Coronavirus: Health Care Industry

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Addie
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Coronavirus: Health Care Industry

#1

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WaPo
Unprotected and unprepared: Home health aides who care for sick, elderly brace for covid-19

Millions of poorly paid workers are being given little support even as they risk spreading the coronavirus


All day, most days, for $10 an hour, Marley Brownlee comes and goes from the homes of the old and the weak.

She has almost none of the equipment that could protect her vulnerable clients — or herself — from the deadly virus that has transformed life across the United States. No masks, goggles or gown. She takes what precautions she can using gloves, hand sanitizer and disinfectant wipes. Her hands are raw from washing, and last week, she considered spraying herself down with Lysol between appointments.

Brownlee is one of the millions of health-care workers whose challenges have been largely overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes. At least 12 million people in the United States depend on such services every year, according to the National Association for Home Care and Hospice, many of them older or coping with severe disabilities.

It is a sprawling sector of the U.S. health-care delivery system — and one whose fortunes could be critical in efforts to contain covid-19, the deadly lung disease caused by the coronavirus. With nursing homes across the country locked down and hospitals preparing for an onslaught of covid-19 patients, many who require medical services or help with the basic tasks of daily living are likely to be confined to their homes in the weeks and months ahead. Yet the providers of those services say they are unprepared to step into the breach, hamstrung by regulations ill-suited to the current pandemic and unable to access protective gear that could shield workers and clients alike from infection.
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Re: Coronavirus: Health Care Industry

#2

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Reuters
New York sees glimmer of progress against coronavirus, New Orleans worsens ...

The rate of hospitalizations in New York has slowed in recent days, Governor Andrew Cuomo said, with numbers he called “almost too good to be true.” He also hailed the enlistment of 40,000 retired nurses, physicians and other medical professionals signing up for a “surge health care force,” but warned much remains to be done.

In an ominous sign he and other governors are preparing for the worst, the states of New York, North Carolina and Hawaii requested the Federal Emergency Management Agency send special mortuary teams that can be deployed for mass casualties, FEMA said on Wednesday. ...

At least 30,800 people have tested positive for the virus in New York state and more than 17,800 in New York City alone. By Wednesday night, the number of coronavirus fatalities had climbed to 280, up 81 from the number reported hours earlier when the statewide death toll stood at 285. ...

Health experts insist reopening businesses and schools too soon would only risk fueling transmission of the virus, overwhelming a hospital system already facing equipment and personnel shortages, and ultimately worsen the economic fallout.

Cuomo cited recent coronavirus hospitalization figures in his state as evidence that social distancing was starting to work. While hospitalizations had been doubling every two days as of Sunday, those numbers were doubling every 3.4 days by Monday, and by Tuesday the rate was every 4.7 days, Cuomo said. ...

The deteriorating situation in New Orleans dashed hopes that less densely populated cities and those in warmer climates might escape the worst of the pandemic. Local authorities have warned that hospitals in the Mississippi River port city could reach the point of collapse by April 4.
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Re: Coronavirus: Health Care Industry

#3

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Business Insider
Nurse dies in New York hospital where workers are reduced to using trash bags as protective medical gear

A nurse at Mount Sinai Hospital in New York died from COVID-19 after learning he was infected by the novel coronavirus almost two weeks ago. Protective medical gowns are in such short supply in the Mount Sinai system that some nurses have started to use Hefty-brand garbage bags instead, according to photos on social media.

The New York Post reported that Kious Kelly, an assistant nursing manager at Mount Sinai Hospital in Manhattan, died Tuesday. He was 48 years old.

His sister confirmed his death to the Post, saying that she was told he had been in the intensive-care unit but that he did not think it was serious. The Post did not specify how he contracted the virus. ...

New York state has become the epicenter for the US's coronavirus outbreak, with more than 33,000 infections and more than 360 deaths. In New York and other areas in the US with large outbreaks, healthcare workers are reporting shortages of personal protective equipment like masks, gowns, face shields, and gloves.

At Mount Sinai West, in the same hospital system where Kelly worked, nurses published a photo on social media showing them fashioning plastic trash bags into protective outfits, according to the Post.

"NO MORE GOWNS IN THE WHOLE HOSPITAL," they wrote on Facebook. "NO MORE MASKS AND REUSING THE DISPOSABLE ONES … NURSES FIGURING IT OUT DURING COVID-19 CRISIS." One nurse is seen holding a box of Hefty Strong 33-gallon bags, more commonly used for lining household trash cans.
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Re: Coronavirus: Health Care Industry

#4

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New York Times
6 Die as Coronavirus Races Through Upscale Retirement Community in N.Y.

A peaceful waterfront community in Long Island is now an epicenter of the pandemic.


The first sign appeared two weeks ago, when an employee tested positive for coronavirus. By Wednesday, Peconic Landing, an upscale elder community on the North Fork of Long Island, announced its sixth death from the virus, sparking fears of an even bigger outbreak among a vulnerable, confined population.

What was a peaceful waterfront resort by the shores of Long Island Sound has become a scene emergency crews in hazmat suits. Employees worked double shifts to cover for missing workers; when one threw out her mask to go on break, her supervisor reprimanded her for not reusing it.

Visitors trying to check in with parents were turned away at the gates, and families were advised that removing their relatives was even riskier than keeping them there. ...

Nursing homes and other group residences for older adults are particularly susceptible to the pandemic, because residents are in close contact with one another and with the workers, and because many residents already have other health problems and weakened immune systems. ...

Suffolk County, which includes some of the East Coast’s wealthiest beach communities, had 2,260 confirmed cases of Covid-19, and 20 deaths, as of Wednesday — at least one death in each of the last 7 days. “We’re seeing those numbers on a daily basis continue to rise,” Steve Bellone, the Democratic county executive, said. As elsewhere, there was a shortage of face masks, medical gowns, gloves and hand sanitizer. ...

Peconic Landing, which has 377 residents, or members, was seeking donations of protective gear for workers and residents, but a representative said that because of these donations, lack of equipment had not “impacted care” for any residents. Shortages of the essential protective equipment have been rampant at health facilities around the country, increasing risks of spread.
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Re: Coronavirus: Health Care Industry

#5

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WaPo
Hospitals consider universal do-not-resuscitate orders for coronavirus patients

Worry that ‘all hands’ responses may expose doctors and nurses to infection prompts debate about prioritizing the survival of the many over the one


The conversations are driven by the realization that the risk to staff amid dwindling stores of protective equipment — such as masks, gowns and gloves — may be too great to justify the conventional response when a patient “codes,” and their heart or breathing stops.

Northwestern Memorial Hospital in Chicago has been discussing a do-not-resuscitate policy for infected patients, regardless of the wishes of the patient or their family members — a wrenching decision to prioritize the lives of the many over the one.

Richard Wunderink, one of Northwestern’s intensive-care medical directors, said hospital administrators would have to ask Illinois Gov. J.B. Pritzker for help in clarifying state law and whether it permits the policy shift.

“It’s a major concern for everyone,” he said. “This is something about which we have had lots of communication with families, and I think they are very aware of the grave circumstances.”

Officials at George Washington University Hospital in the District say they have had similar conversations, but for now will continue to resuscitate covid-19 patients using modified procedures, such as putting plastic sheeting over the patient to create a barrier. The University of Washington Medical Center in Seattle, one of the country’s major hot spots for infections, is dealing with the problem by severely limiting the number of responders to a contagious patient in cardiac or respiratory arrest.
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Re: Coronavirus: Health Care Industry

#6

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BuzzFeed News: Doctors And Nurses Say More People Are Dying Of COVID-19 In The US Than We Know

“The numbers are grossly underreported. I know for a fact that we’ve had three deaths in one county where only one is listed on the website,” one California ER doctor told BuzzFeed News.
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Re: Coronavirus: Health Care Industry

#7

Post by Slim Cognito »

I've been given the impression that's the case here in Florida. Treat them as if it was covid, but no tests available so write it down as pneumonia.
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Re: Coronavirus: Health Care Industry

#8

Post by Sugar Magnolia »

A friend's brother in law died the Wednesday before our first case was reported on Friday. High fever, 'belt around the chest' feeling, shortness of breath....all the classic symptoms. They initially diagnosed pneumonia and sent him home. Back to the hospital by ambulance 3 days later, put on a vent and dead 48 hours after that. It took them over a week to decide what to put on the death certificate because WE HAD NO FUCKING TESTS YET. Officially, he died of pneumonia.

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Re: Coronavirus: Health Care Industry

#9

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New York Times
Amid Desperate Need for Ventilators, Calls Grow for Federal Intervention

President Trump wants the private sector to fill the urgent need for the lifesaving devices. Experts say that strategy may doom the thousands who will need them in the coming weeks. ...


Now, with American hospitals facing a grave shortage of the vital devices, the Big Three automakers, small engineering firms, software designers and medical equipment manufacturers are rushing to figure out ways to produce more of them. But President Trump has so far declined to use powers that public health experts say could make a real difference in getting more ventilators to places that need them the most — right now.

What is really needed, a number of public health experts and former government officials say, is for Washington to take control of the nation’s existing ventilator supply. Because peak coronavirus infections will hit cities and regions at different times in the coming months, a centralized federal effort could send unused machines to hospitals that need them most.

“This is a national crisis,” said Frank Kendall, who served as under secretary of defense for acquisition and logistics in the Obama administration. “In a time of scarcity, you can’t leave it up to companies and governors to manage it themselves.”

Mr. Kendall said that only the federal government had the authority to take over the allocation of ventilators, both from manufacturers who are in the business of selling devices to the highest bidder, and state leaders unlikely to voluntarily let go of machines they fear they might need in the future.
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Re: Coronavirus: Health Care Industry

#10

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The Age
Tuberculosis vaccine could help protect health workers from COVID-19

A century-old vaccine used to prevent tuberculosis will be trialled on thousands of Australian doctors and nurses in an attempt to protect those on the frontline of the COVID-19 crisis from infection.

The Bacille Calmette-Guerin vaccine, also known as BCG, was first used to inoculate babies against tuberculosis in 1921 in a revolutionary move that saved the lives of millions.

Researchers at Melbourne's Murdoch Children's Research Institute are hoping they can now trigger a medical breakthrough in the fight against coronavirus with the drug.

The announcement comes two days after authorities revealed four Victorian health workers at a hospital emergency department in Melbourne's outer west had tested positive for coronavirus, fuelling fears more medics could contract the deadly virus as Australia edges closer to the peak of the pandemic, expected to hit in May or June.
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Re: Coronavirus: Health Care Industry

#11

Post by TexasFilly »

Interesting. My 6th grade term paper was about Tuberculosis and I remember it was caused by a bacteria. I suppose there might be some properties with a protein or something that could help. Dr. Hotes from Texas Children's Hospital has been saying for weeks now they think they have developed a vaccine for COVID19 but all attempts to interest BigPharma have been rebuffed.
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Re: Coronavirus: Health Care Industry

#12

Post by Orlylicious »

Broward (Ft. Lauderdale) lost a doctor -- this is so sad and will have a ripple effect. How many doctors will opt out?

Broward doctor Alex Hsu dies from coronavirus
By EILEEN KELLEY
SOUTH FLORIDA SUN SENTINEL |
MAR 26, 2020 | 6:58 PM


Image

Dr. Alex Hsu

A Broward County doctor who served the community for close to 40 years has died of the new coronavirus.

Dr. Alex Hsu, 67, who died Tuesday, tested positive for the disease, Broward Medical Examiner Craig Mallak confirmed.

Officials haven’t said whether Hsu’s case stemmed from him traveling abroad or whether it was work-related. It also was not clear when he became ill.

“It’s so sad,” said a receptionist who answered the phone at Hsu’s practice Thursday morning.

Hsu practiced internal medicine at Northwest Medical Center in Margate. His death is the region’s first for a case where a medical provider has died from the disease.
https://www.sun-sentinel.com/coronaviru ... story.html
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Re: Coronavirus: Health Care Industry

#13

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Boston Globe: More than 150 Boston hospital workers test positive for coronavirus

Many appear to be due to community spread, as opposed to contact with infected patients.
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Re: Coronavirus: Health Care Industry

#14

Post by Sam the Centipede »

Addie wrote:
Thu Mar 26, 2020 3:01 pm
BuzzFeed News: Doctors And Nurses Say More People Are Dying Of COVID-19 In The US Than We Know

“The numbers are grossly underreported. I know for a fact that we’ve had three deaths in one county where only one is listed on the website,” one California ER doctor told BuzzFeed News.
When epidemiologists can draw a breath they should be able to estimate the number of under-reported COVID-19 deaths by calculating the number of actual pneumonia deaths less the number expected in a typical period. That will make for somber reading.

It would be better (imho) if reports were of "deaths probably due to COVID-19" where any pneumonia death is assumed to be COVID-19 unless there is a clear indication of a different, specific cause. It would give a more useful picture.

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Re: Coronavirus: Health Care Industry

#15

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The Guardian: US private health insurance companies clog system amid Covid-19 pandemic

Patients left waiting in beds until private insurance companies authorize next steps, which can take days ...

In the past two weeks the reality of the Covid-19 pandemic has hit the country. States and cities have been weighing public health measures, making changes to government health plans, and pushing sweeping changes to everyday life. Physicians have largely sought to reschedule and cancel elective surgeries and other patient visits deemed non-essential to free up resources to handle the virus.

But with a history of restrictive and confusing policies, private health insurance companies have lagged behind: making incremental changes to plans even as health providers seek to change course.
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Re: Coronavirus: Health Care Industry

#16

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March 20

Italian doctor dies of coronavirus after reportedly having to treat patients without gloves
Just before he was tested for covid-19, Marcello Natali appeared in a TV news interview to show how dire the situation had become for doctors on the front lines.

From his hospital in Codogno, Italy, the general practitioner raised a bottle of hand sanitizer and showed his face mask. But as for protective gloves?

“They have run out,” he told Euronews late last month. “Certainly, we were not prepared to face this situation."
Natali died Wednesday after testing positive for the novel coronavirus and then battling double pneumonia, Italy’s National Federation of Doctors and General Practitioners announced in a statement. He was 57.
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Re: Coronavirus: Health Care Industry

#17

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The next coronavirus crisis will be a shortage of doctors and nurses
What happens when America’s medical workers get Covid-19?


New York is living through what other cities may soon experience. Morale is low and the mood anxious across the country, as the pandemic continues to worsen. Based on what we’ve seen already in other countries, a lot of doctors and nurses are highly likely to get sick.

“As soon as you have the first case, you immediately have a staffing problem; you’re probably furloughing people who made the first contacts before you had test results,” Chip Kahn, president of the Federation of American Hospitals, said. “Then as you get further into it, it gets more and more intense.”

And the problem that other countries face may be worse in America.

“With already lower staffing ratios plus the very real risk of losing more [health care workers] due to illness, this could spiral and get much worse,” Jen Kates, who leads the global health program at the Kaiser Family Foundation, said.

https://www.vox.com/2020/3/26/21192191/ ... ors-nurses
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#18

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More than 160 Boston hospital workers test positive for coronavirus
Many appear to be due to community spread, as opposed to contact with infected patients.
By Priyanka Dayal McCluskey Globe Staff,Updated March 26, 2020, 12:13 p.m.


Major hospitals in Boston are seeing a steep rise in the number of infected workers, a doubling to more than 160 in the past two days, which officials believe may be more attributable to community spread than contact with infected patients.

At Massachusetts General Hospital, 41 members of the staff have tested positive for COVID-19, a quadrupling from earlier in the week, and at Brigham and Women’s Hospital, 51 employees have been infected, up from 33 two days ago.

:snippity:

The staff infections raise alarms about the ability of the hospitals to meet the challenge of a potential deluge of patients. When a staff member is infected, it has a ripple effect on close colleagues, who must be quarantined, and could spread the virus to others within the institutions.

The escalation comes at a time when the state has seen an increase in the number of infected patients, both in and out of hospitals, and a death toll that climbed from 15 to 25 in the past day.

:snippity:

Officials at Mass. General, the Brigham, and Tufts all said the workers infected at their hospitals did not work together in one area. In fact, some of them do not work directly with patients, which leads officials to believe their infections came from their ordinary lives, not work.

“There was definitely no clustering,” Tufts spokeswoman Rhonda Mann said. “This was across the hospital, and across job sites, and not just clinical people but people who worked in other parts of the hospital as well.”

Indeed, Tufts has five times the number of infected workers as it does patients admitted for coronavirus.
One indication that testing is a huge problem is the number of potential cases versus confirmed cases.
For example, Beth Israel Lahey Health has not disclosed the number of employee infections at its 12 hospitals, which include Beth Israel Deaconess Medical Center in Boston. The system does release information about patient admissions: As of Thursday, it had 93 patients confirmed with coronavirus, including 26 in the intensive care unit. It also admitted 214 patients being investigated for possible infections.
https://www.bostonglobe.com/2020/03/26/ ... newsletter
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Re: Coronavirus: Health Care Industry

#19

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And more on testing...
Here are the coronavirus testing materials that are in short supply in the US
March 25, 2020


At first, federal agencies were slow to approve tests that laboratories would need to help diagnose patients. Now, with those approvals in effect, labs around the country are reporting shortages of some of the chemicals and other materials necessary to perform diagnostic tests.

To understand the shortages, you need to understand the testing process, which confirms the presence of coronavirus by looking for its genetic material. Every stage demands a new set of highly-specialized supplies—each of which adds a potential bottleneck in testing capacity.

https://qz.com/1822596/all-the-coronavi ... in-the-us/
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Re: Coronavirus: Health Care Industry

#20

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WGAL: Penn State Health doctor on front lines of outbreak talks about experience

HERSHEY, Pa. — Hospitals in the Susquehanna Valley are caring for patients with COVID-19. An infectious disease specialist at Penn State Health described what she's experiencing.

“This is like nothing I've ever seen," said Dr. Catharine Paules. ...

Four people are hospitalized at Penn State Health with COVID-19, and others are suspected of having the virus.

Paules said she witnessed patients become critically ill very quickly.
"One minute someone will be just talking to you on no oxygen. The next second they might be requiring full ventilator support," she said.

Oxygen and ventilation are the current therapy.

The drug remdesivir is considered to have promise, but doctors don't know if it works. Penn State Health will soon be part of a clinical trial.
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Re: Coronavirus: Health Care Industry

#21

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The Hill
EXCLUSIVE: Top CDC official warns New York's coronavirus outbreak is just a preview

American health officials are deeply concerned that the coronavirus outbreak that has overwhelmed New York City hospitals in recent days is just the first in a wave of local outbreaks likely to strike cities across the country in the coming weeks.

In an exclusive interview, Dr. Anne Schuchat, the principal deputy director of the Centers for Disease Control and Prevention (CDC), said her agency is seeing early signs that the number of cases in other cities are already beginning to spike. While New York City is home to almost half the cases in the country at the moment, other cities are seeing their case counts rising at alarming rates.

“We're looking at our flu syndromic data, our respiratory illness that presents at emergency departments. Across the country there's a number of areas that are escalating. The numbers in New York are so large that they show up, but we're looking at increases over time and we're really seeing some in a number of places. It would be surprising to me based on what I've seen about how this virus spreads if it were not going to increase in many other parts of the country,” Schuchat said.

The CDC has deployed about 1,500 of its epidemiologists, scientists and experts to hot spots around the country, including the New York City area and Seattle, where the first American cases of the coronavirus emerged in January and early February. Now, Schuchat said, the CDC has dispatched teams to Louisiana, Wisconsin and Colorado, among others.

Schuchat declined to name the cities that are likely to become the epicenters of new and worrying outbreaks, but New Orleans has stood out in recent days for the rapid growth in cases it has seen. Louisiana reported its first case of coronavirus on March 9; it crossed 100 cases a week later. Its case count doubled between Sunday and Wednesday, when the state reported almost 1,800 cases.
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Re: Coronavirus: Health Care Industry

#22

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WaPo: In hard-hit areas, testing restricted to health care workers, hospital patients

Officials direct scarce resources where they are needed most to save people’s lives.


Health officials in New York, California and other hard-hit parts of the country are restricting coronavirus testing to health care workers and the severely ill, saying the battle to contain the virus is lost and the country is moving into a new phase of the pandemic response.

As cases spike sharply in those places, they are bracing for an onslaught and directing scarce resources where they are needed most to save people’s lives. Instead of encouraging broad testing of the public, they’re focused on conserving masks, ventilators and intensive care beds — and on getting still-limited tests to health-care workers and the most vulnerable. The shift is further evidence that rising levels of infection and illness have begun to overwhelm the health care system.

A similar message was hammered Saturday by members of the White House coronavirus task force, who said it was urgent to conserve scarce supplies and offered guidelines about who should get tested. Top priority, they said, should go to those who are hospitalized, along with health-care workers, symptomatic residents of long-term care facilities and people over 65 — especially those with heart and lung disease, which place them at higher risk.

“Not every single person in the U.S. needs to get tested,” said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. “When you go in and get tested, you are consuming personal protective equipment, masks and gowns — those are high priority for the health care workers who are taking care of people who have coronavirus disease.”

Health officials are now struggling with a complicated and shifting message. More people can get tested as drive-through sites open and more tests are finally available. Nevertheless, those with mild symptoms should stay home and isolate. And everyone should practice social distancing to preserve the health care system’s finite resources.

To convey those points clearly, many officials are speaking in increasingly blunt terms, saying that wide testing could jeopardize the lives of health care workers and the U.S. response by burning through precious supplies as a tidal wave of sick people descend on the system.
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Re: Coronavirus: Health Care Industry

#23

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Addie wrote:
Fri Mar 27, 2020 9:32 am
The Hill
EXCLUSIVE: Top CDC official warns New York's coronavirus outbreak is just a preview

American health officials are deeply concerned that the coronavirus outbreak that has overwhelmed New York City hospitals in recent days is just the first in a wave of local outbreaks likely to strike cities across the country in the coming weeks.

In an exclusive interview, Dr. Anne Schuchat, the principal deputy director of the Centers for Disease Control and Prevention (CDC), said her agency is seeing early signs that the number of cases in other cities are already beginning to spike. While New York City is home to almost half the cases in the country at the moment, other cities are seeing their case counts rising at alarming rates. :snippity:
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Re: Coronavirus: Health Care Industry

#24

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Newsweek: New York City Builds Makeshift Morgue to Handle Expected Rise in Coronavirus Deaths
New York Mag - Jonathan Chait: Trump Is Haggling Over Ventilator Prices While Coronavirus Patients Die
WaPo Editorial: Trump can’t fix the ventilator problem. But right now, he’s not even managing it.
Politico: Could Obamacare save jobless Americans from coronavirus?

The law's backers say it will prove a crucial safety net during the pandemic. The Trump administration may soon agree.
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Re: Coronavirus: Health Care Industry

#25

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WaPo - Drew Harwell: Gouged prices, middlemen and medical supply chaos: Why governors are so upset with Trump

Masks that used to cost pennies now cost several dollars. Companies outside the traditional supply chain offer wildly varying levels of price and quality. Health authorities say they have few other choices to meet their needs in a ‘dog-eat-dog’ battle.
Adding:
New York Times - Bari Weiss: Doctors Are Writing Their Wills

“You feel radioactive,” say doctors who are treating coronavirus patients while trying, desperately, to protect their own families.
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