“..More than 15,000 people with Covid-19 have been hospitalized in the city (NYC) in the past four weeks, the most since the initial surge. About half of all patients in the city’s hospitals now have Covid-19.
“The biggest mistake the Biden administration made was to push a vaccines-only approach, rather than a ‘vaccines-plus,’ including rapid tests, improving indoor air quality, and distributing high-filtration masks ubiquitously, coupled with public indoor mask mandates for high-risk shared spaces.
“Vaccines-only suffers from a key weakness: variants. And we have now seen this play out with Omicron. We have wildfire spread as our current vaccines do not provide sterilizing immunity — meaning, people can and do still transmit the virus effectively.”” (M)
for links to POSTS 1-229 in chronological order highlight and click on
“The U.S. is likely reaching the end of the road on new vaccinations, after the U.S. Supreme Court blocked the Biden administration’s vaccine mandate for large employers.
Why it matters: Cash prizes and other incentives barely moved the needle on vaccinations. So the government turned from carrots to sticks — but now it has lost its biggest stick.
“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,” tweeted Celine Gounder, an infectious disease expert and former Biden administration advisory board member.
By the numbers: 63% of eligible Americans are fully vaccinated and about 38% of them have gotten boosted.
About 75% of Americans have gotten at least one dose of a COVID vaccine, according to the CDC.
State of play: Employers in most of the country are still free to impose their own mandates, if they want to, but there’s not much reason to expect that to produce any major increase in vaccinations.
Only a few large companies, such as United Airlines, have required vaccines. Most employers haven’t enacted a mandate, and labor shortages could make them even less likely to do so now.” (A)
“At the same time, the court is allowing the administration to proceed with a vaccine mandate for most health care workers in the U.S.
The court’s orders Thursday during a spike in coronavirus cases was a mixed bag for the administration’s efforts to boost the vaccination rate among Americans.
The court’s conservative majority concluded the administration overstepped its authority by seeking to impose the Occupational Safety and Health Administration’s vaccine-or-test rule on U.S. businesses with at least 100 employees. More than 80 million people would have been affected.
“OSHA has never before imposed such a mandate. Nor has Congress. Indeed, although Congress has enacted significant legislation addressing the COVID–19 pandemic, it has declined to enact any measure similar to what OSHA has promulgated here,” the conservatives wrote in an unsigned opinion…
The vaccine mandate that the court will allow to be enforced nationwide covers virtually all health care workers in the country. It applies to health care providers that receive federal Medicare or Medicaid funding, potentially affecting 76,000 health care facilities as well as home health care providers. The rule has medical and religious exemptions.” (B)
“Florida won’t be enforcing the Biden Administration’s mandatory vaccination policy for health care workers upheld by the U.S. Supreme Court, a spokeswoman for the governor’s office said Thursday.
“The state of Florida is not going to serve as the Biden Administration’s biomedical police,” Christina Pushaw, press secretary for Gov. Ron DeSantis, said in an email to the USA TODAY Network-Florida. “Firing unvaccinated healthcare workers, many of whom have infection-conferred immunity, is unethical and unscientific on its face.”
She said it also harms patients “because hospitals in California and other states are now requiring vaccinated, COVID-infected healthcare workers to treat patients due to staffing shortages — which were exacerbated by vaccine mandates. How does that keep anyone safe?”” (C)
“General Electric suspended its Covid vaccine and testing requirement on Friday after the Supreme Court blocked the Biden administration’s mandate, a company spokesperson told CNBC.
GE, which had174,000 employees at the end of 2020, has encouraged its employees to get vaccinated, the spokesperson said.
President Joe Biden, in a statement after the court’s decision, called on companies to voluntarily implement the vaccine and testing rules.” (D)
“Potentially active SARS-CoV-2 may persist beyond 10 days say researchers from the University of Exeter, facilitating onward transmission of COVID-19 after a person has completed the advised quarantine period….
Prof Lorna Harries, of the University of Exeter Medical School, who oversaw the study, said, “Our data suggest that after 5 days, about 1 in 3 people could potentially remain infectious for COVID-19; a figure that is backed up by the UK Health and Safety Authority’s own data, and could pose a potential risk of onward transmission.”” (E)
“A year ago, just two doses of a Covid-19 vaccine — or even one, in the case of Johnson & Johnson’s formulation — were thought to offer sufficient protection against the coronavirus.
Now, faced with the extraordinarily contagious Omicron variant, Israel has begun offering fourth doses to some high-risk groups. On Wednesday, the Centers for Disease Control and Prevention expanded eligibility for boosters to adolescents and backed away from describing anyone as “fully vaccinated” because two shots no longer seem adequate.
Instead, one’s vaccination status will now be “up to date” — or not. It’s no surprise that many Americans are wondering: Where does this end? Are we to roll up our sleeves for booster shots every few months?
Humbled repeatedly by a virus that has defied expectations, scientists are reluctant to predict the future. But in interviews this week, nearly a dozen said that whatever happens, trying to boost the entire population every few months is not realistic. Nor does it make much scientific sense.
“It’s not unheard-of to give vaccines periodically, but I think there are better ways than doing boosters every six months,” said Akiko Iwasaki, an immunologist at Yale University. Other strategies, she said, could “get us out of this forever-boosting kind of a situation.”
For starters, persuading people to line up for shots every few months is probably a losing proposition. About 73 percent of American adults are fully vaccinated, but so far just over a third have opted for a booster….
“We’re going somewhere fast, but we don’t know where we’re going,” said Natalie Dean, a biostatistician at Emory University in Atlanta. “Whatever the future holds, it just needs to be clear what the goal is.”” (F)
“Starting Saturday, new federal rules will require private insurers to cover the at-home coronavirus tests that Americans buy in pharmacies and other stores. The new system could, in theory, allow millions of consumers to pick up tests at thousands of locations without spending any money.
The reality, at least in the short term, is likely to be messier: Some insurers say it will probably take weeks to fully set up the system the White House envisions.
The new process will be hard, the insurers say, because over-the-counter coronavirus tests are different from the doctor’s visits and hospital stays they typically cover.
The tests do not currently have the type of billing codes that insurers use to process claims. Health plans rarely process retail receipts; instead they’ve built systems for digital claims with preset formats and long-established billing codes.
Because of this, some insurers plan to manage the rapid test claims manually at the start…
The new rules require private insurers to cover eight at-home coronavirus tests for each person, every month. The rules will not apply retroactively to at-home tests that Americans have already purchased, and do not cover patients with public insurance such as Medicare and Medicaid.” (G)
“The latest Covid-19 wave has left millions of Americans scrambling for tests, braving long lines in the cold at pop-up sites or searching furiously online for kits to use at home. But for a select group of employees at some of the country’s largest companies, tests are free and often readily available.
Without an adequate federal system for developing and distributing rapid tests, companies have put their own testing services in place.
Google will send full-time employees in the United States free at-home tests that deliver results within minutes and retail for more than $70 each. BlackRock, an investment firm that manages nearly $10 trillion in assets, offers tele-health supervision as employees self-administer rapid tests for international travel. At JPMorgan Chase, bankers, including those at its retail sites, can order at-home rapid tests from an internal company site.
Some companies are using the tests to call their staff back to the office. For others, at-home Covid testing has become the newest wellness benefit, a perk to keep employees healthy and working — even from their couches — while providing peace of mind.
The testing available to a small number of white-collar professionals underscores the difference between their pandemic experience and that of other Americans, putting them at an advantage over many, including workers at small businesses without the means to procure testing kits for their staffs. Like personal protective equipment and vaccines, tests have become the latest example of how a tool to battle the pandemic can exacerbate social and economic divides.
“We’re the epicenter of the epicenter and I can’t get test kits anywhere,” said Thomas Grech, president of the Queens Chamber of Commerce, which has roughly 1,400 members that employ about 150,000 workers in the borough.” (H)
“The Omicron variant of the coronavirus is causing Covid-19 cases to spike, with an average of more than 747,000 new cases a day, according to the latest numbers from Johns Hopkins University. That’s almost three times the average daily cases from a year ago, when the country was going through its previous peak, and it’s putting an incredible strain on hospitals and emergency rooms.
The good news since the last peak is that the US Food and Drug Administration authorized new antiviral pills. Both Paxlovid and molnupiravir were given emergency use authorization in late December to treat mild to moderate Covid-19. They interfere (through different pathways) with the virus’ ability to replicate — and they can be taken at home, before someone becomes seriously ill.
Molnupiravir reduces the rate of hospitalizations in high-risk patients by about 30% and carries some possible side effects, but Paxlovid reduces the rate of hospitalizations by around 90% and is considered safer. In other words, Paxlovid is a bit of an antiviral superstar…
The bad news? Supply is very limited for both but especially for Paxlovid. Patients and their doctors are struggling to find it.
Just 160,000 courses have been delivered across the country, and with more people now hospitalized with Covid-19 than at any other time during the pandemic, these pills are in short supply.” (I)
“The American Red Cross says the nation is facing its worst blood shortage in more than a decade, citing a drop in blood drives due to the pandemic.
The organization said on Tuesday that the “national blood crisis” is threatening patient care and forcing doctors to make tough choices about who is able to receive blood transfusions, and it’s urging people to donate.
In recent weeks, the Red Cross — which provides some 40% of the nation’s blood — has had less than a one-day supply of critical blood types and has had to limit blood product distributions to hospitals. It says that at times, up to one-quarter of hospital blood needs are not being met.
There has been a significant drop in donations during the pandemic, and weather conditions and staffing limitations have caused ongoing cancelation of planned blood drives. There’s been a 10% overall blood donation decline since March 2020, and a 62% drop in college and high school blood drives during the pandemic, it says.” (J)
“Two of the country’s largest retail pharmacies are temporarily closing stores on weekends due to an increase in the number of COVID-19 infections among staffers.
The two chains said that the rapid spread of the Omicron variant has depleted staffing at several locations nationwide, affecting customer service and delaying key services like medication prescriptions and vaccinations.
Walgreens boasts nearly 9,000 locations across 50 states, the District of Columbia, Puerto Rico, and the US Virgin Islands. CVS operates around 10,000 pharmacies throughout the country.” (K)
“Like many hospitals in New York City, the Brooklyn Hospital Center is straining under the biggest surge of Covid-19 patients since spring 2020, when ambulance sirens filled the air and more than 20,000 New York City residents died.
In the pandemic’s early days, doctors and nurses looked out on emergency rooms filled with patients who were desperate for oxygen. Today, Covid-19 patients’ symptoms are generally milder — stomach aches, fainting, dizziness, nausea, some shortness of breath — and far fewer people are dying.
But the patients keep arriving, and in droves: More than 15,000 people with Covid-19 have been hospitalized in the city in the past four weeks, the most since the initial surge. About half of all patients in the city’s hospitals now have Covid-19.
And there are simply not enough nurses to care for them all. Across New York, hospitals generally employ fewer nurses than they did at the start of the pandemic, according to the New York State Nurses Association, a union.
Some nurses, burned out by stress, have left the profession; others have taken traveling nurse jobs at considerably higher pay. And the Omicron variant’s extreme infectiousness has meant many are out sick or in isolation on any given day.” (L)
“Today, notable members of the Biden administration’s COVID-19 pandemic transition team called on the president to shift his approach to the virus, accepting that it will be endemic and that new variants could emerge and arguing that the country needs a new strategy for living with the virus 2 years after it was first identified in Wuhan, China.
In one of three articles published today in the Journal of the American Medical Association, Ezekiel Emanuel, MD, PhD, of the University of Pennsylvania; Michael Osterholm, PhD, MPH, who directs the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP), publisher of CIDRAP News; and Celine Gounder, MD, of New York University, argue that a new normal must be based on understanding COVID-19 as a respiratory illness, similar to influenza or respiratory syncytial virus (RSV).
Doing so would help the country develop an appropriate risk threshold that would establish peak weekly deaths, hospitalizations, and community prevalence of viral respiratory illnesses during high-severity years.
“This risk threshold triggers policy recommendations for emergency implementation of mitigation and other measures. In addition, health systems could rely on this threshold for planning on the bed and workforce capacity they need normally, and when to institute surge measures,” the authors write.
In an interview with CIDRAP News, Osterholm said members of the Biden transition team were having these discussions before the Omicron (B.1.1.529) variant emerged. The federal government has been acting in emergency mode, they said, and needs to start thinking of the pandemic with long-term goals in mind.
“What’s the end game? With the variants, we are never sure what the end game is going to be,” Osterholm said in the interview. “This is not a critique of the current administration, as much as an opportunity to plan.”
In the same article, experts tout the important of accurate, free, and reliable at-home testing. Widespread access to N95 or KN95 respirators is also argued for, as is better air filtration systems in schools and congregate buildings.” (N)
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…”
“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. The policy, set to remain in place through Feb. 1, is designed to keep many healthcare workers on the job at a time when hospitals are expecting more patients.
Some experts say California’s stance is an unorthodox yet necessary solution to a difficult problem. Yet many healthcare workers and community members say the policy is not only ill-advised, it’s potentially dangerous…
The California Department of Public Health said hospitals are reaching capacity, and the decision was driven in large part by staffing shortages making it difficult to provide essential care.
“Given those conditions, the department is providing temporary flexibility to help hospitals and emergency services providers respond to an unprecedented surge and staffing shortages,” the agency said.
According to the guidelines, hospitals should exhaust all other options before resorting to the new policy, and workers who have tested positive for the virus should “preferably be assigned to work with COVID-19 positive patients.” The workers must always wear N95 masks…
“Is the situation ideal? No,” said Dr. Robert-Kim Farley, an epidemiologist and infectious-diseases expert at the UCLA Fielding School of Public Health. “Is it the lesser of the two evils of having no one to care for patients, versus having staff caring for them that may have COVID? Yes, it’s the lesser of two evils.”
Kim-Farley said the policy is a recognition of the significant strain hospitals are experiencing amid an increased number of patients and decreased number of staff. The chances of transmission from an asymptomatic worker are minimal, he said, particularly since he or she would be practicing precautions, including wearing high-grade medical masks…
One thing that is clear, however, is that understaffing poses a substantial risk to patients. Research has found that short staffing results in more deaths, more morbidity and more accidents and errors, she said.
“Hospitals are really stuck between a rock and a hard place, in that you really do have these staffing shortages and you have volumes of patients increasing,” Spetz said. “What do you do?”” (E)
“The new protocol, announced Saturday by the California Department of Health, means health workers exposed to COVID-19 or those who have the virus with no symptoms may return to work “immediately” – without the need for a test or quarantine – and wear an N95 mask. The move comes in response to a severe staffing shortage in the state, amid an upsurge in the omicron variant.
Asymptomatic health professionals who had tested positive for COVID-19 should “preferably be assigned to work with COVID positive patients”, the Californian health officials said, adding that this might not be possible in areas of “extreme” staff shortages or in places such as the emergency room where it wasn’t possible to know who had COVID-19.
According to the Centers for Disease Control (CDC), health professionals with COVID-19 may work without restrictions if “asymptomatic” or “mildly symptomatic” as part of a staff shortage “crisis” plan.
In “conventional” situations, health workers who had tested positive for COVID-19 and had no symptoms or mild symptoms should isolate for 10 days or seven days with a negative test, the CDC says.
Insider reported Thursday that some nurses with COVID-19 in the US are being forced to work, even with symptoms.
The California Department of Health said the measures were due to “critical staffing shortages”. Sites that implement this change must have made “every attempt” to bring on additional staff and considered “modifications to non-essential procedures”, it said…
Robert Siegel, a professor of microbiology and immunology at Stanford University, told the Chronicle, that there might be situations where “we might want to relax some of the testing requirements because staffing situations are dire, but in general, we should be more cautious.”
“It’s clear that a great deal of transmission occurs from asymptomatic people,” he said.” (F)
“The acting head of the US Food and Drug Administration said on Tuesday that most people in the United States are eventually going to get infected with COVID-19.
“It’s hard to process what’s actually happening with now, which is most people are going to get COVID,” Janet Woodcock, acting commissioner of the FDA, said to a Senate Health, Education, Labor, and Pensions Committee hearing.
The highly transmissible Omicron variant is currently sweeping through the country, and Woodcock said that past approaches to mitigating the spread of the virus don’t reflect the current situation in the US.
“What we need to do is make sure that hospitals can still function, transportation, you know, other essential services are not disrupted while this happens,” she said.” (A)
“In a series of tweets last week, Dr. Ashish Jha, dean of the Brown University School of Public Health, stressed that both patients “with COVID-19” and those admitted “for COVID-19,” have an impact on care, utilization, and can stress the health care system.
Patients, who may have come in for another ailment, such as a broken leg, and are found to be positive for the virus must stay in a COVID-19 isolation room, explained Jha, who added that there are already a limited number of such rooms available.
In addition, every time a health care worker enters a room with a COVID-19 positive patient, they must be wearing full PPE, which in turn, prolongs wait times for many patients.
“Admissions with COVID is still very disruptive to the health care system, at a time when it can’t afford more disruption,” Jha said.” (B)
“The number of hospitalized people with COVID-19 in New Jersey rose by 225 Monday night to 6,036, after an overnight adjustment to Sunday’s numbers by the state Health Department due to a reporting error.
That represents a 28% increase in COVID hospitalizations since Jan. 2. And the number of people seriously ill needing a ventilator rose to 500 Monday — a 71% jump in that period. The number in intensive care also rose, to 892, a 39% increase since Jan. 2…
“In reports from some of the state’s hospitals, a profile of ventilator patients is beginning to emerge, with a significant number unvaccinated against COVID, and many with morbid obesity and vascular conditions as complicating, co-occurring conditions,” Bennett said.
While rising steeply, the number of patients on ventilators still remains far below what it was during the first wave of the pandemic in late April of 2020, when more than 1,300 ventilators were in use.” (C)
“There are a lot of ways to describe the we-simply-don’t-have-enough-health-care-workers-to-handle-this-wave staffing crisis that is going on in hospitals around the state, if not the country.
As CEO of RWJBarnabas Health, it is something that Barry Ostrowsky said his team deals with around the clock.
“It takes literally hourly management and leadership to ensure you have the right level of personnel bedside and supporting the bedside personnel,” he said. “And that has been the case through the pandemic.”
Hospitals are again struggling to find enough staff. The surging wave of cases from the COVID-19 Omicron variant hasn’t helped. Hospitalizations have now exceeded 6,000 — a number the state hasn’t seen since the opening months of the pandemic.
Last week, Health Commissioner Judith Persichilli said hospitals should prepare for a 30% absentee rate for workers…
Mike Maron, the CEO at Holy Name in Teaneck, said the long-term outlook is just as tough. Finding additional personnel to assist has been nearly impossible.
“I’ve never seen this many vacancies in 34 years here,” he said….
Horan said Trinitas has become a community health center, which it is not meant to be during a pandemic.
“Patients are coming in just because they want to be tested, not because of an emergency reason,” he said. “They may need a test just to be able to fly someplace or go visit someplace. The problem is, once they get registered into the emergency department, you can’t just say, ‘Oh, we don’t do the test, go home.’ We have to see them.”” (D)
“About 24% of U.S. hospitals are reporting a “critical staffing shortage,” according to data from the U.S. Department of Health and Human Services, as public health experts warn the COVID-19 surge fueled by the omicron variant threatens the nation’s health care system.’’ (G)
“The Chief Medical Officer at the Colorado Department of Health and Environment reactivated Crisis Standards of Care for Emergency Medical Services. Guidance to the EMS providers on how to best use their services is needed at this time. The last time the state activated Crisis Standards of Care for Emergency Medical Services was April of 2020.
These crisis standards provide guidance for call centers, dispatch centers, and emergency medical service agencies, and responders regarding how to:
Interact with potentially infectious patients.
Maximize care for multiple patients with limited staff and emergency vehicles.
Determine what kind of treatment to provide, such as whether and where a patient should be transported for further care, if deemed necessary.” (H)
“Citing the “unprecedented strain” from the latest COVID-19 surge, a majority of Delaware hospitals are implementing emergency rules to cope with the surge of COVID-19 patients.
ChristianaCare, Bayhealth, TidalHealth Nanticoke and Saint Francis announced in a joint statement on Monday that they all will be implementing the rules, called Crisis Standards of Care.
This will allow the hospitals to redeploy clinical and non-clinical staff, adjust staffing ratios and change how treatment resources are distributed, according to a news release.
ChristianaCare, the largest health system in Delaware, was the first hospital to make this announcement.
The rules are implemented only during emergencies. Hospitals across the country have made similar decisions due to the number of COVID-19 hospitalizations.
“The current demand for care surpasses the normal resources that we have available,” hospital officials said in a statement. “Each of our organizations is taking steps to ensure that we are able to prioritize care for those with the greatest needs.”
Delaware’s health systems, officials said, are “stretched beyond capacity.” Hospitals are also asking residents to go to hospitals’ emergency rooms for serious health issues only…
The ChristianaCare release defined the emergency rules as a “framework in which health care providers can modify processes or change the way resources are allocated in order to care for patients with the highest need in conditions when it is no longer possible to deliver care according to normal standards.” (I)
“We have more patients,” Dr. Hassan Khouli, who is head of critical care at the Cleveland Clinic, told Snow when comparing the current situation to last year. “Our patients are sicker. Our teams are tired and exhausted, too.”
He said their unit is seeing patients in their 20s, 30s and 40s.
The conversation between Snow and Dr. Hassan then turned to the possibility that overcrowded COVID conditions in the ICU could lead to life-threatening concerns for other patients.
Snow: “Does that mean that somebody that comes in with a heart attack might end up dying because they can’t get into your ICU?”
Dr. Khouli: “That is possible, or they would wait in the emergency room while waiting for a bed in the intensive care unit — or they may be actually crashing on the floor.”
Snow’s report said most of the patients in the Cleveland Clinic’s ICU are currently on ventilators – 90 percent of which are unvaccinated. Approximately 5 percent of the hospital’s staff is also out sick. One nurse, for example, is now covering as many as 17 patients compared to eight on a typical day.” (J)
“Members of the U.S. Air Force will begin arriving in Ohio over the next several days to begin deployment to Cleveland Clinic.
Starting next week, 20 Air Force members will be helping staff the Clinic to deal with the omicron surge.
Those 20 people could have a big impact.
The hope is that adding these service members will allow Clinic hospitals to open more beds and accept more transfers from other hospitals.” (K)
“The Oregon Health Authority (OHA) has provided the state’s hospitals with an interim crisis care tool to help them prioritize treatment if they reach a point when critical care beds, specialized equipment, such as ventilators, and other resources become scarce due to surging COVID-19 admissions.
Oregon hospitals may activate crisis standards of care if their critical care resources are severely limited, the number of patients presenting for critical care exceeds capacity, and there is no option to transfer patients to other critical care facilities, according to a release from the OHA.
Hospitals may implement OHA’s interim crisis care tool – or one of their own that is consistent with Oregon’s Principles in Promoting Health Equity in Resource Constrained Events – if they have taken specific steps to extend their capacity to deliver care. Those steps include stockpiling supplies, delaying non-urgent care, and repurposing existing beds and staff that are not typically used to provide critical care.
Under the interim triage tool, all patients who can potentially benefit from treatment will be offered care, if health care resources are sufficient. If hospital staff, beds and treatment are insufficient, all patients will be individually assessed according to the best available objective medical evidence. According to the tool:
No one will be denied care based on stereotypes, assumptions about any individual’s quality of life, or judgement about an individual’s “worth” based on the presence or absence of disabilities.
Care decisions should be based on the likelihood of survival to hospital discharge.
Under Oregon’s interim crisis care standards, state health officials expect providers to treat all patients with respect, care and compassion. Hospital clinicians may not base care decisions on an individual’s use of past or future medical or social resources. They should apply reasonable modifications to any triage scoring criteria when considering individuals with underlying disabilities or certain underlying health conditions, according to the release.
Triage decisions will be made without regard to morally or scientifically irrelevant considerations such as income, race, ethnicity, gender identity, sexual orientation, immigration status, health insurance coverage or other factors…
At the same time, OHA also is calling for applicants today to serve on a new Oregon Resource Allocation Advisory Committee.
The Oregon Resource Allocation Advisory Committee’s role will be to:
Review and inform updates to OHA’s Principles in Promoting Health Equity During Resource-Constrained Events, which ensures health equity in decision-making when resource shortages occur.
Review and inform future amendments or changes to the interim crisis care tool.
Guide development of any additional necessary resources – including triage tools, guidance, best practices – to ensure these principles can be readily applied in Oregon during a resource-constrained event.
Inform the norms and expectations regarding patient communication and transparency when health system allocation decisions are necessary due to resources constraints.
OHA is seeking applicants representing: the state’s health care delivery system, including hospitals, health care providers and local public health agencies; and organizations and community members who can speak to community needs, especially communities of color, tribal communities and people with disabilities, including people with intellectual and developmental disabilities.” (L)
“President Joe Biden on Thursday said he was deploying more military health workers to hospitals in six U.S. states, and would give Americans free masks and more free tests to tackle the fast-spreading Omicron variant around the country.
The phased dispatch of 1,000 military health personnel beginning next week comes as U.S. COVID-19 hospitalizations hit a record high with Omicron overtaking Delta as the dominant variant of the coronavirus and health facilities facing a staffing crunch.
The move is “part of a major deployment of our nation’s armed forces to help hospitals across the country manage this surge of the Omicron virus,” Biden said.
“I know we’re all frustrated as we enter this new year,” Biden said, while reiterating his message that COVID-19 continues to be a “pandemic of the unvaccinated.”
In the first wave of the deployment, teams of military doctors, nurses and other personnel will head to Michigan, New Jersey, New Mexico, New York, Ohio and Rhode Island to support at-capacity emergency rooms and free up overwhelmed hospital staff for non-COVID cases, the White House said.
But with the teams ranging in size from seven to 25, hospitals due to receive the health workers welcomed the assistance but warned it would not be enough to combat the surge.
“There is not a silver bullet solution,” said Bob Riney, president of healthcare operations at Detroit’s Henry Ford Health System, which has already received some federal help and expects to welcome new military medics next week.
“We have systemic challenges (with) incredible volume and very, very tired medical practitioners … and that is true of all health systems that have been in the middle of this surge,” Riney said. The White House’s more aggressive stance follows months of criticism from health experts that the administration was relying too heavily on vaccines alone to stop the spread of the coronavirus, especially given a politically motivated anti-vaccine movement pushed by some Republican officials. About 62% of Americans are considered fully vaccinated, according to U.S. data.” (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 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….”
“With infection rates mounting, the Omicron variant has ushered in a new and disorienting phase of the pandemic, leaving Americans frustrated and dismayed that the basic elements they thought they understood about the coronavirus are shifting faster than ever.
There were reasons for heightened concern and reasons for consolation: Omicron is more transmissible than previous variants, yet it appears to cause milder symptoms in many people. Hospitalizations have soared to new highs in some states, but “incidental patients” — people who test positive for Covid-19 after being admitted for another reason — make up close to half of their cases in some hospitals.
Public health officials, in response to the new variant, have halved the recommended isolation period for people with positive tests to five days from 10 days, while also suggesting people upgrade their masks from cloth to medical-grade when possible.
“Omicron has turned, quickly, into something that is just different,” said Dr. Allison Arwady, Chicago’s top health official.
Amid shifting federal public health guidance and the new and distinct variant, President Biden’s own former transition team has called on the president to adopt an entirely new domestic pandemic strategy geared to the “new normal” of living with the virus indefinitely, not to wiping it out.
And Americans, confronted with these new sets of facts, warnings and advisories, have responded with a mix of confusion, vigilance and indifference. Left mainly to navigate it all on their own, they must sort through an array of uncertain risks — ride a bus? visit friends? eat inside? — hour by hour.” (O)
“The director of the Centers for Disease Control and Prevention took a calculated gamble Friday as she sought to assume greater control over confused public health messaging about the coronavirus as the pandemic enters its third year.
Rochelle Walensky held her first solo covid-19 news conference since becoming the chief of the public health agency nearly a year ago, vowing that it would be “the first of many.”
The briefing comes at a precarious moment for Walensky, a highly regarded infectious-diseases physician who has come under intense criticism for failing to communicate CDC’s often-changing guidance clearly. With coronavirus cases surging to record levels in the United States and around the world, that criticism has been particularly stinging of late, with an uncharacteristically sharp critique this week from the American Medical Association over the agency’s failure to require a negative coronavirus test result before people exit shortened isolation.
“Potentially hundreds of thousands of people could return to work and school infectious if they follow the CDC’s new guidance on ending isolation after five days without a negative test,” the group said…
Inside the administration, frustration has also been mounting. Officials acknowledge the rapidly changing virus complicates the pandemic response, but some worry Walensky’s public statements have only added to many Americans’ confusion. At times, her guidance has also been at odds with that of other senior administration officials, most notably, that of Anthony S. Fauci, President Biden’s chief medical adviser…
Experts say Walensky has nothing to lose by “putting herself out there” to improve her relationship with the public, said Jody Lanard, a physician who worked for nearly two decades as a pandemic communications adviser consulting with the World Health Organization.
“I’m not worried about the White House throwing the CDC under the bus, because the CDC is already under the bus,” Lanard said…
“The lack of recognition that there is a problem — that’s a problem,” the scientist said, noting they had had to spend time explaining it to family members. “You kind of have to be a PhD or an MPH…”” (A)
“The following statement is attributable to: Gerald E. Harmon, M.D., President, American Medical Association
“Nearly two years into this pandemic, with Omicron cases surging across the country, the American people should be able to count on the Centers for Disease Control and Prevention (CDC) for timely, accurate, clear guidance to protect themselves, their loved ones, and their communities. Instead, the new recommendations on quarantine and isolation are not only confusing, but are risking further spread of the virus.
“Living during a pandemic is challenging, and what we learn along the way—and data we collect—will necessarily change our course of action at times. According to the CDC’s own rationale for shortened isolation periods for the general public, an estimated 31 percent of people remain infectious 5 days after a positive COVID-19 test. With hundreds of thousands of new cases daily and more than a million positive reported cases on January 3, tens of thousands—potentially hundreds of thousands of people—could return to work and school infectious if they follow the CDC’s new guidance on ending isolation after five days without a negative test. Physicians are concerned that these recommendations put our patients at risk and could further overwhelm our health care system.
“A negative test should be required for ending isolation after one tests positive for COVID-19. Reemerging without knowing one’s status unnecessarily risks further transmission of the virus.
“Test availability remains a challenge in many parts of the country, including in hospitals, and we urge the administration to pull all available levers to ramp up production and distribution of tests. But a dearth of tests at the moment does not justify omitting a testing requirement to exit a now shortened isolation.””(G)
“For every modification and revision of its guidelines, the CDC, and Walensky, have taken heat. In May 2021, when vaccination rates were increasing, Walensky recommended that immunized people could stop wearing masks indoors. The decision balanced the science at the time—cases were falling but still far from zero—against the growing backlash from the public about the lack of benefits of vaccination; if getting the shots changed nothing about what they could do safely, then why get vaccinated? Two and a half months later, the CDC went back to urging even vaccinated people to wear masks indoors as a new variant pushed case numbers up again.
The media, politicians and the public demolished the CDC for flip-flopping. “I have spent a lot of time thinking about” the shifting advice, says Walensky. “All of the science in that moment said it was safe to take off your masks if you were vaccinated. We perhaps should have said ‘for now.’ I think that if we had said, ‘Despite the science, you have to keep your masks on,’ we would have lost the trust of people with regard to actually following the science.”
Finding that balance is a task unique to the CDC: keeping up with constantly changing science and turning that data into practical public-health advice. “We have to provide what the science says not in a vacuum but with the understanding of the uncertainty and the moment,” says Walensky. And that means adapting recommendations to the influx of new data. “Translating science into practiceable guidance is what has really distinguished the value of CDC over the arc of time,” says Dr. Julie Gerberding, chief patient officer at Merck, who ran the CDC from 2002 to 2009. “We have all had scenarios where we weren’t able to provide perfect communication [and] perfect guidance. That’s part of the challenge.”” (B)
“Nowhere are these issues more apparent than on the confusing and zigzag messaging around rapid antigen tests and N95 masks, both of which are important weapons in our arsenal.
With a barrage of cases threatening vital services, the Centers for Disease Control and Prevention announced on Dec. 29 that people could return to work, masked, five days after they first learned they were infected, arguing that many people are infectious for only a short period. People could return to work even while still sick, as long as their symptoms were abating.
It’s not unreasonable to shorten quarantine for some, especially if they are vaccinated. Other countries have allowed infected people to isolate for a shorter time with the added precaution that they take rapid antigen tests to show they are negative two days in a row.
Why doesn’t the C.D.C. call for that added measure of safety? Its director, Dr. Rochelle Walensky, has explained this by saying, “We know that after five days, people are much less likely to transmit the virus and that masking further reduces that risk.”
“Much less likely” isn’t zero, and the likelihood probably varies from person to person. All this means that some would continue to be infectious. So wouldn’t it be great if we could tell who was probably still infectious after five days, and took extra precautions, while allowing people who may be clearing the virus even faster than five days to stop isolating earlier?
Not according to our top officials.
“We opted not to have the rapid test for isolation because we actually don’t know how our rapid tests perform and how well they predict whether you’re transmissible during the end of disease,” Walensky said on Dec. 29. “The F.D.A. has not authorized them for that use.”
Dr. Anthony Fauci, the president’s chief medical adviser, argued the same, also on Dec. 29. Referring to antigen tests, he said, “If it’s positive, we don’t know what that means for transmissibility” and that these antigen tests aren’t as sensitive as P.C.R. tests.
Might the real reason be that rapid tests are hard to find and expensive here (while they are easily available and relatively cheap in other countries)?…
It’s hard not to worry that officials may be denigrating rapid tests now for the same reason they denigrated the use of masks early in the pandemic — we don’t have enough of them. Fauci essentially acknowledged this about masks, saying that the public health community had feared that they “were in very short supply” — a fair concern, but that’s not what we were told. I wouldn’t be surprised if officials eventually admitted the same about rapid tests…
On Tuesday, the C.D.C. updated its guidance to say that “if an individual has access to a test and wants to test” and is positive after five days, he or she should “continue to isolate until Day 10.” So is the C.D.C. now conceding that people who test positive are indeed still infectious? And if they don’t have a test, or don’t want one, no worries?
The job these officials have is tough, given both the reckless political opposition even to vaccines and the inevitable criticism even from people who support public health measures. Still, it’s so disappointing to enter 2022 with 2020 vibes, scouring for supplies, trying to make sense of official declarations that don’t cohere, and wondering what to do.” (C)
“In their attempts to defend the new guidelines, Dr. Rochelle Walensky, the CDC’s director, and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, actually helped undercut whatever support there was for those changes among people who take Covid seriously. Walensky told CNN on Wednesday that the change “really had a lot to do with what we thought people would be able to tolerate.” Fauci, meanwhile, said, “If you are asymptomatic and you are infected, we want to get people back to jobs — particularly those with essential jobs to keep our society running smoothly.”…
But by incorporating societal responses and employer requirements into their arguments, Walensky and Fauci implied that the CDC’s decision wasn’t based purely in science. While the evidence shows that people are most contagious during the early days of their infection, health experts say there’s no new data that justifies changing the guidelines. Experts haves also expressed concerns that the new guidance doesn’t include a testing requirement and leaves it up to individuals to presume they’re not infectious.
That brings us to the biggest problem Walensky and her staff face trying to explain their thinking: The gig is one of inherent contradictions. People respond well to clear, concise instructions: easy-to-remember slogans, bullet-point checklists, things that would look good on a poster. But by its very nature, there is no real certainty in the middle of a pandemic. The government’s public health officials are constantly learning new things, dealing with new variants and revising previous recommendations.
This has meant any proclamation from authorities has been required to be issued with a pretty substantial set of “buts” and “ifs” and other hedges. But if there’s one thing Americans really seem to hate, it’s a caveat…
The country’s health leaders promise that they incorporated a number of factors into their decision. I believe them on that front. Did they consider how those guidelines will be abused to make people who are sick with Covid report to work because they are unable to find a rapid test to prove that they have Covid? Yeah, I have doubts.” (D)
“In laying out the scientific basis for the revisions, the agency said more than 100 studies from 17 countries indicate that most transmission happens early in an infection. The CDC acknowledged the data come from research done when delta and other pre-omicron variants were causing the most infections. But the agency also pointed to limited, early data from the U.S. and South Korea that suggests the time between exposure and the appearance of symptoms may be shorter for omicron than for earlier variants.” (E)
“Early research suggests that some rapid COVID-19 tests may be less able to detect the Omicron variant, the U.S. Food and Drug Administration said Tuesday.
In a statement, the FDA said that antigen tests “do detect the Omicron variant, but may have reduced sensitivity,” meaning it’s possible the tests could miss an infection, particularly in the early stages of the disease.
That’s not good news, as the Omicron variant fuels surging case numbers across the country and people are scrambling to find at-home rapid testing. Antigen tests can be done within minutes at home, while the more accurate PCR tests are processed in labs and have longer turnaround times.
Still, the FDA stopped short of saying that people should stop using antigen tests.
“The FDA continues to authorize the use of these tests as directed in the authorized labeling and individuals should continue to use them in accordance with the instructions included with the tests,” the agency said. “Antigen tests are generally less sensitive and less likely to pick up very early infections compared to molecular [PCR] tests.”
The FDA didn’t specify what rapid at-home tests were used in its early research.
“With every new variant, we have to make sure that the tests work, and it looks like the tests work for this. But they’re not picking up infections as early as previous versions,” Gigi Gronvall, a senior researcher at the Johns Hopkins Center for Health Security in Baltimore, told NBC News. “So if you feel any symptoms but test negative, it’s not a get-out-of-jail-free card. You may need to test again and hold off a little bit on assuming that you’re negative.”
The FDA encouraged follow-up testing for anyone who tests negative with a rapid antigen test but is experiencing symptoms.” (H)
“A small, new real-world study suggests that two widely used at-home antigen tests, the Abbott BinaxNOW and Quidel QuickVue, may fail to detect some Omicron infections even when people are carrying high levels of the coronavirus.
The study, which has not yet been peer-reviewed, focused on 30 people infected with the virus at five workplaces that experienced what were most likely outbreaks of the Omicron variant in December. The people received both saliva-based P.C.R. tests and rapid antigen tests using nasal swabs.
It took three days, on average, for people to test positive on a rapid antigen test after their first positive P.C.R. result. In four cases, people transmitted the virus to others while the rapid test showed the negative result, according to the study, which was conducted by several members of the Covid-19 Sports and Society Working Group.
It is not clear whether the infections were missed because the antigen tests are inherently less sensitive to Omicron or because saliva tests may be better at detecting the new variant.
But the results are consistent with other preliminary evidence that the at-home tests that many Americans have come to rely on — at least as currently administered, with a nasal swab — may fail to detect some Omicron cases in the first days of infection.
The researchers said they shared their results with federal officials — including at the White House, the Food and Drug Administration and the Centers for Disease Control and Prevention — in real-time, as the outbreaks were occurring last month.” (I)
“After we released our recs early last week, it became very clear people were interested in using the rapid test, though not authorized for this purpose after the end of their isolation period,” Walensky said. “We then provided guidance on how they should be used.” (J)
“The crux of the problem, several administration officials said, is a failure by the C.D.C. and the Biden administration’s messaging experts to work in concert. Who is to blame for that is a matter of debate. Dr. Walensky’s critics say she is not collaborative enough, too often springing decisions on other federal officials who then struggle to defend them in public. Her defenders say she strives to coordinate, but that it is not her job to ensure consensus across the entire administration.
Some suggest the White House has gone too far in its hands-off, let-the-scientists-rule approach, leaving a vacuum of leadership and forcing ad-hoc coordination between the various public health agencies. That has been exacerbated by a health secretary, Xavier Becerra, who receives routine briefings from scientists but does not settle interagency disputes about the pandemic response.
Dr. Fauci, the administration’s best-known spokesman on the pandemic, has further muddied the waters at times, publicly contradicting the C.D.C. as he did this week or making statements he has later walked back.
He said in late December, for instance, that a vaccination requirement for domestic airline passengers should be seriously considered, leaving the White House to field a flurry of questions on a policy it was not prepared to recommend. Later, he said a mandate was unlikely.
On Wednesday, Jen Psaki, the White House press secretary, said it was OK for the C.D.C. to modify its guidance, adding that, for one thing, “if they hadn’t changed their recommendations over the course of time, schools would probably be closed across the country.”
But even some within Dr. Walensky’s own agency agree that the C.D.C.’s public pronouncements on the pandemic have repeatedly fallen short, long after experts say the agency should have mastered clear and concise public messaging on the worst public health crisis in a century.” (K)
“On the day President Biden was inaugurated, the advisory board of health experts who counseled him during his transition officially ceased to exist. But its members have quietly continued to meet regularly over Zoom, their conversations often turning to frustration with Mr. Biden’s coronavirus response.
Now, six of these former advisers have gone public with an extraordinary, albeit polite, critique — and a plea to be heard. In three opinion articles published on Thursday in The Journal of the American Medical Association, they called for Mr. Biden to adopt an entirely new domestic pandemic strategy geared to the “new normal” of living with the virus indefinitely, not to wiping it out…
Outlining their ideas for the “new normal” strategy, Dr. Emanuel and two co-authors — Michael T. Osterholm, an epidemiologist at the University of Minnesota, and Dr. Celine Gounder, an infectious disease expert at New York University — pointedly noted that in July, Mr. Biden proclaimed that “we’ve gained the upper hand against this virus,” which in retrospect was clearly not the case.
Now, with the Omicron variant fueling an enormous new surge, they wrote, the United States must avoid becoming stuck in “a perpetual state of emergency.” The first step, they wrote, is recognizing that the coronavirus is one of several respiratory viruses circulating, and developing policies to address all of them together.
To be better prepared for inevitable outbreaks — including from new coronavirus variants — they suggested that the administration lay out goals and specific benchmarks, including what number of hospitalizations and deaths from respiratory viruses, including influenza and Covid-19, should prompt emergency mitigation and other measures.
In addition to urging the administration to adopt a longer view, the authors took pointed issue with some of Mr. Biden’s current policies and stances — especially on political lightning rod issues. They called for more aggressive use of vaccine mandates, which have drawn fierce opposition from Republicans, and said the nation needed a digital verification system for vaccination — so-called vaccine passports — which Mr. Biden has resisted in the face of Republican attacks on the concept.” (L)
“Fauci, in other words, sounded far more hesitant than the JAMA experts to declare a “new normal.” There were, he said, “too many unknowns.” We don’t know the number of people in the country with no experience of the virus—who haven’t been vaccinated or infected. We also don’t know what level of protection an Omicron infection might provide against the next variant. “Because we will undoubtedly get a next variant,” he said. He spoke for a little while about the differing severity of various kinds of respiratory infections and the challenge of predicting how further covid variants would fit in. “I mean, for people who are not responsible for policy, it’s very easy to make a prediction,” he said. “Because if you are right you’re a hero, and if you’re wrong nobody cares.”” (M)
“A researcher in Cyprus has discovered a strain of the coronavirus that combines the delta and omicron variant, Bloomberg News reported on Saturday.
Leondios Kostrikis, professor of biological sciences at the University of Cyprus, called the strain “deltacron,” because of its omicron-like genetic signatures within the delta genomes, Bloomberg said.
So far, Kostrikis and his team have found 25 cases of the virus, according to the report. It’s still too early to tell whether there are more cases of the strain or what impacts it could have.
“We will see in the future if this strain is more pathological or more contagious or if it will prevail” against the two dominant strains, delta and omicron, Kostrikis said in an interview with Sigma TV Friday. He believes omicron will also overtake deltacron, he added.” (N)
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)
The directive from the FDNY puts EMS crews on notice that “effective immediately, stable patients with influenza-like illness … should not be transported to a 911-receiving facility” unless they meet certain criteria: being over 65 years old, having a fever above 100.4 degrees or a history of diabetes or heart conditions, according to a copy obtained by The Post…
Under the new order they’ll call an FDNY emergency doctor on duty to help decide whether a patient who appears stable should be taken to a hospital, he said.
The doctor could get on the phone and directly ask the patients questions to help make a decision, he added.”,,,
The FDNY acknowledged the order was due to “high medical leave” among EMS workers because of the COVID surge, but didn’t immediately respond to further questions Saturday.” (A)
“As the state broke another record Thursday with nearly 9,000 new COVID-19 cases driven by the severely transmissible omicron variant, Utahns were warned hospitals are overwhelmed and treatments for the virus are so limited, there’s only enough for 1 in 100 patients.
“Unfortunately, we’re beginning the new year in a really dire position when it comes to COVID-19,” Dr. Michelle Hofmann, deputy director of the Utah Department of Health told reporters during a virtual news conference as said Wednesday’s record-setting case count was broken with 8,913 new cases reported Thursday.
“There are more people hospitalized than yesterday, 530. There are more people in the ICU than yesterday, 188,” Hofmann said, and another 13 lives have been lost in the state to COVID-19, including a child. There have now been three Utah youths who died from the virus.
The situation is only going to get worse, she said, citing a U.S. Centers for Disease Control and Prevention model that estimated Utah will face somewhere between 12,600 and 38,800 new COVID-19 cases a day by the end of January.
Even though omicron is considered milder, the sheer volume of cases is already sending the state’s health care systems into crisis mode.
Both testing facilities and hospitals — many dealing with staff sickened by COVID-19 — are “bursting at the seams,” Hofmann said, as the omicron variant first identified in South Africa around Thanksgiving roars through the state. Until this week, the most cases reported in a single day was just over 4,700, in late December 2020.” (B)
“A Florida hospital has been forced to close its maternity unit and tell expectant moms to give birth elsewhere after the state’s record-breaking COVID surge caused staff shortages.
Holy Cross Health Hospital in Fort Lauderdale announced on Sunday afternoon that it is shutting down its Labor and Delivery delivery unit ‘until further notice’ due to ‘critical staffing levels.’
That means pregnant women who’d planned to give birth there and are almost at their due dates must now go through the stress of finding a new hospital.
However, the hospital said in a statement that its neonatal intensive care and post-partum units will remain open.
‘People are out sick due to the surge in Covid cases,’ Holy Cross spokesperson Christine Walker added in an interview with NBC Miami. She spoke after Florida recorded 85,000 COVID cases on Saturday and Sunday, and almost 50,000 new infections on Monday.
The hospital did not mention a re-opening date for its Labor and Delivery Unit. Its emergency service division was also shut down on December 29 for similar reasons….
More hospitals throughout the state have simultaneously reported staffing shortages last week, according to the Department of Health & Human Services, and are among many services affected by the labor shortfall…” (C)
“More than 3,000 Michigan health care workers are off the job because they tested positive for coronavirus or were exposed to it, forcing hospitals to postpone some elective procedures as they brace for an influx of more patients in a COVID-19 surge fueled by the highly transmissible omicron variant.
Strained workers, who have been on the front lines treating patients for nearly two years, are exhausted, but their work is far from over as the surge pushes on, driving up cases and hospitalizations, including among children.
“We have an obligation to take care of the COVID patients,” said Dr. Jeffrey Fischgrund, Beaumont Health’s chief of clinical services. But the health system also must be able to take care of people who’ve been injured in car accidents, those who’ve had heart attacks and other illnesses.
“We’ve really asked our physicians to postpone, if safe, any procedures that can be postponed. … We’re trying to take care of the community, but we’re also trying to take care of our staff. … We know our 33,000 staffers are working as hard as they’ve ever worked.
“We are really at a breaking point. … We are really at a point where it’s the worst it’s ever been and … we’re afraid it’s going to get even worse next week. So we’re trying to be proactive. We’re cutting back on things that we don’t have to do today, but we still want to take care of our patients.”
On Thursday, Beaumont Health said more than 430 employees are out with coronavirus symptoms.
By postponing the less urgent procedures and tests, Beaumont can shift more staff to caring for COVID-19 patients along with those with cancer, traumatic injuries and other acute medical issues.” (D)
“At UMass Memorial Medical Center in Worcester, hospital epidemiologist Dr. Richard Ellison said he’s hoping staffing issues don’t get bad enough to require reductions in crucial care.
“Nurses who give chemotherapy for cancer patients get special training, and we can’t train our entire hospital workforce nursing staff to give cancer chemotherapy,” he said.
If too many of those nurses are out, Ellison said, the hospital may not be able to provide that care.
“So we have great concern that we could actually impact our ability to provide care for some patient populations,” he said.
The demand for emergency room beds is so high at UMass Memorial Medical Center, Ellison said, that some patients are being cared for in hallways, with privacy barriers put up between beds.
“There is no bed capacity right now in the UMass system,” he said. “As soon as someone gets discharged, the bed is being filled immediately.”” (H)
“In Los Angeles, where the fast-spreading omicron variant reigns, roughly two-thirds of covid patients in the county’s public hospitals were initially admitted for other causes, officials said Wednesday.
But at CoxHealth in Springfield, Mo., where officials say the older delta variant remains a ferocious threat, the coronavirus remains the immediate cause for 81 percent of covid hospitalizations…
Many hospitals are reporting record surges of covid cases even as staff shortages hit their highest levels nationally during the pandemic, according to federal health data reviewed by The Washington Post — a one-two punch that is forcing hospitals to turn away ambulances, cancel procedures and warn would-be patients to stay away because they can’t promise prompt care.
While most hospitalized patients are adults, the number of pediatric covid inpatients has doubled since Christmas to a seven-day average of 3,800 children.
But the emerging picture varies dramatically from one region to the next, according to interviews with hospital leaders and health workers across 18 states. It ranges from omicron epicenters such as New York City, where many patients aren’t aware they’re infected until testing positive while visiting the hospital for other procedures, to Michigan and Minnesota, where health workers continue to treat patients fighting for survival against the more severe delta variant.
The Centers for Disease Control and Prevention projects that delta may have accounted for as much as 41 percent of covid cases across parts of the Midwest last week and as little as 1 percent of cases in Texas and surrounding states, although the CDC has repeatedly revised its national map of variant spread in recent weeks, struggling to keep up with the fast-moving omicron.” (E)
“The U.S. documented a record number of COVID-19 pediatric hospital admissions on Wednesday, with federal data showing almost 1,000 children with confirmed infection were admitted.
Department of Health and Human Services data updated Thursday shows that 951 children were hospitalized with COVID-19 on Wednesday — the highest number throughout the pandemic.
These daily new pediatric admissions skyrocketed in the last weeks of December into January, almost tripling in the last two weeks as the omicron variant spreads rapidly throughout the country.
The numbers surpassed previous records set during the delta wave this summer, when daily children hospitalizations reached a peak of nearly 400 in one day.
In total, more than 3,100 children are hospitalized with confirmed COVID-19 as of Thursday, with another 1,300 suspected to be infected with the virus.
The government’s top infectious diseases expert, Anthony Fauci, noted during a press briefing Wednesday that even though the omicron variant “appears to be less severe” than the delta strain, the “caveat” is that omicron’s high transmissibility leads to more cases and the “inevitability” of more hospitalizations.
“The sheer volume of infections because of its profound transmissibility mean that many more children will get infected,” he said. “And as many more children will get infected, a certain proportion of them — usually children that have underlying comorbidities — are going to wind up in the hospital. That is just an inevitability.”” (F)
“Chicago-area hospitals are postponing many elective surgeries, as Illinois on Sunday set a record for COVID-19 hospitalizations.
The news of postponed surgeries comes just days after Gov. J.B. Pritzker and the Illinois Health and Hospital Association urged hospitals to delay nonemergency procedures as needed, without risking patient harm. They issued the plea in anticipation of a post-holiday, omicron-driven surge and potential shortage of staffed intensive-care beds.
Chicago-area hospitals are stressed as they deal with influxes of COVID-19 and non-COVID-19 patients amid industrywide staffing shortages. The vast majority of hospitalized COVID-19 patients are unvaccinated, doctors say.
NorthShore University HealthSystem, which has six hospitals, has largely suspended elective surgeries for the next two weeks, said CEO and President J.P. Gallagher.
Advocate Aurora Health, which has 26 hospitals in Illinois and Wisconsin, is delaying and rescheduling certain procedures to times and places where it has the staffing and capacity to perform them, said Dr. Jeff Bahr, chief medical group officer. It is continuing to do surgeries in situations where not performing them might result in a person needing hospitalization, or losing a limb. Advocate is also continuing to perform cancer treatments and diagnoses, he said…
Though the term “elective” may bring to mind cosmetic surgeries and other optional procedures, it actually encompasses a wide range of necessary, if not emergency, treatments — everything from heart valve replacements and repairs of herniated discs to certain cancer therapies…
Delaying elective surgeries is just one way Illinois hospitals are trying to manage the surge of patients.
NorthShore is again dedicating its inpatient beds at Glenbrook Hospital in Glenview to only COVID-19 patients, Gallagher said. It’s generally sending COVID-19 patients who need hospitalization, across most of its system, to Glenbrook — something NorthShore did earlier in the pandemic as well.
Rush University Medical Center has again transformed its lobby into an expansion of its emergency department.
Hospitals are also, in some cases, redeploying staff and paying extra to nurses who pick up additional shifts.” (I)
“With the fast-spreading omicron variant now upon us, some of the rhetoric around the pandemic has changed. Government officials, starting with President Joe Biden, are pointedly differentiating between the risks for vaccinated and unvaccinated people. This could create the perception that some places face more of a risk than others: Perhaps omicron will threaten rural communities (where vaccination rates are lowest) and their health systems, but perhaps more vaccinated cities and their hospitals will be better off.
Such thinking would be misguided. As convoluted and sometimes siloed as the US health system may seem at times, it is still a system. Patients transfer between facilities based on capacity or clinical need. If rural hospitals are shipping seriously ill patients to their urban neighbors, which already tend to run close to capacity even in normal times, a rural Covid-19 crisis could quickly become a crisis for everybody.
One hospital being overwhelmed isn’t a one-hospital problem, it’s an every-hospital problem. Even if your community is not awash with Covid-19 or if most people are vaccinated, a major outbreak in your broader region, plus all the other patients hospitals are treating in normal times, could easily fill your hospital, too. That makes it harder for the health system to treat you if you come to the ER with heart attack symptoms or appendicitis or any acute medical emergency.
Already, because of existing staffing shortages, rural hospitals are finding it difficult to find room for their patients at larger hospital systems. With omicron spreading rapidly, increasing the number of patients seeking care while sidelining health workers who have to quarantine, systemic overload may not be far off….
The feedback loop works in reverse as well. Recently, the HCA hospital in Conroe, Texas, about 40 miles north of Houston, was dealing with such a staffing shortage in its emergency department that the facility temporarily asked ambulances to bypass it because the ED couldn’t handle any more patients, according to a spokesperson. Suddenly, hospitals in the heart of Houston were seeing an unexpected surge of patients who needed emergency care, causing long wait times at their facilities.” (G)
“As the number of Covid-19 hospitalizations surpasses those during the Delta variant surge over the summer and fall, more states are enacting emergency protocols to deal with growing staff shortages at hospitals.
The greater transmissibility of the Omicron variant — which in just one month has led to millions of new cases — has left frontline workers at a higher risk of exposure, needing to quarantine and recover after positive tests. And health officials are working to plug any gaps in coverage.
In the last week, states such as Ohio, Maryland, Delaware and Georgia have mobilized National Guard members to assist with patient care.
“We still face a very serious situation with Covid-19 in Delaware, especially in our hospital facilities,” Gov. John Carney said Monday as about 100 members of the National Guard are training to become certified nursing assistants.
At the MetroHealth Medical Center in Cleveland, officials told CNN that not only is the hospital filled with people needing treatment, but roughly 400 employees are out with Covid-19.
Ohio Air National Guard Cpt. Lanette Looney, who is overseeing the mission at the hospital where 28 Guard members are helping with medical and non-medical tasks, noted they have faced Covid-19 infections as well.
“Within two days of being here, we had four Guard members that were symptomatic with sore throats, headaches, body aches, fever, nasal congestion, and they all tested positive for Covid,” she told CNN’s Gary Tuchman…
Teams of military medical personnel are working with the Federal Emergency Management Agency to aid with health care staffing in multiple states, including Arizona, Colorado, Indiana, Michigan, Minnesota, New Mexico, Pennsylvania and Wisconsin, US Army North said in a statement Tuesday.
A 15-person team from the Air Force is due to support a hospital in Manchester, New Hampshire, and another 20-person team from the Navy will assist a medical center in Buffalo, New York, the statement said.” (J)
“When health systems are moving toward crisis conditions, the first steps we take are to do all we can to conserve and reallocate scarce resources. Hoping to keep delivering quality care – despite shortages of space, staff and stuff – we do things like canceling elective surgeries, moving surgical staff to inpatient units to provide care and holding patients in the emergency department when the hospital is full. These are called “contingency” measures. Though they can be inconvenient for patients, we hope patients won’t be harmed by them.
But when a crisis escalates to the point that we simply can’t provide necessary services to everyone who needs them, we are forced to perform crisis triage. At that point, the care provided to some patients is admittedly less than high quality – sometimes much less.
The care provided under such extreme levels of resource shortages is called “crisis standards of care.” Crisis standards can impact the use of any type of resource that is in extremely short supply, from staff (like nurses or respiratory therapists) to stuff (like ventilators or N95 masks) to space (like ICU beds).
And because the care we can provide during crisis standards is much lower than normal quality for some patients, the process is supposed to be fully transparent and formally allowed by the state….
So, hospitals around our state are yet again facing triage-like decisions on a daily basis.
In a few important ways, the situation has changed. Today, our hospitals have plenty of ventilators, but not enough staff to run them. Stress and burnout are taking their toll.
So, those of us in the health care system are hitting our breaking point again. And when hospitals are full, we are forced into making triage decisions.”
In early 2020, we were looking for the patients who would die with or without a ventilator in order to preserve the ventilator; today, our planning team is looking for people who might survive outside of the ICU. And because those patients will need a bed on the main floors, we are also forced to find people on hospital floor beds who could be sent home early, even though that might not be as safe as we’d like.
For instance, take a patient who has diabetic ketoacidosis, or DKA – extremely high blood sugar with fluid and electrolyte disturbances. DKA is dangerous and typically requires admission to an ICU for a continuous infusion of insulin. But patients with DKA only rarely end up requiring mechanical ventilation. So, under crisis triage circumstances, we might move them to hospital floor beds to free up some ICU beds for very sick COVID-19 patients.
But where are we going to get regular hospital rooms for these patients with DKA, since those are full too? Here’s what we might do: People with serious infections due to IV drug use are regularly kept in the hospital while they receive long courses of IV antibiotics. This is because if they were to use an IV catheter to inject drugs at home, it could be very dangerous, even deadly. But under triage conditions, we might let them go home if they promise not to use their IV line to inject drugs.
Obviously, that’s not completely safe. It’s clearly not the usual standard of care – but it is a crisis standard of care.
Worse than all of this is anticipating the conversations with patients and their families. These are what I dread the most, and in the last few weeks of 2021, we’ve had to start practicing them again. How should we break the news to patients that the care they are getting isn’t what we’d like because we are overwhelmed? Here’s what we have to say:
“… there are just too many sick people coming to our hospital all at once, and we don’t have enough of what is needed to take care of all the patients the way we would like to …
… at this point, it is reasonable to do a trial of treatment on the ventilator for 48 hours, to see how your dad’s lungs respond, but then we’ll need to reevaluate …
… I’m sorry, your dad is sicker than others in the hospital, and the treatments haven’t been working in the way we had hoped.”
Back when vaccines came on the horizon a year ago, we hoped we’d never need to have these conversations. It’s hard to accept that they are needed again now.” (K)
