@1Benice ive heard some are also using the combo with zinc as well. Any info on that or why ?
Links, please.
[USA Today](Florida cases pass 4,000; governor advises, 'Don't come here') reported yesterday that Florida Governor Ron DeSantis is setting up checkpoints to intercept cars from New Orleans and New York, both areas heavily affected by the coronavirus, but has left open two throughfares that directly connect to Albany, Georgia, an area researchers at the University of Chicago have found contain [“significant clusters”](State-level data misses growing coronavirus hot spots in U.S., including in the South) of the disease. So limiting traffic, but selectively.
Florida was open for spring break and the governor has reportedly been slow to close down the state’s beaches which are popular tourist destinations. According to Friday’s [Business Insider](Phone Data Shows Spring Breakers in Florida Dispersing Across US), spring break travelers from just one beach in Fort Lauderdale spread out to cities across the eastern US.
Governor DeSantis has suspended vacation rentals for 2 weeks but is refusing to issue a statewide stay at home order, despite the urging of state representatives.
Source:
USA Today, [Florida Coronavirus Cases Pass 4000: State Border Checkpoints Begin, Vacation Rentals Halted](Florida cases pass 4,000; governor advises, 'Don't come here'), 3/28/2020.
In our state, the situation is so far under control, there are cases but no desperate situations, I think people are more concerned about losing their jobs than anything else. But the attitude in general is one of self reliance of smaller communities. That is more difficult to replicate in a city like NY.
“They may be good for information but not for innovation.”
Government agencies were never good for innovation, they have too much red tape and do not more fast enough. They may have other roles but innovation is not their strong point.
"Not sure if this was posted yesterday. Orleans parish has the highest death rate (per capita) for Covid19, by far.
that is probably because the idiots in government let the Mardi Gras celebration go on in late Feb.
More than a MILLION people were in close contact during the celebration.
NEW ORLEANS — More than a million dancing, singing, bead-catching celebrants packed the streets of the French Quarter and other venues across this city in the weeks leading up to the sprawling open-air party that is Mardi Gras.
There was little worry during the February festivities about the new virus that had infected a few dozen people in other parts of the country. The city’s top health official believed the flu “is far more dangerous right now than the coronavirus,” she told the Times-Picayune/New Orleans Advocate newspaper.
Thirteen days later, on March 9, Louisiana reported its first case of covid-19. Then came another, and another. Clusters broke out in several nursing homes. The cases popping up across the state were not easily linked to each other, meaning that a galloping community spread was already underway.
A terrible realization began to dawn on residents and political leaders: The famous bonhomie of the world’s biggest free party may have helped supercharge one of the most rapid spreads of the coronavirus, which is now threatening to overwhelm Louisiana’s health-care system and potentially make the state one of the next epicenters.
“We had people from all over the world. We also had the spread of this virus, and people did not realize it was spreading,” said Rebekah Gee, a former state health secretary now on the faculty of Louisiana State University’s medical school. “So people not only caught beads, but they caught covid-19.”
As of Thursday, Louisiana had reported 2,305 cases and 83 deaths related to coronavirus — with about two-thirds of the cases and deaths in the New Orleans metro area.
New Orleans Mayor LaToya Cantrell said canceling or curtailing Mardi Gras was never considered. Federal agencies that are part of planning Mardi Gras every year — including the FBI and Homeland Security — did not raise concerns about the coronavirus, she said. Federal officials who walked the parade route with members of her administration were focused on terrorist attacks.
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“We were not given a warning or even told, ‘Look, you know what? Don’t have Mardi Gras,’ ” she said.
At that point in late February, American life had not been seriously altered. People were still packing airports. The NBA hadn’t suspended games, and Disney World was still open for business.
“Leadership matters,” Cantrell said. “And if the federal government is not responding to or saying that we’re potentially on the verge of having a crisis for the pandemic coming to the U.S. — that would change everything. But that wasn’t happening.”
Cantrell noted that a couple weeks later, she did cancel the St. Patrick’s Day Parade — and was harshly criticized by some in New Orleans. As it happened, partiers didn’t heed the ban, and bars in the French Quarter were packed.
During the first two weeks of known infections, the virus was coursing through Louisiana at an extraordinarily rapid pace, according to an analysis by Gary Wagner, a professor at the University of Louisiana at Lafayette. He found that the rate of growth in that period was the highest in the world.
“It seems the virus was there when crowds were around for Mardi Gras and it may have turned into a super-spreader event,” he said. “You can see what’s happening in Italy and Spain, and there is every reason to think the same events are going to happen here.”
NY current (daily) positive test rate is around 44%
Total number of tests done in NYS: 172,360
Mardi Gras was a really dumb idea.
But the mayor and gov bel Edwards blaming the feds for their parade is ludicrous. Especially a city with little or no confidence in federal disaster response.
It’s cya and expedient.
A little background on how Cuomo has mismanaged NY healthcare over the years and now totally unprepared for this pandemic and blames Trump for lack of hospital beds and ventilators. The state’s hospital bed shortage is in part due to years of Medicaid mismanagement.
Twenty some hospitals have closed in New York City alone over the last two decades, most located in low-income communities.
Blame New York’s miserly Medicaid program, which reimburses providers far below the cost of care. Physicians are on average compensated at 56% of what Medicare pays—the fourth lowest in the country after Rhode Island, New Jersey and California—and Medicare also pays below cost. Hospitals typically make up for paltry government payments by charging privately insured patients more, but hospitals that treat mostly Medicaid and Medicare patients don’t have this option.
Many doctors in New York also don’t accept Medicaid patients because of low payment rates, so low-income folks stream to emergency rooms when they’re sick. This has caused a financial contagion among hospitals. When one closes, patients flock to others nearby and increase their financial strain.
Recall how Democrats claimed that expanding Medicaid under the Affordable Care Act to individuals up to 133% of the poverty line would reduce emergency-room visits. This hasn’t happened. Emergency-room visits per capita in New York have ticked up 3% since the ACA expansion took effect in 2014 and 7% since 2010.
While expanding Medicaid enrollment, Mr. Cuomo in 2014 sought to rationalize costs with an $8 billion federal grant for putative payment reforms aimed at reducing ER visits. “Will it mean some hospital beds are reduced?” Mr. Cuomo said at the time. “Yes, because that is the point of the exercise. You will have a decrease in beds.”
Yet there’s no evidence this has flattened the Medicaid cost curve. As more low-income hospitals have closed, the state’s Medicaid costs have soared. This year the Trump Administration declined to renew the waiver, and Mr. Cuomo announced a $4 billion shortfall in New York Medicaid, which he has proposed patching by cutting payments to providers.
Congress’s second coronavirus relief bill increases the federal Medicaid match by 6.2 percentage points. The state’s hospitals will also receive tens of millions from the Senate bill this week for virus-related costs and equipment, as they should. New York state also will get another $3.1 billion for its budget, though Mr. Cuomo said Wednesday this is too little.
This will all help for now, but it won’t relieve the long-term strain on hospitals that have been chronically underfunded by New York and amid the coronavirus are now gasping for air.
From WSJ.
Tests are nice but health care workers including my wife would prefer to be able to get N95 masks and other safety equipment. They’re reusing masks. Think about that.
The reasons why have very little to do with government. It’s all about cost containment and supply chain. Complain about US healthcare all you want compared to single payer systems…they’re all in the same boat. They can’t buy and store that many masks and ventilators. All healthcare is rationed today to some extent.
The bigger issue in my mind is supply chain. We don’t make much in the US anymore. Any disruption and we’re in deep trouble. It’s great seeing everyone chip-in and use good old ingenuity. Many people are sewing masks and inventing ventilators and new, simple ways to sterilize. We spend $Trillions on bombs, planes, and ships and all it takes to stop America is virus. Maybe national security should be focusing on other things?
The good news is that we’ll bounce back…I look in awe at my grandparents who survived the Spanish flu pandemic, polio, smallpox, 2 world wars and a great depression. I wish they were around today for some perspective.
Albany 206 (+10) reported numbers in previous post
No community testing. This number is completely unreliable. Capital District, Saratoga, Lake George, ADK hotels full with Westchster/NYC. If they are under quarantine I’m sure they hit the grocery store first. Fleeing downstate and heading toward hospitals that aren’t full if needed. Bringing virus with them.
This is the state management. Envious of FLA keys.
I’d like the evidence that hydroxychloroquine is helping since the studies I’ve seen are mixed at the absolute best.
If I and my fellow autoimmune disease sufferers are going to lose access to our life saving meds, there better be damn good evidence that it’s saving lives.
Michigan IS being hurt by Trump’s pettiness. But whatever, I’m not going to be able to convince some of that.
What I can tell you is that our hospitals can’t handle the numbers we’re seeing and that even at incredibly wealthy and well stocked hospitals like umich, non ER/ICU nurses get one mask a day if lucky.
My friends at Detroit hospitals are using and reusing PPE for days, even in the ER. The situation is very, very bad here even though it’s not really making the news.
For the HI quarantine, nearly ALL arrivals are screened (temp check and answer questions) and quarantined. They are to go from airport straight to place of quarantine via their own mode of transport. They are to remain there for 14 days and only allowed to dePart for airport or urgent medical care. They must arrange for delivery of food and other needs and pay all costs.
Exception is for travel medical personnel and airline staff, who are temp checked and answer Qs only. I’m fuzzy about the details for these few who are excepted.
No cruises are being allowed to disembark passengers or crew—refueling and restocking only and only by permission are they allowed to dock at all.
It is hoped these measures will help prevent out very fragile medical system avoid being overrun and collapsing. It has reduced arrival traffic to below 15% of what it was and most now are returning residents.
https://www.mediterranee-infection.com/hydroxychloroquine-and-azithromycin-as-a-treatment-of-covid-19/
It is a small trial but the experience of a few ICU physicians in the US seems to agree that it does make a difference. More data is needed.
As far as Tocilizumab, all the info I have so far are from my ICU physician friends who work in 2 big hospitals with large amount of COVID intubates patients. They use it if the IL6 level is high and after 48 hrs can see a decrease in inflammatory markers ( ARDS is an inflammatory reaction as a response to infectious as well as non infectious causes ). The important outcome to follow is not just mortality but also extubation time and for that we need another 2 weeks. Again , the numbers are still small.
As far as zinc, it is a cofactor of some enzymes, has some role in wound healing as well as immune system ( lack of zinc may decrease some of the white cell function ). However, in 24 years I have seen maybe a handful of truly zinc deficient patients, so it is rare. I don’t know if it will play a significant role in the end.
Some progress in the supply chain for protective gear, but it’s unlikely Americans will ever have access to enough face masks for the walking well who are unknowingly spreading contagion.
https://www.axios.com/coronavirus-airlift-masks-medical-supplies-1d1913bf-744e-41cf-895c-d8934afa2c36.html
If I and my fellow autoimmune disease sufferers are going to lose access to our life saving meds, there better be damn good evidence that it’s saving lives."
I hope that it will not happen, there are several companies ramping production of hydroxychloroquine, so that should replenish the coffers in the next month
I just talked to someone who came back from Australia. No questions asked when he landed in San Francisco. None. No screening, no temp taking, not even “where are you coming from”
Unfortunately surgical masks aren’t much help. Maybe we should quickly figure out a way to make this stuff here?
There are two concerns with healthcare workers. First, they’re concerned about not having enough equipment and getting sick. The second fear is that if enough healthcare workers get sick not only will they not be available but the healthy ones won’t show up. Healthcare workers are some of the most selfless people around, especially nurses but they also have families.
I’m guessing that community spread is happening and you wills see cases increase. This virus isn’t under control anywhere in the USA at this time as we are not doing widespread testing, and that is needed to even begin to know what the area is dealing with. If your state isn’t preventing out of state travel and quarantining those who enter, it also isn’t ‘under control’. You may have low official case counts but that is not very meaningful for the future.
The Oxford model of the coronavirus infection is now available as a preprint. It is well worth reading. The bottom line is that if the coronavirus is as contagious as feared (R0 between 2 and 3), it is likely much more widespread than imagined, its fatality rate is much lower than feared (possibly under even regular flu at 0.1% of those infected), and the populations of Italy and the UK (and presumably those of Spain and other countries) have already acquired significant levels of herd immunity.
https://www.medrxiv.org/content/10.1101/2020.03.24.20042291v1.full.pdf
Look especially at the model fits, which show that recent numbers of deaths in Italy and the UK are consistent with a wide range of assumptions about the virus and the susceptibility of the populations generally to bad outcomes.