About Covid-19
Millions of Rapid Covid-19 Test Results Risk Going Uncounted: “Popular at-home Covid-19 tests from Abbott Laboratories and Quidel Corp., available without a prescription, were launched without a mechanism for reporting results to health officials, potentially leaving many cases uncounted by authorities as the delta variant spreads around the U.S.”
Labs unable to specify which COVID-19 variant patients have: “Despite recent COVID-19 surges largely due to the spread of the delta variant and vaccine hesitancy, most physicians and their patients are legally prevented from knowing which variant infected them because of regulatory hurdles…
That's because CMS requires genome-sequencing tests to be federally approved, a process that lab scientists say is too costly and time consuming to be done for every patient.”
Israel's COVID-19 vaccine boosters show signs of taming Delta: “The rate of disease spread among vaccinated people age 60 and over [the first group to receive a booster] - known as the reproduction rate - began falling steadily around Aug. 13 and has dipped below 1, indicating that each infected person is transmitting the virus to fewer than one other person. A reproduction rate of less than 1 means an outbreak is subsiding.”
Delta cases show 300 times higher viral load - S.Korea study: “People infected with the more transmissible Delta variant have a viral load 300 times higher than those with the original version of the COVID-19 virus, when symptoms are first observed, a South Korea study found.
But the amount gradually decreased over time - to 30 times in four days and over 10 times in nine days - and it matched levels seen in other variants after 10 days, the Korea Disease Control and Prevention Agency (KDCA) said on Tuesday.
The higher load means the virus spreads far more easily from person to person, increasing infections and hospitalisations, a health ministry official Lee Sang-won told a news conference.”
COVID-19 Transmission Dynamics Among Close Contacts of Index Patients With COVID-19: “In this cohort study of 730 index patients with a COVID-19 diagnosis and 8852 close contacts, transmission potential was greatest in the first 2 days before and 3 days after onset of symptoms in the index patient. When contacts received a diagnosis of COVID-19 infection, they were more likely to present asymptomatically if they had been exposed to an asymptomatic patient.”
It's Pronounced Koe-mir'-na-tee. How The Pfizer-BioNTech Vaccine's Name Came To Be: “The name ‘represents a combination of the terms COVID-19, mRNA, community, and immunity, to highlight the first authorization of a messenger RNA (mRNA) vaccine, as well as the joint global efforts that made this achievement possible with unprecedented rigor and efficiency — and with safety at the forefront — during this global pandemic,’ Pfizer and BioNTech said.”
American Academy of Pediatrics Cautions Against Off-Label Use of COVID-19 Vaccines in Children Under 12: “While the FDA is considering full approval of the vaccine for ages 12 through 15, it is available under emergency use authorization for this age group now, and AAP strongly recommends all eligible adolescents be vaccinated as soon as possible. The data from clinical trials and experience with the vaccine over the past four months in these adolescents show that it is safe and very effective in this age group, said Dr. Beers.
The dose of the adult vaccine is much higher than the doses being tested in children younger than 12.
Yvonne Maldonado, MD, FAAP, chair of the AAP Committee on Infectious Diseases, urged physicians to wait until the clinical trials are complete in children to give the vaccine to those under 12.”
Association of the COVID-19 Pandemic With the Prevalence of Homebound Older Adults in the United States, 2011-2020: “Between 2011 and 2020, the prevalence of homebound adults aged 70 years or older more than doubled, from approximately 5.0% from 2011-2019 to 13.0% in 2020. In 2020, an estimated 4.2 million adults aged 70 years or older were homebound compared with 1.6 million in 2019. The prevalence of being homebound in 2020 was greatest among Hispanic/Latino individuals (34.5% homebound compared with 12.6%-17.2% in prior years), followed by Black non-Hispanic individuals (22.6% homebound compared with 6.9%-9.9% in prior years) and White non-Hispanic individuals (10.1% homebound compared with 3.7%-6.0% in prior years).”
With Pfizer's COVID-19 vaccine approval, 145 health systems now require mandatory vaccination for their workforces: “Organizations that have taken the leap include major names like Kaiser Permanente, Trinity Health, Banner Health, Atrium Health and the Veterans Health Administration. Across the board, the policies of these and other providers include exemptions for medical, religious or other legally protected reasons.
At the same time, some health systems that are encouraging staff to vaccinate are holding back on making it a hard requirement.
Ballad Health CEO Alan Levine, for instance, told local press that forcing shots on the 22-hospital system’s remaining 38% of unvaccinated workers would likely exacerbate an ongoing nursing shortage.”
What if the federal government made hospital worker vaccinations a requirement of participation for Medicare, just as it does for nursing home personnel?
About hospitals and health systems
Advocate Aurora's net income, revenue bounce back in Q2: “Although much of its $739 million second-quarter net income came from its investments, Advocate Aurora Health also saw consistent gains across its operating income, overall revenue and operating margins.”
See the article for more details. Fortunately for hospitals, their investments buffered losses due to reduced volumes of profitable services caused by the pandemic.”
A Century of Care: This year is Cleveland Clinic’s 100th anniversary. It is worthwhile to review its history and mission on this site.
About pharma
FDA to Launch New Board to Improve Monitoring of Supply Chain: “The FDA’s Center for Drug Evaluation and Research (CDER) is setting up a new board to strengthen pharmaceutical supply-chain monitoring in the wake of COVID-19-related drug shortages.
The Pharmaceutical Supply Chain Governance Board, which will get under way next month, is tasked with coordinating all CDER supply-chain initiatives and providing guidance and fixes for major supply-chain issues.”
Pharma's reputation drops again. Could it foreshadow a return to the bottom?: “Pharma's reputation continues to slide, now down to 53% of consumers who still hold a positive view. The decline began after a February high of 62% approval, down to 60% in May and then 56% in June—and now down three more percentage points, according to The Harris Poll.
The steady drip, drip of approval drops now adds up to an overall nine-point decline in six months.”
About healthcare professionals
Survey Finds Slight Increase in Physician Compensation and Sharp Decline in Productivity in 2020: “Data from the 34th annual AMGA Medical Group Compensation and Productivity Survey demonstrates the profound effect of COVID-19 on physician compensation. Though the survey, conducted by AMGA Consulting, found very modest increases in compensation, there were significant decreases in productivity, which can be directly tied to the pandemic. The data reveals the devastating economic impact of COVID-19 on healthcare provider organizations and indicates that they may need to rethink their compensation models in order to remain resilient in the face of future disruptions.”
Look at the Figures for specifics by specialty.
About health insurance
COVID-19 Flexibilities Reminder: From CMS: “In light of the recent surge of the COVID-19 delta variant and increased hospitalizations across the country, the Centers for Medicare & Medicaid Services (CMS) strongly encourages all Medicare Advantage Organizations (MAOs) to waive or relax plan prior authorization requirements and utilization management processes to facilitate the movement of patients from general acute-care hospitals to post-acute care and other clinically-appropriate settings, including skilled nursing facilities, long-term care hospitals, inpatient rehabilitation facilities, and home health agencies. The ability of hospitals to transfer patients to appropriate levels of care without unnecessary delays or administrative burdens is critical to ensuring that hospitals have open acute-care beds to treat patients requiring emergent care.”
Majority of Health Insurers Concerned Over No Surprises Act’s Impending Transparency Requirements: Yesterday, Zelis “released findings from a survey conducted in July 2021 that polled healthcare insurers to assess their current readiness and preparation plans to meet the requirements set by the No Surprises Act (NSA). The NSA seeks to protect patients from surprise medical bills and includes transparency requirements, including an Advanced Explanation of Benefits (AEOB) for members that applies to both in- and out-of-network care. The way the law is currently written, for any healthcare service, a provider must send the patient’s insurer an estimate of expected charges. With that information, the insurer creates an AEOB, including the patient’s out-of-pocket estimates, and sends it to the patient before the scheduled service.
The poll of more than 100 healthcare executives revealed that a majority of insurers are concerned about the NSA’s transparency requirements. The results indicate that:
Three-quarters of respondents (74%) are concerned about meeting the Advanced Explanation of Benefits (AEOB) requirements.
Nearly two-thirds (63%) don’t know how they’re going to obtain the provider estimates required for AEOBs.
More than half (58%) expressed uncertainty about their ability to obtain the additional data required for AEOBs.”
About the public’s health
Screening for Prediabetes and Type 2 Diabetes: “The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity. Clinicians should offer or refer patients with prediabetes to effective preventive interventions. (B recommendation)”