Coronavirus Briefing: Long-term health care, new medical trials, support in isolation

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CORONAVIRUS BRIEFING Happy Earth Day! (Every day should be earth day.) Today’s Coronavirus Briefing is 1,179 words and will take you five minutes to read. Top news
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The official global death toll from the pandemic as of this morning is 172,000 — a number said to vastly underestimate the true count. The price of benchmark U.S. crude oil dropped below zero yesterday, causing stocks to plunge more than 600 points. Millennials may be the ones most economically damaged by the pandemic. Hydroxychloroquine may not be the pandemic wonder drug after all. The FDA approved the first self-swab, at-home coronavirus test. The test will initially be available only to health care workers and first responders.
The Takeaway:
Capturing the daily death toll seems macabre, but knowing how many lives have been lost will help predict who needs what, when and where. Sometimes, no matter how much we want something to be true, it just isn’t. And millennials, we’re so sorry.
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New tests and old technology
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There are promising new tests, encouraging clues for early detection, and a need for more technology.
Diana Ernst in Monthly Prescribing Reference takes a look at a trial evaluating ruxolitinib for COVID-19. The RUXCOVID study, sponsored by Incyte and Novartis, will enroll approximately 400 patients globally, evaluating the safety and efficacy of the drug in patients with COVID-19 associated cytokine storm (an overproduction of immune cells and their activating compounds, cytokines). The primary outcome measure will be the proportion of patients who die, develop respiratory failure requiring mechanical ventilation, or require intensive care unit care by day 29. Rachel Beairsto of Endocrinology Advisor reports that the Centers for Medicare and Medicaid Services have issued an interim rule to allow greater flexibility with regard to payment for clinicians and institutions that provide care to Medicare beneficiaries. These rules are aimed at improving access to telemedicine and remote monitoring services in an effort to circumvent unnecessary exposure to COVID-19 for clinicians, patients, and the greater community. Nick Bostock reports for GP that The Research & Surveillance Centre warned of many GP practices being held back by poor IT equipment that has left doctors unable to work remotely. The Centre has called on government to roll out technology that would allow all primary care doctors to deliver video consultations. Gilead, an American biopharmaceutical company, has initiated phase 3 clinical studies to evaluate the safety and efficacy of remdesivir in adults diagnosed with COVID-19. The randomized studies will enroll a total of approximately 1,000 patients in countries with a high prevalence of COVID-19. Remdesivir, an antiviral drug previously used to treat Ebola, showed promise in earlier studies of uncontrolled groups as well as in monkeys. Dr. Richard Levitan, an emergency doctor, spent 10 days helping out at Bellevue hospital in New York City at the end of March when a crush of COVID-19 patients began overwhelming hospitals. Over the course of his time in the E.R., he realized that almost all of the patients had COVID pneumonia, and that detecting it early enough was the key to keeping more patients off ventilators, and alive.
The Takeaway:
We’ve said it before, maybe yesterday or the day before: we’re living in an experiment.
Nursing home news
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At the beginning of March, Tom Frieden, the former CDC director, called the Life Care Center of Kirkland nursing home in Kirkland, Washington ground zero for COVID-19. Since then, long-term care facilities have experienced some of the worst outbreaks of the virus.
Danielle Brown of McKnight’s Long-Term Care News recaps the comments by Seema Verma, Centers for Medicare & Medicaid Services Administrator, regarding the new requirements of nursing homes in the U.S. to report infectious disease outbreaks directly to the CDC. The call for reporting to the CDC is not without its challenges. “The figures are self-reported, and no state inspectors are on the ground in these nursing homes to check their accuracy,” explained Mike Dark, a lawyer with the nonprofit California Advocates for Nursing Home Reform. And a lack of testing — a problem affecting every sector’s ability to function safely — was raised by Toby Edelman, senior policy attorney with the Center for Medicare Advocacy. “Nursing homes can't provide accurate information if they don't have testing,” Edelman said. “Facilities should be reporting to state health departments that can send in tests, equipment and additional staff.” Despite these challenges, Lois Bowers of McKnight’s Senior Living reports that the pandemic is not dampening the desire for luxury retirement living. Moorings Park Grande Lake in Naples, FL, closed on the sale of the first phase of the luxury continuing care retirement/life plan community on April 13. Residents have begun moving and will continue to move in over the next three months. And an article in McKnight’s Long-Term Care News states that West Virginia nursing home residents and staff members will be retested for coronavirus following an executive order issued by Governor Jim Justice. The mandate was issued following inaccuracies and discrepancies among some test results.
The Takeaway:
In the same way that tracking global deaths will help craft responses to future outbreaks, knowing what’s happening in long-term care facilities will enable systems to be put in place to stop the spread.
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Jobs today, tomorrow, and in perpetuity
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Our work experiment continues apace.
In People Management, Susanne Jacobs, organizational engagement expert and author of Drivers: Creating Trust and Motivation at Work, takes a look at how HR can support social connection when staff are socially isolating. Jacobs raises the importance of social support, not just for today’s urgent situation but in relation to our wellbeing and performance at any time. Arvind Hickman reports in PRWeek U.K. that while agencies face a cash flow squeeze and slashed marketing budgets, confidence has improved markedly. Elsewhere in People Management, Merrill April and Sophie Rothwell, a partner and associate, respectively, at partnership and employment law specialist CM Murray, explain what employers should consider when reducing senior employees’ salaries. They urge managing directors to think dynamically when formulating continuity plans and generating a proactive analysis of both legal and commercial implications. The Congressional Budget Office expects unemployment to top 10% for the second quarter of 2020 and remain at 9% at the end of 2021. For those who still have jobs, there’s an ever-present fear of what the next wave of unemployment will bring. “We are likely to see a repeat of the unemployment crisis of the Great Recession — but the underlying dynamics will be amplified,” writes Victor Tan Chen, a sociologist at Virginia Commonwealth University and author of Cut Loose: Jobless and Hopeless in an Unfair Economy. And for those whose jobs include hours on Zoom, perhaps it’s time to invite a llama.
The Takeaway:
Both working and being out of work have never been as synchronously challenging. All social pack animals should have a seat at the table.
Music + poetry
In honor of Mother Earth, four female artists whose music is poetry and excellent pop.
Katy Perry, “Roar” Beyoncé, “Hold Up” Fiona Apple, “Paper Bag” Björk, “It’s Oh So Quiet”