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CDC director acknowledges hospitals have a monetary incentive to overcount coronavirus deaths – Washington Examiner

U.S. Centers for Disease Control and Prevention Director Robert Redfield agreed that some hospitals have a monetary incentive to overcount coronavirus deaths as they do deaths for other diseases.

“I think you’re correct in that we’ve seen this in other disease processes, too. Really, in the HIV epidemic, somebody may have a heart attack but also have HIV — the hospital would prefer the [classification] for HIV because there’s greater reimbursement,” Redfield said during a House panel hearing Friday when asked by Rep. Blaine Luetkemeyer about potential “perverse incentives.”

Redfield continued: “So, I do think there’s some reality to that. When it comes to death reporting, though, ultimately, it’s how the physician defines it in the death certificate, and … we review all of those death certificates. So I think, probably it is less operable in the cause of death, although I won’t say there are not some cases. I do think though [that] when it comes to hospital reimbursement issues or individuals that get discharged, there could be some play in that for sure.”

Questions have been raised about coronavirus counting in hospitals across the country, and conflicting conclusions have been raised about whether or not deaths are being accurately counted.

A Yale study concluded that the overall coronavirus death toll in the United States is a “substantial undercount” of the actual number; White House coronavirus response team member Dr. Deborah Birx suggested in May that deaths are being overcounted by 25%.

There appear to be cases where the opposite has happened. An investigation in Florida found that several deaths were wrongly attributed to the virus, including the case of a man who died from a gunshot wound to the head.

The CDC’s website lists over 3,700 coronavirus deaths characterized as “intentional and unintentional injury, poisoning and other adverse events.” In Texas, more than 3,000 people were recently removed from the overall coronavirus count because they were never actually tested but considered “probable” cases.

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COVID Director

CDC director: Covid-19 has ‘brought this nation to its knees’ former CDC chief says – msnNOW

(CNN)Covid-19 has “brought this nation to its knees,” Dr. Robert Redfield, director of the US Centers for Disease Control and Prevention, said Tuesday.

The country is probably going to spend about $7 trillion “because of one little virus,” Redfield said during a House Energy and Commerce Committee hearing.
“We’ve all done the best that we can do to tackle this virus.”
Redfield’s comments were made as half of US states are seeing spikes in new coronavirus cases — and it’s not just due to increased testing, health officials say.
As of Tuesday, 25 states have recorded higher rates of new cases compared to last week: Arizona, California, Colorado, Delaware, Florida, Georgia, Hawaii, Idaho, Kansas, Michigan, Mississippi, Missouri, Montana, Nevada, Ohio, Oklahoma, Oregon, South Carolina, Tennessee, Texas, Utah, Washington, West Virginia, Wisconsin and Wyoming.
And no state has effectively transitioned from stay-at-home orders “to a public health model of testing, tracking, isolating and quarantining,” said Dr. Richard Besser, former acting director of the US CDC.
“We have to figure out how to make that transition in a successful way, or every state that reopens — even those that have done a really good job at tamping this down — are going to see pretty dramatic rises,” Besser told CNN Tuesday.
“And we’re going to end up back to where we were.”
If the U.S. doesn’t get control of the coronavirus pandemic by fall, “you’re essentially chasing after a forest fire,” Dr. Anthony Fauci told the House committee Tuesday.
The goal would be to get complete control of the virus instead of just mitigating it, which is happening now, said Fauci, who is director of the National Institute of Allergy and Infectious Diseases.
Redfield said the virus has highlighted decades of underinvesting in the “core capabilities of public health data.” Now is the time to fix the broken system, he added.
“This needs to be a partnership. It’s not all the burden of the federal government to invest in public health at the local level,” Redfield said. In reality, “if your funding of CDC was to go away tomorrow, public health infrastructure across this nation would just crash.”
“We’re right now the backbone of it.”
Nationwide, more than 2.3 million people have been infected with coronavirus, and almost 121,000 have died, according to data from Johns Hopkins University.
“The next couple of weeks are going to be critical in our ability to address those surgings that we’re seeing in Florida, in Texas, in Arizona and in other states — they’re not the only ones having difficulty,” Fauci said.
During Fauci’s testimony in Tuesday’s hearing, the nation’s top infectious disease expert made a plea to all Americans:
“Plan A: Don’t go in a crowd. Plan B: If you do, make sure you wear a mask.”

Why the timing of these surges makes sense

Health experts say the spikes in new cases now coincide with states starting to reopen several weeks ago — with many people refusing or abandoning safety measures such as wearing masks and social distancing.
And while health officials are reporting jumps in cases among younger people, Redfield said Tuesday more than half the nursing homes in the country — over 7,000 — have a Covid-19 patient in them.
“Two weeks ago, we had 17 states with increasing cases,” said Michael Osterholm, director of the Center for Infectious Disease Research & Policy at the University of Minnesota.
Now, that number has jumped to at least 25 states. “And we’re likely to move more states into that category of increasing cases very shortly,” Osterholm said Tuesday. “So, we are seeing what in a sense is the reaction in the virus to opening up and having much more contact with each other.”
After a new exposure to this virus, it can take up to two weeks for symptoms appear. After that, people might not get tested immediately. Then, it can take even longer for severe cases to require hospitalization.
Deaths from new Covid-19 exposures often don’t get reported until several weeks after the new cases have been reported.
While health officials expected new cases as states reopened, many did not expect new cases and hospitalizations to rise so dramatically in some places.
Arizona set a new record this week for the number of people hospitalized on a given day with Covid-19 — about 2,000, according to data from the COVID Tracking Project. The state’s seven-day moving average of hospitalizations is also going up.
“People are being admitted to hospital beds and being admitted to ICU (intensive care unit) beds faster than they’re being discharged,” said Will Humble, executive director of the Arizona Public Health Association.
With about 84% of the state’s ICU beds already full, Humble said he’s worried hospitals will go into “crisis standards of care,” which basically means “lower care for everybody, not just people with Covid-19.”
California recorded more than 35% of its total infections from the entire pandemic in just the past two weeks. The state on Monday recorded 5,019 confirmed coronavirus cases, yet another daily high, according to data provided by California Department of Public Health. Hospitalizations are also at their highest level for Covid-19 patients.

It’s not just increased testing

Some politicians have attributed spikes in new cases to increased testing. But in many places, the number of new Covid-19 cases are disproportionately higher than the number of new tests being performed, researchers say.
“In many states, the testing is increasing, but the percentage of those people who are positive is actually going much higher,” Osterholm said.
“This is not an artifact of just more testing at all.”
Even with the increased testing, the country is still “way behind the virus,” a former US Health and Human Services secretary says.
“We are still reacting. We’re not ahead of it,” Kathleen Sebelius said.
“The only way to get ahead of the virus is to tamp way down the cases in any area, and then test like crazy when a case appears, contact trace, and make sure you quarantine. We can’t do that yet because we are still finding all kinds of people who have the virus.”

‘Moving very fast in the wrong direction’

What’s happening in Arizona and other states could erase much of the progress made during weeks of stay-at-home orders.
“The number of new cases had been stabilizing in early May, and actually the positivity rate (in testing) had been improving,” Humble said.
“We came out of our stay-at-home order in the middle of May, and what we saw happening was that around May 26, that increase in cases that corresponded with the end of the stay-at-home order.”
Florida, a popular destination for beachgoers, is also grappling with a surge in new cases and hospitalizations. The Sunshine State now has “all the markings of the next large epicenter of coronavirus transmission,” researchers say.
And in Texas, where the rates of daily new cases and new hospitalizations are rising, Houston is “moving very fast in the wrong direction,” Mayor Sylvester Turner told CNN affiliate KTRK.
After Houston reported its highest daily count of new Covid-19 cases, Turner called on residents to take safety measures more seriously.
“This is a health care crisis,” he said. “Quite frankly, your failure, for example, to wear masks … or to engage in social distancing directly impacts on somebody else.”

Where states are seeing steady or improving numbers

In 12 states, the numbers of new daily cases have generally held steady in recent days: Alaska, Arkansas, Illinois, Iowa, Kentucky, Minnesota, Nebraska, New Mexico, North Carolina, North Dakota, Pennsylvania and Virginia.
And in 13 states, the numbers of new cases are generally declining: Alabama, Connecticut, Indiana, Louisiana, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, South Dakota and Vermont.
“New York went from one of the highest infection rates in the country to one of the lowest because we made decisions based on science, not politics,” Gov. Andrew Cuomo said Tuesday.
“We’re seeing in other states what happens when you just reopen with no regard for metrics or data — it’s bad for public health and for the economy, and states that reopened in a rush are now seeing a boomerang.”
Cuomo is consider forcing visitors from high-transmission states to quarantine upon arrival to New York state, he said.

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Director Schumacher

Joel Schumacher, Director of Batman Films and ‘Lost Boys,’ Dies at 80 – Variety

Joel Schumacher, costume designer-turned-director of films including “St. Elmo’s Fire,” “The Lost Boys” and “Falling Down,” as well as two “Batman” films, died in New York City on Monday morning after a year-long battle with cancer. He was 80.

Schumacher brought his fashion background to directing a run of stylish films throughout the 1980s and 1990s that were not always critically acclaimed, but continue to be well-loved by audiences for capturing the feel of the era.

Schumacher was handed the reins of the “Batman” franchise when Tim Burton exited Warner Bros.’ Caped Crusader series after two enormously successful films. The first movie by Schumacher, “Batman Forever,” starring Val Kilmer, Tommy Lee Jones, Jim Carrey and Nicole Kidman, grossed more than $300 million worldwide.

Schumacher’s second and last film in the franchise was 1997’s “Batman and Robin,” with George Clooney as Batman and Arnold Schwarzenegger as villain Mr. Freeze. For “Batman Forever,” the openly gay Schumacher introduced nipples to the costumes worn by Batman and Robin, leaning into the longstanding latent homoeroticism between the two characters. (In 2006, Clooney told Barbara Walters that he had played Batman as gay.)

Several years after the Batman debacle, Schumacher directed the feature adaptation of Andrew Lloyd Webber’s musical “The Phantom of the Opera.” Despite tepid reviews, it received three Oscar noms.

In 1985 Schumacher struck gold with his third feature film, “St. Elmo’s Fire,” which he directed and co-wrote. Brat Packers including Rob Lowe, Emilio Estevez and Ally Sheedy as well as a young Demi Moore starred in the story of a bunch of Georgetown grads making their way through life and love. Even the theme song was a hit and is still played to evoke the era. The film offered a pretty smart take on the complexities of post-college life.

His next film was a big hit as well: horror comedy “The Lost Boys,” about a group of young vampires who dominate a small California town, starred Jason Patric, Kiefer Sutherland, Corey Feldman and Corey Haim. It became a cult favorite, and a TV series adaptation has long been in the works.

Schumacher had a high-concept screenplay by Peter Filardi and an A-list cast — Julia Roberts, Kiefer Sutherland, Kevin Bacon, William Baldwin — for the 1990 horror thriller “Flatliners,” about arrogant medical students experimenting with life and death, and the director hit it fairly big again, with a domestic cume of $61 million.

While those hits captured the era well, others during that period were misfires, such as the 1989 remake of the French hit “Cousin/Cousine” called “Cousins” and starring Ted Danson and Isabella Rossellini and the sentimental “Dying Young,” starring Roberts and Campbell Scott.

But in 1993 he showed what he was capable of with the critically hailed “Falling Down,” starring Michael Douglas as a defense worker who’s lost it all and decides to take it out on whomever he comes across. The film played in competition at the Cannes Film Festival.

The New York Times said the film “exemplifies a quintessentially American kind of pop movie making that, with skill and wit, sends up stereotypical attitudes while also exploiting them with insidious effect. ‘Falling Down’ is glitzy, casually cruel, hip and grim. It’s sometimes very funny, and often nasty in the way it manipulates one’s darkest feelings.”

Schumacher’s next film was also a solid hit. “The Client,” based on a John Grisham novel, was a highly effective legal thriller that also boasted terrific rapport between Susan Sarandon’s lawyer and her 11-year-old client, a boy played by Brad Renfro who has witnessed a murder.

Between the two “Batman” films, Schumacher directed another Grisham adaptation, “A Time to Kill,” which sported a terrific cast (including Samuel L. Jackson, Kevin Spacey, Sandra Bullock, Ashley Judd and a career jump-starting turn by a young Matthew McConaughey) and, while not without its own weaknesses, asked important questions about race.

After the second “Batman” he made the much darker, smaller-scale thriller “8MM,” which followed a miscast Nicolas Cage as a family-man private detective in pursuit of those who made what appears to be a snuff film.

His next film, 1999’s “Flawless,” about a homophobic cop who’s suffered a stroke, played by Robert De Niro, and a drag-wearing Philip Seymour Hoffman, was formulaic — the odd couple who couldn’t be more different find out they have a lot in common — but it sported excellent performances by the leads and certainly had heart.

Switching gears dramatically, Schumacher made “Tigerland,” starring a young Colin Farrell in the story of young recruits preparing to go off to Vietnam. It had a gritty look, but while some critics saw an earnest quality, others saw cynicism.

Schumacher’s 2002 thriller “Phone Booth,” which reunited the director with Colin Farrell and Kiefer Sutherland — and intriguingly trapped Farrell’s antihero in the title New York City phone booth for almost all of the film’s running time — had critics and audiences alike talking, even if the ending was a cop-out.

His other films included actioner “Bad Company,” starring Anthony Hopkins and Chris Rock; “Veronica Guerin,” starring Cate Blanchett as a journalist crusading rather recklessly against the Irish drug trade; and Jim Carrey thriller “The Number 23” and “Trespass,” starring Nicolas Cage and Nicole Kidman.

Schumacher started out in showbiz as a costume designer, earning credits on 1972’s “Play It as It Lays,” Herbert Ross’ “The Last of Sheila” (1973),  Paul Mazursky’s “Blume in Love (1973), Woody Allen’s “Sleeper” (1973) and “Interiors” (1978) and 1975 Neil Simon adaptation “The Prisoner of Second Avenue.” He was also credited as the production designer on the 1974 TV horror film “Killer Bees.”

He also started to write screenplays, including 1976’s “Sparkle,” 1978 hit “Car Wash” and the adaptation for 1978 musical “The Wiz.”

Schumacher’s first directing assignments came in television: the 1974 telepic “Virginia Hill,” which he also co-wrote and starred Dyan Cannon, and the 1979 telepic “Amateur Night at the Dixie Bar and Grill,” which he also penned. He stepped into the feature arena with the 1981 sci-fi comedy “The Incredible Shrinking Woman,” starring Lily Tomlin, followed in 1983 by “D.C. Cab,” an action-comedy vehicle for Mr. T that Schumacher also wrote.

Born in New York City, he studied at Parsons the New School for Design and the Fashion Institute of Technology in New York. He worked in the fashion industry, but decided to instead pursue a career in filmmaking. After moving to Los Angeles, he applied his fashion background to working first as a costume designer and worked in TV while earning an MFA from UCLA.

Schumacher directed a couple of episodes of “House of Cards” in 2013, and in 2015 he exec produced the series “Do Not Disturb: Hotel Horrors.”

Camerimage, the International Film Festival of the Art of Cinematography, awarded Schumacher a special award in 2010. He also received the Distinguished Collaborator Award at the Costume Designers Guild Awards in 2011.

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