Trump backs targeting of hotspots,
easing social distancing elsewhere
Big Data permits shift in tactics;Europe readies similar approach
Ramped-up Covid-19 testing will feed a Big Data drive for a laser-focus approach to curtailing the dangerous contagion while hopefully putting much of America back to work, it was disclosed today.
President Trump said in a letter to governors that “the day will soon arrive” when Americans can resume their “normal economic, social, and religious lives.”
Trump said his health team is working on new guidelines that will advise state governors on using "robust surveillance" to inform their decisions on loosening or tightening social distancing restrictions, based on whether counties are at low, medium or high risk for the Covid-19 infection.
Trump's action follows closely on the heels of similar actions by European nations hard hit by the contagion, as disclosed by the World Health Organization. WHO refers to the epidemic control approach as "sentinel testing."
If the current number of U.S. infections were to double every 4 days (a conservative estimate), then in 15 days the current 80,000 cases would have ballooned to some 1 million. As hospitals become overwhelmed, the mortality rate would likely surge as some patients are left untreated. But these trends may be arrested with a vigorous "sentinel system" surveillance method, some experts believe.
Prez thanks governors
In the letter, Trump thanked the governors for “stepping up to help America confront this unprecedented global pandemic.”
Before sending the letter, Trump made peace with Illinois Gov. J.B. Pritzker after a Twitter spat, with Pritzker saying Trump was responsive to the state's needs. Trump had blasted Pritzker for criticizing him when he was trying to help. Pritzker shot back that Trump had been dawdling as the epidemic approached. Another Democrat, New York Gov. Andrew Cuomo has been at pains to avoid criticizing Trump as Cuomo copes with the nation's worst hot zone.
Better data based on more widespread testing that is now kicking into gear will permit health authorities to use a more focused approach, easing the shutdowns and lockdowns that have brought America's economy to a halt, the President said, while cautioning that there remains a "long battle ahead."
The President said his health experts believe that expanded testing capabilities will “enable us to publish criteria, developed in close coordination with the nation’s public health officials and scientists, to help classify counties with respect to continued risks posed by the virus.”
“This will incorporate robust surveillance testing, which allows us to monitor the spread of the virus throughout the country,” Trump wrote. “Under these data-driven criteria, we will suggest guidelines categorizing counties as high-risk, medium-risk, or low-risk.”
He added, “This new information will drive the next phase in our war against the invisible enemy.”
'Slowdown' policy may end Monday
Earlier this month the White House launched a policy called “15 days to slow the spread,” which included social distancing, working from home when possible and avoiding gatherings of more than 10 people in order to curb the contagion. Many governors and mayors have forced non-essential businesses to close during the pandemic.
That 15-day period ends on Monday.
The President has argued that he doesn’t want “to turn the country off” and see a continued economic tailspin. He also said he worries that the country will see “suicides by the thousands” if the panic over the pandemic wrecks the economy.
While every state in the union has positive cases of Covid-19, some states have taken a much worse drubbing than others, in particular New York State with more than 37,000 cases as of Thursday afternoon, although the rate of increase has reportedly slowed dramatically.
States with more than 1,000 positive coronavirus cases include New Jersey, California, Washington, Florida, Michigan, Illinois, Louisiana, Pennsylvania, Texas, Georgia, Massachusetts and Colorado.
New York, California, New Jersey, Connecticut, Illinois and Michigan have issued executive orders that closed non-essential businesses and urged residents to work from home unless they are an essential worker. But even small cities in states not so badly affected are under "safer-at-home" orders, such as Knoxville, Tenn., which has only a handful of cases and no crush reported on emergency rooms at this time.
By Thursday afternoon, the United States had reported more than 75,200 positive cases of Covid-19 and more than 1,000 deaths.
'Encouraging signs' in Europe
In a related development, the World Health Organization’s European office said today that it saw “encouraging signs” in Italy reporting a lowered infection rate, though the UN agency cautioned that it was too soon to say whether the worst had passed.
Also, WHO said, many European countries have implemented or plan to implement changes in testing strategies to focus on severe cases and on hot zones in order to improve the quality of data used by epidemiologists.
A very similar approach has been recommended by Marc Siegel, MD, who has written about epidemics and is a media personality.
Generally, the focused approach means to have health authorities spot people who have the disease, track their contacts and apply medication and quarantines. That is the approach generally used for other contagions, so that society need not grind to a halt. But authorities cannot implement that policy when their data are insufficient. In various locales across the United States, there have been complaints of underreporting of Covid-19 infections and deaths due, in part, to shortage of tests and lab equipment.
“While the situation remains very serious, we are starting to see some encouraging signs,” declared Jan Kluge, WHO's regional director for Europe.
“Italy, which has the highest number of cases in the region, has just seen a slightly lower rate of increase, though it is still too early to say that the pandemic is peaking in that country,” he added.
WHO's European office said that to date more than 220,000 cases of Covid-19 had been reported on the continent, along with 11,987 deaths.
That means that globally, roughly 6 out of every 10 cases and 7 out of 10 deaths have been reported in Europe, with the number of confirmed infections worldwide now topping 400,000.
As the virus has spread across the continent, many European countries have adopted severe measures to curb the outbreak, including shelter-in-place lockdowns, the shuttering of nonessential businesses and the closing of borders, as well as the limiting of public gatherings.
Kluge said it will soon be evident whether these social mobility clampdowns have had an impact on curbing the rate of contagion.
WHO reports that
Elements of this story came from the White House, the World Health Organization, Al Manar TV (Lebanon), Fox News, wire services and other sources.
President Trump said in a letter to governors that “the day will soon arrive” when Americans can resume their “normal economic, social, and religious lives.”
Trump said his health team is working on new guidelines that will advise state governors on using "robust surveillance" to inform their decisions on loosening or tightening social distancing restrictions, based on whether counties are at low, medium or high risk for the Covid-19 infection.
Trump's action follows closely on the heels of similar actions by European nations hard hit by the contagion, as disclosed by the World Health Organization. WHO refers to the epidemic control approach as "sentinel testing."
If the current number of U.S. infections were to double every 4 days (a conservative estimate), then in 15 days the current 80,000 cases would have ballooned to some 1 million. As hospitals become overwhelmed, the mortality rate would likely surge as some patients are left untreated. But these trends may be arrested with a vigorous "sentinel system" surveillance method, some experts believe.
Prez thanks governors
In the letter, Trump thanked the governors for “stepping up to help America confront this unprecedented global pandemic.”
Before sending the letter, Trump made peace with Illinois Gov. J.B. Pritzker after a Twitter spat, with Pritzker saying Trump was responsive to the state's needs. Trump had blasted Pritzker for criticizing him when he was trying to help. Pritzker shot back that Trump had been dawdling as the epidemic approached. Another Democrat, New York Gov. Andrew Cuomo has been at pains to avoid criticizing Trump as Cuomo copes with the nation's worst hot zone.
Better data based on more widespread testing that is now kicking into gear will permit health authorities to use a more focused approach, easing the shutdowns and lockdowns that have brought America's economy to a halt, the President said, while cautioning that there remains a "long battle ahead."
The President said his health experts believe that expanded testing capabilities will “enable us to publish criteria, developed in close coordination with the nation’s public health officials and scientists, to help classify counties with respect to continued risks posed by the virus.”
“This will incorporate robust surveillance testing, which allows us to monitor the spread of the virus throughout the country,” Trump wrote. “Under these data-driven criteria, we will suggest guidelines categorizing counties as high-risk, medium-risk, or low-risk.”
He added, “This new information will drive the next phase in our war against the invisible enemy.”
'Slowdown' policy may end Monday
Earlier this month the White House launched a policy called “15 days to slow the spread,” which included social distancing, working from home when possible and avoiding gatherings of more than 10 people in order to curb the contagion. Many governors and mayors have forced non-essential businesses to close during the pandemic.
That 15-day period ends on Monday.
The President has argued that he doesn’t want “to turn the country off” and see a continued economic tailspin. He also said he worries that the country will see “suicides by the thousands” if the panic over the pandemic wrecks the economy.
While every state in the union has positive cases of Covid-19, some states have taken a much worse drubbing than others, in particular New York State with more than 37,000 cases as of Thursday afternoon, although the rate of increase has reportedly slowed dramatically.
States with more than 1,000 positive coronavirus cases include New Jersey, California, Washington, Florida, Michigan, Illinois, Louisiana, Pennsylvania, Texas, Georgia, Massachusetts and Colorado.
New York, California, New Jersey, Connecticut, Illinois and Michigan have issued executive orders that closed non-essential businesses and urged residents to work from home unless they are an essential worker. But even small cities in states not so badly affected are under "safer-at-home" orders, such as Knoxville, Tenn., which has only a handful of cases and no crush reported on emergency rooms at this time.
By Thursday afternoon, the United States had reported more than 75,200 positive cases of Covid-19 and more than 1,000 deaths.
'Encouraging signs' in Europe
In a related development, the World Health Organization’s European office said today that it saw “encouraging signs” in Italy reporting a lowered infection rate, though the UN agency cautioned that it was too soon to say whether the worst had passed.
Also, WHO said, many European countries have implemented or plan to implement changes in testing strategies to focus on severe cases and on hot zones in order to improve the quality of data used by epidemiologists.
A very similar approach has been recommended by Marc Siegel, MD, who has written about epidemics and is a media personality.
Generally, the focused approach means to have health authorities spot people who have the disease, track their contacts and apply medication and quarantines. That is the approach generally used for other contagions, so that society need not grind to a halt. But authorities cannot implement that policy when their data are insufficient. In various locales across the United States, there have been complaints of underreporting of Covid-19 infections and deaths due, in part, to shortage of tests and lab equipment.
“While the situation remains very serious, we are starting to see some encouraging signs,” declared Jan Kluge, WHO's regional director for Europe.
“Italy, which has the highest number of cases in the region, has just seen a slightly lower rate of increase, though it is still too early to say that the pandemic is peaking in that country,” he added.
WHO's European office said that to date more than 220,000 cases of Covid-19 had been reported on the continent, along with 11,987 deaths.
That means that globally, roughly 6 out of every 10 cases and 7 out of 10 deaths have been reported in Europe, with the number of confirmed infections worldwide now topping 400,000.
As the virus has spread across the continent, many European countries have adopted severe measures to curb the outbreak, including shelter-in-place lockdowns, the shuttering of nonessential businesses and the closing of borders, as well as the limiting of public gatherings.
Kluge said it will soon be evident whether these social mobility clampdowns have had an impact on curbing the rate of contagion.
WHO reports that
¶ The number of cases reported in Europe has doubled since last weekEuropean nations believe that targeted virus surveillance -- known as "sentinel surveillance" -- will provide better data on the most efficient ways to break the back of the epidemic. WHO says that:
¶ 61% of the cases and 90% of the deaths have been reported from Italy, Spain and France
¶ 96% of deaths were in persons aged 60 years and older
¶ 87% of infected persons with outcome data available recovered
¶ 10% of reported infections with information available was a health care worker
A sentinel surveillance system is used when high-quality data are needed about a particular disease that cannot be obtained through a passive system.
Selected reporting units, with a high probability of seeing cases of the disease in question, good laboratory facilities and experienced, well-qualified staff, identify and notify on certain diseases.
Whereas most passive surveillance systems receive data from as many health workers or health facilities as possible, a sentinel system deliberately involves only a limited network of carefully selected reporting sites.
For example, a network of large hospitals might be used to collect high-quality data on various diseases and their causative organisms, such as invasive bacterial disease caused by Haemophilus influenzae type b, meningococcus or pneumococcus.
Elements of this story came from the White House, the World Health Organization, Al Manar TV (Lebanon), Fox News, wire services and other sources.
No comments:
Post a Comment