Latest Healthcare News | FOX 5 New York

FDA announces recall of various heartburn and blood pressure medications

Sat, 11 Jan 2020 12:57:32 -0500

The FDA is recalling some heartburn and blood pressure medicines that may present a cancer risk.

Denton Pharma Inc. is recalling antacid medications containing what may be a carcinogenic ingredient, NDMA. The FDA says the ingredient is found in Ranitidine tablets, Zantac and other heartburn medications.

The recall is for unexpired products in in two dosage amounts.

Appco Pharma LLC has also recalled Ranitidine products, and Mylan Pharmaceuticals has also recalled three lots of Nizatidine, used to treat duodenal ulcers and acid reflux.

Consumers with Ranitidine tablets should check the FDA website for dosage and lots and immediately discontinue use, discard the products and consult with their physicians about treatment options.

2020 brings over 300 drug price hikes

Thu, 02 Jan 2020 15:48:11 -0500

Drug makers, including Bristol-Myers Squibb, Gilead Sciences and Biogen welcomed Americans into 2020 with price hikes on over 50 drugs on January 1.

On Thursday, Abbvie raised the cost of rheumatoid arthritis treatment Humira, the world’s top-selling medicine, bringing the total New Year’s Day drug price increases to over 330, according to data analyzed by healthcare research firm 3 Axis Advisors.

The companies join Pfizer Inc., GlaxoSmithKline and Sanofi, who were planning to increase prices on more than 200 drugs on January 1.

Axis estimates that the increase is around 5 percent and more early-year price increases could still be announced.

Study: Connecticut, New Jersey ranked as healthier states than New York

Thu, 23 Jan 2020 15:16:48 -0500

A new study ranks the healthiest states in the U.S., and New York finds itself finishing behind two of its neighbors.

According to the study by the United Health Foundation, New York is just the 11th-healthiest state in the nation, behind New Jersey at 8th and Connecticut at 4th.

The rankings were created using an index of over 30 metrics that give an annual snapshot of the health of a state’s population relative to others. Among the categories used were environmental factors, public policies and typical health outcomes.

New Yorkers shouldn’t be too sad however, the state has seen a significant improvement in its health ranking since 2009, jumping up fourteen places from 25th.

Vermont, Massachusetts and Hawaii made up the top three healthiest states, while Arkansas, Louisiana and Mississippi made up the bottom three.

FDA approves new drug to treat pancreatic cancer

Tue, 31 Dec 2019 20:41:03 -0500

The U.S. Food and Drug Administration approved an ovarian cancer drug for the maintenance and treatment of pancreatic cancer, according to AstraZeneca and Merck.

The drug, Lynparza (olaparib), has been approved in the United States for pancreatic cancer patients whose disease has not progressed on at least 16 weeks of a 1st-line platinum-based chemotherapy regimen.

Earlier this month, a panel of experts at the FDA recommended Lynparza after a study found that pancreatic cancer patients who were treated with the drug could go nearly twice as long without their cancer worsening than those taking a placebo.

“Patients with advanced pancreatic cancer historically have faced poor outcomes due to the aggressive nature of the disease and limited treatment advances over the last few decades,” said Dave Fredrickson, executive vice president of the Oncology Business Unit. “Lynparza is now the only approved targeted medicine in biomarker-selected patients with advanced pancreatic cancer,” he added.

Biomarker-selected patients are those with BRCA gene mutations, which hinder the body’s ability to fix damaged DNA and ultimately make it more likely that cells develop genetic mutations that can lead to cancer.

Lynparza is a PARP inhibitor, a type of drug that is used to stop cancer cells from reproducing.

"Metastatic pancreatic cancer patients have been waiting a long time for new therapy options for their devastating disease," said Julie Fleshman, president and CEO of Pancreatic Cancer Action Network. "Today’s approval of Lynparza provides an exciting new treatment option for patients with germline BRCA-mutated metastatic pancreatic cancer.”

Lynparza is already approved for advanced ovarian cancer and metastatic breast cancer and has been used to treat 25,000 patients worldwide, and now AstraZeneca and Merck (the drug’s makers) are looking into the possibility of using it to treat other types of cancer as well.

This story was reported from Los Angeles.

Murphy signs bill giving $9.5M to family-planning clinics

Thu, 02 Jan 2020 14:41:05 -0500

TRENTON, N.J. (AP) — New Jersey Democratic Gov. Phil Murphy on Thursday signed legislation setting aside $9.5 million for family planning services to counteract a Trump administration rule barring clinics from referring women for abortions.

Murphy, a first-term self-styled progressive and former Obama administration ambassador to Germany, signed the bill alongside lawmakers, first lady Tammy Murphy and Planned Parenthood officials, among others. He said the bill was necessary in light of a recent federal regulation.

Planned Parenthood in August announced it would not participate in a federal family planning program known as Title X, because of a new regulation from Republican President Donald Trump's administration prohibiting clinics that get federal funds from referring women for abortions.

In New Jersey, about 100,000 people, mostly women and mostly through Planned Parenthood, got services under the Title X program, which allocated about $9 million.

Murphy and Acting Health Commissioner Judith Persichilli said the law means family planning clinics will be able to continue to provide services to more than 100,000 people, mostly women.

Nationally, the federal family planning program serves about 4 million women, annually, distributing about $260 million a year in state grants to keep the program running. Many low-income women also get basic health care from the clinics.

The Trump administration's action was part an effort to recast policy on reproductive health to please conservatives — a key part of the president's political base.

Some conservatives argue the family planning program gives an indirect subsidy to Planned Parenthood, which runs family planning clinics and is also a major abortion provider.

Murphy criticized Trump before signing the measure Thursday.

“The federal government has once again put narrow political interests before the best interests of the American people," he said.

Abortion opponents, though, in New Jersey pointed the finger at Murphy for acting politically to please his own political base.

Marie Tasy, executive director of New Jersey Right to Life, said in a statement that the bill was a “disgraceful" money grab to help a group that supports Democrats at election time.

“The taxpayers of NJ should not be forced to fund abortion – and make no mistake – that is what this bill will do," Tasy said.

The law takes effect immediately.

Report: Over 13M Americans have gotten the flu this season

Fri, 17 Jan 2020 15:41:49 -0500

According to a report by the Centers for Disease Control and Prevention, roughly 13 to 18 million Americans have gotten the flu this season. Of those sickened, between 120,000 and 210,000 have been hospitalized and 6,000 to 17,000 people have died.

The CDC also reports that the flu has spread to 48 states, up from 46 last week.

Health officials recommend that anyone older than 6 months get the flu vaccine every season.

GPS system hidden in a shoe helps track Alzheimer’s patients

Sat, 01 Feb 2020 14:23:35 -0500

A new device is aiming to help calm the worries of having to keep track of people with Alzheimer’s disease.

A company called GPS SmartSole has come up with insoles that help you know where your Alzheimer’s loved one is at all times.

The insole has a built-in tracking chip with a cellular signal, helping you find people with memory impairments.

The device needs regular charging and requires a cellular service plan of at least 2G.

So far, the SmartSole is so popular its small size has sold out.

According to the Alzheimer’s Association, around 5.8M Americans have the disease. In Japan, the number of elderly Alzheimer’s patients is expected to reach 7M by 2025 and almost 16,000 of them went missing at some point.

Google creates AI to help doctors find breast cancer in patients

Fri, 03 Jan 2020 18:03:59 -0500

According to the American Cancer Society, mammograms generally fail to find one in five breast cancers.

“Physicians can struggle to read some mammograms when the breast tissue is dense,” said Mount Sinai’s Chief of Breast Imaging, Dr. Laurie Margolies.

According to Dr. Margolies, more fibrous tissue can obscure tumors from doctors. But now, new technology is helping doctors find that hidden 20 percent of breast cancers.

“I think we’re excited about empowering radiologists with these tools, and hoping they become ubiquitous,” said Google Software Engineer Scott McKinney.

McKinney helped design a program that uses artificial intelligence to find tumors in mammograms.

According to a study published in the journal “Nature,” Google’s AI identified nine percent more cancer in screenings than its human counterparts, reducing false positives by nearly six percent.

“Using these tools allows clinicians to have significantly more free time to concentrate on what we all went to medical school for, which is to actually take care of patients,” said Dr. Mozziyar Etemadi.

Dr. Margolies says that she expects artificial intelligence to transform all of healthcare in the future, but especially radiology.

One in eight women are at risk of getting breast cancer in their lives. Doctors perform 35 million mammograms every year, requiring massive computing power to combine and analyze the images.

Researchers also found instances in which all six participating radiologists found the cancer, while Google’s algorithm did not, suggesting similar programs might one day exist to supplement and not replace the human component.

No plan in sight: Test troubles cloud Trump recovery effort

Fri, 17 Apr 2020 16:23:00 -0400

WASHINGTON (AP) — The United States is struggling to test enough people to track and control the spread of the novel coronavirus, a crucial first step to reopening parts of the economy, which President Donald Trump is pushing to do by May 1.

Trump on Thursday released a plan to ease business restriction that hinges on a downward trajectory of positive tests.

But more than a month after he declared, “Anybody who wants a test, can get a test," the reality has been much different. People report being unable to get tested. Labs and public officials say critical supply shortages are making it impossible to increase testing to the levels experts say is necessary to keep the virus in check.

“There are places that have enough test swabs, but not enough workers to administer them. There are places that are limiting tests because of the CDC criteria on who should get tested," said Dr. Megan Ranney an emergency doctor and associate professor at Brown University. "There’s just so many inefficiencies and problems with the way that testing currently happens across this country.”

Trump's plan envisions setting up “sentinel surveillance sites” that would screen people without symptoms in locations that serve older people or minority populations. Experts say testing would have to increase as much as threefold to be effective.

The plan pushes responsibility for testing onto states.

“You know, the federal government shouldn’t be forced to go and do everything, ,” Trump told reporters Thursday.

But state and local officials as well as lab managers say they cannot expand testing until there are more supplies.

MORE CORONAVIRUS COVERAGE

This week governors, physician groups and laboratory directors called on the Trump administration to address shortages of swabs, protective gear and highly specialized laboratory chemicals needed to analyze the virus' genetic material. Hospitals and state health departments report scouring the globe to secure orders, competing against each other and their peers abroad in a system that Gov. Andrew Cuomo, D-N.Y., described as “mayhem.”

“The federal government cannot wipe their hands of this and say, ‘Oh, the states are responsible for testing,’” Cuomo said Friday as he complained of a shortage of chemicals manufactured in China. “I don't do China relations. I don't do international supply chain."

Trump has denied that the U.S. has fallen short, asserting that the U.S. has the “most expansive and accurate testing system anywhere in the world.” Only in recent days has the U.S. surpassed the rate of testing in South Korea, which has conducted about one test for every 100 people. Vice President Mike Pence told reporters Monday that if governors “would simply activate” underused high-capacity testing machines, “we could double the amount of testing in the U.S. literally overnight.”

"That is not the experience in Rhode Island,” said Gov. Gina Raimondo, D-R.I.

Democratic Gov. Laura Kelly of Kansas, whose state has one of the lowest per capita testing rates in the country, told CNN it has been difficult to get testing supplies. Gov. Jim Justice, R-W.Va., a Trump ally, said testing needs to be stepped up before he can lift restrictions.

Jennifer Rodriguez, a pharmacy technician at a major retail chain in California, said she was sent home by her employer last week after coming down with symptoms. Her company would not test her, and she spent hours on the phone trying to find a place that would, she said.

Researchers developing app that can detect COVID-19 based off the sound of your cough

The San Luis Obispo County health department can only test 50 samples per day, and a spokeswoman said those tests are reserved for people who are hospitalized, first responders and those who have had contact with people who tested positive. Rodriguez didn’t qualify. Another clinic told her she might have to pay $150 if it determined she did not fit its test criteria.

“I just feel like medical workers, or even people on the front line, they should have some kind of priority,” said Rodriguez.

For most people, the new coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia, and death.

Lab officials and health expert told The Associated Press that supply shortages have prompted them to limit who can be tested. That can leave out people who have symptoms but aren’t sick enough to be hospitalized, or people who have no symptoms and might unwittingly spread the virus. Experts say it will be crucial to test those people if the economy is to reopen.

Reopening US could require thousands more public health workers

Ed Thornborrow, medical director of the University of California at San Francisco Clinical Microbiology Laboratory, said he wants to run 3,000 tests per day, but he can only do 100 to 250 now because he lacks enough nasal swabs. He works constantly to find more.

“That’s what I spend most of my time on these days,” he said.

Meghan Delaney, chief of pathology and lab medicine at Children’s National Hospital in Washington, says shortages of chemicals known as reagents are constraining how many tests her lab can perform.

Vendors, in response, are restricting what hospitals can buy, said Dr. Robin Patel of the Mayo Clinic’s infectious disease laboratory.

“It’s a little bit like rationing,” Patel said.

In early March, Trump announced a plan for nationwide testing via drive-thru sites at chains such as Walmart and Target, linked by a Google-affiliated website. Six weeks later, the website is a pilot program available in just four California counties. Few of the retailers' sites have opened, and executives from companies including Walgreens have said they are waiting for direction from the federal government.

Trump also has promoted a 15-minute test developed by Abbott Laboratories as a “game changer.” Federal officials initially distributed 15 machines to public health labs in each of the 50 states and U.S. territories, along with 250 to the Indian Health Service. Alaska received 50.

But governors say they didn't get enough cartridges needed to run large numbers of the Abbott tests.

Rhode Island received only 120, much fewer than they were promised. Raimondo said when the state tried to get more, Abbott and others that make the test cartridges directed her to the federal government, which in turn told her to go directly to the companies. The state has now received 850 tests, far fewer than it requested, Raimondo said Friday.

Federal health officials declined to say how many cartridges were initially sent to states, but said more will be available as Abbott increases production. The company says it is currently producing 50,000 cartridges daily.

The U.S. bungled its initial rollout due to flaws with the test developed by the Centers for Disease Control and Prevention. Precious time was wasted in February as the test was corrected and redistributed. Private labs at hospitals, universities and commercial companies weren't fully enlisted in the effort until March.

The U.S. is currently testing roughly 145,000 people daily, for a total of 3.4 million results reported, according to state data compiled by the Covid Tracking Project. Public health experts say capacity needs to be much higher, in part to repeatedly test essential workers and to isolate those who test positive and to track down their close contacts to prevent new outbreaks.

“We still probably need to be doing three times more testing than we’re doing now,” said Dr. Ashish K. Jha, director of the Global Health Institute at Harvard. “I don’t see America getting by anytime soon with 100,000 to 150,000 tests.”

___

Smith reported from Providence, Rhode Island.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Nurses suspended for refusing to treat patients without being given masks

Thu, 16 Apr 2020 08:51:45 -0400

Nurse Mike Gulick was meticulous about not bringing the coronavirus home to his wife and their 2-year-old daughter. He’d stop at a hotel after work just to take a shower. He’d wash his clothes in Lysol disinfectant. They did a tremendous amount of handwashing.

But at Providence Saint John’s Health Center in Santa Monica, California, Gulick and his colleagues worried that caring for infected patients without first being able to don an N95 respirator mask was risky. The N95 mask filters out 95% of all airborne particles, including ones too tiny to be blocked by regular masks. But administrators at his hospital said they weren’t necessary and didn’t provide them, he said.

His wife, also a nurse, not only wore an N95 mask but covered it with a second air-purifying respirator while she cared for COVID-19 patients at Cedars-Sinai Medical Center across town in Los Angeles.

>SPECIAL COVERAGE - 24 Hours: The fight for New York

Then, last week, a nurse on Gulick’s ward tested positive for the coronavirus, which causes the disease COVID-19. The next day doctors doing rounds on their ward asked the nurses why they weren’t wearing N95 masks, Gulick said, and told them they should have better protection.

For Gulick, that was it. He and a handful of nurses told their managers they wouldn’t enter COVID-19 patient rooms without N95 masks. The hospital suspended them, according to the National Nurses Union, which represents them. Ten nurses are now being paid but not allowed to return to work pending an investigation from human resources, the union said.

They are among hundreds of doctors, nurses and other health care workers across the country who say they’ve been asked to work without adequate protection. Some have taken part in protests or lodged formal complaints. Others are buying — or even making — their own supplies.

>MORE CORONAVIRUS COVERAGE

Guidelines from the Centers for Disease Control and Prevention don’t require N95 masks for COVID-19 caregivers, but many hospitals are opting for the added protection because the infection has proven to be extremely contagious. The CDC said Wednesday at least 9,200 health care workers have been infected.

Saint John’s said in a statement that as of Tuesday it was providing N95 masks to all nurses caring for COVID-19 patients and those awaiting test results. The statement said the hospital had increased its supply and was disinfecting masks daily.

“It’s no secret there is a national shortage,” said the statement. The hospital would not comment on the suspended nurses.

Angela Gatdula, a Saint John's nurse who fell ill with COVID-19, said she asked hospital managers why doctors were wearing N95s but nurses weren’t. She says they told her that the CDC said surgical masks were enough to keep her safe.

Then she was hit with a dry cough, severe body aches and joint pain.

“When I got the phone call that I was positive I got really scared,” she said.

She’s now recovering and plans to return to work next week.

“The next nurse that gets this might not be lucky. They might require hospitalization. They might die,” she said.

As COVID-19 cases soared in March, the U.S. was hit with a critical shortage of medical supplies including N95s, which are mostly made in China. In response, the CDC lowered its standard for health care workers’ protective gear, recommending they use bandannas if they run out of the masks.

Some exasperated health care workers have complained to the Occupational Safety and Health Administration.

“I ... fear retribution for being a whistleblower and plead to please keep me anonymous,” wrote a Tennessee medical worker, who complained staffers were not allowed to wear their own masks if they weren’t directly treating COVID-19 patients.

In Oregon, a March 26 complaint warned that masks were not being provided to nurses working with suspected COVID-19 patients. Another Oregon complaint alleged nurses “are told that wearing a mask will result in disciplinary action.”

One New Jersey nurse who asked not to be named out of fear of retribution, said she was looking for a new job after complaining to OSHA.

“Do I regret filing the complaint? No, at least not yet,” she said. “I know it was the right thing to do.”

Some are taking to the streets.

On Wednesday, nurse unions in New York, Massachusetts, Michigan, Illinois, California, and Pennsylvania scheduled actions at their hospitals and posted on social media using hashtag “PPEoverProfit.”

Nurses at Kaiser Permanente’s Fresno Medical Center in central California demanded more protective supplies at a protest during their shift change Tuesday. The hospital, like many in the U.S., requires nurses to use one N95 mask per day, which has raised concerns about carrying the infection from one patient to the next.

Ten nurses from the facility have tested positive with COVID-19, Kaiser said. Three have been admitted to the hospital and one is in critical care, protest organizers said.

Wade Nogy, a Kaiser senior vice president, denied union claims that nurses have been unnecessarily exposed.

“Kaiser Permanente has years of experience managing highly infectious diseases, and we are safely treating patients who have been infected with this virus, while protecting other patients, members and employees,” Nogy said.

Amy Arlund, a critical care nurse at the facility, said that before the pandemic, following infection control protocols they’re currently using would have been grounds for disciplinary action.

“And now it’s like they’ve thrown all those standards out the window as if they never existed,” Arlund said. “It’s beyond me.”

Nursing home deaths soar past 3,300 in alarming surge

Sun, 12 Apr 2020 14:19:03 -0400

NEW YORK (AP) — More than 3,300 deaths nationwide have been linked to coronavirus outbreaks in nursing homes and long-term care facilities, an alarming rise in just the past two weeks, according to the latest count by The Associated Press.

Because the federal government has not been releasing a count of its own, the AP has kept its own running tally based on media reports and state health departments. The latest count of at least 2,646 deaths is up from about 450 deaths just 10 days ago.

But the true toll among the 1 million mostly frail and elderly people who live in such facilities is likely much higher, experts say, because most state counts don’t include those who died without ever being tested for COVID-19.

Alarming outbreaks in just the past few weeks have included one at a nursing home in suburban Richmond that has killed 39 and infected 84, another at nursing home in central Indiana that has killed 24 and infected 16, and one at a veteran’s home in Holyoke, Mass., that has killed 37, infected 76 and prompted a federal investigation. This comes weeks after an outbreak at a nursing home in the Seattle suburb of Kirkland that has so far claimed 43 lives.

And those are just the outbreaks we know about. Most states provide only total numbers of nursing home deaths and don’t give details of specific outbreaks. Most notable among them is New York, which alone accounts for 1,439 nursing home deaths but has so far declined to detail specific outbreaks, citing privacy concerns.

MORE CORONAVIRUS COVERAGE

Experts say the deaths may keep climbing because of chronic staffing shortages in nursing homes that have been made worse by the coronavirus crisis, a shortage of protective supplies and a continued lack of available testing.

And the deaths have skyrocketed despite steps taken by the federal government in mid-March to bar visitors, cease all group activities, and require that every worker be tested for fever or respiratory symptoms at every shift.

But an AP report earlier this month found that infections were continuing to find their way into nursing homes because such checks didn't catch people who were infected but asymptomatic. Several large outbreaks were blamed on such spreaders, including infected health workers who worked at several different nursing home facilities.

This past week, the federal Centers for Medicare and Medicaid Services that regulates nursing homes issued recommendations urging nursing homes to use separate staffing teams for residents, and to designate separate facilities within nursing home to keep COVID-19 positive residents away from those who have tested negative.

Dr. Deborah Birx, who leads the White House coronavirus response, suggested this past week that as more COVID-19 tests become available, nursing homes should be a top priority.

“We need to really ensure that nursing homes have sentinel surveillance. And what do I mean by that? That we’re actively testing in nursing homes, both the residents and the workers, at all times,” Birx said.

Doctor gambles on clot-busting drug to save coronavirus patients

Sat, 11 Apr 2020 18:07:33 -0400

WASHINGTON (AP) — The woman was dying. New York’s Mount Sinai Hospital was about to call her husband and break the news that there was nothing left to try. Then Dr. Hooman Poor took a gamble.

With high-stress, high-stakes decisions, doctors around the world are frantically trying to figure out how COVID-19 is killing their patients so they can attempt new ways to fight back. One growing theory: In the sickest of the sick, little blood clots clog the lungs.

Poor couldn’t prove it. The tests required would further endanger his staff, who were already at risk of getting the virus. But the lung specialist saw clues that were “screaming blood clots.” So Poor pulled out a drug best known for treating strokes, and held his breath.

“I said, ‘What do we actually have to lose?’” Poor told The Associated Press. “That’s when I decided to give not just a blood thinner but a blood clot buster.”

MORE CORONAVIRUS COVERAGE

Exactly what’s going on with blood clots in at least some COVID-19 patients is a mystery.

Chinese doctors were first to sound the alarm. In March, Chinese heart specialists advised the American College of Cardiology to watch for clots and said certain blood tests showing a rise in clot risk might signal which patients were in greatest danger. Other reports suggested the clots can show up all over the body. But were they a cause of deterioration or an effect?

Already, many hospitals are attempting preventive doses of blood thinners to keep clots from forming. There’s huge debate over what kind to try, what dose is safe — the drugs can cause dangerous bleeding — and how soon to start.

In New York, Poor was going a step further with a drug named tPA that doesn’t prevent clots — it breaks them up.

It's an example of how, with no vaccine or approved treatment for the coronavirus, many overwhelmed doctors are following trails of clues to figure out what to try next.

1st results in on Gilead coronavirus drug; more study needed

Poor's 55-year-old patient wasn’t getting enough oxygen even after doctors rolled her onto her stomach for an extreme ventilation technique called “prone positioning.” She was in shock. Other organs were failing fast.

Twenty minutes after the injection of tPA, her oxygen levels rose. Poor was elated. But not for long.

“She gets better, but then she starts to get worse,” he said. “Most likely we’re breaking up the clot, but she is immediately forming the clot again.”

So he next tried something novel, putting the woman on a low-dose drip of tPA for about 24 hours together with a blood thinner, in hopes of chipping away at existing clots while blocking new ones.

To Poor’s dismay, the experimental treatment bought the woman only a few more days of life. A sudden, different complication killed her on Friday.

But last weekend, Poor's team tested the new clot-fighting approach in four additional severely ill patients. One didn’t survive, dying of cardiac arrest from a massive blood clot in his heart.

The rest saw improvement in oxygen levels and shock. As of Friday, three remained on ventilators but were doing better, especially one who had been treated soon after her lungs failed. In a new report, Poor called for urgent study of whether abnormal clotting drives at least some people's deterioration, even as his own hospital updated treatment advice for its sickest patients.

Others are onto the same lead. Specialists at the University of Colorado and Harvard recently published a similar tPA research call, and cited three additional cases where it was tried as hospitals in Colorado and Massachusetts prepare for a study.

“We’re taking care of extremely ill patients that are dying in front of us, and we can’t get any diagnostic testing,” yet still have to make treatment decisions, said Dr. Steven Pugliese, a lung specialist at the University of Pennsylvania.

Pugliese called Poor’s tPA report “very intriguing” and concluded: “What these doctors did in these very ill patients who were dying was a judgment call, and it was the right thing to do.”

But with the bleeding risk, it has to be studied in carefully chosen patients, Pugliese said, especially with no good way to tell in advance who really has these tiny clots.

Poor first noticed oddities as his ICU filled with patients who just weren’t responding to care the way doctors expected. They were on breathing machines after developing ARDS, acute respiratory distress syndrome. It's an inflammatory form of lung failure that, when caused by other infections, stiffens lungs.

At least early on, Poor didn’t see that.

“It was like ‘Groundhog Day’ with each patient,” he said, referring to the movie where the same events repeat day after day. They had severe abnormalities in oxygen and carbon dioxide levels but “shockingly, their lungs were not stiff.”

He recalled Italian doctors who spotted the same thing and wrote in an American Thoracic Society journal that COVID-19 was causing atypical ARDS.

Back in Poor's hospital, when ventilated patients looked improved enough to let them wake up a bit, alarms would sound as their blood oxygen levels immediately plummeted.

“The residents would yell at me, ‘So and so is desaturating!’” Poor recalled. “Classically in ARDS, we think that’s because the lung is collapsing.” But it wasn’t.

Poor often treats an emergency called pulmonary embolism, a large clot in the lungs that can quickly kill. The COVID-19 patients didn't look quite like that. Nor were their hearts struggling to pump blood into the lungs.

Then as he was doing laundry at 2 a.m., Poor remembered a rare disease in which some lung blood vessels abnormally dilate even as others are clogged. If that explains the COVID-19 contradictions, he thought, a clot-buster might help.

“I did a case series of five. This does not prove anything,” he cautioned. “Perhaps it brings light to possibilities where further research can delve into what exactly is going on.”

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

1st results in on Gilead coronavirus drug; more study needed

Fri, 10 Apr 2020 20:59:35 -0400

More than half of a group of severely ill coronavirus patients improved after receiving an experimental antiviral drug, although there’s no way to know the odds of that happening without the drug because there was no comparison group, doctors reported Friday.

The results published by the New England Journal of Medicine are the first in COVID-19 patients for remdesivir. The Gilead Sciences drug has shown promise against other coronaviruses in the past and in lab tests against the one causing the current pandemic, which now has claimed more than 100,000 lives.

No drugs are approved now for treating the disease. At least five large studies are testing remdesivir, and the company also has given it to more than 1,700 patients on a case-by-case emergency basis.

MORE CORONAVIRUS COVERAGE

Friday’s results are on 53 of those patients, ages 23 to 82, hospitalized in the United States, Europe, Canada and Japan. Thirty-four of them were sick enough to require breathing machines.

All were given the drug through an IV for 10 days or as long as they tolerated it.

After 18 days on average, 36 patients, or 68%, needed less oxygen or breathing machine support. Eight others worsened.

Seven patients died, nearly all of them over age 70. That 13% mortality rate is lower than seen in some other reports, but no true comparisons can be made without a study rigorously testing the drug in similar groups of patients, the authors noted.

A dozen patients had serious problems but it’s not clear whether they were from the drug or their disease. Those included septic shock and trouble with kidneys and other organs. Four discontinued treatment because of health problems they developed.

“It looks encouraging,” said Dr. Elizabeth Hohmann, an infectious disease specialist at Massachusetts General Hospital who is helping lead one of the studies testing the drug. The problems that occurred were not unexpected given the disease, she said.

Dr. Derek Angus, critical care chief at the University of Pittsburgh Medical Center who wasn't involved with the research, said the recovery rate is good but “there is no way of knowing from this series if remdesivir was helpful.”

Results from more rigorous studies are expected by the end of this month.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Tracking NYC's coronavirus fight, from 911 call to ER door

Fri, 10 Apr 2020 19:07:13 -0400

NEW YORK (AP) — The coronavirus crisis is taxing New York City’s 911 system like never before.

Operators pick up a call every 15.5 seconds. Panicked voices tell of loved ones in declining health. There are multitudes of cardiac arrests and respiratory failures and others who call needing reassurance that a mere sneeze isn't a sign they've been infected.

The system is so overwhelmed, the city has started sending text and tweet alerts urging people to only call 911 “for life-threatening emergencies.”

As the city staggered through its deadliest week of the pandemic, its emergency response system and army of operators, dispatchers and ambulance crews is being pushed to the brink.

The fire department said it has averaged more than 5,500 ambulance requests each day — about 40% higher than usual, eclipsing the total call volume on Sept. 11, 2001.

“When you hang up with one call, another one pops in,” said 911 operator Monique Brown. “There’s no time for a minute’s rest.”

“It’s back-to-back, nonstop,” said dispatcher Virginia Creary.

“We just pick up call after call after call,” said paramedic Ravi Kailayanathan.

City Under Siege: 24 hours in the fight to save New York

Between the torrent of calls and so many requiring immediate intervention, like IVs and breathing tubes, it's taking longer for help to arrive.

The fire department said response times for the most serious calls have been averaging more than 10 minutes, up from about 6½ to 7 minutes under normal circumstances. People with mild symptoms or a minor injury could wait hours.

‘NEW YORK CITY 911’

Operators begin each 911 call in the nation’s largest city with the same question: “Do you need police, fire or medical?” Then they evaluate the call's urgency, prioritizing them on the fly.

Brown and her colleagues often work mandatory 16-hour shifts, crammed into Bronx and Brooklyn call centers behind screens that flash call details.

The fevers and coughing that crowded the city’s 911 lines early in the crisis have given way to frantic calls about grave illnesses. Creary said she’s noticed cardiac arrest calls spike. Some people call back within hours to report symptoms suddenly worsening.

The fire department said it is seeing more than 300 cardiac arrest calls per day, with well over 200 of those patients dying. A year ago, the department averaged 64 calls for cardiac arrest per day.

“The worst thing is taking a call and hearing somebody screaming because their loved one has stopped breathing or they’re in distress and they don’t know what to do,” said Creary, who's also an EMT. “You just feel utterly helpless.”

‘WE CAN NOT HANDLE THIS’

After the 911 operator, medical dispatchers like Creary take charge. They find an ambulance to respond and act as a liaison between crews in the field and the hospitals.

Hospitals swamped by the surge of patients sometimes make ambulances lined up outside, with crews waiting upward of 40 minutes to hand over a patient.

Creary said twice in recent days hospitals have told her to divert ambulances elsewhere. A nurse she alerted about an impending arrival pleaded: “We cannot handle this. We have no beds. We have no oxygen. We have no equipment. They cannot come here.”

ER doctor's virus fight: 'We're all in with our patients'

Nearly a quarter of the city’s EMS workers have been out sick, the fire department said. On one day last week, 3,000 members of the fire department were sidelined, including about 950 of the city’s 4,300 EMS workers.

The federal government sent 250 ambulances and 500 EMTs last week to supplement the city’s fleet. The fire department has deployed seven rapid-response vehicles, manned by firefighters, to the Bronx to provide care until an ambulance arrives.

“It’s mentally taxing,” said Creary, who copes with the stress at home by playing trumpet and learning bagpipes. “We’re short staffed. We’re short ambulances. Everybody’s basically overwhelmed.”

‘IT’S JUST HEARTBREAKING'

Kailayanathan, a paramedic responding to more than a dozen calls each day, stepped off his ambulance tired, hungry and emotionally drained after another 16-hour day.

Nearly every patient he saw on a recent 7 a.m. to 11 p.m. shift needed to be hospitalized and hooked up to a ventilator. Some patients have had to be resuscitated in the back of the ambulance.

“It’s just heartbreaking,” Kailayanathan said.

The state has instituted a triage protocol that instructs ambulance crews to question patients from a distance to screen for symptoms before initiating an examination with protective gear.

Kailayanathan’s assignment varies depending on where the dispatch system detects a surge in calls. Two weeks ago, he was in Queens, the borough hit hardest by the disease. Last week, he was shuttling patients to Lincoln Hospital in the Bronx.

The daughter of an elderly woman Kailayanathan treated pleaded to ride with her, but to curb the spread of the disease, family members are no longer allowed in ambulances and hospitals have banned visitors.

“There’s a good chance that the daughter is not going see her mother again,” he said. “That’s just really, really draining.”

Paramedic fears the toll of seeing so much sickness and death

‘NO WAY TO AVOID IT’

At least 688 EMS workers and other fire department employees have tested positive for coronavirus. A paramedic, Christell Cadet, has been in intensive care for three weeks. Throughout the city's emergency response system, workers fear they'll be next.

Kailayanathan said he’s only been drinking water on the job, cautious about eating and somehow introducing the virus into his body.

There is no sink in the ambulance to wash hands, so he mainly uses hand sanitizer. After his last run, he showers twice — at work and again at home. Then he has his first meal since 6 a.m.

Kailayanathan worries about infecting his elderly parents. Creary is looking into a temporary living arrangement so she doesn’t bring the disease home to her elderly mother.

The union for 911 operators is demanding that the police department, which runs the call centers, space workers out to protect their health. Instead of social distancing, they’re “sitting on top of each other,” said Alma Roper, of District Council 37’s Local 1549.

“For us, it’s not an if, it’s a when. When are these symptoms going to start? When are we going to start getting sick?” said Creary. “Because there’s no way to avoid it."

On Twitter, follow Michael Sisak at twitter.com/mikesisak and Tom Hays at twitter.com/aptomhays

Next potential shortage: Drugs needed to run ventilators

Fri, 10 Apr 2020 17:49:15 -0400

NEW YORK (AP) — As hospitals scour the country for scarce ventilators to treat critically ill patients stricken by the new coronavirus, pharmacists are beginning to sound an alarm that could become just as urgent: Drugs that go hand in hand with ventilators are running low even as demand is surging.

Michael Ganio, of the American Society of Health-System Pharmacists, said demand for the drugs at greater New York hospitals has spiked as much as 600% over the last month, even though hospitals have stopped using them for elective surgery.

“These ventilators will be rendered useless without an adequate supply of the medications,” Society CEO Paul Abramowitz said in an April 1 letter to Vice President Mike Pence, who is leading President Donald Trump’s coronavirus task force.

Nationwide, demand for the drugs surged 73% in March, according Dan Kistner, a pharmaceuticals expert at Vizient, Inc., which negotiates drug prices for hospitals throughout the country. Supplies, according to Vizient data, have not kept pace.

“Trying to run the ventilators without these drugs will be like trying to operate a fleet of cars without gasoline,” Kistner said.

To date, no hospital has reported being unable to put a patient on a ventilator due to a lack of those drugs, said Soumi Saha, a pharmaceuticals expert at Premiere, Inc., which also negotiates drug prices for hospitals.

MORE CORONAVIRUS COVERAGE

When clinicians put critically-ill patients on ventilators, they generally rely on three categories of drugs: sedatives, pain killers and, at times, paralytics.

“You have a tube basically down your throat to help you breathe,” explained Chris Fortier, the chief pharmacy officer at Massachusetts General Hospital. “We need medications to sedate you and treat your pain, and sometimes to even give you some paralysis so that you’re not pulling on that ventilator and damaging your lungs.”

The demand is surging because hospitals across the country are trying to stock up at the same time, said Erin Fox, director of the drug-information service at University of Utah Health, which runs five hospitals.

“I’m just terrified that we’re not going to have the medicines we need,” Fox said. “It keeps me up at night.”

Fortier said adequate supplies of the drugs are also being stretched because COVID-19 patients typically stay on ventilators from 10 to 14 days, which is longer than typical patients.

At the moment, supplies are not critically low at Mass General, Fortier said, but the concern is so great that hospital staffers are monitoring supplies around the clock. “We have a team looking at it, hour-by-hour, seven days a week,” he said.

If supplies run out, specialists said, doctors have other options — drugs that may not be their first choice, or drugs unavailable in doses they prefer. Using them could increase the risk of medication error or take more time to administer at a time when clinicians are racing to treat as many patients as possible.

“Fentanyl comes in different sizes,” Kistner said, describing a situation where clinicians might have to use several smaller doses for a single patient if larger doses are not at hand. “That would be a lot of work and very inefficient."

The specific drugs running low include the opioid painkillers fentanyl, morphine, and hydromorphone; the sedatives midazolam and propofol; and the paralytics pancuronium, rocuronium, and succinylcholine, according to the letter the ASHP sent to Pence.

Already, the U.S. Drug Enforcement Administration has announced it is raising its 2020 ceiling for opioid production by 15% and is approving drugmaker requests for higher limits, often within a day.

Pfizer, a top maker of injectable drugs, is one of several U.S. drugmakers covered by the new quotas, and is ramping up production of fentanyl, morphine, hydromorphone and other medicines for ventilator patients, according to company spokeswoman Kimberly Bencker.

“For many of these critical medicines, we have ample supply. For some, the unprecedented surge in demand for these products is limiting our ability to fully satisfy customer orders in the short-term,” Bencker said.

QuVa Pharma, a drug compounding business that makes drugs for hospitals nationwide, also received a higher ceiling for making fentanyl and hydromorphone and expects to begin shipping more of those drugs directly to hospitals starting April 20, said co-founder Peter Jenkins.

The Houston-based company aims to make two to three times its normal volume of those drugs while manufacturing extra sedatives and paralytic drugs, plus one to boost blood pressure in COVID-19 patients, said Jenkins.

Even before the coronavirus pandemic, some of the drugs were already in short supply because profit margins for generics are relatively low and, consequently, some manufacturers have stopped producing them.

What’s more, because the drugs are injectables, they must undergo sterility tests, a process that can take weeks. “You can’t say, ‘Hey, we’re going to make more of these drugs’ and have them here tomorrow,” Kistner said.

That’s why some pharmacists fear the shortages may get worse before they get better. Said Fortier: “This is going to get bigger as we move forward over the next couple of weeks.”

__________

Johnson reported from Trenton, N.J.

Immunity card could mark you free of coronavirus, but questions remain

Fri, 10 Apr 2020 17:26:08 -0400

The idea of coronavirus immunity cards has become part of the national coronavirus conversation in the United States, as more medical clinics and labs come out with virus tests.

An immunity card, passport, app or another form of ID would be used to identify people who have been tested as either COVID-19 positive or negative.

The card would determine who is allowed to re-enter the public in an effort to gradually open up the country after the nationwide lockdowns put in place to contain the virus.

MORE CORONAVIRUS COVERAGE

Some U.S. cities have been in lockdown mode for several weeks. Roughly half a million coronavirus cases have been confirmed in the U.S.

Global coronavirus death count tops 100,000, according to Johns Hopkins

However, experts say that the number of confirmed cases would likely be higher if the country had access to more tests, which are in short supply. The use of immunity cards to keep track of those who have tested positive for the virus has been suggested by some health experts.

Critics have pointed to several problems, including how to determine immunity, the logistical issues of delivering cards to everyone in the U.S. and the potential for fraud.

Second vaccine trial for coronavirus begins in U.S.

Thu, 09 Apr 2020 16:16:28 -0400

Researchers in the United States have opened another safety test of an experimental vaccine for COVID-19.

The drug, developed by Inovio Pharmaceuticals is part of a worldwide effort to curb the spread of the virus.

Inovio will test two doses of the vaccine on 40 healthy volunteers at its Kansas City research lab.

Inovio’s researchers package a section of the virus’s genetic code inside a piece of synthetic DNA that’s injected in a skin-deep shot, and those cells act as a mini-factory to produce harmless protein copies while the body’s immune system produces antibodies against them that would also block the virus.

The early-stage studies will determine whether the vaccine is safe enough for larger tests.

Experimental medications, therapies in the works in effort to treat COVID-19 coronavirus

Even if research goes well, it’s expected to be a year or more until the drug is widely available.

Another vaccine candidate backed by the National Institutes of Health Works similarly, except it uses a type of genetic code called Messenger RNA.

Neither vaccine is made using the actual virus, meaning there’s no chance of getting infected from the shot.

Doctors in NJ adjust to new reality of battling coronavirus

Thu, 09 Apr 2020 14:46:16 -0400

The front line in the war against the coronavirus is unmistakably drawn right in our local hospitals.

And for doctors in Bergen County, New Jersey, one of the hotspots, it's meant instant adaptation to save lives, says Dr. Stephen Brunquell, President of the Englewood Health Physican Network.

"I think it's fair to say that everything has changed," said Brunnquell. "The Hospital doesn't look the same, we're all doing different jobs, our day-to-day routines are completely different. I don't think anything was the same as it was a month ago."

As the virus spread endangering and claiming many lives and the sick flooded the emergency department, Dr Brunquell says Englewood Hospital had to quickly expand to fill the need. They added beds wherever they could, tripling the number in the ICU. They quadrupled their number of ventilators to 40. Elective surgeries were suspended and those doctors and nurses put on COVID-19 duty.

"Medical professionals or not, no one has ever seen anything like this, no one has ever experienced or witnessed something like this, and clearly there was no lecture in medical school that taught you how to operate a hospital during a pandemic," he said.

Dr. Brunnquell says they currently are treating just over 200 covid-19 patients. In the beginning as the case load exploded, they had to devise effective treatments for a disease that has been around for less than 6 months, with little clinical research. He says the first wave they treated were many people with serious medical conditions, but now they're getting more essential services workers who were relatively healthy. There is constant communication and reassessment among their medical team.

"We change our plans sometimes on a daily basis not because we're flip flopping, not because we don't know what to do," he said. "It's because the ground is shifting under your feet, and you have to be nimble, you have to respond because this thing changes almost every day."

Former NYPD Commissioner O’Neill working to get NYC hospitals protective equipment

Wed, 08 Apr 2020 17:52:12 -0400

Former NYPD Commissioner James O’Neill is cutting through the red tape to get New York City’s hospitals protective equipment as quickly and as fairly as possible.

O’Neill was appointed Senior COVID-19 Advisor by Mayor Bill de Blasio last week, in order to coordinate the delivery of medical supplies to the city’s 56 hospitals. At the time, there were many healthcare workers pleading for gowns, gloves, face masks and ventilators.

“We’re not embedded in every hospital, but we are sending teams out to eventually every hospital to see what kind of inventory system they have, to see what they use for internal distribution,” O’Neill told FOX 5 NY. “What we found is that depending on the hospital, there are different distribution systems… we’re putting together our best practices.”

O’Neill says that he has not heard of hospital workers or management hoarding or even stealing supplies.

“From every healthcare worker we’ve encountered, nothing but professional, all they’re concerned about is saving lives,” O’Neill said.

Supplies are streaming into the city Health Department’s warehouse in Edison, New Jersey. PPE is coming from donations, vendors, the state and the federal government.

In response to criticism from Staten Island President Jimmy Oddo that his borough has been chasing supplies and communication without staffing help, O’Neill said that he is in direct communication with hospitals in the borough and that his team is continuing to scrutinize and improve the supply chain.

Currently, O’Neill says that surgical gowns are currently the biggest need in the city’s hospitals, but that could change in just a few days.

No COVID-19 testing at home yet but quicker options coming

Sun, 05 Apr 2020 12:55:53 -0400

WASHINGTON (AP) — Home testing for the new coronavirus may sound like a good idea, but U.S. regulators say it's still too risky.

They've stopped companies that quickly launched home-testing kits until they can show their products can accurately detect the virus.

For now, the only way Americans can get tested is at hospitals, clinics or drive-thru sites, with a doctor's order.

After a botched rollout, testing in the U.S. has ramped up thanks to high-volume testing machines and new rapid tests. Last week, federal officials said total tests topped 1.4 million, and labs are processing nearly 100,000 tests daily. That's the threshold many experts say is needed to track the virus.

MORE CORONAVIRUS COVERAGE

Still, testing continues to be constrained by shortages of medical supplies like gloves, masks and swabs. And the widespread drive-thru testing proposed for parking lots at chains like Walmart, Walgreens and Target has barely gotten off the ground.

Meanwhile, the Food and Drug Administration is aggressively pushing new options onto the market.

FASTER RESULTS

Genetic tests are the gold standard for detecting COVID-19 infections. New, quicker ones are replacing the original laboratory tests that have to be manually mixed and developed.

The idea behind both tests is the same: chemical solutions are used to isolate the virus from the patient sample, grab its genetic material and then reproduce it millions of times until it's detectable with a computer.

New rapid tests such as the one by Abbott Laboratories automate the process, cutting the time from four to six hours to about 15 minutes.

“Essentially all of the reactions are squeezed into a little cartridge, so it's a very nice, self-contained system.” said Dr. Bobbi Pritt, lab director at the Mayo Clinic in Rochester, Minnesota

The cartridges from Abbott and other companies run on small, portable electronic machines found in thousands of U.S. hospitals, clinics and doctor's offices. That's expected to increase testing beyond large universities, government and commercial labs. Abbott said it plans to begin shipping 50,000 tests per day this month. U.S. officials said they'd go first to remote areas with less access to labs.

For now, only a health care professional can order a coronavirus test. Under current guidelines, priority is given to people with COVID-19 symptoms who fall into several high-risk groups, including hospitalized patients, health care workers and the elderly.

“If you’re not sick, you don’t need to be tested,” has been the mantra for weeks.

DON'T TRY THIS AT HOME

Accurately testing for coronavirus involves several steps, including carefully swabbing the nose or throat to collect a sample, placing it in a sterile tube, storing it below 46 degrees Fahrenheit and then shipping it to a lab within three days.

Health officials warn a number of things could go wrong if consumers try to swab, store and ship their own samples, potentially resulting in testing errors and undetected infections.

The FDA is talking to companies working on at-home kits, but they'll be required to show that their results are comparable to those of people under professional care, agency spokesman Jeremy Kahn said in a statement.

Many of the proposed at-home tests aren't like home pregnancy tests — they won't provide instant results. The samples still need to go to a lab.

After several companies began shipping test kits last month, the FDA quickly intervened. No home tests have been approved and the products sent to U.S. consumers were frauds, regulators said.

Several companies were caught off guard including San Francisco startup Nurx, which initially built its business around prescribing birth control drugs via brief online consultations.

On March 20, the company announced plans to ship 10,000 testing kits to customers for $181 each. Within 24 hours, the FDA warning went out and Nurx's plan was off.

UPCOMING OPTIONS

Simpler, cheaper blood tests could also have a role in tracking the virus — and possibly expanding testing to the home.

The FDA is permitting companies to launch certain types of finger-prick tests that can detect whether people may have recently been infected.

Instead of detecting the virus itself, these tests detect proteins called antibodies that the immune system generates to fight COVID-19.

Public health experts hope that mass screening with antibody tests could eventually help track how the virus spreads and who might have built up immunity.

“We have this massive epidemic on our hands and if we really want to control it through testing we need to have it more readily available and on a repeated basis — potentially every week to know who is truly positive and negative,” said Harvard University’s Dr. Michael Mina.

Because the blood test is easy to perform and can be developed in 15 minutes — without laboratory equipment — some companies think it could become a viable home-testing option.

Scanwell Health is seeking approval for a home test using one developed by Chinese manufacturer Innovita and deployed by the Chinese government.

People who meet criteria through an online questionnaire would receive a test kit in the mail, take a blood sample and scan the test with a smartphone app. Next is an online consultation with a health professional who will deliver and interpret the results.

“The entire testing process happens within the home— nothing needs to be shipped back,” said Scanwell executive Dr. Jack Jeng.

___

AP business writers Tom Murphy in Indianapolis and Anne D'innocenzio in New York contributed to this report.

___

Follow Matthew Perrone on Twitter: @AP_FDAwriter

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

'I cried on the truck': Fatigued NY workers forge ahead

Sun, 05 Apr 2020 12:12:51 -0400

Josh Allert’s days are a blur and a battle.

His mental and physical stamina are constantly put to the test as the 22-year-old emergency medical technician transports coronavirus patients around New York. He is burdened by the push-and-pull between the desire to help at the epicenter of the pandemic and the knowledge doing so separates him from the people he loves. He worries about getting sick or infecting his family.

Sitting in an ambulance as it dashed across New York City near the end of another draining shift earlier this week, the stress overwhelmed him.

“I cried on the truck,” Allert told The Associated Press. “I’ve been working this hard and just wanted to go see my family and spend time with them and kiss them and hug them, and I can’t right now.”

Allert is part of an army of workers who have suddenly been thrust onto the front lines of the outbreak in New York, where the staggering death toll from coronavirus has surpassed 4,000.

A month ago, Allert’s EMT job served as his side hustle. Then COVID-19 crashed into the city. Everything shut down, including the computer work he was trying to turn into a full-time gig.

The private ambulance company where Allert moonlights began offering more opportunities. A lot more. During a recent weekend, he put in a 12-hour shift on Friday followed by a 21-hour stint the following day. The phone can ring at all hours.

He was on his Xbox at 2 a.m. recently trying to decompress when they asked him to come in. So he did. Another wearying 18-hour stint followed.

“Technically I’m only part-time, but I know what the deal is,” Allert said. “There’s a lot of patients going in. They need us to take people out. ... It’s hard work. A lot of us are only making a couple dollars more than minimum wage but I’m doing this for my family, trying to help them out.”

The sight of Allert coming into a COVID-19 patient’s room is typically good news. Many of his runs during the epidemic have centered around transporting recovering patients back home to open up beds for the next in a seemingly unending wave.

Americans brace for 'hardest, saddest' week of their lives

Yet the process is anything but smooth. Whenever Allert enters a hospital, he is required to have his temperature taken before filling out paperwork concerning his recent whereabouts.

As he navigates hospital hallways in his protective gear, he walks into a sea of patients on ventilators fighting an opponent blind to race, gender and circumstance.

“It’s looking very grim,” Allert said. “A lot of hospitals are overpacked. You got people in the hallways, standing, sitting on chairs. You can see the staff interacting with other patients. Tensions are high, people are frustrated.”

The job is not easy. He’d like to receive hazard pay. He’s not. He’d like his company to have a bigger stash of personal protection equipment. It doesn’t. He’d like for things to return to some semblance of normal. It won’t. Maybe not for a long time.

“There’s still a lot more to go around, as morbid as that sounds,” he said. “This is spreading really fast."

Where will the bodies go? Morgues plan as coronavirus deaths grow

So for now, he’ll keep doing what he can when he can. That means answering the phone when it rings. That means giving himself a self-administered breathing test shortly after waking up. That means taking care of the people in front of him now in hopes he can take care of the people closest to him the next day.

“I’m still working and breathing,” Allert said. ”(My family), I think they’re concerned. They’re Christian. They want you to take your precautions. They believe this is in God’s hands.”

___

Follow AP news coverage of the coronavirus pandemic at https://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreaks.

A mounting casualty of coronavirus crisis: Health care jobs

Sat, 04 Apr 2020 17:23:58 -0400

HARRISBURG, Pa. (AP) — Tens of thousands of medical workers across the United States are suddenly out of work as operating rooms and doctor's offices go dark, casualties of urgent calls to prioritize coronavirus patients at overwhelmed hospitals and of the economic waves the crisis is churning.

Even as hospitals scrounge for professionals from the industry to treat the burgeoning numbers of people with COVID-19, others are on the sidelines as elective procedures, diagnostics and appointments are canceled or postponed.

For instance, many nurse anesthetists in Pennsylvania have been laid off, even though they are particularly critical to the coronavirus response because they can help intubate patients and manage them on ventilators.

“I certainly never thought there would be a day as a nurse that I would be filing for unemployment, so it’s quite surreal for all of us,” said Jess Poole, a nurse anesthetist who, until a couple weeks ago, worked for an anesthesia practice in the Pittsburgh area.

MORE CORONAVIRUS COVERAGE

Big-city physician and specialist groups, tiny independent hospitals from Oregon to Connecticut, and big multistate hospital systems such as Steward Health Care are seeing big dropoffs in revenue and laying off or furloughing hundreds of workers.

A tally of out-of-work medical professionals is elusive, since the coronavirus began taking a devastating toll on jobs only in mid-March. Many institutions have said nothing publicly, quietly making cutbacks, and the monthly jobs report issued Friday by the federal government showed 42,000 job losses in health care — just a small indication of what’s to come, because the government surveyed employers before the heaviest layoffs hit.

US sheds 701,000 jobs, ending a record-long hiring streak

Not all states release that data in real time, although Minnesota reported that from March 16 through March 31, more than 13,600 health care practitioners or technicians filed unemployment claims in that state alone.

Some layoffs, the generally permanent loss of a job, and furloughs, a reduction in hours or a leave of absence with the option to return, are focused on nonclinical staff. Elsewhere, clinical professionals — specialists, lab techs, operating room staffs, nurse specialists, support staff — suddenly find themselves with a cut in pay or hours, or sitting at home, including some in coronavirus hotspots.

In hard-hit Michigan, Mercy Health and Saint Joseph Mercy Health System, which runs eight hospitals in the state, said it will furlough 2,500 workers, including an undisclosed number of clinical staffers, and shift others to jobs “needed to respond to the crisis.”

The cuts are driven primarily by pressure from state and federal officials to shelve elective procedures, appointments, diagnostics and other services to preserve hospital beds, while many patients are postponing appointments to observe social distance restrictions.

For some provider groups and hospitals, the lion's share of their revenue has dried up.

While $100 billion from the federal relief package signed last month by President Donald Trump might help cover that, it’s not clear how the money will be distributed, or how soon, or whether it will be enough.

Erlanger Health System, which operates six hospitals in Tennessee and one in western North Carolina, reported it lost millions of dollars in the past week alone.

"The financial bleeding was immediate," said Chip Kahn, CEO of the Federation of American Hospitals.

The federation said it believes hospitals are eligible to apply for loans in the federal emergency relief bill to maintain payroll or rehire workers, loans that can then be forgiven.

In the meantime, states reeling from the pandemic are calling for help from medical professionals or relaxing regulations to allow retired workers, students or out-of-state professionals to come to the rescue.

Call for virus volunteers yields army of health care workers

Some hospitals — such as rural hospitals or urban ones with a heavy Medicaid caseload — were on precarious financial footing when the crisis struck, sending some states scrambling to keep them open, including in Pennsylvania and West Virginia.

In North Carolina, Cape Fear Valley Health system is furloughing about 300 employees but offering idled specialty nurses the opportunity to fill open positions as floor nurses.

Hospital executives say they have no choice but to issue furloughs and meet the most immediate needs, while shifting to telemedicine and retraining or moving some clinical staff.

Mercy Medical Center in Springfield, Massachusetts, gave 37-year nurse Bruce Moore the option of a furlough from the cardiac catheterization lab — with no guarantee of a recall — or retrain to care for coronavirus patients on ventilators in the intensive care unit.

Moore took the retraining, with a mix of emotions: worried that he would never be recalled if he went on furlough, wanting to help, and apprehensive about the adequacy of two or three weeks of retraining and the prospect of using rationed masks and gowns, which are in short supply.

“Nurses are being expected to do things that they've never done,” Moore said.

Hospital officials say furloughed employees, in most cases, can expect to be recalled if they are needed or when the crisis subsides.

Clinical staff members being sent home are not treating coronavirus patients, or they have little to do in suddenly quiet offices and facilities where there is no crisis, the institutions' leaders say.

“But they may be in areas where there will be growth in the virus, which makes layoffs particularly alarming, because hospitals are gearing up or should be gearing up even in places where coronavirus is not an emergency as it in other parts of the country,” said Tricia Neuman, who directs the Medicare policy program at the Kaiser Family Foundation.

Alex Hlumyk, of Hubbard, Ohio, a certified medical assistant, had been helping screen potential coronavirus patients before his Steward-owned physicians' practice furloughed him.

“I was pulled into a backroom and told, ‘We’re furloughing you because we don’t have the money,'" Hlumyk said.

He's not sure how he would sign up to help in areas slammed by the virus, and his employer didn't give him any guidance, he said.

“That’s the problem with the for-profit health care system,” Hlumyk said, citing the tendency of hospitals to compete for resources instead of share them.

In recent days, hospitals watching the spreading outbreak in the Pittsburgh area are building disaster relief plans and contacting Poole, the nurse anesthetist, to see if she would come in in an emergency.

She's saying yes.

“We don’t know if or when we're going to be called back to work,” Poole said. "We’re kind of stuck in between right now.”

___

Associated Press writer Michael R. Blood in Los Angeles contributed to this report. Follow Marc Levy on Twitter at https://twitter.com/timelywriter. The AP Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Hunt for medical supplies creates marketplace of desperation

Sat, 04 Apr 2020 14:16:14 -0400

ANNAPOLIS, Md. (AP) — Shady middlemen, phantom shipments, prices soaring by the hour, goods flown in on a private plane.

What sounds like an organized-crime thriller is now the new reality for governors desperately trying to find the medical equipment their states need in the throes of a pandemic. With the federal stockpile dwindling fast, and the Trump administration limiting access to what’s left, state leaders are going to extraordinary measures on their own to secure faces masks, ventilators, gloves and other equipment essential to fighting the outbreak.

They’ve ventured into a global market-place one governor described as the “wild, wild, West,” only to compete against each other and their own federal government. They’ve watched the price of a ventilators double and masks go for 10 times their original price. They’ve turned to rich friends and businesses for help. Massachusetts Gov. Charlie Baker enlisted NFL owner Robert Kraft to send the Patriots team plane to China to retrieve over a million masks.

In New York, an epicenter of the outbreak in the U.S., Gov. Andrew Cuomo has looked closer to home to secure ventilators, issuing an order that forces even private hospitals to redistribute ventilators to the hospitals most in need.

“Let them sue me,” Cuomo said.

Gov. Cuomo authorizes seizure of ventilators if needed

All this has led many governors to call on the federal government to centralize purchases. But President Donald Trump has not appeared inclined to intervene in the private market. And the White House made clear this week that Trump views the federal stockpile as a “backup” for the states.

“It is the greatest frustration,” said Maryland Gov. Larry Hogan, a Republican who heads the National Governors Association. “We have states out competing on the open markets with totally uneven distribution of these things, and now the federal government competing with us — and other countries competing against us — and then a very limited supply of all of these things and no real coordination of where it’s going.”

Hogan said there has been progress from the Federal Emergency Management Agency distributing supplies from the nation's dwindling stockpile, but he described it as a “tiny percentage” of what is needed."

“We’ve been buying up everything that we can possibly get our hands on in the open market all over — not just domestically, but all over the world, from places like Korea and China and other places,” he said.

MORE CORONAVIRUS COVERAGE

It's not just governments competing with each other for the precious and ever-pricier supplies. States also sometimes compete with their own hospital systems, which are trying to get direct shipments so they can quickly resupply their medical workers.

Hospital employees like Dr. Daniel Durand, a physician for a hospital system in Maryland, now have a role they never imagined overseeing purchases in a market gone haywire.

As just one example, Durand said coveted N95 face masks that used to cost less than a dollar each can't be found for less than $3.70. And that's a bargain: Plenty of buyers are willing to pay much more — up to $10 apiece.

He said some middlemen threaten to take their products to another hospital when he starts asking basic questions.

“And then what I’m hearing is that people are paying millions for shipments and nothing’s showing up," said Durand, who is the chairman of radiology for LifeBridge Health's five hospitals. "So, there are just totally people scamming hospitals.”

Virginia Secretary of Finance Aubrey Layne vets suppliers for that state's medical gear and said they have to deal with people with questionable qualifications, and with little time to determine whether they are qualified or trustworthy.

"Everybody knows somebody who knows somebody in China," he said.

Earlier this week, Trump acknowledged that the federal stockpile is nearly depleted, signaling that states will remain largely on their own just as the death toll begins to spike. Many governors have been complaining for weeks that they have not received the shipments they requested from the nation's supply.

Middlemen and suppliers are taking advantage of the desperation: Smaller ventilators that had been selling for $11,000 to $14,000 are now going for $20,000 to $30,000, said Christian Mitchell, deputy governor in Democratic Illinois Gov. J.B. Pritzker’s administration. More deluxe models that had topped out at $45,000 now cost $20,000 more.

“Your choices are between, ‘Do I get enough of the stuff that I need to protect my front-line health care workers, do I get enough ventilators to make sure that more people get to stay alive. Or do people die?’” he said.

Big states like California have an advantage because their sheer size gives them massive purchasing power that others lack. California Gov. Gavin Newsom says he doesn't want that leverage to hurt smaller states and has reached out to Washington, Illinois, New Jersey and others about creating a partnership to centralize their purchases.

“Much of what you’re hearing is true in terms of it being the wild wild West out there,” Newsom said.

Small states, like New Hampshire, are at a disadvantage.

“I’m sorry, New Hampshire does not have the scale to compete with the state of New York, with the state of Illinois," said Brendan Williams, president of the New Hampshire Health Care Association, which represents the state’s nursing homes.

“If it’s just going to be this sort of Darwinian free-for-all, like ‘Lord of the Flies' ... I don’t know what to say. It’s absolutely unconscionable. It’s unimaginable that this is where we are at right now.”

Some states are working with private manufacturers to convert buildings so they can produce their own medical equipment.

LifeBridge Health is among those taking matters into its own hands.

It converted a building in the Baltimore suburbs into a factory to produce masks. LifeBridge’s head of oncology, who sews, trained 40 staff members how to make the masks, said Durand, the radiologist.

“It’s like a half sewing factory, half surgery suite,” he said.

___

Associated Press writers John Hanna in Topeka, Kansas; John O'Connor in Springfield, Illinois; Kathleen Ronayne in Sacramento, California; Holly Ramer in Concord, New Hampshire, and Alan Suderman in Richmond, Virginia, contributed to this report.

___

Follow AP news coverage of the coronavirus pandemic at https://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

Central Park houses hospital ward as NY races to add beds

Thu, 02 Apr 2020 22:36:14 -0400

NEW YORK (AP) — There is a coronavirus ward in tents in Central Park. A makeshift hospital has been set up in a Manhattan convention center. Over the next few weeks, spaces including pro tennis courts, college dorms and a cruise ship terminal are supposed to start housing patients as New York state races to roughly triple its hospital capacity.

And still, officials worry whether the massive effort will be enough in the U.S. epicenter of the coronavirus pandemic.

A recent state chart tallying the planned hospital beds ended with question marks about how much space might be found in nursing homes. Some hospital and city leaders have questioned whether too much temporary hospital space is being reserved for patients who don't have the virus that causes COVID-19, though there are now plans to shift one big temporary site's focus to caring for them.

And officials underscore that beds alone can’t solve a problem growing by more than 1,000 hospitalizations a day.

New York surpasses 90,000 coronavirus cases; 2,373 dead

“Beds, we can find. Not easy, but we can find them. The harder components are the staff and the supplies,” Gov. Andrew Cuomo said Thursday.

As he spoke, over 13,300 coronavirus patients were hospitalized and more than 3,300 needed intensive care around the state, though mostly in New York City. The outbreak’s expected peak was still seven to 30 days away, the Democrat said.

When that happens, New York expects to need 140,000 hospital beds — compared to the 53,000 it had when the crisis began. So many seriously ill patients are anticipated that New York City is preparing to turn all its 20,000 permanent hospital beds into intensive care ones, while trying to add 65,000 temporary beds for other patients.

For most people, the new virus causes mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with chronic health problems, it can cause more severe illness, including pneumonia, and can be fatal. It has killed over 2,300 people in New York state so far, according to the governor.

The scramble for hospital space, staff and ventilators is intended to ward off a dire worst-case scenario: medical centers becoming so swamped that some people die whose lives could otherwise be saved.

Even though they are working to squeeze in thousands of extra beds, some New York City facilities have been overloaded at times, transferring patients around the city and sometimes as far away as the Albany area.

Emergency rooms at Mount Sinai Health System’s Brooklyn and Queens hospitals started getting backed up over the weekend, emergency medicine chair Dr. Brendan Carr said.

Patient transfers to larger Mount Sinai hospitals ultimately eased the crunch. But if not for that, “two of our hospitals would be in terrible distress,” he said Wednesday.

“That can’t keep going. We’re continuing to grow capacity at all these hospitals, but at some point, we run out of space,” he said.

Some relief is now in sight, even from the windows of Mount Sinai’s flagship hospital in Manhattan.

Across Fifth Avenue, white tents now cover much of Central Park’s East Meadow. They form a 68-bed emergency field hospital for coronavirus patients that opened Wednesday.

Nine patients were being cared for Thursday, according to Samaritan’s Purse, the evangelical Christian relief group running the operation.

The group’s opposition to same-sex marriage sparked concern among some of New York’s Democratic political leaders. The organization’s CEO, the Rev. Franklin Graham, told Fox News on Monday that “we’re going to give the best health care we can to all New Yorkers — it doesn’t matter who they are or what they are.”

State, city and federal officials say they have lined up — and in some cases, opened — dozens of additional spots for temporary hospitals around the metropolitan area.

A Navy hospital ship, the USNS Comfort, is docked in Manhattan with 750 beds, three of them occupied as of Thursday, commanding officer Capt. Patrick Amersbach said in a telephone news briefing. The Javits Center, a glassy convention facility where such events as New York Comic Con and the New York International Auto Show usually take place, now houses a federally-run hospital, with 2,500 beds as of Thursday, according to Cuomo.

Officials also are tapping colleges, the Aqueduct horse-racing track, a part of the tennis center that hosts the U.S. Open, a Brooklyn cruise terminal, and 20 hotels so far.

Decisions on routing patients to the temporary hospitals are made from a state-run operations hub set up in the Javits Center, according to city Emergency Management Office spokesman Omar Bourne. A similar system has been used before during such disasters as Superstorm Sandy.

Some facilities are intended for COVID-19 patients who need hospitalization, but not intensive care. Others, including the Comfort and the Javits Center, were designated for patients who don’t have the virus but need care for other reasons — though President Donald Trump said Thursday evening that the Javits would switch to caring for coronavirus patients.

New York officials and hospital leaders had urged a change in focus.

"You’re only going to help if you take the patients that we need help with, which is COVID patients,” Michael Dowling, CEO of Northwell Health, said before Thursday's announcement. “If they don’t relieve us of the pressure that we’re under, then I’m not sure the utility.”

While scouring for temporary hospital space, state and city officials are also sounding even more urgent calls for ventilators, medical personnel and protective gear for them.

Cuomo warned Thursday that the state’s supply of breathing machines could be exhausted in six days if the current rate of critical COVID-19 illness continues. Democratic New York Mayor Bill de Blasio asked the federal government this week to supply 1,000 nurses, 150 doctors and 300 respiratory therapists by Sunday.

“The bed,” he said, "is only as good as the supplies, the equipment, and especially the people that go with it.”

___

Associated Press writers Michael R. Sisak in New York, Marina Villeneuve in Albany, New York, and Robert Burns in Washington contributed to this report.

‘It’s hell’ - NYC EMTs claim to be overwhelmed due to coronavirus

Wed, 01 Apr 2020 22:47:20 -0400

The strain being placed on EMTs and paramedics in New York City is being called “unprecedented,” as the number of confirmed cases and hospitalizations due to the coronavirus in the city continues to increase.

Oren Barzilay, the President of the FDNY EMS Union 2507, said the current situation in New York City is even more taxing than September 11.

Of New York City’s 4,500 EMS members, 60 have tested positive for coronavirus, with another 700 showing symptoms. This, at a time when 9-1-1 operators are fielding more than 7,000 calls a day.

New York has 7,917 new coronavirus cases; 1,941 deaths reported

“It translates to 16-17 hour days,” Barzilay said.

During those days, EMTs and paramedics wear facemasks, gloves and thin paper garments.

“It’s extremely frustrating that we haven’t elevated to higher safety precautions,” Barzilay said. “This thing is airborne, the thing lands on us we’re taking it home.”

The FDNY released a statement to FOX 5 News saying it is following CDC guidelines and making sure crews have enough masks, eye shields, gloves, and gowns. It says crews are never sent out without proper equipment.

Barzilay also said he worries that the system, already stretched near to its limits, will fare in the coming weeks when the need for hospital resources reaches its projected peak.

ER doctor dies a week after first exhibiting coronavirus symptoms

“It’s frightening. If we’re not at the top and we’re already falling, it’s going to be a disaster,” Barzilay said.

But, despite the challenges, Barzilay says his members will continue to show up to save lives in New York City.

To help mitigate that disaster, FEMA has dispatched 250 ambulances and 500 EMTs to New York City.