Apr 8, GMT 100
News source: State-by-state coronavirus news
“Right now we’re projecting that we are reaching a plateau in the total number of hospitalizations, and you can see the growth and you see it starting to flatten,” Cuomo told reporters Tuesday. “Change in daily ICU admissions is way down, and that’s good news. The daily intubations number is down, and that’s good news. The discharge rate is right about where it was.”
In another positive sign, several West Coast states announced this week that they are sending ventilators to New York since their need is now less urgent. California Gov. Gavin Newsom (D) said he will send 500; Oregon is contributing 140; and Washington state — which was an early epicenter — is dispatching 400 ventilators.
“Everybody who knows me knows I’m very conservative about making projections, but those are the kind of good signs that you look for,” Fauci said of the New York figures. “You never even begin to think about claiming victory prematurely, but that’s the first thing you see when you start to see the turnaround.”
Olga Matievskaya and her fellow intensive care nurses at Newark Beth Israel Medical Center in New Jersey were so desperate for gowns and masks to protect themselves from the coronavirus that they turned to the online fundraising site GoFundMe to raise money.
The donations flowed in — more than $12,000 — and Matievskaya used some of them to buy about 500 masks, 4,000 shoe covers and 150 jumpsuits. She and her colleagues at the hospital celebrated protecting themselves and their patients from the spread of the virus.
But rather than thanking the staff, hospital administrators on Saturday suspended Matievskaya for distributing “unauthorized” protective gear.
The hospital told ProPublica in a statement that Matievskaya’s suspension ended Monday. “No employee is allowed to distribute unauthorized medical supplies within the hospital,” the statement said. “The nurse in question was temporarily suspended for inappropriately distributing unauthorized medical supplies, against this policy.”
Dr. Samantha Houston says she lost her job of four years at Baptist Memorial Hospital-North in late March for “disruptive” behavior. In the weeks prior, Houston, a hospitalist, used Facebook to organize a local donation drive for masks and baby monitors so that hospital staff could cut down on face-to-face interactions with patients.
Houston, 34, also says she sent several emails to colleagues raising concerns about the availability of personal protective equipment, or PPE, for some workers.
Dr. Jennifer Bryan, who chairs the Mississippi State Medical Association board of trustees, told Mississippi Today that she knows of at least one other doctor in the state who was also fired for advocating for stronger safety measures.
"If you're shopping for groceries, picking up a prescription or visiting any other essential business, and if you're not covering your face, by Friday morning, an essential business can refuse you service," the mayor said.
Frontline staff at long-term care centers say they have been forced to work without proper protective gear, compelled to come to work sick or risk termination, and punished for speaking out. They say they have become unknowing carriers of the virus, bringing it back home and fostering its invisible spread.
A nursing home administrator and at least two nurses’ aides have died of coronavirus complications since the outbreak began. Nurses, doctors and other aides are hospitalized — some in critical condition — and scores of other employees are infected. Unions representing nursing home workers are demanding that owners be held to account.
Of the 1,232 people in New Jersey who have died from coronavirus, 10 percent were long-term care residents.
Alarmed by the disclosures, Persichilli said “we have to develop a statewide plan to assist the nursing homes that are experiencing outbreaks and a shortage of staff and equipment.”
The plan she described will designate some nursing homes to care for symptomatic and COVID-positive residents, and others to care for those without symptoms. Residents will be moved within three regions of the state to the appropriate setting to avoid causing further exposures. Staff will work in one type of facility or the other, with no mixing.
Only a fraction of long-term-care residents with coughs or fevers have been tested for coronavirus because of the shortage of test swabs, priority given to hospitals and health-care workers, and, at times, the outright refusal of administrators to do so.
Delays in receiving results leave staff ignorant of their patients’ viral status as they brush their teeth and feed and bathe them. This has allowed the virus to potentially leap from symptomatic, but untested, residents to their roommates and caregivers.
Test swabs had been locked away by her supervisor, she said, and "we were told to assume everyone is positive." The nurse, who asked that her name not be used, said she was suffering from a temperature of 103.8 and diarrhea after working with residents at the home. She planned to be tested for coronavirus.
A nurse's aide said she had been exposed to the virus by her patients and several co-workers, and as the sole caregiver for her 78-year-old disabled mother, was "terrified" of becoming ill. Her doctor had advised her to self-quarantine, but the physician's note was refused, said LaDawn Chapman. She was told if she didn't show up for work, her resignation letter would be accepted.
At another nursing home in Elizabeth, Plaza Healthcare and Rehabilitation, personal protective equipment is locked in the administrator's office, two employees said. When the staff asks for it the administrator "launches it out the door" at them, because he does not want to come out, said Gabby Niziolek, a nurse's aide, who tested positive after caring for two patients she did not know had the virus.
Workers said they had been taping plastic sheet covers to their glasses to serve as face shields. An aide said she had been given one N95 mask for a week.
At the Elizabeth Nursing and Rehabilitation Center, 22 people have died, 12 after testing positive for the virus, Elizabeth Mayor J. Christian Bollwage said Tuesday.
Sixteen of the remaining 58 nursing home residents currently are ill with the virus, and five are awaiting test results, he said. Yet the current official total of deaths reported by the state for Elizabeth is 13, he said.
At the Alameda Center for Nursing and Rehabilitation in Perth Amboy, eight residents had died as of Friday. Two were known to have the virus, one was awaiting a test result and the deaths of five were considered sudden and unexplained. A nurse's aide, Courlande Dauphin, also has died of complications from the virus.
At one nursing home this past weekend, two staff members cared for 45 residents.
"It's ridiculous, the staffing," said an aide. "How can one aide and one LPN [licensed practical nurse] do that?"
Louisiana確診 17,030 +746， 死亡652 +70 ，檢測81K（17K/1M）
On March 13 when Gov. John Bel Edwards ordered school closings and other restrictive measures with 36 cases identified in the state, more than 1,100 sick patients reported experiencing symptoms. By March 22, when the governor issued his stay-home order after the state reported 837 cases and 32 deaths, 8,327 patients showed symptoms and eventually tested positive for COVID-19, the health department's data show.
As the state’s confirmed number of patients infected grew to 2,747 by March 27, more than 13,250 people were actually infected with the virus and showing symptoms, based on case studies reported to the state health department.
The lag in test results being returned shows a delay of about 10 days before officially reported numbers of confirmed cases in the state caught up with the number of people who started exhibiting symptoms on a given day and who later tested positive for COVID-19.
- Hispanics make up 34% of the fatalities (They are 29% of NYC’s population)
- Blacks make up 28% of the fatalities (22% of the population)
- Whites make up 27% of the fatalities (32% of the population)
- Asians make up 7% of the fatalities (17% of the population)
De Blasio announced a four point plan to confront the racial disparities that includes grassroots outreach and a multimillion dollar ad campaign in 14 languages.
De Blasio said the city is responding to those troubling statistics by focusing on supporting public hospitals, launching a multi-million dollar advertising campaign in 14 languages and focusing on communities of color, grassroots outreach to leaders and clinics in those communities and expanding telemedicine. He also said 311 resources needed to expand.
New Jersey 47,437 +3,021 1,504 +272
- All grocery stores have to limit the number of customers in their stores to 50% of their capacity. In addition, all store workers and customers must wear face coverings, and stores must provide special shopping hours for high-risk customers, and erect barriers between cashiers and customers where practical.
- All non-essential construction in the state is being shut down as of Friday
- New Jersey’s primary date is being moved from June 2 to July 7.
- Weight limit on trucks carrying COVID-19 relief has been raised
20,346 +1,376 959 +114
Detroit, Oakland, Wayne最多
Detroit City 5824 251
Oakland 4007 234
Wayne 3802 195
Georgia 確診10,204 +1,048 ，死亡370 +22，檢測38.8K（3.7K/1M）
Texas 確診10,065 +1,126 ， 死亡195 +28，檢測96K（3.4K/1M）
@恆智德 之前喺NYT 見到有個醫生喺醫院public area戴豬咀，跟住醫院管理話佢製造恐慌，唔俾佢戴 ,仲要佢開冇人工嘅OT。私立醫院啲管理好似好離地，唔知呢個病傳染性有幾高咁。
The new guidelines will allow critical workers who have been exposed go back to work as long as they are asymptomatic and follow conditions like taking their temperature before going to work, wearing a face mask at all times and practicing social distancing at work as much as possible.
The new guidance is intended to allow health care workers, food supply workers, and others in critical industries to go back to work sooner, as long as they do not have symptoms.
President Trump is preparing to announce as soon as this week a second, smaller coronavirus task force aimed specifically at combating the economic ramifications of the virus and focused on reopening the nation’s economy, according to four people familiar with the plans.
The goal is to get as much of the country as possible open by April 30, the current deadline Trump set for stringent social distancing measures.
The White House is developing plans to get the U.S. economy back in action that depend on testing far more Americans for the coronavirus than has been possible to date, according to people familiar with the matter.
The effort would likely begin in smaller cities and towns in states that haven’t yet been heavily hit by the virus. Cities such as New York, Detroit, New Orleans and other places the president has described as “hot spots” would remain shuttered.
According to the Medscape Physician Compensation Report, in 2018, Primary Care Physicians in the United States earned on average $237,000, while Specialists earned $341,000.
After announcing two weeks ago that the state had distributed 24.5 million N95 masks, Newsom on Tuesday night told "The Rachel Maddow Show" on MSNBC that California had struck a deal for more than 200 million protective masks per month.
About three-quarters will be N95s, the rest surgical, he told the show.
New York 確診161,504 +10,333 ，死亡 7,067 +799
Amid the horrific death toll, Cuomo announced he’ll issue an executive order to ease licensing rules to help bring out-of-state funeral directors to New York.
“It’s gotten to the point, frankly, that we’re going to go into bring in additional funeral directors to deal with the number of people who have passed," Cuomo said.
Some coronavirus patients who would have been admitted into the emergency department at a New York hospital are being sent home with an oxygen-monitoring device as the city's medical system struggles to reserve resources for only the sickest people.
Since last week, more than 200 people with confirmed or suspected COVID-19, the respiratory illness caused by the virus, have been sent home with a pulse oximeter to track their oxygen levels. A doctor or nurse practitioner follows up with them via video conference.
An oximeter is a small electronic device that clips onto a fingertip to indirectly measure the oxygen saturation of a patient's blood.
New research indicates that the coronavirus began to circulate in the New York area by mid-February, weeks before the first confirmed case, and that travelers brought in the virus mainly from Europe, not Asia.
“The majority is clearly European,” said Harm van Bakel, a geneticist at Icahn School of Medicine at Mount Sinai, who co-wrote a study awaiting peer review.
A separate team at N.Y.U. Grossman School of Medicine came to strikingly similar conclusions, despite studying a different group of cases. Both teams analyzed genomes from coronaviruses taken from New Yorkers starting in mid-March.
On Feb. 26, two days before President Trump called the coronavirus outbreak the Democratic Party’s “new hoax,” the Cleveland Clinic alerted the public that it was prepared to quickly open 1,000 additional hospital beds should the need arise.
On March 4, the day Trump boasted that “we have a very small number” of infected people in the United States, Ohio’s Republican governor, Mike DeWine, shut down a weekend fitness expo expected to draw 60,000 people a day to a Columbus convention center. There were no identified coronavirus cases in the state at the time.
But an early look at Ohio’s preparations and decision-making shows they reflect textbook recommendations for the way to handle an outbreak. Identify it early. Plan for the worst, hope for the best. Move swiftly because disease expansion will be exponential, not linear. In the absence of testing, assume the virus is spreading through the community. Communicate with the public clearly, and keep the message consistent.
Now, Ohio may be realizing the benefits of early intervention in the pandemic by its government and medical community. With about 5,100 covid-19 cases, it has fewer than a third the number of people with the novel coronavirus in three comparably sized states — Michigan, Pennsylvania and Illinois. And Ohio has just a small fraction of the deaths reported in those states.
A Detroit hospital has been so overwhelmed by the influx of Covid-19 patients that at least 2 people have died in its emergency room hallways before help can arrive, health care workers there told CNN.
Conditions are so drastic at Sinai-Grace that on Sunday night, all of the emergency room's night shift nursing staff --seven in total -- staged a sit-in, where they refused to work and demanded that more nurses be sent in to help.
Patients at Sinai-Grace aren't just two-to-a-room -- they have been lining many of the hallways in the emergency room, according to the four health care workers. Two workers said critically ill patients, including ventilated patients, have been at times kept in the hallways.
New York 確診172,358 +10,854 ，死亡7,844 +777
The running three-day average of new hospitalizations was 359 on Thursday, down from 481 the day before. The average has also been declining sharply in recent days.
ICU admissions were actually negative on Thursday, Cuomo said, with 17 more people leaving those units than entering. It’s the first time those admissions have been negative since the crisis began, he said.
Fox News主持人Tucker Carlson前兩日屌曬鬼，話專家搞錯曬，預測根本唔準
Initially, the I.H.M.E. predicted that on April 4th, the state of New York would require 65,000 hospital beds to handle infected patients. The low-end estimate of what the state would need was nearly 48,000 beds.
In fact, on April 4th, New York had fewer than 16,000 hospitalizations for coronavirus, and many other states fell far below the model's projections as well -- in many states.Over the weekend, the I.H.M.E. updated its model. Its projections across the country have been scaled back dramatically. And yet, they are still significantly overstated.
For example, as of April 7th, the updated I.H.M.E. model predicts that New York will need 25,000 hospital beds. As of Tuesday morning, the real number was just under 17,500. The new model also predicted that as of today, almost 6,600 people would be in intensive care, and the actual number is just under 4,600.
For many years, the CDC has tracked the total number of Americans who die every week from pneumonia. For the last few weeks, that number has come in far lower than at the same moment in previous years. How could that be?
Well, it seems entirely possible that doctors are classifying conventional pneumonia deaths as COVID-19 deaths. That would mean this epidemic is being credited for thousands of deaths that would have occurred if the virus never appeared here.
Now, it's time to look ahead. If the virus is doing less systemic damage to our system than expected, then presumably, we can begin to consider how to improve the lives of the rest, the countless Americans who have been grievously hurt by this, by our response to this.
How do we get 17 million of our most vulnerable citizens back to work? That's our task. Other countries are already hard at work doing it.
When asked about his thought process for reopening the country, Trump acknowledged that he can listen to dozens of experts, but ultimately, the the decision lies with him.
“The metrics right here,” he said, pointing to his head. That's my metrics. That's all I can do. I can listen to 35 people. At the end, I've got to make a decision," he said.
"I will have to make a decision, and I only hope to God it is the right decision. But I would say without question, it is the biggest decision I'll have ever had to make," he said.
"It's the biggest decision of my life," he repeated.
Dr. Anthony Fauci, the government's top expert on infectious diseases, has cautioned that the virus dictates the timeline and warned that to "gradually" reopen the country widespread testing must be in place, so doctors can better identify, isolate and trace cases.
USPS looking into Wisconsin absentee ballot issues
Nebraska gets $300K from feds for each virus case while N.Y. gets $12K
Antibody tests that would verify whether a person recently had the novel coronavirus could be available within a week, according to the nation's top infectious disease expert.
"Within a period of a week or so, we're going to have a rather large number of tests that are available," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on CNN's "New Day" Friday morning.
The governor says he’s signing an executive order to allow certain low-risk inmates to be placed on temporary home confinement or granted parole if eligible amid the pandemic.
Michigan 22,783 +1,279 1,281 +205，創單日死亡新高
Massachusetts 20,974 +2,033 599 +96
Pennsylvania 20,340 +1,794 446 +86