Monday, March 30, 2020

Coronavirus Update 2

Chivis Martinez for Borderland Beat
Trump displays the 5 min test
Tuesday Stats 3.31.20 
U.S.: 164,400 Cases 3173 Deaths… since Sunday a 24k increase nationwide in cases and 773 deaths increase over the two day period.
Global: 803,605 Cases and 39,033 Deaths in 155 countries

California is experiencing a slow increase with 7429 Cases and 149 Deaths.  44 deaths in L.A...Possibly attributed to social distancing as Governor Newsom was the first in the nation to call for “sheltering in place”.
New York: 75,795 Cases 914 Deaths  Note: hospitalizations have slowed for 7 days straight

Mexico: 1094 Cases 28 Deaths Note: Mexico is not providing confirmed comprehensive information including affected states (see graph below)

To mask or not to mask….citizens left confused…
Since I have been reporting on the CV, I have stressed the CDC and Dr Fauci, warning that masks were not needed to be worn and by hoarding the masks and other medical protection wear; it has caused a critical shortage needed by first responders, medical personnel and those high risk persons, such as those with immune deficiencies.
Now there is discussion being conducted by professionals and the CDC, masks worn in public by asymptomatic persons it would stop that person from transmitting the virus.   The masks worn by healthy persons is useless in protection but worn by a carrier may stop that person from spreading the highly contagious disease.  CDC is looking into this and may impose a mandatory face shielding such as bandannas.


Surgeon General says wearing masks are an added danger of acquiring the virus, as people improperly wear the masks, and touch them with hands.....Stay tuned

Trump and the coronavirus task force addresses nation today on new guidelines, and “important announcements”

Gov. Cuomo of NY New York's governor urgently appealed for medical volunteers Monday amid a “staggering” number of coronavirus deaths. Even before the governor's appeal, close to 80,000 former nurses, doctors and other professionals were stepping up to volunteer.

Testing: U.S. has tested over 1m and is testing 100k per day, more than any other country in the world.  That number will jump as new testing products are used.  The “5 Minute Testing” machine began yesterday.  The noninvasive test machine can be utilized anywhere, mobile units, urgent care, doctor’s office.  Normally taking 8 to 10 weeks to present a new test, this took a couple of weeks and is highly accurate. Trump displayed the small unit at the task force presser yesterday.  Trump says there are now 20 testing options. The 5 Min machine was sent to NYC, Seattle, DC and 2 to Ohio.

Treatment: Malaria drugs combined with ZPac antibiotic continues to show positive results, Bayer, Norvatis and Sandoz is donatin 37m tablets of the generic hydroxychloroquine, and chloroquine.


FDA Approval: The Food and Drug Administration on Sunday issued an emergency use authorization for hydroxychloroquine and chloroquine, decades-old malaria drugs Trump for coronavirus treatment.  

Ventilators: Ford along with GE are speedily churning out the pNueton non-electric ventilators.  The machine works on compressed oxygen, important in situations such as mash type facilities where electricity is limited.  Ford/GE They will produce at least 50k in 100 days.
Remember: Coronavirus and Taking ibuprofen, Aspirin or Naprosyn is ill advised based on study results from France where patients worsened exponentially after taking these over the counter meds.  Tylenol is safe.  HOWEVER, if you are on therapeutic doses or regimen of any of the drugs, check with you physician before stopping.

ZPac Allergy: Zpac is an antiviral mediation that in combination and hydroxychloroquine has been promising as a treatment to coronavirus.  Some, such as me have an allergy to the medication.  There is unfortunately no substitute at this time.  

Alex Agar of Health & Human Services: Spoke of the mask sterilization machine that will allow masks to be worn up to 20 times.

Seema Verma CMS Administrator: They are waving regulations in order to provide expanded care such as “wall-less” hospitals facilities operating outside a hospital. (non CV patients)

Mobile Labs now being used for home appointments, for persons unable to travel to a facility.

Now allowing ER’s to use Telemedicine systems.

Now providing childcare, laundry services, meals for medical personnel and will pay for physicians to make phone calls with their patients for consultation appointments.
Fauci:  Expects another wave of the virus in the fall.  But emphasizes “It will be a whole different ballgame”, citing testing, treatments and the ability “to trace and isolate” plus “a number of clinical trials for therapeutic intervention, and most importantly multiple vaccine candidates may be ready next season”.

Dozens of companies in the U.S. have stepped up and are manufacturing medical protection gear, medical supplies and equipment.  Many are donating the product.


Mike Lindell of My Pillow is making 50 masks a day rather than pillows.  He is just one of the many citizens that have stepped up to the virus challenge.


4 of the last 5 Viruses originated in Asia’s “Wet Markets” 

Mexico cases and deaths


Go to interactive map using this hyperlink
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Sunday President and Coronavirus Task Force News Conference 3.29.30


I apologize for not being able to post notes from yesterday CV news.  Today in the Rose Garden there was a CV press conference, which just ended, here are my notes which include the news from CNN that Dr. Fauci says there would be 1 to 2M deaths in the U.S.  Fauci gives the complete context of his statement.
Fauci at today's conference
“No darkness can dim the light of American courage”
“We likely to hit the peak of deaths in 2 weeks.” …Trump

Stats U.S. 140k cases  2400 deaths note: half in New York, U.S. mortality rate 1.5 
Second lowest in the world

Global 718,119 cases 33,881 deaths

New York hospitalizations is experiencing a decline in numbers

Trump:  “15 Days to Slow the Virus” guidelines have been extended to April 30th.  This was decided after Dr Birx and Fauci used model data and recommended the extension to Trump. (See the guideline at the bottom of this post.  Click on hyperlink that will take you to my Scribd page and full view)
In 2 weeks the death rates should peak.

On June first it is expected to be well on the way to recovery.

Testing; FDA gave an emergency approval for a new test from Abbott that produces results in 5 to 13 mins.  The difference is positive results in 5 minutes and negative results in 13 minutes. 

Abbott will produce 50k per day beginning this week.

Treatments: The combination of hydroxychloroquine and azithromycin is being tested in NY.  hydroxychloroquine is a long standing drug to treat malaria.  Azithromycin or commonly known as “Z Pac” is an antibiotic.

Other treatment drugs are being tested as well as a blood plasma.  Plasma from coronavirus recovered persons, is infused into patients with promising results.

Masks: Approval is pending for a sterilization process rendering masks sterile and ready for reuse up to 20 times.

Trump is questioning certain hospitals in NY going form 10k mask orders to 300k, he suggested NY or reporters look into why. 

Unemployment:  Government will pay 100 percent of pay up to 4 months.  Trump says he is not happy that the bill dictated that the states would process and send checks to citizens.  He says the systems are antiquated and slow and worries that the checks will be delayed.

Humana and Cigna: Have agreed not to charge deductibles or co-pays for any CV related medical.

151 countries are now affected by coronavirus

Dr Fauci:  CNN and then picked up by most news outlets, reported that Fauci, in a CNN interview said that he expected 1 to 2 million U.S. deaths.  He spoke about the statement that was taken without contextual information.

He says  “I based the statement out of modeling data it could be 1-2M if we did not mitigate to the extent that we have, it would be then conceivable it could have gone that high.”

“But we feel what we are doing by mitigation is having a positive effect.”

He says “the decision to extend the 15 day guidelines we feel is a wise and prudent decision that Dr. Birx and I recommended to the president and he accepted and approved our recommendation.”

Dr. Birx: “We reviewed 12 different models and ended up the same numbers.  The models revealed a number of 1.2 to 1.6 deaths in the U.S. if we didn’t mitigate.”

“We looked at all the global impacts of mitigations, and brought that evidence to the president.  It is not a simple thing as we are asking of people from them to stay home for another 30 days.”

“We feel that this action will save 100s of thousands of lives.”

There will be a comprehensive piece presented on Tuesday says Birx.  This will address diagnosing individuals but increasing our surveillance, she said.


Chivis Note on China: Something is going on in China.  I mean more than the usual obscuring of facts.  3 days ago China announced the closing of all theaters in the nation of almost 1.4B people.

The next day they announced the closing of their borders to all but Chinese citizens.

Hong Kong announced closing its border due to a new wave of CV.


It would not be surprising if China also is experiencing CV 2.0 and are concealing the news.  And yet in their news they are touting the full opening of Wuhan on April 8th

House passes 2T CV bill, Trump signs into law..
US cases: 86,012 surpasses China and Italy now leads with confirmed CV cases...yet remains the lowest with S.K. in morality percent...
US Hospital Ship "Mercy" arrives in LA (video below of ship)
Apple launches new CV App in coordination with CDC
Coronavirus Task Force Presser 3.27.20
“We are at war with an invisible enemy…” President Trump

President Trump: Announced that he evoked the ‘Defense Production Act’.  This was evoked after the administration say they had problems with General Motors.  (the President may, by rule or order, require the allocation of, or the priority performance under contracts or orders  relating to, materials, equipment, and services in order to maximize domestic energy supplies...read full doc below)

“As usual with “this” General Motors, things just never seem to work out. They said they were going to give us 40,000 much needed Ventilators, “very quickly”. Now they are saying it will only be 6000, in late April, and they want top dollar.” Because of the broken agreement, Trump says he had to evoke the DPA.

Today GM announced it will go ahead with production of both ventilators and surgical masks.  Ventilators will be produced at a Kokomo Indiana plant, in which they already started retooling to build ventilators in partnership with Ventec Life Systems.

GM plans to call back 1,000 UAW workers to produce the ventilators. GM expects to deliver the first ventilators next month with the ability to produce 10,000-plus per month as production ramps up. 

The masks will be produced at a “clean plant” in Warren Michigan, about 25 mins driving time north of Detroit, which was closed in 2019.  It will reopen to build Level 1 surgical masks for health care workers.   GM says it will make 50,000 masks per day within two weeks, with the potential to increase output to 100,000 masks per day. (Many readers will remember that in December 19, 2008; President GW Bush approved a bailout plan and gave General Motors and Chrysler $13.4 billion in financing from TARP (Troubled Assets Relief Program) funds, as well as $4 billion to be "withdrawn later").

Ford and Tesla have also said they're gearing up and procuring equipment to build ventilators at US production facilities.

Peter Navarro was appointed by Trump to oversee the enforcement of Defense Production Act. Navarro said that the act was needed after “we ran into roadblocks with GM”.

Trump says unneeded medical supplies, including ventilators, will be shared with other countries in need, and to save for emergency back stock ready for future emergencies.

A second CV Vaccine: Trump announced that today Emory University, has begun a phase one clinical trial for a CV vaccine. Volunteers for the trial have been enrolled.  This is in addition to the vaccine in phase one already.

NY Ventilators: NY governor, Andrew Cuomo, had said yesterday and this morning that ventilator shortage was a problem.  This conflicted with what Dr. Deborah Birx, of the task force, had reported yesterday.  She reported they had sent NY three shipments of ventilators, 2k, 2k and this week 4k.  Their calculation was that NY had a surplus of ventilators that had not been used as of yet, and they also had a surplus of ICU beds.  She mentioned that although NY has the highest outbreak of cases and deaths, these were in 4 cities and the remainder of NY cities having little or no cases, and that equipment in those cities conceivably be used if the 4 impacted cities needed them.

Cuomo at first said they did not have the 4k ventilators, but later today confirmed they were in a warehouse in New Jersey and not accounted for.  NY physicians have reported attempting to use a sharing method where 2 patients use the same ventilator.

Trump says they’re working constructively with 10 companies, one is Boeing.  Boeing is set to produce medical face shields.  They will be donating all the shields for medical personnel and first responders.  Additionally,  they are donating the use of the “Dream Lifter” for distributing supplies throughout the U.S.. The plane is the world’s largest cargo plane capable to hulling 68k pounds of cargo per flight.

Apple iPhone coronavirus app: Today Apple released new COVID-19 app and website based on CDC guidance.  “The COVID-19 app and website allow users to answer a series of questions around risk factors, recent exposure and symptoms for themselves or a loved one. In turn, they will receive CDC recommendations on next steps, including guidance on social distancing and self-isolating, how to closely monitor symptoms, whether or not a test is recommended at this time, and when to contact a medical provider.”  

U.S. is now testing at least 100k per day, more than any country in the world.  Although this has caused the uptick in cases, it has also revealed a low mortality rate, around the same as South Korea, the two lowest percentages globally.

Trump and China president Xi shared a one hour conversation last night.  Xi said Chinese scientists have developed theories with respect to the virus and is sending data to the U.S. 

There are fears of a rebound of the virus in China as the nation inexplicably ordered the closing of all theaters in the nation.

Euro countries that China had sent medical supplies to report having issues with the quality, including the poor quality of the CV tests.

Trump was asked what will happen after the 15 day imposed quarantine the country has endured that will be up early next week, he was asked if it will be repeated, he said the task team will look at the data this weekend and he will be given recommendations.  Trump said “We want to open the country but we need to open safe.

Education Secretary Betsy Devos: She announced that standardized testing is cancelled this year and will resume in 2021.  She also said that for information about schools, and education during the virus, to go to the COVID-19 ("Coronavirus") Information and Resources for Schools and School Personnel. 

The last question trump took was from John Roberts who said he just received a message that WSJ had a headline “Trump is suspending tariffs for 3 months”.  Trump responded with “Fake News”.  Trump further stated that he and Xi have not even spoken about the subject.

Note: all stations stopped broadcasting the presser early; unfortunately leaving out the two people I most look forward to hearing from, Drs Fajuci and Birx.  Maybe over the weekend…

Coronavirus Task Force presser notes 3.26.20
USNS Comfort worlds largest hospital ship
Tests: 550k tests completed of those with significant symptoms with 14% positive

New self-administered tests (not at home tests) will save protective equipment, N95 masks, gowns etc medical.  The test is a front of the nasal passage rather than a sample to be taken from the back of the throat through the nasal passage.  Finger stick blood test will soon be available with results in minutes.

Dr Birx: NY informs the task force today there are empty ICU beds and 2000 unused ventilators.  She would like to squash reports that imply DNR (do not resuscitate) orders are being used already in NY.   She says reports are implying this and that when hospital beds and ventilators are needed will not be available are not backed by any evidence, or that even warrants such discussion.  She mentions that in NY for example,  who is hit heavily in urban areas, have many areas in the state that have no cases whereby equipment could be used, or even hospital beds.   “The evidence does not support these extreme predictions”.

Speaking of extreme predictions, the U.K. had predicted 500k deaths from the virus in their country but now say the figure is more like 20k. 
USNS Comfort hospital ship: is ready and will leave Virginia to NYC on Saturday and arrive on Monday.  It has 1000 beds.  It will be used to transfer patients to make room for seriously ill CV patients.


Dr Fauci:  Phase II trial for CV vaccine will begin wide trial testing for safety, in summer 2020.  Simultaneously, pharma companies will take the risk that it will pass and be approved and began production.  The result will be a vaccine ready for next “corona virus season”.

Fauci also indicates there are a host of drugs being tested for coronavirus therapy, in randomized control trials.


Birx: Mentioned that 19 of 50 states have less than 200 cases.  

STATS 3.27.20
U.S.:86,012 Cases, 1,301 Deaths,  New York: 39140 cases 365 Deaths
Global: 553,244 Cases, 25035 
Few cases: 16 U.S. States have no deaths, 14 states have less than 100 cases

Mexico:  585 Cases 8 Deaths

Thursday 3.26.20: Senate passes 2T coronavirus relief-stimulus agreement see below…......... U.S. deaths surpass 1000--40 percent  cases in 4 New York Counties
Economic relief checks will go out in 3 weeks says Mnuchin 


Will retirees and Social Security beneficiaries get stimulus checks?
Yes. The proposed bill includes language that allows Americans receiving Social Security—many of whom are retired and don’t file taxes—to obtain direct financial assistance through the coronavirus stimulus package. In such cases, the government would access their data through the Social Security Administration to determine their rebate. Source  

Something to think about: U.S. has been hit with a deadlyinfluenza season. Already 150 children have died this season; the mortality rate is over 7%, as of March 9th more than 20k persons of all ages have been killed by influenza.

China: China is back in business.  Lockdowns lifted within the nation, factories at full throttle, restaurants opened, traffic normal.  My husband took these images yesterday when leaving home, in a southwest China city with a population of 130M.   Just 10 days ago everything was closed and the streets empty.


Testing: in 8 days more tests than S. Korea in 8 weeks.  Fatality rate for S.K. and U.S. 1.2%.  as testing increases the U.S. death rate becomes lower.  It is with the nations with the lowest percentage. Average age 85. with three or more underlying pre-existing conditions. 

China: Ends  lock down in most places as daily life returns to normalcy Wuhan lockdown lifts April 8th. 
Wuhan China: The CV epicenter Ends mandatory quarantine on April 8th
Hong Kong: Tomorrow 3.24.20 another lock-down (info below)
L.A. walking back report of Lancaster teen reported dead from coronavirus---CDC wants to take a look at what LA now calls “complex case…

Stocks: e+2,112.98 Dow's best day since 1933---3.24.20
Trump sets a "flexible goal" of Easter to reopen U.S. taking in account "above all the health and safety of citizens..."
Fauci says data will determine where. That large areas are not that affected...so far.
Gallup Poll has Trump with an approval rating of 60% for his handling of the crisis, including independents. 94% of Republicans, 60% of independents, and 27% democrats
His presidential job approval rating now is 49%

Trump, during Fox News coronavirus townhall, calls for re-opening economy by Easter: ‘We have to get back to work’
Trump on COVID-19 relief bill hang up: 'No way I'm signing' with 'Green New Deal stuff' in it. for example; 35M for The Kennedy Center, Federalizing Elections, Solor Panel and windmill rebates....
Pence says thousands of ventilators en route to New York amid coronavirus crisis
Pence says White House not considering a nationwide coronavirus lockdown
VP Pence details what Trump is doing to support small businesses right now

VP Pence: FDA approved 'off label' use for Chloroquine, no barrier to access

Dr. Fauci NIAID: “Trump as an incessantly inquisitive leader who heeds scientific counsel.”

Hong Kong: Tomorrow 3.24.20 another lockdown as stats reveal uptick

Previously HK required a at home quarantine when entering HK.

On March 2, after several weeks of shutdown, most of Hong Kong’s 180,000 civil servants returned to their offices, with the private sector following their lead. It all seemed fine until March 16. But now, with the number of confirmed cases nearly doubling in the past week, as of Wednesday, only residents will be allowed back in the territory. Civil servants are back working at home and strict quarantine measures are in place once again.

CARES Economic bill:
The bill would help replace the salaries of furloughed workers for four months, rather than the three months first proposed. Furloughed workers would get whatever amount a state usually provides for unemployment, plus a $600 per week add-on, with gig workers like Uber drivers covered for the first time. The package also would give one-time payments of $1,200 per adult and $500 per child directly to the public.

Although 2019 tax returns would be used to determine income (or 2018 tax returns if those are the most recent available), experts said it was likely the bill would contain provisions for those who do not file returns.  Full bill see below

Sources:
coronavirus.org, John Hopkins coronavirus resource center, CDC, NIH, Whitehouse coronavirus guidelines website, South China Post, Notes taken from daily Task Force pressers

Below is the Defense Production Act


Click on U.S. map any city for stats-John Hopkins Tracker