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Prosecuting the case against the COVID response

https://mailchi.mp/647832f9aa9e/the-weekly-gist-august-14-2020?e=d1e747d2d8

Bruce Plante Cartoon: Corona virus denial

This week, in her debut as running mate to presidential candidate Joe Biden, California Sen. Kamala Harris gave a preview of one of the Democratic ticket’s key arguments for the fall campaign, making a full-throated, prosecutorial case against the Trump administration’s handling of the coronavirus pandemic.

“The virus has impacted almost every country,” Harris said, “but there’s a reason it has hit America worse than any other advanced nation. It’s because of Trump’s failure to take it seriously from the start.

After receiving a briefing from public health experts on Thursday, Biden and Harris argued for a more comprehensive, aggressive national strategy to battle the virus, including major federal investment in contact tracing, a national mask mandate, and guaranteed free access to a COVID vaccine when it becomes available.

The remarks came as the US experienced the deadliest day of the summer so far, with nearly 1,500 COVID fatalities on Wednesday, and a seven-day rolling average of over 1,000 deaths per day for the last 17 days. Meanwhile, a new analysis by the New York Times, using data from the Centers for Disease Control and Prevention (CDC), indicated that the true US death toll from COVID may be as much as 35 percent higher than the reported total of 167K—a finding based on “excess deaths” above normal levels since March.

As President Trump continued to urge schools to reopen for in-person instruction nationwide, the White House released new guidance for ensuring students’ safe return to school. The guidance encouraged social distancing, frequent handwashing, better ventilation of school facilities, and the use of outdoor settings wherever possible.

Despite the President’s claim last week that children are “virtually immune” from the virus, a new analysis from the American Academy of Pediatrics and the Children’s Hospital Association showed that 97,000 children tested positive for COVID in the last two weeks of July alone, a 40 percent increase in the total number of known cases over that period.

About 340,000 children have tested positive so far, representing about 9 percent of all US cases. As schools face pressure to reopen, those numbers are likely to mount, and early-opening school districts in Georgia, Tennessee, Indiana, and Mississippi are already struggling to keep schools open amid rising cases.

Federal assistance to help schools deal with what seems like inevitable rounds of positive cases and closures is not forthcoming, however: after failing to reach a deal on another round of COVID relief, lawmakers have left Washington until September.

US coronavirus update: 5.2M cases; 167K deaths; 64.6M tests conducted.

 

 

 

COVID-19 long haulers on months of debilitating symptoms: ‘They don’t know how to make me better’

https://www.yahoo.com/lifestyle/covid-19-long-haulers-debilitating-symptoms-210633981.html

COVID-19 'long-haulers' complain of symptoms lasting weeks and ...

SARS-CoV-2, the virus that causes COVID-19, has prompted more questions than science can answer. But of the many puzzles that remain, few are more perplexing — or urgent — than this one: Why do some people get sick and never get better?

This group of individuals, nicknamed the “long haulers,” are people of all ages, races and genders. Survivors of the virus who, months later, find themselves battling a constellation of debilitating side effects that disrupt their ability to function. In a study released by Indiana University School of Medicine this August, in partnership with COVID-19 nonprofit Survivor Corps, long haulers describe nearly 100 side effects, from fatigue and body aches to night sweats and neuropathy.

The study casts doubt on the idea that the COVID-19 is a respiratory illness that lasts only a few weeks, suggesting instead that it may be a vascular disease capable of wreaking havoc on the eyes, skin, heart and brain, long after the sore throat goes away. While some hospitals, such as Mount Sinai in New York, have launched recovery centers for post-COVID care, the Centers for Disease Control and Prevention has released little data on the longterm prognosis for those who survive.

In the interim, it’s the long haulers themselves who are helping demystify their strange new world. Karyn Bishof, a firefighter paramedic in Florida, is one of them. After coming down with sore throat, nausea and fatigue in late March, she tested positive for COVID-19 and was told her case was mild. But as the weeks went on, the symptoms didn’t go away. Over four months later, the fatigue remains constant and along with it, a host of other exhausting side effects.

“I’m dealing with drastic changes in heart rate … My oxygen levels drop into the low 90, sometimes even the low eighties, I’m still dealing with headache, memory issues. I have a lot of trouble recalling things or sometimes finding my words,” Bishof tells Yahoo Life. “I’m still dealing with a runny and stuffy nose on and off. And then just a ton of other neurological issues, cardiac issues, chest pain, shortness of breath. I mean, the list goes on.”

Jessica Hulett, a writer in New York, has been battling similar effects. “The fatigue has been really persistent … All I want to do is go to sleep from like two o’clock on every day, and some days I have to,” says Hulett. “I’ve also started having a lot of like cognitive difficulties. Like I can’t remember things, I can’t focus on things.

Both Hulett and Bishof have struggled to find answers from doctors about what’s happening. “I’ve been talking a lot to my primary care doctor … she has kind of admitted, she’s like, ‘We don’t know, like we don’t know how long you’re going to be sick,’” says Hulett. “We don’t know what’s gonna make you better. We don’t know why you’re still sick.”

Luis Santos, a native-New Yorker who’s been experiencing “crushing fatigue,” cognitive issues and an unexplained spike in his cholesterol since getting COVID-19 in March, is too. “I have a team of about seven or eight doctors … and it’s a very scary thing that all these physicians are saying they don’t know. They don’t know how to make me better,” says Santos. “They’re hoping that with time they get better.”

Natalie Lambert, an associate research professor at IU School of Medicine and the lead author of the long haulers study, says this reaction is common. “I feel like this is a huge problem in health care around the world...We’re just kind of a society where you’re healthy until you can prove that you’re sick,” Lambert tells Yahoo Life. “If you’re experiencing something that’s outside of the standard of medical care, it can be really hard to get answers.”

Lambert, who began talking to patients after seeing a “wide range of COVID-19 symptoms” early on, says she doesn’t blame doctors for the gap in knowledge. “They can only treat you with the appropriate and approved standard treatments,” says Lambert. “They can’t experiment on people — so it’s understandable. But if there’s no answer to your question, what can you do?”

Survivor Corps, a grassroots movement connecting COVID-19 survivors, is trying to figure out just that — hosting webinars, sharing research and creating a Facebook group nearly 100,000 people strong. It’s from this group that Lambert pulled information about side effects, using an open-ended survey that allowed long haulers to add their symptoms.

She says the importance of these individuals, and their stories, can’t be overstated. “They are the world’s experts in the disease at this point in time,” Lambert tells Yahoo Life. “I mean, these patients know more about the disease than the medical community does.”

She hopes her research will serve as validation to long haulers — and proof that they’re not alone. “If you’re experiencing any of these symptoms, lots of people are experiencing these symptoms,” says Lambert. “And if your doctor won’t treat them, continue to advocate for yourself to try to get medical care because some of these can result in very serious health consequences.”

When it comes to the long haulers themselves, they’re urging others not to overlook the seriousness of this virus. “Right now the science for long haulers is showing that [COVID-19] doesn’t care about your age. It doesn’t care about your fitness level,” says Bishof. “It doesn’t care if you’re a firefighter-paramedic, or if you work on your computer from home … Do everything you can to protect yourself and others. This is not just a cold or a flu.”

 

 

 

Cash-Pinched Hospitals Press Congress to Break Virus Fund Logjam

https://news.bloomberglaw.com/health-law-and-business/cash-pinched-hospitals-press-congress-to-break-virus-fund-logjam

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Hospital groups are pressing Congress to put more money into a relief fund for hospitals and providers, even as labor data showed signs of a turnaround for the health-care industry last month.

Congressional leaders are at a standstill over the next coronavirus-relief package and it could be weeks until lawmakers vote on legislation. Hospital groups have said the $175 billion Congress already approved has been a crucial lifeline to keep hospitals from laying off more staff or potentially closing. Some are worried the money may start to run dry soon.

The coronavirus is prompting many Americans to delay health care, and further funding delays exacerbate the need for assistance, the hospitals warn. Some providers that shed jobs earlier in the pandemic have begun adding them back, but employment levels remain far below where they once were.

“The longer we are in the pandemic the more clear it becomes that this is not going to be a short-term issue,” Beth Feldpush, senior vice president of policy and advocacy at America’s Essential Hospitals, said.

Leaders of both parties back more federal funding to help hospitals and doctors’ offices stay in business. Democrats proposed $100 billion for the industry, as hospital groups such as AEH sought, in virus-relief legislation (H.R. 6800) the House passed earlier this year. Republicans included $25 billion in their counterproposal.

The Health and Human Services Department has promised about $115 billion of the $175 billion in relief Congress approved this year to help health-care providers offset their Covid-19-related losses, according to agency data. That leaves the industry with about $60 billion left.

The U.S. exceeded 5 million confirmed Covid-19 cases Aug. 9, according to data from Bloomberg News and Johns Hopkins University, more than any other country. Almost 165,000 people in the U.S. have died from the virus.

Industry Impact

The health-care industry added more than 126,000 jobs in July, according to data released last week by the Bureau of Labor Statistics. Dentist offices and hospitals, the section of the industry that was laying off tens of thousands of people in April and May, accounted for more than 70,000 of those new jobs.

Still, there were 797,000 fewer health-care jobs compared to before the pandemic, according to BLS.

The virus hit parts of the heath-care industry unevenly. Large health systems such as HCA Healthcare Inc. and Universal Health Services Inc. posted better-than-expected profits for the second quarter of 2020.

Some hospitals that didn’t have much cash-on-hand to start the year are struggling with lower profits and may need added relief if the virus continues to keep Americans from seeking care, industry watchers said.

“No hospital is going to come out of this year better than they were in prior years,” Suzie Desai, senior director for S&P Global Rating’s Not-for-Profit Health Care group, said.

The federal relief funds helped buoy hospitals this year, hospital groups argue. The American Hospital Association estimates that without relief funds, hospitals margins would have been down 15% and could be down 11% at the end of 2020 if the virus continues to spread at its current pace.

The AHA estimated losses for the nation’s hospitals and health systems will reach $323 billion this year.

 

 

U.S. records deadliest coronavirus day of the summer

https://www.axios.com/1485-us-coronavirus-death-record-5ee493cc-df91-4549-8c9d-43a5fee0bd87.html

U.S. records deadliest coronavirus day of the summer - Axios

The U.S. reported 1,485 deaths due to the coronavirus on Wednesday, COVID Tracking Project data shows.

Why it matters: It’s the highest single-day COVID-19 death toll since May 15, when the country reported 1,507 deaths. The U.S. has seen a total of 157,758 deaths from the virus.

The big picture: Georgia reported 109 deaths on Wednesday — its second triple-digit day in a row.

Go deeper: 5 states set single-day coronavirus case records last week

 

 

 

 

The two sides of America’s coronavirus response

https://www.axios.com/us-coronavirus-vaccine-testing-science-b656e905-67d1-4836-863e-c91f739cfd1e.html

The two sides of America's coronavirus response - Axios

America’s bungled political and social response to the coronavirus exists side-by-side with a record-breaking push to create a vaccine with U.S. companies and scientists at the center.

Why it matters: America’s two-sided response serves as an X-ray of the country itself — still capable of world-beating feats at the high end, but increasingly struggling with what should be the simple business of governing itself.

What’s happening: An index published last week by FP Analytics, an independent research division of Foreign Policy, ranked the U.S. 31st out of 36 countries in its assessment of government responses to COVID-19.

  • That puts it below developed countries like New Zealand and Denmark, and also lower than nations with fewer resources like Ghana, Kenya and South Africa.
  • The index cited America’s limited emergency health care spending, insufficient testing and hospital beds and limited debt relief.

By the numbers: As my Axios colleague Jonathan Swan pointed out in an interview with President Trump, the U.S. has one of the worst per-capita death rates from COVID-19, at 50.29 per 100,000 population.

Yes, but: Work on a COVID-19 vaccine is progressing astonishingly fast, with the Cambridge-based biotech company Moderna and the National Institutes of Health announcing at the end of July that they had begun Phase 3 of the clinical trial.

  • Their efforts are part of a global rush to a vaccine, and while companies in the U.K. and China are jockeying for the lead, U.S. companies and the NIH’s resources and expertise have been key to the effort.
  • Anthony Fauci has said he expects “tens of millions” of doses to be available by early 2021, a little over a year after the novel coronavirus was discovered.
  • If that turns out to be the case, “the Covid-19 vaccine could take a place alongside the Apollo missions as one of history’s greatest scientific achievements,” epidemiologist Michael Kinch recently wrote in STAT.

So which is the real American response to COVID-19? The bungled testing policies, the politically driven rush to reopen, the tragic racial divide seen in the sick and the dead? Or the warp-speed work to develop a vaccine in a year when most past efforts took decades?

Be smart: It’s both.

The bottom line: It can often feel as if there are two Americas, and not even a virus that has spread around the world seems capable of bridging that gap.

 

 

 

 

U.S. doing a lot less coronavirus testing

https://www.axios.com/newsletters/axios-vitals-32689a40-e409-4547-8468-b03dc589c082.html

The two sides of America's coronavirus response - Axios

The U.S. is cutting back on coronavirus testing. Nationally, the number of tests performed each day is about 17% lower than it was at the end of July, and testing is also declining in hard-hit states.

Why it matters: This big reduction in testing has helped clear away delays that undermined the response to the pandemic. But doing fewer tests can also undermine the response to the pandemic.

By the numbers: At the end of July, America was doing more than 800,000 tests a day. This week, it’s hovered around 715,000.

  • Even as states with particularly bad outbreaks pull back on their testing, the proportion of tests coming back positive is still high — which would normally be an indication that they need to be doing more tests.
  • In Texas, 19% of tests are coming back positive, according to Nephron Research. In Florida, the rate of positive tests is 18%, and in Nevada, 17%.

Yes, but: Experts have said reducing the demand for testing may be the best way to alleviate long delays, which made tests all but useless. And that appears to be working.

Driving the news: The Department of Health and Human Services estimated this week that nearly 90% of all tests are being completed within three days — a big improvement from turnaround times that had been stretching well over a week.

  • Quest Diagnostics says its expected turnaround time is now 2–3 days, and less for priority patients. LabCorp announced a similar turnaround time last week.

The bottom line: The U.S. is averaging 50,000 new cases a day, and that high caseload is ultimately why the demand for testing is more than the system can handle.

  • We can’t get our caseload under control without fast, widespread testing, but we can’t achieve fast, widespread testing with such a high caseload.

 

 

 

 

Rely on the science and avoid the politics, Fauci says

https://www.cnn.com/2020/08/12/health/us-coronavirus-wednesday/index.html?utm_source=nl&utm_brand=wired&utm_mailing=WIR_Science_081220&utm_campaign=aud-dev&utm_medium=email&utm_term=WIR_Science&bxid=5db707423f92a422eaeaf234&cndid=54318659&esrc=bounceX&source=EDT_WIR_NEWSLETTER_0_SCIENCE_ZZ

Science Day

Although practices like wearing face coverings have been politicized, Dr. Anthony Fauci said Tuesday he has learned that in order to be a good public health leader in a crisis, you have to divorce yourself from politics, rely on science and be as transparent as possible.

“Completely divorce yourself from the kind of political undertones that sometimes go into an important outbreak like this,” Fauci, director of the National Institute of Allergy and Infectious Diseases, said as he was honored with a 2020 Citizen Leadership Award on Tuesday night by the Aspen Institute.
“You’ve got to stay away from that, lead by example, be perfectly honest and don’t be afraid to say you don’t know something when you don’t know it. I find that to be a very good formula when you’re dealing in a crisis.”
Even with the polarization, every state in the US passed at least one physical distancing measure in March to slow the spread, researchers from Harvard University and University College London said. Those measures worked, a new study found.
Physical distancing resulted in a reduction of more than 600,000 cases within just three weeks, according to the study, published Tuesday in the journal PLOS. Had there not been preventative interventions, the models suggest up to 80% of Americans would have been infected with Covid-19.
“In short, these measures work, and policy makers should use them as an arrow in their quivers to get on top of local epidemics where they are not responding to containment measures,” said the study’s co-author Dr. Mark J. Siedner in a news release.

 

 

US has averaged over 1,000 coronavirus deaths per day for 16 straight days

https://www.cnn.com/2020/08/12/health/us-coronavirus-wednesday/index.html?utm_source=nl&utm_brand=wired&utm_mailing=WIR_Science_081220&utm_campaign=aud-dev&utm_medium=email&utm_term=WIR_Science&bxid=5db707423f92a422eaeaf234&cndid=54318659&esrc=bounceX&source=EDT_WIR_NEWSLETTER_0_SCIENCE_ZZ

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Coronavirus continues to spread at high rates across the US South, Midwest and West, even as the total number of new Covid-19 cases has declined since a summer surge.

Nationally, over the last seven days, the US is averaging just under 53,000 new cases of Covid-19 per day, down 11% from the week prior.
As a result of all those cases, deaths from the virus have remained high. The seven-day average of daily coronavirus deaths was just over 1,000 on Tuesday, the 16th consecutive day the US averaged over 1,000 deaths per day.
Adjusting for population, states in the Southeast are seeing the most new cases. Georgia and Florida — states led by Republican governors who have not issued face mask requirements — have the highest per capita new cases over the last seven days, followed by Alabama and Mississippi.
On Wednesday, Florida reported more than 8,000 new cases and 212 new deaths, according to data released by the Florida Department of Health.
Covid-19 causes worse outcomes for older people, but young people are not immune. In Florida, people under 44 make up about 57% of the state’s 545,000 cases, 20% of the state’s 31,900 hospitalizations, and 3% of the state’s 8,765 deaths, according to state data.
Robert Ruiz, 31 and the father of a 3-year-old, was one of the 265 people under 44 who died from coronavirus in Florida.
His sister, Chenique Mills, told CNN he was overweight and had seasonal asthma but otherwise did not smoke or drink and had no underlying health conditions.
“This is all really sudden, unexpected,” she said. “I (saw) him on Friday. I (saw) him on Saturday. He was fine, to say that he was up, and he was walking and he was eating. He was functioning. So for him to be gone on Sunday? It’s just a lot to take in.
“This virus is so serious. It really really is. And I think people (won’t) understand until it hits home, because I would be one to say that I took it really lightly until it hit home.”
The virus’s ongoing spread around the country has frustrated plans to safely reopen schools, forced college football conferences to postpone the lucrative fall season, and caused vast medical and economic pain.
And it will continue to rattle American society until people more seriously adopt recommended public health measures: social distancingavoiding large indoor gatheringshand-washingmask-wearingrapid testing and quarantining the sick.
“We have to figure out how to deal with this as a whole country because as long as there are cases happening in any part, we still have transit, especially now we have students going back to college,” said Dr. Michael Mina, assistant professor of epidemiology at Harvard T.H. Chan School of Public Health. “Any cases anywhere really keep risk pretty high all across the entirety of the United States.”

 

 

 

Fauci: ‘I seriously doubt’ Russia’s coronavirus vaccine is safe and effective

https://thehill.com/policy/healthcare/511615-fauci-seriously-doubt-russias-coronavirus-vaccine-is-safe-and-effective?utm_source=Sailthru&utm_medium=email&utm_campaign=Issue:%202020-08-12%20Healthcare%20Dive%20%5Bissue:29035%5D&utm_term=Healthcare%20Dive

The White House has pushed Fauci into a little box on the side

Anthony Fauci, the nation’s top infectious diseases expert, said Tuesday that he has serious doubts about Russia’s announcement that it has a vaccine ready to be used for the novel coronavirus.

“Having a vaccine and proving that a vaccine is safe and effective are two different things,” Fauci said during a panel discussion with National Geographic.

The comments came just hours after Russian President Vladimir Putin said that the country had become the first in the world to gain regulatory approval for a COVID-19 vaccine.

Putin said that the vaccine went through clinical testing and that it had proven to offer immunity to the deadly disease, which has infected more than 20 million people worldwide, according to a Johns Hopkins University database.

However, phase three trials for the drug have reportedly not been completed, triggering skepticism from international health experts about its usefulness. 

Fauci, the director of the National Institute of Allergy and Infectious Diseases and a key member of the White House coronavirus task force, said that he had seen no evidence supporting Putin’s position. 

“I hope that the Russians have actually, definitively proven that the vaccine is safe and effective. I seriously doubt that they’ve done that,” he said, adding that Americans need to understand that the process for gaining vaccine approval requires safety and efficacy. 

More than 100 possible vaccines are being developed around the world as part of efforts to offer immunity protection for the coronavirus. Moderna, in collaboration with the National Institutes of Health, launched a phase three trial for a vaccine in July, making it the first U.S. candidate to reach that stage.

Fauci has said that he’s “cautiously optimistic” that a COVID-19 vaccine will be ready by the end of the year. He told a House committee on July 31 that he was encouraged by everything he’s seen in the early data but that “there’s never a guarantee that you’re going to get a safe and effective vaccine.”

The World Health Organization said Tuesday that it was monitoring Russia’s progress in developing a COVID-19 vaccine. Progress in combating the virus “should not compromise safety,” the health agency said.

Former Food and Drug Administration Commissioner Scott Gottlieb echoed Fauci’s skepticism earlier Tuesday, noting in a tweet that Russia has been behind disinformation campaigns related to the pandemic. 

“Today’s news that they ‘approved’ a vaccine on the equivalent of phase 1 data may be another effort to stoke doubts or goad U.S. into forcing early action on our vaccines,” he said.

Russia is reportedly planning to offer its COVID-19 vaccine to medical personnel as soon as this month. It will be made available to the general public in October, according to Reuters