March 31, 2020

MARSHALL NEWS MESSENGER
https://www.marshallnewsmessenger.com/news/commissioners-to-consider-extending-declaration-of-local-disaster/article_e49c5bb2-72d5-11ea-81ab-4b82ec866d2f.html?utm_medium=social&utm_source=email&utm_campaign=user-share

Northeast Texas COVID-19 case count
Updated 16 hrs ago
The total of cases in Northeast Texas is now at least 56 in 14 counties. Here’s a look at totals reported late Sunday and early Monday, and changes from Sunday’s report:

Angelina: 3
Bowie: 9 (+5)
Camp: 1 (+1)
Cass: 2
Cherokee: 1
Gregg: 5 (+1)
Harrison: 1
Hopkins: 2 (+1)
Morris: 1
Nacogdoches: 2 (+1)
Rusk: 3 (+1)
Shelby: 2 (+1)
Smith: 32 (+1), 1 death
Upshur: 2 (+1)
Van Zandt: 1 (+1), 1 death

MESSAGE FROM DR. HERMAN FELTON OF WILEY:
Marshall News Messenger] Leading with Faith during a global crisis
https://www.marshallnewsmessenger.com/opinion/leading-with-faith-during-a-global-crisis/article_1591373e-7145-11ea-b870-d3bae7275e1b.html?utm_medium=social&utm_source=email&utm_campaign=user-share

NEW ENGLAND JOURNAL OF MEDICINE RE CERTAIN BP PILLS:
KEEP TAKING THEM
https://www.nejm.org/doi/full/10.1056/NEJMsr2005760?query=RP
Renin–Angiotensin–Aldosterone System Inhibitors in Patients with Covid-19

SUMMARY: Given the common use of ACE inhibitors and ARBs worldwide, guidance on the use of these drugs in patients with Covid-19 is urgently needed. Here, we highlight that the data in humans are too limited to support or refute these hypotheses and concerns. Specifically, we discuss the uncertain effects of RAAS blockers on ACE2 levels and activity in humans, and we propose an alternative hypothesis that ACE2 may be beneficial rather than harmful in patients with lung injury. We also explicitly raise the concern that withdrawal of RAAS inhibitors may be harmful in certain high-risk patients with known or suspected Covid-19.
Renin–Angiotensin–Aldosterone System Inhibitors in Patients with Covid-19
https://www.nejm.org/doi/full/10.1056/NEJMsr2005760?query=RP

NAMES OF THIS TYPE OF MEDICINE: KEEP TAKING THEM UNLESS YOUR DOCTOR TELLS YOU TO STOP.

candesartan Atacand
eprosartan
irbesartan Avapro #
losartan Cozaar #
olmesartan Benicar
telmisartan Micardis
valsartan Diovan #
benazepril Lotensin

captopril Capoten
enalapril Vasotec #
enalapril solution Epaned
fosinopril
lisinopril Prinivil #
lisinopril Zestril #
lisinopril solution Qbrelis
moexipril
perindopril
quinapril Accupril #
ramipril Altace #
trandolapril

Covid-19 — Navigating the Uncharted (A NEJM editorial by DR. FAUCI—the little NIH doctor on the TV updates)
List of authors.
Anthony S. Fauci, M.D., H. Clifford Lane, M.D., and Robert R. Redfield, M.D.

https://www.nejm.org/doi/full/10.1056/NEJMe2002387?query=recirc_mostViewed_railB_article

This editorial is somewhat reassuring about the severity or mortality rate of the C-19 virus, but it points out it will take time to clear out. Easy to read. Based only on China, which means the cases are several months old. That’s why I also read the MNM and the NYT.  J. Harris, MD

ANOTHER NEJM SHORT ARTICLE WORTH READING:
Feeding Low-Income Children during the Covid-19 Pandemic
nejm.org/doi/full/10.1056/NEJMp2005638?query=RP

HERE’S HOW TO FIGHT CORONAVIRUS MISINFORMATION
Send this to the person in your life who needs to read it.

https://www.theatlantic.com/ideas/archive/2020/03/heres-how-fight-coronavirus-misinformation/608914/?utm_source=newsletter&utm_medium=email&utm_campaign=atlantic-daily-newsletter&utm_content=20200330&silverid-ref=NTM4OTU2MTE5MTE0S0

Consider the source and consider the source’s source.

Be patient, kind, deliberate, and fact-based. More people will listen.

We’re in this together. It’s our civic duty to ensure we’re all making the smartest decisions and not allowing rumors or conspiracy theories to take seed. We all have a role to play. You don’t have to become an epidemiology expert—the medical professionals and journalists will do their jobs. You do have to make an effort to not spread rumors or falsehoods, or anything else that could make a public-health response harder for those around you.

Lives depend on it.

JOHNS HOPKINS DAILY MESSAGE:
(Multiple helpful stories)
https://mail.google.com/mail/u/0/#inbox/FMfcgxwHMZPhtTChBCPJRvQLmhKXbDNv

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[Marshall, Texas, March 31, 2020]

Harrison County and City of Marshall Issue Mandatory Shelter in Place Orders

First Amended Declaration of Local Disaster and Public Health Emergency Related to Communicable Disease

[Harrison County and Marshall, Texas] Harrison County Judge Chad Sims and City of Marshall Mayor Terri Brown confirm a second and third positive case of the coronavirus (COVID-19) in Harrison County. In each case, the cause of COVID-19 exposure was travel-related. County and City leadership believe it to be in the best interest to be proactive and take measures to further safeguard our citizens and prevent community spread. In response, Judge Sims and Mayor Brown are both issuing Mandatory Shelter in Place orders effective at 11:59 p.m. on March 31, 2020.

                Under this Order, citizens of Harrison County and the City of Marshall are still permitted to perform essential activities for their families; including obtaining medical supplies, visiting a health care provider, obtaining supplies they need to work from home, grocery shopping, engaging in outdoor activities while maintaining social distancing, and to perform work defined as an essential service. Citizens at a high risk of illness from COVID-19 and people who are sick are urged to remain in their residence except to receive medical care.

                Essential services are defined as all first responders, emergency management personnel, individual performing government functions, healthcare operations, essential infrastructure, grocery stores, farmers’ market, food banks, pet stores, farming, livestock, fishing, social services, media, gas stations, auto supply/repair, banks, hardware, mailing services, plumbers, electricians, exterminators, laundromats, dry cleaners, restaurants, office supplies, airlines, private transportation, home-based services or shelters for seniors, adults or children, professional services (legal, accounting, insurance, real estate, appraisal, survey, and title), childcare, utilities, telecommunications, janitorial, maintenance, healthcare operations, funerals, defense industry, and educational services operating online. A full list of all essential services may be found in the Ordinance at www.marshalltexas.net.

Non-essential businesses shall shut down except for maintaining Minimum Basic Operations.  Essential Businesses exempted from shut-down are encouraged to determine staff who are essential to operations and to send non- essential staff home.

For the purposes of this Order, “Essential Travel” includes travel for any of the following purposes:

•             Any   travel   related   to   the provision of or access to Essential Activities, Essential Governmental Functions, Essential Businesses, or Minimum Basic Operations;

•             Travel to care for the elderly, minors, dependents, persons with disabilities, or other vulnerable persons;

•             Travel to or from educational institutions for purposes of receiving materials for distance learning, for receiving meals, and any other related services;

•             Travel to return to a place of residence from outside the jurisdiction;

•             Travel required by law enforcement or court order; or

•             Travel required for non-residents to return to their place of residence outside the City. Individuals are strongly encouraged to verify that their transportation out of the City remains available and functional prior to commencing such travel.

When citizens need to leave their places of residence, whether to obtain or perform vital services or to otherwise facilitate authorized activities necessary for continuity of social and commercial life, they should at all times comply with the Social Distancing Requirement.

Failure to comply with any of the provisions of this Order constitutes an imminent threat to public health. In accordance with Texas Government Code §418.173, a person who knowingly or intentionally violates this Order commits an offense punishable by a fine up to $1,000.00 and/or confinement in jail for a term that does not exceed 180 days, and each day or portion of a day that such a violation continues shall constitute a separate offense.

                The Emergency Management Team will continue to meet with leaders from Harrison County, Marshall – Harrison County Health District, CHRISTUS Good Shepherd Health System – Marshall, and City of Marshall monitoring the situation on an ongoing basis and providing notices to citizens as needed.

Harrison County and the City of Marshall are following the Centers for Disease Control’s (CDC) guidelines and recommendations on the steps our community can take to help prevent catching or spreading the coronavirus (COVID-19). This is a situation that continues to evolve and we will do our best to keep our citizens informed of the latest information.

Harrison County and the City of Marshall urge our community to practice healthy habits including:

1.        Restrict physical contact and publicly used areas.

2.        Maintain Social Distancing with a safe distance of six (6’) feet between individuals.

3.       Every person in Texas shall avoid social gatherings in groups of 10 or more per Executive Order of Governor Abbott.

4.         Residents should not visit nursing homes, retirement, or long-term care facilities unless to provide critical assistance.

5.        In accordance with the CDC, people shall avoid eating or drinking at bars, restaurants, and food courts, or visiting gyms or massage parlors. Residents may still utilize drive-thru, pickup, or delivery options through the Executive Order.

6.        Regularly wash hands with warm soap and water for at least 20 seconds.

7.        Avoid touching eyes, nose, or mouth.

8.        If soap is not available, use at least a 60% alcohol-based hand sanitizer.

9.        Avoid close contact with people who are sick. All persons should remain in the home if one person in the home exhibits symptoms

If you are experiencing fever, cough or difficulty breathing, been exposed to a sick traveler or been exposed to a person with COVID-19 in the last 14 days, please contact your healthcare provider immediately. Inform your physician or emergency department of your symptoms to prevent any potential spread.

The City of Marshall will hold City Commission meetings utilizing a video and audio conferencing tool, as well as, a standard conference call.  Instructions and direct links to view meetings or speak during Citizen Comment can be found at http://www.marshalltexas.net.

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