2:04 PM ET
Greg WyshynskiESPN
The NHL retested players from the St. Louis Blues and Vegas Golden Knights on Wednesday after false positive results for COVID-19 were reported from one U.S.-based lab on Tuesday.
Wednesday's retests confirmed that the originals were in error, the league said, and all players involved were made available for their next games.
For the Blues, that meant Wednesday night against the Colorado Avalanche for Game 2. Though the names of St. Louis' players involved in the retesting were not released, there were four Blues -- Jaden Schwartz, Vladimir Tarasenko, Marco Scandella and Jordan Binnington -- who missed the morning skate on Wednesday. All four were on the ice for pregame warm-ups in Denver, and they played in Game 2.
"Those reported results emanated from the same laboratory, and due to other peculiarities and similarities as among the test results themselves, an investigation was initiated into the possibility that the initial test results reported may have been in error," the league said in a statement. "All affected players were immediately isolated and further testing was done involving collected samples. Those tests have returned uniformly negative results, therefore confirming that the initial reported test results were in error. As a result, all affected players will be eligible to play in their team's next game."
The Blues were without forward David Perron, their leading scorer, for Game 1 because of protocols. Forward Nathan Walker and defenseman Jake Walman also were on the list. They did not dress for Game 2.
Walman was a notable absence because the Blues said he was the rare "breakthrough case" of COVID-19 after vaccination. He was placed on the list May 12 after the team asked for additional testing.
The Golden Knights and Minnesota Wild will play Game 3 of their first-round series on Thursday. That series is tied 1-1.
There is still consistent testing of players in the Stanley Cup playoffs, but the NHL announced earlier in May that it would be easing COVID-19 restrictions for U.S. teams once 85% of each traveling party was fully vaccinated. Those teams could have players gather in groups and not undergo PCR (polymerase chain reaction) testing on off days, among other perks.
Well over 100 NHL players missed time in the regular season after going on the NHL's coronavirus-related absences list. Multiple teams had their seasons interrupted by COVID-19 outbreaks, including the Vancouver Canucks, who finished their regular season on Wednesday with a loss to the Calgary Flames.
Introduction
Telehealth, the provision of health care services to patients from providers who are not at the same location, has experienced a rapid escalation in use during the COVID-19 pandemic, among both privately-insured patients and Medicare beneficiaries. Before the pandemic, coverage of telehealth services under traditional Medicare was limited to beneficiaries living in rural areas only, with restrictions on where beneficiaries could receive these services and which providers could be paid to deliver them. Soon after the federal government declared a public health emergency due to COVID-19 in early 2020, Congress and the Centers for Medicare & Medicaid Services (CMS) expanded traditional Medicares coverage of telehealth services in order to make it easier for beneficiaries to get medical care and minimize their exposure to coronavirus in health care settings. When the public health emergency ends, however, Medicares coverage of telehealth services will revert back to the more limited availability that existed before the pandemic, unless policymakers take action to extend the expanded coverage.
In light of the rapid, but time-limited, expansion of telehealth coverage under traditional Medicare, this brief provides an overview of the changes made during the COVID-19 pandemic to Medicares coverage of telehealth. It also presents new analysis of Medicare beneficiaries utilization of telehealth between the summer and fall of 2020, and discusses issues and questions related to extending telehealth coverage under traditional Medicare beyond the public health emergency. Our analysis of beneficiaries use of telehealth services is based on survey data of Medicare beneficiaries living in the community from the CMS Medicare Current Beneficiary Survey (MCBS) Fall 2020 COVID-19 Supplement. All differences reported in the text are statistically significant, unless otherwise noted. (See Data and Methods for details.)
Before the COVID-19 pandemic, coverage of telehealth services under traditional Medicare was limited. Medicare paid for approximately 100 services provided by telehealth, and there were limitations on how these services could be delivered and which beneficiaries could access them. Such limitations do not apply in Medicare Advantage plans, which have flexibility to offer additional telehealth benefits not covered by traditional Medicare outside of the public health emergency (see below for more information). Prior to the pandemic, the utilization of telehealth among traditional Medicare beneficiaries was extremely low, with only 0.3% of traditional Medicare beneficiaries enrolled in Part B using telehealth services in 2016, accounting for only 0.4% of traditional Medicare Part B spending. Similarly, analysis of primary care visits in traditional Medicare found that only 0.1% of these visits were provided via telehealth before the pandemic in February 2020.
To make it easier and safer for beneficiaries to seek medical care during the COVID-19 pandemic, the HHS Secretary waived certain restrictions on Medicare coverage of telehealth servicesfor traditional Medicare beneficiaries during the COVID-19 public health emergency, based on waiver authority included in theCoronavirus Preparedness and Response Supplemental Appropriations Act(and as amended by theCARES Act). The waiver, effective for services starting on March 6, 2020, significantly loosened coverage restrictions for telehealth under traditional Medicare during the public health emergency, as described below. The public health emergency was most recently renewed in April 2021, and, according to the Biden Administration, is expected to remain in place for the duration of 2021.
Before the public health emergency, telehealth services were generally available only to beneficiaries in rural areas originating from a health care setting, such as a clinic or doctors office. Beneficiaries in urban areas were ineligible for telehealth services, and beneficiaries could not receive telehealth services in their own homes. During the public health emergency, beneficiaries in any geographic area can receive telehealth services, and can receive these services in their own home, rather than needing to travel to a distant site (i.e., a health care setting).
Under Medicares existing telehealth benefit, a telehealth visit must be conducted with two-way audio/video communications and the use of smartphones or audio-only telephones in lieu of video is not permitted. For the duration of the COVID-19 public health emergency, telehealth services can be conducted via an interactive audio-video system, as well as using smartphones with real-time audio/video interactive capabilities without other equipment. Additionally, a limited number of telehealth services can be provided to patients via audio-only telephone or a smartphone without video.
Before the public health emergency, only physicians and certain other practitioners (such as physician assistants, clinical social workers, and clinical psychologists) were eligible to receive Medicare payment for telehealth services provided to eligible beneficiaries in traditional Medicare, and they must have treated the beneficiary receiving the services in the last three years. During the public health emergency, any health care professional that is eligible to bill Medicare for professional services can provide and bill for telehealth services, and does not need to have previously treated the beneficiary. Also, federally qualified health centers and rural health clinics are allowed to provide telehealth services to Medicare beneficiaries during the COVID-19 public health emergency; these settings were not authorized as providers of telehealth services for Medicare beneficiaries prior to the pandemic.
Before the public health emergency, traditional Medicare covered about 100 services that could be administered through telehealth, including office visits, psychotherapy, and preventive health screenings, among other services. During the public health emergency, the list of allowable telehealth services covered under traditional Medicare expanded to include emergency department visits, physical and occupational therapy, and certain other services. Some evaluation and management, behavioral health, and patient education services can be provided to patients via audio-only telephone.
Separate from Medicares coverage of telehealth services, traditional Medicare covers brief, virtual check-ins (also called brief communication technology-based services) via telephone or captured video image, andE-visits for all beneficiaries, regardless of whether they live in a rural area. Both of these services, which were not amended during the public health emergency, are more limited in scope than a full telehealth visit. For example, virtual check-ins can only be reported by providers with an established relationship to the patient, cannot be related to a recent medical visit (within the past 7 days), and cannot lead to a medical visit in the next 24 hours (or the soonest available appointment, and payment is intended to cover only 5-10 minutes of medical discussion.
Before the public health emergency, Medicares payment for a telehealth service was the same regardless of whether it was provided in a non-facility setting, such as a clinicians office, or a facility setting, such as a hospital outpatient department, and the payment rate was based on the lower amount paid to facility-based providers for a service delivered in person. (Under Medicares physician fee schedule, the payment to facility-based-providers for in-person services is lower than the payment to non-facility providers because Medicare makes a separate payment to facilities to cover practice expenses, such as physical space, medical supplies, medical equipment, and clinical staff time.) The rationale for using the lower facility payment amount for telehealth services was that practice expenses for the delivery of telehealth services should be lower than those for an in-person visit.
During the public health emergency, Medicare pays for telehealth services, including those delivered via audio-only telephone, as if they were administered in person, with the payment rate varying based on the location of the provider, which means that Medicare pays more for a telehealth service provided by a doctor in a non-facility setting than by a doctor in a hospital outpatient department. This also means that during the public health emergency, doctors in non-facility settings are receiving a higher payment for services provided by telehealth than they did before the public health emergency.
Beneficiary cost sharing for telehealth services has not changed during the public health emergency. Medicare covers telehealth services under Part B, so beneficiaries in traditional Medicare who use these benefits are subject to the Part B deductible of $203 in 2021 and 20% coinsurance. However, the HHS Office of Inspector General hasprovided flexibilityfor providers to reduce or waive cost sharing for telehealth visits during the COVID-19 public health emergency, although there is no publicly-available data to indicate the extent to which providers may have done so. Most beneficiaries in traditional Medicare have supplemental insurance that may pay some or all of the cost sharing for covered telehealth services.
Separate from the time-limited expanded availability of telehealth services, CMS has granted providers participating in some alternative payments models, including Next Generation accountable care organizations (ACOs) and Medicare Shared Savings Program ACOs, greater flexibility to provide care through telehealth, including billing for telehealth services provided to both urban and rural beneficiaries and to beneficiaries when they are at home. Telehealth flexibilities in the Next Generation ACO demonstration are granted via benefit enhancement waivers administered by CMS. From 2016-2018, few Next Generation ACOs received and implemented telehealth waivers (4 ACOs; 8% of all ACOs in the model).
Medicare Advantage plans have been able to offer additional telehealth benefits not covered by traditional Medicare outside of the public health emergency, including telehealth visits provided to enrollees in their own homes and services provided outside of rural areas. In 2021, virtually all Medicare Advantage plans (98%) offer a telehealth benefit.
Medicare Advantage plans are paid a capitated amount by Medicare to provide basic Medicare benefits covered under Parts A and B; legislative changes implemented in 2020 allow plans to include additional telehealth benefits beyond what traditional Medicare covers in their bids for basic benefits. Therefore, the cost of additional telehealth services offered by Medicare Advantage plans are reflected in the capitated payment that plans receive.
Medicare Advantage plans have flexibility to waive certain requirements with regard to coverage and cost sharing in cases of disaster or emergency, such as the COVID-19 outbreak. In response to the coronavirus pandemic,CMS has advised plans thatthey may waive or reduce cost sharing for telehealth services, as long as plans do this uniformly for all similarly situated enrollees. Many Medicare Advantage plans have waived or reduced cost sharing for enrollees for some or all services administered via telehealth during the public health emergency.
As of Fall 2020, six months after the expansion of telehealth benefits in traditional Medicare for the COVID-19 pandemic, nearly two-thirds of community-dwelling Medicare beneficiaries who say they have a usual source of care (64%, or 33.6 million beneficiaries), such as a doctor or health professional, or a clinic, reported that their usual provider offers telehealth appointments, up from roughly 1 in 5 (18%, or 6.1 million) beneficiaries who said their usual provider offered telehealth before the pandemic (Figure 2; Table 1). (The majority of community-dwelling Medicare beneficiaries, 95% or 52.7 million, report having a usual source of care). Conversely, 13% of beneficiaries with a usual source of care said their provider does not currently offer telehealth, a substantial decrease compared to the 52% who said their provider did not offer telehealth before the COVID-19 pandemic.
While the reported availability of telehealth has increased during the pandemic, nearly a quarter of Medicare beneficiaries with a usual source of care (23% or 11.9 million beneficiaries) said they do not know if their usual provider currently offers telehealth appointments.
The reported rates of beneficiaries who say their provider currently offers telehealth was similar across most demographic groups (Figure 3). However, a smaller share of Medicare beneficiaries living in rural areas than those living in urban areas said their provider currently offers telehealth (52% vs. 67%, respectively), and a larger share of rural beneficiaries report not knowing if their usual provider offers telehealth appointments than beneficiaries living in urban areas (30% vs 21%, respectively).
A larger share of Black Medicare beneficiaries with a usual source of care (23%) say their usual provider does not currently offer telehealth appointments than White (12%) and Hispanic (15%) beneficiaries with a usual source of care. Additionally, a larger share of Medicare beneficiaries enrolled in both Medicare and Medicaid (19%) say their usual provider does not currently offer telehealth appointments than Medicare beneficiaries who are not enrolled in both Medicare and Medicaid (12%).
Among the two-thirds of Medicare beneficiaries with a usual source of care who reported in the Fall of 2020 that their usual provider offers telehealth during the pandemic (33.6 million beneficiaries), nearly half (45%, or 14.9 million beneficiaries) reported having a telehealth visit since July 2020. Some groups of Medicare beneficiaries were more likely than others to report having a telehealth visit with a doctor or other health professional since July 2020, including Medicare beneficiaries under age 65 with long-term disabilities, Black and Hispanic beneficiaries, Medicare beneficiaries enrolled in both Medicare and Medicaid, and beneficiaries with multiple chronic conditions (Figure 4; Table 2).
Among Medicare beneficiaries who have a usual source of care and whose usual provider offers telehealth:
Notably, among Medicare beneficiaries with a usual source of care and whose usual provider offers telehealth, we found no significant difference between the share of rural and urban Medicare beneficiaries who had a telehealth visit (43% and 45%, respectively). However, based on the overall population in these groups, rural Medicare beneficiaries were less likely than urban beneficiaries to have a telehealth visit with a doctor or other health professional (21% vs. 28%, respectively). This difference is likely driven by the fact that rural Medicare beneficiaries were more likely than urban Medicare beneficiaries to say they do not know if their usual provider offers telehealth (30% vs. 21%, respectively).
Similarly, among Medicare beneficiaries with a usual source of care whose usual provider offers telehealth, we found that a larger share of Black and Hispanic beneficiaries had a telehealth visit compared to White beneficiaries (52%, 52%, and 43%). However, among the total Medicare population, the difference in the share of Black and White beneficiaries who reported having a telehealth visit was not statistically significant (30% vs. 26%), while a larger share of Hispanic beneficiaries than White beneficiaries had a telehealth visit (33% vs. 26%). For Black Medicare beneficiaries, this result is likely related to the fact that nearly a quarter of Black beneficiaries overall (23%) say their usual provider does not offer telehealth appointments, compared to 12% of White beneficiaries and 15% of Hispanic beneficiaries.
Among Medicare beneficiaries with a usual source of care whose provider offers telehealth appointments, the majority of those who had a telehealth visit since July 2020 accessed the service by telephone (56%), compared to 28% who reported having a telehealth visit by video and 16% who used both telephone and video (Figure 5; Table 3). This may be related to the fact that while more than 8 in 10 Medicare beneficiaries report having access to the internet (83%), smaller shares say they own a computer (64%) or a smartphone (70%) (Figure 6, Table 4).
There are notable differences by demographic characteristics in how beneficiaries have accessed telehealth services during the pandemic and the availability of technology that enables access to telehealth, for example:
Our analysis finds that 1 in 4 Medicare beneficiaries have had a telehealth visit during the COVID-19 public health emergency, representing a substantial increase in use since before the pandemic. Our finding that, among beneficiaries whose provider offers telehealth, a greater share of those with disabilities, with low incomes, and in communities of color have used telehealth suggests that the temporary expansion of telehealth coverage may be helping some of Medicares more disadvantaged populations continue to access needed care. At the same time, in light of our finding that a quarter of Medicare beneficiaries overall (and an even larger share of those in rural areas) do not know if their doctor currently offers telehealth, efforts to increase awareness of covered telehealth services under Medicare during the public health emergency could help to broaden its reach.
Currently, policymakers are considering a variety of proposals to expand some or all of the existing flexibilities surrounding telehealth services under Medicare beyond the public health emergency, and many have expressed support for doing so. Among the telehealth-related bills that have been introduced in the 117th Congress include proposals to permanently cover some of the telehealth expansions provided during the public health emergency, expand Medicare-covered mental health services and evaluation and management services administered via telehealth, and expand the scope of providers eligible for payment for telehealth services covered by Medicare. Other bills are aimed at assessing the impact of expanded telehealth services on the quality of patient care and program spending.
Under Medicares existing telehealth benefit, a telehealth visit must be conducted with two-way audio/video technology, while under the current public health emergency waiver, a limited number of telehealth services can be provided to patients via audio-only telephone. Given that the majority of Medicare beneficiaries in our analysis reported accessing telehealth services by telephone only, an expanded telehealth benefit that requires two-way video communication could be a barrier to care for subgroups of the Medicare population that relied more heavily on telephones than video-capable devices during the pandemic.
MedPAC has recommended that Medicare continue a modified version of expanded telehealth coverage for another year or two after the public health emergency ends, giving Medicare time to assess the effects of telehealth use on total costs, access, and quality of care. During this additional time, MedPAC recommends that Medicare pay for specified telehealth services regardless of where a beneficiary lives; cover some additional telehealth services beyond those covered prior to the public health emergency if there is potential for clinical benefit; and cover audio-only telehealth visits if there is potential for clinical benefit. MedPAC has also recommended that payment for telehealth services after the public health emergency revert to the lower facility-based payment rate in effect before the pandemic, and that providers should not be allowed to waive or reduce beneficiary cost sharing.
Expanded coverage of telehealth beyond the public health emergency could affect the quality of patient care as well as program and beneficiary spending. Broadening telehealth coverage has the potential to improve access to needed care, but there is uncertainty as to whether it would lead to an overall increase or decrease in program spending. Some telehealth services may be substitutes for in-person care, such as a behavioral health care visit, though easier access to telehealth could lead to an overall increase in visits and costs. Other telehealth services may not fully replace the need for (or occurrence of) an in-person visit, such as a visit to evaluate a skin rash or where lab work is determined to be needed. In building evidence on the cost and quality impacts of telehealth use in Medicare, the Administration could also potentially gain insights based on telehealth use by enrollees in Medicare Advantage plans, or by testing different approaches through Center for Medicare and Medicaid Innovation models.
The potential expansion of telehealth coverage brings with it concerns about the potential for fraudulent activity. There have been several large fraud cases involving telehealth companies in recent years, most of which involved the submission of fraudulent claims for items, services, and tests to Medicare and other insurers that were never given or administered to patients. HHS Office of the Inspector General (OIG) is conducting several studies to assess the appropriateness of use of telehealth during the public health emergency, including an analysis of provider billing patterns in order to identify providers that could pose a risk for program integrity and an audit of telehealth services under Part B to assure that services are meeting Medicare requirements. MedPAC has recommended that Medicare apply additional scrutiny to outlier clinicians who deliver more telehealth services than others, as well as requiring in-person visits before clinicians can order high-cost equipment or services for beneficiaries.
The temporary expansion of coverage for telehealth services has allowed many people with Medicare to access medical care during the coronavirus pandemic. Given that the temporary waiver of restrictions on coverage of telehealth services under Medicare will come to an end with the expiration of the public health emergency, the question of whether and how to ensure continued access to these services, while balancing concerns about quality of care and spending, looms large.
In order to determine the share of Medicare beneficiaries whose provider offers telehealth, beneficiaries who answered affirmatively to the question Is there a particular doctor or other health professional, or a clinic you usually go to when you are sick or for advice about your health? (9,216 out of 9,686 respondents) were asked Does your usual provider offer telephone or video appointments, so that you dont need to physically visit their office or facility? (5,644 respondents answered affirmatively).
In order to determine the share of Medicare beneficiaries who had a telehealth visit, beneficiaries with a usual source of care whose usual provider offers telehealth appointments were asked Since July 1, 2020, have you had an appointment with a doctor or other health professional by telephone or video? (2,515 respondents answered affirmatively). Similarly, beneficiaries with a usual source of care whose provider offers telehealth were asked Did your usual provider offer telephone or video appointments before the coronavirus pandemic? (1,035 respondents answered affirmatively).
To determine how beneficiaries accessed telehealth appointments, beneficiaries who had a telehealth appointment since July 2020 were asked Was it a telephone appointment, video appointment, or both? The majority of Medicare beneficiaries who had a telehealth visit since July 2020 had a visit via telephone (n=1,460), while fewer had a telehealth visit via video (n=653) or via both telephone and video (n=393).
Based on the questionnaire skip patterns, beneficiaries were only asked about their use of telehealth if they answered affirmatively that they had a usual source of care and that their usual provider offers telehealth. In order to determine the share of Medicare beneficiaries who had a telehealth visit among Medicare beneficiaries overall, we created a categorical variable that included beneficiaries whose provider did not offer telehealth or it was unknown. The variable had three categories: 1) usual provider offers telehealth and beneficiary had a telehealth visit (n=2,515); 2) usual provider offers telehealth and beneficiary did not have a telehealth visit (n=3,074); 3) usual provider does not offer telehealth or it was unknown (n=4,097).
Results from all statistical tests were reported with p<0.05 considered statistically significant.
What GAO Found
GAO analysis of data from the Centers for Disease Control and Prevention (CDC) shows that, from May 2020 through January 2021, nursing homes commonly experienced multiple COVID-19 outbreaks. According to CDC, an outbreak starts the week a nursing home reports a new resident or staff COVID-19 case and ends when there are 2 weeks with no new cases. GAO found that nursing homes had an average of about three outbreaks during the review period, with most of the nursing homes (94 percent, or 12,555 of the 13,380 nursing homes) experiencing more than one COVID-19 outbreak.
Note: Percentages may not add to 100 due to rounding. Data are from the weeks ending May 31, 2020, through January 31, 2021. An outbreak begins when a nursing home reports a new case of COVID-19 in residents or staff.
For each nursing home's longest-lasting COVID-19 outbreak, GAO found that about 85 percent (11,311 nursing homes) had outbreaks lasting 5 or more weeks. Conversely, for about 15 percent of nursing homes (2,005 homes), the longest outbreak was shorter in duration, lasting between 1 and 4 weeks, with 267 of those homes able to control their outbreaks after the initial week.
Note: Of 13,380 nursing homes reviewed, 13,316 nursing homes had COVID-19 outbreaks and 64 nursing homes did not. Data are from the weeks ending May 31, 2020, through January 31, 2021.
The COVID-19 pandemic has had a disproportionate impact on the 1.4 million elderly or disabled residents in the nation's more than 15,000 Medicare- and Medicaid-certified nursing homes. The Centers for Medicare & Medicaid Services (CMS) is responsible for ensuring that nursing homes nationwide meet federal quality standards.
The CARES Act includes a provision directing GAO to monitor the federal pandemic response. GAO was also asked to review CMS oversight of nursing homes in light of the pandemic. This report describes the frequency and duration of COVID-19 outbreaks in nursing homes. Future GAO reports will further examine nursing homes' experiences with COVID-19 outbreaks.
To conduct this work, GAO analyzed CDC data on COVID-19 reported by nursing homes each week of the review period from May 2020 through January 2021, the most recent data available at the time GAO conducted its review. Using CDC's definition of an outbreak, GAO determined the number and duration of outbreaks each nursing home experienced during the review period. GAO included data from the 13,380 Medicare- and Medicaid-certified homes (88 percent of Medicare- and Medicaid-certified homes) that passed CDC and CMS quality checks each week of the review periodthe most reliable data for calculating the number and duration of outbreaks. GAO also categorized the nursing homes into two groups based on the duration of their longest outbreak: 1) those nursing homes with outbreaks lasting less than 5 weeks and 2) those nursing homes with outbreaks lasting at least 5 weeks.
For more information, contact John E. Dicken at (202) 512-7114 or dickenj@gao.gov.
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Alaskas average daily case counts are now trending down significantly statewide, though a few regions in the state are still in the highest alert category based on their current per capita rate of infection.
Anyone 12 and older who lives or works in Alaska can now receive a COVID-19 vaccination. Alaskans can visit covidvax.alaska.gov or call 907-646-3322 to sign up for a vaccine appointment, and new appointments are added regularly. The phone line is staffed from 9 a.m. to 6:30 p.m. on weekdays and 9 a.m. to 4:30 p.m. on weekends.
Only Pfizers vaccine is approved for children as young as 12; the Moderna and Johnson & Johnson vaccines are approved only for those 18 and older.
By Tuesday, 315,049 people about 53.1% of Alaskans age 16 and older had received at least their first dose of vaccine. At least 275,567 people 47.4% of Alaskans 16 and older were considered fully vaccinated, according to the states vaccine monitoring dashboard, which hadnt yet been updated as of early Wednesday afternoon.
By Wednesday, there were 27 people with confirmed or suspected cases of COVID-19 in hospitals throughout the state, far below a peak in late 2020.
Of the 95 cases reported Wednesday among Alaska residents, there were 22 in Anchorage, plus one in Chugiak and three in Eagle River; 12 in Ketchikan; nine in Fairbanks; nine in Wasilla; six in Palmer; four in Hooper Bay; two in North Pole; two in Ester; two in Craig; two in Metlakatla; one in Anchor Point; one in Homer; one in Sterling; one in Delta Junction; one in Tok; one in Juneau; and one in Petersburg.
In smaller communities that are not named to protect residents privacy, there were eight in the Chugach Census Area, two in the Ketchikan Gateway Borough, two in the Aleutians East Borough and two in the Bethel Census Area.
Two new nonresident cases, one in Anchorage and one in Juneau, were also identified.
While people might get tested more than once, each case reported by the state health department represents only one person.
The states data doesnt specify whether people testing positive for COVID-19 have symptoms. More than half of the nations infections are transmitted from asymptomatic people, according to CDC estimates.
[Correction: This story has been updated to reflect that the new death reported Wednesday involved a Palmer man in his 60s, not a nonresident in Anchorage. The state health departments data showed an additional Anchorage nonresident death due to the reclassification of a death originally reported to involve an Anchorage resident.]
UPDATE: Oh, thank God:
You may have seen the earlier reports that the NHL and other sports leagues were having issues with potential false positives on COVID-19 tests.
If you were wondering what teams it was impacting, well, its the Blues. Of course, its the Blues. This situation is happening after NHL Deputy Commissioner Bill Daly said that the league was not considering any rescheduling of playoff games due to positive Covid tests.
This may or may not be related to David Perrons positive test that kept him out of Mondays 4-1 loss, but as of right now (1:15 pm), Schwartz, Tarasenko, and Binnington are not on the ice.
Blues GM Doug Armstrong has released a statement:
We have discovered discrepancies in Covid test results relating to multiple players. We have been in touch with and are working with the League to address these discrepancies with additional testing and expect to have further information later this afternoon.
The League will provide a further update when we have more information. Head Coach Craig Berube and our players will not be available to the media until after tonights game.
This post will be update with further info as it becomes available.
After you get your COVID-19 vaccine, you can get freebies including free doughnuts, beer and more. USA TODAY
Did you lose your COVID-19 vaccination card already? Or has it been destroyed?
You are in luck if you need to get another one.
Michiganders can contact the site where they were vaccinated, such as the local health department or health care provider, and request a new vaccination card,said Lynn Sutfin, spokesperson for theMichigan Department of Health and Human Services.
She said residents also can fill out a form to get a copy of their immunization record from the Michigan Care Improvement Registry (MCIR), an immunization database that documents inoculations given to Michiganders,at https://www.mcir.org/public/.
The Wayne County Health Department announced Tuesday it can provide its residents with a replacement COVID-19 vaccination card if the original one was lostor destroyed.
A stack of vaccine cards wait to be handed out to registered residents after they receive their Moderna COVID-19 vaccines from the Oakland County Health Division at Suburban Showplace in Novi, Mich. on Jan. 23, 2021. Three thousand four hundred appointments were made for groups 1A and 1B based on the State of Michigan's COVID-19 Vaccination plan(Photo: Kimberly P. Mitchell, Detroit Free Press)
Residents can request a replacement card by calling the health department clinic at 734-727-7100. Staff will verify the person's vaccination record through the state database and issue a new card. The new card can be picked up at the county's public health clinic, 33030 Van Born Road, in Wayne.
Also, ifa resident hasn't received both doses of the Pfizer or Moderna vaccines, Wayne County said it can provide the person with a copy of his or her vaccination record that can be taken to thesecond-dose appointment. Residents will receive a new card at their second-dose appointment, the county said in a release.
Detroit officials had not responded to how or whethercity residents can get a replacement card locally at the time of publication. But they can use the MCIR, state officials said.
More: Face masks in Michigan: What you need to know about the new CDC guidelines
More: Gift cards for hospitality workers part of new statewide COVID-19 vaccine campaign
Thomas Miller, 53, of Detroit looks over his vaccination card after receiving a Moderna COVID-19 vaccine along 2nd Avenue and Pingree Street in Detroit on Wednesday, April 28, 2021 as he waits for fifteen minutes following the vaccination. Central City Integrated Health paired up with The Salvation Army during their Bed & Bread Club delivery route as they deliver meals to those in need to help supply access to the COVID vaccine to Detroit residents who might not have transportation.(Photo: Ryan Garza, Detroit Free Press)
Macomb County Deputy Executive Vicki Wolber said residents should first check with the provider that administered their last dose of vaccine for a new vaccination card. They also can use MCIR to request their record.
If that doesn't work, she said residentscan call the county health department's immunization division at 586-469-5372.
In Oakland County, if anyone loses their vaccination card, the health division is able to give them their MCIRrecord and another card, said Bill Mullan, spokesman for County Executive Dave Coulter.
Anyone with questions can call the Nurse on Call number at800-848-5533. They could also make the request in person with the health division during business hours, Mullan said.
More: Michigan courts keeping mask mandate, say too difficult to identify who is vaccinated
More: Michigan hits first COVID-19 vaccine goal, to roll back workplace restrictions May 24
Sutfin said public health officials suggestresidents take a photo of their vaccination card so that they have a copy of it on their phone.
She said there are no issues with laminating the cards. Some people have reported issues with the ink on their cards when they had them laminated or concerns about adding information to the card if a booster is needed in the future.
More: Where you can get your 12- to 15-year-old a COVID-19 vaccine in Michigan
Anyone age 12 and older is eligible for the two-shot Pfizer vaccine. Anyone age 18 and older also can receive the Moderna two-dose vaccine or the one-dose Johnson & Johnson shot.
More than 4.5 million Michiganders, or 56.5% of the population age 16 and older, have received at least one dose of vaccine, according to the state's dashboard.
Contact Christina Hall: chall@freepress.com. Follow her on Twitter: @challreporter.
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A raging Covid-19 outbreak in India has not hampered the promotion of some questionable science by the government, drawing the ire of some of the countrys scientists.
One example is the Indian science ministrys funding of an Indian Council of Medical Research (ICMR) trial on whether reciting an ancient Hindu prayer, Gayatri Mantra, along with a set of deep breathing exercises in yoga could improve treatment of Covid-19 patients.
The chanting of the prayer is being evaluated along with pranayama breathing exercises from yoga as a pilot study to assess inflammatory markers in hospitalised Covid-19 patients at the All India Institute of Medical Sciences (AIIMS), Rishikesh, under the ICMR.
Patients will be given instructions on chanting and breathing exercises through video-conferencing for an hour in the morning and evening in the hospital room or at home after discharge, for up to 14 days. The criticism is mostly aimed at the design of the trial, small sample size and pre-conceived bias.
Breathing exercises are expected to benefit Covid-19 patients, says Partha Majumdar, founding director of National Institute of Biomedical Genomics, Kolkata. But when they are mixed with chanting of the prayer, it will be impossible to separate the effects of the two on Covid-19 patients, he says. Even if the prayer has no effect, which is the most plausible expectation, the beneficial effect of pranayama will show up as the confounded effect of both, he says.
Scientists have also criticised the small sample size just 20 volunteers. It is too small a number for arriving at any inference, especially because we are still unclear about the rather large variability of Covid-19 symptoms during the disease and during recovery, says Subhash Lakhotia, a cytogeneticist at the Banaras Hindu University. The details available at the clinical trials registry also do not make it clear if the analysis would follow a blind protocol. I am surprised that such an irrationally planned research project, even if claiming to be a pilot study, is approved for funding.
A greater worry [with] such directed research is the pre-existing bias, says Lakhotia. Previous studies undertaken to validate the claimed benefits of chanting Gayatri Mantra too suffered from a similar absence of rational planning. Such improperly planned studies are indeed typical of pseudoscience, he says.
On 7 May, Indias Ayush ministry that deals with alternate systems of medicines, ayurveda, yoga, unani, siddha and homeopathy, announced a nationwide campaign to promote polyherbal drugs for Covid-19 patients undergoing treatment at home. It states that the efficacy of these drugs has been proved through robust multi-centre clinical trials, but does not link to any peer-reviewed evidence for this claim.
In February 2021, Indias science and health minister Harsh Vardhan, himself a doctor and surgeon, was present at the launch of a Coronil kit, containing three herbal medicines, which is claimed to boost immunity. It was formulated by self-styled godman Baba Ramdevs company Patanjali. Ramdev initially claimed Coronil was certified by Indias drug regulator and the World Health Organization (WHO). The WHO quickly clarified on Twitter that it has not reviewed or certified any traditional medicine for the treatment [of] #Covid-19.
The Indian Medical Association described the claims that Coronil could be used in prevention, treatment and post-Covid care as a false and fabricated projection of an unscientific medicine.
In recent times we are witnessing a trend where governmental agencies offer funding to scientifically validate personal beliefs, says Soumitro Banerjee, a professor of physics at the Indian Institute of Science Education and Research, Kolkata, and general secretary of Breakthrough Science Society (BSS) that promotes scientific rationalism. The BSS condemns financial support for ill-conceived research projects when mainstream science is suffering due to the lack of funding, he adds.
The world is very worried about coronavirus variants.
As the virus mutates which all viruses do variant strains emerge. Some of these variants are more effective at infecting humans and may even cause more severe disease.
Variants that appear to fall into this category have been identified in Brazil, South Africa, the United Kingdom and now India. And in an interconnected world, they can spread from one country to another.
How does a mutated version of the virus improve its chances of being transmitted to humans? If you imagine viruses as puzzle pieces, as this video does, that can help explain what is happening when a coronavirus variant comes into contact with human cells.
This illustrated guide and video can help:
panel 12 Kaz Fantone for NPR hide caption
Good evening. Im Kiera Feldman, and its Wednesday, May 19. Heres whats happening with the coronavirus in California and beyond.
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Every Friday night, I trek to The Times building in El Segundo to feed the colony of feral cats that lives in the office parking lot. The cats have their own schedule of caretakers, and my weekly slot has become a comforting ritual throughout the pandemic. I look up at the seventh floor where my desk has sat unused for the past 14 months and remember the Before Times, then turn back to the felines I see more than my actual colleagues.
By and large, Los Angeles Times staffers have not yet resumed normal office routines. Perhaps we will soon. Theres a lot of logistical stuff to figure out regarding the health and safety issues of a pandemic thats still ongoing. And thats where a lot of companies are finding themselves these days.
After more than a year of remote work, employers across the country are trying to figure out what the future of offices will look like.
Many of the white-collar workers whove had the privilege of doing their jobs safely from home dont want to go back to cubicle land. Or, if they do, they want employer expectations to change dramatically, reports my colleague Ronald White.
Just over a third of workers surveyed recently by staffing firm Robert Half said they would quit if required to return to the office full time. Nearly half said that if they had to return to their offices, they would prefer a hybrid arrangement, dividing their time between the office and home (or wherever else they choose).
If Im going to be sitting on a computer on calls all day, Id rather be at home, said Rebecca Jacobsson, director of digital marketing strategy for an Irvine advertising agency. At least then I can be here for my kids when they get home from school.
Some big businesses are responding to those sentiments.
Google, for instance, walked back an announcement that all employees would be required to return to their offices three days a week. Now the company says employees worldwide can continue working remotely until September, after which theyll have the choice to return to their pre-pandemic schedules (either in their original office or at another Google location) or go entirely remote if their jobs allow it.
Microsoft said it will allow employees to work from home up to 50% of the time or work remotely full time if their manager approves.
In-person attendance is just one of the many issues employers are grappling with. COVID-19 precautions are a separate matter. In a Times survey of a dozen local companies, nearly all said they wouldnt require employees to get the COVID-19 vaccine. Many have encouraged workers to get the shot, and some have offered them paid time off to get vaccinated.
A number of L.A.-area companies are parsing the still-evolving mask guidelines to figure out how they will work in practice. Some are upgrading ventilation systems and installing new filters. But such measures may be overkill if most workers want to telecommute.
I really dont want to go back. I enjoy working from home, said Gary Holbrook, a software developer for a Southern California company. Once the shutdown began, I didnt have one-hour-plus commutes twice a day.
A shift to hybrid work may herald a deep culture change. Salesforce, a San Francisco-based software firm, has declared the traditional 9-to-5 workday dead, at least for now, and will allow employees to work away from their offices up to four days a week. Facebook and Twitter said they will allow employees to work from home indefinitely.
But each workplace is a world unto its own. You might find that you want one thing and your boss wants another. Reconfiguring the expectations around in-person work can make for a tricky negotiation. (Check out todays reader question below for advice on how to handle this.)
There will be growing pains, but the end result may be something better than we had in the Before Times.
Lets rethink work design, said Dr. Pouran D. Faghri of UCLAs Fielding School of Public Health. Lets think about how we can provide better mental health for employees to have better physical health to perform their jobs and use this as an opportunity, a starting point in the United States, and allow our workplaces to be a better place to work.
California cases, deaths and vaccinations as of 6:19 p.m. Wednesday:
Track Californias coronavirus spread and vaccination efforts including the latest numbers and how they break down with our graphics.
Speaking of the complexities around returning to work, California officials said Wednesday that they are considering dropping mask mandates and physical distancing rules for workplaces where everyone is fully vaccinated.
For the first time in a long time, I feel optimistic, said Dr. Sara Cody, the Santa Clara County health officer and public health director. For a while, it seemed uncertain to me whether the vaccines or the variants would win.
Californias Occupational Safety and Health Standards Board will meet Thursday to weigh a number of proposed changes to masking and physical distancing rules for vaccinated workers. For instance, if a workplace wanted to ditch masks and physical distancing, the employer would need to verify workers vaccination records. However, workers who want to keep wearing masks would be allowed to do so.
Its not clear yet how this would play out at stores or other businesses that deal with customers who may or may not be vaccinated. If not everyone in a room is vaccinated, the proposed standards call for employees to still wear face coverings and stay six feet away from other workers.
Workers have been required to wear masks indoors since Nov. 30, unless they are alone in a room or are eating or drinking. Theyve also generally been required to stay at least six feet apart from others.
Finding yourself in a room where everyone is fully vaccinated is becoming more and more likely. In another hopeful milestone, two-thirds of adults in California are now at least partially vaccinated.
The U.S. Centers for Disease Control and Prevention released data on Wednesday showing that more than 67% of Californians over 18 have received a vaccine dose. After getting off to a slow start, California now ranks 11th out of all states.
The states with the highest partial-vaccination rates for adults are Vermont (78.6%), Hawaii (77.1%) and Massachusetts (75.9%).
Factoring in newly eligible adolescents, about 63% of all Californians age 12 and older have received at least one dose so far.
But huge disparities remain. Many Latino men in L.A. havent been vaccinated, and the primary reasons come down to misinformation, fear and busy lives, my colleague Alejandra Reyes-Velarde reports.
Nationally, one-third of unvaccinated Latinos say they want to get the shot as soon as possible, according to a survey by the Kaiser Family Foundation. But many are concerned about missing work if they develop temporary side effects. Others are held back by a lack of transportation or the mistaken belief that theyll have to pay for the vaccine.
In L.A. County, vaccination rates are especially low among Latino men. As of May 9, 39% had gotten at least one shot, compared with 59% of white men and about 46% of Latina women.
Latino men are often heads of households, working multiple jobs to support their families. They dont have time to get vaccinated or to vet everything that comes their way on social media, explained Dr. Ilan Shapiro, a physician involved in #VacunateYa, a community vaccination effort.
Ive heard from a lot of men that theyre worried it will make them sexually impotent, said Jaime Guzman, a worker in Vernon. But Ive always thought, Theres a solution for everything except for death.
Guzman ignored the rumors and got vaccinated at a mobile clinic that came to his workplace. He said he firmly believes in listening to health experts who spend years studying diseases so they can advise the public.
Community leaders and health officials alike hope that trust in the vaccine will prove contagious.
See the latest on Californias coronavirus closures and reopenings, and the metrics that inform them, with our tracker.
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Health officials are worried about a preexisting condition that could put youth at greater risk of getting COVID-19: indifference.
Many teens (and their parents) think they dont need the COVID-19 vaccine, but experts say theyre wrong. Theyre urging the newly eligible 12- to 15-year-olds to get vaccinated, warning that adolescents can suffer severe complications if they get sick.
While adults face higher risks of becoming seriously ill or dying from COVID-19, thousands of children around the world have been hospitalized as well, and hundreds have died in the U.S. alone.
Nor are kids and teens immune from long COVID, a puzzling condition that leaves patients suffering an array of symptoms including fatigue, muscle aches, sleep disorders, stomach problems, and difficulty concentrating or focusing for months on end.
A study in Italy found that more than half of COVID-19 patients ages 6 to 16 had at least one symptom of long COVID for more than four months, with many experiencing symptoms severe enough to impair their daily activities.
Andy Slavitt, a senior Biden administration advisor on the pandemic, said that one of his sons contracted COVID-19 last fall and still suffers from long-term symptoms.
Hes young and fit and in the prime of his life. But six months later, he still suffers from tachycardia, shortness of breath, and ongoing and frequent flu-like symptoms, Slavitt said. Many young people are in this situation, and many, many have it worse.
Heres another thing many people dont understand about the pandemic: Stay-at-home orders saved lives and didnt significantly harm economies, writes columnist Michael Hiltzik.
Though they remain controversial, numerous studies from around the world offer clear evidence that lockdowns succeeded in lowering coronavirus transmission rates, Hiltzik says. An Italian team found that lockdowns start to reduce the number of coronavirus infections about 10 days after theyre enacted.
What they didnt do is prevent people from going out and spending money. In America, mobility data culled from smartphone records show that people started withdrawing from face-to-face commerce well before stay-at-home orders went into effect. The sharpest reductions occurred in the first half of March 2020. Yet the countrys first mandatory shutdown wasnt ordered until March 19, by California Gov. Gavin Newsom.
The vast majority of the decline was due to consumers choosing of their own volition to avoid commercial activity, according to a study of the economic slump by researchers at the University of Chicago. In other words, it wasnt government policy that kept people home. It was fear.
Sweden makes for a useful comparison, Hiltzik notes. The country did not impose any economic lockdowns and went on to suffer a devastating human toll many times higher than neighboring countries that took strict measures. But Sweden didnt reap economic rewards for staying open. On the contrary, the countrys economy shrank by 2.8% in 2020, according to Eurostat.
International travelers, take note: The European Union on Wednesday took a step toward letting in visitors whove been fully vaccinated, including Americans.
The EU had imposed travel restrictions to contain coronavirus outbreaks but now is moving toward easing them. However, individual countries in the EU will decide for themselves whether to require proof of a negative coronavirus test, a quarantine period after arrival or other control measures.
If youre able to take advantage of the EUs new openness, consider a visit to Paris. The sidewalks of the French capital are less deserted now that cafes have reopened following a six-month coronavirus shutdown.
Its part of a plan to bring back the essence of French life. The countrys 7 p.m. nightly curfew was pushed back to 9 p.m., and museums, theaters and cinemas also reopened. Starting June 9, the government plans to extend the curfew until 11 p.m. and indoor dining will be allowed.
About 40% of Frances adult population has received at least one dose of a COVID-19 vaccine but that rate is still well behind Britains 70%. France has recorded more than 108,000 coronavirus deaths.
Todays question comes from readers who want to know: How can I convince my employer to let me keep working remotely?
If youve been working from home since March 2020, the prospect of returning to the office five days a week may fill you with existential dread.
Maybe you have coronavirus worries and dont want to breathe the same air as your (possibly unvaccinated) colleagues. Maybe your commute killed a little part of you each day. Or maybe youve found that working remotely made it easier to juggle the demands of child care or elder care.
Figuring out a flexible work arrangement with your employer will likely be a process of negotiation. The Times has put together these helpful tips for approaching it.
First, do your research. Read your companys policies related to remote work, especially any communications that have been issued during the pandemic. Ask around and find out whether other employees have been allowed to work from home long term.
Dont wait too long to start these conversations policies around remote work are being crafted now. You wont necessarily get what you want from your employer, but if you dont speak up, your manager wont know where you stand.
Remember that many workplaces will be crafting policies thatll be applied across the board, not on a case-by-case basis. If you want to help shape those policies, this is the time to do it.
When you approach your managers, have a plan for what you want and how you can continue doing your work effectively. What hours do you propose working, and how will you handle meetings with colleagues who are in the office? Make sure you understand any potential concerns your employer might have. And make a case for how working remotely will benefit your team and the business as a whole.
Be sure to remind your employer about your successes over the past year and how productive its been working from home.
Celebrate your achievements and bring those forward, one expert advised. And just say, I can keep doing this remotely.
If you havent been working from home, you can ask your employer for a trial period.
Be ready to compromise. Even if youre hoping to work from home exclusively, decide for yourself whether youre willing to come to the office a few days a week or a certain number of time per month.
If your boss agrees to remote work, be sure to get it in writing. This goes for whether youve been offered a new job or if its a new setup at your current gig.
Always follow up with an email and say, you know, We had this meeting on Oct. 1, and I just want to confirm that this is what we agreed to, another expert suggested.
Workplace negotiations like this might not come together at first. If your boss seems resistant, you might revisit things in a few months.
Finally, be prepared to hear no. Some workplaces simply wont budge on remote work. And if thats a deal breaker for you, it might be time to start looking for a job elsewhere.
We want to hear from you. Email us your coronavirus questions, and well do our best to answer them. Wondering if your questions already been answered? Check out our archive here.
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Need more vaccine help? Talk to your healthcare provider. Call the states COVID-19 hotline at (833) 422-4255. And consult our county-by-county guides to getting vaccinated.
Practice social distancing using these tips, and wear a mask or two.
Watch for symptoms such as fever, cough, shortness of breath, chills, shaking with chills, muscle pain, headache, sore throat and loss of taste or smell. Heres what to look for and when.
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A petrol station attendant prepares to refuel a car in Rome, Italy, January 4, 2012. REUTERS/Max Rossi
Oil prices fell on Thursday after a slump in the previous session, as rising U.S. stockpiles added to concerns about a hit to demand from surging coronavirus infections in Asia and possible U.S. rate hikes.
Brent crude was down 6 cents, or 0.1%, at $66.60 a barrel by 0141 GMT, having fallen 3% on Wednesday. U.S. oil fell 7 cents, or 0.1%, to $63.29 a barrel, after a 3.3% drop in the previous session.
"A resurgence in COVID-19 cases across parts of Asia is doing little to support the market in the near term," ING Economics said in a note.
Almost two-thirds of people tested in Indian show exposure to the coronavirus, suggesting a spiralling spread of the virus as the daily death toll rose to a record 4,529. read more
The decline in prices this week was given added impetus on Wednesday after media reports said the U.S. and Iran have made progress in talks over Tehran's nuclear programme that could result in sanctions being lifted and more supply coming to the market.
Later reports indicated that more time was needed to reach an agreement. read more
Speculation the Fed might raise rates weighed on the outlook for economic growth and prompted investors to reduce exposure to oil and other commodities. read more
Rising U.S. stockpiles of crude also weighed on prices, although the gain in the most recent week was below expectations.
Crude inventories (USOILC=ECI) increased by 1.3 million barrels last week, against analysts' expectations in a Reuters poll for a 1.6 million-barrel rise.
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