Covid-19 May Have You Working At Home

The numbers don’t tell the whole story. Nine Americans have died of Covid-19, and the Centers for Disease Control and Prevention confirms more than 100 cases in 15 states. But there are probably already several thousand Americans who have been infected. For now, the average person’s risk is low in a nation of 330 million, but that may soon change. The highest risk is for those who live in regional hot zones such as Washington state or Northern California.

Measures that limit social activity may soon be in place. China tried to curb transmission by shutting down entire cities and mandatory mass quarantines. That won’t fly in the U.S., socially or legally. Iran is taking the opposite approach amid what may be a wider epidemic. Tehran appears resigned to letting the virus rage through the country’s population. Iran’s official reports say there are 2,300 cases in the country with 77 deaths, but the true number is likely much higher.
There’s still a chance to delay an American epidemic, though full containment is no longer possible. The key is to develop a strategy of mitigation, which will buy time to prepare hospitals, expand testing, and develop vaccines and therapies. This doesn’t mean the U.S. needs to ban people from moving freely in the country, which has happened in China and even Italy. Public-health authorities must develop an approach suited to American law, technology and social structures.

The original priority was tightening travel to and from China. But travel restrictions and advisories will become obsolete as the number of affected countries grows. Any of the thousands of airplanes that land in the U.S. each day could be carrying people who are infected. Airports should remind incoming travelers to isolate themselves and seek medical care if they develop symptoms. Decisions to travel outside the U.S. will largely depend on factors such as individual’s risk tolerance, health status, and the ability to access medical care in a foreign country.

As the number of cases expands, other time-worn public-health measures for containing disease—detecting infected individuals and tracing their contacts—will no longer be enough. Slowing down community spread may require aggressive steps aimed at “social distancing”—keeping people who are sick away from others. The CDC provides guidance to help states and cities put these measures into place—for example, canceling mass gatherings or closing schools and conducting classes online. But it’s up to local authorities to decide what measures to implement. A patchwork of policies may initially confuse the public.
The usual flu-season advice applies: Wash your hands frequently, avoid handshakes, and try not to touch your face. Most important, stay home when you or someone in your household is sick. For home isolation and quarantine to work, employers need to be as understanding and flexible as possible. They can help by holding videoconferences instead of meetings and letting employees work from home. Some may consider alternative schedules or staggered shifts.
These measures will be most effective if applied early and widely. Singapore suspended mass gatherings at schools and eldercare facilities immediately after detecting local disease transmission. This appears to have slowed the number of new infections. But it is important to acknowledge that these measures can cost workers money and even their jobs.
The coming weeks will be hard as more Americans become infected and some die of the disease. Mitigation efforts will be disruptive. But these steps are the best defense until innovation can produce an effective treatment or vaccine that can arrest the virus’s spread.
Dr. Borio is a vice president at In-Q-Tel and was director for medical and biodefense preparedness policy at the National Security Council, 2017-19. Dr. Gottlieb is a resident fellow at the American Enterprise Institute and a partner at New Enterprise Associates. He was commissioner of the Food and Drug Administration, 2017-19.
https://www.wsj.com/articles/covid-19-may-have-you-working-at-home-11583279399

$30 checkup, without insurance? Walmart wants to make it happen

Venturing further into the health care arena, Walmart is testing out yet another concept in providing some forms of care whether customers are insured or not.
According to a KCRA report, Walmart is testing its new health center in Georgia, where customers can stop in to see a doctor for routine checkups as well as for ongoing treatment of chronic illnesses like diabetes and heart disease—even if they have no health coverage.

It’s not free, of course, but the costs are low at “Walmart Health”—and not just for the abovementioned services. The facility, which opened in January, also offers lab work, X-rays, dental care, behavioral health counseling, eye and hearing exams and other services—with the bill for an annual adult checkup just $30 without insurance. Eye exams are $45, while dental exams are $25. They can even get therapy sessions for $60.

There are two of these health centers; the first is in Dallas, Georgia, and opened back in September; this second one is located in Calhoun, Georgia. Walmart would like to wade into the health care market’s 15+ percent share of the national economy and hopes that such heath centers can do the job.
By starting in areas in which care is both expensive and hard to come by, Walmart hopes to make some inroads against conventional health insurance by providing primary care options to those who normally may have little or no access to care for chronic diseases (both areas have higher-than-normal rates) and fewer primary care physicians to go to (again, a circumstance haunting the regions around both new health centers).
According to KCRA, “Walmart believes it can fill that gap for its customers without health insurance, as well as those who have insurance plans with high deductibles and out-of-pocket costs.” And it thinks it can do so by easing its own doctors into the slots currently filled—when available—by patients’ current primary care providers.
It certainly won’t hurt the megachain’s retail side, with health care bringing in ready-made customers in the form of patients who can’t get—or can’t afford—care anywhere else. And the addition of medical, dental and therapist care, in addition to its already-established pharmacies and optical departments, signals not just a broader approach but also a more concentrated effort to enlarge the relationship it already has with its customers.
In doing so, it’s challenging not just Amazon’s efforts to provide health care, but also CVS and Walgreens clinics—and it thinks it can be profitable, because it’s not operating the same way as the current health care system. In addition, it has all those big-box stores and massive parking lots to take advantage of.
Walmart vice president of health and wellness transformation Marcus Osbore, speaking in an interview, explained that those who visit its clinics have not seen a primary care provider or dentist in a number of years, and that for many patients, this was their first opportunity to access mental health services.
https://www.benefitspro.com/2020/03/05/a-30-checkup-without-insurance-walmart-wants-to-make-it-happen/?slreturn=20200205214202

3 Who Attended Biogen Meeting in Boston Test Positive for Coronavirus

Three people who attended a meeting with Biogen employees in Boston last week have tested positive for the coronavirus, the company said Thursday.
Following a meeting with Biogen employees in Boston last week, a number of attendees reported varying degrees of flu-like symptoms. Some attendees have been confirmed with influenza and three attendees have tested positive for COVID-19 to date,” Biogen said in a statement. “At the present time, these individuals are doing well, improving and under the care of their healthcare providers.”
“Protecting our employees and our communities is our priority,” the company added.
Everyone who attended the meeting, whether they have symptoms or not, have been directed to work from home for the next two weeks, Biogen said. Anyone who feels sick is being advised to contact their healthcare provider.
The company said it will also be taking other precautionary measures, including restricting travel through the end of March.
Biogen is a 42-year-old biopharmaceutical company that has created treatments for diseases and conditions like Alzheimer’s and multiple sclerois. Its headquarters are in Cambridge.

3 Who Attended Biogen Meeting in Boston Test Positive for Coronavirus

DOJ Launches a National Nursing Home Initiative

U.S. Attorney Peter G. Strasser of the Eastern District of Louisiana joined Attorney General William P. Barr on March 3, 2020 to announce the Department of Justice’s National Nursing Home Initiative, which will coordinate and enhance civil and criminal efforts to pursue nursing homes that provide grossly substandard care to their residents.

This initiative is focusing on some of the worst nursing homes around the country and the Department has already initiated investigations into approximately thirty individual nursing facilities in nine states as part of this effort.

“Millions of seniors count on nursing homes to provide them with quality care, and to treat them with dignity and respect when they are most vulnerable,” said Attorney General William P. Barr.  “Yet, all too often, we have found nursing home owners or operators who put profits over patients, leading to instances of gross abuse and neglect. This national initiative will bring to justice those owners and operators who have profited at the expense of their residents, and help to ensure residents receive the care to which they are entitled.”

“As the population of our nation ages, more and more American families rely on nursing homes to provide quality care to their loved ones,” said U.S. Attorney Peter G. Strasser.  “Sadly, however, the instances of physical, psychological, or financial neglect have become more common.   The implementation of The National Nursing Home Initiative provides another tool to ensure the welfare of our elderly family members that we have entrusted to the care of nursing homes.  The ultimate goal of this worthy initiative is to root out those nursing homes that prey on both their elderly residents as well as the family of those residents.”

“The mission of the FBI is to protect the rights of all Americans, especially those who cannot protect themselves,” said Bryan A. Vorndran, FBI New Orleans Special Agent in Charge. “People housed in nursing homes rely on the support, attention, and care of the nursing home staff to fulfill their basic needs.  Too often, we hear of situations of abuse by nursing home personnel to a family member or friend residing in an assisted living facility.  We urge Americans to report this abuse and mistreatment, so we can bring justice to those who seek to defraud or abuse the most vulnerable members of our community.”

The department considers a number of factors in identifying the most problematic nursing homes.  For example, the department looks for nursing homes that consistently fail to provide adequate nursing staff to care for their residents, fail to adhere to basic protocols of hygiene and infection control, fail to provide their residents with enough food to eat so that they become emaciated and weak, withhold pain medication, or use physical or chemical restraints to restrain or otherwise sedate their residents.  These care failures cause residents to suffer in pain and to be exposed to the great indignities.  Care failures cause residents to develop pressure sores down to the bone, to lie in their own waste for hours, to starve because they cannot reach the food on their trays and to remain unwashed for weeks at a time.  Nursing homes that provide grossly substandard care also force vulnerable elderly residents who cannot leave the facilities to live in filthy and dangerous conditions where there are leaks in the roofs, mold is found growing and rodents found living in residents’ rooms.  These are some of the actions and the inactions that the department intends to pursue.

The National Nursing Home Initiative reflects the department’s larger strategy and commitment to protecting our nation’s seniors, coordinated by the department’s Elder Justice Initiative in conjunction with the U.S. Attorneys’ Offices.  The Elder Justice Initiative and the U.S. Attorneys’ Offices are essential to the department’s investigative and enforcement efforts against nursing homes and other long-term care entities that deliver grossly substandard care to Medicare and Medicaid beneficiaries.  The Initiative and the U.S. Attorneys’ Offices also support the efforts of state and local prosecutors, law enforcement, and other elder justice professionals to combat elder abuse, neglect and financial exploitation, with the development of training, resources, and information.  Learn more about the Justice Department’s Elder Justice Initiative at http://www.justice.gov/elderjustice/.

https://www.justice.gov/usao-edla/pr/department-justice-launches-national-nursing-home-initiative

As India coronavirus cases spike, experts daunted by prospect of South Asia spread

India has ramped up the screening of travelers to keep the coronavirus at bay but a flurry of new cases has experts warning that it may be hard to contain a spread in densely populated South Asia with its generally poor medical infrastructure.

India, Pakistan and Bangladesh are home to some 1.7 billion people, or more than a fifth of the world’s population, but their over-stretched health systems could struggle to handle the type of intensive care required for coronavirus patients.
On top of that, a prevalence of existing health problems such as diabetes could spell trouble while the sort of sweeping restrictions China has imposed to stifle the virus would be hugely difficult in South Asia’s more unruly cities.
“The way Indian society is structured, the kind of lockdown that many countries including China and Japan have instituted, is pretty much impossible even under good circumstances,” said Vivekanand Jha, executive director of the George Institute for Public Health, in New Delhi.
India’s total confirmed coronavirus rose to 29 on Wednesday, from six early this week.
The coronavirus, which emerged in China late last year, has infected more than 95,000 people globally, and killed more than 3,200, most of them in China.
Some health experts fear that even with the recent spike in cases, India’s actual tally could be much bigger.
“There is a strong possibility that the number of cases in India is much higher than what has been detected,” Arunkumar G., director of the Manipal Institute of Virology, said, citing a virus incubation of up to two weeks.
Fears were fanned this week when India’s health minister disclosed that 16 foreign tourists who have tested positive had been touring since mid-February.
Last week, U.S. intelligence sources told Reuters that India’s available countermeasures and the potential for the virus to spread its dense population was a focus of serious concern.

‘ALL INITIATIVES’

India’s government says it has screened more than one million travelers, boosted its testing capabilities and set up isolation wards in all major cities with international airports.
But 450 million of India’s 1.3 billion people are estimated to be migrants, with vast numbers packing its rail and road systems daily meaning controlling any spread would be a huge challenge.
India’s high number of diabetics – 77 million – and high rates of problems like kidney disease could lead to higher morbidity, or protracted treatment, experts said.
“One particular risk of India is the co-existence of other non-communicable disease epidemics,” Dr Rajib Dasgupta, who is a professor of community health at the Jawaharlal Nehru University in New Delhi.
Prime Minister Narendra Modi’s government says it is confident of its ability to arrest the spread of the virus.
“Coronavirus is a challenge, but the government of India has taken all initiatives to ensure that it is stopped,” said D.V. Sadananda Gowda, minister of chemicals, who oversees the pharmaceuticals sector.
Neighboring Pakistan has found five coronavirus cases. A top health official was gloomy about the prospects of tackling a major outbreak.
“We don’t have human resources, we don’t have the required inventory, we don’t have a capacity to cope with a big emergency with the given resources,” Shahid Malik, secretary general of the Pakistan Medical Association, told Reuters.
Bangladesh has not confirmed any cases of the coronavirus but five Bangladeshi workers have tested positive in Singapore.

Bangladesh’s health ministry said more than 300,000 people have been screened at airports and other border entry points.
But one passenger was not impressed by what he considered lax screening upon arrival in the capital, Dhaka.
“Many of us could skip the screening. Just imagine what would happen if someone infected with the virus enters. It’ll be a total disaster,” Farid Yamin, a Bangladeshi working in Singapore, told Reuters.
https://www.reuters.com/article/us-health-coronavirus-southasia/as-india-coronavirus-cases-spike-experts-daunted-by-prospect-of-south-asia-spread-idUSKBN20S0WR

South Korea declares new ‘special care zone’ as coronavirus spreads

South Korea declared a “special care zone” on Thursday around a second city hit hard by the coronavirus and the U.S. military confirmed two new cases among relatives of its troops in the country, which is battling the biggest outbreak outside China.

Australia and Japan have joined the list of almost 100 nations now limiting arrivals of people from South Korea, which reported 760 coronavirus cases on Thursday for a total of 6,088.
Japanese Prime Minister Shinzo Abe said Japan will suspend existing visas for visitors from China and South Korea and quarantine them for two weeks in response to the widening outbreak of the flu-like virus.
The measures will go into effect on March 9.

Following the announcement, the South Korean Foreign Ministry summoned a Japanese diplomat to “hear Japan’s explanations regarding its announcement,” Yonhap news agency reported, citing a ministry official.
The South Korean government declared a “special care zone” around Gyeongsan, a city of about 275,000 people 250 km (150 miles) southeast of Seoul, promising extra resources such as face masks.
Gyeongsan has seen a spike in cases in recent days, many of them linked to a fringe Christian group at the center of South Korea’s outbreak. Similar zones have been declared around the neighboring city of Daegu and Cheongdo County.
About 75% of all cases in South Korea are in and around Daegu, its fourth-largest city, according to the Korea Centers for Disease Control and Prevention (KCDC).
“Every day is sad and tough like a war. But our Daegu citizens are showing surprise wisdom and courage,” Daegu Mayor Kwon Young-jin told reporters on Thursday.
About 2,120 patients were waiting for hospital beds in Daegu, city officials said. Dozens of newly commissioned military nurses were due to begin work in the city on Thursday, according to the health ministry.
The KCDC reported five more deaths from the virus, bringing the total to 37. The virus surfaced in China late last year and has infected more than 95,300 people and killed almost 3,300 worldwide, mostly in China, according to a Reuters tally.
South Korea also said it was banning the export of face masks, and would step up their production and ration them to limit individual purchases to two a week, in an attempt to ease shortages and curb hoarding.
People have flocked to supermarkets, pharmacies and online distributors to snap up masks and other supplies, with hundreds lining up at some stores every morning.

KCDC Deputy Director Kwon Jun-wook advised all South Koreans to stay home and avoid “any gatherings, especially those that take place in enclosed places with many people such as religious events”.
He also advised employers in Asia’s fourth-largest economy, highlighted by tech giants like Samsung Electronics Co Ltd, to allow staff to work from home.

‘DEEPLY REGRETTABLE’

U.S. Forces Korea (USFK) reported two new cases, for a total of six among soldiers, employees or people related to the roughly 28,500 U.S. troops stationed in South Korea.
Despite the new cases, USFK had resumed sending troops to bases in Daegu and surrounding areas, according to the military newspaper Stars and Stripes.

It said commanders believed the bases were protected from the outside population, and troop rotations were needed to maintain readiness in the face of threats from nuclear-armed North Korea.
Australia’s ban on the arrival of foreigners from South Korea is a blow to Seoul’s efforts to prevent the United States from imposing such restrictions.
“It is a deeply regrettable step, and we will closely consult Australian authorities for a swift revocation of the measure and to minimize inconvenience for our citizens,” Foreign Ministry spokesman Kim In-chul told reporters.
South Korean officials met the U.S. ambassador in Seoul on Wednesday to urge the United States not to limit travel. Similar talks would be held on Friday with diplomats from other nations, the Foreign Ministry said.
According to the U.S. State Department, anyone with a fever of 100.4 Fahrenheit (38 Celsius) is already banned from boarding direct flights from South Korea to the United States.
Korean Air Lines said it would screen all departing passengers for high temperatures and reject those deemed a risk.
South Korea also sent three “rapid response” teams to Vietnam on Thursday to help more than 270 citizens quarantined there over coronavirus concerns, the Foreign Ministry said.
https://www.reuters.com/article/us-health-coronavirus-southkorea-toll/south-korea-declares-new-special-care-zone-as-coronavirus-spreads-idUSKBN20S04O

U.S. will be able to test 400,000 people for coronavirus by week’s end: officials

U.S. health officials said on Thursday they expect to be able to get enough coronavirus tests to public laboratories this week to test about 400,000 people, and acknowledged the challenge for doctors seeking to get patients screened for the disease.
Officials expect to ship additional test kits to cover between 1.5 and 1.7 million people by the end of next week, U.S. Health and Human Services Secretary Alex Azar told reporters.
“Right now, it is a challenge if you are a doctor wanting to get somebody tested,” Azar said, following a briefing with lawmakers, adding that physicians could only reach out to a limited network of public health labs.
“That experience will get better over the next week, week and a half, two weeks. But do not be surprised if you hear concerns of doctors saying: ‘I have a patient. I don’t know how to get this done,’” Azar told reporters.
The private contractor that makes the test used by the Centers for Disease Control and Prevention (CDC) for public labs – privately held Integrated DNA Technologies Inc, or IDT – is seeking to get its test to hospitals and other labs for wider use in the coming days.
Separately, other HHS officials offered a lower expected rate of mortality from the coronavirus than that estimated by the World Health Organizations, saying it was hard to quantify because many people with the disease do not experience severe enough symptoms to get tested.

The best estimate of the overall mortality rate from the novel coronavirus lies somewhere between 0.1% and 1%, U.S. Assistant Secretary for Health Brett Giroir said.
The WHO this week said about 3.4% of confirmed cases of COVID-19 have died.
https://www.reuters.com/article/us-health-coronavirus-usa-risk/u-s-will-be-able-to-test-400000-people-for-coronavirus-by-weeks-end-officials-idUSKBN20S22M