Either Louisiana has more than 6,424 cases or it is experiencing an exceptionally high mortality rate.
I feel like some of the heroes we’ve overlooked are the doctors who picked up those first few cases.
In Santa Clara County, we got a couple of cases related to travel very early, one on Jan. 31 and one on Feb. 2. The health department chased down contacts. They thought they’d identified contacts. There were no cases after a week, after two weeks, after three weeks.
Then on Feb. 28, a woman in her 60s, with no known risk factors, showed up in El Camino Hospital, which is near me. She had some pre-existing conditions, and I assume she was pretty sick. And some eagle-eyed doctor noticed that she maybe had symptoms of that virus that was messing up Italy, and got her tested. I’m guessing that patients like her were showing up elsewhere, but for whatever reason weren’t being tested: maybe the doctors in other emergency rooms couldn’t get their patients tested, or maybe they thought pneumonia in older patients wasn’t remarkable, but for whatever reason, our hero doctor got this woman tested, and she was positive.
Then the Santa Clara Health Department sprang into action. The head, Dr. Sara Cody, brought in people from the CDC. Over the coming days, she made stricter and stricter orders: a suggestion that big gatherings cease, then when that didn’t happen a ban on big gatherings, and then smaller gatherings, and then even smaller gatherings, and then on March 16 she persuaded the other local counties to have all of us in the Bay Area shelter in place. This shelter in place was just strengthened, with harsher bans on inessential businesses.
We have cases here in Santa Clara County. We have deaths, 33 of them, and every day we have more. But in the last eight days, our death total has doubled. In the same time, the national total has gone up over sixfold.
I hail the anonymous hero doctor and the courageous head of public health who weren’t afraid to do the right thing.
Re: American Chinese restaurants, I still haven’t heard of any case or spread being tied to one.
Can’t say that for churches, other religious gatherings, conferences, and many things.
@“Cardinal Fang” , one of my children lives in Santa Clara County. She was the first person I know to sound the alarm in our family, which also includes a few residents of New York City. I very much appreciate that public officials and decision-makers in the Bay area began taking COVID-19 seriously as soon as they did.
@gwnorth it’s possible that LA is not testing as much as NJ and that’s why it looks so bad. But Louisiana only has 4.6 million people compared to NJ’s 9 million, and NJ is also much more densely populated (most densely populated state in the union, although largely suburban).
A Ventilator Stockpile, With One Hitch: Thousands Do Not Work
While President Trump has assured states that thousands of ventilators remain at the ready, thousands more are in storage, unmaintained or otherwise unusable.
WASHINGTON — President Trump has repeatedly assured Americans that the federal government is holding 10,000 ventilators in reserve to ship to the hardest-hit hospitals around the nation as they struggle to keep the most critically ill patients alive.
But what federal officials have neglected to mention is that an additional 2,109 lifesaving devices are unavailable after the contract to maintain the government’s stockpile lapsed late last summer, and a contracting dispute meant that a new firm did not begin its work until late January. By then, the coronavirus crisis was already underway.
The revelation came in response to inquiries to the Department of Health and Human Services after state officials reported that some of the ventilators they received were not operational, stoking speculation that the administration had not kept up with the task of maintaining the stockpile.
In fact, the contract with a company that was maintaining the machines expired at the end of last summer, and a contract protest delayed handing the job to Agiliti, a Minneapolis-based provider of medical equipment services and maintenance. Agiliti was not given the $38 million task until late January, when the scope of the global coronavirus crisis was first becoming clear.
It is not known whether problems with the ventilators predated the contract lapse, but maintenance of the machines did halt. That delay may become a potentially deadly lapse.
“We were given a stop-work order before we’d even started,” said Tom Leonard, the chief executive of Agiliti, which had won the contract to service the ventilators in the stockpile. “Between the time of the original and the time of this contract award, I don’t know who was responsible or if anybody was responsible for those devices. But it was not us.”
Mr. Leonard said confidentiality agreements with the government over the stockpile prohibited him from giving specific figures on the number of ventilators the company was now working on.
“We still have that first tranche of ventilators, although we’re accelerating the work to get them deployable,” Mr. Leonard said. “We haven’t seen or touched or had anything to do with the ones that have already been deployed to date.”
Ventilators are sensitive machinery that Mr. Trump described on Sunday as so complex they were like “building a car.” But, experts say, like a car, they cannot be stored for lengthy periods without maintenance. So few are surprised that as the nation’s hospitals scramble to pull together every usable ventilator they can find, some have come out of storage with depleted batteries, missing oxygen hoses and other issues.
California recently discovered that 170 of its ventilators arrived broken, disputing the claim from the Department of Health and Human Services that all of the ventilators shipped by the Federal Emergency Management Agency were ready to use. The agency said in a statement that problems with some ventilators were limited to the devices’ external batteries, and that federal officials were quick to assist the states with any technical issues.
Federal officials revealed on Wednesday that their stockpile of medical gear was nearly depleted. FEMA has shipped 26 million surgical masks, 11.6 million respirator masks and more than five million face shields to states, setting off a race to obtain millions of recently produced masks from a variety of manufacturers at a moment of huge price spikes for respirators that previously sold for about 85 cents.
The bigger struggle, however, has focused on ventilators because states have asked for tens of thousands more than the approximately 9,400 that the U.S. government currently has in its stockpile. The Defense Department is also making 1,065 ventilators available, although those require special training and are not used as frequently in hospitals.
As White House officials have for the first time looked at a supply they had not thought about, they have discovered it is not only far smaller than what they need — it is also in constant need of maintenance.
Aric Vacchiano, the vice president of U.S. sales and services at Vyaire Medical in Chicago, which produces the LTV 1200, one of the ventilators in the federal stockpile, said the company had been fielding calls from all over the country as hospital officials rushed to get the machines in working order.
“They’re reaching out in every direction,” Mr. Vacchiano said.
Vyaire was responsible for maintaining some of the ventilators in the federal stockpile until that contract ran out in late August. The company protested when a broader contract to keep the stockpile up-to-date was granted to Agiliti instead. The dispute was not resolved until January, when Agiliti again prevailed.
It then received thousands of ventilators — it would not say how many — for restoration, and that work is still underway.
A spokeswoman for Health and Human Services did not respond to questions about what had happened to ventilator maintenance during the lapse, but she said the agency had sped up the contract with Agiliti to make the remaining 2,109 ventilators available by April 30.
As of Wednesday morning, FEMA had sent about 7,000 ventilators to a number of states, with 4,000 directed to New York. Mr. Trump said he wanted to hold the current stockpile in reserve until it was clear where new hot spots would emerge.
“We’re very short,” Gov. Ned Lamont of Connecticut said on CNN on Monday. “We had our ventilators all set to come, and at the last moment FEMA redirected them,” he said, to “another place that they considered more urgent than Connecticut.”
Officials in Illinois say they asked for 4,000 and got 450. New Jersey sought 2,300 and got 300. New Mexico has only 370. Virginia requested 350 ventilators but has not received any. The governor of Illinois asked Vice President Mike Pence for 4,000 ventilators this week and was told the state would not need that many.
At the same time, states are trying to grab whatever else they can, converting anesthesia machines for use as ventilators and sometimes fashioning new valves on 3-D printers so that multiple patients can share the same machine. That has never been tested on a broad scale, and it carries some risks.
To manage the scarcity of ventilators in the stockpile, FEMA has begun sending a questionnaire to states seeking ventilators, asking about available resources and whether hospitals have tried converting anesthesia machines. A FEMA official said state leaders could submit requests for ventilators at any time but should not expect their delivery unless patients were at risk of dying within 72 hours without the devices.
And states are discovering that much of what they can get their hands on needs work.
“Devices are being deployed, and many times it’s not clear to us whether they’re from the Strategic National Stockpile or some cache of products that may have been from that specific hospital, from that specific state or maybe another entity locally,” Mr. Vacchiano said. “In many cases, especially in places like New York, we are definitely overnighting materials to step up to the plate and try to help.”
He estimated that 80 percent or more of the calls that Vyaire has received have come from the greater New York area.
“We’re not hearing or seeing units showing up being truly or fundamentally broken,” Mr. Vacchiano said. But, he conceded, “they probably have not been maintained.”
D texted tonight that Indianapolis currently has 1/2 as many cases now as does Seattle. Sadly, I looked and she is correct. King Co., WA has 2,496 cases for 2.189,000 population and Marion Co., IN has 1,117 cases for 950,000.
Indianapolis is roughly 11-12 days behind Seattle, based on quick searching of first cases. Seattle also had the Kirkland nursing home. Doesn’t bode well for the trajectory of Indy… Edit: surely seems like Seattle was more than 12 days earlier
https://www.huffpost.com/entry/infant-coronavirus-death-connecticut_n_5e851c54c5b692780507154b
A six-week-old infant has died after testing positive for COVID-19.
It occurred to me even back a month ago that at Chinese restaurants, as opposed to some other cuisines, much of what you get is boiling hot from a pot right onto your plate. No (or less) bread, salad, etc. that hasn’t been safely cooked before you get it.
Food might be safe, but serving contamination, handling of plates, water glasses, silverware, the list goes on… including staff using the same bathroom you might have to duck into.
Different people have different risk levels but they do share the commonality of being assessed on current conditions.
Yesterday, some people avoided Chinese restaurants and were called xenophobic for doing so. Today, other people are pointing fingers at politicians and asking why they failed them.
In fact, we didn’t go to any restaurants in Feb or Mar, and didn’t eat the catered food at our own son’s wedding (March, right as things were just starting to get crazy in our area). I was just reflecting on what seemed to me different relative risk in the kind of food.
Ok. Why is color-safe bleach now impossible to find at my usual places? Why would that have been panic-bought?
Some Chinese students at Stanford were early and strong advocates for the university to go to online classes. Stanford was one of the first higher-education institutions in the U.S. to respond seriously and strongly to the COVID-19 outbreak. I am grateful to these Chinese citizens.
I thought this was cool from MIT:
http://news.mit.edu/2020/face-shield-ppe-manufacture-covid-19-0331
(helpful for reducing need to change masks, plus their manufacturing method is cool)
and also this:
http://news.mit.edu/2020/pandemic-health-response-economic-recovery-0401
(interesting that the same methods work for both better health and better $$ outcomes)
fretfulmother: Apologize for piggybacking on your post. Should have prefaced mine by saying it was a general comment in regards to what has been an underlying component of this thread.
That’s OK 
I didn’t take it personally.
Wow. H had been telling me that the higher viral exposures would lead to worse cases of the disease, but this article really brings it home and has many specifics.
https://www.nytimes.com/2020/04/01/opinion/coronavirus-viral-dose.html
I’m assuming because people are using the bleach to make their own wipes since Clorox wipes are impossible to find.
Back a month or two ago, Chinese scientists had mentioned the viral dose thing as being a factor in severity of cases. I think Western countries have overlooked some of what the Chinese have said about the virus.
Sure, but it’s literally “not a disinfectant” right? Maybe it’s just a side effect like paper towels and tissues being panic-bought.