Coronavirus 3

[WiseGirl]

I'm having difficulty finding toilet bowl and bathroom cleaner of all things. 

[thoughtful]

I went beyond the mailbox (sounds like a horror movie  . . . Beyond the Mailbox) for the first time since March 10 yesterday. I deposited some paper checks at an ATM.

The only thing I keep ordering and not getting is disinfectant cleaning wipes. I have plenty of Lysol spray, though, so I just spray that on a paper towel, and am using the pre-moistened wipes sparingly.

I don't keep flour in the house - it will just tempt me to make biscuits or other easy baked goods, and I really shouldn't eat starchy stuff. So I have no idea if that's still hard to find around here.

I fought with the Instagram website for hours last night, typing out a search or putting in an item, going off to do something else for 10 minutes, coming back to see if it the page had caught up. About half of the items I'd added to the cart disappeared when I placed the order, and I had to put them in again (and, in some cases, again and again and again!).

To add insult to injury, that screen that says something like "congratulations! You've saved ___ shopping hours" pops up. I've probably spent 10 times as much time fighting with Instagram as I ever did just shopping for myself.

I'm happy to say that the actual human who did my shopping was lovely, fast, and accurate. I wish I could shift the mysterious "service fee" Instacart adds to his tip, so he'd get more money and they'd get less.

 

[JMarie]

https://www.msn.com/en-us/health/health-news/antimalarial-drug-touted-by-president-trump-is-linked-to-increased-risk-of-death-in-coronavirus-patients-study-says/ar-BB14sKRo?ocid=spartanntp

Quote

A study of 96,000 hospitalized coronavirus patients on six continents found that those who received an antimalarial drug promoted by President Trump as a “game changer” in the fight against the virus had a significantly higher risk of death compared with those who did not.

People treated with hydroxychloroquine, or the closely related drug chloroquine, were also more likely to develop a type of irregular heart rhythm, or arrhythmia, that can lead to sudden cardiac death, it concluded.

The study, published Friday in the medical journal the Lancet, is the largest analysis to date of the risks and benefits of treating covid-19 patients with antimalarial drugs. It is based on a retrospective analysis of medical records, not a controlled study in which patients are divided randomly into treatment groups — a method considered the gold standard of medicine. But the sheer size of the study was convincing to some scientists.

“It’s one thing not to have benefit, but this shows distinct harm,” said Eric Topol, a cardiologist and director of the Scripps Research Translational Institute. “If there was ever hope for this drug, this is the death of it.”

David Maron, director of preventive cardiology at the Stanford University School of Medicine, said that “these findings provide absolutely no reason for optimism that these drugs might be useful in the prevention or treatment of covid-19.”

Past studies also found scant or no evidence of hydroxychloroquine’s benefit in treating sick patients, while reports mounted of dangerous heart problems associated with its use. As a result, the Food and Drug Administration last month warned against the use of the drug outside hospital settings or clinical trials.

The new analysis — by Mandeep Mehra, a Harvard Medical School professor and physician at Brigham and Women’s Hospital, and colleagues at other institutions — included patients with a positive laboratory test for covid-19 who were hospitalized between Dec. 20, 2019, and April 14, 2020, at 671 medical centers worldwide. The mean age was 54 years, and 53 percent were men. Those who were on mechanical ventilators or who received remdesivir, an antiviral drug made by Gilead Sciences that has shown promise in decreasing recovery times, were excluded. 

Mehra said in an interview that the widespread use of antimalarials for covid-19 patients was based on the idea of “a desperate disease demands desperate measures," but that we have learned a hard lesson from the experience about the importance of first doing no harm.

In retrospect, Mehra said, using the drugs without systematic testing was “unwise.”

“I wish we had had this information at the outset,” he said, “as there has potentially been harm to patients.”

Nearly 15,000 of the 96,000 patients in the analysis were treated with hydroxychloroquine or chloroquine alone or in combination with a type of antibiotics known as a macrolide, such as azithromycin or clarithromycin, within 48 hours of their diagnosis.

The difference between patients who received the antimalarials and those who did not was striking.

For those given hydroxychloroquine, there was a 34 percent increase in risk of mortality and a 137 percent increased risk of a serious heart arrhythmias. For those receiving hydroxychloroquine and an antibiotic — the cocktail endorsed by Trump — there was a 45 percent increased risk of death and a 411 percent increased risk of serious heart arrhythmias.

Those given chloroquine had a 37 percent increased risk of death and a 256 percent increased risk of serious heart arrhythmias. For those taking chloroquine and an antibiotic, there was a 37 percent increased risk of death and a 301 percent increased risk of serious heart arrhythmias.

 

[fraurosena]

Friday's update:

• There are now 252 corona patients in the ICU in the Netherlands, 3 less than yesterday. 
  There were 9 hospitalisations, the lowest number since early March. The total number of hospitalisations is 11.613.
  There were 13 corona related deaths, bringing the total number of deaths up to 5788.
  he RIVM (Dutch CDC) also looks at mortality rates, that is, the number of deaths in relation to the average number of deaths in the corresponding weeks in previous years. The mortality rates are better indication of the actual number of people who die from corona related causes, as the official corona related reported deaths are limited to confirmed (i.e.tested) cases. Therefore, when there is an excess in the mortality rates, that number is closer to the actual number of corona related deaths.
  Last week, for the first time in months, the mortality rate was lower by 200 in comparison to previous years. Remarkable as it may seem, this isn't an unknown phenomenon after epidemics though. Many vulnerable people with underlying health issues die sooner than they normally would have in during an epidemic, which causes the mortality rate to be lower than average for a period after the epidemic.
  The Dutch government is probing the need to postpone special elections in a number of counties in Groningen and Brabant and on the island of St. Eustatius (a 'special county' of the Netherlands) planned for this fall, and the national elections planned for March next year. Home Affairs minister Kasja Ollongren has said that as yet she doesn't see any grounds to believe that organising these elections wouldn't be possible. If postponement were to become necessary, then the lawful grounds to do so depends on the type of election. National elections may be postponed by a maximum of one year. Mail-in voting is theoretically possible, Ollogren said, but would need measures in place to ensure people can vote freely, and can keep their choice to themselves if they wish. She will look in to how that could be made possible. She is also going to find out if polling stations can be re-organised so that 1.5m social distancing is possible. 
  The special elections in the counties can be postponed by a maximum of six weeks. If that turns out to be inadequate, the law will have to be changed.
• A businessman in Colombia, South America, has designed a hospital bed that converts into a coffin. He was inspired to do something when he saw that in Ecuador there is such a shortage of coffins that bodies are left out in the streets. His company, ABC Displays, makes the biodegradable beds for corona patients out of cardboard. Medics can easily transform the bed into a coffin without touching the body. 
• From June 8, everyone visiting Great Britain must go into a two week quarantine. Travellers must give their phone numbers say where they are staying, the Secretary of Home Affairs, Priti Patel announced at a press conference. Authorities can impose £1000  fines on anyone who breaching the order.
  Upon this announcement, the French Foreign Affairs department has said that France will do the same for all Brits. France is furious about the British decision because earlier this month both countries had mutually agreed not to isolate each others citizens. There is extensive traffic over the Channel between the two countries.
• Trump has said that he has deemed churches and other houses of worship 'essential' and called on governors across the US to allow them to reopen this weekend. Trump said that "... governors need to do the right thing and allow these very important essential places of faith to reopen right now, for this weekend." And he warned that if governors don't aid by his request, he will "override" them. "Some governors have deemed liquor stores and abortion clinics as essential, but not churches," he said. "It's not right. So I'm correcting this injustice and calling houses of worship essential."
  The CDC has released new guidelines that include limiting the size of gatherings and holding services outdoors or in large, well-ventilated areas. Dr. Birx said that faith community leaders should be in touch with their local health departments and can stake steps to mitigate risks, including making sure those who are at high risk of severe complications remain protected. "There's a way for us to work together to have social distancing and safety for people so we decrease the amount of exposure that anyone would have to an asymptomatic," she said.
• Iceland is deliberating if they can reopen cafes and allow gatherings of more than 200 people. The country only has two people left who are recovering from the corona virus in isolation, and there have been no new cases.
  Immediately after the global corona outbreak, Iceland took counter measures, and the country only has 10 corona related deaths.
• According to a report published in The Lancet today, a new study has shown that hydroxycholorquine and chloroquine are not effective against the corona virus. Scientists examined 96.000 corona patients in different hospitals. They found that the drugs have no effect on the corona virus, and use of the medication increases the chance risk of mortality in patients.
• The number of registered corona cases in Africa has risen above 100.000, the African CDC has announced. The official number of corona related deaths in Africa is 3100. The CDC director, John Nkengasong, hasn't seen an explosive rise in confirmed cases in weeks. "We are hoping this trend continues," he said. At the same time, he emphasised that there should be more testing on the continent with a population of 1.3 billion.
  Moreover, each country has its own way of dealing with the corona pandemic. The Tanzanian president John Magufuli, for example, has said that three days of prayer have defeated the virus. The country hasn't adjusted its numbers in the past three weeks. 
  South Africa, the country that tests the most in Africa, also has the highest number of cases, about 19.000.
• Globally there are 80 million children younger than one year old that are at risk of becoming ill from diseases such as measles, diphtheria or other illnesses for which vaccines are available. In 68 countries the national vaccination programmes have been disrupted by the corona virus, Unicef, the WHO and Gave said in a joint statement. WHO director general Tedros Ghebreyesus is worried. "Disruption of vaccination because of the pandemic can eradicate decennia long progress against illnesses such as measles," he said. Unicef director Henrietta Fore warns that the battle against one disease should not be at the cost of the battle against other illnesses. "Even though current circumstances are forcing us to put some vaccination programmes on hold temporarily, we must restart these programmes as soon as possible. Otherwise we will be risking one deadly outbreak after another."
• Spanish authorities have announced that the lockdowns in Madrid and Barcelona will be eased on Monday. Outdoor seating at restaurants and cafes will be reopened (at half capacity) and gatherings of up to 10 people will be allowed again. Museums, swimming pools and other public places and hotels are also reopening. A strict social distancing of 2 metres remains in place.
• Portugal is welcoming tourists again, said minister of Home Affairs Augusto Santos Silva this afternoon. Portugal is one of the first European countries to welcome foreign travellers after easing its corona measures. Santos Silva explained that certain health checks will be held at airports, but that there won't be a mandatory quarantine period for people entering the country. 
  There are 30.200 confirmed cases in Portugal, with 1289 corona related deaths.

[clueliss]

Yikes (locally for me) Audrain County Missouri.  

History here - they had 1 case (and that was fairly late compared to the rest of Mid-Mo).  Earlier this week that took a couple of jumps (initial jump due to 9 cases from a hog farm operation).  They were up to 23 total (22 active)

Now this:  (so, theydoubled - in a day)

 

[CTRLZero]

Who knew that there would be a pandemic and I'd develop an intense interest in everyone's grocery shopping habits!?!  But it's true!  I've been ordering what I can online lately, but today we bicycled to a small Safeway store that is fairly close to us (3-1/2 miles).  The large grocery store that we usually frequent has had line ups and, once we get inside, we end up trudging forever to collect our goods (this was not a problem pre-pandemic).  So...I appreciated that this small store, though more expensive, has the fresh fruits/vegetables/dairy sections at one entrance, making it so easy to zip in and out. 

Eventually I'm going to have to go back to a bigger store for paper products, but so far so good. 

[GreyhoundFan]

What a kind little girl: "A 10-year-old gave 1,500 art kits to kids in shelters and foster care during the pandemic"

Quote

For Chelsea Phaire’s 10th birthday last summer, she asked her guests to bring art supplies instead of gifts. She evenly distributed the crayons, markers, paper and colored pencils into 40 plastic kits, and then she hand-delivered them to a homeless shelter in New York.

“That was really the starting point,” said her mother, Candace Phaire.

After seeing the kids’ happy faces, she wanted to do more. Chelsea pooled her allowance and tooth fairy money, and asked friends and relatives to check out her Amazon wish list. Donations started pouring in.

Between August and March, the Phaires made nearly 900 art kits for shelters and homes in various states. They drove from Danbury, Conn., where they live, to hand-deliver the packages. As part of the in-person deliveries, Chelsea gave an art lesson to the recipients of her kits, including a small presentation on why art is important to her.

“Whether I’m happy or sad, art is always there for me,” said Chelsea, who is in the fifth grade.

When the pandemic hit, her family decided it was more important than ever to provide as many art kits as possible to children in need. They made around 1,500 kits, which have been sent to kids in 12 states, her mother said. At first, the Phaire family was paying for all the shipping costs, but they eventually started a PayPal account to help with the mounting postage fees.

With the help of her parents, she now runs Chelsea’s Charity, an organization aimed at providing art supplies to children, particularly those who have endured hardship and trauma in their young lives.

For Chelsea, art is communication. She knows that a simple sketch, a carefully crafted painting or a glitter-covered canvas serves a powerful purpose in the life of a child.

The idea behind the initiative came to Chelsea after she was given an art kit by a family friend two years ago. Her mother told her to take good care of it, since many children don’t have any art supplies.

“This made me so sad,” said Chelsea, who then decided she wanted all kids to have access to basic art supplies.

“Chelsea always had a strong desire to start a charity and asked us about it from the time she was only 5 years old,” said Candace Phaire. “When she got a little older, my husband and I said yes.”

The materials from Chelsea’s Amazon wish list ship to her father’s office in New York City, and with the help of her younger brother Corey, 9, Chelsea organizes the products and divides them into separate containers to send to children in homeless shelters, foster care homes, and schools in need of additional support.

“It quickly became a family project,” Candace Phaire said. “Everybody has a role.”

The shelters and foster care services that have received the art kits have been grateful.

“The kids were just so excited, and it was a huge weight off the parents’ shoulders,” said Shana Carignan, development director at Families Moving Forward, the largest shelter for children and families experiencing homelessness in Durham, N.C.

The shelter, which regularly uses art therapy to help children cope with trauma, is no longer able to facilitate these programs due to coronavirus concerns. They used to share art supplies among the children.

“The kids were really missing this,” she said. “So, having their own art kits has been very helpful.”

Stacy Dewitt, the executive director of James Storehouse, which provides resources for youth in Los Angeles entering the foster care system, received 50 kits from Chelsea’s Charity last week.

“Children who enter the foster care system typically have no belongings, which is traumatic for them,” she said. “It is so nice to be able to give them something extra, especially because art is very therapeutic for processing emotions.”

Foster parents, too, said the kits are particularly useful for occupying the kids, and allowing them to channel their energy in a positive way.

“These art kits have helped caregivers, particularly those with new foster placements, engage in conversation with the kids in a safe way that builds trust,” Dewitt said.

Chelsea’s Charity communicates directly with shelters and organizations to offer supplies, but recently, families in need have also started reaching out to the Phaires.

“I had a foster mom contact us personally today,” Candance Phaire said this week. “We are sending her some kits tomorrow.”

Candace Phaire, who is a professor of early-childhood education at Central Connecticut State University, believes art plays an important role in the emotional development in children.

Recently, Chelsea’s class had plans for a field trip, and she was counting down the days with excitement. But when the students were told the trip was canceled due to the coronavirus pandemic, Chelsea grabbed her own art kit to cope with her disappointment.

“Art helps me communicate when I can’t express myself,” she said. “Art is my voice.”

With more free time lately, she has also started a “Chat with Chelsea” initiative, facilitating weekly interviews on Instagram Live with different artists.

She’s already chatted with Nikkolas Smith — children’s book author and illustrator at Walt Disney Imagineering, as well as Kathy Cano-Murillo, the chief executive of The Crafty Chica, and Najee Dorsey, the founder of Black Art In America, among others.

Beyond providing art supplies to children across the nation, Chelsea has high hopes to expand her charity around the world.

“I think if every child had access to art supplies, it would make the world a much better place,” she said.

 

[thoughtful]

Some time during the second half of each month, I send an email to all of my piano students, just checking to make sure there is nothing getting in the way of our having a lesson at the usual time every week of the following month.

Being Everything's a Song Cue woman, I couldn't resist writing "June is bustin' out all over . . .

Spoiler

 . . . but we are not.

So, let me know if you are OK with lessons via Skype at our usual time every week next month."

 

[smittykins]

The annual fair in neighboring Cayuga County has been canceled. 

[clueliss]

Hairstylist showing symptoms exposes clients 

 

[Seahorse Wrangler]

Can some-one help me out here?

I saw part of a FB thread where Person 1 claimed that the state closing churches was against the First Amendment  (separation of church and state) and that the current holder of the presidential office was in his rights to order them opened. Person 2 claimed that would be against the Tenth Amendment (states rights).

 

I can't find it again and my knowledge of American law is almost non-existent when it comes to things like this. So who is right? Or do both points have some justification?

[Howl]

On 5/22/2020 at 4:21 PM, fraurosena said:

From June 8, everyone visiting Great Britain must go into a two week quarantine.

Hawaii is already doing this; incoming visitors must undertake a strict 2-week quarantine.  And when I say strict, it's staying inside a hotel room or whatever lodging for two weeks, period.  A visitor from Arizona was caught at a fast-food place during her quarantine period, was reported to police and arrested. Hefty fine is involved. 

Edited May 23, 2020 by Howl

[Cartmann99]

3 hours ago, Seahorse Wrangler said:

I saw part of a FB thread where Person 1 claimed that the state closing churches was against the First Amendment  (separation of church and state) and that the current holder of the presidential office was in his rights to order them opened. Person 2 claimed that would be against the Tenth Amendment (states rights).

I found this article from March helpful: 

Coronavirus and the First Amendment

Quote

The Rev. Rodney Howard Brown, who pastors a megachurch in Tampa, was arrested for holding a worship service despite an emergency order that people maintain social distancing and avoid large gatherings during the coronavirus outbreak. This photo is a screenshot from the livestream of the Rev. Rodney Howard-Browne speaking to his congregation on March 29 in Tampa, Fla.

On March 30, 2020, officers with the Hillsborough County Police Department in Florida arrested the Rev. Rodney Howard-Browne, who pastors a Pentecostal megachurch, for holding a worship service despite an emergency order ordering people to maintain social distancing and avoid large gatherings in order to combat the coronavirus epidemic.  He posted a $500 bond and was released (Mazzei 2020).   

A week earlier, Pastor Tony Speel of the Life Tabernacle Church in Baton Rouge, Louisiana hosted Sunday morning services of 1,825 people, claiming that his church was helping to handle the pandemic by the laying on of hands of the sick, although it is not clear that he violated a specific order in so doing (Nextar Media Wire).

Would restrictions during coronavirus violate First Amendment?

These cases lead to the obvious question as to whether they violate the First Amendment, which guarantees both the free exercise of religion and the right to peaceable assembly.

The scholarly consensus appears to be that states and localities have the right to limit the size of gatherings of non-family members consistent with their state police powers over matters of local health and welfare, which are recognized by the Tenth Amendment to the U.S. Constitution. 

In Jacobson v. Commonwealth of Massachusetts, 197 U.S 11 (1905), Justice John Marshall Harlan thus upheld a compulsory state vaccination law for smallpox as a legitimate exercise of state police powers against charges that it unduly interfered with personal liberties.

Churches would not be exempt from generally applicable laws

Cases that involve possible conflicts with the free exercise and peaceable assembly clauses are somewhat more complicated, but in times of genuine public health crises, churches, synagogues, and mosques are no more exempt from neutral and generally applicable laws designed to protect health than are any other institutions.

Russell Moore, the president of the Ethics and Religious Liberty Commission of the Southern Baptist Convention, which has long been committed to separation of church and state, thus likens such laws to laws like occupancy limits that would apply equally to theaters, diners, or other buildings (Moore 2020). 

He notes that the Religious Freedom Restoration Act of 1993, which was designed to help secure religious liberty in the wake of the Supreme Court’s decision in Employment Division, Department of Human Resources of Oregon v. Smith (1990), continued to subject religious groups to laws in cases where these laws had a “compelling state interest” and in which states used the “least restrictive means.” 

Moore further suggests that there may be cases where ministers should be classified as health workers in cases where they are carrying out their ministry (in which cases, they would presumably have to wear the same protective devices as their medical counterparts).

Restrictions that singled out churches could violate First Amendment

To be clear, any laws that singled out churches for special restrictions would likely not only violate the First Amendment but also violate due process requirements in the Fifth and Fourteenth Amendments. As one reporter summarized her findings, places of worship are not entitled to “special treatment during a public health crisis, but they are guaranteed fair treatment” (Dallas 2020). A law allowing large numbers of people to attend sports events but not places of worship or a policy that provided for the punishment of pastors but not sports managers for holding gatherings with similar numbers would thus be clearly unconstitutional.

John Vile is a professor of political science and dean of the Honors College at Middle Tennessee State University. He is co-editor of the Encyclopedia of the First Amendment. This article was published March 31, 2020.

That said, there will be lawsuits over these issues.

 

Protesters rally for lifting all COVID restrictions on Texas

Quote

AUSTIN, Texas (AP) — As more sectors of the Texas economy reopened from the freeze of the coronavirus pandemic, a few dozen anti-government demonstrators rallied Saturday at the state Capitol to demand that all limitations be lifted.

The “Texas Freedom Rally,” sponsored by the Texas Freedom Coalition, featured speakers who called for the state to remain “open and free” and for an end to what they call the “unconstitutional” policies related to COVID-19, the illness caused by the new coronavirus. That illness has struck at least 54,000 Texans as of Saturday, killing at least 1,500 since mid-March, according to state health officials.

There were 1,509 new COVID-19 cases and 26 new coronavirus-related deaths reported since Thursday afternoon alone, the Texas Department of State Health Services reported Saturday. However, the true numbers are likely higher because many people have not been tested, and studies suggest people can be infected and not feel sick.

Nevertheless, Republican Gov. Greg Abbott has been reopening the state’s economic activity in phases, most recently the limited reopening of bars, bowling alleys, skating rinks and even some strips clubs going into the weekend. The new standards don’t apply yet in El Paso and Amarillo, which have seen a recent increase in coronavirus cases.

But speakers at Saturday’s rally demanded unfettered reopening of all activities. Among the speakers was Dallas hair stylist Shelley Luther, who gained national notoriety when she was jailed for defying Abbott’s initial executive order that barbers, hair stylists and other non-essential businesses close up shop. She demanded that schools be reopened.

Shelly Luther needs to hurry up and self-publish the book about her experience before her fans move onto the next aggrieved blonde conservative.

 

[clueliss]

Well, I’m guessing Missouri will have more cases in the next two weeks.  But you know, open up the lake and let the morons come on down.

 

Arkansas cluster after swim party

Spoiler

 

 

And that stylist in Springfield Missouri I posted the earlier article about?  A coworker is now reported as infected, also worked while symptomatic.  

Spoiler

 

 

[Ozlsn]

11 hours ago, Howl said:

Hawaii is already doing this; incoming visitors must undertake a strict 2-week quarantine.  And when I say strict, it's staying inside a hotel room or whatever lodging for two weeks, period.  A visitor from Arizona was caught at a fast-food place during her quarantine period, was reported to police and arrested. Hefty fine is involved. 

Australia, NZ and Japan also. I think Singapore too. The Northern Territory is also doing it for anyone arriving from anywhere - a friend relocated to Darwin for work last month and spent his first two weeks in quarantine. 

[47of74]

Fornicating for film has been affected by all this

Quote

In an average month, Alex Jett stars in and directs 15 to 20 sex scenes for pornographic films. But with a March 15 moratorium on the adult entertainment industry because of COVID-19, the 30-year-old Californian has been working remotely, shooting home videos with his three roommates, also adult performers, as freelance projects.

Just as in Hollywood, the coronavirus pandemic has stopped production of the multibillion-dollar porn industry, pushing performers into dual roles as star-director in DIY home content, ironically while the demand for XXX-films increases with home isolation, according to statistics from the website PornHub. Taking into account mask and social-distance requirements, performers, whose incomes hinge on physical contact and exposure to bodily fluids, wonder when, if at all, it will be safe to work again. 

“[Right now], I don’t even know how you shoot porn without it being insanely high risk,” Jett tells Yahoo Entertainment, later adding, “There’s a lot of panic in the industry, more so for production than performers, who have other avenues of generating revenue ... basically, all you need is a cell phone and you can make money if you’re attractive and well-known.”

From what we understand about COVID-19, the disease caused by the coronavirus pathogen, it’s spread through respiratory droplets from sneezing, coughing or talking, or by touching a contaminated surface and then touching the eyes, mouth or nose (though the CDC recently noted it “does not spread easily” through surface contact). However, sex as a conduit is pending — a small Fertility and Sterility study of 34 men with mild COVID-19 symptoms did not show traces of the virus SARS-CoV-2 in semen. But a JAMA Network Open study of 38 semen samples from men hospitalized with the virus found six that contained SARS-CoV-2. But the small sample size suggests more studies are needed “about virus shedding, survival time and concentration in semen,” wrote the study authors.

 

[JMarie]

3 hours ago, 47of74 said:

Fornicating for film has been affected by all this

 

Why is The Activist Mommy not jumping up and down over this???

[47of74]

1 hour ago, JMarie said:

Why is The Activist Mommy not jumping up and down over this???

Or bouncing up and down over this?  (Ducks on the way to the prayer closet). 

[clueliss]

Well, that’s ‘encouraging’ just got a notice that the city won’t be picking up recycling this week due to a manpower issue — you guessed it because of covid exposure.  (Granted waste removal here is incredibly sensitive to manpower issues at all for any reason and a year or so ago we had trash etc pickup missed because there was an issue with the temp agency the city uses). 
 

also not surprised by a slight uptick in cases here because we are a city that is now conducting free testing without doctor orders.  More tests mean more positive cases.

[Ozlsn]

Coronavirus: 'baffling' observations from the front line.

Long, very comprehensive overview of what we know and don't know about what it does in patients right now.

Spoiler

When you talk to intensive care doctors across the UK, exhausted after weeks of dealing with the ravages of Covid-19, the phrase that emerges time after time is, "We've never seen anything like this before."

They knew a new disease was coming, and they were expecting resources to be stretched by an unknown respiratory infection which had first appeared in China at the end of last year.

And as the number of cases increased, doctors up and down the UK were reading first-hand accounts from colleagues in China, and then in Italy - in scientific journals and on social media - about the intensity of infection.

"It felt in some ways like we were trying to prepare for the D-Day landings," says Barbara Miles, clinical director of intensive care at Glasgow Royal Infirmary, "with three weeks to get ready and not a great deal of knowledge about what we would be facing".

But what arrived in the UK as winter turned into spring took even the most experienced ICU specialists by surprise.

Most people infected with the coronavirus have only mild symptoms, or sometimes none at all. But in many thousands of patients who fall critically ill, Covid-19 is a disease of alarming complexity.

What follows is a summary, often in their own words, of what doctors have learnt about how Covid-19 attacks the human body, and what they still need to know.

More than viral pneumonia

"I think most clinicians were expecting a respiratory virus that causes pneumonia," says Prof Anthony Gordon, a consultant on the intensive care unit at St Mary's Hospital, Paddington, "something similar to diseases like seasonal flu on a much bigger scale".

But, he says, it became apparent very quickly that it was affecting far more than just people's breathing.

Viral pneumonia is a nasty disease - a serious infection of the lungs which causes inflammation as the body fights against it.

But the worst cases of Covid-19 have been something new.

"The volume of this is, of course, unprecedented in the era of modern medicine," says Ron Daniels, an intensive care consultant at hospitals in Birmingham.

"But it's also the type of illness which is so distinct, and the way it's really different from almost every other patient that we've ever seen before." 

For the critically ill, this is a disease of such severe inflammation and blood clotting that it attacks multiple organs and causes life-threatening problems that cascade around the body.

"As a doctor it seems at times quite horrific, we have had so many very, very sick patients who are having these profound changes in their body en masse," says Beverley Hunt, a professor of thrombosis - the clotting of the blood - who works in intensive care at a leading London hospital.

"We're all struggling to understand it better and it's absolutely key that we get more research done so we can understand what is going on."

Oxygen

As the virus began to spread more rapidly in the UK throughout March, patients started arriving in hospitals because they were breathless and short of oxygen. But many of the most seriously ill - such as those who were admitted to intensive care - often had problems with other organs, not just their lungs. And their blood was acting in ways that have yet to be fully explained.

"We still don't really know why some patients feel OK to begin with, even though they have incredibly low levels of oxygen in their blood," says Prof Hugh Montgomery, a consultant in critical care at the Whittington Hospital in north London. 

Doctors measure what they call oxygen saturation - the percentage of haemoglobin molecules in the blood that are carrying oxygen. Usually the aim with patients who are unwell is to keep it at 90% or above. But in some Covid-19 patients the levels drop quite a lot further, down to 80% and sometimes considerably lower than that.

Normally that is enough to set serious alarm bells ringing, but a number of patients appeared to be functioning relatively well with remarkably low levels of oxygen. "It may be related to the inflammation which is affecting the blood vessels," says Anthony Gordon. "It's stopping the oxygen getting into the blood, and that's what's leading to the low levels. But the lungs themselves are not so affected in the early stages."

It is one of the many mysteries of Covid-19 on which more research is urgently required. And it's led many doctors to question whether mechanical ventilation, to help patients breathe, is always the right course of action for this disease. To be connected to a ventilator, a patient has to be rendered unconscious and a tube has to be inserted into their main airway. This process has saved many seriously ill Covid-19 patients.

But for some, the focus on the lungs may have been the wrong treatment at the wrong time.

"The disease appears to go through different stages," notes Barbara Miles, "and so knowing more about how to use the breathing machines on these patients at different stages of the illness would be something I hope we will learn as time goes on."

Normally, patients who are seriously ill with viral pneumonia have to be on a ventilator for about a week. With Covid-19, a week is often not enough. "We've been seeing people on a ventilator for much longer than that, and we don't quite understand why that is," observes Prof Danny McAuley, an ICU consultant at the Royal Victoria Hospital in Belfast.

"It may be that there is still untreated virus continuing to cause damage. Or it may be that it's a response to the virus, with all the excessive inflammation causing multiple problems in the body."  And many of those problems appear to be connected to the blood.

Inflammation and blood clots

Everyone agrees that unprecedented levels of inflammation in the lungs make this a very different disease. When the lining of blood vessels gets inflamed, the blood is more likely to clot. And Covid-19 creates incredibly thick sticky blood in seriously ill patients.

"We find small clots in the small arteries of the lungs but also big clots in the big arteries of the lungs," says Hugh Montgomery. "More than 25% of patients have significant clots and this is a real problem." And the stickier the blood, the bigger the problem.

"You're much more prone to having deep vein thrombosis," explains Beverley Hunt, which usually means a blood clot in your leg. "And pulmonary embolism, when one of the deep vein thromboses travels around the body and blocks the blood supply to the lungs, adding to the problem of the pneumonia."

Blood clots also prevent proper circulation of the blood to other organs like the heart and the brain, making it far more likely that seriously ill Covid-19 patients could suffer a heart attack or a stroke. And some of the warning signs about blood clotting have astonished doctors.

The main protein in the blood which forms blood clots is called fibrinogen.

"Normally," says Beverley Hunt, "it's somewhere between two and four grams per litre in your blood. It goes up a bit in pregnancy, but what we're getting with Covid is as high as 10 to 14 grams per litre. I've never seen that in all my years as a doctor."

Another measure of the risk of clotting, a blood protein known as D-dimer, has also been off the scale. "In a healthy patient, levels are measured in the tens or hundreds," says Hugh Montgomery. "With Covid it's not been at all unusual to be seeing levels of 60, 70 or 80,000, which is quite unheard of."

Immune system and other organs

In some cases, such extraordinary numbers must be due to the presence of multiple clots. But D-dimers can also be a marker of an infection so severe that it triggers a lethal over-reaction from the body's immune system. 

Cytokines are small molecules produced by the body as part of its defence against infection. A chemical warning system. They lead to inflammation, and up to a certain level that is good for you. It allows you to fight an infection and hopefully get rid of it.

But in some patients, Covid-19 provokes what is known as a cytokine storm.

"The problem," says Anthony Gordon, "is that if the infection overwhelms the response, you get a massive release of these inflammatory markers. They then cause even more excessive inflammation, which leads not just to the breathing problems we've talked about, but damage to the body's other organs."

One focus of study in seriously ill patients is that the number of T-cells - important blood cells in the immune system - appears to be lowered dramatically during the cytokine storm. Researchers hope that boosting T-cell numbers will aid recovery.

But all of these factors add up to Covid-19 being highly unpredictable - it is what specialists call a multisystem disease. That makes it much harder to know how best to treat any individual patient, and at the moment there is no textbook to tell doctors what to do.

"It's not just the lungs being affected," says Hugh Montgomery, "it's the kidneys, the heart, the liver. We've also seen severely inflamed muscle which is doing a lot of damage." More than 2,000 Covid patients admitted to intensive care have suffered kidney failure.

We've been giving patients dialysis machine support," says Barbara Miles. "But the blood flowing through the machines clots far more readily than we're used to, so we've had to give them increased amounts of blood thinning medication as well."

In a growing number of patients, the brain has also become a serious cause for concern among senior doctors who've been exchanging information on a daily basis for weeks. "We now know that large numbers of patients are having significant inflammation of the brain," observes Hugh Montgomery.

"The inflammation presents with everything from delirium and confusion, even more than we would normally expect in ICU, to fits and what we call diffuse encephalitis."

"That means some people not waking up properly after being taken off a ventilator."

It is a litany of challenges, and doctors are desperate to know exactly why and how all these different parts of the body are being so badly affected.

Lack of oxygen and damaged blood vessels are clearly part of the equation. But evidence is mounting that many organs are being attacked by the virus directly, and it is striking that the most common underlying conditions involved with Covid-19 are not respiratory problems like asthma.

Instead, they are vascular conditions that affect the veins and the arteries - high blood pressure, diabetes and heart disease, along with associated factors such as gender, obesity and in particular old age.

According to the Intensive Care National Audit and Research Centre, more than 70% of patients admitted to critical care units in England, Wales and Northern Ireland have been male, and more than 70% have been overweight or obese.

More than two thirds of those who have died in intensive care have been over the age of 60.

Some people and not others

But that still doesn't entirely explain why so many people infected with this coronavirus have only mild symptoms or even no symptoms at all, while others become dangerously ill very quickly.

"We've yet to fully understand this condition, it is baffling," admits Ron Daniels, pointing out that even in intensive care, patients present in a variety of different ways. "We can have a patient in their 70s who has isolated respiratory failure and just needs a bit of help with a ventilator. And we can have a patient in their 20s who develops multi-organ failure very quickly."

In the absence of solid proof, many theories are being discussed, based on observation of patients, and much research is being done. Many ICU doctors think it is highly likely that genetics plays a part in some people becoming critically ill with Covid-19, but they can't yet say for sure.

"It could be partly responsible for the disproportionate effect it has had on people of African and Asian origin," says Ron Daniels. "It may also be responsible for the differences in the response of individuals."

It is possible, for example, that the genetic variation that makes you more susceptible to getting high blood pressure or diabetes also makes you more susceptible to the virus.

One leading theory focuses on ACE-2, a protein which sits on the surface of many types of cells and helps regulate blood pressure. It is ACE-2 that the coronavirus uses to enter the body and infect healthy cells. Some people may be genetically predisposed to having more ACE-2 receptors in their body, and may therefore be more likely to fall seriously ill with Covid-19.

Further evidence to support this theory can be found in the number of seriously ill patients who develop gut problems, which suggests the virus can also attack the lower digestive tract where there are plenty of ACE-2 receptors. It looks likely that ACE-2 is also responsible for the high incidence of kidney failure.

For now, though, there are as many questions as answers.

Barbara Miles says dealing with Covid-19 has been the steepest learning curve of her career. "We'd like to know more about how to treat and prevent blood clots in these patients - what's the optimum treatment to try to prevent them and the optimum treatment if they occur," she says.

Getting the right balance between different kinds of drugs is absolutely vital - trying to solve one problem can sometimes create another. "We don't really know exactly how much therapy to give and for how long to give it. But that will hopefully come as we gain more experience of this condition."

Trials

Similar responses emerge to a series of questions that ICU consultants have been grappling with, even as the number of patients in intensive care has fallen again:

When is the right time to mechanically ventilate patients with Covid-19?

What might be the best antiviral drugs to use, and what might be the right dose of anti-inflammatory or immune-suppressing drugs to prescribe?

Could the idea of using convalescent plasma - antibodies from the blood of patients who have recovered - be part of the solution?

"We've multiple anecdotal reports that say this works or that works," says Danny McAuley. "And really the only way to know the correct answer to this new disease is to do large clinical trials over the next few months." A huge number of such trials are already taking place - there are 41 'nationally prioritised' studies being funded in the UK alone - as doctors prepare for the possibility of the virus returning in a second surge.

There is frustration in some quarters that trials aren't being approved quickly enough, but the UK is a world leader in medical research. And the more doctors know, the better they can treat Covid-19.

They know the failure of lungs has certainly been the biggest cause of Covid deaths in intensive care, but it is not the only one. That means what has been done in the past may not always be the right thing to do for this particular illness.

"It's been almost medieval," says Beverley Hunt as she describes the challenges of the past three months. The best ICU doctors in the land have had to make educated guesses about a disease they have never encountered before. For much of the time they have had to base their medicine on observation, rather than on knowledge gained from previous experiments and existing data.

And one of the greatest clinical challenges in dealing with Covid-19 in the future is to improve the outcome for patients admitted to intensive care.

"We've learnt an awful lot and the teamwork has been amazing, but I've struggled," says Anthony Gordon, who has worked on intensive care wards for more than 20 years. "At times I've come home thinking I really don't know if what I did today was the right thing.

"We're having to learn in a few months what we've learnt over many hundreds of years for other diseases, and that has been a real challenge."

 

[clueliss]

Cell receptors of covid identified

 

Quote

 

Arkansas has a second peak after a pool party cluster.  Missouri trying the same stunt.

[GreyhoundFan]

There are some good people out there: "Hearing that medical workers were sleeping in campers, this group gives them free temporary condos"

Spoiler

Emergency room doctor Jim Sauto works long shifts at the Cleveland Clinic, and as soon as he walks into his home, he immediately showers to decontaminate himself. Then he isolates in a small back bedroom away from his wife and two children until he heads back to the hospital the next morning.

Like all medical workers who treat coronavirus patients, Sauto is afraid he might somehow pass the virus to his family, he said.

“Everyone I know [at the hospital] is doing the same thing,” Sauto, 58, said. “I miss hugs from my kids and my wife — that’s the hardest part. But we all know it’s necessary. We can’t take the risk.”

For nearly three weeks, though, Sauto was able to not fret about possibly infecting his family because he was staying in a free apartment provided by the Caregiver Shelter Fund — a nonprofit started by Airriva, a property management company in Columbus, Ohio. The agency fills up empty corporate apartments and condominiums with doctors and nurses working on the front lines of the pandemic, no payment required.

Last month, Sauto checked into a fully furnished condo near the hospital. Although he didn’t have much time to appreciate the new big-screen television in his temporary digs, he was pleasantly surprised to hear a knock on the door one night from somebody at a nearby restaurant offering plates of hot lasagna to him and other medical workers, he said.

“They were more than accommodating — it was wonderful to come and go without any worries,” said Sauto, who took Airriva up on the housing offer after his wife, Isabel, came across the new nonprofit online.

“Initially, I thought I might be able to stay there for a discounted rate, but they told me, ‘No, it’s gratis, with everything included,’ ” he said. “It was a much-welcomed surprise."

The Caregiver Shelter Fund launched in March and is among several groups nationwide offering temporary housing for those working on the front lines of the pandemic.

Airriva offers more than 150 free apartments and condos to doctors, nurses, paramedics and other first responders throughout Ohio, along with rooms at a variety of hotels in cities such as Miami, Boston and Los Angeles.

It was the idea of Sean Whittaker, a partner sales executive at Airriva who was distressed to hear stories of care providers living in garages, basements, campers and cars so they wouldn’t expose their families to the coronavirus.

“These people are risking their lives to keep us safe,” Whittaker, 28, said. “So we need to do what we can to help keep them safe, right?”

“When travel came to a halt, almost all of our corporate guests canceled their business trips, so we had a surplus of empty housing on hand,” he added. “Our occupancy went from 95 percent to 10 percent overnight."

Whittaker and his co-workers asked property owners whether they’d be on board with providing caregivers a free place to stay, and almost all were enthusiastic about having a way to give back to their communities, he said.

Brent Zimmerman is one of those property owners, with several condo units in Cleveland.

“I was happy to help after recognizing that so many first responders were truly scared to go home to their families and possibly infect their loved ones due to being in contact all day with sick patients,” Zimmerman, 42, said.

To cover the costs of employing people to thoroughly scrub each unit between stays and replenish cleaning and paper products along with masks and gowns for housekeeping crews, Airriva is raising money with the goal of opening up hundreds of additional apartments and condos. More than $60,000 has been raised so far, Whittaker said.

“Nobody should have to resort to sleeping in their garage,” he said. “And a lot of front-line medical workers don’t have money to pay for a hotel for two or three months at a time.”

As money is raised to employ more professional cleaners, additional units will be opened up, said Whittaker, who initially put word out about the Caregiver Shelter Fund on Facebook.

“The response has been so incredible that we now have a waiting list of people wanting to stay in one of our units for a few weeks or a month and give themselves and their families a much-needed break,” he said. “It’s not a vacation for them by any means, but it’s a safe and clean place to rest for a while."

For Jeanne Pharo, a 58-year-old registered nurse at the University of Cincinnati Medical Center, the caregiver charity allowed her to get a solid night’s sleep for the first time in months, she said.

Last fall, Pharo took in the cognitively impaired son of a friend who had passed away. At 38, he is fairly high-functioning but needs somebody to help him with his finances and other important decisions, she said.

“My goal was to see if I could get him functioning at some point in his own apartment, and then coronavirus hit,” she said. “I’d been worried about exposing him to the virus or vice versa.”

When Pharo heard about Airriva's shelter fund, she called the company with a request: How would they feel about allowing her housemate to stay in a condo for a month so she could continue her own routine without worry?

“They immediately said yes, and I can’t tell you how grateful I am,” she said. “It’s hard for a health-care provider to ask for help — I don’t want to take from somebody else. Giving is what we do in our jobs. Having this option made available has been an immense relief, and it’s provided my friend a safe place to learn to be independent, as well.”

Most medical workers stay an average of 10 days, Whittaker said, with some staying for several weeks or a month.

Sauto left the Airrivia condo after an 18-day stay and checked into a nearby Hampton Inn.

“I probably could have stayed longer, but I didn’t want to overstay my welcome,” said Sauto, who FaceTimes with his wife and kids at night. “Since we’re in for a long haul with this virus, though, you never know. It’s really nice to know that this option is out there.”

 

[GreyhoundFan]

Interesting:

 

[clueliss]

ST Louis issues travel advisory/self quarantine order for people who went to the lake of the ozarks

 

And Camden County Sheriff says not my problem to enforce, that’s public health regarding the issue at the lake, 

Quote

 

 

[GreyhoundFan]

@clueliss  -- I don't know if you listen to All Things Considered on NPR. Today, they featured an interview with the Osage Beach, MO mayor about the crowds at Lake of the Ozarks. It's a good listen. The mayor was spouting typical repug crap. The interviewer, at about the three minute mark, tosses a grenade. He asked, (paraphrased) So you don't care about the crowds because they're just tourists and if they get sick and take the sickness back to their communities, it doesn't matter to you, right? The mayor got ticked off, but continued spouting nonsense.

Here's a link to the interview.