About the public’s health
How long should you isolate if you test positive for the coronavirus? At least 10 days after symptom onset:”The CDC had previously recommended people who test positive isolate until they had two negative swabs for the coronavirus — but that turned out to be impractical given the shortage of tests. It now advises most people with active cases of covid-19, the illness caused by the coronavirus, to isolate for 10 days after symptoms begin and 24 hours after their fever has broken. After that, they are free to leave isolation.”
President Trump defends response to COVID crisis in exclusive interview with Chris Wallace: This article is a transcript of the “Fox News Sunday," July 19, 2020 interview with the President. Read it in its entirety.
Trump Says He ‘Aced’ a Cognitive Test. What Does That Really Mean?: The article is not really a political comment but a good summary of the value of cognitive testing.
Erythrocyte omega-3 index, ambient fine particle exposure and brain aging: As we age, brain white matter shrinks. Air pollution makes it worse. In this study of women ages 65-80, consumption of omega-3s (largely from fish) mitigated these changes.
Blue states sue HHS over controversial transgender coverage rule:”A collection of 23 states is suing the Trump administration over a rule the states say eliminated healthcare protections for transgender Americans.
The states, which are led by California, Massachusetts and New York, argue in the lawsuit filed Monday that the rule finalized last monthviolates the Affordable Care Act (ACA)—which prohibits discrimination in federal healthcare such as Medicare, Medicaid and the exchanges—and the equal protection guarantee within the U.S. Constitution.”
We'll need enormous numbers of Americans to test COVID-19 vaccines; a 'very encouraging' 138,600 have signed up: The headline speaks for itself.
Social determinants of health amplify stroke risk in adults younger than 75 years:”Among adults younger than 75 years, those with multiple social determinants of health were at more than a 2.5-fold greater risk for stroke than those without any, according to new data from the REGARDS study.
Determinants most strongly associated with stroke were race, education, income, ZIP code poverty, health insurance, social isolation and residence in one of the 10 lowest-ranked states for public health infrastructure.”
Race, Postoperative Complications, and Death in Apparently Healthy Children: “Among 172 549 apparently healthy children, the incidence of 30-day mortality, postoperative complications, and serious adverse events were 0.02%, 13.9%, and 5.7%, respectively. Compared with their white peers, AA [African American]children had 3.43 times the odds of dying within 30 days after surgery (odds ratio: 3.43; 95% CI: 1.73–6.79). Compared with being white, AA had 18% relative greater odds of developing postoperative complications (odds ratio: 1.18; 95% CI: 1.13–1.23) and 7% relative higher odds of developing serious adverse events (odds ratio: 1.07; 95% CI: 1.01–1.14)…Mechanisms underlying the established racial differences in postoperative outcomes may not be fully explained by the racial variation in preoperative comorbidity.”
Double-Shot Covid Vaccines Multiply Immunization Challenges: “When it comes to protecting the world from the coronavirus, two doses of a vaccine may be better than one. But doubling the number of jabs each person needs could complicate efforts to immunize billions of people.
The latest results from front-runners in the sprint to come up with a vaccine, including the University of Oxford-AstraZeneca Plc partnership and Modern Inc.., highlight that prospect. Both efforts are conducting final-stage testing with two doses.”
Testimony of Macaya Douoguih, M.D., M.P.H. Head of Clinical Development and Medical Affairs, Janssen Vaccines and Prevention Johnson & Johnson: Submitted to the Oversight & Investigation Subcommittee of the U.S. House of Representatives Energy & Commerce Committee: In today’s prepared statement, J&J gave an update on its vaccine progress and made a promise that: “Johnson & Johnson is committed to bringing an affordable COVID-19 vaccine to the public on a not-for-profit basis for emergency pandemic use… We are committed to one price globally, regardless of country or income tier. The not-for-profit price will be for the emergency pandemic period.
Our not-for-profit framework is consistent with established vaccine costing methodologies. Our price will be determined based on one cost structure, with all appropriate costs included. We are pursuing external validation of our not-for-profit calculation approach and external audit / certification of not-for-profit price.”
Two Chinese Hackers Working with the Ministry of State Security Charged with Global Computer Intrusion Campaign Targeting Intellectual Property and Confidential Business Information, Including COVID-19 Research: This announcement came today from the Department of Justice. It is on the heels of the Russian hack last week.
About health insurance
Administration Eases Rules to Give Laid-Off Workers More Time to Sign Up for COBRA:”Under the federal law known as COBRA, people who lose their job-based coverage because of a layoff or a reduction in their hours generally have 60 days to decide whether to continue their health insurance. But under the new rule, that clock doesn’t start ticking until the end of the COVID-19 “outbreak period,” which started March 1 and continues for 60 days after the COVID-19 national emergency ends. That end date hasn’t been determined yet.
By extending the time frame to sign up for COBRA coverage, people have at least 120 days to decide whether they want to elect COBRA, and possibly longer depending on when they lost their jobs.”
About hospitals and health systems
The Effect of COVID-19 on Hospital Financial Health: KaufmanHall prepared this report for the AHA. —Before COVID-19 the median hospital margin was 3.5%
—Funding from the CARES Act (distributed April, May and June) is mitigating the negative financial “impact to a certain degree. Median margins are forecast to drop to –3% in the second quarter of 2020; however, those margins would have been –15% without CARES Act funding.”
—”In the most optimistic scenario, median margins could be –1% by the fourth quarter of the year. In a less optimistic scenario, margins could sink to –11%.” By then, half of all hospitals could have negative margins.