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Top news stories from AMA Morning Rounds®: Week of March 16, 2020

Read AMA Morning Rounds®’ most popular stories in medicine and public health from the week of March 16, 2020 – March 20, 2020.

President declares coronavirus pandemic a national emergency

The AP (3/13, Mascaro, Miller, Taylor, Colvin) reported that on Friday, the president “declared the coronavirus pandemic a national emergency, freeing up money and resources to fight the outbreak, and then threw his support behind an aid package in Congress that is on track to provide direct relief to Americans.” The declaration could free up “as much as $50 billion for state and local governments to respond to the crisis.” In addition, the president “announced a range of executive actions, including a new public-private partnership to expand coronavirus testing capabilities with drive-through locations, as Washington tries to subdue the new virus whose spread is roiling markets, shuttering institutions and disrupting the lives of everyday Americans.” The AMA “said the emergency declaration would help ensure America’s health care system has sufficient resources to properly respond to the ongoing outbreak.”

In a separate article, the AP (3/13, Tanner) reported that last week, the American Medical Association, the American Hospital Association, and American Nurses Association “asked for a presidential emergency declaration that would allow doctors and nurses to work across state lines and would waive certain rules to free up hospital beds.” On Friday, the president “responded by issuing an emergency declaration and said he was giving the U.S. health secretary authority to waive federal regulations and laws to give” physicians and hospitals “flexibility” to treat patients. AMA President Patrice A. Harris, M.D., M.A., “praised the action,” saying it was necessary to ensure the U.S. health system “has sufficient resources to properly respond to the ongoing outbreak, prevent further spread of illness and keep our communities safe.”

The Wall Street Journal (3/13, Armour, Subscription Publication) reported that the president’s emergency declaration will give Medicare and state Medicaid programs more flexibility to respond to coronavirus.

Researchers say there may be five to 10 people with undetected coronavirus infections for every confirmed U.S. case

The New York Times (3/16, Carey) reports a study published in Science suggests that “for every confirmed case, there are most likely another five to 10 people in the community with undetected infections.” In the study, “researchers modeled the virus’s natural spread in China before the government instituted a travel ban and an aggressive testing policy. During that time, from December of last year through late January, about 6 in 7 cases went undetected. That situation is analogous to the current state of affairs in the United States and other Western countries, where tests are not widely available, the researchers said.”

Newsweek (3/16, Georgiou) reports the study suggests the rapid spread of the virus in China can largely be accounted for by “stealth transmissions” from undetected cases. The researchers from Columbia University’s Mailman School of Public Health “used advanced computer simulations to mathematically model the spread of the novel coronavirus.”

CMS announces Medicare will expand coverage for telemedicine to help seniors avoid coronavirus

The AP (3/17, Alonso-Zaldivar) reports CMS announced Medicare "will immediately expand coverage for telemedicine nationwide to help seniors with health problems stay home to avoid the coronavirus." With the policy change, Medicare beneficiaries will be able to consult physicians, "while heeding public health advice to stay home during the outbreak." HHS Secretary Alex Azar stated, "Providers will be allowed to use everyday technologies to talk to telehealth patients, more telehealth services will be covered...and providers will be allowed to offer these telehealth benefits to Medicare beneficiaries at a lower cost than traditional services."

CNN International reports "Verma said...that Medicare beneficiaries who were previously limited to telehealth services based on their location 'will be able to receive a wide range of services via telehealth without ever having to leave home.'"

The Hill reports that according to Verma said, "These changes allow seniors to communicate with their doctors without having to travel to a healthcare facility so that they can limit risk of exposure and spread of this virus. Clinicians on the frontlines will now have greater flexibility to safely treat our beneficiaries."

STAT (3/17, Facher) reports that federal health officials also said that they would stop enforcing many HIPAA provisions in order to facilitate the expanded use of telemedicine for seniors.

For more information on how to implement telemedicine quickly in your practice, see the AMA’s Guide to Telemedicine.

Hospitals confront potential shortage of ventilators to treat patients with coronavirus

The New York Times (3/18, Kliff, Satariano, Silver-Greenberg, Kulish) reports there is a shortage of ventilators, which are needed to care for patients with COVID-19, and “desperate hospitals say they can’t find anywhere to buy the medical devices, which help patients breathe and can be the difference between life and death for those facing the most dire respiratory effects of the coronavirus.” Manufacturers in the U.S. and Europe “say they can’t speed up production enough to meet soaring demand, at least not anytime soon.” The article adds that ventilators are also in short supply in Italy, Germany, and other countries. Greg Crist, a spokesman for AdvaMed, said less than a dozen companies in the U.S. make ventilators.

Meanwhile, the Washington Post (3/18, Rowland) reports that “hospitals are holding back from ordering more medical ventilators because of the high cost for what may be only a short-term spike in demand from the coronavirus epidemic, supply chain experts and health researchers say, intensifying an anticipated shortage of lifesaving equipment for patients who become critically ill.”

NBC News (3/18) says that “amid growing fears that the United States could face a shortage of ventilators for coronavirus patients, state officials and hospitals are quietly preparing to make excruciating decisions about how they would ration lifesaving care.” NBC reports that “the plans may not be necessary, as officials are scrambling to secure more ventilators, which can make the difference between life and death for coronavirus patients in critical condition who are struggling to breathe...But hospitals are already huddling with state health officials to hammer out their policies to determine which coronavirus patients would get ventilators if they run short – essentially deciding whose lives to save first.”

Number of confirmed coronavirus cases in U.S. passes 14,000

The Wall Street Journal (3/19, A1, Calfas, Yap, Stancati, Subscription Publication) reports on Thursday, the number of confirmed cases of coronavirus in the U.S. passed 14,000. The article adds that the number of cases jumped in several states including New York.

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