The week of September 8, 2020, the Medicare Payment Advisory Committee (MedPAC) produced a summary on the impact of federal funds provided to hospitals in response to the COVID-19 pandemic. Notably, MedPAC reported that the negative impact on hospital operating profits was significantly less than the American Hospital Association (AHA) estimated. According to Healthcare Dive, “[AHA] estimated the pandemic would reduce U.S. hospital operating profits by almost $51 billion in April, the month with the sharpest decline in patient volume. But MedPAC researchers estimate hospitals only lost about half that: between $20 billion and $30 billion that month.” Additionally, they note that while some facilities reported an extraordinarily high income because of increased federal aid, many cash-strapped rural facilities are continuing to plead for aid as the COVID-19 pandemic rages on in rural America.

For the second week in a row, the rates of COVID-19 infections in rural and urban areas are trending in opposite directions. According to the Daily Yonder, “The proportion of new cases generated in rural counties continued to increase as the number of new cases in metropolitan counties fell for the sixth straight week.” This disturbing trend is placing a strain on patients and providers in rural areas, and as Alan Morgan, NRHA CEO, noted in May 2020, “Unfortunately, we are now entering a phase where rural America is going to be front and center of these discussions as we go forward. The challenge is: we are moving into an area where those most in need of health care services and those that are most at risk of COVID-19 are going to be in these small towns where they have limited access to health care.”

Senate Majority Leader Mitch McConnell (R-KY) and his Republican colleagues introduced a new COVID-19 relief package. This package was even more narrow than previous GOP proposals. Notably, this package included very few health care provisions and no additional funding for the Provider Relief Fund. Leader McConnell filed cloture on this bill. The vote, which required a 60-vote threshold for passage, failed on a nearly party-line vote 52-47, with Senator Rand Paul (R-KY) being the only Republican to vote against the proposal.

As part of NIOSH’s efforts to keep stakeholders up to date on the CDC and NIOSH coronavirus disease 2019 (COVID-19) response, below is a summary of new information posted this week.

General Resources

Two New NIOSH Science Blogs are Now Available on Respiratory Protection

• The Blog, Respiratory Protection vs. Source Control – What’s the Difference?, helps readers understand the difference between respiratory protection, which protects the wearer, and source control, which protects others.
• The Blog, Supplementing the Supply of N95s With Reusable Elastomeric Half Mask Respirators, discusses the use of reusable elastomeric half mask respirators (EHMRs) as a substitute for N95 respirators. This comes as organizations rely on other types of respiratory protection due to the high demand and limited supply of N95 respirators during the COVID-19 pandemic.

Industry-Specific Resources

Update to Wildland Firefighter FAQs   

Updates to the Wildland Firefighter FAQs webpage address new concerns, clarify that testing recommendations are relevant to prevent infection and the spread of COVID-19 regardless of test result or exposures, and update the screening terminology to be consistent across the CDC website.

Limiting Workplace Violence Infographic Translated

The webpage Limiting Workplace Violence Associated With COVID-19 Prevention Policies in Retail and Services Businesses has a newly translated infographic. “Basic dos and don’ts for EMPLOYEES to prevent workplace violence” has been translated into eight languages: Chinese, Korean, Vietnamese, French, Haitian-Creole, Portuguese, Spanish, and Russian.

New Fact Sheets

CDC recently published fact sheets for two additional groups that provide suggestions for preventing the spread of COVID-19

• Hotel, resort, and lodge employees and employers
• Paratransit operator employees and employers

The Advisory Committee on Immunization Practices updated its recommendations for prevention and control of seasonal flu with vaccines for the 2020-2021 flu season. Influenza vaccination of persons aged ≥6 months to reduce prevalence of illness caused by influenza will reduce symptoms that might be confused with those of COVID-19. See CDC’s interim guidance for immunization services during the COVID-19 pandemic.

The U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH) will host a virtual symposium, Advancing the Response to COVID-19: Sharing Promising Programs and Practices for Racial and Ethnic Minority Communities, to highlight state, tribal, territorial and community-based efforts addressing COVID-19 among racial and ethnic minority populations. The event is on Thurs., Sept. 17, 2020, 12:00 – 6:00 pm. Register here. Learn more here.

The National Institute of Health (NIH) National Institute of Allergy and Infectious Diseases (NIAID) has formed the COVID-19 Prevention Network to respond to the global pandemic. The COVID-19 Prevention Network is now enlisting volunteers to participate in clinical trials. Health centers can encourage participation by talking with patients and pointing them to reliable information about clinical trials. The COVID-19 Prevention Network’s website includes:

• Definitions of terms like “clinical study” and descriptions of available clinical studies
• A map of clinical trial locations across the nation
• Frequently Asked Questions (FAQs)
• A volunteer sign-up portal

FQHCs are encouraged to share these resources with their patients and encourage them to consider joining a nearby trial.

The Trump administration said it will not join a global effort to develop, manufacture and equitably distribute a coronavirus vaccine, in part because the World Health Organization is involved, a decision that could shape the course of the pandemic and the country’s role in health diplomacy. More than 170 countries are in talks to participate in the COVID-19 Vaccines Global Access (Covax) Facility, which aims to speed vaccine development, secure doses for all countries and distribute them to the most high-risk segment of each population.

Relying on a public health law intended to prevent the spread of an illness, the Trump administration said it is extending a national moratorium on residential evictions. The moratorium, announced by the Centers for Disease Control and Prevention, was the latest measure by the administration to get a handle on the economic fallout from the coronavirus pandemic absent an agreement with Congress on a more far reaching package that would have the force of law. The moratorium, which will extend through Dec. 31, applies to individuals making $99,000 or less a year and who are unable to make rent or housing payments.