COVID-19 as of today (03-17-20, summary is my own, not my employer’s – today’s update is short, but still very important – US state case counts at the bottom of the post):

Cases in New Countries and Community Spread: Countries Barbados, the Gambia, and Montenegro all report their first COVID-19 cases. 88 countries and territories across the world are now reporting community spread. [1, 2]

Every Country Should Test Every Suspected Case, WHO Says: The World Health Organization’s Director-General states: “We have a simple message for all countries: test, test, test. Test every suspected case. If they test positive, isolate them and find out who they have been in close contact with up to 2 days before they developed symptoms, and test those people too.” [3]

Los Angeles County Director of Public Health Explains Why Staying Home and Social Distancing Are So Important: “Our evidence to date suggests that there are people in every community who are positive; they don’t know they’re positive, and we don’t know they’re positive. And we may not have enough testing for a very long time for every single person to get tested. So in the absence of that, what you have to assume is that there are positive people who are in your community who don’t know that they’re positive and have the capacity to infect others. And that’s why we ask for all of the social distancing. For those of you in healthcare, we talk about universal precautions. Just assume that everybody you’re treating may in fact be infectious, and then take the precautions you need for everyone. And that’s what we’re asking all of you to do. Take all of the precautions we’ve asked you to take, assume that there may be lots of people who may be either asymptomatic or mildly ill, who have been circulating, that there may have been a lot of exposure, and don’t focus so much on the numbers – focus much more on the fact that COVID-19 is in all of our communities, there are enough people infected to infect other people, and if we’re not careful, and we don’t do our due diligence now, we will continue to see exponential increases for many, many weeks to come.” Los Angeles County reported 50 new cases today, bringing its total to 144, or 1.4 cases per 100,000 people (up from 94 cases, or 0.9 cases per 100,000 yesterday). [4]

New York Braces for COVID-19 Surge: The mayor of New York City activates the 9,000 licensed and retired workers in the Medical Reserve Corps, attempting to quickly build up surge capacity in the city’s healthcare system. Today, New York City reports 923 positive cases (10.7 cases per 100,000 people in NYC), bringing the case count for New York State to 1,653 (6.7 cases per 100,000 people outside of NYC). This is a 2.3-fold increase in cases from two days ago. A new drive-thru testing facility opens in Nassau County; more are expected in Suffolk County, Rockland County and on Staten Island in the days to come. The Greater NY Hospital Association and Healthcare Association of NYS are working with 1199 SEIU (the largest healthcare union in the US) to develop a plan for drop-in child care and an expansion of child care facilities at hospitals; this should help offset the impacts of school cancellations on parents who are members of the healthcare workforce. [5, 6]

Italy Close to Healthcare System Collapse: An anesthesiologist in Milan, the epicenter of Italy’s COVID-19 outbreak, summarizes the country’s current condition. “As of Tuesday, nationwide, there were 31,506 cases, of which 2,941 recovered and 2,503 died. Lombardy, the region most affected, has 16,220 cases, with 1,640 dead, 879 in intensive care — 56 more than the day before — and 2,485 clinically cured. With these numbers, the country’s health care system may soon collapse.” Of note, Italy reported its first case on January 31, more than a week after the US reported their first. [7]

Healthcare Workers on the Front Lines of the Outbreak: Dozens of healthcare workers have fallen ill in the US, in Washington State, California, Massachusetts, Pennsylvania, and likely other states; there is no current state or federal reporting on healthcare workers testing positive for COVID-19, so these are based on news reports. Based on the most recent year of data available (2016), the US trails behind 30 other countries in its hospital bed capacity (2.8 per 1,000 people); the country’s hospital bed capacity has gradually declined since 2000, when it had 3.5 per 1,000 people. A board member of the American College of Emergency Physicians states: “The risk to our health-care workers is one of the great vulnerabilities of our health-care system in an epidemic like this. Most ERs and health-care systems are running at capacity in normal times.” Of note, Italy has 3.2 hospital beds per 1,000 people. [8, 9]

All 50 States Now Reporting COVID-19, Half Experiencing Exponential Increases in Confirmed Cases: West Virginia reported its first case today; all 50 states and 3 territories in the US now have active cases. States reporting 10 or more cases as of today that have seen a 2 fold increase or higher in the past 48-72 hours include Alabama, Connecticut, Delaware, Florida, Georgia, Illinois, Kansas, Louisiana, Maine, Maryland, Minnesota, Mississippi, Missouri, New Hampshire, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Wisconsin, and Wyoming. NOTE: These 2+ fold increases could be due to exponential spread, increased testing capacity, increased awareness of symptoms (so more patients requesting care), or some combination of the three. [AL, CT, DE, FL, GA, IL, KS, LA, MD, ME, MN, MO, MS, NH, NJ, NY, OH, OK, PA, SC, TN, UT, VT, WI, WV, WY]

Summary of Outbreak on the Diamond Princess: The CDC releases an article summarizing the Diamond Princess outbreak and investigation. While the index case for this outbreak could not be determined, the passenger with the earliest known symptoms started becoming ill on January 22. The second known case started becoming ill on January 23 and disembarked the ship on January 25. All symptomatic passengers were tested upon arrival in Yokohama, and those with positive results were disembarked February 4 and 5; on February 5, the remaining passengers (who were not ill at the time) were requested to remain in their cabins on the ship for 14 days. Because the first detected cases occurred among passengers who became symptomatic on January 22 and 23, COVID-19 was likely transmitted first from passengers to crew members and then spread among the crew, especially among food service workers. These crew members continued to perform their regular duties, such as delivering meals to passengers. By the end of the 14-day quarantine, about 700 cases had been confirmed among passengers and crew. [10]

More Fraudulent Products Being Hawked as COVID-19 Cures: The FDA is working closely with major retailers who are monitoring their online marketplaces for fraudulent products claiming to treat COVID-19 or other illnesses. To date, the FDA has received reports of more than 90 products marketed with unapproved claims to prevent, treat or cure COVID-19. The agency has found 50 products marketed on popular online marketplaces with similar, unproven claims. All of these listings have since been removed. They are also monitoring retail stores, websites that appear to be legitimate pharmacies, and social media platforms for fraudulent claims, and will take action against those attempting to defraud customers with fake COVID-19 products. [11]

[1] WHO COVID-19 Situation Report, 03-17-20

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200317-sitrep-57-covid-19.pdf?sfvrsn=a26922f2_2

[2] Johns Hopkins COVID-19 Map

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

[3] WHO Director-General's opening remarks at the media briefing on COVID-19 - 16 March 2020

https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---16-march-2020

[4] LA County officials give update on COVID-19 (March 17, 2020) [Around the 1-hour mark]

https://www.facebook.com/countyofla/videos/136652997777166/

[5] MSNBC, Tweet, 03-17-20, 07:14 pm

https://twitter.com/MSNBC/status/1240099337595768834?s=20

[6] Governor Cuomo Announces Three-Way Agreement with Legislature on Paid Sick Leave Bill to Provide Immediate Assistance for New Yorkers Impacted By COVID-19

https://www.governor.ny.gov/news/governor-cuomo-announces-three-way-agreement-legislature-paid-sick-leave-bill-provide-immediate

[7] I’m a Doctor in Italy. We Have Never Seen Anything Like This.

https://www.nytimes.com/2020/03/18/opinion/coronavirus-italy.html

[8] COVID-19 hits doctors, nurses and EMTs, threatening health system

https://www.washingtonpost.com/health/covid-19-hits-doctors-nurses-emts-threatening-health-system/2020/03/17/f21147e8-67aa-11ea-b313-df458622c2cc_story.html

[9] OECD Health Care Resources: Hospital Beds

https://stats.oecd.org/index.aspx?queryid=30183

[10] Initial Investigation of Transmission of COVID-19 Among Crew Members During Quarantine of a Cruise Ship — Yokohama, Japan, February 2020

https://www.cdc.gov/mmwr/volumes/69/wr/mm6911e2.htm?s_cid=mm6911e2_e&deliveryName=USCDC_921-DM22863

[11] FDA Commissioner Stephen Hahn: “Be Wary of Anyone Claiming They Can Cure COVID-19. Talk to Your Doctor.”

https://www.whitehouse.gov/briefings-statements/fda-commissioner-stephen-hahn-wary-anyone-claiming-can-cure-covid-19-talk-doctor/

Case Counts:

[AK] http://dhss.alaska.gov/dph/Epi/id/Pages/COVID-19/monitoring.aspx

[AL] http://www.alabamapublichealth.gov/infectiousdiseases/2019-coronavirus.html

[AR] https://www.healthy.arkansas.gov/programs-services/topics/novel-coronavirus?

[AS] https://www.samoanews.com/covid-19

[AZ] https://www.azdhs.gov/preparedness/epidemiology-disease-control/infectious-disease-epidemiology/index.php?#novel-coronavirus-home

[CA] https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/nCoV2019.aspx

[CO] https://docs.google.com/document/d/e/2PACX-1vRSxDeeJEaDxir0cCd9Sfji8ZPKzNaCPZnvRCbG63Oa1ztz4B4r7xG_wsoC9ucd_ei3--Pz7UD50yQD/pub

[CT] https://portal.ct.gov/Coronavirus

[DC] https://coronavirus.dc.gov/page/coronavirus-surveillance-data

[DE] https://www.dhss.delaware.gov/dhss/dph/epi/2019novelcoronavirus.html

[FL] http://www.floridahealth.gov/diseases-and-conditions/COVID-19

[GA] https://dph.georgia.gov/covid-19-daily-status-report

[GU] https://twitter.com/louleonguerrero

[HI] https://health.hawaii.gov/docd/advisories/novel-coronavirus-2019/

[IA] https://idph.iowa.gov/Emerging-Health-Issues/Novel-Coronavirus

[ID] https://coronavirus.idaho.gov/

[IL] http://www.dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/coronavirus

[IN] https://www.in.gov/coronavirus/

[KS] http://www.kdheks.gov/coronavirus/index.htm

[KY] https://chfs.ky.gov/agencies/dph/pages/covid19.aspx

[LA] http://ldh.la.gov/coronavirus/

[MA] https://www.mass.gov/info-details/covid-19-cases-quarantine-and-monitoring#covid-19-cases-in-massachusetts-

[MD] https://phpa.health.maryland.gov/Pages/Novel-coronavirus.aspx

[ME] https://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/coronavirus.shtml

[MI] https://www.michigan.gov/Coronavirus

[MN] https://www.health.state.mn.us/diseases/coronavirus/situation.html

[MO] https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus

[MS] https://msdh.ms.gov/msdhsite/_static/14,0,420.html

[MT] https://dphhs.mt.gov/publichealth/cdepi/diseases/coronavirusmt

[NC] https://www.ncdhhs.gov/covid-19-case-count-nc

[ND] https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases

[NE] http://dhhs.ne.gov/Pages/Coronavirus.aspx

[NH] https://www.dhhs.nh.gov/dphs/cdcs/2019-ncov.htm

[NJ] https://www.nj.gov/health/cd/topics/covid2019_dashboard.shtml

[NM] https://cv.nmhealth.org/

[NMI] https://www.cdc.gov/coronavirus/2019-ncov/index.html

[NV] http://dpbh.nv.gov/coronavirus/

[NY] https://www.health.ny.gov/diseases/communicable/coronavirus/

[OH] https://coronavirus.ohio.gov/wps/portal/gov/covid-19/

[OK] https://coronavirus.health.ok.gov/

[OR] https://www.oregon.gov/oha/PH/DISEASESCONDITIONS/DISEASESAZ/Pages/emerging-respiratory-infections.aspx

[PA] https://www.health.pa.gov/topics/disease/Pages/Coronavirus.aspx

[PR] https://www.miamiherald.com/news/nation-world/world/americas/article241237251.html

[RI] https://health.ri.gov/data/covid-19/

[SC] https://www.scdhec.gov/infectious-diseases/viruses/coronavirus-disease-2019-covid-19/monitoring-testing-covid-19

[SD] https://doh.sd.gov/news/Coronavirus.aspx

[TN] https://www.tn.gov/health/cedep/ncov.html

[TX] https://www.dshs.texas.gov/news/updates.shtm#coronavirus

[USVI] https://doh.vi.gov/covid19usvi

[UT] https://coronavirus.utah.gov/latest/

[VA] http://www.vdh.virginia.gov/surveillance-and-investigation/novel-coronavirus/

[VT] https://www.healthvermont.gov/response/infectious-disease/2019-novel-coronavirus

[WA] https://www.doh.wa.gov/Emergencies/Coronavirus

[WI] https://www.dhs.wisconsin.gov/outbreaks/index.htm

[WV] https://dhhr.wv.gov/COVID-19/Pages/default.aspx

[WY] https://health.wyo.gov/publichealth/infectious-disease-epidemiology-unit/disease/novel-coronavirus/