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Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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25 minutes ago, Royalfan5 said:

So on the livestock worries front, Cattle slaughter jumped from 70% of capacity to close to 80% today, hogs from 60% to about 85%, so decent progress on that front. 

I didn't know you'd become so important in these times of crisis, but you're doing a great job. Keep us up to date, we have meat to eat.

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hospital systems info

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Michigan’s Beaumont is one of the more financially stable hospital systems in the country, Fox said. Under normal conditions, the company earns about $16 million each month in net operating income. But after postponing elective surgeries, Beaumont is losing about $100 million a month, he said...

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Across Virginia, hospitals and health-care systems expect to lose a total of $600 million for the 30 days between late March and late April, said Julian Walker, spokesman for the Virginia Hospital & Healthcare Association.

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These experiences reflect the losses across the entire health-care system given the cancellation of nonessential procedures, analysts said. A typical hospital system with 1,000 beds and the ability to perform outpatient surgeries is predicted to lose around $140 million — half its operating revenue — over a three-month period, the Advisory Board, a consulting firm, reported this week.

 

WaPo: Cash-starved hospitals and doctor groups cut staff amid pandemic

Spoiler

 

Cash-starved hospitals and doctor groups cut staff amid pandemic


A medical professional from Children's National Hospital holds a coronavirus test specimen after administering a test at a drive-thru site for children 22 and under at Trinity University in Washington on April 2, 2020.
A medical professional from Children's National Hospital holds a coronavirus test specimen after administering a test at a drive-thru site for children 22 and under at Trinity University in Washington on April 2, 2020. (Drew Angerer/AFP/Getty Images)
By 
Shane Harris, 
Justin Sondel and 
Gregory S. Schneider 
April 9, 2020 at 10:05 p.m. CDT
Hospitals across the country have deferred or canceled non-urgent surgeries to free up bed space and equipment for covid-19 patients. But that triage maneuver cut off a main source of income, causing huge losses that have forced some hospitals to let go of health-care workers as they struggle to treat infected patients.

Last week, Bon Secours Mercy Health, which runs 51 hospitals in seven states, announced it would furlough 700 workers. On Wednesday, Ballad Health, which operates 21 hospitals across Tennessee and southwest Virginia, delivered the same bad news to 1,300 employees and said executives would take pay cuts. Employees at Children’s National Hospital in the District were informed this week that they must take off one week, using either vacation time or, if they have none, unpaid leave.

Hospital executives and analysts emphasize that not all the furloughed or fired workers are directly involved in treating covid-19 patients. Others say the furloughs help reduce the number of people in hospitals, slowing the spread of the virus.

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But the absences have put a strain on doctors, nurses and other health-care workers treating a surge of patients that has already stretched some health-care systems to the breaking point. Remaining front-line workers face longer hours, and some have seen their pay cut and benefits reduced.

For hospitals already in bad financial shape before the outbreak, the loss of income has raised doubts about their ability to keep treating patients.

As coronavirus spreads, rural hospitals are running out of money
Three Rivers Hospital in rural Washington state doesn’t have any coronavirus patients yet, but the outbreak has put the facility in financial straits. (Lee Powell, Tim Matsui/The Washington Post)
“I’m concerned about the [financially] weakest 25 percent of hospitals, because there’s no way the other hospitals can absorb their covid patients,” said John Fox, the CEO of Beaumont Health, Michigan’s largest hospital system.

Sign up for our Coronavirus Updates newsletter to track the outbreak. All stories linked in the newsletter are free to access.

“If they start going down, that changes the whole algebra for the size of the system to handle the pandemic,” Fox added. He worries that a surge in patients could overwhelm more stable hospitals. “That’s when you’re treating people on the front lawn.”

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It has also made it harder for some hospitals to finance the considerable costs of treating covid-19 patients — from efforts to purchase personal protective equipment and ventilators to setting up drive-by testing sites.

A report this week by the Inspector General for the Health and Human Services Department blamed the cash crunch for ill-timed layoffs and furloughs.

“Hospitals reported laying off staff due to financial difficulties, which further exacerbated workforce shortages and the hospitals’ ability to care for covid-19 patients and the routine patient population,” the IG found.

“One administrator stated that it had been ‘an absolute financial nightmare for hospitals.’ ”

Michigan’s Beaumont is one of the more financially stable hospital systems in the country, Fox said. Under normal conditions, the company earns about $16 million each month in net operating income. But after postponing elective surgeries, Beaumont is losing about $100 million a month, he said.

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John Starcher, the chief executive of Bon Secours, told employees that system also was hemorrhaging about $100 million a month.

Across Virginia, hospitals and health-care systems expect to lose a total of $600 million for the 30 days between late March and late April, said Julian Walker, spokesman for the Virginia Hospital & Healthcare Association.

These experiences reflect the losses across the entire health-care system given the cancellation of nonessential procedures, analysts said. A typical hospital system with 1,000 beds and the ability to perform outpatient surgeries is predicted to lose around $140 million — half its operating revenue — over a three-month period, the Advisory Board, a consulting firm, reported this week.

Further complicating problems has been the need to finance the purchase of additional equipment to protect staff and prepare for coronavirus patients.

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Facilities have spent large sums to create negative air pressure rooms, so infected patients can be effectively isolated from those who have not contracted the virus. Many have also set up drive-through clinics and tent facilities, further depleting their coffers, the IG found.

“Hospitals noted sharp increases in prices for some equipment,” with one administrator reporting that masks that normally cost 50 cents each now sell for $6. Some hospitals are concerned vendors are buying up supplies to sell them at a higher cost, the IG found.

Fox said he has seen price spikes for both goods and labor. In places where skilled workers are in demand, for instance, agency rates for nursing staff have doubled in the past three weeks, he said.

As part of the stimulus package enacted last month, the federal government has allocated $100 billion to hospitals and some other health providers to help offset lost income, pay for the construction of temporary facilities and retrofits and to buy equipment and supplies.

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But health-care executives and analysts doubt that will be sufficient. That $100 billion pot is about equal to total hospital industry revenue per month, according to the Advisory Board. Hospitals expect to be treating covid-19 patients for several months to come.

“This is the first wave of this whole effort,” Fox, the CEO of Beaumont, said of the covid-19 aid.

Seema Verma, Administrator of the Centers for Medicare and Medicaid Services.
Seema Verma, Administrator of the Centers for Medicare and Medicaid Services. (Andrew Harnik/AP)
This week, the Trump administration will begin to roll out the first $30 billion as grants to hospitals, which will come with “no strings attached,” Seema Verma, the administrator of the Centers for Medicare & Medicaid Services, announced on Tuesday. Coupled with other aid, $64 billion in assistance to hospitals will be dispensed this week, some of it directly deposited into hospital bank accounts, she said.

Fox said he backs a recommendation by the American Hospital Association, a trade group, that health systems in coronavirus “hot spots,” including New York, Detroit, Washington and New Orleans, receive a lump sum of about $30,000 per bed to offset the money lost from elective procedures.

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“That would take care of April,” he said.

Asked how much he thought his hospitals would ultimately need, he replied, “Tell me how long the virus lasts, and I can answer that.”

Verma said hospitals would receive the first tranche of aid based on the volume of services they bill for Medicare patients. “This is not on a first-come, first-serve basis,” she said.

But that could leave hospitals that treat more people on Medicaid, or who have no insurance, without an immediate boost when they are hemorrhaging cash.

The approach “could tilt the playing field against” hospitals that primarily serve low-income and uninsured patients, Bruce Siegel, the president and CEO of America’s Essential Hospitals, said in a statement. “It is especially concerning because their narrow margins and front-line role mean these hospitals are among those in greatest need of funding support.”

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Verma said a second tranche of funds would go to providers that do not get large sums from Medicare, including pediatricians and children’s hospitals.

Hospitals are also concerned that the administration’s pledge to cover the cost of covid-19 treatment for uninsured Americans will take a big bite out of the $100 billion allocated to them. That cost has been estimated at up to $42 billion by the Kaiser Family Foundation, a nonpartisan research group.

It is not just hospitals feeling the crunch. Family physicians, pediatricians, internists and other doctors who make their money from in-person visits have seen their business dry up because patients are staying home, putting off checkups or putting elective procedures on hold.

In the days after social distancing guidelines were put in place in Oregon, the Grants Pass Clinic reduced its workforce by about 30 percent, including providers and other staff, said CEO Christi Siedlecki.

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The clinic recently laid off a physician Siedlecki hopes will become a partner in the practice one day. “Furloughing him risks our future,” she said.

Siedlecki said the practice is still deciding whether to apply for money from the Paycheck Protection Program, another part of the stimulus that will provide up to $350 billion in loans to companies that keep employees on their payrolls during the pandemic. (Primary care doctors are not eligible for the $100 billion set up to help hospitals.)

But she and other primary care executives worry those government loans might not be forgiven. “Even loans without interest, somebody has to pay those loans,” she said.

Still, for many doctors, that may be their only option.

“A lot of these small primary care practices just don’t have weeks to wait for cash to get to them,” said Shawn Martin, a senior vice president of the American Academy of Family Physicians.

David Pawlowski of Highgate Medical Group in Amherst, N.Y., a partner physician in a practice of about 100 employees, said his group has laid off about 40 percent of the workforce. The practice had gone from seeing about 250 patients each day to just five.

Pawlowski said he and his partners felt pressure to see more patients but ultimately made the decision to reduce to a skeleton staff and deliver as much care as possible electronically.

“We knew we couldn’t keep that going because it’s not the right thing to do to bring people in with chronic disease and having them exposed to us and us exposed to them,” he said.

“It’s really changed in a way I never thought medicine could be changed in the last few weeks,” he added. “It’s almost like a bad dream.”

Medical personnel move a deceased patient to a refrigerated truck serving as makeshift morgues at Brooklyn Hospital Center on April 9, 2020, in New York City.
Medical personnel move a deceased patient to a refrigerated truck serving as makeshift morgues at Brooklyn Hospital Center on April 9, 2020, in New York City. (Angela Weiss/Agence France-Presse/Getty Images)
Sondel reported from Buffalo, and Schneider reported from Richmond.

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Headshot of Shane Harris
Shane Harris
Shane Harris covers intelligence and national security for The Washington Post. He has been a writer at the Wall Street Journal, the Daily Beast and Foreign Policy, among other publications. He has written two books, "The Watchers" and "@War," and is a national security analyst for CNN. Follow
Headshot of Gregory S. Schneider
Gregory S. Schneider
Greg Schneider covers Virginia from the Richmond bureau. He was The Washington Post's business editor for more than seven years, and before that served stints as deputy business editor, national security editor and technology editor. He has also covered aviation security, the auto industry and the defense industry for The Post. Follow

 

 

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2 minutes ago, closetojumping said:

 

I don't think it's unreasonable or irresponsible to view handling things in low-infection places like Texas differently than in NYC or the tri-state + MI + LA. The bottom line is that there's no reason to believe that Texas has anywhere close to 10% of the total population infected right now. No markers indicate that in any form.

So sure, isolate when you have symptoms, get tested, let everyone you know that you've been around that you got it, and ride it out and hope they do too. Keep the social distancing. Forbid the large gatherings. Keep school closed. But feeling like everyone should be getting tested in a place that isn't a hot spot seems pointless. Let people do it if they want, but even that creates some sort of bizarre sense of security that is dangerous. Like I said, "not infected" means nothing when facing your next new interaction unless you've had a confirmed positive antibody test along with it. 

Obviously, with 40+% of tests showing positive in the tri-state, they should be testing everyone they can and anyone living there should be assuming they've got it or had it and get the tests as soon as possible.

I don't think testing every single person has ever been goal. I'm not sure where you got that. The goal is to have enough testing so that we can test everyone that needs it (e.g., those with symptoms or who have been in contact with someone who was positive). 

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3 minutes ago, Dahobbs said:

I don't think testing every single person has ever been goal. I'm not sure where you got that. The goal is to have enough testing so that we can test everyone that needs it (e.g., those with symptoms or who have been in contact with someone who was positive). 

Which is what I already accounted for, but you had to post right through it out of an addiction to pedantry. 

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25 minutes ago, closetojumping said:

 

I don't think it's unreasonable or irresponsible to view handling things in low-infection places like Texas differently than in NYC or the tri-state + MI + LA. The bottom line is that there's no reason to believe that Texas has anywhere close to 10% of the total population infected right now. No markers indicate that in any form.

So sure, isolate when you have symptoms, get tested, let everyone you know that you've been around that you got it, and ride it out and hope they do too. Keep the social distancing. Forbid the large gatherings. Keep school closed. But feeling like everyone should be getting tested in a place that isn't a hot spot seems pointless. Let people do it if they want, but even that creates some sort of bizarre sense of security that is dangerous. Like I said, "not infected" means nothing when facing your next new interaction unless you've had a confirmed positive antibody test along with it. 

Obviously, with 40+% of tests showing positive in the tri-state, they should be testing everyone they can and anyone living there should be assuming they've got it or had it and get the tests as soon as possible.

The Tri-State area needs both, and they need them to be home based.  I would love to get an antibody test (not sick, nor feeling sick, so not going to have a swap shoved into my brain), but I am not going ANYWHERE near a healthcare facility at this point.  

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17 minutes ago, closetojumping said:

Which is what I already accounted for, but you had to post right through it out of an addiction to pedantry. 

You seemed to be suggesting that there was a broader push for "everyone" to get tested. I responded that I didn't think anyone was seriously making that argument. The rest of your post seemed reasonable. Sometimes a post is a just a post and not an attack.

Edited by Dahobbs
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There are way too many 60+ that would not abide by that order if the rest of society is doing it's thing. There are also a lot of dumbfuck under 60s that would go see relatives and what have you. Finally, if the virus is allowed to run essentially unchecked through the under 60 population, you're still going to get a ton of hospitalizations and critical care patients that would stress the system just due to thr sheer size of the population. Even five percent of the under 60s needing hospital care is a very large amount of people. And you'd have your hospitalizations from things like car crashes coming back up.

I get where people are coming from when they say this but it seems unrealistic.


Where did you get 5%?
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20 minutes ago, EuroHorn said:

Here’s some hopeful music from around the world including ATX

 

 

 

Grown, adult males who voluntarily choose to go by the name Robbie are almost without fail serial killers or some other kind of emotional deviant. 

Edited by SydneyCarton
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3 minutes ago, Pato del Muerto said:

Well I ordered a half hog and quarter beef yesterday so you’re all welcome. 

No one here wants to read about your sexual preferences. That niche is already filled, neigh overflowing, thanks to Vic Mackey and Iconoclast Texan. 

Edited by SydneyCarton
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56 minutes ago, Royalfan5 said:

They can try and reopen their football program while they are at it, since it’s been closed for the last three years.  

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On a bacon note, belly values are up 16 bucks over the last 5 days, but remain very cheap for this time of year. The rebound in run rates was good news today, but will need to hold for the next few days to make everyone feel better. My hunch is that some of the slowdown is semi-wild cat strikes, and the packers are going have open their wallets to keep it going.

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3 minutes ago, Royalfan5 said:

I’m much more interested in knowing if we are going do anything useful for public health with the money we’re not sending the WHO. 

Probably going to be thoroughly wasted elsewhere, but at least it won't be going to the WHO

 

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3 minutes ago, utee94 said:

Probably going to be thoroughly wasted elsewhere, but at least it won't be going to the WHO

 

What the hell has The Who done to you? Pretty decent band in the day. 
I laugh cause I guy I used to work with was a great cello player that had toured with Joe Ely. His wife and my wife also worked together. He was crushed the day he found out Townsend was bi. 

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7 minutes ago, Shaddie said:

What the hell has The Who done to you? Pretty decent band in the day. 
I laugh cause I guy I used to work with was a great cello player that had toured with Joe Ely. His wife and my wife also worked together. He was crushed the day he found out Townsend was bi. 

Because he missed his chance?

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Had a patient confirm to me this morning that TXDPS is indeed following up with people who are flying in from out of state. They're making you fill out a form ordering you to shelter in place for 14 days and a DPS officer is calling/visiting at home to make sure you're complying. Scary stuff.

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1 minute ago, HRSchenker said:

Had a patient confirm to me this morning that TXDPS is indeed following up with people who are flying in from out of state. They're making you fill out a form ordering you to shelter in place for 14 days and a DPS officer is calling/visiting at home to make sure you're complying. Scary stuff.

Hi, we're from TXDPS.....

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So Dallas had a large bump in deaths today (+10 to 42 total) but that was to be expected given it's a lagging indicator.  I didn't post Friday as I was busy, but the hospital data from last Friday and today confirm that the spread is currently under control in Dallas (64 fewer hospital admissions on a week over week basis).  I heard local officials indicate today that they don't anticipate any need for the pop up hospital at the convention center given the current significant excess capacity.   So from purely a "flattening the curve" perspective, Mission Accomplished?!   I also haven't heard anything locally about lacking PPE which is good.  But our testing still pretty much sucks and nothing gives me confidence we'll have anything resembling sufficient testing and ability to contact trace anytime soon. So I'll be interested to see what local officials roll out because at this point the only think holding back easing of restrictions is (i) an actual plan and (ii) inability to widely test/contact trace (which of course, is pretty important).   So what plan will we see given the latter?  It will be interesting, and they better have something ready sooner rater than later as people start realizing this.

 

Total Hospital Admissions (the numbers below aren't current, rather they are the aggregate as of each date including those that have been released or died)

3/24:  61

3/27: 111

3/31:  192 

4/3:  290 

4/7: 383 

4/10: 431 

4/14:  510 

ICU Admissions

3/24:  21

3/27: 40 

3/31:  59 

4/3:  89 

4/7: 119 

4/10: 142 

4/14: 173

 

Vents

3/24:  9

3/27: 23 

3/31: 42 

4/3: 56 

4/7: 72 

4/10: 83

4/14:  102 

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17 minutes ago, HRSchenker said:

Had a patient confirm to me this morning that TXDPS is indeed following up with people who are flying in from out of state. They're making you fill out a form ordering you to shelter in place for 14 days and a DPS officer is calling/visiting at home to make sure you're complying. Scary stuff.

Easy work around for north Louisiana,  go thru Texarkana

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47 minutes ago, HRSchenker said:

Had a patient confirm to me this morning that TXDPS is indeed following up with people who are flying in from out of state. They're making you fill out a form ordering you to shelter in place for 14 days and a DPS officer is calling/visiting at home to make sure you're complying. Scary stuff.

So I flew from DFW to ABQ Monday. Sign as exiting gates was New Mexico was having 14 day quarantine. Grabbed luggage and went to customer. Nobody checked shit. 

Edited by Shaddie
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6 hours ago, PenelopeWitherspoon said:

The Tri-State area needs both, and they need them to be home based.  I would love to get an antibody test (not sick, nor feeling sick, so not going to have a swap shoved into my brain), but I am not going ANYWHERE near a healthcare facility at this point.  

I think the anti-body test is a prick of the finger. Also, the newer, 15-minute COVID-19 tests do not sound as invasive as the swab through the back of your head.

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Just now, C-Man said:

I think the anti-body test is a prick of the finger. Also, the newer, 15-minute COVID-19 tests do not sound as invasive as the swab through the back of your head.

Yes, the antibody test is a prick of the finger.  And that can be done via a home kit.  They have home kits for diabetics.  

The lack of movement on all fronts on testing is a fucking embarrassment.  

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1 minute ago, PenelopeWitherspoon said:

Yes, the antibody test is a prick of the finger.  And that can be done via a home kit.  They have home kits for diabetics.  

The lack of movement on all fronts on testing is a fucking embarrassment.  

The issue with antibody test is amount of antibodies in blood. Nobody has determined amount to be safe from re-infection 

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  • hayden_horn changed the title to Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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