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Weekly Rounds 4-12-20


Doctors For America joined forces with several other national organizations insisting that EVERY Affordable Care Act exchange reopen enrollment periods to help reduce the number of newly uninsured who have lost jobs and with it their employer-provided insurance. The DFA further is calling for the expansion of Medicaid in states that have yet to do so.


SIGN THE PETITION: EVERY Affordable Care Act (ACA) exchange must reopen enrollment to ensure everyone has access to healthcare amid the coronavirus pandemic.


Thanks & keep up the tremendous work you are doing for your communities and our country.


DFA’s Dr. Ximena Levander: Covid-19 Will Worsen the Opioid Overdose Crisis If We Don’t Prepare Now - In cities across the country, morning is peak time at almost any opioid treatment program. The line stretches from the front counter to the back door as patients wait to get their daily dose of methadone. It’s an absolutely essential gathering, but one that runs counter to containing the Covid-19 outbreak. (Ximena A. Levander & Sarah E. Wakeman STAT)

DFA’s Dr. Steven Weisman:In-Person Voting Expected to Contribute to Spread Of COVID-19 -  “I sat at home, aghast, when I saw the images of my fellow citizens lining up with masks, some without,” noting some held signs “expressing their disgust with the way the citizens of our state were treated.”  (WisBusiness)


SPEAK THE TRUTH: Speak the truth. Speak it clearly. Speak it with compassion. Speak it with empathy for what folks are going through. The biggest mistake any [of] us can make in these situations is to misinform, particularly when we’re requiring people to make sacrifices and take actions that might not be their natural inclination,"  - President Obama

THAT’S NOT HOW BIOLOGY & RESEARCH WORKS: "The kind of normal where we go traveling, we go to restaurants, we go to concerts, we go to religious services, we go on cruises, until we have a vaccine that protects everyone. That's 18 months, it's not going to be sooner, Anyone who tells you we're going to have a vaccine in three or four months, that's just not the reality of how biology and research works,"  Dr. Zeke Emanuel, Special Adviser to the Director General of the World Health Organization - Oncologist, Bioethicist and Professor and Vice Provost at the University of Pennsylvania

SECOND WAVE: "What's really important is that people don't turn these early signs of hope into releasing from the 30 days to stop the spread — it's really critical, If people start going out again and socially interacting, we could see a very acute second wave very early." - Dr. Deborah Birx, White House coronavirus Response Coordinator

NO NATIONAL STRATEGY FOR TESTING:  “Unfortunately, states really are on their own, It’s problematic at best and egregious at worst, because some states have more resources than others; some states have more leadership than others.” - Joia Mukherjee, Partners in Health Medical Director

BLACK AMERICANS DISPROPORTIONATELY DYING FROM VIRUS:  “This outbreak is exposing the deep structural inequities that make communities pushed to the margins more vulnerable to health crises in good times and in bad, These structural inequities in our health care system do not ignore racial and gender disparities — and neither should our response to this pandemic.” - Dorianne Mason, the Director of Health Equity at the National Women’s Law Center

CALIFORNIA AS A NATION-STATE: “We've been competing against other states, against other nations, against our own federal government for PPE — coveralls, masks, shields, N95 masks — and we're not waiting around any longer,’ We decided enough is enough: let's use the power of the purchasing power of the state of California as a nation-state," - California Gov. Gavin Newsom

GOVERNOR INSLEE: "This is ludicrous, The surgeon general referred to Pearl Harbor. Can you imagine if Franklin Delano Roosevelt said, 'We'll be right behind you, Connecticut. Good luck building those battleships?'" - Governor Jay Inslee (D-WA)

GOVERNMENT WATCHDOGS: The Trump Administration seems to be engaged in a mass-culling of government watchdogs, which is a real threat to independent oversight, This appears to be part of an alarming trend by the Trump Administration to remove independent inspector generals and replace them with the president’s loyalists.” - United States Senator Jack Reed, Senate Armed Services Committee (D-RI)



The U.S. Was Beset by Denial and Dysfunction as the Coronavirus Raged - From the Oval Office to the CDC, political and institutional failures cascaded through the system and opportunities to mitigate the pandemic were lost. (Yasmeen Abutaleb, Josh Dawsey, Ellen Nakashima and Greg Miller, Washington Post)

Bill Gates to Spend Billions on Coronavirus Vaccine Development - Microsoft Corp. co-founder Bill Gates said his foundation will spend billions of dollars to fund the construction of factories for the most promising efforts to develop a vaccine to combat the novel coronavirus. (Jennifer Calfas, Wall Street Journal)

The Coronavirus Is Infecting and Killing Black Americans at an Alarmingly High Rate - As the novel coronavirus sweeps across the United States, it appears to be infecting and killing black Americans at a disproportionately high rate (Reis Thebault, Andrew Ba Tran and Vanessa Williams, Washington Post)

C.D.C. Releases Early Demographic Snapshot of Worst Coronavirus Cases - Approximately 90 percent of the 1,482 hospitalized patients included in the study released Wednesday had one or more underlying medical conditions. (David Waldstein, New York Times)

Haywire Immune Response Eyed in Coronavirus Deaths, Treatment - Researchers are looking at treatments to suppress ‘cytokine storm,’ increasingly linked to the most severe Covid-19 cases. (Joseph Walker, Jared S. Hopkins, Wall Street Journal)

6.6 Million Americans Filed for Unemployment Last Week, Bringing the Pandemic Total to Over 17 Million - Economists say the U.S. unemployment rate is now 13 percent, the worst since the Great Depression. (Heather Long and Andrew Van Dam, Washington Post)


‘We’re Being Put at Risk Unnecessarily’: Doctors Fume at Government Response to Coronavirus Pandemic - Now, there’s simmering anger, and a deep sense of betrayal among health professionals who say they feel forsaken by their government. (Meghana Keshavan, STAT)

How Did the U.S. End Up with Nurses Wearing Garbage Bags? - What followed over the next two weeks was an inside glimpse of the dysfunction emanating from Trump’s Washington in the midst of the pandemic, a crash course in the breakdown that has led to nurses in one of the wealthiest countries in the world wearing garbage bags to protect themselves from a virus whose outbreak the President downplayed until it was too late to prepare for its consequences. (Susan B. Glasser, The New Yorker)

Government Watchdog: Hospitals Face Severe Shortages of Medical Gear, Confusing Guidance from Government - Hospitals across the country face dire shortages of vital medical equipment amid the coronavirus outbreak — including testing kits and thermometers — and fear they can't ensure the safety of health care workers needed to treat patients with COVID-19, according to an internal government watchdog report released Monday. (Laura Strickler, Hannah Rappleye, Dan De Luce and Ken Dilanian, NBC News)

Rationing Protective Gear Means Checking on Coronavirus Patients Less Often. This Can Be Deadly. - Low on essential supplies and fearing they’ll get sick, doctors and nurses told ProPublica in-person care for coronavirus patients has been scaled back. In some cases, it’s causing serious harm. (Joshua Kaplan, Lizzie Presser and Maya Miller, ProPublica)


In the Absence of a National Testing Strategy, States Go Their Own Way - Three months into the coronavirus epidemic, the Trump administration has yet to devise a national strategy to test Americans for the deadly disease — something experts say is key to blunting the outbreak and resuming daily life. In the absence of a national plan, several states are developing their own testing systems, but the emerging picture varies widely. (Juliet Eilperin, Laurie McGinley, Steven Mufson and Josh Dawsey, Washington Post)

Unprecedented Nationwide Blood Studies Seek to Track U.S. Coronavirus Spread - The United States has launched an unprecedented effort as well. One serosurvey is already underway in six metropolitan areas, including New York City, the hardest hit city in the United States. A second, even larger one, is on its heels, and together they should give a strong nationwide effort to track closely how many Americans have become infected as the pandemic unfolds. Serosurveys may also help efforts to develop vaccines, and, separately attempts to devise therapies to stop the virus from causing harm. (Jon Cohen, Science)


Competing Hospitals Cooperate to Meet the Crisis - U.S. hospitals are cooperating in unprecedented ways. In addition to postponing elective surgeries and other procedures, they are transferring children from adult hospitals to pediatric hospitals and sharing staff, equipment and supplies. (Michael Ollove & Christine Vestal, Stateline)

Hospitals Open Grocery Stores for Providers Treating COVID-19 Patients - As frontline caregivers across the country struggle to treat a growing wave of coronavirus patients, hospitals are increasingly adding grocery stores with little or no cost markups so employees can grab the essentials on their way out. (Tara Bannow, Modern Healthcare)

Coronavirus Means Americans Are Finally Embracing Virtual Health Care  - Until now, the nation’s health-care system was slow to adopt new technologies allowing doctors, nurses and other medical providers to see or monitor patients remotely.  (Paige Winfield Cunningham, Washington Post)


Trump Administration Pushing to Reopen Much of the U.S. Next Month - The Trump administration is pushing to reopen much of the country next month, raising concerns among health experts and economists of a possible covid-19 resurgence if Americans return to their normal lives before the virus is truly stamped out. (Matt Zapotosky, Josh Dawsey, Jose A. Del Real and William Wan, Washington Post)

As Pandemic Deepens, Trump Cycles Through Targets to Blame - First, it was the media that was at fault. Then, Democratic governors came under fire. China, President Barack Obama and federal watchdogs have all had a turn in the crosshairs. And now it’s the World Health Organization that’s to blame. … There is no “The buck stops here,” like the sign once found on President Harry S. Truman’s desk. (Jonathan Lemire, Associated Press)

Trump Administration Says Front-line Workers Can Go Back to Work Sooner After Virus Exposure - The Trump administration Wednesday announced that health workers and other essential employees who have been exposed to the coronavirus will be allowed to go back to work instead of quarantining for 14 days. (Brianna Ehley, Politico)

Surprise Billing Banned for Providers That Get CARES Act Grants - The White House announced Thursday that providers receiving grants from the $100 billion aid fund in Congress' third stimulus package will be banned from balance billing patients for COVID-19 treatment. (Rachel Cohrs, Modern Healthcare)


Trump Quietly Shuts Down Asylum at US Borders to Fight Virus - The U.S. government used an obscure public health law to justify one of its most aggressive border crackdowns ever. People fleeing violence and poverty to seek refuge in the U.S. are whisked to the nearest border crossing and returned to Mexico without a chance to apply for asylum. It eclipses President Donald Trump’s other policies to curtail immigration — which often rely on help from Mexico — by setting aside decades-old national and international laws. (Maria Verza, Elliot Spagat and Astrid Galvan, Associated Press)


For Jobless Americans, Obamacare Is Still a Potential Lifeline - Millions of Americans losing their jobs may still be able to sign up for Obamacare — but Trump officials haven’t been urging people to grab onto that safety net while they can. … But Trump administration officials have done little to let people know how they can get covered under a health care law Trump has spent years trying to obliterate and is still fighting in the Supreme Court. Nor are they streamlining the sign-up system, which requires that people document that they’ve lost their jobs in order to qualify for coverage right now. (Susannah Luthi, Politico)

Coronavirus Double Whammy: Unemployed and Uninsured - While many of those people are now eligible for insurance through the Affordable Care Act (ACA) marketplaces or Medicaid, the White House isn’t promoting either of those options. (Jessie Hellmann, The Hill)


REACH OUT: If you get an opinion piece or letter to the editor published PLEASE send me (Pete Van Vranken - an email with a link to your piece and I will include it in the next edition of the Physician Rounds. Also please send me any feedback you may have on the “Rounds” - Much Appreciated - Pete

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