Tag: COVID-19

  • COVID-19: How to Recover

    In the absence of a coherent plan from our Federal government, Medical professionals offer specific recommendations. Here is a summary from the New York Times with hyperlinks to sources for details.

    The Association of American Medical Colleges released a “road map” listing areas for action. The groupsays its members include all 155 accredited medical schools in the United States, as well as more than 400 teaching hospitals and health systems. “If the nation does not change its course – and soon – deaths in the United States could be well into the multiple hundreds of thousands,” the preamble warns. 

    No. 1 on their list is remedying shortages: “Laboratory supplies (e.g., reagents, transport media, plastic trays, sample vials, swabs for testing) are a critical national need. The federal government should negotiate with plastic fabricators and chemical supply houses, using the authority of the Defense Production Act or other means, to redirect American manufacturing to urgently eliminate shortages. … The federal government should negotiate with paper companies, rubber companies, and fabricators to increase domestic production of these urgently needed [personal protective equipment]. … The government should issue large contracts to companies producing critical medications needed for COVID-19 treatment so that companies are willing to overproduce in the short term and ameliorate national shortfalls.” 

    (Read the AAMC’s 16-page report here.)

    The Johns Hopkins University Center for Health Security released a report on Wednesday with its own 10 recommendations. “Unlike many countries in the world, the United States is not currently on course to get control of this epidemic. It’s time to reset,” six scholars write in the introduction of their report. Like the academic medicine association, they also call for bolstering PPE and testing supply chains. Also on their list: “Close higher risk activities and settings in jurisdictions where the epidemic is worsening and reinstitute stay-at-home orders where healthcare systems are in crisis. … Conduct and make public detailed analyses of epidemiologic data collected during case investigations and contact tracing. … Scale up contact tracing and continue to improve performance. … Develop policies and best practices to better protect group institutions.”

    (Read Hopkins’s 15-page report here.

    The Florida chapter of the American Academy of Pediatrics issued new guidance on reopening schools. Education reporter Valerie Strauss reports that the guidelines sent to Gov. Ron DeSantis (R), who has pushed for schools to reopen fully, list measures schools should take to safely offer in-person learning, including: Staggering start times for students to keep the number of children low inside classrooms. Keeping kids in cohorts throughout the school day. Enforcing strict handwashing requirements; disinfecting classroom surfaces every day. Ensuring that ventilation systems for classrooms are in good working order. Keeping children and teachers six feet apart in classrooms and during outdoor activities. Barring any activities in which students face each other.

    “In the absence of robust and rapid diagnostic testing for schools, the major tools for disease mitigation are personal (social) distancing, mask usage, strict hand hygiene, fomite prevention on surfaces (enhanced cleaning measures), and proper room ventilation,” says the guidance, submitted by Paul Robinson, the chapter’s president. 

    (Read his full 11-page letter here.)

    At least 17 of 21 states flagged as “red zones” in the latest internal report compiled for the White House coronavirus task force are apparently not following recommendations by federal authorities to slow the spread. “The report, which is sent regularly to state officials but is not released to the public, categorizes states as green, yellow or red based on their levels of new cases and rate of tests coming back positive,” Hannah Knowles reports. “A state is designated a red zone if it reports more than 100 new cases per 100,000 people or if more than 10 percent of its virus tests come back positive.”

    Rep. Jim Clyburn (D-S.C.), the chairman of the House’s Select Subcommittee on the Coronavirus Crisis, sent letters on Wednesday to the governors of the red-zone states of Georgia, Oklahoma, Florida and Tennessee urging them to follow the White House task force’s advice, including requiring masks, closing bars and more strictly limiting gatherings. He also demanded states turn over documents and data to his committee. “The White House’s refusal to publicly call for strong public health measures and to ensure nationwide compliance has led to an uneven patchwork of restrictions across states, counties, and cities,” Clyburn wrote in an open letter to Vice President Pence and White House coronavirus task force coordinator Debbie Birx. “This approach is allowing the virus to spread, prolonging and exacerbating the public health crisis facing this country.”

    (Read Clyburn’s letter to DeSantis here and his letter to Pence and Birx here.) 

    A study released this morning by the Massachusetts Institute of Technology calls on governors in neighboring states to coordinate economic reopening plans more closely. The Social Analytics Lab at the MIT Initiative on the Digital Economy says its researchers used data from mobile phones, social media and the census to conclude that residents are worse off when reopening is not coordinated among states and regions. “When we analyzed the data, we were shocked by the degree to which state policies affected outcomes in other states, sometimes at great distances,” said Sinan Aral, an author of the study, in a statement. “Travel and social influence over digital media make this pandemic much more interdependent than we originally thought. Our results suggest an immediate need for a nationally coordinated policy across states, regions and nations around the world.”

    “Florida’s social distancing was most affected by New York implementing a shelter-in-place policy due to social media influence and travel between the states, despite their physical distance,” according to a summary of the study, while “New Hampshire had a strong influence on adjacent Massachusetts, despite being a small state.”

  • Insider’s View

    This interview of a veteran reporter who has studied epidemics and knows the experts well reveals the scientific effort to fight COVID-19.

  • Improvised Face Covering

    After surveying many YouTube videos for face masks, I condluded that I could design a better cloth mask. Many designs I viewed did not seal the gap between the mask and cheek bones — particularly when worn by someone who has a prominent nose, like me.

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  • Bill Gates on COVID-19

    Gates’ Foundation has been a major funder and a leader in the response to global epidemics for years, most notably Ebola. Now they are working on COVID-19. What is less well known is the fact that Bill Gates did a TED talk warning of the danger of just the sort of pandemic we now face. Here are both talks.

    And his warning of March 2015 …

    Our government did not see this disaster coming and defunded and downsized the departments that were responsible for ensuring preparedness. These talks demonstrate that those responsible could have known and should have been ready. Failure is always an orphan.


    Trevor Noah interviews Gates on fighting the pandemic.

    4/3/2020
  • Improvised Sterilizers? [Stanford’s Research]

    Are we so immersed in our throw-away culture that we have forgotten how to reuse scarce items? As the COVID-19 pandemic exhausts supplies of basic protective gear some workers are going without masks and protective gear because all that’s available is disposable. But that may not be necessary.

    An ordinary clothes dryer set on high should be hot enough to destroy viruses on contaminated clothing. An infra-red thermometer would allow you to check the temperature inside the dryer. Before relying on this, get an expert opinion. That said, wouldn’t it be better to use the dryer than to simply re-use potentially contaminated gear or go without?

    An ordinary pressure cooker develops 10 to 15psi steam at 240 to 250 degrees Fahrenheit. Objects suspended in a wire basket or colander would be steamed at this temperature.

    Stanford has tested various methods for sanitizing disposable masks for reuse. They don’t recommend any method, possibly for liability reasons. They have determined that steam sterilization destroys the effectiveness of N-95 masks.

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  • Graphic Best Practices

    Thanks to USA Today and the Bucks Courier Times for these excellent charts…

    Note that you can download and print these charts. Look for the download arrow in the bottom margin of the picture.

  • About Gloves and Masks

    These may not be as helpful as one would think, mainly because they require the proper donning and disposal procedure to be effective.

    Gloves

    Remember that the virus needs to reach your mucus membrane (eyes, nose, or mouth) to infect you and replicate. If you touch your face with contaminated gloves they accomplish nothing. So you’d have to change gloves often, or wash them, to get the protection.

    Contaminated gloves will also transfer virus to other surfaces, just as touching with contaminated hands would.

    For these reasons, gloves are not recommended for protection when shopping or other everyday activities. Clinical use by professionals is a very different matter and they are trained to use them properly.

    If you decide to use rubberized kitchen gloves when cleaning and sanitizing, be sure to sanitize the gloves before removing them.

    Masks

    When worn by an infected person, masks help to contain the tiny droplets of virus-laden fluid exhaled while breathing, sneezing, or coughing. When worn by a caregiver they afford some protection against inhaling these droplets. Either use causes one surface of the mask to become contaminated. For this reason, use of a mask requires care in handling to avoid spreading the virus. Healthcare professionals know the drill.

    Since the masks are disposable and in short supply for the healthcare workers whose safety depends on using them, non-caregivers are discouraged from buying and using them.

    Some websites offer instructions for sewing masks from scraps of fabric. Reuse of a mask requires sterilization. I imagine you could steam a mask, or dry it in a clothes dryer, or wash it, to sanitize it for reuse. But I don’t know how you verify that it still works like new. In the end you are left wondering if you should rely upon a mask for protection, or simply practice social distancing and hygiene to protect yourself and others.

  • Sanitizing Surfaces

    Probably the most common sanitizing solution is one tablespoon of regular strength bleach (unscented) in one gallon of warm to hot water (70 to 110 degrees). This solution degrades over 24 hours and should be made fresh for each use.

    NOTE: Use 4 teaspoons of household bleach [Clorox] per quart to make a sanitizing solution. (This is stronger than the 1 teaspoon per quart recommended for foodservice uses.)

    cdc: HOW TO PROTECT YOURSELF 4/6/2020
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  • Prudence and COVID-19

    This is my take on the attitudes and actions that are prudent now and for the coming months of widespread contagion. First, adhere to the guidelines of the CDC.

    https://youtu.be/m4gborCUztk?list=PLvrp9iOILTQatwnqm61jqFrsfUB4RKh6J
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  • Johns Hopkins COVID-19 Experts

    Here is an excellent overview by Johns Hopkins…