President Biden said: “It’s time for Americans to get back to work and fill our great downtowns again,”… But some experts expressed concern that the country is trying to move past the pandemic too quickly — repeating mistakes made several times over the last two years.”
for links to POSTS 1-238 in chronological order highlight and click on
“President Biden announced during his State of the Union address on Tuesday that individuals who test positive for COVID-19 at a pharmacy will soon be able to get free antiviral treatments immediately after.
“We’ve ordered more pills than anyone in the world has. Pfizer is working overtime to get us a million pills this month and more than double that next month,” Biden said. “And now we’re launching the ‘Test to Treat’ initiative. So people can get tested at a pharmacy and, if they prove positive, receive the antiviral pills on the spot at no cost.”
“If you’re immunocompromised or have some other vulnerability, we have treatments and free high-quality masks. We’re leaving no one behind or ignoring anyone’s needs as we move forward,” he added.” (A)
“The Biden administration doubled its order for Pfizer Inc’s (PFE.N) oral COVID-19 antiviral treatment, the company and the White House said on Tuesday, providing the government a total of 20 million courses as it fights a record surge in COVID-19 cases.
The White House now expects some 4 million treatment courses of the pills to be available by the end of January and 10 million by June, three months sooner than previously planned, according to an administration official.
“We’re getting them as soon as they come off the line,” the official said.
Details of the expanded deal, Pfizer’s largest yet for the pill, were not disclosed by the company.
For the first order of 10 million courses in November, the U.S. government had said it would pay Pfizer $5.29 billion.
“These pills will be delivered in the coming months and have been shown to dramatically decrease hospitalization and death from COVID-19,” the White House said on Twitter.” (B)
““Tonight, I can say we are moving forward safely, back to more normal routines,” Biden said. “It’s time for Americans to get back to work and fill our great downtowns again.”…
COVID-19 cases have fallen to their lowest level since last summer in recent weeks, after a winter spike from the highly-transmissible Omicron variant. Deaths, though, which lag cases by weeks, are still elevated, with an average of nearly 1,700 people dying in the U.S. each day. U.S. officials emphasize that most instances of serious illnesses and death in the U.S. occur among those who are unvaccinated or who have not received a booster dose of the vaccines.
Earlier Tuesday, Biden extended the federal government’s 100% reimbursement of COVID-19 emergency response costs to states, tribes and territories through July 1, the White House announced Tuesday.” (C)
“The president’s plan focuses on four major areas: protecting against infection and treating people who develop COVID-19; preparing for new variants; preventing economic and school shutdowns; and supporting efforts to prevent and treat infections around the world, he said.
Right now, it’s complicated to access medications for COVID-19, which must be given within five to seven days of the onset of symptoms. Tests can sometimes take days to confirm an infection. Getting a prescription can be tricky and time-consuming, particularly for people who don’t have a primary care doctor. And the drugs remain in short supply.
With his “test to treat” initiative, Biden plans to dramatically increase supply, particularly of an antiviral made by Pfizer, which has been shown to prevent nearly 90% of COVID-19 hospitalizations in people at high risk for disease.
He announced Tuesday that his administration has bought 20 million doses of the antiviral, and Pfizer will provide 1 million doses this month and twice that amount next month. Monoclonal antibodies, which provide the body tools to fight off infection, also will be made available at no cost, along with the drug remdesivir, which has been shown to prevent the vast majority of hospitalizations if given within a week of the onset of symptoms…
Part of the administration’s plan is boosting American manufacturing capacity to produce 1 billion doses of COVID-19 vaccine a year and expanding and extending coronavirus testing capacity.
To avoid having to close schools and businesses during future outbreaks, the plan also includes better ventilation and air filtration, sick leave for people who are infected or who need to care for someone who has been infected, and assistance for child care facilities.
To quickly identify and combat new viral variants, the administration plans to expand wastewater tracking, which can detect an increase in infections four to six days before people are diagnosed, and expand genomic surveillance to learn of the presence of new variants when they represent just .1% of cases, Dr. Rochelle Walensky, who directs the Centers for Disease Control and Prevention, said at the news conference.
The CDC also is developing systems for more quickly determining the effectiveness of vaccines and medications against new variants, provide emergency supplies, extend hospital capacity and accelerate development and distribution of new vaccines and treatments.” (D)
“There have been an estimated 140 million Covid-19 infections in the US, the US Centers for Disease Control and Prevention estimates, even though only 74.3 million cases have been reported as of January 31.
The data comes from the CDC’s nationwide antibody seroprevalence survey, in which it’s working with state, local, academic and commercial partners to test blood samples for antibodies to the coronavirus triggered by infection, not by vaccination. By measuring Covid-19 seroprevalence, the study provides an estimate of the percentage of the population that was previously infected…
Keri Althoff, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, told CNN that although the CDC data can accurately say who does or doesn’t have antibodies, “what it doesn’t tell us is: Are those antibodies high enough to actually protect against infection if the virus would come that person’s way again?”
The presence of antibodies does not imply protection from reinfection, and the survey does not measure how much antibody is present.
Studies have shown that the level of protective antibodies created from an infection can last longer than those from vaccination, but the CDC does not recommend using antibody testing to assess for immunity to Covid-19.
“The Covid infections themselves have created a lot of immunity. How durable, how strong, what the duration of that immunity is, remains to be determined,” said Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center….
“What these data are designed to give us a sense of is: What’s the magnitude of the issue? It’s a little like looking at some mountains across a big plain. You can see where the mountains rise, where they peak and where they fall. You don’t have to count every tree to get the big picture,” Schaffner said…
However, there are limitations to the data. Althoff said that because it sources blood work done for non-Covid purposes, it’s important to consider who is being left out of the study.
“Who’s having blood work done? People who have access to health care. And what do we know about this virus? … It disproportionately impacted communities of lower socioeconomic statuses, communities that also tend to have a lower access to health care,” she said, noting that the seroprevalence measure is probably an underestimate.
Nevertheless, the data offers a snapshot of one source of immunity for the US population.
“As we’re peeling back these mandates … it’s important to know we’ve got a pretty good cushion of population immunity going on right now. And we’re going to have to watch it closely, because that will wane,” Althoff said.” (E)
“Biden said now was the moment for people to begin going back to work regularly, following two years of pandemic-related changes to the workplace. “It’s time for Americans to get back to work and fill our great downtowns again,” he urged.
Biden called for a bipartisan “reset” from the polarization of the past two years. “We can’t change how divided we’ve been. But we can change how we move forward — on Covid-19 and other issues we must face together,” he said.” (F)
“Officials still shied away from declaring that the pandemic is winding down or could turn into a regular, endemic, part of life. “We are clearly going in the right direction,” said Anthony Fauci, Biden’s chief medical adviser and infectious disease expert. “And with all the interventions we have, I believe that we are prepared for the possibility that we will get another variant.”
The strategy, which was developed by White House and health officials over the last several weeks, is organized around the central goals of protecting and treating Covid; preparing for new variants; guarding against economic and educational shutdowns; and leading the global vaccination effort…
The administration’s descriptions for how it anticipates meeting its long-range objectives are largely high level so far, with the plan asserting aspirations of “ensuring there are enough treatments for Americans who need them” and to “continue to have a robust supply of tests.”
At multiple points during Wednesday’s briefing, officials emphasized that much of the strategy relies on Congress authorizing significantly more funding — a step that Republicans have signaled they are skeptical of taking. Zients refused to detail how much money the administration needs to execute on its plan, saying only that it will soon send its request to Capitol Hill…
“We’ve reached a new moment in the fight against COVID-19, with severe cases down to a level not seen since last July,” Biden said during his Tuesday State of the Union address, in what amounted to his most optimistic remarks on the pandemic in months.
But the White House is also determined to avoid a repeat of last summer’s July Fourth celebration, when it all but declared the pandemic over only to get hit with a lethal surge within weeks.
The administration has stressed this time around that it will spend the next several months preparing for the next dangerous variant, with the plan vowing to expand its data capabilities and supplies.
The plan proposes bolstering surveillance and data collection and speeding the Food and Drug Administration’s review of already-authorized vaccines that are altered to target new variants. It also announced that coronavirus tests, antiviral pills and masks would be added to the Strategic National Stockpile for the first time. Officials are also attempting to source child-sized masks and add them to the Strategic National Stockpile.” (G)
“Outside experts also helped federal health officials game out a range of future scenarios, including strategies to prevent a new variant from overwhelming the country the way omicron did.
In the best case, they said, infections might continue declining with no new variant emerging that would be capable of reinfecting large numbers of people, according to two individuals familiar with the discussions. In the worst case, the administration would need to prepare for another omicron-like variant that is able to reinfect and sicken those who are vaccinated or had previous infections — feedback the White House appeared to implement in its new plan.
“We need to be prepared for our new normal, or another new surge,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota and a member of Biden’s covid-19 transition task force. “We’ve got to do both.”
To prepare for the worst case, Osterholm and other experts said the administration needs to help states make better decisions about mitigation measures and ensure there are ample supplies of vaccines, tests, antivirals and masks. Some privately worry the administration has spent too much time addressing “yesterday’s problem,” rather taking more creative approaches, according to a person familiar with the discussions…
But some experts expressed concern that the country is trying to move past the pandemic too quickly — repeating mistakes made several times over the last two years.
“Two years into the pandemic, the idea of “following the science” has oversimplified what’s actually a complex array of factors that policymakers must weigh in formulating a response…
Driving the news: The CDC’s decision to loosen masking guidance is the latest example of a pandemic policy rooted in science, but that is ultimately a judgment call.
The agency tied the revised guidance to an updated formula for determining a community’s risk level. The change reflects the fact that vaccinations and the Omicron variant have made case counts a less useful measure of pandemic severity, and some experts say it was long overdue.
Other experts, however, have also used science to criticize the change, arguing it fails to protect people who are immunocompromised, children who aren’t eligible for vaccination or children for whom new data suggests vaccines don’t adequately protect against infection.
The big picture: President Biden took office vowing to “follow the science.” But science is much less of a road map than it is information that should be used to choose the best route.
For example, science told us last summer that the vaccines’ effectiveness had waned over time. But it didn’t tell us what level of effectiveness was acceptable, or if and when a booster shot was needed. Policymakers and regulators had to provide those answers.
Similarly, there is no scientific marker for when someone needs to wear a mask. This allows health experts and scientists to be able to disagree on what policy should be while still claiming that they are following the science.
“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.”
Between the lines: Science isn’t absolute — data can come with uncertainties and unknowns.” (I)
“So what will the pattern look like for SARS-CoV-2, the virus that causes Covid-19, once it becomes endemic? And how much disruption will it cause? The short answer is: We don’t know yet. The endemic pattern of any disease is more easily understood retrospectively, and the coronavirus has been with us for only about two years. However, there are signs and factors that we can all watch for, which provide indications of how Covid-19 will affect our lives in the seasons and years to come. Those signs are worth discussing and bookmarking in our brains as we move toward a more normal, functioning society.
An optimistic scenario is for SARS-CoV-2 to settle into a less disruptive flulike pattern, producing wintertime outbreaks with hospitalization and mortality rates lower than we saw in 2020 and 2021. A more pessimistic scenario is for the virus to continue to generate variants that evade immunity and are capable of infecting large numbers of the population.
While it is difficult to know how endemic coronavirus will manifest, there are two important characteristics worth monitoring in the coming months and years: the frequency and severity of outbreaks. These two factors will delineate the disruption caused by the coronavirus going forward.” (J)
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
POST 93. December 19, 2020. CORONAVIRUS. On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?
POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”
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 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 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 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 231. January 24, 202. CORONAVIRUS. “Florida’s top public health official in Orlando has been placed on administrative leave after sending an email to his employees noting their lackluster coronavirus vaccination rates and urging them to get the shots.”
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.””
“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?
Fortunately, they don’t have to guess. There are four underutilized data metrics they can use to guide decisions — not only for this surge, but for the rest of the pandemic.
First, if we want to know whether covid-19 is getting worse or better in an area, turn to the sewers. That’s right — levels of the virus in wastewater is one of the best early indicators of where the virus is spreading.
Second, keep an eye on health-care capacity. The biggest societal threat during the omicron surge was its impact on the health-care system, including on health-care workers. The Department of Health and Human Services does this already with its “Protect Public Health” data hub, and colleagues of mine have created their own “circuit breaker” tool. But these data tools don’t receive enough attention…
Third, track how many hospitalizations are actually due to covid. This is different from people who arrived at the hospital for something else but happened to test positive. Massachusetts just started reporting on this and the data are illuminating. About half of all hospitalizations there are for people being treated for covid. This means others who tested positive were not there for a covid infection; they were just captured in the routine surveillance testing…
Fourth, we must incorporate risk into our decision-making. The two biggest determinants of risk have stayed constant over the past year — age and vaccination status. The latest CDC data show that the hospitalization rate for unvaccinated adults is 67 per 100,000. For a vaccinated adults and unvaccinated teenagers, it is approximately 5 per 100,000. The rate for a vaccinated teen is 1 per million…
These four metrics can help decision-makers determine when to lift restrictions. And when they do, it doesn’t mean our work is done. The big problem remains the same — the risks for those adults who are unvaccinated is extraordinarily high. We should be spending more energy on vaccinating everyone — both in the United States and around the world — and less on imposing restrictions on those already vaccinated. Just as important as knowing when to put in controls is knowing when to pull them back.” (A)
February 17, 2022
As the pandemic has evolved and most Americans have sought vaccines for protection, and as those who chose to forgo vaccination became infected (often more than once), the risk that COVID-19 poses for most Americans has declined. It’s estimated that more than 90% of Americans have some level of immunity to COVID-19 through vaccination or prior infection.
Along with this wall of immunity, approaches adopted when we had few tools to prevent spread are no longer providing benefits that always justify their costs of social disruption, diminished classroom experiences, and economic drag.
But we’ve been slow to adapt our strategies to the evolving notions of risk. The CDC is soon expected to update its policies, moving away from national recommendations and instead tying to measures of local prevalence its guidance for the protective steps people should take. This community-by-community standard may not be enough. We’ve turned restrictions on but haven’t turned them off as conditions changed. In many cases, it’s because we’re still relying on the same metrics that we used at the start of the pandemic. These concepts for measuring risk have remained mostly fixed since that time, even as people acquired protections from the virus.
At the outset of the pandemic, we had a shared sense of the threat and a shared willingness to sacrifice a lot to deal with it. As the pandemic has evolved, and its burdens accumulated, that social compact has frayed. Now we need to shift from measures adopted collectively, to tactics taken individually by people who are judging their own individual risk against their degree of caution. This means we must accept more regional and local variation in measures adopted at the state level. The government’s role will be to make sure people have the tools they need to make those choices.
Steps that were critical in 2020 to reduce death and health care strain when we were overwhelmed are no longer justifiable. But what anchors that change? Even when actions were adjusted based on risk, in many cases it came too slow. Without deliberate guideposts, it’s hard to gauge why one posture should give way to another, and how to make these decisions….
Now in 2022, we need to leave those 2020 notions of risk behind. What was judged to be “moderate” prevalence this time last year, when we were largely unvaccinated, may be the new “low” when our vulnerability has declined. Especially as we confront a more transmissible but less severe strain like Omicron….
Yet a lot of the other constructs have stayed in place, even as the Omicron wave has started to subside. Until very recently, many children were still wearing masks in schools, with no agreed-upon standard for when that will end. When Omicron peaked, some schools reverted to remote learning. Offices are closed in many big cities. Some states and businesses are still mandating vaccines, trying to coerce a shrinking pool of vaccine holdouts at the cost of increasing acrimony, even as many of the unvaccinated have probably been infected, some more than once…
But so long as we remain mired in a 2020 doctrine for measuring prevalence and how it correlates with risk, we’re going to be unable to adapt public-health measures to the virus’s ebb and flow, or find a common touchstone for managing risk in our lives.
COVID-19 will remain a fearsome virus for the foreseeable future, but one that we must learn how to live with. Federal health officials have steered us through one of the hardest periods in our country’s modern history, and helped preserve life, even as we lost more than 900,000 of our fellow citizens.
We’ve gradually found a way to coexist with this virus. Now we need a glide path to what normal becomes and a new math to guide how we adapt to COVID-19 even if we never fully defeat it.” (B)
February 18, 2022
“The New York State health commissioner announced on Friday that the state would not enforce a booster-shot requirement that had been scheduled to take effect for health care workers on Monday.
The decision was an acknowledgment that too many workers were refusing boosters for the state’s health care system to continue functioning normally with the mandate in place. Three-quarters have “received or are willing to receive their booster,” said the commissioner, Dr. Mary T. Bassett, but the state cannot afford to lose the other 25 percent.
“The reality is that not enough health care workers will be boosted by next week’s requirement in order to avoid substantial staffing issues in our already overstressed health care system,” Dr. Bassett said in a statement on Friday. “That is why we are announcing additional efforts to work closely with health care facilities and ensure that our health care work force is up-to-date on their doses.”
She said New York officials continued to view booster shots as “critical tools to keep both health care workers and their patients safe,” and the statement said officials would reassess in three months.
While overall booster uptake among New York’s health care workers is 75 percent, the numbers vary widely among types of health care workers. For instance, according to the New York State Department of Health, 95 percent of hospice workers report that they have been or are planning to be boosted, but only 51 percent of nursing home workers say the same.
Health care workers are still required to have received their initial vaccination series under a mandate that took effect last year. Some workers challenged that requirement based on religious objections, but the Supreme Court declined to block it.
Separately, New York City fired about 1,400 public employees this week — less than 1 percent of the city’s work force — for not complying with a mandate requiring at least one dose of a coronavirus vaccine. The Supreme Court also declined to block that mandate.” (C)
February 20, 2022
“For more than a year, the Centers for Disease Control and Prevention has collected data on hospitalizations for Covid-19 in the United States and broken it down by age, race and vaccination status. But it has not made most of the information public.
When the C.D.C. published the first significant data on the effectiveness of boosters in adults younger than 65 two weeks ago, it left out the numbers for a huge portion of that population: 18- to 49-year-olds, the group least likely to benefit from extra shots, because the first two doses already left them well-protected.
The agency recently debuted a dashboard of wastewater data on its website that will be updated daily and might provide early signals of an oncoming surge of Covid cases. Some states and localities had been sharing wastewater information with the agency since the start of the pandemic, but it had never before released those findings.
Two full years into the pandemic, the agency leading the country’s response to the public health emergency has published only a tiny fraction of the data it has collected, several people familiar with the data said.
Much of the withheld information could help state and local health officials better target their efforts to bring the virus under control. Detailed, timely data on hospitalizations by age and race would help health officials identify and help the populations at highest risk. Information on hospitalizations and death by age and vaccination status would have helped inform whether healthy adults needed booster shots. And wastewater surveillance across the nation would spot outbreaks and emerging variants early.
Without the booster data for 18- to 49-year-olds, the outside experts whom federal health agencies look to for advice had to rely on numbers from Israel to make their recommendations on the shots. (After several inquiries from The New York Times about the booster data for that age group, the agency posted it on its website Thursday night.)…
“Tell the truth, present the data,” said Dr. Paul Offit, a vaccine expert and adviser to the Food and Drug Administration. “I have to believe that there is a way to explain these things so people can understand it.”
Knowing which groups of people were being hospitalized in the United States, which other conditions those patients may have had and how vaccines changed the picture over time would have been invaluable, Dr. Offit said.
Relying on Israeli data to make booster recommendations for Americans was less than ideal, Dr. Offit noted.
“There’s no reason that they should be better at collecting and putting forth data than we were,” Dr. Offit said of Israeli scientists. “The C.D.C. is the principal epidemiological agency in this country, and so you would like to think the data came from them.”” (D)
February 20, 2022
“Gov. Gavin Newsom of California on Sunday described the new pandemic plan he released last week as a “more sensible and sustainable” approach that would lead the state out of “crisis mode” now that Omicron cases had dropped significantly and many residents were eager to move on.
His comments on MSNBC followed an announcement from state officials last week about a “next-phase” plan, which would prioritize strategies like coronavirus vaccination and stockpiling supplies while easing away from emergency response measures like mask mandates.
“A year and a half, two years ago, we had a war metaphor and we were hoping there would be a day where there would be a ticker-tape parade à la World War II,” Governor Newsom said. “At the end of the day, though, I think we are realizing that we’re going to have to live with different variants and this disease for many, many years. And that’s what this plan does, it sets out a course to do it sustainably.”
The Omicron variant sparked an enormous surge in California. Though the state has seen a sharp decline in known infections since mid-January, new cases are still hovering at more than 13,000 per day. Overall through the pandemic, the coronavirus has infected at least 1 in 5 Californians and killed more than 84,000, according to a New York Times database.
California is among the many states to loosen masking requirements in recent weeks, with Hawaii as the last state holding onto a statewide mandate. Puerto Rico also has yet to announce upcoming changes.
But federal health officials have yet to release any new recommendations that reflect the lifting of restrictions — including mask mandates in schools — in nearly every state, and the U.S. path in the next phase remains complicated.
Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, last week cited the need to “remain vigilant” so that infections continue their promising decline nationwide. She said the C.D.C. would soon be releasing new “relevant” guidelines that would suggest adjusting restrictions, including for mask-wearing, based on factors like hospital capacity, not just case counts…
California’s new plan emphasizes surveillance and preparedness, focusing on continuing to promote vaccines while stockpiling medical supplies, ensuring surge staffing, combating disinformation and increasing wastewater and genomic tracking to spot new variants. Under the plan, mask requirements would be subject to change based on the severity and volume of new infections…” (E)
February 21, 2022
As states loosen COVID-19 restrictions across the country, masking, particularly in schools, remains a controversial—and confusing—issue.
While it is true that COVID-19 case rates are dropping after the Omicron surge, hospitalizations remain high in many parts of the country, and the Centers for Disease Control and Prevention (CDC) and Biden administration say it is premature to lift mask mandates in schools. (The CDC continues to recommend that everyone wear a high-quality, well-fitting mask in all indoor places.)
Those in favor of unmasking in schools, however, say transmission among school children has never been well-studied and point to the social and emotional burden of masking, particularly in young children who benefit from seeing their teachers’ facial expressions.
Given these various points of view, it’s no wonder that many parents are torn—and frustrated—as an increasing number of governors, including Connecticut’s, have set a date to lift mask mandates in schools, leaving the decision up to local authorities.
If your child’s school makes masks optional and you aren’t ready for them to be removed, should you make your child continue to mask up? What do we know about how masks prevent COVID-19 transmission in schools?
“Local governments are saying one thing, and the CDC is saying another. How can both of these things be true?” asks Jaimie Meyer, MD, MS, a Yale Medicine infectious diseases expert. “It seems that we are arbitrarily saying, ‘Hey, it’s time to take off the mask.’”
We talked more with Dr. Meyer and a fellow Yale Medicine expert to help make sense of this latest stage of the pandemic—and how best to navigate it—as sanely and as safely as possible.
Why are mask mandates in schools an issue?
The move to unmask started in early February when several states announced plans to ease many pandemic restrictions as the Omicron surge began to recede. It was a loosely coordinated effort that came on the heels of public health discussions and focus groups that began after the November election.
In Connecticut, the impending expiration of the governor’s pandemic-related executive orders, including a mask mandate in schools, brought the topic to the forefront. The state legislature voted to extend the mask mandate in schools until Feb. 28, after which the decision will fall to individual schools, towns, and cities.
Dr. Meyer notes that there is nothing from a health metrics perspective that is “magical” about this date.
“Why now? Why this moment? That’s pure politics. It is just executive orders expiring,” she says. “But I also think people don’t like mandates. They are tired of being told what to do. I think that really frustrates people.”
Ending mask mandates: a science- or political-based decision?
As Connecticut prepares to end its mask mandate, Dr. Meyer says she would prefer to see concrete metrics that prove it’s time to end them.
“Sometimes, mandates are needed for public health and safety,” she says. “So, it would be helpful to have a plan in place where we said that, for example, once the hospitalization rate is X and the vaccination coverage is Y—and when we’re able to better ventilate our spaces and spend more time outside—it would be OK to take the mask off. But to arbitrarily pick a date makes absolutely no sense to me. This virus will dictate what the right date is.”
Similarly, when the mandates are removed and you’re left only with personal choice, there should be metrics that allow us to say that certain measures are recommended or required for certain groups of people, she says.” (F)
February 23, 2022
“A more infectious type of the Omicron variant has surged to account for more than a third of global Covid-19 cases sequenced recently, adding to the debate about whether countries are ready for full reopening.
Health authorities are examining whether the subvariant of Omicron, known as BA.2, could extend the length of Covid-19 waves that have peaked recently in Europe, Japan and some other places.
“We’re looking not only at how quickly those peaks go up, but how they come down,” World Health Organization epidemiologist Maria Van Kerkhove said. “And as the decline in cases occurs…we also need to look at: Is there a slowing of that decline? Or will we start to see an increase again?”..
New York University virologist Nathaniel Landau has led research suggesting that Omicron BA.2 is even better than BA.1 at evading monoclonal antibody drugs developed to fight Covid-19. Nonetheless, he said a new Greek letter wouldn’t be needed unless BA.2 turned out to be more harmful to humans.”” (G)
February 23, 2022
“Chicago’s mask and vaccination requirements will end on Monday, February 28, the same day the state mask mandate is lifted, Mayor Lori Lightfoot announced yesterday. Suburban Cook County will follow suit, the Tribune reports.
Chicagoans will no longer be required to wear masks or show proof of vaccination in most indoor spaces, though individual bars and restaurants could still impose their own requirements, just as they did before the citywide vax mandate began on January 3. Masks will still be required on public transportation, in healthcare settings, and in certain school districts, including the Chicago Public Schools.” (H)
February 23, 2022
“As COVID-19 cases and hospitalizations continue to decline across the U.S., all states but one — Hawaii — have dropped their mask mandates or have announced plans to do so in coming weeks.
Retailers and cruises are following along, with Apple and Target stores lifting their own mask mandates this week. Cruise lines such as Norwegian and Royal Caribbean International have said mask requirements will be relaxed for vaccinated passengers, according to The Washington Post.
But CDC guidance hasn’t changed even as the Omicron variant recedes across the country. Vaccinated people should wear masks when indoors in areas of “substantial or high transmission,” which still covers more than 95% of the country, according to a CDC map.
As daily cases continue to fall, the CDC is reviewing its recommendations, Rochelle Walensky, MD, the CDC director, said during a briefing last week.
“We want to give people a break from things like mask-wearing, when these metrics are better, and then have the ability to reach for them again should things worsen,” she said.” (I)
Most people in the United States live in areas where those who are healthy do not need to wear masks indoors, according to new US Centers for Disease Control and Prevention guidance — a sweeping change from what earlier Covid-19 metrics recommended.
New CDC metrics indicate that about 28% of people in the United States live in a county where they need to wear masks indoors. Previously, CDC pointed to levels of coronavirus transmission within communities as a key metric for restrictions and recommended that people in areas with high or substantial levels of transmission — about 99% of the population — should wear masks indoors.
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. The CDC’s website includes a list of US counties and their current Covid-19 levels.
Under the updated guidance, more than 70% of the US population is in a location with low or medium Covid-19 community levels. For those areas, there is no recommendation for indoor masking unless you are at potential “increased risk” for Covid-19 and if so, the CDC recommends to talk to your health care provider about wearing a mask.
“We’re in a better place today than we were six months ago, six weeks ago, six days ago,” US Health and Human Services Secretary Xavier Becerra said in a statement to CNN. “Now it’s time to focus on severity, not just cases, of COVID. Because of all the hard work that’s been done and the many tools we’ve developed to tackle COVID, we can ease the guidance on mask use — not everyone in every place needs to wear a mask.”
At all levels, the CDC recommends people get vaccinated and boosted, and get tested if they have symptoms.
In areas with “high” levels, the CDC also advises wearing a mask in public indoor settings, including schools. In areas with “medium” levels, the CDC advises talking with your doctor about wearing a mask if you’re at increased risk for Covid-19. In areas with “low” Covid-19 community levels, there is no recommendation for mask wearing.
The CDC notes that anyone who wants to wear a mask should continue to do so.
The updated CDC recommendations reflect “a new approach” for monitoring Covid-19 in communities, Dr. Gerald Harmon, president of the American Medical Association, said in a statement Friday.
“But even as some jurisdictions lift masking requirements, we must grapple with the fact that millions of people in the U.S. are immunocompromised, more susceptible to severe COVID outcomes, or still too young to be eligible for the vaccine. In light of those facts, I personally will continue to wear a mask in most indoor public settings, and I urge all Americans to consider doing the same, especially in places like pharmacies, grocery stores, on public transportation — locations all of us, regardless of vaccination status or risk factors, must visit regularly,” Harmon said.
“Although masks may no longer be required indoors in many parts of the U.S., we know that wearing a well-fitted mask is an effective way to protect ourselves and our communities, including the most vulnerable, from COVID-19—particularly in indoor settings when physical distancing is not possible.”
Community Covid-19 levels
Counties with fewer than 200 new Covid-19 cases per 100,000 people in the past week are considered to have “low” Covid-19 community levels if they have fewer than 10 new Covid-19 hospital admissions per 100,000 or less than 10% of staffed hospital beds occupied by Covid-19 patients on average in the past week.
Levels are “medium” if counties have 10 to nearly 20 new Covid-19 hospital admissions per 100,000 or between 10% and 14.9% of staffed hospital beds occupied by Covid-19 patients on average in the past week.
Levels are considered “high” if counties have 20 or more new Covid-19 hospital admissions per 100,000 or at least 15% of staffed hospital beds occupied by Covid-19 patients on average in the past week.
Counties with 200 or more new Covid-19 cases per 100,000 people in the past week are not considered to have “low” levels of Covid-19. They are considered “medium” if they have fewer than 10 new Covid-19 hospital admissions per 100,000 or less than 10% of staffed hospital beds occupied by Covid-19 patients on average in the past week. They are considered “high” if they have if they have 10 or more new Covid-19 hospital admissions per 100,000 or at least 10% of staffed hospital beds occupied by Covid-19 patients on average in the past week.
“This new framework moves beyond just looking at cases and test positivity, to evaluate factors that reflect the severity of disease — including hospitalizations and hospital capacity — and helps to determine whether the level of Covid-19 and severe disease are low, medium or high in a community,” CDC Director Dr. Rochelle Walensky told reporters during a telebriefing call Friday.
“The Covid-19 community level we are releasing today will inform CDC recommendations on prevention measures, like masking, and CDC recommendations for layered prevention measures will depend on the Covid-19 level in the community,” Walensky said. “This updated approach focuses on directing our prevention efforts towards protecting people at high risk for severe illness and preventing hospitals and health care systems from being overwhelmed.”” (J)
February 27, 2022
“Gov. Kathy Hochul said the indoor mask requirement for schools statewide would expire Wednesday, March 2…
A drop in new cases of COVID-19 by a whopping 98% since omicron’s peak in early January, whose highest single-day total skyrocketed past 90,000 cases, is one of several improving metrics that the governor says supports lifting restrictions. She also pointed to a drop in hospitalizations and “strong vaccination rates.”
Counties and cities, the governor stipulated, will still have the authority to require masks in schools after the statewide order expires this week. Parents and guardians can also still send their kids to school in masks regardless of the change…
“We will lift the statewide requirement based on all the data that I’ve just outlined. However, there are some counties in the state that have a higher rate of transmission — we will allow them the flexibility to determine what’s best for their county. We would encourage them to take a look at this and follow the CDC, but this will no longer be a mandate,” Hochul explained.
It has been said that New York City, which just dropped mask requirements for students and staff while outdoors, would likely keep its indoor mask mandate through the April break, at least, though much could change in the next two weeks.” (K)
“Hawaii will soon be the only state in the country to have an indoor mask mandate, CBS News reports.
The news: Hawaii Gov. David Ige told local news station KITV that he has kept the indoor mask mandate because Hawaii has had the second-lowest death rate for COVID-19 in the United States.
What he said: “I am working with the Department of Health to determine when the time is right for Hawaii to lift the indoor mask mandate. Hawaii ranks second in the nation when it comes to COVID-deaths, in part because of the indoor mask requirement and other measures that have proven successful in protecting our community from this potentially deadly virus.
“We base our decisions on science, with the health and safety of our community as the top priority.”” (L)
POSTSCRIPT
MIAMI — Dr. Joseph A. Ladapo has come out strongly against mask mandates and lockdowns, only supports vaccination campaigns if the shots are voluntary and will not say whether he himself has been vaccinated.
But in pushing for State Senate confirmation of Dr. Ladapo as Florida’s next surgeon general, Gov. Ron DeSantis has found a partner in fighting what Dr. Ladapo calls the policies of “fear.”
For a Republican governor whose brash opposition to conventional public health wisdom has helped fuel obvious presidential ambitions, the appointment of Dr. Ladapo signals Mr. DeSantis’s determination to continue powering through a pandemic that has already cost 68,000 lives in Florida — this time, with what the governor can claim is a medical seal of approval.
The Florida Senate confirmed Dr. Ladapo’s appointment on Wednesday by a 24-15 vote, with all Republicans voting in favor over strong objections from Democrats…
Some of Dr. Ladapo’s positions, like his opposition to lockdowns and mask-wearing in schools, have been conservative stances for some time and are beginning to be accepted by liberal leaders now that more people are vaccinated and cases are plummeting. But these views were relatively rare among physicians in charge of public health policy at the time he was espousing them…
“Florida will completely reject fear as a way of making policies,” Dr. Ladapo said.
He did away with school quarantines and masks. When public health officials across the country were urging vaccines as a way to end the pandemic, Dr. Ladapo was raising warning flags about possible side effects and cautioning that even vaccinated people could spread the virus. He has refused to disclose his own vaccination status, which he maintains is a private matter.
Though Dr. Ladapo has acknowledged that vaccines are highly effective at preventing hospitalization and death, he said in October that “adverse reactions” to vaccines should receive more attention and urged people to “stick with their intuition and their sensibilities.”
Equally troubling for his critics was Dr. Ladapo’s failure to reject more fringe views on virus treatments, including the drugs hydroxychloroquine and ivermectin. He joined Mr. DeSantis in clamoring for the federal government to supply some monoclonal antibody treatments even after they had been deemed ineffective against the Omicron variant, which dominated caseloads.
“To say he’s out of the mainstream would be an understatement,” said Dr. Ashish K. Jha, dean of the Brown University School of Public Health. “His views are not only very unorthodox — they don’t make any sense.”” (M)
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
POST 93. December 19, 2020. CORONAVIRUS. On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?
POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”
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 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 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 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 231. January 24, 202. CORONAVIRUS. “Florida’s top public health official in Orlando has been placed on administrative leave after sending an email to his employees noting their lackluster coronavirus vaccination rates and urging them to get the shots.”
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.”
NOTE: I been on the faculty of the Icahn School of Medicine at Mount Sinai for forty-five years. I am not involved in any Mount Sinai COVID initiatives.
“Mount Sinai at Home is distinct from home health care, the more familiar and common offering, which most often describes a visiting nurse service that provides non-acute treatments like wound care and chronic care management. In our program, we treat acutely ill patients who would otherwise require hospitalization, providing them with a suite of integrated services that may include daily visits from nurses, doctors, and social workers; IV support; oxygen; X-rays; and physical therapy. Our research finds that patients who receive hospital-at-home care have fewer complications and readmissions; they also rate their health care experience more highly.
Our protocols allow us to provide home hospital care safely for a set of specific conditions, including community-acquired pneumonia, congestive heart failure, COPD, cellulitis, and dehydration. Patients are either referred to the program by their primary care physicians or are enrolled in it after visiting the emergency department. Once home, they receive a combination of in-person visits, video visits, and monitoring. One of the first steps is to have a nurse visit the patient at home and set up a tablet with a connected blood pressure monitor, which allows the patient to send a blood pressure reading while talking to the nurse remotely. But ongoing at-home management of acute-care patients requires making services available 24 hours a day. We have physicians on call around the clock, and we collaborate closely with community paramedics who we can dispatch to a patient’s home at any hour. Say it’s 2 am and a patient isn’t feeling well. We immediately send a paramedic who can set up a video link with a doctor that is compliant with patient privacy laws; then, in consultation with the physician, the paramedic provides treatment, or, if necessary, transports the patient to the hospital.”” (A)
April 7, 2020
“As health care experts eye the next two weeks as possible peaks for the nation’s COVID-19 hotspots, hospital systems continue to search for innovative ways to increase their capacity…
One such hospital-at-home program making inroads is Mount Sinai at Home, housed out of New York City-based Mount Sinai Health System.
Launched in 2014 as part of a three-year CMS Innovation Center grant, Mount Sinai at Home has been actively working to free up beds across Mount Sinai’s eight hospital campuses. It’s doing so by shifting certain vital services into the home for patients nearing the end of their in-patient stays.” (B)
May 13, 2020
Mount Sinai Health System is launching a new Center for Post COVID Care to offer additional support for and gather crucial data from patients recovering from the virus as they transition from hospital to home.
Mounting evidence shows that the virus extends beyond respiratory symptoms to include multiple systemic complications that impact the brain, heart, kidneys and other regions of the body. There are also growing concerns over striking disparities in outcomes for different patient groups, officials said.
“COVID-19 will be with us for years to come, and this Center will ensure that all New Yorkers, regardless of their disease state or socioeconomic status, will be able to get the comprehensive, expert care they need for this complex disease,” said Kenneth Davis, M.D., president and CEO of the Mount Sinai Health System, in a statement.
Mount Sinai has treated more than 8,000 patients diagnosed with COVID-19. Located at Mount Sinai-Union Square, the center will serve as a destination for patients across the Mount Sinai Health System. It will provide comprehensive multispecialty care and systematic evaluation of the long-term impact of COVID-19, officials said.
The long-term complications of acute infection are still unknown.
The center will also have a COVID-19 registry in which participating patients will undergo a baseline survey to collect information regarding sociodemographics, behaviors, comorbidities, mental health conditions and medications. Researchers will gather baseline measures of pulmonary symptoms, cognition and other mental health measures along with physical indicators including biometrics, spirometry, EKG, bloodwork and antibody titers for SARS-CoV-2, the virus that causes COVID-19.
“The entire research and clinical community has raced to understand this virus and has swiftly moved treatment and testing innovations from the lab to the bedside,” said Barbara Murphy, M.D., chairwoman of the Department of Medicine at the Icahn School of Medicine at Mount Sinai, in a statement. “The Center continues that excellence by caring for a wide spectrum of patients—from those just diagnosed to those already discharged from the hospital and those who were never hospitalized but need help recovering.” “(C)
Aug. 20, 2020
“As hospitals care for people with COVID-19 and try to keep others from catching the virus, more patients are opting to be treated where they feel safest: at home.
Across the U.S., “hospital at home” programs are taking off amid the pandemic, thanks to communications technology, portable medical equipment and teams of doctors, nurses, X-ray techs and paramedics. That’s reducing strains on medical centers and easing patients’ fears.
The programs represent a small slice of the roughly 35 million U.S. hospitalizations each year, but they are growing fast with boosts from Medicare and private health insurers. Like telemedicine, the concept stands to become more popular with consumers hooked on home delivery and other Internet-connected conveniences.
Eligible patients typically are acutely ill with — but don’t need round-the-clock intensive care for — common conditions including chronic heart failure, respiratory ailments, diabetes complications, infections and even COVID-19.
They are linked to 24/7 command centers via video and monitoring devices that send their vital signs. They get several daily home visits from a dedicated medical team. Just like in a hospital, they can press an emergency button any time for instant help…
……the hospital-at-home model has been used on a small scale in the U.S. since the mid-1990s, but it was held back because traditional Medicare and some insurance plans either didn’t cover such treatment at all or didn’t reimburse for the full cost of care.
But when the pandemic struck, the Centers for Medicare and Medicaid Services temporarily let hospitals bill for care outside their walls, including in patients’ homes. Many private insurers also are covering in-home hospital care during the pandemic. Hospital groups and others want Congress to make those changes permanent, at the same rates as in-hospital care…
Raphael Rakowski, co-founder of 4-year-old Medically Home, said the number of patients treated this July is up tenfold from July 2019.
“Our business is exploding because of COVID,” he said.
It now treats patients for 10 hospitals and one physicians’ group in five states, including two that were set up soon after the pandemic hit: Boston’s Tufts Medical Center and Adventist Health’s West Coast hospitals. Two Mayo Clinic hospitals joined this summer. Medically Home should be operating in 12 states by early 2021, Rakowski predicts.
He says some patients are offered at-home care after being examined in an emergency room. In other cases, doctors arrange the care for patients getting cancer treatment, those with a sudden illness, some about to get surgery, or homebound patients with dangerous complications.
The Veterans Health Administration operates 12 hospital-at-home programs. Last year, they served 1,120 veterans…
While interest in the programs has skyrocketed, whether in-home hospital care blossoms after the pandemic largely depends on whether government and private insurers continue to cover it at profitable prices.
If they don’t, Johns Hopkins’ Leff said: “I think most hospitals will go back to normal.”” (C)
November 29, 2021.
The Icahn School of Medicine at Mount Sinai will serve as a hub site for two cohort studies contributing to a nationwide health consortium study by the National Institutes of Health (NIH) on the long-term effects of SARS-CoV-2, the virus that causes COVID-19.
The NIH Researching COVID to Enhance Recovery (RECOVER) Initiative will examine the long-term effects of the virus, which are known as post-acute sequelae of SARS-CoV-2 infection or “long COVID.” As part of the RECOVER Initiative, which is building a national study of diverse participant research and supporting large-scale studies on long COVID, Mount Sinai will be a hub site for one of the more than 30 research teams across the United States…
Mount Sinai researchers will lead recruitment of an adult cohort to identify, evaluate, and characterize the pace and extent of recovery after severe SARS-CoV-2 infection, the course of clinical care after a severe infection, and the risk factors associated with the severity of this condition. The study will also focus on the biological differences and social determinants that distinguish patients who recover quickly from those who develop long-term effects and symptoms, such as racial and ethnic disparities in risks and outcomes. The participant group will include people during various phases of SARS-CoV-2 infection including the acute and post-acute stages, as well as pregnant people…
Mount Sinai will also be a hub site for a tissue pathology cohort that examines the molecular profiling of COVID-19 autopsies…. Under the leadership of the late Mary Fowkes, MD, PhD, Mount Sinai conducted one of the first COVID-19 autopsies in New York State in March 2020, which revealed how the virus spreads throughout the body and altered management of COVID-19 patients at Mount Sinai and globally. The tissue pathology cohort for the RECOVER Initiative will specifically evaluate the tissues and organs of long-term symptoms in people who succumbed to COVID-19 to elucidate pathophysiologic alterations—including changes in respiratory, neurological, neuropsychiatric, and inflammation-mediated multi-organ failure states. Mount Sinai researchers have committed to at least 50 autopsies per year with a capacity to increase cases…” (D)
April 7, 2020
“As health care experts eye the next two weeks as possible peaks for the nation’s COVID-19 hotspots, hospital systems continue to search for innovative ways to increase their capacity…
One such hospital-at-home program making inroads is Mount Sinai at Home, housed out of New York City-based Mount Sinai Health System.
Launched in 2014 as part of a three-year CMS Innovation Center grant, Mount Sinai at Home has been actively working to free up beds across Mount Sinai’s eight hospital campuses. It’s doing so by shifting certain vital services into the home for patients nearing the end of their in-patient stays.
“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 in the context of the [Gov. Andrew Cuomo’s] state of emergency,” Al Siu, director of Mount Sinai at Home, told HHCN in mid-March. “What we have done is made various [moves] to be able to take care of a number of subsets of patients. We believe doing that will help create some hospital capacity to take care of patients who truly need our hospital beds.”
In some cases, for example, that could mean continuing IV-antibiotic treatment at home instead of in the hospital. With patients that require general monitoring, it could mean shifting daily nursing services into the home, paired with physician monitoring and select laboratory testing.
“Rather than focusing on specific diagnoses, our focus has been on specific services that we’re able to render at home — and whether those are the services that are keeping the patient in the hospital,” Siu said.”” (E)
April 4, 2021
“New Jersey-based RWJBarnabas Health Medical Group said it’s seen positive outcomes among 120 COVID-19 patients treated through its integrated care program and has expanded its effort into other facilities and younger cases…
Through a groundbreaking combination of data, technology, services and scale, PINC AITM is designed to accelerate ingenuity in healthcare.
To this end, RWJBarnabas Health launched an integrated, multidisciplinary program focused on treating persistent COVID-19 symptoms at its flagship Saint Barnabas Medical Center (SBMC) in October…
The Post-COVID CARE (Comprehensive Assessment, Recovery and Evaluation) program incorporates 17 different specialties supported by the health system, ranging from infectious diseases to neurology to behavioral health. It’s recommended for patients who are still experiencing lingering symptoms four weeks after a COVID-19 diagnosis and does not require a referral to participate.
Those enrolled in the program are guided by the process by a designated nurse navigator, who connects them to the appropriate specialist, schedules their care and corresponds with the patient and their primary care physician.
“Unlike other diseases, Post-Acute Sequelae of COVID-19 (PASC) impacts each patient differently resulting in a very individualized treatment plan,” Trespalacios, who serves as director of the program, said. “On average, each patient may have three to four specialty referrals in addition to diagnostic testing. The nurse navigator is critical to facilitating patient appointments in order to minimize treatment delays.”
Trespalacios said adopting this personalized, adaptive approach has helped the organization better tackle the wide range of issues that follow a COVID-19 infection. Among the 120 patients treated through the program to date, outcomes have varied from an improvement in symptoms or daily function to “a complete resolution of symptoms,” she said.
Also of note, she said the medical center has been logging relevant data points over time to flesh out its COVID-19 care pathways and inform future efforts.
While RWJBarnabas Health initially took a “measured” approach to ensure it had the capacity to treat those who were enrolled, in late 2020 it decided to move forward with a pediatric version of the program that hosts the same full range of specialty services, which officially launched in February. (F)
February 11, 2022
“When we face a serious health issue that demands attention, we typically access that care beyond the confines of our home, traveling to a healthcare facility like a doctor’s office, urgent care clinic or — in especially serious situations — the hospital.
It hasn’t always been that way. Healthcare — from birth through death — once happened in the home. Now, with a boost from technology, we may find that home once again provides more and more of our healthcare solutions.
How did we get to this place? In the Middle Ages, barbers, skilled in wielding sharp instruments like razors and scissors, diversified into a range of procedures aimed at restorative health. They practiced bloodletting and tooth-pulling, as well as surgical procedures such as bladder-stone removal and limb amputation.
Many barber-surgeons worked from shops or storefronts with red, white and blue poles. Meanwhile, “flying barbers” took their services from town to town either in the home or on the battlefield. They were the predecessor of house-call doctors or Mobile Army Surgical Hospital (MASH) units.
War is a scourge, but it’s also a profound change accelerant — especially with respect to medicine and healthcare. During the U.S. Civil War, thousands of wounded and sick soldiers prompted a proportionate medical response. Armies needed beds, bandages and surgeries at scale. The response became a giant leap forward for medical practice. Public expectations shifted, and new practices migrated from the military to the civilian sphere. Hospitals evolved and soon became a fixture in our national and global healthcare system.
Hospitals Interrupted
How permanent is the hospital’s position in modern life? In an interview with the New York Times, George Halvorson, the former CEO of Kaiser Permanente, challenged us to look beyond hospitals for better solutions to healthcare problems by “[moving] care farther and farther from the hospital setting — and even out of doctors’ offices.”
The data support this shift.
1. Hospital admissions were trending downward across all age cohorts. The length of hospital stays is shrinking for procedures like childbirth, joint replacement and cardiac surgery.
2. In-patient services at hospitals are expensive, straining the budgets of households, employers and national economies. The average daily charge for a hospital bed is several thousand dollars. Patients can get treatments and procedures in doctors’ offices and ambulatory surgical centers for much less.
3. Hospital stays can be risky. Hospital-acquired infections and medical errors are two preventable causes of death in hospitals. While precise estimates have been subject to considerable debate, estimates of preventable hospital deaths range from as many as 100,000 to well over two times that number. While the debate continues, there is risk involved.
4. Better and cheaper alternatives to hospital care exist. A “continuum of care” supports those who need medical attention. That continuum moves from home care to residential care to acute care. Each has its role, but home healthcare typically combines the lowest cost of care with the highest quality of life.
Smart Home Equals Smart Healthcare
The pendulum is swinging back home. Whereas technology once pulled many breakthrough innovations beyond the home, it’s now enabling a virtual homecoming for those same activities. Home offices, remote classrooms and home gyms are commonplace. Hardware and software advances have been combined with ingenious design and artificial intelligence to inspire its own category: the smart home.
Many smart devices have home-healthcare applications. Amazon recently announced a new service called “Alexa Together” that targets families with aging family members who live independently and may require extra monitoring, support and emergency services. Smartwatches can detect falls and summon quick assistance.
Of course, the smartphone can monitor an impressive range of human activity, access relevant data, find information and tap expertise. Phones can also administer care through meditation apps, weight-loss programs and behavioral nudges. In an NPR interview, Dr. Eric Topol reports that a UCLA startup may even coax our smartphones to take X-rays — the ultimate selfie.
More technological advancements are coming. Advances in virtual reality platforms could allow virtual doctor visits and consultations. Plus, they may enable experiences that mimic travel, entertainment and social interaction to reduce social isolation and boost mental health.
How Will The Healthcare Establishment Respond?
The prospect of more healthcare delivered in a home setting represents a big shift in the industry. Control and power are shifting away from the medical establishment and toward the consumer of healthcare — a seismic change in the established paradigm. The patient increasingly will call the shots. How will the traditional healthcare establishments and professionals respond?
The stakes are high. Not only do patients expect better treatment and outcomes — at costs that are both transparent and affordable — but the size and inefficiencies of our healthcare system encourage competition from outside the system. Newcomers and tech firms that have demonstrated the potential of data-driven service models can apply their business models and platforms to get a piece of a multitrillion-dollar healthcare market that looks ripe for disruption.
The battle lines are forming. The winners will break through in these areas.
1. Utilization of personal health data. With the spread of activity monitors and the continuous capture of information about sleep, heart rate, blood sugar and more, the scale and scope of personal health data has jumped ahead of healthcare providers’ capacity to manage, analyze and use it. Electronic health records (EHRs) have now arrived, but patients have yet to see all the expected and promised benefits.
2. Better patient experience. For too long, dealing with the healthcare establishment has been a frustratingly slow and complex experience for patients. While other industries have harnessed digital services to streamline shopping, payment, delivery and consumption, traditional healthcare providers continue to lag.
3. Home sweet home. The continuum of care is shifting from institutional settings — the hospital in particular — to more convenient locations for patients. Home care puts less of a cost burden on resource-constrained consumers. Meanwhile, patients can enjoy the therapeutic comforts of their familiar surroundings. Who will be the first to hang out the “Welcome Home” sign?” (E)
February 3, 2022
Hackensack Meridian Health, New Jersey’s largest and most integrated health network, is pleased to announce the launch of Hospital At Home at JFK University Medical Center in Edison, a program that delivers high-quality acute care in the home of a Medicare patient and may ultimately be scalable to the larger patient population.
“Healthcare continues to expand beyond the walls of the hospital and this new program will help us advance strategies to improve outcomes and patient satisfaction while making care more affordable,” said Robert C. Garrett, FACHE, chief executive officer of Hackensack Meridian Health.
The program is created through a Medicare waiver, which permits hospitals to provide acute care at home to Medicare patients. The network will select patients based on factors that include diagnoses that often result in frequent and costly readmissions to hospitals: uncomplicated Congestive Heart Failure (CHF), pneumonia, Chronic Obstructive Pulmonary Disease (COPD) and cellulitis.
Initially the program will admit a few patients a week and provide the following services delivered in the home: two nursing visits daily; medications delivered to the home including infusions; rehab visits as needed; remote patient monitoring which includes pulse ox, blood pressure, heart rate, weight and temperature. Nutritious meals and home health support can be provided as needed.
The program was created during the COVID-19 pandemic to help hospitals struggling with bed capacity. In November 2020, the Centers for Medicare & Medicaid Services (CMS) released a waiver called the Acute Hospital Care at Home Waiver allowing for hospitals to bill for acute care services that patients receive at home.
“We are proud to offer this innovative program to our community, a new approach that is showing great promise for improving outcomes, meeting the needs of our patients and continuing our efforts to transform care,” said Amie Thornton, chief hospital executive at JFK University Medical Center.
Research shows that these programs are at least as safe as inpatient care and result in improved clinical outcomes, higher rates of patient satisfaction and reduced healthcare costs. Patients have indicated that they want to receive care at home, especially during the pandemic. According to a recent survey, 85 percent of adults say it should be a high priority for the government to expand Medicare coverage for at-home health care.
Ultimately the network plans to expand the program to other hospitals once the pilot is proven successful. Additionally, Hackensack Meridian Health believes Hospital-at-Home can be scaled significantly to include patients who are not covered by Medicare.
“This program can also provide an excellent opportunity to expand care in underserved communities where transportation may be an issue,” Mr. Garrett said. “A major strategic priority of the network is to help reduce inequality in care delivery.”” (F)
February 17, 2022
“At MGB, patients who come to the Emergency Department or who are already hospitalized with an acute illness may be offered the option of receiving hospital-level care at home if they meet certain criteria. The core HaH team for each patient includes a physician who sees the patient once a day, either by video or in the home, plus a nurse and specially trained paramedic who visit the patient at least twice a day at home to deliver the care they would receive in the hospital, such as IV medications and advanced respiratory therapies.
The authors discuss the technologies that have enhanced MGB’s hospital-level care at home and that are critical to scaling the model to accommodate a growing number of patients. The key technology domains are telemedicine, remote patient monitoring, clinical team coordination, and supply chain management.
More than half of the patients enrolled in HaH are over the age of 65 and have limited technology literacy. “It was very important to create technology systems that broke down the barriers to patients using individual technologies,” says Levine. Patients don’t need to have Internet access in their homes or own any electronic devices to enroll in HaH; the care team supplies everything the patient needs for remote visits. For example, patients receive a dedicated tablet installed with specialized software so they need only touch an icon of the physician’s face to initiate a video visit or to communicate with the home hospital team. Other technologies make it easy for patients with visual or hearing impairments to communicate with their healthcare team.
Eligible patients wear sensors that provide continuous hospital-level monitoring of their vital signs, such as a chest patch that records the heart’s activity. In the near future, sensors will be able to measure even more advanced parameters completely touchless, says Levine. And research is underway to use artificial intelligence to analyze the massive amounts of data generated from sensors. “Humans may benefit from machine algorithms to put all the information together to make predictions about the course of a patient’s illness based on physiologic measurements,” says Levine. “We believe that we are just beginning to realize the potential for technology to assist acute care at home.”” (G)
February 17, 2022
Healthcare is increasingly provided in a patient’s home, with potential cost savings and clinical improvements. But the hospital-at-home also raises unique liability issues not only for physicians and hospitals but also for caregivers and patients.
The COVID-19 pandemic has spurred hospitals to increasingly implement remote care models that replace in-patient care — from checkups to diagnosis to treatment — with services delivered in the patient’s home, known as the ‘hospital-at-home’ (HaH) (Box 1). Such patients typically move through the HaH in the same way that a patient moves through a traditional hospital: admission, monitoring, intervention, and discharge. But there are differences. Care occurs in the patient’s home, rather than in the hospital, which requires that the HaH providers use physicians, nurses, technicians, and caregivers in different ways from their use in the traditional hospital setting, such as telehealth or house visits. The HaH has potentially substantial economic and health benefits and has been associated with reduced risk of infections, increased mobility for patients, cost savings, and improved clinical outcomes1,2. Despite these potential benefits, the HaH poses several pressing legal and ethical challenges, including legal liability, that must be resolved for its safe, ethical, and effective implementation.
An HaH is defined as a care-delivery paradigm characterized by the following:
A pre-specified geographic catchment area for eligible patients that is delineated largely by travel time
An acuity and intensity of medical care needs that would otherwise warrant admission to an inpatient facility
An inability of community-based home health services to appropriately coordinate and deliver the services needed to sufficiently address the severity of illness…
A clinical vignette (Fig. 1) can be used to demonstrate and map the unique and complex liability issues likely to arise in the HaH setting, including liability for physicians, hospitals, and third-party service providers3. Some potential liability, such as liability for admission decisions or delayed response times, exists in the hospital setting but applies to the HaH in a unique way. Other potential liability, such as liability arising from dangerous conditions at the patient’s home, is unique to the HaH setting (Table 1).
The patient is a 61-year-old male, otherwise healthy, who recently initiated outpatient-based chemotherapy for a locally advanced renal cancer. The patient developed a non-productive cough and shortness of breath after a walk. The patient’s wife and primary caregiver immediately took the patient to the nearest emergency department, where the patient began to develop a fever. IV, intravenous; ICU, intensive care unit.
Under US tort law, when caring for patients, physicians must provide a certain standard of care: they must, depending on the state in which they practice, act either according to the “generally recognized and accepted practices in their profession” or as a “reasonable physician under similar circumstances” would act4,5,6. Although standards of care apply equally to HaH care (physicians and hospitals have duties to exercise reasonable care in admitting, monitoring, and treating patients), courts may apply them differently in the HaH context.
Consider a physician’s decision to admit a patient. In the traditional setting, the physician evaluates the patient’s symptoms, the capacities of the hospital, and level of care required. In the HaH context, because the care setting is at home, the physician must also account for the readiness of the home environment, caregiver availability, and other social determinants of health or factors not relevant to the hospital setting…
Device-manufacturer liability…
Intentional and unintentional harms…
Risk of discrimination…
Guidelines and training…
HaH programs hold great promise but also present novel liability concerns. Decisions about admission to the HaH invite a unique set of considerations that go beyond the appropriateness of hospital-level acuity to include home safety, logistics, technological limitations, and cultural considerations, as well as potential liability for caregivers and for patients themselves. Professional societies and hospital associations should proactively establish practice guidelines and training curricula for the HaH to enhance its implementation and scalability, and to reduce liability risks.” (H)
Undated
“MOUNT SINAI Center for Post-COVID Care
It was initially thought that patients with COVID-19 fell into two groups: those who experience severe symptoms and require hospitalization; and those who have mild flu-like symptoms and recover within a couple of weeks. We now know that there is an important third group: people who begin to recover from COVID-19 but continue to experience heart issues, shortness of breath, fatigue, or cognitive difficulties—often for weeks or months…
Recovering from COVID-19 is Different for Every Patient
COVID-19 affects every patient differently, so your treatment needs to be personalized to you. While the long-term effects of the virus are not clear yet, we do know that it can affect many different systems within the body, from the lungs to the heart to the kidneys. That is why we offer our patients coordinated care from a broad range of medical specialties and support services. We understand that the road to recovery may be concerning, and may require multiple specialists, appointments, and procedures. We are here for you, and you are not alone in this journey. We will take care of scheduling and work with you to develop an individualized treatment plan including experts in: Primary care; Pulmonary medicine; Cardiology; Infectious diseases; Nephrology; Psychiatry; Physical and occupational therapy; Radiology; Neurology; Neuropsychiatry; Behavioral health; Social work; Pharmacy.” (I)
(H) The hospital-at-home presents novel liabilities for physicians, hospitals, caregivers, and patients, David A. Simon, I. Glenn Cohen, Celynne Balatbat & Anaeze C. Offodile II, https://www.nature.com/articles/s41591-022-01697-3
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
POST 93. December 19, 2020. CORONAVIRUS. On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?
POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”
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 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 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 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 231. January 24, 202. CORONAVIRUS. “Florida’s top public health official in Orlando has been placed on administrative leave after sending an email to his employees noting their lackluster coronavirus vaccination rates and urging them to get the shots.”
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 23, 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…”
“The stark reality of the COVID-19 pandemic challenged the very systems established to ensure the nation’s safety and quality. The pandemic resurfaced long-endemic challenges within the health care quality and standards ecosystem and identified novel challenges that cannot be ignored…
The pandemic demonstrated the stark divide between our public health and clinical care systems. For decades, public health has been underfunded at all levels of the government, which hampered U.S. pandemic preparedness and response. In addition, the quality and safety focus areas for public health and clinical care have been poorly aligned, with health systems focused more on specific clinical areas such as treatment for acute cardiac conditions and avoidance of localized nosocomial infections; public health systems are traditionally more focused on communicable disease control and prevention of chronic disease and injuries. There was no existing data infrastructure across these systems that included key variables and metrics around readiness to inform preparedness and the response capacity of the health care system. As a result, most health systems did not have data or systems for collecting and sharing information about personal protective equipment (PPE), essential staffing, or ventilator shortages at the start of the crisis. The locus of control between the federal, state, and local governments was not always clear, with emergency response responsibilities resting in multiple federal government agencies and varying forms of state-local governance structures for public health, which can generally be described as centralized, decentralized (or home rule), mixed, and shared state and local governance. Each model presents its unique coordination challenges. The state-local mixed models are described in more detail in Public Health COVID-19 Impact Assessment: Lessons Learned and Compelling Needs [37].
Within the health care sector, multiple organizations and systems compete for business in a market-based system, with little guidance, much less metrics, for cooperation and collaboration during a public health emergency [44].
The broad quality frameworks for payers and providers have created a large infrastructure and set of resources that focus on tackling dissimilar requirements and metrics across markets and providers, supporting the disparate data and reporting systems. The resources devoted to this enterprise generate revenue and enable provider incentives—but this “teaching to the test” does not contribute enough to the health of individuals, and activities such as support for SDoH are not always rewarded.
The complex and layered measurement system was largely built through federal and state legislation. Measurement currently serves multiple agendas. The wide-ranging focus and cumbersome data capture and reporting system leave the health sector unable to tackle novel or emerging specific issues, particularly crises such as COVID-19, which required such comprehensive cross-sector collaboration. Without an overarching strategy or direction, the current system is one in which no outcomes are prioritized—there is no ability to create consistent directional change for the health of a population.”…(A)
February 17, 2022
“Since the Covid-19 pandemic began, however, many indicators make it clear that health care safety has declined. The public health emergency has put enormous stress on the health care system and disrupted many normal activities in hospitals and other facilities. Unfortunately, these stressors have caused safety problems for both patients and staff. Managing the competing priorities of providing care for large numbers of patients with Covid, as well as for the patients without Covid who need care every day, and of maintaining safety efforts such as robust infection-control practices is both difficult and essential…
We have observed substantial deterioration on multiple patient-safety metrics since the beginning of the pandemic, despite decades of attention to complications of care.2-4 Central-line–associated bloodstream infections in U.S. hospitals had decreased by 31% in the 5 years preceding the pandemic; this promising trend was almost totally reversed by a 28% increase in the second quarter of 2020 (as compared with the second quarter of 2019).3 There were also increases in catheter-associated urinary tract infections, ventilator-associated events, and methicillin-resistant Staphylococcus aureus bacteremia. Safety has also worsened for patients receiving postacute care, according to data submitted to the Centers for Medicare and Medicaid Services (CMS) Quality Reporting Programs: during the second quarter of 2020, skilled nursing facilities saw rates of falls causing major injury increase by 17.4% and rates of pressure ulcers increase by 41.8%. The surges of the delta and omicron variants of SARS-CoV-2 in late 2021 and early 2022 do not bode well for a return to prepandemic levels for any of these indicators…
Over time, the U.S. health care sector has implemented various pieces of the 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. For example, it is important to have sufficient resources such as staff and personal protective equipment for times of stress. The United States deserves breakthrough thinking about systems built on foundational principles of safety, akin to those used in other industries in which safety is embedded in every step of a process, with clear metrics that are aggregated, assessed, and acted on. We also need renewed national goals of harm elimination throughout the health care system and a core safety strategy that includes promoting radical transparency, addressing workforce shortages, and continuing to strive for safety while being sensitive to such trade-offs as reporting burden and costs. This effort should extend across the continuum of care, beyond the traditional hospital-based safety indicators, and include attention to diagnostic errors and outpatient care.” (B)
February 10, 2022
“As the Omicron wave recedes in the United States, public health officials are faced with a new round of decision-making on the best way for the country to move forward.
It’s a critical moment to rebuild the trust that has been lost among weary Americans over the past two years, said Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials.
But the best way to gain that trust — offering a transparent, metric-based approach — is challenged by a fractured and undervalued health data infrastructure. It’s problem that has long plagued the United States and one that has hindered the ability to respond swiftly and pointedly to the Covid-19 pandemic since the beginning.
“It’s difficult not just during pandemic times, but even more difficult during the pandemic,” Freeman said. “Our data modernization infrastructure for governmental public health is just really nonexistent. So when you think about having to pivot quickly with new metrics and how that data gets collected and reported and accumulated, aggregated, de-aggregated, it can be daunting.”
The data failings of America’s public health system are many and varied, tainting nearly every decision-driving metric in one way or another.
“Lack of accurate, real-time information was one of the greatest failures of the US response to the Covid-19 pandemic,” Dr. Tom Frieden, former director of the US Centers for Disease Control and Prevention, said at a hearing before the House Energy and Commerce Committee in March 2021.
Nearly a year later, these issues persist.
States have led the way in public dissemination of Covid-19 data, but experts say the federal government — particularly the CDC — could have offered more leadership and guidance on priorities. The CDC did not respond to CNN’s request for comment for this story.
Holding on to what progress has been made will require states to keep up their own efforts, as well as federal commitment to the investment of resources, but signals are mixed…
One of the most glaring issues throughout the pandemic has been the lack of clear definitions of what is even meant to be measured…
Some states report only PCR tests, while others include positive antigen tests, too.
Covid-19 hospitalization data, often viewed as one of the most stable metrics, has also come under scrutiny recently, with questions raised about how to differentiate between patients who are specifically admitted for treatment of Covid-19 and those who test positive incidentally while being treated for something else.
The US Department of Health and Human Services has outlined guidance for hospital reporting of Covid-19 data in a 50-plus-page document that is regularly reviewed and updated. And although there was intent to capture hospitalizations caused by Covid-19, the process can vary in practice, according to an agency spokesperson.
If disease severity or hospitalization data becomes a trigger metric for decision-makers going forward, having this distinction in the data will be critical, said NACCHO’s Freeman.
“We need to get that data correct, and we need to do it quickly,” she said…
“Our nation had a patchwork of underfunded, understaffed, poorly coordinated health departments and decades out-of-date data systems, none of which were equipped to handle a modern-day public health crisis,” said Frieden, who is now president and CEO of Resolve to Save Lives.
Building the national public health data infrastructure will be a “long, difficult and expensive process,” he said — but it’s critical to prevent another pandemic.” (C)
“A leading health expert said the largely more mild symptoms reported by vaccinated people against the coronavirus proves the inoculation is the best way to protect yourself from being seriously sick or dying from the disease and that a surge in case numbers should no longer be the central metric by which to measure the pandemic.
“For two years, infections always preceded hospitalizations which preceded deaths, so you could look at infections and know what was coming,” Ashish K. Jha, dean of Brown University and a former Harvard health expert said during an appearance on ABC’s “This Week” on Sunday. “Omicron changes that. This is the shift we’ve been waiting for in many ways.”
The country has shifted, Jha said, to a place where people who are vaccinated and especially those who have received a booster shot “are gonna bounce back” if they become infected with the coronavirus.
“That’s very different than what we have seen in the past,” he said. “So I no longer think infections, generally, should be the major metric.” ..
“But we really need to focus on hospitalizations and deaths now,” he said. (D)
“There are two paths world leaders can take.
It’s a little like Aesop’s fable, The Ant and the Grasshopper – a story about the virtues of planning for the future. Like the ants in the fable, we could learn from Covid-19, stock-up, prepare and keep watch as a global community.
Or policymakers could breathe a sigh of relief, hope nothing like this happens again, and carry on much as before.
Governments cannot make the same mistakes again.
They must do better.
And they must work together to strengthen global health systems to better prevent, prepare for and respond to the next pandemic.
Here’s how:
1. Improve global coordination and leadership…
2. Provide a sound financial footing for pandemic preparedness and response…
3. Invest in the gaps in infrastructure to monitor and respond to threats…
At the start of the Covid-19 pandemic, very little was known about the virus, even less how to diagnose, treat and prevent it. Thankfully, scientists could build on existing research on other coronaviruses, such as vaccines for MERS and new mRNA technology. As a result, multiple vaccines were developed, approved and manufactured in record time.
Next time, the world may not be so lucky.
Consider our response to Ebola, where failures to continue key areas of research between outbreaks led to a delay in the development of usable diagnostics, treatments and vaccines when the next outbreak hit.
There are still no WHO-approved diagnostic tests for six out of the WHO’s 10 priority diseases. “ (E)
“Preparing for the next pandemic implies that policymakers will have to understand and address the cited failures. Here, it’s imperative that policymakers develop a long-term pandemic preparedness strategy that is evidence-based, educates the population, and strives for what the former WHO Director-General Dr. Margaret Chan calls “health security.” Chan posits that “respiratory pathogens with pandemic potential pose an existential threat as serious as climate change, environmental degradation and nuclear war.” Underscoring Chan’s point, Dr. Maria Van Kerkhove, Technical Lead of the WHO’s Covid-19 Response, warned that “pandemic preparedness and readiness is a constant. It doesn’t begin, it doesn’t end. There is no peacetime.”
Echoing the warnings issued by Chan and Van Kerkhove, Dr. Scott Gottlieb writes in his book, Uncontrolled Spread, why we must view public health preparedness through the lens of national security. Here, the U.S. has an indispensable role to play, given the influence it exerts as the world’s largest economy, along with having several public health agencies the world has traditionally looked up to, including the Centers for Disease Control and Prevention.
But, public health preparedness in the U.S. faces enormous challenges. For one thing, it appears that already U.S. legislators are no longer prioritizing efforts to prepare for the next pandemic. Some might be shocked by this, in light of what has transpired over the last 20 months. But, the apathy displayed by many lawmakers is consistent with decades of neglect of public health, which has led to chronic underfunding, at the local, state, and federal levels.
Essential public health components are even an afterthought in the Biden Administration’s $65 billion pandemic preparedness initiative. Missing in this plan are, for example, comprehensive plans on how to equitably distribute and provide access to developed and procured medical technologies, as well as ways to improve outreach and information campaigns, and properly fund local public health authorities.
At a bare minimum, public health departments at the local, state, and federal levels ought to be revitalized. But, this will be a difficult undertaking in the face of entrenched opposition to public health interventions. Twenty-six states have curtailed public health powers amid the Covid-19 pandemic. In these states, legislators have rolled back the capacities which state and local officials use to protect the public against infectious diseases…
Preparing for the next pandemic will be difficult under any circumstances. But, it’s made harder by a persistent lack of resources and the rise of anti-science attitudes. Accordingly, making preparations for future infectious disease outbreaks will involve more than just resource deployment. Public health officials will also need to work on improving messaging, specifically to explain science-based decisions to the public in a nuanced way that allays fears of government overreach. Here, policymakers will have to walk a fine line when rebutting the narrative of disinformation campaigns, as run, for example, by the anti-vaccine community.” (F)
“U.S. health officials said on Wednesday they are preparing for the next phase of the COVID-19 pandemic as Omicron-related cases decline, including updating CDC guidance on mask-wearing and shoring up U.S. testing capacity.
The plans come as a growing number of U.S. states have begun to ease COVID-19 restrictions as cases decline. The seven-day average of daily cases dropped 40% from the previous week, while the daily hospital admission average dropped 28% and the average daily deaths dropped 9%, according to CDC data.
“We’re moving toward a time when COVID isn’t a crisis, but is something we can protect against and treat. The president and our COVID team are actively planning for the future,” White House COVID-19 Response Coordinator Jeff Zients told reporters.
“Our highest, first priority is fighting Omicron,” Zients said. “At the same time, we are preparing for the future.”
The U.S. Centers for Disease Control and Prevention is weighing new COVID-19 guidance, including on when to wear face masks, CDC Director Rochelle Walensky said at the same briefing, adding that hospital capacity will be a key metric.
The CDC expects many of the revised guidelines will be issued in late February or early March, around the same time mask mandates in several states are lifted, she said.
“We want to give people a break from things like mask- wearing when these metrics are better, and then have the ability to reach for them again should things worsen,” said Walensky.
Walensky cautioned that people will still have to wear masks in certain situations such as when experiencing COVID-19 symptoms, during the ten days following a COVID-19 diagnosis, or following exposure to someone with COVID-19.” (G)
B.Health Care Safety during the Pandemic and Beyond — Building a System That Ensures Resilience, by Lee A. Fleisher, M.D., Michelle Schreiber, M.D., Denise Cardo, M.D., and Arjun Srinivasan, M.D., https://www.nejm.org/doi/full/10.1056/NEJMp2118285
