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July 2020

Heart Association statement ties poor housing quality to cardiovascular problems

The American Heart Association released a scientific statement detailing the many correlations between homelessness, low-quality housing and neighborhood environment with the prevalence of cardiovascular disease and its risk factors (Source: “AHA: Housing status significant risk factor in development of CVD,” Cardiology Today via Healio, July 15, 2020).

According to the statement, which was published in the journal Circulation, adults who are homeless may experience up to 70% higher rates of cardiovascular events compared with the general population.

This association may be a result of the lack of cardiovascular risk factor diagnosis in this population, the inherent barriers to care, medication initiation and adherence and access to healthy foods.

"The disparities in cardiovascular health among people who are homeless and marginally housed are largely due to psychosocial stressors, unhealthy behaviors used as coping mechanisms and barriers to health care, including lack of insurance and stigmatization among this population,” Mario Sims, a professor in the department of medicine at the University of Mississippi Medical Center in Jackson and chair of the writing group for the scientific statement, said in a press release.


Studies find heart damage from COVID-19 months after patients recover

New evidence suggests the coronavirus has lasting impacts on the heart, raising alarm for cardiologists who have been concerned about potential long-term heart injury from COVID-19 (Source: “Heart damage found in coronavirus patients months after recovering from COVID-19, study says,” Columbus Dispatch, July 30, 2020).

Two German studies (found here and here), published Tuesday in the peer-reviewed journal JAMA Cardiology, found heart abnormalities in COVID-19 patients months after they had already recovered from the disease caused by SARS-CoV-2. The majority of patients didn’t exhibit any symptoms and these specific abnormalities detected by the MRI wouldn’t have been seen on an echocardiogram, which is more commonly used in the standard clinical setting.

Experts say the prevalence of inflammation is an important connection to COVID-19 as the disease has a clinical reputation for a high inflammatory response. Dr. Thomas Maddox, chair of the American College of Cardiology’s Science and Quality Committee, said heart inflammation could lead to the weakening of the heart muscle and, in rare cases, abnormal heartbeats.

On Friday afternoon, the Ohio Department of Health reported 91,159 cases of COVID-19 (an increase of 9,413 since last Friday), 10,790 hospitalizations (an increase of 718 this week) and 3,489 deaths (192 more reported since last Friday).


Black children 3 times as likely to die after surgery, study finds

Even among apparently healthy children, Black patients are almost three and a half times more likely to die within 30 days after surgery than white patients, according to a new study (Source: “Study: Black Children Face Higher Risk of Death After Surgery,” July 27, 2020).

The study, published in the journal Pediatrics, analyzed data from over 172,000 children who underwent surgery between 2012 and 2017. The data came from hospitals across the country through the National Surgical Quality Improvement Program-Pediatric database. All of the patients were age 17 or younger. Of the patients included in the study, 70% were white and about 11% were Black.

The study did not provide definitive answers for the causes of the disparities.

“That is going to require more research. We cannot answer that question from the current study, and we’re just going to have to go back to the database to see whether we can find some answers and continue to provide the best care for the children,” said Dr. Olubukola O. Nafiu of Nationwide Children’s Hospital in Columbus, who was one of five researchers who conducted the study.


Ohio Medicaid enrollment spikes due to pandemic, economic downturn

Ohio Medicaid rolls continue to increase, due to the pandemic and economic fallout associated with it (Source: “Ohio Medicaid rolls climbing toward 3 million again,” Cleveland.com, July 28, 2020).

In June, 2.98 million low-income Ohioans were enrolled in Medicaid, up from 2.92 million in May and 2.88 million in April, according to the Ohio Department of Medicaid’s caseload report.

The program tends to get more enrollees as the economy gets worse. Ohio’s strong economy over the past couple of years has resulted in lower numbers of beneficiaries. The last time Ohio Medicaid had 3 million enrollees was January 2018.


Study: Latinos bear disproportionate impact of COVID-19

A national study of COVID-19 cases and deaths among Latinos released this week found that there are several factors leading to Latinos being disproportionately impacted by the pandemic (Source: “Coronavirus pandemic tearing through Latino communities – and it may get worse,” USA Today, July 24).

The first nationwide analysis of COVID-19 cases and deaths among Latinos concludes that crowded housing arrangements and high-risk jobs in industries like meatpacking, poultry and hospitality are among the major reasons for the disproportionate impact of COVID-19.

A New York Times analysis based on data from the Centers for Disease Control and Prevention – released after a lawsuit was filed – shows 73 of every 10,000 Latinos contracted the virus, compared to 62 Blacks and 23 whites.

One of the study’s most surprising findings was the Midwest, where only 4% of the counties are predominantly Latino, was the one region where their coronavirus-related deaths were higher than their representation.

“We found access to health care was harder in the Midwest, so it’s very likely people only accessed care when they felt really bad, and as the disease progresses it gets more difficult to manage,’’ said Carlos Rodriguez-Diaz, the study's lead author. “There’s also the fact they need to continue working.’’


Eight more counties moved to red on COVID alert system; DeWine orders statewide mask mandate

Eight Ohio counties moved to “red” status on the latest update to the state’s color-coded COVID-19 alert system, with Allen County marked as approaching Level 4, or “purple” status (Source: “Eight Ohio counties move to ‘red’ coronavirus alert status; Allen County approaching ‘purple’ status,” Cleveland.com, June 23).

That makes 23 counties out of 88 that fall into level 3 status, the second-highest risk alert category. Level 4 status is when there is severe exposure and spread in a community. Northwestern Allen County, which contains Lima, has reported 110 coronavirus in the past 14 days -- 23% of the total cases the county has experienced.

Also this week, Gov. Mike DeWine announced that he is issuing a statewide face mask mandate (Source: “Coronavirus in Ohio: Gov. Mike DeWine issues statewide mask order,” Columbus Dispatch, July 22).

Effective on Thursday, masks are required for people in indoor public places, in outdoor places where social-distancing can’t be maintained, and using public transportation, DeWine said. Exceptions will be made for those who are under the age of 10, have a medical condition, are playing sports, are eating or drinking, or who are speaking at a religious service.

On Friday afternoon, the Ohio Department of Health reported 81,746 cases of COVID-19 (an increase of 1,560 from Thursday), 10,072 hospitalizations (an increase of 104) and 3,297 deaths (41 more reported in past 24 hours).


Half of U.S. hospitals in red without more federal dollars, association report finds

A report commissioned by the American Hospital Association found that 51% of U.S. hospitals are expected to have negative operating margins by the end of the year without additional federal support (Source: “Half of U.S. hospitals in the red by year's end without more federal support,” Modern Healthcare, July 21).

The new report found that U.S. hospitals' median operating margin could sink to -7% by the end of 2020 without additional federal government support to offset COVID-19 losses.

The American Hospital Association commissioned the report from healthcare consultancy Kaufman Hall and timed its release on Tuesday to coincide with bipartisan talks around a new federal COVID-19 relief package, just as increased unemployment benefits are set to expire. The prominent hospital lobbying group has released multiple reports during the pandemic to support its requests for more federal grants and loans.

According to the latest report, under an optimistic scenario, hospitals' median margin would be -1%. Under a less optimistic one, that margin could sink to -11%, the report found.


19 Ohio counties under state masking mandate

There are now 19 counties under a Level 3 advisory for the spread of COVID-19 in Ohio, according to the latest data released by the Ohio Department of Health (Source: “Mask Mandate Coming For More than Half Of Ohio Population,” Statehouse News Bureau, July 16).

The "red" counties in Ohio hit enough indicators for the spread of coronavirus to trigger a mandatory mask order in public. This means more than 60% of the state's population will be under a mask mandate going into the weekend.

The new advisory came a day after Gov. Mike DeWine made a statewide plea to the people of Ohio to wear masks and to stop gathering in large groups. But he stopped short of issuing stronger health orders, such as a statewide mask mandate.

According to the latest ODH data released on Friday afternoon, 72,280 Ohioans have tested positive for COVID-19, an increase of 1,679 from the day before. That is the largest one-day increase since the pandemic began in March. ODH also reported a total of 9,445 hospitalizations, a 24-hour increase of 121 and nine additional deaths reported in the last day, bringing the total number of COVID-19 deaths to 3,112.


CDC: Drug overdose deaths hit record high in 2019

Drug deaths in America, which fell for the first time in 25 years in 2018, rose to record numbers in 2019 and are continuing to climb, a resurgence that is being complicated and perhaps worsened by the coronavirus pandemic (Source: “In Shadow of Pandemic, U.S. Drug Overdose Deaths Resurge to Record,” New York Times, July 15).

Nearly 72,000 Americans died from drug overdoses last year, according to preliminary data released Wednesday by the Centers for Disease Control and Prevention — an increase of 5 percent from 2018. Deaths from drug overdoses remain higher than the peak yearly death totals ever recorded for car accidents, guns or AIDS, and their acceleration in recent years has pushed down overall life expectancy in the United States.

It looks as if 2020 will be even worse. Drug deaths have risen an average of 13 percent so far this year over last year, according to mortality data from local and state governments collected by The New York Times, covering 40 percent of the U.S. population. If this trend continues for the rest of the year, it will be the sharpest increase in annual drug deaths since 2016, when a class of synthetic opioids known as fentanyls first made significant inroads in the country’s illicit drug supply.


HHS changes hospital requirements for reporting COVID-19 data

The U.S. Department of Health and Human Services earlier this week changed rules for reporting COVID-19 data (Source: “How HHS’s new hospital data reporting system will actually affect the U.S. Covid-19 response,” STAT News, July 16).

Hospitals are now required to report data on COVID-19 patients and deaths directly to HHS, rather than to both HHS and the CDC, as they had been doing. HHS said it would help the administration better allocate supplies and drugs.

To some, the change could have some merits. They say the CDC’s data system was built for tracking hospital-acquired pneumonias and urinary tract infections, for instance, and it wasn’t perfect for keeping up with coronavirus data. But CDC supporters saw the change as further evidence of the agency being sidelined, and hospitals decried the implication that it was their reporting — rather than changing federal requirements — that was to blame for data issues and supply shortages.