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.”
“When senior Food and Drug Administration officials held their morning call one day this week, they received a sobering warning from the agency’s chief, Dr. Stephen M. Hahn, who had just gotten off the phone with the White House: Block out “all the craziness” afoot and stay focused on fighting the pandemic, he said.
There are plenty of distractions. President Trump is pushing to overturn the results of the election and his only public statements about the coronavirus in the last few days were to make clear his pique that good news about a vaccine had not come until after Election Day — even as the number of new daily infections on Wednesday topped 140,000, average daily deaths shot past the 1,000 mark, and Covid-19 hospitalizations hit a record high of 65,368.
Vice President Mike Pence canceled a vacation at the last minute as the virus numbers grew worse, but the White House coronavirus task force that he leads has been all but publicly silent. Mark Meadows, the White House chief of staff who is infected with the virus, declared last month, “We are not going to control the pandemic,” and said the focus should instead be on the longer-term goals of developing vaccines and treatments.
Since then, the White House political director, Brian Jack, and two other White House aides have become the latest administration officials to test positive for the virus, people familiar with the diagnosis said on Wednesday.
The pandemic caught the nation flat-footed in March, but epidemiologists have been warning for months of a fall and winter wave as people are driven indoors, schools resume in-person classes and Americans grow tired of months of precautions. Yet shortages of personal protective equipment are back, especially among rural hospitals, nursing homes and private medical practices that lack access to the supply networks that serve larger hospital chains.
The Strategic National Stockpile, the nation’s emergency reserve, has only 115 million N95 masks, far short of the 300 million the administration had hoped to amass by winter, Rear Adm. John Polowczyk, who retired on Monday as the national supply chain commander, said in a recent interview, though he added that the government is continuing to expand its supplies of protective gear.
Dr. Shikha Gupta, the executive director of Get Us PPE, a volunteer effort that matches available supplies to health care providers, said 70 percent of those requesting help from the organization last month reported being completely out of some gear, especially masks, gloves and disinfecting wipes.
“Health care workers are exhausted and frustrated, and it’s really hard to believe that on Nov. 10, it feels very much like the middle of March all over again,” she said.
Governors are once again competing with one another and big hospital chains for scarce gear. Nursing homes are grappling with staff shortages, which have left hospitals unable to discharge patients to their care. In Wisconsin, the situation is so severe that health officials are mulling a plan to train family members of nursing home residents to fill in at facilities that lack enough workers.
“We’re throwing every idea that we can conceivably think of to the state, but we really need bold action from the federal government,” said John Sauer, the president of LeadingAge Wisconsin, an association that represents nonprofit nursing homes and long-term care facilities. “We can’t muddle through this on our own.”
The United States is on somewhat better footing now than in the earliest days of the pandemic. States and hospitals have their own stockpiles, and Admiral Polowczyk said the federal government had met its goal of acquiring 153,000 ventilators.
But as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged. President-elect Joseph R. Biden Jr. is trying to assume a leadership mantle, with the appointment of a coronavirus advisory board and a call for all Americans to wear masks, but until his inauguration on Jan. 20, he lacks the authority to mobilize a federal response.” (A)
“President-elect Biden’s transition team unveiled the members of his Covid-19 task force on Monday, a who’s-who of former government health officials, academics, and major figures in medicine…
Biden has cast the escalating Covid-19 crisis as a priority for his incoming administration. The task force, he said, would quickly consult with state and local health officials on how to best prevent coronavirus spread, reopen schools and businesses, and address the racial disparities that have left communities of color harder hit than others by the pandemic.
“Dealing with the coronavirus pandemic is one of the most important battles our administration will face, and I will be informed by science and by experts,” Biden said in a statement Monday. “The advisory board will help shape my approach to managing the surge in reported infections; ensuring vaccines are safe, effective, and distributed efficiently, equitably, and free; and protecting at-risk populations.”
As expected, the board’s three co-chairs are Marcella Nunez-Smith, a Yale physician and researcher; Vivek Murthy, a former U.S. surgeon general; and David Kessler, a former FDA commissioner…
Separately, the Biden transition announced that it had appointed two health advisers who will guide the incoming administration’s Covid-19 preparations but will not serve on the task force. One of those advisers, Beth Cameron, is the former director of a White House biodefense council that Trump has been criticized for closing in 2017. The other, Rebecca Katz, is a well-known Georgetown global health security professor.” (B)
“President-elect Joe Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government, according to documents obtained by POLITICO and people familiar with the decision…
The Covid-19 team has not yet been formally announced and is largely separate from the coronavirus task force that Biden unveiled Monday, which is primarily advising Biden and handling the incoming administration’s public messaging…
The coronavirus transition team is broken down into three specialties, according to a roster obtained by POLITICO, with each led by a handful of transition officials dubbed the “central team.”
Those central team leaders will coordinate efforts with designated transition officials assigned to individual agencies, such as the Health and Human Services, Homeland Security and State departments.
The team’s “domestic” work is led by a five-person group that includes Sarah Bianchi, a top economic and domestic policy aide to Biden when he was vice president. Transition officials in that group include Johns Hopkins infectious disease expert Tom Inglesby and Luciana Borio, a former FDA official and National Security Council member.
The team’s “national security/foreign policy” work is headed by Rebecca Katz, director of Georgetown’s Center for Global Health Science and Security, and Dylan George, a former biological threats specialist in the Obama administration. Members include Craig Fugate, who is part of Biden’s Homeland Security review team, and Deborah Rosenblum, a member of the Department of Defense review team.
The team’s third specialty, “tech strategy delivery,” is led by a five-person team that includes Mina Hsiang of the health care firm Devoted Health and Amy Pitelka, a tech legal and policy specialist.” (C)
…The agency’s new guidance also notes that numerous studies have demonstrated the benefits of “universal masking policies.”” (A)
“Wearing a mask not only protects others from the spread of Covid-19, but it protects the wearer as well, the Centers for Disease Control and Prevention said Tuesday in its strongest messaging yet on face coverings.
The CDC also said that “adopting universal masking policies can help avert future lockdowns,” particularly when combined with a doubling down of mitigation strategies available to virtually every American: physical distancing, hand washing and ventilation.
SARS-CoV-2, the virus that causes Covid-19, spreads mainly through respiratory droplets, especially when people are coughing, sneezing, singing, talking or even breathing. Infectious disease experts have long said that when one person covers his or her mouth and nose, it protects those who are nearby. The CDC report estimated that more than 50 percent of transmissions originate from asymptomatic people, or those who have been infected but have not yet developed symptoms.
When the CDC first urged Americans to wear face coverings in public in spring, the guidance was that it protected others. But there is growing evidence that a mask can also give protection to the person wearing it.
“Studies demonstrate that cloth mask materials can also reduce wearers’ exposure to infectious droplets through filtration, including filtration of fine droplets and particles less than 10 microns,” the report’s authors wrote.” (B)
“But the different state-level approaches mean researchers can now parse the results of a trial they never would have received approval to conduct. New unpublished research from Kansas and Tennessee suggests that not only do mask mandates prevent Covid-19 spread, they may also blunt the severity of illness and reduce the number of serious cases that require hospitalization. Other findings support the argument more and more public health experts are making: that masks remain among our cheapest most effective tools to control the pandemic — if worn consistently.
“If you’re not in the ICU, the only tools at our disposal that we know work are the tried-and-true public health measures, like social distancing, hand-washing, and masks,” says Vin Gupta, a critical care pulmonologist and affiliate assistant professor for the Institute for Health Metrics and Evaluation at the University of Washington. “We’re bearing the brunt of those things being implemented poorly.”
“You’re less likely to get Covid-19 if you’re wearing a mask,” says Donna Ginther, an economist and director of the Institute for Policy and Social Research at the University of Kansas. And “even if you do get sick while wearing a mask, you’re less likely to get deathly ill.” “ (C)
(A)Live updates: CDC offers stronger endorsement of mask-wearing as U.S. sets another record for infections, by Antonia Noori Farzan, Rick Noack, Marisa Iati, Paulina Villegas and Siobhán O’Grady,
“New York City-based drug company Pfizer made the announcement on 9 November. It offers the first compelling evidence that a vaccine can prevent COVID-19 — and bodes well for other COVID-19 vaccines in development. But the information released at this early stage does not answer key questions that will determine whether the Pfizer vaccine, and others like it, can prevent the most severe cases or quell the coronavirus pandemic.
“We need to see the data in the end, but that still doesn’t dampen my enthusiasm. This is fantastic,” says Florian Krammer, a virologist at Icahn School of Medicine at Mount Sinai in New York City, who is one of the trial’s more than 40,000 participants. “I hope I’m not in the placebo group.”
The vaccine, which is being co-developed by BioNTech in Mainz, Germany, consists of molecular instructions — in the form of messenger RNA — for human cells to make the coronavirus spike protein, the immune system’s key target for this type of virus. The two-dose vaccine showed promise in animal studies and early-stage clinical trials. But the only way to know whether the vaccine works is to give it to a large number of people and then follow them over weeks or months to see whether they become infected and symptomatic. These results are compared with those for a group of participants who are given a placebo.”(A)
“A preliminary analysis of the race frontrunner, Pfizer-BioNTech’s mRNA vaccine, suggested it was 90% effective in preventing symptomatic Covid disease. While these are early findings — the trial is still ongoing — they suggest the vaccine could be very protective.
There’s another important caveat. We don’t yet have details about whether the vaccine blocked mainly mild cases, or if there is evidence that it seemed to prevent some severe infections, too.
Still, the early results are encouraging for the Pfizer-BioNTech partnership. But embedded in the announcement is broader good news for Covid-19 vaccine development. Here are four reasons for encouragement based on the early results, starting with the most important.
We are likely to have multiple successful Covid-19 vaccines.
The Pfizer vaccine targets the spike protein, the knobby protrusion on the SARS-CoV-2 virus that allows the virus to attach to and invade human cells, initiating infection.
In fact, all of the vaccines being developed by major manufacturers working with Operation Warp Speed, the U.S. government effort to fast-track vaccines, target the spike protein.
There have been at least theoretical concerns that this was the vaccine development equivalent of putting all our eggs in one basket. The interim Pfizer data suggests the basket is the right one.
“There was always a discussion: Is the spike protein the right target? Well, now we know it’s the right target,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told STAT on Monday. “So, it’s not only immediate good news, it really is optimistic about what’s going to roll out in the next several months with the other vaccines.”
That forecast applies globally. All the vaccines being developed with the help of the Coalition for Epidemic Preparedness Innovations — which has been funding research and production with the aim of producing vaccine for worldwide distribution — target the spike protein.
“We believe these interim results also increase the probability of success of other Covid-19 candidate vaccines which use a similar approach,” CEPI CEO Richard Hatchett said in a statement.” (B)
“The news — the first results from any late-stage vaccine trial — buoyed stock markets and spirits as the public saw a glimmer of hope. But it’s worth noting that the news is still preliminary, and there is much that is still not known about how well the vaccine works.
And one thing remained clear: The vaccine will not come in time to rescue the world from the next several months, when the virus will take many more lives unless the public takes more stringent public health measures.
Here’s what we know, and don’t know, about the vaccine.
What did these scientists find out?
Is that a good result?
Is the Pfizer vaccine safe?
Who will get the new vaccine first?
When will the general public be able to get it?
What is left to do in the trial?
Will it work on older people?
The new results also don’t tell us whether older people will get strong protection from the vaccine.
What about children? (C)
“It’s said that success has many authors, and the encouraging data from Pfizer Inc.’s experimental Covid-19 vaccine had plenty of people in Washington lining up to take credit.
Vice President Mike Pence was among Trump administration officials saying support from the government’s Operation Warp Speed program helped accelerate the development of the vaccine, which was found to be more than 90% effective in preventing symptomatic Covid-19 infections in an interim analysis.
The truth is that Pfizer didn’t receive any funding from Operation Warp Speed for the development, clinical trial and manufacturing of the vaccine. Rather, its partner, BioNTech SE, has received money — from the German government.
BioNTech is credited for contributing the messenger RNA technology, which prompts the body to make a key protein from the virus, creating an immune response. The biotechnology company already had a history of working with Pfizer on influenza vaccines, and in March they clinched a deal to co-develop a shot to prevent against Covid-19 at research sites both in the U.S. and Germany. The two companies began human testing of the vaccine in April, before the existence of Operation Warp Speed was revealed publicly.
Berlin gave the German company $445 million in an agreement in September to help accelerate the vaccine by building out manufacturing and development capacity in its home market.
What the U.S. did, meanwhile, was commit to buying hundreds of millions of vaccines in advance to ensure Americans were among the first in line if it clinches an emergency-use authorization or approval from the FDA. The Trump administration agreed in July to pay almost $2 billion for 100 million doses, with an option to acquire as many as 500 million more, once that clearance comes.
As part of that agreement, the U.S. gets to decide who gets the vaccine first, and will work with the company on logistical support. While most vaccine front-runners that have been tapped by Warp Speed will distribute their doses through a government partnership with McKesson Corp., Pfizer is handling its own delivery of its products. The company has designed reusable containers that can keep the doses at ultracold temperatures, and is organizing trucks and flights to move them.” (D)
“…The Center for Post-COVID Care, opened May 13, will help patients hospitalized for COVID-19 transition from the hospital to their homes. The center is also open to patients who were never hospitalized but need help during their recovery.
At the center, patients will be offered a personalized treatment plan that will include input from several specialties, including primary care, pulmonary medicine, cardiology, infectious disease and physiatry, as well as social workers and pharmacists.
The center will also focus on evaluating the long-term effects of the disease, which are largely unknown. Mount Sinai will create a COVID-19 registry and collect information on sociodemographics, behaviors, underlying conditions, mental health conditions and medications from patients with the disease.
“This center will provide a unique opportunity to follow this population and systematically evaluate the long-term impact of COVID-19,” said Dennis S. Charney, MD, president for academic affairs at Mount Sinai Health System.” (A)
“Because the Center for Post-COVID Care was established to conduct research on the potential long-term health outcomes of COVID-19 in addition to providing care, it has so far prioritized patients who have tested positive for COVID-19 or for antibodies, which can develop as part of the immune system’s response to the disease. But Chen acknowledges that it’s a flawed system and says he is working on getting appointments for people who were waitlisted by the Center because they lacked a positive test.
“Initially, what we were designed to do was take care of patients we knew had COVID-19, meaning they had a positive PCR test or had a positive antibody test, so we’re sure these are [COVID-19-related] symptoms and can enroll them in research,” Chen said. “But even from the beginning, we realized you have patients who didn’t get tested in New York and around the country and there are patients who may have had a not-so-good test because testing was not perfect.”
COVID-19 diagnostic tests were harder to access early in the pandemic and many patients were simply told to stay home if they were sick in order to conserve resources and prevent the spread of the disease. Meanwhile, the reliability of antibody tests has been called into question and experts have said they are more useful on a population level than for determining whether an individual has had COVID-19…
The inclination to put certain criteria in place to identify long-haul patients for the purpose of research is understandable. The symptoms COVID-19 long-haulers report are extremely wide-ranging and there is a risk that some people may think they fall into that group, but are, in fact, suffering from an unrelated health issue.
“Part of the challenge is separating out these patients from patients who had COVID-19,” Chen said.
Adina Gerver, a Washington Heights resident, still suffers from extreme fatigue as well as ear, throat, and chest pain months after getting sick with COVID-19 in March. She says she was able to get an appointment at Mount Sinai’s Center for Post-COVID Care in about three weeks when she reached out in mid-July and appreciates that the model combines research and care.
“I feel like Mount Sinai is a little bit helping people and a little bit studying people and all of it is fine with me because I feel like they’re going to learn things that will help everyone,” Gerver said…. (B)
“Michael Reagan first got sick with COVID-19 on March 22 and spent the next 2 months in and out of Mount Sinai Hospital in New York City. He had pneumonia, scarring in his lungs, and blood clotting issues, and while he was never put on a ventilator, he came close.
By the end of May, the 50-year-old felt well enough to go for a jog — but that unexpectedly set him back severely. He started having seizures, tremors in his left hand, numbness, and muscle weakness on the left side of his body, and involuntary muscle movements on the left side of his face.
He also suffered memory loss and even had trouble navigating around his neighborhood. Then there was the debilitating joint pain in his elbows and knees, and his heart rate would sometimes skyrocket to 200 beats per minute with the slightest exertion.
“Before all this happened, I was always on the go,” Reagan told MedPage Today. “I played the cello, I was into biking, rock climbing, horseback riding. Now some days I can’t even get out of bed. Taking a shower and getting dressed feels like a superhuman effort.”
Reagan is among a growing number of COVID-19 “long-haulers” who suffer with long-term and often varied consequences from the virus. These patients often require care from a gamut of specialists, including pulmonologists, cardiologists, neurologists, rheumatologists, and psychiatrists.
That’s why health systems in the hard-hit greater New York area have launched COVID-19 rehabilitation and recovery programs, to serve as a medical home for patients with myriad complications who require coordinated care.
Reagan is a patient at the Center for Post-COVID Care at Mount Sinai…
“Right now, we have almost every medical specialty working with the program,” Chen told MedPage Today. “We’re looking at a broad spectrum of disease. Some may have permanent lung fibrosis … that may last for the rest of their lives. Others have reactive airway or inflammatory problems that will subside over time. It’s unpredictable. It’s the same for cardiac symptoms and neurological symptoms.”..
Mount Sinai is creating a registry of COVID long-haulers for further study. Chen said his team spoke with the health system’s World Trade Center victims program when they were developing the COVID recovery center. Between 7,000 and 8,000 COVID patients were treated in the Mount Sinai system, and Chen’s team is assessing symptom surveys to determine which of those patients may benefit from their post-COVID care program.” (C)
“Mount Sinai has been in the forefront of understanding and treating COVID-19. We were among the first to develop an antibody test to identify individuals who have recovered from COVID-19. We were then able to use plasma from these individuals to help critically ill patients recover. Researchers at the Icahn School of Medicine at Mount Sinai have been helping our frontline physicians treat all the varied aspects of the disease—from thrombosis to the sudden inflammatory response known as a “cytokine storm.” Because COVID-19 behaves so differently in many patients, we have created this multi-disciplinary team working together for your recovery to health.
Experts from Every Specialty, Working for Your Care
The long-term effects of COVID-19 are not clear yet. The virus can affect many different systems within the body—from the lungs to the heart to the kidneys. But by bringing in specialists who have been on the frontlines of the outbreak, you will have the most knowledgeable experts available. Your team and clinical staff may include disciplines such as:
Primary Care; Pulmonary Medicine; Cardiology; Infectious Diseases; Nephrology; Physiatry; Physical and Occupational Therapy; Radiology; Neuropsychiatry; Behavioral Health; Social Workers; Pharmacists
Treating the Whole Person, Not Just the Disease
This time has caused all of us anxiety—and some, more than others. The Center has the resources to help you manage anxiety and depression, PTSD, and other emotional issues. Getting “back to normal” may require physical therapy, occupational therapy, or other types of support—whether in groups or one-on-one. Whatever your needs, the Center is a compassionate, holistic source of care.
You Can Help Us Understand COVID-19
To understand the long-term effects of COVID-19, we are offering patients the opportunity to participate in the Mount Sinai COVID-19 Registry. Participation is voluntary, and you don’t have to register to get care at the Center. However, by being part of the Registry, you will help us understand the effects of COVID-19 on long-term health and well-being. Together, we will overcome COVID-19.” (D)
Note: I have been a proud member of the Mount Sinai faculty since the mid 1970’s (currently voluntary Adjunct Professor of Environmental Medicine and Public Health). I am not involved with the new Center. JMM
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….”
“ When the country reached the million-case mark in late April, the virus was more concentrated geographically — the New York area and the West Coast were the main hot spots — but outbreaks were surfacing elsewhere in vulnerable settings like nursing homes, prisons and meat packing plants…
Six weeks after reaching a million cases, the nation passed the two million case mark. It took four weeks to add the third million, and less than three weeks each to add the fourth and fifth, as states in the Sunbelt struggled following early reopenings. By the end of August, the pace had slowed slightly, and the nation was taking three weeks or more to pass each million-case milestone.
That changed in mid-October, when the virus began surging again across much of the country. The ninth million followed the eighth by just over two weeks, and now the 10th has taken just 10 days.” (A)
