July 4, 2020

As coronavirus rebounds, more patients are being hospitalized and capacity is stretched


Florida sets a record-high 10,000 new cases - but deaths are still not rising in the South


U.S. Coronavirus Cases Are Rising Sharply, and Deaths Are Slowly Rising.

WASHINGTON POST
Patients suffering from covid-19 are rapidly filling hospitals across the South and West, with Mississippi, Tennessee, Texas, Nevada and Arizona setting records for hospitalizations Thursday, a sign that the coronavirus pandemic is entering a dangerous new phase.
The coronavirus continued its recent surge across swaths of the United States, with more than 55,000 new cases reported Thursday, eclipsing the record for the largest single-day total that was set Wednesday. Reports of new cases have increased 90 percent in the United States in the last two weeks
Medical workers at United Memorial Medical Center in Houston on Thursday transporting a patient from the Covid-19 intensive care unit.
Deaths, which had declined steadily for several months, also are rising. States reported that 700 people died Thursday of covid-19 — an increase of more than 25 percent compared to the previous seven-day average.

“There’s a lag between confirmed case and hospitalization, and between hospitalization and death. So you look at the numbers and you can see how hospital capacity could quickly become strained in coming weeks,” said Saskia Popescu, an epidemiologist at the University of Arizona.
As hospitals have become overwhelmed, deaths have risen — not just among covid-19 patients who get insufficient care, but among those facing other medical crises who don’t seek care from an overwhelmed system because they think they won’t receive it.

The Centers for Disease Control and Prevention estimated that since Feb. 1, about 20,000 to 49,000 more people have died of all non-covid-19 causes than would have been expected.  In Arizona, if hospitalizations push past capacity, patients will be given a score based on life expectancy and underlying conditions.

In Arizona, where the virus appears to be spreading out of control, hospitals rushed to expand capacity and adopted practices similar to those employed at the height of the outbreak in New York City and Italy, including doubling up hospital beds in rooms, pausing elective surgeries and bringing in health-care workers from other states.

Perhaps most chillingly, at the urging of doctors and advisers, state officials this week activated “crisis standards of care” protocols, which determine for hospitals which patients get ventilators and care as the system becomes overwhelmed under the crush of patients.

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A stronger than expected jobs report indicated the June unemployment rate went down to 11.1 percent, from a high of 14.7 percent at the height of the coronavirus shutdowns in April. Whether the unemployment rate continues to decrease is uncertain as numerous states are moving to slow the reopening of their economies or shut down bars and other businesses in a desperate attempt to bring the outbreak under control. Also new data released by the Labor Department showed that 1.4 million people filed unemployment claims for the first time last week, marking the 15th straight week of claims that exceeded 1 million.
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Director of the National Institute of Allergy and Infectious Diseases Dr. Anthony Fauci speaks during a Senate Health, Education, Labor and Pensions Committee hearing on Capitol Hill in Washington, Tuesday, June 30, 2020.
Dr. Anthony Fauci, said during a YouTube live stream. that while some countries in Europe locked down around 97 percent of activity to control the virus, even the strictest U.S. restrictions only shut down about 50 percent.
“That allowed the perpetuation of the outbreak that we never did get under very good control,” he said. The United States has been hit worse than any other country in terms of case numbers and deaths, he noted.
Diners at a restaurant in Scottsdale, Ariz., this week. The state, which reopened quickly and widely, has sent mixed messages on everything from the use of masks to enforcement of social distancing rules.

Diners at a restaurant in Scottsdale, Ariz., this week. The state, which reopened quickly and widely, has sent mixed messages on everything from the use of masks to enforcement of social distancing rules. Credit...Adriana Zehbrauskas for The New York Times
In few places is that more evident than in Arizona, where bars were packed before some restrictions went back into effect and where Trump held a crowded indoor political rally last week where very few people wore protective masks. Until recent days, cities and counties were forbidden from passing local ordinances requiring masksAfter insisting for weeks that hospitals had adequate capacity, Arizona Gov. Doug Ducey (R) said for the first time last week that hospitals could reach surge capacity “very soon.”
Banner Health — the largest health-care delivery system in Arizona, with 17 hospitals across the state — said Thursday it is exploring “all options” to increase beds, including repurposing pediatric beds and using spaces in their hospitals not usually used for care.
Other hospital systems said they are enacting similar surge plans. And state leaders are now preparing to reopen a shuttered Phoenix hospital — St. Luke’s Medical Center — as a field hospital.
Health professionals administering a coronavirus test at a  Guarani tribal camp in Brazil on Thursday.
Brazil tops 1.5 million total infections, just two weeks after reaching a million.
Brazil, which has more coronavirus cases than any country but the United States,  topped 1.5 million total infections on Friday,  just two weeks after reaching a million cases, according to a New York Times database.
But even as the country passed that grim milestone, President Jair Bolsonaro vetoed a measure that would have provided masks to vulnerable groups and required businesses to provide masks to their employees, according to The Associated Press.
Since mid-June, some major cities in Brazil have eased preventive measures. Shopping malls have already reopened in São Paulo and Rio de Janeiro. Beaches are starting to draw crowds again. And Rio allowed gyms and bars to reopen at 50 percent capacity on Thursday, while some hospital systems were close to running out of intensive care beds.