Doctors and Nurses Grow Desperate for Protective Gear

Health care workers at a drive-through coronavirus testing site in Arlington, Virginia, on Wednesday. The CDC recently issued guidelines allowing surgical masks to be worn instead of N95 respirators in many cases. (Drew Angerer/Getty Images)

Topher Sanders

Maya Miller

Lexi Churchill

and

David Armstrong

This story is co-published with

The Times-Picayune

and

The Advocate

March 19, 2020-

–

Emergency room physician John Gavin can’t identify the exact patient from whom he contracted the coronavirus, but he’s confident he picked up the illness working one of his 12-hour shifts in Amite, Louisiana’s small, rural emergency room.

“There were just so many people who had so many vague symptoms that any of them could have been that person,” he said. “We see a lot of viral-type illnesses.”

But Gavin, 69, is certain that before his coronavirus diagnosis on March 9, officials at Hood Memorial Hospital, where he works, hadn’t made any specific changes to protocols or procedures to protect doctors and nurses from contracting the disease.

“Not at that point they hadn’t,” said Gavin, who is recovering from the disease caused by the virus. “I don’t know if they’ve done anything since then. But during that time there was nothing other than advice to wash your hands frequently and ‘we’ll try to keep the water on,’” a reference to a water cutoff that had taken place in early March.

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Gavin also said the ER at the time didn’t have gowns or N95 respirator masks designed to protect medical providers from airborne particles and liquids.

“No, no, we didn’t have any of that,” he said. “They offered us paper face masks, that’s it.”

Gavin later joked that wearing a paper mask was like “putting up chicken wire on your windows to keep the mosquitos out.”

Amid the response to the coronavirus, officials are particularly concerned about doctors and nurses getting sick themselves and being unable to care for others. There is no official data accounting for the number of health care workers who have been exposed or infected so far, but providers worry about what will happen as supplies runs out. On Tuesday, The Washington Post

reported

that at least 60 providers had tested positive for COVID-19. In Italy,

data published in JAMA

shows that 9% of those infected are health care workers.

Officials with Hood Memorial Hospital declined interview requests but said in a statement that the facility has protective gear available for staff. The statement also said there was no evidence Gavin contracted the disease at the hospital. The statement quotes the hospital’s CEO, Mike Whittington, saying that “no patient or employee that Hood is monitoring has developed any symptoms of COVID-19 in the eight days since their interaction with the provider.”

Confusion and concerns around supplies extend well beyond Amite. Given the nationwide supply shortages, the U.S. Centers for Disease Control and Prevention recently downgraded its guidelines for how health workers should protect themselves, allowing them to use surgical masks instead of N95 respirator masks in many cases. And this week, the CDC went further, publishing directions that providers “might use homemade masks” like a bandanna or scarf if no masks are available.

Gavin said he was unable to call in sick in the days before his diagnosis because of a shortage of doctors in the area. The small hospital Gavin works at is about 60 miles northeast from Baton Rouge and serves a wide area that stretches to neighboring Mississippi.

“So I went in and worked that shift,” he said. “I’m sure I exposed everybody I saw.”

And on one of the days immediately prior to Gavin having symptoms, there was a period of time where the water in Amite was shut off and he and his colleagues were unable to wash their hands for hours. They relied on hand sanitizer during the outage.

Sick doctors and nurses cause a ripple effect.

Beth Oller, a family physician in rural Rooks County, Kansas, said the five doctors who treat patients in her area are working together to minimize the risk of any of them getting sick with the coronavirus.

“We are terrified of this taking out providers or our nurses,” she said.

The ripple effect of one or two health care workers in the county being sidelined by the virus would be devastating. Oller said she is one of two doctors in the area who delivers babies. Her husband, one of the four other doctors in the county, also cares for patients at the area nursing homes and heads up the local EMS service. There are only a handful of X-ray technicians at the hospital and a small number of nurses.

Oller said the local hospital has a limited supply of masks and gowns. The burden on the local doctors is already beginning to increase because of the virus. The county hospital depends on out-of-area emergency room providers to help cover weekend shifts. One of those, a nurse practitioner based three hours away in Topeka, informed the hospital this week that her travel was being limited by her own hospital because of the virus and she might not be available to cover shifts in Rooks County, Oller said.

Reduced standards due to gear shortages are putting front-line health workers at additional risk.

Medical providers in Washington, Ohio, New York, Connecticut, Oregon, Illinois, Texas and California told ProPublica that in the past week, hospitals have changed recommendations around protective equipment. The moves come after the CDC modified its guidance March 10 on the kinds of precautions health care workers should take in light of supply shortages.

Doctors and nurses in these states said their hospitals initially told them to use sealed face masks like N95s when treating patients presenting COVID-19 symptoms. Providers are now being told to use surgical masks when interacting with a symptomatic patient. In the past week, their hospitals have placed N95s in locked cabinets to make sure they are available for cases requiring intubation.

Are Hospitals Near Me Ready for Coronavirus? Here Are Nine Different Scenarios.

How soon regions run out of hospital beds depends on how fast the novel coronavirus spreads and how many open beds they had to begin with. Here’s a look at the whole country. You can also search for your region.

Some hospitals have gone further in loosening restrictions, recommending staff reuse disposable masks. Medical providers on the front lines are concerned by this move, saying masks are only intended to be used once because the risk of contamination increases as they are reused.

“It’s like doing surgery with gloves on one patient and using the same gloves for another surgery,” said John Pearson, an emergency room nurse at Highland Hospital, a public hospital in Oakland, California. The hospital has told staff to reuse surgical masks and place them in paper bags between patients. He said a few of his colleagues have already gotten sick. “It goes against all our training and all the standards and practices we’ve been drilled in year over year.”

Reusing disposable masks is bad practice, but it is understandable in the current situation, experts said. Hospital administrators see reusing masks as a necessary move given the current shortages and the fact that the virus has not hit its peak. The CDC has not issued guidance around mask reuse.

Of the 65 medical providers who

wrote into ProPublica

this week, 31 said they felt as though they were being asked to take measures that made them uncomfortable, such as reusing protective masks. All but two respondents cited supply shortages as a factor.

A number of hospitals and clinics have advised staff they have less than two weeks of supplies and don’t know when additional orders will be fulfilled, according to emails reviewed by ProPublica. In a private Facebook group, doctors and medical staff are sharing tips for building their own masks from materials they have at home or are ordering from Amazon. After reading through the posts, someone in the group explained they sent a note to a state ACLU chapter to outline conditions and ask if doctors have any recourse to keep themselves safe.

“There is a massive shortage and a dramatic lowering of the quality of care,” Pearson said. “We’ve seen our health care system fall, and we’re paying a huge price.”

Alameda Health Systems, which oversees the hospital, did not respond to questions about supplies and requests for comment.

Protective gear shortages are a national problem.

“This is all driven by shortages of protective gear,” said Dr. Robert Harrison, the director of the University of California San Francisco’s Occupational Health Services. In the United States, surges in demand, lackluster preparation and some overseas suppliers shutting down as their countries grapple with the virus have contributed to the shortages.

Vice President Mike Pence, who is leading the U.S. response to COVID-19, has said a handful of manufacturers are ramping up their production efforts for masks, gloves and gowns. The CDC also has begun fulfilling orders by states requesting masks from the country’s Strategic National Stockpile, which has less than 5% of the 300 million masks public officials estimate the country will need.

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Representatives of hospitals and nursing homes shared concerns about a shortage of supplies on a call Monday hosted by the U.S. Centers for Medicare and Medicaid Services. On the call, a high-level official from the U.S. Department of Health and Human Services gave an update on the supply shortage and the hope for replenishment.

The strategic national stockpile “has a significant but, quite frankly, very small percentage of what is needed in today’s crisis,” the HHS official said. Federal officials are coordinating their capabilities with those in the private sector, including group purchasing organizations, distributors and manufacturers, “to basically pull all this together,” he said. Proposals include purchasing a large number of N95 masks, for example, and working with the CDC “to extend the reuse” of what have traditionally been single-use products, he said.

On Wednesday, President Donald Trump invoked the

Defense Production Act

, which allows for the large-scale diversion of materials and facilities “when national defense needs cannot otherwise be satisfied in a timely fashion.” In recent days, senators and local officials had urged the administration to invoke the legislation that Congress first passed in 1950, during the Korean War.

Front-line health care workers are being pushed to the brink of quitting.

Several health care workers told ProPublica they are already weighing the possibility of quitting if their workplace runs out of protective gear.

A nurse practitioner working in northeast Connecticut says her office has already canceled nonessential surgeries and procedures. Staff are now relying on telehealth, in which they communicate with patients largely over the phone or online, to keep people from coming to the facility.

She has five N95 masks stowed away for patients still coming in. She says she’ll reuse them until they’re “soiled or ruined,” but if her office ultimately runs out of protective gear, she will not come in.

“Zero PPE means zero providers,” she said, referring to personal protective equipment. “And I know that my other colleagues feel the same way.”

One intensive care nurse in Columbus, Ohio, says she has an underlying lung disease that puts her especially at risk for COVID-19. During her latest shift this week, she was told her hospital was on its last few boxes of N95 masks. Nurses were hiding the remaining gear and putting their initials on the masks they reused throughout the day.

She says if she is asked to care for potential COVID-19 patients without the proper protection, she will request a different assignment. Still, the mere risk of possible exposure given her condition scares her husband.

“It’s something that’s on the table that we are going to keep discussing, which worries me because I don’t know if people are going to hire nurses that quit at the time they’re needed,” she said.

Marshall Allen contributed reporting.

republished here by

The Gloucestercitynews.net

SOURCE:

ProPublica — Investigative Journalism and News in the Public Interest

What Every CEO Needs to Know About Cybersecurity

Companies often push cybersecurity aside, but CEOs are responsible for helping teams create and implement effective cybersecurity and risk management plans.

Gloucestercitynews.net-(March 19, 2020)–As companies continue to expand their information technology resources, cybersecurity measures can often get left behind. CEOs are forced to focus on the more pressing matters of business as usual, and IT departments are floundering to provide the most effective solutions possible without the support of executives. Instead, an effective approach to cybersecurity begins with the CEO. Your involvement in creating and implementing cybersecurity measures in your organization has a profound impact on how well those security measures work. Unsure of where to begin?

Krystal Triumph with

Atlantic-IT.net

in New Jersey shares what every CEO should know about implementing cybersecurity measures for your organization.

Start with a Risk Assessment

It is difficult to make a plan and take action if you aren\’t aware of the risk your company faces. Work with a managed service provider or your IT team to perform a risk assessment and determine which aspects of your company are most exposed. Are there areas of your company that aren\’t up to current compliance standards? Is lack of knowledge among executives and workers putting your data or finances at risk?

Establishing an effective security protocol in your organization starts with you. Many of the risks organizations face when it comes to cybersecurity are a byproduct of human involvement (phishing emails and social engineering, for example) or lack of communication between your IT team and key decision-makers. Both issues can be resolved through your involvement in establishing a risk management protocol and emphasizing the importance of training both executives and employees in cybersecurity measures.

Train Your Team

Now that you have a better understanding of the threats, or potential threats, your business faces, it is important to pass this knowledge on to your executive team and your employees. Teach your team about the risks of cyber threats and how they could impact your business. It is especially valuable to teach the entire organization how to recognize and avoid phishing emails and other social engineering schemes. According to the most recent data, one in 25 branded emails is a phishing scheme. That means those in your organization who receive far more emails than 25 per day are putting themselves and your company at risk if they lack awareness of phishing tactics.

Develop a Plan

Part of your risk assessment and training process should be working with your IT team or service provider to develop a plan for

IT risk management

and disaster recovery. Should the worst occur, what actions will be taken—and by whom—to either mitigate the risk or recover any lost or damaged data?

By building a plan of action, you provide peace of mind for yourself and for your team knowing that you are in control of how your data is used, where the risks are currently and where they could be in the future, and how to efficiently manage those risks. In order to better navigate the potential for employee-related risk—at least 78% of cyber espionage attacks start with phishing—make continual employee training a part of your risk management plan. Onboarding new employees should involve training, as well as regular updates for both employees and executives.

Create Clear Communication Pathways

In order for your risk management plan to be most effective, you will want to establish who on your team is responsible for each level of communication or risk. Which risks can be dealt with by your cybersecurity team and which risks require executive-level involvement? Assign roles that allow your team to understand exactly what their responsibility is in the face of cybersecurity risk.

With a plan in place and responsibilities clearly delegated, your team will have the tools they need to play their part in managing and mitigating any potential cyber-threats your company faces. Be sure to regularly review your plan and communication pathway, or partner with a managed service provider to delegate the task of consistent monitoring and management of your cybersecurity plan.

Anti-Hunger Advocates Call for U.S. Senate to Immediately Pass House COVID-19 Relief Bill

“Massive Increase in Pre-Existing Hunger Crisis Demands Massive, Highly-Coordinated Response by the Federal, State, and the City Governments, and Corporations, Nonprofit Groups, and Philanthropies”

Hunger-Relief Provisions of the House Bill Detailed Below

In 2018, when the economy was still strong, 37 million Americans, including 11 million U.S. children, lived in food insecure households, unable to afford an adequate supply of food.

In the last few days, tens of millions of low-income students have lost access to school lunches, breakfasts, and after-school snacks and suppers due to school closures. Large numbers of older Americans have lost meals due to senior center shutdowns. In addition, millions of Americans who previously worked for modest wages and/or depended on tips to survive have suddenly lost jobs and/or have suffered from dramatic reductions in incomes.

The economic relief bill pushed by House Speaker Nancy Pelosi, which passed the House of Representatives early Saturday morning, would significantly lessen the hunger crisis, not only providing more funds to make it easier for schools, senior programs, and food charities to provide alternative meals, but, most significantly, creating a vast new, federally-funded program to give extra food purchasing dollars to all families with children in closed schools on ATM-like cards. The bill also includes paid sick leave and expanded unemployment compensation funding, which will more broadly aid struggling working families, maintaining some of their food purchasing power.

On Saturday, President Donald Trump strongly endorsed the bill. Yet Senate Majority Leader Mitch McConnell has yet to schedule a Senate vote on the bill, reportedly because some conservative senators object to the paid sick leave provisions.

Joel Berg, CEO of Hunger Free America, a nationwide direct service and advocacy organization, released this statement in response:

“The instantaneous loss of tens of millions of school meals and tens of thousands of senior meals each day – combined with the rapid reduction in income for numerous low-income workers – has greatly worsened the country’s pre-existing hunger crisis. This is the first time in modern U.S. history that we have seen a nationwide natural disaster combined with an economic collapse, so we can’t even begin to imagine the long-term devastation for the nation, particularly for the vast number of people struggling.

It is distressing, to say the least, that Senate Majority Leader Mitch McConnell has yet to schedule a Senate vote on the bill, reportedly because some conservative senators object to the paid sick leave provisions.

The Senate should immediately pass, and the President should immediately sign, this emergency bill into law.

This massive increase in the pre-existing hunger crisis demands a massive, highly-coordinated response by federal, state, and city government agencies, as well as corporations, nonprofit groups, and philanthropies. If the House bill is passed by the Senate and becomes law, one top priority for such joint efforts should be helping eligible families up enroll in the new government food benefits available. The other key priority should be dramatically ramping-up the home delivery of meals to older Americans, children, and families who lost income; this should be done using a combination of government and nonprofit staff, National Guard members, AmeriCorps national service participants, U.S. Census workers, and community volunteers (all of whom should be given adequate safety training and equipment). The time is now for all hands on deck to jointly combat this grave threat to the city and nation. Hunger Free America stands ready to help any way we can.

Crises such as Katrina, Sandy, and the coronavirus pandemic rip the bandages off society’s most gaping wounds, forcing the nation to confront the reality of how each crisis greatly worsened the pre-existing maladies of hunger, poverty, and inequality. I hope that, after the immediate pandemic subsides, this prompts the nation to launch broader efforts to solve these long-term crises.”

DETAILS OF ANTI-HUNGER PROVISIONS OF HOUSE ECONOMIC RELIEF BILL

The bill states: “The supplemental appropriations provided by the bill are designated as emergency spending, which is exempt from discretionary spending limit.” What that means is that – unlike normal bills, which require other programs to be cut or taxes to be raised to pay for any new spending under so-called PAYGO provisions — this bill is not subject to PAYGO and therefore does not require spending reduction or tax increases to pay for it. Rather, the spending for this bill increased the federal budget deficit, as do tax cuts for which offsets are not found.

All funding through the bill is supposed to expire at the end of this federal fiscal year, which ends September 30, 2020, and is supposed to be used for emergency purposes only related to COVID-19.

Nutrition Assistance Grants for U.S. Territories

The bill provides $100 million to the Secretary of Agriculture to provide grants to the Commonwealth of the Northern Mariana Islands, Puerto Rico, and American Samoa for nutrition assistance. This is particularly important since Puerto Rico’s main federal food aid program, the Nutrition Assistance Program, was chronically under-funded even before Hurricane Maria. Since the hurricane, Puerto Rico has faced a serious food crisis. Puerto Rico now has such a high poverty rate that, as of November 2019, 1,298,518 (41 percent) island residents received food aid through the Nutrition Assistance Program.

Because the combined population of the Commonwealth of the Northern Mariana Islands and American Samoa are about 110,000 people (about 1/29

of the population of Puerto Rico), if 95 percent of the $100 million in this new funding went to Puerto Rico, that would equal $95 million, which would equal only an extra $73 dollars between now and September for each of the participants in Puerto Rico’s Nutrition Assistance Program.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

The federal Special Supplemental Nutrition Program for Women, Infants, and Children, better known as WIC, provides nutritional supplements to pregnant women and children under five. This bill provides an additional $500 million to the program. The bill also authorizes the Secretary of Agriculture to waive administrative requirements for WIC participation, including the requirement for a participant to have a physical presence in a WIC clinic to assess their nutritional risk.

The Emergency Food Assistance Program (TEFAP)

The bill provides an addition $400 million (of which up to $100 million can be used for distribution costs) to increase the availability of commodities (mostly canned and boxed foods) given out by food banks, soup kitchens, and food pantries nationwide.

Food Programs for Older Americans

The bill appropriates $160 million for home-delivered nutrition programs such as Meals on Wheels and $10 million for nutrition services for Native Americans. The bill also allots $80 million for congregate nutrition services, meaning meals delivered to older Americans at senior centers, religious institutions, schools, and other community spaces serving meals through the congregate meals program established by the federal Older Americans Act.

The bill also provides states with more flexibility on how they can enable their older residents to access such meals.

School Meals Programs

Under pre-existing federal law, all school lunches and breakfasts must be served in the school buildings, and variation in the way any meals are served by school districts must not cost the federal government any additional money. The bill allows states and school districts to temporarily use alternative methods of food distribution (such as giving children meals to take home from school distribution sites) and allows states and school districts to spend more federal funds to do so.

The bill also allows additional flexibility in the federally-funded Child And Adult Care Food Program (CACFP), which funds meals at eligible afterschool programs, child care centers, homeless shelters, day care homes, and adult day care centers.

Hunger Free America points out both the benefits and drawbacks of schools allowing students to show up at schools and/or other mass distributions to bring meals home. While it it makes sense that many schools that have closed due to the Coronavirus are allowing children to show up at school to obtain food to take home, this approach is problematic for a number of reasons:

• If schools and workplaces are closed specifically to prevent people from congregating, then giving out food to large numbers of children congregating together could be counter-productive.

• If their parents are still working during the day, it may be more difficult/dangerous for the kids to get meals.

• Some schools have limited such pick-ups to families with cars; many of the lowest-income families don’t own cars or the parents in such families must use their car to get to work.

• Many children live long distances from their schools, and travelling to food pick-up locations could expose them to more disease risks, as well as cost them additional money for travel.

• To date, USDA has only given waiver approval to this alternative meal delivery method to schools in which 50% or more of their students are eligible for free or reduced-price school meals. Yet there are still many low-income children in schools – particularly in suburban and rural areas – that do not qualify for this waiver. If such schools are closed, the low-income students in these schools would miss out on school meals entirely.

While we have not seen data yet on the effectiveness of such alternative food distribution efforts by schools, it is highly likely that they will serve far fewer children than normal school meals programs on regular school days.

The Supplemental Nutrition Assistance Program (SNAP) – Formerly Known as the Food Stamp Program

The most impactful part of the bill in terms of reducing hunger is the creation of a vast new, federally-funded program to give extra food purchasing dollars to all families with children in closed schools on ATM-like cards. Some are calling this a Pandemic EBT program.

To be precise, the bill authorizes the Secretary of Agriculture to approve state agency plans to provide Pandemic EBT benefits to households with children who would receive free or reduced-price school lunches if not for the closure of their schools due to the pandemic emergency.

Under the bill, the Secretary of Agriculture may approve state plans to provide Pandemic EBT benefits to eligible households with children who may or may not already be participating in SNAP. Eligible children must be receiving free or reduced-price school meals and be enrolled at a school that is closed for no less than 5 consecutive days due to the pandemic emergency based on an outbreak of Coronavirus. Benefits provided to approved households can be no less than the value of school meals at the federal free rate over the course of five school days for each eligible child in the household.

The bill also temporary waives the requirement that would ordinarily remove abled-bodied adults without dependents (ABAWDs) who are unemployed from the SNAP program if they are unable to find work.

While the bill does not explicitly address the pre-existing USDA Disaster Supplemental Nutrition Assistance Program (D-SNAP), which gives food assistance to low-income households with food loss or damage caused by a natural disaster, we believe — now that the President has declared a national emergency — USDA can use this authority to make SNAP more widely available in areas particularly hard hit by the pandemic and/or job losses.

Other Economic Aid

The House bill also includes paid sick leave and expanded unemployment compensation funding, which will more broadly aid struggling working families, maintaining some of their food purchasing power.

Specifically, the bill established a federal emergency paid leave benefits program to provide payments to employees taking unpaid leave due to the coronavirus outbreak.

It expands the Family and Medical Leave Act (FMLA) to require businesses with fewer than 500 employees to provide paid leave for all employees (employed for 30 days) for a qualifying need related to a public health emergency related to the Coronavirus declared by a federal, state, or local authority.

The employee must be compensated for this leave at a level that is at least two-thirds of an employee’s regular rate of pay. The first 14 days for which an employee takes FMLA leave under Division C may consist of unpaid leave. However, an employee may elect to substitute any accrued vacation leave, personal leave, or medical or sick leave provided by the employer in lieu of unpaid leave.

The bill outlines specific levels of reimbursement to covered employers and certain individuals in the form of payroll credits and tax credits for the leave payments required by the legislation. The bill also expands unemployment benefits and provides grants to states for processing and paying claims.

CDC Report: PA and NJ Up To 149 Lung Injuries Linked to Vaping

The Center Square

(The Center Square) – The number of lung injury hospitalization cases linked to vaping in Pennsylvania now numbers as high as 149 as of Feb. 25,

according to the U.S. Centers for Disease Control and Prevention

Nationally, the number of cases involving hospitalizations due to e-cigarette use continues to decline after peaking in September of last year, the CDC reports. Patient reports show that black-market vaping products containing THC – the psychoactive component of cannabis – have played a major role in the outbreak.

Among the 100 to 149 cases reported in Pennsylvania, two deaths have been reported, according to the CDC.

Vitamin E acetate, which commonly does no harm when taken as a supplement, has also been linked to the lung injuries, the agency’s data shows. Medical research indicates it can disrupt lung functioning when inhaled.

In total, there have been 68 deaths associated with the vaping incidents in 29 states as well as the District of Columbia, the CDC reports. In addition, the total number of hospitalizations from such vaping activities is now 2,807, the report says.

—

Hospitalizations Related to Vaping, State by State

State

Frequency

(# of Cases)

Deaths Reported

Alabama

10-49

Alaska

1-9

Arizona

10-49

Arkansas

10-49

California

150-199

Colorado

1-9

Connecticut

50-99

Delaware

10-49

Florida

100-149

Georgia

10-49

Hawaii

1-9

Idaho

10-49

Illinois

200-249

Indiana

100-149

Iowa

50-99

Kansas

10-49

Kentucky

10-49

Louisiana

10-49

Maine

1-9

Maryland

50-99

Massachusetts

100-149

Michigan

50-99

Minnesota

100-149

Mississippi

10-49

Missouri

10-49

Montana

1-9

Nebraska

10-49

Nevada

1-9

New Hampshire

1-9

New Jersey

100-149

New Mexico

10-49

New York

150-199

North Carolina

50-99

North Dakota

1-9

Ohio

10-49

Oklahoma

1-9

Oregon

10-49

Pennsylvania

100-149

Rhode Island

1-9

South Carolina

10-49

South Dakota

10-49

Tennessee

50-99

Texas

200-249

Utah

100-149

Vermont

1-9

Virginia

50-99

Washington

10-49

Washington, D.C.

1-9

West Virginia

10-49

Wisconsin

50-99

Wyoming

1-9

Source: U.S. Centers for Disease Control and Prevention

published here with permission of

The Center Square

Archdiocese of Philly Cancels Public Masses Effective at 12 noon Wednesday

Today, the Archdiocese of Philadelphia announced that Archbishop Nelson J. Pérez has

suspended all public Masses in the Archdiocese of Philadelphia effective at 12:00 p.m. on Wednesday, March 18th and until further notice.

Last week, the Archbishop dispensed the faithful from the obligation to attend Sunday Mass. Both decisions were made in response to the growing concern over the spread of the Coronavirus (COVID-19) and the directives provided by government and health department officials at the local, state, and national levels. These measures will be re-evaluated pending future developments.

Archbishop Pérez said, “As the Archbishop of Philadelphia, my first priority is to ensure the health and welfare of those entrusted to the pastoral and temporal care of our Church. So, in light of the developing Coronavirus pandemic, a decision has been made to suspend the public celebration of all Masses in the Archdiocese of Philadelphia for the time being.

All of us need to do our part to slow the spread of this illness. Like you, we are monitoring coronavirus developments and look forward to continuing our lives on a more normal basis.

While things may look and feel different during these uncertain times, I want to be very clear that the Catholic Church in Philadelphia is not closing down. It is not disappearing and it will not abandon you. Time and again as our history has proven the Church has risen to meet great challenges and provide a beacon of hope and light.

As your Shepherd, I promise that the Church remains steadfast and is prepared to walk with you and serve you. Neither the Church nor its charitable works will stop. God is always by our side. He never abandons us. I invite you to join me in prayerful solidarity for the intentions of the sick, suffering, and their caregivers as well as government and health officials. With God’s grace and blessing, we will navigate the difficult waters of this challenge as a united human family, for after all is said and done, we are people of Hope!”

Though public Masses are suspended in all churches in the Archdiocese, the right and need of the faithful to hear the Word of God and celebrate the Sacraments is not put aside. Pastors, along with all those who work with them, will be as attentive as possible to all the spiritual, pastoral, and charitable needs of the people they serve.

Priests will continue to offer the sacrifice of the Holy Mass during this period and to honor all requested Mass intentions.

Churches can remain open as a location for private prayer at the discretion of the pastor. Baptisms, Confessions, Marriages, and Funerals will take place as usual but with due regard for the limitation of participants and reasonable social distancing.

In conjunction with directives already in force in hospitals and institutions, all visits to the sick with Holy Communion, including in private homes, by priests, deacons, and extraordinary ministers of Holy Communion are suspended. In such instances, only priests will be available to celebrate the Sacraments for those in immediate danger of death. In all circumstances, government and health agency directives for group size and social distancing are to be observed as the Archdiocese of Philadelphia strives to meet the pastoral and temporal needs of all those in need.

On Sunday, March 15th, the Archdiocese featured a live streaming broadcast of the 11:00 a.m. Mass on its website and Archbishop Pérez’s Facebook page for the benefit of those wishing to participate in the liturgy remotely. This broadcast will continue each Sunday on an ongoing basis.

Additional information regarding opportunities for prayer and devotions are available on the Archdiocesan website.

CBD Oil Regulations in Philadelphia and New Jersey

Gloucestercitynews.net (March 18, 2020)–Cannabidiol or CBD oil has long been known to have many health benefits. This therapeutic substance has a worldwide fan base with millions of people using it for its wide range of health-related advantages. Despite its health benefits, the distribution and use of CBD oil in the United States are strictly regulated.

Regardless of its health benefits, the extraction process has made the legalization of CBD oil a hot topic for a long time. Laws regarding its use are different in each state and are applied to both people who want to use CBD oil and pet owners who want to administer it to their pets. So, here is what you need to know about CBD oil regulations in Philadelphia and New Jersey.

CBD Oil Regulations in Philadelphia

Philadelphia is Pennsylvania’s largest city. CBD regulations in this part of the US align with federal laws. CBD can be derived from both hemp and marijuana plants, with different laws for each variety. Federal law and laws applying in the state of Pennsylvania only allow the purchase, sale, and use of CBD oil extracted from hemp, as stated in

the Farm Bill of 2018

. That enables citizens to buy and use the oil without a doctor’s prescription.

Oil extracted from marijuana, on the other hand, is legal only for qualified patients. Selling or

purchasing of oil extracted from marijuana for recreational purposes is illegal

and classified as a misdemeanor.

CBD Oil Regulations in New Jersey

The use of CBD oil needs to align with in-state laws. Just like in Philadelphia, whether the CBD oil is legal or not depends on its derivation. Now, you may be wondering why CBD oil extracted from marijuana is different and deemed illegal compared to its hemp counterpart. That is because oil extracted from marijuana is likely to contain

tetrahydrocannabinol

(THC), a substance known to have psychoactive effects on people. Unauthorized usage of this substance is illegal.

According to the Farm Bill, only CBD oil extracted from hemp that contains little to no THC is legal to be distributed and used without a doctor’s prescription. It has no psychoactive effects, hence can be used in a wide range of products. Just like in Philadelphia, marijuana-derived CBD is illegal for retail sale and use and is only authorized for patients in the Medical Marijuana Program.

CBD Oil for People and Pets

While regulations related to the possession and use of CBD oil are strict at the state and federal level, the product is still very much in demand. While a lot of its health benefits are yet to be scientifically proven, what makes CBD oil such a sought after product for both people and their

beloved four-legged friends

is explained below.

Natural Pain Reliever

Some studies have shown that CBD oil can be used to relieve joint pain in people and animals. It is believed that the effect of cannabis on the brain receptors of humans and some animals helps relieve and manage pain in the body.

CBD Oil for Seizures

Seizures are the most studied application of CBD oil in people. Even though there is limited research on pets, the substance is said to reduce the risk of epileptic seizures in

dogs and cats

as well. Research is not yet definitive, but studies have shown that CBD oil reduces the likelihood of seizures and strokes in pets, children, and adults alike.

CBD Oil for Anxiety

While research is still in its infancy, CBD oil has also been known to help people deal with anxiety and other related disorders like PTSD, social anxiety, and panic disorder. Researchers attribute this to CBD\’s effect on the way our brain receptors react to serotonin. It has also been used to relieve anxiety in pets, but research on that is inconclusive.

Conclusion

CBD oil has been proven beneficial to both people and animals. Despite this, federal and state laws remain strict regarding their use. Both Philadelphia and New Jersey only authorize the use of CBD oil extracted from hemp while those extracted from marijuana are illegal. Therefore, before purchasing or using CBD oil in Philadelphia, New Jersey or anywhere else in the US, make sure everything is in compliance with the law.

Officer Down: Police Officer Christopher Walsh, Shot and Killed, Suspect Commits Suicide

Police Officer Christopher Walsh

Springfield Police Department, Missouri

End of Watch

Monday, March 16, 2020

Police Officer Chris Walsh, age 32, was shot and killed as he and another officer confronted an active shooter at a convenience store at 2885 E Chestnut Expressway.

Dispatchers had received numerous calls about shootings at various locations throughout the city between 11:24 pm and 11:43 pm, including one reporting a vehicle crash and shooting at the convenience store. Officer Walsh and another officer arrived at the scene and immediately engaged the shooter.

Both officers were shot in the ensuing exchange of gunfire. Additional officers who arrived at the scene extricated both officers and transported them to the hospital where Officer Walsh passed away.

The subject committed suicide before being taken into custody. Prior to exchanging shots with the officers, the man shot four citizens inside of the store, killing three of them.

Officer Walsh was a U.S. Army veteran and had served with the Springfield Police Department for 3-1/2 years. He is survived by his wife and daughter.

Via

Officer Down Memorial page

CNB Crime

Blue Line

CNBNews Tips and Snippets

CNBNews Point of View

BREAKING NEWS

published Gloucestercitynews.net | March 17, 2020

Children’s National to Make March Matter for Children in the Hospital

(NAPSI)—This month, kids across the region will enjoy playing sports, spending time with friends or traveling for family vacation on spring break. Sadly, hundreds of other children will remain in the hospital fighting to get stronger, coping with

life-altering diagnoses and enduring treatment.

But thanks to dedicated doctors, nurses, child life specialists and more, pediatric hospitals, like premier pediatric hospital Children’s National Hospital in Washington, D.C., make treatment and coping with conditions as positive an experience as possible for patients and their families. Hospitals like Children’s National focus on addressing more than just the underlying illness, injury or condition. They provide critical education, support and encouragement to prepare not only their young patients, but their parents, siblings and families for recovery or coping with a chronic condition. This way, patients can feel informed, empowered and confident to heal or manage their own condition over time. Hospitals also work to treat the whole child and help improve their experience through creative programming like art, music, games and pet therapy.

One Child’s Ability to Take Control

Reese was 5 years old when she had her first seizure and dropped to the ground during a school fire drill. That day, neurologists at Children’s National in nearby Washington, D.C. diagnosed her with epilepsy.

However, with her diagnosis came education, knowledge and power. Not just for her, but for her entire family, allowing her to grow up stronger and enjoy life to the fullest. “My doctors have helped me control my seizures ever since,” says Reese. “They taught me how to limit them, how to trust my instincts when one’s coming on and how to handle a seizure even if I’m by myself.” With this knowledge, Reese, now 9 years old, says she has a lot of confidence to live with her condition, as does her family.

Reese had a seizure on the school bus this year and her friend yelled to the bus driver to get her little brother, John. He’s only 7 but knew what to do thanks to the care and support Reese and her whole family received at Children’s National.

“Some people who have seizures feel like they can’t do anything, but not me,” says Reese. “I have a plan and I know my limits, thanks to my doctors.” Last year, Reese even traveled to Costa Rica with her family where she swam in waterfalls, crossed hanging bridges and climbed cliffs.

Make March Matter

This exceptional level of care can make a big difference in a child and their family’s experience, however, child life and specialty programming as well as research is not often covered by insurance. Rather it is funded through the generous philanthropic support of the local community.

To ensure children like Reese have the programs, resources and exceptional care they need to enjoy stronger futures, Children’s National Hospital Foundation is celebrating its third-annual Make March Matter fundraising campaign all month long. The campaign invites community members to shop, dine and donate at businesses and restaurants in the DC area to help ensure exceptional care for patients and their families, both now and in the future.

Visit

MakeMarchMatterDC.org

to learn more.

GUEST OPINION: Give FERC a chance

By Rea S. Hederman Jr

The Center Square

The Federal Energy Regulatory Commission – or FERC – recently

ruled

that wholesale electricity grid operator, PJM, must set a new price floor for bids to supply electric capacity to PJM’s 13-state mid-Atlantic/Midwest region. State utility regulators in the region are unimpressed by the rule and Maryland, New Jersey, Illinois, Ohio, and Pennsylvania have even

threatened

to leave the PJM market altogether. Such threats are premature.

Motivated by recent power plant subsidies in Illinois, New Jersey and Ohio, FERC’s new pricing rule aims to prevent subsidized power plants from bidding artificially low prices and distorting the electricity-supply market – and to deter neighboring states from following suit. The new rule and subsequent regulator overreaction has broad implications for other electricity markets from New England to California.

Special interests poised to benefit from hard-won subsidies understandably oppose FERC’s effort to curb state-sponsored favoritism. And those same special interests are now pressuring states to leave PJM in order to save their subsidized revenues. During a February earnings call, executives of a Chicago-based electric utility

opined

that “states are right in looking at what their alternatives are to continued participation in [the markets].” Another utility CEO

said

that as state legislators review energy policy this year, “we’ll be at the table helping where they want help.” Expect utility executives in other states to be similarly “helpful” in the coming months.

The stubborn fact is that state power plant bailouts were escalating out of control and risked a dangerous market distortion. Several PJM states directly or indirectly

subsidize

various forms of renewable energy to the tune of nearly $1 billion per year, and taxpayer subsidies for nuclear and coal plants in New Jersey, Ohio, and Illinois will annually cost about $735 million. Proponents often tout such subsidy schemes as saving local jobs, preserving carbon-free power sources, and raising local tax revenue. But state-backed subsidies made it increasingly difficult to find true market prices at auction, and the schemes’ inherent unfairness pressured other states to adopt their own subsidies.

Enter FERC, which took action designed to maintain some semblance of market efficiency. FERC’s attempt may or may not work, but before state regulators storm out of PJM in a huff, they should keep a few things in mind.

First, consumers benefit from participating in PJM. The regional market helps keep electricity supply reliable and affordable. Access to power across state lines makes for a more dependable grid, and allowing customers to get electricity from the lowest-cost providers across a broad region keeps a lid on utility prices. A

joint academic study

found that market competition reduced electricity prices in Pennsylvania, Illinois and Ohio by about 16 percent from 2009 to 2014 versus their vertically integrated neighbors – Indiana, Michigan and Wisconsin. Ohio alone saw roughly $3 billion per year in total savings.

Second, exiting the regional market will require states to replace PJM’s infrastructure for power plant procurement. And replacement costs aren’t cheap. PJM’s independent market monitor

estimated

that replacing PJM’s infrastructure in Illinois’ ComEd region, for instance, would likely cost customers at least an additional $414 million per year.

Third, electricity prices significantly affect state economies. Electricity is critical to production, and especially to energy-intensive manufacturing. The Buckeye Institute’s Economic Research Center

found

that if Ohio’s renewable energy mandates raise electricity prices by just two percent, the state’s industrial sector employment would drop by more than 10,000 jobs and output would decline by up to $1.4 billion by 2026.

Finally, the new FERC rule allows power plants to apply for an exemption. In a nutshell, if a subsidized plant shows that it would be competitive even without the taxpayer-funded subsidy, it may bid below the rule’s price floor. Thus, power providers have the opportunity to demonstrate that they can provide cheap energy even on a level playing field. They should take it.

FERC’s approach may or may not be perfect. It is simply too soon to tell. And that makes any rush to exit PJM and the regional market a premature move. States and their utility regulators should give the new rule a chance, and avoid a messy, costly divorce that will undoubtedly harm consumers, state economies, and taxpayers.

Rea S. Hederman Jr. is the executive director of the Economic Research Center at The Buckeye Institute in Columbus, Ohio and vice president of policy.

published by Gloucestercitynews.net with permission of

The Center Square

Pharmacist Sentenced to Prison for Conspiring to Steal More than $4.5 Million in Prescription Reimbursements

And for Unlawful Opioid Distribution and Agrees to Pay $300,000 to Settle False Claims Act Litigation

PHILADELPHIA – U.S. Attorney William M. McSwain announced that Charles F. Kohlerman, IV, 50, of Media, PA, was sentenced to three years’ imprisonment and two

years of supervised release by United States District Court Judge R. Barclay Surrick for one count of conspiracy to commit wire fraud and 14 counts of distributing and dispensing oxycodone outside the course of professional practice and not for a legitimate medical purpose. The Court further ordered the defendant to pay a special assessment of $1,500 and a forfeiture of $1.7 million. Kohlerman pleaded guilty to these criminal charges in September 2019.

The charges stem from Kohlerman’s role as a licensed pharmacist and the owner of Kohlerman Pharmacy. Kohlerman’s patients sought to fill prescriptions of brand-name Lipitor® and its generic equivalent, atorvastatin calcium. Regardless of their need, and often without their knowledge, Kohlerman enrolled the vast majority of these patients in Manufacturer One’s Lipitor Savings Card coupon program (the “Program”). Under the Program, Kohlerman billed a patient’s private insurance and then submitted a secondary claim to Manufacturer One for payment to his pharmacy in a scheme to defraud the Program.

In order to carry out his scheme, Kohlerman purchased a negligible quantity of brand-name Lipitor® for his pharmacy and significant quantities of its much cheaper generic equivalent. Kohlerman dispensed the generic equivalent in bottles with brand-name Lipitor® on the labels and then submitted claims to Manufacturer One for reimbursement for the brand-name drug that he neither purchased nor dispensed. To maximize his fraudulent returns, Kohlerman created fake prescriptions for Lipitor®—that neither he nor his pharmacy dispensed—and submitted claims for those fake prescriptions to the Program. Kohlerman also changed physician-issued, one-month supply prescriptions of Lipitor® to a three-month supply prescription to triple the fraudulent refund he would receive from Manufacturer One. Additionally, Kohlerman altered legitimate prescriptions that permitted generic substitution to require distribution of the brand name drug, all while he filled actual brand-only prescriptions with the generic equivalent. Kohlerman submitted false and fraudulent claims to Manufacturer One of $4,562,834.97 and was paid $1,696,566.22.

As part of his scheme, Kohlerman also submitted approximately 126 false and fraudulent Lipitor® claims to the Medicare program, approximately two false and fraudulent Lipitor® claims to the Medicaid program, and approximately 18 false and fraudulent Lipitor® claims to federal employee health benefits programs paid for by the Office of Personnel Management (OPM). Kohlerman was reimbursed $106,986.70 from Medicare, $2,686.60 from Medicaid, and $5,600.31 from OPM.

In addition to the wire fraud scheme, Kohlerman also ignored suspicious activity on 14 separate occasions and, in each instance, distributed or caused to be distributed 120 oxycodone 30 mg tablets to a purported pharmacy customer. The customer, however, was not the individual for whom the oxycodone was prescribed. Additional warning signs that Kohlerman ignored included: (1) the quantity of narcotics exceeded Center for Disease Control recommendations for standard medical usage; (2) both the customer and the purported patient lived over 45 minutes away from the pharmacy; (3) the purported patient’s prescribing physician practiced a similar distance away; (4) the purported patient never picked up his/her prescriptions in person and did not visit the pharmacy in person; and (5) the customer filled prescriptions on behalf of the purported patient before they were eligible for refills.

Finally, as part of a civil resolution, Kohlerman and Kohlerman Pharmacy have agreed to pay the United States $300,000.00 to resolve allegations under the False Claims Act, 31 U.S.C. §§ 3729 et seq., that both Kohlerman and the pharmacy submitted or caused the submission of approximately 146 false claims for Lipitor® when they had, in fact, substituted the generic equivalent for those claims. The civil allegations against Kohlerman Pharmacy are allegations only and there has been no finding of liability as to the pharmacy.

“Kohlerman put his own greed above his patients’ well-being,” said U.S. Attorney McSwain. “By changing patients’ legitimately prescribed medications, unbeknownst to them, Kohlerman pumped up the amount of money he could steal. By doing so, he ripped off the American taxpayer and private industry alike. Kohlerman’s self-interest is also reflected in his wanton distribution of illegal painkillers. This criminal sentence and civil resolution demonstrate the coordination between My Office’s Criminal and Civil Divisions and our Health Care Fraud Strike Force. We will use every weapon in our arsenal—criminal and civil—to prosecute medical professionals who put profits over the well-being of patients.”

Thomas W. South, Deputy Assistant Inspector General for Investigations, OPM OIG, said: “In addition to unethically changing patients’ prescriptions without their knowledge or consent, Mr. Kohlerman’s greed also endangered patients’ health through the careless prescription of opioids. The opioid crisis is fueled by corrupt providers that dispense and distribute narcotics outside the course of professional practice and for no legitimate medical purpose. OPM OIG will not tolerate those who put profits above the well-being of patients.”

“As a pharmacist, Kohlerman has a corresponding responsibility, similar to that of a doctor, to insure that prescriptions for controlled substances are filled for a legitimate medical purpose and within the course of professional practice,” said Jonathan A. Wilson, Special Agent in Charge of the Drug Enforcement Administration’s Philadelphia Field Division. “Kohlerman repeatedly ignored that responsibility by dispensing multiple prescriptions for powerful prescription painkillers such as oxycodone to people other than the patient named on the prescription, dispensed before they were eligible for refills, and for patients that lived over 45 minutes away from his pharmacy—all of which are indicative of illegal diversion activity.”

“Chuck Kohlerman used pharmacy patrons as pawns in his money-making scheme, soon adding phony prescriptions into the mix,” said Tara A. McMahon, Acting Special Agent in Charge of the FBI’s Philadelphia Division. “All told, his litany of fraudulent claims netted nearly $2 million to which he wasn’t entitled. Add to that his reckless dispensing of addictive opioids, and it’s clear that the guiding principle here was greed. One of these days, medical professionals will get the message that health care fraud is a high priority for the FBI and we’re working every day to hold perpetrators accountable.”

“Kohlerman chose himself over his patients,” said Special Agent in Charge Maureen R. Dixon, Office of the Inspector General for the Department of Health and Human Services (HHS-OIG). “HHS-OIG and our law enforcement partners will continue to investigate and prosecute individuals who chose to enrich themselves at the expense of patients.”

The case was investigated by the Office of Personnel Management, Drug Enforcement Administration, Federal Bureau of Investigation, Health and Human Services Office of Inspector General, and the U.S. Marshals, and is being prosecuted by Assistant United States Attorney Paul J. Koob and Trial Attorney Adam G. Yoffie. Deputy Chief for Affirmative Litigation Charlene Keller Fullmer of the Eastern District of Pennsylvania is handling the parallel civil case.