Category: Covid-19

The model, from the Institute for Health Metrics and Evaluation at the University of Washington, was created by Dr. Christopher Murray, who told CNN Monday the country can essentially stop coronavirus transmission this summer.

"The one thing we absolutely know for sure is that social distancing measures work," Murray said. "It leads to a situation where every case is infecting less than one other case, and that means if you keep the course, you'll get transmission essentially down to zero."

Murray cited Italy and China as places where this was happening.

According to Murray's model, Monday was the peak day for daily deaths in the United States. It projected about 2,150 Covid-19 deaths Monday, which are expected to decline moving forward.

New York, one of the hotspots for the virus, hit its peak number of deaths three days ago, according to the model, but hundreds of deaths are still expected daily for the coming week.

By August, the model predicts, a total of 68,841 people will have died in the United States, which is up from Friday's projection of 61,500 deaths.

States on both coasts are now banding together to fight the pandemic. On the East Coast, the Northeastern states of New York, New Jersey, Connecticut, Pennsylvania, Delaware, Rhode Island and Massachusetts are coordinating to reopen the economy. Out West, the governors of California, Oregon and Washington agreed on a regional pact.

The number of infections -- which stood at more than 580,000 on Monday afternoon -- was also down Saturday and Sunday.

This comes as US Surgeon General Dr. Jerome Adams says cases in some of the country's hotspots -- New York, New Jersey, Detroit and New Orleans -- appear to be "leveling off" or even declining. The situations in California and Washington, meanwhile, remain stable.

Still, many states are in the throes of an intense effort to stem the illness' spread. New York crossed the 10,000-death threshold Monday, as its cases topped 190,000, Gov. Andrew Cuomo said. New Jersey and Michigan also have frightening death tolls, with more than 2,300 and 1,400 respectively.

The upside to New York's numbers is that the three-day average for hospitalization, new hospitalizations, intensive care admissions and intubations are all down, Cuomo said Monday morning.

States band together to fight Covid-19

Cuomo announced Monday the beginning of a "geographically coordinated" reopening plan in conjunction with leaders in New Jersey, Connecticut, Pennsylvania, Delaware, Rhode Island and Massachusetts. Each state will name health and economic officials to join the governors' chiefs of staffs to a working group, which will begin discussions Tuesday.

The group will come up with "parameters to go forward," Cuomo said, and while they may not agree on every aspect of the strategy, finding areas where they can coordinate will be important, especially given the states' close economic, health and transportation ties.

Calling the commuter thoroughfare from his state of Connecticut to New York the "Covid corridor," Gov. Ned Lamont said it was vital that "you don't pull the trigger too early," but applauded the partnership.

"The reality is this virus doesn't care about state borders, and our response shouldn't either," Rhode Island Gov. Gina Raimondo said.

"By working, sharing our information and intelligence, I think will help each of us make better decisions," Delaware Gov. John Carney added, while Pennsylvania Gov. Tom Wolf said, "We can do anything better when we work together in this region."

On the West Coast, California, Oregon and Washington are joining forces "on a shared approach for reopening our economies," a joint statement from California Gov. Gavin Newsom, Oregon Gov. Kate Brown and Washington Gov. Jay Inslee said.

The public health leaders in the three states will focus on four main goals, the statement read. These goals include: Protecting vulnerable populations at risk like those in nursing homes, ensuring care for those who may contract Covid-19, mitigating the non-direct health impacts of the virus on disadvantaged communities and protecting the public by ensuring the lifting of restrictions comes with adequate testing.

"The states will work together to share best practices and coordinate a framework to get it done," Inslee tweeted.

Minnesota Gov. Tim Walz told reporters Monday he'd contact the governors of Michigan and Wisconsin to begin thinking regionally in terms of opening up the economies in each state.

Colorado Gov. Jared Polis said that he would welcome a national approach to the timing of reopening the states.

"I do hope there is a focus on a better national uniformity about how we can combat this because we do have a lot of commerce and travel between our states just as we do within our state," Polis said during a Monday news conference. "We border different states that have different policies. We border different states that have different trajectories of the infection."

On the federal level, planning is underway for a federally supported "public health force" to carry out the state-level epidemiology "that's going to be necessary to open the country back up," a federal health official with knowledge of the planning told CNN.

The official, who is directly involved in the day-to-day national coronavirus response, told CNN the plan was part of discussions of next steps by the White House Task Force.

"Hundreds of millions of dollars are going out to the state health departments right now," the official said. "They are who are going to hire people to do this work. This is to beef up our public health infrastructure through individuals that the CDC hires and places in state health departments, as well as the state health departments themselves hiring people. This plan would really beef up capabilities for if in fact we reopen and we start to see a re-emergence of cases."

The federal health official told CNN that the "large-scale" push for epidemiology is part of the recent initiative led by eight "community protection" CDC field teams deployed in recent weeks. Those CDC teams were sent to states where transmission rates are low to assist state and local health departments with contact tracing and testing.

Neither the Task Force nor the US Centers for Disease Control and Prevention responded to CNN's request for comment.

The United States is also expected to receive about 750,000 more coronavirus tests from South Korea, according to the Federal Emergency Management Agency.

FEMA awarded contracts to manufacturers in South Korea last week to provide the tests, according to a FEMA spokesperson and federal records.

Over the weekend, the first shipment of 150,000 tests was delivered to the United States. The next shipment of 600,000 tests is expected to arrive April 15.

Trump is scheduled Tuesday to announce the formation of the "Opening our Country Council," which is expected to focus on ways to stimulate the economy. Another panel, the White House's coronavirus task force, has been focusing on providing advice to the states on what to do once reopening is advised.

The task force is weighing potential benchmarks that would precede reopening the states, but have yet to settle on specific targets, people familiar with the discussions said.

Governors say their states aren't ready to be reopened fully

Multiple governors across the country said Monday their states aren't ready to reopen their economies.

Louisiana Gov. John Bel Edwards said it was too early to know if his state was ready to loosen social distancing guidelines.

"As Dr. (Anthony) Fauci said last week, it's not like flipping a light switch, where you just go from being dark to light, all at one time. So this is going to be done in some sort of a transition. And we're going to be doing it that way here in Louisiana," Edwards said. "I cannot tell you exactly what that's going to look like yet, but we will be working really hard with all the experts to get that figured out."

Tennessee Gov. Bill Lee on Monday extended the state's stay-at-home order to April 30, which will make way for a "phased reboot" of the economy in May.

"Between now and then, we'll create industry-specific guidance so that businesses can be fully prepared to operate safely and to protect their employees and their customers," Lee said.

Minnesota Gov. Tim Walz extended the state's peacetime emergency until May 13, he announced Monday. Minnesota's stay-at-home order goes through May 4.

Michigan Gov. Gretchen Whitmer on Monday also extended her state's stay-at-home order until April 30.

"By extending these Executive Orders, we ensure that our state continues to do all it can to suppress the spread of COVID-19 by limiting in-person interactions and services as much as possible right now, while also ensuring that vital goods and supplies get to the people who need them most as quickly and safely as possible," Whitmer said in a statement.

In Georgia, Gov. Brian Kemp dismissed the idea of formulating any plans to reopen the state any time soon.

"Our focus is on the hospital surge capacity, the ability to test more, because we are going to need that when we go back to work," Kemp said.

Governors in the Upper Great Plains say they believe the worst has yet to come as far as a peak in Covid-19 cases and deaths. The curve in North Dakota, said Gov. Doug Burgum, may be going up when other parts of the country are going down.

"We have said all along there are going to be different curves for different parts of the country, and so we are not there yet," Burgum said. "That is going to be confusing for people. If wow, New York had all these deaths and they are opening up, why aren't we opening? That will be a communication challenge for us, but we have to just keep monitoring and see where we are going on this."

Doctors in wait-and-see mode

All 50 states are under a federal disaster declaration for the first time in US history. There are more than 29,000 members of the National Guard deployed across the country to deal with the pandemic, according to the National Guard Bureau. Guardsmen have been called to serve a variety of roles, from staffing emergency operations centers to restocking grocery shelves.

Key to how optimistic Americans should be will depend on what comes next. The country's testing trajectory will be hugely important, experts say.

While President Donald Trump says he wants to reopen the country next month -- even telling state governments to "be ready" as he plans to announce a special council to reopen the country -- health officials say they're still in wait-and-see mode even if the numbers look promising.

"It's important to look at the country as many different separate situations," said Dr. Robert Redfield, director of US Centers for Disease Control and Prevention, on NBC's "Today" show.

"This pandemic has affected different parts of the country differently," Redfield said. "We're looking at the data very carefully, county by county by county, and we will be assessing that."

Public health capabilities need to be improved to perform early case detection, isolation and contact tracing, he said, and officials need to "start working to rebuild confidence in the community, so the community has confidence to reopen."

Testing and social distancing

The US is "nearing the peak right now," Redfield told the morning show.

"You'll know when you're at the peak when the next day is less than the day before," he said. "We are stabilizing across the country in terms of the state of this outbreak."

Detroit and Los Angeles reported lower rates of cases Monday.

As for getting the country back to normal, Redfield said it has to be done correctly and "it's going to be a step-by-step, gradual process."

The call for caution is being echoed on the world stage as World Health Organization Director-General Tedros Adhanom Ghebreyesus asked people to remember the virus accelerates faster than it decelerates, so "control measures can only be lifted if the right public health measures are in place."

Redfield concurred with Adams that social distancing is working -- and said the potential death toll "while sadly too high, was far less than we anticipated" -- but said relaxing those guidelines would need to be done carefully.

Testing is still not widely available, and many states have still tested only small percentages of their populations.

Antibody tests, which reveal past coronavirus infection -- an especially important test for health care workers -- will "give us a good idea from a surveillance point of view of how significant the outbreak was."

A majority of the storms were across the South and East Coast, according to the National Weather Service, with at least 34 tornadoes reported in Texas, Louisiana, Mississippi and Georgia as of early Monday. At least 18 people died.

Continued here:

Model predicts Covid-19 pandemic will 'peter out' by May, but experts are skeptical - CNN

Is it possible to be infected with the coronavirus and show no symptoms? Or go through a period of several days before symptoms kick in?

And even in this stage with no cough, no fever, no sign of illness, could you be transmitting the virus to others?

"There is evidence that SARS-CoV-2 has this ability to spread silently," says Shweta Bansal, an infectious disease modeler at Georgetown University.

Indeed, cases of COVID-19 among nursing home residents, choir groups and families fuel a growing concern about people who are infected, yet feel generally OK and go about their daily lives, giving the virus to friends, family members and strangers without knowing that they themselves have it.

But there are wide gaps in our understanding of how many people fit this category of "silent spreaders" as they're called by some public health researchers and how much they contribute to transmission of the disease.

Silent spreaders can be divided into three categories: asymptomatic, presymptomatic and very mildly symptomatic. Here's what we know about these variations.

Asymptomatic: people who carry the active virus in their body but never develop any symptoms

"Nothing at all," says Tara C. Smith, an epidemiologist at Kent State University's College of Public Health. "No fever, no gastrointestinal issues, no breathing issues, no coughing, none of that."

As you might imagine, it's hard to figure out when someone has a disease but shows no signs of it.

Some cases of asymptomatic carriers have been confirmed by finding and testing people who were in close contact with COVID-19 patients. For those who tested positive without symptoms, follow-up exams confirmed that about 25% continued to show no signs, World Health Organization officials said on April 1, citing data from China.

No one can truly determine the impact of asymptomatic cases on spread until there's more testing. But so far, they have made up a sliver of the total number of people who've tested positive. And the affected individuals seem to skew young. A small clinical study from Nanjing, China, followed 24 people who tested positive but didn't show overt symptoms at the time. In the one to three weeks after diagnosis, seven continued showing no symptoms. Their median age was 14.

"Can those people who are completely asymptomatic, who never develop any symptoms, transmit the infection? That's still kind of an open question," says Smith.

Presymptomatic: people who have been infected and are incubating the virus but don't yet show symptoms

After infection, symptoms might not develop for five to six days or even two weeks, according to the Annals of Internal Medicine. The time between catching the virus and showing symptoms is called the presymptomatic phase.

How do these individuals figure into transmission?

People appear to be most infectious right around the time when symptoms start, said Maria Van Kerkhove, technical lead for the WHO's Health Emergencies Programme, at an April 1 news conference. However, "we do have evidence, from testing and modeling studies, that suggest people who are presymptomatic can definitely transmit this virus," says Smith, the epidemiologist, most likely in the one to three days before they start showing symptoms, according to the WHO.

So far, presymptomatic is a much more common category than asymptomatic. About 75% of people who test positive without showing symptoms turn out to be presymptomatic, displaying coughing, fatigue, fever and other signs of COVID-19 in a later follow-up exam, said Van Kerkhove.

At a nursing home in King County, Washington, about a third of its 82 residents tested positive for the coronavirus in mid-March. Half of those were free of fever, malaise and coughing when they were swabbed for the virus, though most went on to develop symptoms. The coronavirus spread rapidly through the facility just two weeks after it was introduced by a health care provider, despite the nursing home's policy of isolating residents with signs of COVID-19. This suggests that "transmission from asymptomatic and presymptomatic residents, who were not recognized as having SARS-CoV-2 infection and therefore not isolated, might have contributed to further spread," according to research published in the CDC's April 3 "Morbidity and Mortality Weekly Report."

A study in Singapore found similar evidence of presymptomatic spread among people who went to church, took singing classes or puttered at home with their spouses.

Very mildly symptomatic: people who feel a little unwell from a COVID-19 infection but continue to come in close contact with others

"We're very lucky that this isn't a severe infection for everyone, but because of that, some people feel a little sick and power through," says Seema Lakdawala, a flu researcher at the University of Pittsburgh.

Spreading COVID-19 while having a cough or very mild fever doesn't fully count as silent transmission, says Bansal, the infectious disease modeler: "There's some signal there at least."

But people who continue to frequent communal and public places with a light cough or mild fever may unwittingly spread the disease in the early days of symptom onset the time they're thought to be most infectious.

Even when a person's own symptoms remain mild, others they infect can become very sick. In mid-January, a man returned to his home in Nanjing from a trip to Hubei province, the epicenter of China's epidemic. Ten days later, his wife started running a fever and vomiting; soon, she developed severe pneumonia and required care in the intensive care unit. The man was tested for the coronavirus, and the test came back positive; he's presumed to have spread the virus to his wife. X-ray scans showed signs of the virus in his lungs but he consistently reported feeling fine, according to epidemiological research published in Science China Life Sciences.

What we don't yet know

How many people are mingling in the population without knowing they've been infected with the coronavirus?

It's simply too soon to say. In one of the places where there has been extensive testing, the nursing home in Washington state, 56% of those who tested positive had no symptoms when they got tested. Aboard the Diamond Princess cruise ship docked in Japan, February data showed that up to 50% of the people who tested positive showed no symptoms at the time and that an estimated 18% remained asymptomatic.

Are asymptomatic and presymptomatic cases responsible for a lot of transmission?

Uncertainties abound.

Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, told NPR in an interview on April 9 that while he thinks "asymptomatic spread was and is more significant than was appreciated back in January, the relative contribution of asymptomatic spread to symptomatic spread has not been clearly defined."

A modeling paper in Science suggests that in China before the lockdown, undiscovered cases mainly people with "mild, limited or no symptoms" were less infectious than known cases but were still possibly responsible for 79% of transmission, because so many of them continued to congregate or travel while contagious. Other papers from Singapore and China suggest that presymptomatic cases account for 6% to 13% of transmission.

To start answering these questions about spread, "we really need more testing and more follow-up," says Smith.

The National Institutes of Health announced Friday that it's recruiting up to 10,000 volunteers for blood testing to look for antibodies to COVID-19 a sign that a person was infected in the past. "This study will ... [tell] us how many people in different communities have been infected without knowing it, because they had a very mild, undocumented illness or did not access testing while they were sick," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, in a news release.

Even though there is still much to learn about silent spreading, the concerns about this mode of transmission give more weight to the advice we've been hearing all along: Keep a 6-foot distance from others, wash hands often and wipe down surfaces. "Don't wait for symptoms to protect those around you," Bansal of Georgetown University says, because there's mounting evidence that a person with the coronavirus could look and feel as healthy as ever but still be spreading it to others.

Read this article:

The Silent Spreaders Of COVID-19: Asymptomatic, Presymptomatic, Mildly Symptomatic Cases : Goats and Soda - NPR

COVID-19 research is advancing at an unprecedented speed, but one strategy doctors are leaning on to treat COVID-19 patients looks more antiquated than innovative. In hospitals around the United States, caregivers are resorting to using century-old convalescent plasma therapy siphoning blood from survivors and reinfusing it into the sick.

Thats because the hundreds of research papers published in the past few months and the record-setting leaps in vaccine development havent been fast enough to keep up with the blistering speed of the ongoing pandemic. People are sick and dying now, which is why doctors are falling back on plasma therapy as one stopgap measure that they hope can help in the lag time before other treatments come online.

I think of it as a bridge, until we can develop a vaccine or pharmaceutical that can be shown to be safe, and effective, and can be produced in mass quantities, says Elliott Bennett-Guerrero, who is studying the use of this convalescent plasma in COVID-19 patients at Stony Brook Medicine.

After someone is infected with a virus like the novel coronavirus and recovers, their blood is rich with antibodies that their immune system produced to help them fight the virus off. Doctors hope that giving the antibody-infused blood plasma to a newly sick person, who may not have antibodies yet, could help them get better more quickly.

With plasma were leveraging the bodys amazing ability to develop antibodies and immunity to pathogens, Bennett-Guerrero says. We transfer those protective factors to people who are sick and havent been able to mount an immune response.

Its been used as a treatment since at least the 1890s when blood from survivors was given to diphtheria patients. Studies during the 1918 flu pandemic showed that it was an effective treatment. It was used to managed dozens of illnesses in the century since, including measles and chickenpox.

Now, doctors hope it can help people with COVID-19. Preliminary data on a handful of patients in China showed that they got better after receiving a plasma infusion from survivors, but theres still not enough data to say for sure that it works. Researchers in the US are running controlled studies to see if patients who receive the plasma improve faster than patients who dont.

Its an old technique, says Scott Koepsell, medical director in the division of transfusion and transplantation support services at the University of Nebraska Medical Center who has collected plasma from Ebola survivors. He says that while plasma transfusions have been used for over a century, its still a treatment of last resort. Its a really well-meaning approach, but it has a lot of variability and limitations.

For example, every person who survives an infection will have a slightly different mix of immune substances in their plasma. Each sick person treated with plasma, then, is getting a slightly different treatment. That can make it really difficult for researchers to tell whether plasma therapy is generally effective (or ineffective) or whether it depends on if a patient gets a really good (or bad) batch of plasma. Medical researchers are trying to address this issue by only allowing survivors with high levels of antibodies to donate plasma, but the plasma will still vary from donor to donor.

In addition to the general uncertainty over how well these transfusions will work, there are also risks to any blood plasma transfusion: serious side effects can include lung injuries and allergic reactions.

Koepsell treated Ebola patients in the US with convalescent plasma during the outbreaks in 2014 and 2015. With Ebola, unlike COVID-19, there were additional benefits: plasma can also help prevent dangerous bleeding caused by that virus. Ebola was more likely to be dangerous for each person who got it, he says, making the risks easier to justify in the absence of clear evidence that plasma transfusions are effective.

In any outbreak, convalescent plasma has one major upside: its available as soon as someone survives a new illness. The good thing is its readily available shortly after something happens, Koepsell says.

Ideally, other, more standardized drugs specific to this disease would be available quickly, too. Those other drugs still take too long to get to patients in part because there hasnt been enough investment made to develop them. After the outbreaks SARS and MERS, which are also coronaviruses, scientists started work on possible treatments and vaccines. But with more distance from those outbreaks, the money dried up. Researchers doing that work arent as close to answers as they might have been if thered been a more sustained investment.

Its possible to shrink the window between when a new disease appears and when treatments are available, Koepsell says, so that doctors arent left reaching for plasma. Investment in disease preparedness and steady work on antiviral drugs for pathogens like coronaviruses would give them more resources for the next outbreak.

Hopefully well have governments and institutions recognize that pandemics can come with more frequency, he says. Id like to get away from collecting blood and transfusing it every time a new disease arrives.

Excerpt from:

Why were relying on blood infusions from survivors to treat COVID-19 - The Verge

"I mean, obviously, you could logically say that if you had a process that was ongoing and you started mitigation earlier, you could have saved lives," Fauci, the nation's top infectious disease expert, told CNN's Jake Tapper on "State of the Union" when asked if social distancing and stay-at-home measures could have prevented deaths had they been put in place in February, instead of mid-March.

"Obviously, no one is going to deny that. But what goes into those decisions is complicated," added Fauci, who is a key member of the Trump administration's coronavirus task force. "But you're right, I mean, obviously, if we had right from the very beginning shut everything down, it may have been a little bit different. But there was a lot of pushback about shutting things down back then."

Asked why the President didn't recommend social distancing guidelines until mid-March -- about three weeks after the nation's top health experts recommended they be put in place -- Fauci said, "You know, Jake, as I have said many times, we look at it from a pure health standpoint. We make a recommendation. Often, the recommendation is taken. Sometimes it's not. But we -- it is what it is. We are where we are right now."

According to the Times report, Dr. Robert Kadlec, the top disaster response official at the Department of Health and Human Services, convened the White House coronavirus task force on February 21. During his meeting, the group conducted a mock-up exercise of the pandemic that predicted 110 million infections, 7.7 million hospitalizations and 586,000 deaths.

The group "concluded they would soon need to move toward aggressive social distancing, even at the risk of severe disruption to the nation's economy and the daily lives of millions of Americans," but it took more than three weeks for Trump to enact such guidelines on March 16.

Fauci told Tapper that "there is always a possibility, as we get into next fall and the beginning of early winter that we could see a rebound," in the virus, but the lessons learned from the first iteration of it should help the US better respond to a potential new wave.

"Hopefully, hopefully, what we have gone through now and the capability that we have for much, much better testing capability, much, much better surveillance capability, and the ability to respond with countermeasures, with drugs that work, that it will be an entirely different ball game," he said.

'Not going to be a light switch'

Fauci said Sunday that the process of returning to normal "is not going to be a light switch that we say, 'OK, it is now June, July' ... click -- the light switch goes back on."

He added: "It's going to be depending where you are in the country, the nature of the outbreak that you have already experienced and the threat of an outbreak that you may not have experienced. So it's going to have to look at the situation in different parts of the country."

Asked by Tapper when he thought that process could start, Fauci said he thinks "it could probably start at least in some ways maybe next month," but noted that it's "difficult" to make those types of predictions and officials are trying to open the country "appropriately."

Trump said Saturday night that he hopes to make a decision "fairly soon" on when to reopen the country amid the coronavirus pandemic, telling Fox News' Jeanine Pirro, "We have to bring our country back. So, I'll be making a decision reasonably soon, we're setting up a council now of some of the most distinguished leaders in virtually every field -- including politics, and business and medical -- and we'll be making that decision fairly soon."

An ominous warning

The director of the Institute for Health Metrics and Evaluation said Sunday that if the social distancing measures and closures were relaxed on May 1, the country would see a rebound of coronavirus cases.

"We don't think the capability in the states exists yet to deal with that volume of cases and so by July or August we could be back in the same situation we are in now" if there was premature opening of the country, Dr. Christopher Murray said on CBS, adding that West Coast states that are further along in the pandemic will still need "weeks of closures" beyond the peak for the opportunity to conduct proper testing and contact tracing.

Relaxing closures and social distancing measures on a rolling basis, he said, poses a new set of questions that have not been addressed.

"Of course there's a big issue of states are on different timings of their epidemics, which we know is the case. How are they going to control importation from other states into their state?" Murray said.

The inconsistent state mitigation policies have also been a problem for the modeling of the pandemic, according to Murray, who said that "incomplete implementation of social distancing closures in many states (is) adding a degree of uncertainty."

The World Health Organization special envoy, Dr. David Nabarro, went a step further in an interview with NBC on Sunday, issuing an ominous warning about coronavirus, which has already infected more than 1,827,000 people worldwide.

"We're not so sure that it will come in waves in the way that influenza does," he said. "We think it's going to be a virus that stalks the human race for quite a long time to come until we can all have a vaccine that will protect us and that there will be small outbreaks that will emerge sporadically and they will break through our defenses."

Nabarro said it will be "key" for countries to "pick up cases as soon as they appear, isolate them and stop outbreaks from developing."

This story has been updated with additional developments Sunday.

CNN's Kevin Bohn, Maeve Reston, Maegan Vazquez, Jason Hoffman, Kristen Holmes, Jeremy Diamond and Wes Bruer contributed to this report.

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Fauci admits earlier Covid-19 mitigation efforts would have saved more American lives - CNN

Welcome back to AM Intel, a Monday morning round-up of mini news bites to kick off the week.

Evolving Pandemic Regulations

On April 8, Gov. Charlie Baker supplemented previously announced grocery store regulations for Massachusetts with additional requirements, including that grocery stores must limit occupancy including both staff and customers to 40% of their maximum permitted occupancy. (This doesnt apply to stores that already have an occupancy of 25 or fewer people.) Stores are also encouraged to designate one-way aisles where possible.

Within the state, some cities and towns are tightening up their own pandemic-related restrictions. Salem, for example, is now mandating that everyone wears a face covering within essential businesses (such as grocery stores) and communal areas of residential spaces. Ice cream trucks are also banned for now.

Brookline is also requiring customers to cover their faces while inside businesses, and staff must wear protective face, hand, and eye protection as well as install temporary Plexiglas-type barriers at customer service counter areas. Employees temperatures must be taken and recorded at the start of each shift. Restaurants offering takeout are encouraged to transition to non-contact methods with online or phone payment and curbside pickup.

In Lynn, there is now a citywide curfew between 9 p.m. and 6 a.m. only those who are providing or receiving essential services can be out of their homes between those hours.

Openings and Closings

While the local restaurant scene hangs in limbo trying to get by on takeout and delivery and waiting for relief, trying to hold on until regular service is allowed again, some normal restaurant news continues: Some restaurants are opening; some restaurants are closing.

Openings, of course, dont include dine-in service at this time, as mandated by the state until at least May 4 but thats not stopping a couple takeout-friendly places from making their grand debut. Small local coffee chain Coffee Break Cafe opened a new location in South Quincy (102 Franklin St.) in late March, and fried chicken chain Popeyes is now open in West Roxbury (1630 VFW Parkway). The location has a drive-through window.

Prudential Center mainstay Top of the Hub which announced an April closing back in January had its final weeks cut short by the pandemic and is now permanently closed, ending a 55-year run 52 stories above Boston. Over on Stuart Street, Flemings Steakhouse has also closed permanently after operating for two decades. And in Somerville, the Assembly Row location of pizza chain Midici is closed as well.

In Other News...

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Mass. Grocery Store COVID-19 Updates and More News - Eater Boston

She was diagnosed with COVID-19 after a trip to New York. Then the cruelty started.  Hawaii News Now

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She was diagnosed with COVID-19 after a trip to New York. Then the cruelty started. - Hawaii News Now

A sailor assigned to the aircraft carrier Theodore Roosevelt died after being admitted to an intensive care unit in Guam last week for coronavirus complications the first such death of a sailor from the vessel.

The individuals name is being withheld until 24 hours after next-of-kin notification. The sailor was admitted to the ICU at U.S. Naval Hospital Guam on Thursday and died Monday, according to the Navy.

The sailor tested for COVID-19 on March 30 and was removed from the ship and placed in isolation with four other service members.

The deceased sailor was found unresponsive at 8:30 a.m. during one of the two medical checks conducted daily for those in isolation.

While Naval Base Guam emergency responders were notified, CPR was administered by fellow sailors and onsite medical team in the house, a statement from the Navy chief of information office reads. The sailor was transferred to U.S. Naval Hospital Guam where the sailor was moved to the intensive care unit.

The Roosevelt has been in Guam since March 27. The vessels commander, Capt. Brett Crozier, was relieved following the leak of a four-page letter he penned imploring the Navy to remove the majority of the Roosevelts crew and provide individualized isolation for them ashore in Guam to prevent the spread of COVID-19.

Though a small portion of the crew had been removed from the ship and placed into group quarantine sites, only one of the locations complied with Navy guidance, according to the letter. Crozier asked to remove all but about 10 percent of the crew, who would remain to operate the reactor plant and perform sanitization.

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We are not at war. Sailors do not need to die. If we do not act now, we are failing to properly take care of our most trusted asset: our Sailors, Crozier wrote in the letter.

As of Sunday, 92 percent of Roosevelts 4,800 crew members have been tested for COVID-19. There have been 585 positive results. More than 3,900 sailors have since been moved ashore and entered 14-day isolations in hotels and other rooms across Guam, according to the Navy.

We mourn the loss of the Sailor from USS Theodore Roosevelt who died today, and we stand alongside their family, loved ones, and shipmates as they grieve, Chief of Naval Operations Adm. Mike Gilday said.

This is a great loss for the ship and for our Navy. My deepest sympathy goes out the family, and we pledge our full support to the ship and crew as they continue their fight against the coronavirus. While our ships, submarines and aircraft are made of steel, Sailors are the real strength of our Navy.

The sailor who died Monday is the second U.S. service member to succumb to COVID-19.

The first was Army Capt. Douglas Linn Hickok, a 57-year-old physician assistant in the New Jersey National Guard who was hospitalized March 21 after testing positive for COVID-19.

A week later, he succumbed to the respiratory disease at a Pennsylvania hospital. Hickok, however, was not on active duty orders at the time of his death and had not yet been mobilized during the pandemic.

This is a developing story. Stay with Navy Times for updates.

Read more here:

Sailor from Theodore Roosevelt has died of COVID-19 complications - NavyTimes.com

Lets start with the facts, which are incontrovertible.

On Tuesday, March 17, at the stroke of midnight, San Franciscans were made to shelter-in-place, not at the declaration of Mayor London Breed, or any elected official, but due to a regional order banged out over the prior weekend and released by seven health directors across six Bay Area counties.

You can see it here. You can see the places where the order states BLANK so each of the six counties can insert San Francisco or Solano or Alameda or whatever into its version of the text.

The order concludes with a line marked NAME, Health Officer of the County of BLANK.

This order was superseded on March 31 by an extension. You can see it here. You will note that San Francisco has simply copied-and-pasted the text from Santa Clara, which explains why it lists the COVID-19 case totals for that county. (San Francisco only met and passed the 848 cases listed in this March 31 dictum on April 12 or thereabouts after the outbreak at the MSC-South homeless shelter. More about that momentarily.).

Late at night on March 15, state officials confirmed to me that we would be getting a regional shelter-in-place order coming out the next day, and the announcement would be made by the counties health directors on Monday afternoon.

And that did happen. You can see it here. But, before the seven doctors spoke at a press conference helmed by Santa Clara health officer Dr. Sara Cody, San Francisco Mayor London Breed scheduled her own, earlier press conference.

Officials in multiple Bay Area counties told me they were taken aback by this deviation from an agreed-upon plan.

We were told no one would announce anything until the county health officers held their presser. Letting the white coats make the announcement on the order was viewed as the scientists know best optic, said one county official from over the bridge. This was all worked out by the county health officers and then told to the electeds.

Here are the facts, again incontrovertibly: An early March study in Santa Clara led by the Centers for Disease Control found a ghastly 11 percent of sickly people it surveyed tested positive for COVID-19 leading county health director Dr. Cody to convene her medical colleagues and issue that regional order only days later. And if you dont believe me, believe the San Francisco Chronicles brilliant Erin Allday.

But, by holding her press conference first, Breed grabbed the spotlight and the nations attention. A regional order issued by regional health directors for health reasons has instead been portrayed inaccurately as a unilateral San Francisco crusade, led by an intrepid San Francisco elected official.

Other counties elected and appointed officials have grumbled quietly about this, and journalists, to my knowledge, have not yet put all these facts in one place.

Perhaps thats because the mayor deserves no small degree of leeway in the midst of a crisis. And San Franciscans should be, to some extent, grateful for Mayor London Breed.

We should be grateful that our mayor took the COVID-19 threat seriously, listened to her health experts, and supported their dictums. This is not faint praise; this is more than many local, state and notably federal officials could be bothered to do. The comparison of Breed tweeting out warnings of a pending shelter-in-place while New York City Mayor Bill de Blasio made theater recommendations is telling, regardless of who issued the shelter-in-place orders.

Breed declaring a state of emergency on Feb. 25 was a move that has aged well. San Francisco, and the Bay Area writ large, have not been ravaged by COVID-19 as other areas have, and thats because of relatively early, aggressive actions (at least among the housed population).

So, we should praise Mayor Breed for what she did and what shes done. But not for what she didnt do and hasnt done and will not do.

We must not allow a false narrative to become cemented and then serve as a foundation. We must not allow this false narrative to obscure and buttress criticisms against how this city is conducting its business.

And that is happening. To wit, in the latest blithe report from a national publication that San Francisco is single-handedly leading the charge against COVID-19,TheAtlantic this weekend published a jarring article titled The City That Has Flattened the Coronavirus Curve: Mayor London Breeds early and aggressive moves to contain the outbreak have made San Francisco a national model in fighting the pandemic.

Separate and apart from premature medical diagnoses in a city in which, for weeks, first-responders purportedly had to drive out to Hayward to be tested embarrassing San Francisco government officials this article does not make any mention of the five other counties under the identical regional order.

It does not, in fact, make any mention of that regional health order, issued by seven health directors in six counties. It does not make any reference to Dr. Cody or the CDC-led study in her county that led to a cadre of health directors convening and issuing this order. Rather,The Atlanticstates that Breed issued the order, which is factually incorrect and, given the omission of the five other counties and their health directors, is also highly misleading.

The articledoes note that Breed curtailed large gatherings, such as Warriors games, without mentioning that days earlier, Santa Clara County curtailed large gatherings such as Sharks games. The article fails, however, to mention that San Francisco officials implored the Warriors to cancel games for days and were rebuffed; San Francisco banned large gatherings in city-owned venues and left private entities to their own devices.

The citys non-mandatory aggressive recommendations to curtail the virus included canceling non-essential events including large gatherings such as concerts, sporting events, conventions, or large community events but the Dubs a team with a 15-50 record were still allowed to fill Chase Center for two more games.

The Atlantic reports that Breed was inspired to shut this city down when she saw horrific photos and videos emanating from Wuhan from late 2019 and early 2020 even though, again, the health officers shut this city down. But the article does not report that she wrote a letter to would-be attendees of the massive February RSAC Conference in San Francisco downplaying their COVID-19 fears.

Risk of becoming infected with COVID-19 in San Francisco is low as the virus is not circulating in our community, she wrote on Feb. 20. San Francisco is open for business as leaders in business and government, we must set an example to prevent fear, rumors, and misinformation from guiding our actions.

That conference was not canceled, despite Verizon and IBM seeing fit to pull out. At least two attendees did, indeed, subsequently test positive for COVID-19.

On Mission Street. Photo by Lola M. Chavez.

All of which led up to Breeds April 10 announcement that 68 homeless residents and two staffers at MSC-South had tested positive for COVID-19, numbers that have since been updated to 71 residents and five staffers.

And we are all still waiting to hear how awful the outbreak will become at Laguna Honda Hospital city officials I have spoken with are bracing for a dire outcome. Dozens of cases are reported in San Franciscos single-room occupancy hotels, too.

So, the citys manic, incoherent and insufficient COVID-19 plans for its homeless and underserved populations isnt a mere footnote in the grander story, as The Atlantic portrayed it. It may end up being the story. Its a major weak spot that could undermine all the citys best-laid plans, and swamp much or all of the good work San Francisco did.

Even if you dont care much about the plight of impoverished and/or homeless people and, clearly, many in this city do not they will still wander about breathing your air, get sick and go to your hospital and need to use your ventilator. Even the most selfish person should realize this is everyones problem.

A massive outbreak in a crowded homeless shelter manned by under-equipped staffers was this citys Chernobyl the predicted and predictable outcome of a concatenation of missteps and dubious decisions.

For weeks, a growing chorus from the Board of Supervisors, faith leaders, and homeless advocates has called for housing the citys vulnerable homeless population not in crowded, congregate shelters or on the streets but in the citys vast recesses of vacant hotel rooms.

But Breed has resisted this call. First, it was explained that the asymptomatic homeless were not one of the priority groups as prioritized by the Department of Public Health. Then this was portrayed as a staffing/capacity issue. And, finally, it was portrayed as a cost issue; obtaining thousands of hotel rooms and shuttling the homeless into them was not deemed to be fiscally prudent for a city facing a potential shortfall exceeding $1 billion.

Along with all that, Breed claimed that people who have drug challenges and mental health issues are not going to take a room and stay there.

Fair enough. But the relatively functional homeless people who dont fit those criteria perhaps half, by the reported estimate of this citys homeless department officials would take a room and stay there. Families would take a room and stay there. The staffing at such a hotel wouldnt need to be so different than what youll find in supportive housing and San Francisco houses tens of thousands of people in supportive housing every day.

And the costs, while astronomical, likely pale in comparison to paying on the back end in hospitals after leaving people in shelters or fending for themselves on the streets during a pandemic. To say nothing of the moral or humanitarian costs of doing that.

But thats what weve done thus far. The status quo was to keep homeless people crammed into crowded shelters without much in the way of physical distancing. The status quo was to have city policy be to inform homeless providers to keep hotel rooms empty rather than move in vulnerable families who are sleeping in cars or domestic violence shelters in the midst of a plague. The status quo was to curtail new entries into the shelters in a belated attempt to enable distancing, resulting in ever denser shantytowns on the sidewalks. The status quo was to attempt to solve the contagion problem of crowded, congregate shelters by opening up even bigger congregate shelters.

After announcing the outbreak at MSC South on Friday, Breed told the press that the fact is, we were on top of it.

Considering the weeks of high-decibel begging to take action to avoid just such an outcome, this was a truly mind-boggling thing to say. It was akin to boasting, We caught the baby on the first bounce.

She also noted that the city could act fast because hundreds of hotel rooms were at the ready in the event of an outbreak. But not, it would seem, beforehand.

While Breed initially announced that MSC South would become a medical center, that plan, like so many others addressing the plight of the citys neediest, was quickly scrapped. Instead, the shelter-dwellers were moved, en masse, to hotels.

MSC South is now empty. A line of tents ring its perimeter.

Articles like the one in The Atlanticplay into San Franciscos natural sense of exceptionalism. And, in this case, that isnt just uncalled for and factually indefensible. Its also dangerous.

It allows us to ignore the written evidence and see things as wed simply wish they were. San Francisco is doing better because we are better. It allows us to ignore the dearth of testing and insufficient contact tracing and false starts and reversals on housing the homeless and the melodrama on acquiring hotel rooms and the indignant responses to calls for transparency.

It allows us to shrug our shoulders and write off the shelter outbreak as inevitable when it didnt have to be.

We can do better. We must do better. Lives are at stake. We arent out of this yet.

That, too, is an incontrovertible fact.

***

Originally posted here:

COVID-19: 'The Atlantic' article about San Francisco is a fable. Here's what's really happening. - Mission Local

HARRIS COUNTY, Texas Mobile coronavirus testing sites are coming to the Tomball and Humble area starting this week, the Harris County Pct. 4 Commissioner's Office confirmed Monday.

Harris County Public Health is running both sites, which are temporary and only available for pre-approved residents. Officials said walk-ins will not be allowed.

The Tomball site will doing tests through April 14 - 16 and April 27 - 29.

The Humble site will be doing tests through April 20 - 22 and May 7 - 9.

Commissioner R. Jack Cagle said each site is able to complete as many as 100 tests per day, but these numbers expected to increase daily.

Residents must do pre-screening at checkforcorona.com/harriscounty.

Those deemed to be at-risk for coronavirus will be given a code and phone number to call. After a telephone consultation, those still deemed to be at risk will be given another unique code and information on where and when they are to be tested.

OTHER CORONAVIRUS STORIES ON KHOU.COM

The symptoms of coronavirus can be similar to the flu or a bad cold. Symptoms include a fever, cough and shortness of breath, according to the Centers for Disease Control. Some patients also have nausea, body aches, headaches and stomach issues. Losing your sense of taste and/or smell can also be an early warning sign.

Most healthy people will have mild symptoms. A study of more than 72,000 patients by the Centers for Disease Control in China showed 80 percent of the cases there were mild.

But infections can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death, according to the World Health Organization. Older people with underlying health conditions are most at risk for becoming seriously ill. However, U.S. experts are seeing a significant number of younger people being hospitalized, including some in ICU.

The CDC believes symptoms may appear anywhere from two to 14 days after being exposed.

Get complete coverage of the coronavirus by texting 'FACTS' to 713-526-1111.

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Mobile COVID-19 testing sites coming to Tomball, Humble starting this week - KHOU.com

INDIANAPOLIS, Ind. (WANE) Indiana State Health Commissioner Dr. Kristina Box said the health impact of the novel coronavirus on Hoosiers is looking better than initially thought. She shared this insight Monday at Governor Eric Holcombs daily briefing.

Box explained that while some national organizations do make COVID-19 model predictions for Indiana, she trusts the ones done in the Hoosier state itself which use only Indiana numbers that her team has gathered.

She and a group of data engineers look at different models, digest them, and pick the one that the state is following most closely.

Our surge predictions are based much more specifically on Indiana numbers alone, she said. Were looking at what Indiana has done with social distancing. Were looking with regards to where our numbers are highest and in what part of the state, what our hospitalizations look like, and our ventilator usage looks like.

According to the latest report her team has compiled, Box said Indiana wont reach the peak of COVID-19 cases and deaths until late April or early May, but that peak will be lower than originally expected.

I really do believe that we have not seen the peak of that surge yet, but I do believe we will be a lot lower which is the result of the very strict guidelines and the requirements weve had for social distancing in this state and I think thats a really important fact, she said.

Box quoted the nations top infectious disease expert Dr. Anthony Fauci by saying a model is only as good as what you put into it.

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State Health Commissioner: We have not seen the peak of COVID-19 in Indiana - WANE