Daily Archives: July 15, 2020

While good ventilation can dilute aerosols, it is far less effective against droplets, which are much wider and heavier in the same way that a passing breeze would perturb the trajectory of a Ping-Pong ball, but not a cannonball.

The study points to a more important role for aerosolized flu transmission than some might assume, Dr. Marr said.

Determining the exact size of that role, however, is another matter entirely. Its very hard to conduct these human challenge studies and separate the different modes of transmission, Dr. Marr said. That problem applies across respiratory viruses, including the coronavirus.

Part of the problem is the continuum on which aerosols and droplets exist. Though they go by different names, the two categories really belong to the same group: globs of fluid that come in varying sizes. Blobs less than five micrometers in diameter are termed aerosols, which can exit the airway at the slightest breath and waft away; anything larger is a droplet, hefty enough to fall to the ground within a few feet of its source. The boundary between them is somewhat arbitrary, though generally speaking, the smaller the particle, the farther it travels.

When people expel fluid from their airway, it tends to manifest in a mixture, some bigger, some smaller and everything in between, said Seema Lakdawala, who studies influenza transmission at the University of Pittsburgh.

Updated July 15, 2020

Even after they exit an individual, these fluidic blobs remain dynamic. Large droplets, for instance, can disperse or evaporate into little aerosols in midair. Others might scatter onto a surface or a hand, lingering for minutes or hours before encountering someone new. And the rates at which all these events occur can shift, depending on the force with which someone, maybe a loud talker, expels these droplets or the amount of air flow in an area, Dr. Lakdawala said.

Everyone thinks transmission is a very binary concept, she added. The reality is that there is a continuum of aerosols.

See the original post:

The Flu May Linger in the Air, Just Like the Coronavirus - The New York Times

CHICAGO The state has made Chicago into its own region during the coronavirus pandemic, hoping that will help experts better pinpoint where outbreaks are happening and where hospitals need help.

The state divided Illinois into four regions when Gov. JB Pritzker announced his coronavirus recovery plan this spring, grouping Chicago with Cook County and nearby suburbs. Data from the regions like how many coronavirus cases there were and how hospitals were doing was used to determine if a region could progress in the recovery plan and further reopen.

But Pritzker announced a change to the regions Wednesday, saying the state will now be sectioned into 11 areas, with Chicago on its own.

The move is being made because the growth in testing and contact tracing has given officials a much more surgical ability to manage outbreaks and address problems locally, Pritzker said.

Making the change will allow the state to better monitor where outbreaks are occurring, where communities are in danger and if a region has enough hospital capacity should there be an outbreak, Pritzker said.

The entire state is currently in Phase 4, which reopened bars, restaurants, salons and gyms but a recent rise in cases could lead the state to close businesses linked to the spread of COVID-19, officials said.

Chicago has seen an uptick in its positivity rate and its average number of new cases. Mayor Lori Lightfoot warned earlier Wednesday the city could take steps back if that increase continues.

Pritzker said he called Lightfoot last week to talk about the concerning uptick in [Chicagos] positivity rate, but outbreaks have been seen all across Illinois. They have been tied to Fourth of July parties, youth sports, bars, church services and more.

With cases rising throughout the state, the state will use COVID-19 data from the 11 regions to determine whether and where they need to close businesses or impose tighter restrictions.

When officials see trends that indicate a problem in a region, we need to start tightening mitigations in that region before its too late, Pritzker said.

Officials will take action if they see an increase in a regions seven-day average positivity rate for seven days out of a 10, as well as one of these indicators:

Currently, all regions have a positivity rate of 5 percent or lower with the highest rate in the Southern Region of the state.

The new regions:

Pritzker, joined by Public Health Director Dr. NgoziEzike, urged Illinois residents to wear face coverings every day, every time they leave their home. These measures will ensure Illinois does not end up back in Phase 1, when there was a mandatory lockdown, they said.

Pritzker said the state is trying to take a more targeted approach to outbreaks, and the new regions will allow officials to zero in on a county or town and make changes to prevent the spread of COVID-19 instead of shutting down an entire region.

Outbreaks are taking place consistently and in every region of the state, Pritzker said.

The state also released an outline of what businesses will be closed if a surge in cases continued. For example, if a region has a sustained increase in new cases, the state could reduce indoor dining capacity or suspend bar service.

In a worst-case scenario, the region could lose outdoor and indoor dining entirely.

BlockClubChicagos coronavirus coverage is free for all readers.BlockClubis an independent, 501(c)(3), journalist-run newsroom.

Subscribe toBlockClubChicago. Every dime we make funds reporting from Chicagos neighborhoods.

Already subscribe?Click hereto supportBlockClubwith a tax-deductible donation.

Go here to read the rest:

Chicago Now Its Own Region In Illinois' Coronavirus Recovery Plan And Businesses Will Close If Cases Spike, Gov Says - Block Club Chicago

In echoes of the early days of the Covid-19 pandemic, some American states and localities are reversing economic reopenings after spread of the coronavirus accelerated in some regions.

Americas Sun Belt, the region extending from southern California to Florida, has been particularly hard-hit, and now further flung and less populous states are joining the ranks rolling back reopenings.

New Mexico again banned indoor dining. Nevada closed bars in counties with major outbreaks. And Oregon, in the Pacific north-west, banned private indoor gatherings of more than 10 people. Arizona and Texas reimposed restrictions on indoor dining and bars in early July.

California, the most populous state, dramatically expanded restrictions. Indoor operations of theaters, wineries, restaurants and bars were all stopped this week. In addition, some of the nations largest school districts have announced classes will be virtual this fall. Students in Los Angeles, San Diego and Atlanta will not have in-person classes.

The reopening plan was great if everything went well, the Miami mayor, Francis X Suarez, told the Republican Florida governor, Ron DeSantis, at a public roundtable Tuesday. But I think the fact is things have not gone according to plan.

If things do not improve quickly I think were going to be under a significant amount of pressure to shut down, Suarez said.

Florida closed indoor dining in late June but has persisted with other reopening plans. DeSantis called on schools to reopen in a few weeks, and Disney World reopened some of its parks to thousands of visitors on Saturday.

Republican officials moved the national convention, where Donald Trump will formally accept the nomination of his party, from North Carolina to Florida to avoid social distancing and mask requirements. But with cases rising, officials moved the biggest events outdoors, the New York Times reported.

Louisiana, an early center of outbreaks after Mardi Gras this spring, has again seen a spike in Covid-19 cases. Vice-president Mike Pence traveled to the state on Tuesday but was not greeted by one of its top officials, attorney general Jeff Landry, who tested positive for Covid-19 despite showing no symptoms.

The governor, John Bel Edwards, enacted a statewide mask mandate for people aged eight and older, which took effect Monday. He also returned bars to takeout and delivery only. Restaurants, casinos, gyms, salons and other businesses remain open, with occupancy restrictions.

But Americas vast landscape and varied politics means even as many states across the south and west roll back reopening, places whose overburdened health systems became emblematic of the perils of Covid-19 have continued to reopen.

The New York governor, Andrew Cuomo, will allow malls to reopen in some parts of the state. New York City hit a hopeful milestone on Saturday: for the first time since 11 March, no one died of coronavirus.

Its something that should make us hopeful, but its very hard to take a victory lap because we know we have so much more ahead, said the mayor, Bill de Blasio, on Monday, according to NPR. This disease is far from beaten. While New York state announced only 677 new cases of coronavirus on Sunday, Florida reported more than 15,000.

In contrast to states in the south and west, some parts of the north-eastern economy never reopened. In New York City, Broadway shows are likely to remain closed until at least this winter, and indoor dining is still banned.

Across the river in New Jersey, gyms remain closed. Indoor dining in New Jersey was slated to reopen at very limited capacity, but the proposal was rolled back after photos emerged of unmasked crowds at beach bars on the Jersey shore.

Unlike in states such as New York, which has metrics that would trigger closures if the virus began to spread, Miami mayors said Florida had no such plan.

Renewed restrictions in the south and west have also brought renewed frustration. In New Mexico, businesses forced to close their doors again protested against the governors order. At some point you have to protect your livelihood, Kathy Diaz, owner of Monroes Restaurant, told local news station KOB4.

Parents of schoolchildren in Jacksonville, Florida, called for school reopenings, and anti-mask protesters have organized demonstrations against local mask mandates.

Marlyn Hoilette, a nurse who spent four months working in the Covid-19 unit of her Florida hospital until testing positive recently, said she worries about returning to work.

Nurses are getting sick, nursing assistants are getting sick and my biggest fear is that it seems we want to return folks to work even without a negative test, said Hoilette, who works at Palms West hospital in Loxahatchee, Florida. Its just a matter of time before you wipe the other staff out if youre contagious, so that is a big problem.

See the original post here:

'Things have not gone according to plan': America's coronavirus reopening falls apart - The Guardian

Now the economy is traveling sideways, as business failures mount and the virus continues to maim and kill. New applications for unemployment insurance, for instance, are leveling off at more than 1 million a weekmore than double the highest rate reached during the Great Recession, a sign that more job losses are becoming permanent. After rising when the government sent stimulus checks and expanded unemployment-insurance payments, consumer spending is falling again, down 10 percent from where it was a year ago. Homebase, a provider of human-resources software, says that the rebound has hit a plateau, in terms of hours worked, share of employees working, and number of businesses open.

The next, terrifying phase of the coronavirus recession is here: a damaged economy, a virus spreading faster than it was in March. The disease itself continues to take a bloody, direct toll on workers, with more than 60,000 Americans testing positive a day and tens of thousands suffering from extended illness. The statistical value of American lives already lost to the disease is something like $675 billion. The current phase of the pandemic is also taking an enormous secondary toll. States with unmitigated outbreaks have been forced to go back into lockdown, or to pause their reopening, killing weakened businesses and roiling the labor market. Where the virus spreads, the economy stops.

That is not just due to government edicts, either. Some consumers have rushed back to bars and restaurants, and resumed shopping and traveling. Young people, who tend to get less sick from the coronavirus than the elderly, appear to be driving todays pandemic. But millions more are making it clear that they will not risk their life or the life of others in their community to go out. Avoidance of the virus, more so than shutdown orders, seems to be affecting consumer behavior. Places without official lockdowns have seen similar financial collapses to those with them, and a study by University of Chicago economists showed that decreases in economic activity are closely tied to fears of infection and are highly influenced by the number of COVID deaths reported in a given county.

Read: A devastating new stage of the pandemic

In other ways, the spread of COVID-19 is keeping Americans from going back to work. The perception of public transit as unsafe, for example, makes it expensive and tough for commuters to get to their jobs. Schools and day-care centers are struggling to figure out how to reopen safely, meaning millions of parents are facing a fall juggling work and child care. This is a disaster. The lingering uncertainty about whether in-person education will resume isnt the result of malfeasance, but utter nonfeasance, the former Department of Homeland Security official Juliette Kayyem has argued in The Atlantic. Four months of stay-at-home orders have proved that, if schools are unavailable, a city cannot work, a community cannot function, a nation cannot safeguard itself.

Here is the original post:

The Terrifying Next Phase of the Coronavirus Recession - The Atlantic

Most of the new cases are young people between the ages of 15 and 25, the Washtenaw County Health Department said in a press release Monday.

It is believed that the party took place between July 2 and 3, and health officials are now asking anyone who attended the party to self-quarantine and monitor themselves for symptoms of the virus for 14 days.

There were an additional 66 people who are believed to have had face-to-face contact with a confirmed case. That number does not include family members who are immediate household contacts of the newly identified cases, the release said.

Over the weekend, Louisiana Gov. John Bel Edwards said may new cases had been linked to casual gatherings in people's backyards. The governor issued a restriction mandating gatherings be under 50 people.

Local health officials said this cluster in Michigan highlights how easily and rapidly the virus can infect people.

Spread from the party has impacted people outside the county and even the state, according to the release.

The party and subsequent events have led to additional exposures at retail stores, restaurants, businesses, canoe rentals, clubs, camps, athletic teams and a retirement community, the release said.

"None of us wants to be the reason someone in our community or county becomes seriously ill or dies," says Brian Marl, mayor of the city of Saline. "We have the opportunity to work together and with our local health department to contain this as quickly as possible. We know what we need to do, and we can certainly do it."

Originally posted here:

43 new coronavirus cases have been linked to one large house party in Michigan - CNN

Well, I was writing just the other day about what we dont know about the T-cell response to coronavirus infection, and as of today we know quite a bit more. And from what I can see, we have encouraging news, mixed with some things that were going to need to keep an eye on.

Heres a post from May on a paper in Cell that looked at T cell responses in recovering SARS CoV-2 patients and compared them to reports of people who had been infected with original SARS back in 2003, and to people who had never encountered either. It also has some background on T cells in general, which might be useful if you dont have that info right at the top of your brains queue. Thats the paper that showed that the T-cell response to this virus is less Spike-o-centric than it was to SARS. It also showed that there are, in fact, people who have both CD4+ and CD8+ T cells that recognize protein antigens from the new coronavirus even though they have never been exposed to SARS, MERS, or the new virus. The paper speculated that this might be due to cross-reactivity with proteins from the common cold coronaviruses, and raised the possibility that there might be a part of the population that has at least some existing protection against the current pandemic.

Now comes a new paper in press atNature. It confirms that convalescent patients from the current epidemic show T-cell responses (mostly CD4+ but some CD8+ as well) to various epitopes of the N (nucleocapsid) protein, which the earlier paper had identified as one of the main antigens as well (along with the Spike and M proteins, among others, with differences between the CD4+ and CD8+ responses as well). Turning to patients who had caught SARS back in 2003 and recovered, it is already known (and worried about) that their antibody responses faded within two or three years. But this paper shows that these patients still have (17 years later!) a robust T-cell response to the original SARS coronaviruss N protein, which extends an earlier report of such responses going out to 11 years. This new work finds that these cross-react with the new SARS CoV-2 N protein as well. This makes one think, as many have been wondering, that T-cell driven immunity is perhaps the way to reconcile the apparent paradox between (1) antibody responses that seem to be dropping week by week in convalescent patients but (2) few (if any) reliable reports of actual re-infection. That would be good news indeed.

And turning to patients who have never been exposed to either SARS or the latest SARS CoV-2, this new work confirms that there are people who nonetheless have T cells that are reactive to protein antigens from the new virus. As in the earlier paper, these cells have a different pattern of reactivity compared to people who have recovered from the current pandemic (which also serves to confirm that they truly have not been infected this time around). Recognition of the nsp7 and nsp13 proteins is prominent, as well as the N protein. And when they looked at that nsp7 response, it turns out that the T cells are recognizing particular protein regions that have low homology to those found in the common cold coronaviruses but do have very high homology to various animal coronaviruses.

Very interesting indeed! That would argue that there has been past zoonotic coronavirus transmission in humans, unknown viruses that apparently did not lead to serious disease, which have provided some people with a level of T-cell based protection to the current pandemic. This could potentially help to resolve another gap in our knowledge, as mentioned in that recent post: when antibody surveys come back saying that (say) 95% of a given population does not appear to have been exposed to the current virus, does that mean that all 95% of them are vulnerable or not? Ill reiterate the point of that post here: antibody profiling (while very important) is not the whole story, and we need to know what were missing.

There are still major gaps in our knowledge: how many people have such unknown-coronavirus-induced T-cells? How protective are they? How long-lasting is the T-cell response in people who have been infected with the current SARS CoV-2 virus, and how protective is it in the declining-antibody situation that seems to be common? What sorts of T cell responses will be induced by the various vaccine candidates? We just dont know yet. But were going to find out.

Originally posted here:

New Data on T Cells and the Coronavirus - Science Magazine

Buy Photo

The River Crab, 1337 River Road, has confirmed to the health department that an employee tested positive for COVID-19.(Photo: Brian Wells/Times Herald)

An employee of a waterfront restaurant in St. Clair Township has tested positive for the coronavirus, theSt. Clair County Health Department confirms.

The county was notified of the confirmed COVID-19 case at the River Crab this week, and according to a health department news release, the management at the restaurant is "working very closely" with health officials.

Patrons who visited the restaurant along M-29 on July 5, 6, 7 or 8 may have been exposed, the health department stated, and are encouraged to self-monitor for symptoms over the next 14 days and seek testing if they becomesymptomatic.

The release states that River Crab, 1337 River Road, has COVID-19 procedures in place, including daily employee health screenings and required masking throughout the facility.

Late Wednesday afternoon, Melanie Lewis, the dining room's manager, confirmed that the restaurant maintains a binder to ensure adherence to coronavirus protocols, and after examination, the health department approved them to remain open.

"Every day before our servers or any of our staff are allowed to enter the building or clock in, (they have their) temperatures (checked)," she said. "... Not only do we have extra cleaning set up and in place where things are disinfected nightly and throughout the day, (but) we also have disinfecting stations throughout the restaurant."

Lewis said employees also aren't allowed to remove their masks until they leave, adding, "We feel confident this will be an isolated event."

Health officials have said they've begun to receive a lot of calls or complaints about potential COVID issues in area businesses. As of earlier this month, Dr. Annette Mercatante,the county's medical health officer, said they were still trying to standardize their response. She said they were open to releasing names of restaurants where enough complaints or instances of COVID arise.

"If you walk into an establishment and see there's no way you can safely sit six feet apart and have a drink, you're not safe to take your mask off yet," Mercatante said in the recent interview. "If everybody in the building's not wearing a mask, you're not safe to go in. That's one of the choices people have."

As of Monday, it is required for Michiganders to wear masks in public spaces and for establishments to refuse entry or service to those who don't comply.

General questions can be directed to the St. Clair County COVID-19 informational hotline (810) 966-4163.(Photo: Brian Wells/Times Herald)

Symptoms of COVID-19 can include fatigue, cough, fever, chills, shortness of breath, muscle aches, headaches, nausea or vomiting, congestion, sore throat, diarrheaand abdominal pain.

Extra precautions to avoid transmitting the virus to others have also been highly encouraged, as individuals may be able to spread the disease for up to 48 hours priorto symptoms and some may remain asymptomatic.

COVID can spread primarily from person to person through respiratory droplets produced when an infected person coughs, sneezes or talks, according to the U.S. Centers for Disease Control and Prevention. Droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs, and social distancing of at least six feet is encouraged.

Other ways to reduce the spread of the virus and to protect others includes:

For more information on testing locations, visitwww.michigan.gov/coronavirus. St. Clair County updates its dashboard daily atwww.stclaircounty.org/offices/healthand provides weekly graph updates every Friday online and through social media.General questions can be directed to the St. Clair County COVID-19 informational hotline (810) 966-4163 or email covid19@stclaircounty.org.

Contact Jackie Smith at (810) 989-6270 or jssmith@gannett.com. Follow her on Twitter @Jackie20Smith.

Read or Share this story: https://www.thetimesherald.com/story/news/2020/07/15/were-you-exposed-river-crab-employee-tests-positive-coronavirus/5445940002/

Original post:

River Crab employee tests positive for COVID-19; potential exposure reported around July 5-8 - The Times Herald

TheWest Virginia Department of Health and Human Resources (DHHR)reports as of 10:00 a.m., on July 15, 2020, there have been 215,450total confirmatorylaboratory results received for COVID-19, with 4,463 totalcases and 97 deaths.

In alignment with updated definitions fromthe Centers for Disease Control and Prevention, the dashboard includes probablecases which are individuals that have symptoms and either serologic (antibody)or epidemiologic (e.g., a link to a confirmed case) evidence of disease, but noconfirmatory test.

CASESPER COUNTY (Case confirmed by lab test/Probable case):Barbour(23/0), Berkeley (530/19), Boone (42/0), Braxton (5/0), Brooke (31/1), Cabell(196/7), Calhoun (4/0), Clay (13/0), Fayette (86/0), Gilmer (13/0), Grant(20/1), Greenbrier (74/0), Hampshire (45/0), Hancock (43/3), Hardy (47/1),Harrison (128/0), Jackson (148/0), Jefferson (254/5), Kanawha (430/12), Lewis(22/1), Lincoln (10/0), Logan (40/0), Marion (113/3), Marshall (69/1), Mason(26/0), McDowell (12/0), Mercer (63/0), Mineral (68/2), Mingo (29/2),Monongalia (604/14), Monroe (14/1), Morgan (19/1), Nicholas (19/1), Ohio(151/0), Pendleton (16/1), Pleasants (4/1), Pocahontas (37/1), Preston (84/21),Putnam (91/1), Raleigh (81/3), Randolph (191/2), Ritchie (2/0), Roane (12/0),Summers (2/0), Taylor (22/1), Tucker (7/0), Tyler (10/0), Upshur (31/2), Wayne(128/1), Webster (1/0), Wetzel (37/0), Wirt (6/0), Wood (185/9), Wyoming (7/0).

As case surveillance continues at thelocal health department level, it may reveal that those tested in a certaincounty may not be a resident of that county, or even the state as an individualin question may have crossed the state border to be tested.

Pleasenote that delays may be experienced with the reporting of information from thelocal health department to DHHR.

Please visit thedashboard at http://www.coronavirus.wv.gov for more detailed information.

Read the original post:

COVID-19 Daily Update 7-15-2020 - 10 AM - West Virginia Department of Health and Human Resources

A coronavirus patient in Anahuac was flown by helicopter to a hospital in El Campo 120 miles away because closer facilities could not take him.

Ambulances are waiting up to 10 hours to deliver patients to packed Hidalgo County emergency rooms.

And short-staffed hospitals in Midland and Odessa have had to turn away ailing COVID-19 patients from rural West Texas facilities that cant offer the care they need.

As the tally of coronavirus infections climbs higher each day, Texas hospitals are taking extraordinary steps to make space for a surge of patients. Some facilities in South Texas say they are dangerously close to filling up, while hospitals elsewhere are taking precautionary measures to keep their numbers manageable.

Doctors warn of shortages of an antiviral drug that shows promise for treating COVID-19 patients. And epidemiologists say the states hospitals may be in for a longer, harder ride than places like New York, where hospitals were stretched to capacity in the spring and some parked refrigerated trailers outside to store bodies of people who died from COVID-19.

It used to [be that] if one hospital got kind of overwhelmed you would start transferring out ICU patients to other facilities that had ICU beds available, said Dr. Robert Hancock, president of the Texas College of Emergency Physicians. And there really is none of that now, because everybodys in the same boat and theyre struggling to get their own patients admitted.

Cases of the new coronavirus have surged in Texas since Memorial Day weekend at the end of May, one month after Gov. Greg Abbott allowed a phased reopening of businesses. In June, Abbott scaled back parts of that plan, first pausing elective procedures in the states biggest cities in an attempt to conserve hospital capacity for COVID-19 patients, then ordering bars to close and capping restaurant occupancy at 50%.

Last week, he expanded the ban on elective procedures to more than 100 counties across broad swaths of the state, a sign of the increasing urgency of the virus toll on Texas hospitals. Then he warned that if the trend continues, he might order another economic lockdown.

Its going to be a rough few weeks, said John Henderson, president of the Texas Organization of Rural and Community Hospitals. Most everything were seeing is worrisome or scary.

State data shows the hardest-hit regions include most of Texas biggest cities, as well as large swaths of South and Central Texas and the Gulf Coast.

Dr. John Zerwas, the executive vice chancellor for health affairs at the University of Texas System and a former state representative who is advising Abbott on coronavirus response, forecasted that July will be a month for peak activity related to the epidemic.

Probably toward the end of the month, well be seeing ourselves get into a bit more comfortable place, he said.

Local officials in urban centers throughout Texas say more restrictions are needed now to slow the virus spread and keep hospitals from being overwhelmed in the future. On Sunday, Houston Mayor Sylvester Turner called on the governor to shut down businesses for two weeks.

Many Texas hospitals have stopped accepting transfer patients in order to maintain space for a surge thats expected to come. In the Rio Grande Valley, that moment has already arrived, with hospital beds in short supply.

The tsunami is here, Hidalgo County Judge Richard Cortez said last week.

DHR Health, based in Edinburg, the county seat, is creating a third special COVID-19 ward in a facility normally used for physical therapy after spending more than $9 million to convert a hospice center and rehabilitation facility into COVID-19 units.

Were full to the gills, said Dr. Carlos J. Cardenas, chairman of the board at DHR Health.

In neighboring Cameron County, all of the hospitals were at or above capacity and holding patients in their emergency departments Monday, said Dr. James Castillo, the county health authority. Some were converting or eyeing areas not typically used for patient care, like conference rooms or lobbies, he said.

At Valley Baptist Medical Centers in Brownsville and Harlingen which keep opening new units to care for critically ill patients there were people waiting in the emergency room hallways for treatment this week, said Dr. Jamil Madi, medical director of the ICU in Harlingen. The hospitals are nearly out of ventilators and are starting to consider older models and disaster ventilators that are less optimal for treating the virus, he said.

Theres nothing else other than COVID. You treat COVID, you look at COVID, you see COVID, you smell COVID, you hear COVID. Everythings COVID, Madi said. There are two parallel worlds: The world inside the hospital and the world outside. We need people to understand that it is a dire situation going on inside the hospital.

Ambulances are sometimes waiting hours to deliver patients to the emergency rooms, said Mack Gilbert, chief operating officer of Med-Care EMS, which services most of Hidalgo County. Normally, the wait is less than 30 minutes, he said.

You cant blame the hospitals for being full. The ICUs are full, Gilbert said. But the longer [the patients are] with us, the longer it takes to get them the care they need. Were not really set up for long-term care like that, for four to six to eight hours.

The extended delay also leaves medics in the confined space of an ambulance with a COVID-19 positive patient for longer, increasing their risk of exposure to the virus even though they wear full protective gear, Gilbert said.

The state sent hundreds of medical personnel to South Texas earlier this month to alleviate staffing shortages. It also deployed a fleet of 10 ambulances to Hidalgo, of which Med-Care can use two for 12 hours a day.

Gilbert is grateful these guys are doing a great job. But in a 12 hour shift, they're only able to do three calls, because each call is taking four hours, he said.

In Houston, major hospitals have had to treat hundreds of COVID-19 patients in their emergency rooms as they await space in intensive care units. Data shows the dozen busiest hospitals in the area are increasingly telling emergency responders that they cannot safely accept new patients.

Ripple effects can be felt throughout the region, including at El Campo Memorial Hospital, about 75 miles southwest of Houston.

Under normal circumstances, hospitals in Houstons world-renowned Texas Medical Center would accept transfers of medically complex patients from smaller regional hospitals that are less equipped to handle them. But with many Houston hospitals diverting patients away, smaller facilities like the 49-bed El Campo Memorial Hospital have taken them on.

On Monday, the hospital was caring for 18 coronavirus patients, including at least two who were admitted from Houston and the Anahuac patient who was transported by helicopter, said Nathan Tudor, chief executive of the Mid Coast Health System, which includes the hospital.

Traditionally, if the complex cases need to go out, they do go to Houston, Tudor said. Were just praying that this virus gets behind us sooner rather than later.

In Dallas, some hospitals are gearing up for crisis as the number of admitted patients climbs. After requests from Abbott and Dallas Mayor Eric Johnson, federal medical teams are heading to Parkland Memorial Hospital, one of the citys biggest facilities, to help treat an onslaught of patients.

Additional staff is our primary need, said Donna Richardson, chief nursing officer for Parkland Health and Hospital System.

Similar teams were already sent to Houston and San Antonio.

And for the next two weeks, Medical City Healthcare is suspending elective surgeries at 10 of its 16 North Texas facilities, even though the governors order allows such surgeries to take place outside Dallas County.

The pause will enable us to safely and quickly expand capacity and staff to care for hospitalized patients, spokeswoman Janet St. James said. While we currently have adequate capacity, staff, and [personal protective equipment] we are concerned that there is a misconception in the community that this rate of growth can continue.

Meanwhile, short-staffed West Texas hospitals have been forced to turn away patients from rural areas, where small regional hospitals lack the resources to treat the sickest patients.

Earlier this month, Medical Center Health System in Odessa went on diversion meaning it did not accept transfer patients from regional hospitals outside the county as it faced severe staffing shortages. Currently, more than 20 staff members are out because either they or their family members have been exposed to COVID-19, said Trevor Tankersley, a spokesperson for the Medical Center Health System in Odessa.

When MCHS resumed accepting transfer patients, 15 arrived in one day, from West Texas towns as far-flung as Kermit and Alpine. Soon after, the citys other major hospital, Odessa Regional Medical Center, stopped accepting transfers.

Nearby Midland Memorial Hospital stopped accepting transfers of critical patients Thursday, spokeswoman Tasa Richardson said. At that point, the 286-bed hospital was treating 34 coronavirus patients. By Monday, the number had grown to 44.

Its important that the numerous rural hospitals in the region have somewhere to send their patients, hospital representatives said.

We know what its like to be in a small hospital outside of this area and not have the resources, and its difficult to turn down a request for a transfer to a higher level of care, said Dr. Rohith Saravanan, Odessa Regional Medical Centers chief medical officer. There is really no option for that patient at that point theres no care they can provide that would give these patients a good fighting chance.

But even larger hospitals face severe staffing limitations. At ORMC, nurses in the intensive care unit are working with twice as many patients as they normally would. In remote West Texas, there is a severe shortage of nurses, respiratory therapists, and radiology and medical technicians, he said. So the hospital is turning to more expensive contract labor.

We have the bed capacity, we have [personal protective equipment]. ... The capacity is limited mostly by staffing, Saravanan said. There isnt any talent in the area that we can tap into.

Farther west, El Pasos University Medical Center is doing OK on capacity and ... able to handle all patients under a surge planning process that was set up early on, said Ryan Mielke, the hospitals director of public affairs.

Neighboring El Paso Childrens Hospital is prepared to offer up a number of its own units for adult COVID-19 patients if that becomes necessary, but we are not close to reaching that right now, said Audrey Garcia, director of marketing for El Paso Childrens.

You just gotta pray that it stays on that curve, Garcia said.

Health care workers urged Texans to wear masks, wash their hands frequently and avoid contact with others as much as possible to help prevent new coronavirus infections.

The community has an expectation of us as a hospital. The expectation is that well have beds to take care of them, staff to take care of them, medications, Saravanan said. They need to have an expectation of themselves to say, Were gonna do everything we can so we dont have to utilize those resources. The only way we can do that is by preventing the spread of this disease.

Disclosure: The Texas College of Emergency Physicians, the University of Texas System, the Texas Organization of Rural and Community Hospitals, and Parkland Health and Hospital System have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.

Go here to read the rest:

Texas hospitals are running out of drugs, beds, ventilators and even staff - The Texas Tribune

I'm hearing a lot of talk about the coronavirus spreading through aerosols is wearing a mask in a grocery store enough protection? What else should I do to stay safe?

Quick answer first: Going to the grocery store where you and everyone else is wearing a mask and keeping a distance from each other is still considered a low-risk activity. Go get your summer strawberries!

For background, aerosols are tiny microdroplets containing the virus that can be expelled when we talk or breathe and can stay aloft and travel on air currents. It's still unclear how much of a role they play in spreading the virus, but recently more than 200 scientists wrote an open letter asking the World Health Organization to pay more attention to them.

The agency still maintains that the greater risk of spread appears to be from droplets larger particles, also expelled when we talk or breathe, which settle more quickly and are less likely to accumulate in the air. However, WHO released a new scientific brief on July 9 saying that airborne transmission might be contributing to spread in crowded, poorly-ventilated indoor spaces such as gyms, choir practice rooms and nightclubs. But how much transmission aerosolized particles are responsible for, versus droplets and contaminated surfaces, they can't say for sure.

"What we are calling for is more systematic research to be done in these types of settings," said Maria Van Kerkhove, technical lead for WHO's health emergencies program, at a press conference on Friday. In other words, stay tuned.

Bottom line: It's impossible to rule out that some amount of transmission may be caused by aerosols. If you want to err on the side of caution, here's what some infectious disease researchers say can help minimize the risks:

Face away from people when you talk: When you're talking face to face with someone, you're in direct line of the plumes of breath that come out of their mouths when they speak. "If there's any scenario where I'm face to face, with someone, I move my head off-center so I'm no longer inhaling that direct plume," says Seema Lakdawala, a flu transmission researcher at the University of Pittsburgh. One tip that helps her is to not make direct eye contact with people. It can be awkward, she acknowledges, but "it's not just about protecting myself, but also about protecting other people," since it's possible to shed the virus without knowing you're infected.

Wear your mask properly: Wear a layered cloth mask in public spaces, especially if you're indoors or in a setting where you can't socially distance. Make sure it covers your nose and mouth. This will catch many of the droplets that come out when you breathe or speak and prevent them from getting into the air. Ideally, to take precautions against tiny, aerosolized microdroplets, "we should be masking everyone with better masks," says Abraar Karan, a physician at Harvard Medical School. But the N95 masks that effectively filter most aerosol particles are in short supply and uncomfortable to wear. Karan suggests well-fitting KN95 masks which have similar protection (but make sure your mask isn't counterfeit).

Make the indoors more like the outdoors: "You limit aerosol transmission by increasing ventilation and increasing air circulation by opening a window, putting on a fan and just moving the air," says Lakdawala, who keeps several fans running at all times in her lab and office space. Moving air disperses the particles in the air and makes it less likely that someone will breathe in a concentrated cloud of infectious virus. Donald Milton, an infectious disease aerobiologist at the University of Maryland and lead author on the open letter about aerosols, also recommends cleaning indoor air, through air filtration and ultraviolet sanitizing light. "You wouldn't drink water downstream from another town without treating it. But we breathe air from other people without treating it," he says.

Limit the amount of time you're in close contact with people: The public health rule of thumb for what counts as an exposure is close contact with an infected person for 15 minutes or more, so uncrowded grocery stores where everyone is masked and moving represents a relatively low-risk situation, both Lakdawala and Milton agree. Hopefully, you're not standing in one aisle for very long, but you're going to shop efficiently, says Lakdawala, "So even if there are fine aerosols that are getting released by somebody who is infected, they're getting diluted out as these people move in air currents." Indoor bars, restaurants and other situations where people are staying in one place for a period of time, and speaking or singing loudly, make Milton more wary. "I don't know how to drink a beer with a surgical mask on," he says. "And I wouldn't go sing at choir practice, OK?"

Keep a buffer of personal space: This isn't just important for the spray of droplets, it may also help when it comes to tiny airborne particles. If you are planning to sit and talk to a friend, keeping a distance of at least 6 feet creates more opportunities for airflow between you and others. "We have a happy hour in our neighborhood where everybody brings our chairs, and we sit on someone's lawn," says Lakdawala. "Everyone is spatially distanced, and we bring our own drinks and talk." Maintaining a distance from others means there's more ventilation and space for air to pass between you, says Lakdawala.

Each precaution adds another layer of safety from aerosolized particles, says Milton. "Wearing a mask means you're putting less virus droplets into the air, sucking less out [of the air]. Keeping distances means there's less of it near you. And having good ventilation or air sanitation means what's in the air is getting removed. All of those things add up to giving you good protection."

Excerpt from:

How To Protect Yourself From The Risk Of Airborne Coronavirus Transmission? : Goats and Soda - NPR