October 1, 2020

CP Online Health

Eat Well, Life Well

Our regular newsletter editor remains on hiatus, so I’m back for a second (and final) round providing highlights of all the health care news you missed if you were locked in a closet or otherwise occupied.

While New York City, the Washington metro area, California and other regions loosen their stay-at-home restrictions, coronavirus cases continue to rise to surpass 2 million domestic infections. Hospitalizations are increasing in Arizona, Arkansas, Mississippi, North Carolina, South Carolina, Tennessee, Texas and Utah. Arizona’s health director told hospitals to “fully activate” their emergency plans as the state’s biggest system, Banner Health, said its ICU bed use was nearing capacity.

Dallas County reported new daily highs of new cases, and there are outbreaks in immigrant communities in Florida. The head of North Carolina’s health and human services department told NPR’s “Morning Edition” that “this is an early warning sign for us that we really need to take seriously and make sure that we don’t forget that COVID-19 is with us.” Yet some public health officials are being harassed or pushed out of their jobs.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, called the coronavirus “my worst nightmare” and underscored that “it isn’t over yet.” He said that AIDS, the disease caused by HIV, was “really simple” in comparison because the coronavirus presents so differently in different people.

Oregon’s governor put on hold county applications for further reopenings, but governors in other states seem reluctant to impose or reimpose restrictions. So do some individuals. A Houston hospital CEO told The Wall Street Journal, “I have been to pools where there are 100 people crowded in, and that’s not safe behavior.”

In The Hot Spots

Journalist Sara Shipley Hiles traveled to the Ozarks for KHN to see how the tourist season was shaping up, and found it’s going bananas after a shoulder-to-shoulder Memorial Day Weekend that went viral on social media. One resident said people have been eager to get out of the house because “it’s just the nature of freedom lovers.” Health authorities discovered one such freedom lover who was possibly already infected with the coronavirus partied through an ambitious Memorial Day itinerary that included stops at Backwater Jacks, Buffalo Wild Wings, Shady Gators and the Lazy Gators pool.

As President Donald Trump’s campaign prepares to resume rallies, attendees are being asked to sign waivers that they won’t sue if they get COVID-19. Joe Biden is warning of a second wave and wants to hire 100,000 contact tracers so that workers can return to their jobs.

The federal response continues to be pilloried as insufficient as each state struggles to figure out how to expand testing and how to reopen. A fifth of nursing homes still lack sufficient personal protective equipment despite Trump’s promise to “deploy every resource and power that we have” to protect older Americans.” Instead of proper medical gowns, a government contractor has been sending homes plastic ponchos without armholes that a nursing home administrator says look like trash bags.

To find supplies on their own, health care workers are resorting to desperate measures, including parking-lot meetings to negotiate gown purchases and arrangements with “shady characters” to blend their own hand sanitizer. Massachusetts has also turned to the gray market out of desperation, inking contracts with a businessman with expertise in selfie-taking equipment and a company run out of a New Jersey home.

Chris Kirkham and Benjamin Lesser at Reuters took a comprehensive look at how already-low nursing home staffing levels, a perennial concern for residents and their families, have gotten worse during the pandemic. Nursing home nurses and aides told them staffers are quitting “in large numbers” for fear of getting sick and because of a lack of testing and protective gear, and management’s downplaying of the dangers. Katie Thomas at The New York Times found some nursing homes want employees and their insurers to pay for testing rather than pay for it themselves.

In The Hot Seat

Heeding persistent complaints that provider relief money wasn’t helping those most in need, the U.S. Health and Human Services Department announced it would send $25 billion to safety-net providers, including $10 billion to about 750 hospitals that treat the most poor or uninsured patients.

The Wall Street Journal autopsies New York City’s hospital response to the pandemic and finds plenty of blame to apportion, including hospitals that transferred patients who were so sick they should not have been sent elsewhere, changing state and city guidelines about when sick health care workers could come back, and problems in obtaining personal protective equipment. “We are not running these ICUs safely or appropriately,” a resident wrote in an email to the attending physicians at NewYork-Presbyterian/Columbia. “The emotional burden of working in these sci-fi-movie-gone-wrong ICUs is through the roof.”

So Young

Researchers and doctors are still trying to decipher how the virus injures children in a small number of cases known as pediatric multisystem inflammatory syndrome. NPR’s Peter Breslow and Lulu Garcia-Navarro reported how doctors at Children’s National Hospital in Washington, D.C., are handling the cases. One big mystery is how the syndrome afflicts children differently than adults, since a majority of the kids did not test positive for the virus but did have antibodies. “Is this acute viral? Is this post-infectious? Is it a combination? We’ve got to figure this out in our patient cohort,” one doctor told NPR. In Queens, St. Mary’s Hospital for Children is allowing one parent for each hospitalized child to move in during their stay.

Another medical mystery is why the debilitating symptoms of the virus linger for more than 60 days in some people, including younger ones in great shape. “I’m better, but the hardest, most confusing thing about this is that I’m not well,” one triathlete told The Washington Post’s Ariana Eunjung Cha and Lenny Bernstein.

Medical Advances

The first-known double lung transplant in a COVID patient, a Hispanic woman in her 20s, occurred at Northwestern Memorial Hospital in Chicago. Dr. Ankit Bharat, Northwestern’s chief of thoracic surgery, said he’s been contacted by health centers around the country to see if Northwestern would perform transplants on their patients, and five other patients are now being evaluated as candidates.

Researchers are looking at decades-old vaccines against tuberculosis and polio to see if they might be useful to fight COVID-19, and seeing if mosquito spit might be used to ward off all diseases spread by the insects. If the rest of this week’s crop of we-don’thave-a-vaccine-or-treatment-but-we’re-working-on-it updates are too numerous to digest, The New York Times has a nice tracker of where individual vaccination efforts stand. The Urban Institute published a tracker of more than 100 resources summarizing state policy responses, data and other relevant information on COVID, food, income, housing and elections. This tracker of trackers — very meta! — will be updated monthly, Urban says.

Do Not Disturb

The hotel experience will be changing as chains try to provide psychological comfort that their guests will not check out with a case of “corona.” Chains such as Hilton are asking guests to use mobile apps to unlock their rooms rather than giving them key cards. Buffets are being replaced with prepacked foods, coffee stations are gone, and if you want one of DoubleTree’s warm chocolate chip cookies, you’ll need to ask for it. The Beverly Hills Hilton is using a 3-foot-tall robot named Kennedy that flashes ultraviolet light into rooms to kill germs.

Finally, the New York Times’ Modern Love column offers 18 first-person sketches of how relationships are going in pandemic isolation. The tl;dr version is: not so hot for everyone. A wife wants to scream every time her husband yells “woo” as his go-to response; a couple stuck in a studio apartment is celebrating their one-year anniversary by spending a week apart; and a 30-year-old living with her boyfriend in New Jersey declares she’s moving across the country when their lease is up. On the positive side, a grandmother is doing the swiping for her granddaughter on dating sites; two roommates, one 83 and the other 27, enjoy ogling handsome men on TV, and a couple in Florida now argue in British accents so they don’t take themselves too seriously.

Enjoy the weekend, and if you’re in the Ozarks, try to limit yourself to one gator-themed venue per day.