Coronavirus in the US

We don’t know that NY has the biggest or only forest fire - only that they have tested more than the other places. Can’t find what you can’t test for.

Hot spots are popping up in all sorts of places now that tests are starting to slowly become available - Atlanta, New Orleans, Detroit, Chicago, Miami. But since 5% of the US population (or less if we’re talking about NYC - the 5% represents all of NY state) has had the benefit of over 30% of the tests available and performed, it’s now also received 25% (2k now with 2k promised en route) of the 16k national stockpile of ventilators, one of only two military support hospital ships, the Army Corps of Engineers assistance, etc… whew, good thing none of the other US citizens are going to need any of that stuff. /s

Paris hospitals to reach capacity in 48 hours, says head of French Hospital Federation
A spike in coronavirus patients means hospitals in and around Paris will reach saturation point within 48 hours, the head of the French Hospital Federation said on Friday, with the peak not expected until April, Reuters reports.

Paris and its suburbs now account for over a quarter of the 29,000 confirmed coronavirus infections in French hospitals, with almost 1,300 now in intensive care. The death toll nationwide as of Thursday evening stood at 1,696.

“We will clearly need help in the Ile-de-France (Greater Paris region) because what happened in the east is coming here,” Frederic Valletoux, the federation’s president told BFM TV.

He was referring to the Grand Est region, where the first major cluster took hold in France and where hospitals are already overwhelmed, with the army helping to transfer some critically ill patients to other cities.

“We will be at the limit of our capacities in 24 or 48 hours. We will need to show real solidarity between regions, hospitals and increase the numbers of patient transfers.”

Officials in the Paris area have been scrambling to find more intensive care beds, ventilators and medical staff and spread the load of patients across the capital and its wider suburbs.

President Emmanuel Macron imposed on 17 March a lockdown to slow the spread of the virus, but doctors say they expect a wave of cases next week after the government pressed ahead with local elections and thousands of people mingled in parks and streets before they were confined at home.

“If we let hospitals cope by themselves, and let every territory that has been taken by the epidemic cope alone, then we shall head towards a catastrophe,” Valletoux said.

Ireland and Northern Ireland are preparing improvised morgues as they brace for a sharp increase in the number of deaths from coronavirus.

Health officials in Dublin on Thursday night announced 10 more deaths, bringing the republic’s death toll to 19, and warned that Ireland was just starting a curve that would sweep upwards.

They also announced 255 new infections, bringing the confirmed total to 1,819. Clusters in nursing homes and healthcare settings are of particular concern.

Liz Canavan, assistant secretary for social policy for the taoiseach, told a media briefing the government was preparing temporary morgues. “We are still, largely, in the preparation phase – getting the country ready and putting the necessary infrastructure in place, in particular the medical infrastructure, to deal with the surge when it comes.”

Authorities in Northern Ireland, which has recorded 10 deaths and 241 cases of infection, plan to use an army base in County Down as a morgue and to set up field hospitals at several sites, possibly including Belfast’s Titanic quarter and the former Maze prison. The health minister, Robin Swann, has warned deaths could exceed the more than 3,500 people killed during the Troubles.

Covid-19 spreads across the African continent
Jason Burke, Guardian

Covid-19 continues its spread across the African continent with 3243 cases now recorded, and 83 deaths, writes Jason Burke.

The 56m inhabitants of South Africa woke up to the first day of a rigorous lockdown enforced by the police and army. Streets in much of Johannesburg were quiet, though there was significant activity in many high-density neighbourhoods amid complaints that the tight restrictions on movements would deny many vital income.

Similar strict measures are now being rolled out across the continent, though some governments, such as Zimbabwe, are yet to impose full curfews.

Eritrea, one of the most authoritarian states on the continent, has so far only suspended public transport and schools. More than 20 countries have suspended almost all passenger flights.

South Africa’s high total is partly explained by an aggressive and relatively extensive testing effort, and its official figures are seen by experts as reliable, in contrast to those of Egypt, on 495, for example.

The overall figure for the continent is almost certainly a significant underestimate, as testing had been extremely limited in many places.

Amid fears of massive casualties from the virus across the developing world, international health officials say there is still a chance Africa can avert catastrophe.

About half of the countries in sub-Saharan Africa still have a “narrowing” opportunity to contain the disease, Matshidiso Moeti, the WHO World Health Organisation director for Africa said.

“It has been a very dramatic evolution,” Moeti told reporters. “Countries need to work on this containment while preparing for a possible, broader expansion of the virus.”

There is widespread recognition that the virus would be very difficult to control in the overcrowded conditions of many poor neighbourhoods of Africa’s major cities or refugee camps, and could hit vulnerable communities such as sufferers of HIV or tuberculosis very hard.

“We still have a window… it is narrowing every day as data on the geographic spread to more and more countries tell us,” Moeti said.

Guardian

Hungary’s prime minister Viktor Orbán has announced new restrictions on movement in the country, reports the Guardian’s Shaun Walker in Budapest.

From tomorrow, for an initial period of two weeks, Hungarians will only be able to leave the house to go to work or for other basic essentials, bringing the country in line with many other European nations.

People over the age of 65 will only be able to visit grocery shops and pharmacies between the hours of 9am and midday, and during these hours those under 65 will be banned from the shops.

Orbán said he was refraining from ordering a “total curfew” for now. People are still allowed to exercise, but only if they practice social distancing.

Orbán said people should take responsibility for themselves and the moves would require voluntary cooperation, however he also noted that there could be fines imposed of up to 500,000 Hungarian forint (£1,278) for violations.So far in Hungary, there are 300 confirmed cases of the coronavirus and 10 people have died.

German hospitals with spare capacity will take in at least 47 coronavirus patients from Italy in a sign of European solidarity, Foreign Minister Heiko Maas said on Thursday.

Reuters reports:

“Because we stand by our Italian friends. We can only manage this together,” Maas said in a short statement.

In Italy, an overwhelmed health care system has witnessed the outbreak kill more people than in any other country.

Ahead of an expected larger wave of domestic infections that German authorities are preparing for, a first group of six Italian patients arrived at Leipzig airport in the eastern state of Saxony on Tuesday.

The western state of North Rhine-Westphalia also announced plans to take 10 Italian patients in coming days.

As of Wednesday, there were 36,508 cases of coronavirus in Germany, with 198 deaths, the Robert Koch Institute for infectious diseases said. That compares with 74,386 confirmed cases in Italy, where 7,503 have died.

The fire service in the UK could be drafted in to support the NHS with firefighters taking on roles such as driving ambulances and delivering food and medicine, it emerged this morning.

The Press Association report:

The General Secretary of the Fire Brigades Union Matt Wrack said it would be “quite a serious challenge” for firefighters to take on more work to help deliver food and medicine and drive ambulances.

Wrack told BBC Radio 4’s Today Programme: “Well, training is a key element of a document that we will be releasing today. Firefighters are clearly keen to do whatever they can to help in the situation.”

He added: “We have been approached on a number of issues and this next step will be discussions at a local level about what firefighters can do and what firefighters are able to use their skills for and that includes issues like assisting ambulance staff and so on.”

Wrack added that there is a “need to protect core functions” of the fire service while firefighters may be asked to take on additional roles.

He said: “I think this is a huge challenge across public services and also clearly we need to ensure that firefighters and others are protected in terms of personal protective equipment because no one can do their job if their own safety is compromised.”

Guardian

US President Donald Trump has publicly ranted at car-manufacturing giant General Motors over a delay in its production of ventilators.

There has been some suggestions he could invoke the Defense Production Act, which allows the federal government to direct industries.

Donald J. Trump
:heavy_check_mark:
@realDonaldTrump
General Motors MUST immediately open their stupidly abandoned Lordstown plant in Ohio, or some other plant, and START MAKING VENTILATORS, NOW!!! FORD, GET GOING ON VENTILATORS, FAST!!! @GeneralMotors @Ford

His tweet comes a day after he dismissed demands from governors for more ventilators and said New York, which is the epicentre of the crisis in the US, was exaggerating the need.

The state of New York pleaded to be sent 30,000 ventilators to help with its growing numbers of coronavirus patients.

[ I guess Jared isn’t on top of this. Are they going to pay GM and Ford to retool their plants or not? How about conducting business through something other than Twitter in a global crisis. SMDH ]

Can we please be done with the NYC vs. Upstate/Florida/the rest of the county discussion? It’s been hashed to death at this point and it doesn’t appear anyone’s mind is being changed.

'“…Prolonged mechanical ventilation is increasingly common. It is expensive and associated with significant morbidity and mortality. Our objective is to comprehensively characterize patients admitted to a Ventilator Rehabilitation Unit (VRU) for weaning and identify characteristics associated with survival…”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3091409/

Here is a link about ventilation. We definitely need more. But it is invasive and the longer they stay on it the worse the outcome. (from another source) This article unfortunately does not describe COVID as it predates. I hope that many patients only need this for a short time.

Why doesn’t he just “invoke P?”

for reference: https://gizmodo.com/trump-threatens-to-invoke-p-after-finding-out-how-muc-1842528015

Until tests are widely available throughout the entire US, it’s an important point to keep making. Decisions are being made based on lack of information and bad information. There is still time to do things differently.

The country should listen to pandemic experts and medical experts and etc. Trump should listen to those people on what to do. He should not be angling for reelection or going on ‘hunches’. Those people must know the best way to divvy up resources in a time like this much better than any of us here. It isn’t a partisan issue. This is impacting all the country. It is not good to let NY get this many cases (and there are many more cases not diagnosed). It is a very, very bad situation. We are the world leader in cases now, having gone by China. This isn’t a liberal vs conservative issue or a pro or anti-trump issue. Trump is undeniably not doing a good job stopping the virus from spreading. He is doing worse than those leading various other countries. That’s fact based on numbers, rate of increase of the disease, time to start his active response, and too much more. Whether I like him or not, I would be fully on board with his response if he were doing what he should have all along. He should have done a travel ban and I supported it but it came a few weeks too late and was not a strict enough or well enough enforced ban. That’s the only good thing he seems to have done until very recently!

Sending verbal attacks at the governors of states dealing with serious issues like this is not helping the situation. Those so loyal that whatever he says they take on as their own causes scare me. Can we look at this situation objectively? Can we work together?

NY needs respirators. they are likely going to go through the peak of the pandemic sooner, worse off, and faster than much of the rest of the country. After that, they will be able to send respirators they no longer need elsewhere, as the virus gets worse in other places.

If Trump had acted sooner in late December (pandemic experts knew about it even earlier than that as I know one personally who flew there in mid-December to study it), or early January to try to boost production, buy more or do anything to get more respirators rather than wait until now, maybe we would have more.

If it’s the case (and I think it is) that we don’t have enough ventilators, then it’s awful to pit state against state, knowing that the losers get to have their population die. Instead, we need a national response, that starts with

(1) Nationally distributing ventilators to areas that need them, without regard to the political beliefs of the people in those areas
(2) Coordinating and paying manufacturers to build more ventilators
(3) Publicizing methods like ventilator splitting, conversion of other hospital resources to ventilators, to make more ventilation available
(4) BUILDING MORE VENTILATORS

We’re all in this together.

A stay at home order for all of Florida would be a good place to start. Lots of bad decisions in that state.

Statements like this is exactly why the point has to be made over and over and over and over.

We really do not know if NY has the most cases or will go through the peak sooner, faster, worse. All we know is NY has had access to the most tests so has a better count than the rest of the US.

Until we have tests (and testing materials and reasonable turnaround for lab times) across the US, we have no idea if NY has more infections or if areas like New Orleans, Atlanta, Chicago, Miami or some other place has more infections.

We only have a small about of highly suspect data.

And the idea that NY will use the ventilators and then pass them along to whoever needs them next is also highly suspect given how long Coronavirus patients remain on ventilation.

Test, test, test, test, test the rest of the US and then we will know where the ventilators, PPE, experimental drugs, hospital ships, Army Corps of Engineers, etc are most needed. Right now, we only know one state was able to test more, has been screaming loudest and houses most of the national media. Those are not good reasons for the rest of the nation to send most of their supplies when we don’t really know where those supplies are most needed.

Agree. And all this starts with widespread testing.

Make tests widespread throughout the nation and then we’ll have the data we need to make these decisions.

And also buying more ventilators and being nice enough to other countries like China so they will lend/give us some!!

Of course, I completely agree that there should be more testing, everywhere, to see what the actual number of cases is. That said, I think we can also say with confidence that NY does in fact have the most cases right now, because NY’s hospitals are becoming deluged with patients and are overwhelmed. The death rate is also very high. Much higher than most other states. Anywhere that starts to have hospitals overwhelmed will also very clearly have a large number of positive cases in the community, whatever level of testing there is.

https://www.latimes.com/california/story/2020-03-27/coronavirus-california-mobile-hospitals-ventilators

Gov. Brown (Cal) dismantled a pandemic rapid response program. But had to have the bullet train to nowhere.

Hospitals everywhere are starting to be overwhelmed. And the death rates outside NY don’t reflect all Coronavirus related deaths because many states don’t have enough testing capacity to know if the person that died was even infected.

Again, you’re basing decision making on partial and faulty info. Until we have widespread testing everywhere, we do not know which place has the most infections or most needs the help.

Get the info before devoting a majority of the scarce resources to one area.

Illinois governor says Trump’s comments about ventilators could be “deadly”
From CNN’s Hollie Silverman

Illinois Gov. J.B. Pritzker said President Trump’s comments about ventilators during a television appearance Thursday could be “deadly.”

Pritzker said that Trump questioned whether more ventilators were needed during an appearance the same day the US reported more cases than China and Italy.

“At worst the comments are deadly,” Pritzker said.

He said his state is still working to obtain more personal protective equipment and supplies, including ventilators, at the recommendation of epidemiologists and doctors on the front lines of the pandemic.

Trump invokes the Defense Production Act on General Motors to supply ventilators
From CNN’s Matthew Hoye

President Trump has invoked the Defense Production Act for the first time, requiring General Motors to supply ventilators.

“Today, I signed a Presidential Memorandum directing the Secretary of Health and Human Services to use any and all authority available under the Defense Production Act to require General Motors to accept, perform, and prioritize federal contracts for ventilators,” Trump said in a statement.

Some context: US automakers have come to the rescue when the nation has faced supply shortages during wartime in the past. Ford built heavy bomber airplanes and GM built amphibious assault craft, among other things. So it seems only natural that, in the rush to address the critical shortage of ventilators in the US due to the coronavirus pandemic, automakers would again be among the first to answer the call to help.

Last week, Trump tweeted that automakers have the green light to make ventilators, although he stopped short of issuing formal orders to do so under the Defense Production Act at that time.

Nevertheless, Ford, GM, Toyota and Tesla, which have all temporarily shut down their factories in recent weeks, have pledged to help.

But switching from cars to ventilators is not so easy. Ventilators are complex machines that use sophisticated software and specialized parts, and companies that seek to manufacture them face several hurdles — including intellectual property rights, the need for specially trained workers, regulatory approvals and safety considerations.

[ Bunch of posturing it appears. The car makers already said they were willing and able yet awaiting confirmation on details and payment from the administration. Those seem like completely reasonable asks to me. ]

At least 488 new cases of coronavirus have been identified in Illinois Friday, bringing the state total to 3026 cases, a news release from the Illinois Department of Public Health said.

Eight new deaths were reported, bringing the number of deaths to 34, the release said.

Patients with confirmed cases range in age from under 1 to 99, according to the release.

About 86% of fatalities are in those older than 60, the release said.

Army Corps of Engineers will convert Chicago convention center to treat coronavirus patients
From CNN’s Ryan Browne

The Army Corps of Engineers said it will convert a Chicago convention center to treat 3,000 coronavirus patients.

The head of the Army Corps of Engineers said Friday that the military is working to convert the Chicago McCormick Place convention center into a hospital capable of treating some 3,000 coronavirus patients.

“What we’re doing in McCormick—we basically got turned on by FEMA to do a $75 million build,” Lt. Gen. Todd Semonite told reporters at the Pentagon Friday.

“Our goal is to have that one done somewhere around the 24th April,” he said, adding that the new hospital will be treating some 3,000 patients and that those patients will all be coronavirus related.

“All Covid…I did not think we could meet the Covid standard in a big building but my engineers are telling we think we’ve got the capability to do that,” Semonite said.
The Army Corps of Engineers will not be treating coronavirus patients at the Javits center in New York.

Trump invokes Defense Production Act to compel GM to manufacture ventilators for coronavirus outbreak

BREAKING: Trump invokes Defense Production Act to compel GM to manufacture ventilators for coronavirus outbreak

The announcement was made hours after President Trump complained in tweets that General Motors and Ford were not doing enough to help produce the medical equipment during the pandemic.“Our negotiations with GM regarding its ability to supply ventilators have been productive, but our fight against the virus is too urgent to allow the give-and-take of the contracting process to continue to run its normal course,” Trump said in a statement. “GM was wasting time. Today’s action will help ensure the quick production of ventilators that will save American lives.”

https://www.washingtonpost.com/politics/trump-raises-prospect-of-ordering-gm-ford-to-manufacture-ventilators/2020/03/27/92f82db6-7043-11ea-aa80-c2470c6b2034_story.html

Disneyland and Walt Disney World will remain closed “until further notice”
From CNN’s Richard Davis

Disneyland in California and Walt Disney World in Florida will remain closed until further notice, according to a statement from The Walt Disney Company.

Disney previously announced theme park closures through the end of March.

On Friday, the company also announced that it would extend paying hourly parks and resorts cast members through April 18.

“The safety and well-being of our guests and employees remains The Walt Disney Company’s top priority,” the company said

Coronavirus cases triple in Los Angeles in past 6 days
From CNN’s Cheri Mossburg

Coronavirus cases in Los Angeles have more than tripled in the past six days, going from 409 at the beginning of the week to 1,465 on Friday.

Speaking at a news conference Friday, Health Director Barbara Ferrer noted that limited testing has been done so far in Los Angeles.

She said that she expects to see cases double every four days for the next two to three weeks.

Fort Lauderdale issues stay at home order

The mayor of Fort Lauderdale, Florida, Dean Trantalis, has issued an emergency declaration requiring residents to stay at home in an effort to slow spread of coronavirus in the city.

Travel is restricted in the city to visiting essential businesses only.

This goes into effect at 12:01 a.m. ET on Saturday.

CNN