William Wan, Carolyn Y. Johnson, Joel Achenbach.
I thought my last post was my last. But I had visitants to this blog. Ask me what can be done
if we have a second wave to this pandemic after the door is open to it again?
By the end of the week, residents in Georgia will be able to get their hair permed and nails done. By Monday, they will be cleared for action flicks at the cineplex and burgers at their favorite greasy spoon. And it will almost certainly lead to more novel coronavirus infections and deaths. As several states — including South Carolina, Tennessee and Florida — rush to reopen businesses, the sudden relaxation of restrictions will supply new targets for the coronavirus that has kept the United States largely closed down, according to experts,
math models and the basic rules that govern infectious diseases.
“The math is unfortunately pretty simple. It’s not a matter of whether infections will increase but by how much,” said Jeffrey Shaman, a leading epidemiologist at Columbia University. Closing America was hard.
But it came with one simple instruction: Everyone stay at home. There are no easy answers for the phase that comes next, especially with a continued lack of testing, contact tracing and detailed guidance from federal health agencies, disease experts said. Instead, every state will conduct its own improvised experiment with thousands of lives in the balance.
Many of the earliest reopenings will probably be confusing, chaotic, risky affairs —
especially for states restarting their economies before most infectious-disease experts and
some mayors and residents believe it’s safe to do so. South Carolina’s governor issued an executive order this week reopening department stores and retailers previously regarded as not essential. Tennessee’s governor said he plans to allow most businesses to reopen once his “safer-at-home” order expires next week. Governors in Mississippi and Ohio have said the same. And in Denver, Gov. Jared Polis (D) said some business could reopen on Friday. Some of those same states are, however, still struggling to contain outbreaks.
In Ohio, where businesses are expected to reopen by next week, a prison has become one of the most worrisome outbreaks in the country, with more than 2,000 inmates testing positive. In South Dakota, more than 700 infections have shut down a Smithfield Foods meatpacking plant. And because South Dakota remains one of the few states without a stay-at-home order, one business said it plans to go forward on Saturday
with a car race drawing 700 spectators.
Georgia, according to some models, is one of the last states that should be reopening. The state has had more than 830 covid-19 deaths. It has tested less than 1 percent of its residents — low compared with other states and the national rate. And the limited amount of testing so far shows a high rate of positives at 23%. On Monday, Georgia Gov. Brian Kemp (R) explained his decision to reopen tanning salons, barber shops, massage parlors and bowling alleys, saying: “I see the terrible impact of covid-19 on public health as well as the pocketbook.”
Kemp said he will urge businesses to take precautions, such as screening for fevers, spacing workstations apart and having workers wear gloves and masks “if appropriate.” President Trump Wednesday said he told Georgia’s governor that he “disagree strongly with his decision.” But Trump added, ‘At the same time, he must do what he thinks is right.” In recent days, other governors have defended their decisions to reopen quickly as an economic necessity, an exercise in states’ rights and a matter of freedom.
“What I’ve seen across the country is so many people give up their liberties for just a little bit of security, and they don’t have to do that,” South Dakota Gov. Kristi L. Noem (R). “We can’t wait until there’s a cure to this,” said Mississippi Gov. Tate Reeves (R), who plans to reopen some businesses after a stay-at-home order expires Monday. “We can’t wait until every single person can get tested every single day to open up our economy.”
But even states proceeding more slowly, such as Massachusetts and California, will have to walk their residents through the coming experiment with competing pressures and voices threatening to drown out public health instructions. “As a country, we’re unprepared not just logistically but mentally for this next phase,” said Michael T. Osterholm, a University of Minnesota infectious-disease expert. He worries most Americans do not grasp the long, hard months facing them and the likelihood of repeated surges of the virus.
“For a while, people were told all we need is to get past the peak. Then, they started hearing all we need is testing. Meanwhile, the president keeps telling everyone that things are going to reopen in a matter of weeks,” Osterholm said. “The way you prepare people for a sprint and marathon are very different. As a country, we are utterly unprepared for the marathon ahead.” This is the central problem: The vast majority of Americans are still believed to be uninfected, making them like dry kindling on a forest floor. Barring a vaccine or treatment, the virus will keep burning until it runs out of fuel.
“The trick is to keep that burn at a controlled rate,” Osterholm said. “We have focused so much on how we are dying from the virus that we have not focused enough on how to live with the virus.” Epidemiological models suggest the best strategy for keeping the burn rate under control is to drive the number of infections as low as possible before restoring economic activity. That would then provide time to react if cases flare.
The economic devastation that would cause is significant. But those same models suggest that opening prematurely increases the likelihood that communities will have to shut back down once infections reach a certain level, creating multiple open-shut cycles. Adding to those concerns, the director of the Centers for Disease Control and Prevention said Monday that a second wave of infections next winter would be even more devastating because it would coincide with flu season.
There’s no simple, one-size-fits-all protocol for reopening the economy, said David Rubin, director of PolicyLab at Children’s Hospital of Philadelphia. Rubin is developing a model to forecast how reopening 260 large U.S. counties on May 15 would play out if residents maintained only half the social distancing measures now in place. The good news, Rubin said, is that modest-size, relatively spread-out cities will probably have room to make adjustments. But if restrictions ease too much, New York and similarly dense cities will rapidly see infections spike again.
“It comes back really quick, and the peaks are much higher than what you’re seeing right now,” Rubin said. “It was sobering. I was more optimistic before we did our models.” This is why epidemiologists are cautioning state leaders to inch toward reopening with tentative, staggered steps. Newly emerging science illustrates just how complicated and fraught those steps may be. Dine-in restaurants are one sector President Trump and some governors have repeatedly mentioned. To reopen, owners may have to rethink not just how closely diners sit together and how food is served but how ventilation systems and airflow may need to be retooled.
A recent case study — published by the CDC — examined how a single patron infected nine others at an air-conditioned restaurant in China. The infected person, a 63-year-old retired woman, did not begin running a fever and coughing until after her lunch Jan. 24 at the Guangzhou restaurant. But over the next two weeks, it became apparent the virus had spread to four diners at her table and to five people sitting at adjacent tables roughly three feet away. Researchers studying the seating arrangements believe an air-conditioning unit propelled tiny viral droplets over distances that are normally safe between the tables. “To prevent the spread of the virus in restaurants, we recommend increasing the distance between tables and improving ventilation,” the researchers concluded.
Donald Milton, a professor of environmental health at the University of Maryland School of Public Health, said the restaurant appears to have had an air-conditioning unit popular in China — and increasingly used in the United States — that recirculates warmed or cooled air, with no air intake or filtration. Milton said measures to make such a situation safe would include a ceiling fan paired with better air filtration and ultraviolet lights that kill germs. But he noted such measures would need to be designed to suit specific establishments.
Studies emerging in the past week are also changing scientists’ understanding of how the virus spreads, which will make efforts to reopen society even harder.
A growing body of evidence suggests the virus is most contagious in people before they develop a fever or even feel a tickle in their throat. That suggests silent spreaders are seeding new cases. When severe acute respiratory syndrome (SARS) — the cousin to this new coronavirus — emerged in 2002, Asian countries were able to stop it because people became physically ill roughly at the same time they became contagious.
That made it far easier to isolate and prevent the spread of disease.
A study published in the journal Nature Medicine last week estimated that people infected with the novel coronavirus are contagious almost two and a half days before symptoms appear — and that peak contagiousness occurs about 17 hours before people start feeling sick. In a sample of patients from China,
the study estimated 44 percent of cases spread from person to person before symptoms appeared.
A study of Iceland’s population found that 43 percent of the people who tested positive didn’t have symptoms at the time of the test. And a recent New England Journal of Medicine study of 210 pregnant women in New York found that 14 percent tested positive but had no symptoms. Warning signs are also emerging from abroad. For months, Singapore has served as an exemplar, with its pandemic response praised and emulated around the world. Despite its proximity to China and early cases, Singapore used massive testing and contact tracing to keep its disease curve flat. It even deployed police to trace people’s movement
with security camera footage and credit card records.
Those painstaking efforts kept schools and businesses open and its economy afloat — until this month, when the virus found and exploited a weak point: low-wage migrant workers living in densely packed dormitories. “It only takes a few people to let down their guard, and the virus will slip through,” said Prime Minister Lee Hsien Loong, who begged citizens to maintain discipline. The daily number of new cases has soared from 200 last month to 1,426 on Monday. In recent days, the government shut down schools, made masks mandatory and forced hundreds of thousands of migrant workers into quarantine.
“What worries me looking at Singapore is how much capacity they have on testing and contact tracing compared to the U.S. and yet months into the pandemic, even they are having to become more restrictive,”
said Tom Inglesby, director of the Johns Hopkins Center for Health Security. “Meanwhile, we in America have nowhere near that testing and tracing, yet all we’re talking about is loosening up our restrictions.” Given the dangers involved in reopening, what states desperately need are a warning system and suppression tool to prevent infections from cresting again into the deadly peaks the United States saw in March and April.
But states are jumping into their experiments without the two tools deployed by almost every other advanced nation: massive testing and contact tracing. Governors — Republicans and Democrats — from Virginia to Washington to Ohio continue to plead for federal authorities to fix shortages of swabs, chemical reagents and testing kits, a national supply problem they cannot solve independently. Similarly, local health departments, decimated by decades of budget cuts, lack the money and the hundreds of thousands of workers needed to trace and quarantine everyone who comes into contact with infected people.
By pushing responsibility for the pandemic response and reopening onto the states, experts said, Trump has freed himself to play the role of criticizer-in-chief. Already, he is criticizing governors for not reopening immediately, but if cases rise uncontrollably, he can criticize state leaders for reopening too early or mishandling it. “It might be a clever and effective political strategy, but it leaves our country without
any way to pull itself out of the current mess,” said Jeremy Konyndyk, who was in charge of U.S. foreign disaster assistance during the Obama administration.
In Maryland, Republican Gov. Larry Hogan’s wife — who was born in South Korea —
struck a deal to buy 500,000 tests from South Korea. Hogan said this week that he turned for help from a foreign government rather than the federal government after Trump “made it clear over and over again” that states “have to go out and do it ourselves.” In Massachusetts, state leaders have partnered with a nonprofit that works mainly in the developing world to hire and train contact tracers. But such efforts, born of desperation, will go only so far without federal intervention and funding, public health experts say.
Even if a handful of states find some way to shore up testing and contact tracing, the virus could rage on in neighboring states, throwing off sparks that can ignite new outbreaks. “The only tool the governors have had so far is the clampdown because it deprives the fire of oxygen. The second you let that up, the fire comes roaring back,” said Konyndyk, who oversaw the U.S. government’s Ebola response in West Africa. “But until you have water or sand, that’s all you can do. And it remains to be seen whether we as a country are going to figure out
a way to get that bucket of water to start putting out the fire.”
NORC poll: Few Americans support easing virus protections
THOMAS BEAUMONT and HANNAH FINGERHUT, Associated Press
WASHINGTON (AP) — Despite pockets of attention-grabbing protests, a new survey finds Americans remain overwhelmingly in favor of stay-at-home orders and other efforts to slow the spread of the coronavirus.
A majority say it won’t be safe to lift such restrictions anytime soon, even as a handful of governors announce plans to ease within days the public health efforts that have upended daily life and roiled the global economy.
The survey from The Associated Press-NORC Center for Public Affairs Research finds that more than a month after schoolyards fell silent, restaurant tables and bar stools emptied, and waves from a safe distance replaced hugs and handshakes, the country largely believes restrictions on social interaction to curb the spread of the virus are appropriate. Only 12% of Americans say the measures where they live go too far. About twice as many people, 26%, believe the limits don’t go far enough. The majority of Americans — 61% — feel the steps taken
by government officials to prevent infections of COVID-19 in their area are about right.
Bing COVID-19 tracker: Latest numbers by country and state
About 8 in 10 Americans say they support measures that include requiring Americans to stay in their homes and limiting gatherings to 10 people or fewer — numbers that have largely held steady over the past few weeks. “We haven’t begun to flatten the curve yet. We’re still ramping up in the number of cases and the number of deaths,” said Laura McCullough, 47, a college physics professor from Menomonie, Wisconsin. “We’re still learning about what it can do, and if we’re still learning about what it can do, this isn’t going to be the time to let people go out and get back to their life.”
While the poll reveals that the feelings behind the protests that materialized in the past week or so in battleground states such as Michigan, Ohio, Pennsylvania and Wisconsin are held by only a small fraction of Americans, it does find signs that Republicans are, like President Donald Trump, becoming more bullish on reopening aspects of public life. Just 36% of Republicans now say they strongly favor requiring Americans to stay home during the outbreak, compared with 51% who said so in late March. While majorities of Democrats and Republicans think current restrictions where they live are about right,
Republicans are roughly four times as likely as Democrats to think restrictions in place
go too far — 22% to 5%.
More Democrats than Republicans, meanwhile, think restrictions don’t go far enough,
33% to 19%.
“They’ll be lifted, but there are still going to be sick people running around,” said 66-year-old Lynn Sanchez,
a Democrat and retired convenience store manager from Jacksonville, Texas, where Gov. Greg Abbott has reopened state parks and plans to announce further relaxations next week. “And we’re going to have another pandemic.” More than 45,000 people in the United States have died from COVID-19, while 22 million have applied for unemployment benefits since March. It’s the economic cost that has led some governors to follow Trump’s lead and start talking about allowing some shuttered businesses to reopen, including in Georgia, where many businesses — including gyms, bowling alleys and tattoo parlors — can do so starting Friday.
Restaurants there can resume dine-in service next week. Yet the survey finds that few Americans — 16% — think it’s very or extremely likely that their areas will be safe enough in a few weeks for the restrictions to be lifted. While 27% think it’s somewhat likely, a majority of Americans — 56% — say conditions are unlikely to
be safe in a few weeks to start lifting the current restrictions. “If we try too hard to restart the economy prematurely, there will be waves of reinfection,” said 70-year-old retired medical equipment salesman
Goble Floyd, of Bonita Springs, Florida.
“I don’t think the economy or life will get back to normal until there’s a vaccine. It just seems this is so seriously contagious.” The partisan differences are apparent. Georgia Gov. Brian Kemp is a Republican and unwavering Trump supporter. GOP lawmakers in Wisconsin filed suit Tuesday against the state’s Democratic governor after he ordered most nonessential businesses to remain closed until May 26.The poll finds 59% of Republicans say it’s at least somewhat likely that their areas will be safe enough for reopening in just a few weeks,
compared with 71% of Democrats who say it is unlikely.
Still, even among Republicans, just 27% say that’s very likely. “I haven’t met one person at the protests that disagrees with the fact that we need to self-quarantine until April 30,” said Matt Seely, a spokesman for the Michigan Conservative Coalition, which sponsored an automobile-based protest at the state’s capitol in Lansing last week. “Nobody wants to do the wrong thing. But the solution is not to stay in your home until
the last case of COVID is gone.”
The AP-NORC poll of 1,057 adults was conducted April 16-20 using a sample drawn from NORC’s probability-based AmeriSpeak Panel, which is designed to be representative of the U.S. population. The margin of sampling error for all respondents is plus or minus 4.0 percentage points. Respondents were first selected randomly using address-based sampling methods and later were interviewed online or by phone.
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Jessica Dolcourt April 22, 2020 8:27 a.m. PT
If you’re not already using these tips for grocery shopping, opening doors and signing
your name when you leave the house, now’s a good time to start. Read More Here.
Coronavirus: What To Do
By Dr. David Brownstein
I am sure you are aware of the coronavirus infection that is causing concern around the world. A January 24, 2020 study in The Lancet reported the latest statistics. (1) The fatality rate (so far) from the corona infection is approaching 15%. That is not good news.
There is a big HOWEVER here: This Lancet report is based on only 41 laboratory confirmed cases of the recent coronavirus strain (2019-nCoV). Keep in mind, the 15% fatality rate is the percentage of hospitalized patients suffering with corona virus. There must be many more people who became ill with this coronavirus and recovered uneventfully and therefore, did not seek care.
The symptoms of corona virus initially mimic the flu—fever, headache, cough, fatigue and muscle aches.
The 41 patients admitted to the hospital all developed pneumonia.
Coronavirus is nothing new. It has been with us for a long time. Coronavirus can affect both animals and humans. It is important to keep in mind that most corona viral infections are mild. In the last two decades, there were two serious corona virus infections–severe acute respiratory syndrome coronavirus (SARS-CoV)
and Middle East respiratory syndrome coronavirus (MERS-CoV) which both had elevated death rates.
So, what can you do? Wearing a mask will not help protect you from becoming ill with any viral infection—corona virus included. I would check that off the list.
First, its important to maintain optimal levels of nutrients, particularly vitamins A, C, and D. Most people have suboptimal vitamin A and C levels. Both of these nutrients have antiviral abilities and are able to support the immune system when it is under viral attack. If you are not ill, I suggest taking 3-5,000 mg/day of vitamin C. At the first sign of an illness, I would suggest taking 1,000 mg/hour until diarrhea develops, then back off for a time period. For vitamin A, I suggest using 5,000 Units/day if you are not sick and 100,000 Units/day for four days at the first sign of an illness. Pregnant women cannot take these doses. (Note: Take vitamin A, not beta carotene.) Also, vitamin D is very important for fighting infections.
I suggest, at the onset of an illness, taking 50,000 IU of vitamin D3/day for four days.
Iodine is essential to not only fighting off an infection it is necessary for proper immune system functioning. There is no bacteria, virus, parasite or fungus that is known to be resistant to iodine. As I have written in my book, Iodine: Why You Need It, Why You Can’t Live Without It, most of the population is low in iodine. If fact, iodine levels have fallen nearly 60% over the last 40 years. The RDA for iodine is inadequate to supply enough iodine for all the bodily tissues. For the majority of my patients,
I suggest taking 25 mg/day as a daily dose and more (sometimes 50-100 mg/day) at the first sign of an illness. Iodine can cause adverse effects and it is best used under the guidance of an iodine-knowledgeable doctor.
To prevent becoming ill and to avoid having a poorly responding immune system, it is vitally important to
eat a healthy diet free of all sources of refined sugar. Refined sugar has been shown to negatively alter the functioning of the white blood cells for hours after ingestion. Finally, it is important to maintain optimal hydration—drink water! Take your body weight in pounds, divide by two and the resultant number is the amount of water to drink per day in ounces. Dehydration ensures you will be much more likely to suffer serious problems from any infectious process.
Conventional medicine has little to offer to prevent or treat coronavirus infections other than washing your hands–I agree with that one. It is time for you to take the initiative and learn what other therapies are out there. Your conventional doctor simply has no effective tools in his/her toolkit for this.
As for getting the flu shot? Fugetaboutit.
It won’t help corona infections and there was a study which found an increased risk in non-influenza infections, including coronavirus, in those that received the trivalent flu vaccine. (2)
My last recommendation is to work with a holistic doctor who can give you nutrient IVs when you become ill. Vitamin C, hydrogen peroxide, and ozone IVs can help anyone suffering from an infection. At my office,
The Center for Holistic Medicine, we have seen the positive results a holistic approach to combatting viruses can provide. To find a holistic doctor near you go to: www.icimed.com.
To learn more about virus’, vaccines and other health issues from a holistic point of view,
join me on Saturday, March 7th for my annual lecture, ‘Holistic Medicine for the 21st Century’.
See below for details.
To Everyone’s Good Health!
~Note: These therapies should only used under the guidance of a physician. Dr. B
Coronavirus Preppers Guide: Remain Calm, Don’t Panic, Be Smart, Stay Informed!!!