COVID-19 Articles and Issues that EMS Agencies Should Read

By A.J. Heightman, MPA, EMT

There are three important articles and issues that I want to bring to the attention of EMS agencies during these trying times. Clinical and regulatory changes are happening almost on a minute-by-minute basis. The federal government, particularly the CDC and CMS are loosening (and interpreting) regulations that can help EMS agencies. So, read each of these articles carefully:

#1) This first article from Science Magazine (How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes) does a very good job of summarizing the clinical challenges currently being faced with COVID-19.

More importantly, the detail in this article will make your staff understands what is physically happening inside the body of their COVID positive patients and why PPE use and decontamination are so important. One of the articles introductory paragraphs tells it all:

What follows is a snapshot of the fast-evolving understanding of how the virus attacks cells around the body, especially in the roughly 5% of patients who become critically ill. Despite the more than 1000 papers now spilling into journals and onto preprint servers every week, a clear picture is elusive, as the virus acts like no microbe humanity has ever seen. Without larger, prospective controlled studies that are only now being launched, scientists must pull information from small studies and case reports, often published at warp speed and not yet peer reviewed. “We need to keep a very open mind as this phenomenon goes forward,” says Nancy Reau, a liver transplant physician who has been treating COVID-19 patients at Rush University Medical Center. “We are still learning.”

This CAT Scan image provided by George Washington University shows the coronavirus wreaked extensive damage (yellow) on the lungs of a 59-year-old man who died at George Washington University Hospital, as seen in a 3D model based on computerized tomography scans. 

#2) USA TODAY article, The tests that could reopen the country: How they work, will help crews and administrators understand the importance of the many tests that will be rolling out soon that will impact them personally and professionally.

#3) Finally, Matt Zavadsky, has highlighted some important sections of the recent Modern Healthcare article “CARES Act grants could spark False Claims Act issues” that I want to pass along to EMS Agencies.

Matt says it is good information for providers as they evaluate the risks/benefits of accepting the initial CMS funds distribution. He also passed along that Kaiser Health News and NPR reported over the weekend about an ambiguous phrase in the HHS post regarding the distribution.

It also insinuates that “every patient is a possible COVID-19 patient.”  Therefore, the fear is that CMS may see that as a reason to have no balance billing occur for ANY patient during the Pandemic.  This could be financially disastrous for EMS agencies treating chest pains, asthma attacks, fractures, multi-system traumas.

Here is the excerpt:

Providers accepting the funds agree to not balance bill COVID-19 patients, and:

“If you ceased operation as a result of the COVID-19 pandemic, you are still eligible to receive funds so long as you provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. Care does not have to be specific to treating COVID-19. HHS broadly views every patient as a possible case of COVID-19.”

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