Doctor, Did You Wash Your Hands?®

Curated Contemporaneous Case Study Methodology

Jonathan M. Metsch, Dr.P.H.

PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”

PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”

PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)

PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….

PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”

POST 6. February 18, 2020.  Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””

PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.

PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”

PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”

Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.

PART 11. March 5, 2020.  CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”

Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”

Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”

PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”

PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.

PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT

PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.”  “New York’s private and public hospitals unite to manage patient load and share resources.

PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.

PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”

PART 20. April 20, 2020. CORONAVIRUS. “…nothing is mentioned in the “Opening Up America Again” plan about how states should handle a resurgence.”

PART 21. April 23, 2020. CORONAVIRUS. “We need to ask, are we using ventilators in a way that makes sense for other diseases but not this one?”

POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”

POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)

POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.

POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”

POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”

POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…

POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.

PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!

POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….

POST 31. June 9, 2020. CORONAVIRUS. “I think we had an unintended consequence: I think we made people afraid to come back to the hospital,”

Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”?  “ If Fauci didn’t exist, we’d have to invent him.”

POST 33. June 21, 2002. CORONAVIRUS….. Smashing (lowering the daily number of cases) v. flattening the curve (maintaining a plateau)

POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!

POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..”  While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”

POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..

POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”

POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)

POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)

POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”

POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”

POST 42. August 11, 2020. CORONAVIRUS. “I think that if future historians look back on this period, what they will see is a tragedy of denial….

POST 43. August 22, 2020. CORONAVIRUS.”  “we’ve achieved something great as a nation. We’ve created an unyielding market for FAUCI BOBBLEHEADS”!! (W)

POST 44.  September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”

POST 45. September 9, 2020. CORONAVIRUS.  Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’

POST 46.  September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”

POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”

POST 48. October 1, 2020.   “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)

POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”

POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).

POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).

POST 52. October 18, 2020.  ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018

POST 53. October 20, 2020. CORONAVIRUS. “a…“herd-immunity strategy” is a contradiction in terms, in that herd immunity is the absence of a strategy.”

POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.

POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”

Post 56. October 30, 2020. CORONAVIRUS. “Trump’s now back in charge. It’s not the doctors.”

POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”

POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”

POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..

POST 60. November 7, 2020. “White House chief of staff Mark Meadows has tested positive for the coronavirus….” (A)

POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”

POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”

POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”

POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”

POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…

POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”

POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”

POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”

POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….

POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.

POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”

POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”

POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”

POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.

POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….

POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”

POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”

POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”

POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”

POST 80. November 29, 2020. CORONAVIRUS. Op-Ed in the Jersey Journal. Do you know which hospital is right for you if you have coronavirus? | Opinion

POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”

POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?

POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”

POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”

POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”

POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)

POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”

POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…

PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill

POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”

POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”

POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)

POST 93. December 19, 2020. CORONAVIRUS.  On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?

POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”

POST 95. December 23, 2020. “The Murphy administration may step in to force (New Jersey) hospitals to report COVID-19 outbreaks among staff.”

POST 96. December 26, 2020. CORONAVIRUS. “Achieving herd immunity against the coronavirus could require as much as 90 percent of the population to be vaccinated, Anthony Fauci…”…”..he hesitated to state a number as high as 90% weeks ago because many Americans still seemed skeptical about vaccine….”

POST 97. December 27, 2020. “A new variant of the coronavirus that has been spreading through the UK and other countries has not yet been detected in the United States..”.. . But if new-wave medicines like antivirals and antibody therapy contributed to the development of viral variants, it will be “a reminder for all the medical community that we need to use these treatment options carefully.”

POST 98. December 28, 2020. CORONAVIRUS. “Governor Andrew Cuomo announced new penalties in order to rein in possible vaccination fraud…

POST 99. December 29, 2020. CORONAVIRUS. “ICUs are being overwhelmed across many parts of California. Statewide aggregate ICU availability has been at 0% since Christmas Eve…. a surge on top of a surge on top of a surge.”… “hospitals are getting close to the point where they would begin putting COVID-positive patients under the care of COVID-positive staff who are asymptomatic.”

POST 100. December 29, 2020. CORONAVIRUS. Front line hospital workers – in the ER, ICUs, EMS, acute medical care, behavioral health – are amongst the most courageous, heroic and dedicated colleagues you will ever meet.

POST 101. December 30, 2020.CORONAVIRUS. Is there a point where the increasing Coronavirus trajectory so far exceeds the slow growth of the vaccination rate that reaching herd immunity through vaccinations becomes less likely?

POST 102. January 2, 2020. CORONAVIRUS. “We’ve taken the people with the least amount of resources and capacity and asked them to do the hardest part of the vaccination — which is actually getting the vaccines administered into people’s arms,” said Dr. Ashish Jha, the dean of Brown University’s School of Public Health. “Ultimately, the buck seems to stop with no one,”…

POST 103. January 4, 2021. CORONAVIRUS. Dr. Fauci said “that the United States would not follow Britain’s lead in front-loading first vaccine injections, potentially delaying the administration of second doses…Dr. Moore – ”British officials “seem to have abandoned science completely now and are just trying to guess their way out of a mess.”

POST 104. January 6, 2021. CORONAVIRUS. “Paramedics in Southern California are being told to conserve oxygen and not to bring patients to the hospital who have little chance of survival…”

POST 105. January 8, 2021. CORONAVIRUS. POST 105. January 8, 2021. CORONAVIRUS. “Facing a shortage of vaccinators, the Association of Immunization Managers… recommends relaxing regulation or adjusting licensing requirements. At least two states, Massachusetts and New York, have changed their laws in recent weeks to expand those who are eligible to give shots.”

POST 106. January 9, 2021. CORONAVIRUS. The riots at the Capitol could have been a superspreader event. “From what I saw… you had a large congregation of individuals who were in close contact for an extended period of time and almost universally unmasked…. many coming and going on buses as well, also unmasked, and hanging out in hotel lobbies.”

POST 107. January 8, 2021. CORONAVIRUS. “Our job is to make sure the vaccine isn’t politicized the way masks were politicized,” Rep. Alexandria Ocasio-Cortez, D-N.Y., said after getting her vaccine.   South Carolina Rep.-elect Nancy Mace, a Republican, wrote that “Congress shouldn’t be putting themselves first in line for the COVID-19 vaccination when the average American can’t get it.”

POST 108. January 9, 2021. CORONAVIRUS. (vaccination)”Line-cutters will be named and shamed. It’s inevitable, as will be the congressional hearings and front-page investigative stories ferreting out who saved their own skin at the expense of others.”

POST 109.January 9, 2021. CORONAVIRUS. “President-elect Joe Biden will aim to release nearly every available dose of the coronavirus vaccine when he takes office, a break with the Trump administration’s strategy of holding back half of US vaccine production to ensure second doses are available.

POST 110. January 13, 2021. CORONAVIRUS. ““The (federal) government is changing the way it allocates Covid vaccine doses, now basing it on how quickly states can administer shots and the size of their elderly population.”… “New York State sent a letter to hospitals saying if they don’t use their vaccine allocations by the end of this week, they won’t receive any further allocations.”

POST 111. January 14, 2021. CORONAVIRUS. “Visitors from Toronto to New York to Buenos Aires have long flocked to Florida for sun, surf and shopping. Now they are coming for the Covid-19 vaccine….

POST 112. January 14, 2021. CORONAVIRUS. CHINA – “Eleven million people are under lockdown in Hebei province after a new cluster of coronavirus infections.

PART 113. January 17, 2021. CORONAVIRUS. The Next President Actually Has a Covid Plan… New York City and other places in the state expect to exhaust their supply of doses as early as next week… Charles Barkley said during the “NBA on TNT” broadcast that pro athletes should get the first round of the vaccine…..

POST 114. January 18, 2021. CORONAVIRUS. “When government programs that have been unattended, underfunded and bogged down by red tape suddenly have to meet a huge demand in a crisis, they can’t cope and people suffer….”

POST 115. January 21, 2020. CORONAVIRUS. A year ago today an unnumbered POST was headlined “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.” The CORONAVIRUS CONTENT TRACKING PROJECT started with HISTORIOGRAPHY and over time moved to LESSONS LEARNED, RAPID RESPONSE, and THE VACCINATION PROGRAM. Now 115 POSTS later – the BIDEN CORONAVIRUS PLAN.

POST 116. January 22, 2021. President Biden – “We’re entering what may be the toughest and deadliest period of the virus. We must set aside politics and finally face this pandemic as one nation.”

POST 117. January 23, 2021. CORONAVIRUS. 1.Dr. Fauci:“The idea that you can get up here….”and.. let the science speak”… “It is somewhat of a liberating feeling.” 2.updated CDC guidance:”.. providers could give the second dose up to six weeks after the first dose..” 3.Dr. Fauci: people would be “taking a chance” if they follow the CDC’s updated guidance.

POST 118. January 24, 2021. CORONAVIRUS. “Unfortunately, we’ve let this virus spread extensively and are launching the vaccination campaign at the height of the threat,” Dr. Meyers said. “The more the virus spreads before the vaccine reaches people, the fewer deaths we can prevent with the vaccine.”

POST 119. January 27, 2010. CORONAVIRUS. Amazon is offering its help to President Joe Biden with the rollout of COVID-19 vaccines. Washington’s governor, Jay Inslee, included the help of companies like Starbucks, Costco and Microsoft in a plan to vaccinate 45,000 residents a day.

POST 120. January 28, 2021. CORONAVIRUS. “The fact that four vaccines backed by the federal government seem to be less effective against the (South African) B.1.351 variant has unsettled federal officials and vaccine experts alike. Facing this uncertainty, many researchers said it was imperative to get as many people vaccinated as possible — quickly. Lowering the rate of infection could thwart the contagious variants while they are still rare, and prevent other viruses from gaining new mutations that could cause more trouble.”

POST 121. January 30, 2021. CORONVIRUS. Will our communities become stratified by which vaccine is distributed? 95%ters v. 72%ters? Will the easier distribution of the J&J vaccine drive its inequitable distribution to” hard-hit, marginalized, and medically underserved communities.” (thanx! to XJ/LA)

POST 122. February 1, 2021. CORONAVIRUS. Dr.Fauci endorses double-masking. Dr.Osterholm disagrees!

POST 123. February 4, 2021. CORONAVIRUS. “Nursing homes across the country are facing the same struggle, as workers have been more reluctant than residents to be vaccinated…

POST 124. February 5, 2021. CORONAVIRUS. Dr. Osterholm ” …it may be time to..go with a ‘first-dose only’ approach, so more people over the age of 65 can have at least some protection right away. He said that would require delaying second doses until this summer.” Dr.Fauci “warned against this practice, and cautioned people about “the danger” that could come with focusing only on the first dose.”

POST 125. June 9, 2021. CORONAVIRUS. “States are rolling back Covid-19 restrictions as new cases trend down from record highs across the country. But experts warn it might be too much too soon as variants pose an increased risk and the pandemic… is far from over.”

POST 126. February 11, 2021. CORONAVIRUS. “There will be more coronavirus outbreaks in the future. Bats and other mammals are rife with strains and species of this abundant family of viruses. Some of these pathogens will inevitably spill over the species barrier and cause new pandemics. It’s only a matter of time.” (A)

POST 127. February 12, 2021. CORONAVIRUS. “… Trump only agreed to be hospitalized when aides told him that he could walk to Marine One or he could wait until his case progressed and he would be carried out.”

POST 128. February 14, 2021. CORONAVIRUS. “The Centers for Disease Control and Prevention released new research on Wednesday that found wearing a cloth mask over a surgical mask offers more protection against the coronavirus, as does tying knots on the ear loops of surgical masks…

POST 129. February 15, 2021, CORONAVIRUS. “ “The CDC released its much-anticipated, updated guidance to help school leaders decide how to safely bring students back into classrooms, or keep them there.”…” For politicians, parents and school leaders looking for a clear green light to reopen schools, this is not it.”

POST 130. February 16, 2021. CORONAVIRUS. “A second person who had contracted the Ebola virus died this week in the Democratic Republic of Congo, marking another outbreak just three months after the nation outlasted the virus’s second-worst outbreak in history…”

POST 131. February 17, 2021. CORONAVIRUS. “It really is right now – a race between how quickly new variants, particularly the U.K. variant, can spread in the United States and how quickly we can get people vaccinated”

POST 132. February 20, 2021. CORONAVIRUS. “In Texas, where over 2.5 million people are still without power, the state health department said this week’s vaccine shipments wouldn’t arrive until Wednesday at the earliest.”

POST 133. February 23, 2021. CORONAVIRUS. “Going off your meds is a surefire way to aggravate your doctor. What if a whole country did it?” The United Kingdom has veered into uncharted territory by changing tack and introducing a revised COVID-19 vaccination protocol, one that involves distributing the second dose at 12 weeks, rather than the prescribed 21 days.”

POST 134. February 24, 2021. CORONAVIRUS. The first tranche of the J&J (single dose) vaccine must go to K-12 teachers, so schools can open safely in the first 100 days of the Biden Administration. The federal government…”can set up its own vaccination centers in regions with eligible populations it’s trying to target.” We owe our front-line teachers nothing less!

POST 135. February 27, 2021. CORONAVIRUS. “As Chief Executive Officers of New York’s major health care systems, we would like to provide facts to clear up confusion in the public and the media regarding decisions to discharge patients to nursing homes during New York’s spring coronavirus surge.”

POST 136. March 2, 2021. CORONAVIRUS. ““The governors of Texas and Mississippi both announced on Tuesday they would be lifting their states’ mask mandates and rolling back many of their Covid-19 health mandates..”…while “The US could experience a “fourth surge” of coronavirus before the majority of the country is vaccinated.”

POST 137. March 4, 2021. CORONAVIRUS. “The clamor for hard-to-get Covid-19 vaccines has created armies of anxious Americans who have resorted to hunting for leftovers on the fringes of the country’s patchwork vaccination system. They haunt pharmacies at the end of the day in search of an extra, expiring dose. They drive from clinic to clinic hoping that someone was a no-show to their appointment. They cold-call pharmacies like eager telemarketers: Any extras today? Maybe tomorrow? Some pharmacists have even given them a nickname: vaccine lurkers.” (H)

POST 138. March 6, 2021. CORONAVIRUS. “New cases are decreasing in the third wave because we are past the holidays, not because of vaccinations. It is a common misconception that the decrease we are seeing in new cases, hospitalizations, and deaths in the U.S. is due to vaccinations. The two aren’t related; at least yet.”

POST 139. March 8, 2021. CORONAVIRUS. CDC Issues First Set of Guidelines on How Fully Vaccinated People Can Visit Safely with Others…” In practice, that means fully vaccinated grandparents may visit unvaccinated healthy adult children and healthy grandchildren of the same household without masks or physical distancing.” (C)

POST 140. March 9, 2021. CORONAVIRUS. “In West Virginia, they are bracing for the second wave….. Not coronavirus but opioid overdoses, with one scourge driving a resurgence of the other.

POST 141. March 11, 2021. CORONAVIRUS. Today is the first anniversary of the WHO declaration that the novel coronavirus was a Public Health Emergency of International Concern… “To truly prepare itself against the next pandemic, the U.S. has to reimagine what preparedness looks like.”

POST 142. March 15, 2021. CORONAVIRUS. “Candida auris is a superbug, a pathogen that can evade drugs made to kill it—and early signs suggest the COVID-19 pandemic may be propelling infections of the highly dangerous yeast. That’s because C. auris is particularly prominent in hospital settings, which have been flooded with people this year due to the coronavirus.”

POST 143. March 17, 2021. CORONAVIRUS. “The Trump administration sought to suppress Covid-19 testing in the United States last year by softening guidance from the Centers for Disease Control and Prevention on who needed to be tested, a House panel said Monday.”

POST 144. March 20, 2021. CORONAVIRUS. ““The vaccine hesitancy we are seeing isn’t just about Covid vaccines,”… “It is a general reflection of Americans’ lack of trust in science, the pharmaceutical industry, and large health care institutions. We need a full court press on science and vaccine education right now to prevent more aggressive Covid-19 variants from developing and taking hold.”

POST 145. March 25, 2021. CORONAVIRUS. “Efforts to disseminate Covid-19 vaccines as widely as possible are hitting an unexpected obstacle: health-care workers who decline the shots.

POST 146. March 30, 2021. CORONAVIRUS. Dr. Osterholm told Becker’s: “This is the perfect storm,”…”Here is Europe locking down and having problems containing B.1.1.7, even with vaccinations and previous infection histories. Here we are opening up as wide as we can. We are literally just walking into the mouth of the virus saying, ‘Don’t worry.’” (M)

POST 147. April 5, 2021. CORONAVIRUS. “The pandemic helped cement the shift to “a philosophy of really focusing on the role of the physician in reasoning through ambiguous and unknown problems as the focus of education, rather than teaching students that the role of physician was to memorize a body of knowledge that was already in existence and good enough for what usually happens.”

POST 148. April 7, 2021. CORONAVIRUS. While the Biden administration accelerates vaccinations to ward off numerous variants and as more young people are being hospitalized, states, even with increasing case rates are on paths to fully reopen. Politics v. public health!

POST 149. April 10, 2021. CORONAVIRIUS. “From Michigan to Massachusetts, COVID-19 cases and hospitalizations are on the rise again. Deaths will soon follow. “ ”.. the Biden administration is facing renewed calls to delay second vaccine doses and blanket more of the U.S. population with an initial shot.”

POST 150. April 10, 2021. CORONAVIRUS. “The use of so-called COVID-19 “vaccine passports” is quickly becoming a divisive issue across the US – with several states, including New York, embracing the idea, while others have already moved to ban them.”

POST 151. April 14, 2021. CORONAVIRUS.   the J&J vaccination pause. “ Federal officials are concerned that doctors may not be trained to spot or treat the rare disorder if recipients of the vaccine develop symptoms of it…”  “…a standard treatment for blood clots — use of an anticoagulant drug — could be dangerous or even fatal in such cases…”

POST 152. April 15, 2021. CORONAVIRUS. “The Chinese Center for Disease Control and Prevention’s director said Saturday authorities are considering mixing COVID-19 vaccines because the country’s domestically made doses “don’t have very high protection rates,”

POST 153. April 18, 2021. CORONAVIRUS. “At least 35 hospitals across Michigan were listed Thursday as nearing capacity and three were at full capacity for COVID-19 patients..”.. We can manufacture beds. We can open up beds. We can create entire wings of the hospital if we have to, but if we don’t have staff for those beds, we’ve got nothing.”..

POST 154. April 19, 2021. CORONAVIRUS. “Breakthrough infections, which occur when fully vaccinated people are infected by the pathogen that their shots were designed to protect against, are an entirely expected part of any vaccination process.”   “Pfizer’s chief executive said that a third dose of the company’s Covid-19 vaccine was “likely” to be needed within a year of the initial two-dose inoculation — followed by annual vaccinations.”

POST 155. April 24, 2021. CORONAVIRUS. As the J&J vaccine pause is ended Senator Johnson said “The science tells us that vaccines are 95% effective. So if you have a vaccine, quite honestly, what do you care if your neighbor has one or not? I mean, what is it to you?”

POST 156. April 28, 2021. CORONAVIRUS. As CDC revises guidance on outdoor masking, Texas Governor Abbott says “the state is “very close” to herd immunity… despite acknowledging that he does not know what the herd immunity threshold is for the virus, an uncertainty echoed by the public health community.”

POST 157. April 25, 2021. CORONAVIRUS. Ohio hospitals; “We agreed in multiple conversations, there’s nothing in fighting a pandemic that creates a competitive advantage.”…

POST 158. May 5, 2021. CORONAVIRUS. . As populations get closer to herd immunity “ it may be helpful to introduce some nuance to what we mean by the term. Nationwide herd immunity. Regional herd immunity. Temporary herd immunity. Endemicity.”

POST 159. May 9, 2021. CORONAVIRUS. “Without deeper sharing of expertise in how to make vaccines…waiving patent obligations is unlikely to be a game-changer… Having access to the “recipe” certainly helps, but understanding how to put it together and produce it at scale is something else.”

POST 160. May 13, 2021.CORONAVIRUS. “The CDC acknowledged Friday that airborne spread of COVID-19 among people more than 6 feet apart “has been repeatedly documented.”” Meanwhile states relax or eliminate indoor dining restrictions. HUH?

POST 161. May 15, 2021. CORONAVIRUS. “Even if the spread of Covid-19 decreases enough to allow a return of most activities, there are some aspects of pandemic life that epidemiologists say will persist much longer. In particular, they say that masks are a norm that should continue, even if that view puts them at odds with the new C.D.C. guidance. More than 80 percent of them say people should continue to wear masks when indoors with strangers for at least another year, and outdoors in crowds.”

POST 162. May 21, 2021. CORONAVIRUS. “New Jersey Gov. Phil Murphy is refusing to lift his indoor mask mandate for vaccinated residents…” “…fully vaccinated residents in New York and Connecticut are no longer required to wear masks..”..” “California says it isn’t ready to follow the federal lead and unmask, at least for another month..”.. “..Texas Gov. Greg Abbott issued an executive order Tuesday prohibiting state governmental entities such as counties, public school districts, public health authorities and government officials from requiring mask wearing.”

POST 163. May 23, 2021. CORONAVIRUS. RWJBarnabas Health in New Jersey announced a mandate…saying supervisors and those of higher rank must get the vaccine by June 30. They will eventually require the system’s 35,000 employees to do the same.

POST 164. May 26, 2021. CORONAVIRUS. On Wednesday, health minister Norihisa Tamura warned Olympic organizers they would have to “secure their own” hospital beds for anyone falling ill at the Games, explaining the government would not release beds set aside for Japanese covid-19 patients.”

POST 165. May 31,2001. CORONAVIRUS. “Like all pandemics, this one will end either with millions — maybe billions — being infected or being vaccinated. This time, world leaders have a choice, but little time to make that choice before it is made for them.”

POST 166. June 3, 2020. CORONAVIRUS. “President Biden said Wednesday that he has asked intelligence agencies to double down on their efforts to investigate whether the coronavirus originated from human contact with an animal or in an laboratory in China, saying there is not “sufficient information” to assess whether one is more likely than the other.”

POST 167. June 9, 2021. CORONAVIRUS. Hospitals prevaricate on mandatory staff vaccinations.  Florida’s Governor forbids cruise ship vaccine mandates. Pfizer and Moderna apply for FDA full approval.

POST 168. June 10, 2021. CORONAVIRUS. “Our species has a tendency to get distracted. We have a very strong appetite for distraction, and when something is not in the spotlight, when it’s not a crisis anymore, we tend to forget and move on to something else. So the biggest challenge is going to be maintaining focus on this next step of developing vaccines that anticipate pandemics.”

POST 169. June 14, 2021. CORONAVIRUS. “Hospitals in Washington, D.C…announced a consensus agreement to mandate COVID-19 vaccinations for more than 30,000 workers, 70% of which are already vaccinated. Each of 14 hospitals will set their own deadline…”

POST 170. June 17, 2021. CORONAVIRUS. “Dr. Ashish Jha…is worried about the potential impact  the delta variant could have in the United States… “I’m concerned about the Delta variant,”… “Why? Most contagious variant yet. Wreaked havoc in India. Spiking cases in UK. Growing rapidly in the US.”

POST 171. June 19, 2021. “A 34-year-old man (a Covid-19 survivor) has been diagnosed with India’s first known case of “green fungus” infection.”… “Green fungus is the new infection to join the earlier known cases of black, white and yellow fungus.”…”green fungus was earlier seen only as a “junior partner” in other infections… In the current patient, this fungus is acting as the aggressor.”

POST 172. June 23, 2021. CORONAVIRUS. Morgan Stanley chief executive James Gorman said: “If you can go into a restaurant in New York City, you can come into the office.”…”remote work can “dramatically undermine” the character and culture a company is attempting to build; and “virtually eliminates spontaneous learning and creativity.”

POST 173. June 26, 2021. CORONAVIRUS. “The daily toll of COVID-19, as measured by new cases and the growing number of deaths, overlooks a shadowy set of casualties: the rising risk of mental health problems among health care professionals working on the frontlines of the pandemic.”

POST 174. July 1, 2021. CORONAVIRUS. “..while the WHO is encouraging people to keep wearing masks even if they’re vaccinated, Dr. Anthony Fauci says it doesn’t look like the CDC currently plans to change its guidelines.” … health officials in Los Angeles recommended that “everyone, regardless of vaccination status, wear masks indoors in public places as a precautionary measure.”..”

POST 175. July 5, 2021. CORONAVIRUS. “Can a health care worker who is not against vaccines in general still harbor sincere concerns that scientists don’t yet know about all the side effects of these vaccines? Yes, says Ezekiel Emanuel, MD, PhD — but those people should not work in health care.”

POST 176. July 9, 2021. CORONAVIRUS. Mercy Springfield ( Missouri) hospital…” ran out of ventilators for its patients over the Fourth of July weekend…”…“Mercy will require all current and future employees to be fully vaccinated.”…“The US government is deploying a Covid-19 surge team to provide public health support in southwest Missouri

POST 177. July 12, 2021. CORONAVIRUS. the Delta variant is “the 2020 version of Covid-19 on steroids,”… “It is the most hypertransmissible, contagious version of the virus we’ve seen to date…it’s a superspreader strain if there ever was one .” but… now, there’s a Delta Plus variant…

POST 178. July 15, 2021. CORONAVIRUS. “Tennessee’s top vaccine official says she has been fired as punishment for doing her job in the face of political pushback.”..” More than 180 state and local public health leaders…have resigned, retired or been fired since April 1…”“Former President Trump and his GOP allies have stepped up attacks on Anthony Fauci…”

POST 179. July 16, 2021. CORONAVIRUS. “It, therefore, follows that the “harm principle” (“first, do no harm.”) can be used to justify compulsory vaccination programs in specific instances where the community interests or benefits are deemed to be significant.”

POST 180, July 20, 2021. CORONAVIRUS. “Most people will either get vaccinated, or have been previously infected, or they will get this Delta variant,”.. “And for most people who get this Delta variant, it’s going to be the most serious virus that they get in their lifetime in terms of the risk of putting them in the hospital,”

POST 181. July 22, 2021. CORONAVIRUS. “Health experts fear the Tokyo Olympics could become a COVID-19 superspreader event.” “Whatever happens in Japan isn’t likely going to stay in Japan since all of the athletes and accompanying coaches and staff will be returning to their home countries.”

POST 182. July 26, 2021. CORONAVIRUS. Alabama Gov. Kay Ivey (R): “Folks supposed to have common sense.”…“But it’s time to start blaming the unvaccinated folks, not the regular folks. It’s the unvaccinated folks that are letting us down.” ““Beginning in mid-September, New York City will require all of its 340,000 municipal workers, including police, firefighters and teachers, to either be vaccinated against COVID-19 or tested weekly.”

POST 183. July 29, 2021. CORONAVIRUS. When I was appointed President and CEO of Jersey City Medical Center in1989 in the peak of the HIV/ AIDS crisis, we had a dedicated, and always full, dedicated 60 bed AIDS unit, staffed by one full time nurse and numerous part-time and per diem nurses. Today, right now, hospitals caught in the Covid-19 surge, are forced to redeploy nursing staff, respiratory therapists and other clinicians, most without prior infectious diseases experience. Why are we tolerating the unvaccinated putting our hospital staffs at risk?

POST 184. August 1, 2021. CORONAVIRUS. “The coronavirus could be “just a few mutations potentially away” from evolving into a variant that can evade existing COVID-19 vaccines, CDC director Rochelle Walensky said..” (A) “The Delta variant is more transmissible than the viruses that cause MERS, SARS, Ebola, the common cold, the seasonal flu and smallpox, and it is as contagious as chickenpox..” (I)

POST 185. August 6, 2021. CORONAVIRUS. ‘If you aren’t going to help, please get out of the way’: Biden turns up the pressure on GOP governors as Delta spreads”

POST 186. August 8, 2021. CORONAVIRUS. “One of the last things they do before they’re intubated is beg me for the vaccine. I hold their hand and tell them that I’m sorry, but it’s too late,” she added, referring to patients who have to be put on a ventilator.” (A) “There is no one definition of what the end of a pandemic means.”.. “The question of when the crisis will be over is a layered one — with different answers from local, national and global perspectives.”

POST 187. August 11, 2021. CORONAVIRUS. “As a result of the increase in COVID-19 cases and hospitalizations, the state of Florida requested 300 ventilators from the federal government.”… “An 11-month-old girl with Covid-19 is stable and no longer intubated one day after she was airlifted to a Texas hospital 150 miles away because of a shortage of pediatric beds in the Houston area.”

POST 188. August 15, 20201. CORONAVIRUS. “According to an internal CDC briefing….an estimated 1.1 million people have already gotten unauthorized booster shots…”….”If it is left up to the honor system, I think many Americans will suddenly wake up and find themselves immunocompromised enough to get a 3rd dose,”

POST 189. August 19,2021. CORONAVIRUS. “There wasn’t a single I.C.U. bed available in Alabama on Wednesday…”…”A triage plan on the Alabama health department’s website suggests that “persons with severe mental retardation” are among those who “may be poor candidates for ventilator support.”

POST 190, August 21, 2021. CORONAVIRUS. “We’re looking, in essence, at running two systems — a COVID system and a non-COVID system of care,”..“Emergency medical technicians (EMTs) and certified paramedics can now care for patients in Mississippi hospitals and emergency rooms under a new health office order issued by the Mississippi State Department of Health on Wednesday.”

POST 191. August 27, 2021. CORONAVIRUS. “Anthony Fauci, MD, chief medical advisor to the president and director of the National Institute of Allergy and Infectious Diseases, explained that late September gives the United States time to set up the logistics.” This is not medical science, but perhaps Political Science?

POST 192. August 30, 2021. CORONAVIRUS. Gov. John Bel Edwards on Hurricane Ida – “I hate to say it this way, but we have a lot of people on ventilators today and they don’t work without electricity,” he said.”

POST 193. September 3, 2021. CORONAVIRUS. Nurses are leaving their hospitals and becoming travel nurses at hospitals across town “because they can make $4,000, $5,000, $6,000, $7,000 a week while not having to relocate anywhere..”

POST 194. August 2, 2021. CORONAVIRUS. “Recently-released data is painting a grim picture of the opioid epidemic that has gripped the United States — as the country is still grappling with the coronavirus pandemic that has killed more than half a million Americans. Some people are calling them twin pandemics that have collided”…“Faced with a novel health crisis, researchers are collecting data on the long-term impact of using opioids to treat COVID-19 pain…

POST 195. September 6, 2021. CORONAVIRUS. “…there are “zero ICU beds left for children in Dallas County, Texas,”.,..”That means if your child’s in a car wreck, if your child has a congenital heart defect or something and needs an ICU bed, or more likely if they have Covid and need an ICU bed, we don’t have one. Your child will wait for another child to die… (county judge Clay Jenkins)

POST 196. SEPTEMBER 11, 2001. PART 1. Military helicopters and jets were overhead, as President Bush was getting ready to leave NYC. PART 2. LESSONS LEARNED memorandum by hospital CEO Jonathan Metsch goes “viral”…

POST 197. September 12, 2021. CORONAVIRUS. Idaho officials have instituted “crisis standards of care” to help 10 hospitals and health care systems decide how to allocate personnel and resources to deal with a crush of COVID-19 patients.”… “The Washington Medical Coordination Center oversees facilitating transfers in the state, and it’s warning we could be nearing the point of “Crisis Standards of Care,” just like Idaho.” .. “These crisis models don’t actually save more lives, they just save different lives..”

POST 198. September 15, 2021. CORONAVIRUS. A pundit said “The most elegant policy riposte to the anti-vaxxers… is to refuse to allow Medicare or Medicaid to pay their medical bills in the event they become seriously ill. Private health insurers might also follow suit.” (but is making our hospitals become the bill collectors right?)

POST 199. September 19, 2021. CORONAVIRUS. Crisis Standards of Care. “… to his knowledge, no patient in Idaho has been taken off life-support therapy in order to provide that therapy to another patient who has a better prognosis.” “While that has yet to occur, if we continue on this path, it will,”

POST 200. September 23, 2021. CORONAVIRUS. CDC Director overrides a recommendation of its scientific advisors saying “that people can get a booster if they are ages 18 to 64 years and are health-care workers or have another job that puts them at increased risk of being exposed to the virus.”…“In a pandemic, even with uncertainty, we must take actions that we anticipate will do the greatest good.”

POST 201. September 27, 2021. CORONAVIRUS. “A multibillion-dollar institution in the Seattle area is sitting on nearly $12 billion in cash… received at least $509 million in government funds (from) a federal program that is supposed to prevent health care providers from capsizing during the coronavirus pandemic.”

“Based on our estimates…we find preventable COVID-19 hospitalizations cost $5.7 billion from June to August in 2021.”…

POST 202. September 30, 2021. CORONAVIRUS. “..NY Governor Hochul signed an executive order expanding healthcare worker eligibility requirements…to head off potential staffing shortages fueled by the state’s new COVID-19 vaccination requirements.” “The.. order allows out-of-state/ out-of-country healthcare workers to practice in New York…”..”It allows EMTs graduates to temporarily pitch in at additional healthcare settings; allows various types of healthcare workers to more easily administer and order COVID-19 vaccinations; enables telemedicine physician visits in nursing homes; permits facilities to more quickly discharge, transfer or receive patients…”

POST 203. October 3, 2021. CORONAVIRUS. “.. more than 125,000 laboratory-confirmed COVID-19 cases have been reported in pregnant people, including more than 22,000 hospitalized cases and 161 deaths”…The risk is not just to the mother. Covid-19 in pregnancy can cause preterm birth or babies born so sick they have to go straight to the neonatal intensive care unit, or NICU.”

POST 204. October 5, 2021.CORONAVIRUS. “News that an experimental antiviral drug from Merck appears to halve the risk of hospitalization or death from Covid-19 has bolstered hopes of finding a simple at-home treatment for the virus.”..” A more blunt assessment came from vaccine scientist Dr. Peter Hotez of Baylor College of Medicine’s National School of Tropical Medicine. “It’s not a miracle cure but a companion tool, So get vaccinated.””

POST 205. October 11, 2021. CORONAVIRUS. The AAP reported nearly 226,000 new child cases over the past week ending. “Hospital care for children does not occur in isolation from that of adults. Many of the resources we use are the same—a twenty-pound baby and a two-hundred-pound man might use the same kind of ventilator, for example. Dialysis machines, which could cleanse a seven-year-old’s blood as easily as his grandfather’s, are in high demand. Pediatric resident physicians, nurses, and respiratory therapists get cross-deployed to care for adults during the surges.”

POST 206. October 15, 2021. CORONAVIRUS. to borrow from Winston Churchill about where we are with the pandemic –  “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”

POST 207. October 17, 2021. CORONAVIRUS. “…if you choose your own unauthorized booster shot, what happens if later research proves a different combination is better? That’s why experts say it’s a bad idea to become your own vaccine advisory committee and get a shot out of turn.”

POST 208. October 22, 2021, CORONAVIRUS. “What is the “delta plus” variant?” Scientists are monitoring the delta-related variant — known as AY.4.2. — to see if it might spread more easily or be more deadly than previous versions of the coronavirus.

POST 209. October 28, 2021. CORONAVIRUS. “The quest at Mount Sinai began with a mystery.”…”America was not simply struggling to contain a once-in-a-century pandemic, caused by a virus far more dangerous than seasonal influenza. Many patients were, for unknown reasons, not recovering.”

POST 210. October 31, 2021. CORONAVIRUS. “Some people want the FDA to speed up. Others want it to be more cautious…There’s a fundamental tension between the right to get access to a drug people are desperate for and the right to protection from dangerous failures of quality. The first demands speed; the second requires time…”

POST 211. November 4, 2021. CORONAVIRUS. Colorado – “…there are patients who really ought to be in an intensive care unit but instead they’re in an emergency room. Or they ought to be in a step-down unit but instead they’re on the floor. Or they ought to be getting one-to-one nursing, and instead they’re getting two-to-one, or three-to-one nursing….”

POST 212. November 9, 2021. CORONAVIRUS. “They went into hospitals with heart attacks, kidney failure or in a psychiatric crisis. They left with covid-19…” “A new report shows the coronavirus pandemic had a direct increase on the number of healthcare-acquired infections in hospitals nationwide.”

POST 213. November 13, 2021. CORONAVIRUS. “Since the earliest days of the pandemic, there has been one collective goal for bringing it to an end: achieving herd immunity…Now the herd is restless. And experts at the Centers for Disease Control and Prevention have set aside herd immunity as a national goal.”

POST 214. November 20, 2021. CORONAVIRUS. “This virus is doing what this virus does,” said Michael Osterholm… “We don’t understand why surges start, we don’t understand why they end.” (A)

POST 215. November 26, 2021. CORONAVIRUS. Dr. Fauci on the new South African variant: “It’s not going to be possible to keep this infection out of the country. The question is: Can you slow it down?”

POST 216. December 1, 2021. CORONAVIRUS. Covid cacophony: as states struggle to address health care staffing shortages, a federal court puts Biden administration health care worker vaccination mandate on hold.

POST 217. December 3, 2021. CORONAVIRUS. President Biden Announces New Actions to Protect Americans Against the Delta and Omicron Variants as We Battle COVID-⁠19 this Winter

POST 218. December 5, 2021. CORONAVIRUS. “In some ways, Delta is the ideal variant: It’s transmissible enough to dominate more dangerous variants, and its virulence can be controlled through vaccination. In the next few weeks, we’ll find out whether Omicron will have its own silver lining—or whether it’ll be catastrophically worse.”

POST 219. December 9, 2021. CORONAVIRUS. “Entering uncharted territory, the U.S. counts 500,000 Covid-related deaths.”… “So yes, I am furious at the unvaccinated, and I am not ashamed of disclosing that. I am no longer trying to understand them or educate them.”

POST 220 December 13, 2021. CORONAVIRUS.  Dr. Osterholm. “You cannot outrun the game clock with this pandemic. This virus will find you… We’ve seen health care systems virtually broken by this pandemic. They just couldn’t provide critical care to non-Covid patients.” (A)

POST 221. December 18, 2021. CORONAVIRUS. “Johnson & Johnson’s Covid vaccine was going to be a shot for the world. Now, under the weight of a mountain of bad PR, one wonders if the world will want it.”

POST 222. December 20, 2021. CORONAVIRUS. So why my “inside baseball” focus on COVID-19 from the perspective of a retired hospital CEO?

POST 223. December 28, 2021. CORONAVIRUS. Links for a case study of Crisis Standards of Care.

POST 224. December 29, 2021. CORONAVIRUS. “crisis standards of care protocols in Maryland – “It also allows us to slim down documentation,… allows unconventional staffing models such as using nurses that have not been bedside. It also sets the expectations for the community that it’s not business as usual.”

POST 225. January 3, 2021. CORONAVIRUS. “Be first, be right, be credible,” are among the most important principles for health authorities to follow in a crisis, the Centers for Disease Control and Prevention shared in a pamphlet on crisis communication in 2018….”

Post 226. January 5, 2022. CORONAVIRUS.  New York City – “The city’s ambulance corps are so understaffed because of the COVID-19 surge, they’re now under new orders to try to convince stable patients with flu-like symptoms not to go to the hospital.”

POST 227. January 10, 2020. CORONAVIRUS.  “Stay indoors. But also return in person. Wear a mask. Not that one. The expensive one, that you can’t find. Take rapid tests. Which you also can’t find. But if you find them, don’t buy them. Rapid tests don’t work. You need PCR. There are zero appointments in your area.” (F)

POST 228. January 13, 2022. CORONAVIRUS. “State officials are attempting to address California’s staffing shortage through a sweeping policy change that allows asymptomatic healthcare workers who have tested positive for the coronavirus to return to work immediately.” “Asymptomatic health professionals who had tested positive for COVID-19 should “preferably be assigned to work with COVID positive patients.”

POST 229. January 16, 2020. CORONAVIRUS. “It is now highly unlikely that the U.S. will hit the ~85-90% of Americans vaccinated to get to the other side of the pandemic…”

POST 230. January 20, 2022. CORONAVIRUS. “Dr. Fauci also said that the world is still in the first of what he considered to be the five phases of the pandemic. The first is the “truly pandemic” phase, “where the whole world is really very negatively impacted,” followed by deceleration, control, elimination and eradication.”…to paraphrase Churchill – “This is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”..

POST 232. January 28, 2022. CORONAVIRUS. “A Boston hospital’s denial of a heart transplant to a man who is unvaccinated for Covid-19 has generated national attention, but experts say mandating vaccines is in keeping with other long-standing requirements that patients have to meet to receive an organ — including getting other shots…”

POST 233. February 2, 2022. CORONAVIRUS. “The same virus can cause endemic, epidemic or pandemic infections: it depends on the interplay of a population’s behaviour, demographic structure, susceptibility and immunity, plus whether viral variants emerge.”

POST 234. February 2, 2022. CORONAVIRUS. “Senate Republican leader Mitch McConnell demanded an end to the COVID-19 state of emergency on Wednesday , saying it was time for Americans to get on with their lives after two years on a ‘hellish highway.’”

POST 235. February 17, 2020. CORONAVIRUS. “Over time, the U.S. health care sector has implemented various pieces of the  (pandemic) safety-assessment-and-improvement puzzle, but it has not instituted a thorough system of safety that reaches from the boardroom to the front lines and that can be maintained during times of crisis.”

POST 236. February 22, 2021. CORONAVIRUS.  MOUNT SINAI AT HOME – “We began thinking about how we could use hospital-at-home to meet the needs of our hospital system in our community, in terms of responding to the crisis of COVID-19…”

POST 237. February 27, 2020. CORONAVIRUS. “Decision-makers are increasingly embracing the reality that we will have to “learn to live with” the coronavirus. But how will they know when to impose or lift restrictions?”  “Now, the CDC’s “Covid-19 community level” metrics are based on three pieces of data in a community: new Covid-19 hospitalizations, hospital capacity and new Covid-19 cases.”

POST 238. March 5, 2022, CORONAVIRUS. “Two different scientists can look at the same set of data and come up with different conclusions. That’s not to say that one person is being unscientific or ignoring the scientific process,” said Leana Wen, an emergency physician and a professor at George Washington University. “Public health policy is also a measure of values.””

POST 239. March 9, 2022. CORONAVIRUS. “War is an infectious disease’s best friend,” says Michael Osterholm, “It challenges every public health program you can possibly have. It limits the medical care available for those who might be seriously ill, and often fosters transmission when so many people are crowded into bomb shelter locations and on trains. This is going to be the perfect storm of one serious challenge after another.” (E)

POST 240. March 15, 2022. ““China is modifying its Covid-19 playbook amid a surge in cases as it seeks to avoid strains on its healthcare system.”

POST 241. March 20, 2022, CORONAVIRUS. Dr. Ashish Jha will serve as the new White House COVID-19 response coordinator.” He is not, for the record, a virologist, immunologist, or vaccinologist…But he is a public health expert and a practicing internist, which means he has years of experience explaining complicated and often incomplete information to people who neither know nor care about the correct pronunciation of “adenovirus.” That’s who he imagines on the other end of his webcam.”

POST 242. March 24, 2022. CORONAVIRUS. “How worried should people be about the BA.2 variant? Will vaccines protect against it? What if someone contracted a previous variant — could they become reinfected? Is BA.2 milder than previous versions, and if so, should people try to get it? Could BA.2 cause another surge in the US, and is it time for restrictions to be put back into place?”

POST 243. March 28, 2022. CORONAVIRUS. “…the US Food and Drug Administration is planning authorize a fourth dose of the Pfizer and Moderna mRNA vaccines for adults over age 50 next week.”…”The decision to make fourth doses available now will bypass independent groups of scientific advisers for both the FDA and CDC, which would normally meet and publicly review the available science and then make recommendations to the agencies.”

POST 244. April 4, 2022.CORONAVIRUS. “Here’s a scary thought: America’s ability to face the pandemic’s next phase may depend on a handful of senators.”…. “When the end of the COVID-19 pandemic comes, it could create major disruptions for a cumbersome U.S. health care system made more generous, flexible and up-to-date technologically through a raft of temporary emergency measures.”

POST 245. April 10, 2022. CORONAVIRUS. We can’t react to a wave we don’t see coming. “I keep thinking back to this idea of If we don’t measure it, it won’t happen,”…(As President Donald Trump once put it, “If we stop testing, we’d have fewer cases.”) In reality, “it’s very well happening, and we just don’t see it yet.”

POST 246. April 15, 2022. CORONAVIRUS. “State authorities and health care organizations could pay a high price for reinstating SCOPE OF PRACTICE (SOP) restrictions when the pandemic ends.” (e.g. NPs, PAs, Pharmacists +++)

POST 247. April 23, 2020. CORONAVIRUS. “The DOJ lawyers tasked with defending the CDC’s mask mandate authority have warned Biden administration officials that continuing to push the legal fight over the mask mandate could backfire, if the conservative-leaning appeals court upholds the order.”….”A Supreme Court ruling upholding the decision to strike down the mask mandate would make the Florida judge’s conclusions about CDC authority binding nationwide.”

POST 248. April 27, 2022. CORONAVIRUS. “For at-risk Americans without access to a “test-to-treat” drugstore that has a qualifying provider available, this means some will have to make multiple trips to get the pills. You have to develop COVID symptoms, you have to subsequently get a test for COVID-19, get the result of that test, find and go to see a provider, get a prescription, and then fill that prescription. That’s six steps in five days,”…

POST 249. May 6, 2022. CORONAVIRUS. “The United States is “certainly, right now, in this country, out of the pandemic phase..” (Dr. Anthony Fauci). “The US should prepare for a possible summer surge of Covid-19 cases across Southern states..” (Dr. Deborah Birx)

POST 250. May 11, 2022. Herd Immunity Deja vu. “Not so long ago, the world was clinging to the hope of herd immunity—to the notion that the population would eventually reach some communal level of protection sufficient to quash the outbreak for good. Maybe, experts posited many months back, once 60 to 90 percent of people had been infected or vaccinated or both, the virus would run out of viable hosts, and simply fizzle out. Now it’s clear that “that’s too simplistic…”

POST 251. May 16, 2022. CORONAVIRUS. “Now, nearly one million people have died. It did not have to be this way.”

POST 252. May 20, 2022. CORONAVIRUS. “The stakes, two years into the pandemic, should be clear. Fewer vaccines, fewer treatments, and fewer tests will mean more infections, more serious illnesses, and more deaths. That is the scenario the country is staring down: one million people already dead and more to come because politicians became complacent.”

POST 253. May 29, 2020. CORONAVIRUS. “Significant obstacles persist in getting Paxlovid to everyone who could benefit from it; more than a million courses of Paxlovid purchased by the government are still available…”..” However, some doctors have also voiced concerns over wider use of the antiviral drug amid reports of so-called “rebound” symptoms following use of Paxlovid, which might raise the risk of the virus evolving resistance to the pills.”

POST 254. June 2, 2022. MONKEYPOX, “Massachusetts General Hospital this week began vaccinating a small group of workers against monkeypox — the first time the new medicine has been used in this country outside of clinical trials. The workers were in close contact with a man diagnosed with the virus and hospitalized at Mass General from May 12 to May 20. The patient was the first person in the United States to be tied to an ongoing outbreak of the rare virus in Europe and North America.”

POST 255. June 5, 2022. CORONAVIRUS. “More than a year after U.S. health care workers were saluted for saving lives in the COVID-19 outbreak and celebrated with nightly clapping from windows and balconies, some are being issued panic buttons in case of assault and ditching their scrubs before going out in public for fear of harassment.”

“The shooting in Tulsa is an extreme example of a growing trend: violence against doctors, nurses, and other health care workers.”

POST 256. June 10, 2022. MONKEYPOX. “This is one of the rare diseases in which you can vaccinate somebody after they’ve been infected, before they have symptoms, and block the disease,”… “We would have to really screw things up not to be able to contain this..”

POST 257. June 17, 2022. CORONAVIRUS. “We’re now in a very weird pandemic phase. On Twitter, doctors such as Eric Topol sound five-alarm warnings about the latest subvariants of omicron. Offline, even in blue states, people are back to parties, bars and restaurants — and will soon be flying around the world with no testing requirements to return to the US. Things feel as if they’ve lost any coherence. There’s no discernible strategy or guidance on what Covid precautions we should still be taking.”

POST 258. June 26, 2022. CORONAVIRUS. “For a long time, whenever companies wanted to hire a CEO or another key executive, they knew what to look for: somebody with technical expertise, superior administrative skills, and a track record of successfully managing financial resources.”..” That practice now feels like ancient history. So much has changed during the past two decades that companies can no longer assume that leaders with traditional managerial pedigrees will succeed in the C-suite..”

POST 259. June, 2022. Monkeypox. ”If HIV and Covid-19 were wake-up calls for the government to prioritize public health, monkeypox shows the consequences of hitting the snooze button too many times. HIV showed the importance of creating an infrastructure of health care workers who can provide approachable, competent care for stigmatized infections. Covid-19 revealed the make-or-break nature of coordinated logistics and communications.”

POST 260. July7, 2022. CORONAVIRUS. “Fauci says he’s taking 2nd course of Paxlovid after experiencing rebound with the antiviral treatment.”…” At this time, CDC states that there is currently no evidence that an additional treatment of Paxlovid, is needed, following a rebound.” So what happened to “following the science”?

POST 261. July 14, 2022. CORONAVIRUS+. A trifecta of threats which could breach hospital capacity again! – BA.5, monkeypox, & drug-resistant infections (Acinetobacter and Candida auris)

POST 262. July 21, 2022. CORONAVIRUS. Michael Osterholm, PhD: “I think the (COVID) challenge we have and continue to have are these viruses keep throwing 210-mile-an-hour curveballs. We just don’t know what the next situation is going to be.” (H) New this week: Parechovirus & Marburg virus disease.

POST 263. July 24, 2022. CORONAVIRUS. “Inside the West Wing, there was never much doubt that Mr. Biden would eventually contract the disease.”…”The president’s access to healthcare started even before he got sick. He receives full time medical care from the White House Medical Unit, a part of the military located on the first floor of 1600 Pennsylvania Avenue.”

POST 264. July 30, 2022. Monkeypox. “The federal response to monkeypox, including the limited testing capacity, has echoes of how public health authorities initially mismanaged Covid-19.”

POST 265. August 4, 2022. Monkeypox. “The shortage of vaccines to combat a fast-growing monkeypox outbreak was caused in part because the Department of Health and Human Services failed early on to ask that bulk stocks of the vaccine it already owned be bottled for distribution…”

POST 266. August 11, 2022. Polio/ Monkeypox ++.   CDC ”..has deployed a federal team to New York to investigate the case of polio detected in Rockland County. ““Based on earlier polio outbreaks, New Yorkers should know that for every one case of paralytic polio observed, there may be hundreds of other people infected..”

POST 267. August 20, 2022. CDC IMPLOSION! Lessons Learned (or not). CDC Director Walensky “…delivered a sweeping rebuke of her agency’s handling of the coronavirus pandemic, saying it had failed to respond quickly enough and needed to be overhauled.”

POST 268. August 23, 2022. PANDEMICS. “The Covid-19 pandemic has been a lesson in speed — the speed at which a novel virus among humans can spread, the speed at which it can rack up fatalities and cripple economies, the speed at which vaccines can be designed and produced, the speed at which misinformation can undermine public health. Amid all that rapidity is a different kind of speed, which drives the rest, like an engine spinning the cars on a nauseating carnival ride: the speed of viral evolution…”

POST 269. August 31, 2022. “Everyone Has a Plan Until They Get Punched in the Mouth.” (Mike Tyson). Are we in a slow retreat to herd immunity?

POST 270. September 6, 2022. CORONAVIRUS+. This is a RAPID RESPONSE/ LESSONS LEARNED project meant to: facilitate immediate decisions in the command center and incident review/ Lessons Learned ; then in the classroom, the board room, policy making forums, project management teams; ++++. me!)

POST 271. September 8, 2020. CORONAVIRUS+++. CONTENT BUNDLES PART 2 – Protecting Health Care Staff. Trump/Biden. Fauci/ Osterholm. Vaccine distribution discombobulation. Public Health 101!

September 7, 2022


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