The Wall Street Journal - 28.03.2020 - 29.03.2020

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A8| Saturday/Sunday, March 28 - 29, 2020 *** THE WALL STREET JOURNAL.


suppliers began churning out
parts for the ventilators in re-
cent days, the people familiar
with the effort said.
“If you think about what
goes into a vehicle—the air-cir-
culation systems, filtration,
electronics, lots of hoses—a lot
of those types of components
also are contained in ventila-
tors,” said Carla Bailo, presi-
dent of the Center for Automo-
tive Research.
The president has publicly
admonished GM and Ms. Barra
personally several times during

his tenure. Last year he repeat-
edly criticized GM for closing
factories and laying off work-
ers in Midwestern states.
In his series of tweets, Mr.
Trump said GM should reopen
its plant in Lordstown, Ohio, to
make ventilators, “or some
other plant.” GM last year sold
the Ohio factory to a start-up
electric truck maker.
President Trump also
tweeted thatFord Motor Co.
needed to “get going on venti-
lators, fast!!!”
In the past two weeks, sev-

eral auto makers, including
Ford, have disclosed plans to
work with medical-device com-
panies to boost ventilator pro-
duction. Ford this week said it
would work withGeneral Elec-
tric Co. to increase ventilator
supply but didn’t offer specif-
Toyota Motor Corp. said
Friday that it is finalizing
terms with two ventilator mak-
ers to help increase their ca-
The president said later Fri-
day that the administration

A ventilator is shown at the Jacob K. Javits Convention Center in New York this past week.


ity in Bothell, Wash.
The most severely ill pa-
tients infected with the new
coronavirus have such trouble
breathing that they are put on
a ventilator, an invasive ther-
apy that involves inserting a
tube into the patient’s wind-
People involved in GM’s ef-
forts said Ventec hadn’t made
a firm commitment to deliver a
specific number of ventilators,
but rather provided the admin-
istration with a range of poten-
tial production volumes that
would scale up to gradually
starting in April.
With hospitals in some ar-
eas experiencing a surge in
Covid-19 patients, the Trump
administration wanted a faster
ramp up to meet the urgent
need, a White House official
GM, and other car compa-
nies that have moved to help
boost the ventilator supply
don’t plan to retool their exist-
ing vehicle-assembly plants to
produce the devices. Instead,
they are lending their expertise
in supply-chain management,
purchasing and manufacturing
to help other medical-device
makers boost output. In GM’s
case, this meant establishing a
new manufacturing line at its
electronic-parts factory in Indi-
GM said about 1,000 em-
ployees would work on the
project and that the company’s
resources would be donated
“at cost.”
Some of GM’s auto-parts

was working to sign contracts
with more than a half-dozen
other companies, including
General Electric,Philips, Ham-
ilton andMedtronic
He said the administration
had deals in place to collect
100,000 ventilators within 100
days. Speaking to reporters at
the White House, Mr. Trump
said he was skeptical that the
U.S. would need as many venti-
lators as the administration
was collecting, adding that he
may send any surplus to other
countries. To underscore the
point, he said he spoke to the
U.K. Prime Minister Boris
Johnson, who tested positive
for the virus, and asked how
his British counterpart was do-
ing. Mr. Johnson told him: “We
need more ventilators.”
TeslaInc. Chief Executive
Elon Musk has said he is work-
ing with medical device-maker
Medtronic and has said the
auto maker’s New York solar
panel factory “will reopen for
ventilator production as soon
as humanly possible.” He also
said he acquired ventilators
from China and has been work-
ing to deliver them in the U.S.
On Friday, Mr. Musk said on
Twitter the biggest value Tesla
was providing was precise de-
livery of ventilators to the in-
tensive care units that need
them most.
“There are many ventilators
in warehouses, but stuck in lo-
gistics/routing/paperwork is-
sues,” he wrote.
—Tim Higgins
contributed to this article.

On Friday, the Detroit auto
maker said, “Ventec, GM and
our supply base have been
working around the clock for
weeks to meet this urgent
The president had criticized
GM and its leadership earlier
Friday, saying in a series of
Twitter posts that the com-
pany had initially said it could
supply 40,000 ventilators, but
then later said it could make
only 6,000 available by late
April. In one of his Friday
tweets, the president criticized
GM Chief Executive Mary Barra
as “always a mess.”
White House officials said
the two sides had been dis-
cussing a contract worth about
$1 billion, but the talks broke
down over the timeline for de-
livering the devices.
Earlier Friday, after the
president’s Twitter posts, GM
and Ventec said they aimed to
produce as many as 10,
ventilators a month, in part
through a new assembly line
being set up at a GM facility in
Indiana. Closely held Ventec
normally makes a few hundred
ventilators a month at its facil-


GM Told

To Ma ke


When the U.S. government
barred family members from
visiting relatives in nursing
homes, it made an exception
for “end of life situations”—
setting off a painful, nation-
wide debate about the mean-
ing of the phrase.
The Centers for Medicare
and Medicaid Services issued
the order on March 13 to pro-
tect nursing-home residents
from the coronavirus after
dozens of them died in facili-
ties across the country.
Many families see the pol-
icy as a painful but necessary
step to protect the elderly and
ill. But it has been hardest on
those who fear their loved
ones have just days to live, say
families and nursing home of-
Some 1.4 million elderly and
disabled adults live in more
than 15,000 nursing homes,
according to U.S. government
data. Stanford Medical School
estimates that about 20% of
Americans end their days in
nursing homes.
Sherry Culp, who works at
the Nursing Home Ombudsman
Agency of the Bluegrass in
Kentucky, fields calls from pa-
tients and families and commu-
nicates their issues to facilities.
“The biggest concern that
we are hearing from family
members is that they have a
resident in a nursing home

who they think is ‘end of life,’
but they are having trouble ac-
cessing the resident for in-
person visits,” she said.
“There is some confusion
about what is ‘end of life,’”
said Ms. Culp.
The government directive
didn’t define the phrase, and it
left some delicate questions
unanswered: How long before
death should visits be al-
lowed? How many relatives
can visit? What safety proce-
dures should be adopted to
protect other residents?
Last week Ms. Culp got a call
from an 86-year-old man who
worried he would be turned
away from the nursing home
where his wife was receiving
hospice care. Ms. Culp assured
him he had the right to visit
because his wife was dying.
Kentucky and some other
states, responding to pleas
from anguished families who
wanted to visit dying relatives,
have drawn up their own
guidelines and definitions of
end of life. “This includes any
resident who is receiving hos-
pice care, not just a resident
who is facing imminent death,”
the Ohio Department of Health
wrote in a memo to nursing
home administrators last week.
That memo came too late
for Joe Race, an Ohio trade as-
sociation executive, whose 87-
year-old mother, Bernadine
Raicevich, was dying of ovarian
cancer. When her condition de-
teriorated earlier this month,
Mr. Race called seven hospices.
All said they would take her
but that family members
wouldn’t be allowed to visit.
So he and his four siblings
kept her home near Cleveland

and took turns caring for her
around the clock, even though
they felt she would have bene-
fited from professional pallia-
tive care. Mrs. Raicevich, a re-
tired nurse, died peacefully
this past Sunday, with one of
her daughters by her side.
“I want to be a team player,
but I wish they had fewer re-
strictions for people at the end
of their life,” Mr. Race said.
“Take my temperature at the
door, put me in hazmat cloth-
ing. I’d gladly wear it and go
see my mom,” he said. “I don’t
think it’s too much to ask.”
In Kentucky, Gov. Andy
Beshear said in a statement
last week that families should
be notified “several days and
up to one week in advance of”
a substantial change in a pa-
tient’s condition, but didn’t
specify how that should be de-
termined. “Providers should

not wait until active dying.”
At Jordan Center in Louisa,
Ky., nursing home officials
called families of its nearly
100 residents to ask how they
felt about the coming ban on
visits. All but five families said
they were supportive. Two de-
cided to take their residents
home, and others initially re-
fused to heed the ban, accord-
ing to David McKenzie, Jordan
Center’s administrator.
Among them was an 82-
year-old woman who visited
her husband with dementia
every day, arriving before
breakfast and leaving after
“It was heartbreaking,” Mr.
McKenzie said. “I can’t even
imagine what it would be like
to be separated from your
spouse after being together
Mr. McKenzie met with the
woman twice and convinced
her to accept the ban. She now
speaks with her husband via
video calls.
Kathleen Heren, an om-
budsman at the Alliance for
Better Long-Term Care in
Rhode Island, has to improvise
when advising facilities be-
cause the state hasn’t issued
She recommends that facili-
ties have family members visit
“toward the end,” when hos-
pice nurses see signs of immi-
nent death, rather than at the
start of hospice care.
Just one or two family
members should be allowed in
at any time, she said.
“It’s really a case of com-
mon sense,” Ms. Heren said.
“There is no set answer to


Nursing Home Visitor Ban

Raises Difficult Questions

Defining ‘end of life’
to allow people to see
dying loved ones is
being widely debated

Bernadine Raicevich when she
attended nursing school.


The world-wide spread of
the new coronavirus is throw-
ing into disarray studies criti-
cal to the development of
promising new medicines.
The pandemic is causing de-
lays in starting clinical drug
trials and temporarily halting
others, according to companies,
consultants and industry offi-
cials. Patients enrolled in some
studies have stopped showing
up at trial sites, while hospitals
the were seeing trial subjects
are shifting attention to tack-
ling coronavirus patients.
Industry scientists, mean-
while, can’t travel for research.
“Things are just getting
canceled left and right,” said
Christian Burns, president of
ClinEdge LLC, which helps
drug companies recruit drug-
trial participants in more than
30 countries.
The disruptions, which
aren’t affecting research into
coronavirus drugs and vac-
cines, mean it could take lon-
ger for new drugs aimed at
treating conditions like diabe-
tes and liver disease to reach
patients, if the medicines even-
tually prove to work safely.
Company revenue could
suffer, too, if future sales of
drugs are deferred because of
trial delays.
The drug studies most af-
fected are in heavy-hit regions,
such as Italy, China and South
Korea, where lockdowns have
restricted the ability of pa-
tients to leave their homes,
enroll in trials and travel to
study sites to get experimental
treatments, industry officials
say. Studies in the U.S. are
also starting to feel an impact.
Bristol-Myers Squibb Co.
and Eli Lilly & Co. said this
week they will hold off start-
ing most new trials, citing
safety concerns. Bristol is also
temporarily halting infusions
of experimental cellular thera-
pies under study, while Lilly
said it would pause enrolling
new study subjects for trials
already under way. Pfizer Inc.
said Wednesday it is suspend-
ing recruitment of patients for
most new and ongoing studies
that don’t involve life-threat-
ening conditions.
Trials play a pivotal role in
the introduction of new medi-
cines. Regulators rely on the
results to gauge whether an
experimental drug is safe and
works, and should be approved
for use. Companies can spend
tens of millions of dollars to
carry out a single study.
Many current drug trials
for critical ailments are ex-
pected to continue, though,
because hospitals and drug-
makers view them as crucial
for patients. Moreover, pa-
tients testing drugs for fatal
or critical conditions such as
cancer are motivated not to

skip treatments.
The pandemic, though,
threatens to delay research
into much-needed treatments
for other critical conditions.
Nearly two-thirds of 170
clinical trial sites surveyed in
the U.S. believe patients will
be much less or somewhat less
likely to enroll in new clinical
research trials due to the cor-
onavirus, according to a re-
view last week from consul-
tancy Continuum Clinical. And
nearly half the sites expect pa-
tients enrolled in trials to be
much less or somewhat less
willing to keep participating.
“That’s where this could be
really damaging,” said Contin-
uum President Neil Weisman.
“If too many patients discon-
tinue with a clinical trial,
pharma companies aren’t going
to have enough data to prove
their products hit an endpoint
and show their drug does what
they hope it would do.”
The Northwell Health sys-
tem on Long Island, N.Y., has
paused about 50 clinical trials
to protect patients and free up
more than 40 staffers for cor-
onavirus drug research. “Right

now, I’m prioritizing,” said
Kevin Tracey, president of
Northwell’s Feinstein Insti-
tutes for Medical Research.
Arrowhead Pharmaceuticals
Inc., which is based in Pasa-
dena, Calif., last week sus-
pended enrollment in a liver-
disease trial for at least four
weeks because the study
needs patients who are at risk
for coronavirus infections and
who must get a liver biopsy,
which requires visiting a
clinic, said Chief Executive
Christopher Anzalone.
“There’s probably some
type of disaster-planning go-
ing on in every single com-
pany,” said Laurie Halloran,
chief executive of Halloran
Consulting Group, which ad-
vises firms on clinical trials.
To keep trials moving for-
ward despite the virus, some
drugmakers are trying to
transfer to patients’ homes the
work typically done at re-
search sites.
Scynexis Inc., of Jersey
City, N.J., is directing patients
in a trial for its experimental
fungal treatment to have blood
drawn at home or alternative
sites, and to receive the drug
at home, after some patients
missed appointments in Italy
and other European countries,
said Chief Executive Marco Ta-



Drug Testing

Is Interrupted

The crisis threatens
to delay research into
treatments for other
critical conditions.

Bernadine Raicevich surrounded by her children, who decided to care for her at home until her death in Cleveland this past Sunday.


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