Category Archives: Economy Reopening

‘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.”

 

 

 

 

New unemployment insurance claims rise for the first time since March

Posted on by • Posted in 2020 Election Issues, Coronavirus, 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, Health Insurance Coverage Adequacy, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Job, Job Loss, Job Market, Job Search, Job Security, Leadership Decentralized, Mortality, National Strategy, Pandemic, Public Health, Public Safety, Quarantine, Social Distancing, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://www.washingtonpost.com/business/2020/07/23/another-14-million-workers-filed-unemployment-benefits-last-week-pandemic-continues-weigh-labor-market/

 

Some 1.4 million workers filed for unemployment last week, the first increase in months, as the pandemic continues to weigh on the labor market

The number of new unemployment claims rose for the first time in months last week, to 1.4 million — a troubling sign for the labor market that’s weathering a new round of closures as the pandemic spreads.

For the week ending July 18, about 109,000 more jobless claims were filed compared to the week prior, according to the Department of Labor.

“What you’re seeing is that, as the economy slows, the pace of claims picks back up — which really puts at risk the monthly jobs report over the next few months,” said Joseph Brusuelas, the chief economist at RSM. “The July numbers are going to be tenuous, but it’s August that I’m worried about.”

The number of workers continually claiming unemployment insurance went down, however, a statistic that lags by a week, to 16.1 million workers for the week ending July 11, from 17.4 million for the week ending July 4.

In addition to the 1.4 million seeking unemployment nationwide last week, another 980,000 new Pandemic Unemployment Assistance claims were filed, the benefits offered to self-employed and gig workers.

The numbers come as millions of unemployed workers are about to exhaust stimulus payments from two federal benefits programs whose expiration economists have warned could have dire effects on the economy.

Brusuelas said the numbers are a sign that the burst of economic activity that marked the country’s reopening has waned, and that shrinking consumer demand remained a significant risk for businesses and the workers they employ across the country.

“We are going to see a much slower pace of growth the reset of the year,” he said. “While we still are retaining our call for a swoosh-shaped recovery, one has to acknowledge a w-shaped recovery is possible.”

The extra $600 a week in unemployment benefits that the federal government has offered to supplement more modest state unemployment benefits will end this week, as lawmakers wrangle over legislation that could extend it.

Including the new benefits available to gig workers and the self-employed, more than 53 million applications have been filed for some form of unemployment insurance during the pandemic.

 

 

Cartoon – Pandemic Management

Posted on by • Posted in 2020 Election Issues, Cartoon, Coronavirus, Crisis, Crisis Management, Data Analytics, Data Governance, Data Integrity, Data Interpretation, Data Management, Economic Crisis, Economic Recovery, Economy Reopening, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Leadership, Pandemic, State of the Union, Uncertainty • Leave a comment

Reflections on an Ad Industry at War With Itself | MediaVillage

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.

 

 

 

 

Mask resistance during a pandemic isn’t new – in 1918 many Americans were ‘slackers

Posted on by • Posted in 2020 Election Issues, Change, Change Management, Changing Behavior, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Evidence-Based Care, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, History, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Misinformation, Misinterpret, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Partisanship, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Social Responsibility, Wishful Thinking • Leave a comment

https://theconversation.com/mask-resistance-during-a-pandemic-isnt-new-in-1918-many-americans-were-slackers-141687?utm_medium=email&utm_campaign=The%20Weekend%20Conversation%20-%201680716207&utm_content=The%20Weekend%20Conversation%20-%201680716207+Version+A+CID_c211e1b0b6c4b69b3a29a9d1624a2ab6&utm_source=campaign_monitor_us&utm_term=Mask%20resistance%20during%20a%20pandemic%20isnt%20new%20%20in%201918%20many%20Americans%20were%20slackers

Mask resistance during a pandemic isn't new – in 1918 many ...

We have all seen the alarming headlines: Coronavirus cases are surging in 40 states, with new cases and hospitalization rates climbing at an alarming rate. Health officials have warned that the U.S. must act quickly to halt the spread – or we risk losing control over the pandemic.

There’s a clear consensus that Americans should wear masks in public and continue to practice proper social distancing. While a majority of Americans support wearing masks, widespread and consistent compliance has proven difficult to maintain in communities across the country. Demonstrators gathered outside city halls in Scottsdale, Arizona; Austin, Texas; and other cities to protest local mask mandates. Several Washington state and North Carolina sheriffs have announced they will not enforce their state’s mask order.

I’ve researched the history of the 1918 pandemic extensively. At that time, with no effective vaccine or drug therapies, communities across the country instituted a host of public health measures to slow the spread of a deadly influenza epidemic: They closed schools and businesses, banned public gatherings and isolated and quarantined those who were infected. Many communities recommended or required that citizens wear face masks in public – and this, not the onerous lockdowns, drew the most ire.

Mask resistance during a pandemic isn't new – in 1918 many ...

In mid-October of 1918, amidst a raging epidemic in the Northeast and rapidly growing outbreaks nationwide, the United States Public Health Service circulated leaflets recommending that all citizens wear a mask. The Red Cross took out newspaper ads encouraging their use and offered instructions on how to construct masks at home using gauze and cotton string. Some state health departments launched their own initiatives, most notably California, Utah and Washington.

Nationwide, posters presented mask-wearing as a civic duty – social responsibility had been embedded into the social fabric by a massive wartime federal propaganda campaign launched in early 1917 when the U.S. entered the Great War. San Francisco Mayor James Rolph announced that “conscience, patriotism and self-protection demand immediate and rigid compliance” with mask wearing. In nearby Oakland, Mayor John Davie stated that “it is sensible and patriotic, no matter what our personal beliefs may be, to safeguard our fellow citizens by joining in this practice” of wearing a mask.

Health officials understood that radically changing public behavior was a difficult undertaking, especially since many found masks uncomfortable to wear. Appeals to patriotism could go only so far. As one Sacramento official noted, people “must be forced to do the things that are for their best interests.” The Red Cross bluntly stated that “the man or woman or child who will not wear a mask now is a dangerous slacker.” Numerous communities, particularly across the West, imposed mandatory ordinances. Some sentenced scofflaws to short jail terms, and fines ranged from US$5 to $200.

Mask resistance during a pandemic isn't new – in 1918 many ...

Passing these ordinances was frequently a contentious affair. For example, it took several attempts for Sacramento’s health officer to convince city officials to enact the order. In Los Angeles, it was scuttled. A draft resolution in Portland, Oregon led to heated city council debate, with one official declaring the measure “autocratic and unconstitutional,” adding that “under no circumstances will I be muzzled like a hydrophobic dog.” It was voted down.

Utah’s board of health considered issuing a mandatory statewide mask order but decided against it, arguing that citizens would take false security in the effectiveness of masks and relax their vigilance. As the epidemic resurged, Oakland tabled its debate over a second mask order after the mayor angrily recounted his arrest in Sacramento for not wearing a mask. A prominent physician in attendance commented that “if a cave man should appear…he would think the masked citizens all lunatics.”

In places where mask orders were successfully implemented, noncompliance and outright defiance quickly became a problem. Many businesses, unwilling to turn away shoppers, wouldn’t bar unmasked customers from their stores. Workers complained that masks were too uncomfortable to wear all day. One Denver salesperson refused because she said her “nose went to sleep” every time she put one on. Another said she believed that “an authority higher than the Denver Department of Health was looking after her well-being.” As one local newspaper put it, the order to wear masks “was almost totally ignored by the people; in fact, the order was cause of mirth.” The rule was amended to apply only to streetcar conductors – who then threatened to strike. A walkout was averted when the city watered down the order yet again. Denver endured the remainder of the epidemic without any measures protecting public health.

Mask resistance during a pandemic isn't new – in 1918 many ...

In Seattle, streetcar conductors refused to turn away unmasked passengers. Noncompliance was so widespread in Oakland that officials deputized 300 War Service civilian volunteers to secure the names and addresses of violators so they could be charged. When a mask order went into effect in Sacramento, the police chief instructed officers to “Go out on the streets, and whenever you see a man without a mask, bring him in or send for the wagon.” Within 20 minutes, police stations were flooded with offenders. In San Francisco, there were so many arrests that the police chief warned city officials he was running out of jail cells. Judges and officers were forced to work late nights and weekends to clear the backlog of cases.

Many who were caught without masks thought they might get away with running an errand or commuting to work without being nabbed. In San Francisco, however, initial noncompliance turned to large-scale defiance when the city enacted a second mask ordinance in January 1919 as the epidemic spiked anew.

Many decried what they viewed as an unconstitutional infringement of their civil liberties. On January 25, 1919, approximately 2,000 members of the “Anti-Mask League” packed the city’s old Dreamland Rink for a rally denouncing the mask ordinance and proposing ways to defeat it. Attendees included several prominent physicians and a member of the San Francisco Board of Supervisors.

It is difficult to ascertain the effectiveness of the masks used in 1918. Today, we have a growing body of evidence that well-constructed cloth face coverings are an effective tool in slowing the spread of COVID-19. It remains to be seen, however, whether Americans will maintain the widespread use of face masks as our current pandemic continues to unfold.

Deeply entrenched ideals of individual freedom, the lack of cohesive messaging and leadership on mask wearing, and pervasive misinformation have proven to be major hindrances thus far, precisely when the crisis demands consensus and widespread compliance.

This was certainly the case in many communities during the fall of 1918. That pandemic ultimately killed about 675,000 people in the U.S. Hopefully, history is not in the process of repeating itself today.

 

 

 

How the coronavirus pandemic became Florida’s perfect storm

Posted on by • Posted in 2020 Election Issues, ACA, Aging Population, Asymptomatic Transmission, Chronic Care Management, Chronic Conditions, Chronic Diseases, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Income Tax - State, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Medicaid, Medicaid Expansion, Misinformation, Misinterpret, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, Pandemic, Partisanship, Preexisting Conditions, Public Health, Public Safety, Quarantine, School Reopening, Scientists, Social Distancing, Tourism Industry, Transparency, Underinsured, Uninsured, Vulnerable Populations • Leave a comment

https://theconversation.com/how-the-coronavirus-pandemic-became-floridas-perfect-storm-142333

How the coronavirus pandemic became Florida's perfect storm

If there’s one state in the U.S. where you don’t want a pandemic, it’s Florida. Florida is an international crossroads, a magnet for tourists and retirees, and its population is older, sicker and more likely to be exposed to COVID-19 on the job than the country as a whole.

When the coronavirus struck, the conditions there made it a perfect storm.

Florida set a single-day record for new COVID-19 cases in early July, passing 15,000 and rivaling New York’s worst day at the height of the pandemic there. The state has become an epicenter for the spread, with over 300,000 confirmed cases. Its hospital capacity is under stress, and the death toll has been rising.

Despite these strains, Disney World reopened two theme parks on July 11, and Florida Gov. Ron DeSantis announced schools would reopen in August. The governor had shut down alcohol sales in bars in late June as case numbers skyrocketed, but he hasn’t made face masks mandatory or moved to shut down other businesses where the virus can easily spread.

As public health researchers, we have been studying how states respond to the pandemic. Florida stands out, both for its absence of statewide policies that could have stemmed the spread of COVID-19 and for some unique challenges that make those policies both more necessary and more difficult to implement than in many other states.

The challenges of economic pressures

Florida is one of nine states with no income tax on wages, so its tax base relies heavily on tourism and property in its high-density coastal areas. That puts more pressure on the government to keep businesses and social venues open longer and reopen them faster after shutdowns.

If you look closely at Florida’s economy, its vulnerabilities to the pandemic become evident.

The state depends on international trade, tourism and agriculture – sectors that rely heavily on lower-wage, often seasonal, workers. These workers can’t do their jobs from home, and they face financial barriers to getting tested, unless it’s provided through their employer or government testing sites. They also struggle with health care – Florida has a higher-than-average rate of people without health insurance, and it chose not to expand Medicaid.

In the tourism industry, even young, healthy employees typically at lower risk from COVID-19 can unknowingly spread the virus to visitors or vice versa. The tourism industry also encourages crowded bar and club scenes, where the governor has blamed young people for spreading the coronavirus.

The past few weeks have been emblematic of the economic battles facing a state that depends on tourism for both jobs and state revenues.

Even as the public health risks were quickly rising, businesses continued to open their doors. Major cruise lines planned to resume their itineraries in the fall. A note on the Universal Studios website read: “Exposure to COVID-19 is an inherent risk in any public location where people are present; we cannot guarantee you will not be exposed during your visit.”

Disney World reopened on July 11 with face mask requirements. Matt Stroshane via Disney

Reopening guidance has been largely ignored

The Governor’s Re-open Florida Taskforce issued guidelines in late April meant to lower the state’s coronavirus risk, but those guidelines have been largely ignored in practice.

No county in Florida has reduced cases or maintained the health care resources recommended by the task force. The data needed to fully assess progress are also questionable, given a recent scandal regarding the state data’s accuracy, availability and transparency.

Still, the coronavirus’s rapid surge in Florida is evident in the state-reported cases. Testing lines are long, and almost 1 in 5 tests have been positive for COVID-19, suggesting the prevalence of infections is still increasing.

Florida’s patchwork of local rules also makes it hard to contain the virus’s spread.

With no statewide mask rules or plans to reverse reopening, other than for bars, communities and businesses have taken their own actions to implement public health precautions. The result is varying mask ordinances and restrictions on large gatherings in some cities but not those surrounding them. Though the Florida Department of Health has issued an advisory recommending face coverings, some local areas have voted down mask mandates.

More warning signs ahead

Late summer and fall will bring new challenges for Florida in terms of the virus’s spread and the state’s response to it.

That’s when Florida’s risk of hurricanes grows, and while Floridians are well-versed in hurricane preparedness, storm shelters aren’t designed for social distancing and will need careful plans for protecting nursing home residents. Storm cleanup could mean lots of people working in close proximity while protective gear is in short supply.

If Florida’s schools reopen fully, the risk of the virus rapidly spreading to teachers, parents and children who are more vulnerable is a real concern being weighed against the costs of keeping schools closed.

Colleges that reopen to classes and sporting events also raise the risk of spreading the virus in Florida communities. And the possible return of retirees who spend their winters in Florida would increase the high-risk population by late fall. One in five Florida residents is over age 65, giving the state one of the nation’s oldest populations – a risk factor, along with chronic illnesses, for severe symptoms with COVID-19.

Florida is also a battleground state for the upcoming presidential election, and that’s likely to mean campaign rallies and more close contact. The Republican National Convention was moved to Jacksonville after President Donald Trump complained that North Carolina might not let the GOP fill a Charlotte arena to capacity due to coronavirus restrictions. Florida organizers recently said they were considering holding parts of the convention outdoors.

The high number of cases being reported in Florida will lead to even more hospitalizations and fatalities in coming weeks and months. Without clear public health messages and precautions implemented and enforced across the state, the coronavirus forecast for the Sunshine State will remain stormy.

 

 

 

U.S. Coronavirus Pandemic Status: It’s about to get a lot worse

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The pain of the coronavirus is about to get a lot worse - Axios

For months now, American workers, families and small businesses have been saying they can’t keep up their socially distanced lives for much longer. We’ve now arrived at “much longer” — and the pandemic isn’t going away anytime soon.

The big picture: The relief policies and stopgap measures that we cobbled together to get us through the toughest weeks worked for a while, but they’re starting to crumble just as cases are spiking in the majority of states.

Next week, the extra $600 per week in expanded unemployment benefits will expire. And there’s no indication that Congress has reached a consensus on extending this assistance or providing anything in its place.

  • But nearly half of the U.S. population is still jobless, and millions will remain jobless for the foreseeable future. There are 14 million more unemployed people than there are jobs, per the Economic Policy Institute.
  • Nearly a third of Americans missed a housing payment in July — and that was with the additional $600. Plus, most Americans have already spent the stimulus checks they received at the beginning of the pandemic.
  • “We should be very concerned about what’s going to happen in August and beyond” — starting with a spike in evictions, Mathieu Despard, who leads the Social Policy Institute at the Washington University in St. Louis, tells Axios.

Expect more furloughs and layoffs as more small businesses are pushed off the pandemic cliff.

  • By economists’ estimates, more than 100,000 small businesses have permanently closed since the pandemic began.
  • For those that are hanging on, loans from the Paycheck Protection Program (PPP) have not been enough, and the back and forth between re-opening and then closing again as states deal with new case waves has been devastating. In fact, rates of closure have started increasing, the New York Times reports, citing Yelp data.
  • The big firms aren’t immune either. Just last week, behemoths like United Airlines, Wells Fargo, Walgreens and Levi’s either cut jobs or told workers their jobs were at risk, Axios’ Dion Rabouin writes.

And the question of whether schools will reopen looms.

  • Since schools sent kids home in March, and most summer camps didn’t open their doors for the summer, working parents have been dealing with a child care crisis — attempting to do their jobs, care for their kids and homeschool all at once — and hoping that the stress will be temporary.
  • The situation is more dire for low-income families with kids who rely on school lunches or for single parents who are juggling work and parenting without any help.
  • Now the public heath crisis hasn’t abated, and school districts are running out of time to figure out what the fall will look like. Some, starting with Los Angeles, have already decided to go online.

The bottom line: “It’s the uncertainty that is anxiety-inducing,” says Despard. “If you give people a time horizon and say, ‘Look you have to get through these next 8 weeks of extreme shutdown,’ they’ll do it. Now it’s like, ‘How much longer?'”

 

 

 

 

 

U.S. Coronavirus Response: We blew it

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Essential Businesses, Essential Workers, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Infection Control, Infection Control Plan, Infectious Virus, Job, Job Loss, Job Market, Job Search, Job Security, Leadership Decentralized, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Partisanship, Public Health, Public Safety, Quarantine, Social Distancing, The CARES Act, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

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We blew it: Why America still hasn't gotten the coronavirus under ...

America spent the spring building a bridge to August, spending trillions and shutting down major parts of society. The expanse was to be a bent coronavirus curve, and the other side some semblance of normal, where kids would go to school and their parents to work.

The bottom line: We blew it, building a pier instead.

There will be books written about America’s lost five months of 2020, but here’s what we know:

We blew testing. President Trump regularly brags and complains about the number of COVID-19 tests conducted in the U.S., but America hasn’t built the infrastructure necessary to process and trace the results.

  • Quest Diagnostics says its average turnaround time for a COVID-19 test has lengthened to “seven or more days” — thus decreasing the chance that asymptomatic or mildly symptomatic carriers will self-quarantine.
  • The testing delays also make it harder for public health officials to understand current conditions, let alone implement effective contact tracing.
  • Speaking of contact tracing, it remains a haphazard and uncoordinated process in many parts of the country.

We blew schools. Congress allocated $150 billion for state and local governments as part of the CARES Act, but that was aimed at maintaining status quo services in the face of plummeting tax revenue.

There was no money earmarked for schools to buy new safety equipment, nor to hire additional teachers who might be needed to staff smaller class sizes and hybrid learning days.

  • U.S. Education Secretary Betsy DeVos was not among the 27 officials included in the White House Coronavirus Task Force.
  • The administration insists that schools should reopen this fall because kids are less likely to get very sick from the virus, but it has not yet offered detailed plans to protect older teachers, at-risk family members, or students with pre-existing respiratory or immune conditions.
  • Silicon Valley provided some free services to schools, but there was no coordinated effort to create a streamlined virtual learning platform. There also continue to be millions of schoolkids without access to broadband and/or Internet-connected devices.

We blew economics. The CARES Act was bold and bipartisan, a massive stimulus to meet the moment.

  • It’s running out, without an extension plan not yet in place.
  • Expanded unemployment benefits expire in days. Many small businesses have already exhausted their Paycheck Protection Program loans, including some that reopened but have been forced to close again.
  • There has been no national effort to pause residential or commercial evictions, nor to give landlords breathing room on their mortgage payments.

We blew public health. There’s obviously a lot here, but just stick with face masks. Had we all been directed to wear them in March — and done so, even makeshift ones while manufacturing ramped up — you might not be reading this post.

We blew goodwill. Millions of Americans sheltered in place, pausing their social lives for the common good.

  • But many millions of other Americans didn’t. Some were essential workers. Some were deemed essential workers but really weren’t. Some just didn’t care, or didn’t believe the threat. Some ultimately decided that protesting centuries of racial injustice was a worthy trade-off.
  • All of this was complicated by mixed messages from federal and state leaders. Top of that list was President Trump, who claimed to adopt a wartime footing without clearly asking Americans to make sacrifices necessary to defeat the enemy.
  • Five months later, many of those who followed the “rules” are furious at what they perceive to be the selfishness of others.

The bottom line: America has gotten many things right since March, including the development of more effective hospital treatments for COVID-19 patients.

  • But we’re hitting daily infection records, daily deaths hover around 900, and many ICUs reports more patients than beds. It didn’t have to be this way.

 

 

 

 

The surge in coronavirus hospitalizations is severe

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, False Hope, False Narrative, Health System, Hospital, Hospital Industry, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Misinformation, Misinterpret, Mislead, Misleading, Mortality, National Strategy, Pandemic, Public Health, Public Safety, Quarantine, Social Distancing, Uncertainty, Wishful Thinking • Leave a comment

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Share of hospital beds occupied
by COVID-19 hospitalizations

States shown from first date of reported data, from March 17 to July 19, 2020

  • In the last two weeks hospitalizations are:

The coronavirus surge is real, and it's everywhere - Axios

 

Coronavirus hospitalizations are skyrocketing, even beyond the high-profile hotspots of Arizona, Florida and Texas, Axios’ Bob Herman and Andrew Witherspoon report.

Why it matters: The U.S. made it through the spring without realizing one of experts’ worst fears — overwhelming hospitals’ capacity to treat infected people. But that fear is re-emerging as the virus spreads rapidly throughout almost every region of the country.

Where things stand: Arizona remains in the worst shape; 27.1% of all hospital beds in the state are occupied by COVID-19 patients as of July 15, according to an analysis combining data from the COVID Tracking Project and the Harvard Global Health Institute. Texas is second at 18.8%.

  • Nevada is the next worst, with COVID-19 patients taking up 18.7% of all hospital beds. That’s up significantly from 11.2% at the start of July.
  • Florida just started tallying current hospitalization data, showing more than 16% of all hospital beds occupied.

It gets worse: Many other states are showing significant upticks in coronavirus hospitalizations during the first half of July, including Alabama, California, Louisiana, Mississippi, South Carolina and Tennessee.

  • Many of these states, which reopened a lot of their economies in May, do not have mask mandates.

Between the lines: Intensive-care unit beds, reserved for the sickest patients, are completely full in parts of Arizona, Florida, Mississippi and Texas.

  • Hospitals can convert other areas into ICUs, but that’s not all that useful if hospitals don’t have enough staff and supplies.

The bottom line: Cases have soared over the past 45 days, and hospitalizations naturally follow many of those cases.

  • Rising hospitalizations mean the outbreaks in many areas are not close to being controlled, and some percentage of those hospitalizations will end as deaths.

 

 

Coronavirus updates: U.S. infections top 76,000 in a day as virus’s spread continues unabated

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

https://www.washingtonpost.com/nation/2020/07/18/coronavirus-updates-us-infections-top-76000-day-virus-spread-continues-unabated/?utm_campaign=wp_main&utm_medium=social&utm_source=facebook&fbclid=IwAR3cnVHnhbmPw7a_og-oZc1Ocgfs-A_y4Qr6Ht8OKDkxpiWv7E7ydb67EqA

Coronavirus in the U.S.: Latest Map and Case Count - The New York ...

The United States on Friday set another record for daily coronavirus infections, with states reporting a combined 76,403 new confirmed cases — more than double the amount the country was reporting daily during the initial surge of cases in the spring.

Coronavirus-related deaths are rising, too, after declining nationally throughout May and June. The country reported 963 fatalities from the virus Friday, the most in a single day since June 3.

Here are some other significant developments:

  • A federal appeals court blocked a lower-court ruling that would have allowed the Republican Party of Texas to proceed with its planned in-person convention in downtown Houston. Mayor Sylvester Turner (D) said the event poses too great a health risk with infections in the area spiraling out of control. “In the middle of a pandemic, the doors remain locked,” Sylvester said of the appeals court’s decision.
  • The nine largest brick-and-mortar retail companies — including Walmart, Lowe’s and CVS — have adopted new policies requiring customers to wear masks inside U.S. stores.
  • President Trump affirmed in a Fox News interview he does not favor requiring face coverings nationwide. “I want people to have a certain freedom,” Trump told Chris Wallace in an interview set to air in full on Sunday.
  • California Gov. Gavin Newsom (D) on Friday announced new guidelines that will bar schools in 32 hotspot counties from reopening in the fall unless they meet strict standards for preventing the spread of the coronavirus. Iowa Gov. Kim Reynolds (R) said Friday the state’s schools must resume in-person instruction.

Infections and deaths are rising in states around the country, led by Texas, California, Florida, Georgia and Arizona. Texas on Friday reported a record 14,916 new cases and 174 new deaths related to the virus. Other states, including Ohio, Utah and the Carolinas, have reported single-day records in the past week.

The sharp increases have prompted many states to adopt new public health measures to prevent the virus spread. California ordered most of its schools to conduct remote instruction in the new academic year unless counties can meet strict benchmarks for reducing community transmission. More than half of all U.S. states have instituted some form of statewide mask requirements, including Alabama and Arkansas, where governors previously balked at mask mandates.