Coronavirus in the US

Puerto Rico governor asks FAA to restrict and redirect flights to the island
From CNN’s Melissa Alonso

Puerto Rico Gov. Wanda Vazquez Garced is requesting that the Federal Aviation Administration restrict and redirect flights to the island, Vazquez said at a press conference Thursday.

“Many countries have closed off their borders because it’s the way to contain community spread,” she said. “It’s severe but I think we can” work with the FAA on this."

There are five travel-related cases of coronavirus on the island, three were cruise passengers and two flew-in from abroad, the governor said. A sixth case was reported from a veteran’s hospital on the island.

“If we can redirect all flights to enter through the international airport,” for example, the island can “centralize” screenings, the governor said.

“It’s not a complete cut-off,” Vazquez added.

Puerto Rican officials are scheduled to speak to FAA officials on Friday, she said.

“We’ll see what the concerns are or if there are any alternatives they can offer to our request,” says Vazquez.

[makes sense]

Igloo has already said it, but it bears repeating. It was only after half the world was wondering whether a completely asymptomatic carrier could infect so many people in a business meeting that someone managed to reach out to her in China and she admitted she had felt ill at the time and covered her symptoms with paracetamol. And she had hosted her parents from Wuhan shortly before the trip.
It is too late now to harp on how much responsibility this patient might have had, but there are theories that one infected person may have escaped the German containment effort and carried the virus to Italy. More deaths there than in China by now.

Edited to add I still feel that a head of state insisting on calling it the “Chinese virus” when there is an established scientific name for it, but the world could have done without the moaning from China and the WHO about how mean those travel bans were at the time, when they still might have helped.

And it’s really important to get the stories about about individual responsibility. For everyone.

Colombia has become the latest country to block the entrance of all non-citizens, Reuters reports. The restriction will begin this weekend in a bid to control the spread of coronavirus, President Ivan Duque said on Thursday.

The Andean country earlier this week closed its land and water borders and limited entry through airports to citizens and foreigners who are residents. Citizens will still be allowed to return, Duque said in a televised address.

The prime minister of the Netherlands has offered reassurances amid the global coronavirus outbreak: telling citizens there is no shortage of loo roll, Reuters report.

“Yes, I have enough,” Mark Rutte told a shopper in an informal exchange while visiting a supermarket to show support for workers. “They have it (on shelves) again.”

He added: “But there’s enough in the whole country for the coming 10 years. We can all poop for 10 years.”

Dutch supermarkets shelves have mostly refilled following a stockpiling episode last week.

It is “just a matter of time” before the coronavirus reaches Syria’s last opposition-held pocket, an aid agency warned on Thursday, as civil defence rescue teams worked round the clock to sterilise public facilities and set up containment centres.

The UN says around 900,000 people are living in makeshift accommodation and overcrowded tents in Idlib province, where adequate hygiene and social distancing measures are impossible. Idlib is home to approximately three million people.

While the area was granted some respite from a brutal regime offensive when a ceasefire was brokered on 5 March, bombing campaigns by Bashar al-Assad and his Russian backers have put 61 medical facilities out of action over the past year, and medicine, equipment and beds are already dangerously scarce.

A total of 60 beds are now available ahead of a Covid-19 outbreak. The White Helmets have begun disinfecting schools and other public spaces and have held 328 awareness sessions about the risk to the public and best practices for protection, the Syria Campaign said on Thursday.

“After all the death brought by warplanes and bombs, a new disaster – coronavirus – is chasing Syrians here. Of course people are scared, but they have nowhere to escape to. It’s very overcrowded everywhere and people can’t just stay home or inside their tent,” said Ibrahim al-Haj, a White Helmets volunteer.

Guardian

France has warned it may start turning away travellers from Britain unless the UK adopts a similar near-total lockdown to those in place in other European countries.

With EU governments including Italy, Spain and France requiring citizens to stay at home to contain the coronavirus, and Italy threatening to tighten restrictions even further, the French prime minister, Édouard Philippe, said if the UK did not follow suit soon, arrivals from Britain could be refused entry.

“Everyone in the EU must adopt logical methods and processes to fight against the epidemic,” Philippe said. “It’s obvious that if neighbouring states like the UK leave it too long, we would have difficulty allowing British citizens who are moving freely around their country to come to France.

Death toll in Spain increases to 767

Spain’s health ministry said the death toll from coronavirus soared by 169 to 767 fatalities in the last day.

Among the latest victims was a 52-year-old nurse from the Basque country. “Today the coronavirus dealt a blow to the soul of the Basque health system,” the regional government said in a statement announcing the death. “We were not prepared for this blow.”

The country is battling an epidemic that is spreading at a rate faster than almost anywhere else in the world, with health authorities reporting 17,147 confirmed cases on Thursday.

The steady growth in cases is expected to continue for several days, particularly as authorities attempt to roll out expanded testing for the virus in the coming days.

“These are difficult days,” said Fernando Simón, the head of the country’s health emergency centre. “These are the days where will continue to see the number of cases rise.”

Nearly half of the country’s cases are in Madrid, where the regional leader has described a system that is in dire need of protective gear, staffed by workers run off their feet and where hospital beds are at capacity. “I beg you earnestly for supplies to save lives and protect our healthcare professionals,” Isabel Díaz Ayuso said earlier this week pleading for ventilators and other essential supplies.

Help has started to arrive from unexpected sources.

A military base on the outskirts of Madrid has been converted into a production facility, producing supplies of hand-sanitiser and paracetamol. In the centre of Madrid, patients have begun arriving at a four-star hotel – one of several vacant hotels being turned into makeshift hospitals.

On the Valencian coast, local clothing company The-Are has swapped out production on their own clothing line to focus on sewing masks for healthcare workers, while fast-fashion giant Inditex – owners of Zara, among other brands – has said it is looking into using some of its capacity to produce hospital gowns.

As authorities in Madrid scrambled to contain the deaths caused by the virus, some of the focus has shifted to the region’s more than 400 elderly care homes, where the uncontrolled spread of the virus has been blamed for dozens of cases.

Authorities this week launched an investigation into one nursing home where at least 17 people have died and dozens more are believed to be infected. Many of the residents died with only staff by their side, as regional authorities banned visitors, including relatives, from all nursing homes earlier this month.

The total number of coronavirus cases climbed by a quarter to 17,147. On Wednesday, there were 13,716 cases in Spain.

Guardian

Plaquenil is used for sarcoidosis, which most often presents in the lungs. H was on it for several years and it worked very well for him. It’s cheap, too.

About 7 weeks ago, I threw out the rest of his supply, thinking we’d never be using it again. Argggg, kicking myself now.

City hospitals wanting supplies available at rural hospitals concerns me. Pretty happy at this point with my state’s response, except the level of testing is abysmal. The state is now partnering with Eli Lilly & Co., and I’m hoping that ramps it up. I think the Ohio governor clamped things downs fast, and maybe that had some effect on Indiana’s response.

This is too political to be useful, and too political to risk giving it a reasoned reply, lest the whole thread gets damaged.

The forum demographic appears to have much higher SES than the US generally. For example, it is common for posters to say that they are “middle class” but their kids will not get financial aid from any college due to their income (which would have to be over about $260k for that to be true).

They present a global image of ruthless efficiency, but Mossad, the Israeli intelligence service, has been lambasted today after it bought 100,000 Covid-19 testing kits that experts said lacked a crucial component.

Ynet reports comments from Itamar Grotto, the deputy director general of Israel’s health ministry, who said: “Unfortunately, what Mossad has delivered is not what we are in need of.”

According to the Jerusalem Post, the tests are missing a patented liquid in which testing swabs need to be dipped before carrying out screenings.

Israel so far has 529 confirmed cases of Covid-19, but has reported no deaths while 11 people in the country have recovered. (Guardian)

Americans eager for emergency relief will be forced to wait on Congress
From CNN’s Manu Raju

Senate Majority Leader Mitch McConnell vowed to move a massive $1 trillion economic stimulus bill at “warp” speed. But on Capitol Hill, warp speed isn’t that simple and could mean more than a week before relief comes.

There are many legislative hurdles and ample policy differences that lawmakers still have to iron out.

That’s left Republican and Democratic leaders uncertain how quickly a bill can pass Congress, meaning getting a final measure to President Trump’s desk next week is currently the most optimistic assessment, at best.

That means industries and workers now under siege from the damaging economic crisis will be forced to wait for the legislative sausage-making to work its course. And once the bill is eventually passed, it will take time to get implemented, including proposed payments to workers who have been displaced because of the unprecedented impact of the novel coronavirus.

While Treasury Secretary Steven Mnuchin asked congressional leaders for a bill to be completed by Monday, House Speaker Nancy Pelosi told Democratic lawmakers that is an unrealistic timeframe, according to a source familiar with her remarks.

Pelosi pointed to the last round of talks with the Trump administration that continued to drag on over the emergency relief package that was just signed into law, the source said.

Republicans in the Senate seem to share a similar assessment.

“A lot of it depends on how quickly things can come together through the weekend,” said Sen. John Thune, the Senate majority whip and a South Dakota Republican. “But then we are going to start the negotiations with the Democrats. And we got a number of our members who will be involved in that and hopefully through the weekend we can bring some closure to it through the weekend and early next week.”

Weird. It brought me to the story about the family that lost 7 members.

https://www.yahoo.com/news/coronavirus-ravages-7-members-single-125000381.html

On a lighter note, I can hear my D20 in the other room, engaged in her Spanish class right now (online through Zoom). Just having some semblance of normalcy and knowing she is able to carry on with her classwork right now is calming. :slight_smile:

Excuse me? Did you read the link? It is about chicken production and spike in the demand in the US.

A New York Doctor’s Coronavirus Warning: The Sky Is Falling

Alarmist is not a word anyone has ever used to describe me before. But this is different.

I’ve had hard conversations this week. “Look me in the eye,” I said to my neighbor Karen, who was spiraling to a dark place in her mind. “I make this personal promise to you — I will not let your children die from this disease.” I swallowed back a lump in my throat. Just the image of one of our kids attached to a tube was jarring. Two weeks ago our kids were having a pizza party and watching cartoons together, running back and forth between our apartments. This was before #socialdistancing was trending. Statistically, I still feel good about my promise to Karen because children do not seem to be dying from Covid-19. There are others to whom I cannot make similar promises.

A few days later, I got a text from another friend. She has asthma. “I’m just saying this because I need to say it to someone,” she wrote. She asked that if she gets sick and has a poor prognosis, to play recordings of the voice of Josie, her daughter. “I think it would bring me back,” she said. Josie is my 4-year-old’s best friend.

Today, at the hospital where I work, one of the largest in New York City, Covid-19 cases continue to climb, and there’s movement to redeploy as many health care workers as possible to the E.R.s, new “fever clinics” and I.C.U.s. It’s becoming an all-healthy-hands-on-deck scenario.

The sky is falling. I’m not afraid to say it. A few weeks from now you may call me an alarmist; and I can live with that. Actually, I will keel over with happiness if I’m proven wrong.

Alarmist is not a word anyone has ever used to describe me before. I’m a board-certified surgeon and critical care specialist who spent much of my training attending to traumas in the emergency room and doing the rounds at Harvard hospitals’ intensive care units. I’m now in my last four months of training as a pediatric surgeon in New York City. Part of my job entails waking in the middle of the night to rush to the children’s hospital to put babies on a form of life support called ECMO, a service required when a child’s lungs are failing even with maximum ventilator support. Scenarios that mimic end-stage Covid-19 are part of my job. Panic is not in my vocabulary; the emotion has been drilled out of me in nine years of training. This is different.

We are living in a global public health crisis moving at a speed and scale never witnessed by living generations. The cracks in our medical and financial systems are being splayed open like a gashing wound. No matter how this plays out, life will forever look a little different for all of us.

On the front lines, patients are lining up outside of our emergency rooms and clinics looking to us for answers — but we have few. Only on Friday did coronavirus testing become more readily available in New York, and the tests are still extremely limited. Right next to my office in the hospital, a lab is being repurposed with hopes of a capability to run 1,000 tests a day. But today, and likely tomorrow, even M.D.s do not have straightforward access to testing across the country. Furthermore, the guidelines and criteria for testing are changing almost daily. Our health care system is mired in situational uncertainty. The leadership of our hospital is working tirelessly — but doctors on the ground are pessimistic about our surge capacity.

Making my rounds at the children’s hospital earlier this week, I saw that the boxes of gloves and other personal protective equipment were dwindling. This is a crisis for our vulnerable patients and health care workers alike. Protective equipment is only one of the places where supplies are falling short. At our large, 4,000-bed New York City hospital, we have 500 ventilators and 250 on backup reserve. If we are on track to match the scale of Covid-19 infections in Italy, then we are likely to run out of ventilators in New York. The anti-viral “treatments” we have for Covid-19 are experimental and many of them are hard to even get approved. Let me repeat. The sky is falling.

I say this not to panic anyone but to mobilize you. We need more equipment and we need it now. Specifically gloves, masks, eye protection and more ventilators. We need our technology friends to be making and testing prototypes to rig the ventilators that we do have to support more than one patient at a time. We need our labs channeling all of their efforts into combating this bug — that means vaccine research and antiviral treatment research, quickly.

We need hospitals to figure out how to nimbly and flexibly modify our existing practices to adapt to this virus and do it fast. Doctors across the globe are sharing information, protocols and strategies through social media, because our common publishing channels are too slow. Physician and surgeon mothers are coming together on Facebook groups to publish advice to parents and the public, to amplify our outrage, and to underscore the fear we feel for our most vulnerable patient populations, as well as ourselves and our families.

Please flatten the curve and stay at home, but please do not go into couch mode. Like everyone, I have moments where imagining the worst possible Covid-19 scenario steals my breath. But cowering in the dark places of our minds doesn’t help. Rather than private panic, we need public-spirited action. Those of us walking into the rooms of Covid-19-positive patients every day need you and your minds, your networks, your creative solutions, and your voices to be fighting for us. We might be the exhausted masked face trying to resuscitate you when you show up on the doorstep of our hospital. And when you do, I promise not to panic. I’ll use every ounce of my expertise to keep you alive. Please, do the same for us.

https://www.nytimes.com/2020/03/19/opinion/coronavirus-doctor-new-york.html?action=click&module=Opinion&pgtype=Homepage

My humble apologies. I did but it linked me to a different story somehow. I’m very sorry. I thought you were making fun of the family who lost 7 people. It didn’t seem like something you or anyone would post and I was shocked. I am sorry!

I see that. I clicked the link and it took me to this story.

https://www.yahoo.com/news/coronavirus-ravages-7-members-single-125000381.html

France has suggested extending a two-week lockdown to try to stem the spread of the coronavirus as the interior minister blasted “idiots” who flout home confinement rules and put others at risk, AFP reports.

President Emmanuel Macron has ordered French residents to stay at home except for essential excursions such as going to the doctor, walking the dog, or going for a solitary run, and banned any gatherings.

For a two-week period that began Tuesday, people can go to work only if their employer cannot make tele-commuting possible.

But news reports have shown groups of friends and families strolling in parks despite the clampdown, prompting calls from some officials for even stricter limits.

Many have been observed ignoring the one-metre (three feet) safe inter-personal distance in queues at the essential businesses that were allowed to stay open.

Interior Minister Christophe Castaner said people ignoring the measures were “idiots”.

“There are people who underestimate the risk… There are people who think they are modern-day heroes by breaking the rules while they are in fact idiots,” he told Europe 1 radio.

Macron on Thursday urged companies and workers to continue their activities “in compliance with the health safety rules”.

Genevieve Chene, who heads France’s public health agency, said between two and four weeks are needed for the outbreak to be adequately contained.

“Within two to three weeks we should be able to observe a slightly different dynamic” to the outbreak’s momentum, she told Franceinfo radio, and “a significant braking” within two to four weeks.

“It is likely that it is indeed necessary to extend (the containment measures) in order for the braking to be sufficient,” Chene said.

Meanwhile, the French government has started requisitioning hotel rooms for homeless people to occupy during the confinement period, Housing Minister Julien Denormandie announced.

More than 170 rooms will be made available in Paris by the end of the week, and the government has identified 80 sites elsewhere across the country to accomodate the country’s estimated 250,000 homeless people.

The number of confirmed cases in Germany has risen to 12,853, with the number of deaths reaching 34.

Politicians, police and prominent figures appealed to Germans to ‘stay at home’, or risk the introduction of curfews as in France, amid widespread evidence that many people are still not sufficiently reducing their movements to halt the spread of coronavirus.

The Robert Koch Institute, the leading public health body in Germany, has said it is planning to track mass amounts of mobile phone data, to establish whether Germans are reducing their movements enough.

Deutsche Telekom is giving it access to the anonymous data of millions of its customers. A data protection ombudsman has said the measures are acceptable, as long as the data remains anonymous. The move would usually raise the hackles of those who recall the mass surveillance of German citizens in the communist east by the state police, the Stasi, but in general it is being seen as an acceptable measure in desperate times.

Curfews could be imminent. Bavaria’s minister president, Markus Söder, said: “I understand that the isolation of many people is very difficult, but if you don’t restrict yourselves, there will be no other possibility. In Bavaria there are more than 1,700 confirmed infections and 14 people have died.

The mayor of Berlin, Michael Müller said he was appalled by the lack of consideration many Berliners were showing. “People do not understand. It is unacceptable that people are actually inviting each other to Corona parties. It is terrible!” he said.

He also condemned the extent to which people were stockpiling, saying there was no need to do so.

A curfew for the 3.6m Berliners could not be ruled out, he said. The German capital has 519 confirmed cases so far.

Guardian

Therein lies the problem. What the health experts world-wide want to do to end this thing is being discarded by too many people. It doesn’t matter that it has worked and where they haven’t done it life is falling apart.

Will it be ok? Time will tell. If other countries are our example, no. Too many people are walking on thin ice and some will fall in - then presumably 10-20% of those wanting hospitalization health care. Those who don’t fall in will probably remain as smug as ever.

@OneMoreToGo2021 I am curious. Can you explain your rationale for not doing social distancing and not staying home except for essential trips?

Even if you don’t think that you would get very sick, the inconvenience of a two week isolation is immense.

Cuomo should remember that if NY hogs all the available resources, the rest of the country suffer. NY was not a hot zone only a week ago. Through their inaction to sacrifice as other states are doing, they created a hot zone. The country really didn’t need another hot zone. That, I think, is sheer selfishness. My state with far fewer cases, just over 100, closed schools and restaurants well before NY. He is just as bad as or worse than kids partying at the beach.

Couldn’t agree more Igloo. I look at states like Ohio with very few cases doing everything they can to help this situation. Not Cuomo.

Spain and Italy have single payer health systems that guarantee health care to all citizens (not residents by the way), don’t they? (I know there are small private systems as well that have recently been commandeered in Spain.)

I do not know much about the Chinese health system, honestly, but my understanding is that it is not a guaranteed system, and that there are multiple systems of health care delivery. I’d appreciate being educated on this, frankly.

We all know the byzantine, cross-subsidized, public-private hybrid in the US.

This virus is going to provide many interesting retrospective studies someday on the efficiency and quality of the differing systems.

Russia reports first Covid-19 death

Russia has recorded its first death from coronavirus.

The victim was a 79-year-old woman from Moscow who was taken to hospital late last week and died on Thursday in a Moscow infectious diseases hospital. Russian officials said that she had underlying conditions, including diabetes and hypertension. Her family is under observation.

Coronavirus numbers have more than doubled in Russia over the last week, but the country has still shown surprisingly few infections, with 147 confirmed cases as of Wednesday evening, the most recent official numbers. Moscow is rushing to build a new hospital similar to the ones that were built in China at the height of the coronavirus outbreak there. The new hospital will have beds for 500 patients and will be ready in the next month, officials have said.

While the government has claimed that its success has stemmed from early border closures with China and quick isolation of suspected cases, there are also concerns that Russia may be underestimating the official numbers of those infected with coronavirus in order to avert public panic.

Last week, the Russian business daily RBC reported that registered pneumonia cases in Moscow had grown 37% between January 2019 and January 2020, speculating that a wave of new coronavirus infections could have been registered as cases of pneumonia or other pulmonary diseases.

The Kremlin has said that it is protecting Vladimir Putin, 67, from contracting the disease by testing members of his entourage. During a trip to Crimea, the peninsula annexed from Ukraine in March 2014, Putin said: “Thank God, we generally have everything under control so far. Hopefully, it will continue in the future.”

Russia has closed its borders to most foreigners and has cancelled many flights to Europe and the US. The economy has taken a significant hit due to the simultaneous effects of the coronavirus outbreak and an oil price war with Saudi Arabia. The value of Russia’s rouble has decreased by more than 30% against the dollar in 2020.

Guardian