Chartis Top Reads – Week of February 1 - 6, 2021

Our research team breaks down this week’s top healthcare news.


Top Reads Overview

In an age of unprecedented change, staying current has never been more important. Our team at Chartis is curating news most relevant to the healthcare industry and tracking the topics that are trending on seven key issues: high reliability care, digital and advanced technology, financial sustainability, health disparities, the health ecosystem of the future, partnerships, and the provider enterprise. Each week, we break down what’s happening and why it matters.

The State of COVID-19

The Buzz This Week

A third COVID-19 vaccine, made by Johnson & Johnson (J&J), is expected to be approved for emergency use as soon as this week in the United States, joining the Moderna and Pfizer/BioNTech vaccines that were approved in December. With three different vaccines being distributed in the coming month, some have questioned which vaccine offers the best protection. The simple answer is that because all three COVID vaccines are so effective, most of the population should take the first vaccine accessible to them. While J&J’s vaccine showed 66 percent prevention of moderate to severe illness, compared to nearly 95 percent with the Pfizer and Moderna vaccines, the clinical trials were done at different times in the pandemic with different patient populations, so the results are not an apples-to-apples comparison. Importantly, no one who received any of the vaccines in trials was hospitalized or died from the disease.

There were additional positive indications from vaccine studies this week. It was already known that all approved vaccines have shown significant reduction in symptomatic disease and moderate to severe illness, but a preliminary study from the AstraZeneca/Oxford vaccine also showed reduced transmission of the disease by 67 percent, indicating the vaccine not only prevents symptoms but also reduces asymptomatic spread.

Why It Matters

Vaccine administration has been steadily growing over the last two months. As of this week, the United States now has more people that have received at least one dose of a COVID vaccine (more than 33 million) than have tested positive for COVID (26.5 million). The number of vaccines administered per day has grown to a seven-day average of 1.3 million per day in the last week.

While there is much to celebrate in that news, even at the current rate of just over 1 million vaccinated per day, it will still take 11 months to fully vaccinate 75 percent of the U.S. population. Continued social distancing, mask use, and increased funding for public health and hospitals must be part of the ongoing plan. But increasing the speed of the vaccine rollout, especially if further studies validate that people who are vaccinated are significantly less likely to spread the disease, could have the biggest impact. Because the J&J vaccine is easier to ship and store without freezer requirements and only requires one vaccine, it could be a key factor in getting to herd immunity sooner, preventing thousands of deaths. Continuing prevention methods to reduce new COVID cases remains vital now, but the incredible life-saving potential of the vaccine should not be undersold.

Health Ecosystem of the Future

The Buzz This Week

This is the time of year when a variety of reports and articles reflect on the past year in healthcare and opine on trends that will be especially relevant in the year ahead. 2020, however, was a unique year on which to reflect. In addition to the predictable commentary about ever-rising healthcare expenditures, continued digital advances in healthcare, the rise of consumerism, and the important but oft-ignored threats to cyber-security, the COVID-19 pandemic has been the centerpiece (or at least an area of focus) in most of these reflection and forecast reports.

The National Academy of Medicine (NAM) recently released Vital Directions for Health and Health Care: Priorities for 2021, as covered in the most recent issue of Health Affairs. In one article, NAM outlines six steps it believes will strengthen the United States’ preparedness for a future pandemic:

  1. Launch a commission to study the U.S.’s preparedness and response to COVID and glean lessons learned and develop resulting recommendations
  2. Modernize the national public health system and strengthen it, beginning with stronger federal leadership and funding
  3. Re-engage in global health efforts, including committing to a long-term participation in the World Health Organization (WHO)
  4. Reinforce a science-based approach to public health policy
  5. Expand federal funding to support agencies that will work to “predict, prevent, prepare for, and contain pandemics”
  6. Embrace the concept of One Health, which recognizes the connections among human, animal, and environmental health and approaches public health research and initiatives in a coordinated, rather than siloed, manner

The NAM also reminds us that this pandemic “has demonstrated that healthcare inequity in the U.S. is a public health threat to the whole population.” It also contributed to the same issue of Health Affairs articles with specific recommendations to reduce and prevent health disparities.

An article in the Journal of the American Medical Association Health Forum lauds the unprecedented speed at which two (and now more) highly effective vaccines were developed for a previously unknown virus. At the same time, it underscores that our lack of preparedness for a pandemic and the breakdown in state and local public health responsibilities had a devastating impact on our economy, taxed our healthcare system to the extreme, contributed to enormous loss of life, and is now complicating vaccine distribution.

Rebecca Bartles, Executive Director of System Infection Prevention at Providence St. Joseph Health, commented in a recent interview published in Fierce Healthcare that she never would have imagined a time when health systems wouldn’t be capable of doing what the Centers for Disease Control and Prevention recommended or would see such disjointed recommendations from local, state, national, and international public health organizations. “If you had told me that … I would have laughed. That wasn’t a reality before. The scale and size of this has stretched our system and showed a lot of failure points.” Author and journalist Malcolm Gladwell recently commented that the nation’s public health system can learn from the companies that performed well during the pandemic, such as FedEx or Walmart, in a recent “fireside chat” hosted by Law Firm Arent Fox that Fierce Healthcare covered. Regarding the rocky vaccine rollout and how it could be improved, Gladwell stated, "Your local health department does not resemble FedEx — it should."

Why It Matters

The common takeaway that permeates each of these reports and commentaries is that the United States was woefully unprepared for a pandemic and faced dire consequences in 2020. The reasons for this lack of preparedness and recommendations as to what we can learn and do going forward vary, but a common theme persists in most commentary: that the U.S. demonstrated a striking failure in leadership and breakdown in coordination in response to COVID. Pandemics and other widespread public health crises are complicated, but by most accounts, stronger leadership in preparing for and reacting to a pandemic, and a clear construct by which to coordinate efforts to fight and contain the pandemic, would produce a far better outcome.

Health Disparities

The Buzz This Week

Vaccines offer a life-saving option in the middle of a deadly pandemic. Vaccine prioritization was intended to be equitably distributed amongst those most at-risk: healthcare and essential workers and older Americans. However, the data available thus far tells a different story. While the complete picture is missing (with race and ethnicity data missing for nearly 50 percent of the people who have been vaccinated), the data that is available shows that eligible Black and Hispanic populations are being vaccinated at far lower proportions than White counterparts.

An additional (and sometimes overlapping) group that is being left behind in the vaccination process is older Americans living alone who do not have family members or friends to help secure their appointments or drive them to get their vaccines. The data, though incomplete, show that those in low-income areas, those unable to afford broadband and/or smartphones, those who speak English as a second language, and those with hearing and vision impairments have a significant disadvantage in getting vaccinated.

Why It Matters

The data indicates that people who are poor or marginalized are falling to the back of the line. We have an opportunity to prevent history from repeating itself. For those who are eligible but unable to register or get to a vaccine site, we must find strategies that can bring COVID vaccines to the community. A community vaccine strategy will require funds for additional public health workers and infrastructure. It will also likely require a single-dose vaccine without temperature requirements. The J&J vaccine may make this option a possibility in the U.S. Getting to herd immunity in the communities most impacted by COVID should be one of the metrics of success by which we measure the rollout.


Contributors

Roger A. Ray. MD
Chief Physician Executive
[email protected]

Alexandra Schumm
Principal, Vice President of Research
[email protected]

Abigail Arnold
Senior Research Manager
[email protected]


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Past Top Reads

JANUARY 2021
Week 4
Week 3
Week 2
Week 1

DECEMBER 2020
Week 2
Week 1

NOVEMBER 2020
Week 3
Week 2
Week 1

OCTOBER 2020
Week 5
Week 4
Week 3
Week 2
Week 1

SEPTEMBER 2020
Week 4
Week 3
Week 2
Week 1

AUGUST 2020
Week 4

Chartis Top Reads - Week of February 1 - 6, 2021 - The Chartis Group