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Thursday, July 30, 2020

Overnight Health Care — presented by That's Medicaid — Race for vaccine faces daunting distribution challenges | Hotspots ease, but officials say normal a long way off

 
 
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Welcome to Thursday’s Overnight Health Care. 

Congress still appears a long ways off from agreement on another COVID-19 relief package. The coronavirus testing turnaround is getting slightly better. And Ohio's governor got the state's pharmacy board to reverse a decision banning hydroxychloroquine.

We'll start with vaccine distribution: 

Race for vaccine faces daunting distribution challenges

When a vaccine is shown to work and be safe, that will be a big moment. But that doesn’t mean you’re going to get a shot the next day.

There are daunting challenges in making sure the U.S. has the millions of vials, needles and syringes needed to administer a vaccine nationwide, and some experts warn the Trump administration is not doing enough to lay the logistical groundwork.

If production is not ramped up sufficiently, the country risks a repeat of the supply shortages that have plagued widespread COVID-19 testing, meaning more people would be waiting longer to get a vaccine even after it’s proven to work.

“A massive coordinated effort is needed and there is little evidence that the Trump administration is adequately preparing now,” the Center for American Progress stated in a new vaccine report. 

Prashant Yadav, a health care supply chain expert at the Center for Global Development, said some vaccine supply production can be ramped up by getting more out of existing production lines, but major manufacturing capacity increases will take eight to 12 months.

If a vaccine is ready by the end of the year, “then we would not have sufficient vials, we would not have sufficient syringes, essentially all of the things for meeting a significant cohort of the U.S. demand,” he said.

Read more here.

 

Senate rejects dueling coronavirus bills as unemployment cliff looms

The Senate on Thursday rejected two competing proposals for coronavirus relief as the deadline for extending enhanced unemployment benefits looms and Congress struggles to break an impasse over a fifth stimulus bill.

The floor drama comes as the $600 federal boost to unemployment benefits passed as part of the March bill is set to formally expire on Friday with no consensus in Congress about how to replace it. 

The GOP bill: Sens. Ron Johnson (R-Wis.) and Mike Braun (R-Ind.) tried to pass a bill that would tie overall unemployment benefits to a two-thirds match to an individual's previous wages, with the per week federal payment capped at $500.

If states cannot implement that formula — several have warned that because of archaic systems it could take months to put in place — then they could pick a $200 per week federal unemployment benefit instead.  

Dem response: But Senate Minority Leader Charles Schumer (D-N.Y.) blocked the GOP proposal and instead tried to pass a roughly $3 trillion Democratic House bill that, among other provisions, would extend the $600 per week federal unemployment benefit through the end of the year. 

"People will be stuck with that big cut," Schumer said, adding that "many states will not be able to implement this new plan for weeks or even months."  

Read more here.



Coronavirus hotspots ease, but officials warn normal is long way off

The number of new coronavirus infections in some of the states hit hardest by the pandemic in the last month is easing, but public health officials warn that widespread transmission is still taking place, and that a return to normal life is a long way off.

New daily case counts have declined in the last two weeks in 11 states where the virus surged after lockdowns eased and people began venturing out more. However, state officials said they remain concerned that the drop in new cases may be a plateau at an unacceptably high level of transmission, rather than a sustained decline.

“Our numbers seem to be stabilizing, which is fantastic. I’ll take stable, but I’d rather see them stable at a lower rate,” said Mandy Cohen, North Carolina’s secretary of Health and Human Services. “We still have work to do to go from stable to decline.”

The states coming off their recent highs are being steadily replaced by new states where counts are rising. Colorado, Illinois, Indiana, Kentucky, Maryland, Virginia and Pennsylvania, all epicenters of the first spike in cases, have seen their numbers tick up. Missouri, Oklahoma and Mississippi, which avoided the first surge, are still marching toward new highs.

Read more here.

Related: Arizona, Mississippi, Florida see record one-day coronavirus deaths

Wisconsin governor issues statewide mask mandate
 

Testing czar says majority of results coming back within 3 days

The Trump administration official in charge of the United States's COVID-19 testing strategy said Thursday backlogs are improving and most lab results are coming back within three days or less. 

COVID-19 outbreaks in the south and west have strained laboratory testing capacity, leading to turnaround times of several days or even weeks, hampering efforts to contain the spread of the virus.

Over the past seven days, 56 percent of COVID-19 tests had a turnaround time of three days or less, which Assistant Secretary for Health Adm. Brett Giroir characterized as an improvement.

Over the past month, 45 percent of test results came back from commercial labs within three days, he said. 

“We’re seeing an improvement week over week,” Giroir said in a call with reporters, adding that turnaround times of 10-14 days are “outliers.” 

“I expect that to get markedly better in the next couple of weeks,” he added. 

Why it matters: Turnaround times need to be as fast as possible to contain the outbreak, experts say. While public health officials say people should be self-isolating while they wait for their test results, there’s little data to indicate how often that’s happening. Longer turnaround times run the risk of making it less likely someone will self-isolate, especially if they’re not experiencing any symptoms.

Read more here.

 

FDA chief: Hydroxychloroquine use a decision between doctor and patient

FDA Commissioner Stephen Hahn on Thursday declined to take a definitive stance on whether people should take hydroxychloroquine as a treatment for the coronavirus, instead saying the decision should be made between a doctor and a patient.

“We had data that when this drug was combined with others, there was some risk associated with that. But the question you’re asking me is a decision between a doctor and a patient,” Hahn said on NBC’s “Today” show.  

"FDA does not regulate the practice of medicine, and that in the privacy of the doctor-patient relationship is where that decision should be made,” Hahn said.

Compared to Fauci: Hahn's dodge on the question is even more apparent when you compare it to Anthony Fauci, who said multiple times this week that clinical trials have shown hydroxychloroquine is not effective in treating COVID-19.   

Read more here.

 
 
 
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Ohio board withdraws rule barring use of hydroxychloroquine to treat coronavirus 

The State of Ohio Board of Pharmacy on Thursday withdrew a rule that would have barred pharmacists, licensed distributors of drugs and medical institutions from prescribing the controversial anti-malaria drug hydroxychloroquine to treat or prevent the novel coronavirus after Gov. Mike DeWine (R) voiced concerns. 

The rule would have prohibited the use of hydroxychloroquine and chloroquine for the treatment or prevention of COVID-19. No prescription would be allowed to be dispensed by a pharmacist and a licensed distributor of dangerous drugs would not be permitted to sell it. The rule also applied to hospitals and nursing homes.

Pushback: But DeWine urged the board to reconsider, citing Hahn's comments about it being a private medical decision. In a statement, the board said it dropped the policy at DeWine's request.

Read more here.

 

Birx recommends face shields in addition to masks

Deborah Birx, the White House coronavirus response coordinator, is recommending the use of face shields along with masks to protect against COVID-19 infection.

Face shields can offer more protection to the wearer than cloth face coverings, which are intended to prevent asymptomatic individuals from spreading coronavirus to others.

“The mask protects others, to block those droplets and block that contamination that happens when you speak or sing or talk, or even breathe,” Birx said on "Fox & Friends" Thursday morning.

“The thing about the face shields — we think that could protect the individuals and that it would decrease the ability for them to touch their eyes and spread the virus as well as those droplets coming towards them. So there are two different technologies for two different reasons.”

Why it matters: Anthony Fauci, the nation’s top infectious disease expert, pointed out Wednesday that complete protection would involve covering the eyes as well as the nose and mouth since all are potential entry points for the virus. However, it seems like public health officials have picked their battles up until this point in urging people to just focus on the lower half of the face. 

Read more here.

Related: Birx says state and local leaders should issue mask mandates as cases rise

 

What we’re reading

Phillies halt activity at stadium after positive tests for coronavirus (ESPN)

Yes, the Coronavirus is in the air (New York Times)  

As California coronavirus cases spike, contact tracing stalled by fear and embarrassment (NBC News

 

State by state

As COVID-19 hammers Texas, Hispanic residents are dying at the highest rate (NBC News

DeWine wants to limit alcohol sales as Ohio sets record for new cases per day (Columbus Dispatch)

State won't collect, release data on coronavirus cases in Tennessee schools (Tennessean

 
 
 
 
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