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New Data On COVID Risk and Recovery as Trump Urges Mask Wearing

Masks take the spotlight as new data emerges, showing a large portion of the United States at risk for severe COVID complications, while natural immunity amongst recovered patients remains in question. 

New Data On COVID-19 Risk and Recovery as Trump Urges Mask Wearing 

Nearly six months after the Trump administration declared COVID-19 a public health emergency, new data has emerged regarding the percentage of Americans at risk for severe COVID-related complications. Meanwhile, researchers continue to explore the efficacy of coronavirus antibodies to ward off reinfection. With the U.S. now reporting 4 million cases, President Trump has come out more strongly in favor of mask-wearing, and the efficacy of the controversial hydroxychloroquine is receiving new press.     

40 percent of Americans at Risk for Severe COVID-19 Complications 

A brand new report by the CDC says that roughly 40 percent of Americans have at least one underlying health condition that puts them at risk for severe complications due to the novel coronavirus. These chronic conditions include obesity, Type 2 diabetes, kidney disease, heart disease, and chronic obstructive pulmonary disease. Early in the pandemic, data emerged showing the COVID-related death rate to be as much as 12 times higher amongst those with chronic health conditions compared to those without. Underlying conditions also significantly increase hospitalization rates.

Such chronic medical conditions where found to be more widespread in rural areas, and according to the study, “Counties with the highest prevalences of any condition were concentrated in Southeastern states, particularly in Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Tennessee and West Virginia, as well as some counties in Oklahoma, South Dakota, Texas and northern Michigan.”  

Studies Suggest a Moderate Level of COVID-19 Antibody Protection 

Early research has also suggested that those who recover from COVID-19 may lose their immunity within a matter of months, casting doubt on the development of herd immunity in the population. In some milder cases, no antibodies were detectable after 50 days. However, a more recent study out of Icahn School of Medicine at Mt. Sinai in New York gives a somewhat more optimistic picture. Of nearly 20,000 people with mild or moderate illness, nearly 90% showed an antibody response of at least three months.  According to Florian Krammer, a scientist in the study, “It’s reasonable to assume that there will be protection for a time frame of one to three years.” 

Nevertheless, scientists are still looking to an eventual vaccine as the best hope for widespread immunity. Adrian Hill, the principal investigator for a promising vaccine study out of the University of Oxford, says, “We know from many other infections, the vaccine response can be much more durable than the natural infection response. I’m pretty confident that in COVID we’re going to see the vaccines are more durable than a natural COVID infection. But again, we don’t know yet. We need to wait and see.”  

Trump Promotes Mask-Wearing

As COVID-19 cases continue to increase, President Trump, who did not appear publicly in a mask until July, has recently become more vocal about the importance of mask-wearing. During a recent press conference, Trump spoke of the uptick in cases, saying, “It will likely unfortunately get worse before it gets better,and voiced his support for masks, saying, “Whether you like the mask or not, they have an impact.” 

The president also tweeted a picture of himself wearing a mask, calling mask-wearing “patriotic.” While cloth masks for the general public have become easier to find than they were in the early days of the pandemic, supply of hospital-grade masks, such as the N95, remain a great concern for many medical facilities and first responders in light of recent surges. Blueflame Medical is amongst those who have stepped into the fray to procure and distribute these high-demand pieces of PPE. 

Meanwhile, the drug hydroxychloroquin, touted by Trump, decried by others, has received new press. Harvey Risch, professor of epidemiology at the Yale school of Public Health, penned a piece advocating the use of hydroxychloroquine to improve health outcomes for COVID-19 patients, saying, “When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.” 

The Association of American Physicians and Surgeons has also filed new evidence with a federal court in an attempt to prevent FDA and Department of Health and Human Services interference with doctors’ use of the drug, saying, “As confirmed by another recent study of thousands of patients at the Henry Ford Health System in Michigan, HCQ is both very safe and highly effective in treating COVID-19, reducing mortality by 50%. Countries with underdeveloped health care systems are using HCQ early and attaining far lower mortality than in the United States, where [HHS and the FDA] impede access to HCQ.” 

On the other hand, a study led by researchers out of Brazil and published in The New England Journal of Medicine claims the use of hydroxychloroquine does help COVID patients. 

A Serious Situation 

What is clear is that the novel coronavirus pandemic remains a serious situation that scientists, doctors, and politicians are trying to understand and deal with in real time. Also evident is the fact that life will not return to normal for a while, making the need for masks and PPE a long-term, critical need.     

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New Science Emerges as COVID Cases Surge and Schools Make Plans for Fall

New Science Emerges as Coronavirus Cases Surge, Schools Make Plans for Fall 

Amidst a nationwide surge in COVID-19, scientists are learning more about the activity of the virus and investing in new treatment options. Nevertheless, much uncertainty remains, with limitations on drug supply and questions about the financial resources required to head safely into fall.   

As the COVID-19 pandemic rages on, states across the nation report a continued surge in new cases. California alone saw a recent two-week infection rate increase of 43% with ICU admissions up 37%. Meanwhile, new science is painting a better picture of the virus and honing in on treatment while schools grapple with how to safely educate students in the fall. 

 

Recent Discoveries Provide Better Understanding of COVID-19

In Spain, one of the hardest-hit European countries, new data suggests that only 5% of the country’s residents have developed antibodies through exposure to the virus, leaving 95% of the population susceptible to illness. Similar studies in China and the United States also show that the vast majority of individuals remain vulnerable. By some estimates, a 60% exposure rate is necessary to develop herd immunity, but according to Isabella Eckerle, head of the Geneva Centre for Emerging Viral Diseases, and Benjamin Meyer, a virologist at the University of Geneva, “In light of these findings, any proposed approach to achieve herd immunity through natural infection is not only highly unethical, but also unachievable.” 

In addition, researchers have learned more about the behavior of the virus itself. A study out of UC San Francisco has determined that cells infected with COVID-19 grow arms, called filopodia, that reach into neighboring cells to infect them with the virus. While other viruses also replicate using filopodia, COVID-19 appears unusual in that it grows these tentacles so rapidly. 

Moreover, a mutated form of the virus, known as G614, appears to spread more rapidly than the earlier D614 variety, being three to nine times more infectious. It is now the dominant viral strain. Fortunately, while more infectious, this mutation does not appear to cause more severe illness. Theoretical biologist Bette Korber of Los Alamos National Laboratory indicates, “We interpret [the more rapid spread of G614] to mean that the virus is likely to be more infectious. Interestingly, we did not find evidence of G614 impact on disease severity.” 

Similarly, Lawrence Young, a professor of medical oncology at the UK’s University of Warwick, has said, “The current work suggests that while the G614 variant may be more infectious, it is not more pathogenic. There is a hope that as SARS-CoV-2 infection spreads, the virus might become less pathogenic.” 

 

Drug Remdesivir Shows Promise, Pricing and Supply an Issue 

Gilead Sciences has developed a new antiviral drug, called Remdesivir, which is the first to show effectiveness against COVID-19 in a large clinical trial, reducing patients’ recovery time by an average of four days. The drug works by disrupting the virus’s ability to replicate within the patient’s cells. 

Since its approval for emergency use in May, the U.S. Government has been distributing Remdesivir donated by Gilead. This month, though, Gilead will begin charging for the drug, which will cost U.S. hospitals an average of $3120 per patient. However, Gilead estimates a savings of $12,000 per patient in reduced hospitalization time. While some politicians have criticized the price of the drug, Steven D. Pearson, President of the Institute for Clinical and Economic Review, said in a written statement, “Gilead made a responsible pricing decision based on the evidence we have today. If further data do not show a clear mortality benefit for remdesivir, then the price of the drug should be dramatically reduced.”    

With the donated supply of Remdesivir now used up, the Trump administration has made a deal with Gilead to procure the first 500,000 doses, which amounts to all of July’s production and 90% of August and September’s. According to Health and Human Services Secretary Alex Azar,  “President Trump has struck an amazing deal to ensure Americans have access to the first authorised therapeutic for Covid-19. To the extent possible, we want to ensure that any American patient who needs Remdesivir can get it.” 

Schools Make Plans for Fall 

As summer moves along and cases spike, educators are contending with the very real challenges that back-to-school will bring. In the Ivy League, Harvard has announced that the majority of classes will be taught online, with no reduction in tuition, and up to 40% of students may be allowed to live on campus.  Similarly, Princeton plans to offer mostly online instruction, but is offering a 10% tuition reduction and considering a plan to allow 50% of students back for a semester at a time during the coming school year. 

Other colleges and universities are likewise making plans, in many cases investing large sums of money to create a safe learning environment. Already facing budget crunches due to lower anticipated enrollment, these institutions are spending millions on everything from plexiglass barriers to face masks and other protective gear. The University of Southern Florida recently placed an order for 1,200 hand sanitizing stations, while Purdue University has budgeted $50 million dollars for safety gear and has begun a fundraising campaign to assist with the effort. Fortunately, supplies of Personal Protective Equipment (PPE) are rising to meet the demand with new manufacturers and suppliers such as Blueflame Medical entering the fray.    

Blueflame Medical

Adding to budget concerns, schools must take on significant added cost to hire new, hourly employees to wipe down doorknobs and other surfaces throughout the day and to take the temperatures of all students and faculty entering buildings on campus, With the viability of sports, another significant source of revenue for universities in question, much uncertainty looms on the horizon this coming fall. 

Evidence of Progress and a Hopeful Outlook 

Even as cases spike, however, good news remains. With a better understanding of coronavirus and the development of promising treatments, plans to resume schooling reflect a certain optimism in our ability to manage this deadly pandemic and get on with life.    

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Two Steps Forward, One Step Back: Americans Attempt to Resume Normalcy as COVID Cases Spike

Facemasks and other PPE remain critical as Americans seek to resume daily life and favorite summer pastimes amidst recent spikes in COVID-19 infection rates.  

Two Steps Forward, One Step Back: Americans Attempt to Resume Normalcy as COVID Cases Spike

Summer has officially begun. Lockdown restrictions are loosening nationwide, professional athletes are preparing to play, and lockdown-weary individuals are hoping to travel. Yet, despite these optimistic attempts to return to normal, some states are seeing a spike in COVID-19 cases. In other instances, stores and venues reopened for business have been forced to pull back.

Meanwhile, airlines feel the pinch as summer travel operates at a fraction of its usual capacity, and eager travelers face frustration over quarantine waiting periods upon arrival. As athletes and eager fans prepare for opening day, Major League Baseball and the National Football League question whether their seasons will be a go.

 

Cases Spike in California, Florida, Others

In recent days, California has seen an unprecedented spike in COVID-19 cases. On Friday, June 19, California saw a record 4,317 new cases, topping the previous day’s record of 4,084. In response, California governor Gavin Newsom issued a statewide order requiring facemasks. North Carolina and the state of Washington have also followed suit with statewide mask mandates.

Florida has also experienced rapid COVID escalation, with a recent, single-day high of 5,506 cases. Despite Florida Governor Ron DeSantis’ insistence that there is “plenty of hospital space,” other figures indicate that the number of available hospital beds in the state’s intensive care units has fallen to below 20%.

As the median age of infection in Florida has fallen, associate professor of epidemiology at the University of Florida, Cindy Prins, believes improper adherence to social distance and mask-wearing is a factor, saying, ““I’m definitely seeing when I’m out and about that people are not necessarily adhering to social distancing guidelines, that they’re not necessarily wearing a mask or wearing it correctly.”

Similarly, Arizona has experienced rapid COVID escalation of late, with some hospitals nearing capacity and Governor Doug Ducey also issuing a facemask requirement. Ducey recently admitted, “I said two weeks ago that there is not a trend here. Looking at the last two weeks of data, there is a trend. And the trend is headed in the wrong direction and the actions we’re going to take are intended to change that direction and reverse this trend.”

Nevada and Texas have also seen recent infection-rate spikes.

Travel, Sports Face Uncertain Future

More than three months into the pandemic, Americans are eager to return to usual activities, hoping to watch sports and travel for business and pleasure. However, coronavirus spikes and other uncertainty shroud these activities. The aviation industry has been hit hard. Southwest Airlines has fared better than most airlines, but is still operating at only 40% of its usual capacity for this time of year.  Closed borders, a halt on business travel, and pocketbooks hit by recession are all factors in decreased travel. Moreover, leery travelers worry about safety due to lax enforcement of in-flight mask policies. Delta and American Airlines intend to remedy such laxity with strict, new policies of enforcement, while JetBlue, hopeful for a travel uptick, will reinstate some flights beginning in July and August.

Further complicating matters is the fact that many states have imposed quarantine measures for out-of-state travelers, reducing the appeal or practicality of interstate travel. Recently, New York, New Jersey, and Connecticut announced a 14-day quarantine for any individuals traveling from viral hotspots, including Alabama, Arizona, Arkansas, Florida, North Carolina, South Carolina, Washington, Utah, and Texas. These nine states are being monitored, with the potential to fall off that list if infection rates improve. Of course, other states could find their way onto the list if they experience similar spikes.

Another staple of summer, Major League Baseball, has faced uncertainty, missing its usual opening day and having proposed a shortened, 60-game season to begin July 19. However, the Philadelphia Phillies recently confirmed that five players and three staff are COVID-19 positive. As a result, the team closed its spring training facility indefinitely, casting an air of uncertainty over the viability of a 2020 season. As NFL teams begin to practice, in anticipation of a September 10 start date, White House advisor Dr. Anthony Fauci has offered a grim prediction: “Unless players are essentially in a bubble — insulated from the community and they are tested nearly every day — it would be very hard to see how football is able to be played this fall.”

Retail Opens, and Closes

Over the past several weeks, many of the business that shut down in March have begun to reopen. In New Jersey, one of the areas hardest hit by illness, Governor Phil Murphy has announced a June 29 mall reopening, with stores at 50% capacity and face coverings required. New York is also preparing for its next opening phase, to include offices, in-store retail, hair salons, barbershops, real estate, and auto sales.

However, some stores that have resumed business are being forced to close again. Apple, which had reopened the majority of its stores, is one such business. The closures include eleven stores in hotspot states – Florida, Arizona, North Carolina and South Carolina. According to an Apple spokesperson, “Due to current COVID-19 conditions in some of the communities we serve, we are temporarily closing stores in these areas. We take this step with an abundance of caution as we closely monitor the situation and we look forward to having our teams and customers back as soon as possible.”

Retail has been hit especially hard during the pandemic. Apple stock prices fell upon the announcements of these re-closures, while Triple Five Group missed a $7 million mortgage payment in June for its Mall of America in Minnesota.

PPE Still Necessary for Successful Reopening

A common thread as retail, travel, sports and other services seek to resume and stay open is the necessity of face-coverings. From tightened airline restrictions to mask-wearing mandates, protective face-coverings appear to be a feature of everyday life that is not going away anytime soon.

As certain industries reopen, demand for PPE has increased, but some businesses are finding the necessary equipment in short supply. According to Don Yoshikawa, a dentist in Huntington Beach, California, “It’s been impossible to get enough proper PPE equipment. My dental supply company has been on back-order for months.”

To meet the need for face masks and other PPE, companies such as Blueflame Medical have stepped in the gap to source and distribute these high-demand items. What is clear is that facemasks and other protective equipment will continue to be essential as Americans move to resume, and retain, their usual routines and activities.

PPE Shortages

To Reopen Economy, PPE Shortages Must Be Addressed

In the fight against Covid-19, personal protective equipment (PPE) such as masks, gloves, and gowns is critical to protecting the wellbeing of health care and other front line workers. Nevertheless, from hospitals to fire stations, these items have been in short supply. Nationwide, as social distancing measures continue, local, state, and federal governments cite the necessity of PPE availability as they seek to reopen the economy. 

California was the first state to issue a stay-at-home order on March 19. Since then, the vast majority of states have followed suit with some measure of social distance mandates. While experts laud the efforts and indicate that we have seen a large measure of success in flattening the curve, the collateral has come in the form of significant job loss and economic stagnation. As states make plans to reopen their economies and businesses implement hygiene practices required to keep employees and patrons safe, PPE shortage remains a major concern. 

States’ Plans for Reopening Dependent on PPE supplies

Several states have planned, or have already begun, multi-phase easing of restrictions. In some cases, governors are making decisions on a county- by-county basis in coordination with local municipalities. These decisions hinge not only on infection rates, but also PPE supplies. In Oregon’s Deschutes County, for example, city officials feel confident that PPE supply level are adequate, though they still need more N95 masks. In Washington, Governor Inslee has extended the stay-at-home order through May 31, while outlining a 4-step plan for reopening. Ten counties with lower infection rates may apply for more rapid opening, provided PPE supplies and medical capacity remain adequate. 

New York, meanwhile, is devising a 12-step plan for reopening, but as yet remains unprepared, with too few masks and inadequate testing capacity. States such as Maine and Virginia have also begun to unveil their plans to reopen, with PPE being a central feature. In Maine, residents must wear face coverings, while health care providers that have heretofore been subject to lockdown must be sure to “manage the use of essential resources such as personal protective equipment and testing supplies” as they reopen.  Governor Ralph Northam of Virginiaexpressed confidence in his state’s progress as far as PPE supply and testing capacity, but has emphasized the need to maintain this stream of goods in order to successfully and fully reopen. 

Even Where Reopening Allowed, Many Businesses Delay Due to PPE Shortage 

Even as states make moves to lift restrictions, many business and industries are ill equipped to open their doors. In Georgia, one of the first states to lift its stay-at-home mandate, beauty salon owner Alyson Hoag says that she is not ready to reopen, even though the state has given her the green light. According to Hoag, “We need to be in protective gear. I need time to get the supplies and sterilize the studio.” 

Similarly, West Virginia businesses must provide appropriate PPE to employees as a condition of reopening, but many business owners cannot find these supplies due to the nationwide shortage. In Arizona, Green Valley Recreation, which owns and runs several recreation centers, says that PPE equipment required to open for business, which they ordered during the first half of March, still had not arrived as of May 1.

Some dental offices have likewise indicated that they cannot open due to insufficient PPE. The American Dental Association has published a guide for recommended PPE and cautioned dentists to consider the availability of these items before seeing patients again. 

Why the PPE Shortage?

Although the federal government maintains a stockpile of items such as respirators and ventilators, that supply has proven insufficient. For example, the stockpile includes 15,000 ventilators, but New York City alone expects to need 16,600. A further problem is the supply chain for obtaining such goods. Much of our needed medical equipment comes from China, and when the pandemic there began to spread, supply chains were disrupted as exports from China came to a halt. As conditions in China have improved, they have shipped items, such as masks, to other countries as part of goodwill packages, of which the United States has not been a recipient. 

While some companies stateside, such as Ford Motor Company, have converted their factories to produce these high-need goods, new business like Blueflame Medical have emerged as purveyors of PPE and Covid-19 testing equipment. Other efforts to extend current supplies include decontaminating and reusing items such as masks. 

Conclusion 

With joblessness, lost wages, and lockdown fatigue on the rise, private citizens as well as state and federal governments understand the urgent need to reopen the economy as soon as possible. Doing so safely, however, is key.  In addition to sickening workers, experts warn that moving too quickly without sufficient precautions risks undoing progress made in the fight against Covid-19, further extending the economic and social impact of this deadly pandemic. They say that increasing the availability of PPE is crucial to a safe and lasting reopening.