StemCell Therapy

For the first time in its 68-year history, the Legal Aid Society of Mid New York Inc. has a director of development and communication. Alex Simon started as the new head of fundraising and comes to Legal Aid after a nearly 10-year career in which he has served in fundraising and communication roles at colleges and universities across upstate New York.

Simon has been a part of fundraising teams at Cazenovia College, Union College, SUNY Polytechnic and the Masonic Medical Research Institute that achieved record-breaking support. In these roles, Simon has worked with business and community partners to fund research programs, pushed for unrestricted capital and established endowments for deserving students.

Simon works out of the Utica office at 120 Bleecker St.

IN OTHER BUSINESS NEWS:

NBT Bank has been recognized with six awards in the 2019 Greenwich Excellence Awards in Small Business Banking and Middle Market Banking. In the U.S. Middle Market Banking category, more than 600 banks were evaluated for excellence with 33 recognized with distinctive quality. NBT earned the following three designations: Cash Management Overall Satisfaction (Northeast), Likelihood to Recommend (Northeast) and Overall Satisfaction (Northeast). In the U.S. Small Business Banking category, more than 600 banks were evaluated for excellence with 36 recognized for distinctive quality. NBT earned the following three designations: Overall Satisfaction, Likelihood to Recommend (Northeast) and Overall Satisfaction (Northeast). The awards are based on interviews with more than 13,000 middle-market businesses with sales of $10 to 500 million and more than 14,000 small businesses with sales of $1 to 10 million across the country.

Michael Tucciarone, a chiropractor, along with his wife, Mary, have announced their retirement. Tucciarone has had offices in Utica, Herkimer, Hamilton and most recently in Clinton. Kelsey Roberts is taking over the day-to-day operations of the practice. Roberts is a graduate of Le Moyne College and New York Chiropractic College. She has a doctorate in chiropractic and a masters in clinical nutrition. Roberts will administer and treat patients in the Clinton area. For information or concerns about future treatment, contact the office at 315-853-6225.

The Genesis Group along with The Medical Societies and its partners will host the 15th annual Healthcare Recognition at 5:30 p.m. Tuesday, May 19, at Hart's Hill Inn, 135 Clinton St., Whitesboro. The recognition honors area health care professionals who have demonstrated excellence in the workplace and in the community. Nominations are being accepted. Deadline for submission is Friday, April 3. For information and nomination form, email info@TheGenesisGroup.org.

Taylor Arcuri Unser is practicing cardiovascular and preventative medicine with Fred Talarico, MD, and Pat Rosati, ANP, at 2115 Genesee St., Utica, and is accepting new patients. Unser recently earned a masters degree as a nurse practitioner from SUNY Polytechnic. Prior to her recent graduation, she was employed at Mohawk Valley Health System as a registered nurse at the St. Elizabeth Medical Center caring for internal medicine and acute cardiac patients.

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Legal Aid Society hires director of development and communication - The Times Telegram

MILAN/SEOUL In Italy, millions are locked down and more than 1,000 people have died from the coronavirus. In South Korea, hit by the disease at about the same time, only a few thousand are quarantined and 67 people have died. As the virus courses through the world, the story of two outbreaks illustrates a coming problem for countries now grappling with an explosion in cases.

Its impractical to test every potential patient, but unless the authorities can find a way to see how widespread infection is, their best answer is lockdown.

Italy started out testing widely, then narrowed the focus so that now, the authorities dont have to process hundreds of thousands of tests. But theres a trade-off: They cant see whats coming and are trying to curb the movements of the countrys entire population of 60 million people to contain the disease. Even Pope Francis, who has a cold and delivered his Sunday blessing over the internet from inside the Vatican, said he felt caged in the library.

Thousands of miles away in South Korea, authorities have a different response to a similar-sized outbreak. They are testing hundreds of thousands of people for infections and tracking potential carriers like detectives, using cell phone and satellite technology.

Both countries saw their first cases of the disease called COVID-19 in late January. South Korea has since reported 67 deaths out of nearly 8,000 confirmed cases, after testing more than 222,000 people. In contrast, Italy has had 1,016 deaths and identified more than 15,000 cases after carrying out more than 73,000 tests on an unspecified number of people.

Epidemiologists say it is not possible to compare the numbers directly. But some say the dramatically different outcomes point to an important insight: Aggressive and sustained testing is a powerful tool for fighting the virus.

Jeremy Konyndyk, a senior policy fellow at the Center for Global Development in Washington, said extensive testing can give countries a better picture of the extent of an outbreak. When testing in a country is limited, he said, the authorities have to take bolder actions to limit movement of people.

Im uncomfortable with enforced lockdown-type movement restrictions, he said. China did that, but China is able to do that. China has a population that will comply with that.

The democracies of Italy and South Korea are useful case studies for countries such as America, which have had problems setting up testing systems and are weeks behind on the infection curve. So far, in Japan and the United States particularly, the full scale of the problem is not yet visible.

Germany has not experienced significant testing constraints, but Chancellor Angela Merkel warned her people on Wednesday that since 60% to 70% of the populace is likely to be infected, the only option is containment.

South Korea, which has a slightly smaller population than Italy at about 50 million people, has around 29,000 people in self-quarantine. It has imposed lockdowns on some facilities and at least one apartment complex hit hardest by outbreaks. But so far no entire regions have been cut off.

Seoul says it is building on lessons learned from an outbreak of Middle East Respiratory Syndrome in 2015 and working to make as much information available as possible to the public. It has embarked on a massive testing program, including people who have very mild illness, or perhaps dont even have symptoms, but who may be able to infect others.

This includes enforcing a law that grants the government wide authority to access data: CCTV footage, GPS tracking data from phones and cars, credit card transactions, immigration entry information, and other personal details of people confirmed to have an infectious disease. The authorities can then make some of this public, so anyone who may have been exposed can get themselves or their friends and family members tested.

In addition to helping work out who to test, South Koreas data-driven system helps hospitals manage their pipeline of cases. People found positive are placed in self-quarantine and monitored remotely through a smartphone app, or checked regularly in telephone calls, until a hospital bed becomes available. When a bed is available, an ambulance picks the person up and takes the patient to a hospital with air-sealed isolation rooms. All of this, including hospitalization, is free of charge.

South Koreas response is not perfect. While more than 209,000 people have tested negative there, results are still pending on about 18,000 others an information gap that means there are likely more cases in the pipeline.

The rate of newly confirmed cases has dropped since a peak in mid-February, but the systems greatest test may still be ahead as authorities try to track and contain new clusters. South Korea does not have enough protective masks it has started rationing them and it is trying to hire more trained staff to process tests and map cases.

And the approach comes at the cost of some privacy. South Koreas system is an intrusive mandatory measure that depends on people surrendering what, for many in Europe and America, would be a fundamental right of privacy. Unlike China and the island-state of Singapore, which have used similar methods, South Korea is a large democracy with a population that is quick to protest policies it does not like.

Disclosing information about patients always comes with privacy infringement issues, said Choi Jaewook, a preventive medicine professor at Korea University and a senior official at the Korean Medical Association. Disclosures should be strictly limited to patients movements, and it shouldnt be about their age, their sex, or their employers.

Traditional responses such as locking down affected areas and isolating patients can be only modestly effective, and may cause problems in open societies, says South Koreas Deputy Minister for Health and Welfare Kim Gang-lip. In South Koreas experience, he told reporters on Monday, lockdowns mean people participate less in tracing contacts they may have had. Such an approach, he said, is close-minded, coercive, and inflexible.

Italy at the limit

Italy and South Korea are more than 5,000 miles apart, but there are several similarities when it comes to coronavirus. Both countries main outbreaks were initially clustered in smaller cities or towns, rather than in a major metropolis, which meant the disease quickly threatened local health services. And both involved doctors who decided to ignore testing guidelines.

Italys epidemic kicked off last month. A local man with flu symptoms was diagnosed after he had told medical staff he had not been to China and discharged himself, said Massimo Lombardo, head of local hospital services in Lodi.

The diagnosis was only made after the 38-year-old, whose name has only been given as Mattia, returned to the hospital. Testing guidelines at the time said it was not necessary to test people who had no link to China or other affected areas. But an anesthetist pushed the protocols and decided to go ahead and test for COVID-19 anyway, Lombardo said. Now, some experts in Italy believe Mattia may have been infected through Germany, rather than China.

Decisions about testing hinge partly on what can be done with people who test positive, at a time when the healthcare system is already under stress. In Italy at first, regional authorities tested widely and counted all positive results in the published total, even if people did not have symptoms.

Then, a few days after the patient known as Mattia was found to have COVID-19, Italy changed tack, only testing and announcing cases of people with symptoms. The authorities said this was the most effective use of resources: The risk of contagion seemed lower from patients with no symptoms, and limited tests help produce reliable results more quickly. The approach carried risks: People with no symptoms still can be infected and spread the virus.

On the other hand, the more you test the more you find, so testing in large numbers can put hospital systems under strain, said Massimo Antonelli, director of intensive care at the Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome. Testing involves elaborate medical processes and follow-up. The problem is actively searching for cases, he said. It means simply the numbers are big.

Italy has a generally efficient health system, according to international studies. Its universal healthcare receives funding below the European Union average but is comparable with South Koreas, at 8.9% of GDP against 7.3% in South Korea, according to the World Health Organization.

Now, that system has been knocked off balance. Staff are being brought into accident and emergency departments, holidays have been canceled and doctors say they are delaying non-urgent operations to free up intensive care beds.

Pier Luigi Viale, head of the infectious disease unit at Sant Orsola-Malpighi hospital in Bologna, is working around the clock in three jobs. His hospital is handling multiple coronavirus cases. His doctors are shuttling to other hospitals and clinics in the area to lend their expertise and help out with cases. In addition, his doctors also have to deal with patients with other contagious diseases who are struggling to survive.

If it drags on for weeks or months well need more reinforcements, he told Reuters.

Last week, the mayor of Castiglione dAdda, a town of about 5,000 people in Lombardys red zone which was the first to be locked down, made an urgent online appeal for help. He said his small town had had to close its hospital and was left with one doctor to treat more than 100 coronavirus patients. Three of the towns four doctors were sick or in self quarantine.

Doctors and nurses are at the limit, said a nurse from the hospital where Mattia was taken in. If you have to manage people under artificial respiration you have to be watching them constantly, you cant look after the new cases that come in.

Studies so far suggest that every positive case of coronavirus can infect two other people, so local authorities in Lombardy have warned that the regions hospitals face a serious crisis if the spread continues not just for COVID-19 patients but also for others whose treatment has been delayed or disrupted. As the crisis spreads into Italys less prosperous south, the problems will be magnified.

Intensive care facilities face the most intense pressure. They require specialist staff and expensive equipment and are not set up for mass epidemics. In total, Italy has around 5,000 intensive care beds. In the winter months, some of these are already occupied by patients with respiratory problems. Lombardy and Veneto have just over 1,800 intensive care beds between public and private systems, only some of which can be set aside for COVID-19 patients.

The government has asked regional authorities to increase the number of intensive care places by 50% and to double the number of beds for respiratory and contagious diseases, while reorganizing staff rosters to ensure adequate staffing. Some 5,000 respirators have been acquired for intensive care stations, the first of which are due to arrive on Friday, deputy Economy Minister Laura Castelli said.

The region has already asked nursing institutes to allow students to bring forward their graduation to get more nurses into the system early. Pools of intensive care specialists and anesthetists are to be set up, including staff from outside the worst affected regions.

To add to the burden, hospitals in Italy depend on medical personnel to try to trace the contacts that people who test positive have had with others. One doctor in Bologna, who asked not to be named, said he had spent a 12-hour day tracing people who had been in contact with just one positive patient, to ensure those who next need testing are found.

You can do that if the number of cases remains two to three, the doctor said. But if they grow, something has to give. The system will implode if we continue to test everyone actively and then have to do all this.

Maximum power

In South Korea as in Italy, an early case of COVID-19 was identified when a medical officer followed their intuition, rather than the official guidelines, on testing.

The countrys first case was a 35-year-old Chinese woman who tested positive on Jan. 20. But the largest outbreak was detected after the 31st patient, a 61-year-old woman from South Koreas southeastern city of Daegu, was diagnosed on Feb. 18.

Like the patient named Mattia in Italy, the woman had no known links to Wuhan, the Chinese province where the disease was first identified. And as in Italy, the doctors decision to recommend a test went against guidelines at the time to test people who had been to China or been in contact with a confirmed case, said Korea Medical Associations Choi Jaewook.

Patient 31, as she became known, was a member of a secretive church which Deputy Minister for Health and Welfare Kim Gang-lip said has since linked to 61% of cases. Infections spread beyond the congregation after the funeral of a relative of the churchs founder was held at a nearby hospital, and there were several other smaller clusters around the country.

Once the church cluster was identified, South Korea opened around 50 drive-through testing facilities around the country. In empty parking lots, medical staff in protective clothing lean into cars to check their passengers for fever or breathing difficulties, and if needed, collect samples. The process usually takes about 10 minutes, and people usually receive the results in a text reminding them to wash their hands regularly and wear face masks.

A total of 117 institutions in South Korea have equipment to conduct the tests, according to the Korea Centers for Disease Control and Prevention (KCDC). The numbers fluctuate daily, but an average of 12,000 is possible, and maximum capacity is 20,000 tests a day. The government pays for tests of people with symptoms, if referred by a doctor. Otherwise, people who want to be tested can pay up to 170,000 won ($140), said an official at a company called Seegene Inc, which supplies 80% of the countrys kits and says it can test 96 samples at once.

There are also 130 quarantine officers like Kim Jeong-hwan, who focus on minute details to track potential patients. The 28-year-old public health doctor spends his whole working days remotely checking up on people who have tested positive for COVID-19, the disease caused by the virus.

Kim, who is doing military service, is one of a small army of quarantine officers who track the movements of any potential carriers of the disease by phone, app or the signals sent by cell phones or the black boxes in automobiles. Their goal: To trace all the contacts people may have had, so they too can be tested.

I havent seen anyone telling bad lies, Kim said. But lots of people generally dont remember exactly what they did.

Underlining their determination, quarantine officers told Reuters they located five cases after a worker in a small town caught the virus and went to work in a coin karaoke, a bar where a machine lets people sing a few songs for a dollar. At first, the woman, who was showing symptoms, did not tell the officers where she worked, local officials told Reuters. But they put the puzzle together after questioning her acquaintances and obtaining GPS locations on her mobile device.

Now, quarantine officers have maximum power and authority, said Kim Jun-geun, an official at Changnyeong County who collects information from quarantine officers.

South Koreas government also uses location data to customize mass messages sent to cellphones, notifying every resident when and where a nearby case is confirmed.

Lee Hee-young, a preventative medicine expert who is also running the coronavirus response team in South Koreas Gyeonggi province, said South Korea has gone some of the way after MERS to increase its infrastructure to respond to infectious diseases. But she said only 30% of the changes the country needs have happened. For instance, she said, maintaining a trained workforce and up-to-date infrastructure at smaller hospitals isnt easy.

Until we fix this, Lee said, explosions like this can keep blowing up anywhere.

The rest is here:
Italy and South Korea virus outbreaks reveal disparity in deaths and tactics - The Union Leader

Coronavirus has officially been declared a pandemic and every time you look at news about current events you see another set of numbers, each higher than the last, telling how many people are infected or have tested positive. Amidst the warnings from actual health officials and the brush-off from politicians, you'll also find more and more companies have closed offices down and have employees working from home.

Coronavirus and tech: Ongoing list of event cancellations, disruptions, product delays, and more

All the big names have already done it: Google, Microsoft, Facebook, Amazon, Apple, and Twitter off the top of my head. And doing it was the smart call from both a company liability standpoint as well as a way to look out for the welfare of employees.

Cornavirus is passed from person to person so limited exposure is the best preventative medicine.

Avoiding any setting where a large group of people is near each other is smart right now, but for tech companies, it's even smarter so many employees are flying all over the world visiting other offices and that means the chances of those folks contracting the virus is much higher because of basic math. Get close to more people, the chances you'll come in contact with someone who has the virus and doesn't know it yet gets higher.

It sounds like an easy idea to grasp, but I'm also seeing a good many people saying that closing offices and schools, telling people to avoid large crowds, or even self-isolating if you think you've been in contact with the virus is a silly panic manufactured by the media. It's not, and the people saying this are either ill-informed and have bad intentions.

Google has well over 120,000 employees spread out among 70 offices in 50 countries. The odds are that a significant portion of them will eventually come in contact with the coronavirus is fairly high. And that is enough reason why employees need to work from home. Add in the fact that many Google employees have travel as part of their job and those odds get higher.

The employee flying home with the virus can infect almost anyone at their office, who can then infect almost anyone else there.

If someone were to fly from Mountain View to South Korea, for example, where the population per square mile is extremely high they stand a higher chance coming in contact with the virus. If they then fly home, they could infect the people they share an office with, the people staffing the cafeteria, and the people providing security. Those people then could spread the virus if they were to catch it, eventually spreading it outside of the Google campus to children, the elderly, and other at-risk persons.

Best Cheap Office Desk for Working From Home

That's how a pandemic works. Numbers increase exponentially with one infected person creating many new infected people. The idea that one person can infect only one other person doesn't work, and since this is a virus that transmits without any exchange of bodily fluids or a particular type of contact, the odds of transmitting it to someone else before you even know you're infected are rather high.

If a chicken has a contagious infection, you euthanize the whole flock. That doesn't work with people.

People aren't livestock. If we find an infected individual amongst the flock, we can't just euthanize everyone to prevent the spread. And by the time a person realizes they are infected, the number of other people they have eaten lunch with, or shook hands with, or patted on the back, or rode the subway with is almost too big to count. That's why closing your child's school or your office or even canceling NBA games makes sense.

And if you're a big tech company that has employees jumping between offices on six different continents, it makes even more sense. It's not creating panic or even contributing to media hysteria it's being proactive and smart.

Maximize your productivity: 7 working from home hacks to get more done

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The fine line between panic and preparedness: Keeping tech workers at home is the right call - Android Central

As we navigate the unknown and the attendant stress, fears, and challenges of the global Covid-19 coronavirus crisis, it can be difficult to stay relaxed, function normally, and tend to life as usual. Taking preventative measures is important and the medical and media communities are providing guidance. Along with my colleague, Ed Harrold, we offer you added prevention strategies that are paramount to your physical and mental health, both now and on an ongoing basis, enhancing your immune system function to keep you healthy and strong: Proper breathing and sufficient sleep. We are here to offer some tips to help you navigate these times, hoping that our recommendations become inscribed in your way of living for a healthy and happy life.

BREATHING:How & Why

From Ed Harrold, Author, Educator, Consultant

Lets start with your breathing. At a timewhen you may be feeling a bit nervous about inhaling for fear of what you maybe inhaling, here are some simple tools and strategies, to remain calm,strengthen your immune system and reduce the risk of unhealthy invadersentering your body.

I begin by explaining why breathing throughyour nose and not your mouth is key. When we inhale oxygen through our nose, wehave a built-in protective system that filters the air of toxins andbacteria. Our nostrils are lined withtiny hairs called cilia that protect our body from roughly 20 billion foreigninvaders per day. Yes, 20 billion per day! They are quite busy keeping ourlungs clear of air borne bacteria and viruses like Covid-19.

The second benefit of nasal diaphragmaticbreathing is the production of nitric oxide.Nitric oxide combats harmful bacteria and viruses in our bodies andboosts the immune system; among other things. The filtering benefits from thecilia and the release of Nitric Oxide ONLY happen with nasal DiaphragmaticBreathing; not mouth breathing.

If these two things werent enough, the key toreducing anxiety and stress during challenging times is controlling the length,depth, and pace of our nasal breath.Breathing rates and patterns signal our brain to behave in the stressresponse or the relaxation response.When we breathe at a rate of 12 breaths or more per minute, we signalthe stress response. When we breathe ata rate of 10 breaths or less per minute, we signal the relaxation response.

When your mind is becoming agitated, fearfuland nervous, an easy tool to access to calm yourself is your breath. Irecommend diaphragmatically breathing with anocean sound from at a pace of 10 breaths or less per minute. The Ocean Sounding breath is agreat compliment to the Diaphragmatic breath as it helps introvert the mind,reduces inflammation and helps you improve your breathing rate and pattern.

Apply breath as medicine in yourself- care routines to remain vibrant and healthy. For more instruction, pleasesee: Life WithBreath.

SLEEP:Preventive Medicine for Optimal Health & Living

From Nancy H. Rothstein, MBA, The Sleep Ambassador

Sleep is essential for life. Period. Yet, millions of peoplestruggle to get the sleep quality and quantity they need. In stressful timessuch as these, adding concerns and fears to our already demanding lives canresult in compromised sleep. However, as research confirms, insufficient sleepplaces us at heightened risks for illnesses such as the common cold and theflu, both of which are forms of corona virus. Recognizing this newest coronavirus, Covid-19, and the unknowns about its contagious properties and when/whereit may arise, its all the more important to keep your immune system hard atwork to keep you well should you be exposed to the Covid-19, or any virus orillness for that matter.

Here are a few tips from sleep expert Nancy H. Rothstein, The Sleep Ambassador, to helpyou navigate your nights with good, restorative sleep.

Staying healthy in times such as these, both physically and mentally, can be challenging for many people. Proper breathing and sufficient sleep can help you maintain your well-being, support your immune system, and mitigate the impact of stress and risk of becoming sick.

Prevention through proper breathing and good sleep may be just the medicine you need to navigate the waves of the unknown. That said, if you are experiencing breathing challenges or suspect you are at risk for a sleep disorder, please seek medical attention for assessment and treatment.

The rest is here:
Breathing & Sleeping Your Way Through the Covid-19 Crisis - Thrive Global

The main uncertainty in the coronavirus outbreak in the United States now is how big it will get, and how fast. The Centers for Disease Control and Preventions Nancy Messonnier told reporters on March 9, many people in the US will at some point, either this year or next, get exposed to this virus.

According to infectious disease epidemiologist Marc Lipsitch at Harvard, its plausible that 20 to 60 percent of adults will be infected with Covid-19 disease. So far, 80 percent of cases globally have been mild, but if the case fatality rate is around 1 percent (which several experts say it may be), a scenario is possible of tens or hundreds of thousands of deaths in the US alone.

Yet the speed at which the outbreak plays out matters hugely for its consequences. What epidemiologists fear most is the health care system becoming overwhelmed by a sudden explosion of illness that requires more people to be hospitalized than it can handle. In that scenario, more people will die because there wont be enough hospital beds or ventilators to keep them alive.

A disastrous inundation of hospitals can likely be averted with protective measures were now seeing more of closing schools, canceling mass gatherings, working from home, self-quarantine, self-isolation, avoiding crowds to keep the virus from spreading fast.

Epidemiologists call this strategy of preventing a huge spike in cases flattening the curve, and it looks like this:

Even if you dont reduce total cases, slowing down the rate of an epidemic can be critical, wrote Carl Bergstrom, a biologist at the University of Washington in a Twitter thread praising the graphic, which was first created by the CDC, adapted by consultant Drew Harris, and popularized by the Economist. The chart has since gone viral with the help of the hashtag #FlattenTheCurve.

Flattening the curve means that all the social distancing measures now being deployed in places like Italy and South Korea, and on a smaller scale in places like Seattle and Santa Clara County, California, arent so much about preventing illness but rather slowing down the rate at which people get sick.

The CDC advises that people over age 60 and people with chronic medical conditions the two groups considered most vulnerable to severe pneumonia from Covid-19 to avoid crowds as much as possible.

If more of us do that, we will slow the spread of the disease, Emily Landon, an infectious disease specialist and hospital epidemiologist at the University of Chicago Medicine, told Vox. That means my mom and your mom will have a hospital bed if they need it.

So even if youre young and healthy, its your job to follow social distancing measures to avoid spreading it to others, and keep the epidemic in slow motion. The more young and healthy people are sick at the same time, the more old people will be sick, and the more pressure there will be on the health care system, Landon explained.

Hospitals filled with Covid-19 patients wont just strain to care for those patients doctors may also have to prioritize them over others. Right now theres always a doctor available when you need one, but that may not be the case if were not careful, Landon said.

At this point, with the virus spreading in America, the top priority is making sure the health care system avoids being flooded with very sick patients who need ventilators and intensive care.

From a US standpoint, you want to prevent any place from becoming the next Wuhan, said Tom Frieden, who led the CDC under President Barack Obama. What that means is even if were not able to prevent widespread transmission, we want to prevent explosive transmission and anything that overwhelms the health care system.

Remember, Americas hospitals and doctors are already dealing with their usual caseloads during a pretty bad flu season. Now they have to be ready to handle any Covid-19 patients who come their way.

There are serious concerns about the US systems capacity to handle a severe outbreak. Covid-19 is a respiratory illness and in its most serious stages can require patients with pneumonia to be put on a ventilator. But there might not be enough ventilators to meet that need if the outbreak becomes too widespread.

The Johns Hopkins Center for Health Security reported in 2018 that, according to US government estimates, about 65,000 people in the United States would require ventilation in an outbreak similar to the flu pandemics of 1957-1958 (which killed 116,000 people in the US) and 1968 (which killed 100,000 Americans).

The maximum number of ventilators that could be put in the field in the United States is about 160,000. So under those scenarios, there would theoretically be enough capacity to meet the need.

But if the coronavirus outbreak gets worse, we could quickly run out. In a situation more similar to the Spanish flu pandemic (675,000 dead in the US), about 742,500 people in the United States would require ventilation, according to government estimates. We dont have that many.

The health system is much more than ventilators, of course, and the concerns about capacity apply to the rest of it, too. As HuffPosts Jonathan Cohn reported, US hospitals have about 45,000 beds in their intensive care units. In a moderate outbreak, about 200,000 patients may need to be put in the ICU, but under a more severe outbreak, it could be nearly 3 million.

And while all 3 million of them would likely not need treatment at the same time, we again need to account for the ICU patients hospitals already had before coronavirus arrived, as Cohn noted:

On the one hand, those are total numbers, for the duration of the epidemic. Even under the most dire scenario, its unlikely that 2.9 million people would need ICU beds all at once. On the other hand, ICU beds in the U.S. are already pretty full, thanks to the normal crush of patients with influenza and other major medical problems.

As a result, hospitals are routinely at capacity, forcing backups of patients boarding in emergency departments for hours or even days, waiting on the beds there until inpatient slots become available. And thats before any influx from COVID-19.

Hospitals are already doing what they can rationing surgical masks, preparing to stand up temporary facilities, etc. and they will take more extreme measures if they cant handle all the people with Covid-19 plus their more routine patients.

But one thing people can do to help is stay home if they are feeling unwell and especially if they received a formal Covid-19 diagnosis and advice to self-isolate. That way, the US health care system can focus on the patients who really need it during this outbreak.

Go here to read the rest:
Coronavirus chart: School closings and quarantines save lives by flattening the curve - Vox.com

The coronavirus of 2019 has infected more than 155,000 people and claimed more than 5,000 lives. Some countries have closed their borders and discriminatory practices of xenophobia have swarmed their way into classrooms, the workplace, media and other institutions.

Hysteria, fear and anxiety have become the hallmarks of this growing epidemic since the first cases were reported in Wuhan, China. Exact incubation periods, profile of symptomatology and whether or not this is truly the first time coronavirus has been around are still in question. The anxiety surrounding this disease is even hampering the vitality of domestic and global economies. Last week, stocks tumbled for 7 consecutive days, with one of the sharpest declines occurring after President Trump gave a news conference earlier last week.

However, this writing wont be a political debate. It wont determine the fitness of Vice President Mike Pence to lead this national health emergencybut rather, will give needed attention to a public health and ethical concern.

Americans and other people around the world have been following the growing list of CDC guidelines. Weve been washing our hands for 20 seconds (approximate length of the Happy Birthday song sung twice), obeying travel restrictions, self-quarantining at the start of flu-like symptoms. Although these measures have potentially slowed the spread of the virus, an instrument to cease its transmission is needed. A vaccine would be the answer. Problem solved? Not quite.

On one hand, its estimated that a coronavirus vaccine may not be market-ready for approximately 1-2 years. On the other hand, according to U.S. Health and Human Services Secretary Alex Azar, the Trump administration cant promise that a vaccine will be affordable to all. Panicked and vulnerable Americans may not be able to get a preventative treatment to ensure their protection. A promising formula hasnt even made its way into a syringe yet, but somehow, has already been assigned an expensive price tag. Why so prematurely?

Market exclusivity appears to be a main culprit behind high drug prices in the U.S. As the coronavirus vaccine is in development, the first drug company to reach success in developing a vaccine will be granted a patent by the Food and Drug Administration (FDA), essentially ensuring several years of protected monopoly status and profit given it meets FDA qualifications. The presence of generic vaccines wont be a reality for several years, which is one of the most useful tactics in driving prices down.

Newsflash.America has seen this before. We have seen our best minds, resources and capital funneled towards public health crises. However, when the prized breakthrough is achieved, the less fortunate are the last in line to reap its benefits. For example, in 2013, the more effective drugs Solvaldi and Olysio were added to the market for treatment and cure of Hepatitis C, a viral infection that can cause liver damage and cancer.

A study in the Journal of Health & Biomedical Law highlighted the challenges patients face in getting these promising drugs within our complex healthcare system. Specifically, just one pill of Sovaldi costs approximately $1,000, which brings the total cost of the 12-week treatment to $84,000, according to the study. While patients with private insurance showed higher rates of denied authorization, even patients with Medicare and Medicaid faced strict restrictions when trying to access these drugs. Some need access to a primary care doctor, a hepatologist or to show proof that they do not use alcohol. This is a difficult laundry list for people to accomplish, particularly those who are a part of the lower economic class, with limited access to routine care or specialists who accept Medicaid.

What should be established as a low hanging and accessible fruit has been selfishly turned into a high-hanging potential source of disparity. I would argue that a medical practice or development fueled by a profitable end falls short of providing equitable access to healthcare. The practice of medicine exists for the expedient and efficient treatment of all, not the few with hefty pockets.

Although the warnings of HHS Secretary Azar and health care leaders may appear to simply be rhetoric at the moment, health disparities are not. Marginalized members of society will predictably carry the heaviest burden of this disease. Notably, Duke Health has been reported as the largest employer in Durham county, employing over 19,000 within its healthcare system. It can therefore be deduced that it is one of the largest contributors to not only the economy of Durham county, but the health of its residents. In light of its mission to deliver a healthier tomorrow, DukeHealth should not only investigate the epidemiology of this disease, but the access (or lack thereof) that residents may have to upcoming technologies and medical advances.

Whether private investors are called upon to make this vaccine a reality, which significantly drives up the cost, or not, the federal government should have the health and pockets of all in mind. To our public leaders and advisors, such as those with the federal Centers for Disease Control who are working on the front lines of this emerging pandemic: We, the people, are doing our part with adherence to guidelines that have been established to prevent transmission of COVID-19. We are hopeful that a vaccine would be economically accessible to everyone at risk. In the meantime, the subsidizing of coronavirus diagnostic tests and related treatment for non or underinsured people remains a reasonable public health response. Should the latter become a reality, our government can begin to match what has been its potential for centuries. Enabling the latter will begin to lessen the burdens of human finitude and show us what equitable human flourishing truly looks like.

Kirsten Simmons is a third-year medical student at Duke University School of Medicine. She is also completing a Masters of Health Science in Clinical Research and a Masters of Theological Studies at Duke University Divinity School as a Theology Medicine and Culture Fellow.

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A coronavirus vaccine is in the making But you may have to check your pockets first - Duke Chronicle

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As cases of COVID-19 continue to rise around the country, maternity hospitals are cracking down on visitors to protect the health of mothers and theirbabies as well as considering early discharge post-delivery, in line with new national advice.

On Saturday,The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) issued new guidelines,which acknowledged the risk posed to the community, health workers, all patients and pregnant patients due to the COVID-19 pandemic.

How will this affect you?

As well as reducing, postponingand/or increasingthe interval between antenatal visits and limiting routine antenatal visits to less than 15 minutes, RANZCOG also recommended closing access to hospital and maternity units to visitors (excludingpartners).

While there is some variationbetween hospitals, and you will need to check with your own, most have now issued updated visitor requirements.

In an Instagram post, The Mater Private Hospital in North Sydney told patientsthat while partners are welcome, other family members and friends are not permitted to visit.Maternity Tours have also been cancelled.

Meanwhile, the Royal Women's Hospital in Melbourne has advised patients to "keepvisitor numbers to a minimum" and discourage siblings and other children from visiting. "We remind the community that visitors should not come to the Women's if they are unwell," they note.

While most parents and parents-to-be aresupportive of the move, some have admitted to feeling "heartbroken" and concernedabout the logistics.

"I completely understand this,I really do," one mum wrote on Instagram. "However, I'm due in eightweeks and will be having a c-section and therefore staying for fivenights. Will be heartbreaking to not to be able to see my eldest child for that amount of time. Or for him to be able to meet his sibling for that amount of time. It will also result in my husband not being able to spend time at the hospital due to caring for him at home ... "

New South Wales mum Hayley is currently five days overdue with her fourth child and tells Essential Baby that she's torn about the ban, but also understands that it's warranted. "We'd love people to come and support us and welcome the baby but obviously a bit wary of germs," she says. She's also prepared for a quick discharge from hospital. "I left four hours after birth with my other babies and that'll be the plan this time," Hayley says.

Dr Nicole Highet, Founder and Executive Director of the Centre ofPerinatalExcellence (COPE) tells Essential Baby:"It's understandableto be anxious at the moment and disappointed about not having visitors however it's always better to be safe, and prevention is always the best approach when it comes to public health issues such as this.

"Try to think about way that you can still connect with friends and family through for exampleFaceTimeorSkypefrom Hospital," she says. "Whileit is never going to be quite the same as having a hold of bub, remember, there are many days and years ahead for cuddles, as this too shall pass."

Newborn baby tests positive for COVID-19

The move comes as a newborn baby in London testedpositive for thecoronaviusminutes afterbeing born. The baby's mother had been admitted to hospital suffering frompneumonia but only testedpositive for COVID-19 after givingbirth,reportsThe Sun,who say the baby is the "world's youngest victim".

But questions remain around how the newborncontracted the illness.

"We can't say it happened while the baby was still in the womb," Dr. WilliamSchaffner, a professor of Preventive Medicine and Infectious Diseases at the Vanderbilt University School of Medicine, toldLive Science. "The baby could have also contracted the virus during, or immediately after, birth."

What we currentlyknow about the impact on babies and pregnant women:

The news remains comforting for babies and pregnant women.

A recent study of19 pregnant women infected with COVID-19, which was published in The Lancetfound no evidence of mum to baby transmission.

In addition, research published inJAMAon February 14 looked at cases ofcoronavirusin infants under the age of one in China. Nine babies were infected betweenDecember 8, 2019, and February 6, 2020.The youngest was justonemonth old and the oldest was 11 months. All babies were hospitalised. One baby had no symptoms but tested positive for the illness. None of the infantsbecame seriously unwell.

RANZCOG advisesthe followingpreventative measures for pregnant women:

Pregnant women are also advised to avoid all non-essential overseas travel and to report early symptoms to theirmidwife,obstetrician or GP.

Tele-health now available:

The government recently announced thatTelehealth(consultations with doctors via phone)will be bulk-billed forpregnant women and those with newborns.

What else can parents do?

In an article for The Conversation,Karleen GribbleAdjunct Associate Professor, School of Nursing and Midwifery, Western Sydney University andNina Jane ChadResearch Fellow, Sydney School of Public Health, University of Sydney suggest parents of babies prepare for COVID-19 by taking the following steps:

What about breastfeeding?

According to the Australian Breastfeeding Association (ABA) women can continue to breast feed even if unwell.

"Breastfeeding helps protect babies from a variety of illnesses," the ABA notes. "This is because breast milk contains antibodies and other immune protective factors. If you have been diagnosed with or are suspected of having COVID-19, care should be taken to avoid spreading the virus to your baby while you continue to breastfeed."

If you notice a drop in supply (which can happen during illness) you can contact aAustralian Breastfeeding Association counsellorfor support, see alactation consultantor a medical advisor.

As the COVID-19 pandemic is an evolving issue, for more resources and up to date information, visit:

RANZCOG

Centre of PerinatalExcellence (COPE)

PANDA Helpline:1300 726 306

Australian Breastfeeding Association

Continue reading here:
Coronavirus crackdown: only partners allowed to visit maternity wards - Essential Baby

By Express News Service

NEW DELHI: In a bid to check the spread of novel coronavirus in the national capital, the state government-run Nehru Homeopathic Medical College and Hospital in Defence Colony has come up with an isolation ward with a capacity of 30 beds.

According to the hospital administration, the decision was taken following a meeting with the Union Health and Welfare Ministry where hospitals were asked to prepare isolatedbeds to tackle the disease if more suspected cases arise.

"Here, only the suspected cases of coronavirus are to be taken. If found positive, the patients will be transferred to nodal hospitals," said Dr Neeraj Gupta. The hospital further stated that the initial preparations have been undertaken to handle any emergency situations and more beds will be added to the facility soon.

"Right now, masks and other preventative equipment are in the process of procurement. Since this is a homeopathic hospital, we also follow the guidelines of the Ayush Ministry which has come up with selected medicines that are to be taken as preventive measures against coronavirus. The medicines are provided for free at the hospital," Gupta added.

The outdoor patient department and 100-bed indoor hospital attached to the teaching institute is providing curative, preventive and promotive homoeopathic healthcare services along with providing basic testing facilities.

Tested positive

One man who returned from Italy on March 11 and was at the Armys quarantine facility in Manesar has tested positive. He was employed in a restaurant in Italy for last 14 years.

Read more from the original source:
Delhi government-run homeopathic hospital adds isolation beds for suspected coronavirus cases - The New Indian Express

Frontline medics talk about how they are fighting the disease despite being short-staffed and overwhelmed by the growing number of patients around the world.

Hospitals scrambling, a disease without a vaccine (yet) or a cure, hospital beds dwindling, patients increasing and testing the patience of medics who are trying to keep up. Covid-19 is creating a peace-time battle line at which doctors and nurses go to war against a coronavirus. From Italy to China, Iran to the US; doctors are scrambling to contain the virus in their communities and hospitals. Emergency Rooms are working hard to host everyone who is concerned, has been diagnosed and even quarantined. TRT World caught up with doctors to find out how they're handling the crisis.

In Modena, in northern Italy, infectious disease doctor Giovanni Guaraldi is working 16-hour shifts, treating patients and trying to understand the viral mutation. "The major damage that is produced by this virus appears to be [not only] a disproportionate inflammatory reaction affecting both of the lungs, but also the whole body," he said.

He explained that patients who are more at risk of death aren't just isolated to the elderly, but anyone, even the middle aged who may have comorbidity conditions or multiple medical conditions which they are already treating, makes contracting this coronavirus a unique issue. So far, doctors have used a drug called Kaletra, an antiviral treatment which has been used for HIV patients. And in recent months, for severe cases, Guaraldi said they were using Remdesivir, which is still only in clinical trials. He said that because "the number of people eligible were so many" thecompany that produces it, Gilead reduced the possibility of access and now they are rejecting it for those who are not in intensive care.

The fact remains there is no officially approved antiviral, and so it seems, the treatment for Covid-19 is its own experiment.

But beyond symptoms and medicine; doctors and nurses worry about protecting themselves. "We need to work now. This means I [tell] my children, better not see you tonight, I ask parents, my friends, I am a bit isolated." Guaraldi said. "When we go home, we stay alone and we try to rest. Of course this implies the psychological reaction...we say two patients of mine died, three patients of mine died, .every day this is quite stressing. But we also appreciate a lot of messaging, [to] encourage us. Of course, we need psychological support but Im proud to be in my position."

Meanwhile, in Rome, the Red Cross of Italy welcomed a team of Chinese doctors to assist in organising efforts to contain the virus. General Practitioner, Dr Andi Nganso, who heads up the office in Rome and is deployed from Northern Europe said they have faced serious challenges in responding to the virus. He told TRT World: There are a lot of [Red Cross] workers that are now affected, so now we have to manage, like a puzzle, all of the ambulances, to be sure we can continue to assist patients.

The Red Cross supports up to 70 percent of the ambulance assistance for the countrys national health system. They are first responders in communities across the country, regularly receiving calls about protocol and psychological support.

In just the last few days, Nganso has been scrambling to organise everyones post. Ngansoo is thankful for the Chinese support: Their knowledge, they are serious,...it will be good to understand the next step for Italy.

He misses his family, spread across Germany, France and Belgium. Im alone. its really stressful, I have difficulties sleeping. I hear too many stories and I have to manage them, he said.

Nevertheless, he presses on and encourages the public to seek information, only from official sources, such as the Red Cross, or National Health Agencies or their doctors. We understand the fear, he said.

Across the oceans, in Hong Kong, Chinese doctors are still managing. Resident and respiratory specialist Dr Joyce Ng just finished her shift. Every week, she serves an overnight call to take in new patients in the isolation ward.

She said her team has been greatly supported by their superiors. We can test whoever we like, there is no restriction. We have four batches of testing everyday, the results can come back quite quickly, around four hours. Its around the clock, she said.

She also noted many people are nervous and may come in with minor symptoms which can strain their bed capacity. Even so, some patients with no symptoms at all still show haziness over their lungs.

Ng did say she is taking precautions to protect herself as well, wear proper gear and has moved out of her family home, but, she says, the morale of her team remains high. Every one of us, on the team is a volunteer, so we have a very good team spirit. That helps a lot. We help each other, she said.

Many Asian nations are capping the spread quickly. Singapore has been praised for its reduction of infected patients. Kuala Lumpur has yet to report any deaths and Chinas numbers are halted. Asian countries, however, have dealt with outbreaks before, namely SARS in 2002 and 2003. Even before viral outbreaks, due to pollution, sick people knew to wear masks in public. And its worth noting; ancient Eastern medicines and preventive care are often found to boost quality of life in their cultures. Still, theres much work to be done.

Singapores Prime Minister Lee Hsieng Loong stated in a public video: Everyone feels the impact. But by taking preventive measures and being transparent, he believes planning for a possible spike will keep everyone safe, calm and bring the numbers back down. He is not shutting down the country and with reassurances, citizens are far more mindful of reducing public consumption and refraining from larger crowds.

The World Health Organization also issued a statement last week from its Director General Tedros Adhanom Ghebreyesus, who said: "All countries must strike a fine balance between protecting health, minimising economic and social disruption, and respecting human rights.every individual must be involved in the fight.

But the US is largely behind as President Donald Trump dismissed its gravitas earlier in the year. Hes come under intense fire from health officials and opposing party politicians for his lack of an effective response. His failure to act early and issue proper testing throughout the country has created confusion for much of the public. Most hospitals dont have enough tests to offer the growing number of suspected cases coming through.

Doctors in the US are largely overwhelmed and it was difficult to reach them. But many have taken toYouTube and social media websites to dispense their own messages of assurance, reduce public panic and offer preventative advice, which largely follows social distancing, hand-washing and mindfulness of symptom severity. Mental health professionals are also issuing statements to help people cope with the chaos.

Back in Italy, Guaraldi said he believes its important to build up infrastructure for the most vulnerable and will take a big welfare system to make it happen.

But it was his closing message that echoed the loudest: Frightened doesn't protect people, he said. Frightening [people] in infectious diseases produces disaster. We knew it from previous epidemics ...from history. We know that we can cope with this epidemic. Give people hope, at the same time make people understand, now, their lifestyle must change.

Perhaps, then, its time we follow the doctor's orders before its too late.

Source: TRT World

Read the rest here:
Doctors tell of their experiences and offer hope in a time of Covid-19 - TRT World

Temple Grove care home near Uckfield area has closed its doors to visitors in a bid to stop the Coronavirus COVID-19 reaching residents.

And doctors surgeries at Buxted, East Hoathly and Horam are no longer booking appointments at reception desks or online.

All appointments at those surgeries will be telephone triaged, and no face-to-face appointments will be booked with the GP prior to a telephone consultation.

Illustration of COVID-19, created by the Centres for Disease Control and Prevention.

Events are being cancelled or postponed following confirmation of the first case in East Sussex.

Panic buying is clearing supermarket shelves of items such as toilet paper, hand wash and painkillers as soon as they are stocked.

There have even been reports of shoppers taking products from the trolleys of others in Uckfield Tesco.

One woman, for example, said on Uckfield Talk: To the lady I just had an argument with in Tesco: I hope you enjoy the chicken breasts you took out of my trolley. Your rudeness and language when I caught you was just despicable and the whole thing unnecessary. I cant believe the behaviour some people are showing!

Temple Grove

Temple Grove Care Home at Herons Ghyll closed its doors to visitors yesterday (Sunday) afternoon having given relatives and friends of residents advance warning on Saturday.

Home manager Alison Barnes wrote to relatives saying: As the UK moves from the Containment to the Delay stage of its Coronavirus response we are committed to ensuring the well-being of all our residents and staff and as such continue to review our policies and procedures.

Restricted

As part of this review, as a preventative measure we are asking that from Sunday, March 15, all visits to the home are restricted, any visits will need to be vital and subject to prior arrangement by telephone with the Home Management Team.

This is not a decision that we take lightly and we appreciate this will cause some discomfort, but I hope you understand that this is a necessary step to take in the current circumstances. We will review this policy on a daily basis and continue to monitor the situation with the Public Health Authorities.

Non-essential

The manager went on the say that the home would be restricting visits more generally and all non-essential visits from the local community and external entertainment will also be cancelled for the foreseeable future.

We will continue to ensure that those who make essential medical visits are not displaying symptoms, and follow our infection control policies.

Meanwhile, some events are being cancelled, or postponed in the area, while extra precautions are being taken so that other activities can continue.

Curry club

A networking curry club organised by Rix & Kay Solicitors and Oldfield Smith & Co chartered surveyors, due to be held in April, has been cancelled.

Victoria Regan and Richard Oldfield emailed contacts saying: This was not an easy decision to make but we hope that you understand our reasons and we very much look forward to seeing you at the next Uckfield Curry Event which will hopefully be back on track in June.

Elton Tribute Night

An Elton Tribute Night in Framfield due to have been held on March 28 to raise funds for the village school has been postponed. Another date is yet to be arranged.

Community orchestra

Uckfield Community Orchestra has decided to suspend rehearsals until after the Easter break in view of the potential worsening of the virus outbreak.

The orchestra committee is due to review the situation again after Easter and base any decisions on Government advice at that time.

The committee said: It is difficult to know what is best, but overall we have decided to take the cautious route and keep our members from passing on any new contamination.

Extra measures

Elsewhere clubs and organisations, such as Uckfield Yoga Studio are taking extra measures to keep everyone safe.

The studio says:

The studio has asked members to stay at home if they have a temperature, cough or cold, until symptoms pass.

Trampoline

Sky High Trampoline Gymnastics Academy says it will operate fully until Government intervention.

But the academy, which meets at Fun Abounds, is advising that all members and parents must not come to lessons, or on site, for a minimum of seven days if they or their family have any of the following symptoms, a high temperature/fever, a cough, trouble breathing, or mild respiratory symptoms including a sore throat or runny nose.

The academy says: Please note to keep our members safe anyone showing signs of respiratory illness with the symptoms shown above will be sent home immediately.

Anyone who has visited the gym and has to self isolate is notify the gym by emailing info@funaboutds.co.uk.

Fun Abounds has increased the frequency of cleaning and is monitoring the situation and following advice from British Gymnastics, Public Health England and NHS UK.

Offers of help

On the other side of the coin offers are being made via Facebook to help others in need over the coming months.

A group has been set up on Facebook for Uckfield Coronavirus Volunteers who would like to help in the coronavirus lockdown.

People are encouraged to join if they can collect, or deliver, groceries and medicine or support local medical staff. Requests for help are also welcome.

There is a Framfield Isolation Support Group on Facebook too.

For more information on the symptoms and steps to take if you suspect you have been exposed to COVID-19, go to http://www.nhs.uk/coronavirus.

For the latest advice on travellers returning from affected areas, plus guidance to schools and care homes, visit http://www.gov.uk/coronavirus.

Read the original here:
Uckfield organisations act in bid to stop spread of Coronavirus - Uckfield News

In Italy, millions are locked down and more than 1,000 people have died from the coronavirus, meanwhile in South Korea, hit by the disease at about the same time, only a few thousand are quarantined and 67 people have died.

As the virus courses through the world, the story of two outbreaks illustrates a coming problem for countries now grappling with an explosion in cases.

Its impractical to test every potential patient, but unless the authorities can find a way to see how widespread infection is, their best answer is lockdown.

Italy started out testing widely, then narrowed the focus so that now, the authorities dont have to process hundreds of thousands of tests. But theres a trade-off: They cant see whats coming and are trying to curb the movements of the countrys entire population of 60 million people to contain the disease. Even Pope Francis, who has a cold and delivered his Sunday blessing over the internet from inside the Vatican, said he felt caged in the library.

Thousands of miles away in South Korea, authorities have a different response to a similar-sized outbreak. They are testing hundreds of thousands of people for infections and tracking potential carriers like detectives, using cell phone and satellite technology.

Both countries saw their first cases of the disease called COVID-19 in late January. South Korea has since reported 67 deaths out of nearly 8,000 confirmed cases, after testing more than 222,000 people. In contrast, Italy has had 1,016 deaths and identified more than 15,000 cases after carrying out more than 73,000 tests on an unspecified number of people.

Epidemiologists say it is not possible to compare the numbers directly. But some say the dramatically different outcomes point to an important insight: Aggressive and sustained testing is a powerful tool for fighting the virus.

Jeremy Konyndyk, a senior policy fellow at the Center for Global Development in Washington, said extensive testing can give countries a better picture of the extent of an outbreak. When testing in a country is limited, he said, the authorities have to take bolder actions to limit movement of people.

Im uncomfortable with enforced lockdown-type movement restrictions, he said. China did that, but China is able to do that. China has a population that will comply with that.

The democracies of Italy and South Korea are useful case studies for countries such as America, which have had problems setting up testing systems and are weeks behind on the infection curve. So far, in Japan and the United States particularly, the full scale of the problem is not yet visible. Germany has not experienced significant testing constraints, but Chancellor Angela Merkel warned her people on Wednesday that since 60% to 70% of the populace is likely to be infected, the only option is containment.

South Korea, which has a slightly smaller population than Italy at about 50 million people, has around 29,000 people in self-quarantine. It has imposed lockdowns on some facilities and at least one apartment complex hit hardest by outbreaks. But so far no entire regions have been cut off.

Seoul says it is building on lessons learned from an outbreak of Middle East Respiratory Syndrome (MERS) in 2015 and working to make as much information available as possible to the public. It has embarked on a massive testing programme, including people who have very mild illness, or perhaps dont even have symptoms, but who may be able to infect others.

This includes enforcing a law that grants the government wide authority to access data: CCTV footage, GPS tracking data from phones and cars, credit card transactions, immigration entry information, and other personal details of people confirmed to have an infectious disease. The authorities can then make some of this public, so anyone who may have been exposed can get themselves or their friends and family members tested.

In addition to helping work out who to test, South Koreas data-driven system helps hospitals manage their pipeline of cases. People found positive are placed in self-quarantine and monitored remotely through a smartphone app, or checked regularly in telephone calls, until a hospital bed becomes available. When a bed is available, an ambulance picks the person up and takes the patient to a hospital with air-sealed isolation rooms. All of this, including hospitalization, is free of charge.

South Koreas response is not perfect. While more than 209,000 people have tested negative there, results are still pending on about 18,000 others an information gap that means there are likely more cases in the pipeline. The rate of newly confirmed cases has dropped since a peak in mid-February, but the systems greatest test may still be ahead as authorities try to track and contain new clusters. South Korea does not have enough protective masks it has started rationing them and it is trying to hire more trained staff to process tests and map cases.

And the approach comes at the cost of some privacy. South Koreas system is an intrusive mandatory measure that depends on people surrendering what, for many in Europe and America, would be a fundamental right of privacy. Unlike China and the island-state of Singapore, which have used similar methods, South Korea is a large democracy with a population that is quick to protest policies it does not like.

Disclosing information about patients always comes with privacy infringement issues, said Choi Jaewook, a preventive medicine professor at Korea University and a senior official at the Korean Medical Association. Disclosures should be strictly limited to patients movements, and it shouldnt be about their age, their sex, or their employers.

Traditional responses such as locking down affected areas and isolating patients can be only modestly effective, and may cause problems in open societies, says South Koreas Deputy Minister for Health and Welfare Kim Gang-lip. In South Koreas experience, he told reporters on Monday, lockdowns mean people participate less in tracing contacts they may have had. Such an approach, he said, is close-minded, coercive, and inflexible.

Italy and South Korea are more than 5,000 miles apart, but there are several similarities when it comes to coronavirus. Both countries main outbreaks were initially clustered in smaller cities or towns, rather than in a major metropolis which meant the disease quickly threatened local health services. And both involved doctors who decided to ignore testing guidelines.

Italys epidemic kicked off last month. A local man with flu symptoms was diagnosed after he had told medical staff he had not been to China and discharged himself, said Massimo Lombardo, head of local hospital services in Lodi.

The diagnosis was only made after the 38-year-old, whose name has only been given as Mattia, returned to the hospital. Testing guidelines at the time said it was not necessary to test people who had no link to China or other affected areas. But an anaesthetist pushed the protocols and decided to go ahead and test for COVID-19 anyway, Lombardo said. Now, some experts in Italy believe Mattia may have been infected through Germany, rather than China.

Decisions about testing hinge partly on what can be done with people who test positive, at a time when the healthcare system is already under stress. In Italy at first, regional authorities tested widely and counted all positive results in the published total, even if people did not have symptoms.

Then, a few days after the patient known as Mattia was found to have COVID-19, Italy changed tack, only testing and announcing cases of people with symptoms. The authorities said this was the most effective use of resources: The risk of contagion seemed lower from patients with no symptoms, and limited tests help produce reliable results more quickly. The approach carried risks: People with no symptoms still can be infected and spread the virus.

On the other hand, the more you test the more you find, so testing in large numbers can put hospital systems under strain, said Massimo Antonelli, director of intensive care at the Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome. Testing involves elaborate medical processes and follow-up. The problem is actively searching for cases, he said. It means simply the numbers are big.

Italy has a generally efficient health system, according to international studies. Its universal healthcare receives funding below the European Union average but is comparable with South Koreas, at 8.9% of GDP against 7.3% in South Korea, according to the World Health Organization.

Now, that system has been knocked off balance. Staff are being brought into accident and emergency departments, holidays have been cancelled and doctors say they are delaying non-urgent operations to free up intensive care beds.

Pier Luigi Viale, head of the infectious disease unit at Sant Orsola-Malpighi hospital in Bologna, is working around the clock in three jobs. His hospital is handling multiple coronavirus cases. His doctors are shuttling to other hospitals and clinics in the area to lend their expertise and help out with cases. In addition, his doctors also have to deal with patients with other contagious diseases who are struggling to survive.

If it drags on for weeks or months well need more reinforcements, he told Reuters.

Last week, the mayor of Castiglione dAdda, a town of about 5,000 people in Lombardys red zone which was the first to be locked down, made an urgent online appeal for help. He said his small town had had to close its hospital and was left with one doctor to treat more than 100 coronavirus patients. Three of the towns four doctors were sick or in self quarantine.

Doctors and nurses are at the limit, said a nurse from the hospital where Mattia was taken in. If you have to manage people under artificial respiration you have to be watching them constantly, you cant look after the new cases that come in.

Studies so far suggest that every positive case of coronavirus can infect two other people, so local authorities in Lombardy have warned that the regions hospitals face a serious crisis if the spread continues not just for COVID-19 patients but also for others whose treatment has been delayed or disrupted. As the crisis spreads into Italys less prosperous south, the problems will be magnified.

Intensive care facilities face the most intense pressure. They require specialist staff and expensive equipment and are not set up for mass epidemics. In total, Italy has around 5,000 intensive care beds. In the winter months, some of these are already occupied by patients with respiratory problems. Lombardy and Veneto have just over 1,800 intensive care beds between public and private systems, only some of which can be set aside for COVID-19 patients.

The government has asked regional authorities to increase the number of intensive care places by 50% and to double the number of beds for respiratory and contagious diseases, while reorganising staff rosters to ensure adequate staffing. Some 5,000 respirators have been acquired for intensive care stations, the first of which are due to arrive on Friday, deputy Economy Minister Laura Castelli said.

The region has already asked nursing institutes to allow students to bring forward their graduation to get more nurses into the system early. Pools of intensive care specialists and anaesthetists are to be set up, including staff from outside the worst affected regions.

To add to the burden, hospitals in Italy depend on medical personnel to try to trace the contacts that people who test positive have had with others. One doctor in Bologna, who asked not to be named, said he had spent a 12-hour day tracing people who had been in contact with just one positive patient, to ensure those who next need testing are found.

You can do that if the number of cases remains two to three, the doctor said. But if they grow, something has to give. The system will implode if we continue to test everyone actively and then have to do all this.

In South Korea as in Italy, an early case of COVID-19 was identified when a medical officer followed their intuition, rather than the official guidelines, on testing.

The countrys first case was a 35-year-old Chinese woman who tested positive on Jan. 20. But the largest outbreak was detected after the 31st patient, a 61-year-old woman from South Koreas southeastern city of Daegu, was diagnosed on Feb. 18.

Like the patient named Mattia in Italy, the woman had no known links to Wuhan, the Chinese province where the disease was first identified. And as in Italy, the doctors decision to recommend a test went against guidelines at the time to test people who had been to China or been in contact with a confirmed case, said Korea Medical Associations Choi Jaewook.

Patient 31, as she became known, was a member of a secretive church which Deputy Minister for Health and Welfare Kim Gang-lip said has since linked to 61% of cases. Infections spread beyond the congregation after the funeral of a relative of the churchs founder was held at a nearby hospital, and there were several other smaller clusters around the country.

Once the church cluster was identified, South Korea opened around 50 drive-through testing facilities around the country. In empty parking lots, medical staff in protective clothing lean into cars to check their passengers for fever or breathing difficulties, and if needed, collect samples. The process usually takes about 10 minutes, and people usually receive the results in a text reminding them to wash their hands regularly and wear face masks.

A total of 117 institutions in South Korea have equipment to conduct the tests, according to the Korea Centers for Disease Control and Prevention (KCDC). The numbers fluctuate daily, but an average of 12,000 is possible, and maximum capacity is 20,000 tests a day. The government pays for tests of people with symptoms, if referred by a doctor. Otherwise, people who want to be tested can pay up to 170,000 won ($140), said an official at a company called Seegene Inc, which supplies 80% of the countrys kits and says it can test 96 samples at once.

There are also 130 quarantine officers like Kim Jeong-hwan, who focus on minute details to track potential patients. The 28-year-old public health doctor spends his whole working days remotely checking up on people who have tested positive for COVID-19, the disease caused by the virus.

Kim, who is doing military service, is one of a small army of quarantine officers who track the movements of any potential carriers of the disease by phone, app or the signals sent by cell phones or the black boxes in automobiles. Their goal: To trace all the contacts people may have had, so they too can be tested.

I havent seen anyone telling bad lies, Kim said. But lots of people generally dont remember exactly what they did.

Underlining their determination, quarantine officers told Reuters they located five cases after a worker in a small town caught the virus and went to work in a coin karaoke, a bar where a machine lets people sing a few songs for a dollar. At first, the woman, who was showing symptoms, did not tell the officers where she worked, local officials told Reuters. But they put the puzzle together after questioning her acquaintances and obtaining GPS locations on her mobile device.

Now, quarantine officers have maximum power and authority, said Kim Jun-geun, an official at Changnyeong County who collects information from quarantine officers.

South Koreas government also uses location data to customize mass messages sent to cellphones, notifying every resident when and where a nearby case is confirmed.

Lee Hee-young, a preventative medicine expert who is also running the coronavirus response team in South Koreas Gyeonggi province, said South Korea has gone some of the way after MERS to increase its infrastructure to respond to infectious diseases. But she said only 30% of the changes the country needs have happened. For instance, she said, maintaining a trained workforce and up-to-date infrastructure at smaller hospitals isnt easy.

Until we fix this, Lee said, explosions like this can keep blowing up anywhere.

(Additional reporting by James Mackenzie in Milan and Josh Smith in Seoul, Julie Steenhuysen in New York; Edited by Sara Ledwith and Jason Szep)

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Italy and South Korea's coronavirus outbreaks show the disparity between deaths and tactics - Infosurhoy

By RYAN MCCRACKEN on March 16, 2020.

rmccracken@medicinehatnews.com

With a second consecutive David Johnston University Cup within his grasp, former Medicine Hat Tigers captain Mark Rassell watched the world unravel.

Waking up in Halifax with his University of New Brunswick Varsity Reds, ready to make their debut at the U Sports mens hockey championship tournament the following afternoon the news started rolling in. The National Hockey League announced it was suspending the season, Major League Baseball stepped in to cancel spring training, the Canadian Hockey League quickly followed suit.

Over the course of just a few hours, the U Sports hockey championships became some of the only sporting events on the planet still hoping to carry on through the growing concerns surrounding the spread of COVID-19. With no confirmed cases in Nova Scotia, there was reason for optimism then U Sports joined the rest of the world, and pulled the plug.

It was just so sudden, Rassell said in a Sunday phone interview. It was the night before our game and it was about 9:30 p.m. when we saw a tweet from Victor Findlay hes like the one U Sports insider and he said he was hearing rumours that the tournament may be canceled. When you see that theres rumours, you just kind of know.

We all understand the preventative measures and we have nothing against U Sports or Hockey Canada, they probably made the right decision in the big picture. Its just disappointing. There were no cases here at the time that they canceled it, right now no ones really freaking out. It hasnt hit the Maritimes too hard yet everything is open. If I didnt have social media I wouldnt think anything is different.

Despite an earlier announcement from U Sports suggesting the tournament as well as its female counterpart in Prince Edward Island would go ahead as planned, the season was over. For some of the tournaments graduating players, it meant the end of a career.

Our coach made the announcement, he said it sucks, and then our fifth-years kind of broke down, said Rassell. When I saw those guys cry, thats what hit the boys the hardest, just seeing the guys who dont have another chance. Some of them, their hockey careers are over just like that, because theyre in university and they might not want to go pro. So the fact they dont even have a chance to try was awful. We all kind of agreed, wed rather have lost and embarrassed ourselves than just not even had the opportunity.

In the days since, Rassell says he and his teammates have been making the most of their time together, as well as with their respective families, while taking in a few of the sights in Halifax.

Nova Scotia announced its first presumptive case of COVID-19 Sunday afternoon, however Rassell says the city remains lively.

I think there are about 10 guys on the team who stayed with their families and were all just kind of doing our thing. Right now were walking downtown Halifax and were going to go for a nice brunch, said Rassell. Its just kind of filling time. Classes are cancelled. We have no reason to be back in New Brunswick. Minute by minute, something else is getting cancelled. Now Im here and our exams will be online. It almost feels like purgatory just not knowing what were going to do and how were going to do it so were just trying to make the best of it in downtown Halifax. It really is a lot nicer than downtown Fredericton.

Even Rassells classes at UNB have been postponed or cancelled, with many moving toward an online component to close out the semester. Thankfully, the campus remains open, allowing Rassell and his teammates to continue off-season training when they return to Fredericton.

From what I heard our campus isnt closed. The classes are suspended or cancelled and moving online, but the campus is still open because the campus still has essential services for students that live there, he said. Its not like those schools that are telling people to go home. I think I can still go hit the gym, work out and do all that.

Rassell racked up 14 goals and 18 assists over 29 games as a sophomore with the Varsity Reds this season. While a professional career is still the goal, the 23-year-old Calgary product says hes already dedicated his next season to UNB.

After winning your first year and thinking youre going to win your second year, then having it taken from you, its kind of motivating, he said. Its driving me right now. I know next year were going to come back and be all wound up and ready to finish off what we started this year.

Rassell added hes been thoroughly enjoying the academic portion of his time in New Brunswick as well. With a Bachelor of Business Administration on the horizon, he has plenty of options but for now hes just enjoying the ride.

Im on schedule to get my undergrad next year, after my third year. That puts me in a position where I can choose to either leave and go play pro with my undergrad or come back and do a Masters program, said Rassell. You go to school and you think its going to be like high school and you think youre going to hate it, but honestly, university changes your mindset. Academically, its been awesome for me. Im studying finance, thats something Im really interested in and I could see myself having a career in. It kind of opens your eyes.

A lot of people say junior hockey is a bubble. When you get out of that bubble you realize theres more to the world than just playing hockey. But the hockey is an unreal part of university and the fact I get to do both is a dream come true every day.

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Making the most of it: Former Tigers captain Mark Rassell enjoying time in Halifax after having hopes of second straight U Sports title dashed by...

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Global Chemotherapy Induced Peripheral Neuropathy Treatment Market Current Analysis and Estimated Forecast to 2026 | Achelios Therapeutics Inc,...

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The Global Diabetic Neuropathy Treatment Market Anticipated to exhibit a CAGR 4.9% during Forecast Period 2018-2025. - Galus Australis

AP Mar 14, 2020 2 days ago

In this March 12, 2020, photo, Steve Sedlacek, right looks at his father, Chuck Sedlacek, back left, through reflections in the window of his room at Life Care Center in Kirkland, Wash., near Seattle. The facility has been at the center of the coronavirus outbreak in the state, and Sedlacek's brother Scott said that he and his siblings have barely spoken to their father inside the center, who in addition to testing positive for the coronavirus, has blindness, neuropathy, and has difficulty using a phone, saying he is more of an "inmate" than a patient. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

Flowers and other memorials are viewed Friday, March 13, 2020, near a sign at the entrance to the Life Care Center in Kirkland, Wash., near Seattle, which has been at the center of the coronavirus outbreak in the state. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

In this March 12, 2020, photo, Scott Sedlacek poses for a photo while holding a photo of his father, Chuck, outside Life Care Center in Kirkland, Wash., near Seattle. The facility has been at the center of the coronavirus outbreak in the state, and Sedlacek who also has tested positive for the virus said he and his siblings have barely spoken to their father, who in addition to testing positive for the coronavirus, has blindness, neuropathy, and has difficulty using a phone, saying he is more of an "inmate" than a patient. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

A nurse works in the room of Chuck Sedlacek who has tested positive for the COVID-19 coronavirus Friday, March 13, 2020, as seen through the window of his room at Life Care Center in Kirkland, Wash., near Seattle. The facility has been at the center of the coronavirus outbreak in the state, and Sedlacek's son Scott Sedlacek said that he and his siblings have barely spoken to their father inside the center, who in addition to testing positive for the coronavirus, has blindness, neuropathy, and has difficulty using a phone, saying he is more of an "inmate" than a patient. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

In this March 12, 2020 photo, Scott Sedlacek becomes animated as he holds a picture of his father, Chuck, and talks to reporters outside Life Care Center in Kirkland, Wash., near Seattle. The facility has been at the center of the COVID-19 coronavirus outbreak in the state, and Sedlacek who also has tested positive for the virus said he and his siblings have barely spoken to their father who lives inside the center, and in addition to testing positive for the coronavirus, has blindness, neuropathy, and has difficulty using a phone, saying he is more of an "inmate" than a patient. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

In this March 12, 2020, photo, Scott Sedlacek, left, who has tested positive for the COVID-19 coronavirus, listens as Tim Killian, right, a spokesman for Life Care Center in Kirkland, Wash., answers one of Sedlacek's questions during Killian's daily press briefing. Sedlacek's father, Chuck, who also has tested positive, lives in the facility, which has been at the center of the COVID-19 coronavirus outbreak in the state, and Sedlacek said he and his siblings have barely spoken to their father, who has blindness and neuropathy, and difficulty using a phone, saying he is more of an "inmate" than a patient. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

In this March 12, 2020, photo, a person is loaded into an ambulance at Life Care Center in Kirkland, Wash., which has been at the center of the COVID-19 coronavirus outbreak in the state. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

In this March 6, 2020, photo, Su Wilson, left, takes a photo with a worker at Life Care Center in Kirkland, Wash., after handing off flowers to give to her mother, June Liu, who lives at the facility, which has been at the center of the COVID-19 coronavirus outbreak in the state. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

In this March 6, 2020, photo, Su Wilson, front left, smiles after giving a worker at Life Care Center in Kirkland, Wash., flowers to give to her mother, June Liu, who lives at the facility, which has been at the center of the COVID-19 coronavirus outbreak in the state. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

In this March 11, 2020, photo, Scott Sedlacek, right, who has tested positive for the COVID-19 coronavirus, wears a mask as he stands near reporters and listens to a spokesman for Life Care Center in Kirkland, Wash., during a daily press briefing. Sedlacek's father, Chuck, who also has tested positive, lives in the facility, which has been at the center of the COVID-19 coronavirus outbreak in the state, and Sedlacek said he and his siblings have barely spoken to their father, who has blindness and neuropathy, and difficulty using a phone, saying he is more of an "inmate" than a patient. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

A nurse wearing a mask walks past the room of Chuck Sedlacek who has tested positive for the COVID-19 coronavirus Friday, March 13, 2020, as seen through the window of his room at Life Care Center in Kirkland, Wash., near Seattle. The facility has been at the center of the coronavirus outbreak in the state, and Sedlacek's son Scott Sedlacek said that he and his siblings have barely spoken to their father inside the center, who in addition to testing positive for the coronavirus, has blindness, neuropathy, and has difficulty using a phone, saying he is more of an "inmate" than a patient. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

In this March 12, 2020, photo, family members of Chuck Sedlacek, left, look at him through reflections in the window of his room at Life Care Center in Kirkland, Wash., near Seattle. The facility has been at the center of the COVID-19 coronavirus outbreak in the state, and Sedlacek's son Scott said that he and his siblings have barely spoken to their father inside the center, who in addition to testing positive for the coronavirus, has blindness, neuropathy, and has difficulty using a phone, saying he is more of an "inmate" than a patient. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

In this March 11, 2020, photo, Scott Sedlacek, left, who has tested positive for the coronavirus, wears a mask as he stands near reporters and listens to Tim Killian, right, a spokesman for Life Care Center in Kirkland, Wash., during Killian's daily briefing. Sedlacek's father Chuck, who also has tested positive, lives in the facility, which has been at the center of the coronavirus outbreak in the state. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

In this March 12, 2020, photo, Scott Sedlacek becomes animated as talks to reporters outside Life Care Center in Kirkland, Wash., near Seattle. The facility has been at the center of the coronavirus outbreak in the state, and Sedlacek who also has tested positive for the virus said he and his siblings have barely spoken to their father who lives inside the center, and in addition to testing positive for the coronavirus, has blindness, neuropathy, and has difficulty using a phone, saying he is more of an "inmate" than a patient. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

In this March 12, 2020, photo, family members of Chuck Sedlacek wave and greet him through reflections in the window of his room at Life Care Center in Kirkland, Wash., near Seattle. The facility has been at the center of the COVID-19 coronavirus outbreak in the state, and Sedlacek's son Scott said that he and his siblings have barely spoken to their father inside the center, who in addition to testing positive for the coronavirus, has blindness, neuropathy, and has difficulty using a phone, saying he is more of an "inmate" than a patient. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

In this March 12, 2020, photo, Scott Sedlacek poses for a photo while holding a picture of his father, Chuck, outside Life Care Center in Kirkland, Wash., near Seattle. The facility has been at the center of the COVID-19 coronavirus outbreak in the state, and Sedlacek who also has tested positive for the virus said he and his siblings have barely spoken to their father, who in addition to testing positive for the coronavirus, has blindness, neuropathy, and has difficulty using a phone, saying he is more of an "inmate" than a patient. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

In this March 11, 2020, photo, Scott Sedlacek, left, who has tested positive for the coronavirus, wears a mask as he stands with his brother Steve outside the Life Care Center in Kirkland, Wash. Their father Chuck, who also has tested positive, lives in the facility, which has been at the center of the coronavirus outbreak in the state. Residents of assisted living facilities and their loved ones are facing a grim situation as the coronavirus spreads across the country, placing elderly people especially at risk. (AP Photo/Ted S. Warren)

KIRKLAND, Wash. (AP) Desperate to talk to their dad, Scott Sedlacek and his brother, Steve, stood outside his open nursing home window and shouted. They could barely hear his weak replies, but one came through clearly.

I feel like (expletive), the 86-year-old told them.

Chuck Sedlacek arrived at the Life Care Center of Kirkland three weeks ago for physical therapy, just before the suburban nursing home became the epicenter of the nation's worst coronavirus outbreak.

Now he's in worse shape than before.

Hes in isolation after contracting the virus, but his symptoms haven't progressed enough to warrant moving him to a hospital. He came seeking rehab for a broken ankle and banged-up knee after a fall, but he hasn't gotten out of bed in two weeks. Though he previously lived independently in a senior community where he could walk the halls and visit old friends, hes now losing his mobility from lack of exercise.

His five children have hardly spoken with him because his near blindness and neuropathy in his hands make it tough for him to use a phone. And, they say, the overwhelmed Life Care staff has given him just two sponge baths since he arrived.

Hes an inmate as much as he is a patient, said Scott Sedlacek, 64, who also caught the virus. We all love and really care about our dad, and we are absolutely scared. Loneliness kills a lot of people, too. We think this is a license for death.

The Sedlaceks experience is a grim tale of what residents and their loved ones face as the coronavirus spreads around the country and enters other long-term care facilities. While most people recover from the virus and many have mild symptoms, elderly residents are especially at risk.

The virus has been confirmed in at least 11 nursing homes or senior apartments in western Washington. A cluster has also emerged at a veterans home in Lebanon, Oregon, where eight cases were confirmed in recent days.

Nursing homes around the country which are frequently cited for infection control problems are on high alert for coronavirus, boosting their cleaning regimens and clamping down on visitors.

The families of the remaining Life Care residents have reason to be terrified. More than two dozen coronavirus deaths have been linked to the facility, and more than half of those inside have tested positive.

The residents remain in a purgatory. They are mostly restricted to their rooms with no visitors. Roommates or neighbors across the hall have vanished without explanation. Some people are confused about whats going on.

The families, meanwhile, say their anguish has been compounded by mixed messages and a lack of information.

The nurses have told the Sedlaceks they check their fathers temperature every four to eight hours, less often than the two hours promised by administrators. That's troubling, since the virus seems able to cause fevers to spike drastically in a short period. The family has no idea how or when theyll be able to transfer their father out of the center if he recovers from the virus.

Families also question why, long after the outbreak began in China, the U.S. health system was so ill-prepared to test for coronavirus that the facility was still admitting new patients, including Chuck Sedlacek, even after the first resident had been sent to the hospital with flu-like symptoms.

Life Care said there was no reason to think the cornavirus was present until it received news Feb. 29 that a resident had tested positive. Administrators said remaining workers one-third are out with virus symptoms are doing what they can to care for residents.

All I can say is the nurses share your frustration, spokesman Tim Killian told the Sedlaceks when they questioned him during a media availability outside the nursing home this week. We have diminished capability to take care of all the patients in the exact manner they need. ... We do need more help.

The inability to comfort confused parents has been especially painful.

June Lius family used to pick her up several times a week for home-cooked Taiwanese meals and church services. The 93-year-old, who doesnt speak English, has lived at Life Care for two years since a small stroke.

During a flu outbreak there last year, she was able to leave the facility to stay with her daughter, Su Wilson. But now shes stuck at the facility after developing a cough two weeks ago and testing positive for the virus. She doesn't understand why no one is coming to visit her and why she cant go stay with her family.

I think shes very, very depressed, not knowing whats going on, Wilson said. This is sad for a lot of families and for us. The staff are trying to do their best, but are you caring for their mental health, or is it just Isolation! Isolation! Check vitals! IV!?

Wilson has now taken to leaving homemade soup outside the nursing home for staff to bring inside to her mom.

There is hope that outbreaks at other nursing homes might be less severe as they adopt restrictions and learn from Life Cares experience.

For example, at the senior living community where Chuck Sedlacek typically lives, Emerald Heights in Redmond, a staff member at a skilled nursing facility developed symptoms early this month and immediately began staying home before a test confirmed the disease. Eleven residents deemed at risk were quickly isolated and tested; only one was positive.

Meanwhile, though, a resident of the separate independent living community has been confirmed to have the disease and is now in self-isolation.

Despite our advanced planning, were having to run very, very fast to stay ahead of this virus, said Kris Egskov, Aegis Living president, after a resident at Aegis Marymoor in Redmond, Washington, tested positive. We are preparing for the long-haul and accept that this may in fact be an entirely new paradigm in which to protect our residents.

Scott Sedlacek visited his dad four times before Life Care was locked down to visitors on Feb. 29. No one inside was even wearing face masks, he said.

On March 1, the sons joints began to ache. He spent two days trying to get tested for COVID-19, asking doctors as well as public health officials. Even though hed spent time at Life Care, the center of the worst U.S. outbreak, he couldnt obtain a test until after his fever spiked, he had trouble breathing and his wife brought him to a hospital emergency room, which cleared him of the flu and other illnesses.

He felt fine again within 12 hours of being treated with a bronchial nebulizer, and he quarantined himself until last Wednesday, when he cut the period short so he could visit his dad through the hospital window. He wore a yellow face mask as he yelled to him.

This is supposed to be my last day of quarantine, but being with my dad is way more important, Sedlacek said that night. Hes in there and hes lonely. The big thing we wanted to convey to him was, Were here for you, we love you and we want you to get better we just cant be in there with you.

___

Johnson reported from Seattle.

___

The Associated Press receives support for health and science coverage from the Howard Hughes Medical Institutes Department of Science Education. The AP is solely responsible for all content.

___

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'He's an inmate': Anguish mounts over virus-hit nursing home - RiverBender.com

THE Yorkshire Ripper is suffering from a condition that leaves him with uncontrollable shaking.

Ailing Peter Sutcliffe, 73, has been diagnosed with diabetic neuropathy, causing tremors in his limbs.

2

It means the serial killer often shakes so badly he struggles to eat and to look after himself.

The progressive illness which is linked to overweight Sutcliffes diabetes is caused by high blood sugar levels and can result in nerve damage, numbness, pain and cramps.

In severe cases, sufferers cannot feel their limbs due to nerve damage. And it can lead to limbs, particularly feet, having to be amputated.

The Ripper, being held at Category A Frankland Prison, County Durham, is in poor general health and is given a daily cocktail of pills.

He has previously suffered a heart attack and angina.

Sutcliffe, who killed 13 women and attempted to murder seven more between 1975 and 1980, is waiting for an NHS operation to reduce the size of his prostate.

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He is also losing his eyesight, which medics have fought to save.

A source told The Sun on Sunday: Sutcliffe does not look a well man and his shakes are really noticeable. It is really bothering him.

This condition is one of the worst things you can get if youre diabetic particularly if youre fairly old and overweight.

2

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Yorkshire Ripper Peter Sutcliffe struck down with condition that leaves him uncontrollably shaking - The Sun

The intraoperative neuromonitoring market in US is poised to grow by USD 955.33 million during 2020-2024, progressing at a CAGR of over 10% during the forecast period. Request free sample pages

This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20200316005573/en/

Technavio has announced its latest US research report titled Intraoperative Neuromonitoring Market in US 2020-2024 (Graphic: Business Wire)

Read the 120-page report with TOC on "Intraoperative Neuromonitoring Market In US Analysis Report by Type (Insourced IONM and Outsourced IONM), Application (Orthopedic and neurosurgeries, Cardiovascular surgeries, ENT surgeries, and Other surgeries), Methodology (Evoked potential (EP) monitoring, Electroencephalogram (EEG), and Electromyography (EMG), End-user (Hospitals, Ambulatory surgical centers (ASG), and Other end-users), and the Segment Forecasts, 2020-2024".

https://www.technavio.com/report/intraoperative-neuromonitoring-market-in-us-industry-analysis

The market is driven by the increasing number of surgeries that require IONM. In addition, the rising adoption of remote IONM is anticipated to boost the growth of the intraoperative neuromonitoring market in the US.

The number of high-risk surgeries such as cardiovascular procedure, musculoskeletal, and spinal is increasing. Many people in the US, suffering from this condition experience severe long-term pain and disabilities. In addition, patients suffering from cervical or neck pain and lumbar or low back pain require medical attention. IONM are extensively used by surgeons because these medical conditions are often associated with neurological complications. For instance, surgeons use IONM while performing spine surgery because it allows the early identification of electrophysiologic changes. It is also used to identify hemodynamic and other abnormalities. Thus, the increasing number of surgeries that require IONM is expected to drive market growth during the forecast period.

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Major Five Intraoperative Neuromonitoring Companies in the US:

Accurate Neuromonitoring LLC

Accurate Neuromonitoring LLC operates the business under the Services segment. The company offers various services including motor strip mapping, cranial nerve monitoring, pedicle screw stimulations, and more. It also offers intraoperative neuromonitoring for performing neuro-surgical and other procedures.

Cadwell Industries Inc.

Cadwell Industries Inc. offers products through the following business units: EEG, EMG, IONM, Sleep, CADLINK, and Electrodes and accessories. The company offers Cascade IOMAX, Cascade PRO, Arc Alterna, and Arc Essentia.

Computational Diagnostics Inc.

Computational Diagnostics Inc. operates under various business segments, namely NeuroNet and Services. The company offers NeuroNet VII, NN600, and NN650. NN650 is a durable and easy to use IOM system, whereas, NN600 is a portable multi-modality capable system.

IntraNerve Neuroscience Holdings LC

IntraNerve Neuroscience Holdings LC offers products through the Services business segment. The company offers neuroscience services such as remote professional interpretation services, neurotelemetry/cEEG services, and intraoperative neuromonitoring services.

Medtronic Plc

Medtronic Plc offers products through the following business segments: Cardiac and Vascular Group, Minimally Invasive Therapies Group, Restorative Therapies Group, and Diabetes Group. The company offers NIM-RESPONSE 3.0, BIS Complete 2-Channel Monitor, BIS Complete 4-Channel Monitor, and NIM-Neuro 3.0.

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Intraoperative Neuromonitoring Market in US: Type Outlook (Revenue, USD Billion, 2020-2024)

Intraoperative Neuromonitoring Market in US: Application Outlook (Revenue, USD Billion, 2020-2024)

Intraoperative Neuromonitoring Market in US: Methodology Outlook (Revenue, USD Billion, 2020-2024)

Intraoperative Neuromonitoring Market in US: End-user Outlook (Revenue, USD Billion, 2020-2024)

Technavio's sample reports are free of charge and contain multiple sections of the report, such as the market size and forecast, drivers, challenges, trends, and more. Request a free sample report

Related Reports on Health Care Include:

Neurodiagnostic and Monitoring Devices Market Global Neurodiagnostic and Monitoring Devices Market by product (electroencephalograph (EEG) devices, intracranial pressure (ICP) devices, electromyography (EMG) devices, and others) and geography (Asia, Europe, North America, and ROW).

Diabetic Neuropathy Drugs Market Global Diabetic Neuropathy Drugs Market by action (calcium channel alpha-2-delta ligand, SNRIs and TCAs, and others) and geography (Asia, Europe, North America, and ROW).

About Technavio

Technavio is a leading global technology research and advisory company. Their research and analysis focus on emerging market trends and provides actionable insights to help businesses identify market opportunities and develop effective strategies to optimize their market positions.

With over 500 specialized analysts, Technavio's report library consists of more than 17,000 reports and counting, covering 800 technologies, spanning across 50 countries. Their client base consists of enterprises of all sizes, including more than 100 Fortune 500 companies. This growing client base relies on Technavio's comprehensive coverage, extensive research, and actionable market insights to identify opportunities in existing and potential markets and assess their competitive positions within changing market scenarios.

View source version on businesswire.com: https://www.businesswire.com/news/home/20200316005573/en/

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Intraoperative Neuromonitoring Market in the US 2020-2024 | Evolving Opportunities with Accurate Neuromonitoring LLC and Cadwell Industries Inc. |...

Vir Biotechnology, Inc. (San Francisco, CA, USA) has entered into a collaboration with Biogen Inc. (Cambridge, MA, USA) for the development and clinical manufacturing of human monoclonal antibodies (mAbs) for the potential treatment of COVID-19, the disease caused by the SARS-CoV-2 virus.

Vir Biotechnology is a clinical-stage immunology company focused on combining immunologic insights with cutting-edge technologies to treat and prevent serious infectious diseases. The company has assembled four technology platforms that are designed to stimulate and enhance the immune system by exploiting critical observations of natural immune processes. Vir has a robust method for capitalizing on unusually successful immune responses naturally occurring in people who are protected from, or have recovered from, infectious diseases. The platform is used to identify rare antibodies from survivors that have the potential to treat and prevent rapidly evolving and/or previously untreatable pathogens via direct pathogen neutralization and immune system stimulation. Vir engineers the fully human antibodies that it discovers to enhance their therapeutic potential. The company has identified a number of mAbs that bind to SARS-CoV-2, which were isolated from individuals who had survived a SARS (Severe Acute Respiratory Syndrome) infection. The company is conducting research to determine if its antibodies, or additional antibodies that it may be able to identify, can be effective as treatment and/or prophylaxis against SARS-CoV-2.

Due to the urgency of the situation, Vir and Biogen have begun work while a Clinical Development and Manufacturing Agreement is being negotiated. Subject to the completion of a definitive agreement, Biogen would continue cell line development, process development, and clinical manufacturing activities in order to advance the development of Virs proprietary antibodies.

These exceptional circumstances presented by the threat of COVID-19 require that we work with great urgency in the interest of the public good, said George Scangos, Ph.D., CEO, Vir. Biogen is one of the global leaders in cell line and process development for advanced biologics; tapping into their capabilities will provide us with a U.S. base for supply and manufacture of antibody therapies.

Similarly, Vir has also entered into a research collaboration agreement with the National Institutes of Health (NIH) and the National Institute of Allergy and Infectious Diseases (NIAID), Vaccine Research Center (VRC) to advance characterization and development of mAbs against coronaviruses. The joint project will augment ongoing efforts by both parties to identify antibodies that can be used to prevent or treat infection with existing and emerging viruses and help inform the development of vaccines. Vir and NIAID will work together to identify and optimize combinations of antibodies against coronaviruses, including SARS-CoV-2, SARS and MERS, as well as antibodies that may be effective across additional types of coronaviruses. The two parties will exchange antibodies and other materials for testing in combination and individually and, by mutual agreement, will perform in vivo animal studies to analyze immune responses.

This collaboration expands Virs efforts to characterize and develop antibody therapies against coronaviruses by allowing us to access the VRCs significant and broad research experience with coronaviruses, which is complementary to ours, said Herbert Skip Virgin, M.D., Ph.D., Chief Scientific Officer, Vir. This is one of multiple approaches we are taking to rapidly identify and test potential prophylactics and therapeutics for COVID-19 and we expect it to allow us to accelerate finding solutions to this urgent public health need.

Related Links:Vir Biotechnology, Inc. Biogen Inc.

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Vir Biotechnology Partners with NIH and Biogen for Developing Coronavirus Antibodies - HospiMedica

COVID-19 continues to spread worldwide. The latest situation report from the World Health Organization (WHO) shows that there are now more than 125,000 confirmed cases of the disease and more than 4,600 deaths. Several biotech companies are racing to find a vaccine or a treatment for the rapidly spreading disease.

One of these companies is Vir Biotechnology (NASDAQ:VIR), which focuses on developing treatments for infectious diseases. Recently, Vir announced it was partnering up with Biogen (NASDAQ:BIIB) to develop and manufacture antibodies that could treat COVID-19. Given the gravity of the situation, the two companies decided to start working on this project while negotiating the terms of the deal.

Image Source: Getty Images.

On Jan. 22, Vir announced it was screening its library of antibodies to identify one that could be effective against COVID-19. The company had previous experience dealing with other coronaviruses, including Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). On Feb. 12, Vir announced it identified two antibodies with the potential to be effective against SARS-CoV-2, the virus that causes COVID-19.

The company partnered with other companies in its quest to beat the potentially deadly disease. Vir entered into an agreement with WuXi Biologics, a China-based biologics technology platform that helps companies develop and manufacture drugs.According to the terms of the deal, WuXi Biologics "will conduct cell-line development, process and formulation development, and initial manufacturing for clinical development." WuXi Biologics will hold the right to market this treatment in China if it is approved, and Vir will market it in the rest of the world.

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Biogen and Vir Biotechnology to Collaborate to Find a Treatment for the Coronavirus - The Motley Fool

NEW YORK Stocks that moved heavily or traded substantially on Thursday:

United Airlines Holdings Inc., down $12.26 to $37.08.

The U.S. is restricting travel from most of Europe for 30 days over the virus outbreak.

Boeing Co., down $34.24 to $154.84.

The airplane maker is reportedly freezing hiring and could draw down the remainder of a $13.8 billion loan.

Apache Corp., down 49 cents to $7.76.

The oil and gas company is cutting spending, reducing its rig count and drastically slashing its dividend.

Expedia Group Inc., down $11.63 to $65.04.

The economic impact from the virus outbreak is expected to inflict severe financial pain on travel-reliant companies.

United Parcel Service Inc., down $1.82 to $86.17.

The package delivery service said board member Carol Tome will take over from its retiring CEO.

Vir Biotechnology Inc., up $3.83 to $37.60.

The biotechnology company will work with Biogen to develop a potential treatment for COVID-19.

Live Nation Entertainment Inc., down $5.81 to $36. 20.

The concert promoter faces a dismal outlook as the virus outbreak cancels large public events.

Carnival Corp., down $6.78 to $14.97.

The companys Princess Cruises will suspend global operations through May 10 because of the virus outbreak.

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Live Nation, Carnival fall; Vir Biotechnology, rises - The Republic