Wednesday, April 22, 2020

CT Scans Can Detect COVID-19

I'm going to read thoroughly and see what imagery comes to mind:

"Could CT scans for COVID-19 speed up the economy’s restart?" by Sharon Begley STAT  April 19, 2020

To safely relax the chokehold that policies to control COVID-19 have on the economy, most experts agree the United States will need a four-pronged strategy: aggressive diagnostic testing for the disease, isolation of known cases, tracing of their contacts, and quarantining of anyone who might have been exposed until they are clearly uninfected. Many public health officials have focused on the challenge of contact tracing, saying it will require “an army” of new workers.

I'm wondering where the money is going to come from to pay them, because right now this is all cost. 

Don't tell me it is going to come from the trillions in bailout loot.

In fact, however, the reopening effort is in danger of failing spectacularly because the country hasn’t gotten the first and last steps right — which both rely on accurate diagnostic testing. The current swab tests for the novel coronavirus are missing up to 30 percent of infected people.

I no longer believe this crap as reported, sorry, and you can do it at home for $119.

In a scramble to fix that before it’s too late, a growing number of doctors are calling for the use of another method to detect COVID-19, one that would miss fewer cases than molecular testing of swabs does: chest CT scans.

CT scans are far more expensive, they expose patients to a low dose of radiation, and the Centers for Disease Control and Prevention and some medical groups recommend against using them to diagnose COVID-19, but they were widely used in China to identify cases, and their reliability there is fueling growing interest in adding chest CT to the diagnostic arsenal in the United States.

The scans detect hazy, patchy, “ground glass” white spots in the lung, a telltale sign of COVID-19. In one recent study of 1,014 patients, published in the journal Radiology, scientists in China reported that chest CT found 97 percent of COVID-19 infections. In comparison, the study found that 48 percent of patients who had negative results on the swab test, which detect the coronavirus’s genome, in fact had the disease.

I'm not believing this kind of crap anymore knowing all the test kits are crap as well as the conflating of death totals. I mean, it's a consider the source situation.

“Once you’re a couple of days into infection, chest CT scans don’t miss,” said an emergency medicine physician in Louisiana who asked not to be named. With the swab test missing 30 to 50 percent of cases, physicians in China called for the diagnostic use of CT early in the outbreak there, and “fever clinics” set up in Wuhan and elsewhere began routinely using them.

A positive result on the swab tests is usually reliable. “If you get a positive test result, looking for the RNA of the virus with the current methods that we have, it’s very likely to be a true positive,” said Jana Broadhurst, an infectious disease doctor and director of the Nebraska Biocontainment Unit Clinical Laboratory at the University of Nebraska Medical Center, but “if you get a negative test result, [the chance that it’s wrong is] about 30 percent.” Of every 100 symptomatic people who test negative for COVID-19, 30 are actually infected. The test missed them.

Yeah, right, the false results all go one way! 

It's like exit poll anomalies during elections!

Look, I'm just a layman but this is not passing the smell test!

The main reason is sample collection. The swab that’s supposed to be pushed into the back of the nose (often painfully) and then curve down into the throat sometimes doesn’t reach far enough, or doesn’t remain in place long enough, to collect a decent sample. The swab can trigger violent coughing, making the technician or nurse taking the sample pull back too soon.

But they are here to help! 

Help themselves to your DNA and tag you as COVID!

Because the fault is human rather than molecular, there is no technological fix. If tests are the first leg of an exit strategy, as the Johns Hopkins Center for Health Security said in a plan released last weekend for reopening the US economy, then incorrectly “clearing” 30 percent of those who are tested will doom any exit plan. They could be cleared to return to work when they’re actually infectious, and — even worse — those they encounter and potentially expose to the virus would not be identified and quarantined.

JH was the one who hosted the Event 201 simulation last October, and that looks more like a dry run all the time. Get everyone on the same page for rollout months later.

“We cannot rely fully on the test” to guide decisions crucial to reopening the economy, said Sandro Galea, a physician and epidemiologist who is the dean of the Boston University School of Public Health.

The alarming rate of false negatives from molecular testing, as well as the often dayslong wait to receive results, is driving more and more medical centers to adopt CT scans for COVID-19 testing. They include Mount Sinai in New York City, Bloomberg News reported, and a growing number of physicians across the country.

No false positives, though?

That doesn't make sense unless you are lying to push an agenda.

Earlier this month, the Fleischner Society, an international group of chest radiologists, broke with the CDC and the American College of Radiology, which recommend against chest CT to diagnose COVID-19. The society concluded that it can in fact be appropriate in some situations, including a pandemic, but despite China’s experience, the use of chest CT to diagnose COVID-19 in the United States remains limited. That’s due in large part of the CDC and the American College of Radiology recommendations.

One of their objections is that CT scanners will become contaminated with the coronavirus. China, whose fever clinics routinely scanned 200 patients per day per machine, managed to clean the machines between patients well enough to avoid infecting health care workers or subsequent patients, however. Researchers there reported last month that CT scanning is far safer for health care workers than the swabs that reach the throat via the nose, and often trigger explosive coughing that can spew virus particles into the air. Thanks to staff training and between-patient scanner cleaning, after 3,340 CT scans for suspected COVID-19, another group of physicians in China reported, “none of the staff of the radiology department was infected with COVID-19.”

“It’s not like China has a monopoly on the technology to clean CT scanners,” said the Louisiana emergency medicine physician who asked not to be identified, so as not to anger colleagues. “Are you really going to say that your cleaning protocol is why you’re willing to kill 1 million people?” if the test/isolate/trace strategy fails because of faulty swab tests.

There he goes with the outrageous death figures, and if the tests are faulty why should we believe in anything these guys do?

Fraiman said he is able to do chest CTs for his suspected COVID-19 cases by getting the technicians and cleaning crews on board: “I tell them, you are the guys who are going to save us!”

Another objection is that CT scans cannot easily distinguish between COVID-19, SARS, MERS, and other viral pneumonias, including from influenza. “They’re not specific enough,” said Sanjat Kanjilal, an infectious disease physician at Brigham and Women’s Hospital in Boston.

Oh, no. 

I've read this far in the article as it pushed its point, and now that point has just vanished in hazy patch.

Although SARS, which is caused by a coronavirus related to the one causing COVID-19, was eliminated, and MERS (also from a coronavirus) is extremely rare outside the Middle East, viral pneumonia looks a lot like COVID-19 in a chest CT. “That makes me skeptical that it can have a big role to play,” Kanjilal said.

The rate of false positives from misidentifying other viral pneumonias as COVID-19 might be as high as 30 percent, said radiologist Paras Lakhani of Thomas Jefferson University Hospital in Philadelphia, but it would be much lower outside of flu season, which is ending. Reading scans during a time of year when flu and therefore pneumonia is rare, he said, “would give us more confidence in interpreting a scan.”

It is misidentifying COVID when it is something else?

Also increasing confidence are artificial intelligence add-ons being developed to reduce how often the scans mistake other pneumonias for COVID-19. Those systems have yet to prove themselves, but “radiologists are becoming better at interpreting chest CTs in potential COVID-19 patients, since we’re seeing more and more of them,” Lakhani said.

Oh, so if you are old and come down with pneumonia they will automatically call it COVID!

Even a false positive rate of 30 percent is less problematic than false negatives, argued Fraiman, who before COVID-19 gave “grand rounds” talks to hospital physicians warning against the overuse of CT. That’s because the consequences of telling someone she has COVID-19 when she actually has the flu are not like telling someone she has cancer when she doesn’t: The advice is simply to self-isolate (a good idea for flu patients, too), not undergo dangerous surgery or other treatment.

OMG, they are saying the MISDIAGNOSIS is NO BIG DEAL!

HOW EVIL!!!

How can we ever trust you guys again?

Absent more accurate COVID-19 tests, states’ tentative reopening plans will be inefficient at best and failures at worst. The many COVID-19 cases that swab tests miss, said BU’s Galea, “is why the proposed Massachusetts contact tracing plan I have seen will quarantine people for 14 days even if they test negative” — a fortnight that someone could have been safely back at work and in the community if only a negative result on the molecular tests were more credible.

Like many others, however, Galea questions whether “something as resource-intensive as CT scans can ever be an effective population-wide screener.” He calls it “implausible” but “not impossible.”

Then this whole article was a big waste of time?

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Better give the kid one:

"In rare but growing number of cases, children hospitalized with coronavirus in Massachusetts; Boston Children’s Hospital has 13 admitted patients, including three in the ICU" by Rebecca Ostriker Globe Staff, April 19, 2020

In a pandemic perceived as largely sparing the very young from serious illness, a growing number of children infected with COVID-19 in Massachusetts have become so severely ill that they have needed hospitalization — sometimes even ventilators. The sickest of these patients have typically had underlying health conditions.

Oh, mercy!

What are the guidelines for who gets ventilators again?

One such child was a 16-year-old girl admitted last month at Boston Children’s Hospital in serious condition. Staff immediately suspected coronavirus. Her blood oxygen was low, plummeting briefly to 52 percent — a startlingly dangerous level.

You don't say!

She was also autistic, and couldn’t tolerate a mask on her face to deliver oxygen, so a therapist positioned a tube a few inches away. Still, her oxygen remained too low.

Too many vaccinations!

A team swiftly brought the girl, feverish and suffering from pneumonia, up to the intensive care unit. Doctors tried a BiPAP machine to deliver oxygen, then intubated her with a ventilator. Seventy-two hours after admission, the test results came in: a confirmed case of COVID-19.

It was a phenomenon that is still relatively unusual: a child descending into life-threatening illness from the coronavirus.

“They have the full range of severity of illness that one sees in adults,” said Dr. Michael Agus, division chief of medical critical care at Boston Children’s Hospital. “However it is a far, far smaller number.”

“Children are intriguingly resistant to developing critical illness,” said Dr. Jeffrey Burns, chief of critical care at Boston Children’s Hospital. “Why do they get infected apparently as easily as anyone else, but why are they resistant to critical illness?” It’s still a mystery, he said.

They shut down society and destroy livelihoods because of that.

Still, rare severe cases do occur. Boston Children’s Hospital. The 16-year-old girl had been receiving chemotherapy because of a genetic disease, so her immune system was suppressed, said her mother, who requested anonymity out of concern for her family’s privacy. The girl was initially treated at a hospital north of Boston, but transferred to Boston Children’s Hospital, where her specialists were based.

Oh, still, and I wonder what the Pelletiers would think of all this.

They tortured that poor kid against the will of her parents because they knew better, and then hurled false accusations at them.

When those specialists heard about her condition, they immediately recommended that chemotherapy be suspended to help protect her immune system. “I was so shocked about how they reacted so fast,” said the mother, who praised the hospital’s doctors, nurses, and social workers for their care.

Radiation destroys your immune system!

The girl improved enough to be taken off the ventilator and even to eat some of her favorite foods — pizza and strawberries. After about three weeks, she walked out. “She is happy,” said her mother. “She’s loving being outside of the hospital right now.”

Well thank God for that.

Some serious coronavirus cases involving children that might otherwise be handled elsewhere in Massachusetts are now coming to Boston Children’s Hospital, Burns said, as other pediatric intensive care units in the state have been converted to help care for adult COVID-19 patients, either in whole or in part.

As such, Boston Children’s is on the front lines of pediatric COVID-19 care. While Massachusetts General Hospital has two COVID-19 inpatients under the age of 18, other major Massachusetts hospitals told the Globe they did not have children hospitalized for the coronavirus, or declined to offer data.

Coronavirus treatment at the hospital varies on a case-by-case basis. “I’m not sure you’d find two patients who are treated exactly the same,” said Agus. When using ventilators, they can manipulate the pressure and air flow to adjust for the size of the child. They are also trying to use more non-invasive ventilation, applying it through a mask or using a high-flow nasal cannula, to avoid putting in a breathing tube and sedating a patient.

Therapies have included hydroxychloroquine, remdesivir, and tocilizumab, said Agus — three medicines that are now in US clinical trials for COVID-19 treatment, and the hospital has joined a trial for convalescent serum, which involves plasma donated by recovered COVID-19 patients who have antibodies to the virus.

Not supposed to be using that first one, but oh, well.

As with adult patients, the illness can take sudden and unpredictable shifts with children. On more than one occasion, Agus said, the hospital has seen children who had gotten dramatically better, and then they “suddenly flip and begin to get significantly worse.”

“We had our eye open for it,” he said, “but until you see it, one’s medical instinct is that when a patient begins to get better, they continue to get better.”

Amid the pandemic, Boston Children’s Hospital has had a major advantage: a biocontainment unit originally created to deal with Ebola, another infectious disease, several years ago. At the beginning of March, the team sprang into action. Members trained doctors and nurses on protocols for personal protective equipment, and they used simulations to practice treating coronavirus patients.

You might want to keep your distance.

“The biggest lesson for me is that preparation for the incredibly unlikely is always worth doing,” said Agus, who is co-medical director of the biocontainment unit. “The team has enabled this 400-bed hospital to mold itself and reimagine itself into an infectious disease hospital. Making that transition is not something that 99 percent of hospitals thought they would ever have to do.”

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Who really knows what is going on behind those walls.

Now they would like to draw some blood:

"Antibody test, seen as key to reopening country, does not yet deliver" by Steve Ederand Megan Twohey New York Times, April 19, 2020

Remember Theranos?

In recent weeks, the United States has seen the first rollout of blood tests for coronavirus antibodies, widely heralded as crucial tools to assess the reach of the pandemic in the United States, restart the economy, and reintegrate society, but for all their promise, the tests — intended to signal whether people may have built immunity to the virus — are already raising alarms.

That's supposed to be part of the future.

Officials fear the effort may prove as problematic as the earlier launch of diagnostic tests that failed to monitor which Americans, and how many, had been infected or developed the disease the virus causes. Criticized for a tragically slow and rigid oversight of those tests months ago, the federal government is now faulted by public health officials and scientists for greenlighting the antibody tests too quickly and without adequate scrutiny.

The Food and Drug Administration has allowed about 90 companies, many based in China, to sell tests that have not gotten government vetting, saying the pandemic warrants an urgent response, but the agency has since warned that some of those businesses are making false claims about their products; health officials, like their counterparts overseas, have found others deeply flawed.

More Chinese crap flooding the market!

Tests of “frankly dubious quality” have flooded the US market, said Scott Becker, executive director of the Association of Public Health Laboratories. Many of them, akin to home pregnancy tests, are easy to take and promise rapid results, and the federal guidance that does exist is so confusing that health care providers are administering certain tests unaware that they may not be authorized to do so. Some are misusing antibody test results to diagnose the disease, not realizing that they can miss the early stages of infection.

“People don’t understand how dangerous this test is,” said Michael Osterholm, an infectious disease expert at the University of Minnesota. “We sacrificed quality for speed, and in the end, when it’s people’s lives that are hanging in the balance, safety has to take precedence over speed.”

Will still cost you $119 a kit.

Even as government agencies, companies and academic researchers scramble to validate existing tests and create better ones, there are doubts they can deliver as promised. Most tests now available mistakenly flag at least some people as having antibodies when they do not, which could foster a dangerously false belief that those people have immunity, and even if the tests do improve, their availability could be hampered by the same manufacturing shortages that have prevented the COVID-19 diagnostic tests from scaling up adequately.

Look at all the goddamn qualifiers as they walk back everything!

This stuff is becoming more sickeningly offensive than COVID.

As President Trump presses to reopen the country and several states are considering lifting lockdowns in the next few weeks, widespread screening is considered critical. On Friday, Trump cheered the FDA’s emergency approval of some antibody tests, saying they would support efforts to get Americans back to work “by showing us who might have developed the wonderful, beautiful immunity.”

Epidemiologists are testing for antibodies in hot spots to better measure the extent of the outbreaks, and government officials intend to use those results to help decide when and how to return residents to daily life, but many scientists and political leaders say the country is nowhere close to deploying enough diagnostic and antibody tests at the speed and volume required.

More than 90 companies have jumped into the market since the FDA eased its rules and allowed antibody tests to be sold without formal federal review or approval.

Some of those companies are startups; others have established records.....

I'm sure they will Thrive like Theranos and Holmes, and speaking of cancer:

Don’t blink, but 5G is about to change a lot more than just watching movies

Yeah, “it is so frickin’ awesome,” and the cancer can be blamed on the Russians!

--more--"

Got a shock looking for some PPE:

"Mass. hospital executive says he was questioned by FBI while buying equipment" by Andy Rosen Globe Staff, April 19, 2020

A top physician at the Baystate Health medical system in Western Massachusetts says he was questioned by the FBI as he was buying badly needed personal protective equipment, offering a detailed glimpse into the difficulties faced by hospitals as they try to navigate supply shortages amid the coronavirus pandemic.

Dr. Andrew W. Artenstein, who is chief physician executive at the system that includes Springfield’s Baystate Medical Center, described the maddening process of buying equipment in an account published in the New England Journal of Medicine.

“Protecting our caregivers is essential so that these talented professionals can safely provide compassionate care to our patients,” Artenstein wrote. “Yet we continue to be stymied by a lack of personal protective equipment, and the cavalry does not appear to be coming.”

Artenstein wrote that the encounter with the federal agents was part of a quest for gear that “might have made for an entertaining tale at a cocktail party, had the success of our mission not been so critical.”

In an interview with the Globe, Artenstein said that in a career that included a decade of active duty as as a physician in the US Army, he has never been on such an involved mission to supply his staff.

“I’ve never experienced anything like this. I’ve certainly never been involved at this level of the supply chain, and I can tell you, it’s very foreign for most physicians and most physician leaders,” he said.

He said he has stepped in to help his procurement team because of the scale of the emergency. It has not been easy.

“Deals, some bizarre and convoluted, and many involving large sums of money, have dissolved at the last minute when we were outbid or outmuscled, sometimes by the federal government,” Artenstein wrote in the article.

Finally, a lead “from an acquaintance of a friend of a team member” came through: It looked as though Baystate would be able to buy a large shipment of respirators and face masks. They would cost more than five times what the organization would normally pay, he said, but it was a decent deal compared with what other sellers are now charging.

Related(?):

"The Justice Department says it is distributing about 192,000 N-95 masks to frontline medical workers in New York and New Jersey that were found during an investigation by the new coronavirus hoarding and price gouging task force. Officials say the masks, gloves, gowns, hand sanitizer, and other personal protective equipment were found by the FBI on March 30. The Justice Department says it notified the Department of Health and Human Services, which compelled the supplies be turned over as part of the Defense Production Act. Agents also found nearly 600,000 medical-grade gloves, 130,000 surgical masks, some N100 masks, and disinfectant spray and towels. Authorities said the owner would be paid “fair market value” for the supplies. The equipment is being sent to officials with the New York city and state health departments and the New Jersey Department of Health."

Also related:

"A Brooklyn man was arrested for coughing on FBI agents who came to investigate whether he was selling medical supplies, including N95 masks, at inflated prices in what appears to be one of the first cases related to alleged profiteering from the coronavirus pandemic. Baruch Feldheim, 43, was charged with assaulting federal officers and lying to them about his accumulation and sale of medical supplies, the US attorney’s office in New Jersey said Monday. He wasn’t charged with profiteering. The agents had been staking out Feldheim’s residence in Brooklyn, watching people leave with what looked like medical supplies. Prosecutors said that Feldheim sold supplies at as much as a 700 percent markup to doctors and nurses. Hospitals in New York, New Jersey, and elsewhere are running so short on medical equipment that doctors and nurses are being forced to reuse disposable masks for days at a time. That’s spurred a wave of brokers and hustlers who are bombarding purchasing departments with offers, claiming they’ve located sources of supplies. Even if the administrators are willing to pay high prices, they’re having trouble telling who’s legitimate. The Trump administration has said it will crack down on profiteering. One doctor in New Jersey contacted Feldheim on March 18 through a WhatsApp chat group called “Virus2020!” and arranged to buy about 1,000 N95 masks and other goods for $12,000, prosecutors said. Feldheim sent the doctor to an auto repair shop in Irvington, N.J., to pick up his order, according to the statement. The doctor later said that the shop had enough hand sanitizer and surgical supplies to outfit a hospital, prosecutors said."

It's gotta be him, so why did the jew$paper shield him

Is the the "owner" they were talking about?

The supply team received samples to be sure they would fit properly, but Artenstein said he wanted to inspect the final shipment before buying it ― just to be sure. Four of his team members flew to the mid-Atlantic April 8 to receive the masks, and Artenstein followed by car to make the final call on whether to buy it.

“Two semi-trailer trucks, cleverly marked as food-service vehicles, met us at the warehouse,” Artenstein wrote. “When fully loaded, the trucks would take two distinct routes back to Massachusetts to minimize the chances that their contents would be detained or redirected.”

In retrospect, he told the Globe, the cloak-and-dagger move with the trucks may have been overkill, but he believes it was worth doing. He noted that the equipment remains under 24-hour guard, which is normal for drugs, but not for protective gear.

“The concern was that somewhere, at some point some ... authority or a regulatory body might have looked to try to seize the equipment,” he said. “It might have been overstated, but that’s the way we felt.”

Just before the team arrived, Baystate learned that the shipment would include just a quarter of what they had ordered, but they decided to go anyway. After inspecting a few boxes, Artenstein wrote, he was ready to pull the trigger.

That’s when two FBI agents showed up, Artenstein said, and asked for assurances that he was who he said he was, and that the equipment would really go to help front-line workers.

“They were good guys, and I mean that in the broad sense,” he told the Globe. “They were trying to do their jobs and make sure this got to places where it was really needed.”

OMG, have mercy!

The whole thing was a STING OPERATION!

The agents let the Baystate team take the equipment and drive away, but Artenstein said that on the way back to Massachusetts, he was told that US Department of Homeland Security was still considering redirecting the shipment.

WTF is all this?

Artenstein got in touch with US Representative Richard Neal, a Democrat whose district includes Springfield, and Neal said he was able to get the equipment released through a call to the US Department of Health and Human Services.

“It was a tense period there for a few hours there,” Neal, who chairs the powerful House Ways and Means Committee, told the Globe. He said he relayed to federal officials that “there are a lot of lives that could be on the line because of this, and I wanted that equipment moved now.”

The FBI said in a statement that it is working “to ensure PPE is not being unlawfully distributed or hoarded.” Homeland Security representatives could not be reached to comment.

Artenstein told the Globe that he believes Baystate is seeing its coronavirus cases begin to plateau. It said April 12 it had 160 patients with COVID-19, and Artenstein said Sunday that the number had declined slightly, but even with the shipment of masks in hand, Artenstein said his staff still needs supplies including protective gowns. He doesn’t know what he’ll have to do to procure them ― he’s still shaking his head over the last deal.

“Did I foresee, as a health-system leader working in a rich, highly developed country with state-of-the-art science and technology and incredible talent, that my organization would ever be faced with such a set of circumstances?” he wrote in the article. “Of course not.”

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I wonder if they will make a movie of it.

Related: 

Vocational schools across Mass. donate 13,000 masks, 140,000 gloves to organizations across state

Nike donates face shields and respirator lenses to 3 Boston hospitals

Analog Devices donating $4.5m to virus relief efforts

Also see:

"One toddler became dizzy, fell, and hit her head after drinking from a bottle of hand sanitizer. A woman had a scary coughing and wheezing fit while soaking her produce in a sink containing bleach, vinegar, and hot water. Reports of accidental poisonings from cleaners and disinfectants are up this year, and researchers believe it’s related to the coronavirus epidemic. Such poisonings were up about 20 percent in the first three months of this year, compared with the same period in 2018 and 2019, according to a report Monday from the Centers for Disease Control and Prevention. The authors said they can’t prove coronavirus drove the increase, but said it seems likely the two are linked, given the number of stay-at-home orders and guidance to clean hands and dirty surfaces. The report was based on more than 45,000 recent calls to 55 poison control centers across the country involving exposures to cleaning chemicals or disinfectants. The same period in 2019 saw 38,000 such calls, while 2018 had 39,000."

That's one way to abort a pregnancy.

"Coronavirus is dealing a gut punch to the illegal drug trade, paralyzing economies, closing borders, and severing supply chains in China that traffickers rely on for the chemicals to make such profitable drugs as methamphetamine and fentanyl. Associated Press interviews with nearly two dozen law enforcement officials and trafficking specialists found Mexican and Colombian cartels are still plying their trade as evidenced by recent drug seizures but the lockdowns that have turned cities into ghost towns are disrupting everything from production to transport to sales."

They must be the ones responsible for the cyber attacks on hospitals and front lines:

Hospitals redeploy thousands of health care workers to respond to COVID-19 crisis

Not all health care workers have the option to be redeployed; many have been furloughed. While hospitals are treating growing numbers of coronavirus patients, they’re also struggling financially after canceling other surgeries and appointments. About 700 people were temporarily laid off at Boston Medical Center, and almost 700 were furloughed or had their hours reduced at Tufts Medical Center. Tufts has reassigned about 250 clinicians and other staff.

They are cutting staff during an existential crisis?

Mass General models show flattening curve; COVID-19 patients not expected to overwhelm the system during this week’s surge

They expect admissions may begin to lower in about a week, and it looks to me like the entire above the fold selections are fiction.

(below the fold)

As screen time rules relax, parents shouldn’t feel too guilty

The kids will be all right, but why did the Globe run a WEEK OLD STORY on the MY PRINTED FRONT PAGE? 

Harvard grad students say remote teaching can bring ‘workplace abuses’

They have done that forever, and long, long before corona!

He says it's the loneliness, anxiety, and grief that is the wor$t thing.

"A plan to close three of Vermont’s state college campuses amid the COVID-19 outbreak, drew a sharp rebuke over the weekend from students, faculty, state lawmakers, and business leaders, but on Monday, state college officials said they have been left with few options to salvage a system that is rapidly running out of money. The state colleges chancellor Jeb Spaulding said “the entire system is at risk,” during a board of trustees meeting....."

A long line of vehicles paraded through downtown Montpelier, Vt., honking, waving and holding signs for more than an hour on April 20 to protest a proposed plan to shutter three campuses in the Vermont state college system because coronavirus.
A long line of vehicles paraded through downtown Montpelier, Vt., honking, waving and holding signs for more than an hour on April 20 to protest a proposed plan to shutter three campuses in the Vermont state college system because coronavirus. (Jeb Wallace-Brodeur/The Times Argus via AP)

Forgot to pick up turn-in, sorry.

"Federal agency orders nursing homes to alert residents, families to coronavirus cases; Massachusetts lists long-term care facilities with multiple infections" by Robert Weisman and Laura Krantz Globe Staff, April 20, 2020

The top US regulator of nursing homes ordered them Monday to alert residents and families to COVID-19 outbreaks.

Starting this week, skilled nursing facilities — serving an old and frail population at highest risk for the novel coronavirus — also will be required to report cases and deaths to the Centers for Disease Control and Prevention, where they’ll be used as an “early predictor” of regions where the disease is spreading.

Massachusetts for the first time Monday released data about the number of cases in specific long-term care facilities. Out of 218 facilities that have at least two positive cases, 78 had more than 30 cases, the state reported. The new state data, however, didn’t list the total number of cases or deaths in long-term care facilities, something it had been doing since earlier this month.

Its site-specific data listed a range of cases for each facility, without specifying how many had been confirmed at each, or how many residents and staffers had died.

The moves come three months after the first confirmed COVID-19 case in the United States. Families in Massachusetts and across the country have clamored for better information about what’s happening inside nursing homes, which have been hard hit by the pandemic and have been mostly closed to the public for the past six weeks to keep the virus from spreading.

News about nursing home deaths and infections has been trickling out day by day in Massachusetts and beyond.

See: Nursing This Blog Home

On Monday, Briarwood Rehabilitation & Healthcare Center in Needham confirmed 18 residents have died and an additional 32 have tested positive for the coronavirus.

Spokesman David Ball said 16 new residents who are positive were recently moved into Briarwood from a local hospital. The facility is serving as a recovery center for COVID-19 patients who are Needham residents and have left hospital care, Ball said.

Meanwhile, two additional veterans at the Holyoke Soldiers’ Home, site of the deadliest known outbreak in Massachusetts, passed away Sunday, bringing the total to 62. There have also been 16 deaths at the Chelsea Soldiers’ Home, according to state officials.

All COVIDS?

Federal officials haven’t previously tracked the number of virus cases in nursing homes, even though they appear to be a magnet for the disease. The new order by the Centers for Medicare and Medicaid Services (CMS), which regulates the homes, is “unprecedented in its transparency,” CMS administrator Seema Verma told reporters.

“Now more than ever, nursing home residents and their families have a right to know what’s happening in their facilities,” Verma said at a press briefing. She said nursing homes that fail to report COVID-19 cases within 12 hours will face fines of $1,000 a week.

The federal move is “overdue,” said Alison Weingartner, executive director of the Medford-based Massachusetts Advocates for Nursing Home Reform. She said families have been kept in the dark by many institutions since visits by relatives and state ombudsmen were halted in early March.

“Why did it take [CMS] until today?” Weingartner said. “The families have been calling and making noise for weeks.”

The American Health Care Association, which represents more than 13,000 long-term care facilities nationally, applauded the CMS move and said nursing home managers stand ready to provide the information.

"This announcement reinforces much of what long-term care providers are already doing and are currently required to do in their states,” the trade group’s president, Mark Parkinson, said in a statement.

Nursing homes in Massachusetts already are required to report virus cases to their local health departments and the state Department of Public Health, which licenses the homes, but many families have complained that they are only notified if their loved one tests positive for the virus, not if others in their facility are infected.

Verma said the CMS will consult with its attorneys about making the outbreaks at specific sites public and will likely post the information on its website after families are notified. Several states, including New York and Connecticut, have begun doing that. Massachusetts public health officials have been providing daily updates on the number of nursing home cases but until Monday were not breaking out the data by sites.

COVID-19′s danger to nursing home residents, especially those with underlying health conditions such as heart or lung disease, was laid bare in late February when the virus ripped through the Life Care Center in Kirkland, Wash., where it’s killed more than 40 residents. Since then, thousands of residents in nursing facilities across the country have succumbed to the respiratory disease, including more than 800 in Massachusetts.

Verma said nursing home infection data will prove valuable to health officials as they consider whether, and when, to begin recommending reopening parts of the country to normal life and commerce.

“Nursing homes have been ground zero” for the coronavirus pandemic, Verma said. “We recognize that in communities across the county, that’s where we see the first indication of spread.”

UGH!

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Also see:

"Some cities in China have reported a spike in divorce applications, now that more people are leaving their homes after months of quarantine. Xi’an, the capital of the Shaanxi Province, for instance, was flooded with requests last month, according to the English-language Chinese newspaper the Global Times and Bloomberg Businessweek. The news might imply that too much time trapped with a spouse can end a marriage. That begs the question: What will happen here? When this period of social distancing is relaxed in the United States, will married people run for the hills — and from each other? According to family lawyers and mental health professionals around Boston and beyond, the answer is a complicated maybe....."

Let's hope the break-up doesn't end in violence, and that article was dated April 13, 2020.

I think it's clear that you need the right connection to get into your comfort zone even as your condo or apartment has turned into a tower of fear while searching for a bottle of Purell, and "is it petty to gossip about your husband during a pandemic?"

The answer, technically, is yes, but with the whole family home all day, every day, for every meal, and with some people talking very loudly on conference calls, and every day both a weekend and a workday, and restaurants closed, and the sudden mandate to home-school, many moms are so burdened they can’t help themselves. A mere few days into the great shut-in, the whispered gripes were flooding in like grandparents not listening to their kids’ coronavirus lectures and lying about going to the grocery store and pretending they weren’t playing bridge because the original helicopter parents won’t be grounded because they are now Boomer Teenagers or Disobedient Parents or Senior Delinquents proving ungovernable (She is the same one who slung such sh!t as the mask is on and don't happy, be worry, telling you to be afraid of your own children, folks, and rush them off to school as fast as you can).

Don't get stuck on stupid

That's why I'm not reading it.

"Mass. reports 1,566 new coronavirus cases, 103 new deaths; Walsh warns police will keep dispersing crowds" by Martin Finucane, Travis Andersen, Danny McDonald and Andy Rosen Globe Staff, April 20, 2020

Boston Mayor Martin J. Walsh warned Monday that police will continue dispersing crowds that gather amid the ongoing COVID-19 pandemic and said officials are considering expanding the 9 p.m. to 6 a.m. curfew beyond May 4 as cases in the city and state continue to mount.

Speaking during a briefing outside City Hall, Walsh also said “kids aren’t going back to school” on May 4 and he’s “not too confident we’ll have [a resumption] of school this year,” adding that there “could be a different-looking situation in the classrooms” in September.

Yeah, school is out for the summer -- and forever!

On Monday the state Department of Public Health reported that the death toll from the coronavirus outbreak in Massachusetts had risen by 103, to 1,809. The state also reported 1,566 new cases, bringing the total to 39,643.

The number of new cases reported has been declining for four days, though state officials have cautioned against reading too much into daily changes given the variability in how laboratories report test results. The state also reported a total of 169,398 people in the state had been tested, up from 162,241 a day earlier.

In Boston, where the number of total cases stood at 5,749 on Monday, patients are being sent to the field hospital that has been constructed at the Boston Convention and Exhibition Center.

Want to take a tour of the rescue center?

As of Sunday night, the Boston Hope Medical Center, as it’s being called, had 162 patients, including 86 on the hospital side, and 76 on the respite side, which is for the homeless, according to Walsh’s office. The number of patients was 10 higher than the previous day’s count.

Half of the facility’s 1,000 beds are reserved for people experiencing homelessness who have “tested positive for the virus and need care, but not full hospitalization,” according to city officials.

Walsh, meanwhile, implored people to continue following the restrictions put in place to slow the spread.

The mayor reserved his strongest language for people who played golf over the weekend at city courses in violation of the ban on gatherings, as well as people responsible for gun violence in recent days that claimed the life of a teenage girl and wounded another teen and a 10-year-old girl in separate incidents.

“You’re a coward,” Walsh said of perpetrators of gun violence amid the pandemic, “and you will face justice.”

The gun violence that injured the 10-year-old on Saturday night in Roxbury was born out of a situation involving a crowd in an apartment, according to Walsh. The crowd, he said, ignored the city’s curfew brought on by the pandemic and other public health guidelines.

“This infuriated me,” he said.

Walsh also criticized golfers who took to courses at Franklin Park and in Hyde Park, including one young man he saw smiling on a course during a television news broadcast.

“Nothing to smile about,” Walsh said of the scofflaw. “Nothing to be proud of. Not impressive. [The course] is closed. That was a completely irresponsible move.” He added that the city and state are not playing a “game” by banning public gatherings.

“We’re doing it because we want to keep people alive,” Walsh said, adding that Boston police will be out dispersing crowds who violate the emergency order banning gatherings.

Why not catch the shooters first?

What a holier-than-thou asshole!

Asked if he was considering a citywide stay-at-home order or an order making his advisory to wear masks in public mandatory, Walsh said “we’re not there yet.”

Walsh said "we won't hesitate to send police officers, if necessary, to deliver citations" to people who gather in crowds.

Fa$ci$t!

Asked about the possibility of issuing fines to people who fail to maintain social distancing, Walsh said,"This is not something I want to do. I don’t want to put fines on residents who are already financially burdened." 

But he will! 

You made him do it! 

She made me do it, Jerry!

In pandemic-battered New York City, Mayor Bill de Blasio is increasing the maximum fine for violating social distancing rules to $1,000, which is double the previous highest amount, The New York Daily News reported over the weekend.

Related: New York mayor eyes late summer for fans to return 

He's taking what he thinks is a “cautious, steady approach to how to reopen New York City, and is planning on the worst-case scenarios because they have to protect themselves.

Meanwhile, the hospital are quiet.

Prior to the briefing, Walsh’s office said in a statement that the city had expanded its COVID-19 informational text service to 11 languages including Somali, Chinese, Arabic, Vietnamese, Russian, English, Spanish, Haitian Creole, French, Cabo Verdean Creole, and Portuguese.

That's what happens when you are a sanctuary city and state.

“It’s important that the critical public health information we are sharing with our residents reaches every person in the language they speak so that collectively as a city we can be informed about the seriousness of this virus, and work together to stop its spread,” Walsh said in the statement. “I am glad that we’re further expanding our multilingual capacity by adding five additional languages to our text alert service.”

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Denyson Pierre
Denyson PierreWalpole Police Department

He robbed a Cumberland Farms.