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There are now 13 states with at least 1000 cases:
1. NY 33013
2. New Jersey 4402
3. California 3158
4. Washington 2588
5. Michigan 2295
6. Florida 1977
7. Illinois 1865
8. Massachusetts 1838
9. Louisiana 1795
10. Georgia 1387
11. Texas 1155
12. Pennsylvania 1127
13. Colorado 1086
Lockdowns vary. In NY people > 70 must wear a 😷 in company of others. NJ has broad protections for religious/political events. In California it’s effectively a crime to socialize outside of the home. Washington state’s “stay home” order expires April 6. Michigan’s ends April 14.
Louisiana “stay home” order ends April 13. Georgia requires high-risk patients to be indoors. Texans are banned from nursing homes unless providing critical assistance. Pennsylvania closed “non-life-sustaining businesses.” Colorado just issued stay-at-home order through April 11.
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Matt McCarthy
@DrMattMcCarthy
Best Practices (cont): 1. Some doctors report "shortness of breath" is an unreliable symptom to track with #coronavirus. Hospitalized patients may not sense hypoxia; more useful to follow oxygen saturation with pulse oximetry. Takeaway: Do not waste precious time on this symptom.
2. Minimize testing for influenza & other respiratory viruses when flu-activity is low (like right now). Helps conserve limited number of swabs & testing media. Exceptions include: 1) immunocompromised and 2) cluster of respiratory illnesses within a unit (e.g., neonatal ICU).
3. We are using a peer-support system for frontline healthcare workers. Doctors are paired up & make an effort to talk (or text) several times/week. It has been tremendously helpful for processing raw emotions and offering reassurance. I highly recommend it.
Read 3 tweets
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Matt McCarthy
@DrMattMcCarthy
Briefed ethicists on #coronavirus. Most agree we should not allocate resources on first-come, first-served basis. So do we try to save the most individual lives or give priority to patients likely to survive the longest after treatment? Key question: How do we maximize benefit?
Example: In the setting of scarce #coronavirus vaccine, should we prioritize inoculation of older patients because COVID19 outcomes are worse in this group? Or prioritize young people because it may be better way to limit spread of the virus? Or should we just use a lottery?
New paper in @NEJM provides some guidance. Authors argue we should: 1) apply the same principles to all #COVID19 & non–Covid19 patients; 2) be responsive to evidence; 3) give priority to research participants & frontline healthcare workers. nejm.org/doi/full/10.10…
Read 3 tweets
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Matt McCarthy
@DrMattMcCarthy
Update: Gilead has suspended access to the experimental drug remdesivir due to “overwhelming demand.” It is now only available through clinical trials at select sites. My hospital is one of them. Here’s how our trials are designed. I am an investigator on these phase 3 studies.
First trial is for severe disease, defined as 1) laboratory-confirmed COVID19 2) fever 3) abnormal chest x-ray and 4) oxygen saturation < 94% on room air. All patients receive remdesivir: 200mg IV loading dose, followed by 100mg IV once daily. 1:1 randomization to 5 days or 10.
Exclusion criteria: mechanical ventilation, multi-system organ failure, other experimental agents, including hydroxychloroquine in the past 24hrs.
Read 5 tweets

Related threads

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Daniel Sinclair
@_DanielSinclair
"Who wants to go to the dentist or the hospital during an outbreak if a visit isn’t necessary? Yet health spending is 17 percent of the U.S. economy — more than triple the proportion spent in China."
"Agriculture, a sector not noted for day-to-day social interaction and so potentially less harmed by social withdrawal, is a 10 times larger share of China’s economy than it is in the United States."
"For all the talk about the global 'supply shock' set off by the coronavirus outbreak and its impact on supply chains, we may have more to fear from an old-fashioned 'demand shock' that emerges when everyone simply stays home."
Read 3038 tweets
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Daniel Sinclair
@_DanielSinclair
The cliché cover photos have even become a meme of sorts for Asian Americans and westerners, with people from many backgrounds throwing their hat into the ring with corona aesthetic ™
Last Monday, a young Singaporean man — Jonathan Mok — was assaulted in an unprovoked hate crime on Oxford Street in London. The men reportedly yelled “I don’t want your coronavirus in my country.” theguardian.com/uk-news/2020/m… Image
I don't know why the man in Flushing collapsed, but he doesn't look much older than Jonathan Mok, and as we approach this pandemic, I am given a little hope in that — unlike China's lifeless pariahs on the streets — people came to help in America. ImageImage
Read 3004 tweets
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Bloomberg Opinion
@bopinion
🇺🇸New York, California and Illinois have been hemorrhaging residents.

Almost 3.2 million more people left those states for elsewhere in the U.S. than arrived from other states from 2010 through 2019. Where are all these people going? trib.al/HpJEZQE
👶🏼Thanks to 2 million more births than deaths and 1 million newcomers from other countries, California’s population still grew by 2 million over this period.

New York's population grew only slightly, while Illinois lost an estimated 159,751 people trib.al/HpJEZQE
🚚Here's where people are leaving New York for.

The adjusted gross income of New York taxpayers who didn’t migrate averaged $88,940, 2012-2018.

Those who left for Florida, New Jersey, California and Connecticut made more money than that trib.al/HpJEZQE
Read 9 tweets
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MissMAGA2016
@MissMaga2016
Here's another Democrat who is a candidate of people who would make BIG money from the #GreenNewDeal.

#GreenScam #JayInslee
The SUPER PAC that is backing Inslee is "Act Now on Climate."

So far, they've been primarily targeting #Texas, New York, California, #Iowa, and #Florida with ad buys.
Act Now On Climate PAC is run by former #Democrat operative Corey Platt. who was also the former political Director of the Democratic Governors Association.

Jay Insless also CHAIRED the Democratic Governors Assn in 2018.

Another web of corruption.

politico.com/story/2019/02/…
Read 10 tweets
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Steve Herman
@W7VOA
Possible hostages inside a grocery store in Los Angeles, #California.
Live coverage:
Scant official information so far from @LAPDHQ:
Read 14 tweets
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sevvie Rose
@sevvierose
(1) The #California Legislature is panicking tonight. They're currently presented with a watered-down #ConsumerProtection bill that would require tech companies to disclose the data collected on users, and delete the data collected on them at request. leginfo.legislature.ca.gov/faces/billNavC…
(2) This bill poses a huge threat to the profits of FAANG corporations, and it poses a threat to the companies who rely on this data to sell advertisers and political groups analytics on prospective consumers/voters.

Why is it such a problem, though?
(3) The #CCPA is actually quite milquetoast, as it's written now. But if they don't pass this bill, California has a much bigger problem coming for them in November: the will of the people.
Read 18 tweets

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