Coronavirus in the US

@romanigypsyeyes You might want to call your doctor first. A hospital isn’t the place to be, IMO, right now unless you really need to go. More germs there than out in the broader world.

As posted upthread, Boston did cancel St. Pat’s day parade (I heard Ireland canceled theirs first). But apparently the Flower Show is still on.

@doschicos no worries I’ll be calling triage before I make any decisions about going. They’re really great about getting back to us quickly.

If I go, they’ll send me to L&D instead of the regular ER - which is on its own floor in an almost separate building from ER and the general hospital. Breathing is just becoming more difficult even though I’m still not running a fever or anything. knock on wood

I’ve heard Marty Walsh isn’t a big fan of the parade to begin with (issues with behaviors and costs) with so this is a good idea. Less hangovers too I’m sure.

Take good care of you two, @romanigypsyeyes!

FRANCE - 203 new cases today for a total of 1,412 putting it in 5th place after China, S. Korea, Italy and Iran. 11 new deaths for a total of 30.

SPAIN - finished the day with 557! new cases totaling 1,231 and 13 new deaths totaling 30.

UK - 43 new cases for a total of 321, 2 new deaths for a total of 5.

BAHRAIN - 24 new cases totaling 109.

I think that it isn’t just the fatality rate that is important but the % of the population who will get this illness. Some estimates are 70% of the population will get it. If it has even a 1% fatality rate, that’s a staggering amount of fatalities. Hopefully the treatments will improve the survival rate.

I keep posting stuff in the wrong thread - too many coronavirus threads going on.

Meant to post this here.

Just listened to the WH press briefing. Reporters asked about the amount of testing going on. They could not answer. The answer was basically they only know of the number from CDC labs and public health labs. They do not know the number from hospitals and private labs (I think that is just starting and should be minimal? Or hasn’t quite started yet?) They are working on an “IT system” as it was put several times.

I think it is very unfortunate they aren’t collecting this data. How can they have a handle on the situation without these tallies? It’s important for the here and now planning and response but also important to have for historical and study purposes.

If you can’t get a system built right away (and call on the tech industry - they could set it up quickly) then create a simple spreadsheet in the meantime and hire someone to data entry, the old school way.

It shouldn’t be this complicated.

My contribution to the thread: BBC world service has a podcast with the day’s news, and quite a bit of excellent coverage of the coronavirus.

My current worry is that people who are “younger” (under 60) might not have a high mortality rate, but the BBC quoted an Italian doctor heading up Lombardy’s response as saying 10% of those younger people need to be hospitalized, and of that group, 10% need ICU care, including intubation. I worry that people who could otherwise survive might not if we run out of ICU beds and equipment.

Adding ICU capacity is what we should be working on now.

I agree. I’m also very nervous that the lack of testing here is creating a false sense of security that this is no big deal because of the circular argument that there are so few confirmed cases in the U.S. Italy has tested around 50000 people already. We have tested less than 2000. We are way behind.

https://www.politico.com/news/2020/03/06/coronavirus-testing-failure-123166

https://www.theatlantic.com/health/archive/2020/03/how-many-americans-have-been-tested-coronavirus/607597/

Our state has tested 20 or fewer! Crazy!

Son just sent this statement from the Port of Seattle; they haven’t decided yet what to do about the upcoming Alaska cruise season: https://www.portseattle.org/news/port-statement-start-2020-cruise-season

He said:

Maybe it can just sail around quarantining the crew for three weeks then head up to Seattle.

Exactly. More testing and more positive cases will bring more awareness which in turn will slow down the spread.

Per today’s presser, Quest Diagnostics is starting testing today. Note, only upon order from a physician, after meeting the CDC criteria. Starting on west coast; adding other states shortly.

https://www.questdiagnostics.com/home/Covid-19/

It would be worthwhile to know the death rate by age, gender, and pre-existing condition, as opposed to one of the three factors. 80-year-old people are much more likely to have the pre-existing conditions listed, so is the higher death rate due to having the pre-existing conditions, or because they are older?

"In the US, passengers are expected to start disembarking the Grand Princess cruise ship, which has 21 confirmed cases of coronavirus, mostly among crew members, on board.

The cruise ship was forced to idle for days off the coast of California because of the cluster cases. It arrived in port on Monday as state and US officials prepared to transfer its thousands of passengers to military bases for quarantine or return them to their home countries.

When the ship pulled into the Port of Oakland near San Francisco with more than 3,500 people aboard, passengers lining the balconies waved and some left the cabins where they had been in isolation to go onto deck as the ship entered the port near San Francisco, AP reports.

Workers wearing gloves and yellow protective gear have placed a large tent by a platform where passengers will disembark. At least 20 buses and five ambulances are parked nearby, and officials have said those needing acute medical care for any reason will get off first. (Guardian)

In the lockdown in Italy, WHO director general Tedros Adhanom Ghebreyesus voiced hope that drastic measures taken there could help rein in the virus, and would give less-affected countries more time to prepare for a wider spread.

But he acknowledged that “the disease has not run its course”.

“Right now I think we are still very much in the beginning or middle… of this fight,” he said, warning against complacency towards the virus.

As for the word pandemic, “I am not worried about the word, I am more worried about what the world’s reaction to the word will be,” Tedros told reporters.

He also slammed those who might suggest simply letting the virus run its course, pointing out that for the elderly and weak especially “it is very fatal.”

“If anything is going to hurt the world it is a moral decay, and not taking the deaths of the elderly or senior citizens” seriously, he said.

“Pandemic doesn’t mean that we say it is fine to live with it… we can contain it,” he said.

“No white flag. We don’t give up.”

“Pandemic” is not an official WHO term, and it does not trigger any specific actions. WHO has already put out its highest level of alert - saying the world is at “high risk”" (Guardian)

The death rate is much higher in the countries where a severe cluster of cases came all at once and overwhelmed the health system. (China, Italy, Iran). But South Korea, Germany, and France have fared better (so far), even as cases rise.

https://www.worldometers.info/coronavirus/#countries

Another one…

US congressman goes into self-quarantine
From CNN

Republican Rep. Mark Meadows, President Trump’s new chief of staff, is in self-quarantine as a protective measure, his office said.

“Rep. Meadows was advised this weekend that he may have come in contact with the (Conservative Political Action Conference) attendee who tested positive for COVID-19, now 12 days ago,” said Ben Williamson, Meadow’s chief of staff.

“Out of an abundance of caution, Meadows received testing which came back negative. While he’s experiencing zero symptoms, under doctors’ standard precautionary recommendations, he’ll remain at home until the 14-day period expires this Wednesday.”
Meadows was not scheduled to start his new job this week, an official said.

Some background: Georgia Rep. Doug Collins, the top Republican on the House Judiciary Committee, Rep. Matt Gaetz of Florida, Sen. Ted Cruz of Texas and Rep. Paul Gosar of Arizona announced that they would self-quarantine after coming into contact with an individual who has been diagnosed with the novel coronavirus at the recent CPAC.

Rep. Louie Gohmert of Texas was told by officials over the weekend that he had also been in proximity to the individual, but he is not planning to self-quarantine, a Gohmert aide tells CNN, details the congressman himself confirmed on Twitter on Monday evening.

The CDC criteria appears to be part of the problem. If there is starting to be community spread - and given that we’re seeing confirmed cases in people who haven’t traveled to only narrowly defined areas and haven’t had direct contact with a known case - the guidelines that require those two things to happen before someone can be tested are a problem.

It’s like keeping our hands covering our eyes to deliberately not see what is happening. When there was a severe shortage of tests, it might have made sense to dictate that they only be used on people who had personally traveled or had contact with an infected person, but it’s time to start testing others who may not have hit those criteria but clearly show symptoms and have tested negative for flu and other similar illnesses.

Apologies for going a little off track, but I have a feeling I saw an actual list of the steps/hierarchy in the NY testing protocol - something like, 1.) if you’ve been in a level 3 country 2.) if you have flu-like symptoms but have tested negative for Type A and B, and continuing from there - in this or the other coronavirus thread. Does this ring a bell with anybody, and if yes, can you point me to it? Many thanks.