By the time the aircraft carrier Theodore Roosevelt was ordered to port in Guam on March 26, the hulking ship was already being ransacked by the outbreak of an invisible enemy.
At sea on March 24, the first three cases were reported. Within 24 hours, the number of infected more than doubled. Each subsequent day yielded more confirmed cases, numbering 615 as of Wednesday. A 41-year-old chief petty officer became the first to succumb to COVID-19 on Monday, four days after being found unresponsive by other quarantined sailors.
Officials retracing the ships activity pointed to a scheduled port stop in Da Nang, Vietnam, as the source of the outbreak. The oft-questioned decision to continue with the long-planned 25th anniversary celebration of U.S. and Vietnamese diplomatic relations was made at a time when the country had only 16 confirmed cases, all of which were reportedly confined to the northern city of Hanoi, Chief of Naval Operations Adm. Michael Gilday said.
As Navy officials analyzed the ships chronological movement, however, the once-firm belief of where the virus first meandered onto the ship was called into question and potentially debunked.
According to a Wall Street Journal report Wednesday, Navy officials now believe the outbreak on the carrier Roosevelt was initiated by the ships routine flight operations.
Numerous carrier on-board delivery flights originating in Japan, the Philippines, and Vietnam occurred in the days following the ships departure from Da Nang, the report said. With some of the first Roosevelt sailors to contract the virus coming from the carriers air wing, the picture began to clarify.
Furthermore, the eight sailors who first tested positive did so over the course of March 24 and 25, more than two weeks after the ship departed Da Nang a time period in excess of the virus incubation. A Navy Times request for officials to confirm which units the first infected sailors belonged to was not returned as of publication.
Additional evidence materialized when the Navy pinpointed a hotel in Da Nang, where 30 sailors had stayed while Roosevelt was in port. Two British nationals who stayed at the same hotel later tested positive for COVID-19, the WSJ reported.
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Each of the 30 sailors who were at the hotel, however, yielded negative test results.
Still, Navy officials are holding off on saying for certain where the virus onboard Theodore Roosevelt originated.
We just dont know, one official told the Wall Street Journal.
Uncertainty has loomed over the Big Stick in the weeks since the first COVID-19 cases emerged.
Upon arriving pierside in Guam, former Theodore Roosevelt commanding officer, Capt. Brett Crozier, penned a letter pleading for Pentagon assistance to evacuate the majority of his sailors off of the ship and into isolated quarantine.
We are not at war. Sailors do not need to die, he wrote. If we do not act now, we are failing to properly take care of our most trusted asset our Sailors.
Crozier was subsequently fired by former Acting Secretary of the Navy Thomas Modly after the captains letter was leaked to the San Francisco Chronicle.
Days after leaving the ship to rousing applause and chants of his name, Capt. Crozier tested positive for COVID-19. Like many of the sailors he used to command, Crozier is now in isolated quarantine.
Modly then flew to Guam to offer Roosevelt sailors an explanation for their captains hasty dismissal, a last-minute tirade that, according to estimates obtained by the Washington Post, came with an airfare tab of $243,151.65.
It was a betrayal," Modly told Roosevelt sailors over the ships 1MC intercom.
And I can tell you one other thing: because he did that he put it in the publics forum and it is now a big controversy in Washington, D.C. If he didnt think, in my opinion, that this information wasnt going to get out to the public, in this day and information age that we live in, then he was either A, too nave or too stupid to be a commanding officer of a ship like this. The alternative is that he did this on purpose.
According to a USA Today report Tuesday, Modly expensed the trip before formally submitting a waiver to side-step a policy that limits senior officials to one air crew per trip to curb the cost of travel by military aircraft, the report said. The former Navy secretary took the trip while only informing the Pentagon orally that he intended to use more than one crew.
Pressured by lawmakers on Capitol Hill following his infamous speech the audio was obtained by Military Times Modly resigned.
Now, in the aftermath of his ill-advised trip and potential exposure to COVID-19, Modly, too, is in quarantine.
Since Croziers firing, approximately 85 percent of Roosevelts crew has been evacuated from the carrier, Navy officials said.
In addition to the sailor who died from coronavirus complications, five sailors have been hospitalized. One of the five crew members has been moved to the ICU.
GE Healthcare is extending its longtime collaboration with Microsoft to launch a cloud-based COVID-19 patient monitoring software for health systems.
GE Healthcare had originally intended to debut its Mural Virtual Care Solution at the Healthcare Information and Management Systems Society meeting earlier this year. When the COVID-19 epidemic scuttled those plans the company went redesigned the software offering initially intended to be a new feature for its Edison platform to focus on a COVID-19 application that could be distributed quickly to hospitals that need it using Microsofts Azure Cloud.
GE Healthcare and Microsoft are waiving everything but the installation costs for the software until January 2021, the companies said.
The software is designed to provide a central hub from which hospital staff can monitor patients in intensive care units including those on medical ventilation.
As Dr. David Rhew, the chief global medical officer of Microsoft noted, the remote monitoring tools could help hospital staff limit their exposure to infected patients and help conserve needed personal protective equipment.
If you think about what the solution was originally built on it was built on an on-prem solution that would take weeks to install and would take time to set up the servers, said Rhew. It clearly is a great way for us to more efficiently monitor [And] because you dont need to walk into the room it saves PPE decreasing that risk of exposure.
A Mural installation can monitor a 100-bed, multi-site ICU network with just three senior nurses and two intensivists, according to a company statement. The software collects real-time data from ventilators, existing patient monitoring systems, electronic medical records, labs and other diagnostics into a single surveillance hub, the companies said.
Facing the daunting outlook of a COVID-19 surge, it is imperative that I and my fellow healthcare workers use virtual ICU technology to safely monitor and care for our sickest patients while preserving PPE, said Matthias Merkel, M.D., Ph.D., OHSUs Chief Medical Capacity Officer, Vice Chair of Critical Care Medicine, and Professor of Anesthesiology and Perioperative Medicine, in a statement. Remaining closely connected and supported through technology enables us to progress our patients care across a geographic distance that we would otherwise be unable to manage.
During the 2014 Ebola outbreak in Guinea, global health researcher Anne Liu struggled to convince public health officials that apps and other technologies could help manage the spread of disease. To beat back the outbreak, officials had to locate every person an Ebola patient may have interacted with while they were infectious, in a process called contact tracing. Liu and her colleagues wanted investigators to use apps to compile information, rather than pen and paper. At the time, it was a hard sell.
The fight was more, is technology going to be useful at all, says Liu, now the senior technical advisor at the Clinton Health Access Initiative. I dont think thats the battle anymore.
Now, during the ongoing novel coronavirus pandemic, some experts are turning to technology to take over the contact tracing process entirely. Countries like Singapore and China are using cellphone-based tools to identify and monitor people who might have been exposed to someone with COVID-19. The United Kingdom is building a contact tracing app, and in the United States, Google and Apple partnered to build a Bluetooth-based tracking system that can automatically log peoples interactions.
Whether this type of tech could help halt a disease outbreak is still unclear; its never been studied before. Some experts are optimistic that automating contact tracing could scale up the COVID-19 response in the US. But creating systems that can do that work is only the start of the conversation.
This type of technology is not a silver bullet. It has to be part of a comprehensive public health strategy, Liu says. Technology is usually the easy part. These new systems wont be useful without a dramatic increase in the amount of testing done in the United States, clear messaging, and strong integration with public health policies.
The goal of contact tracing apps is fairly simple. Theyd log every phone within a certain range of a person, and if that person later tested positive for COVID-19, they could send an alert to each phone that had been nearby. Google and Apple turned to Bluetooth, which can monitor the other phones in your area without tracking your specific location. There are limitations to this approach: Bluetooth casts a wide net and may struggle to tell if two phones were actually close enough for their users to transmit a virus between them. The systems also wouldnt be able to monitor the contacts of people who didnt agree to use it or of people who dont have smartphones.
Thats why app-based tracking will not be a full replacement for manual contact tracing, and public health agencies still need to vastly expand the contact tracing workforce in the United States. Apps could, though, take on some of the work and make the process more efficient.
Generally whats done is a huge amount of manual work. We have to increase the public health workforce, and this new technology could ease a lot of that burden, says John Brownstein, an infectious disease epidemiologist and chief innovation officer at Boston Childrens Hospital.
An automatic system can do things that a manual contact tracer cant. Its hard for people to remember everyone they interact with each day, let alone over a week or two-week period, and an app would take some of the guesswork out of the equation. It would also be able to flag people who someone may not know they interacted with, like a stranger they stood next to in a subway car.
Lets say youre an infected grocery store worker, says Ranu Dhillon, a researcher in the division of global health equity at Brigham and Womens Hospital. Theres no way to track who you may have exposed. An automated system could comprehensively identify those previously unknown contacts at a huge scale.
An automated system is also fast. The biggest advantage, I think, is speed, Dhillon says. It can take a few days for a contact tracer to manually track down everyone on their list for each case and in that time, infected people could be passing the virus on to others. Instantaneous notification can make a big difference, he says.
Once those notifications are made through the app, the second wave of work begins. Its still not clear if the system will give public health agencies any information about the identified contacts of a known positive case.
Typically, in contact tracing you want a health official to have some ability to follow up, Liu says. Manual check-ins or follow-ups may not be as important for COVID-19 contacts as they were for Ebola contacts for Ebola, tracers circle back to contacts every single day for a few weeks. People exposed to COVID-19 are usually just asked to monitor themselves for two weeks.
Liu still thinks that it would be helpful for officials to know who the contacts of each case were, just like they would with manual contact tracing. She acknowledges that it might be a difficult ask given that people may feel differently if that information is processed through an app or software. I can understand that in settings where people are concerned about privacy, that might be a challenge, she says. At a minimum, contacts should still be given some sort of public health information by the app so that they can make a decision about what steps to take after finding out theyd been exposed.
The recommendations that each contact would get depends a lot on the infrastructure and policy in place for the disease response. Ideally, Dhillon says, every contact could be tested for the novel coronavirus, and then potentially tested again around a week later (to make sure a first test, if negative, wasnt incorrect).
Right now, in the United States, there isnt nearly enough testing available for that to be possible. Instead, its more likely that a notification about a possible exposure to a person with COVID-19 would trigger a recommendation to quarantine for two weeks. Thats still useful, Dhillon says. Id rather isolate all contacts than isolate everyone. Contacts are still far fewer people than the whole population.
Without testing, though, the potential burden of a notification would be higher. Youd be asking a lot of people to potentially quarantine themselves based on a potential contact, Brownstein says. If the Bluetooth system wasnt specific enough, and it flagged people as contacts who werent actually at risk, those false positives could be stressful and overwhelming. Too many perceived false alarms may also make people less likely to follow instructions after an alert.
If people are regularly alerted to a possible exposure, though, it may have more to do with the caseload in their community than with the reliability of Bluetooth particularly if the tech can be refined. If people are flagged multiple times, it probably indicates that people in their social networks are the ones coming back positive, Dhillon says. It shouldnt be as much an issue of false alarms as of a cluster of cases.
If people are getting lots of alerts, it could also mean that the number of people sick with COVID-19 is so high that contact tracing is no longer the best strategy and that everyone should be isolating anyway. Thats when youre in a situation, such as New York City is in right now, when you just have widespread community transmission. You have to make an assumption that everyones been somewhat exposed, Liu says.
Telling someone that theyve been around someone with a case of COVID-19 isnt as useful when the disease is everywhere. Contact tracing isnt done manually when case counts are high, so it might not be worth having automated systems turned on, either. Decisions around when and where to send notifications have to take that context into consideration, Liu says. That way you help avoid this issue of notification fatigue.
Along with ensuring that a system works well and fits into the public health ecosystem, the officials working with automated contact tracing have to push out clear communications to users. A big part of it is the messaging itself, Liu says. Regardless of the technology, you have to make sure the messaging itself is clear.
Messaging from public health officials about the COVID-19 pandemic has been inconsistent and often misleading, which doesnt bode well for clear communications around any automated testing system. Still, its something that experts say could make or break the proposed systems.
People deciding if they want to use an app or opt into a tracking system need to understand exactly what the technology is for and how its being used. They also need to know what a notification from the system would mean and what they should do with that information. An alert wouldnt necessarily mean a person is in imminent danger, but it could mean that theyre at a certain level of risk of developing COVID-19 and they have to know what those risks are. We need to have a lot of public messaging where people understand what the notification is, and can put it into context, Dhillon says.
Clear communication would also increase the odds that people would choose to use the automated system, which needs a high percentage of participation in order to work. In Singapore, for example, around 12 percent of the population downloaded a contact tracing app but statistically, that translates to only around a 1 percent chance of two people both using it. With such a low rate of use, its not going to catch many random contacts. Its hard to say how many people in the United States would need to use an app to give it value.
What would be ideal from an epidemic control perspective is not necessarily what is ideal at a social and policy level, which is just as important, Dhillon says. We need enough people to opt-in to make a dent.
The pandemic is moving at unprecedented speed, and public health experts are sprinting to build the tools they think might help bring it under control. Its a little bit of flying the plane while still building it, Dhillon says. Any automated contact tracing program would have to be carefully monitored to see how well it helps contain COVID-19, how people are interacting with it, and if its flagging more people than actually would be at risk from an exposure.
Whatever the systems eventually end up looking like, they have to be introduced alongside public health infrastructure to ensure they have as big an impact as possible. The tools cant be used in isolation, Liu says. You have to make sure you have the policies in place to support them.
Here are the latest updates on the fight to slow the spread of COVID-19 in Minnesota and Wisconsin.
According to a press release put out by the office of Gov. Walz and Lt. Gov. Peggy Flanagan, Minnesota received roughly $1 billion in coronavirus relief from the federal government on Wednesday, as part of the CARES Act.
The funds will serve to offset the economic toll the COVID-19 pandemic is having on the state.
The governor said, the state is providing critical funding to hospitals, public health departments, and first responders as we work together to keep Minnesotans safe amid the COVID-19 pandemic. This critical federal funding will help support Minnesotas state and local governments as we continue our efforts to combat the spread of the virus in Minnesota.
The release says the state is expected to receive a total of $2.187 billion in coronavirus relief through the federal Coronavirus Relief Fund, with some of that funding going to "local units of government."
Minnesota Management and Budget Commissioner Myron Frans said, This is an important first step from the federal government as Minnesota responds to COVID-19 in a fiscally responsible manner.
Minnesota can expect to see the remaining balance of payments allocated to the state by no later than April 24, 2020, according to the release.
The Office of Governor Tim Walz and Lt. Governor Peggy Flanagan announced the signing of a new COVID-19 relief package aimed at expanding COVID-19-related healthcare coverage for both insured and uninsured Minnesotans.
The governor's office says the package enables those with Medicaid and MinnesotaCare to receive care at temporary sites once they are set up.
The legislation grants full eligibility for uninsured Minnesotans to be covered for COVID-19 testing, and a 100% federal reimbursement will be offered for the associated clinic visit.
Describing the bipartisan effort, Governor Walz said, Our team partnered with legislators on both sides of the aisle in putting together this legislation to help Minnesotans weather COVID-19. We will continue working with our local, state, and federal partners to ensure Minnesotans have the support they need during this pandemic.
According to the press release, The bill (HF 4556) represents the fourth legislative relief package passed and signed in the month of April.
This legislation will help Minnesotans with and without insurance afford COVID-19 testing and care, streamline telemedicine, and extend administrative deadlines to provide Minnesotans with more flexibility,said Flanagan.
Minnesota Gov. Tim Walz continues to emphasize a "ramping up" of testing as the best way to get people back to work amid the COVID-19 pandemic.
Walz maintained on his daily COVID-19 update call Wednesday that Minnesota will need to be testing at a rate of 5,000 per day, or 35,000 to 40,000 per week, before the state can safely "reopen" in a more substantial way.
Both the Mayo Clinic and the University of Minnesota have said that they are able to help with this tall order, as they are testing in the thousands already and plan to expand. But their capacity is being used nationally, and will need to increase even further to provide that level of testing to Minnesota specifically.
"I believe Minnesota can be the one example of where this can work," Walz said. "I am going to push my team, I am going to push these researchers, I am going to push Mayo Clinic to lean into this."
There are still questions about the accuracy of serology tests, which measure antibodies to show whether a person has already had COVID-19. Walz said that these types of blood tests will be one of the main avenues to figuring out who may be able to go back to work and who may have some immunity.
He and Minnesota Department of Health (MDH) Infectious Disease Director Kris Ehresmann acknowledged that the science in this area is new, and they don't know for certain that someone who has had the coronavirus previously would have immunity, or how long that immunity would last.
Walz said some of the tests on the market are "just plain worthless." But there is a "good probability that there will be some immunity," he said, and Minnesota will utilize the more reliable tests including those from Mayo Clinic and the U of M.
"This is not the panacea, this is not the easy fix," he said, but "it is promising."
Although testing capabilities by Mayo and the U of M are increasing, MDH Commissioner Jan Malcolm said there are still challenges on the collection end where providers take samples for tests. The issues are related to availability of personal protective equipment (PPE) for those health care workers, and staff capacity to take those samples.
The benefit to serology tests, though, is that they are blood tests that do not require swabs, which are in very short supply globally. Ehresmann said Minnesota is in "a much better place" with serology test capability for that reason.
Walz said that in terms of Minnesota's supply of PPE, he is "feeling more confident" than he was a week ago.
"I think there's reasons to think that we are building toward the capacity that we need," He said. "But there's still an unknown."
We cannot lose all that weve gained," Walz said. "We have put this state in a position where were saving lives and we can do it as well as anybody, and we want to prove that.
Malcolm said Wednesday that MDH is comfortable enough with its diagnostic testing capacity that they can begin to test more people beyond health care workers, hospitalized patients and people in congregate care. They've added police and other first responders to the priority list already.
"We've had to restrict the list more than we would have wanted at many points and we're now at the place where we are, we believe it's important to and we're able to, because of this added capacity that we've talked about coming online just recently, we're able to expand that priority list now," Malcolm said.
Ehresmann said they also want to expand serology testing to health care workers and essential workers, along with people at the highest risk for severe illness from COVID-19.
Walz congratulated the University of Minnesota on receiving FDA approval for a low-cost ventilator. It's the first of its kind to be authorized, Walz said, and plans will be published online for others to follow.
Malcolm said of the eight new deaths reported Wednesday from COVID-19, all were people in long-term care facilities.
Malcolm said health officials are seeing "early indications" that infection control measures being put into place in these facilities are having a positive impact.
Half of the facilities with confirmed cases have only one case, she said, which indicates a limited spread. "It's important to take a moment to acknowledge the hard work of those facilities ... and to thank them for all the work they are doing to protect our loved ones," Malcolm said.
Malcolm said with regard to families wanting to pull residents out of these facilities, there are health risks inherent in moving people back and forth.
"In many respects they are the safest environment for our loved ones," she said.
She said they believe in general these are "good environments for our seniors," and MDH is urging families to have conversations with their facilities about their concerns.
Department of Employment and Economic Development (DEED) Commissioner Steve Grove said his department plans to have unemployment insurance for the self-employed and independent contractors up and running by the end of April.
DEED is asking those workers to apply now, even though they'll be denied under current eligibility rules. Then when officials have the system set up to issue unemployment payments to this new category of applicants, they'll already be in the system and DEED will reach out to them proactively.
Gov. Walz also took a moment Wednesday to celebrate the passage of the Alec Smith Insulin Affordability Act.
Walz signed the act into law Wednesday after it was passed by both the Minnesota House and Senate.
"No Minnesotan should have to choose between food, rent, and a drug that they need to survive," Walz said.
Less than 24 hours after state lawmakers moved to help Minnesotansdealing with the coronavirus come daily numbers from the Minnesota Department of Health (MDH) that underline a far more personal impact from the virus.
MDH says 1,809 Minnesotans have tested positive for COVID-19, an increase of 114 from Tuesday. The virus has now claimed 87 lives, up eight from 79 yesterday. Hospitals are currently treating 197 patients, with 93 in the ICU. Health officials say 445 coronavirus patients have been hospitalized since MDH began tracking the pandemic in late January.
In a bit of good news, 940 people who contracted COVID-19 no longer require hospitalization and are recovering, more than 50 percent of all those who have tested positive.
MDH statistics indicate that more than 40,000 Minnesotans have been tested for the coronavirus, and that number will increase dramatically if Gov. Tim Walz and state health officials have their way. Walz says in order for him to "reopen" Minnesota for business the state will need the capacity to test 5,000 Minnesotans for COVID-19 or its antibodies each day.
A breakdown of the more than 1,800 confirmed coronavirus cases shows 35% of those testing positive are between the ages of 20 and 44, with 34% between 45 and 64, and 29% over the age of 65. Hennepin County has the most COVID-19 cases with 651. Ramsey County has reported 164, Olmsted 153 and Dakota 103.
The Minnesota Legislature has approved a COVID-19 relief bill, the fourth such measure approved by the state in recent weeks.
The House passed the package 103-31 and sent it to the Senate, which approved it 64-3 and forwarded it to Gov, Tim Walz for his signature.
The bill contains mostly policy tweaks that we need in order for Minnesotans to live their lives during the COVID-19 pandemic, Democratic House Speaker Melissa Hortman told reporters before the vote. But she highlighted a provision that allows couples to obtain marriage licenses online or by mail rather than in person during the public health crisis.
Other highlights include provisions that will: make it easier for health care providers to use telemedicine; cover some testing costs for the uninsured; extend various deadlines and expiration dates, including for mediation of disputes between farmers and creditors; codify temporary rules under which lawmakers can vote remotely and state agencies can exercise emergency powers and; make it easier for government bodies to meet remotely while complying with open meeting laws.
The Legislature earlier approved bills providing an initial $21 million for the Minnesota Department of Health, and $200 million for health care providers. A third bill ensures that first responders, health care workers and child care workers who serve the families of those front-line employees qualify for workers compensation if they catch COVID-19.
Lawmakers approved a long-awaited insulin affordability bill as well as additional relief for coronavirus on Tuesday.
Governor Tim Walz clarified that the Peacetime Emergency order is different from the Stay at Home order. The extension to the Peacetime Emergency to May 13 does not affect the Stay at Home order, which is currently set to expire May 4.
Health Commissioner Jan Malcolm said that Monday was a low-volume testing day, which is why there weren't many more new cases Tuesday. However, there were nine deaths Monday, bringing the total to 79. There's a total of 1,695 positive cases in the state.
Emergency Management Director Joe Kelly said he will be meeting with the U.S. Army Corps of Engineers to discuss plans it can provide in setting up alternative care sites to help deal with any surge in COVID-19 cases.
Commissioner of Department of Employment and Economic Development Steve Grove said that more than 450,000 Minnesotans have applied for unemployment insurance in the past month, which is more than double the total from all of 2019.
People who are self-employed or are contractors should apply for benefits now even though they will be denied at the moment. This is because their information will be in the system, which will allow them to received the benefits faster once this category of workers is able to receive benefits, which Grove said should be by the end of this month.
Walz said the state is going full speed to expand testing to unprecedented levels. Walz said he is optimistic the state will be able to ramp up testing in the early short run. He also expressed hopes to move into the type of testing that would show who has already had the virus and is immune.
Malcolm said different health institutions are trying to develop different testing methods in order to avoid material shortages.
Fifty-seven of the 79 deaths in the state due to the virus have been individuals who were in long-term care, Infectious Disease Director Kris Ehresmann said. Ninety eight point five percent of the people who have died due to the virus have underlying or pre-existing health conditions, Ehresmann added.
The Minnesota Department of Health (MDH) reported 45 new lab-confirmed COVID-19 cases in the state on Tuesday, and nine additional deaths related to the virus.
There are now 1,695 total positive cases, and 79 deaths. Of the people who have tested positive, 909 no longer require isolation.
In total, 405 people have been hospitalized, and 177 of them are still currently in the hospital. Seventy-five of those people are in the ICU.
The number of people who have been tested in Minnesota since late January is inching closer to 40,000. As of Tuesday's update, it stands at 39,241. Gov. Tim Walz said Monday that he believes the state will need to be testing more like 40,000 people per week before it will be possible to fully reopen the economy.
The median age of all cases is 52 years old, and 65 for hospitalized cases and ICU patients. The median age of people who have died is 87. The youngest person to test positive was 4 weeks old, according to MDH, and the oldest was 104.
Hennepin County has the most cases at 588, and 40 deaths. Ramsey County has 153 cases and seven deaths, and Olmsted has 147 cases and two deaths. Dakota County has passed the 100-case mark with 103, and has reported five deaths.
Researchers and public health officials in Minnesota have estimated that for every one lab-confirmed case, there are 100 more that have not been officially detected.
KARE 11s coverage of the coronavirus is rooted in Facts, not Fear. Visit kare11.com/coronavirus for comprehensive coverage, find outwhat you need to know about the Midwest specifically, learn more about thesymptoms, and see what companies in Minnesota are hiring. Have a question? Text it to us at 763-797-7215. And get the latest coronavirus updates sent right to your inbox every morning. Subscribe to the KARE 11 Sunrise newsletter here. Help local families in need: www.kare11.com/give11.
The state of Minnesota has set up a hotline for general questions about coronavirus at 651-201-3920 or 1-800-657-3903, available 7 a.m. to 7 p.m. There is also a data portal online at mn.gov/covid19.
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S. Erdem Ayta, a professor of political science in the Department of International Relations at Ko University in Istanbul, argues that anger can be a central ingredient in driving voter behavior. He wrote by email to say that an examination of American turnout over 40 years
found that while unemployed people participate in elections at lower rates than the employed in general, the difference between the two groups diminishes when unemployment is high around the election period.
Ayta, who co-authored the 2018 paper Beyond Opportunity Costs: Campaign Messages, Anger and Turnout among the Unemployed with Eli Gavin Rau and Susan Stokes, political scientists at Yale and the University of Chicago, explained the reasons for the varying levels of turnout in his email:
When unemployment is widespread, the opposition draws attention to it in their campaigns and blames incumbents. The unemployed are exposed to messages that stress the governments responsibility for the dire state of the economy. This, in turn, stokes anger among those hit hardest by the economic downturn.
Ayta pointed to the crucial role of aggravated, even enraged, voters in elections:
Anger is a well-known mobilizing emotion, and therefore the angry unemployed are more prone to return to the polls.
While Trump is vulnerable to an aggrieved and angry electorate, there are other emotions at play with the potential to work to Trumps advantage: panic and fear.
In March, Filipe R. Campante, a political economist at Johns Hopkins, Emilio Depetris-Chauvin and Ruben Durante, professors of economics at the Pontificia Universidad Catlica de Chile and Universitat Pompeu Fabra in Barcelona, published a study of the political consequences of an earlier public health scare, The Virus of Fear: The Political Impact of Ebola in the U.S.
The Ebola scare hit the United States one month before the 2014 midterm congressional elections. A total of 11 people were treated for Ebola in this country, according to the Centers for Disease Control; two died.
Campante and his colleagues found that:
Heightened concern about Ebola, as measured by online activity, led to a lower vote share for the Democrats in congressional and gubernatorial elections.
Republican candidates, the three authors wrote, responded to the Ebola scare by mentioning the disease in connection with immigration and terrorism in newsletters and campaign ads, and the strategy proved effective:
Survey evidence suggests that voters responded with increasingly conservative attitudes on immigration but not on other ideologically-charged issues.
In an email, Campante wrote me:
Quite clearly, the GOP is trying to run the same playbook now Chinese virus, Wuhan virus, etc. What the Democrats would need to do to counteract that again, from the pure psychological perspective is to find a theme that resonates with voters and helps them.
As both parties and their candidates seek to turn the pandemic to their advantage, there are potential pitfalls for politicians and political parties that are attempting to court voters during a crisis.
Adam Seth Levine, a political scientist at Cornell and the author of the 2015 book American Insecurity: Why Our Economic Fears Lead to Political Inaction, wrote by email of the dangers of stressing hardship in an effort to mobilize those suffering the most: The suffering, he said, are the ones who are demobilized by rhetoric that reminds them of their own resource constraints.
There are unanticipated adverse consequences to certain strategies, Levine contended: Appealing to material self-interest is self-undermining when it reminds people of what they dont have. It persuades but also paralyzes them by reducing their willingness to spend scarce resources like money and time that are key ingredients of political activism.
In American Insecurity, Levine makes the case that
on issues that reflect financial constraints that people are facing or worry that they could face in the future, there is an identifiable lack of large-scale political participation that (a) is politically consequential, (b) goes against our expectations, and (c) motivates the need to identify heretofore unrecognized barriers to collective action.
Levine maintained that his warnings about generating citizen paralysis also apply to political activism volunteering, working for a candidate, going door-to-door, whenever that can happen again as well as to voting.
The research described in this article has been published on a preprint server but has not yet been peer-reviewed by scientific or medical experts.
Every day for the past few weeks, charts and graphs plotting the projected apex of Covid-19 infections have been splashed across newspapers and cable news. Many of these models have been built using data from studies on previous outbreaks like SARS or MERS. Now, a team of engineers at MIT has developed a model that uses data from the Covid-19 pandemic in conjunction with a neural network to determine the efficacy of quarantine measures and better predict the spread of the virus.
Our model is the first which uses data from the coronavirus itself and integrates two fields: machine learning and standard epidemiology, explains Raj Dandekar, a PhD candidate studying civil and environmental engineering. Together with George Barbastathis, professor of mechanical engineering, Dandekar has spent the past few months developing the model as part of the final project in class 2.168 (Learning Machines).
Most models used to predict the spread of a disease follow what is known as the SEIR model, which groups people into susceptible, exposed, infected, and recovered. Dandekar and Barbastathis enhanced the SEIR model by training a neural network to capture the number of infected individuals who are under quarantine, and therefore no longer spreading the infection to others.
The model finds that in places like South Korea, where there was immediate government intervention in implementing strong quarantine measures, the virus spread plateaued more quickly. In places that were slower to implement government interventions, like Italy and the United States, the effective reproduction number of Covid-19 remains greater than one, meaning the virus has continued to spread exponentially.
The machine learning algorithm shows that with the current quarantine measures in place, the plateau for both Italy and the United States will arrive somewhere between April 15-20. This prediction is similar to other projections like that of the Institute for Health Metrics and Evaluation.
Our model shows that quarantine restrictions are successful in getting the effective reproduction number from larger than one to smaller than one, says Barbastathis. That corresponds to the point where we can flatten the curve and start seeing fewer infections.
Quantifying the impact of quarantine
In early February, as news of the virus troubling infection rate started dominating headlines, Barbastathis proposed a project to students in class 2.168. At the end of each semester, students in the class are tasked with developing a physical model for a problem in the real world and developing a machine learning algorithm to address it. He proposed that a team of students work on mapping the spread of what was then simply known as the coronavirus.
Students jumped at the opportunity to work on the coronavirus, immediately wanting to tackle a topical problem in typical MIT fashion, adds Barbastathis.
One of those students was Dandekar. The project really interested me because I got to apply this new field of scientific machine learning to a very pressing problem, he says.
As Covid-19 started to spread across the globe, the scope of the project expanded. What had originally started as a project looking just at spread within Wuhan, China grew to also include the spread in Italy, South Korea, and the United States.
The duo started modeling the spread of the virus in each of these four regions after the 500th case was recorded. That milestone marked a clear delineation in how different governments implemented quarantine orders.
Armed with precise data from each of these countries, the research team took the standard SEIR model and augmented it with a neural network that learns how infected individuals under quarantine impact the rate of infection. They trained the neural network through 500 iterations so it could then teach itself how to predict patterns in the infection spread.
Using this model, the research team was able to draw a direct correlation between quarantine measures and a reduction in the effective reproduction number of the virus.
The neural network is learning what we are calling the quarantine control strength function, explains Dandekar. In South Korea, where strong measures were implemented quickly, the quarantine control strength function has been effective in reducing the number of new infections. In the United States, where quarantine measures have been slowly rolled out since mid-March, it has been more difficult to stop the spread of the virus.
Predicting the plateau
As the number of cases in a particular country decreases, the forecasting model transitions from an exponential regime to a linear one. Italy began entering this linear regime in early April, with the U.S. not far behind it.
The machine learning algorithm Dandekar and Barbastathis have developed predictedthat the United States will start to shift from an exponential regime to a linear regime in the first week of April, with a stagnation in the infected case count likely betweenApril 15 and April20. It also suggests that the infection count will reach 600,000 in the United States before the rate of infection starts to stagnate.
This is a really crucial moment of time. If we relax quarantine measures, it could lead to disaster, says Barbastathis.
According to Barbastathis, one only has to look to Singapore to see the dangers that could stem from relaxing quarantine measures too quickly. While the team didnt study Singapores Covid-19 cases in their research, the second wave of infection this country is currently experiencing reflects their models finding about the correlation between quarantine measures and infection rate.
If the U.S. were to follow the same policy of relaxing quarantine measures too soon, we have predicted that the consequences would be far more catastrophic, Barbastathis adds.
The team plans to share the model with other researchers in the hopes that it can help inform Covid-19 quarantine strategies that can successfully slow the rate of infection.
Dozens of Australians have lodged workers compensation claims related to Covid-19, prompting fresh warnings that employers must take heed of their employees health and safety during the pandemic.
Experts say employer obligations include ensuring physical distancing and good hygiene practices at workplaces that remain open.
Bosses must also take steps to ensure the wellbeing of employees who have switched to working-from-home arrangements including ensuring they have access to mental health support.
Based on responses from numerous state-based agencies, Guardian Australia is aware of at least 175 workers compensation claims or notifications that relate in some way to Covid-19, although this figure is not exhaustive and the coverage and method of reporting may differ from state to state.
In NSW, the State Insurance Regulatory Authority said it had been advised of 153 claims or notifications related to Covid-19, including 23 where a worker had tested positive to the disease and there was a possibility work was the main contributing factor.
A spokesperson for the authority said 101 cases in the exposure category involved workers who may have come into contact with another person such as a colleague, customer or visitor who was confirmed or suspected of having Covid-19.
Of the remaining Covid-19-related cases in NSW, 17 were linked to mental health, while the remaining 12 were classed as other injuries or diseases.
WorkSafe Victoria said it had so far received nine claims from workers impacted in some way by Covid-19. WorkCover Queensland has so far accepted six claims for work-related diagnosis of Covid-19 five of whom contracted it while on work-related overseas travel, and one while working at a restaurant, according to the Office of Industrial Relations.
Dr Stacey Jenkins, the acting head of the school of management and marketing at Charles Sturt University in Wagga Wagga, said business operators had to meet their existing health and safety obligations and bore a responsibility to support their workers, especially in uncertain, changing times such as the Covid-19 pandemic.
Workers compensation definitely does extend to Covid-19 and employers need to make sure that they prepare and manage that risk in their workplace, Jenkins said.
Implementing physical distancing was the biggest challenge for those still at work, she said.
Jenkins said she was aware of construction and electrical workers who had been split into different teams and rostered on at different times, so that any outbreak could be contained and allow the business to continue operations.
Jenkins said employers should remind workers of the importance of hand hygiene to avoid the spread of Covid-19 and underline the need to stay home from work if they were sick.
The national body Safe Work Australia has called for people to be allowed to work from home where possible, but it noted that employers still needed to do what they reasonably could to manage the risks to someone operating remotely.
It said possible new issues included physical risks from a poor work environment, such as not having a proper workstation, and psychosocial risks such as isolation, reduced social support from managers and colleagues, fatigue, online harassment and family and domestic violence.
Jenkins, who is herself working from home, said an ergonomically safe work environment was important, and isolation could prove very damaging to mental health.
While managers might feel as though making contact with a worker twice a week was enough, staff were also looking for informal methods of communication, she said.
I think thats important and employers have an obligation to just make sure that they are providing them with support where they can, and providing them with other resources such as employee assistance providers or resources such as Beyond Blue.
Safe Work Australia noted that workers who sustained an injury while working from home might be eligible for workers compensation. While the rules differ from state to state, a worker would generally need to prove the injury, illness or disease arose out of or in the course of their employment.
It is not known if any cases gathered by Guardian Australia relate to working from home.
Apart from the 168 claims, notifications or accepted claims reported in NSW, Victoria and Queensland, it is understood there are at least seven cases related to Covid-19 in other states. WorkCover WA has been advised of five Covid-19-related claims, ReturnToWorkSA has received one work injury claim, and Tasmanias Department of Justice reported that one claim had been received by an insurer.
As everyone has been made aware, the coronavirus is a very dangerous virus especially in the elderly and it is unfortunate that the center has had multiple confirmed positive cases. We want to convey our deepest concern for our residents and/or staff who have been diagnosed positive for coronavirus; our thoughts are with them and their loved ones at this challenging time. Our center leadership and staff continue in their vigilance to keep our residents and staff safe taking significant measures to limit the spread of the COVID-19 virus. The safety of our residents and staff is paramount. As a proactive and preventative measure, the facility management initiated testing residents with symptoms for COVID-19. Once notified of testing results, residents with positive tests will continue to be monitored at the centers designated observation unit unless the physician orders them to be transferred to the local hospital for further care and services. We thank our local hospital systems for their service in providing excellent care and aid to our residents and our continued partnership. The center has also followed protocol by communicating with all residents and their responsible party by notifying them once the center had an individual that was confirmed positive for COVID-19.
As Covid-19 sweeps across the world, health care workers have become prime victims of it, accounting for up to 20% of cases in the U.S. Infections and deaths among physicians, nurses, and support staff are straining the ability of hospitals to respond to the disease. The very people who are taking care of patients are becoming patients themselves and spreading the virus to others, including to their own families.
I feel like were all just being sent to slaughter, Thomas Riley, a nurse at Jacobi Medical Center in New York, told The New York Times. Riley and his husband both contracted the virus. At this scale, current efforts to protect health care workers from infection simply cant be effective, especially with equipment shortages.
The age of the health care workforce is a problem. More than half of physicians are over age 50, and the average age of a nurse is 51 putting them at risk of severe manifestations of Covid-19. So far in New York, patients in their 60s were 37 times more likely to die than those in their 20s.
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And yet states are imploring older health care workers to fill hospital ranks to fight Covid-19. New York City, Connecticut, and Alabama, for example, have special initiatives to recruit retired medical staff. The Wall Street Journal highlighted a 60-year-old retired nurse who returned to help battle Covid-19 despite having to return each evening to her husband, a cancer survivor. The New York Times profiled seven retired doctors and nurses heading to hospitals to reinforce systems in crisis around the country. Their average age? Sixty-seven.
While the dedication of older health care providers is admirable, these plans are short-sighted. The odds that these retired health workers will become infected, pass the virus to family and friends of similar age, and together rapidly add to the hospital burden is high.
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Instead of sending older workers into the fray, we need to deploy virus fighters who are less likely to die or get very sick. We also need a two-layer system of medical quarantine, not just for the patients themselves but also for the people who are treating them.
There are two rich sources of workers with less risk of becoming seriously ill: the thousands of individuals who have recovered from infections and thus have antibodies that provide immunity, and healthy members of the military under age 30.
Mobilizing large numbers from these groups can help hospitals care for patients and can staff alternative care facilities such as field hospitals, repurposed hotels, and empty college dormitories where patients with milder illness are isolated and treated. These health workers could live in the same alternate care facilities or be isolated in nearby buildings.
The military is already playing a role in fighting the Covid-19 epidemic but, with the exception of hospital ships that have taken a limited number of patients, that role has mainly been logistical. There arent enough military medics to take on these tasks. What we are advocating is training young members of the military to assume positions in isolation centers and assist in hospitals so they can relieve doctors and nurses for more important work, reduce their cumulative exposure to infection and allow them needed time to rest.
Theres no question that military men and women would be assuming a risk by doing this, but it is a far lower risk than when they are deployed abroad or even training on U.S. bases. Some will get sick and recover and join others with immunity, who can work without the protective gear needed to protect older and disease-nave doctors and nurses.
Service members already work and live in communal units, and so would be used to isolation in alternate care facilities or dorms. Community volunteers with immunity need not be quarantined. If at all possible, quarantine quarters should be provided for current hospital staff caring for the sickest patients to support them and protect their families.
China, which moved thousands of health workers from around the country into isolation centers in Wuhan, has demonstrated how successful this kind of two-layer patient and caregiver quarantine can be.
The media, politicians in fact all Americans have been lauding the courage of hospital staff. But praise is not enough. As much as possible, we must keep them out of harms way while making it possible for them to continue to provide life-saving care. Lets let the military and immune volunteers come to the rescue.
Bruce E. Wexler, M.D., is professor emeritus of psychiatry at the Yale School of Medicine and a winner of the NIH Directors Award for high innovation. James K. Glassman, former under secretary of state for public diplomacy, advises health care companies and nonprofits.
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COLUMBUS, Ohio (WJW)-- Ohio Gov. Mike DeWine, Lt. Gov. Jon Husted and Health Director Dr. Amy Acton held their daily news conference on the coronavirus outbreak at 2 p.m. Wednesday.
As of Wednesday afternoon, there were 7,628 confirmed cases of COVID-19 and 163 probable cases for a total of 7,791 in the state, according to the Ohio Department of Health. The virus resulted in 2,237 hospital admissions with 677 in the intensive care unit. In Ohio, 361 have died.
DeWine announced he's expanding the state's partnership with Columbus-based company Battelle. Starting Friday, local law enforcement and EMS agencies can bring their packaged masks to any Ohio State Highway Patrol post, who will take them to Battelle for sanitizing. Agencies can pick up the masks at the OSHP post.
DeWine said there is a critical shortage around the globe of COVID-19 test kit components, including swabs and the solution needed to transport the swabs. Ohio State University's Wexner Medical and Ohio State worked with a national group to design 3-D printed swabs. The first order of 15,000 will be delivered to Ohio State. The governor said 200,000 swabs and swab kits will be shared with the Ohio Department of Health and the state's hospital systems by the end of April.
There were two additional COVID-19-related deaths at Pickaway Correctional Institution. DeWine, who's been trying to reduce the state's prison population to allow more social distancing during the outbreak, said he approved the early release of 105 inmates. Those convicted of sex offensive, homicide, kidnapping ,abduction, ethnic intimidation, making terroristic threats and domestic violence were not eligible, as well as those previously denied early release. Ohio's prison population dropped by 311 inmates last week.
