Category Archives: Quarantine

Biden’s Panel Outlines Proactive Pandemic Response as COVID-19 Toll Soars

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https://www.chcf.org/blog/bidens-panel-outlines-proactive-pandemic-response-covid-19-toll-soars/?_cldee=aGVucnlrb3R1bGFAeWFob28uY29t&recipientid=contact-58e265c0591ce51180f7c4346bac4b78-529ece099ac842a7a3e91446b69b4508&utm_source=ClickDimensions&utm_medium=email&utm_campaign=Essential%20Coverage_2020_Q4&esid=50d0ab49-b1f6-ea11-a815-000d3a994d85
Essential Coverage

On the morning of November 7, major news networks starting with CNN called the presidential election for Joe Biden. Although the election has yet to be officially certified, Biden and Vice President-elect Kamala Harris have wasted no time preparing their response to the rapidly worsening coronavirus pandemic.

Over the past week, the US has averaged more than 150,000 new COVID-19 cases per day, an increase of 81% from the average on November 1. The US had a record 181,200 new reported cases on November 13. Over 11 million Americans have been infected, and the nation is nearing a grim milestone of 250,000 deaths. Experts warn that the worst is yet to come. As temperatures drop and family-centric holidays approach, people are likely to spend more time socializing indoors with non-household members, increasing the risk for COVID-19 transmission.

Mitigating the spread of the coronavirus and preventing more deaths are top priorities for the incoming Biden-Harris administration. Biden’s campaign team published a seven-point plan to beat COVID-19, and on November 9, the Biden-Harris transition team named a COVID-19 Advisory Council tasked with guiding the federal response to the pandemic immediately after the inauguration.

The council “will be consulting with state and local officials to gauge public-health steps needed to bring the virus under control,” Evan Halper and Noam Levey reported in the Los Angeles Times. “The board will also focus on racial and ethnic disparities in how, where, and how quickly the virus is spreading.”

Innovative Plan: Tell the Truth

The Biden-Harris plan sets a new tone for the nation’s coronavirus response, using federal powers and leadership to centralize the acquisition and distribution of personal protective equipment (PPE), along with the coordination of testing and contact tracing, instead of leaving those vital resources to be led in 50 different ways by state governors. It emphasizes evidence-based guidance and empowers public health officials and scientists to guide and revise the nation’s reopening strategy as the pandemic evolves.

“You’ll immediately see a change of tone, a change in communication,” Ezekiel Emanuel, MD, PhD, the vice provost for global initiatives at the University of Pennsylvania, told Politico. “This is the stuff of real leadership: telling the truth, modeling the right behaviors like wearing a mask, only having small crowds, putting the scientists out there.”

The first priority in the plan is to ensure that all Americans have access to regular, reliable, and free coronavirus testing. Rapid testing is vital for identifying, isolating, and treating new cases of COVID-19, but the US has been crippled by continuing test shortages and long lag times before results are reported. Biden plans to double the number of drive-through testing sites while scaling up next-generation solutions like home tests.

Contact tracing goes hand-in-hand with testing in the public health response to COVID-19, and the plan would establish a US Public Health Job Corps to train and mobilize 100,000 Americans to perform culturally competent contact tracing in communities most affected by COVID-19.

The second priority is to fix the nation’s PPE problems. N95 masks, gloves, gowns, and other PPE used by health care staff are still in short supply. AARP reported that one in four nursing homes ran short of PPE between August 24 and September 20. (Nursing homes continue to be a hot spot for coronavirus transmission.) Biden would use the Defense Production Act to increase production of PPE and distribute the supply to states instead of leaving states to fend for themselves.

For the third priority, Biden would tap the nation’s wealth of science experts to provide clear public guidance on how communities should navigate the pandemic. The US Centers for Disease Control and Prevention (CDC) would lead this effort, with an emphasis on helping communities determine when it is safe to reopen schools and various types of businesses.

Navigating Hurdles to Safe, Effective, Accepted Vaccine

Although the pharmaceutical company Pfizer announced on November 9 that its coronavirus vaccine trial showed positive early results, the road to vaccinating all Americans is tortuous. Pfizer still needs to seek emergency use authorization from the Food and Drug Administration (FDA) and ramp up vaccine production to meet the global need. In the meantime, Biden plans to invest $25 billion in a vaccine manufacturing and distribution plan that ensures every American can get vaccinated for free. This fourth priority would make the vaccine accessible to all people and communities regardless of income or any other factor.

The fifth priority is to protect Americans who are at high risk of getting seriously ill or dying from COVID-19. This includes people over 65, nursing home residents, and people living in neighborhoods with higher rates of COVID-19. Biden would establish a COVID-19 Racial and Ethnic Disparities Task Force (PDF) to report on disparities in COVID-19 infection, hospitalization, and death rates, as well as to provide recommendations to Congress and the Federal Emergency Management Agency on how best to distribute resources and relief funds to combat these disparities. The plan also calls for strengthening the Affordable Care Act to ensure that during the pandemic, Americans have health insurance coverage.

During the presidential campaign, Biden called for a national mask mandate based on the growing body of evidence that mask-wearing can considerably reduce the transmission of respiratory viruses like the one that causes COVID-19. Biden plans to coordinate with governors and mayors to convince Americans to wear a mask when they are around people outside their household. Currently, 34 states and the District of Columbia mandate face masks in public, but there is no nationwide requirement.

Finally, the plan takes the long view on pandemic threats by rebuilding and reinvesting in defenses that will help the world predict and prevent future pandemics. The Biden administration has declared that the US will rejoin the World Health Organization, restore the White House National Security Council Directorate for Global Health Security and Biodefense, which was eliminated by the Trump administration in 2018, and shore up CDC’s global corps of disease detectives.

Public Health Experts at the Helm

The newly announced COVID-19 Advisory Council is a who’s who of public health experts, former government officials, and doctors, including several from California. The panel currently comprises 13 members, but Biden has said it may be expanded.

The three cochairs of the advisory board are former surgeon general Vivek Murthy, MD; former FDA commissioner David Kessler, MD, a UCSF professor of pediatrics, and of epidemiology and biostatistics; and Marcella Nunez-Smith, MD, MPH, an associate professor of internal medicine, public health, and management at Yale University whose research focuses on health disparities.

The other members appointed so far include:

  • Luciana Borio, MD, vice president at the venture capital firm In-Q-It. Borio served in multiple leadership roles in the Trump and Obama administrations in the National Security Council and FDA.
  • Rick Bright, PhD, director of the Biomedical Advanced Research and Development Authority under Trump and Obama. Bright resigned from the government in October after being removed from his vaccine development role by President Trump.
  • Ezekiel Emanuel, MD, PhD, the vice provost for global initiatives at the University of Pennsylvania. Emanuel served in the Obama administration as special advisor for health policy to Peter Orszag, PhD, the former director of the Office of Management and Budget.
  • Atul Gawande, MD, MPH, a professor at Harvard Medical School and the Harvard T.H. Chan School of Public Health. Gawande is a staff writer covering health and medicine at the New Yorker and served in the Clinton administration as senior adviser in the Department of Health and Human Services.
  • Eric Goosby, MD, a professor of medicine at UCSF. Goosby, an expert on HIV/AIDS, led policy work in this field under Clinton and Obama.
  • Celine Gounder, MD, a clinical assistant professor of internal medicine and infectious diseases at New York University.
  • Julie Morita, MD, executive vice president of the Robert Wood Johnson Foundation and former commissioner of the Chicago Department of Public Health.
  • Michael Osterholm, PhD, MPH, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
  • Loyce Pace, MPH, president and executive director of the Global Health Council.
  • Robert Rodriguez, MD, a professor of emergency medicine at UCSF.

Cartoon – What’s the Matter with America?

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Tribune Editorial: Ignorance and apathy in Utah increase threat of coronavirus - The Salt Lake Tribune

Cartoon – Price of Freedom

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A B- for Canada, an F for the U.S. | The Seattle Times

States split on COVID-19 responses as cases surge

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https://thehill.com/homenews/state-watch/525952-states-split-on-covid-19-responses-as-cases-surge?rnd=1605382007

Ben Sargent

Governors across the country are grappling with an alarming surge of coronavirus cases and hospitalizations, so far putting forward a fractured response.

Despite the escalating public health crisis, many governors have taken only modest actions; most states still allow major sources of spread such as bars and indoor restaurants to remain open.

President Trump on Friday touted progress on a vaccine but did not announce any major new steps aimed at slowing the spread of the virus in the short term, and he is leaving most of those decisions to states.

Experts are urging governors to impose stronger measures such as closing bars and gyms, prohibiting indoor dining, mandating masks, and advising people to limit in-person gatherings.

“There are many very troubling warning signs in outbreaks across the U.S.,” said Anita Cicero, deputy director of the Johns Hopkins Center for Health Security. “I do feel that more immediate action is required.”

While most state actions have been relatively minor, stricter rules are starting to pop up, particularly from states with Democratic officials, underscoring the red versus blue divide on public health measures reminiscent of earlier this year.

New Mexico Gov. Michelle Lujan Grisham (D) on Friday instructed residents to stay home except for essential business, and Chicago Mayor Lori Lightfoot (D) issued a similar advisory. More such orders could be coming as the situation worsens.

Experts for the most part are not calling for a return to full-scale lockdowns, saying much has been learned since the spring about how the virus spreads, and there is little reason to stop low-risk activities such as curbside pickup from a store.

But significant sources of spread such as bars, indoor restaurants and gyms should be closed in hard-hit areas, they said.

Many states have not taken those steps, despite the ever-mounting case counts.

The country is now recording an unprecedented 150,000 new cases every day, with hospitalizations at record levels of more than 60,000 and deaths at around 1,000 per day and starting to rise. Hospitals in some areas are reaching capacity and becoming overwhelmed.

These trends show no signs of slowing as temperatures get colder and more activity moves indoors.

Just 13 states have closed their bars, according to a tracker from the Kaiser Family Foundation.

But there’s bipartisan pressure for states to do more.

A Washington Post op-ed on Wednesday — authored by Richard Danzig, Navy secretary under former President Clinton; James Lawler, an infectious disease doctor at the University of Nebraska; and Tom Bossert, a former homeland security adviser to President Trump — called on states to take three specific actions: limit indoor gatherings to no more than 10 people, close indoor restaurants and bars, and require masks in public.

The authors said those steps should be taken in any region where there are more than 20 new cases per 100,000 people per day. Forty states are already above that threshold, according to the COVID Exit Strategy tracking site.

Still, governors in some of the hardest-hit states have resisted actions such as statewide mask mandates and bar closures.

Iowa Gov. Kim Reynolds (R) has long opposed a statewide mask mandate, but amid the worsening outbreak, she issued an order last week requiring masks at businesses such as barbershops and at large gatherings.

At the same time, she emphasized that she did not want to close businesses.

“You can still eat in a restaurant, you can still go to a movie and work out at a gym, and in many states you can’t do that,” she said at a press conference on Tuesday. “Iowa is open for business, and we intend to keep it that way.”

Mississippi Gov. Tate Reeves (R) struck a similar note in an address on Thursday.

“We’re trying to open things up but to do it in a safe, responsible way,” he said. “We’re not going to shut down businesses. We’re not going to have long term mandates with no end in sight.”

On Capitol Hill, congressional leaders have been deadlocked over a new round of economic aid, which could provide relief for businesses such as bars and restaurants and allow them to temporarily close to slow the spread of the virus without taking a major financial hit.

“There needs to be a policy lever to help support and maintain those small businesses,” said Preeti Malani, chief health officer and professor of medicine at the University of Michigan.

In New York City, bars and restaurants are still open, with a new 10 p.m. curfew. But the prospect of schools closing has sparked criticism about the city’s priorities.

“If NYC closes schools and continues to allow indoor dining our priorities are totally backwards,” tweeted New York City Council member Mark Levine.

Malani said schools have been a “good-news situation” and have not been a significant source of transmission.

“If the balance is between keeping the bars open and keeping the schools open, that’s an easy decision in my mind,” she said.

Celine Gounder, a coronavirus adviser to President-elect Joe Biden, made a similar point on Friday.

“Some of those higher-risk places are, for example, restaurants, bars and gyms, whereas schools are not zero risk, but they’re much much lower risk, and they’re an essential service really,” she told CNBC. “So I think we need to close only those things that really are contributing to the spread and really try to let as much as possible remain open, like schools, if they’re not contributing to spread.”

Anthony Fauci, the government’s top infectious disease expert, said at an event hosted by the think tank Chatham House on Thursday that the news that Pfizer’s vaccine candidate was more than 90 percent effective in an interim analysis provides something of a light at the end of the tunnel.

That promising news, he said, should encourage people to take some tough steps for a few months until the vaccine is widely available.

“Ever since it became clear a few days ago that we have a really quite effective vaccine getting ready to deploy, [the message] is rather than ‘Hey. Don’t worry. You’re OK,’ it’s ‘Don’t stop shooting. The cavalry is coming. But don’t put your weapons down. You better keep fighting because they’re not here yet,'” Fauci said.

Cartoon – Covid Denialism

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Cartoons

Cartoon – State of Denial

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Granlund cartoon: State of denial

Cartoon – State of the Union on Covid

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Cartoon, Centers for Disease Control & Prevention (CDC), Clinical Testing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Misinformation, Misinterpret, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Out of Control, Pandemic, Partisanship, Public Health, Public Opinion, Public Perception, Public Safety, Public Trust, Quarantine, Scientists, Social Distancing, State of the Union • Leave a comment
Hands on Wisconsin: Listen to doctors about COVID-19, not politicians | Opinion | Cartoon | madison.com

Cartoon – Struggling with Capacity for Patients vs. Patience

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Hands on Wisconsin: COVID-19 is taxing for everyone | Opinion | Cartoon | madison.com

Cartoon – Covid Denial

Posted on by • Posted in Asymptomatic Transmission, Cartoon, Clinical Testing, Coronavirus, Denial, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Misinformation, Misinterpret, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Out of Control, Pandemic, Public Health, Public Opinion, Public Perception, Public Safety, Public Trust, Quarantine, Scientists, Social Distancing • Leave a comment
Bruce Plante Cartoon: Corona virus denial

184,514 new COVID-19 cases in 1 day; states ramp up safety measures: 5 updates

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https://www.beckershospitalreview.com/public-health/184-514-new-covid-19-cases-in-1-day-states-ramp-up-safety-measures-5-updates.html?utm_medium=email&utm_content=newsletter
The Coronavirus Outbreak - The New York Times

The U.S. recorded 184,514 new COVID-19 infections Nov. 13, a 20 percent increase from the new case count one day prior, according to data compiled by Johns Hopkins University.

The country also hit a 10-day high in daily deaths, with 1,431 reported Nov. 13. 

The COVID Tracking Project reported more 68,516 hospitalizations for Nov. 13, with 19 percent of those patients in intensive care units and 6 percent on ventilators. 

Here are several other noteworthy developments related to COVID-19 in the U.S. over the past 24 hours:

1. Several governors rolled out measures Nov. 13 to mitigate the virus’s spread, according to the Wall Street Journal. 

  • New Mexico Gov. Michelle Lujan Grisham issued a two-week shutdown of all nonessential activities effective Nov. 16. COVID-19 hospitalizations in the state tripled in the past four weeks.
  • Oregon Gov. Kate Brown tightened capacity restrictions for restaurants, gyms, retail stores and places of worship, effective Nov. 18. 
  • Virginia Gov. Ralph Northam expanded a mask mandate and restricted public and private gatherings in the state to 25 people, effective Nov. 15. Masks are now required for everyone age 5 and older, rather than age 10 and older.
  • New York‘s court system issued plans to indefinitely halt most in-person proceedings, including jury duty. 
  • North Dakota Gov. Doug Burgum issued a mask mandate effective Nov. 14 through Dec. 13, as well as capacity limitations for bars, restaurants and event venues.
  • Vermont Gov. Phil Scott issued an executive order to close bars and clubs and ban multihousehold gatherings of any size, according to The Boston Globe. 

2. Massachusetts Gov. Charlie Baker is reopening the state’s field hospital after it went inactive roughly five months ago, according to The Boston Globe. The 240-bed facility at the DCU Center in Worcester should be primed to accept patients the first week of December. 

3. The recent widespread surge of COVID-19 cases across most of the U.S. is prompting several states to adjust plans for schooling. Detroit, Boston and Baltimore have shut down or scaled back in-person learning because of increases in coronavirus cases, the Wall Street Journal reports. New York City’s mayor warned parents Nov. 13 that the schools could be closed as soon as Monday if COVID-19 cases continued their climb.

4. Wisconsin’s field hospital, which opened Oct. 14 on the state fairgrounds in West Allis, currently has 15 patients under its roof, Wisconsin Public Radio reports. The site could accommodate 50 patients upon opening; as operations ramped up it could take up to 530. WPR reports that the facility is too far for some patients from central and Northern Wisconsin, while others have refused to go to the field hospital even after education about how the alternate care site could free up hospital beds for those who are critically ill. 

5. Fewer systems and clinician communities have the option to send help. The geographic distribution of COVID-19 activity means it is less likely that hospitals could deploy a similar strategy to the first and second surges earlier this year, in which medical professionals traveled to reinforce care teams in cities and areas that were in the height of crisis. “We haven’t extended the request, but I’m confident that there’s no one that could come to help,” Jeff Jensen, MD, a critical care physician who splits his time between Mayo Clinic Rochester and Mayo Clinic Health System in La Crosse, Wis., told Bloomberg. “They would be busy taking care of the local issues in their community.”