The Pulse: April 2020 Edition
Updated: May 4
Keep your finger on The Pulse of what's happening in health care. We deliver monthly highlights of the developments shaping our exciting field. From the unclear death toll of the pandemic to the unexpected effects on the healthcare industry, here is the latest from April.
The War on Health Wages On
Since our last Pulse published on March 31, 2020, America’s number of COVID-19 cases went from 140,000 cases to 1,052,069 confirmed cases. That’s just under an eightfold increase over the course of four weeks, and the virus has now claimed more lives than the number of battlefield casualties from World War I (53,402) and the Vietnam War (47,434).
Worse yet, new data from the CDC suggests that these figures are drastically lower than the reality. Many hot spot states have reported high numbers of “excess deaths,” referring to the gap between recent trends (i.e. COVID-19) and a normal number of deaths. The data below depicts the total deaths in these states from March 8 through April 11 and suggests that the average is nearly 50% higher than normal.
What isn’t clear is whether the coronavirus accounts for all these excess deaths or if other factors, such as people not getting treatment for other ailments, could be the cause. The answer is likely both.
The pandemic has had major implications for non-COVID patients, who cannot or are advised against in-office visits for fear of exposing themselves to the virus, as many states have ordered a delay in non-urgent medical procedures.
But as Dr. Lisa Rosenbaum, M.D. writes in The New England Journal of Medicine, “Although canceling procedures such as elective hernia repairs and knee replacements is relatively straightforward, for many interventions the line between urgent and nonurgent can be drawn only in retrospect.” For example, Dr. Brian C. Kolski, MD, Director of the Structural Heart Disease Program at St. Joseph Hospital in Orange County, CA, had two patients die while waiting to get their transthoracic aortic valvular replacements that had gotten postponed.
The effects are rippling throughout the industry. Healthcare professionals of every specialty are frustrated because they are unable to care for their patients, even those in dire need, and many are losing their jobs for it.
Mass Unemployment and Pay Cuts Among Healthcare Workers
In an industry that is America’s biggest source of jobs and normally immune to economic recession, this development has perhaps been the most unexpected offshoot of COVID-19. Hospitals and clinics across the country are struggling to stay afloat in the wave of the pandemic, and one in four rural hospitals were at high financial risk of closing even before the virus hit.
Atrius Health, the largest independent physician group in Massachusetts that includes primary care, specialists, radiology and pharmacy, has experienced a 75% reduction in patient volume since mid-March. The group serves 745,000 patients among its multi-specialty clinics. To mitigate its losses, Atrius is temporarily closing its offices, furloughing and withholding pay from employees, with the exception of its lowest-paid workers.
Unfortunately, this is by no means an exceptional case. Healthcare systems everywhere are financially strapped by the inability to perform elective procedures and having patients who are understandably afraid to receive care. Hopefully as states resume non-urgent procedures, some of these financial woes will be alleviated.
This war against coronavirus is devastating our industry, and the soldiers on the frontlines have never been asked to do so much for so little. If there is anything we can do to help you in the fight, please let us know. For physicians or advanced practice providers willing and able to help, we have many opportunities available for you. For employers seeking help, please let us know what specialty of providers you need and where. We are here to support you.