Month: March 2020

Addiction Is ‘A Disease Of Isolation’ — So Pandemic Puts Recovery At Risk

By Martha Bebinger: For More Info, Go Here…

Before the coronavirus became a pandemic, Emma went to an Alcoholics Anonymous meeting every week in the Boston area and to another support group at her methadone clinic. She said she felt safe, secure and never judged.

“No one is thinking, ‘Oh, my God. She did that?’” said Emma, “’cause they’ve been there.”

Now, with AA and other 12-step groups moving online, and the methadone clinic shifting to phone meetings and appointments, Emma said she is feeling more isolated. (KHN is not using her last name because she still uses illegal drugs sometimes.) Emma said the coronavirus may make it harder to stay in recovery.

“Maybe I’m old fashioned,” said Emma, “but the whole point of going to a meeting is to be around people and be social and feel connected, and I’d be totally missing that if I did it online.”

While it’s safer to stay home to avoid getting and spreading COVID-19, addiction specialists acknowledge Emma’s concern: Doing so may increase feelings of depression and anxiety among people in recovery — and those are underlying causes of drug and alcohol use and addiction.

“We consider addiction a disease of isolation,” said Dr. Marvin Seppala, chief medical officer at the Hazelden Betty Ford Foundation. “Now we’re isolating all these people and expecting them to pick up the phone, get online, that sort of thing — and it may not work out as well.”

Emma has another frustration: If the methadone clinic isn’t allowing gatherings, why is she still required to show up daily and wait in line for her dose of the pink liquid medication?

The answer is in tangled rules for methadone dispensing. The federal government has loosened them during the pandemic — so that patients don’t all have to make a daily trip to the methadone clinic, even if they are sick. But patients say clinics have been slow to adopt the new rules.

Mark Parrino, president of the American Association for the Treatment of Opioid Dependence, said he issued guidelines to members late last week about how to operate during pandemics. He recommended that clinics stop collecting urine samples to test for drug use. Many patients can now get a 14- to 28-day supply of their addiction treatment medication so they can make fewer trips to methadone or buprenorphine clinics.

Unemployment Insurance Agency Update

From MDLEO: For More Info, Go Here…

Unemployment Benefits Increased and Expanded

Governor Whitmer today has announced new programs for workers affected by COVID-19. The governor, under the federal CARES Act, signed an agreement between Michigan and the U.S. Dept. of Labor to implement Pandemic Unemployment Assistance and Compensation programs that grant benefits to workers who do not already qualify for state unemployment benefits. Workers include self-employed, 1099-independent contractors, gig, and low-wage workers who can no longer work because of the pandemic. The agreement also increases weekly benefits for all unemployed workers by $600 a week and extends benefit payments from 26 to 39 weeks. If someone has already applied for unemployment benefits, you DO NOT need to reapply at this time.

The UIA will provide additional guidance regarding eligibility and application details in the coming days as it implements these new programs.

New Filing Schedule

The new system uses alphabetical order to manage web visits and calls. It is being implemented as UIA has moved nearly all of its staff members to customer service positions in order to faster assist Michiganders in filing for benefits. At the same time, the Michigan Department of Technology, Management and Budget is working to expand capacity and infrastructure of the State’s online systems. Potential benefit recipients can help alleviate the system overload by following a few simple steps:

  • If you have a computer and the internet, please use the website, not the phone system, to apply for benefits: Michigan.gov/UIA.
  • Log onto the website during off-hours for better access – late at night or very early in the morning.
  • Please be patient. If the page is loading slowly, DO NOT refresh. Give it a few minutes to load.
  • View the online tool kit and frequently asked questions before you apply to ensure that you have the appropriate information and documents you will need on hand.
  • If you must use the Call Center, please observe the alphabetical system outlined below beginning this Sunday to help ease the burden.

Online Filing Schedule – Michigan.gov/UIA

Why the U.S. doesn’t have more hospital beds

By Drew Altman: For More Info, Go Here…

The shortage of hospital beds in the U.S. didn’t happen by accident. It’s a result of both market pressures and public policy.

Why it matters: The bed shortage is one of many factors complicating America’s response to the new coronavirus. But if we want to have more beds and critical equipment on hand for the next pandemic, the government will need to make it happen — and pay for it.

By the numbers: The U.S. has 2.8 hospital beds per 1,000 people, far fewer than other developed countries.

How it happened: Health care resources, including hospital beds, are allocated mainly by market dynamics, not public-health blueprints.

  • Over the last 50 years, a great deal of care has shifted away from inpatient hospital settings and into outpatient services.
  • The motivation was to help control costs and improve the quality of care, while making it more convenient for patients.

Government also worked to directly cut the number of U.S. hospital beds, believing in a rule called Roemer’s Law, which said that “a hospital bed built would be a hospital bed filled,” driving up costs.

  • The push to reduce beds was embodied in a 1974 law that set up a health planning system in every state. A central objective was to get the U.S. below three hospital beds per 1,000 people, the level many think is now too low today.
  • And though it was repealed under President Ronald Reagan, the broader push to reduce capacity continued in many states.

The bottom line: If we want to have surge capacity of hospital beds and equipment in place for the next crisis, and if we don’t want to push health care costs higher, hospitals will need to acquire extra beds and then leave that surge capacity largely unused until the next crisis.

A COVID-19 Message from the CEO of Spectrum Health System

From Spectrum: For More Info, Go Here…

We are living in an unprecedented time. As we fight a deadly virus that is rapidly spreading, our economy, our connections and our lives are being challenged in significant ways. Life as we know it has changed. And it will continue to change.

At Spectrum Health, we are leaving no stone unturned to be as prepared as possible to take care of our community as COVID-19 continues to accelerate. I want to take this opportunity to be transparent about the reality of the situation we are facing and what is to come.

Please know that COVID-19 is far more dangerous than the flu. It is more contagious — contagious for longer and much more deadly. After two months, one person with the flu will pass it on to about 386 people. Comparatively, one person with COVID-19 will pass it on to up to 99,000 people. The fatality rate for those contracting the flu is about 0.1%. For COVID-19, this rate is 10 times higher.

Because of this, we are closely studying our models, which include learnings and data from across the state, country and world. These models project the spread of COVID-19 and enable us to estimate how many people in our communities will need hospitalization and intensive care services. They also allow us to understand the collective resources that would then be necessary to serve those needs. These are just estimates and we hope for the best, but our job is to plan for the worst.

At present, based on the information available, the rate of growth of deaths from COVID-19 in Michigan is at least as fast as New York, if not faster. The modeling for our area shows that, at its current rate, we would exceed demand for hospital and intensive care services in early May and this would last many, many weeks. This peak in cases would be more than our health care system, or any health care system, could handle.

In response, we are making every possible effort to increase the capacity of our hospitals. We have already canceled all non-urgent surgeries and procedures. We have plans in place to substantially expand our ICU capacity. And we are preparing to have as many health care workers as possible ready to care for us.

However, these actions alone will not be enough. We must do more, and we need your help. We know enough from models and trends that our primary tool to slow the spread and lower the curve is social distancing. This makes the governor’s “Stay Home, Stay Safe” order critical. I know this is challenging for our families, our businesses and our organizations, but this is the best action we can take to lower the curve.

Please stay home unless it is absolutely essential to leave. Keep a social distance of at least 6 feet. Wash your hands frequently for at least 20 seconds.
We can still change these numbers, but we can only do so together.

Together, we are strong. And together, we will see this through.

3 patients at Michigan psychiatric hospitals have coronavirus, officials say

From Fox2 Detroit: For More Info, Go Here…

State health officials announced three cases of coronavirus among patients at its Center for Forensic Psychiatry in Saline and Walter Reuther Psychiatric Hospital in Westland.

Two of the positive cases are patients at Walter Reuther and one is at the Center for Forensic Psychiatry. In addition, three staff members at Walter Reuther have tested positive for COVID-19.

Michigan Department of Health and Humans Services made the announcement Tuesday. No additional information was released about the patients or staff who tested positive.

“Our primary focus is the health and safety of our staff and the patients at our state hospitals,” said MDHHS Director Robert Gordon. “We treat the spread of COVID-19 with the greatest seriousness and are taking many steps to address it.”

Several weeks ago, isolation units were equipped in each of the state’s five psychiatric hospitals, according to the state.

HHS Warns States Not To Put People With Disabilities At The Back Of The Line For Care

By JOSEPH SHAPIRO: For More Info, Go Here…

With coronavirus cases continuing to climb and hospitals facing the prospect of having to decide how to allocate limited staff and resources, the Department of Health and Human Services is reminding states and health care providers that civil rights laws still apply in a pandemic.

States are preparing for a situation when there’s not enough care to go around by issuing “crisis of care” standards.

But disability groups are worried that those standards will allow rationing decisions that exclude the elderly or people with disabilities.

On Saturday, the HHS Office for Civil Rights put out guidance saying states, hospitals and doctors cannot put people with disabilities or older people at the back of the line for care.

“We’re concerned that crisis standards of care may start relying on value judgments as to the relative worth of one human being versus another, based on the presence or absence of disability,” said Roger Severino, the director of the Office for Civil Rights. “We’re concerned that stereotypes about what life is like living with a disability can be improperly used to exclude people from needed care.”

Severino said his office has opened or is about to open investigations of complaints in multiple states. He did not say which states could be the focus of an investigation, but in the last several days, disability groups in four states — Alabama, Kansas, Tennessee, and Washington — have filed complaints.

Ethics Consult: Deny Elderly COVID-19 Patient Ventilator? MD/JD Bangs Gavel

by Gregory Dolin MD, JD: For More Info, Go Here…

ngd- Even the notoriously and moralistically judgemental medical ethics profession sees some limits on killing off disabled people…

Last week, you voted on the ethics of taking an elderly man with COVID-19 off a ventilator in a triage situation. Here are the results from almost 4,000 votes:

Would you prioritize the care of healthier and younger patients and shift the ventilator from the elderly man to patients with a higher probability of recovering?

Yes: 55.65%

No: 44.35%

Would you change your decision if the elderly patient had been in intensive care for a non-COVID-19-related illness?

Yes: 21.89%

No: 78.11%

Would you prioritize the older man over college students who had likely been infected during spring break trips?

Yes: 28.88%

No: 71.12%

And now bioethics scholar Gregory Dolin, MD, JD, weighs in:

Generally speaking, under traditional common law, one is under no obligation to render aid to anyone. (EMTALA has, of course, changed that in certain situations, but the basic principle remains.) However, once a person begins to render aid, he or she must continue to do so. That does not mean that extraordinary or futile actions must be taken; rather, it means that one cannot stop aiding simply because he no longer wants to or thinks that a more “worthy” activity needs to be attended to. Thus, there is a difference between DNR or even withdrawal of futile care and withdrawing care simply because the doctor thinks a newly arrived patient is more “worthy” of it.

Preventing Discrimination in the Treatment of COVID-19 Patients: The Illegality of Medical Rationing on the Basis of Disability

From DREDF: For More Info, Go Here…

As the COVID-19 crisis amplifies in the United States, the Disability Rights Education and
Defense Fund (“DREDF”) reminds lawmakers and providers of health care, education,
transportation, housing, and other critical services of their duty to uphold the civil and human rights of people with disabilities.

In the face of a public health crisis, where projections show that the need for intensive medical care for individuals made ill by COVID-19 may far exceed the resources of the U.S. healthcare system, the inclination of healthcare providers may be to take “rationing” measures—or rather, make decisions about who should or should not receive care and, if they do, what level of care.

While COVID-19 poses a serious challenge to the capacity and resources of our healthcare system, DREDF reminds healthcare providers that longstanding federal and state nondiscrimination laws, such as the Americans with Disabilities Act (“ADA”), Section 504 of the Rehabilitation Act, Section 1557 of the Affordable Care Act (“ACA”), the California Unruh Civil Rights Act, and California Government Code Section 11135, prohibit such rationing measures when they result in the denial of care on the basis of disability to an individual who would benefit from it.

I. The Legal Obligations of Healthcare Providers to People with Disabilities

CORONAVIRUS (COVID-19) Real Time Stats

From The Weather Channel; An IBM Company: For More Info, Go Here…

Lansing, MI

Ingham County

As of Sat, Mar 28, 2020, 8:09 PM EDT

CONFIRMED CASES32190.9%Since last week
DEATHS0

Michigan

CONFIRMED CASES4650

DEATHS111
Source*Note: Some locations do not currently provide all data.

See the Trend

View:CountyState

See how the coronavirus is trending across time in your state.

Updates about the dire situation inside Macomb prison in Michigan

From Rustbelt Abolition Radio: For More Info, Go Here…

ngd- a 7 minutes podcast…

As of today (3/27/2020), there are 24 confirmed cases of Cov-19 inside Michigan prisons.

Two weeks ago, we spoke with Bruce “X” Parker about the situation inside Macomb prison and he warned us about what would happen if no action was taken. The Michigan Department of Corrections (MDOC)- even though they had placed multiple facilities on quarantine- seemed to play down the threat of the pandemic.

Today, we hear once again from Bruce X Parker, a 35 year old ashmatic, who is facing an increasingly desperate situation inside Macomb prison. Just north of Detroit, Macomb prison is located in the midst of the epicenter of the rapidly growing pandemic in Michigan. Bruce X tells us that he has been having headaches, and is experiencing both shortness of breath and cold sweats. He tells us that the situation is so dire that “I would rather go to segregation than have my life put in danger by this deadly disease.” Inside Macomb’s “5 block,” he’s sharing a tiny cell with someone that was just on quarantine.

Needless to say, he is not able to follow Governor Whitmer’s order to “social distance.” Citing the MDOC’s own policies (in particular MDOC policy directive 03.04.110), he tells us that the MDOC is not even following their own rules and is putting the health of both staff and prisoners at risk.

Bruce X directs two demands by prisoners inside Macomb to Governor Whitmer and Director Heidi Washington; they are as follows: (1) Release prisoners who have preexisting conditions over the age of 50 and (2) commute sentences. It is only by taking these extraordinary measures that we might interrupt the tragic ending of what we are seeing unfold right before our eyes.