POST 54A. October 23, 2020. CORONAVIRUS. 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.

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Followed by:

– immediate adherence to ever-evolving CDC and FDA guidelines.

– rapid implementation of Lessons Learned from the preceding New York experience.

– a mobile app, in collaboration with New York and Pennsylvania, that notifies users when they have been exposed to another user who has tested positive for COVID-19.

– and every day 24/7 working with hospitals and nursing homes to make sure preparedness for the next surge is at the highest level.

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On the radio this morning, former Governor Christie acknowledged his lapse in mask wearing during debate preparation in the White House. Everyone in the prep group tested negative before each meeting but everyone in the group contracted Coved-19. Governor Christie then unnecessarily spent seven days in the ICU.

“Interestingly, The Centers for Disease Control and Prevention has broadened the definition of what it means to be a “close contact” of a person with COVID-19.Previous language defined a close contact as someone who spent at least 15 minutes within 6 feet of a person with a confirmed case. The CDC now defines a close contact as someone who was within 6 feet of an infected person for a total of 15 minutes or more over a 24-hour period.” (J)

By comparison, Governor Murphy self-quarantined after contact with a staff member tested positive for COVID-19.

To read post 1-54 in chronological order, highlight and click on https://doctordidyouwashyourhands.com/2020/10/coronovirus-tracking-links-to-parts-1-54/

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‘Dr. Scott Gottlieb is warning that the United States is about “a week away from seeing a rapid acceleration in cases” of Covid-19 as the number of coronavirus infections and hospitalizations surge.

In an interview on CNBC’s “The News with Shepard Smith” on Monday evening, the former FDA chief in the Trump administration said the country no longer has any pandemic backstops.

“The summer was a backstop, of sorts, to the spring surge, and we have no therapeutic backstop,” Gottlieb said. “The fall and winter season is when this coronavirus is going to want to spread.”

Echoing similar comments from Dr. Anthony Fauci, the nation’s top infectious disease expert, Gottlieb said the holiday season and family gatherings are especially precarious for the spread of coronavirus because that’s when people let their guard down.” (A)

“Dr. Francis Collins, director of the National Institutes of Health, says “it was all sadly somewhat predictable.”

Hospitalizations are up in more than 40 states. The rising number of cases has not led to a corresponding rise in the number of deaths — yet.

But Collins tells NPR’s Steve Inskeep on Morning Edition that an increase in the number of fatalities will soon follow, as it has previously when cases and hospitalizations went up.

“All of this, I’m afraid, happens because we have not succeeded in this country in introducing really effective public health measures, those simple things that we all could be doing,” he says. “Wear your mask, keep that 6-foot distance and don’t congregate indoors whatever you do, and wash your hands. It’s so simple. And yet people are tired of it. And yet the virus is not tired of us.”” (B)

“U.S. Surgeon General Jerome Adams said Wednesday that a “herd immunity” approach to combating COVID-19 could “lead to many complications/deaths.”

Adams posted the comment on his official Twitter account, along with a link to a recent article from The Journal of the American Medical Association entitled “What is Herd Immunity?”

“The summary: Large numbers of people would need to be infected to achieve herd immunity without a vaccine; this could overwhelm health care systems and lead to many complications/deaths,” Adams tweeted. “So far, there is no example of a large-scale successful intentional infection-based herd immunity strategy.”

Instead, Adams urged people to “wear masks,” “wash hands” and “watch distances.”

The surgeon general’s comments come after the White House embraced a controversial declaration by a group of scientists calling for an approach that relies on “herd immunity.”” (C)

“A frustrated and at times foul-mouthed President Donald Trump claimed on a campaign call that people are tired of hearing about the deadly pandemic which has killed more than 215,000 Americans and trashed Dr. Anthony Fauci as a “disaster” who has been around for “500 years.”

Referring to Fauci and other health officials as “idiots,” Trump declared the country ready to move on from the health disaster, even as cases are again spiking and medical experts warn the worst may be yet to come.

Baselessly claiming that if Fauci was in charge more than half a million people would be dead in the United States, Trump portrayed the recommendations offered by his own administration to mitigate spread of the disease as a burdensome annoyance.

“People are tired of Covid. I have the biggest rallies I’ve ever had, and we have Covid,” Trump said, phoning into a call with campaign staff from his namesake hotel in Las Vegas, where he spent two nights amid a western campaign swing. “People are saying whatever. Just leave us alone. They’re tired of it. People are tired of hearing Fauci and all these idiots.”

“Fauci is a nice guy,” Trump went on. “He’s been here for 500 years.”” (D)

“Hospitals across the United States are starting to buckle from a resurgence of COVID-19 cases, with several states setting records for the number of people hospitalized and leaders scrambling to find extra beds and staff. New highs in cases have been reported in states big and small — from Idaho to Ohio — in recent days.

The rise in cases and hospitalizations was alarming to medical experts.

Around the world, disease trackers have seen a pattern: First, the number of cases rises, then hospitalizations and finally there are increases in deaths. Seeing hospitals struggling is alarming because it may already be too late to stop a crippling surge.

“By the time we see hospitalizations rise, it means we’re really struggling,” said Saskia Popescu, an epidemiologist at George Mason University.”” (E)

“Coronavirus cases in New Jersey, an early epicenter of the pandemic, are on the rise again, doubling over the last month to an average of more than 900 new positive tests a day, a worrisome reversal of fortune for a state that had driven transmission rates to some of the nation’s lowest levels.

After an outbreak several weeks ago in a heavily Orthodox Jewish town near the Jersey Shore, cases are now rising in counties across the state, driven, officials say, by indoor gatherings.

The state’s health commissioner has said there are signs of “widespread community spread” for the first time since New Jersey successfully slowed the spread of a virus that has claimed the lives of more than 16,000 residents. A small, densely packed state, New Jersey has the highest virus fatality rate in the country…/..

State government and hospital officials said they have stockpiled months’ worth of masks, gowns and gloves — the critical personal protective equipment, or PPE, that was in short supply early in the pandemic — and are amassing medications to treat COVID-19 patients. Some acute-care facilities are signing advance contracts with staffing agencies in case they need to supplement their existing workforce…

State Health Commissioner Judy Persichilli said Monday that her team holds daily calls with hospital leaders to check on bed capacity and other resources, including staff — a protocol that has continued, unabated, since the pandemic began.

“We’ve never stopped working with the hospitals. We never considered the (first) wave to be over,” she said. “It’s an everyday event. We’re working with the hospitals and preparing with them every step of the way.”

The state DOH worked with the hospital association to create a database for all providers to report their PPE capacity; the department also requires hospitals to keep 90 days’ worth of surge-level supplies in stock, according to a spokesperson. Persichilli said the state is also stockpiling protective gear and some medicines — in particular Remdesivir, which appears to benefit some patients.

“My anticipation is that our biggest struggle will be staffing as we experience community spread,” Persichilli said Monday as she urged the public to keep up with infection control measures. “People that work in hospitals and in long-term care facilities also are members of a community.”

“These are very valuable individuals that we need, but if they fall ill, backup will be difficult … because every other state in the nation is having the same difficulties we’re having,” she said. In the spring, other states then relatively spared by the pandemic sent backup staff to help New Jersey.” (F)

“It’s no longer just a few hotspot counties causing the virus to spread in New Jersey. The problem is now widespread, from north Jersey to south.

But experts say a second wave is here.

“This is not something we didn’t expect. We expected a second wave to happen in the fall. But the question is how bad it gets. That means peak, and how quickly we get to that peak,” said Dr. Shereef Elnahal, president and CEO of University Hospital, Newark.

Dr. Elnahal says the hospital is already nearly at capacity with non-COVID patients. Now the COVID hospitalizations are increasing again.

“Signs are pointing that this is about to get worse,” Dr. Elnahal told CBS2’s John Dias. “When you start to hit levels of 3 or 4% positivity, you can expect even more admissions. And most concerningly, John, we did have one COVID-19 death last week for the first time in many weeks.”

“The other patients will have to delay their care even more,” Dr. Elnahal added….

New Jersey and Connecticut now technically qualify for the Tri-State travel advisory list, where travelers from states with rising infection rates must quarantine for two weeks.” (G)

“As the coronavirus races across the country, it has reached every corner of a nursing home in Kansas, infecting all 62 residents inside. There are so few hospital beds available in North Dakota that patients sick with the virus are being ferried by ambulance to facilities 100 miles away. And in Ohio, more people are hospitalized with the virus than at any other time during the pandemic.

After weeks of warnings that cases were again on the rise, a third surge of coronavirus infection has firmly taken hold in the United States. The nation is averaging 59,000 new cases a day, the most since the beginning of August, and the country is on pace to record the most new daily cases of the entire pandemic in the coming days.

But if earlier surges were defined by acute and concentrated outbreaks — in the Northeast this spring, and in the South during the summer — the virus is now simmering at a worrisome level across nearly the entire country. Colorado, Illinois, Kentucky, Michigan, Montana, New Mexico, North Dakota, Ohio, South Dakota, Utah, Wisconsin and Wyoming each set seven-day case records on Tuesday. Even New Jersey, once a model for bringing the virus under control, has seen cases double over the past month…

The latest wave threatens to be the worst of the pandemic yet, coming as cooler weather is forcing people indoors and as many Americans report feeling exhausted by months of restrictions. Unlike earlier waves, which were met with shutdown orders and mask mandates, the country has shown little appetite for widespread new restrictions…

The newest surge sets the stage for a grueling winter that will test the discipline of many Americans who have spent warmer months gathering in parks and eating outdoors, where the virus is known to spread less easily. At the current rate of growth, new daily confirmed cases could soon surpass 75,687, the record set on July 16.

The rising case count has so far not translated to increased deaths: About 700 people are dying on average each day, a high but steady rate. So far, more than 220,000 Americans have died from the virus.

The latest developments represent a serious new level of spread. Deaths are considered a lagging indicator of new infection, and experts believe the daily toll is likely to rise in the coming months. Nationwide, hospitalizations, the most accurate gauge of how many people are currently sick from the virus, are already trending upward, at a pace slightly lower than new infections.” (H)

“On Tuesday, local health authorities issued an emergency stay-at-home order for the campus in Ann Arbor, Mich., mostly restricting undergraduates to their residences unless they’re getting food, doing an essential job or going to class.

Athletics, though, are exempt — meaning that the Wolverines’ football team will keep preparing for a road game in Minnesota on Saturday and an Oct. 31 home opener against rival Michigan State University. Although the Michigan stadium won’t feature a large crowd, some officials worry that the home game will fuel new cases anyway because of Spartan fans who travel to Ann Arbor and Michigan supporters who gather for watch parties.” (I)

• A.Dr. Scott Gottlieb: U.S. about ‘a week away from a rapid acceleration’ of coronavirus cases, by Emily DeCiccio, https://www.cnbc.com/2020/10/20/dr-scott-gottlieb-us-about-a-week-away-from-rapid-covid-cases-rise.html
• B.NIH Director ‘Guardedly Optimistic’ About COVID-19 Vaccine Approval By End Of 2020, JAMES DOUBEK, https://www.npr.org/sections/coronavirus-live-updates/2020/10/20/925790239/nih-director-guardedly-optimistic-about-vaccine-approval-by-end-of-2020
• C.US surgeon general says herd immunity could ‘lead to many complications/deaths’, http://www.wcsjnews.com/news/national/coronavirus-live-updates-us-surgeon-general-tweets-herd-immunity-could-lead-to-many-deaths/article_d30cd7d5-98f1-5230-a962-e9b3485718da.html
• D.Trump trashes Fauci and makes baseless coronavirus claims in campaign call,By Kaitlan Collins and Kevin Liptak, https://www.cnn.com/2020/10/19/politics/donald-trump-anthony-fauci-coronavirus/index.html
• E.Coronavirus resurgences have officials across the country looking to shore up hospitals, by  Lisa Marie Pane, Carla K. Johnson and Daniella Peters, https://www.inquirer.com/health/coronavirus/coronavirus-covid-19-resurgence-hospitals-beds-staffing-20201021.html
• F.With cases rising, NJ hospitals prepare for what’s ahead, by LILO H. STAINTON, https://www.njspotlight.com/2020/10/nj-covid-19-hospitals-cases-rising-ppe-staffing-concerns/
• G.Head Of University Hospital Says New Jersey’s Second Wave Is Here: ‘This Is About To Get Worse’, https://newyork.cbslocal.com/2020/10/21/new-jersey-connecticut-qualify-for-coronavirus-travel-advisory/
• H.‘It Has Hit Us With a Vengeance’: Virus Surges Again Across the United States, By Sarah Mervosh and Lucy Tompkins https://www.nytimes.com/2020/10/20/us/coronavirus-cases-rise.html?referringSource=articleShare
• I. U of Michigan hit with emergency stay-at-home order amid coronavirus spike. But the football team will play on., by Tim Elfrink,
• https://www.washingtonpost.com/nation/2020/10/21/university-michigan-covid-emergency-football/?utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1&pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJjb29raWVuYW1lIjoi
• J.CDC Reduces Consecutive Minutes Of COVID-19 Exposure Needed To Be A ‘Close Contact’, by JOE NEEL, https://www.npr.org/sections/coronavirus-live-updates/2020/10/21/926365995/cdc-reduces-consecutive-minutes-of-covid-19-exposure-needed-to-be-a-close-contac