Fauci says US needs to be prepared for coronavirus to be cyclical March 25,2020
Coronavirus in N.Y.: Toll Soars to Nearly 3,000 as State Pleads for Aid
New York, the increasingly battered epicenter of the nation’s coronavirus outbreak, on Friday reported its highest number of deaths in a single day, prompting state officials to beg the rest of the United States for assistance and to enact an emergency order designed to stave off medical catastrophe.
In the 24 hours through 12 a.m. on Friday, 562 people — or one almost every two-and-a-half minutes — died from the virus in New York State, bringing the total death toll to nearly 3,000, double what it was only three days before. In the same period, 1,427 newly sickened patients poured into the hospitals — another one-day high — although the rate of increase in hospitalizations seemed to stabilize, suggesting that the extreme social-distancing measures put in place last month may have started working.
Despite the glimmer of hope, the new statistics were a stark reminder of the gale-force strength of the crisis that is threatening New York, where more than 102,000 people — nearly as many as in Italy and Spain, the hardest-hit European countries — have now tested positive for the virus. The situation, as it has been for weeks, was particularly dire in New York City, where some hospitals have reported running out of body bags and others have begun to plan for the unthinkable prospect of rationing care.
“It is hard to put fully into words what we are all grappling with as we navigate our way through this pandemic,” Vicki L. LoPachin, the chief medical officer of the Mount Sinai Health System, wrote in an email to the staff on Friday. “We are healing so many and comforting those we can’t save — one precious life at a time.”
Around the country, the total number of coronavirus cases spiked sharply as of Friday afternoon, exceeding 275,000, with more than 7,000 total deaths. After New York, New Jersey was the state with the highest rate of infection. Globally, more than one million people had been infected and nearly 60,000 had died.
Hot spots continued to emerge.
“We continue to watch, in addition, the Chicago area, the Detroit area, and have developing concerns around Colorado, the District of Columbia,” Dr. Deborah Birx, the White House coronavirus response coordinator, said at a daily news briefing on Friday. She added that the government would “move supplies creatively around the country to meet the needs of both the front line health care providers but also every American who needs our support right now.”
As the inexorable march of contagion in New York continued, Gov. Andrew M. Cuomo issued an impassioned plea to the nation to hurry medical staff and equipment to the state before an expected shortfall of both overwhelmed its already groaning health care system, perhaps as early as next week.
Mr. Cuomo, vowing to return the favor, said he would redirect hundreds of lifesaving ventilators and teams of local doctors to other states as soon as the crisis in New York passed its peak.
But unable to count on reinforcements arriving fast enough, Mr. Cuomo also issued an extraordinary executive order on Friday giving him the power to commandeer ventilators from hospitals in less-affected counties in the state and to redeploy them to hard hit areas in Brooklyn, Queens and Long Island.
“I’m not going to let people die because we didn’t redistribute ventilators,” Mr. Cuomo said, adding, “We don’t have enough — period.”
But Representative Elise Stefanik, a Republican congresswoman who represents a rural district of northern New York, said in a statement that she was “very concerned” about the order.
“I represent demographically the largest number of seniors of any district in New York,” she wrote. “This is the most vulnerable age group facing Covid-19 and needs to be considered.”
She and 11 other state and federal Republican officials later issued a joint statement opposing Mr. Cuomo’s action.
As the outbreak entered its second month, New York City in particular hunkered down for what promised to be a long and grueling siege.
Earlier in the week, city officials rushed 45 refrigerated trailers to overburdened hospitals where in-house morgues were filling up with bodies. Crematories, under eased restrictions, are now allowed to run around the clock. A special team of 42 military mortuary affairs officers was starting to arrive from Virginia to help the city’s medical examiner.
One out of every six police officers in the city had called out sick or was in quarantine, straining the department at the very moment when its 36,000 officers have been asked to enforce new rules intended to slow the spread of infection.
To cut back on crowding in emergency rooms, the city’s Fire Department issued new guidelines to thousands of paramedics, telling them not to bring cardiac patients to hospitals unless they were able to find a pulse.
Mayor Bill de Blasio has been warning that the city was only days away from what he called a “D-Day,” when the outbreak would overwhelm the health care system, putting hundreds, if not thousands, of additional people at risk. In an early morning television appearance on Friday, he made his own appeal to the country, asking for what amounted to a draft for medical personnel.
“Unless there is a national effort to enlist doctors, nurses, hospital workers of all kinds and get them where they are needed most in the country in time, I don’t see, honestly, how we’re going to have the professionals we need to get through this crisis,” Mr. de Blasio said.
As the weekend neared, the possibility emerged that the city could finally get relief from the U.S.N.S. Comfort, the Navy hospital ship that arrived in New York to great fanfare on Monday.
Pentagon officials had initially said the ship would treat only non-coronavirus patients in an effort to keep the vessel free from infection. But on Friday, Gen. Mark A. Milley, the chairman of the Joint Chiefs of Staff, said the military was “reassessing” its policy and might allow coronavirus patients aboard the ship.
In one sign of the strain on hospitals, Lenox Hill Medical Center in Manhattan temporarily experienced a drop in pressure in its oxygen supply on Friday, according to a memo that hospital executives sent to staff members. The cause was apparently the heavy demand.
To bolster the local health care system, Mr. Cuomo this week enacted an unprecedented plan for all of New York’s hospitals — public and private, upstate and downstate — to work together in a kind of single network. By the end of the week, there were early signs that the effort was working.
On Thursday, Woodhull Medical Center, a public hospital in Brooklyn, reached its capacity for treating virus patients and transferred 15 to the Bellevue Medical Center, a public hospital in Manhattan, said Dr. Robert Chin, Woodhull’s emergency department director.
“So far, we’ve been holding it together,” Dr. Chin said. “Are we ready for what’s coming? I can’t really say — because I don’t know what’s coming.”
Jesse McKinley, William K. Rashbaum, Matt Richtel, Brian Rosenthal, Michael Rothfeld and Ali Watkins contributed reporting.
High Blood Pressure of Pregnancy Tied to Developmental Problems in Children
Pre-eclampsia — the high blood pressure of pregnancy — can be harmful and even fatal to the mother. Now a new study suggests that children exposed to pre-eclampsia may be at increased risk for a number of developmental problems.
Researchers used a Norwegian health database to study 980,560 children, of whom 28,068 were exposed to pre-eclampsia in full-term pregnancies. The study, in JAMA Psychiatry, followed the children for an average of five years, some as long as 14 years.
After adjusting for birth weight, sex, the mother’s age, parental educational level and immigration status, they found that exposure to pre-eclampsia was associated with a 50 percent increase in the relative risk for epilepsy, a 50 percent increased risk for intellectual disability and a 21 percent increased risk for vision or hearing loss.
Pre-eclampsia also increased the risk for cerebral palsy, attention-deficit hyperactivity disorder and autism spectrum disorder.
The senior author, Dr. Allen J. Wilcox, an investigator emeritus at the National Institutes of Health, emphasized that these numbers represent an increase in relative risks, and that the absolute risk of these developmental disorders in full-term babies is very small. So any potential increase in the number of cases would be very small. The study also showed only an association, so could not prove cause and effect.
The reason for the association is unknown, he said, and “women with pre-eclampsia shouldn’t add this to their list of things to worry about. But we were surprised to see in this large database evidence that pre-eclampsia was increasing the risk for a wide spectrum of neurodevelopmental problems.”
Ex-Wife Sick. Daughter Sick. 3 Friends Dead. Everyone Knows Someone.
A New York City Housing Authority retiree ticked off his running tally: an ex-wife sick, a daughter sick, and three old friends dead. In Queens, a young poet learned a friend’s parents are in the hospital, one on a ventilator.
And Qtina Parson of Parkchester, the Bronx, gave a grim reversal of the cheerful family updates one expects from the proud mother, sister and aunt that she used to sound like just a couple of weeks — a lifetime — ago.
“My nephew — sick, he’s 28,” she said. “Him and his girlfriend. My sister-in-law, she’s 46, she had it.” Her son, Marcus, 18, is with relatives in South Carolina, where he has developed a fever and a cough. “But he’s out there cutting grass,” she added, as if saying this aloud would make it true: “I’m telling him it’s his allergies.”
New Yorkers have watched in helpless fear as the coronavirus, with dizzying speed and ferocity, truly took hold of the city in recent days. With more than 1,500 dead, many have already lost someone in their circle — a co-worker, an old friend from high school, the parent of a child’s classmate. The parish priest, the elderly neighbor upstairs. A mother, a father.
Almost everyone now knows someone who is sick.
The story is told in the numbers: There were nearly 52,000 confirmed cases of coronavirus infections in New York City as of Thursday. But the reality of its reach is far worse — one study of cases in China suggested that up to 10 times the people who have tested positive may be infected, which could make the true number in the city close to half a million. And the apex is believed to still be weeks away.
The rising numbers have conversely shrunk the private worlds of some eight million individual people. It is as if the microscopic enemy, once an abstract nuisance to many, something happening someplace else, seemed to be closing in, its arrival announced with the now-constant peal of the ambulance siren.
If the pandemic can be thought of as playing out in weeks — the week the restaurants closed, the week schools closed, stores closed — this has been the week its true grip was felt throughout the city.
“It is the great equalizer,” said Gov. Andrew M. Cuomo on Tuesday at a briefing. “I don’t care how smart, how rich, how powerful you think you are. I don’t care how young, how old.”
To many, the rules of engagement suddenly changed this week.
“They were saying, ‘just if you’re immuno-compromised,’” said M. Marbella, 27, a poet and writer who recently learned that a friend’s parents were both in the hospital. “Now everyone’s dropping like flies.”
The speed could make it feel unreal. A person who enjoyed dinner in Manhattan before attending a Broadway show exactly one month ago could today be sick, mourning a family member, out of a job or all of the above. There was next to nothing to compare it to; thousands lost a loved one on Sept. 11, but those losses arrived in a single terrible day, in an instant. Some reached further back to find a comparison, to World War II or the Spanish flu of 1918, or beyond.
“It’s like the plague from England from the 14th century,” said Max Debarros, 67, in Fort Greene, Brooklyn.
It is a plague playing out not only on the streets, but also on the screens, racing through people’s Facebook accounts and Twitter feeds as old friends and friends of friends announced personal losses. The threat seems to be everywhere.
“Every day on social media, we see someone new,” said Audrey Cardwell, 30, of Sunnyside, Queens. At first skeptical of the outbreak’s potential — “it felt like fearmongering” — she now seeks ways to address the anxiety she feels, through meditation and walks with her dog. “I have to monitor how much I’m reading and scrolling,” she said.
Likewise, Leora Fuller, 33, of Bedford-Stuyvesant in Brooklyn, who said two of her students at Rutgers University-Newark had been hospitalized, is focusing more on friendships and her own well-being. “Real care,” she said, “like not, ‘Oh, I’m going to buy something for myself.’”
Other means of coping play out across the city. Aurelio Aguilar, 36, at work in a bodega on the Lower East Side, drinks a concoction of ginger, lemon and mashed garlic, his grandmother’s recipe to boost the immune system. In Fort Greene, Aidan Sleeper, 36, carries a homemade mix of 30-to-1 water and bleach and sprays every doorknob he’s about to touch.
In Long Island City, Queens, Glenn Harris, 54, celebrated a birthday last week with 20 friends on the videoconferencing platform Zoom — “people from all over the country,” he said. At the same time, Andy Arroyo, 35, planned for the worst and spoke of the gun he’s owned since Hurricane Sandy struck in 2012.
“It may seem like an overreaction, but you really can’t predict how people will act during desperate times,” said Mr. Arroyo, who lives in Port Chester, in Westchester County, and was on the way to a potential job in the Bronx. “I need to make sure myself and my loved ones are safe.”
Americans over all, not just in large cities, are feeling the arrival of the coronavirus in their own lives. A Civiqs/Daily Kos poll this past week asking 1,505 adults in the United States about the pandemic found that 13 percent had been infected or knew someone who had, and that 60 percent worried they would become sick.
The coronavirus was an abstract concept to Cat Harper, 59, in the Bronx, until word arrived that members of her family’s church in Long Island City were becoming ill. Then, her sister began coughing, and it wouldn’t go away.
Her sister tested positive and was admitted to Montefiore Medical Center several days ago. “I was starting to get scared that I might not get to see her ever again,” Ms. Harper said. She called, but many days her sister’s throat was so sore she could barely speak.
“She was seeing all the other people around her, a lot of them way sicker than she was,” Ms. Harper said. “She was probably thinking that would happen to her.”
Instead, she recovered and was released to quarantine at home. Other families have had much worse outcomes.
“There are people that are close to me, that I know, who are sick,” said Angelo Alston, 60, a retired employee of the New York City Housing Authority. “My ex-wife. My daughter. A friend of mine in Georgia that I grew up with passed away. Two other friends that I grew up with also passed.”
He moved to Pennsylvania years ago, but was back in the city after the death of a stepson from a nonviral medical condition — a terrible loss at any time, but now, also a threat, bringing family back to the city to claim his remains.
“I’m trying to get out of here,” he said.
In Fort Greene, Blair Smith, 35, was already dealing with a sick relative when she ran into a neighbor with bad news about a handyman, Jorge, whom they both knew. He had just died.
“Oh, my God,” she said. “It’s like watching a storm and you’re just watching for that moment when it really hits.”
Dion Faria, 44, of Bedford-Stuyvesant, was more annoyed than afraid when he was forced to keep his club on Pacific Street closed. Now, with Facebook friends of friends getting sick and a viral video of bodies being loaded into a refrigerated truck outside a city hospital, he finds himself imagining a time after this one.
“Hopefully, the gates open,” he said on his stoop, “and we all go back to living.”
Jo Corona, Matthew Sedacca, Jeffrey E. Singer, Alex Traub and Rebecca Liebson contributed reporting.
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