Coronavirus COVID-19 *Global Health Emergency* #16

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The Grand Princess cruise ship, which has been held off the coast of Northern California since Thursday because of a coronavirus outbreak on board, will dock at the Port of Oakland on Monday.

As of Friday, 19 crew members and two passengers had tested positive for COVID-19 and those who need "acute" medical treatment or hospitalization will be transported to medical facilities in the state.

Only 45 of the ship’s passengers have been tested for the virus, meaning the other nearly 3,500 aboard will need to be tested and quarantined once the ship docks.

Cruise ship off California amid coronavirus outbreak to dock in Oakland on Monday, operator says
 
Scott Gottlieb - previous head of FDA
Scott Gottlieb, MD on Twitter

PLEASE READ


THREAD: On #Coronavirus, we may be entering a period of accelerating cases. The country could look very different over next two weeks. We’ll get through this, but need to take steps now to limit the scope and impact of virus. There are things we can do now to help ourselves. 1/n

2/n In last 10 days Italy diagnosed 95% of total cases they now report; South Korea 85%. 2 weeks ago, Italy had just 9 cases. 7 weeks ago, China reported 50 cases. The point: once the epidemics are discovered, they’ve been underway. Case counts grow quickly. Same likely true here.

3/n What should we do now? Moving quickly and aggressively to mitigate spread, reduce the scope of the epidemic here, continue to ready the healthcare system, work with cities and states to develop a uniform, systematic response; provide financial assistance to help these efforts.

4/n Mitigation: The goal is to reduce the number of cases at the peak of the epidemic. This extends the length of the epidemic, but can push the total number of cases at any one time below the point where the healthcare system gets exhausted, improving outcomes for patients.

5/n We need a uniform and timely approach to mitigation and social distancing that local, state officials can follow and clear set of principles on when to adopt the measures. School closures, event cancellations, other aggressive steps need to be implemented now in certain areas.

6/n We must support affected cities, states with financial assistance. The feds must strongly encourage states and cities that have outbreaks to take mitigation steps to help protect nation. But localities that take on these burdens should be compensated for hardships they incur.

7/n Simple measures still matter. Hand washing, avoiding crowded indoor spaces, cleaning surfaces, keeping people more apart where appropriate. Businesses and individuals are responding with prudent and measured action, and need to step up these efforts.

8/n There will be hardship especially among the vulnerable. We need to consider financial assistance; first aid through existing programs then perhaps a bigger supplemental. Many people can’t easily absorb missed work, closed schools. We must assist them for the measures to work.

9/n Businesses need to do their part by offering flexibility to workers in order to make these mitigation measures effective - telework, flexibility when schools are closed and parents must tend to children, avoidance of unnecessary travel especially to and from areas of spread.

10/n We will get through this. Some of these measures at social distancing, improved hygiene techniques, could persist. The epidemic will abate but outbreaks could occur again until we have a vaccine. Ultimately technology will vanquish this disease.

11/n This is a dangerous virus. We have faced worse, and prevailed. People will suffer and die. The most vulnerable are at greatest risk. We must all work together to protect them. The next few months will be hard, but we will preserve life, and eventually conquer this pathogen
 

Tri-State COVID-19 Cases Nearly Double Over Weekend; NY Under State of Emergency

New York

The number of cases in New York State rose to 89 by Saturday evening, up from 45 reported just one day before. Those 89 cases include 70 in Westchester County, 11 in New York City, four in Nassau County, two in Rockland County and two in Saratoga County.

One of the new cases in New York City involved an Uber driver from Queens. The Far Rockaway patient is being treated in isolation at St. John's Episcopal Hospital.

The driver, in his 30s, is part of the Taxi and Limousine Commission and works on Long Island. Uber said that all of his passengers were notified as of Saturday.

Two women from Brooklyn returned from a cruise in Egypt, while a Brooklyn man is in serious condition after returning from Italy.

In Westchester, the testing could still be improved, Gov. Cuomo said. "We have ongoing testing more than dozens in Westchester. There is one test kit per person, one sampling kit. We need the CDC to authorize automated testing," he said.
 
Tri-State COVID-19 Cases Nearly Double Over Weekend; NY Under State of Emergency

In New Jersey, four people tested positive and the samples were sent to the CDC for confirmation. Those results were still pending federal confirmation as of Saturday night.

One is a health care worker in his 30s who works in New York City and splits time between homes there and in New Jersey. It's not clear where he works or in what capacity. He's doing well in isolation at the hospital. Another woman tested positive in Bergen County, and was released into isolation at her home.

Two other cases included a man in his 60s in southern New Jersey's Camden County and a man in his 50s in Bergen County. Both have been hospitalized.

Organizers for the Conservative Political Action Conference (CPAC) hosted in Maryland last week said an attendee tested positive for COVID-19 and was under quarantine in New Jersey. President Donald Trump and Vice President Mike Pence attended CPAC but "there is no indication" they came in contact with the patient.

Cranford Public Schools announced its classes would be canceled on Monday, March 16, to give staff and administrators time to "develop strong and meaningful plans for your children in the event of school closures due to the coronavirus”. The day off will also give faculty time to clean and disinfect buildings.
 
VANCOUVER -- B.C. health officials have announced six new cases of COVID-19, and in a concerning development, two of them are residents of a North Vancouver long-term care home.

Provincial health officer Dr. Bonnie Henry said on Saturday that the residents of the Lynn Valley Care Centre were infected via a care home worker who also works at other care home facilities in Metro Vancouver.

6 new cases of COVID-19 in B.C., including 2 long-term care home residents
 
I haven’t heard anything about testing here in MI.

The Michigan Department of Health and Human Services said that as of March 5, 406 cases were referred for assessment and/or monitoring, to date (This includes referrals from CDC airport quarantine stations, self-referrals, close contacts of pending PUIs and healthcare provider referrals entered by local health departments), and 16 tests have been approved in total, to date. 82 are being actively monitored.

All eight of those tests (1 Allegan, 2 Macomb, 2 Oakland, 2 Washtenaw, 1 out of state) were negative for the new coronavirus. The other eight tests have pending results.

There are currently zero confirmed coronavirus cases in Michigan, as of March 7.

Coronavirus: Latest testing, monitoring numbers in Michigan
 
Yesterday I went to visit a friend’s mom who is a resident in a memory care center. I ha d been visiting her twice a week for the past few months.

The receptionist stopped me as I walked into the lobby, saying that visitors had to fill out a new form each time they came in. The form asked if I had any symptoms, then she took my temperature.

Finally she asked if I had traveled “anywhere” in the past week. I told her I hadn’t been out of the country, and she asked if I had traveled outside of Indiana. I told her I had been in Ohio, and then she wasn’t going to allow me in! I pointed out that Ohio had no cases iv CV yet, but here in Indiana we had one case.

She had to ask the administrator if I could be allowed inside since I had traveled to Ohio. He had to call someone on the phone and ask, because he didn’t know.

After a conversation with the person on the phone he told me I would be allowed inside.
 
VANCOUVER -- B.C. health officials have announced six new cases of COVID-19, and in a concerning development, two of them are residents of a North Vancouver long-term care home.

Provincial health officer Dr. Bonnie Henry said on Saturday that the residents of the Lynn Valley Care Centre were infected via a care home worker who also works at other care home facilities in Metro Vancouver.

6 new cases of COVID-19 in B.C., including 2 long-term care home residents

The province now has 27 cases.
 
Yesterday I went to visit a friend’s mom who is a resident in a memory care center. I ha d been visiting her twice a week for the past few months.

The receptionist stopped me as I walked into the lobby, saying that visitors had to fill out a new form each time they came in. The form asked if I had any symptoms, then she took my temperature.

Finally she asked if I had traveled “anywhere” in the past week. I told her I hadn’t been out of the country, and she asked if I had traveled outside of Indiana. I told her I had been in Ohio, and then she wasn’t going to allow me in! I pointed out that Ohio had no cases iv CV yet, but here in Indiana we had one case.

She had to ask the administrator if I could be allowed inside since I had traveled to Ohio. He had to call someone on the phone and ask, because he didn’t know.

After a conversation with the person on the phone he told me I would be allowed inside.
That's the best story I've heard in days....thanks for sharing it.
 
:( It’s not uncommon at all for health care workers of all types to work in multiple facilities or travel between them.


VANCOUVER -- B.C. health officials have announced six new cases of COVID-19, and in a concerning development, two of them are residents of a North Vancouver long-term care home.

Provincial health officer Dr. Bonnie Henry said on Saturday that the residents of the Lynn Valley Care Centre were infected via a care home worker who also works at other care home facilities in Metro Vancouver.

6 new cases of COVID-19 in B.C., including 2 long-term care home residents
 
Yesterday I went to visit a friend’s mom who is a resident in a memory care center. I ha d been visiting her twice a week for the past few months.

The receptionist stopped me as I walked into the lobby, saying that visitors had to fill out a new form each time they came in. The form asked if I had any symptoms, then she took my temperature.

Finally she asked if I had traveled “anywhere” in the past week. I told her I hadn’t been out of the country, and she asked if I had traveled outside of Indiana. I told her I had been in Ohio, and then she wasn’t going to allow me in! I pointed out that Ohio had no cases iv CV yet, but here in Indiana we had one case.

She had to ask the administrator if I could be allowed inside since I had traveled to Ohio. He had to call someone on the phone and ask, because he didn’t know.

After a conversation with the person on the phone he told me I would be allowed inside.
I am glad they let you in, but in all likelihood OH has no official cases because they haven't been testing (my understanding only 9 people were tested so far in OH). Regardless, it's not like virus cares about state lines.
 
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King County WA

Latest update from our @KCPubHealth team:
▪️No restrictions #COVID19 testing
▪️Providers may test any patient

▪️While testing is more available, limitations exist in healthcare providers' capacity to obtain samples and process lab results rapidly
See the complete thread.

King County, WA on Twitter
We urge @KingCountyWA residents to follow guidance to reduce the risk of #COVID19 in our community.
There are currently no restrictions on who can be tested for #coronavirus, and commercial testing is becoming more available.

Healthcare providers may test any patient in whom they suspect #COVID19.
While testing is becoming more available, there are limitations in healthcare providers' capacity to obtain samples and process lab results rapidly.
Glad to see the decision to test is with the healthcare providers, where it should be, imo.

Now let's support that decision by actually making it possible to process the tests. Geez, every step of the way seems to be blocked by bureaucracy.

jmo
 
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