Coronavirus COVID-19 - Global Health Pandemic #63

[tresir2012]

JAMA: The Journal of the American Medical Association published a piece on the mortality at nursing homes in Cleveland, Detroit, and New York.

The piece (linked below) found that:

• In Cleveland, there was higher mortality at SNFs in 2020 vs 2019 (mean, 6.3 and 4.9, respectively, per 1000 residents per week during March-May), but the difference was not statistically significant (adjusted IRR, 1.02; 95% CI, 0.94-1.11).
  
• In Detroit, there was higher mortality at SNFs in 2020 vs in 2019 (mean, 7.9 and 3.5, respectively, per 1000 residents per week during March-May; adjusted IRR, 2.18; 95% CI, 2.01-2.37).
• In New York City, there was higher mortality at SNFs in 2020 vs in 2019 (mean, 13.8 vs 4.1, respectively, per 1000 residents per week during March-May; adjusted IRR, 4.13; 95% CI, 3.95-4.33).

So from March to May, the mortality rate in nursing homes was up about 25% in Cleveland, up about 100% in Detroit, and up a stunning 300% in NYC.

The governors of New York and Michigan were 2 of the 7 governors that required or pushed nursing homes to take back from hospitals, residents who had tested positive for COVID-19. The governor of Ohio did not make that same policy choice.

The attached charts are from that piece and show how awful the situation was at New York City nursing homes.

View attachment 253150

Mortality, Admissions, and Patient Census at Urban US SNFs During the COVID-19 Pandemic

Many countries did this and I am wondering why they all made the same fatal error, sending elderly CV19 patient back to nursing homes from hospitals. Was there some sort of global health advice that advocated that at the time ?

From your link,

"Mortality from coronavirus disease 2019 (COVID-19) is disproportionately concentrated in skilled nursing facilities (SNFs). As of June 18, 2020, 50 185 residents died of COVID-19 in the 41 states reporting deaths at SNFs, accounting for 45% of their total COVID-19 deaths statewide.1 In addition to long-term care, SNFs provide short-term care after elective surgeries and hospitalizations. With the decreases in hospital volume for elective surgeries and other services during the pandemic, SNF admissions may also be declining."

So this is saying that 50,185 US deaths were from SNF's? Did we already know this? Ie that 50k of the 125k deaths were in skilled nursing facilities?

 

[MimosaMornings]

I’m scratching my head, protests and marches - safe, beaches - not safe.
Neither are social distancing but maybe because no masks at the beach? IDK

 

[Reasonable & Just]

Black Lives Matter protests have not led to a spike in coronavirus cases, research says
By Leah Asmelash, CNN
Black Lives Matter protests have not led to a spike in coronavirus cases, research says - CNN

Parties — Not Protests — Are Causing Spikes In Coronavirus
June 24, 20203:23 PM ET
Parties — Not Protests — Are Causing Spikes In Coronavirus

Black Lives Matter protests haven't led to COVID-19 spikes. It may be due to people staying home.
As the protests grew, many people not participating opted to stay home and avoid going out.
Black Lives Matter protests haven't led to COVID-19 spikes. It may be due to people staying home.

Why protests aren't as dangerous for spreading coronavirus as you might think
Ashish Jha
Why protests aren't as dangerous for spreading coronavirus as you might think | Ashish Jha


Did Black Lives Matter protests cause a coronavirus surge ...
www.vox.com › coronavirus-pandemic-black-lives-mat...2 days ago - But multiple analyses suggest the protests are not to blame, according to what ... and so on — in which the coronavirus is more likely to spread.

Still too soon for them to be saying that the BLM protests had no effect, IMO, but anyway, those "Liberate" people and their powerful backers ruined our progress from the get-go. For haircuts... (and paychecks that should have been protected by a functioning government). IMO.

 

[gitana1]

Indiana postponed elective surgeries to conserve supplies.

This appears to suggest the main reason was to prevent spread. A secondary reason was to conserve certain supplies:

Among the many challenges all healthcare providers are trying to navigate is the issue of elective surgery, which has been identified as one area where we can limit the spread of the COVID-19 virus. The advice of sources such as the CDC, state government agencies, and US Surgeon General is to limit elective surgery. Additionally, we have been urged to reduce the use of vital resources (including blood products, critical equipment and staff) in preparation for the expected influx of COVID-19 patients.
COVID-19 update: Elective surgeries limited | Community Health Network

 

[tresir2012]

True, and since we're passing blame around, we should include those who were actively publicly saying in the middle of March that there wasn't a problem, and the virus was under complete control.

Have you links for those public comments from mid March? Because the deaths in SNF's began in March so they must have known about that then at a minimum.

 

[10ofRods]

Still too soon for them to be saying that the BLM protests had no effect, IMO, but anyway, those "Liberate" people and their powerful backers ruined our progress from the get-go. For haircuts... (and paychecks that should have been protected by a functioning government). IMO.

Yes, very difficult to disentangle the general opening around Memorial Day (even when not advised by the state) and the ensuing protests, IMO. In Los Angeles, officers who were out on the night of the protests are more likely to have CoVid than those who were not - so there's that (was in the LA Times a couple of days ago - but I guess that's not as headline grabbing).

It did start with the "liberate" protests (but now a whole lot of social malaise is being expressed through protest, yelling and mass action all over the place).

This does remind me why I don't read or watch MSM that involves reporters attempting to translate research into headlines.

I dip my toe in every once in awhile (by coming here, for example).

This article, which has gotten little press (but should) is interesting:

https://royalsocietypublishing.org/doi/10.1098/rsos.200915

It shows why testing and contact tracing alone might work. Of course, for UK and USA, it means ramping up testing capability far past what we have - and getting every person who goes outside their house to be tested once a week.

Pie in the sky, so no headlines, I guess.

 

[CSIDreamer]

This appears to suggest the main reason was to prevent spread. A secondary reason was to conserve certain supplies:

Among the many challenges all healthcare providers are trying to navigate is the issue of elective surgery, which has been identified as one area where we can limit the spread of the COVID-19 virus. The advice of sources such as the CDC, state government agencies, and US Surgeon General is to limit elective surgery. Additionally, we have been urged to reduce the use of vital resources (including blood products, critical equipment and staff) in preparation for the expected influx of COVID-19 patients.
COVID-19 update: Elective surgeries limited | Community Health Network

Ah, I see where you found that.

I was using executive order 20-13

Governor Eric J. Holcomb: Executive Orders

 

[Trino]

I am just getting plain angry. Whiskey Tango... Why isn't the federal government stepping in and mandating things, i.e. domestic travel, masks, closures? This haphazzard closing/not closing is ridiculous!

 

[JerseyGirl]

The Florida DOH reported 8,530 new COVID-19 cases Sunday, 2,152 of which came from Miami-Dade County.

The record number was also the first time Miami-Dade eclipsed 2,000 positive cases in one day. Miami-Dade County alone now has 33,714 confirmed cases and 953 deaths.

Florida Gov. Ron DeSantis spoke to the media today to discuss the spike, saying younger people are continuing to drive up the numbers. “You’re seeing it in those groups who are less at risk, but you’re seeing them test positive at much higher rates. I think (ages) 25 to 34 has been pretty close to 20 percent.”

The governor also noted the state’s ever-rising positivity rate, something FIU School of Medicine infectious disease expert Aileen Marty, M.D., explained is an obvious indication of increased spread.

“That tells me there’s increased transmission,” said Marty. “This virus is now spreading almost as it was before we ever instituted any other of the public health measures we implemented. And that to me is a crime.”

 

[jjenny]

Did someone say Church?
I can't even and in TX?
This won't turn out well!
IMO
Mike Pence in Dallas: Vice president wears mask but 100-person choir sings without them - CNNPolitics

View attachment 253165

Yep, we know singing spreads covid, if any of those singers were infected, watch out.

 

[Deleted member 158085]

Did someone say Church?
I can't even and in TX?
This won't turn out well!
IMO
Mike Pence in Dallas: Vice president wears mask but 100-person choir sings without them - CNNPolitics

View attachment 253165

Dude... I hope he had an N-95 on. That’s a lot of moist speaking right there.

 

[jjenny]

I’m scratching my head, protests and marches - safe, beaches - not safe.
Neither are social distancing but maybe because no masks at the beach? IDK

Beaches might be relatively safe unless there are so many people there, they are packed like sardines.

 

[jjenny]

Dude... I hope he had an N-95 on. That’s a lot of moist speaking right there.

He took his mask off when he spoke, per the article.

 

[Deleted member 39678]

All we need to do is get rid of the US Constitution and the use of freedom of religion and free speech would no longer protect people going to church singing and protesters yelling which spew the virus a greet distance. JMO

 

[Deleted member 158085]

He took his mask off when he spoke, per the article.

I am, at this moment, Kitty Forman shaking my head and screaming you know what.

 

[Deleted member 158085]

All we need to do is get rid of the US Constitution and the use of freedom of religion and free speech would no longer protect people going to church singing and protesters yelling which spew the virus a greet distance. JMO

Or people could use common sense.

That’s not likely, of course.

 

[jjenny]

All we need to do is get rid of the US Constitution and the use of freedom of religion and free speech would no longer protect people going to church singing and protesters yelling which spew the virus a greet distance. JMO

Singing indoors spreads it incredibly well. At the church choir practice in Washington, it spread among the members and several died.
"Following a 2.5-hour choir practice attended by 61 persons, including a symptomatic index patient, 32 confirmed and 20 probable secondary COVID-19 cases occurred (attack rate = 53.3% to 86.7%); three patients were hospitalized, and two died. Transmission was likely facilitated by close proximity (within 6 feet) during practice and augmented by the act of singing."
High SARS-CoV-2 Attack Rate Following Exposure at a Choir Practice ...

 

[Deleted member 39678]

Or people could use common sense.

That’s not likely, of course.

I don't know how to force people to comply.

 

[Deleted member 39678]

Singing indoors spreads it incredibly well. At the church choir practice in Washington, it spread among the members and several died.
"Following a 2.5-hour choir practice attended by 61 persons, including a symptomatic index patient, 32 confirmed and 20 probable secondary COVID-19 cases occurred (attack rate = 53.3% to 86.7%); three patients were hospitalized, and two died. Transmission was likely facilitated by close proximity (within 6 feet) during practice and augmented by the act of singing."
High SARS-CoV-2 Attack Rate Following Exposure at a Choir Practice ...

It sure does.

 

[SoCalDavidS]

It's going to take roughly 3-4 weeks before the impact of these bar closings will be felt. Assuming that is a major contributor to the recent increases, then better late than never. If not, we're still whistling past the graveyard on the cause of exponential spread, and we won't see a significant change in the #'s over the coming weeks. But all the impact through now, are already baked in, so it's likely we'll still see increasing #'s over the next couple of weeks.