Dispensed: Doctors are seeing new COVID-19 complications and symptoms, the promises and pitfalls of getting back to business, and why the healthcare industry will never be the same

Hello,

Welcome to Dispensed, Business Insider's weekly healthcare newsletter. How are you all? Can you believe we've been doing this for more than a month by now?

This week, the healthcare team here at BI has stayed busy keeping tabs on the latest efforts to reopen parts of the country (including some places that are expected to open today), the latest drama in the coronavirus drug development world, and my personal obsession, some of the troubling and fascinating potential symptoms related to COVID-19.

Are you new to the newsletter? You can sign up here.

Doctors are finding new complications and symptoms in COVID-19 patients

Doctors on the front lines of the pandemic are picking up on certain new problems in patients with COVID-19.

The latest potential symptom? Something called "COVID toes," in which patients with COVID-19, especially younger patients, many of whom are otherwise healthy, are showing up with purple, swollen toes that look like they've been frostbitten, Yeji Lee reports.

I'll spare this newsletter a photo of feet, but you can read the whole story here and see it for yourself.

The workers on the front lines deserve a 50% bonus, according to Gov. Andrew Cuomo, Yeji reports. Already, Northwell Health, which operates 23 hospitals in New York, is giving a $2,500 bonus and a week of vacation to some workers. In total, 45,000 people are eligible.

Last week, I spoke with experts about a troubling complication I was hearing about in severely ill COVID-19 patients: blood clots forming in the body, including in the lungs. That can lead to complications like strokes and heart attacks.

While clotting isn't uncommon in critically ill patients in the ICU, the higher rate of these clots forming has doctors looking into new ways to treat them (with trials underway to see what works and what doesn't, but not much evidence available yet).

Even more curious, the clots seem to be implicated in a relatively high percentage of COVID-19 patients who are dying at home after being discharged.

Yeji spoke with a patient whose doctors found blood clots in his lungs as he was recovering. We teamed up to bring you this story about the potentially deadly complication.

You can read the full story here:

A coronavirus patient thought he was recovering. Then doctors found blood clots in his lungs — a new and potentially deadly complication of the virus.

The financial implications of COVID-19

The pandemic is proving to be devastating to the US economy. And because healthcare coverage in the US is largely tied to employment in most cases, the consequences of laying people off amid a pandemic are becoming clearer.

Kimberly Leonard spoke with Sumir Beaspal, a 36-year-old who lost his job and his health insurance when restaurants shuttered. His wife, who's seven months pregnant, can't qualify for Medicaid until the baby's born.

It's a story that's likely to become even more common amid the fallout of millions of Americans losing their jobs, Kimberly reports.

Starting today, the next round of stimulus funding is going out to doctors, targeting coronavirus hot spots, rural areas and the Indian Health Service.

On Thursday, Congress passed an interim coronavirus stimulus package, which provides more funds for healthcare providers as well as researchers, as well as some funding for pay for testing for people who don't have health insurance.

You can read the full story here:

Congress just passed a $484 billion coronavirus stimulus bill. Here's what's in it for small businesses, hospitals, and the public.

The promises and pitfalls of getting back to business

States are itching to reopen for business. To do that as safely as possible, experts have started putting out guidelines on what they'd keep in mind.

• Bill Gates laid out 5 innovations that are crucial to overcoming the pandemic, Zach Tracer reports.
• Experts from Johns Hopkins and AEI provided a playbook for governors on how to reopen states, including 2-3 week phases and ways to apply social distancing measures to places like restaurants
• Cuomo is thinking New York might open back up by region, Jeremy Berke reports. Areas hit less by the outbreak could stand to open before harder-hit spots.
• Even as places consider reopening, we might be stuck in a cycle of shutdowns and reopenings until 2021, according to Matthew Harrison, a managing director at Morgan Stanley, Blake Dodge reports.

Among Gates' 5 innovations needed to overcome the pandemic are testing, treatments, and vaccines, elements we've chatted a bunch about in this newsletter.

Let's start with testing. Cuomo surveyed New York to see what percentage of the population might have been exposed to the novel coronavirus.

The results came back Thursday, finding that 21% of NYC residents have antibodies to the virus. Overall, it found 13.9% of New York state has been infected. To be sure, there are massive caveats associated with these results. They're survey results that haven't been peer-reviewed nor published in a medical journal. We're also strictly talking about exposure to the virus. There's still a big debate around whether having antibodies confers immunity.

Generally, there are some big caveats with all the antibody tests flooding the market. The tests might be inaccurate, leading people to think they have the antibodies when they don't, Blake reports.

You can read more about the problems facing antibody testing here.

On the treatment and vaccines front, so much is unfolding that a top Food and Drug Administration official is warning that we might run out of researchers to test everything, Andrew Dunn reports.

Last week, I mentioned how early results from remdesivir, an experimental antiviral medication being tested for its use treating COVID-19, leaked from one of the investigators.

Well, another week, another (accidental) leak. On Thursday, the World Health Organization accidentally published results from one of the remdesivir trials in China that showed that the treatment didn't help patients. The results were quickly taken down.

What I wouldn't give right about now for a randomized, controlled clinical trial published in a peer-reviewed journal.

Speaking of which — Andrew reports on the latest on the antimalarial medication chloroquine.

You can read the full story here:

A slew of new studies are raising fresh doubts on whether malaria pills should be used to treat the coronavirus, and a top US health agency just warned against widespread use

The healthcare industry will never be the same

It sometimes feels like my whole beat — keeping tabs on the changing ways Americans are going to the doctor — made a complete 180 in March as the pandemic hit the US.

Back in February, I spoke with a bunch of pharmacy startups about their approaches, promising convenience over going to a drugstore.

Well, in the intervening weeks, that's gone from a convenience to a necessity for a bunch of Americans. I wondered how that might have changed the business, so I called the startups — Capsule, Alto, and others — back up.

Here's what the pharmacy startups told me.

(Are you to BI Prime? Use my link here to get 20% off your subscription.)

We're starting to see some fallout as well in the startup space. Forward, a primary care startup, and Komodo Health, a health IT startup, both laid off part of their teams amid the pandemic.

Meanwhile, big thinkers in business have their own ideas of where the industry is headed.

Acclaimed tech investor Mary Meeker released a trend report, outlining in part how the pandemic upended the way we go to the doctor.

And Blake spoke with Judy Faulkner, the CEO of Epic, which makes electronic medical records for health systems. Faulkner laid out all the ways the pandemic will change healthcare as we know it.

You can read the full story here:

Bankruptcies, tech-savvy doctors, and data for the greater good: The CEO of health-tech giant Epic shares her predictions for how US healthcare will change after the coronavirus

Heard about other layoffs affecting the healthcare industry? Reach me at lramsey@businessinsider.com, or the entire team at healthcare@businessinsider.com. Otherwise, I hope you all have restful weekends — I'd love to hear more about any new hobbies you've picked up.

- Lydia