Better Living Through Well Being
In just the few months since our last quarterly eNewsletter, the novel coronavirus (COVID-19) pandemic has led to sweeping changes and disruptions in nearly every aspect of daily life for us all. I hope you are all well, and that you and your family and friends are keeping safe and healthy.
Far more dangerous than the common flu, the COVID-19 pandemic is a human tragedy, affecting millions of people, and increasingly having an impact on the global economy. With mandates and guidelines changing all the time, it’s easy to feel overwhelmed by our own anxieties. It is important to practice empathy during this time, not only for others, but for yourself as well.
Take heart in all acts of kindness, both those you practice yourself and those you observe. Keep listening to the scientists and health professionals, and follow their good advice while we all wait for widespread availability of diagnostic and antibody testing, effective antiviral treatment and vaccine. Please join me in expressing thanks to all the frontline and essential workers in our society, for the work they do at risk to themselves and their loved ones. To them I say, “Your dedication, commitment and courage deserve our deepest gratitude and admiration.” May they continue to be given the protection they need to do their work.
This outbreak is moving quickly, and some of the perspectives in this eNewsletter may fall out of date soon as well, but I hope the information here will be useful and also give hope. The first testing in humans of an experimental vaccine for the novel coronavirus began in Seattle in March, and other vaccines are in the works in various laboratories.
I cannot remember a time when it has become so clear so fast how everything we do impacts someone else, and how we are truly all in this situation together. Social distancing efforts are saving lives. They are also causing us much hardship, but we do them because we love our family members and friends and don’t want to lose them. So now, in the midst of an alarming rate of transmission and infection of COVID-19, family physicians implore Americans to stay home and help stop the spread.
In early March, Washington State began implementing increasing levels of social separation to stem the spread of COVID-19, including closing schools and prohibiting gathering of large groups, and eventually requiring nonessential workers to stay home. Soon similar policies were put in place across the U.S. Computational modeling data from Seattle’s Institute for Disease Modeling and Bill and Melinda Gates Foundation show evidence of the effectiveness of these strict containment strategies. The modeling indicates how generic “social distancing” can overcome the spread of COVID-19, but only if 75 percent reduction in person-to-person contact is achieved. The State of Washington has seen great success in flattening the curve of coronavirus cases as a result of the social distancing measures.
Governor Inslee now anticipates a “phased approach” for the reopening of the state’s economy, by using more of a “dial” than a “light switch.” This will require continued controlled use of social distancing methods along with mass testing and contact tracing to reopen where appropriate while being sure to protect the most vulnerable people.
Governors of the West Coast (California, Oregon, Washington) are now collaborating in a shared vision for reopening their economies and controlling the coronavirus in the future. Their framework will be based on the common understanding that residents’ health comes first, that decisions will be made based on science - not politics, and that the states will only be effective by working together.
With more than 90 percent of the U.S. population under some form of stay-at-home order, a recent mental health study looked at the mental health of Americans during the pandemic. There was already a mental health crisis in America before the pandemic due to high demand and limited resources. The pandemic appears to be making it worse in terms of negative consequences of isolation: anxiety, depression, and suicidality. People who are having trouble securing the basics of living can be distracted from self-care during their fight to stay safe, healthy, fed, sheltered, and employed. These concerns can exacerbate existing mental health problems. This is a tough time for many and emphasizes the importance of remaining hopeful and optimistic.
Many mental health clinics offer telehealth sessions as an alternative to in-person therapy, and it is felt to be equally effective. One mental health network is reporting a 475 percent increase in their use of telehealth sessions for their patients. Americans should know that mental health providers are available and offer solutions that work, and that they can be trusted to meet our mental health needs during this pandemic health crisis.
A team of health management associates, health economists, and data analysts have calculated the approximate change in health insurance coverage by state caused by economic disruptions of COVID-19. Unemployment rates are projected to rise as high as 25 percent of the population. There will be a significant shift from the number of Americans covered by employer provided insurance to some form of Medicaid or a Marketplace plan.
In addition to Medicaid enrollment expanding, millions of people could enroll in a Marketplace plan after losing their employer-sponsored coverage, but millions could also leave the Marketplace due to lower income. What we are seeing is unprecedented. This is the first economic downturn since Medicaid expansion, and the influx of individuals enrolling in the Marketplace and Medicaid will require significant implementation efforts by state governments, managed care organizations, and providers.
A new report identifies at-risk individuals and maps them against the locations of intensive care unit (ICU) beds. It predicts highest risk areas in order to inform resource allocation and response during the COVID-19 crisis. It is important to note that there is significant variance within counties in terms of resources and presence of high risk populations. This data underscores the need for coordination among local public health officials and hospital administrators. Results of the study have been shared with local governments to inform plans for coordination of resources across areas of potential need.
This study follows the launch of a COVID-19 testing site finder tool, which is the first comprehensive directory of all 50 states.
Another report showing the cost of seeking care for COVID-19 across and within major U.S. cities found extreme variation in cost of COVID-19 evaluation across 12 cities, including Los Angeles, Dallas, and Miami.
Other articles of interest in this Spring 2020 TMIS eNewsletter:
* National online autism research initiative announces findings of an online survey of autism families, their shared disruptions related to COVID-19, and strategies for overcoming them.
* Responding to increased need for help, a premier in-home senior care company experiences tremendous job growth in the U.S. and becomes the first national in-home care organization to provide personal protection equipment for all its staffers.
* Clinical trial of experimental drug remdesivir treats people with serious COVID-19 complications.
* New study finds a third of the public believes in COVID-19 myths due to increased virus misinformation on social media.
* National Pharmacy Technician Association study prompts call to immediately require employers to take necessary actions and precautions to safeguard pharmacists and technicians on the frontline of the COVID-19 pandemic.
* Tencent Health joins with WHO to make open source COVID-19 Symptoms Self-Triage Assistant freely available online.
* National distributor pledges to provide protective masks at no profit to first responders and urges other sellers to join in the commitment.
I am grateful to be in a collaborative business with many talented and skilled professionals. Additional feedback and recommendations for our services at TM Information Services are always welcome.
- Mary Michele McLaughlin
From the Front Page of TMIS News
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Family Physicians Write "Prescription for America" to Stop Spread of COVID-19
The U.S. now has the highest number of known COVID-19 cases in the world with projections showing that U.S. deaths may soon surpass other countries as well. As the rate of transmission grows exponentially, the American Academy of Family Physicians (AAFP) has shared a new campaign calling on all Americans to protect themselves, their communities and health care workers by staying home.
The Prescription for America campaign demonstrates how improper social distancing quickly leads to new infections, while offering a very simple action everyone can take to stop the spread: staying home. The video released by family physicians around the country highlights how common scenarios that seem harmless, such as going to a friend's house for game night or going for a walk with a neighbor, can accelerate the spread of the deadly virus. Family physicians urge everyone to follow doctor's orders to stop the spread and save lives with a "prescription to stay home."
"Staying home saves lives," said AAFP President Gary LeRoy, M.D. "The number of deaths we've seen from COVID-19 is devastating. Our patients, our friends and family, and our fellow health care workers are dying. In times of a pandemic, we depend on the public to stay off the streets to help keep us healthy so we can keep everyone else healthy. We are doing our best to treat our patients, but we need every American to help us out and stay home."
New data out of Seattle show evidence of the effectiveness of strict containment strategies. In the absence of a national lockdown, physicians are appealing directly to their fellow citizens to do their part and stay home.
Anxiety, Depression, Insomnia: New Study Reveals COVID-19 is Having an Impact on Americans' Mental Health
Cohen Veterans Network (CVN), a national not-for-profit philanthropic organization that operates 15 mental health clinics nationwide, has revealed findings of its America's Mental Health COVID-19 Pulse Study, which looked at the mental health of Americans during the pandemic. With more than 90 percent of the U.S. population under some form of stay-at-home order, and social distancing in place until at least April 30, the situation is beginning to impact the mental health of many Americans. The survey of more than 2,000 U.S. adults offers a comprehensive snapshot of the mindset of Americans surrounding mental health during the pandemic.
"We are beginning to see a significant impact on the mental health of everyday Americans as a result of the pandemic," said Cohen Veterans Network President and Chief Executive Officer Dr. Anthony Hassan. "Before the pandemic, there was already a mental health crisis in America, with high demand and relatively limited resources, the pandemic appears to be making it worse. And we know isolation can have negative consequences in terms of anxiety, depression, and suicidality."
HMA Model Provides Forecast of COVID-19 Impact on Medicaid, Marketplace, Uninsured
A model developed by Health Management Associates (HMA) assesses COVID-19's potential impact on health insurance coverage for each state and forecasts Medicaid enrollment could increase by 11 to 23 million across all states over the next several months.
A team of HMA Medicaid experts, health economists, and data analysts calculated the approximate change in health insurance coverage by state as a result of the economic disruptions primarily driven by COVID-19. With COVID-19 having the potential to cause unemployment rates to climb to anywhere from 10 to 25% of the population, HMA utilized three unemployment rate scenarios to estimate the impact on Medicaid, the ACA Marketplaces, employer provided insurance, and the uninsured.
All three scenarios result in a significant shift from the number of Americans covered by employer provided insurance to some form of Medicaid or a Marketplace plan. The number of people uninsured is estimated to reach 30 million in the lowest unemployment rate scenario and could climb to 40 million if the country experiences a 25% unemployment rate.
New Study of Americans At Risk for Severe COVID-19 Illness Shows More than a Quarter Lack Access to Adequate Intensive Care Resources
San Francisco, California
Castlight Health, Inc. has announced the results of a new report examining claims data from more than 6 million commercially-insured individuals to identify geographic populations at high-risk for COVID-19 illness relative to local capacity for intensive care. The study found that more than a quarter--28.4 percent--of high-risk Americans would likely have challenges accessing critical care resources during the COVID-19 pandemic.
Specifically, the study found that the metro areas surrounding Washington D.C., Detroit, New York City, Seattle, Atlanta, Charlotte, and Dallas are more likely to face scarcity of intensive care units and have high pre-COVID ventilator use, suggesting high-risk patients in these areas could see shortages of these critical resources.
"We know people at-risk for severe illnesses are dispersed across the U.S., and we know that ICU beds and ventilators are in short supply. This study allows us to project areas of highest need as the pandemic evolves," said Maeve O'Meara, CEO of Castlight Health. "Some of the most vulnerable populations are in cities that have yet to hit peak incidence of COVID-19, and this study can help provide the head start they need to prepare."
The study found 22.8 percent of the evaluated population had at least one clinical risk factor for severe illnesses with a COVID-19 infection, such as asthma, diabetes or high blood pressure. Age was highly associated with an increasing number of risk factors. The study also found that 19.2 percent of at-risk patients live in metropolitan areas with lower ICU bed availability, and more than ten percent live in areas with no ICU beds.
SPARK, the largest study of autism families in the U.S., announces findings on effects of COVID-19
New York, New York
When COVID-19 arrived in New York, Dr. Wendy Chung, principal investigator of the SPARK study and a physician in New York City, knew that this was a singular moment in time. She wanted to understand how the pandemic was affecting families with autism across the country -- in real time -- and then share what she found with the community. She sent SPARK study participants a quick but important survey. SPARK, the largest study of autism families in the United States, was designed to allow for this kind of rapid data collection and sharing of information.
"SPARK provides the infrastructure for the autism community to learn from each other and immediately share those lessons learned, even at times as challenging as this coronavirus crisis," says Chung. "We are learning at the community level, and scientists are partnering with us to understand the fundamental differences in the mind, brain, and behavior of individuals with autism. Even though we are apart in space, we are together in spirit."
Before SPARK, many families had never participated in autism research, and scientists struggled to find participants for their studies. SPARK fills this gap with over 230,000 participants currently enrolled, and counting. To date, SPARK has matched over 65,000 families with 60 outside studies on topics like services and treatment patterns, anxiety, and social skills. Importantly, SPARK also maintains, and is still recruiting for, the largest genetic data set of autism families to date. The purpose of this data set is to identify genes that are linked to autism. SPARK is currently analyzing DNA data from approximately 30,000 people who have autism and will share the findings sometime this year.
To learn how COVID-19 is affecting the autism community, on March 20, SPARK launched a massive online survey to almost 70,000 families, and within two weeks, received responses from over 8,000. The results show that many families are coming up with innovative and successful strategies to navigate therapies, education, and daily life, whereas others are struggling to handle the new challenges.
Senior Helpers Ramps Up Caregiver Hiring Amid COVID-19 Crisis
One impact of the COVID-19 pandemic has been a recommendation that seniors need to avoid public groups. According to the Centers for Disease Control and Prevention (CDC), seniors are exceptionally vulnerable to the novel Coronavirus and should avoid being out in public. This makes in-home care one of the safest options available for seniors today, which means more seniors are now staying in their homes and need assistance.
Senior Helpers, one of the nation's premier providers of personalized in-home care, is seeing the demand for its services increase and has begun hiring new caregivers in most markets across the U.S. to focus more on taking care of others. Thousands of seniors have been told to stay in their homes. Many of these seniors need care, and Senior Helpers is being called on to help.
Senior Helpers also recently announced an additional step to ensure its caregivers can deliver their services safely and effectively. Certified as a Great Place to Work, the company is the first, and so far the only, national in-home care provider to provide each franchise owner across its nationwide network with Personal Protection Equipment (PPE) designed to help ensure all caregivers and clients remain safe under its care amid the current pandemic.
"People want to keep their parents safe and follow the CDC's recommendation to have seniors avoid groups of people. This has translated into a significant increase in the need for in-home care," said Peter Ross, co-founder and CEO of Senior Helpers.
With health and safety in mind for both its staff and applicants, Senior Helpers is taking the unprecedented step of using corporate resources to ship every location the PPE that is needed. Further, the company will host virtual interviews and pre-hire sessions for a safe and effective hiring process for all new team members. In addition to traditional onboarding, every new caregiver will also complete extensive, updated training with courses such as Hand Hygiene, Infection Control, Influenza Prevention and Transmission-Based Precaution, among others.
"We place the safety and care of our team members and clients above all else," said Ross. "We are looking for great people who are interested in joining a great company in an industry that is projected to grow consistently over the next 30 years." Senior Helpers locations are currently hiring nationwide; for more information on how to apply, visit www.seniorhelpers.com/careers/apply-now.
Trial for Potential Coronavirus Treatment is Underway at Montefiore and Einstein
Bronx, New York
Montefiore Health System and Albert Einstein College of Medicine has joined a clinical trial to evaluate the experimental drug remdesivir to treat people who are hospitalized with severe COVID-19 infection. The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, is sponsoring the trial. This treatment has the potential to help people who have serious lung complications as a result of COVID-19. Recruitment for the trial began in March and is still underway.
Montefiore-Einstein is one of 46 testing sites nationwide and is the first site in New York State to open. NIAID launched the multi-center international effort to determine if remdesivir, a broad-spectrum antiviral drug, acts against COVID-19 viral infection. Remdesivir has shown promise in animal models of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), both caused by human coronaviruses.
The randomized, double-blind, placebo-controlled trial is being led by principal investigator Barry Zingman, M.D., professor of medicine at Einstein and clinical director, infectious diseases, in the Moses division of Montefiore Health System. The trial is "adaptive," meaning it can be modified to include other investigational treatments. "This flexibility allows us to add additional therapies to the trial step-by-step to improve treatment as the pandemic continues," said Dr. Zingman.
Trial participants are hospitalized patients with a laboratory-confirmed coronavirus infection and lung complications, including rattling sounds when breathing, a need for supplemental oxygen, abnormal chest X-rays showing pneumonia, or the need for a mechanical ventilator. People in the treatment group will receive 200 mg of remdesivir intravenously on the first day of their enrollment in the study and will receive another 100 mg each day for the duration of hospitalization, for up to 10 days total. The placebo group will receive an equal volume of a solution that resembles remdesivir but contains inactive ingredients.
A Third of The Public Believes in COVID-19 Myths: Social Media Use Linked with Increased Virus Misinformation
Misinformation can be dangerous even during times of relative calm, but during a health crisis like the current pandemic the stakes are much higher. Titled "Going Viral: How Social Media Is Making the Coronavirus Worse," a new study from the Reboot Foundation found that close to a third of the public may harbor false views about the pandemic.
"Defeating the coronavirus depends on an informed and conscientious public that will conform to social distancing guidelines; practice good hygiene; and avoid unnecessary trips away from home," says Helen Lee Bouygues, author of the report and head of the Reboot Foundation. "But so far the public's response has been mixed, and misinformation about COVID-19 are a big part of the problem."
To help understand the role misinformation is playing in the crisis, Reboot's study both surveyed members of the public to see how well they understood COVID-19 and analyzed social media posts about the virus. The survey included 1,000 participants, from a diverse range of ages and geographical locations. The team drew on information from the Center for Disease Control and Prevention and the World Health Organization.
National Pharmacy Technician Association Study Shows Majority of Pharmacy Technicians Feel Unsafe at Work Amid COVID-19 Pandemic, and Likely for Good Reason
New research shows pharmacy technicians feel unsafe working in pharmacy amid COVID-19 pandemic and that employers are not doing enough to protect the safety and well-being of the pharmacy staff, while also serving the needs of their patients. The survey, "COVID-19: A Survey of Pharmacy Technicians," compared the current workplace environment and opinions of U.S. pharmacy technicians working in a variety of practice settings to guidelines and recommendations for the protection of pharmacy personnel facing the COVID-19 pandemic.
Based on the findings, the majority of pharmacy technicians feel unsafe, unprotected, uninformed and ill-equipped as a result of a lack of resources and support from pharmacy employers, particularly in chain drugstores, mass-retail and grocery-store pharmacies. Independent community pharmacies and hospital pharmacies scored significantly better on the survey.
While only 26.1% of pharmacy technicians working in chain/mass/grocery-based retail pharmacies feel safe at work, 63.8% of those working in independent pharmacies and 52.8% of those working in hospital pharmacies reported feeling safe. Additionally, only 17.7% of pharmacy technicians working in chain/mass/grocery-based pharmacies feel that their employers are doing enough to protect the safety and well-being of the pharmacy staff, while also serving the needs of their patients, compared with 55.3% of pharmacy technicians working in independent pharmacies and 48.5% of those working in hospital pharmacies
WHO and Tencent Deepened Collaboration to Fight Against COVID-19 Through Open Source Digital Health Solutions
Tencent Holdings Limited has announced an action to deepen collaboration with the World Health Organization (WHO) via a US$10 million donation to WHO's COVID-19 Solidarity Response Fund, and an agreement to open source their digital health solutions to assist the global fight against the pandemic.
WHO Director-General Dr. Tedros Adhanom Ghebreyesus, and Tencent President Martin Lau made the announcement via video conference. "I warmly thank Tencent for its generous contribution to the COVID-19 Solidarity Response Fund. I look forward to the collaboration with Tencent on promoting the use of digital health tools in the fight against COVID-19 and for a healthier, safer, fairer world," said Dr. Tedros.
"The world is facing unprecedented challenges and needs to come together with great solidarity. WHO is leading and coordinating the global efforts, supporting countries to combat the pandemic. Tencent believes that global solidarity will help all of us fight the spread of COVID-19, and we will open source our digital health solutions in addition to making a donation to achieve this shared mission," said Martin Lau, President of Tencent.
Announced last month by WHO, the COVID-19 Solidarity Response Fund will help all countries, particularly those most vulnerable, at-risk, and with the weakest health systems, to prepare for and respond to the COVID-19 crisis by rapidly detecting cases, stopping transmission of the virus, and caring for those affected.
National Distributor Pledges No Profits On Sale Of Protective Masks To First Responders
In the midst of the global COVID-19 pandemic and in an effort to ensure access to protective gear to first responders, Galls, a national distributor of equipment to state and local first responders, has pledged to offer N95 and other protective masks to its public safety partners at no profit to the company.
The following is a statement from Galls CEO Mike Wessner:
"Galls and our 1500 employees across the country have proudly supported the needs of America's first responders for over 50 years. As the COVID-19 crisis has spread across the country over the past few weeks, we have increasingly been asked by many of our public safety partners to assist them in securing protective masks. We are working night and day to secure masks that are in short supply and desperately needed by our first responders. The reality is that we have seen a significant increase in the prices charged by manufacturers and distributors of these products across the world. This threatens the access our local first responders have to this equipment at a critical moment. As a result, we at Galls will not profit from the sale of these protective masks to our first responders and public safety partners. We are making this commitment for as long as it takes to see our country through this crisis, and urge other companies to join us in this pledge."
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