Pbmom's Blog

How US Companies Will Profit Off this Public Health Crisis

Today I had to run down to the Texas Medical Center to see my rheumatologist.  For those of you who don’t know me or don’t know my history, I am on immunosuppressants.  I was curious to see what was going on in the heartbeat of Houston’s best and finest.  Not a damn thing different.  No one was pushing the elevator buttons with their Kleenex; no visitors were washing their hands any better in the restroom.  It was reassuring. 

Before I left to go down there (which is like a 4-hour commitment for me), I saw a segment on my favorite local TV station, Fox 26 Houston, about myths people were writing about COVID-19 and the facts.  I thought that might make a great blog for today.   The mayor’s FB page is RICH with misunderstandings (the one I found the other day, in fact, how a coronavirus test can be positive without it being the China version).  Then when I got home, I saw a post from a friend Michael, from another local news station about a 70-year-old man in Fort Bend County (which is southwest of downtown Houston) who they are certain is positive for COVID-19 (just got back from an extensive overseas trip), and they were awaiting confirmation. 

But then I saw why the stock market was rallying today:  Greedy bastards with their tongues hanging out who plan to profit off this horrible public health crisis.  Read below about the involvement of private companies like Quest Laboratories.  Don’t be surprised if you get the $3000 bill that your insurance won’t cover should you need a test.  Osmel Martinez Azcue had returned from China to Miami.  He was worried about the coronavirus.  Jackson Memorial Hospital told him he needed a “CT scan” to see if he had this.  He said he would have to pay out of pocket for this so asked for a flu test first, which they did, which was positive.  He later received a bill for a test for the flu for $3200 plus the small amount of time someone was saw him in the ER.  I’m glad he didn’t have a CT scan because that could have been $20,000 or more.  Mine was $30,000 for a different thing.  Once you send this out to for-profit companies, you are going to see the internet light up with people taking pictures of what they were billed for the test.  And Quest is an outpatient facility.  Do you really want to sit next to someone coming in to get tested for COVID-19 and you don’t know it?  They obviously haven’t really thought this through.  Hospitals have their own laboratories. 

Later I saw a news conference. I will have to say that Dr. Deborah Birx, the Obama appointee who VP Pence put in charge of the virus effort, after Trump put him in charge of it, was making VP Pence look pretty competent.  As he is talking, you see her in the background nodding her head (as if she herself wrote most of those talking points…up to a point…then her nodding stopped…until he said, “whole of America approach.). 

All my comments will be in bold italics.  

VP Pence:  “All state laboratories and all university laboratories at the state level can conduct coronavirus tests without any additional assets or resources from the federal government.  They have the FDA approved test; they can conduct the test all across the country in all the states.”  (Hmmm.. Does he mean that FDA/CDC flawed test or have they fixed the flawed test? He doesn’t say).  VP Pence continues: “Beyond that, as we announced, through the efforts of HHS, 2500 kits of tests are going out this week… (then he corrects himself) …2500 kits including tests has gone out this week, that’s roughly 1.5 million (WHICH IS ABOUT THE POPULATION SIZE OF PHILADELPHIA).  VP Pence continues: “A test that will available this week, we will continue to build on that number.  But perhaps most significantly, thanks to Dr. Birx’s effort and leadership, we brought together today at the White House the leaders of all of the largest commercial laboratories in this country, companies like Quest who have vast capabilities, logistic and testing capabilities, and we were pleased to report today that they have created a consortium to share information and to share resources and literally have told us that as they go through what is called the validation process on testing that by next week individual companies will be able to do, as they said to me, thousands of tests of coronavirus if they are needed and are required and many many multiples more of that in the not-distant future.  Our objective here is Dr. Birx raised with the task force is we’ve got hospitals in affected areas and those are requesting they have kits.  We’ve got universities and state labs that now can perform the test on a requested basis.  But our objective ultimately, and as quickly as possible, is to have tests made through these commercial laboratories (cough, cough – for profit – your dime), and commercial providers that your local doctor, your CVS (okay so Minute Clinic might have COVID-19 patients now, or will pharmacists be doing that along with vaccines—unless they are thinking of drive-through like South Korea has with hazmat suits??), your Med-Check is able to have coronavirus tests.  That isn’t there yet.  We are working to make that a reality but again it is one more example—its not just a whole of government approach—it’s a whole of America approach (until you get the bill & their profit in a big way or bankrupt a whole family who has to get tested especially if they have no insurance).   Whether it be our nursing home industry or it be our airline industry or whether it be our commercial laboratories, I can (he stutters for a minute) on behalf of President Trump and our entire task force when I say we are profoundly grateful for the spirit—this being reflected by the companies all across the United States of America, grateful for the leadership at the state level, and the American people should be confident (in your pending bankruptcy) that that spirit of partnership is going to continue to drive this at every level as we work our way through dealing with the coronavirus in the United States.   End of VP Pence’s speech. 

Then they were going to let Dr. Birx speak but the segment was interrupted. 

So, there we are—how America will be profiting off this public health crisis. 

The CDC is still showing their incompetence.  This is what their website shows today.  The correct amount is 152 confirmed cases.  Even if they were just going by YESTERDAY’S (March 3) TOTAL, that one was 118 confirmed cases.  ARGGHHHHHHHHHHHHHHHHHHHHH!!!!

And the tally updates: 

There are now 80 countries with some level of confirmed cases.  There are now 152 cases confirmed in the United States (remember, not that there were more infected, but more are just testing positive).  This information was valid as of 10:43 p.m. Eastern Time on March 4. 

All countries on the list have still seen a rise in confirmed cases, the most still being China.  Today, countries not having new confirmed cases (that doesn’t mean there aren’t people infected, just that they don’t have updates in their confirmations) were:  Afghanistan, Armenia, Argentina, Azerbaijan, Cambodia, Canada, Chile, Denmark, Dominic Republic, Egypt, Finland, Georgia, Gibraltar, Indonesia, Jordan, Kuwait, Latvia,  Lebanon, Liechtenstein, Lithuania, Luxembourg, Macau, Mexico, Monaco, Morocco, Nigeria, Nepal, Pakistan, Philippines, Qatar, Republic of Macedonia, Romania, Russia, Saint-Barthelemy, Saudi Arabia, Singapore, Sri Lanka, Taiwan, Tunisia, United Arab Emirates, Ukraine, and Vietnam. 

New to the list are:  Estonia, Faroe Islands, French Guiana, Hungary and Poland.

Super Tuesday sucked the oxygen out of the COVID-19 talk which I think is really a good thing for us.   Today Dr. Irwin Redlener, Director of National Center for Disaster Preparedness said, when someone said the word ‘epidemic:” “Actually we have been in a pandemic for some period of time.  This is a pandemic, so pussyfooting around that is not helping anymore.” 

What are you doing (or not) to get ready for possible self-quarantined states? Are you changing your travel plans at all? Has your employer given you a plan yet? I’m interested so let me know in the comments.

Today another case popped up in New York and it appears to be the first “community spread” case in the state.  The man in his 50’s was hospitalized in severe condition.  Nothing in his travel history suggested any direct connection to China or any countries on the watch list.  He had no travel during the [supposed] 2-week incubation period.  His severe symptoms became noticeable at the end of last week, but he had respiratory issues for the last month [which makes me think they may need to rethink their incubation period time as he had been in Israel where 12 people are now testing positive and to Miami, Florida].  He has two sons with a NYC connection.  Both sons are now isolated at their home.  Four schools the one son is associated with are all now closed.  The other is an undergraduate student; he has not been on campus since Feb 27.  Both boys are now isolated at home.  The place of worship of the ill man has been notified.  They have suspended services for the foreseeable future.  Some of the members have been ordered to self-quarantine due to possible exposure. 

Five additional COVID-19 cases are still under investigation.  The state of New York is also testing two families in Buffalo who recently returned from Italy.  They are being tested and are quarantined.  SUNY schools plan to send home students who are studying abroad in countries with high prevalence of the virus.  The state public health laboratory is teaming up with hospitals with a goal of ensuring the state can handle up to 1,000 tests per day.  Governor Cuomo said that New York will institute a new cleaning protocol at schools and in the public transportation system. 

There are now 76 countries who are dealing with COVID-19.  There are now 118 identified cases in the United States; 9 people in the United States have died.  The charts were updated 11:50 p.m.  Most of the countries on the list have increased both in numbers of confirmed cases and deaths, although for some their death totals have not changed.  San Marino and Spain both had their first casualties of the virus. 

Several countries have no new confirmed cases to report (but that usually changes as they get their testing processes straightened out):  Afghanistan, Algeria, Armenia, Azerbaijan, Belarus, Brazil, Cambodia, Dominican Republic, Egypt, Finland, Georgia, Greece, India, Indonesia, Jordan, Lebanon, Lithuania, Luxembourg, Macau, Mexico, Monaco, Nepal, New Zealand, Nigeria, Philippines, Russia, and Vietnam.

New countries who have had people test positive for the disease are Argentina, Chile, Gibraltar, Latvia, Liechtenstein, Morocco, Saint Barthelemy, Sri Lanka, North Macedonia, Saudi Arabia, Tunisia, and Ukraine. 

Coronavirus (COVID-19) Update March 1, 2020

Hand sanitizer is gone.  My sister, who is a nurse, warned me this weekend it was probably gone by now.  I told her we weren’t going specifically for that; we were going to do early hurricane supply run.  After all, hurricane season starts June 1. 

We aren’t panicking; we are being practical.  If we don’t use the supplies we had planned to get yesterday, they will last well past hurricane season this year.  We viewed it more as “we’re doing our hurricane supplies shopping 3 months early.”  No one else was panicked in the store, but you could tell the tone was different with some people; some people it seemed that was just doing their normal Sunday shopping.  We were going up and down the aisles to be sure we didn’t miss anything we needed that might not be on our list, like toothpaste for Jeff (while not a hurricane supply, he actually needed it).  We turned our head and I nodded to my right; I said to him, “sanitizer is gone.”  I told him no worries! I had cleaning hacks we could use to get around that:  Essential oils work.  So do bathroom and kitchen wipes.  Just grab a few before getting out of the car (making sure the lid closes—he forgets to do that part of it at time—and stick it in a snack Ziploc bag that would easily fit in his front pocket and will keep his pants dry. 

Here is what I learned today about COVID-19

HOW IT IS SPREAD:   It is spread from person to person.  Between people who are in close contact with one another (within about 6 feet).  Through respiratory droplets produced when an infected person coughs or sneezes.

WARNING SIGNS:  Fever, cough, shortness of breath.  It will occur 2 days to 2 weeks after exposure. 

DIFFERENCES BETWEEN THE FLU AND COVID-19:   The flu:  Transmitted through respiratory droplets of an infected person.  There is a vaccine available (their best estimated guess based on the past and possible one for the upcoming year; they aren’t always right about that second part).  There are 1 billion+ cases worldwide; there are 291,000+ related deaths.  The average rate is about 0.1% (so one-tenth of 1%). 

COVID-19: “May” also be an airborne virus.  No vaccine available.  86,000+ cases worldwide; 2900+ related deaths.   In the February 18 China CDC Weekly, they were putting the death rate at 2.3% on Mainland China.                              

According to Dr. Natalie Azar, masks on your face will not work.  The ones you are seeing that people can just snap on will not filter the viral particles that you can.  There are N-95 masks that are made for healthcare workers only at this moment.  Yes, you could buy them on line but the CDC are asking people not to do this; it will create a shortage and they are needed to first responders and healthcare workers.  The vast majority of people, says Dr. Azar, are not at risk of being exposed currently and the vast majority may just have an experience of a mild illness. 

The Life Care Center in Kirkland, WA

The first patient to first exhibits signs and symptoms of this virus was 6 weeks ago.  Yep.  Six weeks.  A worker and a resident have tested positive.  There are 288 staff and residents there.  There has been no travel as far as they know, but they are doing their protocols right now.  I did this for a friend to help them understand the contacts problem.  The CDC measure that each person will encounter 1.5 to 3.5 people close enough to spread something (some more and some less, but an average). 

As of March 1, six people infected with 288 total of people who may turn up positive once tested.  A resident of the facility died of the virus and three more are in critical condition.  Let’s just go with the 2 individuals we know about and just say they are patients zero—which they aren’t but the math has to start somewhere: 

1 person x 3.5 contacts = 3.5 (4) people exposed

3.5 people x 3.5 contacts = 12.25 (12) people exposed

12.25 people x 3.5 contacts = 42.875 (43) people exposed

42.875 people x 3.5 contacts = 150.06 (150) people exposed

150.06 people x 3.5 contacts = 525.21 (525) people exposed

525.21 people x 3.5 contacts = 1838.235 (1838) people exposed

1838.235 people x 3.5 contacts = 6433.8225 (6434) people exposed

Now these people have had symptoms for 6 weeks.  You can’t use the last number and figure it out because they exponentially get higher as every day passes.  BUT, we can multiple 288 people in that facility and over 7 days, the total number of people exposed comes to 1,852,972 people.  In a week.  Of course, some of the contacts will be similar contacts (like a daughter who visits every day).  This is just an illustration of how things can multiple out of hand pretty quickly. 

One quarter of the firefighters were in quarantine on Sunday because they had been to that nursing facility.  The hospital has asked visitors to stay away.  A nearby college campus spent the day cleansing its campus because students had visited that nursing home. 

King County earlier on Sunday announced two additional cases of COVID-19 that were unrelated to the nursing home and those patients were in critical condition at hospitals in Seattle and Renton. 

MAPS AND UPDATED INFO

The map says the US has 88 cases; the detailed breakdown by country only says 87.  The map was updated shortly after midnight on 3/2/2020; the detailed breakdown was created at 10:15 p.m. on 3/1/2020. 

As far as the world totals, all countries showed increases in their totals except for Afghanistan, Belarus, Brazil, Cambodia, Estonia, India, Japan, Kuwait, Lithuania, Luxembourg, Macau, Monaco, Nepal, New Zealand, Nigeria, North Macedonia, Oman, Pakistan, Philippines, Romania, Russia, Thailand, Vietnam, and UAE. New to the list included Armenia, Czech Republic, Dominican Republic, Ecuador, and Ireland.

The chart below was updated at 10:15 p.m. March 1, 2020

Coronavirus (COVID-19): Where We Are Worldwide Feb 29, 2020

As of Friday evening, the US has only tested 460 people. South Korea has run more than 35,000 tests (see more about their drive-through testing process). The test the CDC developed was defective; the labs running the tests are not confident with the results. Now the state of New York is going to be making its own coronavirus test after the CDC’s has repeatedly failed.

The first person, as far as we know, who died of coronavirus in the United States: Dr. Robert Redfield of the CDC said the person had no known travel disease. The only one in Washington State with no known travel history was a teenager. Trump said, in the same conference, that the person who died was a woman in her 50’s that was medically high risk. Will you all PLEASE GET YOUR MESSAGING STRAIGHT? We don’t have much confidence in your handling in this if you can’t get your stories straight in the same news conference. Deepest sympathy to the family and friends of that individual. (Update 3/1:  The person who died was a man in his 50’s).

How is the rest of the world handling this:

According to Kaiser Health News:

South Korea: There were 28 cases of the coronavirus in South Korea on Feb. 13. Four days had passed without a new confirmed infection. President Moon Jae-in predicted that the outbreak would “disappear before long,” while the prime minister assured people that it was OK not to wear surgical masks outdoors.

As it turns out, the virus had been rapidly spreading at the time through a large, secretive church in Daegu, where it has since mushroomed into the largest epidemic of the coronavirus outside China, with 2,022 cases, including 13 deaths.

Now the president is facing a political backlash over his response as the number of cases continues to climb — 505 new infections on Thursday alone. One million South Koreans have signed an online petition for his impeachment.

BUT: From inside their cars, people can be checked by medical staff in protective clothing and goggles who will lean in through the window at a new drive-thru coronavirus clinic in South Korea. The entire procedure took less than 10 minutes. One individual tested said this was easier than the 1-hour wait at a clinic. (1-hour wait???—let that sink in for all of America who can count on a 6-hour wait during normal hours with no epidemic in any ER of any hospital in this country).

Japan: Apparently closing the schools in Japan shocked parents after weeks of bungling their response to this virus.

USA: We already know that the uninfected people on the cruise ship were placed onto a plane with infected people on the same cruise ship by the Trump administration over the deep objections of the CDC. And thanks to the whistleblower in HHS, we found out that they were allowed to move freely on and off the bases [with infected people on site] and at least hotel and leaving California on a commercial flight. They were visiting Travis Air Force Base. The Safety protocol training did not happen until 5 days after their assignment.

Then we got word that a woman with no known travel history got the virus. Guess where she was living? In the same county as Travis Air Force Base. She was first treated at a hospital 15 minutes from Travis Air Force base. You can bet that infection occurred when someone who was unprotected from that HHS group went into the general public and crossed paths with this woman.

On Thursday, point man VP Pence was in Florida at a $25,000 a plate fundraiser for congressional Republicans and on Friday repeated a Rush Limbaugh theory that the coronavirus was like “the common cold.” It is NOT.

A woman in Florida went in to get the coronavirus test; she had insurance; her insurance refused to pay it; it was $3000. This is a public health crisis; no one should be getting any bill.

Myths and Facts

Myth: This is just like the flu.
Truth: The symptoms are flu-like, but the mortality rate is 15-20 times higher than the flu. (per Dr. McCarthy)

Myth: Trump keeps repeating that there are only 15 cases.
Truth: As of last night, there were 62 confirmed; according to Dr. Matt McCarthy there are probably a lot more infected that just don’t know it because we aren’t testing in mass volumes.

Myth: Trump says it will disappear like a miracle in April.
Truth: That is not what the CDC expects.

Myth: Trump is saying that this is a conspiracy by the Democrats to take his presidency down; that its another hoax.
Truth: This affects everyone; this virus isn’t going to ask your brain what your party designation is. It’s up to his administration to show leadership competence or not. Competence would probably get him re-elected; incompetence will most surely seal his fate otherwise.

The world and of the US updated Feb 29, 2020

COVID-19 (Coronavirus) Update Feb 28, 2020 as of 11 p.m.

The first COVID-19 cases have now been reported in Belarus, Lithuania, New Zealand, Nigeria, The Netherlands, and Mexico. Japan’s Hokkaido (one of the main islands) declares a state of emergency. Switzerland bands all events over 1,000 people. Kenyan medical personnel are taking charge of border crossings. In the US, the official count of infections stands at 60 as of this morning, but once again, they believe the numbers are much higher as people are likely thinking they have the flu as they share similar symptom presentation. (Has anyone told Trump yet that Dr. Birx, an Obama appointee, is leading the task force now and reporting to Pence who is supposed to be leading the task force?)

Trump was at a rally in South Carolina on Friday saying that this is all a Democratic hoax. You can understand then when the mixed messaging from the administration makes the stock market react, or maybe you can’t because you don’t care; remember that people’s 401K’s are tied to the stock market.

While putting this blog together, the news came through that San Antonio, Texas has 11 confirmed cases of coronavirus in San Antonio.  Those infected with the coronavirus, per the CDC, included 9 from the Diamond Princess cruise ship, one from the Wuhan group of quarantined passengers and one that was transferred from the Marine Corps Air Station Miramar in San Diego, CA. One-hundred-forty-five people remain under quarantine in San Antonio after two planes—one from Wuhan and one from Tokyo—arrived at Joint Base San Antonio Lackland. Ninety people from Wuhan were released after clearing quarantine without contracting the virus. Two of those infected were part of the group that came from Wuhan.

An HHS Whistleblower has now come forth (seeking immunity from repercussions) alleging that the workers met with the first evacuees from China’s Wuhan Province without proper training and without proper infection control or appropriate protective gear. [I apparently know more about infection control than an HHS person with any common sense should have known—I spared my entire family from my bout with the flu in January that lasted 2 weeks. Also when I had surgery and my husband had to change my bandage on my spine, I watched him and every time he broke sterile precautions, he was made to start at the beginning (for example, he would put on gloves, but then touch the sink top, or scratch his face, or blow into his glove to get it on his hand. He got really good after we went through a whole box of gloves the first few dressing changes).] Also, VP Pence is controlling all messaging about the virus which includes health officials. Yes, be suspicious about this. I noticed that on all the channels I was looking at that if someone from the CDC was talking on the news, they spoke their minds. That should reassure you AND make you trust what is coming from them and no others.

My favorite infectious disease doctor, Dr. Matt McCarthy of NY-Presbyterian Hospital and author of the book “Superbugs”, was on a news segment today. The question was asked, “What’s changed since? [he had spoken last].” He said, “A lot has changed. Two days ago, I was here saying we’ve got to focus on testing. Now we have to focus on three things. We have to focus on these drug shortages. That’s the big news going on right now is that what people don’t realize—your viewers may not realize—is when they put a pill in their mouth there are a number of different compounds inside that pill. There is only one that really matters. That’s called the API (active pharmaceutical ingredient). A lot of those APIs are made in China and if we cannot get that API we can’t get to your drug and we’re just starting to see the tip of the iceberg with this. There is the first coronavirus-related drug shortage in the United States. That’s a big problem. And I’m going to say, it’s not just the APIs. We also have to worry about medical devices. We’ve got a whole lot to be worried about. I know we have this Task Force that’s coming out and saying, “Don’t worry; everything’s fine.” Well I can tell you things are not fine.”

How badly did Trump sabotage America’s coronavirus response? Efforts included reducing $15 billion in national health spending and cutting the global disease-fighting operational budgets of the CDC, NSC, DHS, and HHS. Neither the NSC nor the DHS epidemic teams have been replaced. Trump said it is no problem; he can get them back whenever he wants them. Can he? The answer is “no” he can’t. In previous administrations people in these agencies would work with and respond to health crises for long periods of time which is essential for a team to work efficiently and trust one another. Drills were done all the time for different case scenarios, much like a fire drill, or sadly active shooter drills, to work out problems when the emergency doesn’t exist so you aren’t having to take time out to fix problems while time is of the essence.

Will this get significantly worse? Dr. McCarthy states (to a question if the numbers are going to get higher): “Absolutely and it is spreading. We aren’t testing at full capacity. We are starting to roll out tests. We are getting more people done.” The interviewer interrupts and says, “So people who are walking around this building who don’t feel so well, and they have it?” Dr. McCarthy responds: “Absolutely; that is a possibility. The concern I also have is that the people who are getting tested, it is a tremendous delay. There is somebody in New York City we think who might have coronavirus. We can’t test them in this city. We send the test to Atlanta, to the CDC; that’s an unacceptable delay. We’ve got to fix that. When you see the testing change to where we can test, at the bedside, which is called point of care diagnostics, that’s when we can actually start to have some certainty about what’s happening. That’s when we are going to start getting real numbers, that’s when the markets are going to stabilize, but until then it’s going to be a guessing game.”

The interviewer asks: “What are the symptoms?” Dr. McCarthy responds: “It’s much like a flu-like symptom. So, you have a runny nose, fever. You’re on the subway and somebody sneezes on you this could ABSOLUTELY spread like crazy. And so, when you have the administration censoring experts, people like Tony Fauci, who is the most respected infectious disease doctor in the country. When I wrote my book, “Superbugs” the first doctor I quote in that book is Tony Fauci. He is no longer allowed to speak freely. He has to clear every scientific statement with Mike Pence and it should be the opposite. Mike Pence should have to clear statements with Tony Fauci and that has to change.”

The interviewer asked what can the media be doing better do to prepare for this: Dr. McCarthy responded: “Asking tough questions.”

Interviewer: “To whom?” Dr. McCarthy: Number One Mike Pence—the buck stops with him. We’ve established the chain of command. I think Trump did the right thing by saying ‘here is the process; I’m putting this man in charge.’ We need to hold his feet to the fire and say 1) drug shortages, medical devices—what’s happening with these things.”

The interviewer: “Your average person doesn’t have access to the Task Force or Mike Pence but you know what they have access to? Social media. Their Facebook page. We already know there is so much disinformation. As it relates to medicine, how do people protect themselves at a time when—the situation around corona for anyone there are more questions than answers, and no doubt people’s Facebook feeds are filled with stuff.”

Dr. McCarthy replies: “What I always say I would never get my medical advice from a stockbroker. I would not go to somebody who is thinking about the stock market or thinking about viewership to get their medical advice. You want to go to medical professionals. I don’t wake up every morning thinking how the markets are going to fluctuate. I’m thinking about how do we to contain this pandemic. And the key here is to get reliable information and it is a mistake to tune into these cable news shows to try to sensationalize things and that’s the problem we have right now.