28 March 2020 : COVID-19 news
WA research center forecasts shortage of hospital beds; rural areas are limiting entry to residents to protect resources; NY Gov. Cuomo calls for a national buying consortium for medical supplies
Expect that anything you're told today is going to change, and likely not into something more lenient. ~Debi Robson Vans Evers
It’s day 68 since the first case of coronavirus disease was announced in the United States, the third largest country in the world. And the 28th daily missive. I did not let myself look four weeks into the future when I started writing; had I done that, I might not have sat down at the keyboard. I hope the newsletter has helped you, as it has me, process the daily deluge. If it has, please share!
Saturday, Johns Hopkins reported 124,464 (104,829) cases and 2,191 (1,707) deaths, an increase of 22.1 and 31.7 percent, respectively, since Friday. Our reported case rate is 38 per 100,000; our death rate is 6.62 per million.
On 06 March, Liz Specht, associate director of science and technology at The Good Food Institute, explained exponential growth. She elaborated: if 10 percent of those cases were to require hospitalization (that was Italy’s experience), “by about May 8th, all open hospital beds in the US will be filled.”
On 26 March, The Institute for Health Metrics and Evaluation (IHME), an independent global health research center at the University of Washington, estimated national peak demand for health service utilization (hospital beds and the like) in mid-April. And we don’t have enough beds.
The date of peak excess demand by state varies from the second week of April through May. We estimate that there will be a total of 81,114 deaths (95% UI 38,242 to 162,106) from COVID-19 over the next 4 months in the US…
The epidemic in the US will place a load well beyond the current capacity of hospitals to manage, especially for ICU care.
A plea from rural America: Urban covid-19 refugees, please stay home. Washington Post, 28 March 2020.
Tourists with Washington and California license plates have “overrun” beaches in Oregon’s rural coastal areas. “In the beach town of Manzanita, a grocery contemplated closing down Sunday — to the detriment of its bottom line — in order to have something left to feed the locals on Monday.” Small communities across the country are having to close their borders to non-residents.
Ebola Should Have Immunized the United States to the Coronavirus. Foreign Affairs, 28 March 2020.
Although the costs of the current pandemic will not be fully measurable for some time, what was done and what was left undone in the nearly four years between the end of the Ebola crisis and the first appearance of COVID-19 is now in the public domain. It is all too clear how and when the United States failed to better prepare.
Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington. New England Journal of Medicine, 27 March 2020.
… proactive steps by long-term care facilities to identify and exclude potentially infected staff and visitors, actively monitor for potentially infected patients, and implement appropriate infection prevention and control measures are needed to prevent the introduction of Covid-19.
The missing six weeks: how Trump failed the biggest test of his life. The Guardian, 28 March 2020.
When the definitive history of the coronavirus pandemic is written, the date 20 January 2020 is certain to feature prominently. It was on that day that a 35-year-old man in Washington state, recently returned from visiting family in Wuhan in China, became the first person in the US to be diagnosed with the virus.
On the very same day, 5,000 miles away in Asia, the first confirmed case of Covid-19 was reported in South Korea. The confluence was striking, but there the similarities ended.
CBS All Access is offering a free one-month trial, just in time to binge Star Trek: Picard. The Verge, 25 March 2020.
There is no requirement that you know or like Star Trek: The Next Generation to enjoy Star Trek: Picard. And although the title is “Picard” the story is about him only as a central figure around whom the multi-generational story swirls. You do need to enjoy “speculative fiction”. And it will help if you appreciate British-style storytelling (slower, more character-driven, than Hollywood mainstream). Tackles important questions about ‘what is life’ and what our responsibilities are to those who are different from us.
Around the country
All 50 states, the District of Columbia, Guam, the Northern Mariana Islands, Puerto Rico and the US Virgin Islands have identified COVID-19 cases. Today’s 3,035 known deaths are from 46 states plus the District of Columbia, Guam and Puerto Rico.
Florida: The number of confirmed coronavirus cases in Florida is doubling every three days. “We do understand the math and the models well enough to say with great confidence that Florida is going to have a huge public health crisis.”
Idaho: Governor Little will answer questions about COVID-19 on Idaho Public Television at 8 p.m. on Thursday, 02 April; watch online. There is a statewide stay-at-home order in effect.
New York: On Friday, the New York Department of Health added two exceptions to its hospital visitor guidelines: obstetrics and pediatrics. In each case, “the Department considers one support person essential to patient care” [emphasis in the original]. The psychological support is essential, as is the role of advocate. This is welcome news, assuming hospitals abide by it, and Gov Cuomo said on Saturday that they shall.
Pennsylvania: A suburban Philadelphia police officer was exposed to coronavirus on a 9-1-1 call. A ‘first responder refuge’ helps him quarantine safely.
Rhode Island Gov. Gina Raimondo is demanding that New Yorkers entering the state self-quarantine for 14-days. “That’s a law — that’s an order,” Ms. Raimondo said. “It comes with penalties. It’s not a suggestion.”
She sent troops and police officers to the main highways entering the state, as well as to Amtrak stations and the main airport, to stop and warn people coming from New York State about the quarantine order. And on Saturday, she extended the order to cover travelers from any state.
Politics, economics and COVID-19
Know someone in local government? Please forward this guide to preparing for COVID-19.
New York Gov. Andrew Cuomo is describing a disease-related market failure, especially when you frame hospitals and life-saving equipment as public infrastructure (versus a private good):
President Trump traveled to Norfolk, VA to give a speech prior to the USNS Comfort leaving port for New York. Trump’s travel “stands at odds” with his own public health agency advisories against non-essential travel and gatherings of more than 10 people.
The 200-mile trip to the naval base was Mr. Trump’s first time leaving the White House in nine days, and his decision to turn the moment into a high-profile photo opportunity raised questions about safety and his use of government resources at a time when the administration’s own federal guidelines advise against most travel and gatherings of more than 10 people.
As is his customary practice, Trump took to Twitter to float the idea of a regional quarantine after his public remarks.
CSPAN has the video and transcript.
Later Saturday, CDC issued a travel advisory urging people in the tri-state area to "refrain from non-essential domestic travel" for the next two weeks.
The number of affected countries/territories/areas jumped from 29 at the end of February to 197 yesterday. There were no additions today. Although early reports tied the outbreak to a seafood (“wet”) market in Wuhan, China, analyses of genomic data suggest that the virus may have developed elsewhere.
Australia: There are people stuck on cruise ships on “never-ending holiday from hell” around the world as “governments struggle to work out how to get them safely home.”
Canada: On Monday, Prime minister Justin Trudeau will issue an order prohibiting anyone who shows symptoms of COVID-19 from boarding domestic flights or intercity trains.
France: The country has a total of 38,105 cases and 2,317 deaths (John Hopkins, 28 March, 9 pm Pacific). At a press conference Saturday, Prime Minister Edouard Philippe and Health Minister Olivier Veran said that they have ordered 1,000 ventilators from French manufacturer Air Liquide SA as well as 5 million rapid diagnostic tests.
Spain: The government has (belatedly) directed non-essential workers to stay at home for the next two weeks.
Switzerland has the highest case load per capita in the world. The government has recommended that all citizens stay home and has banned gatherings of more than five people. They are testing more than 6,000 per day; the population is 8.65 million (similar to Virginia, which has currently tested a total of 9,166).
The Bahamas have identified 11 cases, which is a rate of 28 cases/million.
Tests are becoming much more widely available. There is a lag between being contagious and showing symptoms. The virus was not created in a lab.
28 March, global
Globally: 571,678 confirmed (62,514) with 26,494 deaths (3,159)
Regions of the Americas: 100,314 confirmed (19,177) with 1,485 deaths (309)
Global confirmed: 664,695
Total deaths: 30,847
Total recovered: 140,156
Johns Hopkins interactive dashboard (9 pm Pacific)
28 March, domestic
Nationally* there are a total of 85,356 cases and 1,246 deaths according to the CDC (last updated Friday), and 124,464 (104,686) cases and 2,191 (1,701) deaths according to Johns Hopkins (11.00 pm, Pacific) All 50 states plus DC are reporting 121,128 identified cases and 3,035 deaths.
*Data include Puerto Rico, Guam, and US Virgin Islands
What you can do
Stay home when sick.
Stay home as much as possible, period.
Avoid crowded places.
Digestive problems may be a symptom.