CMS calls for gradual return to elective procedures: 6 national COVID-19 updates

The U.S. has reported 760,245 COVID-19 cases and 40,702 related deaths as of 10 a.m. CDT April 20. Worldwide, 2,424,419 COVID-19 cases and 166,256 deaths have been confirmed, while 635,895 patients have recovered. 

Six updates: 

1. CMS on April 19 shared recommendations on restarting essential healthcare services. The guidelines are intended for healthcare organizations in areas with low or stable levels of COVID-19. CMS previously recommended hospitals limit nonessential surgeries and medical procedures during the pandemic. The new guidelines encourage a gradual transition back to these services in which healthcare leaders collaborate with local and state public health officials. Hospitals should also assess their supply levels, workforce availability, facility readiness and testing capacity when deciding when to resume or ramp up in-person care.

"Today, some areas of the country are experiencing fewer cases and lower incidence of the virus, necessitating a more tailored and flexible approach," CMS Administrator Seema Verma, said in a press release. "Every state and local official will need to assess the situation on the ground to determine the best course forward, but these guidelines provide a gradual process for restarting non-COVID-19 essential care while keeping patients safe."

2. The White House plans to invoke the Defense Production Act to increase testing swab production, President Donald Trump said during an April 19 media briefing. The DPA will compel an unnamed company to increase production at a single U.S. facility by more than 20 million swabs per month. The White House is also close to finalizing a second partnership with a manufacturer that will produce more than 10 million swabs per month, President Trump said.

3. CDC violated its own manufacturing standards, contaminating some of the nation's first COVID-19 tests, rendering them ineffective, according to The New York Times. The CDC sent tests that didn't work to nearly all state and local public health labs after two of three Atlanta CDC sites violated test kit development standards, the FDA said April 18. 

The FDA announced issues with certain CDC test components on March 1, but did not publicly detail the problem. Now, officials say researchers entered and exited labs without changing coats to test ingredients in the same room positive coronavirus samples were worked on. Such practices contaminated the tests with the virus and produced some inconclusive results. Following these issues, the CDC suspended COVID-19 testing kit development for a month. 

4. CMS is rolling out new reporting requirements for nursing homes, CMS Administrator Seema Verma said April 19 during the daily White House news briefing. Ms. Verma said nursing homes must report COVID-19 cases at the facility to patients, their families and directly to the CDC. The Federal Emergency Management Agency is also working to provide more supplies for nursing homes, according to Ms. Verma. The push for transparency follows an analysis by The New York Times that reported about 20 percent of known COVID-19 deaths in the U.S. have been tied to nursing homes, about 7,000 deaths.  

5. Some health experts are questioning the reliability of new antibody tests rolled out this month, according to The New York Times. After facing criticism over the slow rollout of COVID-19 diagnostic tests, the FDA quickly permitted about 90 companies, many of which are based in China, to sell antibody tests that have not undergone formal review. The FDA has since warned that some companies have made false claims about their products, or that the tests themselves are flawed. Confusion about how to use the tests has also led some healthcare providers to administer the tests without proper authorization or misuse them to diagnose COVID-19, according to NYT.

6. New York will begin antibody testing for thousands of residents this week, Gov. Andrew Cuomo said April 19, according to Politico. It will be the first state in the U.S. to conduct COVID-19 antibody testing on such a large scale with about 2,000 tests expected to be conducted per day. The effort is still not enough to screen New York's 9 million person workforce and 19 million residential population, Mr. Cuomo said, though the tests will offer "the first true snapshot" of the state's exposure to COVID-19. 


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