Bulgaria Plans Lockdown to Contain Coronavirus Infection Surge | World News

SOFIA (Reuters) – Bulgaria plans to close schools, restaurants and shops and ban all sports events, private celebrations and excursions as it struggles to contain a coronavirus case surge.

The Balkan country’s health minister Kostadin Angelov said on Monday that the measures, to be debated by the centre-right government on Wednesday, were aimed at preventing a struggling health system from being overwhelmed.

New coronavirus cases have doubled in the past week to 23,569, Bulgarian health ministry data showed, bringing the total number to 121,820 in the country of 7 million.

Some 6,350 people are in hospitals, 1,000 more than a week ago, and more than 400 are in intensive care.

Hospitals are strained, with many short-staffed due to rising infections among medics, while ambulances have been searching for coronavirus beds in major cities.

Bulgaria’s COVID-19 fatalities per 100,000 people are the third highest in the European Union in the past 14 days, data showed. In total, 2,880 people have died from COVID-19.

“No matter how prepared, no (health) system can withstand such a pressure,” Angelov told reporters.

“We cannot afford to lose the lives of young people, of old people, of doctors and of teachers,” he added.

Under the plan, which if approved will be enforced from Nov. 27, schools and universities will switch to online studies, while kindergartens and nurseries will be closed.

Sports and cultural events will be banned, including seminars, conferences and private celebrations. All restaurants, bars and cafes will be shut, as well as all shops except for pharmacies, food stores and banks.

Tourist trips both at home and abroad will also be banned.

Earlier, Prime Minister Boyko Borissov said the measures should be balanced to keep the small and open economy going and Angelov said he hoped the measures could allow some easing for the Christmas holidays.

(Reporting by Tsvetelia Tsolova; Editing by Alexander Smith)

Copyright 2020 Thomson Reuters.

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Here’s how the U.S. government plans to distribute the first Covid-19 vaccines.

In the wake of a steady stream of positive results indicating the effectiveness of several coronavirus vaccines, the official in charge of the federal coronavirus vaccine program explained on Sunday news shows how the vaccines might be distributed to Americans as early as next month.

Dr. Moncef Slaoui, head of the administration’s Operation Warp Speed, said that within 24 hours after the Food and Drug Administration approves a vaccine, doses will be shipped to states to be distributed. “Within 48 hours from approval,” the first people would likely receive injections, Dr. Slaoui said on ABC’s “This Week With George Stephanopoulos.”

Two companies, Pfizer and Moderna, announced this month that their vaccines were about 95 percent effective, and Pfizer formally submitted an application to the F.D.A. for emergency approval. Regulators at the agency will spend about three weeks reviewing the application. On Dec. 10, an outside advisory board on vaccines will meet to discuss the application, and the agency is expected to make a decision shortly after that meeting. Moderna is expected to submit its own application soon.

Even if the first vaccine is authorized in mid-December, officials and company representatives have estimated that there will only be enough doses available to treat about 22.5 million Americans by January. Each vaccine requires two doses, separated by several weeks.

Dr. Slaoui said vaccines would be shipped to states, proportioned according to their population, and that states would decide how and where to distribute the doses. He said that likely within a day after a vaccine receives F.D.A. authorization, a committee at the Centers for Disease Control and Prevention would issue recommendations for which groups should be first to receive a vaccine.

High-priority groups are likely to include frontline medical workers and residents of nursing homes. Dr. Scott Gottlieb, a former F.D.A. commissioner, said on the CBS show “Face the Nation” that those groups would likely be followed by other older adults and then expanded to younger adults in the spring. Both he and Dr. Slaoui estimated that tens of millions of adults could be vaccinated by sometime in May.

Immunizations for children would follow. Dr. Slaoui said on the CNN show “State of the Union” that the youngest participants in the clinical trials so far have been 12 to 14 years old and that approval for younger children and toddlers would likely not occur until late in 2021, after clinical trials for those age groups are conducted.

On “Face the Nation,” Larry Merlo, the chief executive of CVS Health, said that pharmacists and other medical staff from CVS plan to immunize residents of more than 25,000 long-term care facilities, beginning about 48 hours after a vaccine is approved. He said that for several years, CVS has been going to nursing homes to administer the seasonal flu vaccine, so “we have the systems, we have the processes, and we have built the logistics directly for the Covid vaccine.”

Mr. Merlo, whose company runs 10,000 pharmacies across the country, also said as the supply

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Trump Suggests He Plans to Fire Fauci After Election | Health News

By Ernie Mundell and Robin Foster HealthDay Reporters

(HealthDay)

MONDAY, Nov. 2, 2020 (HealthDay News) — During a rally in Florida late Sunday night, President Donald Trump suggested that he would fire the nation’s top infectious disease expert, Dr. Anthony Fauci, as soon as the presidential election is over on Tuesday.

As he expressed frustration that the coronavirus remains prominent in the news — U.S. case counts are at their highest levels since the pandemic began — supporters in the crowd began chanting, “Fire Fauci,” the Associated Press reported.

Trump replied with this: “Don’t tell anybody, but let me wait until a little bit after the election.” He has previously expressed that he was concerned about the political blowback of removing the popular and respected doctor before Election Day. He added he appreciated the “advice” of the crowd.

Fauci, who heads up the U.S. National Institute of Allergy and Infectious Diseases, has begun to challenge the president publicly, saying that Trump has ignored his advice for containing the virus and that he hasn’t spoken with Trump in more than a month. He has also warned repeatedly that the nation is heading for a tough winter if more isn’t done soon to slow the spread of the disease which has killed more than 230,000 Americans so far this year, the AP reported.

The latest case counts suggest Fauci is right: More than 9.2 million Americans have been diagnosed with COVID-19, and the seven-day average of new daily coronavirus infections in the United States hit a new high of 81,740 on Sunday, the Washington Post reported. Record-shattering numbers of hospitalizations were also recorded in nine states: Alaska, Iowa, Missouri, Montana, Nebraska, New Mexico, Ohio, South Dakota and Utah.

“There is no way to sugarcoat it: We are facing an urgent crisis, and there is an imminent risk to you, your family members, your friends, your neighbors,” Gov. Tony Evers of Wisconsin said last week, The New York Times reported.

Evers’ state has been hard by coronavirus: More than 200 coronavirus deaths were announced last week, and as case numbers have exploded, hospitals have been strained.

But Wisconsin is not alone. The surge that started in the Upper Midwest and rural West has now spread far beyond, sending infection levels soaring in places as disparate as El Paso, Chicago and Rexburg, Idaho, according to the New York Times.

Daily reports of deaths from the virus still remain far below their spring peaks, averaging around 800 a day, but those have also started to climb, the Times reported.

States say they don’t have enough money to distribute a COVID vaccine

Meanwhile, state health officials say they are frustrated about a lack of financial support from the federal government as they face orders to prepare to receive and distribute the first doses of a coronavirus vaccine by the unlikely target date of Nov. 15, the Post reported. And these officials stress that they don’t have enough money to pay for the massive undertaking.

State

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Breast cancer sufferer fast-tracks plans to end life at Dignitas

Health insurance, The patient was treated at the hospital with the health of the insured.
A breast cancer sufferer said she has brought forward her plans to travel to Dignitas in Switzerland due to the impending second lockdown in England. (Stock picture: Getty)

A 45-year-old woman suffering from breast cancer has fast-tracked her plans to end her life at Swiss clinic Dignitas due to “antiquated laws” and the impending second national lockdown in England.

The British woman has reportedly been granted a special waiver by the Swiss government to allow her to travel to Switzerland for a final appointment at the euthanasia clinic near Zurich without having to self-isolate for 10 days.

The woman told the Sunday Times she has brought her plans forward to avoid an “agonising, protracted death” due to the UK’s ban on assisted dying as well as the imminent second national lockdown, set to start on Thursday.

This picture taken on July 14, 2009 shows the building of the assisted suicide clinic, Dignitas in Pfaeffikon near Zurich. A renowned British conductor and his wife have died in the assisted suicide clinic Dignitas in Switzerland, their family said. Edward Downes, 85, was almost blind and deaf, and his 74-year-old wife Joan was terminally ill when they chose to end their lives, a statement released to the BBC said. AFP PHOTO/ SEBASTIAN DERUNGS (Photo credit should read SEBASTIAN DERUNGS/AFP via Getty Images)
The Dignitas clinic near Zurich, where the woman plans to go. (Stock picture: Getty)

Writing in the newspaper, she said she felt she should go now, before she was “truly ready”, saying that coronavirus regulations would mean she would be “forced to die in the presence of strangers, in unfamiliar surroundings, without my husband, family or friends to comfort me”.

The woman, who previously worked as a senior mental health professional in the NHS, said the current UK laws that rule assisted suicide illegal and punishable by up to 14 years in prison have created a ‘cruel’ situation and said she had been met by a “wall of silence” when trying to discuss the issue with medics.

She said: “When I have attempted to speak openly about what I feel is a perfectly rational desire to avoid a traumatic death, I have been met by a wall of silence from doctors.”

Watch: Assisted dying could be legalised in the UK within four years

She told the Sunday Times that she was diagnosed with stage four secondary breast cancer last September, then learned in August that it had spread to her liver.

She said she is in considerable pain and suffers from extreme fatigue and nausea, and is likely to die from blood poisoning, suffocation or strokes due to cancerous tumours in her brain.

The woman told the newspaper she “desperately wants to live” but since she cannot she is trying to seek an option that will allow her a peaceful death – something that is currently impossible due to UK laws.

Watch: What is long COVID?

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Analysis: Bidencare or Trumpcare? Health plans will affect the U.S. economy differently

(Reuters) – Democratic presidential candidate Joe Biden wants to expand the Affordable Care Act, President Barack Obama’s signature healthcare legislation, and then name it after himself.

FILE PHOTO: U.S. President Donald Trump speaks about healthcare at a campaign event at Charlotte Douglas International Airport in Charlotte, North Carolina, U.S., September 24, 2020. REUTERS/Tom Brenner

Republican President Donald Trump wants to end it altogether, and replace it with something that has yet to be defined.

An ongoing debate over which approach is better for the economy is partly about price tags. Bidencare is forecast to increase federal healthcare spending by $2 trillion or more over 10 years. Trump’s approach is to hold federal spending stable or reduce it.

Bidencare supporters emphasize the stimulative effects of government spending, especially in a period of economic distress, and the benefits of insuring more people in the middle of a pandemic. Those who prefer Trump’s approach say it would avoid debt or tax increases they say would drag on future economic growth.

The United States has about 30 million people without health insurance tmsnrt.rs/3mzqQxC now, down from about 46.5 million in 2010, when the ACA was passed.

Graphic – Under ACA, a drop in the number of uninsured:

Bidencare would cut that figure by a further 15 million to 20 million, an analysis by the Committee for a Responsible Federal Budget estimates. Trump isn’t expected to try to reduce that.

Healthcare spending is equal to 17% of the U.S. economy, far more than any other industrialized country, so the Trumpcare vs. Bidencare debate is no small economic matter. It’s further complicated by the fact that extra spending doesn’t translate to a healthier populace than other counties.

“Improving healthcare performance is a critical part of strengthening America’s health, economy and fiscal future, and should be top a priority for the next president and Congress,” says Peterson Foundation CEO Michael Peterson.

BIDENCARE FOCUSES ON LOWER-INCOME AMERICANS

Bidencare would cover more Americans by increasing subsidized health insurance purchases through tax credits.

It would also offer a “public option,” allowing anyone who wants it to buy in, even if their job offers private insurance. Lower-income families shut out of ACA’s expanded Medicaid eligibility because of where they live could get it premium-free.

Any boost to health and financial stability is likely to be biggest for millions of low-income households, particularly Latino and Black families who have been particularly hard-hit during the pandemic.

For these groups especially, says the University of Michigan School of Public Health’s Helen Levy, being able to accumulate assets “is really important if you think about supporting economic mobility.”

Minorities get and die from COVID-19 at higher rates than whites, data shows. Some of that is probably because Blacks and Latinos are more likely to work in jobs that put them at higher risk of transmission.

But even without COVID-19, minorities face higher rates of chronic disease and earlier death than whites. They also have lower rates of health insurance despite substantial gains since the advent

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Bidencare or Trumpcare? Health plans will affect the U.S. economy differently

By Ann Saphir

(Reuters) – Democratic presidential candidate Joe Biden wants to expand the Affordable Care Act, President Barack Obama’s signature healthcare legislation, and then name it after himself.

Republican President Donald Trump wants to end it altogether, and replace it with something that has yet to be defined.

An ongoing debate over which approach is better for the economy is partly about price tags. Bidencare is forecast to increase federal healthcare spending by $2 trillion or more over 10 years. Trump’s approach is to hold federal spending stable or reduce it.

Bidencare supporters emphasize the stimulative effects of government spending, especially in a period of economic distress, and the benefits of insuring more people in the middle of a pandemic. Those who prefer Trump’s approach say it would avoid debt or tax increases they say would drag on future economic growth.

The United States has about 30 million people without health insurance https://tmsnrt.rs/3mzqQxC now, down from about 46.5 million in 2010, when the ACA was passed.

Bidencare would cut that figure by a further 15 million to 20 million, an analysis by the Committee for a Responsible Federal Budget estimates. Trump isn’t expected to try to reduce that.

Healthcare spending is equal to 17% of the U.S. economy, far more than any other industrialized country, so the Trumpcare vs. Bidencare debate is no small economic matter. It’s further complicated by the fact that extra spending doesn’t translate to a healthier populace than other counties.

“Improving healthcare performance is a critical part of strengthening America’s health, economy and fiscal future, and should be top a priority for the next president and Congress,” says Peterson Foundation CEO Michael Peterson.

BIDENCARE FOCUSES ON LOWER-INCOME AMERICANS

Bidencare would cover more Americans by increasing subsidized health insurance purchases through tax credits.

It would also offer a “public option,” allowing anyone who wants it to buy in, even if their job offers private insurance. Lower-income families shut out of ACA’s expanded Medicaid eligibility because of where they live could get it premium-free.

Any boost to health and financial stability is likely to be biggest for millions of low-income households, particularly Latino and Black families who have been particularly hard-hit during the pandemic.

For these groups especially, says the University of Michigan School of Public Health’s Helen Levy, being able to accumulate assets “is really important if you think about supporting economic mobility.”

Minorities get and die from COVID-19 at higher rates than whites, data shows. Some of that is probably because Blacks and Latinos are more likely to work in jobs that put them at higher risk of transmission.

But even without COVID-19, minorities face higher rates of chronic disease and earlier death than whites. They also have lower rates of health insurance despite substantial gains since the advent of the ACA, a study by Kaiser Family Foundation shows.

Biden said he would pay for his plan through higher taxes on the wealthy, and use the clout of expanded public insurance to keep

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J&J plans to test its COVID-19 vaccine in ages 12-18 soon

FILE PHOTO: The company logo for Johnson & Johnson is displayed on a screen to celebrate the 75th anniversary of the company’s listing at the New York Stock Exchange (NYSE) in New York, U.S., September 17, 2019. REUTERS/Brendan McDermid

NEW YORK (Reuters) – Johnson & Johnson plans to start testing its experimental COVID-19 vaccine in youths aged 12 to 18 as soon as possible, a company executive said at a meeting held by the U.S. Centers for Disease Control and Prevention (CDC) on Friday.

“We plan to go into children as soon as we possibly can, but very carefully in terms of safety,” J&J’s Dr. Jerry Sadoff told a virtual meeting of the CDC’s Advisory Committee on Immunization Practices.

Depending on safety and other factors, the company plans to test in even younger children afterwards, Sadoff, a vaccine research scientist at J&J’s Janssen unit, said.

J&J started testing the vaccine in adults in a 60,000-volunteer Phase III study in late September. It had to pause the trial earlier this month because of a serious medical event in one participant. The study resumed last week.

Rival drugmaker Pfizer Inc has already begun testing the COVID-19 vaccine it is developing with Germany’s BioNTech in children as young as 12.

Reporting by Michael Erman; Editing by Chizu Nomiyama and Bill Berkrot

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Trump rule says health plans must disclose costs up front

WASHINGTON (AP) — Trying to pull back the veil on health care costs to encourage competition, the Trump administration on Thursday finalized a requirement for insurers to tell consumers up front the actual prices for common tests and procedures.

A major health insurance industry group said the regulation would have the opposite effect, raising premiums.

The late-innings policy play ahead of Election Day comes as President Donald Trump has been hammered on health care by Democratic challenger Joe Biden for the administration’s handling of the coronavirus pandemic and its unrelenting efforts to overturn “Obamacare,” the 2010 law providing coverage to more than 20 million people.

A related Trump administration price disclosure requirement applying to hospitals is facing a federal lawsuit from the industry, alleging coercion and interference with business practices.

The idea behind the new regulations on insurers is to empower patients to become better consumers of health care, thereby helping to drive down costs.


But the requirements would take effect gradually over a four-year period, and patients face a considerable learning curve to make cost-versus-quality decisions about procedures like knee replacements or hernia repairs. Add to that political uncertainty about the policy’s survival if Trump doesn’t get reelected, and the whole effort is running into skepticism.

Administration officials are adamant the changes will stand, arguing the goal of price transparency transcends political partisanship.

“It will be impossible to walk backwards on this,” Health and Human Services Secretary Alex Azar said. “How do you fight transparency on prices? How do you actually articulate the argument that you should conceal what something costs from the person trying to purchase it?”

Insurance companies contend that the rules will boomerang economically, by undercutting their ability to bargain with hospitals, drug companies, doctors and other industry players. Providers now accepting discounted rates will press to get paid more once they see what their upper-end competitors are getting.

“The final rule will work to reduce competition and push health care prices higher — not lower — for American families, patients, and taxpayers,” Matt Eyles, president of America’s Health Insurance Plans, said in a statement. “This is precisely the opposite of what Americans want in their health care.”

The new rules are being issued jointly by HHS, the Labor Department and the Treasury, which share jurisdiction over health insurance plans. They would:

— Starting in 2022, require insurers to make available data files on the costs of various procedures, allowing technology companies to design apps that let patients see costs not only under their own plan but other insurers’ plans as well.

— Starting in 2023, require insurers to make available to their policyholders cost-sharing details on 500 specific services, medical equipment and other items, as called for by the government.

— Starting in 2024, require insurers to make cost-sharing information available on all the services and goods they cover.

Patients would use an online shopping tool from their plan to see the negotiated rate between their doctor and the insurer, as well as an out-of-pocket

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Pacific Source: Medicare Advantage plans: Locations, plans, and costs

PacificSource Medicare was founded in Oregon in 1933 as a not-for-profit company, offers Medicare Advantage plans, and has more than 300,000 members throughout the Northwest.

According to the Kaiser Family Foundation (KFF), Medicare-approved insurance companies, such as PacificSource, provided Advantage plans to more than 24 million US citizens in 2020.

This article looks at the PacificSource Advantage plans and availability. It also looks at the coverage, benefits, and costs.

We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:

  • Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
  • Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
  • Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.

PacificSource offers several Medicare Advantage plans, including Health Maintenance Organization (HMO), Health Maintenance Organization Point of Service (HMO-POS), and Preferred Provider Organization (PPO).

HMO plans

PacificSource HMO plans include Medicare Essentials 2 without Part D prescription drug coverage and MyCare Rx 40 including Part D.

When a person enrolls in an HMO plan, they agree to use the plan’s network of healthcare providers. They also choose a primary care doctor from within the network, who then coordinates health services and referrals to specialists.

If a person wants to use a healthcare provider from outside the network, they may have more costs, except in a medical emergency.

Medicare Essentials 2 (HMO) plan

This plan is available in certain counties in Oregon. In 2021, the monthly premium and the annual deductible are both zero, while the out-of-pocket maximum expense is $5,500. A person must use in-network providers.

My Care Rx 40 (HMO) plan

This plan is available in certain counties in Oregon.
The monthly premium in 2021 is zero. Out-of-pocket expenses in 2021 have an annual maximum of $4,950, and a person must use in-network providers.

HMO-POS plans

PacificSource HMO-POS plans include Medicare Essentials Choice Rx 14, and MyCare Choice Rx 24, both of which include prescription drugs (Part D) coverage.

With HMO-POS plans, people have the freedom to use healthcare services outside of their plan’s network. However, they must pay a higher copay or coinsurance to do so.

Medicare Essentials Choice Rx 14 plan (HMO-POS) plan

This plan is available in certain counties in Oregon.
In 2021, the monthly premium is $99.00 and the in-network out-of-pocket maximum is $5,500.

2021 MyCare Choice Rx 24 (HMO-POS) plan

This plan is available in certain counties in Idaho.
The monthly premium in 2021 is $35. Out-of-pocket expenses have an annual maximum of $5,500 in 2021 for in-network providers and no maximum for out-of-network services.

PPO plans

PacificSource PPO plans include Explorer 12 without the prescription drug (Part D) cover and Explorer Rx4, including Part D prescription drug coverage.

These

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Trump Rule Requires Health Plans to Disclose Costs up Front | Business News

By RICARDO ALONSO-ZALDIVAR, Associated Press

WASHINGTON (AP) — Trying to pull back the veil on health care costs to encourage competition, the Trump administration on Thursday finalized a requirement for insurers to tell consumers up front the actual prices for common tests and procedures.

The late-innings policy play comes just days ahead of Election Day as President Donald Trump has been hammered on health care by Democratic challenger Joe Biden for the administration’s handling of the coronavirus pandemic and its unrelenting efforts to overturn “Obamacare,” the 2010 law providing coverage to more than 20 million people.

A related Trump administration price disclosure requirement applying to hospitals is facing a federal lawsuit from the industry, alleging coercion and interference with business practices.

The idea behind the new regulations on insurers is to empower patients to become better consumers of health care, thereby helping to drive down costs.

But the requirements would take effect gradually over a four-year period, and patients face a considerable learning curve to make cost-versus-quality decisions about procedures like knee replacements or hernia repairs. Add to that political uncertainty about the policy’s survival if Trump doesn’t get reelected, and the whole effort is running into skepticism.

Administration officials are adamant the changes will stand, arguing the goal of price transparency transcends political partisanship.

“It will be impossible to walk backwards on this,” Health and Human Services Secretary Alex Azar said. “How do you fight transparency on prices? How do you actually articulate the argument that you should conceal what something costs from the person trying to purchase it?”

Insurance companies contend that the rules will boomerang economically, driving up costs. Hospitals and doctors now accepting discounted rates will press to get paid more once they see what their upper-end competitors are getting.

The new rules are being issued jointly by HHS, the Labor Department and the Treasury, which share jurisdiction over health insurance plans. They would:

— Starting in 2022, require insurers to make available data files on the costs of various procedures, allowing technology companies to design apps that let patients see costs not only under their own plan but other insurers’ plans as well.

— Starting in 2023, require insurers to make available to their policyholders cost-sharing details on 500 specific services, medical equipment and other items, as called for by the government.

— Starting in 2024, require insurers to make cost-sharing information available on all the services and goods they cover.

Patients would use an online shopping tool from their plan to see the negotiated rate between their doctor and the insurer, as well as an out-of-pocket cost estimate for procedures, drugs, durable medical equipment and any other item or service they may need.

The information would be available ahead of time, enabling an informed decision. Currently, most patients find out what they owe after they get back from the hospital and receive their “explanation of benefits” statement.

“We need to keep pricing on the front end, not the back end,” said Seema Verma, head

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