About the public’s health
Dr. Fauci: Second wave isn't inevitable if we do this: In a video interview he says we need to follow the science (masks, social distancing, etc.) and not open up public activities too early. Oh, yes…and hydroxychloroquine does not work against SARS-CoV-2
WHO creates foundation to boost funding in coronavirus fight: “The World Health Organization announced on Wednesday the creation of a foundation to tap new sources of funding that could help ease a potential cash shortage as it leads the global fight against the coronavirus pandemic.”
Comparison of Clinical Characteristics of Patients with Asymptomatic vs Symptomatic Coronavirus Disease 2019 in Wuhan, China: “Our finding…suggests that damage to the immune system in asymptomatic infections was milder compared with symptomatic infections. Although patients who were asymptomatic experienced less harm to themselves, they may have been unaware of their disease and therefore not isolated themselves or sought treatment, or they may have been overlooked by health care workers and thus unknowingly transmitted the virus to others. Fortunately, patients with asymptomatic SARS-CoV-2 infection have a shorter duration of viral shedding from nasopharyngeal swabs and lower risk of a recurring positive test result of SARS-CoV-2 from nasopharyngeal swabs, which can provide a reference for improving the prevention and control strategies for patients who are asymptomatic.”
Effects of a Workplace Wellness Program on Employee Health, Health Beliefs, and Medical Use: A Randomized Clinical Trial: Evaluations of workplace wellness programs have revealed widely different results- depending on such factors as the target of the intervention (like smoking cessation or weight loss), the company culture, and method of intervention (such as bonuses, penalties, or other benefits). So each study needs to be interpreted very cautiously when generalizations are made about their effectiveness. In this study: “…a comprehensive workplace wellness program had no significant effects on measured physical health outcomes, rates of medical diagnoses, or the use of health care services after 24 months, but it increased the proportion of employees reporting that they have a primary care physician and improved employee beliefs about their own health.See the editorial as well: Taking Stock of Employer Wellness Program Effectiveness—Where Should Employers Invest?
Half of Americans in new poll say they would get COVID-19 vaccine: “The Associated Press-NORC Center for Public Affairs Research poll found that 49 percent of respondents said they would get a vaccine for the disease, which is caused by the novel coronavirus. Twenty percent of respondents said they would not, and 31 percent said they weren’t sure yet.” Safety is the major concern of those who said they would not get the vaccine.
GSK targets production of 1bn doses of coronavirus vaccine booster: “UK drugmaker GlaxoSmithKline plans to produce 1bn doses of a vaccine booster as it steps up its preparations for an eventual immunisation for coronavirus.” Such boosters, called adjuvants, enhance the immunologic response to vaccines and also may allow a lower effective dose to be used - thus extending the available supply.
EMA Picks University to Lead Real-World Monitoring of COVID-19 Vaccines “European Medicines Agency (EMA) has signed a contract with Utrecht University to lead a research project for real-world monitoring of COVID-19 vaccines once they are authorized in the European Union.”
Thinking twice about the rush to give CPR to COVID-19 patients: From the AMA, here is a discussion of and references on ethical decisions regarding exposure of healthcare workers to contagion while performing CPR.
About pharma
Remdesivir for 5 or 10 Days in Patients with Severe Covid-19:”In patients with severe Covid-19 not requiring mechanical ventilation, our trial did not show a significant difference between a 5-day course and a 10-day course of remdesivir. With no placebo control, however, the magnitude of benefit cannot be determined.” With cost becoming more of a consideration, this finding is good news if results are further confirmed.
FDA finds likely carcinogen in the common diabetes drug metformin. Will recalls follow?:”The FDA found carcinogen contamination in extended-release formulations of metformin, supporting outside laboratory Valisure's findings in early March, a spokesman said Thursday.
Tested lots of extended-release metformin showed levels of N-Nitrosodimethylamine (NDMA)—a likely human carcinogen that's led to recalls of ‘sartan’ blood pressure drugs and the heartburn remedy Zantac—above acceptable limits, the FDA said. Those elevated levels weren't found in samples of metformin's immediate-release formula.”
Financial ties between leaders of influential US professional medical associations and industry: cross sectional study: “Financial relationships between the leaders of influential US professional medical associations and industry are extensive, although with variation among the associations. The quantum of payments raises questions about independence and integrity, adding weight to calls for policy reform.” You should look at the methodology (is research money that is disclosed a problem?) and differences across organizations (ties involving the American College of Physicians and American Psychiatric Association are markedly lower than for other groups). Also, the article splits the analysis between the ties with pharma and devices.
Merck adopts ‘error catastrophe’ coronavirus drug: “Merck is launching its hunt for a coronavirus treatment with a pill developed by US academics that is designed to force an “error catastrophe” on viruses. The compound, which is known as EIDD-2801, works by planting molecules in a virus’s RNA genetic material that then trigger a cascade of mutations, which ultimately kill it. The drug completed its first safety trial in about 100 human volunteers in the UK and is set to begin extensive clinical testing in the US and UK early in June.”
FDA Approves Only Drug in U.S. to Treat Severe Malaria: “…the U.S. Food and Drug Administration approved artesunate for injection to treat severe malaria in adult and pediatric patients. Treatment of severe malaria with intravenous (IV) artesunate should always be followed by a complete treatment course of an appropriate oral antimalarial regimen…According to the CDC, approximately 2,000 cases of malaria are diagnosed in the United States each year, with 300 of those infected having severe disease.”
6 BCBS companies sue CVS, claiming decadelong insurance fraud scheme: “Six Blue Cross Blue Shield companies filed a lawsuit against CVS Health, claiming the retail pharmacy chain has ‘intentionally engaged’ in a fraud scheme for more than a decade to overcharge for prescription drugs by submitting insurance claims for payment at artificially inflated prices.”
Evidence-Based Quality Scores for Rating Drug Products and Their Utility in Health Systems: This pre-reviewed paper proposes: “A system of quality scores… to enable health-systems and other purchasers and payers of medication to differentiate among drug products according to evidence-based metrics. Metrics influencing the quality scores described herein include both broadly applicable regulatory information and more drug-specific, third-party chemical analysis information.” The quality measure evaluates manufacturing not the actual drug effectiveness.
About healthcare IT
Barriers to Hospital Electronic Public Health Reporting and Implications for the COVID-19 Pandemic: This survey is another reminder about interoperability problems: “Public health agencies’ inability to receive electronic data is the most prominent hospital-reported barrier to effective syndromic surveillance. This reflects the policy commitment of investing in information technology for hospitals without a concomitant investment in IT infrastructure for state and local public health agencies.”
Is the glass half full or half empty? Here are two articles about the same survey whose headlines reach opposite conclusions:
Surveys Suggest Seniors Aren’t Using Telehealth During COVID-19 Crisis: ”In a survey of roughly 1,000 seniors on Medicare Advantage plans conducted earlier this month by the Better Medicare Alliance, just 24 percent said they’ve used telehealth during the COVID-19 crisis. And just 52 percent of the seniors said they’d be comfortable using telehealth to access care, while 30 percent said they’d be uncomfortable and 18 percent were unsure.”
Medicare Advantage members are taking to telehealth: “A new poll found that roughly half of seniors are comfortable using telehealth to get healthcare, and those that do largely say they had a favorable experience.
The poll, conducted by Morning Consult and sponsored by the Better Medicare Alliance, comes as providers and insurers have started to embrace telehealth amid the COVID-19 pandemic.
The survey of more than 1,000 seniors found 52% are comfortable using telehealth for their healthcare, with 30% uncomfortable and another 18% unsure.”
About health insurance
Hospitals not entitled to additional payments after 'two-midnight' rate cut: “A federal appeals court said a group of hospitals that received lower Medicare reimbursement because of a rate reduction implemented by HHS aren't entitled to additional payments, according to court documents.
For fiscal year 2014, HHS implemented a 0.2 percent rate reduction in an effort to reduce costs associated with its ‘two-midnight’ rule. The rule says costs for hospital stays of a least two midnights are presumptively appropriate for reimbursement at inpatient rates. After revisiting the actuarial processes behind the cuts, HHS eliminated the 0.2 percent rate reduction for fiscal year 2017 and implemented a one-time 0.6 percent reimbursement rate increase to account for the three years of cuts.”
Public Option Could Lower Health Insurance Premiums, But Would Not Substantially Raise Number of Insured: This RAND Corporation study, published today, modeled “four scenarios for adding a public option for individual coverage available nationwide” The “researchers found that premiums for public plans could be 10% to 27% lower than private insurance plans because of lower provider payment rates in the public option.”
However, a “public option had much less impact on boosting the number of people with insurance. Under three of the scenarios, the number of uninsured people fell 3% to 8%, while the number of uninsured declined marginally under a fourth scenario studied.”
About healthcare companies
20 healthcare companies with biggest annual profits: The list is from the latest “Fortune 500.”