06Jun

We interrupt all the bad news about COVID with this from the Institute for Health Metrics and Evaluation: surviving the virus has improved dramatically since the early days of the pandemic.

The likelihood of someone dying from COVID-19 has declined by a third.

In an interview with Reuters news agency, IHME Director Dr. Christopher Murray said 0.6% of those infected with the virus die, compared to 0.9% last spring. Improvements in treatment, including the use of blood thinners, oxygen and the generic steroid dexamethasone are a large part of the reason for the decline, he said.

Two research studies of patients in New York and in the UK bear out the positive news, finding sharp decreases in mortality.

Published last month in the Journal of Hospital Medicine, the New York City study found an 18% decline in COVID deaths since March among 5,121 hospitalizations.

second study released just recently found a 20% decrease in mortality among hospitalized patients in England in June compared to the beginning of the pandemic in April.

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“I would classify this as a silver lining to what has been quite a hard time for many people,” Bilal Mateen, a data science fellow at the Alan Turing Institute in the United Kingdom, told NPR.

Leora Horwitz, M.D., an author of the New York City study, echoed those findings. “We find that the death rate has gone down substantially,” she told NPR. “I do think this is good news,” she said, adding, “but it does not make the coronavirus a benign illness.”

The Institute of Health Metrics and Evaluation, based at the University of Washington, cautions that with the advancing winter months, it expects the infection rate globally to increase to 4 million new cases a day. It estimates daily deaths will reach over 15,000 a day in mid-January declining to under 13,000 by March 1.

“If universal mask coverage (95%) were attained [by last week], our model projects 571,000 lives could be saved by March 1, 2021,” the Institute said in its weekly global report.

Specifically in the United States, another Institute report predicts “daily deaths to reach 2,200 in mid-January and slowly decline to 1,750 on March 1… we expect daily infections to reach 325,000 by early January.”

Estimating national mask use at 67% — lower than many other organizations have found – the IHME report projects the US could save 68,000 lives by March 1 if 95% of the population wore masks.

CDC report released at the end of October said that as of June, 88.7% of the US population wore masks. Even among the youngest group surveyed, those 18-29, 86.1% wore masks.

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Green Key
Jun 6, 2023

Hiring In Health Home Care Is As Tough As Ever

Far from becoming an employer market, hiring home health care workers is as hard as ever, industry executives say.

In SeptemberHome Health Care News said industry jobs posted on Indeed were trending down, suggesting “home health and home care agencies simply aren’t looking to fill as many positions.” With the national unemployment rate at 8.4% in August and fewer jobs to fill, agencies would have an easier time recruiting.

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Even then, some agency leaders felt differently.

“I think we have to respectfully disagree with that point, because it is challenging for us to find caregivers — and very challenging for us also finding the right one,” Ryan Iwamoto, the president and co-founder of 24 Hour Home Care, said in September. “That has been probably the biggest challenge that we’ve had.”

Now, an October survey by myCNAjobs found 57% of 281 participating home health care agencies admitting they are struggling with recruiting staff. Only 5% maintain they are doing well.

Despite a still high unemployment rate, hiring workers has become so much a challenge that 71% of the agencies report turning down business because they didn’t have the staff.

One important reason for the recruiting difficulty, according to 87% of the agencies, is COVID. 72% said the pandemic has also made retention and scheduling more difficult.

Just getting people to apply for a job is difficult. Almost 3 in 10 agencies say they get too few applicants; 23% say they can’t get applicants to call them back. And 35% say when an interview is scheduled, the candidates simply don’t show up.

That’s lead the industry to try bold new recruiting methods and experiment with flexibility in requirements and scheduling for their workers.

“COVID will reshape the labor market in many industries for quite some time,” said Brandi Kurtyka, the CEO of myCNAjobs, speaking at the online conference of the Home Care Association of America last month.

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That’s already the case at Alternate Solutions Health Network, one of the largest operators in the country.

Amy Smith, corporate VP of revenue cycles, told Home Health Care News that Alternate Solutions courts restaurant workers. After bringing several on staff, the company discovered their experience in the busy, customer-focused food service environment taught them how to multitask effectively.

Instead of leaning toward candidates with health care experience, the company now looks more for candidates able to multitask, undaunted by the need to “start, pause, start something else, pause, and go back to something that was started weeks ago.”

Photo by Zach Vessels on Unsplash

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Green Key
Jun 6, 2023

Dog Study Could Lead to Help For Humans with Sports Injuries

Osteoarthritis of the knee is a common condition in humans and in their canine companions. An estimated 20% of dogs older than a year and 12% of people between 25 and 74 will develop the condition.

The causes and mechanisms are not well understood, however age and weight are considered major risk factors.

Injuries also lead to developing the disease. In fact one of the most common of all sports injuries in humans as well as dogs – a tear of the anterior cruciate ligament — is the leading cause of post traumatic osteoarthritis.

The mystery is why many, but not all, dogs and people with ACL injuries develop post traumatic osteoarthritis, medically referred to as PTOA. Now, a study of dogs at Cornell University’s veterinary school, published this month in Scientific Reports, offers clues to the potential for developing PTOA.

Researchers led by Dr. Heidi Reesink, assistant professor in equine health at Cornell, found that changes in the production of lubricin, a joint lubricating protein, could be a precursor to developing joint disease.

Lubricin is critical to smooth joint functioning. “We know that if a person or animal doesn’t make that protein, they will develop devastating joint disease affecting all the major weight-bearing joints,” says Reesink.

The prevailing view among veterinarians and physicians is that lubricin production declines after injury, leading to the development of PTOA. “The dogma in this field has been that lubricin decreases in joint disease,” Reesink said.

But the study found that in canine patients with a knee ligament tear lubricin increased and it was correlated with the development of osteoarthritis.

“This indicates that the presence of increased lubricin might actually be a biomarker for predicting future osteoarthritis,” said Reesink. “We also saw increased lubricin in dogs months to years after they injured their ACLs, suggesting that lubricin might be an indicator of ongoing joint instability.”

Increased lubricin could serve as a tipoff to clinicians to intervene with early treatments to ward off or slow the development of osteoarthritis, not just in dogs, but in people, too.

Photo by Alvan Nee on Unsplash

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