In the U.S., we're not testing for Covid-19 enough to have any idea of what's going on. But what else should we expect from an imperial power whose health care system is GoFundMe?
17
No one is thinking about the safety of our elections. This virus may slow in the summer but will be back with a vengeance come November. There needs to be a push for mail in paper ballots nationwide now!
13
@Sasha -
Rest assured., Republicans are. To cancel them if possible.
6
Do you know all the truth about COVID-19 in U.S.?
@Trassens -
No. I just share what little I know ir remember.
I don't believe in conspiracy theories.
3
You fearful of a pandemic? A friend sent this to me today. From a pathologist and molecular virologist.
Date: February 26, 2020 at 2:35:50 PM EST
Subject: What I am doing for the upcoming COVID-19 (coronavirus) pandemic
Dear Colleagues, as some of you may recall, when I was a professor of pathology at the University of California San Diego, I was one of the first molecular virologists in the world to work on coronaviruses (the 1970s). I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (e.g., SARS, MERS), from different animal sources.
The current projections for its expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the US by mid to late March and April.
Here is what I have done and the precautions that I take and will take. These are the same precautions I currently use during our influenza seasons, except for the mask and gloves.:
End of Part 1 (it’s long)
7
Seattle is one of the known flash points of the epidemic at the present—and has one of the largest homeless populations in USA, which adds to the danger.
Despite that, Seattle has failed to shut down one of the largest garden shows in USA. The Northwest Flower & Garden Show is a large annual exhibition of horticulture and gardening held in Seattle, Washington, for five days each February.
...
It was in full swing this weekend, with expected attendance in one single building, on one single floor, of 60,000-65,000 people.
Many people ( like my Seattle sister who says “ I am not about to alter how I live my life”) rode the rail link system that goes from just south of Sea-Tac Airport to north of downtown.
In another week or two, one of the largest USA sewing, fabric design and quilting shows runs for 3 days in a community near Sea-Tac airport. It, too, will draw many thousands of people.
Why are these not being cancelled this year?
9
Thing us, we’re not sensational, nor alarmists, or defeatists, because the news is both alarming and sensationalistic and defeating. We’re just trying to navigate a seemingly endless maze of contradictory information.
I post comments to share information and to relieve stress.
Safety requires taking unsafe measures. Dare I go out to the super-market? Dare I visit my favorite social haunt? Dare I go to the usual train or subway station? Or, do I cancel that haircut appointment?
Dare I?
Dare I tempt fate?
We should not be thinking like that.
That we are suggests what?
2
It’s another existential threat added to a world already full, if not full to overflowing, with them.
However it develops, it’s the last thing that we needed; which is why it has seized and now continues to seize the imagination.
2
In 1918, the Great Flu Epidemic killed the young and healthy virtually overnight. An estimated 40-50 million people died as the epidemic raged. Children were left orphaned and families were devastated. As many American soldiers were killed by the 1918 flu as were killed during World War I. No area of the globe was safe; eskimos living in remote outposts in the frozen tundra were sickened and killed by the flu in such numbers that entire villages were wiped out. Scientists have found shards of the flu virus frozen in Alaska and preserved in scraps of tissue in a government warehouse. One in four Americans were afflicted. The virus itself began as a fairly mild illness in the spring, and then diminished. It came raging back in the fall, but so deadly people became ill and within a few days died. One of the reasons it became so deadly the second time around was due to news blackouts at the time as to its lethal nature. This is not meant to instill panic, but it is important that our experts and the govt make this a priority in its early stages and keep us informed.
3
Gun deaths are far more deadly per day in the USA, than coronavirus is deadly in the entirety of the Globe. Why not write about gun violence in a sensationalized, breathless manner in the same way you do about a strain of coronavirus that is on course to replicate the fatality rate of the common Flu?
9
@Sean I am a dedicated anti-gun violence activist and appreciate your instincts. The issue deserves far more attention, it's true. However, COVID-19 is NOT tracking the same as the flu. More contagious and up to 20x more lethal. Do your research, follow CDC recommendations, and act accordingly. Be safe.
51
@Sean
Classic whataboutism. We know -- at least some of us do -- that gun deaths are a scourge in this country, one that Trump supporters care nothing about. That doesn't mean, therefore, that we shouldn't also be concerned about COVID-19.
We can walk and chew gum at the same time.
27
@Sean
Because it can spread far further in a population without a vaccine (unlike flu) and 2% of 350 million is a large number of dead, and the 20% that would need hospital care will overwhelm the system. Not seeing many steps to reduce the risk of that outcome.
22
The headline writer wrote "The country is better positioned than most". If we are talking about developing countries, that's true. But the absence of universal health care in the US puts in a worse position than most civilized countries.
Millions of people are without health insurance, and millions of others live close to the edge, financially speaking. Together, they are much less likely to go to a doctor or clinic at the first sign of a fever or cough. Instead, they'll be out in public, following their normal routines to the extent possible, raising the chances of transmission for everyone. That makes the US more likely to have a major outbreak than those countries where health care is a human right.
353
@Bluevoter Besides, what the whistleblower has revealed about the personnel taking care of those repatriated from Hubei having no protection whatsoever is quite worrying.
I am afraid there is a lot of complacency and navel gazing in that stance that the US is "best prepared in the world".
76
@Bluevoter
And yet there are too many in this country -- Democrats and Republicans alike -- who continue to argue that the nation cannot afford Medicare for All.
Just think how much we would be saving in costs and human life if everyone who was or will become sick could go to the doctor's office without fear of how to pay for it.
Still, there are those who are willing to deny them access.
Don't like Bernie? Then vote for Elizabeth Warren. But vote to protect the health of our fellow citizens.
59
@avrds . Yes the cracks in our healthcare system will turn into the Grand Canyon. Under-insured, uninsured and those with high deductibles will not be able to access care easily and risk personal bankruptcy and yes, long term disability if they get sick enough and survive. It pays to have everyone covered. Oh my state announced that they will have test kits by "sometime next week". This is scandalous. I do not trust the filtering of information that will likely come from this administration.
41
A careful and meticulous policy of euthanizing the severely ill early in the course of their illness would dramatically reduce the strain on healthcare resources and probably would contribute to reducing the spread of this disease.
3
@A Cynic Did you not read the story? They said they could be authorized to deprive care to certain patients to save others but those patients could survive if cared for too! You support doing just that and deciding who gets care first and offloading others! It's all a bad idea because the rich and powerful will push for their families first over some poor sap in a nursing home. How would it feel if it was your mother or father?
14
@Elizabeth At least the poor sap in the nursing home has Medicare. I can only imagine that Hospitals won't hesitate to deny care to the uninsured.
4
@A Cynic
Well, Mr. Swift, would you propose solving a food Bank shortage problem by eating them as well? We old guys are a tough stringy lot.
8
This country is extremely poorly prepared. For an illness with a 2% mortality that also requires 10% of patients to be hospitalized or in ICU... we are looking at a disaster.
We don't have protective equipment for health personnel, we don't have enough ICU beds, we don't have enough doctors or hospital beds, or ventilators. This is why China had to build popup hospitals, ship military medical personnel in to help and create huge supply chains of equipment. This country is doomed... and trump had three weeks to be thinking and planning...but NO all that mattered was his golfing, and his reelection, and the stock market. Will prayers work at this point?
65
@Somebody -
It’s a matter of scarcity. You’re confronting the logistical overload of any healthcare system. Ours’ is a blend of public and private. It doesn’t work well under these stressful conditions. Can’t. People who are very sick must get in line, stand in it and wait their turn for some relief, however fleeting. The great danger is exploitation.
5
My husband, a retired AF doc, predicts we will need to call up military medical personnel to work in Civilian hospitals and other facilities before this is over.
3
We need leadership. Why haven’t tests been done in Chinatown in NYC and San Francisco. Test 5000 and see if anyone is infected. If it is over 5% we are in trouble. Order a two week curfew for the entire city and stop waiting for it to spread causing havoc .
20
@Ralph Petrillo -
Probably won’t happen.
Authorities will hoard what test kits they have, counting on people to self-report. It’s the bureaucratic mindset.
6
@Steve Singer
I agree however a simple test could save us months. If no one is infected that would be great news. However if 5% infected then we can take action.
3
@Ralph Petrillo -
President D. J. Trump is a better politician than many give him credit for, although he was an amateur coming in. It’s an existential threat that he now confronts. Time wise, the arrival of the virus couldn’t be more terrible. So he's doing his best to cover his tracks, while praying.
FOX news (essentially trump’s propaganda agency) is fully engaged in a concerted cover up effort to deliberately camouflage just how badly managed the COVID-19 response has been in the US. The trump administration over the last two years has been drastially cutting budgets and gutting public health agencies, eliminating preparedness teams, and abruptly dismissing expertise. It’s clearly a deliberate effort to dismantle the important measures Obama made to effectively protect the nation from the 2014 Ebola infection crisis. And as with all things Obama, trump is doing these things vengefully, recklessly and surreptitiously. The nation is already paying a huge price with the looming emergence of a similar infection crisis, the COVID-19 outbreak and undoubtedly there is more to come.
85
@John Townsend
Absolutely spot on John. And Donald Junior (of Natalia Veselnitskaya, collusion fame) had the audacity to rant on Fox that the Democrats wanted the virus to spread to hurt his poor beleaguered hardworking father politically. He even said they wanted I think millions of people to die for that purpose. Just the unifying pan-American inclusive attitude required. I found the quote:
"But for them to try to take a pandemic and seemingly hope that it comes here, and kills millions of people so that they could end Donald Trump's streak of winning, is a new level of sickness. You know, I don't know if this is coronavirus or Trump derangement syndrome, but these people are infected badly."
https://edition.cnn.com/2020/02/28/politics/donald-trump-jr-coronavirus-democrats/index.html
7
@Bob Guthrie -
President D. J. Trump will do and say whatever he must to win re-election.
1
@John Townsend -
We’re a big, disorganized, ethnically, sectionally, regionally and racially divided country. We do this sort of thing just as badly as the Chinese did, and still do. Bet on it.
The thing about masks is if it's vital for medical folks working amongst people with the contagion, then heck, why should it be proclaimed that those who are not working with the stricken shouldn't bother using them even if they lessen the spread and hence the number of patients needing a masked medic to attend to them?
Isn't what's good for the gander, good for the goose.?
1
This is a true national emergency. Costs for responding NOW will dwarf the costs for responding AFTER COVID-19 HAS ALREADY SPREAD THROUGHOUT THE LAND. This is a classic case of pay me now or pay me later. So, go back and fulfill the recommendations from 2005 (that's from Pres. George W.'s term) and get as many ventilators manufactured TO SPEC as soon as they can. Set up hotlines between all 50 states' health depts. and the CDC, and further verify that all hospitals have links with the health depts links WITHIN each state, and do it in 30 days. Set up a national tips hotline for citizens in all 50 states to report possible infection outbreaks. And, please, will someone give Trump a Nintendo to play with, and keep him from tweeting more and more misinformation.
3
Sorry,that respirator is "out of network".
1
Shame on you NYTimes. You are creating fear where there should be teamwork. Fueling misinformation and scare tactics. Even the Editorial board!!! Your motives are clear.
But in the mean time, thousands are working on understanding this new corona virus mutation, we've only known about in the US since the start of the year (with very little information from China), but what we do know is that it's a flu that is highly contagious with a death rate of 2% or less. Currently, experts believe that the virus manifests differently in different people - many had it and didn't know they had it. It is prudent to behave just as we do at the heart of flu season; still going on.
And there were no cuts to the CDC, which has billions at their disposal. The Ebola division had millions each years since 2002. Cutting that budget would not have been a bad thing; that money needs to go to other groups as we don't have an Ebola issue. Also, billions going to other countries may be worth questioning - are we sending money for research, supplying technology or personnel, or providing ??? It isn't wrong to question.
This virus will likely spread, but whether it's a crisis depends on attitude and effort. I believe the CDC, NIH are putting forth great effort, as are health agencies and research facilities around the world. But the attitude created by the NYTimes and other far left outlets is beyond the pale; a disgrace!!
It's insane that to get tested, it would cost insured Americans $1500 and the non-insured $3500 for being tested. My friends in Korea have told me that the government is paying for all the testing fees and it is free of charge. If you don't have the symptoms and want to be tested, they only charge $150. That's the kind of healthcare system we need in America - a healthcare system managed by the country and affordable for everyone in the country, not these outrageous bills!
6
@Julie -
The South Korean public health authorities wants to know who has it. Ours don’t. Hence, the difference.
5
@Julie it costs around 60 bucks not 150
2
There are two answers your question “how prepared is the U.S. for a Coronavirus outbreak “. If you are foolish enough to believe the Trump administration that this is just a hoax and nothing more than the flu, then you will have no doubt that we are well prepared. And if the best-case-scenario plays out, this will be the conclusion pushed by the President and his minions at Fox. In reality, the answer to this question became abundantly clear when President Trump name Mike Pence as the Coronavirus Czar. His primary goal will be to contain the truth and hide the facts. This is how we are preparing for the Coronavirus. In other words, we are preparing to fail when we fail to prepare.
6
@Enrique Puertos
Our biggest failure, expanded by you, is to ensure the virus issue becomes a political football. Dems are weaponizing the topic to help their election chances in Nov. This insane practice will seriously hinder would be policies designed to lessen spread.
1
Meanwhile, in Brooklyn:
"Why did CDC send NYC man home without testing for coronavirus?"
https://abc7ny.com/5974999/
4
Trump's surgeon general has just made it impossible for Trump to ever wear an N-95.
No wonder he stood 100 yards back from the press gaggle yesterday.
The following are published data as of March 1 12:00 am:
Covid-19 cases/Death/Mortality rate:
Wuhan/Hubei province epi-center are 66907/2761/4.1%,
rest of China:12917/109/0.8%,
SouthKorea/3526/17/0.48%.
Italy:1128/29/2.5%.
Japan:947/11/1.1%
Iran:593/43/7.2%
Hong Kong:95/2/2.1%
USA:71/1/1.4%
Taiwan: 39/1/2.5%
The high mortality rate 4.1% in Wuhan/Hubei province is a reflection of the virus outbreak overwhelm the healthcare system capacity in the beginning. The mortality rate 7.2% in Iran is probably showed under surveillance .
US has just reported at least 3 cases with no known contact history along with one death. I believe the more realistic mortality rate is from South Korea 0.48% or may be lower with time more cases being identified.. The outbreak in SK is related to the Shincheongji Church of Jesus. The health official carried out an aggressive case tracing with initial double digits of covid-19 infections reported to 3,526 in less than 2 weeks
With the current epidemic started 6 weeks ago in China, it provides the rest of the world borrow time for preparation. We definitely do not want to experience what has occurred in Wuhan. With aggressive case finding and local containment may reduce the impact of the infection.
Remember mortality rate of 1% with one death means 100 or more infected persons are not identified ( The infection ratio is 1 to 2.2 published in NEJM). Time is essence.
3
@SK -
It all depends on the total number of patients with long term, or chronic, pre-existing medical conditions like diabetes or cancer who are infected by the virus, and later show up to then later die in a hospital bed, hooked up to a ventilator. Figure it will be a greater number than in Wuhan province, China.
Trump is about to purge members of the medical left.
2
It's not just possible, but likely that the whole country will be home-quarantined for 2-3 weeks. Will utilities keep operating? What about emergency services? This COVID-19 situation is much more serious than anyone is admitting.
4
No one is investigating preparedness of the US nursing workforce, and all of the physicians in the world aren't able and educated to provide nursing care for critically ill ventilator dependent and hemodynamically unstable patients.
There has been a baseline national nursing shortage for decades. The numbers of university educated public health nurses and critical care nurses falls short of current demand, let alone a 20% predicted need increase.
Critical care infrastructure is lacking. There aren't enough isolation and negative pressure rooms available now.
The RN/MD hospital based workforce is majority women with childcare needs and non-union/weak worker protections. When schools/daycare close for weeks/months and children are home quarantined, RNs will take unplanned leave or quit entirely.
The low wage workers in hospitals have the most prolonged and intensive patient contact: housekeeping staff, janitorial staff, nursing assistants and patient transporters. Many work under part time/no guaranteed hours and no benefits/paid sick leave conditions. These are the people who WILL come to work, ill or otherwise.
The VA system closed thousands of beds nationwide as it converted to a predominant ambulatory model. Without a trustworthy and competent leader under Trump, it's patient population demographics are at highest mortality risk. It will be overwhelmed.
Military medicine will also be overwhelmed.
8
@aek
Such an important comment, aek, and I hope the NYT makes it a Times Pick.
These are some of the critical knock-on effects about which some of us have been ringing alarm bells for weeks (and been told we're "hysterics" in the bargain). This country is unprepared for the repercussions of this public health problem.
We got basically 6 weeks of a heads-up thanks to China's efforts, and we've squandered it. Now we're playing catch-up. The American way.
5
@aek -
More like non-existant. The infrastructure just isn’t there, any more than it was for Hurricane Sandy, which wrecked havoc on New York City's five boroughs and much of Long Island.
"They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk! "
What? If they are not effective, than why do health care providers need them?
@slangpdx Health care providers get special training and fitting to make sure the masks are put on and disposed of safely. The average person would probably not put it on correctly, they will reuse the mask, and contaminate others while taking it off.
2
@slangpdx -
Why? Amateurs don’t do it as well as trained professionals do it. Funny thing about that.
As we've seen in China, much depends on the quality of local public health. They're deciding when and how hard to push CDC, and they need to coordinate local health systems. Sadly, I'm a doc in a poor city in a state that spent decades divesting from the public health system. We'll surely pay the price now. I look to colleagues in other regions with envy.
7
This virus, if it continues to develop, will put the US and the world on its heals. But, I don’t expect civilization to break. However, the world is now vulnerable. If a statistically rare event happened, a second more virulent and contagious virus were to hit during this outbreak, I would expect the dark ages to follow. Fortunately, that kind of concurrence of major viruses rarely if ever happens. And so we’ll avoid the right hook and just take the left jab.
@David Gibson relax. The fatality rate is most likely way overstated. As they record more mild and asymptomatic cases the fatality rate will fall dramatically as the denominator gets larger. If you are a healthy adult below the age of 50 you will more than likely just experience symptoms of a bad cold or flu.
@kp -
It’s the Law of Large Numbers vs Hospital Capacity.
“Large Numbers” always wins out in the end.
1
Of course the United States is not prepared for this virus. How could it be when the budget of the CDC has been slashed to about 1/3 of what it was in 2016? The appointment of the vice-president as point person and the requirement that all medical information go through his office for approval before being disseminated will result in political responses before medical response. Trump's mistrust of most scientists could well lead to unnecessary deaths in America.
6
I am a Professor of Medical Genetics. Reading about the unexplained cases of coronavirus in the US and elsewhere raises the possibility that the Coronavirus was for a long time indigenous to humans where only recently a pathogenic variant or unknown co-factor. result in a flu. If true, asymptomatic carriers were for a long time present in the human population. I suspect that population wide screening will show that in every country a certain % of the population are corona virus carriers. The test kit just enables to quantitate indigenous coronavirus carriers that have been there long ago. In other words, it may well be that the hundred of thousands of people that are known to come down with the flu each year in spite of the flu vaccine, actually were infected with the Coronavirus instead to the four variants of the common types of influenza viruses: A, B, C and D. The bottomline-Covid-19 is essentially a flu with low mortality rates like the common flu that may have went molecularly undiagnosed for a long time. Caution and 14 days quarantine of carriers are a good approach until a vaccine is at hand, but all the hype and economical panic may have much more dangerous consequences than the virus itself
5
I am a Professor of Medical Genetics. Reading about the unexplained cases of coronavirus in the US and elsewhere raises the possibility that the Coronavirus was for a long time indigenous to humans where only recently a pathogenic variant or unknown co-factor. result in a flu. If true, asymptomatic carriers were for a long time present in the human population. I suspect that population wide screening will show that in every country a certain % of the population are corona virus carriers. The test kit just enables to quantitate indigenous coronavirus carriers that have been there long ago. In other words, it may well be that the hundred of thousands of people that are known to come down with the flu each year in spite of the flu vaccine, actually were infected with the Coronavirus instead to the four variants of the common types of influenza viruses: A, B, C and D. The bottomline-Covid-19 is essentially a flu with low mortality rates like the common flu that may have went molecularly undiagnosed for a long time. Caution and 14 days quarantine of carriers are a good approach until a vaccine is at hand, but all the hype and economical panic may have much more dangerous consequences than the virus itself
2
How many test kits does each state have? Are the ten thousand ventilators currently in storage being parceled out to each state?
When vaccines are ready, how will they be distributed?
https://m.sfgate.com/science/article/COVID-19-coronavirus-vaccine-Israel-15093659.php
1
@M
Our entire country has only 62,000 ventilators. 930,000 hospital beds and 62,000 mechanical ventilators.
And of course people will still need routine hospital care for other things -- broken bones, heart attacks, car crashes, shootings, etc. At least one hospital in Lombardy closed its emergency room. Closed its emergency room! Because it was devoting the entire hospital to COVID-19 care.
As for vaccine, mass-produced vaccines for the general public are at least 18 months off. And even then, not everyone will be able to afford them. Land of the Free, you see.
3
For those of you complaining about a lack of information, or a lack of anybody looking into things or just wringing your hands for the sake of it, go to the New England Journal of Medicine website. Go to the coronavirus section. It’s free of charge. There you’ll see some legitimate scientific data and some people who actually know what they’re talking about. And understand that the conclusion of a 12 page investigation may boil down to a single sentence. That is how science works.
And then please find something else to occupy yourselves with. It’s not all about you.
1
How prepared is the mighty USA? It'll do just as terrible a job as it did for Katrina. Just as terrible as in Puerto Rico. The rich are already esconced in their private estates, 'let the poor die of pneumonia,' they already purchased their personal ventilators.
5
I suspect Liberia is better prepared than the US.
4
@gmp why?
Iran's mortality rate is now at 7 percent.
16:00 GMT - Azerbaijan shuts border with Iran
Azerbaijan said it had closed its border with Iran for two weeks to prevent the spread of coronavirus, after the death toll in Iran rose to 43, the highest number outside of China.
10:00 GMT - Iran reports nine more deaths
Iran's health ministry has said 205 new cases of coronavirus have been confirmed in the country in the last 24 hours, with nine more deaths reported.
The new numbers bring the total deaths in the country to 43 among 593 cases.
2
This is moving around the world. Accept reality. many will never even know they even have it. I am based in Shanghai and I am telling you all .. if the world tries to stop it they will fail and worse they will destroy the economy trying to do so. GET SICK go out and get it and accept that every man woman and child will get it. you can’t stop it. By getting it you wil build natural antibodies, a natural resistance. Yes some will die and that is the part that noone likes but it is the inevitable. Fear the unexpected ? the unexpected ? you are foolish to hide from reality. Wait - here we go a prediction you read it here first: announcements by world governments "Not feeling well ? dont come to our overcrowded hospitals (with VIPS) stay at home, take it easy, drink chicken soup and if someone dies call 1-800-COVID19 and we will come by and pick up the body." anyone remember the monty python skit "bring out your dead" well COVID ain’t no black plague but there will be death and death will happen at home. Now - bring it on. No? still want to fight it ? then short all travel stocks, airline stocks, cruise ship stocks, luxury stocks. Careful now - you might get COVID at the Rangers Game ! hey honey do we really need to see Celine Dion in Vegas ? Do I really want to touch those poker chips? short everything accept online gaming and streaming videos. Panic ? I have seen panic first hand in China. We human love to panic in the face of the unknown.
1
I wouldn't worry folks, Mr. Vice President Mike Pants has is all under control.
4
@Positively
Pence has gotta lotta nerve to say he is our friend. When Indiana was down with an HIV epidemic, Mike just stood there grinning like the grim reaper.
He refused to allow the needle exchange program- some say on religious grounds; yet I have never seen intravenous heroin use forbidden in the Bible.
People contracted HIV as a result of a lack of needle exchange. He also claimed that cigarettes did not cause cancer in 2001. I wish that for just one moment Pence could stand inside the shoes of a heroin addict. He would know what a drag it is to have him in charge of any health issue.
1
Is Trump now blaming the death from the Coronavirus in Washington State on Democrats and a hoax? Trump and Pence, the anti-science Neanderthals leading an administration of fellow incompetent political hacks, are the last people we need leading the fight against this pandemic.
4
The following are published official data as of March 1 12:00 am:
Covid-19 cases/Death/Mortality rate:
Wuhan/Hubei province epi-center are 66907/2761/4.1%,
rest of China:12917/109/0.8%,
SouthKorea/3526/17/0.48%.
Italy:1128/29/2.5%.
Japan:947/11/1.1%
Iran:593/43/7.2%
Hong Kong:95/2/2.1%
USA:71/1/1.4%
Taiwan: 39/1/2.5%
US just reported at least 3 cases with no known contact history along with one death. I believe the more realistic mortality rate is from South Korea 0.48%. The outbreak in SK is related to the Shincheongji Church of Jesus. The health official carried out an aggressive case tracing with initial double digits of covid-19 infections reported to 3,526 in less than 2 weeks.
I hope US should appoint a coronavirus czar from CDC and let the health professionals to do their work. Dom't let the politician polities a deadly epidemic ( Trump in a rally SC said, " Coronavirus infection is a hoax ). With the current chains of command in the White House, they cannot even announce the gender of first deceased person correctly.
With the current epidemic started 6 weeks ago in China, it provides the rest of the world borrow time for preparation. Remember mortality rate of 1% with one death means 100 person or more infected persons are not identified ( The infection ratio is 1 to 2.2 published in NEJM). Time is essence.
2
@SK -
The response has been both delayed and politicized.
Why do I still see people at the LA International Airport wearing masks but not glove??!! Cover your hands folks. Gloves create a barrier between your hands and the virus. The virus seeks a moist landing to survive. Cotton, leather, wool gloves will do! Latex gloves unnecessary. Also breathe through your nose, out through your mouth. The hair follicles in your nose are designed to protect you.
2
@Christine A Roux -As a proud part-Italian nose hair farmer aware of the outbreak in Italy,I've decided to allow my nostrils to crust over+breathe through my ears(which also contain this valuable form of filtration).
1
mad king donnie said it would disappear like a miracle
and now he's turned the crisis over to miracle mike who's record on epidemics is to INCREASE HIV in Indiana.
guess Sec HHS will see his pharma buddies get richer
4
W. Post … “ Per Bureau of Labor Statistics, 28 percent of U.S. civilian workers — about 45 million — have no access to paid sick leave.”
Wikipedia— “Paid sick leave is a statutory requirement in most European, many Latin American, a few African and Asian countries…”
W POST. Technology
“Gig workers face the spread of the new coronavirus with no safety net. Drivers for Uber and Lyft and delivery people for Instacart and DoorDash are independent contractors and do not receive sick leave or health-care benefits.”
NYT– "How to Prepare for the Virus -----many people who work in minimum-wage jobs do not get sick days….. they often must work when ill, despite public contact. ”
Thus, multi millions of uninsured and even many insured Americans may put off going to doctor due to high costs.
For many, it's been easy for many people to ignore all that with the attitude "I'm Alright, Jack".
Now we can all be affected -- and infected.
But the center of our politics calls the remedies for this too 'left wing', and has gotten little factual coverge in media. Yet it's one of the main issues voters must take into account in the 2020 election.
This is a chance for the candidates to make it a big issue.
7
Is the U.S. prepared for a pandemic? Our President doesn't even know what the word "pandemic" means.
Impeachment was our best chance to be well-positioned for the coronavirus and that failed. God help us.
3
So sad and dangerous. These days I can't believe the President and federal departments.
Am I being a good citizen by not buying a mask or, at 78, a high-risk fool?
3
@joan -
You ever did?
The US is going to be a day late & a dollar short.
They are reacting, instead of planning. They’ve had 2 mo.
6
Now that America's ayatollah, Veep Mike Pence, is in charge of what is sure to be a faith-based solution to the COVID-19 pandemic, we should all just relax and accept that the issue is mostly about a sneaky attack on his boss, His Excellency The Donald.
Of course, it's nonsense that we should at all be worried about this. The president assures us that the whole thing is being blown out of proportion by those few Americans we still don't yet support Trump 2020.
So it's all safe against that nasty coronavirus. We've been able to trust the Orange Coif on so much. No collusion, no quid pro quo, and no emoluments. He's clean as a whistle, it's only the haters that can imagine him ever letting us down.
So hurry on down to your neighborhood Trump 2020 rally, without any of those silly masks that doubters wear to undermine his and Pence's leadership, cluster together closely in your thousands, and shout and yell as much as possible.
The only thing you'll catch there is Trump fever...
Which is what I'd suggest re-naming the US version of COVID-19 in spite of my preceding sarcasm.
7
The NYT needs to compare the Us to other developed countries. Not third world countries. And if that’s done, the US is bringing up the rear in preparedness.
5
This should be THE END of Donald Trump (and the Republicans )-- we hope! It is a sin that it will be at the expense of deaths of American citizens.
6
@Lois Lettini
It should be, but probably won’t be. But bad things usually come in threes, I notice. Am waiting for the third.
No mention of North Korea and how their citizens could be moving back and forth between China and North Korea and spreading the virus. What about the North Koreans that escape into South Korea - they could be virus carriers.
@CK:
Coronavirus: North Korea quarantines foreigners
https://www.bbc.com/news/world-asia-51609360
1
@Lisa Simeone -
Reread the story about the social terror that surrounded the Medieval “Black Death” Bubonic Plague that hit during of the 1650’s. Especially about the collapse of the social order. “Journal of A Plague Year”. It, too, came out of the east.
‘
Forget ventilators, what's the status of orange makeup? THIS IS SERIOUS!
3
Less prepared than we were when Obama left office as Trump fired the pandemic experts from HHS, NSA, and State who would have engaged China earlier.
4
With Trump and Pence involved the government is not prepared at all. Pence is in charge only to lie and deceive the American people in order to make Trump look good. Besides the stupidity of Pence claiming publicly that people don’t die from smoking. Pence completely failed the people of Indiana when he, for political reasons, refused to provide Indianans with clean needles to prevent the AIDS virus infection and many Indianans died as a direct result. I could not think of a person less qualified than Pence to be “in charge” of the CDC’s handling of the corona virus in the US except Trump himself or maybe Rush Limbaugh who also publicly claimed tobacco didn’t cause cancer only to find himself presently dying due to lung cancer. Republicans care about nothing and no one but themselves and their power and greed. They don’t care at all about the American people.
5
@DSD -
Vice President Mike Pence is politically expendable, why he was officially put in charge of the government’s anti-virus
“war” effort; to deflect blame to himself, although he can’t really be held responsible, any more than then-Attorney General Jeff Sessions could be held responsible for recusing himself from the Mueller Report’s sordid findings.
Where is he now? In the political Wilderness. The same thing will happen to Mike Pence, if anything goes wrong.
If anything goes wrong? It’s like in Iran, now. A 7% death rate?
Nobody saw it coming, and it arrived.
Nobody is in charge. Nobody is responsible.
1
Thank you for this informative article.
2
Mike Pence implemented the policies that led to an increase in HIV infections in Indiana. What is there to worry about?
3
Are we prepared?
anyone who thinks we are must watch Netflix's "Pandemic" documentary that describes the reality of health care in rural America focusing on a small hospital in Waurika, Oklahoma where one doctor is responsible for the whole community.
If a pandemic were to ensue, this hospital and countless others like it would be woefully ill-equipped to fight the spread of the virus.
https://depauliaonline.com/45852/artslife/pandemic-teaches-and-terrifies/
3
@Mary Elizabeth Lease -
I anticipate that a situation similar to China’s response to the virus outbreak will develop. Hospital cots will be deployed en masse inside building corridors, school gyms and parking structures, as the virus migrates to us.
President D. J. Trump will look like the fool that he is, or rather the virus will make him look like one. Like the generals say, “the Enemy has a vote” He won’t escape scrutiny.
1
“Critics say a contradictory message about the threat posed by the virus from President Trump...amplified on conservative media, has caused confusion, arguably slowing efforts to prepare.”
Can we call a spade a spade? It’s not “conservative” media. It’s “reactionary“ or “right wing propaganda“ media. Also could we just say “Fox” when that’s what we mean? To keep using the word “conservative” is, quite literally, not telling the truth. To not call out Fox as destructive of the health of the nation at this very moment is, it seems to me, to abdicate all journalistic responsibility.
7
@ADN -
We could, if we weren’t muzzled “call a spade “a spade”.
I’d have hoped that people wouldn’t cheer for lower taxes and attack all the boring people who wear lab coats and hang around in labs for decades workng slowly and patiently on things they refuse to try and understand (chopping CDC and NIH research funding, I’m looking at you) and then turn around and scream about why weren’t they WARNED, why don’t you have test kits and a vaccine YET, why won’t you tell us the TRUTH, but I really knew better.
You were warned about emergent viruses for at least the last twenty years. There were whole MOVIES on this stuff that told you how hard it’d be to stop once ot got going. You were told about shortages in research funding. You were told about why we needed everybody to have access to health care. You were told about our shortages of new researchers. You were even told, again and again, about global supply chains and why we need strong alliances and international cooperation.
And you were most def told about the basics of home self-defense—the real ones, not those involving assault weapons and hundred-round magazines. Oh, and the need to learn some science basics.
You
Were
Told.
So after a couple decades of warnings and entreaties for help during which you found better stuff to do (like watch “The Apprentice,” and elect a grinning fool who can’t be trusted, and you were warned about THAT, too), now you’re running around yelling and buying up all the Purell.
We’ll most likely be okay.
I wonder if we’’ll learn this time?
2
Well, thank God the person who occupies our White House has been laser focused on his number one priority to protect us all - building his wall.
Meanwhile, we live with the situation where we're all at far greater risk from potential pandemics due to his dismantling of the Pandemic Preparedness group (an absolute necessity to do so, as it was created by Pres. Obama), slashing funding for CDC and WHO (pandemics are a perfect example of why the US cannot cut itself off from the rest of the world). And creating an anti-science environment that resulted, in part, in 1,600 scientists leaving the federal govt. And, of course, appointing Mike Pence as the person through whom all communication must first pass. Really? Does anyone doubt why he was chosen? Do we really think he'll share info from Anthony Fauci and other experts that might help the US deal with this situation, but possibly taint his Great Leader? And a CDC Director who stated abstinence as the solution to HIV /AIDS, as opposed to the proven value of condoms in saving lives.
God help us all
2
@Sue H -
We’re always fighting the last war. “The Wall” is just a myth, and it won’t work anyway.
The US is not better positioned to deal with an epidemic than other first world countries. We might have the scientists, and the facilities, but who's going to get to use them? 40% of Americans are afraid to go to the doctor or hospital because of cost. Even worse, doctors and hospitals send patients to collection agencies, sue them, and garnish their wages if they fall behind on bills, as if sick patients had any choice in needing healthcare. In Kansas it's so bad they throw people into prison if they don't show up to court hearings after getting sued for medical debt.
Because of our punitive medical debt collection industry, and because people are already facing thousands of dollars of debt just to get tested and treated for COVID 19, we are a third world country at the absolute bottom in terms of being able to stop this epidemic.
https://features.propublica.org/medical-debt/when-medical-debt-collectors-decide-who-gets-arrested-coffeyville-kansas/
4
If someone working in the Postal Service is carrying the virus and you get your mail, the envelope may transfer the virus to you. Always wash your hands real good after reading your mail. Be safe.
3
@Ted Bishop Good advice for everyone, every day - pandemic or not.
1
"We're better prepared than most countries!" That's a laugh! We've only tested 500 people...third world countries have tested more than that...plus our tests don't work. Who knows how many people are walking around spreading the infection?
This is a Black Swan Event and we have Donald Trump leading our response...the Onion couldn't come up with a better joke!
3
For profit healthcare at it's finest.
4
So in answer to the question posed in the headline, "How Prepared Is the U.S. for a Coronavirus Outbreak?"
The answer is: not very.
Other than that, thank god for the state and local healthcare workers on the front lines, heroes all even in the best of times, and especially now when we have a buffoon in the White House calling this pandemic a "hoax" and his science-denying sidekick.
4
@Lisa Simeone What federal healthcare workers are you referring to?
Trump was so concerned about the plight of dying Americans he had time to hold his umpteenth campaign rally last night.
5
@Kristin
Yes, Trump supporters, despite advice from actual health experts (because who should believe science?) about modes of this virus's transmission, should definitely keep attending those rallies jammed full of those whose demographics experts have noted are most susceptible to taking ill en masse .
Catch that Trump fever!
2
It would help dealing with the problem if Trump explained why he disbanded pandemic services at HHS. .
Trump's acting chief of staff told people to "turn off your TV" instead of staying informed.
Republicans says Democrats should not "politicize" the issue, to be followed with slurs by the President on Democrats.
None of these is a hoax.
Trump is grotesquely incompetent. His credibility is non-existent, as sensible people increasingly ask "How is Trump out for himself here?"
That is not a hoax either.
3
Just from what I am seeing play out there is a serious lack of testing happening in our country already. Meanwhile this highly contagious virus is spreading which is why we are hearing of cases where people did not travel at all. As for masks, I really don't blame people for trying to protect themselves. I just upgraded my respirator that I already have with new filters. In the past, I have used correctly sized N95's disposables for air travel in the winter and as an added measure bactracin ointment over each nostril. I also kept my hands sanitized and rinsed my nostrils with salt water after I am home. I have never become ill, even with visibly sick people near me on the plane. By comparison, I got infected by a flu strain not in the shot I had that year, by standing behind a woman with a sick toddler at the feed store when the kid coughed. After that experience, I am convinced that masks can and do work when used properly.
1
I keep asking this question but no so far has answered it. What about the immigrants in detention (cages) centers south of the border? An outbreak there would be catastrophic to all the country.
5
Canadian health officials are worried about the US response (or almost complete lack thereof) to the COVID 19 outbreak. Seems odd that a nation as supposedly well prepared as the USA doesn't even have the capability to test people for what could become a pandemic. A large swath of your populace is unable to go see a physician on an even semi-regular basis. How is this "better" prepared?
4
How exactly is the US better prepared for the pandemic? Do we have well stacked food banks that can feed the nation if imports have to be stopped, however momentarily? Are public schools equipped with nurses to monitor children and teachers symptoms? If small businesses lose revenue, how is the government going to support them from going under?
Surprise hospital ER billing resulting from the unsuspected use of outsourced Drs , nurses, ambulances, etc, that are not covered by insurance programs, leave people with unscrupulous sky-high out of network bills. The two major outsourcing companies are EmCare owned by KKR and TeamHealth, owned by Blackstone. Both private equity companies. How are these bankers not similar to the Sacklers and their poisoning and killing of American for with OxyContin for profit? And, what’s to be done about these unscrupulous private equity companies?
How’s Bloomberg better than Trump in this sense, as he claims in the just released slick made TV ads? He’s not!!!!
1
We have a lot to worry about with this pandemic. The last thing we need is that clown in our White House telling our citizens that the coronavirus is a hoax. And then downplaying it when a person dies from it. I don't know if our government can handle this crisis as well as other countries have done..We are spoiled and set in our ways so we will do what we want to.
2
It would appear that inspite of Trump's claims to have begun preparation for this virus way ahead he has once again lied to the American people. His inability to manage anything, much less a pandemic, makes him totally unfit for office. Perhaps a number of deaths in his base will start wising people up to his ineptness.
3
The best thing we can do is continue to pay people if we are all quarantined. I'm paying my housekeeper regardless. If companies penalize workers who have to stay home because of quarantine or school closings things will be so much worse.
1
As a physician, it is concerning that the Times would use photos that show improper Coronavirus procedures. In the photo above noting “demonstration of coronavirus response at American Family Care”, the doctor should be using an N95 mask as a regular face mask is insufficient protection. And in a different Times piece today with the photo where a healthcare worker is transferring an actual patient w/ Coronavirus in Kirkland, WA, shocking to see NO gown, gloves, or N95 mask! It is apparent to me now why so many healthcare workers treating Coronavirus are also falling ill and why the virus is further spread.
3
Don’t get sick. Don’t spread disease.
If you feel well, you are 99.9999% probably fine.
Keep yourself well. Hand washing is #1. Keep your hands away from your face! Avoid crowded places. This a situation of statistics in real life. Best practices will save THOUSANDS of lives.
Behavior modification is not really that hard, and it can mitigate the severity of the pandemic. Less sick people infect less well people and stress facilities less, so sick people can be treated.
OK?
2
I saw the interview with Trump, Pence and a few health officials behind. He started by eulogising those killed in Afghanistan as though any new deaths from the virus would be a minor sacrifice compared to the brave people who kept returning for further tours of duty. It felt like he was implying the inevitable coming hardships will be negligible compared to those of the service people. He was using them again for political purposes. But I could not help recall how he dodged national service during Vietnam. It was a sickening exhibition of manipulative dishonesty. Then he went on to the coronavirus; bragging about what an amazing job he has done when only hours before it was a Democrat hoax!
He has not done a good job. It was the height of incompetence
* Bringing in infected Americans back with those of uncertain infective status on the same aircraft
* Sending people to pick them up unprotected without proper clothing and training
* Dismantling the needed agencies before the event so that the repatriation and pick up was a hopeless shambles
* This list could be very long but I will just cite the extreme lack of testing equipment and the difficulty in getting testing organised when other countries have conducted thousands of tests.
It's a wonder he doesn't purge medical staff of any never trumpers or others who don't pay tribute to the very stable genius. What a shameless exercise in fakery.
5
@Bob Guthrie If you were in those groups returned to the US you might have a different opinion.
@Bob Guthrie -
An understatement.
The coronavirus outbreak should give pause to the trendy, urbanist view that US housing policy should encourage higher density developments. Higher density probably means higher vulnerability to epidemics.
2
I searched the article for 'testing' because reports says that the US does not have enough testing kits. Did not get a search hit. Due to the possible spread of the virus from someone who was exposed but is symptom free, the testing of possibly exposed people with a reliable test that can yield an answer quickly seems to be very important and should be a national priority.
1
Thanks to NY Times providing such a timely article on virus prevention and our ability to deal with it.
People should be more self disciplined by avoiding mass gathering and close contact in public areas, wash hands often, and work from home if necessary.
I hope our government officials are up to this task since Chinese government took tremendous and draconian measures, and has bought us about a month of time to prepare.
But most of all, I would pray for those medical doctors and health worker who will fight the contagious disease in the front line.
4
None of the seriously infected countries tell their people not to buy mask to wear. For mask shortage, they scrambled up to find sources for availability. The communities worked on ways and means to solve the mask shortage problem.
3
@PT Which countries are those? Other sources report wide shortages of face masks.
About those masks.... There has always been a sign in the University Health Center Pharmacy asking people with coughs to take and wear a mask to protect others. It has been replaced by a sign that says no masks are available. And I see apparently healthy people wearing them hoping for a bubble of immunity. Sigh.
11
BY THE NUMBERS
US Population about 330 million
Based on no immunity and no vaccine
and about 2.3 infection rate per person infected
and transmission without symptoms
John Hopkins estimates 40 to 60% will get the virus
within the next year
Experts think the virus will be less contagious this summer.
Using the midpoint 50% then 165 million will get the virus
China data says 20% of those with the virus need hospital care
So 33 million will need hospital care
If the 2% mortality rate is close then 3.3 million will die
If 1% then 1.65 million will die.
Based on China data death rate by age is
>80 is 16% of those with the virus
>70 to 79 is 8% of those with the virus
>60 to 69 is 4% of those with the virus
In the US approximately 2.5 to 3.0 mm deaths a year
In the US approximately 37 to 40 hospitalizations per year
The system is staffed and equipped for these rates.
Hopefully the spring and summer will provide a window to prepare
a therapeutic and available vaccine for the 60 and older population that will be needed in the northern hemisphere by October. No way is it appropriate to go thru normal procedures and timeline to develop therapeutics and a vaccine. The southern hemisphere needs therapeutics and a vaccine now.
6
@wmbeaty
Facts. Good.
1
@wmbeaty -
We can’t hospitalize a low fraction of those mass casualties. One consequence of our hybrid public/private healthcare system.
@wmbeaty -
It will destroy as many lives here as it did in China.
I still have not seen a comparison of this threat vs. influenza. Is it really that much worse? Of course understand the need for preparation but still would like to know the difference between these two illnesses.
@AFR:
There have tons of articles on the difference between this novel coronavirus and influenza, here at the NYT and everywhere else.
2
@AFR
Here's an article from the NYT, just yesterday:
How Does the Coronavirus Compare With the Flu?
As new cases appear on the West Coast, some — including the president — are comparing it to the seasonal flu. Here’s a close look at the differences.
https://www.nytimes.com/2020/02/29/health/coronavirus-flu.html
1
As a retired public health nurse who worked primarily in TB control, I’m thinking of the people we required to isolate. There are so many issues. One that I haven’t seen addressed is that since most people live paycheck to paycheck without sick leave, they won’t make rent. How can we deal with evictions without a fund to cover these kinds of expenses? Luckily, our department had such a fund which was essential to better assure compliance. As the article points out, while public health can have the authority to mandate quarantine and isolation, it doesn’t have the resources to do it with one case let alone an outbreak. Let me say, carrots are ALWAYS cheaper and more effective than sticks for compliance.
7
with the cost of medical care in this country ($3500 for a coronavirus test), most people who have symptoms are not going to go to the doctor until they are half dead.
12
@kerri -
If they have even that luxury ... they’ll hide to the bitter end. The virus with them.
1
Thank you for this cold-light situation summary, NYT. Mass public health threats are one of the situations that test the true mettle of national leadership. When you cast a vote for a top national or local seat you should ask yourself if this is a person you would trust for leadership in such a crisis. I think it’s plainly obvious that we’ve done very poorly on that choice lately. It’s imperative that we choose more wisely right now.
7
This may be a test that will expose America's current social contract.
Many big firms have stayed mum while Republicans, veering further and further right, undermined national resilience. Cutting health care budgets at the state and national level leave many populations vulnerable. Suddenly companies realize that medical infrastructure matters, not just for executives. Microbes spread.
Corporate America happily led the charge against unions, leaving the dirty work to well-lobbied DC politicians. Now workers face immense challenges if job sites close down for weeks or months. It's not just low pay, but contracts that don't provide support in emergencies.
The wealthy regularly complain of paying 50% or, gasp, 55% of their income in taxes, local, state, federal. Along with inheritance, they pass along the message that government wastes their money. Fox News won't go down so well when your neighbors, family, and yourself get sick.
Those who say media and others hype this for political purpose are way behind the curve. Everything gets politicized in this culture. This won't help Biden or Pelosi. Americans fed a diet of right-wing pablum, or left-wing animus, will turn angry. Sanders is the most likely beneficiary.
A Sanders Presidency is a risky proposition, not as dangerous as Trump's, but not one for the thoughtful. If the US social contract is ripped, and CV19 reveals it, it's their own fault if corporate America gets the President they fear.
4
@Brian -
“Social contract”? Republicans tore it up several decades ago. They represent the interests of the very rich. Ever hear of “MAGA”? They wish to cut “social” service many that predate them, to the bone. Sanders is unelectable, why Putin backs him.
2
I think the gov't ...one source...should issue official statements several times a day as this virus progresses in the U.S. The statement should cover updates in the U.S. only. A statement including worldwide coverage should be issued once a day...same time every day. We should not be bombarded by the WHO, CDC, etc. It should come from one...and only one official source.
We need to do a much better job testing and tracking. MUCH better.
So far, I don't like the way this is organized...and while the Trump administration tried to calm the waters, now is not the time to minimize this. Be truthful and tell the facts, and let people know that you really don't know how this will progress but you're planning for all possibilities.
5
@J. G. Smith
I don't trust the Trump Administration to rely solely on it for information about this outbreak. This is the effect of originating and perpetuating so many falsehoods.
Sad.
1
Imagine yourself suffocating as your lungs fill with fluids from a reaction to a virus, or as you suffer a systemic reaction to the Covid 19 virus. Relief could be as simple as a ventilator, or drugs to counter the immune system's over-reaction to the invading virus. Then imagine the scenario in which a simple respirator is denied to you as you lay dying, because the hospital had no budget to stock up for epidemics. Far fetched? For-profit hospitals and even most not for profit medical systems have strong disincentives to incur costs for unlikely events. Their mandates are profit maximization, or cash generation targets. Their executives' bonusses depend on reaching respective targets, not on filling closets with respirators that might go unused for decades, and not in building capacity that might be used only in the event of a disaster. For 'free market' purists out there, perhaps now is the time to consider that government does have a legitimate role in the fantasy world conjured up by America's reality television version of a social contract.
15
A bad outbreak is likely to affect the Fox-News watching Trump base more than the rest of us, since they tend to be proud Know-Nothings. If I were Trump, I'd worry about this potential loss of supporters, just for selfish reasons.
7
I am glad someone mentioned below the universal care – or lack thereof –in America.
If this story tells us anything as it reports mainly from private hospitals and researchers in private institutions – a total government care may not be a solution at all.
In the last few decades, China has now unleashed on the world three viruses costing thousands their lives. H1N1 first, SARS the next and now, Wuhan.
And no one will disagree that China is a totalitarian and all government country.
Yet, despite their versions of universal health care – the Chinese continue to lose lives despite creating or at least giving rise to these viruses.
I think in the next Democrat debate – if we have a real good questioner – might want to ask Bernie how he thinks his Medicare for All – will be better positioned for a viral epidemic.
But I know the answer.
Just look to China which has failed miserably, or for that matter, even Italy.
1
@Neil Seriously? Are you arguing that the outbreak of epidemics in China is evidence that universal health care is a bad idea? Or that Italy's health coverage is in some way related to the explosion of caronavirus incidents there?
Surely one can find a better argument against Bernie Sander's universal health care proposal than this.
9
I am glad someone mentioned below the universal care – or lack thereof –in America.
If this story tells us anything as it reports mainly from private hospitals and researchers in private institutions – a total government care may not be a solution at all.
In the last few decades, China has now unleashed on the world three viruses costing thousands their lives. H1N1 first, SARS the next and now, Wuhan.
And no one will disagree that China is a totalitarian and all government country.
Yet, despite their versions of universal health care – the Chinese continue to lose lives despite creating or at least giving rise to these viruses.
I think in the next Democrat debate – if we have a real good questioner – might want to ask Bernie how he thinks his Medicare for All – will be better positioned for a viral epidemic.
But I know the answer.
Just look to China which has failed miserably, or for that matter, even Italy.
I never thought I would ever say anything like this, because I so highly value human rights and oppose political prisoners, but:
We owe China a huge debt for “going medieval” on the coronavirus, and being willing to lose so much monetary capital in order to save lives. They bought the rest of the world time by falling on their own sword.
And, in comparison to the Western attitude we’re seeing (Trump’s stock market tunnel vision, and Italian business ceo’s already complaining, basically saying we can all handle the deaths, but they don’t want to lose money), one can begin to wonder who values lives over profits? I always assumed the Western world obviously valued lives more than the Chinese Communist Party full of kleptocrats....
But, now...wow...the Chinese have really thrown me for a loop. Their response to the virus was initially not perfect, but I fear that they will have done much, much better than our Western capitalist greed power players will be willing to do.
I call a spade a spade: China deserves our praise and gratitude on this, and their response was awesome.
9
@Lily -
They’re actually incinerating their own paper and plastic renminbi bills rather than allow them to freely circulate.
3
Run away! Run away! Panic! How embarrassing. No, I won't ever wear a mask when I go outside or in public (or buy one). I won't stock up on hand sanitizers or cleaning wipes. I'll wash my hands like I always do, no more or less. And, yes, I'll avoid people who are obviously sick with a cold or flu, and if I'm sick, I'll stay home from work when at all possible. I will live my life now, as I have in the past before this panic ensued. Really, this is embarrassing.
2
@PJ -
Then you’ll be one of the mass casualties.
If you won’t change your daily routines out of selfish pride — what I’m hearing you say — it will get you.
The shape and substance of life isn’t static. It’s dynamic.
COVID-19 isn’t static. It’s dynamic.
You must be dynamic. Adjust to the times!
So, be embarrassed.
I can't get any masks or face shields for my medical office, been on back order for weeks, due to a virtual shut-down of the Chinese economy. I'm not only worried about my staff & other patients for Covid 19, but for flu & other respiratory infections. We are just recovering from unprecedented recalls of common blood pressure meds (made in China & India) for carcinogen contamination. We are certainly NOT "better positioned" in our country for any medical emergency. Our national leaders need to stop tweeting, investigating & retaliating and address America's problems!
8
@John Ryan -
The lost manufacturing jobs are coming home, then. What Trump wanted, and promised, his backers.
@John Ryan
Yes. Supply chain problems. The missing surgical masks are just the tip of the iceberg.
Trump has chosen Pence as the 'coronavirus czar'. He has NO medical training but is a loyal sycophant. Loyalty is ALL that matters. This is another unfit political appointee.
It is certain that if coronavirus comes to the US that it will overwhelm our current medical facilities. Having an unfit person in charge is already proving to be disastrous. There is chaos and uncertainty regarding how to proceed. Trump, as usual, only cares about the stock market OR how the fallouts from this disease will affect him in the polls.
It is very sad that rural hospitals are often underfunded and that rural people are neglected in many ways. How sad that the middle class and the poor are also neglected. It is the wealthy who get everything...the best medical care and the best hospitals and can afford the wealthiest, highest paid doctors.
Medicare for All is now desperately needed BUT Congressmen are all getting paid off by the medical lobbyists and drug companies. How will the US fair in the future? Not very good, if all that matters is profits.
5
@Carol Ring -
It’s politics, pure and simple; also symbolic: to deflect all attention from himself. He can first blame, then later discard, his current Vice President for a failure of policy leadership, in favor of someone else, someone different. Gov. Nikki Haley? Whoever has the most Electoral College potential.
President Trump is himself agnostic. And he will say or do anything to win re-election.
Really we are better off than other countries based on what? We have genius doctors who know their craft but how are better off?
The kits don’t work the administration has called this all a hoax.
We don’t have health care for all , rural America doesn’t have medical access .
So all of our greedy corporate sins are coming back to destroy us. No health care because of greed, so don’t think sick peoples are going to seek out medical care because they are not going to
Thank you corporate
America
4
@Tony -
True, but rural America has distance and scarcity of sheer opportunity and a few other things going for it. The virus will try to find a foothold in another animal, and unless its uses field mice, rural America is fairly safe.
I see it as a disease of crowded city-urban living.
I think what happened is fairly obvious: it jumped from a wild animal species to us.
@Tony
Oh, it’s American Exceptionalism at work. Here.
We only have "70 cases" because widespread testing hasn't been done. We are way behind the eight ball because there is Zero leadership in this Country on the Federal Level.. Propaganda won't cover up ineptitude this time. I do have faith that Gavin Newsome will ramp up the effort in CA as much as a State Governor can without the resources of a competent Federal Government. Too bad the CDC has been crippled by the GOP.
9
@Sasha -
It conflicts with their ideological agenda. That makes a crash prevention program a non-starter.
2
@Sasha Please understand, testing in no way prevents transmission of disease. It simply identifies those having the disease. Considering the current tests are over $3000, widespread testing would be insanely expensive. Your best bet is to avoid crowds, wash your hands frequently after being in contact with anything outside your home and keep up with good health practices.
@Margo yes that is the plan but it is necessary to provide free testing in a pandemic and to identify hot spots to quarantine in order to slow down the spread.
These is no lie people and one need not miss the general health wise comorbid conditions to the American public. Overweight, sedentary and more or less incapable of walking a city block at a fast pace. This will create a crushing demand on ventilation capability and a logjam for optimal care. Trump's team, CDC especially, needs to tell smokers and asthmatics and morbidly obese people to stay home entirely and not venture out at all. The country is only better positioned ( if and only if) -- the general population is young and healthy.
1
In the interest of public health and safety, because he is OUR President and wants only the best for ALL of us ...
Will Trump stop his rallies with thousands of deluded supporters all cheering and shouting?
Second thought .... he should be doing them 3x a week,,,,,and bring Melania and even Barron (if he remembers who he is). And Steve Miller too ... they should work the crowd, hands on.
@Tim -
No. Not unless forced to.
The weakest link in America's battle with coronavirus occupies the White House. Trump's comments were decidedly different from Dr. Anthony Fauci, so who am I going to trust? The con man whose lied 16,000 times or the doctor/director of NIAID?
The problem is, Trump is in charge.
4
@Scientist -
President D.J. Trump isn’t in charge. No one is, in part because the peril is unprecedented, in part because he’s the worst president ever to occupy the White House.
President D. J. Trump invites chaos. He seems to want it. He seems to believe in its curative powers. He said as much in his very bizarre Inaugural Address.
To make up for his stumbles, Trump should declare an executive order that people without insurance coverage can get free testing at hospitals and clinics as long as the crisis lasts, and that the government will reimburse the hospitals from the Defense Budget. (I think it was $486 billion last year.)
Will he do it?
What a silly question.
3
@ernieh1 -
He won’t.
He’ll wait for advice about what to do from his “czar”.
@Steve Singer I would not cont on Mike Pence to come up with such an idea.
But even more germane, the Defense Secretary should propose something like that for the very reason that if coronavirus sweeps through the military bases, the country's security will be put a serious risk.
So it is very much in the interest of the Defense Department to put their half-trillion dollar budget to use.
Why has no one come up with this idea, except a NY Times reader?
The answer is that Trump and the GOP are all about politics and nothing else.
So when this is all over, how many people will have died because of Trump's obsession to get rid of anything that Obama
had accomplished? The man has no idea what he is doing, and he never did.
4
I've been in isolation, here in Seoul for the last week and will continue, however I am very concerned about the reports from the PRC which describe how patients, who were released from hospital care, are still testing positive for the virus. Is this bi-phasic?, will there be relapses? Will this still be out there when I go back out?
If I come out of hiding and this virus is still waiting out here for me, I might have a problem. Considering this, I think it is quite clear that America is not really prepared to deal with these issues very well either.
16
@Ronn -
Just because a virus is contracted by someone doesn’t mean that they’re ever “cured”, even when they leave a hospital bed and return to the unhospitalized public world. Being HIV positive is a good example.
Economics dictates it. Hospitals need their beds open for new paying patients. To retrieve them, they need hospital discharges. They can only do so much for patients.
1
@Ronn – Your Comment raises questions about what the “coronavirus test” tests *for*. Does it measure antibodies? If so, which ones? Is carrying antibodies equivalent to being a risk for transmission? Unfortunately, I haven’t seen such questions, and others like it, addressed, even in top-tier media like the Times.
1
@Ronn -
What’s the old comedic expression? “3 into 2 won’t go”?
We want it, but won’t buy it. It costs a ton of money. Although we’ve spent over six times the Gross National Product on the nuclear national security state, nuclear weapons and delivery systems? The CIA, the DIA, the NSA, a two ocean Navy and Air Force, and now a national Space Force, and the National Reconnaissance Directorate, drone robot aircraft, and now something called “kinetic non-nuclear weapons deterrence”?
Don’t forget three catastrophic foreign wars. Or is it five?
So we refuse to borrow even more money and pay for it? For our own people?
Are you crazy?
1
The Costco picture looks like every Costco at quarter of ten, just before opening. Nothing special about the crowd.
1
It seems that Trump is withholding facts from the US people. Here in the UK, it's a really big deal because of the % who are badly affected or die, and currently all we can do is test people. After that, it's medieval stuff like isolation.
Also in the UK we have the NHS, which is imperfect and is creaking, but is free at the point of delivery. The NHS has a buffer to treat emergencies, called discretionary operations and appointments which can be rescheduled.
I was in San Francisco last week for the first time in years, and the number of homeless was far higher than 10 years ago.
Where do they get medical help?
10
@Richard -
He’s running for re-election. He will say or do whatever he must to win a second term. It’s frightening.
This virus will run its course and this country can in no way contain it in meaningful ways. Too many loopholes.
Each individual will decide for himself or herself how best to weather this. Some will make good decisions, and some will not.
Many people will get milder cases and recover without medical treatment.
Others will die because they are frail or because of compromised immunity or because Covid is more lethal than known.
By this time next year we will learn whether coronavirus becomes less impactful ... or continues to be an ongoing threat.
By then we will learn if having Covid provides lasting immunity or if it can be contracted again, much like any flu.
What will start to ebb is the panic as we see this play out firsthand this year and realize that this is another fact of life.
9
And people who voted to close their rural hospitals will be taken to suburban and urban hospitals, potentially crowding out those who didn't vote to have their hospitals close.
Doesn't seem fair.
10
Nobody gets to vote on closing their local hospital, big business does that.
5
@Funky Brewster -
They don't want to pay taxes. They consider it a waste of taxpayer money. So they mooch. Unashamedly.
It’s a matter of being “anti-tax”.
And they think ”I’ll never use it. It will never happen to me”. Or, so they think.
It’s our main weakness as a nation. We tell ourselves things that aren't actually true but are impossible to do — or to finesse. We live in a fantasy world. Along comes a lethal and very unpredictable virus ... .
Welcome to the American Healthcare system!
1
We are all in this together.
Good article. I would urge U.S. public health agencies to study South Korea's response to coronavirus. I am currently in Seoul and this is what I have observed.
1. The government is totally transparent about the numbers. Briefings are conducted by Korean CDC officials, not politicians, twice daily.
2. Tremendous efforts are made to track the movements of people found to be infected. Government health workers have had direct phone contact with 200,000 members of the secretive religious group that is at the center of Korea's outbreak. They are asked if they have symptoms and they are tested if they do.
3. The government pays for the test if a health official requests it. Those who seek a test on their own pay about $125.
4. Korea is capable of doing 15,000 corona virus tests per day.
5. Drive-thru testing centers have been set up in hot spots.
6. Korea sends emergency alert messages to all phones when new cases arise so that everyone has details about the neighborhood where infections have occurred.
35
@Robin -
South Korea is a much smaller and a very militarized country. And it has major socioeconomic problems. It isn’t a good example.
@Steve Singer I am not saying the US could do everything Korea is doing, but certainly briefings by scientists and government-paid or subsidized tests would be possible. Also, I would not describe South Korea as militarized. I don't even know what you mean by that. And, I'm not sure what socioeconomic problems you're referring to that would be different from the US.
28
@Robin -
It’s politicized, there and here.
There, its the North Korea military problem, and that the South Korean capitol city is well within North Korean artillery range.
Here, it’s the 2020 election campaign, just a few months away. The virus complicates the process, and it will be difficult for all campaigns to operate at peak efficiency.
Trump’s, of course, is playing a deep defense; to be expected.
1
Excellent article. We all need to remind ourselves of the arrogance of Nick Mulvaney, Trump's (Acting at) Chief of Staff. Probably not even knowing what a virus is, he cravenly told the American public to turn off their TVs for 24 hours (to prevent the stock market from tanking further). If we look back, it is likely we would not have learned important information that is pertinent to decisions we need to be making now to save our, and our families, lives. We all want to be reassured that "everything will be ok", so when a conman (Trump), and a pastoral counselor (Pence) reassure us, it is wise to be very very skeptical of anything they tell us, unless we have already learned from other sources that the supporting facts are real. Being a physician, I suspect Dr Fauci is in a bind only he can navigate -he knows how important he may be to the effort to combat the pandemic, and he knows he needs to not get fired to do that job, and to provide real information to the public. I will give his words credence, at the same time knowing he may have to "shade" his statements, so that his steady hands, despite beiing slapped, are still at the wheel. preventing his bosses from making catastrophic mistakes, that literally could cause the deaths of hundreds of thousands,or possibly, millions, of Americans. Trump should have been touching anyone's hands anyway. Where is his germophobia when we need it?
25
@riverrunner -
He embarrasses himself. I, for one, pay him no mind
We’re rapidly being forced into an impossible position: forced to depend on the advice and scientific knowledge of undependable government officials. They, of course, will blandly state that nothing is amiss, and insist on doing it, although they know better.
7
Fauci has enough credibility to forcefully denounce Trump. Even members of the cult concerned about the lethality of the virus would come to Fauci’s aid. But Fauci may be more interested in his paycheck than in serving the American public. And he would get his job back in a year providing Trump is fired 11/20 and not rehired.
@riverrunner
In answer to your last question ask Stormy and Karen, both of whom claim he used no condom. I guess he was just feeling extra romantic being lonely and away from his wife.
Poor fellow - especially considering his phobia which apparently did not inspire a panic attack like the one he suffers now over the stock market.
1
Why the highest recommendation is avoid non essential travel? What would constitute "essential travel" these days especially given the risks and consequences at stake and with all the online technology available today? Travel should be banned to those places, not recommend avoidance.
7
@tdb -
What’s “inessential” to you is “essential” for somebody else.
It’s all subjective. You take your life in your hands if you do check in at a crowded airport, forget the jetliner travel part.
For what it’s worth, I got sick a lot right away after traveling any great distance by jet- passenger plane or even by a turbo-prop plane; one reason why I stopped. Going though TSA check-in lines and screening is another. Contagion wasn’t foremost on my mind, as I did it. I learned that it just wasn’t worth it to force myself to go through all those ordeals.
4
@Steve Singer
The securities markets are now discounting our reduced economic activity.
1
As for testing kits: these are important for tracking the progress of the virus through a community. We've already lost some ground in alerting some areas that the virus Has Arrived and I have no doubt that it's a lot more widespread than is being reported.
However, for us as individuals, once we're sick it's a moot point: if you have a fever and a cough, then "suit up" before going to the doctor if you feel really awful, but otherwise self-quarantine. (I'd call in and say I suspect I have it.) Knowing whether its Covid-19 or not doesn't matter, because there's no specific treatment for it.
11
@Flânuese. It is important to know if the virus is COVID19 or not even if one has light symptoms, or not so serious symptoms, because the person would have spread the virus to others before having any symptom. For young healthy adults and kids they are likely to recover, but if any elderly people or those with existing illness are around the person who has the virus, they can be in danger. The fatality rate of COVID19 for 70 and older and for those with other illness is high >~15-20%. So even if people self quarantine themselves after realizing symptoms they would have spread the virus to others for past 14 days at least before they knew they had it. So it is very important to know if it is COVID19 or not, and inform people around them about it. It is for those who are vulnerable.
19
@Flânuese -
But how do you do it? If you can, or must, travel by a municipal public conveyance, you add to the viral load in the car — spreading your disease to many others — this while risking catching another, usually a bacterium.
1
@Flânuese
@jsk - right, that's what I was saying - it's important for the community to know but for the individual it doesn't make much different when it comes to managing the course of the disease.
@Steve Singer - I'm in the same boat (or bus) as you: how (or if) to get around to my usual activities now, and then later, how to get to the hospital if I need hospital care. I'd feel bad about summoning a taxi or ride-sharing cars to take me to the hospital, even if I'm swathed in mask and gloves.
I'm mixed about uber & lyft: OTOH I avoid these in general because of their business and employment model; OTOH I feel for the drivers because they will be impacted in various ways and could add a bit to their income by taking them to my Spanish class. But the drivers might be sick and unable to self-quarantine.
2
Technologically we are at a very high level, but not everyone is able to use it meaning able to pay for it..
40% of Americans don't have $500 in savings for emergencies
27 Million Americans have no health insurance
30% of Americans are on high deductible insurance plans
1 in 4 Americans have to refuse medical care because they can’t afford it
35% of Americans get no sick pay
40% of Americans don’t get flu vaccinations
Now imagine just a small portion of these people are forced to see a doctor and get checked for the corona virus? A guy in Florida felt sick after returning from China to Florida. He went to the hospital to get tested. The tab, $3,200 and $1,400 co-pay. You get the picture? This is why the market is crashing. We are a consumer oriented market and a lot of people are realizing right now that they are ill prepared for an emergency.
Politically, Trump and the Republicans are very afraid of the virus as it might expose their failure in healthcare. People in Europe are pretty relaxed as they know all of their expenses are covered. People are also encouraged to stay at home when they have flu like symptoms and a doctor will be send to their home. Can anyone imagine that here? Unless the CDC offers at least free testing for the virus I see a recipe for a possible disaster until vaccinations are available..
114
@balance Very good points! that's why we should be concerned and we really need to have a way to get the test done cheaper and quicker. Someone who visited Italy and got sock with fever and coughs don't get tested even if the person develop pneumonia. It's a true story...
The medical care here in this country reality makes me very concerned. The test should be free.
10
@balance , Any testing performed through a state public health laboratory or the CDC is free of charge. The caveat is that any testing must be approved through state and local health authorities (and their criteria is still fairly strict at this time).
The other caveat is that at this time, many state health laboratories are requiring negative tests for other respiratory pathogens, which in many cases the patient would be billed for.
Thus, technically the COVID-19 test itself is free (if a patient meets testing criteria), but it’s all the other testing and possibly other medical care that patients will be on the hook for.
8
@balance
It doesn't matter how many medical ventilators, hospital beds or testing kits there are: when people won't see a doctor because they are afraid the medical bill or the possible time in quarantine without pay would financially ruin them, all those medical supplies and capacities are pretty much useless.
What's even worse: most of the people without proper health insurance work in low paying jobs in the service sector and have a lot of contact with a lot of people during the day: waiters, employees in fast food, delivery drivers, retail store personell... They all could spread the infection to hundreds of random people before the symptoms get so severe that they are forced to stay at home and seek medical help. This makes it much harder to contain the virus since it's nearly impossible to trace back everyone who - for example - in the past 14 days got a coffee at a Starbucks where one infected worked.
14
Why is the CDC so restrictive on who can be tested? It makes no sense. This means that the asymptomatic and mildly symptomatic are walking around Infecting many more people!
The strategy should be to test liberally so as to catch as many cases as possible and prevent this from becoming an outbreak.
Is the government not doing this for political reasons? Due to incompetence? Is there any logical justification for it? Please, someone explain whether there’s any logic to this?
36
@L It’s because they have a limited number of test kits and personnel qualified to do the testing. Each public health lab may have only a few hundred kits available to them. They have to focus the resources on the most likely people to have the virus which, until recently was people with a history of travel to countries with (known) outbreaks. With the recent reports of community spread, they had to revise that criteria to include patients without a travel history.
The problem with a virus that has such a long incubation period is that you can’t predict where it is in real time. You only know where it was two weeks ago.
The fact that there are not more widely available tests for this virus is actually not the fault of the CDC(they are churning them out and sending to public health labs as fast as they possibly can). The real fault lies with the FDA and their over regulation of laboratory diagnostics- preventing commercial manufacturers from getting their tests out to the public and also preventing laboratories from developing their own tests.
Laboratories in Europe and other parts of the globe are not hindered to nearly the same extent as we are in the US.
Tess Karre, MD
10
@L
Shortages. Manpower shortages, and a shortage of test material. And a shortage of time to test. That’s the great enemy, time. This is all crashing over their heads. Never forget that. The viruses have no weekends, or holidays.
So, rationing ensues. As a result, mistakes are going to be made. Governments are going to lie, because they don’t know, lack the resources, and they’re papering over vast political chasms. They aren't “rational”, in a word.
So, take everything coming from that information source with a grain of salt. Don’t believe or disbelieve, either. Assume the worst. That way, you’ll never be disappointed.
It will come on suddenly. So, practice a hard defense. Be paranoid. Assume that all the various COVID strains in this coronavirus outbreak will spread widely.
4
@L There are 300 miilion Americans. Most of us get a cold this time of year. You cannot possibly test everybody. Its just an issue of logistics
Please tell us what the "underlying health conditionions" are. We need to know where we fit on the vulnerability Lickert scale. Our doctors stick to the now irrelevant script that the "flu kills more people", which is not helpful. We need clarity on the types of underlying conditions increase risk of death.
19
@Nancy
Tony Fauci addressed this at the press conference today. Not surprisingly, the most vulnerable are older people who have underlying, pre-existing health problems. Of course there will be outliers, as there are with every disease. But in general, 80-85% of people will just experience the feeling of a nasty flu or cold.
Again, this is IN GENERAL. That still leaves 15-20% who will need hospitalization. These numbers are also based on the experience in China.
5
@Lisa Simeone -
You forget mutation.
The virus wants to mutate into a non-lethal form. So it throws off different strains, most with weaker effects, some stronger, randomly. These work, or not. It knows nothing. It’s all math and probability.
It wants to spread. Find new, and better hosts. It’s the oldest evolutionary engine, what’s at work here.
2
@Nancy
They don’t have any answers because they don’t know. Simple answers are not the answers but with Trump leading we will never know how to protect ourselves
So I am reading between the lines of these great doctors who I know know the real deal
2
Florida as a state, with its huge elderly population, seems hardly prepared at all. Within one block of the hospital in my town is a condo with perhaps 75 people over the age of 60, many already in declining health due to infirmity of age. In this condo, people use the same four elevators, the same laundry facility, mailbox area and perhaps other places of close contact. If half of them were stricken in a month, I doubt there's space for 30 or more acutely ill people in the hospital. This is just one such condo community in one of the smaller towns in a county of more than half a million people. At least two more assisted living facilities would be served by the hospital.
These elderly are only one population segment of the people around here who might be infected. The article mentions 62,000 full-featured ventilators nationwide. That many could be needed in Florida in a week for old people who'd be the first to get the virus and need treatment.
Plus, those sick with pneumonia will need a lot more care than only ventilators. We'd need help brigades in neighborhoods to shop for the sick if we don't want the walking ill to go out themselves and thus to spread the virus.
The plain fact is that if the virus gets loose in a place like Florida's retirement communities and neighborhoods, residents will suffer and some will die of causes we could avoid but won't due to lack of organization and leadership
40
@Roy One comforting thought is that hot weather in Florid will shorten the survival time of viruses once they get out of a host. Probably why we don't see an outbreak in tropical areas such as India.
2
@Roy
You can repeat that dismal picture throughout the entire country, the entire United States of America. It’s why we’re so vulnerable to something so bad arriving from overseas. For the virus, it’s easy pickings. That’s why it’s here to stay. We aren’t designed to combat it, so it comes here. It tries to exploit opportunities to spread itself through others. That’s what it’s been designed to do by Mother Nature, and it does it very well, evidentially.
1
@Michael
I have been advising my friends and neighbors to wait and see what happens here. In Florida, winters are an alternating week of cool, dry air from the north with a week of humid moist air from the southwest. Spring has already started in the mid-peninsula. The regular flu has already run its course, it seems, following its usual seasonal pattern.
That having been said, generalizations about the role of environmental factors overlooks many special cases. Vulnerable older people living in close quarters are going to bear the brunt whether the virus proceeds through the worst-case scenario or one that is just notable for its severity.
In either case, if in-hospital care for the tens of thousands of people who need medical care as it is delivered now in for-profit hospitals comes to pass in an epidemic, it will be a health disaster like this country has not seen since polio epidemics a century ago.
So, no, my county's health care businesses are not remotely prepared and have no realistic path to reach such a condition.
1
Bloomberg is showing great leadership in broadcasting his message Sunday night as to how he would handle a crisis.
Maybe this will embarrass Trump and Company enough to get serious about this threat.
25
Doubtful. They’ll just try to discredit Bloomberg who is only 5’6”.
1
@Bronx Jon -
Assuming President Trump even watches “fake news” TV networks.
1
Everybody should calm down. The fatality rate is almost certainly way overstated. The denominator is only currently capturing people with severe symptoms. If it turns out many are infected but do not show or have only mild symptoms the fatality could drop to way below 1% because the denominator will increase dramatically.
https://www.fool.com/investing/2020/02/29/coronavirus-emerging-numbers-provide-reasons-for-c.aspx
5
@kp -
There’s probably more than one virus strain circulating within the general population. And other medical conditions are stressed out by them.
Most victims of the 1918 “Spanish” Flu are thought to have died of their immune system’s over-the-top over-reaction. The advanced age of the victims is also a factor. It’s murky.
I favor the first explanation. A strain, one strain, kills most of its victims. Another manifests itself as a sharp head cold.
1
@kp These are the problems, I believe:
1. 80% of the cases are mild.
-So these folks can walk around in public, unknowingly spreading the virus.
2. It is a novel disease, so no one has developed any immunity to this new type of virus.
Anyone who inhales droplets from a sneeze or cough of an infected person will most likely get the disease.
This means a rapid and broad transmission can occur, especially in cities, overwhelming health care services.
Once that happens, the only way to slow it is to do what China did in Wuhan - placing the city under quarantine.
5
@DataDad
We have a degree of vestigial immunity to it. Its precise genetic origin and mutation history is unknown. Since the genes that it swaps are your’s, the outcome is variable.
facts on the ground over the past week argue we aren't any better prepared than was China if we have a Wuhan scenario.
11
How prepared ? Like going on a Family Road Trip with the gas tank on empty, the Kids hungry, and leaving your wallet at Home.
Seriously.
34
@Phyliss Dalmatian -
As a practical matter, you can’t deal with multiple crises at a time.
That says it all.
Given that the president has recently reduced funding for addressing pandemics the US is less prepared than we were!
22
@Baruch -
It’s all posturing. It will probably be re-funded by a special act of a Democratic Congress, one that President D.J. Trump will try to veto but risk being over-ridden. It’s a political gesture in an election year. So, he will probably acquiesce. Not do anything but posture. It’s all posturing.
1
The thing is, many people are unwilling to stay home when they are sick, make no effort to contain coughs and sneezes, spit into the street and do not wash their hands. I believe a public service campaign regarding hygiene (as they have in other countries) needs to launch immediately - it may not change everyone's habits, but it certainly might make an impact for some.
19
@479 When I worked for employers I was ordered to show or be fired... I didnt care, it was on them if the rest got sick.
13
As a small business owner for a small animal veterinary clinic in Knoxville, TN, I just had a staff meeting last week regarding illness - stay home when you are sick, hand hygiene practices, cough etiquette, etc. Business owners (corporate, large, and small) must educate employees about sick leave policies, paid time off, and come up with a plan re: emergency preparedness for COVID-19. Education, communication, and discussion about company policy is a VERY important factor to helping stop the spread of COVID-19. Hoping all business owners will do their part and step up to help curb spread of this illness ASAP.
29
@DG -
It’s a dog eat dog world. No allowances made. No mercy shown.
Because so few in the US have been tested ( about 500, as opposed to 10,000 in UK and 60,000 in South Korea) the number of known positive cases in the US is still low. The actual number may be in the thousands or more. The US does not have sufficient kits for testing. It seems like the CDC has fixed the problem of defective coronavirus test kits and a few hundred kits each will arrive in state testing facility by the end of next week. So we may only begin to get an idea of the numbers of people infected in about 2 weeks. Meantime infected people will continue to spread the virus. Difficult to believe how the US of all countries messed this up so bad. Don’t think we have the luxury to wait several weeks to find out. Testing must be ramped up immediately. The country probably needs a few hundred thousand coronavirus test kits. Import them if needed. In the meantime until we know the true extent of the spread of the virus, instead of telling people that the risk is low, and not to worry, they should be told to assume that the epidemic is already here and begin taking common sense precautions.
43
@Tom -
Mass testing will come much too late to be of preventive value; anything but a statistical afterthought.
Bear in mind how it escaped China, and act accordingly.
Don’t be its vicim. Figure you have 100% of being infected if you put yourself in an infect-able situation. What after happens after that is a guess. You could catch one of the milder versions. Or catch the lethal strain. It could kill you. No way to know.
Its incubation period appears to be about two weeks. Avoid public places, if you can, during its communicability period.
Assume that complete strangers are sick and don’t know it yet.
Assume that the surfaces around you that you touch are contaminated by them; again unknowingly.
Wash your hands frequently. Don’t touch your face. Don’t transmit it to yourself.
Be paranoid. The life you save could be your own.
1
Until Trump starts telling the truth nothing will begin to be anywhere close to resolvable and we should have learned by now that can never happen.
37
@Brendan Varley -
Tell the truth? Right.
But President D. J. Trump’s lawyer, Rudi Giuliani, told us, “truth isn’t truth”. So don’t hold your breath.
has the White House or any federal government agencies provided local and state governments with recommendations or suggestions how to deal with these questions:
allowing employees to work from home? How should governments deal with employees who recently travelled from countries/locations with Covid-19 viruses? What happens if an employee is sitting near an employee who is coughing and doesn't feel good but is at work? Can they demand that they go home? What happens if someone just came back from an area with virus victims and wasn't tested?
PAUL FEINER
10
My hospital won’t. They are only focused on money and marketing. Our hospital looks the other way as sick coughing employees are allowed to stay because we are understaffed. I’m afraid to report this to DPH because I will be fired if found out. So I keep quite violating Biblical commandment found in Leviticus 5:1. It starts out by staying,
“ If anyone fails to speak up...”
I am one who failed. The plague is upon us.
1
This newspaper just had an article about people being sent a bill of nearly $4,000 for being quarantined. That is as bizarre as being sentence by a judge to 10 years in jail for a bank robbery and then receiving a bill from the judge for 'services rendered.' If we continue to charge people for quarantine, we will drive the sick underground. The second issue is if we have to restrict large public gatherings, let us not forget we are in the middle of a primary season, and I wonder whether Bernie Sanders will selflessly agree to suspend his large rallies.
14
@boji3
Interesting. So Bernie Sanders is the only one who has to "selflessly agree to suspend his large rallies"? What about the other candidates? What about Trump? Do they get a pass because . . . why?
23
@boji3 Without a universal health system many people in the service industries (hotels, hospitality, transport etc) are not going to report symptoms as they need their job and will fear any crippling bills from health providers if they are uninsured.
It would seem there are two ways to approach this,
1. Would be to declare an amnesty on all health charges related to diagnosing and treating Coronavirus until there is a vaccine, with costs covered federally.
2. Secondly, employers should be required to provide temporary sick leave to anyone in their employ who is diagnosed for quarantine or treatment. They should also face fines if it is discovered people they employ are carrying the virus at work and still required to work to retain their job. This sick leave could be offset with federal subsidies to employers as is being proposed in other industrial countries.
29
@boji3 -
The sick are already “presenting”, as their doctors would say were they, their patients, not hiding underground, and struggling to contain their symptoms all by themselves.
It’s a zero sum game. They can’t afford it — “it” being their medical treatment, and the medical bills for it — so they hide, creating a vacuum, and a personal/public health menace down the road because the virus hides with them in its new reservoir, where it mutates.
Welcome to the United States.
2
65 confirmed cases in the U.S.? Anyone who has been paying attention knows that this is a laughably low number. I estimate that the real numbers are in the high thousands, if not already in the lower ten thousands.
I am not in panic mode - no member of my immediate family is in the most dangerous demographic. But I am beyond angry at the completely inadequate, inept and yes, criminal response of the Trump administration so far.
This is the president we have: someone who is more concerned about getting re-elected so he can escape punishment for his crimes and keep making money than safeguarding millions of lives of Americans.
78
@SYJ : President Obama in 2016 warned of who Donald Trump was to voters. Obama said, "Donald Trump spent 70 years of his life only caring about himself. And now all of a sudden he says he's going to be YOUR champion? Come on man!"
Too bad voters didn't take President Obama seriously before they stepped into the voting booth in 2016.
5
@SYJ -
It only takes one family member who is careless or unlucky. Talk to the entire family. Warn them. Ignorance isn’t bliss.
They’ll be hit before they know it.
You don’t want this problem in your life. Trust me.
Here in Spain the public has been informed in a calm and realistic manner: "this is what we're up against, this is what we are doing. Some people will die, but that is inevitable, and we are working to keep those numbers to a minimum." This is how you speak to a mature society. The attitude of many people on this very thread seems very childish, very unwilling to accept mortality and the fact that some people in the US will perish from this, or survive it only to get pneumonia next winter and die or get hit by a bus. I don't see the difference.
13
@Kris:
Because you have national healthcare and a social safety net. We don't.
There are millions of people in this country who can't afford health insurance and don't have it, or they have it but their annual deductible is outrageously high, so none of them can afford to go to the doctor when they get sick. So they'll just continue to circulate in society and spread this virus.
They also can't afford to take time off work. They tend to be the most lowly paid and most vulnerable people in society, working manual or service jobs with no paid sick leave. Again, they'll work till they drop because they can't afford to do anything else.
The U.S. is completely unprepared for this pandemic. Richest country on earth, and this is where we are.
53
Don’t forget the legions sleeping on the street. Richest country in the world?
Maybe silliest. Most cruel.
And now ripe for contagion, community spread and decimation.
What a way Mother Nature, has, with redressing imbalance. This will highlight in a finally inescapable way, that we are all in this together- and we are indeed our brothers keepers.
2
We should close all schools and let students work online. This would be the prudent thing to do.
Why wait until the outbreak spreads?
19
@Rax -
Watch for it to happen. Mathematically, some of it will deliberately target human gathering-points. The great danger is that it takes up residence in hospitals.
@Rax What plans are in place for families without online access? Suggesting computers at libraries contradicts rationale to not bring people together in large groups. Schools have been encouraged to plan for a public health emergency just like this. My hope is that they are reviewing and tweaking their plans-not beginning to develop them just now.
Under or Un-Insured patients are going to be reluctant to seek medical care and testing due to large bills. Thanks to our broken system we will have more spread than most other modern countries.
We also don’t protect our workers with enough paid time off for sick days, so many sick, possibly Corona Virus infected people will continue to go to work.
These two factors alone make it very risky for the US.
45
My district (I'm a teacher) in Western Washington just sent a robo-call with info. We are currently scheduled as open, but if any cases are found they'll close the school9(s) to clean it, and they'll follow CDC rules.
I think it's a minute by minute situation right now, and I don't think that anybody really knows what is happening. I suspect that the rules will change in the next 24 hours: there is a facility a few miles from my school with 52 possible cases of coronavirus (two are confirmed, the others have symptoms), and that's new info today. The Seattle mayor has set up emergency operations, the governor of Washington has declared a state of emergency, and hospitals are saying "if you have symptoms, CALL US but don't come in." This is all new in the past few hours - who knows what the next few hours will bring! I'm glad it's the weekend so many folks are at home.
I did stock up on basics including plenty of groceries, picked up my one prescription, etc. The stores were busy, and some items (hand sanitizer) were sold out. That's okay with me: if I'm stuck at home it's easy to wash my hands with soap and water, of which I have plenty. As healthy people (no underlying disease), if things are canceled my daughter and I will be bored being stuck at home, but we'll be just fine. I feel sad for those less fortunate.
So - now we wait!
70
Hand sanitizer sold out at my local CVS today. My assumption is people are definitely panicking re: stocking supplies. Agree, it is reasonable to stock up of necessary supplies, but I was a bit shocked to see this at my local pharmacy. As a former EMT, current veterinarian with a masters in public health, I do very much worry about this disease but worry more about mass hysteria re: COVID-19 and media making this situation worse. Everyone sit tight, wash your hands, and stay home of you are sick or have traveled to active epidemic area within last 14 days. This is all we can reasonably do to avoid any viral epidemic, including influenza.
10
@Kristina I just got an e-mail (on a Saturday night!) from the Oregon Health Authority that someone being tested came up negative—I'm impressed that Oregon is organized and keeping us informed; other state and local health departments may also have handy tools for tracking this thing.
6
Why would anyone listen to Trump's statements regarding the coronavirus? Might as well believe China's reported numbers. All lies to ensure political survival.
36
This is laughable at best.
There are large numbers of people who do not have any health insurance and therefore do not go to doctors unless on their deathbed.
There are even larger numbers of people who do have insurance but who also have high deductible plans who also do not go to a doctor except as a last resort.
Then there are those who can't afford to miss a day of work at all and because of this are more likely to spread diseases, cases of flu, and other communicable ailments.
We are NOT at all prepared here if this becomes much worse.
125
@quantum
The US has a for profit healthcare system designed to avoid providing care. Insurance companies just lost billions in the stock market and now they are going to go broke covering all of their insured clients.
Hospitals are for profit. Shortages guarantee that uninsured and under insured patients will be denied care.
It could get very messy.
23
@self -
“Will”, not “could” get messy.
It’s a world-wide phenomenon, and our stupid and ancient, still unreformed private/public healthcare for-profit hybrid healthcare system is on trial. Bet that it won’t perform very well compared to all the other models.
God forbid, if I happened to get the coronavirus, I would rather be a resident of the US. We have some of the best doctors and medical professionals in the world. We have first rate hospital facilities with the latest modern procedures and know how anywhere. I would feel I was in good hands and very confident. That cannot be said of all countries. We have very high standards and this is why people want to immigrate here.
4
Only problem is that the US seems very underprepared. Not enough masks, test kits, hospital beds or ventilators. Our system will be rapidly overwhelmed. Yes under normal circumstances US hospitals do fine. But we are going to be tested like never before. And this administration has lost a lot of time. The fact that we still don’t have enough kits to test suspected patients, says it all.
33
I’ve been in practice in critical care and cardiology as well as primary care. Everything you said is wrong. I’d rather be in Europe or Canada.
2
@Tom What exactly do you think a better president would have done since this thing was discovered a mere 8 weeks ago?
Better prepared than the countries with universal health coverage? 27 million Americans have no health insurance, not even through their jobs, and millions more have such a high deductible with their insurance that they avoid going to the doctor or hospital.
We won't be prepared until people can either afford health insurance (not likely) or we have universal healthcare (not likely.) Millions of Americans will be up a creek without a paddle if the epidemic hits here hard.
56
@Linda
Hospitals are required by law to provide emergency medical treatment regardless of insurance status. Even without this law no one is going to be denied care in this country.
4
Yes, but then the uninsured individual will receive a bill for thousands of dollars for which they most likely will not be able to afford. That concern alone will drive some people to not seek medical care.
30
@MLH: But if you go to an ER you will still get stuck with a huge bill, so the uninsured will avoid going to the ER.
20
Well, we need to buy the medical community more time to deal with potential patients. Instead of pondering for any longer, perhaps they should start by closing schools. Yes, terrible for parents across professions etc. It would not stop the spread of the disease, but might slow the spread as families stay home instead of mingling. We are badly underprepared for the vast numbers of older people and immunologically susceptible people falling seriously ill. So yes the public may be inconvenienced, but we need to act with humanity and compassion towards the vulnerable population. So shut the schools in California, Washington and Oregon for a start, from Monday onwards.
28
@Meena -
It will come in waves, the infections. We don’t know the length of the post-symptom “presentation transmission period” of some strains. It could be very short. It could be very long, too. The initial virus throws off variants with different capabilities.
So you need to close public venues and gathering places.
This fact of life isn’t often discussed in any detail by elected politicians, for obvious reasons. And whatever they do say might be contradicted by the viruses.
Because of the lack of foot traffic, most of these businesses will first teeter then go out of business altogether.
1
We have zero national leadership - merely obvious lies and the muzzling of experts who could help us all know what to do, from employers to health care workers to average citizens.
The John Hopkins website at this hour states that there are 68 confirmed diagnoses. Every time I look at the tally for worldwide cases, it increases substantially.
42
@Lynn Taylor -
You’ve been told what to do, repeatedly.
Stay out of public places like airports and train stations, subway cars, subway stations, sporting events, restaurants, markets of any kind, coffee houses; wherever the general public gathers, as hard as it will be.
Don’t touch anything, your face especially.
Wash hands frequently.
Be vigilant.
Assume that whomever you encounter out there is carrying the virus and doesn’t know it, else they wouldn’t be out and about. They’re just as afraid as you are, or should be.
Assume, too, that you will be exposed to it at some point.
Assume that it will happen, and it will sicken you. Assume it. If not sooner, then later. So, prepare yourself for some physical and mental nastiness. Also, prepare yourself for a supply chain collapse. Prepare yourself with adequate dry food and, especially, bottled water reserves.
I can almost guarantee that you won’t want to be forced to leave your sickbed in search of food and clean water; clean water especially.
1
So....the government can do with us what they will? What is this law? I would hope you could tell us exactly where that can be found.
Can the government break into our homes and scurry us away to where ever they want?
That's rather disconcerting.
6
These are state laws. In New York State, this is public health law which can be accessed on the internet. In general, isolation and quarantine are done by a health commissioner’s order for an individual who has not voluntarily complied with measures designed to protect the community’s health. There is a judicial process to safeguard individual rights. However, one does not have a right to infect one’s neighbors with a potentially fatal illness. Since most people are responsible, legally enforced isolation is rarely needed.
16
Why are there no testing kits available to local health care centers?
15
Not yet, but commercial labs are working on it.
@Alexander K. -
Are you kidding? There aren’t even enough tested rape kits. There’s a backlog of untested kits.
This is a lot of expensive work, depending on what’s in the “kit”. Oh, six months from now there might be more of something. But the best thing you can do is be proactive. Don’t put yourself in a medically compromising situation. Stays away from public places.
Golly, maybe we could train and hire some of the populace? For this immensely important Social work?
Testing rape kits and testing the population to prevent pandemic spread seem like worthwhile jobs programs.
You know, how they used to do before everything required a degree- and the big joke is you go get a degree and then all the good jobs are reserved for the connected and you and your student debt can go back to serf land and make $10 per hour.
How prepared is the U.S. for another viral Trump outbreak? Every opportunity is a self-serving one for this man, and no opportunity is too extreme. His routine is by now nigh predictable. How many of those he appoints to leadership positions are eventually fired? Appointing Pence to head the coronavirus response may have been Trump's kiss of death, for Trump can now blame Pence for anything short of miraculous. And thus replace Pence with Nikki Haley just in time for the election, once again, trumping the Democrats. Deplorable, yes, but plausible?
17
@pardon me -
It’s all transactional. He will try to ride it in some way. His problem is, the virus is unpredictable. But so are the voters. So he will become more shrill, if that’s possible, while it does it’s thing.
I don’t pretend to know what its going to do before it becomes innocuous. I also don’t know what he’s going to do if anyone in his immediate family get’s sickened by it. He himself might not. But he has attended public gatherings at which somebody must be contagious. Like Imsaid, it’s a roll of the dice.
1
@pardon me That Pence is the fall guy is obvious. Pence has been praying for the Apocalypse, so he is not worried.
Testing costs thousands of dollars. The average American can't afford to take a sick day. You can catch it and spread it 30 days before symptoms arise. We're not ready.
26
Not well prepared at all.
Plus we had almost sixty days of head start since the disaster in the making was first uncovered, and yet, we don’t have test kits to detect the virus or enough facilities to isolate the infected. How dare you say say well prepared.
36
How prepared is the U.S. for a coronavirus outbreak? With this "leadership", not at all.
After Trump spoke this afternoon, it is clear that we are now all on our own. Each family, each individual. Under this "president" our federal government will do nothing but worsen the problem. Expect our "president" to continue to lie to us about this illness. Expect our "president" to continue saying it is all a hoax, even though several community acquired cases have already been documented in this country. Expect our "president" to have his toadies oversee the containment efforts - all the while ignoring the advice of skilled scientists. Mike Pence as "Virus Czar"? Positively Kafkaesque.
And expect that all of the "president's" supporters to also believe it is a hoax. This means that some 45% of our citizens will not be taking even the most basic of sensible precautions. Trump has, with his reckless talk, essentially primed tens of millions of his adoring fans as nothing more than disease vectors. If this disease spreads rapidly, they'll be to thank for failing to take the crisis seriously.
So expect that the truth will not be reported. Expect that medical resources will not be available when they are needed. Expect hospitals to be overrun by the many tens of thousands of folks (or more) without health care coverage, or who cannot afford their deductibles. In short, expect to see this virus play out as it would in any Third World country.
20
Trump and Pence let the experts talk and the message clearly was rational. Trump’s typical message that, “we have done a better job than any previous humans”, was pompously asserted by Trump but only his supporters see as anything but nonsense. While the CDC doc was talking, Pence’s eyes glazed over and Trump could hardly keep his eyes open. Neither of them know what is going on and have to rely upon experts, for now.
6
@Casual Observer -
Oh, they know, in a vaguely general way, else they wouldn’t have had a bonafide scientist there to speak out of school, showing them up.
It’s not an honest profession, being an electoral politician. More like the blind leading the blind.
We could tumble into a shooting war with China in a few years thanks to this.
Weakness begets weakness.
China is a weak and weakened state pretending to be rich, righteous and strong. It’s as corrupt as money can make anything. Chairman Mao must be spinning in his glass catafalque. We are a weak and weakened state pretending to be righteous and strong. The virus is in a weak and weakened state, as it looks for new species to conquer. Cats? House cats? Not necessarily us. We are a just a vector for it. Consider humans a meal for it.
Or, it could become a monster for us, and it could wreck President D. J. Trump’s reelection chances, and the Republican Party‘s, and keep going. It’s a wild card, a roll of the dice.
How many N95 respirator masks has the government warehoused in its Strategic National Stockpile so we US citizens can protect ourselves in the event of a local outbreak? Hopefully we can also distribute to countries less fortunate.
4
@Tom At least until the panic buying set in recently, you could get N95 masks at Home Depot or any hardware store. They're a common safety item for contractors or DIY'ers. If you didn't think of this sometime before this week, your lack of masks is on you, not the government . . ..
When things get back to normal, buy a box they store forever. and you'll be ready next time!
The running comment under the title was "The country is better positioned than most" - utter nonsense. Compared to whom?? We have a highly fragmented health delivery system, a stripped down public health response capability, recently dismantled pandemic response command structure, political gagging of federal doctors and scientists, federal response led by a totally incompetent VP, insufficient hospital beds (thanks to privatizing everything), low domestic drug supplies, drug supply chains that extend overseas -so that we may well run out of important drugs to treat concurrent illnesses, scant stockpiles of PPE for healthcare workers, insufficient numbers of ventilators, woefully insufficient numbers of test kits for the virus.
And just to accelerate matters and illustrate our incredible incompetence and lack of leadership: according to a senior government employee/whistle blower, unprotected federal workers and base staff were exposed to infected US evacuees brought in from China. The potentially infected workers and staff left the military base and traveled. And, in at least one case, on a commercial flight!
39
“Better prepared than most”... means better than half of all countries ( which is a very low bar)!
8
@Mario -
We aren’t prepared for it, or prepared for any mass casualty event. Why? It costs a lot money. The United States is the Great Bankrupt. President D. J. Trump would simply go the last yard and declare it if he could, and default on $30-trillion in federal government long-term debt. He won’t now. It would ruin his re-election chances. Look for it to happen during his second term, if he has one.
Like I said earlier, we are weak, righteous — and very self righteous about it — and denying we’re anything like in a weakened state, confronting great weakness in a weak, righteous and self-righteous Red China. Plenty of dry tinder lies between us, especially those Chinese attempts to annex new territory in the South China Sea.
1
People used to ridicule the Bush, Jr. public health plan as "don't get sick." Trump has managed to move down from that level of ineptitude to a propaganda campaign that is insidious and, eventually, deadly: pretending that a deadly new disease is not really moving through the United States.
For a time, that may comfort some people, but at the expense of unnecessarily increasing their vulnerability, which in turn can accelerate the speed with which COVID-19 will move through the country and overwhelm health care and prevention resources. Apparently the blue states in the west are emerging as ground zero for America's initiation into widespread community transmission of the virus.
Trump will almost certainly try to spin that into a story about Democrats being responsible for the epidemic to come. That could very well succeed as a means of dividing the country, but it will only worsen the vulnerabilities of those who choose to believe that this disease discriminates on the basis of politics.
25
I went out today and stocked up on Kleenex, chicken noodle soup, and toilet paper. The stores were jammed, and the virus isn't even here as far as we know. Tomorrow I'll go buy more canned food and then plan to stay in as much as possible. I don't know what else I personally can do.
17
I think limiting contacts is the best you can do.
I would add, taking Vit C and antioxidants (like blueberries, but only fresh or frozen, not in juice or dry). Someone told me zinc is also good for the immune system? Buying a spare can opener might also prove useful...
But mostly hands off the face, hands washed in a proper manner, don't share food, wash hands before eating, social isolation, physical distance, etc.
3
@Pam G
Sounds like good list. On purpose I shopped at slightly “off” places today for supplies. The local mega drugstore had canned food, the hardware store had soap and the office supply store had toilet paper. No one had hand sanitizer but the drug store had a two for one sale on rubbing alcohol and spray bottles. I noticed someone buying an excessive number of coffee filters.
A good supply of ingenuity and tolerance for macabre humor might be of lasting service.
Our bottom line hopes are for continued electricity and safe water supply. With those we can manage a lot.
2
@Pam G When the chicken noodle soup runs out we are in big trouble.
Reading about the three cases in Washington, Oregon, and California immediately reminded me of what is a likely flight path from the Asian flights refuelings in Alaska then down the coast. Please follow my recommendation of days ago to retrofit all airliners with filtration and germ killing ultraviolet lighting in series with the cabin air exhaust ports that must be present in all planes. I wondered if flights with infected people were streaming traces of the virus during flights that are making their way to the ground.
Plans should be made now to utilize Hotels and Motels while imploring them to civic duty and assured full occupancy financing.
If many lose income, something has to be done for housing finance, be it mortgage insurance legislation to assure a lack of foreclosures, or temporary rental assistance while a resident is sick or out of work with business closures.
Ventilator manufacturers have to quickly design simplistic gas powered ventilators for tank mounting or pipeline connection, and that means gas suppliers have to ramp up production of gas cylinders, gas supplies, and oxygen generators and compressors.
6
We don't have enough test kits (!?!), and still haven't heard, clearly, why the first release could have had a "bad component"(rendering them useless), and what corrective action was undertaken to rectify the problem? Who is making these kits? How could they have followed FDA GMP protocols and released failed product?
Are we now only testing the obviously sick? Why aren't we testing the families and off-site associates of all the employees at the affected WA nursing facility? That should have been an immediate priority. Testing the sick is almost pointless, if we want to contain the spread of infection.
It's clear from today' "press briefing" that the WH is more concerned with the stock market, and making the "president" "look good", than focusing on the health and safety of American citizens.
22
@Slann
Apparently you didn't watch the live press briefing. Had you done so you would be disabused of your gratuitous swipe at the President.
We are flying blind. Basic epidemiological studies have not been done. We need population-based testing that would identify asymptomatic and very mild infections—especially important because covid-19 is known to be contagious before symptoms manifest. Fecal-oral spread has been identified as another potential route of infection, but no testing is being carried out. Children have been identified as being at low risk for severe disease, but they can be infected and infectious. At the moment, we have no idea where the virus is or how widespread it might be. Stop saying don’t worry, it’s just like the flu: one major difference is that this is a new virus, so by definition no one has any immunity. Please, put public health professionals in charge, and operate with complete transparency: to do otherwise encourages the spate of conspiracy theories and misinformation that are already circulating faster than the virus.I
25
We shouldn’t buy masks because medical professionals might have a resulting shortage? Why is there no huge stockpile of masks available to hospitals in the event of a pandemic?!!! They have no expiry date as far as I know. Are they buying them at the local hardware store like us?! And if you are isolated at home with the virus, will someone give you masks? Unless you live alone I guess.
5
It is not reassuring to learn that in 2018 the Trump administration fired the government's ENTIRE pandemic response team chain of command, including the White House management infrastructure. In addition, in 2018 Donald Trump ordered the National Security Council's ENTIRE global health security unit shut down. It also cut the CDC's global health section's budget by 80%!
Then I read that in 2017 & 2018 Bill Gates was running around with his hair on fire, repeatedly meeting with National Security Advisors H.R. McMaster & then John Bolton, warning them that ongoing cuts to the global health disease infrastructure would render the US vulnerable to the "significant probability of a large and lethal modern-day pandemic occurring in our lifetime." (Gates' exact words).
That next epidemic is now here, & we'll soon learn the results & costs of the Trump administration's negligence.
https://foreignpolicy.com/2020/01/31/coronavirus-china-trump-united-states-public-health-emergency-response/
108
The biggest problem our country has is the President and his loyalists can’t be trusted to tell the truth. In order to help his Donald Trump wants people to believe his close to zero number of people in the US have the virus. Pence, Pompeo, Mulvaney want to somehow blame Democrats for inflating the number of people with the virus.
The people of Puerto Rico are still suffering due to Trump’s denial about the number of deaths and damage.
28
I would like to know more about how a history of smoking may affect an individual's response to this disease. China and Korea are nations of heavy smokers as is Iran. Could this be a factor in the virus's spread?
8
@R. Vasquez I don't know if smoking is a factor in the spread, but an article I read said that smokers were more likely to die from coronavirus than non-smokers.
4
Who says we didn’t make good use of the extra month China afforded us? Trump got a LOT of golf in before he finally had to do his first press conference in a year. So he certainly appreciates it!
17
A Mexican state official says the virus can't survive temperatures above 26°C (78.8° F). Is this true?
2
@redman214
If that was true, almost no one would have the virus replicating in them. Maybe my ex wife ( its a joke... and a bad one - I don’t have an ex wife).
People who are coughing or sneezing should be legally required to stay home.
Everyone should wash their hands before touching their face and after returning home.
People on public transportation should wear scarves or home made face masks that cover their noses and mouths so they don’t cough or sneeze on others.
4
Should we be concerned about the millions who have no insurance and are not eligible for medicaid because their state said ..dont need it or Trumps policies have kicked them off. So If I am one of these people, generally poor and can not afford a doctor, I will treat my being sick as just kinda flu thing and will continue to go about my business and send kids to school etc.
Well everything should be ok come spring according to the countries leading genius.. Sleep well.
14
UNprepared
Why should we prepare when our president says (a) it’s a hoax,(b) it’s not severe, or (c) like a miracle it will disappear very quickly?
The first death has been announced.
Neither a,b, not c are true.
At the very least, Americans are being fed lies by our political leaders. At worst, covid-19 will infect a large number of people and even with a small percentage of lethal cases, the death toll could be in the thousands.
The coronavirus, unlike trump’s republican minions, isn’t afraid of his tweets and pronouncements, won’t hide in the dark.
But all are infected.
13
@Steve Ell
That Dr. Fauci has allowed his sterling reputation to be sullied by standing on the same stage as President Stable Genius is truly sad...
Does it matter how well prepared the medical community is if the populace is being gaslit by Trump's right-wing white-ring that this pandemic is just "the common cold" and the "new hoax," and that the only real victim is Trump?
Trump supporters are now a new level of threat as they are being told not to worry about the coronavirus.
29
@D.A.Oh
I fear they will all listen to President I-Hate-Science, take no precautions, and Darwin themselves to oblivion.
How prepared is the corporate media to report this story accurately and help, instead of confuse and panic, the populations of the world? Not very well, in my opinion. The media have created a panic from the reporting of the stock market crashes being caused by the virus. They have fueled fear on a massive scale. Today the Washington Post and NYTimes printed inaccurate identification of the gender of the first American death. NPR did not. NPR did not give a gender ID until it had been confirmed. I am reading the print versions of NPR reports and find them much more informative, and far less provocative.
4
“The Chinese bought us a month of time to prepare ourselves by imposing these astonishing and draconian measures,” said J. Stephen Morrison, ...“Unfortunately, we didn’t make good use of that time and now we’re heading into a very dangerous situation.”
I have commented on this before. That it was imperative that we use that time to prepare our response. But instead, we squandered that time smugly criticizing China and living in denial.
While the death rate might be about 2%, the real problem is the 20% who get seriously ill. It all depends on how much we can stagger infections. If everyone gets it at once, we are doomed. There are 8 million plus souls in NYC. If even 1% get it at the same time, that is already 80,000 people. That means roughly 16,000 people seriously ill at the same time. Medical services would have been completely overwhelmed long before that. You think they built those emergency hospitals in Wuhan for kicks? And it still wasn't enough. Unlike Wuhan and China, however, this is America. We will not be able to pull off the containment measures that they did. And unlike China, in the US, there will be fire and gunfire.
18
@Pigsy
I have heard of proposals to manage the pandemic to ensure that infections are spread out. Sort of like flattening and stretching the bell curve. It works for herds of cattle and elk. It is a moral minefield for people.
3
I talked to a friend who works at a local Emergency Room yesterday.
He told me they still don't have any PRC test kits they can use immediately, to confirm the Covid-19 virus.
So they have to take a nasal swab and then wait 2 or 3 days to get results back from the CDC. The CDC has rigid criteria, for whom they can even test. Recently traveled to China, etc.
Meanwhile they have a patient in their ER, who may or may not be infectious. No way to tell. As he said,
"Lock them up in an isolation room, while they wait for results?"
12
I find it most informative when top experts are interviewed about the Coronavirus. Though some seem to be more knowledgeable than others or don’t expound enough on their short answers
What’s most curious to me is the conspicuous absence of Professor Michael T. Osterholm, with the University of Minnesota, on the TV airwaves. Professor Osterholm is widely regarded as being the world’s foremost expert on Infectious disease pandemics. His list of accomplishments, distinctions and experience is second to none.
I would love for him to bring his formidable knowledge to the TV table to add important context to this most critical discussion.
Dr. Osterholm, widely interviewed during the H5N1 Bird Flu scare, is currently the Director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota.
NYT and major TV news sources: please seek out his expertise and voice of experience!
Paging Dr. Osterholm...
11
@Luke You may have missed it, but he has been interviewed and has discussed this outbreak publicly already.
4
@Luke
There is a very good link to the work, the University of Minnesota is doing here, at CIDRAP, or Center for Infectious Disease Research and Policy.
link here
http://www.cidrap.umn.edu/news-perspective/2020/02/some-covid-19-patients-test-positive-days-after-recovery
3
@Luke
He has been interviewed regularly on NPR
The government seems to be emphasizing how the person who died in the US was in poor health, as if that makes it OK that he has died. If you add up all the high risk individuals, including people over 65 (over 50 million), people with no health insurance, who won't go to the Doctor because they can't afford it ( 30 million), those in poor health (30 million diabetics, 70 million obese people, etc), then there are likely well over 100 million at risk of dying. So if 30% of those get the virus and 2% who get it die, that would be 600,000 deaths. The more people that get sick, the less prepared we are.
14
@Valerie FYI, the person who died in Washington state was a woman, in her 50's. I agree with the rest of your points. To quote @azbrodsky, "A friendly reminder: people who will be high-risk patients if we get coronavirus can hear you when you reassure everyone we're the only ones who might die."
6
@Valerie Neil Ferguson of the Imperial College in London, who is an acknowledged expert in these things, says that a reasonable estimate of the rate of infections if the virus is not contained is 60%
@Valerie Where are you getting the 30% morbidity rate from? According to you, nearly 1 in 3 people will become ill. That kind of a rate has not been reached even in China. I think we should really leave the epidemiology to the experts. It's very nuanced.
3
Prepared? This virus appeared more than two months ago in China. As of today there is still a shortage of testing kits in our country. This is one of the reasons we have no idea who has been exposed and who they have been in contact with. In a nursing home in Washington State where we have had our first fatality 50 people (a combination of staff and patients) are showing symptoms . We had the chance to prepare but our leaders (I'm looking at you Donnie) were either asleep at the switch or deliberately lying.
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We have had several virus scares during the Obama Administration. Surely during those events, Democrats supported Obama’s purchase of hundreds of millions of masks, testing supplies, and the establishment of numerous isolation and treatment facilities. Trump needs to put that material and those facilities to use immediately.
2
@greg What is your source for the claim that 50 people in the facility where the first fatality occurred are showing symptoms. I have read every article in the Times about this and have not seen that information. On cable news and in the Trump press conference there was some ambiguity about the person who died. Trump said she was a woman in her 50s. Was she working in the nursing home you refer to or are you confusing the health care facility where she died to a nursing home. It is fine to make comments but please back them up with sources.
2
@greg In terms of my last comment to you I have found the information you seem to be referring to and you are basically correct that there was a confirmed case in the nursing home (but not the death) and that up to 50 (residents plus staff) are showing symptoms but it is not clear they have been tested which supports your point about need for testing kits. The death was a man in his 50s not from a nursing home (not a woman like Trump said and even embellished as being a "wonderful woman"). Later CDC sent a corrected tweet. Trump not even prepared enough to give basic identity of first death let alone information about getting needed testing kits out and available. Who knows how they will screen all this passengers coming from Italy and South Korea. Will the screening include not only Italian and South Korean residents but also everyone on flights from Italy and South Korea even if they just changed flights and passed through airports in these countries. It sounds like a very big task.
3
At the federal level, we must now count on a dwindling number of capable health related public servants and experts still working in the government after Trump’s loyalty purges and agency defunding. So far, it’s not looking good.
The burden of responding effectively to this emerging pandemic will fall on states, localities - and us. That’s not looking so good, either.
Let’s start with getting more test kits.
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There are no clear protocols in place for hospitals to follow when presented with a possible coronavirus case. My husband flew from Venice to Boston on Monday 2/24, just as coronavirus cases were rising in northern Italy. On Thursday he started having cold symptoms. On Friday he had deep chest congestion and coughing. His doctor told him they would not see people coming from Italy in their office, and to go to the ER.
At a hospital ER in southeastern MA, they had no idea what to do with him. ER staff told my husband that they had no protocols for dealing with people coming from Italy. They said he did not meet the criteria for a coronavirus test, even though the media has been reporting that the CDC updated the criteria to include symptomatic persons coming from Italy, South Korea and Iran. The ER personnel knew nothing about this. They tested him for the flu, saying that if he was positive for a known flu, they could rule out coronavirus. The flu test came back negative. A chest x-ray did not show cause for concern. They sent him home without a diagnosis and did not even tell him to self-quarantine! I understand that the chances of his having coronavirus are small. My concern is that medical staff are not trained. This country is NOT prepared for a pandemic.
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@Ivy Agree that protocols in the ER are seriously lacking. Previously we haven't been able to test anyone outside of the official criteria- travel to an endemic area and certain symptoms. Now, with the virus spreading among those who have NOT travelled, it's almost irrelevant, as the disease is no longer trackable. The truth is, mild cases of corona virus are indistinguishable from a cold. Who are we supposed to test NOW?
12
@Dr K As I understand the new process, you are supposed to direct any questions like that to the Vice President (Pence)
19
@Ivy We went through a very similar situation. My husband had a business meeting at the same place as the man from Chicago who got Coronavirus from his wife (first cases in the U.S for spread). After returning home from his trip my husband got very sick (and he never gets sick). He went to urgent Care where they said his flu test was negative. During his time there, I found an article about the Chicago man and their overlapping business trip. My husband stopped driving home and went directly to the E.R. They did at least take proper precautions to quarantine him and all the staff members were properly dressed, but after several hours of being in the E.R, he was informed that the CDC would not test him because he did not have "direct" contact with the man from Chicago. Even the doctors were surprised but there was nothing they could do. We live in a very dense area just outside of Chicago. They sent him home with no instructions to self quarantine (but my husband did voluntarily anyway). Had he not, I shudder to think of all the people he would have encountered on the train rides to work, and everywhere else.
22
Yes, ventillators are in short supply, and that’s bad. But even more, just beds in the community are in short supply, and our hospitals are not likely to be able to scale up for a large influx of patients. Our hospitals are designed to run lean and provide just enough beds for the average needs, otherwise it is financially wasteful. Empty beds are expensive. The number of hospital beds since the 1970s has dropped by a third, even while the population has increased by 50%. And with health care workers being quarantined, soon there will not be enough doctors or nurses to take care of the patients. And with everyone rushing to the ED with their minor cold symptoms (and coronavirus usually presents as just a cold), especially with the hysteria about this disease, many nurses and physicians are going to be exposed. Some of those minor colds are going to turn out to be COVID-19.
23
@Dr K It's the for-profit health system that forces "efficiency", resulting in a brittle system that cannot handle a large influx.
13
@Dr K -- Oh ye of little faith! If we run out of ventilators, the invisible hand of the free market will just bag the patients and do chest compressions when they code. Right? That's what the invisible hand of the free market does -- swoops in to save the day during public crises that the government failed to prepare for Why, I remember the invisible hand of the free market plucking people from the floodwaters of Katrina!
6
As long as all announcements by federal health officials are filtered through Pence, a science denier who fanned an HIV epidemic in Indiana by refusing to allow a needle exchange (and instead counseled prayer) and who also doesn’t believe smoking causes cancer, the American people should have NO faith in the accuracy of these announcements. We are no better than China where the information comes not from scientists, but from politicians spinning the news for political points. This is a horror show when the tRump administration cares more about an election than public health. As usual, Republicans are either silent or playing down the facts. How low can they go?
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@Avatar Dr. Fauci has corrected the misunderstanding that he is being muzzled by the Trump Administration. If a story about Donald Trump is written by Maggie Haberman, please just assume it's not the truth.
1
@JW Yeah, saw that on Fox News and the WashIngton Examiner so it must be true. Two completely reliable sources. Didn’t see anything stating that statements didn’t have to be filtered through Pence. And by the way, Maggie Haberman isn’t the VP, not just a partisan hack but a government official.
6
This article refers to an 18 year old NYU student who reentered the country from Italy and who was not asked any questions upon re-entry. She is voluntarily self-quarantining and monitoring her temperature. I would like to thank her. She shows more common sense and compassion than the president.
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As long as a situation is manageable people will be reasonable. No doubt she is holed up at her parents with resources to ride it out. But many need to go to work or do other things and self quarantining becomes a burden
8
@Meryl g So does my dog. Thanks to this young lady for showing social responsibility.
1
The Surgeon General says to stop buying masks, they don't keep you from getting the coronavirus. However wouldn't they help stop the spread of the virus if a person had contracted it unknowingly and would then spread it through respiration?
Maybe there is a greater need for the masks, for those who are known to be infected, but just saying, if everyone in the US wore a mask all the time for the next 2 months, it would seem that there would be no risk for transmission between people.
5
medical personnel need them more, much more, and there just isn't enough. plus masks don't work well if you don't wear them properly or take them off properly. they're also really hot and uncomfortable after a short while.
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Surgical masks are meant for one time use, are not sealed, and do not protect from inhaling airborne particles.
The more effective way to prevent the spread of the virus, as the CDC states, is to wash your hands frequently and thoroughly and avoid touching your mouth, nose, and eyes with unwashed hands.
Masks provide a false sense of security and are counter-productive for the general public.
2
@very sore loser If face masks are running short and will be needed for health care personnel and patients who have the virus, the president could issue an emergency order to halt retail sales.
Of course he won't do that because it's a hoax, in his mind, conjured up by a mythical deep state to prevent his reelection.
1
How many doctors and nurses and so on work for the Veterans Administration and how many beds and ventilators do they have? Is there any chance that there is some percentage of unused resources that could help if the virus spreads widely in our country?
3
No mention of the US Medical Reserve Corp, which will be responsible for distributing a vaccine if and when it is available?
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@qisl Vaccine is a year to 18 months away
We know that people with viruses are contagious long before they have symptoms...and now from patient reports of those already quarantined, they are also contagious after their symptoms have eased. Therefore, there is really no way to tell who has the virus unless they are actively ill.
A hairdresser in Australia has been diagnosed with Covid-19, but she had at least 40 clients before she had symptoms.
We don't have the personnel to track everyone nor do we have the tests available.
Why not just tell people to treat it like the flu, do what you would do for the flu and to get to hospital or care center the instant they have trouble breathing to get antiviral medication.
Quarantines and chasing people around may slow it...but these measures will never stop it.
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@Sue
...get to hospital or care center the instant they have trouble breathing to get antiviral medication.
Then everyone else waiting there gets sick too! No thanks! ERs and urgent care centers should not have people walking in with symptoms and sitting there in a crowd!!
1
Here's the awful truth. In an environment where Trump has turned lying into an art form and where information provided by the administration seems calibrated to help ensure his reelection, my first reaction when I saw the message from the Surgeon General urging people to stop by masks was, "Has he been directed by Pence to say this?"
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Masks do not help filter out anything. Surgeons wear them to keep from contaminating the surgical arena and patients. Not to keep microbial bacteria out. Masks are useless. The Surgeon General is trying to get facts out contradictory to what comes out of the White House. We have to depend on reliable government sources and media to get truth and facts. The only thing we get from trump is SAD.
4
Come on, it is clear that even at this time Trump and his government are playing politics in the worst possible way.
While tens of thousands of cases are in China, Japan, and South Korea, Trump talks about closing the border with Mexico.
When it comes about stopping the source of most cases outside of Asia, Italy, Trump is implementing bans against Iran.
There is no hope with an administration that is just playing a potential tragedy involving thousands of deaths --indeed it is jaw dropping how low and base can this administration be.
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@lieberma
I'm no longer a professor of anything, but I have good critical thinking skills and I think all of your points are very possible. I definitely think the panic is going to cause a lot more trouble than is warranted. When it's all over, I wonder if we will even see a noticeable spike in mortality over 2020.
5
@SB
Although I can guarantee there will be a lot fewer cases
of Corona beer sold this year.
1
@lieberma There is absolutely no factual basis for any of your claims ... in fact most of them are starkly contradictory to known facts.
There has been a lot of criticism about the CDC not making tests available. The CDC has always followed evidence based protocols in preparing tests for various pathogens. When I see South Korea testing nearly 12,000 at such a short notice and at the same time widespread disease activity, I am beginning to believe something is off. Their tests may be flawed and they maybe releasing people from quarantine with flawed negative tests. I think it is better to get testing correctly rather than depend on flawed testing. This may well be the case in China too. Hopefully the CDC has better test kits available this week. I still think it is not too late. Travel restrictions have given some time. In New York State, the government has been proactive in keeping adequate supplies of PPEs for hospitals and health care facilities in case of need. I hope all local governments are working in the same manner.
8
@SridharC
And/Or maybe the tests are resulting in false positives due to exposure to other coronaviruses. But I agree, something seems off.
Not testing potential cases of infection or people surrounding those who’ve contracted the virus for fear of keeping numbers to a minimum is clearly showing the system’s failure.
The reason why numbers are so high in Italy is because testing has occurred on very high numbers of individuals and potential cases. In a situation where symptoms are difficult to identify and often very mild, many will overlook them and continue spreading an infection that is deadly for some.
The US should a page from Italy’s management of the crisis.
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Do we even know the source of this Coronavirus?
All we know for sure is China tested their population and found this new strain.
That doesn’t mean it’s from China
Most countries aren’t even testing.
The US can’t and won’t test
The media had their fun for weeks criticizing China
But how are we doing?
CDC can’t even get their testing kit to work, and doesn’t even want to test the population.
And now things have to go through Mike Pence?
41
One COVID-19 patient has resulted the quarantine of over 100 hospital employees at UC Davis. This should provide instant sobriety for those with any illusion of our being prepared for this looming pandemic.
It's plausible we will shortly run out of front line staff to provide medical care. Even in a world with ample staff, supplies and equipment, the infrastructure to support caring for large numbers of COVID-19 patients, which requires negative pressure rooms for airborne contact precautions, simply does not exist in the USA.
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@lieberma This morning I saw a news piece that a Covid-19 case was discovered in a very small town in Germany outside of Stuttgart, with no known causation. The story mentioned it was accidentally caught due to increased testing of suspected influenza samples that came up negative then were further tested for Covid-19. Doesn’t sound like the ‘medically advanced’ US is keeping up...
7
@Sas
The healthcare workers in quarantine could be caring for known cases.
One thing should be absolute: those people who have real prepaid medical insurance (not Medicaid) or an HMO should get treatment if needed.
If people die because they are denied care they have paid for,
it should "destroy the lives" (as in financial or political lives) of those doing the denying.
8
@Doug McDonald
Doesn't matter, if they "paid for". Everyone needing essential health care should be served. This has a lot to do with being a human being and caring about dignity of our species, it also will help to slow down the spread of the Virus.
But I am fearing, by now it's a matter of avoiding cost and (if Corona escalates) an issue of capacities.
In Germany several people tried to get tested after being in Italy and coming down with a cold. They were insured (practically everyone is), but still refused, because it's still not clarified, who is responsible and who has to cover the costs.
13
@Doug McDonald
Will that work? Surely your 'paid' contract is with the insurer (or HMO) rather than with an individual provider hospital. And, surely, your contract says that the insurer is required to PAY for your care - not ensure it's available.
You might think the problem is more acute with 'socialised medicine'. After all, your contract is with the state - which is also the provider of care. Not so, at least in the UK, where with the exception of certain nationally mandatory benchmarks for cancer care, the National Health Service offers only vague promises of 'medical services' without anything specific being guaranteed - so, if you're denied, say an ICU bed, well, that's tough.
@Doug McDonald
I have read this every which way I can - and I think you just said: the poor and uninsured should be left to die. Probably the most scary comment yet.
When the Spanish flu spread across the United States in the fall of 1918, both the government and the media continued the same rosy strategy to keep morale up.
Trump is repeating the same error during this national health emergency. At least I am hopeful the media will tell Americans the facts.
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@Jacquie
WW1 was going on at the same time, and it was 100 years ago. Viral pathogens had just been discovered, and were poorly understood. Plus there were no antibiotics for secondary bacterial infections. There is NO comparison.
9
@Matt There is a comparison. I agree with you in that this pandemic will not be a 1918 event, but it will be a pandemic. Even though viruses are better known, people make stupid mistakes, as seen by the Trump administration.
2
Tell the "facts"...like they did about Russia, Russia, Russia?
We are done for.
We have Mike Pence, who doesn’t even believe in Biology 101 (i.e. evolution), leading our effort.
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@Jay Lincoln We're in luck. Pence doesn't believe in evolution so there is absolutely no chance of this virus mutating to something worse. Oh wait, isn't that how it made the jump from some animal to us. I take back the comment about luck.
7
@Jay Lincoln
I just can't wait for his moment of enlightenment. The minister of health in Iran already experienced one.
This administration and its experts and pundits keep insisting the virus will minimally impact our country medically.
But no one has explained how they’ve reached that conclusion. We’ve already seen early incompetence handling infected individuals.
80
Per a local newspaper, over 600 people who recently visited mainland China have been asked to self-quarantine here in Orange County, CA.
Also, an additional unstated number who are said to be at higher risk for contracting the Coronavirus, have been sent to "repatriation" centers here for quarantine meeting federal standards.
12
This needs to be said.
I have seen far too many pictures of people wearing protective face masks incorrectly.
1 - A mask must cover both the mouth and the nostrils. When you breath in you are taking in air through your mouth and your nose, The nose is an especially warm, friendly environment for airborne pathogens, who will find the nasal mucosa lining your sinuses perfect breeding grounds and gateway to your body. Covering you mouth and nose also protects others if you are a carrier of the virus.
2 - Most face masks have a metal strip that should be placed across the nose above the nostrils. Make sure you pinch the metal to fit the contour of your nose and cheek, making as good a seal as possible. The metal strip should never be under your chin. The face mask itself, if it is the flat rectangular kind as opposed to the molded kind, should be pulled snugly under the chin. The metal strip on the molded style of mask should similarly be pinched to fit the shape of your nose.
3 - Change them frequently. They are not meant to be worn for extended periods of time.
It may prove that the simple face masks in general are ineffective means for protection. Until then please use them properly.
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@Larry
There has also been strong suggestion that people try to conserve masks and sanitize them between use. I don't know what the protocol on that looks like. Anecdotally people talk about spritzing with alcohol and air-drying.
An infectious disease expert on Singapore news urged people to use masks carefully, and reuse where possible (requiring some kind of sanitizing). He urged all to consider that use of a mask now, means not having that mask later and that their may be continued scarcity going forward so people should be thoughtful. If masks can be safely reused for X number of times, healthcare officials should impress on people the means to do so safely and share a protocol.
11
@Larry
In the past when I've had to wear a mask for allergens or dust, I get hydrated and then tape the thing on with bandage tape.
4
@Larry
Thank you for those clarifications. I hope your message will be shared and heard.
Also: We need to wash our hands after handling used masks (i.e. after we have removed and discarded them safely).
2
Yeah the hospitals are great - but only if you can afford them. Beyond it’s health effects, a pandemic of corona virus in the US will lead to an epidemic of personal bankruptcy afterwards.
115
The people who are smugly dismissing the widespread concerns over Covid-19 are missing the point: it’s not that Covid-19 in and of itself is to be feared. It’s the myriad ways that it will exploit holes in a catastrophically bad health care system here in the United States. This article does a good job of laying some of those out.
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@Maple Surple Unfortunately through no fault of their own too many people in this country won’t be able to do anything if they get sick from the virus. Some people won’t be able to afford getting tested or treated. Other people may not do anything out of fear of losing their job.
20
Why does it take days to get diagnostic test results in the US, when tests in France yield results in two hours? Why do we test far fewer people than they do in European countries or South Korea?
Maybe it's time to stop pretending that we're great, and actually make America great again. If I'm still alive on November 3, I know how I'm going to vote to make that happen.
274
@MikeG We have the most expensive healthcare system on the planet. But we have the 37th in quality of care.
After this week, that number will probably change downward.
32
@MikeG If covid-19 is widespread before 3-nov, don't count on elections being held. Trump, being in difficulties, might declare martial law and cancel the 2020 elections.
14
@MikeG This is how it's done in Ontario, Canada.
It's performed at Public Health Ontario laboratory Toronto as required. Current test requires less than 24 hours to complete.
NOTE: Turnaround time will vary according to geographical location and proximity to PHO Laboratory Toronto.
Additional testing is conducted at the National Microbiology Laboratory (NML) in Winnipeg when required.
3
Looking for money to defend America against this new enemy?
See the Pentagon. I'm betting that even if we clawed back a billion dollars, they could still scrape by.
73
Exactly right! Particularly that “emergency” Wall money, which has never been an emergency in the first place! Claw back the money from that account!
1
@Joe
Good excuse for Trump not finishing the Wall. Who will have time to go to court for all the eminent domain cases in Texas?
1
This sounds like every jurisdiction for itself. With the popular high deductible heath insurance, lack of paid time off and gig economy, there is every incentive to keep working while sick and not going in for healthcare. This is a recipe for super-exponential infection rates (now showing up in the outside of China convex logarithmic curves on JHU arcgis dashboard).
58
My son, a physician at a Boston-area hospital, just told me that someone had stolen all their N95 face masks that are recommended for all health-care personnel and those with the virus. If one searches online, you'll discover the masks not available anywhere. The masks require special care and training to be fitted properly so that they're effective and most non-professionals don't know how to fit them. But, what it does mean is that health-care providers who come in contact with patients will be unable to obtain them. This is one example where the bluster and blame from President Trump and his staff while muzzling those experts like Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, is hurting both the public and the health-care community.
195
@Paul Wortman NO ONE WAS MUZZLED, Dr. Fauci has been on many cameras stating so; never happened. And when a theif takes all the masks, you become somehow angry at Trump?! Perhaps he'll get arrested, but in the mean time, your blame and anger are incorrectly placed. I'm not a fan of Trump, but the hourly attacks with misinformation and hate are to the detriment of us all.
Are you willing to create panic and a global depression to get rid of Trump? I think most here would say yes. We are in sad times indeed, and the virus is the least of our problems.
By choosing not to test any secondary infections, CDC failed to monitor the spreading of COVID-19 in the US. Since half of those infected remain asymptomatic, it is logical to assume that some of those who came into/back to the US from China carried the virus. They then unknowingly spread the virus to their families, friends and co-workers. With CDC refusing to test anyone who had not traveled to China (or had been in contact with someone confirmed to be positive), all secondary infections and beyond went unconfirmed.
The US failure to test and gather data makes us all dependent on the Chinese data. I wouldn't be surprised if Chinese scientists develop the vaccine first. The US is not only failing to control the disease but it may also be showing to the world how it cannot compete with China.
35
@Margarita Human beings are imperfect. I know I am. Mistakes will be made. We are confronting an enormous challenge -- one that even the most capable and competent among us will have their limits tested. When confronting a pandemic, the virus and only the virus is the enemy.
11
@Margarita The most recent report from the WHO and CDC China indicates that "Asymptomatic infection has been reported, but the majority of the relatively rare cases who are asymptomatic on
the date of identification/report went on to develop disease. The proportion of truly asymptomatic infections is unclear but appears to be relatively rare and does not appear to be a major driver of transmission."
5
National health officials have had since January to get this right or at least better. CDC learned after Ebola and Mers, but that seems not to come in to play, yet. Paid government officials are not paid to be imperfect. They are paid to be leaders and experts. It's just not happening.
28
Let's see only 62,000 ventilators in the entire USA. You neglected to state how many are actually available for a new epidemic. Under just-in-time capitalist profit medicine, one must assume there couldn't be much more that a 5-10 percent vacancy rate, leaving perhaps 10,000 ventilators available in the entire country. Given that bare bones emergency rooms are designed to not even meet normal run-of-the-mill demand to maximize profits, we can imagine hundreds overflowing the meagre medical resources and staff. Americans are too easily confused with the Hollywood Super-America mirage and reality. No, we're going to be completely on our own like every disaster. Remember Katrina, just add Coronavirus. Remember Hurricane Maria in Puerto Rico, just add Coronavirus. That will be the reality.
135
Well I’m retired from medicine and surgery, but as a medical student at the University of Wisconsin long ago, I was doing my first clinical rotation on anesthesia and my first patient required multiple CT scans under general anesthesia and other procedures in different locations throughout the hospital. This did not allow the use of a ventilator, and being the lowly 3rd year medical student, I was given the task of ventilating the patient by hand using the old black rubbery smelly anesthesia bag. I did it continuously for 6 or more hours. So in an emergency without ventilators available - I think I still have enough in me to volunteer and do a few more shifts on the bag to help. No insurance needed. I’m also more expendable than most of the other health care workers.
As Thomas Jefferson wrote, in his last line of the Declaration of Independence, - “And for the support is this Declaration, we call on the protection of Divine Providence, and we pledge to one another, our Lives, our Fortunes, and our Sacred Honor.”
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@MD
"So in an emergency without ventilators available - I think I still have enough in me to volunteer and do a few more shifts on the bag to help. No insurance needed."
Thank you!
129
Thank you for your service. I am also a physician. I think it isn’t coming on us to advocate for what we think is important for public health. I see most critical is ample testing kids to test most of those who can be in places that have been exposed to such as the schools in the case of several patients because this disease is transmissible even without symptoms.
8
As a small animal veterinarian in private practice, we do not have to on site capability to put our patients on ventilators, as these are reserved for specialty and EM facilities. Assisted ventilation to keep veterinary (and human) patients alive is difficult, time consuming, physically, and mentally challenging. Nice to see a positive comment here and that you are willing to help patients after your retirement. The world needs more people like you!
22
So...Wuhan is a major travel center within China. Chinese tourists travel extensively. This virus was noticed in December by the opthalmologist in Wuhan who later unfortunately died of the virus. Presumably it had been already circulating for a few weeks by the time he noticed it. I would imagine it has traveled on separate paths and maybe has already been affecting people here even in January before everyone was really aware. Because it sounds like people may have it with no symptoms or minor cold symptoms, so only the most severe cases are noticeable without testing. Just wondering if this is a possibility.
14
@Boggle
NYC’s health Commissioner Barbot irresponsibly encouraged those returning from Wuhan China to go out and mingle in the community and enjoy Lunar New Year festivities and parties. The returnees themselves thought it was wiser to self quarantine.
There must be a lot of Coronavirus in New York.
I am not only worried about a shortage of health worker, respiratory devices and hospital beds. If to many people suffer pneumonia all over the world, will there be enough medicine in storage to help them to survive? Especially, as a lot of the cheaper antibiotics are made in China now. I ndon't believe, that the capacity of production is large enough, to cover the demand, if there will be 1,04 billion severe or critical cases (estimated 65% of the worlds population being infected).
In Germany, the minister of health announced two days ago, that he wants to stop exporting products which could be usefull (masks, suits, googles etc.) and might even seize the stuff from producers and sellers. Doesn't sound like being well prepared...
24
This is what happens when American Corporations ship manufacturing off shore to make the Old Mighty Dollar they gotta make sure the CEO and upper executives are able to buy those extra Mansions, Yachts and Jets
7
Let’s be honest. This Corona virus has recently jumped species so is new to humans. We do not know the virulence, transmission (casual or repeat contact), life cycle, mutation rate, whether the virus causes death or our immune systems cytokine storm, etc. We are flying blind so we need to use good public health practices until the scientists know. Good hand washing with regular soap and water, sneezing or coughing controlled and not sprayed, forget handshaking, and avoiding crowds. Panic is counterproductive.
32
@Molly Ciliberti covid-19 was recently detected in a dog owned by a covid-19 patient. So, DEATH TO ALL PETS!
Nah, no science. Thoughts and prayers will do!
I’d expect some good information from the nation’s medical and scientific experts, but Trump and the Republicans have muzzled them out of fear that they’ll tell the truth. Trump and the Republicans politicized this whole thing. Lying and Trying to blame the Democrats won’t work against a virus. Shame on Trump.
273
@GC reminiscent of how Xi withheld information from the world in China.
Look what happened there. Could be worse in the USA because of lack of healthcare for the less well off
@GC re "Trump and the Republicans politicized this whole thing"
This is a key pillar of the trump agenda widely abetted by powerful politicians whose thirst for power manifests this new reality of an emerging authoritative political system.
"The party told you to reject the evidence of your eyes and ears. It was their final, most essential command." — George Orwell, “1984”
2
@GC It's all Trump's fault. Seems to be the default refrain in the Times, regardless of the issue. Please correct me if I'm seeing this incorrectly, but it is likely the top comment no matter the issue.
Doctors who are working with this disease should have some fairly clear ideas of how it progresses and why but there is an information blackout on specific facts. Can people be reinfected? How long does it take from infection to clearing the disease normally? Why two months after the disease was discovered are half the patients still considered active cases? How many people really have been infected but never counted because their symptoms were so minimal? If this is really as contagious as they say and 2% of people die, we should be expecting millions of deaths but that is not what they are preparing us for.
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@Michael Green
Coronaviruses have a proofreader so therefore the genetics of the virus remain stable. Therefore once one has recovered from an infection one is immune, most likely for life, provided one’s immune system is functioning properly.
This is in contrast to the HIV virus which keeps mutating so that it can constantly evade immune surveillance.
I commend the student from Florence who independently chose to self quarantine. I am astounded that visitors from South Korea and Italy have been allowed into New York unquestioned. It seems that businesses could easily take a proactive stance, since our leaders do not, and have employees who have traveled abroad to stay home for 2 weeks. I understand that Conde Nast asked all employees return from fashion week in Milan to work from home. This is so simple, and costs nothing. Why isn’t this happening?
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@Steph
The article noted."As of Friday, about 47,000 travelers had been subjected to “enhanced screening” at airports, according to the C.D.C. All passengers arriving from China have their temperatures checked, and those who are feverish or present other symptoms of the coronavirus undergo further evaluation to determine whether they require hospitalization."
We know people can be fever free and then develop full out corona virus after that. So that strategy is far from failsafe.
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@lieberma I have to take exception with the following: "The bottomline-Covid-19 is essentially a flu with low mortality rates like the common flu that may have went molecularly undiagnosed for a long time. " We're unable to rely on China for accurate data, but it appears the CoVid19 mortality rate may be as high as 2%, as opposed to 0.1% for influenza - 20 times higher. We all need to be careful to not only prevent making statements that could provoke panic, but also going in the other direction. Making it seem as though this virus is no more dangerous, in terms of mortality, than seasonal flu. That's impossible to know until, unfortunately, more people die in this or other countries that provide accurate reporting
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@Steph
Amazon today cancelled all “non essential” travel for their employees ( they have nearly 800,000 employees) in the US and internationally. My understanding is Google did too. Presume more companies will follow suit.
Of course what a for profit company thinks is non essential and what a government does might be different —- who knows. But it’s welcome nonetheless.