Coronavirus in the US

Parent Cafe
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Sources at two US hospitals say they’re running out of sedation drugs
From CNN’s Paul Murphy and Lauren DelValle

Two nurses at St. Joseph’s Hospital in Denver, Colorado, have told CNN that they’re running out of proper sedation drugs because they’ve had to intubate so many patients since the coronavirus epidemic began in the US.

A nurse at Johns Hopkins Hospital in Baltimore, Maryland, tells CNN that their hospital is running out of fentanyl, which they used to sedate intubated Covid-19 patients.

“We are starting to run out of proper sedation medication like propofol and fentanyl,” one nurse says.

“It’s hard to watch when you have to flip these people onto their bellies and use oral medications to sedate them through their feeding tubes.”

SCL Health Vice President of System Communications Nikki Sloup said that their hospital system, which includes St. Joseph’s Hospital, currently has an adequate supply to meet patient needs. But Sloup warns that if they experience a patient surge, it could see shortages.

“We have put in place numerous conservation programs and continue to work with public and private partners to secure the supplies we need to provide safe and appropriate care to our patients and ensure the safety of our caregivers,” Sloup told CNN in a statement.
CNN reached out to Johns Hopkins Hospital for comment but did receive a response.

One nurse said they’ve never seen so many ventilators being put to use.

“Being on a ventilator is a package deal – it typically comes with the addition of sedation in order to tolerate being ventilated and that’s where fentanyl comes into play,” they said. “It is being used in such high doses to appropriately sedate these patients.”

Plane with aid from Russia expected to arrive in US on Wednesday
From CNN’s Kylie Atwood

A plane from Russia loaded with personal protective equipment (PPE) and other supplies to assist in the response to Covid-19 is expected to arrive in the United States on Wednesday, a senior administration official tells CNN.

“We expect Russia to deliver a planeload of personal protection equipment and supplies tomorrow, as President Putin offered President Trump yesterday,” the official said.

“We will put into immediate use any needed items that are FDA approved. Likewise, the United States is sending equipment and supplies to many other countries and will continue to do more as we are able.”

President Trump on Monday told reporters that Russia sent the US “a very, very large planeload of things, medical equipment which was very nice.”

Why is Russia sending the equipment? The Russian embassy in DC tweeted Tuesday that President Vladimir Putin provided the assistance with the consideration that manufacturers would reciprocate and share supplies with Russia if need be.

The National Security Council and State Department did not reply to inquiries as to if President Trump promised that US manufacturers would share supplies with Russia if Russia gets to a point where they need them.

Russia in USA ??
:heavy_check_mark:
@RusEmbUSA

StopCovid19

Importantly, when offering assistance to the American colleagues, President Putin is guided by the following consideration: when manufacturers of medical equipment gain momentum they will be able to reciprocate if need be - #Peskov

Russia in USA ??
:heavy_check_mark:
@RusEmbUSA
Russia may send plane with medical equipment to #US by end of day. Being aware of the serious epidemiological situation in America, the Russian side offered medical equipment and protective gear as assistance - #Peskov

Georgia governor will deploy National Guard to long-term health care facilities
From CNN’s Jamiel Lynch

Over the next few weeks, Gov. Brian Kemp will deploy the National Guard to help long-term care facilities, assisted living facilities and nursing homes in Georgia with Covid-19 cases.

The National Guard will help implement infection control protocols and enhance sanitation methods in hopes of mitigating exposure to the vulnerable residents, the governor said in a press release.

“Georgia’s top priority is increasing healthcare capacity to protect vulnerable Georgians, especially those residing in long-term care facilities,” Kemp said. “If we can keep these populations as healthy as possible, we will be able to conserve precious medical supplies and hospital bed space in the coming days and weeks.”

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It did initially look like someone put some major tranquilizers in his KFC, and the experts actually got to speak (and he actually deferred to them at one point) but then the need to be center stage seemed to kick in, and the experts got interrupted so he could pontificate a bit and describe the graphs incorrectly. At that point I turned it off.

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So based on these numbers, if the predicted numbers are correct, COVID-19 could be the 3rd or 4th major cause of death this year. Thats sobering.

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Washington deploys National Guard to help food banks

Washington Governor Jay Inslee announced on Tuesday that the Washington National Guard will be deployed in the state this week to assist local food banks with their operations.

“They’re filling an important need and I ask that you welcome them in your communities as they process, package and distribute meals,” Inslee said in a tweet. Inslee spokesman David Postman said earlier on Tuesday that the National Guard wasn’t being deployed in a law enforcement role or to enforce restrictions, according to the Tacoma News Tribune.

Start-ups cut nearly 4,000 jobs in March as coronavirus impact ripples through tech

Start-ups eliminated nearly 4,000 jobs this month as the coronavirus crisis disrupted business-as-usual across the economy.

The layoffs, compiled by CNBC based on multiple media reports, included more than 3,800 people spanning more than 40 companies operating in sectors including hospitality, transportation, meal delivery and artificial intelligence. They are headquartered across the country, in California, Austin, Boston and Portland, Ore., among others. The companies have collectively raised nearly $15 billion, according to Crunchbase data.

Senators push Mnuchin to guarantee oversight of $500 billion bailout fund

Leading Democratic senators called on Treasury Secretary Steven Mnuchin to ensure proper oversight of a $500 billion fund aimed at helping companies hit by the coronavirus’ economic fallout.

The fund, which was established as part of a more than $2 trillion stimulus bill President Donald Trump signed into law last week, became a point of contention for Democrats who worried that earlier versions of the bill gave Mnuchin too much discretion over how the funds are dispersed. After tense negotiations, Republicans and Mnuchin agreed to add an inspector general to oversee that fund, as well as a congressional committee.

But Trump on Friday questioned the authority of the inspector general. According to a signing statement he released alongside the bill, he declared his belief that the inspector general needs his permission before letting Congress know whether Mnuchin or Treasury block efforts to glean information.

The Fed’s Loretta Mester says to expect ‘some really bad economic numbers’ before things get better

Fed’s Mester: Our banking system was strong coming into this
The coronavirus crisis is going to push unemployment past 10%, but it may not be as bad as some forecasts, Cleveland Federal Reserve President Loretta Mester said in a CNBC interview.

Recent outlooks have seen the St. Louis Fed estimate the jobless rate to as bad as 32%, while Goldman Sachs this week upped its prediction to 15%.

Mester said the final number is likely to fall somewhere above 10% though likely not as bad as the upper range.

“Those numbers are not out of the range of possibilities, according to our own forecasts at the Cleveland Fed,” Mester said on “Closing Bell.” “How things play out really is going to depend on the course of the virus.”

CNBC

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CDC says diabetes, lung disease, heart disease and smoking may increase risk of severe coronavirus illness

People with diabetes, chronic lung disease, heart disease or those who smoke may be at increased risk of developing severe complications if they get infected with the coronavirus, the Centers for Disease Control and Prevention said Tuesday.

In its first report looking at underlying health conditions that could make COVID-19 worse, the CDC analyzed data from confirmed cases in all 50 states and four U.S. territories between Feb. 12 and March 28. The agency examined 7,162 cases where data was available on underlying health conditions or other potential risk factors. Confirmed cases among people repatriated to the United States from Wuhan, China, where the virus emerged, and the Diamond Princess cruise ship were excluded, the agency said.

Among the 7,162 U.S. cases, 37.6%, had one or more underlying health conditions or risk factors, and 62.4%, had none of these conditions reported, according to the CDC’s preliminary findings. The most commonly reported conditions were diabetes, chronic lung disease and cardiovascular disease.

The CDC found that a higher percentage of patients with underlying conditions were admitted to the hospital or into intensive care than patients without underlying conditions. About 78% of ICU patients and 71% of hospitalized COVID-19 patients had one or more reported underlying health conditions, the CDC said. In contrast, 27% of the patients who were not hospitalized had at least one underlying health condition, the agency said.

“These preliminary findings suggest that in the United States, persons with underlying health conditions or other recognized risk factors for severe outcomes from respiratory infections appear to be at a higher risk for severe disease from COVID-19 than are persons without these conditions,” the CDC wrote. It recommended that people with underlying health conditions keep at least a 30-day supply of medication, a 2-week supply of food and other necessities and to know the COVID-19 symptoms.

The new data comes as U.S. cases climb to more than 181,000 and deaths surpass 3,000, more than the number of people who died in the Sept. 11, 2001, terror attacks. The death toll is expected to rise over the next few weeks as more patients flood hospitals, U.S. officials say.

Public health officials have long said the virus appeared to be particularly severe in the elderly and those with underlying health conditions. Symptoms can include a sore throat, runny nose, fever, dry cough, diarrhea or pneumonia and can progress to multiple organ failure or even death in some cases, they said.

A recent study published journal Pediatrics showed that some children can develop severe or critical disease. More than 90% of the cases were asymptomatic, mild or moderate cases. However, nearly 6% of the children’s cases were severe or critical, compared with 18.5% for adults.

The CDC said Tuesday the findings were in line with data from researchers in China and Italy, where the number of confirmed cases has topped 105,000.

The CDC recommended people who are sick, especially those with underlying health conditions, should stay at home, except to get medical care.

https://www.cnbc.com/2020/03/31/cdc-says-diabetes-lung-disease-heart-disease-and-smoking-may-increase-risk-of-severe-coronavirus-illness.html

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We don’t have murders anymore?

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100,000 to 200,000 with full mitigation. We don’t have full mitigation. I obviously lied about getting off the computer a half hour ago but really do have to get off soon. I have watched the first 1 hour 15 min. Trump is talking now, talking about if he didn’t do the travel ban. Pence seemed to want to skip the question about where are the missing 23 million test kits and I don’t think the answer to that was very good.

Overall they were giving good info with the apparent goal of getting the country onboard at staying home and taking this seriously. I don’t think they were giving any info I have not heard elsewhere. I like that they were overall standing further apart. I like that so far Trump seems like a human being how cares about what is going to happen to others. That has not come though in his other talks on this topic.

I wish Dr. Birx talked more about what Wa state did that helped prevent bigger growth.

WA state didn’t start in a nursing home. It started in early January and spread undetected because the CDC refused to allow the UW affiliated private lab to test since they were a research and not a testing facility. It took off more in the nursing home but there was pretty wide-spread community spread by then.

Unlikely we will be able to attain the 100,000 deaths. He is right that if he hadn’t done even the travel ban, it would have been worse. His travel ban was not as soon (by weeks) or as strong as i would have had but better than nothing and I’m sure made a difference. If we did nothing at all it would be worse, certainly. But we can’t congratulate him for not taking all the other important actions from then (when he did his travel ban) and the middle of March when he had a big turn around in his attitude toward this. He can say NY and NJ got late starts but he certainly did as well. I can’t understand that he doesn’t appear to feel any guilt over that. In Japan, no joke, people at the least frequently throughout history would bow deeply and say there was no excuse and step down if not even kill themselves (something I don’t recommend to anyone). He doesn’t appear to accept any blame or feel any guilt. That’s pretty amazing to me. I’m not saying that because of how I feel about him. If he had acted the way he did overall in this press conference since January, i would support his response regardless of what I think of him as a person or his handling of anything else. He acted like a human being for the most part here and was focused on the problem and solutions.

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One has to wonder in what other universe those predicted numbers would be considered a victory and/or “not a big deal” as asserted by some.

Then one has to wonder what the numbers are going to tally up to around the world, esp poorer countries if they get hit (sigh).

May the scientists working on treatments and social distancing slowing the onslaught help us out so we don’t actually reach numbers that high. If it weren’t for the numerous idiots out there, we’d have a better chance - quicker for economic purposes too.

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OK - I’m really going to get off the computer now but Trump just said he thinks DeSantis is doing a great job. No, DeSantis is not doing a great job. Florida is going to have a very serious problem soon as a result. I have family there and this is very concerning to me. So, that part I for sure do not agree with Trump.

11950

English translation of the New York state Latin motto Excelsior.

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Encouraging news re California:

More at: https://www.usatoday.com/story/news/nation/2020/03/27/scientists-track-coronavirus-strains-mutation/5080571002/

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Disturbing Boston Globe story – Coronavirus outbreak was apparently kept secret at Soldiers’ Home in Holyoke even as the death toll rose

https://www.bostonglobe.com/2020/03/31/metro/holyoke-mayor-accuses-suspended-soldiers-home-director-concealing-deaths/?s_campaign=rhodemap:newsletter

"The anonymous tip landed Saturday in Holyoke Mayor Alex Morse’s office, a phone complaint about unhealthy conditions at the Soldiers’ Home, a hilltop complex where veterans go for walk-in medicine, long-term care, and occasionally to die in hospice among their comrades.

A nurse with the city’s health board called the Soldiers’ Home that day but got no response. The next day, Morse reached out directly to Bennett Walsh, the facility’s superintendent, and received the devastating news.

The coronavirus outbreak had descended upon the 68-year-old complex, and veterans were dying rapidly. They had been dying since the first of the month, and on Tuesday the toll reached 13 fatalities, with at least six due to the virus. Pending tests could show a link to others of the dead, as well.

Yet somehow, at a time when infection control at elder care facilities is of paramount importance and any trace of the virus poses a systemic threat, the outbreak was apparently kept secret, even as casualties accelerated.

No one at City Hall had been told of the deaths before last weekend, according to Morse. No one at the highest levels of state government had, either, officials said. And neither had family members of the veterans who survive.

The stunning breakdown of public health protocol touched off a swirl of accusations and disbelief Tuesday and a pledge from state leaders to uncover how such a widespread outbreak could have gone undetected for so long.

The deceased were placed in a refrigerated storage truck that was parked in the home’s rear loading area since late last week, three staffers said. A supervisor told staff that federal guidelines required coronavirus-infected bodies to be held for a certain time before being released to avoid spreading the virus. But the sight disturbed several staffers.

“We take care of our veterans with honor and dignity,” said a nurse who spoke on condition of anonymity for fear of retaliation. “It’s emotionally shocking when you have to watch people you’ve cared for for a long time be stored in a refrigeration truck. It’s not dignified.” …

But the deaths at the Holyoke Soldiers’ Home — the largest fatal outbreak in the state thus far — stunned state and local officials.

“We were not aware of the gravity of the situation at the Soldiers’ Home. I was shocked,” Morse said Tuesday in a speech live-streamed on Facebook. “If they followed [public health] guidelines, we would have been notified. And we weren’t.”

During the call over the weekend, Morse recounted, Walsh looped in his boss, Secretary of Veterans’ Services Francisco Urena. Morse said that he was not sure if Urena had known previously about the situation in Holyoke but that he did not seem to consider it a significant issue.

“I didn’t leave [the telephone conversation] assured that action would be taken,’’ Morse said.

Frustrated, Morse said, he called Lieutenant Governor Karyn Polito on Sunday and said she responded within minutes. Shortly afterward, Health and Human Services Secretary Mary Lou Sudders told him she would be sending a team of health specialists to the facility the following day."

Story continues for quite a bit.

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@suteiki77 thank you. She’s doing much better. Boston looks like a potential hotspot. Scary.

@“Snowball City” daughter is still processing through it too. Hope she’s better soon too.

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^ haven’t heard much about Boston - any stats you can share?

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Too. Much. Data.

https://www.seattletimes.com/seattle-news/flood-of-coronavirus-data-overwhelms-states-disease-reporting-system-leading-to-lag-in-data/

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Turkmenistan is one of the few places that got a lower score from Freedom House than North Korea.
https://freedomhouse.org/countries/freedom-world/scores?sort=asc&order=Total%20Score%20and%20Status

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https://www.cdc.gov/nchs/fastats/homicide.htm says that there were 19,510 homicides in the US in 2017. Note that homicide is not necessarily murder, since there are lesser crimes like manslaughter, as well as justifiable homicide (e.g. while resisting a serious enough crime being committed or attempted against you).

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“World’s busiest airport” sees operations fall by 60% amid coronavirus pandemic
From CNN’s Nick Valencia

The coronavirus pandemic has dramatically cut operations at Atlanta’s Hartsfield-Jackson International Airport by 60%, according to an airport official.

In the past 10 days, operations – categorized by officials as the combination of departures and arrivals – were down from 2,700 on average to 1,100 on Monday.

The airport official said many employees were teleworking, while essential workers are still reporting for work.

Atlanta Hartsfield-Jackson is known as the “world’s busiest airport” and is often listed among the top airports ranked in passenger traffic and flights. More than 107 million passengers flew through Hartsfield-Jackson in 2018.

Illinois governor says the state will run out of ventilators “and the federal government really isn’t helping at all”
CNN

Illinois Gov. J.B. Pritzker told CNN’s Chris Cuomo Tuesday that the federal government isn’t meeting the needs of his state for ventilators for Covid-19 patients and that the state is purchasing its own.

The governor said the state has requested 4,000 additional ventilators from the federal government, but only received 450.

“I’m purchasing every ventilator that I can find,” Pritzker said. “But we’re buying them in 100 lots and 200 lots, frankly, I’m taking them 50, 20, 10, wherever I can get them.”
“We are going to run out of ventilators and the federal government really isn’t helping at all,” Pritzker said.
Federal miscommunication over ventilators: Pritzker’s comments come after the Department of Defense said it still hadn’t shipped 2,000 ventilators to the Federal Emergency Management Agency and the Department of Health because it didn’t know where to send them.

“There was discussion with (Health Department) on where to send them. And then they said: ‘Hey wait, we’re trying to take a look at the demand that’s required,’ and so we were asked to just wait while there was just some sorting through on that. And I won’t speak on behalf of them, but we were in a position to provide 2,000,” said Lt. Gen. Giovanni Tuck, the Pentagon’s top logistics official, on Tuesday.

[ At the press conference today, Trump did state that the stockpile had 10,000 ventilators but mentioned they were hanging onto them for now. Hopefully the new ones can be built before other states run out of free ventilators. ]

US Coast Guard warns medical evacuations are putting strain on its resources
From CNN’s Rosa Flores and Sara Weisfeldt

As more and more foreign passenger vessels require medical evacuations for people with flu-like symptoms, the US Coast Guard’s strained local medical resources are feeling the pressure.

According to a Marine Safety Information Bulletin issued by the US Coast Guard and obtained by CNN, the increased demand “is leading to the establishment of improvised field hospitals.”

“Medical facilities in the Port of Miami, for example are no longer accepting medevac patients due to limited hospital capacity and it is expected that neighboring counties will follow suit,” the bulletin warned.

The Zaandam cruise ship, which is headed to Florida with dozens of people with flu-like symptoms – and at least eight people who tested positive for Covid-19 – is flagged in the Netherlands. It is requesting to dock at Port Everglades. There are 305 US citizens on board, including 49 Floridians.

Foreign-flagged vessels that sit beyond US territorial seas “should seek flag state support prior to seeking support from the limited facilities in the U.S,” the bulletin said.

The bulletin goes on to say that an evacuee “has better access to comfortable surroundings and medical staff on board the foreign passenger vessel where care is already being provided.”

“This is necessary as shore-side medical facilities may reach full capacity and lose the ability to accept and effectively treat additional critically-ill patients,” the bulletin said.

Samsung works with mask companies to help increase output
From CNN’s Sophie Jeong in Seoul

Samsung, the world’s largest maker of smartphones, TVs and memory chips, has sent its manufacturing experts to mask-producing firms to increase output without adding new equipment, according to a news release from the South Korean tech giant.

At one firm, the daily mask output increased from 40,000 to 100,000, the release said. Samsung also imported 284,000 masks and donated them to the Daegu region, where the outbreak in South Korea has been concentrated.

Samsung’s 14 affiliates, including Samsung Electronics, have donated 30 billion won ($24.6 million) to the Korea Disaster Relief Association to support efforts to overcome the coronavirus outbreak in the country.

Samsung also provided South Korean authorities with its training facility to use as a care center for coronavirus patients with mild symptoms.

South Korea has recorded 9,887 cases of the novel coronavirus, including 165 deaths.

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US federal prisons will confine inmates to cells for 2 weeks due to coronavirus
From CNN’s David Shortell

The US federal prison system will move to a heightened state of lockdown as it fights the spread of coronavirus behind bars, the Bureau of Prisons announced.

Beginning Wednesday, inmates will be confined to their cells for a two-week period, with exceptions for certain programs and services like mental-health treatment and education.

Limited group gatherings – like access to prison stores, laundry, showers and the telephone – will be “afforded to the extent practical,” the agency said.

The strict protocols come just days after the first coronavirus death in the federal prison system – at a Louisiana prison over the weekend.

“It’s like war,” Detroit emergency medical technician says
From CNN’s Paul Murphy

Detroit hospitals are being stretched thin as coronavirus cases skyrocket in the Michigan city.

First responders at the city’s fire department are still assisting residents – and when the call comes in as code “Charlie,” that signifies it’s a possible Covid-19 call, a Detroit Fire emergency medical technician (EMT) tells CNN.

“I see citizens still wanting to go to the ER for mild symptoms who should reality isolate at home and follow CDC guidelines,” the EMT says. “Hospitals are just flooded and overwhelmed. It’s like war.”

First responders try to educate and inform those with mild symptoms of the CDC guidelines, the EMT says. Ultimately, they have to transport people if they ask to be brought to the hospital.

“We try and give them every possible scenario,” the EMT says. “But we never discourage anyone from seeking treatment.”

While responding to a call, the EMT says first responders from the fire department are in constant communication with “medical control,” an ER physician on the other radio.

While in the home, even with their personal protective equipment (PPE) on, they’re trying to maintain a six-foot (1.8 meters) distance with any patients.

Right now, the EMT says they believe they have a good supply of PPE. They are constantly cleaning their trucks, too.

“I come home smelling of bleach,” the EMT says. “If the coronavirus doesn’t get to my lungs the bleach will.”

Tokyo records highest single-day jump in coronavirus cases as lockdown pressure builds
From CNN’s Emiko Jozuka in Tokyo

Tokyo reported 78 new coronavirus cases on Tuesday – the highest single-day increase for Japan’s capital – as pressure builds to lock down the city.

The latest rise in people testing positive in Tokyo came as Japan recorded over 200 new coronavirus cases on the same day – the biggest single-day jump during the outbreak, according to public broadcaster NHK.

“This is the biggest increase so far and is certainly of high concern. I’m worried by what tomorrow’s figure could show,” said Tokyo governor Yuriko Koike in a news conference.

On Tuesday, Koike urged Japan’s Prime Minister Shinzo Abe to use Tokyo as a reference to decide whether to declare a state of emergency to deal with the coronavirus pandemic, NHK reported.

“Tokyo is on the verge of an explosive increase of infections. We are trying to prevent that situation and trying to prevent further spread (of the virus). A decision by the state is needed now,” Koike told reporters Tuesday.

Lockdown measures: Last Wednesday, Koike urged residents in Tokyo to avoid bars, restaurants and large public gatherings, and telework where possible until April 12.

Koike’s remarks were a test for the city of over roughly 13.5 million people, which until then had been reluctant to impose a lockdown on its residents. While other countries have been quick to enforce restrictions on their citizens to contain the spread of the coronavirus, in Japan it’s largely been business as normal.

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Do people in the rural panhandle and the dusty center get the flu? I’m sure they do. So they could get covid-19. So they need to be locked down to prevent transmission.