Nevada Orders Closure of Health Food Stores, While Liquor Stores Remain Open


You can’t make this stuff up. Nevada governor says health food stores are not essential, but liquor stores are.

It may sound like something out of the Twilight Zone, but it’s real:

The Governor of Nevada has ordered small health food stores (excluding Amazon-owned Whole Foods) to close, calling them “non-essential businesses,” according to a press release by the Natural Products Association.

Meanwhile, liquor stores are still up and running. No joke.

“Governor Sisolak’s decision is shortsighted and inconsistent with the federal government and other states and amounts to an assault on small businesses,” writes CEO of the NPA Daniel Fabricant.

“Amidst the recent COVID-19 outbreak, we’ve seen firsthand the importance of supporting a healthy immune system. Proper nutrition is a cornerstone of a ‘health-first’ strategy and essential vitamins and minerals, like Vitamin C, are highly efficient ways to support your daily health and wellness…Don’t let Governor Sisolak and his accomplices take away health choices away from your family.”

A health food store called Stay Healthy of Las Vegas shared on its website that the store was forced to close as of April 7.

Due to a Mandate issued by Governor Sisolak we are considered NON-Essential, contrary to Federal Guidelines, and had to temporarily CLOSE our doors. We need your help! Please call Governor Sisolak at (775) 684-5670 or to State of Nevada Homepage to at least allow Curbside Pick Up for us.”

Please click here to sign the Natural Products Association’s petition to the governor to let these essential businesses open back up.

The post Nevada Orders Closure of Health Food Stores, While Liquor Stores Remain Open appeared first on Return to Now.

This content was originally published here.

No, The Health Department Did Not Say To Microwave Face Masks To Sterilize Them

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Y’all…please do not microwave your face masks. I guess somewhere on the internet there was a post telling people to do this. No. Do not do this!

There are people that are showing images of their burnt masks because they followed this advice that someone gave on the internet.

Health Departments are speaking up and asking you to not do this.

Fabric/home made masks are to be marked as to which side you will wear as inside to be consistent. These masks are to be…

Posted by

You wash your face mask. If you microwave it you will burn it. You could even catch your house on fire!

DO NOT TRY TO STERILIZE FABRIC MASK IN THE MICROWAVE as directed on facebook. This is what happened to mine this morning.This was at 2 minutes in an unsealed Ziploc bag.

Posted by

You can wash your face masks in your clothes washing machine. Mine has a sanitizing setting, so that is what I would use. But even if you don’t have that setting you can still do a hot water wash with laundry soap.

People are saying you can sterilize a face mask by placing it in a plastic baggy and microwaving it for 2 to 3 minutes. NO!

Do not put your face mask in the microwave to sanitize it , my house stinks bad ! My favorite mask to . Bummer

Posted by

Thankfully, those that tried it are speaking up so that others do not make the same mistake. Masks are hard to get, even if you are making your own, you don’t want to ruin it.

Do Not put cloth face mask in microwave!! This is mine on 1 1/2 minutes!!!!!

Posted by

I did a very quick search and came across many posts with the same results. Burnt, ruined face masks.

Don’t microwave the mask

Posted by

So do yourself a favor and skip the microwave. Just wash them in the washing machine or you can even hand wash them if needed. Give them a good soak and scrub, rinse and hang them to dry.

This content was originally published here.

Concerts Won’t Return Until “Fall 2021 at the Earliest,” Health Expert Warns | Consequence of Sound

Large-scale gatherings such as conferences, sport events, and live concerts won’t be safe to attend until “fall 2021 at the earliest,” according to Zeke Emmanuel, director of the Healthcare Transformation Institute at the University of Pennsylvania.

Emmanuel was part of an expert panel assembled by the New York Times on life after the COVID-19 pandemic. The problem, according to Emmanuel, is “You can’t just flip a switch and open the whole of society up. It’s just not going to work. It’s too much. The virus will definitely flare back to the worst levels.”

As he sees it, “restarting the economy has to be done in stages,” and crowded events will be the last part of our old lives to return. He said,

“It does have to start with more physical distancing at a work site that allows people who are at lower risk to come back. Certain kinds of construction, or manufacturing or offices, in which you can maintain six-foot distances are more reasonable to start sooner. Larger gatherings — conferences, concerts, sporting events — when people say they’re going to reschedule this conference or graduation event for October 2020, I have no idea how they think that’s a plausible possibility. I think those things will be the last to return. Realistically we’re talking fall 2021 at the earliest.”

So why do we have to wait until the second half of 2021? That has to do with the development timeline of the coronavirus vaccine. And Emmanuel isn’t alone in thinking a vaccine will take 12-18 months — in fact, that seems to be the expert consensus.

Larry Brilliant, the epidemiologist who led the effort to eradicate smallpox, told The Economist, “I think we will have a vaccine that works in less than a couple of months.” Unfortunately, that’s the easy part. “Then it will be the arduous process of making sure that it is effective enough and that it is not harmful. And then we have to produce it. [America’s Director National Institute of Allergy and Infectious Diseases] Tony Fauci’s estimate of 12 to 18 months before we have a vaccine, in sufficient quantities in place, is one that I agree with.”

But Brilliant, who also consulted on the 2011 Steven Soderbergh film Contagion, sounds even more pessimistic than Emmanuel. He thinks the COVID-19 virus will still be a problem — at least for a while — after the development of a vaccine.

“I just want to mention, once we have that vaccine, and we’ve mass vaccinated as many people as we could, there will still be outbreaks. People are not adding on to the backend of that time period the fact that we will then be chasing outbreaks, ping-pong-ing back and forth between countries. We will need to have the equivalent of the polio-eradication program or the smallpox-eradication program, hopefully at the WHO. And that mop-up—I hate to use that word when we’re talking about human beings—but that follow-on effort will take an additional period of time before we are truly safe.”

In other words, the re-opening of society will be slower and more painful than some are anticipating.

For now musicians have adapted with quarantine videos and isolation livestreams, as when Willie Nelson announced a digital Farm Aid with Neil Young, Dave Matthews, and more over the weekend. For a full list of upcoming concerts and livestreams, click here. But that’s not going to replace the lost revenue stream for middle-class and rising artists. If you want to help musicians impacted by the novel coronavirus, or are yourself a musician looking for help, check out our pandemic resource guide.

This content was originally published here.

Mertz Family Dentistry

Prominent Longmont family dentistry relocates and updates facilities

Everyone knows those semi-annual trips to the dentist are crucial to preserving and perfecting your smile…but something to smile about? If you’re one of the many loyal patients with Mertz Family Dentistry, it’s not out of the question that you may actually look forward to your dental visits. That sort of anticipation tends to happen when those whose services you consult provide ongoing attentive care; they become practically family. What’s more, the team at Mertz Family Dentistry are truly invested in making your experience as enjoyable as possible. This goal has just gotten all the easier to accomplish, thanks to a new, brighter, airier, more spacious setting; one which they plan to show off at an upcoming Open House from 4 – 7 p.m. on June 15.

Formerly located on Terry Street, Mertz Family Dentistry recently made the move to 1325 Dry Creek Drive, Suite 304. The new, modern facility offers twice as much space, allowing the team to optimize their capacity to provide superior care to an expanded number of patients. It offers a few new perks in comfort, too, featuring heated massage chairs with patient-operated remotes and sunlit rooms that lend a spa-like feel not typically associated with the dentist’s chair. “Our previous location was a great facility from which to provide excellent dental care in the past,” Dr. Peter Mertz says. “But looking into the future, we couldn’t be more excited about the new location and its capacity to further service our community well into the next decades. I wanted to create a facility that gave us a platform to provide the best in dental care while utilizing the latest, most up-to-date, technology. It’s a very modern, bright, relaxing setting. It’s inviting.”

Founded in 1985 by Dr. Guy Mertz, Mertz Family Dentistry is family-focused and family-rooted. In 2000, Dr. Peter Mertz joined his uncle in the mission to provide the best, most comprehensive and technologically advanced dental health care possible. Dr. Brett Nelson, who is now approaching his one-year anniversary with the practice since joining the team, says the close-knit staff of 16 is like family. “The long-term staff really distinguishes this amazing practice,” says Dr. Guy Mertz.

High-tech and high-service meet at the new Mertz Family Dentistry location to provide patients with an overall pleasant experience.

“Everyone is very dedicated. We have several employees who have been here 20, 30 years.”

Dr. Peter Mertz, who now owns the practice, has been selected as a top dentist for more than a decade consecutively, recently receiving that designation for the 11th time this year. He has advanced implant, sedation, CEREC single-visit crowns, and the most up-to-date Solea® laser systems training available.

Dr. Guy Mertz began his esteemed career 33 years ago with the opening of his practice, and is dedicated to the Longmont community. He has extensive training in laser dentistry systems. Dr. Guy Mertz was also selected as a top dentist by 5280 Magazine for the past two years.

A second-generation dentist originally from Indiana, Dr. Brett Nelson is a member of the American Academy of Cosmetic Dentistry, American Association of Endodontists, Academy of General Dentistry, American Academy of Implant Dentistry, and is a certified Invisalign provider. He is further certified in sedation dentistry. Dr. Nelson takes great care to practice what he refers to as ‘golden rule’ dentistry. “I treat all patients exactly as I would treat my closest friends and family members,” he says.

Prioritizing a personalized approach, doctors and staff at Mertz Family Dentistry take time to genuinely listen and understand the needs of each patient. And, the team does all they can to ensure they are equipped to meet those needs. They are highly skilled in pediatric dental care, and sensitive to the importance and personal means of helping children develop a positive relationship with healthy dental hygiene.

Throughout all ages and stages of life, Mertz Family Dentistry is invested in the wellbeing of its patients. “We’ve watched children grow up, go to college, and start their own families,” says Dr. Guy Mertz. “We have a great staff. We all enjoy each other, and we love our patients.” Dr. Peter Mertz attributes the notable, steady increase in patients the practice serves in great part to the warmth and dedication of his team. “We believe our staff is a big reason that our patients want to come back,” he says. “They each bring a high level of caring to their work.”

Bright new spaces have a spa-like feel, emphasizing relaxation and comfort for patients.

Alongside caring and understanding, Mertz Family Dentistry offers exceptional expertise. The wide range of services goes well beyond standard offerings, including sedation dentistry, Invisalign, and Laser Dentistry. Mertz’ cosmetic dentistry includes teeth whitening, porcelain veneers and crowns. Botox and Juvederm treatments are also performed on site. What’s more, all procedures are provided as comfortably as possible.

Mertz Family Dentistry has always been committed to investing in state-of-the-art, best practice technologies that provide the ultimate in dental care for patients. In fact, Dr. Peter Mertz is one of only a very few general dentists in the area to use a surgical microscope during dental procedures. “You can’t treat what you can’t see,” Dr. Peter Mertz says, stressing the significance of this technology. “The surgical microscope ensures the greatest accuracy possible.”

At Mertz Family Dentistry, three-dimensional X-rays provide the most thorough, comprehensive information for complex dental procedures. Such technologies further increase efficiency and ease for patients. “Utilizing our three-dimensional x-ray and scanner, we can have a guide fabricated for implants before the patient is even here, allowing for minimally invasive procedures,” Dr. Nelson says, explaining a few of the many benefits.

Mertz Family Dentistry was the first in Longmont to offer a special technology, which debuted 15 years ago- an advanced system that can create a crown or set of veneers in just a matter of hours. Each step is completed right in the office for same day fittings. Mertz Family Dentistry uses a detailed camera to map and measure the contours of the tooth. The remaining specifications are added into a chair-side computer, and the new piece is milled to tight specifications, increasing capability to closely match the new surface to surrounding teeth.

Skilled, caring professionals, cutting-edge technology, and a wide range of services offered-what more could one hope for in a dental office? How about painless visits? At Mertz Family Dentistry, the use of in-office lasers allows for anesthesia-free fillings, as well as other procedures to be completed without the use of shots. For all patients, and the youngest in particular, this is significantly reassuring.

Why not check out Mertz Family Dentistry for yourself? Stop by the new office at 1325 Dry Creek Drive on Friday, June 15, from 4- 7 p.m. Enjoy hors d’oeuvres, wine, and the opportunity to visit with staff and tour the office. “We would love to extend an invitation to our whole community to join us, see the new space, and celebrate our grand opening with us,” Dr. Peter Mertz invites. “Come on by.”

This content was originally published here.

About half of France’s coronavirus patients in intensive care are under 65, health official says

A French health official says warnings to stay home in the coronavirus pandemic are in some cases falling on deaf ears while noting that the virus hasn’t just been posing a risk to seniors.

French health ministry official Jérôme Salomon said Monday that the situation is “deteriorating very quickly” while providing this statistic: of the between 300 and 400 coronavirus patients in intensive care in France, about half of them are younger than 65, The New York Times reports.

Salomon is looking to “dispel the notion that the virus seriously threatens only the elderly,” the Times reports, and Mother Jones observes that even though the novel coronavirus is “understood to be particularly lethal among the elderly,” these numbers “underscore the reality that younger generations can still face serious consequences.”

Salomon also said Monday that in France, “a lot of people have not understood that they need to stay at home,” and as a result, “we are not succeeding in curbing the outbreak of the epidemic,” per Reuters. Most nonessential businesses in France were ordered to be closed over the weekend.

France has confirmed more than 5,400 cases of the novel coronavirus, and by Sunday, the number of deaths had risen to 127. Salomon said Monday the number of cases has been doubling “every three days.” Brendan Morrow

NBCUniversal announced Monday it will make Universal Pictures films that are playing in theaters right now, including The Invisible Man and The Hunt, available to rent at home for $19.99 beginning this Friday, per The Hollywood Reporter. The rental period will last 48 hours. This is a game-changer for theatrical moviegoing, as major studio films typically play in theaters exclusively for about three months before being made available for home viewing. The Hunt hit theaters just three days ago.

Universal’s new policy will also apply to at least one upcoming movie: Trolls World Tour, which is set to be made available digitally on the same day it’s released in theaters — at least, the theaters that are still open. The policy isn’t expected to apply to all of Universal’s upcoming movies, the Reporter says.

“We hope and believe that people will still go to the movies in theaters where available, but we understand that for people in different areas of the world that is increasingly becoming less possible,” NBCUniversal CEO Jeff Shell said.

Is Sen. Mitt Romney (R-Utah) ready to join the Yang Gang?

Romney is out with a proposal that should make entrepreneur and former 2020 Democratic candidate Andrew Yang proud, on Monday saying every American adult should receive a check for $1,000 amid the COVID-19 coronavirus pandemic.

This step, Romney said, will “help ensure families and workers can meet their short-term obligations and increase spending in the economy.” Romney added that “expansions of paid leave, unemployment insurance, and SNAP benefits” are also “crucial,” but the $1,000 check “will help fill the gaps for Americans that may not quickly navigate different government options.”

The Utah senator offered numerous other proposals for responding to the coronavirus crisis, including providing grants to small businesses impacted by the pandemic and deferring student loan payments “for a period of time to ease the burden for those who are just graduating now, in an economy suffering because of the COVID-19 outbreak.”

Yang’s central proposal during his 2020 campaign was to provide Americans with a universal basic income of $1,000 a month, an idea that some Democrats have been re-upping in the midst of the coronavirus crisis. Like Romney, Sen. Sherrod Brown (D-Ohio) is also backing the $1,000 payment idea, saying a check in that amount should go to all middle class and low-income adults because “we can’t leave the hardest-hit Americans behind.”

Romney’s proposal is for a one-time check and not a monthly payment as Democrats like Yang have called for. But Rep. Alexandria Ocasio-Cortez (D-N.Y.) tweeted Monday, “GOP & Democrats are both coming to the same conclusion: Universal Basic Income is going to have to play a role in helping Americans weather this crisis.”

This content was originally published here.

Sedation Dentistry Options For Children

Children can often be apprehensive about dental treatment, but keeping oral health in good condition is important, especially at a young age. In certain situations, your dentist might recommend using a type of sedation during your child’s treatment. This can be a worrying concept, but the right information will help to put your mind at rest.

Types of Sedation

There are several levels of sedation your dentist may choose to use depending on your child and the procedure to be undertaken.

Nitrous oxide, commonly known as laughing gas, is the lowest level of sedation. It is blended with oxygen and administered through a small breathing mask. It is non-invasive, and once your child stops breathing nitrous oxide then the drug will quickly leave their system, and they will return to normal. Nitrous oxide won’t put your child to sleep, but it will help them to relax.

Mild sedation is usually induced using orally administered drugs. Your child will remain awake and usually be able to respond normally to verbal communication, but their movement and coordination may be affected. Respiratory and cardiovascular reflexes and functions are not affected at all, so there is no need for any additional monitoring equipment or oxygen.

Moderate sedation will make your child drowsy, and although they will usually respond to verbal communication they may not be able to speak coherently. They are likely to remain a little sleepy after the procedure, and most children cannot remember all or any of the procedure. This type of sedation can be reversed easily and breathing and cardiovascular function are generally unaffected.

Deep sedation is induced using intravenous drugs and will mean that your child is fully asleep. They may move a little and make sounds in response to repeated stimulation or any pain, but they will be in a deep sleep. Recovery from this type of sedation takes a little longer, and it is highly unlikely that your child will remember anything that happened. Sometimes respiratory or cardiovascular function can be impaired using these types of drugs, so there will be an extra qualified person present to monitor your child throughout the procedure.

The deepest option is a general anaesthetic, also induced using intravenous drugs. During a general anaesthetic, your child will be completely asleep and unable to respond to any stimulation, including pain. Your child will not remember any of the procedure, and should remain drowsy for some time afterwards. During this type of sedation, your child would be monitored by an anaesthetist who is trained in taking care of people under general anaesthetic. Recovery time is a little longer after a general anaesthetic than the other sedation types, and your child may need assistance with breathing during the procedure.

When Is Sedation Required?

There are a few reasons why sedation might be necessary for your child during a dental procedure. First of all, the procedure may be painful, so sedation would be appropriate to avoid unnecessary discomfort. Depending on the type and length of the procedure required, any of the above types of sedation might be appropriate.

If your child is at all anxious about visiting the dentist, it is important to make their experience as smooth as possible to avoid worsening the problem. The level of sedation required will depend on the level of anxiety and the procedure. For mild anxiety, nitrous oxide or mild sedation would help your child relax. If your child is very young, then a higher level might be appropriate to prevent them from moving during the procedure. In more extreme cases of anxiety or phobia, higher sedation levels may be required.

Sedation is sometimes required for children with behavioural disorders or other special needs. It can be difficult, or impossible, to explain to these children why dental care is required. The whole experience can therefore be very frightening for them, so an appropriate level of sedation may be used to help them remain calm and still for the procedure.

Concerns and Contraindications

Sedation has been used in dentistry for a long time, and the drugs and methods used are constantly reviewed. Anyone recommending or administering sedation is specially trained to do so safely, and during deep sedation and general anaesthetic your child is monitored by a trained professional in the room solely for that purpose.

Sometimes sedation can result in side effects such as nausea, vomiting, prolonged drowsiness, and imbalance. These effects usually wear off by themselves. After a deep sedation or general anaesthetic your child should be closely supervised to prevent falling, choking if they vomit, or airway obstruction.

Sedation of children for dental procedures is a common and safe practice. It may be worrying when your dentist first suggests it, but it is important not to increase your child’s anxiety so that they can maintain excellent dental care throughout their lives.

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Children’s Health
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This content was originally published here.

Sen. Joe Manchin erupts into shouting match with McConnell: You’re ‘more concerned about the health of Wall Street’ – Alternet.org

Sen. Joe Manchin erupts into shouting match with McConnell: You’re ‘more concerned about the health of Wall Street’

by David Edwards

Sen. Joe Manchin (D-WV) called out Senate Majority Leader Mitch McConnell (R-KY) on Monday for being more concerned with propping up the economy than providing supplies to hospitals fighting the novel coronavirus.

“You can throw all the money at Wall Street you want to,” Manchin said after McConnell blamed Democrats for a stalled stimulus bill. “People are afraid to leave their homes. They’re afraid of the health care. I’ve got workers who don’t have masks. I’ve got health care workers who don’t have gowns.”

“And it looks like we’re worried more about the economy than we are the health care and the wellbeing of the people of America,” the West Virginia senator complained.

McConnell interrupted: “The American people are waiting for us to act today! We don’t have time for this! We don’t have time for it!”

“Let me ask you a question,” Manchin implored.

“Answer my question!” McConnell demanded. “In what way would the Democratic Party be disadvantaged?”

“Thirty hours [of debate] or 30 days, as long as you have the votes, 51 votes rule,” Manchin said. “So the final vote is going to be on passage, whether you have to negotiate or not with us.”

“Here’s the way it works!” McConnell exclaimed. “We have been fiddling around as the senator from Maine pointed out for 24 hours…”

At that point, Manchin reclaimed his time, silencing McConnell.

“We just have a little different opinion about this,” Manchin said. “You can’t throw enough money to fix this if you can’t fix the health care.”

“My health care workers need to be protected,” he added. “But it seems like we’re talking about everything else about the economy versus the health care. That doesn’t make any sense to me whatsoever.”

“It seems like we’re more concerned about the health care of Wall Street,” Manchin remarked. “That’s the problem that I’ve had on this.”

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In just 24 hours, 1,000 retired health care workers volunteered to help fight coronavirus in New York City – CBS News

In just 24 hours, 1,000 retired health care workers in New York City volunteered to join the fight against coronavirus, Mayor Bill de Blasio said in an interview with WCBS 880 on Wednesday. The mayor likened their bold decision to his parents’ generation entering war.

“This is going to be like a war effort. Most New Yorkers haven’t experienced what this city and this country is like in a full-scale war,” de Blasio said. “My parents both served in the war effort in WWII. I heard these stories from the youngest years of my life.”

“When the entire community, the entire city, the entire nation are in common cause, it’s a different reality and everyone is going to have to work together to overcome this crisis, and we’re going to use every tool, every building, every resource to get us through this,” the mayor said.

He added that he asked earlier this week for retired health care workers to return to work, and he had good news: “In the last 24 hours, 1,000 New Yorkers who are retired medical personnel have volunteered to join the effort to fight coronavirus. I think that’s so inspiring. So many people are coming forward to help and that’s how we’re going to beat this back.”

Last week, other elected officials called on “former” health care workers to rejoin the workforce, including Colorado Governor Jared Polis and New York Governor Andrew Cuomo.

According to Polis, former health care workers include anyone retired or working in another field whose medical license is still active or can be reactivated.

Health care workers have been struggling to balance providing care with the fear of exposing their families to the illness. Some say they do not have the protective equipment they need.

“We are two weeks or three weeks away from running out of the supplies that we need most for our hospitals,” de Blasio said Thursday, according to The Associated Press

Lack of hospital beds has also been a concern — especially in New York City. In his interview with WCBS 880, de Blasio said the city is looking to convert large spaces like hotels into health care facilities or logistics staging. On Wednesday, Cuomo said President Trump agreed to send a Navy ship to New York City that will function as a hospital. 

This content was originally published here.

Simple math offers alarming answers about Covid-19, health care – STAT

Much of the current discourse on — and dismissal of — the Covid-19 outbreak focuses on comparisons of the total case load and total deaths with those caused by seasonal influenza. But these comparisons can be deceiving, especially in the early stages of an exponential curve as a novel virus tears through an immunologically naïve population.

Perhaps more important is the disproportionate number of severe Covid-19 cases, many requiring hospitalization or weekslong ICU stays. What does an avalanche of uncharacteristically severe respiratory viral illness cases mean for our health care system? How much excess capacity currently exists, and how quickly could Covid-19 cases saturate and overwhelm the number of available hospital beds, face masks, and other resources?

This threat to the health care system as a whole poses the greatest challenge.

As of March 8, about 500 cases of Covid-19 had been diagnosed in the U.S. Given the substantial underdiagnosis at present due to limitations in testing for the coronavirus, let’s say there are 2,000 current cases, a conservative starting bet.

We can expect a doubling of cases every six days, according to several epidemiological studies. Confirmed cases may appear to rise faster (or slower) in the short term as diagnostic capabilities are ramped up (or not), but this is how fast we can expect actual new cases to rise in the absence of substantial mitigation measures.

That means we are looking at about 1 million U.S. cases by the end of April; 2 million by May 7; 4 million by May 13; and so on.

As the health care system becomes saturated with cases, it will become increasingly difficult to detect, track, and contain new transmission chains. In the absence of extreme interventions like those implemented in China, this trend likely won’t slow significantly until hitting at least 1% of the population, or about 3.3 million Americans.

What does a case load of this size mean for health care system? That’s a big question, but just two facets — hospital beds and masks — can gauge how Covid-19 will affect resources.

The U.S. has about 2.8 hospital beds per 1,000 people (South Korea and Japan, two countries that have seemingly thwarted the exponential case growth trajectory, have more than 12 hospital beds per 1,000 people; even China has 4.3 per 1,000). With a population of 330 million, this is about 1 million hospital beds. At any given time, about 68% of them are occupied. That leaves about 300,000 beds available nationwide.

The majority of people with Covid-19 can be managed at home. But among 44,000 cases in China, about 15% required hospitalization and 5% ended up in critical care. In Italy, the statistics so far are even more dismal: More than half of infected individuals require hospitalization and about 10% need treatment in the ICU.

For this exercise, I’m conservatively assuming that only 10% of cases warrant hospitalization, in part because the U.S. population is younger than Italy’s, and has lower rates of smoking — which may compromise lung health and contribute to poorer prognosis — than both Italy and China. Yet the U.S. also has high rates of chronic conditions like cardiovascular disease and diabetes, which are also associated with the severity of Covid-19.

At a 10% hospitalization rate, all hospital beds in the U.S. will be filled by about May 10. And with many patients requiring weeks of care, turnover will slow to a crawl as beds fill with Covid-19 patients.

If I’m wrong by a factor of two regarding the fraction of severe cases, that only changes the timeline of bed saturation by six days (one doubling time) in either direction. If 20% of cases require hospitalization, we run out of beds by about May 4. If only 5% of cases require it, we can make it until about May 16, and a 2.5% rate gets us to May 22.

But this presumes there is no uptick in demand for beds from non-Covid-19 causes, a dubious presumption. As the health care system becomes increasingly burdened and prescription medication shortages kick in, people with chronic conditions that are normally well-managed may find themselves slipping into states of medical distress requiring hospitalization and even intensive care. For the sake of this exercise, though, let’s assume that all other causes of hospitalization remain constant.

Let me now turn to masks. The U.S. has a national stockpile of 12 million N95 masks and 30 million surgical masks for a health care workforce of about 18 million. As Covid-19 cases saturate nearly every state and county, virtually all health care workers will be expected to wear masks. If only 6 million of them are working on any given day (certainly an underestimate) they would burn through the national N95 stockpile in two days if each worker only got one mask per day, which is neither sanitary nor pragmatic.

It’s unlikely we’d be able to ramp up domestic production or importation of new masks to keep pace with this level of demand, especially since most countries will be simultaneously experiencing the same crises and shortages.

Shortages of these two resources — beds and masks — don’t stand in isolation but compound each other’s severity. Even with full personal protective equipment, health care workers are becoming infected while treating patients with Covid-19. As masks become a scarce resource, doctors and nurses will start dropping from the workforce for weeks at a time, leading to profound staffing shortages that further compound the challenges.

The same analysis applied to thousands of medical devices, supplies, and services — from complex equipment like ventilators or extracorporeal membrane oxygenation devices to hospital staples like saline drip bags — shows how these limitations compound one another while reducing the number of options available to clinicians.

Importantly — and I cannot stress this enough — even if some of the core assumptions I’m making, like the fraction of severe cases or the number of current cases, are off even by several-fold, it changes the overall timeline only by days or weeks.

Unwarranted panic does no one any good, but neither does ill-informed complacency. It’s inappropriate to assuage the public with misleading comparisons to the seasonal flu or by assuring people that there’s “only” a 2% fatality rate. The fraction of cases that are severe really sets Covid-19 apart from more familiar respiratory illnesses, compounded by the fact that it’s whipping through a population without natural immune protection at lightning speed.

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Individuals and governments seem not to be fully grasping the magnitude and near-inevitability of the national and global systemic burden we’re facing. We’re witnessing the abject refusal of many countries to adequately respond or prepare. Even if the risk of death for healthy individuals is very low, it’s insensible to mock decisions like canceling events, closing workplaces, or stocking up on prescription medications as panicked overreaction. These measures are the bare minimum we should be doing to try to shift the peak — to slow the rise in cases so health care systems are less overwhelmed.

The doubling time will naturally start to slow once a sizable fraction of the population has been infected due to the emergence of herd immunity and a dwindling susceptible population. And yes, societal measures like closing schools, implementing work-from-home policies, and canceling events may start to slow the spread before reaching infection saturation.

But considering that the scenarios described earlier — overflowing hospitals, mask shortages, infected health care workers — manifest when infections reach a mere 1% of the U.S. population, these interventions can only marginally slow the rate at which our health care system becomes swamped. They are unlikely to prevent overload altogether, at least in the absence of exceedingly swift and austere measures.

Each passing day is a missed opportunity to mitigate the wave of severe cases that we know is coming, and the lack of widespread surveillance testing is simply unacceptable. The best time to act is already in the past. The second-best time is right now.

Liz Specht is the associate director of science and technology at The Good Food Institute.

This content was originally published here.

Keeping the Coronavirus from Infecting Health-Care Workers | The New Yorker

The message is getting out: #StayHome. In this early phase of the coronavirus pandemic, with undetected cases accelerating transmission even as testing ramps up, that is critical. But there are many people whom the country needs to keep going into work—grocery cashiers, first responders, factory workers for critical businesses. Most obviously, we need health-care workers to care for the sick, even though their jobs carry the greatest risk of exposure. How do we keep them seeing patients rather than becoming patients?

In the index outbreak in Wuhan, thirteen hundred health-care workers became infected; their likelihood of infection was more than three times as high as the general population. When they went back home to their families, they became prime vectors of transmission. The city began to run out of doctors and nurses. Forty-two thousand more had to be brought in from elsewhere to treat the sick. Luckily, methods were found that protected all the new health-care workers: none—zero—were infected.

But those methods were Draconian. As the city was locked down and cut off from outside visitors, health-care workers seeing at-risk patients were housed away from their families. They wore full-body protective gear, including goggles, complete head coverings, N95 particle-filtering masks, and hazmat-style suits. Could we do that here? Not a chance. Health-care facilities don’t remotely have the supplies that would allow staff members to see every patient with all that gear on. In Massachusetts, where I practice surgery, the virus is circulating in at least eleven of our fourteen counties, and cases are climbing rapidly. So what happens if you are exposed to a coronavirus patient and you don’t have the ability to go full Wuhan? My hospital system, Partners HealthCare, has already sent more than a hundred staff members home for fourteen days of self-quarantine because they were exposed to the coronavirus without complete protection. If we had to quarantine every health-care worker who might have come into contact with a COVID-19 patient, we’d soon have no health-care workers left.

Yet there are lessons to be learned from two places that saw the new coronavirus before we did and that have had success in controlling its spread. Hong Kong and Singapore—both the size of my state—detected their first cases in late January, and the number of cases escalated rapidly. Officials banned large gatherings, directed people to work from home, and encouraged social distancing. Testing was ramped up as quickly as possible. But even these measures were never going to be enough if the virus kept propagating among health-care workers and facilities. Primary-care clinics and hospitals in the two countries, like in the U.S., didn’t have enough gowns and N95 masks, and, at first, tests weren’t widely available. After six weeks, though, they had a handle on the outbreak. Hospitals weren’t overrun with patients. By now, businesses and government offices have even begun reopening, and focus has shifted to controlling the cases coming into the country.

Here are their key tactics, drawn from official documents and discussions I’ve had with health-care leaders in each place. All health-care workers are expected to wear regular surgical masks for all patient interactions, to use gloves and proper hand hygiene, and to disinfect all surfaces in between patient consults. Patients with suspicious symptoms (a low-grade fever coupled with a cough, respiratory complaints, fatigue, or muscle aches) or exposures (travel to places with viral spread or contact with someone who tested positive) are separated from the rest of the patient population, and treated—wherever possible—in separate respiratory wards and clinics, in separate locations, with separate teams. Social distancing is practiced within clinics and hospitals: waiting-room chairs are placed six feet apart; direct interactions among staff members are conducted at a distance; doctors and patients stay six feet apart except during examinations.

What’s equally interesting is what they don’t do. The use of N95 masks, face-protectors, goggles, and gowns are reserved for procedures where respiratory secretions can be aerosolized (for example, intubating a patient for anesthesia) and for known or suspected cases of COVID-19. Their quarantine policies are more nuanced, too. What happens when someone unexpectedly tests positive—say, a hospital co-worker or a patient in a primary-care office or an emergency room? In Hong Kong and Singapore, they don’t shut the place down or put everyone under home quarantine. They do their best to trace every contact and then quarantine only those who had close contact with the infected person. In Hong Kong, “close contact” means fifteen minutes at a distance of less than six feet and without the use of a surgical mask; in Singapore, thirty minutes. If the exposure is shorter than the prescribed limit but within six feet for more than two minutes, workers can stay on the job if they wear a surgical mask and have twice-daily temperature checks. People who have had brief, incidental contact are just asked to monitor themselves for symptoms.

The fact that these measures have succeeded in flattening the COVID-19 curve carries some hopeful implications. One is that this coronavirus, even though it appears to be more contagious than the flu, can still be managed by the standard public-health playbook: social distancing, basic hand hygiene and cleaning, targeted isolation and quarantine of the ill and those with high-risk exposure, a surge in health-care capacity (supplies, testing, personnel, wards), and coördinated, unified public communications with clear, transparent, up-to-date guidelines and data. Our government officials have been unforgivably slow to get these in place. We’ve been playing from behind. But we now seem to be moving in the right direction, and the experience in Asia suggests that extraordinary precautions don’t seem to be required to stop it. Those of us who must go out into the world and have contact with people don’t have to panic if we find out that someone with the coronavirus has been in the same room or stood closer than we wanted for a moment. Transmission seems to occur primarily through sustained exposure in the absence of basic protection or through the lack of hand hygiene after contact with secretions.

Consider a couple of data points. Singapore so far appears not to have had a single recorded health-care-related transmission of the coronavirus, despite the hundreds of cases that its medical system has had to deal with. That includes one case reported this week of a critically ill pneumonia patient who exposed forty-one health-care workers in the course of four days before being diagnosed with COVID-19. These were high-risk exposures, including exposures during intubation and hands-on intensive care. Eighty-five per cent of the workers used only surgical masks. Yet, owing to proper hand hygiene, none became infected.

Our early experiences in the U.S. have so far been similar. The Centers for Disease Control and Prevention, in the face of limited information, recommended stricter precautions than have been employed in Asia, putting health-care workers on fourteen-day self-quarantine if they are exposed to an infected person for even a few minutes without protection, including a mask and goggles. That policy was implemented at U.C. Davis Medical Center, where the first case of community transmission was diagnosed, in late February. Eighty-nine health-care workers involved in the patient’s care were put under self-quarantine. None, it turned out, had been infected. Sacramento, Seattle, and San Francisco became coronavirus hot spots; as of this writing, however, significant occupational transmission has not been found.

This content was originally published here.

Orthodontist, dentist practices told to shut down offices

TROY – Cooney Orthodontics, one of the region’s larger practices, is closing its two offices for 11 days except for emergency cases per recommendations from the the American Dental Association, the American Association of Orthodontics and the New York State Dental Association Board of Trustees.

Other practices have announced the same, such as The Smile Lodge pediatric dentistry office in Clifton Park, which serves children from the Mohawk Valley, Capital Region and Adirondacks.

“At this point, taken together with Governor Cuomo’s announcement closing additional businesses, we have decided for the safety of our patients and staff to temporarily close both our Troy and Ballston Lake offices starting Tuesday March 17th through Friday March 27th,” Cooney wrote. “If you have an appointment scheduled during this time, we will be reaching out to reschedule shortly,” the practice said in an email to patients.

This content was originally published here.

Ohio health official estimates 100,000 people in state have coronavirus

A top health official in Ohio estimated on Thursday that more than 100,000 people in the state currently have coronavirus, a shockingly high number that underscores the limited testing so far.

Ohio Department of Health Director Amy Acton said at a press conference alongside Gov. Mike DeWine (R) that given that the virus is spreading in the community in Ohio, she estimates at least 1 percent of the population in the state has the virus.

“We know now, just the fact of community spread, says that at least 1 percent, at the very least, 1 percent of our population is carrying this virus in Ohio today,” Acton said. “We have 11.7 million people. So the math is over 100,000. So that just gives you a sense of how this virus spreads and is spreading quickly.”

She added that the slow rollout of testing means the state does not have good verified numbers to know for sure.

“Our delay in being able to test has delayed our understanding of the spread of this,” Acton said. 

The Trump administration has come under intense criticism for the slow rollout of tests. Dr. Anthony Fauci, a top National Institutes of Health official, acknowledged earlier Thursday it is “a failing” that people cannot easily get tested for coronavirus in the United States.

Not everyone with the virus has symptoms, and about 80 percent of people with the virus do not end up needing hospitalization, experts say. However, the virus can be deadly especially for older people and those with underlying health conditions.

The possible numbers in Ohio are a stark illustration of how many cases could be in other states as well, but have not been revealed given the lack of widespread testing.

More than 1,300 people in the U.S. have currently tested positive for the illness, according to data from Johns Hopkins University, while about three dozen people in the country have died.

Vice President Pence, who is overseeing the administration’s coronavirus response, said earlier Thursday that the U.S. can expect “thousands of more cases.”

Ohio officials said they are taking major actions to try to slow the spread of the virus. They are closing schools in the state for three weeks and banning large gatherings of 100 or more people. 

The state currently has just 5 confirmed positive cases, and 30 negative tests. Acton said Thursday that it appears that the number of cases of the virus doubles every six days.

As other experts have as well, she urged actions to slow the spread of the virus to avoid overwhelming the capacity of hospitals. Banning large gatherings and stopping school is part of that process.

“We’re all sort of waking up to our new reality,” she said, adding later that the state is “in a crisis situation.”

Noting the concerns about hospital capacity if the number of cases spikes too quickly, Acton said “there are only so many ventilators,” referring to machines that allow people to breathe when they cannot on their own.

Models indicate the number of cases could peak in late April to mid-May, she said.

If people are not seriously ill, she urged them to stay home so that only the sickest people who most need help are showing up at hospitals.

“This will be the thing this generation remembers,” she added. 

This content was originally published here.