The most popular news media outlets are television ones, which freely mix news reporting with opinionated editorializing. Truth does not seem to matter.
“There is absolutely no reason to believe that plaquenil/hydroxychloroquine works for people in ventilators and doctors should stop using it that way. Even the charlatan Didier Raoult doesn’t say it works in the later stages of the disease, when the damage is done and the body is trying to repair itself.”
This is true, but there is some evidence (obviously not conclusive) that HC can be helpful if used early on. I mentioned an op ed piece in today’s WSJ earlier (post 11493) pointing out that lupus patients in a Wuhan hospital who were already on HC did not develop Covid 19 even though the disease was rampant in the hospital. Some anti viral medicines are only effective if taken early. Tamiflu is like that. I take Valacyclovir for cold sores (caused by a form of the herpes virus). It works like a charm, but you have to take it at the first sign of a cold sore developing.
There’re very little independent reporting these days. How many reporters each of these networks has? Only a few places, like the NY Times, are capable sourcing and verifying their news independently. People today don’t even agree on the underlying facts, let alone their interpretations.
While I can’t confirm everything on this timeline, I can verify parts of it & find the timeline realistic. My DH is one of those suppliers working on sourcing parts for the ventilators. He knows the players and the facilities being utilized, and I’ve been hearing him on the phone the last few weeks as he’s working. So I tend to believe that more than the general media.
The ventilator issue spans three presidential administrations. Reports and GAO recommendations led to no real action. The only order for new ventilators in Dec 2019 after years of mismanagement regarding orders of simplified ventilators for an emergency that were never filled. The most recent recommendation seems to indicate that less would be needed than it seems they need now.
I don’t no anything about the machines. But not seems they are not like stockpiling batteries and water etc. they must be very sophisticated.
Here’s the best article on the whole matter with less of an angle. At least to me.
“The overwhelming number of coronavirus patients flooding hospitals across the U.S. has resulted in a shortage of ventilators for those experiencing difficulty breathing.
But while President Trump has faced criticism from states, like New York, for the short supply, federal agencies have been predicting the need for more ventilators for nearly two decades. Reports from various government offices have been sounding the alarm over the course of at least three successive presidencies dating back to the George W. Bush administration.
GAO found that most hospitals lack the capacity to respond to large-scale infectious disease outbreaks,” concluded the U.S. Government Accountability Office in a 2003 report after the SARS outbreak, noting that “few hospitals have adequate medical equipment, such as the ventilators that are often needed for respiratory infections such as SARS, to handle the large increases in the number of patients that may result.”
A 2005 Congressional Research Service report examining avian flu also noted that the U.S. was unlikely to be prepared for a pandemic due to that virus’ effect on the lungs.
“If this strain were to launch a pandemic and retain this trait, large numbers of victims may require intensive care and ventilatory support, likely exceeding national capacity to provide this level of care,” that report said. “In any event, such specialized care is not available in most developing countries, and access to it is uneven within the United States.”
Later that same year, the Department of Health and Human Services released an extensive report on the plan for an influenza pandemic. A key item on their list of actions to take for a “health care and emergency response” was to “assess surge capacity” of medical systems including ventilators, noting the necessity for maintaining an emergency stockpile.
Despite planning and preparedness, however, in a severe pandemic it is possible that shortages, for example of mechanical ventilators, will occur and medical care standards may need to be adjusted to most effectively provide care and save as many lives as possible,” the report warned, noting the likelihood of a significant increase in the demand for ventilators in the event of a large-scale outbreak.
The need for ventilators – and other resources – is repeatedly discussed in this report, even referencing a CDC spreadsheet that could help predict the potential need for ventilators at different stages of a pandemic.
A CNN report last week detailed a number of these internal government reports.
The mounting problem after nearly two decades of warnings, however, is not simply the product of a problem ignored. The government accepted bids from companies in 2008 planning to buy tens of thousands of additional ventilators for the stockpile after swine flu, avian flu, SARS, and MERS revealed the need.
According to a New York Times report, the federal government contracted the small Japanese company Newport Medical Instruments to develop and produce inexpensive ventilators that the U.S. would purchase.
Years later, after prototypes were developed, Newport was bought out by Covidien in 2012, and the project ground to a halt. By 2014, Covidien wanted out of the contract, former federal officials told the Times, and the government agreed to cancel it. A year later, Covidien was purchased by Medtronic, which told the Times that the ventilators Newport was developing would not have been usable on newborns and would have fallen short of the government’s requirements.
The government entered into a new contract with Philips in 2014, and finally ordered 10,000 ventilators in December 2019, with delivery expected later this year.
“We definitely saw the problem,” Dr. Thomas R. Frieden, CDC director from 2009 to 2017, told the Times. “We innovated to try and get a solution. We made really good progress, but it doesn’t appear to have resulted in the volume that we needed.”
Meanwhile, reports sounding the alarm continued to pile up while that effort stalled.
In 2006, the Congressional Budget Office warned that in the event of a flu pandemic on the level of the 1918 Spanish flu, the U.S. would be grossly underprepared when it comes to ventilators. The CBO noted that at the time there were an estimated 100,000 ventilators in the country, but “a severe influenza pandemic like the one in 1918 would require 750,000 ventilators to treat victims.”
A 2007 flu pandemic plan published by the Department of the Interior also noted that in such an event: “A substantial percentage of the world’s population will require some form of medical care,” and that medical facilities would likely be “ overwhelmed, creating a shortage of hospital staff, beds, ventilators and other supplies.”
Similar language was used in a 2009 OSHA report for influenza pandemic preparedness that also referred to instructions from the Department of Health and Human Services and the CDC for estimating the demand for ventilators and other equipment in the event of pandemics of varying scales.
The same year, a report on preparedness for swine flu from the President’s Council of Advisors on Science and Technology warned then-President Barack Obama that “[c]ases requiring mechanical ventilation or intensive care could reach 10 to 25 per 100,000 population, requiring 50 to 100 percent or more of the total ICU capacity available in the United States and placing great stress on a system that normally operates at 80 percent of capacity.”
In 2013, an avian flu outbreak in China led to a report from the National Institutes of Health on the demand for ventilators in the event of a flu pandemic.
There is a clear challenge to plan and prepare to meet demands for mechanical ventilators for a future severe pandemic,” the report said, estimating that in a “high severity scenario,” the U.S. would need “approximately 35,000 to 60,500 additional ventilators
The Trump administration was also warned, as a June 2017 CDC report discussed the agency-managed Strategic National Stockpile (SNS) of ventilators, stating that “SNS ventilators might not suffice to meet demand during a severe public health emergency.”
In 2006, the American Association for Respiratory Care recommended that the SNS increase its ventilator inventory to between 11,000 and 16,000. Earlier this month, Dr. Anthony Fauci told CNN that the stockpile currently has 12,700 ventilators. This is up from roughly 4,000 in 2006.
Now that the country is in the midst of the coronavirus pandemic, the government is pushing for speedier delivery of the ordered ventilators that had been expected later on this year, as well as looking to other manufacturers for additional machine
General Motors has been working with medical device company Ventec Life Systems and parts suppliers to build more ventilators, and Trump invoked the Defense Production Act when he felt they were not moving fast enough.
GM expects to produce ventilators at a rate of 10,000 per month starting in mid-April.
Ford has announced that they and General Electric are also working together to produce “a simplified version” of an existing GE ventilator.
Before AP Stats, you just had to pick it up on your own.
Went looking for the exact Pauline Kael quote and found it’s a little more nuanced than what is generally passed around:
That’s a little less clueless than the version I’ve always heard, but… a good bit more patronizing.
(Just my opinion, but when a reading list is predominately composed of: The Guardian, CNN, NYT’s, etc., the reader’s world is indeed a more special place than most.)
Richard Epstein is committing a fallacy that good cross-examiners and good debaters are vulnerable to: Winning the debate is not the same as being right. Sometimes, experts are not excellent at describing their work, but reality is still reality even when people who study it are worse debaters than Epstein is.
220 = normal per day cremations in Wuhan => ~ 6,400 to 6,800 = normal per month cremations in Wuhan
~ 28,000 = recent month number of cremations in Wuhan from “a source close to the provincial civil affairs bureau” who said that there were deaths at home without any diagnosis of or treatment for COVID-19
~ 2,500 = official number of COVID-19 deaths in Wuhan
The article also gives some numbers of total deaths that are estimated based on the number of urns of cremated ashes being handed out to families (500 per day for each of seven funeral homes) or the cremation capacity of the funeral homes (estimated at 1,560 per day), assuming that they are/were doing these things at maximum capacity for some amount of time.
US Marine Corps temporarily suspends new recruit training
From CNN’s Ryan Browne
The US Marine Corps said Monday that due to coronavirus concerns, it is “temporarily suspending the shipping of new recruits” to Marine Corps Recruit Depot Parris Island, South Carolina," where some 50% of enlisted Marines receive their basic training.
There has been a significant amount of Covid-19 cases at Paris Island, according to a Marine Corps official.
“Amid the national emergency caused by the COVID-19 outbreak and out of an abundance of caution, the Marine Corps is taking steps to protect its recruits, recruit training personnel, their families and the communities where they live and serve by temporarily suspending the shipping of new recruits to Marine Corps Recruit Depot Parris Island, South Carolina,” the Marines said in a statement.
“Recruit training for individuals already at the Depot will continue as planned, with continued emphasis on personal and environmental cleanliness and social distancing,” the statement added.
Enlisted entry level training also takes place at Marine Corps Recruit Depot San Diego. No announcement about training there has been made at this time.
With suspension of training at Paris Island, this includes basic training for all female enlisted Marines.
“The preservation of our Marines, recruits and their families is the highest priority for Marine Corps Recruiting during this national emergency,” said Gen. David H. Berger, Commandant of the Marine Corps said in the statement Monday.
“With that in mind, we’ve paused this week’s shipping of new recruits to Parris Island and will revise our overall shipping plan to ensure we are able to meet the Nation’s needs while protecting its next generation of Marines,” he added.
Virginia governor issues stay-at-home order
From CNN’s Stephanie Gallman
Virginia Gov. Ralph Northam announced at a news conference today that he issued a stay-at-home order for the state.
Everyone must stay at home unless leaving to get food, supplies, going to work, seeking medical care or going outside to get exercise.
Northam said his order is partially in response to seeing beaches in his state “literally packed” over the weekend. Beaches are now closed except to those exercising or fishing, Northam said.
Trump asked if masks in New York are “going out the back door.” Here’s how the governor responded.
From CNN’s Giulia McDonnell Nieto del Rio
New York Gov. Andrew Cuomo was just asked about President Trump’s suggestion that personal protective equipment, such as masks, could be “going out the back door.”
Cuomo said New York City has a warehouse of supplies — and said the city is creating a “stockpile” for the “high point” of the coronavirus pandemic.
“First, there is a warehouse and that is in New Jersey, it’s the New York City warehouse. We are creating a stockpile. For someone to say, ‘well the warehouse has equipment in it, you should be using that equipment today’ — that defies the basic concept of planning and the basic operation that we have to have working not just in this state but across the country," Cuomo said.
He added:
“If you are not preparing for the apex, and for the high point, you are missing the entire point of the operation. It is a fundamental blunder to only prepare for today. That’s why in some ways we are where we are.”
Cuomo said he’s not sure what Trump meant by the suggestion.
“In terms of a suggestion that the PPE equipment is not going to a correct place, I don’t know what that means, I don’t know what he’s trying to say, if he wants to make an accusation, then let him make an accusation. But I don’t know what he’s trying to say by inference,” he said.
What this is about: At a briefing last night, Trump appeared to suggest, without evidence, that hospitals in New York are somehow stealing masks.
“Even though this is different, something is going on, and you ought to look into it as reporters. Where are the masks going? Are they going out the back door? How do you go from 10,000 to 300,000?” he asked.
New York governor says ventilator prices went from $20,000 to $50,000 in a matter of weeks
CNN
New York Gov. Andrew Cuomo said 50 states and the federal government are all competing for supplies and driving up prices.
“Ironically enough. We are fighting among ourselves, we competing among ourselves,” he said.
“When we started buying ventilators, they were under $20,000. The ventilators are over $50,000 if you can find them. The ventilators didn’t change that much in two weeks,” Cuomo said.
New York governor to out-of-state health care workers: “Come help us, please”
Gov. Andrew Cuomo urged health care workers from other states to join the fight against coronavirus in New York state.
“As governor of New York, I am asking health care professionals across the country: If you don’t have a health care crisis in your community, please come help us in New York now,” he said.
Cuomo said the state’s health care workers need help and relief now — and he promised they’d “return the favor” if coronavirus outbreaks hit other states next.
“If you are not busy, come help us, please. We’ll return the favor,” he said. “The New York way is to be helpful.”
Rate of coronavirus hospitalizations in New York is slowing, governor says
CNN
New York Gov. Andrew Cuomo said the rate of hospitalizations for coronavirus cases in the state has slowed, citing the rate of “doubling” of people admitted to the hospital for Covid-19.
Cuomo said the rate of new hospitalizations is now doubling every six days, as compared to every two and three days like last week.
“So, while the overall number is going up, the rate of doubling is actually down,” Cuomo said.
Australia too. Do we have evidence that any “warm/hot” country has an infection curve anywhere near Europe and the US? I don’t think so. Singapore does tons of business with China and has a lot of international activity yet they have very low rates of infection. Is it the weather?
Our road association really needs to meet soon due to demands being placed on us by the state of Maine (we have a RR crossing on our private road that’s a pain in the rear). I can’t believe they’re worrying about such minor details at a time like this!
A neighbor suggested we meet by Zoom OR at the end of our road, using physical distancing. I wrote back that we should meet by Zoom only, since physical distancing is appropriate only for ESSENTIAL activities, not meetings or socializing. Get this - the neighbor who suggested the in-person meeting is a hospital doctor! That shocked me.
"Coronavirus job losses could total 47 million, unemployment rate may hit 32%, Fed estimates
Millions of Americans already have lost their jobs due to the coronavirus crisis and the worst of the damage is yet to come, according to a Federal Reserve estimate."
Holy s***
If that comes to pass that will mean the Great Depression of the 21st century has arrived.
If hospitals are asking for much more than they need as a planning mechanism. I’m all for it. But they should be clear on that fact. Perhaps they are afraid they won’t get what they need if they don’t ask as though it’s a current need. However the narrative I am reading and hearing is that there are critical shortages in some spots.
Why is gov. cuomo warehousing things and hospital staff is using garbage bags for gowns in one picture. It should be a combo. It probably is but it’s not really the conversation.
I think shortages are very localized and moving materials from place to place requires the hospital or local mayors etc to give up their stash temporarily and that’s a near impossible thing to do when you are afraid.
The Israeli prime minister, Benjamin Netanyahu, has tested negative, his spokesman has said.
The British Virgin Islands, a British overseas territory, has become the latest country to defy the US state department by soliciting medical help from Cuba.
Andrew Fahie, the BVI premier, said the territory had asked Cuba to send up to 30 doctors to help with its response to the coronavirus pandemic. Fahie said he was now waiting to see whether the UK would ‘support’ the territory’s request for this ‘invaluable assistance’ from Cuba, BVI News reports.
There are currently two confirmed cases of coronavirus infection in the BVI, with test results on nine other patients still due to come in.
Cuba has so far sent medical teams to over a dozen countries battling coronavirus outbreaks.
A motorsport chief has revealed he suggested that his Red Bull team’s drivers should try to become infected with coronavirus as it is the “ideal time” with the season on hold.
The start of the 2020 F1 season has been decimated by the global pandemic, with the opening six races of the year either cancelled or postponed. As things stand, the first grand prix of a truncated season will be in Canada on 14 June but that will almost certainly change in the coming days.
Red Bull’s Helmut Marko told Austrian television station ORF that he came up with a plan in which his driver pairing Max Verstappen and Alexander Albon – as well as the AlphaTauri duo Pierre Gasly and Daniil Kvyat – contract Covid-19 in an attempt to have them fit and healthy when the season finally begins.
“We have four Formula One drivers and eight or 10 juniors,” he said.
“The idea was to organise a camp where we could bridge this mentally and physically somewhat dead time and that would be the ideal time for the infection to come.
USNS Comfort - a NAVY ship with 1,000 beds and 12 operating rooms arrive to NYC today
Hospital(s) in the Javits Center opened today
Both Javits and Comfort are NON Covid-19 hospitals (per Trump’s requirement). This may be a big relief for those who need immediate medical attention but are mortified to go to the hospital. It will also free up space in other NYC hospitals.
A new hospital system was put in place to coordinate among all NYS hospitals regarding the distribution and balance of equipment, patients, .
The rate of newly hospitalized patients is indeed doubling every 6 days now
66,497 cases (+6,984)
number of tests in 12K (less than usual)
9,517 currently hospitalized (1,014 new patients yesterday)
2,352 current ICU patients