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šŸ¤® Coronavirus (Community Thread)

Dire situation with nursing shortages nowā€¦and the numbers ramping up.

The American Hospital Associationā€™s vice president of quality and patient safety, Nancy Foster, said sheā€™s heard from two dozen hospital leaders over the past two weeks, warning her of staffing shortages in states including Texas, North and South Dakota, Minnesota, Wisconsin, and Illinois. Health care providers in Kansas, Oklahoma, Arkansas, Ohio, Missouri, Michigan, and Utah said theyā€™re facing the same problem, as do local reports from New Mexico, Nebraska, Colorado, Wyoming, Tennessee, Georgia, Alabama, Indiana, Montana, California, Rhode Island, and South Carolina.

The shortages are primarily caused by overwhelming numbers of patients as coronavirus spreads, combined with decreasing staff levels as nurses and doctors themselves fall sick or have to quarantine after being exposed to infected people. Covid-19 is also prevalent in rural areas that have been struggling with a shortage of health professionals for years; hospitals in more remote regions donā€™t have equipment such as ventilators, and so must transfer severely ill patients to already-overwhelmed urban health care systems. The scale of the problem makes it harder to address: Systems designed to offset shortages by bringing in backup from other areas donā€™t work when so many states are affected simultaneously.

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The lack of staff reflects the dramatic increase in patients. There has been an average of 157,318 new cases per day over the past week, according to the STAT Covid-19 Tracker ā€” 74% more than two weeks ago ā€” and there simply arenā€™t enough ICU nurses, in particular, to meet the need. Hospitals currently have 2,000 ICU nurse jobs open on Trusted Health, a company that connects travel nurses, who hop from job to job around the country, with hospitals.

The situation is exacerbated as staff get sick with coronavirus themselves, or else have to quarantine after exposure. The staffing need is so dire, hospital workers who have tested positive for Covid-19 but are asymptomatic have been told to continue working in North Dakota.

One rural hospital in Texas is struggling with 30% of staff nurses out of commission because of infection with or exposure to Covid-19, said TORCHā€™s Henderson. At one point earlier this month, more than 1,000 staff from the Mayo Clinic were out of work because of Covid-19, said Amy Williams, executive dean of Mayo Clinic Practice.

ā€œIt could be caring for a family member who has Covid, it could be on quarantine because of being exposed in the community, or it could be because the staff member actually has Covid,ā€ Williams said. More than 90% of possible exposures occurred in the community as transmission picked up, she said, not in the hospital.

As health care systems compete for additional staff, salaries skyrocket. ICU nurses are a ā€œhot commodity,ā€ said Dan Weberg, a former emergency room nurse and head of clinical innovation at Trusted Health, and their fees are currently twice as much as pre-Covid rates, at around $5,000 to $6,000 per week.

ā€œThis is how PPE was in the beginning of the pandemic. When youā€™re competing with everyone else in town, and state, and the country, that creates a market thatā€™s not sustainable,ā€ said SSM Healthā€™s Garza.

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Just abhorrentā€¦8 months out and all red

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Junior got it.

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Sen Loeffler says she had tested Positive for Covid but now testing Negative.
Wonder which one you believe?

She is in a huge Georgia Runoff contestā€¦so she may be playing it coy here.

Just know we are dealing with a slippery one.

Sen. Kelly Loefflerā€™s campaign says the Georgia Republicanā€™s previously inconclusive Covid-19 test has come back negative, but that she will continue to undergo testing for the virus.

ā€œSenator Loefflerā€™s previously inconclusive PCR results were retested overnight and the results thankfully came back negative,ā€ campaign spokesperson Stephen Lawson said in a statement Sunday.

Lawson added that, "out of an abundance of caution, (Loeffler) will continue to self-isolate and be retested again to hopefully receive consecutive negative test results. We will share those results as they are made available. She will continue to confer with medical experts and follow CDC guidelines."

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Rapid Testing Is Less Accurate Than the Government Wants to Admit

The promise of antigen tests emerged like a miracle this summer. With repeated use, the theory went, these rapid and cheap coronavirus tests would identify highly infectious people while giving healthy Americans a green light to return to offices, schools and restaurants. The idea of on-the-spot tests with near-instant results was an appealing alternative to the slow, lab-based testing that couldnā€™t meet public demand.

By September, the U.S. Department of Health and Human Services had purchased more than 150 million tests for nursing homes and schools, spending more than $760 million. But it soon became clear that antigen testing ā€” named for the viral proteins, or antigens, that the test detects ā€” posed a new set of problems. Unlike lab-based, molecular PCR tests, which detect snippets of the virusā€™s genetic material, antigen tests are less sensitive because they can only detect samples with a higher viral load. The tests were prone to more false negatives and false positives. As problems emerged, officials were slow to acknowledge the evidence.

With the benefit of hindsight, experts said the Trump administration should have released antigen tests primarily to communities with outbreaks instead of expecting them to work just as well in large groups of asymptomatic people. Understanding they can produce false results, the government could have ensured that clinics had enough for repeat testing to reduce false negatives and access to more precise PCR tests to weed out false positives. Government agencies, which were aware of the testsā€™ limitations, could have built up trust by being more transparent about them and how to interpret results, scientists said.

When health care workers in Nevada and Vermont reported false positives, HHS defended the tests and threatened Nevada with unspecified sanctions until state officials agreed to continue using them in nursing homes. It took several more weeks for the U.S. Food and Drug Administration to issue an alert on Nov. 3 that confirmed what Nevada had experienced: Antigen tests were prone to giving false positives, the FDA warned.

ā€œPart of the problem is this administration has continuously played catch-up,ā€ said Dr. Abraar Karan, a physician at Harvard Medical School. It was criticized for not ensuring enough PCR tests at the beginning, and when antigen tests became available, it shoved them at the states without a coordinated plan, he said.

If you tested the same group of people once a week without fail, with adequate double-checking, then a positive test could be the canary in the coal mine, said Dr. Mark Levine, commissioner of Vermontā€™s Health Department. ā€œUnfortunately the government didnā€™t really advertise it that way or prescribe itā€ with much clarity, so some people lost faith.

HHS and the FDA did not respond to requests for comment.

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Given that weā€™re in unprecedented Covid numbers, hereā€™s some helpful information on where you can get testing.

Across the U.S. many people are seeking Covid-19 tests before traveling or attending Thanksgiving celebrations. Primary, urgent-care and public-testing facilities have reported long lines for tests and a paucity of appointments in the lead-up to the holiday, and turnaround times for test results are on the rise.

The Centers for Disease Control and Prevention has urged Americans not to travel for Thanksgiving, which has coincided with the worst phase of the pandemic to date.

The U.S. reported 142,732 new coronavirus cases on Sunday. Case surges also typically lead to more testing demand as people learn that they have been exposed to an infected person or start developing symptoms after becoming infected.

Doctors and public-health officials encourage those with symptoms or known contact with an infected individual to get tested. They warn that people interested in getting tested before seeing family should continue to take other measures like wearing a mask, social distancing and washing hands.

Hereā€™s some advice from public-health officials and doctors on where to get tested before Thanksgiving and what to expect.

Where can I get a test before Thanksgiving?

Many urgent- and primary-care facilities offer testing appointments in addition to the mobile and other clinics run by state and county health departments across the country. Some doctors also offer testing in their offices. Many states publish maps and testing site information on their public-health department websites.

The federal government has also set up surge testing sites in states including Pennsylvania, Utah, New Mexico and Kentucky. The U.S. Department of Health and Human Services offers a website that lists no-cost testing centers by state and health benefits company Castlight Health Inc. offers a test site finding website.

Finding an available appointment given the recent increase in demand may be challenging, and some clinics offer walk-in appointments onlyā€”and some test sites have age limits and wonā€™t test children. Lines for testing stretched around city blocks in New York the weekend before Thanksgiving. Some facilities across the country are now giving priority for those with symptoms or known contact with someone who is infected, so be sure to check test sitesā€™ eligibility criteria before waiting in line.

Finding an available appointment may require a mix of online research and phone calls to facilities to learn about testing availability.

Whatā€™s the turnaround time going to be?

If you receive a PCR test that is processed in a lab, you should expect to wait two to four days or more. Turnaround times for results from PCR testsā€”those sent to labs for processingā€”have crept up in recent days amid a surge in demand. Laboratory Corp. of America said on Friday that the time to get a result once they receive the sample ā€œremains strong,ā€ at about one to two days, up slightly from earlier in the fall. Rival Quest Diagnostics Inc. said last week that its Covid-19 test-turnaround time was more than two days, after hovering at two days since late August.

If you receive a rapid antigen test, which trades some accuracy for speed, you will receive results in minutes or later the same day, depending on how the testing facility operates.

How much will it cost?

Covid-19 testing is often free, especially when tests are administered at a publicly run site. Many insurers cover the costs of testing, particularly if the person has symptoms or a known exposure to an infected person. The advertised price of lab-based PCR tests ranges from about $60 to $200 or more depending on the facility. The Coronavirus Aid, Relief, and Economic Security Act, or Cares Act, requires testing providers to publish the cash price of Covid-19 tests on their public website.

Rapid tests can cost $100 to $200 or more depending on the facility.

links
No-cost testing by State

Where to find a Covid-19 Test Site
https://my.castlighthealth.com/corona-virus-testing-sites/

@MissJava Can you please move this to Coronavirus section please and maybe add one of your own entries in there too. I reached my max number of entries on that one? Thanks!

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Keep on archivinā€™! Thanks for your hard work on all this.

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Thx - you too!

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A rough thread to read.

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:unamused:

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We are facing unprecedented amount of Covid infections, and once Biden takes power, the increasing numbers seem beyond daunting. Some strategies that they might employ involve getting help from the Right - former Senator Dr. Frist who is also a doctor, and a Republican to set up a straight narrative (from that Right.) Perhaps they might also get Hannity or Carlsonā€™s help, but someone like Lebron James may be able to help as well.

Long, well-researched article in NYTā€¦on where we are with the pandemic, how to plan for large numbers, what the vaccine can do and where Biden must act.

Mr. Biden has said he supports a national mask mandate, although his plan calls on governors to impose state ones.

Among the suggested names with those skills were Heidi J. Larson of the Vaccine Confidence Project in London, Carl T. Bergstrom of the University of Washington and Zeynep Tufekci of the University of North Carolina.

Others said the panel had too many members tied to the Obama-Biden administration. Dr. Ezekiel J. Emanuel, for example, was an architect of the Affordable Care Act and Dr. Eric Goosby was Mr. Obamaā€™s global AIDS coordinator. To reach Mr. Trumpā€™s base, they said, the panel needs credible Republican experts.

ā€œOtherwise,ā€ said Dr. Leana Wen, a former Baltimore health commissioner, ā€œthere will be even more of a mistaken perception that this is Democrats and doctors trying to shut down the economy, when actually controlling the virus is key to economic recovery.ā€

Experts suggested adding Dr. Bill Frist, a transplant surgeon and former Republican senator, or Dr. Marc K. Siegel, an internist and Fox News opinion writer.

Mr. Warren suggested consulting marketing experts and recruiting ā€œeveryone from Santa Claus to LeBron Jamesā€ as trusted spokesmen.

Another expert suggested adding Dr. Mehmet C. Oz, a heart surgeon and television personality who was criticized for promoting hydroxychloroquine on Fox News (he later relented), and possibly even asking Sean Hannity and Tucker Carlson to join, because they are popular with Mr. Trumpā€™s base and might be persuaded to accept science that would save the lives of their own viewers.
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All the experts interviewed by The Times praised the plan, but several felt it was not aggressive enough. The pandemic is raging so far beyond control, they argued, that it can be contained only with deeply unpopular but necessary measures, such as rigorously enforced mask laws, closing bars and restaurants, requiring regular testing in schools and workplaces, isolating the infected away from their families, prohibiting travel from high-prevalence areas to low ones, and imposing quarantines that are enforced rather than merely requested.

Many other countries have imposed such measures despite fierce opposition from some citizens, they said, and they have helped.

ā€œColleges are the Wuhans of this fall surge,ā€ said Dr. Howard Markel, a medical historian at the University of Michiganā€™s medical school. Universities, he and other experts said, must stop students from going back and forth between their hometowns and college towns, both of which have many vulnerable residents.

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The next dozen weeks will be long and painful. But spring is likely to bring highly effective vaccines and a renewed commitment to medical leadership, something that has been missing under Mr. Trump.

ā€œThe C.D.C. will have to be rebuilt, and its guidelines and the F.D.A.ā€™s have to be promptly re-evaluated,ā€ said Dr. Robert L. Murphy, director of the Institute for Global Health at Northwestern Universityā€™s medical school. ā€œThe Biden team will move quickly. Itā€™s not like they donā€™t know what to do.ā€

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Honestly, I wish he could be prosecuted!
Heā€™s done damage that is still lingering! :rage:

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SCOTUS seems to side with all religious freedomsā€¦thatā€™s what is to come. No concern for health issues which are glaring.

The U.S. Supreme Court on Thursday delivered a blow to California Governor Gavin Newsomā€™s pandemic-related ban on indoor religious services, siding with a church that defied the policy and challenged it as unconstitutional religious discrimination.

The decision followed a similar action by the justices on Nov. 25 that backed Christian and Jewish houses of worship that challenged New York state restrictions in coronavirus hot spots.

The U.S. Supreme Court on Thursday delivered a blow to California Governor Gavin Newsomā€™s pandemic-related ban on indoor religious services, siding with a church that defied the policy and challenged it as unconstitutional religious discrimination.

The decision followed a similar action by the justices on Nov. 25 that backed Christian and Jewish houses of worship that challenged New York state restrictions in coronavirus hot spots.

The justices, with no noted dissents, set aside a lower court ruling that rejected a challenge to Newsomā€™s policy by Harvest Rock Church Inc, which has several campuses in the state, and Harvest International Ministries Inc, an association of churches. Both are based in Pasadena, a city in Los Angeles County.

The justices directed the lower court to reconsider the case in light of their ruling in the New York case.

Gov Newsom is taking the next step and putting 5 regions of California under Stay-at-Home orders because the Covid numbers are so high - !9K deaths to date, and 2500 + new cases per day - 12% infection rate and ICUā€™s are at near capacity.

OAKLAND, Calif. ā€” California regions will face stay-at-home orders when their hospital capacity shrinks to an alarmingly low level under a new plan Gov. Gavin Newsomā€™s health chief announced Thursday.

In a region where rising cases threaten to overwhelm limited intensive care units, pushing available units to below 15 percent of capacity, residents will be directed to remain in their homes unless they are conducting essential activities.

While no area of California currently faces a severe enough ICU shortage to meet those requirements, health officials said some regions could hit the threshold and come under stay-at-home requirements as soon as this week.

ā€œIf we donā€™t act now, our hospital system will be overwhelmed,ā€ Newsom said Thursday.

Newsom is dividing the state into five geographic regions and lockdowns would last for three weeks minimum. Residents would be unable to gather, while playgrounds, salons and restaurant dining would have to close. Food takeout would still be allowed, while hotels could only open for critical infrastructure support. Religious institutions would be limited to outdoor services.

Schools that are already open can remain so even if they are in counties that come under the new orders. Retailers would be able to continue operating indoors but would need to sharply curtail their operations so they only allow 20 percent of their capacity. People could still seek non-urgent medical and dental care.

The governor said the order is "fundamentally predicated on the need to stop gathering with people outside your household."

The five regions are the Bay Area; Southern California; Greater Sacramento; San Joaquin Valley; and Northern California. Regions would have 48 hours to adopt a stay-home order once the state imposes one.

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:sob:

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The new guidance.

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Sideshow Rudy gets Covid -

Is it true?? Iā€™ve gotten so cynical these 4 years, I think he might have already had it (when he was practicing w/ T on his debates) but Rudy needs and easy ā€œoutā€ that would get him out of the multiple (by 10ā€™s) lost ā€˜voter fraudā€™ lawsuits.

Just a thought. This administration will do and say anythingā€¦

Yes it is trueā€¦he has gone to the hospital

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