Latest COVID-19 wave worries hospitals even with new treatments Surge in hospitalizations reaches deeper into the country, testing some regions’ ability to cope https://www.foxbusiness.com/lifesty...ve-worries-hospitals-even-with-new-treatments Advances in Covid-19 treatment have shortened hospital stays, easing capacity strains. But doctors and health-care disaster experts say the gains are not enough to meet a sustained rise in hospitalizations, particularly in remote pockets of the country that have smaller hospitals and fewer medical professionals. Nationally, a spring surge of Covid-19 hospitalizations peaked in mid-April and was followed by a second wave in late July. The latest rise began in late September, data from the Covid Tracking Project show, with the number soaring 60% from the low point that month. People hospitalized with Covid-19 in the U.S. and its territories reached 46,095 on Thursday. Treatment of the disease remains limited and too many patients with lengthy stays can still overwhelm available doctors and nurses and swamp emergency departments and intensive-care units, they say. Those risks are greater now as fatigue with restrictions on public life is complicating efforts to stem contagion. The virus is also reaching more sparsely populated regions of the U.S. where many hospitals are small and farther apart. Coinciding with the latest surge, the nation has entered flu season, which typically fills hospital beds each year. "It's just a numbers game," said Dixie Harris, an intensive-care doctor in Utah, who is anxiously making her own calculations for how long beds will remain available at her hospital in Salt Lake City. Dr. Harris saw firsthand the consequences of overwhelmed hospitals when she volunteered in New York in April. "You don't want to be in an ICU without enough nursing," she said. "When you don't get good nursing care, it's harder to survive." The rise in hospitalizations is troubling but doesn't fully reflect the risk to hospitals and patients from the latest wave, health-care officials and disaster-response experts said. "A couple things are not obvious just looking at the national numbers," said Eric Toner, a senior scholar with the Johns Hopkins Center for Health Security. The latest wave is spreading across a wider geographic area, he said. Locales swamped by Covid-19 in the spring were concentrated in a few spots, primarily New York, Dr. Toner said. As patients now stream into hospitals across many states, there are fewer unaffected areas able to send relief, such as temporary nurses and doctors. New York and New Jersey hospitals accounted for nearly half -- 45% -- of hospitalizations in the U.S. and territories at the peak of the spring surge, Covid Tracking Project data show. The second wave was concentrated in California, Florida and Texas, which had 49% of hospitalizations at the late July peak. Now, about the same percentage is spread across nine states: Texas, California, Illinois, Florida, Georgia, Indiana, Ohio, Wisconsin and Tennessee. "It is much more difficult when everyone is feeling the pain at the same time," said Jonathan Greene, an official dealing with preparedness and response within the U.S. Department of Health and Human Services. "There is a finite number of resources." Mr. Greene oversees some health-care workers deployed to provide federal relief in disasters. During the pandemic, many such personnel have already been sent more than once to help with Covid-19 emergencies, he said. Cases are also surging across rural regions of the country. The total numbers of Covid-19 hospital patients are smaller but so too is the number of hospitals in remote areas, Mr. Greene said. Without another hospital nearby, more outside aid is needed. In Red Lodge, Mont., the local 10-bed hospital is now often over capacity, placing overflow patients in beds normally used for those needing temporary observation, said Kelley Evans, chief executive of the hospital, Beartooth Billings Clinic. The Red Lodge facility is one of 14 small hospitals owned by, or have agreements with, the Billings Clinic. The small hospitals, separated by as many 470 miles, typically transfer sicker patients to the flagship Billings Clinic hospital in Billings, Mont. But as coronavirus cases surge in the state, the 290-bed flagship hospital is sending Covid-19 patients to Beartooth, which also continues to care for local patients. As occupancy across the region rises, Beartooth and other hospitals are swapping staff to fill emergency shortages when health-care workers enter quarantine after being exposed to the virus. Beartooth had one radiology technician to cover the emergency room around the clock after two other technicians needed to quarantine, Ms. Evans said. Doctors would hastily meet to consider options for how to treat trauma patients without diagnostic imaging before temporary help arrived from another hospital, she said. Beartooth sent nurses to Billings briefly, but couldn't afford to go long without them. "It's tight," Ms. Evans said. "It's completely tight. We all have to take a deep breath and say 'We can do this today.' " So far, Beartooth hasn't seen patients with influenza, but the seasonal virus typically fills some hospital beds each year. "It's keeping me up at night," Ms. Evans said. "I don't know how much longer this is sustainable." Last year, the flu sent about 400,000 people to U.S. hospitals in what the Centers for Disease Control and Prevention called a moderate season. Officials fear the flu-virus overlap with Covid-19 could mean little relief for hospitals in coming months. "This is a sign of things to come," said Jim Murphy, Montana's administrator of the Communicable Disease and Laboratory Services Division for the Montana Department of Public Health & Human Services. HCA Healthcare Inc., one of the nation's largest hospital systems, saw its ICU capacity increase as the Nashville-based company used data analytics to monitor care of critically ill patients and ventilator use, Chief Executive Sam Hazen told analysts earlier this month. "It creates a lower length of stay for the patient and ultimately a much better outcome," he said. New treatments, though limited, have also helped improve care and shorten hospital stays for Covid-19 patients. Those gains and a rising number of infections among young people -- who are the least likely to die if infected -- have probably helped lower the death rate, according to epidemiologists, though measuring that rate is challenging. Steroids and remdesivir are "great weapons in the arsenal of Covid 19" and have shortened hospital stays, said Ryan Mielke, spokesman for the University Medical Center in El Paso. But the benefit of improved care and shorter hospital stays can be overmatched if people relax health precautions, he said. A month ago, University Medical Center had 30 Covid-19 patients. Thursday, it had 206, many of them in tents serving as makeshift ICUs in a city that has seen a sustained rise in coronavirus cases for weeks, he said. "It's fatigue," Mr. Mielke said. "Mitigation efforts such as staying away from groups start to get put aside and people want to see their friends, they want to go to a restaurant. People are not wearing masks." Officials said the majority of new cases involve people under 30, but they are spreading their infection to more-vulnerable populations. New cases of Covid-19 have been steadily rising for a month in El Paso, Texas's sixth largest city, and hospital administrators have warned that facilities were approaching capacity. El Paso County has averaged 942 new cases daily in the past two weeks -- the most in Texas -- up from a daily average of 137 in September. Deaths, which typically lag behind new cases by a few weeks, have stayed in the single digits. The region appealed to the state for help as Covid patients filled more than a third of its hospital beds. Other hospitals in El Paso treating coronavirus patients have added tents. But some patients are being flown to hospitals in cities hundreds of miles away, such as Dallas and San Antonio. The Texas Division of Emergency Management is sending medical equipment and personnel to turn the El Paso Convention and Performing Arts Center into a temporary hospital with up to 100 beds. The state has also assisted hospitals with extra beds and more than 900 medical workers. "The alternate care site and auxiliary medical units will reduce the strain on hospitals in El Paso as we contain the spread of Covid-19 in the region," Gov. Greg Abbott said in a news release.
El Paso, Texas, Gets 4th Mobile Morgue As COVID-19 Deaths Rise https://www.npr.org/sections/corona...-morgue-is-delivered-as-coronavirus-deaths-mo With new coronavirus infections surging and area hospitals already at capacity, medical examiners in El Paso, Texas, have received a fourth refrigerated morgue to temporarily store bodies, a county official says. It is a stark reality for a city where coronavirus patients have been succumbing to COVID-19 at a rate faster than medical personnel can investigate their cases. El Paso sits along the U.S. southern border and is referred to as part of the Borderplex, along with Mexico's Ciudad Juárez. "People that die are under investigation, to see if they died of COVID and to discern whether or not they had other diseases. That holds back the process," El Paso County Judge Ricardo Samaniego told local television station KFOX-TV. "I think you're going to see tremendous more deaths coming up in the next two to three days," he said. As of Sunday, Samaniego said, the county had a backlog of 85 bodies that still required a medical personnel investigation, according to the station. "My understanding is that we just got our fourth one," Samaniego confirmed to local TV station KVIA TV in El Paso Sunday afternoon, referring to the number of mobile morgues in place. (More at above url)
Countries controlling the coronavirus have 3 strategies in common: masking, robust testing and tracing, and a consistent federal plan https://www.businessinsider.com/how...oronavirus-masks-testing-tracing-plan-2020-11
Dr. Scott Gottlieb warns of a ‘sustained period’ in the U.S. of ‘well above’ 1,000 Covid deaths per day https://www.cnbc.com/2020/11/03/dr-...f-period-of-1000-us-covid-deaths-per-day.html The United States will likely see more than 1,000 Covid-19 deaths per day for a “sustained period of time,” former FDA Commissioner Dr. Scott Gottlieb told CNBC on Tuesday. Gottlieb said the next couple of months could prove to be “the densest phase of the pandemic.” The average number of currently hospitalized Covid-19 patients is up by at least 5% in 40 states and the District of Columbia, according to a CNBC analysis of data from the Covid Tracking Project. (More at above url)
New US Covid-19 deaths have topped 1,000 for four straight days as infections soar https://www.cnn.com/2020/11/07/health/us-coronavirus-saturday/index.html
Biden Coronavirus Task Force Member: ‘We Are About To Enter COVID Hell’ “The next three to four months are going to be, by far, the darkest of the pandemic,” warned infectious disease expert Michael Osterholm. https://www.huffpost.com/entry/mich...rus-warning-winter_n_5faa403ec5b6f21920df3c97 Renowned infectious disease expert Michael Osterholm on Monday spelled out a dire view of what Americans should expect from the coronavirus pandemic in the next few months. “We are about to enter COVID hell,” he said. Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota and newly minted member of President-elect Joe Biden’s coronavirus advisory team, told CNBC’s “Squawk Alley” the number of daily new infections is “going to continue to increase substantially.” “We have not even come close to the peak and, as such, our hospitals are now being overrun,” Osterholm said, cautioning the pressure on health services will soon become so high that the quality of care will drop. “The next three to four months are going to be, by far, the darkest of the pandemic,” Osterholm continued. “I don’t think America quite gets this yet,” he said. “This is going to get much worse. This is not to scare people out of their wits. This is to scare people into their wits to understand that because we still have control. We can basically limit the contacts we have with people that will dramatically impact our ability of getting this disease.” The U.S. on Sunday became the first country to surpass 10 million cases of COVID-19 — with an average of 108,000 people being diagnosed every day. The daily count will soon soar so high that Americans will look back at the 100,000 figure and “wish to be back there,” Osterholm added. A glimmer of hope came Monday when drug giant Pfizer announced early data on its COVID-19 vaccine showed more than 90% effectiveness. Osterholm described the progress as a “great, great finding,” but cautioned that more data is needed to understand whether the 90% figure means to prevent serious illness or just milder symptoms. “Until we have those pieces of information, we can’t really know how much of a game-changer this really is,” he said.
More Than 59,000 Americans Are Hospitalized With Coronavirus—a New High https://www.thedailybeast.com/more-than-59000-americans-are-hospitalized-with-coronavirusa-new-high
Biden Covid advisor says U.S. lockdown of 4 to 6 weeks could control pandemic and revive economy https://www.cnbc.com/2020/11/11/bid...ould-control-pandemic-and-revive-economy.html Dr. Michael Osterholm, a coronavirus advisor to President-elect Joe Biden, said a nationwide lockdown would help bring the virus under control in the U.S. He said the government could borrow enough money to pay for a package that would cover lost income for individuals and governments during a shutdown. “We could really watch ourselves cruising into the vaccine availability in the first and second quarter of next year while bringing back the economy long before that,” he said. Shutting down businesses and paying people for lost wages for four to six weeks could help keep the coronavirus pandemic in check and get the economy on track until a vaccine is approved and distributed, said Dr. Michael Osterholm, a coronavirus advisor to President-elect Joe Biden. Osterholm, who serves as director of the Center of Infectious Disease Research and Policy at the University of Minnesota, said earlier this week that the country is headed toward “Covid hell.” Cases are rising as more people grow tired of wearing masks and social distancing, suffering from so-called “pandemic fatigue,” he said Wednesday. Colder weather is also driving people indoors, where the virus can spread more easily. A nationwide lockdown would drive the number of new cases and hospitalizations down to manageable levels while the world awaits a vaccine, he told Yahoo Finance on Wednesday. “We could pay for a package right now to cover all of the wages, lost wages for individual workers, for losses to small companies, to medium-sized companies or city, state, county governments. We could do all of that,” he said. “If we did that, then we could lock down for four to six weeks.” Osterholm was appointed to Biden’s 12-member Covid “advisory board” on Monday. The panel of advisors is co-chaired by former Surgeon General Vivek Murthy, former Food and Drug Administration Commissioner David Kessler and Dr. Marcella Nunez-Smith of Yale University. Other task force members include Dr. Atul Gawande, a professor of surgery and health policy at Harvard, and Dr. Rick Bright, the vaccine expert and whistleblower who resigned his post with the Trump administration last month. A representative for Biden did not respond to CNBC’s request for comment. Osterholm on Wednesday referenced an August op-ed he wrote with Minneapolis Federal Reserve President Neel Kashkari in which the two argued for more restrictive and uniform lockdowns across the nation. “The problem with the March-to-May lockdown was that it was not uniformly stringent across the country. For example, Minnesota deemed 78 percent of its workers essential,” they wrote in The New York Times. “To be effective, the lockdown has to be as comprehensive and strict as possible.” On Wednesday, Osterholm said such a lockdown would help the country bring the virus under control, “like they did in New Zealand and Australia.” Epidemiologists have repeatedly pointed to New Zealand, Australia and parts of Asia that have brought the number of daily new cases to under 10 as an example of how to contain the virus. “We could really watch ourselves cruising into the vaccine availability in the first and second quarter of next year while bringing back the economy long before that,” he said Wednesday. On the current trajectory, Osterholm said the U.S. is headed for dark days before a vaccine becomes available. He said health-care systems across the country are already overwhelmed in places such as El Paso, Texas, where local officials have already closed businesses and the federal government is sending resources to handle a surge in deaths caused by Covid-19. Osterholm said the country needs leadership. The president-elect is up to the task of providing that leadership, Osterholm said, adding that it could also come from local and state officials or those in the medical community. He referenced the fireside chats broadcast over radio during former President Franklin D. Roosevelt’s terms, through which Roosevelt addressed the country on issues ranging from the Great Depression to World War II. “People don’t want to hear that El Paso isn’t an isolated event. El Paso, in many instances, will become the norm,” he said. “I think that the message is: How do we get through this? We need FDR moments right now. We need fireside chats. We need somebody to tell America, ‘This is what in the hell is going to happen.’”
A complete nationwide shutdown results in an economic catastrophe. You can turn it off like a light switch. Turning it back on not so easy. If Biden buys into this he will reign over an ash heap of a country and Democrats will be completely and totally destroyed in 2022 and beyond, assuming anything remotely resembling a country remains.
I tend to believe that you only get one shot at a full national lockdown. The U.S. blew its opportunity.... and there will be no second chance. A full national lockdown only really works at the beginning of a pandemic and the goal is to effectively eradicate the disease like South Korea, New Zealand, Tawain, Australia and other countries did. This allows you to have proper contact tracing and testing in place to catch any follow-up breakouts which are usually caused by incoming travelers who failed to properly quarantine. Th U.S. has reached a point where city, county, state or regional lockdowns may be used -- but the intent at this point is to stop hospitals in the area from being overwhelmed. There is no objective in the U.S. to get proper contact tracing in place or to eliminate the disease. Any lockdowns by area are simply to buy time until a vaccine is widely deployed in the population. This may continue all the way until 2022 considering the obstacles facing vaccine rollouts. The lockdowns by city, county, state or region will probably only last 2 to 4 weeks -- as mentioned you are only trying to stop hospital overload while buying time. A more likely variant is that we are likely to see states rolling back their phased re-openings. Effectively going in reverse from Phase 3 to Phase 2 to Phase 1 -- adding more restrictions. Of course, there is not national plan to guide this so each locality will follow their own path. Even if the Biden administration gets to work on January 20th to provide a national plan -- it is probably too late for a coordinated national level response guiding localities to have an impact in regards to this winter season with a COVID wave. One item from a national level that can prove beneficial is a national mask mandate. Of course, Biden can only push governors to do this state-by-state; he does not have federal power to mandate this. Arizona found that its cases dropped 75% when a mask mandate was put in place. Mandatory masks would greatly reduce the need for more lockdowns in the U.S. One additional problem is "lockdown fatigue". At this point only half of people are likely to comply with another lockdown. I expect the longer a lockdown is.. the fewer people would follow it. ============================================================================= Fewer than half of Americans are very likely to comply with another lockdown, polling shows https://edition.cnn.com/world/live-...12-20-intl/h_dfcb6d73fe1ab79c282fee500a5c5f6e Fewer than half of Americans say are very likely to comply with another lockdown, despite growing concerns over the coronavirus pandemic, the latest Gallup polling shows. About 49% of Americans polled between October 19 and November 1 said they would be very likely to stay home for a month if health officials recommend it following a coronavirus outbreak in their community, down from 67% in the spring. While 18% said they were somewhat likely to comply, a third of respondents said they would be unlikely to comply with lockdown orders -- double the rate seen in the spring. Though Americans are less willing to stay at home, the results show they are more worried about the pandemic, with 61% saying they believe the situation is getting worse, compared to 40% in April. Political divide: The results show a political divide in those willing to stay home. About 40% of Republicans polled said they were willing to comply with a stay-at-home order, down from 74% in the spring. In comparison, 87% of Democrats said they would likely comply, a slight drop from 91% in March and April. About 82% of people said they were confident in their ability to avoid infection, compared to 64% in March, which could play a role in Americans’ willingness to stay home. Mask wearing: Health experts have said that mask use could significantly reduce the need for another lockdown. Only about half of Americans reported wearing masks in April, shortly after the Centers for Disease Control and Prevention suggested the practice for the general public. The number rose to 92% in July and now sits at about 88%.