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Posts Tagged ‘Covid-19 epidemic’

 

Internet photo. Feds may suggest masks for everyone. It’s being discussed now at CDC Internet photo. Blogfinger screen shot.

 

Paul Goldfinger, MD, Editor @Blogfinger.net

a.  There is talk of having gas customers pump their own to get rid of the interaction with the attendant.  It would give the customer more control of the situation.

Governor Murphy says:   “PLEASE NOTE: We have no plans to turn our gas stations into self-serve at this time.
Please DO NOT pump your own gas.”

 

b. From a Professor of Public Health at William Patterson U regarding grocery shopping

” When you bring your packages home, unpack them in a sheltered area such as outside your front door, in your garage, etc. Discard packaging that you don’t need.  Scrub down the packing that you plan to keep.

“You have produce that other people have touched, so when you get that produce home it needs to be washed with soap and water for 20 seconds, just like you washed your hands. Any surfaces where bags have touched needs to be disinfected.

“She recommends writing your grocery list on a piece of paper that you can easily discard, instead of using your phone. She says the more time you linger in a supermarket, the higher your risk of contracting the virus becomes.”

“Be sure to wash hands after you enter your house.”

And don’t forget the option of having your groceries delivered to your front door.

 

c.  Shortages of PPE’s. (personal protective equipment) is threatening care in hospitals.  The AMA is urging the Trump administration to “take a stronger role to coordinate a national effort of acquisition and distribution of PPE, ensuring that critical PPE no longer goes to the highest bidder and areas in urgent need can protect essential health care workers.”  Bidding wars for this equipment tends to involve states and institutions which tend to lose out to the federal government.

d.  Regarding facemasks  for everyone, this is still the official CDC position:     “If you are NOT sick: You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask).   Facemasks may be in short supply and they should be saved for caregivers.”

e. Some medical schools are graduating their seniors early. (eg NYU) These new MD’s can go to work right away to help with Corona cases.  Come July they will leave for residencies.

f.  UPS workers complain that they have to work in unsanitary conditions.

Amazon employees are also worried about their safety.  Some of them suggest that people order only essential items and wait awhile for other goods.

g.  5 minute Corona tests by Abbott Labs will be available soon.  The government is currently working with manufacturers of a number of different tests.

Sources:  APP, AMA Morning Report,  Daily News Roundup. (Montclair State U) and NJ.com, USA Today.

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This evocative image was featured during the Fox music fundraiser 3/29/20. Photographer unknown. Click to enlarge.

Paul Goldfinger, MD  Blogfinger.net

Monday, March 30, 2020

 

At Blogfinger we can’t compete with the major news sources, and despite my medical background, I would have to spend every waking hour reading the myriad of articles.

Our goal is relative brevity while tryng to gain a few insights into the Covid-19 situation.  Maybe we can offer you something that you don’t already know.

And we may add some music just to cheer you up.

a.  NJ.com  FEMA will set up 4 temporary NJ hospitals in the coming weeks.  Total N.J. cases of Covid-19  as of Nov. 27 was 8,825.

b.  Planet Princeton:  Gov. announced that financial institutions will provide mortgage forbearance for New Jerseyans:  90 day grace period for mortgage payments.

c.  NJ.com.    Distancing:    The 6 foot distancing rule is for when you leave your home for a quick run to get essentials. But the benefit is lost if a group stands around and socializes while maintaining the 6 foot distance. This is from Dr. Maria Ciminelli, the president of the NJ Academy of Family Physicians.

d.  NJ.com Ocean City has suspended short term rentals  (ie Airbnb’s.)  The same town has closed its boardwalk and beaches.

e. The Daily Signal:   About Anthony Fauci, MD:  In the 1980s, Fauci played a leading role in federal research efforts that helped to reverse the spread of another deadly virus, HIV, which causes the disease AIDS.

In 1984, Fauci became director of the National Institute of Allergy and Infectious Diseases, one of several smaller agencies within the National Institutes of Health, and he has held that post ever since.

Washington Post  re: face masks to combat Covid-19,  quotes research scientist Jeremy Howard of he University of San Francisco:

“When historians tally up the many missteps policymakers have made in response to the corona virus pandemic, the senseless and unscientific push for the general public to avoid wearing masks should be near the top.  The evidence not only fails to support the push, it also contradicts it. It can take a while for official recommendations to catch up with scientific thinking.

“In this case, such delays might be deadly and economically disastrous. It’s time to make masks a key part of our fight to contain, then defeat, this pandemic.

“Masks effective at ‘flattening the curve’ can be made at home with nothing more than a T-shirt and a pair of scissors. We should all wear masks — store-bought or homemade — whenever we’re out in public.”

But this issue is not yet resolved. This is the official point of view:

On Feb. 29, the U.S. Surgeon General, Jerome M. Adams, M.D., warned Americans, via Twitter,  “Stop buying masks”    He emphasized that masks don’t help prevent the spread of coronavirus in the general public.

“In the U.S., where there is a severe shortage of masks and other protective equipment, health officials want to ensure that the healthcare workers who are caring for the sick and getting the most benefit from masks are able to access them.”

Some experts think that everybody should wear a mask, even a homemade one, all the time.  The official ruling is that only N95 masks can protect against the Covid-19 virus.

Another source on this topic is Live Science.   www.livescience.com/face-mask-new-coronavirus.html

It seems to me now that a homemade mask is likely to be useless.  A surgical mask or dust mask may be slightly helpful, and the N95 will work, but they should only be worn by professionals, even if you could get one.

They are very difficult to put on correctly and to use for long without feeling like you need to tear it off and take deep breaths.

 

EDMUNDO ROS   “Te Quiero  Dijiste”

 

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Most of the information below is from Johns Hopkins Medicine:

Isolation and quarantine are public health practices used to protect the public by preventing exposure to people who have or may have a contagious disease.

 

Isolation separates sick people with a contagious disease from people who are not sick.  Isolation can happen at home or in the hospital.   That is what we do in the hospital with people who are “contagious.”  Someone who is admitted with Covid-19 would be kept in isolation, and no one could go into the room without appropriate cover including cap, gown and N-95mask.  Some would wear a face shield.

 

Self-quarantine is defined by Johns Hopkins as:  ” People who have been exposed to the new coronavirus and who are at risk for coming down with COVID-19 might practice self-quarantine. Health experts recommend that self-quarantine lasts 14 days. Two weeks provides enough time for them to know whether or not they will become ill and be contagious to other people.

Such people may have been exposed to a disease and do not know it, or they may have the disease but do not show symptoms. These people will have to stay home except for trips to doctor. For example, if one just came off a cruise ship where there were viral patients.

Self-quarantine involves:

  • Using standard hygiene and washing hands frequently
  • Not sharing things like towels and utensils
  • Staying at home
  • Not having visitors
  • Staying at least 6 feet away from other people in your household

 

Social distancing is what most of us are doing.  It involves what we do as individuals but also public policies that keep us apart such as cancelling athletics and crowded events. Don’t forget the 6 foot rule when away from the house. You can go outdoors.

Other examples of social distancing that allow you to avoid larger crowds or crowded spaces are:

  • Working from home instead of at the office
  • Closing schools or switching to online classes
  • Visiting loved ones by electronic devices instead of in person
  • Cancelling or postponing conferences and large meetings

 

IMG_9742

 

Flattening the curve refers to using protective practices to slow the rate of COVID-19 infection so hospitals have room, supplies and doctors for all of the patients who need care. This graphic is adapted from the CDC by Johns Hopkins.

“A large number of people becoming very sick over the course of a few days could overwhelm a hospital or care facility. Too many people becoming severely ill with COVID-19 at roughly the same time could result in a shortage of hospital beds, equipment or doctors.

“On a graph, a sudden surge in patients over a short time could be represented as a tall, narrow curve.

“On the other hand, if that same large number of patients arrived at the hospital at a slower rate, for example, over the course of several weeks, the line of the graph would look like a longer, flatter curve.

“In this situation, fewer patients would arrive at the hospital each day. There would be a better chance of the hospital being able to keep up with adequate supplies, beds and health care providers to care for them.”

 

Paul Goldfinger, MD   Blogfinger.net

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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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