The new coronavirus is losing its potency and has become much less lethal, a senior Italian doctor said on Sunday.
"In reality, the virus clinically no longer exists in Italy," said Alberto Zangrillo, the head of the San Raffaele Hospital in Milan in the northern region of Lombardy, which has borne the brunt of Italy's coronavirus contagion.
"The swabs that were performed over the last 10 days showed a viral load in quantitative terms that was absolutely infinitesimal compared to the ones carried out a month or two months ago," he told RAI television.
Ninety-five percent of the country is currently under a stay-at-home order, thanks to the coronavirus pandemic. So for those in need of a check-up, or a prescription refill, or a quick look at some swelling around a child's eye, a virtual visit to the doctor may be the best option.
That may seem like a suboptimal substitute for a conventional doctor's appointment. But it's much safer in the midst of the pandemic when every trip to a public place could result in exposure to the coronavirus. Telemedicine isn't just quicker and more convenient than in-person care – it's actually every bit as effective.
That's among the findings of a study published April 14 in the Annals of Internal Medicine. Researchers reviewed more than 6,500 remote consultations and found that more than seven in 10 were completely appropriate for the patients screened. More than eight in 10 of those telehealth consults resulted in the avoidance of an in-person visit in the four months that followed
The cruise industry is making waves to ensure passengers stay from the coronavirus and future viruses.
The financially battered cruise lines are hoping to return to the seas this summer. In order to do this, industry experts are eyeing two forms of innovate measures that will help keep the ships clean and disinfected while tracking passengers to reduce the potential for infection.
Although the Centers for Disease Control and Prevention has a no-sail order in place until July 24, many lines plan to resume operations sooner.
USA Today said cruise ships have been at the epicenter of the pandemic nightmare with passengers and crews trapped aboard quarantined vessels for weeks. They need to making sweeping changes in hygiene and safety to regain the trust of potential travelers.
According to Fox News, the use of UVC lights to sterilize places — and even people — might be implemented. They would most likely be installed in high traffic areas and elevators. Another form of technology that will help identify where passengers are congregating is a tracking device that collects data from Wi-Fi, Bluetooth, and cellular signals. If there are too many people in one area, the crew may encourage them to disperse.
"If a certain deck is turning yellow to red, maybe someone needs to go make sure it's not too crowded," Nadir Ali, the CEO of Inpixon, an indoor data intelligence company who is working with cruise lines, told USA Today.
In the meantime, both Apple and Google are releasing coronavirus tracking applications that can alert people anonymously if they are near an infected person. Once a person tests positive, they enter the information into the app, and anyone who has been near that person over the past 14 days will get notified.
Even though the technology keeps the information anonymous, 3 out of 5 Americans said they were uncomfortable with the concept, according to USA Today. If this technology is embraced, it is yet another way cruise ships can identify and isolate potentially infectious passengers.
Coronavirus, Patent Trolls and Telemedicine
Connecting patients with medical professionals instantaneously via mobile telehealth applications, whether across town or on the other side of the world, allows those affected by or exposed to the virus to receive proper medical care without potentially exposing others. In fact, in response to the coronavirus outbreak, President Trump just signed legislation allowing Medicare to expand the use of telemedicine in vulnerable areas – demonstrating just one of the many ways in which these developing technologies will facilitate rapid, efficient responses to the virus.
Advancements in telemedicine and mobile-health will be critical to containing and managing the corona virus outbreak; this virus is also bringing their broader benefits sharply into focus. In fact, telemedicine and mobile-health technology are supporting countless initiatives to improve access to health care and enhance patient outcomes
The irony in such language is that children are safe at school already. The Centers for Disease Control and Prevention (CDC) states that of the first 68,998 U.S. deaths from COVID-19, only 12 have been in children under age 14 — less than 0.02 percent. Nor is coronavirus killing teenagers. At last count, the fatality total among children under 18 without an underlying condition is one; only ten of the 16,469 confirmed coronavirus deaths in New York City were among those under the age of 18. That’s similar to the fatality rate for those under 20 in France, estimated at 0.001 percent, and in Spain.
The death of even one child is tragic, of course. Yet, it must be kept in mind that as many as 600 children in the United States died from seasonal influenza in 2017-18, according to CDC estimates, while the CDC’s estimate for COVID-19 fatalities number just 12. A just-released JAMA Pediatrics study flatly states: “Our data indicate that children are at far greater risk of critical illness from influenza than from COVID-19.” If the COVID-19 hazard sets the new standard for health safety, the country will need to close its schools each year from November until April to guard against influenza.
CBO Says Economy Could Take Nearly 10 Years to Catch Up After Coronavirus
The U.S. economy could take the better part of a decade to fully recover from the coronavirus pandemic and related shutdowns, the Congressional Budget Office said Monday.
In an analysis that highlights both the depth and duration of the pandemic’s economic impact, the CBO said it has marked down its 2020-30 forecast for U.S. economic output by a cumulative $15.7 trillion, or 5.3%, relative to its January projections. Adjusted for inflation, the shortfall is estimated at $7.9 trillion, or 3% of cumulative gross domestic product.
Most of the gap results from the sharp contraction in economic activity this year, which was unforeseen when the CBO last published its 10-year outlook in January. The nonpartisan agency said last month it expects U.S. GDP to finish the year 5.6% lower than in the fourth quarter of 2019.
Eli Lilly & Co. said Monday it began the first study of an experimental drug derived from a blood sample of an early U.S. survivor of Covid-19, a new effort to take advantage of the molecular defenses developed by recovered patients.
The Indianapolis company said the testing aims to assess the drug’s potential to treat patients hospitalized with the coronavirus.
The drugmaker also plans eventually to test whether the antibody-based drug could prevent disease in people at risk of infection, an approach that could serve as a bridge toward curbing the pandemic until a successful vaccine is developed.
Lilly’s experimental drug is part of a broader push to harness the power of proteins known as antibodies that are found in the plasma of people who have recovered from coronavirus infection. Antibodies are agents of the immune system that counteract pathogens including viruses.
Researchers are also studying the use of plasma from recovered patients as a treatment for infections and a plasma-based therapy that has been used previously for other diseases.
In Lilly’s case, the experimental therapy—code-named LY-CoV555—doesn’t contain the plasma of recovered patients. Instead, the drug’s design was triggered by antibodies in the plasma.
Researchers at AbCellera Biologics Inc., a Canadian company that partnered with Lilly in March, and the U.S. National Institute of Allergy and Infectious Diseases identified an antibody with virus-fighting potential in a blood sample taken from one of the first U.S. patients who recovered from Covid-19.
Lilly’s scientists then essentially cloned the antibody to make the new therapy. Its goal is to block the virus from attaching to and entering human cells, thus neutralizing it.
“We’re not experienced in vaccines, or antiviral small molecules,” Lilly Chief Scientific Officer Daniel Skovronsky said in an interview. “But we’re really good at antibodies, engineering them, testing them, manufacturing them. That’s a capability we have, so the opportunity to work on antibodies against Covid-19 made total sense.”
The drug is taken intravenously.
The first study will primarily track safety and side effects, but will also test whether the treatment can reduce the length of hospital stays and curb the number of patients admitted to intensive care and in need of ventilators. Researchers expect to enroll up to 32 patients in the study.
One of the sites for the first study is at NYU Grossman School of Medicine in New York.
“What we’re doing here is taking patients with Covid, offering the opportunity to participate in a new treatment, hopefully to help them recover more quickly and uneventfully from their infection,” said Dr. Mark J. Mulligan, director of the infectious-disease and vaccine-research units at NYU Langone Health.
Dr. Mulligan said Gilead Sciences Inc.’s remdesivir has been shown to have some benefit in Covid-19 patients, but it is a moderate effect. Remdesivir was authorized for emergency use last month.
“We’d like to have stronger therapies,” he said.
If the first study is successful, Lilly said it plans to test the antibody in a second study that includes treating patients who aren’t in a hospital.
Other studies would examine whether the drug can prevent people from getting sick, focusing on vulnerable patient populations who aren’t optimal candidates for vaccines.
Lilly and AbCellera also have developed other antibodies that Lilly plans to test in coming months in Covid-19 patients, either alone or in combination with each other.
Lilly said it is starting large-scale manufacturing of the therapy, so that if studies prove successful, it will have several hundred thousand doses available by the end of the year.
How Independent Primary Care Practices Can Survive The Coronavirus Downturn
https://www.forbes.com/sites/theapothecary/2020/05/30/how-independent-primary-care-practices-can-survive-the-coronavirus-downturn/
The COVID-19 economic lockdown hasn’t just affected your favorite local restaurants and bars, but also your primary care physician. Many independent practices may permanently close. Others will survive by embracing new ways of practicing medicine.
In the traditional fee-for-service model of physician care, doctors get paid the more often they see you. So when COVID–19 hit, and people started staying at home, doctors’ revenues collapsed. A recent study by researchers at Harvard and Phreesia, a health care software company, found that physician office visits declined as much as two-thirds at the peak of the pandemic. There has since been a modest rebound; as of May 10, office visits were down 31 percent from pre-pandemic levels.
If the shutdown is prolonged, many independent practices will permanently close. A 2016 survey from the JPMorgan Chase Institute found that the average small health care business had 30 days of cash in reserve, meaning that one could survive for 30 days with no revenue at all. In the current crisis, that means that the typical independent practice could go belly-up by the end of June.
In primary care practices, the impact has been especially hard. A survey by the Larry A. Green Center conducted between May 8 and 11 found that 40 percent of physician practices have had to furlough or lay off employees, while 23 percent have gone into debt.
Congress has thrown trillions of dollars of taxpayer funds into the coronavirus crisis, with $100 billion earmarked for hospitals, and $300 billion in small business loans. But little of that money has made it to small physician practices, which lack the bandwidth and lobbying skill to draw down those funds. Indeed, the initial tranche of hospital assistance money was sent to hospital systems who had billed the most to Medicare—irrespective of providers’ actual financial need.
It’s a double-whammy for everyday patients. Patients are not seeing their doctors, which has significant public health consequences. And as physician practices close, or get sold to larger systems, patients struggle to gain access to affordable care.
Direct primary care: A path to financial stability
Today, primary care practices are the most financially vulnerable. But they are fortunate in one sense: they have a way out that other outpatient physician clinics do not. That way out is direct primary care.
In a direct primary care model, doctors receive a monthly fee from their patients, comparable to a cell phone or cable TV plan, regardless of whether the patient comes in or not. In exchange, the patient has access to services that conventional health insurers don’t cover. Patients benefit from the broader and deeper involvement of their doctors in their lives.
Instead of the typical 21st-century schedule in which the average patient encounter with a doctor lasts 5 minutes, direct primary physicians can spend 30 to 60 minutes with their patients—or even longer. That leads to better insights and better management of chronic medical conditions.
Physicians benefit from this model as well, not least because they’re less harried. The stable, predictable monthly revenue stream means that direct primary care practices are largely insulated from the volatility of patient visits that we’re seeing during the pandemic. And physicians can spend far less time—and money—haggling with insurers over their reimbursement rates.
Some people think of direct primary care as “concierge medicine,” by which they mean that it’s only available to the wealthy. But flip that on its head. The people most in need of concierge medicine are low-income Americans on Medicaid, who today struggle to obtain doctor’s appointments because Medicaid reimbursement rates are so much lower than those from private insurers...
