Most COVID-19 Fatalities Are Men Over 50 With Chronic Disease  

HealthDay News – Most fatal cases of coronavirus disease 2019 (COVID-19) occur in men aged older than 50 years with noncommunicable chronic diseases, according to a study published online April 3 in the  American Journal of Respiratory and Critical Care Medicine .

Yingzhen Du, from the Chinese PLA General Hospital in Beijing, and colleagues reported the clinical features of 85 fatal cases with COVID-19 in two hospitals in Wuhan to define risk factors for death. Medical records were obtained for 85 fatal cases between January 9 and February 15, 2020.

To Mask or Not to Mask?
The recent emergence of a deadly mutated strain of coronavirus (COVID-19) and its spread across the world has heightened interest in the role of the surgical mask as one possible barrier to a potential pandemic. The media has touted the use of surgical masks and the types of masks that should be worn as a barrier to airborne viral spread. The need and desire of entire urban populations and travelers for facial barriers have literally created a worldwide shortage of surgical masks and viral barrier respirator masks. The largest surgical mask provider, Prestige Ameritech, no longer is accepting orders for masks from individuals as it focuses on supplying U.S. hospitals. Not since the SARS epidemic in 2002-2003 has there been such interest in the varieties of mask protection.

Initial interest in the use of masks as protection against infection, especially tuberculosis, began in the late 19th century but did not routinely translate to usage in the OR until the 1920s. It is reported that Paul Berger, a Parisian surgeon, first began routinely using a mask during surgical procedures in 1897. These early masks were made of fine mesh gauze and used to cover the mouth only. During World War I, the use of gauze masks in military hospitals was introduced to protect patients who were placed in mixed wards with a high incidence of respiratory infections.
Dr. Devi Pens Book
Hospitals and healthcare workers struggle to keep up with the demand as the new coronavirus (COVID-19) spreads across the U.S. and throughout the world. 

Hundreds of millions of people are social distancing, quarantining, and sheltering in place to slow down the spread of the virus. The stock market is plunging and the global economy is heading into a recession because of the virus and because of the measures we are enforcing to stop it. Schools are closed. Restaurants, bars, and gyms are closed in many areas of the country. Major sports events, concerts and shows have been cancelled. Perhaps our greatest asset in this fight against the new coronavirus-- healthcare workers-- are becoming infected on the front lines. In the midst of this crisis, Doctor Devi explains what you need to know in a concise and easy-to-understand Question and Answer format.

Dr. Devi Nampiaparampil, a Harvard-trained doctor and a professor at NYU School of Medicine, breaks down the issues in this clear and compassionate handbook. What makes this virus so dangerous? How can I protect myself and my family? How did this happen?

This book discussed the fundamentals behind the coronavirus epidemic.
For the latest guidelines, please always check:
Pain Physician March/April  
2020 Articles Available Online Now 
The March/April issue of Pain Physician  features 

Evolutionary Therapeutic Strategies
Sairam Atluri, MD, Laxmaiah Manchikanti, MD, and Joshua A. Hirsch, MD

Position Statement
Laxmaiah Manchikanti, MD, Christopher J. Centeno, MD, Sairam Atluri, MD, Sheri L. Albers, DO, Shane Shapiro, MD, Gerard A. Malanga, MD, Alaa Abd-Elsayed, MD, MPH, Mairin Jerome, MD, Joshua A. Hirsch, MD, Alan D. Kaye, MD, PhD, Steve M. Aydin, DO, Douglas Beall, MD, Don Buford, MD, Joanne Borg-Stein, MD, Ricardo Buenaventura, MD, Joseph A. Cabaret, MD, Aaron K. Calodney, MD, Kenneth D. Candido, MD, Cameron Cartier, MD, Richard Latchaw, MD, Sudhir Diwan, MD, Ehren Dodson, PhD, Zachary Fausel, MD, Michael Fredericson, MD, Christopher G. Gharibo, MD, Myank Gupta, MD, Adam M. Kaye, PharmD, FASCP, FCPhA, Nebojsa Nick Knezevic, MD, PhD, Radomir Kosanovic, MD, Matthew Lucas, DO, Maanasa V. Manchikanti , R. Amadeus Mason, MD, Kenneth Mautner, MD, Samuel Murala, MD, Annu Navani, MD, Vidyasagar Pampati, MSc, Sarah Pastoriza, DO, Ramarao Pasupuleti, MD, Cyril Philip, MD, Mahendra Sanapati, MD, Theodore Sand, PhD, Rinoo Shah, MD, Amol Soin, MD, Ian Stemper, MS, Bradley W. Wargo, DO, and Philippe Hernigou, MD

Health Policy Review
Laxmaiah Manchikanti, MD, Mahendra R. Sanapati, MD, Amol Soin, MD, Maanasa V. Manchikanti, BS, Vidyasagar Pampati, MSc, Vanila Singh, MD, and Joshua A. Hirsch, MD

Laxmaiah Manchikanti, MD, Mahendra R. Sanapati, MD, Vidyasagar Pampati, MSc, Amol Soin, MD, Sairam Atluri, MD, Alan D. Kaye, MD, PhD, Joysree Subramanian, MD, and Joshua A. Hirsch, MD

Sanjeeva Gupta, MD, and Manohar Sharma, MD
Pain Management
Workgroup to Hold Evidence Review Advisory Meeting
Please find the letter  addressed to American Society of Interventional Pain Physicians, along with other pain organizations from the Pain Management Workgroup Evidence Review advisory meeting with important updates.
They are planning an evidence review advisory meeting for LCD policies on facet joint injections and medial nerve branch procedures. The meeting, which will be a combined meeting with all Medicare Administrative Contractors (MACs), is currently planned for May 28th in Nashville and as a teleconference. A link to the meeting and registration information will be posted to each MAC’s website and the CMS Landing Page within the next 2‐3 weeks.  ASIPP will be watching for this posting and will notify you so that you may register to attend.

Some of the ASIPP members are already serving on this committee; however, it is crucial that each state contact their own carriers and try to represent them. We need as many people as you can participate.
It is very crucial that you participate and understand. If you register you should be able to ask questions and give opinions, etc.
Please block your time for May 28 th from 1:00 to 3:00 pm CST.
FRIDAY, APRIL 17, 2020 | 3:00PM - 5:00PM CST
Comprehensive Physician and Practice Resuscitation Training
3:00pm 3:05pm            Webinar Introduction
3:05pm 3:20pm            Overview Laxmaiah Manchikanti,
3:20pm 3:30pm       Financial Overview Amol Soin,
3:30pm 3:45pm            The Evolving Role of Online Platforms During the Pandemic -
Kevin Pho,
3:45pm 4:00pm            Physician Burnout Suneel Dhanda, MD
4:00pm 4:15pm            CMS Session
4:15pm 4:30pm            Complying with New Copay and Cost Sharing Rules
Judith L. Blaszczyk, RN, CPC
4:30pm 5:00pm            Open Forum Discussion Panel
THURSDAY, APRIL 23, 2020 | 5:00PM – 7:00PM CDT
Comprehensive Physician and Practice Resuscitation Training
5:00pm – 5:05pm        Introduction
5:05pm – 5:20pm        CPPR Training – Laxmaiah Manchikanti, MD
5:20pm – 5:35pm        Getting Back to Normal: Scheduling – Testing – Shalini Shah, MD
5:35pm – 5:50pm        Revenue Cycle Management – Maharshi Patel
5:50pm – 6:15pm        Forming an IPA: Revolutionary or Reactionary – Ian Meyers
6:15pm – 6:30pm        Marketing During a Recession – Randy Alvaraez
6:30pm – 6:55pm        Open Forum Discussion
                                    Moderators: Laxmaiah Manchikanti, MD and Amol Soin, MD
WEDNESDAY, APRIL 29, 2020 | 5:00PM – 7:00PM CDT
Comprehensive Physician and Practice Resuscitation Training
5:00 pm – 5:05pm        Introduction
5:05 pm – 5:20pm        Overview of Physician and Practice Rehabilitation –
Laxmaiah Manchikanti, MD
5:20pm – 5:35pm        Getting Back to Normal: Procedure Scheduling and Execution –
Shalini Shah, MD
5:35pm – 5:50pm        Revenue Cycle Management – Maharshi Patel
5:50pm – 6:15pm        Financial Rehabilitation: Fact Vs Fiction – Amol Soin, MD
6:15pm – 6:55pm        Open Forum Discussion
                                    Moderators: Laxmaiah Manchikanti, MD and Amol Soin, MD
Five Ways to Cope When Masks Run Low
New CDC guidance offers options on reuse, decontamination -- and no, don't use home ovens or tanning beds

With hospitals in coronavirus hotspots struggling to preserve personal protective equipment (PPE),  MedPage Today  spoke with experts in engineering, medicine, and infection prevention on ways to extend their supply and use.

Infection preventionists spend their days "frantically searching" for PPE, teaching clinicians how to reuse masks and gowns or how to create their own, said Ann Marie Pettis, RN, BSN, president-elect of the Association for Professionals in Infection Control and Epidemiology (APIC) during a  press briefing last week.
FDA Announces  Coronavirus Treatment Acceleration
Program (CTAP)  
FDA has created a special emergency program for possible therapies, the Coronavirus Treatment Acceleration Program (CTAP). It uses every available method to move new treatments to patients as quickly as possible, while at the same time finding out whether they are helpful or harmful. We continue to support clinical trials that are testing new treatments for COVID so that we gain valuable knowledge about their safety and effectiveness.
Snapshot for Developing Therapeutics

Given the urgent nature of the pandemic and the number of companies and researchers developing COVID-19 related therapies, the following numbers may change frequently.

Our current snapshot is:

  • 10 therapeutic agents in active trials
  • Another 15 therapeutic agents in planning stages
Announcing A New ASIPP ® Partnership - Fedora Billing
And Revenue Cycle
Management Company 
After long discussions, in addition to our NorCal liability program for ASIPP ® members, now we are able to offer unique benefits for revenue cycle management with billing, etc.

Fedora is a company known to many of our board members and others. ASIPP ® has reached an agreement with Fedora to provide exclusive discounts on billing or revenue cycle management that will decrease practice costs and promote growth, or at least stop deterioration. It is not just a billing company; they streamline the billing and receivable process and constantly update payor regulations keeping your practice up to on date on a daily basis. 

You may view the ASIPP ® billing program website at the following link:  

Some of the ASIPP ® Billing Program highlights are below:
Up to 50% savings for ASIPP ® members for their billing or revenue cycle management for their offices and surgery centers:
  • Expertise in interventional pain management billing for all types of services
  • 99% Clearing House Rate
  • 95% First-Time Claim Passage
  • 23.4 Average Days in A/R
  • Eligibility and Benefits Verification 
  • Pre-Certification/Prior Authorization
  • Denials and A/R Management 
Join The Group Purchasing Organization Today
ASIPP ® has formed a partnership with Henry Schein and PedsPal , a national GPO that has a successful history of negotiating better prices on medical supplies and creating value added services for the independent physician. Working with MedAssets, PedsPal provides excellent pricing on products like contrast media that alleviate some of the financial pressures you experience today. While the cost of contrast media has skyrocketed due to the single dose vial issue, because we have partnered with Henry Schein, this could enable you to purchase Omnipaque 240mg/50mL for slightly above $4.50.

It will be easy for  ASIPP ® members in good standing to enroll today and begin to realize the savings this partnership can bring. Members can join or see sample prices by going to l   

Click on “view our discounted supplier prices” (Username:ASIPPmember and Password: Save) or click on the words "join for free now" and begin saving today!
CMS Approves Approximately
$34 Billion for Providers with the Accelerated/Advance Payment Program for Medicare Providers
in One Week  
The Centers for Medicare & Medicaid Services (CMS) has delivered near $34 billion in the past week to the healthcare providers on the frontlines battling the 2019 Novel Coronavirus (COVID-19). The funds have been provided through the expansion of the Accelerated and Advance Payment Program to ensure providers and suppliers have the resources needed to combat the pandemic.  

“Healthcare providers are making massive financial sacrifices to care for the influx of coronavirus patients,” said CMS Administrator Seema Verma. “Many are rightly complying with federal recommendations to delay non-essential elective surgeries to preserve capacity and personal protective equipment. They shouldn’t be penalized for doing the right thing. Amid a public health storm of unprecedented fury, these payments are helping providers and suppliers – so critical to defeating this terrible virus – stay afloat.”

The streamlined process implemented by CMS for COVID-19 has reduced processing times for a request of an accelerated or advance payment to between four to six days, down from the previous timeframe of three to four weeks. In a little over a week, CMS has received over 25,000 requests from health care providers and suppliers for accelerated and advance payments and have already approved over 17,000 of those requests in the last week. Prior to COVID-19, CMS had approved just over 100 total requests in the past five years, with most being tied to natural disasters such as hurricanes.

The fact sheet on the accelerated/advance payment process and how to submit a request can be found here:  Fact Sheet Providers can also contact their Medicare Administrative Contractor for any questions.

This action, and earlier CMS actions in response to COVID-19, are part of the ongoing White House Coronavirus Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, visit . For a complete and updated list of CMS actions, and other information specific to CMS, please visit the  Current Emergencies Website .
Coronavirus Disease 2019 in Children — United States, February 12 – April 2, 2020    

What is already known about this topic?
Data from China suggest that pediatric coronavirus disease 2019 (COVID-19) cases might be less severe than cases in adults and that children (persons aged <18 years) might experience different symptoms than adults.

What is added by this report?
In this preliminary description of pediatric U.S. COVID-19 cases, relatively few children with COVID-19 are hospitalized, and fewer children than adults experience fever, cough, or shortness of breath. Severe outcomes have been reported in children, including three deaths.

What are the implications for public health practice?
Pediatric COVID-19 patients might not have fever or cough. Social distancing and everyday preventive behaviors remain important for all age groups because patients with less serious illness and those without symptoms likely play an important role in disease transmission.
Multispecialty Organizations
during the COVID-19 Pandemic and Public

It is nearly impossible to overestimate the burden of chronic pain, which is associated with enormous personal and socioeconomic costs. Chronic pain is the leading cause of disability in the world, is associated with multiple psychiatric co-morbidities, and has been causally linked for the opioid crisis. Access to pain treatment has been called a fundamental human right by numerous organizations. The current COVID-19 pandemic has strained medical resources, creating a dilemma for physicians charged with a responsibility to limit spread of the contagion, and their responsibility to treat the patients they are entrusted to care for.

To address these issues, an expert panel was convened that included pain management experts from the military, Veterans Health Administration, and academia. Endorsement from stakeholder societies was sought upon completion of the document, with a 1-week suspense period.

In these guidelines, we provide a framework for pain practitioners and institutions to balance the often-conflicting goals of risk mitigation for health care providers, risk mitigation for patients, conservation of resources, and access to pain management services. Specific issues discussed include general and interventional-specific risk mitigation, patient flow issues and staffing plans, telemedicine options, triaging recommendations, strategies to reduce psychological sequelae in health care providers, and resource utilization.

The COVID-19 public health crisis has strained health care systems, creating a conundrum for patients, pain medicine practitioners, hospital leaders, and regulatory officials. Although this document provides a framework for pain management services, systems-wide and individual decisions must take into account clinical considerations, regional health conditions, government and hospital directives, resource availability, the welfare of health care providers.

Essentials of Regenerative Medicine in Interventional
Pain Management
Essentials of Regenerative Medicine in Interventional Pain Management is a book to bring concise, collective, and comprehensive information to interventional pain physicians practicing regenerative medicine in managing chronic pain. Regenerative medicine is an integral part of interventional pain management within the definitions of interventional pain management and interventional techniques.

Each chapter contains an introduction of the subject, historical context,pathophysiology, applicability of regenerative medicine with its evidence base, indications, anatomy, technical aspects, complications, and precautions for each topic when available and applicable. This comprehensive book consists of 35 chapters, more than 350 figures, and 50 tables.
Essentials of Regenerative Medicine in Interventional Pain Management | ORDER |
Control Your Waiting Room TV

Customized waiting room TV exclusively for ASIPP ® members. Create your own ad-free television broadcasts using our videos, custom informational slides and your own YouTube videos. Even add local weather reports, news and live messages.
Send in your state society meeting news to Holly Long ,
ASIPP ® | Pain Physician Journal | Phone | Fax | Email