Uncharted waters, lines of credit, and heroes
Last week there was shock, the emptying of offices and filling of hospital beds-and whiplash as the economy came to grinding halt.
This week, less shock, some numbness, more adjustment. But also more COVID-19 cases, more deaths-and a huge jump in unemployment. Part of the response: A $2 trillion stimulus bill and a Defense Production Act order to make ventilators.
Mid-week, there was talk of an exit ramp, perhaps a “tiered approach” that would mean testing and surveillance, not social distance and shuttered businesses, and different guidelines for different parts of the country.
But at today’s White House Coronavirus Task Force press conference, Anthony Fauci, MD, talked about the uncertainty of the COVID-19 outbreak relative to the others (HIV/AIDS, SARS, Ebola) he has seen during his 36 years director of the National Institute of Allergy and Infectious Diseases.
“But we are also in uncharted waters - and that is the thing that I find different - is that the waters are uncharted so it isn’t as if we have an example of how do it,” Fauci said. “We have an extraordinary confrontation on the health and welfare of the globe, particularly for us in the United States. So as somebody who has been through all those outbreaks, this is truly unprecedented.”
That doesn’t read like a sign pointing to an exit.
Meanwhile, in hospital C-suites, CFOs were looking at the collapse of revenues as elective surgeries and other services were canceled while expenditures changed little or escalated in areas with large numbers of COVID-19 cases, Eric Jordahl of Kaufman Hall, a Chicago management consulting company, told us in an interview this afternoon.
In the short term, those CFOs can deal with any liquidity problems by arranging lines of credit with their relationship banks, Jordahl said, and with interest rates low, that won’t be expensive money. But Jordahl said he is advising clients to think ahead now to how much liquidity they might need-and how they might get that cash. That rule of thumb about having 25-30 days of cash on hand? Time to rethink it.“Twenty-five to 30 days is not enough right now,” he said. “It has to be higher than that.”
C-suites were talking on Zoom this week-and some of those conversation were about telehealth. CMS loosened its telehealth rules for Medicare beneficiaries last week. Humana was just one insurer that expanded its coverage this week. Scores, if not hundreds, of telehealth vendors were hawking their wares. More than one post-COVID-19 scenario has telehealth moving squarely into the mainstream of American healthcare because of its COVID moment.
Donations were another topic, trumpeted by press releases. From Merck, 800,000 personal protective masks. From Zurn, a Milwaukee fabricator of faucets, hand dryers, and plumbing supplies, $1 million in “hygienic products.” From Mary Kay, the cosmetics company, hand sanitizer for the Baylor, Scott & White, the Dallas health care system.
Donations are not a free lunch for the recipients. Managing them takes time and effort.
“I’m sure all healthcare organizations are receiving offers of support from their local communities – including money, supplies, or offers to produce personal protective equipment that is in short supply,” Cynthia Hundorfean, CEO of Allegheny Health Network and a member of our editorial advisory board, told us in an email interview this week. “The time spent by our leadership team in managing all of this has been a challenge but completely worthwhile. We are very grateful.”
COVID-19 is a crisis. Crises can beget heroes
For Don Hall, a member of our editorial advisory board and a health care consultant, Fauci has emerged as one: “He keeps us grounded in science and reality.”
Hundorfean points to her frontline caregivers: “In our organization, it’s the frontline caregivers - which includes everyone that cares for our patients. They are courageous, compassionate and caring. How much courage it must take to come to work each day under these circumstances."
"We are," continued Hundorfean, "so blessed.”