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November 2020

Ohio hits new COVID-19 record on Friday

New coronavirus cases hit a new record on Friday as Ohioans headed into their first weekend under Gov. Mike DeWine's mandated statewide overnight curfew (Source: “Ohio sets new record with 8,808 new coronavirus cases,” Columbus Dispatch, Nov. 20).

The state reported 8,808 new cases on Friday, eclipsing the 8,071 record set a week ago.

Friday's record new cases, up from 7,787 on Thursday, doesn't account for a backlog of about 12,000 less reliable rapid antigen tests that the state is double-checking. The state always verifies those tests, but the number performed daily has exploded from hundreds to thousands, making it difficult to check within 24 hours.

The state also reported on Friday another 65 deaths and 398 new hospitalizations from the coronavirus. A total of 42 have been admitted to intensive care units in the last 24 hours.

Pfizer first to apply for emergency use of COVID-19 vaccine

Pfizer Inc. said Friday that it will apply to U.S. health regulators for emergency use authorization (EUA) of its COVID-19 vaccine, the first such application in a major step toward providing protection against the new coronavirus (Source: “Pfizer files COVID-19 vaccine application to U.S. FDA,” Reuters, Nov. 20).

The application to the U.S. Food and Drug Administration comes just days after Pfizer reported final trial results that showed the vaccine was 95% effective in preventing COVID-19 with no major safety concerns.

“We literally could be weeks away from the authorization of a 95% effective vaccine,” U.S. Health Secretary Alex Azar said.

The companies expect the FDA to grant the EUA by mid-December and said they will begin shipping doses almost immediately. Pfizer has said it expects to have 50 million vaccine doses ready this year, enough to protect 25 million people.

Moderna Inc. is expected to be the next company to seek a U.S. emergency use nod for a COVID-19 vaccine. An initial analysis of data from its late-stage trial showed the vaccine was 94.5% effective. Final results and safety data are expected in the coming days or weeks. The next late-stage data is expected to come from AstraZeneca Plc., which is working with the University of Oxford, in November or December. Johnson & Johnson said it expects to have data needed to seek U.S. authorization for its experimental vaccine by February.

The rapid development of multiple COVID-19 vaccines will lead to many decisions for state policymakers on how best to distribute the vaccine in an efficient and equitable way. HPIO recently added a section on vaccine distribution to its COVID-19 resource page to provide resources for policymakers as they begin planning.

Childhood vaccines down as much as 26% this year, report finds

New data from the Blue Cross Blue Shield Association shows that vaccinations for measles, polio and other highly contagious diseases had fallen by as much as 26% during the coronavirus pandemic (Source: “Children in U.S. May Miss 9 Million Vaccine Doses in 2020, Report Warns,” New York Times, Nov. 18).

Children in the United States are on pace this year to miss nine million vaccine doses for measles, polio and other highly contagious diseases, according to medical claims data — a disruption that health care authorities called alarming and attributed to the coronavirus pandemic.

The data was made public on Wednesday by the Blue Cross Blue Shield Association, one of the nation’s largest federations of insurance companies, which said that routine childhood vaccinations had declined by as much as 26%, compared with 2019.

The findings emerged less than two weeks after the World Health Organization and UNICEF warned that progress vaccinating children from polio and measles was being threatened by the pandemic. In an emergency call to action, the two organizations said that the risk of measles and polio outbreaks was on the rise.

Deadline for Ohio Medicaid managed care bids is today


Bids are due today for insurance companies that want to be a part of Ohio Medicaid’s overhaul  (Source: “Insurance company bids due today for Ohio Medicaid overhaul,” Dayton Daily News, Nov. 20).

The state is overhauling how the health insurance program for people who are disabled or have low incomes operates and picking new insurance companies as contractors to manage those insurance claims. By rebidding the contracts, the state can update the conditions for getting and spending Medicaid dollars and can re-select which insurers it trusts to meet its goals.

In 2019, Ohio paid about $17 billion to Medicaid HMOs and about 90% of the 3 million Ohioans who are covered by Medicaid get an insurance plan managed by an insurance company. These insurers get a payment per member per month and use that money to pay for their member’s health care.

Ohio sets another COVID-19 record on Friday, 8,071 positive cases

Ohio's worsening COVID-19 pandemic continued on Friday with a record 8,071 new cases (Source: “New daily Ohio COVID-19 cases jump nearly 1,000 to a record 8,071,” Columbus Dispatch, Nov. 13).

The prior record of 7,101 new infections came on Thursday as cases have increased from an average of about 1,000 per day in mid-September to more than 4,200 per day now. The state also reported an above-average 298 hospitalizations and 42 more deaths, nearly twice the average, from the deadly virus on Friday.

The positive rate on tests remained high at 12.9% on the latest available day (Wednesday). The seven-day average positivity rate rose to 11.2%, a figure not seen since early in the outbreak. That number stood at 2.7% about seven weeks ago.

HPIO has updated analysis it conducted for its August COVID-19 data brief comparing COVID-19 deaths in Ohio to the leading causes of death in 2018 (the most-recent year for which complete data is available). As show in the graphic below, COVID-19 deaths now outpace causes such as Alzheimer’s disease, diabetes, influenza/pneumonia and drug overdose deaths for all of 2018.


New study pinpoints locations that are highest risk for COVID-19 spread

Re-opening full-service restaurants, gyms, hotels and religious organizations produced the most significant predicted increases in COVID-19 infections, according to a report conducted in the early stages of the pandemic (Source: “New study says restaurants and gyms are high-risk places to catch COVID-19,”, Nov. 12).

The study, published in Nature on Tuesday, used location data from mobile applications, examined data from March through May 2. It analyzed cellphone data from 98 million Americas in 10 metro areas, including Chicago and New York City.

Places of worship, gyms, and cafes were shown to be high-risk vectors for the coronavirus’s spread. The models do not pinpoint exactly where the exposure happened. Also, location data was unavailable in certain areas, such as nursing homes or schools. The model also predicted an increase in infections from hotels, sporting good stores and doctor’s offices.

Another significant takeaway from the data showed that people from lower-income areas encountered higher virus transmission rates at these venues than visitors from higher-income areas. Data showed that the average grocery store frequented by people from lower-income neighborhoods had almost 60% more hourly visitors per square foot, and their visitors stayed 17% longer on average.

CDC: Teen mental-health emergency visits climb during pandemic

The proportion of mental health-related pediatric visits to hospitals are on the rise during the coronavirus pandemic, according to a new federal analysis (Source: “CDC: Proportion of pediatric emergency room visits for mental health increased sharply amid pandemic,” The Hill, Nov. 12).

According to analysis from Centers for Disease Control and Prevention, mental health-related emergency room visits increased 31% for children between the ages of 12 and 17 from March to October compared to the same period in 2019. There was also a 24 percent increase in emergency room visits for children between the ages of 5 and 11.

The increase comes as in-person school schedules have been dramatically reduced to stem the spread of COVID-19, limiting children's interactions with peers and teachers. In addition, sports and extracurricular activities have been limited or canceled — conditions that could isolate children at home causing anxiety, depression, lack of sleep and bad eating habits. 

The CDC analyzed hospital data from 47 states that comprised about 75% of nationwide emergency room visits. One in 85 pediatric visits were mental health-related from March to October in 2019, compared to one in 60 in 2020.

Supreme Court justices signal likely support for keeping ACA

Statements made by Supreme Court justices during the latest challenge to the Affordable Care Act indicate that the law is likely to be upheld (Source: “‘Obamacare’ likely to survive, high court arguments indicate,” Associated Press, Nov. 10).

Meeting remotely a week after the election and in the midst of a pandemic that has closed their courtroom, the justices on Tuesday took on the latest Republican challenge to the Obama-era health care law, with three appointees of President Donald Trump, an outspoken critic of the law, among them.

But at least one of those Trump appointees, Justice Brett Kavanaugh, seemed likely to vote to leave the bulk of the law intact, even if he were to find the law’s now-toothless individual mandate that everyone obtain health insurance to be unconstitutional.

“It does seem fairly clear that the proper remedy would be to sever the mandate provision and leave the rest of the act in place,” Kavanaugh said.

Chief Justice John Roberts, who wrote two earlier opinions preserving the law, stated similar views, and the court’s three liberal justices are almost certain to vote to uphold the law in its entirety. That presumably would form a majority by joining a decision to cut away only the mandate, which now has no financial penalty attached to it. Congress zeroed out the penalty in 2017, but left the rest of the law untouched.

DeWine announces new leaders at Ohio Department of Health

Ohio Gov. Mike DeWine appointed Ohio Bureau of Workers' Compensation administrator Stephanie McCloud to lead the Ohio Department of Health, which has gone without a permanent director since June 11 when Dr. Amy Acton stepped down from the position (Source: “Coronavirus in Ohio: DeWine names new state health director, chief medical officer,” Cincinnati Enquirer, Nov. 5).

McCloud will take over as the state continues to break records for new COVID-19 cases heading into winter, which is expected to exacerbate the disease. DeWine previously prioritized finding a doctor with public health experience to lead the department. Now, he says, Ohio is in a different stage of fighting the disease and needs someone who can focus on administration.

DeWine also announced a new chief medical officer: Dr. Bruce Vanderhoff, who served as senior vice president and chief medical officer at OhioHealth. Lance Himes, who has served as interim director, will continue with the health department as a senior deputy. Himes will lead the coordination of distributing a vaccine and will continue to work directly with Ohio’s local health officials.

On Friday, Ohio set yet another new record with 5,008 new COVID-19 cases over the past 24 hours, breaking the previous record set the day before (Source: “Ohio reports 5,008 new COVID cases, setting a new record,” Columbus Dispatch, Nov. 6). As of Friday, 2,170 Ohioans remained hospitalized with COVID-19, also a new record. Of that, 547 patients with COVID-19 were in the intensive care unit and 280 on ventilators, according to the state. Deaths rose Friday by 33, which is more than the three-week average of 21 new deaths reported per day. So far, the virus has killed 5,494 Ohioans, according to the state.

Ohio Medicaid facing budget gap

As Medicaid enrollment increases amid the pandemic and recession, declining state revenue and a projected budget shortfall will challenge the $23 billion budget of the federal-state program, Medicaid Director Maureen Corcoran said during a virtual post-election conference (Source: “Ohio Medicaid caseload soars due to COVID-19, but now program faces budget gap of billions,” The Columbus Dispatch, Nov. 6).

Medicaid caseloads have surged during the coronavirus pandemic, topping 3 million this year, up 9%, from last year.

During a discussion on health care and Medicaid during Impact Ohio's post-election conference, Corcoran and representatives of the healthcare industry said the coronavirus has strained the system, but also spurred improvements, such as expanded telehealth services.