Coronavirus

The governor of Kansas also issued a stay-at-home order to begin Monday, as the virus takes hold in more rural areas where doctors worry about the lack of ICU beds.

A cluster of three counties in rural Indiana have surging rates of confirmed cases. One of them, Decatur, population 26,000, has 30 cases with one confirmed death and another suspected, said Sean Durbin, the county’s public health emergency preparedness coordinator. Several cases were traced to large gatherings earlier in the month, including a religious retreat and a high school basketball tournament.

The disease threatens to be devastating for close-knit communities where everyone knows everyone, Durbin said, adding that he was a friend of the person believed to have died from the virus as well as others currently in critical condition.

The county health department has already run out of personal protective equipment, Durbin said. The last supply from the federal stockpile arrived more than a week ago and contained just 77 N95 masks and two dozen face shields.

“I wish there was a stronger word for disappointed,” he said. “I’m calling on them to do better.”

Blaine County, Idaho, a scenic ski haven for wealthy tourists, now has around 100 confirmed cases of COVID-19, the highest rate per capita outside the New York area. Two people have died.

Spreading to rural communities...

The doctor's time spent spreading the word on social media was wise, USC's Craig said. With a combined audience of more than four billion, YouTube and Facebook alone reach more than half the world's population.

"When we’re talking about the scale and breadth and diversity, they mirror half of the human race," he said. "I’m just grateful Fauci agreed to YouTube’s efforts."

Fauci said on Sunday that the task force has had "very intensive discussions" at the White House with the president this weekend.

“As you know, the original proposal was to consider seriously an enforceable quarantine," he said. "After discussions with the president, we made it clear, and he agreed, that it would be better to do what’s called a strong advisory.”

New York is now the epicenter of the coronavirus outbreak in the United States, with more than 52,000 positive tests for the illness and more than 700 deaths. About 7,300 people were in New York hospitals Saturday, including about 1,800 in intensive care.

He noted that the administration will not be pulling back measures on the hot spots including New York.

“When we start to see a daily number of cases instead of increasing and escalating, they start to flatten out, turn the corner and then start coming down, when we see that, then you can start doing the modification of the intensity of your mitigation,” Fauci said.

“The virus itself determines that timetable,” he added.

90 US cases, 2 deaths in the US, 90,000/3,000 worldwide.

Also hope the rest of us don't have to climb a similar hill to get where Italy is hopefully done with.

We have to get over our pre-existing biases
First and foremost, the US has to recognize the seriousness of the situation. A couple of weeks ago, it was common to see private citizens and government officials skeptical of the Covid-19 threat pointing to low fatality numbers and asking why there was panic, given how many people die of the seasonal flu every year.

But they were already dealing in the past. The coronavirus spreads stealthily, with those who contract it not showing symptoms for days, and the full gravity of their illness not becoming clear until a week or two after infection. This means that back when skeptical perspectives were still common, the seeds had been planted for the explosion in US cases and deaths seen in the last few days.

We can’t take half measures to combat the coronavirus
Italy started small with its coronavirus containment and only expanded it as the scale of the problem revealed itself. The country started with a targeted strategy: certain areas with a lot of infections were designated as “red zones.” Within the red zones, there were progressive lockdowns depending on the severity of the outbreak in the area. The restrictions were only broadened to the whole country when these measures did not stop the virus’s spread.

In fact, these limited lockdowns might have made it worse. Because the coronavirus transmits so silently, the “facts on the ground” (number of cases, deaths, etc.) didn’t actually capture the full scale of the problem. Once partial lockdowns went into effect, people fled to less restricted parts of the country — and they may have unwittingly taken the virus with them.

We have to learn from successful containment strategies
You might wonder why the Harvard experts looked at Italy instead of South Korea or Taiwan, places that successfully managed the coronavirus threat from the start. One reason was that the US and many European countries had already lost the opportunity for those containment strategies by the time they began more aggressive measures, given the slow response to the outbreak at first. This makes Italy a much closer comparison to what the US is living through than those Asian countries — or even China — where the growth in reported cases has slowed to a crawl.

But there are strategies that have worked for the Italians, and the US can borrow them. The experiences of Lombardy and Veneto, two neighboring Italian regions that took two different strategies for their coronavirus response and saw two different results, are instructive. Lombardy has 10 million people, and it’s endured 35,000 Covid-19 cases and about 5,000 deaths; Veneto is home to 5 million people, but it’s seen just 7,000 cases and less than 300 deaths, its outbreak a fraction the size of its neighbor’s.

This is what Veneto did to successfully control the outbreak within its borders:

- Extensive testing: both people with symptoms and people who were asymptomatic were tested whenever possible
- Proactive tracing: if somebody tested positive, everybody they live with was tested or, if tests weren’t available, they were required to self-quarantine
- Emphasis on home diagnosis and care: Health care providers would actually go to the homes of people with suspected Covid-19 cases to collect samples so they could be tested, keeping them from being exposed or exposing other people by visiting a hospital or doctor’s office
- Monitoring of medical personnel and other vulnerable workers: doctors, nurses, caregivers at nursing homes, even grocery store cashiers and pharmacists, were monitored closely for possible infection and given ample protective gear to limit exposure.
Lombardy, on the other hand, was much less aggressive on all of those fronts: testing, proactive tracing, home care, and monitoring workers. Hospitals there were overwhelmed, while Veneto’s have been comparatively spared.

And yet it took weeks upon weeks for Lombardy to adopt the same strategies that were already working next door in Veneto:

We have to be ready for the long haul
The Harvard researchers also single out the importance of good data — the raw numbers themselves — which were lacking in the early days of Italy’s outbreak. These figures should focus on the important metrics like tests conducted and hospitalizations. Some questions have already been raised about whether the US is undercounting its fatality numbers, per this BuzzFeed report, and vigilance is warranted about the official numbers coming from an administration known for its obfuscation of the truth.

What those numbers say, and what policies they suggest might be most effective at mitigating the outbreak, is largely a concern for policymakers, journalists, and medical professionals. But it is important everyone sees those numbers to help underscore the authors’ concluding point, which seems essential for the public to understand:

An effective approach towards Covid-19 will require a war-like mobilization — both in terms of the entity of human and economic resources that will need to be deployed as well as the extreme coordination that will be required across different parts of the health care system (testing facilities, hospitals, primary care physicians, etc.), between different entities in both the public and the private sector, and society at large.

Together, the need for immediate action and for massive mobilization imply that an effective response to this crisis will require a decision-making approach that is far from business as usual.

CDC: 80,000 people died of flu last winter in the U.S. - STATwww.statnews.com › 2018/09/26 › cdc-us-flu-deaths-winter
CDC: 80,000 people died of flu last winter in U.S., highest death toll in 40 years. By Associated Press. September 26, 2018. Flu vaccine vials Vials of flu vaccine ...

The US is looking at a death toll in the hundreds of thousands here.