FOX 2 - For 31 years - Deborah Gatewood wore the Beaumont badge doing blood draws at the Farmington Hills hospital.
So, in the third week of March when she started coughing with a fever it is where she turned for help.
For 31 years - Deborah Gatewood wore the Beaumont badge doing blood draws at the Farmington Hills hospital. So, in the third week of March when she started coughing with a fever it is where she turned for help.
"They sent her home saying you are showing signs of COVID," said Kaila Corrothers, her daughter. "So they were confirming that she most likely had COVID, but they did not test her."
Her daughter, Kaila marked in a calendar the days her mom went to ER. She says her mom was sent home four times - with cough medicine and told to rest. Each time, the fever got higher and the symptoms worse.
"The fact that she got infected by doing the job she did for 31 years and she couldn't get taken care of by her own family, meaning Beaumont its sad," said Corrothers. "It is disheartening to say the least."
By the end of March, she withered away - developing bi-lateral pneumonia.
"All of this time when you're telling her to go home and rest it off how do you really rest off bi-lateral pneumonia other than cough medicine to cough it out, it's too severe at this point," Corrothers said.
Deborah collapsed and was taken by ambulance to Sinai-Grace Hospital - at that point, inundated and understaffed, it is where she'd spend her final days.
"I just went up to the hospital and sat in the parking lot. If this was as close as I can be to her if this is going to happen, I'm going to sit in my car until I get that phone call," Corrothers said.
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This only child said goodbye to her 63-year-old mother, two years from retiring, when she planned to be a full-time grandma.
"She said she's going to hang in there for a couple more years and she say she going to retire and be the greatest nanny I need her to be," her daughter said.
It was a different point in the pandemic a month ago when Deborah first went to Beaumont's ER. We asked Beaumont what their protocol is now for admitting people, this was the response:
"As patients come to Beaumont for care during this pandemic, we are doing everything we can to evaluate, triage and care for patients based on the information we know at the time. We grieve the loss of any patient to COVID-19 or any other illness."
Nurses reposition an intubated COVID-19 patient in a prone position in the intensive care unit at Sharp Chula Vista Medical Center, Chula Vista, Calif., on April 10. Marcus Yam/Los Angeles Times via Getty Images hide caption
Nurses reposition an intubated COVID-19 patient in a prone position in the intensive care unit at Sharp Chula Vista Medical Center, Chula Vista, Calif., on April 10.
On April 8, David Williams got a standing ovation as he was wheeled out of the John L. McClellan Memorial Veteran's Hospital in Little Rock, Ark.
Williams, 54, a Marine Corps veteran, had survived eight perilous days on a ventilator with COVID-19, and the hospital staff had lined up to give him a joyous, fist-bumping send-off.
Today, Williams is back at home with his wife, D'Anna. But a full recovery remains a distant prospect.
"I still have to wear oxygen," he says. "I have like a hundred-foot cord. And so I wear my oxygen in my nose, and I'm still able to travel all over the house."
Williams can take a few steps on his own, but still uses a walker.
"I need it like when I have to wake up in the middle of the night or something and need to go to the bathroom," he says. "Because trying to get the feet going again is a little rough."
Williams has improved a lot since leaving the hospital. And he says he might be doing better if he hadn't been out of shape and overweight when he got sick.
When Williams first woke up with a breathing tube in his throat, he had almost no control of his arms or legs. And, like most patients on a ventilator, he felt parched pretty much all the time. He couldn't drink, so one day a nurse left him a damp swab to suck on.
"It took me like five or six minutes to just pick that thing up, to get my fingers actually on it and my brain telling my hand to lift it up and you know to put it in my mouth," he says.
A selfie of David Williams and nurse Melanie Bryant during his stay at the John L. McClellan Memorial Veteran's Hospital in Little Rock, Ark. Williams spent eight days on a ventilator during treatment for COVID-19. David Williams hide caption
Williams can feed himself now. But he's still having problems with memory and thinking.
Computer passwords he's used for years are now hard to recall, and he is sometimes unable to complete sentences. "It takes me awhile to think about the words I need to say," he says.
Williams hopes he can work around these limitations and resume his job as veteran's service coordinator at the University of Central Arkansas.
If Williams makes a full recovery, he can count himself among the fortunate, says Dr. Amy Bellinghausen, a pulmonary and critical care fellow at the University of California, San Diego.
Some COVID-19 survivors will never recover completely from a condition known as post-intensive-care-unit syndrome, she says. It can produce long-term disabilities from muscle wasting, organ damage, brain damage, and PTSD.
"Unfortunately, oftentimes when they're coming off the ventilator, it's not the same person who went on the ventilator," Bellinghausen says.
One of the most common problems among ICU survivors is weakness and fatigue, Bellinghausen says. "That whole time in the ICU, they're losing muscle mass. People lose 20,30,40 pounds over a week or two."
As a result, "things like walking the dog, going up a flight of stairs, doing your laundry are really, really difficult to do," she says.
And many COVID-19 patients will also have organ damage, which can be caused by the virus itself, or the extreme measures used to keep them alive.
"People can have scarring in their lungs, sometimes kidneys are impacted, but really any organ can suffer injury in the ICU," Bellinghausen says.
The brain is especially vulnerable.
In part, that's because the drugs used to sedate patients while they're on a ventilator can have lasting effects on memory and thinking. Also, COVID-19 patients whose lungs are badly impaired in the ICU "often have times when their oxygen level is very low. And that also causes damage to the brain," Bellinghausen says.
Then there's the emotional impact.
Bellinghausen says patients who may be delirious from fever or sedation can feel trapped in a scary, noisy place where they are connected to machines that have taken control of their bodily functions. And if they move too much or try to remove a tube, they may be forcibly restrained.
All that can contribute to paranoia, she says. "They really think that all these efforts that we're doing in the ICU to try to save their life may be [us] trying to harm them. And so people come out of the ICU with pretty profound symptoms of PTSD sometimes."
Patients with life-threatening COVID-19 seem to be especially vulnerable to post-ICU syndrome, says Dr. Negin Hajizadeh, a pulmonary critical care doctor at the Donald and Barbara Zucker School of Medicine at Hofstra-Northwell in New York.
One reason is that the infection is often so severe that patients spend weeks on a ventilator, not just days. "The longer you are on the breathing machine, the steeper the road to recovery," Hajizadeh says.
As a result, many COVID-19 survivors will need months or years of rehabilitation. But a few have been able to bounce back quickly.
Matthew Robertson, 28, a tech worker who lives near Seattle, was one of the country's first COVID-19 patients, and nearly became one of the first fatalities.
"I got to the hospital on Feb. 29," Roberts says. "When I woke up I was looking at the date on my chart that was on the window and it already said, like, March 7."
Robertson spent a week on a ventilator and nearly two weeks in the hospital. Today, though, he's pretty much back to normal.
"I think the only thing that still hasn't properly recovered is the vocal range of my voice," says Robertson, who likes to sing. That's a common problem caused by breathing tubes that pass through the vocal cords.
So Robertson says he's not ready to go back to the karaoke clubs yet. But at the moment, they're all closed anyway.
As COVID-19 continues to create the perception of global chaos were all living in the 1989 Billy Joel hit song We Didnt Start the Fire the reality is tensions with traditional American foes have always been smoldering.
As COVID-19 has impacted U.S. readiness and even sidelined the Nimitz-class aircraft carrier Theodore Roosevelt, theres a brewing perception that Americas adversaries Russia, China and Iran are taking advantage of the chaos to prod American military weakness as the U.S. stumbles during COVID-19.
But a former U.S. defense official and other analysts say recent aggression by Americas adversaries is nothing new and fit a pattern of behavior established over the years. There is, however, fear the virus could cause miscalculation leading to a broader conflict.
Its just a continuation of kind of whats been going on for some time, said Mike Jones, who served as U.S. Central Command chief of staff in 2011 under then-commander James Mattis. I dont think this is brand new.
On April 19 there was an unprofessional and unsafe intercept of a U.S. Navy P-8A Poseidon over the Mediterranean Sea, the Navy announced. It was the second intercept of a P-8 over the same waters in less than a week though the Navy deemed the first incident as safe and professional.
On April 14, 11 Islamic Revolutionary Guard Corps vessels harassed six U.S. warships operating in the Persian Gulf. On Wednesday, President Donald Trump tweeted he has instructed the Navy to destroy any Iranian gunboats if they harass U.S. warships.
At the Pentagon on Wednesday, the vice chairman of the Joint Chiefs of Staff, Gen. John Hyten, a former commander of American, called Trumps tweet a useful warning to Iran.
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Voice of America reported that China has stepped up patrols in the South China Sea and that a Chinese aircraft carrier with five other ships were spotted conducting an exercise near Taiwan in April.
Youve also seen that the Chinese Communist Party is exerting military pressure on Taiwan and coercing its neighbors in the South China Sea, even going so far as to have so far as to sink a Vietnamese fishing vessel, Secretary of State Mike Pompeo said Wednesday.
The Ticonderoga-class guided missile-cruiser Bunker Hill, amphibious assault ship America, Arleigh-Burke class guided missile destroyer Barry, along with the Australian Anzac-class frigate Parramatta teamed up for operations in the South China Sea on April 13, according to the Navy.
Retired Marine Lt. Col. Dakota Wood, a senior research fellow with the Washington D.C.-based think tank The Heritage Foundation, told Military Times that recent machinations by American adversaries fit established patterns of behavior," but still serves as a reminder that global competition still rages and the U.S. military needs to be postured to deal with it.
Whether it is exploiting a perception of U.S. military readiness, only they would know that," Wood said.
Before COVID-19 even became a part of our vocabulary we had Iranian gunboats that would make runs at U.S. Navy ships, he explained. The Russians have been buzzing our aircraft for a very long time.
I think its business as usual despite COVID-19, said Aaron Stein, the director of Middle East and national security projects for the Foreign Policy Research Institute. Iran has not stopped its policy of coercion, stemming from U.S. actions taken to reimpose sanctions.
But COVID-19 could create false perceptions of weakness and disunity causing an adversary to wrongfully assume the U.S. will not respond to certain actions that could turn into a broader conflict.
The U.S. is politically weak COVID-19 is proving it every day. Whether or not these actors want to press the Trump administration is a different question, Eric L. Robinson, a former U.S. defense, official told Military Times.
Robinson said he helped advise Elizabeth Warrens presidential campaign regarding counterterrorism issues.
COVID-19 merely is a factor that can lead to miscalculation, Jones said. If they were to assume this is one more destraction that would keep the U.S. from responding to an attack or challenge it could add to the possibility of miscalculation.
Jones said American diplomats need to be working hard during this time to ensure countries know Americas red lines to avert a conflict.
Prior to Trumps tweet threatening Iran, U.S. officials have been clearly voicing that Americas forces stand ready to deter and react to any aggression despite the ongoing pandemic.
Adversaries who think now is the time to challenge the #USA: youre dangerously wrong, Secretary of Defense Mark Esper tweeted in mid-April.
This pandemic does not curtail our duty. From patrolling the high seas to escorting Russian bombers out of U.S. airspace, our mission continues, Esper tweeted April 14.
Russian aircraft on several occasions over the last two months have entered the Alaskan Air Defense Identification Zone, but they have not breached U.S. air space.
To those who wish us harm, make no mistake: even with the challenges that this disease has brought to our shores, the Department of Defense stands ready to meet any threat and defend our nation, Deputy Secretary of Defense David L. Norquist said in early April.
The beaches of Pensacola Beach, Florida | Getty
TALLAHASSEE Republican governors across the Southeast are teaming up to reopen the regions economy, even as they lack the testing to know how rapidly the coronavirus is spreading.
One health expert called the political decision a perfect storm for the virus to reassert itself.
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The newly formed coalition includes Florida, Georgia, South Carolina, Tennessee, Alabama and Mississippi, a part of the country that has underfunded health systems, as well as high rates of obesity, diabetes and other illnesses that amplify the deadliness of the coronavirus.
And unlike their peers in New York, New Jersey and other Northeastern states that have been working cooperatively since last week to restart their economies, the six in the South have lagged on testing and social distancing measures.
If you put these states together, there is a perfect storm for a massive epidemic peak later on, said Jill Roberts of the University of South Floridas College of Public Health. The Southeast region is not known for having the best health record. Diabetes and heart disease come to mind. I am very concerned about how our states will do it.
Its not evident how the coalition will work. Florida Gov. Ron DeSantis mentioned the move Tuesday on "Fox & Friends," but there was no formal announcement or much communication from other states involved.
We have had a meeting with all the Southeastern governors Mississippi, Alabama, Georgia, Florida, South Carolina, and Tennessee, DeSantis said. And we shared a lot of ideas. I think we will be the same page on some stuff.
Governors from Georgia, South Carolina, Tennessee, Alabama and Mississippi did not respond to questions.
DeSantis communications director Helen Aguirre Ferr wrote on Twitter that the six states would be working in a coalition.
As of Tuesday morning, the six states had collectively tested about one-tenth of 1 percent of their total populations. Mississippi, which ranks 15th nationally in testing, had the groups best testing rate at 1.7 percent of its population. Georgia was the lowest, with a testing rate of less than one one-hundredth of 1 percent, or 42nd in the country, according to the Covid Tracking Project.
By comparison, the coalition of seven states in the Northeast has a collective testing rate twice that of the Southeast, having swabbed more than two-tenths of 1 percent of their collective population.
Five of the seven states included in the Northeastern coalition are in the top 15 nationally in per-capita testing.
Beyond the numbers, the two regions differ culturally and in the political instincts of their leaders. Even as the Northeast looks to band together, its governors are urging caution.
Southern governors, most of whom have built political careers on small-government conservatism, are driving, by contrast, to restart their economies and get people back to work, even as infections mount.
Southern governors, including DeSantis, point to their slowing rate of increases of positive tests and falling numbers of hospitalizations.
On Tuesday, DeSantis jabbed the media and public health experts for predicting initially that state hospitals would be overwhelmed.
Our work is succeeding, DeSantis told reporters. We flattened the curve.
Dr. Aileen Marty, a pandemic and infectious disease expert at Florida International University, said gains made through social distancing and other precautions are good signs, but not the signal to loosen efforts that Southern governors think they are.
They are heavily Republican with social conservatives who are all of a like mind, Marty said. They are tempting fate by having the virus out and about among us, but if they dont do it in a controlled way, we will again be back in situations of overwhelmed hospitals and more people dying.
She praised Republican Miami-Dade County Mayor Carlos Gimenez, who has not pushed as hard to reopen areas of his county, including beaches. Gimenez has said the county should considering reopening, but is not moving at the same pace as DeSantis and some governors.
They are making decisions with inadequate knowledge, Marty said of the governors. They should be more like Carlos Gimenez, and put in strict measures on how people should behave when initially out.
Georgia drew national attention and some ridicule after Republican Gov. Brian Kemp said Monday that he would allow bowling alleys, gyms, nail salons and massage therapists to reopen on Friday, and let theaters show movies starting Monday, even as he admits the number of cases is likely to grow.
This is the right approach at the right time, Kemp told reporters Monday. Were probably going to see our cases continue to go up, but were a lot better prepared for that now than we were over a month ago.
Roberts, with the University of South Florida, called the move fraught with peril.
I kind of enjoyed Gov. Kemps talk about reopening these places with screening. He did not say testing. That capacity does not exist, Roberts said. My guess is he meant taking temperatures, which as we know is pointless, because asymptomatic people can carry and spread the coronavirus.
Former Food and Drug Administration Commissioner Scott Gottlieb was equally blunt.
Gyms, nail salons, bowling alleys, hair salons, tattoo parlors, he said Tuesday on CNBC. It feels like they collected a list of the businesses you know that were most risky and decided to open those first.
As COVID-19 cases in the United States passed 700,000 today, researchers published early findings that suggest, as expected, the disease is more widespread than case numbers reflect.
And in international developments, outbreak totals climbed in parts of Asia, including Japan, Indonesia, and Singapore, as well as in Russia. US cases reached 726,645 cases, with nearly 39,000 deaths, according to the Johns Hopkins online dashboard. The global total stands at 2,310,572 cases from 185 countries, with 158,691 deaths.
Testing issues continue to hobble states plans to ease off stay-at-home orders, and yesterday at a White House briefing, President Trump said the administration will be sending 5.5 million swabs to the states, though he signaled the governors have the capacity to provide them, CNN reported. And in an interview with PBS, Vice President Pence said the administration is focusing on expanding unused capacity at labs.
Meanwhile, the American Association for Clinical Chemistry in a statement yesterday said supply chain issues, such as personal protective equipment, swabs, and reagents are obstacles to scaled-up testing and that the White House is in the best position to coordinate resources, the Washington Post reported.
Yesterday, 130 Republican House members had a conference call with Health and Human Services Secretary Alex Azar and other officials, and aired questions about testing and supply shortages, but federal officials reiterated that it's up to state and local officials to obtain supplies from manufacturers, according to the Post report.
Meanwhile, Democrat lawmakers who had a conference call with Pence yesterday also focused their concerns on testing issues, but some voice frustration with unclear answers and the continued assumption that states are responsible for unraveling the testing problems, according to the CNN report.
In another testing related development, contamination at a Centers for Disease Control and Prevention (CDC) lab delayed the distribution of COVID-19 tests to states, the Washington Post reported today. Citing scientists with knowledge of the situation and federal regulators, the report said cross contamination probably stemmed from assembling chemical mixtures in a lab space that handled synthetic coronavirus material, a practice that didn't follow CDC procedures.
It took the CDC a month to remove the problem step from its test kits, adding to delays in the rollout of the test. In the middle of February, the CDC had said there was a problem with one of the reagents, that the test wasn't performing consistently at state labs, and that problem reagent would be manufactured.
In another federal government development, the US Department of Agriculture (USDA) announced a $19 billion COVID-19 food assistance program to support farmers, ranchers, and consumers. It targets $16 billion in direct relief to farmers and ranchers and $3 billion to buy fresh produce, dairy, and meat to provide food boxes to food banks and other nonprofit groups.
Three new studiestwo involving seroprevalence and one analyzing a home-based polymerase chain reaction (PCR) testrevealed early clues about how widespread the disease is in some US communities.
A study of seroprevalence in Santa Clara County, Calif., by a team based at Stanford University found that based on three scenarios for test performance, the population prevalence ranged from 2.49% to 4.16%, suggesting that 48,000 to 81,000 people in the county were infected by early April. They published their findings in the preprint server medRxiv.
The authors enrolled participants through Facebook ads, and the sample size included 2,718 adults and 612 children who were tested at one of three drive-through testing locations. At the time of the study, Santa Clara County had about 1,094 cases, the largest in northern California. The test kit, made by Premier Biotech, based in Minneapolis, was tested in Stanford labs before it was used to test study participants.
Researchers not involved in the study who weighed in on Twitter noted a "consent bias" in the study, meaning participants may have volunteered, because they had been sick with COVID-19. Natalie Dean, PhD, with the University of Florida Department of Biostatistics, on Twitter also raised concerns about unstable population weighting, wide uncertainty bounds after adjusting for clustering, and test specificity.
In Chelsea, Massachusetts, a seroprevalence study of 200 city residents conducted this week by a team from Massachusetts General Hospital found that 64 (32%) had antibodies to the virus, the Boston Globe reported. The participants were generally healthy, though half said they had at least one symptom of the illness in the past 4 weeks. The city is one of the state's hot spots and earlier this week had recorded at 712 cases, at least 39 of them fatal.
Meanwhile, a home-based swab testing study launched on Mar 23 by the Seattle and King County health department and the Seattle Flu Study group found that of 4,092 samples, 44 (1.6%) were positive for COVID-19. In a blog post, researchers said the proportion of positive tests was lower than testing through the medical system, but may still represent thousands of unrecognized community infections. Prevalence declined over the testing period, but the drop wasn't statistically significant.
The team urged caution in analyzing the findings because of the sample size and said it's too early to draw general conclusions from the data.
At the international level, Russia for a sixth day in a row reported a record high number of COVID-19 cases, the Moscow Times reported. The country reported 4,785 cases, raising its total to 36,793. So far, at least 313 people have died from their infections. The country's hot spot is Moscow, which is on lockdown at least until May 1. A city health official said Moscow is still 2 to 3 weeks away from its peak and warned that difficult days are ahead.
In Italy, where illnesses and deaths are still high but slowing, experts said at a briefing yesterday that the lockdown had reached a lid on its benefits and that the main source of infection is now families, the Canada-based Globe and Mail reported. They said the only way to drive illness levels down further is to isolate people who test positive in treatment centers away from their relatives.
In Asia, Japan's outbreak continues to accelerate, especially in Tokyo, and cases have now passed 10,000, Reuters reported. The country's prime minister recently extended the state of the emergency to the whole country, and health officials warn that disease spread to rural areas could overwhelm health systems.
Singapore reported a record-high daily total of 942 cases today. The country's health ministry said of the latest cases 893 involve foreign workers living in dormitories, 27 are foreign workers residing outside of the dorms, and 22 are community cases.
Elsewhere, Indonesia, which is experiencing a spike in infections, health officials extended social distancing measures to people on the main island of Java and in West Sumatra, areas that have seen significant increases, Bloomberg News reported. The country has expanded its measures outside of Jakarta, its main hot spot.
Indonesia, the world's fourth most populated country, reported 325 cases today, down from 407 yesterday, raising its total to 6,248. And China today reported 27 new cases, 10 of them local cases form Heilongjiang (7), Guangdong (2), and Sichuan (1) provinces, according to the National Health Commission. It also reported 54 more asymptomatic cases, 3 of them imported.
Antitrust enforcers need to be vigilant in these uncertain and troubling times. Think about the effect on consumers from price gouging, price fixing, mergers in concentrated markets and the unilateral exercise of monopoly power. We rely on vigorous rivalry between firmsin good times and badto deliver us quality goods and services at competitive prices. The American consumer remains entitled to the benefits of competition, especially during a major health and economic crisis. It is up to federal and state enforcers to serve as the economic cops on the beat as we begin the long road to recovery.
What needs to be done? In the short term, the Department of Justice and the Federal Trade Commission need to facilitate legitimate cooperation among manufacturers, distributors, and retailers to ensure critical goods and servicesthink masks and respiratorsget to market in a timely fashion. To their credit, the two agencies are trying to do just that. In late March the two agencies jointly announced an expedited process for reviewing and green lighting collaborations of businesses working to protect the health and safety of Americans during the COVID-19 pandemic. And true to their word, 10 days later DOJ formally advised certain medical supplies distributors that it would not stand in the way of a joint effort to work with FEMA and expedite sourcing, production and delivery of personal protective equipment.
But getting out of the way at the right time is just one priority. Antitrust enforcers must be vigilant in attacking efforts by firms to limit competition in a time of crisis. And the temptation will be there. Those of us involved over the years in investigating and prosecuting price fixing and bid rigging know well that the urge to cartelize markets is strongest in the face of falling prices triggered by reduced demand. Although it is often rationalized during tough economic times as not raising prices, just stabilizing them, or just protecting our margins, not increasing them, agreements between companies that restrict competition are per se unlawful and subject the companies and their executives to criminal prosecution. Consumers deserve the benefit of market competition regardless of where we are in the economic cycle.
The temptation to cheat is not limited to traditional brick and mortar commerce. While at DOJ in the Obama Administration we uncovered a scheme involving two online sellers of poster art on Amazon Marketplace. After experiencing shrinking margins due to price competition, executives of the two companies got together and wrote an algorithm that priced their online offerings identically when consumers searched for poster art. The result was corporate and individual criminal charges.
Antitrust enforcers will need to vigilantly police mergers and acquisitions as the economy struggles to regain its footing. Our sudden but necessary shutdown has put business of all sizes at risk of permanent closure. Economists see small businesses as particularly vulnerable, and the CARES Act only begins to address the problem. Policy makers must continue to provide financial support and other incentives to keep small and medium-sized businesses afloat. But realistically, not all businesses are going to be able to get up and running again. That means many markets are going to become more concentrated. We will see it in all sectors, from agriculture and retail to manufacturing and travel. Fewer competitors means less competition, more market power for some sellers and some buyers, and more risk of tacit price coordination. At the end of the day consumers will pay more.
And competitors will want to combine. We have seen this before as the U.S. and world economies struggled to get back on track from prior recessions. Firms will see horizontal and some vertical mergers as the quickest way to raise shareholder value. That is where tough merger enforcement will be critical, because shareholder value should not be given priority at the expense of the American consumer. It is easy to imagine scenarios where airlines or cruise ship companies, supermarket and drugstore chains, agricultural producers and processors, and wireless providers will argue that the weakness of one or more firms in those sectors requires consolidation and quick merger approval. In unconcentrated markets, that may be the right outcome, but in markets with just a handful of players, that is likely to be the wrong move for the American consumer, with long-term adverse consequences on innovation, quality, and price.
There is an exception in antitrust law allowing a competitor to acquire a failing firm in limited circumstances. The would-be buyer must show that it is effectively the only company willing to pay any meaningful value for the distressed firm. That is rarely the case. A competitor in a concentrated market may well be willing to pay the most for the firm. But if this is a market power premium premised on the belief that the buyer will be able raise prices to consumers and recoup its acquisition costs at our expense, the merger should not be allowed.
We face an uncertain path to economic recovery in the days, months, and years ahead. The public policy choices we make today and tomorrow will live with us for a long time. We need to make sure the steps we take to get back to normal do not irreversibly alter markets and deprive consumers of competition in the long run. Our antitrust enforcersthe economic cops on the beathave a big job to do.
CRETE, Neb. (News Channel Nebraska) -- 10/11 media partner News Channel Nebraska reports five new confirmed cases of COVID-19 have been tied to Smithfield Foods in Crete.
Public Health Solutions reported the five cases on Wednesday. The individuals include four men, ranging in age from their 30s to 60s, and one woman in her 40s.
There are now six confirmed COVID-19 cases associated with Smithfield Foods.
Additional cases of COVID-19 have also been confirmed at the Tyson Foods plant in Madison.
According to News Channel Nebraska, the Elkhorn Logan Valley Public Health Department said a total of 29 confirmed cases of COVID-19 have stemmed from employees of the plant.
Another 56 tests are still pending in the district, but it's unknown whether any of those tests are connected to Tyson employees.
The health department has sent quarantine directives to Tyson to be used for all symptomatic workers, including a mandatory minimum two-week quarantine for anyone at the plant experiencing COVID-19 symptoms.
A laboratory technician wearing full protective equipment holds a container of live samples taken from people tested for the novel coronavirus. (Andrew Milligan / Pool/AFP via Getty Images)
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If you watch the news on television during the age of Covid-19, youll see a kind of story often featured on the legacy networks and cable stations. Heartwarming and filling you with hope, these stories are about a survivorsomeone who was in an intensive care unit, on a ventilator, and not expected to live for much longer. Then, a plucky spouse fights to get his or her partner access to an experimental treatment, and, once it is administered, the near-dead rise up like Lazarus. Except most of these stirring tales are tall ones, not true in the causal sense. That is, while our valiant couple may vanquish their SARS-CoV2 infection together, their stories do not provide evidence that the new drug was behind these stunning clinical reversals of fortune. With many diseases, people often just get betterwith or without an experimental treatment. That is why we do randomized clinical trials: to keep from fooling ourselves.Ad Policy
Over the past few months, weve seen this cycle of hope and disappointment play out with several drugs. The most famous couple was hydroxychloroquine and chloroquine, which were touted by President Donald Trump and even led his China trade adviser Peter Navarro to scold our nations leading infectious disease researcher, Dr. Anthony Fauci, for not being sufficiently credulous about the evidence that was out there. Ive seen these boom-and-bust cycles beforein the 1980s and early 1990s during the age of HIV/AIDS, when, for over a decade, we grasped in desperation for the latest cure. In the mid-1990s, we developed drugs that finally brought that virus under control, making AIDS a chronic, manageable illness for those who had access to these medications.
There are four classes of treatments currently under study for use against SARS-CoV2 and Covid-19: antiviral medicines, which are meant to attack SARS-CoV2 itself; the two quinolines, hydroxychloroquine and chloroquine, which, although used for malaria and lupus, have been tested for indirect antiviral activity as well; immunomodulatory therapies, often antibodies targeted at disease-fighting molecules in our own body (these can end up doing more harm than good in what are known as cytokine storms, where our immune systems in overdrive starts devouring us); and convalescent plasma, blood products from survivors of Covid-19, which are thought to be enriched in antibodies that can target the virus through passive transfer to another patient with the same blood type. All of these have been in the news.
I talked to a few of my colleagues who worked with HIV/AIDS about the landscape of treatments for Covid-19: Dr. Rochelle Walensky, chief of infectious diseases at Massachusetts General Hospital; Dr. Robert Chip Schooley, a professor of infectious diseases and global health at University of California at San Diego; Dr. Carlos Del Rio, a professor of infectious diseases and global health at Emory; and James Krellenstein, an AIDS activist with the group PreP4All in New York City. Each of them is now working on Covid-19 and following the research closely. Some are treating Covid-19 patients themselves. All of them agree: None of these therapies have yet been shown to be effective as treatments for SARS-CoV2 or the disease it causes. We have to wait to see what happens in the clinical trials. Data from those should be forthcoming in the next few weeks or months. MORE FROM Gregg Gonsalves
Meanwhile, many of these therapies are being used around the country off-label or as part of expanded access programs, in which drug companies offer their experimental treatments to patients with no other options. However, the impact of these agents on individual patients doesnt signal a breakthrough on Covid-19; nor do the results from small, poorly designed studies or preliminary results from clinical studies underway.
Just this week though, the prospects for the quinolines took a hit. Without evidence for benefit from clinical trials, a panel at the National Institutes of Health issued recommendations against the use of hydroxychloroquine in combination with the antibiotic azithromycin because of toxicities associated with this two-drug cocktail. In particular, these two drugs in combination can cause a type of irregular heartbeat that can lead to cardiac arrest. This same panel also warned against the use of a class of immunomodulatory molecules, called interferons, outside of the context of clinical trials as well, as they have their own toxicities and havent been shown to be effective against SARS-COV2s cousins, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).
So where does that leave us? First, we have to wait. Acting without evidence has consequences. Untested medicines are not uniformly helpful and can, in fact, present dangers to those who try them even as a last resort. Weve seen this throughout the history of medical research, where a new drug can shorten life, or make a disease worse. In what is known as the therapeutic misconception, we wrongly assume if its being studied in a clinical trial, it must be beneficial to us.Current Issue
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If you have Covid-19, what do you have to lose? Without evidence of clinical benefit from well designed randomized clinical trials, the life you lose could be your own. Weve also got to beware of policy vultures, who never let a crisis go to waste. These are groups, like the Goldwater Institute and others, who see this moment as just another reason to suggest that the FDA is standing in the way of access to new treatments and demand rollback of more regulations that protect us from unsafe and ineffective drugs. Lastly, we have to keep an eye on the state of medical research and drug development.
Weve seen a crisis in leadership throughout the SARS-CoV2 pandemic. Its absolutely crucial to advocate for a coordinated, fast-tracked effort bringing together all our nations research agencies, academic centers, and drug companies to move us more expeditiously to the goal of an effective treatment for Covid-19. James Krellenstein, from PreP4All, which is issuing a report shortly on the state of antiSARS-CoV2 research, warned me this week that what theyre seeing is a lack of leadership of this critical national project.
The problems that PreP4All are documenting run from basic tasks like coordinating high-throughput screening of candidate molecules active against SARS-CoV2 among all the compound libraries in the United States, in private hands or run by the US government, to the management of clinical trials to ensure we have adequately powered, well-designed studies targeting treatments based on the best scientific evidence and preliminary data. Susan Ellenberg, a professor of biostatistics at the University of Pennsylvania underscored this last point to me in a recent email: Many sites, especially those with large numbers of patients, are doing their own trials. But we will get answers faster if people collaborate. As some treatments show evidence of benefit we will be moving to studies of drug combinations and these trials will require larger sample sizes, meaning in most cases multicenter trials.
Thats whats needed. Instead. as this article goes to press there are over 100 studies of hydroxychloroquine underway, listed in the federal clinical trials registry, based on hype, hope, and desperation.
One of the many unknowns about the novel coronavirus SARS-CoV-2 is how we might become immune to it. When you get infected with viruses, along with other baddies like bacteria, your immune system fights back by producing proteins called antibodies. These stick around for the long haul, and your body is prepared to churn out more of them if you come into contact with the pathogen again.
It's how vaccines work: By introducing a dead or weakened version of a virus to your immune system, you trick it into producing antibodies in response. Then if you come into contact with the real virus, your body will be ready.
Viruses vary widely in terms of the immune response they elicit. For instance, if you got chicken pox as a kid, you are likely to be immune to reinfection for the rest of your life. With whooping cough, immunity might last for up to 20 years, and for the H1N1 flu strain, up to 10. With the seasonal coronaviruses that cause the common cold, immunity fades after a few months, which is why you can pick up new infections year after year.
But when it comes to SARS-CoV-2, because this is such a new infection, were not sure how long those antibodies hang around for, says Dr. Seema Yasmin, director of the Stanford Health Communication Initiative.
Our best bet may be to compare it to the original SARS coronavirus, SARS-CoV. In patients infected with this virus, antibody levels peaked between two and four months after infection and offered protection for two to three years. I think the glimmer of hope might be that theres so much genetic similarity between SARS-CoV-2 and SARS-CoV, adds Yasmin.
Read all of our coronavirus coverage here.
Speaking of genetics, another virus to consider as a comparison is HIV. This virus is so difficult to treat because it mutates like mad as it multiplies. The human body might develop an antibody, but it's one that will become less effective as the virus changes. Some good news on the coronavirus front is this virus does not seem to mutate anywhere near as frequently as HIV mutates, says Yasmin. That means it stays much more consistent, and it means we have far less of a moving target.
Discovering more about how immunity to this new coronavirus works will be key to fighting the pandemic. The more people who become immuneeither from beating an infection or from receiving a vaccinethe closer we get to herd immunity, or the point at which most members of the population have antibodies. Then well start to slow and eventually stop the pandemic.
To learn more about how antibodies work, and how they might help in the fight against the coronavirus pandemic, check out our video with Yasmin above.
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The largest union representing Las Vegas casino workers is condemning the mayors call for those businesses to reopen immediately.
Some context: Las Vegas Mayor Carolyn Goodman said on CNN today that businesses including casinos should reopen, but offered no guidance on how to do it safely.
They better figure it out. Thats their job, Goodman said. Thats not the mayors job.
The Culinary Union says it supports Gov. Steve Sisolaks decision to keep casinos closed, adding, The Culinary Union is majority women and people of color, and we are not expendable.
Goodman does not have jurisdiction over the major casinos on The Strip, which are located outside of the Las Vegas city limits and are governed by Clark County.
Commissioner Michael Naft wrote on Twitter that [Mayor Goodmans] defiance of Gov. Sisolaks stay-at-home order is reckless and dangerous.
The Nevada Gaming Control Board says it is not yet safe for the states casinos to reopen.
According to Governor Sisolaks medical advisory team, the data related to the spread of COVID-19 does not support the reopening of gaming establishments in Nevada at this time, the board says in a written statement.
