Is The Possible V-Shaped Recovery Flattening As The Second Quarter Comes To An End?

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Coronavirus dashboard for June 22: a pandemic newly focused on the young appears to be changing the dynamics

Confirmed US coronavirus infections: 2,280,969
Confirmed US coronavirus deaths: 119,977

The 7 day average of new infections in the US has risen 30% from its low of 20,357 on June 9 to 26,546 yesterday:

On a per capita basis, US infections are now roughly 4x those in Europe:

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Coronavirus dashboard for June 19: infections and hospitalizations have increased; it may be too late for Arizona

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Do BLM Protests Prove No More Pandemic?

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Coronavirus dashboard for June 17: the second wave of the tsunami comes ashore

As of yesterday, there were 2,137,731 total documented coronavirus infections in the US. Total known deaths were 116,963.

As I have stated several times in the past month, I believe that coronavirus infections and deaths will wax and wane around the April-May plateau of roughly 20-25,000 new daily infections and 500-2000 daily deaths, at least as long as Trump remains President. This is because, absent competent Federal leadership, the US lacks the political and social will to do what is necessary – distancing + mask-wearing + tracing – in order to “crush the curve” as almost every other industrialized European and Asian country has been able to do.

The current situation in the US is divided by region. In the early hard-hit areas of the Northeast and Midwest, effective measures were put in place and have been relaxed more gradually. As a result, the infection rates there have continued to decline. By contrast, in the Confederacy, the High Plains, and the Southwest, lockdowns were put in place late if at all and lifted early without any meaningful restrictions. As a result infection rates have begun to rise, in a few States at an exponential rate.

Yesterday the COVID Tracking Project finally released graphs for each region per capita, shown below:

In the Northeast and Midwest, the 7 day moving average of new infections has fallen to roughly 40 and 45 per million, respectively. In the South and West, it has risen to 89 and 76 per million, respectively.

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Just in case, you missed it,  Medicaid Eligibility Is Based On Current Monthly Income. Still do not understand? Let me try a different way to explain it, Medicaid Eligibility Is Based On Current Monthly Income.

There, I have said it three times –  once in the title and twice in the beginning text of this post. And yet people will not apply because it is something others do or they are easily discouraged or the information is hidden. If you are laid off and have no income, you could qualify for Medicaid regardless if you are collecting unemployment or received the extra $600 (not counted in calculation) or made good money beforehand. For Medicaid, you or you and your family still must be below 138% FPL in Expansion states or 100% FPL in non-Expansion states.

In an Urban Institute base scenario estimate of 20 percent unemployment; ~ 25 million people will lose ESI coverage. Of the 25 million; 12 million could gain Medicaid coverage, 6 million could gain ACA Marketplace coverage or other private coverage, and 7 million could become uninsured. What is important to understand is if you lose your current monthly income, you could qualify for Medicaid in a Medicaid expansion and non expansion states.

Some detail:

By visiting the home page of any ACA exchange, you will find the exchanges were conceived as a market place for private plans. This creates an impression it is what everyone wants, will seek, and easily find. The sites are hiding another product that two thirds of “customers” could and should end up “buying (almost free)” called Medicaid. Those who fill out an application will be routed to Medicaid if eligible and if they accurately report current monthly income and not annual income. Due to misdirection, many visitors to the exchanges may never get to the Medicaid area. Other than lack of emphasis on Medicaid, or failure to post the eligibility criteria, ACA Healthcare exchange messaging and structure can cause people to miss their Medicaid eligibility in at least two ways.

The extra $600/week in unemployment benefits provided by the CARES Act causes some to include that extra income in their income estimate. For ACA Healthcare marketplace coverage this is correct; however, for Medicaid  –  the Cares Act extra $600 does not count in qualifying for Medicaid coverage. The Maryland exchange has a page that does a nice job explaining how to handle this on the actual application:  add the $600 to the annual income estimate (ACA) , but not to the monthly income estimate (Medicaid). You have to get to this page first and decide if applying is worthwhile. The screening tool, unlike the application, does not ask for monthly as well as annual income and it may mislead. This is a problem.

The second problem is information about Special Enrollment Periods (SEPs) are relevant to the ACA marketplace coverage but not Medicaid. You have a specified 60 day period of time in which to enroll for ACA coverage after losing your job (not Medicaid). The message “Uninsured Marylanders (example) can enroll for ACA coverage by June 15” does not specify the ACA marketplace and excludes Medicaid (as it should).  Medicaid enrollment is available year-round.

States need to emphasize Medicaid enrollment more as many who are unemployed due to Covid would qualify. Make sure you visit xpostfactoid blog as Andrew expands on this topic. Also rather than going to the ACA healthcare sites, one could go to the state Medicaid sites directly and enroll.

What is Not Found on ACA Exchanges, xpostfactoid, June 14, 2020

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Abbreviated Coronavirus dashboard for June 15: tracking the four horsemen of the reopening apocalypse

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On June 12, 2016, Omar Mateen murdered forty-nine people in a gay night club located in Orlando, Florida in what was to be identified as the Pulse massacre.  Four years later June 12, 2020; the  Office for Civil Rights (OCR) of the Department of Health and Human Services (HHS) issued a new final rule to dramatically revise the agency’s prior interpretation of Section 1557 of the Affordable Care Act (ACA), the law’s primary anti-discrimination provision. The new rule removes protections against discrimination based on sex stereotyping and gender identity afforded by the 2016 rule and allows for discrimination.

This is a purposeful and vindictive move on the anniversary of the Pulse massacre by the Administration to openly discriminate.

Background since 2016

Detail as taken from Harvard Law Review Blog beyond the leap . . .

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Coronavirus dashboard for June 12: the costs of recklessly reopening begin to come due

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Author of Two Retracted COVID-19 Studies Once Bemoaned Misconduct

The Lancet retracted a controversial “observational study” on the use of hydroxychloroquine or chloroquine with or without antibiotics or zinc in the treatment of COVID-19. The retraction came after scientists, doctors, etc.  raised questions about the data used to draw the the study’s conclusions.   The authors were not able to access and vouch for the underlying data, which came from the company Surgisphere. The New England Journal of Medicine also retracted a similar paper that drew on the same Surgisphere’s proprietary database of global hospital medical records. This action came after it had asked the authors to provide evidence that the data was reliable.

Surgisphere’s CEO, coauthored both papers.

What appears to have happened is Surgisphere data-mined the data from a multiple hospital data bases which lead to its findings. Data mining is a common process used to extract usable  data  from a larger set of any raw data.

To get to the source and use of the data in the observational study, The Lancet‘s editor-in-chief posted on May 28 an open letter  to the authors citing 10 concerns with it. Identifying themselves (letter’s authors) as “clinicians, medical researchers, statisticians, and ethicists from across the world; the signatories” claim the researchers failed to sufficiently identify factors which may have influenced their results such as disease severity, dosage used, lack of ethics review, and errors in the underlying database. This is nothing that has not been pointed out before and ignored by others touting other potential drugs.

Interesting enough, Surgisphere’s CEO and a coauthor of the study had written an earlier publication warning against research misconduct .

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