Here are the coronavirus stories Medscape's editors around the globe think you need to know about today:
Topol: US Betrays Healthcare Workers
In the early days of the COVID-19 pandemic in the US, officials repeatedly made choices that put the health of the public and healthcare workers in jeopardy, Eric Topol, MD, writes in Medscape, including inadequate testing. Now, clinicians face equipment shortages and young doctors are writing their wills. "The handling of the COVID-19 pandemic in the US will go down as the worst public health disaster in the history of the country," predicts Topol, Medscape's editor-in-chief. "Perhaps what we in the medical community will remember most is how our country betrayed us at the moment when our efforts were needed most."
CMS to Prepay Clinicians
The Centers for Medicare & Medicaid Services (CMS) announced it will advance payments for Medicare claims to qualified physician practices and hospitals to help them deal with cash flow problems caused by COVID-19, a move that expands a program typically used during natural disasters. Physician practices can request their full Medicare payment amount for 3 months, and hospitals can request theirs for 6 months, based on historical payments.
HCP Couples Prepare
From childcare dilemmas to quarantine quandaries to end-of-life considerations, health professional couples across the country are confronting tough questions as the COVID-19 pandemic continues. Four physicians shared their stories with MDedge News. Cornelia Griggs, MD, and her husband, Robert Goldstone, MD, spent a recent weekend drafting a will. Because of the pandemic, "[m]y husband is in Boston," Griggs said. "The kids are in Connecticut and I’m in New York. That inherently is hard because our whole family is split up. I don’t know when it will be safe for me to see them again."
Adapting to Data
Six weeks ago, Medscape contributor F. Perry Wilson, MD, MSCE, made a video explaining key epidemiology terms at play in the COVID-19 epidemic. He predicted the case fatality rate, then around 2%, would decrease with wider testing, and that social distancing interventions would reduce the spread. Neither of those things has happened yet, and other sobering data about the COVID-19 disease course have been published, Wilson said in his update. "Data are coming fast and furious, and we need to be able to adapt our conceptions about this disease quickly," he said.
Ethics Guidelines for the Pandemic
Anticipating shortages of critical healthcare equipment, ethicists and clinicians are preparing guidance documents on how to make hard decisions fairly, such as which patient gets an intensive-care bed or ventilator. It's easy to criticize a guideline and say it could lead to a tragic choice, said one health law researcher. "It's not the guideline that's forcing a traumatic choice," he added. "It's the fact that we don't have enough ventilators."
Clinician Deaths in Italy
Sixty-one healthcare professionals including doctors and dentists have died of COVID-19 in Italy, according to a list compiled by the country's National Federation of Orders of Surgeons and Dentists. "It is reasonable to assume that these events would have been largely avoidable if health workers had been correctly informed and equipped with sufficient adequate personal protective equipment: masks, gloves, disposable gowns, protective visors, which instead continue to be in short supply," the federation’s president said in a statement.