Archive for Blake Dodge

School districts are canceling thousands of classes due to staff shortages and teacher burnout

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Elementary school children
  • Schools across the US are canceling classes over staff shortages and teacher burnout.
  • Such cancellations have affected 858 districts and 8,692 individual schools just this month.
  • Some working parents are furious, especially about sudden cancellations.

Schools across the US are canceling classes over staff shortages and teacher burnout, sparking fury among some working parents. 

Cancellations have affected 858 districts and 8,692 individual schools in November, NPR reported, citing Burbio, a tracker of school district websites. In 2021, there have been at least 3,145 school closures to give teachers and students mental-health days, according to the Wall Street Journal and Burbio.

This is being caused by the COVID-19 pandemic. After more than a year of virtual learning, students have returned to schools burdened by new health protocols, such as extra cleaning requirements, and not enough staff to take on the extra work. 

The cancellations often come with short notice, putting some parents in a tough position.

One Michigan school district announced earlier this month that they were taking the full week of Thanksgiving off, NPR reported. The staff had no summer break, since a lot of students did summer school, Alena Zachery-Ross, the superintendent of Ypsilanti Community Schools, told NPR. And coming back in-person hasn't been an easy transition. Custodial workers have racked up 800 hours of combined overtime, and they still can't keep up with all the disinfection tasks, she told NPR.

Zachery-Ross's staff told her they were going straight to sleep when they got home this weekend.  "They were spent," she told NPR.

Schools in Suffolk, Virginia, recently said there would be early dismissals every other Wednesday this year to avoid teacher burnout, the Wall Street Journal reported. Reagan Davis, a math teacher there, said they were staying late to catch up on work after losing planning time to record lessons for students in quarantine and cover for absent teachers

"We're exhausted, for lack of a better term," Davis told the Journal.

Some of these closures are an indirect result of COVID-19 infection risk. One school told NPR that many staff took the day off after Thanksgiving. Classes would usually be combined and stay open, but rules around social distancing made that impossible.

Still, some parents are infuriated. Parents wrote to NPR's Anya Kamenetz after a tweet asking how the closures were affecting their families.

Tabbatha Renea, a single mom with a young child wrote to her school district superintendent and shared the email with NPR. She said the closures are adding to the uphill battle she's fighting for her daughter, a young Black girl, to be successful.

"It's not just about finding childcare," she said in the email shared with NPR. "I can typically send my kid to sit in front of the tv at her Grandma's house, but her Grandma can't do homeschooling work with her," she said.

Read the original article on Business Insider

UK suspending flights from 6 African countries over new coronavirus variant fears: ‘Our scientists are deeply concerned’

Britain's Health and Social Care Secretary Sajid Javid.
Britain's Health and Social Care Secretary Sajid Javid.
  • A new coronavirus variant has been identified in Botswana and South Africa.
  • Dubbed "B.1.1.529," it has many mutations, concerning scientists and the World Health Organization.
  • The UK instituted travel restrictions on Thursday for six African countries following the news. 

The United Kingdom has added six African countries to its "red" travel list and temporarily suspended flights over concerns about a new coronavirus variant. 

Sajid Javid, UK secretary of state for health and social care, made the announcement on Thursday shortly after the World Health Organization gave a briefing about the variant, dubbed B.1.1.529. It was initially identified in Botswana. Cases have sprung up there and in South Africa.

South Africa, Namibia, Lesotho, Botswana, Eswatini, and Zimbabwe are on the "red list," which entails that there are more travel restrictions for people who live in the UK. People that don't live in the UK aren't allowed to travel into the UK from these countries.

Javid said that the variant hasn't been detected in the UK yet and that its implications are still unclear. But based on the early indications, it may be more transmissible than the Delta variant, and our current vaccines may be less effective against it, he said. 

"Our scientists are deeply concerned about this variant. I'm concerned, of course, that's one of the reasons we have taken this action," Javid said during the briefing.

Delta, a variant first spotted in 2020, currently accounts for 99.9% of new coronavirus cases in the US, per ABC News. It had mutations compared to the last strain that helped make it more infectious by comparison. 

The newest variant, which will likely be assigned a Greek codename similar to Delta and the formerly-dominant Alpha variant by the WHO, has more than 50 mutations overall, and more than 30 on the spike protein, Prof Tulio de Oliveira, the director of the Centre for Epidemic Response and Innovation in South Africa, said during a briefing on Thursday.

The variant seems to be responsible for an uptick in coronavirus cases in South Africa, per officials. At least 100 cases have been confirmed through sequencing samples, up from just 10 recorded cases on Wednesday.

After Sunday morning, people traveling into the UK from the designated African countries will need to quarantine for 10 days in government-approved hotels, per Javid. Starting midday Friday, the government is suspending all flights from the countries until the hotel quarantine system is up and running, according to the BBC.

The WHO will be meeting on Friday to further analyze the situation. Javid stressed that we don't know enough about the variant yet, but said that the restrictions were meant to protect the UK's progress to date. 

"It's a real reminder to us all that this pandemic is not over," he said.

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Miami mayor warns Florida is already packed for spring break with too many people on the way: ‘We’ve got a problem’

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Spring breakers at Miami Beach, Florida in March 2016.
  • Miami Beach Mayor Dan Gelber on Saturday said that Florida has a problem.
  • Too many people are visiting for spring break, he said.
  • In March 2020, the state hosted droves of partying young people before the US saw a major outbreak.
  • See more stories on Insider's business page.

History may soon repeat itself in Florida, where some beaches are already packed with spring breakers, according to CNN.

"We're seeing too much spring break activity," Miami Beach Mayor Dan Gelber told CNN on Saturday. "We've got a problem with too many people coming here. We've got a problem with too many people coming here to let loose."

"We are concerned," he said. "It's very challenging."

Air travel has risen to its highest level in nearly a year, according to The Transportation Security Administration. On Saturday, a spokesperson for the agency said that TSA had screened about 1.4 million people at airport security checkpoints on Friday, the highest number of passengers since March 15, 2020, when about 1.5 million people were screened, Insider reported.

This rise in travel coinciding with the beginning of spring breaks and generally warmer weather, making Florida a popular destination for people who could potentially spread COVID-19.

"We've come a long way as a community in slowing the spread of the virus," Orlando Mayor Buddy Dyer said on Twitter. "As you enjoy our city and our wonderful weather this weekend, continue your pandemic precautions."

In September, Florida lifted all COVID-19 restrictions on all businesses in the state, allowing local governments to enforce stricter protocols however they chose.

Ron DeSantis, Florida's governor, recently said that more lockdowns or travel restrictions "ain't happening in Florida," WPTV NewsChannel 5 reported.

The governor has been critical of President Joe Biden's calls for continued precautions and has generally adopted a more laissez-faire approach to public health restrictions.

Last year, Florida made headlines for the droves of young people that partied there with abandon, then returned to their homes throughout the US and abroad, an analysis by Tectonix GEO X-Mode Social found, based on anonymized cell phone data.

It can't really be known how widely the spring break parties spread the coronavirus, but by the end of March 2020, Florida cases had more than tripled, from 1,700 on March 1 to 5,473 by March 30. Cases as far away as California and Massachusetts have been linked to a single event, the "Winter Party Festival," in Miami Beach, The New York Times reported.

DeSantis didn't order people to stay home until April 1, but little testing was available at the time. The Winter Party Festival ended the day before the World Health Organization declared COVID-19 a pandemic, the Times reported.

Florida coronavirus cases peaked in January 2021 at about 19,500 new cases per day. Today they've leveled off to roughly 5,244 daily cases, according to a Times tracker. Nearly 4 million people have been vaccinated, about 18% of the state's population.

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Marketers are reportedly underpaying Black influencers compared to white people with less followers

fitness influencer
A big following doesn't mean an influencer is qualified to be sharing advice.
  • Bloomberg's Businessweek found that Black influencers are underpaid compared to white peers.
  • Sometimes they're even paid less compared to white creators that mimic their content, the report found.
  • Black influencers told Bloomberg they would get paid in products as opposed to cash.
  • See more stories on Insider's business page.

White people who are popular on social media tend to make more money than Black stars, according to Bloomberg's BusinessWeek.

The same is true for when Black influencers have more followers or are doing creative work that's later appropriated by white people, the report found, citing interviews with dozens of influencers. Sometimes they're not paid but instead given products from brands.

In one example Bloomberg reported, 22-year-old Sydnee McRae, who is Black, has more than 1 million followers on TikTok, most of whom took interest in her account after she made a "viral" dance video that choreographed a dance to "Captain Hook" by Megan Thee Stallion.

It led to a $700 deal with the Universal Music Group to promote rapper Lil Tecca's "Out of Love." A white influencer, Addison Rae Easterling, was paid thousands by Lil Tecca just to emulate it. Easterling has more followers than McRae, totaling more than 78 million, but white influencers with smaller followings typically make $5,000 for dances. McRae is still getting $500.

Read more: How much money nano influencers make, according to 5 creators

There are several similar examples highlighted by Black influencers in the report, including McRae, Stacy Thiru (1.4 million TikTok followers), Kenny Knox (843,000 Instagram followers), Jordan Craig (52,000 Instagram followers), Layla Qasim (2.4 million TikTok followers), Dare Ajibare (1 million TikTok followers), and Challan Trishann (915,200 TikTok followers).

The disparity goes against the meritocratic promises of the social media platforms, where supposedly anyone can get famous, and disadvantages Black creators in a market worth $10 billion each year, the report said.

Their accounts are also heavily monitored, with Knox losing a Target gig for using the N-word in a recent video. Other white influencers like Felix Kjellberg appeared to get away with worse, including anti-Semitic jokes, filming dead bodies, and throwing un-masked parties during the coronavirus pandemic.

Read more: The top 17 influencer marketers at brands who plan creative campaigns and partner effectively with creators on Instagram, TikTok, and YouTube

Since the racial reckoning of 2020, marketers seemed more willing to work with Black influencers and engage in conversations about inequity, the report found. Previously Black creators were told not to post about Black Lives Matter or law enforcement.

In June, Instagram's product chief said the company was taking a harder look at whether its algorithms held a bias against Black people. About two years prior, an Instagram employee who worked with the influencer partnerships team, resigned over concerns about the disenfranchisement of Black people on the platform.

But creators are skeptical about whether the brands are actually changing their ways, Bloomberg reported.

Read the original article on Business Insider

Several patients at a Virginia Kroger clinic received an empty shot instead of COVID-19 vaccine

Vaccine distribution

A Virginia Kroger gave several people "empty" shots that were supposed to contain vaccines for COVID-19, according to ABC 8News.

The healthcare professional who gave the shots to less than 10 people believed that the syringes had been previously filled by a colleague before the appointments started, a spokesperson for Kroger told 8News.

At first, the company told outlets 8News and CBS 6 that the syringes contained saline but later clarified that they were completely empty.

Read more: The 4 things the US is doing wrong in the fight against COVID-19, and what we should be doing instead

"All impacted customers were contacted and have received their COVID-19 vaccine. We thank these customers for their understanding and have apologized for their inconvenience," a spokesperson for Kroger told Insider.

The clinic is investigating the matter to prevent a similar situation from recurring in the future, and the Virginia Department of Health is aware of the incident, they said.

The retail chain aims to double its vaccine capacity to 1 million doses per week.

As of March 13, about 20% of the US population has received at least one dose of the vaccine for COVID-19, Bloomberg data show. More Americans have received vaccines than have tested positive for the virus, that report said. At the current rate, it will only take about 5 months until 75% of the US population, enough for "normalcy," according to Dr. Anthony Fauci, is inoculated.

Read the original article on Business Insider

Haven, the Amazon-JPMorgan-Berkshire Hathaway healthcare venture, is disbanding after 3 years of struggling to fix healthcare

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Haven is shutting down.

The company told employees on Monday that it will disband by the end of next month, CBNC reported

"In the past three years, Haven explored a wide range of healthcare solutions, as well as piloted new ways to make primary care easier to access, insurance benefits simpler to understand and easier to use, and prescription drugs more affordable," Haven said in a statement on its website.

Haven began in 2018, when Amazon, JPMorgan, and Berkshire Hathaway got together to solve the rising cost of healthcare in the US. At the time of its announcement, Warren Buffet memorably said that the ballooning costs of healthcare act as a "hungry tapeworm" on the economy. 

Haven was supposed to use the combined companies' resources to get costs under control and improve care for the member companies' employee populations, but it struggled to find an identity.

It began by tackling primary care pilots that it couldn't market widely to employees in an effort to maintain secrecy, The Information's Paris Martineau reported in July.

The pilot connected employees to primary care teams, similar to Amazon's app and service Amazon Care. Amazon Care, as Business Insider reported, was underway at the tech giant before Haven got started. 

Haven lost financial backing, The Information reported, as well as key leaders like Dr. Atul Gawande, the former CEO. Tensions escalated between Haven and the founding companies as the upstart struggled to come up with ideas quickly, and Amazon in particular has been the most reluctant to make commitments to Haven, according to The Information and a person close to Amazon.

"Haven will end its operations at the end of February," Brooke Thurston, a spokesperson for Haven, told Business Insider in an email.

The three founding companies will continue to work together informally to design new healthcare programs meant for the specific needs of their own employee populations, Thurston said. 

Read the original article on Business Insider

Inside Amazon’s efforts to build a national telehealth business geared toward big employers

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Amazon is building a telehealth business and pitching the service to major employers including Zillow, five people familiar with the matter, who were not authorized to talk to the press, told Business Insider.

It's a part of Amazon's massive ambitions in healthcare. In November, it announced Amazon Pharmacy, a drug-delivering business in 48 states with steep discounts for Prime members.

Through Amazon Care, the $1.6 trillion shipping giant is getting into the business of actual medical services for the first time, dealing with patients, their protected health information, and their doctors.

Amazon Care started as a pilot in 2019 for just Amazon employees in Seattle, providing them with medical care at home or in person. Now, it wants to sell that service to other large companies. 

For employers who sign on for the service, which is run in partnership with the medical group Care Medical, employees near their headquarters will get online and in-person doctor visits, Business Insider has found. Employees elsewhere will get just the virtual components.

"We do not comment on rumor or speculation," an Amazon spokesperson said in an emailed response to Business Insider's request for comment and interviews. "Amazon Care is a healthcare benefit pilot for Amazon employees in the state of Washington."

The idea got started in Amazon's human-resources department and in Grand Challenge, Amazon's secretive lab, signaling that Amazon Care is an important project to CEO Jeff Bezos and the rest of the leadership team.

The goal is to lower healthcare costs internally for Amazon and externally for some of the world's most powerful companies, using telehealth to meet people where they're at with good care. But Amazon Care has a long way to go.

Subscribe to Business Insider to read the full story:

Amazon is quietly building a business to offer medical care to major companies. Here's an inside look at Amazon Care.

Are you an Amazon insider with more to share? Contact Blake Dodge via encrypted email ([email protected]) or on the encrypted messaging app Signal (1-252-241-3117).

Read the original article on Business Insider

5 healthcare leaders discuss the future of telemedicine, the workplace, and drug research

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  • Business Insider selected the top 10 people transforming healthcare in the North America, Europe, and Asia Pacific regions.
  • We also hosted a virtual roundtable with five of these leaders to chat about the post-pandemic future and what changes in healthcare will likely be permanent.
  • The live discussion featured Virginia Savova, a distinguished scientist at the French pharmaceutical giant Sanofi; Dr. Kevin Tracey, CEO of the Feinstein Institutes for Medical Research; and Mike Pykosz, CEO of the primary-care startup Oak Street Health.
  • Visit Business Insider's Transforming Business homepage for more stories.

No industry has been impacted more by the coronavirus pandemic than healthcare. 

Doctors and nurses in hospitals have been working nonstop to treat the millions of people who have fallen ill from the virus. How people get their healthcare had to fundamentally shift from in-person visits to online, resulting in an explosion in telehealth. And researchers and drug companies have been furiously working on coronavirus treatments and vaccines to eventually pull society out of this pandemic's shadow.

With that, it's no surprise the pandemic was top of mind for Business Insider's recent virtual roundtable with a few industry leaders. Business Insider selected the top 10 people from North America, Europe, and Asia Pacific that have been transforming healthcare this year, and brought five of those honorees together for a round table to discuss the state of healthcare, in particular what the post-pandemic future may look like.

Business Insider was joined by Virginia Savova, a distinguished scientist at the French pharmaceutical giant Sanofi, Dr. Kevin Tracey, CEO of the Feinstein Institutes for Medical Research, and Mike Pykosz, CEO of the primary-care company Oak Street Health.

Xavier Palomer, the founder of a virtual-reality treatment startup called Psious, and Ken Endo, CEO of the prosthetic blade startup Xiborg, also participated via email. (Palomer and Endo are respectively based in Spain and Japan.) 

Here's how these leaders are handling the pandemic, and imagine it will change the future of healthcare.

The transcript has been edited for clarity and length:

Business Insider: How have you seen the coronavirus pandemic permanently change your slice of the healthcare industry?

Pykosz (Oak Street Health): I've seen two things. Number one, I think healthcare, especially primary care, had these artificial distinctions that were created around what was billable. So a visit looks like this, and it's done this way. Why? Well that's what's required to bill the code that gets you reimbursed.

That's what doctors did and were trained to do, so that's what a good visit meant to them. That's what patients came to expect, so that's what good healthcare meant to a patient. And it kind of created this cycle. Now a lot of those artificial barriers are being pushed aside out of necessity. Why does everything need to be in-person? Can't something just be a telephone call or a video visit? What does it matter if the doctor in the video visit happens to be seeing a patient in Illinois and the doctor is in Dallas or Paris, right? Who cares? Why aren't we reimbursing for the doctor's time to do a video visit with someone when that is the right level of care?

So, some of those artificial barriers got broken down very quickly.

I think what patients found also, we've certainly heard this from our patients, is the vast majority preferred to be seen in-person. Our patients are generally older adults and so not as technologically savvy as others would be probably. But I think they also felt that like, 'Hey, this is good care. I wouldn't have done a telehealth visit before, but now I'm forced to.' 

I don't think that's going to go back. Doctors who never would have tried a telehealth visit because it's not good care, they realize actually it works. And patients who've never tried it realize this works. Now, again I think we're going to find a portfolio, right, where some patients may move much more virtual, some may still use more in-person and augment it with virtual. And virtual can be a telephone call, virtual could be a telehealth visit, virtual can be so many different things. I do think that's going to be one big change.

I think what it's also proven is the downside of a traditional fee-for-service model. Where you had a lot of primary care groups and doctors groups that relied on this house of cards of reimbursement and procedure mix and payer mix and all these different components. And COVID comes in. There's still need for healthcare and there was still healthcare providers in demand, but that connective tissue of how that was paid for fell apart. I think that will soon accelerate the move to a more value-based model.

At Oak Street, we're paid not based on the volume we do, we're based on how healthy we keep our patients. So we were able to take the same team we have and we're going to deploy them in various ways. We deployed them in telehealth. We took our transportation, that usually picks up patients and brings them to our centers, and instead pick up food from food pantries and deliver it to our patients' homes. And great, you know what, who cares how we're deploying as long as it's helping patients because we're going to get the same amount of revenue. So it created this huge amount of flexibility within the overall model.

Those are trends that were already happening. I think this was a massive accelerant to those trends. 

Palomer (Psious): Telemedicine has played an important role. Remote sessions were anecdotal and now, any kind of remote monitoring or disease management is key for therapeutic success. We have seen a major change and it's here to stay.

On the other hand, unfortunately, we have seen an increase in demand for mental-health services. The situation we are all going through and the tremendous impact the pandemic has had on our daily routines has had a negative impact on our mental health and well-being.

Tracey (Feinstein Institutes for Medical Research): I think what the biggest, most important thing that I hope comes out of this, is that I hope that America sits up and confronts this as a Sputnik moment.

Sputnik was a terrifying event in the late 1950s, 1957, when the satellite was circling around and our military, and our federal government, and our civilian population had no idea that Russia could do that. And what did it mean? What would it mean to our day to day life and our national security?

It had a huge influence on spawning the investment, and research, and science, and technology that led to - in addition to NASA - to NIH, to our large medical training centers that we have today, and to establishing the US as a leading scientific and technology center on the planet.

What's happened in the last 20 years is we have not kept up with inflation and our investments in research from the federal government. We were unprepared for COVID.

It's wonderful how fast the vaccine is being developed now, but we're not done yet. The two vaccines don't look like they protect everybody and we're a long way from knowing, months to years, long-term what do these vaccines mean. Risk-benefit ratio, first do no harm. And how long is the protection? Is it specific to specific cohorts?

There's just a lot. The virus hasn't had its first birthday. But, we should have been more prepared.

I went to Washington in COVID-1 and SARS-1 and I was part of a small panel, which included the current Secretary for Emergency Preparedness, Secretary Kadleck, and Lt. Col. Mike Callahan, and Dr. Mitch Fink, God rest his soul. We recommended stockpiling PPE, stockpiling ventilators, having tents and ancillary hospitals, antibiotics for everybody, and IV bags in stockpile.

The model we looked at was 10 times more fatal than COVID, and 40% of the United States could have been dead by now. And the hospitals wouldn't have been functioning. We recommended stockpiling jet-pack ventilators like the Green Beret's carry and putting them in fire stations and local schools, in the hopes that a few people in the village or town would be alive and figure out how to use them and save a few lives. That's what it would look like if you get a really bad pandemic. We have to be ready for this.

I was one of four people, and there were probably hundreds of official reports made. To not be prepared is a disaster, number one. And number two, to have our research investment and the basic infrastructure that's essential to national security, to economic security, and to the health of the country. I mean what's more national security than those three things? To not have the federal support for research keep up with inflation for 20 years? It better be a wake-up call. That's my macro comment.

Endo (Xiborg): This situation strictly restricts physical interaction with patients. More specifically, amputees lose their opportunity to run on blades as they currently need PO support. But this is a typical case for the disabled which we need to change.

Business Insider: What's changed within your organization over the past nine months that you expect will be permanent?

Savova (Sanofi): We basically had to rethink how long it takes to develop a vaccine. How long it takes to find a drug that helps patients. We didn't have the luxury of going with the old model, where we could take years to develop a vaccine, to mount the proper clinical trials, and so forth.

I think we have we have discovered within Sanofi an amazing amount of creativity and passion that has allowed us to concentrate on solving these problems in an unprecedented, short amount of time. I think we will leverage some of this going forward. Like thinking about repurposing existing programs or drugs in the fight of a new disease. Can we leverage the kind of genomic technology that I work with, for example, to quickly establish a proof of concept and how we move forward in this environment? I think these are important lessons that we learned this year.

We were thrown at the midst of something that we never could anticipate or experience at the end of March, where all of a sudden, we had to basically pack up, close down research, and move online within the space of literally a few days.

It works really well for us in a way that we could not have anticipated. Because we did think that we need these in-person meetings, that we need this kind of presence at the office. And it turns out that really the more important factor behind getting research done is keeping people motivated and interested, and actually enjoying being invested in the process and not so much the physical presence.

Now of course, there's certain aspects that cannot be changed. We still need lab work. And that still requires a physical location. And we have been able to continue our activities as the pandemic progressed and as local regulations allowed for that.

But I think fundamentally, looking forward, we are going to be more digital. Much less constrained in terms of time and space in our communications. And as a multi-national company, I think this is going to release us from some of the constraints that we had in terms of how we work together.

Pykosz: The vast majority of our team members work in primary care centers, generally in low-income, underserved communities. Our patient base is all older adults. Eighty-six percent of them have two or more chronic illnesses. As COVID became a real thing and spread, it created really dual challenges for Oak Street.

On the one hand, operating primary-care centers in urban markets that had some of the spreading back in the spring and try to figure out how we keep our team safe. What does operations look like in a COVID world? How do we get enough PPE?

By the same token, our patient base was already at-risk for hospitalizations, already at-risk for adverse outcomes because of their chronic disease burden and their social determinants, and all the different challenges they face.

We have a model that's really focused on caring for them, keeping them healthy, but how do we run that model for them in a much more difficult circumstance? Also knowing that if they do have an acute event and go to a hospital, who knows what kind of shape the hospital's going to be in. Will they have hospital beds available? Or will they go to the hospital and now catch Covid and exasperate the original problem? 

So there was a huge amount of challenges in the early part of the year that we had to navigate through. We went from 99.9% of our visits being in-person, either in the home or in our centers, to 90% being telehealth in a month, from March to April.

And then what we found is while we could do telehealth for a period of time, and patients accepted it, that actually patients want to be seen in-person and we could be more effective in-person. So now we're much more 90% in-person, although that's shifting a little more towards telehealth with what's going on. It's kind of in a switch back and forth.

Internally, I think I would agree with some of the thing said around rethinking office space, rethinking remote work, rethinking business travel.

I'm sitting here at home right now. Our central offices have been largely closed. I was there yesterday for an all-staff video and spent couple hours working in my office. And I thought, 'This is great!' I didn't realize how much I missed it until I was there.

It will be interesting to see how far this goes. Like most things, it will probably be somewhere in the middle where maybe not everyone's remote, but actually people aren't spending 40 hours a week in the office either. We have team members that have literally moved to different cities. You can't put that back in the box at this point.

But I think we can still do some of the things we need to do, which is form those human interactions you don't get over Zoom. That's what I miss the most and can't wait to get come back to: the ability to have those hallway conversations, talk to team members. Because at some point in time the goodwill that we've built up goes away. I think that's an important thing to bring back.

Tracey: I'm the executive vice president of a company with 70,000 employees, 23 hospitals, hundreds of ambulatory sites, pharmacies. So there are people better informed than me in this company to talk about a lot of the things that are going to change.

People have shown that productivity might be down a few percentage points. In some cases it actually goes up. I think our lab productivity's gone up. But you're going to have to balance the cost of any changes in productivity, or lost productivity, from the savings in real estate expenses. This is going to be a huge topic in big cities for a long time. 

I think there's a huge lesson learned for us in going forward with clinical investigation. I think we as a group also should be advocating for some sort of coordination at the national level for these clinical trials.

Right now, we have four or five drugs that are all EUAs (emergency use authorization, the FDA's temporary mark of approval during emergencies). Which means if I wanted to do a trial tomorrow, on a new drug that Virginia has, I'm going to have to figure out how to accommodate the fact that the patient shows up to get the new drug in the new trial, but they might have got convalescent plasma, they might have got remdesivir, they might have got dexamethasone. What the heck; how do you do that trial?

You don't want to add bureaucracy, believe me. I'm a researcher. I don't want to have bureaucracy, but there's got to be some sort of prioritization of these questions, or frankly we're not going to find out how to treat Covid. That's a big deal to me. That's what wakes me up at 3 a.m. now in this whole Covid conversation - how are you going to figure out what works and what doesn't?

Palomer: Aside from the product evolution towards telemedicine, the main change we have seen is on our team. The interaction among team members. Having to work remotely has ripped off the human touch when we interact and that has had a tremendous impact on the culture of the company. We'll need to create new ways of interacting and getting to know each other.

On the other hand, the company has adapted the product to the new needs. For example, we released the smartphone version of our system. This change among others will be the basis for our growth in the future.

Dunn: All of your answers mention this idea of being able to maintain productivity or even enhance it going virtual throughout this year. But I'm wondering about creativity. Do you agree or disagree that it's a challenge to maintain some level of out-of-the-box thinking during this?

Savova: To me, creativity actually doesn't really come from going to the office. I think that the interpersonal connections are important, but these can also be maintained in the virtual world. I think creativity comes from not having a top-down style in the company, from not being told what to do, to sort of giving room for grass roots ideas. I think these are the really important underpinnings of creativity.

This is just sort of a situation that we experience at the personal level, or even more than on the professional level, as not healthy. But I think that creativity - certainly I wouldn't pin it to physical presence in the office. I would pin it on relationships in teams, and I think we have really done a good job sort of switching, finding the virtual space to be connected and be creative.

Pykosz: I would probably use a different word than creativity. I'd say collaboration.

I'm looking at Dr. Tracey's screen and see a whiteboard. At Oak Street we love whiteboards. I personally love whiteboards. I have not found an effective way to virtually whiteboard. I've tried a lot of tactics and none of them work so far.

That ability to be together - you don't need to do it for all problem solving, you don't need to do it for all collaboration - but I think there's certain things that are so much more effective if you've got four or five people in a room and a whiteboard, and just work on it together.

A lot of the pieces of productivity or work you can replicate in a remote environment, but I do think there's certain things that are missing. I'm excited for those to come back.

Tracey: I think the human species over millions of years is an adaptable machine. I think the brain is a perfect pattern finder, and I think as we're confronted with this you're going to have cohorts of people that adapt differently. I think some people are going to have their creativity impaired, and I think other people are going to have their creativity unleashed. I think if you're collaborating, like Mike and Virginia said, I think that the organizations will adapt.

I was feeling what you said Andrew. But what happened as we kept doing our lab meetings, and kept doing Zooms, and WebEx, and Google, and Teams. All of a sudden I looked back, and nine months have gone by. Whether you're looking at funded grants, patents, or publications in good journals, our productivity and creativity went up!

So my biases and my frustrations were wrong. It would be a bad business decision to go back to business as it was. I don't understand it, but we're living through an adaptive crisis that we as a group will rise through, or rise above. It feels weird, I have to agree with you. But I think it spawns creativity from some groups.

Business Insider: Do you expect we'll see more consolidation, more M&A, in your slice of the industry due to the current circumstances?

Palomer: Of course, in some specific areas. In other areas, where we are seeing new ways of targeting problems and new solutions, the drivers are going to be small companies or startups. Again, the key is the right mix. We are seeing some solutions, such as video consultation, maturing very fast. This is an area where we are already seeing some consolidation. Some other areas, such as VR, still need more time.

Pykosz: Certainly in the providers' case, that's already been the trend. That was a trend coming in, that's been a trend for the last decade. I think a lot of the reasons for that trend were increased complexity, whether it's reimbursement or technology, and that complexity driving increased costs. It's just harder to be a small operator in that world. I certainly think this will be an accelerant to that, because the costs of operating, the kind of business disruptions that have occurred, have made it even harder to be small. So I certainly think you'll see more consolidation from that standpoint.

But I think at the same time you see more consolidation, I think you also see a mass amount of new entrants. As to Kevin's point around creativity, I think you're having a lot of groups saying, 'Hey there's a better way to do this.' People are more willing to try better ways. So again, I think you'll see a cycle where the traditional, smaller physician group - those were going away already. I think that's going to accelerate because it's hard to survive. And I think you'll see more groups that are trying to do things differently. Those will pop up, and hopefully some of those will win and push us all forward in improvement. Right? I think you're always going to see an action and a reaction-type of situation.

Tracey: I think on the clinical side consolidation's going to continue to happen. I think you're going to end up with large health systems and they're going to start to merge or consolidate. Hopefully we don't end up with a single payer, I don't think that would be good, but I think you're going to see more consolidation there, too. On the clinical side, I think Mike covered that. On the research side, research is a strange cat, but my favorite definition of research is Albert Einstein's definition of research. If we knew what it was we were doing it wouldn't be called research, would it?

So I think COVID has to be a wake up call to not consolidate research, but expand it. You've got to acknowledge the fact that we're going up alleys to discover if they're blind. And there's not an efficient business process to do that.

I think we fell into the trap in the United States, maybe worldwide arguably, you know, it's a business of doing research, and we've got to be more efficient, and we've got to cut the costs. That doesn't work. I hope that COVID taught us that the wake up call has to be double down on research, expand research. Don't worry about consolidating it, and invest in it. Because the stuff that comes out of it, some of it will be exactly solving the problem we want. And some of it will be good surprises to have in the file cabinet for the next time that a pandemic comes along. Because there will be another one, and it won't be COVID. It'll be something else.

Business Insider: Kevin, I have a quick follow up. Do you think we'll see better infectious disease models come out of this whole thing? It's traditionally been so hard to make a new drug.

Tracey: When I say research, as a national response, we have to include public health at the local level, at the state level, at the federal level. Those budgets have been decimated for the last 20 years. We've got to resuscitate what we knew to take care of polio. We had people on the ground everywhere and they were talking to each other and sharing best practices. We have to go back and expand that.

In terms of how you would do the clinical trials, Virginia's got more expertise than me in this. But I think we can't have in the next six months, which I think will happen, ten more, or a hundred more, or two hundred more therapeutic candidates come out to be tested, and 25 more vaccines. That's what's going to happen. And trust me, from trying to do clinical trials in the middle of a pandemic, it was really difficult because of the infectivity of the virus and the layers of protection you had to put around the paper consent form, and the robot getting consent from the family in another city. But when it stopped, when the surge went away, we can't do any clinical trials now. Because every patient is so far apart, so disconnected. They're on different drugs, they're different age groups. How do you design the trial?

So yeah we have to elevate that discussion. I think it has to happen at some sort of national, coordinated level. I don't see how we can do this hospital-by-hospital. On a bad day now, we're getting a few patients at each hospital. Maybe 50 people a day or something. How are you going to figure this out? It's much more complicated than that. It's going to have to be coordinated. Probably not by the drug companies themselves, that's what I'm saying, with all due respect.

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Fauci says ‘it’s going to be months’ before a coronavirus vaccine is approved for children

Anthony Fauci, MD, Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, looks on before testifying at a U.S. Senate Senate Health, Education, Labor, and Pensions Committee Hearing to examine COVID-19, focusing on an update on the federal response at the U.S. Capitol Washington, D.C., U.S., September 23, 2020.
Dr. Anthony Fauci testifies before the US Senate about the federal coronavirus response in September 2020.
  • Dr. Anthony Fauci told host Chuck Todd on NBC's "Meet the Press" that the US is "months" away from a coronavirus vaccine that's approved for children.
  • It's normal in vaccine development for children to be studied after adults so that researchers can make sure the shots are safe, and vaccine studies so far have mainly involved adult participants. 
  • Fauci estimated that the process for approving vaccines for kids will start in January.
  • That's a likely hiccup in the reopening of schools, as several cities have suspended or canceled their plan to resume in-person classes.
  • Visit Business Insider's homepage for more stories.

Dr. Anthony Fauci on Sunday warned that a vaccine won't be approved for children likely until after January

Fauci, a world-renowned expert in infectious disease and longtime director of the National Institute of Allergy and Infectious Diseases, told host Chuck Todd on NBC's "Meet the Press" that authorities are "going to start the process very likely in January to get it to the children sooner rather than later." 

While drugmakers Pfizer, Moderna, and AstraZeneca have recently announced promising results for their shots, they have yet to gain the US Food and Drug Administration's go-ahead for distribution, which requires more safety data, Business Insider's Andrew Dunn previously reported.

The early shots will likely go to healthcare workers and the elderly, Fauci has said, but other adults could get vaccinated as early as April or June, depending on who you ask. But getting approval to sell vaccines for kids requires further safety data and studies

That's a likely hiccup in the reopening of schools, as several cities have suspended or canceled their plan to resume in-person classes. Earlier this month, Mayor Bill de Blasio re-closed New York City schools — sending students in many cases back to their parents for home-schooling — as the city hit a 3% testing positivity rate for the coronavirus. 

"Children, as well as pregnant women, are vulnerable," Fauci said on NBC. "So before you put it into the children you're going to want to make sure you have a degree of efficacy and safety that is established in an adult population, particularly an adult normal population."

The vaccine studies to date have mainly involved adult participants, which is how vaccine development normally works. Researchers start with young and healthy adults before expanding into more vulnerable groups, Dunn reported in September

In late October, Pfizer expanded its trial to include children as young as 12. Moderna is still looking to expand its trial to include teenagers, but Tal Zaks, its Chief Medical Officer, told Axios that a vaccine could be ready for children by the middle of next year.

"It's going to be months," Fauci said on Sunday. 

The next steps, according to Fauci, are Phase I and II trials, testing a growing number of patients, and then a bridge study, a research method that commonly allows drugs approved in one region of the world to be deployed in another. 

"You can say okay, now we have safety in the children, we have comparable immunogenicity, namely the same type of immune response — we can get this expeditiously approved for the children before going through a 30,000-person trial that may take a longer period of time," Fauci said. 


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