Coronavirus wording on computer screen

Check back often as we continue to post timely updates on COVID-19. 

COVID-19 update: Early release from the April issue of Today’s Hospitalist

its here home pageToday’s Hospitalist has published its April coverage of COVID-19 online ahead of the print issue. The article looks at hospitalists’ efforts to prepare for—or deal with—the COVID-19 pandemic. We ask hospitalists how they’re working around growing resource constraints, what strategies they’re using to make sure groups have enough clinicians on board, and how they are trying to keep physicians and health care workers safe and virus-free. We hope that by publishing the story early online, we’ll help hospitalists continue to fight COVID-19.

March 31, 2020

The new normal: Experts predict between 100K-200K U.S. dead

Federal experts today plan to release the statistical models they’re using to come up with stunning predictions of expected dead in the U.S.: between 100,000 and 200,000. The New York Times reports that the death toll in the U.S. today surpassed 3,100, with the U.S. having the highest number of confirmed cases in the world: more than 160,000. (With testing so sparse and delayed, many cases remain undetected.) Virus expert Anthony Fauci, MD, discussed those estimates over the weekend, saying he expects the number of cases in the U.S. to eventually be in the millions. Better news: With close to 250 million Americans in 29 states now ordered to stay at home, data on daily fever readings (a tell-tale covid symptom) around the country show a decline.

CMS waives more regulations to boost hospital capacity

hospital capacity

The CMS yesterday announced a host of temporary waivers of regulations, all to allow hospitals to quickly ramp up capacity and expand the number of health care workers. Hospitals may now, for instance, contract with ambulatory surgery centers to provide hospital services including trauma surgeries and cancer procedures. Non-hospital buildings and spaces—including hotels and dormitories—may now be used for patient care and quarantine, and ambulances may now transport patients to a wide range of outpatient locations including urgent care centers and physician offices. As for boosting the workforce, the CMS is now allowing hospitals to hire private practice providers, and it is waiving requirements that CRNAs must be supervised by physicians. Hospitals also now have a blanket waiver to provide benefits to staff including meals, laundry service and day care.

Is using hydroxychloroquine “a rush to judgment”?

The FDA has given an emergency green-light to using the anti-malarial hydroxychloroquine to treat covid patients. While the agency acknowledged that the therapy is unproven in coronavirus, it said that deriving any benefit in treating serious covid cases risk may be worth the risk. Experts warn that use of the drug could affect heart rhythms among patients taking certain drugs or those with heart problems, and long-term use is associated with retinopathy. Researchers writing in Annals cautioned against using the drug without further investigation, writing that doing so would be “a rush to judgment” that could endanger supplies for approved uses among patients with lupus and rheumatoid arthritis.

Hospitals develop, deploy their own covid tests

Some good news: More hospitals and academic centers report that they’ve now developed the ability to test covid patients in-house, cutting down on crippling testing delays. While reagent shortages continue to threaten that capability, FierceHealthcare reports that the lab at New York’s Montefiore Medical Center is now running hundreds of tests a day, while the test developed at Baltimore’s Johns Hopkins Hospital is being used for 1,000 daily tests. The stimulus package that Congress passed last week requires insurers to cover the cost of tests developed by hospitals, and the CMS is now asking hospitals to report their daily testing data along with their daily supply needs and bed capacity. JAMA livestream contains more news on managing covid patients.

March 30, 2020

When 911 is overwhelmed

Coronavirus calls are overwhelming the 911 call system in New York City. While EMS in that city typically fields 4,000 calls a day, that number has now risen to more than 7,000. The outsized volume has left paramedics making on-the-spot decisions about who is well enough to stay in place and who needs to be taken to one of the city’s hospitals, with EMS rationing protective gear. Over the past several weeks, the nature of the calls has also changed from reporting fever or respiratory distress to cardiac arrest and organ failure. New York’s governor on Sunday reported that more than 76,000 retired health care workers have now volunteered to work in New York hospitals. And New Yorkers are taking to their balconies and open windows at 7 p.m. to cheer for health care workers and first responders.

How bad is the PPE shortage?

Pretty dire, according to survey results released by APIC. In an online survey of U.S. facilities, the infection control association learned that close to half—48%—are either already or almost out of respirators. Close to half (49%) reported they don’t have enough face shields, and nearly one-third (31%) don’t have enough masks. Even hand sanitizer is in short supply with 25% of facilities saying they are almost out. APIC called on the federal government to help alleviate those shortages, while Science News reports that “carpenters, clothing companies and local sewing circles are stepping up to help.” JAMA put out a call for creative ideas in how to conserve PPE and has received scores of responses.

CMS waives its (loathed) three-day SNF rule

The CMS this month announced that it is waiving its three-day rule for covering SNF care for Medicare beneficiaries, part of the agency’s emergency efforts to make regulations more flexible and allow hospitals to more effectively discharge patients. Inpatients who need SNF care no longer need to first be hospitalized for at least three days. Other changes: The CMS is renewing SNF coverage for some Medicare patients who have exhausted those benefits. It is also waiving its requirement that critical access hospitals can have only 25 beds and that patients’ length of stay much be limited to only 96 hours.

March 27, 2020

U.S.A.: We’re No. 1

The U.S. yesterday surpassed China as the nation with the highest number of confirmed cases. This morning’s Johns Hopkins’ stats: 85,996 cases in the U.S., 542,788 cases worldwide, 24,361 deaths worldwide. The House today may vote on the largest economic relief bill in U.S. history, one that would give hospitals $100 billion to offset the costs of treating covid patients. Early trials on the efficacy of lopinavir-ritonavir and hydroxychloroquine to treat hospitalized covid patients found neither to be effective. Research on patients hospitalized with coronavirus in Wuhan finds that 20% had cardiac injury, making those patients more likely to need noninvasive and invasive ventilation and have much higher mortality. The FDA is allowing clinicians to use alternative respiratory devices, and it has given the green-light to convalescent plasma from covid patients who have recovered as an investigational treatment for those with severe disease. Pediatric hospitals are resisting taking adult patients from other facilities, saying doing so wouldn’t be safe. Instead, they urge hospitals that treat adults and are at capacity to send all pediatric patients to children’s hospitals. An NEJM perspective outlines what the government can do to help alleviate PPE shortages. And hospitals are now debating whether to institute universal do-not-resuscitate orders for coronavirus patients, citing infection-control concerns and the shortage of PPE.

How to stretch ICU staffing

ICUs should switch to a model of tiered staffing that integrates experienced critical care clinicians with others repurposed from other hospital departments. That’s according to pandemic recommendations issued by the SCCM. The suggested model gives a physician who has critical care experience oversight over four teams, with each team managing 24 beds. Further, each team should consist of four staffing tiers. An experienced ICU APC or a reassigned non-ICU physician should be the first tier, while the second tier would consist of both experienced and reassigned physicians, APCs, respiratory therapists, CRNAs and CAAs; personnel in that second tier would concentrate on ventilation. Experienced ICU nurses would make up the third tier and reassigned non-ICU nurses would be in the fourth. To make such staffing possible, the SCCM issued the following recommendations: limit elective surgeries to free up beds, staff and ventilators; train reassigned staff; combine those who have ICU experience with those who don’t; and practice public health measures to minimize transmission. The SCCM also points out that 48% of U.S. hospitals have no intensivists on staff.

Teaching hospitals face visa moratorium

With the State Department putting a temporary halt to issuing visas, the visas of more than 4,000 foreign physicians are now up in the air. Those doctors, most of whom are waiting for J-1 visas, are slated to begin their residencies in U.S. teaching hospitals in July. Earlier this month, the state department sent out guidance to sponsors including the ECFMG to either cancel their programs or postpone their start dates. Among the more than 7,000 IMGs placed in residency programs in last week’s Match, more than 3,000 are already U.S. citizens.

March 26, 2020

Staffing strategies: All hands on deck

fight against coronavirusWhat types of staffing strategies do you need when more than 50% of all your admissions are coronavirus patients? That’s the situation Northwell Health, the largest system in the greater metro New York area with 15 hospitals, now finds itself in. Those hospitals are also dealing with this reality: Between 25% and 35% of those admitted patients need ICU-level care.

Joshua Case, MD, is medical director of Northwell’s hospital medicine program. In an SHM Webinar, Dr. Case discussed the tactics his hospitalist programs are using to increase provider capacity:

• Reach out to outpatient physicians. Talk to the physicians in your community, whether or not they still have hospital privileges, to have them come into the hospital and treat low-acuity patients. Be sure to devise some quick computer training as well as emergency credentialing so onboarding isn’t held up by red tape.

Bring back the “-ists.” Hospitalists have typically taken on specialists’ admissions to allow those physicians to focus on outpatient procedures and visits. Now that those outpatient options are shut down, give back admissions with those primary diagnoses to the specialists. Pulmonologists, meanwhile, and anesthesiologists can be enlisted to run vents.

Partner any outpatient clinicians who are unfamiliar with the hospital with early-year residents or NPs/PAs. In academic settings, think about how to deploy third-year residents and fellows.

• Figure out who shouldn’t come in. Hospitalists who have been exposed may be in quarantine while they wait for test results. Others—including those who are pregnant or immunocompromised—should likewise work offsite. Have those doctors take cross coverage at night, freeing up the onsite physicians. If your hospital has telemedicine, staff those services with offsite physicians as well.

For hospitals that don’t yet have a big COVID population, some physicians who shouldn’t work with coronavirus patients may still be able to come in and treat other patients

But at Northwell’s sites, “there’s no such thing any longer as a non-COVID unit,” Dr. Case said. If coronavirus patients are still only a minority of admissions, let physicians decide who wants to staff those teams or units.

“Physicians now have a tremendous amount of anxiety,” Dr. Case said.

Instead of work clothes and white coats, clinicians are wearing scrubs. The health system is exploring how to provide onsite showers as well as scrub services so doctors can clean up before they come go and have their work clothes laundered without taking them home.

In the presentation, Dr. Case was joined by Romil Chadha, MD, interim director of the hospital medicine division at the University of Kentucky. That entire state, Dr. Chada pointed out, has only 160 COVID-positive patients, so it is weeks away from being in the same situation as the hospitals in New York.

But the academic center has made essential plans including for child care. “We need child care for between 1,500 and 2,000 children a day,” said Dr. Chadha. Local YMCAs have stepped up to provide that care, while medical students have also volunteered. All the staff—doctors as well as nurses, pharmacists and social workers—are sharing their child-care resources.

Dr. Chadha also noted the tremendous number of volunteer offers that he and his colleagues have received. He mentioned one vascular surgeon—now sidelined—who wanted to know what he could do to help, fi out the hospitalists.

“He said he hadn’t placed a vent in 10 years, but he was willing to do so,” he said. “I’ve been floored by the response.”

Dr. Case agreed. “The only answer to give people is ‘yes,’ ” he said. ” ‘I will find something for you.’ ”

What the stimulus bill could mean for hospitals

The Senate this week approved a $2 trillion economic stimulus bill that, if it becomes law, would deliver $130 billion to hospitals and community heath centers.

Hospitals would receive $100 billion to help offset the costs of treating COVID patients and to make up for lost revenue from suspended surgeries and procedures. That’s good news, given reports that hospitals—because of too low reimbursement rates—might lose an average of $2,800 per COVID patient and have to initiate layoffs within several months.

The bill also includes $16 billion for medical supplies, $11 billion to develop vaccines and diagnostic tests, $250 million to boost hospital capacity, and $275 million to expand capacity for rural hospitals. In addition, $200 million is earmarked for promoting telehealth. The House is expected to vote on the bill this week.

March 25, 2020

PPE: How to extend the use of N95s

N95 maskIn a new SHM Webinar, Joshua Case, MD, medical director of hospital medicine for Northwell Health in New York, discussed how health care personnel in his system—which is at the epicenter of the epidemic in this country—are extending the use of N95s appropriately and safely.

For one, hospitalists don’t need to use N95s all the time they’re in the hospital or with low-risk patients. Instead, all personnel wear surgical masks in the hospital all the time, as do all suspected or confirmed COVID patients when they’re not alone.

To extend N95 use with high-risk patients, Dr. Case said it’s OK to use the same N95 to go from patient to patient. (For added protection, personnel also put surgical masks over their N95s.) Between patients, perform hand hygiene, remove the gown and gloves you used with one patient, and don a new gown and gloves.

As for reuse, N95s can be stored in a paper bag or “breathable” plastic. How long can an individual N95 be used altogether? According to manufacturer recommendations, there is no specific time limit to N95 use, and the same mask can be used until it’s worn, dirty, damaged or tough to breathe in. In his system, Dr. Case said, they’re using N95s for up to a total of about 100 hours.

That is absolutely not the case when doing aerosolizing procedures such as intubations; in such cases, N95s must be thrown away. To limit the number of such procedures, the health system is no longer doing nebulizer treatments or BiPAP/CPAP. Obtaining a nasopharyngeal swab is not considered an aerosolizing procedure.

As for donning PPE, “use the buddy system,” said Dr. Case. “Have someone else check your equipment as you’re putting it on.” And even if patients are crashing, “always put your equipment on first. It’s like those airplane safety videos that tell you to put on your own oxygen mask before trying to help others.”

Other tips: To limit your exposure, limit your time with COVID patients and visit them only once a day. Take advantage of technology—any telehealth robots or in-room video cameras or tablets, even in-room telephones—for additional communication with patients.

As for making sure your N95 fits properly: Kiss the beards goodbye. “If you have facial hair,” said Dr. Case, “you need to shave.”

Survey finds PCP practices already reeling from COVID-19

A mid-March survey of more than 500 PCPs in 48 states finds that just over half of respondents were already saying that they face a lack of personal protective equipment (PPE); nearly half also reported that they had inadequate testing capabilities. About one-fifth (21%) of respondents reported that the pandemic was already having a “severe impact” on their groups, while 30% said the strain of the pandemic on their practice was “close to severe.” An article in FierceHealthcare says the survey found that physicians are dealing with staff illnesses and a flood of questions via the phone and e-mail. Practices are also reeling from the financial impact of cancelling face-to-face patient appointments and replacing them with lower-paying tele-visits. In related news, a survey of Chinese physicians who treated coronavirus patients found high rates of depression, anxiety, insomnia and distress.

Are these hospital hacks safe or not?

As hospital-based doctors brace for the impact of COVID-19, some have started coming up with workarounds to shortages of supplies. Baby monitors are being rigged to help keep clinicians from having to enter the rooms of infected patients in an effort to preserve personal protective equipment, for example, and physicians are looking at ways to share ventilators among more than one patient. But as an article in Medscape warns, not all hacks are necessarily safe. For a look at other hacks (and a review of the safety of at least one of them), see the article in Medscape.

March 24, 2020

Moving care from the hospital to the community

medical exam via telehealthIn a new NEJM perspective, Italian doctors a hospital in Bergamo—the epicenter of the outbreak in Italy where, the physicians write, they are “far beyond the tipping point”—argue that a new model of care must be devised to effectively fight the outbreak. Instead of patient-centered care that revolves around hospitals, community-centered models need to move much more treatment and surveillance out into the community.

What would such a model look like? One that relies on a comprehensive network of home care, mobile clinics, telemedicine, and the delivery of early oxygen, pulse oximeters, and nutrition to the homes of patients with only mild illness or those who are recovering.

Without those robust outpatient resources, the authors argue, hospitals such as their own—which they call “highly contaminated”—as well as medical transport and health care personnel will remain vectors of infection. “The more medicalized and centralized the society, the more widespread the virus.”

March 23, 2020

NY guv to hospitals: Expand capacity now

New York governor Andrew Cuomo this weekend outlined an aggressive emergency agenda to expand hospital capacity in his state. That state, he said in a Sunday briefing, had about 15 times more confirmed cases than any other.

While New York currently has 53,000 hospital beds, more than twice that number—110,000—are needed. To that end, he asked hospitals to devise plans to double their number of beds, and he mandated them developing plans to increase bed capacity by 50%. He also ordered suspending elective surgeries in the state as of Wednesday, discussed repurposing now-empty hotels and school dormitories to take care of patients, and said he was waiving all state regulations on licensed beds.

In the same briefing, the governor asked the Army Corps of Engineers to immediately begin building four temporary hospitals in the greater New York metropolitan area. He also asked FEMA to set up four field hospitals in Manhattan’s Jacob K. Javits Convention Center, each with a capacity of 250 beds.

As for stats on COVID-19: According to Gov. Cuomo, 13% of confirmed cases in the state have needed to be hospitalized.

And speaking of New York: CBS News on Friday reported that 1,000 retired health care workers in New York City volunteered over the course of 24 hours to come back to work.

What worked in Asia?

In a New Yorker article, Atul Gawande, MD, reports on how health care workers in some Asian countries treated COVID-19 patients while keeping themselves infection-free. The article holds out hope of preserving critically important equipment like N95s.

All health care workers in Hong Kong and Singapore wore surgical masks and gloves, practiced hand hygiene, and disinfected all surfaces between consults. Patients with tell-tale symptoms, known contact or a travel history were treated in separate clinics and wards. Doctors stayed six feet away from patients (except during exams) and from each other. N95s were used only for procedures, like intubations, that involved aerosols.

Each country also defined “close contact.” In Hong Kong, that meant spending 15 minutes at a distance of less than six feet without a surgical mask. (The definition was 30 minutes in Singapore.) When clinicians were exposed to suspected or positive patients within six feet for less than 15 minutes but more than two, they could stay on the job wearing a surgical mask and checking their temperature twice daily. Those with only brief contact monitored themselves for symptoms.

“Extraordinary precautions,” Dr. Gawande writes, “don’t seem to be required to stop it,” adding that hospital workers in those Asian countries were able to stay infection-free without strict quarantine policies.

March 20, 2020

“At war with no ammo”: tests, vents, swabs and PPE

male doctor wearing protective maskThis morning’s Johns Hopkins COVID-19 stats: 14,250 U.S. cases, 246,275 cases worldwide, 10,038 deaths worldwide. To address the shortage of doctors, the HHS this week announced that physicians will be able to practice across state lines.

Some health systems are figuring out a role for retired clinicians and medical students. While coronavirus testing is still in very short supply, some providers are suspending testing drive-thrus due to limited test supplies, including swabs, and to conserve tests for critically ill patients. Other systems have decided to preserve tests for high-risk patients and for health care workers.

To shore up hospitals’ stock of protective gear, the CMS this week recommended delaying all elective surgeries and non-essential medical and surgical procedures. Some innovative  hospitals are building simpler ventilators themselves.

An ED physician in Oregon launched the #GetMePPE hashtag, asking front-line providers to photograph themselves in protective gear and tag their federal officials and Congressional representatives.

Car companies offered to begin manufacturing respirators, while the department of defense this week said it will release 2,000 ventilators and five million masks to federal agencies. An ED physician in Detroit demonstrates how to modify a ventilator to accommodate two to four patients at a time. A California surgeon, with only a limited supply of respirator masks in the OR, had this description: “We’re at war with no ammo.” More than 600,000 health care workers have signed onto a letter asking the government, industry, media and general population to help immediately with supplies

Different predictions: How bad will it get?

Among many models released this week predicting possible pandemic outcomes, none contained good news. One model given a great deal of credibility was issued by Britain’s Imperial College. It predicted 2.2 million deaths in the U.S. if no containment or mitigation strategies were pursued, with aggressive mitigation measures cutting that mortality in half.

A Harvard analysis looked at several scenarios, weighing different infection rates across different timelines in the U.S. to gauge where—and how soon—hospitals could run out of beds. A health care analysis company this week also released its model of projected ICU bed shortages, breaking those down by state. According to those predictions, Seattle will hit its ICU capacity at the end of this month, with New York filling its ICU beds in the first week of April. Specialty hospitals, including Cancer Treatment Centers of America, and ambulatory surgery centers are offering to accept acute and critical care patients if hospitals are overwhelmed. The New York Times has compiled a list of bed shortages around the US.

How long does COVID-19 survive in air, on surfaces?

Experimental findings released this week indicate how long the coronavirus can survive in the air and on surfaces, results that have key implications for health care workers. Aerosolized virus (droplets smaller than 5 micrometers) can stay suspended in the air for a half hour before falling onto surfaces.

Such aerosols could infect clinicians who don’t have proper protections while intubating sick patients. Aerosolized virus and droplets could also land on protective equipment and be released into the air when that equipment is being removed. (In their experiments, researchers found that virus remained viable in aerosols for three hours.)

On surfaces, the virus can live the longest on both stainless steel and plastic—for 72 hours, although the amount of viable virus decreases over that time. The virus survives only four hours on copper and up to 24 hours on cardboard.

March 20, 2020

Analysis: Young adults aren’t immune

It’s been known for months that coronavirus is particularly dangerous for elderly patients, and a new CDC analysis of COVID-19 patients in the U.S. between Feb. 12 and March 16 bears that out. But the analysis also finds that the majority of coronavirus patients hospitalized in the U.S. so far—55%—were under age 65, with 20% between the ages of 20 and 44. (Eighteen percent were ages 45–54 and 17% were ages 55–64.) As for ICU admissions, 7% were among patients 85 or older, 46% among ages 65–84 years, 36% among ages 45–64 years and 12% among adults 20–44 years. Twenty percent of the deaths in the U.S. included in the analysis were among patients age 64 or younger.

March 13, 2020

Where are the tests?

With the World Health Organization this week announcing that coronavirus is now a global pandemic, Johns Hopkins yesterday reports that there are more than 127,800 cases worldwide and more than 4,700 deaths. The number of confirmed cases in the U.S. stands at 1,323—a figure assumed to be under-reported, given crippling delays in testing and in test shortages. Testing reports this week indicate that the U.S. has administered five tests per million people vs. 3,692 per million in South Korea.

The Cleveland Clinic announced yesterday that it had started testing for coronavirus in-house, one of perhaps only a dozen institutions in the country that can do so. Other labs in the U.S. worry about supply shortages, while doctors in Italy have <a href=>received guidelines on how to ration ICU beds and ventilators. An article in Annals details how hospitals should prepare to handle rising volumes and protect health care workers.

Hospitals race to get telemedicine up and running

woman docWith coronavirus bearing down, the Wall Street Journal reports that hospitals are scrambling to build—or expand—their telemedicine capacity as a potential tool for testing and monitoring COVID-19 patients. Part of what’s driving that rush is the need to allow nonclinical staff to work offsite. In addition to rising demand for telehealth vendors and software upgrades, some hospitals—including New York’s Mount Sinai—are developing coronavirus dashboards in their EHRs so that doctors and nurses can access all patient information related to screening, labs and images in one place. The $8.3 billion coronavirus relief legislation passed last week waives longstanding Medicare restrictions on paying for telemedicine, but challenges remain.

March 6, 2020

States of emergency

With California, Maryland and Washington declaring a state of emergency, coronavirus has now caused 12 deaths with more than 200 confirmed cases  in the U.S., and infections reported in 18 states. Internationally, there are nearly 100,000 cases and more than 3,300 deaths, with Johns Hopkins reporting that more than 53,600 patients have recovered from the virus. Both the House and Senate this week passed $8.3 billion in emergency coronavirus aid, with funds earmarked for state and local health departments and for telehealth services for Medicare beneficiaries, among other items.

An online survey done this week of 6,500 nurses found that only 29% reported that their hospitals had a plan to isolate potential coronavirus cases and only 44% had been given guidance on how to manage the virus. Only 30% felt their hospitals had enough protective gear for health care workers. The FDA has approved a policy allowing some labs to create and use their own coronavirus tests; the UW Medicine lab in Seattle, for instance, which covers the UW medical school and hospitals, is now processing 100 coronavirus tests a day, with the capacity to do up to 4,000 a day.

February 28, 2020

First case of community transmission

This week, the CDC reports 60 coronavirus cases in the U.S., 45 of whom were repatriated from either China or a cruise ship docked in Japan. The CDC also suspects that one patient in California may be the first case of community transmission in this country. Coronavirus has now spread to 47 countries outside China, with major outbreaks in South Korea, Italy and Iran. A CDC director this week urged Americans to prepare for a potential outbreak and noted that the CDC will send out modified versions of its faulty virus test kits to state and local governments and commercial labs.

Axios reports that the FDA is maintaining a list of about 150 drugs that might experience shortages if the outbreak worsens in China, a major supplier of raw pharmaceutical ingredients. Meanwhile, researchers are testing HIV medications against the virus as well as an experimental infusion first tested against Ebola, and Emory University plans to begin a trial on a nucleoside analog developed to treat flu. A JAMA infographic breaks down the numbers for COVID-19 and this year’s moderately severe flu season.

February 21, 2020

Panel warns hospitals to have a plan

With the disease toll in China standing at about 75,000 confirmed cases and 2,100 deaths, a new analysis finds that the novel coronavirus is more contagious than the viruses that cause MERS and SARS. Meanwhile, an expert panel at this week’s Society of Critical Care Medicine meeting warned hospitals to prepare now for a possible influx of COVID-19 patients by having a plan to identify and isolate patients as well as to collect and report data on cases.

Experts worry that in the event of an outbreak here, hospitals may run short of ECMO machines and ventilators. Analysts this week also warned that the current outbreak could disrupt the U.S. medical supply chain, which relies on products and components from China. The CDC has begun monitoring some patients with flu-like symptoms for COVID-19 in New York, Los Angeles, San Francisco, Chicago and Seattle. The CDC also released this reality check: This season, the flu has caused 250,000 hospitalizations in the U.S. and 14,000 deaths.

February 14, 2020

Cases in the United States

The CDC announced yesterday that it has confirmed the 15th coronavirus case in the U.S. That patient has been under quarantine in Texas since arriving on a flight from China earlier this month. Meanwhile, China revised up its number of coronavirus cases by 20,000 as the result of new diagnostic criteria that don’t rely on lab tests, according to the Washington Post. The new case total there is more than 63,000, with more than 1,300 deaths reported. That puts the coronavirus death toll higher than that of the 2003 SARS pandemic, although the CDC notes that the mortality rate associated with the novel coronavirus is less than that of SARS: 2% vs. 10%.

While the new virus’ mortality rate may be lower, experts believe it’s more easily transmitted. Researchers are optimistic that they may have a vaccine against the novel coronavirus by this fall. The virus has been given at least two official names: severe acute respiratory syndrome coronavirus 2 and COVID-19.

January 31, 2020

WHO declares coronavirus a global public health emergency

The World Health Organization yesterday declared that the coronavirus outbreak that originated in China is now a global emergency, with more than 8,000 cases reported worldwide. While most of those cases are in China, the virus has spread to many other countries including the U.S. The declaration escalates global response to the disease but leaves it up to individual countries to decide what protective measures to take, including whether to close their borders or screen airport passengers. As of Thursday, officials had confirmed the sixth case of coronavirus in the U.S., the first case in this country of clear human-to-human transmission.

January 24, 2020

Infectious diseases

The CDC has confirmed that a patient in Washington state is being treated for the 2019-nCoV coronavirus that broke out in China last month, making him the first patient in the U.S. with that diagnosis. The man had recently traveled to Wuhan province, the site of the outbreak in China where at least 17 deaths from the pneumonia-like disease have been reported.

While the CDC announced this week that it would begin screening passengers returning from Wuhan at several U.S. airports, Chinese authorities have since imposed travel restrictions on Wuhan and surrounding municipalities, covering about 25 million people. Cases have been detected around China as well as in Thailand, Japan, South Korea, Singapore and Vietnam, in addition to the U.S.

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