COVID-19 Update May 12, 2020
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Notes from Governor Cuomo’s COVID-19 Briefing
Data:
– Hospitalizations and intubations are down
– Deaths 195 (142 in hospitals, 53 in nursing home)
Emerging Issue Among Youth:
– NYS DOH is investigating 100 cases of what may be COVID related illness
in children with symptoms similar to Kawasaki disease and toxic shock-like
syndrome
– Illness has taken lives of 5 year old boy, 7 year old boy, and 18 year old
girl
– Out of 100 cases, 5% of cases are found in those aged 1 or younger,
18% of cases are found in those aged 1-4, 29% is found in those aged 5-9,
28% in kids aged 10-14, 16% in those aged 15-19, and 4% in
those 20-21
– DOH is advising all hospitals to prioritize COVID-19 testing for children
presenting symptoms
Reopening:
– Heed Dr. Fauci’s warnings on risking an outbreak that cannot be controlled
– Learn from others’ mistakes (China, South Korea, Germany)
– Maintain regional management and citizen participation
– Calibrate/control by monitoring diagnostic testing, antibody testing,
hospitalizations rate and capacity, infection rate
– – Finger Lakes, Mohawk Valley, and Southern Tier meet reopening criteria
– Status of regions will be updated daily and available to view at
forward.ny.gov/regional-monitoring-dashboard
Federal Assistance:
– This is time to pass a smart federal bill
– No time for handouts to corporations, political port, or partisanship
– Bill must fund state and local governments, working families, state testing
and tracing
– NY needs $61B in federal support or we will have to reduce spending
– Schools, local governments, and hospital spending will be cut by
20% each
– Federal bill must also respond to working families with:
– Landlord and renter assistance
– Payroll protection
– Funeral costs
– Repealing of SALT
– “No bailout boondoggles”
– Corporations have already forecasted next scam and will use pandemic
to enact layoffs and not rehire as many employees increasing corporate
profit and stock values on backs of American workers
Nursing Homes
– We now have more testing capacity, so nursing homes should be prioritized
– We will work with regions who do not have the testing capacity to do
two tests per week for staff
Dr. Fauci: Death Toll Higher than Reported
Dr. Anthony Fauci, the Trump administration’s top infectious disease expert, testified Tuesday that the consequence of reopening the country too early could be “really serious” if states don’t have the capability to respond to new coronavirus infections. The warning offered a stark contrast to the case made in recent weeks by President Trump, who has pushed to quickly restart the economy in spite of a mounting death toll and few signs that the months long pandemic is beginning the subside.
“My concern is that we will start to see little spikes that then turn into outbreaks,” Fauci told the Senate HELP Committee during a hearing on how to safely reopen the nation. “The consequences could be really serious.” The vast majority of states have yet to meet the most basic reopening benchmarks set out by the White House by last month, even as most move in stages toward lifting their social distancing guidelines.
That means that new outbreaks are likely as public life resumes, Fauci said, prolonging the coronavirus fight if states are not adequately prepared to respond. Already, more than 80,000 Americans have died from the disease — a figure that most public health experts agree likely undercounts the true toll. “There is no doubt even under the best of circumstances when you pull back on mitigation, you will see some cases appear,” he said.
Fauci added it’s almost certain the death toll is higher than recorded. He said that schools and businesses hoping to open their doors any time soon should not count on therapeutics or vaccines, saying that public safety hinges on the nation’s ability to regularly test Americans. “The idea of having treatments available or a vaccine to facilitate the reentry of students into the fall term would be something that would be a bit of a bridge too far,” he said. (Politico, May 11)
Please Join the NYS DOH in a COVID-19 Update Webinar
Thursday May 14th at 1-2PM for a
COVID-19 update for healthcare providers.
To accommodate the large number of participants, find our webinar streaming via YouTube Live (and available for viewing immediately thereafter) on the NYSDOH COVID website for providers:
For audio only, please dial in: 844-512-2950
Registration Now Open Mental Health and COVID-19 for Health Professionals May 20, 2020 @ 7:30am Medical Matters CME Webinar
As health professionals, we are at great psychological risk simply by virtue of our “exposure” to the reality of COVID-19. Registration is now open for MSSNY’s next Medical Matters webinar related to the COVID-19 pandemic, Medical Matters: Mental Health and COVID-19 for Health Professionals. Faculty for this program is Craig Katz, MD.
Registration is now open for this webinar
Educational objectives:
Better understand the mental health risks posed by COVID-19 for physicians
Review the possible range of psychological and psychiatric responses to the pandemic
Discuss principles and interventions for helping ourselves, our families, and our colleagues
To view MSSNY’s other COVID-19 related programs, be sure to go here and view Medical Matters: Coronaviruses 2020: COVID-19 An Evolving Story recorded on March 18, 2020, Medical Matters: Psychosocial Dimensions of Infectious Outbreaks recorded on April 1, 2020 and Medical Matters: COVID-19 for Office-Based Physicians: How to Handle Surge and Psychological First Aid recorded on April 29, 2020. You can also listen to MSSNY’s podcasts related to COVID-19 by going here.
Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
NYC’s Death Toll Worse than City and State Figures
New York City’s death toll from the coronavirus may be thousands of fatalities worse than the tally kept by the city and state, according to an analysis released Monday by the U.S. Centers for Disease Control and Prevention.
Some of those excess fatalities could be COVID-19 deaths that went uncounted because a person died at home, or without medical providers realizing they were infected, the researchers at New York City Department of Health and Mental Hygiene said. It might also represent a ripple effect of the health crisis, they wrote. Public fear over contracting the virus and the enormous strain on hospitals might have led to delays in people seeking or receiving lifesaving care for unrelated conditions like heart disease or diabetes.
“Tracking excess mortality is important to understanding the contribution to the death rate from both COVID-19 disease and the lack of availability of care for non-COVID conditions,” the report said.
The report underscored the challenges authorities face in quantifying the human toll of the crisis. Deaths caused by the coronavirus are believed to be undercounted worldwide, due in large part to limits in testing and the different ways countries count the dead.
Through Sunday, New York City had recorded nearly 14,800 deaths confirmed by a lab test and another nearly 5,200 probable deaths where no test was available, but doctors are sure enough to list the virus on the death certificate. In its analysis, the report released Monday said the 5,293 excess deaths were on top of both confirmed and probable fatalities.
Between March 11 and May 2, about 24,000 more people died in the city than researchers would ordinarily expect during that time period, the report said. That is about 5,300 more deaths than were blamed on the coronavirus in official tallies during those weeks. (AP News, March 11)
NY Rolling Out Training for Virus Detectives
New York is poised to launch a training plan for the huge corps of disease detectives it plans to deploy to track people who coronavirus. The effort, seen as a key to keeping the outbreak from flaring again once it is under control, is likely to involve hiring several thousand people who have no background in public health.
Because getting huge groups of people together in one place for a contact-tracing boot camp is not possible, the training is being done through a five- to six-hour online course launching Monday. “There’s all this discussion about using technology in some way. But fundamentally, this is a pretty human activity,” said Josh Sharfstein of the Johns Hopkins Bloomberg School of Public Health, which developed the course with Bloomberg Philanthropies, the charitable foundation of former Mayor Michael Bloomberg.
When someone becomes newly infected with the virus, the tracers will be tasked with figuring out everyone who might have had contact with that person, reaching out to them and advising them how to quarantine themselves until they know for certain they aren’t sick with the virus.
In the video training, actors portray how the tracing interviews—mostly conducted by phone or video chat—are supposed to go. Sharfstein said the training, to be offered on the Coursera website, will be available to anyone, not just those seeking to become contact tracers.
Bloomberg is putting up $10.5 million through his foundation to help the state roll out its tracing plan. Gov. Andrew Cuomo has made hiring at least 30 contact tracers per 100,000 residents requirement for any region of the state to reopen. (Crain’s, May 12)
NIH to Test Remdesivir in Combo with Eli Lilly Arthritis Drug
The National Institutes of Health announced its sponsorship of a controlled clinical trial of the investigational antiviral drug remdesivir in combination with the anti-inflammatory drug baricitinib to treat COVID-19. The trial is NIH’s second iteration of its Adaptive COVID-19 Treatment Trial, launched Feb. 21. It tested Gilead Sciences Inc.’s antiviral drug remdesivir in treating COVID-19. Analysis of the trial revealed patients who took remdesivir experienced significantly shorter recovery periods than patients who received placebos.
“ACTT 2 will examine if adding an anti-inflammatory agent to the remdesivir regimen can provide additional benefit for patients, including improving mortality outcomes,” said Anthony S. Fauci, MD, director of the NIH’s National Institute of Allergy and Infectious Diseases. The new trial will incorporate baricitinib, Eli Lilly’s anti-inflammatory drug commonly used to treat rheumatoid arthritis. Baricitinib is expected to inhibit cytokine signaling that causes lung inflammation and shortness of breath among COVID-19 patients.
Investigators will evaluate the recovery times of patients prescribed remdesivir with baricitinib versus those of patients prescribed remdesivir only. ACTT 2 is expected to enroll about 1,000 U.S. hospitalized adults with COVID-19 at 100 sites. (Becker’s Hospital Review, May 11)