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Morning Briefing

Summaries of health policy coverage from major news organizations

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Monday, Jun 22 2020

Full Issue

Viewpoints: Most Of U.S. COVID Deaths Were Preventable With Faster Action; Are Americans Seeking Too Much Care?

Opinion writers and editorials focus on issues related to COVID-19.

More than 120,000 Americans have now perished from Covid-19, surpassing the total number of U.S. dead during World War I. Had American leaders taken the decisive, early measures that several other nations took when they had exactly the same information the U.S. did, at exactly the same time in their experience of the novel coronavirus, how many of these Covid-19 deaths could have been prevented? (Isaac Sebenius and James K. Sebenius, 6/19)

SARS-CoV-2, a coronavirus that humans have never before encountered, is causing hundreds of thousands of deaths around the globe. The emergence of new infectious agents is tragically part of the cycle of infectious disease. What is not part of that cycle are the many Covid-19-related deaths that occur because of our systemic failure to employ rapid diagnostic tools, something that health systems have long neglected 鈥 to our peril. Many deaths from Covid-19 mirror deaths from sepsis, which are also largely preventable with better diagnostic tools. Sepsis, the immune system鈥檚 out-of-control response to infection, often leads to organ failure and death. (Prabhavathi Fernandes and Steve Brozak, 6/22)

As stay-at-home orders ease and cities reopen for business, many doctors and hospital administrators are calling for a quick return of health care to pre-pandemic levels. For months now, routine care has been postponed. Elective procedures 鈥 big moneymakers 鈥 were halted so that hospitals could divert resources to treating Covid-19 patients. Routine clinic visits were canceled or replaced by online sessions. This has resulted in grievous financial losses for hospitals and clinics. Medical practices have closed. Hospitals have been forced to furlough employees or cut pay. Most patients, on the other hand, at least those with stable chronic conditions, seem to have done OK. In a recent survey, only one in 10 respondents said their health or a family member鈥檚 health had worsened as a result of delayed care. Eighty-six percent said their health had stayed about the same. (Sandeep and Jauhar, 6/22)

A new study finds that adding a simple steroid to the treatment of severe Covid-19 cases can significantly reduce deaths. That鈥檚 another milestone in the battle against the virus. It shows a path for reducing Covid deaths faster through medical innovation and for keeping the health-care system from being overwhelmed as the epidemic spreads. The U.S., unlike Europe and Asia, seems to have decided not to crush the virus but try to reduce its spread to a controllable level. The 30,000 cases diagnosed each day probably represent no more than 20% of the total infections. It鈥檚 a lot of virus, but mostly manageable, for now. It won鈥檛 stay that way. (Scott Gottlieb and Mark McClellan, 6/21)

Covid-19 is not a gender- or sex-neutral killer. Men are more likely than women to need intensive care for the disease or die of it. Among health care workers, however, the tables are turned: Women accounted for 73% of the more than 9,000 U.S. health care workers who had been infected with the novel coronavirus by early April. This gender/sex difference has been seen in other countries, and it isn鈥檛 because more women than men are on the frontlines of Covid-19 care. The design of personal protective equipment might be to blame. (Saralyn Mark, 6/19)

At the MGM鈥檚 Bellagio hotel and casino, patrons are welcomed with branded pouches stocked with hand sanitizer, face masks and a stylus they can use to push elevator buttons. At the Cosmopolitan鈥檚 elevated pool, an L.C.D. screen flashes the message, 鈥淔ace masks are the new tan lines.鈥滻n typical Las Vegas style, the hospitality industry is going overboard to make sure visitors feel safe, and to make the precautions the pandemic requires feel luxurious. Visitors can check in using their phones and take advantage of hand- washing stations. On the gambling floors, chips, cards and dice are disinfected between players. (Brittany Bronson, 6/21)

It's quiet in the laboratory, almost peaceful. But I'm holding live SARS-CoV-2 in my hands and this virus is not to be taken lightly. As I dilute the coronavirus to infect cultured cells, I hear the reassuring sound of purified air being blown by my respirator into my breathing space. There are three layers of nitrile and protective materials between me and the virus, and every part of my body is wrapped in protective equipment. Thanks to these precautions and other features of our high containment lab, I'm not nervous about being up close and personal with this dangerous pathogen. (Troy Sutton, 6/22)

That the Chinese government has significant culpability for the global spread of Covid-19 and needs to be held accountable for its misconduct should not be a partisan issue. We already know that the Associated Press has reported the Chinese government concealed critical facts about the emergence of the virus; that local officials silenced voices of warning; and that as a result, actions of Chinese officials most likely deprived the world early on of critical information about the virus' transmissibility and lethality. (James D. Schultz and Sean Carter, 6/20)

Alarming headlines about surging Covid-19 cases in some states dominated the news this week, but there was some good news: A University of Oxford drug trial found that a low-cost steroid can substantially reduce deaths in severely ill patients. As results from more studies roll in this summer, improved treatments could blunt the impact of any second wave. The randomized trial compared 2,100 hospitalized patients who received the steroid dexamethasone at low-to-moderate doses for 10 days with 4,300 controls receiving standard hospital care. Dexamethasone reduced fatalities among patients receiving supplemental oxygen by 20% and by a third among those on mechanical ventilators. The drug had no impact on less sick patients. (6/19)

It is not so much that Americans have given up. Rather, it is that their president has made coronavirus-spreading conduct a test of political loyalty. President Trump gleefully assembled in Tulsa thousands of his followers (albeit far fewer than he hoped). They were apparently too deluded to know they were putting their lives and the lives of their loved ones at risk by cramming into an enclosed arena without masks, just so Trump could bask in the glory of a red-state crowd. (The Post reported, 鈥淥klahoma reported 331 new coronavirus infections Saturday afternoon. The new cases put the state鈥檚 rolling average at 281, setting the average high record for the eighth day in a row. (Jennifer Rubin, 6/21)

America needs a national center for infectious disease intelligence whose mission is to monitor trends and provide a real-time interpretation of outbreak data through modeling, biostatistics, and data science. This idea has been bandied about at least since the Obama administration and reiterated recently in Johns Hopkins University鈥檚 reports A Road Map to Reopening and Modernizing and Expanding Outbreak Science.聽Such an agency may cost billions and take time to plan and implement, but we can take the first step now, which is to create a national network of the people and organizations where the essential talent lies. (John M. Drake, 6/21)

If you work for any number of public-facing small businesses 鈥 an auto body shop or a dry cleaner or a pizza place 鈥 your boss will need you back at work for the business to function, but interaction with customers will likely increase your risk of infection. (Drew Altman, 6/22)

Hospital restrictions on visitors during the COVID-19 era keep away a crucial support system of family and friends. (Nathan Gray, 6/22)

America鈥檚 economic and racial inequality, thin social safety nets and fragmented health care system are putting the most disadvantaged people at the greatest risk from COVID-19. Yet, in the midst of this crisis, there are inspiring examples of organizations that are transforming health care through trust-based relationships and community partnerships that provide whole-person care for people鈥檚 physical, economic and social needs. (Gary Hirsch and Kate Isaacs, 6/18)

Over the last few months, many patients have been in fear of their cancer journey. This fear had nothing to do with receiving their diagnosis or walking into a screening because of a found lump or increased risk. It wasn鈥檛 about dealing with the side effects of their chemotherapy, surgery, or radiation treatment. And, it was not caused by the stress felt when waiting for results from a significant medical test or scan. The fear was caused by our country鈥檚 myopic focus on flatting the COVID-19 curve. (Dr. Pat Basu, 6/18)

Like almost every part of the U.S. economy, healthcare providers have faced unprecedented challenges over how to operate during the COVID-19 pandemic. Rising costs and shrinking revenue have left many healthcare providers in a dire financial situation. The direct medical costs of COVID-19 patients are substantially higher than those of patients with other common infectious diseases. COVID-19 patients are more likely to require longer inpatients stays and more resources including intensive care, ventilator care and personal protective equipment. COVID-19 also requires more staff time for infection control. And staff require additional resources including overtime and hazard pay. (Lisa M. Grabert and David C. Grabowski, 6/17)

Some experts are warning of a looming mental health crisis in the wake of the Covid-19 pandemic that we are apparently ill-prepared for, and journalists are amplifying this message. Everyone, it seems, is depressed and there is a new health curve to flatten. We believe these warnings are being overdone, and definitely overlook the potential for post-traumatic growth (more on that in a minute). (Jay Behel and Jennifer A. Coleman, 6/22)

A new study shows a steroid, dexamethasone, improves the survival of some COVID-19 patients, especially those with severe forms of the diseases. These include some on ventilators and some who require oxygen.聽The study enrolled 2,100 participants who received dexamethasone at a low or moderate dose for ten days. The control group was 4,300 patients who received standard care for coronavirus infection. Results show a reduction in risks of dying by 30 percent in patients on ventilators and 20 percent in patients receiving oxygen.聽(Dr. Ifeanyi M. Nsofor, 6/19)

1920. 2020. A hundred years apart but closer than one might think. In 1920 the world was just recovering from the devastating influenza pandemic that shuttered schools, killed nearly 50 million people and laid waste to the economy. Just like now, an untried cure 鈥 aspirin 100 years ago, today hydroxychloroquine 鈥 did more harm than good, causing a number of unnecessary deaths. And chillingly, the previous summer, 1919, had seen a wave of racial violence across the U.S. and would become known as the Red Summer. Lynchings and anti-black violence forced African Americans to the streets to protest, and it was their actions that were branded dangerous and lawless, rather than the hate they were desperate to counter.聽(Philippa Levine, 6/17)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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