JHU site lists the total of cases at 7,780 and the death toll at 170. All of the deaths have occurred within China, all but 8 within Hubei, the province in which Wuhan is located.
Yes. I have wondered, however, how the American healthcare system would deal with a similar breakout and strain on our hospitals and healthcare structure. Many Americans are still underinsured/uninsured and many donāt have primaries, overusing emergency rooms and such.
Another report says that of the 3 confirmed cases, 2 of the people were not presenting with any symptoms.
A second plane came back Thursday, Japan time and reports say either 9 or 12 of those had symptoms upon arrive in Japan.
The few times Iāve been to ERs in HI, the few people Iāve watched actually get seen are those who arrive by ambulance, often elderly and either having trouble breathing or chest pain. The rest just sit and sit and sit in the waiting room.
I experienced this about 20 years ago and also more recently. There isnāt much room for people to sit, since so much is taken by folks who are already there.
Have heard from healthcare providers that uninsured and underinsured use the ER as their primary care and for a bed and meal and shower and getting more Rx when they run out or lose their Rx. Definitely NOT ideal.
From Time:
āThe agency said Wednesday that 165 individuals across 36 states were considered to be āpersons under investigation.ā āThat is a cumulative number and will only increase,ā said Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the CDC. Of these 165, five had tested positive, 68 tested negative and 92 determinations are still pending. The people being investigated could include those who have a fever and respiratory illness after traveling to Wuhan and individuals who have had contact with a patient who tested positive for the disease and have a fever and respiratory illness.ā
Looks like people arriving from China can slip through the cracks:
A person who arrived at Logan International Airport on a flight from Beijing was medically evaluated Wednesday, according to Boston Emergency Medical Services.
Boston EMS officials told WCVB that the patient refused transportation to an area hospital for further treatment.
An official with the health commission said Boston EMS determined the person showed no signs of any symptoms related to the Wuhan coronavirus and was cleared to leave the airport.
The health commission said it was able to verify with Massport that the individual in question left the airport and was never in quarantineā¦
The Centers for Disease Control and Prevention did not say whether or not the passenger who was evaluated is being held in quarantine.
Massport said it still has not been contacted by the CDC in order to start screening for the coronavirus at Logan Airport."
Thatās as it should be. If you are in respiratory distress or having chest pain indicating a possible MI (heart attack), of course you should get priority.
But as you mention, all those other people have legitimate issues, and need to be seenā¦ in urgent care, not ERs.
Well, I do not blame the person who escaped. Who wants to be locked up for 2 weeks and then be presented with a massive hospital bill? Even if the person has insurance, copays and out of pockets could be astronomical.
Good point @BunsenBurner! I actually never thought about the insurance/financial implications of being quarantined. Yikes. In this society, that could be ruinous for most people, especially since insurance companies have probably all kinds of ways to protect themselves from such extensive coverageā¦
Would insurance even cover an inpatient stay for quarantine with zero symptoms?
ERs donāt have the authority or staffing to get folks to shift from their ER to an urgent care, even though it is likely an more appropriate place for many patients languishing in ER waiting rooms.
I would assume the government would cover the quarantine? Maybe not. Inquiring minds want to know.
But, obviously, as previously discussed, I guess people canāt be forced into quarantine. The reports from the govt. on the evacuees that arrived back today make it quite clear that the folks are staying on a voluntary basis.
The interesting thing about the story to me was that statement that CDC hasnāt contacted MassPort about screening for the coronavirus yet people are flying in from China. Cracks in the system.
Oh I am sure insurance companies will be weaseling out of any quarantine-related payments as much as they can.
Itās probably tough to screen for passengers who have connected through cities outside of China on different airlines from the ones they took out of the country. I wonder if theyāre sending holders of Chinese passports through secondary inspection.
CBP has some pretty sophisticated systems. Canāt imagine it is that hard for them to pinpoint final destinations of people coming into the country via connecting flights from China but who knows how siloed that info is away from CDC and efforts to control the virus in the USA.
Hereās a wsj article about the high cost of quarantine but no answer about whether any insurers pay any of it.
There are many other costs, including lost wages, meals, monitors, etc. I suspect it would have mentioned if any insurer helped with costs.
I canāt read the article.
But, if the goal is to get folks to cooperate with a voluntary quarantine to stem the spread, wouldnāt it make sense to make that at least somewhat attractive/tolerable to the person? If the individual had to pay, seems like that would be counterproductive to the goal.
ETA: found this online
42 U.S. Code Ā§ 249. Medical care and treatment of quarantined and detained persons. Any person when detained in accordance with quarantine laws, or, at the request of the Immigration and Naturalization Service, any person detained by that Service, may be treated and cared for by the Public Health Service.
What is the Public Health Service?
The United States Public Health Service (USPHS) is a division of the Department of Health and Human Services (HHS) concerned with public health. Their Commissioned Corps are health professionals whose missions is to protect, promote, and advance, the health and safety of the Nation.
Kind of ridiculous we even have to discuss this because of the state of our health care system. Kind of a moot point in many other countries.
This article (from 3 years ago), says SOME insurance policies cover quarantine costs and others donātācheck the terms of your policy.
I think this NYTimes article is helpful:
Looks like the death rate is a lot lower than SARS (10%) and MERS (35%). Still, seasonal flu is 0.1%.
https://www.google.com/amp/s/www.nytimes.com/2020/01/29/health/china-coronavirus-outbreak.amp.html
DH Is back from his travels (for work but not to Asia this time) and says that he thinks the low number of samples being sent to the CDC for testing is due to the protocol, hassle and paperwork of sending. Docs arenāt going to send unless they have a very sick person and no other explanation. So the 80% who get a mild case are flying under the radar, and even with the sicker 20%, if they seek care, providers may find another virus, bacteria etc. and chalk it up to that. I thought they would be asking everyone with a cough if theyād traveled to China. DH is more intellectually curious than worried, so I will try to follow suit.
Our state is officially going to start screening passengers from Wuhan. Iām not sure our state is prepared to treat any that are suspected of being infected, as most of our hospitals run close to full beds most of the time.
Itās important enough that theyāll find beds.
In regards to the whole whoāll pay for it question, there is a big thread on reddit about it. More than a few posting there who have indicated that theyāve been quarantined in the past for other things and never saw a bill.