Category Archives: Infectious Virus

California Hospitals Face Surge With Proven Fixes And Some Hail Marys

Posted on by • Posted in Coronavirus, Crisis, Crisis Management, Elective Surgery, Emergency Preparedness, Health System, Hospital, Hospital Bed Shortage, Hospital Industry, Infection Control, Infectious Virus, Intensive Care (ICU), Leadership, Pandemic, Public Health, Public Safety, Social Distancing, Telemedicine, Ventilators • Leave a comment

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California Hospitals Face Surge With Proven Fixes And Some Hail ...

California’s hospitals thought they were ready for the next big disaster.

They’ve retrofitted their buildings to withstand a major earthquake and  whisked patients out of danger during deadly wildfires. They’ve kept patients alive with backup generators amid sweeping power shutoffs and trained their staff to thwart would-be shooters.

But nothing has prepared them for a crisis of the magnitude facing hospitals today.

“We’re in a battle with an unseen enemy, and we have to be fully mobilized in a way that’s never been seen in our careers,” said Dr. Stephen Parodi, an infectious disease expert for Kaiser Permanente in California. (Kaiser Health News, which produces California Healthline, is not affiliated with Kaiser Permanente.)

As California enters the most critical period in the state’s battle against COVID-19, the state’s 416 hospitals — big and small, public and private — are scrambling to build the capacity needed for an onslaught of critically ill patients.

Hospitals from Los Angeles to San Jose are already seeing a steady increase in patients infected by the virus, and so far, hospital officials say they have enough space to treat them. But they also issued a dire warning: What happens over the next four to six weeks will determine whether the experience of California overall looks more like that of New York, which has seen an explosion of hospitalizations and deaths, or like that of the San Francisco Bay Area, which has so far managed to prevent a major spike in new infections, hospitalizations and death.

Some of their preparations share common themes: Postpone elective surgeries. Make greater use of telemedicine to limit face-to-face contact. Erect tents outside to care for less critical patients. Add beds — hospital by hospital, a few dozen at a time — to spaces like cafeterias, operating rooms and decommissioned wings.

But by necessity — because of shortages of testing, ventilators, personal protective equipment and even doctors and nurses — they’re also trying creative and sometimes untried strategies to bolster their readiness and increase their capacity.

In San Diego, hospitals may use college dormitories as alternative care sites. A large public hospital in Los Angeles is turning to 3D printing to manufacture ventilator parts. And in hard-hit Santa Clara County, with a population of nearly 2 million, public and private hospitals have joined forces to alleviate pressure on local hospitals by caring for patients at the Santa Clara Convention Center.

Yet some hospitals acknowledge that, despite their efforts, they may end up having to park patients in hallways.

“The need in this pandemic is so different and so extraordinary and so big that a hospital’s typical surge plan will be insufficient for what we’re dealing with in this state and across the nation,” said Carmela Coyle, president and CEO of the California Hospital Association.

Across the U.S., more than 213,000 cases of COVID-19 have been confirmed, and at least 4,750 people have died. California accounts for more than 9,400 cases and at least 199 deaths.

Health officials and hospital administrators are singling out April as the most consequential month in California’s effort to combat a steep increase in new infections. State Health and Human Services Secretary Mark Ghaly said Wednesday that the number of hospitalizations is expected to peak in mid-May.

Gov. Gavin Newsom said there were 1,855 COVID-19 cases in hospitals Wednesday, a number that had tripled in six days, and 774 patients in critical care. By mid-May, the number of critical care patients is expected to climb to 27,000, he said.

Newsom said the state needs nearly 70,000 more hospital beds, bringing its overall capacity to more than 140,000 — both inside hospitals and also at alternative care sites like convention centers. The state also needs 10,000 more ventilators than it normally has to aid the crush of patients needing help to breathe, he said, and so far has acquired fewer than half.

Newsom and state health officials worked with the Trump administration to bring a naval hospital ship to the Port of Los Angeles, where it is already treating patients not infected with the novel coronavirus. The state is working with the Army Corps of Engineers to deploy eight mobile field hospitals, including one in Santa Clara County. And it is bringing hospitals back online that were shuttered or slated to close, including one each in Daly City, Los Angeles, Long Beach and Costa Mesa.

The governor is also drafting a plan to make greater use of hotels and motels and nursing homes to house patients, if needed.

But the size of the surge that hits hospitals depends on how well the public follows social distancing and stay-at-home orders, said Newsom and hospital administrators. “This is not just about health care providers caring for the sick,” said Dr. Steve Lockhart, the chief medical officer of Sutter Health, which has 22 hospitals across Northern California.

While hospitals welcomed the state assistance, they’re also undertaking dramatic measures to prepare on their own.

“I’m genuinely very worried, and it scares me that so many people are still out there doing business as usual,” said Chris Van Gorder, CEO of Scripps Health, a system with five major hospitals in San Diego County. “It wouldn’t take a lot to overwhelm us.”

Internal projections show the hospital system could need 8,000 beds by June, he said. It has 1,200.

In addition to taking precautions to protect its health care workers — such as using baby monitors to observe patients without risking infection — it is working with area colleges to use dorm rooms as hospital rooms for patients with mild cases of COVID-19, among other efforts, he said.

“Honestly, I think we should have been better prepared than we are,” Van Gorder said. “But hospitals cannot take on this burden themselves.”

Van Gorder and other hospital administrators say a continued shortage of COVID-19 tests has hampered their response — because they still don’t know exactly which patients have the virus — as has the chronic underfunding of public health infrastructure.

Kaiser Permanente wants to double the capacity of its 36 California hospitals, Parodi said. It is also working with the garment industry to manufacture face masks, and eyeing hotel rooms for less critical patients.

Harbor-UCLA Medical Center, a 425-bed safety-net hospital in Los Angeles, is working to increase its capacity by 200%, said Dr. Anish Mahajan, the hospital’s chief medical officer.

Harbor-UCLA is using 3D printers to produce ventilator piping equipped to serve two patients per machine. And in March it transformed a new emergency wing into an intensive care unit for COVID-19 patients.

“This was a shocking thing to do,” Mahajan said of the unprecedented move to create extra space.

He said some measures are untested, but hospitals across the state are facing extreme pressure to do whatever they can to meet their greatest needs.

In March, Stanford Hospital in the San Francisco Bay Area launched a massive telemedicine overhaul of its emergency department to reduce the number of employees who interact with patients in person. This is the first time the hospital has used telemedicine like this, said Dr. Ryan Ribeira, an emergency physician who spearheaded the project.

Stanford also did some soul-searching, thinking about which of its staff might be at highest risk if they catch COVID-19, and has assigned them to parts of the hospital with no coronavirus patients or areas dedicated to telemedicine. “These are people that we might have otherwise had to drop off the schedule,” Ribeira said.

Nearby, several San Francisco hospitals that were previously competitors have joined forces to create a dedicated COVID-19 floor at Saint Francis Memorial Hospital with four dozen critical care beds.

The city currently has 1,300 beds, including 200 ICU beds. If the number of patients surges as it has in New York, officials anticipate needing 5,000 additional beds.

But the San Francisco Bay Area hasn’t yet seen the expected surge. UCSF Health had 15 inpatients with COVID-19 Tuesday. Zuckerberg San Francisco General Hospital and Trauma Center had 18 inpatients with the disease Wednesday.

While hospital officials are cautiously optimistic that local and state stay-at-home orders have worked to slow the spread of the virus, they are still preparing for what could be a major increase in admissions.

“The next two weeks is when we’re really going to see the surge,” said San Francisco General CEO Susan Ehrlich. “We’re preparing for the worst but hoping for the best.”

 

 

 

 

At the population level, the coronavirus is almost literally everywhere

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At the population level, the coronavirus is almost literally ...

95 percent of Americans live in a county that has reported at least one case.

More than 6 in 10 Americans live in counties where people have died of the disease caused by the coronavirus, and about 95 percent live in places reporting at least one case, according to a Washington Post analysis of data compiled by Johns Hopkins University.

At the population level, in other words, the virus is almost literally everywhere, turning the epidemic into a crisis directly affecting the lives of nearly every single person in the United States.

Image without a caption

The first coronavirus case in the United States was confirmed on Jan. 20 in a man in Snohomish County, Wash., who had recently visited the epicenter of the global pandemic in Wuhan, China. In just over two months, the virus has spread to more than 2,000 counties representing at least 95 percent of the U.S. population, according to tracking data maintained by Johns Hopkins.

March 13 marks an inflection point in the virus’s spread. That day, it was reported in counties representing more than half the population. Coincidentally, it was a day after Americans woke up to news of travel restrictions on Europe, the cancellation of March Madness and Tom Hanks’s covid-19 diagnosis in Australia.

The virus continued its rapid spread to new segments of the population until about March 21, when confirmed cases reached counties representing 80 percent of Americans. Since then the rate of county-level exposure has slowed somewhat, if only because the virus is running out of new population centers to infect.

As of March 30, nearly every county in the United States with a population of 100,000 or more is reporting at least one coronavirus infection.

These numbers come with caveats. The virus is almost certainly already present in a number counties where no cases have yet been confirmed via testing. Many people who become infected show no or only mild signs of infection, so they may not seek testing. In many regions of the country, there still aren’t enough tests for every potential patient.

Image without a caption

Nevertheless, it’s instructive to see where the virus has not yet been reported. The map above, in which counties with no confirmed cases are in orange, is essentially an inverse population map. The orange counties are some of the least populated in the United States, including the wide belt of sparsely populated counties in the central plains.

These counties represent well over half the country’s land area, but only about 5 percent of its population. Their lack of cases illustrates an obvious but easy to forget point: The virus has a harder time spreading in places with fewer people. Density is one of cities’ great strengths, but during a pandemic it becomes a weakness, allowing an infection to spread rapidly among a tightly packed population.

It’s worth pointing out that while rural counties may be remote, they are not necessarily isolated. People living in these places often routinely travel to cities and towns to shop, receive health care and visit friends and family. Rural areas pride themselves on self-sufficiency, but they are nevertheless connected to the rest of the country via travel and trade.

Some rural areas, particularly vacation and second home destinations, are growing concerned at the prospect of city-dwellers fleeing to the country to ride out the pandemic, potentially bringing the virus with them. Many rural counties lack hospitals, making health care access a challenge even in normal times.

If city transplants cause a coronavirus outbreak disproportionate to the availability of hospital beds in a rural area, the results could be catastrophic.

 

 

 

The outbreak won’t peak in every state at once

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USA Projected date of peak hospital
resource demand due to COVID-19

The coronavirus projected peak date in each state - Axios

 

Although the coronavirus is expected to peak in the U.S. in two weeks, many states will see their individual peaks well after that, according to a model by the University of Washington’s Institute for Health Metrics and Evaluation.

Why it matters: States like Virginia and Maryland have more time to prepare for their systems to be maximally strained — if they make good use of that time.

States’ coronavirus peaks are defined as the point at which there is the most demand for resources, namely hospital beds and ventilators.

  • This is also the point at which the most health care workers will be needed to care for coronavirus patients.

Some experts warn that states expected to face the hardest hit later in the year aren’t using their lead time well.

  • “The states that are going to be affected last need to start husbanding resources now, because the feds could get tapped out … by some of these early states, particularly New York, which has absorbed a lot of federal resources,” former Food and Drug Administration commissioner Scott Gottlieb told me.
  • Even though they may not be seeing a huge number of cases now, states like Texas and Florida should stop doing elective surgeries now in order to preserve personal protective equipment — like masks, gowns and gloves — for their health care workers, Gottlieb added.

The bottom line: Coronavirus outbreaks, both globally and in the U.S., have seemed manageable until it’s too late. For states that so far aren’t hit hard, there’s no such thing as over-preparing.

 

 

An explosion of coronavirus cases cripples a federal prison in Louisiana

Posted on by • Posted in American Civil Liberties Union (ACLU), Clinical Testing, Coronavirus, Crisis, Crisis Management, Hazard Pay, Health Policy, Infection Control, Infectious Virus, Labor Union, Leadership, Pandemic, Preexisting Conditions, Prison Safety, Public Health, Public Safety, Quarantine • Leave a comment

https://www.washingtonpost.com/national/an-explosion-of-coronavirus-cases-cripples-a-federal-prison-in-louisiana/2020/03/29/75a465c0-71d5-11ea-85cb-8670579b863d_story.html?fbclid=IwAR2rjY1fk7FF2H1vhUxaeZ4c8F3_Vi1HUJhCUkhP-bjFdc_tbuHV8KrKN80&utm_campaign=wp_main&utm_medium=social&utm_source=facebook

Federal prison in Louisiana crippled by coronavirus cases as ...

A federal prison in Louisiana has, within days, exploded with coronavirus cases, leading to the death of one inmate on Saturday, the admission of a guard into a hospital intensive care unit, and positive test results for another 30 inmates and staff.

Patrick Jones, 49, was the first inmate in the Federal Bureau of Prisons diagnosed with the novel coronavirus, which causes covid-19, and the first to die.

At least 60 inmates at the Oakdale prison are in quarantine and an unknown number of staff are self-quarantining at home, said Corey Trammel, a union representative for correctional officers at the 1,700-inmate facility about 110 miles northwest of Baton Rouge.

“It’s been simultaneous, just people getting sick back to back to back to back,” Trammel said. “We don’t know how to protect ourselves. Staff are working 36-hour shifts — there’s no way we can keep going on like this.”

The prison bureau is not releasing the names of other infected inmates or staff, citing medical and privacy concerns. Jones complained of a “persistent cough” on March 19, the prison bureau said, and was transported to a hospital where he was diagnosed and placed on a ventilator.

The prison bureau also said Jones had “long-term, preexisting medical conditions” that increased his risk of developing the disease. Jones was convicted in 2017 of possession with intent to distribute crack cocaine within 1,000 feet of a junior college. He was serving a 27-year sentence.

Louisiana ranks 10th highest among states for reported coronavirus cases, with more than 3,300 people who have tested positive and another 137 who have died, government reports show. A week before the Oakdale prison had its first positive case, Gov. John Bel Edwards (D) issued a stay-at-home order and closed all public schools.

Trammel said the prison bureau has been slow to respond to the crisis across the country. The bureau last week banned family and friends from visiting inmates, but the officers’ union had lobbied the federal prison system to take this action for weeks to keep the disease from infiltrating the prison walls.

The Bureau of Prisons updates confirmed coronavirus cases most afternoons on its website, but there has been a lag between cases reported by the officers’ union and prison officials. As of Sunday afternoon, the prison system had only confirmed 14 inmates and 13 staff have tested positive.

At Oakdale, Trammel said staff also asked prison officials — weeks before the first coronavirus case — to shut down a prison labor program within the facility, where more than 100 prisoners make inmate clothing. The program, Trammel said, was not shut down until after the first inmate tested positive.

The Bureau of Prisons — which operates 122 prisons with more than 175,000 inmates — did not immediately respond Sunday to a request for comment. Oakdale Warden Rod Myers could also not be reached for comment.

Trammel said he asked the prison bureau on Saturday to send specialized medical teams to the facility to help with staffing shortages. He’s also asking for hazard pay, which would increase their salaries by 25 percent as they respond to the crisis. And he’s asking for more robust protective gear, including masks with respirators and perhaps face shields.

“We are bringing inmates to the hospitals and are staying right beside them around the clock,” Trammel said. “All we have is these itty bitty masks — a piece of towel over our faces — and nurses are coming into the room for a few minutes and they are all suited up.”

He also said he believes all Oakdale prison staff have now been exposed to the virus. Days ago, he interacted with an inmate who had a fever and still doesn’t know if the prisoner has received a test.

“We should all be in quarantine,” Trammel said. “We should not be going in to spread this monster of a virus.”

Prison reform advocates, who have been pushing for the early release of elderly and severely ill inmates due to covid-19, said the death of a federal inmate illustrates why government officials need to be doing a better job of protecting people like Jones.

“The conditions and reality of incarceration make prisons and jails tinderboxes for the spread of disease,” said Udi Ofer, director of the American Civil Liberties Union’s Justice Division. “A prison sentence should not become a death sentence. Our leaders must immediately take steps to release those identified by the CDC as most vulnerable to covid-19. With every hour of inaction that passes, the greater the human tragedy.”

 

 

 

 

Amazon Worker Fired After Staging Walkout Over Company’s Handling Of Coronavirus Risk

Posted on by • Posted in Coronavirus, Infection Control, Infectious Virus, Leadership, Living Wage, Management, Market Consolidation, Market Power, Pandemic, Public Health, Public Safety, Sick Leave, Strike, Unfair Labor Practices, Worker Rights, Workers Compensation, Workflow Environment, Workforce Shortages, Wrongful Dismissal • Leave a comment

https://www.yahoo.com/huffpost/amazon-fires-worker-chris-smalls-033240313.html

Amazon Worker Fired After Staging Walkout Over Company's Handling ...

Amazon fired an employee who helped organize a walkout at one of its fulfillment centers over the company’s response to the ongoing coronavirus pandemic on Monday.

Chris Smalls, the employee who helped organize the demonstration, said he felt Amazon had failed to enact adequate measures to protect workers at the facility as many Americans turn to online shopping as stay-at-home mandates expand around the country. Smalls was one of a small group who walked out at a fulfillment center on Staten Island, demanding the company close the site and sanitize it before reopening. He said Amazon had notified employees at the warehouse of one confirmed case of the virus but claimed there were several others that hadn’t yet been reported.

Shortly after the strike, Smalls was terminated after working at Amazon for five years.

“Amazon would rather fire workers than face up to its total failure to do what it should to keep us, our families, and our communities safe,” Smalls said in a statement obtained by HuffPost. “I am outraged and disappointed, but I’m not shocked. As usual, Amazon would rather sweep a problem under the rug than act to keep workers and working communities safe.”

Amazon disputed Smalls’ account in a statement on Monday, saying he had been warned several times for “violating social distancing guidelines” and had been fired after failing to stay home. The company said Smalls’ claims were “simply unfounded.”

“He was also found to have had close contact with a diagnosed associate with a confirmed case of COVID-19 and was asked to remain home with pay for 14 days, which is a measure we’re taking at sites around the world,” a company spokesperson told HuffPost. “Despite that instruction to stay home with pay, he came onsite today, March 30, further putting the teams at risk. This is unacceptable and we have terminated his employment as a result of these multiple safety issues.”

The company also said just 15 employees out of 5,000 at its Staten Island location had participated in the demonstration.

“Our employees are heroes fighting for their communities and helping people get critical items they need in this crisis,” the spokesperson said. “Like all businesses grappling with the ongoing coronavirus pandemic, we are working hard to keep employees safe while serving communities and the most vulnerable.”

The Washington Post notes workers in at least 21 Amazon warehouses and shipping facilities in the U.S. have tested positive for the virus.

Employees at several other major companies staged walkouts on Monday. Workers at Instacart, the grocery delivery company, went on strike nationwide to demand better protections, including hazard pay and expanded paid sick leave. And employees at Whole Foods, owned by Amazon, said they planned to hold a nationwide “sick out” on Tuesday.

Workers at the Staten Island warehouse were first told last week that an employee had tested positive for the novel coronavirus, but they told HuffPost’s Emily Peck that business was “normal” and “running just as it had been” after the declaration. Others said they were afraid of getting sick at work, saying there wasn’t enough protection equipment on site, such as hand sanitizer or masks.

Amazon said it has extended a range of benefits to help protect workers during the pandemic, including extended paid leave options for some employees and increased health and safety measures. Employees diagnosed with COVID-19 are entitled to up to two weeks of paid leave, and Amazon says it notifies workers at sites with infected individuals.

The ongoing efforts by warehouse workers throughout the coronavirus pandemic have garnered support from several lawmakers. Rep. Alexandria Ocasio-Cortez (D-N.Y.) wrote Monday that the employees were simply “demanding dignity.”

“When people work an hourly job, it’s suggested in many ways that you‘re unimportant or expendable,” she wrote on Twitter. “Except you aren’t. Everyone deserves safe work, paid leave, & a living wage.”

 

 

 

Dr. Birx predicts up to 200,000 coronavirus deaths ‘if we do things almost perfectly’

Posted on by • Posted in Centers for Disease Control & Prevention (CDC), Coronavirus, Crisis, Crisis Management, Emergency Preparedness, Health Policy, Infection Control, Infectious Virus, Intensive Care (ICU), Pandemic, Public Health, Public Safety, Social Distancing, Ventilators • Leave a comment

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Dr. Birx predicts up to 200,000 U.S. coronavirus deaths 'if we do ...

The White House coronavirus response coordinator said Monday that she is “very worried about every city in the United States” and projects 100,000 to 200,000 American deaths as a best case scenario.

In an interview on “TODAY,” Dr. Deborah Birx painted a grim message about the expected fatalities, echoing that they could hit more than 2 million without any measures, as coronavirus cases continue to climb throughout the country.

“I think everyone understands now that you can go from five to 50 to 500 to 5,000 cases very quickly,” Birx said.

“I think in some of the metro areas we were late in getting people to follow the 15-day guidelines,” she added.

Birx said the projections by Dr. Anthony Fauci that U.S. deaths could range from 1.6 million to 2.2 million is a worst case scenario if the country did “nothing” to contain the outbreak, but said even “if we do things almost perfectly,” she still predicts up to 200,000 U.S. deaths.

Fauci, the director of the National Institute of Allergy and Infectious Diseases, reiterated Monday on CNN that “I don’t want to see it, I’d like to avoid it, but I wouldn’t be surprised if we saw 100,000 deaths.”

Politics

Birx said the best case scenario would be for “100 percent of Americans doing precisely what is required, but we’re not sure that all of America is responding in a uniform way to protect one another,” referencing images circulating online of people still congregating in big groups and ignoring guidelines from the Centers for Disease Control and Prevention.

Birx was also on “Meet the Press” on Sunday warning that “no state, no metro area will be spared,” a message she repeated Monday. Even if metro or rural areas don’t see the virus in the community now, by the time it does appear, the outbreak will be significant, she added.

How long Americans will be expected to comply with measures, including socially distancing and sheltering in place, remains unclear in this growing pandemic after several states and larger cities began implementing measures over the past couple of weeks.

President Trump announced Sunday that the administration’s guidelines on social distancing have been extended until April 30. Trump said last week that he wanted to see much of the country return to normal by Easter, April 12, despite warnings from top health experts that easing guidelines early could cause mass deaths. Now, Trump said he expects “great things to be happening” by June 1.

Birx said on Sunday that the choice to extend the guidelines had not been made lightly.

“We know it’s a huge sacrifice for everyone,” she added.

 

 

 

 

Amazon, Instacart Grocery Delivery Workers Strike For Coronavirus Protection And Pay

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https://www.npr.org/2020/03/30/823767492/amazon-instacart-grocery-delivery-workers-strike-for-coronavirus-protection-and-

Amazon, Instacart Grocery Delivery Workers Strike For Coronavirus ...

Amazon warehouse workers in Staten Island, N.Y., and Instacart’s grocery delivery workers nationwide plan to walk off their jobs on Monday. They are demanding stepped-up protection and pay as they continue to work while much of the country is asked to isolate as a safeguard against the coronavirus.

The strikes come as both Amazon and Instacart have said they plan to hire tens of thousands of new workers. Online shopping and grocery home delivery are skyrocketing as much of the nation hunkers down and people stay at home, following orders and recommendations from the federal and local governments.

This has put a spotlight on workers who shop, pack and deliver these high-demand supplies. Companies refer to the workers as “heroes,” but workers say their employers aren’t doing enough to keep them safe.

The workers are asking for a variety of changes:

  • Workers from both Amazon and Instacart want more access to paid sick time off. At this time, it’s available only to those who have tested positive for the coronavirus or get placed on mandatory self-quarantine.
  • Amazon workers want their warehouse to be closed for a longer cleaning, with guaranteed pay.
  • Instacart’s grocery delivery gig workers are asking for disinfectant wipes and hand sanitizer and better pay to offset the risk they are taking.

Workers at Amazon’s Staten Island facility have said that multiple people at the warehouse have been diagnosed with COVID-19. Some of them plan to walk off the job on Monday to pressure the company to close the warehouse for an extended deep cleaning.

At Amazon, which employs some 800,000 people, workers have diagnosed positively for COVID-19 in at least 11 warehouses, forcing a prolonged closure of at least one warehouse in Kentucky. The company says it has “taken extreme measures to keep people safe,” including allowing unlimited unpaid leave time for employees who feel uncomfortable working.

Amazon says its decision on whether to close a warehouse for cleaning or for how long depends on where the sick workers were in the building, for how long, how long ago and other assessments. The company has also temporarily raised its pay by $2 an hour through April.

Instacart’s army of grocery delivery workers are not employees, but independent contractors. They say the company has not provided them with proper protective items like disinfectants, hazard pay of an extra $5 per order and a higher default tip in the settings of the app.

Instacart on Sunday said it would distribute supplies, including hand sanitizer, to more workers and that it would change some tipping settings, but did not address paid sick leave for its contractors.

“Actions speak louder than words,” Instacart worker Sarah Polito told NPR. “You can tell us that we’re these household heroes and that you appreciate us. But you’re not actually, they’re not showing it. They’re not taking these steps to give us the precautions. They’re not giving us hazard pay.”

 

 

 

 

Nurse dies in New York hospital where workers are reduced to using trash bags as protective medical gear

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Nurse dies in New York hospital where workers are reduced to using ...

A nurse at Mount Sinai Hospital in New York died from COVID-19 after learning he was infected by the novel coronavirus almost two weeks ago. Protective medical gowns are in such short supply in the Mount Sinai system that some nurses have started to use Hefty-brand garbage bags instead, according to photos on social media.

The New York Post reported that Kious Kelly, an assistant nursing manager at Mount Sinai Hospital in Manhattan, died Tuesday. He was 48 years old.

His sister confirmed his death to the Post, saying that she was told he had been in the intensive-care unit but that he did not think it was serious. The Post did not specify how he contracted the virus.

“We are deeply saddened by the passing of a beloved member of our nursing staff,” Renatt Brodsky, a representative for the Mount Sinai Health System, told Business Insider in a statement. Brodsky did not provide any further details.

New York state has become the epicenter for the US’s coronavirus outbreak, with more than 33,000 infections and more than 360 deaths. In New York and other areas in the US with large outbreaks, healthcare workers are reporting shortages of personal protective equipment like masks, gowns, face shields, and gloves.

At Mount Sinai West, in the same hospital system where Kelly worked, nurses published a photo on social media showing them fashioning plastic trash bags into protective outfits, according to the Post.

“NO MORE GOWNS IN THE WHOLE HOSPITAL,” they wrote on Facebook. “NO MORE MASKS AND REUSING THE DISPOSABLE ONES … NURSES FIGURING IT OUT DURING COVID-19 CRISIS.” One nurse is seen holding a box of Hefty Strong 33-gallon bags, more commonly used for lining household trash cans.

 

 

 

What the U.S. can learn from other countries in the coronavirus fight

Posted on by • Posted in Centers for Disease Control & Prevention (CDC), Clinical Testing, Communication, Coronavirus, Crisis, Crisis Management, Dept of Health and Human Services (HHS), Emergency Preparedness, Health Policy, Infection Control, Infectious Virus, Leadership, Pandemic, Public Health, Public Safety, Quarantine, Trust, Truth, Universal Healthcare System • Leave a comment

https://www.axios.com/coronavirus-lessons-other-countries-24794264-1653-4500-922c-7f1c66efa011.html

Coronavirus lessons that the U.S. can learn from other countries ...

The countries that have most successfully fended off the novel coronavirus have mainly done it with a combination of new technology and old-school principles.

Why it matters: There’s a lot the U.S. can learn from the way other countries have handled this global pandemic — although we may not be able to apply those lessons as quickly as we’d like.

The big picture: A handful of Asian countries, including South Korea, Singapore and Taiwan, have succeeded where the U.S. and Europe have failed.

  • They were able to quickly bring the virus under control, reducing the number of new cases that cropped up each day. And they did it largely without shutting down schools, businesses and public life.

The bad news: It’s too late for the U.S. to simply do what worked in those countries. We’ve already made too many mistakes.

  • But there are still lessons for the U.S. to learn for future outbreaks — and, hopefully, there are some pieces of those countries’ larger strategies that we can adapt to our coronavirus response now.
Lesson 1: The playbook works

As a new infection begins to spread, you want to quickly test the people who might have it, and quarantine the ones who do. Then you want to figure out who else they might have infected, and test those people, and quarantine the ones who are indeed sick. This process gets repeated.

  • “If you don’t know what your population is that you’re supposed to be monitoring, you don’t have a chance,” said Claire Standley, an infectious-disease expert at Georgetown University’s Center for Global Health Science and Security.

This test-and-trace process is nothing new. It’s the standard playbook. South Korea, Singapore and Taiwan just executed it a lot better than the United States.

  • Testing and contact tracing are particularly important with this strain of coronavirus because people can spread it before they start to feel sick — so if you’re only testing the sickest patients, the virus is still spreading unchecked.
  • And it’s important to do this early. It’s a lot easier to stop five people from infecting another 15 than it is to stop 20,000 people from infecting another 60,000.

Next time a mysterious virus starts spreading abroad, better testing and a much faster response will be imperative.

Lesson 2: Technology can help

Singapore has gotten pretty draconian with its track-and-trace process.

  • The government tracks the location of residents’ smartphones, so it knows exactly who had come within a few feet of an infected or potentially infected person.
  • It uses the same location data to help enforce mandatory quarantines.

That might be too Big Brother for the U.S., but a voluntary version of it might work — we already consent to a whole lot of location tracking for much less important ends.

  • And researchers are already using population-level smartphone data to see, for example, which cities are flouting stay-at-home orders. That can help inform local response even without individualized tracking.
  • “I think we’re further along that pathway than maybe people think,” Standley said.

Taiwan, meanwhile, aided its coronavirus response by making better use of data it already had. It quickly merged its immigration and health care databases, giving authorities a real-time view of who was getting sick and where they had traveled.

  • That might be hard to copy in the U.S., though, because the relevant data are scattered across multiple local, state and federal agencies with little to no integration. And we have no centralized health data.
Lesson 3: Messaging matters

Public communication is one of the big things Italy — a leading example of what not to do — got wrong.

  • Some Italian officials downplayed the virus for too long. Leaders often contradicted each other, and sometimes themselves, about piecemeal interventions before finally locking down the entire country as cases skyrocketed.

Singapore, by contrast, came out early with a clear message: This was going to be bad for a while, and people needed to stick together and do their part.

The U.S., so far, looks a lot more like Italy.

  • President Trump has sent similarly mixed messages here, initially downplaying the virus and saying it would go away on its own before changing his tone as cases mounted.
What’s next

The U.S. can’t go back in time to get things right at the beginning. So we can’t match the success of places like South Korea.

  • Our best backup plan is to stick with aggressive social distancing and give our testing capacity more time to ramp up.
  • We don’t seem to be on track to ever achieve the kind of sophisticated track-and-trace programs Asia employed, but hopefully some cruder version can help us find our way out of this if we keep the number of new cases low in the meantime.

The bottom line: “If we had got on top of this thing two months ago, America would look very, very different,” Ashish Jha, director of Harvard’s Global Health Institute, said in a recent interview with the New Yorker.