Three out of four health care workers infected are women
ACCORDING TO CDC data released in mid-April, more than 9,000 health care workers in the U.S. had tested positive for coronavirus and 27 had died.
Yet Kaiser Health News reports that commentators believe the true tally is actually far higher, and U.S. officials admit they have no system to provide a comprehensive count.
The CDC data, which were based on a sample of only 16% of covid cases in the country, found that the vast majority—73%—of infected health care workers were female with a median age of 42. For a more accurate count, the CDC is studying hospitals in 14 states and reviewing infection surveillance and media reports.
Meanwhile, a JAMA editorial published online last month proposed this bold response to the pandemic: Suspend the first year of medical school for the 20,000 incoming students slated to begin in July and enlist them instead in a national public health service program. After a month of training in infectious diseases epidemiology and control, those students would be deployed nationwide to help test, trace, track and isolate.
What’s happened to all the heart attacks?
HOSPITALISTS BRACING for a coronavirus surge also report that their regular medical census is way down. In a New York Times article, famed Yale cardiologist Harlan Krumholz, MD, wrote that hospitals, besides treating covid patients, are “eerily quiet.” The sharp drop in normal hospital volume can’t be explained by just the suspension of elective procedures; instead, heart attack and stroke patients aren’t showing up.
An informal Twitter poll in early April found that almost half (45.4%) of responding cardiologists said their number of MI/ACS admissions during the pandemic has fallen between 40% and 60%. Twenty-two percent reported a more than 60% reduction.
The most troubling explanation, Dr. Krumholz wrote, is that patients who have symptoms are too afraid to come to a hospital and risk becoming infected. Or social distancing and the adoption of new activity and food behaviors may be reducing MI and stroke triggers. “As we fight coronavirus, we need to combat perceptions that everyone else must stay away from the hospital.”
New CMS waivers aim to boost hospital capacity, resources
THE CMS has announced a host of temporary waivers, sweeping aside longstanding regulations to allow hospitals to ramp up capacity.
One suspended item: the much-hated three-day rule for SNF coverage. Inpatients who need SNF care no longer need to be hospitalized for at least three days, giving hospitals more flexibility at discharge.
The CMS has also waived its requirement that critical access hospitals can have only 25 beds and that length of stay in them must be limited to only 96 hours. Other changes: Hospitals may contract with ambulatory surgery centers to provide hospital services, including trauma surgeries and cancer procedures. Non-hospital buildings—such as hotels and dormitories—may be used for patient care and quarantine, and ambulances may transport patients to outpatient locations such as urgent care centers and physician offices.
As for boosting the health care workforce, the CMS is allowing hospitals to hire private practice providers, and it is waiving requirements that CRNAs must be supervised by physicians. Hospitals now also have a blanket waiver to provide staff benefits including meals, laundry service and day care.
Physicians who need to recertify in 2020 get a reprieve
DOCTORS WHO are supposed to complete MOC requirements this year are getting a pass from the ABIM, at least through next year.
In a letter from its president, the board last month announced that physicians will have through 2021 to complete any MOC requirements due this year, including assessments, point requirements or attestations, and that diplomates will not lose their certification. Further, doctors in their grace year will receive an additional year.
Other boards, including the ABFM, are following suit, as is the American Board of Pediatrics. While the pediatric board hasn’tt yet worked out the details of how it will ease deadlines and grant credits, its president said that pediatricians will get credit for the learning curve related to coronavirus and for that specialty’s “huge transformation in practice using telehealth.”
The American Board of Obstetrics & Gynecology is likewise giving credit to recertifying diplomates for recognition of the practice improvement they’re undertaking as they deal with the pandemic.Published in the May 2020 issue of Today’s Hospitalist