The United States continues to see increasing numbers of COVID-19 cases due to the rapid spread of the Delta variant. As of August 20, the seven-day moving average of daily new cases is about 133,000, a 14% increase compared to the previous week. The rising Delta variant cases have an obvious impact on the healthcare system. Overwhelmed hospitals in severely affected states such as Alabama, Florida and Louisiana face record-high hospitalization rates and ICU bed shortages, with some having no choice but to send critically ill patients to different states for treatment.

Federal and state governments, the Centers for Disease Control and Prevention (CDC), and the Food and Drug Administration (FDA) are responding to the changing environment by introducing new regulations and enforcements in attempts to limit the spread of the virus.

This image shows the CDC's Daily Number of COVID-19 Cases Tracker as of August 23, 2021
CDC Daily Number of COVID-19 Cases Tracker as of August 23, 2021

Vaccination proof is becoming new normal to attend local activities and return to work

New regulations across the country encourage vaccination to lower cases and reduce the Delta variant’s impact on the healthcare system. For instance, New York City will require vaccination proof for indoor dining, gyms and performances starting September 13. In California, vaccination proof or a negative test is needed to attend indoor gatherings with at least 1,000 people, such as concerts and sports games. Governor Greg Abbott of Texas asked hospitals to cancel or delay elective surgeries and procedures, while mask mandates returned to many states like Louisiana and Washington.

Furthermore, over 150 health systems in the U.S. now require employees to be vaccinated by the end of the year, although there are exemptions for medical, religious and other legally protected reasons. For certain health systems, the consequences of being unvaccinated may include employment termination. These requirements come with resistance in the form of protests and growing concerns over nurse shortages after firing unvaccinated employees. Major insurers like Cigna and Blue Cross Blue Shield of Massachusetts are also setting mandatory vaccination rules for employees returning to offices this fall.

The U.S. recently reached a 70% vaccination milestone for adults and continues to push forward by requiring vaccination proof for various activities, leaving unvaccinated individuals with no choice but to get the vaccine or leave.

Insurers are also responding to this new normal by developing vaccination records. United Healthcare provides digital records in member accounts and uses this information to communicate with members, such as by sending reminders for booster shots. Members can use this record as proof for employers or to attend events. Kaiser Permanente also keeps COVID-19 vaccination records on its member site. Both member sites conveniently allow members to print their records for proof.

One of the Delta variant's impacts on the healthcare system includes digital records of COVID-19 Vaccinations, such as this one from UnitedHealthcare
United Healthcare Member Vaccination Record

The FDA, CDC and Biden administration introduce new vaccine guidelines in August

Vaccine guidelines are also changing in response to new data and growing concerns over how the Delta variant will impact the healthcare system. On August 12, the FDA authorized a third COVID-19 vaccine shot for immunocompromised individuals. Eligible individuals are not required to show proof of health status to receive this additional dose. Following this authorization, the Centers for Medicare and Medicaid Services (CMS) announced that Medicare will cover costs for this third shot and reimburse providers at the rate of other COVID-19 vaccine doses, which is around $40 per dose.

Similarly, the Biden administration plans to make a third booster shot available as of September 20 for Americans who have been fully vaccinated for at least eight months. Health officials and experts are still deciding whether booster shots are necessary for the Johnson & Johnson vaccine, but guidance is expected to be introduced soon.

The CDC is also stepping up to encourage pregnant women, those who are thinking about having children and those who are breastfeeding to get vaccinated. On August 11, the CDC released new data showing that women who received the COVID-19 vaccine before 20 weeks of pregnancy are not at increased risk of miscarriage. Combined with previous data that there are no safety concerns for women late in their pregnancy, the CDC now strongly encourages pregnant women to get vaccinated.

Most recently, the FDA granted full approval to the Pfizer-BioNTech vaccine on August 23. The vaccine will be marketed as Comirnaty for individuals ages 16 and above, although emergency use authorization still applies to those ages 12 to 15. This full approval launched an additional wave of health systems requiring employees to get vaccinated, with more expected to come. Altogether, various agencies are staying on top of current scientific research and data, as well as the changing situation, to introduce new guidelines.

Amwell predicts fewer telehealth visits for the second half of the year despite the Delta variant’s impact on healthcare

Telehealth cannot be skipped over when considering the Delta variant and COVID-19’s impact on the healthcare industry, as the pandemic contributed to telehealth moving into the mainstream healthcare experience. Telehealth usage across the U.S. peaked during April 2020 and has since stabilized at levels 38 times higher than pre-pandemic.

Interestingly, the telehealth giant Amwell predicts 200,000 fewer telehealth visits—or a loss of $8 million in revenue—for the second half of 2021. This comes from projections that newly reinstated mask mandates and increased social distancing will correspond to a weaker cold and flu season and therefore less need for telehealth services. The telehealth giant does not expect extra COVID-19 demand for such services. At the same time, due to uncertainty with the ongoing pandemic, Amwell acknowledges that the opposite is possible.

While Amwell predicts fewer telehealth visits for the second half of 2021, telehealth seems to be staying and continues to be a key player in today’s digital healthcare experience.

Corporate Insight closely monitors the digital patient experience across leading health systems. Within our Health System Monitor, we see organizations responding to new and changing pandemic regulations to provide care for patients. Access further insights on the nation’s leading healthcare organizations on our blog.

Stephanie Chan
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