POST 142A. March 15, 2021. CORONAVIRUS. “Candida auris is a superbug, a pathogen that can evade drugs made to kill it—and early signs suggest the COVID-19 pandemic may be propelling infections of the highly dangerous yeast. That’s because C. auris is particularly prominent in hospital settings, which have been flooded with people this year due to the coronavirus.”
“Seeing the world as a one-pathogen world is really problematic,” said Dr. Susan S. Huang, an infectious disease specialist at the University of California at Irvine Medical School, noting that the nearly singular focus on the pandemic appears to have led to more spread of drug-resistant infection. “We have every reason to believe the problem has gotten worse.”…
“Patient care staffing, supplies, care sites and standard practices have all changed during this extraordinary time,” the letter stated…
Dr. Huang and other experts said they are not suggesting that the priority on fighting Covid-19 was misplaced. Rather, they say that renewed attention must be paid to drug-resistant germs. Earlier research has shown that as many as 65 percent of residents of nursing homes carry some form of drug-resistant infection…
But after the pandemic began, there was much less monitoring and even, at times, a wholesale breakdown of communications about the transfer of such patients, experts said. Plus, the sickest Covid-19 patients were put on ventilators, where drug-resistant infections can cling and then spread.
Another possible contributor has been the heavy and regular use of steroids to treat Covid-19. These drugs help alleviate the virus’s most dangerous symptoms but can leave the immune system compromised in a way that allows other germs to more easily infiltrate the body.
The combination of these factors “is perfect” for the fungus to “take hold,” said Dr. Tom Chiller, the head of the fungal division of the C.D.C….
The upshot is that the confirmed cases are “likely the tip of the iceberg,” Dr. Chiller said.” (G)
PREQUEL
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
to see links to POSTS 1-142 in chronological order, highlight and click on https://doctordidyouwashyourhands.com/2021/03/coronavirus-tracking-links-to-posts-1-142/
POST 142. March 15, 2021. CORONAVIRUS. “Candida auris is a superbug, a pathogen that can evade drugs made to kill it—and early signs suggest the COVID-19 pandemic may be propelling infections of the highly dangerous yeast. That’s because C. auris is particularly prominent in hospital settings, which have been flooded with people this year due to the coronavirus.”
to see links to POSTS 1-142 in chronological order, highlight and click on https://doctordidyouwashyourhands.com/2021/03/coronavirus-tracking-links-to-posts-1-142/
PREQUEL
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
Over Christmas break in 2015, Johanna Rhodes received a panicked email from a doctor working at the Royal Brompton Hospital, the largest heart and lung center in the United Kingdom. A horrid yeast was invading the skin of patients, spreading through the intensive care unit even though the hospital maintained extensive protocols for infection control.
“The doctor asked me to take a look … I thought, how bad can it be?” recalls Rhodes, an infectious disease expert at Imperial College London who studies antifungal resistance. Rhodes stepped in to help one of the world’s top cardiology hospitals identify the pathogen and clear it from the premises. The germ was Candida auris, little known at the time. What she saw stunned her: “You think COVID-19 is bad until you see Candida auris.”
Candida auris is a superbug, a pathogen that can evade drugs made to kill it—and early signs suggest the COVID-19 pandemic may be propelling infections of the highly dangerous yeast. That’s because C. auris is particularly prominent in hospital settings, which have been flooded with people this year due to the coronavirus.
The superbug sticks stubbornly to surfaces such as sheets, bed railings, doors, and medical devices—making it easier to colonize skin and pass from one person to another. Moreover patients who have tubes that go into their body, such as catheters or ones for breathing or feeding, are at the highest risk for C. auris infections, and these invasive procedures have become more common because of the respiratory failure associated with COVID-19…
The worry is that if C. auris becomes more common in hospitals or the general public, it could bolster the growing crisis of superbugs, which already infect millions worldwide. Last year, the CDC classified C. auris as one of the biggest drug resistance threats in America. Now, though it’s too early to confirm a direct knock-on effect, the U.S. has recorded 1,272 confirmed cases of C. auris in 2020, a 400 percent increase over the total recorded during all of 2018, the most recent year with available data.
The real number is likely to be much higher, though, as the COVID-19 pandemic has halted much of the disease surveillance for C. auris at hospitals and because the germ can often colonize a person’s skin without generating symptoms.
Such superbugs may also be contributing to the tens of thousands of excess deaths occurring during the COVID-19 era. Hence why doctors around the world are sounding the alarm.” (A)
“Health systems have had to adapt their operations to meet the urgent needs of the COVID-19 pandemic, but experts warn that pathogens like Candida auris are taking advantage of gaps in monitoring and containment efforts, and COVID-19 patients are at risk for fatal coinfection.
“Most health care facilities have been extremely stressed for resources and personnel during the pandemic, which may create ideal conditions for nosocomial outbreaks with pathogens such as C. auris,” said Melissa Johnson, PharmD, an associate professor of medicine, Division of Infectious Diseases and International Health, at Duke University Medical Center, in Durham, N.C.
At the CDC’s last count on Nov. 30, 2020, there were 1,595 confirmed clinical cases of C. auris reported in the United States—an increase of more than 400% over 2018, which is the most recent year with available data. Rising C. auris infection rates make coinfection with SARS-CoV-2 increasingly likely, recent data indicated.
According to a report this year in Morbidity and Mortality Weekly Report (2021;70[2];56-57), a Florida hospital reported three C. auris infections in four patients with SARS-CoV-2, who were hospitalized in the same COVID-19 unit in July 2020. The acute care hospital’s COVID-19 unit took up five wings on four floors, each with ICU rooms…
“The crowding in our ICUs and the need in some places to provide intensive care in hospital units not designed for this purpose, sometimes staffed by health care workers not completely prepared to provide this level of care, augurs a repeat of this Indian experience in the U.S.,” Stephen Baum, MD, a professor of medicine and of microbiology and immunology at Albert Einstein College of Medicine, in New York City, cautioned in an online commentary on the Indian study.
Indeed, the California Department of Public Health issued a health advisory based on sharp increases in C. auris cases in health care facilities in that state after the numbers nearly doubled.
“Personal protective equipment conservation strategies and other containment strategies (e.g., cohorting) on the basis of COVID-19 status alone might be contributing to this resurgence of C. auris,” the agency stated on its website.
Hospitals need to “continue with routine screening and infection control practices despite having the increased workload of dealing with COVID-19,” said Susan Poutanen, MD, MPH, a medical microbiologist and an infectious disease physician at the University Health Network and Sinai Health, and an associate professor, Departments of Laboratory Medicine and Pathobiology and Medicine at the University of Toronto.
The reports of “nosocomial C. auris transmission in patients with COVID-19 admitted to the ICU is an excellent reminder of the need for such efforts,” Poutanen said.
Despite their best intentions, some hospitals experienced interruptions in their C. auris screening programs during the pandemic, she noted.” (B)
“The yeast infection may have been caused due to the reuse of the personal protective equipment (PPE), as per a report by the Centers for Disease Control and Prevention (CDC)…
The recent outbreak began in July when a hospital, which the report did not name, notified the Florida Department of Health of an initial four cases of the fungus among patients being treated for the coronavirus.
The next month, the hospital carried out additional screening in its Covid-19 unit, which spanned four floors across five wings, and identified 35 more patients as being Candida Auris-positive.
Follow-up data was available for only 20 out of the 35 patients. Eight of these 20 people died, but it was not clear whether the fungus was the main factor or not.
The Florida Department of Health and CDC performed a joint investigation focused on infection prevention and control measures, finding numerous weaknesses.
“Mobile computers and medical equipment were not always disinfected between uses, medical supplies (e.g., oxygen tubing and gauze) were stored in open bins,” the CDC report said.
It added that hospital staff, possibly out of fear of the coronavirus, were wearing multiple layers of personal protective equipment (PPE), which is not recommended and in fact heightens the risk of microbe transmission.
There were also instances of extended PPE use and re-use.
After the hospital removed supplies from hallways, enhanced cleaning and disinfection practices, and improved practices around PPE use, no further Candida Auris was detected on subsequent surveys.
“Outbreaks such as that described in this report highlight the importance of adhering to recommended infection control and PPE practices and continuing surveillance for novel pathogens like Candida Auris,” the report concluded.
Candida Auris has now been documented in more than 30 countries, with some 1,500 US cases reported to the CDC as of October 31, 2020.
The CDC says the fungus can spread in healthcare settings “through contact with contaminated environmental surfaces or equipment, or from person to person.” (C)
“The recent outbreak of the fungal infection was reported in July 2020. the Florida Department of Health reported the initial four cases of the fungus, among patients being treated for COVID-19, the disease caused by the novel coronavirus.
The following month, they carried out additional screening and identified 35 more patients were already infected with the fungus.
Eight of 20 people, whose follow-up data were available, died. However, it was not certain if the fungus was the main factor or not.
The Florida Department of Health and CDC performed a joint investigation focused on infection prevention and control measures, finding numerous weaknesses.
“Mobile computers and medical equipment were not always disinfected between uses, medical supplies (e.g., oxygen tubing and gauze) were stored in open bins,” the CDC report said.
It added that hospital staff, possibly out of fear of the coronavirus, were wearing multiple layers of personal protective equipment (PPE), which is not recommended and in fact heightens the risk of microbe transmission.
There were also instances of extended PPE use and re-use, Wion News reported.
After the hospital removed supplies from hallways, enhanced cleaning and disinfection practices, and improved practices around PPE use, no further Candida Auris was detected on subsequent surveys.
“Outbreaks such as that described in this report highlight the importance of adhering to recommended infection control and PPE practices and continuing surveillance for novel pathogens like Candida Auris,” the report concluded.
Candida Auris has now been documented in more than 30 countries, with some 1,500 US cases reported to the CDC as of October 31, 2020.
The CDC says the fungus can spread in healthcare settings “through contact with contaminated environmental surfaces or equipment, or from person to person.” (D)
“The California Department of Public Health (CDPH) has released a Health Advisory alerting providers of the increasing number of Candida auris (C. auris) cases reported in Southern California in recent months.
CDPH notes that personal protective equipment conservation strategies and cohorting COVID-19 patients might be contributing to this resurgence of C. auris. As a result, CDPH recommends health care facilities:
Assess C. auris and other multidrug-resistant organism (MDRO) status for all patients and residents upon admission, by reviewing medical records and screening high-risk individuals.
When cohorting patients by COVID-19 status, consider C. auris and other MDRO status during room placement.
Do not reuse or extend use of gloves or gowns between patients with different or unknown C. auris or other MDRO, and COVID-19 status.
CDPH also advises health care facilities to report any cases of C. auris or unusual or highly-resistant organisms to their local health department and CDPH at [email protected].
CDPH also advises health care facilities to report any cases of C. auris or unusual or highly-resistant organisms to their local health department and CDPH at [email protected].” (E)
“Whenever a facility has a suspected or confirmed case of C. auris, rapid action is the name of the game. Nursing and infection prevention teams need to be notified swiftly, so that they in turn can immediately implement appropriate infection prevention protocols, stressed Teri Caughlin, RN, MHA, regional director of infection prevention for Southern California Kaiser Permanente in Pasadena. These protocols typically include contact precautions, personal protective equipment (PPE), and Environmental Protection Agency-approved surface cleaning products effective against C. auris. The latter matters because even products with fungicidal claims might not kill C. auris.
Establishing point prevalence and conducting contact tracing and admission screening also are essential elements for controlling the spread of C. auris, added Sudha Chaturvedi, PhD, director of the Mycology Laboratory at the New York State Department of Health’s Wadsworth Center in Albany. All of these strategies depend on the availability of swift and accurate testing, she stressed.
Although some hospitals in high prevalence areas might routinely test all patients for C. auris colonization, others might not do so until they have a positive case. This type of epidemiologic search is critical, said Procop: “The clinical isolate may be the tip of the proverbial iceberg.”
Some evidence suggests that the COVID-19 pandemic could exacerbate C. auris transmission in healthcare facilities. PPE shortages, or changes in infection control practices spurred by concerns about future shortages, could allow the fungus to spread. “This has been observed in long-term care facilities, as well as acute care hospitals, which typically had less C. auris transmission prior to the COVID-19 pandemic,” said Meghan Lyman, MD, epidemiologist at CDC.
Facilities also can’t take for granted that the same procedures that curb the spread of SARS-CoV-2 will work for C. auris. For example, “disinfectants recommended for use against COVID-19 in the United States are either ineffective against C. auris or have not yet been tested for effectiveness,” warned Berkow.
However, improved hand hygiene due to the COVID-19 pandemic has benefited patients by reducing the transmission of non-COVID pathogens, said Caughlin. And the COVID-19 pandemic might not have compromised the ability to detect C. auris in facilities like Van Horn’s with dedicated mycology labs, he suggested.
“We will have a clearer picture of what, if any, impact the COVID-19 pandemic has had on C. auris control later in the year,” added Chaturvedi.” (F)
“Seeing the world as a one-pathogen world is really problematic,” said Dr. Susan S. Huang, an infectious disease specialist at the University of California at Irvine Medical School, noting that the nearly singular focus on the pandemic appears to have led to more spread of drug-resistant infection. “We have every reason to believe the problem has gotten worse.”…
In an acknowledgment of the issue, three major medical societies sent a letter on Dec. 28 to the Centers for Medicare and Medicaid Services asking for a temporary suspension of rules that tie reimbursement rates to hospital-acquired infections. The three groups — the Society of Healthcare Epidemiology of America, the Society of Infectious Diseases Pharmacists, and the Association for Infection Control and Epidemiology — feared that the infection rates may have risen because of Covid-19.
“Patient care staffing, supplies, care sites and standard practices have all changed during this extraordinary time,” the letter stated.
Not all types of drug-resistant infections have risen. For instance, some research shows no particular change during the pandemic in the rate of hospital patients acquiring the bacterium Clostridioides difficile — a finding that suggests the overall long-term impact of the pandemic on these infections is not yet clear.
Dr. Huang and other experts said they are not suggesting that the priority on fighting Covid-19 was misplaced. Rather, they say that renewed attention must be paid to drug-resistant germs. Earlier research has shown that as many as 65 percent of residents of nursing homes carry some form of drug-resistant infection.
Over the years, critics have charged that hospitals and, in particular, nursing homes, have been lax in their efforts to confront these infections because it is expensive to disinfect equipment, train staff, isolate infected patients and screen for the germs.
In response to these and other concerns, a greater effort was beginning to be made before the pandemic to monitor patients for these infections, particularly as they cycled in and out of nursing homes and intensive care units. This revolving door is known to spread germs that are carried by infected patients.
But after the pandemic began, there was much less monitoring and even, at times, a wholesale breakdown of communications about the transfer of such patients, experts said. Plus, the sickest Covid-19 patients were put on ventilators, where drug-resistant infections can cling and then spread.
Another possible contributor has been the heavy and regular use of steroids to treat Covid-19. These drugs help alleviate the virus’s most dangerous symptoms but can leave the immune system compromised in a way that allows other germs to more easily infiltrate the body.
The combination of these factors “is perfect” for the fungus to “take hold,” said Dr. Tom Chiller, the head of the fungal division of the C.D.C….
The upshot is that the confirmed cases are “likely the tip of the iceberg,” Dr. Chiller said.” (G)
- A.Drug-resistant superbug thriving in hospitals hit hard by COVID-19, BY SOPHIE COUSINS, https://www.nationalgeographic.com/science/article/drug-resistant-superbug-candida-auris-thriving-hospitals-coronavirus-era
- B.C. auris Taking Advantage of Focus on COVID-19, By David Wild, https://www.pharmacypracticenews.com/Covid-19/Article/03-21/-em-C-auris-em-Taking-Advantage-of-Focus-on-COVID-19/62809
- C.Candida auris: Killer fungus spreading rapidly in coronavirus wards in US, https://www.wionews.com/world/candida-auris-killer-fungus-spreading-rapidly-in-coronavirus-wards-in-us-355544
- D.Candida Auris: All you need to know about the deadly fungus that plagued COVID wards in the USHealth, by Anushree Gupta, https://www.timesnownews.com/health/article/candida-auris-all-you-need-to-know-about-the-deadly-fungus-that-plagued-covid-wards-in-the-us/705286
- E.Candida auris Cases Related to COVID-19 Surge in Health Care Facilities, by KIYOMI BURCHILL, https://www.calhospital.org/cha-news-article/candida-auris-cases-related-covid-19-surge-health-care-facilities
- F.Institutions explore the best options for identifying and mitigating C. Auris, by Kristin Harper,https://www.aacc.org/cln/articles/2020/october/stopping-superbug
- G.With All Eyes on Covid-19, Drug-Resistant Infections Crept In, By Matt Richtel, https://www.nytimes.com/2021/01/27/health/covid-drug-resistant-infections.html?referringSource=articleShare
CORONAVIRUS TRACKING Links to POSTS 1-142
CORONAVIRUS TRACKING
Links to POSTS 1-142
Doctor, Did You Wash Your Hands?®
https://doctordidyouwashyourhands.com/
Curated Contemporaneous Case Study Methodology
https://doctordidyouwashyourhands.com/2019/12/9897/
Jonathan M. Metsch, Dr.P.H.
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
PART 20. April 20, 2020. CORONAVIRUS. “…nothing is mentioned in the “Opening Up America Again” plan about how states should handle a resurgence.”
PART 21. April 23, 2020. CORONAVIRUS. “We need to ask, are we using ventilators in a way that makes sense for other diseases but not this one?”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
POST 31. June 9, 2020. CORONAVIRUS. “I think we had an unintended consequence: I think we made people afraid to come back to the hospital,”
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 33. June 21, 2002. CORONAVIRUS….. Smashing (lowering the daily number of cases) v. flattening the curve (maintaining a plateau)
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 42. August 11, 2020. CORONAVIRUS. “I think that if future historians look back on this period, what they will see is a tragedy of denial….
POST 43. August 22, 2020. CORONAVIRUS.” “we’ve achieved something great as a nation. We’ve created an unyielding market for FAUCI BOBBLEHEADS”!! (W)
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 53. October 20, 2020. CORONAVIRUS. “a…“herd-immunity strategy” is a contradiction in terms, in that herd immunity is the absence of a strategy.”
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
Post 56. October 30, 2020. CORONAVIRUS. “Trump’s now back in charge. It’s not the doctors.”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 60. November 7, 2020. “White House chief of staff Mark Meadows has tested positive for the coronavirus….” (A)
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 80. November 29, 2020. CORONAVIRUS. Op-Ed in the Jersey Journal. Do you know which hospital is right for you if you have coronavirus? | Opinion
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
POST 93. December 19, 2020. CORONAVIRUS. On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?
POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”
POST 95. December 23, 2020. “The Murphy administration may step in to force (New Jersey) hospitals to report COVID-19 outbreaks among staff.”
POST 96. December 26, 2020. CORONAVIRUS. “Achieving herd immunity against the coronavirus could require as much as 90 percent of the population to be vaccinated, Anthony Fauci…”…”..he hesitated to state a number as high as 90% weeks ago because many Americans still seemed skeptical about vaccine….”
POST 97. December 27, 2020. “A new variant of the coronavirus that has been spreading through the UK and other countries has not yet been detected in the United States..”.. . But if new-wave medicines like antivirals and antibody therapy contributed to the development of viral variants, it will be “a reminder for all the medical community that we need to use these treatment options carefully.”
POST 98. December 28, 2020. CORONAVIRUS. “Governor Andrew Cuomo announced new penalties in order to rein in possible vaccination fraud…
POST 99. December 29, 2020. CORONAVIRUS. “ICUs are being overwhelmed across many parts of California. Statewide aggregate ICU availability has been at 0% since Christmas Eve…. a surge on top of a surge on top of a surge.”… “hospitals are getting close to the point where they would begin putting COVID-positive patients under the care of COVID-positive staff who are asymptomatic.”
POST 100. December 29, 2020. CORONAVIRUS. Front line hospital workers – in the ER, ICUs, EMS, acute medical care, behavioral health – are amongst the most courageous, heroic and dedicated colleagues you will ever meet.
POST 101. December 30, 2020.CORONAVIRUS. Is there a point where the increasing Coronavirus trajectory so far exceeds the slow growth of the vaccination rate that reaching herd immunity through vaccinations becomes less likely?
POST 102. January 2, 2020. CORONAVIRUS. “We’ve taken the people with the least amount of resources and capacity and asked them to do the hardest part of the vaccination — which is actually getting the vaccines administered into people’s arms,” said Dr. Ashish Jha, the dean of Brown University’s School of Public Health. “Ultimately, the buck seems to stop with no one,”…
POST 103. January 4, 2021. CORONAVIRUS. Dr. Fauci said “that the United States would not follow Britain’s lead in front-loading first vaccine injections, potentially delaying the administration of second doses…Dr. Moore – ”British officials “seem to have abandoned science completely now and are just trying to guess their way out of a mess.”
POST 104. January 6, 2021. CORONAVIRUS. “Paramedics in Southern California are being told to conserve oxygen and not to bring patients to the hospital who have little chance of survival…”
POST 105. January 8, 2021. CORONAVIRUS. POST 105. January 8, 2021. CORONAVIRUS. “Facing a shortage of vaccinators, the Association of Immunization Managers… recommends relaxing regulation or adjusting licensing requirements. At least two states, Massachusetts and New York, have changed their laws in recent weeks to expand those who are eligible to give shots.”
POST 106. January 9, 2021. CORONAVIRUS. The riots at the Capitol could have been a superspreader event. “From what I saw… you had a large congregation of individuals who were in close contact for an extended period of time and almost universally unmasked…. many coming and going on buses as well, also unmasked, and hanging out in hotel lobbies.”
POST 107. January 8, 2021. CORONAVIRUS. “Our job is to make sure the vaccine isn’t politicized the way masks were politicized,” Rep. Alexandria Ocasio-Cortez, D-N.Y., said after getting her vaccine. South Carolina Rep.-elect Nancy Mace, a Republican, wrote that “Congress shouldn’t be putting themselves first in line for the COVID-19 vaccination when the average American can’t get it.”
POST 108. January 9, 2021. CORONAVIRUS. (vaccination)”Line-cutters will be named and shamed. It’s inevitable, as will be the congressional hearings and front-page investigative stories ferreting out who saved their own skin at the expense of others.”
POST 109.January 9, 2021. CORONAVIRUS. “President-elect Joe Biden will aim to release nearly every available dose of the coronavirus vaccine when he takes office, a break with the Trump administration’s strategy of holding back half of US vaccine production to ensure second doses are available.
POST 110. January 13, 2021. CORONAVIRUS. ““The (federal) government is changing the way it allocates Covid vaccine doses, now basing it on how quickly states can administer shots and the size of their elderly population.”… “New York State sent a letter to hospitals saying if they don’t use their vaccine allocations by the end of this week, they won’t receive any further allocations.”
POST 111. January 14, 2021. CORONAVIRUS. “Visitors from Toronto to New York to Buenos Aires have long flocked to Florida for sun, surf and shopping. Now they are coming for the Covid-19 vaccine….
POST 112. January 14, 2021. CORONAVIRUS. CHINA – “Eleven million people are under lockdown in Hebei province after a new cluster of coronavirus infections.
PART 113. January 17, 2021. CORONAVIRUS. The Next President Actually Has a Covid Plan… New York City and other places in the state expect to exhaust their supply of doses as early as next week… Charles Barkley said during the “NBA on TNT” broadcast that pro athletes should get the first round of the vaccine…..
POST 114. January 18, 2021. CORONAVIRUS. “When government programs that have been unattended, underfunded and bogged down by red tape suddenly have to meet a huge demand in a crisis, they can’t cope and people suffer….”
POST 115. January 21, 2020. CORONAVIRUS. A year ago today an unnumbered POST was headlined “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.” The CORONAVIRUS CONTENT TRACKING PROJECT started with HISTORIOGRAPHY and over time moved to LESSONS LEARNED, RAPID RESPONSE, and THE VACCINATION PROGRAM. Now 115 POSTS later – the BIDEN CORONAVIRUS PLAN.
POST 116. January 22, 2021. President Biden – “We’re entering what may be the toughest and deadliest period of the virus. We must set aside politics and finally face this pandemic as one nation.”
POST 117. January 23, 2021. CORONAVIRUS. 1.Dr. Fauci:“The idea that you can get up here….”and.. let the science speak”… “It is somewhat of a liberating feeling.” 2.updated CDC guidance:”.. providers could give the second dose up to six weeks after the first dose..” 3.Dr. Fauci: people would be “taking a chance” if they follow the CDC’s updated guidance.
POST 118. January 24, 2021. CORONAVIRUS. “Unfortunately, we’ve let this virus spread extensively and are launching the vaccination campaign at the height of the threat,” Dr. Meyers said. “The more the virus spreads before the vaccine reaches people, the fewer deaths we can prevent with the vaccine.”
POST 119. January 27, 2010. CORONAVIRUS. Amazon is offering its help to President Joe Biden with the rollout of COVID-19 vaccines. Washington’s governor, Jay Inslee, included the help of companies like Starbucks, Costco and Microsoft in a plan to vaccinate 45,000 residents a day.
POST 120. January 28, 2021. CORONAVIRUS. “The fact that four vaccines backed by the federal government seem to be less effective against the (South African) B.1.351 variant has unsettled federal officials and vaccine experts alike. Facing this uncertainty, many researchers said it was imperative to get as many people vaccinated as possible — quickly. Lowering the rate of infection could thwart the contagious variants while they are still rare, and prevent other viruses from gaining new mutations that could cause more trouble.”
POST 121. January 30, 2021. CORONVIRUS. Will our communities become stratified by which vaccine is distributed? 95%ters v. 72%ters? Will the easier distribution of the J&J vaccine drive its inequitable distribution to” hard-hit, marginalized, and medically underserved communities.” (thanx! to XJ/LA)
POST 122. February 1, 2021. CORONAVIRUS. Dr.Fauci endorses double-masking. Dr.Osterholm disagrees!
POST 123. February 4, 2021. CORONAVIRUS. “Nursing homes across the country are facing the same struggle, as workers have been more reluctant than residents to be vaccinated…
POST 124. February 5, 2021. CORONAVIRUS. Dr. Osterholm ” …it may be time to..go with a ‘first-dose only’ approach, so more people over the age of 65 can have at least some protection right away. He said that would require delaying second doses until this summer.” Dr.Fauci “warned against this practice, and cautioned people about “the danger” that could come with focusing only on the first dose.”
POST 125. June 9, 2021. CORONAVIRUS. “States are rolling back Covid-19 restrictions as new cases trend down from record highs across the country. But experts warn it might be too much too soon as variants pose an increased risk and the pandemic… is far from over.”
POST 126. February 11, 2021. CORONAVIRUS. “There will be more coronavirus outbreaks in the future. Bats and other mammals are rife with strains and species of this abundant family of viruses. Some of these pathogens will inevitably spill over the species barrier and cause new pandemics. It’s only a matter of time.” (A)
POST 127. February 12, 2021. CORONAVIRUS. “… Trump only agreed to be hospitalized when aides told him that he could walk to Marine One or he could wait until his case progressed and he would be carried out.”
POST 128. February 14, 2021. CORONAVIRUS. “The Centers for Disease Control and Prevention released new research on Wednesday that found wearing a cloth mask over a surgical mask offers more protection against the coronavirus, as does tying knots on the ear loops of surgical masks…
POST 129. February 15, 2021, CORONAVIRUS. “ “The CDC released its much-anticipated, updated guidance to help school leaders decide how to safely bring students back into classrooms, or keep them there.”…” For politicians, parents and school leaders looking for a clear green light to reopen schools, this is not it.”
POST 130. February 16, 2021. CORONAVIRUS. “A second person who had contracted the Ebola virus died this week in the Democratic Republic of Congo, marking another outbreak just three months after the nation outlasted the virus’s second-worst outbreak in history…”
POST 131. February 17, 2021. CORONAVIRUS. “It really is right now – a race between how quickly new variants, particularly the U.K. variant, can spread in the United States and how quickly we can get people vaccinated”
POST 132. February 20, 2021. CORONAVIRUS. “In Texas, where over 2.5 million people are still without power, the state health department said this week’s vaccine shipments wouldn’t arrive until Wednesday at the earliest.”
POST 133. February 23, 2021. CORONAVIRUS. “Going off your meds is a surefire way to aggravate your doctor. What if a whole country did it?” The United Kingdom has veered into uncharted territory by changing tack and introducing a revised COVID-19 vaccination protocol, one that involves distributing the second dose at 12 weeks, rather than the prescribed 21 days.”
POST 134. February 24, 2021. CORONAVIRUS. The first tranche of the J&J (single dose) vaccine must go to K-12 teachers, so schools can open safely in the first 100 days of the Biden Administration. The federal government…”can set up its own vaccination centers in regions with eligible populations it’s trying to target.” We owe our front-line teachers nothing less!
POST 135. February 27, 2021. CORONAVIRUS. “As Chief Executive Officers of New York’s major health care systems, we would like to provide facts to clear up confusion in the public and the media regarding decisions to discharge patients to nursing homes during New York’s spring coronavirus surge.”
POST 136. March 2, 2021. CORONAVIRUS. ““The governors of Texas and Mississippi both announced on Tuesday they would be lifting their states’ mask mandates and rolling back many of their Covid-19 health mandates..”…while “The US could experience a “fourth surge” of coronavirus before the majority of the country is vaccinated.”
POST 137. March 4, 2021. CORONAVIRUS. “The clamor for hard-to-get Covid-19 vaccines has created armies of anxious Americans who have resorted to hunting for leftovers on the fringes of the country’s patchwork vaccination system. They haunt pharmacies at the end of the day in search of an extra, expiring dose. They drive from clinic to clinic hoping that someone was a no-show to their appointment. They cold-call pharmacies like eager telemarketers: Any extras today? Maybe tomorrow? Some pharmacists have even given them a nickname: vaccine lurkers.” (H)
POST 138. March 6, 2021. CORONAVIRUS. “New cases are decreasing in the third wave because we are past the holidays, not because of vaccinations. It is a common misconception that the decrease we are seeing in new cases, hospitalizations, and deaths in the U.S. is due to vaccinations. The two aren’t related; at least yet.”
POST 139. March 8, 2021. CORONAVIRUS. CDC Issues First Set of Guidelines on How Fully Vaccinated People Can Visit Safely with Others…” In practice, that means fully vaccinated grandparents may visit unvaccinated healthy adult children and healthy grandchildren of the same household without masks or physical distancing.” (C)
POST 140. March 9, 2021. CORONAVIRUS. “In West Virginia, they are bracing for the second wave….. Not coronavirus but opioid overdoses, with one scourge driving a resurgence of the other.
POST 141. March 11, 2021. CORONAVIRUS. Today is the first anniversary of the WHO declaration that the novel coronavirus was a Public Health Emergency of International Concern… “To truly prepare itself against the next pandemic, the U.S. has to reimagine what preparedness looks like.”
POST 142. March 15, 2021. CORONAVIRUS. “Candida auris is a superbug, a pathogen that can evade drugs made to kill it—and early signs suggest the COVID-19 pandemic may be propelling infections of the highly dangerous yeast. That’s because C. auris is particularly prominent in hospital settings, which have been flooded with people this year due to the coronavirus.”
March 14 2021
POST 141. March 11, 2021. CORONAVIRUS. Today is the first anniversary of the WHO declaration that the novel coronavirus was a Public Health Emergency of International Concern… “To truly prepare itself against the next pandemic, the U.S. has to reimagine what preparedness looks like.”
for links to POSTS 1-141 in chronological order, highlight and click on https://doctordidyouwashyourhands.com/2021/03/coronavirus-tracking-links-to-posts-1-141/
“At the time there were fewer than 100 cases of the disease we now call Covid-19 and no deaths outside China,” WHO Director-General Tedros Adhanom Ghebreyesus said Friday. “This week we reached one hundred million reported cases. More cases have been reported in the past two weeks than during the first six months of the pandemic. A year ago, I said the world had a window of opportunity to prevent widespread transmission of this new virus. Some countries heeded that call, some did not.”
The rare emergency declaration, also known as a PHEIC, is the highest level of alarm under international law. Only six have ever been declared in history.
It’s supposed to notify the world that urgent action is needed, but experts say the reason “some countries heeded that call, some did not” is because the declaration has no teeth.
The declaration gives the WHO “few surge powers and no funding,” according to Lawrence Gostin, a professor of public health law at Georgetown University and the director of the World Health Organization Collaborating Center on Public Health Law & Human Rights.
“The only power a declared emergency provides is to make ‘recommendations’ to governments. But most governments, especially in the US and Europe, almost universally failed to adhere to (WHO) recommendations,” Gostin said.
The WHO has been evaluating how it can improve the system, and changes could happen during the World Health Assembly in May.
In this second year of the declaration, Gostin and other legal scholars argue that there needs to be urgent reform to give the WHO much stronger authority and more ample funding, if such a declaration is ever to work more effectively in a global health crisis.” (A)
“At the time the WHO declared the virus a pandemic, there had been 118,000 confirmed coronavirus cases reported in 114 countries, resulting in 4,291 deaths, many of those in the Wuhan region of China.
According to Johns Hopkins University’s global coronavirus tracker, more than 117 million cases of the coronavirus have been reported, killing more than 2.6 million people.
In the United States alone 29 million COVID-19 cases have been confirmed, resulting in more than 528,000 coronavirus deaths. At the time, 31 coronavirus deaths were reported in the US with just over 1,000 confirmed cases. But testing was scarce at the time, meaning many cases likely went undetected at the time…
Following the WHO’s announcement, a number of major universities decided to suspend in-person classes, the NCAA announced that its March Madness men’s and women’s basketball tournaments would be held without fans, and governors began limiting access to the nation’s nursing homes.
Later in the evening, a contest between the Utah Jazz and Oklahoma City Thunder was suspended right at tip-off when the Jazz had a player test positive for the virus. The NBA then announced that it was suspending its season.
“It’s, ‘Oh my God.’ The NBA is such an ingrained part of American culture that it almost is sacrosanct. To be able to suspend that means something really, really serious is going on,” Fauci said in a 30 for 30 podcast about the events of March 11.
President Donald Trump announced that most non-essential travel between most of Europe and the US would be suspended.
Then actors Tom Hanks and Rita Wilson both announced they had contracted the virus.
While groceries store had been depleted of hand sanitizer and paper towels for days, the series of announcements on March 11, 2020, was a shocking notice to Americans of the severity of the coronavirus.
In the coming days, states closed schools, non-essential businesses and even places of worship and parks. Hospitals began suspending non-essential procedures. Nearly all sports leagues suspended play, and would not resume for months. Some leagues, such as minor league baseball, have yet to resume since the start of the pandemic.” (B)
“Reflecting on the past year in a new interview with Savannah Guthrie for the Today show on Thursday morning, Dr. Anthony Fauci expressed cautious optimism about what lies ahead for the rest of 2021 while also noting the litany of failures that helped fuel the virus’ spread here in the U.S.
While the virus is “still very much circulating,” Dr. Fauci said there is indeed “light at the end of the tunnel” as the vaccine rollout continues…
Later, Dr. Fauci was asked what his reaction would have been if he had been told one year ago today that the U.S. would ultimately see more than half a million deaths due to the pandemic.
“Well, I have to tell you quite honestly, Savannah, it would have shocked me completely,” he said. “I mean, I knew we were in for trouble … I said it then, ‘we better be really careful.’ In fact, that day at a congressional hearing, I made the statement ‘things are gonna get much worse before they get better’ and that was at a congressional hearing a year ago today.”
Dr. Fauci, however, never imagined that “much worse” would come to mean so many deaths.
Asked what went wrong, particularly earlier in the pandemic, Dr. Fauci explained that “a lot of things” contributed to the dire situation in the U.S. and the full extent of their damage will be studied historically for years to come.
“One of the things I keep harkening back to that you can’t run away from is that we had such divisiveness in our country that even simple, common-sense public health measures took on a political connotation … It wasn’t a pure public health approach,” he said. “It was really very much influenced by the divisiveness that we had in this country.” (C)
“The past year has seen nearly 86 million cases of COVID-19 and more than 1.8 million deaths. In the immediate aftermath of the virus’ global spread, economies around the world were sent reeling, with the World Bank estimating that the global economy would shrink by 5.2 percent by the end of 2020. More than 20 million people lost their jobs in the United States alone, where unemployment reached 14.7 percent in April—the highest level of unemployment since the Great Depression. Just last month, the United Nations warned that the loss of jobs and income threatens to push a billion people—nearly one-eighth of the world’s population—into extreme poverty, erasing decades of progress on poverty reduction in an instant. Reports of discrimination and xenophobia, against people of Asian descent, refugees and other groups inaccurately perceived as being more likely to spread COVID-19, are on the rise and hampering disease control efforts, according to the United Nations. The pandemic has also strained governments at all levels and impaired the work of international organizations. (D)
“Even though pandemic preparedness and biodefense have had ardent and clarion supporters, namely Bill Gates and the first Secretary for Homeland Security Tom Ridge, COVID-19 proved how ill-prepared we were to combat a 100-year pandemic. It is not too early to draw lessons from this lack of preparation and global coordination. Not only will doing so aid current recovery efforts, but it would also increase readiness for the next communicable or vector-borne disease to threaten the world. Below are seven areas of opportunity to learn from our COVID-19 response and improve readiness for future pandemic shocks…
There is an adage in management circles that if you do not measure something, you cannot manage it. In fighting the spread of COVID-19, data and science should be the most critical elements of decision making. Unfortunately, the void of reliable real-time information has been a global challenge during the COVID-19 crisis. This has been particularly true in the U.S., where different states have each pursued varying degrees of transparency, accuracy, accountability, and, critically, methodologies, with regards to reporting infection and casualty rates. In some instances, low-levels of technological processes like the limits of Excel spreadsheets or the specter of keystroke errors, have created misreporting and miscalculation on the number of confirmed cases, as well as the prevalence of community spread.” (F)
“The pandemic will end not with a declaration, but with a long, protracted exhalation. Even if everything goes according to plan, which is a significant if, the horrors of 2020 will leave lasting legacies. A pummeled health-care system will be reeling, short-staffed, and facing new surges of people with long-haul symptoms or mental-health problems. Social gaps that were widened will be further torn apart. Grief will turn into trauma. And a nation that has begun to return to normal will have to decide whether to remember that normal led to this. “We’re trying to get through this with a vaccine without truly exploring our soul,” said Mike Osterholm, an epidemiologist at the University of Minnesota….
After the post-9/11 anthrax attacks in 2001, fears of bioterrorism encroached on American attitudes toward naturally emerging diseases. Preparedness was framed with the rhetoric of national security. Health experts developed surveillance systems for disease, simulated epidemics in war games, and focused on fighting outbreaks in other countries. “This came at the expense of investment in public health, equity, and housing—boringly crucial sectors that actually support human wellness,” Lincoln said. “One cannot prevent a pandemic by preparing for a war, but that is exactly what the U.S. has been doing.”
To truly prepare itself against the next pandemic, the U.S. has to reimagine what preparedness looks like. Every epidemic is different, as new pathogens with unique characteristics emerge from different regions. But those pathogens eventually test the same health systems and expose the same historical inequities. Think of epidemics as a million rivers that must all flow through the same lake. The U.S. has been trying to dam the rivers. It has to focus on the lake…
In The Past Is a Foreign Country, the historian David Lowenthal wrote, “The art of forgetting is a high and delicate enterprise … It can be a process of social catharsis and healing or one that sanitises and eschews the past.” The choice between those options is now before us, as the coronavirus pandemic enters its second full year. As Americans get vaccinated, they must decide whether to remember the people who sacrificed to keep stores open and hospitals afloat, the president who lied to them throughout 2020 and consigned them to disaster, the families still grieving, the long-haulers still suffering, the weaknesses of the old normal, and the costs of reaching the new one. They must decide whether to resist the decay of memory and the elision of history—whether to forget, or to join the many who will never be able to.” (G)
“Seeking to comfort Americans bound together by a year of suffering but also by “hope and the possibilities,” President Biden set out concrete steps to build on the progress so far, starting with a requirement that states act by May 1 to make all adults eligible to be vaccinated. The administration had already announced last week that it would have enough doses to begin inoculating every adult by the end of May. Mr. Biden said that Americans should expect to get in line for a vaccine by May 1, but not to expect to have been vaccinated.
He said the federal government would also create a website that would allow Americans to search for available vaccines, make the vaccine available at more pharmacies, double the number of mass vaccination sites and certify more people — including dentists, paramedics, veterinarians and physician assistants — to deliver shots into arms.” (H)
(A)On the anniversary of Covid-19 becoming an official public health emergency, experts say it’s time for a change, By Jen Christensen, https://www.cnn.com/2021/01/30/health/covid-19-public-health-emergency-first-anniversary/index.html
(B) March 11, 2020: After the WHO declared COVID-19 a pandemic, the world came to a screeching halt, by Justin Boggs, https://www.thedenverchannel.com/news/national/coronavirus/march-11-2020-after-the-who-declared-covid-19-a-pandemic-the-world-came-to-a-screeching-halt
(C) Dr. Fauci Reflects on One-Year Anniversary of COVID-19 Being Declared Pandemic, by Trace William Cowen, https://www.complex.com/life/dr-fauci-reflects-on-one-year-anniversary-of-covid-19-being-declared-pandemic
(D)Three Public Health Lessons From Year One of COVID-19, by Jeremy Youde, https://www.worldpoliticsreview.com/articles/29327/what-the-coronavirus-has-taught-us-about-fighting-pandemic-disease
(E) A Timeline of COVID-19 Developments in 2020, by AJMC Staff, https://www.ajmc.com/view/a-timeline-of-covid19-developments-in-2020
(F) Preparing for the next pandemic: Early lessons from COVID-19, by Dante Disparte, https://www.brookings.edu/research/preparing-for-the-next-pandemic-early-lessons-from-covid-19/
(G) Where Year Two of the Pandemic Will Take Us, by Ed Yong, https://www.theatlantic.com/health/archive/2020/12/pandemic-year-two/617528/
(H) Biden Tells Nation There Is Hope After a Devastating Year, By Katie Rogers, https://www.nytimes.com/2021/03/11/us/politics/biden-coronavirus.html?referringSource=articleShare
This is an updated look at how the pandemic progressed throughout 2020.
January 9 — WHO Announces Mysterious Coronavirus-Related Pneumonia in Wuhan, China
January 20 — CDC Says 3 US Airports Will Begin Screening for Coronavirus
January 21 — CDC Confirms First US Coronavirus Case
January 21 — Chinese Scientist Confirms COVID-19 Human Transmission
January 23 — Wuhan Now Under Quarantine
January 31 — WHO Issues Global Health Emergency
February 2 — Global Air Travel Is Restricted
February 3 — US Declares Public Health Emergency
February 10 — China’s COVID-19 Deaths Exceed Those of SARS Crisis
February 25 — CDC Says COVID-19 Is Heading Toward Pandemic Status
March 6 — 21 Passengers on California Cruise Ship Test Positive
March 11 — WHO Declares COVID-19 a Pandemic
March 13 — Trump Declares COVID-19 a National Emergency
March 13 — Travel Ban on Non-US Citizens Traveling From Europe Goes Into Effect
March 17 — University of Minnesota Begins Testing Hydroxychloroquine
March 17 — CMS Temporarily Expands Use of Telehealth
March 17 — Administration Asks Congress to Send Americans Direct Financial Relief
March 19 — California Issues Statewide Stay-at-Home Order
March 24 — With Clinical Trials on Hold, Innovation Stalls
March 25 — Reports Find Extended Shutdowns Can Delay Second Wave
March 26 — Senate Passes CARES Act
March 27 — Trump Signs CARES Act Into Law
March 30 — FDA Authorizes Use of Hydroxychloroquine
March 31 — COVID-19 Can Be Transmitted Through the Eye
April 8 — Troubles With the COVID-19 Cocktail
April 16 — “Gating Criteria” Emerge as a Way to Reopen the Economy
April 28 — Young, Poor Avoid Care for COVID-19 Symptoms
April 29 — NIH Trial Shows Early Promise for Remdesivir
May 1 — Remdesivir Wins EUA
May 9 — Saliva-Based Diagnostic Test Allowed for At-Home Use
May 12 — Death Toll Likely Underestimated, Fauci Testifies
May 21 — United States and AstraZeneca Form Vaccine Deal
May 28 — US COVID-19 Deaths Pass the 100,000 Mark
June 4 — Lancet, NEJM Retract COVID-19 Studies on Hydroxychloroquine
June 10 — US COVID-19 Cases Reach 2 Million
June 16 — HHS Announces COVID-19 Vaccine Doses Will Be Free for Some
June 18 — WHO Ends Study Into Hydroxychloroquine
June 20 — NIH Halts Trial of Hydroxychloroquine
June 22 — Study Suggests 80% of Cases in March Went Undetected
June 26 — White House Coronavirus Task Force Addresses Rising Cases in the South
June 29 — Gilead Sets Price for Remdesivir at $3120
June 30 — Fauci Warns New COVID-19 Cases Could Hit 100,000 a Day
July 2 — States Reverse Reopening Plans
July 6 — Scientists, Citing Airborne Transmission, Ask WHO to Revise Guidance
July 7 — CMS Plans to Pay More for Home Dialysis Equipment
July 7 — US Surpasses 3 Million Infections, Begins WHO Withdrawal
July 9 — WHO Announces COVID-19 Can Be Airborne
July 14 — States With COVID-19 Spikes Report Greatest Health Insurance Coverage Losses
July 14 — Early Moderna Data Point to Vaccine Candidate’s Efficacy
July 15 — New Hospital Data Reporting Protocol Prompts Concern
July 16 — US Reports New Record of Daily COVID-19 Cases
July 20 — Diagnostic Delays From COVID-19 May Increase Cancer-Related Deaths
July 21 — Vaccines From AstraZeneca, CanSino Biologics Show Promising Results
July 22 — HHS, DOD Announce Vaccine Distribution Agreement With Pfizer and BioNTech
July 23 — Antibody Levels Drop After First 3 Months of COVID-19 Infection
July 23 — Antibody Cocktail May Treat, Prevent COVID-19
July 27 — Moderna Vaccine Begins Phase 3 Trial, Receives $472M From Trump Administration
July 27 — Senate Introduces HEALS Act
July 29 — FDA Grants Truvian EUA for Rapid Antibody Test
August 3 — New US Pandemic Phase; US to Pay Sanofi, GlaxoSmithKline $2B for Vaccine
August 4 — Rural Hotspots Face Lack of Intensive Care Unit Beds
August 7 — Talks Stall on Second Relief Package
August 11 — Trump Administration Reaches Deal With Moderna
August 12 — Severe Obesity Increases Mortality Risk From COVID-19
August 13 — Biden Calls for 3-Month Mask Mandate
August 15 — FDA Approves Saliva Test
August 17 — COVID-19 Now the Third-Leading Cause of Death in the US
August 23 — Convalescent Plasma Is Cleared for Use by FDA
August 24 — Remdesivir’s Clinical Benefits Questioned
August 25 — CDC Changes Testing Guidance, but Later Reverses Itself
August 26 — FDA Grants EUA to Abbott’s Rapid Test
August 28 — First Known Case of COVID-19 Reinfection Reported in the US
September 1 — US Rejects WHO Global COVID-19 Vaccine Effort
September 3 — Steroids Reduce Mortality in Severe Cases; Sanofi, GSK Begin Human Vaccine Trials
September 3 — Bioethicists Weigh In on Equitable Vaccine Distribution
September 8 — AstraZeneca Halts Phase 3 Vaccine Trial
September 14 — US Airports Stop Screening International Travelers
September 14 — Pfizer, BioNTech Expand Phase 3 Trial
September 14 — NIH Launches Investigation Into Halted Astrazeneca Trial
September 15 — CDC Reports on Spread of COVID-19 at Restaurants
September 16 — Trump Administration Releases Vaccine Distribution Plan
September 17 — Europe Reports Rising COVID-19 Cases
September 21 — CDC Pulls Guidance Saying COVID-19 Transmission Is Airborne
September 21 — Johnson & Johnson Begins Phase 3 Vaccine Trial
September 23 — A New, More Contagious Strain of COVID-19 Is Discovered
September 25 — Midwest States See Increase in COVID-19 Cases
September 28 — Global COVID-19 Deaths Surpass 1 Million
September 29 — HHS to Distribute 100 Million Rapid Tests to States
September 29 — Regeneron Announces Positive Results for Monoclonal Antibody Treatment
October 2 — Trump, First Lady Test Positive for COVID-19; Trump Enters Hospital
October 5 — Trump Leaves Hospital, Continues Receiving Treatment
October 8 — NEJM Criticizes Trump’s COVID-19 Response; 39 States See Case Spikes
October 8 — More Americans Trust Biden to Lead Health Care System
October 8 — White House COVID-19 Outbreak Grows to 34
October 9 — US Signs Deal With AstraZeneca
October 12 — Johnson & Johnson Halts Vaccine Trial
October 15 — US Cases Spike Again; Studies Connect Blood Type and COVID-19 Risk
October 19 — Global Cases Top 40 Million
October 22 — FDA Approves Remdesivir as First COVID-19 Drug
October 23 — AstraZeneca and Johnson & Johnson Announce Restart of COVID-19 Vaccine Trials
October 28 — CMS Issues Vaccine, Treatment Coverage Rules
November 4 — US Reports Unprecedented 100,000 Cases in 1 Day
November 5 — Study Predicts Difficulties in Nationwide COVID-19 Immunity
November 9 — President-Elect Biden Announces COVID-19 Transition Team; Pfizer Publishes Vaccine Results
November 9 — FDA Issues EUA for Eli Lilly’s Antibody Treatment
November 11 — Indoor Venues Responsible for Much of COVID-19’s Spread
November 16 — Moderna Reveals Vaccine Efficacy Results
November 16 — FDA to Move Rapidly on EUAs for Pfizer, Moderna Vaccines
November 17 — Fauci Highlights the Need for Long-term Follow-up of COVID-19 Effects
November 18 — Pfizer, BioNTech Vaccine Is 95% Effective
November 20 — Pfizer, BioNTech Submit EUA Application; CDC Warns Against Holiday Travel
November 23 — AstraZeneca Reports Vaccine Is 90% Effective; FDA Grants EUA for Second Antibody Treatment
December 10 — FDA Advisory Panel Recommends Pfizer, BioNTech COVID-19 Vaccine
December 11 — FDA Agrees to EUA for COVID-19 Vaccine From Pfizer, BioNTech
December 17 — FDA Panel Backs Moderna COVID-19 Vaccine
December 18 — FDA Signs Off on EUA for Moderna’s COVID-19 Vaccine
December 21 — New COVID-19 Variant Circling the UK
December 23 — US Buys More Pfizer Vaccine
December 28 — Novavax Starts Phase 3 Trial of COVID-19 Vaccine
December 29 — First US Case of New COVID-19 Variant Found in Colorado
December 30 — UK Approves Emergency Authorization for the AstraZeneca and Oxford COVID-19 Vaccine
December 31 —US Falls Short of Goal to Give 20 Million Vaccinations by Year End (E)
CORONAVIRUS TRACKING Links to POSTS 1-141
POST 140. March 9, 2021. CORONAVIRUS. “In West Virginia, they are bracing for the second wave….. Not coronavirus but opioid overdoses, with one scourge driving a resurgence of the other.
to read links to POSTS 1-140 in chronological order highlight and click on https://doctordidyouwashyourhands.com/2021/03/coronavirus-tracking-links-to-posts-1-140/
Covid-19 has claimed 93 lives in West Virginia over the past three months. That is only a fraction of those killed by drug overdoses, which caused nearly 1,000 deaths in the state in 2018 alone, mostly from opioids but also methamphetamine (also known as meth).
That year was better than the one before as the Appalachian state appeared to turn the tide on an epidemic that has ravaged the region for two decades, destroying lives, tearing apart families and dragging down local economies.
Now coronavirus looks to be undoing the advances made against a drug epidemic that has claimed close to 600,000 lives in the US over the past two decades. Worse, it is also laying the ground for a long-term resurgence of addiction by exacerbating many of the conditions, including unemployment, low incomes and isolation, that contributed to the rise of the opioid epidemic and “deaths of despair”.
“The number of opioid overdoses is skyrocketing and I don’t think it will be easily turned back,” said Dr Mike Brumage, former director of the West Virginia office of drug control policy.
“Once the tsunami of Covid-19 finally recedes, we’re going to be left with the social conditions that enabled the opioid crisis to emerge in the first place, and those are not going to go away.”
To Brumage and others, coronavirus has also shown what can happen when the government takes a public health emergency seriously, unlike the opioid epidemic, which was largely ignored even as the death toll climbed into the hundreds of thousands…
Public health officials from Kentucky to Florida, Texas and Colorado have recorded surges in opioid deaths as the economic and social anxieties created by the Covid-19 pandemic prove fertile ground for addiction. In addition, Brumage said significant numbers of people have fallen out of treatment programmes as support networks have been yanked away by social distancing orders.
“I’m a firm adherent to the idea that the opposite of addiction is not sobriety, the opposite of addiction is connection. Clearly, what we have lost with the pandemic is a loss of connection,” he said….
You can think of Covid-19 as a hurricane whereas the opioid crisis is more like global warming. It’s happening, it’s slow, it’s dangerous. “(A)
“More than 2 million Americans struggle with opioid use disorder, and about 130 Americans on average die every day from an opioid overdose. Opioids account for a majority of drug overdose deaths, the leading cause of accidental death in the US. It’s a crisis that’s been a priority for officials at the federal, state and local levels for years.
Now, the coronavirus has disrupted all matters of life across the country — including efforts to combat the nation’s opioid problem.
Some who struggle with substance abuse are homeless or incarcerated and can’t comply with social distancing guidelines, while those who can are left isolated and at risk. On top of all that, the pandemic is causing massive stress — a primary driver of relapse…
There are a few reasons that experts are concerned about a potential coronavirus-related increase in opioid overdoses.
For one, harm reduction programs across the country have been experiencing reduced capacity given the pandemic, Heller said.
Though many states have defined such services as essential in their stay-at-home orders, some programs have had to restrict access or reduce staffing because of a lack of funding or personal protective equipment for their workers.
Federal agencies have eased some regulations that have mitigated the risks of overdoses and Covid-19 infection, Heller said.
For example, patients receiving medication-assisted treatment for opioid use disorder often have to visit a provider daily for a dose of methadone. But because such visits could expose both patients and health care workers to Covid-19, the Substance Abuse and Mental Health Services Administration (SAMHSA) is temporarily allowing treatment programs to provide patients with two to four weeks’ worth of methadone doses to take home.” (B)
U.S. opioid overdoses increased 29% in 2020 amid the COVID-19 pandemic, a study finds…
According to latest research, the opioid epidemic did not disappear. Rather, it lurked in the shadows of the coronavirus pandemic, growing in strength and taking advantage of a society now more susceptible than ever.
In a large cross-sectional study published in JAMA Psychiatry on Feb. 3 that analyzed nearly 190 million emergency department (ED) visits, researchers found significantly higher rates of visits to EDs for opioid overdoses during the months of March to October 2020 when compared against the same dates in 2019. The study found that, from mid-April onward, the weekly rates of ED visits for drug overdoses increased by up to 45% when compared against the same period in 2019.
Overall ED visits for opioid overdoses were up 28.8% year over year.
While some survived these overdoses, many others were not so lucky….
The CDC said in December that the rate of overdose deaths was accelerating during the pandemic, driven by synthetic opioids, which rose 38.4% during the year leading up to June 2020.
Opioid overdoses do not exist in a vacuum; rather, any force that threatens mental health leaves society more susceptible to the threat of addictions. For some, this force may be the fear of contracting COVID-19. For others, the stress of losing a job. And still others, the boredom of being trapped in your home with nothing to do.
“The disruption to daily life due to the COVID-19 pandemic has hit those with substance use disorder hard,” said former CDC director Dr. Robert Redfield, in December.
This same JAMA Psychiatry study found that emergency department visits for mental health conditions, intimate partner violence, and child abuse and neglect increased during the same time period as did suicide attempts.
While many lives were saved with stay-at-home orders, these savings were not without cost. While vaccines appear to have provided a light at the end of this COVID-19 tunnel, America will need to face its growing problem of social isolation and mental illness in the age of the internet, experts say.
“Social distancing has forced many 12 Step programs, such as Alcoholics Anonymous, to suspend their meetings. The need for an effective treatment for substance abuse has never been greater,” said Linville M. Meadows, M.D., a physician and author on addictions.” (C)
“Numerous factors may be contributing to increased use of certain non-prescribed drugs and dangerous drug combinations during the pandemic. At the onset of the pandemic, to help stop the spread of COVID-19 and prevent further deaths in health care settings, the CDC recommended that health care systems delay elective care.5 Although necessary to help mitigate the spread of the pandemic, these orders appear to have led to one of the most dramatic changes brought on by the convergence of the drug epidemic and the COVID-19 pandemic—the temporary discontinuation of testing for drug and alcohol misuse. The result is that many clinicians continue to prescribe controlled substances without drug testing and are therefore “flying blind,” lacking objective evidence to assess their patients for potential drug misuse.” (D)
“The pandemic is in many ways a perfect storm for anyone who is struggling with substance use disorder. People have lost their jobs. Social and family interactions have been limited. And the pandemic itself is depressing and anxiety provoking. These are all stimuli that can stress the psyche and the finances of someone who has an addiction. In some cases, it could push a person who was getting their addiction under control back toward substance use. In other cases, the pandemic might be the trigger that actually makes someone consider initiating drug use, which could end up becoming an addiction and being harmful.
Another point to consider is that the pandemic took away the attention—from the media, from legislators, from public health agencies—that was being focused on the opioid crisis. We have an addiction crisis in the U.S. that was being discussed quite a bit in 2019 and it seemed like we were starting to inch toward policy solutions. Now it feels like we need to start over again.” (E)
“Absent meaningful and immediate change, the medical community has an opportunity to step up and address the opioid epidemic head on: Large employers of physicians should require their doctors to possess the federal waiver that would allow them to prescribe Food and Drug Administration-approved medications to treat addiction. Physician groups require doctors to have a state medical license and a federal Drug Enforcement Administration license as a condition of employment. Yet, most physician employers do not even ask if their physicians hold the Drug Addiction Treatment Act of 2000 X-waiver required to prescribe buprenorphine, thereby offering tacit approval of a physician’s inability to adequately treat patients with substance use disorder.
As a result of this gross oversight, we are living in a time when only 7 percent of doctors can effectively treat opioid use disorder, and it should be no surprise that only about 10 percent of people in need of addiction medicine in the US receive adequate treatment. All this despite the requisite training being ubiquitous and available for free, including online. The opt-out remains squarely on the table thanks to the medical industry’s failure to normalize this credential.
Most doctors today are employed by large, consolidated groups. And in many areas, only a single hospital is present. Even a narrow requirement, focused specifically on emergency medicine providers, internists, and primary care physicians, could create treatment on demand virtually overnight, especially in the 42 percent of US counties that have no buprenorphine prescribers and where access is almost non-existent…
And we cannot have an honest dialogue on this topic without talking money. It is the reason hospital systems and health care institutions have been slow to build these capabilities. The case is simple: Why compel your doctors to do something that isn’t well-reimbursed or otherwise required? Why risk offending your highest-paid and hardest-to-recruit employees for something that won’t make the biggest profit? Behavioral health is not a hill on which any hospital CEO is willing to die. And it’s not the CEO’s fault: The gulf between payment for physical health care versus addiction and mental health services is only worsening…
Without question, the broader barriers to treatment access should be diminished or eliminated altogether via the legislative pathways currently being explored—but those efforts will take time and the system will still need greater numbers of professionals who can prescribe the requisite medications. The medical community now has an opportunity to be an intentional, proactive part of the solution. If we take these steps now, when the next generation asks how we were able to manage an epidemic amidst a pandemic, we’ll be able to say that we took meaningful action simultaneously on two fronts—and saved countless lives in doing so.” (F)
- A.’Opioid overdoses are skyrocketing’: as Covid-19 sweeps across US an old epidemic returns, by Chris McGreal, https://www.theguardian.com/us-news/2020/jul/09/coronavirus-pandemic-us-opioids-crisis
- B.The opioid epidemic was already a national crisis. Covid-19 could be making things worse, By Harmeet Kaur, https://www.cnn.com/2020/05/07/health/opioid-epidemic-covid19-pandemic-trnd/index.html
- C.Opioid overdoses 29% higher in 2020 than before the pandemic: Study, By Dr. Nicholas Nissen, https://abcnews.go.com/Health/opioid-overdoses-29-higher-2020-pandemic-study/story?id=75785104
- D.The Opioid Epidemic Within the COVID-19 Pandemic: Drug Testing in 2020, by Justin K. Niles, Jeffrey Gudin, Jeff Radcliff, and Harvey W. Kaufman, https://www.liebertpub.com/doi/10.1089/POP.2020.0230
- E.A crisis on top of a crisis: COVID-19 and the opioid epidemic, https://www.hsph.harvard.edu/news/features/a-crisis-on-top-of-a-crisis-covid-19-and-the-opioid-epidemic/
- F.Once The Coronavirus Pandemic Subsides, The Opioid Epidemic Will Rage, Navdeep S. Kang, https://www.healthaffairs.org/do/10.1377/hblog20200407.290720/full/