue Cross already has spent to expand the availability of no-cost benefits for members and to support health providers in response to COVID-19.

"For 81 years, Blue Cross has stood behind our members' care in good times and bad," said Dan Loepp, Blue Cross president and CEO, in a statement. "We've been proactive in addressing the pandemic, providing no-cost benefits for members and advancing millions of dollars to care providers. Now we can return money to our customers and members."

Blue Cross Blue Shield of Michigan provides health benefits to more than 4.7 million members residing in Michigan, accounting for about 70 percent of the insured market.

Loepp said the coronavirus outbreak has created uncertainty in healthcare spending. "At this point in the pandemic, we're confident in premiums exceeding claims for the year—so we are starting to give money back to our customers," he said.

10:49 AM CT on 5/21/20

(AP) The Los Angeles County Board of Supervisors will be asked to create the position of inspector general for oversight of skilled nursing facilities, which account for more than half the county's coronavirus death toll.

Under the proposal, the inspector general would develop recommendations on strengthening oversight and improving long-term operations.

As of Wednesday, 1,033 people in so-called institutional settings have died of COVID-19 and the vast majority were residents of skilled nursing facilities, according to county Public Health Director Barbara Ferrer. That toll is 52% of the 1,970 countywide COVID-19 deaths.

In addition, the total number of infections among residents is nearing 6,800. Thousands of staff members have also been infected.

The inspector general motion by Supervisors Mark Ridley-Thomas and Kathryn Barger will be up for a vote at the May 26 board meeting.

"While some skilled nursing homes may be doing their best to respond to COVID-19, we've seen hundreds of deaths at these facilities, tragically exposing the urgent need for stronger oversight across the industry," Ridley-Thomas said in a statement.

Barger said the ability to assess and oversee the facilities must be greatly improved.

9:39 AM CT on 5/21/20

(AP) Gov. Gretchen Whitmer on Thursday relaxed coronavirus restrictions to lift a ban on nonessential medical and dental procedures, reopen retail shops and let residents gather in groups of 10 or less.

The small social gatherings can start immediately. Retail stores and auto dealerships can reopen by appointment only starting Tuesday. Medical, dental and veterinary offices can resume nonessential procedures beginning May 29.

The governor said her stay-at-home order likely will be extended beyond May 28.

"This is another positive step forward with reengagement," Whitmer said.

9:40 PM CT on 5/20/20
(AP) President Donald Trump said Wednesday that he will soon stop taking anti-malaria drug hydroxychloroquine, after stirring controversy for turning to the unproven treatment to protect himself against the new coronavirus.

"I think the regimen finishes in a day or two," he told reporters. He said on Monday that he has been taking "a pill every day" for about a week and a half.

The revelation was surprising as U.S. regulators warned in late April that the drug's side effects include "serious and potentially life-threatening heart rhythm problems."

With the U.S. Food and Drug Administration cautioning against the use of hydroxychloroquine for COVID-19, the disease caused by the virus, outside of a hospital setting or a clinical trial, concerns have grown that the president's action could encourage misuse of the drug among the public.

7:59 PM CT on 5/20/20
Fewer than 1% of hospitalized patients who tested positive for COVID-19 also suffered a stroke, a rate much lower than the 2% to 5% reported in China and Italy, said a news release on a study led by the NYU Grossman School of Medicine.

But the people who had a stroke and the virus were younger, had worse symptoms and were seven times more likely to die, according to the release.

“Our study suggests that stroke is an uncommon yet important complication of coronavirus given that these strokes are more severe when compared with strokes occurring in patients who tested negative for the virus,” says study lead author Dr. Shadi Yaghi, an assistant professor in the Department of Neurology at NYU Langone Health, in the release.

6:59 PM CT on 5/20/20
(AP) Before COVID-19 killed thousands of nursing home residents, about 4 in 10 homes inspected were cited for infection control problems, according to a government watchdog report Wednesday that finds a "persistent" pattern of lapses.

In light of the pandemic, seemingly minor cutting of corners such as an employee caring for residents while battling a cold has taken on new significance. "Warning signs were ignored and nursing homes were unprepared to face a pandemic," said Sen. Ron Wyden of Oregon, the top Democrat on a committee that oversees Medicare and Medicaid. "There need to be big changes in the way nursing homes care for seniors."

The report from the Government Accountability Office  found that state inspectors who help enforce federal nursing home standards classified the overwhelming majority of violations as not severe, generally meaning there was no actual harm to residents. The federal Centers for Medicare and Medicare Services carried out enforcement actions for 1% of violations classified as not severe from 2013-2017, the report said.

5:55 PM CT on 5/20/20

A model designed to predict future COVID-19 infections based on social distancing indicates that areas that relaxed social distancing measures early, mainly in the south, are at high risk of a resurgence of infections.

The model, produced by PolicyLab at Children's Hospital of Philadelphia, said the risk of a resurgence is high in areas such as Texas and southeast Florida, according to a CHOP news release.

"I'm encouraged to see that our models have been accurate—that as we predicted, many communities, including large cities, may be ready to reopen if they take a cautious and slow approach," said Dr. David Rubin, director of PolicyLab at CHOP and a professor of Pediatrics at the University of Pennsylvania's Perelman School of Medicine, in the release. "Unfortunately, we are already seeing some areas move too quickly and without enough vigilance."

4:15 PM CT on 5/20/20

Rural health clinics will receive $225 million for COVID-19 testing from the federal government, HHS said in a statement Wednesday.

Clinics can use the funding for implementation planning, supplies for testing and staff training, and data reporting related to COVID-19 testing. They can also use the money to build temporary structures, lease properties or retrofit facilities “to support COVID-19 response,” said Tom Engels, head of HHS’ Health Resources and Services Administration.

HHS will spend another $500,000 on technical help to support the testing efforts of rural health clinics.

In April’s Paycheck Protection Program and Health Care Enhancement Act, Congress directed the Trump administration to send the money to rural health clinics.

2:53 PM CT on 5/20/20

Leadership of national Democratic campaign arms issued a memo Tuesday stating their intent to make healthcare a top issue in the 2020 presidential, congressional and gubernatorial races.

Democrats are focusing on the Trump administration and Republican-led states’ attempts to repeal the Affordable Care Act in its entirety, the memo states. Democrats argue the COVID-19 pandemic highlights the pain that repealing Medicaid expansions would cause as enrollment spikes across the country.

“For more than a decade, Republicans have been the architects of countless votes to repeal, lawsuits, electoral blockades, and executive intransigence that continue to threaten access to affordable health care for millions while the nation battles a deadly virus,” the campaign leaders said.

The Supreme Court has said it will take up the case that could overturn the Affordable Care Act in its fall 2020 term. It remains unclear when arguments for the case could take place.

1:44 PM CT on 5/20/20

(AP) A new Virginia-based company has won a massive federal contract aimed at beefing up the U.S. supply chain while manufacturing medicines needed to respond to the coronavirus pandemic.

HHS announced Tuesday that it was awarding a contract worth up to $812 million to Richmond-based Phlow Corp., to manufacture pharmaceutical ingredients, chemical compounds and generic drugs needed to soften or prevent drug shortages in the U.S.

Phlow is partnering with Civica Rx, Virginia Commonwealth University’s Medicines for All Institute, and AMPAC Fine Chemicals. Phlow was officially founded in January but Dr. Eric Edwards, a co-founder of Phlow and its CEO, said members of the various groups have been discussing ways of improving the U.S. supply chain for more than a year.

“It’s amazing how many individuals don't realize how vulnerable our active ingredient supply chain has been," Edwards said.

Edwards said the company plans to create about 350 new jobs and will build “multiple” facilities next to an existing AMPAC-owned pharmaceutical plant in Petersburg, just south of Richmond.

12:46 PM CT on 5/20/20

Centene Corp. will waive cost sharing for in-network primary care, behavioral health and telehealth visits for Medicare Advantage members for the rest of 2020.

The company had previously waived pre-authorizations, co-pays and other costs related to COVID-19 testing and necessary treatment through the end of the year.

"As many states begin to lift shelter-in-place orders and reopen the healthcare system, we want to help our members stay safe while removing any unneeded financial burdens to accessing care," said Michael Polen, senior vice president and CEO for medicare solutions at WellCare Health Plans.

12:07 PM CT on 5/20/20

A new app rolling out at UPMC uses artificial intelligence to draw out information from conversations during telemedicine visits to provide patients with more detailed after-visit summaries.

The app's meant to improve patient experience and health literacy, said Tami Minnier, UPMC's chief quality officer, in a statement. The Pittsburgh system, like many healthcare providers, is shifting toward using more virtual care in the wake of the COVID-19 outbreak. UPMC conducted up to 9,500 telemedicine visits per day in April, up from roughly 250 in March.

The app, developed by a startup called Abridge, records phone calls and video visits between physicians and patients and uses natural language processing to identify and transcribe "medically relevant sections," such as diagnoses and next steps, according to UPMC. Both physicians and patients have to provide consent before using the app.

For now, patients can access their after-visit summary through the Abridge app. In the future, UPMC plans to add some of the summaries into patients' medical records.

UPMC is an investor in Abridge, which is also based in Pittsburgh. Abridge was created through the Pittsburgh Health Data Alliance, a collaboration between UPMC, Carnegie Mellon University and the University of Pittsburgh, and co-founded by a UPMC cardiologist.

10:41 AM CT on 5/20/20

Testing all U.S. nursing home residents and staffers one time would cost $440 million, according to an analysis by the American Health Care Association and the National Center for Assisted Living.

“For months now, we have been advocating for expanded and priority testing in nursing homes to protect our residents and caregivers, but this is a significant undertaking and cost for nursing homes to shoulder on their own,” said Mark Parkinson, president and CEO of AHCA and NCAL. “That’s why we have asked HHS to grant our request for a $10 billion emergency relief to help fund expedited testing and the additional staffing needed to respond to this unprecedented health crisis.”

9:38 AM CT on 5/20/20

(AP) New Mexico health insurance regulators say statewide enrollment in Medicaid is on the rise as businesses shed workers in response to the coronavirus pandemic.

Medicaid enrollment increased by roughly 8,650 people in April over the previous month, the Office of the Superintendent of Insurance said on Tuesday.

Colin Baillio, a project manager at the agency, said the state can expect to see more people shifting from employer-based health insurance to the federally subsidized plan for residents living in poverty or on the cusp, as unemployment swells.

The state's Workforce Solutions Department was providing unemployment benefits to roughly 117,000 New Mexico residents as of last week, up from about 10,000 early this year. That could signal an eventual exodus from employer-based health plans.

The nonprofit Urban Institute research organization estimated this month that between 102,000 and 197,000 people may lose their job-based insurance, depending on levels of unemployment. More than half are expected to enroll in Medicaid and a smaller share is expected to turn to New Mexico's insurance exchange that provides subsidies to households with low and moderate incomes.

The number of residents without insurance could increase by 25,000 or more, the institute said.

About 40% of New Mexico residents already rely on Medicaid for healthcare.

8:55 PM CT on 5/19/20

(AP) COVID-19 patients will be allowed visitors in some New York hospitals and small Memorial Day ceremonies will be allowed, Gov. Andrew Cuomo said.

Sixteen hospitals in New York state will allow visitors as part of a pilot program addressing the heartbreak of COVID-19 patients suffering while isolated from their families and friends.

Cuomo said visits under the two-week pilot program will be time-limited. Visitors will need to wear protective equipment and will be subject to temperature and symptom checks.

Strict visitation rules were adopted to check the spread of the virus, but they have resulted in painful scenes of patients relying on phones or tablets for emotional conversations with loved ones.

“It is terrible to have someone in the hospital and then that person is isolated, not being able to see their family and friends,” Cuomo said.

Nine of the hospitals participating are in New York City, with the rest spread out around the state.

Cuomo made the announcement as COVID-19-related hospitalizations and deaths continue to decline. There are an average of 335 new hospitals admissions a day.

7:45 PM CT on 5/19/20

(AP) Republican political operatives are recruiting “pro-Trump” doctors to go on television to prescribe reviving the U.S. economy as quickly as possible, without waiting to meet safety benchmarks proposed by the federal Centers for Disease Control and Prevention to slow the spread of the new coronavirus.

The plan was discussed in a May 11 conference call with a senior staffer for the Trump reelection campaign organized by CNP Action, an affiliate of the GOP-aligned Council for National Policy. A leaked recording of the hour-long call was provided to The Associated Press by the Center for Media and Democracy, a progressive watchdog group.

CNP Action is part of the Save Our Country Coalition, an alliance of conservative think tanks and political committees formed in late April to end state lockdowns implemented in response to the pandemic. Other members of the coalition include the FreedomWorks Foundation, the American Legislative Exchange Council and Tea Party Patriots.

Tim Murtaugh, the Trump campaign communications director, confirmed to AP that an effort to recruit doctors to publicly support the president is underway, but declined to say when the initiative would be rolled out.

5:57 PM CT on 5/19/20

(AP) The chief architect of Florida’s coronavirus website was fired after an apparent disagreement over what information should be made public, raising questions about the integrity of Florida’s public health data.

Florida Gov. Ron DeSantis has said his decision to begin reopening his state has been driven by science, and federal epidemiologists have praised his administration’s daily release of COVID-19 related data. 

But Rebekah Jones, an information systems manager with the Florida Department of Health, announced in an email to researchers Friday that she was no longer in charge of the dashboard that provides daily snapshots of Florida’s COVID-19 infections, testing and deaths. She said she would not expect “the same level of accessibility and transparency” in the data presented there, adding that her “commitment to both is largely (arguably entirely) the reason I am no longer managing it.”

Jones was more pointed in an email to an Orlando television station, CBS12 News, when she said she was removed from her role because she would not “manually change data to drum up support for the plan to reopen.” It was unclear what data she was asked to change.

Jones could not be reached for comment.

4:21 PM CT on 5/19/20

(AP) New Hampshire is closing in on its goal to test all nursing home residents and staff for the coronavirus.

Department of Health and Human Services Commissioner Lori Shibinette said May 6 that all nursing home residents would be tested within two weeks. A department spokesman said that process will be completed early next week, which would be a few days behind schedule.

The testing of all staff is expected to be completed by the end of next week, or early in the following week.

The state also plans to set up a sentinel surveillance system in which 10% of the facilities will test 10% of their residents each week, and mobile teams to test all long-term care staff every seven to 10 days.

As of Monday, 3,652 people in New Hampshire had tested positive for the virus, an increase of 57 from the previous day. The number of deaths stood at 172.

For most people, the virus causes mild or moderate symptoms, such as fever and cough, that clear up in two to three weeks. For some, especially older adults and the infirm, it can cause more severe illness, including pneumonia, or death. Nursing home residents have made up more than three-quarters of the virus-related deaths in New Hampshire.

3:00 PM CT 5/19/20

(Crain’s New York Business) Some providers are using remote monitoring technology to monitor COVID-19 patients recovering at home.

Prime Home Health Services, a home care agency based in Brooklyn, N.Y.,  is working with MonitorMe to equip about 30 patients' homes. MonitorMe's system uses a wireless patch that is attached to the left side of a patient's chest and relays heart rate and electrical activity, breathing rate and oxygen levels.

The patient data is overseen by MonitorMe's Monitoring Intervention Center around the clock, and its team of physicians and nurses can coordinate with Prime to get patients medical attention if necessary. Patients can also communicate with MonitorMe's clinicians through a mobile app.

Chris Doulos, Prime's chief financial officer, said the agency had been in discussions with MonitorMe to use the technology for chronically ill patients last year and reached back out in March when it saw the potential to use it during the COVID-19 crisis.

"What spurred this in the beginning is, how do we make patients comfortable at home?" Doulos said. "The hospitals needed to clear these patients, and the nursing homes, as we know now, are not the place to send these patients."

Geiginer is also using a mobile app to allow patients to check in with providers as they recover. They can report their symptoms, temperature and oxygen levels twice a day to a team of nurses. If they get worse, an automated alert is sent to the team who can coordinate a telehealth visit with a doctor to direct them to the emergency department.

“One of the clinical challenges with COVID-19 is being able to identify patients who need additional care or hospitalization,” said Dr. Benjamin Hohmuth, chief medical informatics officer at Geisinger. “By closely monitoring patients recovering at home, we can quickly make adjustments to their level of care, answer any questions they might have and help keep them healthy and safe.”

2:13 PM CT on 5/19/20

(AP) The Oregon Supreme Court has kept statewide virus restrictions in place by halting a judge's order to end them in a lawsuit filed by churches claiming the governor exceeded her authority when she shut down in-person religious services.

Baker County Circuit Judge Matthew Shirtcliff ruled Monday that Gov. Kate Brown erred by not seeking the Legislature's approval to extend her stay-at-home orders beyond a 28-day limit. Brown's lawyers appealed to the Oregon Supreme Court, which just hours later put a hold on Shirtcliff's decree until the high court's justices can review the matter.

Presiding Justice Thomas Balmer gave both sides until Friday to submit legal briefs. He did not give a timeline for a decision.

In a statement late Monday, Brown, a Democrat, praised the state Supreme Court action.

"There are no shortcuts for us to return to life as it was before this pandemic. Moving too quickly could return Oregon to the early days of this crisis, when we braced ourselves for hospitals to be overfilled," she said.

2:07 PM CT on 5/19/20

Mount Sinai researchers have created an algorithm that can detect COVID-19 based on how lungs look in CT scans combined with patient information like age, symptoms, bloodwork and possible contact with others infected with the coronavirus.

“Imaging can help give a rapid and accurate diagnosis—lab tests can take up to two days, and there is the possibility of false negatives—meaning imaging can help isolate patients immediately if needed, and manage hospital resources effectively. The high sensitivity of our AI model can provide a ‘second opinion’ to physicians in cases where CT is either negative (in the early course of infection) or shows nonspecific findings, which can be common,” said Zahi Fayad, director of the BioMedical Engineering and Imaging Institute at the Icahn School of Medicine at Mount Sinai.

1:05 PM CT on 5/19/20

(AP) Making himself an example for using a malaria drug against the coronavirus, President Donald Trump sent the White House scrambling Tuesday to defend his decision amid medical concerns the unproven treatment could spark misuse of a medication with potentially fatal side effects.

Trump's announcement a day earlier that he was taking the drug, hydroxychloroquine, caught many in his administration by surprise and set off an urgent effort by officials to justify his action. The president's own government has warned that the drug should be administered for COVID-19 only in a hospital or research setting.

Trump decided to take hydroxychloroquine after two White House staffers tested positive for the coronavirus, but he already had spent months promoting the drug as a potential cure or preventive despite the cautionary advice of many of his administration's top medical professionals. The drug has the potential to cause significant side effects in some patients and has not been shown to combat the virus.

Amid concerns from some public health experts that Trump's example could send many more people to misuse the drug, White House press secretary Kayleigh McEnany said Tuesday that "tens of millions of people around the world have used this drug for other purposes," including malaria prophylaxis. She emphasized that "any use of hydroxychloroquine has to be in consultation with your doctor. You have to have a prescription. That's the way it must be done."

The drug is also prescribed for some lupus and arthritis patients.

Trump said his doctor did not recommend hydroxychloroquine to him, but that he requested it from the White House physician.

"I started taking it, because I think it's good," Trump said. "I've heard a lot of good stories."

The White House physician, Dr. Sean Conley, said in a statement released through the press office that, after "numerous discussions" with Trump about the evidence for and against using hydroxychloroquine, "we concluded the potential benefit from treatment outweighed the relative risks."

The Food and Drug Administration warned health professionals last month that the drug should not be used to treat COVID-19 outside of hospital or research settings due to sometimes fatal side effects. Regulators issued the alert, in part, based on increased reports of dangerous side effects called in to U.S. poison control centers.

Calls to centers involving hydroxychloroquine increased last month to 96, compared with 49 in April 2019, according to data from the American Association of Poison Control Centers provided to the AP. It was the second month of elevated reports involving the drug, following 79 calls in March. The problems reported included abnormal heart rhythms, seizures, nausea and vomiting.

Trump dismissed reports of side effects, saying, "All I can tell you is, so far I seem to be OK."

12:02 PM CT on 5/19/20

Some small and rural hospitals could face closure after the repeated financial stresses of the COVID-19 pandemic and the repeal of the Affordable Care Act’s individual mandate.

The Center for Public Integrity reports rural hospitals were already struggling with more uninsured patients, especially in states that didn’t expand Medicaid. The provision in the Tax Cuts and Jobs Act that repealed the ACA’s individual mandate means more uninsured, and the pandemic has forced hospitals to suspend lucrative elective procedures.

Small and rural hospitals are especially high-risk because they have fewer patients, fewer revenue streams and their patients tend to be older and sicker.

“They can hardly keep their doors open, so how are they expected to deal with that?” Max Isaacoff, government affairs and policy manager at the National Rural Health Association told the Center for Public Integrity.

11:04 AM CT on 5/19/20

(AP) Racial and economic disparities in the coroanvirus pandemic's impact in New York City present a challenge for an administration that has sought to fight inequality, Mayor Bill de Blasio acknowledged Tuesday.

"There's a lot we're going to do right now but the big question is going forward: how do you create a city where these disparities don't exist?" de Blasio said on TV station WPIX.

Data released by the city Monday showed that the coronavirus has hit hardest in low-income neighborhoods outside of Manhattan. The data showed that black and Hispanic New Yorkers were more than twice as likely to be killed by the virus as white people.

De Blasio, a Democrat who first ran for mayor in 2013 vowing to end the "Tale of Two Cities," said the city is meeting the coronavirus threat in severely affected communities through beefed-up testing for the virus as well as outreach "to make sure people have the information they need to protect themselves and their families."

9:45 AM CT on 5/19/20

(AP) Health experts say U.S. President Donald Trump's increasing attacks on the World Health Organization for its handling of the coronavirus demonstrate a profound misunderstanding of the U.N. agency's role and could ultimately serve to weaken global health.

In a letter to the WHO's director-general, Tedros Adhanom Ghebreyesus, Trump wrote that the WHO's "repeated missteps" in its response to the pandemic have proven "very costly for the world."

On Monday, Trump threatened to permanently cut U.S. funding to the WHO  unless the agency commits to "substantive improvements" in the next 30 days.

"I cannot allow American taxpayer dollars to continue to finance an organization that, in its present state, is so clearly not serving America's interests," he wrote.

The U.S. is the WHO's biggest donor, providing about $450 million a year.

Devi Sridhar, a professor of global health at the University of Edinburgh, said the letter was likely written for Trump's political base and meant to deflect blame for the virus' devastating impact in the U.S., which has by far the most infections and virus deaths in the world.

"China and the U.S. are fighting it out like divorced parents while (the) WHO is the child caught in the middle, trying not to pick sides," she said.

"President Trump doesn't understand what the WHO can and cannot do," she said, explaining that it sets international standards and is driven by its member countries. "If he thinks they need more power, then member states should agree and delegate it more."

In Brussels, the European Union threw its weight behind the WHO, urging all countries to support it in the wake of Trump's continued attacks.

"This is the time for solidarity," said European Commission spokeswoman Virginie Battu-Henriksson. "It is not the time for finger pointing or undermining multilateral cooperation."

Michael Head, a senior research fellow at the University of Southampton, said much of what Trump was demanding was beyond the WHO's intended scope.

"The WHO have limited powers, in terms of what they can demand of countries where outbreaks are taking place," Head said. "They provide expert guidance and not enforcement by law."

Head noted that there are clear gaps in governance elsewhere that have allowed COVID-19 to spread — notably in the U.S., which has seen 1.5 million infections and over 90,000 deaths linked to COVID-19.

9:10 PM CT on 5/18/2020

As positive early results from COVID-19 vaccine trials emerge, National Institutes of Health Director Dr. Francis Collins highlighted the need for an unprecedented public-private partnership to further accelerate vaccine development.

In a viewpoint on JAMA, Collins detailed how the Accelerating COVID-19 Therapeutic Interventions and Vaccines Partnership breaks down, with four working groups focusing on various stages of development like preclinical work and trial capacity. Some of the first vaccine trials started in January, and some developers have optimistically predicted there could be a vaccine as early as September. But that will require help from more than one biopharmaceutical company, Collins wrote.

Ultimately, the biotechnology companies working in the partnership will band together to study and ultimately manufacture therapeutic and vaccine candidates, even if they did not develop the successful treatment. Regulatory partners will expedite evaluation of the candidates to speed up the manufacturing process and get the approved treatment to market quickly.

"What has made the difference? Aside from the unquestionable urgency and enormous public health need posed by the COVID-19 pandemic, one key factor that helped to speed the formation of this partnership was having the US and European government regulatory agencies directly involved from the outset," Collins wrote.

8:37 PM CT on 5/18/2020

AMGA on Monday endorsed two pieces of legislation that would revamp the terms of a Medicare loan program for providers during COVID-19. 

Originally, Congress passed legislation that would offer loans to providers based on their revenue history, but the application period closed on April 26. The new bills, called the Medicare Accelerated and Advance Payments Improvement Act, would reopen the program, lower interest rates for the loans and give providers a longer period of time to repay the funds.

“AMGA members are fighting COVID-19 on two fronts,” AMGA President and CEO Dr. Jerry Penso said in a statement. “Defeating and containing the disease is one battle, and fighting off the dire financial impact of it is another. The legislation AMGA is endorsing today not only will help our members continue to care for their patients during this national crisis, but also will help ensure they can serve their communities into the future.”

8:05 PM CT on 5/18/2020

HHS on Monday said it was giving out another $11 billion in testing capacity funding to states, territories, tribal organizations and the Indian Health Service. The money comes from the Paycheck Protection Program and Health Care Enhancement Act.

“For the sake of all Americans’ health and well-being, we must help Americans get safely back to work and school, and that requires continued expansion of testing, surveillance, and contact tracing," HHS Secretary Alex Azar said in a statement. "The Trump administration stands ready to support and guide states in their life-saving work to combat the virus and reopen our country.”

The funds will be used to purchase COVID-19 tests, laboratory capabilities and pay for these additions.

7:24 PM CT on 5/18/2020

(AP) A judge in rural Oregon on Monday tossed out statewide coronavirus restrictions imposed by Democratic Gov. Kate Brown, saying she didn’t seek the Legislature's approval to extend the stay-at-home orders beyond a 28-day limit.

Baker County Circuit Judge Matthew Shirtcliff issued his opinion in response to a lawsuit filed earlier this month by 10 churches around Oregon that argued the state's social-distancing directives were unconstitutional.

Brown filed paperwork within hours seeking an emergency review by the Oregon Supreme Court and a hold on the ruling until the high court could take it up. Her attorneys had asked the judge to stay his ruling until that time, but he declined.

In a statement, Brown said: “The science behind these executive orders hasn’t changed one bit. Ongoing physical distancing, staying home as much as possible, and wearing face coverings will save lives across Oregon."

Scott Erickson, chief pastor of one of the churches behind the lawsuit, is waiting to see what the Supreme Court does before making any move to open the doors. Currently, his Peoples Church in Salem, Oregon, has drive-in church, with worshippers tuning in service on their radios from the parking lot, and livestreaming.

“We're going to wait until there's finality,” he said in a phone interview.

If the judge's ruling stands, Erickson's church, which 3,700 people normally attend regularly, will change its ways, the pastor said. It will adhere to 6-foot (2-meter) distancing, every other row would be empty and anything that people touch, like chairs and pews, will be wiped down before each service. Masks would be optional.

6:43 PM CT on 5/18/2020

UW Medicine will temporarily furlough 1,500 employees for one- to eight-weeks as the health system faces a $500 million shortfall due to the COVID-19 pandemic.

The Seattle-based provider has 30,000 employees, and the furloughs will affect professional and classified non-union staff. UW will also negotiate furloughs for union staffers this week. Senior leadership members are also taking paycuts, and the system will put any non-essential capital projects on hold.

6:06 PM CT on 5/18/2020

Governors and policymakers have called for private insurers to cover the costs of coronavirus-related testing and care. But one health policy and insurance expert on Monday said she has rethought her position on who should cover testing.

In a blog on Health Affairs, Sabrina Corlette said a publicly administered fund that pays providers directly would be a more effective solution. The professor at Georgetown University's Center on Health Insurance Reforms suggeted the fund could negotiate prices and pay for multiple tests per person, even if the individual is asymptomatic. That may not be the case with some insurance plans. She believes that model would better facilitate people returning to work and opening the economy.

"The massive and continual testing and vaccination effort required to extricate us from this crisis is will be extraordinary," Corlette wrote. "If we are ever to fully return to our workplaces, schools, concert halls, sporting venues, and other community experiences, widely accessible and free testing and vaccination is our only option. Extraordinary times call for an extraordinarily different kind of response."

5:28 PM CT on 5/18/2020

(AP) President Donald Trump said Monday that he is taking a malaria drug to protect against the new coronavirus, despite warnings from his own government that it should only be administered for COVID-19 in a hospital or research setting due to potentially fatal side effects.

Trump told reporters he has been taking the drug, hydroxychloroquine, and a zinc supplement daily “for about a week and a half now.” Trump spent weeks pushing the drug as a potential cure or prophylaxis for COVID-19 against the cautionary advice of many of his administration's top medical professionals. The drug has the potential to cause significant side effects in some patients and has not been shown to combat the new coronavirus.

Trump said his doctor did not recommend the drug to him, but he requested it from the White House physician.

"I started taking it, because I think it’s good," Trump said. "I’ve heard a lot of good stories.”

The Food and Drug Administration warned health professionals last month that the drug should not be used to treat COVID-19 outside of hospital or research settings, due to sometimes fatal side effects. Regulators issued the alert for the drug, which can also be used to treat lupus and arthritis, after receiving reports of heart rhythm problems, including deaths, from poison control centers and other health providers.

Trump dismissed reports of side effects, saying, “All I can tell you is, so far I seem to be OK.”

At least two White House staffers tested positive for COVID-19 earlier this month, sparking concerns about the steps taken by the administration to protect the president and sending Vice President Mike Pence and other officials into varying forms of self-isolation.

The White House has since mandated that those in the West Wing wear face coverings and has introduced daily testing for the virus for the president, vice president and those they come in close contact with.

4:17 PM CT on 5/18/20

(AP) Harnessing today's technology to the task of fighting the coronavirus pandemic is turning out to be more complicated than it first appeared.

The first U.S. states that rolled out smartphone apps for tracing the contacts of COVID-19 patients are dealing with technical glitches and a general lack of interest by their residents. A second wave of tech-assisted pandemic surveillance tools is on its way, this time with the imprimatur of tech giants Apple and Google. But those face their own issues, among them potential accuracy issues and the fact that they won't share any information with governments that could help track the spread of the illness.

Contact tracing is a pillar of infection control. It's traditionally conducted by trained public health workers who interview those who may have been exposed, then urge them to get tested and isolate themselves. Some estimates call for as many as 300,000 U.S. workers to do the work effectively, but so far those efforts have lagged.

Other tech companies like Salesforce have offered database tools to assist manual tracing efforts, although those also raise privacy concerns because of the need to collect and store detailed information about people's social connections, health status and whereabouts.

Privacy advocates warn that the danger of creating new government surveillance powers for the pandemic could lead to much bigger problems in the future. In a new policy paper shared with The Associated Press, the American Civil Liberties Union is warning state governments to tread more carefully and establish stricter privacy procedures before deploying technology meant to detect and curb new coronavirus outbreaks.

Even the most privacy-minded tools, such as those to be released soon by Apple and Google, require constraints so that they don't become instruments of surveillance or oppression. "The risks of getting it wrong are enormous," said Neema Singh Guliani, a senior legislative counsel with the ACLU.

ACLU's report says the worst location-tracking technology should be rejected outright, such as apps that track individual movements via satellite-based GPS technology and feed sensitive personal data into centralized government databases. "Good designs don't require you to gather people's location information and store that," Singh Guliani said.

She urged governments to set rules addressing both privacy and efficacy so that surveillance tools don't interfere with more conventional public health methods.

3:01 PM CT on 5/18/20

(AP) The World Health Organization bowed to calls Monday from most of its member states to launch an independent probe into how it managed the international response to the coronavirus, which has been clouded by finger-pointing between the U.S. and China over a pandemic that has killed over 300,000 people and leveled the global economy.

The "comprehensive evaluation," sought by a coalition of African, European and other countries, is intended to review "lessons learned" from WHO's coordination of the global response to COVID-19, but would stop short of looking into contentious issues such as the origins of the new coronavirus. U.S. President Donald Trump has claimed he has proof suggesting the coronavirus originated in a lab in China while the scientific community has insisted all evidence to date shows the virus likely jumped into humans from animals.

WHO's normally bureaucratic annual assembly this week has been overshadowed by mutual recriminations and political sniping between the U.S. and China. Trump has repeatedly attacked WHO, claiming that it helped China conceal the extent of the coronavirus pandemic in its early stages. Several Republican lawmakers have called on WHO Director-General Tedros Adhanom Ghebreyesus to resign.

U.S. Health and Human Services Secretary Alex Azar said Monday it was time to be frank about why COVID-19 has "spun out of control."

"There was a failure by this organization to obtain the information that the world needed and that failure cost many lives," Azar said. Speaking hours after Chinese President Xi Jinping announced China would provide $2 billion to help respond to the outbreak and its economic fallout, Azar said the U.S. had allocated $9 billion to coronavirus containment efforts around the world.

Tedros said he would launch an independent evaluation of WHO's response "at the earliest appropriate moment" — alluding to findings published Monday in a first report by an oversight advisory body commissioned to look into WHO's response.

The 11-page report raised questions such as whether WHO's warning system for alerting the world to outbreaks is adequate, and suggested member states might need to "reassess" WHO's role in providing travel advice to countries.

1:55 PM CT on 5/18/20

(AP) New York City is ramping up its ability to test for the coronavirus, with testing available at more than 150 sites citywide and test kits made in the city now in use at city-run health clinics, Mayor Bill de Blasio said Monday.

The partnership between the Albert Einstein College of Medicine and local businesses Print Parts and Collab will be producing 60,000 test kits weekly by the week of June 1, de Blasio said, adding, "We'll keep going as far as we have to go to make sure that every New Yorker who needs a test gets one."

De Blasio announced Sunday that urgent care provider CityMD would offer tests for the virus at its 123 locations, raising the number of test sites in the city to more than 150.

The mayor said the city is continuing to hire public health workers to trace the contacts of people who test positive for COVID-19.

"All of the pieces — the test kids, the test sites, the labs, the tracers — all of these pieces are coming together to give us the huge, robust test and trace program we need to push back this disease and move forward in this city," he said.

12:52 PM CT on 5/18/20

(AP) The first outbreak of the coronavirus at a nursing home in Wyoming has infected at least nine people, the Wyoming Department of Health said Sunday.

So far, five employees and four residents at the Worland Healthcare and Rehabilitation have been found to have COVID-19, with most of the cases confirmed through laboratory testing.

More test results were pending, but officials believe all the residents and employees at the facility have been tested, department spokeswoman Kim Deti said. No one has died, she said.

The testing began after staff members became sick and sought medical care. But it is not clear how the virus was introduced into the facility, the department said in a press release. State health department staff will likely visit the facility to review the situation, interview patients and staff and to conduct more testing.

Visitors and non-essential workers are limited in Wyoming's nursing homes because of the pandemic.

"We believe this policy has been helpful in Wyoming over the last couple of months, but the risk of potential exposure through staff and patients still exists," Dr. Alexia Harrist, state health officer and state epidemiologist said in the announcement of the cases.

There was an outbreak at an assisted living facility in Lander in March. But there has not previously been one at a nursing home, where patients are more medically fragile and receive more care, Deti said.

11:50 AM CT on 5/18/20

Right ventricular dilation, where the right side of the heart enlarges and doesn’t function correctly, may indicate worse outcomes in hospitalized COVID-19 patients, according to a study in the Journal of the American College of Cardiology: Cardiovascular Imaging.

Researchers analyzed records of 105 patients and found right ventricular dilation was the only factor that significantly correlated with increased mortality. Though the reason for the correlation is unknown, researchers say there could be multiple factors, including possible clots, lung damage, low blood oxygen level or heart damage.

“Echocardiography is a readily available bedside tool that yields essential diagnostic and prognostic information in these patients,” said Dr. Edgar Argulian, an author of the study. “Clinicians can use bedside echocardiography as a readily available tool to identify patients with COVID-19 infection at the highest risk of adverse hospital outcomes.”

10:47 AM CT on 5/18/20

(Crain’s Detroit Business) Michigan on Sunday reported the fewest coronavirus deaths in a single day since March 24.

The Michigan Department of Health and Human Services reported 11 new deaths Sunday, bringing the state's total from the outbreak of the deadly disease to 4,891. Reported numbers on weekends have typically been smaller than other days of the week.

The state also tallied 638 newly confirmed cases of COVID-19, which brings the total to 51,142.

The figures brought the seven-day rolling average of new cases per day down to 572 and the seven-day average of deaths to 49. A week ago, the seven-day average was 71 deaths and 483 positive tests.

The number of people hospitalized statewide for the disease stood at 1,114, less than a third of its peak of 3,896 on April 12.

Though the number of positive tests reported daily has risen slightly over the past week, the number of tests performed also rose sharply, from 12,116 on Monday to more than 25,000 on Wednesday and just under 20,000 on Friday. On Friday, 7 percent of tests reported came back positive for the virus.

9:43 AM CT on 5/18/20

(AP) An experimental vaccine against the coronavirus showed encouraging results in very early testing, triggering hoped-for immune responses in eight healthy, middle-aged volunteers, its maker announced Monday.

The vaccine by Cambridge, Massachusetts-based Moderna Inc., generated antibodies similar to those seen in people who have recovered from COVID-19 in study volunteers who were given either a low or medium dose.

In the next phase of the study, led by the U.S. National Institutes of Health, researchers will try to determine which dose is best for a definitive experiment that they aim to start in July.

The vaccine seems safe so far, the company said. A high dose version is being dropped after spurring some short-term side effects.

Worldwide, about a dozen vaccine candidates are in the first stages of testing or nearing it.

9:36 PM CT on 5/17/2020 

(AP) — Seven weeks after Congress unleashed more than $2 trillion to deal with the pademic, an oversight commission intended to keep track of how the money is spent remains without a leader.

Four of the five members of the Congressional Oversight Commission have been appointed, but House Speaker Nancy Pelosi, D-Calif., and Senate Majority Leader Mitch McConnell, R-Ky., have not agreed on a chair.

Without a leader, the panel's remaining members can still do some oversight work, but cannot hire staff or set up office space. The four members have not met as a group since the economic rescue law was passed by Congress and signed by President Donald Trump in late March.

Congress created the panel to watch over $500 billion in lending to distressed industries backed by the Treasury Department and Federal Reserve. The Fed has said the money can be leveraged to offer more than $2 trillion in loans to U.S. companies.

But without a chairman, the panel's activity has been reduced to tweets and letters by individual commissioners and a May 8 statement in which it pledged to publish a required report "soon.”

The failure by Pelosi and McConnell to agree on an oversight head is the latest example of a broken Congress, marked by partisanship and polarization. Even as both sides acknowledge the importance of overseeing the sprawling economic rescue law, lawmakers are immobilized by a larger political fight, with no resolution immediately in sight.

8:47 PM CT on 5/17/2020

(AP) The Los Angeles Police Department wants to test everyone its officers arrest to determine whether they are infected with the coronavirus.

Police Chief Michel Moore told the department’s civilian oversight body last week that jails are testing all new arrivals, but the results take days to come back. He said real-time data from a rapid-result test would help authorities isolate sick detainees, keep others detained in local jails safe and quickly alert officers to any potential exposure.

Moore is asking city officials to purchase a rapid-result testing system, but it’s unclear whether such a system will produce accurate test results.

7:20 PM CT on 5/17/2020

(AP) — Federal Reserve Chair Jerome Powell expressed optimism Sunday that the U.S. economy can begin to recover from a devastating recession in the second half of the year, assuming the coronavirus doesn't erupt in a second wave. But he suggested that a full recovery won't likely be possible before the arrival of a vaccine.

In an interview with CBS’s “60 Minutes," Powell noted that the economy was fundamentally healthy before the virus struck suddenly and forced widespread business shutdowns and tens of millions of layoffs. Once the outbreak has been contained, he said, the economy should be able to rebound “substantially.”

Powell offered an overall positive message while warning that it would take much longer for the economy to regain its health than it took for it to collapse with stunning speed.

“In the long run, and even in the medium run," the chairman said, "you wouldn’t want to bet against the American economy. This economy will recover. And that means people will go back to work. Unemployment will get back down. We’ll get through this."

Powell pointed out that the downturn wasn't a result of deep-seated financial instabilities, like the housing meltdown and the excessive risk-taking among banks that ignited the Great Recession. Rather, it resulted from an external event — a pandemic — that required a shutdown of the economy. That may mean, he said, that “we can get back to a healthy economy fairly quickly.”

6:32 PM CT on 5/17/2020

(CNN) HHS Secretary Alex Azar told Jake Tapper that unhealthy Americans increased the death toll from the coronavirus.

"Unfortunately the American population is a very diverse ... It is a population with significant unhealthy comorbidities that do make many individuals in our communities, in particular African American, minority communities particularly at risk here because of significant underlying disease health disparities and disease comorbidities -- and that is an unfortunate legacy in our health care system that we certainly do need to address," he told CNN's Jake Tapper on "State of the Union."

Azar said that the U.S. had a "significantly disproportionate burden of comorbidities ... (including) obesity, hypertension, diabetes." 

5:24 PM CT on 5/17/2020

Geisinger Health is providing tools, information and guides to help employers tackling reopening plans for their offices.

This online resources center allows for virtual consultations and includes best practices, guidance for screening employees, signage kits promoting handwashing and social distancing at the workplace.

“As a healthcare partner in the community, Geisinger is lending expertise and best practices in care delivery to our local businesses as they carefully return to in-person operations,” said Allison Hess, vice president of health at the Geisinger Steele Institute for Health Innovation.

The system's insurer, Geisinger Health Plan also is offering new virtual and telephonic services to members.

4:12 PM CT on 5/17/2020

(AP) Worries about the breach of individual privacy rights could undermine Louisiana's ability to quickly pinpoint those who have encountered someone infected with COVID-19, a tracking plan that public health experts say is critical to slowing the spread of the coronavirus disease.

Dr. Alex Billioux, leader of Louisiana's public health office, said he knows some people will find the process of contact tracing “scary," to be asked about their interactions with people and businesses or to find out someone else has shared information about where they've been.

"The goal here, though, is to help protect you. The goal here is to identify where you have risk,” Billioux said.

But word that Gov. John Bel Edwards's administration has hired nearly 300 contact tracers on top of 70 already employed — and could eventually build up to 700 disease detectives to track the virus— quickly raised concerns about collecting personal medical information and spreading it improperly.

Realizing that widespread reluctance to respond to contact tracers could hamper Louisiana's efforts to contain the virus, Edwards has appealed to people to be “good neighbors” by participating.

3:18 PM CT on 5/17/2020

A research team comprised of scientists from the National Institute of Health and the University of Pennsylvania have found that the coronavirus can stay airborne for anywhere between eight and 14 minutes after conversation.

Previously, scientists have researched how cough or sneeze generated droplets carried the virus.

They used the phrase "stay healthy" for 25 seconds into an open end of a cardboard box. The inside was lit with lasers that could measure the droplet spray the speaker produced. Researchers admitted that the controlled setting, a stagnant air environment, could vary greatly from well ventilated room.

2:29 PM CT on 5/17/2020

The U.K. will have first access to Oxford University's COVID-19 vaccine if it's successful, according to ABC news.

Oxford has a deal with U.K.-based pharmaceutical company AstraZeneca to deliver 100 million doses of Oxford's potential vaccine; the company will work to make up to 30 million of those doses available for the U.K. by September as part of the deal, according to Business Secretary Alok Sharma.

Human clinical trials for Oxford's coronavirus vaccine began last month. Imperial's vaccine trial is set to begin in June.

12:42 AM CT on 5/17/2020

(AP) New York  Gov. Andrew Cuomo got tested for coronavirus on live TV as he announced all people experiencing flu-like symptoms are now eligible for tests.

All New Yorkers experiencing flu-like symptoms or other signs of coronavirus, such as a dry cough or chest pains, are now eligible to be tested for the disease, along with people who will be returning to work as part of phased reopenings across the state, Cuomo said Sunday.

The state is expanding eligibility as it deals with a surplus of testing capacity. Drive-thru and walk-in testing sites are performing about one-third of the 15,000 tests they're capable of each day, Cuomo said.

In all, the state is testing about 40,000 people per day. As the weather heats up, though, more and more New Yorkers are flocking to public spaces and familiar haunts for a sense of normalcy after spending most of the last two months cooped up inside — and not always policing themselves.

An agreement with CVS will allow samples to be collected at more than 60 pharmacies across the state, Cuomo said. Testing in New York City is being expanded to 123 CityMD walk-in clinics.

De Blasio also made an urgent appeal Sunday for blood donations, saying coronavirus-related blood drive cancellations have led supplies to dwindle to about two days’ worth, which could mean postponing some surgeries.

11:32 AM CT on 5/17/2020

Ford will test hourly and salaried employees for COVID-19 as it prepares to reopen facilities this month.

The automaker wants to resume operations at its North America facilities on Monday. The company’s parts distribution centers reopened in North America on May 11.

The automaker will enlist health systems to conduct the testing. Beaumont Health will test workers in Southeast Michigan, the University of Louisville Health will conduct testing in Louisville, Liberty Hospital will do testing in the Kansas City area and the University of Chicago Medical Center and UChicago Medicine-Ingalls Memorial Hospital will test employees in the Chicago area.

Ford said it will initially use polymerase chain reaction (PCR) testing, which identifies if someone is actively infected. PCR tests are used to detect the presence of viral RNA, not the presence of the antibodies, which are the body’s immune response, according to TechCrunch.

10:33 AM CT on 5/17/2020

(AP) In separate, stark warnings, two major European leaders have bluntly told their citizens that the world needs to adapt to living with the coronavirus and cannot wait to be saved by the development of a vaccine.

The comments by Italian Prime Minister Giuseppe Conte and British Prime Minister Boris Johnson came as nations around the world and U.S. states are both struggling with restarting economies blindsided by the pandemic. With 36 million newly unemployed in the U.S. alone, economic pressures are building even as authorities acknowledge that reopening risks off new waves of infections and deaths.

Pushed hard by Italy’s regional leaders and weeks in advance of an earlier timetable, Conte is allowing restaurants, bars and beach facilities to open Monday, the same day that church services can resume and shops reopen.

’’We are facing a calculated risk, in the awareness ... that the epidemiological curve could go back up," Conte said late Saturday. “We are confronting this risk, and we need to accept it, otherwise we would never be able to relaunch.”

Conte added that Italy could "not afford” to wait until a vaccine was developed. Health experts say the world could be months, if not years, away from having a vaccine available to everyone despite the scientific gold rush now on to create such a vaccine.

Italy’s economy is forecast to contract 9% this year due to the coronavirus amid a long, strict lockdown.

For his part, Britain's Johnson, who was hospitalized last month with a serious bout of COVID-19, speculated Sunday that a vaccine may not be developed at all, despite the huge global effort to produce one.

“I said we would throw everything we could at finding a vaccine,” Johnson wrote in the Mail on Sunday newspaper. “There remains a very long way to go, and I must be frank that a vaccine might not come to fruition. We have to acknowledge we may need to live with this virus for some time to come.” 

The Conservative leader said the U.K. needs to find new ways of controlling the virus, including more testing for people who have symptoms and tracing the contacts of infected people. One minister said Sunday that 17,200 people had been recruited to be contact tracers.

9:39 AM CT on 5/17/2020

(AP) Former President Barack Obama on Saturday evening criticized U.S. leaders overseeing the nation's response to the coronavirus, telling college graduates in an online commencement address that the pandemic shows many officials "aren’t even pretending to be in charge.”

Obama spoke on “Show Me Your Walk, HBCU Edition,” a two-hour event for students graduating from historically black colleges and universities broadcast on YouTube, Facebook and Twitter. His remarks were unexpectedly political, given the venue, and touched on current events beyond the virus and its social and economic impacts.

“More than anything, this pandemic has fully, finally torn back the curtain on the idea that so many of the folks in charge know what they’re doing,” Obama said. “A lot them aren’t even pretending to be in charge.”

Obama did not name President Donald Trump or any other federal or state officials. But earlier this month, he harshly criticized Trump’s handling of the pandemic as an “absolute chaotic disaster” in a call with 3,000 members of his administrations obtained by Yahoo News.

8:45 PM CT on 5/16/20
(AP) As state after state begins to reopen, local health departments charged with tracking down everyone who has been in close contact with those who test positive for the new coronavirus are still scrambling to hire the number of people they need to do the job.

They are often hundreds — even thousands — of people short of targets for their contact tracing programs. Public health experts have consistently said robust programs to test more people and trace their contacts are needed for states to safely reboot their economies and prevent a resurgence of the virus.Cook County, Illinois, has just 29 contact tracers serving 2.5 million people living in suburban communities around Chicago.

"The whole point of the lockdown was to buy time to have a better way to keep numbers down," said Jeremy Konyndyk, who led the humanitarian response to the Ebola outbreak in West Africa during the Obama administration. "And that's why so many of us are screaming ourselves hoarse about testing and tracing."

7:55 PM CT on 5/16/20
(AP) A nurse from Virginia took a unique path to travel to New York to help out during the COVID-19 pandemic.
Rather than risk flying during the crisis, 26-year-old Rachel Hartley and her husband sailed hundreds of miles to Brooklyn last month.

Hartley, of Lynchburg, told  the New York Post she left her job at a local hospital and has been working four 12-hour night shifts a week at NYU Langone Brooklyn.

She and husband Taylor have been living on the boat, a four-bedroom, 50-foot vessel named Turning Points, at a marina in Brooklyn Heights. Hartley said the marina owner has even waived thousands of dollars in monthly fees for the couple.

"I was hearing how badly New York City had been hit — and the area I was in wasn't nearly as bad," Hartley told the newspaper. "That really pulled on my heart. I thought, I have to go help."

6:40 PM CT on 5/16/20
(AP) — More than 3,000 nursing home residents in Texas have tested positive for the coronavirus, according to data released by the state on Friday.

The 3,000 positive tests represent about 4% of the estimated number of Texans living in nursing homes, the Houston Chronicle reported. By comparison, about 0.15% of Texas residents have tested positive for the virus that causes COVID-19.

Republican Gov. Greg Abbott on Monday ordered coronavirus testing for all Texas nursing home residents and staff after the White House urged governors to do so as deaths mount nationwide.

5:26 PM Ct on 5/16/20
Morehouse School of Medicine is planning a two-week pilot with "staggered work schedules and class instruction following social distancing guidelines and other actions," which, if deemed a success will allow for a June 1 phased-in return to campus, according to a news release.

“Just as our graduates cannot truly master their craft without touching patients, peering through a microscope or engaging community, we cannot truly prepare them for the challenge of addressing the COVID-19 pandemic or other future health crises without demonstrating, in person, the best practices for testing, treating and contract tracing,” said President and Dean Valerie Montgomery Rice, MD. “Ours is an evidence-based, data-driven approach and is the result of a rigorous planning process.”

Faculty and staff were all tested by a company called Color on May 11-15.

4:05 PM CT on 5/16/20

(AP) As businesses reopened Friday in more of the U.S., an overwhelming majority of states still fall short of the COVID-19 testing levels that public health experts say are necessary to safely ease lockdowns and avoid another deadly wave of outbreaks, according to an Associated Press analysis.

Rapid, widespread testing is considered essential to tracking and containing the coronavirus. But 41 of the nation's 50 states fail to test widely enough to drive their infections below a key benchmark, according to an AP analysis of metrics developed by Harvard's Global Health Institute.

Among the states falling short are Texas and Georgia, which recently moved aggressively to reopen stores, malls, barbershops and other businesses.

2:31 PM CT on 5/16/20

A Pennsylvania dog training center is teaching man's best friend to help fight the coronavirus, according to CBSNews in New York. The Penn Vet Working Dog Center is training 10 dogs to use their strong sense of smell to detect coronavirus 

Dogs have long been used to help detect diseases, like cancer and Parkinson’s. The trainers say they aren't worried about the dogs contracting COVID-19 since the samples they are using as human strains. 

“We know that all diseases seem to have a unique odor and we know that viruses themselves actually have a unique odor,” said Cynthia Otto, the director of the Working Dog Center.

1:59 PM CT on 5/16/20

(GenomeWeb) Both Abbott Laboratories and the Food and Drug Administration released statements Thursday addressing recent concerns raised about the accuracy of Abbott's ID Now point-of-care test.

A recent study from New York University published Tuesday on the BioRxiv preprint platform compared the results of Abbott and Cepheid's SARS-CoV-2 point-of-care tests and found Abbott's test missed as much as almost half of the cases found positive by Cepheid's Xpert Xpress SARS-CoV-2 test. The study has not been peer-reviewed.

In light of these results, the FDA said it is still evaluating the information and is in communication with Abbott about the potential false negatives. "We will continue to study the data available and are working with the company to create additional mechanisms for studying the test," Tim Stenzel, the director of the Office of In Vitro Diagnostics and Radiological Health at the FDA, said in a statement.

Stenzel added that the test "can correctly identify many positive cases in minutes," but noted "negative results may need to be confirmed with a high-sensitivity authorized molecular test." Abbott's test received Emergency Use Authorization from the agency in March.

12:58 PM CT on 5/16/20
Columbia University Irving Medical Center, New York, conceived and deployed a virtual obstetric clinic for pregnant COVID-19 patients in just 10 days, according to an article in NEJM Catalyst.

The virtual clinic includes virtual visits and computer algorithms designed to easily triage patients and also to transition patients between outpatient and inpatient care, according to the article.

Fundamentals of the clinic include the beliefs that:

• Virtual monitoring is essential during the coronavirus pandemic.
• A telehealth model must include close patient surveillance and engagement.
• Standardized visit templates and escalation protocols are needed.
• Effective communication and coordination can minimize viral exposure.
• Technical problems with video connections will occur; non-video phone calls are a viable alternative.

11:39 AM CT on 5/16/20
(AP) A northern Illinois nurse expressed regret Friday for not taking better precautions while visiting her sister's Wisconsin bar after the Supreme Court overturned the state's "Safer at Home" order.

Katie Koutsky, a nurse with the Downers Grove, Ill.-based Advocate Aurora Health system, says she was helping her sister reopen her suburban Milwaukee bar Wednesday when she was interviewed by a local television station. She told WTMJ-TV being in the bar was no greater risk than being in a grocery.

"First, while my priority was to support my sister and her attempt to restart her business which has been devastated by this pandemic, I'd like to express my regret for not wearing a mask or practicing social distancing while there," Koutsky said in a statement released by Advocate Aurora Health.

Koutsky said she doesn't have COVID-19 symptoms and has no indication she was exposed to the virus. Advocate Aurora Health said in a statement it was "disappointed" in Koutsky's decision not to wear a mask in a bar that wasn't practicing social distancing.

10:36 AM CT on 5/16/20
(AP) — Facing growing criticism, the Department of Veterans Affairs said Friday that it will not halt use of an unproven malaria drug on veterans with  COVID-19 but that fewer of its patients are now taking it.

In responses provided to Congress and obtained by The Associated Press, the VA said it never "encouraged or discouraged" its government-run hospitals to use hydroxychloroquine on patients even as President Donald Trump heavily promoted the drug for months without scientific evidence of its effectiveness.

Still, it acknowledged that VA Secretary Robert Wilkie had wrongly asserted publicly without evidence that the drug had been shown to benefit younger veterans. The VA, the nation's largest hospital system, also agreed more study was needed on the drug and suggested its use was now limited to extenuating circumstances, such as last-ditch efforts to save a coronavirus patient's life.

In the first week of May, 17 patients had received the drug for COVID-19, according to VA data obtained by the AP. The department declined to say how many patients had been treated with hydroxychloroquine for the coronavirus since January, but a recent analysis of VA hospital data showed that hundreds of veterans had taken it by early April.

9:40 AM CT on 5/16/20
(AP) Nebraska will require long-term care centers to develop formal plans outlining how they'll keep the coronavirus from spreading among the vulnerable residents who live in those facilities, Gov. Pete Ricketts said Friday.

Facilities such as nursing homes and assisted living centers will have to submit plans to state regulators explaining how they intend to identify ill people and deal with visitors for the rest of the year. They'll also have to discuss their disinfection protocols.

The announcement comes as state officials scramble to keep the virus from spreading among long-term care facilities, whose residents are generally older and have underlying health problems. Long-term care residents are among the hardest-hit population groups in Nebraska, accounting for at least 75 of the state's 113 coronavirus deaths. At least 82 long-term care facilities have reported coronavirus cases in Nebraska, including 35 with cases among residents.

Nebraska health officials reported a one-day jump of six COVID-19 deaths on Thursday, as new cases were reported among police and several Omaha-area nursing homes.