Germany reports third straight drop in daily rate of new coronavirus infections

Germany’s confirmed coronavirus infections rose by 5,936 in the past 24 hours to 91,714 on Sunday, the third straight drop in the daily rate of new cases, according to data from the government’s Robert Koch Institute.
Sunday’s figure amounted to a drop of 146 cases compared with 6,082 new infections recorded on Saturday, itself a fall from 6,174 new infections on Friday.
The reported death toll rose by 184 to 1,342.
https://www.reuters.com/article/us-health-coronavirus-germany-infections/germany-reports-third-straight-drop-in-daily-rate-of-new-coronavirus-infections-idUSKBN21N0EF

As COVID-19 deaths steady, Italy’s health minister eyes next phase

Roberto Speranza said it was too early to say when Italy would be able to lift the measures imposed across the country on March 9, when it became the first country in Europe to impose a general lockdown to slow the spread of the virus.
With more than 15,000 dead, Italy has the world’s highest death toll from disease, accounting on its own for almost a quarter of all deaths globally. But the government is also grappling with the economic devastation caused by the sudden halt to business across the country.
“There are difficult months ahead. Our task is to create the conditions to live with the virus,” at least until a vaccine is developed, he told the daily La Repubblica newspaper, adding that some social distancing measures would also have to remain.
The smallest daily rise in COVID-19 deaths for nearly two weeks on Saturday and the first fall of the number of patients in intensive care have fed hopes that the epidemic may have reached a peak in Italy and focused attention on the next phase in the crisis.
The national lockdown, strictly limiting people’s movements and freezing on all non-essential economic activity, will officially last until at least April 13 but it is widely expected to be extended.
“If we’re not rigorous we risk throwing away all the efforts we’ve made,” Speranza said in separate comments to the Corriere della Sera daily.
Speranza said he had issued a note outlining five principles around which the government planned to manage the so-called “phase two” of the emergency, when lockdown restrictions begin to be eased but before a full return to normal conditions.

He said social distancing would have to remain, with wider use of individual protection devices such as face masks, while local health systems would be strengthened, to allow a faster and more efficient treatment of suspected COVID-19 cases.
Testing and “contact tracing” would be extended, including with the use of smartphone apps and other forms of digital technology while a network of hospitals dedicated solely to treating COVID-19 patients would be set up.
“Until a vaccine is distributed, we cannot rule out a new wave of the virus,” he said.
https://www.reuters.com/article/us-health-coronavirus-italy/as-covid-19-deaths-steady-italys-health-minister-eyes-next-phase-idUSKBN21N0GA?il=0

Non-COVID medical emergencies take a back seat, putting patients at risk

“I would rather die than risk getting coronavirus right now.”

That’s what a patient told Dr. Comilla Sasson, an emergency medicine physician in Denver, after she advised the patient during a telemedicine visit that she was showing signs of a heart attack and should go to a hospital.

“I asked if I could talk to one of her family members and she said ‘no’ — that she had already made up her mind,” Sasson told NBC News. It’s unclear what the woman’s diagnosis turned out to be, because she did not reach out to Sasson again.

In the midst of the coronavirus pandemic, medical emergencies unrelated to COVID-19 still occur. Sasson, who works at three hospitals in the Denver area, is among a number of doctors who worry that people experiencing warning signs of life-threatening conditions are delaying seeking emergency help out of fear of going to coronavirus-strained emergency rooms.

“Every minute that you delay, the likelihood of you having a worse outcome increases,” said Sasson, who is also vice president for science and innovation for emergency cardiovascular care at the American Heart Association.

She used a heart attack as an example: “If you get to the hospital within a few minutes, we can open up that heart vessel and get blood flowing to your heart, but if you delay even a few hours, that could be the difference between life and death.”

Fear or benevolence?

At the height of the coronavirus outbreak in Hong Kong, doctors observed the same trend that U.S. doctors are seeing now. In a letter in the journal Circulation: Cardiovascular Quality and Outcomes, physicians wrote that people who were experiencing symptoms of a heart attack waited to seek care after hospitals had suspended nonessential visits. Treatment for a heart attack, however, is essential.

According to Dr. Dhruv Kazi, a cardiologist at Beth Israel Deaconess Medical Center in Boston, putting off seeking medical care for potentially life-threatening conditions unrelated to COVID-19 is likely fueled by multiple factors: people choosing not to go to the hospital out of fear of contracting the virus, lack of transportation to the hospital, and citizens concerned about clogging the medical system.

“Whether it’s benevolence or fear of exposure, we need to address that,” he said.

Kazi is most worried about people who are experiencing acute symptoms that could snowball into a severe condition if left untreated.

“Individuals who are having very extreme heart attacks are going to get help, but at the fringes you have people who have acute symptoms who are staying home,” said Kazi. “I am worried that these patients could suffer severe consequences weeks or months down the road that could have been avoided if we had intervened.”

Most hospitals have instituted telehealth programs that allow patients to seek a medical evaluation remotely. In a situation that is not potentially life-threatening, these lines should always be used over showing up at a hospital, but people should still follow typical protocol for all medical emergencies during the pandemic, not just those related to the virus, Kazi said.

“I do not recommend that if patients are having warning signs of a heart attack or stroke that they should try and use telehealth to reach their doctor,” Kazi said. “These warning signs should result in a 911 call, and because EMS may be busy, calling 911 in a timely manner is even more important right now.”

Delaying care could also put more strain on the health care system in the long run.

“If people defer calling 911 for life-threatening emergencies or put off life-saving procedures because they’re afraid of getting exposed to the coronavirus in emergency rooms or hospitals, we can expect to see an increase in deaths among these people that is not reflected in COVID-19 death toll numbers,” said Kazi.

Emergencies in New York City

In New York City, the national center of the pandemic, 911 calls are at all-time highs, fleets of first responders are coming down with COVID-19 and wait times for ambulances have exceeded six hours in recent weeks.

But according to Oren Barzilay, president of the FDNY EMS Local 2507, which represents 4,500 first responders in New York City, call priorities, which determine where help is sent first, have not changed because of COVID-19. Low-priority calls are the ones experiencing these significant delays, not high-priority emergencies.

In fact, holding off on calling 911 until heart attack symptoms worsen could make it impossible for New Yorkers to get to a hospital at all. The Regional Emergency Medical Advisory Committee of New York City announced on Tuesday, March 31, that if an adult is in cardiac arrest and emergency responders are unable to restart their heart at the scene after 20 minutes, that person will not be taken to the city’s overburdened hospitals for further revival attempts, as is normally the case. This means seeking help when symptoms start is even more crucial.

“If anybody is experiencing a true emergency, we will always be there for you. We will never turn anyone away,” Barzilay said.

That goes for doctors working in New York City hospitals as well, though they are carefully weighing treatment options to keep emergency patients from staying in the hospital when possible, said Dr. Daniel Herron, the chief of general surgery at Mount Sinai Health System.

One example is appendicitis: “If a patient presents with abdominal pain which is strongly suggestive of appendicitis, which can be treated with surgery or with antibiotics, we would lean very heavily toward the treatment option that minimizes the use of hospital resources, which would be the antibiotic option,” Herron said. But “in cases where there is only a surgical option, then surgery is still available.”

https://www.nbcnews.com/health/health-news/coronavirus-surges-non-covid-medical-emergencies-take-back-seat-putting-n1175871

India curbs diagnostic testing kit exports as virus spreads

India is restricting the export of most diagnostic testing kits, as coronavirus cases in the South Asian nation topped 3,350 on Sunday despite a three-week nationwide lockdown to slow the spread of the respiratory disease.

India, which in recent weeks already banned the export of certain drugs, along with ventilators, masks and other protective gear needed by both patients and medical staff, issued the latest directive on Saturday.
The move comes even as U.S. President Donald Trump urged Prime Minister Narendra Modi in a phone call on Saturday, to release supplies of anti-malaria drug hydroxychloroquine, which is being tested as a possible treatment for patients with COVID-19 – the disease caused by the coronavirus.
“The two leaders agreed to remain in touch on the issue of global supply chains for critical pharmaceuticals and medical supplies and to ensure they continue to function as smoothly as possible during the global health crisis,” White House spokesman Judd Deere, said in a tweet on Saturday.
In a briefing note on the conversation, India said the two leaders “agreed to deploy the full strength of the India – U.S. partnership to resolutely and effectively combat COVID-19.”

BANGLADESH STIMULUS PLAN

The total number of confirmed COVID-19 cases in South Asia, home to roughly 1.9 billion people, climbed close to 7,000 on Sunday, even as the death toll from the respiratory disease in the Indian subcontinent rose to 143.
While the figures are relatively low in comparison with the United States, China, Italy and Spain, health experts fear that the spread of the pandemic in South Asia would overwhelm already weak public health systems in the region.
Bangladesh’s Prime Minister Sheikh Hasina on Sunday unveiled a 727.50 billion taka ($8.56 billion) stimulus package to help the economy overcome the impact of the coronavirus outbreak.
“The amount is equivalent to 2.52 percent of gross domestic product,” Hasina said in a televised address.
Reuters earlier this month reported that Bangladesh, the second-largest apparel producer after China, is set to lose roughly $6 billion in export revenue this financial year amid order cancellations from some of the world’s largest brands and retailers.
Bangladesh has so far recorded 88 cases of the disease that has so far claimed nine lives.
Following are government figures on the spread of the coronavirus in South Asia:
– India has 3,374 cases, including 77 deaths
– Pakistan has 2,880 cases, including 45 deaths
– Afghanistan has 337 cases, including 7 deaths
– Sri Lanka has 166 cases, including 5 deaths
– Bangladesh has 88 cases, including 9 deaths

– Maldives has 32 cases and no deaths
– Nepal has nine cases and no deaths
– Bhutan has five cases and no deaths
https://www.reuters.com/article/us-health-coronavirus-southasia/india-curbs-diagnostic-testing-kit-exports-as-virus-spreads-idUSKBN21N0BE?il=0

Trump: May take drug to treat Covid-19, questions states’ ventilator needs

President Donald Trump on Saturday doubled down on his support for a drug that is still being tested to treat the coronavirus, saying he might take the medicine himself and encouraging others with doctor approval to do the same.

At his daily press briefing, Trump also chided some states for requesting more ventilators from the federal government than he said they needed.
Trump said the next week would be particularly tough with a “lot of death” coming from the coronavirus. But he also reiterated his concern that the social distancing “cure” for the outbreak was worse than the problem.
Trump faced criticism for initially playing down the risks of the coronavirus and has vacillated between warning Americans about its severity and complaining about its economic costs.
Trump’s optimistic comments on Saturday about the benefits of anti-malaria drug hydroxychloroquine to treat COVID-19, the disease caused by the coronavirus, reflected his tendency to put a positive spin on an issue even as data was still being gathered.
“I may take it,” Trump said. “I’ll have to ask my doctors about that, but I may take it.” Trump has been tested twice for the coronavirus, according to the White House, and both times the results were negative.
The European Commission said this week that the efficacy of hydroxychloroquine treating COVID-19 had not been proven.
Trump said the federal government had 29 million doses of the drug and was adding to its national stockpile. He said he had asked Indian Prime Minister Narendra Modi on Saturday to lift a hold on a U.S. order of the drug as well.
The U.S. Food and Drug Administration has issued an emergency authorization for the drug to be distributed from the national stockpile for doctors to prescribe to hospitalized COVID-19 patients, even as tests continue to be conducted and data collected.
“We’re just hearing really positive stories and we’re continuing to collect the data,” Trump said.
The president said fears of shortages had prompted U.S. states to request more ventilators than they needed. He said the federal government had 10,000 in its stockpile. “Some states have more ventilators than they need, they don’t even like to admit it,” he said.
The president, a Republican who is running for re-election in November, also praised Republican governors who have not issued “stay at home” orders for their states.
“They’re doing very well and they’re doing a magnificent job of running their states,” he said.
Even as top doctors emphasized the importance and effectiveness of social distancing measures, Trump again seemed to chafe at their impact on the economy.

“We’re not going to destroy our country,” he said. “We cannot let this continue, so at a certain point some hard decisions are going to have to be made.”
The current federal guidelines, which include admonitions for people to wash their hands and avoid groups larger than 10, are in place through the end of April.
https://www.reuters.com/article/us-health-coronavirus-trump/trump-says-he-may-take-drug-to-treat-coronavirus-questions-states-ventilator-needs-idUSKBN21N011

Welltower drops £2.5B bid for Barchester

Welltower (NYSE:WELL) has dropped its £2.5B bid to buy nursing home group Barchester Healthcare, the Sunday Times reports.

That pullout comes amid the ongoing pandemic, which is shifting business plans worldwide.

Barchester employs more than 17,000 to run more than 200 care homes and seven registered hospitals in the UK, with more than 12,000 beds.

https://seekingalpha.com/news/3558443-welltower-drops-2_5b-bid-for-barchester-report

Big Tobacco joins hunt for COVID-19 vaccine

British American Tobacco (NYSE:BTI) is developing a potential vaccine grown in tobacco plants, while Medicago, a biotech firm partly owned by Philip Morris (NYSE:PM), is pursuing a similar effort, WSJ reports.

The success of BAT’s approach will depend on whether its product elicits the appropriate immune response to protect against future infection with the new coronavirus, said Beate Kampmann, director of the London School of Hygiene and Tropical Medicine’s Vaccine Centre.

“What’s promising is the scalability,” she added.

https://seekingalpha.com/news/3558452-big-tobacco-joins-hunt-for-covidminus-19-vaccine