Coronavirus in the US

Texas has reported its first coronavirus-related death.

The patient was a male resident of Matagorda County in his late 90s. He died Sunday evening at Matagorda Regional Medical Center “with symptoms consistent with Covid-19,” said a news release from the hospital.

The statement also announced a second positive case in the county. The state is now investigating this second case, and have informed the hospital district that "evidence exists of a possible community link to the earlier positive case in Matagorda County.”

Texas now has 57 cases and one death from the coronavirus. (CNN)

That is correct. But now I know someone is actually reading it. :sunglasses:

@thumper1 and @rosered55

Re: the suggestion that med student graduate earlier

I think the author is overly enthusiastic and doesn’t understand the realities of what it’s like to be actual doctor on the ward, nor the complexities of medical licensing. New interns don’t even know how to use the EHR when they they first arrive. Or how to properly fit and wear PPEs. Plus the on-boarding process for licensing take weeks. (And until that license is granted, all they can do is observe. Assisting in patient treatment is malpractice.)

If the almost med grads really want to help, they can volunteer to nanny or do in-home elder care for nursing, medical and therapy staff so they can go to work.

P.S., I believe the recommendation that healthcare workers with potential coronavirus exposure self quarantine for 2 weeks has be lifted.

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One step forward, three steps back. :slight_smile:

@doschicos - I skim all of your posts and read the most important parts! Keep on posting! ?

Yeah. Probably a dead cat bounce. Still searching for a Haynes bottom.

But any interim good news is a short respite from all of this

@BunsenBurner

I’ve kept checking back to the Worldometer site, for the outcome of the Diamond Princess experiment… locking about 4000 people up for a couple of weeks with the virus. Turns out someone did an analysis.

https://www.medrxiv.org/content/10.1101/2020.03.05.20031773v2.full.pdf

Not that many came down with it, not that many died from it… not considering what I’ve seen as to mortality rates. The first may be debatable, but the second isn’t.

Different strain in Italy? Infection rate is grossly miscalculated due to mild or asymptomatic cases?

@doschicos i think you have moved CC site visits back to the old numbers with your incredible work.

Everyone is reading your posts.

Edit: please rest too. It’s going to be a busy month.

In Table 2, it looks like older people were much more likely to get asymptomatic cases compared to younger people, although there was much less variation in the rate of symptomatic cases across age groups.

@4kids4us

Thank you, I stand corrected.

Trump did say something to the effect that he and the people behind him had been very careful and “very strongly tested” when asked about the 25th amendment.

Along with admitting the obvious… I edited the post… I’ll suggest that the average 60+ cruise ship passenger might be a little more fit and active than the norm.

Never been on one, not going to start now, and am just guessing. Heard the food was good.

I wonder what the difference is between being “very strongly tested” and just tested. Is it a different test???

It’s the best test…a test like you have never seen before!

Greetings from Kirkland, WA, Part III.

Except for the grocery stores, this area has turned into a ghost town. The person who came to check on our fire extinguishers at work was wearing gloves and an N95 mask. The exception is the teenagers and young adults who many are out and about like nothing is happening.

For those wondering how testing is going in the worst hit area of the US, the short answer is “not well.”

Can you guess how many test kits were given to a primary care clinic that has roughly 10,000 patients that is supposed to start testing for coronavirus? Less than 20. When are they getting more? No idea, but not anytime soon.

How about guessing how many hours it takes to get results? Insufficient data, but so far it has been a minumum of 6 days.

Testing criteria is still contact with a known diagnosed person. It’s not good enough to have all the symptoms, or to live across the hall from someone with it, or to have a doctor begging to get you tested. The CDC and the State Health dept set the guidelines. Most are stuck in their houses trying not to need to go to the hospital.

On a personal note, D is self-quarantined for 6 more days. So far, so good, feeling OK.

Thanks for the laugh, @CT1417! :lol:

Interesting article:
https://www.cnn.com/2020/03/16/asia/coronavirus-xi-wuhan-anger-intl-hnk/index.html

South Korea and Japan expand travel restrictions
From CNN’s Yaejin Kang in Seoul, Yoko Wakatsuki in Tokyo, and Eric Cheung in Hong Kong

South Korea has expanded its special immigration measures to cover all arrivals starting Thursday, the country’s health ministry announced during a news conference.

The new policies will require all visitors regardless of the port of origin to undergo a one-on-one temperature check when entering the country, it said. Those exhibiting symptoms will be required to take a diagnostic test and quarantine for two weeks.

All visitors will also be required to confirm their local addresses and phone numbers, and install a self-diagnosis app on their smartphones before they are allowed entry.

In Japan, the Ministry of Foreign Affairs also raised its outbound travel advisories for several European countries amid the novel coronavirus outbreak.

The highest warning, which advises citizens not to travel, has been issued for all of Iceland, as well as some provinces of Italy, Spain, and Switzerland. The ministry currently also advises its citizens not to make non-essential trips to other continental European countries.

The US doesn’t have enough stockpiled medical equipment for the pandemic, health officials warn
From CNN’s Kristen Holmes

Top health care officials in the US warned today that the country doesn’t have enough stockpiled medical equipment like masks and gloves to deal with the coronavirus pandemic.

Officials from the Department of Health and Human Services told medical professionals on a conference call today that there was not enough personal protective equipment in the Strategic National Stockpile to fulfill anticipated gaps in state and local supplies, according to a source who was on the call.

These crucial equipment include masks, gowns and gloves. The call was confirmed to CNN by a Department of Health and Human Services official.

The officials said on the call that the government didn’t yet have a solution for the looming shortfall, but was working on one.

“We have been transparent that more supplies are needed – hence the request to Congress for additional funding so we could procure more and scale up production,” an HHS spokesperson said in a statement to CNN.

The role of the national stockpile is to fill the gap temporarily until states and localities working with the private sector can respond to the state and local needs.

[ the same thing was told to states about respirators today - try to source your own. Seriously, how is this going to work? Do they really think stockpiles of PPE and respirators are sitting around in each state? Don’t state governments have enough on their plate right now? Last I heard we only had 1% of the necessary masks in the stockpile so obviously nothing has changed because, believe me, if we were at full capacity, Trump would be crowing about it. What happened to that 3M contract and the promises of millions of masks? They must have vanished along with the millions of tests. Trump gave himself a 10 on a 1-10 scale today at the presser. I am giving him a failing grade thus far. The safety of our medical professionals is at stake - they are putting their lives on the line so let’s at least give them a fighting chance with the proper equipment. Jack Ma finds masks. Maybe the White House should give him a call. Swear words. ]

The authors came up with an infection fatality rate of 1.2%. That’s the percentage of people who die if they are infected, including the people who are infected but have no symptoms. That seems alarmingly high to me.

They come up also with a case fatality rate of 2.3%. That’s the percentage of people who died among those who not only got infected, but developed symptoms. This also seems pretty high.

‘This is like a war’: the view from Italy’s coronavirus frontline

There are the elderly couples who died hours apart and without their families around them. There is the 47-year-old woman who died at home, and who remained there for almost two days because funeral companies refused to collect her body. There are the doctors who lost their lives after assisting their infected patients.

Among the 2,158 people to have been killed by the coronavirus pandemic in Italy as of Monday, the oldest was 95 and the two youngest were 39.

“The reality is this virus is spreading like wildfire. Death is not certain, but the contagion is real,” said Luca Franzese, whose sister, Teresa, 47, died at home in Naples on 7 March.

“My parents are heartbroken, they are destroyed,” he told the Guardian

Teresa, who lived with her elderly parents, sister, brother-in-law and their two children, suffered from epilepsy but was otherwise in good health. A week before she died, she came down with the flu.

“My parents called her doctor but they refused to come to the house despite knowing she had a disability,” said Franzese.

“She went into a coma on 7 March, we tried to call the emergency hotline, they arrived after 40 minutes. In the meantime, I tried to give her mouth-to-mouth resuscitation.”

Teresa tested positive for the virus postmortem. Franzese spoke of his family’s frustration at being “abandoned” by the authorities after his sister was left to die at home.

It was only after he made an appeal for help via Facebook that a local funeral company eventually came to collect her body. But as with other coronavirus victims, she was buried quickly and without ceremony to mitigate the risk of infection posed by her corpse. Her parents, who have underlying health issues, tested negative for the virus, as did Luca and a nephew. The rest of Teresa’s immediate family of seven have tested positive.

Silvio Brusaferro, the president of Italy’s Higher Institute of Health, said on Friday that the average age of coronavirus victims was 80.3, with the majority having suffered underlying illnesses. The most common additional health issue was arterial hypertension followed by chronic heart disease, atrial fibrillation and cancer.

More than 70% of those who have died were men. The two 39-year-old victims were a man with diabetes and a woman with cancer. The vast majority of deaths have been in the northern Lombardy region (1,420 as of Monday night), followed by Emilia-Romagna (346) and Veneto (69).

But not all of the dead had other health issues, at least as far as is known. Luca Carrara lost his father, Luigi Carrara, 86, and mother, Severa Belotti, 82, within a few hours of each other. He told the Italian press they were in good health. “I was unable to see my parents, they died alone, that’s what this virus is,” he added. “The truth is this is not a banal flu and if you end up in hospital, you leave either alive or dead.”

The couple lived in Albino, a town in the badly-affected province of Bergamo in Lombardy. The harrowing impact of the virus on the area can be gleaned from the obituary section of the local newspaper L’Eco di Bergamo.

On Friday, reader Giovanni Locatelli shared online footage comparing the newspaper’s obituary section on 9 February, when listings took up just one page, to a copy dated 13 March, when 10 pages were needed to commemorate the dead.

In Codogno, the Lombardy town where the outbreak began, Enrico Palestra lost his 80-year-old father, Giovanni, who was otherwise in good health. “It’s not a normal flu like people are saying,” Palestra told the Guardian. He declined to speak further.

Another victim in Codogno was the 74-year-old uncle of Alessandro, who asked for his surname not to be used. “He got a fever five days ago and died on Sunday,” said Alessandro. “He was in good form, didn’t smoke and had no previous illnesses. A good part of my family are sick with this virus.”

Alessandro, who lives in Lake Garda, between the Lombardy and Veneto regions, added: “People who don’t live here don’t realise how bad it is. We’re hearing ambulances every half an hour as they take the sick to hospital. It’s striking.

“What amazes me is that other countries are seeing these things, not only England, but have taken precautions too late – or not been decisive enough ones. This worries me.”

Several medics have died, among them Roberto Stella, the president of the order of doctors in Varese, Lombardy. The 67-year-old was tending to patients until he started to suffer symptoms and went into intensive care himself. He died last Wednesday.

“They are all doctors who had no fear of going into combat knowing the risks they were running,” said Saverio Chiaravalle, the vice-president of the Varese doctors order and a close friend of Stella.

“They died on the field, but when you are in combat you don’t imagine it could happen to you. The enemy is invisible, but this is like a war, and the only solution is to isolate – those who have to work must work with precautions, the rest must stay at home.”

https://www.theguardian.com/world/2020/mar/17/this-is-like-a-war-view-from-italys-coronavirus-frontline

“Yeah. Probably a dead cat bounce.”
I agree… its going to be a rough time until we see a reduction of new cases in the US.
As for me, as I am in one of the 7 Calif counties that are mandating “shelter in place”, I shall probably be on CC a lot over the next 3 weeks.
see you all again soon…

Orderly, dour, cowed: how my beloved Italy is changed by coronavirus

Holed up with his family in their Parma flat, our writer tells of the eerie atmosphere in a country usually known for sociability, chaos and fun

by Tobias Jones

Since the whole of Italy was put in quarantine last Monday, it has been surreal here in the northern city of Parma. When you wander around the alleys and squares, you begin to feel like the protagonist of a post-apocalyptic film, constantly asking yourself, “Where is everyone?”

If you do see a solitary human, their reaction is diffidence, if not alarm: they adjust their face mask and move away. The habitual warmth of Italians has been replaced by self-preserving coolness. A very touchy-feely country is now obsessed by personal space.

That eerie sense of living in the end times only increases when you watch the news. Prison riots erupted across the country last week. There was a mass break-out in Foggia (six inmates are still at large). At Milan’s San Vittore prison, black smoke was seen gushing from the windows, and seven inmates died in violence in Modena. The police patrols and blockades only make things feel more ominous.

Free movement within a borderless Europe already seems like a distant memory: there were 90km queues on the Brenner pass (into Austria) last week, and Slovenia has blocked its roads with Italy. It is understandable that Italy, the country with the highest rate of coronavirus infections outside China, should be isolated, but to Italians it feels as if the country is being left to rot. Italy has received more aid from China than from the US or the EU.

Every day the numbers of Italy’s infections and deaths leap by 20% or 30%. Parma is in the Emilia-Romagna region, where so far more than 2,000 people have tested positive and more than 200 have died. In the province of Parma there have been more than 518 cases. One of those, Giovanna, is a close family friend. It feels as if the darkness just keeps getting closer.

The intensive care units are now all full. Hospital wards are spilling out into corridors, tents, car parks, gardens and commercial warehouses. We are hearing words – like “triage” – which are usually associated with warfare. Medics and nurses are having to make decisions on which patients to prioritise. Some doctors have died, and others have compared the numbers of admissions to dealing with “an earthquake every day”.

Part of the weirdness comes from that fact that you can’t go anywhere. Museums, gyms, schools, cinemas and libraries are all closed. Your instinct is to hunker down with the wider family, but all the advice is to stay away from the older generation, who are the most vulnerable to infection. You can’t gather round those who, like Giovanna, are ill. Not even her ailing husband is allowed close to her. You can’t go to church because they, too, are now closed. I would like to head to my mother-in-law’s house in the hills, but we’re not allowed out of the city.

It’s amazing how quickly you become used to new habits: not getting in the lift with other people or standing well apart in a queue (normally we’re bunched tight to foil the queue-bargers). When you ask a shopkeeper for a loaf of bread, they put it on the counter then step away. You pick it up, pay and step away. They put your change out and move back as you move forward. You feel like repelling magnets.

Some friends are fretful, washing their hands every half-hour or putting on surgical gloves to open doors. It’s hard not to begin to doubt your own sanity and wonder whether it’s rational to be following all these restrictions and rituals.

Then, last Wednesday night, another emergency decree ramped up the restrictions: all shops, except chemists and food stores, were ordered to remain closed. If you want to leave the house, you now have to print off a document to explain to police your timing, destination and motive.

In some ways it feels a little as you might imagine the Middle Ages. It’s as if we’re inside a city with metaphorical walls where rumours abound: that a friend, Marco, has a rasping cough; that politician Silvio Berlusconi has tested positive; that our kids will have to attend school throughout Italy’s baking summer. And Parma feels medieval because it is so quiet. I’ve never known it so safe to cycle around an Italian city. It’s as if the cars, as well as the humans, are keeping their distance.

So everything feels softer somehow. I never knew there was someone in the next block of flats who played the guitar. You can hear them strumming late at night. The natural world – all the turtle doves and cherry blossom – seems brighter or emboldened. That quietness extends to the football. Watching Juventus v Inter Milan the other night (before Serie A, too, was suspended) you could hear, in the absence of the crowds, almost everything from the actual game: the laces on leather, the players’ groans, shouts and insults. It made them seem mortal, like Sunday league players. Now, of course, several players – Juventus’s Daniele Rugani and the former Southampton (now Sampdoria) striker Manolo Gabbiadini – have tested positive.

What’s intriguing is that all the adjectives you might normally use to describe Italy (sociable, excitable, chaotic, undisciplined, polemical, fun and – despite all its troubles – somehow optimistic) have become redundant. It feels completely the opposite: isolated, calm, orderly, obedient, cowed, dour and pessimistic. It’s as if the country has suddenly discovered a different, maybe deeper, side. It’s a sterner, more serious place.

It’s sombre, of course, because there have now been more than 1,200 deaths from Covid-19 in Italy. There’s bafflement at the fact that the mortality rate here is (at time of writing) 7.17% compared with 0.05% in Sweden and 0.2% in Germany. We don’t understand why we’ve got it so bad, whether it’s related to hospital capacity, superbugs, a very aged population, a high proportion of smokers or something else entirely. Nor do we understand why the contagion has spread so fast in Italy: the cases per million of the population is, at 250, far higher than anywhere else in the world: Iran stands at 120, China at 56.

There are also well-founded fears about the Italian economy, which was in deep trouble even before this crisis. The Milan stock market plunged 11% last Monday, then plummeted another 17% on the Thursday. With shops and businesses at a standstill, the government has promised a moratorium on mortgage payments, childcare vouchers for working parents and a suspension of tax payments. The costs of unemployment benefit (the country’s cassa integrazione) is likely to spike. Those measures will cost the treasury an estimated €25bn.

Part 1

Part 2

The trouble is that the cupboard is bare. If banks are not receiving mortgage repayments, nor the government its usual tax revenue in spite of soaring expenditure, there will suddenly be a liquidity crisis. The ruthless markets know that: the yields on Italy’s 10-year bonds (a clear indication of the cost of government borrowing) rose more in one day last week than ever before – 50 basis points. Shares in some of Italy’s biggest banks – Intesa and Unicredit – saw double-digit falls. Hence the fury in Italy when the European Central Bank offered no assistance to the country. The response from Italy’s president, Sergio Mattarella, was close to institutional incandescence. “We need solidarity, not impediments to our actions,” he seethed.

Many of us feel deeply melancholic at the suffering Italy is going through. For all my frustrations with this country, I’m an Italian patriot, obsessed by the underdog heroics of the Risorgimento in the mid-late 19th century, when Giuseppe Garibaldi’s guerrillas fought for Italian reunification against the European super-powers. When they were younger, my kids used to salute Garibaldi every time they passed his statue in Parma’s main square, and I would repeat my favourite Garibaldi line: “Italy will never be wholly without sons [and daughters, I added] who can astound the world.”

So I, too, felt offended at the latest international media coverage. There was a discernible glee in some quarters that the “silly Eye-ties” had messed things up again. “They’ll never follow the rules,” said some.

Prejudices about Italy – assuming that problem was the country itself, and not coronavirus – meant that few people abroad took note when, for weeks, Italian leaders, epidemiologists and journalists urged similarly decisive action across Europe. Even as this slow-motion, medical tsunami was moving towards the UK, the prime minister, Boris Johnson, was sneering at the need for “draconian” measures. We watched in disbelief as thousands of people travelled to watch horse racing in Cheltenham and 3,500 gathered in Paris dressed as smurfs just to break a world record.

From our lockdown in Italy, it seemed at that time as if the world’s addiction to sport, partying and frivolity was blinding it to the most serious pandemic in our lifetimes.

Because actually Italians are very well-informed (some might even say obsessive) about personal health. They learn about plague and contagion at school because two of the classics of Italy’s literary canon – Alessandro Manzoni’s The Betrothed and Giovanni Boccaccio’s The Decameron, deal with precisely those themes. Italians, on the whole, know far more about hygiene and medicine than their European counterparts. Now that so many other countries are following Italy’s lead – closing schools, universities and sports events – we feel, at least, somewhat vindicated.

Meanwhile, the five of us are all holed up at home. This is the third week our kids have not been to school with, at least, another three to go. They are sent homework by their teachers through the school websites. There are endless technical hitches and there’s barely enough work to fill a morning. Benedetta attends her ballet school online, using a chair as the bar and dancing around her (neither tidy nor spacious) bedroom.

We’re fortunate that we all get along and that Francesca and I both work flexibly or from home. But some families, and couples, are really struggling with being cooped up, and as well as a spike in birth rates later this year, one suspects divorce rates may also rise.

Even for us, this forced time together is subtly shifting the way we all rub along and who does what. With their usual, frenetic hobbies cancelled, the children have a lot of spare time, so we’re shamelessly giving them domestic chores. They’re cleaning the fridge and the windows, mopping the floors and hanging out laundry. I’m also setting them daily challenges with a didactic dad’s earnestness: if they want to watch TV they have to learn the Nato phonetic alphabet (three passes), the names and dates of the Plantagenet monarchs (two passes), how to tie knots (three passes) or a Shakespeare soliloquy (only one pass). I’m learning quite a lot myself.

But you do wonder what’s going through their minds. Quite apart from the fear, they’re dealing with disappointments which, at their age, must seem huge. Benedetta had won, along with her dance troupe, an international ballet competition, the prize for which was to dance in New York in April. That won’t now happen. Emma, Mozart-obsessed, was due to go with her grandmother to the opera house in Giuseppe Verdi’s birthplace, Busseto, to see The Marriage of Figaro. That, too, has been cancelled. She has started playing melancholic Chopin instead of playful Mozart. Leonardo, like me, just longs to be able to play football again. In our manic matches of indoor one-aside, we’ve accidentally pruned the Victoria spiderworts and smashed the odd lightbulb.

They’re finding new passions too. They love playing euchre and blackjack, betting with matchsticks. Leo is teaching himself Spanish and now calls me el padre or hombre. Benedetta is sewing, she says from behind her bedroom door, a suit jacket. Emma is pretending to get fit. It’s all fairly wholesome in a Waltons kind of way. But they are, like us, getting cabin fever. We don’t know when this is going to end or what the outside world will look like when it does.

There have been eight deaths so far in Parma and, we assume, there will be many more. Parma is a small city. With more than 518 cases, almost everyone has a friend or friend-of-a-friend who is ill. It’s less important, perhaps, but many businesses, too, will go under.

Everyone is trying to be resilient. Children across the country are hanging out paintings on balconies saying andrà tutto bene (everything will be fine). There have been many goosebump moments, like the spontaneous singing of whole streets, the voices joining in complex harmonies through the open windows. There have been laughs: one Roman market stallholder wore a wide, plywood doughnut to guarantee personal distance. But it feels like gallows humour and the songs sound mournful.

Since we’ve been in lockdown, spring has erupted. You can see pinky-white bursts of magnolias lining the empty roads. Daises, primroses and dandelions are suddenly brightening the grass. It even smells like spring. The Parma air is, for once, so clean you can see the snow-capped Apennines from my study. It only makes you keener to get out.

But until this emergency lockdown ends, we will – except for rare excursions – experience the world like prisoners, from the windows of our cells.

Tobias Jones lives in Parma. He is the author of Ultra: The Underworld of Italian Football

https://www.theguardian.com/world/2020/mar/15/life-lockdown-parma-italy-coronavirus