Coronavirus Status Updates

[johnrr6]

The CDC did not fail. Politicalizing the issues of the directives by the CDC is what failed. The CDC are the people equipped with the data and the science to make the critical decisions.

Exactly ....ONE of their failures and not one anyone could foresee or say it was “their fault,” But a concept failure none the less because there is not sufficient protection for them from existing laws that would prohibit political interference. And that needs fixing in the future. I said so as much in an earlier post you are probably not aware of.

But the CDC DID FAIL, in a catastrophic fashion, when it came to our initial testing at the most critical time of this entire situation...initial outbreak.

The New York Times, the Washington Post, and even the Wall Street Journal have detailed the initial failures in decision making which led to almost 6 weeks of confusion and lack of any quantity of testing in the United States. I always like to verify with an outside source what I’m reading in the media...if I can...and in this particular instance I have a retired scientist cousin, a virologist, who was a subcontractor for NIH and the CDC on several different occasions. In fact, his last major work was on the ebola vaccine. I asked him to take a look at the articles from a scientist’s point of view. He is still very active in that overall community and wrote me back saying that the articles pretty much hit the nail on the head. Some woeful decision making took place....possibly some scientific hubris.

The bottom line is that the United States knew that the disease was coming and had a workable solution for a test that could be produced fairly quickly. A team at the CDC felt that the test could be “improved on” with the addition of another element which would not only identify a coronavirus positive but if it was not Coronavirus, would give evidence of what the individual was really suffering from. This additional element increased the cost and increased the amount of time that it would take to produce the tests but because they thought they could accomplish it within time and that it would give valuable information they went ahead anyway. There was much discussion within the CDC whether this was a proper procedure and whether the United States should just stick with a known test procedure that works.The chief of that department convinced leadership that it could be accomplished easily and not that big of a risk.

This led to a smaller amount of testing materials initially available and the situation was exacerbated when it was discovered that it was this new “additional element” that was causing far too many of the failures of the CDC provided test. It was even discovered (by the University of Nebraska medical center if I’m not mistaken) that if that additional element was removed from the test, The CDC test then performed within standards. All the while this information was being forwarded to the CDC and an almost 2 week delay occurred before the CDC would allow the removal of the additional element in order to conduct a viable test. Then it was discovered that there were problems with contamination dealing with the CDC lab that was producing this already smaller number of tests. The final problem added on top of all of this was the fact that the CDC decided to produce all tests within its own lab facilities which are fairly robust, but at the same time one has to wonder how they thought they could produce enough tests for 328 million Americans.

The bottom line was a catastrophic failure of initial testing that can be solely pinned on the CDC. Was it mistakes in judgment? Scientific hubris? A series of unfortunate events? Lack of leadership and controls over that department making such huge and risky decisions? Probably a combination of all of this but in the end does it matter. The CDC failed in this particular, highly critical area, and we need to make efforts to prevent it from ever happening again.

I’m not part of the problem my friend, I am advocating for solutions to the problems that have appeared in this pandemic.

Perhaps you misunderstand me.

 

[Goal-line]

Exactly ....ONE of their failures and not one anyone could foresee or say it was “their fault,” But a concept failure none the less because there is not sufficient protection for them from existing laws that would prohibit political interference. And that needs fixing in the future. I said so as much in an earlier post you are probably not aware of.

But the CDC DID FAIL, in a catastrophic fashion, when it came to our initial testing at the most critical time of this entire situation...initial outbreak.

The New York Times, the Washington Post, and even the Wall Street Journal have detailed the initial failures in decision making which led to almost 6 weeks of confusion and lack of any quantity of testing in the United States. I always like to verify with an outside source what I’m reading in the media...if I can...and in this particular instance I have a retired scientist cousin, a virologist, who was a subcontractor for NIH and the CDC on several different occasions. In fact, his last major work was on the ebola vaccine. I asked him to take a look at the articles from a scientist’s point of view. He is still very active in that overall community and wrote me back saying that the articles pretty much hit the nail on the head. Some woeful decision making took place....possibly some scientific hubris.

The bottom line is that the United States knew that the disease was coming and had a workable solution for a test that could be produced fairly quickly. A team at the CDC felt that the test could be “improved on” with the addition of another element which would not only identify a coronavirus positive but if it was not Coronavirus, would give evidence of what the individual was really suffering from. This additional element increased the cost and increased the amount of time that it would take to produce the tests but because they thought they could accomplish it within time and that it would give valuable information they went ahead anyway. There was much discussion within the CDC whether this was a proper procedure and whether the United States should just stick with a known test procedure that works.The chief of that department convinced leadership that it could be accomplished easily and not that big of a risk.

This led to a smaller amount of testing materials initially available and the situation was exacerbated when it was discovered that it was this new “additional element” that was causing far too many of the failures of the CDC provided test. It was even discovered (by the University of Nebraska medical center if I’m not mistaken) that if that additional element was removed from the test, The CDC test then performed within standards. All the while this information was being forwarded to the CDC and an almost 2 week delay occurred before the CDC would allow the removal of the additional element in order to conduct a viable test. Then it was discovered that there were problems with contamination dealing with the CDC lab that was producing this already smaller number of tests. The final problem added on top of all of this was the fact that the CDC decided to produce all tests within its own lab facilities which are fairly robust, but at the same time one has to wonder how they thought they could produce enough tests for 328 million Americans.

The bottom line was a catastrophic failure of initial testing that can be solely pinned on the CDC. Was it mistakes in judgment? Scientific hubris? A series of unfortunate events? Lack of leadership and controls over that department making such huge and risky decisions? Probably a combination of all of this but in the end does it matter. The CDC failed in this particular, highly critical area, and we need to make efforts to prevent it from ever happening again.

I’m not part of the problem my friend, I am advocating for solutions to the problems that have appeared in this pandemic.

Perhaps you misunderstand me.

Exactly ....ONE of their failures and not one anyone could foresee or say it was “their fault,” But a concept failure none the less because there is not sufficient protection for them from existing laws that would prohibit political interference. And that needs fixing in the future. I said so as much in an earlier post you are probably not aware of.

But the CDC DID FAIL, in a catastrophic fashion, when it came to our initial testing at the most critical time of this entire situation...initial outbreak.

The New York Times, the Washington Post, and even the Wall Street Journal have detailed the initial failures in decision making which led to almost 6 weeks of confusion and lack of any quantity of testing in the United States. I always like to verify with an outside source what I’m reading in the media...if I can...and in this particular instance I have a retired scientist cousin, a virologist, who was a subcontractor for NIH and the CDC on several different occasions. In fact, his last major work was on the ebola vaccine. I asked him to take a look at the articles from a scientist’s point of view. He is still very active in that overall community and wrote me back saying that the articles pretty much hit the nail on the head. Some woeful decision making took place....possibly some scientific hubris.

The bottom line is that the United States knew that the disease was coming and had a workable solution for a test that could be produced fairly quickly. A team at the CDC felt that the test could be “improved on” with the addition of another element which would not only identify a coronavirus positive but if it was not Coronavirus, would give evidence of what the individual was really suffering from. This additional element increased the cost and increased the amount of time that it would take to produce the tests but because they thought they could accomplish it within time and that it would give valuable information they went ahead anyway. There was much discussion within the CDC whether this was a proper procedure and whether the United States should just stick with a known test procedure that works.The chief of that department convinced leadership that it could be accomplished easily and not that big of a risk.

This led to a smaller amount of testing materials initially available and the situation was exacerbated when it was discovered that it was this new “additional element” that was causing far too many of the failures of the CDC provided test. It was even discovered (by the University of Nebraska medical center if I’m not mistaken) that if that additional element was removed from the test, The CDC test then performed within standards. All the while this information was being forwarded to the CDC and an almost 2 week delay occurred before the CDC would allow the removal of the additional element in order to conduct a viable test. Then it was discovered that there were problems with contamination dealing with the CDC lab that was producing this already smaller number of tests. The final problem added on top of all of this was the fact that the CDC decided to produce all tests within its own lab facilities which are fairly robust, but at the same time one has to wonder how they thought they could produce enough tests for 328 million Americans.

The bottom line was a catastrophic failure of initial testing that can be solely pinned on the CDC. Was it mistakes in judgment? Scientific hubris? A series of unfortunate events? Lack of leadership and controls over that department making such huge and risky decisions? Probably a combination of all of this but in the end does it matter. The CDC failed in this particular, highly critical area, and we need to make efforts to prevent it from ever happening again.

I’m not part of the problem my friend, I am advocating for solutions to the problems that have appeared in this pandemic.

Perhaps you misunderstand me.

Apparently.

 

[Robago]

We absolutely could have done better. I agree with johnrr6 that the initial decision to go with the testing the CDC came up with was detrimental to responding to the situation with the best foot forward. "If" you think that testing, isolation and contract tracing are the best routes to "prevent" spreading the disease vs "slowing" the spread. I however do not think that is the best case to prevent spread with such a large population of people who moves about the whole of the USA along with 80 million people traveling to the country yearly. I can see this being an effective strategy for New Zealand, an island who has much less travelers 1.2 Million people.

I will give you one example of the freedom choice problem with contract tracing. Phones seem to be the dominating theory of contact tracing. After speaking to numerous people who have said that they will just leave their phones at home if they decide to do that, I don't know that you will effectively be able to accomplish the "goal" of prevention based on contact with an individual. Also narking out your friends who you were hanging out with might cause even more detriment to having social contacts. Especially those who don't buy into the idea that this reaction for this particular bug is what we should be doing.

As a side note to the whole unpreparedness factor. I hope that we have identified that we need resource capacity and have improved coms across the states to do such things. Some states have done that well. The other thing I hope we can gain from this, is that when a physician comes out and says we are doing something wrong, i.e. "intubating people is actually killing them" we as healthcare professionals can take a moment to identify if this is an issue vs. vilifying them and casting them aside. I know from working on the coasts that moving inward to the central US that new information and process change can take years. We have to shorten these time frames.

 

[HuskerWeatherman]

There's been some solid discussion on the past couple of pages. I appreciate reading through it!

 

[johnrr6]

It’s that “cultural” problem we have in the US. And it’s not really a problem because those differences make us a strong and powerful nation. It only exists as a “problem” with something like this virus. Phone tracing the perfect example. No way we as Americans with our love of personal freedoms and security will sign up to voluntarily giving away our location.

I myself have the Virginia tracking app for the virus running on my phone. I’m probably the only guy in Virginia who does LOL.

But given those disadvantages we STILL have the best medical, communications and tech capabilities in the world. There is no reason why we can’t leverage that to have a much more comprehensive nationwide reporting system for critical medical assets and then the ability to shift those critical assets to someone who needs it in a pandemic. And also use that system for the communication of key information.

Even though we had the CDC we frankly were not ready for this...at all. Part of it was we’ve never gone through something like this and we really don’t have a good recent experience. Part of it was lack of foresight and part of it has been the political situation we are in currently.

OK, fine......let’s keep adapting and adjusting and trying to do better.... but in the meantime we need to make an absolutely clear commitment to developing proper systems, procedures, laws and capabilities to prevent something like this happening in the future.

Chalk this one up to first combat with green troops that have never seen action and and in probably the worst time in recent history for an event like this to happen...given our politics.

But it would be criminal to ignore the hard earned lessons, and sacrifices, and not make changes for the future.

 

[BigRedMax]

Unstick

 

[johnrr6]

My state, Virginia, has shown a definite increase in the amount of cases in the last two weeks.

we were holding steady at 600 to 800 confirmed new cases a day and that has now shot up to 1200 to 1400 cases a day.

But something really weird is happening:

Because our hospitalizations per day are virtually the SAME as they were with the lower amount of cases.

Our ICU Bed occupancy has declined throughout the state to the point that it is six percentage points below what the average occupancy rate was in pre-Covid 2019 and this doesn’t even count the additional surge bed capacity that the governor requires!

And most importantly our death rate has gone down.

The only thing I can think of is that Virginia is testing virtually twice as many people as it was during the period where we were getting 600 to 800 confirmed cases a day. We went from 10,000 to 20,000 tests on average per day

So naturally more people are going to the be identified.

But they aren’t getting sick enough to go to the hospital to stress our hospitals....and they aren’t dying as much.

All positives.

is this what is happening back in Nebraska or your states?

I mean I’m bombarded daily with the press hollering about “coronavirus cases are shooting up across America“ but if the hospitals are handling it....and the death rate is actually going down. Is this more of your normal press “headlines sell” crap?

I absolutely do not want to downplay the seriousness of the disease or in anyway say that increased cases numbers are nothing and not important. But what I am saying is that perhaps are there some positives that are NOT being pointed out by the press.

 

[BleedinHuskerRed]

My state, Virginia, has shown a definite increase in the amount of cases in the last two weeks.

we were holding steady at 600 to 800 confirmed new cases a day and that has now shot up to 1200 to 1400 cases a day.

Buy something really weird is happening:

Because our hospitalizations per day are virtually the SAME as they were with the lower amount of cases.

Our ICU Bed occupancy has declined throughout the state to the point that it is six percentage points below what the average occupancy rate was in pre-Covid 2019 and this doesn’t even count the additional surge bed capacity that the governor requires!

And most importantly our death rate has gone down.

The only thing I can think of is that Virginia is testing virtually twice as many people as it was during the period where we were getting 600 to 800 confirmed cases a day. We went from 10,000 to 20,000 tests on average per day

So naturally more people are going to the be identified.

But they aren’t getting sick enough to go to the hospital to stress our hospitals....and they aren’t dying as much.

All positives.

is this what is happening back in Nebraska or your states?

I mean I’m bombarded daily with the press hollering about “coronavirus cases are shooting up across America“ but if the hospitals are handling it....and the death rate is actually going down. Is this more of your normal press “headlines sell” crap?

I absolutely do not want to downplay the seriousness of the disease or in anyway say that increased cases numbers are nothing and not important. But what I am saying is that perhaps are there some positives that are NOT being pointed out by the press.

Good question, and similar to what we were seeing in Colorado until recently (hospitalizations are starting to tick up again.)

But what I’m hearing ad hoc from family in Nebraska are that hospitalizations are definitely increasing. Lots of stories of shuffling patients due to space limits. My brother works at an area hospital and said Omaha is full. My grandma just told me about a guy she knows in the West Point area that ended up in a hospital in Council Bluffs because nowhere else could take him. (She didn’t specify his condition - could have been a contributing factor.) Another guy she knew from the area ended up in Lincoln.

For a long time it was the younger people getting sick, who tend to not get it as bad, and so while case rates were up, hospitalizations weren’t. That appears to be changing, unfortunately.

 

[Robago]

@johnrr6, Here are some thoughts as to what you are seeing that are floating around intellectual circles as to what is happening.
1. The virus has mutated to be less deadly, theory goes, more deadly less chance of survival of life of the virus
2. People are self isolating according to deadly opportunity. >65 with multiple comorbidity more likely to die. If you are that group you self select to isolation and perfecting mask wearing and social distancing. In Virginia 75% of deaths are >70 years old. 55% of hospitalizations are >60. If the virus really does lend to age, comorbidity of heart disease, obesity, and diabetes, this trifecta is more greatly found in elderly.
3. Younger healthier are less likely to die and get severe sickness. As such the younger population does not take as many precautions and does not avoid the disease as older generations. Are the numbers growing with younger people getting it? I went to the state website and it does not break this down at all. However, younger population is the 80% of the cases is < 60 years old in Virginia.
4. Deaths are also going down as we have had a number of care pathways that are showing promise where we are getting in front of severe illness.
5. People who were really susceptible to dying from this virus have already died. Therefore deaths are going down.

I don't ascribe to all of them just thoughts that I have seen floating around. I lean towards the young are getting it at a higher rate, who are less susceptible to severe illness, than the old are getting it. Adding to that is we are better at treating it overall.
I would love for websites to do graphs based on age and date not just totals. That way we could see if that's true. Second on your state website https://www.vdh.virginia.gov/coronavirus/coronavirus/covid-19-in-virginia-outbreaks/ there is an interesting break down of the outbreaks and deaths. Long term care facilities and deaths have a significant proportion compared to other settings, suggesting that Older sicker are at most risk of death. If your state has adopted policies that are stringent enough to halt infections at the long term care facilities then that would be why deaths are going down.

 

[HuSkaBob]

Good question, and similar to what we were seeing in Colorado until recently (hospitalizations are starting to tick up again.)

But what I’m hearing ad hoc from family in Nebraska are that hospitalizations are definitely increasing. Lots of stories of shuffling patients due to space limits. My brother works at an area hospital and said Omaha is full. My grandma just told me about a guy she knows in the West Point area that ended up in a hospital in Council Bluffs because nowhere else could take him. (She didn’t specify his condition - could have been a contributing factor.) Another guy she knew from the area ended up in Lincoln.

For a long time it was the younger people getting sick, who tend to not get it as bad, and so while case rates were up, hospitalizations weren’t. That appears to be changing, unfortunately.

FWIW, Swedish in Denver is now on referral only, not allowing general admissions. Hearing of many more people in my sphere catching it in the last couple of weeks, but not as many people with serious symptoms. This is all hearsay -- we'll probably see numbers explaining it a bit better in a few weeks. Colorado is releasing pretty good data.

 

[Oracle of Lincoln]

We are entering the most concerning and most deadly phase of this pandemic . . . leading to increasing mortality," said the Monday report from Deborah Birx, coordinator of the White House coronavirus task force. "This is not about lockdowns - It hasn't been about lockdowns since March or April. It's about an aggressive balanced approach that is not being implemented."

Top White House adviser bluntly contradicts Trump on COVID

WASHINGTON - A top White House coronavirus adviser sounded alarms Monday about a new and...

www.stamfordadvocate.com

 

[johnrr6]

@Oracle of Lincoln

“most concerning and most deadly phase of this pandemic”

I like Dr. Birx....she seems a common sense type.....but in this case I just don’t know what she is basing her statement on

concerning = yes

most deadly phase of this pandemic = it just doesn’t appear that way..... at least in my state and when I look at the national figures. The death toll is either maintaining or going down.....yet case numbers per day continue to rise. Crazy.

Maybe we have a “lag“ in process where the death toll will start to shoot up a couple of weeks from now. I hope not.

And I do see some states are having some concerns about hospitalization availability.

But in my state (Virginia) our hospital system does not seem stressed at this point at all. In fact, the numbers have remained remarkably the same since mid July even though our identified case numbers have gone from approximately 600 a day to 1300 a day......over twice the amount of cases.

 

[BleedinHuskerRed]

FWIW, Swedish in Denver is now on referral only, not allowing general admissions. Hearing of many more people in my sphere catching it in the last couple of weeks, but not as many people with serious symptoms. This is all hearsay -- we'll probably see numbers explaining it a bit better in a few weeks. Colorado is releasing pretty good data.

Oh I hadn’t heard that. I did just find out about another area hospital that now has over 60 inpatients with Covid - near their previous peak.

Hopefully more statewide data will be released soon. I agree that Colorado has been doing a pretty good job providing data.

 

[Oracle of Lincoln]

@Oracle of Lincoln

“most concerning and most deadly phase of this pandemic”

I like Dr. Birx....she seems a common sense type.....but in this case I just don’t know what she is basing her statement on

concerning = yes

most deadly phase of this pandemic = it just doesn’t appear that way..... at least in my state and when I look at the national figures. The death toll is either maintaining or going down.....yet case numbers per day continue to rise. Crazy.

Maybe we have a “lag“ in process where the death toll will start to shoot up a couple of weeks from now. I hope not.

And I do see some states are having some concerns about hospitalization availability.

But in my state (Virginia) our hospital system does not seem stressed at this point at all. In fact, the numbers have remained remarkably the same since mid July even though our identified case numbers have gone from approximately 600 a day to 1300 a day......over twice the amount of cases.

The epidemiologists have been spot on with the fall case outbreak. Are they wrong on the mortality rate? Possible. But, do you want count on that?

 

[johnrr6]

@Oracle of Lincoln

I don’t wanna count on anything at this point.

What I am saying is at least in my state (and many others I glanced at) almost double the amount of case numbers has neither stressed our hospital system or increased our hospitalizations rates.....and our death rates have gone down.

i’m not glad that case numbers are going up and it’s worrisome.

However, there has to be other factors in play....mutation, better treatment, more testing, running its course on the more susceptible...all the things mentioned. And I think that is a positive.

I’m just frankly tired of all the gloom and doom and dire warnings over and over and over again when other facts....facts that have bearing....are never mentironed.