#New story in Health from Time: As U.S. Braces for Coronavirus to Spread | Explore Tumblr posts and blogs

newstfionline · 5 years ago

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Global institutions are flailing in the face of the pandemic (Washington Post) As the coronavirus pandemic sweeps across the world, institutions founded decades ago to organize and manage coherent responses to global crises seem to be flailing on the sidelines. Individual nations have turned inward, competing for resources and hurling blame at each other for allowing the virus to spread. Some are hoarding vital medical supplies and restricting exports, while others are suffering acute shortages. Countries have set their own guidelines for behavior and determined their own travel restrictions without consulting neighbors or the wider international community. The World Health Organization, charged with anticipating and alleviating international health insecurity, is accused by the United States and others of making the situation worse. President Trump, who has said the WHO favors China, on Tuesday announced a halt to U.S. funding. The U.N. Security Council, the world’s premier international decision-making forum, has been paralyzed by disputes among its leading members. The question is not only whether the world order has stumbled but what direction it will take when the current crisis is over. Will there be a new appreciation of its importance, and a determination to make it work better? Or will pre-virus trends accelerate toward tighter borders, less cooperation and a tilt toward nationalism?

Now joining the fight against coronavirus: The world’s armed rebels, drug cartels and gangs (Washington Post) In Afghanistan, the Taliban has dispatched health teams to far-flung provinces to confront the coronavirus. In Mexico, drug cartels are offering aid packages to those feeling its economic impact. In Brazil and El Salvador, gangs enforce curfews to prevent its spread. As governments around the world have responded to the coronavirus, so too have armed insurgents and terrorist groups and drug cartels and gangs, a parallel underworld of public health policy and strategic messaging. It is hardly the first time such groups have attempted to fill the role of government. But few crises in modern times have tested the limits of the world’s nation-states as the coronavirus has, providing an opening for armed groups to step in where presidents, police forces and parliaments have failed. Analysts who study the organizational structure of armed groups are now cataloguing dozens of instances of rebels and bandits making forays into public health policy.

IMF predicts worst recession since Great Depression (Foreign Policy) The International Monetary Fund Chief Economist Gita Gopinath projected that the global economy would contract by 3 percent, a downturn three times greater than the contraction after the 2008 financial crisis. “It is very likely that this year the global economy will experience its worst recession since the Great Depression,” Gopinath said. She added that although a “partial recovery is projected for 2021” countries should still expect their economies to be 5 percent smaller.

Would you give up health or location data to return to work? (AP) As countries around the world edge toward ending lockdowns and restarting their economies and societies, citizens are being more closely monitored, in nations rich and poor, authoritarian and free. New systems to track who is infected and who isn’t, and where they’ve been, have been created or extended in China, South Korea and Singapore. And a range of other surveillance systems – some utilizing GPS location data, some gathering medical data – have been debated or piloted in Israel, Germany, the U.K., Italy and elsewhere. The challenge: achieving the tricky balance between limiting the spread of disease and allowing people freedom to move outside their homes. Whether the prospect on the table is “immunity passports” or cellphone-based tracking apps, the aim is to protect public health. But experts say it’s also important to avoid a slippery-slope scenario where data collected to minimize the spread of disease is stored indefinitely, available without limits to law enforcement or susceptible to hackers.

Military sees no quick exit from 'new world' of coronavirus (AP) The U.S. military is bracing for a months-long struggle against the coronavirus, looking for novel ways to maintain a defensive crouch that sustains troops’ health without breaking their morale — while still protecting the nation. Officials have frozen most forces in place overseas, stopped troops and their families from moving to new assignments, and cut back access to the Pentagon. The military services have halted or restricted recruit training, canceled major exercises, and isolated troops in the most sensitive units. The new Space Force has delayed a satellite launch, and the Navy this week postponed the return of the USS Harry S. Truman, keeping the aircraft carrier at sea to shield its crew from virus exposure at home. These steps to protect the force have parallels in civilian society, but a far-flung military can’t function by staying at home. “This will be a new way of doing business that we have to focus in on,” says Air Force Gen. John Hyten, vice chairman of the Joint Chiefs of Staff. “We’re adjusting to that new world as we speak today.”

In Pandemic’s Grip, Russia Sees Spike in Age-Old Bane: Drinking (NYT) Across the world, the coronavirus pandemic has sparked fears of increased alcohol abuse, as people locked in and anxious turn to drink. In Russia, two weeks into a nationwide partial lockdown, those fears are becoming reality as evidence mounts that a spike in alcohol sales is fueling a rise in domestic violence. Reducing the country’s passion for inebriants has been one of the government’s main public health goals under President Vladimir V. Putin, and the most recent official statistics showed Russians consuming about one-third less alcohol per year than they did in 2003. But dayslong drinking binges are still a habit for some people, especially during holidays. In late March, when Mr. Putin obliged with a nationwide paid week off to combat the spread of the coronavirus, the habit kicked in. Sales of vodka in Russia shot up 65 percent in the last week of March, compared with a month earlier, according to the market research firm GfK.

China Grapples With Diplomatic Disasters (Foreign Policy) Beijing is trying to put out multiple diplomatic fires this week, as China discriminates against foreign residents amid the coronavirus pandemic and its embassies spread misinformation online. It faces the biggest crisis across Africa, after hundreds of African nationals, mainly from Nigeria, were expelled from their homes in Guangdong and banned from restaurants or shops. The discrimination has caused widespread outrage, including a rare joint complaint by around a dozen African countries. Anti-black racism in China is common, and it has grown more intense in recent years. China’s initial response to the protest was to deny the discrimination, though there have now been some attempts at conciliation. Elsewhere, France summoned the Chinese ambassador in Paris on Tuesday after his embassy made false claims online that French nursing home workers were abandoning their charges. The comments follow a pattern of aggressive efforts by Chinese diplomats to depict the rest of the world as slipping into chaos and even to blame other countries for the coronavirus outbreak. Meanwhile, much of the Chinese medical equipment delivered to Europe during the pandemic has been found to be defective or counterfeited.

Taiwan’s coronavirus success (Foreign Policy) Taiwan detected the threat of the coronavirus as early as Dec. 31, 2019, by watching China closely—followed by prompt action by Taiwanese health officials and immediate checks on travelers from Wuhan, where the virus originated. Taiwan remains one of the pandemic’s outstanding success stories, especially given its high degree of travel from China. On Tuesday, Taiwan reported zero new cases of the coronavirus.

North Korea Fires Missiles as South’s Elections Loom (NYT) North Korea fired several short-range missiles off its east coast on Tuesday, a day before South Korea is scheduled to hold elections for its 300-seat Parliament. The projectiles, launched from the town of Munchon, were believed to be cruise missiles, the South Korean military said in a statement. Under a series of United Nations resolutions, North Korea is banned from testing ballistic — but not cruise — missiles. Thus, its launchings on Tuesday were considered less provocative than its recent tests of ballistic missiles. But South Koreans remain sensitive to any move by the North to raise tensions during an election time for fear it might sway how voters cast their ballots.

Japan Needs to Telework. Its Paper-Pushing Offices Make That Hard. (NYT) Officially, Shuhei Aoyama has been teleworking for a month. But that doesn’t mean he can avoid going to the office. Several times a week, Mr. Aoyama makes a half-hour commute across Tokyo for a task seemingly more suited to the age of the samurai than of the supercomputer: stamping his official corporate seal on business contracts and government paperwork. The stamps, known as hanko or inkan, are used in place of signatures on the stream of documents that fill Japan’s workplaces, including the hotel network that employs Mr. Aoyama. They have become a symbol of a hidebound office culture that makes it difficult or impossible for many Japanese to work from home even as the country’s leaders say working remotely is essential to keeping Japan’s coronavirus epidemic from spiraling out of control. While the world may see Japan as a futuristic land of humanoid robots and intelligent toilets, inside its offices, managers maintain a fierce devotion to paper files, fax machines, business card exchanges and face-to-face meetings.

#headlines #news

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phooll123 · 5 years ago

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As doctors in the U.S. have watched Italy’s health care system buckle under the sudden strain of the coronavirus, the magnitude of the problems that could be heading their way have begun to sink in. The crises Italian medical staff have been reportedly facing — overwhelming conditions, choosing which patients get treatment, and desperately working to expand their manpower — are all things that hospitals in the U.S. could encounter if the virus continues on its path, doctors say.

“For me it flipped from, ‘This is a real concern, I wonder what’s going to happen’… to ‘Holy cow, I think we’re in trouble,’” says Laurel Fick, a residency director and an internal medicine physician at Ascension St. Vincent Hospital Indianapolis hospital, when she realized how grim the situation in Italy had grown.

As of Monday, the U.S. had more than 4,000 confirmed coronavirus cases, according to Johns Hopkins University, only a fraction of the approximately 28,000 cases in Italy. But the slow start of rolling out testing has made it impossible to know exactly how widespread the pandemic actually is in the U.S. What is clear is that the rate at which cases are increasing is similar to Italy’s trajectory. The Surgeon General said Monday that the U.S. is two weeks behind Italy.

“When you look at the projections, there’s every chance that we could be Italy,” U.S. Surgeon General Jerome Adams told Fox News on Monday.

As health care professionals watch the potential future unfold across the Atlantic, they are growing increasingly anxious that the novel coronavirus, which is particularly dangerous for the elderly and people with underlying medical conditions, could overrun the American healthcare system. As public officials and businesses try to enforce social distancing to slow the spread, hospital staff say they are concerned about shortages of specialized equipment like ventilators, hospital beds, masks and personnel. If the system grows too stretched, they worry they may ultimately have to ration health care.

For now, hospitals can only prepare for the worst. One estimate reportedly presented by the American Hospital Association predicts there could be 96 million cases of coronavirus in the U.S. in the next couple of months, with 1.9 million intensive care unit admissions, 4.8 million hospitalizations, and 480,000 deaths associated with the virus.

“We are not ready. We are not ready virtually anywhere in the country for that kind of onslaught on our health care system,” says Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.

For instance, Redlener estimates that there are 95,000 intensive care beds in the country, but “even in the moderate attack rate of the coronavirus,” he believes there could be a need for more than double that number. He also believes the U.S. has only a “fraction” of the mechanical ventilators that could be needed, a device that will be crucial for a virus that aggressively attacks the lungs and for which there is no good substitute. A 2010 survey estimated that there were likely around 62,000 mechanical ventilators in U.S. hospitals.

The Trump Administration has slowly begun to publicly recognize the gravity of the situation hospitals and medical staff are facing. Health and Human Services Secretary Alex Azar acknowledged during a White House briefing on Sunday that a “pandemic like this runs the risk of exceeding our health care system capacity.”

In a sign of how difficult these resources are to come by as the pandemic spans the globe, Trump held a call with governors on Monday telling them they should seek crucial equipment on their own, according to a New York Times report. “Respirators, ventilators, all of the equipment — try getting it yourselves,” Trump reportedly said. “We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.”

Some of these supplies are available in the federally managed, secretive Strategic National Stockpile (SNS), which distributes supplies during crises like this one. On Sunday, Azar said there are “thousands and thousands” of ventilators available in the SNS, but cited national security reasons for not disclosing specific numbers of the supplies available.

Knowing their facilities cannot handle experts’ worst-case scenarios, doctors have been aggressively calling for social distancing to “flatten the curve,” or slow the rate at which the population gets infected and therefore keep the health care infrastructure from being overwhelmed. On Sunday, the Centers for Disease Control put out new guidelines recommending events with 50 or more people be cancelled for the next eight weeks, as well as events of any size where social distancing could not be incorporated.

By Monday, Trump was urging people to avoid gatherings of groups of more than ten. Several cities have now started cracking down on social life, closing restaurants and bars and asking residents to “shelter in place,” and businesses across the country have sent employees to work from home.

“I actually worry that there are a lot of individuals who are not taking it seriously,” says Avital O’Glasser, medical director for the Preoperative Medicine Clinic at Oregon Health & Science University in Portland. “I worry about the banter that people are still saying, ‘I’m going out to bars. I want to go celebrate St. Patrick’s Day. This isn’t going to affect me. I’m young and healthy. Why do I have to isolate myself?’”

If the country is unable to reduce its infection rate, the nation’s health care infrastructure will not be able to cope, and it could result in a decline of adequate care both for coronavirus patients and people suffering everyday health issues, complications or trauma, experts across the country worry.

On Friday, the American College of Surgeons released guidance on minimizing, postponing, or cancelling elective operations in the midst of the pandemic. The Surgeon General also tweeted for hospitals to consider stopping elective procedures, citing the tax it would put on personnel needed for coronavirus response. If there aren’t enough resources to provide proper continuing care to people with chronic illness, medical professionals say that in itself may also have long-term consequences in the health care system.

And while medical professionals are thinking that far ahead, they have more urgent advice. “If we don’t keep that curve flat, and try to keep the critical cases down to a minimum, we’re going to get to a point where we just don’t have enough resources,” says John Hick, medical director for emergency preparedness and emergency physician at Hennepin Healthcare in Minneapolis.

Hick worries about the number of ventilators available, as well as the number of extracorporeal membrane oxygenation, or ECMO, systems, which function like an external blood pump. “So that’s kind of what we’re wrestling with right now — in addition to just space and the staffing,” he said.

He also pointed to appropriate hospital beds as something difficult to work around, describing how unrealistic it would be, for example, to place an 80-year-old patient on a makeshift cot. “Their skin breaks down. A lot of times we have to position those patients differently in order to ventilate them appropriately,” he said. “There’s just no substitute for a good, quality hospital bed.”

Hospitals are also increasingly concerned about the short supply of the personal protective equipment (PPE) used to keep health care workers safe and healthy, like gowns, N95 respirators, surgical masks, gloves and eye protection.

“We’re seeing significant shortages of personal protective equipment and [a] shift to having to really conserve personal protective equipment to make sure that our nurses, physicians and others are adequately protected,” says Paul Biddinger, Vice Chairman for Emergency Preparedness in the Department of Emergency Medicine at Massachusetts General Hospital. “Every health care system has been having to very carefully determine how they allocate and use their PPE so that they try to preserve it to protect the workforce.”

As an increasing number of first responders are likely to come in contact with and contract coronavirus — and therefore be unable to continue working themselves — staffing could become a major problem. Facing furloughed workers, or workers simply exhausted after endless hours on the job, trained professionals out of the workforce may be looked to as standby substitutes. Health care professionals who are not normally considered frontline workers are also figuring out how they can jump in and get involved in the fight.

“I think we’re having to all get comfortable with the idea of practicing outside of our comfort zone,” Fick says. “I’m an internal medicine physician, I’m trained in critical care for my residency, but that was 10 years ago. I haven’t operated a ventilator in 10 years, but I’m preparing to rapid-fire relearn that skill in the event that I have to use that.”

#News Updates #New story in Health from Time: As U.S. Braces for Coronavirus to Spread #Hospitals Wor

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differentnutpeace · 4 years ago

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The Most Popular J&J Vaccine Story On Facebook? A Conspiracy Theorist Posted It

CNN. ABC News. The New York Times. Fox News.

Those are the publishers of four of the five most popular Facebook posts of articles about the Johnson & Johnson Covid-19 vaccine this week. They're ranked 2-5 in total interactions, according to data from the tracking tool Crowdtangle. หวย บอล เกมส์ คาสิโนออนไลน์

Number one however, isn't from a news organization. Or a government official. Or a public health expert.

The most popular link on Facebook about the Johnson & Johnson news was shared by a conspiracy theorist and self-described "news analyst & hip-hop artist" named An0maly who thinks the pandemic is a cover for government control.

It's a stark example of what experts warn could be a coming deluge of false and misleading information related to the one-shot vaccine.

When most Americans went to bed Monday evening, the news about Covid-19 vaccinations in the U.S. was overwhelming positive: the average number of shots administered per day was well over three million, leading to many rosy predictions that pandemic restrictions could ease in the coming months and some semblance of normalcy could return.

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But that story shifted on Tuesday after federal health officials recommended a temporary halt in the use of the Johnson & Johnson vaccine, after a handful of reports about blood clots surfaced among the millions of people who have received the shot.

Many doctors argue this sort of delay should actually be seen as a positive for vaccine safety: officials are paying close attention to the reports of side effects and acting quickly to maintain public confidence in the vaccination effort.

But experts who follow internet trends are bracing for the worst when it comes to how this news is understood and received by the public.

"This is what I would call the perfect storm for misinformation," said Jennifer Granston at Zignal Labs, a media intelligence platform.

POLITICS

NPR/Marist Poll: Biden Gets High Marks On COVID-19. It's Not The Case On Immigration

Millions of Americans were already skeptical of the vaccines before the Johnson & Johnson news, and a vast online network exists to feed that skepticism with bad information and conspiracy theories.

That network went into action almost immediately after the pause in vaccinations was announced.

Robert Kennedy Jr., who is considered one of the top spreaders of vaccine misinformation in the U.S., posted the news to his 230,000 Facebook followers.

Rizza Islam, another prominent promoter of vaccine hesitancy especially within the Black community, tweeted conspiracy theories about the Johnson & Johnson news to his 54,000 followers on Twitter (Islam was recently removed from Facebook).

Even some state lawmakers used the news to imply vaccines aren't safe. One Pennsylvania state lawmaker, Rep. Rob Kauffman, posted to his 13,700 Facebook followers that "we don't fully understand these vaccines."

UNTANGLING DISINFORMATION

Few Facts, Millions Of Clicks: Fearmongering Vaccine Stories Go Viral Online

A trending topic means opportunity

In most cases, the social media companies say they can't do much to respond in cases like this, since people largely are sharing articles based on factual information, even if the commentary and subtext around the posting is meant to further false ideas.

Many anti-vaccine activists have adopted this tactic as a way of getting around social media networks' policies designed to halt the spread of false information.

An0maly, the influencer with the widely-shared posting about the Johnson & Johnson vaccine, shared a CNN story with a misleading caption to his 1.5 million Facebook followers.

"The issue is this is a factual report," said Sarah Roberts, an information studies professor at UCLA. "But the people reading the report either have such deeply-held preconceived notions about its meaning or they lack appropriate context to receive the information."

Overall, it's hard to overstate the degree to which the Johnson & Johnson story blew up online.

The company was getting as many mentions online every hour Tuesday as it had during entire weeks prior to the news, according to data from Zignal.

Much of those mentions were not in reference to misinformation, but Zignal's Granston says anytime interest in a topic spikes like that online, especially with a polarizing subject like vaccines, it provides a ripe environment for misinformation as well.

"These big conversations provide this huge platform for people to further a specific agenda around this information," she said.

UNTANGLING DISINFORMATION

Few Facts, Millions Of Clicks: Fearmongering Vaccine Stories Go Viral Online

Zignal saw an uptick in mentions of narratives about side effects, but also in other vaccine misinformation narratives unrelated to the actual news like vaccine passports, deaths, and microchips.

Disinformation economy

The Johnson & Johnson pause is also fertile ground for conspiracies because it is a developing topic with a number of unanswered questions.

Often, misinformation peddlers with a specific agenda will fill in knowledge gaps with false information, knowing that people are desperate for any information at all.

"It's supply and demand," said Keenan Chen, a disinformation researcher at the nonprofit First Draft News.

THE CORONAVIRUS CRISIS

U.S. Health Officials Continue Pause Of Johnson & Johnson Vaccine

Because health officials are still investigating the clotting issue, and determining guidance about the vaccine, there isn't much trustworthy information the government or credible outlets can provide to fill that void.

Roberts, of UCLA, says the problem is further exacerbated because the country has become so divided over the pandemic in general.

Former President Trump primed a portion of the country over the past few years to be skeptical of official sources of science information, including the Centers for Disease Control and Prevention. On Tuesday, he released a statement that included a false conspiracy theory about the Johnson & Johnson vaccine, claiming without evidence that the decision was made to benefit rival drug makers.

Now, Roberts says, whenever the CDC comes out with guidance about the Johnson & Johnson vaccine, health officials will be fighting ingrained doubts.

"Every time there's going to be a new bit of negative [vaccine] information or circumstances that sow doubt, it's like we're caught on the back foot and we have to come together again and push forward," Roberts said. "To call that an uphill battle... I mean it's like a Mount Everest-sized battle. Uphill seems like an understatement."

Even after that guidance does come out, which officials say they hope will be in a matter of days, it's likely this development has ripple effects, especially driven by those who have made fear a business model and built their brands on vaccine skepticism.

Chen, of First Draft, notes that many of the actors who push vaccine disinformation also pushed election-related disinformation last fall, and disinformation about other aspects of the pandemic.

"[For] the group of people whose business is about growing their audience on social media, and they monetize it, it's very easy for me to imagine that they would keep pushing this narrative, that they would come back and point to this pause," Chen said. "It would be hard for me to imagine that they would just stop — that they would just give up."

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stephenmccull · 4 years ago

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Despite Covid, Many Wealthy Hospitals Had a Banner Year With Federal Bailout

Last May, Baylor Scott & White Health, the largest nonprofit hospital system in Texas, laid off 1,200 employees and furloughed others as it braced for the then-novel coronavirus to spread. The cancellation of lucrative elective procedures as the hospital pivoted to treat a new and less profitable infectious disease presaged financial distress, if not ruin. The federal government rushed $454 million in relief funds to help shore up its operations.

This story also ran on The Washington Post. It can be republished for free.

But Baylor not only weathered the crisis, it thrived. By the end of 2020, Baylor had accumulated an $815 million surplus, $20 million more than it had in 2019, creating a 7.5% operating margin that would be the envy of most other hospitals in the flushest of eras, a KHN examination of financial statements shows.

Like Baylor, some of the nation’s richest hospitals and health systems recorded hundreds of millions of dollars in surpluses after accepting the lion’s share of the federal health care bailout grants, their records show. Those included the Mayo Clinic, Pittsburgh’s UPMC and NYU Langone Health. But poorer hospitals — many serving rural and minority populations — got a tinier slice of the pie and limped through the year with deficits, downgrades of their bond ratings and bleak fiscal futures.

“A lot of the funding helped the wealthy hospitals at a time, especially in New York, when safety-net hospitals were hemorrhaging,” said Colleen Grogan, a health policy professor at the University of Chicago. “We could have tailored it to hospitals we knew were really suffering and taking on a disproportionate amount of the burden.”

In Baylor’s case, the system, which runs Baylor University Medical Center in Dallas and 51 other hospitals, said it spent $257 million last year on pandemic-related costs, including protective clothing for employees and patients and creating isolation rooms. Baylor has $197 million in unspent federal relief funds to use this year to cover costs of battling the virus and refrigerating vaccines, it said.

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“Our covid-19-related expenses and lost revenue continue to exceed the funding we have received to date,” Baylor said in a statement to KHN.

Other well-heeled hospitals or large systems faced bigger problems. Both NewYork-Presbyterian Hospital and CommonSpirit Health, a 140-hospital Catholic system that operates in 21 states, lost money despite federal grants in the vicinity of a billion dollars each. A few systems, including the for-profit chain HCA Healthcare, returned federal funds when they saw they had skirted their worst-case scenarios. But most spent the aid and held onto any leftover money and new grants to cover anticipated pandemic costs this year because hospital executives fear more case spikes.

Much of the lopsided distribution was caused by the way the Department of Health and Human Services based the allotment of the initial bailout funds on hospitals’ past revenue. That favored institutions with well-off patients who have private health plans over those that rely on lower-paying government insurance, which is what many poor people use.

HHS distribution formulas did not take into account which hospitals had enough assets to survive.

Baylor, for instance, began 2020 with $5.4 billion in cash and investments, enough to keep it running for 238 days, the financial disclosures show.

Hospitals that ended the year with profits were entitled to federal aid because of the extraordinary latitude Congress and HHS set in how hospitals could classify their pandemic costs.

Last fall, when HHS attempted to limit how much aid hospitals could keep based on their profits — so the money could be redirected to struggling hospitals — the effort was swiftly beaten back by the industry and Congress. HHS officials declined requests for an interview but noted in a statement that Congress had ordered it to revert to its “broader definition of permissible use of PRF funds.”

“The Biden Administration continues to review programs and policies including considerations for the unallocated funding under the PRF program and the $8.5 billion recently appropriated under the recently signed American Rescue Plan Act,” the statement said.

Avoiding a Drawdown of Reserves

The bailouts were initiated last spring to help health care providers ride out a once-in-a-century public health calamity. The money designated to hospitals and other health care providers from the Coronavirus Aid, Relief, and Economic Security (CARES) Act and subsequent legislation totaled $178 billion.

It was intended to offset all costs of treating infected patients, including purchasing ventilators, masks, gowns and other personal protective equipment. Congress further authorized hospitals to use the money to compensate for a drop in revenue when they shut down elective surgeries and non-emergency treatments to prepare for the anticipated deluge of covid-19 patients.

The money, referred to as the Provider Relief Fund, helped many poorer hospitals avert cash crunches, layoffs and bond rating downgrades. A survey by the consulting firm Kaufman Hall found that the median hospital gain during 2020 would have been 0.3% without the federal support. With it, half of hospitals posted gains of 2.7% or more, below the 2019 median margin of 3.1%, according to the firm, which also produces analytic work for the American Hospital Association.

In February, the association urged Congress to replenish the nearly empty relief fund, saying, “hospitals have never experienced such a widespread, national health crisis.”

Some hospitals’ finances deteriorated significantly during the pandemic. From the end of March through December, the rating agency Moody’s downgraded 28 hospitals, primarily because of weaknesses such as higher debt or more competition, said Lisa Goldstein, associate managing director at Moody’s.

Others suffered worse fates, like Williamson Memorial Hospital, which shut down last April. The hospital, in West Virginia’s coal country, had been trying to climb out of bankruptcy protection, but “unfortunately, the decline in volumes experienced from the current pandemic were to[o] sudden and severe for us to sustain operations,” its CEO wrote on Facebook.

Conversely, many prosperous health systems emerged unscathed from the moratoriums of last spring, often due to the federal aid. “It gave them an ability to not have to draw down on their reserves to make up for the loss in revenue,” said Suzie Desai, a senior director at S&P Global Ratings.

Systems saw patient visits return to near normal as the year wore on. In some cases, business in the latter half of 2020 was even higher than in the same period in 2019 because of pent-up demand for treatments postponed from the spring, financial records show.

“We saw volumes spring back” in every area except emergency room visits, said Kevin Holloran, a senior director at Fitch Ratings. Major hospital systems also reported that cases tended to be more complex than normal, leading to higher insurance payments.

UPMC accepted $460 million in bailout funds while collecting $2.5 billion more in revenue in 2020 than in 2019. The nonprofit system ended the year with an $836 million operating surplus — providing a 3.6% margin that was triple the prior year’s — in part due to the growth of the health insurance plan the system owns.

Other hospitals that sold insurance, including Baylor, persevered because the cause of their financial troubles — fewer surgeries and doctors’ visits — meant the health plans paid fewer claims.

UPMC’s strong finances went unmentioned in a recent fundraising pitch announcing the launch of its “Health Care Heroes” campaign. “During the past year, health care workers have carried the weight of the world on their shoulders, risking their own health and safety to ensure ours as we navigated the covid-19 pandemic,” the email said. “Now it’s our turn to recognize their hard work. … By making a donation, you will help provide training, recognition, and support for our staff initiatives.”

Donald Yealy, a senior vice president of UPMC and the chief medical officer of UPMC Health Services, said the fundraising appeal was a way to allow people in the community to show their appreciation.

“The intent of the request and the letter were clear. People are free to ignore or to have an opinion. I don’t begrudge that at all. I respect people having a different opinion," he said.

Hospitals can hold on to unspent relief funds until the end of July to defray any further pandemic-related costs. After that, any unspent money must be returned to the U.S. Treasury. UPMC retains $80 million in unspent relief funds, which the health system said it expects to use. “We’re still in the process of incurring significant costs related to covid,” said Edward Karlovich, UPMC executive vice president and chief financial officer.

‘A Shot in the Arm’ Sometimes Unneeded

In April 2020, the Mayo Clinic in Rochester, Minnesota, forecast up to $3 billion in lost revenue because of the pandemic. Instead, Mayo, which received $338 million in federal relief funds, ended the year with revenue that was $202 million higher than in 2019. Mayo recorded a $728 million surplus, which equaled a 5.2% margin.

“It gave us a shot in the arm when we needed it,” said Dennis Dahlen, Mayo’s chief financial officer. Later, when it seemed likely Mayo would run a surplus, executives debated what to do with the federal funds.

“Honestly, we considered dropping the margin,” Dahlen said. After weighing their options, Mayo “landed in a middle-of-the-road decision” by returning $156 million to the federal government.

“We considered it with what everyone else was doing … and we thought about what was good for society,” Dahlen said. “'Nonprofit’ doesn’t really mean no profit. It means tax-exempt. We still have to create earnings so we can reinvest in ourselves.”

Mayo ended the year with $14 billion in investments, $3 billion more than it had in 2019, a 29% increase.

The funds were, indeed, a lifesaver for some. Marvin O’Quinn, president and chief operating officer of CommonSpirit Health, said “there was never a thought of turning back the money.”

Despite receiving $1.3 billion in relief funds, CommonSpirit, based in Chicago, ended last year with a $75 million deficit, which translated to a 0.2% loss.

“We have been set back by a year,” O’Quinn said. “All the things we wanted to do — to renovate, to building new facilities, to expand our service — we’ve had to slow up to get through the crisis.”

Scattershot Relief

The first $50 billion in relief funds “was sent out indiscriminately as a life support,” said Ge Bai, an associate professor at Johns Hopkins Bloomberg School of Public Health. HHS tried to target subsequent distributions. It sent $22 billion to 1,090 hospitals with large numbers of covid patients. It sprinkled an additional $16 billion among hospitals that serve poor populations, Native American tribes, people in rural areas and children.

But even with the targeted aid, recipients included well-endowed academic medical centers and major urban hospitals. Only $14 billion took profitability into consideration, HHS documents show. HHS restricted those payments to hospitals with 3% or lower profit margins.

Wealthy hospitals also benefited because HHS used a broad definition of lost revenue. If a hospital earned less than in the year before, or simply less revenue than it had budgeted for, it could chalk up that difference to the pandemic and apply the relief funds to it. The implications garnered little attention at the time as they were overshadowed by the concerns about how HHS was doling out the money rather than how it could be used.

In September, HHS attempted to tighten its overall limits on how much money the hospitals could keep by basing it on the difference from the previous year’s net income rather than overall revenue — a number that in many cases would be much lower. The goal, the department said, was to “prohibit most providers from using PRF [Provider Relief Fund] payments to become more profitable than they were pre-pandemic, to conserve resources to allocate to providers who were less profitable.”

The American Hospital Association complained that would punish hospitals that had behaved responsibly by cutting costs and be an “administrative and accounting disaster,” as many hospitals had already spent the grant money.

HHS backed down a month later, citing “significant attention and opposition from many stakeholders and Members of Congress.” Not fully satisfied, Congress cemented the rollback in a December law.

Some hospital executives attributed their surpluses to their aggressive cost-cutting measures.

NYU Langone Health, for instance, received $461 million in relief funds, which covered about a third of its pandemic-related losses, said Daniel Widawsky, chief financial officer. Another third of Langone’s losses was absorbed by the record-high financial performance in the months before the pandemic, he said, and prompt cost control addressed the rest.

Widawsky said that at the beginning of March Langone canceled travel, froze hiring, paused construction and stopped discretionary purchases. “The first three days in March, we locked down spending,” he said. “If they wanted to buy a pencil, they had to call me.” Langone ended its fiscal year in August with $208 million in net income, and recorded a $136 million surplus in the final quarter of 2020, or 5.5%. Earlier this year, two credit agencies upgraded their outlook on Langone from stable to positive.

Despite accepting $942 million in bailout funds, NewYork-Presbyterian Hospital had a $457 million operating deficit, a 7% loss, at the end of September. It was a sharp turn from September 2019, when the system recorded a $166 million surplus, a 2.5% gain.

The system, which declined to comment, has not yet released its financial metrics for the final three months of 2020, but Fitch projected it would remain in the red. Still, NewYork-Presbyterian remains fiscally solid: Its most recent disclosure reported $3.8 billion in cash and short-term investments, enough to keep operating for more than a year.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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Despite Covid, Many Wealthy Hospitals Had a Banner Year With Federal Bailout

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“Our covid-19-related expenses and lost revenue continue to exceed the funding we have received to date,” Baylor said in a statement to KHN.

HHS distribution formulas did not take into account which hospitals had enough assets to survive.

Baylor, for instance, began 2020 with $5.4 billion in cash and investments, enough to keep it running for 238 days, the financial disclosures show.

Hospitals that ended the year with profits were entitled to federal aid because of the extraordinary latitude Congress and HHS set in how hospitals could classify their pandemic costs.

Avoiding a Drawdown of Reserves

In February, the association urged Congress to replenish the nearly empty relief fund, saying, “hospitals have never experienced such a widespread, national health crisis.”

Other hospitals that sold insurance, including Baylor, persevered because the cause of their financial troubles — fewer surgeries and doctors’ visits — meant the health plans paid fewer claims.

Donald Yealy, a senior vice president of UPMC and the chief medical officer of UPMC Health Services, said the fundraising appeal was a way to allow people in the community to show their appreciation.

“The intent of the request and the letter were clear. People are free to ignore or to have an opinion. I don’t begrudge that at all. I respect people having a different opinion," he said.

‘A Shot in the Arm’ Sometimes Unneeded

“Honestly, we considered dropping the margin,” Dahlen said. After weighing their options, Mayo “landed in a middle-of-the-road decision” by returning $156 million to the federal government.

Mayo ended the year with $14 billion in investments, $3 billion more than it had in 2019, a 29% increase.

The funds were, indeed, a lifesaver for some. Marvin O’Quinn, president and chief operating officer of CommonSpirit Health, said “there was never a thought of turning back the money.”

Despite receiving $1.3 billion in relief funds, CommonSpirit, based in Chicago, ended last year with a $75 million deficit, which translated to a 0.2% loss.

Scattershot Relief

HHS backed down a month later, citing “significant attention and opposition from many stakeholders and Members of Congress.” Not fully satisfied, Congress cemented the rollback in a December law.

Some hospital executives attributed their surpluses to their aggressive cost-cutting measures.

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New York City Restaurants Continue To Get Creative As They Face A Potential Indoor Dining Shutdown

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New York City Restaurants Continue To Get Creative As They Face A Potential Indoor Dining Shutdown

Lil’ Sweet Chick introduced breakfast service for the first time in October.

Restaurants throughout the country are bracing themselves for a rough winter as concerns for public health and safety could lead to further restrictions on an industry that’s already been hard hit since March.

Operators in New York City, where restaurants can currently seat guests at 25% capacity indoors with a 10 p.m. curfew on dine-in service, fear they will have to close their interior spaces again.

An end to indoor dining grows more likely each day. There has been a rise in Covid-19 infections nationwide, with a daily average of over 190,000 new cases reported to the CDC. In the Big Apple alone, confirmed cases have totaled over 14,000 over the last seven days, according to data from NYC Health as of 10 a.m. on December 7.

Elected city and state officials have already called on Governor Andrew Cuomo to declare New York City an orange zone—a designation that would force restaurants to halt indoor dining and transition back to only offering takeout, delivery and outdoor seating.

But dropping temperatures and a potential indoor dining shutdown haven’t stopped New York City restaurants from making the most of what they have and adapting in creative ways.

Sweet Chick rebranded all of its locations, including this one in New York City’s Lower East Side, … [] to Lil’ Sweet Chick.

John Seymour, founder, and Kyle Martin, COO, had to let go of all of their employees and close their Sweet Chick locations in Brooklyn, Manhattan and Queens in March. When thinking about ways to adjust their operations upon reopening, the restaurateurs decided it was time to try something they had considered even prior to the pandemic—a shift from full service to quick service.

Their concept opened back up in May with a lot of the original staff members and a new moniker: Lil’ Sweet Chick. All of the locations have rebranded and switched to a quick-service model with a new menu focused on more grab-and-go-friendly items such as fried chicken sandwiches.

Customers can order breakfast items such as buttermilk biscuit sandwiches at Lil’ Sweet Chick every … [] day from 9 a.m. to 12 p.m.

Seymour and Martin then set their sights on launching a breakfast menu for the first time but only if they could come up with biscuits that were up to their standards. “We started with the fried chicken sandwiches, really went full force with those, and then always wanted to do more of a breakfast program,” Martin says. “We took a while to get the biscuits right.”

In October, Seymour and Martin debuted breakfast service at all Lil’ Sweet Chick locations. Every day, from 9 a.m. to 12 p.m., New Yorkers can order savory items such as buttermilk biscuit sandwiches, chicken and waffles, and hash browns. For a sweet start to the day, there are options like the Blueberry Muffin Waffle, a Belgian waffle topped with cinnamon crumble, blueberries and lemon glaze.

The Blueberry Muffin Waffle is a Belgian waffle topped with cinnamon crumble, blueberries and lemon … [] glaze.

According to Martin, a few breakfast items that have been most popular among customers are the Bacon, Egg and Cheese Buttermilk Biscuit (a biscuit version of the classic New York bodega breakfast sandwich with thick bacon, egg, cheddar cheese and a side of housemade tomato jam) and the vegetarian-friendly Impossible Sausage, Egg and Cheese Buttermilk Biscuit.

When looking at Lil’ Sweet Chick’s operations for the near future, Martin says he and Seymour are just focusing on “hopefully getting through the winter.” They anticipate business will get slower during the colder weather months and plan on “using that time to come up with new ideas and new dishes” for the spring, according to the COO.

Nan Xiang Xiao Long Bao in Flushing has adapted its operations and is experimenting with new menu … [] items.

Nan Xiang Xiao Long Bao in Flushing has also been experimenting with its operations and menu. After closing its doors for less than three weeks during the pandemic, the restaurant, well known for its xiao long bao (soup dumplings), reopened and started selling frozen products for customers to make at home.

The dining spot also implemented “safety protocols including booking nearby hotels and shuttle cars for staff, installing hand sanitizer stations, and creating contactless order and payment systems,” Eddie Zheng, general manager, said in a release.

The new pan-fried cheese and shrimp dumplings at Nan Xiang Xiao Long Bao

In addition to releasing new bites such as pan-fried cheese and shrimp dumplings, Nan Xiang launched a limited-time xiao long bao set—the Three Treasures XLB—last month during a one-year anniversary celebration of its new location. The restaurant is hoping the special will draw in diners looking for “Instagram-worthy” dishes to post on social media.

The new soup dumplings have skins with colorful swirls inspired by watercolors. Each color corresponds with a particular filling that contains a Chinese delicacy: green (braised abalone); black (spiny sea cucumber); and red (Chinese-style dry-cured and smoked ham).

The Three Treasures XLB contains delicacies: braised abalone (green), spiny sea cucumber (black) and … [] Chinese-style dry-cured and smoked ham (red).

Nan Xiang plans on seeing how popular these eye-catching soup dumplings are with its customers and possibly introducing different versions with new luxury ingredients in the future.

Huertas experimented with selling wines at retail price. At a recent sale, $5 from every bottle sold … [] supported the Georgia Fund.

The end of indoor dining in New York City is highly likely, according to Jonah Miller, chef and owner of Huertas, an East Village spot for Basque-influenced cuisine. In preparation, he has invested in outfitting his outdoor space with heaters to keep diners warm. But given the expected decrease in foot traffic during the colder weather months, Miller also has another strategy: trimming down the restaurant’s existing inventory.

Recently, Huertas held its own wine sale, featuring bottles from its back room at retail price. $5 from every bottle sold supported the Georgia Fund from Dine for Democracy for the upcoming Senate runoffs in January.

Miller is also collaborating with Table 22 to create subscriptions for curated goodies from Huertas at varying membership levels. These subscriptions are monthly and can be gifted to others in three-month or six-month allotments.

Conservas are tinned seafoods commonly enjoyed in Spain and Portugal.

The Conserva Club tier, priced at $30 per month, is available locally for pickup and delivery and nationwide with free shipping. It includes two conservas (tinned seafood), two accompaniments such as chips or crackers, and an exclusive monthly at-home recipe from Miller.

There are also one-time gift bundles from Huertas through Table 22, such as the Vermouth & Conservas Bundle, priced at $50. It features a bottle of housemade vermouth, three conservas, hot sauce and herb salt. This package can be picked up or delivered for free in New York City, or shipped nationwide for an additional $10.

UNITED STATES – DECEMBER 7: Plates marked with the names and stories of restaurant workers who have … [] either been laid off or are in fear of losing their jobs lay across the East Lawn of the Capitol as part of a demonstration to urge Congress to pass the RESTAURANTS Act in Washington on Monday, Dec. 7, 2020. (Photo by Caroline Brehman/CQ-Roll Call, Inc via Getty Images)

The creative efforts New York City operators are putting in to keep their restaurants going and their staff employed are commendable; however, in the face of further restrictions as Covid-19 cases continue to rise, additional federal support is ultimately what many restaurants in the city and throughout the country need to sustain themselves.

The outlook for restaurants is more dire than ever. 17% of restaurants, which accounts for more than 110,000 eateries, across the U.S. have closed completely as the industry continues to struggle with an “economic free fall as a result of mandated closures and capacity limits due to the coronavirus pandemic,” according to a letter sent to Congressional leaders Nancy Pelosi, Mitch McConnell, Kevin McCarthy and Chuck Schumer from the National Restaurant Association (NRA) on December 7.

The letter lists other results from the nationwide survey the trade association recently conducted among its members. Roughly one in every six restaurants have shuttered its doors over the past nine months, and a vast majority of these establishments had been considered fixtures within their communities. Less than half of the owners of these closed businesses expect to stay involved in hospitality in any form in the coming months or years.

WEST HOLLYWOOD, CALIFORNIA – DECEMBER 07: A man walks past shuttered outdoor restaurant seating … [] decorated with American flags on the first day of new stay-at-home orders on December 7, 2020 in West Hollywood, California. Under state order, 33 million residents of California have entered into regional shutdowns in an attempt to contain the spread of the coronavirus as ICU capacity has dipped below 15 percent in most regions of the state. Barbershops, hair and nail salons, museums, zoos, movies theaters are closed while restaurants are open for takeout or delivery only. In Los Angeles County, outdoor dining was shuttered nearly two weeks ago amid a surge of coronavirus cases there. (Photo by Mario Tama/Getty Images)

“Efforts in Washington to find the ‘perfect’ solution are laudable, but the lack of progress in the meantime has led too many operators to give up on the government and close down for good,” Sean Kennedy, NRA executive vice president of public affairs, wrote in the letter.

Talks over the passage of the RESTAURANTS Act, a relief bill from Congress, continue to stall—leaving operators are unsure if they can survive through the winter.

As Kennedy put it in the NRA’s letter to Congress, “the restaurant industry simply cannot wait for relief any longer.”

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The Future Of The Pandemic In The U.S.: Experts Look Ahead

A year after the pandemic shut down the country, a growing number of infectious disease experts, epidemiologists, public health officials and others have started to entertain a notion that has long seemed out of reach: The worst of the pandemic may be over for the United States. หวย บอล เกมส์ สล็อต คาสิโนออนไลน์

No one thinks that's guaranteed by any means. There are many ways the pandemic could resurge. But many say it's becoming increasingly possible that the end may finally be in sight.

Even experts who have raised the alarm about the severity of the COVID-19 crisis nonstop for more than a year are optimistic.

"The worst may in fact be behind us," says Dr. Ashish Jha, dean of the Brown School of Public Health, one of more than 20 people interviewed by NPR for this story. "To be able to say: 'I think, [I'm] cautiously optimistic that the worst may be behind us?' Boy, that does feel really good."

Now, to be clear, more than 50,000 people are still getting infected daily with the coronavirus and hundreds are dying. So there's a great deal of sickness and suffering still in store for the country before the pandemic ends.

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And the newfound optimism comes with three big caveats: The worst may be over if too many people don't let down their guard too fast, if the more dangerous variants don't make cases surge before enough people get vaccinated, and if the vaccination campaign doesn't stumble badly.

But if none of those problems occurs, life could slowly but steadily return to something much more normal.

The optimism is based on the rapid ramp-up of the vaccination campaign combined with the fact that a significant proportion of the country already has some immunity from being exposed to the virus, and the warmer weather that is linked to slower viral spread.

"If all goes well, if we stick by the public health measures, if we effectively vaccinate, I think we are looking at a brighter future over the next several months. That's entirely conceivable and probably likely," says Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

Now, not everyone is quite ready to say the worst might be over. Several experts worry about the more contagious variants combining with too many communities lifting mask mandates and other restrictions and too many people letting down their guard, especially over spring break and Easter.

"I'm worried," says Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy. "If you wanted to put all the viral ingredients in one big mixing bowl to cause them to transmit in ways that would be very damaging to us, do what we're doing right now."

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In fact, new hot spots may already be emerging, especially in Michigan and other parts of the Midwest, and in the Northeast, including New York City and New Jersey. Not only has infections started increasing in dozens of state, but hospitalizations may have also started creeping up again in at least a dozen states, according to new data from Pinar Karaca-Mandic and her team at the University of Minnesota COVID-19 Hospitalization Tracking Project.

But while most experts agree that there's still a sword of Damocles hanging over the nation's hopes, most think that the country could avoid another big surge such as the one that occurred over the winter.

"There are nightmare scenarios that we can paint out. And I can't say that those are such remote possibilities that we can dismiss them," says Jeffrey Shaman, an infectious disease researcher at Columbia University. "But I do think that this was probably the worst, and it will continue to go down."

Here's a road map to what we can expect for the future of the pandemic in the United States.

Late spring and summer: a cautious return to social life

Experts NPR spoke to predict that this spring, as more people are vaccinated, more people may be able to return safely to stores, restaurants and work, more children could return to in-person learning, and small groups of fully vaccinated people can get together for dinner parties indoors without masks.

In fact, the Centers for Disease Control and Prevention recently issued guidelines that say vaccinated people can already start to get together that way.

And if case counts continue to decline and vaccination rates increase, many public health authorities think the summer could be even better.

"Life will get better for sure," says Ali Mokdad at the University of Washington's Institute for Health Metrics and Evaluation. "We will see more grandparents visiting and hugging their grandchildren. More restaurants will open. We will see sport events. Weddings. Church and religious events. We will have summer camp for kids. People will travel more."

In fact, Mokdad says, he has plans to fly to see his mother.

Still, Mokdad stresses that activities such as summer camps could only probably safely operate with precautions, such as random testing, mask-wearing and open windows to provide fresh air.

And Americans still need to be careful: Hot spots could flare up due to the variants, people getting careless and triggering superspreader events, and among pockets of people who haven't gotten vaccinated.

"Specific communities may see a resurgence because of the variants — there may be hot spots," says Caitlin Rivers, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. "But I don't think there will be another wave like we saw in the winter."

Fall: Schools reopen, and life starts feeling almost normal

By the fall, while young children still won't be vaccinated because scientists have just started testing the vaccines on them, their teachers hopefully will be. So in places where infections are low, schools should be pretty safe, experts told NPR.

Students will probably still wear masks and may still need to keep their distance from one another. But hopefully no more slogging through school on laptops at the kitchen table for most kids.

Experts predict in-person schools will be able to open widely around the country by fall. Some places already have, such as Medora Elementary School in Louisville, Ky.

Jon Cherry/Getty Images

"I am counting on it, and I'm thrilled," says Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security, who has a 7-year-old son. "Seven-year-olds aren't supposed to spend their entire days on a computer."

Researchers such as Fauci hope that more aspects of our day-to-day lives could edge back closer to pre-pandemic times.

"It is conceivable, and probably likely, by the time we get to the fall — late fall, early winter, by the end of this year — that we have a gradual but very noticeable and important return to some form of normality," Fauci says.

Winter: Brace for another possible surge — and booster shots

Some experts worry the virus could follow a seasonal pattern like the flu and surge again in the late fall or early winter. And that threat may be even greater because of the variants, especially the strains originally spotted in South Africa and Brazil that appear to be better at evading natural immunity and the vaccines.

The vaccine works against the U.K. variant, says Mokdad of the University of Washington, so with more vaccination, other variants may become dominant. "And by winter we assume these two will become the dominant one unless we have more that show up. And they will cause more infections and more mortality."

But even if there is no new winter surge, the virus won't be gone. It just hopefully won't be causing anything like the suffering that's already occurred.

It could, however, still be causing significant problems in parts of the world that haven't gotten vaccinated, which could spawn new, even more dangerous variants that could travel to the United States.

As a result, the country will probably need new versions of the vaccines for the variants and booster shots. And many experts say it's crucial that the U.S. help the rest of the world vaccinate as quickly as possible, too.

"If we don't get rid of this thing everywhere, it's going to just come back and get us again," says Robert Murphy, executive director of Northwestern University's Institute for Global Health. "The virus will continue to mutate. This is really a worldwide problem."

The pandemic's aftereffects

But even if the country is on the road out of this, the impact has been tremendous, and the aftereffects are likely to be long-lasting, many experts say.

"This pandemic is right up there as a world-changing event. It has already had a profound impact on society, on basic questions like the nature of our social interactions. It's already shaped and reshaped this particular generation," says Keith Wailoo, a historian at Princeton University. "And the ripple effects are likely to play out for years, perhaps even decades to come."

The pandemic revealed some deep problems, such as how society treats older people, poor people and people of color.

"Pandemics create what some people have called a kind of stress test for all of the weaknesses and vulnerabilities and fault lines of societies, and I think that's been especially true of COVID-19," says Allan Brandt, a historian at Harvard University.

It could change so many parts of our lives. Our homes. Our work. Travel. How we touch each other. Will the elbow bump replace the handshake for good?

Online schooling and social distancing have taken a toll on kids and adults during the pandemic. The aftereffects of such widespread social challenges may be felt for years, experts say.

Gabrielle Lurie/San Francisco Chronicle via Getty Images

"There's a whole realm of everyday interpersonal practices that are going to be, you know, very, very hard to revisit and redevelop easily, like handshaking and kissing and hugging," Wailoo says. "Or even walking closely together with friends and laughing together. All of these things today carry the stigma of disease transmission."

The Black Death led to the Renaissance. The 1918-19 flu pandemic gave way to the roaring '20s. We've just begun the new '20s. It's impossible to know what world will emerge as the virus recedes. But it seems pretty clear we'll be hearing the echoes of this pandemic for a long time.

"The disruptions to our economy, to our sense of safety in the world are of an order that our established ways of thinking are likely to undergo some pretty significant changes," says Nancy Tomes, a historian at Stony Brook University.

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As Demand for Mental Health Care Spikes, Budget Ax Set to Strike

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HELENA, Mont. — When the pandemic hit, health officials in Montana’s Beaverhead County had barely begun to fill a hole left by the 2017 closure of the local public assistance office, mental health clinic, chemical dependency center and job placement office after the state’s last budget shortfall.

Now, those health officials worry more cuts are coming, even as they brace for a spike in demand for substance abuse and mental health services. That would be no small challenge in a poor farming and ranching region where stigma often prevents people from admitting they need help, said Katherine Buckley-Patton, who chairs the county’s Mental Health Local Advisory Council.

“I find it very challenging to find the words that will not make one of my hard-nosed cowboys turn around and walk away,” Buckley-Patton said. “They’re lonely, they’re isolated, they’re depressed, but they’re not going to call a suicide hotline.”

States across the U.S. are still stinging after businesses closed and millions of people lost jobs due to covid-related shutdowns and restrictions. Meanwhile, the pandemic has led to a dramatic increase in the number of people who say their mental health has suffered, rising from 1 in 3 people in March to more than half of people polled by KFF in July. (KHN is an editorially independent program of KFF.)

The full extent of the mental health crisis and the demand for behavioral health services may not be known until after the pandemic is over, mental health experts said. That could add costs that budget writers haven’t anticipated.

“It usually takes a while before people feel comfortable seeking care from a specialty behavioral health organization,” said Chuck Ingoglia, president and CEO of the nonprofit National Council for Behavioral Health in Washington, D.C. “We are not likely to see the results of that either in terms of people seeking care — or suicide rates going up — until we’re on the other side of the pandemic.”

Last year, states slashed agency budgets, froze pay, furloughed workers, borrowed money and tapped into rainy day funds to make ends meet. Health programs, often among the most expensive part of a state’s budget, were targeted for cuts in several states even as health officials led efforts to stem the spread of the coronavirus.

This year, the outlook doesn’t seem quite so bleak due in part to relief packages passed by Congress last spring and in December that buoyed state economies. Another major advantage was that income increased or held steady for people with well-paying jobs and investment income, which boosted states’ tax revenues even as millions of lower-income workers were laid off.

“It has turned out to be not as bad as it might have been in terms of state budgets,” said Mike Leachman, vice president for state fiscal policy for the nonpartisan Center on Budget and Policy Priorities.

But many states still face cash shortfalls that will be made worse if additional federal aid doesn’t come, Leachman said. President Joe Biden has pledged to push through Congress a $1.9 billion relief package that includes aid to states, while congressional Republicans are proposing a package worth about a third of that amount. States are banking on federal help.

New York Gov. Andrew Cuomo, a Democrat, predicted his state would have to plug a $15 billion deficit with spending cuts and tax increases if a fresh round of aid doesn’t materialize. Some states, such as New Jersey, borrowed to make their budgets whole, and they’re going to have to start paying that money back. Tourism states such as Hawaii and energy-producing states such as Alaska, Wyoming continue to face grim economic outlooks with oil, gas and coal prices down and tourists cutting back on travel, Leachman said.

Even states with a relatively rosy economic outlook are being cautious. In Colorado, for example, Democratic Gov. Jared Polis proposed a budget that restores the cuts made last year to Medicaid and substance abuse programs. But health providers are doubtful the legislature will approve any significant spending increases in this economy.

“Everybody right now is just trying to protect and make sure we don’t have additional cuts,” said Doyle Forrestal, CEO of the Colorado Behavioral Healthcare Council.

That’s also what Buckley-Patton wants for Montana’s Beaverhead County, where most of the 9,400 residents live in poverty or earn low incomes.

She led the county’s effort to recover from the loss in 2017 of a wide range of behavioral health services, along with offices to help poor people receive Medicaid health services, plus cash and food assistance.

Through persuasive grant writing and donations coaxed from elected officials, Buckley-Patton and her team secured office space, equipment and a part-time employee for a resource center that’s open once a week in the county in the southwestern corner of the state, she said. They also convinced the state health department to send two people every other week on a 120-mile round trip from the Butte office to help county residents with their Medicaid and public assistance applications.

But now Buckley-Patton worries even those modest gains will be threatened in this year’s budget. Montana is one of the few states with a budget on a two-year cycle, so this is the first time lawmakers have had to craft a spending plan since the pandemic began.

Revenue forecasts predict healthy tax collections over the next two years.

In January, at the start of the legislative session, the panel in charge of building the state health department’s budget proposed starting with nearly $1 billion in cuts. The panel’s chairperson, Republican Rep. Matt Regier, pledged to add back programs and services on their merits during the months-long budget process.

It’s a strategy Buckley-Patton worries will lead to a net loss of funding for Beaverhead County, which covers more land than Connecticut.

“I have grave concerns about this legislative session,” she said. “We’re not digging out of the hole; we’re only going deeper.”

Republicans, who are in control of the Montana House, Senate and governor’s office for the first time in 16 years, are considering reducing the income tax level for the state’s top earners. Such a measure that could affect state revenue in an uncertain economy has some observers concerned, particularly when an increased need for health services is expected.

“Are legislators committed to building back up that budget in a way that works for communities and for health providers, or are we going to see tax cuts that reduce revenue that put us yet again in another really tight budget?” asked Heather O’Loughlin, co-director of the Montana Budget and Policy Center.

Mary Windecker, executive director of the Behavioral Health Alliance of Montana, said that health providers across the state are still clawing back from more than $100 million in budget cuts in 2017, and that she worries more cuts are on the horizon.

But one bright spot, she said, is a proposal by new Gov. Greg Gianforte, a Republican, to create a fund that would put $23 million a year toward community substance abuse prevention and treatment programs. It would be partially funded by tax revenue the state will receive from recreational marijuana, which voters approved in November, with sales to begin next year.

Windecker cautioned, though, that mental health and substance use are linked, and the governor and lawmakers should plan with that in mind.

“In the public’s mind, there’s drug addicts and there’s the mentally ill,” she said. “Quite often, the same people who have a substance use disorder are using it to treat a mental health issue that is underlying that substance use. So, you can never split the two out.”

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

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gordonwilliamsweb · 4 years ago

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As Demand for Mental Health Care Spikes, Budget Ax Set to Strike

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“Everybody right now is just trying to protect and make sure we don’t have additional cuts,” said Doyle Forrestal, CEO of the Colorado Behavioral Healthcare Council.

That’s also what Buckley-Patton wants for Montana’s Beaverhead County, where most of the 9,400 residents live in poverty or earn low incomes.

Revenue forecasts predict healthy tax collections over the next two years.

It’s a strategy Buckley-Patton worries will lead to a net loss of funding for Beaverhead County, which covers more land than Connecticut.

“I have grave concerns about this legislative session,” she said. “We’re not digging out of the hole; we’re only going deeper.”

Windecker cautioned, though, that mental health and substance use are linked, and the governor and lawmakers should plan with that in mind.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

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As Demand for Mental Health Care Spikes, Budget Ax Set to Strike published first on https://nootropicspowdersupplier.tumblr.com/

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