Week 29 Newsletter Update

10/21-10/27 Updates

Surge Capacity Strategies

Cases of COVID-19 approach record levels in many states, with hospitalizations on the rise in more than 75% of states.

Limitations on which health services are offered during the pandemic raises  questions about what should be considered  essential vs. non-essential services.

Surge Capacity Strategies

(10/22/20) COVID-19 Surges in Rural Communities, Overwhelming Some Local HospitalWhile the midwestern United States experiences some of the largest surges in COVID-19 infections and hospitalizations, many of the rural health systems that serve them are beginning to be overwhelmed. Difficulties finding bed space and intensive care unit capacity is necessitating transferring patients to urban settings, sometimes even out of state.

(10/22/20) 16 States See Record COVID-19 Hospitalizations; CDC Expands Definition of ‘Close Contact’ — 6 Updates
This update from Becker’s Hospital Review covers the current rises in hospitalizations for COVID-19 experienced across the United States, with many states reaching record levels of hospitalization, as well as revision of the Centers for Disease Control and Prevention guidelines.

(10/20/20) ‘At a Breaking Point’: New Surge of COVID-19 Cases Has States, Hospitals Scrambling, Yet Again
An article form STAT covering the rise in cases and hospitalizations for COVID-19 experienced across the United States. As the surge continues, some fear the health care system is nearing a breaking point, with states establishing field hospitals and experiencing reemergence of cases in places that had outbreaks months ago.

(10/19/20) 1 Big Thing: Coronavirus Hospitalizations Are on the Rise
This newsletter from Axios highlights major rises in hospitalizations with a state-by-state diagram. Hospitalizations are currently rising in 39 states, with 16 states having reached or currently approaching record highs.

(10/19/20) Coronavirus Hospitalizations Are Growing in 37 States As Fauci Warns the World Not ‘on the Road’ to Ending Pandemic Yet
This story from CNBC covers the 37 states seeing an increase in hospitalizations for COVID-19 of 5% or more over the past week. Daily cases are also on the rise with hospitalizations, leading health experts like Dr. Anthony Fauci to call for caution and awareness.

(10/22/20) Stories of COVID-19: The Fine Line Between Essential and Non-essential Care
This personal essay discusses the differentiation between what is essential and non-essential care, and how sometimes the differences in designation can lead to missed diagnoses and worse outcomes for patients, especially as non-essential care is put on hold during rises in COVID-19 infection and hospitalization.

Policies and Guidelines

Health Affairs’ blog series “Higher Health Care Value Post COVID-19” provides more potential learnings from the COVID-19 pandemic.

Hospital admissions data are being used to estimate the changes brought by the pandemic as hospitals evaluate their long-term financial health.

Policies and Guidelines

(10/21/20) Opportunities to Improve Value in Health Following the COVID-19 Pandemic
This blog post from the Health Affairs series “Higher Health Care Value Post COVID-19” discusses the learning opportunities for health care in the United States taken from the COVID-19 pandemic. These opportunities are presented as avoiding wasteful and unnecessary treatments and changing payment methodology, among others.

(10/21/20) Applying Value Assessment to the Health Care Sector for COVID-19
This blog post from the Health Affairs series “Higher Health Care Value Post COVID-19” seeks to assess the opportunity costs, cost-effectiveness thresholds, and dominance and cost-savings potentials from changes to health care experienced in the COVID-19 pandemic.

(10/19/20) Trends in Overall and Non-COVID-19 Hospital Admissions
This issue brief from the Kaiser Family Foundation covers trend data for hospital admissions, both overall and exclusive of COVID-19. This data can be helpful in estimating the impact of changes to admissions and services on the long-term financial health of hospitals in the United States.


Teledentistry was attempted on a wide scale for the first time in the COVID-19 pandemic. Some providers found value, while others found poor quality service.

The Centers for Medicare and Medicaid Services announced new changes to telehealth services; some could become more permanent changes to improve access and quality of care.


(10/21/20) Bridging the Miles — And the Pandemic — Teledentistry Makes Some Dentists Wince
An article jointly published by Fortune and Kaiser Health News which looks at the positive and negative consequences of teledentistry. While some have benefited significantly from the service, detractors complain of an inability to thoroughly test and diagnose a patient, leading to worse quality and potentially worse outcomes.

(10/20/20) Medicaid Telehealth Policies States Can Make Permanent to Ensure Access for Children/Families
This newsletter from Manatt Health discusses some of the policies enacted in response to COVID-19 that could be made permanent in an effort to expand access for children and families beyond the pandemic. Suggestions include changes to coverage, reimbursement, sites of care, and services offered.

(10/19/20) CMS Announces New Medicare Telehealth Services and Updates Medicaid Telehealth Toolkit
An article covering new services announced by the Centers for Medicare and Medicaid Services to be covered by Medicare during the COVID-19 Public Health Emergency. This emergency was recently extended to January 20, 2021, and meet an executive order from President Trump seeking to expand access to telehealth.

Maintaining the Educational Pipeline

The recent death of a medical resident sparks discussion on the difficult situation health care trainees face on the front-line of the pandemic.

Maintaining the Educational Pipeline

(10/20/20) A 28 Year Old Physician Died From COVID-19. Her Death Exposes the Harsh Realities of Medical Training
Following the death of a young physician, the author of this piece published in Forbes discusses the difficulties involved in medical education and residency in the United States, especially in the context of the COVID-19 pandemic. Residency is well known for long hours and low pay, leading to issues when facing a pandemic of a highly infectious and dangerous disease.

Health Workforce Safety

There is continued emphasis on protecting and caring for health workers as the COVID-19 pandemic continues.

A new study finds significant benefits in universal masking policies in preventing the spread of COVID-19 in health care settings.

Health Workforce Safety

(10/22/20) Stories of COVID-19: Caring for the Caregivers
A personal essay published by Health Affairs as part of the “Stories of COVID-19” series, this time coming from a hospitalist who treats patients diagnosed with COVID-19. This essay discusses the trauma experienced by those treating patients during the pandemic and the need to address the care of physicians and other health care providers before the end of the pandemic, as burnout and mental health issues plague these professionals.

(10/16/20) Hospitals Must Do More to Protect Their Workers From COVID-19
This opinion piece featured in STAT is authored by three physicians who live together and treat patients with COVID-19. The physicians discuss how federal guidelines do not come with funding to help hospitals with implementation and often are ineffective with the patient population. The authors suggest rapid testing would be an essential response to protect health care workers.

(10/21/20) Effects of Universal Masking on Massachusetts Healthcare Workers’ COVID-19 Incidence
A new study conducted by researchers from the Harvard University T.H. Chan School of Public Health found significant benefits from universal masking in preventing spread of COVID-19 infection within health care workplaces. The researchers recommend universal masking policies in all health care settings as well as indoor businesses where distancing and ventilation may leave people vulnerable.

State Workforce Strategies

Staffing issues remain a concern for hospitals and other health care providers facing increased COVID-19 cases and hospitalizations.

The Governor of New York has announced the intended COVID-19 vaccine distribution priority for New York State, with health care workers on the front-line given highest priority.

In efforts to prevent the spread of COVID-19, many health clinics have either reduced services or closed in rural locations of Maine. As a result, federal funding is being directed to expand the state’s telehealth services.

State Workforce Strategies

(10/21/20) NJ Hospitals Prepare for What’s Ahead as Cases Rise
With cases of COVID-19 rising across the United States, hospitals in New Jersey are preparing for another potential surge in hospitalizations. Although any future surge would be met with adequate stock of personal protective equipment, meeting staffing issues remain a concern for New Jersey.

(10/15/20) Montana Hospitals Grapple With Staffing Challenges Amid COVID-19 Surge
This article discusses the move from hospitals in Montana to work with the state to meet issues with staffing, which are being exacerbated by the recent surge in COVID-19 cases and hospitalizations. While previously in the pandemic hospitals would lend some of their workforce across the state as needed, they are currently unable to with a strained workforce experiencing surges in many parts of the state.

(10/18/20) Healthcare Workers, High-risk People Will Get Priority for COVID-19 Vaccine in New York: Governor
An article highlighting an announcement by New York Governor Andrew Cuomo that the state will prioritize distribution of any approved COVID-19 vaccine to front-line health care workers and the elderly first. The health care workers prioritized include those directly working with patients in primary care, hospitals, and long-term care facilities.

(10/20/20) CARES Act Grant to Expand Telehealth Services for Seniors in Maine
A new federal grant to the University of New England is being used to launch telehealth services for residents in rural Maine. This telehealth program will incorporate wellness services and advanced care planning.