Category: Covid-19

About 47% of US adults have an underlying condition strongly tied to severe COVID-19 illness, researchers at the Centers for Disease Control and Prevention (CDC) have found.

The model-based study, published today in the CDC's Morbidity and Mortality Weekly Report, used self-reported data from the 2018 Behavioral Risk Factor Surveillance System and the US Census.

Researchers analyzed the data for the prevalence of chronic obstructive pulmonary disease (COPD), heart disease, diabetes, chronic kidney disease (CKD), and obesity in residents of 3,142 counties in all 50 states and the District of Columbia. They defined obesity as having a body mass index (BMI) of 30 kg/m2 or higher.

They found that prevalence patterns generally followed population distributions, with high numbers in large cities, but that these conditions were more prevalent in rural than in urban areas. Counties with the highest prevalence of these conditions were generally clustered in the Southeast and Appalachia.

Severe COVID-19 disease, requiring hospitalization, intensive care, and mechanical ventilation or leading to death, is most common in people of advanced age and in those who have at least one of the previously mentioned underlying conditions.

A CDC analysis last month of US COVID-19 patient surveillance data from Jan 22 to May 30 showed that those with underlying conditions were hospitalized six times more often, needed intensive care five times more often, and had a death rate 12 times higher than those without these conditions. But the authors of today's reported noted that the earlier study defined obesity as a BMI of 40 kg/m2 or higher and included some conditions with mixed or limited evidence of a tie to poor coronavirus outcomes.

Median estimated county prevalence of any underlying illness was 47.2% (range, 22.0% to 66.2%). Numbers of people with any underlying condition ranged from 4,300 in rural counties to 301,744 in large cities.

Prevalence of obesity was 35.4% (range, 15.2% to 49.9%), while it was 12.8% for diabetes (range, 6.1% to 25.6%), 8.9% for COPD (range, 3.5% to 19.9%), 8.6% for heart disease (range, 3.5% to 15.1%), and 3.4% for CKD, 3.4% (range, 1.8% to 6.2%).

Nationwide, the overall weighted prevalence of adults with chronic underlying conditions was 30.9% for obesity, 11.4% for diabetes, 6.9% for COPD, 6.8% for heart disease, and 3.1% for CKD.

The estimated median prevalence of any underlying condition generally increased with increasing county remoteness, ranging from 39.4% in large metropolitan counties to 48.8% in rural ones.

The authors noted that access to healthcare resources in some rural counties may be poor, adding to the risk of severe COVID-19 outcomes.

"The findings can help local decision-makers identify areas at higher risk for severe COVID-19 illness in their jurisdictions and guide resource allocation and implementation of community mitigation strategies," they wrote. "These findings also emphasize the importance of prevention efforts to reduce the prevalence of these underlying medical conditions and their risk factors such as smoking, unhealthy diet, and lack of physical activity."

The researchers called for future studies to include the weighting of the contribution of each underlying illness according to the risk of serious COVID-19 outcomes and identifying and integrating other factors leading to susceptibility to both infection and serious outcomes to better estimate the number of people at increased risk for COVID-19 infection.

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Chronic conditions put nearly half of US adults at risk for severe COVID-19 - CIDRAP

Who We Are

The COVID-19 Prevention Network (CoVPN) was formed by the National Institute of Allergy and Infectious Diseases (NIAID) at the US National Institutes of Health to respond to the global pandemic. Using the infectious disease expertise of their existing research networks and global partners, NIAID has directed the networks to utilize their experience and expertise to address the pressing need for vaccines and antibodies against the SARS-CoV-2 virus.

COVID-19 Prevention Network (CoVPN)

The UCSD Mother-Child-Adolescent Programprovides comprehensive, family centered care of women, children, youth and families. This internationally recognized multidisciplinaryspecialists provides medical care, clinical research trials, patient education, counseling, case management, peer advocacy, and community education. Its team of investigators is highly experienced in vaccine clinical trials with an emphasis on the prevention of respiratory viral diseases.

To Conduct Phase 3 Efficacy Trials to prevent infection and COVID-19 disease. CoVPN will work to develop and conduct studies to ensure rapid and thorough evaluation of United States government-sponsored COVID-19 vaccines and antibodies for the prevention of COVID-19 disease.

The CoVPN expects to open four Phase III vaccine efficacy trials trials that make sure the vaccine works - in 2020, with the potential for additional trials to follow. Each study is anticipated to enroll roughly 30,000 people, and participants will either get the vaccine product or a sterile saltwater injection (placebo). Some trials may be conducted only in the United States, while others will enroll global communities.

The first Phase III vaccine trial will be of the Moderna mRNA vaccine that is planned to begin enrollment in the end of July 2020.

These efficacy trials hope to enroll persons who are at risk for exposure to SARS-CoV-2. This risk could be associated with, but is not limited to:

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Overview of the COVID-19 Prevention Network Study - UC San Diego Health

Given the increase in the spread of COVID-19 in our community, our infectious disease team is encouraging high-risk patients to take special precautions.

Dr. Christopher Penn, infectious disease physician at LMH Health, reminds us that COVID-19 is a new disease, and as such, theres limited information about the impact of underlying medical conditions and how they might create additional challenges for patients with COVID-19.

The CDC indicates that patients of any age with the following conditions are at increased risk of severe illness from COVID-19:

Additionally, people with the following conditions might be at an increased risk for severe illness from COVID-19:

If you fall into one of the above categoriesor if you live with someone who doesDr. Penn said its all that much more important to protect yourself from exposure to COVID-19. This means limiting your interactions with other people as much as possible.

Yes. Dr. Penn explained that our hospital and clinics have the most up-to-date COVID-19 precautions in place. These safeguards help protect you, our staff and ultimately the community. As we contact you to schedule or remind you of an appointment, we will ask several screening questions to verify your health status. We will gather as much registration, health history, insurance and payment information in advance as possible, and we will also notify you of changes to our process when you arrive at our campus and entrances.

Not every health need requires an in-person visit. LMH Health offers TeleCare, a service that is available to almost all clinics and appointments. Any existing or new patient can take advantage of this serviceall you need is a smart device such as a tablet, smartphone or laptop. TeleCare can be very effective even outside of a pandemicthink of it as another convenient option for care delivery. Ask your treatment team if a TeleCare visit is an option for you.

Dr. Penn said that the most important thing for all patients to keep in mindespecially those who fall into a high-risk category due to certain conditionsis to avoid any and all delays to necessary emergency care. Delaying your care can create even more significant health issues, and the infection prevention measures in place in our Emergency Department are meant to keep you safe.

If you cant avoid interaction altogether, remember that the virus is thought to spread mainly from person-to-person, specifically:

You can best protect yourself and those around you by following this guidance from the CDC:

Monitor your health daily, and be alert for fever, cough, shortness of breath, or other symptoms of COVID-19. If you think youve been exposed to COVID-19, call your healthcare provider before coming in. If you dont have a provider, you can contact Lawrence-Douglas County Public Health.

You can also keep track of your symptoms, and watch for emergency warning signs. Seek care immediately if you have trouble breathing or experience confusion, chest pain or chest pressure.

For nearly 100 years, our community has relied on LMH Health to provide exceptional, safe care. This has always been our top priority, and it remains true now more than ever. Our purpose is to be A Partner for Lifelong Health, in all times, but especially in these challenging ones.

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High-risk individuals urged to take special precautions to protect against COVID-19 | LMH Health | Lawrence, KS - LMH Health

The GeneXpert cartridge-based platform is used routinely at the CAPRISA clinic in Durban, South Africa, to rapidly test for tuberculosis and HIV viral load, but it is now also being used to test for COVID-19.

Shortly after instituting coronavirus disease 2019 (COVID-19) mitigation measures, such as banning air travel and closing schools, the South African government implemented a national lockdown on 27 March 2020 when there were 402 cases and the number of cases was doubling every 2 days (1). This drastic step, which set out to curb viral transmission by restricting the movement of people and their interactions, has had several unintended consequences for the provision of health care services for other prevalent conditions, in particular the prevention and treatment of tuberculosis (TB) and HIV. Key resources that had been extensively built up over decades for the control of HIV and TB are now being redirected to control COVID-19 in various countries in Africa, particularly South Africa. These include diagnostic platforms, community outreach programs, medical care access, and research infrastructure. However, the COVID-19 response also provides potential opportunities to enhance HIV and TB control.

In Africa, the COVID-19 epidemic is unfolding against a backdrop of the longstanding TB and HIV epidemics. South Africa ranks among the worst-affected countries in the world for both diseases. Despite having just 0.7% of the world's population, South Africa is home to 20% (7.7 to 7.9 million people) of the global burden of HIV infection (2) and ranks among the worst affected countries in the world for TB, with the fourth highest rate of HIV-TB co-infection (59%) (3). South Africa has made steady progress since 2010 in controlling both diseases. Increased access to antiretroviral drugs for treatment and for prevention of mother-to-child transmission of HIV has resulted in a 33% reduction in AIDS-related deaths between 2010 and 2018 (2). Similarly, the death rate among TB cases has declined from 224 per 100,000 population in 2010 to 110 per 100,000 population in 2018 (3). Have the strategies implemented for COVID-19 mitigation, particularly the lockdown, inadvertently threatened these gains in HIV and TB?

HIV and TB polymerase chain reaction (PCR) tests are key to treatment initiation and monitoring to achieve the United Nations goals for the control of HIV and TB. Disturbingly, these diagnostic tests declined during the lockdown. The 59% drop in the median number of daily GeneXpert TB testsa cartridge-based PCR test capable of diagnosing TB within 2 hours while simultaneously testing for drug resistancewas accompanied by a 33% reduction in new TB diagnoses (4). The restriction of people's movement and curtailment of public transport has led to substantial declines in patient attendance at health care facilities. A survey of 339 individuals in South Africa revealed that 57% were apprehensive about visiting a clinic or hospital during the lockdown, in part because of concerns that they may be exposed to infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from COVID-19 patients attending these facilities (5). Delayed HIV and TB testing impedes initiation of appropriate treatment, which increases the risk of new infections and drug resistance (6).

Both TB and HIV diagnostic platforms are important contributors to COVID-19 testing. The GeneXpert point-of-care testing platform, which is widely used in South Africa to diagnose TB, with more than 2 million individuals tested annually (7), is also being used to diagnose COVID-19. Until now, the limited availability of the GeneXpert COVID-19 cartridges has meant that spare capacity is mostly being used with little, if any, displacement of TB testing. Because there was also a decline in CD4+ assays (to test for immune status in HIV patients), it indicates decreased demand rather than displacement because this assay is not used for COVID-19. This may change as the demand for COVID-19 point-of-care testing rises and GeneXpert cartridges for COVID-19 become more readily available.

South African clinical laboratories have substantial capacity to perform high-throughput PCR assays for HIV viral load (more than 50,000 tests per day). However, the lack of COVID-19 test kits in South Africa, stemming from the global shortage, has meant that the available spare capacity on these platforms has sufficed for COVID-19 testing. The full potential of this PCR capacity is likely to be called upon when the country needs to expand COVID-19 PCR testing for the expected surge in cases, estimated to exceed 1 million at peak (8). Laboratory capacity for PCR testing developed for HIV and TB is now an essential resource for COVID-19 testing. The use of this capacity for COVID-19 needs to be monitored to identify and address any potential displacement of HIV and TB testing.

South Africa's experience in dealing with substantial HIV and TB epidemics has laid the foundations for the country's rapid, early community-based response. Both TB and COVID-19 are respiratory infections and can present with similar symptoms. They therefore present substantial infection control challenges, requiring timely and rapid diagnosis. Both diseases can spread more easily in conditions associated with poverty where social distancing is difficult to implement. Well-established community outreach capabilities for contact tracing, established for TB, were deployed to undertake contact tracing and quarantine monitoring for COVID-19.

With the highest HIV burden in the world, South Africa has a highly developed network of health care providers that includes tens of thousands of community health care workers who are trained to interact safely with infectious individuals and have experience in undertaking door-to-door visits in South Africa's most socially vulnerable communities. About 28,000 HIV community health care workers were deployed for COVID-19 symptom screening and testing referral (HIV outreach was put on hold) in 993 vulnerable, high-density communities, many lacking running water, to identify cases and thus reduce time to diagnosis and hence limit transmission. As clinical cases increased, there were insufficient tests for community-based screening, creating testing backlogs that delayed hospital patient results and led to curtailment of the community program with proposed adjustment to screening and quarantine without testing.

The established community engagement and outreach for HIV, TB, and noncommunicable diseases (such as hypertension and diabetes) provide an opportunity for integrating screening and testing in the long-term COVID-19 response. This approach will play an important role in reaching at-risk populations who do not readily make use of health services to establish a broader program of health promotion, prevention, and early detection. Such integration can be facilitated by the expansion of mobile onsite rapid testing approaches, using newly developed COVID-19 tests (9) and existing tests for HIV and other conditions on readily accessible samples such as saliva and blood from finger pricks. Combining health promotion programs for these diseases will reduce duplication and provide synergistic messaging because social distancing affects not only COVID-19 transmission but also that of TB and other respiratory infections. After the COVID-19 surge, integrated services could potentially provide an important approach to balancing ongoing vigilance for COVID-19 with early community-based detection of individuals with HIV and/or TB.

Access to medical care for nonCOVID-19 conditions was limited during the lockdown, with health facilities experiencing declines in the number of TB and HIV patients collecting their medication on schedule. The World Health Organization estimates that a 6-month disruption of antiretroviral therapy could lead to more than 500,000 additional deaths from AIDS-related illness in 2021 and a reversal of gains made in the prevention of mother-to-child transmission (10). In South Africa, 1090 TB patients and 10,950 HIV patients in one province have not collected their medications on schedule since the start of the national lockdown (11). A national survey of 19,330 individuals in South Africa found that 13.2% indicated that their medication for chronic disease was inaccessible during the lockdown (12). Furthermore, hospital admissions for HIV and TB declined as a result of hospitals reducing nonurgent admissions in preparation for a surge of COVID-19 cases and owing to closures to reduce exposure to COVID-19 patients. The potential negative impact on the continuity of care for HIV and TB patients could have substantial repercussions for both treatment and control, including development of drug resistance (6).

The biological and epidemiological interaction of COVID-19, HIV, and TB is not well understood. Patients immunocompromised by HIV or with TB lung disease could be more susceptible to severe COVID-19. However, preliminary results from a study of 12,987 COVID-19 patients in South Africa indicate that HIV and TB have a modest effect on COVID-19 mortality, with 12% and 2% of COVID-19 deaths attributable to HIV and TB, respectively, compared to 52% of COVID-19 deaths attributable to diabetes (13). The small contribution of HIV and TB to COVID-19 mortality is mainly due to these deaths occurring in older people, in whom HIV and active TB are not common. Integrated medical care for these three conditions is important as COVID-19 patients coinfected with HIV or TB start attending health care services in larger numbers.

South Africa's COVID-19 response, especially the lockdown, has led to substantial economic hardship, particularly among the poor and vulnerable. This has had a disproportionate impact on women, many of whom are self-employed or day laborers without a safety net (14). This may have a longer-term effect on increasing diseases associated with poverty (such as TB) and with gender, such as HIV, for which young women bear a disproportionate burden (15). The social determinants of HIV and TB will need to be carefully monitored to assess the impact of COVID-19. The effect of the lockdown on the economy, including declining taxes, is also likely to negatively affect funding for HIV and TB programs, among many others.

New and ongoing research on HIV and TB prevention and treatment have been severely affected by the COVID-19 epidemic. At the initiation of the lockdown in South Africa, the National Health Research Ethics Committee suspended all medical research, including clinical trials. Research progress on these two conditions has also slowed because several of the country's AIDS and TB researchers are redirecting their efforts to COVID-19. However, COVID-19 research efforts have increased collaboration and created new approaches to speed up therapeutic and vaccine development and testing, which will likely have long-term benefits for medical research beyond COVID-19. Several countries in Africa have well-developed HIV and TB clinical trial infrastructure that could contribute to COVID-19 vaccine trials. Past investments in infectious disease training and research have generated handsome returns to the COVID-19 response, highlighting the importance of maintaining these investments in the future.

Acknowledgments: We thank C. Baxter, W. Stevens, and A. Rademeyer for their assistance as well as the South African Department of Science and Innovation and Medical Research Council. Both authors are members of the South African Ministerial Advisory Committee for COVID-19.

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COVID-19 affects HIV and tuberculosis care - Science Magazine

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More than 90 babies have tested positive for COVID-19 in Travis County, Austin Public Health reports - KXAN.com

"From day one, any discussion of herd immunity or survival of the fittest or, you know, 'Say farewell to the elderly,' are the things that just did not sound right for us," Jordan's Prime Minister Omar Razzaz tells NPR. "So we went for a very different model in Jordan, based on social solidarity." Jane Arraf/NPR hide caption

"From day one, any discussion of herd immunity or survival of the fittest or, you know, 'Say farewell to the elderly,' are the things that just did not sound right for us," Jordan's Prime Minister Omar Razzaz tells NPR. "So we went for a very different model in Jordan, based on social solidarity."

Jordanian Prime Minister Omar Razzaz sits in the front room of his family home in a middle-class Amman neighborhood of traditional white stone houses with small gardens and low walls. Unusually, in a region where senior officials typically live in gated compounds far from public view, the residential street has been kept open to traffic to minimize disruption to Razzaz's neighbors.

Razzaz, an MIT and Harvard-educated economist, was appointed by Jordan's King Abdullah II to head a new government two years ago, following anti-government protests that were sparked by IMF-mandated tax increases seen as bypassing the rich. Although he'd served previously as education minister, Razzaz was seen as a relative outsider.

The small, resource-poor kingdom is surrounded by dangers from neighboring countries: a war in Syria, conflict between the U.S. and Iran in Iraq, and Israeli plans to annex parts of the West Bank it occupies something Jordan says poses a danger to the entire region.

But those issues have taken a back seat to controlling the coronavirus a feat Jordan has accomplished with an early and severe lockdown. The country of roughly 10 million has registered 1,131 coronavirus cases, with 11 deaths.

Razzaz sees vulnerable groups in other countries paying a disproportionate price for policies that don't prioritize them, and says Jordan's approach from the start was to protect the most vulnerable.

"From day one, any discussion of herd immunity or survival of the fittest or, you know, 'Say farewell to the elderly,' are the things that just did not sound right for us," Razzaz tells NPR. "So we went for a very different model in Jordan, based on social solidarity, in fact, helping the weakest. We did everything we can to make sure our children, our elderly, our refugees you know, the haves and the have-nots are protected."

In mid-March, Jordan was one of the first countries in the region to shut its airports and borders for all but essential goods. Arriving passengers were sent into compulsory quarantine. All but emergency workers and security forces were confined to their homes, with even grocery stores shut and the army distributing bread to poor neighborhoods.

The government cut public sector salaries and allowed businesses to reduce workers' wages, but banned them from laying off employees.

Razzaz says in the last four months, almost half of Jordan's population received some form of government assistance.

This week, the country announced it would reopen its airport to flights from a dozen countries where coronavirus rates are also low. With no cases of local transmission on most days, Jordan has stopped enforcing mask wearing and reopened restaurants and shopping malls.

Razzaz says industry production is now back to pre-coronavirus standards, and Jordan is exporting pharmaceuticals and food to other countries.

Jordan took a chance with the lockdown, he says, but felt it had little choice, given the prospect of its health care system being overwhelmed with COVID-19 cases.

"When we took the steps that we took, we did that not because we were certain about the outcomes. So there's always hindsight ... But we're very, very glad we did what we did. And a lot of countries that waited longer, including the U.S., ... are having a harder time containing the coronavirus," he says.

Razzaz and health officials note Jordan remains on guard for a possible resurgence of the virus as its airport reopens.

The longer-term challenge is an already fragile economy in which unemployment is rising sharply. Tens of thousands of Jordanians have lost their jobs in the Arab Gulf states, as those economies decline due to the pandemic and a plunge in oil prices.

The official unemployment rate for the first quarter of the year had already topped 19%. Some economists expect the real rate could reach 30% by the end of the year, with many of the unemployed young people.

Razzaz says, though, he is not worried by the prospect of renewed demonstrations that could be sparked by the economic crisis.

"While some countries worry a lot about social unrest, we see it as people expressing views about that hardship," he says. "We're going to be proactive with employment and job creation. And if you get frustrated and want to shout, we have a constitution and set of laws and institutions that allow that to happen in democratic ways."

The other wild card facing the kingdom is Israel's annexation threat. Jordan, along with Egypt, is one of only two Arab countries in the region to have signed a peace treaty with Israel. Jordan's king says he might suspend the 26-year-old treaty if Israel takes unilateral steps to claim sovereignty over parts of the West Bank.

Israel cites Jewish ties and a strategic need for it, but most of the international community opposes such a move, which could doom Palestinian hopes for an independent state.

Jordan, where a majority of citizens are of Palestinian origin, would be the country most affected by Israel's move, and instability could ripple across the region.

Razzaz says Jordan has not changed its insistence on the need for an independent Palestinian state alongside Israel.

"If you don't provide a just solution for the Palestinian people and sovereignty, you are pushing them and the region towards despair and extremism. So will there be conflict under such conditions? Yes, there will be, definitely," he says. "I think what His Majesty and Jordan have been doing is sounding the alarm bells."

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Jordan's Prime Minister Says His Country Contained COVID-19 By 'Helping The Weakest' - NPR

We're making coronavirus coverage available without a subscription as a public service. But we depend on reader support to do this work. Please consider joining others in supporting local journalism in Alaska for just $3.23 a week.

The city of Seward became the center of Alaskas two largest coronavirus outbreaks on Wednesday, with a factory trawler and a local seafood-processing plant where a combined 181 people had tested positive.

The American Seafoods ship carrying 85 infected crew members arrived in Seward from Unalaska on Wednesday afternoon.

After the 286-foot American Triumph moored at Sewards cruise ship dock, the crew disembarked and were ushered into the waiting buses by the drivers, who were wearing ventilated PPE suits. A handful of onlookers drove by as the crew disembarked, some with binoculars. They were taken to Anchorage.

Also on Wednesday, 96 seafood workers at the OBI Seafoods processing plant in Seward which employs 262 people tested positive for the novel coronavirus, causing the plant to temporarily shut down, city officials said.

An employee at the plant first tested positive for COVID-19 on Sunday, after seeking medical care for an unrelated health issue, the company said. The plant immediately closed so that the company could test all its employees and disinfect the campus.

The cases included 85 nonresident and 11 resident employees, according to a presentation from Alaskas state medical officer, Dr. Anne Zink, at a community briefing on Wednesday.

The OBI outbreak is the latest to hit the seafood industry in Alaska, occurring just days after the 85 crew members aboard the American Triumph tested positive for the virus, and more than 40 became infected at a plant operated by a Juneau fish processor.

Alaska is currently experiencing three large, separate outbreaks of COVID-19 in the seafood industry, said Dr. Joe McLaughlin, Alaskas State Epidemiologist, in a written statement Wednesday evening. These outbreaks are reminiscent of the meat packing plant outbreaks in the Lower 48 and stress the importance of vigilant symptom screening and prompt facility-wide testing in congregate work settings when index cases are identified.

Until now, the seafood industry has remained relatively unscathed despite concerns earlier in the year about the influx of out-of-state workers and potential for outbreaks in close quarters, on vessels and in processing plants that could overwhelm the states fragile health care system.

In response, 11 seafood companies released a letter addressed to communities to confirm our commitment that we are prioritizing health and safety of local residents in which they detailed their COVID-19 mitigation plans.

With the exception of some smaller outbreaks in Dillingham and Whittier, the companies safety plans appeared to have been mostly effective.

From Seward, infected crew from the ship and the plant were headed to Anchorage for isolation or quarantine, officials said. It isnt clear where the workers will be housed while in the city.

The sudden influx of infected people prompted municipal concerns about Anchorage hospital capacity. OBI Seafoods said in a statement that the vast majority of their employees who tested positive are not currently experiencing symptoms of the virus, and none have been hospitalized.

But the possibility that some could get sick enough to need medical care was a factor in Anchorage Mayor Ethan Berkowitzs decision to issue new restrictions on bars and restaurants Wednesday.

Berkowitz at a briefing said the new restrictions stemmed in part from Anchorages role providing medical care for most of the state including infected seafood workers, as well as residents of rural communities that rely on Anchorage hospitals.

When were looking at the hundreds of cases coming in from seafood workers, that will put a burden on our ability to provide capacity for people in Anchorage, he said. And so were watching the numbers not only inside Anchorage, were watching what is happening outside the community.

Crew disembark from the American Triumph and board busses in Seward on Wednesday, July 22, 2020. American Seafoods, which operates the factory trawler, reported over the weekend that 85 crew members tested positive for COVID-19. The crew disembarked in Seward and will be transported to Anchorage where they will be isolated for further care. (Loren Holmes / ADN)

Crew members from the American Triumph are transported by bus from Seward to Anchorage on Wednesday, July 22, 2020. American Seafoods, which operates the factory trawler, reported over the weekend that 85 crew members tested positive for COVID-19. The crew disembarked in Seward and will be transported to Anchorage where they will be isolated for further care. (Loren Holmes / ADN)

The American Triumph docks in Seward on Wednesday, July 22, 2020. American Seafoods, which operates the factory trawler, reported over the weekend that 85 crew members tested positive for COVID-19. The crew disembarked in Seward and will be transported by private bus to Anchorage where they will be isolated for further care. (Loren Holmes / ADN)

The OBI seafood processing plant in Seward, photographed on Wednesday, July 22, 2020. (Loren Holmes / ADN)

OBI Seafoods LLC was formed in June, the result of a merger between major processors Ocean Beauty Seafoods and Icicle Seafoods, and includes five shoreside locations in Alaska.

Earlier this summer, outbreaks were confirmed at two other OBI Seafoods plant locations in Dillingham, where 12 workers tested positive, and at the companys Excursion Inlet salmon processing plant in Southeast Alaska, where three employees also tested positive in late June.

The company has said it has extensive safety protocols in place to prevent an outbreak like this: All employees upon arrival in Alaska are required to quarantine for 14 days, and are then tested a second time, the company said in a statement. Every OBI employee also goes through a symptom and temperature check each day, according to the company.

But the close quarters and long working hours at fish processing plants can make social distancing difficult.

The American Triumph docks in Seward on Wednesday, July 22, 2020. American Seafoods, which operates the factory trawler, reported over the weekend that 85 crew members tested positive for COVID-19. The crew disembarked in Seward and will be transported by private bus to Anchorage where they will be isolated for further care. (Loren Holmes / ADN)

Crew disembark from the American Triumph and board busses in Seward on Wednesday, July 22, 2020. American Seafoods, which operates the factory trawler, reported over the weekend that 85 crew members tested positive for COVID-19. The crew disembarked in Seward and will be transported to Anchorage where they will be isolated for further care. (Loren Holmes / ADN)

Annie Berman reported from Anchorage and Loren Holmes from Seward.

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Seward announced 96 new COVID-19 cases at a seafood plant as a trawler with 85 infected crew arrived. They're all headed for Anchorage. - Anchorage...

Long-standing systemic health and social inequities have put members of racially and ethnically minoritized and marginalized communities at an increased risk for severe illness from COVID-19. With the disproportionate impact the pandemic has on Black, Latinx and other underserved communities, Kaiser PermanenteanAMA Health System Program Partnersends a clear message that the health program stands with those fighting for equity and justice.

We have a long-standing commitmentits in our DNAthat equity is important to us, said Edward M. Ellison, MD, a physician executive leading Permanente Medical Groups in Georgia and Southern California, and co-CEO of The Permanente Federation. It always has been equity, diversity and inclusion, and we recognize that there's more that we can do, and we want to do more.

In a recent call with Dr. Ellison, we discussed what Kaiser Permanente is doing to address inequities in health care. Here is what he had to say.

AMA: What inequities are driving the disproportionate impact of COVID-19 on Black and Latinx communities?

Dr. Ellison: Nationally it has been recognized that Black and Latinx communities have historically had increased challenges with access to health care in generalthe availability of proper nutrition, higher rates of preexisting conditions that we know predispose you to more significant outcomes with COVID-19, like heart disease, respiratory disease, diabetes, and there are other socioeconomic and environmental factors.

We also know the impact of ACEs [adverse childhood events] early in life and how that contributes to lifelong challenges with health, chronic stress, and what that can contribute to in terms of overall health.

In our country we've long had inequities in health care outcomes in Black, Latinx and underserved communities. COVID-19 has just exacerbated what we've observed in the past and highlighted the need to approach communities of color with targeted interventions to help us better serve and improve the outcomes, not just for COVID-19, but in all of the other areas.

Learn about five steps physicians can take to prioritize Black patients well-being.

AMA: What inspired Kaiser Permanentes 75-year commitment to equity and inclusion?

Dr. Ellison: I've been with the organization for 35 years and one of the things that drew meand kept me hereis I am inspired by the mission, vision and values of Kaiser Permanente. If you look at our mission, we are committed to providing high quality, affordable, accessible care for our members and the communities that we serve.

We have a history going back to the early days of Kaiser Permanente when Henry Kaiser declared that our hospitals would not be segregated. We want everyone to have equitable opportunities and recognized that with all thats going on in the country today, it was important to recommit. It was important to be public and make sure that all of our patients, our people, our communities knew where we stood. It was about how we've always had a long-standing commitment to closing gaps in health care inequities. We can always do better, but we've made a tremendous impact.

AMA: How do you help physicians and other health professionals maintain that commitment?

Dr. Ellison: One of the things that we have done is to embark on listening sessions. They have been powerful. I have appreciated the courage and the vulnerability of my Black colleagues and my Latinx colleagues who are sharing their experiences of discrimination and racism, and at times violence. There's so much for us to learn and so we want to use those learnings to help inform the actions that we take.

We participate in something called Hippocrates Circle, which includes our own physicians who have come from underserved populations and minority groups who found their own path through medicine to become physicians and overcame many obstacles. We affiliate with middle schools in underserved communities and students who self-identify as being interested in a career in medicine.

Kaiser Permanente sponsors fellowships for physicians to go into the community, identify need, and then help to address that need. There are many ways in which we try to help support our physicians and staff to stay connected to and understand how they can contribute and give back to the community.

We have something in Southern California called the Watts Counseling and Learning Center. It was founded in 1967, two years after the civil unrest in Watts and it started with just going out and meeting with mothers in the community.

We opened another facility, Baldwin Hills Crenshaw, in an underserved area in need of revitalization. We learned what they needed in the community and so when we built this facility, part of this almost nine-acre campus includes two and a half acres of green space and a two-mile walk.

They have this motto that health care is interwoven into people's daily lives, meeting people where they stand, and I think that's the philosophy that you take into making a difference in the communities. That particular facility was intentional40% of the contracts for building the building were to diverse businesses and companies owned by women, minorities, or veterans.

AMA: Are there different solutions for Latinx and Black communities, or does a broader solution work for all vulnerable communities?

Dr. Ellison: There are approaches that would be beneficial to all communities, including appropriate use of language, being culturally sensitive and responsive to different needs that different communities that we serve have, and understanding the impact of socioeconomic differences.

The cultural values for many Latinx patients and their families are gathering together, celebrating together, living in multi-generational households. But we know that is an added risk for COVID-19. We know that for the African American community, we have to work harder at building trust in the health care system because of past history.

We have to understand that there are actions we can take that are helpful, but it's not one size fits all. There are attributes beyond race that are impacted in terms of culture, socioeconomic conditions and educational background.

Learn about eight steps Kaiser Permanente is taking to suppress COVID-19.

AMA: During the COVID-19 pandemic with concerns about physical distancing, what ways have physicians continued to be involved in those communities?

Dr. Ellison: We've seen a tremendous acceleration of virtual care delivery of telemedicine both in terms of video and telephone, so understanding how you can meet the needs of the patient, even if it's virtually is really important. And those same cultural and language issues are just as important, if not more so.

Establishing a trusting relationship between the patient and the person providing care is really important and providing education to our physicians and other providers about how you can do that effectively, virtually. Then recognizing that not all of our members have access to virtual care.

Providing appropriate face-to-face care is still important but doing it in a safe way. Many of our patients want their care virtual right now for obvious reasons. And for those who need or desire face-to-face care, it's important that it's provided.

We worked hard to do outreach to our patients with communication about what's going on to reduce fear and uncertainty about the COVID virus, to get facts, to be as fact-based as possible, and to provide that in different languages so that we can make it easier for different communities to have the information that they need.

Learn more about helping patients put essential care ahead of COVID-19 fears.

AMA: Regarding staffing, how is Kaiser Permanente improving inclusiveness and diversity now and in the future?

Dr. Ellison: We're looking at how we recruit, how we develop individuals, how we provide opportunities for advancement. All of those are part of the work that we do, but I would say I'm very excited about the Kaiser Permanente School of Medicine.

In just a few weeks our first class of 50 students will be arriving. We took a very holistic approach in recruitment, so that we will be welcoming a class that does bring a diverse background and lived experiences.

We train a larger number of residents so after medical school, in a wide array of specialties, we have physicians being trained within our system and they're being exposed to the same vision, values and commitment in our organization.

It's also working with the communities and providing opportunities for minority-owned businesses to succeed. When we're contracting for services, were being intentional about providing opportunities from the communities that we serve.

AMA: Do you have any tips for other organizations that want to make a commitment to equity and inclusion?

Dr. Ellison: It starts with having a passionthat this is the right thing to do. I believe that it starts with the leadership of any organization. You have to create intentionality, be explicit in declaring what you value and why you value it. Create a safe space to execute on those values and create infrastructure that supports it and remove barriers to it.

The more of us that lean in together, the more successful that we'll be. But I do think it comes from also a place of humility knowing we don't have all the answers. It means listening to your peoplethey have the answers.

Whatever impact you can make, where you are with your opportunity, start there. Its about starting where you are and then reaching out and connecting. The more of us that do that, the more successful we'll be.

The AMA continues to compile criticalCOVID-19 health equity resourcesto shine a light on the structural issues that contribute to and could exacerbate already existing inequities. Physicians can also access the AMAsCOVID-19 FAQs about health equity in a pandemic.

Go here to see the original:

How Kaiser Permanente fights inequity in the face of COVID-19 - American Medical Association

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This month, Stephen Miller, the extremist anti-immigrant Trump adviser who has promoted white nationalist ideas, lost a relative to the coronavirus pandemic, and his uncle tellsMother Jones that the Trump administration is partly to blame for this death.

On July 4, David Glosser, the brother of Millers mother, posted a Facebook note announcing the death of his mother, Ruth Glosser, who was Millers maternal grandmother:

This morning my mother, Ruth Glosser, died of the late effects of COVID-19 like so many thousands of other people; both young and old. She survived the acute infection but was left with lung and neurological damage that destroyed her will to eat and her ability to breathe well enough to sustain arousal and consciousness. Over an 8-week period she gradually slipped away and died peacefully this morning.

David Glosser is a retired neuropsychologist and passionate Trump critic who has publicly decried Miller for his anti-immigrant policies, and he contends that Trumps initial lack of a response to the coronavirus crisis led to the deaths of tens of thousands of Americans who might have otherwise survived. In an interview, he says, With the death of my mother, Im angry and outraged at [Miller] directly and the administration he has devoted his energy to supporting.

In response to a request seeking comment from Miller, a White House spokesperson sent Mother Jones this statement:

This is categorically false, and a disgusting use of so-called journalism when the family deserves privacy to mourn the loss of a loved one. His grandmother did not pass away from COVID. She was diagnosed with COVID in March and passed away in July so that timeline does not add up at all. His grandmother died peacefully in her sleep from old age. I would hope that you would choose not to go down this road.

Glosser, a former health professional, posted his mothers death announcement on a public Facebook page. Responding to the White House statement, he writes in an email, Keeping the tragic facts about COVID deaths of our countrymen and women, young and old, from the American public serves no purpose other than to obscure the need for a coherent national, scientifically based, public health response to save others from this disease. My mother led a long, satisfying, productive life of family and community service. She had nothing to be ashamed of, and concealing her cause of death to offer privacy to me, our family, her hundreds of relatives and friends, does nothing to assuage our regret at her loss.

Moreover, Ruth Glossers death certificatewhich her son shared with Mother Joneslists her cause of death as respiratory arrest resulting from COVID-19.

Informed that Ruth Glossers death certificate cited COVID-19, the White House spokesperson replied, Again, this is categorically false. She had a mile [sic] case of COVID-19 in March. She was never hospitalized and made a full and quick recovery.

Miller has played a role in the Trump White Houses ineffectual response to the coronavirus crisis. He was credited with helping to write the Oval Office address Trump delivered on March 11 that was widely panned. In that speech, Trump branded the coronavirus as the foreign virus and downplayed the damage already caused by it. He hailed his administrations actions regarding the growing pandemic, ignoring his recent and repeated efforts to dismiss the threat posed by the virus. Trump announced in this speech that he would suspend all travel from Europe to the United Statesa statement that caused panic, as Americans overseas rushed back to the United States and ended up in crammed and unsafe conditions at US airports. (The ban only applied to foreign citizens.) In the months since, Miller has attempted to exploit the pandemic to implement anti-immigration measures.

On Facebook, Glosser described his 97-year-old mother as a scholar, a social worker, and the teacher of a generation of social work students in Western Pennsylvania who founded and administered a foster parents program for children with special needs in Johnstown. He added, Her passion was the careful documentation of the Glosser family and its flight from Czarist persecution in what is now Belarus to life and freedom in the USA. An ardent advocate of education, womens rights, and the struggle for civil rights in the USA. In an addendum to the post, he pointed out that she had depended on immigrants for her health care:

I neglected to mention that in moms declining years she was lovingly cared for by health aides nurses, and doctors from India, Philippines, Mexico, Nicaragua, Haiti, Korea, El Salvador, Uganda, and Nigeria. Immigrants all of them. I am indebted to them for helping us through some very difficult times. Without them there would be no one to take care of our elderly.

Glosser tells me that he tacked on this comment to register a political point: I wanted to make it clear the best I can that the message the Trump administration pumps outthat immigrants who come here spread death, destruction, disease, and murderis wrong. We were those people not too long ago. Thats the story of America.

Ruth Glosser was living in an assisted living facility in the Los Angeles area. According to her son, she contracted COVID-19 in early March, when the facility was low on tests and PPE. One or more of the staff, he says, were asymptomatic carriers of the virus, and the disease spread quickly through the facility. She had what might be regarded as a weak case, Glosser notes. She survived the immediate acute effects but lost 20 pounds within a few weeks and was very much weakened. His mother was hit hard by the neurological side effects and soon began a slow decline: She lost the will to eat because of enormous fatigue, enormous confusion, and the loss of her sense of smell and taste, and her lungs continued to deteriorate. Finally, she could not sustain a level of oxygen to remain conscious. In accordance with her living will, the oxygen was withdrawn. She basically fell asleep and died.

Like many other relatives of COVID-19 patients, Glosser found the hardest part of this loss was that he could not visit her because the facility had gone into lockdown: We did the best we could with phone calls and the occasional FaceTime. But as time went by, her ability to focus and to breath and talk diminished. I could get only a few words. I love you. But there was no chance to hold her hand and help her go out easy.

Glosser has long been a foe of the Trump administration and his nephew. Shortly before the 2016 election, in a letter to a Pennsylvanian newspaper, he criticized Miller for engineering Trumps assault on immigration. My nephew and I, he said, must both reflect long and hard on one awful truth. If in the early 20th century the USA had built a wall against poor desperate ignorant immigrants of a different religion, like the Glossers, all of us would have gone up the crematoria chimneys with the other six million kinsmen whom we can never know. He explains that this letter was written at the behest of several family members to disassociate the family from Miller.

In 2018, Glosser penned a piece forPolitico headlined Stephen Miller is an Immigration Hypocrite. I Know Because Im His Uncle. He wrote: I have watched with dismay and increasing horror as my nephew, an educated man who is well aware of his heritage, has become the architect of immigration policies that repudiate the very foundation of our familys life in this country. I shudder at the thought of what would have become of the Glossers had the same policies Stephen so coolly espousesthe travel ban, the radical decrease in refugees, the separation of children from their parents, and even talk of limiting citizenship for legal immigrantsbeen in effect when Wolf-Leib [Glosser] made his desperate bid for freedom and fled anti-Jewish pogroms for the United States.

In response to Miller and his now-wife setting up a wedding gift registry in February, Glosser sent a donation to a refugee relief organization and posted a not-too-subtle explanation on Facebook:

Ill be making a contribution to HIAS, a world wide agency that serves to protect refugees and helped to rescue my family from Czarist oppression in the Russian Empire in 1906. Had our refugee forebears not been helped to emigrate to the USA, they and their children would have been murdered by the racial madness of Nazism; as were the 74 of our relatives who were shut out of America by the race/religion based immigration exclusion act of 1925 enacted by the America First populists of the day. Protect the refugee and welcome the strangerthey built America.

Glosser notes that he has watched the Trump administrations managementor mismanagementof the pandemic with dismay, calling it chaotic, incompetent, uninformed, and entirely politically motivated. Trump, he asserts, is interested in only one thinghis political survival His initial response to the epidemic was denial, distraction, misinformation, propaganda and lies.

Glosser says that he cannot blame Trump for the fact that his mother was 97 years old and frail, but he insists Trump and his enablers bear tremendous responsibility for the failure to respond and their continued unwillingness to do what public health experts say must be done. An effective response, he notes, might have limited the number of deaths to 20,000: So Trump bears substantial responsibility for the deaths of over 100,000 Americans who didnt need to die, including my mother.

What is it like to have a family member in the middle of this failure? Glosser describes his nephew as an ambitious kid who for some reason decided to become infatuated with the idea of white supremacy and who has been obsessed with gaining power and influence. Miller, Glosser maintains, sees Trump as a useful idiot in his quest to advance his white power agendaHe has been able to use Trump to advance his political vendetta against the world. Glosser is not surprised that Miller has been part of the Trump administrations coronavirus failure: He has no ability to demonstrate empathy.

Ruth Glosser, according to David Glosser, was highly disturbed when Trump became president: She was terribly torn between the normal love for grandchildren and horror at the racist content of Trumps policies and Stephens role in it. He says he has not heard from Miller since his mother died. But that is no shocker. He has not spoken to Miller since the 2016 campaign.

Excerpt from:

Stephen Miller's Grandmother Died of COVID-19. Her Son Blames the Trump Administration. - Mother Jones

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Starting Friday at 8 a.m., new capacity restrictions will be imposed on Anchorage bars, restaurants, gyms and other establishments.

The new emergency order, Anchorage Mayor Ethan Berkowitzs 14th during the COVID-19 pandemic, was announced Wednesday afternoon.

The changes once again make for a more fettered city as residents wont be able to enjoy activities like dining out or gathering in large groups as freely as before. For many Anchorage businesses, the new order means fewer customers coming through the doors. It also means many businesses must now keep a log of customers who visit for longer periods, to aid with the citys strained capacity for contact tracing.

The restrictions come as cases in Anchorage and Alaska have surged, and follow capacity restrictions being imposed in several other U.S. cities and states.

Weve seen a rapid acceleration in the number of cases, Berkowitz said in a community briefing Wednesday. Berkowitz said the medical infrastructure is currently unable to keep pace with the rise in COVID-19 transmission.

We are experiencing exponential growth at this time, Anchorage Health Department Director Natasha Pineda said during the briefing.

Since Friday, there have been 260 more cases in Anchorage, Pineda said. The city is averaging 37.9 cases per day. Last week, the city reported 24.9 cases per day. State data updated Wednesday showed 1,068 total Municipality of Anchorage residents have tested positive for COVID-19, including 391 recovered cases, 668 active cases and nine deaths.

Anchorage Mayor Ethan Berkowitz announced new capacity restrictions for bar, restaurants, gyms and other gatherings beginning 8 a.m. on Friday. (Bill Roth / ADN)

On Sunday, the city saw a daily record with 65 new cases, Pineda said.

Currently, our reproduction rate is one of the highest in the country, for the state. I am sure that the Municipality of Anchorage is contributing to that increasing reproduction rate, she said. Which means our virus is growing fast.

Fifty-nine percent of the citys ICU beds are occupied. While those arent all COVID-19 patients, the city is starting to see a creep-up in need for beds for patients with the virus, Pineda said.

The cases are rising and the pressure on our system is imminent, she said.

Under the mayors new order, indoor gatherings will be limited to 25 people, and outdoor gatherings where people are consuming food or beverages will be limited to 50 people.

Bars will be limited to 25% of their maximum building capacity, including staff.

Restaurants and breweries can reach 50% of their maximum capacity indoors, including staff. Outdoor space will be limited to table service only, and tables must be spaced at least 10 feet apart.

When bars and restaurants were operating under limited capacity in May under the second phase of Berkowitzs reopening plan, several cited concerns about being able to turn a profit or break even with limited customers.

Under the new order, other indoor entertainment facilities, such as gyms, bingo halls and theaters, are limited to 50% of their building occupancy. General retail businesses and personal care businesses such as salons do not fall under the capacity restrictions.

The new regulations will not apply to farmers markets, outdoor food truck events or drive-in events where people are in their cars.

A notice requiring patrons to wear masks is posted at the entrance of Spenard Roadhouse on July 22, 2020. (Emily Mesner / ADN)

Also, all businesses that have sit-down service lasting at least 15 minutes must keep a log of all adult customers, recording their first and last names, phone numbers and email addresses to be used by contact tracers in the event of people being exposed to COVID-19 at their establishment. This record must be kept for 30 days.

Places like banks would also have to keep a log of visitors involved in extended, sit-down situations such as applying for a loan.

If a business does have COVID-19 exposure, employees as well as the state and local health departments must be notified. They also must assist public health authorities in alerting customers to the exposure.

Finally, hotels and other lodging are required to inform employees of any guests who are in quarantine or isolation due to travel or COVID-19 exposure. The hotels and lodges must also provide adequate personal protective equipment and cleaning supplies to employees.

Alaska has seen a significant and consistent increase in cases since reopening its economy, regularly hitting record single-day case counts. Recently, there have been several days with more than 100 cases.

Standing still in the face of adversity is not the kind of option that we have, Berkowitz said.

While hospitalizations and deaths are believed to be an especially lagging indicator of how present the virus is, all data is on somewhat of a delay. Pineda said daily case numbers are actually indicative of what was happening 10 to 14 days before.

That is why when we see this significant increase in numbers, were concerned, she said. That means the community spread has been happening over the past two weeks, and its still incubating and moving around our community.

On June 26, Berkowitz imposed a face covering mandate within the municipality to try to limit the spread of the virus when people are in public.

Anchorage Economic and Community Development Director Chris Schutte said there has been enforcement of the citys mask mandate. When someone files a complaint to the city about a business not complying, city workers will call the business and inform them of the mandate, Schutte said.

Schutte said there have been instances where businesses or employees were not complying.

Pineda said compliance is something the community is still working on, and said people should be wearing masks outside if they are coming within 6 feet of non-household members.

Berkowitz and Pineda said the decision to limit capacity is partially driven by the virus surging statewide, and in other parts of the country. Anchorage is the health care hub for Alaska, so outbreaks in other parts of the state can put a strain on the local health care infrastructure.

Part of Alaskas surge has involved the seafood industry.

When we are looking at hundreds of cases coming in from seafood workers, that will put a burden on our ability to provide capacity for people in Anchorage, Berkowitz said.

Clarification: An earlier version of this story cited Mayor Ethan Berkowitz saying general retail businesses would be limited to 50% capacity. The mayor misspoke when he announced that, his spokesperson later said. Those businesses will not be under a capacity restriction.

Also, an earlier version of this story cited Anchorage Health Department Director Natasha Pineda saying the city has had 430 new cases since Friday. The city later said that is incorrect; there were 260 new cases in that time.

See original here:

Citing spike in COVID-19 cases, Anchorage mayor announces new restrictions for bars, restaurants and gatherings - Anchorage Daily News