27 October 2014


Original Story: latimes.com

California's health insurance exchange is vowing to fix enrollment delays and dropped coverage for about 30,000 consumers before the next sign-up period this fall.

Covered California said it failed to promptly send insurance applications for 20,000 people to health plans recently, causing delays and confusion over their coverage.

Another group of up to 10,000 people have had their insurance coverage canceled prematurely because they were deemed eligible for Medi-Cal based on a check of their income, officials said.

The exchange said the private insurance should remain in place until coverage kicks in under Medi-Cal, the state's Medicaid program for lower-income residents.

"There have been some cases of individuals where the wires got crossed and people were removed from Covered California before Medi-Cal was live," said Peter Lee, executive director of Covered California. "It's been a limited number of cases, but it's still a concern."

At the same time, Covered California has been contacting nearly 100,000 households that risked losing coverage if they didn't provide proof of citizenship or legal residency.

Covered California said it has cleared half of that list and about 50,000 households must still provide verification. Their coverage under the Affordable Care Act will be canceled Oct. 31 if they fail to provide the proper documentation.

That verification effort, in particular, has taken a toll on the state's customer service, according to the exchange.

Less than 1% of callers reached the exchange within 30 seconds last month; the state's goal is an 80% response rate in half a minute.

Sixty-four percent of people abandoned their call entirely.

Lee attributed the poor performance to shifting call-center workers to citizenship and residency issues.

"We have taken a lot of people off the phone in the past month," Lee said. "Unfortunately, we haven't been answering the phone as quickly as we would like."

Robert Ross, a Covered California board member, asked at last week's board meeting whether there was a plan to reduce wait times before calls ramp up when open enrollment begins Nov. 15.

Also, about 1.2 million enrollees will be looking to renew their coverage or shop for a new policy prior to January.

Lee said the exchange is close to hiring an outside vendor to supply extra call-center support during peak times.

He also noted that upgrades to the state website should decrease the number of consumer questions and calls.

For instance, applicants will be able to pay their initial premium online at sign-up rather than wait for their insurer to bill them. That two-step process confused many consumers who were unsure about the status of their coverage, and it triggered a high volume of calls.


Original Story: forbes.com

Kaci Hickox treated Ebola patients in West Africa. She’s a hero.

Since she got home to America, she’s been treated like a criminal.

Hickox is a nurse who specializes in infectious disease, and the first American to be isolated under New Jersey’s new 21-day quarantine on Ebola aid workers. She worked for Doctors Without Borders — the aid group fighting West Africa’s Ebola epidemic — before flying home on Friday and being rushed into a surprise isolation that she’s described as scary, disorganized, and even cruel.

Let’s be clear: Hickox’s not sick with Ebola right now, and even if she was, she wouldn’t be at a stage of the disease where she’d be able to accidentally infect anyone else. To be on the safe side, she’d planned to spend the next few weeks in isolation at her home in Maine.

Stuck in a tent at a Newark hospital for three weeks instead, Hickox doesn’t have a flushable toilet. She can’t see her friends or family. She initially wasn’t even allowed to talk to a lawyer, although she’s hired one to try and get her out of quarantine.

The planned argument: That quarantining Ebola aid workers who aren’t actually sick is a civil-rights violation.

New Jersey Gov. Chris Christie, who imposed the quarantine — and who Hickox plans to sue — isn’t backing down. In a press conference on Saturday, Christie said he was “sorry” if Hickox was inconvenienced, “but inconvenience that could occur from having folks that are symptomatic and ill out amongst the public is a much, much greater concern of mine.”

“When I left this morning she still had a fever and she was being tested for other illnesses after the Ebola test came back negative,” Christie added, “I hope she recovers quickly.”

Hickox, to put it mildly, thinks Christie doesn’t know what he’s talking about.

“I am not, as he said ‘obviously ill.’” Hickox told CNN. Two separate tests have cleared her of Ebola.

“I am completely healthy and with no symptoms,” she added. “And if he knew anything about Ebola he would know that asymptomatic people are not infectious.”

Several leading public health experts have suggested that Christie’s decision to confine Hickox is an attempt to score political points, given the public’s fear of Ebola. There’s no evidence that a mandatory quarantine will help fight the disease’s spread, and the CDC hasn’t called for one.

Hundreds of other American aid workers have encountered Ebola patients in Africa and were not quarantined upon their return to the United States. There are no current plans to quarantine the thousands of U.S. military personnel headed to West Africa to fight Ebola, either.

Hickox says she hasn’t been told how long she’ll be forced to stay at the hospital. “To put me in prison,” she told CNN, “is just inhumane.”

The emerging backlash over quarantining health workers has gotten politicians to back down, a bit. New York Gov. Andrew Cuomo — who initially stressed that New York City’s first case of Ebola wasn’t cause for panic, before reversing and claiming it was a major concern — on Sunday relaxed the quarantine to say that aid workers in New York could go back to their homes.

Christie made a similar announcement, suggesting that New Jersey residents could be quarantined in the homes too. But according to Christie’s statement, “non-residents would be transported to their homes if feasible and, if not, quarantined in New Jersey.”

Hickox is from Maine.

Public health groups and volunteers have stressed that states’ decision to confine Ebola aid workers under mandatory quarantines will hurt the global fight against Ebola, because it will convince some workers not to go in the first place. It also could be a source of stress for health workers as they return to America, emotionally spent and seeking comfort of their own.

As Vox’s Sarah Kliff poignantly noted, Hickox spent her last night at an Ebola treatment center in Sierra Leone, trying to save a 10-year-old girl from dying.

“I had spent a month watching children die, alone,” Hickox told the Dallas Morning News. “I had witnessed human tragedy unfold before my eyes. I had tried to help when much of the world has looked on and done nothing.”

Now back in America, Kacie Hickox spent last night confined to a tent.

Chris Christie spent last night at home in his mansion.

01 October 2014


Original Story: bbc.com

The first case of the deadly Ebola virus diagnosed on US soil has been confirmed in Dallas, Texas.

Officials at Texas Health Presbyterian Hospital say the unidentified patient is being kept in isolation.

The man is thought to have contracted the virus in Liberia before travelling to the US nearly two weeks ago.

More than 3,000 people have already died of Ebola in West Africa and a small number of US aid workers have recovered after being flown to the US.

The US Centers for Disease Control and Prevention (CDC) says the Ebola virus seems to have been contained in Nigeria and Senegal, with no new cases reported there for almost a month.

"An individual travelling from Liberia has been diagnosed with Ebola in the United States," CDC Director Thomas Frieden told reporters on Tuesday.

According to Dr Frieden, the unnamed patient left Liberia on 19 September and arrived in the US the next day to visit relatives, without displaying any symptoms of the virus.

Symptoms of the virus became apparent on 24 September, and on 28 September he was admitted to a Texas hospital and put in isolation.

The disease, which is not contagious until symptoms appear, is spread via close contact with bodily fluids.

Aid workers who caught Ebola in West Africa have come back to the US for treatment but this is the first case of a patient developing the virus on US soil, says the BBC's Alastair Leithead in Los Angeles.

A hospital official told reporters on Tuesday the facility already had procedures in place to deal with any such cases.

Preliminary information indicates that the unnamed patient, who was described as critically ill, was not involved in treating Ebola-infected patients while in Liberia.

Health officials are working to identify all people who came into contact with the unnamed patient while he was infectious, including family and a "couple" community members.

Those people will then be monitored for 21 days to see if an Ebola-related fever develops.

But they will not be monitoring passengers on the man's flight, where Dr Frieden said there was "zero risk of transmission" as the man had been checked for fever before boarding.

'We will stop it'
According to Dr Frieden, it is possible a family member who came in direct contact with the patient may develop Ebola in the coming weeks.

But "the bottom line here is I have no doubt that we will control this importation, this case of Ebola, so it does not spread widely in this country," he added. "We will stop it here."

The World Health Organization (WHO) says more than 3,000 people have died of the virus so far, mostly in Liberia.

Earlier on Tuesday, the head of a new UN body set up to fight the disease urged more action within the next 60 days.

Anthony Banbury told reporters in Ghana that 70% of infected people needed to be receiving treatment and 70% of burials should be done safely within two months.

It is the world's most deadly outbreak of the virus.

Ebola virus disease (EVD)

  • Symptoms include high fever, bleeding and central nervous system damage
  • Spread by body fluids, such as blood and saliva
  • Fatality rate can reach 90% - but current outbreak has mortality rate of about 70%
  • Incubation period is two to 21 days
  • There is no proven vaccine or cure
  • Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery
  • Fruit bats, a delicacy for some West Africans, are considered to be virus's natural host