Category Archives: Centers for Disease Control & Prevention (CDC)

Reopening the U.S. Economy

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Allison Nathan, senior strategist for Goldman Sachs Research, discusses her latest Top of Mind report where she speaks with leading experts across health and policy to understand how well-positioned the U.S. is to achieve a safe reopening of the economy and how quickly it would translate into economic recovery. 

With COVID-19 mitigation measures leading to an apparent leveling off of case
growth globally at the same time that the economic costs of such measures continue
to mount, several countries around the world have begun to plan for—or have
already started to implement—economic reopening. But absent herd immunity or
a vaccine for the virus, such reopenings increase the risk of disease resurgence.
With this in mind, what a safe reopening might look like, how well-positioned the
US is to achieve one and how quickly reopening would really translate into economic
recovery is Top of Mind. We consult three experts on these questions: University of
Pennsylvania’s Dr. Zeke Emanuel, Duke University’s Dr. Mark McClellan and Harvard
University’s Dr. Barry Bloom. And we share our own take on a potential US recovery path, informed by lessons from
China’s reopening experience so far. Finally, with more complete economic normalization only likely with an effective
testing regime, treatments, or a widely available vaccine for COVID-19-we discuss where we are on all of the above.

 

 

 

The White House said it was following health experts’ advice. Then we learned it isn’t approving a key CDC document.

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Diseases & Conditions | CDC

White House press secretary Kayleigh McEnany made a point at the start of Wednesday’s news briefing to emphasize that President Trump is following health experts’ advice as we enter what Trump has labeled the “next stage” of the coronavirus response — reopening the economy.

“As you are well aware, President Trump has consistently sided with the experts and always prioritized the health and safety of the American people,” McEnany said.

Several hours later, we got another example of the White House resisting what those health experts are advising.

The Associated Press reported around midnight that the White House had shelved planned guidelines from the Centers for Disease Control and Prevention. The document, which was due nearly a week ago, was aimed at providing local authorities with step-by-step guidance on how to reopen:

The 17-page report by a Centers for Disease Control and Prevention team, titled “Guidance for Implementing the Opening Up America Again Framework,” was researched and written to help faith leaders, business owners, educators and state and local officials as they begin to reopen.
It was supposed to be published last Friday, but agency scientists were told the guidance “would never see the light of day,” according to a CDC official. The official was not authorized to talk to reporters and spoke to The Associated Press on the condition of anonymity.

A coronavirus task force official told The Washington Post that the document has not been completely shelved but was in the process of being revised because it was “overly specific.” The official also indicated that it was felt the document was too broad, as “guidance in rural Tennessee shouldn’t be the same guidance for urban New York City.”

The denial, though, reinforces that the White House is reluctant to submit to the CDC’s more detailed prescriptions for reopening the economy. And it’s difficult to divorce the delay in this document’s publication from Trump’s anxiety to reopen the economy — and the tension that has created with past guidelines.

The administration in mid-April issued phased advice on when areas should start to reopen places such as restaurants and other nonessential businesses. But many states have moved forward with certain elements of reopening without actually satisfying those guidelines. Most notably, they have begun to reopen without meeting the Phase One guideline that they should see a decrease in confirmed coronavirus cases over a 14-day period.

As The Post’s Philip Bump reported, some states that have pushed forward with reopening have also seen an increase in cases — which would prevent them from satisfying the requirement for moving into Phase Two. That requirement is that the decline should continue for another 14 days after Phase One begins.

Issuing a detailed document would seemingly complicate further reopenings, because it would again restrict what states and local authorities are supposed to do.

The Washington Post’s Lena H. Sun and Josh Dawsey previewed what the document was set to look like last week. And they also obtained a draft of the document. The new guidelines were to go beyond the initial ones in prescribing specific actions that could be taken in each phase of the reopening. Advocates for reopening have worried that strict guidance could make it difficult for businesses, churches, child-care centers and other facilities to actually function.

Trump, who has long signaled a desire to begin reopening that economy sooner rather than later, has doubled down on that rhetoric in recent days. Despite a steady national death rate that approached previous highs on Tuesday and Wednesday, and even though cases continue to increase outside the major U.S. hotbed of New York City, Trump on Tuesday signaled that we are entering the “next stage” of reopening the economy.

“Thanks to the profound commitment of our citizens, we’ve flattened the curve, and countless American lives have been saved,” Trump said. “Our country is now in the next stage of the battle: a very safe phased and gradual reopening. So, reopening of our country — who would have ever thought we were going to be saying that? A reopening. Reopening.”

Trump has been resistant to the advice of the health officials around him, from the early days of the outbreak when he continuously downplayed the severity of the situation. On several occasions, this tension has boiled over.

We’re also hearing from those officials less and less. The CDC long ago ceased holding briefings on the coronavirus outbreak, and the White House coronavirus task force briefings, which often featured health experts Anthony S. Fauci and Deborah Birx, have now been halted in favor of less-frequent and less-coronavirus-focused briefings from McEnany. Fauci has also been prevented from testifying to the Democratic-controlled House, although he is still slated to testify in the GOP-controlled Senate and has continued doing some interviews. The cumulative effect is that these health experts aren’t on the record as much as the effort to reopen the economy begins in earnest.

In the place of those public comments, the CDC guidelines were to provide firm and detailed advice from those officials for the new stage. But for reasons that seem pretty conspicuous, we still don’t have them.

 

 

 

The U.S. coronavirus recovery is way behind Europe

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Other countries — even some hit hard by the coronavirus — are beating back their outbreaks more successfully than the U.S., Axios’ Dave Lawler and I report.

Why it matters: The number of new cases every day is holding steady in the U.S., but it’s not going down — a key benchmark many other countries achieved before loosening their lockdowns and social distancing measures.

In some of Europe’s hardest-hit countries, case counts seemed to skyrocket uncontrollably even amid some of the world’s strictest lockdowns.

  • Italy and Spain followed a similar pattern. New cases climbed over about a month from under 100 per day to terrifying peaks of roughly 8,000 per day in Spain and 6,000 per day in Italy.
  • The fall was nearly as sharp. Within two weeks of the peak, the rates of daily recorded cases had been halved. They’ve continued to fall since.

America’s daily rate climbed faster and higher (due in part to its larger population), but appears to have peaked at around 30,000 new cases per day in the first week of April.

  • But rather than falling, the rate stagnated. Outside of New York (which has bent its curve) the rate is actually continuing to climb.

Between the lines: The U.S. didn’t lock down as tightly as some of those countries, and made a host of mistakes early in the response.

  • Italy and Spain issued strict nationwide lockdowns that forced most people to remain inside except to shop for necessities. Spain didn’t allow children outside at all.
  • “Our economic shutdown … wasn’t as broad as some of the other countries’, so there was more opportunity for the virus to spread,” said Amesh Adalja, a senior scholar at the John Hopkins Center for Health Security.

The big picture: “It seems that this is a controllable pandemic without it having to run its natural course,” says Columbia University economist Jeffrey Sachs.

 

 

 

Coronavirus in the U.S.: An Unrelenting Crush of Cases and Deaths

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Coronavirus in the U.S.: An Unrelenting Crush of Cases and Deaths ...

While cities like New York have seen a hopeful drop in cases, upticks in other major cities and smaller communities have offset those decreases.

In New York City, the daily onslaught of death from the coronavirus has dropped to half of what it was. In Chicago, a makeshift hospital in a lakefront convention center is closing, deemed no longer needed. And in New Orleans, new cases have dwindled to a handful each day.

Yet across America, those signs of progress obscure a darker reality.

The country is still in the firm grip of a pandemic with little hope of release. For every indication of improvement in controlling the virus, new outbreaks have emerged elsewhere, leaving the nation stuck in a steady, unrelenting march of deaths and infections.

As states continue to lift restrictions meant to stop the virus, impatient Americans are freely returning to shopping, lingering in restaurants and gathering in parks. Regular new flare-ups and super-spreader events are expected to be close behind.

Any notion that the coronavirus threat is fading away appears to be magical thinking, at odds with what the latest numbers show.

Coronavirus in America now looks like this: More than a month has passed since there was a day with fewer than 1,000 deaths from the virus. Almost every day, at least 25,000 new coronavirus cases are identified, meaning that the total in the United States — which has the highest number of known cases in the world with more than a million — is expanding by between 2 and 4 percent daily.

Rural towns that one month ago were unscathed are suddenly hot spots for the virus. It is rampaging through nursing homes, meatpacking plants and prisons, killing the medically vulnerable and the poor, and new outbreaks keep emerging in grocery stores, Walmarts or factories, an ominous harbinger of what a full reopening of the economy will bring.

While dozens of rural counties have no known coronavirus cases, a panoramic view of the country reveals a grim and distressing picture.

“If you include New York, it looks like a plateau moving down,’’ said Andrew Noymer, an associate professor of public health at the University of California, Irvine. “If you exclude New York, it’s a plateau slowly moving up.”

In early April, more than 5,000 new cases were regularly being added in New York City on a daily basis. Those numbers have dropped significantly over the last few weeks, but that progress has been largely offset by increases in other major cities.

Consider Chicago and Los Angeles, which have flattened their curves and avoided the explosive growth of New York City. Even so, coronavirus cases in their counties have more than doubled since April 18. Cook County, home to Chicago, is now sometimes adding more than 2,000 new cases in a day, and Los Angeles County has often been adding at least 1,000.

Dallas County in Texas has been adding about 100 more cases than it was a month ago, and the counties that include Boston and Indianapolis have also reported higher numbers.

It is not just the major cities. Smaller towns and rural counties in the Midwest and South have suddenly been hit hard, underscoring the capriciousness of the pandemic.

Dakota County, Neb., which has the third-most cases per capita in the country, had no known cases as recently as April 11. Now the county is a hot zone for the virus.

Dakota City is home to a major Tyson beef-processing plant, where cases have been reported. And the region, which spreads across the borders of both Iowa and South Dakota, is dotted with meat-processing plants that have been a major source of work for generations. The pattern has repeated all over: Federal authorities say that at least 4,900 meat and poultry processing workers have been infected across 19 states.

The Tyson plant in Dakota City has temporarily closed for deep cleaning. Now the workers wait, afraid to go back to work but fearful not to.

“They need money and they want to go back of course,” said Qudsia Hussein, whose husband is an imam in the area. With many businesses shuttered or suffering financially because of the pandemic, she said, “There’s no other place they can work.”

Trousdale County, Tenn., another rural area, suddenly finds itself with the nation’s highest per capita infection rate by far. A prison appears responsible for a huge spike in cases; in 10 days, this county of about 11,000 residents saw its known cases skyrocket to 1,344 from 27.

As of last week, more than half of the inmates and staff members tested at Trousdale Turner Correctional Center in Hartsville, Tenn., were positive for the virus, officials said.

“It’s been my worst nightmare since the beginning of this that this would happen,” said Dwight Jewell, chairman of the Trousdale County Commission. “I’ve been expecting this. You put that many people in a contained environment and all it takes is one.”

Everyone in town knows about the outbreak. But they are defiant: Businesses in the county are reopening this week. On Monday evening, county commissioners were scheduled to have an in-person meeting, with chairs spaced six feet apart. They have a budget to pass and other issues facing the county, Mr. Jewell said.

“We’ve got to get back to the business of the community,” he said.

Infectious-disease experts are troubled by perceptions that the United States has seen the worst of the virus, and have sought to caution against misplaced optimism.

“I don’t see why we expect large declines in daily case counts over the next month,” Trevor Bedford, a scientist at the Fred Hutchinson Cancer Research Center who has studied the spread and evolution of the virus, wrote on Twitter. He added, “There may well be cities / counties that achieve suppression locally, but nationally I expect things to be messy with flare-ups in various geographies followed by responses to these flare-ups.”

The outbreak in the United States has already killed more than 68,000 people, and epidemiologists say the nation will not see fewer than 5,000 coronavirus-related deaths a week until after June 20, according to a survey conducted by researchers at the University of Massachusetts at Amherst.

An aggregate of several models assembled by Nicholas Reich, a biostatistician at the university, predicts there will be an average of 10,000 deaths per week for the next few weeks. That is fewer than in previous weeks, but it does not mean a peak has been passed, Dr. Reich said. In the seven-day period that ended on Sunday, about 12,700 deaths tied to the virus occurred across the country.

“There’s this idea that it’s going to go up and it’s going to come down in a symmetric curve,” Dr. Reich said. “It doesn’t have to do that. It could go up and we could have several thousand deaths per week for many weeks.”

The deaths have hit few places harder than America’s nursing homes and other long-term care facilities. More than a quarter of the deaths have been linked to those facilities, and more than 118,000 residents and staff members in at least 6,800 homes have contracted the virus.

There is no escaping some basic epidemic math.

In the absence of a vaccine, stopping the spread of the virus requires about two-thirds of the population to have been infected. And some experts have argued that before what is known as herd immunity kicks in, the number of people infected nationwide could reach a staggering 90 percent if social distancing is relaxed and transmission rates climb. (It is also not clear how long immunity will last among those who have been infected.)

As testing capacity has increased, so has the number of cases being counted. But many jurisdictions are still missing cases and undercounting deaths. Many epidemiologists assume that roughly 10 times as many people have been infected with the coronavirus than the number of known cases.

Because of the time it will take for infections to spread, incubate and cause people to die, the effects of reopening states may not be known until six weeks after the fact. One model used by the Centers for Disease Control and Prevention includes an assumption that the infection rate will increase up to 20 percent in states that reopen.

Under that model, by early August, the most likely outcome is 3,000 more deaths in Georgia than the state has right now, 10,000 more each in New York and New Jersey, and around 7,000 more each in Pennsylvania, Illinois and Massachusetts. Under the model’s most likely forecast, the nation will see about 100,000 additional deaths by Aug. 4.

“Even if we’re past the first peak, that doesn’t mean the worst is behind us,” said Youyang Gu, the data scientist who created the model. “It goes up quickly but it’s a slow decline down.”

 

 

 

 

The Health 202: Social distancing hasn’t been as effective in stemming U.S. coronavirus deaths as policymakers had hoped.

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Social distancing isn’t having the effects many had hoped for.

Despite encouraging signs on the nation’s East and West coasts, daily diagnosed cases of the novel coronavirus appear to still be on the rise in about 20 states. A number of rural counties have become unexpected hot spots in recent weeks, including in the Black Belt region of Mississippi and Alabama and in communities throughout Iowa and northern Texas around the Oklahoma panhandle. The country’s overall daily figures of diagnoses and deaths have plateaued, worrying health policymakers as many states move to reopen parts of their economy.

That steep curve of covid-19 cases in March and April isn’t receding the way it rose.

Hot spots are shifting geographically from New York City to areas around the country. For the past month, the figures have hovered around 30,000 diagnosed cases and around 2,000 deaths every day, former Food and Drug Administration commissioner Scott Gottlieb noted in a Wall Street Journal op-ed.

“Everyone thought we’d be in a better place after weeks of sheltering in place and bringing the economy to a near standstill,” he wrote. “Mitigation hasn’t failed; social distancing and other measures have slowed the spread. But the halt hasn’t brought the number of new cases and deaths down as much as expected or stopped the epidemic from expanding.”

President Trump, who last week suggested the novel coronavirus would disappear even without a vaccine, has now upgraded his prediction of fatalities to as many as 100,000 people. Nonetheless, he said in a New York Post interview yesterday that Americans are “starting to to feel good now. The country’s opening again. We saved millions of lives, I think.”

A leaked government report, still in draft version, predicts a spike in cases and deaths beginning on May 14.

The report, which the Centers for Disease Control quickly disavowed as an unfinished projection, suggests new cases could surge to 200,000 per day and daily American deaths could number more than 3,000 by June 1. That’s far more than what other models predict, but the Johns Hopkins epidemiologist who prepared it told my colleagues William Wan, Lenny Bernstein, Laurie McGinley and Josh Dawsey that 100,000 new cases per day by the end of the month isn’t out of the realm of possibility.

Former FDA commissioner Scott Gottlieb:

University of Michigan professor Justin Wolfers:

That’s not the only model showing discouraging figures for the month of May. A model out of the University of Washington, relied upon heavily by the administration, yesterday upgraded its U.S. fatality predictions for the virus’s first wave from 72,433 deaths to 134,475 deaths by Aug. 4.

These aren’t the trends many policymakers had hoped to see, after most Americans spent seven weeks at home under an unprecedented lockdown that has torched the once-booming economy and thrust millions into economic uncertainty. Protests against extended lockdowns are starting to mount around the country, and many governors have assembled and even embarked upon gradual plans to reopen businesses, schools and other public areas.

Nonetheless, a new Washington Post-University of Maryland poll out this morning shows sizable majority of Americans oppose the reopening of restaurants, retail stores and businesses.

Executive producer of 7News WHDH in Boston:

Social distancing did accomplish some important objectives. It undoubtedly saved the health-care system from being crushed by an overwhelming caseload of sick patients all at once.

And the United States is still outranked by half a dozen European countries when it comes to deaths per capita. The U.S. death rate is about 206 deaths per million people. That figure is 538 in Spain, 372 in France, 481 in Italy, 432 in the United Kingdom and 207 in Switzerland, according to a tally by Mother Jones.

But distancing clearly hasn’t been enough — at least the way it’s been carried out — to halt the spread of the highly contagious virus in some places.

New cases and deaths across the whole U.S. are about where they were 20 days ago, my colleague Philip Bump reports. He created a graphic where you can view the three-day averages of cases, deaths and tests performed by state (check it out here).

“The back of the mountain doesn’t look the way the front did,” Philip writes. “We saw a steady, exponential rise in confirmed cases and deaths each day for several weeks. But particularly with daily case totals, the period after the peak nationally has looked more like a plateau than a downward slide.”

Daily cases appear to be rising significantly in Delaware, Illinois, Indiana, Minnesota and Virginia. They’re also trending upward in Arizona, Colorado, D.C., Iowa, Kansas, Maryland, Mississippi, Nebraska, New Hampshire, New Mexico, North Carolina, Tennessee, Texas, Utah and Wisconsin.

Andy Slavitt, former head of the Centers for Medicare and Medicaid Services:

“There are so many emerging areas still throughout the country that our group has been trying to wave our hands about,” Marynia Kolak, a health and spatial data science researcher at the University of Chicago, told me.

Kolak and her colleagues are tracking covid-19 cases and deaths at the county level. They’ve been increasingly spotting clusters of the disease in rural areas. Kaiser Family Foundation researchers have also found that rural areas are experiencing a faster growth in cases, even as their total numbers remain far below those seen in urban settings.

One example: Five counties in Minnesota with significant meat-processing plants. State officials said about a quarter of cases reported over the weekend came from those counties.

One is Nobles County, home to a JBS USA pork processing plant in Worthington, with a population of around 22,000. It is scheduled to partially reopen this week, under an order by Trump to keep meat plants open.

The outbreaks in counties with meat-processing plants “illustrates how powerfully situations can change at the community level,” said Jan Malcolm, commissioner of Minnesota’s Department of Health.

Malcolm stressed how hard it is to stem the spread of the virus in these types of facilities.

“These are particularly challenging investigations,” Malcolm said. “Many of the workers involved don’t have phones, don’t provide phone numbers, aren’t answering calls. It’s been a very labor-intensive, shoe-leather kind of an approach.”

 

 

U.S. Coronavirus Updates

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COVID-19 in the U.S.

As of May 3, 11pm EDT

Deaths     Confirmed cases

67,682         1,158,040

Kudlow defends claiming U.S. had coronavirus "contained" in ...

 

Former FDA commissioner Scott Gottlieb said on Sunday that despite widespread mitigation efforts, the coronavirus has exhibited “persistent spread” that could mean a “new normal” of 30,000 new cases and over 1,000 deaths a day through the summer.

The big picture: COVID-19 has killed over 66,000 Americans and infected over 1.1 million others in less than three months since the first known death in the U.S., Johns Hopkins data shows.

By the numbers: As states try to mitigate the spread of the coronavirus while easing restrictions, unemployment filings in the U.S. topped 30 million in six weeks, and the number of unemployed could be higher than the weekly figures suggest.

  • Over 175,000 Americans have recovered from the virus and over 6.8 million tests have been conducted in the U.S. as of Sunday.

Catch up quick: The number of deaths in states hit hardest by the coronavirus is well above the normal range, according the CDC.

Lockdown measures: Dozens of states have outlined plans to ease coronavirus restrictions, but the pandemic’s impact on our daily lives, politics, cities and health care will outlast stay-at-home orders.

 

The audacity of those comparing ‘open up’ protesters to Rosa Parks

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Civil Rights Movement Timeline From 1951 to 1959

President Trump has a couple of times now encouraged or praised the Americans protesting government-issued stay-at-home orders and other recommendations from medical experts in a tone that is quite different from how he talks about protesters who aren’t aligned with him politically.

The response to the movement by some conservatives suggests that they are willing to wield the legacies of civil rights icons when it benefits them politically while blasting Americans whose activism actually aligns more closely with the work of those historical figures.

After demonstrators filled the streets near the several state capitols last month demanding that their political leaders reopen the states, Trump was asked his view on the protesters, many of whom were photographed carrying Make America Great Again signs. He appeared to embrace them: “They seem to be protesters that like me.”

“These are people expressing their views,” he also told reporters on April 17. “I see where they are, and I see the way they’re working. They seem to be very responsible people to me, but they’ve been treated a little bit rough.”

Shortly after, he took to Twitter and seemed to affirm their protests by calling for these states’ liberation.

Other Trump allies have compared protesters to civil rights activists protesting racism — despite some of them carrying Confederate flags and flags with swastikas.

Stephen Moore, a member of the White House council to reopen the country, praised those taking to the streets.

“I call these people the modern-day Rosa Parks — they are protesting against injustice and a loss of liberties,” he told The Washington Post earlier this month.

Trump was asked about Moore’s words the following day at a White House news briefing. “Yeah, I can see where he’s coming from. Strong statement. Strong statement,” Trump said.

And GOP-endorsed Houston City Council member Michael Kubosh invoked Parks as he violated a stay-at-home order this past weekend in a restaurant.

“Sometimes civil disobedience is required to move things forward, and so that’s why we remember Rosa Parks,” he told Houston’s NBC affiliate.

Conservative radio host Dennis Prager, who has questioned the constitutionality of the government advising Americans to stay at home, also invoked Parks while discussing his plans to rebut some recommendations from the Centers for Disease Control and Prevention to slow the spread of the coronavirus.

“Civil disobedience in the United States has a very, very, very noble history,” he said Thursday. “Rosa Parks wouldn’t sit in the back of the bus because the disgusting law of blacks had to sit in the back of the bus in some Southern cities in the United States. Should she have obeyed the law?”

Parks protested discrimination by refusing to give up her seat on a bus in Montgomery, Ala. Her defiant act is largely viewed as the beginning of the civil rights movement. But when it comes to modern-day protests about racial injustice, Trump and his allies often respond harshly.

After NFL players grabbed headlines for regularly taking a knee during the national anthem to protest racism and police brutality, Trump said they should be fired. At a September 2017 rally in Huntsville, Ala., the president said: “Wouldn’t you love to see one of these NFL owners, when someone disrespects our flag, to say: ‘Get that son of a bitch off the field right now. Out. He’s fired. He’s fired.’ ”

Moore, who served as an economic adviser to Trump, also criticized these athletes’ protests, calling them “shameful and unpatriotic antics.” And Prager called them “divisive.”

And when Black Lives Matter activists interrupted a Bernie Sanders rally in August 2015, Trump suggested that he might respond violently to protesters doing the same to him.

“That will never happen with me,” he told reporters. “I don’t know if I’ll do the fighting myself or if other people will, but that was a disgrace. I felt badly for him. But it showed that he’s weak.”

And multiple personalities on Fox News have praised the “open up” protesters, comparing them to disadvantaged groups around the world.

Yet the same network has regularly showed its most prominent voices criticizing Americans protesting historically marginalized groups.

In June 2018, Fox host Laura Ingraham said athletes critical of Trump and his attacks on athletes protesting racism were “bratty”:

It’s not about bowing down to the president. He doesn’t want you to disrespect the country, the flag, the anthem, which is what these bratty players are doing, using the excuse of Black Lives Matter or some other issue that they probably haven’t even read up on. They just repeat whatever Colin Kaepernick says on any given day. And they think they’re a member of a cool club by doing this. It’s ridiculous.

The inconsistency in approach to these protesters is sparking frustration with many black Americans, a demographic that overwhelmingly disapproves of Trump but that his campaign is hoping to make some gains with in 2020. To many black Americans, Parks is an icon whose act was a pivotal step in helping eradicate American laws that made treating black people as second-class citizens legal. Whatever issues Americans have with government leaders mandating that people stay home, it is quite a stretch to compare those orders to the state-sanctioned racism that Parks was combating.

 

 

 

 

US surpasses 1 million COVID-19 cases

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Emergency Preparedness, Health Policy, Infection Control, Infectious Virus, Mortality, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

https://thehill.com/policy/healthcare/494792-us-surpasses-1-million-covid-19-cases

Did the Trump Administration Overpromise 1 Million COVID-19 ...

More than a million people in the United States have tested positive for the coronavirus, a sobering milestone that experts say represents only the beginning of a months-long battle to end the pandemic.

The United States has now registered about a third of all confirmed cases of COVID-19 around the globe, according to data compiled by the Center for Systems Science and Engineering at Johns Hopkins University. More than 57,000 people have died in the United States, about a quarter of the known COVID-19 deaths around the globe.

The United States has now registered more confirmed cases than the next five countries suffering the largest outbreaks — Spain, Italy, France, Germany and the United Kingdom — combined.

Those numbers are partly a reflection of population, but there are troubling signs for the United States.

While those countries have reduced the pace of transmission and the growth in the number of new cases they are seeing on a daily basis, the United States has not similarly bent the curve.

Instead, it is stuck at a deadly plateau: In the last week, the U.S. has reported between 24,000 and 41,000 new cases a day, and between 1,200 and 2,600 deaths per day, according to The Covid Tracking Project, a group of researchers who keep tallies of case counts around the country.

Even as some states begin to relax orders that closed retail and service stores, experts warned the country is still at risk of a new rush of cases, and that the downslope of declining case counts will be much longer than the sudden surge the United States saw in April.

“We’re in the opening stages of this,” said Michael Osterholm, director of the Center for Infectious Disease Research and Prevention at the University of Minnesota. States “are not in the mountains, they’re in the foothills. The mountains are still to come.”

More than a quarter million residents of New York have tested positive for the virus, and commuter suburbs in New Jersey and Connecticut have reported tens of thousands of cases. More than 50,000 residents of Massachusetts have tested positive, and California, Illinois and Pennsylvania have all confirmed more than 40,000 cases.

There are growing signs that the virus is shifting into new, more rural territory. States like Arkansas, Kansas, Minnesota, Nebraska, New Mexico, Rhode Island, Tennessee and Virginia all recorded substantial growth in the number of new cases they had confirmed in the last few days.

That pattern of viral spread beginning in large urban cores and eventually making its way to rural areas is typical, experts said, given societal connections between urban areas, suburbs and more rural areas.

“Epidemiologists know that this pattern is a very expectable one, that rural areas are going to have lagged waves of cases. So we’ve been bracing for that,” said Nita Bharti, a biologist at the Center for Infectious Disease Dynamics at Penn State University. “What they’re experiencing now is what cities have been seeing. It’s the same, it’s just delayed, and we knew it would happen.”

About six months after the coronavirus outbreak was detected in Wuhan, China, and four months after the first case arrived on American shores, the United States still lags the world in testing capacity. States have bolstered their capacity in recent days, conducting more than 225,000 tests per day over four of the last five days, the capacity needed to ensure the virus can be brought under control lags substantially.

An analysis by Harvard researchers for the scientific publication STAT found more than half of states would have to significantly bolster their testing capacity in order to safely begin easing stay-at-home orders in May. The hardest-hit state, New York, will have to be able to test at least 100,000 more people every day than it is currently able to; New Jersey’s capacity would need to increase by 68,000 a day.

Smaller states and those that have yet to experience thousands of new cases — places like Mississippi, Idaho, Montana, Wyoming, Arizona and New Mexico — already have the testing capacity they need to identify and squelch any new viral hotspots. Even Washington state, the first state to confirm a positive case, has built its capacity to meet demand.

Public health experts say a robust testing program must be supplemented by armies of contact tracers who can track down those who are at risk of contracting the virus.

Already, Massachusetts has partnered with the nonprofit Partners In Health to deploy about 1,000 contact tracers across the state. Alaska has managed to trace the contacts of each of its 341 positive cases. New York City Mayor Bill de Blasio said Monday that the city would hire 1,000 contact tracers of its own, and former Mayor Mike Bloomberg has pledged $10 million to kick start a contact tracing program in the tri-state area.

On Monday, a bipartisan group of top public health experts led by President Trump‘s former FDA commissioner Scott Gottlieb and President Obama’s former Centers for Medicare and Medicaid Services administrator Andy Slavitt called on Congress to spend $46 billion to expand contact tracing capacity, including $12 billion to hire 180,000 new workers.

It is unclear how the outbreak in the United States compares with outbreaks in authoritarian countries like China, Russia and Iran, which do not report reliable numbers.

But even in the United States, where state and local governments are transparent about the data they collect, the actual number of cases and deaths are higher — likely significantly so. Early antibody tests in places like New York City and Miami show a significant number of people contract the virus without showing symptoms, and as studies show people who died inexplicably over the last several months tested positive for the virus.

 

 

 

U.S. with 1/3 of Confirmed Coronavirus Cases with Less Than 2% of Population Tested

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Coronavirus, Crisis, Crisis Management, Denial, Dept of Health and Human Services (HHS), Emergency Preparedness, Health Policy, Infection Control, Infectious Virus, Intensive Care (ICU), Mislead, Misleading, Mortality, Pandemic, Public Health, Public Safety, Social Distancing, Ventilators • Leave a comment

https://coronavirus.jhu.edu/map.html

Coronavirus outbreak affecting some Durham high school students ...

By the numbers: The coronavirus has infected over 2.9 million people and killed over 200,000, Johns Hopkins data shows. More than 829,000 people have recovered from COVID-19. The U.S. has reported the most cases in the world (more than 940,000 from 5.1 million tests), followed by Spain (over 223,000).

 

 

 

Tentative steps toward recovering from a deadly pandemic

Posted on by • Posted in 2020 Election Issues, Center for Medicare and Medicaid Services (CMS), Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Dept of Health and Human Services (HHS), Economic Crisis, Economic Stimulus, Economy, Elective Procedures, Elective Surgery, Health Policy, Health System, Hospital, Hospital Industry, Infection Control, Infectious Virus, Medicare, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Safety Net Hospitals, Safety-Net Providers, Social Distancing, The CARES Act • Leave a comment

https://mailchi.mp/0d4b1a52108c/the-weekly-gist-april-24-2020?e=d1e747d2d8

Baby Steps – Selah Someonetotalkto's Blog

The death toll from the novel coronavirus continued to mount this week, with more than 50,000 deaths reported in the US, and over 900,000 confirmed cases nationwide. Globally, the disease has infected more than 2.7M people and killed nearly 200,000. On Tuesday, public health officials in California announced that two people who died in Santa Clara County in early February were victims of COVID-19, making them the earliest known fatalities in the US, and altering experts’ understanding of how long the disease has been spreading in the country. New modeling from researchers at Northeastern University this week suggested that the virus may have been spreading widely in several cities by early February, but went undetected because of restrictions on testing.

National attention has remained focused on the subject of testing, as states and localities scramble to secure enough testing supplies and equipment to allow them to understand community spread and identify new cases. President Trump signed an emergency $484B relief bill on Friday that will provide $25B to ramp up testing, give additional aid to businesses forced to shutter, and send hospitals $75B in additional emergency funding.

The new money for hospitals is in addition to $100B already approved by Congress for a “provider relief fund” as part of the CARES Act. Having already distributed $30B of the initial grant money to hospitals, the Department of Health and Human Services (HHS) was expected to pay out an additional $20B today, this time according to a formula based on the net patient revenue of each hospital, rather than the earlier approach based on Medicare billings. The shift is expected to address concerns among children’s hospitals, safety-net providers, and others who were disadvantaged by the Medicare-based approach. It is unclear how the newly approved $75B of additional funding will be allocated.

Meanwhile, states began to plan for the reopening of their economies, with most governors taking a measured approach in coordination with neighboring states. A handful of states moved to loosen stay-at-home restrictions in advance of meeting the Trump administration’s “gating” criteria, including Florida, which reopened some beaches for recreational use, Oklahoma, and Georgia, which controversially allowed gyms, bowling alleys, hair and nail salons, and tattoo parlors to reopen on Friday.

Many states began to put in place plans to restart elective surgeries, which had been curtailed by a patchwork of differing state and local directives. The Centers for Medicare and Medicaid Services (CMS) released guidelines this week to help local officials decide when and how to restart surgeries. Whether for healthcare services or other types of economic activity, states will (and should) be guided by the ability to conduct widespread testing, robust contact tracing, and isolation of those infected with the virus. Ensuring that ability will likely make the next phase of the pandemic a protracted and frustrating “dance” of fits and starts, likely to last into the summer months and beyond.