NYC hospitals prepare for virus resurgence

NEW YORK (AP) — Like battle-hardened veterans, New York City hospitals and nursing homes are bracing for a potential resurgence of coronavirus patients, drawing on lessons learned in the spring when the outbreak brought the nation’s largest city to its knees.

The new playbook derives from the apocalyptic days of March and April, when testing and resources were scarce, emergency rooms overflowed, and funeral homes stacked corpses in refrigerated trailers.

Those insights, however hard won, make it far less likely that the city’s hospitals would collapse under a second wave of COVID-19, health care leaders said.

Even without a vaccine, doctors are touting increasingly effective coronavirus treatments, three-month supplies of personal protective equipment and contingency staffing plans.

Similar preparations are underway at New York’s hard hit nursing homes, which accounted for a staggering percentage of the state’s coronavirus deaths.

“We didn’t even have testing in February when there was so much transmission,” Dr. Mitchell Katz, head of the city’s public hospital system, said in an interview. “I can’t see how we’d ever have the same situation that we had in March and April, but we are preparing for that possibility anyway.”

Not only has critical care improved, Katz said, but coronavirus patients also are generally “not getting as intense as an exposure as they once did because of the wearing of masks.” New cases also are afflicting younger people, who are less likely than older patients to need hospitalization.

“Our hospitals are still quieter than they would have been a year ago because people are avoiding care out of concerns about COVID,” Katz added. “We can have several hundred additional patients and still not be full.”

New York has recorded nearly 37,000 new COVID-19 infections in October and is on pace to have more than double the number of people sickened this month as fell ill in September.

But so far, that increase has led to only a modest uptick in hospitalizations. On average, about 45 people a day have been admitted to New York City hospitals each day in October, city statistics show, up from an average of 29 per day in September.

That compares to an average 1,600 per day during the worst two weeks of the pandemic in March and April — a time when the state also recorded its highest daily death tolls and ambulance sirens became an ominous soundtrack to the city’s out-of-control pandemic.

Last week, by contrast, the city’s 11 public hospitals had six total intubated patients — down from a peak of 960.

The relative quiet stands in stark contrast to hospitals in Europe and the Mountain West that have been increasingly overwhelmed by new surges.

“The measures that were put in place seem to be working,” said Dr. Fritz Francois, chief medical officer at NYU Langone Health, alluding to widespread mask use, social distancing and authorities’ focus on hot spots in pockets of the city.

“Even if we see something of a resurgence,” Francois said, “the outlook is that it’s not going

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India Near 8 Million Cases; Europe Wave Resurgence: Virus Update

(Bloomberg) — India’s confirmed cases reached just under 8 million as virus infections spread across the country. Europe’s resurgent coronavirus outbreak intensified, with Italy’s new cases reaching a record and France reporting the most deaths since April as stricter measures are weighed on the continent.

Japan passes a bill to offer a free vaccine. In a rare admission, U.S. President Donald Trump acknowledged that coronavirus cases are rising in “certain areas” of the Midwest. Covid-19 hospitalizations have risen at least 10% in the past week in 32 states and the nation’s capital as the month-old viral surge increasingly weighs on America’s health-care system.

Pfizer Inc. CEO Albert Bourla said the company may know by the end of October whether its vaccine is effective. Russia has begun production of a second vaccine that hasn’t completed trials.

Key Developments:

Global Tracker: Cases top 43.9 million; deaths exceed 1.16 millionEast Europe fights for its life against virus it thought crushedCity locked down for three months has bleak lesson for the worldCan you get Covid twice? What reinfection cases mean: QuickTakeSlow Covid recovery stalks health industry as new cases surgeEuropean governments running out of options to avoid lockdownsVaccine Tracker: Vaccine trials restart, providing hope

Subscribe to a daily update on the virus from Bloomberg’s Prognosis team here. Click CVID on the terminal for global data on coronavirus cases and deaths.

chart, histogram: Seven-day average of U.S. death toll is at 800 again

© Bloomberg
Seven-day average of U.S. death toll is at 800 again

India Virus Cases Reach Almost 8 Million (12:22 p.m. HK)

India’s total confirmed virus cases reached 7.99 million on Wednesday, according to government data. The nation added 43,893 cases in a day. Coronavirus-related deaths rose to 120,010.

India trails only the U.S. as the nation with the most number of cases. The U.S. has 8.77 million cases, according to data collected by Johns Hopkins University.

Iran’s Parliament Speaker Tests Positive (11.26 a.m. HK)

Iranian parliament speaker Mohammad Baqer Qalibaf has tested positive for coronavirus and is currently in self-isolation, the state-run Islamic Republic News Agency reported. Earlier this month, IRNA reported the country’s nuclear energy chief Ali Akbar Salehi as well as Mohammad Bagher Nobakht, a deputy president and top aide to President Hassan Rouhani, had also tested positive for the virus.

Trump Says Midwest ‘Heated Up’ With Cases (10:41 a.m. HK)

President Donald Trump on Tuesday night acknowledged that coronavirus cases are rising in “certain areas” of the Midwest, a rare admission during the final week of the presidential campaign.

“Certain areas that are heated up right now,” Trump said at a rally in Omaha, Nebraska. “They’ll go down. They’ll go down very quickly. They’ll be down within two weeks, they’re figuring.”

Trump has routinely downplayed the virus while making his closing argument to voters, who have rated his pandemic response poorly, according to opinion polls. The president said again on Tuesday that the country is “turning that corner.”

South Korea’s Moon Says Virus Contained, Seeks to Revive Economy (9:34 a.m. HK)

Video: Health panel proposes colon cancer tests start

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Florida is on the verge of a COVID-19 resurgence

FORT LAUDERDALE, Fla. — Florida’s rising number of COVID-19 cases could be the leading edge of a dangerous spike that could continue for months as the state remains wide open for business, tourism and education, public health experts warn.

A decline of cases since the summer surge is over, four weeks into the state’s Phase 3 reopening of bars and restaurants at full service, state and national data indicates.

With Gov. Ron DeSantis promising there’s no chance of a return to lockdowns, no matter the severity of another surge, we can expect more people will need hospital treatment and more will die, experts say.

“My worry for Florida is that the embers are out there and they’re starting to burn, and by the time we see it in the numbers that are reported officially, it’s too late, and you’re going to see it only in the rearview mirror and wish you’d been a little more aggressive,” said Dr. Thomas Giordano, chief of infectious diseases at Baylor College of Medicine in Houston.

As of Friday, the number of new COVID cases per day in Florida had increased 36.4% over the past week (3,335) compared to 14 days earlier (2,445.) That followed a 6.1% decrease in the state’s average daily cases in the two weeks from Sept. 25 to Oct. 9.

The White House Coronavirus Task Force as recently as Oct. 11 cited “early warning signs” of an uptick in Florida cases.

A report obtained Thursday by the Orlando Sentinel came with recommendations for more testing and “mask and physical distancing messages for all residents, both in public and private spaces.”

Florida, which had been withholding the report from the public, released it under pressure from the Sentinel’s lawyers.

“There’s a real effort to obfuscate the pandemic, for reasons beyond my comprehension, because sticking your head in the sand doesn’t make it go away,” said Dr. Aileen Marty, professor of infectious diseases at Florida International University in Miami.

Florida is not alone among Sunbelt states that were hit hard by outbreaks in the summer. Many improved considerably in September and are experiencing a new rise in cases.

In Texas, the seven-day average of cases increased by 20.5% between Oct. 8 and Thursday. Arizona’s cases were up 47.1% over the same stretch, based on information from the COVID Tracking Project.

In California, which has had limited reopenings — Disneyland still remains closed — average daily cases are up only 5.7% over the past two weeks.

California, the most-populous state in the nation, has seen a rate of 8.1 new cases for every 100,000 people in the last seven days, according to the Centers for Disease Control and Prevention. Florida is almost twice as high at 15.2 cases per 100,000 people — more than Arizona’s 12.3 cases but less than Texas’ 17.6 cases.

The situation is far worse in the country’s upper Midwest, which is in the throes of a major coronavirus surge, according to the CDC. North Dakota has recorded 101.9

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Jeff Asher: Amid national resurgence of coronavirus, Louisiana can be proud of ‘fragile’ progress | Coronavirus

In my last column, I made what I might call the “cautiously pessimistic” forecast for COVID-19 in Louisiana over the next few weeks/months. But, as I said in that piece, “the evidence is not particularly strong just yet, meaning there is plenty of uncertainty about whether we are actually seeing increasing infections, where they’re occurring, and how bad things could get.”

Today let’s look at the relatively optimistic present, where things in Louisiana are about as good as they have been — while still being in a deadly global pandemic — since early March.

In much of America right now, there is ample evidence that things are getting bad. There were nearly 70,000 new cases reported nationally on Oct. 16, the most since July, and cases are rising faster than tests nationally.

Jeff Asher analysis: Signs of 3rd wave of coronavirus are present, but no reason to panic

There is growing evidence that Louisiana’s next wave of COVID-19 is at our doorstep, just as the state begins to relax restrictions. Still, th…

Wisconsin reported over 4,000 new cases on Oct. 16 with 28% of tests coming back positive, indicating that the number of infections is significantly higher than even that incredible number of known new cases. The Dakotas are seeing some of the highest rates of new cases in the country.

It is not just the U.S. either. Countries across Europe are implementing new restrictions in the face of a new surge.

But so far, Louisiana has been spared the COVID spike that is gripping much of the country.

So far.

A partial explanation may be that Louisiana was arguably the only state in the country to have an initial wave in March and a second wave in June/July. Louisiana’s re-opening has also been cautious and staggered, which has helped to prevent outbreaks over a month after the state entered Phase 3.

Jeff Asher: It's hard to see how celebrating Mardi Gras 2021 in the usual way makes sense

‘We know very little about what the virus will be doing four months from now’

Fewer than 5% of tests reported statewide have come back positive on 13 of the first 14 days of October where data was reported. The data has been even better in Orleans Parish, where tests have come back positive at a rate of 2.5% or less on all 14 days.

Florida, by contrast, fully re-opened restaurants, bars, and gyms, among other businesses, on Sept. 28 despite still logging around 100 deaths per day and a positivity rate of over 10%, and the state is already seeing increasing cases and a climbing positive test rate.

Meanwhile, the evidence of increasing COVID in Louisiana that I wrote about last time has not really panned out. COVID-related hospitalizations are up slightly from where they were in early October, but they have been relatively steady for much of the last three weeks. And Google searches for COVID symptoms looked like they were increasing in early October, but that trend seems less clear now than it did a week or two ago.

The progress that Louisiana has made is real, but it is also fragile.

Data from Tulane and LSU

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