US has three months to rebuild medical supplies stockpile before Second COVID-19 Wave Hits
Last month, Robert Redfield, director of the Centers for Disease Control and Prevention, issued a candid warning (April 22 ) in a Washington Post interview.
A simultaneous flu and coronavirus outbreak next fall and winter “will actually be even more difficult than the one we just went through,” adding that calls and protests to “liberate” states from stay-at-home orders — as President Trump has tweeted — were “not helpful.”
President Trump’s tenuous relationship with his own administration’s scientific and public health experts (Dr. Fauci, CDC, NIH) has created a political filter for all public information relating to the present pandemic. The unofficial message from the Oval Office is an unmistakable warning: Those who challenge the president’s erratic and often inaccurate coronavirus views will be punished — or made to atone.
Fast Forward to Present Day and Hear Scientists’ Warnings – Outside the Trump White House Bubble
Nine top scientists who advised President Barack Obama during his term in the White House are warning that the United States has just three months to rebuild its national stockpile of emergency medical supplies or risk further drastic shortages of testing kits and protective gear should coronavirus strike again in the fall.
The group of nine are among the most pre-eminent scientists in the country. In addition to Holdren, now at Harvard, they include Eric Lander of MIT and Harvard, Chris Chyba of Princeton and Susan Graham of UC Berkeley.
All nine were members of the Council of Advisors on Science and Technology assembled by Obama at the start of his presidency. Between 2009 and 2016 they co-wrote six reports for the president that touched on viral pandemics.
The dramatic warning from the former White House science advisers contains an implicit criticism of Donald Trump’s handling of the pandemic. The group of scientists warn that present federal government preparations for a possible resurgence of the disease must be triggered immediately inn order to avoid a repeat of the “extraordinary shortage of supplies” that the Country suffered earlier this year during the current first wave of the Pandemic.
“Preparation for a resurgence needs to be initiated now. It needs to be at a national level, in close collaboration and coordination with state and local officials,” the letter says.
In a series of recent statements, Obama has been searingly critical of Trump’s management of the pandemic. Last Saturday he told graduating students in an online commencement address that coronavirus had “finally torn back the curtain on the idea that so many of the folks in charge know what they’re doing – a lot of them aren’t even pretending to be in charge”.
The nine authors, led by John Holdren, Obama’s White House science adviser throughout his two terms in office, criticize the Trump administration for failing to act on numerous studies urging replenishment of the Strategic National Stockpile (SNS) in preparation for just the kind of health emergency unfolding today.
“The United States was unprepared for the supply needs of the spring 2020 Covid-19 pandemic,” the group says.
The scientists add: “There has been a persistent shortage of ventilators, testing kits, masks and other PPE [personal protective equipment] … In recent years the nation has let down its guard.
As states reopen, efforts to ramp up testing have been hampered by the fragmented U.S. health system
The inability of the United States to provide broad diagnostic testing, widely seen as a pivotal failing in the nation’s effort to contain the virus, has been traced to the absence of a cohesive Federal policy, and the the botched rollout by the Centers for Disease Control and Prevention, couple to delayed response by the Food and Drug Administration, and supply shortages of swabs and masks.
But the fragmented Federal response has been compounded by a poorly organized American health care system, making it difficult for hospitals and other medical providers to quickly overcome obstacles to testing, tracing, and treatment.
In recent days, Mr. Trump has delivered a mixed message on testing, saying on May 11 that in ramping up, “we have met the moment and we have prevailed,” while a few days later, he suggested that testing was “overrated” and that the high number of cases in the United States could be traced to more prevalent testing.
The picture for testing is improving, slowly. The United States is completing more than 300,000 tests a day, double the amount of a month ago, according to the Covid Tracking Project.
Still, the level of testing in the United States is orders of magnitude less than what many epidemiologists say it should be. The country should be doing at least 900,000 tests a day — and as many as 20 million — to yield an accurate picture of the outbreak, they say.
The need for extensive testing is even more acute as many governors have reopened their states before the epidemic has crested. Without sufficient testing it will be hard to identify and contain new outbreaks.
Most testing is not done by public health authorities — whose labs have been chronically underfunded — but by hospital laboratories and major for-profit testing companies.
There have been calls for more than a decade to create a national laboratory system that could oversee a testing response in a public health crisis. An effort to create one 10 years ago withered away over time because of a lack of funding.
America’s Nurses Speak Out — Survey finds 87% of forced to reuse one-time protective equipment
Despite ongoing calls for protective measures, 84% of those surveyed have not been tested for Covid-19 and 72% work with exposed skin or clothing,
The nationally representative survey finds that “dangerous healthcare workplace conditions have become the norm” since Covid-19 spread widely in the US.
Some Covid-19 patients who have symptoms for months
Prof Tim Spector, of King’s College London, estimates that a small but significant number of people are suffering from the “long tail” form of the virus.
Spector is head of the research group at King’s College London which has developed the Covid-19 tracker app. This allows anyone who suspects they have the disease to input their symptoms daily; some 3 to 4 million people are currently using it, mostly Britons and Americans.
Spector estimates that about 200,000 of them are reporting symptoms which have lasted for the duration of the study, which is six weeks. There is good clinical data available for patients who end up in hospital.
Thus far the government is not collecting information on those in the community with ostensibly “mild” but often debilitating symptoms – a larger group than those in critical care.
“These people may be going back to work and not performing at the top of their game,” Spector says. “There is a whole other side to the virus which has not had attention because of the idea that ‘if you are not dead you are fine.’”
He adds: “We are the country that invented epidemiology. We haven’t produced any epidemiological studies other than the app. It’s kind of embarrassing.”
As more information becomes available, the government’s Covid model seems increasingly out of date.
Many Covid patients do not develop a fever and cough. Instead they get muscle ache, a sore throat and headache.
The app has tracked 15 different types of symptoms, together with a distinct pattern of “waxing and waning”. “I’ve studied 100 diseases. Covid is the strangest one I have seen in my medical career,” Spector says.
The president’s outlandish behavior as Americans suffer has inspired horror and confusion while alienating allies
The Trump administration has repeatedly claimed that the US is “leading the world” with its response to the pandemic, but it does not seem to be going in any direction the world wants to follow.
Across Europe, Asia, Africa and Latin America, views of the US handling of the coronavirus crisis are uniformly negative and range from horror through derision to sympathy. Donald Trump’s musings from the White House briefing room, particularly his thoughts on injecting disinfectant, have drawn the attention of the planet.
“Over more than two centuries, the United States has stirred a very wide range of feelings in the rest of the world: love and hatred, fear and hope, envy and contempt, awe and anger,” the columnist Fintan O’Toole wrote in the Irish Times. “But there is one emotion that has never been directed towards the US until now: pity.”
The US has emerged as a global hotspot for the pandemic, a giant petri dish for the Sars-CoV-2 virus.
As the death toll rises, Trump’s claims to global leadership have became more far-fetched. He told Republicans last week that he had had a round of phone calls with Angela Merkel, Shinzo Abe and other unnamed world leaders and insisted “so many of them, almost all of them, I would say all of them” believe the US is leading the way.
None of the leaders he mentioned has said anything to suggest that was true.
Top health experts testify before the Senate today that the U.S. is not “out of the woods” and warn against reopening too fast.
Dr. Robert R. Redfield, the director of the Centers for Disease Control and Prevention, warned the Senate Health Committee on Tuesday (5-12) morning that “we are not out of the woods yet,” a day after President Trump declared, “we have met the moment, and we have prevailed.”
Dr. Redfield is one of four top health officials testifying remotely by video, three of which in some form of self-isolation after exposure to a White House official who tested positive for the coronavirus, including Dr. Anthony S. Fauci, the nation’s top infectious disease expert, and Stephen M. Hahn, the Food and Drug Administration commissioner.
Americans should brace themselves for the risk that they will suffer their “darkest winter in modern history” due to the ongoing federal government failures in addressing the coronavirus pandemic, a recently ousted public health official turned whistleblower warned the US Congress.
Dr. Bright, who was removed from his role heading a federal agency in charge of vaccines last month, told a congressional committee on Thursday that as the virus continues to spread in the US the “window is closing to address this pandemic” because the Trump administration still lacks a comprehensive plan to tackle Covid-19.
Dr. Fauci on Monday said he would tell the panel that there could be “needless suffering and death” if the country opens prematurely, but steered clear of that language during the early part of the hearing, instead saying, “the consequences could be really serious.” Mr. Trump has pushed for states to reopen and at times has encouraged people to defy governors’ orders.
“If that occurs there is a real risk that you will trigger an outbreak that you may not be able to control,” Dr. Fauci said, adding that it would not only lead to deaths but would set the economic recovery back as well.
Senator Patty Murray of Washington, condemned the Trump administration’s response to the virus, saying that Mr. Trump “has been more focused on fighting against the truth than fighting the virus.”
She criticized “delays” and “missteps” on tests, “corruption and political interference” in the government’s attempts to acquire personal protective equipment, and the White House’s move to put off guidelines the C.D.C. drafted to help schools, restaurants, churches and other establishments safely reopen.
“Americans have sadly paid the price,” she said.
In a tense exchange about whether children should go back to school, Senator Rand Paul, Republican of Kentucky, noted that the mortality rate in children is low, and suggested that schools should be reopened district by district.
“As much as I respect you Dr. Fauci, I don’t think you’re the end all. I don’t think you’re the one person who gets to make the decision,” Mr. Paul said. “We can listen to your advice but there are people on the other side saying there won’t be a surge.”
To that, Dr. Fauci gave a pointed response. “I have never made myself out to be the end all and only voice in this,” he said. “I’m a scientist a physician and a public health official. I give advice on the best scientific evidence.”
New COVID-19 case clusters emerge in Asian countries previously praised for their successful coronavirus containment.
As the world confronts the pandemic, several nations in Asia have been hailed for curbing the spread within their borders. But in the face of the coronavirus, victory can be elusive and fleeting.
And as several countries make moves to lift measures aimed at slowing the spread of the coronavirus, officials from the World Health Organization are urging governments and the public to maintain “extreme vigilance” to avoid a new wave of infections.
Singapore – once a model for its speed and efficiency in tracing the contacts of infected people, has seen its cases balloon to more than 23,000 as the virus spread in dormitories for foreign workers.
China – Officials in Wuhan, the Chinese city where the outbreak began and which celebrated its recent emergence from more than two months in lockdown, said it would test all 11 million residents after six new cases were confirmed this week.
The new cluster of cases, the first recorded there since April, were linked to a man who fell sick in March but was not tested. He recovered, then fell ill again last month.
Japan – As reported earlier (https://www.beyondkona.com/covid-19-end-game/), the northern island of Hokkaido offers a grim lesson in the next phase of the battle against COVID-19. It acted quickly and contained an early outbreak of the coronavirus with a 3-week lockdown. But, when the governor lifted restrictions, a second wave of infections hit even harder. Twenty-six days later, the island was forced back into lockdown.
A divide between so-called red states and blue states is driving a US congressional dispute over COVID-19 recovery aid.
Hawaii and other state governments are incurring large economic costs to respond to COVID-19. States are also experiencing large declines in tax revenues and increased enrollment in safety-net programs as disruptions caused by COVID-19 drive incomes and consumption lower. Without assistance from the federal government, states will likely be forced to make deep program cuts, enact substantial tax increases, or both, signs of which have already begun here in Hawaii.
The disagreement is another reminder as Mr. Trump and a divided Congress make decisions about federal relief, based on politics — which is never far from their calculations.
Democrats are presently urging action that a much needed next phase of assistance in the form of state aid be enacted now, but President Trump and Republicans argue that the government should wait to see how the economy is faring before enacting another sweeping stimulus law.
Much of the dispute — unfolding months before the November elections is about control of the Senate — a political calculation not lost on this Administration, and which states that stand to benefit or lose.
President Trump has suggested that he viewed the issue through an entirely partisan lens. But the reality is that many states and cities (both blue and red) are experiencing devastating fiscal crises during the pandemic, and Congressional Democrats have joined bipartisan groups of governors and mayors in pressing for as much as $700 billion for troubled states, cities and towns.
Men’s blood has higher levels of an enzyme used by the Sars-CoV-2 virus to infect cells
The results of a study published in the European Heart Journal show. Angiotensin-converting enzyme 2 (ACE2) is found in the heart, kidneys and other organs. It is thought to play a role in how the COVID-19 infection progresses into the lungs.
The World Health Organization says “extreme vigilance” is needed as countries begin to exit lockdowns imposed to curb the virus’ spread.
The warning comes after Germany reported an acceleration in new infections after easing its lockdown, and South Korea, another country that succeeded in limiting infections, saw a new outbreak in nightclubs.
Follow the Money – Economic Impact Payments
Economic Impact Payment from the IRS. The latest figures show that nearly 130 million individuals have received their payments, accounting for $200 billion in support during the first four weeks of the program. For Hawaii residents, so far, the IRS has issued 542,426 Economic Impact Payments, a total of $923,960,321.
The IRS is committed to helping you get your Economic Impact Payment as soon as possible. The payments, also referred to by some as stimulus payments, are automatic for most taxpayers. No further action is needed by taxpayers who filed tax returns in 2018 and 2019 and most seniors and retirees.
The IRS is encouraging everyone who has not yet used the “Get My Payment” tool on its website to do so no later than Wednesday, May 13 for a chance to get a quicker delivery of their Economic Impact Payment.
Hawaii’s Department of Labor and Industrial Relations (DLIR) announced it distributed $140,300,082 in unemployment insurance benefits for the week of May 3rd.
- In March, Congress passed a historic $2 trillion stimulus package to shore up the economy.
- The CARES Act includes $150 billion for state and local governments to help them respond to the coronavirus crisis.
- But the money hasn’t been distributed evenly: Rural states are receiving a disproportionate amount of relief funds relative to their COVID-19 case and death counts, according to the Center for Budget and Policy Priorities.
- That has major implications for states with larger outbreaks, since governments are being forced to make severe cuts to programs like Medicaid, even as millions lack health insurance.
Hawaii State legislature comes back to work next week to face up to uncertain times ahead and an emerging budget crisis.
Hawaii’s rainy day fund is one area that will be tapped to cover revenue-budget shortfalls. One thing certain, Hawaii’s legislature cannot assume a return to business-as-usual revenue assumptions going forward and for the foreseeable near future – adjustments will need to be made. Question is what “adjustments” will be made that will be sufficient to balance the state budget.
After being recessed since March due to COVID-19, the Hawai‘i legislature will be reconvening on Monday, May 11. Lawmakers will focus on state budget issues and board member confirmations. The Capitol will also be closed to the public, but all committee hearings and floor sessions will be live streamed on ʻŌlelo and written testimony will be accepted on all active matters before this renewed legislature session.
Hawaii — Govenor Ige, eases “Stay at Home” to “Safer At Home”
More Hawaii businesses will be permitted to reopen Thursday, (5/7) in a new statewide emergency proclamation.
Governor Ige’s new proclamation allows “low-risk” businesses to reopen as long as they follow social distancing guidelines.
Re-opening Hawaii’s business community and beaches
Hawaii businesses eligible for reopening include retail businesses and services, non-food agriculture, astronomical observatories and support facilities, car washes, pet grooming services, non-profit organizations, shopping malls and wholesale and warehousing operations. Health care providers also will be allowed to resume elective surgeries.
The primary consideration for determining which businesses can reopen is they can effectively enforce social distancing protocols.
The reopening requires that patrons and customers maintain minimum distances between people, limit the number of simultaneous customers and require employees and customers to wear masks.
“Although we encourage you to patronize the newly reopened businesses and activities, you are safer at home,” Ige said.
Hawaii state, since the pandemic hit the islands, has tested less than 2% of the population, and so far has failed to employ statewide COVID-19 case tracing.
The current “flattening of the curve” in the state is more a testament to the state’s early and aggressive virus containment measures than the potential for a wider spread of COVID-19 throughout the state as containment management restrictions are lifted.
Updated Hawaii State and County Face Mask Guidance
On April 24, 2020, the governor previously issued a statewide order encouraging all to wear cloth face masks based on CDC recommendations, which is that everyone should wear a cloth face covering when out in public. They also advise that cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or anyone otherwise unable to remove the mask without assistance.
The governor’s order also exempts the use of a face mask while using an ATM or in a bank, and while engaging in physical exercise.For Hawaii County, Mayor Kim also issued a new rule requiring the use of face coverings or masks for all essential businesses and operations. All customers and all employees are required to wear face coverings. Children younger than 5 and those with health or medical conditions, trouble breathing, or who are otherwise unable to remove the covering without assistance are exempted from this rule. Unless there is an exemption, a business is required to refuse service to those without face coverings.
- US infection rate rising as states open up
New confirmed infections per day in the U.S. exceed 20,000, and deaths per day are well over 1,000, according to figures from Johns Hopkins University. And public health officials warn that the failure to flatten the curve and drive down the infection rate in places could lead to many more deaths — perhaps tens of thousands — as people are allowed to venture out and businesses reopen.
“Make no mistakes: This virus is still circulating in our community, perhaps even more now than in previous weeks” said Linda Ochs, director of the Health Department in Shawnee County, Kansas.
Elsewhere around the world, Britain’s official coronavirus death toll, at more than 29,000, topped that of Italy to become the highest in Europe and second-highest in the world behind the United States. The official number of dead worldwide surpassed a quarter-million, by Johns Hopkins’ count, though the true toll is believed to be much higher.
When the still locked-down area is included, new infections in the U.S. appear to be declining, according to the AP analysis. It found that the five-day rolling average for new cases has decreased from 9.3 per 100,000 people three weeks ago on April 13 to 8.6 on Monday.
U.S. testing for the virus has been expanded, and that has probably contributed to the increasing rate of confirmed infections. But it doesn’t explain the entire increase, said Dr. Zuo-Feng Zhang, a public health researcher at the University of California at Los Angeles.
“This increase is not because of testing. It’s a real increase,” he said.
On Monday, a model from the University of Washington nearly doubled its projection of COVID-19 deaths in the U.S. to around 134,000 through early August, with a range of 95,000 to nearly 243,000.
Dr. Christopher Murray, director of the institute that created the projections, said the increase is largely because most states are expected to ease restrictions by next week.
Without stay-at-home orders and similar measures, Murray said, “we would have had exponential growth, much larger epidemics and deaths in staggering numbers.” But cooperation is waning, with cellphone location data showing people are getting out more, even before their states reopen, he said.
The Trump administration projects about 3,000 daily deaths by early June
As President Trump presses for states to reopen their economies, his administration is privately projecting a steady rise in the number of cases and deaths from the coronavirus over the next several weeks, reaching about 3,000 daily deaths on June 1, according to an internal document obtained by The New York Times, nearly double from the current level of about 1,750.
The projections, based on modeling by the Centers for Disease Control and Prevention and pulled together in chart form by the Federal Emergency Management Agency, forecast about 200,000 new cases each day by the end of the month, up from about 25,000 cases now.
The numbers underscore a sobering reality: While the United States has been hunkered down for the past seven weeks, not much has changed. And the reopening to the economy will make matters worse.
“There remains a large number of counties whose burden continues to grow,” the C.D.C. warned.
The projections confirm the primary fear of public health experts: that a reopening of the economy will put the nation right back where it was in mid-March, when cases were rising so rapidly in some parts of the country that patients were dying on gurneys in hospital hallways as the health care system grew overloaded.
On Sunday (5-3), Trump said deaths in the United States could reach 100,000, twice as many as he had forecast just two weeks ago. But his new estimate still underestimates what his own administration is now predicting to be the total death toll by the end of May — much less in the months that follow. It follows a pattern for Mr. Trump, who has frequently understated the impact of the disease.
At least 1,000 people with the virus, and sometimes more than 2,000, have died every day for the last month. On a near-daily basis, at least 25,000 new cases of the virus are being identified across the country.
Trump prepares country for politically-driven calculus; re-opening U.S. against all odds and public health consequences… Slow, conflicting, and confused Federal response to pandemic contributes to national PPE supply, equipment, and virus testing shortage, as national death toll exceeds 51,450..
US Federal Gov’t ReOpening Plan – PHASE ONE —
ALL VULNERABLE INDIVIDUALS should continue to shelter in place.
Members of households with vulnerable residents should be aware that by returning to work or other environments where distancing is not practical, they could carry the virus back home. Precautions should be taken to isolate from vulnerable residents.
All individuals, WHEN IN PUBLIC (e.g., parks, outdoor recreation areas, shopping areas), should maximize physical distance from others. Social settings of more than 10 people, where appropriate distancing may not be practical, should be avoided unless precautionary measures are observed.
EMPLOYERS will continue to ENCOURAGE TELEWORK, whenever possible and feasible with business operations. If possible, RETURN TO WORK IN PHASES. Close COMMON AREAS where personnel are likely to congregate and interact, or enforce strict social distancing protocols.
A Second Wave of COVID-19 infections is projected for Hawaii…
A month ago, it was reported (3-31) that …COVID-19 is spreading in Hawaii communities at a wider scale than being reported. That’s according to two medical experts on the frontlines of containing the virus.
“There’s no fear mongering here. We need to isolate we need to separate,” Dr. Miscovich, founder of Premier Medical Group Hawaii, whose clinics have identified about 40 of the 175 positive cases so far in the state.
Dr. Miscovich added that most of the professional community are “thinking there’s probably 800 to 1,000 unidentified cases on Oahu right now, and that would also be across the neighbor islands. We need to test them we need to find them, we need to isolate them, we need to treat them and I still am very confident that we have the ability to flatten the curve.”
But that’s just the tip of the iceberg.
Dr. Miscovich added that most of the professional community are “thinking there’s probably 800 to 1,000 unidentified cases on Oahu right now, and that would also be across the neighbor islands. We need to test them we need to find them, we need to isolate them, we need to treat them and I still am very confident that we have the ability to flatten the curve.”
Dr. Miscovich has been on the front lines of the fight against the coronavirus. He and his team held another drive-thru testing site last weekend in Oahu. He said Hawaii can expect to see an increase in positive cases in the near future.
“The people of Hawaii need to know, we are going to see a massive surge. It does not mean that we have a massive new influx. This is just the data we’re getting today is coming from the last 10 days,” Dr. Miscovich explained about the lag in testing results.
However, he adds that testing is getting faster, and a new blood test can help speed up results.
“We have a pilot on a device right now, which is a 10 minute blood test, and that pilot is about 95% accurate,” Dr. Miscovich said about the new form of testing. He said the blood test is used for patients with a high probability of having the virus. “It still needs to be quantified with a nasal swab,” he said.
More states are allowing certain businesses to open up
After a wave of reopenings over the weekend, at least six more states will begin allowing certain businesses to open back up on Monday, the latest expansion in economic activity despite rising coronavirus cases.
In Florida, restaurants, stores, museums and libraries are allowed to reopen with fewer customers, except in the most populous counties, which have seen a majority of the state’s cases. Restrictions on certain businesses or parts of the state were also lifted in Indiana, Kansas, Missouri, Nebraska and West Virginia.
About half of all states have now begun reopening their economies in some significant way, introducing a pivotal new chapter. Some states have lifted stay-at-home orders or reopened businesses even though reported new cases are rising or remaining steady. Public health experts have warned that reopening too soon could lead to a new wave of cases and deaths.
“The fact remains that the vast majority of Americans have not been exposed to the virus, there is not immunity, and the initial conditions that allowed this virus to spread really quickly across America haven’t changed,” said Dr. Larry Chang, an infectious-diseases specialist at Johns Hopkins University.
Though businesses are almost universally reopening under restrictions, such as allowing fewer customers or enforcing social distancing, experts say it’s too soon to tell how much that will help stop the spread of the virus. “Reopening is not a one-way street,” Dr. Chang said. “If there is a surge in cases, we need to clamp down again.”
Countries are taking steps to ease restrictions, and their neighbors are watching closely to see what happens
At least 12 countries began easing restrictions on public life on Monday, as the world tried to figure out how to placate restless populations tired of being inside and reboot stalled economies without creating opportunities for the virus to re-emerge.
The steps, which include reopening schools and allowing airports to begin domestic service, offer the rest of the world a preview of how areas that have managed to blunt the toll might work toward resuming their pre-pandemic lives. They also serve as test cases for whether the countries can maintain their positive momentum through the reopenings, or if the desire for normalcy could place more people at risk.
Most of the countries easing their restrictions are in Europe, including Italy, one of the places where the virus hit earliest and hardest, leaving more than 28,000 dead. The country plans to reopen some airports to passengers.
In Germany, where widespread testing has kept the pandemic under control, children will return to schools. Austria also plans to restart its school system.
Sweden’s approach to the pandemic sets a seductive, but foolhardy course for the nation
For the US and other countries battling the coronavirus pandemic, Sweden sets a seductive example. While the world’s biggest economies have shut down, one small, well-governed Scandinavian country has allowed most businesses to stay open. The strategy apparently relies on “herd immunity,” in which a critical mass of infection occurs in lower-risk populations that ultimately thwarts transmission.
In Sweden, business is not actually proceeding as usual. Most travel and mass gatherings are not allowed, and some schools have been closed. But restrictions from government are considerably less severe than many other countries. Restaurants and bars are still functioning, some of them only with minimal distancing taking place.
The results have been mixed. Sweden has the highest fatalities and case count per capita in Scandinavia, but is lower than some of its neighbors to the south. Economic disruption has been significant but not as debilitating as other countries. In the capital, Stockholm, the nation’s top infectious disease official recently estimated that approximately 25 percent of the population has developed antibodies.
We don’t know if that percentage is accurate because the data isn’t available, the antibody tests still appear to be of uncertain accuracy, and we don’t even know what a positive antibody test means. There is some optimism that most people who are infected will have some temporary immunity. But if immunity is short-lived and only present in some individuals, that already uncertain 25 percent may be in jeopardy of re-infection, which could prove deadly.
We also still don’t know what total population percentage would be necessary to reach the herd immunity goal. It could be as high as 80 percent of the population.
There are huge risks for the US to copy Swedan’s laissez faire pandemic policy. The simply fact is that Americans are far less healthy than Swedes. We have significantly higher rates of asthma, diabetes, hypertension, three of the most-risky underlying conditions, and four out of every 10 Americans are obese. A herd immunity strategy in America would mean many more deaths, and more people forced into some form of lockdown for many more weeks, most likely months.
Moreover, the Sweden example demonstrates that a targeted herd immunity strategy doesn’t do much to protect at-risk populations either. Deaths among the elderly in Sweden have been painfully high. In a more densely populated country like the United States, and with a larger proportion of vulnerable people, the human toll of a herd immunity strategy could be devastating.
But what about the economy? The choice is not between indefinite shutdown and Russian roulette. A transition needs to occur that balances the risks at play. From that perspective, Sweden is the future. But not because of a herd immunity strategy. Because a more targeted approach to social distancing can be deployed when the timing calls for it, when old-fashioned public health methods can foster a gradual easing of restrictions in a way that can be tweaked as we learn more and develop new tools — treatments, understanding of immunity, testing improvements, and epidemiological data.
COVID-19 – Infection Cycle
Data is beginning to emerge indicating that individuals infected with the virus, once recovered, remain active carriers of the virus for up to 24 days.
Currently, it is estimated to take about 2 weeks, once inflected with COVID-19 virus, to manifest symptoms. And then it takes another 2-3 weeks to recover, and an additional 2-3 weeks once recovered, to remain a carrier of the (active) virus, and with possibility of inflecting others.
Add it all up, and that’s about 8 weeks or about two months — the total timeline for individuals infected to carry the “active” virus within their body.
Hawaii state, as is occurring nationally, is experiencing shortages of essential pandemic supplies: hand sanitizer, N95 masks, thermometers, gloves, and related panic purchase effects on supplies of toilet paper and some food stocks. Raw material shortages essential to the production of items ranging from N-95 masks to toilet paper are beginning to be reported by some U.S. manufacturers.
Officials are screening passengers that arrive at the Daniel K. Inouye International Airport to identify those coming from countries that require quarantine or public health supervision. Anyone who has traveled to areas with sustained community transmission are being asked to self-isolate and monitor their health for 14 days.
COVID-19 – VACCINE ?
BeyondKona first reported in April the promise of existing virus vaccines and their potential role in treating COVID-19, with a particular focus on Remdesivir.
It was reported today that severely ill coronavirus patients were responding well to Remdesivir, a Gilead Sciences drug, at a Chicago hospital. The trial involved only 125 people and the preliminary results were not peer reviewed, but it was welcome news, and a possible beginning to a virus vaccine based on science and not politics.
Previously, Remdesivir was given to the first known U.S. coronavirus patient: a man in Washington State who had recently returned from the outbreak’s epicenter in Wuhan, China. And he has made a good recovery.
But that patient is, of course, only a single person, and a larger sample size will be needed to determine the drug’s efficacy.
Another clinical trial is planned in the U.S., and it will be run by the University of Nebraska Medical Center and the National Institute of Allergy and Infectious Diseases. That trial will take months to be conducted and at up to 50 sites around the world, testing Remdesivir against a placebo.
Remdesivir has been shown to be effective against many other viruses, and some experts are optimistic that it—or similar compounds—may work for the pathogen responsible for COVID-19.
The surge was based on a report by the news site STAT about videotaped comments by a University of Chicago Medicine researcher leading a local trial site for Gilead’s experimental drug Remdesivir. Of 113 patients with severe disease, only two people treated with the drug died, and most got better quickly, the researcher said. It was not disclosed how many were on ventilators before they improved.
University of Chicago Medicine is one of the dozens and dozens of sites listed by Gilead on clinicaltrials.gov as trial locations around the world for the company’s Remdesivir study, with the 6,000 patients being grouped into four categories of disease severity and dosing. The worldwide trial is ongoing, with preliminary results not expected until next month.
“Drawing any conclusions at this point is premature and scientifically unsound,” University of Chicago Medicine said in a statement.
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