MRCS Weekly Recap 6 (3.6.2022 - 3.12.2022)

1. COVID

New COVID cases are decreasing! On February 1, we saw 296,000 new cases and 440,000 total cases over a 7-day average in the US. By March 1, this fell to just 47,000 new cases and just 62,000 on a 7-day average. Although cases are dropping, the White House announced that its COVID-19 response money had nearly run out a few weeks ago. The White House had not publicly detailed exactly how it spent the more than $4 trillion Congress authorized for Covid-19 relief. Three dozen Republican senators refused to consider more Covid-19 relief funding unless the federal government fully accounts for how funds have been spent. Last week, Congress agreed to extend funding through the end of the fiscal year. Democratic leaders pulled $15.6 billion in emergency COVID-19 funding from the funding package after facing opposition within their party.

The Covid-19 report with the "path to the next normal" is a 136-page report written by nearly two dozen health experts and thirty others. This report explains that getting to the "next to normal" will require improvements on many fronts. This includes better surveillance for Covid pathogens, keeping tabs on how taxed hospitals are, and efforts to address the air quality in buildings. The authors also call for offering those with respiratory symptoms easy access to testing and a quick prescription for the relevant antiviral drug if positive for Covid or influenza. A similar report, a roadmap for what's to come, offers almost identical suggestions for reducing the spread of the virus.

In opposition to these reports, Florida Surgeon General, Joseph Ladapo, announced that the state would recommend that "healthy children" not be vaccinated. This comes after the CDC reduced the guidance of mask mandates but stays firm that children over the age of 5 should get vaccinated. The Florida Surgeon General has added to the confusion and mistrust of public health officials offering conflicting viewpoints on the vaccine. Meanwhile, six Boston hospitals joined forces with RECOVER, an NIH-sponsored effort whose mission is to understand and treat long-term covid symptoms.

Journalist Connor Friedersdorf gave four reasons why government entities should not impose tight restrictions on misinformation-

i. Discussion of vaccines can increase scientific trust. Trust in vaccinations can be at its peak when all relevant information is available.

ii. Defining misinformation is complex and often subjective.

iii. When free speech is restricted, those with dissenting opinions can become louder and become virtual martyrs.

iv. The evidence on how much misinformation influences people's medical decisions is inconclusive.

2. Practice Management Updates

Nurses are more empowered and powerful after Covid. They have been able to capitalize their attention to spotlight oppressive and poor working conditions. National Nurses advocacy groups use this time to get in front of Congress, explain what's going on, and work for proper solutions. One of the biggest deterrents to medical professionals is dealing with prior authorizations. Among 644 medical practices, 79% said insurers' prior authorization requirements had risen over the past year (down from 90% in 2019). The requirements are a significant headache for medical groups. MGMA members surveyed in October rated prior authorization the top regulatory challenge they face, with 88% calling it "very" or "extremely" burdensome.

3. IT Updates

The FDA is warning of cyber vulnerabilities in medical device software. Last Tuesday, the FDA issued an alert warning about a potential seven (7) vulnerabilities in third-party components that enable remote service through the internet.

Experts say that Alexa and Amazon Cares will not improve access to care as one might think. Those who have an Alexa device have the means to afford these technologies, which is correlated with high technical and health literacy. The partnership is more likely to deepen Amazon's foothold in the health care market than it is to draw vast numbers of new patients who had previously been left out, researchers and analysts say.

4. Telehealth Updates

As 2021 ended, telehealth use increased due to the omicron variant's surge in new COVID-19 cases. Telehealth claims grew more than 11% from November to December, with the South having the most significant increase (over 18%). The question remains whether telehealth was just a fad during the pandemic or if it is here to stay. Lawmakers are extending the loose telehealth policies to allow older adults access to telehealth visits in their homes, even outside the coverage areas. Congress is set to grant a five-month extension to telehealth flexibilities, created during the pandemic, as part of the 2022 omnibus spending bill made public on March 9. The $1.5 trillion legislation, which would set defense and non-defense spending levels for fiscal 2022, would also extend the telehealth public health emergency.

5. Policy Updates

Last week, the FDA approved two drugs from Johnson & Johnson and CTI BioPharma. A new cancer drug from Johnson & Johnson and partner Legend Biotech, a CAR T-cell therapy for multiple myeloma. The treatment, named Carvykti, targets the BCMA protein on multiple myeloma cells. FDA approval of Carvykti makes it the second CAR T-therapy approved for treating blood cancer. CTI BioPharma won FDA approval for pacritinib as a treatment for myelofibrosis in adults. Meanwhile, Congress is close to giving FDA the authority to regulate synthetic nicotine products such as e-cigarettes and Puff Bars.

6. 2022 Key Trends

Preliminary CDC estimates show that the seasonal influenza vaccine (flu shot) was not as effective as in prior years. Luckily, our flu hospitalizations and complications rates were lower than in years past, likely due to the COVID-19 pandemic.

Oregon will be the first state with widely legalized psychedelics. This is something that several mental health therapists and pharmaceutical companies are researching more about.

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