The Countdown to the restart of the economy has begun.

[Darren]

More plasma trial success:

"During the past week, nine patients came off ventilators and are breathing on their own again."

https://www.slhn.org/blog/2020/covid-19 ... llvEHoJL0Y

[Scooter]

"All the best people" was how Trump described who would staff his administration:

Special Report: Former Labradoodle breeder tapped to lead U.S. pandemic task force

WASHINGTON (Reuters) - On January 21, the day the first U.S. case of coronavirus was reported, the secretary of the Department of Health and Human Services appeared on Fox News to report the latest on the disease as it ravaged China. Alex Azar, a 52-year-old lawyer and former drug industry executive, assured Americans the U.S. government was prepared.

“We developed a diagnostic test at the CDC, so we can confirm if somebody has this,” Azar said. “We will be spreading that diagnostic around the country so that we are able to do rapid testing on site.”

While coronavirus in Wuhan, China, was “potentially serious,” Azar assured viewers in America, it “was one for which we have a playbook.”

Azar’s initial comments misfired on two fronts. Like many U.S. officials, from President Donald Trump on down, he underestimated the pandemic’s severity. He also overestimated his agency’s preparedness.

As is now widely known, two agencies Azar oversaw as HHS secretary, the Centers for Disease Control and Prevention and the Food and Drug Administration, wouldn’t come up with viable tests for five and half weeks, even as other countries and the World Health Organization had already prepared their own.

Shortly after his televised comments, Azar tapped a trusted aide with minimal public health experience to lead the agency’s day-to-day response to COVID-19. The aide, Brian Harrison, had joined the department after running a dog-breeding business for six years. Five sources say some officials in the White House derisively called him “the dog breeder.”

Azar’s optimistic public pronouncement and choice of an inexperienced manager are emblematic of his agency’s oft-troubled response to the crisis. His HHS is a behemoth department, overseeing almost every federal public health agency in the country, with a $1.3 trillion budget that exceeds the gross national product of most countries.

Azar and his top deputies oversaw health agencies that were slow to alert the public to the magnitude of the crisis, to produce a test to tell patients if they were sick, and to provide protective masks to hospitals even as physicians pleaded for them.

The first test created by the CDC, meant to be used by other labs, was plagued by a glitch that rendered it useless and wasn’t fixed for weeks. It wasn’t until March that tests by other labs went into production. The lack of tests “limited hospitals’ ability to monitor the health of patients and staff,” the HHS Inspector General said in a report this month. The equipment shortage “put staff and patients at risk.”

A promised virus surveillance program failed to take root, despite assurances Azar gave to Congress. Rather than share information, three current and three former government officials told Reuters, Azar and top staff sidelined key agencies that could have played a higher-profile role in addressing the pandemic. “It was a mess,” said a White House official who worked with HHS.

Officials across the government, from President Trump on down, have been blasted for America’s halting response to the pandemic. Critics inside and outside the administration say a meaningful share of the responsibility lies with HHS and Trump appointee Azar.

“You have to blame the problem on the virus, but it’s Azar’s operation,” said Lynn Goldman, the dean of the public health school at George Washington University, who has served on advisory boards of the FDA and CDC. “And the buck stops there.”

HHS declined to make Azar available for an interview. Michael Caputo, the new chief HHS spokesman, declined to answer Reuters questions about Azar’s stewardship, saying in a statement: “We are communicating to the American public during a deadly pandemic.”

Azar is a Republican lawyer who once clerked for the late conservative Supreme Court Justice Antonin Scalia and counts current Supreme Court Justice Brett Kavanaugh as a friend. Under George W. Bush, Azar worked for HHS as general counsel and deputy secretary. During the Obama years, he cycled through the private sector as a pharmaceutical company lobbyist and executive for Eli Lilly. After Trump’s first HHS secretary was forced out in a travel corruption scandal, Azar stepped in, in January 2018.

Two years later, at the dawn of the coronavirus crisis, Azar appointed his most trusted aide and chief of staff, Harrison, as HHS’s main coordinator for the government’s response to the virus.

Harrison, 37, was an unusual choice, with no formal education in public health, management, or medicine and with only limited experience in the fields. In 2006, he joined HHS in a one-year stint as a “Confidential Assistant” to Azar, who was then deputy secretary. He also had posts working for Vice President Dick Cheney, the Department of Defense and a Washington public relations company.

Before joining the Trump Administration in January 2018, Harrison’s official HHS biography says, he “ran a small business in Texas.” The biography does not disclose the name or nature of that business, but his personal financial disclosure forms show that from 2012 until 2018 he ran a company called Dallas Labradoodles.

The company sells Australian Labradoodles, a breed that is a cross between a Labrador Retriever and a Poodle. He sold it in April 2018, his financial disclosure form said. HHS emailed Reuters that the sales price was $225,000.

At HHS, Harrison was initially deputy chief of staff before being promoted, in the summer of 2019, to replace Azar’s first chief of staff, Peter Urbanowicz, an experienced hospital executive with decades of experience in public health.

This January, Harrison became a key manager of the HHS virus response. “Everyone had to report up through him,” said one HHS official.

One questionable decision, three sources say, came that month, after the White House announced it was convening a coronavirus task force. The HHS role was to muster resources from key public health agencies: the CDC, FDA, National Institutes of Health, Office of Global Affairs and the Assistant Secretary for Preparedness and Response.

Harrison decided, the sources say, to exclude FDA Commissioner Stephen Hahn from the task force. “He said he didn’t need to be included,” said one official with knowledge of the matter.

When task force members were announced January 29, neither Hahn nor the FDA were included. Hahn wasn’t put on the task force until Vice President Mike Pence took over in February. Two of Hahn’s high-profile counterparts were on it from the start: CDC director Robert Redfield and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

The HHS denied it was Harrison’s decision to leave out Hahn and the FDA, but declined to say who made the call. The agency lauded Harrison’s work on the task force.

In a statement, Hahn said the FDA was focused on the coronavirus epidemic, “not on when we were added to the task force,” and that the agency was not “excluded.”

Fauci, who has become a public face of the Trump Administration’s COVID-19 effort, said he wasn’t sure including the FDA was necessary at the start. Initially, the Chinese government was saying the virus spread through animals, not human to human, he said. “You would include the FDA when you want to expedite drugs or devices,” Fauci said.

Others said the lack of a strong FDA role early on had direct consequences. Two sources familiar with events say the White House wasn’t getting information from the FDA about the state of the testing effort, a crucial element of the coronavirus response.

Reached by phone, Harrison declined to answer Reuters’ questions. In a later statement, he did not address questions about the task force but said he was proud of his work history. “Americans would be well served by having more government officials who have started and worked in small family businesses and fewer trying to use that experience to attack them and distort the record,” he wrote.

In a statement to Reuters, Azar said Harrison has been an asset. “From day one, Brian has demonstrated remarkable leadership and managerial talents,” Azar wrote.

In the pandemic’s early days, Azar offered words of both concern and assurance in public. On January 31, a day after the WHO declared COVID-19 a global health emergency, Azar declared it a public health emergency.

That same day, during the first Coronavirus Task Force briefing, Azar told the public: “I want to stress: The risk of infection for Americans remains low.”

The United States, he said, had taken adequate precautions. Travel restrictions and 14-day quarantines on Americans who had been to Wuhan, where the virus originated, were imposed. Americans returning from other parts of China had to self-quarantine.

The next week, on February 7, in another press conference, Azar repeated the message. “The immediate risk to the American public is low at this time,” he announced.

Behind the scenes, his aides say, Azar had alerted the White House in early January, and then later that month spoke directly to the president. It is unclear exactly what Azar told the president, because transcripts are not available.

“There’s a lot of CYA going on,” said one senior administration official, who said Azar never spelled out that stockpiles of protective equipment might be inadequate or the tests were not working. “We were told the test was ready. That turned out to be flat-out wrong.”

Trump denied Azar sent out alarms. “@SecAzar told me nothing until later,” he tweeted earlier this month.

Meanwhile, Azar continued to say “the immediate risk” to Americans was low and that travel restrictions had worked. “So I think so far, our measures have been quite effective,” he told NPR on February 14.

Others were raising alarms. “It’s not so much of a question of if this will happen any more, but rather more of a question of exactly when this will happen,” Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, said at a February 25 news briefing.

Responding to Congressional concerns, Azar said HHS had launched a coronavirus surveillance system in five cities. The plan was to test patients who showed up with flu symptoms, to see if they actually were infected with the novel coronavirus.

But the system was either delayed or not implemented in the cities and now is seen by epidemiologists as irrelevant given the massive community spread and continued inadequate testing.

By the end of February, Azar sought more money to attack the crisis as he testified before Congress. “This is an unprecedented potentially severe health challenge globally, and will require additional measures,” he said.

Still, he assured senators his agency was in control. “We have enacted the most aggressive containment measures in the history of our country,” he said.

He again provided words of calm, appearing on Fox News. “But thanks to President Trump’s historically aggressive containment efforts, we’ve actually contained the spread of this virus here in the United States at this point,” he said February 25. “I think part of the message to the American people is we all need to take a bit of deep breath here.”

“The government is working on this. You’ve got the right people on this.”

By the end of February, Azar and Harrison were no longer running the White House task force. That month, Vice President Pence took control. The FDA and Hahn are now actively involved. A Pence spokesperson said the issue of precluding the FDA from the task force “pre-dates the VP’s leadership” and declined further comment.

Azar seemed caught off guard by the change. “I’m still chairman of the task force,” he told the press after Pence took over.

Given Azar’s early struggles, the White House should have taken a stronger role over the task force from the outset, said Ashish Jha, director of Harvard University’s Global Health Institute. “It was very clear that Azar wasn’t able to marshal the forces across the government like he needed to,” he said.

Jeffrey Flier, a former Harvard Medical School dean, said the HHS role remains as vital as ever. As of Wednesday, over 47,000 Americans have died of COVID-19, and more than 830,000 have been infected.

“Clearly there was a need for better coordination of the FDA and CDC and other agencies,” he said. “HHS has to be operating effectively in a crisis like this.”

[Darren]

"In coordination with the U.S. Food and Drug Administration (FDA), the Red Cross is seeking people who are fully recovered from the new coronavirus to sign up to donate plasma to help current COVID-19 patients."

https://www.redcrossblood.org/donate-bl ... ients.html

[Darren]

April 8th

"Arturo Casadevall and collaborators at Johns Hopkins and beyond have worked around the clock to develop a convalescent serum therapy to treat COVID-19 using blood plasma from recovered patients. If early promising studies on the therapy done in China are confirmed by U.S. trials, thousands of survivors might soon line up to donate their antibody-rich plasma. "I absolutely think this could be the best treatment we have for the next few months," Hopkins pathologist Aaron Tobian says."

https://hub.jhu.edu/2020/04/08/arturo-c ... a-profile/

[Scooter]

Jim Wright

Trump: "Special care is, and always will be, given to our beloved seniors..."

Imma stop you right there.

Which seniors? What special care? What are the guidelines? Who issued them? How were they decided? Who enforces it? Who provides the funding? What's the plan and is it uniform across all states and fully funded and ... well, I have some questions.

Special Care? Show your work.

Let's see it.

Yeah, while you gather your notes, let's take a look at HOW this works in, oh for example, Las Vegas.

https://www.rollingstone.com/politics/p ... w3VAnYeiMs

Las Vegas Mayor, Carolyn Goodman, in an interview with MSNBC's Katy Tur, said, "My whole opinion is: get our people back to work ... Most importantly, take care of our elderly, who are the most susceptible to having a terrible experience or perhaps even dying. And we love our seniors. I happen to be a senior!”

Okay. Sounds ... good. I guess. Except, most susceptible to having a terrible experience?

A terrible EXPERIENCE?

Yeah, I'd say dying of the fucking plague would be a terrible experience. Probably.

But, maybe we should cut her some slack on the wording. Maybe she's got a good plan. Yeah. Okay. So, Tur asked Goodman HOW she would safely reopen Vegas businesses. Businesses that specifically require as their business model large groups of people to be in close quarters, breathing common air, touching gambling equipment, and doing the kinds of things that people do in a casino.

Goodman answered, "We’ve survived the West Nile and SARS, bird flu, E. coli, the swine flu, the Zika virus.”

Uh, what?

Those diseases weren't pandemics in the sense that COVID 19 is, but even so the lesson of those diseases is that you DON'T reopen businesses that require close contact among people. Until there is adequate testing, vaccines, and treatment.

Tur: "Those were not as contagious, and they did not spread as far as this disease has already done.”

To which Goodman shrugged and said, “Well, we’ll find out the facts afterward. Unfortunately, we all do better in hindsight.”

We will find out the facts AFTERWARD?

AFTERWARD?!

If a lot of people get infected and die, we'll maybe do better next time.

Goodman, who literally learned nothing from previous disease outbreaks Q.E.D, is now promising us she'll do better next time with the hindsight of our deaths.

But, this person? Right? SHE's the one who's going to keep seniors "safe."

Okay then.

Goodman claimed she was following Dr. Faucci's recommendations -- then proceeded to demand exactly the opposite. “I am making the assumption that everybody’s a carrier. So let’s go forward, open up the city, open up whoever wants to but do it in a very responsible, cautious way.”

I repeat myself: WHAT?

Everybody is already infected? That's the assumption. Everyone is already infected. I mean, if you assume everybody is a CARRIER, then by definition EVERYBODY HAS THE DISEASE and thus can't get any more infected.

Which is completely and utterly WRONG.

But it gets even more insane.

Goodman continued, "Assume everybody is a carrier. And then you start from an even slate. And tell the people what to do. And let the businesses open and competition will destroy that business if, in fact, they become evident that they have disease, they’re closed down. It’s that simple.”

"Assume everybody is a carrier?" Wrong.

Wrong. Wrong. Wrong. You're wrong.

"Start from an even slate?" What the hell does that even mean? What does that mean in context? First of all, it's not true. Second, even if everybody WAS infected, the disease progresses differently in every case AND it turns out having recovered from the virus may not confer any immunity at all. We're seeing people REINFECTED. There's no even slate, the fuck is she even talking about?

"Tell people what to do?" No shit, Lady. We're telling you to stay home. Except you're not listening and you're using your office to encourage other people not to listen.

"Let businesses open and competition will destroy that business if they become evident that they have disease" and WHAT THE ACTUAL FUCK ARE YOU EVEN TALKING ABOUT?

This is the ultimate conclusion of libertarianism and the magic free market fairies, right here.

No government. No regulations. Survival of the fittest. Let business kill people and eventually "the Free Market (dunt dunt DAAAAHHH!) will shut that business down.

Sure. Except that NEVER happens.

The Free Market Fairies are the most pernicious myth of libertarianism. It's absolute and complete bullshit. Business has been cheerfully killing people as its business model for thousands of years. Killing people is profitable. NOT killing people costs the shareholders money. Not polluting, not dumping your waste in the river, not lying about the benefits of your product, not cheating your customers, not bankrupting your investors, making quality products that don't poison people or electrocute them or choke children or burn their houses down, all of that costs businesses profit. And never once, not one goddamned time ever, has the free market done a fucking thing to stop it. EVER.

It is just the opposite, in point of provable fact.

The only thing that prevents business from killing you is GOVERNMENT.

Except, of course, when government itself is trying to kill you.

Seniors aren't going to be taken care of. Neither are not-seniors. There isn't any plan. There aren't any guidelines. There isn't anybody keeping any eye on things. They can't show you their work, because they haven't done any.

Listen to me: when you elect business run your government like a business, well then, Folks, what you're going to get IS the business.

And you're going to get it good and hard.

[Scooter]

Furious Donald Trump throws tantrum after CDC boss directly contradicts him at White House press conference - after President claimed second wave danger was 'fake news' and that coronavirus 'might not come back at all'

President Donald Trump on Wednesday raged about the coverage of CDC Director Robert Redfield's interview with The Washington Post, where the medical expert warned about the dangers of a second wave of the coronavirus.

Trump brought Redfield to the White House podium to repudiate the interview only for the CDC director to confirm the newspaper correctly quoted his warning.

The farce took place at the daily White House press briefing on the coronavirus and was sparked by Redfield telling The Washington Post that a second wave of the coronavirus this winter, combined with flu season, 'will actually be even more difficult than the one we just went through.'

The newspaper ran the interview under the headline: 'CDC director warns second wave of coronavirus is likely to be even more devastating.'

Trump was furious at the coverage of Redfield's comments - several news outlets, including DailyMail.com, wrote stories on the CDC director's warning - calling the articles 'inaccurate.' He snapped at reporters who asked about the warning and whether Redfield was accurately quoted.

The president brought Redfield before the White House press corp to explain what he said in the interview, only for the CDC director to confirm he was accurately quoted. Redfield did say the headline on the Post's story was 'inappropriate.'

'I think it's really important to emphasize what I didn't say,' Redfield said. 'I didn't say this was going to be worse, I said it was going to be more difficult and potentially complicated because we'll have flu and coronavirus circulating at the same time.'

Trump then jumped in to complain his CDC director was misquoted.

'He was totally misquoted. He said they could come together, they didn't talk about that and his whole purpose in making the statement was to get a flu shot so that next fall, we don't have such a big season of flu and we possibly won't,' the president said.

Redfield went on to clarify what he said in his interview with The Post, which was also essentially what he told the newspaper.

'Next fall and winter, we are going to have two viruses circulating and we are going to have to distinguish between which is flu and which is coronavirus - the spirit of the comment that I made is more difficult. It doesn't mean it's impossible, it doesn't mean it's going to be worse, it's just going to be more difficult because we have to distinguish between the two,' he said.

Redfield's warning in the interview with The Post was clear and essentially what he said in the briefing.

'There's a possibility that the assault of the virus on our nation next winter will actually be even more difficult than the one we just went through,' he told the newspaper. 'And when I've said this to others, they kind of put their head back, they don't understand what I mean.'

'We're going to have the flu epidemic and the coronavirus epidemic at the same time,' is what he told The Post.

ABC's Jonathan Karl asked Redfield at the White House briefing if he was accurately quoted.

'I'm accurately quoted in The Washington Post as difficult, but the headline was inappropriate,' Redfield said.

Karl read the headline: 'The headline says CDC director warned second wave of coronavirus is likely to be even more devastating.'

President Trump stepped to say: 'That's not what he said.'

Another reporter asked Redfield why he retweeted The Washington Post article.

'You weren't called on,' Trump told the reporter.

The president then took the podium back to declare the coronavirus may not come back this winter.

'It might not come back at all. He's talking about a worst-case scenario where you have a big flu and you have some Corona,' Trump said.

He added if it did return 'it's not going to be like it was. We have much better containment now, before nobody knew about it. Now if we have a little pocket here, we're going to have it put out, we're going to put it out fast. It's also possible it doesn't come back at all.'

But Dr. Anthony Fauci repudiated what Trump said, saying he was 'convinced' the coronavirus would come back this fall.

'What Dr. Redfield was saying, first of all, is that we will have coronavirus in the fall. I am convinced of that,' he said during his turn at the podium.

'What happens with that will depend on how we are able to contain it when it occurs. What we are saying is that in the fall, we will be much, much better prepared to do the kind of containment compared to what happened to us this winter,' he noted.

He added that 'it's going to get complicated by the influenza season. I believe that's what Dr. Redfield was saying. It's going to be complicated. So whether or not it's going to be big or small is going to depend on our response. And that's what I think people sometimes have misunderstanding. Nobody can predict what is going to happen within outbreak, but you can predict how you're going to respond to it.'

The White House was quick to react after The Post published its interview with Redfield, complaining his quotes were misinterpreted.

New White House press secretary Kayleigh McEnany said he was advising people to get a flu shot.

'I was on the phone with him just before I walked out here. The main stream media has been taking him out of context as they so often do with Trump administration officials. What he was trying to say was this: Everyone get your flu shot,' she told Fox News Wednesday in an interview conducted from the White House.

'That's what he was saying but leave it to CNN and some of the other networks to really take those comments out of context,' she added.

Redfield told The Washington Post in an interview on Tuesday that a second wave of the coronavirus, combined with the regular flu season, could be devastating for the country.

CNN and other news outlets wrote up his comments given their high news value and interest to the public.

The White House, however, has pushed back at what he said.

President Donald Trump also claimed Redfield's quote was taken out of context.

'CDC Director was totally misquoted by Fake News @CNN on Covid 19. He will be putting out a statement,' the president tweeted.

Redfield ended up coming to the daily press briefing at the White House instead of putting out a statement.

His warning in the interview with the Post was clear.

'There's a possibility that the assault of the virus on our nation next winter will actually be even more difficult than the one we just went through,' he said. 'And when I've said this to others, they kind of put their head back, they don't understand what I mean.'

'We're going to have the flu epidemic and the coronavirus epidemic at the same time,' he said.

Redfield also retweeted the Washington Post's tweet on his interview, which contained the headline: 'CDC director warns second wave of coronavirus this winter will be worse.'

In the interview, he warned the dual trenches of illness could overwhelm the healthcare system. The United States has more than 850,000 cases of the coronavirus and more than 48,000 deaths.

And Redfield reiterated 'the enormous impact' social distancing has 'had on this outbreak in our nation'.

He said guidance for reopening states 'will be in the public domain shortly.'

The CDC is looking to hire more staff, Redfield said, as 'contact tracers'.

They alert people who may have come in contact with someone who tested positive for the virus so they can self-quarantine or be tested themselves.

But Redfield also urged Americans to get the flu vaccination which 'may allow there to be a hospital bed available for your mother or grandmother that may get coronavirus.'

He said that if flu and corona had peaked at same time 'it could have been really, really, really, really difficult in terms of health capacity.'

[Bicycle Bill]

Has it occurred to you the big Democrat controlled cities are seeing the highest death tolls while the rural areas that supported Trump aren't seeing much?

Population density, Darren.  I live in what could be called a rural environment, and when there's only five hundred people in town it's easy to keep your distance.
Wait until those rural rednecks are allowed to go back to their village taverns, their NASCAR races, and their tractor pulls.

-"BB"-

[Darren]

"Pa. Gov. Tom Wolf announced Wednesday that construction projects can restart before the state begins to reopen amid the coronavirus pandemic.

Wolf said that construction that was previously deemed non-essential can begin on May 1, even though his phased red, yellow, green plan to start lifting parts and eventually all of the statewide stay at home order on a county-by-county basis won’t begin until at least May 8."

https://www.pennlive.com/news/2020/04/c ... 1jSJmnLVts

[Darren]

Has it occurred to you the big Democrat controlled cities are seeing the highest death tolls while the rural areas that supported Trump aren't seeing much?

Population density, Darren.  I live in what could be called a rural environment, and when there's only five hundred people in town it's easy to keep your distance.
Wait until those rural rednecks are allowed to go back to their village taverns, their NASCAR races, and their tractor pulls.

-"BB"-

The electoral system isn't going away.

[Scooter]

[Scooter]

‘They’re Coming Back To The Hospital Sicker’: Boston ER Doctor Seeing Repeat Coronavirus Hospitalizations

BOSTON (CBS) – A Boston emergency room doctor working on the front lines to fight the coronavirus epidemic says his hospital is seeing a new trend – repeat patients.

Dr. Jon Santiago, who is also a state representative, works in the ER at Boston Medical Center. While Massachusetts is in the midst of its surge in cases, Dr. Santiago said that from what he’s seeing, protocols put in place to flatten the curve are helping.


When we spoke with him two weeks ago, Santiago told us that BMC briefly ran out of ICU beds during a spike in admissions and homeless patients. He said that is not the case right now, and there are ICU beds open. However, some of those earlier patients are now coming back.

“Over the last week we’ve seen an interesting phenomenon where people who’ve been initially diagnosed a week ago, they’re coming back to the hospital sicker and often requiring a ventilator or the ICU,” Santiago told WBZ. “That just demonstrates how insidious the virus can be.”

This weekend he will be assigned to work in the Boston Hope field hospital at the Boston Convention and Exhibition Center, where he said there are currently 40 to 50 COVID-19 patients.

[Darren]

Wow! Did someone not get the memo viruses mutate and big cities are incubators?

[Scooter]

In New York’s largest hospital system, 88 percent of coronavirus patients on ventilators didn’t make it

Throughout March, as the pandemic gained momentum in the United States, much of the preparations focused on the breathing machines that were supposed to save everyone’s lives.

New York State Gov. Andrew M. Cuomo (D) and President Trump sparred over how many ventilators the state was short. DIYers brainstormed modifications to treat more patients. And ethicists agonized over how to allocate them fairly if we run out.

Now five weeks into the crisis, a paper published in the journal JAMA about New York State’s largest health system suggests a reality that like so much else about the novel coronavirus, confounds our early expectations.

Researchers found that 20 percent of all those hospitalized died — a finding that’s similar to the percentage who perish in normal times among those who are admitted for respiratory distress.

But the numbers diverge more for the critically ill put on ventilators. Eighty-eight percent of the 320 covid-19 patients on ventilators who were tracked in the study died. That compares with the roughly 80 percent of patients who died on ventilators before the pandemic, according to previous studies — and with the roughly 50 percent death rate some critical care doctors had optimistically hoped when the first cases were diagnosed.

“For those who have a severe enough course to require hospitalization through the emergency department it is a sad number,” said Karina W. Davidson, the study’s lead author and a professor at the Feinstein Institutes for Medical Research at Northwell.

The mortality rates in the JAMA study only include patients who died or were discharged. About half of patients treated during the period of the study were still hospitalized when the analysis was conducted so their final outcomes were unknown.

The analysis is the largest and most comprehensive look at outcomes in the United States to be published so far. Researchers looked at the electronic medical records of 5,700 patients infected with covid-19 between Mar. 1 and Apr. 4 who were treated at Northwell Health’s 12 hospitals located in New York City, Long Island, and Westchester County — all epicenters of the outbreak. Sixty percent were male, 40 percent female and the average age was 63.

“It’s important to look to American data as we have different resources in our health care system and different demographics in our populations,” Davidson said.

The paper also found that of those who died, 57 percent had hypertension, 41 percent were obese and 34 percent had diabetes which is consistent with risk factors listed by the Centers for Disease for Control and Prevention. Noticeably absent from the top of the list was asthma. As doctors and researchers have learned more about covid-19, the less it seems that asthma plays a dominant role in outcomes.

One other surprising finding from the study was that 70 percent of the patients sick enough to be admitted to the hospital did not have a fever. Fever is currently listed as the top symptom of covid-19 by the CDC, and for weeks, many testing centers for the virus turned away patients if they did not have one.

Davidson said that as a result of that findings, Northwell is encouraging people with underlying health conditions, such as hypertension and diabetes, who are potentially exposed to the virus and who might not have a fever to consult with a doctor sooner rather than later.

[Darren]

The fever is mild if it presents. The key is O2 levels. When you drop below 93% you're in trouble. IIRC down below 40% you're pretty much screwed because the red blood cells can longer do their job,

[Big RR]

Not always, the fever can often spike quite high (my own briefly exceeded 103), and it is best not to treat it if possible (that was the only time I took acetaminophen, and only one dose) to allow the body's immune system to mobilizie--monitoring temperature is important; monitoring blood O2 levels is also key. It depends how badly your lungs get attacked, which also depends the state of your lungs (and other physical parameters) before.

[Darren]

It depends on whether your bone marrow can crank out enough new red blood cells to replace the damaged ones while your immune system produces antibodies to kill the virus. If either your bone marrow or immune doesn't work as fast as needed and medical intervention doesn't buy you the time needed for those to work you're DRT.

[BoSoxGal]

I've been reading and watching YouTube videos put out by doctors who are treating the virus in the field; more and more are discussing concerns that traditional ventilation therapy as utilized for ARDS isn't working well for covid19 patients - the hypoxia is so great that the ventilation pressures they are having to utilize are among the highest available and ultimately this damages the lungs while not being successful in raising O2 sats reliably. There is something very weird about how this virus operates in the body; I hope they figure it out soon. I'm sure the doctors are devastated knowing that the therapies they are using are in many cases causing additional harm and a higher fatality rate than they would normally see in ARDS. It sounds like ECMO might be the better approach, but I can't help but wonder where that would put us - I suspect there are far fewer ECMO devices available than ventilators in our hospital systems.

[Darren]

I've been reading and watching YouTube videos put out by doctors who are treating the virus in the field; more and more are discussing concerns that traditional ventilation therapy as utilized for ARDS isn't working well for covid19 patients - the hypoxia is so great that the ventilation pressures they are having to utilize are among the highest available and ultimately this damages the lungs while not being successful in raising O2 sats reliably. There is something very weird about how this virus operates in the body; I hope they figure it out soon. I'm sure the doctors are devastated knowing that the therapies they are using are in many cases causing additional harm and a higher fatality rate than they would normally see in ARDS. It sounds like ECMO might be the better approach, but I can't help but wonder where that would put us - I suspect there are far fewer ECMO devices available than ventilators in our hospital systems.

There was a paper that said the virus destroys the red blood cells' O2 transport capability. The link references the study.

https://www.thailandmedical.news/news/m ... al-protoco

[Darren]

"The results of clinical trials are making their way to publication showing hydroxychloroquine to be effective in many, although possibly not all, situations. The American media is silent on these studies. Instead, the American media headlined a non-experimental and biased study showing the drug to be ineffective and, even, a cause of death."

https://www.heartland.org/news-opinion/ ... ican-media

[MajGenl.Meade]