Category: Covid-19

But what is most worrisome is the racial disparity in prior health conditions that exist in the United States. As Bloomberg reported about a study of the deaths in Italy: Almost half of the victims suffered from at least three prior illnesses, and about a fourth had either one or two previous conditions. More than 75 percent had high blood pressure, about 35 percent had diabetes and a third suffered from heart disease.

According to the Centers for Disease Control and Prevention, high blood pressure is most common in non-Hispanic black adults (54 percent), and black people have the highest death rate from heart disease.

As for diabetes, the 2015 National Medical Association Scientific Assembly, held in Detroit, where my friend died, delivered these stark statistics:

African-American patients are more likely than white patients to have diabetes. The risk of diabetes is 77 percent higher among African-Americans than among non-Hispanic white Americans. The rates of diagnosis of diabetes in non-Hispanic African-Americans is 18.7 percent compared to 7.1 percent.

The group went on to say that in 2006, African-Americans with diabetes were 1.5 times more likely to be hospitalized and 2.3 times more likely to die from diabetes than non-Hispanic whites.

In addition, many Southern states refused to expand Medicaid under the Affordable Care Act, and there is a rural hospital crisis in this country. But that crisis is compounded in the South, where, as the magazine Facing South points out, the rural areas have higher poverty rates, higher mortality rates, and lower life expectancies than other rural regions of the country.

This all worries me, because I take a lesson from the H.I.V./AIDS crisis. In the beginning, it was largely seen as a New York and San Francisco problem affecting white men who were gay. Over the decades, treatments became available, and those cities saw their new infection rates plummet.

But the disease remained very much alive, particularly in the South, particularly among black people, where it has reached epidemic proportions. In the United States, more than 40 percent of people living with H.I.V. and 40 percent of people with new infections are black, according to the C.D.C., and African-American men accounted for three-quarters of new H.I.V. infections among African-Americans in 2016, and 80 percent of these were among African-American gay and bisexual men.

Link:

The Racial Time Bomb in the Covid-19 Crisis - The New York Times

So if epidemiological models dont give us certaintyand asking them to do so would be a big mistakewhat good are they? Epidemiology gives us something more important: agency to identify and calibrate our actions with the goal of shaping our future. We can do this by pruning catastrophic branches of a tree of possibilities that lies before us.

Epidemiological models have tailsthe extreme ends of the probability spectrum. Theyre called tails because, visually, they are the parts of the graph that taper into the distance. Think of those tails as branches in a decision tree. In most scenarios, we end up somewhere in the middle of the treethe big bulge of highly probable outcomesbut there are a few branches on the far right and the far left that represent fairly optimistic and fairly pessimistic, but less likely, outcomes. An optimistic tail projection for the COVID-19 pandemic is that a lot of people might have already been infected and recovered, and are now immune, meaning we are putting ourselves through a too-intense quarantine. Some people have floated that as a likely scenario, and they are not crazy: This is indeed a possibility, especially given that our testing isnt widespread enough to know. The other tail includes the catastrophic possibilities, like tens of millions of people dying, as in the 1918 flu or HIV/AIDS pandemic.

Read: The curve is not flat enough

The most important function of epidemiological models is as a simulation, a way to see our potential futures ahead of time, and how that interacts with the choices we make today. With COVID-19 models, we have one simple, urgent goal: to ignore all the optimistic branches and that thick trunk in the middle representing the most likely outcomes. Instead, we need to focus on the branches representing the worst outcomes, and prune them with all our might. Social isolation reduces transmission, and slows the spread of the disease. In doing so, it chops off branches that represent some of the worst futures. Contact tracing catches people before they infect others, pruning more branches that represent unchecked catastrophes.

At the beginning of a pandemic, we have the disadvantage of higher uncertainty, but the advantage of being early: The costs of our actions are lower because the disease is less widespread. As we prune the tree of the terrible, unthinkable branches, we are not just choosing a path; we are shaping the underlying parameters themselves, because the parameters themselves are not fixed. If our hospitals are not overrun, we will have fewer deaths and thus a lower fatality rate. Thats why we shouldnt get bogged down in litigating a models numbers. Instead we should focus on the parameters we can change, and change them.

Every time the White House releases a COVID-19 model, we will be tempted to drown ourselves in endless discussions about the error bars, the clarity around the parameters, the wide range of outcomes, and the applicability of the underlying data. And the media might be tempted to cover those discussions, as this fits their horse-race, he-said-she-said scripts. Lets not. We should instead look at the calamitous branches of our decision tree and chop them all off, and then chop them off again.

Sometimes, when we succeed in chopping off the end of the pessimistic tail, it looks like we overreacted. A near miss can make a model look false. But thats not always what happened. It just means we won. And thats why we model.

We want to hear what you think about this article. Submit a letter to the editor or write to letters@theatlantic.com.

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Dont Believe the COVID-19 Models - The Atlantic

Over a normal two-week period wed expect around half a million U.S. workers to file claims for unemployment insurance. Over the past two weeks weve seen almost 10 million filings. Were facing an incredible economic catastrophe.

The question is whether were ready to deal with this catastrophe. Alas, early indications are that we may be handling fast-moving economic disaster as badly as we handled the fast-moving pandemic thats causing it.

The key thing to realize is that we arent facing a conventional recession, at least so far. For now, most job losses are inevitable, indeed necessary: Theyre a result of social distancing to limit the spread of the coronavirus. That is, were going into the economic equivalent of a medically induced coma, in which some brain functions are temporarily shut down to give the patient a chance to heal.

This means that the principal job of economic policy right now isnt to provide stimulus, that is, to sustain employment and G.D.P. It is, instead, to provide life support to limit the hardship of Americans who have temporarily lost their incomes.

There is, to be sure, a strong risk that well have a conventional recession on top of the induced coma; more on that in subsequent columns. But for now, the focus should be on helping those in need.

Paul Krugmans Newsletter: Get a better understanding of the economy and an even deeper look at whats on Pauls mind.

The good news is that the $2 trillion CARES Act (Coronavirus Aid, Relief, and Economic Security Act) Congress passed last week does, on paper, provide a lot of economic life support. The bad news is that it looks as if it could be weeks, maybe even months, before serious amounts of money flow to those who need aid right now.

Journalists keep referring to the CARES Act as a stimulus package, but mainly its disaster relief. The best piece of the legislation which, by the way, Democrats forced unwilling Republicans to include is a major enhancement of unemployment benefits. Not only will laid-off workers get much more than they normally would, but many workers who werent previously covered by unemployment insurance, such as freelancers and independent contractors, are supposed to receive full benefits.

The legislation also provides loans to small businesses loans that will be forgiven, that is, turned into straight subsidies, if businesses use the money to maintain their payrolls.

Both of these programs are very good ideas. The trouble is that both are having a hard time getting started and time is one thing millions of distressed Americans, many of whom were already living on the edge, dont have.

On unemployment benefits: State unemployment offices, already overwhelmed by the surge in applications, arent ready to disburse these extra benefits, and may not be ready for quite a while a disastrous delay for families already in dire financial straits.

Small business loans are also facing a crippling lag in processing, with potential borrowers either unable to complete the forms or being told that they will have to wait three weeks. Furthermore, for some reason the federal government, instead of lending money directly, is channeling small-business lending through private banks and the banks are complaining that they have yet to receive crucial guidelines and that the administration is setting unworkable requirements.

In other words, it may be a long time before the economy starts getting the life support it needs right away.

And even when workers and businesses finally get the promised aid, the CARES Act doesnt provide remotely enough money to state and local governments, which are seeing revenues plunge and expenses soar. This is likely to force big cuts in government services precisely when theyre needed most.

So what do we need right now? First, we need an all-hands-on-deck effort to resolve the bottlenecks that are holding up unemployment benefits and small-business loans.

The obvious parallel here is to the crash of healthcare.gov when the Affordable Care Act was first going into effect; things looked terrible at first, but an Obama administration expert task force, working around the clock, resolved the problems more quickly than anyone imagined possible, and new enrollments ended up exceeding expectations.

I dont see any reason, in principle, a similar effort couldnt rescue the CARES Act. But heres the thing: Were talking about the Trump administration, which disdains expertise of every kind, and in which every effort somehow ends up being directed by Jared Kushner.

Second, we need another relief bill to fill the holes in the CARES Act, especially inadequate aid to state and local governments.

But will Republicans be willing to provide that aid? Donald Trump is talking, as he has many times before, about a giant infrastructure bill. But Senate Republicans are notably unenthusiastic. And while going big on infrastructure is a good idea, right now its less pressing than providing aid to states facing huge budget gaps.

And going back to the bill that Congress already passed: Im fairly sure that well eventually get the kinks worked out. But when youre losing six million jobs a week, eventually isnt good enough.

The Times is committed to publishing a diversity of letters to the editor. Wed like to hear what you think about this or any of our articles. Here are some tips. And heres our email: letters@nytimes.com.

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The Covid-19 Slump Has Arrived - The New York Times

A medical worker administers a COVID-19 test at a facility in Camden, N.J., on Wednesday. Matt Rourke/AP hide caption

A medical worker administers a COVID-19 test at a facility in Camden, N.J., on Wednesday.

The new coronavirus is killing hundreds each day and swamping hospitals around the world. But catching the disease does not mean you will end up in the ICU.

"There are many patients that are fine and that are at home," says Michelle Ng Gong, the chief of critical care medicine at the Montefiore Health System in New York City. Those who don't need a hospital make up "I would dare say, in fact, the vast majority of people," she says.

Doctors like Gong are seeing many dozens of patients walk through their doors each day, and they're getting a better idea of who is at risk for severe illness. Here's their advice for what to watch out for if you think you or a loved one might have COVID-19.

Know who's at high risk of developing complications

Anyone can be made very sick by the coronavirus, but there are risk factors that increase your chances of developing serious disease.

By far the biggest factor is age. Data from several nations suggest that hospitalization and death rates rise in people older than 60. Those stats seem to be borne out by what Gong is seeing on the ground in New York City. "We've seen over and over again that our elderly patients are faring poorly," she says.

Additionally, there are a number of other health conditions that also put a person at risk. According to recent data from the Centers for Disease Control and Prevention, diabetes is a leading factor as is cardiovascular disease. Those two diseases often go hand-in-hand with obesity, and that means heavier people should also be vigilant, says Daniel Griffin, chief of the division of infectious disease for ProHEALTH Care Associates, a group of physicians that serves the New York City area.

Because COVID-19 is fundamentally a respiratory disease, anyone with lung ailments also needs to be careful. Asthma, chronic obstructive pulmonary disease and emphysema are all risk factors, the CDC says.

Finally, patients who have undergone transplants or who are immunocompromised can also get into trouble, Gong says. "It's particularly difficult with regards to being able to control the disease," she says.

Some symptoms are more worrisome than others

Fever and dry cough are among the most common symptoms of COVID-19, and by themselves, they don't require immediate medical attention. Additionally, Griffin says, many patients may experience gastrointestinal problems such as diarrhea or loose stools.

But Griffin says other symptoms early on in the illness could spell trouble later. In particular, he says, experiencing shortness of breath, significant headache, abdominal pain and severe fatigue in the first few days of illness all appear to be signs that a patient may be in for a tough fight to beat COVID-19.

Trouble with breathing, eating and drinking are all red flags, Gong says. "Those are all cause for you to consider calling a physician and seeing if you need to be evaluated for admission."

Griffin says one easy way to check breathing is to monitor how many breaths somebody takes a minute. "If they're starting to breath 24, 26, 30 times a minute, those are the high-risk people," he says.

Anyone who is worried should call their doctor rather than visit. "We're doing a lot more telehealth medicine," says Pavan Bhatraju, an assistant professor of medicine at the University of Washington. "Patients should use that as a resource."

Be vigilant, especially as the illness drags into the second week

A unique and unfortunate feature of COVID-19 is that some patients who are starting to feel better suddenly take a turn for the worst. The downturn usually comes between five to seven days into the illness.

A recent study by Bhatraju found that patients who need intensive care tend to arrive at the hospital around this time in the progression of their illness, and their deterioration can be extremely rapid. He says he's seen patients that "initially were just requiring a little bit of oxygen in 24 hours they're on a ventilator."

Doctors are still unsure what causes these late turns for the worse, but it may be the body's own immune system overreacting to the disease.

"We're all still trying to figure it out," Gong says. "But it does seem like some subset of these patients, they have a resurgence of an inflammatory response."

Regardless, if a week or so into the illness a high fever returns or a person suddenly feels short of breath, they should seek help immediately.

If you're not too sick, you may be better off at home

"As a general rule, people should stay out of the hospital if they don't need to be in the hospital," Gong says. "Fortunately, most cases of COVID seem to be able to be managed at home."

According to the CDC, the most important thing to do if you're sick at home is to quarantine yourself from others in your household. That may mean living in a separate room from loved ones or avoiding common spaces. When around other people, the CDC recommends wearing a face mask or scarf to reduce the chance of sickening others, and always try to keep six feet apart.

In terms of self-care, Gong says acetaminophen (Tylenol) and cold compresses can help with fever, and she sometimes recommends trying to sleep on your stomach to open up the lungs.

Beyond that, Griffin says the same remedies we use for other viral illnesses like the flu will also work for COVID: "Warm beverages, stay hydrated, take it easy, continue to eat healthy foods," he says. "You know, all the things your mother and grandmother probably told you."

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Think You've Got COVID-19? Here's What Doctors Say About When To Seek Help - NPR

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N95s are the gold standard in protecting health care workers from particles and droplets in the air. (Mladen Antonov/AFP via Getty Images)

Here's the scenario: your loved one is in a nursing home on lockdown, you know people there are sick with COVID-19, you have no way to visit or see for yourself how it's being handled.

That's Debra Hoffman's reality. Her 74-year-old aunt is a resident at the Cedar Mountain nursing home in Yucaipa, where a COVID-19 cluster is occuring. So far 51 residents and six staff members have tested positive for the new coronavirus and two infected residents have died.

Hoffman said her aunt, who suffered a stroke, needs full-time care.

"The hardest thing is that I can't physically go up there and control this situation," Hoffman said. "I can't go in to see what's really going on and I'm not getting accurate information."

Hoffman learned of the outbreak at Cedar Mountain only after it was reported in a local TV newscast, she said, adding that a representative from Cedar Mountain called the following day to let her know the situation at the nursing home.

"It's frustrating because I don't know what's going to happen," Hoffman said. "I don't know how they're treating it, I don't know what their procedures are to keep this from spreading, other than my aunt told me they're not allowed out of their room."

Hoffman wants her aunt and all residents and staff at Cedar Mountain to be tested for COVID-19 and she said she's getting conflicting information on whether or not that's happened.

Lana Culp, a spokeswoman for the San Bernardino County Department of Public Health, said most of the residents had been tested, but not all.

"There isn't much value in testing everyone at this point now, just because it should be assumed that their whole facility has been exposed due to the large number of confirmed cases," Culp said.

Cedar Mountain staff were not immediately available to provide comment.

THE STATE'S RESPONSE

"Infection control specialists from CDPH [California Department of Public Health], along with county staff, have been at the facility to provide assessments and work in real time on infection control measures," the California Department of Public Health said in an emailed statement to LAist.

According to the state's guidance for skilled nursing facilities: "symptomatic residents and exposed roommates must limit movement outside their room; if they need to leave the room, they should wear a facemask."

That means other families across California and the nation are finding themselves in Hoffman's shoes unable to see for themselves how their loved ones are being treated.

To prevent the spread of the virus, CDPH guidelines say residents with confirmed or suspected COVID-19 infection should be kept in the same wing or building and that communal dining areas should be closed. They also say 'high touch' surfaces should be cleaned and disinfected with Environmental Protection Agency-registered, healthcare-grade disinfectants.

'DIRE' NEED FOR MORE PROTECTIVE EQUIPMENT

As nursing homes across California brace for more outbreaks among their vulnerable populations, a coalition of nurses, skilled nursing facility operators and a union which represents thousands of nursing home workers in California is pleading with the federal government to urgently get millions of masks and gowns to the front lines.

"Unfortunately, Yucaipa... it is the tip of the iceberg," April Verrett, President of Service Employees International Union (SEIU) Local 2015, said on a call this week with reporters.

Verrett said nursing home workers don't have enough protective equipment to keep themselves and residents from getting infected should we see more outbreaks and clusters in these close-quarters settings.

"The need is so acute and so dire, the solution must come from the federal government," Verrett said.

State leaders, including California State Senator Richard Pan and Assemblywoman Eloise Reyes are also demanding the federal government do more to insure production of personal protective equipment is made in the U.S. and distributed to facilities in need.

"We're sending our frontline workers to a war zone without protection," Reyes said. "And that cannot continue."

MORE ON CORONAVIRUS:

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COVID-19 Cluster In Yucaipa Is 'Tip Of The Iceberg,' Nursing Home Union Leader Says - LAist

For Immediate Release: April 02, 2020 Statement From:

Statement Author

Leadership Role

Director - Center for Biologics Evaluation and Research (CBER)

As part of the U.S. Food and Drug Administrations ongoing commitment to fight the Coronavirus Disease 2019 (COVID-19) pandemic, today the agency issued guidance for immediate implementation to address the urgent and immediate need for blood and blood components.

The COVID-19 pandemic has caused unprecedented challenges to the U.S. blood supply. Donor centers have experienced a dramatic reduction in donations due to the implementation of social distancing and the cancellation of blood drives.

Maintaining an adequate blood supply is vital to public health. Blood donors help patients of all ages accident and burn victims, heart surgery and organ transplant patients and those battling cancer and other life-threatening conditions. The American Red Cross estimates that every two seconds, someone in the U.S. needs blood.

People who donate blood are part of our critical infrastructure industries. More donations are needed at this time and we hope people will continue to take the time to donate blood. We have also encouraged, and continue to encourage, state and local governments to take into account the essential nature of donating blood - and that it can be done safely and consistently within social distancing guidelines - when considering travel and business restrictions, and we encourage them to communicate that to their citizens.

At the FDA, we want to do everything we can to encourage more blood donations, which includes revisiting and updating some of our existing policies to help ensure we have an adequate blood supply, while still protecting the safety of our nations blood supply.

Based on recently completed studies and epidemiologic data, the FDA has concluded that current policies regarding certain donor eligibility criteria can be modified without compromising the safety of the blood supply. Therefore, the FDA is revising recommendations in several guidances regarding blood donor eligibility. These changes are being put forth for immediate implementation and are expected to remain in place after the COVID-19 pandemic ends, with any appropriate changes based on comments we receive and our experience implementing the guidances. At this time, the alternatives to certain donor eligibility requirements being provided generally will apply only for the duration of the declared pandemic.

Revised Recommendations for Reducing the Risk of Human Immunodeficiency Virus Transmission by Blood and Blood Products

Among others, the FDA is making the following changes, for immediate implementation, to the December 2015 guidance:

Revised Recommendations to Reduce the Risk of Transfusion-Transmitted Malaria

The FDA is making the following changes, for immediate implementation, to the August 2013 guidance:

Recommendations to Reduce the Possible Risk of Transmission of Creutzfeldt-Jakob Disease and Variant Creutzfeldt-Jakob Disease by Blood and Blood Components

The FDA is finalizing the January 2020 draft guidance, which includes the following change from the previous guidance:

To help address this critical need, the FDA is also providing notice of alternatives to certain requirements regarding blood donor eligibility for the duration of the COVID-19 pandemic. Blood establishments are not required to implement the changes in the FDA recommendations or the alternative procedures.

We expect that the updated guidance and alternative procedures will help increase the number of donations moving forward, while helping to ensure adequate protections for donor health and maintaining a safe blood supply for patients.

We believe these updated recommendations will have a significant and positive impact on our blood supply. As noted above, the changes being announced to the HIV, vCJD and malaria guidances are being put forth for immediate implementation. The updated recommendations in these guidances are based on data and analysis that the FDA believes are applicable to circumstances outside of (and after) the COVID-19 pandemic and reflect the agencys current thinking on this issue. These recommendations are expected to remain in place after the COVID-19 pandemic ends, with any appropriate changes based on comments we receive and our experience implementing the guidances.

The FDA will provide notification when the alternative procedures are no longer in effect. The FDA will monitor these changes in policy, alongside the National Institutes of Healths National Heart, Lung and Blood Institute and major blood partners to ensure the continued safety of the blood supply.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nations food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

###

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Coronavirus (COVID-19) Update: FDA Provides Updated Guidance to Address the Urgent Need for Blood During the Pandemic - FDA.gov

HOUSTON There's new information on how COVID-19 spreads and it's a lot easier than scientists expected. New research suggests coronavirus can spread through talking and even breathing.

The troubling news was delivered in an overnight letter to the White House from Dr. Harvey Fineberg and the National Academy of Sciences.

The CDC says COVID-19 spreads when people are within six feet of one another through tiny droplets produced by an infected person's coughs or sneezes. Experts now saying talking and something as simple as breathing could transmit the virus too.

In other words, the six foot rule may not cut it.

Research at a Chinese hospital found traces of coronavirus suspended in the air when doctors or nurses took off protective gear.

Researchers at the University of Nebraska noted they found traces of the virus too airborne in a patient's room even they were more than six feet away from the patient.

All this means it's possible aerosolized coronavirus droplets released by talking or even breathing could hang in the air and yes potentially infect a person who walks by later.

How long the virus is in the air can depend how much virus was released by a person breathing or talking and whether or not there's circulation in the air.

All this is pushing the White House Coronavirus Task Force closer to recommending the general public wear masks when not in their homes. Cities like Los Angeles have put that recommendation in place.

OTHER COVID-19 STORIES ON KHOU.COM

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New warning to White House: COVID-19 can spread through talking and breathing - KHOU.com

Welcome to the first of what will be regular chapters of a living oral history of the Covid-19 pandemic, an attempt to capture in real time the stories playing out across our country, in the words of those who are experiencing the crisis. This installment focuses on people who are ill right now (or suspect they are sick) because of the virus, along with the voices of doctors and health care workers taking care of them.

The project grows out of my work writing and researching an oral history of September 11th, a world-changing disaster that rewrote our geopolitics, our economy, and our society. Now, of course, were all living through another once-in-a-century crisisone that appears to have the potential to rewrite even more of our geopolitics, our economy, and our society.

Capturing the evolution of the Covid-19 pandemichow this crisis unfolds and how our thinking about it changesis critical both to understanding it now as well as to the stories we someday will tell about it. Each Friday, WIRED will publish a new chapter, weaving together as many stories as we can from across the country about living through this Covid Spring, trying to capture the story of American government, American business, and American life, and the titanic task ahead for our health care system.

Share Your Stories

Some fine print, required by WIRED: By submitting your Covid Spring story you are agreeing to WIRED's User Agreement and Privacy Policy found at WIRED.com. All submissions become the property of WIRED, must be original and not violate the rights of any other person or entity. Submissions and any other materials, including your name or social media handle, may be published, illustrated, edited, or otherwise used in any medium.

To tell this story, though, I need your help. Please write in and share your own storiestell me how your life has been affected, how your family is handling this moment, how your work has changed, tell me what youre seeing in your home, on the streets, at the grocery stores, in the parks where youre walking or runningat an appropriate social distance, of course.

Email your stories to me at covid@wired.com, write as much or as little as you wish, and stay tuned each week for additional chapters of our series: Covid Springan oral history of a pandemic. None of us knows how many chapters it may take until were out of this.

Editors note: The following oral history has been compiled from original interviews, social media posts, and online essays. Quotes have been lightly edited, copy-edited, and condensed for clarity.

I: Living With Covid-19

As of Thursday afternoon, the United States overtook China as the country with the most confirmed Covid-19 cases in the world, more than 85,000 total. Yet that number still represents what is almost surely a fraction of the actual number of cases in the US, as testing has lagged nationwide and many who are ill and wish to be tested dont meet the strict criteria to receive a test still in place across much of the country. The scale of the nations epidemic also means that public health officials have quickly abandoned attempts to trace the contacts of those infected, leaving those sickened by the virusor those who think theyve been sickened by the viruswondering not only if they have it, but how they caught it.

Amee Vanderpool, writer and lawyer, Washington, DC: People are in total denial about this. I even did that for the first three days. The 21st was a Saturday. Saturday is when I came out of denial. I definitely had something that Id never had before. I could get really sick.

Anne Kornblut, director, news and new initiatives, Facebook, Palo Alto, California, via Facebook: I tested positive for Covid-19 [last week]. Im relatively fine; lucky, even. Around here, officials have been preparing, so much so that I was able to get a test when I needed it. Facebook sent us home many days ago, so its unlikely I affected a big group of colleagues. I went supply shopping weeks ago. Heres what I didnt prepare for: telling my kids to back away from me, while informing them that this scary thing upending the entire planet is now inside our house. Inside their mom. My daughter cried and asked if I will get better. I couldnt hug her. My son wrote an account of it for our home newspaper. Anne Kornblut has the coronavirus but do not worry it is not the bad kind, he wrote on the front page. Please note that you should not be within 10 feet of Anne.

Morgan Madison, age 18, Chandler, Arizona: I really wasnt paying attention at allI didnt really care [about the virus]. Trump told us it was never going to hit the United States. He said there were like three cases. I thought I definitely wouldn't get itif there are just a handful of cases, why would I be one? I work at a car dealership, and my GM got back from a seven-country tour, and four or five days after he got back I had a sore throat. Our receptionist got a horrible cough too. She just stopped coming to work. Last Monday, I got to my desk and just started hacking up a lung. My GM came in and said, Clorox wipe your office and go home. I woke up the next day and felt like trash. I felt I had inhaled glue. My throat was sticky. I was coughing. Lots of migraines. Horrible migraines. It just went from feeling great to taking a five-hour nap in the afternoon. There was dizziness and confusion. Sometimes I feel fine, then the coughing up a lung came back. There were a couple of times Ill just be sitting on the floor hitting my inhaler.

Howard Yoon, literary agent, Washington DC: A week prior to getting a fever, Id developed a sore throat and a runny nose. That was the seventh of March. The idea of the coronavirus was creeping into everyones minds when they got sore throats. Out of an abundance of caution, I stayed home. I felt fine the next day. That might have just been a cold or maybe that was the onset of the virus? Since I felt fine after that first day, I went to New York that Wednesday. I tried to take some precautionsavoided the subway, walked most places. That night, I had drinks with some friends and colleagues. I knew I had it [four days later] on Sunday the 15th. All the days leading up, I dont know whether I had it and was developing all week or it came on full-blown after catching it in New York. One of the people I had drinks with, she has tested positive for the coronavirus. I dont know if I gave it to her or she gave it to me.

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First Denial, Then Fear: Covid-19 Patients in Their Own Words - WIRED

SIOUX FALLS, S.D. (KELO) If the state of South Dakota is working with a COVID-19 spread and response model, why would Sioux Falls want one?

It can be valuable for cities to have a COVID-19 model specific to it, said Kurt Cogswell, a data science professor at South Dakota State University in Brookings.

The growth and peaks of COVID-19 infection levels depend on key factors such as population density, age distribution, and travel patterns that will be different in Sioux Falls, New York, and Minneapolis, Cogswell said in an email interview with KELOLAND News. These key factors are important parts of the mathematical and statistical models used to predict infection growth and peaks, leading to different predictions for these cities.

Based on news conferences conducted Thursday by the city of Sioux Falls and Gov. Kristi Noems office, the COVID-19 peak periods could vary within the state.

Gov. Kristi Noem said Thursday afternoon the peak of the COVID-19 pandemic in South Dakota may not happen until the end of June or into July and said the situation can change rapidly. On Wednesday, Noem said the peak could be July into August.

A Sioux Falls doctor from Sanford responded to a question as to what the medical professionals expected the surge to look like during a city of Sioux Falls news conference.

Dr. Mike Wilde of Sanford Health said, The surge, thanks to the cooperation of all of us in the community, (and) based on the modeling, looks to still be a ways off. By that I mean around another two to four weeks, Wilde said.

The surge will not a rapid peak but a flatter, sustained influx of patients, Wilde said.

Dr. Mike Elliot of Avera Health said the models vary some in terms of peak times and duration. Avera and Sanford continue to work with local officials on a peak/surge model, he said.

Cogswell said it wouldnt be unusual for areas to have a different surge or peak time.

Just as key factors impacting infection growth and peaks differ between Sioux Falls and New York, they differ between Sioux Falls and a more rural region of the state, Cogswell said. For example, greater population density generally means greater rates of people interacting and thus more rapid infection spread. That would result in an earlier peak in a metro area than a rural region in the same state.

Sanford and Avera Health are among the partners the city is working with to develop a local surge model, Jill Franken, the director of Sioux Falls Public Health said in Thursdays city news briefing and at the April 1 Sioux Falls Council meeting.

Franken said at the April 1 meeting the city wants a model specific to the Sioux Falls Metropolitan Area so the city can better determine surge or peak rates and actions the city may need to take. The U.S. Commerce, U.S Census Bureau include McCook, Turner, Minnehaha and Lincoln in the Sioux Fall Metro Area with an estimated 2018 population of about 266,000.

Noem said Thursday a one size fits all approach statewide wont work in South Dakota. Communities may need specific measures that fit their communities, Noem said.

If I tell everyone to go into their homes and dont come out for two weeks (it wouldnt stop the virus), Noem said. COVID-19 cant be stopped but the spread can be slowed so that infected patients wont overwhelm hospitals and that fewer people get it, Noem said.

Also, measures that are taken must be sustainable, Noem said. So far, the states measures have helped slow the COVID-19 spread and make it possible for medical workers to better respond when there is a peak, Noem said.

The city of Sioux Falls may possibly consider a shelter in place regulation. City officials mentioned the possibility of shelter in place regulation at the April 1 meeting but Mayor Paul Ten Haken said that possibility could not be legally discussed at that time. That possible measure could be addressed if added to next weeks council meeting or at a special meeting. More information related to additional measures such as shelter in place would also soon be available, Ten Haken said.

Franken said at the meeting, the local DOH continues to gather information for the city including for the COVID-19 peak or surge model.

Franken said one source of data and information is cities in a position similar to Sioux Falls. Franken said officials are examining data and measures from cities including Fargo, North Dakota; Des Moines, Iowa; Tallahassee, Florida, and others.

Those examples have similar populations, demographics, COVID-19 case timing and other features similar to Sioux Falls, Franken said.

The point Im trying to make is we are trying to utilize data in another way and not just looking at our community, Franken said on April 1.

Tallahassee for example had its first case of COVID-19 about the same time as Sioux Falls but has fewer COVID-19 cases, Franken said. Tallahassee also enacted more restrictive measures sooner than the state of South Dakota or Sioux Falls, she said.

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City of Sioux Falls working on its own COVID-19 peak model - KELOLAND.com