Hospitals Know What’s Cominghttps://amp.theatlantic.com/amp/article/617156/“We are on an absolutely catastrophic path,” said a COVID-19 doctor at America’s best-prepared hospital.Perhaps no hospital in the United States was better prepared for a pandemic than the University of Nebraska Medical Center in Omaha.
After the SARS outbreak of 2003, its staff began specifically preparing for emerging infections. The center has the nation’s only federal quarantine facility and its largest biocontainment unit, which cared for airlifted Ebola patients in 2014. The people on staff had detailed pandemic plans. They ran drills. ... There’s a reason many of the Americans who were airlifted from the Diamond Princess cruise ship in February were sent to UNMC.
In the past two weeks, the hospital had to convert an entire building into a COVID-19 tower, from the top down. It now has 10 COVID-19 units, each taking up an entire hospital floor. Three of the units provide intensive care to the very sickest people, several of whom die every day. One unit solely provides “comfort care” to COVID-19 patients who are certain to die. “We’ve never had to do anything like this,” Angela Hewlett, the infectious-disease specialist who directs the hospital’s COVID-19 team, told me. “We are on an absolutely catastrophic path.”
To hear such talk from someone at UNMC, the best-prepared of America’s hospitals, should shake the entire nation. ...
UNMC is fuller with COVID-19 patients—and patients, full stop—than it has ever been. “We’re watching a system breaking in front of us and we’re helpless to stop it,” says Kelly Cawcutt, an infectious-disease and critical-care physician.
Cawcutt knows what’s coming. Throughout the pandemic, hospitalizations have lagged behind cases by about 12 days. Over the past 12 days, the total number of confirmed cases in Nebraska has risen from 82,400 to 109,280. That rise represents a wave of patients that will slam into already beleaguered hospitals between now and Thanksgiving. ...
“the assumption we will always have a hospital bed for them is a false one.” ...
... When UNMC finally hits its capacity ceiling, people with COVID-19 will die not just because of the virus, but because the hospital will have nowhere to put them and no one to help them. Empty hospital beds might as well be hotel beds without doctors and nurses to staff them.
... Doctors will have to choose whether to abandon entire groups of patients who can’t get help elsewhere.
... COVID-19 works slowly. It takes several days for infected people to show symptoms, a dozen more for newly diagnosed cases to wend their way to hospitals, and even more for the sickest of patients to die. These lags mean that the pandemic’s near-term future is always set, baked in by the choices of the past. It means that Gov. Ricketts is already too late to stop whatever UNMC will face in the coming weeks (but not too late to spare the hospital further grief next month). It means that some of the people who get infected over Thanksgiving will struggle to enter packed hospitals by the middle of December, and be in the ground by Christmas. ... --------------------------------------
1,000 U.S. Hospitals Are 'Critically' Short On Staff — And More Expect To Be Soonhttps://www.npr.org/sections/health-shots/2020/11/20/937152062/1-000-u-s-hospitals-are-short-on-staff-and-more-expect-to-be-soonMore than 1,000 hospitals across the United States are "critically" short on staff, according to numbers released this week by the Department of Health and Human Services.
Those hospitals, which span all 50 states, Washington, D.C. and Puerto Rico, represent about 18% of all hospitals that report their staffing status to HHS. And that number is expected to grow: 21% of all hospitals reporting say they anticipate having critical staffing shortages in the next week.
The worst-hit state is North Dakota with 51% of hospitals that reported saying they're facing shortages; seven states say over 30% of their hospitals are in trouble.While the data is a welcome addition to the arsenal of information that public health officials have to fight COVID-19, it highlights the shortcomings of what the federal government has made available to the public. Though the government has precise daily figures for COVID-19 hospitalizations at thousands of the country's hospitals, it shares only a small subset of this information to people outside government.
https://www.npr.org/sections/health-shots/2020/10/30/929239481/internal-documents-reveal-covid-19-hospitalization-data-the-government-keeps-hidLooking ahead toward the next week, additional hospitals report expecting staffing shortages in 40 states, as well as Puerto Rico. Nebraska, Virginia and Missouri top the list in places that are expected to have the biggest upticks. ...
State List at link ...
https://www.npr.org/sections/health-shots/2020/11/20/937152062/1-000-u-s-hospitals-are-short-on-staff-and-more-expect-to-be-soon---------------------------------------
Gene Experts Claim They Identified Human Genes That Can Protect Against Covid-19https://www.cnbc.com/amp/2020/11/20/crispr-scientists-claim-identified-genes-that-protect-against-covid.htmlA team of CRISPR scientists at the New York Genome Center, New York University and Icahn School of Medicine at Mount Sinai say they have identified the genes that can protect human cells against Covid-19.
Leading virologist at Mount Sinai, Dr. Benjamin tenOever, developed a series of human lung cell models for coronavirus screening to better understand immune responses to the disease and co-authored the study.
The goal was two-fold: to identify the genes that make human cells more resistant to SARS-CoV-2 virus; and test existing drugs on the market that may help stop the spread of the disease.
... After intensive research the scientists and doctors claim they have found 30 genes that block the virus from infecting human cells including RAB7A, a gene that seems to regulate the ACE-2 receptor that the virus binds to and uses to enter the cell.
The team discovered that the top-ranked genes — those whose loss reduces viral infection substantially — clustered into a handful of protein complexes, including vacuolar ATPases, Retromer, Commander, Arp2/3, and PI3K. Many of these protein complexes are involved in trafficking proteins to and from the cell membrane.
The research team also identified drugs that are currently on the market for different diseases that they claim block the entry of Covid-19 into human cells by increasing cellular cholesterol. In particular, they found three drugs currently on the market were more than 100-fold more effective in stopping viral entry in human lung cells: ...
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Most Coronavirus Cases are Spread by People Without Symptoms, CDC Now Sayshttps://amp.cnn.com/cnn/2020/11/20/health/cdc-coronavirus-spread-asymptomatic-website-wellness/index.html... "CDC and others estimate that more than 50% of all infections are transmitted from people who are not exhibiting symptoms," it added in the guidance posted Friday.
"This means at least half of new infections come from people likely unaware they are infectious to others."
According to the CDC, 24% of people who transmit the virus to others never develop symptoms and another 35% were pre-symptomatic. It also said 41% infected others while experiencing symptoms.
Peak infectiousness comes five days after infection, the agency said on the website. "With these assumptions, 59% of infections would be transmitted when no symptoms are present but could range (from) 51%-70% if the fraction of asymptomatic infections were 24%-30% and peak infectiousness ranged 4-6 days."
https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.htmlThe CDC said studies have shown 40-45% of infected people never develop symptoms.
"Among people who do develop symptomatic illness, transmission risk peaks in the days just before symptom onset (presymptomatic infection) and for a few days thereafter."
"Accordingly, the number of infections transmitted peaks when virus levels peak," the agency noted.
So, people are spreading the virus when they have no idea they are infected.
Masks can prevent this spread.
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Ben Carson Says He Was 'Desperately Ill' With The Coronavirushttps://www.npr.org/sections/coronavirus-live-updates/2020/11/20/937170338/ben-carson-says-he-was-desperately-ill-with-the-coronavirusBen Carson, secretary of the Department of Housing and Urban Development, took to Facebook on Friday to report he has been "extremely sick" with the coronavirus.
Carson said his initial symptoms were light, but then he became "desperately ill," and noted that he has "several co-morbidities" that played a role.
"President Trump was following my condition and cleared me for the monoclonal antibody therapy that he had previously received, which I am convinced saved my life," Carson wrote. He said he is now "out of the woods."
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German Doctor Arrested On Suspicion of Killing Coronavirus Patientshttps://m.dw.com/en/german-doctor-arrested-on-suspicion-of-killing-coronavirus-patients/a-55682819A German doctor is facing manslaughter charges over two deaths, reportedly of COVID-19 patients. Police cited him as giving medication to hasten the death of one patient and to "avert further suffering."
The senior doctor, 44, employed since February at the University Hospital in Essen city in North Rhine-Westphalia (NRW), was arrested on Wednesday, charged with manslaughter on Thursday and remained in custody, city police said.
Two patients, aged 47 and 50, were terminally ill with COVID-19 when a senior doctor allegedly administered medication that led to their immediate deaths, police said Friday.
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