The Healing American Healthcare Podcast
The Healing American Healthcare Podcast

Episode 14 · 1 year ago

Vaccine vs. Virus in the US


Ed Eichhorn & John Dalton, editors of The Three Minute Read™, give an update on the US’s vaccine vs. virus race with statistics and success rates for vaccines currently on the market and give updates on the trials for new ones. They also touch on the Biden Administration’s and the healthcare industry’s plans for moving towards universal healthcare and further mitigating Covid-19. 

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"The Discovery" 

by The Lemming Shepards 

Exzel Music Publishing ( 

Licensed under Creative Commons: By Attribution 3.0 

Welcome to the three minute read podcasts. I'm John Dalton, editor of the twice monthly newsletter of the healing American healthcare coalition. Joining me once again is Ed Ichorn, the coalition's CO founder and Co author of healing American healthcare, a plan to provide quality care to all while saving one trillion dollars a year. Good Morning John, it's good to be with you again today. Well, between us and I have nearly a century of healthcare experience and we're still trying to figure it out ED. I watched the three minute read a year ago to summarize some of the critical issues affecting busy Coalisians and positions as they struggle through this pandemic. To date, we summarize a hundred thirty two articles from fifty different sources on eight topics, including physician practices, insurance coverage, drug course and, of course, the pandemic. President Biden took off as fifty seven days ago and wasted no time in declaring war on the pandemic. He signed ten executive orders that first day to jump start his national covid nineteen strategy. Today, more than seventy three million Americans have received at least one dose of vaccine. So let's dive into the issue and see how this war on the pandemic is going. We have five articles, for of which deal with various clinical issues, and then the final one, the health care industry seeks common ground with by is right in Thatt I coins wheelhouse and he'll be joining us to discuss that article. The first article is about UPMC and the three front of fight against code, entitled it was in modern healthcare. Is In February twenty eight issue titled Fighting Covid on Three Fronts. The University of Pittsburgh Medical Center health system. Now in western Pennsylvania, university in Pittsburgh Medical Center health system is the eight under pound guerrilla anywhere west of Harrisburg. They have thirty five hospitals and Ninetyzero employees, and what that gives them is the critical mass to be able to invest in research efforts and finding ways to deal better with some of the issues that are emerging. There's a plauses and minuses there the eight under pound guerrilla, but they are also making some progress in terms of looking at how best to deal with issues like the pandemic. So the first one is general masking they took a closer look at mask strategy, including fin testing for a ninety five masks and availability, and they found that there were a number of areas in which they can improve their use of masks. So their degree of repairing is needed to be a notch higher on ongoing basis. On contact tracing, UPMC created a contact tracing ad that has allowed the health system to stay ahead of the game. On the coronavirus, nearly all of their employee exposures did not come from contact within the health system, but really from community events outside of work. We're caught there from their chief quality officer, Rymnear, who said are contact racing APP really allowed us to contain things. The third area where UVMC was ahead of the curve is on mass vaccination. They had already research where he's to accelerting mass vaccinations and tested their approaches with the influenza vaccines, getting vaccinated in the fall for the seasonal fluid. When the pandemic began, they already had a structure in place to mass vaccinate their employees as well as workers in nearby health systems. Again a quote from Terry manear. She talks again about how this is help facilitate getting people vaccinated. By mid February, eighty percent of their healthcare employees had completed...

...their first dose of the vaccine, and UVFC is now making me that capability available to other non UVMC hospitals and health systems. The second article is a subject that we first looked at back last August with two articles in our August issue that dealt with long Al Covid symptoms. And actually now there's a definition for what is a long hauler. It's a person who suffers from symptoms of Ovid nineteen for longer than two weeks and generally for several months. And that obvious issue. We talked about a nerve scientists, Athena are Crammy, a sturdy eight, who was not able to return to her euroscience lab in London this is the end of July. She had contracted the covid nineteen in March to suffering from brain fog occasional muscular difficulties and so four months later had not been able to return to work. That issue, we also talked about the long term healthcare course that would be associated with covid nineteen and in that article we also talked about billions of dollars in course and long term care. Course. We also commented about Mount Sinai leading a multi center trial to monitor patients who had long covid and two quotes from that article. We quoted Dr Gregory Poland, who's a covid nineteen expert at Mayo Clinic. He warned that some of the possible long term effects can even affect patients who are asymptomatic and have mild cases, quote. I think it's an argument for why we take this disease so seriously. We're going to need to study those as vigorously as we did the acute symptoms. Dr Anthony Faucchi also pitched in, talking about wrong covid at, quote, grain frog fatigue and difficulty in concentrating. This is something we really need to look seriously at, and now we're seeing much more on the subject. For example, New York Times editorial board member Marigae at a case of codd that resulted in long covid symptoms. After getting her first faccine dose two weeks later, she felt much better. In the we've seen her interviewed on occasion on the cable TV news. A UK survey found the sixteen percent of patients said their long covid symptoms had improved by two weeks after the first dose. So that's encouraging news. Yale universities. I keep going Eve Asaki PhD again, of person we quoted before in previous articles. He has suggested studying three potential mechanisms that drive long covid. Is that a persistent viral reservoir? Is a viral fragments of reminisces that drive information, or is it an autoimmune response induced by the infection? Stanley Weiss, an infectionous disease specials here in New Jersey. At records, New Jersey Medical School agrees with it. Was Saki quote. The way you progressed in science and medicine is that you take observations from expert observers and pursue them with scientific rigor, and that's very important that we do that on the over wrong holes front because, remembering back to insurance before the affordable care act, insurance underwriters want a cherry pick their risks. Pool. Long covid now is a re existing condition. Next to article in the issue dealt with the novovacs vaccine. As from the from Reuters on Marchial Leven. No VACs vaccine is ninety six percent effectively against original coronavirus, eighty six percent versus the British variant in a UK trial. That UK trial in roll more than fifteen thousand people age eighteen to eighty four. But assess the vaccines efficacy during a period with high transmission to the UK virus, virus variant, the one seven now we're circulating widely, including here... the US. What they find? No VACs's vaccine was ninety six percent effected against the original variant, the one that we've seen most prevalent of the course of the last year, was eighty six percent effective and protecting against the bee seven variant. However, in South Africa it was only fifty five percent effective. Still good, but against the South African variant it did fully prove vent severe illness. Now No VACs expects their thirtyzero person clinical trial in the US and Mexico to have complete data by early April. The vaccine could be cleared for use in the US as soon as may if US regulators decide the UK data is enough to make a decision. However, that's probably a long shot for the FDA to accept another nations that it would be, to use an overworked word, unprecedented. So that's less likely to happened. But once the US trials are completed, it's likely that novacs ultimately would get an emergency use authorization within the US. Having the novacs vaccine available will give us yet another weapon in the vaccine versus virus race to recovery. You already have three with the MODERNA visor and single Dose Change Day vaccine. Ultimately, when the NOVAC's vaccine is approved of use in the US, it's another single dose vaccine that will be helpful in this race to recovery, about the same time as three meter read that everybody's inboxes. On Tuesday The New York Times morning report had an interesting chart that really shows how this vaccine versus virus race is progressing. So let's say a minute to look at this. Chart shows how vaccines are slowing the spread of the coronavirus to change in new daily Covid nineteen cases per million residents over the last month, from February fourteen march fourteen. The country is listed are listed in sequence of the doses given per hundred people and, as you know, Israel has been the most aggressive in terms of its vaccine roll out and at March fourteen that had administered a hundred six doses a hundred people, and you can see how dramatically the number of cases dropped because of this aggressive vaccine iministration. United Arab Emirates Sixty eight four hundred. Britain, which, unlike the rest of the WHO was very aggressive in his rolled out because of the concerns about the d one hundred and seven variant. That has had a major positive effect in terms of the number of new daily cases. Chile, for some reasons, has down in the opposite direction, although their vaccine doses were up to thirty five four hundred people. The US at thirty two a hundred. Check this morning that's now about thirty four hundred. You can see that the race to recovery is on. The number of the daily cases still too high, but coming down steadily, about half what they were at the peak in the winter surge. So very important that we get those shots into arms. As of yesterday, something like a hundred and thirteen million doses had been administered in the US. On the day that President Biden was inaugurated, that number was sixteen point five million, so that's quite a change over the last fifty seven days. The next article deals with an issue that we first talked about back in September. Is from the hill and it was written by Joseph Choi. On March, fourth most virus deaths recorded nations with high obesity levels, and this is an analysis. And then the link is between obesity and Covid nineteen. It is something we first talked about back in September issue. There was a article from the Associated Press Doctors studying why...

...obesity may be designed to serious covid nineteen and it mentioned some of the studies that were then showing that high body mass indexes or a significant complicating condition for those who contracted covid nineteen. So let's look at the article the World Ob City Foundation, which is an organization I didn't even realize existed place, so of this article. They are affiliated with the World Health Organization and they're located in London. They put out an annual report and looks at virtually every country in the world and they found a connection between increased covid nineteen deaths and high obesity rates, and this is quote from the report. Comparing countries around the world. We find a closest association between deaths from Covid Nineteen and the prevalence of overweight in the adult population. The connection between increased risks of severe covid nineteen cases or death and higher vital weight was observed across multiple countries, but much less so in many of the poorer countries in the world. And there's been a lot of concern about vaccine distribution to many of the poorer countries. For a number of reasons. They are in much better shape with respect to covid nineteen than as much of the OECD and will see some of those connections in a minute. A recent US study reported that obes people work twice as likely to be hospitalized with Covid nineteen and six times more likely to die after developing disease. So it is a major concern. The Brookings Institution study agrees with the World Obesity Federations findings. Quote a large part of the positive correlation between income and deaths familion is due to the age distribution and obesity. So what's take a look at the US data from the world obcity federations annual report, and this was extracted from their report. The first table is more that they present for every country in the world as of January one, and that one hundred five point six eight covid deaths for a hundred thousand population is consistent with the numbers that we can filed as a December thirty one. In the US, as of two thousand and sixteen, Sixty seven point nine percent, more than two out of three American adults, is to overweight and obesity. That's a body mass index greater than the thirty thirty six point two percent of us are obese. The guys population of raise sixty five sixteen point six. And that's one of the differences between major OCDD developed countries and the developing world. We see a lot less overweight, a lot less obesity and a lot up lower percentage of population over sixty five years. In many of those poorer countries. You're doing better on covid nineteen than are week. They also present the table for each country that shows the two thousand and ten target and twenty twenty five particular prevalence and number of cases of obesity and overweight. So for the US, in two thousand and ten men were that one out of three males and one out of three females was overweight. In Two thousand and twenty five. Those numbers are projected to go up to forty four point two, twenty four point four percent. And more troubling trend obesity and children fit. Twenty point one percent in two thousand and ten, and close to one and four of our two twenty five. Now looking at the CDC data, which surprised me. In one thousand nine hundred and ninety five Gill BEC rate in America was fifteen point six percent, so one out of six, one out of seven adults was obased. That moved depth of nineteen point eight percent in two thousand, one out of five adults, and twenty three point seven percent in Oh five, almost one out of four adults. So clearly the fast... nation is eating itself to death. And for this next article it's right in your we all have any comments before you tackle this one? I think the articles that you coverage on certainly are important with respect to covid and where we stand today and how organizations have worked to, you know, try to keep the employee, say foil dealing with patients. This article appeared in modern healthcare on March eighth by Lola Butcher. It's entitled Healthcare Industry Gearing Up to find common ground with Biden. Generally, the healthcare industry agrees with the Biden Administration. The current top priority has to be the covid nineteen pandemic, followed by increasing insurance coverage. In support of that and their common ground, lobbies representing providers, payers and employers formed the affordable coverage coalition, whose goal is to achieve universal health coverage through a number of steps. Let me digress a little bit here and tell you who is in this coalition. It includes America's health insurance plans, the American Academy of Family Physicians, the American Benefits Council, the American Hospital Association, the American Medical Association, the Blue Cross Blue Shield Association, the Federation of American hospitals and the US Chamber of Commerce. And when they formed their group in February, they put out a document, and I'd like to share the first paragraph with you to give you a sense of the magnitude of this new lobbying organization. They represent the nation's doctors, hospitals, employers and health insurance providers. Collectively, the organization includes hundreds of thousands of individual physicians, thousands of hospitals and hundreds of employers and health insurance providers that serve hundreds of millions of American patients, consumers and employers every day across the United States. That makes them a very, very powerful group, and you know they are interested working with the president's administration to enhance a see a premium subsidies and providing sentences for more states to expand Medicaid. This includes things like they support tax credits and cost sharing reductions, insurance affordability, automatic and facilitated enrollment, federal funding for outreach and enrollment incentives to close the low income coverage gap and preventing increases in the number of uninsured, and those things all aligned with their overall mission, or the shared missions of this number of lobbies that represent such a large percentage of healthcare providers and insurance providers and employers. Now, while they agree on many things, members of this coalition do not agree with creating a public option that would allow people to buy into Medicare or reducing Medicare eligibility age to sixty. In fact, they cite a survey from two thousand and nineteen that suggests that a government run Medicare like option would lead to nearly eight hundred million in provider payment cuts over ten years while utilization was growing. Now you think about it for a moment, they are very supportive, as all obvious are, of things that are good for the members of the lobby. They want more patients, they want those patients to be paid for and certainly physicians that see the patients would like to be paid. Hospitals would have less unpaid care that they don't want, employers would have more...

...covered employees, and those things are all good for healthcare, but they're especially good for that lobby. A Medicare like option or a public option is good for Americans, but it's not as good for this lobbying group. Now, if you're going to have more people on Medicare, you have to look at the trust fund, and the article reports that the Medicare Trust Fund is projected to have insufficient funds to cover its obligations within three years, at the beginning of two thousand and twenty four. And in response to that, Commonwealth funds CEO, Dr Bloomenthal, said that if Congress wants to give more people the coverage that Medicare offers. There are ways to fund it. It's just a matter of finding the political will to do so now during the pandemic. The article also reports on the expansion of telehealth to fill the gap, and it's made healthcare more accessible and more affordable, especially in rural communities, and there is a general bipartisan support on this issue, as well as on drug pricing. The American Hospital Association's Senior Vice President for policies said we're going to need help from Congress to remove some of the key barriers in order to make telehealth continue being used as it has during this public health emergency. Now, of course, the lobbying organization for the pharmaceutical industry is not on board with all of these things. Their representative said that government price setting is a bright line that the industry is unwilling to cross. They believe that their success in rapid vaccine development provides the clout needed to oppose price controls. But we also should understand that for many of them who have developed new drugs and vaccines, they received payment from the federal government to do that. John reported on Nova VACs in earlier article. Novavacts is steaming ahead to make vaccines in preparation for getting approval for their use, but they were also paid one point six billion dollars from the United States federal government to do so. So we need to keep these issues balanced between what the government has paid for and what the lobbyists of representing for the industries that they represent. It's also important to understand that there have been a lot of workforce issues associated with the pandemic. It is severely strained America's healthcare workforce and in fact, to help with part of that, a bill in December authorized Medicare to fund a thousand additional physician residency slots, and this is very important because the Association of American Medical Colleges predicts a shortage of up to about a hundred and forty thousand physicians by twenty thirty three, and they see this as an opportunity to begin to address this projected shortage because to project the shortage means people have to go to medical school, graduate for medical school and do their internships are going to practice. That's a very long leading time. So having a thousand additional residency seats makes good sense in a time like this. The bill that was recently past the American rescue plan actually provides for funding for a hundred thousand additional public health workers, and they are going to be sorely needed as we address growths and care over the next several years. We also wanted to share with you that there was a recent study by a populace, which is a Massachusetts think tank, and the study that we are referencing here was conducted very recently. It was conducted from January twenty... to January twenty eight and it found that across race, gender, income, education and generation, after the two thousand and twenty presidential vote, there is a great agreement in America's long term national priorities, regardless of whether a person as a Republican or Democrat or which presidential candidate they voted for. The leading one among these was high quality healthcare as a necessity, not a privilege, and there was also an overwhelming commitment to individual rights and upholding equal treatment for all. But that doesn't necessarily mean that would be equal outcomes. Very interesting article, in fact. There is a quote at the beginning of that that I thought I would share that relates to all the lobbying we talked about in this article. The quote is from Abraham Lincoln in one thousand eight hundred and fifty eight, and he said public sentiment is everything. With public sentiment nothing can fail, without it nothing can succeed, and I think all of these efforts for lobbying organizations to make their points in support of the Biden initiative and also where they disagree, are really important for the public to embrace and understand as these efforts to go forward. Thank you. And so where is the Coalition for the public? That's the key question. May that that's an all American route that you talked about for the affordable care coalition, and their aims are laudable, all being a bit self serving and somewhat one dimensional. Some of their aims make a lot of sense. For example, they are talking about things that we can all endorse and support, such as automated and facilitated enrollment to get new individuals enrolled and medicate in premium free marketplace plans and to facilitate in rolling for any remaining on insured. Let's Biden has opened up healthcare dot go through March thirty. First, we're starting to fund navigators again. That's all good stuff. That talking about preventing increases in the uninsured to help prevent the arrogance of laws or at risk of losing employer provided health covers from becoming uninsured and funding Cobra benefits in that kind of stuff. That's all good for that coalition, but who's really looking at for the patients and making sure that the public needs are met? And enough of the editorializing. But spending thirty five years on the boards of not for profit hospitals that have to run emergency rooms twenty four seven and accept whatever patients going through the door, I get a little bit upset some of the lobbyists and they're rather entrenched positions. We really need to simplify and streamline healthcare get rid of some of that administered in clinical waste, and let me talk you more about that in future issues. Speaking of future issues, if you haven't already done so, please take our healthcare survey at www dot healing American healthcare dotcorg. We're interested in your insights and views. In future podcasts will be sharing feedback with our listeners on issues that include universal health care versus Medicare for all and that will be looking at some of the legislative proposes of the currently moving through the Congress we talked about the Chord Hutchson all care plan. That can say up to a trillion dollars a year for American healthcare. Let me talk about prescription drug pricing and much, much more. This morning we saw the announcement that Amazon is moving out with its tell a health proposal, and we'll be making their tell a health platform available to all American businesses. Again, tell the health is here to stay. So will be discussing some of that in our future podcast. So thanks again for listening. There issues of particular interest that you would like to see covered, please feel free to contact us. If you're interested... joining our mailing list. Text healed healthcare to two eight, two eight to get our mailing list. Until next time, wash your hands, watch your distance and wear a mask. Thanks for joining us.

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