H5N1

In Maryland's Garrett County, coronavirus pandemic no longer far away

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Via The Washington Post: In Maryland's Garrett County, coronavirus pandemic no longer far away. Excerpt:

OAKLAND, Md. — Mark Boucot learned the rural hospital he runs would be left out of the initial vaccine distribution a few days before covid-19 killed his first staff member.  

It seemed hope would be slow to reach the Garrett County mountains, just like everything else.  

The pandemic initially skirted this eastern edge of Appalachia, but arrived with a vengeance in November. Case rates soared to four times the state average. The small emergency room at Garrett Regional Medical Center, where Boucot is president, was hammered. Coronavirus patients consumed nearly half the hospital’s beds and all of its four-bay intensive care unit.  

Isolated in the farthest stretch of Western Maryland, residents did what they could to prepare for the virus, even when the pandemic seemed impossibly far away. But their community was overwhelmed when it materialized. The region’s treasured independent streak didn’t help matters. Locals have been reluctant to distance themselves from family members, slow to admit they are weakened with infection, and — in seven out of 10 cases — unwilling to get a vaccine.  

All spring, summer and into the fall, Garrett County saw the pandemic on national news but not at home. It welcomed tourists escaping virus-laden cities and spent federal aid on infrastructure and economic relief rather than testing sites or an intensive campaign to warn skeptics about the coronavirus. 

But as Christmas approached and the first shipments of vaccine rolled into bigger towns and cities across the country, the small hospital in Oakland was in distress. Ten people had died in 10 days, doubling the death toll in a county of 29,000. The positivity rate was 17.75 percent, the state’s highest. 

Ten percent of the hospital staff was out with the virus or quarantined, and the hospital was deploying third- and fourth-year nursing students from a nearby community college to help. 

“I feel like we’re a bunch of rusty tools in the garage that no one cares about,” said Jeffrey Bernstein, a semiretired emergency room physician whose part-time schedule ballooned in December to more than 40 hours a week.

Sweden government to get wider shutdown powers under proposed pandemic law

Via Reuters: Sweden government to get wider shutdown powers under proposed pandemic law. 

STOCKHOLM (Reuters) - The Swedish government will have the power to close shopping centres and public transport from Jan. 10 and fine people who break the rules,under a new law proposed on Monday to help halt the spread of the coronavirus pandemic.  

Up to now, Sweden has relied mainly on voluntary social distancing measures, setting it apart from most other countries in Europe where enforced lockdowns have been used to fight the COVID-19 virus. 

“In very serious situations, the government will be able to decide on more extensive measures to prevent crowding,” Health Minister Lena Hallengren told a news conference. 

“That includes the closure of shops, public transport, shopping centres, or other kinds of businesses that fall under the new law.” 

While the government has stressed its faith in Swedes’ individual sense of responsibility, it has also lacked the legal tools to take a tougher stance. 

The law will only stay in force until September unless renewed. 

The government had originally planned to introduce the law in March, but has moved up the timetable amid a second wave of infections that has put the health service under severe strain.  

Sweden registered 6,609 new coronavirus cases on Wednesday last week - the most recent figures reported. 

It has now seen 8,279 COVID deaths, a rate per capita several times higher than that of its Nordic neighbours, but lower than several European countries that opted for lockdowns.

Los Angeles: A new post-Christmas COVID-19 surge as holidays create 'viral wildfire'

Via The Los Angeles Times: A new post-Christmas COVID-19 surge as holidays create 'viral wildfire'. Excerpt:

Los Angeles County health officials are warning of a possible surge in COVID-19 cases following family gatherings and out-of-town trips during the holidays, despite pandemic guidelines that asked the public to stay home. 

Under one scenario, experts predict there could be a boost in new coronavirus cases by mid-January, a surge in hospitalizations by late January and early February, and another burst of deaths by early to mid-February.  

The quick succession of holidays in the fall and winter months typically allows people to celebrate and spend time with loved ones in a brief period.  

But that leaves little time for coronavirus cases to start falling before they spike again, creating surges on top of surges.  

People may be getting together in small groups to try to be safe because of the COVID-19 surge, but those interactions can still fuel the spread of the virus, said UCLA infectious disease specialist Dr. Tim Brewer. 

“I’m very concerned about the next two months,” Brewer said. 

Dr. Robert Kim-Farley, a medical epidemiologist and infectious disease expert at the UCLA Fielding School of Public Health, said a person who is exposed to COVID-19 at a Christmas gathering could be infectious by New Year’s Eve.  

However, the individual may be asymptomatic, go to a New Year’s Eve party and unknowingly spread the disease, he said. 

Coupled with a high infection rate — about 1 in 95 in Los Angeles County are contagious with the virus, according to county estimates — the holidays are creating a “viral wildfire,” he said.  

In Los Angeles County, the pace of daily deaths is higher than ever — with a person dying of the coronavirus about every 10 minutes.  

On Saturday, county health officials reported 29,423 new coronavirus cases over Christmas Day and Saturday combined. Friday’s numbers — 15,538 cases — were delayed because of an interruption with Spectrum internet service in the L.A. area.  

Local health agencies also reported 136 deaths over the two-day period. The county averaged about 14,000 new coronavirus cases a day and 88 COVID-19 deaths daily over the past week.

America's healthcare system will struggle to deal with Covid-19 'long-haulers'

Via The Guardian: America's healthcare system will struggle to deal with Covid 'long-haulers'. Excerpt:

Post-viral fatigue syndrome (PVFS) isn’t new, but that won’t stop Covid “long-haul” syndrome from toppling an already unsteady medical system. The symptoms faced by so-called long-haulers – Covid patients who don’t seem to fully recover, even months after infection – can be debilitating. Understanding the similarity of long-haul syndrome to previous outbreaks (as well as the differences) should advise an incoming administration on the need for massive healthcare reform. 

Post-viral fatigue syndrome has followed many viral outbreaks, such as the Spanish Flu of 1918, the 2002 SARS-CoV, the 2009 influenza, and the Ebola outbreak of 2014 – to name a few. PVFS is also frequently linked to Epstein-Barr virus (EBV), which can cause infectious mononucleosis (mono, sometimes called the “kissing disease”). Similar to Covid-19, EBV may present with no symptoms – especially in children – but it has been linked to the triggering of autoimmune disorders.  

The threat of long-haul syndrome isn’t its novelty, but rather its history. Post-viral fatigue is often categorized with (and sometimes becomes) chronic fatigue syndrome (CFS), an illness that effects women at four times the rate as men and still eludes effective treatment. 

Current reports estimate that at least 10% of people reportedly infected with Covid-19 have gone on to develop long-haulers syndrome. As of Thanksgiving, the United States will have surpassed 12m cases of Covid. At 10%, we can anticipate a heavy addition to the already staggering rate of chronic illness in the US; if our healthcare system doesn’t adapt, it will likely fail. 

COVID-19 on Boxing Day: 80,273,645 cases, 1,756,435 deaths

A screenshot from the Johns Hopkins Coronavirus COVID-19 (2019-nCoV) dashboard:

Peru has joined the One Million Club. The US will reach 19 million very soon, and Russia is closing in on 3 million. The case count on Christmas Day, unsurprisingly, was a relatively low 465,742 cases. We will doubtless see a bump in numbers for today and Monday.

Coronavirus Government Response Tracker

Via the Blavatnik School of Government: Coronavirus Government Response Tracker. Click or tap through for many links. I'm putting this site in the COVID-19 Links list. Excerpt:

The Oxford COVID-19 Government Response Tracker (OxCGRT) systematically collects information on several different common policy responses that governments have taken to respond to the pandemic on 18 indicators such as school closures and travel restrictions. It now has data from more than 180 countries.  

The data is also used to inform a Risk of Openness Index which aims to help countries understand if it is safe to ‘open up’ or whether they should ‘close down’ in their fight to tackle the coronavirus. 

LATEST INSIGHTS 

• New Vaccination policy now included in the government response tracker. Data now includes a new indicator (H7) to record policies for vaccine delivery for different groups (key workers, clinically vulnerable groups, elderly groups). Please see the latest version of the working paper (WP-2020-032-v10, December 2020) or the codebook on GitHub. 

• New Canada sub-national data now added. Data is available for Canadian provinces and territories, allowing comparisons within the country. See the full dataset on GitHub.

• New Updated US states' responses to COVID-19 - see the updated working paper and see the secondary US state-level dataset on GitHub. 

• New England, Northern Ireland, Scotland and Wales data is now included. Read the UK nations working paper about how the nations have used their autonomy to implement and ease different restrictions. 

• New Updated Risk of Openness Index (previously 'Lockdown Rollback Checklist') now published: see the research note. The index aims to help countries understand if it is safe to ‘open up’ or whether they should ‘close down’ in their fight to tackle the coronavirus. See the full dataset on GitHub. 

• A new indicator, facial coverings (H6) was added to the data in October. The indicator tracks (also retrospectively) the policies on face coverings implemented at different levels of stringency. 

• Report on US school closures is now available 'Where and how are schools reopening in the United States?' (12 October update) 

• Read our regional reports summarising recent changes in government responses. These summaries are available for East Asia and Pacific, Europe and Central Asia, Latin America and the Caribbean, Middle East and North Africa, North America, South Asia, and sub-Saharan Africa. 

• See also our related project on Brazil's COVID-19 policy response.

As COVID-19 resurges in Africa, doctors fear the worst is yet to come

Via The New York Times: As Virus Resurges in Africa, Doctors Fear the Worst Is Yet to Come. Excerpt:

PORT ELIZABETH, South Africa — At the center of a terrifying coronavirus surge, 242 patients lay in row after row of beds under the soaring metal beams of a decommissioned Volkswagen factory. 

Workers at the vast field hospital could provide oxygen and medications, but there were no I.C.U. beds, no ventilators, no working phones and just one physician on duty on a recent Sunday — Dr. Jessica Du Preez, in her second year of independent practice. 

In a shed-like refrigerator behind a door marked “BODY HOLD,” carts contained the remains of three patients that morning. A funeral home had already picked up another body.

On rounds, Dr. Du Preez stopped at the bed of a 60-year-old patient, a grandmother and former college counselor. Her oxygen tube had detached while she was lying prone, but the nurses had so many patients they hadn’t noticed. Now, she was gone.

As two porters placed her corpse in a bag, a worker peeked through the door to tell them another patient, a 67-year-old diabetic man, had died.  

Meanwhile, the condition of a teacher in her 50s was deteriorating. Dr. Du Preez tried to find I.C.U. space for her elsewhere in the city, to no avail. She called the teacher’s husband, who asked what he could do. “Not much,” the young doctor responded. 

“Shame,” she said again and again that day.  

For hours, the alarm on the teacher’s bedside monitor bleated. Her oxygen level was dangerously low, her pulse racing and her blood pressure soaring. Still, she remained conscious, saying she could not breathe. That evening, she died alone. A book, “A Heartbeat of Hope: 366 devotions,” lay on her bedside stand alongside a pair of reading glasses. 

When the pandemic began, global public health officials raised grave concerns about the vulnerabilities of Africa. But its countries overall appeared to fare far better than those in Europe or the Americas, upending scientists’ expectations. Now, the coronavirus is on the rise again in swaths of the continent, posing a new, possibly deadlier threat.

LA's Covid-19 'tsunami': Inside the new center of America's raging pandemic

Via The Guardian: LA's Covid 'tsunami': inside the new center of America's raging pandemic. Excerpt:

Los Angeles is becoming the center of America’s out-of-control coronavirus pandemic in these final days before the new year, with officials warning that a meteoric rise in infections is crushing the healthcare system in one of the country’s largest metropolitan regions.  

LA county has faced an onslaught of terrifying Covid developments in recent days, including a surge in deaths, dire shortages of hospital resources, and fears that doctors will have to make agonizing choices to ration care.  

“Do we need to start filming people dying?” said Marcia Santini, a nurse at the University of California, Los Angeles (UCLA), medical center, who is recovering from a brutal Covid-19 infection that forced her to be hospitalized at her own workplace. 

“People need to understand, there is no place to take care of you. You can’t have this mindset that this isn’t going to happen to you. It doesn’t work like that any more. The virus is rampant.”  

An uncontrolled ‘viral tsunami’ 

Heading into the darkest holiday season some have ever endured, there were grim reminders across the LA region that the virus is spreading uncontrolled. The city’s mayor briefed the public while in quarantine after his daughter became infected. Hospitals were setting up triage tents. Residents waited in line for hours for Covid tests at Dodger stadium. The region recently ordered more body bags. 

Outbreaks were afflicting grocery stores, restaurants, stores, shopping malls, Amazon warehouses, manufacturing plants, government buildings, police and fire departments, jails and prisons and film sets. 

Officials in LA county estimated that one in 95 residents were currently infectious, and that two residents were dying of Covid every hour. More than 6,000 Covid patients are in the hospital, and intensive care units (ICU) are filled to capacity.  

And yet the region is continuing to obliterate records. LA is now reporting an average of more than 14,700 cases each day, a 78% increase from two weeks ago, according to LA Times data. Seven hundred people are hospitalized daily; in October there were fewer than 150 daily hospitalizations. By January, officials say it could be 1,400 admissions each day. More than 9,000 people have died. 

“We’ve moved from having waves to now having a viral tsunami occurring here in Los Angeles,” said Dr Robert Kim-Farley, a medical epidemiologist at UCLA, who said for the first time his family would not gather for the holidays.  

The horror inside hospitals: ‘So many dying alone’ 

LA’s crisis is close to resembling the catastrophe that New York endured in the spring. The situation inside some hospitals this week became untenable, and workers were bracing for it to get worse. 

“We’re not only seeing the numbers of Covid patients increasing, we’re also seeing longer wait times for people,” said Yolanda Tominac, a critical care nurse at West Hills hospital, where workers recently threatened to strike over staffing concerns. “It’s physically draining, it’s mentally draining. Morale is so low.”

Covid-19 in China: People asked to stay home for the holidays as 20 new infections reported

Via the South China Morning Post: Covid-19 in China: people asked to stay home for the holidays as 20 new infections reported. Excerpt:

City and provincial governments across China have asked people to remain in their regions over the upcoming holiday periods in a bid to prevent the spread of Covid-19 amid reports of several new local infections. 

Beijing has introduced some of the strictest measures, ordering all employees of ministries and central state organs and institutions to stay in the city for the duration of the New Year festivities and Lunar New Year holiday in February. 

Everyone else in the capital will have to abide by strict travel controls, which include restrictions on the number of people allowed to use public transport, including trains, planes, buses and the underground. Lunar New Year events will be downsized or cancelled, while 

libraries, museums, parks and other venues will open only for visits by appointment during the holiday period, the government said. 

Authorities in other parts of the country, including Liaoning, Shannxi and Guangdong provinces, have also advised people against non-essential travel outside their hometowns and cities. 

China’s National Health Commission said on Saturday that 20 new Covid-19 cases were reported on Friday, of which eight were locally transmitted. Of those, six were in Liaoning, in the northeast of the country, and two in Beijing, it said.

The CDC’s failed race against covid-19: A threat underestimated and a test overcomplicated

Via The Washington Post: The CDC’s failed race against covid-19: A threat underestimated and a test overcomplicated. Excerpt:

A new virus was exploding in Wuhan, a Chinese city with 11 million people connected by its airport to destinations around the world. In the United States, doctors and hospitals were waiting for the federal Centers for Disease Control and Prevention to develop a test to detect the threat. 

On Jan. 13, the World Health Organization had made public a recipe for how to configure such a test, and several countries wasted no time getting started: Within hours, scientists in Thailand used the instructions to deploy a new test. 

The CDC would not roll out one that worked for 46 more days.  

Inside the 15-acre campus of the CDC in northeast Atlanta, the senior scientists developing the coronavirus test were fighting and losing the battle against time.  

The agency squandered weeks as it pursued a test design far more complicated than the WHO version and as its scientists wrestled with failures that regulators would later trace to a contaminated lab. AD 

The Washington Post reviewed internal documents and interviewed more than 30 government scientists and others with knowledge of the events to understand more fully the missteps in those early weeks as the coronavirus began to spread unchecked across the nation. Most spoke anonymously because they were not authorized to do so publicly. 

This account reveals new details about how an overly ambitious test design and laboratory contamination caused the CDC’s delay, and describes previously unreported challenges that confronted the agency scientists assigned to carry out the work. 

CDC leaders underestimated the threat posed by the new virus — and overestimated the agency’s ability to design and rapidly manufacture a test. Quality-control measures failed to prevent the shipping of compromised kits to dozens of state and local public health labs.  

The CDC’s response to what became the nation’s deadliest pandemic in a century marked a low point in its 74-year history. More than 329,000 Americans have died of the virus. In an agency long known for its competence, hubris became the nemesis that could not be overcome.