BY JYOTHSNA HEGDE
Atlanta, GA, July 29, 2020: Even as the world races to find a preventive vaccine and effective ways for the diagnosis and treatment of COVID-19, people from all walks of life and businesses big or small, continue to face unprecedented social and economic crisis. Healthcare systems and providers, the most affected, are bracing themselves to an ever-changing landscape as new challenges continue to surface each day.
Addressing these issues, Seema Verma, Administrator of the Centers for Medicare & Medicaid Services (CMS) and a member of the White House Coronavirus Task Force, alongside US Senator Kelly Loeffler (GA), convened a roundtable discussion on the impact of COVID-19 on July 27, 2020 at the Sam Nunn Federal Center in Atlanta.
“This is a public health issue but not delinked from the economic issues. And I can appreciate that at the White House we try to look at this together. It is not one or the other,” stated Verma.
The discussion primarily focused on challenges facing health systems and skilled nursing facilities during the public health emergency, and the impact COVID-19 has had on vulnerable Georgians, especially those with pre-existing conditions such as kidney disease and diabetes. Representatives from the National Black Nurses Foundation, Diabetes Patient Advocate Coalition, Emory Healthcare, Georgia Department of Community Health, Georgia Health Care Association, Grady Health System, The Office of Governor Brian Kemp, McRae Manor, National Kidney Foundation, Morehouse School of Medicine, Piedmont Healthcare, PruittHealth, and Wellstar Health Systems were in attendance.
Ritesh(Rick) Desai, who serves on Governor Kemp’s Georgians First Commission, facilitated the presence of Indian media at the event.
“It was an honor to see Ms. Verma in action at the Covid-19 roundtable hosted at the CMS regional office in Atlanta along with Senator Kelly Loeffler. Two strong women winning hearts as well as the battle against COVID-19. I couldn’t be prouder of a more result driven Senator, compassionate and articulate CMS director and a President that is not afraid of taking bold decisions to put the lives and livelihood of Americans first,” said Desai.
He lauded President Trump’s leadership, terming it “steadfast” in tumultuous times and the President’s appointment of “people of merit over race, creed or religion”, citing Verma as a shining example.
Georgia healthcare has been facing multitude of issues since the spread of the virus. On Monday, the day of the event, state officials reported 3,181 COVID-19 hospitalizations, an increase of 102 patients in 24 hours. The number of COVID-19 patients hospitalized inside Emory Healthcare has jumped nearly fivefold since early June, straining the state’s largest health system as its doctors, nurses and staff work around-the-clock tending to sick patients, states a GPB report. Already facing financial challenges even before the pandemic struck, Southwest Georgia Regional Medical Center, Randolph County, which has among the highest per-capita infection rates in the state, has been forced into closure, planned for Oct. 22. Cuthbert nursing home, of the same health system has seen 55 residents and 33 staff members test positive for the disease.
“We have always been concerned about rural hospitals,’’ said Verma addressing the issue, stressing that the Trump administration has taken action to help rural medical providers in many ways including improving ways that rural hospitals have been reimbursed, allowing them more regulatory flexibility, and dedicating funding from a provider relief fund.
Healthcare leaders also deliberated infection and treatment disparities among minority communities, which have seen higher positive-case rates compared to white population. On average across the United States, white people, Hispanic or Latino people, and Black people comprise 61.1%, 17.8%, and 12.3% of the population. According to the Centers for Disease Control and Prevention (CDC) weekly COVID-19 data release for the week of July 21, white people have accounted for 52.7%, Hispanic or Latinos 17.2%, and Black or African Americans 22.3% of COVID-19 deaths in the United States.
Verma and hospital officials were in agreement about more outreach to minority communities and overall health improvements. Dr. Jayne Morgan, director of innovation at Piedmont Healthcare advocated stronger efforts to recruit more minority patients into clinical trials citing her observations that the underlying premise of what’s driving the disproportionate negative impact to African American communities is the “fractured relationship” between the community and the health care industry. “Public messaging that resonates with those communities will be key to inoculating as many people as possible in minority communities once a vaccine is approved,” said Laurie Reid, registered nurse and member of the Atlanta Black Nurses Association.
“The financial burden, especially in hot spots, has been really tremendous on health care systems and hospitals,’’ said Dr. Jonathan Lewin, CEO of Emory Healthcare, adding that obtaining personal protective equipment and even disinfectant wipes has been a big challenge.
John Haupert, CEO of Grady Health System said that hospital systems were financially affected by the 300 percent increase in COVID-19 patients since a month ago, also adding, “What we’re very concerned about now is there is not a great compliance with social distancing and masking in our community.”
Dr. Morgan questioned the collateral damage of hospitals being on unstable financial footing, citing furloughed and eliminated health care jobs that are deemed “nonessential.” Loeffler said that the roughly $1 trillion left in the CARES Act needs to be targeted to the areas that were missed, areas that are starting to show up as cracks in this response, adding that future funding needs to focus on children, jobs and the health care industry and its patients.
As of July 22, 1,223 long-term care residents in Georgia have died with COVID-19, about 45% of the state’s official total. Meanwhile, the battle is far from over: new senior care homes join the state’s official outbreak list almost daily, states an AJC report. Tony Marshall of the Georgia Health Care Association, which represents nursing homes, observed that overall occupancy of nursing homes is down significantly, which is costing the industry $1 million per day in lost revenue, Marshall added.
Representatives from several nursing-home groups expressed concern about many elderly residents showing signs of weight loss and depression due to their isolation as long-term care facilities remain locked down across the state. “We are identifying the need that they have to see each other,” said Deborah Meade, board chair of the American Health Care Association.
“Obviously, nursing homes have been hit hard by this,’’ said Verma. She said her agency has started sending “point-of-care” test kits to nursing homes across the country to conduct COVID-19 tests for residents and staff inside facilities rather than off-site. Around 1,000 kits have already been sent, she said. “I think the tests that we’re doing are really going to be that turning point and allowing for that reunification and allowing for them to have a better quality of life inside the nursing home.”
Before the coronavirus pandemic, telehealth visits with doctors were limited for Medicare patients, primarily to those who live in rural areas.” One of the things the President did from the very beginning is focus on Telehealth. We have got rid of all the federal regulations that didn’t allow telehealth and I can tell you that we used to have 13, 000 people that are using Telehealth services and now the numbers are over 10 million,” said Verma addressing concerns about elderly patients being unable to visit hospitals for regular visits.
Loeffler who has brought legislation to broaden insurance coverage for telemedicine, aims to focus on federal aid for schools, health-care providers and businesses as Congress hashes out another funding package.
“We have to figure out how to live with this virus and do it in a safe way,” Verma said, adding that she understood the issue from all sides as a mother of two and a husband with underlying health issues. “As we’re thinking about this, from my perspective, this virus is going to be here for a while, and while we’re hopeful for a vaccine, we need to think about how we coexist. The precautions that we’re taking in terms of masking, in terms of social distancing, but also about how we keep our economy open is extremely important.”
“All the good stuff happens on the ground in Georgia. We are here to support you. Please keep up your dialogue. We welcome you input,” said Loeffler.