COVID-19 day 148 : 📈 2,137,731 cases; 116,963 deaths : 16 June 2020
Searing analysis from the LA Times provides more evidence of failed federal response to COVID-19; FL sets a state record for cases, 2,783; and about that dexamethasone study from the UK
It’s day 148 since the first case of coronavirus disease was announced in the United States.
Texas led the nation in reported cases on Tuesday, in part because of 2,622 cases among Texas Department of Criminal Justice inmates that had not been reported by local health departments, according to the Texas data dashboard. This increased the number of inmates diagnosed with COVID-19 from 1,476 to 4,098. Today’s data anomaly illustrates the pitfalls of reporting daily numbers as well as the challenge of COVID-19 for the incarcerated.
The LA Times has identified two long-haul flights into LAX in mid-March (NYC and Seoul) where a passenger was diagnosed as positive ... but public health officials failed to alert airline, crew or passengers. The County says it reported one to the CDC; the CDC says it didn't receive a report.
Without instructions to self-quarantine or seek testing, more than 200 people on these flights returned to their families and communities ignorant of their exposure, potentially seeding new outbreaks.
One of the two, on the Korean flight, was the first confirmed death in LA County. She had a heart attack the morning after she landed.
The other, a sick passenger on the NYC flight, was en route to a long-term dementia care center in Los Angeles, Silverado Beverly Place.
According to the family of Brittany Bruner-Ringo, 32, a nurse at the center who would subsequently die of COVID-19:
Her supervisors at Silverado Beverly Place had instructed her to admit a new resident, a retired doctor flown in from New York City, despite the fact that the facility was under lockdown to prevent the sort of COVID-19 outbreaks that were cropping up in the man’s hometown.
They rushed the retired surgeon, who had flown to LA first class, to Cedars-Sinai Medical Center the next day.
Had the White House taken COVID-19 seriously in January, by March identification and contact protocols should have been more robust. Each of these cases occurred before Trump banned flights from Europe (12 March 2020) and long after the first case had been diagnosed in Washington (21 January 2020).
The county health department said that officials informed a CDC office at LAX about the South Korean flight. In the case of the JFK flight, its contact tracers closed the case after they were unable to reach the surgeon for an interview (emphasis added).
The case closure is a “you gotta be kidding me” action.
NOTE: CDC “guidance” about notification of exposure on airlines is insufficient and yet another reason Not To Fly:
When a passenger travels while infected with the novel coronavirus, CDC’s protocol is to notify those seated in a six-foot radius…
One 2016 study found that for both SARS and influenza, approximately half of those who contracted the viruses were seated more than two rows away from the infected person…
When a passenger on a two-hour flight to Rochester, N.Y., from JFK came down with COVID-19 in mid-March, public health officials there made a public announcement that everyone aboard and anyone in the airport at the time should be on the lookout for symptoms.
🦠 Tuesday, Johns Hopkins reported 2,137,731 (2,114,026) cases and 116,963 (116,127) deaths, an increase of 1.12 % (0.95%) and 0.72% (0.34%), respectively, since Monday (Sunday). A week ago, the daily numbers increased by 0.94% and 0.90%, respectively.
The seven-day average: 22,104 (21,458) cases and 747 (702) deaths
Percent of cases leading to death: 5.47% (5.49%).
Today’s case rate is 645.83 per 100,000; the death rate, 35.34 per 100,000.
One week ago, the case rate was 598 per 100,000; the death rate, 33.83 per 100,000.
Note: numbers in (.) are from the prior day and are provided for context. I include the seven-day average because dailies vary so much in the course of a week, particularly over a weekend.
🤓 Recommended reading
Because ventilators are in the news with the report from the UK about dexamethasone, a reality check about ventilators (that no one really wants to read).
About 1 in 10 of all patients who have been in the ICU have PTSD. About 30 percent experience depression. Thirty percent have symptoms of anxiety. And another 40 percent report cognitive impairment on par with moderate brain injury…
[M]any COVID-19 patients have what looks like a form of respiratory failure called ARDS, in which the lungs fare best with short, quick puffs of air from the ventilator. This feels deeply unnatural... All of this is so uncomfortable that doctors use powerful drugs such as propofol and fentanyl to sedate patients on ventilators. Even then, some need to have their arms and legs restrained to prevent them from ripping the breathing tube out.
What Life Is Like After Being Taken Off a Ventilator. The Atlantic, 22 April 2020.
🔬 Research and medical news
It’s doubtful that you’ve missed the breathless headlines about a steroid, dexamethasone, that may reduce deaths in very serious cases of COVID-19. This even-handed analysis reminds all of us of the previous breathless headlines and provides rationale for “wait and see.” For more nitty-gritty, read Carl’s thread.
British researchers say a cheap steroid is a COVID-19 lifesaver, but experts want to see their data. The Philadelphia Inquirer, 16 June 2020.
Sections (no jump links, sorry!)
1, Around the country; 2, Around the world; 3, Politics, economics and COVID-19;
4, Case count; 5, What you can do and resources
⓵ Around the country
⛱ Florida bars and restaurants have begun closing temporarily after employees and customers test positive, one week after re-opening. On 05 June, most of the state entered Phase two of the Florida plan for re-opening.
In Jacksonville Beach, at least three bars have closed temporarily. (First person story, Facebook)
In Daytona Beach, a popular restaurant has closed temporarily as it tests all employees after one tested positive.
In Fort Lauderdale, as many as 15 bars and restaurants held “rallies” on Tuesday to demand that they be allowed to re-open.
In St. Petersburg, restaurants and bars are temporarily closing (“a growing number of restaurants and bars across the Tampa Bay area have seen more positive cases”).
Aside from reporting cases to the Florida Department of Health, there are limited guidelines for how to handle an employee testing positive for COVID-19. Restaurants and bars are not required to close. And they don’t have to disclose to the public when staff members have tested positive….
The sudden increase in reported COVID-19 cases at local bars and restaurants comes amid an uptick in cases statewide. In Hillsborough and Pinellas counties, public health officials have said the number of positive cases in young people is on the rise — the percentage of infections in people under 34 years old has nearly doubled since mid-May. (source)
Despite urging from medical doctors, Gov. Ron DeSantis (R) refuses to require Floridians to wear masks at any time. According to WFLA, “14 states and the District of Columbia have mandatory face mask requirements in public spaces.”
🌵Turning to Arizona, before Gov. Doug Ducey (R) lifted the stay-at-home order on 15 May, only about 5% of COVID-19 tests registered as positive. Today, about 16% registered as positive.
The WHO has said that in countries that have conducted extensive testing for COVID-19, [positivity] should remain at 5% or lower for at least 14 days.
☆ Texas has reported record numbers of hospitalizations for five days in a row.
⓶ Around the world
Beijing has now reported 137 cases of COVID-19 in domestic, community spread. The BCC reports it had been 57 days without a domestic case. “At least 27 neighbourhoods have been classed as medium risk and one neighbourhood, near the market, is high risk. People in medium or high-risk areas cannot leave the city.”
Airlines have cancelled 1,255 flights in and out of Beijing as of Wednesday.
Read those numbers again: Beijing (population 21.54 million) has reported 137 cases in five days. It has locked down neighborhoods. Florida had almost 2,800 cases in one day, with comparable population, and is mostly open. People don’t have to wear masks.
⓷ Politics, economics and COVID-19
Although nursing home residents account for less than 1% of the US population, a Wall Street Journal analysis suggests that nursing homes and assisted living facilities account for about 43% of the COVID-19 deaths to date. A running count by the Associated Press also suggests it’s about 40%.
Monday, Seema Verma, head of the Centers for Medicare and Medicaid Services (CMS) claimed that CMS data “suggest a connection between low ratings on safety inspections and COVID-19 outbreaks. But several academic researchers say their own work has found no such link.”
Harvard researcher David Grabowski has pushed back:
“The secret weapon behind COVID is that is spreads in the absence of any symptoms,” Grabowski told lawmakers at a recent briefing. “If COVID is in a community where staff lives, it is soon to be in the facility where they work.”
⓸ Case count
There is a lag between being contagious and showing symptoms, between having a test and getting its results. There is also a lag in reports of cases and deaths making their way into daily results; this lag is visible in predictable declines for both reports containing weekend data.
🌎 16 June
Globally: 7 941 791 cases (118 502 new) with 434 796 deaths (3 255 new)
The Americas: 3 841 609 cases (60 071 new) with 203 574 deaths (1 726 new)
US: 2 079 592 cases (21 754 new) with 115 484 deaths (372 new)
Johns Hopkins interactive dashboard (11.00 pm Pacific)
Global confirmed: 8,175,482 (8,018,742)
Total deaths: 443,730 (436,899)
Recovered: 3,956,263 (3,844,407)
🇺🇸 16 June
CDC: 2,104,346 (18,577 new) cases and 116,140 (496 new) deaths
Johns Hopkins*: 2,137,731 (2,114,026) cases and 116,963 (116,127) deaths
State data*: 2,126,055 (2,103,63) identified cases and 110,683 (109,983) deaths
Total tested (US, Johns Hopkins): 24,449,307 (23,984,592)
Take with a grain of salt. Tests not necessarily people. The CDC and at least 11 other states have combined the data for active infections with data for antibodies, boosting total number of tests which can drop the percentage who test positive.
📣 View weekly state infographics
* Johns Hopkins data, ~11.00 pm Pacific.
State data include DC, Guam, the Northern Mariana Islands, Puerto Rico and the US Virgin Islands
The virus was not created in a lab and the weight of evidence is it was not released intentionally. Although early reports tied the outbreak to a market in Wuhan, China, analyses of genomic data in January suggested that the virus might have developed elsewhere.
⓹ What you can do
Stay home as much as possible, period.
Wear a mask when near non-family members.
Digestive problems may be a symptom.
Resources
👓 See COVID-19 resource collection at WiredPen.
📝 Subscribe to Kathy’s COVID-19 Memo :: COVID-19 Memo archives
🦠 COVID-19 @ WiredPen.com
📊 Visualizations: US, World
🌐 Global news (at WiredPen)