14% of hospital accreditation requirements for 2023 cut, Fees frozen

 The Joint Commission revealed Wednesday it is trimming down or revising numerous quality standards and freezing domestic hospital accreditation fees in 2023 “in recognition of the many financial challenges hospitals and health systems continue to face.”

The cuts follow a review the commission launched earlier this year to identify any “above-and-beyond” requirements that were redundant, no longer addressed an important issue or required time and resources that outstripped any estimated benefits.

In total, the Joint Commission said 168 standards (14%) are being cut and another 14 are being revised, effective Jan. 1, 2023. These changes will be followed by a second round of cuts and revisions the organization expects to have ready in “approximately six months.”

The full list of discontinued standards outlines changes affecting hospitals, critical access hospitals, ambulatory healthcare, behavioral health care and human services, home care, laboratory services, nursing care centers and office-based surgeries.

“The standards reduction will help streamline Joint Commission requirements, as well as provide some much-needed relief to healthcare professionals and organizations as they continue to recover from the pandemic,” Jonathan B. Perlin, M.D., Ph.D., president and CEO of the Joint Commission, said in the announcement. “Our goal is to eliminate any standard that no longer adds value. We want to have fewer, more meaningful requirements that best support safer, higher-quality and more equitable health outcomes.”

The Joint Commission said its review incorporated quantitative analyses of scoring patterns and, when needed, literature reviews and expert input. The Centers for Medicare & Medicaid Services also greenlighted the changes.

The changes come earlier than anticipated as the commission had initially said it was targeting January for the review’s first batch of cuts.

Adding to the Joint Commission’s goal of reducing provider burden, the organization also said it wouldn’t raise its accreditation fees for the new year—a decision it said will see some surveys conducted for less than cost.

“As with so many other organizations, we are experiencing inflation in several areas of our business, notably travel costs for surveys, however, we are steadfast in our decision not to raise domestic hospital accreditation fees,” Perlin said. “We believe this is the right thing to do and look forward to further supporting our accredited healthcare organizations in 2023.”

https://www.fiercehealthcare.com/providers/joint-commission-cuts-14-accreditation-requirements-2023-freezes-fees

XBB COVID variant presents a unique threat: study

 While the U.S. and other countries focus on the increasing footprint of sub-subvariants of the omicron iteration of COVID-19, BQ.1 and BQ.1.1, healthcare systems here and around the world might also want to keep a wary eye on yet another sub-subvariant: XBB.

Japanese researchers say in a preprint study posted Tuesday that XBB exhibits a unique path into existence not seen before in COVID-19 variants, and this gives it more of a “profound resistance to antiviral humoral immunity induced by breakthrough infections of prior Omicron subvariants.”

Their findings (PDF) were posted on medRxiv, a website featuring studies that have not yet been peer reviewed. XBB was first identified by researchers at Peking University in Beijing in September, and one of the authors of that study said that “XBB is currently the most antibody-evasive strain tested.”

The study, unveiled Tuesday by researchers with the University of Tokyo, bolsters that assessment, stating that “to our knowledge, this is the first documented example of a SARS-CoV-2 variant increasing its fitness through recombination rather than single mutations.”

Recombination means the joining of variants that arise from two genetically distinct parental strains, creating opportunities for a virus to adapt to, and escape from, antibodies and other genetic roadblocks, be they produced by scientists or nature. Recombination presented a significant challenge in the early days of the fight against HIV/AIDS.

Kevin Kavanagh, M.D., is the president and founder of the patient advocacy organization Health Watch USA and has kept a close eye on COVID-19 throughout the pandemic. Kavanagh told Fierce Healthcare that “the most disturbing finding in the study is that this virus is a recombinant virus where two different genomes or genetic materials from viruses were recombined, as opposed to a chance mutation.”

Kavanagh pointed out that the U.S. healthcare system currently deals with the tripledemic of influenza, respiratory syncytial virus (RSV) and COVID-19. Kavanagh said how, in the summer, Texas Children’s Hospital had to deal with about 25 cases where children had been infected by RSV and COVID-19 at the same time.

“If viruses can start swapping genetic material, then the sky is the limit on the number of variants and the various characteristics which may be produced,” says Kavanagh. 

XBB is not as lethal as the delta variant, the deadliest iteration of COVID-19, but it is as lethal as BA.2.75, according to the study by Japanese researchers. The study notes that XBB first emerged in the summer in India and its neighboring countries, but health systems should not consider XBB a regional problem, and “this variant has a potential to spread worldwide in the near future.”

XBB’s presence in the U.S. is growing rapidly and now makes up 18.3% of new cases as of the week ending Dec. 24, according to the Centers for Disease Control and Prevention. That’s a sharp increase from the week before.

University of Tokyo researchers said that “XBB acquired two sets of a pair of immune escape-associated and infectivity-enhancing substitutions by only one recombination event. Harboring the two sets of the substitution pairs would be one of the causes why XBB shows higher Re than other Omicron subvariants. Together, although XBB emerged via a unique evolutionary pathway, our data suggest that XBB also follows the same evolutionary rule with other Omicron subvariants.”

The R0, or R naught, estimates a pathogen’s contagiousness, accounting for biological features as well as behavior of individuals. Re is the same as R0, minus the assumption that everybody’s susceptible to infection.  

The study said that “although various ‘local variants’ including XBB have simultaneously and convergently emerged in late 2022, local variants showing a higher transmissibility will eventually spread to the whole world, like XBB. Therefore, continued in-depth viral genomic surveillance and real-time evaluation of the risk of newly emerging SARS-CoV-2 variants, even though considered local variants at the time of emergence, should be crucial.”

Kavanagh stressed that a virus created through recombination “can make huge leaps and bounds in changes in its characteristics in a very short period of time. The fact that this has been observed is even more concerning than this virus itself.”

https://www.fiercehealthcare.com/providers/xbb-covid-variant-presents-unique-threat-study

China Sails Warships Near Guam in Warning to U.S. Over Taiwan

 China has sailed one of its three aircraft carriers near the U.S. territory of Guam, Japanese officials confirmed, ending an already combative year with a rare move that Beijing signaled as a clear warning to the Biden administration over Taiwan.

The Chinese fleet, led by the aircraft carrier Liaoning, had already spurred several clashes with U.S. allies in the region with its tour of the western Pacific, most recently by conducting roughly 260 takeoff and landing drills near the Japanese island of Okinawa, home to a major U.S. military presence. The operations prompted the Japanese air force to scramble fighter jets and helicopters, as well as a destroyer and other elements of its self-defense forces.

But Japanese officials also confirmed Thursday that the Chinese vessels had transited to the south, near the western edge of territory the U.S. claims as part of the remote island of Guam – a critical element of America’s ability to project military might in the region as both a stopping point and a base for strategic Air Force bombers and Navy submarines.

Chinese state news framed the deployment as an overt provocation to the U.S. and a warning against continuing behavior this year that has outraged Beijing.

The operation “showed that the Chinese carrier is ready to defend the country against potential US attacks launched from there, including military interference attempts over the Taiwan question,” according to an article from the English-language Global Times, citing Chinese analysts.

Though not a direct mouthpiece for the Chinese Communist Party, U.S. officials believe the outlet is aligned with its views and regularly publishes what officials in Beijing choose not to say publicly themselves.

China claimed the Liaoning had never sailed so close to U.S. territory before. Press reports in 2019 indicated the carrier had approached Guam as a likely response to U.S. military exercises with its allies in the region at the time.

The U.S. Navy’s 7th Fleet, responsible for operations in the region, did not immediately respond to requests for comment, nor would it say if it had responded to the Chinese deployment in any way.

The move punctuates a year that has seen heightened tensions between Beijing and Washington. The Biden administration has expressed outrage at China’s continued national security crackdown on Hong Kong, the former British colony and semi-independent economic powerhouse that Beijing has increasingly taken under its control. Analysts generally believe China sees the assimilation of Hong Kong as a test-run for similar moves on other territories it considers its own.

New tensions have not been limited to the military sphere. China similarly condemned the Biden administration’s decision to require COVID-19 tests for travelers from China, citing a “lack of adequate and transparent” data from the government in Beijing about a surge in cases there.

More directly, the two countries clashed over Taiwan, another entity whose independence has embarrassed the Chinese Communist Party, which sees control of the island nation as critical to its legitimacy.

Beijing expressed outrage at House Speaker Nancy Pelosi’s visit to Taiwan in August – a move the California Democrat had previously rescheduled, reportedly over concerns about blowback from China. Though the White House supported the move, it conspicuously distanced itself from what it considered an independent decision from the congressional leader.

Nonetheless, China has not forgotten what it considers an unforgivable diplomatic slight. The Global Times referenced it clearly in its analysis of the Liaoning’s latest deployment.

“China will never attack US military bases in Guam as long as the US military does not attack China or interfere in the Taiwan question,” it wrote, citing Chinese analysts, “but having such capabilities is a deterrent against potential US provocations.”

It also cited the latest U.S. military funding bill that Biden signed this week that funds unprecedented levels of weapons sales and other military support directly to Taiwan – a move U.S. officials agree is designed to shift the balance of military power in the Pacific.

Sen. Robert Menendez, New Jersey Democrat and chairman of the Foreign Affairs Committee, earlier this month called the legislation “one of the most consequential in years” by “setting the theater for real deterrence by implementing a more resilient strategy for Taiwan should China continue pursuing a collision course toward war.”

https://www.usnews.com/news/world-report/articles/2022-12-29/china-sails-warships-near-guam-in-warning-to-u-s-over-taiwan

US says it killed nearly 700 Islamic State suspects this year

 American military personnel, together with local forces in Iraq and Syria, killed nearly 700 suspected members of the Islamic State in 2022, officials said Thursday, highlighting an aggressive counterterrorism campaign that quietly endures five years after a U.S.-led coalition destroyed the militant group's caliphate.

U.S. forces conducted 108 joint operations in the past year against alleged ISIS operatives in Syria and an additional 191 in Iraq, U.S. Central Command said in a statement, which notes that American troops undertook another 14 missions by themselves and only inside Syria. Nearly 400 suspects were detained, it says.

"The emerging, reliable and steady ability of our Iraqi and Syrian partner forces to conduct unilateral operations to capture and kill ISIS leaders allows us to maintain steady pressure on the ISIS network," Maj. Gen. Matt McFarlane, the top commander of the task force overseeing these operations, said in the statement.

Last year, following the chaotic U.S. withdrawal from Afghanistan, President Joe Biden declared at the United Nations that the United States would no longer "fight the wars of the past." But in Iraq and Syria, the Pentagon maintains contingents of about 2,500 and 900 troops, respectively, who still occasionally come under enemy fire.

Biden, writing in an opinion piece published in July by The Washington Post, said that the Middle East is "more stable and secure" than when his administration took over in January 2021, highlighting the U.S. operation in February that killed Abu Ibrahim al-Hashimi al-Qurayshi, then the leader of the Islamic State. The group has affiliates elsewhere, including in Afghanistan and parts of Africa.

Gen. Michael "Erik" Kurilla, the top U.S. commander in the Middle East, said in Thursday's statement that the American military is approaching the campaign in three ways: Pursuing the group's leaders through partnered operations with local forces, continuing to detain Islamic State members in the region, and attempting to prevent children from being radicalized.

The U.S. military in September disclosed that, combined with Syrian partner forces, it has carried out dozens of raids on the al-Hol detention camp in northeast Syria, a sprawling facility in the desert that houses tens of thousands of people, many considered to be Islamic State sympathizers, and either the wives or children of men who joined the militant group.

The United States has found a model to counter the Islamic State in Iraq and Syria that is sustainable, said Col. Joe Buccino, a U.S. military spokesman. With Iraqi and Syrian forces taking a leading role, he said, no U.S. troops were killed or seriously injured during any of the counter-ISIS operations undertaken this past year.

But deployed U.S. forces continue to face other threats.

In Syria, operations were upended last month by Turkey, a NATO ally, which launched cross-border strikes on the Syrian Democratic Forces, the main U.S. partner against the Islamic State there. Turkey considers the SDF to be a segment of the Kurdistan Workers' Party, which Washington and Ankara alike have designated a terrorist organization. The United States has drawn a distinction, however, saying that the SDF has been a reliable and courageous partner in countering the Islamic State.

U.S. forces paused partner operations with the SDF for days as Turkey threatened to launch a ground invasion into Syria, before resuming them early in December.

In both Iraq and Syria, U.S. forces also have had to remain vigilant against both the Islamic State and Iranian-backed militias that have sought to drive the United States out of the country. In one recent example, three U.S. troops were wounded in Syria in August when Iranian-backed militias launched rockets at two U.S. military positions. U.S. forces responded, military officials said, with attack helicopters that destroyed three vehicles and weapons used to launch the rockets.

ISIS fighters are thought to be behind a spate of deadly attacks this month targeting Iraqi troops.

https://www.stripes.com/theaters/middle_east/2022-12-30/700-islamic-state-suspects-killed-8587582.html

Tesla short-sellers reap $17B windfall during Elon Musk company’s worst year ever

 Tesla’s unprecedented stock struggles during CEO Elon Musk’s Twitter takeover have been a major boon to the automaker many short sellers, according to market data published Thursday.

Investors who bet against Tesla’s stock are set to earn a whopping $17 billion in mark-to-market profits this year, Bloomberg reported, citing data from analytics firm S3 Partners Research. Tesla ranked as the most lucrative short bet over the last 12 months.

The boost to short-sellers occurred as Tesla tracked for its worst year of market performance on record. As of Thursday’s closing price of $121.82, Tesla shares were down 69% on the year.

S3 Partners’ Ihor Dusaniwsky told the outlet that the windfall came after several years of major losses for short-sellers during Tesla’s pandemic-era stock boom.

“When Tesla’s stock begins to tick upwards, there should be a flurry of short covering which will help boost its stock price higher and quicker as shorter-term short sellers look to realize their outsized mark-to-market profits before they evaporate,” Dusaniwsky said.

COVID-19 case surges have slowed Tesla production in China.

EPA

The decline included an 11% plunge on Tuesday alone after the Wall Street Journal reported that a surge in COVID cases had forced Tesla to temporarily halt production in Shanghai.

Musk sought to assuage concerns among Tesla employees this week. In a memo to staffers Wednesday, the billionaire thanked workers for their “exceptional execution” throughout the year while downplaying the company’s dismal stock performance.

“Don’t be too bothered by stock market craziness,” Musk said in the memo obtained by CNBC. “As we demonstrate continued excellent performance, the market will recognize that.”

Elon Musk sought to downplay concerns about Tesla’s stock performance.

REUTERS

“Long-term, I believe very much that Tesla will be the most valuable company on Earth!” Musk added.

Tesla investors have grown frustrated with Musk as he has devoted more of his time to revamp Twitter since his $44 billion takeover of the social media site in October.

Critics say Musk’s controversial actions at Twitter — which have included sweeping layoffs, clashes with advertisers and an overhaul of the platform’s verification process — have become an overhang on Tesla’s stock. Musk has also roiled investors by selling massive tranches of Tesla stock – including at least $36 billion to fund his acquisition of Twitter.

Tesla has been the most profitable short trade this year.

REUTERS

The ongoing Twitter drama added to existing challenges at Tesla, which has contended with lingering global supply chain issues, diminished demand in China and mounting fears of a global recession.

Earlier this month, Electrek reported that Tesla would conduct an unspecified number of layoffs and implement a hiring freeze in the first quarter of 2023. Musk had previously signaled in June that he wanted to cut 10% of corporate staffers due to a “super bad feeling” about the state of the economy.

https://nypost.com/2022/12/29/tesla-short-sellers-reap-17b-windfall-during-elon-musk-companys-worst-year-ever/

In the name of ‘equity,’ companies are now ignoring educational achievement

 Today, at least two-thirds of higher education institutions, including Harvard and Stanford, don’t require the SAT for admission. The American Bar Association recently announced it will drop the LSAT as an admissions requirement for law school. And now, some are calling for the prestigious MCAT to be scrapped as the gold standard for medical school admissions — all in the name of racial equity.

Now, the latest standard on the chopping block are colleges themselves, as a recent job posting for a director position demonstrates.

A LinkedIn posting by HR&A Advisors, the TriBeCa-based real estate consultancy, asked applicants for the $121,668- to $138,432-a-year position to remove “all undergraduate and graduate school name references” from their résumés and only cite the degree itself. A quick spin through a few other HR&A job postings confirmed that this policy extends company-wide as part of their “ongoing work to build a hiring system that is free from bias and based on candidate merit and performance.”

Erasing education histories from resumes follows moves by schools like Harvard to do away with long-standing admission requirements such as standardized testing.

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At a time when equity and inclusion policies have become corporate must-haves, efforts to ignore educational bona fides for new hires are hardly surprising. After all, as colleges and even the military (which no longer requires a high school diploma) drop the most basic entry requirements, why shouldn’t the private sector follow suit?

There’s no doubt that access to fancy schools and pricy education has historically shut out racial and economic minorities from many employment arenas — particularly at the highest ends of the earning spectrum. But obscuring education histories won’t solve these inequities. It simply creates new ones.

The American Bar Association is also phasing out standardized testing and no longer requires LSAT scores for entry into law school.

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For one thing, education still matters to companies like HR&A. If it didn’t, they would ask candidates to entirely remove schooling from their CVs, not just school names.

Secondly, education also matters to job applicants. Many have worked hard and taken out loans to acquire college degrees that, they think, mean something to the HR&As of the world. Many have also devoted hours to the college sports teams, academic societies and other extracurricular activities that are both resume-building and deeply rewarding.

The military, too, has abolished traditional entry requirements such as a high school diploma for prospective recruits.

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While removing education histories from CVs may appear to level the playing field, it actually creates new forms of inequities while suggesting that academic achievement does not matter to minorities.

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I myself attended universities (Brandeis, NYU) that were far above my family’s affordability level precisely because I knew they were investments in my long-term earning potential as well as a way to keep me on the straight and narrow in high school. Sure, as with many Americans — particularly African-Americans like myself — I took on student debt. But the quest for academic success not only helped me avoid (most) teenage troubles, it also helped me secure a career with good pay and a strong sense of self-worth and satisfaction.

Policies like HR&As are not just punitive, they’re downright lazy. Telling young people —particularly the young people-of-color this “school-blind hiring” purports to benefit—that academic prestige doesn’t matter literally reinforces the worst stereotypes of minority cultures. It says academic prestige doesn’t matter to them.

Higher education is not just about academics, but extracurricular activities such as college sports teams, which can both improve a job candidate’s competitiveness and self-esteem.

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Furthermore, for HR folks and recruiters, ignoring educational bona fides — while appearing benevolent—is a missed opportunity to truly learn, as they say in woke-speak, about the “lived experiences” of the diverse workforce they are so desperate to attract. 

Many black students (like my own grandparents, for instance) have attended Historically Black Colleges and Universities (HBCUs). These are not just places of learning, but integral components of their graduates’ identities. HBCUs mean something: they matter. And yet, these well-intentioned initiatives, led mostly by white liberals, completely erase that meaning. 

Ignoring education histories also denies the importance of Historically Black Colleges and Universities such as Howard University in Washington, DC in their graduates’ identities and lives.

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This is why school-blind hiring feels so frustrating — and phony. In this period of quiet-quitting and mass resignations, it offers already unmotivated workers one less task to tick off while burnishing their anti-bias credentials for literally doing nothing. 

Of course, this doesn’t mean that graduates of schools less costly or “lower ranking” than my own should be denied a chance at the American Dream. Rather, hiring teams need to work harder to figure out how to get them there without erasing the educational achievements of others. 

https://nypost.com/2022/12/31/in-the-name-of-equity-companies-are-now-ignoring-education/

US helped Ukraine target Russian generals, sink Moskva, book reveals

 American intelligence agencies gave highly sensitive data to the Ukrainian armed forces that allowed them to track and kill a dozen Russian generals and sink the Russian flagship Moskva, a new book reveals — despite strident administration denials.

A “furious” President Joe Biden gave “presidential tongue-lashings” to CIA chief Bill Burns and other top aides in May after leakers told NBC News and the New York Times that Ukrainians had been given real-time intelligence from US sources.

“He didn’t like what he considered to be publicly taunting the Russians,” White House Chief of Staff Ron Klain told author Chris Whipple in the forthcoming book “The Fight of His Life,” out Jan. 17.

The reports of secret streams of real-time battlefield intelligence drew a furious response from the Kremlin — and instant repudiation from the Pentagon, the National Security Council, and Biden’s press office.

“We do not provide intelligence with the intent to kill Russian generals,” NSC spokesperson Adrienne Wilson said May 5.

President Biden was reportedly “furious” that leakers told media outlets that the US shared intelligence with Ukraine.

AP

Former White House press secretary Jen Psaki denied that the US shared intelligence that helped Ukraine sink the Moskva.

LUIS ACOSTA/AFP via Getty Images

“We did not provide Ukraine with specific targeting information for the Moskva,” insisted Jen Psaki, then the White House’s press secretary. “We were not involved in the Ukrainians’ decision to strike the ship or in the operation they carried out.”

The Post has obtained a copy of the book, which contains a string of revelations about Biden’s disastrous pullout from Afghanistan and other incidents from the first two years of his administration.

https://nypost.com/2022/12/31/us-helped-ukraine-target-russian-generals-sink-moskva-book/