With CDC guidelines approved, states establish their own vaccine distribution plans.
The federal Centers for Disease Control and Prevention have sent $200 million to the states for the effort (vaccine implementation), with another $140 million promised in December…Health departments have asked Congress for at least $8.4 billion more..
‘The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices is formally recommending that 21 million health care workers and 3 million older adults living in long-term care facilities (plus the people caring for them) be first in line for COVID-19 vaccinations, which could begin within weeks…
The committee did not consider a third major contributor to COVID-19 cases, prisons and jails, as a priority for vaccinations. The Marshall Project says prisons and jails have counted 197,000 COVID-19 cases — among both prisoners and staff — and 1,400 deaths.
The ACIP has been wrestling with a central, strategic issue that may play out differently around the country. One vaccination strategy is to protect the most vulnerable populations, which would put people in nursing homes, health care workers and people with other health issues (including smokers and people with morbid obesity) at the top of the list. Another strategy would be to stop the spread of the virus first, which would put people in places like jails, prisons, nursing homes and homeless shelters and essential workers — like taxi and Uber drivers and store clerks who come in contact with lots of people every day — higher on the priority list.
The ACIP’s recommendation is that the “health care worker” designation includes people who have direct patient contact, and people who work with infectious materials, such as lab work, and also hospital food services and medical aides. Committee members were especially concerned that lower-wage health care workers be given priority consideration because COVID-19 rates are higher among lower-wage workers than higher-paid health care workers.
After health care workers and people living in long-term facilities, the next priority, referred to as Group 1B, will be “essential workers,” which would still have to be defined but would likely include police and other emergency workers, as well as people who work in essential services like utility companies, grocery stores and so on.
The third priority group (Group 1C) will be people with other health issues that place them at higher risk.
The fourth priority (Group 1D) will be 53 million Americans who are 65 years old and older but not suffering from other serious health issues.” (A)
“Health care workers. Essential workers. Nursing home residents. New Yorkers who live in the hardest-hit neighborhoods.
These are among the different groups that the public health authorities in New York want to prioritize for coronavirus vaccination.
On Wednesday, Gov. Andrew M. Cuomo said that the state would receive its first batch of the vaccine — 170,000 doses from the drug maker Pfizer — on Dec. 15, pending federal approval.
New York City expected to have received around 480,000 doses by the beginning of January, a spokesman for Mayor Bill de Blasio said on Wednesday. Bill Neidhardt, the spokesman, said about roughly half would be Pfizer’s vaccine and half would be from Moderna, another drug maker….
While the C.D.C. will offer a broad framework for which groups to prioritize, there is considerable room for New York State and New York City to make their own decisions.
Hospitals are already preparing to receive their first shipments, even if they don’t know how many doses they will get. Northwell Health, the state’s largest hospital system, was told it would receive 48 hours’ notice before its first allotment of the Pfizer vaccine shipped from a distribution center in Michigan, according to Onisis Stefas, the hospital system’s chief pharmacy officer.
The vaccine would arrive in a suitcase-sized box, packed with dry ice. Inside, a smaller box would contain the frozen vaccine vials.
There was so much uncertainty that Dr. Stefas said he was unsure whether to use those doses quickly, or reserve half to use as the second dose.
Who will get the vaccine first?
An advisory committee to the C.D.C. on Tuesday recommended that the first people to receive the vaccine should be health care workers, along with nursing home residents and staff.
Mr. Neidhardt, the spokesman for the mayor, said the 480,000 expected doses would be given to health care personnel performing high-risk activities, like working on coronavirus floors at hospitals, and people living and working in nursing homes.
“It’s important to protect health care workers so they can continue to go to work and take care of the sick,” said Jessica Justman, an epidemiology professor at Columbia University’s Mailman School of Public Health.
Nursing home residents are being prioritized for a different reason: They are at high risk of dying from the coronavirus. Residents and staff of long-term care facilities have made up about 40 percent of the deaths attributed to the virus in the United States.
On Wednesday, Mr. Cuomo and his aides said the first shipments of the vaccine would go to nursing home residents and staff, as well as frontline health care workers. (A second dose of the Pfizer vaccine and initial shipments of the Moderna vaccine would arrive later in December, the governor’s office said.)
There are about 85,000 residents of nursing homes, according to the governor’s office, and the state has told the C.D.C. that there are more than “800,000 critical health care workers.” That includes home health care aides and staff members in hospitals, nursing homes and ambulance companies. In all, that is more than 4 percent of the state’s population.
There is likely some overlap between the 480,000 doses New York City expects to receive and the 170,000 doses Mr. Cuomo described Wednesday.
Getting through the high-priority groups could take some time, experts said. Hospitals are already deciding which employees are eligible to be vaccinated once the first shipments come in.
Mount Sinai Health System, for example, will include some janitors and food delivery personnel who work in the emergency department and intensive care units among the health care workers slated to receive some of the earliest vaccines, said Susan Mashni, the chief pharmacy officer of the system.
Who is after that?
New York State has told the C.D.C. that the next groups to be “targeted” for the vaccine will be “other frontline essential workers, medically high risk individuals and individuals over 65.”
In a draft plan that the state released publicly in October, more than a dozen categories of people were put in one of five priority groups. Grocery store workers were ahead of “individuals under 65 with high-risk comorbidities,” who were in turn ahead of certain groups of essential workers.
Mr. Cuomo has also been expressing concern that low-income and minority areas could be underserved by the vaccines, a point he reiterated on Wednesday, saying the federal vaccination plan “overlooks the Black, brown, and poor communities.”
A draft plan that New York City filed with the C.D.C. raised the possibility that race would factor into the city’s vaccination plans. Black and Hispanic New Yorkers have died of the virus at a disproportionate rate. The draft stated that “vaccine planning and allocation decisions must be made through an anti-racist and intersectional lens.”
What that means in practice remains unclear. One city official, speaking on condition of anonymity because the plans were still evolving, said that there had been some discussion about prioritizing residents of some 27 neighborhoods that had been disproportionately hard hit in the spring. Many of those neighborhoods have predominately Black or Hispanic residents, the official said.
But the official added that the plans largely depended on how much of the vaccine the city received in the coming months.
In the past, the city has released lists of neighborhoods it has deemed particularly hard-hit.” (B)
“The first COVID vaccines are expected to arrive in New Jersey within days — even before the vaccine is authorized for use by the federal government. Six hospitals have been selected to receive the super-cold cases of frozen vaccine as part of a dry run by Operation Warp Speed.
“They’re checking their own logistics and want to check their plan” before full-scale distribution gets underway once the vaccines are authorized by the federal Food and Drug Administration, said Regina Foley, Hackensack Meridian Health’s vaccine czar.
The six hospitals — Hackensack University Medical Center, Morristown Medical Center, University Hospital in Newark, Robert Wood Johnson University Hospital in New Brunswick, AtlantiCare Regional Medical Center in Atlantic City and Cooper University Hospital in Camden — all have Arctic-level subzero freezers ready to receive the shipments.
“When we talk about light at the end of the tunnel, this is real,” Gov. Phil Murphy said Wednesday. No details were provided about the amount or dates of the shipments.
Positioning the vaccine in advance of its authorization allows the government “to test the delivery and storage systems,” said Donna Leusner, a spokeswoman for the state health department. Hospitals receiving the shipments have freezers that can maintain temperatures of –94 degrees Fahrenheit. Hackensack Meridian recently bought four of the freezers, and Atlantic Health two.
The state Health Department is finalizing its vaccine distribution plan this week. Its goal is to inoculate 70% of the adult population, or 4.7 million people, in six months. The governor said he expects everyone in the state who wants a vaccine will be able to get one by April and May.
Hospitals receiving the “pre-position” shipments won’t actually use the vaccine until the FDA issues an Emergency Use Authorization.
The agency is meeting on Dec. 10 to consider an application from Pfizer to authorize its vaccine and on Dec. 17 to consider an application from Moderna. Clinical trials have shown both vaccines have an efficacy rate of around 95%.
Once authorized, the vaccines will be given to two top priority groups first: nursing home staff and residents, and health care workers who face potential exposure to COVID patients or infectious materials on the job.
Two shots are required to be effective. Pfizer’s must be spaced three weeks apart, and Moderna’s four weeks apart.
How COVID vaccine will be distributed
Hospitals will follow state guidelines on distribution, they said. They expect to vaccinate “patient-facing” staff first. The vaccines are voluntary — no one is required to get one. They are not recommended for pregnant women, because they have not been tested in that group.
One issue that health care institutions face is scheduling the vaccine. Results from early clinical trials of the vaccines showed that a significant percentage of recipients — perhaps as many as one-third — developed mild side effects such as headaches, low-grade fevers, muscle aches or fatigue, most commonly after the second shot.
While the side effects are minor and should not discourage anyone from receiving the shot, “We don’t want anyone working who doesn’t feel well,” said Dr. Jan Schwarz-Miller, the chief medical and academic officer for Atlantic Health system. Staggered schedules should be used to vaccinate the staff, so that an entire shift or unit is not affected by potential absences.
The eligible staff for the first tranche of vaccines includes about 26,000 employees of Hackensack Meridian Health system’s hospitals from Pascack Valley Medical Center in the north to Ocean Medical Center in the south, Foley said. The priority list includes not only nurses, doctors, and respiratory therapists, but environmental services and dietary workers, who clean rooms and deliver meals to patients.
Atlantic Health System, with five hospitals in Summit, Pompton Plains, Newton and Hackettstown as well as Morristown, also hopes to immunize nearly all of its 23,000 staff members, said Schwarz-Miller.
Nursing home residents and staffs will receive the vaccines through CVS or Walgreens, two national retail pharmacy chains that have partnered with the federal Department of Health and Human Services.
The pharmacies will make three separate visits to the nursing homes to make sure everyone is vaccinated, according to the plan presented to the national Advisory Committee on Immunization Practices on Tuesday.” (J)
“Doses of Pfizer’s coronavirus vaccine, the first expected to gain federal approval, could arrive in Massachusetts in mid to late December. Hospitals should expect 975 doses in each cooler, identify their first 975 frontline staff who will receive it and then the next 975. Hospitals that don’t have super cold (-80 degrees Celsius) freezers should get in touch with their local dry ice supplier ASAP.
That’s some of the latest guidance from the state Department of Public Health as Massachusetts and communities around the world prepare for an historic coronavirus vaccination campaign. The DPH instructions apply to phase one, which is expected to include vaccines produced by both Pfizer and Cambridge-based Moderna, although Moderna has not yet filed for federal approval.
Hospital leaders say federal officials have suggested a wide range of estimated doses that may come to Massachusetts, between 200,000 and 700,000, depending on when the Moderna vaccine is approved.
The first doses may be limited to hospitals and long-term care facilities. The state’s interim plan says other essential workers might be included in the initial offering of vaccines, but there’s no mention of the other workers in this update. Some community health workers, teachers and EMTs say they should be on the list for early vaccines as well.
The CDC, in partnership with CVS and Walgreens, is managing vaccination of staff and patients at long-term care facilities. The DPH guidance for hospitals says priority should be given to health care personnel in direct or indirect contact with COVID-19 patients or infected materials. That includes doctors, nurses, radiology technicians, the people who disinfect rooms and cafeteria staff.
Even on the current high end of vaccine projections — 700,000 — there would not be enough doses for all those hospital employees, estimated to number about 350,000, and the thousands of employees and residents of nursing homes and other long-term care facilities. Both the Pfizer and Moderna vaccines are delivered as two shots administered several weeks apart. So 700,000 doses would cover 350,000 people. Hospitals say coronavirus vaccination will not be required for staff, at least not until there is enough for all health care workers.
Both the Pfizer and Moderna vaccines will come with the needles, face shields and other items used to give the shots. The Pfizer vaccine can either be stored in specialized freezers or kept in the coolers it arrives in, as long as the container is not opened more than twice a day for no more than three minutes each time and is repacked with dry ice every five days.
There’s concern that some Pfizer vaccines may be thrown out if they aren’t used quickly enough or if the hospitals don’t use all 975 doses. That’s less of a concern with Moderna’s vaccine, which DPH says will be shipped in 100-dose packages, can be stored in standard hospital freezers and does not need to be reconstituted with a liquid before administering.” (C)
“Which Virginians will receive the first vaccinations?
Phase I
In the first wave, once it receives approval, Virginia will receive 70,000 doses of Pfizer’s vaccine.
Approval and distribution could begin as early as mid-December, said Northam.
Both Pfizer and Moderna vaccines require two doses, about two weeks apart. It’s expected that the second 70,000 doses of Pfizer’s vaccine will be ready in time for people’s second doses.
Health care workers and residents of long-term care facilities have been identified on a federal level as the top-priority groups to receive the vaccine.
The decisions for who goes first will be based upon medical ethics and protocols created by the Virginia Hospital and Health Association and the Virginia Disaster Medical Advisory Committee.
That group contains about 500,000 Virginians, according to Northam.
Phase II
Following them comes critical infrastructure staff, adults with high-risk medical conditions and adults ages 65 and older.
Phase III
After that group comes the general public, a group that shouldn’t expect the be eligible anytime soon.
“It will be a ways before we get to the general public,” said Dr. Daniel Carey, Virginia’s Secretary of Health and Human Resources, during Wednesday’s news conference.
How will the COVID-19 vaccine be distributed?
VDH has been working with hospitals, long-term care facilities and community providers for months in preparation for a vaccine distribution plan.
Along with administering the vaccine, these organizations will work with VDH on the following pieces of updating management information system:
Vaccine allocation
Vaccine ordering/tracking
Clinic operations (including appointment scheduling and recording of doses administered)
Tracking of doses administred
The vaccine will be administered by hospital systems or facilities equipped with ultra-cold storage facilities, which exist within each region of Virginia.
The state has also partnered with CVS and Walgreens, as well as other pharmacies, and medical offices for vaccine and distribution.” (G)
“Wisconsin ready to distribute vaccines.
State health officials have been working with partners at the federal and local levels, and are ready to distribute vaccines pending regulatory approval, Goodsitt said.
Wisconsin’s plan will be implemented in partnership with the state’s 97 local health departments and tribal jurisdictions, as well as health care providers, pharmacies, community-based organizations and other public agencies, she said.
More than 1,100 providers and 485 organizations have submitted forms to become vaccine providers, Goodsitt said Wednesday.
Two companies, Pfizer and Moderna, already have applied for emergency use authorization from the U.S. Food and Drug Administration for their vaccines. More companies are expected to apply in the coming months.
Once vaccines arrive, the first to be inoculated will be health care workers who have treated or been exposed to COVID-19 patients, residents of long-term care or assisted living facilities, people over age 65, and some essential workers under the DHS plan. Those groups are considered to be priority “Phase 1 populations” by the state.
If there aren’t enough doses for all frontline workers and first responders, state officials will follow guidance provided by the Advisory Committee on Immunization Practices and State Disaster Medical Committee, Goodsitt said.
The second phase will include all those from Phase 1 who have yet to be vaccinated, along with “other critical populations to be determined.” The state expects a larger number of doses to be available, likely enough to meet demand.
Wisconsin plans to take part in a program that will pair long-term care and assisted living facilities with specific pharmacies. Residents would be vaccinated where they live.
Vaccine distribution points would include health care providers and pharmacies, Goodsitt said.
Enrolled vaccine providers will order the COVID-19 vaccine from their state immunization program’s allocation, and the vaccine will then ship from the CDC’s distributor directly to the provider, the DHS plan says.
The minimum order for the Moderna vaccine is expected to be 100 doses, while Pfizer’s minimum is 975, Goodsitt said. Vaccines will be shipped with the supplies needed to administer the vaccine, including needles, syringes, and some PPE.
The state also plans to track COVID-19 vaccinations through the Wisconsin Immunization registry, an information system that can track doses administered, to whom, and where.
With the prospect that a coronavirus vaccine will become available for emergency use as soon as next month, states and cities are warning that distributing the shots to an anxious public could be hindered by inadequate technology, severe funding shortfalls and a lack of trained personnel.
While the Trump administration has showered billions of dollars on the companies developing the vaccines, it has left the logistics of inoculating and tracking as many as 20 million people by year’s end — and many tens of millions more next year — largely to local governments without providing enough money, officials in several localities and public health experts involved in the preparations said in interviews.
Public health departments, already strained by a pandemic that has overrun hospitals and drained budgets, are racing to expand online systems to track and share information about who has been vaccinated; to recruit and train hundreds of thousands of doctors, nurses and pharmacists to give people the shot and collect data about everyone who gets it; to find safe locations for mass vaccination events; and to convince the public of the importance of getting immunized.
“We absolutely do not have enough to pull this off successfully,” said Dr. Thomas E. Dobbs III, the state health officer of Mississippi. “This is going to be a phenomenal logistical feat, to vaccinate everybody in the country. We absolutely have zero margin for failure. We really have to get this right.”
Health departments have asked Congress for at least $8.4 billion more for “a timely, comprehensive, and equitable vaccine distribution campaign”; the C.D.C. director, Dr. Robert R. Redfield, has said that at least $6 billion is needed. But negotiations for further funding are caught up in the stalemate between House Democrats and the Trump administration over the coronavirus stimulus bill.
“Much of the discussion around vaccine priority has focused on minimizing the number of Covid-19 deaths and cases, but those will not be the only two factors in play. Dr. Anthony S. Fauci, the nation’s top infectious disease expert, said on NPR in November that the priority list will be graded according not only to risk but to the degree to which certain people, like teachers and child-care providers, are deemed “important to society.”
How one measures importance to society is, of course, a very thorny question. The National Academies framework, for its part, suggests that people should have higher priority “to the extent that societal function and other individuals’ lives and livelihood depend on them directly and would be imperiled if they fell ill.” In other words, economic and quality of life concerns will be part of the equation.
But state officials may come to different conclusions about where the right balance lies between those concerns and the need to contain the virus. In New York, for example, Gov. Andrew Cuomo announced that, in contrast to the National Academies plan, the state would prioritize teachers, transit workers and grocery store workers before the 65 and older age group. That may not minimize the number of lives lost to the virus, but it could presumably do more to relieve the strain so many parents, children and workers are facing.” (D)
“The first rigorously tested coronavirus vaccine was given a green light for use on Wednesday in Britain. Doses of the vaccine, made by the American pharmaceutical giant Pfizer and a small German company, BioNTech, will be injected starting next week, the government said.
In leaping ahead of the United States to allow mass inoculations, Britain added to the pressure on American drug regulators, who were summoned to the White House on Tuesday by President Trump’s chief of staff to explain why they were not ready to do the same.
Why did Britain authorize a vaccine before the U.S.?,
The two countries vet vaccines differently.
Rather than accepting the findings of vaccine makers, American regulators painstakingly reanalyze raw data from the trials to validate the results, poring over what regulators have described as thousands of pages of documents. Dr. Stephen Hahn, the commissioner of the Food and Drug Administration, said on Tuesday that the F.D.A. “is one of the few regulatory agencies in the world that actually looks at the raw data.”” (E)
“…..when it comes to coronavirus testing, this is a nation of haves and have-nots.
Among the haves are professional and college athletes. That’s been true, and a subject of fierce debate, since at least March, when entire rosters of NBA teams got tested for the virus before many Americans could access tests. As sports lurched back to life over the summer, health experts debated the ethics of entire leagues jumping to the front of the testing line. But ultimately the leagues, with billions of revenue dollars at stake, contracted with private labs to pay for the best and fastest tests available — a luxury many hospitals and other healthcare providers, reeling from the pandemic, can’t afford.
From Nov. 8 to 14, the NFL administered 43,148 tests to 7,856 players, coaches and employees. Major college football programs supply dozens of tests each day, an attempt — futile as it has been — to maintain health and prevent schedule interruptions. Major League Soccer administered nearly 5,000 tests last week, and Major League Baseball conducted some 170,000 tests during its truncated season.
Sandoval, meanwhile, is a 58-year-old front-line worker who regularly treats patients either suspected or confirmed to have been infected by the coronavirus. In eight months, she has never been tested. She says her employer, California Pacific Medical Center, refuses to provide testing for its medical staff even after possible exposure.
Watching sports, then, no longer represents an escape from reality for Sandoval. Instead, she says, it’s a signal of what the nation prioritizes.
“There’s an endless supply in the sports world,” she says of coronavirus tests. “You’re throwing your arms up. I like sports as much as the next person. But the disparity between who gets tested and who doesn’t, it doesn’t make any sense.”
This month, registered nurses gathered in Los Angeles to protest the fact that UCLA’s athletic department conducted 1,248 tests in a single week while health-care workers at UCLA hospitals were denied testing. Last week National Nurses United, the country’s largest nursing union, released the results of a survey of more than 15,000 members. About two-thirds reported they had never been tested.
Since August, when NFL training camps opened, the nation’s most popular and powerful sports league — one that generates more than $15 billion in annual revenue — has conducted roughly 645,000 coronavirus tests.
“These athletes and teams have a stockpile of covid testing, enough to test them at will,” says Michelle Gutierrez Vo, another registered nurse and sports fan in California. “And it’s painful to watch. It seemed like nobody else mattered or their lives are more important than ours.”
Months into the pandemic, and with vaccines nearing distribution, testing in the United States remains something of a luxury. Testing sites are crowded, and some patients still report waiting days for results. Sandoval said nurses who suspect they’ve been exposed are expected to seek out a testing site on their own, at their expense, and take unpaid time while they wait for results — in effect choosing between their paycheck and their health and potentially that of others.” (F)
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?
(President Donald Trump and his deputies are privately admonishing Food and Drug Administration officials for not moving faster to authorize promising coronavirus vaccines.)
(..the White House said it’s still planning to host holiday parties despite dire warnings from health experts..)
“The move was not entirely unexpected. Dr. Atlas joined the White House in August as a special government employee for a limited term after he caught Mr. Trump’s eye with his frequent appearances on Fox News over the summer. Dr. Atlas’s term was set to expire this week.
“I worked hard with a singular focus — to save lives and help Americans through this pandemic,” Dr. Atlas wrote in a letter that he posted Monday night on Twitter, adding, “I always relied on the latest science and evidence, without any political consideration or influence.” Fox News earlier reported his resignation.
But some of Dr. Atlas’s Trump administration colleagues would most likely contradict that assessment, citing views starkly different from those put forth by officials at the Centers for Disease Control and Prevention and by other government scientists. Dr. Atlas has argued, for example, that the science of mask wearing is uncertain and that children cannot spread the coronavirus.
Even more contentious was his libertarian vision of the role of the government in the pandemic. In Dr. Atlas’s view, the government’s job was not to stamp out the virus but simply to protect its most vulnerable citizens as Covid-19 took its course.
His argument was that most people infected with the coronavirus would not get seriously ill, and at some point, enough people would have antibodies from Covid-19 to deprive the virus of carriers — so-called herd immunity. Dr. Atlas also railed against anything that smacked of a lockdown or business closure.
Public health experts were appalled and warned that his ideas were dangerous and would have disastrous results.” (A)
“Since joining the White House task force, Atlas has been widely criticized by scientists:
In September, more than 100 of Atlas’ former colleagues at Stanford Medical School signed a letter warning that many of his “opinions and statements run counter to established science.”
Bill Gates also suggested that Atlas was hired only because he “agrees” with what Gates called the White House’s “crackpot COVID theories.”
Later that month, fellow task force member and top US infectious-disease expert Dr. Anthony Fauci told CNN he was concerned that Atlas was feeding information “really taken either out of context or actually incorrect” to the president.
Around the same time, CDC Director Robert Redfield was overheard by a reporter criticizing Atlas in a phone call, saying “everything he says is false.”
In October, former CDC Director William Foege wrote to Redfield saying the Trump administration had turned the CDC’s reputation “from gold to tarnished brass.” Foege said Atlas’ joining the task force was what prompted him to speak out.
In response to Redfield and Fauci’s criticism, Atlas told Business Insider in late September: “All of my policy recommendations to the president are directly backed by the current science, and they are in line with what many of the world’s top medical scientists advise … Career government public health officials do not have a monopoly on knowledge.” (B)
“Atlas’ field of expertise is in magnetic resonance imaging. He wrote a book on the subject and co-authored numerous scientific studies on the economics of medical imaging technology. He was also a professor and chief of neuroradiology at Stanford University Medical Center from 1998 to 2012, according to a university biography.
“He’s an MRI guy. … He has no expertise in any of this stuff,” Dr. Ashish Jha, the dean of the Brown University School of Public Health, told NPR in a September story. The COVID-19 pandemic has now killed more than 267,000 people in the U.S.
“He’s been bringing out arguments that have been refuted week after week, month after month, since the beginning of this outbreak,” Jha added.” (C)
“A president who preached “America First” is demanding to know why the United States could end up third, or worse, in the global vaccine race.
President Donald Trump and his deputies are privately admonishing Food and Drug Administration officials for not moving faster to authorize promising coronavirus vaccines — a push partially motivated by Trump’s desire to claim credit for record-fast vaccine development, four officials said.
HHS Secretary Alex Azar and White House Chief of Staff Mark Meadows grilled Commissioner Stephen Hahn and other top FDA officials in meetings this week on their decisions to require more rigorous review of initial data from the first vaccine candidates. In particular, they questioned why the agency won’t authorize a vaccine until after Dec. 10 at the earliest — about a month after Pfizer first reported that its shot was more than 90 percent effective, and roughly three weeks after Moderna announced similarly impressive findings. Multiple Trump appointees and even some career civil servants have argued that every day of delay could make a difference for the most vulnerable populations in a life-threatening pandemic.” (D)
U.S. public health officials have cautioned that large, indoor holiday gatherings during the winter months could lead to a dramatic uptick in cases, hospitalizations and deaths. The novel coronavirus already has killed more than a quarter million Americans.” (E)
Do you know which hospital is right for you if you have coronavirus? | Opinion
By Jersey Journal Guest Columnist Jonathan M. Metsch
With coronavirus, the hospital to which you are admitted is most likely the hospital where you will stay.
We don’t have “emerging virus” hospital designations like we do for trauma centers, cardiac surgery and newborn nurseries….
Bottom line is that where a coronavirus patient gets treated should not be a random event. Hospitals need to be designated for different levels of care, and patients, where necessary and appropriate, should be transferred to a hospital with the best capability for a successful outcome.
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.”
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.”
“Colorado Gov. Jared Polis (D) signed an executive order on Monday that allows hospitals to stop admitting new patients when they reach capacity and transfer patients to other hospitals.
The executive order permits the Colorado Department of Public Health and Environment to direct at-capacity hospitals to transfer patients to other facilities, without first obtaining written permission from the patient.
“Unfortunately, given the increase in infections, the number of persons seeking medical treatment at hospitals may far exceed the capacity of any given hospital,” the order reads.
“Hospitals who have reached capacity may need to cease admitting patients and may also need to transfer such patients to a separate facility without first obtaining the individual’s written or informed consent for such transfer,” the order continues.
The order, which will be in effect for the next 30 days, permits hospitals that are at “capacity to examine and treat patients” to send them to other health care facilities in an effort to prevent the hospitals from becoming overwhelmed.” (A)
“Your local hospital could soon take on a new policy that aims to clear up any confusion surrounding your ability to visit patients during the coronavirus pandemic.
Hospital leaders in the state, along with the New Jersey Hospital Association, have partnered to develop color codes based on the level of COVID-19 risk, that would ideally be used by medical institutions statewide.
“Our hospitals recognize how difficult it is for patients when they are isolated from their families and support systems,” NJHA President and CEO Cathy Bennett said. “Our goal with this color-level visitation policy is to create transparency and consistency, using a data-driven formula that continues to put the safety of patients and staff first and foremost.”
Determining where hospitals land on the three-level spectrum is based on four key metrics: COVID-19 levels in the community; the level of hospitalized COVID-19 patients; staffing levels; and availability of personal protective equipment.
The codes, though, would not be applied hospital to hospital. To provide greater consistency, color levels would be applied to regions of the Garden State — for example, hospitals in Northeast New Jersey would all be considered to be under the same “threat.”
No matter the color-code at the time, hospitals would not be permitting visitors for COVID-19 patients or those who are immunocompromised, except for circumstances approved by a care team.” (B)
“The Center for Disease Control and Prevention may soon shorten its quarantine guidelines for those who believe they have been exposed to COVID-19, according to a report in the Wall Street Journal. The move, which has been floated in the past, is reportedly aimed at motivating more people to quarantine.
Dr. Henry Walke, the CDC’s director of the division of preparedness and emerging infections, told the Wall Street Journal that an increase in the availability and accuracy of tests are part of what’s driving the change. “We do think that the work that we’ve done, and some of the studies we have and the modeling data that we have, shows that we can with testing shorten quarantines,” Walke said.
According to the WSJ, the new recommendation — which is reportedly in the final stages of approval — would suggest individuals who were exposed to someone with COVID-19 quarantine for between seven and 10 days, and then get tested before seeing other people. So how does that differ from the current guidelines and what do experts think about the possible shift? Here’s what you need to know.
The current CDC guidelines call for a 14-day quarantine
The new guideline would be a significant departure from the CDC’s current quarantine recommendations, which state that “anyone who has had close contact with someone with COVID-19 should stay home for 14 days after their last exposure to that person.” The guidance exempts those who have tested positive for COVID-19 within the last three months — as long as symptoms do not reappear.
The shorter quarantine time is likely a reflection of incubation period
Although the full incubation period for COVID-19 is technically between two and 14 days, the amended guidelines from the CDC would reflect a growing body of evidence showing that the median incubation period from exposure to onset of symptoms is five days. Yes, a positive test can occur after 10 days, but experts say it is extremely rare, which is why the organization may be considering shortening it.” (C)
“A mom of eight boys, Kim Gudgeon was at her wits’ end when she called her family doctor in suburban Chicago to schedule a sick visit for increasingly fussy, 1-year-old Bryce.
He had been up at night and was disrupting his brothers’ e-learning during the day. “He was just miserable,” Gudgeon said. “And the older kids were like, ‘Mom, I can’t hear my teacher.’ There’s only so much room in the house when you have a crying baby.”
She hoped the doctor might just phone in a prescription since Bryce had been seen a few days earlier for a well visit. The doctor had noted redness in one ear but opted to hold off on treatment.
To Gudgeon’s surprise, that’s not what happened. Instead, when she called, her son was referred to urgent care, a practice that has become common for the Edward Medical Group, which included her family doctor and more than 100 other doctors affiliated with local urgent care and hospital facilities. Because of concerns about the transmission of the coronavirus, the group is now generally relying on virtual visits for the sick, but often refers infants and young children to urgent care to be seen in person.
“We have to take into consideration the risk of exposing chronically ill and well patients, staff and visitors in offices, waiting areas or public spaces,” said Adam Schriedel, chief medical officer and a practicing internist with the group.
Gudgeon’s experience is not unusual. As doctors and medical practices nationwide navigate a new normal with COVID-19 again surging, some are relying on urgent care sites and emergency departments to care for sick patients, even those with minor ailments.
That policy is troubling to Dr. Arthur “Tim” Garson Jr., a clinical professor in the College of Medicine at the University of Houston who studies community health and medical management issues. “It’s a practice’s responsibility to take care of patients,” Garson said. He worries about patients who can’t do video visits if they don’t have a smartphone or access to the internet or simply aren’t comfortable using that technology.
Garson supports protocols to protect staff and patients, including in some instances referrals to urgent care. In those cases, practices should be making sure their patients are referred to good providers, he said. For instance, children should be seen by urgent care facilities with pediatric specialists.” (D)
“As the crush of new COVID-19 hospitalizations stretches hospitals around the state to their limits, the Mayo Clinic Health System is taking unprecedented steps to expand capacity at its northwestern Wisconsin locations. Those include moving beds into waiting rooms, surgical spaces and even a parking garage.
It’s been just more than a week since the Mayo Clinic announced 100 percent of its hospital beds in Northwestern Wisconsin were full. That number fluctuates by the hour, but emergency room physician Paul Horvath said hospitals and emergency rooms have been forced into what is known as “diversion status.”
“I worked a shift in one of the emergency departments the other evening,” Horvath said, “and literally every bed in northwest Wisconsin was full, and hospitals just weren’t able to admit new patients. Which means that I had the challenge of managing ICU level care in my ER for hours, which is obviously not routine.”
A recent surge of 20 patients at Mayo’s hospital in Barron forced staff to move some patients into a room designated for preparing people for surgery, said Horvath. He said when emergency departments fill up, paramedics have to find new places to bring patients that are further away and may not have the same level of staff or equipment to treat the critically ill.
Horvath said from a patient’s perspective, the team of doctors and nurses all look the same in their layers of personal protective equipment. Beeping monitors and the hurried, labored breathing of paitients makes communication more difficult too. Horvath said he sometimes feels like he’s yelling at patients and staff to cut through the noise.
Sue Cullinan is an emergency room doctor at Mayo Clinic’s Eau Claire hospital. On Oct. 12, she recorded video diary entries detailing how the hospital was preparing for the ongoing surge of new admissions.
“Our surge plan expands into the garage, it opens up more beds, we’re expanding into lobbies, we’re putting people where we wouldn’t normally put patients,” said Cullinan.
“Not where I’d want to put my grandfather or my grandmother,” she said, though it “may have to happen.” (E)
“Wealthy New Yorkers are shelling out big bucks to professional line-waiters so they won’t have to sit in hours-long COVID-19 testing queues ahead of Thanksgiving.
Cash-strapped locals who offer their line-sitting services on freelance marketplace TaskRabbit told The Post they’ve been charging up to $80 an hour for the service — and people are paying.
“I’ve already done this about five times already,” said one out-of-work writer as she waited in a CityMD line in Soho for someone else.” (F)
