WTF Community

🤮 Coronavirus (Community Thread)


(David Bythewood) #303

Hell. Ford just halted ALL of its production in North America and Europe for at least a month. Fiat-Chrystler and GM are expected to follow suit.

It’s all about the money:



#304

This is the what has been so baffling…why so slow with the testing? And here’s a deep dive into that.

A multitude of reasons and illogical set ups. - which they discuss below. Hot zones, Delayed Reaction, Deterred Development, Broader Testing, Short supply

Submitting most of the WSJ article here…will try to put in some charts, in the next few.

When cases of the new coronavirus began emerging several weeks ago in California, Washington state and other pockets of the country, U.S. public-health officials worried this might be The Big One, emails and interviews show.

The testing program they rolled out to combat it, though, was a small one.

Limited testing has blinded Americans to the scale of the outbreak so far, impeding the nation’s ability to fight the virus through isolating the sick and their contacts, public-health officials say. As of early Wednesday, about 6,500 people in the U.S. had tested positive, data compiled by Johns Hopkins University show, but the Centers for Disease Control and Prevention had reported only about 32,000 tests conducted at its facilities and other public health labs.

While the virus was quietly spreading within the U.S., the CDC had told state and local officials its “testing capacity is more than adequate to meet current testing demands,” according to a Feb. 26 agency email viewed by The Wall Street Journal, part of a cache of agency communications reviewed by the Journal that sheds light on the early response. The agency’s data show it tested fewer than 100 patients that day.

When the CDC first dispersed test kits in early February, it shipped them to a network of state and local government labs and restricted testing to people with virus symptoms who had recently traveled to China, where the virus first emerged, or had been exposed to a known case. Federal officials hoped the virus could be contained—even as they disputed alarms from those on the front lines that the CDC’s guidelines weren’t keeping up with the outbreak’s spread, emails between the U.S. agency and local officials show. The government left other laboratories on the sidelines for crucial weeks.

The narrow effort is “a failing,” said Anthony Fauci, a government doctor who has become the de facto face of the administration’s coronavirus response, in congressional testimony last week that for many in Washington was a wake-up call.

Three separate failures’

CDC officials botched an initial test kit developed in an agency lab, retracting many tests. They resisted calls from state officials and medical providers to broaden testing, and health officials failed to coordinate with outside companies to ensure needed test-kit supplies, such as nasal swabs and chemical reagents, would be available, according to suppliers and health officials.

When the U.S. Food and Drug Administration, also involved in the response, finally opened testing to more outside labs, a run on limited stocks of some supplies needed for the CDC-developed test quickly depleted stores, lab operators and suppliers said. Hospital and commercial lab operators said the government didn’t reach out to enlist their help until it was too late.

Hot Zones

Increased U.S. testing for the new coronavirus has produced spikes in confirmed cases.

“This was kind of a perfect storm of three separate failures,” said Tom Frieden, who directed the CDC from 2009 to 2017, citing the botched test, overstrict FDA rules and sidelined private labs. He cautioned he didn’t have direct knowledge of details.

Now, the U.S. is testing far fewer patients than public-health and infectious-disease experts say is necessary and just a fraction as many as other countries that rolled out wide-reaching diagnostic programs. South Korea as of Tuesday was testing up to 20,000 patients a day, more than half the total of U.S. patients who have been tested since the outbreak began.

The test shortage hurt U.S. efforts to contain the virus, said Neil Fishman, chief medical officer at the Hospital of the University of Pennsylvania and an infectious-disease specialist.

“If we would have had a true understanding of the extent of disease several weeks ago, implementation of social distancing measures could have prevented the escalation of the disease,” Dr. Fishman said, and demand for the test is now huge.

Health-care officials say the current state of testing reflects both technical and planning failures, as well as a broader failure of imagination. Leaders including President Trump and Health and Human Services Secretary Alex Azar early in the outbreak appeared unable or unwilling to envision a crisis of the scale that has now emerged, and no one stepped up to effectively coordinate among federal agencies or the private sector labs, medical providers and manufacturers needed for a large-scale testing push, they say.

Delayed Reaction

While widespread testing in South Korea helped control the new coronavirus outbreak, Italy’s testing quickly fell behind, contributing to the surge of cases in the last week.

Some White House aides learned of complaints about the availability of testing from the media, not the public-health officials in their own government, an administration official familiar with the matter said. Only in the first week of March did discussions in a White House coronavirus task force about the testing shortfall take on a sense of urgency, the person said.

Even then, Mr. Azar, defended the testing program in television interviews including twice on ABC News that week, citing the low number of confirmed cases—at a time when almost no tests were available to detect them.

The Government Accountability Office had warned federal officials in early January that its readiness for something like a pandemic fell short, a GAO official said. GAO investigators found crisis plans didn’t fully account for the huge role the private sector would have to play, documents show.

The HHS spokeswoman said the agency’s coronavirus response was guided by other “well-practiced” operational plans, and not the strategic one the GAO reviewed. An HHS official told the GAO, in a letter dated Jan. 31, that the agency had addressed their concerns and put in place policies that would “prevent early implementation challenges from becoming institutionalized.”

Deterred development

In the weeks ahead, however, those very challenges did become institutionalized. The FDA first announced labs seeking to perform testing would have to submit a special application to get permission to start on Feb. 4. That initially deterred some hospitals and other lab operators—which normally aren’t required to submit any application—from developing tests, experts say.

“We had considered developing a test but had been in communication with the CDC and FDA and had been told that the federal and state authorities would be able to handle everything,” Alan Wells, the medical director for the University of Pittsburgh Medical Center’s clinical laboratories, told reporters over the weekend. He said in an interview on Monday that it later became clear the CDC and states were overwhelmed.

Once the CDC launched its initial test in the first week of February, the response was quickly stymied by setbacks, including flaws that forced the CDC to claw back many of the kits it had already sent out to state public health laboratories, according to the agency and public-health officials.

An email to state public-health-lab officials later in February gives the fullest account from the CDC to emerge yet of what happened: The agency said some labs had encountered “sporadic reactivity in the negative control of one of the three assay components.” That means the test in some cases wrongly indicated it had detected coronavirus in samples of laboratory-grade water.

“It is unclear why quality control did not detect this issue before the kits were sent out to states,” said the email.

The CDC on Monday said it “has not yet determined if the problem involves the assay design or contamination. It could have been either.”

At one critical juncture, just before the CDC opened up testing to more state laboratories in February, its officials clashed with state epidemiologists on the front lines of the response to the epidemic over the scale of testing.

Despite news and official reports heralding the rapid spread of the virus in Japan and Hong Kong, on Feb. 22 CDC officials told state officials to refer for testing only patients showing symptoms who had travel histories in mainland China.

When a top Minnesota epidemiologist pointed out in an email to CDC officials that agency director Robert Redfield had recently tweeted that doctors treating patients who had visited Hong Kong and Japan should consider “#COVID19,” the CDC’s deputy incident commander responded: “This tweet is being taken down.” And, in fact, it was.

The CDC hasn’t responded to requests for comment on why the tweet was deleted.

Rather than expand testing, the CDC replied that it was considering changes to its travel notices.

The epidemiologists, too, recognized the current testing program wouldn’t meet the widening need. As they debated expanding testing to more people, Marcelle Layton, a top official with the New York City Department of Health and Mental Hygiene, expressed the worry that too many returning travelers would expect to be screened as the list of affected countries expanded.

“We all know this is not sustainable,” Dr. Layton said in a Feb. 25 email to other public-health officials. She and Dr. Park didn’t respond to requests for comment.

Broader testing

As the CDC sought to get the network of state labs up and running, it finally turned to an outside manufacturer, Integrated DNA Technologies Inc., to order a run of custom reagents—substances used in a chemical reaction—needed to identify the genetic imprint of coronavirus in late February, according to the company and a timeline provided by the CDC. IDT said in a statement that it shipped the CDC’s first order on Feb. 26.

The CDC said it signed a contract with IDT to supply reagents on Feb. 20. Contracting records show one IDT order from that day, for only about $90,000 of testing supplies. The CDC said that contract was for coronavirus-test material. IDT denied that contract was related to the coronavirus tests.

Short Supply

A run on some supplies needed for the CDC-developed coronavirus test has quickly depleted limited stocks.

CHARTS - Swabs, RNA Extraction Kits, Assays, Control

With IDT creating special coronavirus test kits, the federal government abruptly began to make moves that would open the door to more and broader testing, including expanding its criteria for whom to test. On Feb. 26, Nancy Messonnier, a top CDC official, promised in a call with reporters that commercial labs would “be coming online soon,” and a couple of days later, the FDA allowed some labs seeking to use the CDC’s testing method or developing their own to jump through fewer hoops.

IDT would produce millions of tests worth of its coronavirus-detecting reagent over the next couple of weeks, according to the company’s statement.

Even still, the wave of private labs joining the fight against the virus didn’t arrive on schedule. One reason was that many of the off-the-shelf supplies used in the CDC’s testing method weren’t readily available on the scale needed, the Journal found. That included both the simple products like synthetic swabs—cotton interferes with readings—used to collect mucus samples, and complex ones. Because labs copying the CDC’s test method have to use its exact chemical recipe, there has been a run on manufacturer QiagenN.V.’s reagent for separating viral RNA from human mucus, one of the products used by the agency.

The U.S. government “could have just got out in front of it,” said Greg Ingle, one of the Dayton lab’s owners and an industry consultant. Rather, “we watched it play out in the rest of the world before getting into the market.”

Through mid-March, Qiagen spokesman Thomas Theuringer said the Dutch biotech has shipped more than twice as many units of the product in question as in the whole of 2019 to U.S. clients.

“It’s like queuing up in line to buy toilet paper at the grocery store,” said Richard Scanlan, the medical director of the Oregon Health and Sciences University Hospital laboratory, comparing the lab’s predicament to the empty shelves consumers are facing around the country. “Everyone is trying to buy it at the same time,” he said.

Qiagen said it was rationing test kits to its “most critical customers” and acknowledged the company was struggling to meet demand. Dr. Theuringer said the factories producing the kits had ramped up to “three shifts working seven days a week.”

Virus researcher Scott Weaver, at the University of Texas Medical Branch at Galveston, said a group he directs has sent out coronavirus RNA samples needed to do the validation studies to around 50 labs. Nonetheless, he said, some of those labs, including one at his own institution, were delayed as they waited for Qiagen to fill orders in order to begin testing. The Galveston lab is now able to perform tests, he said, but supplies remain limited.

On Wednesday, Mr. Trump said in a briefing that, “in case we need it,” he would invoke a Korean War-era law called the Defense Production Act, allows the federal government to force U.S. companies to produce needed supplies.

In recent days, the FDA has tried to confront the testing shortage by approving new test designs by manufacturers such as Thermo Fisher Scientific Inc. and testing firms like Laboratory Corporation of America Holdings Inc., and relaxing requirements for labs to prove their tests actually work and stick strictly to the CDC recipe. Thermo said Tuesday it has 1.5 million tests ready to ship.

FDA Commissioner Stephen Hahn maintained the agency’s insistence on test accuracy has been vital. “If you don’t have that check on the test findings,” he said, “you run the risk of inaccurate test results which means you aren’t truly assessing the full scope of the outbreak.”

Now, in a concession to demand, the agency is letting labs run tests first and prove they are accurate later—within about two weeks.

After hearing news reports saying more tests had become available, Nathan Conder, a 30-year-old in Salt Lake City, called Utah’s coronavirus hotline Monday to ask about getting tested. He’d been sick with a fever, dry cough and fatigue for a week—all coronavirus symptoms, although also of other maladies.

“They told me all my symptoms match, but they don’t have enough tests so they’re only testing people who were in contact with someone who already tested positive,” said Mr. Conder, a regulatory specialist at a microbiology lab. Public health officials said “that I should act like I had it, but they can’t test,” he recalled.

On Tuesday, a doctor prescribed a coronavirus test for Mr. Conder after extensive screening and sent him to a nearby hospital lab. From there, he said, he was diverted to a new drive-in testing facility, where workers requested an additional form that took hours to obtain. After an ordeal of nearly six hours in total, he said, he got the test and was told he would get results within three days.


(David Bythewood) #305

Here is where he effectively endorses “Kung Flu”:


#306

Stock market in free fall…Coronavirus is everywhere…yeah, it’s bad.

Investor Bill Ackman urged President Donald Trump and corporate America in an impassioned plea on CNBC to shut down the country for 30 days to contain the fast-spreading coronavirus, calling it the only option to rescue the economy.

“What’s scaring the American people and corporate America now is the gradual rollout,” Ackman told Scott Wapner on “Halftime Report” on Wednesday. “We need to shut it down now. … This is the only answer.”

America will end as we know it. I’m sorry to say so, unless we take this option,” he said. Ackman added that if Trump saves the country from the coronavirus, he will get reelected in November.

Ackman urged U.S. companies to stop their buyback programs because “hell is coming.” The biggest U.S. banks have already halted repurchasing stocks to put their capital to use helping consumers and businesses.

Worldwide coronavirus cases topped 200,000 on Wednesday, while confirmed cases in the U.S. have surged to at least 6,496. The Trump administration is working on a $1 trillion stimulus package to combat the impact of the virus, including sending out checks to the American people and providing financial relief to airlines.


#307

Reps. Mario Diaz-Balart and Ben McAdams each said Wednesday evening that they have tested positive for COVID-19. They are the first two members of Congress to announce positive tests for the novel coronavirus.

They both said they experienced symptoms and have been self-quarantining.

Diaz-Balart, 58, and McAdams, 45, both voted on the House floor as recently as early Saturday morning, when lawmakers passed a coronavirus relief package.

This is what is going to happen more unfortunately. I know some House members were looking for offsite locations


#308

I finally found guideline from the CDC for making DIY face masks. It’s from 2006 but better than thoughts and prayers :pray:

I don’t know why this shows as 404.


(David Bythewood) #309

This is nice; I am in not one but two high risk categories so taking all precautions.

Younger Adults Make Up Big Portion of Coronavirus Hospitalizations in U.S.

New C.D.C. data showed that nearly 40 percent of patients sick enough to be hospitalized were aged 20 to 54. But the risk of dying was significantly higher in older people.

CDC analysis shows coronavirus poses serious risk for younger people



Hospital sewing makeshift masks together out of desperation

A Georgia hospital has begun making makeshift masks from surgical sheeting as they risk running out of supplies due to increased worldwide demand for medical equipment.

Hospital Workers Make Masks From Office Supplies Amid U.S. Shortage

‘We’re not getting new supplies and our stores are almost depleted.’

https://www.bloomberg.com/news/articles/2020-03-18/hospital-makes-face-masks-covid-19-shields-from-office-supplies

The Leader of the Free World Gives a Speech, and She Nails It

Inside the National Quarantine Center, There Is No Fear of Coronavirus. There Is Only Urgency.

Esquire was granted exclusive access to the nation’s only federal quarantine and biocontainment center in Nebraska. We met the people who work there, and they are as extraordinary—and as courageous—as you think they are.


(David Bythewood) #310

Fortress Russia Begins to Show Cracks as Coronavirus Spreads

Russian officials once touted their success in holding off the virus. Now cases are rising as their statistics are being questioned.

Why Did the Trump Administration Reject the WHO Coronavirus Test?

Scientists say mass tests in Italian town have halted Covid-19 there

A study in Vò, which saw Italy’s first death, points to the danger of asymptomatic carriers

2020 Time Capsule #4: Trump Is Lying, Blatantly


(David Bythewood) #311

This is the proof of why we need testing for all. Period. If this family could have gotten testing sooner, this tragedy might have been avoided.

Coronavirus Ravages 7 Members of a Single Family, Killing 3 With 3 More in Critical Condition

Racist Attacks Against Asians Continue to Rise as the Coronavirus Threat Grows

Countries worldwide are reporting an uptick in assaults against citizens of Asian descent

100 Million Mask Challenge: Volunteers Making Masks to Combat Shortage


Frustrating thread: Hospitals are flooded and insurance carriers are making it worse with red tape.

I know of at least two airport towers shut down because of controllers who tested positive for the #coronavirus, one in Chicago and one in Las Vegas. This affects all aspects of life.


#312

Sen Burr (R-NC)arns that COVID-19 could be worse than Spanish flu 3 weeks ago behind closed doors to a private group, Tar Heel Society (from his state North Carolina) but he never told the public what he thought could happen.

Contrast it to what the President was saying, which was this would pass, Burr has a long history as a lawmaker, and has been an advocate for Bio Hazard. According to Public Health official, Burr should have given more information to help people prepare.


#313

We all know Fox and their minions are promoting false stories, and are downright divisive. I do like seeing that Hannity has been called out on it.

Watch videos :point_down:

Talking with Ted Koppel Video


#314

This is not easy to read.

Straight-up dire descriptions from a in-the-trenches doctor in a NYC hospital. While the administration continues to drone on about how they are ‘handling’ it, and espousing that all things are mobilized - tests, ventilators, vaccines and masks, PPE, etc are out there, we know and this doctor knows that this is NOT the case.

The sky is falling.

WTF :sos:

Today, at the hospital where I work, one of the largest in New York City, Covid-19 cases continue to climb, and there’s movement to redeploy as many health care workers as possible to the E.R.s, new “fever clinics” and I.C.U.s. It’s becoming an all-healthy-hands-on-deck scenario.

The sky is falling. I’m not afraid to say it. A few weeks from now you may call me an alarmist; and I can live with that. Actually, I will keel over with happiness if I’m proven wrong.

Alarmist is not a word anyone has ever used to describe me before. I’m a board-certified surgeon and critical care specialist who spent much of my training attending to traumas in the emergency room and doing the rounds at Harvard hospitals’ intensive care units. I’m now in my last four months of training as a pediatric surgeon in New York City. Part of my job entails waking in the middle of the night to rush to the children’s hospital to put babies on a form of life support called ECMO, a service required when a child’s lungs are failing even with maximum ventilator support. Scenarios that mimic end-stage Covid-19 are part of my job. Panic is not in my vocabulary; the emotion has been drilled out of me in nine years of training. This is different.

We are living in a global public health crisis moving at a speed and scale never witnessed by living generations. The cracks in our medical and financial systems are being splayed open like a gashing wound. No matter how this plays out, life will forever look a little different for all of us.

On the front lines, patients are lining up outside of our emergency rooms and clinics looking to us for answers — but we have few.

Making my rounds at the children’s hospital earlier this week, I saw that the boxes of gloves and other personal protective equipment were dwindling. This is a crisis for our vulnerable patients and health care workers alike. Protective equipment is only one of the places where supplies are falling short. At our large, 4,000-bed New York City hospital, we have 500 ventilators and 250 on backup reserve. If we are on track to match the scale of Covid-19 infections in Italy, then we are likely to run out of ventilators in New York. The anti-viral “treatments” we have for Covid-19 are experimental and many of them are hard to even get approved. Let me repeat. The sky is falling.


#315

Yes, it’s time for the entire country to shelter in place. Shut everything down, including travel. All we can do is ride this thing out in isolation of each other.


#316

This is why social isolation is the only way, this virus can make anyone severely ill. We need those beds for the elderly, stay home to save someone’s grandparent.


#317

A-day-late-a-dollar short version…

Say what they will.


#318

Everyone needs to assume anyone they meet is a carrier of the virus until wide spread testing can be done to quarantine the infected populations.

Stay inside people, wear gloves and masks if you need to go out to get essentials. Shower when you get home, do laundry everyday. Sanitize frequently touched things in your home like doorknobs, light switches and toilets as often as you can.

If you get sick, stay home and contact you’re doctor, you’re doctor will decide if you are a candidate for the limited testing that the CDC is doing.


#319

Why we are not seeing the CDC up on the podium speaking to this issue is confusing, and why isn’t Dr. Fauci up there too? You wonder WTF.

As the United States enters a critical phase in fighting the [coronavirus pandemic](https://www.washingtonpost.com/health/coronavirus-forecasts-are-grim-its-going-to-get-worse/2020/03/11/2a177e0a-63b4-11ea-acca-80c22bbee96f_
story.html?tid=lk_inline_manual_2&itid=lk_inline_manual_2), the country’s leading public health agency, the Centers for Disease Control and Prevention, appears to be on the sidelines, with its messages increasingly disrupted or overtaken by the White House.

Neither CDC Director Robert Redfield nor Anne Schuchat — the principal deputy director who has played key roles in the agency’s emergency responses stretching back two decades, including the 2009 influenza pandemic — have appeared on the podium during White House briefings by the coronavirus task force for more than a week.

Redfield did join a smaller briefing Wednesday afternoon, for the first time since March 9. He and three other task force members stood with President Trump and Vice President Pence for the day’s second task force appearance. The event, which lasted seven minutes, followed a task force meeting with nurses groups, according to the White House. Trump and Pence were the only ones who spoke, and they took no questions.

The CDC, which has come under fire because of protracted delays in the rollout of agency-developed test kits, has not conducted its own telephone briefings for reporters in more than a week. Recent CDC recommendations on school closures and mass gatherings were overtaken by different guidelines issued by the coronavirus task force, creating confusion, experts and officials said.

“It is confusing for the public to have CDC say no gatherings of more than 50 people, and the next day, the task force says no gatherings of more than 10 people,” said Tom Inglesby, director of the Johns Hopkins Center for Health Security. “If the information has changed, tell everyone why. Let’s make sure everyone is on the same page.”


#320

Comments from media on Q & A with T - during today’s briefing today.

OMFG

OANN (One American News Network - far right network) - T’s network tosses him an easy question and an opening where T can bash NYT, WSJ etc. “dishonest media sources” “They don’t call me.”

Video :point_down:


(Matt Kiser) #321

a timeline of the earliest weeks of the coronavirus outbreak in China, highlighting when the cover-up started and ended — and showing how, during that time, the virus already started spreading around the world, including to the United States.


#322

I believe this…

NBC Reporter - Richard Engel