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Lottie is a pretty female yellow Lab mix! She came in with her sister, Amelia, on February 25th after their family abandoned them. They can go home together, but it’s not required. So far Lottie seems to like other dogs since being at the VHS! Her adoption fee is $110 and includes her spay, microchip, vaccines, and more. Contact Vanderburgh Humane at (812) 426-2563 or adoptions@vhslifesaver.org for details!
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Health Department Updates COVID-19 Case Count
INDIANAPOLIS —The Indiana State Department of Health (ISDH) today reported four new presumptive positive cases of COVID-19, bringing to 19 the number of Hoosiers diagnosed through ISDH, the Centers for Disease Control and Prevention (CDC) and private laboratories.
The new cases involve residents of Hamilton and Marion counties and have been included on ISDH’s online dashboard at https://www.in.gov/coronavirus/. Eleven counties now have cases. The dashboard will be updated daily at 10 a.m. Cases are listed by the county of residence.
Additional updates on the state’s response to the COVID-19 outbreak will be provided later today.
Longtime health reporter Charles Ornstein says that comparing the novel coronavirus to the flu is dangerously inaccurate. Not one public health expert he trusts has called that comparison valid. Here’s why.
As a longtime health care reporter, the unfolding coronavirus pandemic represents everything I’ve read about — from the early days of epidemiology to the staggering toll of the 1918 Spanish Flu pandemic— but had not covered in my lifetime.
And still, I have been caught off guard by the pushback from top elected officials and even some friends and acquaintances who keep comparing it to the flu.
“So last year 37,000 Americans died from the common Flu,†President Donald Trump wrote on Twitter on March 9. “It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!â€
By Friday, Trump had declared coronavirus a national emergency, freeing up resources and removing hurdles for a faster response.
In the meantime, not one public health expert I trust — no one — has said this flu comparison is valid or that we’re overdoing it. Every single one, from former FDA Commissioner Scott Gottlieb to Harvard professor Ashish Jha, has said we’re not doing enough, that this is far more serious than it is being taken.
Here’s why that is:
As Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and others have said, COVID-19 is deadlier than the flu. It’s deadlier for young adults. It’s deadlier for older adults. In China, early data shows that it was 10 times deadlier. This chart from Business Insidercompares U.S. flu deaths to deaths in China from COVID-19.
The flu kills less than 1% of infected people who are over age 65. By comparison, in China, COVID-19 killed 8% of those infected who were 70-79 and almost 15% of those infected who were age 80 or older. That’s a staggering difference.
Even for younger people, the difference was striking. Flu killed .02% of infected patients age 18-49. It’s 10 times that for COVID-19.
In other countries, such as South Korea, the death rate has been far lower.
But if 1 in 12 people age 70-79 who get the virus and 1 in 7 people age 80 or older who get the virus die, and the virus spreads to 20%, 40% or 70% of the population, we’re talking massive death tolls, the likes of which we have never seen before in our lives.
“I mean, people always say, well, the flu does this, the flu does that,†Fauci said Wednesday during congressional testimony. “The flu has a mortality of 0.1%. This has a mortality rate of 10 times that. That’s the reason I want to emphasize we have to stay ahead of the game in preventing this.â€
Epidemiological experts keep talking about the need to “flatten the curve.†What they mean by that is that we need to slow the speed at which new cases are reported. We may not be able to stop the spread of the coronavirus, but we have to try to manage it. If 1,000 new cases happen over a month instead of a week, the health care system is more able to handle them.
Here’s why this is a worry: Overall, our hospitals have fewer beds than other developed countries, according to recent data from the Organization for Economic Cooperation and Development. The United States had 2.8 beds per 1,000 residents. By comparison, Germany had 8 beds and China 4.3 per 1,000.
The United States looks better when it comes to intensive care beds, but there’s tremendous variation between regions and states. If we experience what parts of China and Italy saw, we won’t have anywhere for sick patients to go. We will quickly run out of capacity.
In a crisis moment, supplies like ventilators and N95 face masks will be key. But as National Geographic and other media have reported, the United States has only a fraction of the medical supplies it needs.
Others have reported shortfalls as well, and ProPublica has been hearing from health care professionals across the country who say their own institutions are running short of supplies. (Share your story here.)
U.S. Surgeon General Jerome Adams tweeted at the end of February, “Seriously people- STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!â€
And if that weren’t enough, there’s another problem. Health care workers who have been exposed to the virus are now quarantining themselves, further reducing available staff at hospitals. Kaiser Health News reported on the effects of this:
“In Vacaville, California, alone, one case — the first documented instance of community transmission in the U.S. — left more than 200 hospital workers under quarantine and unable to work for weeks.
“Across California, dozens more health care workers have been ordered home because of possible contagion in response to more than 80 confirmed cases as of Sunday afternoon. In Kirkland, Washington, more than a quarter of the city’s fire department was quarantined after exposure to a handful of infected patients at the Life Care Center nursing home.â€
This week, Banner Health in Colorado informed employees that a co-worker is among those with the coronavirus, The Colorado Sun reported. “People who came into prolonged, close contact with the woman in a Banner Health emergency room are being notified and asked to home-quarantine for 14 days, according to a source close to the investigation who spoke to The Sun on the condition of anonymity.â€
And my ProPublica colleagues reported Friday how some EMS workers are also being quarantined because of exposure. (It didn’t help, of course, that the EMS system was slow to get up to speed on the threat.)
More than that, many health care workers have children and as schools begin to close, they have to figure out how to care for their own families.
Rural areas in the U.S. are losing their hospitals entirely, and residents are having to travel hours for care. According to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, 126 rural hospitals have closed since 2010, including six so far this year. That’s about 6%.
An analysis by the Chartis Center for Rural Health and iVantage Health Analytics this year found that about a quarter of the nation’s 1,844 open rural hospitals are vulnerable.
As The Washington Post described it last year, “Hospitals like Fairfax Community [in Oklahoma] treat patients that are on average six years older and 40 percent poorer than those in urban hospitals, which means rural hospitals have suffered disproportionately from government cuts to Medicaid and Medicare reimbursement rates. They also treat a higher percentage of uninsured patients, resulting in unpaid bills and rising debts.
“A record 46 percent of rural hospitals lost money last year. More than 400 are classified by health officials as being at ‘high risk of imminent failure.’ Hundreds more have cut services or turned over control to outside ownership groups in an attempt to stave off closure.â€
(With razor-thin margins and Congress failing to reauthorize their funding, many nonprofit community health centers face running out of money in May)
The full outfit is necessary every time he meets patients — largely low-income Asian Americans and immigrants who have Medicaid or no insurance at all — even as the clinic’s orders for medical supplies come in short and disinfectant levels run low.
Administrators reminded all the nurses and doctors to be careful, especially after the clinic admitted their first confirmed coronavirus case: a patient who arrived from a nearby nursing home, the Life Care Center of Kirkland, where several residents and workers have fallen ill.
Still, the potential risks are hard to forget: The news is preoccupied with the coronavirus outbreak and the state of Washington has reported 572 cases of the disease and 37 deaths as of Saturday.
Once the clinician entered the room, he took down his patient’s medical history, noted whom they may have come in contact with and weighed whether he would be allowed to administer one of the clinic’s few coronavirus tests — all while assuaging his patient’s fears after traveling to Vietnam at the start of a pandemic.
Time and resources at nonprofit community health centers, which serve approximately 29 million low-income Americans across 1,400 facilities like this one, are being stretched to their breaking point amid the coronavirus outbreak even as they could prove essential in combating its spread, Dr. Asqual Getaneh, the center’s medical director, said.
Their ability could be further handicapped very soon: Federal funding that accounts for 70 percent of these nonprofit health centers’ budgets will run out in May.
“The unknown is an added stress for everyone,†Getaneh said, who noted their pharmacies are running short on essential medications. “There’s also stress associated with whether or not we have the supplies to protect ourselves and take care of patients who are symptomatic. We’re told this is the tip of the iceberg for this epidemic, so we’re seeing a lot of people coming in and trying to figure out how best to deliver care.â€
That is a challenge for these nonprofit health centers, which were first funded by the federal government more than 50 years ago as part of the “War on Poverty.†These clinics located in every state, from dense urban centers to rural towns and communities, have served a vital role in combating national emergencies such as the opioid crisis and the HIV/AIDS epidemic.
The trouble is they don’t know how long they can hang on, which would inhibit efforts to stymie the spread of the disease.
Because the House and the Senate have failed to reauthorize the Community Health Center Fund — a piece of the Affordable Care Act that provides more than 70 percent of the budget for these medical nonprofits — and make a commitment beyond temporary measures, many health centers have experienced staffing shortfalls and have cut back the services they provide.
The National Association of Community Health Centers sent a letter to Senate Majority Leader Mitch McConnell on Thursday asking that he prioritize the reauthorization of their funding, warning that millions of people are at the cusp of losing access to healthcare services through them.
Their situation is particularly concerning since they predominantly provide care to low-income people and immigrants on Medicaid and Medicare, as well as the uninsured who pay on a sliding scale at these nonprofits. These are all populations of people who are more likely to avoid going to the doctor for fear of the cost, but these clinics relieve the stress on hospitals and help flatten the spread of the disease.
Washington is seeing the worst of these cases, but the coronavirus is quickly spreading across the United States. Those states with fewer resources and larger uninsured rates are increasingly nervous about a wider outbreak — especially when they lack the ability to test for the disease.
Because the House and the Senate have failed to reauthorize the Community Health Center Fund — a piece of the Affordable Care Act that provides more than 70 percent of the budget for these medical nonprofits — and make a commitment beyond temporary measures, many health centers have experienced staffing shortfalls and have cut back the services they provide.
The National Association of Community Health Centers sent a letter to Senate Majority Leader Mitch McConnell on Thursday asking that he prioritize the reauthorization of their funding, warning that millions of people are at the cusp of losing access to healthcare services through them.
Their situation is particularly concerning since they predominantly provide care to low-income people and immigrants on Medicaid and Medicare, as well as the uninsured who pay on a sliding scale at these nonprofits. These are all populations of people who are more likely to avoid going to the doctor for fear of the cost, but these clinics relieve the stress on hospitals and help flatten the spread of the disease.
Washington is seeing the worst of these cases, but the coronavirus is quickly spreading across the United States. Those states with fewer resources and larger uninsured rates are increasingly nervous about a wider outbreak — especially when they lack the ability to test for the disease.
With the fifteenth coronavirus case confirmed in North Carolina this week, the 42 community health care centers in the state that serve its 100 counties are gearing up to respond. But unlike Washington state, they will see a larger gap in health care coverage because North Carolina did not expand Medicaid.
North Carolina remains one of 14 states that hasn’t accepted the ACA’s federal funding, which would provide coverage to 194,000 more people. The conservative state Legislature has consistently cited fiscal and ideological reasons for their opposition to the program, causing them to turn down an estimated $40 billion since 2014.
With community health centers in the state largely serving those people who fall in that coverage gap, as well as those able to sign up for Medicaid, health care workers are preparing as best they can for the spread of the coronavirus at the level seen on the West Coast — albeit with even fewer resources.
“Between the federal funding challenges and covering a lot of uninsured patients, it makes it really hard to do anything when you are not financially secure and you have to plan month to month,†said Leslie Wolcott, the emergency preparedness coordinator for the North Carolina Community Health Center Association.
There are approximately 30 million people in the U.S. living without insurance and more than half of American adults put off medical care last year due to the cost, the Kaiser Family Foundation reported. Without these health centers, there is even more concern that these individuals will not visit the doctor because of the expense — a serious problem during a pandemic.
“In the best of times that funding situation is challenging to manage for these health centers,†Jennifer Tolbert the director of state health reform at the Kaiser Family Foundation, said. “But when you’re dealing with a pretty significant health crisis on top of that, it just really creates more challenges and puts the care of these vulnerable populations at risk.â€
MARCH 7, 202003:29
That funding, however, has often gotten tied up in unrelated political fights, and Stabenow said she was not particularly hopeful that they would get any legislation through until the last minute.
“We are very hopeful that in May, when their temporary funding runs out, that we can do a full bill and get the full authorization so that community health centers can plan,†she told NBC News, though she emphasized that it was much too late and the funds offered by Congress’s appropriation was too little.
The $100 million they’re receiving will quickly be exhausted by the clinics at the frontlines of this outbreak, said Dr. Ron Yee, chief medical officer of the National Association of Community Health Centers.
“We have no problem telling Congress this is a drop in the bucket in terms of the demand and how fast this disease is spreading,†Yee said.
Yee noted they are also concerned about testing for the disease. He said clinics on the West Coast are rationing test kits and triaging those who come in with symptoms.
But a fearful public demanding more evaluations and a shortage of tests are further straining these health centers. While the White House announced that 1 million more tests would be available by Monday, doubts were raised about whether they will meet their own self-imposed deadline — one they already missed last week — and how many these nonprofits would receive.
Yee said they are in constant communication with the Centers for Disease Control and Prevention, but the federal agency has not said how many tests they will be provided. The agency did not respond to NBC News’ request for comment.
Meanwhile, North Carolina Health and Human Services Secretary Dr. Mandy Cohen told the state Legislature on Tuesday that there are only 300 test kits in the entire state to serve its population of 10.4 million people. This comes on the same day that Gov. Roy Cooper, a Democrat, declared a state of emergency there.
Even if the clinics had tests, however, because of the backlog of samples to be checked by the states’ public health departments, it can take several days to get results. The labs are just so overwhelmed.
As of now, the best many health care workers can do is tell patients to go home, stay there, take acetaminophen and call back if they experience shortness of breath.
“We’ve shown that we’re there on the front lines taking care of people,†Yee said. “Maybe Congress will come up with more funds or shift things, but we’ll take what we can get and use it the wisest way we can.â€
By John Krull
TheStatehouseFile.com
INDIANAPOLIS – Government matters.
That’s one lesson the exploding coronavirus crisis has delivered.
In the countries – China, Italy and, now, the United States – where the national government has tried to deny that a potential pandemic presents problems, leaders have made the situation worse.
In parts of China, all commerce and social interaction have been frozen for weeks. The cost in lost lives, frayed health, and forsaken productivity are beyond calculation.
In Italy, the entire nation is on lockdown. The country’s hospitals are overwhelmed, and its old people exist in a constant state of risk.
Here in the United States, the president consistently has tried to minimize the crisis by calling it a “hoax†– his favorite term for any bad news he just doesn’t want to hear – while healthcare and national security professionals in his administration have just as consistently sounded alarms.
While the president engages in absurd conspiracy theories, businesses have canceled conferences. States and communities have banned large public gatherings. Schools across the nation have been closed. Entire towns have been put under quarantine.
This, in its way, is heartening.
While the federal government, led by a president who prefers fantasy to reality, flails, state and local governments have stepped up to meet the challenge.
This has been true in states, such as New York and Washington, where Democrats occupy the governor’s offices. They have acted with vigor to perform the government’s first function – protecting the safety of the people the government is supposed to serve.
But it also has been true in states, such as Indiana, which are led by Republicans.
Here, Gov. Eric Holcomb has done the things President Donald Trump should have done at the national level. Holcomb recognized the threat, provided information about it in a transparent fashion and took immediate steps to provide for public safety
When the first coronavirus case was discovered in Indiana, the Holcomb administration called a press conference on the issue before the news was even an hour old. Since then, the governor’s response has been rock-steady, concerned but not panicked, confident but not oblivious.
This is as it should be.
Leadership, like nature, abhors a vacuum.
When the president of the United States refuses or is unable to lead, it is natural that others will step forward to fill the void.
In a country in which millions of Americans along all points of the ideological spectrum have found a reason to doubt the effectiveness of the government that draws its authority from their consent, this should provide some reassurance.
When one part of our system of representative government fails – as the executive and legislative branches of the federal government have and continue to do in this case – other parts of the government often find ways to bridge the gaps. The system’s safeguards may be imperfect, but they do exist.
That’s another important lesson from this crisis.
Still, another is this: Frequently, the most fundamental question to be answered about a leader isn’t about ideology.
It’s about competence.
We Americans tend to tie ourselves in knots over how of solving problems. We fret and fume over whether a proposed solution is progressive or conservative, Republican or Democrat in conception.
The truth is there are liberal solutions to problems. There also are conservative solutions. Republicans have some good ideas. So do Democrats.
All these solutions and ideas have benefits. They also have costs.
Certain solutions and ideas benefit some Americans more than others. That’s true across the board.
No party or leader has a monopoly on wisdom or virtue. This also is true across the board.
But the one thing the successful leaders – Republican or Democrat, progressive or conservative – have in common is the ability to recognize challenges when they exist and confront them in a realistic fashion.
That’s how our government is supposed to function. At its most basic level, the government is an instrument to exert the public will to solve public problems.
We’re seeing now at the federal level what happens when a leader doesn’t grasp that – doesn’t see public office as a duty and a trust, but only as an opportunity for personal aggrandizement.
But we’re also seeing at the state level the good that can happen when leaders do understand and meet their duties.
Together, the president who flails and the governors who act are teaching an important lesson.
Government matters.
FOOTNOTE: John Krull is director of Franklin College’s Pulliam School of Journalism and publisher of TheStatehouseFile.com, a news website powered by Franklin College journalism students.
The City-County Observer posted this article without opinion, Â bias or editing.
