In The News

OSHA Issues COVID-19 Workplace Standards

From SESCO Management Consultants

The Occupational Safety and Health Administration (OSHA) has released an emergency temporary standard (ETS) that healthcare employers must follow. At the same time, OSHA concurrently issued updated, non-mandatory guidance for non-healthcare employers.

The ETS is effective immediately upon publication in the Federal Register. As of June 17, 2021, the ETS has not been published in the Federal Register; as such, it is uncertain when the ETS will become effective. Employers must comply with most provisions within 14 days of the effective date, and with provisions involving physical barriers, ventilation, and training within 30 days of the effective date.

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Researchers: Nearly 90% of Americans Do Not Understand Palliative Care

By Jim Parker

About 89% of people in the United States have inadequate knowledge of palliative care. One key determinant was health care utilization. The more regular health care services a patient receives, the more likely they are to have some understanding of palliative care, according to a study published in Cancer Epidemiology, Biomarkers & Prevention.

Among the 3,450 patients surveyed by researchers from the University of Oklahoma Health Sciences Center, those who have a regular source of medical care were 2.67 times more likely to have adequate knowledge of palliative care than people who do not, the study found. Cancer patients in particular were 51% more likely to be familiar with palliative care than those who have never been diagnosed with that disease.

“Despite the known benefits of palliative care and its endorsement by the American Society of Clinical Oncology and the National Comprehensive Cancer Network, we have not seen an increased uptake of palliative care by those who need it most,” said Motolani Ogunsanya, PhD, an assistant professor at The University of Oklahoma Health Sciences Center. “A common misconception is that palliative care is only for end-of-life care when, in fact, it can begin at any point in the disease course.”

About 50% of community-based palliative care providers are hospices, according to the Center to Advance Palliative Care. A rising number of hospices have been diversifying their services to engage patients further upstream and take advantage of emerging value-based payment models, with palliative care as one of the most common new business lines.

Public awareness is a major barrier to expanding the use of palliative care, which many people, including some clinicians, conflate with hospice.

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HHS: Provider Relief Timing Determines Spending Deadline

Inside Health Policy
By Dorothy Mills-Gregg
. . . HHS’ announcement [on June 11th] creates four provider relief payments periods and gives providers one year to spend it all. For example, the upcoming deadline of June 30 applies to the payment period of April 10, 2020 to June 30, 2020, and the next deadline of Dec. 31 applies to monies received July 1, 2020 to Dec. 31, 2020.
Providers receiving more than $10,000 in relief during a payment period will have three months to report how they used it -- previous guidance gave them one month to submit all their expenditures and revenue separated by type and grouped by quarter. Providers who received $10,000 or less during a payment period will not have to submit a report for that period.
The audit requirements for provider relief recipients who received $750,000 or more appear to be unchanged. These reporting requirements do not apply to the rural health clinic COVID-19 testing program or the uninsured program.
HHS began distributing a large chunk of the $178 billion provider relief fund early on -- before June 30, 2020 -- with a $46 billion general distribution and $20 billion in targeted relief for hospitals in so-called hot spots, $13 billion for safety net hospitals and $11 billion for rural facilities.
The other general and targeted distributions, including the problematic second general distribution, went to providers no earlier than July 3, according to the Government Accountability Office. HHS is still distributing provider relief; the last distribution was announced in October.
“These updated requirements reflect our focus on giving providers equitable amounts of time for use of these funds, maintaining effective safeguards for taxpayer dollars, and incorporating feedback from providers requesting more flexibility and clarity about [provider relief fund] reporting,” said Diana Espinosa, acting administrator for the Health Resources and Services Administration, the agency that manages provider relief distributions…

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One-fifth of asymptomatic COVID patients developed long-haul symptoms

Modern Healthcare
Lisa Gillespie
Almost one-fifth of asymptomatic COVID-19 patients later developed conditions associated with long-haulers, according to a new white paper from FAIR Health.
The healthcare transparency not-for-profit studied private insurance claims associated with 1.9 million patients who had a COVID-19 test, and then and looked at any health issues 30 days or more after their initial diagnosis. The analysis found 19% of asymptomatic individuals had at least one long-haul symptom, but the number is likely larger.
"A large number of asymptomatic people probably escaped attention in the early months of the pandemic, because testing wasn't that widely available," FAIR Health president Robin Gelburd said. "This should alert physicians and other providers to being attentive to those kinds of symptoms, because they may not have had a COVID-19 diagnosis in their chart."
The most common post-COVID-19 conditions include pain, breathing difficulty, high cholesterol, fatigue and hypertension. Anxiety was also commonly reported.
Meanwhile, half of patients who were hospitalized with COVID-19 had associated conditions after diagnosis, and 27.5% who had symptoms when tested later had linked conditions. The ranking of the most common post-COVID conditions varied by age group. For example, in the under 18 population, pain and breathing difficulties were the top two conditions.
"If someone tested positive, and escaped getting quite ill or were completely symptomatic, they should be attentive to the fact that they may still be exposed to some lingering symptoms," Gelburd said. "If they are experiencing different kinds of conditions that are atypical from the time before the diagnosis, they should communicate the fact that they tested positive, even though they may not have been quite sick."
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The Delta variant is serious. Here’s why it's on the rise.

National Geographic – By Sanjay Mishra

With vaccination rates slowing in the United States, and other countries struggling to secure vaccines, public health experts have growing concerns that the so-called Delta coronavirus variant, first identified in India in March, could trigger dramatic rises in cases and deaths in the U.S. and the world.

The Delta variant already accounts for 18 percent of cases in Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming, and about six percent of cases nationwide. It has already spread to more than 70 countries and is now the most dominant variant in India, the United Kingdom, and Singapore. Last week, Delta caused more than 90 percent of the new COVID-19 cases in the U.K., leading to a 65 percent bump in new infections since May 1. On Monday, to curb Delta’s spread, the U.K. government decided to postpone “freedom day,” which would mark the end of public health restrictions.

The Delta variant is 60 percent more transmissible than the Alpha variant—first identified in the U.K.—which in turn was about 50 percent more transmissible than the ancestral Wuhan strain. “It’s a super spreader variant, that is worrisome,” says Eric Topol, founder and director of the Scripps Research Translational Institute. It has features that enable escape from the immune system and is perhaps more evasive than the Beta variant (B.1.351) first identified in South Africa, which was the worst until now, says Topol. “Plus, it has the highest transmissibility of anything we've seen so far. It's a very bad combination.”

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