COVID-19 as of today (03-22-20; summary is my own, not my employer’s):

[QUICK NOTE: You can find definitions of some terms I use commonly in these posts, as well as the link to your state health department’s up-to-date COVID-19 case counts, here: https://docs.google.com/document/d/1CQZ9KGRJ8gLqSs89sEjpVSr5jBEkgvgBT-QoMOy-O0w

I am starting a new school term tomorrow for my doctoral program and will be unable to keep doing these updates daily; I still aim to do them every other day going forward.]

Countries and Territories with New COVID-19 Cases:

Countries Dominica, Grenada, Mozambique and Syria report their first COVID-19 cases. [1]

New Test Kit Will Speed Up Turnaround Time for Results, Warning on Fraudulent “In-Home” Test Kits:

On March 20, the FDA warned the American public that any advertised COVID-19 home test kits are fraudulent and asks that you report any you see to them so they can investigate. Yesterday, they announced the first Emergency Use Authorization given to a “point of care” diagnostic COVID-19 test. This type of test can be used in more laboratories and even in labs at certain medical care providers, which should reduce the time needed to get results from days to hours (the test itself can be run in 45 minutes). Cepheid, the company who makes this test, intends to start rolling them out on March 30. The company has 23,000 automated testing systems worldwide that can process these tests on a 24/7 basis, without the need for those using the machines to be specially trained. [2-4]

Devices that Monitor COVID-19 Patients’ Vitals Can Now Be Used for Those Recovering at Home:

The FDA issued a new policy on March 20 that allows for non-invasive vital sign-measuring devices to be used by doctors to check on their patients’ vital signs remotely. The devices include those that measure body temperature, respiratory rate, heart rate and blood pressure. This is a welcome development, as anecdotal reports from some doctors indicate that COVID-19 patients may report feeling better before becoming more ill. This will allow doctors to determine if there’s a shift in a patient’s symptoms and help them decide if these patients may need to be hospitalized. [5, 6]

New Shelter in Place Orders and Potential Problems:

States Delaware, Ohio, and Louisiana; cities Belton (MO), Kansas City (MO), Nantucket (MA), Nashville (TN), Philadelphia (PA), St. Louis (MO), and Tupelo (MS); and counties Clay (MO), Dallas (TX), Jackson (MO), Johnson (KS), Leavenworth (KS), Platte (MO), and Wyandotte (KS) are the newest areas to issue shelter-in-place/stay-at-home orders. More than 1 in 3 Americans are living in an area that currently has such an order in place. A pressing issue many are facing under these new orders is that though some areas have enacted emergency rulings protecting renters from evictions, and the White House has passed such a ruling for 30 million homeowners, there are no national-level eviction protections for 40 million renters across the country. Another concern is that as stay-at-home orders are rolled out in a piecemeal fashion, residents of these areas could easily travel to a different city, county or state that does not have such an order in place, potentially starting outbreaks in areas that have not been hit as hard yet. [7-18]

California, New York and Washington Major Disaster Declarations Approved:

The US President approves the California, New York, and Washington Major Disaster Declarations, which orders federal assistance to supplement state, tribal, and local recovery efforts in the areas in areas affected by the COVID-19 outbreak; makes federal funding available for crisis counseling for all individuals in these states; and directs federal funding toward emergency protective measures, including direct federal assistance, for all areas in these states impacted by COVID-19. [19-21]

Support for Healthcare Providers by Way of More Flexible Rules for Devices, Medicare Reporting:

The FDA announces that it is relaxing its policies on ventilator modifications, allowing the use of ventilators outside of their normal environments (for example, a provider could use a ventilator normally intended for ambulance transport in the hospital setting), and allowing ventilators to be used beyond their normal shelf life. The agency also encourages both domestic and foreign manufacturers to pursue emergency use authorizations that would allow them to distribute their ventilators in the United States. The Centers for Medicare & Medicaid Services announces relief for clinicians, providers and facilities participating in Medicare quality reporting programs by making some reporting deadlines optional and extending others. [22, 23]

Americans and Canadians Fly Home from a Cruise Ship with an Active COVID-19 Outbreak:

Nearly 400 Americans and Canadians disembarked from the Costa Luminosa cruise ship as their COVID-19 tests in France were still pending; three positive results were reported as the plane landed in Atlanta, forcing it to idle on the tarmac for about 5 hours. French health authorities had already found 36 positive cases in people who had fevers on the cruise ship; Carnival (the company operating the Costa Luminosa) claims that they were not made aware of these initial cases. [24]

COVID-19 Outbreaks in Prisons, Among Police Forces [TWO PARAGRAPHS]:

Four days after announcing the first positive COVID-19 case in an imprisoned person in Riker’s Island, and the suspension of all in-person visits to any jail operated by the New York City Department of Correction, the Mayor of New York City announces that 21 imprisoned people and 17 employees have tested positive for COVID-19 at the facility. Unconfirmed reports from officials connected to the New York state prison system allege that Harvey Weinstein is among those who have been found to have COVID-19. Individual information on cases is generally not allowed to be released publicly, as it constitutes a violation of patients’ medical privacy. Yesterday, the federal Bureau of Prisons announced that one individual has tested positive for COVID-19 at the Metropolitan Detention Center in Brooklyn.

Three Los Angeles Police Department (LAPD) employees have tested positive for COVID-19; the third case, announced yesterday, was in an individual who went to work while sick. LAPD stated that this employee was sent home after a supervisor was made aware that the individual was showing symptoms; however, several officers at the station where this individual worked claimed that the officer was allowed to work at least two days while coughing. [25-29]

Treating Cytokine Storms in COVID-19 Patients with Severe Illness:

Cytokines are small proteins secreted by cells to help cells communicate with each other. One of cytokines’ many functions is to help regulate immune and inflammatory responses to infections. A cytokine storm is what happens when cytokines over-react to infection; it can cause inflammation that spreads throughout the body, swelling, pain, loss of bodily functions, acute lung injury, sepsis, and in many cases, death. Increasing anecdotal reports indicate that a subgroup of patients with severe COVID-19 might have cytokine storm syndrome. The primary cause of death in COVID-19 patients is from acute respiratory distress syndrome, but a recent study of patients in Wuhan found that some who died had virally driven hyperinflammation that may have been caused by cytokine storms. A recent article in the Lancet calls for drugs that suppress the immune system’s response to be used in patients with this type of hyperinflammation, though they remind healthcare providers that these drugs could also make COVID-19 associated lung injuries worse. More studies are needed urgently to determine whether these drugs would be more beneficial or harmful for patients experiencing signs of respiratory distress and hyperinflammation. [30, 31]

Germany Bans Gatherings of More than Two People, Chancellor is Self-Quarantining After Exposure:

Angela Merkel, the German Chancellor, learned that the doctor who vaccinated her against pneumonia on March 20 had tested positive for COVID-19; she is now self-quarantining and monitoring herself for symptoms. This news came shortly after Germany imposed new social-distancing rules that limit public gatherings to two people, not including families. Under the new restrictions, restaurants will be allowed to stay open, but provide only takeout and delivery services. People will still be allowed to go to work and to leave home to care for relatives, shop and visit doctors. [32]

Racist Extremist Groups Encouraging Members to Spread COVID-19 to Police Officers, Jews:

An FBI alert that went out from its New York office to local police agencies on March 19 states that neo-nazis and other white supremacist groups want their followers to try to use spray bottles to spread bodily fluids to cops on the street. The extremists are also directing followers to spread the disease to Jews by going "any place they may be congregated, to include markets, political offices, businesses and places of worship." [33]

First Senator to Test Positive for COVID-19 is Asymptomatic, Stalled Aid Bill with Doomed Amendment, Visited Gym While Waiting for Test Results:

Rand Paul, a Kentucky senator, is the first US senator to test positive for COVID-19. A tweet reporting this, written in the third person, states that he “was tested out of an abundance of caution due to his extensive travel and events. He was not aware of any direct contact with any infected person.” His chief of staff later clarified that he decided to be tested after attending an event where two other attendees later tested positive for COVID-19. A senator from Kansas states that Rand Paul went to the Senate gym this morning; Paul’s Twitter account later stated that he went before knowing his test result. While he was not symptomatic, public health agencies instruct suspect cases to self-isolate while waiting for their test result. Earlier this week, Paul forced a delay on the Senate's first coronavirus aid bill by pushing a doomed amendment that would have required termination of United States military operations and reconstruction activities in Afghanistan. He later voted against the bill. Two members of the House of Representatives have also been found to be positive for COVID-19; another representative is hospitalized with pneumonia from a rib fracture and has not been found to have the virus. [34-36]

[1] Johns Hopkins COVID-19 Map

https://coronavirus.jhu.edu/map.html

[2] Coronavirus (COVID-19) Update: FDA Alerts Consumers About Unauthorized Fraudulent COVID-19 Test Kits

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-alerts-consumers-about-unauthorized-fraudulent-covid-19-test-kits

[3] Coronavirus (COVID-19) Update: FDA Issues first Emergency Use Authorization for Point of Care Diagnostic

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-issues-first-emergency-use-authorization-point-care-diagnostic

[4] Cepheid Receives Emergency Use Authorization from FDA for Rapid SARS-CoV-2 Test

http://cepheid.mediaroom.com/2020-03-21-Cepheid-Receives-Emergency-Use-Authorization-from-FDA-for-Rapid-SARS-CoV-2-Test

[5] Coronavirus (COVID-19) Update: FDA allows expanded use of devices to monitor patients’ vital signs remotely

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-allows-expanded-use-devices-monitor-patients-vital-signs-remotely

[6] 'A slow burn': Coronavirus symptoms often linger before worsening

https://www.nbcnews.com/health/health-news/slow-burn-coronavirus-symptoms-often-linger-worsening-n1164756

[7] Governor Carney Issues Stay-at-Home Order for Delawareans

https://news.delaware.gov/2020/03/22/governor-carney-issues-stay-at-home-order-for-delawareans/

[8] Ohio Issues "Stay at Home" Order; New Restrictions Placed on Day Cares for Children

https://coronavirus.ohio.gov/wps/portal/gov/covid-19/home/news-releases-news-you-can-use/ohio%2B-issues-stay-at-home-order-new-restrictions-placed-on-day-cares-for-children

[9] Gov. Edwards Issues Statewide Stay at Home Order to Further Fight the Spread of COVID-19 in Louisiana

https://gov.louisiana.gov/index.cfm/newsroom/detail/2427

[10] Stay at Home Order FAQ

https://www.kcmo.gov/city-hall/departments/health/coronavirus-covid-19/stay-at-home-order-faq

[11] Town of Nantucket Emergency Order

https://nantucket-ma.gov/DocumentCenter/View/35718/Emergency-Order-N3---Stay-at-Home-aka-Shelter-in-Place-Order-PDF?bidId=

[12] Order 3 from the Chief Medical Director: Safer at Home Order

https://www.asafenashville.org/updates/order-3-from-the-chief-medical-director-safer-at-home-order/

[13] The new Business Activity and Stay at Home Order: What you need to know

https://www.phila.gov/2020-03-22-the-new-business-activity-and-stay-at-home-order-what-you-need-to-know/

[14] Health Commissioner's Order #5

https://www.stlouis-mo.gov/government/departments/health/communicable-disease/covid-19/documents/health-commissioners-order-5.cfm

[15] City of Tupelo, MS: Shelter in Place

http://media.heartlandtv.com/documents/009+Executive+Order.pdf

[16] Amended Order: Stay Home Safe

https://www.dallascounty.org/government/comcrt/jenkins/covid-19.php

[17] ‘Stay at home’ order issued for Clay and Platte counties in Missouri, Leavenworth County in Kansas

https://www.kmbc.com/article/stay-at-home-order-issued-for-belton-leavenworth-county-kansas-platte-county-missouri-because-of-covid-19-outbreak-coronavirus/31875442#

[18] Facing eviction as millions shelter in place

https://www.washingtonpost.com/dc-md-va/2020/03/22/evictions-coronavirus-renters-shelter-in-place/

[19] President Donald J. Trump Approves Washington Disaster Declaration

https://www.whitehouse.gov/briefings-statements/president-donald-j-trump-approves-washington-disaster-declaration-2/

[20] President Donald J. Trump Approves Major Disaster Declaration for California

https://www.fema.gov/news-release/2020/03/22/president-donald-j-trump-approves-major-disaster-declaration-california

[21] President Donald J. Trump Approves Major Disaster Declaration for New York

https://www.fema.gov/news-release/2020/03/20/president-donald-j-trump-approves-major-disaster-declaration-new-york

[22] Coronavirus (COVID-19) Update: FDA Continues to Facilitate Access to Crucial Medical Products, Including Ventilators

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-continues-facilitate-access-crucial-medical-products-including

[23] CMS Announces Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19

https://www.cms.gov/newsroom/press-releases/cms-announces-relief-clinicians-providers-hospitals-and-facilities-participating-quality-reporting

[24] Hundreds Exposed to Coronavirus on Cruise Ship Fly Home

https://www.nytimes.com/2020/03/20/us/coronavirus-cruise-ship-costa-luminosa.html

[25] 21 Inmates, 17 Employees Test Positive for COVID-19 on Rikers Island: Officials

https://www.nbcnewyork.com/news/coronavirus/21-inmates-17-employees-test-positive-for-covid-19-on-rikers-island-officials/2338242/

[26] At New York prison, Harvey Weinstein put in isolation after contracting virus

https://www.niagara-gazette.com/covid-19/at-new-york-prison-harvey-weinstein-put-in-isolation-after/article_26e38374-6c7d-11ea-9f8a-3b2c09e7817d.html

[27] New York City Department of Correction: COVID19 Preparation & Action Plan

https://www1.nyc.gov/site/doc/media/coronavirus-news.page

[28] 3rd Department Employee Tests Positive for Coronavirus

http://www.lapdonline.org/home/news_view/66436

[29] 3rd LAPD officer tests positive for COVID-19 after showing symptoms inside station for days, sources say

https://ktla.com/news/coronavirus/3rd-lapd-officer-tests-positive-for-covid-19-after-showing-symptoms-inside-station-for-days-sources-say/

[30] Into the Eye of the Cytokine Storm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3294426/

[31] COVID-19: consider cytokine storm syndromes and immunosuppression

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30628-0/fulltext

[32] German Chancellor Angela Merkel Goes into Self-Isolation

https://www.npr.org/sections/coronavirus-live-updates/2020/03/22/819889070/german-chancellor-angela-merkel-goes-into-self-isolation

[33] White supremacists encouraging their members to spread coronavirus to cops, Jews, FBI says

https://abcnews.go.com/US/white-supremacists-encouraging-members-spread-coronavirus-cops-jews/story?id=69737522

[34] Rand Paul becomes first senator known to test positive for coronavirus

https://www.nbcnews.com/politics/congress/rand-paul-becomes-first-known-senator-test-positive-coronavirus-n1166111

[35] Senate coronavirus vote delayed after Rand Paul pushes doomed amendment

https://www.nbcnews.com/politics/congress/senate-coronavirus-bill-vote-delayed-after-rand-paul-pushes-doomed-n1162356

[36] Congressman Mark Desaulnier in Critical Condition Following Battle With Pneumonia

https://www.newsweek.com/congressman-mark-desaulnier-critical-condition-following-battle-pneumonia-1493630