POLICY BRIEFING – WEEK IN REVIEW

New York City, other cities release updated race data for covid-19 fatality and hospitalization rates

On April 6th, the NYC Department of Health (NYC DOH) released data showing that death rates of African Americans and Hispanic persons with covid-19 were twice their non-Hispanic white counterparts (NHWC). The data were age-adjusted, and based on lab-confirmed cases. As of April 22nd, which included probable deaths as well, these numbers held. Additionally, the data show that African Americans were twice as likely to be hospitalized, compared to their NHWC. As reported previously in Brief19, disproportionate covid-19 hospitalization and fatality rates of African Americans highlight ongoing health and economic disparities. For example, the Bronx borough's population is 43.6 percent African American, and contains the poorest congressional district in the U.S. It also has the highest rate of positive covid-19 cases in NYC. In Richmond, VA, all eight people who have died from covid-19 are African American (the city's African American population is 48 percent). Cases may be undercounted among Black people, as early covid-19 testing criteria appear to have been biased in ways that decreased the number of tests performed for Black people. Various. 27 April 2020.

Remdesivir poised to obtain emergency use authorization despite mixed data

On April 29 President Trump and Dr. Anthony Fauci both celebrated preliminary data from an NIH trial suggesting that remdesivir can shorten recovery time for some covid-19 patients, even as The Lancet published a trial that found no statistically significant clinical benefit for patients with severe covid-19 receiving the drug. Now the FDA is likely to issue an Emergency Use Authorization for remdesivir, an administration official told the New York Times. An EUA is a temporary approval the FDA can grant a drug or device that has not otherwise met the criteria for FDA approval, including rigorous, peer-reviewed clinical trials. Just a few weeks ago the FDA issued an EUA for hydroxychloroquine, another drug President Trump has touted as a game-changer, as a covid-19 therapeutic. There are now allegations that the FDA was responding to political pressure, prompting a Congressional investigation. New York Times. 30 April 2020.

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States stockpile hydroxychloroquine (HCQ) despite FDA recommendations

State and local governments have acquired ~30 millions doses of HCQ, despite concerns about dangerous side effects and an FDA warning that doctors should not prescribe it to coronavirus patients outside of hospitals or research settings. Some states and cities have received donations of the drug from pharmaceutical companies or received shipments of it from FEMA. Others have purchased the drug with taxpayer dollars. HCQ has FDA approval for use in treating malaria, lupus, and rheumatoid arthritis, but is known to have serious side effects including abnormal heart rhythms that can result in death. While there have been anecdotal reports and preliminary findings in clinical trials that the drug may be effective against SARS-CoV-2 infection, robust clinical evidence is still lacking. AP. 29 April 2020.

Advanced service payments coming to a halt

In late March, as hospitals, clinics and doctors' offices saw their revenue plummet as a result of the coronavirus pandemic, the Centers for Medicare and Medicaid Services (CMS) expanded its Accelerated Payment Program and Advance Payment Program, programs that allow healthcare entities to apply for payment in advance of anticipated services rendered. On Sunday CMS announced that, after paying out $100 billion through these programs since March 28, it was re-evaluating the amounts that would be paid under the Accelerated Payment Program and would not be accepting any new applications under the Advance Payment Program. CMS said it was making these changes in light of funding for healthcare providers in the subsequent federal stimulus packages. The Centers for Medicare and Medicaid Services. 29 April 2020.

Administration embraces telehealth

To support the expansion of telehealth on a national scale, the Federal Communications Commission (FCC) has released the details of its $200 million incentive program, created as part of the CARES Act. This package provides funding for the purchase of telehealth-related services and devices. A new online application details the steps, requirements and restrictions to apply. Money will be distributed on a rolling basis until the funds are exhausted or the pandemic has ended. Separately, the Department of Health and Human Services (HHS) has launched a telehealth website for patients and providers. The patient portal provides education about the basics of telehealth and different ways to connect, while the provider side focuses on changes to billing, policy, and legal considerations associated with telehealth use. Various. 28 April 2020.

Week in Review
Publishing, Design, Tech

(Review)
RESEARCH
  • Breaking news briefing: Lancet lifts embargo to sound cautionary note about Remdesivir
  • Can alpha-1 adrenergic receptor antagonists (⍺1-AR antagonists) prevent covid-19 cytokine storm?
  • News leak from the CORIMUNO-TOCI clinical trial
  • Do people lose their sense of smell or taste when they have SARS-Cov-2?
  • Does confinement or shelter-in-place affect the mental health of children?

RESEARCH
  • Covid-19 and blood clots? Dermatologists weigh in
  • Air Pollution Exposure Appears to Increase Covid-19 Mortality Rate
  • Disparate covid-19 hospitalization and death rates across New York City boroughs
POLICY
  • Consciously unmasking
  • States ignore the White House guidelines on re-opening
  • Tribal tribulations continue