A Texas-based health care system announced Tuesday that it would convert one of its hospitals in Boston into a treatment center specifically for patients with Covid-19, taking special measures to clear the air of contamination and increasing its supply of ventilators and personal protective equipment.
The company, Steward Health Care, said Carney Hospital, located in Bostons Dorchester neighborhood, would become the nations first dedicated care center for treating patients with Covid-19, the disease caused by the novel coronavirus.
In a statement Tuesday, Steward Health Care said, among other measures, crews are adding negative pressure systems that clear the air of any contamination. The goal is to ensure that people who are hospitalized with severe Covid-19 infections can receive the dedicated care some require, as well as to allow regular operations at the companys other sites.
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We are prepared for an influx, the company said, though, as of now, the companys hospitals nationwide have treated just 10 patients with confirmed infections. The company, which is based in Dallas, has 35 community hospitals in nine states.
A significant amount of our resources remains centralized, ready to be deployed or redeployed across our different regions if and when they are needed, the company said.
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Hospitals around the country have already been allotting certain floors to treat Covid-19, canceling elective surgeries and other procedures that can be delayed, and postponing some appointments.
The concern is that a crush of Covid-19 patients could require all of a hospitals resources and equipment. Though its estimated that only a few percent of infections cause critical disease, a rapid spread of the virus throughout communities could still leave thousands of patients requiring intensive care and needing to be put on ventilators for long stretches of time.
Already, some hospitals have reported shortages of personal protective equipment like masks, gloves, and gowns, and some providers have said they have resorted to cleaning and reusing supplies they would have normally discarded. Though the availability of supplies varies around the country, some facilities have said theyre facing a lack of basic materials as well, including nasal swabs that are needed to conduct test for the virus.
On Sunday night, her sons fever spiked, and in the morning he woke with body aches, a sore throat and a bad headache.
The mother, a nurse practitioner in the Birmingham area, told APR on Tuesday that shed spent the morning trying unsuccessfully to get her 10-year-old tested for COVID-19.
She wasnt able to, in part because drive-thru testing at the Church of Highlands Grandview campus closed after hundreds of cars clogged U.S. 280, cutting off access to and from a nearby hospital.
But there are also concerns over a lack of tests and testing supplies in Alabama and across the country, and public health officials cautioned that those without symptoms dont need to be tested, which could overwhelm a system already under strain.
She first called a pediatrician and was told the office couldnt help her.
Theyre seeing patients with fever via telehealth, they will not stop for strep or flu, she said.
She was told to call Urgent Care for Children, which is operating drive-thru COVID-19 testing for people up to 20-years-old, but her son wasnt experiencing a cough at the time, so she was turned down for a test.
She said we have a limited number of tests, which is completely understandable, she said.
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Her son has since developed a cough, so she tried to get him tested at the Church of the Highlands Grandview campus only to find herself stuck in traffic next to others on U.S. 280, who seemed to also be trying to get to the church.
I saw people enjoying conversation and laughing, and I saw a lot of people smoking cigarettes out of their car windows, she said. Theres no way that all these people meet criteria for testing and Ive got a sick kid in my backseat.
By the time she got up to the intersection, police officers were telling drivers that the testing site was closed.
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They didnt say why at the time, but it was very clear to me, looking at Grandview hospital, that this was really compromising access to the hospital, she said.
Attempts Tuesday to reach the church were unsuccessful, but Al.com reports that the church will move the testing to the churchs Grants Mill Road campus and reopen for testing on Wednesday.
She said theyve left a message with Urgent Care for Children and will try there again on Wednesday since hes developed a cough.
So Im hopeful, but if that doesnt pan out, I have no idea, she said.
As a health care provider herself, the nurse said shed like to see more communication to the public about who needs to be tested and who doesnt.
Try to keep people from panicking, but we need more tests, and we need more testing capacity, she said. Its not just the test, its the people who are going to process those tests.
Thats a concern expressed by Dr. Jeanne Marrazzo, head of infectious diseases at the University of Alabama at Birmingham, who told reporters Monday that the state simply doesnt have the staffing and resources to test as quickly and as widely as is needed.
Marrazzo urged the public to seek a test only if they have symptoms, which are fever, shortness of breath and a cough.
Its a message echoed by other state health officials in recent days who have pleaded for the public to first call the states COVID-19 hotline at 1-888-264-2256 before driving to a testing location.
Sen. Doug Jones, D-Alabama, on Tuesday told reporters that were seeing long lines in the drive-thru test center yet people are still having trouble getting a test.
Ive got a friend who sent me a text just a moment ago, whos been trying to get a test for five days. Now shes got symptoms, shes got a fever, shes got respiratory issues, but she cant get a test, Jones said. And that is in part because so many people are willing to get tests that dont really have any symptoms and arent really sick. Im not criticizing. What Im asking people to do is to hold back if you dont have a fever and respiratory issues.
The nurse said she also worries that if theres a panic, asymptomatic people could flood emergency rooms and primary care offices, which would cut off access to care for people like her son, whose fever had come down some Tuesday afternoon.
Hes probably improving, and I hope that will continue, but again, I dont know. I cant be certain of what it is without testing, she said.
After 3 hours on hold with Urgent Care for Children, the nurse said she was able to get her son an appointment to be tested later on Tuesday.
That took far too much effort for someone who even knows how to navigate the healthcare system. I cant imagine what its like for those uninsured, she said.
The first COVID-19 case in the United States was discovered in January. Since then approximately,12,000 tests have been conducted by U.S. public health laboratories. South Korea also announced their first case in January, and theyve conducted nearly250,000 teststo date.
A shortage of testing kits in the U.S. has been well documented, and will eventually be resolved. But patient costs will continue to be front and center. We must prevent high costs from decreasing the availability of testing and treatment. The U.S. Department of Health and Human Services must cover vaccination (once a vaccine is developed and approved), diagnostic testing and treatment without any cost-sharing (i.e. co-payments, co-insurance or deductibles).
As the pandemic explodes across the country, we know that costs are weighing heavily on the minds of many Americans andlegislators.
Americas Health Insurance Plans (AHIP), the chief lobbying organization for private insurers, recently announced that it will work to ensure out-of-pocket costs are not a barrier to people seeking testing for, and treatment of, COVID-19. But this is not enough.
Insurance is complicated and hard to navigate. With complex networks and bills that frequently perplex beneficiaries, many rightlyquestion AHIPs transparency. Meanwhile, President Trump hasnot been clear or accurate: after announcing that insurance companies would waive all co-pays for testing and treatment, the insurance industry pushed back, saying it had not agreed to include treatment.
The recently passed U.S.House bill would make COVID-19 diagnostic testing free for everyone, but it remains to be what will happen with the legislation in the U.S. Senate. A uniform requirement from the federal government is needed to clarify what services are covered, and how expensive they are.
As healthcare providers, we are disheartened that we cannot tell our patients who are literally and figuratively worried sick how much the COVID-19 care they need and deserve will cost.
In the early stages of a local outbreak,Massachusetts-- along with several other states, includingWashingtonandNew York-- issued a bolddirectivefor free diagnostic testing and in some cases treatment. The U.S. government should follow the lead of these states.
A uniform requirement from the federal government is needed to clarify what services are covered, and how expensive they are.
There is precedence for requiring private insurers to cover preventive care (vaccines and screening tests) without cost-sharing. Under the Affordable Care Act (ACA), private insurersmust covervaccines approved by the Centers for Disease Control and Prevention (CDC) without cost-sharing.Diagnostic testing, while not strictly a preventive service, should also fall under the purview of the ACA mandate. Vaccination coverage clearly falls under the current requirement by the ACA. For example, influenza vaccination is covered under this directive.
The eventual COVID-19 vaccine should be treated similarly, and must be added to the CDCs list of covered vaccinations to make this possible.
Vaccinations require herd immunity, a concept in immunology that dictates a critical mass of the society needs to have immunity to prevent community spread of an infectious disease. If the immunization is free at the point of care, Americans willmore readily obtain it.
In the case of a pandemic disease such as COVID-19, diagnosis is preventative care because it encourages better compliance with isolation measures intended to avoid disease spread. Testing could also streamline quarantine and isolation measures if cases are detected earlier.
A federal directive requiring free access to diagnostic tests, treatment and the eventual vaccine will reduce the spread of the virus within communities.
One of the most progressive measures the U.S. government could take, would be waiving all cost-sharing related to COVID-19 care. In the past few years, there has been an increase in high deductible health plans. Many underinsured individuals will facecost-sharing exceeding a thousand dollarsto receive inpatient care.
While no precedent that we are aware of exists, covering all treatment related cost-sharing is morally and financially responsible. Decreasing barriers to care will likely help control community spread and thereby reduce U.S. health system costs overall. Worst-case estimates implyover 20 million Americans could be hospitalized. Unsurprisingly, insurers oppose removing cost-sharing related to COVID-19 treatment. However, it is possible for a compromise to be reached that would waive most elements of cost-sharing such as deductibles for related treatment.
A federal directive requiring free access to diagnostic tests, treatment and the eventual vaccine will reduce the spread of the virus within communities. Federal intervention also provides a regulatory framework to enact faster responses to future public health crises.
Coronavirus is a threat. To thoroughly contain it, we must thoroughly screen for it. And to thoroughly screen for and prevent it, the U.S. government must make allCOVID-19 care free for patients.
Nicole Bustosis a rising fourth-year graduate student at Massachusetts Institute of Technology. Her research examines transmission of respiratory infectious diseases.
Alex Pomerantzis a rising fourth-year medical student at Harvard. He has conducted health care delivery and public health research that has been published locally and nationally.
Aakash Shah M.D. M.B.A. M.Sc.is a practicing emergency room doctor and public health expert who was involved in the care of the first confirmed cases of COVID-19 in New Jersey.
Follow Cognoscenti on Facebook and Twitter.
SEATTLE -- The first people to roll up their sleeves to receive an experimental vaccine for the coronavirus say they were inspired to help because they wanted to do more to fight the disease than wash their hands and work from home.
Three of the study participants spoke to The Associated Press on Monday following the trial's first injections in Seattle. They said the shots were no more painful than an ordinary season flu vaccine.
Some will get higher dosages than others to test how strong the dose should be. They will be checked for side effects and have their blood tested to determine whether the vaccine is revving up their immune systems.
The volunteers said they weren't acting in hopes of protecting themselves. They understand their role is a small part of what could be an 18-month hunt for a successful shot that could be distributed widely.
They work in the tech industry and in health research. Two have children, and all three are working from home to slow the spread of COVID-19.
They are a 43-year-old operations manager at a small tech company, a 46-year-old network engineer at Microsoft and a 25-year-old editorial co-ordinator at an independent global health research centre at the University of Washington.
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Jennifer Haller, 43, still cuts up apples for her 16-year-old son and 13-year-old daughter each morning, even though the teenagers now make their own lunches. She leaves for work before they head to school on a normal day.
On Friday, however, the governor ordered the closure of all Washington state schools that were still open. Her company wants everyone to work from home.
Her husband, a software tester, was laid off last week, a move unrelated to the pandemic. The family's income was cut in half. The job market looks grim.
"I figure we probably need to prepare for him to be off work for six months," she said.
Haller works as an operations manager at a small tech company that normally runs out of a shared working space in Seattle. She learned of the vaccine study through Facebook on March 3, the day Kaiser Permanente Washington Research Institute started recruiting. She submitted her application immediately.
Two days later, she was dining at a Mexican restaurant when she answered a phone call from an unknown number. It was a member of the research team asking if she wanted to participate and if she had 15 minutes to answer some questions. She interrupted her dinner and agreed.
"We all feel so helpless. This is an amazing opportunity for me to do something," she said Monday.
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Neal Browning, 46, lives in Bothell, Washington, north of Seattle, with his fiancee and their daughters. He works as a network engineer at Microsoft, one of the first companies to require its employees to work remotely.
At a neighbourhood gathering Sunday, Browning watched his daughters and other children improvise a game of tag without touching each other. They'd been told about social distancing, a way to fight the virus by staying away from others.
"Kids are fairly adaptable," Browning said. "If you give them a set of rules, they like to follow them if at all possible."
Browning and his fiancee have three daughters between them, ages 8, 9 and 11. The girls are proud of him for testing the first vaccine for the new virus, he said.
"Every parent wants their children to look up to them," Browning said Monday after his shot. But he's told the girls not to brag to their friends too much. "It's other people too. It's not just Dad out there."
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Rebecca Sirull, 25, barely stopped working to get her shot Monday, participating in a conference call for work while sitting in the research institute's clinic.
She moved to Seattle from the Boston area in December to work as editorial co-ordinator for the Institute for Health Metrics and Evaluation.
She lives in an apartment with roommates, and her social life took a hit with the coronavirus restrictions. The ultimate frisbee team she joined for the spring season is no longer playing: "Our very first game was cancelled," she said.
"The dating scene is kind of on hold for the moment," Sirull added. "You know, people talk about finding their quarantine buddy, but I'm happy to kind of wait another couple months. You know, it's not that pressing an issue right now for me."
She's heard friends make dark jokes about parallels between the coronavirus pandemic and the start of every zombie apocalypse movie ever made. "I say, `No, guys, it doesn't have to go that way!"'
She joined the vaccine study as "a way to contribute to the situation in a positive way, considering, you know, the main guidelines that we all have right now are to stay home and do nothing, which is sort of a hard message to hear when you want to help out."
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.
GAITHERSBURG, Md. (WDVM) A global life sciences company headquartered in Montgomery County is making headway when it comes to manufacturing products to stop the spread of the coronavirus.
With local facilities in Gaithersburg, D.C., and Baltimore, Emergent BioSolutions has started the development of products to prevent and treat coronavirus.
We are actively funding the advancement of two different technologies, said Sean Kirk, Executive Vice President of Manufacturing and Technical Operations at Emergent.
In a remote briefing with 6th District Congressman David Trone on Tuesday morning, executives from Emergent broke down the biology behind manufacturing therapeutic medications.
Well begin collecting plasma from citizens who have navigated their way through the infection, so they have antibodies in their blood. We can purify those antibodies to create a treatment for folks who are actively sick, Kirk explained.
Theyre also planning to collect and purify antibodies from horses to create a potential treatment.
Developing these products takes time, and theyre partnering with Maryland-based vaccine developer Novavax to bring a COVID-19 vaccine to market.
The team is in active execution of that project, they have a target of June for their clinical trial, said Senior Vice President and head of Contract Development and Manufacturing Organization Syed T. Husain.
Congressman Trone says he hopes to help the companies through the process as much as he can.
Weve got to get all hands on deck, were all part of one team and thats the American peoples health, he said.
Updated: May 25, 2018:
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Checks may come to Americans as jobs vanish
With big pieces of the U.S. economy rapidly shutting down because of the coronavirus outbreak, President Trump urged Congress to go big with a stimulus package that would include sending checks directly to many Americans.
The details were in flux. Steven Mnuchin, secretary of the Treasury, told Republican senators privately that the administration wanted to pump about $850 billion more into the economy. About $250 billion would be used to give all but the highest earners about two weeks pay each. The checks would go out sometime in April.
The pandemic is beginning to hit workers hard. Restaurants, coffee shops, gyms and other businesses are laying people off. So are hotel chains: Marriott International is furloughing tens of thousands of employees. A flood of people inquiring about unemployment insurance in New York State crashed the website.
In less directly affected industries, employers are largely trying to keep people on the payroll, even if it means cutting hours. But many lack the means to keep that up for very long.
Its simple math, said Deborah Weinswig, founder of Coresight Research, a business consulting firm. You cant have all expenses and no revenue.
Kevin Hassett, a former top economic adviser to Mr. Trump, thinks the U.S. economy could shed as many as a million jobs in March because of the coronavirus. The left-leaning Economic Policy Institute projects up to three million jobs lost by summer.
One bright spot: Amazon said it would hire 100,000 workers to handle an expected surge in demand for home delivery of household goods.
Laid off because of the virus? Theres a good chance you qualify for unemployment benefits. If youre new to all of that, here are the basics.
Researchers are racing to come up with a drug to fight the coronavirus, either by destroying it or by interfering with how it attacks the body, our science correspondent Carl Zimmer reports. At least 50 possible drugs are being studied.
Scientists at Mount Sinai Hospital in New York and the Pasteur Institute in Paris are already testing some drugs on coronavirus grown in their labs. Findings are expected at the end of the week.
A key piece of the puzzle is understanding exactly how the virus hijacks host cells. For that, researchers at the Quantitative Biosciences Institute at the University of California, San Francisco, have drawn a map of the coronavirus. That job, which might typically take two years, was done in a few weeks.
I got to the lab and said, Weve got to drop everything else, said Dr. Nevan Krogan, the institutes director. Everybody has got to work around the clock on this.
Theres work on a vaccine, too. The first human testing of an experimental vaccine began Monday in Seattle, with 45 healthy adult subjects ages 18 to 55. The trial is expected to take at least a year.
The Trump administration plans to immediately turn back anyone attempting to illegally enter the United States from Mexico in an effort to limit the spread of the coronavirus, several officials told The New York Times.
The administration officials said ports of entry would remain open to American citizens, green-card holders and foreigners with proper documentation, as well as to commercial traffic.
But the order calls for anyone found to have entered the United States away from a legal crossing point, including asylum seekers, to immediately be returned to Mexico, and not be detained or given any hearing in the United States.
Officials said the effort was intended to prevent a virus outbreak inside border detention facilities, which they feared could spread quickly among the immigrant population and border patrol agents.
President Trump has already announced restrictions on travel from China and numerous countries in Europe, where there are large outbreaks of the virus. But Mexico has had only 82 confirmed cases to date far fewer than the United States. The measure would not affect the border with Canada, which has more than 470 cases.
A new project from The Timess graphics team explores just how far coronavirus testing in the United States has lagged behind other countries. Recent data shows that about 125 people per million have been tested in the United States; Italy has tested more than 16 times as many, and South Korea more than 40 times.
The coronavirus has now been identified in all 50 U.S. states, and more than 100 deaths in the country have been linked to the illness.
France, with more than 6,600 reported cases and 148 deaths, went into lockdown on Tuesday at noon, turning Paris into a ghost town. The European Union banned all nonessential travel to 26 member countries for the next 30 days.
The French Open, a Grand Slam tennis tournament scheduled for May, was postponed until September. The Brooklyn Nets said four members of the team, including the all-star Kevin Durant, had tested positive.
St. Patricks Day passed without parades in New York City, Boston and Dublin. Bars and pubs were closed in all three cities. In Ireland, people were encouraged to celebrate the day virtually using the hashtag #StPatricksDayTogether.
Florida moved to bar beach groups of more than 10, after photos showed Gulf Coast beaches packed this week.
Two famous island resorts in the U.S. North Haven, off the coast of Maine, and North Carolinas Outer Banks are trying to seal themselves off from the virus by barring all visitors.
In Greece, the government forced the Greek Orthodox Church to suspend services. Doctors Without Borders called for the countrys overcrowded migrant camps to be evacuated.
Survive your self-quarantine: Here are our suggestions for what to watch, listen to, cook and do with your kids.
Manage your anxiety: A psychiatrist explains how simple awareness training can hack your brain to keep panic at bay.
Dont fall for myths: Vitamin C wont ward off the virus; neither will zinc, echinacea or green tea. And wearing gloves may not be protective as you think.
Master hand-washing: Experts taught us the proper technique for keeping your hands clean, including how to turn off a faucet and to scrub often-overlooked areas like fingertips and wrists. They recommend liquid soap over bars, and clean cloth or paper towels over hand dryers.
Pandemics are anti-urban, preying on the human longing for connection and the draw toward centers of capital and creativity, Michael Kimmelman, The Timess architecture critic, observes.
But its not just crowded metropolitan areas. Rick Rojas writes about how a cluster of cases has upended a rural Kentucky town.
Wall-to-wall crowds packed Disney World on Sunday, the last day the theme park was open.
One good thing that may come out of the crisis? Our tech columnist, Kevin Roose, writes: The virus is forcing us to use the internet as it was always meant to be used to connect with one another, share information and resources and come up with collective solutions to urgent problems.
The coronavirus isnt a temporary disruption its the start of a completely different way of life, writes the editor in chief of the M.I.T. Technology Review.
Seeking one last hurrah, carefree young people around the world have flouted restrictions and thrown lockdown-themed parties.
How Cardi Bs off-the-cuff video became a coronavirus anthem: It started as a 46-second monologue. It was remixed into a dance track. Now the rapper and the D.J. who transformed Cardi B's clip are promising itll help the needy.
The pandemic has brought most major sports to a standstill, but the Tokyo Olympics, set to begin in late July. Can they possibly take place?
My three kids and I are using the time to get creative together in the kitchen and reconnect with from scratch cooking. We kicked things off this morning with colorful new drinks using fruits and herbs. Tomorrow, Ill be baking my first homemade bread I found a two-hour recipe that looks amazing!
Chana Davis, Vancouver
Let us know how youre dealing with the outbreak. Send us a response here, and we may feature it in an upcoming newsletter.
Sign up here to get the briefing by email.
Lara Takenaga and Tom Wright-Piersanti contributed to todays newsletter.
As the new coronavirus shuts down countries around the world, the impact can be seen from space.
A satellite that detects traces of human activity tailpipe emissions from cars and trucks, fossil fuel burned in power plants and other industrial activities shows striking reductions in pollution across China and Italy since the outbreak first started.
Both countries have taken unprecedented measures to limit the movement of people in the hope of slowing or even containing the spread of the disease. Even in South Korea, which has put more modest restrictions on the movement of its citizens, pollution appeared to fall.
Its the first time in history weve seen something like this, said Marco Percoco, an associate professor of transportation economics at Bocconi University in Milan, referring to the speed and the size of the pollution declines in Italy and China.
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Italy is facing the largest coronavirus outbreak outside of China, with nearly 30,000 illnesses and 2,100 deaths reported so far.
Early cases were clustered in the north, where the outbreak has been especially severe, but the disease has continued to spread throughout the country.
In early March, the government imposed emergency measures restricting the movement of roughly 16 million people throughout northern Italy, including major cities like Venice and Milan. Bars, restaurants and other gathering places were closed, and citizens were asked to avoid all unnecessary movement. Soon after, similar restrictions were extended countrywide.
The impact of those restrictions can be seen in pollution readings gathered by the European Space Agencys Sentinel-5P satellite. The images show that emissions of nitrogen dioxide, a gas closely linked to vehicle exhaust, are considerably lower across northern Italy compared to the same time period last year. The region regularly struggles with wintertime smog.
The satellite data was analyzed for The New York Times by Descartes Labs, a geospatial analysis group.
In a separate analysis made public this weekend, researchers from Bocconi University reported a sizeable decline in several types of air pollution in Milan during the lockdown, including nitrogen dioxide levels and particulate matter pollution, a byproduct of burning fossil fuels that is highly damaging to human health.
It is clear people are not moving by cars, said Dr. Percoco, an author on the study, noting that vehicle emissions are a major source of particulate matter and other pollution in Italian cities. Few people are on the streets, he said, with many Italians staying home to avoid the virus.
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The drop in pollution was even starker in China, where the new coronavirus was first detected. The largest emissions reductions were seen surrounding the city of Wuhan, in Hubei Province.
Chinese officials put the region on lockdown in late January, following the Chinese New Year holiday, and have only recently begun relaxing restrictions to allow workers in key industries to return to their jobs. That includes public transportation workers and those involved in making medical supplies and other necessities.
The unprecedented lockdown, which barred the movement of nearly 35 million people, caused widespread economic disruptions, including a slowdown in manufacturing and electricity generation.
Pollution across the region plunged accordingly.
What we saw in China was a very rapid effect, said Joanna Joiner, an atmospheric physicist at NASA. The agencys own analysis found that nitrogen dioxide emissions over eastern and central China were significantly lower during January and February this year compared to what is normal for the period.
Every year, pollution dips across the country during the weeklong Lunar New Year celebration, as factories shut down and people stay home from work. (The holiday falls in late January or early February each year). But usually, emissions rebound as the country reopens for business. This year, they stayed at lower levels for weeks.
A smaller decrease in nitrogen dioxide pollution can also be seen in South Korea, around the capital, Seoul. The South Korean government did not bar the movement of its citizens but encouraged strict social distancing by closing down schools and universities, asking people to work from home and canceling large gatherings.
The social distancing measures, as well as an increasing number of people in self-quarantine, appear to have had an impact on air pollution, said Minwoo Sun, a coordinator at the Global Air Pollution Unit of Greenpeace East Asia. But further analysis is needed to fully understand the depth of coronavirus impact on South Koreas air, he added.
As more countries shut down life as usual to slow the spread of coronavirus, we may see further drops in pollution around the world, Dr. Joiner said.
Were seeing changes in human behavior, in how people are moving around and how theyre using fuels, she said. Pollution wont hide from the satellite data. Its going to tell us whats going on.
