Category Archives: Contact Tracing

U.S. Passes 2 Million Coronavirus Cases as States Lift Restrictions, Raising Fears of a Second Wave

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Communication, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Messaging, Mortality, Pandemic, Protest, Public Debate, Public Discourse, Public Health, Public Safety, Quarantine, Social Distancing, Vaccination, Vaccine, Vulnerable Populations, World Health Organization (WHO) • Leave a comment

https://www.democracynow.org/2020/6/11/dr_craig_spencer?utm_source=Democracy+Now%21&utm_campaign=a7a0b2232c-Daily_Digest_COPY_01&utm_medium=email&utm_term=0_fa2346a853-a7a0b2232c-192434661

U.S. Reaches More Than 2 Million Coronavirus Cases - YouTube

The number of confirmed U.S. coronavirus cases has officially topped 2 million as states continue to ease stay-at-home orders and reopen their economies and more than a dozen see a surge in new infections. “I worry that what we’ve seen so far is an undercount and what we’re seeing now is really just the beginning of another wave of infections spreading across the country,” says Dr. Craig Spencer, director of global health in emergency medicine at Columbia University Medical Center.

AMY GOODMAN: I certainly look forward to the day you’re sitting here in the studio right next to me, but right now the numbers are grim. The number of confirmed U.S. coronavirus cases has officially topped 2 million in the United States, the highest number in the world by far, but public health officials say the true number of infections is certain to be many times greater. Officially, the U.S. death toll is nearing 113,000, but that number is expected to be way higher, as well.

This comes as President Trump has announced plans to hold campaign rallies in several states that are battling new surges of infections, including Florida, Texas, North Carolina and Arizona — which saw cases rise from nearly 200 a day last month to more than 1,400 a day this week.

On Tuesday, the country’s top infectious disease expert, Dr. Anthony Fauci, called the coronavirus his worst nightmare.

DR. ANTHONY FAUCI: Now we have something that indeed turned out to be my worst nightmare: something that’s highly transmissible, and in a period — if you just think about it — in a period of four months, it has devastated the world. … And it isn’t over yet.

AMY GOODMAN: This comes as Vice President Mike Pence tweeted — then deleted — a photo of himself on Wednesday greeting scores of Trump 2020 campaign staffers, all of whom were packed tightly together, indoors, wearing no masks, in contravention of CDC guidelines to stop the spread of the coronavirus.

Well, for more, we’re going directly to Dr. Craig Spencer, director of global health in emergency medicine at Columbia University Medical Center. His recent piece in The Washington Post is headlined “The strange new quiet in New York emergency rooms.”

Dr. Spencer, welcome back to Democracy Now! It’s great to have you with this, though this day is a very painful one. Cases in the United States have just topped 2 million, though that number is expected to be far higher, with the number of deaths at well over 113,000, we believe, Harvard University predicting that that number could almost double by the end of September. Dr. Craig Spencer, your thoughts on the reopening of this country and what these numbers mean?

DR. CRAIG SPENCER: That’s a really good question. So, when you think about those numbers, remember that very early on, in March, in April, when I was seeing this huge surge in New York City emergency departments, we weren’t testing. We were testing people that were only being admitted to the hospital, so we were knowingly sending home, all across the epicenter, people that were undoubtedly infected with coronavirus, that are not included in that case total. So you’re right: The likely number is much, much higher, maybe 5, 10 times higher than that.

In addition, we know that that’s true for the death count, as well. This has become this political flashpoint, talking about how many people have died. We know that it’s an incredible and incalculable toll, over 100,000. Within the next few days, we’ll have more people that have died from COVID than died during World War I here in the United States. So that’s absolutely incredible.

We know that, also, just because New York City was bad, other places across the country might not get as bad, but that doesn’t mean that they’re not bad. So, we had this huge surge, of a bunch of deaths in New York City, you know, over 200,000 cases, tens of thousands of deaths. What we’re seeing now is we’re seeing this virus continue to roll across this country, causing these localized outbreaks.

And this is, I think, going to be our reality, until we take this serious, until we actually take the actions necessary to stop this virus from spreading. Opening up, like we’ve seen in Arizona and many other places, is exactly counter to what we need to be doing to keep this virus under control. So, yeah, I worry that what we’ve seen so far is an undercount and what we’re seeing now is really just the beginning of another wave of infections spreading across the country.

NERMEEN SHAIKH: Well, Dr. Spencer, I want to ask — it’s not just in the U.S. that cases have hit this dreadful milestone. Worldwide, cases have now topped 7 million, although, like the U.S., the number is likely to be much higher because of inadequate testing all over the world. But I’d like to focus on the racial dimension of the impact of coronavirus, not just in the U.S., but also worldwide. Just as one example, in Brazil — and this is a really stunning statistic — that in Rio’s favelas, more people have died than in 15 states in Brazil combined. So, could you talk about this, both in the context of the U.S., and explain whether that is still the case, and what you expect in terms of this racial differential, how it will play out as this virus spreads?

DR. CRAIG SPENCER: Absolutely. What we’re seeing, not just in the United States, but all over the world, is coronavirus is amplifying these racial and ethnic inequities. It is impacting disproportionately vulnerable and already marginalized populations.

Starting here in the U.S., if you think about the fact, in New York City, the likelihood of dying from coronavirus was double if you’re Black or African American or Latino or Hispanic, double than what it was for white or Asian New Yorkers, so we already know that this disproportionate impact on already marginalized and vulnerable communities exists here in the United States, in the financial capital of the world. It’s the same throughout the U.S. A lot of the data that we’re seeing over the past few days, as we’re getting this disaggregated data by race and ethnic background, is that it is hitting these communities much harder than it is hitting white and other communities in the United States.

The statistics that you give for Brazil are being played out all over the world. We know that communities that already lack access to good healthcare or don’t have the same economic ability to stay home and participate in social distancing are being disproportionately impacted.

That is why we need to focus on and think about, in our public health messaging and in our public health efforts, to think about those communities that are already on the margins, that are already vulnerable, that are already suffering from chronic health conditions that may make them more likely to get infected with and die from this disease. We need to think about that as part of our response, not just in New York, not just in the U.S., but in Brazil, in Peru, in Ecuador, in South Africa, in many other countries, where we’re seeing the disproportionate number of cases coming from now.

We’re seeing — you know, I think it was just pointed out that three-quarters of all the new cases, the record-high cases, over 136,000 this past weekend on one day, three-quarters of those are coming from just 10 countries. And we know that that will continue, and it will burn through those countries and will continue through many more.

As of right now, we haven’t seen huge numbers in places like West Africa and East Africa, sub-Saharan Africa, where many people were concerned about initially. Part of that is because they have in place a lot of the tools from previous outbreaks, especially in West Africa around Ebola. But it may be that we need more testing. It may be that we’re still waiting to see the big increase in cases that may eventually hit there, as well.

NERMEEN SHAIKH: Dr. Spencer, you mentioned that on Sunday — it was Sunday where there were 136,000 new infections, which was a first. It was the highest number since the virus began. But even as the virus is spreading, much like states opening in the U.S., countries are also starting to reopen around the world, including countries that have now among the highest outbreaks. Brazil is now second only to the U.S. in the number of infections, and Russia is third, and these countries are opening, along with India and so on. So, could you — I mean, there are various reasons that countries are opening. A lot of them are not able — large numbers of people are not able to survive as long as the country is closed, like, in fact, Brazil and India. So what are the steps that countries can take to reopen safely? What is necessary to arrest the spread of the virus and allow people at the same time to be out?

DR. CRAIG SPENCER: It’s tough, because we know that this virus cannot infect you if this virus does not find you. If there’s going to be people in close proximity, whether it’s in India or Illinois, this virus will pass and will infect you. I have a lot of concern, much as you pointed out, places like India, 1.3 billion people, where they’re starting to open up after a longer period of being locked down, and case numbers are steadily increasing.

You’re right that a lot of people around the world don’t have access to multitrillion-dollar stimulus plans like we do in the United States, the ability to provide at least some sustenance during this time that people are being forced at home. Many people, if they don’t go outside, don’t eat. If they don’t work, you know, their families can’t pay rent or really just can’t live.

What do we do? We rely on the exact same tools that we should be relying on here, which is good public health principles. You need to be able to locate those people who are sick, isolate them, remove them from the community, and try to do contact tracing to see who they potentially have exposed. Otherwise, we’re going to continue to have people circulating with this virus that can continue to infect other people.

It’s much harder in places where people may not have access to a phone or may not have an address or may not have the same infrastructure that we have here in the United States. But it’s absolutely possible. We’ve done this with smallpox eradication decades ago. We need to be doing this good, simple, bread-and-butter, basic public health work all around the world. But that takes a lot of commitment, it takes a lot of money, and it takes a lot of time.

AMY GOODMAN: It looks like President Trump is reading the rules and just doing the opposite — I mean, everything from pulling out of the World Health Organization, which — and if you could talk about the significance of this? You’re a world health expert. You yourself survived Ebola after working in Africa around that disease. And also here at home, I mean, pulling out of Charlotte, the Republican convention, because the governor wouldn’t agree to no social distancing, and he didn’t want those that came to the convention to wear masks. If you can talk about the significance, what might seem trite to some people, but what exactly masks do? And also, in this country, the states we see that have relaxed so much — he might move, announce tomorrow, the convention to Florida. There’s surges there. There’s surges in Arizona, extremely desperate question of whether a lockdown will be reimposed there. What has to happen? What exactly, when we say testing, should be available? And do you have enough masks even where you work?

DR. CRAIG SPENCER: Great. Yes. So, let me answer each of those. I think, first, on the World Health Organization, and really the rhetoric that is coming from the White House, it needs to be one of global solidarity right now. We are not going to beat this alone. I think that that’s been proven. This idea of American exceptionalism now is only true in that we have the most cases of anywhere in the world. We are not going to beat this alone. No country is going to beat this alone. As Dr. Fauci said, this is his worst nightmare. It’s my worst nightmare, as well. This is a virus that was first discovered just months ago, and has now really taken over the world. We need organizations like the World Health Organization, even if it isn’t perfect. And I’ve had qualms with it in the past. I’ve written about it, I’ve spoken about it, about the response as part of the West Africa Ebola outbreak that I witnessed firsthand. But at the end of the day, they do really, really good work, and they do the work that other organizations, including the United States, are not doing around the world, and that protects us. So, we absolutely, despite their imperfections, need to further invest and support them.

In terms of masks, masks may be, in addition to social distancing, one of the few things that really, really helps us and has proven to decrease transmission. We know that if a significant proportion of society — you know, 60, 70, 80% of people — are wearing masks, that will significantly decrease the amount of transmission and can prevent this virus from spreading very rapidly. Everyone should be wearing masks. I think, in the United States right now, we should consider the whole country as a hot zone. And the risk of transmission being very high, regardless of whether you’re in New York or North Dakota, people should be wearing a mask when they’re going outside and when they’re interacting with others that they generally don’t interact with.

We know the science is good. I will say that from a public health perspective, there was some initial reluctance and, really, I guess, some confusion early on about whether people should be using masks. We didn’t have a lot of the science to know whether it would help. We do now. And thankfully, we’re changing our recommendations.

We also were concerned about the availability of masks early on. As you mentioned, there was questions around availability of personal protective equipment, whether we had enough in hospitals to provide care while keeping providers safe. It’s better now, but there are still a lot of people who are saying that they’re reusing masks, that we still need more personal protective equipment. So, for the moment, everyone should be wearing a mask.

AMY GOODMAN: And for the protests outside?

DR. CRAIG SPENCER: Absolutely. Yeah, of course. Just because I think we have personal passions around public health crises, that doesn’t prevent us from being infected. From a public health perspective, of course I have concerns that people who are close and are yelling and are being tear-gassed and are not wearing masks, if that’s all the case, it’s certainly an environment where the coronavirus could spread.

So, what I’ve been telling everyone that’s protesting is exercise your right to protest — I think that’s great — but be safe. We are in a pandemic. We’re in a public health emergency. Wear a mask. Socially distance as much as you possibly can. Wash your hands.

AMY GOODMAN: And are you telling the authorities to stop tear-gassing and pepper-spraying the protesters?

DR. CRAIG SPENCER: I mean, well, one, it’s illegal. You should definitely stop tear-gassing. We know that what happens when people get tear-gassed is they cough, and it increases the secretions, which increases the risk. It increases the transmissibility of this virus.

In addition to that, you know, holding people and arresting them and putting them into small cells with others without masks is also, as we’ve seen from this huge number of cases in places like meatpacking plants or in jails, in prisons, the number of cases have been extremely high in those places. Putting people into holding cells for a prolonged period of time is not going to help; it’s definitely going to increase the transmissibility of this virus.

So, yes, everyone should be wearing a mask. I think everyone should have a mask on when you’re anywhere that your interacting with others can potentially spread this.

I think your other question was around testing. We know that right now testing has significantly increased in the U.S. Is it adequate? No, I don’t think so. I know I hear from a lot of people who say they still have to drive two to three hours to get a test. We still have questions around the reliability of some of serology tests, or the antibody tests. Those are the tests that will tell you whether or not you’ve been previously exposed and now have antibodies to the disease. Some of the more readily available tests just aren’t that great. And so, we can’t use them yet to make really widespread decisions on who might have antibodies, who might have protection and who can maybe more safely go back into society without the fear of being infected.

NERMEEN SHAIKH: Dr. Spencer, we just have 30 seconds. Very quickly, there are 135 vaccines in development. What’s your prognosis? When will there be a vaccine or a drug treatment?

DR. CRAIG SPENCER: We have one drug that shortens the time that people are sick. We don’t know about the impact on mortality. There are other treatments that are in process now. Hopefully some of them work.

In terms of vaccines, we will have a vaccine, very likely, that we know is effective, probably at some time later this year. The bigger process is going to be how do we scale it up to make hundreds of millions of doses; how do we do it in a way that we can get it to all of the people that deserve it, not just the people that can pay for it. I think these are going to be some of the bigger questions and bigger problems that we’re going to face, going forward. But I’m optimistic that we’ll have a vaccine or many vaccines, hopefully, in the next year.

AMY GOODMAN: Dr. Craig Spencer, we want to thank you so much for being with us, director of global health in emergency medicine at Columbia University Medical Center. And thank you so much for your work as an essential worker. Dr. Spencer’s recent piece, we’ll link to at democracynow.org. It’s in The Washington Post, headlined “The strange new quiet in New York emergency rooms.”

When we come back, George Floyd’s brother testifies before Congress, a day after he laid his brother to rest. Stay with us.

 

 

 

 

Cartoon – Coronavirus Projections

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Vanish Cartoons and Comics - funny pictures from CartoonStock

Scientists caught between pandemic and protests

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https://www.axios.com/black-lives-matter-protests-coronavirus-science-15acc619-633d-47c2-9c76-df91f826a73c.html

Scientists accused of double standards on coronavirus and Black ...

When protests broke out against the coronavirus lockdown, many public health experts were quick to warn about spreading the virus. When protests broke out after George Floyd’s death, some of the same experts embraced the protests. That’s led to charges of double standards among scientists.

Why it matters: Scientists who are seen as changing recommendations based on political and social priorities, however important, risk losing public trust. That could cause people to disregard their advice should the pandemic require stricter lockdown policies.

What’s happening: Many public health experts came out against public gatherings of almost any sort this spring — including protests over lockdown policies and large religious gatherings.

  • But some of the same experts are supporting the Black Lives Matter protests, arguing that addressing racial inequality is key to tackling the coronavirus epidemic.
  • The systemic racism that protesters are decrying contributes to massive health disparities that can be seen in this pandemic — black Americans comprise 13% of the U.S. population, but make up around a quarter of deaths from COVID-19. Floyd himself survived COVID-19 before he was killed by a now former police officer in Minneapolis.
  • “While everyone is concerned about the risk of COVID, there are risks with just being black in this country that almost outweigh that sometimes,” Abby Hussein, an infectious disease fellow at the University of Washington, told CNN last week.

Yes, but: Spending time in a large group, even outdoors and wearing masks — as many of the protesters are — does raise the risk of coronavirus transmission, says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

  • In a Twitter thread over the weekend, coronavirus expert Trevor Bedford estimated that each day of protests would result in some 3,000 additional infections, which over time could lead to hundreds of additional deaths each day.
  • Public health experts who work in the government have struck a cautionary note. Mass, in-person protests are a “perfect setup” for transmission of the virus, Anthony Fauci told radio station WTOP last week. “It’s a delicate balance because the reasons for demonstrating are valid, but the demonstration puts one at additional risk.”

The difference in tone between how some public health experts are viewing the current protests and earlier ones focused on the lockdowns themselves was seized upon by a number of critics, as well as the Trump campaign.

  • “It will deepen the idea that the intellectual classes are picking winners and losers among political causes,” says Tom Nichols, author of the “The Death of Expertise.”
  • Politico reported that the Trump campaign plans to restart campaign rallies in the next two weeks, with advisers arguing that “recent massive protests in metropolitan areas will make it harder for liberals to criticize him” despite the ongoing pandemic.

The current debate underscores a larger question: What role should scientists play in policymaking?

  • “We should never try to harness the credibility of public health on behalf of our judgments as citizens,” writes Peter Sandman, a retired professor of environmental journalism. He tells Axios some scientists who supported one protest versus others “clearly damaged the credibility of public health as a scientific enterprise that struggles to be politically neutral.“
  • But some are pushing back against the very idea of scientific neutrality. “Science is part of how we got to our racist system in the first place,” Susan Matthews wrote in Slate.
  • Medical science has often betrayed the trust of black Americans, who receive less, and often worse, care than white Americans. That means — as Uché Blackstock, a physician and CEO of Advancing Health Equity, told NPR — that the pandemic presents “a crisis within a crisis.”

The big picture: The debate risks exacerbating a partisan divide among Americans in their reported trust in scientists.

  • 53% of Democrats polled in late April — about a month before Floyd’s death — reported a “great deal of confidence in medical scientists to act in the public interests” versus 31% of Republicans.
  • If science-driven policymaking continues to be seen as biased, it will have repercussions for public trust in issues beyond the pandemic, including climate change, AI and genetic engineering.

What to watch: If there is a rise in new cases in the coming weeks, there will be pressure to trace them — to protests, rallies and the reopening of states. How experts weigh in could affect how their recommendations will be viewed in the future — and whether the public, whatever their political leanings, will follow them again.

 

 

 

 

US showing signs of retreat in battle against COVID-19

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Leadership Centralized, Mortality, National Strategy, Pandemic, Public Health, Public Safety, Quarantine, Social Distancing, World Health Organization (WHO) • Leave a comment

US showing signs of retreat in battle against COVID-19

COVID-19 Crisis: Political and Economic Aftershocks - Foreign ...

When throngs of tourists and revelers left their homes over Memorial Day weekend, public health experts braced for a surge in coronavirus infections that could force a second round of painful shutdowns.

Two weeks later, that surge has hit places like Houston, Phoenix, South Carolina and Missouri. Week-over-week case counts are on the rise in half of all states. Only 16 states and the District of Columbia have seen their total case counts decline for two consecutive weeks.

But instead of new lockdowns to stop a second spike in cases, states are moving ahead with plans to allow most businesses to reopen, lifting stay-at-home orders and returning to something that resembles normal life.

“There is no — zero — discussion of re-tightening any measures to combat this trend. Instead, states are treating this as a one-way trip. That sets us up for a very dangerous fall, but potentially even for a dangerous summer,” said Jeremy Konyndyk, a senior fellow at the Center for Global Development who oversaw the U.S. Agency for International Development’s Office of Foreign Disaster Assistance during the Obama administration.

The moves suggest that many Americans — anxious to end two-plus months of lockdowns, smarting from the devastating economic toll they have already suffered and focused on the social justice protests that have roiled the nation — are ready to put the coronavirus behind them.

Even as case curves bend upward again, little action has been taken to counter the reversal.

“There are places that I suspect a lot of people are shrugging their shoulders and just rushing forward,” said David Rubin, who runs the PolicyLab at Children’s Hospital of Philadelphia. “I just worry that they might lose control of their epidemic, and that’s what you have to worry about these days.”

The statistics are startling. The average number of confirmed cases over a two-week period has doubled or more in Arizona, Arkansas, Oregon and Utah. Fewer than a quarter of intensive care unit beds in Alabama, Georgia and Rhode Island are available.

In Texas, the number of people admitted to the hospital has grown 42 percent since Memorial Day. Arizona’s top health official has urged hospitals to activate their emergency plans.

North Carolina, California, Mississippi and Arkansas are all reporting record levels of hospitalizations.

Some experts worry Americans have begun to accept the drumbeat of death, numbed by the nearly 2 million cases already confirmed across the country and the 112,000 who have died.

A virus once dismissed as not a serious threat to the nation and later acknowledged as a public health emergency is now becoming just another daily worry to be absorbed.

“One fear is that the U.S. will accept tens of thousands of deaths, as from gun violence, unlike other countries,” said Tom Frieden, director of the Centers for Disease Control and Prevention during the Obama administration.

“It’s not just lives. Unless we protect lives, we won’t get livelihoods back,” said Frieden, who now runs Resolve to Save Lives, a global health nonprofit.

The race to reopen comes even as new research shows the lockdowns were working. The dramatic steps Americans took to stop the virus saved an estimated 5 million infections through April 6, according to research by the Global Policy Lab at the University of California-Berkeley.

President Trump has been perhaps the loudest proponent of reopening, at times putting pressure on states to lift coronavirus restrictions even if the data is flashing warning signs.

World Health Organization (WHO) officials have practically begged nations to be slow and considerate as they move to reopen their economies.

“We need to focus on the now. This is far from over,” Maria Van Kerkhove, the WHO’s technical lead on the coronavirus, told reporters at a virtual press conference Monday. “I know many of us would like this to be over and I know many situations are seeing positive signs. But it is far from over.”

On Wednesday, WHO’s director of emergency programs acknowledged the challenges of lockdown life.

“We fully understand that governments are very reticent to go back into lockdowns that can be damaging to social and economic life,” said Mike Ryan.

“There has to be a balance between lives and livelihoods and the public health control of COVID-19,” Ryan added.

There are few signs that Americans are heeding the warnings.

“We’re just at the beginning of the Memorial Day story, not at the end,” Rubin said. “We are seeing the sea levels rise.”

 

 

 

 

U.S. tops 2 million confirmed coronavirus cases

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

https://www.cbsnews.com/news/coronavirus-united-states-cases-2-million/

i24NEWS DESK | U.S. coronavirus cases top 2 million | Thursday ...

The number of confirmed coronavirus cases in the United States topped 2 million late Wednesday night, according to Johns Hopkins University. The mark was passed with all 50 states in various stages of re-opening and with numerous states experiencing surges in cases and severe strain on their hospitals.

It’s been just five months since the coronavirus caused its first known U.S. fatality, in California, broke out in Washington state and quickly spread around the country.

The next closest nation to the U.S. in terms of number of cases is Brazil, with some 772,000.  

The virus has killed almost 113,000 people in the U.S., Johns Hopkins said, and there were more than 7.3 million cases worldwide and 416,000 deaths.

And according to the Reuters News Service, the head of Harvard’s Global Health Institute, Ashish Jha, told CNN Wednesday that, “Even if we don’t have increasing cases, even if we keep things flat, it’s reasonable to expect that we’re going to hit 200,000 deaths sometime during the month of September. And that’s just through September. The pandemic won’t be over in September.”

Seventeen states have reported an increase in average daily new COVID-19 cases compared with two weeks ago, including Florida, California and Texas.

The ongoing pandemic has wreaked havoc on the U.S. economy. Tens of millions of people have filed for unemployment since states shut down to try to limit the virus’ spread. Several major companies, including J.C. Penney, J. Crew, Gold’s Gym and Hertz have filed for bankruptcy.

The Congressional Budget Office predicts the coronavirus could impact the nation until 2029 and cost the economy almost $16 trillion.

On Monday, White House Coronavirus Task Force officials said the police brutality protests around the country may spur a spike in virus cases. Many demonstrators haven’t been heeding public health guidelines for containing the virus, such as wearing masks and social distancing.

 

 

 

 

White House goes quiet on coronavirus as outbreak spikes again across the U.S.

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Dept of Health and Human Services (HHS), Economic Crisis, Economic Stimulus, Economy Reopening, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employee Protections, Expert, Expert Opinion, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, National Strategy, Pandemic, Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Transparency, Trust, Truth • Leave a comment

https://www.politico.com/news/2020/06/10/white-house-stops-talking-about-coronavirus-309993?utm_source=ActiveCampaign&utm_medium=email&utm_content=Mnuchin%3A+More+Stimulus++Definitely++Needed&utm_campaign=TFT+Newsletter+06102020

White House goes quiet on coronavirus as outbreak spikes again ...

The coronavirus is still killing as many as 1,000 Americans per day — but the Trump administration isn’t saying much about it.

It’s been more than a month since the White House halted its daily coronavirus task force briefings. Top officials like infectious disease expert Anthony Fauci have largely disappeared from national television — with Fauci making just four cable TV appearances in May after being a near fixture on Sunday shows across March and April — and are frequently restricted from testifying before Congress. Meanwhile, President Donald Trump is preparing to resume his campaign rallies after a three-month hiatus, an attempted signal to voters that normalcy is returning ahead of November’s election, and that he’s all but put the pandemic behind him.

“We’ve made every decision correctly,” Trump claimed in remarks in the Rose Garden Friday morning. “We may have some embers or some ashes or we may have some flames coming, but we’ll put them out. We’ll stomp them out.”

Inside the White House, top advisers like Jared Kushner privately assured colleagues last month that the outbreak was well in hand — citing data on declines in community spread — and that the long-feared “second wave” may have even been averted, according to three current and former officials.

However, new data from states like Florida and mass protests across the country are renewing concerns about the virus’s spread. Texas, for instance, has reported two straight days of record-breaking coronavirus hospitalizations — highs that come shortly after the state kicked off the third stage of its reopening plan.

Those officials also acknowledge that the Covid-19 task force has scaled back its once-daily internal meetings — the task force now meets twice per week — but insist that the pandemic response remains a priority. One official with direct knowledge of the administration’s strategy cited efforts to scale up testing, accelerate the development of treatments and vaccines and perform other behind-the-scenes work to get ready for a potential fall surge.

“We’re delivering the supplies and resources that states asked for,” said the official. “This doesn’t need to be the public ‘coronavirus show’ every day anymore.”

“You can’t win,” said a senior administration official. “Some people complained for weeks that ‘we don’t want so much White House involvement,’ and that ‘the President should stop doing daily briefings,’ and then they turn around and complain that there aren’t enough or as many briefings.”

But the White House’s apparent eagerness to change the subject comes as new coronavirus clusters — centered around meatpacking plants, prisons and other facilities — drive spikes in disparate states like Utah and Arkansas. Meanwhile, states and major cities are lifting lockdowns and reopening their economies, prompting public health experts to fret that additional outbreaks are imminent. And several Democratic governors also have defied their own states’ social distancing restrictions to join mass protests over police brutality, where hundreds of thousands of Americans have spilled into the streets, further raising public health risks.

The fear is that all the mixed signals will only confuse people, stoke public skepticism over the health threat and promote the belief the worst is over just as the outbreak enters a dangerous new phase.

“Cases are rising, including from cases in congregate settings,” said Luciana Borio, who led pandemic preparedness for the National Security Council between 2017 and 2019. “We still have a pandemic.”

Nine current and former administration officials, as well as outside experts, further detailed how the White House is steadily ramping down the urgency to fight a threat that continues to sicken more than 100,000 Americans per week and is spiking in more than 20 states.

For instance, the administration in recent days told state health officials that it planned to reorganize its pandemic response, with HHS and its agencies taking over the bulk of the day-to-day responsibilities from the Federal Emergency Management Agency.

“The acuity of the response is not what it was, so they’re trying to go back to a little more of a normal ongoing presence,” said Marcus Plescia, the chief medical officer of the Association of State and Territorial Health Officials.

The coronavirus task force, which used to send daily updates to state officials, has done so with less regularity over the last several weeks, Plescia said. And the CDC has restructured its daily conference calls with states, moving away from the practice of giving top-down briefings to encouraging state officials to offer updates on what they’re seeing in their parts of the country.

One current and one former FEMA official also said they’re keen to have HHS resume its leadership role in containing the coronavirus so FEMA can make contingencies for a summer of hurricanes, floods and other natural disasters.

“Given the likelihood that we will soon see both hurricanes and coronavirus, HHS should manage the ongoing pandemic response so FEMA can prepare for coming ‘coronacanes,’” Daniel Kaniewski, who served as the top deputy at FEMA through January, wrote last week. “But they need to act soon. Coronacanes are in the forecast.”

Meanwhile, officials in at least 19 states have recorded two-week trends of increasing coronavirus cases, including spikes of more than 200 percent in Arizona and more than 180 percent in Kentucky. Two months after the White House issued so-called gating criteria that it recommended states hit before resuming business and social activities, only a handful of states — like Connecticut, New Jersey, New York and South Dakota — currently meet all of those benchmarks, according to CovidExitStrategy.org.

Officials within Trump’s health department are strategizing over how to convey the current level of risk, given data that Americans have put off emergency care and other potential medical needs, fearful of contracting Covid-19. “Our message now is that people should start returning to their health care providers to get the screenings, vaccines, care, or emergency services that they need,” Laura Trueman, the HHS official in charge of external affairs, wrote in an office-wide email to colleagues and shared with external groups on June 3, which was obtained by POLITICO.

Dan Abel, a longtime Coast Guard vice admiral, also has been installed at HHS with a small team, where he’s coordinating daily Covid-19 calls with HHS Secretary Alex Azar and the department’s division leaders, according to four officials with knowledge of the calls — an arrangement that’s raised some questions.

“Why is a Coast Guard admiral leading meetings between the HHS secretary and his senior staff?” asked one senior official, suggesting it created an unnecessary layer of management.

Meanwhile, the department is steadily turning back to its many pre-Covid-19 priorities. At the Food and Drug Administration, officials are returning to hot-button issues like tobacco and CBD regulations. Some staff in the health department’s emergency response arm are pivoting away from Covid-19 and back toward natural disasters as hurricane season begins.

At the same time, the Centers for Disease Control — traditionally the beating heart of the nation’s infectious disease response — remains largely demoralized and often sidelined in fighting what CDC director Robert Redfield last week acknowledged as the nation’s biggest health challenge in more than a century, and one he said is “moving through our social consciousness, our outward expression, and our grief.” That grim message has conflicted with Trump’s frequent vows of victory over the coronavirus.

“We were able to close our country, save millions of lives, open,” Trump said in Friday’s Rose Garden remarks. “And now the trajectory is great.”

“I fully recognize the anguish our Nation is experiencing & am deeply saddened by the many lives lost to COVID19,” Redfield tweeted just minutes later. “I call upon the American people to remain vigilant in protecting the vulnerable – protect your community, grandparents and loved ones from COVID-19.”

Redfield and other top officials also have spent the past week reckoning with the implications of widespread protests over police brutality, from meeting with staff to discuss longstanding concerns about systemic racism in health care to acknowledging the probability that those protests will spark new outbreaks.

HHS also on Monday sent members of Congress a fact sheet on its response to racial disparities in Covid-19 care — a much scrutinized issue in public health, with African Americans contracting and dying from the virus at much higher rates.

But on Capitol Hill, watchdogs say that fact sheets don’t cut it, and they’re frustrated by the lack of access to experts and insight into how the administration is handling a historic pandemic.

“Some are acting like the battle has been won when in reality it’s just beginning,” said a senior Democratic staffer. “The White House still won’t let task force members testify at hearings in June even though they have disappeared from TV and it’s not clear how often they are meeting.”

Fauci, meanwhile, has continued to issue a string of dire warnings in his lower-profile media appearances and at an industry conference on Tuesday.

“We have something that turned out to be my worst nightmare,” Fauci said in virtual remarks aired at a conference of the biotech industry’s Washington trade group, recounting how quickly the virus spread around the globe, outpacing Ebola and HIV. “And it isn’t over yet.”

The White House has maintained that chief of staff Mark Meadows has needed to clear officials like Fauci to testify, so they can stay focused on other priorities, and a spokesperson insisted that Trump has still prioritized the coronavirus fight even as the White House shifts toward focusing on revitalizing the economy.

Several officials have suggested that the task force’s lower profile has been helpful for the response, especially because the daily Covid-19 press briefings were often hijacked by Trump’s meandering remarks or the day’s other political news.

“In some ways, it actually has been easier to get Covid-related work done,” said one HHS staffer who’s helped support the Covid-19 response. “The task force briefings and the prep sessions for them took up a lot of principals’ time, and staff would sometimes have to crash on putting together materials for them.”

But the white-hot spotlight on the coronavirus also brought urgency and intensity, and the increasingly scattered nature of the current response could present new challenges if there’s an uptick in cases.

“This is when a one-government approach is needed more now than ever,” said Howard Koh, who served as President Barack Obama’s HHS assistant secretary for health. “Get all those people together in one room every day at the highest level and track outcomes and address all the questions and try to maximize coordination as much as possible.”

 

 

 

 

Protests essential despite risk of coronavirus spread, healthcare workers say

Posted on by • Posted in Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Free Speech, Freedom, Freedom of the Press, Infection Control, Infection Control Plan, Infectious Virus, Justice, Mortality, Pandemic, Police Brutality, Police Violence, Protest, Public Debate, Public Discourse, Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

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After months of pleading for social distancing, health officials ...

Though the protests that erupted after a black man died in police custody might result in spikes of COVID-19, some healthcare workers say that they are important, as racial disparities in healthcare is also a public health issue, according to The Wall Street Journal.

Public health experts and healthcare workers across the country are joining in the protests that began after George Floyd died at the hand of police in Minneapolis in late May. He is the most recent example of police brutality against black people and joins a long list of deaths of African Americans in police custody.

Healthcare experts and workers are saying though the protests may result in a new wave of coronavirus cases, the issue at hand is more important and the potential benefits outweigh the risks, especially since the risk of transmission is lower outside than inside when precautions are taken.

Darrell Gray, MD, a black gastroenterologist at the Ohio State University Wexner Medical Center in Columbus, has been attending protests, telling the Journal, “I prioritize being at protests and peaceful demonstrations because I strongly believe that they can be leveraged to produce change.” He said that he is taking precautions, wearing a face mask and distancing himself as much as possible.

Dr. Gray also said that the pandemic has disproportionately affected black communities, as the underlying conditions that are linked to more severe COVID-19 illness, such as diabetes and high blood pressure, are more rampant in those communities.

Jennifer Nuzzo, DrPH, an epidemiologist and senior scholar at the Johns Hopkins Center for Health Security in Baltimore, also supports the protests, though she has not been able to attend one in person as yet due to time constraints.

She told the Journal although she is worried about virus transmission, “there are some categories of risk that are, for me, completely worth it.” These protests are in those categories, she said.

Dr. Nuzzo and other health experts have also said protesters can reduce the risk of transmission by wearing masks, trying to maintain 6 feet of social distance when possible and making sure they are washing their hands often or using hand sanitizer.

More than 1,000 public health and infectious disease experts and community stakeholders signed an open letter last week saying that demonstrations were important for combating race-based health inequities, largely a result of racism, the Journal reports.

 

 

COVID-19 activity by region: Cases ramp up in rural areas

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

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Coronavirus Timeline: March 2020 | WATE 6 On Your Side

Progress on containing COVID-19’s spread continues to vary drastically across regions, states and cities.

As the incubation period for COVID-19 is up to 14 days, most states have yet to report a potential surge in cases linked to nationwide protests against police violence.

What’s clear is the pandemic is loosening its grasp on major urban areas and ramping up in more rural areas, according to The Washington Post. Cases have increased in at least 22 states over the past two weeks, according to a June 9 analysis by The New York Times. Fourteen states have also had a record-high seven-day average of new coronavirus cases since June 1, according to data tracked by the Post.

Below is a snapshot of what COVID-19’s spread looks like across the U.S., as of June 9.

West

More COVID-19 cases have been confirmed in Oregon over the past week than any other time since the pandemic began, according to data from the Oregon Health Authority. The state reported 620 confirmed or presumed infections in the past week, with the state’s largest daily case total reported June 7 at 146 cases. The spike began the week ending May 31, when new COVID-19 cases in Oregon increased by 18 percent (353 cases) compared to the previous week. Between June 5-8, 26 counties in Oregon were able to enter Phase 2 of reopening, KGW reported.

COVID-19 cases in California hit 3,094 new daily cases June 5, the state’s second highest daily count after 3,705 cases reported May 30. Recently, some counties have resisted Gov. Gavin Newsom’s distancing orders and reopened sections of the economy, according to The Guardian.

Washington reported 442 new confirmed cases of COVID-19 on June 6, the most daily cases since April 10, according to KOMO News. The state has acquired sufficient supplies to expand COVID-19 testing and better monitor Washington’s 39 counties as they ease social distancing restrictions, Gov. Jay Inslee said June 4, according to The Seattle Times. As of June 8, all employees in the state must wear face coverings, with some exceptions for certain jobs or individuals with medical conditions, according to King 5.

Southwest

COVID-19 cases hit record-high numbers in Arizona in late May. The state reported more than 700 cases daily between May 26-29, the largest single-day increases seen since the pandemic started. However, known deaths have been decreasing since late May, with less than 10 deaths occurring daily between May 29 and June 2. On June 6, Cara Christ, MD, Arizona Department of Health Services director, sent a letter to hospitals urging them to “fully activate” emergency plans, according to AZ Central.

Meanwhile, COVID-19 cases and deaths are steadily increasing in Texas. The state reported 1,949 new cases May 31, marking the highest single-day increase seen since the pandemic’s start. Texas also reported a record number of related hospitalizations, with 1,935 people admitted June 8. Ten counties are reporting increased case counts because of testing at prisons or meatpacking plants, according to the Texas Department of State Health Services. On June 3, Gov. Greg Abbott announced the third phase of reopening, which includes increasing capacity and opening additional businesses and activities.

Nevada reported 194 new cases June 5, marking the largest single-day increase seen since May 22, when the state saw a record 255 cases. The cumulative death toll has also been rising since the start of the pandemic, although the state reported no new deaths between June 5 and June 7.

Northeast

New York reported 35 COVID-19 deaths June 5 — the lowest figure seen in eight weeks, according to The New York Times. The daily death toll has been steadily declining since New York reported nearly 800 deaths daily in late March and early April, according to state data. New York also reported a record-low number of hospitalizations last week.

The number of new cases, deaths and hospitalizations have significantly fallen in New Jersey since April. The state reported 356 new cases June 8, representing the 10th consecutive day in which new cases remained under 1,000. The state is set to enter phase 2 of its reopening June 15, which will allow restaurants to offer outdoor dining and nonessential businesses to open at half capacity, according to nj.com.

Massachusetts reported a large spike in new COVID-19 cases June 1 after conducting a retrospective review of state data since March 1. Of the 3,840 new cases reported, 3,514 were newly probable and 326 were newly confirmed, according to Boston 7 News. Overall, the state has seen a sustained decline in new cases throughout May, according to a New York Times analysis.

Southeast

Florida saw a large spike in new COVID-19 infections last week amid a steady increase in testing capacity. After reporting just 606 cases June 1, Florida had more than 1,000 new infections daily between June 3 and June 7. This marks the state’s longest sustained increase since early April. The state also reported 1,419 new infections June 4 — the largest single-day increase seen since the Florida health department started publishing COVID-19 data in March, according to the Miami Herald.

COVID-19 hospitalizations started falling in Mississippi in early June. However, the state reported a record 498 new cases June 8, the highest single-day increase seen since May 30 when 439 cases were reported, according to the Sun Herald.

North Carolina reported 1,370 new cases June 6, the highest daily increase seen during the pandemic, according to WSOC-TV. The previous record was set just a day prior when the state saw 1,289 new cases. North Carolina also reported 739 hospitalizations June 8, surpassing the previous record of 717 hospizaltions reported June 5, according to The News & Observer.

Midwest

Wisconsin reported no new COVID-19 deaths June 8 for the first time since May 17, reports CBS affiliate WSAW-TV. The number of people hospitalized with the virus also fell to a three-week low June 3, according to Urban Milwaukee. The state reported 203 new cases June 8, down from 733 on May 29. Wisconsin also performed a record 16,451 tests June 3, of which 483 were positive.

The rate of new COVID-19 cases and the number of people requiring intensive care continues to decline in Minnesota. The state reported 388 new infections June 7, the second-lowest daily increase since April 28, according to the StarTribune. In addition, 199 patients were being treated for COVID-19 in ICUs, marking the lowest total since May 13.

 

 

 

 

Coronavirus Live Updates: W.H.O. Walks Back Claim That Asymptomatic Transmission is Rare

Posted on by • Posted in Clinical Testing, Contact Tracing, Coronavirus, Economy Reopening, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Supply Chain, World Health Organization (WHO) • Leave a comment

Virus spreaders who never show symptoms 'very rare,' WHO says ...

Seven million people have been infected worldwide, and new cases hit a high globally on Sunday, according to the W.H.O. Central banks are seeking new tools to offset the downturn.

RIGHT NOW

New Jersey’s governor said on Tuesday that he was lifting the stay-at-home order that he issued in March. “With more and more of our businesses reopening, we’re no longer requiring you to stay at home,” he said.

The W.H.O. walked back an earlier assertion that asymptomatic transmission is ‘very rare.’

A top expert at the World Health Organization on Tuesday walked back her earlier assertion that transmission of the coronavirus by people who do not have symptoms is “very rare.”

Dr. Maria Van Kerkhove, who made the original comment at a W.H.O. briefing on Monday, said that it was based on just two or three studies and that it was a “misunderstanding” to say asymptomatic transmission is rare globally.

“I was just responding to a question, I wasn’t stating a policy of W.H.O. or anything like that,” she said.

Dr. Van Kerkhove said that the estimates of transmission from people without symptoms come primarily from models, which may not provide an accurate representation. “That’s a big open question, and that remains an open question,” she said.

Scientists had sharply criticized the W.H.O. for creating confusion on the issue, given the far-ranging public policy implications. Governments around the world have recommended face masks and social distancing measures because of the risk of asymptomatic transmission.

A range of scientists said Dr. Van Kerkhove’s comments did not reflect the current scientific research.

“All of the best evidence suggests that people without symptoms can and do readily spread SARS-CoV-2, the virus that causes Covid-19,” scientists at the Harvard Global Health Institute said in a statement on Tuesday.

“Communicating preliminary data about key aspects of the coronavirus without much context can have tremendous negative impact on how the public and policymakers respond to the pandemic.”

A widely cited paper published in April suggested that people are most infectious about two days before the onset of symptoms, and estimated that 44 percent of new infections are a result of transmission from people who were not yet showing symptoms.

Dr. Van Kerkhove and other W.H.O. experts reiterated the importance of physical distancing, personal hygiene, testing, tracing, quarantine and isolation in controlling the pandemic.

The debate over transmission erupted a day after the W.H.O. said that cases had reached a new single-day global high — 136,000 on Sunday, with three-quarters in just 10 countries, mostly in the Americas and South Asia. The coronavirus has already sickened more than seven million people worldwide and killed at least 405,400, according to a New York Times database.

The Pan American Health Organization said on Tuesday that 3.3 million people in South and Central America have been infected with the coronavirus. Dr. Carissa F. Etienne, the agency’s director, said that many areas are experiencing exponential growth in infections and death.

In India, health experts are warning of a looming shortage of hospital beds and doctors to treat patients as the country grapples with a sharp surge of infections. India reported 10,000 new infections in the past 24 hours, for a total of at least 266,500, and has surpassed Spain to become one of the five countries with the highest caseloads.

Rajnish Sinha, the owner of an event management company in Delhi, struggled to find a hospital bed for his 75-year-old father-in-law, who tested positive for the virus on Tuesday.

“This is just the beginning of the coming disaster,” Mr. Sinha said. “Only God can save us.”

 

 

 

 

How Many More Will Die From Fear of the Coronavirus?

Posted on by • Posted in Centers for Disease Control & Prevention (CDC), Chronic Care Management, Chronic Conditions, Clinical Testing, Contact Tracing, Coronavirus, Deferred Healthcare, Emergency Care, Employer-Based Health Insurance, Fear, Health Insurance Coverage Adequacy, Health Policy, Health System, High Deductible Health Plans, Hospital, Hospital Industry, Infection Control, Infection Control Plan, Infectious Virus, Mortality, Office Visit, Out of Pocket Expenses, Pandemic, Physician, Preexisting Conditions, Preventable Disease, Preventative Care, Public Health, Public Safety, Quarantine, Social Distancing, Telemedicine, Underinsured, Unemployment, Unemployment Insurance, Uninsured, Unintended Consequences, Virtual Healthcare, Virtual Visit • Leave a comment

Fear of contracting the coronavirus has resulted in many people missing necessary screenings for serious illnesses, like cancer and heart disease.

Seriously ill people avoided hospitals and doctors’ offices. Patients need to return. It’s safe now.

More than 100,000 Americans have died from Covid-19. Beyond those deaths are other casualties of the pandemic — Americans seriously ill with other ailments who avoided care because they feared contracting the coronavirus at hospitals and clinics.

The toll from their deaths may be close to the toll from Covid-19. The trends are clear and concerning. Government orders to shelter in place and health care leaders’ decisions to defer nonessential care successfully prevented the spread of the virus. But these policies — complicated by the loss of employer-provided health insurance as people lost their jobs — have had the unintended effect of delaying care for some of our sickest patients.

To prevent further harm, people with serious, complex and acute illnesses must now return to the doctor for care.

Across the country, we have seen sizable decreases in new cancer diagnoses (45 percent) and reports of heart attacks (38 percent) and strokes (30 percent). Visits to hospital emergency departments are down by as much as 40 percent, but measures of how sick emergency department patients are have risen by 20 percent, according to a Mayo Clinic study, suggesting how harmful the delay can be. Meanwhile, non-Covid-19 out-of-hospital deaths have increased, while in-hospital mortality has declined.

These statistics demonstrate that people with cancer are missing necessary screenings, and those with heart attack or stroke symptoms are staying home during the precious window of time when the damage is reversible. In fact, a recent poll by the American College of Emergency Physicians and Morning Consult found that 80 percent of Americans say they are concerned about contracting the coronavirus from visiting the emergency room.

Unfortunately, we’ve witnessed grievous outcomes as a result of these delays. Recently, a middle-aged patient with abdominal pain waited five days to come to a Mayo Clinic emergency department for help, before dying of a bowel obstruction. Similarly, a young woman delayed care for weeks out of a fear of Covid-19 before she was transferred to a Cleveland Clinic intensive care unit with undiagnosed leukemia. She died within weeks of her symptoms appearing. Both deaths were preventable.

The true cost of this epidemic will not be measured in dollars; it will be measured in human lives and human suffering. In the case of cancer alone, our calculations show we can expect a quarter of a million additional preventable deaths annually if normal care does not resume. Outcomes will be similar for those who forgo treatment for heart attacks and strokes.

Over the past 12 weeks, hospitals deferred nonessential care to prevent viral spread, conserve much-needed personal protective equipment and create capacity for an expected surge of Covid-19 patients. During that time, we also have adopted methods to care for all patients safely, including standard daily screenings for the staff and masking protocols for patients and the staff in the hospital and clinic. At this point, we are gradually returning to normal activities while also mitigating risk for both patients and staff members.

The Covid-19 crisis has changed the practice of medicine in fundamental ways in just a matter of months. Telemedicine, for instance, allowed us to pivot quickly from in-person care to virtual care. We have continued to provide necessary care to our patients while promoting social distancing, reducing the risk of viral spread and recognizing patients’ fears.

Both Cleveland Clinic and Mayo Clinic have gone from providing thousands of virtual visits per month before the pandemic to hundreds of thousands now across a broad range of demographics and conditions. At Cleveland Clinic, 94 percent of diabetes patients were cared for virtually in April.

While virtual visits are here to stay, there are obvious limitations. There is no substitute for in-person care for those who are severely ill or require early interventions for life-threatening conditions. Those are the ones who — even in the midst of this pandemic — must seek the care they need.

Patients who need care at a clinic or hospital or doctor’s office should know they have reduced the risk of Covid-19 through proven infection-control precautions under guidelines from the Centers for Disease Control and Prevention. We’re taking unprecedented actions, such as restricting visiting hours, screening patient and caregiver temperatures at entrances, encouraging employees to work from home whenever possible, providing spaces that allow for social distancing, and requiring proper hand hygiene, cough etiquette and masking.

All of these strategies are intended to significantly reduce risk while allowing for vital, high-quality care for our patients.

The novel coronavirus will not go away soon, but its systemic side effects of fear and deferred care must.

We will continue to give vigilant attention to Covid-19 while urgently addressing the other deadly diseases that haven’t taken a pause during the pandemic. For patients with medical conditions that require in-person care, please allow us to safely care for you — do not delay. Lives depend on it.