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COVID-19 Resources

COVID-19 Facts and Recent News

  • *UPDATED* Estimates of when the pandemic will peakin each state, courtesy of the University of Washington Institute for Health Metrics. (Updated 7/22/20)
  • *UPDATED* The New York Times publishes and regularly updates this interactive map showing state-by-state COVID-19 statistics, hotspots and disease clusters. (Updated 7/23/20).
  • *UPDATED* The Centers for Disease Control and Prevention (CDC) have published their own tracking website providing detailed COVID-19 case and mortality data. (Updated 7/23/20).
  • *NEW* Safety National published this article providing helpful guidance on reopening businesses.
  • The New York Times publishes and regularly updates this interactive map showing state-by-state COVID-19 statistics, hotspots and disease clusters. (Updated 6/29/20)
  • The Centers for Disease Control and Prevention (CDC) have published their own tracking website providing detailed COVID-19 case and mortality data. (Updated 6/29/20).
  • How fast is COVID-19 spreading in your state? The Effective Reproduction Rate or Rt, is a measure that calculates how fast the virus is spreading in a particular geographic region measured by the average number of people who become sick from an infected person. RT.live is a website that calculates infection rates and provides detailed reporting for each state.
  • In a study recently published by PLOS ONE, researchers examined a cohort of 592 healthcare workers who had been screened and tested according to reported symptoms. They found that workers who reported three or more symptoms were more likely to test positive, as were those reporting fever (>37.5C) or myalgias. Ninety-seven percent (97%) of workers who were asymptomatic or reported only mild sore throat/congestion tested negative.
  • Zurich has published this resource discussing the transition of employees back to the workplace post-pandemic. There is an associated video and podcast with additional information.
  • Law360 has published this list of regulatory and legislative changes made in the last two weeks relating to the COVID-19 pandemic.
  • FDA Press Announcements – Daily updates
  • The death toll from COVID-19 could be far greater than what’s been reported according to a recent New York Times article that reviewed CDC data and death statistics.
  • The FDA issued a warning regarding the use of hydroxychloroquine or Chloroquine to treat COVID-19 outside of the hospital setting citing risks of cardiac arrhythmias.
  • A new study released by the Commonwealth Fund shows a sixty percent decrease in ambulatory visits to providers due to the coronavirus.  An analysis of outpatient data obtained by a healthcare technology firm and in conjunction with Harvard researchers  reveals that the drop in patient visits was only partially offset by telehealth consultations. This will likely improve as ambulatory practices ramp up their access to telehealth technologies. (April 23, 2020)
  • A new article published by Health Affairs explores the potential impact of COVID-19 on the US healthcare system.
  • A joint statement, developed by AHA, ACS, ASA and AORN, provides key principles and considerations to guide health care professionals and organizations regarding how and when to safely resume the performance of elective surgical procedures.
  • As part of the federal government’s plan to “open up America”, CMS has also issued recommendations for re-opening facilities that are providing non-urgent, non-COVID-19 care.
  • On April 9, 2020 the Centers for Medicare & Medicaid Services (CMS) temporarily suspended a number of rules so that hospitals, clinics, and other healthcare facilities can more efficiently respond to the needs of patients. These changes affect doctors, nurses, and other clinicians nationwide, and focus on reducing supervision and certification requirements so that practitioners can be hired quickly and perform work to the fullest extent of their licenses. The new waivers sharply expand the workforce flexibilities CMS announced on March 30, 2020.
  • The Johns Hopkins University Coronavirus Resource Center maintains this map of all reported COVID-19 diagnoses, deaths and recoveries.
  • The Association of State and Territorial Health Officials publishes this reference document that provides a wealth of general information and an FAQ.

Accreditation

Allocation of Ventilators & Other Scarce Supplies

  • The society of Critical Care Medicine has developed Standard of Care Recommendations to provide a transparent, equitable and consistent approach to allocation of scarce critical care bed resources during the COVID-19 emergency.  The threshold to implement these recommendations should be determined by hospital leadership and reconciled with state and local laws/regulations.
  • University of Pittsburgh Medical Center recently shared their policy for allocating critical care resources.
  • The New York State Ventilator Allocation Guidelines – These guidelines are a few years old, but were prepared with exactly this type of crisis in mind, and include triaging, exclusion criteria as well as criteria for risk and mortality assessment.
  • ECRI published the results of a recent study that examined the risks and benefits of reusing N95 respirators versus extended use.
  • California Hospital Association crisis resources – Ventilator Allocation.
  • Use of 3-D printing to alleviate medical supply shortages – legal concerns

Business Interruption

Hospitals who purchase business interruption coverage are advised to contact their insurance broker to get clarification about their eligibility to recover from a claim involving the interruption of their business during the coronavirus outbreak.  

  • Proposed federal legislation introduced by Rep. Mike Thompson (D-Calif.) in April 2020 is entitled H.R. 6494, the “Business Interruption Insurance Coverage Act of 2020,” (BIICA), is intended “To make available insurance coverage for business interruption losses due to viral pandemics, forced closures of businesses, mandatory evacuations, and public safety power shut-offs, and for other purposes.
  • A March 31, 2020 article from the Congressional Research Service discusses why some healthcare organizations may be ineligible for compensation from their insurance companies for recouping the costs of business interruption during the COVID-19 pandemic.     
  • The National Law Review posted an Article on April 10, 2020, titled COVID-19: States Attempt to Shift Economic Burden to Insurance Industry with New Legislation on Business Interruption Coverage.  The article provides information on States with pending legislation regarding business interruption coverage for the COVID-19 pandemic.

Cyber-Liability Concerns

  • *NEW* The Congressional Research Service published this recent Legal Sidebar discussing the concept of digital contract tracing and how it may impact current privacy laws. There is currently no single federal law which creates consistent, applicable privacy protections for the information that would be gathered during contact tracing activities.  In addition, state and local health departments conducting contact tracing and their partner app developers may not qualify as covered entities or business associates subject to HIPAA’s privacy requirements.
  • The American Medical Association and the American Hospital Association have teamed up to help healthcare organizations respond to a rise in cyber threats exploiting the COVID-19 pandemic. The white paper outlines the electronic safeguards that should be in place for healthcare providers who work remotely during the pandemic.
  • The FBI recently provided an alert warning of increasing attacks by cybercriminals targeting US hospitals and healthcare providers who are using Skype and Zoom for videoconferencing.
  • The American Hospital Association (AHA), posted the recording of a podcast with the FBI discussing cyber threats related to COVID-19.
  • The Baker & Hostetler law firm warns that cyber-threats to healthcare organizations remain, despite the current crisis.
  • The American Hospital Association is recommending four ways to mitigate cyber risks.
  • Beazley’s latest Cyber Report indicates that cyber attacks increased 131% from 2018 to 2019, and suggests that attacks may increase even further during the current crisis with so many people forced to work from home.

Ethical Considerations

Litigation Concerns

  • *NEW* This comprehensive Emergency Legal Preparedness primer was prepared and published by the Network for Public Health Law. (Current as of 6/30/20)
  • AM Best has made available this short video containing a panel discussion of several industry specialists discussing their experiences with the COVID-19 pandemic, its impact on healthcare operations, and the types of new liability exposures that healthcare organizations may be faced with in the future.
  • Recently posted on the Law360 website is an article describing the five types of lawsuits that employers may face following the pandemic.
  • Ohio joined the ranks of states that have passed legislation that seeks to provide immunity for healthcare workers involved in caring for patients infected with COVID-19. HB 606 will take effect immediately if signed by the governor, however, it will remain in effect only until the end of the year.  A similar bill now being considered by the Ohio Senate, SB 308 does not currently have an expiration date.
  • The current crisis has created significant delays in the litigation process, and in many jurisdictions, it has come to a screeching halt. This short article by WTO cites several very recent cases where a discovery stay or extending deadlines has become necessary.
  • In an article published by Law360.com, author Y. Peter Yang makes some interesting observations about how the COVID-19 pandemic may impact medical malpractice cases and how they are handled, at least in the near future
  • In a recent article, Joe Farchione and Joel Neckers of Wheeler Trigg discuss the potential for future litigation surrounding COVID-19.
  • How COVID-19 could affect the logistics of litigation in the future – virtual trials?

Long-term Care

As the COVID-19 pandemic continues to spread, there are several helpful resources available to the long-term care community that are worth mentioning. We hope that you find these resources to be of value in protecting our vulnerable elderly population. 

Mental Health & Well Being

Mental health trauma and post-traumatic stress in healthcare workers are issues now and will continue in the next few months after the initial wave of COVID-19 has passed. 

  • The AHRQ Patient Safety Network examines the role of Human Factors Engineering in improving safety by addressing the risks and challenges created by fatigue, burnout, and lack of self-care among healthcare providers.  This primer provides strategies and other resources for healthcare organizations
  • The American Nurses Foundation has established an initiative that provides nurses with digital mental health and wellness-related resources and tools to support their emotional well-being while serving on the front lines of the COVID-19 pandemic. Resources include a mobile app focused on wellness content, such as mindfulness meditation and breathing exercises, as well as peer-to-peer calls organized on Zoom, where nurses can share thoughts and ask questions.
  • Read about the prevalence of corona psychosis in healthcare workers on the ECRI COVID-19 website through your AEIX subscription.    
  • The U.S. Department of Veterans Affairs National Center for PTSD has resources and tools for helping healthcare organizations and caregivers in “Managing Healthcare Workers’ Stress Associated with the COVID-19 Virus Outbreak”.
  • The University of North Carolina offers resources and solutions for providing mental health and emotional support for co-workers and providers coping with COVID-19. 
  • The University of California, San Francisco has a website that contains resources and webinars that provide healthcare workers with practical tips for managing stress and anxiety during the COVID-19 pandemic.
  • The American Medical Association website offers resources and practical strategies for health system leadership to consider in support of their physicians and care teams during the COVID-19 crisis. 
  • The Inter-Agency Standing Committee (IASC) briefing on the psycho-social aspects of the current outbreak.
  • The Center for the Study of Traumatic Stress (CSTS) has created this page of resources for providers and families dealing with the effects of the pandemic.

Palliative Care

Patient Care Issues

Physician Practices

Regulatory Response

  • In response to public health and safety concerns regarding the appropriateness of decontaminating certain respirators, the FDA reissued Emergency Use Authorizations revising which type of respirators can be decontaminated for reuse.  The CDC has issued similar guidance relating to decontamination and reuse of filtering faceplate respirators.
  • In a recent press release, Premier recommends to HHS and Congress that at least 24 of the regulatory waivers issued during the pandemic for the purpose of streamlining processes and clearing barriers to effective patient care be made permanent.
  • Many states have streamlined licensure processes and otherwise enhanced the portability of licensure across state lines for medical providers. In an effort to further improve and expedite the process, the NPDB has recently announced that it will be waiving the fees associated with querying the databank through May 31. The waiver is available for both one-time and continuous queries.
  • CMS recently updated their Blanket Waivers for Healthcare Providers relating to EMTALA, verbal orders, patient rights, reporting restraint usage, sterile compounding, discharge planning, etc.
  • The FDA has currently issued (as of 4/22/2020) an amazing 35 warning letters to companies marketing products that allege therapeutic or diagnostic properties relating to COVID-19.
  • On March 22, 2020 CMS announced it is granting exceptions from reporting requirements and extensions for clinicians/providers participating in quality reporting programs.
  • On April 8, 2020 CMS issued a new wave of infection control guidance based on CDC guidelines to protect patients and healthcare workers from COVID-19.
  • CMS issued a memorandum on March 4, 2020 suspending non-emergency inspections across the country due to the COVID 10 pandemic.
  • CMS implemented waivers on March 1, 2020 which exempt providers from sanctions for noncompliance of certain Stark Laws rules.
  • HHS guidance relating to HIPAA and Telehealth services.

Rural Healthcare

  • According to this recent study published by Guidehouse, a quarter of all rural hospitals in the US are in danger of closing their doors due to financial pressures.  The study was conducted in 2019, prior to the current COVID-19 pandemic, which has no doubt made their financial outlooks even more perilous.
  • The Rural Health Information Hub offers resources on the COVID-19 pandemic for small/rural hospitals. 

Sample COVID-19 Policies

State Actions & Declarations       

State-level Emergency Standards of Care

Many states have developed documents and plans to manage the potential surge of patients in various crisis/disaster situations, including the potential for a pandemic illness.  Many of these documents are based on the work done by the Institute of Medicine, who published these guidelines for Catastrophic Disaster Response in 2012.  Volume four of that document deals specifically with standards for hospitals and other acute care facilities.

Telemedicine

Workers Comp

  • *NEW* Insurance Business Magazine provides recordings of recent podcasts, including a discussion with Matt McDonough of Safety National discussing business continuity and workers comp.
  • The National Council on Compensation Insurance (NCCI) has updated its Workers Comp and COVID-19 FAQ. The organization has also compiled a reference list of state workers comp statutes showing statutory standards of compensability relating to occupational diseases.
  • OSHA issued a new enforcement memo indicating that on May 26, 2020 they will begin actively assessing employer efforts in making work-related determinations of COVID-19.  At that time, OSHA will begin examining the process organizations are using to make determinations of work-related COVID-19 along with the evidence that should have been considered based on the discretionary authority granted in the May 19, 2020 enforcement memo. 
  • What may be the first workers comp lawsuit relating to COVID-19 has been filed in Cook County, providing a possible preview of future wrongful death claims seeking to avoid the exclusive remedy that normally characterizes workers comp matters.
  • The ongoing COVID-19 pandemic is proving challenging for businesses in many ways, including increases in occupational illnesses. The ultimate impact on workers’ compensation systems, however, could be much more significant, including greater claims frequency for some industries, higher overall costs, and more administrative burdens for many employers.
  • The governors of several states have issued executive orders expanding eligibility for workers comp for employees exposed to COVID-19 in the workplace.
  • It may be months or years before the impact of the COVID-19 pandemic is having on healthcare workers is fully understood.  This recent article provides a few thoughts on how the industry might respond.

Other Pandemic Resources

AEIX Members should contact their Risk Management Consultant if they have questions, wish to request more in-depth research, or would like us to provide more focused assistance.