Dr. Steven Shapiro: Health Care Insight for Reopening the Economy
Dr. Steven Shapiro, UPMC’s chief medical and scientific officer, participated in a virtual roundtable convened by U.S. Senator Pat Toomey (R-Pa.), chairman of the Senate Finance Committee Subcommittee on Health Care, on May 6 to explore the issue of reopening the economy. Following are his remarks:
I would like to thank Senator Toomey and the committee members for the opportunity to share a typical health care experience of COVID-19 through the lens of UPMC, whose hospitals span urban, community and rural areas comprising the largest academic health system in the country and a health plan with 3.8 million subscribers.
As we prepared for the pandemic, we radically transformed our hospital operations to create a safe environment for patients and staff, we delayed non-urgent surgery, reducing it by 70%, and we scaled up telemedicine 38-fold, performing 250,000 visits in April.
We indeed saw a steady stream of patients but never “surged.” At peak in mid-April, COVID-19 patients occupied 2% of our 5,500 hospital beds and 48 of our 750 ventilators. Subsequently, admissions have been decreasing with very few patients now coming from the community, almost all now being from nursing homes. Of note, in the 36 UPMC-owned senior facilities we have had zero positive cases.
Our outcomes are similar to the state of Pennsylvania, where the median age of death from COVID-19 is 84 years old. The few younger patients who died all had significant preexisting conditions. Very few children were infected and none died. Minorities in our communities fared equally as well as others, but we know that this is not the case nationally. In sum, this is a disease of the elderly, sick and poor.
We are now actively bringing back our patients for essential care following CMS guidelines. To assure a safe environment, we use adequate PPE and test all, even asymptomatic, preoperative patients for active viral infection with PCR. To date, 0 out of 1,000 tested positive in western Pennsylvania, New York and Maryland. 3 of 500 are positive in central Pennsylvania. Our community prevalence is low, which we will soon confirm with antibody testing.
Of course, we still need effective prevention and therapy. The scientific community has never worked so rapidly or collaboratively. UPMC and Pitt, home of Jonas Salk, has been in the thick of it. Intense efforts are underway to find antibodies that bind to the virus and prevent it from entering cells. Crude antibody-rich convalescent plasma is already being administered to patients, while development of highly effective synthetic antibodies and vaccines is moving at breakneck speed.
Source: Steven Shapiro, M.D. | UPMC Life Changing Medicine