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| It's been around for awhile and apparently they also want to liberate Palestine.... | good luck ! |
~ From the Lancet (click title for link):
Reviving the USCDC
"The COVID-19 pandemic continues to worsen in the USA with 1·3 million cases and an estimated death toll of 80 684 as of May 12. States that were initially the hardest hit, such as New York and New Jersey, have decelerated the rate of infections and deaths after the implementation of 2 months of lockdown. However, the emergence of new outbreaks in Minnesota, where the stay-at-home order is set to lift in mid-May, and Iowa, which did not enact any restrictions on movement or commerce, has prompted pointed new questions about the inconsistent and incoherent national response to the COVID-19 crisis.
The US Centers for Disease Control and Prevention (CDC), the flagship agency for the nation's public health, has seen its role minimised and become an ineffective and nominal adviser in the response to contain the spread of the virus. The strained relationship between the CDC and the federal government was further laid bare when, according to The Washington Post, Deborah Birx, the head of the US COVID-19 Task Force and a former director of the CDC's Global HIV/AIDS Division, cast doubt on the CDC's COVID-19 mortality and case data by reportedly saying: “There is nothing from the CDC that I can trust”. This is an unhelpful statement, but also a shocking indictment of an agency that was once regarded as the gold standard for global disease detection and control. How did an agency that was the first point of contact for many national health authorities facing a public health threat become so ill-prepared to protect the public's health?
In the decades following its founding in 1946, the CDC became a national pillar of public health and globally respected. It trained cadres of applied epidemiologists to be deployed in the USA and abroad. CDC scientists have helped to discover new viruses and develop accurate tests for them. CDC support was instrumental in helping WHO to eradicate smallpox. However, funding to the CDC for a long time has been subject to conservative politics that have increasingly eroded the agency's ability to mount effective, evidence-based public health responses. In the 1980s, the Reagan administration resisted providing the sufficient budget that the CDC needed to fight the HIV/AIDS crisis. The George W Bush administration put restrictions on global and domestic HIV prevention and reproductive health programming.
The Trump administration further chipped away at the CDC's capacity to combat infectious diseases. CDC staff in China were cut back with the last remaining CDC officer recalled home from the China CDC in July, 2019, leaving an intelligence vacuum when COVID-19 began to emerge. In a press conference on Feb 25, Nancy Messonnier, director of the CDC's National Center for Immunization and Respiratory Diseases, warned US citizens to prepare for major disruptions to movement and everyday life. Messonnier subsequently no longer appeared at White House briefings on COVID-19. More recently, the Trump administration has questioned guidelines that the CDC has provided. These actions have undermined the CDC's leadership and its work during the COVID-19 pandemic.
There is no doubt that the CDC has made mistakes, especially on testing in the early stages of the pandemic. The agency was so convinced that it had contained the virus that it retained control of all diagnostic testing for severe acute respiratory syndrome coronavirus 2, but this was followed by the admission on Feb 12 that the CDC had developed faulty test kits. The USA is still nowhere near able to provide the basic surveillance or laboratory testing infrastructure needed to combat the COVID-19 pandemic.
But punishing the agency by marginalising and hobbling it is not the solution. The Administration is obsessed with magic bullets—vaccines, new medicines, or a hope that the virus will simply disappear. But only a steadfast reliance on basic public health principles, like test, trace, and isolate, will see the emergency brought to an end, and this requires an effective national public health agency. The CDC needs a director who can provide leadership without the threat of being silenced and who has the technical capacity to lead today's complicated effort.
The Trump administration's further erosion of the CDC will harm global cooperation in science and public health, as it is trying to do by defunding WHO. A strong CDC is needed to respond to public health threats, both domestic and international, and to help prevent the next inevitable pandemic. Americans must put a president in the White House come January, 2021, who will understand that public health should not be guided by partisan politics."
~~~~~
~ From MSN/Washington Post: (click title for link)
Growing Friction Between White house, CDC Hobbles Pandemic Response
By, Lenny Bernstien, Josh Dawsey, Yasmeen Abutaleb
(or, "Calling Dr. Kushner.....")
"The meager guidelines for safely reopening the country released this week are the latest sign of the Trump administration’s efforts to sideline the Centers for Disease Control and Prevention and the increasing tension between the White House and the world-renowned public health agency.
With Americans waiting for expert advice on how to resume a semblance of normal life during the pandemic, the CDC released just six short “decision trees” Thursday while the rest of its lengthy proposal remains under review at the White House, where it has been for weeks.
Instead of assuming its traditional lead role in a public health crisis, the 74-year-old agency has become just one of many voices providing often contradictory instructions to a confused and imperiled public.
“Punishing the agency by marginalizing and hobbling it is not the solution,” the venerable British medical journal The Lancet noted Friday in a stinging editorial that called the U.S. response “inconsistent and incoherent.”
“Only a steadfast reliance on basic public health principles, like test, trace, and isolate, will see the emergency brought to an end, and this requires an effective national public health agency.”
Increased friction between the White House and the CDC was predictable as President Trump, who often takes a dim view of scientific expertise, campaigns to revive the moribund economy.
But White House officials also said they are frustrated by what they consider the agency’s balky flow of data and information, the leak of an early version of the CDC’s reopening recommendations and the agency’s crucial early failure to create and roll out a test for the virus, according to three administration officials who spoke on the condition of anonymity to discuss internal disagreements.
Last month, the government awarded an unusual $10.2 million contract to a Pittsburgh information technology company, TeleTracking Technologies, to collect data on available hospital beds, hospital capacity, covid-19 patients and deaths caused by the coronavirus — information it already receives from the CDC.
The White House-led task force also is sparring with public health experts, both inside and outside the CDC, about whether covid-19 death counts collected and disseminated by the CDC are inflated.
Some in the White House, including coronavirus task force coordinator Deborah L. Birx and Trump’s chief of staff, Mark Meadows, have begun to take aim at the leadership and communication skills of the CDC’s director, Robert Redfield.
“We should be thought partners,” one official said. “The CDC is not fulfilling requests, they’re not collaborating and they’re disorganized. They’re not speaking with one voice.”
One senior administration official, speaking on condition of anonymity to discuss these problems, said the soft-spoken, deeply religious Redfield has few allies in the rough-and- tumble internal politics of the Trump administration. During a task-force meeting last week, he apologized for the leak of the reopening recommendations from his agency, an earnest gesture seen by others as a sign of weakness.
“He just has no power over his agency. He has no loyal politicals. He is a man on an island,” that person said.
Redfield did himself no favors with Trump’s inner circle when he told The Washington Post April 21 that a second wave of covid-19 disease this winter could be more challenging than the first because it will coincide with flu season. Redfield was forced to appear at a White House briefing that day to soften his remarks, after Trump surprised the agency by publicly demanding a new statement.
A spokeswoman for the CDC declined to answer questions for this story. Most officials who agreed to discuss the tensions between the White House and the agency asked for anonymity to address sensitive relations between government agencies.
Trump spokesman Judd Deere said “the White House and CDC have been working together in partnership since the very beginning of this pandemic to carry out the President’s highest priority: the health and safety of the American public. The CDC is the nation’s trusted health protection agency and its infectious disease and public health experts have helped deliver critical solutions throughout this pandemic to save lives.
“We encourage all Americans to continue to follow the CDC’s guidelines as state and local leaders implement the president’s data-driven phased approach to responsibly opening up America.”
In task force meetings, however, Birx has questioned whether the CDC death count is inflated. In early April, the agency revised its methodology to include deaths probably attributable to covid-19, the disease caused by the virus, along with fatalities confirmed by laboratory tests. Supporters of the president have publicly expressed the same doubts.
During a task force meeting early this month, a heated discussion broke out between Birx and Redfield over the CDC’s system for tracking virus data, according to four people present for the discussion or later briefed on it.
“There is nothing from the CDC that I can trust,” Birx said, according to two of the people.
Experts such as Anthony S. Fauci, the task force’s top infectious disease specialist, have said the number of covid-19 fatalities is likely undercounted.
Fauci took that position publicly at a Senate hearing Tuesday. Asked by Sen. Bernie Sanders (I-Vt.) about whether the official death toll — listed at more than 85,000 Friday — was 50 percent too low, Fauci said: “I’m not sure, Senator Sanders, if it’s going to be 50 percent higher. But most of us feel that the number of deaths are likely higher than that number.”
In an interview, Robert Anderson, chief of the mortality statistics branch at the CDC’s National Center for Health Statistics, said he is also confident the number of U.S. covid-19 deaths is undercounted.
“I think the evidence points to the fact that we’re underestimating rather than overestimating,” said Anderson, whose agency is part of the CDC. “The system is designed to collect data on causes of death, not on whatever condition the person might have had.”
As recently as April 7, Birx herself took an expansive position on counting covid-19 deaths. At a White House briefing, she said anyone who tests positive for covid-19 and dies should be counted as a covid-19 death, regardless of whether he or she had underlying conditions.
“The intent is, right now, that … if someone dies with covid-19, we are counting that as a covid-19 death,” she said.
The strain between the White House and the CDC was noted Friday by the venerable British medical journal The Lancet, which wrote in an editorial that “punishing the agency by marginalizing and hobbling it is not the solution …
“Only a steadfast reliance on basic public health principles, like test, trace, and isolate, will see the emergency brought to an end, and this requires an effective national public health agency.”
The agency was sidelined soon after Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, warned the public Feb. 25 that the virus could soon change everyday life dramatically. The stock market plummeted on her remarks, enraging the president as he returned from a trip to India, several senior administration officials have said.
Messonnier, who had played a leading role until then, was moved off the response, sending a chill through the agency, three current and former officials said. The next day, Trump named Vice President Pence head of the task force, replacing Health and Human Services Secretary Alex Azar, whose agency oversees the CDC.
The CDC, which has not held a briefing since early March, has repeatedly asked the White House to resume its sessions for the media, according to two senior administration officials, but has not received permission, and has finally given up.
The White House also pushed back when the CDC recommended that all Americans wear face masks when they go out in public. Aides to Vice President Mike Pence were particularly resistant, only wanting to demand masks in “hot spot” areas. Trump undermined the advice when he announced it, saying he would not comply.
More conflict has accompanied the White House’s delay in moving on the detailed CDC recommendations that describe how houses of worship, schools, day care facilities and other places might safely reopen. Top officials viewed those guidelines as overly prescriptive and many of them were challenged during a robust editing process that involved the taskforce, the Office of Management and Budget and the Domestic Policy Council.
Now, as Trump has promised a reignited economy heading into the November election, the CDC is in the awkward position of producing the information Trump wants least — the reminder that the covid-19 death rate has plateaued at nearly 2,000 per day.
The government may be pursuing other ways to collect information through its contract with TeleTracking, which has not previously been reported.
On March 29, Vice President Pence wrote hospital administrators across the country, instructing them to file daily reports on the spread of covid-19 to the CDC’s National Healthcare Safety Network, which collects information on health care-associated infections and other issues.
The network’s website has two new “modules” that hospitals and long-term care facilities such as nursing homes can use to report critical information about patients, staffing and beds. The section for long-term care facilities also offers a spot for reporting on supplies and personal protective equipment.
“The data we are now asking you to report is necessary in monitoring the spread of severe covid-19 illness and death, as well as the impact to hospitals,” Pence wrote.
But on April 6, public records show, the government hired TeleTracking to do some of the same things. The $10.2 million, six-month contract, which was not competitively bid, requires the company to set up a “covid-19 rapid deployment plan for real-time healthcare system capacity reporting,” according to a copy of the contract listed on the Federal Procurement Data System website.
The company was hired by the Office of the Assistant Secretary for Preparedness and Response, part of the Department of Health and Human Services.
On April 10, Azar wrote to hospital administrators again, offering them several options for reporting daily information: via TeleTracking, through the CDC site, straight to HHS through an IT vendor or by publishing it on the hospital’s website.
“The completeness, accuracy and timeliness of the data will inform the covid-19 task force decisions on capacity and resource needs to ensure a fully coordinated effort across America,” Azar wrote.
An HHS spokeswoman said not every hospital was using CDC’s National Healthcare Safety Network and the addition of TeleTracking is capturing additional data.
“Both TeleTracking and CDC’s National Healthcare Safety Network (NHSN) are tools to help hospitals input data in to HHSProtect,” the agency’s new “streamlined data collection platform,” she said in a statement.
Information from across the federal government, state, local and tribal governments, health care facilities and colleges and universities is used to “gain insight into how COVID-19 is spreading, and how the federal government can best apply resources to mitigate and prevent spread,” she said.
Chris Johnson, president of TeleTracking, said his company was hired to help HHS collect more data on the capacity and availability of beds in U.S. hospitals, as well as about covid-19 cases.
“My belief is that, given the fragmented nature of health care, there are people that report in many different ways,”Johnson said. “And what they’re trying to do is reach as many as possible.” He said more than 4,000 hospitals are using TeleTracking to report their daily data.
Richard J. Jackson, a professor emeritus at the University of California-Los Angeles Fielding School of Public Health, who also worked at the CDC, said it is “unprecedented that you’d set up a competing system separate from the CDC. To set up a competing process to do this would appear to really undermine the CDC.”
The decision to award the contract was not made at the task force level and was not briefed to the coronavirus task force, said two people with knowledge of the regular meetings.
But the adviser and a senior administration official said Trump’s son-in-law and senior adviser Jared Kushner and many of his allies do not trust government agencies and prefer to work with officials in the private sector."
~~~~~
A look at the conditions of the Tijuana Hospitals treating the COVID-19 Virus; videos and charts within the report, click the link.
~ From Zeta:
La Crisis de los Hospitales COVID-19: Desabasto de Medicinas y Falta de Camas
Por, Isabel Mercado - 05/15/20
"Helped for days in chairs for lack of beds, without sufficient medication to mitigate the symptoms of the coronavirus and next to corpses, patients are observed in the emergency rooms of hospitals converted to COVID-19 in Tijuana. While some have sufficient financial resources and pay for private medical care, others simply take shelter in their homes, where they perish due to lack of adequate care.
Among corpses wrapped in bags, sitting in the middle of corridors or in any available corner, patients are observed in the emergency rooms of Tijuana hospitals converted to COVID-19. Waiting for a bed to vacate, they remain bedridden for two, three, four days, or more in wheelchairs, desks, benches, or, at best, hospital chairs.
There they are attended by the medical personnel of the high fevers, intense headaches and body, among other symptoms typical of the coronavirus; if they have difficulty breathing, they are supplied with oxygen.
Even so, several have died in the emergency area sitting in a chair and connected to an oxygen tank, before having access to a bed.
The bodies of those who lost the battle against COVID-19 are kept in bags and remain for hours in the area where they perished, before being transferred to the mortuary to be delivered to their relatives.
Those who continue to fight to survive the pandemic eat their food, take their medicine and cling to life next to a corpse.
Although they are transitional spaces in determining whether or not patients require hospitalization, the emergency rooms of the COVID hospitals have become an extension of the hospitalization area, but without the infrastructure for it.
The saturation of this space means that there is a long wait to enter the area that is supposed to give an assessment of the patients; Before they have to pass a filter, called triage, which many are sent home for lack of beds in hospitals or wait for a chair to vacate to access the emergency area.
It is in this filter that half a dozen people have died in the General Hospital of Tijuana during the pandemic.
Given this, tired of navigating their patients from one public hospital to another without achieving hospital admission, some patients or their families make an economic effort to resort to private doctors, acquiring on their own the medication and treatment that may fluctuate between 5,000 and 40,000 pesos, depending on the patient's condition.
Those who lack financial resources have no choice but to settle for waiting to be admitted to a public hospital, to be cared for even if they are sitting in a chair. Otherwise, they take shelter in their homes where they perish, proof of this is that in the last month the number of people who died in their homes with symptoms associated with coronavirus has increased, registering a weekly average of 60 deaths from this cause.
ONLY CHAIRS AVAILABLE
With a temperature of around 40 degrees Celsius, intense muscle aches and increasingly acute difficulty in breathing, Ana attended the Family Medicine Unit Number 18 of the Mexican Institute of Social Security (IMSS) in Tijuana on Saturday, May 9.
Because it was a symptom associated with COVID-19, she was referred to Regional General Hospital Number 1, where they performed a test and kept her for hours sitting in a chair in the emergency room, without supplying her with oxygen "because she was already exhausted."
Given the staff's warning that she could stay for days like this, as there were no beds available to hospitalize her, Ana's daughters chose to remove her from the hospital and take her home, where she was treated by a private doctor.
In addition to buying medications, Ana's family had to rent an oxygen tank for 4,700 pesos, which only lasted a day and a half, having to pay 700 pesos more each time it was refilled during the ten days of treatment.
The woman's condition worsened, to the extent that the doctor predicted on one occasion that she would not spend the night. It was not so, she survived being treated at her home in El Laurel, East Tijuana, for not reaching a bed in a COVID-19 hospital.
The way of the cross to access decent hospital care is not reflected in the statistics of the Secretary of Health of Baja California, Alonso Pérez Rico, with which he maintains that the hospital occupation of Tijuana is 72%, which means a provision for At least 350 beds for the care of patients infected with coronavirus, both in hospitals converted to COVID-19, and in support clinics.
It shows that the numbers that the official presents daily are a fallacy, is the fact that Ana's case has not been the only patient who has been forced to attend to the coronavirus from home, due to lack of space in hospitals .
On April 20, Miguel Ángel Jiménez registered mild symptoms associated with SARS-CoV-2, so he chose to take shelter at home, but a week later, on April 27, he began to have difficulty breathing. He went to the General Hospital of Tijuana, but there was only space to be attended in chairs, even when the health authorities report a hospital occupation of 76% in this hospital, which means a provision of 36 of the 150 beds with which it is enabled .
He chose to move to the IMSS Regional General Hospital Number 20, being admitted to the emergency room, where he observed a dozen patients also sitting in chairs, with oxygen tanks on one side, waiting for a bed to be vacated to be hospitalized.
IMSS Clinic 20 is a support unit that has 100 beds to serve COVID patients, of which 52% occupancy is officially reported.
"I asked those people how many days they had there, some answered that three, others that four days had been there waiting, sitting in hard chairs, the truth is I grabbed my things and I left," he said.
So he decided to go to Hospital Ángeles, where a tent was set up in the parking lot for the care of patients with coronavirus symptoms.
There he was attended by Dr. Michel Martínez, who in addition to the Hydroxychloroquine that he supplies to patients treated in public hospitals, prescribed Baricitinib, at a cost of 21 thousand pesos, as well as Clexane and Prednisone, drugs that in total involved an outlay greater than 22 thousand pesos. To this expense was added the rent of an oxygen concentrate for 2,000 pesos a week.
With everything and that Miguel Ángel suffers comorbidities such as diabetes, hypothyroidism, in addition to having had a heart attack in 2019, he managed to overcome the serious stage of the coronavirus, and although he remains in shelter at home, on May 6 the treatment ended.
“Even the doctor who is treating me is getting medicines that we have left over to those who were already sick to help nurses who are getting contagious. I gave her the medicines that I had left over for a nurse who was very serious at the General Hospital. ; If they had those medications in the General Hospital, the doctor would not be getting them, "he reflected.
From his experience, Miguel Ángel shared: “The truth is sad, that our institutions do not have the appropriate medicines or the capacity to receive the sick. It is unfortunate that people are dying from lack of medicine and hospitalization outside of hospitals. "
THE SICK REMAIN IN CHAIRS WITHOUT A SPECIFIC TIME
Regarding patients treated in chairs in hospitals converted to COVID-19, the Secretary of Health of Baja California, considered it necessary for them to be evaluated by a doctor.
“We are not going to discharge any patient who is pending on, say, I do not want you here for more than two days, I am going to discharge you, no; They will stay as long as necessary for a doctor to assess whether he can go home safely or require hospitalization because we are going to intubate him."
Questioned for how long that assessment requires, the official noted that "depending on the patient, this ... I could not tell you more than two days a specific case, what I do tell you is that emergencies is a transition area to see if the patient requires hospitalization or is required to go home. "
On the other hand, the IMSS delegate in Baja California, Desirée Sagarnaga, did not recognize patient care for more than a day in chairs: “In Phase 3 we are still in beds, with staff and fans, and a fatality rate that does not exceed to the state average, those are the numbers that should count, in the end one should count if you did it right, if you did it wrong ”. The official stressed that no clinic at the Institute has had to reject patients.
FALSE STATISTICS OF HOSPITAL OCCUPATION
In the last 48 hours, Baja California increased the number of COVID-19 positive patients by 311, of which 157 were registered in Tijuana and was not reflected in hospital occupation, since according to statistics from the Secretary of Health, Alonso Pérez Rico stands at 81.6%.
In the case of the General Hospital of Tijuana, enabled with 150 beds, the secretary reported an occupation of 75%, with 46 beds available, despite the fact that the patients continue to be held in the emergency unit, as there is no space for their adequate hospitalization. . In fact, the General's doctors trusted ZETA that the availability of beds in that unit is a lie.
Of the IMSS hospitals, the official also presents the same statistics of unreal occupation, as is the case of the Regional General Hospital Number 1, also located in Tijuana, of which he highlighted a hospital occupation of 73.4%, with 42 unoccupied beds out of 194 that it has.
In none of the daily reports presented by Pérez Rico in the more than two months since the first case of coronavirus in BC was reported, has he reported a hospital occupation above that percentage.
Regarding the conditions in which the hospitals that care for people infected with coronavirus operate, in which patients are cared for due to lack of beds, there is a lack of sufficient medications, among other supplies, he explained: “There are deficits, of course yes, As in all hospitals, the good thing about COVID is that it is showing us that we must have extensive training in terms of Personal Protective Equipment, medications, bedding, fans; to be preventive in relation to the patients, the deficit of the medications ”.
REJECTED PEOPLE TURN TO PARTICULAR ATTENTION
The reality that he has had to attend to the doctor Michel Martínez Franco, in charge of the respiratory evaluation unit of the Angeles Hospital, is different from those described by the health authorities.
He indicated that he has attended patients with pneumonia who arrive at the tent of the private hospital after having traveled up to three times the filters of the hospitals of the IMSS or the General, without being clinically treated. After being assessed in the private hospital, they are provided with treatment, which they take from their homes.
"I have made the decision to manage them at home, I prescribe the medications that we have used in hospitalized patients, oxygen at home for those who require it, oral fluids including electrolytes, I request a specific laboratory to evaluate a patient with COVID disease, I recommend monitoring at home, pulse, oximetry -to know their level of oxygenation-, temperature and I provide insulation guide at home, "he explained.
Through a video call, the medical care of the patients is continued and each patient who is cared for from home has a person in charge who ensures their medical care, regardless of whether they have limited resources.
"I think we have avoided many admissions in public hospitals," he said, specifying that 36 to 40 patients are cared for in that unit daily.
Without specifying an exact number of people infected with coronavirus who have been treated with treatments from their homes, "there are hundreds of patients and they are all alive", only one required to be admitted to hospital and has already recovered.
DRUG SUPPLY IN HOSPITALS COVID-19
Initially improvised as a COVID-19 medical unit, Subzone Area 6 General Hospital, located in Tecate, was adapted a couple of weeks ago to receive patients infected with coronavirus.
The hybrid hospital was expanded to have 36 census beds, so it was no longer necessary to attend to patients in chairs, as happened in the second half of April.
However, medical personnel continue to face hardships to provide care to patients who come with symptoms of coronavirus, such as the lack of drugs, as Hydroxychloroquine, one of the main drugs that has been supplied to seriously ill patients, has been sold out for a week. .
The drug has not been replaced by any other, "the deficit is not covered, there is not, and it is not applied to the patient, while deaths continue to be registered," medical personnel from that hospital shared with ZETA . In the last week, the municipality of Tecate increased the number of deaths from COVID from 13 to 18.
Such is the precarious condition that this hospital unit keeps both due to lack of medication and specialized medical personnel, that given the critical condition of an ambulance driver from that clinic that was infected, his colleagues chose to send him to the intensive care unit of the General Regional Hospital Number 1 of Tijuana, of which the authorities report a hospital occupation of 65%.
The saturation of that hospital is such that the patient - who also works as a volunteer for the H. Tecate Fire Department - had to wait three days for a bed to be vacated and to be admitted on the night of Monday, May 11.
Regional Number 1 is not the only hospital that faces the lack of sufficient treatment to deal with the pandemic, the General Hospital of Tijuana also faces a lack of medications to care for patients, something that is not new in this hospital, “it is our heel of Achilles ”, noted director Alberto Reyes Escamilla.
In his desperation to adequately care for patients, the doctor has confronted the Health authorities in demanding an adequate supply of supplies, “when they tell me that they do not have the economic resource or that they are not in stock, I comment that the money is also for the people, since it comes from them, ”said the director of the General Hospital.
Despite this reality faced by nosocomios that care for those infected with the pathogen, Secretary Pérez Rico maintains that there are 12 thousand boxes of Hydroxychloroquine and the same amount of Azithromycin, drugs that are supplied to patients in public hospitals. In addition, he assured that there is a sufficient supply of "analgesics, anti-inflammatories, oxygen, that is what we can give to patients and, if there was a specific treatment, that we could give them to help, because we do, but there is none he acknowledged.
RE-ACCOMMODATION OF PERSONNEL TO COVER THE DEFICIT
In one shift, a single nurse from any of the IMSS Tijuana hospitals cares for up to 20 SARS-CoV-2 patients, a work overload that has been registered since the arrival of the first infected to date.
Despite the fact that in mid-April both the authorities of the IMSS and the Ministry of Health said they had open the call for the hiring of doctors and nurses, there has been little new recruited staff.
In the case of the IMSS, the regional delegate Desirée Sagarnaga Durante highlighted the authorization of 600 places, but was unable to determine the number of personnel hired to cover the deficit faced by the Institute's medical units.
In the case of the hospitals of the State Health Sector, Alonso Pérez Rico, commented: “We have more than 260 people hired in the State, more than 80 doctors, an incredible amount for such a short period; We have hired many nurses, more than 150 actively hiring. ”
The secretary added that with the amount of personnel hired, only 20 more nurses will be required in Tijuana, 40 in Mexicali, 10 in Rosarito and 10 in Ensenada.
However, according to the personnel deficit reported by the director of the General Hospital of Tijuana, Alberto Reyes Escamilla, 120 nurses and 60 doctors are missing.
Few have been hired for this hospital, and those who are newly admitted are general practitioners, when "we need intensivists, emergency physicians, internists, pulmonologists, mainly, in addition to stretcher bearers and administration and maintenance personnel."
To cover the lack of personnel, it has been forced to rearrange, assigning COVID spaces to personnel from other areas; I even "asked for help from the military doctors, and nothing," Reyes Escamilla concluded.
Due to lack of COVID suits, authorities suspended operations at funeral homes
From May 1 to date, 157 people have died in Tijuana for COVID-19, with most of the debts having to pay a surcharge in funeral services, as most of the funeral companies did not respect the agreement signed on 4 May with the authority to maintain at a cost of 7 thousand pesos the price of cremations, whether or not they are deceased by coronavirus.
Despite this, after the last operation -of only two carried out during the pandemic- carried out on April 30 in funeral homes, no authority from the three levels of government has carried out a new inspection, despite assuming that these businesses continue to incur irregularities such as overcharging of funeral services and accumulating corpses in their facilities due to the lack of cremation ovens, or of having them, not being able to cope with the cremation of bodies.
Given this, the sole federal delegate Jesús Alejandro Ruíz Uribe justified the inaction of the authorities of Cofepris and Profeco due to the lack of protective equipment for the personnel carrying out the inspection.
"We are going to continue intervening, only we are wearing COVID suits because the boys come in and the bodies are there," he said, in addition to considering the resumption of operations in the week that ends.
The official added that to date, 17 funeral homes have signed the agreement, but not all have respected it, some being forced to collect a premium when users file complaints, but without a new inspection.
BC, far from leaving the Red light; COVID-19 infections increased 72.23% in 14 days
May 18 is the scheduled date for some municipalities in Mexico to resume their social and economic activities based on the traffic light model that is part of the "New Normal", proposed by health authorities of the Federal Government.
However, in Baja California the path becomes uncertain to return to that normality, since in the first 14 days of the current month, the number of coronavirus infections increased by 72.3%.
Out of 160 confirmed cases registered on Tuesday, April 7 - the date the entity entered the first three states with a number of infections - 2,835 patients were reached on Thursday, May 14, increasing by 1,889 cases since Friday, May 1.
In these two weeks, only one day the illusion was given that the figure could go down when on May 2, the state Health Secretariat reported that there were only 10 new cases, however, in the following days, at least on three occasions the figure exceeded 100 infections.
One of those days was May 6, when it was announced that 100 people tested positive; a day later, on May 7, it was 181, the highest until then. By May 9, 121 new infections would be registered, and on Wednesday the 13th there would be the number that would break the record to date: 238 new cases of COVID-19.
The other days the number of positive cases has varied between 37 and 95, without the number retracting to decrease the curve as the Health Secretary, Alonso Pérez Rico, insists on mentioning during the morning videoconferences that he heads next to Governor Jaime Bonilla Valdez.
As for deaths, the number does not decrease either, on the contrary, it has doubled on the first day of May, going from 244 to 487 confirmed as COVID-19.
The justification for the increase in infections by Pérez Rico is due to the fact that there were unprocessed tests by the Mexican Social Security Institute in the entity, which since last week have been analyzed in state laboratories, and therefore the lag the number of positives increased.
Meanwhile, it is intended that by June 1, Baja California will leave the red zone and have a sanitary protocol ready for the resumption of activities, reported the Secretary of Health.
For his part, President Jaime Bonilla expressed that "what could be done was done" regarding the closure of the border between Tijuana and San Diego, a situation that in his opinion is not within his powers as it is a matter of federal character, but accepted that had the closure occurred, the number of infections would have been contained. "They are the characteristics of Tijuana, the good comes with the bad," he would add. Uriel Saucedo Ramírez"
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I was surprised they are actually using hydroxychloroquine.
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Update/edit: 05/18/20
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| Courtesy Salon:Dr. Trump's Medicine Show ! |
~ UPDATE/edit 05/18 : The more I thought about it, the more disturbing I thought it was - particularly giving hydroxychloroquine to the man in the Zeta report who had already survived a heart attack ...but for that matter, giving hydroxychloroquine to any COVID-19 patient. Shocking. Apparently Bolsonaro has been handing this shit out like crazy.
Regarding Trump admitting today that he has been taking hydroxychloroquine for a little over a week as a "preventative" measure against the virus on friends advise Mike said: "He's a liar, you cannot believe anything he says, I doubt he is taking it...and if he really is..." I can't repeat that one. But lookie here...follow the money...
From The Salon: (Over a month ago...)
Dr. Trump's Medicine Show: Why Is He Pushing an Unproved Drug ? Follow the Money
By, Bob Cesca
Kind of makes you wonder how many more government "leaders" around the globe are involved in this scam. Bolsonaro for sure.
end edit.
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~ From MSN/The Washington Post:
Drug Promoted by Trump as Coronavirus 'Game Changer' Incresingly Linked to Deaths
by, Toluse Olarumnipa, Ariana Eunjung cha & Laurice McGinley
"For two months, President Trump repeatedly pitched hydroxychloroquine as a safe and effective treatment for coronavirus, asking would-be patients “What the hell do you have to lose?”
Growing evidence shows that, for many, the answer is their lives.
Clinical trials, academic research and scientific analysis indicate that the danger of the Trump-backed drug is a significantly increased risk of death for certain patients. Evidence showing the effectiveness of hydroxychloroquine in treating covid-19 has been scant. Those two developments pushed the Food and Drug Administration to warn against the use of hydroxychloroquine outside of a hospital setting last month, just weeks after it approved an emergency use authorization for the drug.
Alarmed by a growing cache of data linking the anti-malaria drug to serious cardiac problems, some drug safety experts are now calling for even more forceful action by the government to discourage its use. Several have called for the FDA to revoke its emergency use authorization, given hydroxychloroquine’s documented risks.
“They should say, ‘We know there are harms, and until we know the benefits, let’s hold off,’ ” said Joseph Ross, a professor of medicine and public health at Yale University, who added that the original authorization may have been warranted but new evidence has emerged about the drug’s risks.
“I’m surprised it hasn’t been revoked yet,” said Luciana Borio, who served as director for medical and biodefense preparedness of the National Security Council and was acting chief scientist at the FDA.
Testimony this week from a former top vaccine official removed from his post last month further highlighted allegations that Trump’s White House pressured government scientists to quickly sign off on the untested drug in March, at the same time the president was pitching it as a “game changer.”
Rick Bright, former director of the Biomedical Advanced Research and Development Authority, told Congress on Thursday that political pressure forced “dozens of federal scientists” to spend a harried 48-hour stretch rushing to put together a protocol for approving hydroxychloroquine for widespread use in covid-19 patients. Ultimately, that approach wasn’t taken. The FDA issued an emergency authorization for hospitalized covid-19 patients who cannot participate in a clinical trial.
In his whistleblower complaint, Bright said he was removed from his position in part because of his reluctance to promote the use of chloroquine and hydroxychloroquine, because they had not been tested and deemed safe for treating covid-19.
“It’s important to use available clinical data,” Bright told lawmakers. “And if we know there are potential risks, we need to make sure that we are cognizant of those risks and make sure those drugs are used in a very safe and controlled manner.”
The White House did not respond to requests for comment. Health and Human Services Secretary Alex Azar attacked Bright on Thursday, saying “his allegations do not hold water.”
In a recent interview, FDA Commissioner Stephen Hahn denied that he was pressured to authorize hydroxychloroquine: “I can assure you 100 percent that the president has never pressured me to make a decision regarding any regulatory aspect of the FDA’s work.”
The FDA said in a statement Friday that it is continuing to evaluate its emergency use authorization for chloroquine and hydroxychloroquine, as it does with all such authorizations for drugs to ensure their continued safety.
“In general, the FDA may revise or revoke an EUA under certain circumstances, including information related to linked or suspected adverse events, newly emerging data that may contribute to revision of the FDA’s initial conclusion that a product may be effective against the particular threat or a material change in the risk/benefit assessment based on evolving understanding of the disease or condition,” the statement said.
Trump has continued to promote hydroxychloroquine without reservation while attacking those who question its effectiveness. He has described Bright as a “disgruntled employee” who is resisting the proposed treatment without cause.
“So we have had some great response, in terms of doctors writing letters and people calling on the hydroxychloroquine,” Trump told reporters Thursday. “And this guy is fighting it. There’s no reason to fight it. There’s no reason. But more importantly than that, we’ve had tremendous response to the hydroxy.”
But doctors, health experts and officials from Trump’s own administration say the evidence does not back up the president’s positive assertions. Those assertions, which Trump has claimed are partly based on “a feeling,” could be costing lives, they said.
Yogen Kanthi, assistant professor in the division of cardiovascular medicine at the University of Michigan, said that it has been clear that the combination of hydroxychloroquine and azithromycin — used to treat bacterial infections — could lead to cardiac arrhythmias, which cause the heart to beat irregularly or too fast or slow. Many patients hospitalized for covid-19 had underlying cardiovascular disease that put them at higher risk for arrhythmias, “so it shouldn’t be surprising we saw an increase in death,” he said.
“The question has been answered that if you have the infection and it’s significant enough to be in the hospital, the drug doesn’t seem to do anything for you,” he said. “It may be the horse is out of the barn.”
Many hospitals have stopped using the drug outside of clinical trials.
“We no longer are keeping large quantities and have returned most of it,” said Nishaminy Kasbekar, director of pharmacy for the Penn Presbyterian Medical Center in Philadelphia. “I think they should revoke the EUA because clearly based on the data it is no longer considered a treatment for covid.”
Some doctors, including one in Texas who is also a Republican committeeman, have continued to give the drug to coronavirus patients — with mixed results.
A study of Veterans Affairs patients hospitalized with the coronavirus found no benefit and higher death rates among those taking hydroxychloroquine, researchers said last month.
More than 27 percent of patients treated with hydroxychloroquine died, and 22 percent of those treated with the combination therapy died, compared with an 11.4 percent death rate in those not treated with the drugs, the study said.
The National Institutes of Health announced Thursday that it had begun a clinical trial of 2,000 adults to determine if the combination of hydroxychloroquine and azithromycin — the cocktail touted by Trump — works as a therapeutic for those with coronavirus.
“Although there is anecdotal evidence that hydroxychloroquine and azithromycin may benefit people with COVID-19, we need solid data from a large randomized, controlled clinical trial to determine whether this experimental treatment is safe and can improve clinical outcomes,” Anthony S. Fauci, the nation’s top infectious disease expert, said in a statement.
While Fauci has cautioned against drawing broad conclusions from anecdotal evidence, Trump’s promotion of the drug has been almost exclusively based on personal stories he has heard — often on cable news. He has largely ignored scientific studies to pitch the drug without caveat.
In a tweet shared 102,800 times and liked 384,800 times on March 21 Trump claimed that “HYDROXYCHLOROQUINE AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine.”
He invited several recovered coronavirus patients to the White House last month, including some who said hydroxychloroquine saved their lives.
From mid-March through early April, Trump touted the drug as a potential panacea while downplaying any potential risks.
“The nice part is it’s been around for a long time, so we know that if things don’t go as planned, it’s not going to kill anybody,” he told reporters on March 19.
The president’s associates, including Fox host Laura Ingraham and his personal attorney, Rudolph W. Giuliani, have also pushed the drug as a treatment for covid-19 in private Oval Office meetings and phone calls.
Some Republican lawmakers have continued to promote hydroxychloroquine while attempting to defend Trump’s handling of the coronavirus pandemic, which has killed more than 86,000 Americans.
“When you’re the physician at the bedside, and there is a medication that has promise, and that has a safety profile that we understand — doctors will use this medication offline,” Rep. Larry Bucshon (R-Ind.) told Bright during Thursday’s hearing. “That’s what’s happening. Whether that’s right or wrong, it might take us years to prove, but in the meantime, people can die.”
The Trump administration deployed tens of millions of doses of the drug from the Strategic National Stockpile as the president promoted the FDA’s emergency use authorization. His repeated statements that the drug had been fully “approved” by the FDA in record time added to the false sense that hydroxychloroquine had been vetted and declared safe for use, experts said.
While the FDA didn’t intend for the authorization to signal an endorsement, many physicians and patients interpreted it that way, especially with “political figures saying the FDA had approved the drug,” said Jesse Goodman, former chief scientist at the FDA and now a Georgetown University professor.
“There’s a misperception out there that the EUA means that the FDA has approved the drug,” said Aaron S. Kesselheim, a professor of medicine at Harvard Medical School. “That’s wrong, of course, but it’s a widespread misconception driven by irresponsible statements from certain politicians and members of the media.”
Goodman and Kesselheim are among a growing number of medical experts calling for the FDA to revoke its emergency use authorization for hydroxychloroquine in light of new evidence about its risks.
While an emergency use authorization is not a full-fledged approval by the FDA, it allows unapproved drugs and devices to be used during a public health emergency. The standard for an emergency authorization is that the agency “determines that the known and potential benefits of the medical products for their intended uses outweigh their known and potential risks,” according to the agency.
Mark McClellan, who was FDA commissioner during President George W. Bush’s administration, said he disagreed with calls to revoke the authorization. He called for it to be strengthened with additional warnings about side effects for those with heart disease, adding that removing the emergency authorization could create access issues for people who need the drug for ailments other than covid-19.
In weeks before the Veteran’s Administration study was released in late April, there was a steady stream of warnings from different physician groups about the potentially deadly side effects of hydroxychloroquine. On Apr. 8, the United States’ three cardiology medical groups urged “caution” in using the combination. On Apr. 21, a National Institutes of Health panel recommended against using hydroxychloroquine with azithromycin due to potential toxic effects.
While hydroxychloroquine is approved by the FDA to treat malaria, rheumatoid arthritis and lupus, some medical groups have long voiced concern that using it for coronavirus patients was particularly risky.
Several studies have been published since then that support those initial findings. Doctors in Brazil stopped a trial of chloroquine, closely related to hydroxychloroquine, after 11 patients died. They reported in JAMA Open Network on April 24 that in 81 patients, those who took high doses of the drug had a 3.6-fold higher death rate as compared to a lower dose group.
Brazil’s top health official resigned Friday following reported disagreements with President Jair Bolsonaro over the efficacy of the anti-malarial drug in curbing the rapid rise of coronavirus in Latin America’s largest country.
The departure of the oncologist Nelson Teich, who resigned less than one month after becoming health minister, came as Bolsonaro has followed Trump’s lead in wagering heavily on the drug. He has ordered its mass production despite serious questions over its side effects and its effectiveness in a country that now has the worst outbreak in the Southern Hemisphere.
Many public health officials have called for Trump to defer to his medical experts, a push that intensified last month after the president pondered aloud whether light or disinfectant could be used internally to kill the coronavirus.
“Data-free advocacy for projects rarely turns out well,” said Peter Lurie, a former top FDA official and president of Center for Science in the Public Interest who has criticized the promotion of hydroxychloroquine by politicians. “This was a product that never had a solid basis for believing it worked, and the data that has since emerged are not encouraging. The best thing to do is to leave drug review to the experts. That goes for hydroxychloroquine, it goes for bleach and it goes for ultraviolet light as well.”
Terrence McCoy contributed to this report.
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P.S. All of my sources are indeedy doo "ethical". Take Care y'all.
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