Coronavirus Briefing: What Happened Today

Early in the outbreak, California emerged as a leader in fighting the spread of the coronavirus. It was the first state to impose a stay-at-home order, and its swift response is thought to have prevented 1.7 million coronavirus cases in the state.

For months it seemed that California — considered especially vulnerable to the virus because of its large, globe-trotting population — was weathering the storm relatively well.

But over the last week, things have changed. The state’s case count has exploded, reaching 200,000 infections. Gov. Gavin Newsom has rolled back reopening plans. And officials in Los Angeles County are projecting that they may run out of hospital beds in two to three weeks.

Now Californians are asking themselves, what went wrong?

The turn, some say, may have come Memorial Day weekend, when cooped-up residents responded to the state’s reopening by getting out and socializing. According to an analysis by The Los Angeles Times, coronavirus hospitalizations in the state began accelerating around June 15 — which, given the incubation period of the virus, points to holiday barbecues, beach trips and graduation parties as potential culprits.

The Los Angeles Times also noted that Californians, unlike New Yorkers, had not yet felt the trauma of having their hospitals overloaded with patients, so many saw reopening as a license to return to life as it was before the pandemic.

Our colleague Jill Cowan, who writes the California Today newsletter, told us that a complex patchwork of rules that can change from county to county was also to blame.

“State and local officials would say that, recently, people have been letting their guard down, and they’ve been gathering with family members and they’ve been going to bars and restaurants,” Jill told us. “But a lot of people are then saying, ‘Well, why did you let restaurants and bars reopen?’”

“It’s very confusing and it’s very complicated,” she added. “And so for regular Californians, I think it’s been tough to navigate what you shouldn’t do — even if you can.”

Many severely ill patients have developed a terrifying condition that causes nightmarish visions and can have long-lasting consequences. Known as hospital delirium, the phenomenon, which was observed mostly in older people before the pandemic, has struck Covid-19 patients of all ages.

Reports suggest that about two-thirds to three-quarters of virus patients who end up in intensive-care units, even for relatively short stays, have experienced the condition. Their hospitalization often provides the perfect combination of elements: long stints on ventilators, heavy sedatives, poor sleep, minimal social interaction.

Delirium takes two forms — hyperactive, which leads to paranoid hallucinations and agitation, and hypoactive, which causes internalized visions and confusion. Some people experience both.

Recovered virus patients have described thinking they were being abducted or burned alive. Even after their visions go away, the condition can slow the healing process and increase the risk of depression or post-traumatic stress. Older patients can also develop dementia sooner than they otherwise would have, and even die earlier.

Another troubling development: Immunologists believe the coronavirus may be responsible for depleting disease-fighting T cells, similar to how H.I.V. operates. If that’s the case, protection against the virus could be fleeting, and a cocktail of antiviral drugs may be needed to control it.

  • Updated June 24, 2020

    • Is it harder to exercise while wearing a mask?

      A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.

    • I’ve heard about a treatment called dexamethasone. Does it work?

      The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

    • What is pandemic paid leave?

      The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

    • Does asymptomatic transmission of Covid-19 happen?

      So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • How does blood type influence coronavirus?

      A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

    • How many people have lost their jobs due to coronavirus in the U.S.?

      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

Cellphones, chargers, canes, hearing aids, glasses, clothing, shoes, wallets, Bibles, jewelry: Across New York, hospital workers have had to figure out what to do with the thousands of items left behind by patients who have died from the coronavirus.

  • Authorities in China have imposed a strict lockdown on nearly half a million people near Beijing, after a small but stubborn second wave of infections.

  • In a reversal, officials in Jacksonville, Fla., say masks will be required in indoor public spaces where social distancing isn’t possible.

  • Even as the virus surges across far-flung regions of Russia, the Kremlin is pushing ahead with a referendum that could keep President Vladimir Putin in power until 2036.

  • After an outbreak around Leicester, in central England, the city might not follow the rest of the country as it reopens pubs, restaurants and hotels this weekend.

  • Broadway will remain closed for at least the rest of this year. Many shows are signaling that they do not expect a return until late winter or early spring.

Here’s a roundup of restrictions in all 50 states.

I live in a really small, rural logging town. While we don’t have Covid cases here, we have mostly all been staying home and following the guidelines. Several of my neighbors and I have started a “Porch Ninja” game, where we sneak over and leave homemade goodies, wine or fun surprises on each other’s porches.

— Carrie Bredy, Morton, Wash.

Let us know how you’re dealing with the outbreak. Send us a response here, and we may feature it in an upcoming newsletter.

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