Patterico's Pontifications

3/18/2020

Wednesday Evening Music: Brahms

Filed under: General — Patterico @ 8:26 pm



I am currently obsessed with this song. And in particular this performance. Listen to it and then listen to it again. Wash, rinse, repeat.

All hail the genius of Johannes Brahms.

President Trump: Well-Connected Shouldn’t Have Special Access To Coronavirus Testing, But…

Filed under: General — Dana @ 5:42 pm



[guest post by Dana]

Given the lack of widely available coronavirus tests, NBC’s Peter Alexander asked President Trump why well-connected, yet asymptomatic individuals, are able to get tested for coronavirus, while the not well-connected are unable to do so:

“Do the well-connected go to the front of the line?”

“Well, you have to ask them that question,” Trump said. “I mean, I’ve read—.”

“Should that happen?” Alexander asked.

“No, I wouldn’t say so. But perhaps that’s been the story of life. That does happen on occasion and I’ve noticed where some people have been tested fairly quickly.”

He then blamed it on having inherited a very obsolete testing system and/or a system that wasn’t meant to handle the current volume of needed testing:

Note: I know that non-symptomatic Utah Jazz players were tested after one player contracted the virus. Reports say that public health officials consider them “superspreaders” because of the number of people they are in contact with. Rishi Desai, who is the chief medical officer and pediatric infectious disease physician and also used to work for the Centers for Disease Control and Prevention as an epidemic intelligence service officer, explained it this way:

He understands Oklahoma’s decision to test who it did. He called athletes, team personnel and traveling reporters “super spreaders,” people who are often in direct contact with several other people especially in arenas with thousands of people.

“The average person is not exposing as many other people as a super spreader… Whenever there’s an outbreak and you know you have these potential super spreaders who have the potential to be around a lot of people, you want to really get on top of that situation.”

Exit question: Shouldn’t doctors and nurses, and first responders and health care workers be considered “super spreaders” of sorts, given the large number of people they are in direct contact with – including infected people? That way they could get the testing they need, and the testing that we need them to have in order to ensure, not only their well-being but our safety too.

–Dana

Study: Vast Majority Of Coronavirus Fatalities In Italy Were People With Previous Health Conditions

Filed under: General — Dana @ 12:43 pm



[guest post by Dana]

Bloomberg is reporting on a new study out of Italy indicating that nearly all of Italy’s coronavirus fatalities were people with previous health issues:

More than 99% of Italy’s coronavirus fatalities were people who suffered from previous medical conditions, according to a study by the country’s national health authority.

After deaths from the virus reached more than 2,500, with a 150% increase in the past week, health authorities have been combing through data to provide clues to help combat the spread of the disease.

[…]

The new study could provide insight into why Italy’s death rate, at about 8% of total infected people, is higher than in other countries.

The Rome-based institute has examined medical records of about 18% of the country’s coronavirus fatalities, finding that just three victims, or 0.8% of the total, had no previous pathology. Almost half of the victims suffered from at least three prior illnesses and about a fourth had either one or two previous conditions.

More than 75% had high blood pressure, about 35% had diabetes and a third suffered from heart disease.
The average age of those who’ve died from the virus in Italy is 79.5. As of March 17, 17 people under 50 had died from the disease. All of Italy’s victims under 40 have been males with serious existing medical conditions.

While data released Tuesday point to a slowdown in the increase of cases, with a 12.6% rise, a separate study shows Italy could be underestimating the real number of cases by testing only patients presenting symptoms.

Untitled

The report also notes that the median age of the Italians infected is 63.

About testng only patients presenting symptoms… Here in the U.S., it is problematic trying to get a test for those who show symptoms, as well as those who don’t show any symptoms, and that can lead to disastrous consequences:

Morgan Thornberry, a 38-year-old organizer in San Diego, went to an urgent-care clinic earlier this week with a fever, a dry cough, and nausea. The symptoms had started the week before, on the day she was released from the hospital for an unrelated stay.

She went to the clinic with the same question as, it seemed, everyone else: Was she sick with COVID-19, the disease caused by the new coronavirus? The six people behind her in line were all wearing surgical masks.

She still doesn’t know. Though tests showed she was negative for influenza and strep throat, the clinic doctor said he could not test her for COVID-19. “The doctor said he wanted to test me, but the San Diego County Department of Health criteria wouldn’t allow him to,” Thornberry told me.

[…]

For more than a week, federal officials have promised that tests for the new coronavirus would soon be widely available. “Anyone who wants a test can get a test,” President Donald Trump said during a visit to the Centers for Disease Control and Prevention last week. (Secretary Alex Azar, who leads the Department of Health and Human Services, later clarified that a doctor or public-health official would need to approve and prescribe it.)

But the majority of Americans still cannot get tested, as interviews with doctors, patients, and dozens of state public-health officials reveal. While the most stringent federal guidelines are gone, a chaotic patchwork of rules now governs who can and cannot get a COVID-19 test. In many states, symptomatic patients still cannot get tested for the coronavirus unless they meet certain limited criteria—even if their doctor wants to test them.

The report goes on to say that there are a number of entities involved in making testing rules (including states, counties, and cities, as well as by individual hospitals and health systems), and that they generally base these rules on the CDC guidelines, how they are enforced in reality varies state-by-state, and even hospitals-to-hospital.

All of which in turn means:

Under the most widely used criteria, only people who have either traveled recently or have had known contact with a laboratory-confirmed COVID-19 patient can get tested, even if they have all the symptoms of the disease. This means that a city or region’s first community case may not qualify for a test, especially if the person is not sick enough to be hospitalized.

“If those are the requirements, you will miss almost all mild symptomatic transmission, and only become aware [that the coronavirus] is present in your community when it gets into a group of vulnerable people and starts killing them,” William Hanage, an epidemiology professor at Harvard, told me by text message.

On a wider scale, the rules frustrate doctors, nurses, and other front-line medical workers as they try to take care of patients without endangering themselves. Even in the absence of local rules, doctors must sometimes involve dozens of people throughout a sprawling hospital bureaucracy before they can authorize a single test. The rules have prevented medical staff from getting themselves tested: In several cases, a doctor who had symptoms of COVID-19 told me they were denied a test because they could not prove they were exposed to a laboratory-confirmed case.

The rules almost certainly mean that the United States is still greatly understating the number of people nationwide who are sick with COVID-19, experts say.

–Dana

President Trump Takes Additional Steps To Combat Coronavirus

Filed under: General — Dana @ 10:56 am



[guest post by Dana]

This morning, President Trump referred to himself as a “wartime” president and said that he will invoke the 1950 wartime law known as the Defense Production Act in an effort to combat the coronavirus pandemic:

The act ensures the private sector can ramp-up manufacturing and distribution of emergency medical supplies and equipment. The move gives the White House the authority to increase production of masks, ventilators and respirators, as well as expand hospital capacity to combat the coronavirus.

Asked if he saw the nation as being on a wartime footing he said he did and described himself as “in a sense a wartime president.”

Earlier this morning, Sen. Chuck Schumer had called on the President to mobilize “as if it were a time of war” when it comes to medical equipment/supplies.

About the Defense Production Act:

The Defense Production Act (DPA) of 1950 (P.L. 81-774, 50 U.S.C. Appx §2061 et seq.), as amended, confers upon the President a broad set of authorities to influence domestic industry in the interest of national defense. The authorities can be used across the federal government to shape the domestic industrial base so that, when called upon, it is capable of providing essential materials and goods needed for the national defense.

Though initially passed in response to the Korean War, the DPA is historically based on the War Powers Acts of World War II. Gradually, Congress has expanded the term national defense, as defined in the DPA, so that it now includes activities related to homeland security and domestic emergency management. The scope of DPA authorities extends beyond shaping U.S. military preparedness and capabilities, as the authorities may also be used to enhance and support domestic preparedness, response, and recovery from natural hazards, terrorist attacks, and other national emergencies.

President Trump also said he would be invoking a provision that allows limiting certain people from crossing the southern border (including asylum seekers):

“The answer’s yes,” Trump told reporters when asked about the code, adding that he plans to invoke it “very soon. Probably today.”

The administration will invoke 42 U.S. Code 265, a section of the federal legal code that states the U.S. surgeon general “shall have the power to prohibit, in whole or in part, the introduction of persons and property from such countries or places as he shall designate in order to avert such danger, and for such period of time as he may deem necessary for such purpose.”

While the president told reporters that the administration would not be closing the U.S.-Mexico border, he did add that “… we’re invoking a certain provision that will allow us great latitude.”

–Dana

Morning Chuckle

Filed under: General — JVW @ 9:59 am



[guest post by JVW]

Let’s all take a moment away from all of the debating and bickering to salute someone who is finding the humorous moments in social isolation.

– JVW


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