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Author Topic: COVID-19 🏴☠️ Pandemic  (Read 14719 times)

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Surly1

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America’s shamefully slow coronavirus testing threatens all of us
The US lags just about every developed country on testing for Covid-19 disease.


A woman sets up Colorado's first community testing center for coronavirus in Denver on March 11, 2020, RJ Sangosti/The Denver Post via Getty Images

Brian Resnick

In late February, Julie Eaker, a physician assistant and supervisor at a small, rural, tribal community health clinic in Siskiyou County, California, had a patient who had a possible exposure to Covid-19. It wasn’t direct: They had been exposed to a person, and that person had been in direct contact with a confirmed Covid-19 case. Eaker’s patient was developing an upper respiratory infection too, and she wanted to ease their peace of mind — and protect the community — by getting them tested for Covid-19.

To this day, the patient still hasn’t been tested for the illness. And it’s not because Eaker didn’t try. The story she describes is Kafkaesque.

First, Eaker called her local health department and was told her patient didn’t qualify for testing since they hadn’t traveled to China, per the guidelines from the Centers for Disease Control and Prevention at the time. After the CDC relaxed its testing criteria, the patient was still sick, so Eaker called again. “I didn’t receive a phone call back,” she says.

The patient thought they had pneumonia and asked to be tested for peace of mind. Finally, last week, after Eaker ordered some test kits herself from a private lab, she got a call back. “The health department told me I was not allowed to use those test kits — that I ordered — without their permission!”

Eaker was horrified. So she called the CDC to confirm if the local health department was correct. “I did not get through,” she says. “I spent hours and hours and hours on hold. … So I thought I would just call the White House and talk to Vice President Pence, who is in charge of the coronavirus task force.“

She didn’t get Pence, but a White House switchboard operator told her to call the CDC.

“Somebody has got to help us,” she says, exasperated. “We’re out here on the front lines trying to take care of people.”

Meanwhile, the commercial tests the clinic ordered still haven’t arrived. And Eaker wonders if Covid-19 has been spreading in her community of 3,000 people. Siskiyou County might not have big sports arenas or universities where disease can infect masses. But it has multigenerational family homes where viruses can quickly infect a whole family, and a health clinic that’s already at capacity due to the flu.

COVID-19 Test Capacity@COVID2019tests

Updated to reflect testing capacity in hospital and clinical laboratories

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163 people are talking about this

Accurate testing is critical to stopping an outbreak: When one person gets a confirmed diagnosis, they can be put in isolation where they won’t spread the disease further. Then their contacts can be identified and put into quarantine so they don’t spread the virus if they’ve become infected, too. That’s particularly important for a virus like this one, which seems able to spread before people show symptoms, or when their symptoms are mild.

Ever since the first case of Covid-19 was detected in the US on January 20, the government’s blunders in creating and distributing diagnostic testing have greatly handicapped our response to the growing pandemic. Eaker’s story is not unique: Reports suggest providers everywhere are struggling to help their patients, while receiving frustrating guidance from authorities.

Dr. Anthony Fauci, the federal government’s top infectious disease scientist, called the testing situation a “failing” at a congressional hearing on Thursday.

“The idea of anybody getting it easily the way people in other countries are doing it — we’re not set up for that,” he said. “Do I think we should be? Yes. But we’re not. “

While the testing situation in America is getting better — private industry has stepped up to fill in the slow rollout of tests from the CDC, and the Cleveland Clinic announced it has developed a new rapid test that gives results in eight hours, rather than taking days — problems remain. The number of tests that can be performed per day is still limited and varies by testing facility. Part of that is due to a shortage of key chemicals needed to run the tests. It’s becoming increasingly clear that too-stringent testing guidelines early in the outbreak stymied researchers in knowing if Covid-19 was spreading in the US.

“There was clear lack of foresight,” Nathan Grubaugh, an epidemiologist at the Yale School of Public Health, says. “We were very slow to roll out testing capacity to individual places — wherever that came from, it was a very bad strategy.”

How many have been tested, how many tests are there, and how many can be tested

Part of the confusion here is that there are different figures floating around for the number of tests that have been done. As private labs take up the slack from public health facilities, there’s no centralized database of numbers.

“I think that we could have probably controlled this, if we had effective testing,” Angela Rasmussen, a Columbia University virologist, says.

We haven’t. In an investigation led by the Atlantic, a research team reported that a little more than 7,000 Covid-19 tests were performed as of March 11 — putting the US far behind other developed countries. (The Atlantic’s investigation is in partnership with independent researchers, and US testing counts are now being updated daily by the Covid Tracking Project.)

South Korea, for example, has tested more than 140,000 people and has even set up drive-though testing stations for people to access. So far, the Trump administration’s promises to increase testing have fallen flat.

Christina Animashaun/Vox

Test kits have been in short supply — though that’s changing.

The numbers here are a bit confusing, too. As of March 7, Food and Drug Administration Commissioner Stephen Hahn said the CDC has sent out enough test kits to test 75,000 people (far fewer than the million promised by the Trump administration). But those are just the tests sent to public health labs. An additional 1.1 million tests (produced by private industry) have been sent out to non-public commercial and academic labs, according to Hahn. In all, he estimated 850,000 Americans are able to be tested.

But capacity to test is still lagging. Part of that is due to a shortage of key chemicals needed to run the tests. Currently, according to the American Enterprise Institute, 16,030 Covid-19 tests can be processed in the US a day, up from 7,840 a few days ago. (South Korea has been able to run 10,000 tests per day since February.)

Some labs have much higher capacity than others. Even the corporate diagnostic companies like Quest and LabCorp only have the capacity to run 1,000 and 1,500 tests a day, respectively. Your ability to get tested may depend on where you live, the lab your physician uses, and the judgment of your doctor.

The timeline of the testing fiasco shows many sources of error

There’s no one reason the testing effort has been so slow. There seem to be bureaucratic, scientific, and economic drivers for the debacle.

Here’s where the trouble started. The CDC started sending out test kits to laboratories the first week of February, a month after China announced the outbreak. But the health agency quickly encountered a problem.

Some labs reported to the CDC that some of the test kits were delivering inconclusive results during verification. It’s believed that one of the chemicals used to conduct the test was not working properly and needed to be remanufactured.

“I’m very puzzled by what’s happened. The CDC did a really good job with H1N1 and Zika in exactly this thing: sending out huge quantities of test kits very rapidly to every state in the US and more than 100 countries around the world,” Tom Frieden, who led the CDC under President Barack Obama, told Vox. “The world came to rely on the CDC.”

The tests are conducted via mouth or throat swabs, through the testing of mucus that has been coughed up or fluid from a patient’s trachea. They’re designed to identify the virus’s specific genetic signature, and results have to be shipped to labs, where they take a day to process.

Also, at first, the testing was bottlenecked. Most states had to send their samples to the CDC until March 2, and so, to the frustration of state health officials, precious time was lost shipping materials to Atlanta in those critical first few weeks. What’s more, each test required lengthy phone calls with the CDC, Rachel Levine, who leads the Pennsylvania health department, told Vox.

As of February 25, only 12 labs across the country — in just five states — had the ability to test. The first case of Covid-19 detected in the US originally did not meet the criteria for testing, as the New York Times explains. Perhaps that had deadly consequences: The outbreak in Washington state appears to be part of a transmission chain related to that first discovered case. When the CDC refused testing for that case, the Seattle Flu Study, a research group, performed one on its own.

Now that states can perform their own tests, they are able to turn them around in a matter of hours. “It’s a much more efficient mechanism,” Levine said, “but it took a long time for that to happen.”

In Seattle, currently the US city with the most Covid-19 cases, local researchers were so exasperated by the CDC’s initial faulty test that they came up with their own, as Stat’s Helen Branswell reported:

Frustrated by the lack of testing resulting from the problem with the CDC-developed kit, the Seattle Flu Study began using an in-house developed test to look for Covid-19 in samples from people who had flu-like symptoms but who had tested negative for flu.

That testing was vital for Washington, as it led to more clues about how the disease was spreading there. Genetic detective work from Washington suggests the virus has been circulating there for at least six weeks. Modeling suggests there could be 1,110 cases of Covid-19 in the Seattle area.

So there’s been human error. But it’s also important to know that the work of setting up testing for a new virus can be difficult. Laurie Garrett, the science journalist who won a Pulitzer Prize for her reporting on the 1995 Ebola outbreak, said China’s most-used tests have had false negatives nearly half the time.

“Everybody is having trouble with the sensitivity/specificity issues” with the coronavirus, Garrett said. But the slow start to testing in America, compounded by the problematic test kits that were first sent out into the field, has set back the US response.

“I have no criticisms for the scientists at the CDC who developed the test because sometimes tests just don’t work,” Rasmussen says. But she does mention it’s problematic that the CDC has removed data about the number of people tested in the United States from its website, saying it didn’t want there to be discrepancies with state testing numbers. “In my view, the biggest scandal is that sort of response.”

Now that we have a functional test, it’s still not reaching enough people

Vice President Mike Pence and other top Trump administration officials have been promising to ramp up the country’s capacity to test for coronavirus, but they have failed to meet their goals.

As Bloomberg reported on March 5, senators were told in a CDC briefing that the Trump administration would not be ready to roll out the 1.5 million kits it had promised by the end of this week. The number would be fewer than 500,000, it appeared.

The Atlantic has provided the best accounting of how many tests have actually been conducted in the United States so far: around 7,000, according to its survey of state health officials and other sources. That puts the US far behind some of its economic peers with much smaller populations:

In South Korea, more than 66,650 people were tested within a week of its first case of community transmission, and it quickly became able to test 10,000 people a day. The United Kingdom, which has only 115 positive cases, has so far tested 18,083 people for the virus.

Making matters worse, some people who have sought tests in the past few weeks, like Eaker’s patient, have been turned away. And these shortcomings make it harder for the public health community to react to a virus that spreads quickly and easily.

Many people don’t really show symptoms of Covid-19, or their symptoms are very mild, but you want them to be tested anyway if there is an opportunity. To do that, doctors need to be able to order the test, which the CDC is only now permitting them to do. Commercial labs only recently started processing the coronavirus test, too, a step health care providers had been urging the administration to take.

“The issue is with asymptomatic transmission. You don’t know who is infected, and symptoms aren’t going to help if the patient doesn’t have any,” Abraar Karan, a Harvard physician, said. “A rapid test would help because you can then do mass testing at scale.”

Another is the criteria for who qualified to be tested. Originally, that was limited only to people who traveled to China or who had been in close contact with someone known to have Covid-19.

Then the tests expanded to include anyone who traveled to any affected country, as well as people with unexplained flu-like symptoms. Now, anyone with a physician’s authorization can be tested for Covid-19 — that is, if they can access a test.

Meanwhile, the federal government has decreased some regulatory roadblocksfor more testing labs to come online. Labs can now start testing if they are pursuing an emergency authorization to test, and they don’t have to wait for the FDA to give them final approval. But some of the materials to run the tests are growing scarce for some labs, according to Stat.

What needs to happen next

We don’t need testing just to diagnose sick people coming into doctor’s offices and hospitals. We also need testing to do surveillance out in communities. “You actually have to go out now in many places in the US and start taking samples from people,” Grubaugh says.

Those surveillance studies will help us understand how prevalent milder cases are in populations. And adding those milder cases to data sets will help researchers determine more accurately how deadly this virus is, whom it tends to infect, and how often people spread it before showing symptoms. As testing ramps up, be prepared to hear about a lot more cases of Covid-19 in the US.

As former FDA Commissioner Scott Gottlieb tweeted Thursday, the private labs also need to step up. “Only big national clinical labs like LabCorp and Quest can fill the void. A lot rides on them now. ... Only these big national chains have throughput, scale, and ordering systems to fill the void that was created. We look to them now. We need them.”

All that information can then be used to better halt the spread of the illness.

Again, without testing, we’re in the dark. And while we’re in the dark, the virus can spread. As Rasmussen says, “we don’t know what the prevalence actually is.”



« Last Edit: March 15, 2020, 05:47:59 pm by AGelbert »

AGelbert

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March 13, 2020

U.S. COVID-19 Outbreak: ‘We’re At the Beginning’

Lack of tests and testing facilities has the United States playing a dangerous game of catch up


https://therealnews.com/stories/u-s-covid-19-outbreak-were-at-the-beginning

Agelbert QUIBBLE: The USA is not "playing catchup" in regard to COVID-19 test kit availability. As Professor Wolff explains below, the LACK of COVID-19 test kits is a function of our CAPITALIST economy (see: CLUSTERFUCK for we-the-people and profit guarantees for the Medical Industrial Complex). If the GOVERNMENT buys millions of test kits, the pharmaceutical corporations are forced to give volume discounts. If, on the other hand, we-the-people have to pay piecemeal through our health insurance or out of individual pocket for COVID-19 tests, a LARGE profit, PER TEST KIT, is baked into the CAPITALIST CAPTIVE MEDICAL MARKET (CORRUPTED) "cake". 😈

26,685 views•Mar 11, 2020

AskProfWolff: COVID-19 and the Stock Market


Here's a more comprehensive version of the above:

24,014 views•Mar 11, 2020

Changing Strained Alliances of World Capitalism [March 2020]




Click on image for interactive COVID-19 map. 👀



Rob not the poor, because he is poor: neither oppress the afflicted in the gate:
For the Lord will plead their cause, and spoil the soul of those that spoiled them. Pr. 22:22-23

AGelbert

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UK Imposes Travel Restrictions to North Sea Oil and Gas Installations

By Reuters on Mar 12, 2020 01:26 pm

offshore rig

LONDON, March 12 (Reuters) – Britain’s oil and gas sector association OGUK on Thursday banned people from travelling to offshore installations such as platforms if they have travelled to certain countries affected by the coronavirus in the previous 14 days. The ban comes after Equinor reported the oil industry’s first coronavirus infection on an offshore installation on Wednesday, […]  Read full story...
Rob not the poor, because he is poor: neither oppress the afflicted in the gate:
For the Lord will plead their cause, and spoil the soul of those that spoiled them. Pr. 22:22-23

Surly1

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Re: New Pandemic?
« Reply #48 on: March 14, 2020, 05:01:30 am »
Look at the spike in the number of cases reflected in the yellow line on the chart in the lower right corner.

« Last Edit: March 15, 2020, 05:54:33 pm by AGelbert »

Surly1

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Cover Trump's Ass and Fudge the Numbers
« Reply #49 on: March 14, 2020, 10:16:12 am »
Camp Runamuck's Response to a Global Pandemic: Cover Trump's Ass and Fudge the Numbers
Oh, and give Jared Kushner some Internet access to sort it all out.





JIM WATSONGetty Images

Mother of god.

From NPR (via The Week):

In January, Azar "did push past resistance from the president's political aides to warn the president the new coronavirus could be a major problem," Diamond said, but he "has not always given the president the worst-case scenario of what could happen. My understanding is [Trump] did not push to do aggressive additional testing in recent weeks, and that's partly because more testing might have led to more cases being discovered of coronavirus outbreak, and the president had made clear — the lower the numbers on coronavirus, the better for the president, the better for his potential re-election this fall."

Holy mother of god.

From the Los Angeles Times:

In previous emergencies, including the 9/11 terrorist attacks, Hurricane Katrina and the H1N1 flu outbreak, both Republican and Democratic administrations loosened Medicaid rules to empower states to meet surging needs. But months into the current global disease outbreak, the White House and senior federal health officials haven’t taken the necessary steps to give states simple pathways to fully leverage the mammoth safety net program to prevent a wider epidemic.

Holy mother of fcking god.

From Politico:

Just before midnight Wednesday, a doctor asked a group of fellow emergency room physicians on Facebook how they would combat the escalating coronavirus outbreak. “I have direct channel to person now in charge at White House,” Kurt Kloss wrote in his post. The next morning, after hundreds of doctors responded, Kloss explained why he sought the suggestions: Jared Kushner, President Donald Trump’s son-in-law and senior adviser, had asked him for recommendations.
Kloss, whose daughter is married to Kushner’s brother, sent Kushner 12 recommendations Thursday morning. The Facebook crowd-sourcing exercise showed how Trump‘s team is scrambling for solutions to confront the outbreak after weeks of criticism for the administration's sluggish response, a shortage of tests and the president’s own rhetoric downplaying the pandemic. It is now expected to consume the final year of Trump's first term and threaten his campaign for a second term.

This is the response of Camp Runamuck to a global pandemic. Cover the president*’s oversized caboose, fudge the numbers, and give the Dauphin some Internet access? El Caudillo del Mar-a-Lago was planning another news conference for Friday, which promised to be a big bag of lies and blame-shifting. (He’s taken to lying about the Obama administration at full volume, so the elderly shut-ins and proud ignorami in his base will have a black guy to blame.) But the fact is that electing a TV clown and real-estate grifter to be president just to own the libs—and because you hate Hillary Rodham Clinton—turns out to have been a bad idea all around. This is an administration that was set up to fail and it has followed its programming precisely.

President Trump Joins Coronavirus Task Force Briefing At White House
Holy mother of god.

Drew AngererGetty Images

If it were up to me, I’d impeach him again and, this time, no hearings. Straight to the floor of the House with a privileged resolution and then straight to an up-or-down vote on the articles. If that NPR story is accurate, then he has clearly violated his oath of office and put the health and safety of the nation at risk for his own private political purposes. Let 52 Republican senators defend that with their votes. Let Susan Collins furrow her brow over that as her poll numbers tank. The last time, it was the integrity of our elections that was endangered. This time, it’s Grandma with her asthma. People can identify more with the latter, I think, than with the ratfcking of the distant Volga Bagmen.

Of course, that won’t happen. It’s the wrong thing on which to waste time in these perilous days. It’s why I am not a member of Congress, let alone in leadership. (A grateful nation rejoices.) All we can do is listen to the voices of reason that really are out there. It’s only a matter of time before Dr. Anthony Fauci blows his stack regarding administration* incompetence, I’m thinking. On Thursday, on CNBC, Senator Professor Warren proposed an economic emergency plan that seemed to make so much sense to Jim Cramer than he looked like he might vote for her right there on the air. And Joe Biden gave another strong, earnest presidentialish address on the subject. Local and state officials are doing heroic work. If your governor or state legislator is stepping up, drop them a line and tell them you’re behind them.

President Donald J. Trump
The Dauphin will handle this.

The Washington PostGetty Images

It looks like new tests for the virus is not far off; both the Cleveland Clinic and the Mayo clinic have announced that they’ve developed one. If we can get Camp Runamuck and the president*’s elephantine self-regard out of the way, we might even be able to catch up to South Korea and Senegal with our testing regime. Senegal has developed a test that produces results in four hours. Our president* can’t put on his shoes in four hours.

As it happens, I’ve been re-watching HBO’s tremendous Chernobyl miniseries. There is a scene in the third installment in which Legasov, the nuclear scientist who is trying to break through the fog of official lies and stupidity, argues that the evacuation zone around the demolished plant be extended from 30 km to 300 km, based on the amount of radioactivity present in the ground. Legasov cannot get Scherbina, the party apparatchik assigned to his work, to listen to him. Finally, Legasov explodes:

Maybe I’ve just spent too much time in my lab. Maybe I’m just stupid. Is this really the way it all works? An uninformed arbitrary decision that will cost who knows how many lives made by some apparatchik? Some career party man?

Congratulations, Republicans. Congratulations, conservatives. You’re manage to make yourselves into the Soviet party apparatus of the mid-to-late 1980s, when everything was falling apart and the institutions of government were so petrified and stultified that nobody could do anything at all. You’ve dragged us all along with you, too. Vote them out. Vote them all out. It’s all that’s left to do.

Respond to this post on the Esquire Politics Facebook page here.


AGelbert

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Charles P. Pierce is spot on.
« Reply #50 on: March 14, 2020, 12:38:58 pm »

Oh, and give 🐍 Jared Kushner some Internet access to sort it all out.

If that NPR story is accurate, then he has clearly violated his oath of office and put the health and safety of the nation at risk for his own private political purposes. Let 52 Republican senators defend that with their votes. Let Susan Collins furrow her brow over that as her poll numbers tank. The last time, it was the integrity of our elections that was endangered. This time, it's Grandma with her asthma. People can identify more with the latter, I think, than with the ratfcking of the distant Volga Bagmen.

http://renewablerevolution.createaforum.com/advances-in-health-care/new-pandemic/msg15901/#msg15901

Charles P. Pierce is spot on.

Look at the spike in the number of cases reflected in the yellow line on the chart in the lower right corner.


I see that. 
 
The numbers are exploding. And that is just those that are counted. In Trumpland, the deliberate undercounting is, as Charles P. Pierce points out, worthy of Soviet era murderous CYA mendacity modus operandi.

Click on image for interactive COVID-19 map.

« Last Edit: March 14, 2020, 06:49:19 pm by AGelbert »
Rob not the poor, because he is poor: neither oppress the afflicted in the gate:
For the Lord will plead their cause, and spoil the soul of those that spoiled them. Pr. 22:22-23

AGelbert

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Royal Caribbean Suspends U.S. Cruises, Joining Rivals

By Reuters on Mar 13, 2020 04:41 pm
March 13 (Reuters) – Royal Caribbean Cruises Ltd said on Friday it was suspending its cruises in the United States for 30 days, an hour after Norwegian Cruise Line Holdings Ltd said it suspended all its cruise voyages through April 11. Earlier larger peer Carnival Corp’s Italy-based unit Costa Cruises halted its trips until April […]  Read full story...
« Last Edit: March 15, 2020, 05:53:53 pm by AGelbert »
Rob not the poor, because he is poor: neither oppress the afflicted in the gate:
For the Lord will plead their cause, and spoil the soul of those that spoiled them. Pr. 22:22-23

AGelbert

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Agelbert NOTE: To that lowlife who just locked this thread, don't waste your time. Either Surly or I will spot it and unlock the topic thread within hours of your unauthorized thread topic locking. Have a nice day, Mr. COWARD.

The
Intercept_


Ryan Grim

March 14 2020, 4:05 p.m.

The following dispatch was sent by a nurse who asked to remain anonymous in order to protect their job.

SNIPPET:

It was becoming alarming that leadership in my hospital — leadership that includes physicianswere not understanding the potential severity of an outbreak.

Next update was March 11. These other e-mails were from lower-level people in administration. Secretaries sending out a quick note from their bosses. This e-mail was the first that we got from our Top Physician Administrator. We are thanked for our hard work and are assured that we are fully prepared to handle patients with Covid-19. We are told that they are following the CDC recommendations and that the risk according to the CDC is low. A few brief statements about how we need to practice good hygiene, isolation precautions, and that they are working with the local health department. The bulk of this e-mail is regarding privacy. I quote:
Quote
In cases where patients have tested positive for coronavirus, the name of the facility treating the patient is not publicly disclosed. We respect and honor that decision. As we receive these patients, their information and diagnosis will remain confidential; we will not be making any public statement about COVID-19 to protect patient privacy.

This is NOT about patient privacy. This is about keeping the doors open for routine business and not hoping that this silly, inconvenient virus doesn’t impact their bottom line too much. I keep reading about how bad things are in Italy, how hardly anyone in the U.S. is getting tested, and I’m really starting to worry that we are going to be overwhelmed. We aren’t slowing down elective procedures, we aren’t trying to empty our ICUs to be prepared, we aren’t designating an area where suspected patients will be placed to limit exposure, we aren’t limiting the number of visitors allowed. We did put up a larger version of the original sign, so that should keep the virus out…

Full article: :o

Rob not the poor, because he is poor: neither oppress the afflicted in the gate:
For the Lord will plead their cause, and spoil the soul of those that spoiled them. Pr. 22:22-23

Surly1

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Re: New Pandemic?
« Reply #53 on: March 15, 2020, 07:19:39 am »


Coronavirus COVID-19 Global Cases by the Center for Systems Science and Engineering at Johns Hopkins University for March 15. Note that number of new cases worldwide has overtaken the number of recoveries for the first time.
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
« Last Edit: March 15, 2020, 05:55:27 pm by AGelbert »

Surly1

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Hospital workers across the U.S. present sharply different pictures of their preparedness for the coronavirus


Medical workers at the Kaiser Permanente French Campus test a patient for the novel coronavirus at a drive-through testing facility in San Francisco on Thursday. JOSH EDELSON/AFP via Getty Images

Meghana Keshavan

U.S. hospitals are bracing for an onslaught of patients sickened by the new coronavirus, shoring up supplies, refining crisis plans, and putting on a brave face. But there’s another narrative at play: Many health workers feel left in the lurch.

STAT heard in recent days from dozens of frontline hospital employees, and depending on where they worked, they presented sharply different pictures of preparedness. There are those who believe their health systems are equipped to weather the coming storm. Others are less sure.

“For the hospitals, it depends on who is in charge — what camp your leadership is in,” an anesthesiologist on the East Coast, speaking on the condition of anonymity, told STAT. “There’s been the ‘just the flu’ contingent, and everyone else.” but 

Terry Adirim, a trained pediatric emergency physician who helps lead clinical care at Florida Atlantic University College of Medicine, agreed that there is “variability in preparedness” that has to do with hospital leadership. But the former senior Department of Defense and Homeland Security official added, “I think that comes because federal guidances haven’t been as strong as they could be.”

Delays in rolling out coronavirus tests mean it’s impossible to know how many people are infected, and how bad the epidemic will get. Knowing what to be ready for is difficult in these circumstances, and the level of preparedness appears to vary from state to state, city to city, hospital to hospital — and from individual to individual.

Some hospitals have engineered new protocols to triage ill patients — turning to tools like hotlines and telemedicine to advise those with mild illness on how to manage their symptoms. They have devised backup plans should intensive care units become overrun, including stopping elective surgeries and preparing to expand critical care into operating rooms.

But others are lagging.

Despite assurances from their hospitals’ leadership, many frontline workers are worried about emergency departments overrun, and too few life-support devices to go around. They’re afraid of protective supplies running low and of contracting the virus themselves — and passing it along to their loved ones. In China, 3,300 health workers were sickened by the virus, and 13 died.

Reports from the Seattle area, the epicenter of the U.S. outbreak, indicate that some of the city’s hospitals are nearly overwhelmed. One hospital’s note to staff, shared with New York Times columnist Nicholas Kristof, says the “local COVID-19 trajectory is likely to be similar to that of Northern Italy.” The hospital is down to a four-day supply of gloves.

“Our health care staff has been taking our N95 masks, because people are scared for their families,” said a resident physician in Philadelphia, one of the dozens of people who responded to STAT’s callout for health workers’ stories. “I’m worried about my parents, too.”

Hospital employees have uniformly been kept abreast of Covid-19 preparations through emails and web-based training modules. But there has been little in the way of in-person training on protocols for dealing with a virulent contagion. Although many first responders have been schooled in dealing with highly infectious diseases, other hospital employees are left wondering if they’ll be safe.

“This is unlike any other outbreak I’ve been involved with,” said Rainee Sinroll, a nurse in Missouri who worked through the H1N1 epidemic and has spoken extensively with other health workers in her region. “There’s absolutely no training and information to the staff that will be involved. And no message to the community that would lower cases, thereby allowing better care in our facilities.”

A surgical tech in New Mexico is expecting to see Covid-19 patients coming into her hospital, since the first cases were discovered in the state just a few days ago. But she’s deeply unhappy with the guidance from her hospital to date.

“Some of my colleagues and I feel let down,” said Alyssa Estrada, an instrument sterilization technician who says her hospital is already short-staffed. “If something happens, how are we going to keep our department running if we don’t have the manpower?”

There may be enough masks and gowns at her hospital, she said, but she’s already having difficulty getting sterilization equipment. Sanitation wipes, and sprays that get rid of biofilms — that is, slimy amalgamations of pathogens that reside on equipment — are in short supply.

“It’s kind of strange, because I feel like the city has been warning us more than the actual hospital has,” she said. “In the end, we’re all going to have to work together if this gets serious — and I feel like we all need to be more up-to-date on the information.”

Patients hospitalized with Covid-19 typically have pneumonia and difficulty breathing, which would require treatment with oxygen or, in severe cases, intubation and being hooked up to a ventilator. Physicians see these cases on a regular basis, but treating them in droves could overwhelm a hospital’s capacity.

“I’m concerned we won’t have enough epinephrine or albuterol — these are the bread and butter meds we use every day for pneumonias,” a pediatric ICU doctor in Chicago said.

The news reports from China, Iran, and Italy in particular has been sobering. Health workers in some places in Italy have had to choose which patient gets ventilator care, and which patient will not, according to reports from physicians there.

Many hospitals in the U.S. are already operating at high capacity. There are 45,000 ICU hospital beds and 160,000 ventilators nationwide — but, in the event of a moderate outbreak, about 200,000 Americans would need such intensive care. And that leaves out all the patients who might need lifesaving procedures, equipment, and medications for reasons other than coronavirus.

“It’s frightening, because for me as a doctor, I realize there is going to be a certain point where we’ll be forced to make decisions we’re not comfortable making,” the resident physician in Philadelphia said.

Though she’s received plenty of training in how to treat patients sickened by severe pneumonia, she said her medical education hasn’t involved making these heart-wrenching triage decisions.

“We’ve been so blessed by an excess of resources that we’ve never had to withdraw care from someone’s loved one because we need their ventilator for someone else,” she said. “But I’m scared of that happening.”

Many health systems say they are confident in their ability to tackle a surge of novel coronavirus cases.

Stanford University’s health system, for instance, has “redefined its triage process,” according to Sam Shen, a clinical associate professor of emergency medicine. It has set up a drive-through clinic for ill patients, in operation since Monday, that’s meant to test for coronavirus once tests are readily available. Severely ill patients will be directed immediately to negative-pressure rooms.

The university is also setting up tents in front of the emergency department entrance, to create an isolation space so patients with possible Covid-19 infections don’t need to enter the ER.

Mount Sinai Hospital in New York City has kicked off a telemedicine program, as have several other hospitals around the country. Like Stanford, the Manhattan health system has detailed triage plans — with tools to divert milder cases and bring the critical patients in for intensive care.

“I think we’re prepared,” said Jolion McGreevy, medical director of the Mount Sinai Hospital emergency department. “We have the resources, and it’s all being coordinated by a system command center that has high leadership.”

Large hospitals in many cities compete for patients, but the three major health systems in the Cleveland area — University Hospitals, Cleveland Clinic, and MetroHealth are absorbing the lessons taught by hard-hit cities like Wuhan in China and Bergamo in Italy.

“We have a trifecta approach in the city of Cleveland to mobilize joint resources for ambulatory care, mirroring what we’re seeing in other cities abroad,” said Robert Hughes, associate medical director of the department of emergency medicine at University Hospitals. “I’ve found that the collaborative spirit between the health systems in our city has been better for the community we serve.”

The fallout from the national dearth of Covid-19 testing kits looms, as well. Health workers who have fallen ill worry whether they have a cold, the flu, or the novel coronavirus — and most have no way of knowing the truth.

An East Coast emergency room physician who wished to remain anonymous has been ill for several weeks — with symptoms that appear, in her professional opinion, to be consistent with Covid-19. Although confirmed negative for the flu and other respiratory viral illnesses, the physician was denied coronavirus testing because there was no confirmed exposure to another patient ill with the disease.

“I’ve missed several weeks of work, unpaid, to avoid putting patients at risk,” the physician said. “I’m frustrated that I still can’t get tested to ensure I am safe to return to work.”

A certified nurse assistant in Alabama said that she, too, has been recently ill with a virus — and hasn’t had access to testing, despite working with a vulnerable population. The situation has been “very confusing, arbitrary, chaotic!” she said.

“No one among the CNA staff is talking about this in any meaningful way,” she said. “If the nurses are, I don’t know about it.”

In her hospital in Florida, Adirim has seen a disconnect in the attitudes of health workers glued to the news and others who have adopted a wait-and-watch outlook.

“I still hear other doctors in the hallways, saying this is just like the flu,” the East Coast anesthesiologist said. “Not everyone has been taking this as seriously as they should.”

Last month, she used her own money to buy goggles for herself and her husband — to protect against the virus, should it go airborne when patients are put on ventilators.

“If we hadn’t bought those goggles, we wouldn’t have anything,” she said.

In China and Italy, as health workers fell ill with Covid-19, health professionals from other specialties were trained to replace them. That very well might happen in the U.S., Adirim said.

When working with the Department of Homeland Security on prior epidemics, such as H1N1, Adirim’s team considered the possibility of health worker burnout or attrition — whether, under the threat of exhaustion or illness, employees would stop showing up at work.

But that hasn’t happened in Italy, or in China, nor during prior epidemics. The jury’s still out on the U.S. response, Adirim said, but she thinks that health workers will rise to the occasion and work tirelessly to combat the pandemic.

“I think those of us who go into health care fields understand that risk,” Adirim said.

Surly1

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The Hand Sanitizer You Can't Find Is In This Putz's Garage
Online retailers have stopped gouging. Now what?[/b]



By Jordan HoffmanMarch 14, 2020
During troubling times it is psychologically helpful to know where to vent your anger. After the 9/11 terrorist attacks, we had the face of Osama bin Laden. With the Coronavirus, there really isn’t anyone specific to blame, and it’s hard to make a dartboard out of a blown-up photo of an infected cytoplasm. The current pandemic isn’t one specific person’s fault, but there are individuals who have found in this global panic a route to becoming a real jerk.

Chief among them is Tennessee’s Matt Colvin who, with the aid of his brother Noah, was inspired by news of the potential for over 1 million American deaths to turn a handsome profit.

The retired Air Force technical sergeant is the new face of price gouging, thanks to a profile in Saturday’s New York Times. Beginning March 1st, Colvin, whose primary income is reselling collected goods on sites like Amazon, hit the road and bought as much hand sanitizer as he could find. For a while, the money was rolling in. But when his prices soared, Amazon, eBay and other marketplaces rightly shut him and his fellow panic profiteers down. He estimates he now has 17,700 bottles of the virus-killing ooze, as well as hand wipes and all the other highly sought after materials you can’t find in a store right now. The cleaning products are collecting dust.

The Times suggests that Colvin is just one of thousands of resellers that gobbled up prevention goods with an eye toward making a small fortune. (But he’s the one they photographed in a t-shirt that says “Family Man Family Business” in front of shelves of Purel and Clorox wipes he can not sell.) Chris Anderson of Central Pennsylvania estimates he made about $25,000 on masks, similar to the ones that hospitals are now rationing. An Ohio-based online seller by the name of Eric says he has made between $35,000 and $40,000 on masks. He declined to give his last name, not out of shame, but fearing “a retaliation from Amazon.”

On the one hand, you wonder if you can really blame these men? Buying low and selling high is an American tradition with roots as deep as the buttonwood tree where a group of traders created the New York Stock Exchange in 1792. Then you read Matt Colvin, hoarder of hand sanitizer, suggesting that price-gouging laws “are not built for today’s day and age. They’re built for Billy Bob’s gas station doubling the amount he charges for gas during a hurricane.” As if Coronavirus isn’t the world’s biggest hurricane.

As it happens, making your own hand sanitizer isn’t impossible. My wife cooked up a huge batch made of aloe vera gel, rubbing alcohol and some essential oils. (And I am proud to report we are not selling it online at inflated prices.) Additionally, all signs point to soap and water being an effective, if not the most effective, weapon against viruses.

AGelbert

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Quote
The final aid package not only omitted language that would have limited drug makers’ intellectual property rights, it specifically prohibited the federal government from taking any action if it has concerns that the treatments or vaccines developed with public funds are priced too high.

The
Intercept_


By Sharon Lerner

March 13 2020, 2:46 p.m.

SNIPPET:

“Pharmaceutical companies view Covid-19 as a once-in-a-lifetime business opportunity,” said 🦅 Gerald Posner, author of “Pharma: Greed, Lies, and the Poisoning of America.” The world needs pharmaceutical products, of course. For the new coronavirus outbreak, in particular, we need treatments and vaccines and, in the U.S., tests. Dozens of companies are now vying to make them.

They’re all in that race,” said Posner, who described the potential payoffs for winning the race as huge. The global crisis “will potentially be a blockbuster for the industry in terms of sales and profits,” he said, adding that “the worse the pandemic gets, the higher their eventual profit.”

The ability to make money off of pharmaceuticals is already uniquely large in the U.S., which lacks the basic price controls other countries have, giving drug companies more freedom over setting prices for their products than anywhere else in the world. During the current crisis, pharmaceutical makers may have even more leeway than usual because of language industry lobbyists inserted into an $8.3 billion coronavirus spending package, passed last week, to maximize their profits from the pandemic.

Initially, some lawmakers had tried to ensure that the federal government would limit how much pharmaceutical companies could reap from vaccines and treatments for the new coronavirus that they developed with the use of public funding. In February, 🦅 Rep. Jan Schakowsky, D-Ill., and other House members wrote to 🦀 Trump pleading that he “ensure that any vaccine or treatment developed with U.S. taxpayer dollars be accessible, available and affordable,” a goal they said couldn’t be met “if pharmaceutical corporations are given authority to set prices and determine distribution, putting profit-making interests ahead of health priorities.”

Full article:

Rob not the poor, because he is poor: neither oppress the afflicted in the gate:
For the Lord will plead their cause, and spoil the soul of those that spoiled them. Pr. 22:22-23

AGelbert

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Online retailers have stopped gouging. Now what?


By Jordan HoffmanMarch 14, 2020
During troubling times it is psychologically helpful to know where to vent your anger. After the 9/11 terrorist attacks, we had the face of Osama bin Laden. With the Coronavirus, there really isn’t anyone specific to blame, and it’s hard to make a dartboard out of a blown-up photo of an infected cytoplasm. The current pandemic isn’t one specific person’s fault, but there are individuals who have found in this global panic a route to becoming a real jerk.

Chief among them is Tennessee’s Matt Colvin who, with the aid of his brother Noah, was inspired by news of the potential for over 1 million American deaths to turn a handsome profit.

The retired Air Force technical sergeant is the new face of price gouging, thanks to a profile in Saturday’s New York Times. Beginning March 1st, Colvin, whose primary income is reselling collected goods on sites like Amazon, hit the road and bought as much hand sanitizer as he could find. For a while, the money was rolling in. But when his prices soared, Amazon, eBay and other marketplaces rightly shut him and his fellow panic profiteers down. He estimates he now has 17,700 bottles of the virus-killing ooze, as well as hand wipes and all the other highly sought after materials you can’t find in a store right now. The cleaning products are collecting dust.

The Times suggests that Colvin is just one of thousands of resellers that gobbled up prevention goods with an eye toward making a small fortune. (But he’s the one they photographed in a t-shirt that says “Family Man Family Business” in front of shelves of Purel and Clorox wipes he can not sell.) Chris Anderson of Central Pennsylvania estimates he made about $25,000 on masks, similar to the ones that hospitals are now rationing. An Ohio-based online seller by the name of Eric says he has made between $35,000 and $40,000 on masks. He declined to give his last name, not out of shame, but fearing “a retaliation from Amazon.”

On the one hand, you wonder if you can really blame these men? Buying low and selling high is an American tradition with roots as deep as the buttonwood tree where a group of traders created the New York Stock Exchange in 1792. Then you read Matt Colvin, hoarder of hand sanitizer, suggesting that price-gouging laws “are not built for today’s day and age. They’re built for Billy Bob’s gas station doubling the amount he charges for gas during a hurricane.” As if Coronavirus isn’t the world’s biggest hurricane.

As it happens, making your own hand sanitizer isn’t impossible. My wife cooked up a huge batch made of aloe vera gel, rubbing alcohol and some essential oils. (And I am proud to report we are not selling it online at inflated prices.)
Additionally, all signs point to soap and water being an effective, if not the most effective, weapon against viruses.



Agelbert NOTE: Here's the deal with soap. Soap is a type solvent for oily substances. In chemistry, the word "solvent" just means the molecules of some substance are real good at surrounding the moclecules of the substance they are in. For people that are allergic to scientific terms, that means it mixes super well with the other substance. SO WHAT, you ask?

Well, I'm glad you asked. Oils, fats, grease, etc. are easily washed off your skin surface with soap for that reason. SO WHAT, you ask? What does that have to do with COVID-19 virus critters?

Well, I'm glad you asked. The outer "corona" of the sphere shaped COVID-19 virus, like all viruses, is mostly made up of "polar" molecules. Those molecules are exactly the same kind that make up oils, fat, grease, etc. (you get the idea). Soap disorganizes the outer layer of the virus. IOW, it dissolves the wall of the virus sphere into non-cohesive units that can no longer stick together to protect the virus genetic material inside. Large gaps form in the outer layer and the virus genetic material leaks out. Once the virus genetic material leaks out, it can not be transported into some cell in the molecular neighborhood. IOW, it is no longer a threat. Since viruses are really, really tiny, you need to make sure the soap and water making life difficult for the COVID-19 virus critter is doing so for at least 20 seconds in order for the solvent action on the polar exterior of the virus to wreak successful havoc on billions of said COVID-19 critters.

If you want to make sure you always have a powerful weapon against COVID-19 critters on your skin around while you go about your business, hang a soap on a rope around your neck. They aren't going to run out of soap on a rope before global warming does us in, so don't worry about availability of soap, whether on a rope or not. Just go to a source of clean water, pull out your soap on a rope and kill COVID-19 on your skin by washing for 30 seconds or so. The particles of the virus that are disorganized by the soap solvent action are NOT a health threat. They go down the drain as disorganized genetic material with no ability to function as a virus.
 

For those who are confused by the term "polar" in regard to molecular structure, I will be glad to bend your ear about the bipolar nature of the water molecule, what one pole does and what the other one does to make water such a great solvent. That is why soap needs to partner with water to dissolve oily substances (like virus outer layers). For most people, all that polar stuff is boring. Everybody knows that water doesn't mix with oil. Well, water DOES mix quite well with oil IF soap is present. Alchohol, by the way, works like soap mixed with water because it has polar sections and bipolar sections. Alchohol kills bacteria AND viruses by a mechanism called denaturing. Bored yet? I thought so.

Alchohol does the job without water but is expensive. Soap is cheap and every bit as effective as alchohol, as long as you have water available.

Soap and water 🍀 is affordable COVID-19  skin protection for everyone. End of story. 🌞

   
Rob not the poor, because he is poor: neither oppress the afflicted in the gate:
For the Lord will plead their cause, and spoil the soul of those that spoiled them. Pr. 22:22-23

AGelbert

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Could Coronavirus Kill A Million Americans? 

By Tom Frieden, Thinkglobalhealth.org

March 14, 2020 | EDUCATE!


Soon after I became director of the U.S. Centers for Disease Control and Prevention (CDC) in June of 2009, I was asked to brief President Barack Obama about the emerging pandemic of H1N1 influenza. It was the first time I had briefed the president, there was a blizzard of information from CDC’s experts, and I had a videocall with dozens of CDC professionals—most of whom didn’t know I was about to brief the president... -more-

Rob not the poor, because he is poor: neither oppress the afflicted in the gate:
For the Lord will plead their cause, and spoil the soul of those that spoiled them. Pr. 22:22-23

AGelbert

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The Guardian

Philip Oltermann in Berlin @philipoltermann

Sun 15 Mar 2020 10.12 EDT

German government tries to fight off aggressive takeover bid by 🦀 US, say reports

Rob not the poor, because he is poor: neither oppress the afflicted in the gate:
For the Lord will plead their cause, and spoil the soul of those that spoiled them. Pr. 22:22-23

 

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