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*** OFFICIAL *** COVID-19 CoronaVirus Thread. Fresh epidemic fears as child pneumonia cases surge in Europe after China outbreak. NOW in USA (11 Viewers)

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That's almost a million tests a day if you roll out the per capita there across the US.  I'd sign up for that in a heartbeat.
My math gives me under 700,000 each week (assuming the same capabilites are available all over the country)

 
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Kind of makes the CDC and WHO’s early guidance saying not to wear masks look really really bad.
It's the daily mail. I'm not saying face masks aren't helpful, but their new cases were headed down anyway due to bans.  The 90% is inflammatory internet headline stuff.  

Masks are helpful, but they are using masks AND quarantines.  I think that's important as many people seem to think we can just open it all back up and wear masks.  The above headline would give someone that impression.

 
"They" are TX hospitals, and while they are taking the precautions that they have to.... no, no they are not.

I can't speak from any other perspective than surgeons and trauma and supply chain and OR staff.

All now more worried about how to schedule and handle the flood of backlogged cases while jumping through whatever hoops they have to for covid.  Covid precautions are a reality, and they will jump through these hoops to be able to address their primary concern - patients that have been denied care or given sub standard of care for the last month.

eta - ~100 people hospitalized in san antonio for covid total.  25 major hospitals, 300+ total hospitals shut down.  
How many tests per day is San Antonio performing?  What are the results of those tests?

 
Just curious about this legal question.  I understand that any replies to this post should not be viewed as legal advice.

Employee A calls in sick mentioning flu-like symptoms.  Employer tells the employee to stay home for a few weeks.  Employer then tells Employee A's co-workers that Employee A is out sick with flu-like symptoms.

Has employer violated any of Employee's A's health privacy rights?  

 
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Just curious about this legal question.  I understand that any replies to this post should not be viewed as legal advice.

Employee A calls in sick mentioning flu-like symptoms.  Employer tells the employee to stay home for a few weeks.  Employer then tells Employee A's co-workers that Employee A is out sick with flu-like symptoms.

Has employer violated any of Employee's A's health privacy rights?  
From the EEOC website:

A. Disability-Related Inquiries and Medical Exams

A.1.  How much information may an employer request from an employee who calls in sick, in order to protect the rest of its workforce during the COVID-19 pandemic? (3/17/20)

During a pandemic, ADA-covered employers may ask such employees if they are experiencing symptoms of the pandemic virus. For COVID-19, these include symptoms such as fever, chills, cough, shortness of breath, or sore throat. Employers must maintain all information about employee illness as a confidential medical record in compliance with the ADA.

https://www.eeoc.gov/eeoc/newsroom/wysk/wysk_ada_rehabilitaion_act_coronavirus.cfm

So if your company is covered by ADA the EEOC considers it a violation of confidentiality 

 
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Work slowing down...first down to 36 hours max.  Now 20ish (unless you have billable work) & supplement with PTO.  After that I am guessing its furlough time maybe even layoffs.

So, how does insurance work if you get furloughed?

 
Seems like the most opportune time to make strides in completing road construction/repairs.  Especially in places like here in Michigan where they are so bad.  Seems that activity has social distancing built in, not many vehicles on the road, good for road construction workers to get a paycheck.  Governor "Fix the Damn Roads" Whitmer, I assume, has funds set aside to do this since this was her main campaign platform.  What am I missing?

 
Seems like the most opportune time to make strides in completing road construction/repairs.  Especially in places like here in Michigan where they are so bad.  Seems that activity has social distancing built in, not many vehicles on the road, good for road construction workers to get a paycheck.  Governor "Fix the Damn Roads" Whitmer, I assume, has funds set aside to do this since this was her main campaign platform.  What am I missing?
💰 💰 💰

 
Seems like the most opportune time to make strides in completing road construction/repairs.  Especially in places like here in Michigan where they are so bad.  Seems that activity has social distancing built in, not many vehicles on the road, good for road construction workers to get a paycheck.  
Sometimes, but not always. Road crews never let up locally. Yesterday afternoon, I saw a crew of maybe eight guys all standing/sitting in close proximity of one another. I don't know if they were waiting on something or what. Was really surprised that at least the ones idle at that moment didn't take a few steps away (they were on the side of a road in a retail area, could've milled around in the adjacent empty parking lot).

 
From the EEOC website:

A. Disability-Related Inquiries and Medical Exams

A.1.  How much information may an employer request from an employee who calls in sick, in order to protect the rest of its workforce during the COVID-19 pandemic? (3/17/20)

During a pandemic, ADA-covered employers may ask such employees if they are experiencing symptoms of the pandemic virus. For COVID-19, these include symptoms such as fever, chills, cough, shortness of breath, or sore throat. Employers must maintain all information about employee illness as a confidential medical record in compliance with the ADA.

https://www.eeoc.gov/eeoc/newsroom/wysk/wysk_ada_rehabilitaion_act_coronavirus.cfm

So if your company is covered by ADA the EEOC considers it a violation of confidentiality 
But the employer can ask for the employees' permission to share Covid symptom self-diagnosis and self-quarantine and share IF the employee provides approval to do so, right?

 
Your fourth point really is the crux of the issue.  This is an impossible puzzle to solve - fighting the spread of this disease vs. financial ruin for many.  Then when you start factoring in things like lives saved unrelated to COVID (accidents) and the good we are doing with the environment it gets even more complex.  I'm hoping for states like my own (Georgia) which seems to be rushing things, that your fifth point helps mitigate disaster.  It does seem like we have to accept some level of risk here and most people, including myself, are risk averse.  I think the risk we live with day in and day out we are ignoring to a degree when now faced with this new risk that didn't exist 3 months ago.  I plan to keep my family indoors for as long as I can to where I can begin to accept the risk.  I'm not there yet.
Georgian by birth, I'm pretty embarrassed by their leadership. Of the states making arbitrary reopening designations, they seem the most ripe to have a bigger outbreak.

 
Seems like the most opportune time to make strides in completing road construction/repairs.  Especially in places like here in Michigan where they are so bad.  Seems that activity has social distancing built in, not many vehicles on the road, good for road construction workers to get a paycheck.  Governor "Fix the Damn Roads" Whitmer, I assume, has funds set aside to do this since this was her main campaign platform.  What am I missing?
Perfect time to do this sort of thing, particularly with interest rates essentially at zero.

 
State polls starting to back up the national findings:  Biden leading Trump by +8% in Michigan and PA, largely on the back of improving numbers with older voters.  (FOX News poll)

Maybe he can stand in the middle of 5th Ave and shoot someone but apparently if he's shooting at you it doesn't sit very well.

 
How many tests per day is San Antonio performing?  What are the results of those tests?
I can't tell you how many folks are being tested. However, Bexar County, where SA resides, has been having about 50 new reported cases a day or less. We only have 24 people on ventilators (as of yesterday at 6:00 p.m.). Overall, I've been pretty pleased with how our local Mayor has handled this as it seems to be effective so far.

 
These deaths seem puzzling and I cannot find much about them. Did they test 1000 bodies and come up with 2 positive, or just 2? How come if the virus was present, there was not a large spread then? Were those people just hermits? CA should have had a lot of people infected mid/late February if these people had it then. (Not asking you, just thinking outloud)

 
How many tests per day is San Antonio performing?  What are the results of those tests?
I can't tell you how many folks are being tested. However, Bexar County, where SA resides, has been having about 50 new reported cases a day or less. We only have 24 people on ventilators (as of yesterday at 6:00 p.m.). Overall, I've been pretty pleased with how our local Mayor has handled this as it seems to be effective so far.
No offense, but unless you know how many tests you are administering, the comment of "50 new reported cases" is virtually meaningless.

 
How many tests per day is San Antonio performing?  What are the results of those tests?
I can't tell you how many folks are being tested. However, Bexar County, where SA resides, has been having about 50 new reported cases a day or less. We only have 24 people on ventilators (as of yesterday at 6:00 p.m.). Overall, I've been pretty pleased with how our local Mayor has handled this as it seems to be effective so far.
I wonder what factors, in general, have been sparing Texas of a major outbreak? I understand it is a huge state that's probably 90+% rural by land area ... but Dallas-Fort Worth is a major airline hub (how about Houston?). Houston has always had a ton of business travelers.

 
So I'm reading something this morning about wide spread testing and some models want to test 30 million Americans/week, while other models want to test 20 million Americans/day.  I'm showing the entire WORLD has run about 22 million tests over the past 2 months, how are we going to do this in one day?  I mean just the logistics and personal required to accurately run that type of tests would be remarkable and I don't see we have a test quick enough to do this anytime this soon if not before a vaccine is developed.  Maybe just being pessimistic here, but these numbers seem ideal in a vacuum but unrealistic, no?
What we need is a self-administered rapid test, akin to urine pregnancy screening. The problem is urine doesn't harbor the virus, so blood is the next best option - maybe a finger #####, like a glucometer would work? I also saw something promoting sputum samples.

Short of that, I don't see us ramping up testing supply and processing capabilities to the multimillion/week level anytime soon.

 
What we need is a self-administered rapid test, akin to urine pregnancy screening. The problem is urine doesn't harbor the virus, so blood is the next best option - maybe a finger #####, like a glucometer would work? I also saw something promoting sputum samples.
News of a saliva test was posted in this thread in recent days.

EDIT: Here's an NYT article about a home nasal swab test. I read something about an "easy" nasal swab test that only requires going a little ways up the nostril ... I wonder if this home test is that test.

 
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A more recent article about saliva testing for coronavirus (CNBC, 4/21/2020). Needs corroboration and more testing, I am sure. Article highlights:

* A new study found that testing saliva for coronavirus infections gives results that are at least as accurate as nasal swabs, which are much more commonly used in Covid-19 screening.

* Yale University researchers said their findings suggest that saliva samples could be used for at-home coronavirus tests on a large scale nationally.

 
I wonder what factors, in general, have been sparing Texas of a major outbreak? I understand it is a huge state that's probably 90+% rural by land area ... but Dallas-Fort Worth is a major airline hub (how about Houston?). Houston has always had a ton of business travelers.
The fact that Texas and Florida aren't being impacted is what makes me wonder if there's something to the warm weather thing.  I know it arrived there later than WA, CA, NY -- but still seems like cases there are light given the major population centers.

 
I wonder what factors, in general, have been sparing Texas of a major outbreak? I understand it is a huge state that's probably 90+% rural by land area ... but Dallas-Fort Worth is a major airline hub (how about Houston?). Houston has always had a ton of business travelers.
The fact that Texas and Florida aren't being impacted is what makes me wonder if there's something to the warm weather thing.  I know it arrived there later than WA, CA, NY -- but still seems like cases there are light given the major population centers.
Relative lack of public transportation has to be a factor, too. So far as I'm aware, big Texas cities (metro areas for sure) are totally car-based.

 
Newsom

Adding 86 test sites to rural and underserved (black, brown, poor) areas in CA.

Thousands have responded to the call of helping. Healthy volunteers ready to help by getting trained to do what a non professional can do. People are calling elderly to check on them. 

Covid19.ca.gov has resources available broken out like for the elderly,  lgbtq, young, etc. 

Effective today, important procedures can resume. Hospitalisation and ICU graphs remain flat. Surgeries that if not done could lead to bigger problems like tumour removal, heart valve.... Cosmetic plastic surgery is a no.

I forgot the testing numbers part. Took a nap after his presser. But pretty much same ole. No date. Going by data and science. Health first in every decision. We should be getting 100k swabs from the feds end of this week, 250k next week and more the following. That's one piece. The reagent, lab capacity, turn around, etc are just as key in having in place for testing to succeed. 

Wednesdays will be the update on the 6 issues before easing restrictions but restrictions can toggle on any day depending on what they see.

 
Non-China Reported Cases

2/7 - 277 reported cases

3/9 - 33,303 reported cases - 881 dead - USA 628 cases - 26 dead

4/6 - 1,264,826 reported cases - 71,366 dead - USA 367,004 cases - 10,871 dead

4/9 - 1,521,741 reported cases - 92,380 dead - USA 468,566 cases - 16,691 dead - Active USA cases 425,947

4/15 - 2,000,963 reported cases - 131,275 dead - USA 644,089 cases - 28,529 dead - Active USA cases 566,859

4/16 - 2,098,400 reported cases - 142,109 dead - USA 677,180 cases - 34,605 dead * - Active USA cases 585,181

4/17 - 2,166,751 reported cases - 149,573 dead - USA 709,735 cases - 37,154 dead - Active USA cases 612,071

4/20 - 2,397,756 reported cases - 165,765 dead - USA 792,759 cases - 42,514 dead - Active USA cases 677,856

4/21 - 2,473,760 reported cases - 172,980 dead - USA 818,744 cases - 45,318 dead - Active USA cases 690,503

4/22 - 2,550,276 reported cases - 179,251 dead - USA 846,692 cases - 47,537 dead - Active USA cases 715,177

https://docs.google.com/spreadsheets/d/1-J_vry7rclLIGooJ-Cu7OFH8rRRjB51lz1iGkwcTETc/edit#gid=0

Past 700k active cases

Also, the raw CFR just ticked over 7% for the first time.

 
Good lord that Santa Clara study is REEEEAAAALLLLLY popular on Facespace today... and EVERYBODY is an expert and thinks the people blowing it up are Fake News   :lol:   

 
These are PCR tests...they aren't rocket science.  It's the same process many of us learned in high school and most of us in college if you took Biology 101 and it's lab.  While neither aspect (the kits or the staffing) is all that difficult to get set up, the kits would be the prerequisite.  Without the kits, it doesn't matter how many people you have to process them.  I can't fathom the "difficulty" behind putting a swab, a collection tube and instructions into a bag.  There really is no excuse for not having enough test kits.

ETA:  This is not to say that 20M is realistic.  It isn't.  But a couple million a week is.  And that would be a HUGE increase from what we have now.  We have to remember that we are continuing to play catch up because testing has been inadequate from the beginning.  Had we been sufficiently testing this whole time, 20M would be in the rearview mirror.  The number is only going to get larger as we move forward with no real action.
It's more complicated than you think. The most commonly employed swabs are supposed to be held in the back of the nasopharynx for ~10 seconds - not only is that uncomfortable, it causes people to sneeze, which is aerosol-generating. So people collecting the swabs should technically be using full PPE, including N95 masks...and we all know there are issues with finding enough of those.

Self testing is the way to go. Ideally we'd test both acute and resolved infection through a two-step process, but I'm not sure the general public can do all that on their own.

 
I agree 100%.  I don't know what the solution is.  I wish these studies were not made public until they were subjected to a peer review process.  What is the point of that Santa Clara study being released early?  I see no good reason for it.  
I'd never heard of medRxiv.org until this crisis - it appears the site was launched less than a year ago. But they've certainly fueled a bunch of bad decisions based on non peer-reviewed data. 

 
Doug B said:
Relative lack of public transportation has to be a factor, too. So far as I'm aware, big Texas cities (metro areas for sure) are totally car-based.
Not riding on buses and airplanes has to be a big plus these days.

 
I'd never heard of medRxiv.org until this crisis - it appears the site was launched less than a year ago. But they've certainly fueled a bunch of bad decisions based on non peer-reviewed data. 
The medRxiv site is owned by Cold Spring Harbor Laboratory, which does appear to be a real medical institute. It does not look like they are trying to promote fake news and bad studies, even though that is partly what they are doing.

https://www.medrxiv.org/content/about-medrxiv

medRxiv (pronounced "med-archive") is a free online archive and distribution server for complete but unpublished manuscripts (preprints) in the medical, clinical, and related health sciences. Preprints are preliminary reports of work that have not been certified by peer review. They should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

https://www.cshl.edu/about-us/

Founded in 1890, Cold Spring Harbor Laboratory has shaped contemporary biomedical research and education with programs in cancer, neuroscience, plant biology and quantitative biology. Home to eight Nobel Prize winners, the private, not-for-profit Laboratory employs 1,100 people including 600 scientists, students and technicians. The Meetings & Courses Program hosts more than 12,000 scientists from around the world each year on its campuses in Long Island and in Suzhou, China. The Laboratory’s education arm also includes an academic publishing house, a graduate school and programs for middle and high school students and teachers.

 
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Minny ramping up testing...

”Standing with leaders of Mayo Clinic, the University of Minnesota and HealthPartners, the governor said that this $36 million agreement will result in the most aggressive COVID-19 testing program in the nation and allow for the diagnostic testing of as many as 20,000 samples per day — beyond the 5,000 per day that he had said was necessary.”

https://m.startribune.com/gov-tim-walz-announces-increased-covid-19-testing/569860492/
 

On a “woe is me” note my wife is a HCW who has symptoms and got a test today. Hoping they can turn it around quickly as the state just opened up the golf courses last weekend and I have a tee time Saturday morning and if she tests positive or doesn’t get results in time I won’t go. Obviously my wife’s health is paramount but man I need to get outta the house too for my own mental health and this was giving me something to look forward to and now it feels like someone just told me I aint getting presents for xmas anymore. 

 
Covid worldometers: 80,000 new cases; 6,600 deaths.  10% growth in Russia ..Saudi Arabia ..Singapore (for all: again).

Sad start to the day seeing CNN headlines about the looming famines that will lead to maybe a billion more people fighting starvation, and an infectious disease doc saying we're in, like, the 2nd inning of a 9 inning game.  

 
It's more complicated than you think. The most commonly employed swabs are supposed to be held in the back of the nasopharynx for ~10 seconds - not only is that uncomfortable, it causes people to sneeze, which is aerosol-generating. So people collecting the swabs should technically be using full PPE, including N95 masks...and we all know there are issues with finding enough of those.

Self testing is the way to go. Ideally we'd test both acute and resolved infection through a two-step process, but I'm not sure the general public can do all that on their own.
Or if they would be honest with their results. Also, how do you ensure the person in question is taking the test and not having someone else cleared take it? 

 
The medRxiv site is owned by Cold Spring Harbor Laboratory, which does appear to be a real medical institute. It does not look like they are trying to promote fake news and bad studies, even though that is partly what they are doing.

https://www.medrxiv.org/content/about-medrxiv

medRxiv (pronounced "med-archive") is a free online archive and distribution server for complete but unpublished manuscripts (preprints) in the medical, clinical, and related health sciences. Preprints are preliminary reports of work that have not been certified by peer review. They should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

https://www.cshl.edu/about-us/

Founded in 1890, Cold Spring Harbor Laboratory has shaped contemporary biomedical research and education with programs in cancer, neuroscience, plant biology and quantitative biology. Home to eight Nobel Prize winners, the private, not-for-profit Laboratory employs 1,100 people including 600 scientists, students and technicians. The Meetings & Courses Program hosts more than 12,000 scientists from around the world each year on its campuses in Long Island and in Suzhou, China. The Laboratory’s education arm also includes an academic publishing house, a graduate school and programs for middle and high school students and teachers.
I wasn’t trying to imply the site was illegitimate. But making non peer-reviewed research readily available to the general public is problematic at best. I’m not even sure it’s a good idea to promote it within the scientific community, tbh.

 
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Again - a direct quote from the Director of the CDC.

"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," CDC Director Robert Redfield said in a story published Tuesday. "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 added, predicting a dual assault on the health care system.

How do you want the media to report this quote?  Do they need to add a dislaimer?  "but hey - don't worry about what he says - he just said it's a possibility - even though he is a top scientist in his field for the richest country on the planet, I, being an attractive media personality, am here to tell you that nobody knows what will happen, so just chillax!"?
Seems Robert Redfield himself wasnt too keen on the editorializing that happened.

 
The Commish said:
We'd be there had this effort and focus started late Jan, early Feb. :shrug:  

And stating the obvious, this wouldn't be such a monumental task today had we begun months ago.  It's only a big issue now because it wasn't addressed early.  It isn't a big issue now because it's difficult.
That’s exactly what Korea did. But it’s spilt milk at this point, so we have to figure out the best path of damage control.

 
JAA said:
No offense, but unless you know how many tests you are administering, the comment of "50 new reported cases" is virtually meaningless.
What if we are testing 10,000 people a day? Saying the fact that I don't know makes anything meaningless seems like kind of a silly statement to make. I'm pretty sure a county that contains a city of 1.7m people which has only 22 people on a ventilator is a fair sign we are doing pretty good. But whatever. Keep on being you.

 
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Hawai'i extended stay at home order through May 31.
Yep. And we’ve kept our caseload relatively low. Hospitals are preparing to open up things like elective procedures, and outdoor activity is being encouraged for 2 or less people maintaining social distancing.

There’s a few people rumbling about getting back to work, but thankfully our leadership is erring on the side of caution.

The big problem is, our economy is built on tourism, so unemployment jumped from nearly nothing to the highest in the nation. Even though I detest the post-9/11 changes in airport security, I definitely would support enhanced surveillance (?rapid testing) for all visitors moving forward.

 
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