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.”

Pope Francis: A Crisis Reveals What Is in Our Hearts

To come out of this pandemic better than we went in, we must let ourselves be touched by others’ pain.

By Pope Francis

(full message in New York Times. November 26, 2020)

“When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness. It changed the way I saw life. For months, I didn’t know who I was or whether I would live or die. The doctors had no idea whether I’d make it either. I remember hugging my mother and saying, “Just tell me if I’m going to die.” I was in the second year of training for the priesthood in the diocesan seminary of Buenos Aires.

I remember the date: Aug. 13, 1957. I got taken to a hospital by a prefect who realized mine was not the kind of flu you treat with aspirin. Straightaway they took a liter and a half of water out of my lungs, and I remained there fighting for my life. The following November they operated to take out the upper right lobe of one of the lungs. I have some sense of how people with Covid-19 feel as they struggle to breathe on a ventilator.

I remember especially two nurses from this time. One was the senior ward matron, a Dominican sister who had been a teacher in Athens before being sent to Buenos Aires. I learned later that following the first examination by the doctor, after he left she told the nurses to double the dose of medication he had prescribed — basically penicillin and streptomycin — because she knew from experience I was dying. Sister Cornelia Caraglio saved my life. Because of her regular contact with sick people, she understood better than the doctor what they needed, and she had the courage to act on her knowledge.

Another nurse, Micaela, did the same when I was in intense pain, secretly prescribing me extra doses of painkillers outside my due times. Cornelia and Micaela are in heaven now, but I’ll always owe them so much. They fought for me to the end, until my eventual recovery. They taught me what it is to use science but also to know when to go beyond it to meet particular needs. And the serious illness I lived through taught me to depend on the goodness and wisdom of others.”

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.”

to read POSTS 1-75 in chronological order, highlight sand click on

“As record numbers of coronavirus cases overwhelm hospitals across the United States, there is something strikingly different from the surge that inundated cities in the spring: No one is clamoring for ventilators.

The sophisticated breathing machines, used to sustain the most critically ill patients, are far more plentiful than they were eight months ago, when New York, New Jersey and other hard-hit states were desperate to obtain more of the devices, and hospitals were reviewing triage protocols for rationing care. Now, many hot spots face a different problem: They have enough ventilators,  but not nearly enough respiratory therapists, pulmonologists and critical care doctors who have the training to operate the machines and provide round-the-clock care for patients who cannot breathe on their own.

Since the spring, American medical device makers have radically ramped up the country’s ventilator capacity by producing more than 200,000 critical care ventilators, with 155,000 of them going to the Strategic National Stockpile. At the same time, doctors have figured out other ways to deliver oxygen to some patients struggling to breathe — including using inexpensive sleep apnea machines or simple nasal cannulas that force air into the lungs through plastic tubes.

But with new cases approaching 200,000 per day and a flood of patients straining hospitals across the country, public health experts warn that the ample supply of available ventilators may not be enough to save many critically ill patients.

“We’re now at a dangerous precipice,” said Dr. Lewis Kaplan, president of the Society of Critical Care Medicine. Ventilators, he said, are exceptionally complex machines that require expertise and constant monitoring for the weeks or even months that patients are tethered to them. The explosion of cases in rural parts of Idaho, Ohio, South Dakota and other states has prompted local hospitals that lack such experts on staff to send patients to cities and regional medical centers, but those intensive care beds are quickly filling up.

Public health experts have long warned about a shortage of critical care doctors, known as intensivists, a specialty that generally requires an additional two years of medical training. There are 37,400 intensivists in the United States, according to the American Hospital Association, but nearly half of the country’s acute care hospitals do not have any on staff, and many of those hospitals are in rural areas increasingly overwhelmed by the coronavirus.

“We can’t manufacture doctors and nurses in the same way we can manufacture ventilators,” said Dr. Eric Toner, an emergency room doctor and senior scholar at the Johns Hopkins Center for Health Security. “And you can’t teach someone overnight the right settings and buttons to push on a ventilator for patients who have a disease they’ve never seen before. The most realistic thing we can do in the short run is to reduce the impact on hospitals, and that means wearing masks and avoiding crowded spaces so we can flatten the curve of new infections.”…

“If we want to make sure that someone who’s hospitalized in the I.C.U. with the coronavirus has the best chance to get well, they need to have highly trained personnel, and that cannot be flexed up rapidly,” he said in a news briefing on Tuesday.” (A)

“They’ve stockpiled masks and gowns. They’ve reopened the COVID-only patient units created as the pandemic peaked last spring. But as New Jersey hospital officials brace for another rising tide of sick coronavirus patients, the resource they worry most about is human.

Will there be enough doctors, nurses, respiratory therapists, patient-care technicians, and others to care for everyone who needs them?

“That is the one thing that I think keeps us up at night,” said Gov. Phil Murphy. “The staffing piece.”

The one concern that will “determine what happens with this second wave is staffing,” said Dr. Daniel Varga, chief physician executive at Hackensack Meridian Health, which runs multiple acute-care hospitals as well as in-patient behavioral health and children’s facilities. “Remember, we’re trying to run a full-service hospital as well as take care of COVID patients.”…

But three possibilities worry health care officials: If Thanksgiving gatherings spread the disease more widely among older people, if nursing home outbreaks continue to worsen, and if the virus morphs in unpredictable ways — then all bets are off.” (B) 

‘With a combination of luck, new hires and creative reorganizing of staff and patients, Utah’s hospitals haven’t had to eject anyone from intensive care units due to the coronavirus.

But several doctors say the solutions still amount to rationing, with the quality of care deteriorating as hospitals are stretched thinner and thinner….

As of Thursday, there was room for about 45 more ICU patients statewide, said Greg Bell, president of the Utah Hospital Association….

“Standard ICUs are full. Period. We’re now talking about ‘extended access’ ICU. So the care is different,” said Dr. Eddie Stenehjem, an infectious disease physician at Intermountain Medical Center in Murray. “We’re having to ask providers to do things that they aren’t comfortable with.”

ICUs usually are staffed by doctors and nurses who have training and experience specific to intensive care. But to staff the overflow ICUs that have opened around Utah, hospitals are moving doctors and nurses from other departments. And Intermountain Healthcare has hired about 200 nurses from out of state.

“We’re asking them, ‘Take care of the most complex patients that you’ve ever had, in a health care environment that you’ve never been in.’ And so the health care is changing.”

Meanwhile, the patients who are in the ICUs, particularly the ones with COVID-19, are likely to be in precarious condition, with multiple organs at risk of failure, Stenehjem said.

“The margin of error is really low,” he said. “…You’re potentially going to have more errors, and you’re potentially not going to have as good of care that you would have if you had the [regular] ICU team that works together as a cohesive unit … every day.”

At the U., a coronavirus-only overflow ICU has doubled the number of patients per nurse in order to expand intensive care to patients who do need it, but who are on the more stable end of the ICU spectrum, Callahan said. Treating only patients with coronavirus does save time, Callahan said; the tasks are more consistent from patient to patient, and providers don’t have to change personal protective equipment every time they cross a threshold, as they do in the standard ICU.

But coronavirus patients are just like any others requiring intensive care: monitoring is constant, alerts are frequent, and patients don’t have minutes or seconds to spare. The lower staffing ratios mean nurses are sometimes facing more urgent tasks than they have hands for, Callahan said. And when patients in the overflow unit unexpectedly destabilize, setting off more alarms than the staff can respond to, they have to be moved back to the regular ICU — a time-consuming task in its own right, Callahan said…

When overcrowding affects the quality of care across the board, Callahan said, it still amounts to rationing — even without the formal shift to “crisis standards of care,” which require authorization from the governor and give priority to the ICU patients who are likeliest to survive when there aren’t enough beds to go around.”…

It’s going to be even harder, Callahan said, to let hospitals move the very sickest patients out of their ICUs, even if “crisis standards” are necessary to save the most people.” (C)

“Cleveland Clinic has about 1,000 employees away from work due to COVID-19…

Due to a surge in cases, Cleveland Clinic has taken steps to ensure enough staffing to meet patients’ needs, said Ms. Pacetti. This includes shifting some employees to different areas of the health system to enable Cleveland Clinic to expand bed capacity for COVID-19 patients.” (D)

“New York City to open field hospital for first time since spring as Covid-19 cases spike

Gov. Andrew Cuomo announced the Staten Island emergency facility as he pleaded with New Yorkers to stay put for the holidays.

Spiking cases of coronavirus in at least one New York City borough forced the re-opening of a field hospital not used used since the early, dark days of the pandemic, official said Monday.

The temporary facility at Staten Island University Hospital had been operated from early April through the end of June during initial action against the pandemic, authorities said.

The first patients to enter this re-opened field hospital are expected to arrive Tuesday or Wednesday. It’ll be able to hold up to 108 patients for now and could be expanded to 250 if necessary.” (E)

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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….

to read POSTS 1-75 in chronological order, highlight and click on

“….Kelby Krabbenhoft of South Dakota-based Sanford Health laid out his thoughts about having COVID-19, and why he wouldn’t be wearing a mask, in an email sent to health system employees late Wednesday afternoon, Nov. 18, and obtained from multiple sources by Forum News Service.

Krabbenhoft said he is still experiencing “lagging coughs and fatigue,” but told employees he was back in the office — without a mask.

“For me to wear a mask defies the efficacy and purpose of a mask and sends an untruthful message that I am susceptible to infection or could transmit it,” he said. “I have no interest in using masks as a symbolic gesture when I consider that my actions in support of our family leave zero doubt as to my support of all 50,000 of you. My team and I have a duty to express the truth and facts and reality and not feed the opposite.”

Krabbenhoft’s 1,000-word email provides a unique window into the thinking of the leader of the large health system, which has notably not joined cross-town rival Avera Health in supporting a public mask mandate in Sioux Falls, its hometown, even as local and statewide COVID-19 hospitalizations have surged.

Sanford Health employs about 48,000 and has major medical centers and more than 200 clinics in South Dakota, North Dakota and Minnesota….

State health officials said then they’re still waiting for large-scale studies to know if and how long a COVID-19 survivor retains antibodies to the point that they’re immune from reinfection.

The Centers for Disease Control and Prevention currently says that in lieu of a full understanding about reinfection, those who have had COVID-19 should join those who haven’t in taking steps to reduce the risk of spreading the virus, by wearing masks in public places, social distancing and hand hygiene.

“The duration and robustness of immunity to SARS-CoV-2 remains under investigation,” the CDC states, using the technical term for the virus that causes COVID-19, in a summary updated Oct. 19. “Based on what we know from other related human coronaviruses, people appear to become susceptible to reinfection around 90 days after onset of infection.”” (A)

“In a statement to Becker’s, Micah Aberson, executive vice president at Sanford, said Mr. Krabbenhoft’s opinions do not reflect the views of Sanford.

“Kelby Krabbenhoft’s email was based on his own experience with COVID-19 and his personal opinions about the virus. They do not reflect the views of our health system as a whole,” Mr. Aberson said. “Sanford Health’s position is the same as it has always been — consistently wearing masks, avoiding crowds and staying home if you’re sick are critical to preventing the spread of the virus. It is important to follow CDC guidelines. We continue to be incredibly grateful to our frontline workers who are stepping up every day to take care of our patients.”

On Nov. 20, Sanford’s leadership team addressed Mr. Krabbenhoft’s comments in an email sent to the system’s 50,000 employees.

“We know that words matter, and words have power, and we regret that the message left many frustrated and disappointed,” the leaders said regarding Mr. Krabbenhoft’s message. “We want you to know unequivocally that our health system’s position has not changed. We will continue to let science guide the work that we do every day to keep our communities healthy and safe. The science is clear, masks work. When it comes to immunity the science is evolving and we must continue to follow CDC guidelines. Whether you’ve had the virus or not, it is recommended that you wear a mask when you cannot be socially distanced. Our masking policy for Sanford Health remains unchanged.”” (B)

“As the number of COVID-19 cases and hospitalizations continue to climb in Ohio, Cleveland-area hospital leaders are concerned about the growing number of health care workers who are out sick with the coronavirus. 

According to hospital officials, about 800 Cleveland Clinic employees, 200 at University Hospitals, and 60 MetroHealth staffers are out, making it more difficult to care for the rising number of hospitalized COVID-19 patients in Cuyahoga County. 

“If we have many of our staff out because of exposure, while there’s a large influx of COVID patients, we will not be able to provide the best care to everyone who needs it,” said MetroHealth CEO and President Dr. Akram Boutros.

The health care workers are either diagnosed with COVID-19, in the required 10-day waiting period since symptom onset or are recovering and awaiting symptom clearance to return to work, health officials said.

Contact tracing shows the employees are not contracting the virus at work, but out in the community, Boutros said at a Monday news conference.

“They have contact with family members, they go to church, they go to gatherings… that’s where they get it from,” he said, “a child, a cousin, somebody they went to a restaurant with, somebody they went to the gym with.” 

The area hospitals are anticipating a “greater influx” of COVID-19 patients in the next few weeks, officials said. Currently, there are about 400 patients hospitalized across Cleveland Clinic’s Northeast Ohio locations, said CEO Dr. Tom Mihaljevic.

There are about 200 patients hospitalized with COVID-19 at University Hospitals (UH), and the health system is averaging 25 to 30 new COVID-19 patients per day, said UH president Dr. Cliff Megerian.

If trends do not improve, the hospitals could be nearing capacity by the end of the year, Megerian said.

“If we average the increase over the last month, we could see ourselves, by Christmastime, getting up to 800 patients, a four-fold increase, so obviously we’re hoping that does not happen,” he said.

While there is sufficient capacity to treat patients across the Northeast Ohio health care systems for now, Boutros said, the three hospitals will work together on a surge plan, such as preparing buildings for overflow patients, if needed, in the coming weeks.” (C) 

‘Fearing staffing shortages as COVID-19 hospitalizations soar toward new records, several major Michigan health systems are telling employees to report to work, even if they’ve recently had a close or household contact with someone who has COVID-19.

So long as they’re asymptomatic, those employees are required to do their jobs while awaiting test results, according to policies at Michigan Medicine, Beaumont Health, Munson Healthcare and others.

Several health systems say those results are available within 24 to 48 hours. But in areas where testing shortages are causing delays, those results can take up to five days, including at Munson Healthcare, northern Michigan’s largest health system.

Munson employees have been instructed to report to work even if “asked to quarantine by your local health department,” as long as they’re asymptomatic and awaiting test results.

“You are an essential worker because you are in the healthcare field,” staff instructions read. “You may still work to work (sic) even after an exposure as long as you are asymptomatic.

“Other than coming to work, you should quarantine at home. This means only leaving your home to come to work. Other than coming to work, please follow the other guidelines from the Health Department. These may include self-monitoring and limiting exposure to others, even within your own household.” …

Due to short staffing, Mercy Health staff in Muskegon are also being asked to work on COVID-19 floors while they wait for test results, says Kevin Lignell, a spokesperson for SEIU Healthcare Michigan, the union representing workers.” (D)

“More than 1,000 hospitals across the United States are “critically” short on staff, according to numbers released this week by the Department of Health and Human Services.

Those hospitals, which span all 50 states, Washington, D.C. and Puerto Rico, represent about 18% of all hospitals that report their staffing status to HHS. And that number is expected to grow: 21% of all hospitals reporting say they anticipate having critical staffing shortages in the next week.

The worst-hit state is North Dakota with 51% of hospitals that reported saying they’re facing shortages; seven states say over 30% of their hospitals are in trouble…

Looking ahead toward the next week, additional hospitals report expecting staffing shortages in 40 states, as well as Puerto Rico. Nebraska, Virginia and Missouri top the list in places that are expected to have the biggest upticks.” (E)

“The United States is seeing the fastest spread yet of the coronavirus, the White House Coronavirus Task Force said in its first public briefing in four months on Thursday.

Yet, task force members spoke out against the idea of nationwide lockdowns or school closures and held out hope that a vaccine will soon be available to help protect Americans.

Dr. Deborah Birx, once a senior member of the task force, said she’s been traveling the country trying to encourage governors and other state and local leaders to enact measures that will stop the spread of the virus…

But other members of the task force said they would not support a nationwide lockdown.

“President Trump wanted me to make it clear that our task force, this administration and our President, does not support another national lockdown. And we do not support closing schools,” Vice President Mike Pence said at the briefing.” (F)

#CoronavirusTracker   #CoronavirusRapidResponse

CORONAVIRUS TRACKING Links to POSTS 1-75

CORONAVIRUS TRACKING

Links to Parts 1-75

Doctor, Did You Wash Your Hands?®

https://doctordidyouwashyourhands.com/

Curated Contemporaneous Case Study Methodology

Jonathan M. Metsch, Dr.P.H.

https://www.mountsinai.org/profiles/jonathan-m-metsch

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

11/21/2020


 [JM1]

CORONAVIRUS TRACKING Links to Parts 1-74

CORONAVIRUS TRACKING

Links to Parts 1-74

Doctor, Did You Wash Your Hands?®

https://doctordidyouwashyourhands.com/

Curated Contemporaneous Case Study Methodology

Jonathan M. Metsch, Dr.P.H.

https://www.mountsinai.org/profiles/jonathan-m-metsch

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

11/20/2020


 [JM1]

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.

to read POSTS 1-73 in chronological order, highlight and click on

“This is the first coronavirus vaccine to seek regulatory clearance in the United States…

The vaccine, known as BNT162b2, could potentially be available for use in high-risk populations in the United States by the middle to end of December, Pfizer and BioNTech said in a statement earlier Friday. The vaccine requires two doses a few weeks apart, and protection is achieved 28 days after the first shot.

The submission to the FDA is based on results from the Phase 3 clinical trial of Pfizer’s vaccine, which began in the United States on July 27 and enrolled more than 43,000 volunteers.

The final analysis from the trial found the coronavirus vaccine was 95% effective in preventing infections, even in older adults, and caused no serious safety concerns, Pfizer and BioNTech said this week. The submission also includes safety data on about 100 children ages 12 to 15.

About 42% of global participants and 30% of US participants in the Phase 3 study have racially and ethnically diverse backgrounds, the companies said in a news release, and 41% of global and 45% of US participants are ages 56 to 85…

Emergency use authorization, or EUA, from the FDA is not the same as full approval. An EUA allows products to be used under particular circumstances before all the evidence is available for approval. For an EUA, the agency says it will determine whether a product’s “known and potential benefits outweigh its known and potential risks.”

Pfizer’s application for EUA is “encouraging,” but the Infectious Diseases Society of America stressed in a statement on Friday that a transparent review of Pfizer’s data is still needed.

“While encouraging data from the Pfizer/BioNTech COVID-19 vaccine trial indicate the welcome possibility of a critical new tool against the pandemic, a comprehensive, transparent review of data, including evidence that the vaccine has been studied in diverse populations, remains essential to ensure its safety, effectiveness and acceptance,” Dr. Barbara Alexander, president of IDSA, said in the statement.

“If emergency use authorization is granted, clinical trials and data collection must continue. Measures that include wearing masks, frequent handwashing, maintaining physical distance and restricting the size of gatherings will remain crucial,” the statement said in part. “Finally, new federal funding must be provided for widespread, fair and equitable vaccine distribution in addition to campaigns to build vaccine confidence.”” (A)

“The process of issuing an EUA involves five steps:

Determination of an emergency;

Declaration of an emergency;

Review of the request for EUA by the FDA;

Issuance of the EUA or denial of the request; and

Termination of the EUA.

The determination of an emergency can be made by HHS, Department of Homeland Security, or Department of Defense. The emergency can be a military, domestic, or public health emergency that affects, or has a significant potential to affect, national security. Agents involved include chemical, biological, radiological, or nuclear agents. Both the determination and the declaration of the emergency must state the nature of the threat involved.

Once a determination of an emergency has been made and an emergency has been declared, the FDA reviews the EUA request and, if feasible and appropriate given the circumstances of the emergency, consults with the National Institutes of Health and the CDC. If the request is found to meet statutory criteria, the FDA Commissioner issues an EUA. The termination of an EUA is linked to the declaration—once the declaration expires, so does the EUA. A single declaration can support multiple EUAs as necessary.” (B)

“Today, the U.S. Food and Drug Administration issued an emergency use authorization (EUA) for the drug baricitinib, in combination with remdesivir, for the treatment of suspected or laboratory confirmed COVID-19 in hospitalized adults and pediatric patients two years of age or older requiring supplemental oxygen, invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO).

In a clinical trial of hospitalized patients with COVID-19, baricitinib, in combination with remdesivir, was shown to reduce time to recovery within 29 days after initiating treatment compared to patients who received a placebo with remdesivir. The safety and effectiveness of this investigational therapy for use in the treatment of COVID-19 continues to be evaluated. Baricitinib is not authorized or approved as a stand-alone treatment for COVID-19.

“Today’s action demonstrates the FDA’s steadfast efforts to make potential COVID-19 treatments available in a timely manner, where appropriate, while continuing to support research to further evaluate whether they are safe and effective,” said FDA Commissioner Stephen M. Hahn, M.D. “As part of our Coronavirus Treatment Acceleration Program, the FDA continues to use every possible avenue to facilitate new treatments for patients as quickly as possible to combat COVID-19.” (C)

“After a clinical trial in April showed that remdesivir sped up the recovery of people with severe cases of the disease, the U.S. snapped up millions of vials of the drug from its manufacturer Gilead Sciences. Over the summer, European regulators rapidly signed off on the product, leading to nations around the world signing purchase agreements for the drug. And last month, the U.S. Food and Drug administration also signed off.

Now the WHO says remdesivir doesn’t do much of anything to improve the health of people hospitalized with COVID-19.

The recommendations are based on the WHO’s Solidarity Trial, which is examining several coronavirus treatments including remdesivir on more than 11,000 patients in 30 countries.

The WHO panel says the data from the trial shows that remdesivir has “no meaningful effect on mortality or on other important outcomes for patients.”

Remdesivir gained even more prominence in October when it was given to President Donald Trump as part of his treatment after he contracted the virus.” (D)

(A)Pfizer and BioNTech apply for FDA emergency use authorization for coronavirus vaccine, by Jamie Gumbrecht, https://www.cnn.com/2020/11/20/health/pfizer-vaccine-eua-submission/index.html

(B) Emergency Use Authorization, https://www.ncbi.nlm.nih.gov/books/NBK53122/

(C) Coronavirus (COVID-19) Update: FDA Authorizes Drug Combination for Treatment of COVID-19,

https://apnews.com/press-release/pr-newswire/business-corporate-news-drug-trials-products-and-services-lung-disease-a1220b950dc2def0f5db32a9848b1434

(D) WHO Trial Finds Remdesivir Has ‘No Meaningful Effect’ In COVID-19 Patients, by JASON BEAUBIEN, https://www.npr.org/sections/goatsandsoda/2020/11/20/937018585/who-trial-finds-remdesivir-has-no-meaningful-effect-in-covid-19-patients

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….”

to read POSTS 1-73 in chronological order, highlight and click on

“Faced with a seemingly unstoppable surge in coronavirus infections, officials at the Centers for Disease Control and Prevention on Thursday urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households — a message sharply at odds with a White House eager to downplay the threat.

The plea, delivered at the first C.D.C. news briefing in months, arrived as many Americans were packing their bags for one of the most heavily traveled weeks of the year. It is the first time that the agency has warned people away from traditional holiday celebrations…

The C.D.C.’s warning runs counter to messages from administration officials, who have denounced concerns that Thanksgiving celebrations will speed the virus’s spread.

“A lot of the guidelines you’re seeing are Orwellian,” Kayleigh McEnany, the White House press secretary, said on “Fox & Friends,” singling out a requirement in Oregon that gatherings not exceed more than six people.

Members of the White House coronavirus task force did not even mention Thanksgiving at a news conference on Thursday, even as they warned of the hazards associated with indoor gatherings and urged “vigilance” in the face of rampant infections.

Earlier in the week, Dr. Scott Atlas, a scientific adviser to President Trump, mocked the idea that older relatives would be put at risk over the holiday weekend, although there is ample medical evidence that seniors are much more likely to become ill if they are exposed to the virus and to die if they become sick.

“This kind of isolation is one of the unspoken tragedies of the elderly, who are now being told, ‘Don’t see your family at Thanksgiving,’” Dr. Atlas said. “For many people, this is their final Thanksgiving, believe it or not.”” (A)

“As a health journalist, a physician and a former foreign correspondent who lived through SARS in Beijing, I often get questions from friends, colleagues and people I don’t even know about how to live during our current pandemic. Do I think it’s safe to plan a real wedding next June? Would I send my kids to school, with appropriate precautions? When will I trust a vaccine?

to the last question I always answer: When I see Tony Fauci take one….

The past tumultuous months have been filled with information gaps (we’re still learning about the novel coronavirus), misinformation (often from the president) and a host of “experts” — public health folks, mathematical modelers, cardiologists and emergency room doctors like me — offering opinions on TV. But all this time, the person I’ve most wanted to hear from is Dr. Fauci. He’s a straight shooter, with no conflicts of interest — political or financial — or, at 79, career ambition. He has no interests, other than yours and mine.” (B)

(A)C.D.C. Pleads With Americans to Stay Home on Thanksgiving, by Roni Caryn Rabin, https://www.nytimes.com/2020/11/19/health/coronavirus-thanksgiving-cdc.html?referringSource=articleShare

(B) When Will We Throw Our Masks Away? I Asked Dr. Fauci, By Elisabeth Rosenthal, https://www.nytimes.com/2020/11/19/opinion/anthony-fauci-covid-interview.html?referringSource=articleShare