RSV, Other Viruses Making it Hard to Find a Bed in Children’s Hospitals 

Washington Post | By Fenit Nirappil and Ariana Eunjung Cha

Children’s hospitals are under strain in the United States as they care for unusually high numbers of kids infected with RSV and other respiratory viruses.

It’s the latest example of how the pandemic has upended the usual seasonal patterns of respiratory illnesses, denying a respite for health-care professionals ahead of a potential hectic winter as the coronavirus, influenza and other viruses collide.

Respiratory syncytial virus, a common cause of cold-like illness in young children known as RSV, started surging in late summer, months before its typical season from November to early spring. This month, the United States has been recording about 5,000 cases per week, according to federal data, which is on par with last year but far higher than October 2020, when more coronavirus restrictions were in effect and very few people were getting RSV.

“It’s very hard to find a bed in a children’s hospital — specifically an intensive care unit bed for a kid with bad pneumonia or bad RSV because they are so full,” said Jesse Hackell, a doctor who chairs the committee on practice and ambulatory medicine for the American Academy of Pediatrics.

Nearly three-quarters of pediatric hospital beds are occupied, according to federal health data. Rhode Island, the District of Columbia and Delaware report more than 94 percent of pediatric beds occupied. Maine, Arizona, Texas, Kentucky, Oklahoma and Missouri reported between 85 and 90 percent of beds occupied. The data is limited to facilities that report the information.

Several children’s hospitals in the D.C. area have been at capacity for weeks; 18 children were waiting for a room in the ICU on Tuesday at Children’s National in the District.

D.C. Realtor Kate Foster-Bankey was more attuned to RSV after she started hearing from clients whose children were afflicted with the virus in recent weeks, including one whose child was admitted to Children’s National.

Then her 3-year-old daughter Isabelle fell ill, becoming lethargic, complaining of a fast heartbeat and not eating. They waited two hours in the packed waiting room of a pediatric urgent-care center where Foster-Bankey, a mother of four, was used to seeing only a handful of patients.

During a follow-up visit Tuesday, Isabelle was transported by ambulance to the emergency room of a children’s hospital, where she tested positive for RSV and had to wait until the following morning for a bed.

“It sounds like in covid, we gutted our pediatric care,” said Foster-Bankey, 41. “Kids shouldn’t have to wait in a waiting room with a bunch of other sick kids for hours.”

At Connecticut Children’s Hospital, the emergency room is so full that patients are being triaged in hallways. Teens with bone fractures and appendicitis are being diverted or transferred to adult-care centers to create additional space for respiratory patients. Hospital officials are considering the possibility of enlisting the National Guard to set up tents and care for the influx of patients.

Over the past nine days, 110 children with RSV have come in to the emergency room, and at times as many as 25 children with RSV were waiting for an inpatient bed, said Juan Salazar, physician in chief at Connecticut Children’s. He said that for the first time in his career he has had to mandate doctors in other specialties such as endocrinology and rheumatology work with RSV patients — a situation reminiscent of the “all hands on deck” approach many adult hospitals took in March 2020, when the coronavirus began to sweep through the United States.

“During my tenure here I haven’t seen anything like this,” said Salazar, who has worked in infectious diseases for 30 years.

Read Full Story

 

CDC Expands Recommendations for Use of Bivalent COVID-19 Booster

Last Wednesday, the CDC expanded recommendations for the use of Pfizer-BioNTech COVID-19 bivalent vaccine for ages 5 through 11 years old and Moderna COVID-19 bivalent vaccine for ages 6 through 17 years old. The “updated boosters” vaccines target multiple strains of COVID-19—the original strain of the virus and 2 of the Omicron variants (BA.4 and BA.5).

The updated boost doses for this age group are already available for those seeking Moderna and arriving this week for Pfizer. Various providers will be offering the bivalent boost dose for this age group including local pharmacies, doctor’s offices and health departments.
 
Individuals may choose to receive either the Moderna or Pfizer bivalent booster, regardless of which primary series vaccine or original booster dose they received. The current monovalent vaccine is no longer available for those 5 and older for use as a booster but remains available to complete the primary series.

Those who are eligible to receive a bivalent booster dose right now include:

  • Moderna Booster: Individuals 6 years of age and older if it has been at least 2 months since they completed their primary vaccination series or received a booster dose.
  • Pfizer-BioNTech: Individuals 5 years of age and older if it has been at least 2 months since they completed their primary vaccination series or received a booster dose.
 

Employee or Independent Contractor

The Health Group

The Department of Labor has released a “Notice of Proposed Rulemaking” (“Notice”) today, which proposes to modify Wage and Hour Division regulations relating to the determination of whether an individual is an employee or independent contractor under the Fair Labor Standards Act (“FLSA”).

The Notice identifies the following factors for determining whether an individual is considered an employee or an independent contractor.  No one factor is necessarily a determining factor in defining the relationship. 

1, Opportunity for profit or loss depending on managerial skill:  This factor is based on many facts, including, but not limited to, if the worker can negotiate the charge for services provided, whether the worker can accept or decline work, whether the worker can choose the order or time when services are performed, whether the worker engages in marketing or advertising activities, and whether or not the worker makes decisions regarding hiring others, purchasing materials and equipment, and/or renting space. 

2. Investments by the worker and the employer.  The worker’s investments need not be equal to the investments of an employer; however, the workers investments should support an independent business or serve a business-like function.

3. Degree of permanence of the work relationship.  This factor weighs in favor of the worker being an employee when the work is indefinite or continuous.

4. Nature and degree of control.  Control is influenced by many factors, including work scheduling, supervision, and limitation on worker to serve others, The more control by the employer, the more likely the worker will be classified as an employee.

5. Extent to which the work performed is an integral part of the employer’s business.  If the work performed is integral to the employer’s business, the worker is more likely to be involved in an employer-employee relationship.  If the services performed are not critical or central to the employer’s principal business, an independent contractor relationship is more likely.

6. Skill and initiative.  The more specialized the skill of the worker, the more likely the worker is an independent contractor.

The Notice is available here

Comments on the proposed rule are due on or before November 28, 2022. 

 

Renewal of Public Health Emergency Determination

On October 13, 2022, Secretary Xavier Becerra, Secretary of Health and Human Services, renewed the PHE for COVID-19. The renewal is for 90 days, through January 11, 2023. The renewal states:

"As a result of the continued consequences of the Coronavirus Disease 2019 pandemic, on this date and after consultation with public health officials as necessary, I, Xavier Becerra, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective October 13, 2022, the January 31, 2020, determination by former Secretary Alex M. Azar II, that he previously renewed on April 21, 2020, July 23, 2020, October 2, 2020, and January 7, 2021, and that I renewed on April 15, 2021, July 19, 2021, October 15, 2021, January 14, 2022, April 12, 2022, and July 15, 2022, that a public health emergency exists and has existed since January 27, 2020, nationwide."

 

BPC Recommends Two-Year Extension Of Pandemic-Era Telehealth Policies

Inside Health Policy | By Jessica Karins
  
The Bipartisan Policy Center has released a wide-ranging slate of recommendations for telehealth policy after the COVID-19 public health emergency, including calling for a two-year extension of most telehealth flexibilities, which the group says would offer time for policymakers to further study the most-effective approaches to virtual care.
 
The recommendation could boost efforts by stakeholders to convince the Senate to pass by year’s end the two-year telehealth extension bill that cleared the House.
 
But BPC also calls for Congress to require that HHS and Congress’ Medicare payment advisers study hot-button issues before permanently expanding telehealth.
 
Researchers should use the time to study the benefits of hybrid care and what specialties and conditions it is most effective for, asses the value of audio-only care, and consider how telehealth flexibilities can fit into value-based care models, the report says.
 
In the Oct. 11 report titled “The Future of Telehealth After COVID-19: New Opportunities and Challenges,” the think tank issues numerous recommendations for how policymakers can preserve the benefits of telehealth after the end of the PHE.
 
“For starters, Congress and the Biden administration should extend most of the telehealth flexibilities for Medicare beneficiaries for two years after the end of the PHE, and formally evaluate their impact,” BPC wrote.
 
It says a two-year extension of flexibilities to further study their impact and efficacy would maintain patients’ access to care while minimizing risks.

Read Full Article

 
<< first < Prev 31 32 33 34 35 36 37 38 39 40 Next > last >>

Page 34 of 172