This is really bad…and it is the type of enormously impactful move, and huge DIVERSION.
Let’s call it one the most stupid and retaliatory moves he’s made…the problem “sin” does not match the punishment…so I think he’s doing because he is feeling VERY spiteful.
We are dealing with a child…toddler move.
adding this insight -
“doubles down on cruel actions to distract himself and others from other’s cruel actions.”
Dr. Birx and Dr. Fauci are telling it like it is…and countering any notion that the pandemic is under control. Quite the contrary…
‘None of us really anticipated the amount of community spread,’ Birx said.
Dr. Deborah L. Birx, the Trump administration’s coronavirus response coordinator, made an unusually candid admission in comments to a group of foreign diplomats Tuesday afternoon: She said that local and federal officials were not prepared for the kind of outbreaks spreading across the United States, which she said resulted from younger Americans feeling less inhibited.
“None of us really anticipated the amount of community spread that began in really our 18-to-35-year-old age group,” she said in a brief appearance on an Atlantic Council panel. “This is an age group that was so good and so disciplined through March and April. But when they saw people out and about on social media, they all went out and about.”
Separately, Dr. Anthony S. Fauci, the nation’s top infectious disease expert, cautioned on Tuesday that it was a “false narrative to take comfort in a lower rate of death,” something that Mr. Trump, top White House officials and several governors have stressed in recent days.
“By allowing yourself to get infected because of risky behavior, you are part of the propagation of the outbreak,” Dr. Fauci said at an event with Senator Doug Jones, Democrat of Alabama. “There are so many other things that are very dangerous and bad about this virus. Don’t get yourself into false complacency.”
People under 40 have made up a significant portion of new cases recorded in states with recent outbreaks, a sign of how the virus has spread in bars, restaurants and offices that have reopened.
The mask-wearing McConnell suggests that a relief bill will pass by the end of the month. Congress is off for the next two weeks however. Both sides (R’s and D’s) are very far off in their negotiations. McConnell faces re-election soon and his posturing is showing less grim reaper and more helper.
McConnell Expects New Virus Relief Bill by End of Month
By
July 6, 2020, 1:14 PM PDT
Senate leader says U.S. needs ‘one last boost’ to economy
Public officials should set example on masks, McConnell says
Senate Majority Leader Mitch McConnell predicted Congress will pass one final coronavirus rescue package later this month and appealed to everyone in public life to urge people to wear masks to control the spread.
“This is not over. We are seeing a resurgence in a lot of states,” McConnell said at one of three press conferences he held Monday in Kentucky. “I think the country needs one last boost.”
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McConnell said he’s “pretty sure” that a bill will come together in the next couple of weeks. He said it will be crafted in his office with consultation from the administration and then negotiated with Democrats, who endorsed a $3.5 trillion package approved by the House in May. Senate Republicans have dismissed that plan and are discussing a package of as much as $1 trillion in total spending.Whatever the final number, McConnell said it will be harder to get the unanimous Senate support that accompanied the last bill, the $2.2 trillion Cares Act. “The atmosphere has become a bit more political than it was in March,” he said.
COVID-19 survivor Tom Hanks has a message for anyone unwilling to “do their part” to stop the spread of the respiratory illness.
Appearing Tuesday on NBC’s “Today,” Hanks reflected on his own early bout with the coronavirus and questioned why some weren’t taking the pandemic seriously. He also discussed his forthcoming World War II drama, “Greyhound,” which debuts Friday on Apple TV+.
“We don’t know what’s going to happen with COVID-19. The idea of doing one’s part, though, should be so simple: Wear a mask, social distance, wash your hands,” Hanks told host Hoda Kotb. “That alone means you are contributing to the betterment of your house, your work, your town, your society as a whole. And it’s such a small thing. … It’s a mystery to me how somehow that has been wiped out of what should be ingrained in the behavior of us all.”
Though Hanks and his wife, actress Rita Wilson, were in “awfully good hands” and not “afraid” after testing positive for COVID-19, he didn’t want to “dismiss” the severity of their symptoms. The pair became the first major stars to go public with diagnoses in March while visiting Australia for an upcoming Elvis Presley biopic starring Hanks as Presley’s manager, Col. Tom Parker.
“We felt rotten,” Hanks said. “I had body aches — crippling, cracking body aches. … The Australian officials put us in the hospital, and they kept very strict attention on our fevers, because if they had spiked, we were going to be in trouble; our lungs, because if they had filled up or scarred we were going to be in trouble; and the levels of our oxygen.”
Although the screen icon believes the “vast majority of Americans” understand the importance of protecting themselves and others from COVID-19, he didn’t mince words when laying out the dangers some have chosen to ignore.
“Look, there’s no law against ignorance. It’s not illegal to have opinions that are wrong,” Hanks said. “But there is a darkness on the edge of town here folks, and … let’s not confuse the fact: It’s killing people. … Yeah, that’s right. It’s killing people.
“And you can say, ‘Well, traffic accidents kill an awful lot of people too.’ A traffic accident happened because a lot of drivers aren’t doing their part. … I don’t know how common sense has somehow been put in question.”
As for “Greyhound,” one of many films foregoing a theatrical release because of the public health crisis, Hanks is just happy people will have a chance to see the movie at all.
“I’m actually thrilled that Apple TV is making it possible for everybody to see it — not only worldwide, as long as you have Apple television — but also the day after my 64th birthday. … Thank you very much,” he said.
“There isn’t anybody that doesn’t like going to see a good movie with 800 other people and coming out with something in common. Barring that, Apple television has saved the day for us. We had a magnificent movie that was not going to be seen.”
This is fucking infuriating. Carsyn Davis was a cancer survivor with a rare autoimmune disorder.
HER MOTHER WAS A NURSE! Her mother took her to a Church COVID party with over 100 children and treated her with hydroxychloroquine, antibiotics, & oxygen at home.
She should be stripped of her license and jailed.
More showdowns for the WH with CDC - Schools - NYC - public
Trump denounces the C.D.C. over guidelines for opening schools and threatens funding.
President Trump, openly flouting the advice of his own federal health experts, threatened to cut off federal aid to schools that refuse to fully reopen this fall.
He assailed guidelines issued by the Centers for Disease Control and Prevention that recommend a slew of costly preventive measures necessary to bring the nation’s children back to class.
In a pair of tweets on Wednesday morning, Mr. Trump ramped up pressure on state leaders to get children back in brick and mortar buildings, a crucial step to jump-starting the economy.
Mr. Trump has no control over the vast majority of school district budgets, which are raised by local property and sales taxes. And he has little control over federal funding already appropriated by Congress. But the Education Department can withhold emergency relief funding that school districts say they desperately need to fund staff, programming and the public health measures recommended by the C.D.C.segment_id=32892&user_id=2b7d479898d970bec0f899512bbc0cd5
N.Y.C. released its schools plan: Up to 3 days a week in the classroom.
Classroom attendance in New York City will be limited to only one to three days a week in an effort to continue to curb the coronavirus outbreak, Mayor Bill de Blasio said on Wednesday, about four months after 1.1 million New York City children were forced into online learning.
Mr. de Blasio’s announcement of his plan for the system, the largest in the U.S., capped weeks of intense debate among elected officials, educators and public health experts.
The new GOP battle cry of “STOP GETTING TESTED” is not going over so well.
https://www.washingtonpost.com/business/2020/07/08/trump-baseball-tax-breaks-coronavirus/
New daily record levels now at 60,000 new cases, which is the trend that Dr. Fauci had predicted. It is not a virus that is slowing down anytime soon.
Key Points
There were 60,021 new Covid-19 cases reported in the U.S. over the previous 24-hour period. Arizona, California, Florida and Texas have accounted for nearly half of all new cases in the U.S. in recent days.
White House health advisor Dr. Anthony Fauci has lamented in recent days that while many other countries succeeded in shutting down and reducing daily new cases to a manageable level, the U.S. has failed to do the same.
The United States reported more than 60,000 new Covid-19 cases on Tuesday, setting a fresh record for new cases reported in a single day, according to data compiled by Johns Hopkins University.
The country reported 60,021 newly confirmed cases over the previous 24 hours as outbreaks continue to expand across a number of states, mostly across the American South and West. Arizona, California, Florida and Texas have accounted for nearly half of all new cases in the U.S. in recent days.
The Trump regime used veterans as guinea pigs.
SPRING CITY, Pa. — They wrapped the dead in body bags and raced back to treat the living, crammed into a nursing home that, day after day, played the somber sound of taps over the speaker system so the veterans who lived there had the chance to say goodbye.
The nurses and aides at the Southeastern Veterans’ Center in the suburbs of Philadelphia had watched so much go wrong since the start of the coronavirus pandemic. The communal dining that lasted into April, the nights that feverish patients were left to sleep beside roommates who weren’t sick yet. “Merry Christmas,” one nurse told another when they finally got N95 masks, weeks into the crisis and just before administrators stopped staffing the isolation rooms because too many people were feared infected.
But what worried some nurses most was what they called the “covid cocktail,” the widespread, off-label use of one of the antimalarial drugs touted by President Trump in March as a potentially game-changing treatment for covid-19.
For more than two weeks in April, a drug regimen that included hydroxychloroquine was routinely dispensed at the struggling center, often for patients who had not been tested for covid-19 and for those who suffered from medical conditions known to raise the risk of dangerous side effects, interviews, emails and medical notes and records obtained by The Washington Post show.
Though precise estimates vary, the state Department of Military and Veterans Affairs said about 30 residents received the drug. Several nursing home staff members placed the number higher. The Chester County coroner, who reviewed the medical records for some of those who died, said at least 11 residents who had received the hydroxychloroquine treatment had not been tested for covid-19.
The drug regimen appeared to conflict with guidance from the Food and Drug Administration, which issued an emergency-use authorization for the drugs in late March but stressed they should be administered only during clinical trials or in hospitals providing “careful heart monitoring” and only after detailed discussions with patients and families about the risks. At the 238-bed nursing home, the treatment was given over the objections of some nurses, at times with little knowledge among patients’ families and largely hidden from lawmakers who have been probing the matter, according to interviews and emails.
“Started on the Covid Cocktail,” the center’s records noted for an 86-year-old resident with a history of arrhythmia, resulting in a pacemaker placement.
“Prophylactic,” the records said in describing the preventive regimen of hydroxychloroquine for a woman in her 80s who had a cough and was running a fever of 100.4.
The home’s interim commandant, Barbara Raymond, who took over after the treatment ended, declined to comment. Michele Shrikanthan, the center’s medical director, and Rohan Blackwood, the home’s commandant at the time, did not return calls.
State officials said health-care providers at the center had sole discretion on use of the drug. The medical director and another doctor, along with two nurse practitioners, write prescriptions at the home.
“Leadership was aware of [hydroxycholoroquine] being prescribed for residents,” said Joseph Butera, deputy communications director for the Pennsylvania Department of Military and Veterans Affairs, which operates Southeastern and five other state homes for veterans. “It was up to providers as to whether they felt comfortable.”
In May, the state suspended Blackwood and the center’s director of nursing after the Philadelphia Inquirer reported widespread breakdowns at the facility and the use of hydroxychloroquine at that home and others. Dozens of emails, reports, medical notes and records as well as interviews with 17 nurses, family members, doctors and others by The Post show how broadly the home turned to the unproven treatment and how a complex state bureaucracy went on to obscure critical decision-making in the midst of a pandemic.
The center and the two state agencies responsible for oversight have released little information about what transpired. The Department of Military and Veterans Affairs has confirmed the use of the drug but has not offered details about what led the doctors on-site to decide to use it. The state Department of Health, which inspected the home on May 1 and did not cite a single deficiency in infection control or patient care, declined to say whether hydroxychloroquine was administered. The center has released no information about how patients were selected or monitored.
“I am absolutely gobsmacked about the events that have occurred there,” said William C. Hunter, a Johns Hopkins-trained internist who served as the center’s medical director until he retired in December. “It was an untried cocktail. The risks and potential benefits were completely unknown — no real scientific studies were conducted.”
Hunter, who said he has been talking to staff at the home for weeks, called the treatment “reckless.”
“My sense,” he said, “is that things were starting to spiral out of control and they were looking for a magic bullet. It was horrifying.”
Nurses who had spent years caring for veterans and their spouses at Southeastern said they raised concerns. Without covid-19 testing, they said, potentially virus-free patients in their 80s and 90s were at risk of being dosed with an unproven drug they didn’t need or, worse yet, could hurt them.
“Why are we giving this to them?” one nurse recalled asking Shrikanthan after several residents with heart problems were placed on the drug regimen. Like five other caregivers at the home, the nurse spoke to The Post on the condition of anonymity to freely discuss what happened.
In response to the inquiry, the nurse said she was told, “This is the standard order.”
“I felt like I was playing Ring Around the Rosie,” she said. “Nobody wanted to sit and explain why. If that were my mom or dad, I would want answers.”
Another staff member decided to keep a running list of residents who were administered the drugs and counted nearly three dozen. The Post did not have access to the records needed to independently corroborate the numbers.
The cocktail included azithromycin, commonly used to treat infections, and Plaquenil, a brand name for hydroxychloroquine, a sampling of medical records obtained by The Post show.
Doctors “would just give it without any parameters,” the staff member who kept the tally said. “We weren’t monitoring … as much as we needed to.”
There is no way to know whether the treatment played a role in any of the deaths at the home, which has attributed 42 fatalities to covid-19. Chester County Coroner Christina VandePol, a board-certified internist trained at the University of Pennsylvania, said the center signed off on the death certificates of residents and, in many cases, sent the bodies to funeral homes outside the area.
Through medical records and reports from the home, VandePol said, she determined that at least 14 residents whose deaths were tied to covid-19 were never actually tested for the infection. Of those, 11 had been given hydroxychloroquine before they died, she said. VandePol is pressing to have all nursing home deaths reported to the state’s coroners moving forward.
“In the case of hydroxychloroquine, as part of a covid cocktail, perhaps, knowing there would be outside scrutiny, the home would not have been as cavalier about routinely giving elderly debilitated people an unproven drug outside of a clinical trial,” she said.
The center stopped administering the drug around April 22, according to an email obtained by The Post that was sent to more than a dozen staff members. Earlier that week, a nationwide study of 368 hospitalized Veterans Affairs patients with covid-19 reported that the death rate was higher for those treated with hydroxychloroquine.
“The providers have decided not to use this drug anymore,” Deborah Mullane, then the center’s director of nursing, wrote in the email. “All current Plaquenil orders have been discontinued.”
Last month, the FDA reported that the antimalarial drugs had triggered cardiac problems and other adverse effects in covid-19 patients and revoked the emergency-use authorization, which had allowed the transfer of funds to the Strategic National Stockpile for distribution of the drugs to hospitals.
Families and staff members are still grasping for an explanation. In recent weeks, more than 40 people have reached out to state Sen. Katie Muth (D), who lives two miles from the home and has been heading up an unofficial investigation. Answers have been hard to come by.
In response to an inquiry from Muth last month, state Health Department legislative director David Toth defended the use of hydroxychloroquine but declined to say whether it was actually ever used.
“In late March, numerous sources began highlighting a potential benefit of the use of hydroxychloroquine and chloroquine for covid-19,” he said in an email written on behalf of Health Secretary Rachel Levine, whose agency is responsible for ensuring the home meets federal health and safety standards. “Health care providers throughout the country began to use this medication to treat covid-19 patients based on that literature. At that time, the federal government also touted its potential benefit. This was an off-label use of the medication, but it is important to note that doctors can and do write off-label prescriptions for FDA-approved medications.”
Without clarity from state agencies, Muth has called on the state attorney general to investigate.
“I sort of Forrest Gump-ed myself into finding out about the use of Plaquenil,” the 36-year-old lawmaker said. “I knew a lot of really horrible stuff was happening there, all these deaths, but I didn’t know this. … Did they die from the drug? Did they die from covid? What did they die from?”
Chaos, questions, deaths
Residents and their family members had no idea how many people were dying at the four-story veterans’ home near the Schuylkill River when the Philadelphia Inquirer broke a story on April 25. The news was stunning: 26 residents had died in what had clearly become one of the deadliest coronavirus outbreaks in the state.
Inside the home, staff members said, they were pleading to wear personal protective equipment, isolate the sick and keep nurses and aides who had been exposed to the virus away from healthy patients. The sounds of coughing swept the hallways and the activity rooms, where residents shared colored pencils and dice. Those who grew too ill to eat sat listless over ham loaf alongside healthier residents in the dining hall.
“We were handing out Tylenol like crazy,” one nurse said. “There were times when I would stand there peeing on myself because I had so many sick people and you just couldn’t take the time to stop.”
As staff members scrambled to control the rapid-fire spread of infection, the center turned to hydroxychloroquine.
Trump started talking about antimalarial drugs in mid-March, suggesting a potential, off-label treatment for covid-19, which has so far killed at least 42,000 nursing home residents nationwide. Public health experts urged extreme caution, saying the drugs were unproven and could potentially trigger life-threatening side effects, particularly in cardiac patients.
“We do not know if it works for covid-19,” the FDA wrote in March when it authorized the use of the drugs. “There is limited information known about the safety and effectiveness (whether this will make you better).”
The president pressed forward during a series of televised press briefings. “It’s a very strong, powerful medicine, but it doesn’t kill people,” Trump declared in early April. “We have some very good results and some very good tests.”
The FDA made clear the treatment should be used in hospitals, which can provide intense monitoring. Some have deployed teams that include cardiologists, electrophysiologists, infectious-disease physicians, pharmacists and nurses.
“It was a multidisciplinary effort to make sure that if this was used, everyone was making sure it was being used as safely as possible,” said Barbara Santevecchi, an infectious-diseases clinical pharmacy specialist and professor in the Department of Pharmacotherapy and Translational Research at the University of Florida. “You have to be able to watch for adverse effects.”
The Centers for Medicare and Medicaid Services, which regulates the 15,000 nursing homes in the United States, has provided no guidance on the use of the drugs in nursing homes since Trump first touted the potential benefits. Local media have reported that nursing homes in Texas, Illinois, Connecticut and North Carolina treated patients with the drugs.
The Southeastern center ordered hydroxychloroquine from a wholesale pharmacy in March and notified the state Department of Military and Veterans Affairs when health-care workers started administering the drug in April, said Butera, the department’s deputy communications director. Darryl Jackson, the department’s chief medical officer, “ensured the medication was available in case the primary care providers at the homes felt that it was medically necessary,” Butera said in an email.
“There were numerous [Department of Health]/medical reports about the use of this drug across Pennsylvania and throughout the United States,” Butera said.
Muth, the state senator, said it appeared the home focused more on the drug supply than face masks and other protective equipment for front-line caregivers.
“Funny how they didn’t have PPE stockpiled but they made it a priority of their treatment protocol to include a drug that wasn’t proven to work and shouldn’t be used in non-hospital settings,” she said.
Nurses at Southeastern said they received little information about the new course of treatment.
“All they said was that they were starting these residents on Plaquenil. I started asking them, ‘Well, what’s Plaquenil for?’ ” one nurse recalled. “I started looking it up. We were always taught in nursing school that you’re supposed to know what medications you are giving, what it’s for and what the side effects are. I said, ‘Well, I don’t understand. Why are we giving it to the elderly?’ ”
“This is what’s ordered. This is what you’re supposed to give,” the nurse recalled being told by Shrikanthan, the center’s medical director.
In the past, nurses said, doctors at the center had provided explicit instructions for medications that could have adverse effects. In the case of hydroxychloroquine, nurses said they were given standard orders: five days of treatment, even for patients with heart problems. Hydroxychloroquine has been found to cause serious heart irregularities, such as life-threatening arrhythmias, in covid-19 patients.
“We all started looking it up and we found that this wreaks havoc on your system,” another nurse said. “You’re talking about people with pacemakers, people with [arrhythmia] … and we’re giving it to them without any parameters. It was just like we were starting them on any other medication.”
The nurses said they raised questions but did not push the doctors or top administrators further. In interviews with The Post and in emails to Muth, staff members said they feared for their jobs, especially since the center appeared to have unwavering support from the state Department of Military and Veterans Affairs and the state Department of Health.
Health Department inspectors gave the home an overall five-star rating, the highest mark, according to a federal government rating system that takes into account quality and staffing, among other measures, records show. An inspection on May 1, days after the hydroxychloroquine treatment ended, found no violations, records show.
“That so-called DOH [inspector] was just sitting in a room talking for a few hours and they didn’t walk onto any floors nor did they speak to any staff,” one staff member wrote in an email to Muth a week after the inspection.
Nate Wardle, spokesperson for the state Department of Health, said in an email that the department “takes seriously our job of protecting the health and well-being of our most vulnerable Pennsylvanians.”
It is unclear how patients were chosen for the drug regimen. Nurses said they were instructed to give the drugs to anyone with covid-19 symptoms, including those who had not been tested for the infection.
In emails to families and in discussions with nurses, the center attributed the lack of testing to guidance from county health authorities.
According to the center, the Chester County Health Department had ordered no further testing once two or more residents in the same unit tested positive. Instead, everyone else would be considered exposed and, if symptoms developed, presumed positive without laboratory confirmation.
“Chester County stated if we have a unit who has 2 or more people who have tested + that we should presume everyone to be positive and no one additional on that floor will be tested (we tested the 3 residents before we received this directive),” a social worker at the center wrote in an April 8 email to the daughter of a resident. “At this point, everyone including Dad is presumed positive.”
A Chester County Health Department spokesperson acknowledged that in the early stages of the pandemic when supplies were limited, congregate care facilities “where some individuals tested positive could operate as if everyone who was symptomatic was also positive and should be treated as such.” The county was taking direction from the state, spokesperson Becky Brain said.
“The Chester County Health Department was following guidance from the PA Department of Health — not just for [Southeastern], but for all congregate care settings,” she said.
Wardle said the state Health Department did not order nursing homes to consider patients presumed positive for covid-19 without testing. “The department encouraged testing of symptomatic residents once an outbreak was identified,” he said.
One nurse at Southeastern said she grew particularly concerned about a resident with a low-grade fever who was presumed positive, moved into a room with two sick roommates and given Plaquenil. Before the pandemic, the man had often developed fevers from heart problems and blood clots in his legs. Suddenly, she said, he was placed alongside sick people and given a drug with potentially dangerous side effects.
“What if it’s something totally different and you just put him in isolation with two positive people … not even testing him?” she said. “Then they start him on Plaquenil.”
He later died, the nurse said.
A nursing assistant recalled the case of an elderly woman with bronchitis who was placed on the drug. Records from the home said the cocktail was given for prophylactic use.
She later died, the nursing assistant said.
“I just feel as though arrogance and ignorance came into play,” she said. “Granted, nobody really knows anything about covid, but I feel like they were more trying to cover themselves than really helping our residents at the end of the day, and it’s heartbreaking.”
‘It’s just not acceptable’
The relatives of several residents dosed with the drug say they were provided little information about the experimental course of treatment.
Long-standing federal rules on the rights of residents in nursing homes require doctors to inform patients in advance about medication changes and discuss the risks, benefits and treatment alternatives. If patients have dementia or other cognitive impairments, homes are supposed to reach out to a primary point of contact, such as a spouse or child.
Family members say the calls they received from the home about the drug treatment were brief and lacked critical details.
Before he fell ill in mid-April, 87-year-old Paul Ferko had known for days that something was very wrong at his home of nine months.
“He heard the taps,” said his daughter, Chrissy Diaz. “He told us that the virus that was on TV was in the home.”
Diaz said she received a call from the center on April 19, noting that her father was being placed on Plaquenil. She said she grew concerned because her father, a steelworker who had serviced airplanes during the Korean War, had hypertension and other medical conditions.
“They weren’t asking me in any way, shape or form,” Diaz said. “I asked if Plaquenil was hydroxychloroquine. They said it was and I asked about the side effects. I thought it was just used in hospitals. They said nursing homes could use it. They assured me that it was safe, that the side effects were minimal.”
Diaz said her father had not been tested for covid-19 when the treatment began. Medical records show he was running a fever of 99.2 and had a possible case of pneumonia. She saw him for the last time a few days later, propped up against a second-floor window by several aides. He died in a nearby hospital.
“They started using [hydroxychloroquine] on anyone who had symptoms,” Diaz said. “It was in the news. It was like the next great thing. I feel like it was, ‘Let’s use this on our elderly patients and see what happens.’ Maybe they thought they were going to die anyway. I don’t know what was going through their heads. That’s what’s really scary.”
Carol Lewis said her family received a similar call from the center and also grew concerned about the course of treatment. Her father, a computer engineer who served in the Army, had a history of heart problems, she said.
Lewis said the family instructed the center not to use hydroxychloroquine. After her father died on April 13, Lewis requested the medical records and found a doctor’s note indicating that a course of Plaquenil had been completed.
“It’s just disgraceful,” she said. “I want to know who ordered this, first of all. What happened and where was the breakdown that this whole situation went up in flames like this?”
Nursing home experts say patients and their families should have been consulted before the drugs were used and given detailed information about the potential risks and side effects.
“It’s just not acceptable. Facilities aren’t supposed to just give people drugs,” said Toby Edelman, senior policy attorney for the Center for Medicare Advocacy, a nonprofit watchdog and advocacy organization headquartered in Connecticut and Washington, D.C. “Just because it’s an emergency, facilities can’t give residents drugs that are totally unknown, untested and unproven.”
‘A closed-loop system’
Lawmakers, staff members and relatives of the deceased say state regulators have frustrated efforts to probe what happened at the home. Dozens have reached out to Muth, who had been planning to run a bingo game at the center before it was locked down to visitors in March.
“I first heard about him receiving these drugs after they were prescribed and administered with no idea of the risks associated with other preexisting conditions,” the widow of a retired Army officer emailed on May 5. “Why did this happen out of protocol and in this case only? Was this some type of clinical trial or practice test administered to someone that could not engage in his own decision-making or were they just desperate or both?”
Muth called VandePol, the county coroner, who had not heard about the treatment. VandePol started researching the possibility that the residents had been part of an approved clinical trial. No trial existed. VandePol delved deeper, counting 14 residents whose deaths were categorized by the center as “presumed covid-19″ because they had not been tested for the infection.
“I was very surprised to find [hydroxycholoroquine] was being used in an unmonitored way for very elderly people who in some cases had not been tested for covid-19,” said VandePol, who spent more than 20 years conducting pharmaceutical trials.
Other nursing homes in the county allowed VandePol to do postmortem covid-19 tests. Bodies at the veterans’ center, however, were in most cases already released to funeral homes outside the county.
“Their institution became a closed-loop system,” VandePol said. “The people that are taking care of the patients are also certifying what the cause of death is.”
Muth blames a state system that is “internally regulated with no guarantee of transparency,” from the doctors and the director at the Department of Military and Veterans Affairs to the inspectors and the secretary at the Department of the Health.
In late May, the governor’s Office of General Counsel engaged outside counsel to conduct an independent investigation of the outbreak at the center and the way the home and the state Department of Military and Veterans Affairs addressed the crisis. No details have been released.
Amid the ongoing questions and calls for additional investigations, staff members say they are still reeling from all they saw and heard: The dead rolled into body bags with their names on toe tags and the ever-present, unwelcome sound of taps on the speaker system, notice of yet another death. Standing alongside their nurses and listening to the bugles play, residents with dementia who often could not remember what they had for dinner the night before would slowly remove their hats.
And then they would salute.
Some answers to a variety of questions on Covid-10 from Wall Street Journal.
Months into the pandemic, the scientific community’s understanding of Covid-19, the illness caused by the new coronavirus, is rapidly evolving. New reports of patients testing positive, or appearing to suffer symptoms months after initial diagnosis, continues to generate concern that people who have had Covid-19 are getting infected anew.
Here is the latest on what we know, and don’t know, about the possibility of becoming sick with the virus more than once.
I recently recovered from Covid-19. Does that mean I can’t get it again?
Most scientists say that people who have had Covid-19 gain some immunity to the virus that causes it. What they don’t know is whether that protection lasts a few months, a few years or a lifetime.
What factors affect immunity?
The immune system wards off infections by producing antibodies that fight invaders. A range of hereditary and environmental factors, including diet and sleep patterns, typically affect the strength and longevity of those defenses.
Immunity also depends on the pathogen. For example, infection by the virus that causes measles confers lifelong immunity. Others, like the influenza virus, can mutate so rapidly that protective antibodies might not recognize them during a reinfection.
The novel coronavirus mutates more slowly than the influenza virus. That gives researchers hope that any natural immunity, or vaccine, would offer more lasting protection. Even if someone gets sick again, researchers believe a second infection might be milder than the first.
How soon would my body produce antibodies to fight the novel coronavirus after an initial infection?
The U.S. Centers for Disease Control and Prevention says antibodies develop within one to three weeks after infection.
A study involving 34 hospitalized cases in China found that two patients, both in their 80s, produced antibodies within three days of symptom onset. The rest produced them two weeks after symptoms first surfaced. The findings were vetted by other experts and published in an academic journal in March.
Is there any good news?
A group of Chinese researchers reported this month that they had infected six rhesus macaques, allowed them to recover and then reinfected four of them 28 days after the first infection. None became sick again, showing their immune system shielded them from a second infection.
The research, published in Science, says, however, that more studies are needed to understand whether the immune system can shield individuals from reinfection over longer periods of time.
Then why are some people testing positive again?
Roughly 450 South Koreans tested positive for the virus again after meeting the criteria for recovery and being discharged from isolation. The Korea Centers for Disease Control and Prevention re-tested more than half of those people and found no evidence of the live virus circulating.
Peer-reviewed research studies have shown that viral fragments can circulate even after an individual is symptom-free. That doesn’t mean that people are still sick or infectious.
How do I know I’ve fully recovered?
Clinicians have mixed views on what constitutes recovery because long-term data aren’t yet available. Guidelines vary across the globe.
For example, the CDC says that infected individuals are considered recovered if they test negative for the novel coronavirus twice, with tests approved by the U.S. Food and Drug Administration taken at least 24 hours apart.
Or, individuals must be fever-free for three consecutive days and show an improvement in their other symptoms, including reduced coughing and shortness of breath. At least 10 days should have passed since their symptoms first surfaced.
Some survivors testing negative for the virus say that certain symptoms, such as a loss of taste and smell, can linger for months after other symptoms are gone.
Here’s the link to the John’s Hopkins Covid-19 large world map AND looks like they have added a school/university OPENINGS information tracker.
School/University Openings tracker by State
(and of course, this a hotly debated area…but this is a way to look at existing trends with schools)
From newsletter Exclusive: New Hopkins tracker you’ll click constantly - POLITICO
Closing schools was a lot easier than reopening them — Forty-three states and territories have issued plans for reopening schools, according to the JHU tracker.
The idea is for parents, policymakers, and employees ranging from district leaders to cafeteria workers to have access to the information so they can refine those plans, said Annette Anderson, deputy director of JHU’s Center for Safe and Healthy Schools. In some parts of the country, the first day of school is only about a month away.
The tracker is meant to add equity to the conversation by looking at whether states are actively addressing disparities between students, given how many kids were left behind this spring, Anderson said. “At the end of the day, it’s about trying to make sure that when we reopen, that the reopening benefits all.”
More overwhelming information for Texas where people are remaining home and dying there from Covid-19. Just so much chaos in the face of a virus impacting way more people than could be anticipated or controlled. 
A Spike in People Dying at Home Suggests Coronavirus Deaths in Houston May Be Higher Than Reported
As coronavirus cases surge, inundating hospitals and leading to testing shortages, a rapidly growing number of Houston area residents are dying at home, according to an NBC News and ProPublica review of Houston Fire Department data. An increasing number of these at-home deaths have been confirmed to be the result of COVID-19, Harris County medical examiner data shows.
The previously unreported jump in people dying at home is the latest indicator of a mounting crisis in a region beset by one of the nation’s worst and fastest-growing coronavirus outbreaks. On Tuesday, a record 3,851 people were hospitalized for the coronavirus in the Houston region, exceeding normal intensive care capacity and sending some hospitals scrambling to find additional staff and space.
The uptick in the number of people dying before they can even reach a hospital in Houston draws parallels to what happened in New York City in March and April, when there was a spike in the number of times firefighters responded to medical calls, only to discover that the person in need of help had already died. These increases also echo those reported during outbreaks in Detroit and Boston, when the number of people dying at home jumped as coronavirus cases surged.
While far more people died of COVID-19 in those cities than have died so far in Houston, researchers and paramedics say that the trend of sudden at-home deaths in Texas’ largest city is concerning because it shows that the virus’s toll may be deeper than what appears in official death tallies and daily hospitalization reports.
More scrutiny on Florida’s Gov Ron DeSantis over the dispersal of Covid-19 ‘sick’ numbers and an attempt to filter these away from a local sheriff, who may have been providing Rebekah Jones, “formerly a data scientist with the state” with them. She is the fired employee who said that the Covid-19 numbers were being withheld and altered.
“Sorry to inform you tonight that our covid-19 data updates for Volusia County are over,” Chitwood wrote on Twitter on Tuesday evening, explaining that the state’s Department of Health would no longer be providing him with address-specific information that he was then using to determine how the virus was spreading across the county.
On Thursday morning, as Florida reported a record-breaking 120 new coronavirus deaths overnight, Chitwood told Yahoo News that the state had agreed to resume providing the data.
“I vehemently disagree with hiding the numbers,” Chitwood said in a phone interview. He says he remains a supporter of Gov. Ron DeSantis, a Republican, but believes that political retribution did play a part in the sudden decision to stop providing him with data. The state offered no explanation of why it decided to provide the data after all.
“As this pandemic is growing, why are we giving less information?” Chitwood wondered. “That’s not healthy.” He told Yahoo News that he was unaware of any other Florida sheriff who was providing similar coronavirus updates.
The development comes as Florida confronts not only a burgeoning caseload but also persistent questions about how forthcoming state leaders have been with the public. Officials from the same state health department who appeared to be cutting off Chitwood have also been accused of telling Rebekah Jones, formerly a data scientist for the state, to alter statistics in some counties; of telling coroners not to report coronavirus deaths; and, most recently, of hiding information about hospitalizations.
@anon95374541 @MissJava - Would you please put under Coronavirus please? Thanks!
Bill Nye is a national treasure. Video:
The misogyny is the point.
I mean, how dare the CDC warn pregnant women about the dangers of contracting COVID-19 during pregnancy and embarrass dear leader Trump, right?
Daily numbers are growing. Each day a new record. #FauciKnows
The novel coronavirus pandemic could lead to a wave of brain damage in infected patients, warned British researchers in a new study released Wednesday.
Experts at the University College London (UCL) were the latest to describe that Covid-19 could cause neurological complications including stroke, nerve damage, and potentially fatal brain inflammation – even if the patients didn’t show severe respiratory symptoms associated with the disease.
“We should be vigilant and look out for these complications in people who have had Covid-19,” said joint senior author Dr. Michael Zandi in a UCL press release, warning that it remains to be seen “whether we will see an epidemic on a large scale of brain damage linked to the pandemic.”
Follow-up studies will be necessary to understand the potential long-term neurological consequences of the pandemic, they said.
The study, published in the journal Brain, examined 43 patients treated at University College London Hospitals for either confirmed or suspected coronavirus, from April to May. They varied in age from 16 to 85, and showed a range of mild to severe symptoms.
Among these patients, researchers found 10 cases of “temporary brain dysfunction” and delirium; 12 cases of brain inflammation; eight cases of strokes; and eight cases of nerve damage.
Most of the patients who showed brain inflammation were diagnosed with a specific, rare and sometimes deadly condition known as Acute disseminated encephalomyelitis (ADEM). Before the pandemic, the research team in London would see about one ADEM patient per month. During the study period, the number rose to at least one a week.
One woman hallucinated lions and monkeys in her house. Others reported numbness in their limbs or face, double vision, and disorientation. One severe patient was barely conscious, responding only when in pain.
Researchers are still trying to figure out why exactly Covid-19 patients are developing these brain complications. The virus that causes Covid-19 was not found in their brain fluid, meaning the virus does not appear to directly attack the brain. One theory, instead, is that the complications are indirectly triggered by an immune response from the patient’s body – not from the virus itself.
These findings are significant for informing how doctors around the world monitor and treat patients – but they also pose new questions and challenges. For patients who aren’t showing severe respiratory symptoms such as trouble with breathing, it can be difficult to identify these brain complications early enough to prevent or minimize damage. And for patients who are critically ill, their precarious health can limit how much doctors can do to investigate what’s happening in their brain.
The authors warned that further studies will be “essential” in figuring out how exactly the virus causes brain damage, and how to treat it.
“Given that the disease has only been around for a matter of months, we might not yet know what long-term damage Covid-19 can cause,” said joint first author Dr. Ross Paterson in the press release. “Doctors needs to be aware of possible neurological effects, as early diagnosis can improve patient outcomes.”
Dr. David Strain of the University of Exeter Medical School, who was not part of the study, called the findings important but “not surprising” given previous coronavirus cases.
“The main limitation is that we don’t know what the denominator so we don’t know how frequently these complications arise,” he said in a statement on Wednesday. “We’ve already seen that some people with Covid-19 may need a long rehabilitation period – both physical rehabilitation such as exercise, and brain rehabilitation. We need to understand more about the impact of this infection on the brain.”
In Italy, a large proportion of patients with coronavirus disease 2019 (COVID-19) presented with symptoms (71.4% of 31 845 confirmed cases as of June 3, 2020).1 Common symptoms include cough, fever, dyspnea, musculoskeletal symptoms (myalgia, joint pain, fatigue), gastrointestinal symptoms, and anosmia/dysgeusia.2-4 However, information is lacking on symptoms that persist after recovery. We assessed persistent symptoms in patients who were discharged from the hospital after recovery from COVID-19.
Methods
In the waning phase of the pandemic, beginning on April 21, 2020, the Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome, Italy, established a postacute outpatient service for individuals discharged from the hospital after recovery from COVID-19. All patients who met World Health Organization criteria for discontinuation of quarantine (no fever for 3 consecutive days, improvement in other symptoms, and 2 negative test results for severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] 24 hours apart) were followed up. At enrollment in the study, real-time reverse transcriptase–polymerase chain reaction for SARS-CoV-2 was performed and patients with a negative test result were included.
Patients were offered a comprehensive medical assessment with detailed history and physical examination. Data on all clinical characteristics, including clinical and pharmacological history, lifestyle factors, vaccination status, and body measurements, were collected in a structured electronic data collection system. The COVID-19 postacute outpatient service is currently active, and further details about the patient evaluation protocol are described elsewhere.5
In particular, data on specific symptoms potentially correlated with COVID-19 were obtained using a standardized questionnaire administered at enrollment. Patients were asked to retrospectively recount the presence or absence of symptoms during the acute phase of COVID-19 and whether each symptom persisted at the time of the visit. More than 1 symptom could be reported. The EuroQol visual analog scale was used to ask patients to score their quality of life from 0 (worst imaginable health) to 100 (best imaginable health) before COVID-19 and at the time of the visit. A difference of 10 points defined worsened quality of life. All analyses were performed using R version 3.6.3 (R Foundation).
This study was approved by the Università Cattolica and Fondazione Policlinico Gemelli IRCCS Institutional Ethics Committee. Written informed consent was obtained from all participants.
Results
From April 21 to May 29, 2020, 179 patients were potentially eligible for the follow-up post–acute care assessment; 14 individuals (8%) refused to participate and 22 had a positive test result. Thus, 143 patients were included. The mean age was 56.5 (SD, 14.6) years (range, 19-84 years), and 53 (37%) were women. During hospitalization, 72.7% of participants had evidence of interstitial pneumonia. The mean length of hospital stay was 13.5 (SD, 9.7) days; 21 patients (15%) received noninvasive ventilation and 7 patients (5%) received invasive ventilation. The characteristics of the study population are summarized in the Table.
Patients were assessed a mean of 60.3 (SD, 13.6) days after onset of the first COVID-19 symptom; at the time of the evaluation, only 18 (12.6%) were completely free of any COVID-19–related symptom, while 32% had 1 or 2 symptoms and 55% had 3 or more. None of the patients had fever or any signs or symptoms of acute illness. Worsened quality of life was observed among 44.1% of patients. The Figure shows that a high proportion of individuals still reported fatigue (53.1%), dyspnea (43.4%), joint pain, (27.3%) and chest pain (21.7%).
Discussion
This study found that in patients who had recovered from COVID-19, 87.4% reported persistence of at least 1 symptom, particularly fatigue and dyspnea. Limitations of the study include the lack of information on symptom history before acute COVID-19 illness and the lack of details on symptom severity. Furthermore, this is a single-center study with a relatively small number of patients and without a control group of patients discharged for other reasons. Patients with community-acquired pneumonia can also have persistent symptoms, suggesting that these findings may not be exclusive to COVID-19.6
Clinicians and researchers have focused on the acute phase of COVID-19, but continued monitoring after discharge for long-lasting effects is needed.
The cough has come back, without warning and seemingly for no reason; so has the fatigue. True, neither are as debilitating as when I had the actual virus, but they are back.
Like many others, I am now coming to realize that I am living and suffering from the long tail of Covid-19.
I got infected back in mid-April. The onset of symptoms came quickly. I suddenly noticed I was feeling very tired and I had a new cough. I got tested and the morning after I received a phone call from the medical center, I had tested positive for coronavirus.
The virus is like a tornado. When it lands, it swirls through the body, causing chaos, confusion, coughs, wreaking damage to each organ it touches. Some won’t survive its visit. For those that do, when it has gone, one surveys the damage to the human landscape and realizes it’s much greater than first thought. My symptoms were on the milder side: I never had breathing difficulties, or loss of sense or smell. I was wiped-out tired and I always had “the cough,” which has now returned.
The Covid cough is not like your usual cough-it-up deep cough (what doctors politely call a “productive cough.”) It is very distinctive. It is a dry, raspy, wheezy, cough. In my case, lots of short, expelling gasps of air, followed by a long, deep, chest-wrenching expiration cough, that has standers by wondering if I am going to keel over.
I have tested negative for the virus and positive for the antibodies, and my doctor says it won’t return. But there are days when I feel that it has.
I am also discovering new areas of damage: I have now become incredibly clumsy. I was never the most lissome person, no one ever called me graceful, but my clumsiness is off the chart. If I reach for a glass, or take something out of a cupboard, I will knock it, or drop it on the floor. I have tripped over the curb and gone flying. I fall over furniture. It is as if that part of my brain, which subconsciously adjusts hand and movement to obstacles it sees, isn’t working.
At times there’s a sense of mild confusion. The micro delay in a thought, the hesitation with a word. Nobody would notice but me.
My digestive system is peculiar, to say the least.
It doesn’t matter whether I call them symptoms, traits, or wreckage – my body doesn’t feel quite right.
The doctors try to reassure me, saying, this will wear off, but they can’t tell me when. Last week was bad. The cough has been with me for days, I have been tired and needed to take naps. I tripped over the camera tripod then fell over a chair! I am concerned but not panicked, yet. This week already feels much better.
For those who have not had Covid, or witnessed the mess it leaves behind, again, I urge you, do whatever you can to avoid this tornado.
It will roar through the body – kill some on the way – injure all in its path – and then when you think “well, thank God that’s gone,” look around, the damage is strewn everywhere and will be with you long after the crisis has passed.
Covid is a tornado with a very long tail.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31483-5/fulltext
Spain’s large-scale study on the coronavirus indicates just 5% of its population has developed antibodies, strengthening evidence that a so-called herd immunity to Covid-19 is “unachievable,” the medical journal the Lancet reported on Monday.
The findings show that 95% of Spain’s population remains susceptible to the virus. Herd immunity is achieved when enough of a population has become infected with a virus or bacteria – or vaccinated against it – to stop its circulation.
The European Center for Disease Control told CNN that Spain’s research, on a nationwide representative sample of more than 61,000 participants, appears to be the largest study to date among a dozen serological studies on the coronavirus undertaken by European nations.
It adds to the findings of an antibody study involving 2,766 participants in Geneva, Switzerland, published in the Lancet on June 11.
There have been similar studies in China and the United States and “the key finding from these representative cohorts is that most of the population appears to have remained unexposed” to Covid-19, “even in areas with widespread virus circulation,” said a Lancet commentary published along with Spain’s findings.
“In light of these findings, any proposed approach to achieve herd immunity through natural infection is not only highly unethical, but also unachievable,” said the Lancet’s commentary authors, Isabella Eckerle, head of the Geneva Centre for Emerging Viral Diseases, and Benjamin Meyer, a virologist at the University of Geneva.
Doctors are uncertain whether having antibodies to the coronavirus means someone cannot be infected again. It’s not clear how long or how well antibodies protect people from the virus.
Spain’s peer-reviewed study began in April while the nation remained on a strict lockdown, and was conducted by leading government research and epidemiological agencies.
“The relatively low seroprevalence observed in the context of an intense epidemic in Spain might serve as a reference to other countries. At present, herd immunity is difficult to achieve without accepting the collateral damage of many deaths in the susceptible population and overburdening of health systems,” the report reads.
The Spanish study’s lead author, Marina Pollán, who is director of the National Center for Epidemiology, told CNN: “Some experts have computed that around 60% of seroprevalence might mean herd immunity. But we are very far from achieving that number.”
Spain has been one of the countries in Europe hit hardest by the coronavirus, with more than 28,000 deaths and 250,000 cases.
The Lancet published results of the first phase of Spain’s study, conducted from April 27 to May 11, which showed a nationwide antibody prevalence of 5%.
But the Madrid metropolitan area, the hardest-hit in the country by Covid-19, had more than 10% prevalence, and densely urban Barcelona had 7%, while many other coastal provinces had far lower rates.
Similarly, Geneva’s prevalence was 10.8% in the Swiss study conducted from April to early May, the Lancet reported.
“With a large majority of the population being infection naïve, virus circulation can quickly return to early pandemic dimensions in a second wave once measures are lifted,” the Lancet’s commentary authors Eckerle and Meyer wrote of the findings.
Spain’s second study phase results were released on June 4, showing a 5.2% national prevalence, just slightly higher than in the first phase. The results from the third and final phase were made public on Monday; they showed that national prevalence remained at 5.2%, Pollán said.
Seriously, at this point I am waiting to hear that the NRA, KKK, and Martin FUCKING Shkreli got in on this.
https://www.nytimes.com/aponline/2020/07/07/us/ap-us-virus-outbreak-summer-camps.html?smid=tw-share
