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.”
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 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 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 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 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 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 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 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…”
“One of Virginia’s top health officials is warning medical providers about a growing number of COVID-19 outbreaks in state hospitals.
Health Commissioner Dr. Norman Oliver released a new clinician letter on Friday, writing that reported COVID-19 infections in hospitals have “increased substantially” since August.
“The largest monthly number of hospital COVID-19 outbreaks since the pandemic began was reported in October,” he said. Data from the Virginia Department of Labor and Industry, obtained by the Mercury through a Freedom of Information Act request, shows that more than 10 different hospitals reported COVID-19 cases or hospitalizations among employees between August and October.
Some of those facilities, including Bon Secours St. Mary’s Hospital in Richmond and Sovah Health in Martinsville, were also the subject of employee complaints for not following the state’s emergency COVID-19 safety regulations. Dozens of private health care practices — including dental offices, ear, nose and throat specialists and eye doctors — also reported cases or received complaints.
Sarah Lineberger, manager of the Virginia Department of Health’s health care-associated infections program, said COVID fatigue is likely contributing to the spread in hospitals and health care facilities, which have been on the frontline of the pandemic for months.
“With the increase in community transmission, we think we just really have to get to the basics of infection prevention and control,” she said. “We’re seeing issues with personal protective equipment and the need to remind staff to make sure everyone is social distancing and and following public health guidelines before and after work.”
The fact that many hospital employees were furloughed over the spring and summer and are still getting reacquainted with COVID-19 procedures also complicated efforts to control the virus, Lineberger said. Some hospitals have also relaxed visitor restrictions or may still be operating under emergency protocols when it comes to distributing personal protective equipment…
Oliver called the rise of outbreaks in hospitals especially concerning because the state is also seeing an increase in infections related to multidrug-resistant organisms — bacteria and other germs that don’t respond to antibiotics or other treatments.
“Simultaneous transmission of COVID-19 and multidrug-resistant organisms is occurring in several hospitals and other healthcare facilities across Virginia,” he wrote. Lineberger said that both hospitals and long-term care facilities in Virginia have seen co-occurring outbreaks of the virus and other infections such as Candida auris, a multi-drug resistant fungus that hasn’t been historically common in Virginia.
But recently, the state has been seeing an increasing number of cases, she added — underscoring the need for health care facilities to review and stringently implement infection control procedures.
“We’ve been working with facilities to focus on the basics and make sure they’re thinking about other organisms, not just COVID-19,” Lineberger said. “These are issues that we really tried to drive home with nursing homes and are now coming up in hospitals.”” (A)
“Brigham and Women’s Hospital in Boston is experiencing an outbreak of COVID-19 among patients and staff, which the facility blames partly on lapses in infection control practices by employees.
The hospital, a Harvard Medical School teaching facility, reported on September 28 that, so far, 30 employees and 12 patients tested positive as a result of exposure within the hospital. The outbreak was first detected on September 22, and cases have risen with increased testing. The hospital said it had tested 488 employees and 581 patients as of September 28…
Brigham and Women’s reported that the outbreak may have started with a presymptomatic employee who had mild symptoms that the worker attributed to seasonal allergies. That worker interacted with a patient. Both the patient — who received an aerosol-generating treatment — and the employee later tested positive.
The hospital said its investigation determined other factors that likely fueled the spread, including that many patients were not masked during clinical care and interactions with staff; that clinicians and health care workers were inconsistent in the use of eye protection during patient encounters; and that staff did not observe physical distancing while eating and unmasked…
Pettis said it is only natural at this point in the epidemic that staff might be less diligent with personal protective equipment and other infection control practices.
“I like to call it PPE fatigue,” she said, noting the difficulty of wearing masks and other PPE throughout a shift.
Infection control specialists at hospitals help gauge the appropriateness and functioning of air handling and filtering and monitor staff on PPE-wearing and other infection control measures because “of that tendency to perhaps let your guard down a little,” Pettis explained.
With the potential for people with SARS-CoV-2 to be asymptomatic or presymptomatic, it is “incredibly difficult to have an absolute risk-free environment,” she said.
“Even if you do everything right, there is the potential for [an outbreak] to happen,” Pettis continued, adding that hospitals are required to report hospital-acquired COVID-19 infections to their local health departments, which then report to state health officials, but there is no national repository of such COVID-19 outbreaks.” (B)
“Several causes contributed to Covid-19 outbreaks at Mayo University Hospital including a lack of understanding of the virus and the importance of wearing face masks, a report has found.”
“Two outbreaks last April and May occurred on two inpatient wards leading to 75 confirmed cases, 33 among patients and 42 staff….
It conducted an unannounced visit last September to assess Covid-19 related aspects of management. And while it found the hospital to be either compliant or substantially compliant in five of six areas, it raised concerns over its emergency department and addressed the causes of the earlier outbreaks.
“Contributory factors [to the outbreaks] included key information deficits relating to the nature of the Sars-CoV-2 virus at that time, inclusive of the potential for asymptomatic and pre-symptomatic spread, and the importance of mask wearing to prevent cross-transmission,” it found.
Other factors included a delay in turnaround time for tests (subsequently addressed with increased on-site capability), the absence of proper contact tracing, a lack of appropriate isolation facilities, staff crossover between wards and asymptomatic transmission to staff and patients.
During the course of this inspection, Hiqa noted the hospital had implemented several measures to reduce the likelihood of further outbreaks.
However, it said while affected areas of outbreak wards were subsequently closed, “it was of concern” that other areas of the wards remained open to admissions for two weeks afterwards.
Was there an overcrowding problem?
The hospital was found to be non-compliant with standards governing infection prevention and control, specifically relating to overcrowding in its non-Covid emergency department A, where the original outbreak occurred.
“If further outbreaks are to be avoided the hospital must urgently address ongoing risks through improvements in the wider hospital infrastructure, addressing emergency department overcrowding, and through the early closure of outbreak wards to new admissions.” (C)
“On Wednesday, we learned Providence Medical Center in Everett experienced a small COVID-19 outbreak within the hospital.
A hospital spokesperson confirmed “a small number of patients in one unit tested positive for COVID-19 within a few days of each other.”
The spokesperson told KOMO News the first positive test result came roughly two weeks ago.
“At this point, we do not know if these patients may have had a common source of exposure. The investigation is ongoing, and the findings aren’t definitive,” said the hospital statement.
The statement went on say that all visitations were halted within the unit, patients on the unit were discharged, and the unit is currently closed for investigation.
This is just the latest reported outbreak within a hospital in the Puget Sound region.
This week, Multicare Auburn Medical Center confirmed one patient died and eight other patients were infected with COVID-19 last week after a patient tested positive for the virus on a 4th floor unit.
Five employees also tested positive after the hospital tested hundreds of employees that were in the unit within 14 days prior to the first patient testing positive.
“MultiCare is following all public health recommendations and has the PPE we need for our employees to continue to safely care for all of our patients at Auburn Medical Center and throughout our health system.”
In Bremerton, at St. Michael Medical Center, six more people (four patients and two staff members) recently tested positive. This comes after three patients died and more than 70 others were infected during an outbreak in August…
Outbreaks within hospitals have occurred since the start of the pandemic.
According to the latest DOH report, there have been 350 outbreaks within non-long term care healthcare settings. These include hospitals, outpatient settings, behavioral health facilities, supported living facilities, home healthcare, dialysis centers, and independent senior living facilities.” (D)
“At least 100 employees from Ocean Medical Center in Brick Township have been infected with the coronavirus, according to a memo posted on the hospital parent company’s website that attributed the recent outbreak to “colleagues socializing outside of work.”
A spokesman for Hackensack Meridian Health, which owns the 318-bed hospital in northern Ocean County, declined to say Monday specifically how many employees have been affected.
Visits with patients have been suspended with the exception of labor and delivery, end-of-life care, pediatrics and adult patients with special needs, Hackensack Meridian spokesman Benjamin Goldstein said in a statement.
“We continue to have adequate staffing for both COVID-19 cases and elective surgeries, and follow all rigorous safety protocols established by the CDC and the New Jersey Department of Health,” according to Goldstein’s statement…
Ocean Medical Center was treating 68 confirmed COVID-19 patients while 12 others were awaiting test results, according to the Hackensack Meridian Health website data on Monday.
Hackensack Meridian’s 12 acute-care hospitals, Carrier Clinic and its long-term care facilities were treating a total of 737 confirmed COVID-19 patients and 37 other awaiting test results, according to the website.
A rising number of cases can be found throughout the state, as New Jersey has entered the second wave of the pandemic. There were 2,961 patients with confirmed (2,761) or suspected (263) cases Sunday night — including 575 in intensive care, with 332 on ventilators, Gov. Phil Murphy announced on Monday.
Ed Lifshitz, medical director for the Communicable Disease Service at the Department of Health, said during the governor’s briefing he was aware of the outbreak at the hospital, and noted cases are rising at hospitals around the state. Given the nature of hospitals, with patients and staff “coming and going all the time” Lifshitz said it was harder to contain the virus.
Seven of New Jersey’s 71 acute-care hospitals were on “divert status” Monday night but Ocean Medical Center was not among them.
Goldstein, the hospital chain spokesman, stressed that all employees undergo a temperature check and a “comprehensive screening” before they report to work.
“As a result of COVID-19 being widespread in the community, we are also continually reinforcing our safety guidelines with team members to ensure they are maintaining infection prevention practices both inside and outside of the medical center – frequent hand washing, wearing a mask, physical distancing, and staying home when you are sick,” Goldstein’s statement said.” (E)
“As a New Jersey hospital faced a surge of Covid-19 cases in the spring, another deadly foe was quietly spreading among its patients: a drug-resistant bacterial infection.
The superbug outbreak, detailed in a report published Tuesday by the Centers for Disease Control and Prevention, shows how the coronavirus can overwhelm a hospital, straining care and leaving patients vulnerable to other unwanted outcomes.
Carbapenem-resistant Acinetobacter baumanii, or CRAB, is a drug-resistant bacterium known to spread in hospitals, particularly in intensive care units. It can cause pneumonia as well as wound, blood and urinary tract infections, according to the CDC. Carbapenem, a powerful antibiotic, is ineffective at treating the infection.
Not all patients get sick — in some cases, the bacteria can “colonize” the body, but not cause an infection. These patients can still spread the bacteria to others.
The outbreak was first detected in the unnamed New Jersey hospital on May 28, according to the CDC report. Further investigation by the hospital and the state health department identified a total of 34 patients who had caught the superbug from February to July. Typically, the hospital sees up to two cases a month.
The majority of the cases — 82 percent — occurred in March through June, when the hospital was facing a surge of Covid-19 patients, and with it, severe shortages in necessary staff, supplies and equipment.
The bacteria pose a threat to hospitalized patients because they can survive on surfaces for a long time, according to the CDC. Contaminated surfaces must be rigorously cleaned and disinfected to prevent outbreaks.
Such infection control measures, however, took a hit during the hospital’s Covid-19 surge. Personal protection equipment was reused, for example. Fewer screening tests for the bacteria were given to patients, because of staff shortages and higher-need patients.
The report also noted that before the pandemic, key parts of a ventilator were changed every 14 days. To conserve equipment during the surge, however, the hospital switched to replacing these parts only when they were visibly soiled or malfunctioning.
Twenty-five of the 34 patients either infected or colonized with the bacteria were on ventilators at the time.
Twenty of the 34 patients did become infected, including 11 patients with Covid-19. Fourteen developed a form of pneumonia linked to the bacterial infection, four of whom also had bacteremia, a blood infection. A total of 10 patients died, and one remains hospitalized, according to the report.
It wasn’t until late May that the hospital was able to resume normal operations — and with that, CRAB cases fell.” (F)
“The Murphy administration may step in to force hospitals to report COVID-19 outbreaks among staff as legislation requiring the public disclosure remains stalled in the state capital.
Hospitals have so far evaded the same detailed reporting requirements of nursing homes and schools during the pandemic. But with the second wave of the coronavirus threatening to deplete the state’s health care workforce, Gov. Phil Murphy said Monday that he is “100%” in favor of transparency and it is something his staff is working on.
“I can’t promise you executive action,” Murphy said. “That’s something we’re very seriously looking at. Folks have a right to know what’s going on.”
Later Monday, the state hospital association said it would support the now-stalled measure, pending in the Assembly, that “calls for a transparent reporting process for hospital workers infected with the COVID-19 virus.”
Public posting of information about hospital outbreaks will help “residents of this state feel confident seeking medically necessary care at our facilities,” said Cathleen Bennett, president of the association, which represents 71 acute-care hospitals. The association had added its support to A4129, she said.
But to this point neither the state nor hospitals have offered details on recent outbreaks among staff, which generally mean three positive COVID-19 cases that have a “clear link.”
In the past several weeks, outbreaks have sickened more than 100 health care workers at Ocean Medical Center in Brick, sidelined between 30 and 40 employees of Palisades Medical Center in North Bergen and infected hospital workers at Jersey Shore University Medical Center in Neptune.
The Harborage with is part of the Hackensack Meridian Health Palisades Medical Center in North Bergen, N.J. on Wednesday April 22, 2020.
Murphy’s comments came a day after a story by The Record and NorthJersey.com outlining the lack of data on hospital outbreaks, and just hours after unionized health care workers pressed for the passage of a bill to require that hospitals report to the state positive cases, hospitalizations and COVID deaths among staff members.
That bill was introduced shortly after the first wave subsided and passed unanimously in the Senate, but it has made no progress in the Assembly even after the arrival of the second wave of COVID cases this fall…
Hospitals must report some details to the state, such as the number of admitted COVID patients, ventilator use and how many critical care beds are treating COVID patients. That data has helped to show the evolution of the virus and inform decisions by the governor.
As of Monday, there were 3,346 hospitalizations. At the peak of the first wave in the spring there were about 8,300 people hospitalized with COVID, and New Jersey was “at the edge” on hospital capacity, Murphy said.” (G)
“Hospital systems (and other indoor facilities) should focus on a number of provisions in addition to distributing a sufficient supply of masks to all staff and patients. Adequate, well-ventilated, and ideally dedicated space must be provided for breaks from daily work activities and mealtimes for health care workers, with processes in place to ensure that these are staggered to minimize contact and conversation during these higher-risk periods. Shared patient rooms should be avoided when possible, especially when local prevalence of infection is high, because of the possibility that patients might be admitted during the SARS-CoV-2 incubation period and because they must remove their masks to eat. The marginal benefit of universal eye protection should be evaluated, particularly during clinical encounters. Regular, flexible, and convenient testing with short turnaround times and adequate and statutory sick leave should be made available to all health care workers, with systems in place to ensure progression of training for medical trainees. Through these measures, transmission could be further minimized (and perhaps even eliminated), and emerging evidence could continue to direct policies designed to maintain safety in the hospital setting.” (H)
“A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”
Many parts of that hospital are being converted to COVID-19 wards, and ICU teams are being staffed up with workers from other departments that are temporarily halting services. The doctor, who was not authorized to speak to the media and requested anonymity, said it appears that by early January, the hospital will have to begin rationing care….
Already, UCLA Health is scheduling multiple infectious-disease doctors to be on call at any time, due to the unprecedented numbers of COVID-19 patients needing hospitalization, he said. The biggest issue is that hospitals may quickly run out of providers who can administer ICU-level care and will be forced to draft doctors from other specialties.
“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. It’s the physicians, the nurses, the respiratory therapists, all of the trained people to do that highly specific work that you can’t just pull out of a hat.”…
Many hospitals are preparing for the possibility of rationing care in the coming weeks as the number of patients exceeds their staffs’ abilities to care for them. A document obtained by The Times, outlining how to allocate resources in a crisis situation, was recently circulated among doctors at the four hospitals run by Los Angeles County.
The guidelines call for a shift in mindset that is unfamiliar to many medical providers. Instead of trying everything to save a patient, the goal during a crisis is to save as many patients as possible, meaning those less likely to survive will not receive the level of care they would have otherwise. In other words, doctors will no longer be pulling out all the stops to save a life but, instead, will be strategizing about how to keep as many people as possible from perishing.” (A)
““I’m not going to sugarcoat this. We are getting crushed,” said Dr. Brad Spellberg, chief medical officer at Los Angeles County-USC Medical Center, which has more than 600 beds and is one of the largest in the county.
It’s a scene playing out across California. According to state data Friday, all of Southern California and the 12-county San Joaquin Valley to the north had exhausted their regular intensive care unit capacity and some hospitals have begun using “surge” space….,
Spellberg said that every day for the last week at his hospital has begun with no available intensive care beds and a scramble to find room in spaces that don’t usually handle critical patients, like post-surgery recovery areas.
Los Angeles County Health Services Director Dr. Christina Ghaly said hospitals “are adding three beds to a room that maybe was a double room, or turning a single room into a double room,” dangerously stretching staff.
John Chapman, president and chief executive at San Antonio Regional Hospital in Upland, said telemetry nurses who monitor vital signs of patients should be overseeing no more than four people but could wind up taking on five or six because of the crush of cases.
“It definitely increases the risk of something going wrong,” he said…” (B)
“California’s remaining intensive care capacity is alarmingly low, just 2.1% as of Friday. What happens if that number drops even further and hits 0%? Gov. Gavin Newsom explained in a video update Friday afternoon.
“When you see 0%, that doesn’t mean there’s no capacity, no one’s allowed into an ICU. It means we’re now in our surge phase, which is about 20% additional capacity that we can make available,” Newsom said.
Four alternative care sites have already been set up to help handle overflow patients. The sites are located at Imperial Valley College, Sleep Train Arena in Sacramento, Porterville Developmental Center in Tulare County and Fairview Developmental Center in Orange County.
Some sites are accepting COVID-positive patients while others are just helping decompress local hospitals, Newsom said.” (C)
“Brad Spellberg, the chief medical officer of LA County USC Medical Center — one of the largest hospitals in the state — told NPR member station KPCC that means some patients are waiting hours for care as hospitals struggle to free up beds as quickly as possible.
“We are the safety net — that is the point,” Spellberg said. “The safety net itself is being stretched to the limit.”
Some hospitals are now preparing for the possibility of rationing care in the coming weeks, according a document obtained by the Los Angeles Times. The document, which was circulated among doctors at four hospitals run by Los Angeles County, outlined guidelines on how to allocate resources in a crisis situation, shifting from a goal of trying to save every patient to instead saving as many as possible. This would mean that those less likely to survive would not receive the same care that they would in a non-crisis situation.
“Some compromise of standard of care is unavoidable; it is not that an entity, system, or locale chooses to limit resources, it is that the resources are clearly not available to provide care in a regular manner,” the document reads, according to the Times.
In an email, L.A. County Health Services Director Dr. Christina Ghaly told the Times that the guidelines were not in place as of Friday night.
“We have enough beds, supplies, and equipment for now, but we don’t have enough trained staff for the number of patients who need care. We have brought in new staff, retrained and redeployed staff from other areas of the system, and have requested additional resources from the state,” Ghaly wrote. “But these measures are not anticipated to be enough to meet the continuously escalating number of patients that are presenting across the county for care.”
Last week, California was forced to activate its “mass fatality” program, which coordinates mutual aid across several government agencies. According to the California Office of Emergency Services, a mass fatality is an incident in which more deaths take place in a period of time than can be handled by local coroner or medical emergency personnel.” (D)
“Late Wednesday, the Orange County Health Care Agency issued an order suspending the ability of hospitals that take part in the 911 system to request a diversion of ambulances to other medical centers.
Dr. Carl Schultz, the agency’s EMS medical director, said in a statement that hospital emergency rooms have become so overwhelmed due to the COVID surge that “almost all hospitals were going on diversion.”
“If nothing was done, ambulances would soon run out of hospitals that could take their patients,” Schultz said. Therefore, we temporarily suspended ambulance diversion. While this will place some additional stress on hospitals, it will spread this over the entire county and help to mitigate the escalating concern of finding hospital destinations for ambulances.”
Schultz added: “To the best of our knowledge, this has never happened before.”
On Monday, Schultz issued a memo to authorize ambulance providers to take patients up to 29 years old to Children’s Hospital of Orange, but another memo released Tuesday from Schultz scrapped that.
“Multiple logistic complications have occurred as a result of this directive and it would be in everyone’s best interest to cease this activity, effective immediately,” Schultz said.” (E)
“Tennessee Department of Health officials announced Sunday that the state could “break” its hospital system if a Christmas surge of COVID-19 cases matches that of Thanksgiving.
Commissioner Lisa Piercey said there have been multiple household gatherings where people have been affected statewide, as Thanksgiving surges proved.
Piercey said Tennessee requested National Guard staff in the northeastern system and to the Memphis and Shelby County region to go into the hospitals, not just serve testing services. Five large health care systems across the state have also been given flexibility to allow paramedics to practice inside hospitals.
Workers who have tested positive for COVID-19 and “feel up to the challenge” are now allowed to work in long-term care facilities. The same doesn’t apply to hospitals.
Piercey said the state is running out of options for staffing.
“I tell you this because we are looking under every rock. We are turning over every stone to help hospitals. We are running out of options,” she said.
Piercey said the state did identify more than 700 health care professionals, including some from the education system, who could volunteer or seek employment.
“All of the money in the world can’t buy more staff,” Piercey said. “That money will only go so far. We have spent all the money we can spend on staff. There are no more staff to spend money on.” (F)
“A swamped ICU and escalating COVID-19 crisis forced a turning point at VCU Health last week: The Richmond area’s anchor hospital formally deployed the next level of its surge capacity plan, signaling the end of normal operations to prepare for significant strain on its resources.
In Virginia’s hard-hit Southwest, a front-line physician at Ballad Health said weeks and weeks of escalating numbers are threatening a “second pandemic”: the physical and mental exhaustion of its workforce.
At hospitals across the state, a workforce firm is helping backfill 926 health care jobs, three-fourths of which are for the care of the state’s sickest patients.
A relentless surge in COVID-19 cases is threatening to overwhelm Virginia’s hospitals and health care resources — the front lines of the fight against the coronavirus — before new vaccines can change the course of the pandemic…
The state and hospital association declined to publish the levels for each of the state’s hospitals, but said all of the state’s regions remained at a level one. Carey said Ballad Health and VCU Health were the only hospital systems reporting a level two.
“Normal operations is a level one. Two is contingency. And that is the middle ground where you know that you’re starting to either feel the stress, so you have to alter operations, or you’re anticipating that you could in the very near future. And VCU is a good example of that, whereas Ballad Health would be an example of where they definitely have altered their normal operations,” Carey said.
“Then you have the third level, which is crisis standards of care, and that means there is a true crisis where all of the need cannot be met,” he added. “We pray and we’re working very hard to not get there, where you can’t care for everyone the way you want to.”
Carey was briefed by VCU Health officials on the decision Wednesday. Asked about his reaction, he said: “I would recommend that this is clear evidence that Virginia’s health care system is strained, and it’s not just in far Southwest Virginia.”
One way hospitals are managing staffing challenges is by turning to temporary, contracted staff, like traveling nurses.
Qualivis, a South Carolina-based workforce firm that contracts with the Virginia Hospital and Healthcare Association, is working to fill 926 vacancies across Virginia hospitals, said Sherry Kolb, the firm’s president.
Three-quarters of those jobs are for “high-acuity” positions, meaning they work with the sickest patients. That includes ICU nurses, surgical nurses and telemetry nurses.
Kolb said Virginia’s numbers match nationwide trends. The need for temporary hospital staff to help with shortages has spiked. Before the pandemic, Qualivis was working to fill 10,000 health care jobs nationwide; that number is now 29,000. Most of those are “high-acuity” jobs.” (G)
“California’s most recent stay-at-home order zeroes in on a region’s ability to care for their sickest COVID-19 patients.
But for rural hospitals that don’t have an intensive care unit, administrators say the worsening surge is presenting new challenges.
“The critical access hospital program was designed such that these hospitals would primarily be available to accept and stabilize patients and then transfer those patients to a higher level of care,” said Peggy Broussard Wheeler, vice president of rural health for the California Hospital Association. “Now that is whittling away because the larger facilities are all tremendously impacted by COVID and other patients.”…
Wheeler, with the California Hospital Association, says she’s heard stories from many of the rural member facilities that have had to “MacGyver” solutions to treat COVID-19 patients that a few months ago they might have transferred.
“You now have to ask a nurse or maybe even a physical therapist or a respiratory therapist assigned to the COVID beds to be the deliverer of food so that you’re not exposing other people in your hospital,” she said. “You’re having to do this on the fly to keep those patients safe.”
The hospital association says the larger facilities are hitting a bottleneck with staffing. ICU capacity is measured not just by the number of physical beds, but by who is available to treat critically ill patients.
“A hospital might have beds available for patients but they don’t have the staff to support those patients,” said Read of Plumas District Hospital. “Usually they’ll say ‘we don’t have any beds’, but that’s really not true. They have the beds, they don’t have the staff. So opening up whatever bottleneck exists to have more staff available in our hospitals will be really helpful”
Gov. Gavin Newsom took a step in that direction this week when he loosened the required nurse-to-patient staffing ratio in ICUs. Under the change, a nurse can be assigned to three patients at a time instead of just two. The temporary order also loosens rations in other areas of the hospital.
Nurses unions have criticized the measure, arguing it could lower the quality of care, but the California Hospital Association says it will strengthen facilities’ ability to respond to the pandemic.
“California’s ability to care for COVID-19 patients depends on staff, not beds,” the association wrote in a statement. “Without this temporary staffing flexibility, very sick patients will wait on gurneys in the emergency department until a specially trained ICU nurse is available.”
The state has also deployed medical workers from the California National Guard, asked the federal government for medical personnel, and renewed calls for medical or nursing school students to join the volunteer California Health Corps, which launched earlier this year but initially yielded few qualified workers.” (H)
Colorado officials have said ski industry employees living in congregate settings would be part of the early vaccine rounds.
Vaccine distribution has now entered the political phase. This Post attempts to describe some of these asymmetrical discombobulations!
“Members of the U.S. Congress will be able to get vaccinated for COVID-19 with the distribution of the first tranche of vaccine doses, the congressional physician said on Thursday.
In a letter to members of Congress and their staff, Dr. Brian Monahan said he had been notified by the White House’s National Security Council that Congress “will be provided with a specific number of COVID-19 vaccine doses to meet long-standing requirements for continuity of government operations.”…
“My recommendation to you is absolutely unequivocal: there is no reason why you should defer receiving this vaccine. The benefit far exceeds any small risk,” Monahan said in the letter.
He said once members of Congress are vaccinated, Capitol Hill staff members who are considered essential will be given the vaccine, and then it will be made available to other staff members until the doses run out.” (A)
“Dr Anthony Fauci has said that President Trump ultimately ‘might want to get vaccinated,’ as he praised Mike Pence and the surgeon general, Jerome Adams, for opting to be injected live on television.
Fauci, speaking on CNN on Friday night, said he thought it would be a good idea for Trump to get the vaccination.
Being infected does not mean that you are guaranteed immunity.
But Fauci said that, given Trump was recently infected – his diagnosis was confirmed on October 1 – he may still have a high level of antibodies.
‘That’s a personal choice between the president and his physicians,’ said Fauci…
On Wednesday a White House official told CNN that Trump would not be vaccinated until his doctors told him to.
The official said the president continues to be open to getting vaccinated, but that he also wants to make sure frontline medical workers receive the vaccine first.” (B)
“Former New Jersey Gov. Chris Christie revealed Thursday he spent seven days in an intensive care unit before recovering from Covid-19, and implored Americans to wear masks and take the pandemic “very seriously.”
“The ramifications are wildly random and potentially deadly,” Christie said in a statement. “No one should be happy to get the virus and no one should be cavalier about being infected or infecting others.”
Christie tested positive for Covid-19 earlier this month and checked himself into Morristown Medical Center as a precautionary measure.
“Within 24 hours, I went from feeling absolutely fine to being in the intensive care unit,” Christie said Friday on ABC’s “Good Morning America.” He said he was treated with the antiviral drug remdesivir and Eli Lilly’s monoclonal antibody combination therapy.
News of his positive diagnosis — which came a day after President Donald Trump announced that he and first lady Melania Trump had both contracted the virus — followed his assistance to Trump in preparing for the first presidential debate in a series of sessions where no one wore masks.
Christie, who is overweight and asthmatic, had also attended a Supreme Court nomination ceremony for Judge Amy Coney Barrett on September 26, now believed to have been a superspreader event.” (C)
“Rudy Giuliani, the public leader of a quixotic effort by Donald Trump to overturn the 2020 presidential election, was released from hospital on Wednesday evening after being treated for Covid-19.
Giuliani received “exactly the same” treatment that Trump received during his own hospitalization in October, the former New York mayor said, apparently including a drug cocktail of monoclonal antibodies that few patients have access to.
“His doctor sent me here; he talked me into it,” Giuliani said of the president in an interview with a local New York radio station. “The minute I took the cocktail yesterday, I felt 100% better. It works very quickly, wow.”
Giuliani, 76, was admitted to Georgetown University hospital in Washington DC on Monday.
“My treatment by the nurses and staff at Georgetown Med Star hospital was miraculous,” the former New York mayor tweeted on Thursday. “I walked in with serious symptoms. I walked out better than ever.”
That account echoed the experiences of other members of Trump’s inner circle who have fallen grievously ill with coronavirus and been treated with monoclonal antibodies, synthetically manufactured proteins that mimic the immune system’s ability to fight off viruses.
But almost no one has access to the treatments in question: a cocktail manufactured by Regeneron and a similar treatment made by Eli Lilly.
The health secretary, Alex Azar, said on Wednesday that a total of 278,000 doses of the two therapies had been distributed in past months. Some states use a lottery system to allocate the drugs, while others rank patients by eligibility, the New York Times reported.
The United States has confirmed 15.5m cases of coronavirus over time, and more than 106,000 people are currently hospitalized in the United States with Covid-19, according to the Covid tracking project.
Giuliani, who has mocked contact tracing on Fox News and said people “overdo the mask”, is not the first member of Trump’s inner circle to credit the hard-to-get treatment with a fast return to health.
After the housing secretary, Ben Carson, 69, emerged from the hospital last month, he wrote on Facebook that he had been “desperately ill” but “President Trump was following my condition and cleared me for the monoclonal antibody therapy that he had previously received, which I am convinced saved my life.”
After being hospitalized in early October at Walter Reed medical center, Trump, 74, told the radio host Rush Limbaugh, “I might not have recovered at all” without the drug cocktail…
Giuliani credited his celebrity status with his successful course of treatment.
“If it wasn’t me, I wouldn’t have been put in a hospital, frankly,” Giuliani told WABC New York. “Sometimes when you’re a celebrity, they’re worried if something happens to you they’re going to examine it more carefully, and do everything right.” (D)
“Red tape, staff shortages, testing delays and strong skepticism are keeping many patients and doctors from these drugs, which supply antibodies to help the immune system fight the coronavirus. Only 5% to 20% of doses the federal government allocated have been used.
Ironically, government advisers met Wednesday and Thursday to plan for the opposite problem: potential future shortages of the drug as COVID-19 cases continue to rise. Many hospitals have set up lottery systems to ration what is expected to be a limited supply, even after taking into account the unused medicines still on hand.
Only 337,000 treatment courses are available and there are 200,000 new COVID-19 cases a day, “so the supply certainly cannot meet the demand,” said Dr. Victor Dzau, president of the National Academy of Medicine, whose experts panel met to discuss the drugs.
Antibodies are made by the body’s immune system to fight the virus but it can take several weeks after infection for the best ones to form. The drugs aim to help right away, by supplying concentrated doses of one or two antibodies that worked best in lab tests. The government is providing them for free, but there’s sometimes a fee for the IV required to administer the drugs.
Eli Lilly and Regeneron Pharmaceuticals have emergency authorization to supply their antibody drugs while studies continue. But the medicines must be used within 10 days of the onset of symptoms to do any good. Confusion over where to find the drugs and delays in coronavirus test results have conspired to keep many away.
“It can take anywhere between two and four days for results to come back and that’s absolutely precious time” for the drugs to have a chance to help, Dr. Keith Boell of Geisinger Health System in Pennsylvania told the experts panel.
“Our clinics have everything from a bus stop to a buggy stop,” serving big cities and horse-driven Amish communities, he said. “We really want to get these into anybody they can help” but it’s hard, he said.
Many states and health centers were not ready for the sudden availability of the drugs, said Dr. Ryan Bariola of the University of Pittsburgh’s 30-hospital system. It can be a nightmare for doctors or urgent care centers to figure out if a patient qualifies.
“How do you get it done? Do you call your local hospital? They may not have an infusion center set up. For a lot of independent physicians, this is very hard,” he said.
The crunch comes as vaccine efforts begin across the United States, monopolizing attention and staff.
States “didn’t see this coming … and have limited bandwidth” to deal with this on top of allocating vaccines, said Connie Sullivan, president of the National Home Infusion Association.
Many hospitals such as the University of Michigan’s quickly set up outpatient infusion centers but a shortage of nurses and other staff has been “the biggest problem we’ve had,” said a pharmacy resident, Megan Klatt.
Skepticism also is hurting use. The evidence that the drugs help is thin, several leading medical groups have not endorsed them, and many patients who feel only mildly ill see them as a risk: Half who have been offered them in the Michigan system have declined, Klatt said.
“It doesn’t help when physicians themselves are not totally convinced,” said Mohammad Kharbat, a pharmacy chief at a hospital system in Madison, Wisconsin, where half of patients also have declined.
At Wake Forest Baptist Health System in North Carolina, “we’ve had very little activity, very few referrals,” and not much interest from patients or doctors, said Dr. John Sanders.
The University of Utah has seen interest from patients and developed a formula to figure out who most needs the drugs, but getting the infusion “requires going to a website, being notified of your test result … doing some of the legwork yourself” and many people can’t manage that, said Dr. Emily Sydnor Spivak.
“We’re going to have to go out and find people” who qualify and offer them the drugs, she said.” (E)
“New Jersey plans to open six vaccination “mega-sites” in early January, including at the Meadowlands racetrack in East Rutherford, as the campaign to inoculate residents expands beyond hospital employees to other health care and essential workers.
The six sites are expected to provide 2,400 vaccinations per day for health care workers through mid-February, state Health Commissioner Judy Persichilli said Friday…
New Jersey’s vaccine rollout is taking place in phases and began this week with health care workers. Six hospitals that received the first doses of a Pfizer-BioNTech vaccine authorized for emergency use gave first doses to more than 2,100 of their front-line staff. The second of two doses is to be given in three weeks.
Starting December 28, staff and residents of long-term-care facilities will begin to receive vaccines, Gov. Phil Murphy said. Two retail pharmacy chains — CVS and Walgreens — will conduct the vaccinations in nursing homes.
“With each successive wave, we will be closer to offering to general public,” Murphy said. The monthslong campaign is intended to enable any resident who lives, works or studies in New Jersey to receive a vaccine.
The timing of the progression among the groups will depend on the supply of vaccine, Perischilli said.
This week, the state learned that it would be receiving 34% fewer doses of the Pfizer vaccine than it expected next week. And while supplies of a new vaccine by Moderna, which was authorized Friday night, are to arrive next week, the projected amount was also lower than state health officials expected.
That “1a” group will be followed by “1b” — essential front-line workers. This group is expected to include police, firefighters, corrections officers, transportation workers, educators, and food and agriculture workers, according to the federal Centers for Disease Control. Details have not yet been spelled out by the national Advisory Committee on Immunization Practices or the New Jersey Health Department.
Group 1c will include people 65 years old and older and people with medical conditions that make them particularly vulnerable to severe illness with COVID-19.
While the mega-sites continue to operate, the state is also establishing a broad network of local sites to provide vaccines. Among the 215 sites already registered are local and county health departments, health clinics, primary care practices, urgent care centers and some retail pharmacies. That network will expand over time, Persichilli said.
The state plans to open a website in the coming weeks for the public to register, locate a vaccination site and schedule an appointment, the health department has said. Details are not yet available.
New Jersey’s goal is to vaccinate 70% of eligible adults — 4.7 million people — by June.
“Yes, that is aggressive. Yes, it is aspirational,” Persichilli said Friday. “But it’s what we need to do so this virus has no place to go.” (F)
“New York will be setting up regional hubs through local hospital systems to distribute COVID-19 vaccines as early as next month to essential workers and high-risk residents.
Gov. Andrew Cuomo detailed Wednesday that each region will develop its own distribution plan by the first week of January as New York anticipates at least 170,000 doses of the Pfizer/BioNTech vaccine in the near term and the potential for 346,000 doses from Moderna starting Dec. 22.
“It is a medical procedure. It will be handled by medical professionals,” Cuomo said. “There will be no political favoritism.”
The state has received 87,750 doses so far, and those are largely designated for medical staff. Another 80,000 Pfizer doses are scheduled to arrive in the coming days, with those slated for nursing home residents and staff.
Cuomo said all vaccines will be free to New Yorkers, and each region will determine how the doses will be prioritized as part of the Phase II distribution plan.
But he warned it will be a slow process: It could be six to nine months before everyone who wants a vaccine could get one…
The regional vaccine hub coordinators are:
Finger Lakes: University of Rochester Medical Center – Western New York: Catholic Health System – Southern Tier: United Health Services – Central New York: SUNY Upstate Medical Center – Mid-Hudson: Westchester Medical Center – North Country: Champlain Valley Physicians Hospital – Mohawk Valley: Mohawk Valley Medical Center – Capital Region: Albany Medical Center – New York City: Greater New York Hospital Association – Long Island: Northwell Health Systems” (G)
“Tens of thousands of prison inmates in Massachusetts will be among the first to be offered coronavirus vaccines, before home health aides, seniors and medically vulnerable residents of the state.
The inmates, along with people who live in homeless shelters and other congregate settings, will be vaccinated by the end of February, after health care workers, emergency medical workers and residents of long-term care facilities receive the shots.
The state’s high prioritization of inmates is unusual. A dozen states have listed prisoners among those set to receive vaccines in the first round of inoculations, but none ranks inmates so highly. Federal health officials have recommended that corrections officers and staff at state facilities receive high priority but have said nothing about inmates. The federal prison system has said it will vaccinate officers and staff first.” (I)
“Stanford Medicine residents who work in close contact with COVID-19 patients were left out of the first wave of staff members for the new Pfizer vaccine. In their place were higher-ranking doctors who carry a lower risk of patient transmission, according to interviews with six residents and two other staff members and e-mail communications obtained by ProPublica.
“Residents are patient-facing, we’re the ones who have been asked to intubate, yet some attendings who have been face-timing us from home are being vaccinated before us,” said Dr. Sarah Johnson, a third-year OB-GYN resident who has delivered babies from COVID-positive patients during the pandemic. “This is the final straw to say, ‘We don’t actually care about you.’”
Another resident, who asked not to be named, said a nurse who works in an operating room for elective surgeries has been notified she’ll get the vaccine in the first wave. “We test people for COVID before elective surgeries, so by definition, we will know if those patients have COVID,” he said, so to him, it didn’t make sense that that nurse would be prioritized.
“We take complete responsibility for the errors in the execution of our vaccine distribution plan,” said Lisa Kim, a Stanford Medicine spokesperson. “Our intent was to develop an ethical and equitable process for distribution of the vaccine. We apologize to our entire community, including our residents, fellows and other frontline care providers, who have performed heroically during our pandemic response. We are immediately revising our plan to better sequence the distribution of the vaccine.”
An algorithm chose who would be the first 5,000 in line. The residents said they were told they were at a disadvantage because they did not have an assigned “location” to plug into the calculation and because they are young, according to an email sent by a chief resident to his peers. Residents are the lowest-ranking doctors in a hospital. Stanford Medicine has about 1,300 across all disciplines.
Only seven made the priority vaccination list, despite the fact that this week, residents were asked to volunteer for ICU coverage in anticipation of a surge in COVID-19 cases.
Stanford Medicine didn’t respond to a request for comment on how the vaccines were allocated and whether there was a flaw in the algorithm. The tumult reflects the difficulties of ethically parceling out a limited supply of vaccine and weighing competing factors, such as age, risk of contracting the disease and comorbidities. Adding to the challenge is the angst that comes when such decisions are made without all stakeholders involved.” (H)
“Employers can require workers to get a Covid-19 vaccine and bar them from the workplace if they refuse, the federal government said in guidelines issued this week.
Public health experts see employers as playing an important role in vaccinating enough people to reach herd immunity and get a handle on a pandemic that has killed more than 300,000 Americans. Widespread coronavirus vaccinations would keep people from dying, restart the economy and usher a return to some form of normalcy, experts say.
Employers had been waiting for guidance from the U.S. Equal Employment Opportunity Commission, the agency that enforces laws against workplace discrimination, because requiring employees be tested for the coronavirus touches on thorny medical and privacy issues covered by the Americans With Disabilities Act of 1990.
The guidance, issued on Wednesday, confirmed what employment lawyers had expected.
Businesses and employers are uniquely positioned to require large numbers of Americans who otherwise would not receive a vaccination to do so because their employment depends on it.” (J)
“The chief executive of Uber, the ride-hailing company whose six New York lobbying firms include Albany’s best connected, wrote last week to Gov. Andrew M. Cuomo with an ask: priority for its drivers in the next round of coronavirus vaccinations.
Days later, the president of New York’s largest transit union spoke about the same topic with the chairman of the state transit authority, a Cuomo appointee. Not to be outdone, the Hotel Trades Council, a hospitality labor group with an aggressive political arm, urged the state’s health commissioner in a letter on Tuesday to give priority to its members.
Even a presidential elector had hoped to chat with the governor about who was getting vaccine priority — after they both took part in New York’s Electoral College vote.
Among state capitals, New York’s has long stood apart as a venue for favor trading and behind-the-scenes deals. Now, as the coronavirus rages and vaccines remain in short supply, the pandemic has been thrust squarely into the maw of Albany politics.
“Everyone is chasing the same thing now, and it really is remarkable,” said James E. McMahon, a veteran Albany lobbyist who represents a school bus company and other firms interested in early vaccination. “The need was there and then there’s the vaccine and all of a sudden, people are saying, ‘Oh Jesus, we’ve got to get in line now.’”
Apparently attuned to the atmosphere, Mr. Cuomo made several pronouncements this past week that his administration would not be swayed by interest groups.
“There will be no political favoritism,” the governor said in a news conference on Wednesday, a message he repeated on Friday.
The question of where groups of workers stand in the line for vaccines has yet to be resolved in New York or in a majority of other states, according to a review by the nonprofit Kaiser Family Foundation. The federal government is expected to issue final recommendations on who should be deemed essential soon. But it is largely up to states to prioritize vaccine distribution among those workers.
Some states, like Illinois, are awaiting further federal guidance for allocation beyond the initial vaccine supplies.
Others have provided some details. Colorado officials have said ski industry employees living in congregate settings would be part of the early vaccine rounds. Health officials in Georgia and Arkansas are including workers in meatpacking or food processing plants.
In New York, emergency responders like police officers, transit workers and those who maintain power grids and other critical infrastructure will almost certainly be part of the next wave, according to a state plan.
But the remaining uncertainty has led to clamoring for consideration in state capitols and in Washington from a wide array of businesses and workers. Tens of millions of Americans, designated as essential, continue to toil amid the pandemic’s dangers while others work from home.
The list of those who qualified as essential in New York, in order to continue working through virus-related shutdowns, stretched from chiropractors to landscapers to bicycle mechanics. That long list has allowed all sorts of industries to claim they should also be among the first for the vaccine.” (K)
POSTSCRIPT
“Striking a compromise between two high-risk population groups, a panel advising the Centers for Disease Control and Prevention voted Sunday to recommend that people 75 and older be next in line to receive the coronavirus vaccine in the United States, along with about 30 million “frontline essential workers,” including emergency responders, teachers and grocery store employees…
The panel of doctors and public health experts had previously indicated it would recommend a much broader group of Americans defined as essential workers — about 87 million people with jobs designated by a division of the Department of Homeland Security as critical to keeping society functioning — as the next priority population and that elderly people who live independently should come later.
But in hours of discussion on Sunday, the committee members concluded that given the limited initial supply of vaccine and the higher Covid-19 death rate among elderly Americans, it made more sense to allow the oldest among them to go next along with workers at the highest risk of exposure to the virus.
Groups of essential workers, such as construction and food service workers, the committee said, would be eligible for the next wave. Members did clarify that local organizations had great flexibility to make those determinations.” (L)
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PREQUELS
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,”)
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.”
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 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 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 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 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 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 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 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?
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.”
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 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 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 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 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 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 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 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,”)
“In the scramble to vaccinate millions of health workers, difficult choices about who comes first — and who must wait — have started to surface. So far, the effort is concentrated in hospitals. Workers treating Covid-19 patients in intensive care units and in emergency departments have in recent days been beaming symbols of the virus’s demise.
But there are roughly 21 million health care workers in the United States, making up one of the country’s largest industries, and vaccinating everybody in the first wave would be impossible. That has left entire categories of workers — people who are also at risk for infection — wondering about their place in line…
There are broad gray areas, he said: primary care doctors in areas with high infection rates, workers who handle bodies, firefighters who respond to 911 calls, dentists, pathologists who handle coronavirus samples in labs, hospice workers, chaplains…
These are hard choices and will become even harder as the vaccine becomes more widely available for the general public and states begin wrestling with the question of who is an essential worker…
The Centers for Disease Control and Prevention has laid out categories but they are broad, so each state — and each hospital system — has come up with its own plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers like Dr. Baker — as well as professional societies of groups such as pathologists, dentists and medical examiners — wondering where they stand.” (A)
“As frontline healthcare workers around the country receive the first doses of a Covid-19 vaccine, mental health providers worry they may not be included, even though they are often working in hospitals and clinics and may be exposed to Covid-19. The crux of the matter rests with how individual states end up interpreting broad federal guidelines for vaccine distribution. These states will be the ultimate arbiters of who are “essential workers” that qualifies for early inoculations. A CDC committee approved guidance to states in early December that vaccines should go to health care workers “who have the potential for direct or indirect exposure to patients or infectious materials” and to “residents of long-term care facilities.”
Mental health groups worry that wording leaves too much room for interpretation. Without more specific directions, “we would be at the mercy of each state to recognize the importance of mental health and substance use providers,” Reyna Taylor, the head of policy at the National Council for Behavioral Health, said in an email…
Mental health providers should be part of the first group of recipients of these vaccines because they face unique risks treating patients in person, Taylor said. Many take walk-in appointments and provide primary care. In mental health emergencies, she said, providers may have to treat someone before they can learn whether the person has Covid-19 or not. “When you’re providing services to someone who’s in a mental health or substance use crisis, you’re not thinking about Covid-19, you’re thinking about saving someone’s life from that crisis,” she said. Even if they aren’t in crisis, “the nature of serious mental illness and substance use disorder [means] there is at times a lack of awareness of their symptoms, including the symptoms of Covid-19,” she added in an email, and as a result providers “have to treat everyone who walks in as if they are Covid-19 positive.”..
There are not enough vaccine doses to give all the eligible healthcare workers and long-term care residents of the first group recommended by the CDC. That will force states to decide who in the priority group should be vaccinated and who should wait until more vaccine doses are manufactured…
Whether mental healthcare is part of the first subgroup getting the vaccine will be up to each state’s interpretation of the guidelines, Bahta said. Some may decide that mental health and substance use providers belong in the first phase, “Phase 1a,” while others might group them in the “1b” category, which the committee has not yet voted on but may include essential workers like bus drivers, teachers and police officers. “There will be a multitude of variations on how this plays out,” she said in an email…” (B)
“Here’s a look at what to expect from the coming coronavirus vaccination campaign.
Who can get a vaccine and when?
December
Who might get vaccinated: Health care workers and nursing home residents
December is a month for some big decisions. The US Centers for Disease Control and Prevention’s Advisory Committee for Immunization Practices has voted to recommend that 21 million frontline health care workers and support staff and 3 million residents of long-term care facilities who have been hardest hit by the pandemic be in the first group.
Health care workers and long-term care facility residents should get Covid-19 vaccine first, CDC vaccine advisers say
It will be easiest to vaccinate these groups — they’re already in institutional settings and the nursing home residents can get vaccinated at the same time their caregivers are being immunized….
January
Who might get vaccinated: More health care workers, other essential workers like emergency medical technicians, firefighters and police
If two or more vaccines get approved by the FDA, January might be when discussion really starts on who can get vaccinated and when….
Several groups of independent experts have weighed in on how to allocate vaccines, including the National Academies of Science, Engineering and Medicine and Johns Hopkins University.
They’ve all laid out basic principles that include protecting the country’s health care system, protecting the most vulnerable people, controlling the spread of the virus and being equitable across society.
ACIP will need to meet to decide on the details off all these phases.
January might include some of the rest of Phase 1 of a four-phase vaccine rollout.
Phase 1b is roughed out to include essential workers, including emergency medical technicians, as well as frontline workers at very high risk of infection, such as food workers. This phase may also include older adults living in congregate settings or crowded conditions.
There’s a also a proposed Phase 1c, which might include people of all ages with underlying conditions such as diabetes and kidney disease who are at significantly higher risk of dying or getting severely ill from Covid-19.
February
Who might get vaccinated: More essential workers and high-risk adults
By February, states may have hit their stride on vaccinating residents. Vaccination campaigns may move beyond hospitals and nursing homes, rehabilitation centers and other such facilities to pharmacies and medical practices…
March
It’s possible that the US will still be in Phase 1 of vaccination in March, simply because of the sheer numbers involved. Anyone healthy and under 65 who is not an essential or high-risk worker would not be thinking about vaccination yet.
April
If more vaccines have been approved and brought online, it’s possible Phase 2 of vaccination could begin by now.
This group has not been decided yet, but Phase 2 might include K-12 teachers and staff and other child care workers, as well as other critical workers such as retail workers and transportation workers. This group could also include people in homeless shelters and all people over 65 who were not already included in phase 1…
May
Young adults and children would have to wait until Phase 3 and under other scenarios that’s likely to be May at the soonest — perhaps June or later, depending on what ACIP decides, what the vaccine supply looks like and how smoothly distribution is going…
Which vaccine should I get?
At first there will be little choice — both Pfizer and Moderna are providing a new type of immunization called an mRNA vaccine. It’s considered especially safe because it does not use a whole virus — just a piece of genetic material — and both seem especially effective, providing 95% protection against symptomatic disease.
What’s not known is how long that protection might last, whether either vaccine protects against asymptomatic disease and whether either stops people from spreading the virus to others.
Vaccines coming later might offer harder choices. AstraZeneca’s vaccine uses what’s called a replication deficient virus to deliver a piece of genetic material from the coronavirus. So does Johnson & Johnson’s vaccine. There’s not a lot of safety data about these vaccines yet, and no evidence the viral vectors could be harmful. Nonetheless, some doctors may be reluctant to offer them to patients with compromised immune systems, including those with rheumatoid arthritis or multiple sclerosis who are taking immune-suppressing drugs; pregnant women; people taking certain cancer treatments and others..” (C)
“In coming days, squads of CVS and Walgreens employees, clad in protective gear and carrying small coolers, will begin to arrive at tens of thousands of nursing homes and assisted-living facilities to vaccinate staff and residents against the coronavirus.
It promises to be a crucial milestone in America’s battle against a pandemic that has inflicted especially severe carnage on nursing homes. At least 106,000 residents and staff of long-term care facilities have died from the virus, accounting for 38 percent of the country’s Covid-related fatalities.
But even before it begins, the mass-vaccination campaign is facing serious obstacles that are worrying nursing home executives, industry watchdogs, elder-care lawyers and medical experts. They expect nursing homes to be the most challenging front in the mission to vaccinate Americans.
Some residents and staff are balking at taking the vaccine. Short-staffed facilities are concerned about workers calling in sick with side effects, straining resources just as some frail residents are likely to experience fever and fatigue from the shot. Most nursing home employees work in shifts; will it be possible to vaccinate everyone over the course of just a few visits from CVS and Walgreens?
The virus has devastated residents and staff members in more than 28,000 long-term care facilities across the country.
While some states began vaccinations in nursing homes this week, the broader nationwide effort will start over the next few days. And there remains widespread confusion about a key element: how nursing homes will get consent to vaccinate residents who aren’t able to make their own medical decisions. A CVS executive said such residents’ legal representatives will be able to provide consent to nursing homes electronically or over the phone, but officials at multiple large nursing home chains said they weren’t aware of that.
If residents or their representatives haven’t given consent before CVS or Walgreens employees show up, it is not clear whether or when they will have another chance to be inoculated.
“Given the pace of this rollout, I am very concerned that nursing facilities won’t have the time or capacity to really explain the vaccine to residents and their families,” said Nicole Howell, a state-funded ombudsman in California whose office works with 29,000 long-term care residents.
Because of the large number of facilities they must visit, CVS and Walgreens only have the capacity to go to each location two or three times. The Pfizer and Moderna vaccines both require two doses, separated by a few weeks, which means that at most nursing homes, all staff and residents will have to receive their shots on the same days…
But the more employees who get the vaccine, the more who are likely to experience side effects — and that could cause more problems.
“If even as little as 10 percent of your staff calls off the next day — while at the same time all of the residents are irritated, upset and having adverse effects — you’ve created a perfect storm,” said Chad Worz, chief executive of the American Society of Consultant Pharmacists, which represents pharmacies that serve long-term care providers.
There is no federal requirement for people to give consent before getting vaccinated, but it is standard practice and is often needed for billing purposes. States have different requirements about how medical consent can be given and what information needs to be provided to the person who is consenting. The Centers for Disease Control and Prevention’s guidance is that residents or their representatives should receive a fact sheet about the coronavirus vaccine and then consent to receiving it.
The task of getting consent is not always straightforward at nursing homes. Many residents, like those with dementia, aren’t capable of giving it on their own. Instead, nursing homes need to get the permission of their family members or other legal representatives.
CVS and Walgreens have created paper and digital consent forms that nursing homes can use. Consent must be given in advance; the pharmacies need to know how many doses of the vaccine, which must be kept very cold, to bring with them.” (D)
“A top Trump appointee repeatedly urged top health officials to adopt a “herd immunity” approach to Covid-19 and allow millions of Americans to be infected by the virus, according to internal emails obtained by a House watchdog and shared with POLITICO.
“There is no other way, we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,” then-science adviser Paul Alexander wrote on July 4 to his boss, Health and Human Services assistant secretary for public affairs Michael Caputo, and six other senior officials.
“Infants, kids, teens, young people, young adults, middle aged with no conditions etc. have zero to little risk….so we use them to develop herd…we want them infected…” Alexander added.
“[I]t may be that it will be best if we open up and flood the zone and let the kids and young folk get infected” in order to get “natural immunity…natural exposure,” Alexander wrote on July 24 to Food and Drug Administration Commissioner Stephen Hahn, Caputo and eight other senior officials. Caputo subsequently asked Alexander to research the idea, according to emails obtained by the House Oversight Committee’s select subcommittee on coronavirus.
Alexander also argued that colleges should stay open to allow Covid-19 infections to spread, lamenting in a July 27 email to Centers for Disease Control and Prevention Director Robert Redfield that “we essentially took off the battlefield the most potent weapon we had…younger healthy people, children, teens, young people who we needed to fastly [sic] infect themselves, spread it around, develop immunity, and help stop the spread.”..
“So the bottom line is if it is more infectiouness [sic] now, the issue is who cares?” Alexander wrote in a July 3 email to the health department’s top communications officials. “If it is causing more cases in young, my word is who cares…as long as we make sensible decisions, and protect the elderely [sic] and nursing homes, we must go on with life….who cares if we test more and get more positive tests.”” (E)
