Category: Covid-19

The World Health Organization had just declared COVID-19 a pandemic when intensive care units in the United States started to see an influx of severely ill patients. It was mid-March, and though coronavirus cases had been mounting in countries including China, South Korea and Italy, in the U.S. there was still a dearth of knowledge about how the virus spread, how it affected patients, and what type of threat it posed to the doctors treating them.

Within three months, critical care physicians across the country received a crash course on a disease that didn't exist in the U.S. before this year, and are more prepared in the event of a second wave of the illness. Now, in June, doctors have a better sense of which medicines and interventions to use or avoid, how the virus affects the body, and how to face their own COVID-19 fears.

Full coverage of the coronavirus outbreak

In the beginning, "everyone had the concern of getting infected," Dr. Francis Castiller, medical director of critical care at UNC REX Hospital in Raleigh, North Carolina, said. The new disease was spreading rapidly, before many ICUs were able to prepare for the surge or protect their staff appropriately.

Dr. Josh Denson, a pulmonary medicine and critical care physician in New Orleans, said he diagnosed the first critically ill COVID-19 patient in Louisiana. But the hospital did not yet have strict protocols for quarantining patients.

"They hadn't isolated this patient appropriately, so my team members and I were exposed," said Denson, who works at Tulane Medical Center but was at a different hospital when he was exposed to the virus. "We had real concerns about whether we were going to get this or not."

He never got sick, and has since tested negative for COVID-19 antibodies.

But it was those fears, in part, that affected how critically ill patients were cared for in the beginning of the outbreak in the U.S.

COVID-19 notoriously wreaks havoc on the lungs, leaving severely ill patients struggling to breathe. As cases started emerging in the U.S., doctors looked to their colleagues in Italy, who were already in the middle of a huge influx of extremely sick patients.

For patients with severe breathing problems, the Italian doctors were using a type of therapy called high flow nasal oxygen, a much less invasive approach than putting a patient on a mechanical ventilator. Patients can get 100 percent oxygen through the nose without having to have a breathing tube put in place.

But an unusually high number of health care personnel in Italy 20 percent, according to an editorial in The Lancet medical journal were becoming infected with the coronavirus. They blamed the high flow nasal oxygen, figuring the treatment was aerosolizing the virus, spreading it to doctors and nurses.

As a result, many doctors in the U.S. were initially wary of using high flow oxygen for COVID-19 patients.

"We were very concerned, so we didn't use it," said Dr. Hugh Cassiere, director of critical care medicine at Northwell Health's North Shore University Hospital on Long Island, New York.

Instead, patients were intubated and put on ventilators, often right away. "Reports from other places was that you should put people on the ventilator early, because the disease was so rapidly progressive," Dr. Todd Rice, an associate professor of medicine at Vanderbilt University Medical Center, said.

But putting patients on ventilators comes with risks, too, including infection and unintentional damage to the lungs. Very often, patients require heavy sedatives to paralyze them so doctors can get the breathing tube into the patients' windpipe. That procedure, called intubation, also carries the risk of infection and lung complications, and can expose health care workers to virus-filled respiratory droplets.

That's a big deal. If you can prevent someone from being intubated, that could change their whole course.

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What's more, the longer a person remains on a ventilator, the greater the chances for blood clots, gastrointestinal bleeding, pneumonia and death.

The first few months were a learning experience. Now, doctors are trying to avoid ventilators if possible. Both Rice and Cassiere said more current data show high flow oxygen does not put health care workers at increased risk. And experience has shown them that not all patients require a ventilator. When possible, doctors see if patients improve with the high flow oxygen first.

"That's a big deal," Cassiere said. "If you can prevent someone from being intubated, that could change their whole course."

Despite attempts to move away from ventilators, some COVID-19 patients still need them. As the pandemic has progressed, it's become apparent that coronavirus patients on ventilators need special care.

When patients are put on a ventilator, they're often given diuretics to get rid of extra fluid in the body. Lungs that need help need to be "dry" to function properly. When they're wet, "they can't move oxygen as well," Denson said.

But the coronavirus has since proved it's not a simple respiratory illness. It can affect the lungs, the brain, the blood and, critically for patients on ventilators, the kidneys.

Unlike lungs, kidneys prefer to be hydrated. The longer patients are kept dehydrated, their chances of kidney failure increase. Denson said he's changed his treatments for COVID-19 patients to give additional hydration if they're showing damage to the kidneys.

"I'm targeting the kidneys a little bit more," he said. "I'm less aggressive up front getting people dry, and I'm more willing to use fluids if needed."

It's a balancing act that requires extreme attention on the part of ICU doctors and their staff. Too much hydration hurts the lungs. Too little hurts the kidneys. "It's a constant battle," Denson said.

When doctors faced the first surge of severely ill COVID-19 patients, no drugs had been shown to work against the virus, making treatment more challenging. As a result, doctors were willing to try certain medications based on limited evidence.

Early on in the pandemic, the drug hydroxychloroquine emerged as a potential treatment, following two studies that suggested it might be beneficial. As a result, many patients were given the drug, which is already approved for malaria and rheumatoid arthritis. But doctors soon found the drug was not useful in treating COVID-19, and subsequent research has shown it does not appear to help.

Now, doctors in ICUs are turning to the drug remdesivir. It's not a cure, but it's the only treatment that's been shown in a clinical trial to have an effect on the illness so far.

Some physicians are also finding success with other pharmaceutical approaches, though evidence remains anecdotal.

Cassiere has given ventilated patients steroids to reduce inflammation in the lungs.

"I was gun-shy up front about doing that, because I was concerned I could be doing more harm," Cassiere said, citing research from the 2003 SARS outbreak that suggested steroids cause coronaviruses to linger longer in patients. He found that combining the steroids with convalescent plasma, an antibody-rich blood product of recovered COVID-19 patients, appeared to cancel out that risk.

Cassiere also said he's changed his methods of sedating patients who need to be put on a ventilator, opting for fewer narcotics like fentanyl in favor of other drugs such as benzodiazepines or ketamine.

"My experience has been that the narcotics hang around longer, and may have something to do with the prolonged awakening some of these patients have," Cassiere said, referring to those who take an unusually long time to wake up from a coma after being removed from a ventilator.

That COVID-19 patients tend to be sick for a long time, spending weeks in the intensive care unit in some cases, is another factor physicians are getting used to in dealing with COVID-19.

"Taking care of patients requires a lot of patience," Dr. Steve Stigler, director of the medical intensive care unit at the University of Alabama at Birmingham, said. He coaches his physicians to stay the course with treatment and supportive care.

Patients "improve up to a point, and then it can be several weeks before we would see them continue to improve," Stigler said.

Castiller, of UNC REX Hospital in Raleigh, also said it's critical for ICU physicians to communicate that to families of COVID-19 patients.

One of the biggest lessons we've learned is the importance of human contact.

"Families need to prepare for that, as well as peaks and valleys" seen so often in the sickest patients, Castiller told NBC News. To offer support, Castiller said his staff calls patients' families daily with updates.

Rice's team at Vanderbilt does the same. "Every day, we call families and say, 'Here's the update on your loved one.' It's gone really, really well, and it's something we're proud of," he said. The staff also uses videoconference technology, like Zoom, so the family can visit with patients.

"One of the biggest lessons we've learned is the importance of human contact," Castiller said. Hospital restrictions that prohibit visiting COVID-19 patients have been major stressors for families, as well as those in the hospital. "We make sure to address that by using technology to maintain some level of communication."

Early fears that critical care physicians had about becoming infected with the coronavirus have eased significantly. Cassiere, who said he was terrified at the beginning of bringing the virus home to his family, has tested negative for antibodies. He credits appropriate use of personal protective equipment, such as masks, gloves and gowns.

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"All my protection I've had has helped. I'm confident that I'm not bringing it home. I'm confident that if I'm protected, I'm not going to get infected," Cassiere said. "And now, I'm armed with the knowledge and different approaches I have for battling COVID-19."

Experience matters. "Being a good critical care doctor is a lot of experience," Rice added. "Now we've seen this, and we've done this, and it will result in us providing even better care for our patients."

"We know we don't know everything about it, but we know the spectrum of disease and what it does to the body," Cassiere said. "I didn't know that back in March. I have all that knowledge behind me. I'm a COVID-19 warrior now. We're totally prepared for it."

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What ICU doctors have learned about COVID-19 and how they're prepared for a 2nd wave - NBC News

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Susan Peck will remember her father, George Smith, as the practical joker who could fix just about anything.

Smith died Thursday at age 81 after becoming infected with the coronavirus at a transitional care center in Anchorage.

He arrived at Providence Transitional Care Center in late February after a fall that caused a brain hemorrhage and, later, a stroke from surgery. He was making some progress and was starting to use the left side of his body, Peck said in an interview Saturday, though she isnt sure whether he would have been able to eventually come home to the Kenai Peninsula.

Smith had arrived at the Providence facility roughly a week before it stopped allowing visitors due to coronavirus concerns, Peck said. At first, his family would call him and approach the window of the facility.

He was so lonely. That was so hard, Peck said. And it was really hard on my mother too.

Pecks mother would FaceTime Smith every day and Peck would call him too. She and her siblings would use Zoom to talk to him together on the weekends.

In late May, Smiths family received crushing news: He had tested positive for COVID-19. Smith was one of several people with COVID-19 at the center, where by Saturday evening, the virus had infected a total of 27 caregivers and 18 residents.

Smith was transferred to the Providence hospital, and nurses there made certain Smith could get on video calls with his family, Peck said. The communication between Smiths family and the physician was phenomenal, Peck said.

Then we knew that there was no hope left for him," Peck said. "And we decided to do comfort care. Because he really went downhill fast. And then shortly thereafter, he died.

Diane Smith, George Smith's wife, wears personal protective equipment for a visit with her husband. Smith, who died Thursday, June 11, 2020, is the 12th Alaskan with COVID-19 to die since the pandemic began. (Courtesy Susan Peck)

Pecks mother was able to visit Smith before he died Thursday, she said. Geared up in full personal protective equipment, Pecks 78-year-old mother was able to hold the hand of her husband whom shed been married to for 60 years the day before he died.

He knew she was there, Peck said.

Pecks death is the second among Providence Transitional Care Center residents this week. He is the 12th Alaskan with COVID-19 to die since the pandemic began.

"We are saddened by this loss and extend our condolences to all of their loved ones during this difficult time, Providence spokesman Mikal Canfield said in an emailed statement Friday.

Sadly, we are announcing the death of another Alaskan today and I want the individuals loved ones to know we are thinking of them, Alaskas chief medical officer, Dr. Anne Zink, said in a statement Friday. Since the beginning of the COVID-19 pandemic, we have been especially focused on the extra precautions that are needed to prevent the spread of this disease into our more vulnerable populations, including those in skilled nursing facilities like the PTCC."

Initially, Smiths family didnt know that he was showing symptoms of COVID-19 or that he had been tested for the virus, Peck said. She said that she and her mother didnt find out that Smith had COVID-19 until the day after he had tested positive, when they called to check on him which they did frequently.

It was not out of any malice. I do not believe that," Peck said of the timing of the notification. "I think they were just trying to figure out what to do, how to notify people, how to take care of the situation, Peck said.

Once Peck and her mother asked what was happening, she said, they were both told he had the virus.

Carlie Franz, a spokesperson at Providence Health and Services Alaska, said they are required to notify families of a resident who tested positive by 5 p.m. the following day.

However, we make every attempt to make notifications within 24 hours, Franz said in an email.

George Smith during a visit with his family through the window at Providence Transitional Care Center. Smith, 81, died Thursday, June 11, 2020, and he is the 12th Alaskan with COVID-19 to die since the start of the coronavirus pandemic. (Courtesy Susan Peck)

Peck will remember her dads humor. He would play practical jokes on his wife, who still fell for them even after so many years together. He had quite the sense of humor putting pine cones down on the floor and pretending that it was their dogs poop, or short-sheeting the bed while his wife was up in the middle of the night.

And Smith could fix everything, Peck said. When he was 70 years old, he and Pecks mother built a log cabin where they continued to live at the end of Funny River Road, Peck said.

And the two were still affectionate, even after 60 years together, she said.

Every time youd see them walking, theyd be holding hands, Peck said.

And now, their family must mourn their loss in the middle of a pandemic, when large gatherings can be another venue for the spread of the virus.

Theyll have a socially distanced graveside service in Soldotna next week, Peck said, but one sibling cannot attend because of health risks associated with travel.

Theres so much to consider now, Peck said. Do you hug each other? If you cry, can you touch your face?

You want to comfort each other and you cant, Peck said. You cant all be together because of this virus.

[Because of a high volume of comments requiring moderation, we are temporarily disabling comments on many of our articles so editors can focus on the coronavirus crisis and other coverage. We invite you to write a letter to the editor or reach out directly if youd like to communicate with us about a particular article. Thanks.]

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Family describes 12th Alaskan to die with COVID-19 as a devoted husband and practical joker - Anchorage Daily News

HONOLULU (KHON2) -- Theres only one week left until movie theaters, arcades, museums and bowling alleys reopen.

However, with the COVID-19 pandemic, it will be a different experience. For one thing, many of the businesses reopening next week are recommending calling and reserving in advance.

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17 new cases of COVID-19 on Oahu brings state total to 723 - KHON2

Brazil has overtaken Britain as the country with the worlds second-highest Covid-19 death toll after a further 843 deaths pushed its total to 41,901.

The tally was published on Friday night by a coalition of news outlets which has been compiling independent statistics since Brazils health ministry was accused of seeking to conceal the full figures last week.

According to the British government 41,481 lives have been lost in the UK since late January although the number rises to more than 50,000 when suspected cases are included. Brazils death toll is also considered an underestimate.

Only in the US, where the official death toll stands at more than 116,000, have more died.

Medical experts have voiced despair at what they call Jair Bolsonaros calamitous response to the pandemic.

The Trump-admiring former army captain has repeatedly downplayed Covid-19 as media hysteria and a bit of a cold and on 12 April, with the official death toll at 1,223, falsely claimed: This matter of the virus appears to be going away.

Since then more than 40,000 Brazilians have died yet the far-right populist has continued to undermine social distancing by attending rallies and visiting shops. Two health ministers have been forced from government in under a month after clashing with Bolsonaro over coronavirus.

During a live broadcast on Thursday Bolsonaro who has defended his response as designed to protect the economy and jobs again minimized the tragedy.

He accused Brazilian journalists of focusing too much on the dead in order to produce funeral TV and claimed one former health minister, Luiz Henrique Mandetta, had produced ficticious Covid-19 statistics in a bid to keep Brazilians at home. The aim was to disseminate terror.

Bolsonaro also insinuated his rivals were deliberately exaggerating the number of Covid-19 deaths in their states. What do they hope to gain from this? Political benefits, thats all it can be. Theyre taking advantage of people who are dying to profit politically and blame the federal government, Bolsonaro claimed.

Daniel Dourado, a public health expert and lawyer from the University of So Paulo, said the president shouldered overwhelming responsibility for the scale of the catastrophe.

Bolsonaro has played a pitiful role. Ive not heard of a single country whose president has hampered the fight against the epidemic so much. Its as if he still hasnt grasped the danger of the situation. He doesnt even express sympathy to the families Its as if his policies are being driven by a [Freudian] death drive.

Dourado added: If we carry on like this its possible we might even catch up with the US in the number of cases. It seems preposterous to say this now. But if Brazil reopens and does what the federal government wants things could deteriorate very fast. So Im really worried. As incredible as it might seem, with [about] 1,000 deaths a day we could still be underestimating the impact of this pandemic.

The US has recorded more than 2 million infections, according to Johns Hopkins University, while Brazil has registered 829,902.

This week a University of Washington projection found another 100,000 Brazilian lives could be lost by August, meaning Brazil might overtake the US as the country with the highest death toll.

Brazils Covid-19 crisis is playing out against the backdrop of one of the most bitter and bizarre political crises since its return to democracy in the 1980s.

Federal police are investigating at least two of Bolsonaros sons for suspected corruption and links to a fake news racket. Last month investigators raided addresses linked to key Bolsonaristas including a former Femen activist turned anti-abortion-militant and a multimillionaire retail magnate famed for wearing garish yellow and green suits and building Statue of Liberty replicas outside his stores.

In an apparent bid to stave off the threat of Bolsonaros impeachment or the voiding of his 2018 election, loyalists, including top military figures, have played up the threat of military intervention against congress and the supreme court. Last month Bolsonaros politician son Eduardo who is Steve Bannons point man in South America warned Brazil was heading for a moment of rupture.

Lus Francisco Carvalho Filho, the former head of Brazils Special Commission on Political Deaths and Disappearances, said he was deeply worried about Bolsonaros authoritarian vision and the long-term threat he posed to Brazilian democracy.

I was born in 1957 and I think this is the most grave moment my generation has faced. Never before has a Brazilian head of state acted with such contempt for the institutional system, Carvalho Filho said.

Even the last presidents of the military regime played by the rules of the game. Bolsonaro is a man who tries every single day to do away with the rules of the game.

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Brazil overtakes UK with world's second-highest Covid-19 death toll - The Guardian

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The state of Alaska recently implemented a testing-based policy that provides more flexibility for travelers from out of state who want to avoid a 14-day quarantine upon arrival. Hours before that took effect June 6, Anchorage released its own plan to help prevent travelers from spreading the coronavirus.

Anchorages plan lays out restrictions on what indoor spaces travelers can access for the first two weeks after they arrive, unless they pass an additional round of testing.

Part of what we did was try to translate the state guidelines into words that we felt individual travelers and residents thinking about traveling ... could understand, said Anchorage city attorney Kate Vogel.

The citys policy is a reflection of the states, as well as information relayed in state news conferences, on the states website and in conversations with state officials. The city tried to centralize and clarify that information in its own version of the policy, Vogel said.

I think we can all acknowledge this is a complicated plan, and the simpler plan of quarantine for 14 days was easier to understand but provided less flexibility, Vogel said.

Right now, airlines are informing travelers of the state policy. Vogel said the city feels that the states policy is compatible with its own. The city is working on creating its own educational material, but Vogel said she doesnt know when that effort will be launched.

The state and the citys policies say basically the same thing about what travelers should do when they land first in Anchorage.

If travelers show negative results from a test taken within 72 hours of their departure time in another state, they will not have to be tested in an Alaska airport. They may need to get a second test seven to 14 days after arriving, according to the state, and may receive a voucher to offset the cost of that test. Theyll need to minimize interactions until 14 days have passed since their arrival; until they test negative in the second COVID-19 test; or until they leave Alaska, whichever comes first.

Those who get tested upon arrival at an Alaska airport rather than before travel will have to quarantine until they get their results. They will also need to take a second test at least a week later, and will have to minimize interactions until their second test results come back negative. This includes Alaska residents who have been out of state for five days or fewer.

But compared to the state, the city of Anchorage lays out what it means to minimize interactions in greater detail.

Under Anchorages order, people during the first 14 days after their arrival cannot visit indoor entertainment venues, like theaters or museums, or dine in at restaurants. The policies are compatible, Vogel said, but the city created its own definition of minimize interaction." The citys definition is in part based on comments from state officials and state educational materials.

On the states frequently asked questions page about the travel requirements, it explains minimized interaction similarly.

When you buy food, eat in outdoor settings. Order delivery if possible. Wear a face covering if you go into public areas. Take part in outdoor recreation (such as fishing) instead of visiting a museum. Postpone attending gatherings until after this window is over.

If someones second test comes back negative, they can stop minimizing their interactions with others before the end of that 14-day period.

Vogel said its important for travelers to understand the risks before leaving on a trip to Alaska. If they test positive for the virus here, they cannot return home until they are no longer sick. They will have to isolate in Alaska at their own expense.

Businesses are able to refuse service to anyone who is supposed to be quarantining or minimizing interactions. State law dictates that businesses are always able to refuse service to someone, as long as its not discriminatory, Vogel said.

The state in its health mandate describes the testing to occur as molecular based while Anchorage refers to PCR tests. Theyre describing the same thing: viral tests intended to determine whether someone is currently infected (these usually involve a nasal swab, or a saliva sample). Antibody or serology tests, which determine whether someone was previously infected, do not meet the city and state requirements.

There are a couple of key differences between the city and state policies, Vogel said.

Under city rules, a traveler must inform their hotel, rental lodging host, and/or roommates of their quarantine status or whether they are required to minimize in-person interactions during the 14 days after arriving in Alaska.

Also, under the citys policy, people in the minimized-interaction stage are required to wear a face covering anytime they are around non-household members.

Vogel said there is no requirement that places like restaurants ask customers if they have traveled. But businesses might want to post the rules near the entrance to remind customers, she said.

We think empowering businesses to understand their rights in this situation can help with the public information campaign, which we think is the key to enforcement, Vogel said.

Vogel said the policy essentially relies on the honor system, though a fine or criminal charge could be used if someone is aggressively running afoul of the policy. Having a separate mandate allows the city to impose a civil fine, rather than a criminal charge that can be levied under the state policy, she said.

While the different language in the state and the citys travel policies could lead some to believe they are markedly different, thats not the case, Vogel said.

If someone doesnt like Anchorages plan, they probably dont like the states plan, they just maybe havent dug deep enough into it, Vogel said.

[Because of a high volume of comments requiring moderation, we are temporarily disabling comments on many of our articles so editors can focus on the coronavirus crisis and other coverage. We invite you to write a letter to the editor or reach out directly if youd like to communicate with us about a particular article. Thanks.]

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A guide to the differences between Anchorage's new COVID-19 travel policy and the state's - Anchorage Daily News

From 2015 through 2018, the Missouri Health Care Association PAC gave a total of $423,743 to dozens of candidates and committees, including its only contribution in 2018: $1,000 to Parsons campaign.

Two PACs formed in 2017, DSV and RQC, have made similar donations to dozens of candidates. Both PACs are largely funded by the MHCA, as well as a handful of nursing homes and attorneys contributing $300 or less. Last year, RQC PAC made 48 contributions totaling $84,950, to recipients including Uniting Missouri and American Dream. DSV made 39 contributions totaling $67,600 to many of the same candidates.

The two PACs each contributed $5,000 to Uniting Missouri at the Dec. 11 fundraiser.

While the PACs have given to Republican candidates in greater amounts, theyve also supported Democrats. Galloway for Missouri, for example, received $2,500 from the MHCA PAC in 2016; RQC gave $1,000 to Galloway in 2017; and the DSV PAC contributed $2,600 in 2018.

MHCA reported spending $329,767 in nondeductible lobbying expenditures in 2017, according to federal tax filings of the most recent year in which tax filings were available. The association also listed $39,772 in legislative expenses. The group spent $296,357 on lobbying efforts in 2016.

Another industry group, the Missouri Assisted Living Association, also operates three PACS the Missouri Assisted Living PAC, Residential Care Facility PAC, and the MO Residential Care-PAC that also similarly made contributions. Those three PACs have given a total $29,525 since 2017, including $3,000 to the campaign accounts of Parson and $1,000 to Kehoe.

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Hundreds of COVID-19 deaths draw focus on nursing home industry and its political influence in Missouri - STLtoday.com

Ill. (KWQC) - The Illinois Department of Public Health today announced 673 new confirmed cases of COVID-19 in Illinois, including 29 additional confirmed deaths.

Those deaths include:- Boone County: 1 male 90s- Cook County: 1 female 50s, 2 females 60s, 1 male 60s, 2 males 70s, 3 females 80s, 1 male 80s, 2 females 90s- DuPage County: 1 female 90s- Jackson County: 1 male 60s- Kane County: 2 males 80s- Kankakee County: 1 female 80s- Lake County: 1 male 80s- Peoria County: 1 female 80s, 1 male 90s- St. Clair County: 1 male 70s, 3 females 80s, 1 male 80s- Whiteside County: 1 female 80s- Will County: 1 male 40s, 1 male 90s

To date, the Illinois Department of Public Helath is reporting a total of 131,871 cases, including 6,289 deaths, in 101 counties in Illinois.

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Illinois Announces 673 New Confirmed Cases of COVID-19, 29 Deaths - KWQC-TV6

Modeling recently prepared and presented by the University of Arkansas for Medical Sciences shows that new COVID-19 cases in Arkansas could reach around 1,350 per day by Sept. 27, with around 3,100 hospitalizations by October.

That modeling follows an update by the closely watched Institute for Health Metrics and Evaluation (IHME) at the University of Washington which shows pandemic deaths in Arkansas could reach 1,650 by Oct. 1.

The UAMS numbers, presented during an employee town hall by Dr. Mark Williams, dean of the Fay W. Boozman College of Public Health at the University of Arkansas for Medical Sciences, also show the state could have just under 1,000 ICU beds with COVID-19 patients and around 600 ventilators in use. The estimated rise would not exceed capacity. The Arkansas Department of Health has reported 9,111 hospital beds in the state and 896 ventilators. What is unknown is if bed and ventilator capacity will be exceeded in a region in the state.

Active infections in the state could rise to between 170,000-175,000 in early to mid-October, according to the UAMS estimate.

As of Friday (June 12), there have been 2,896 new known COVID-19 cases reported in the previous week (June 5-June 12), which is 33.5% of all reported cases since the pandemic began March 11. Fridays (June 12) COVID-19 report included 731 new known cases, the highest number of new cases in a 24-hour period. Known COVID-19 cases in Arkansas totaled 11,547 on Friday, up from 10,816 on Thursday. The number of deaths rose from 171 to 176. The number of COVID patients hospitalized in Arkansas was 203 on Friday, up from 187 on Thursday. There are 49 patients on ventilators, up from 45 on Thursday.

The IHME modeling estimates 45.12 deaths and 5,587 new cases per day by Oct. 1. The modeling, which has been revised many times since the pandemic began, shows the need for hospital beds peaking Sept. 26 at 1,372 hospitalizations and 360 COVID-19 patients on ventilators. The modeling also shows 397 ICU beds will be needed for COVID-19 patients by Sept. 26, two more than the 395 beds that IHME estimates are in Arkansas.

Joe Thompson, director of the Arkansas Center for Health Improvement and former Arkansas Surgeon General, told Talk Business & Politics that modeling is important to follow, but the estimates will change. He said modeling assumptions likely have more to do with about how many people are wearing masks at Walmart or Home Depot or Lowes. The key takeaway from the UAMS, IMHE and other models is that they point to higher deaths and hospitalizations than we are now discussing.

Under almost every model, things will get significantly worse unless we change our individual behavior in public spaces, he said.

Thompson said there are three reasons the public and political leaders are not always willing to discuss or accept the potential for the virus impact escalating. The first is the virus is an invisible threat and hard to understand.

Weve never been faced with a pandemic before. This is a virus thats never been seen by anyones immune system in Arkansas, Thompson said.

Another reason the topic is not always welcome is the independent nature of many in Arkansas, with Thompson noting that this has become a politicized event. The third reason modeling estimates are sometimes not followed or discussed is the uncertainty in trying to predict the future impact of the virus.

Gov. Asa Hutchinson said he was not aware of the new UAMS modeling, and said previous models from different groups did not mirror reality.

We take this very seriously and we like to get a lot of different information. Historically, the modeling has not been accurate and the modeling is what led us early on to look at War Memorial Stadium as potential hospital expansion opportunity for us. And obviously that has proven to be unnecessary, he said during a brief Saturday interview.

He did say modeling is useful because with the recent spike in new COVID-19 cases, we take worse-case scenarios into consideration and be prepared in terms of capacity building.

The governor also said national politicization of the virus that results in some people not observing health guidelines is not helpful. This is a public health issue first and not a political issue. He reiterated that his key strategy in responding to the virus and keeping the economy open is encouraging Arkansans to wear masks, practice social distancing and follow other health guidelines.

Talk Business & Politics editor-in-chief Roby Brock contributed to this report.

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UAMS modeling shows Arkansas' active COVID-19 infections could reach 175000 - talkbusiness.net

AUSTIN (Austin Business Journal/KXAN) One of Austins largest apartment developers is scaling back due to the COVID-19 pandemic.

Journeyman Group President Sam Kumar said his company will probably build at least 600 fewer apartment units in Austin this year than it had initially planned.

Despite that, the company is still projected to have 2,100 apartment units under construction this year, he said. Thats about the same or slightly more than Journeyman built last year.

FULL Q&A with Sam Kumar at Austin Business Journal

While construction in Austin has continued through most of the pandemic as construction was considered an essential business Kumar says the pandemic worried many potential investors because of possible rent delinquencies.

In March, the CARES Act was passed by Congress and included a 120-day moratorium on evictions. While evictions were prohibited for eligible renters, it didnt forgive any rent due.

Local renters were also protected when Travis County Justice of the Peace Nicholas Chu signed an order that required landlords to prove their properties dont fall under the CARES Act.

The City of Austin also passed its own COVID-19 rental assistance program.

The Relief of Emergency Needs for Tenants program, according to the City, allowed applicants to have at least a portion of their rent paid. In its first hour that applications were open, over 1,300 people applied.

Continued here:

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New York and Chicago, whichsaw a surge of coronavirus cases at the start of the pandemic, are experiencing a decline in cases and have begun reopening in phases.

But that trend doesn't holdthroughout the rest of the country.

Soaring case numbers in Arizona have diverted lawmakers' attention from protestsafter the death of George Floydback to the public health crisis.

Senate Minority Leader Chuck Schumer, D-N.Y., has asked for members of the administration's Coronavirus Task Force, specifically naming Anthony Fauci andDeborah Birx,to conduct a briefing for Democratic senatorsnext week on the spike in cases in Arizona and elsewhere across the U.S., according to his office.

Other states seeing a sudden spike in COVID-19 cases includeSouth Carolina, Florida, Alaska, Arkansas, California, Kentucky, New Mexico, North Carolina, Mississippi, Oregon, Tennessee, Texas, Utah and Puerto Rico.

Though experts aren't exactly sure why these states are experiencing an unexpected uptick in cases, they said lifting lockdown restrictions, isolated outbreaksand the virus catching up to communities previously not impacted may each play a role.

This virus is much more spotty, said Arnold Monto, professor of epidemiology at the University of Michigan School for Public Health. It is so complicated that when people give you a simple answer to this, its probably not right.

In April, the Trump administration announced guidelines to reopen the country, which included a 14-day decline of confirmed coronavirus cases or a decline of positive tests as a percent of total tests within that period.

However, some states eager to get back to work didnt meet those federal governmentguidelines before reopening.

Floridas first phase began May 18, which reopened restaurants, retail and museums at half capacity. Not only did the state fail to meet a two week decline in cases, but it actually reported an increase in cases per day a week before reopening. According to Johns Hopkins data, Florida reported 594 cases on May 10. Five days later there were more than 800 cases.

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About three weeks later, on June 5,Gov.Ron DeSantiswent on to phase two reopening, even as daily cases have topped the 1,000 mark and have continued to do so for the past seven days.

A record 1,698 cases of COVID-19 were announced Thursday morning by the FloridaDepartment of Health, marking the largest single-day increase in the state since the pandemic began.

In Tennessee, Gov. Bill Lee said Wednesdaythat state's recent uptick in coronavirus infections and hospitalizationswas an expected result of the state reopening much ofits economy and urged residents to redouble precautions to prevent the virus from continuing to spread.

Georgia is notably not on the list of states where cases are on the rise, said Dr. Jeffrey Shaman, professor of environmental health at Columbia Universitys Mailman School of Public Health. Gov.Brian Kemp was heavily criticized when the Peach State became one of the first states to begin reopening in April.

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In the six weeks since Georgia loosened restrictions, its curve has stayed relatively flat. Shaman said this could be due to resident behavior, suggesting peoplecontinued to shelter in place despite the lifting of lockdowns.

It's hard to know for sure because there's no real data on how many businesses truly reopened or what percentage of people actually wear masks, he said.

However, Georgia Public Health reported the results of 7,684 tests Tuesday, of which 9.8%were positive, nearly double the rate from the previous day, according to an analysis by the August Chronicle.

We dont want to be totally caught up in a numbers game, Monto said. What we need to look at is patterns.

Both Monto and Shaman say another reason some states may be experiencing unexpected spikes is because of super spreaders, events or enclosed community outbreaks.

A super spreader is an infected person who can transmit the disease to a large number of people.

Weve got a lot of anecdotes and its hard to define who a super spreader is,you only know after the fact, he said.

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Other states say theirspike is due to a local outbreak in a confined space such as anursing home, prisonor meatpacking plant.

The Texas Department of State Health Services attributes the state'sspike in coronavirus casesto increased testing in prisons.

According to the Texas Tribune, the number of prisoners reported to be infected with the virus jumped from about 2,500 to 6,900 in the two weeks since prisons started reporting test results May 26. Overall cases jumped by 34% from May 25 to June 7, and nearly a quarter of the increase came from 10 counties with prisons and meatpacking plants.

You have clusters, you have nursing homes, meat packing and they add a lot of cases, Monto said. So that has to be factored in as well.

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The number of coronavirus cases tied to meatpacking plants has more than doubled since President Donald Trump invoked the Defense Production Act in late April to compel slaughterhouses and processing plants to stay open.

The Midwest Center for Investigative Reporting found more than 20,400 infections across 216 plants in 33 states.

Across the United States, some of the highest spikes in coronavirus cases recently occurred in counties with one or more meatpacking plants Buena Vista County, Iowa; Beadle County, South Dakota; Yell County, Arkansas; and Titus County, Texas, for example. All saw their case counts more than double in the past two weeks, a USA TODAY data analysis found.

Not much is known about the viruss seasonality as it has only been presentfor the past six months. But if its anything like the flu, Monto says, it could come in waves.

I think catching up is a phenomenon, he said. If you miss the first wave, you catch up in the second wave.

With the flu, theres a lull in the summer, Monto says. States that arent impacted in the spring by the seasonal virus usually see a spike in flu infections in a second wave.

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However, there is no data to support this hypothesis with the coronavirus. In fact, seasonality doesnt seem to be a factor, as hotsouthern states like Arizona and New Mexicoare now experiencing a spike in cases.

In Greenville County, South Carolina, the percentage of positive cases recently tripled from 2.9% on May 27 to 9.4% on June 3, prompting state health officials to classify it acoronavirus hot spot,according to The Greenville News.

Shaman said a spike in cases could be due to lack of social distancing, face mask wearing and other non-pharmaceutical prevention methods touted by public health experts for the last six months.

Protesters march during a rally at Cesar Chavez Park on Wednesday, June 3, 2020, in Laveen, Ariz., protesting the death of George Floyd, who died May 25 after being restrained by Minneapolis police.(Photo: Ross D. Franklin, AP)

If you look at the protests you can see the difference between communities, Shaman said. In New York, everyone is wearing a face mask and others arent.

While an increase in cases may be caused for multiple reasons, Monto said states should take heed and take preventative measures to prevent a major outbreak.

The take home message to me is that the virus is still around. Its everywhere, its not going to go away, he said. We cant be complacent.

Contributing: Brett Kelman, USA TODAYNetwork

Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

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