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Coronavirus relief funds for nursing homes dry up, raising fears for elderly, vulnerable

As drafts of a renewed coronavirus relief package continue to be debated in and around the White House, the many millions left languishing in nursing homes and elderly care facilities – along with their loved ones forced to communicate with them from afar – are urging swift action.

According to the American Health Care Association (AHCA), almost all the initial $175 billion U.S. Department of Health and Human Services (HHS) funds from the CARES Act – which was signed into law by President Trump in late March – has been spent, and yet coronavirus – officially termed COVID-19 – cases in at least 22 states continues to ascend, ahead of the already daunting cold and flu season.

“HHS has announced distribution plans for 80 percent of the $175 billion Provider Relief Fund created by the CARES Act. Health care providers, including nursing homes, will need additional resources to continue its response to the COVID pandemic heading into the cold and flu season, which provides new challenges,” Mark Parkinson, president and CEO of American Health Care Association and National Center for Assisted Living (AHCA/NCAL), told Fox News. “COVID-19 disproportionately impacts the elderly – many of whom already have preexisting health conditions and chronic diseases – and the dedicated staff who care for them.”

AMID CORONAVIRUS, 1 IN 4 AMERICANS ARE FAILING TO WASH THEIR HANDS: CDC

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) has thus requested an additional $100 billion from the HHS Provider Relief Fund, which is accessible for all health care providers impacted by the novel pathogen, and asked “that a sizeable portion of the fund be dedicated to helping nursing homes and assisted living communities to acquire resources associated with protecting vulnerable residents and staff from the virus, including constant testing, personal protective equipment (PPE) and staff support.”

Parkinson is urging Congress to provide the additional billions to protect the most susceptible. As of Friday, the notion of further stimulus and relief funding was still the topic of political fodder in Washington.

Parkinson emphasized that the PPE supply shortages and delays in obtaining test results in the first six months of the pandemic “put nursing homes at a serious disadvantage” in keeping COVID out of their facilities.

 “Funding from HHS has helped nursing homes pay for additional staffing, secure vital PPE equipment, and conduct regular testing of residents and staff in response to the COVID pandemic,” he lamented. “We need Congress to prioritize our vulnerable seniors and their caregivers in nursing homes and assisted living communities by passing another COVID-funding package before they leave town for the elections.”

Indeed, a prominent portion of coronavirus deaths have occurred in nursing homes and assisted living facilities nationwide – a chilling consequence of the disease, which is known to be especially lethal to adults over the age of 60, and with underlying health ailments. Furthermore, it can rapidly tear through converging, indoor dwellings and be passed on by workers who move from room and room.

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‘It’s a Slaughter’; Trump Halts COVID Relief Talks; Mask Up Between Bites in Calif.

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William Foege, MD, the former CDC director under Presidents Carter and Reagan, suggested in a private letter to the agency’s current leader, Robert Redfield, MD, that he orchestrate his own firing by revealing the CDC’s failings and the meddling from the White House. “It’s a slaughter and not just a political dispute,” he wrote. (USA Today)

As of 8:00 a.m. ET Wednesday, the estimated U.S. COVID-19 toll reached 7,501,869 cases and 210,918 deaths — up 42,767 and 722, respectively, since the same time a day ago.

President Trump ordered his legislative team to halt negotiations with Congress on a coronavirus relief bill until after the election, but later tweeted that a total of $160 billion should be approved for airline relief and for paycheck protection. (The Hill)

Rick Bright, the administration’s vaccine-expert-turned-whistleblower, resigned from his job at NIH — a job he had been demoted to after being removed from his position as the head of the Biomedical Advanced Research and Development Authority. (STAT)

The FDA released its revised guidance for emergency use authorization of COVID-19 vaccines — guidance that would likely guarantee a vaccine wouldn’t be authorized until after Election Day. Stay tuned to MedPage Today for in-depth coverage of this issue.

Efficacy data from one or two COVID-19 vaccine candidates are expected in the next month or two, according to Moncef Slaoui, PhD, the chief advisor to Operation Warp Speed, the Trump administration’s project to speed up vaccine development. (Reuters)

In a small trial of patients with mild cases, the antidepressant fluvoxamine reduced the likelihood of clinical deterioration compared with placebo, the COVID-19 Early Treatment Fund announced.

Wondering how to ask a stranger to put on their mask? Be discreet, experts say. (AP)

And speaking of masks, going out to eat in a restaurant? Don’t forget to wear your mask between bites, say California officials. (CBS News)

Presidential adviser Stephen Miller and three other White House officials tested positive for COVID-19, while the top U.S. general and several senior Pentagon officials are quarantining after being exposed to a Coast Guard admiral who tested positive for the coronavirus. (New York Times, CNN)

Facebook removed a post from President Trump suggesting that influenza is more lethal than COVID-19, saying it broke the site’s rules regarding misinformation. For comparison, COVID-19 in the U.S. has now killed more people than the last five flu seasons combined. (CNN)

State officials are investigating Trump’s fundraiser last week at his Bedminster, N.J. country club to see whether it violated guidelines on large gatherings. (NBC News)

As if a bobblehead and donuts weren’t enough, now NIAID Director Anthony Fauci, MD, has his own action figure. (The Hill)

A Frontline/AP investigation published in The Washington Post details the breakdown in the U.S. supply chain for personal protective equipment to help fight the spread of COVID-19.

In other news:

Trump Signs Medicare Loan Relief Bill Delaying Repayments

President Trump on Thursday morning signed a bill to keep the federal government running through December 11. This “continuing resolution” (CR), which was approved by the Senate Wednesday on an 84-10 vote, according to The New York Times, includes provisions to delay repayment by physicians of pandemic-related Medicare loans and to reduce the loans’ interest rate.

In an earlier news release, the American Medical Association (AMA) reported that Congress and the White House had agreed to include the provisions on Medicare loans in the CR.

Under the Medicare Accelerated and Advance Payments (AAP) program, the Centers for Medicare & Medicaid Services (CMS) advanced money to physicians who were financially impacted by the pandemic. The program, created in March, was suspended in late April.

Physicians who received the Medicare loans were supposed to start paying them back 120 days after they were made. CMS planned to recoup the advances by offsetting them against Medicare claims payments due to physicians. Practices had up to 210 days (7 months) to repay the loans through this process before being asked to repay them directly with interest of 10.25%.

For the practices that received these advances, that meant their Medicare cash flow was scheduled to dry up, starting in August. However, CMS quietly abstained from collecting these payments when they came due, according to Modern Healthcare.

New Terms

Under the new loan repayment terms in the CR, recoupment of the disbursed funds is postponed until 365 days after the date on which a practice received the money. The balance is due by September 2022.

The amount to be recouped from each claim is reduced from 100% to 25% of the claim for the first 11 months and to 50% of claims withheld for an additional 6 months. If the loan is not repaid in full by then, the provider must pay the balance with interest of 4%.

More than 80% of the $100 billion that CMS loaned to healthcare providers through May 2 went to hospitals, Modern Healthcare calculated. Of the remainder, specialty or multispecialty practices received $3.5 billion, internal medicine specialists got $24 million, family physicians were loaned $15 million, and federally qualified health centers received $20 million.

In the AMA’s news release, AMA President Susan Bailey, MD, who assumed the post in June, called the original loan repayment plan an “economic sword hanging over physician practices.”

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.

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Research gives green light for migraine relief

A pilot study suggests that exposure to green light of a particular wavelength and brightness may be as effective as drugs in reducing the frequency and severity of migraine.

According to the Migraine Research Foundation, about 12% of people in the United States experience migraine.

The condition involves moderate-to-severe headaches, which often accompany debilitating symptoms, such as visual disturbances, nausea, vomiting, dizziness, and extreme sensitivity to sound and light.

Affected individuals frequently report having a lower quality of life and needing to take time off work as a result of their condition. Research suggests that they are more likely to use and overuse pain relief medications, including opioids.

Some people do not get adequate pain control from drugs or experience unpleasant side effects when they take them. Finding alternative therapies to replace or complement these treatments is, therefore, a priority.

One possibility is light therapy. Previous research by doctors at the University of Arizona College of Medicine in Tucson found that green light had pain-relieving effects in rats.

The same team has now conducted the first clinical study of green light as a preventive therapy for migraine, with promising results.

“As a physician, this is really exciting,” says lead author Dr. Mohab Ibrahim, an associate professor at the college and director of its Chronic Pain Management Clinic. “Now, I have another tool in my toolbox to treat one of the most difficult neurological conditions — migraine.”

The researchers report their study in Cephalalgia, the journal of the International Headache Society.

The researchers recruited 29 people, seven of whom had episodic migraine (defined as up to 14 headache days per month), while 22 had chronic migraine (15 or more headache days per month for 3 or more months). All of the participants were unsatisfied with their current treatment.

Initially, for 10 weeks, the participants spent 1–2 hours daily at home in an otherwise dark room lit by a white LED (light-emitting diode) strip. The white lighting served as a control condition.

A “washout period” of 2 weeks without any light treatment followed.

Finally, for a further 10 weeks, all 29 individuals spent 1–2 hours daily with an LED strip emitting green light with a wavelength of about 525 nanometers and the same brightness as the white light.

The researchers encouraged the participants to stay awake during the light treatment and do things that required no additional lighting, such as reading a book, listening to music, or doing exercise.

Throughout the study, each participant filled out questionnaires reporting the number of headaches that they experienced and their intensity. In addition, they answered questions relating to quality of life, such as their ability to work and to fall and stay asleep.

Overall, the green light treatment was associated with a significant decrease in the frequency of headaches, from an average of 18.4 days per month before the treatment to 7.4 days per month afterward (a reduction of about 60%).

Among those with episodic migraine, the number of headache days per month declined

Alcohol Relief For Toothache Problems Using Whiskey Or Brandy

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