Category Archives: Contact Tracing

America Now Has 4 Million Covid-19 Cases, As Calls For Mask Mandates Grow

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Economy Reopening, Employer-Based Health Insurance, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Health Insurance Coverage Adequacy, Infection Control, Infection Control Plan, Infectious Virus, Mortality, National Strategy, Pandemic, Partisanship, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, School Reopening, Social Distancing, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://www.forbes.com/sites/carlieporterfield/2020/07/23/america-nears-4-million-covid-19-cases-as-calls-for-mask-mandates-grow/?utm_source=newsletter&utm_medium=email&utm_campaign=dailydozen&cdlcid=5d2c97df953109375e4d8b68#9e673414550f

America Now Has 4 Million Covid-19 Cases As Calls For Mask ...

TOPLINE

Seven months since the first coronavirus case in the country was reported, the United State’s total infection count passed the 4 million milestone Thursday, according to a tally from The New York Times, a brutal marker as cases continue to rise in most of the country and calls for masking increase.

KEY FACTS

The number of total fatalities attributed to the virus has exceeded 143,000, the Times reported.

On Wednesday, a record-breaking 12,807 new cases was enough to tip California’s total number past that of New York, once the world epicenter of the pandemic (though its per capita infection rate remains less than New York at its peak).

Nationwide daily virus deaths topped 1,000 fatalities Wednesday for the first time since May.

The troubling numbers come as calls for widespread use of face masks grows, with President Donald Trump, who has in the past downplayed the garment, calling their use “patriotic” in a tweet this week.

Labor Department numbers released Thursday showed unemployment claims over the past week have jumped for the first time since March, rising by upwards of 100,000 to total 1.4 million.

KEY BACKGROUND

Around 230 million Americans are under a form of public masking mandate where they live, amounting to some 70% of the country, according to a Forbes analysis. A politically-charged garment for some, Americans on both sides of the aisle seem to be accepting of face masks mandates—a Politico/Morning Consult poll released this week found that 72% of voters surveyed would support a state mask mandate where they live, though Democrats identified as “strongly support[ing]” such an order roughly twice as much as Republicans, according to the survey.

President Donald Trump and inched closer to voicing support for masking during his first coronavirus briefing in months on Wednesday, saying, “Whether you like the mask or not, they have an impact, they’ll have an effect—and we need everything we can get,” Forbes reported.

 

 

 

Canceled elective procedures putting pressure on nation’s hospitals

Posted on by • Posted in 2020 Election Issues, American Hospital Association (AHA), Bankruptcy, Cash, Cash Reserves, Cash-Flow Improvements, Chronic Care Management, Chronic Conditions, Chronic Diseases, Clinical Testing, Contact Tracing, Coronavirus, Cost Management, Cost Reduction, Credit Quality, Credit Ratings, Crisis, Crisis Management, Deferred Healthcare, Economic Crisis, Economic Recovery, Economic Stimulus, Elective Procedures, Elective Surgery, Emergency Care, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employer-Based Health Insurance, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Financial Pressure, Financial Viability, Financially Distressed, Health Insurance Coverage Adequacy, Health Policy, Health System, Hospital, Hospital Industry, Infection Control, Infection Control Plan, Infectious Virus, Labor Spend Management, Liquidity, Market Consolidation, Market Power, Medicare Advance Payments, Mergers & Acquisitions, Mortality, National Strategy, Net Income, Operating Expense Reduction, Operating Expenses, Operating Income, Operating Margin, Operating Performance, Operating Revenue, Outpatient Care, Pandemic, Personal Protective Equipment (PPE), Reorganization, Supply Chain, The CARES Act • Leave a comment

https://www.healthcarefinancenews.com/news/canceled-elective-procedures-putting-pressure-nations-hospitals

U.S. Hospitals Brace for 'Tremendous Strain' from New Virus - JEMS

Even upticks in COVID-19 patients haven’t made up for the revenue losses, since reimbursement for those services is comparatively slim.

Elective procedures are in a strange place at the moment. When the COVID-19 pandemic started to ramp up in the U.S., many of the nation’s hospitals decided to temporarily cancel elective surgeries and procedures, instead dedicating the majority of their resources to treating coronavirus patients. Some hospitals have resumed these surgeries; others resumed them and re-cancelled them; and still others are wondering when they can resume them at all.

In a recent HIMSS20 digital presentation, Reenita Das, a senior vice president and partner at Frost and Sullivan, said that during the pandemic, plastic surgery activity declined by 100%, ENT surgeries declined by 79%, cardiovascular surgeries declined by 53% and neurosurgery surgeries declined by 57%.

It’s hard to overstate the financial impact this is likely to have on hospitals’ bottom lines. Just this week, American Hospital Association President and CEO Rick Pollack, pulling from Kaufman Hall data, said the cancellation of elective surgeries is among the factors contributing to a likely industry-wide loss of $120 billion from July to December alone. When including data from earlier in the pandemic, the losses are expected to be in the vicinity of $323 billion, and half of the nation’s hospitals are expected to be in the red by the end of the year.

Doug Wolfe, cofounder and managing partner of Miami-based law firm Wolfe Pincavage, said this has amounted to a “double-whammy” for hospitals, because on top of elective procedures being cancelled, the money healthcare facilities received from the federal Coronavirus Aid, Relief, and Economic Security Act was an advance on future Medicare payments – which is coming due. While hospitals perform fewer procedures, they will now have to start paying that money back.

All hospitals are hurting, but some are in a more precarious position than others.

“Some hospital systems have had more cash on hand and more liquidity to withstand some of the financial pressure some systems are facing,” said Wolfe. “Traditionally, the smaller hospital systems in the healthcare climate we face today have faced a lot more financial pressure. They’re not able to control costs the same way as a big system. The smaller hospitals and systems were hurting to begin with.”

LOWER REVENUE, HIGHER COSTS

Some hospitals, especially ones in hot spots, are seeing a surge in COVID-19 patients. While this has kept frontline healthcare workers scrambling to care for scores of sick Americans, COVID-19 treatments are not reimbursed at the same level as surgeries. Hospital capacity is being stretched with less lucrative services.

“Some hospitals may be filling up right now, but they’re filling up with lower-reimbursing volume,” said Wolfe. “Inpatient stuff is lower reimbursement. It’s really the perfect storm for hospitals.”

John Haupert, CEO of Grady Health in Atlanta, Georgia, said this week that COVID-19 has had about a $115 million negative impact on Grady’s bottom line. Some $70 million of that is related to the reduction in the number of elective surgeries performed, as well as dips in emergency department and ambulatory visits. 

During one week in March, Grady saw a 50% reduction in surgeries and a 38% reduction in ER visits. The system is almost back to even in terms of elective and essential surgeries, but due to a COVID-19 surge currently taking place in Georgia, it has had to suspend those services once again. ER visits have only come back about halfway from that initial 38% dip, and the system is currently operating at 105% occupancy.

“Part of what we’re seeing there is reluctance from patients to come to hospitals or seek services,” said Haupert. “Many have significantly exacerbated chronic disease conditions.”

Patient hesitation has been an ongoing problem, as has the associated cost of treating coronavirus patients, said Wolfe.

“When they were ramping up to resume the elective stuff, there was a problem getting patients comfortable,” he said. “And the other thing was that the cost of treating patients in this environment has gone up. They’ve put up plexiglass everywhere, they have more wiping-down procedures, and all of these things add cost and time. They need to add more time between procedures so they can clean everything … so they’re able to do less, and it costs more to do less. Even when elective procedures do resume, it’s not going back to the way it was.”

Most hospitals have adjusted their costs to mitigate some of the financial hit. Even some larger systems, such as 92-hospital nonprofit Trinity Health in Michigan, have taken to measures such as laying off and furloughing workers and scaling back working hours for some of its staff. At the top of the month, Trinity announced another round of layoffs and furloughs – in addition to the 2,500 furloughs it announced in April – citing a projected $2 billion in revenue losses in fiscal year 2021, which began on June 1.

Hospitals are at the mercy of the market at the moment, and Wolfe anticipates there could be an uptick in mergers and consolidation as organizations look to partner with less cash-strapped entities. 

“Whether reorganization will work remains to be seen, but there will definitely be a fallout from this,” he said.

 

 

 

 

EXCLUSIVE: WHITE HOUSE PRIVATELY WARNS 11 CITIES MUST TAKE “AGGRESSIVE” ACTION AGAINST CORONAVIRUS

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Decision Making, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Freedom of the Press, Honesty, Infection Control, Infection Control Plan, Infectious Virus, Misleading, Mistrust, Mixed Message, Out of Control, Pandemic, Partisanship, Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Transparency, Trust, Truth, Uncertainty, Wishful Thinking • Leave a comment

Exclusive: White House privately warns 11 cities must take ‘aggressive’ action against coronavirus

New red flags about the severity of the coronavirus outbreak come after Trump focused on upsides in televised briefing.

Dr. Deborah Birx, a leader of the White House Coronavirus Task Force, warned state and local leaders in a private phone call Wednesday that 11 major cities are seeing increases in the percentage of tests coming back positive for COVID-19 and should take “aggressive” steps to mitigate their outbreaks. 

The cities she identified were Baltimore, Cleveland, Columbus, Indianapolis, Las Vegas, Miami, Minneapolis, Nashville, New Orleans, Pittsburgh and St. Louis.

The call was yet another private warning about the seriousness of the coronavirus outbreaks given to local officials but not the public at large. It came less than a week after the Center for Public Integrity revealed that the White House compiled a detailed report showing 18 states were in the “red zone” for coronavirus cases but did not release it publicly.

Increasing test positivity — an indicator that a community does not have an outbreak under control — should be expected in areas that reopened and grew more relaxed about social distancing measures, said Harvard epidemiologist Bill Hanage. He said the warnings and data from the White House should be made public.

“This is a pandemic. You cannot hide it under the carpet,” he said. “The best way to deal with a crisis or a natural disaster is to be straight with people, to earn their trust and to give the information they need to make decisions for themselves and their communities.”

Birx told hundreds of emergency managers and other state and local leaders that they should act quickly to stem the outbreaks. Among her recommendations were to trace the contacts of patients testing positive for COVID-19 in areas where test positivity is going up.

“When you first see that increase in test positivity, that is when to start the mitigation efforts,” she said in a recording obtained by Public Integrity. “I know it may look small and you may say, ‘That only went from 5 to 5-and-a-half [percent], and we’re gonna wait and see what happens.’ If you wait another three or four or even five days, you’ll start to see a dramatic increase in cases.”

Birx said the federal government was seeing encouraging declines in test positivity in places like Phoenix and San Antonio but warned that the outbreak in the Sunbelt was moving north.

“What started out very much as a southern and western epidemic is starting to move up the East Coast into Tennessee, Arkansas, up into Missouri, up across Colorado, and obviously we’re talking about increases now in Baltimore,” she said. “So this is really critical that everybody is following this and making sure they’re being aggressive about mitigation efforts.”

It’s unclear who heard the warnings and was invited to the call, which was hosted by the White House Office of Intergovernmental Affairs and closed to the press. Baltimore and Cleveland were two of the cities Birx warned were facing rising test positivity, but a spokeswoman for the Cleveland mayor’s office, Nancy Kelsey-Carroll, said they did not participate in the call. And Baltimore health department leaders didn’t know about it, agency spokesman Adam Abadir said in an email. That city today announced a mask mandate and new restrictions on indoor dining.

The test positivity rates may not have been news to some elected officials. For example, Pennsylvania already publicly reports that data by county.

Birx’s warning came a day after President Donald Trump resumed his televised coronavirus briefings. The president offered a rosier picture of the pandemic than Birx, focusing on examples of improvements in the fight against the virus, such as better treatment with the drug remdesivir.

Her call also came the same day that Democratic Senate Minority Leader Sen. Chuck Schumer said on the Senate floor that he and House Majority Leader Nancy Pelosi had insisted on greater data transparency in a meeting with White House Chief of Staff Mark Meadows. Schumer said they would push for legislation to “ensure that COVID-19 data is fully transparent and accessible without any interference from the administration.”   

And on Tuesday, former CDC Director Tom Frieden and colleagues released a list of data points they would like states to publish in real-time, standardized, to give officials and residents better information.

“It’s not just people who are holding office who need to make decisions,” said Caitlin Rivers, an epidemiologist at Johns Hopkins University, on a call with reporters. “The more that we can provide information to people to keep themselves and their families safe, the better off we’ll be.”

The White House did not immediately respond to a request for comment on Birx’s warnings, nor did it answer repeated questions over several days from Public Integrity on why it had not made the “red zone” report public. Birx said on the call that the weekly report had been sent to governors for four weeks. One staffer for a governor said his boss received only the section of the report related to his state, not the entire report.

 

COVID-19 More Deadly Than Cancer Itself?

Posted on by • Posted in 2020 Election Issues, Cancer, Cancer Treatment, Clinical Testing, Comorbidity, Contact Tracing, Coronavirus, Crisis, Crisis Management, Hydroxychloroquine, Mortality, Pandemic, Preexisting Conditions, Public Health, Public Safety, Quarantine, Social Determinants of Health, Social Distancing • Leave a comment

https://www.medpagetoday.com/hematologyoncology/othercancers/87750?xid=nl_mpt_DHE_2020-07-25&eun=g885344d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%20Top%20Cat%20HeC%20%202020-07-25&utm_term=NL_Daily_DHE_dual-gmail-definition

During the recent months of the pandemic, cancer patients undergoing active treatment saw their risk for death increase 15-fold with a COVID-19 diagnosis, real-world data from two large healthcare systems in the Midwest found.

Among nearly 40,000 patients who had undergone treatment for their cancer at some point over the past year, 15% of those diagnosed with COVID-19 died from February to May 2020, as compared to 1% of those not diagnosed with COVID-19 during this same timeframe, reported Shirish Gadgeel, MD, of the Henry Ford Cancer Institute in Detroit.

And in more than 100,000 cancer survivors, 11% of those diagnosed with COVID-19 died compared to 1% of those not diagnosed with COVID-19, according to the findings presented at the American Association for Cancer Research (AACR) COVID-19 and Cancer meeting.

“Certain comorbidities were more commonly seen in patients with COVID-19,” said Gadgeel. “This included cardiac arrhythmias, renal failure, congestive heart failure, and pulmonary circulation disorders.”

For their study, Gadgeel and colleagues examined data on 154,585 malignant cancer patients from 2015 to the present day with active cancer or a history of cancer treated at two major Midwestern health systems. Among the 39,790 patients with active disease, 388 were diagnosed with COVID-19 from February 15 through May 13, 2020. For the 114,795 patients with a history of cancer, 412 were diagnosed with COVID-19.

After adjusting for multiple variables, older age (70-99 years) and several comorbid conditions were significantly associated with increased mortality among COVID-19 patients with active cancer:

  • Older age: OR 3.4 (95% CI 1.3-9.3)
  • Diabetes: OR 3.0 (95% CI 1.5-6.0)
  • Renal failure: OR 2.3 (95% CI 1.1-4.9)
  • Pulmonary circulation disorders: OR 3.9 (95% CI 1.4-10.5)

In COVID-19 patients with a history of cancer, an increased risk for death was seen for those ages 60 to 69 years (OR 6.3, 95% CI 1.1-35.3), 70 to 99 years (OR 18.2, 95% CI 3.9-84.3), and those with a history of coagulopathy (OR 3.0, 95% CI 1.2-7.6).

Despite Black patients consisting of less than 10% of the total study population, Gadgeel noted that 39.4% of COVID-19 diagnoses in the active cancer group were among Black patients, as were a third of diagnoses in the cancer survivor group.

And the proportion of COVID-19 patients with a median household income below $30,000 was also higher in COVID-19 patients in both groups, he added.

COVID-19 carried a far greater chance for hospitalization, both for patients with active cancer (81% vs 15% for those without COVID-19) as well as those with a history of cancer (68% vs 6%), with higher hospitalization rates among Black individuals and those with a median income below $30,000. Even younger COVID-19 patients (<50 years) saw high rates of hospitalization, at 79% for those with active cancer and 49% for those with a history of the disease.

While few cancer patients without COVID-19 required mechanical ventilation (≤1%) during the study period, 21% of patients with active disease and COVID-19 needed ventilation, as did 14% of those with a history of cancer, with higher rates among those with a history of coagulopathy (36% and 23%, respectively).

CCC-19 Data Triples in Size

Another study presented during the meeting again showed higher mortality rates for cancer patients with COVID-19, with lung cancer patients appearing to be especially vulnerable.

Among 2,749 cancer patients diagnosed with COVID-19, 60% required hospitalization, 45% needed supplemental oxygen, 16% were admitted to the intensive care unit, and 12% needed mechanical ventilation, and 16% died within 30 days, reported Brian Rini, MD, of Vanderbilt-Ingram Cancer Center in Nashville, Tennessee.

“When COVID first started there was a hypothesis that cancer patients could be at adverse outcome risk due to many factors,” said Rini, noting their typically “advanced age, presence of comorbidities, increased contact with the healthcare system, perhaps immune alterations due to their cancer and/or therapy, and decreased performance status.”

Rini was presenting an updated analysis of the COVID-19 and Cancer Consortium (CCC-19), which now includes 114 sites (includes comprehensive cancer centers and community sites) collecting data on cancer patients and their outcomes with COVID-19.

Initial data from the consortium, of about 1,000 patients, were presented earlier this year at the American Society of Clinical Oncology (ASCO) annual meeting and published in The Lancet. The early analysis showed that use of hydroxychloroquine and azithromycin to treat COVID-19 in cancer patients was associated with a nearly threefold greater risk of dying within 30 days.

Notably, in the new analysis, decreased all-cause mortality at 30 days was observed among the 57 patients treated with remdesivir alone, when compared to patients that received other investigational therapies for COVID-19, including hydroxychloroquine (adjusted odds ratio [aOR] 0.41, 95% CI 0.17-0.99) and a trend toward lower mortality when compared to patients that received no other investigational therapies (aOR 0.76, 95% CI 0.31-1.85).

Cancer status was associated with a greater mortality risk. Compared to patients in remission, those with stable (aOR 1.47, 95% CI 1.07-2.02) or progressive disease (aOR 2.96, 95% CI 2.05-4.28) were both at increased risk of death at 30 days.

Mortality at 30 days reached 35% for patients with an Eastern Cooperative Oncology Group (ECOG) performance status of 2 or higher, as compared to 4% (aOR 4.22, 95% CI 2.92-6.10).

“As you start to combine these adverse risk factors you get into really high mortality rates,” said Rini, with highest risk seen among intubated patients who were either 75 and older (64%) or had poor performance status (75%).

“There are several factors that are starting to emerge as relating to COVID-19 mortality in cancer patients,” said Rini during his presentation at the AACR COVID-19 and Cancer meeting. “Some are cancer-related, such as the status of their cancer and perhaps performance status, and others are perhaps unrelated, such as age or gender.”

Other factors that were significantly associated with higher mortality included older age, male sex, Black race, and being a current or former smoker, and having a hematologic malignancy.

Findings from the study were simultaneously published in Cancer Discovery.

“Importantly, there were some factors that did not reach statistical significance,” said Rini, including obesity.

“Patients who received recent cytotoxic chemotherapy or other types of anti-cancer therapy, or who had recent surgery were not in the present analysis of almost 3,000 patients at increased risk,” he continued. “I think this provides some reassurance that cancer care can and should continue for these patients.”

For specific cancer types, mortality was highest in lung cancer patients (26%), followed by those with lymphoma (22%), colorectal cancer (19%), plasma cell dyscrasias (19%), prostate cancer (18%), breast cancer (8%), and thyroid cancer (3%).

“The COVID mortality rate in cancer patients appears to be higher than the general population,” said Rini. “Lung cancer patients appear especially vulnerable by our data, as well as TERAVOLT‘s.”

 

 

 

U.S. passes 4 million coronavirus cases as pace of new infections roughly doubles

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Blame, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Economy Reopening, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employer-Based Health Insurance, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Financial Pressure, Financial Viability, Financially Distressed, Health Insurance Coverage Adequacy, Health Policy, Honesty, Infection Control, Infection Control Plan, Infectious Virus, Integrity, Job, Job Loss, Job Market, Job Search, Job Security, Leadership Decentralized, Misinformation, Mislead, Misleading, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Recession, School Reopening, Scientists, Social Distancing, Trust, Truth, Underinsured, Unemployment, Unemployment Insurance, Uninsured, Wishful Thinking • Leave a comment

https://www.washingtonpost.com/politics/us-passes-4-million-coronavirus-cases-as-pace-of-new-infections-roughly-doubles/2020/07/23/d0125192-cd02-11ea-b0e3-d55bda07d66a_story.html?utm_campaign=wp_main&utm_medium=social&utm_source=facebook&fbclid=IwAR3Ve5MnHiStJnPO_mzkc1c2sHE2EM6QOG-2HochFPBmJe6hnyvcmqEVQ4U

The United States on Thursday passed the grim milestone of 4 million confirmed coronavirus infections, and President Trump announced he was canceling the public celebration of his nomination for a second term, as institutions from schools to airlines to Major League Baseball wrestled with the consequences of a pandemic still far from under control.

The rapid spread of the virus this summer is striking, taking just 15 days to go from 3 million confirmed cases to 4 million. By comparison, the increase from 1 million cases to 2 million spanned 45 days from April 28 to June 11, and the leap to 3 million then took 27 days.

Trump’s cancellation of the in-person portion of the Republican National Convention planned for next month in Jacksonville, Fla., represented a remarkable reversal. He had insisted for months on a made-for-television spectacle that would have packed people close together in a state that is now an epicenter of the resurgent pandemic.

On Thursday, he conceded that was not going to work. “The timing for this event is not right,” Trump said during the latest of somber, solo White House briefings this week. “It’s just not right with what’s been happening.”

Florida reported 173 deaths on Thursday, its highest single-day count of new deaths, and also reported more than 10,200 new coronavirus cases.

In a scathing statement blaming the surge of new cases on Trump’s “failure to care,” presumptive Democratic nominee Joe Biden said the president “quit on this country and waved the white flag of surrender.”

Meanwhile, nearly every public health metric suggests America is badly losing its fight against the virus.

Positivity rates have reached alarming levels in numerous states, hospitalizations are soaring, and more than 1,100 new coronavirus deaths were reported across the United States on Wednesday, marking the first time since May 29 that the daily count exceeded that number, according to Washington Post tracking.

The rolling seven-day average of infections has doubled in less than a month, reaching more than 66,000 new cases per day Wednesday. The U.S. death toll now exceeds 141,000.

As a result, many businesses appear to be pulling back after their attempts to resume more normal operations proved premature, and an additional 1.4 million American workers filed for unemployment benefits last week. It was the first time since March that new claims rose. Another 980,000 new Pandemic Unemployment Assistance claims — the benefits offered to self-employed and gig workers — were also filed.

Congress, meanwhile, struggled to confront the crisis. Senate Republicans killed Trump’s payroll tax cut proposal on Thursday, widening an unusual rift with the White House over the cost and contents of the latest national coronavirus relief package.

Senate Majority Leader Mitch McConnell (R-Ky.) had planned to roll out a $1 trillion GOP bill Thursday morning, but that was canceled amid the intraparty conflicts.

Administration officials then floated a piecemeal approach, involving several different aid bills, but ran into opposition from lawmakers in both parties.

Trump’s briefing Thursday afternoon, his third of the week, reflected an effort to increase popular support for his management of the coronavirus outbreak, which even many of his allies have criticized. About 2 out of 3 Americans disapprove of Trump’s handling of the pandemic, a new poll found.

Trump dismissed or played down the risk of the virus for months after it had begun spreading in the United States and has been a self-described cheerleader for rapid reopening of businesses and schools shuttered to help slow its spread.

The survey of 1,057 adults in the United States, conducted by the Associated Press-NORC Center for Public Affairs Research, also showed that 3 out of 4 Americans, including a majority of Republicans, support mandatory face coverings when people are outside their own homes.

Democrats overwhelmingly favor mask mandates, at 89 percent. The majority of Republicans — 59 percent — also support them.

Ninety-five percent of Democrats and 75 percent of Republicans say they wear face coverings when leaving home. Overall, more Americans — 86 percent — are wearing masks compared with in May, when 73 percent were doing so.

Trump resisted wearing a mask in public until earlier this month, despite calls to set a good example from the top. He now calls it patriotic to wear a mask, though he still does not wear one consistently and says people should decide for themselves. Trump carries a black-cloth version in his pocket, which he says is sufficient for those instances when he is close to people who have not been screened for the virus.

Trump’s shift may reflect a growing consensus in favor of masks, although it is not clear that opposition to them has ebbed among some of the president’s strongest political supporters.

The business community is struggling, too. American Airlines and Southwest Airlines posted big quarterly losses between April and July in their earnings reports released Thursday, projecting that travel demand will not rebound anytime soon.

In American’s second quarter, revenue dropped more than 86 percent, to $1.6 billion, from nearly $12 billion a year ago, according to a Securities and Exchange Commission filing. The company posted a net loss of nearly $2.1 billion, attributing it to stay-at-home orders, border closures and travel restrictions.

“As a result, we have experienced an unprecedented decline in the demand for air travel, which has resulted in a material deterioration in our revenues,” the company said in the earnings report. “While the length and severity of the reduction in demand due to Covid-19 is uncertain, we expect our results of operations for the remainder of 2020 to be severely impacted.”

Southwest posted revenue of $1 billion in its second quarter, an almost 83 percent dip compared with a year ago. The company also posted a net loss of $915 million.

Trump also took a small step back from his insistence that schools should open on time this fall, conceding instead that some schools might need to delay in-person learning. Many school districts have already announced that decision.

Trump has been critical of guidance from the Centers for Disease Control and Prevention, saying it made it too tough for schools to reopen, and promised new guidelines would be issued. On Thursday, the CDC released several documents emphasizing the benefits of in-person school, in line with Trump’s messaging. Some of the guidance was written by White House officials rather than experts at the CDC, people familiar with the process said. They spoke on the condition of anonymity to discuss internal decision-making.

The new guidelines for school administrators mention precautions outlined in previous documents, but they appear to drop specific reference to keeping students six feet apart — something many schools find almost impossible to do if they are fully reopened. This document also suggests that schools consider closing only if there is “substantial, uncontrolled transmission” of the virus, and not necessarily even then.

Florida Gov. Ron DeSantis (R) echoed Trump in making a case for students to return to classrooms, despite the state’s teachers union suing over an order forcing schools to fully reopen. Meanwhile, a new poll showed that most parents would prefer to delay the start of in-person school.

During an appearance on “Fox & Friends,” DeSantis said that schoolchildren are “by far at the least risk for coronavirus, thankfully.”

“We also know they play the smallest role by far in transmission of the virus, and yet they’ve really been asked to shoulder the brunt of our control measures,” said DeSantis, a close Trump ally who had volunteered his state for the Republican convention next month.

DeSantis said that the “evidence-based decision” is for all parents to have the option of in-class instruction for their children if they choose. He said those who are not comfortable with sending their children back to school could continue distance learning.

The role children play in spreading the virus is still being studied, with experts saying that results are not definitive. A South Korean study found that children over the age of 10 were as likely to transmit the virus as adults, while those under 10 were less likely to spread it.

Deborah Birx, the White House coronavirus response coordinator, said Wednesday on Fox News that the United States is launching a study of its own, adding that the data “really needs to be confirmed here.”

Among the most visible American institutions searching for a path forward is the sports industry. Major League Baseball began a pandemic-shortened season on Thursday, playing in empty stadiums amid questions about whether the sport can make it through October without having to abort. It is as much a science experiment as a championship pursuit.

Players are prohibited from spitting or high-fiving. Foul balls that wind up in the stands will remain there.

Anthony S. Fauci, the nation’s leading infectious-disease expert, threw out the first pitch for the Washington Nationals home opener against the New York Yankees. Nationals star outfielder Juan Soto tested positive for the coronavirus on Thursday and missed the game.

Meanwhile, Japan marked a year’s delay of the Olympic Games on Thursday. Tokyo was to host the 2020 Summer Olympics starting Friday. A 15-minute ceremony in Tokyo’s newly built $1.4 billion Olympic Stadium started the countdown to the delayed games, now set to begin on July 23, 2021. The city also marked a new daily record in reported cases on Thursday, with 366.

A poll this week by Japan’s Kyodo News Agency found that fewer than 1 in 4 people in Japan even want to host the games anymore. One-third of respondents said the games should be canceled, while 36 percent expressed interest in postponing them for more than a year.

 

 

 

‘The virus doesn’t care about excuses’: US faces terrifying autumn as Covid-19 surges

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Blame, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expert Opinion, False Hope, False Narrative, False Reassurance, Health Policy, Health System, Herd Immunity, Hospital, Hospital Industry, Infection Control, Infection Control Plan, Infectious Virus, Job, Job Loss, Job Market, Job Search, Job Security, Leadership Decentralized, Misinformation, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Partisanship, Personal Protective Equipment (PPE), Preexisting Conditions, Public Health, Public Safety, Quarantine, School Reopening, Scientists, Social Distancing, Trust, Truth, Uncertainty, Underinsured, Unemployment, Unemployment Insurance, Uninsured, Vulnerable Populations, Wishful Thinking • Leave a comment

https://www.theguardian.com/world/2020/jul/18/us-coronavirus-fall-second-wave-autumn

The breathing space afforded by lockdowns in the spring has been squandered, with new cases running at five times the rate of the whole of Europe. Things will only get worse, experts warn.

In early June, the United States awoke from a months-long nightmare.

Coronavirus had brutalized the north-east, with New York City alone recording more than 20,000 deaths, the bodies piling up in refrigerated trucks. Thousands sheltered at home. Rice, flour and toilet paper ran out. Millions of jobs disappeared.

But then the national curve flattened, governors declared success and patrons returned to restaurants, bars and beaches. “We are winning the fight against the invisible enemy,” vice-president Mike Pence wrote in a 16 June op-ed, titled, “There isn’t a coronavirus ‘second wave’.”

Except, in truth, the nightmare was not over – the country was not awake – and a new wave of cases was gathering with terrifying force.

As Pence was writing, the virus was spreading across the American south and interior, finding thousands of untouched communities and infecting millions of new bodies. Except for the precipitous drop in New York cases, the curve was not flat at all. It was surging, in line with epidemiological predictions.

Now, four months into the pandemic, with test results delayed, contact tracing scarce, protective equipment dwindling and emergency rooms once again filling, the United States finds itself in a fight for its life: swamped by partisanship, mistrustful of science, engulfed in mask wars and led by a president whose incompetence is rivaled only by his indifference to Americans’ suffering.

With flu season on the horizon and Donald Trump demanding that millions of students return to school in the fall – not to mention a presidential election quickly approaching – the country appears at risk of being torn apart.

“I feel like it’s March all over again,” said William Hanage, a professor of epidemiology at the Harvard TH Chan School of Public Health. “There is no way in which a large number of cases of disease, and indeed a large number of deaths, are going to be avoided.”

The problem facing the United States is plain. New cases nationally are up a remarkable 50% over the last two weeks and the daily death toll is up 42% over the same period. Cases are on the rise in 40 out of 50 states, Washington DC and Puerto Rico. Last week America recorded more than 75,000 new cases daily – five times the rate of all Europe.

“We are unfortunately seeing more higher daily case numbers than we’ve ever seen, even exceeding pre-lockdown times,” said Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Center for Health Security. “The number of new cases that occur each day in the US are greater than we’ve yet experienced. So this is obviously a very worrisome direction that we’re headed in.”

The mayor of Houston, Texas, proposed a “two-week shutdown” last week after cases in the state climbed by tens of thousands. The governor of California reclosed restaurants, churches and bars, while the governors of Louisiana, Alabama and Montana made mask-wearing in public compulsory.

“Today I am sounding the alarm,” Governor Kate Brown said. “We are at risk of Covid-19 getting out of control in Oregon.”

As dire as the current position seems, the months ahead look even worse. The country anticipates hundred of thousands of hospitalizations, if the annual averages hold, during the upcoming flu season. Those hospitalizations will further strain the capacity of overstretched clinics.

But a flu outbreak could also hamper the country’s ability to fight coronavirus in other ways. Because the two viruses have similar symptoms – fever, chills, diarrhea, fatigue – mistaken diagnoses could delay care for some patients until it’s too late, and make outbreaks harder to catch, one of the country’s top health officials has warned.

“I am worried,” Dr Robert Redfield, the director of the Centers for Disease Control (CDC), said last week. “I do think the fall and the winter of 2020 and 2021 are probably going to be one of the most difficult times that we have experienced in American public health because of … the co-occurrence of Covid and influenza.”

Other factors will be in play. A precipitous reopening of schools in the fall, as demanded by Trump and the education secretary, Betsy DeVos, without safety measures recommended by the CDC, could create new superspreader events, with unknown consequences for children.

“We would expect that to be throwing fuel on the fire,” said Hanage of blanket school reopenings. “So it’s going to be bad over the next month or so. You can pretty much expect it to be getting worse in the fall.”

The list of aggravating circumstances goes on and on. A federal unemployment assistance program that gave each claimant an extra $600 a week is set to expire at the end of July. A new coronavirus relief package is being held up in Congress by Republicans’ accusations that states are wasting money, and their insistence that any new legislation include liability protections for businesses that reopen during the pandemic.

Cable broadcasts and social media have been filled, meanwhile, with video clips of furious confrontations on sidewalks, in stores and streets over wearing facial masks. In Michigan, a sheriff’s deputy shot dead a man who had stabbed another man for challenging him about not wearing a mask at a convenience store. In Georgia, the Republican governor sued the Democratic mayor of Atlanta for issuing a city-wide mask mandate.

The partisan divide on masks is slowly closing as the outbreaks intensify. The share of Republicans saying they wear masks whenever they leave home rose 10 points to 45% in the first two weeks of July, while 78% of Democrats reported doing so, according to an Axios-Ipsos poll.

Another divide has proven tragically resilient. As hotspots have shifted south, the virus continues to affect Black and Latinx communities disproportionately. Members of those communities are three times as likely to become infected and twice as likely to die from the virus as white people, according to data from early July.

The raging virus has prompted speculation in some corners that the only way out for the United States is through some kind of “herd immunity” achieved by simply giving up. But that grossly underestimates the human tragedy such a scenario would involve, epidemiologists say, in the form of tens of millions of new cases and unknown thousands of deaths.

“I think that every single serology study that’s been done to date suggests that the vast majority of Americans have not yet been exposed to this virus,” Nuzzo said. “So we’re still very much in the early stages.

“Which is good, that’s actually really good news. I don’t want to strive for herd immunity, because that means the vast majority of us will get sick and that will mean many, many more deaths. The point is to slow the spread as much as possible, protect ourselves as much as possible, until we have other tools.”

But the ability of the US to take that basic step – to slow the spread, as dozens of other countries have done – is in perilous doubt. After half a year, the Trump administration has made no effort to establish a national protocol for testing, contact tracing and supported isolation – the same proven three-pronged strategy by which other countries control their outbreaks.

Critics say that instead, Trump has dithered and denied as the national death toll climbed to almost 140,000. The Democratic presidential candidate, Joe Biden, who is hoping to unseat Trump in November, blasted the president for refusing until recently to wear a mask in public.

“He wasted four months that Americans have been making sacrifices by stoking divisions and actively discouraging people from taking a very basic step to protect each other,” Biden said in a statement last weekend.

Meanwhile the White House has attacked Dr Anthony Fauci, the country’s foremost expert on infectious diseases whose refusal to lie to the public has enraged Trump, by publishing an op-ed signed by one of the president’s top aides titled “Anthony Fauci has been wrong about everything I have interacted with him on” and by releasing a file of opposition research to the Washington Post.

Trump claimed the number of cases was a function of unusually robust testing, though experts said that positivity rates of 20% in multiple states suggested that the United States is testing too little – and that in any case closing one’s eyes to the problem by testing less would not make it go away.

“We’ve done 45 million tests,” Trump said this week, padding the figure only slightly. “If we did half that number, you’d have half the cases, probably around that number. If we did another half of that, you’d have half the numbers. Everyone would be saying we’re doing well on cases.”

Such statements by Trump have encouraged unfavorable comparisons of the US pandemic response with those in countries such as Italy, which recorded just 169 new cases on Monday after a horrific spring, and South Korea, which has kept cases in the low double-digits since April.

But the United States could also look to many African countries for lessons in pandemic response, said Amanda McClelland, who runs a global epidemic prevention program at Resolve to Save Lives.

“We’ve seen some good success in countries like Ghana, who have really focused on contact tracing, and being able to follow up superspreading events,” said McClelland. “We see Ethiopia: they kept their borders open for a lot longer than other countries, but they have really aggressive testing and active case-finding to make sure that they’re not missing cases.

“I think what we’ve seen is that you need not just a strong health system but strong leadership and governance to be able to manage the outbreak, and we’ve seen countries that have all three do well.”

But in America, the large laboratories that process Covid-19 tests are unable to keep up with demand. Quest Diagnostics announced on Tuesday that the turnaround time for most non-emergency test results was at least seven days.

“We want patients and healthcare providers to know that we will not be in a position to reduce our turnaround times as long as cases of Covid-19 continue to increase dramatically,” the lab said.

“You can’t have unlimited lab capacity, and what we’ve done is allow, to some extent, cases to go beyond our capacity,” said McClelland. “We’re never going to be able to treat and track and trace uncontrolled transmission. This outbreak is just too infectious.”

Public health experts emphasize that the United States does not have to accept as its fate a cascade of tens of millions of new cases, and tens of thousands of deaths, in the months ahead. Focused leadership and individual resolve could yet help the country follow in the footsteps of other nations that have successfully faced serious outbreaks – and brought them under control.

But it is clear that the most vulnerable Americans, including the elderly and those with pre-existing conditions, face grave danger. Republicans have argued in recent weeks that while cases in the US have soared, death rates are not climbing so quickly, because the new cases are disproportionately affecting younger adults.

That is a false reassurance, health experts say, because deaths are a lagging indicator – cases necessarily rise before deaths do – and because large outbreaks among any demographic group speeds the virus’s ability to get inside nursing homes, care facilities and other places where residents are most vulnerable.

“If we don’t do anything to stop the virus, it’s going to be very difficult to prevent it from getting to people who will die,” said Nuzzo.

There is a question of whether the United States, for all its wealth and expertise – and its self-regard as an exceptional actor on the world stage – can summon the will to keep up the fight. People are tired of fighting the virus, and of fighting each other.

“I think unfortunately people are emotionally exhausted from having to think about and worry about this virus,” said Nuzzo. “They feel like they’ve already sacrificed a lot. So the worry that I have is, what willingness is there left, to do what it takes?”

It is as if the country is “treading water in the middle of the ocean”, Hanage said.

“People tend to be shuffling very quickly between denial and fatalism,” he said. “That’s really not helpful. There are a number of things that can be done.

“What I would hope is that this marks a point when the United States finally wakes up and realizes that this is a pandemic and starts taking it seriously.

“Folks tend to look at what has happened elsewhere and then they make up some kind of magical reason why it’s not going to happen to them.

“People keep making these excuses, and the virus doesn’t care about the excuses. The virus just keeps going. If you give it the opportunity, it will take it.”

 

 

 

 

Pinning hopes on vaccine is not the right coronavirus strategy, expert says

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Infection Control, Infection Control Plan, Infectious Virus, Intensive Care (ICU), Mortality, National Strategy, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Social Distancing, Vaccine • Leave a comment

https://www.cnn.com/2020/07/22/health/us-coronavirus-wednesday/index.html

As cases continue to rise, Americans looking to a vaccine as the way out of the coronavirus pandemic should consider a more comprehensive approach, a leading medical expert told CNN on Wednesday.

“Pinning all our hopes on a vaccine that works immediately is not the right strategy,” Dr. William Haseltine, a former professor at Harvard University’s medical and public health schools, told CNN’s Wolf Blitzer.
Haseltine said a broad public health strategy is a better way to contain the spread of the virus along with the help of a vaccine and therapeutic drugs. Mandating masks will help but Haseltine said, “we need a lot more than masks to contain this epidemic that’s running through our country like a freight train.”
Haseltine recommended closing bars and other places where young people congregate at night and ban holding large meetings in the worst-hit regions. Life won’t get better until people make major changes to their behavior and public health services come forward with more resources, he said.
He said a vaccine is still six months away at the earliest and he warned not to underestimate a coronavirus. Haseltine, known for his work on fighting cancer and HIV/AIDS, said it won’t be easy to develop a vaccine.
“These are tricky viruses,” he said. “It’s not as simple as measles or mumps. It’s going to be a lot more complicated”.
Any Covid-19 vaccine that’s sponsored by the US government will be free or affordable for the American public, Health and Human Services Secretary Alex Azar told CNBC on Wednesday.
“For any vaccine that we have bought — so for instance the Pfizer vaccine — those hundred million doses would actually be acquired by the US government, then given for free to Americans,” Azar said.
He said the same would apply with the AstraZeneca and the Novovax vaccines.
“We will ensure that any vaccine that we’re involved in sponsoring is either free to the American people or is affordable,” Azar said.
And while some anti-mask protesters refuse to wear a piece of cloth to help save American lives, enormous signs of altruism have emerged.
More than 100,000 people have volunteered to participate in Covid-19 vaccine clinical trials, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
“I think we’ll be fine with regards to getting enough people,” Fauci said during a webinar Wednesday with the TB Alliance.

1 million more cases in two weeks

The US is heading in the wrong direction with Covid-19 numbers, and it’s doing so with astonishing speed.
Just after 1,000 people died in a single day, the country is about to reach 4 million Covid-19 cases.
To put that in perspective, the first reported case came on January 21. After 99 days, 1 million Americans became infected.
It took just 43 days after that to reach 2 million cases.
And 28 days later, on July 8, the US reached 3 million cases. The 4 millionth case could come just two weeks after that.
As of Wednesday night, more than 3.96 million people had been infected across the US, and more than 143,000 have died, according to data from Johns Hopkins University.
Some states are reporting record-breaking numbers of new cases. Johns Hopkins reported at least 68,706 new cases and 1,152 deaths in the US on Wednesday.
More governors are requiring masks, and dozens of hospitals are out of intensive care unit beds.
President Donald Trump said the United States has now conducted more than 50 million coronavirus tests. He told reporters at a White House briefing that people should wear masks, pay attention to social distancing and wash their hands. While hot spots like Florida and Texas have popped up, it’s all going to work out, he said.
“We’re all in this together,” he said.

Covid-19 a leading cause of death in L.A. County

California, the most populous state and the first to shut down months ago, appeared to have Covid-19 under control — only to suffer a massive resurgence and surpass New York with the most coronavirus cases in the nation.
This month, state Gov. Gavin Newsom shut down bars and indoor restaurant services again due to an influx of cases after reopening.
Covid-19 is set to become one of the leading causes of death in Los Angeles County, according to Barbara Ferrer, the county’s health director.
“It’s killing more people than Alzheimer’s disease, other kinds of heart disease, stroke and COPD,” Ferrer said, referring to chronic obstructive pulmonary disease, which causes airflow blockage and breathing issues.
Comparing Covid-19 to the flu, Ferrer said data shows Covid-19 killed twice as many people in six months as the flu did in eight months.

Where cases are surging

Some politicians, including the President, have insisted that much of the soaring case numbers are a reflection of increased testing.
But the surge is new cases has greatly outpaced the increase in testing, with troubling rates of transmission and test positivity in many states.
A CNN analysis of testing data from the Covid Tracking Project reveals the positive test rate — or the average number of positive test results out of 1,000 tests performed — has increased significantly in many of the current hotspots, including Florida, Arizona, Texas and Georgia.
Florida saw an average rate of 35 positive results per 1,000 tests during the month of May. But in June, that number nearly tripled to 105. So far in July, the average rate of test positivity has been 187 out of 1,000.
But Florida Gov. Ron DeSantis said the state is on the “right course” in the fight against the virus.
“I think we will continue to see improvements,” the governor said Tuesday. “We just have to, particularly Floridians, have to continue doing the basic things.”
Over the weekend, nearly 50 Florida hospitals said they were out of ICU beds. Statewide, the ICU bed availability had dwindled to 15.98% on Tuesday, down from about 18.1% on Monday.
And new data from the CDC also show infections could be more than 10 times higher than the number of reported cases in some parts of the US.

More mask mandates lead to decreased death projections

Researchers estimate the US will have 219,864 total Covid-19 deaths by November 1, according to the Institute for Health Metrics at the University of Washington.
That’s actually a decrease of about 5,000 deaths from the IHME’s previous forecast of 224,546 by that date.
The reasons for the slightly better forecast include more face masks mandates, more people wearing masks, and more people practicing social distancing, the researchers said.
“So a mandate is very important and helping, and a national mandate, of course, would do much better,” said Ali Mokdad, a professor of health metrics sciences at the IHME.
If Americans wore masks nationwide, the number of total deaths by November 1 would drop to 185,887, the researchers project. But if the mandates ease more, the US could have 231,012 deaths by November 1.
At least 41 states have some kind of mask requirement in place or planned. Starting Saturday, Minnesota will require people to wear masks inside businesses or indoor public settings. People who have conditions that make “it unreasonable for the individual to maintain a face covering are exempt from the order,” Gov. Tim Walz said.
Trump said Wednesday he would make a decision over the next day on whether to mandate masks on federal property.

Major testing delays make tracing almost useless

With the high transmission levels of the virus, traditional contact tracing has now become “impractical and difficult to do,” said California Health Secretary Dr. Mark Ghaly.
The state is working to refine strategies and continue to work with counties to build up their “tracing army,” but Ghaly warns that “even a very robust contact tracing program will have a hard time reaching out to every single case.”
Contact tracing is now harder all over the nation while testing results take days, Fauci said.
Quest Diagnostics, a leading commercial testing lab, said in a news release Monday that for some patients, testing results can take up to two weeks.
“The time frame from when you get a test to the time you get the results back is sometimes measured in a few days,” Fauci said Tuesday.
“If that’s the case, it kind of negates the purpose of the contract tracing because if you don’t know if that person gets the results back at a period of time that’s reasonable, 24 hours, 48 hours at the most … that kind of really mitigates against getting a good tracing and a good isolation.”

 

 

 

Coronavirus cases could reach 150,000 a day this fall, widely followed Morgan Stanley analyst says

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Health Insurance Coverage Adequacy, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Mortality, National Strategy, Pandemic, Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

https://www.cnbc.com/2020/07/23/coronavirus-cases-could-reach-150000-a-day-this-fall-morgan-stanley-analyst-says.html

KEY POINTS
  • Morgan Stanley’s biotechnology analyst, Matthew Harrison, said 150,000 daily new U.S. coronavirus cases are possible in the fall without better control of the virus.
  • The analyst has gained a wide following on Wall Street for his success in predicting the course of the pandemic and government responses.
  • Harrison previously projected a “second wave” in the fall with daily new cases between 40,000 and 50,000 nationwide.
  • However, the recent hot spots — Arizona, Texas, Florida and California — have shown a high rate of infection, which led the analyst to adjust to a more pessimistic view on the pandemic.

The spread of the coronavirus could be elevated this fall with as many as 150,000 daily cases in the U.S., according to Morgan Stanley’s biotechnology analyst, Matthew Harrison.

“We update our scenarios to account for the higher sustained infection rate,” Harrison said in a note Thursday. “Our bull [most optimistic] case reflects similar virus control to Europe while our base [most likely] case assumes a near-term plateau followed by increased spread in the fall. [About] 150,000 daily new cases are possible without better control of the virus.”

Harrison previously projected a “second wave” in the autumn with daily new cases totaling between 40,000 and 50,000 nationwide. However, the recent emergence of hot spots — Arizona, Texas, Florida and California — has reflected a high rate of infection, which led the analyst to adjust to a more pessimistic view on the pandemic.

The analyst has gained a wide following on Wall Street for his success in predicting the course of the pandemic and government responses. For example, in April, Harrison warned that the reopening of the U.S. economy would be a slow and tedious process.

“Our assumption of a growing reproduction number, and consequently increasing daily cases, throughout the rest of the year is based on the fact that traditionally the spread of viruses is elevated in the fall compared to the summer primarily due to more people in enclosed spaces,” Harrison said.

A recent resurgence in new cases has forced a number of states to roll back their reopening plans, which weighed on the stock market that rallied massively in the second quarter on hopes for a fast economic recovery. 

Texas and Florida hit grim records earlier this week for daily coronavirus deaths based on a seven-day moving average.The virus has infected an average of 66,805 people per day in the U.S. over the past seven days, up more than 7% compared with a week ago, according to a CNBC analysis of data compiled by Johns Hopkins University.

On Wednesday, California reported a record spike in daily infections and passed New York as the U.S. state with the most confirmed infections since the pandemic began. 

To be sure, Harrison said his projection doesn’t take into account any pharmacological intervention such as vaccines or strict lockdown measures that could potentially dampen the infection rate.

There has been a slew of positive news on the vaccine front this week. The U.S. agreed to pay drugmaker Pfizer and German partner BioNTech nearly $2 billion for 100 million coronavirus vaccines if their candidate proves both safe and effective.

Meanwhile, another vaccine candidate from Oxford University and AstraZeneca showed a positive immune response in an early trial. Earlier this week, British pharmaceutical company Synairgen claimed that its new respiratory coronavirus treatment has reduced the number of hospitalized Covid-19 patients needing intensive care in a clinical trial.

Goldman Sachs biotech analyst Salveen Richter said the Covid-19 vaccine market will be similar to the flu vaccine market, which requires an annual or periodic vaccination. The analyst also cited data showing the global vaccine market will grow to at least $40 billion in 2023 from $35 billion in 2018.

 

 

Fauci on coronavirus: ‘I don’t really see us eradicating it’

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Health Policy, Herd Immunity, Honesty, Infection Control, Infection Control Plan, Infectious Virus, Integrity, Mortality, National Strategy, Pandemic, Public Health, Public Safety, Quarantine, Social Distancing, Trust, Truth, Vaccine • Leave a comment

https://thehill.com/policy/healthcare/public-global-health/508530-fauci-on-coronavirus-i-dont-really-see-us-eradicating?utm_source=Sailthru&utm_medium=email&utm_campaign=Issue:%202020-07-23%20Healthcare%20Dive%20%5Bissue:28659%5D&utm_term=Healthcare%20Dive

Anthony Fauci, the nation’s top infectious diseases expert, said Wednesday he doesn’t think COVID-19 will ever be fully eradicated but noted it can be controlled.

“I don’t see this disappearing the way SARS 1 did,” Fauci said during a livestreamed event hosted by the TB Alliance, a nonprofit focused on finding better tuberculosis treatments.

The SARS outbreak that started in 2003 lasted several months and mostly affected Asian countries before eventually vanishing. But in the process the disease sickened more than 8,000 people in 29 countries and claimed 774 lives.

Because COVID-19 is more contagious, it has had a far greater impact, with more than 15 million cases worldwide, including 618,000 deaths.

“It is so efficient in its ability to transmit from human to human that I think we ultimately will get control of it. I don’t really see us eradicating it,” Fauci said.

President Trump has repeatedly said the virus will eventually disappear, even though that is rare for most infectious diseases.

Fauci, who is a member of the White House coronavirus task force, recently responded to Trump’s characterization of him as “a little bit of an alarmist” on the pandemic by saying he prefers to think of himself as “a realist.”

During Wednesday’s interview, Fauci described ways that the U.S. can get the coronavirus under control.

“I think with a good combination of good public health measures, a degree of global herd immunity and a good vaccine, which I do hope and feel cautiously optimistic we will get, I think when you put all three of those together we will get very good control of this. Whether it’s this year or next year, I’m not certain,” he added.

“We’ll bring it down to such a low level that we will not be in the position we are right now for an extended period of time.”

 

 

 

Coronavirus numbers confusing you? Here’s how to make sense of them

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, National Strategy, Pandemic, Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

https://theconversation.com/coronavirus-numbers-confusing-you-heres-how-to-make-sense-of-them-142624?utm_medium=email&utm_campaign=Latest%20from%20The%20Conversation%20for%20July%2021%202020%20-%201683216237&utm_content=Latest%20from%20The%20Conversation%20for%20July%2021%202020%20-%201683216237+Version+A+CID_b109e0db9fc0132f981f087222693bc8&utm_source=campaign_monitor_us&utm_term=Coronavirus%20numbers%20confusing%20you%20Heres%20how%20to%20make%20sense%20of%20them

Coronavirus numbers confusing you? Here's how to make sense of them

Turn on the TV news, or look at a news website, and you’ll see charts, graphics, and dashboards that supposedly indicate the latest with COVID-19 – statistics revealing the number of tests, cases, hospitalizations and deaths, along with where they happened and whether they are rising or falling.

Different stories are told depending on the dashboard. But one thing is certain: These indicators lag behind the actions we take, or don’t take, on COVID-19. As researchers who focus on public health, we can tell you that a fully accurate, real-time snapshot of the progress of the virus isn’t possible.

Some don’t get tested

There are many reasons for this. Here’s one: diagnostic testing data are incomplete. Someone infected with COVID-19 must first come in contact with the virus either through the air or (less likely) environmental surfaces. Symptoms show between two and 14 days later. But at least 40% of those infected will never manifest symptoms, or show such mild ones they don’t even suspect they have COVID-19. So they may never get tested, which means they won’t show up in the total number of tests, or the total number of cases.

Another example: because of the lack of testing availability – a widespread problem in the U.S. since the start of the pandemic – not everyone who should be tested gets a test.

And another: the tests themselves are not perfect. Up to one-third who get a negative result may actually be infected. This happens because they are tested before they have a viral load sufficient enough for detection. Or maybe the sampling is not adequate. Or perhaps the test itself simply failed.

In Florida, people wait outside a COVID-19 testing station.

Case numbers don’t tell the full story

This is why problems arise when we use case numbers to determine disease levels in a community. Case counts actually reflect what was happening in a community weeks earlier. Four weeks, for instance, could elapse between the time a person is exposed to the virus and when they are reported as a case. Even the best testing results often take a week to report to public health authorities, and longer to appear on dashboards. Some testing results, seriously delayed, may take ten days or more.

Other factors impact the metrics. Laboratory results, often released in batches, may introduce artificial variation in case numbers. Someone who tested two days ago, then got a result back immediately, might be added on the same day as someone who was sick two weeks ago, but whose test results were delayed. To smooth out these variations, it helps to look at a rolling seven-day case average.

Hospitalization is a clearer metric for assessing the level of community disease. Those who are seriously ill, in most cases, will be hospitalized whether previously tested or not. Data suggests roughly one in five infected persons are hospitalized. Individuals seem to do okay for the first week, with more life-threatening symptoms showing in the second. That means hospitalizations represent exposures that happened three or four weeks earlier.

Again, a seven-day rolling average evens out artificial variations. There is one caveat for this: Though hospitalization is a useful metric, only about 20% of infected people need it. That means hospitalization numbers alone underestimate the number of people infected and what age groups they represent.

States vary on cause of death

The death numbers are not a reliable indicator either. In some states, to count as a COVID-19 death, the deceased must have had a test reporting positive. In other states, probable cases are reported.

As clinicians learn how to better treat COVID-19, fatality rates are dropping. Deaths, the longest lagging indicator, reflect people who were infected six or eight weeks earlier. When comparing one region to another, deaths are best expressed as rates – a ratio of deaths to population.

Another issue: News reports do not always clearly distinguish between diagnostic testing, which shows if you currently have COVID-19, and antibody testing, which shows if you had it in the past, and now harbor antibodies that can fight it. So far, however, antibody testing has not provided a useful picture of who has been infected and who has not. Once that happens, it could provide researchers and clinicians with some indicators on how widely the virus has spread.

Though the dashboards are ubiquitous on television, none of these frequently used indicators they feature is perfect. Still, taken together, they provide a reasonable approximation of COVID-19 transmission in communities. But as authorities make decisions, they should take into account the numbers are weeks old.

What does this mean to you? Understanding these limitations may help you understand your risk. We are still in the midst of a pandemic that is not under control. Being educated will help all of us from becoming a part of tomorrow’s lagging indicators.