QUICKLINKS AND VIEW OPITONS
Vast majority of Covid-19 cases are mild to very mild as of June 2020 notes Texas ER executive
Wednesday, July 01, 2020 4:56 pm Email this article
Here is a very interesting email sent to investigative reporter Alex Berenson, from a Managing Partner of a Texas based company that owns and operates 13 free-standing emergency clinics in the State of Texas, about how Covid-19 is becoming milder than it was a month or two ago.
The email reads, “Vast majority of the cases are mild to very mild symptoms. ... Vast majority of the patients are better within 2-3 days of the visit and most would be described as having a cold (a mild one at that) or the symptoms related to allergies. ... The hospital ICUs are filled with really sick people with non-covid issues. ... [hospital] discharge planners are being pressured to put Covid as primary diagnosis-as that pays significantly better.”
Alex Berenson posted screenshots of the email on Twitter.
The email reads:
From: JB Neiman
To Alex Berenson
Subject: ER Visits in Texas
Date: June 29, 2020
I am the Managing Partner and General Counsel of a Texas based company that owns and operates 13 free-standing emergency clinics in the State of Texas. I follow your reporting and wanted to share with you some information on Texas. I want people to hear this story as opposed to the mainstream reporting. However, I am sensitive about putting a target on myself or my company for conveying this information. I am not sure how you’ve handled this type of situation but I suspect you’ve had other people send you information who are concerned about becoming a target.
In June, we tested over 2231 patients (data through last Thursday). Positive rate is now close to 20% (was 4-6% positive in May). Vast majority of the cases are mild to very mild symptoms. Average age of the people getting tested is mid-30s. Very different patient (in terms of age) then we’ve seen before June. Most of these patients would not have met the strict criteria that we previously had (and all health facilities had) for Covid testing. Now with more testing kits we are able to test a broader group of patients.
Clinically, we’ve had very few hospital transfers because of Covid. Vast majority of the patients are better within 2-3 days of the visit and most would be described as having a cold (a mild one at that) or the symptoms related to allergies. We’ve often provided a steroid shot and some antibiotics. By the time we have follow up calls most of the patients are no longer experiencing any symptoms. They often say the shot really made a difference.
In terms of what is driving them to the ER- Roughly 1/2 have been told by their employers to get a test.
They have a sneeze or a cough and their employer tells them to go home and get tested. The other 1/2 just want to know. They have mild symptoms (and some don’t have any symptoms but game the system and check a box that they have a symptom so they can get a test-they cannot get a test unless they present with symptoms. If they have no symptoms we send them away-which does happen).
In terms of information from within hospital systems (intel provided through various contact … [part of the email is blocked out] The average length of stay of Covid patients is 3-5 days. Much lower then the patients being seen in April and early May. Their symptoms are also milder. Most of these patients are not ending up in the ICU.
The hospital ICUs are filled with really sick people with non-covid issues. They didn’t come in earlier because they were scared and now they are super sick. From multiple sources at different hospitals- they have plenty of capacity and no shortage of acute care beds. No real data on breakdown of patients who have Covid but are not in the hospital because of Covid. Recognition that because all patients are tested for Covid you have some percentage of patients listed as Covid patients who are non Covid symptomatic and that the hospitalization rate is somewhat driven by hospitals taking in their normal patients with other medical issues.
Finally, heard several stories of how discharge planners are being pressured to put Covid as primary diagnosis-as that pays significantly better.
Hospitals want to avoid the discussion but if they don’t they risk another shutdown. This may be an explanation for why there is a gap in hospital executives saying they have plenty of capacity and the increasing number of Covid hospitalizations. You open up your hospitals for normal medical care and you test everyone of those patients-the result is higher percentage of patients who have Covid- now those patients are listed as Covid patients.
Something else to pass on. Since Covid hit , our ER volume decreased 50% in the month of April (year over year). However, our percentage of level 5 ER claims (highest level and very high acuity patients) doubled. The patients that did come in often waited much longer then they should have (and normally would have). People were just so scared (we had one patient)
Overall , based upon what we are seeing at our facilities the above information is really more of a positive story. You have more people who are testing positive with minimal symptoms. This means that the fatality rate is less then commonly reported.
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