PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
“In the scramble to vaccinate millions of health workers, difficult choices about who comes first — and who must wait — have started to surface. So far, the effort is concentrated in hospitals. Workers treating Covid-19 patients in intensive care units and in emergency departments have in recent days been beaming symbols of the virus’s demise.
But there are roughly 21 million health care workers in the United States, making up one of the country’s largest industries, and vaccinating everybody in the first wave would be impossible. That has left entire categories of workers — people who are also at risk for infection — wondering about their place in line…
There are broad gray areas, he said: primary care doctors in areas with high infection rates, workers who handle bodies, firefighters who respond to 911 calls, dentists, pathologists who handle coronavirus samples in labs, hospice workers, chaplains…
These are hard choices and will become even harder as the vaccine becomes more widely available for the general public and states begin wrestling with the question of who is an essential worker…
The Centers for Disease Control and Prevention has laid out categories but they are broad, so each state — and each hospital system — has come up with its own plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers like Dr. Baker — as well as professional societies of groups such as pathologists, dentists and medical examiners — wondering where they stand.” (A)
“As frontline healthcare workers around the country receive the first doses of a Covid-19 vaccine, mental health providers worry they may not be included, even though they are often working in hospitals and clinics and may be exposed to Covid-19. The crux of the matter rests with how individual states end up interpreting broad federal guidelines for vaccine distribution. These states will be the ultimate arbiters of who are “essential workers” that qualifies for early inoculations. A CDC committee approved guidance to states in early December that vaccines should go to health care workers “who have the potential for direct or indirect exposure to patients or infectious materials” and to “residents of long-term care facilities.”
Mental health groups worry that wording leaves too much room for interpretation. Without more specific directions, “we would be at the mercy of each state to recognize the importance of mental health and substance use providers,” Reyna Taylor, the head of policy at the National Council for Behavioral Health, said in an email…
Mental health providers should be part of the first group of recipients of these vaccines because they face unique risks treating patients in person, Taylor said. Many take walk-in appointments and provide primary care. In mental health emergencies, she said, providers may have to treat someone before they can learn whether the person has Covid-19 or not. “When you’re providing services to someone who’s in a mental health or substance use crisis, you’re not thinking about Covid-19, you’re thinking about saving someone’s life from that crisis,” she said. Even if they aren’t in crisis, “the nature of serious mental illness and substance use disorder [means] there is at times a lack of awareness of their symptoms, including the symptoms of Covid-19,” she added in an email, and as a result providers “have to treat everyone who walks in as if they are Covid-19 positive.”..
There are not enough vaccine doses to give all the eligible healthcare workers and long-term care residents of the first group recommended by the CDC. That will force states to decide who in the priority group should be vaccinated and who should wait until more vaccine doses are manufactured…
Whether mental healthcare is part of the first subgroup getting the vaccine will be up to each state’s interpretation of the guidelines, Bahta said. Some may decide that mental health and substance use providers belong in the first phase, “Phase 1a,” while others might group them in the “1b” category, which the committee has not yet voted on but may include essential workers like bus drivers, teachers and police officers. “There will be a multitude of variations on how this plays out,” she said in an email…” (B)
“Here’s a look at what to expect from the coming coronavirus vaccination campaign.
Who can get a vaccine and when?
December
Who might get vaccinated: Health care workers and nursing home residents
December is a month for some big decisions. The US Centers for Disease Control and Prevention’s Advisory Committee for Immunization Practices has voted to recommend that 21 million frontline health care workers and support staff and 3 million residents of long-term care facilities who have been hardest hit by the pandemic be in the first group.
Health care workers and long-term care facility residents should get Covid-19 vaccine first, CDC vaccine advisers say
It will be easiest to vaccinate these groups — they’re already in institutional settings and the nursing home residents can get vaccinated at the same time their caregivers are being immunized….
January
Who might get vaccinated: More health care workers, other essential workers like emergency medical technicians, firefighters and police
If two or more vaccines get approved by the FDA, January might be when discussion really starts on who can get vaccinated and when….
Several groups of independent experts have weighed in on how to allocate vaccines, including the National Academies of Science, Engineering and Medicine and Johns Hopkins University.
They’ve all laid out basic principles that include protecting the country’s health care system, protecting the most vulnerable people, controlling the spread of the virus and being equitable across society.
ACIP will need to meet to decide on the details off all these phases.
January might include some of the rest of Phase 1 of a four-phase vaccine rollout.
Phase 1b is roughed out to include essential workers, including emergency medical technicians, as well as frontline workers at very high risk of infection, such as food workers. This phase may also include older adults living in congregate settings or crowded conditions.
There’s a also a proposed Phase 1c, which might include people of all ages with underlying conditions such as diabetes and kidney disease who are at significantly higher risk of dying or getting severely ill from Covid-19.
February
Who might get vaccinated: More essential workers and high-risk adults
By February, states may have hit their stride on vaccinating residents. Vaccination campaigns may move beyond hospitals and nursing homes, rehabilitation centers and other such facilities to pharmacies and medical practices…
March
It’s possible that the US will still be in Phase 1 of vaccination in March, simply because of the sheer numbers involved. Anyone healthy and under 65 who is not an essential or high-risk worker would not be thinking about vaccination yet.
April
If more vaccines have been approved and brought online, it’s possible Phase 2 of vaccination could begin by now.
This group has not been decided yet, but Phase 2 might include K-12 teachers and staff and other child care workers, as well as other critical workers such as retail workers and transportation workers. This group could also include people in homeless shelters and all people over 65 who were not already included in phase 1…
May
Young adults and children would have to wait until Phase 3 and under other scenarios that’s likely to be May at the soonest — perhaps June or later, depending on what ACIP decides, what the vaccine supply looks like and how smoothly distribution is going…
Which vaccine should I get?
At first there will be little choice — both Pfizer and Moderna are providing a new type of immunization called an mRNA vaccine. It’s considered especially safe because it does not use a whole virus — just a piece of genetic material — and both seem especially effective, providing 95% protection against symptomatic disease.
What’s not known is how long that protection might last, whether either vaccine protects against asymptomatic disease and whether either stops people from spreading the virus to others.
Vaccines coming later might offer harder choices. AstraZeneca’s vaccine uses what’s called a replication deficient virus to deliver a piece of genetic material from the coronavirus. So does Johnson & Johnson’s vaccine. There’s not a lot of safety data about these vaccines yet, and no evidence the viral vectors could be harmful. Nonetheless, some doctors may be reluctant to offer them to patients with compromised immune systems, including those with rheumatoid arthritis or multiple sclerosis who are taking immune-suppressing drugs; pregnant women; people taking certain cancer treatments and others..” (C)
“In coming days, squads of CVS and Walgreens employees, clad in protective gear and carrying small coolers, will begin to arrive at tens of thousands of nursing homes and assisted-living facilities to vaccinate staff and residents against the coronavirus.
It promises to be a crucial milestone in America’s battle against a pandemic that has inflicted especially severe carnage on nursing homes. At least 106,000 residents and staff of long-term care facilities have died from the virus, accounting for 38 percent of the country’s Covid-related fatalities.
But even before it begins, the mass-vaccination campaign is facing serious obstacles that are worrying nursing home executives, industry watchdogs, elder-care lawyers and medical experts. They expect nursing homes to be the most challenging front in the mission to vaccinate Americans.
Some residents and staff are balking at taking the vaccine. Short-staffed facilities are concerned about workers calling in sick with side effects, straining resources just as some frail residents are likely to experience fever and fatigue from the shot. Most nursing home employees work in shifts; will it be possible to vaccinate everyone over the course of just a few visits from CVS and Walgreens?
The virus has devastated residents and staff members in more than 28,000 long-term care facilities across the country.
While some states began vaccinations in nursing homes this week, the broader nationwide effort will start over the next few days. And there remains widespread confusion about a key element: how nursing homes will get consent to vaccinate residents who aren’t able to make their own medical decisions. A CVS executive said such residents’ legal representatives will be able to provide consent to nursing homes electronically or over the phone, but officials at multiple large nursing home chains said they weren’t aware of that.
If residents or their representatives haven’t given consent before CVS or Walgreens employees show up, it is not clear whether or when they will have another chance to be inoculated.
“Given the pace of this rollout, I am very concerned that nursing facilities won’t have the time or capacity to really explain the vaccine to residents and their families,” said Nicole Howell, a state-funded ombudsman in California whose office works with 29,000 long-term care residents.
Because of the large number of facilities they must visit, CVS and Walgreens only have the capacity to go to each location two or three times. The Pfizer and Moderna vaccines both require two doses, separated by a few weeks, which means that at most nursing homes, all staff and residents will have to receive their shots on the same days…
But the more employees who get the vaccine, the more who are likely to experience side effects — and that could cause more problems.
“If even as little as 10 percent of your staff calls off the next day — while at the same time all of the residents are irritated, upset and having adverse effects — you’ve created a perfect storm,” said Chad Worz, chief executive of the American Society of Consultant Pharmacists, which represents pharmacies that serve long-term care providers.
There is no federal requirement for people to give consent before getting vaccinated, but it is standard practice and is often needed for billing purposes. States have different requirements about how medical consent can be given and what information needs to be provided to the person who is consenting. The Centers for Disease Control and Prevention’s guidance is that residents or their representatives should receive a fact sheet about the coronavirus vaccine and then consent to receiving it.
The task of getting consent is not always straightforward at nursing homes. Many residents, like those with dementia, aren’t capable of giving it on their own. Instead, nursing homes need to get the permission of their family members or other legal representatives.
CVS and Walgreens have created paper and digital consent forms that nursing homes can use. Consent must be given in advance; the pharmacies need to know how many doses of the vaccine, which must be kept very cold, to bring with them.” (D)
“A top Trump appointee repeatedly urged top health officials to adopt a “herd immunity” approach to Covid-19 and allow millions of Americans to be infected by the virus, according to internal emails obtained by a House watchdog and shared with POLITICO.
“There is no other way, we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,” then-science adviser Paul Alexander wrote on July 4 to his boss, Health and Human Services assistant secretary for public affairs Michael Caputo, and six other senior officials.
“Infants, kids, teens, young people, young adults, middle aged with no conditions etc. have zero to little risk….so we use them to develop herd…we want them infected…” Alexander added.
“[I]t may be that it will be best if we open up and flood the zone and let the kids and young folk get infected” in order to get “natural immunity…natural exposure,” Alexander wrote on July 24 to Food and Drug Administration Commissioner Stephen Hahn, Caputo and eight other senior officials. Caputo subsequently asked Alexander to research the idea, according to emails obtained by the House Oversight Committee’s select subcommittee on coronavirus.
Alexander also argued that colleges should stay open to allow Covid-19 infections to spread, lamenting in a July 27 email to Centers for Disease Control and Prevention Director Robert Redfield that “we essentially took off the battlefield the most potent weapon we had…younger healthy people, children, teens, young people who we needed to fastly [sic] infect themselves, spread it around, develop immunity, and help stop the spread.”..
“So the bottom line is if it is more infectiouness [sic] now, the issue is who cares?” Alexander wrote in a July 3 email to the health department’s top communications officials. “If it is causing more cases in young, my word is who cares…as long as we make sensible decisions, and protect the elderely [sic] and nursing homes, we must go on with life….who cares if we test more and get more positive tests.”” (E)
“The Food and Drug Administration authorized Pfizer Inc. and BioNTech SE’s Covid-19 vaccine for emergency use—the first to get such a green light—late Friday, setting in motion UPMC’s push to notify individual employees who will get the opportunity to receive the earliest shots. By Monday, the first UPMC health-care workers finally had an answer to who would be offered the vaccine.
UPMC didn’t have enough to go around. On Monday it received 975 doses at its Children’s Hospital of Pittsburgh and expected another 1,950 doses to arrive Tuesday for its flagship hospital, UPMC Presbyterian in Pittsburgh. A team including doctors, pharmacists and an ethicist had agreed only days earlier how they would pick those to go first.
“It is a very difficult thing for us to all feel confident that what we’ve done is fair and effective,” said Graham Snyder, UPMC’s medical director of infection prevention and hospital epidemiology.
Hospitals are among the first to confront the ethical, legal and practical challenges of coordinating a mass vaccination campaign among employees as shots become available. Federal advisers also identified workers in public transit, food supply and education as high priority, after health-care workers and vulnerable residents in nursing homes…
Divvying up the vaccine isn’t the first time hospitals have been forced to ration critical care and supplies in the pandemic. Surgeons have decided which procedures to put off and which can’t wait as hospitals become swamped with Covid-19 patients. Limited early supply of the antiviral drug remdesivir led to federal distribution of the drug to states, which then awarded scarce supplies to hospitals.
UPMC for six weeks used a weighted lottery to decide which Covid-19 patients would get the drug. “There were many days we did not have enough,” said Doug White, a doctor and ethicist at the University of Pittsburgh. “It’s incredibly sad to not have enough,” he said.
The UPMC weighted lottery for remdesivir slightly boosted chances for patients from economically distressed neighborhoods to help alleviate disparities and reach people hit harder by the pandemic.
UPMC Presbyterian in Pittsburgh is expected to receive 1,950 doses of the vaccine on Tuesday.
For the vaccine, UPMC is expected to receive nearly 30,000 doses by the end of December. UPMC employs about 90,000 people, of which about 60,000 are health-care workers.
Covid-19 has disproportionately hit health-care workers who are people of color, who account for about 40% of the workforce but 53% of Covid-19 cases, an analysis by the Kaiser Family Foundation shows. Black and Hispanic people accounted for a larger share of health-care employees in housekeeping, cafeterias, security, clergy and other support jobs, the analysis found.
That disproportionate impact shouldn’t be overlooked with distribution of the vaccine, which would further exacerbate disparities, said Dayna Bowen Matthew, dean of the George Washington University Law School, whose work focuses on racial disparities in health care. “The way we distribute this vaccine could either decrease or increase existing inequalities,” she said.
To pare the list down further, UPMC will give priority to employees who have the highest risk of severe disease, but this requires information about workers’ health, which employers generally can’t request.
UPMC will ask workers to confirm they have a high-risk condition, such as heart disease, but the system won’t ask for specifics. UPMC also won’t verify it is true.
“It’s an honor system,” said Dr. Snyder. “Could somebody lie and say they do, just to get ahead of the line? Yes. But I have a lot of faith in our health-care workers to answer that honestly.”
“Hospitals in general are advised to target the members of their workforces at highest risk, but the institutions are left on their own to decide exactly who that will be, Colin Milligan, a spokesperson for the American Hospital Association, said by email.
“It is clear that the hospitals will not receive enough in the first weeks to vaccinate everyone on their staff, so decisions had to be made,” Milligan wrote.
At Intermountain Healthcare in Salt Lake City, the first shots will go to staff members “with the highest risk of contact with Covid-positive patients or their waste,” said Dr. Kristin Dascomb, the medical director of infection prevention and employee health. Within that group, managers will determine which caregivers are first in line.
At UW Medicine in Seattle, which includes Harborview Medical Center, an early plan called for high-risk staff members to be selected randomly to receive first doses, said Dr. Shireesha Dhanireddy, medical director of the infectious disease clinic. But the University of Washington hospital system expects to receive enough doses to vaccinate everyone in the high-risk tier within two weeks, so randomization isn’t necessary — for now.
“We are allowing people to schedule themselves,” Dhanireddy said, and encouraging staffers to be vaccinated near the end of their workweeks in case they have reactions to the vaccine.
Trial results have shown that the shots frequently produce side effects that, while not debilitating, could cause symptoms that might keep someone home for a day or two, such as fever, muscle aches or fatigue.
Noting that guidelines call for no more than 25 percent of any unit to be vaccinated at once, Sifri, of UVA Health, said, “We want to make sure that not everybody has the vaccine on the same day so that if there are some side effects, we don’t end up being short-staffed.”
Once the initial 3,000 doses are distributed at UVA Health, the hospital plans to rely on what Sifri described as “a very strong honor code” to allow staff members to decide where they should be in line. They’ve been asked to consider professional factors, like the type of work they do, as well as personal risks, such as age or underlying conditions, like diabetes.
“We’re going to ask team members, using the honor code, to determine what their risk is for Covid and to determine whether they need to have an early vaccine sign-up time or a later vaccine sign-up time,” he said.
The plan was chosen after health care staff members soundly rejected other options. For example, few favored a proposal to allocate doses via a lottery, like the chaotic birthday-based system depicted in the 2011 pandemic horror film “Contagion.”
Hospital officials also stressed that they are trying to devise distribution plans that ensure that vaccines are allocated equitably among health care workers, including the social, racial and ethnic groups that have been disproportionately harmed by Covid-19 infections. That requires thinking beyond front-line doctors and nurses.
At UVA Health, for example, one of the first groups invited to get shots will be 17 workers whose job is to clean rooms in the special pathogens unit where severe Covid-19 cases are treated.
“We acknowledge that everybody is at risk for Covid, everybody is deserving of a vaccine,” Sifri said.
In many cases, it will be clear who should go first. For instance, although Dhanireddy is an infectious disease doctor who consults on Covid-19 cases, she is happy to wait.
“I wouldn’t put myself in the first group at all,” she said. “I think that we need to protect our staff that are really right there with them most of the day — and that’s not me.”
But hospitals must remain vigilant about relying on workers to prioritize their own access, Dhanireddy said. “Sometimes, self-selection works more for self-advocacy,” she said. “It’s great that some individuals say they would defer to others, but sometimes that’s not actually the case.”
For some health care workers, not being first in line is fine. Because the vaccine is initially authorized only for emergency use, hospitals won’t require employees to be inoculated as part of the first round. Between 70 percent and 75 percent of health care staff at UVA Health and Intermountain Health would accept a Covid-19 vaccine, internal surveys showed. The rest are unsure — or unwilling.” (B)
“…Initially, supply will be very limited, meaning states have to make difficult decisions about who should get the first allocations.
To help guide these decisions, the CDC’s Advisory Committee on Immunization Practices (ACIP) released an interim recommendation on December 1 for the highest priority group (“Phase 1a”) to include health care workers (HCWs) and long-term care (LTC) residents; we estimate that this populations together represents about 17.6 million people. ACIP also provided further guidance regarding sub-prioritization within these groups. While ACIP has yet to finalize recommendations on subsequent prioritization (expected soon), according to presentations and materials provided in recent ACIP meetings, the committee is likely to recommend that (non-health care) essential workers be the next priority group (“Phase 1b”), followed by persons age 65 and older and those with conditions that place them at high risk for severe illness from COVID-19 (“Phase 1c”). These groups are much larger, which will likely make the next stages of prioritization much more difficult given that supply will still be limited (according to ACIP, there are an estimated 87 million essential workers, 53+ million seniors and more than 100 million individuals with high-risk medical conditions).
States look to and often follow ACIP guidance, but the federal recommendations are not binding and some states may choose to depart from the prioritization sequence outlined by ACIP, which could mean that initial access will depend on where people live. To see where states stand on prioritization, we collected and reviewed all statements and releases from state officials that reference the criteria they will use to prioritize vaccines during Phase 1 (these prioritization criteria build on and add detail to states’ initial vaccine distribution plans, which we already examined here). We did not assess how individual facilities (such as hospitals) will allocate vaccines once they arrive at their doors….
Our review finds that almost all states hew to ACIP regarding initial allocations of a COVID-19 vaccine (Phase 1a) and have looked specifically at ACIP for decision-making. Beyond that, a good number of states are still developing criteria for Phases 1b-c. Given that ACIP has yet to issue recommendations for these phases, states may be waiting for further guidance. However, based on ACIP’s preliminary framework, there are some differences between state priorities and where ACIP is likely to land, primarily related to the prioritization of seniors and/or those with high risk medical conditions relative to non-health essential workers. Moreover, these later prioritization decisions are likely to be more difficult given the large numbers of people in these groups and continued limits on vaccine supply.” (C)
“These COVID vaccines are preventing clinical disease, we don’t know if they prevent transmission,” Dr. Beyrer said.
It’s important to know the difference between infection and disease. Dr. Moss said just because you are infected or have transmitted coronavirus doesn’t mean you get sick.
“So you know, everyone who gets disease has an infection, and the infection causes the disease,” Dr. Moss said. “But not everyone who is infected has the disease.”
That is where Moderna and Pfizer have aimed their vaccines: preventing people from getting sick.
“What’s being measured in the trials is whether or not they prevent disease, mild, moderate and severe disease,” Dr. Moss explained.
This isn’t rare for vaccines. Dr. Moss said most vaccines don’t actually stop a virus from entering your body.
“That requires a really strong kind of immune response to prevent infection,” he said.
Simply put, we don’t know if these vaccines prevent infection, but we do know their primary job is to stop the virus from becoming a disease or lessen the disease.” (D)
Dr. Jonathan M. Metsch is Clinical Professor of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai; Affiliated Faculty at the Zicklin School of Business, Baruch College, C.U.N.Y. and, until recently Adjunct Professor at Rutgers School of Public Affairs and Administration and Rutgers School of Public Health.
Jonathan is a member (and Acting Chairman) of the Institutional Review Board (IRB) at Stevens Institute of Technology, a Commissioner of the Hoboken Historical Preservation Commission, and a Board member of The Hoboken Shelter.
Jonathan served as a Board member of Jewish Family Service of MetroWest and as a Leadership Newark Coach. He was the Founder of Hudson Cradle and served on the Board of the Hudson County Child Abuse Prevention Center, and the Steering Committee of MetroWest CARES.
From September, 2009 to November, 2011 Jonathan was a Commissioner of the Hoboken Municipal Hospital Authority, and part of the team that “privatized” this City-owned hospital. He was also the organizer and co-chairman of the Hoboken H1N1 Swine Flu Task Force.
Metsch was a UJA-Federation of New York MAP consultant, previously serving: on the Board of Hillel at Baruch College; as a member of the Jewish Community Centers review team; on the Board of Associated Camps; and as a member of the Food Sustainability portfolio review group.
While serving as President and CEO of LibertyHealth/ Jersey City Medical Center (and Associate Dean for Jersey City Medical Center, Mount Sinai School of Medicine) from 1989-2006, Jersey City Medical Center: was designated as a Regional Perinatal Center, Level II Trauma Center, Teaching Hospital Cancer Program, a Children’s Hospital, and a Medical Coordination Center (for statewide disaster preparedness); started cardiac surgery/ interventional cardiology; and became a major teaching affiliate of Mount Sinai School of Medicine. A total replacement hospital was opened on a new site in 2004.
Metsch was Chairman of the Board of the New Jersey Hospital Association and served on the Boards of the Seton Hall University School of Graduate Medical Education, the Hudson County AIDS Consortium, the State Health Planning Board, the Hudson County Perinatal Consortium, and The Hospital Alliance of New Jersey. He served on the Governor’s Advisory Commission on Hospitals, the Task Force on Affordability and Accessibility of Health Care in New Jersey, the Governor’s Advisory Council on AIDS, and the Department of Human Services HMO-Hospital Workgroup.
From 1972-1989 Jonathan worked at The Mount Sinai Medical Center (NYC) as: a faculty member of the Baruch-Mount Sinai Graduate Program in Health Care Administration; Administrator of Mount Sinai Services, City Hospital Center at Elmhurst; Associate Dean for Administration of Mount Sinai School of Medicine; and Senior Vice President for Administration, MSMC.
From 1967-1970 Jonathan was on active duty in the U.S. Air Force leaving with the rank of Captain.
Dr. Metsch earned: a B.A. from Queens College of the City University of New York; an M.P.A. from the University at Albany, State University of New York; and a Dr.P.H. from the University of North Carolina at Chapel Hill (from which he received the School of Public Health’s 2005 Harriet Hylton Barr Distinguished Alumni Award).
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
“What seemed impossible months ago is now a reality: the first doses of a Covid-19 vaccine have been given to the American public, less than a year after the disease was first spotted in the US.
It’s an astonishing feat, since most vaccines take years to develop.
But it will be several months before most Americans can get a Covid-19 vaccine.
In the meantime, thousands of Americans are dying from the virus every day.
And the rates of new infections and deaths are accelerating at unprecedented rates, meaning Americans must hunker down this winter before rolling up their sleeves.
A critical care nurse was the first person in New York and among the first people in the country to get a first dose of the Pfizer/BioNTech vaccine…
The US Food and Drug Administration recently authorized the vaccine for emergency use, and the US Centers for Disease Control and Prevention has allowed it to be given to people 16 and older.
“We expect 145 sites across all the states to receive vaccine on Monday, another 425 sites on Tuesday, and the final 66 sites on Wednesday, which will complete the initial delivery of the Pfizer orders for vaccine,” said Gustave Perna, chief operating officer of Operation Warp Speed.
But the CDC has recommended that health care workers and residents of long-term care facilities get the vaccine first.”(A)
“In the US, the Pfizer/BioNTech vaccine is being distributed to hundreds of hospitals. Healthcare workers at high risk of being infected should get vaccinated first, the US Centers for Disease Control and Prevention’s vaccine advisory panel has recommended. Nursing home residents are next in line, and are due to start getting vaccinated from next week.
Mass vaccination could be a particular challenge in the US because it lacks a centralised healthcare system. Different states and hospitals can make different decisions on who gets the vaccine.
There is also concern about the rate of uptake, even though the vaccine will be free. Only half of US adults say they will get vaccinated, according to a recent survey. Another quarter are unsure and the remaining quarter say they won’t take it.” (B)
“Complicating the matter in Pennsylvania is the fact that the state has not disclosed how many doses are anticipated or how the vaccine will be allocated once it gets here.
The state released an interim vaccine plan Friday, but it doesn’t detail which regions or facilities will get the initial doses, making Pennsylvania and Puerto Rico the only places that haven’t released that information, according to a New York Times survey…
The Pennsylvania Department of Health will determine how much each region will receive, but those numbers have not been disclosed. After postponing release of the information twice last week, a department spokeswoman did not respond Friday, and a spokesman declined to comment on Saturday.
In next-door Ohio, Gov. Mike DeWine has released not only how many doses his state anticipates, but also how many will go to specific facilities statewide.” (F)
“President Donald Trump has asked White House staffers to receive the coronavirus vaccine “somewhat later in the program, unless specifically necessary,” he tweeted Sunday night after it surfaced that high-ranking administration officials were set to receive some of the first doses in the US.
The vaccinations, which were set to begin as soon as this week, would have come while the vaccine is in extremely limited supply and only generally available to high-risk health care workers. Other parts of the Trump administration were intended to be vaccinated in the coming days…
An administration official said health care providers at the National Institutes of Health will begin receiving the vaccine in the near future. Doctors and nurses in the intensive care unit at the NIH Clinical Center will be prioritized to receive the vaccine first. Other top officials, like Dr. Anthony Fauci, are on the list to receive the vaccine following those staffers who rank higher on the priority list, the official said.
“Senior officials across all three branches of government will receive vaccinations pursuant to continuity of government protocols established in executive policy,” National Security Council spokesman John Ullyot said in a statement. “The American people should have confidence that they are receiving the same safe and effective vaccine as senior officials of the United States government on the advice of public health professionals and national security leadership.”..
The President and other White House staff have regularly flouted US Centers for Disease Control and Prevention guidelines for safety during the pandemic such as the wearing of face masks and social distancing.
There have been several Christmas parties held at the White House recently where those guidelines weren’t followed, and Trump held many events during the campaign where large crowds gathered, maskless.” (E)
“With the Food and Drug Administration’s authorization of a coronavirus vaccine on Friday, the United States became the third highly developed Western country — after Britain and Canada — to approve such a shot, and is expected to start inoculating people within days.
But the three countries have very different health care systems. And they face different challenges in the race to get the vaccine to millions of people.
Here are some similarities and contrasts…
How centralized is the rollout?
In Britain, very. In the United States, not. In Canada, somewhere in between.
With a strong central government and a National Health Service that covers all of its people, Britain, which began giving the vaccine this past week, is directing the process from London. The national government chose the 50 hospitals that would initially get the vaccine and made sure they were prepared; decided how much each one would receive; and drafted the rules determining in what order people would be eligible to get it.
The Trump administration has deferred much of the decision-making to the states. The federal government will have the vaccine distributed to each state based on population, not need, but some states have complained that they do not know enough about the arrangements.
It will be up to the states to decide how to divide the doses among hospitals, clinics and, ultimately, drugstores and doctors’ offices, but at first, at least, the vaccine will go to hospitals with ultracold storage…
Like Britain, Canada has a universal health care system, but like the United States, it has a federal government. The Canadian health care system is decentralized, administered by the provinces and territories.
For vaccine distribution, the central government plans to work through those regional governments. Ottawa will play a large role in directing the process.
Canada had ordered enough of the Pfizer-BioNTech vaccine for all of its people, Britain enough for 30 percent and the United States enough for 15 percent…
In Canada, where the military is playing a central role in vaccine distribution, the government is sending shipments to all 10 provinces. The three northern territories will have to wait.
In the United States, FedEx and UPS will ship vaccines from distribution centers to every part of the country. But the holiday season is the busiest time of the year for delivery services, which could slow things down.
How fast will most people get vaccines?
That is even murkier.
Britain, Canada, the United States and the European Union have all followed similar strategies, pre-ordering huge numbers of doses — more than enough to inoculate everyone — from multiple makers, hedging their bets in case some of the vaccines are not approved or some manufacturers have production breakdowns.
Relative to their populations, the United States has ordered far fewer doses than Canada or Britain, and last summer it passed up an offer to increase its advance order from Pfizer. Administration officials say the numbers are misleading, because the government has signed options to buy far more of the vaccine if it sees the need.
But in the face of intense global demand, it is not clear how fast pharmaceutical companies will be able to fulfill the orders they have, much less any additional orders.
And again, the speed of development, approval and production will affect how quickly supplies reach people. A country that places a bigger bet on one vaccine could be much better off than one that relies more heavily on another.” (G)
MEANWHILE –
“Heading into another holiday season, Texas has the fewest number of available intensive care beds to care for its sickest patients since the pandemic began, leaving health care experts worried hospitals could be pushed to the brink as coronavirus cases continue to climb.
As of Thursday, there were 672 staffed ICU beds available statewide. That’s compared with 2,100 open ICU beds available at the end of April, according to the Texas Department of State Health Services.
Intensive care units were full in at least 28 hospitals spread across Texas for the week ending Nov. 27, according to a Texas Tribune analysis of data released by the U.S. Department of Health and Human Services. More than 160 hospitals reported having less than 15% of their ICU beds available during the same period…
The Texas Tribune analyzed data for 200 of the largest hospitals that reported four or more ICU beds or ICU patients across the state. The numbers represent seven-day averages that were self-reported to the federal government.
There were 9,045 people in hospitals with COVID-19 as of Thursday, according to state data, near the record level last seen in late July.
The crush of demand for ICU beds is, in part, because many people put off treatment for non-coronavirus illnesses in the early months of the pandemic, Cummins said. Now, people are returning to emergency rooms with more severe complications for conditions like heart attacks and strokes…
Staff at Texas Health Frisco converted beds used for postpartum recovery to medical overflow, faced with an increasing number of patients with COVID-19, said Barclay Berdan, CEO of Texas Health Resources, one of the largest hospital systems in North Texas…
Texas Medical Center hospitals in Houston exceeded base ICU capacity Thursday for the first time since cases of COVID-19 surged this summer, the Houston Chronicle reported. That prompted hospitals to return to Phase 2 surge planning, in which regular beds are converted to ICU beds…
“The specter of the Christmas holiday is very nerve-wracking for hospitals,” … (D)
“A number of New York City hospitals are nearing capacity in their intensive care units as coronavirus cases rise across the city and state, new data shows.
A total of eight hospitals across the five boroughs have reached more than 90 percent fullness in their ICUs, according to the data, which was recently-released by the United States Department of Health and Human Services and compiled by Gothamist. The hospitals include three in Brooklyn, two in Manhattan, two in Queens and one in Staten Island.
The data comes as coronavirus hospitalizations increase across New York City. As of Friday, an average of 904 people have been admitted into the hospital each week over the last month.
Hospitals and public health officials have assured New Yorkers that, despite the surge, the state and medical response to the virus has improved since it first took hold of the city earlier this year.
“…NewYork-Presbyterian has been preparing for this possibility since the first wave,” NewYork-Presbyterian, which runs Brooklyn Methodist, told Patch in a statement. “We have expanded ICU capacity and are redeploying resources as needed within the hospital and across the NewYork-Presbyterian system, and every patient is receiving the care they need.”
One of the eight hospitals, Flushing Hospital in Queens, surpassed 100 percent capacity, with 123 percent of its ICU beds used by COVID-19 patients. Kingsbrook Jewish Medical Center in Brooklyn, with 100 percent fullness, was the second highest.
Gov. Andrew Cuomo said Friday that the average length of stay in the hospital for coronavirus patients has decreased in New York from 11 days earlier this year to just five days given new treatment methods and better preparation.
The death rate has decreased from 20 recent to 8 percent, Cuomo said.
The governor has also pointed to state-mandated “load balancing” among hospital systems — or distributing patients among hospitals so no one facility is overwhelmed — as a major difference between the handling of the current surge and the first crisis earlier this year.” (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.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
