Winter is Coming - the COVID chronicles

Let's see how England is preparing for winter... welcome to regional lockdowns.

Coronavirus: More than half of England's population wake up to heightened Covid-19 restrictions as Government advisor warns of 'eye-watering' infection rates
https://www.standard.co.uk/news/health/circuit-breaker-john-bell-new-restrictions-a4571987.html

 

Winter is coming. Let's see how hospitals are doing in the U.S.

‘Overwhelmed’: Hospitals engulfed by rebounding virus
The pandemic is spawning new infections at a rate not seen since the end of July.
https://www.politico.com/news/2020/10/16/pandemic-states-virus-rebound-429753

The coronavirus is engulfing big city hospitals in states including Utah, Wisconsin and Indiana that are running low on nurses and beds and are being forced to set up overflow facilities.

With new daily U.S. cases surpassing 62,000 on Thursday, the prospect of swamped intensive care units is prompting some governors who previously resisted public health orders to weigh new restrictions to ease pressure on their health care systems. From the early days of the pandemic, the availability of ICU beds — and hospitals' ability to treat people who need life-support equipment like ventilators to breathe — has been an important benchmark for whether local health systems can handle outbreaks.

“Our hospitals are getting overwhelmed,” Republican Utah Gov. Gary Herbert said this week. “The dramatic increase in infections has put the integrity of our health care system at risk.“

The University of Utah Health System, one of the largest hospitals in the state, reported its ICU is 95 percent filled, and health systems in other parts of the country have been forced to relocate patients because of bed and staffing shortages.

Herbert said the National Guard is on standby to build a field hospital in a convention center outside Salt Lake City, and on Tuesday he ordered masks be worn at all outdoor events.

The pandemic is spawning new infections at a rate not seen since the end of July. Hot spots began to cluster in parts of Utah, Indiana, Wisconsin, Oklahoma, Wyoming, Missouri, Mississippi and North Dakota as the nationwide average number of daily new cases surged over the past month.

In Indiana, the state is facing “critical ICU bed shortages along with personnel shortages” according to Chief Medical Officer Lindsay Weaver, only three weeks after Republican Gov. Eric Holcomb removed most Covid-related restrictions. Officials have put out a call for volunteers to help fill staffing shortages in hard-hit facilities near the Michigan and Kentucky borders.

Indiana has fewer than one-third of its ICU beds available, according to its health department, and there are more than 1,300 patients in the hospital, the most since May and up 67 percent in three weeks.

“This is especially concerning, because we have not begun to see the typical increase in ICU bed usage from influenza,” Weaver said.

Colder weather pushing more people to gather indoors appears to be driving the latest surge more than school reopenings, according to public health experts. Other areas could soon face similar dilemmas, with U.S. hospitalizations at their highest point since the end of August, according to the COVID Tracking Project.

And the phenomenon isn’t confined to the U.S.: The single-day jump in cases worldwide surpassed 350,000 for the first time on Oct. 9.

Wisconsin, where President Donald Trump plans to hold a rally on Saturday, opened a field hospital on its state fairgrounds in West Allis on Wednesdayafter officials said the health care system is in crisis.

“Many of our ICUs are strained,” said Julie Willems Van Dijk, a deputy secretary with the state's health department. “Every region of our state has one or more hospitals reporting current and imminent staff shortages.”

Democratic Gov. Tony Evers' administration asked the Army Corps of Engineers to review plans for two more field hospitals.

The situation appears similarly dire in parts of Texas, Missouri and Oklahoma.

The area around El Paso, Texas, a city of nearly 700,000, has 10 remaining ICU beds, according to the state health department. On Monday, Republican Gov. Greg Abbott announced he was sending 75 health workers, including nurses and respiratory therapists, to help respond.

Meanwhile, two out of three major hospitals in Albuquerque, N.M., are at, or exceeding, capacity. Democratic Gov. Michelle Lujan Grisham on Thursday announced that restaurants and bars must close at 10 p.m. and gatherings of more than five would be prohibited.

“This is the most serious emergency New Mexico has ever faced,” she said.

A spokesperson for Integris, Oklahoma’s largest health system, reported one available ICU bed on Thursday after having none available on Wednesday. The administration of Republican Gov. Kevin Stitt has had multiple conversations about suspending elective surgeries but hospitals, which rely on the revenue from those procedures, have pleaded for the flexibility to manage caseloads without such restrictions.

“That remains an option if needed, but we would prefer to work in partnership with the hospitals as much as we can without issuing mandates,” said Charlie Hannema, a spokesperson for Stitt.

Hospitals have already been paid more than $100 billion from the federal government’s stimulus packages and there were concerted efforts in the spring to ease the shortage of ventilators and personal protective equipment. Many governors prohibited elective surgeries to save room and supplies. But the facilities are still in perilous positions with the pandemic raging in nearly every corner of the country.

In Missouri, hospitals are reaching capacity in every region of the state.

“ICU beds are very limited in several regions,” said Dave Dillon, a spokesperson for the Missouri Hospital Association. “Hospitals are working collaboratively to manage patient flow, but Missourians still have heart attacks, strokes and automobile accidents, for example, that demand ICU care. This is a finite resource and if Missouri cannot bring down the infection rate, we will meet or exceed our capacity to care for the most critical Covid-19 patients.”

In Fargo, North Dakota’s most populous city, there were 10 ICU beds available on Wednesday, and in Bismarck, the state capital, there was only one, according to the health department. Republican Gov. Doug Burgum on Wednesday recommended that bars, restaurants and other large venues in the state’s most populated counties serve only a quarter of their capacity and no more than 50 people but declined to require them to do so.

The recent spike in infections, the coming winter and the prospect of holiday travel and gatherings have many physicians worried that the hospital numbers are only going to get worse.

“This is not going to go away for the next several months,” said Mark Dowell, an infectious disease doctor at the Wyoming Medical Center in Casper, where on Wednesday morning every room was occupied and 17 patients were holding in the emergency room.

“Our hospital is already stretched, and we are not even seeing the amount of Covid we are going to see,” Dowell said.

 

Winter is coming. Let's see how things are going in Italy....

Italy orders bars to shut from 6pm and 'public gathering spaces' to close after 9pm as country battles rising covid cases

• Italy reported 11,705 cases on Sunday, eclipsing Saturday's highest ever toll
• Bars and restaurants have to close at 6pm unless they can offer table service
• Festivals, fairs and amateur sport have all been closed but gyms remain open
• Lombardy, the former epicentre of the virus, is experiencing another surge
• Across Europe, many countries are imposing harsh new measures to curb virus

https://www.dailymail.co.uk/news/ar...spaces-close-9pm-amid-rising-covid-cases.html

Italy has imposed new restrictions on bars and restaurants aimed at halting the spread of coronavirus after days of record infection numbers.

Restaurants and bars are restricted to table service only after 6pm, three hours earlier than the previous measures allowed, but can maintain the current midnight closing time.

Italian mayors can also close public squares and other gathering places after 9pm, permitting access only to reach homes or businesses.

It comes as the country announced 11,705 new cases on Sunday, beating its record of 10,925 it had seen the day before.

The measures announced on Sunday stop short of a curfew like those imposed in Paris and other major French cities.

Local festivals and fairs, very widespread in Italy, will also be banned, affecting a sector which according to the agricultural union Coldiretti represents 34,000 jobs and 900million euros annual turnover.

Amateur sports have been banned but gyms and public swimming pools may remain open for now.

However, Prime Minister Giuseppe Conte said they would be closed in a week if they do not do a better job of following restrictions.

Rome clashed with regional governments over schools, refusing to budge on allowing more distance learning.

But there are allowances for high schools to open later, and hold afternoon shifts, to ease pressure on local transport.

Authorities are loathe to see new lockdowns, after the 10-week closure that successfully impeded the virus's spread, but at a cost of 47 billion euros a month to the economy.

These measures 'should enable us to face the new wave of contagion which is severely affecting Italy and Europe. We cannot waste time,' said Conte.

Lombardy, which became the global epicentre of the virus back in February, has seen a surge in cases, with more than 2,000 infections a day.

Intensive care units are already under strain and alcohol sales have been limited, contact sports banned and bingo parlors closed to help stem the infection.

Campania, which is also suffering similarly high infections, has shut down schools for two weeks.

The Vatican has confirmed that someone who lives in the same hotel as the Pope has tested positive, as well as 11 of the Swiss Guard who protect him.

It comes as countries across Europe are seeing a surge in case numbers, prompting new restrictions.

In Germany, 7,840 cases were reported on Saturday, a new record.

Angela Merkel has urged people to avoid unnecessary travel, cancel parties and stay at home where possible.

By European standards, Germany has experienced relatively low infection and death rates so far during the pandemic, but Chancellor Angela Merkel has warned there could be 19,200 infections per day if current trends continue.

Meanwhile in France, which is currently experiencing the highest number of cases, 12,000 extra police officers have been deployed to enforce new lockdown rules.

In the past seven days it has registered nearly 142,800 new infections, more than the 132,430 registered during the entire two-month lockdown from mid-March to mid-May.

In Paris and eight other cities, restaurants, bars and cinemas have to close by 9pm in an effort to reduce contact.

Meanwhile, in Sweden, authorities are bringing in local lockdowns in a new move for the country which had so far resisted harsh measures.

The Scandinavian country was a talking point during the pandemic for its resistance to imposing a national lockdown like its European neighbours.

In Prague, Czech police have used tear gas and a water cannon to disperse hundreds of violent protesters who attacked them. It came after a rally against government restrictions to slow the spread of coronavirus infections.

The Czech Republic is under partial lockdown closing schools, bars and clubs until November 3. With 1,106 deaths from Covid-19, the country has reported 55,538 new cases in a fortnight.

Europe currently has recorded over 17 per cent of total global coronavirus cases and nearly 22 per cent of deaths worldwide.

As a region, Europe is reporting more daily cases than India, Brazil and the United States combined. The increase is partly explained by far more testing than was done in the first wave of the pandemic.

(More pictures, video, and other information at above url)

 

As coronavirus cases rise, red-state governors resist measures to slow the spread, preach ‘personal responsibility’
https://www.washingtonpost.com/nati...95176e-0fc3-11eb-b1e8-16b59b92b36d_story.html

With cases surging to new highs and hospital capacity running low, North Dakota Gov. Doug Burgum teared up describing a state “caught in the middle of a covid storm.”

To weather it, he said at a news conference last week, people would need to keep their distance, wear masks and avoid gatherings. But the one thing North Dakota did not need were legal limits on reckless behavior.

“It’s not a job for government,” Burgum (R) declared.

The novel coronavirus is hammering middle America this fall, with records shattered daily in states that had escaped the worst of the pandemic this spring and summer. Case numbers also are rising again in other states where the virus was thought to be under control after months of widespread illness.

Yet even as health authorities in small cities and rural towns plead for help in tamping down deadly outbreaks, many Republican governors are resisting new measures to stop the spread. Some are even loosening rules already on the books.

Instead, they preach the mantra of “personal responsibility,” insisting that government interventions such as mask mandates or business restrictions are either unnecessary or harmful, and that people should be trusted to make their own decisions about how to keep themselves — and each other — healthy.

“This is a job for everybody,” Burgum said, describing recommendations for safe behavior, but no new requirements.

Public health experts say that is an inadequate prescription, one that carries great peril as infections climb, the weather drives people indoors and large segments of the population are proving less willing to take the virus seriously.

“This really demands a coordinated, orchestrated, higher-level response than just saying to an individual person, ‘Here’s what you might want to try,’ ” said David Aronoff, director of the Division of Infectious Diseases at the Vanderbilt University School of Medicine.

An overreliance on personal responsibility, health officials say, is one of the reasons America’s struggle with the coronavirus has been so destructive, with more than 8 million cases and at least 219,000 people dead. And they maintain it is unlikely to be the solution now — especially as Republican leaders from President Trump on down send misleading messages and model dangerous behavior.

Covid-19, the disease the coronavirus causes, sent Trump to a hospital for four days this month, with doctors deploying the latest therapeutics— drugs unavailable to many Americans. Yet he has continued to cast doubt on the effectiveness of masks while maintaining that people should not be “afraid” of the coronavirus and bashing public health measures intended to limit viral spread.

Republican governors have mimicked aspects of that stance. While Democratic governors in blue states such as New York, New Mexico and California have rolled back reopening plans in response to rising coronavirus rates, the opposite has been true of Republican leaders in red states where the virus is now running rampant.

Coronavirus hospitalizations in Iowa have regularly hit new highs this month, and the state last week surpassed 1,500 total deaths. But Iowa Gov. Kim Reynolds has refused to revisit her decision to lift most restrictions on businesses and to allow students back to class without masks.

Trump, the Republican said, was “right. We can’t let covid-19 dominate our lives.”

Texas Gov. Greg Abbott (R), meanwhile, has forged ahead with plans to reopen bars, despite the fact that infectious-disease specialists say they are a prime vector for coronavirus transmission. The state has been averaging nearly 5,000 new cases and nearly 100 deaths each day. But Abbott said he saw no reason Texas would not “be able to reopen 100 percent.”

In South Dakota — which together with its neighbor to the north has had the fastest-growing coronavirus infection rate in the country — Gov. Kristi L. Noem (R) has played down the significance of the climbing caseload, claiming that it’s due to testing and is “normal.”

“We have triple the amount of testing that we’re doing in the state of South Dakota, which is why you’re seeing elevated positive cases,” she said. “That is normal. That’s natural. That’s expected.”

But a rise in tests would not explain why hospitalization and death rates have also spiked.

Noem has become a star in Trump’s circle by joining in his antagonism toward mainstream scientific opinion: She is one of the few governors who refused to issue a stay-at-home order in the spring, has repeatedly questioned the validity of using masks to reduce viral spread and hosted the president for a massive, tightly packed Fourth of July celebration at Mount Rushmore.

The state’s struggles now, critics say, are the inevitable result of a failure to take the virus seriously.

“Covid in our state has exploded,” said Linda Duba, a Democratic state legislator. “And that’s unfortunately to be expected when there is no encouragement from our leaders to mask, to social distance or to take basic precautions.”

Late last week, the state of fewer than 900,000 people was racking up around 900 new cases a day, with around 300 people hospitalized.

More than 300 people have died statewide, with one of Duba’s colleaguesin the state House of Representatives among them. Yet when legislators packed the floor in the state capitol to listen to Noem’s speech during a special session this month, Duba said, she could count on 10 fingers the number wearing masks.

“I sat at the very back and high-tailed it out of there as soon as the speech was over,” she said.

The lax attitude toward masks displayed by politicians can be seen among the public, much to the frustration of front-line hospital workers.

Benjamin Aaker, an emergency room doctor, said he and his colleagues have been “proclaiming from the rooftops” the virtues of masks and social distancing. But to little effect.

“Despite the number of cases now dwarfing the number of cases we saw in April and May, concern about the virus has largely evaporated,” said Aaker, who leads the South Dakota State Medical Association. “People are showing real complacency.”

The same has been true in North Dakota, said Renae Moch, director of public health in the state capital, Bismarck.

Last weekend, North Dakota was down to 17 open ICU beds, with some people having to be sent out of state for care. By Friday, the state was contending with more than 5,000 active coronavirus cases, up from just over 3,000 at the start of the month.

Yet, Moch said, even though that endangers everyone — from car crash victims to heart attack patients — public health workers were getting little cooperation from the public in fighting the virus.

Mask usage in the state remains low, she said, and contact tracers have found that people who test positive routinely lie.

“The tracers will ask, ‘How many people in your household?’ ‘Just me.’ ‘Have you been anywhere?’ ‘Nope,’ ” she said, recounting a typical conversation. “Now, we live in a small enough area that we know that that’s just not truthful.”

While Burgum, the governor, has been preaching “personal responsibility” for months, Moch said a mask mandate would be more effective in clarifying how people can protect themselves — and each other.

“People need to know the impact of their decisions,” Moch said. “And I don’t think public officials have been very clear about that.”

While North Dakota had avoided a serious bout with the coronavirus until recently, other states have endured earlier waves and thought they had the disease beaten — only to find it roaring back.

When Tennessee Gov. Bill Lee lifted his few remaining restrictions at the end of September, leaders of the Volunteer State seemed to think they had brought their coronavirus outbreak under control.

“Tennesseans have learned how to assess risk and how to take the right steps to protect themselves and those around them,” Lee (R) said at a news conference at the time.

Two weeks later, however, cases are surging once again. Lee is quarantining after exposure to an infected security staff member. And experts say the state’s struggles should be a lesson that the pandemic requires constant vigilance — and an aggressive response.

“You can almost follow the timeline as for when things got loosened and when the spike came,” said Alex Jahangir, a physician who chairs the Nashville Metropolitan Board of Health. He also noted it would be “very helpful if the state would reimpose some of the stuff they had before.”

Tennessee, for months, largely has left it in the hands of local leaders to set rules concerning the pandemic. Masks, for example, never have been mandated by the state; instead, Lee has signed orders allowing counties to set policies of their own.

The result has been a messy patchwork of protections, with rules that vary depending on geography.

Davidson County, the sprawling central Tennessee expanse that includes Nashville, has required face coverings for its workers, residents and visitors for months. But there’s no such rule in many other parts of the state, including an hour’s drive south, in Maury County, which hosted a record-breaking 22,000 people for an annual fair last month, according to local media outlets.

In South Dakota, there is no statewide mask mandate and the cities have nearly all declined to impose their own. The college town of Brookings is the lone exception, with councilors passing a restriction last month following contentious public hearings.

Local leaders had feared that without more protections, Brookings would be overrun by outbreaks this fall as students returned to school.

The mandate has helped, with residents largely complying, said Nick Wendell, a council member who backed it. But he noted that outlying areas of the county lack a mandate, and that has led to uncertainty.

South Dakota may be the “land of infinite variety,” as the informal motto goes. But “it would be helpful if we were all linking arms and doing this together. Folks are confused. Folks are tired,” Wendell said. “And when you have mixed messaging, that’s challenging.”

 

And yet, we have BLM and Antifa thugs rioting daily and not a single death resulting from Corona Virus infection? We will have a vaccine soon enough and this Corona Virus would be an after thought. Too much panic and hysteria being promoted by extreme liberals. Every country on the planet has Corona Virus so, we should focus on treating those infected and finding a vaccine the soonest. Wear a mask in enclosed areas especially, like malls, supermarkets, post office. Wash your hands and face when you get back home. Take a hot bath scrubbing yourself with soap and rinsing off with hot water. Take zinc gluconate, vitamic C and Vitamin D. Buy a pulse oximeter to monitor your oxygen levels (that is from a doctor). Protect yourself and your family the best you can. Those promoting panic and hysteria in the extreme liberal media, may karma hit you and your families all. You would deserve every dose of it too.

 

“The next 6 to 12 weeks are going to be the darkest of the entire pandemic,” expert says
https://www.cnn.com/world/live-news...19-20-intl/h_2a3dbed3f2466e2c3b1ad5eb65b4d075

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told NBC’s Chuck Todd on “Meet the Press” on Sunday that "the next six to 12 weeks are going to be the darkest of the entire pandemic.”

Vaccines won’t be available “in any meaningful way” until the third quarter of next year, he said – and even when they are, half the US population is skeptical of even taking one.

“So, what we have right now is a major problem in messaging,” he said. “People don’t know what to believe, and that’s one of our huge challenges going forward, is we’ve got to get the message to the public that reflects the science and reflects reality.”

Osterholm added that he doesn’t know if there is a lead when it comes to the federal government’s public health response. There are a lot of different voices, which is part of the problem.

“We don’t have a consolidated one voice,” he said.

Osterholm highlighted the 70,000 cases of Covid-19 reported on Friday, which matched the largest number seen during the peak of the pandemic, and said that between now and the holidays, the US will see numbers “much, much larger than even the 67 to 75,000 cases,” he said.

 

Winter is coming. Let's see how things are going in Ireland...

Coronavirus: Ireland may return to full national lockdown for six weeks in 'surprise move'
Schools and creches will be allowed to stay open but non-essential retail, hairdressers and salons will be told to close.
https://news.sky.com/story/coronavi...full-national-lockdown-for-six-weeks-12108633

 

Countries should meet these five criteria before easing lockdowns, study says. Many aren't even close
https://www.cnn.com/2020/09/24/heal...wn-restrictions-easing-lancet-intl/index.html

Countries should not ease coronavirus lockdown restrictions until they meet five criteria -- and many nations are not even close, according to a new analysis published in The Lancet medical journal.

The research, published Thursday, said that the prerequisites for easing Covid-19 measures are: knowledge of infection status, community engagement, adequate public health capacity, adequate health system capacity and border controls.

The authors looked at nine high-income countries and territories that have started to relax restrictions -- Hong Kong, Japan, New Zealand, Singapore, South Korea, Germany, Norway, Spain and the UK. They found that many governments had failed to meet the criteria necessary to avoid new waves of infection, as seen in Spain, Germany and the UK.

"The evidence is clear. If we are getting a resurgence of disease, of numbers of cases, then they opened up too early, it's sort of axiomatic," co-author Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, told CNN.

The study also found that an effective find, test, trace, isolate, support system is needed to safely reopen. "No country does it perfectly, actually ... England does it particularly badly. Spain and France don't do terribly well either," said McKee.

The authors of the paper said that countries should base decisions about easing lockdowns on a combination of epidemiology and the social and economic consequences of restrictions.
No matter the strategy chosen, it said that governments should be explicit about their goals and transparent in their decision making, and the steps taken should be part of a clear overall strategy, "however, this is not always the case."

The study also said "the argument is strong" for countries to adopt a zero-Covid strategy, like New Zealand, which means eliminating domestic transmission. One reason was because of the growing burden of those who survived the virus but have symptoms for longer than expected, it said.

Infection status and knowledge
The study found that countries including Singapore, Norway, Spain, and (for local outbreaks) the UK, draw on expert advice to decide how to relax restrictions. Yet without explicit and public criteria, the basis on which risk is estimated is often "unclear, with little evidence that the growing understanding of aerosol-related transmission has been considered."

Other nations, including Japan, Germany, South Korea, and (in some cases) the UK, are lifting or reimposing restrictions on the basis of epidemiological thresholds. Countries such as Japan have dashboards showing the various factors. In Germany, local authorities are in charge of lifting restrictions subject to an "emergency brake" mechanism that requires regions to consider reimposing lockdown if there are more than 50 new daily cases per 100,000 residents for seven days in a row.

Hong Kong has a similar strategy, while New Zealand has a four-level alert system. Singapore, South Korea and the UK also have alert levels, but the link to certain measures is not explicit, and "it is not clear that the UK's system is being used," according to the study.

The researchers found that the principle that countries should not reopen until they have a high-quality surveillance system and have confirmed that infections are being suppressed, "has often been disregarded."
Detailed real-time data is essential to accurately calculate the level of transmission occurring in an area and determine how to reopen, the study said.

Public trust
For countries to safely reopen, communities should be "engaged and empowered to protect themselves" and advice should be "consistent and credible," according to the paper, especially for the most vulnerable populations.

However, the messaging on points such as safe physical distancing, face masks and working from home has in many cases been confusing and ever-changing. This has resulted in a lack of public trust and support, the scientists found.

"To some extent, you can divide countries in the world into two groups, the influenza ones and the SARS/MERS ones," said McKee. "The Asian countries essentially came at this thinking, this is a disease that we really have to get on top of, because if we don't, it's going to be really bad."

Western countries were more likely to think "we don't need to worry too much," he said.
England's early telephone contact tracers had "little success," while South Korea used health records, credit card transactions, GPS and CCTV, and Hong Kong relied on a police supercomputer system. Many countries have now launched phone apps.

Singapore, South Korea, and the UK repurposed large spaces as community care facilities, but the UK facilities were understaffed and underused compared with the other two countries.

In some countries, shortages of ventilators have created difficult rationing decisions, and shortages of personal protective equipment (PPE) have forced medical staff to work without adequate protection. Medical staff in Spain made up more than 10% of total cases, the report said.

The five Asia Pacific examples have also implemented strict border control measures, with Hong Kong, New Zealand, and Singapore keeping their borders closed to most visitors and mandating testing and 14-day quarantine, while European countries kept some borders open and were slow to require routine testing.

Many are now facing a "second wave," but the authors say it is not too late to apply these lessons. They said "countries should plan and prepare for the worst-case scenario."

To avoid a return to a full lockdown, the study said, nations need a clear and transparent plan that states the criteria for moving to the next phase and the measures that entails. They need robust systems to closely monitor the infection situation; effective find, test, trace, isolate and support systems; and continued measures to reduce transmission, such as social bubbles and masks.

Communities should be directly involved in the decision-making process, the authors said.

The analysis says the institution-based isolation adopted by some Asian countries appears more effective than home-based isolation, as does traditional manual tracing.

It said these systems should be supported by sustained investment in health facilities, supplies and workforce -- as recommended by the World Health Organization and International Monetary Fund.

 

A second wave of covid-19 sends much of Europe back into lockdown
Even the Germans and Nordics cannot be complacent
https://www.economist.com/europe/20...id-19-sends-much-of-europe-back-into-lockdown

FOR A FEW months this summer it was almost possible for Europeans to believe that life had returned to normal. Parisian museums and Barcelona’s cafés were open, if less crowded. Germans, Dutch and Danes jetted off to holidays on Mediterranean beaches. In August and September, as children across the continent returned to school, covid-19 infections began to rise. Yet governments, worried about a backlash, chose not to reintroduce harsh social-distancing measures.

Their decision has had a price. A second wave of covid-19 is now washing over Europe. In many countries the daily numbers of confirmed cases exceed their spring peaks, though this is mostly because there is a lot more testing; death rates are substantially lower. A model developed by The Economist, based on serological tests showing how many people have been exposed to the virus, suggests the second wave has yet to match the first (see chart), though numbers are clearly rising, as are hospitalisations. Most countries failed to use the summer to build robust testing and tracing operations. Now they are falling back on blunt measures: shutting restaurants and introducing quarantines and curfews.



Spain is among the hardest-hit countries. That is partly because its left-wing minority government and the conservative opposition have failed to agree on a national strategy. Only some regions have set up effective test-trace-isolate systems, and rates of infection vary wildly. Madrid is under a 15-day state of emergency that bars non-essential movement in or out of the city, limits social gatherings to six people and closes restaurants at 11pm. Catalonia and Navarre have been even tougher.

France is in just as bad a pickle. The share of tests that come back positive has climbed from 4.6% on August 31st to 13%. On October 17th the government imposed a curfew on nine big cities from 9pm to 6am. Arnaud Fontanet, an epidemiologist at the Institut Pasteur, says the country must reduce new infections to 3,000 a day before it can get the epidemic under control; they are currently at around 28,000.

When covid-19 first arrived, northern Europeans snidely linked its virulence in Italy and Spain to their physically effusive cultures. That idea is harder to sustain this time: among the hardest-hit countries are Belgium and the Netherlands. “We are really very close to a tsunami. We no longer control what is happening,” warns Frank Vandenbroucke, Belgium’s health minister. The government has closed restaurants and bars and brought in a curfew from midnight until 5am. The virus is also exacerbating regional divisions. Flemish nationalists resent the national lockdown, since transmission rates are higher in French-speaking regions.

In the Netherlands the government dithered while daily cases per million rose steadily. They are now higher than in Spain or France. This month the government at last closed restaurants for four weeks and required masks in public indoor spaces. But when Mark Rutte, the prime minister, apologised last week, it was only for letting the royal family take an autumn holiday in Greece. (They cut it short.)

In south-eastern Europe and the Balkans, which tamed the virus effectively this spring with harsh lockdowns, there has been little appetite to reintroduce restrictions. Serbia’s prime minister, Ana Brnabic, vowed to “act differently” if the virus resurged, yet is taking little action now that it has. But Bulgaria, where hospitals are complaining of a shortage of doctors, has now made mask-wearing compulsory. So has Bucharest, the capital of Romania, where schools have been told to move to online learning and cinemas and theatres have been closed.

One step the EU did take this month was to settle on a Europe-wide map of regional epidemic severity, after a disagreement over the colours. Almost every province in Europe shows up red (a high rate of the virus). But one can easily discern the outlines of the success stories: Germany, Italy and the Nordics, which are mostly yellow (medium) with patches of green (low). Italy may not stay a success for long. It drove transmission rates down with aggressive lockdowns in the spring, but new cases are rising fast. On October 18th it implemented new restrictions. But they were surprisingly lax, thanks to intra-coalition rows.

Germany and the Nordics remain Europe’s star performers, though there are difficulties. Germany has the continent’s best track-and-trace systems, but in parts of Berlin there are now too many cases to follow. Hard-hit areas are imposing early closing-times for restaurants and requiring more mask-wearing. However, Germany’s federal system is causing fragmentation and disagreement. Angela Merkel, the chancellor, fears that going too slowly now could force more drastic restrictions later. That would erode the civic will needed to fight the virus. Where Europeans once embraced that battle with a spirit of shared sacrifice, many now grumble that their governments are blowing it. ■

 

Northern Idaho may send new virus cases to Seattle, Portland
https://komonews.com/news/coronavirus/northern-idaho-may-send-new-virus-cases-to-seattle-portland

Health officials say people with COVID-19 in Northern Idaho soon may have to be sent to Seattle or Portland, Oregon, because the region's hospitals are nearing capacity.

Kootenai Health hospital said in a statement Wednesday that their hospital is at 99% capacity for patients that need medical or surgical care. As of Wednesday morning, Kootenai Health had 31 COVID-19 inpatients and 11 required critical care.

Chief Physician Executive Karen Cabell told KREM the hospital nearing capacity at its current levels is "unprecedented."

Idaho is seeing its largest coronavirus spike since the pandemic began, with newly reported cases increasing statewide by 46.5% percent over the past two weeks.