Face shield.

The Case for Face Shields: Improving the COVID-19 Public Health Policy Toolkit

By Timothy Wiemken, Ana Santos Rutschman, and Robert Gatter

As the United States battles the later stages of the first wave of COVID-19 and faces the prospect of future waves, it is time to consider the practical utility of face shields as an alternative or complement to face masks in the policy guidance. Without face shields specifically noted in national guidance, many areas may be reluctant to allow their use as an alternative to cloth face masks, even with sufficient modification.

In this post, we discuss the benefits of face shields as a substitute to face masks in the context of public health policy. We further discuss the implications and opportunity costs of creating policy guidance with only a small subset of scientific data, much of which is limited. We conclude by arguing that existing federal guidance should be expanded to include face shields as a policy option.

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Santiago, Chile.

The Democratic Case for Social Rights in Chile’s Constitutional Moment

By Koldo Casla

We live an era of nationalistic, angry, and xenophobic challenges to human rights, a time in which the “will of the people” is maliciously presented as contrary to human rights. We have seen human rights backlashes consistent with this instrumentalization of the so-called popular will in India, Hungary, Poland, Turkey, the Philippines, the U.S., the U.K. — the list, sadly, could go on and on.

Chile, however, presents a test case for the opposite, an opportunity to refresh the democratic case for social rights, not due to natural or international law, but because human rights is what people demand.

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Assessing legal responses to COVID-19 graphic.

New Report Assesses Legal Responses to COVID-19

Assessing Legal Responses to COVID-19 is a new, in-depth analysis of U.S. legal and policy responses to the pandemic.

In the report, 50 top national experts offer a new assessment of the U.S. policy response to the crisis. The research details the widespread failure of the country’s leadership in planning and executing a cohesive, national response, and how the crisis exposed weaknesses in the nation’s health care and public health systems.

The report’s authors also offer recommendations on how federal, state and local leaders can better respond to COVID-19 and future pandemics. Their proposals recommend how to strengthen executive leadership for a stronger emergency response; expand access to public health, health care, and telehealth; fortify protections for workers; and implement a fair and humane immigration policy.

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Cartoon of contact tracing for COVID-19.

COVID-19, Misinformation, and the Law in Nigeria

By Cheluchi Onyemelukwe

The spread of COVID-19 in Nigeria has been paralleled by the spread of misinformation and disinformation about the novel coronavirus. In Nigeria, information casting doubt on the existence of the coronavirus is spread especially through social media channels, but also through other informal channels.

Some religious leaders with considerable influence have doubted the existence of the virus, and shared conspiracy theories on its origins and the interventions instituted to prevent further spread of the virus. Others have taken to social media to express concerns about the Nigerian government and a perceived lack of transparency. For example, the government has received criticism for continuing its school feeding program during the pandemic, at a time when schools are closed, children are at home, and the country’s financial resources are scarce.

Unproven cures and interventions are also regularly propagated, especially via social media channels such as WhatsApp. For instance, hydroxychloroquine, a drug used for malaria previously, has been touted as a cure, despite evidence to the contrary, prompting some to stockpile it and instigating much discussion on social media.

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Pets and COVID-19 youtube slide.

Pets and COVID-19: Video Explainer with Tara Sklar

Are our furry friends at risk of contracting the novel coronavirus? Can pets potentially transmit COVID-19 to their human owners?

In this video explainer produced by the James E. Rogers College of Law of The University of Arizona, Tara Sklar, Professor of Health Law and Director of the Health Law & Policy Program, discusses these issues with Dr. Andrew T. Maccabe, Chief Executive Officer of the Association of American Veterinary Medical Colleges (AAVMC).

Dr. Maccabe also explains the importance of interdisciplinary collaboration between veterinarians and physicians in understanding and controlling the coronavirus pandemic, as well as future zoonotic disease outbreaks. Watch the full video below:

Busy Nurse's Station In Modern Hospital

Finetuning Liability Protections in the COVID-19 Emergency

By James W. Lytle 

When the scope of the COVID-19 pandemic became apparent, legal commentators, physician organizations, and health care policymakers sounded the alarm over the potential civil and criminal liabilities that practitioners and facilities might face during the emergency.

In short order, the federal government and many states enacted liability limitations.  At least two states—Maryland and Virginia—had pre-existing legislation that was triggered by the emergency, while many other states enacted or are considering new legislation to limit liability during the crisis.

While the source (executive or legislative), scope (civil or criminal), and precise terms of these liability protections varied by jurisdiction, the speed with which they were enacted was remarkable, given the intensely contentious political battles that typically ensue over medical malpractice and civil justice reform.

Predictably, at least one state has already begun to tinker and fine-tune its liability limitations. Just three months and twenty-one days after liability protections were enacted, the New York State legislature sent a bill to Governor Andrew Cuomo that curbs those protectionsThe Governor signed the bill into law on August 3rd.

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Oxygen mask as part of artificial lungs ventilation machine in surgery room, closeup.

Arizona’s Crisis Standards of Care and Fair Allocation of Resources During COVID-19

By Govind Persad

As COVID-19 cases spiked in Arizona, the state activated its crisis standards of care, which provide triage guidelines if absolute scarcity arises.

Arizona has done the right thing by adopting crisis standards of care instead of leaving these decisions about ventilators to be made ad hoc by medical staff, which presents the risk both of arbitrary and biased decisions and of greater distress for clinical staff who are forced to make decisions without a guidance framework.

Arizona’s activation of its crisis standards of care stands in contrast to most other states’ response to the pandemic, including New York, which ultimately did not activate its crisis standards of care. Even though Arizona and other states have not yet reached the stage of absolute scarcity where triage policies are invoked—and hopefully will take steps to avoid reaching it—the move has prompted discussions about fair triage policies and criticisms from some community organizations.

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a stethoscope tied around a dollar bill, with a bottle of pills nearby

What Ever Happened to NIH’s “Fair Pricing” Clause?

By Jorge L. Contreras

In the midst of the COVID-19 pandemic, calls have been made for “fair” and “reasonable” pricing of the vaccines and therapeutics that will eventually be approved to address the virus. A range of proposals in this regard have been made by members of Congress, the Trump Administration, various states, academics and civil society.

Amid this current debate, it is worth remembering the brief period from 1989 to 1995 when the U.S. National Institutes of Health (NIH) did impose reasonable pricing constraints on drugs that were developed as part of cooperative R&D agreements (“CRADAs”) between federal agencies and private industry.

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Health care workers in personal protective equipment attend to a patient.

Value-Based Reimbursement Can Decrease Spending on Medicare During COVID-19

By Sravya Chary

Since the start of the COVID-19 pandemic, the virus’ disproportionate threat to the Medicare patient population has been widely discussed and acknowledged. In light of the public health crisis and an increasing financial burden placed on entities involved in Medicare cost sharing, a value-based Medicare system would not only reduce costs, but also better protect the elderly and chronically ill during the pandemic.

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The Week in Health Law podcast logo twihl.com

New TWIHL: Ethical Issues in Development of a COVID-19 Vaccine

This episode is the first of a series of shows dealing with health care and research ethics related to COVID-19.

Here, Tara Sklar from The University of Arizona James E. Rogers College of Law introduces Arthur Caplan, the Drs. William F. and Virginia Connolly Mitty Professor, Founding Head of the Division of Medical Ethics, and Co-Chair of the Working Group on Compassionate Use and Preapproval Access (CUPA) at NYU Grossman School of Medicine. Dr. Caplan discusses ethical issues in development of a COVID-19 vaccine.

The series is co-sponsored by the NYU Grossman School of Medicine Division of Medical Ethics and the University of Arizona Health Law and Policy Program.

The Week in Health Law Podcast from Nicolas Terry is a commuting-length discussion about some of the more thorny issues in health law and policy. Subscribe at Apple Podcasts or Google Play, listen at Stitcher Radio, SpotifyTunein or Podbean.

Show notes and more are at TWIHL.com. If you have comments, an idea for a show or a topic to discuss you can find me on Twitter @nicolasterry or @WeekInHealthLaw.