COVID Update April 29: What’s happened to the $20 billion? That’s what I wanted to find out today.
I got some answers but they are not good ones.
Will tweet soon. Follow if interested. 1/
I got some answers but they are not good ones.
Will tweet soon. Follow if interested. 1/
QUIZ:
What percent of Americans say they know someone who has died of COVID-19?
Extra credit: At this very moment, is there “Breaking News” on CNN, MSNBC and Fox.
2/
What percent of Americans say they know someone who has died of COVID-19?
Extra credit: At this very moment, is there “Breaking News” on CNN, MSNBC and Fox.
2/
US hospitals have long been unable to give remdesevir to patients once Gilead stopped compassionate use as demand outstripped supply. Rem has demonstrated promise in shortening illness & potentially saving lives.
But that shortage isn’t everywhere. The VA has a stockpile.3/
But that shortage isn’t everywhere. The VA has a stockpile.3/
A friend of a friend’s father has been on a vent for 3 weeks, unable to get the drug. There are 9500 ppl in ICUs rn. Would it save their lives? No one knows. And likely no one will.
Does the VA need it? That’s wrapped up in another bigger question. 4/
Does the VA need it? That’s wrapped up in another bigger question. 4/
The VA is designed to be the US’s safety net system when hospitals overflow. Before fitting out convention centers & tents, we have the VA’s taxpayer funded hospitals.
In recognition of that role & to ensure our Veterans get the best care, Congress granted them $20 billion. 5/
In recognition of that role & to ensure our Veterans get the best care, Congress granted them $20 billion. 5/
Unlike community hospitals that need revenue from elective procedures to pay the bills, the VA doesn’t. They don’t bill revenue. Unlike other hospitals granted $, if the VA’s volumes drop, no one loses their jobs. 6/
The VA has ~8% of US hospital beds. In the CARES Act they got between 15-20% of the $ for to all health care providers (incl non-hospitals).
So one would think that they would be playing a massive role as a safety net for other hospitals, right? 7/
So one would think that they would be playing a massive role as a safety net for other hospitals, right? 7/
The last report showed that the VA was treating 135 civilians.
Maybe that’s because hospitals don’t need the capacity? Yet at least in NY and MI, ventilators, nurses, & ICU beds were brought in and the outreach to the VA reportedly didn’t work. 8/
Maybe that’s because hospitals don’t need the capacity? Yet at least in NY and MI, ventilators, nurses, & ICU beds were brought in and the outreach to the VA reportedly didn’t work. 8/
And Remdesevr still in short being denied to patients. Does the VA have some? How much? Enough for all 9500 people?
With Gilead claiming they are making enough to more than replenish, could they VA with their stockpiles (not to mention $20 billion) save some civilian lives? 9/
With Gilead claiming they are making enough to more than replenish, could they VA with their stockpiles (not to mention $20 billion) save some civilian lives? 9/
What else are they doing with the $20 billion? According to the VA, they are treating 5000 COVID veterans at last count.
With 2 million Veterans, that’s 1/4 of 1%. Either Veterans are not inclined to get COVID, they are being seen in civilian hospitals, or...10/
With 2 million Veterans, that’s 1/4 of 1%. Either Veterans are not inclined to get COVID, they are being seen in civilian hospitals, or...10/
More likely there are 50,000 to 100,000 Veterans with COVID-19.
If the VA doesn’t play their safety net role, then they should be spending this giant pile of money doing outreach to Veterans to treat them for COVID & for the mental health needs 5ey likely face. 11/
If the VA doesn’t play their safety net role, then they should be spending this giant pile of money doing outreach to Veterans to treat them for COVID & for the mental health needs 5ey likely face. 11/
There seems to be more than enough money. To do all of those things— be a safety net, proactively reach Veterans on COVID & proactively reach out to Veterans on mental health issues. And transparently share what their medication supply is. 12/
I am not interested in waiting 2 years for the inevitable Inspector General’s report on what happened with this $20 billion.
I’d like the VA to publicly share it now & do whatever they can to actively help. 13/
I’d like the VA to publicly share it now & do whatever they can to actively help. 13/
500 Veteran hospital patients + 4500 non-hospital COVID Veterans + 135 civilian cases + ?? Outreach is not $20 billion.
Please, please can we try to save the lives of some of the 9500 ICU cases? If Rem makes a 3 point improvement in mortality, that’s almost 300 lives. 14/
Please, please can we try to save the lives of some of the 9500 ICU cases? If Rem makes a 3 point improvement in mortality, that’s almost 300 lives. 14/
Are we too busy taking premature victory laps to move heaven & earth for 300 people? 15/
There is a story from @davidkski in Bloomberg below which I just saw in my thread. Haven’t read all the way through yet but it has even more data. 16/
The VA could also be spending money providing Veterans care with community providers a big initiative they were funded for, but apparently that suspended (likely for safety reasons). 17/
Now I’m not even sure the VA asked for this $20 billion or in the haste of throwing around a package, it looked like a politically popular thing for Congress to do.
Would also be worth it for staff to release their analysis on that. 18/
Would also be worth it for staff to release their analysis on that. 18/
If someone jumps in my feed to say I’m trying to deny Veteran’s care, that’s just Twitter and my Russian bot followers. 19/
If someone from the VA offers a sensible explanation tomorrow or questions these numbers or demonstrates their actions, I will gratefully apologize.
As long as they give up their Rem to those who need it. 20/
As long as they give up their Rem to those who need it. 20/
I could get into the hype over Rem, but I’m trying to avoid it. There are short sellers & buyers of Gilead’s stock all over. I got no time for them. Be careful your sources on the topic. 21/
Simple enough to say it’s a potential tool in what will need to be a larger arsenal. Doesn’t sound like a silver bullet. And it’s early.
Look at @peterbachmd as someone who can give you reliable assessments & ask the right questions. 21/
Look at @peterbachmd as someone who can give you reliable assessments & ask the right questions. 21/
There is still way more we don’t know here and there will be a lot of highs & lows in drug development. 2 steps forward, 1 step back.
It will feel that way when searching for an answer in the middle of the maze. But for about 300 people it may be an answer. 22/
It will feel that way when searching for an answer in the middle of the maze. But for about 300 people it may be an answer. 22/
You gotta listen to Tina Fey if you haven’t. If you don’t like her take on things, who could you like?
Listen at: smarturl.it/inthebubble
Listen at: smarturl.it/inthebubble
To the quiz— 9% of Americans claim to know someone who has died of COVID-19. That sounds as much like “Breaking News” as these items. So 2/3. Good on ya, Fox. 24/
We keep hearing of an “all of government” response. An “all of America” response. It’s what we need.
The VA is not alone in sitting on the sidelines. There should be no such thing as “not my crisis.” /end
The VA is not alone in sitting on the sidelines. There should be no such thing as “not my crisis.” /end
