Medical roundup

  • Telemedicine has become a crucial tool during the crisis. 2017 paper discusses the regulatory barriers that had constrained it [Shirley Svorny, Cato Policy Analysis; earlier here, here, and here]
  • “Wondered why it’s been so hard to ramp up production of surgical masks and respirators? Why haven’t private companies flooded into the market to meet peak demand? Because they are regulated medical devices and new versions require FDA approval which can take months to obtain.” [Paul Matzko thread on Twitter]
  • Asking former health care workers to “dust off their scrubs” and return for the emergency raises possible liability exposures [Lori Rosen Semlies, Wilson Elser] “Coronavirus could affect med mal rates: Experts” [Judy Greenwald, Business Insurance]
  • A closer look at certificate of need laws, which suppress hospital bed supply [Eric Boehm, related audio clip with Jeffrey Singer, earlier and more]
  • More on the relaxation of occupational licensure in medical jobs during the emergency [Michael Abramowicz, Jeffrey Singer, earlier]
  • Return with us now to those days not so long ago when public health specialists seemed to be in the paper every day inveighing against alcohol, dietary choices, and such like [Elaine Ruth Fletcher, Health Policy Watch last year on World Health Organization (WHO) rumblings against alcohol; JAMA on furious fight over red-meat recommendations]


  • Regarding liability, I can imagine the tort lawyers having a field day with this one. “If you or a loved one died from Covid19, call us, we’ll sue!!”

  • Makes one wish for the days when ads for attorneys were not allowed—and cigarette ads were allowed…

  • Related issue: There is an excellent article and discussion on Volokh Conspiracy on the appropriate standard of care when confronting a pandemic, Hospital Liability for Ventilator Shortages.

    Along those lines was a question to President Trump yesterday on whether he could guarantee that everyone who needed a ventilator would have one. The unasked, but an obvious related question is that if the requests of one place, experiencing peak demand and anticipating that the peak has not yet been reached, are met so the requesting state can put ventilators and other emergency medical supplies and equipment into storage for use should the peak continue to climb, but, for that reason, a state which starts to see a growth in infections and hospitalizations so that it is heading toward a peak which will overwhelm its resources and so requests emergency medical supplies and equipment but those are now available because of satisfying the earlier request, can there be liability because such supplies and equipment are not available?

    Ventilators is a good example to use. Previously, the average annual demand for them in the US was around 39,000. A few years ago, New York had to opportunity to purchase around 16,000 (or around 40% of the average annual demand), but decided not to, and used the money for other purposes. At the time, that looked to be a prudent decision. With hind sight, not so much. Production is being rapidly ramped up, and alternatives are being proposed. It is expected that the production this year will exceed 100,000. Plus, stores of old ventilators are being refurbished. CPAP machines are being repurposed for people needing oxygen but not intubation. And, MIT has received FDA approval of its design for a manually operated ventilator (which could be used in EMS units and to replace ventilators used in teaching, freeing those machines, and, as an emergency standby in event of power failure). Under these types of facts, establishing a standard of care will be a complex exercise.