A false and dangerous rumor has recently been making the rounds that could put more people’s lives at risk, with some rumor mongers accusing hospitals of inflating the numbers, claiming that the hospitals have some kind of profit motive for treating COVID patients.  Let’s talk about why this rumor is false and dangerous.

Can hospitals classify deaths as whatever they want?

NO. There are strict policies and procedures in place, not to mention incurring huge liability and the possibility of audits if done incorrectly. Determining the cause of death is much more complicated than just filling in whatever looks most likely. Medical examiners investigate, test, and when necessary, do autopsies. They report cause of death based on CDC guidelines. Death certificates are also accountable to federal jurisdiction, with each state’s public health division reporting back to the CDC. In addition, knowingly falsifying medical records is a felony crime with a potential fine of $250,000 or 5 years in jail.

Does it cost more to treat COVID-19 patients?

Yes, and most hospitals are losing money due to the COVID-19 pandemic.  COVID-19 patients stay in the ICU, and the PPE, medications, and the equipment they use–including ventilators–is extremely expensive. In addition to the exorbitant cost of treating a COVID-19 patient, most hospitals have had to restrict routine care and elective procedures, so they are losing revenue. Read more about how Medicare pays hospitals here.

What’s the truth?

Deaths are most likely being under-reported, not inflated. Due to a lack of adequate testing and the people who die at home and aren’t counted, it is most likely that the official numbers have underestimated the amount of COVID-19 related deaths, in addition to the scope of the virus.  Some states also give physicians the option of counting the cause of death for a COVID-19 positive patient as due to an underlying condition, rather than the virus if their symptoms weren’t respiratory.  But as we are finding out, COVID-19 can present in many ways unrelated to breathing that have only recently started to be investigated. Read more about how and why the numbers are being updated here.

For additional reading about the true scope of COVID-19 deaths, click here.

Yours in Strength,

The Take Back Control Team

Essential workers have been on the frontlines in the past months, risking exposure to the virus to continue providing essential services, often for low pay and without the option of staying home and receiving unemployment.  Their rights, or lack thereof, have been one of the main parts of a national discussion as COVID-19 has thrown United States’ infrastructure and working conditions into sharp contrast with other developed nations. As some states begin the first phase of reopening, it is not only essential workers who are having to leave the relative safety of their homes, and many workers are uncomfortable with the protection and accountability measures enacted by the government to ensure their safety in the workplace during this pandemic.

On May 8th, Pennsylvania transitioned 24 counties to phase yellow, starting the process of reopening in chosen locations.  During this phase, businesses, unless specifically noted in the reopening plan, may resume while following guidance mandated here by Gov. Tom Wolf.  But what if businesses don’t follow these mandates or employees still don’t feel safe to return to work?  There are depressingly few options.  Gov. Tom Wolf says that workers have “the ultimate sanction” to decide not to come into work.  But when refusing to return to work is tantamount to quitting, that’s not an option for most people.  What else can you do? You can file a complaint with the Occupational Safety and Health Administration (OSHA), contact your local law enforcement (don’t call 911 or emergency services), contact the Department of Health or other relevant agencies.  But as Gov. Tom Wolf has already acknowledged, the Government of Pennsylvania does not have the ability to enforce widespread workplace protections.  So far, PA state police have issued 25 warnings and one citation.  Citations only result in a fine of $300 at their highest.

This leaves workers concerned about their health in a very difficult position. Here are some recommendations on how to handle this situation if you find yourself in the position of having to go back to work before you feel comfortable to do so:

• Familiarize yourself with the state mandated reopening business guidelines and to report, with the option to do so anonymously, any safety guidelines you see violated.  
• If it is still an option to work remotely, do so.
• If your work is not providing PPE, and no action has been taken to address the violation after reporting it, do your best to wear your own PPE and follow social distancing protocols.  
• Do not touch your face. 
• When you get home, disrobe and wash your clothes immediately and then take a shower.  

Because this is such a novel situation we are in, legal precedents have yet to be set. If you cannot find PPE in your area, the resource section on our website has links to how to make your own masks and disinfectant under “Protective Guidance.”

To file a complaint through OSHA, click here.

To file a complaint through the Department of Health, click here.

Yours in Strength,

The Take Back Control Team

What is contact tracing? Contract tracing is an infrastructure that allows COVID-19 cases to be tracked down and isolated, significantly mitigating the spread of the virus.  Tracers find active coronavirus cases, contact the positive individual and find out where they have been and who they have had contact with in the recent weeks.  The tracers provide necessary information and advice to the infected individual and contact those who may have been exposed.  All positive cases are encouraged to self-isolate for two weeks and to continue to monitor their condition.  For more detail on the principles of contact tracing, read the CDC’s contact tracing guide here.

Contact tracing is a necessity to contain COVID-19.  It is a technique already used and credited with containing SARS and Ebola outbreaks.  When implemented properly, it requires data monitoring and management, ongoing communication with the public, housing options for those who need to self-isolate and a comprehensive testing infrastructure.

Before the current outbreak, the US employed about 2,200 tracers but experts say that the US will need closer to 100,000 in order to combat the spread of COVID-19. While this may help offset currently staggering unemployment numbers, it is not clear whether the US stimulus bills so far passed will have enough funding designated to hire the necessary amount of tracers to make a dent.  

To manage COVID-19 epidemics going forward, communities in the United States need: (1) ready access to rapid diagnostic tests for all symptomatic cases or those with a reasonable suspicion of COVID-19 exposure; (2) widespread serological testing to understand underlying rates of infection and identify those who have developed immunity and could potentially return to work or school without fear of becoming infected; and (3) the ability to trace all contacts of reported cases. In order to trace all contacts, safely isolate the sick, and quarantine those exposed, we estimate that our public health workforce needs to add approximately 100,000 (paid or volunteer) contact tracers to assist with this large-scale effort. This workforce could be strategically deployed to areas of greatest need and managed through state and local public health agencies that are on the front lines of COVID-19 response. To do this, we also estimate that Congress will need to appropriate approximately $3.6 billion in emergency funding to state and territorial health departments.

–Excerpt from A National Plan to Enable Comprehensive COVID-19 Case Finding and Contact Tracing in the US, by Johns Hopkins Bloomberg School of Public Health.

Google, Apple and other technology companies are working on tracing initiatives using apps, location data and Bluetooth technology, but this has also raised concern over privacy and data sharing. While information necessary for tracking the virus is highly personal, developers assure users you must opt-in and that no information will be used to identify individuals. For more information on tracking technological development, check out this CNN article. You can read more about the relative merits of contacting tracing technology versus privacy protection in this publication from Cornell. 

Contact tracing is vital to fighting COVID-19.  It’s funding and implementation will be what allows for reopening at any level.  For contact tracing training, click here.  To apply for contact tracing jobs, contact your state’s Department of Health.

Yours in Strength,
The Take Back Control Team

On Friday, May 8th, 24 counties in Pennsylvania will be reopening, moving from “phase red” to “phase yellow” as certain restrictions are lifted, so that businesses and individuals can begin to get back to a “new normal”.  These counties are Bradford, Cameron, Centre, Clarion, Clearfield, Clinton, Crawford, Elk, Erie, Forest, Jefferson, Lawrence, Lycoming, McKean, Mercer, Montour, Northumberland, Potter, Snyder, Sullivan, Tioga, Union, Venango, and Warren.

They have been selected based on a new data dashboard created by the PA government in conjunction with Carnegie Mellon University that measures the economic benefit in the selected region versus the potential health risks.  The health risk factors taken into account are:

COVID Case Risk: # of reported COVID-19 cases / population of area

ICU Capacity Risk: # of 60+ year olds in area / # of unoccupied ICU Beds

Population Density Risk: Population of Region / Area of Region

Population Age Risk: % of population in area > 60 yr old

Re-Opening Contact Risk: % of workers in an area employed in currently “physically closed” industry sectors

In order for a county to reopen, it needs to have fewer than 50 new confirmed cases per a 100,000 population within the previous two weeks.  There must also be testing available for vulnerable populations, emergency responders and health care workers. A comprehensive contact tracing initiative must be in place, and high risk industries, such as congregate care facilities, must have enough equipment and personnel to implement necessary and mandated safeguards and required protocols.

To read more about PA’s testing plan, click here.

To read more about PA’s contact tracing initiative, click here.

These required protocols are still being developed and will be updated based on data and feedback from reopening industries.  In the meantime, the CDC recommends standard social distancing protocols such as staying 6 feet apart, the restriction of unnecessary travel and gatherings of no more than 25 people.  Having a plan that includes disinfection protocols using EPA approved disinfectants and continuing to wear face masks should also be required for any reopening businesses.  To see official CDC recommendations, click here.

To find COVID-19 PPE and supplies for your business reopening in PA, check here.

So what exactly does it mean to move from “phase red” to “phase yellow”? Phase red is the phase most states have been in for the past month–the operation of essential businesses and essential travel only, stay at home mandates, etc.  Phase yellow relaxes some of these restrictions. Although telework must continue where possible, some businesses may open while following business and building safety orders. Child care facilities may start to reopen. While (in PA) entertainment and wellness/recreational businesses remain closed, stay at home orders are remanded and gatherings of up to 25 people are now allowed. This is all with the understanding that social distancing protocol must still be obeyed.  For a complete list and delineation of the phases in PA, click here.

Switching to “phase yellow” does not mean the danger has passed and that things should go back to normal. It means that with strict adherence to government guidelines and recommendations, the State believes that certain parts of the economy may begin to function without overwhelming current hospital capacity.  Make sure you continue to take all necessary and recommended precautions and closely monitor the health of yourself and your loved ones.

Yours in Strength,
The Take Back Control Team