Let’s begin with a story that surprised as well as interested the FEHBlog. The Society for Human Resource Management reports that the U.S. Occupational Health and Safety Administration is requiring health plans, insurers, and other low hazard employers to report to OSHA “work-related coronavirus illnesses that result in a fatality or an employee’s in-patient hospitalization, an amputation or the loss of an eye.” Other employers have broader recording and reporting obligations.

A friend of the FEHBlog called to his attention this Newsweek interview with Dr. Anthony Fauci about whether we may encounter a second wave of COVID-19. While Dr. Fauci expects COVID-19 infections to continue at least through 2020, Dr. “Fauci says whether or not these ongoing new cases will become a wave will depend on whether ‘we prepare ourselves from now through June, July, August and September. We have four months to make sure we have in place the system, the test, the capability, the manpower to do the kind of identification, isolation and contact tracing as cases begin to reappear in the fall, because they will reappear.'”

STATNews also also features an interview with Dr. Fauci which focuses on vaccine development.

Today, prescription drug manufacturer Eli Lilly announced

[hospital] patients have been dosed in the world’s first study of a potential antibody treatment designed to fight COVID-19.

This investigational medicine, referred to as LY-CoV555, is the first to emerge from the collaboration between Lilly and AbCellera to create antibody therapies for the prevention and treatment of COVID-19. Lilly scientists rapidly developed the antibody in just three months after AbCellera and the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases (NIAID) identified it from a blood sample taken from one of the first U.S. patients who recovered from COVID-19. LY-CoV555 is the first potential new medicine specifically designed to attack SARS-CoV-2, the virus that causes COVID-19.

The FEHBlog heard a discussion of the investigational new drug on television this morning. The Eli Lilly representative explained that this drug focuses on one antibody while convalescent plasma relies on an array of antibodies. The investigation. The Wall Street Journal explains that

Researchers at AbCellera Biologics Inc., a Canadian company that partnered with Lilly in March, and the U.S. National Institute of Allergy and Infectious Diseases identified an antibody with virus-fighting potential in a blood sample taken from one of the first U.S. patients who recovered from Covid-19.

Lilly’s scientists then essentially cloned the antibody to make the new therapy [which is administered intravenously]. Its goal is to block the virus from attaching to and entering human cells, thus neutralizing it.

This first random study uses hospitalized patients and if successful the next random study will use non-hospitalized patients. “Lilly said it is starting large-scale manufacturing of the therapy, so that if studies prove successful, it will have several hundred thousand doses available by the end of the year.” Let’s go.

At this point, according to the Centers for Disease Control’s COVID-19 cases in the United State website, which the FEHBlog tracks, the number of confirmed cases topped one million on Wednesday and the number of confirmed deaths topped 60,000 on Thursday. Interestingly, the case fatality rate (deaths over cases) has remained between 5 and 6% for the last fourteen days after jumping from 2% on April 1 to 5% on April 17. The case fatality rate (“CFR”) should drop as the number of confirmed cases increases due to antibiotic testing. The American Spectator observes

To put this in perspective: Last winter 250,000 people tested positive for the flu. 25,000 died. If these numbers are right, the CFR for the flu is 10 percent … but that can’t be right.

And, in fact, it isn’t. The Centers for Disease Control and Prevention (CDC) estimates that, although only 250,000 people tested positive for the flu last year, 39 million people actually got it. Generally only those who are older or otherwise unhealthy, or those who have a severe case, go to the doctor and get tested for the flu; everyone else just takes Motrin and Tylenol and stays home. This drives up the CFR dramatically.

Also check out the CDC’s weekly COVIDView.

The Boston Globe’s STAT offers a pessimistic view of the COVID-19 emergency over time. If the STAT’s view is correct, then we have experienced no progress in medical care since 1918-1919 when the flu decimated the world. The FEHBlog has confidence in our healthcare system to pull us through this crisis.

America’s Health Insurance Plans discusses the steps that health insurers take to expand coverage in the face of the COVID-19 emergency. Health benefits did not exist in 1918-19.

For those interested, the American Medical Association reviews advocacy efforts for its membership during the crisis.

The Harvard Business Review called the FEHBlog’s attention to

Kanter’s Law: that everything can look like a failure in the middle. Unexpected obstacles and difficult predicaments can arise in the middle of any human and organizational endeavor. Give up, and by definition it’s a failure. Persist, pivot, and persevere, and there’s hope for finding another successful path.

In closing Happy Law Day. ” Law Day is held on May 1st every year to celebrate the role of law in our society and to cultivate a deeper understanding of the legal profession.”

The Law Day 2020 theme is “Your Vote, Your Voice, Our Democracy: The 19th Amendment at 100.” In 2019-2020, the United States is commemorating the centennial of the transformative constitutional amendment that guaranteed the right of citizens to vote would not be denied or abridged by the United States or any state on account of sex. American women fought for, and won, the vote through their voice and action.

Here are the Centers for Disease Control’s top line COVID-19 statistics for the past four weeks:

Don’t forget to check out the CDC’s weekly COVIDView which comes out on Fridays. The COVIDView is more encouraging reading than the bare statistics.

A new study in Health Affairs estimates “that a single symptomatic COVID-19 infection would cost a median of $3,045 in direct medical costs.”

Fierce Healthcare reports that CIGNA studied “care utilization among their commercial group and individual plan members between January and March across seven [serious] conditions and found decreases in hospitalizations across the board.”

[The lead researcher] said the team was surprised by the size of these decreases and that they were found across all seven conditions, because going without treatment for these conditions can have serious consequences.

[A research team physician] added that providers can help encourage patients to seek care in these situations by developing a care plan with those at high risk for certain conditions and having open conversations that affirm they should seek care in an emergency situation even if they should stay home otherwise.

It’s a crazy time.

Here are the latest four weeks from the CDC’s COVID-19 Cases in the U.S. website:

This week the CDC began to include deaths probably caused by COVID-19 in its death count. The FEHBlog will stick with confirmed COVID-19 deaths. The probable COVID-19 death count today was 4,226. The CDC’s number close out at 4 pm on the day before the report.

Today the CDC added demographic data to its Cases in U.S. website. The FEHBlog was surprised to find that in almost 75% of the COVID-19 cases, race/ethnicity was not specified. The majority of cases are found in the 18 to 64 age range. The CDC’s statistics do not provide a gender breakdown.

The CDC also released its weekly COVIDView report. 680,000 COVID-19 lab tests were conducted in the week ended April 11. (The CDC’s weekly summaries customarily are a week behind the release date.)

Here’s a link to the President’s three phase guidelines on reopening our country that were issued yesterday. According to the Fierce Healthcare report, Dr. Deborah Birx from the CDC explains that before entering phase one, states and cities “must see data that shows a sustained decline in influenza-like illness, as well as positive COVID-19 cases with persistent testing, for a minimum of 14-days.”

So the FEHBlog was wrong in promoting the fact that the COVID-19 death rate was stable for two days this week. After the period of stability the death rate rose from 3.23% to 3.61%. In other words, the plateau has not yet been reached. Here are the CDC Cases in U.S. Stats for the four Fridays:

Please note that the CDC numbers close at 4 pm on the previous day. The much loved John Hancock COVID-19 site is simply too much for the FEHBlog to handle.

Today, the CDC released its latest COVIDView and its final FluView for the 2019-20 flu season. Thanks heavens for small miracles.

The FEHBlog was overjoyed by a sentence from the following HHS press release that the FEHBlog has placed in bold print:

The Trump Administration is committed to ensuring that Americans are protected against financial obstacles that might prevent them from getting the testing and treatment they need from COVID-19.As announced in early April, a portion of the $100 billion Provider Relief Fund will be used to reimburse healthcare providers, at Medicare rates, for COVID-related treatment of the uninsured.
As a condition, providers are obligated to abstain from “balance billing” any patient for COVID-related treatment.
The Families First Coronavirus Response Act requires private insurers to cover an insurance plan member’s cost-sharing payments for COVID-19 testing. President Trump has also secured commitments from private insurers, including Humana, Cigna, UnitedHealth Group, and the Blue Cross Blue Shield system to waive cost-sharing payments for treatment related to COVID-19 for plan members.

Here’s the rub. How will health plans know that a particular provider is barred from balance billing for COVID-19 care?

It is admirable that UnitedHealthGroup is helping HHS promptly distribute this CARES Act funding to providers.