The hospitals will have to have a plan to increase their bed capacities by 50% — something Polis said many hospitals had already been working on — how they can transition medical and surgical beds into ICU beds; how to treat patients without COVID-19 who need ICU beds; submit plans for how to surge staffing; report the maximum number of non-ICU and ICU beds to the state on a rolling basis; and have a plan on how they will manage, reduce, delay or put a moratorium on elective surgeries, Polis said.
Polis said he had also ordered the state Emergency Operations Center back to Level 1 status – the highest response level – to coordinate the state’s coronavirus response with local and federal agencies…
The Colorado Hospital Association announced Friday that hospitals and health systems in the state had activated Tier 1 of the Combined Hospital Transfer Center to better help transfer patients between facilities amid the sharp spike in COVID-19 cases and hospitalizations here…
Hospitals will first have to increase their internal capacity and open up unused spaces for more, and work to up staffing levels in the event of a continued surge in patients. The next step would be scaling back elective procedures, and Polis said that a statewide moratorium on them – like was in effect in March and April – was not off the table.
If the hospitalization surge continues after the initial steps to increase capacity and staffing, Polis said, the Hospital Transfer Center would see more work transferring patients where there is room.
And the final step – in lieu of a plateauing of cases and hospitalizations in Colorado – would be to utilize the three alternative care sites at St. Mary’s-Corwin Medical Center in Pueblo, St. Anthony’s in Westminster and the Colorado Convention Center in Denver, Polis said.
He said those alternative care sites, which would serve patients who do not need ICU beds, would be able to be operational immediately with a few dozen beds but could increase their bed capacities to the thousands in a month’s time.” (A)
“The Trump administration’s outreach to governors on the coronavirus pandemic has dropped off in recent weeks, even as cases and hospitalizations are climbing nationwide.
The White House had been holding weekly conference calls with state leaders throughout the summer and into October, offering updates on the administration’s approach to the pandemic and gathering input from governors. But there has been no call in two weeks, and Vice President Pence has been absent from the discussions for multiple weeks.
The drop off in communication with state leaders raises questions about how seriously the Trump administration will take the pandemic in its final two months before leaving office as the United States sees sharp increases in infections and public health experts warn of a dangerous few months ahead.
The White House coronavirus task force issues weekly status reports indicating how individual states are faring in the fight against the pandemic, and state officials are in regular contact with public health agencies.
But the task force, led by Pence, has not held a call with governors since the Friday before Election Day. That call was led by Health and Human Services Secretary Alex Azar, according to multiple people on the call, and was focused mostly on vaccine development…
Trump has not met with the task force in months and has barely commented on the pandemic beyond tweets criticizing Pfizer and the Food and Drug Administration (FDA) after the company announced positive developments with its vaccine candidate just after Election Day.
Both Trump and Pence received an update on Friday on Operation Warp Speed and delivered remarks in the Rose Garden to tout the government effort to invest in multiple vaccine candidates and organize distribution.
The Trump administration is tasked with overseeing the pandemic response and public health agencies until President-elect Joe Biden takes office in January. Lawmakers and experts have raised concerns that Trump, who last met with the task force months ago, will become even more disengaged from the health crisis at a time when the country faces the most risk of the virus spiraling out of control.” (B)
to read POSTS 1-68 in chronological order, highlight and click on
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..”
“As the pandemic engulfs the nation, recent recommendations from the Centers for Disease Control and Prevention have been as notable for what they do not say as for what they do. In a turnabout, the agency now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.
In scientific briefs published on Tuesday, the C.D.C. described the benefits of masks to wearers, not just to those around them. Agency researchers also urged people to celebrate Thanksgiving only with others in their households or, failing that, to wear a mask with two or more layers.
Administration officials famously have disregarded evidence about the effectiveness of masks, one reason there have been at least three coronavirus outbreaks at the White House and hundreds of cases linked to President Trump’s rallies.
The guidance was only the latest in a series of newly assertive bulletins from the C.D.C. In recent weeks, agency officials have issued strict requirements for cruise lines; updated the science on coronavirus infections in children; re-evaluated the risk from airborne virus indoors; and released recommendations for labs investigating viral reinfections in patients…
Under the Biden administration, the C.D.C. will be restored to its status as the premier public health agency in the world, said Dr. Céline Gounder, a member of President-elect Biden’s advisory group on the coronavirus.
“While their role has been diminished during this current crisis, they play a very important role in all this,” she said. The new administration will rebuild public health and data infrastructure, restore C.D.C. staffing in its overseas outposts and give “control back to the C.D.C.”…
Until the pandemic, the C.D.C. was widely regarded as the world’s leading public health agency. But the muzzling of its scientists by the Trump administration and the politicization of some of its advice crippled its efforts to answer critical questions, experts say, including how schools, churches and businesses should reopen, and how Americans could best protect themselves and their families.
The turnabout began after the Trump administration meddled in the C.D.C.’s vaunted weekly bulletins, the Morbidity and Mortality Weekly Reports, according to Dr. Thomas R. Frieden, who led the agency under President Barack Obama…
“The huge fight over the M.M.W.R. led to the administration backing off, and they’ve been putting out great M.M.W.R.s for the past six to eight weeks that are really important,” Dr. Frieden said….
Other C.D.C. documents in recent weeks have also taken an uncompromising tone. The Trump administration blocked a C.D.C. order to keep cruise ships docked until February, but in late October, the agency’s scientists outlined strict new rules for the industry, including requiring cruise ships to have C.D.C. approval for the laboratories and tests they use.” (A)
“A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus, according to a reporter traveling on the ship.
Gene Sloan, a cruise writer for The Points Guy, said in a post on Wednesday that the captain of the SeaDream 1 made a shipwide announcement alerting guests to the positive case and asked that everyone return to their rooms…
Sloan told NBC’s “Today” show that the ship came up with an “incredibly rigorous system” to try and keep Covid-19 cases off the vessel. Everyone was tested before arriving in Barbados and again at the pier and received negative results.
Passengers also did not interact with locals during their stops and were shuttled to empty beaches to either relax or do an excursion…
At the beginning of the trip, passengers were not required to wear face masks. Sloan explained that the ship believed that its extensive testing prior to passengers boarding “would block Covid at the door, so to speak.”
But that changed when two days into the voyage the captain said that masks would be mandatory.
“I’m a little worried,” Sloan said. “I’ve interacted with the other passengers on board over the last few days.”
Cruise ships were not allowed to sail U.S. waters after the Centers for Disease Control and Prevention issued a no-sail order in March following coronavirus outbreaks on several ships. On Oct. 30, the CDC issued a “Framework for Conditional Sailing Order,” which will help the cruise industry implement safety.” (B)
“So far a total of seven passengers have tested positive for Covid-19 aboard the SeaDream 1 cruise ship docked in Barbados, according to two passengers on the ship.
Passengers who have tested negative for the virus will be able to leave the ship and travel home, Gene Sloan and Ben Hewitt told CNN on Friday. They are both among a handful of cruise journalists and bloggers on board.
The SeaDream Yacht Club cruise was the first to return to the Caribbean since the coronavirus pandemic shut operations down in March and was meant to demonstrate that increased safety protocols, including regular testing aboard the ship, could allow cruise voyages to take place during the pandemic.” (C)
“North Dakota’s hospitals have reached their limit, and the coming weeks could push them past their capabilities, Gov. Doug Burgum said at a news conference on Monday, Nov. 9.
Due to a major shortage of health care staffing, the state’s hospitals have a severe lack of available beds. Rising COVID-19 hospitalizations and high noncoronavirus admissions, some resulting from residents who deferred health care earlier in the pandemic, have caused the crunch on medical centers.
Burgum said hospitals are implementing their “surge” plans, and some will be voluntarily stopping elective surgeries to free up staff. He added that the state will coordinate with hospitals to move nurses to medical centers in most dire need of staff.
In an attempt to alleviate some of the staffing concerns, Burgum announced that interim State Health Officer Dirk Wilke has amended an order that will allow health care workers with asymptomatic cases of COVID-19 to continue working in COVID-19 units at hospitals and nursing homes.
The move aligns with “crisis” guidelines from the Centers for Disease Control and Prevention. Since only patients with COVID-19 could receive care from doctors and nurses with the virus, Burgum said he believes there will be little risk of more spread. He added that health care workers in COVID-19 units already wear protective gear to prevent them from contracting the virus.
The Republican governor said health care providers asked the state to take the extraordinary step, adding that “apparently some (providers) had the ability to do this in other states.” “ (A)
“Burgum also announced plans to hire emergency medical services personnel to facilitate testing, as well as efforts to expand rapid testing. He has also moved all counties in the state to the orange or “high risk” level.
At his weekly virus press conference, the governor said hospitals requested that asymptomatic workers be allowed to return to staff their coronavirus units. Some hospital systems have done this at their facilities in other states, he said.
Statewide, hospitals have seen a 60% uptick in coronavirus patients in the past four weeks, and their staffs are stretched thin as workers stay home because they have tested positive or must quarantine. On Monday, the state reported 14 more coronavirus hospitalizations, a substantial increase for a single day. Throughout North Dakota, 254 people are hospitalized due to COVID-19.
Burgum said he believed allowing asymptomatic staff to work with patients hospitalized due to the virus would help alleviate capacity issues and not contribute to further spread among health care workers.
“We’re confident it can (work) under the narrow restrictions that we have,” he said, adding that workers would be dressed in full personal protective equipment.
Asymptomatic workers would be “completely isolated” from their coworkers and would enter hospitals through separate doors, said Chris Jones, executive director of the North Dakota Department of Human Services…
Hospital leaders will now have daily meetings with counterparts in their communities to address capacity issues. They might move workers from one location to another, even from one hospital to a competitor, Burgum said.
The North Dakota Department of Health will begin to hire EMS personnel at rates of $30 to $42 per hour, depending on a candidate’s licensure level, to test for COVID-19. Their wages will be paid for by federal coronavirus stimulus dollars.
Burgum said the effort will help “free up some of the nurses we have working for the Department of Health to be deployed to support in-patient care as needed” at hospitals.” (B)
“Guidance from public health experts has evolved as they have learned more about the coronavirus, but one message has remained consistent: If you feel sick, stay home.
Yet hospitals, clinics and other health care facilities have flouted that simple guidance, pressuring workers who contract COVID-19 to return to work sooner than public health standards suggest it’s safe for them, their colleagues or their patients. Some employers have failed to provide adequate paid leave, if any at all, so employees felt they had to return to work — even with coughs and possibly infectious — rather than forfeit the paycheck they need to feed their families.
Unprepared for the pandemic, many hospitals found themselves short-staffed, struggling to find enough caregivers to treat the onslaught of sick patients. That desperate need dovetailed with a deeply entrenched culture in medicine of “presenteeism.” Front-line health care workers, in particular, follow a brutal ethos of being tough enough to work even when ill under the notion that other “people are sicker,” said Andra Blomkalns, who chairs the emergency medicine department at Stanford University…
But the dilemma also strains health workers’ sense of professional responsibility, knowing they may become vectors spreading infectious diseases to the patients they’re meant to heal.
A database of COVID-related complaints made to the Occupational Safety and Health Administration this spring hints at the scope of the problem: a primary care facility in Illinois where symptomatic, COVID-positive employees were required to work; a respiratory clinic in North Carolina where COVID-positive employees were told they would be fired if they stayed home; a veterans hospital in Massachusetts where employees were returning to work sick because they weren’t getting paid otherwise…
Indeed, the pressure likely has been even worse than usual during the pandemic because hospitals have lacked backup staffing to deal with high rates of absenteeism caused by a highly infectious and serious virus. Hospitals do not staff for pandemics because in normal times “the cost of maintaining the personnel, the equipment, for something that may never happen” was hard to justify against more certain needs, said Dr. Marsha Rappley, who recently retired as chief executive of the Virginia Commonwealth University Health System in Richmond.
That has left many hospitals scrambling to find skilled staff to tend to waves of patients with COVID-19…
Federal officials acknowledge that staffing shortages may require sick health care workers to return to work before they recover from COVID-19. The Centers for Disease Control and Prevention even has strategies for it.
The CDC website lists mitigation options for short-staffed facilities, some of which have been implemented widely, such as canceling elective procedures and offering housing to workers who live with high-risk individuals.
But it acknowledges these strategies may not be enough. 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.
“As a last resort,” the website says, health care workers confirmed to have COVID-19 may provide care to patients who do not have the virus.” (C)
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.”
“When senior Food and Drug Administration officials held their morning call one day this week, they received a sobering warning from the agency’s chief, Dr. Stephen M. Hahn, who had just gotten off the phone with the White House: Block out “all the craziness” afoot and stay focused on fighting the pandemic, he said.
There are plenty of distractions. President Trump is pushing to overturn the results of the election and his only public statements about the coronavirus in the last few days were to make clear his pique that good news about a vaccine had not come until after Election Day — even as the number of new daily infections on Wednesday topped 140,000, average daily deaths shot past the 1,000 mark, and Covid-19 hospitalizations hit a record high of 65,368.
Vice President Mike Pence canceled a vacation at the last minute as the virus numbers grew worse, but the White House coronavirus task force that he leads has been all but publicly silent. Mark Meadows, the White House chief of staff who is infected with the virus, declared last month, “We are not going to control the pandemic,” and said the focus should instead be on the longer-term goals of developing vaccines and treatments.
Since then, the White House political director, Brian Jack, and two other White House aides have become the latest administration officials to test positive for the virus, people familiar with the diagnosis said on Wednesday.
The pandemic caught the nation flat-footed in March, but epidemiologists have been warning for months of a fall and winter wave as people are driven indoors, schools resume in-person classes and Americans grow tired of months of precautions. Yet shortages of personal protective equipment are back, especially among rural hospitals, nursing homes and private medical practices that lack access to the supply networks that serve larger hospital chains.
The Strategic National Stockpile, the nation’s emergency reserve, has only 115 million N95 masks, far short of the 300 million the administration had hoped to amass by winter, Rear Adm. John Polowczyk, who retired on Monday as the national supply chain commander, said in a recent interview, though he added that the government is continuing to expand its supplies of protective gear.
Dr. Shikha Gupta, the executive director of Get Us PPE, a volunteer effort that matches available supplies to health care providers, said 70 percent of those requesting help from the organization last month reported being completely out of some gear, especially masks, gloves and disinfecting wipes.
“Health care workers are exhausted and frustrated, and it’s really hard to believe that on Nov. 10, it feels very much like the middle of March all over again,” she said.
Governors are once again competing with one another and big hospital chains for scarce gear. Nursing homes are grappling with staff shortages, which have left hospitals unable to discharge patients to their care. In Wisconsin, the situation is so severe that health officials are mulling a plan to train family members of nursing home residents to fill in at facilities that lack enough workers.
“We’re throwing every idea that we can conceivably think of to the state, but we really need bold action from the federal government,” said John Sauer, the president of LeadingAge Wisconsin, an association that represents nonprofit nursing homes and long-term care facilities. “We can’t muddle through this on our own.”
The United States is on somewhat better footing now than in the earliest days of the pandemic. States and hospitals have their own stockpiles, and Admiral Polowczyk said the federal government had met its goal of acquiring 153,000 ventilators.
But as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged. President-elect Joseph R. Biden Jr. is trying to assume a leadership mantle, with the appointment of a coronavirus advisory board and a call for all Americans to wear masks, but until his inauguration on Jan. 20, he lacks the authority to mobilize a federal response.” (A)
“President-elect Biden’s transition team unveiled the members of his Covid-19 task force on Monday, a who’s-who of former government health officials, academics, and major figures in medicine…
Biden has cast the escalating Covid-19 crisis as a priority for his incoming administration. The task force, he said, would quickly consult with state and local health officials on how to best prevent coronavirus spread, reopen schools and businesses, and address the racial disparities that have left communities of color harder hit than others by the pandemic.
“Dealing with the coronavirus pandemic is one of the most important battles our administration will face, and I will be informed by science and by experts,” Biden said in a statement Monday. “The advisory board will help shape my approach to managing the surge in reported infections; ensuring vaccines are safe, effective, and distributed efficiently, equitably, and free; and protecting at-risk populations.”
As expected, the board’s three co-chairs are Marcella Nunez-Smith, a Yale physician and researcher; Vivek Murthy, a former U.S. surgeon general; and David Kessler, a former FDA commissioner…
Separately, the Biden transition announced that it had appointed two health advisers who will guide the incoming administration’s Covid-19 preparations but will not serve on the task force. One of those advisers, Beth Cameron, is the former director of a White House biodefense council that Trump has been criticized for closing in 2017. The other, Rebecca Katz, is a well-known Georgetown global health security professor.” (B)
“President-elect Joe Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government, according to documents obtained by POLITICO and people familiar with the decision…
The Covid-19 team has not yet been formally announced and is largely separate from the coronavirus task force that Biden unveiled Monday, which is primarily advising Biden and handling the incoming administration’s public messaging…
The coronavirus transition team is broken down into three specialties, according to a roster obtained by POLITICO, with each led by a handful of transition officials dubbed the “central team.”
Those central team leaders will coordinate efforts with designated transition officials assigned to individual agencies, such as the Health and Human Services, Homeland Security and State departments.
The team’s “domestic” work is led by a five-person group that includes Sarah Bianchi, a top economic and domestic policy aide to Biden when he was vice president. Transition officials in that group include Johns Hopkins infectious disease expert Tom Inglesby and Luciana Borio, a former FDA official and National Security Council member.
The team’s “national security/foreign policy” work is headed by Rebecca Katz, director of Georgetown’s Center for Global Health Science and Security, and Dylan George, a former biological threats specialist in the Obama administration. Members include Craig Fugate, who is part of Biden’s Homeland Security review team, and Deborah Rosenblum, a member of the Department of Defense review team.
The team’s third specialty, “tech strategy delivery,” is led by a five-person team that includes Mina Hsiang of the health care firm Devoted Health and Amy Pitelka, a tech legal and policy specialist.” (C)
…The agency’s new guidance also notes that numerous studies have demonstrated the benefits of “universal masking policies.”” (A)
“Wearing a mask not only protects others from the spread of Covid-19, but it protects the wearer as well, the Centers for Disease Control and Prevention said Tuesday in its strongest messaging yet on face coverings.
The CDC also said that “adopting universal masking policies can help avert future lockdowns,” particularly when combined with a doubling down of mitigation strategies available to virtually every American: physical distancing, hand washing and ventilation.
SARS-CoV-2, the virus that causes Covid-19, spreads mainly through respiratory droplets, especially when people are coughing, sneezing, singing, talking or even breathing. Infectious disease experts have long said that when one person covers his or her mouth and nose, it protects those who are nearby. The CDC report estimated that more than 50 percent of transmissions originate from asymptomatic people, or those who have been infected but have not yet developed symptoms.
When the CDC first urged Americans to wear face coverings in public in spring, the guidance was that it protected others. But there is growing evidence that a mask can also give protection to the person wearing it.
“Studies demonstrate that cloth mask materials can also reduce wearers’ exposure to infectious droplets through filtration, including filtration of fine droplets and particles less than 10 microns,” the report’s authors wrote.” (B)
“But the different state-level approaches mean researchers can now parse the results of a trial they never would have received approval to conduct. New unpublished research from Kansas and Tennessee suggests that not only do mask mandates prevent Covid-19 spread, they may also blunt the severity of illness and reduce the number of serious cases that require hospitalization. Other findings support the argument more and more public health experts are making: that masks remain among our cheapest most effective tools to control the pandemic — if worn consistently.
“If you’re not in the ICU, the only tools at our disposal that we know work are the tried-and-true public health measures, like social distancing, hand-washing, and masks,” says Vin Gupta, a critical care pulmonologist and affiliate assistant professor for the Institute for Health Metrics and Evaluation at the University of Washington. “We’re bearing the brunt of those things being implemented poorly.”
“You’re less likely to get Covid-19 if you’re wearing a mask,” says Donna Ginther, an economist and director of the Institute for Policy and Social Research at the University of Kansas. And “even if you do get sick while wearing a mask, you’re less likely to get deathly ill.” “ (C)
(A)Live updates: CDC offers stronger endorsement of mask-wearing as U.S. sets another record for infections, by Antonia Noori Farzan, Rick Noack, Marisa Iati, Paulina Villegas and Siobhán O’Grady,
