Wealthier hospitals stockpiling N95 masks leave nursing homes scrambling

Nursing homes, small physician offices and rural clinics are being left behind in the rush for N95 masks and other protective gear, exposing some of the country’s most vulnerable populations and their caregivers to COVID-19 while larger, wealthier health care facilities build equipment stockpiles.

Take Rhonda Bergeron, who owns three health clinics in rural southern Louisiana. She said she’s been desperate for personal protective equipment since her clinics became COVID testing sites. Her plight didn’t impress national suppliers puzzled by her lack of buying history when she asked for 500 gowns. And one supply company allows her only one box of 200 gloves per 30 days for her three clinics. Right now, she doesn’t have any large gloves on-site.

“So in the midst of the whole world shutting down, you can’t get PPE to cover your own employees,” she said. “They’re refilling stuff to larger corporations when realistically we are truly the front line here.”

More than eight months into the pandemic, health care leaders are again calling for a coordinated national strategy to distribute personal protective equipment to protect health care workers and their patients as a new wave of disease wells up across most of the country. The demand for such gear, especially in hot spots, can be more than 10 times the pre-pandemic levels. While supply chains have adjusted, and the availability of PPE has improved dramatically since the mayhem of the spring, limited factories and quantities of raw materials still constrain supply amid the ongoing high demand.

In this free-market scramble, larger hospitals and other providers are stockpiling what they can even while others struggle. Some facilities are scooping up supplies to prepare for a feared wave of COVID-19 hospitalizations; others are following new stockpiling laws and orders in states such as California, New York and Connecticut.

“They’re putting additional strain on what’s still a fragile hospital supply chain,” said Soumi Saha, vice president of advocacy for Premier Inc., a group-purchasing organization that procures supplies for over 4,000 U.S. hospitals and health systems of various sizes. “We want available product to go to front-line health care workers and not go into a warehouse right now.”

Related: A second surge of the coronavirus in the fall and winter could be catastrophic for the U.S. It’s not just more sick people that doctors worry about.

Over a quarter of nursing homes in the country reported a shortage of items such as N95 masks, gloves or gowns from Aug. 24 through Sept. 20. A recent survey from the American Medical Association found 36 percent of physician offices reported having a difficult time securing PPE. And about 90 percent of nonprofit Get Us PPE’s recent requests for help with protective gear have come from non-hospital facilities, such as nursing homes, group homes and homeless shelters.

“I can completely understand that large health systems don’t want to find themselves short on PPE,” said Dr. Ali Raja, co-founder of Get Us PPE and executive vice chairman of emergency medicine at

Read more

Repeal of Obamacare Could Leave Young Cancer Patients in the Lurch | Health News

By Cara Roberts Murez, HealthDay Reporter

(HealthDay)

THURSDAY, Oct. 22, 2020 (HealthDay News) — If Obamacare, or the Affordable Care Act (ACA), is repealed, pediatric cancer patients could lose critical insurance coverage, a new study warns.

Kids with cancer often require intensive treatment and long-term follow-up to beat the disease. The ACA allows them to stay on their parents’ insurance coverage to age 26 and bans exclusion of patients with preexisting conditions.

The U.S. Supreme Court is poised to rule on the future of the ACA this fall. Researchers at the University of California, San Francisco’s Benioff Children’s Hospital and the Children’s Hospital of Philadelphia studied the potential impact of dismantling it on 18- to 25-year-old cancer patients.

“We know that even brief disruptions in insurance have been associated with harmful health consequences,” said first author Dr. Lena Winestone, of the Helen Diller Family Comprehensive Cancer Center at UCSF. “Strict adherence to chemotherapy regimens, for example, is essential for those patients with acute lymphoblastic leukemia,” the most common pediatric cancer.

Researchers tracked patients born in 1982 or later who were diagnosed with cancer between 2000 and 2015. Most had leukemia, lymphoma or tumors of the brain or spine.

The investigators contrasted insurance status in four age groups, including a group who turned 19 within two years of the ACA’s adoption. They were matched by cancer type, diagnosis date, demographics and treatment characteristics to patients who were two years older and, therefore, unprotected by the ACA.

They did similar comparisons with patients who were 23 to 25 years of age and between 26 and 28 when the ACA went into effect.

The average time to end of coverage was 26 months, compared to 22 months for the older group — a 15% lower risk of insurance loss. The younger patients also were more likely to retain coverage for four years — 37% versus 31%.

Winestone was senior author on a 2019 study that showed private insurance coverage may boost survival in pediatric cancer patients. In that study, 71% of patients with private insurance were alive five years after being diagnosed with bone and soft-tissue sarcomas, compared to 61% of patients with public insurance.

“Cancer survivors experience ongoing loss of income and financial burden related to their medical issues,” Winestone said in a UCSF news release. “At a time when unemployment is rising to unprecedented levels, due to the economic fallout of the pandemic, the Affordable Care Act provides a mechanism for patients to maintain access to their parents’ health insurance.”

The findings were published Oct. 22 in JCO Oncology Practice.

Copyright © 2020 HealthDay. All rights reserved.

Source Article

Read more

COVID-19 safety precautions at the presidential debate are ‘adequate,’ but may leave some in danger, experts say

Clear dividers are seen on stage as preparations are made for the final presidential debate between President Donald Trump and former Vice President Joe Biden (Photo by BRENDAN SMIALOWSKI/AFP via Getty Images)
Clear dividers are seen onstage as preparations are made for the final presidential debate between President Trump and former Vice President Joe Biden. (Photo by Brendan Smialowski/AFP via Getty Images)

President Trump and former Vice President Joe Biden will face off in the final presidential debate at Belmont University in Nashville on Thursday night, just weeks after the president contracted and recovered from COVID-19. Experts say the precautions that have been taken to prevent the spread of the virus are a step in the right direction, but could still leave some of the estimated 200 attendees at risk.

The Commission on Presidential Debates, which sponsors the event, has reportedly put several protective measures in place, including a mask mandate for attendees, pre-testing ahead of the event and social distancing in the audience. Biden has reportedly already tested negative for the virus, and in an email from Yahoo Life asking about President Trump’s status, a spokesperson for his campaign replied that “the President will be cleared by the White House Medical Unit.” White House chief of staff Mark Meadows told reporters on Thursday the president was tested for COVID-19 on his flight to Nashville and was negative.

The two candidates will be separated by plexiglass dividers, and the Nashville Public Health Department is reportedly also installing separate HVAC systems near each candidate to increase airflow. But in a press conference Thursday morning, Nashville Mayor John Cooper warned that a “surge” in cases was occurring in the city, now averaging 175 new infections a day. “Health experts have warned that we need to double down on masks and social distancing to stop this surge in its tracks,” Cooper said.

Nashville experienced a drop in daily COVID-19 cases in September, but city officials have reported a rapid rise in the last weeks — including 249 cases in the past 24 hours alone. In total, Davidson County, where Nashville is located, has 30,115 cases and 328 deaths since the pandemic began, according to Thursday data from the Tennessee Department of Health.

Although the Centers for Disease Control and Prevention has highlighted the importance of ventilation, Dr. Saskia Popescu, an infection prevention specialist at George Mason University, says that the HVAC systems aren’t necessarily as useful as they seem. “I’m assuming they’re saying that they’re using separate air handling units for the candidates … but I’m not sure how that would be a panacea,” she tells Yahoo Life. “Increasing air exchanges and filtration is the goal.”

Dr. Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, thinks the precautions taken to protect Trump and Biden are slightly over the top. “I think that they’re just kind of going above and beyond for most of this,” Adalja tells Yahoo Life. “I don’t think that is going to make much of a difference in transmission risk, especially since President Trump is not really a person who can be infected with the virus.” The audience precautions, however, are sufficient.

The fact

Read more

Vaccine storage issues could leave 3B people without access

GAMPELA, Burkina Faso (AP) — The chain breaks here, in a tiny medical clinic in Burkina Faso that went nearly a year without a working refrigerator.

From factory to syringe, the world’s most promising coronavirus vaccine candidates need non-stop sterile refrigeration to stay potent and safe. But despite enormous strides in equipping developing countries to maintain the vaccine “cold chain,” nearly 3 billion of the world’s 7.8 billion people live where temperature-controlled storage is insufficient for an immunization campaign to bring COVID-19 under control.

The result: Poor people around the world who were among the hardest hit by the virus pandemic are also likely to be the last to recover from it.


The vaccine cold chain hurdle is just the latest disparity of the pandemic weighted against the poor, who more often live and work in crowded conditions that allow the virus to spread, have little access to medical oxygen that is vital to COVID-19 treatment, and whose health systems lack labs, supplies or technicians to carry out large-scale testing.

Maintaining the cold chain for coronavirus vaccines won’t be easy even in the richest of countries, especially when it comes to those that require ultracold temperatures of around minus 70 degrees Celsius (minus 94 F). Investment in infrastructure and cooling technology lags behind the high-speed leap that vaccine development has taken this year due to the virus.

With the pandemic now in its eighth month, logistics experts warn that vast parts of the world lack the refrigeration to administer an effective vaccination program. This includes most of Central Asia, much of India and southeast Asia, Latin America except for the largest countries, and all but a tiny corner of Africa.

The medical clinic outside Burkina Faso’s capital, a dirt-streaked building that serves a population of 11,000, is a microcosm of the obstacles.

After its refrigerator broke last fall, the clinic could no longer keep vaccines against tetanus, yellow fever, tuberculosis and other common diseases on site, nurse Julienne Zoungrana said. Staff instead used motorbikes to fetch vials in insulated carriers from a hospital in Ouagadougou, making a 40-minute round-trip drive on a narrow road that varies between dirt, gravel and pavement.

A mother of two who visits the Gampela clinic says she thinks a coronavirus inoculation program will be challenging in her part of the world. Adama Tapsoba, 24, walks four hours under scorching sun to get her baby his routine immunizations and often waits hours more to see a doctor. A week earlier, her 5-month-old son had missed a scheduled shot because Tapsoba’s daughter was sick and she could only bring one child on foot.

“It will be hard to get a (COIVD-19) vaccine,” Tapsoba said, bouncing her 5-month-old son on her lap outside the clinic. “People will have to wait at the hospital, and they might leave without getting it.”

To uphold the cold chain in developing nations, international organizations have overseen the installation of tens of thousands of solar-powered vaccine refrigerators. Keeping vaccines at stable temperatures from

Read more