Tag Archives: pandemic

Primary Care Assn Objects to Ochsner Expansion Plans

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In a November 24 press release, officials at the Louisiana Primary Care Association asked that citizens take a stand and decline to “reinvent the wheel” and to support Louisiana’s federally qualified health centers.

“Earlier this month, we learned that Ochsner Health intends to re-invent the wheel and spearhead a new $100 million initiative to build 15 ‘health centers’ in underserved communities over the next five years,” said the officials.

“While Ochsner Health and other corporate, profitdriven entities describe themselves as pioneers in this space, the reality is that Community Health Centers have been on the ground serving the people of Louisiana for decades. While we are heartened to see their new commitment to primary and preventive care for these populations, we wish
Ochsner Health would have focused more on partnership, engaging in collaboration, and strengthening the ongoing work of our members.

“Ochsner Health plans to construct ‘health centers’ in areas in which there are a large number of Community Health Centers already operating and serving patients. In the Greater New Orleans region alone, there are 72 Community Health Centers operated by 15 different organizations.

“If you want to address health inequities and improve the health of our citizens all while providing affordable and accessible care, look no further than our Community Health Center network. Our health center members are battle-tested and proven leaders in meeting the needs of these communities. Since Hurricane Katrina in 2005 (and over the past few years with the advent of Medicaid expansion), Louisiana’s Community Health Center network has grown exponentially. Health centers are now located in 55 of Louisiana’s 64 parishes.

“These facilities save taxpayer money by keeping patients out of the emergency room and focusing on the need for primary and preventive care. In fact, in 2019 Louisiana’s Community Health Centers saved our healthcare system nearly $900 million,” authors
wrote.

“Health Centers are also woven deeply into the communities they serve,” and “are held to the most rigorous standards of care, patient safety, transparency, and financial
responsibility,” the Association officials said.

Return to Phase 2 for December Says Governor After Cases Rise

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Last week Gov. Edwards announced that the aggressive third surge of COVID-19 across
all regions of Louisiana has made it necessary to impose tighter mitigation measures and step back to Phase 2 in order to protect public health. The Governor intends to keep these restrictions in place at least through the end of the year.

A November 12 ruling by Judge William Morvant in the 19th Judicial District Court, found that a petition filed by some Republican members of the Louisiana House of Representatives to overturn the Governor’s COVID mitigation strategies, was moot and that the law used to submit it was unconstitutional.

The Governor’s updated Phase 2 proclamation calls for reducing occupancy at some businesses, decreasing gathering sizes, limiting indoor consumption at many bars and urges everyone in Louisiana to avoid gatherings with people outside of their everyday
households.

Louisiana’s statewide mask mandate, which has been in place since mid-July, will continue. In addition, Gov. Edwards encourages any business that can allow its employees to work remotely to do so. He has directed all state agencies to do the same.

“There is not a single region of our state that is not seeing increases in new cases, hospitalizations and growing positivity of COVID tests, and I am incredibly concerned by
Louisiana’s trajectory and our ability to continue to deliver health care to our people if our hospitals are overrun with sick patients,” Gov. Edwards said.

“The data clearly tells us that we have lost all of the gains we had made and that our current mitigation efforts must be increased in order to adequately slow the spread.

On November 20, the Gov. sent a letter to newspapers statewide and released a video
urging all Louisianans to take COVID-19 seriously this holiday season as Louisiana
enters its third surge with increasing cases of coronavirus and hospitalizations.

“Healthcare workers in hospitals across Louisiana are extremely worried about their
staffing and capacity levels not being able to keep up with the growing number of citizens being diagnosed with COVID-19 and being hospitalized. They need us all to do our part to slow the spread,” said Gov. Edwards. “This third surge we are experiencing is worse than the others, and it is so concerning that the Centers for Disease Control has asked that all holiday travel plans be canceled. This year’s holiday celebrations should not look like those from last year. The risk is too great. I know that we want to be together for the holidays, but we need to protect each other and make the sacrifices now so that we can come together when it is much safer.”

Major changes to Louisiana’s COVID-19 restrictions include:

All Louisianans are encouraged to avoid gatherings of individuals not part of their households.
All businesses, private and public sectors, are encouraged to use remote work where
they can.
All restaurants are limited to 50% of their indoor capacity. Restaurants should move as
much dining outdoors as they can. Social distancing is required.
Places of worship will remain at a maximum of 75% of their capacity or the number of
people who can physically distance with at least six feet between each immediate
household.
Barber and beauty shops, and nail salons may open at 50% of their capacity.
Movie theaters may open at 50% of their capacity.
Indoor gatherings at event/receptions centers are limited to 25% capacity or up to 75
individuals.
Outdoor gatherings at event/reception centers are limited to 25% capacity or up to 150
individuals when strict physical distancing is not possible.
All sporting events will be capped at 25% capacity.

For complete guidance on the new Phase 2, visit the Open Safely portal
at opensafely.la.gov.

NPR: Studies Showing Drop in Death Rate for Covid-19

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In an October 20 report, NPR’s All Things Considered said that two peer-reviewed studies showed a sharp drop in mortality among hospitalized COVID-19 patients, said NPR.

The drop is seen in all groups, including older patients and those with underlying conditions. One conclusion is that physicians are getting better at helping patients survive their illness.

“We find that the death rate has gone down substantially,” says Leora Horwitz, a doctor who studies population health at New York University’s Grossman School of Medicine and an author on one of the studies, which looked at thousands of patients from March to August.

In one study, which was of a single health system, mortality dropped among hospitalized patients by 18 percentage points. Patients in the study had a 25.6% chance of dying at the start of the pandemic. Now they have a 7.6% chance.

But 7.6% is still a high risk compared with other diseases, and Horwitz and other researchers caution that COVID-19 remains dangerous.

The death rate “is still higher than many infectious diseases, including the flu,” Horwitz says. And he warned that it is a harmful disease.

Amends Phase 3 Order Governor Files Lawsuit to Defend His Covid Measures

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On October 26, Gov. John Bel Edwards filed a lawsuit in state court defending his COVID-19 public health emergency proclamation, which has been challenged by a group of members of the House of Representatives.

The Governor’s lawsuit asks the 19th Judicial District Court in Baton Rouge to declare a section of the law used by some members of the Louisiana House of Representatives to attempt to overrule his public health emergency order by petition unconstitutional. The
Gov. also says the petition was improperly filed because the Legislature did not consult the public health authority, the Louisiana Department of Health.

“In addition to the fact that getting rid of the mitigation measures that have proven to slow the spread of COVID and save lives is reckless and dangerous, the law being used
blatantly unconstitutional. Louisiana’s Constitution doesn’t allow only one chamber of the Legislature to overturn a public health emergency, and, even if it did, the petitioners did not properly consult the public health experts from the Louisiana Department of Health,” Gov. Edwards said.

On October 22, Gov. Edwards amended his Phase 3 order for outdoor high school sports by allowing outdoor stadiums in parishes with lower rates of positive COVID tests to move to 50 percent capacity, up from 25 percent.

To be eligible, parishes must have percent positivity of less than five percent for two consecutive weeks based on the most recent report from the Louisiana Dept. of Health, which is updated weekly on Wednesdays.

According to the press release, this is very similar to the approach Gov. Edwards has taken with reopening bars, however schools, districts or local governments will not have to opt-in. As with bars, if a parish’s percent positivity reaches more than 10 percent for two weeks, the parish must return to the 25 percent capacity limit. The new order became effective Friday, October 23, 2020.

“After meeting with the leaders of both the House and Senate and considering their requests, I have agreed to make this change in a way that is safe, reasonable and will help more fans enjoy seeing their favorite teams play,” said Gov. Edwards.

“Using the percent positivity as the guide is important because it helps to determine the rate of community spread, which is the safest, most responsible and consistent way to
move forward.”

“Fortunately, Louisiana is not seeing the spike in cases like other parts of the country, a clear sign that our mitigation measures, which align with the White House Coronavirus Task Force, are working. In order for that to continue, we must continue doing those things that are having a positive impact and that we know work even as we expand our activities.”

There are currently 26 parishes that are eligible to participate: Assumption, Avoyelles, Catahoula, East Baton Rouge, East Feliciana, Evangeline, Grant, Iberia, Iberville, Jefferson, Lafayette, Madison, Orleans, Rapides, St. Bernard, St. Charles, St. James, St.
John the Baptist, St. Landry, St. Martin, St. Mary, St. Tammany, Terrebonne, Vermilion, West Feliciana and Winn.

Prior to this change, the capacity for sports stadiums, arenas and athletic events was limited to 25 percent. This change does not apply to any college, professional or indoor sports.

The current Phase 3 order expires on November 6.

KFF Finds 53% of US Adults Stressed by Coronavirus & Economic ConcernsUntitled

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The COVID-19 pandemic and the resulting many people’s mental health and created new barriers for people already suffering from mental illness and substance use disorders,” report authors at the Kaiser family foundation (KFF).

The research team was led by Nirmita Panchal, collected data in July. They found that 53% of US adults said that their mental health has been negatively impacted due to worry and stress over the coronavirus. Researchers noted that this was significantly higher than the 32% they found in March 2020.”

Many adults are also reporting specific negative impacts on their mental health and wellbeing, such as difficulty sleeping (36%) or eating (32%), increases in alcohol consumption or substance use (12%), and worsening chronic conditions (12%), due to worry and stress over the coronavirus.”

Authors concluded that, “As the pandemic wears on, ongoing and necessary public health measures expose many people to experiencing situations linked to poor mental health outcomes, such as isolation and job loss.”

The researcher cited other conclusions noting that research links social isolation and loneliness to poor mental health. The data from late March shows that “significantly higher shares of people who were sheltering in place (47%) reported negative mental health effects resulting from worry or stress related to coronavirus than among those not sheltering-in-place (37%).”

“In particular, isolation and loneliness during the pandemic may present specific mental health risks for households with adolescents and for older adults. The share of older adults (ages 65 and up) reporting negative mental health impacts has increased since March. Polling data shows that women with children under the age of 18 are more likely to report major negative mental health impacts than their male counterparts.”

Authors also point out that job loss is associated with increased depression, anxiety, and low self-esteem. These problems may lead to higher rates of substance use disorder and suicide. “… data shows that more than half of the people who lost income or employment reported negative mental health impacts from worry or stress over coronavirus; and lower income people report higher rates of major negative mental health impacts compared to higher income people,” noted the KFF researchers.

“Prior to the COVID-19 pandemic, nearly one in five of U.S. adults (47 million) reported having a mental illness in the past year, and over 11 million had a serious mental illness, which frequently results in functional impairment and limits life activities. In 2017-2018, more than 17 million adults and an additional three million adolescents had a major depressive episode in the past year.

“Deaths due to drug overdose have increased more than threefold over the past 19 years (from 6.1 deaths per 100,000 people in 1999 to 20.7 deaths per 100,000 people in 2018).

In 2018, over 48,000 Americans died by suicide, and in 2017-2018, nearly eleven million adults (4.3%) reported having serious thoughts of suicide in the past year.

The authors state that during this unprecedented pandemic, it is reasonable to predict that mental health issues and substance abuse are exacerbated.

Legislature Calls Itself into Session

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The Louisiana legislature called themselves into a special session that began on September 28 and which will end by October 27. The September 21 Proclamation lists 70 topics to be addressed, including items for replenishing Louisiana’s Unemployment Trust Fund, addressing COVID-19 recovery efforts, supporting communities impacted by Hurricane Laura, and possible funding of certain devastated school systems.

However, at the top of the list are items about the expanded powers of government under emergency conditions.

The first topic relates to “…legislative procedures, powers, duties, and authority pursuant to the Louisiana Health Emergency Powers Act…” The second item refers to ” … the power and authority of executive branch officers and agencies.”

Gov. Edwards immediately voiced his concerns in a September 21 statement.

“At a time when our state is dealing with the COVID-19 health emergency, hurricanes,
and one severe weather event after another, I am concerned that the Legislature has
again called themselves into a month-long session with an agenda of 70 items. This
session will occur at a time when the public will again be restricted in their access to the
State Capitol and their ability to give needed public input.

“From the beginning of this emergency, I have relied on public health experts and the
White House Coronavirus Task Force to guide Louisiana’s response to this historic
emergency. Further, this response has been in line with the measures taken by our
neighboring states that have unfortunately also been enormously impacted by COVID19.

“Put simply, the measures we have taken in Louisiana are working and we are making
significant progress. However, to abandon these efforts in defiance of the unanimous
advice of the public health experts and the Trump administration would seriously
jeopardize the lives of our people and the gains we have made. Further, it is important
to remember our work in containing COVID19 is far from done, as Louisiana still has the
highest number of per capita infections in the country.

“I am hopeful that the Legislative leadership will significantly narrow the scope and the
duration of this session so that they can do the work they deem necessary, while at the
same time working in a bipartisan and cooperative manner to address our
significant challenges in an honest and transparent manner. Louisianans have come
too far to have all of our effective and lifesaving work upended.”

In a September 28 editorial, The Advocate warned, “As with some of the other
budgetary items on the expansive menu, it’s too soon to say if the body can make
intelligent decisions when so many things, really almost everything, is in flux.

“Further, legislators should remind themselves that interfering with the complex
machinery of emergency declarations means that lawmakers will be taking responsibility upon themselves, individually and as a body, in a situation where there is no pleasant alternative, only a choice among bad options.”

Regarding the special session, proposed measures have been submitted and are being reviewed this month. The Louisiana State Board of Examiners of Psychologists did not submit a new copy of their legislation, which they proposed earlier this year in the
regular session. Sources indicate that the board is working on that legislation for 2021.

Very few bills have to do with psychology since the topics for the session are narrowed
to emergency events. However, House Bill 33 and Senate Bill 12, which are duplicates,
relate to emergency counseling in healthcare facilities.

Present law defines “mental health support personnel” to include psychiatrists, psychologists, social workers, and volunteer crisis counseling groups.

The proposed law provides that the Louisiana Department of Health may include the availability of no-cost or reduced-cost counseling or mental health support services offered by members of the clergy, religious organizations, or other nonprofit organizations when providing information about and referrals to mental health support personnel to address the psychological responses to the public health emergency.

The proposed law requires that, during the COVID-19 public health emergency or any
other contagious or infectious disease for which a state of public health emergency
has been declared, an inpatient healthcare facility provide patient or resident access
to members of the clergy for prayer, mental health support or religious counseling, the sacraments of Holy Communion, Anointing of the Sick, and Last Rites, and other such customary religious services that would normally be offered to patients or residents if the healthcare facility was not subject to a declaration of a state of public health
emergency.

Gov Edwards Signs State Budget

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State Agency Heads Directed to Prepare for Possible Mid-Year Budget Cuts
Gov. Edwards Signs State Budget to Preserve Critical Funding During the Covid-19 Pandemic

Baton Rouge – On July 8, Gov. John Bel Edwards announced that he has signed the
state’s budget for the FY 20-21 operating year, preserving funding for critical health
care, workforce and education services that are needed during the pandemic, especially
as new COVID-19 cases rise again as school systems prepare to return to campus
in the fall, according to the press release from the Governor’s office.

Additionally, the Governor Edwards has ordered cabinet agencies to prepare for possible mid-year budget cuts by sequestering at least 10 percent of their budgets, which he also recommends for the judicial and legislative branches.

He will also issue an executive order to freeze hiring of state employees.

“Right now our budget is in a far better shape than we could have hoped just three
months ago, with funding for critical services in place as we continue to respond to the
COVID-19 pandemic and see case counts as well as hospitalizations rising,” he said.

“I have directed state agencies to prepare for possible mid-year cuts and, we will continue working with the Legislature to make any adjustments that may be necessary this fall,” Gov. Edwards said. “While there are cuts in the budget, federal CARES act funding allowed us to avoid making them even more catastrophic. In addition, we were able to invest CARES act funding into programs for local governments, aid to businesses and direct payments to essential front line workers.”

The Governor also vetoed language that cancelled meritr aises for classified state employees

Gov. Edwards vetoed a provision that impermissibly delayed pay raises for classified state employees and other provisions that sequestered funds appropriated to the executive branch, but not funds appropriated to the legislative and judicial branches.
He also vetoed more than $9 million in
new spending, as well as a provision
contrary to Centers for Medicare and
Medicaid Services guidelines that would
negatively impact the Louisiana
Department of Health and require the
expenditure of more than $10 million of
state general fund plus $32 million of
federal funds.

Cases Rise, Governor Extends Phase Two

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Cases Rise, Governor Extends Phase Two

On July 23, Gov. Edwards signed orders and extending Phase Two and the Statewide Mask Mandate as Louisiana surpassed 100,000 known COVID-19 cases.

State officials put out a graphic highlighting the fact that Louisiana was first in the
nation based on a July 26 high of 3,840 new cases.

The Gov. Edwards signed a renewal of the current proclamation extending Phase Two
in the state, which includes the statewide mask mandate and additional restrictions,
until August 7.

“Today, we are reporting 2,408 new cases, which means that the state has now
surpassed 100,00 total cases. And of course, these are only the cases we know about. There are undoubtedly more,” Gov. Edwards said. “When you hit a milestone like
this one and when you see death totals that are higher than they’ve been in months, as we did yesterday, it’s a reality check.”

“For anyone out there minimizing the seriousness of this situation, you are doing
yourself and this state a terrible disservice. The same is true for anyone questioning the validity of the data that we’re using and releasing every day,” Gov. Edwards said. “COVID-19 is very prevalent throughout our state, and it is more widespread than ever before. We are certainly not where we want to be in Louisiana. I’ve extended Phase 2 with the mask mandate and other restrictions, but we are perilously close to having to make tough decisions that no one wants. This is why we have to follow the mitigation measures that are in place. We have to wear our masks, keep social distance, wash
our hands frequently and stay home when we are feeling sick.”

The statewide mask mandate applies to all 64 parishes in Louisiana. However, parishes with a COVID-19 incidence of fewer than 100 cases per 100,000 people for the most recent two week period for which data is available can choose to opt out of the mandate. Under the state’s policy, parish presidents in parishes with lower incidence rates do not have to opt out and may choose to keep a mask mandate in place.

The Louisiana Department of Health updates its incidence data every other week and at the time of the announcement, no Louisiana parish meets the standard to opt out of the current mask mandate.

The order requires face coverings for everyone ages 8 and older except for the following

Anyone who has a medical condition that prevents the wearing of a face covering
Anyone who is consuming a drink or food
Anyone who is trying to communicate with a person who is hearing impaired
Anyone who is giving a speech for broadcast or to an audience
Anyone temporarily removing his or her face covering for identification purposes
Anyone who is a resident of a parish without a high COVID incidence that has opted out of the masking mandate
Masks are strongly recommended for children
ages 2 to 7.

All bars, including those with food permits from the Louisiana Department of Health, will be closed to on-premises consumption. They can operate for curbside takeout or delivery service only.

The order also limits the size of social gatherings to 50 people indoors. Outdoor
social gatherings are also limited to 50 people if individuals cannot avoid being within six feet of one another.

Experts warn of a mental health crisis due to the impact of Covid-19.

According to a report by ABC News, authored by Alexis Carrington, the impact of Covid-19 could include 20 additional firearm-related suicides per day.

In the July 7 report, the author wrote that a new study has found that there may be a 20 to 30% increase in firearms suicides due to the mental health impact of Covid.

“The uncertainty brought on by the pandemic has been impacting people’s mental health and increasing feelings of anxiety and depression. The pandemic has also led to
increases in gun purchases with an estimated 1.9 million additional guns sold during March and April 2020 compared to the same time period last year. Having access to a firearm in the home triples the risk of death by suicide.”

“The study comes from the research arm of Everytown for Gun Safety, a non profit
organization which advocates for gun control. Rearchers at Everytown looked back at prior crises that led to massive unemployment, including the Great Depression of the 1930s and the Great Recession that ended in 2010.”