CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 12/01/2020

CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 12/01/2020

12/01/2020

From Facebook, Judge Sims: “According to the Governor’s Order #32 if the hospitals in your region exceed 15% of their capacity with COVID patients for seven consecutive days, businesses will have to reduce their occupancy from 75% down to 50%. On November 29, 2020 our region climbed to 15.2%.”

J. Harris: We apparently have only 2 pure “bars” in Marshall, and I don’t know where either of them are located. 

How much did Thanksgiving contribute to Covid-19 spread? It’s wait and see for now

”Patients tend to be at their most infectious for about seven days — two days before they first show symptoms and five days after — according to a new analysis. The C.D.C. has recommended that infected people isolate themselves for at least 10 days, but is considering shortening that period…

”Data from the Transportation Security Administration showed that more than 1 million air travelers were screened the Friday, Sunday, and Wednesday before Thanksgiving — a threshold rarely hit since March, though it’s still less than half of the number of travelers screened around Thanksgiving last year.

”Public health authorities have blamed past holiday weekends for spiking cases in some areas, but gatherings of family and friends are just one log on the fire that is the U.S. epidemic. New cases have cropped up among college students socializing, kids playing after-school sports, and people taking exercise classes. They’ve been fueled at indoor restaurants, religious services, prisons, nursing homes, and other sites. Transmission is so high in many places it’s often hard to track down where people got infected.”

The virus chart that forecasts the future

If you track the number of new cases, you can fairly accurately predict the number of deaths three weeks later. Every 100 new cases in the U.S. has led to an average of about 1.7 deaths, with that three-week lag…In coming weeks, deaths seem almost certain to rise, perhaps sharply. The run-up in cases during November suggests that daily deaths may approach 3,000 in December. 

New York City Will Reopen Elementary Schools and Phase Out Hybrid Learning

“…New York’s schools had extremely low test positivity rates during the roughly eight weeks they were open this fall, and there was wide agreement from everyone from the president of the teachers’ union to the mayor’s top public health officials that schools were safer than they had anticipated.

“When school buildings reopen, the city will significantly increase its random testing in schools: rather than testing a sampling of students and staff in each school building once a month, the city will conduct tests weekly. Students will not be allowed to attend school in person unless they have signed consent forms from their parents, allowing them to be tested.”

J. Harris Comment: 

I hope that I’m wrong, but I am reasonably certain that once school restarts, the rate of illness in school will climb again. In addition, holiday acquired Covid cases will become  epidemic in the city, and school teachers and adult MISD employees will  have frequent Covid exposures. Weekly Covid  tests and quarantine might  help throttle the spread somewhat, but it will not stop it. Of course, the students will also spread the virus, but thankfully not as profusely as was initially thought. In addition, children only very  rarely die and as far as is known now, rarely develop long term complications. I am uncertain just how widespread the ravages of epidemic will  have to be before the state and local powers  shut down the cities again. Who knows just how horrible things have to be to elicit measures draconian  enough to protect the lives of  the people, whether they desire help or not. 

Unfortunately, even if there were enough hospital beds  available  for all the Covid ill, there would not be medical staff enough to utilize these beds. Our hospital system is being overwhelmed despite the tireless, selfless, unending work of our medical heros. Alarmingly, more than a few of the very hospitals that are filling up with Covid patients are going bankrupt because they are unable to perform the special hospital services that generate income.  

It would seem to an outside observer that this might be a good time to shut down the schools for about 6 weeks? However, local school counts are not that high and the students are said to be behind in their studies. Lack of the equipment and  computer techniques and skills necessary for internet education are almost certain to persist  while the students and the faculty are figuring out how to teach and learn from home.  Unfortunately, many local families have no wifi, home computers, recent education, or computer skills. Portable wifi hotspots have helped, but not enough. For better or worse, we find ourselves somewhat removed from the Silicon Valley. 

 In addition local schools are charged with total student welfare and safety and accordingly are charged with feeding, baby sitting, and entertaining students (and sometimes their families). It seems to me that our school board has recognized and handled the Covid induced  problems  very well. I appreciate both their devotion and diligence. Nevertheless,  our schools’ Covid problems are likely to get worse before they get better — next fall. 

COVID Models Show How to Avoid Future Lockdowns

“…Despite all this uncertainty, a recent analysis of 131 countries suggests that moderately severe restrictions—applied individually and in combination—have slowed transmission of SARS-CoV-2 to varying degrees. The researchers found, for example, that banning public events and gatherings of more than 10 people could reduce the reproduction number R (the estimated number of people being infected by one infectious individual) by as much as 29 percent a month after implementation. Add workplace closures to the mix, and R would decrease by approximately 38 percent. However, says the paper’s senior author Harish Nair, a professor of global health at the University of Edinburgh, choosing which interventions to implement “would depend on where in the trajectory of the epidemic [a locale is]. For example, if your R is 1.5, you can use a combination of less severe measures—whereas if it [is] over 2, you would need to go into a lockdown.” That is because so long as R stays above 1, cases will continue to increase.

J. Harris: A readable article that suggests we can get this over with once we make up our collective minds to lock down where indicated by disease and not by  economic or political forces. 

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/30/2020

11/30/2020

HELLO

J. Harris: There should be some case numbers out late this afternoon. For now, Harrison County is hanging in pretty well. Daily numbers will not be as available. They will go up. Don’t let down. We will try and get some understandable and dependable information about Vaccines.  

For now remember: 

 VACCINES DOESN’T EQUAL VACCINATION: There will be lots of administrative problems. Most of us will wait until about 250,000,000 vaccinations (or more if 2 shots are needed) are given to those in more immediate danger than most of the American population. 

As thousands of athletes get coronavirus tests, nurses wonder: What about us?

CDC may shorten 14-day COVID-19 quarantine recommendation

The Role of Cognitive Dissonance in the Pandemic

:…Human beings are deeply unwilling to change their minds. And when the facts clash with their preexisting convictions, some people would sooner jeopardize their health and everyone else’s than accept new information or admit to being wrong…But … don’t say the equivalent of “What are you thinking by not wearing a mask?” That message implies “How could you be so stupid?” and will immediately create dissonance (I’m smart versus You say I’m doing something stupid), making him almost certainly respond with defensiveness and a hardening of the belief …

Hospitals Know What’s Coming “We are on an absolutely catastrophic path,” said a COVID-19 doctor at America’s best-prepared hospital.(Written by Ed Yong who is doing fabulous work during this pandemic)

“…During the spring, most of UNMC’s COVID-19 patients were either elderly people from nursing homes or workers in meatpacking plants and factories. But with the third national surge, “all the trends have gone out the window,” Sarah Swistak, a staff nurse, told me. “From the 90-year-old with every comorbidity listed to the 30-year-old who is the picture of perfect health, they’re all requiring oxygen because they’re so short of breath…This lack of pattern is a pattern in itself, and suggests that there’s no single explanation for the current surge. 

“…the Midwest has taken entirely the wrong lesson from the Northeast’s ordeal. Instead of learning that the pandemic is controllable, and that physical distancing works, people instead internalized “a mistaken belief that every curve that goes up must come down,” he said. “What they don’t realize is that if we don’t change anything about how we’re conducting ourselves, the curve can go up and up…Empty hospital beds might as well be hotel beds without doctors and nurses to staff them… 

“And though health-care workers are resilient, “many of us feel like we haven’t had a day off since this thing began…“Even before COVID-19 hit, we were short-staffed…Of late, there have been days when the hospital had 45 to 60 fewer nurses than it needed. “Every time I’ve been at work, I’ve thought: This is going to be the final straw. But somehow we continue to make it work, and I truly have no idea how.””

J. Harris: Hey Old Timer, better wear your mask if you’re out — but don’t go out unless you just have to. If you get sick, where are they going to put you?

State-by-state breakdown of 134 rural hospital closures

The first piece of luggage on the carousel never belongs to anyone.
~ George Roberts 

America is so advanced that even the chairs are electric.

~ Doug Hamwell

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/28/2020

11/28/2020

HELLO

J. Harris: The R factor is rapidly moving in the WRONG direction. 

From Hopkins Suggestions:

COVID-19 Has Claimed the Lives of 100,000 Long-Term Care Residents and Staff

COVID-19 Has Claimed the Lives of 100,000 Long-Term Care Residents and Staff (KFF) This week marks a bleak milestone in the pandemic’s effect on residents and staff in long-term care facilities across the country. According to our latest analysis of state-reported data, COVID-19 has claimed the lives of more than 100,000 long-term care facility residents and staff as of the last week in November. This finding comes at a time when public health experts are predicting a surge in cases after holiday gatherings and increased time indoors due to winter weather, which will have ripple effects on hospitals and nursing homes, given the close relationship between community spread and cases in congregate care settings.

2.No evidence for increased transmissibility from recurrent mutations in SARS-CoV-2

 No Evidence for Increased Transmissibility from Recurrent Mutations in SARS-CoV-2 (Nature) The most plausible mutations under putative natural selection are those which have emerged repeatedly and independently (homoplasies). Here, we formally test whether any homoplasies observed in SARS-CoV-2 to date are significantly associated with increased viral transmission.

“At this stage we find no evidence for significantly more transmissible lineages of SARS-CoV-2 due to recurrent mutations.”

No One Is Listening to Us’ More people than ever are hospitalized with COVID-19. Health-care workers can’t go on like this.

At least 1,375 U.S. health-care workers have died from COVID-19.

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/25/2020

11/25/2020

Hello. Have a nice and safe Thanksgiving. 

State drops daily COVID-19 updates for Harrison County

(J. Harris: This may just be for schools. I’ll look around.)

‘No more lockdowns in Texas,’ governor says

Hospital financial losses mount amid COVID-19 resurgence: 5 things to know

Hopkins Suggests:

1. Evidence Builds That an Early Mutation Made the Pandemic Harder to Stop (New York Times) As the coronavirus swept across the world, it picked up random alterations to its genetic sequence. Like meaningless typos in a script, most of those mutations made no difference in how the virus behaved. But one mutation near the beginning of the pandemic did make a difference, multiple new findings suggest, helping the virus spread more easily from person to person and making the pandemic harder to stop.

2.  Can dogs smell COVID? Here’s what the science says

“…Researchers don’t know for sure what the dogs are smelling, but many suspect that these illnesses cause the human body to let off a distinct pattern of volatile organic compounds (VOCs). These molecules readily evaporate to create scent that dogs can pick up. Previous work with non-COVID viruses has suggested that viral infections might also cause the body to do this….

 “Trials at airports in the United Arab Emirates, Finland and Lebanon are using dogs to detect COVID-19 in sweat samples from passengers; these are then checked against conventional tests. According to data presented at the K9 meeting, dogs in Finland and Lebanon have identified cases days before conventional tests picked up the virus, suggesting that they can spot infection before symptoms start.”

(J. Harris: Article in Nature that’s easy to read and understand, especially for dog people. The dogs get most of the positive cases and have very few false positives [almost none]. Several more trials are described.)

J. Harris: A 1918 photo at Georgia Tech. They were smart enough in 1918 to wear masks. 

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/24/2020

CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/24/2020

11/24/2020

Some good news first:

Data Show Hospitalized Covid-19 Patients are Surviving at Higher Rates, but Surge in Cases Could Roll Back Gains (STAT News) Patients hospitalized with Covid-19 are surviving at higher rates than in the early days of the pandemic, gains that data and interviews with experts suggest are driven by a more refined understanding of the disease and how to treat it — and, crucially, less strain on hospitals that had been inundated at times. But clinicians warn that this progress won’t withstand what happens when crushes of patients again overwhelm hospitals, as is now occurring in dozens of U.S. states. With the country setting new records of hospitalizations daily, care is getting threatened, and death rates — not just deaths — could increase.

HOPKINS SUGGESTIONS:

1. FDA Authorizes Drug Combination for Treatment of COVID-19 The US Food and Drug Administration issued an emergency use authorization for the drug baricitinib, in combination with remdesivir, for the treatment of suspected or laboratory confirmed COVID-19 in hospitalized adults and pediatric patients two years of age or older requiring supplemental oxygen, invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO). (FDA, 11/19/2020)

2. Trends in County-Level COVID-19 Incidence in Counties With and Without a Mask Mandate — Kansas, June 1–August 23, 2020 The governor of Kansas issued an executive order requiring wearing masks in public spaces, effective July 3, 2020, which was subject to county authority to opt out. After July 3, COVID-19 incidence decreased in 24 counties with mask mandates but continued to increase in 81 counties without mask mandates. Countywide mask mandates appear to have contributed to the mitigation of COVID-19 transmission in mandated counties. Community-level mitigation strategies emphasizing use of masks, physical distancing, staying at home when ill, and enhanced hygiene practices can help reduce the transmission of SARS-CoV-2. (CDC MMWR, 11/20/2020)

(J. Harris: This is a hard to read article, but the heavily populated cities in Kansas wore masks. Most of the lesser populated counties did not op in to the mask mandates and had a higher incidence of Covid. North and South Dakota and W. Texas have proven that the wide open spaces and lesser populations DO NOT KEEP YOU SAFE FROM COVID. Be smart. It’s most inconvenient to die at Christmas.)

3. FDA Authorizes Monoclonal Antibodies for Treatment of COVID-19 The US Food and Drug Administration issued an emergency use authorization for casirivimab and imdevimab to be administered together for the treatment of mild to moderate COVID-19 in adults and pediatric patients (12 years of age or older weighing at least 40 kilograms with positive results of direct SARS-CoV-2 viral testing and who are at high risk for progressing to severe COVID-19. This includes those who are 65 years of age or older or who have certain chronic medical conditions. (FDA, 11/21/2020)

4.  COVID-19 Outbreak Associated with a 10-Day Motorcycle Rally in a Neighboring State — Minnesota, August–September 2020 Following a 10-day motorcycle rally in South Dakota attended by approximately 460,000 persons, 51 confirmed primary event-associated cases, 21 secondary cases, and five tertiary cases were identified in Minnesota residents. An additional nine likely rally-associated secondary or tertiary cases occurred. Four patients were hospitalized, and one died. Genomic sequencing supported the associations with the motorcycle rally. The impact of gatherings as a source of virus transmission underscores the importance of reducing the number of attendees at gatherings, using face masks, and encouraging physical distancing to prevent ongoing transmission of SARS-CoV-2. Furthermore, these findings demonstrate the rationale for consistent mitigation measures across states. (CDC MMWR, 11/20/2020)

(J. Harris: This was  a predictable and predicted result of the bikers rally in Sturgis, SD. There will be more, unless “Hells Angels” have an innate immunity.)

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/23/2020

11/22/2020

On Sunday, Nov. 22, in TSA Areas G, there were 396 Covid patients hospitalized, 102 of them were in ICU, and there were 37 ICU beds available in the area. 

Stats for today will come in after 16oo. 

Family that got virus warns public to spend holidays at home

From Longview Paper and AP

ARLINGTON — Arlington is using one family’s brush with the coronavirus as a warning to others who might be considering big get- togethers this Thanksgiving.

Alexa Aragonez told the Fort Worth Star-Telegram that her family weighed the risks of catching the virus but decided to get together for a birthday party on Nov. 1.

A couple of days after the party, her 57-year-old mother, Enriqueta Aragonez, and others who were at the party began to feel sick. They got tested, and all 12 who had attended were positive for COVID-19. Three other people with whom they had come in contact with also tested positive, said Alexa Aragonez, 26, who didn’t attend the party.

Arlington is using the family’s experience as part of a public awareness campaign to help reduce the spread of the coronavirus this holiday season by staying home.

The Centers for Disease Control and Prevention is also warning people to not spend Thanksgiving with people from outside of their households and to not travel for the holiday.

Statewide, the Texas health department on Sunday reported 8,554 new virus cases, more than 4,000 less than the state’s one-day high of 12,597 new virus cases a day earlier. The state on Sunday also reported 8,174 virus hospitalizations and 89 new deaths.

In a video that’s part of the campaign in Arlington, Enriqueta Aragonez is in her hospital and says, “I went to my nephew’s house and love seeing my family. But now I’m ghting against COVID-19.”

She is now recovering at home, and although she doesn’t need supplemental oxygen, she still has pain in her lungs, Alexa Aragonez said. Most of the others who caught the virus at the party had milder symptoms, she said.

In the end, “not everyone is as lucky as my family has been,” Alexa told the Star-Telegram. She said she doesn’t want anyone to needlessly lose a family member.

“We were scared that my mother, the matriarch of the family, was going to pass,” she said. “So I think that fear in our hearts made us want to put an awareness in the hearts of others.” 

Texas Public Schools COVID-19 Data:

Public schools are required to report positive COVID-19 cases on school campuses. Due to the Thanksgiving holiday, this dashboard will not be updated again until the week of November 30, 2020.  Two weeks of data will be posted that week.

J. Harris: I wonder if anyone thought about shutting down the school house until January? 

The Coronavirus Is Airborne Indoors. Why Are We Still Scrubbing Surfaces? (New York Times) All over the world, workers are soaping, wiping and fumigating surfaces with an urgent sense of purpose: to fight the coronavirus. But scientists increasingly say that there is little to no evidence that contaminated surfaces can spread the virus. In crowded indoor spaces like airports, they say, the virus that is exhaled by infected people and that lingers in the air is a much greater threat. Hand washing with soap and water for 20 seconds — or sanitizer in the absence of soap — is still encouraged to stop the virus’s spread. But scrubbing surfaces does little to mitigate the virus threat indoors, experts say, and health officials are being urged to focus instead on improving ventilation and filtration of indoor air.

Safety and Immunogenicity of ChAdOx1 nCoV-19 Vaccine Administered in a Prime-boost Regimen in Young and Old Adults (COV002): A Single-blind, Randomised, Controlled, Phase 2/3 trial (The Lancet) In this report of the phase 2 component of a single-blind, randomised, controlled, phase 2/3 trial (COV002), healthy adults aged 18 years and older were enrolled at two UK clinical research facilities, in an age-escalation manner, into 18–55 years, 56–69 years, and 70 years and older immunogenicity subgroups. By 14 days after the boost dose, 208 (>99%) of 209 boosted participants had neutralising antibody responses. ChAdOx1 nCoV-19 appears to be better tolerated in older adults than in younger adults and has similar immunogenicity across all age groups after a boost dose.  (J. Harris: This British vaccine requires only one injection and does produce a good antibody response)

SWEDEN The Swedish government approved a measure to limit public gatherings and events to a maximum of 8 individuals and removed existing exemptions for restaurants or other settings. One notable exception remains in place for funerals, which are limited to 20 individuals. The restrictions will begin on November 24 and builds on a previous decision to prohibit alcohol sales after 10pm to reduce gatherings at bars and restaurants. The new limit on gatherings is a drastic shift from the previous limit on events of more than 300 people, signaling a change in how Swedish authorities are approaching the national COVID-19 response. Sweden was previously known for having a relatively lax set of social distancing recommendations and measures, compared to many other countries, but Prime Minister Stefan Lofven recently urged Swedes to avoid settings like gyms, libraries, and even hosting dinners.

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/22/2020

CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/22/2020

11/22/2020

LOCAL INVENTOR’S SALIVA TEST FOR COVID APPROVED 

mLife Diagnostics of Marshall receives FDA authorization for COVID saliva test

FROM THE SAME MNM TODAY. PLEASE SUBSCRIBE IF YOU CAN

(J. Harris: This article has a title that suggests you shouldn’t be concerned.  Only an idiot will not be concerned now. 

Covid-19

AREA ICU’S FILLING UP…….

By Jo Lee Ferguson jferguson@news-journal.com Nov 22, 2020

Longview medical leaders are calling for renewed caution as a wave of new COVID-19 cases and increased hospitalizations plague the area, and the state, with Thanksgiving approaching.

The number of cases and the percent of positive cases are up, said Dr. Craig Meek, a board member of the Texas College of Emergency Physicians who works in the emergency rooms at Excel ER and Christus Good Shepherd Medical Center in Longview.

“This is a more extended wave,” he said, adding that he urges people to limit holiday travel and large gatherings. “It’s pretty important.”

At the same time, he encouraged people who need care, for COVID-19, for other procedures and medical emergencies, to seek help.

He and Dr. Lewis Browne, the Gregg County health authority, said hospitals have capacity and haven’t stopped elective procedures. The local intensive care units are “pretty full” but not at maximum capacity, Browne said, and elective surgeries haven’t been restricted. That means hospitals are not beyond capacity.

“We have capacity right now to take care of patients,” Meek said, adding that “Christus is not shutting down anything.”

The Longview-Tyler area falls into the state’s Trauma Service Area G. Information from the Texas Department of State Health Service shows the area has a total hospital capacity of 2,902 beds. At the beginning of October, there were 189 hospitalized COVID- 19 patients. That number grew to 279 by Nov. 1 and 382 — including 98 patients in intensive care — as of Friday. That means about 13% of hospital capacity in the service area is being used.

Longview Regional Medical Center spokeswoman Libby Bryson said Friday the hospital is caring for 47 COVID-19 patients, including 16 in the ICU.

“Longview Regional Medical Center, like hospitals across the state, is seeing an increase in the number of individuals hospitalized with COVID-19,” she said. “The surge of cases in our community is an important reminder that everyone can take action to reduce the spread of coronavirus. Practice social distancing, wear a face mask covering your nose and mouth when you’re in public, and wash your hands or use hand sanitizer often. We all need to do our part.”

At Good Shepherd, spokesman Will Knous added people should stay at home if they’re ill.

“Since the beginning of the COVID-19 pandemic, we have urged our communities to protect themselves, their loved ones and their neighbors. After months of physical distancing and staying home, infections and deaths began to decline,” he said. “But, as we reopened, some of the steps that were critical to slowing the spread have been relaxed. As a result, we are now experiencing a surge in COVID-19 cases and seeing increased hospitalizations from COVID-19.

“Prevention is crucial to attening the curve and preventing further spread of COVID-19 in our community. Christus Good Shepherd is committed to providing great care to all who seek it, and we encourage everyone to take the simple steps we know will

stop the spread of the virus….”

/

Meek said that at this point in the pandemic, people who live in the same house as someone who has tested positive and who have symptoms should assume they, too, are positive and quarantine for 10 days. A positive test for everyone in the household would have limited value, he said, explaining that while there is more testing and capability for testing, there’s not unlimited testing ability.

Also, while cases and hospitalizations are increasing, Meek and hospital officials offered assurances that local facilities are able to provide care. It’s important, Meek said, for people to go to the emergency room if they’re experiencing symptoms of a heart attack or stroke, for instance.

“An emergency room is a safer place than a lot of big grocery stores,” he said. “They should not be afraid to come into the emergency room.”

During the rst wave of COVID-19, he recalled seeing “some really bad cases” because people delayed seeking care at an emergency room out of fear of catching the virus.

“I”m afraid it’s going to happen again,” he said.

At Longview Regional, Bryson said the hospital has implemented precautions to help protect patients and providers, including restriction visitation.

“Our hospital remains prepared to care for patients needing medical care, whether for COVID-19 or another medical condition,” she said, and went on the praise the hospital’s staff and physicians for their work during the pandemic.

Meek called for people to be kind and patient with each other as the pandemic continues.

Knous said, “Our hospitals and emergency rooms remain safe places for all to receive quality care. We are not powerless in this public health crisis, and we can defeat it in the same way we defeated previous threats to public health — by working together to keep our family, friends and community safe.”

North Dakota Hits Highest COVID-19 Mortality Rate In The World (HuffPost) North Dakota had the highest COVID-19 mortality rate of any other state or even any other country in the world last week, according to a shocking analysis by the Federation of American Scientists. South Dakota ranked third-worst in the world. Both states also have the lowest rates of face mask use in the nation. The rates are what health experts would expect in a war-torn nation — but not in the U.S., the scientists said.

Delirium in Older Patients With COVID-19 Presenting to the Emergency Department (STAT News) In this cohort study of 817 older ED patients with COVID-19, 28% had delirium at presentation, and delirium was the sixth most common of all presenting symptoms and signs. Among delirious patients, 16% presented with delirium as a primary symptom and 37% had no typical COVID-19 symptoms or signs, such as cough or fever. Meaning These findings suggest that older adults with COVID-19 commonly present to the ED with delirium and that delirium should be considered an important presenting symptom of COVID-19. 

What the Data Say About Asymptomatic COVID Infections (Nature) Now, evidence suggests that about one in five infected people will experience no symptoms, and they will transmit the virus to significantly fewer people than someone with symptoms. But researchers are divided about whether asymptomatic infections are acting as a ‘silent driver’ of the pandemic. Although there is a growing understanding of asymptomatic infections, researchers say that people should continue to use measures to reduce viral spread, including social distancing and wearing masks, regardless of whether they have symptoms. 

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/21/2020

CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/21/2020

11/21/2020

J. Harris: I am trying to improve my ability to reproduce data. Please bear with me until I figure it out. 

From a local standpoint, Harrison County continues to have lower counts than some of our neighbors. Cases and death statistics  are based on the county where the patient lives or lived, not where they died, so our death counts are significantly lower in Harrison County.

Perhaps the most dangerous looming danger for Covid patients in East Texas is due to potential staffing problems. Covid is now so widespread that the daring health care workers who have moved from one crisis to another find themselves with more epidemic areas than they can service. Perhaps the military will be necessary for acute hospital staffing as well as for Covid Rehabilitation Facilities. Remember, the nursing homes are already full. Where will the Covid patients who need more rehabilitation go which will be an acute problem as the demand for hospital beds increases, and it will. 

I heard today on NPR a respected expert say that he felt like 6 foot spacing was even more important than masks to prevent Covid spread. He also said that “Herd Immunity” with virulent viruses does not occur. I should be able to supply more about him on Tuesday when the blog will be available. 

 A Living WHO Guideline on Drugs for Covid-19 (BMJ)

(A simplified teaching guide on how and when to treat Covid for universal application)

HOSPITAL DATA FOR TEXAS TSA AREAS UPDATED

https://docs.google.com/spreadsheets/d/1yKi2rancEQv0cZAJUygBrGaVkU0WzasPw5dz-8wb6WE/edit#gid=0

HOME TEST KIT EUA The US FDA granted Emergency Use Authorization to the first fully at-home SARS-CoV-2 diagnostic test kit. The Lucira COVID-19 All-In-One Test Kit must be prescribed by a healthcare provider, but it can be performed by individuals at home. The manufacturer recommends that children under 14 years old should have the test performed by a healthcare provider in order to maximize the chances of obtaining a valid result. The kit comes with a nasal swab, a test tube with detection reagents, and a small test machine. Once the used nasal swab is swirled around the test tube for the requisite amount of time, the user inserts the tube into the machine, which will automatically process the sample and provide visual indication of the results. The test kit will light up as positive, negative, or inconclusive results in around 30 minutes. 

(J. Harris: The Whitehouse proved that you can’t  protect yourself  only with testing. However, a cheap, quick test can be helpful at home, especially with children involved. 

TEXAS SCHOOL COVID STATS–WEEKLY  

 J. Harris: I’ll work on this chart.

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/20/2020

CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/20/2020

11/20/2020

 11/1411/1611/1711/1811/19
COVID IN HOSP333328362368366
COVD IN ICU8087909494
ICU BEDS AVAIL3123292623
TEXAS R FACTOR 1.141.12 1.09
COUNTY CASES/1000 POP 20   
NEW HARRISON?7924
NEW GREGG641551238968
NEW SMITH13932815123887
MISD NEW/ACTIVE Oct-32Jun-33Feb-36 

HOW BIG IS YOUR BUBBLE?

SUGGESTED BY HOPKINS:

1.     They’ve Been Following the Science’: How the Covid-19 Pandemic Has Been Curtailed in Cherokee Nation (STAT) With a mask mandate in place since spring, free drive-through testing, hospitals well-stocked with PPE, and a small army of public health officers fully supported by their chief, the Cherokee Nation has been able to curtail its Covid-19 case and death rates even as those numbers surge in surrounding Oklahoma, where the White House coronavirus task force says spread is unyielding.

2.     Canada celebrates Thanksgiving the second Monday in October. A surge in COVID-19 incidence following Canadian Thanksgiving is a cautionary reminder for the coming US Thanksgiving and other winter holidays. Canadians were advised to limit celebrations to household contacts only or host remote/virtual events, but the extent to which Canadians adhered to that guidance is not fully known. A month after the holiday, COVID-19 incidence continues to rise in Canada, but the largest increase was observed 2 weeks following the holiday, which is consistent with the epidemiology.

3.     HOW GOOD INDICANS STAY ALIVE: How a distinct ethnic groups who are organized, structured, and well led are beating Covid. This is long but readable and illustrates that there are many things we could do (in addition to the Vaccines) to inhibit Covid spread and death.

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/19/2020

CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/19/2020

11/19/2020

THE INFORMATION BELOW IS FOR TSA “G”. HOWEVER, ANY COUNTY IN TEXAS, OR SCHOOL SYSTEM IS CURRENT AND AVAILABLE TO ANYONE. YOU HAVE TO LOOK AROUND AND PLAY WITH THE SITE TO FIGURE OUT JUST WHAT YOU WANT TO KNOW. THE SOURCE IS TEXAS COVID=BEST SITE OF ALL.    

TSA G11/1411/1611/1711/18
COVID IN HOSP333328362368
COVD IN ICU80879094
ICU BEDS AVAIL31232926
TEXAS R FACTOR 1.141.12 
COUNTY CASES/1000 POP 20  
NEW HARRISON?792
NEW GREGG6415512389
NEW SMITH139328151238
MISD NEW/ACTIVE 10/326/332/36

More than 3 million people in U.S. estimated to be contagious with the coronavirus

J. Harris: One out of every 100 Americans is infected.

SUGGESTED BY HOPKINS:

1.  Hospital-Acquired SARS-CoV-2 Infection Lessons for Public Health

“…An illustrative example of the devastating potential for health care transmission of SARS-CoV-2 came from St Augustine’s Hospital in Durban, South Africa, a facility with 469 beds, including 18 wards, 6 intensive care units, and 735 clinical staff.2 Through a detailed epidemiologic study supplemented by phylogenetic analyses, investigators documented how a single unsuspected case of SARS-CoV-2 led to 6 major clusters involving 5 hospital wards and an outside nursing home and dialysis unit, with infection ultimately confirmed among 80 staff members and 39 patients, 15 of whom died.

(J. Harris: Yeah, you read it right. Lack of Covid immunity by everyone makes every single case of Covid  important! This one person   transmitted disease to 119 others, 15 of whom died. I don’t know if the first patient died; I don’t want to know. Please be careful. 

2. Belgian Nursing Homes Failed Patients Amid Pandemic (AP) Belgian authorities “abandoned” thousands of elderly people who died in nursing homes during the coronavirus pandemic and did not seek hospital treatment for many who were infected, violating their human rights, Amnesty International said in an investigation published Monday. During the first wave of the pandemic last spring, the European nation of 11.5 million people recorded a majority of its COVID-19-related deaths in nursing homes. Between March and October, Amnesty International said “a staggering” 61.3% of all COVID-19 deaths in Belgium took place in nursing homes. The group said authorities weren’t quick enough in implementing measures to protect nursing home residents and staff during this period, failing to protect their human rights.

Over 1 Million Children Tested Positive For Coronavirus In The United States

Immunity to the Coronavirus May Last Years, New Data Hint (J. Harris: A good read, maybe good news.)

They’ve Been Following the Science’: How the Covid-19 Pandemic Has Been Curtailed in Cherokee Nation (STAT) With a mask mandate in place since spring, free drive-through testing, hospitals well-stocked with PPE, and a small army of public health officers fully supported by their chief, the Cherokee Nation has been able to curtail its Covid-19 case and death rates even as those numbers surge in surrounding Oklahoma, where the White House coronavirus task force says spread is unyielding.

This was written by someone in California in response to their governor’s COVID orders:

“We’ve been told that only 6 people are allowed to meet for Thanksgiving, but 30 may gather for a funeral.  With this in mind, I announce that we will be holding a funeral for our pet turkey, who will pass away on Nov. 26.

Refreshments provided.

P.S. In lieu of flowers please bring a side or dessert.

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