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Fauci says US needs to be prepared for coronavirus to be cyclical March 25,2020

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Fauci says US needs to be prepared for coronavirus to be cyclical March 25,2020

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Coronavirus in N.Y.: Toll Soars to Nearly 3,000 as State Pleads for Aid

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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.

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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.

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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.”

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.

General Milley’s comments came after New York hospital executives complained on Thursday that the Comfort was sitting at its berth in New York largely empty while hospitals in the city were overrun.

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.

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High Blood Pressure of Pregnancy Tied to Developmental Problems in Children

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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.

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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.

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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.

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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.”

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Ex-Wife Sick. Daughter Sick. 3 Friends Dead. Everyone Knows Someone.

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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.

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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.

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“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.

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.

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“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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