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Paul Goldfinger photo. Monmouth Park. Oceanport, NJ©

 

 

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This graphic is from McGill U. in Canada. 2 meters is 6.5 feet.

 

By Paul Goldfinger, MD.  Edior@Blogfinger.net

Everyday there are more and more sources of information about the epidemic including those that are not medical.  I have heard from my cousin Bobby–a realtor,  Bed, Bath, and Beyond; a political news source, and a local Assemblywoman.  Of course, there are many expert sources as well such as Cornell Medical School, American Medical Association, CDC, etc.

But some doctors may not be helpful such as a group of doctors at the University of Washington who are predicting  numbers of Corona deaths. That is not science, and such information should be reserved for the health authorities and not the public.

Ideally, all public information should be evidence based, but as you know, for example, doctors are using an antimalarial drug to treat serious Corona cases without having any controlled trials.

They argue that these are desperate times and we can’t wait for those studies.  When Dr. Anthony Fauci, the NIH face of expertise in D.C., was asked by a reporter if he would take that or other unproven drugs if he were infected, he replied that he would only consider an unimproved COVID-19 drug if it were part of a scientific controlled trial.

It is tempting to repeat something you hear, but I suggest you pay attention only to authoritative sources such as CDC.gov.

Today we have some powerful quotes from healthcare professionals courtesy of the McGill Office for Science and Society in Montreal.  Thank you to them for these samples:

 An ER doctor in Montreal:   “Please disseminate this message to everyone that you know: to those young and old and those in-between that are underestimating the gravity of this situation. This is NOT the time to hang out, to chill and to party together because then it is YOU that is propagating the rapid spread of this potentially deadly virus. The death of MANY will then be on YOUR shoulders. And why? Because you couldn’t just stay on your damn couch.”    (This doctor took some needed time outdoors to ride bikes with her family when she discovered many “clusters” of people disobeying the 2 meter rule.  (2 meters is 6.5 feet)

A Harvard gastroenterologist:  “I am always trying to find a positive spin on everything and I am optimistic that this will change healthcare forever for the better. Performing telephone interviews with patients or video virtual encounters are helping keep us to communicate with patients and prevent them from feeling abandoned. The overwhelmingly positive response from the patients is making the continued work worthwhile.”

From a scientist from the National Research Council  discussing vaccines:

“In conclusion, there are several steps involved in developing a vaccine before the final step of testing, which is clearly the most critical part of the process. Health practitioners need not only ensure efficacy, but also safety. In addition to general safety considerations, vaccines against a virus have an additional complication. Unfortunately, instead of blocking, some virus-specific antibodies can enhance the entry of the virus, and in some cases the replication of the virus. These can therefore enhance rather than limit the infection and must be eliminated.

“Therefore, yes it may seem that it is taking forever to get a vaccine, but considering all that needs to be done, and done successfully, a year or so is really not that long.”

Dentist in Montreal:  “Dentistry and physical distancing are mutually exclusive. We get very up close and personal with patients as we are literally working inside of mouths. Unlike many other occupations, ours cannot be performed remotely. It is imperative to treat emergencies in the safest possible conditions so as not to endanger the health of patients and caregivers. Of particular concern are treatments in which bio-aerosols are produced, namely when employing handpieces, air-water syringes, and ultrasonic cleaners.”

(PG: My NJ dentist first said “only emergencies” and then said, “We are totally closed.”  Not every dental office is equipped to work on patients with Covid-19 or threats of infection. If you have a dental emergency, call your local health authorities for a referral.)

Pennsylvania internist who takes care of Corona cases:  “…but certain procedures or processes can increase the risk of aerosolizing infectious particles that aren’t filtered by a simple mask. Examples include during intubation, or even when the patient is on noninvasive ventilators.

“The general population who are not in direct and close contact with COVID-19 patients definitely do not need a respirator mask such as the N95 in the US.  So if you happen to have stocked up on some, consider donating them to your local hospital. We are running short.”

(PG:   This doctor sometimes wears regular masks for “regular patients,”  but for the COVID cases she uses a respiratory N-95 mask and she wears the same mask for 8-12 hours. This is probably OK, but supplies of masks are still short. She also doesn’t wear those space suits that you see on TV.  She wears a gown, shoe covers, gloves, hat and appropriate mask. She volunteered to be the Corona doctor for the 12 cases in her hospital.)

This doctor and so many of them like her are so brave.   And their exposure creates  potential risk for their families. They need to be appreciated by all of us.

 

 

 

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Sent to us by Frank Fallon of Ocean Grove.  Ignore the pop-ups.  It is Beethoven’s 9th Symphony finale.   Don’t know whose apartment was hosting the choir.–PG

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Ft Myers, Fla. Feb. 2020. Paul Goldfinger action photo ©

 

FRANK SINATRA.

 

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Barnegat Bay boating. Internet photo. Date unknown. This is what “too close” looks like in a boat.

 

Paul Goldfinger,  Editor@Blogfinger.net

The Corona epidemic is having a ripple effect on boating.  A boater can go out, but social distancing must be practiced, and officials will be looking out.  You can catch the virus in a boat as well as anywhere; something like getting pregnant.

The Outlets Farmers Market in Ft. Myers, Fla. March 27,2020. Paul Goldfinger photo. © Customers line up outside.

Composing a photo always has a challenge, but now you can’t get close to anyone, so if you want a close-up, either stand back 6 feet or put on a telephoto lens.  The photo above was taken from about 6 feet away at least.

The produce vendors have required everyone to line up and just enter a few at a time to keep those distances.  But each week over the last month, there are less and less vendors and customers.  Today it looks like it will soon close.   I spoke to a woman in line, and she said that she liked shopping there because “It is safer than that at Publix Market..”

This farmers market is a microcosm of what happens to our economy during a lock down.  The ripple effect is international, because who will buy perishable items that were shipped some time ago such as onions from Peru and asparagus from Mexico?   The Mexican border has been closed, and America’s situation takes effect on both sides of the border.

We met a cheese salesman from England.  He comes to Florida for 4 months each winter to sell Wisconsin cheese.  Those items are perishable, and he goes back to England in a week.  There, he tells us, a bad viral peak is expected in London on the heels of New York.

Similar issues arise for the guy who is selling Italian olive oil.  The produce is produced to a large extent locally, and now the tourist business is confined to home, so these farmers are facing a large spoilage and cash problem.   Most of the workers speak Spanish, so they are also being affected here and at home.  You can go on and on, and most everyone is affected in one way or another.

Some “essential ” businesses are still able to function, while “nonessential” businesses are less fortunate.  But who is to say what is “essential” because most business are dependent on others whether they are called “essential” or not.  If you are a car repairman, you may be open, but you  will need parts and materials which may be produced by closed businesses. Maybe some car parts factories are now making respirators.

Construction jobs are allowed to proceed, but even though they are considered essential, they do need lots of stuff.

Asbury Park c 2018. Paul Goldfinger, Blogfinger.net ©

 

MARVELOUS WONDERETTES:  Kids can still dream while isolated.

 

 

 

 

 

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AP

Asbury Park. Boardwalk shut, but beaches still open, however practice distancing. This Paul Goldfinger photo is not recent but may be predictive when NJ case numbers get worse in April. ©

 

Paul Goldfinger MD.   Blogfinger.net

a.  Projections from Rutgers suggest a 60,000 bed shortage in April in NJ. They say that it could worsen without “strict” distancing.  Interestingly they mention “a moderate level of distancing” which can make matters worse. We have to be “strict” and many engage in compromises.

I have seen that in action where people make exceptions to the grouping rules and the distance rules of 6 feet, or certainly nothing less than 4 feet, but that is a compromise.

If you get too close, you could get infected droplets in your mouth, nose or eyes due to sneezing and coughing, but also from hands touching live drops and then touching your face, and even from someone with the virus just breathing on you at close range.

b. As of today in NJ  6,876 cases and 81 dead.   The startling thing about these deaths is that they can evolve very quickly from what presents as a minor problem, and the mechanism is not only life threatening respiratory insufficiency, but also unexpected cardiac arrest.

c. The NJ Governor is hoping that banks will allow reprieves for mortgage payments, eg 90 days. In New York, Gov. Cuomo has already mandated that.

d.  The second home issue is still alive.  This is from the APP:

“Many permanent residents (and a few mayors) are urging second home owners to stay away. Never mind if they stock their car before they leave and agree to follow all the virus guidelines once they arrive. The second homeowners argued that this was still a free country and they had a right to use their homes — and they pay a lot of taxes all year round. Some locals defended them.”

This is a debate worth having because it is about freedoms that may be stifled during Corona, and the issues can trigger fundamental disagreements about our liberties.

 

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Ft. Myers, Fla. Eileen  Goldfinger ©  Click to enlarge.  It is mostly found in Europe and Asia.

 

CAROLE KING

 

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Ft. Myers, Florida group with a brief breakdown of 6 foot social distancing. Careless! Paul Goldfinger photo. © Click to enlarge.

 

Eileen keeps a safe social distance away on a chilly Fla morning, Paul Goldfinger photo. © 2/20.

Paul Goldfinger, Blogfinger.net

a.    The Governor of Florida has expanded his ruling about visitors from New York, New Jersey, and Connecticut.  In addition to his requirement that travelers from those states who arrived up to three weeks ago must self quarantine for 14 days, he now has passed an order, enforced with misdemeanor charges, that any such visitor must inform anyone with whom direct physical contact has occurred in past 21 says.   They must tell such contacts that they come from an area where COVID-19 is very prevalent.  Of course, it will be difficult to enforce this in Florida.

Miami Patch quotes:

“Speaking on the first day of his order requiring all incoming air passengers from New York, New Jersey and Connecticut to self-quarantine, Fla. Gov. Ron DeSantis noted the virus has likely been circulating in the New York area for three or four weeks. The order to report and self-quarantine, to some extent relies on travelers to answer honestly and follow the rules.

“The problem for Florida is we have a lot of interaction back and forth between the New York City area and the state of Florida,” DeSantis said Tuesday. “So you had people probably, unwittingly at the time, be there within the last couple of weeks and then come to Florida.”

“Under the Governor’s expanded order, which was released Tuesday night, people who traveled from the New York City area to Florida — at any time during the last three weeks — must self-isolate and report the close contacts they’ve had in the state of Florida.”

“The Florida governor’s expanded order requires travelers “to inform any individual in Florida with whom they have had direct physical contact in the past 21 days that they traveled from an area with substantial community spread.”

“Violations will be treated as second-degree misdemeanors punishable by up to a $500 fine and up to 60 days in jail. The document directs all state, county and local law enforcement officials to enforce the order.”

 

b.  The commercial fishing industry is hurting because restaurants are closed. This could result in a seafood shortage in food stores.

c. NJ Governor closes some day care centers. They only want the children of essential workers to be present in such centers. And they will enforce strict procedures.

d. Some more COVID-19 testing stations are opening in Central Jersey Urgent Care outlets in Howell, Marlboro ,and Eatontown.  You will not be tested if you have no symptoms. Their testing capacity is limited, and the one that opened at PNC on GSP had to quickly close due to crowds s few days ago.

e. Corona deaths as of today, 2 in Monmouth and 4 in Ocean counties.

f.  New York State has 32,000 cases, half in NYC.  There are 8 1/2 million people in the 5 boroughs, so for anyone who lives in the crowded city there is a significant risk of carrying the virus compared to other places, so the Governor of Florida is correct.

And, as noted yesterday, the Federal Government says that New Yorkers must self-quarantine no matter where they go out of state, not just Florida.   Connecticut is on the list, but they have few cases and cannot be compared to New York. Maryland and Hawaii are doing the same thing with quarantine. Alaska will quarantine anybody who arrives from any  state.

 

BILLY JOEL  “A New York State of Mind.”

“Some folks like to get away
Take a holiday from the neighborhood
Hop a flight to Miami Beach or to Hollywood
But I’m takin’ a Greyhound on the Hudson River line
I’m in a New York state of mind.”

<div

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Mazel Tov Israel

Celebrate Israel Parade..    Paul Goldfinger photo © Usually it is on Fifth Avenue in June.

 

DAVID AND THE HIGH SPIRIT    “Mazel Tov” from the album Golden Anniversary to Israel.  “Mazel Tov” is a Yiddish phrase used to express congratulations for a happy and significant occasion or event.

 

 

 

 

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Covic-19 virus under an electron microscope.

Paul Goldfinger.  Blogfinger.net   3/25/20

Blogfinger:     New Jersey Governor Murphy fired the first round on the subject of second homers in a tweet last weekend when he asked that second homers not come to the  Shore during this difficult time.

Only one OG citizen, a second homer, has contacted Blogfinger to complain about Murphy’s  second-homer decision, but we have heard of complaints from Long Beach Island and the Atlantic City area.

This topic related to second homes may explode as “the tension grows.”  One woman from LBI said that the risks to her family include “physical and emotional health.”  She feels that she is entitled to stay in her 2nd home without interference.  It is unclear how such a mandate could be enforced.

But Murphy’s requirements soon expanded via Executive Order which says that everyone in the state (9 million) should follow his “near lockdown” order to stay at  home except for “essential travel” such as going for “essentials” such as food or for medical reasons.  He also asked for non-essential businesses around the state to close and for most people to “stay off the roads.”

You can go outside for walks or other forms of exercise and you can visit family or close friends.  If you go outside you must follow the “social distancing” 6 foot rule and do not assemble in groups. No parties.

APP:  NJ has had 62 Corona deaths so far and 4,402 cases.  New Jersey has the second highest number of cases in the country  (Daily News Roundup. Montclair University.)

Monmouth County has 207 cases and 2 deaths.   Ocean Grove has had only one case so far documented with a positive Corona test.   Asbury Park has 4, Belmar 1, Bradley 1,  and Ocean 4. Ocean County has  Jackson 18 and Lakewood is highest with 69.

Florida Gov. Ron DeSantis announced via a  March 23 Executive Order that passengers flying from the New York area would be subject to mandatory isolation (self-quarantine  for 14 days)  to slow the spread of the virus.

Later it was announced that the Governor’s Executive Order would be expanded saying that anyone flying to Florida from New York, New Jersey or Connecticut would be subjected to 14 days of self quarantine or face misdemeanor charges.   This was reported by the News Press  (Ft.Myers)

The report said that the self quarantine order was not for car or rail passengers.

“It is critical people adhere to the Federal Government’s request so New York City does not become “another seeding point” for the rest of the country, said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.”

Politico:  The Federal Government is mandating that anyone from New York who travels out of the state should “shelter in place” for 14 days no matter where they go.

VP Pence said, “We have to deal with the New York City metropolitan area as a high-risk area, and for that reason we are taking these steps and asking for the cooperation of the American people,” Pence said.

So far 11 states have passed mandatory “stay at home” orders including New Jersey and New York.  These also have mandatory closing of nonessential businesses.

Residents of New Jersey may still leave their homes to head to the grocery store, seek medical care, visit close family or someone you have a “close personal relationship” with like a romantic partner, report to work or go outside for exercise. However, Murphy urged everyone to continue to practice safe social distancing by staying at least 6 feet away from others.

New Jersey Patch report regarding Asbury Park says,

Asbury Park officials want people to adhere to social distancing or they’ll close the beaches and boardwalk during the coronavirus crisis. The Asbury Park Police Department will be monitoring the Asbury Park boardwalk and beaches to ensure social distancing practices are being followed per Gov. Phil Murphy’s executive order.  Should residents and visitors fail to follow guidelines, the boardwalk and beaches are subject to closure, officials said.    Running and walking on the boardwalk is permitted.  Bicycles are not permitted on the boardwalk from 10 a.m. to midnight. Groups of two or more and congregation on the boardwalk are not permitted.

Seaside Heights has closed its beaches. (along with Pt. Pleasant, and Ocean City.)  The Seaside Mayor there has asked people with vacation homes in that town to “stay away.”   (NJ.com)  As of Monday Seaside Heights became the first shore town to shut down its beaches — even for casual walks for year-round residents — to combat the spread of the novel coronavirus.

 

Other notes, reading between the lines: 

a.    Morristowngreen.com   According to  a Morristown infectious disease specialist,  “We still are learning about how the virus is transmitted, its life span, the kinds of surfaces on which it lingers, and how long it can survive in a variety of conditions     “It makes good sense to wash your clothes in general,” he said, adding, “If you come into contact with someone who appears ill or you think is ill, it’s a good idea to wash your clothes in hot water.”  So routine clothes washing is not essential.

Still, “social distancing measures are the most effective part the mitigation strategy as it currently exists,” he emphasized.

b.    In Italy they are studying the use of lung ultrasound exams to look for evidence of viral invasion into lung tissues.  this is being done to help physicians decide on who must be hospitalized.  Not everyone who has a positive Corona test needs the hospital.

Screening in emergency rooms remains a challenge since patients with mild symptoms, even with a positive test, usually can go home.

For those with positive tests and mild symptoms, the ultrasound has been useful for that kind of triage.

c. NBC News reports that plasma taken from recovered Corona patients might help those who are very sick. It is the antibodies in the plasma which may be found to help. Studies are ongoing.

d.  NBC News:   The use of drugs: anti-malarial hydroxychloroquine  and the antibiotic zithromycin in combination has been found to be helpful in reducing the severity of disease.

e. Shortage of nurses is developing, especially for ICU and ER.

 

 

 

 

 

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