As We Try to Kick Through Quicksand

Coronavirus

To my Patients and Friends,
Here’s some of the latest COVID-19 news.

As things stand

On July 10, The U.S. saw a record 70,000 new COVID-19 cases, and we are now brushing up against 1,000 deaths per day.  The current U.S. daily incidence is more than 50% higher than it was at the time of our first peak in April.  Additionally, our national positive test rate continues to increase and outpace our testing capacity, particularly in the south, southwest, midwest and west, where COVID-19 surges are currently underway.  In Florida, 40 hospitals in 21 counties have reported no ICU bed availability.  And one analysis indicates that the U.S. is only conducting 39% of the testing needed to account for the increasing rate of transmission.  These concerning trends have led to more aggressive mask use mandates and a return to some of the physical distancing measures that had previously been lifted.   As we approach the fall school season, difficult decisions regarding physical distancing requirements will need to be made in order to protect students, parents who are planning to return to work and others in the community.  States are taking a variety of approaches to manage COVID-19 surges and mitigate stress on health systems.
Will we ever learn?

During a recent White House event addressing plans for schools to reopen in the fall, Donald Trump indicated that he would pressure states to resume in-person classes, describing the CDC guidelines as “very tough & expensive” and calling for a more relaxed approach.  And although Mike Pence subsequently asserted that the CDC would acquiesce, Dr. Robert Redfield, Director of the CDC, has indicated that that the CDC will not revise their guidance and that states and schools are ultimately responsible for making decisions regarding the implementation of protective measures.  Numerous experts argue that softening the CDC guidance based on factors other than science will result in increased viral transmission in schools.

Magical thinking

In a decision that flies in the face of reason, Walt Disney World in Orlando, Florida is planning a phased reopening beginning July 11.  Florida is currently being crushed by COVID-19… so perhaps Mickey should wait?

Permeable prison walls

Correctional facilities remain concerning sources of COVID-19 spread. San Quentin State Prison in California , where more than a third of the prison population and staff have tested positive in the last 5 weeks, is a new hot spot which will inevitably impact the surrounding Marin County.  Health experts have recommended that correctional facilities release nonviolent inmates or those who are near the end of their sentences and to implement regular testing for all inmates and staff as a means of mitigating the spread of COVID-19 from within these densely populated communities.

PPE paucities

The U.S. is again contending with increasing shortages of crucial personal protective equipment (PPE)—including masks, gowns, and face shields—as COVID-19 disease and hospitalizations continue to increase.  Unions and associations representing nurses and doctors across the country have raised concerns about the lack of PPE and its implications for operations in most healthcare environments, including hospitals and medical practices.

Something’s in the air

Following the publication of a letter signed by more than 200 experts recommending that the World Health Organization (WHO) acknowledge the role of airborne (aerosolized) transmission of the coronavirus, the WHO released an update regarding its current understanding of viral transmission routes. While the WHO continues to emphasize that respiratory droplets are the primary route of transmission, the updated guidance details other types of transmission, including aerosols (much smaller airborne droplets), and contaminated surfaces.  Stay tuned for more on this evolving topic.

WHO could have imagined?

Leading U.S. medical organizations including the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP) and the American Medical Association (AMA) have joined forces to vigorously oppose Donald Trump’s mind-bending decision to withdraw the U.S. from the World Health Organization (WHO), indicating that the move represents “a major setback to science, public health, and global coordination efforts needed to defeat COVID-19.”

More on pigs

There’s new evidence that a novel strain of H1N1 influenza found in pigs in China could be transmitted to humans and reach pandemic potential.  Let this serve as a reminder that we should all get our annual flu shots.  And that masks and hygiene measures work.  And that we should heed the scientists.  And that the animal agriculture industry can contribute to human disease.  And that preparedness matters.  And that we shouldn’t let our guards down once this pandemic ends… but mostly that we should all get our annual flu shots.

The DNA of racism

This is hard to believe: Dr. James Watson, the famed geneticist who, in partnership with Francis Crick, won the Nobel Prize in 1962 for their discovery of the double-helix structure of the DNA molecule, has been stripped of the remainder of his honorary positions with Cold Spring Harbor Laboratory, where Dr. Watson served as the laboratory’s Director since 1968.  Watson has repeatedly put forth statements and writings on race and intelligence in which he claimed that people of African descent have lower intelligence than other groups because of genetics.  It’s really difficult to reconcile Watson’s scientific gravitas on the one hand and his profound ignorance on the other… but there you go.

That’s all for this week.  Be safe, be patient, be kind, and be part of the solution.  And please remember to wear masks and follow all recommended distancing measures.  I’ll see you soon!

PS- As a reminder, please don’t forget to download and use the How We Feel app.

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