COVID-19 may have been circulating in LA in December, UCLA finds
LOS ANGELES — UCLA researchers and colleagues have found that there was a significant increase in patients with coughs and acute respiratory failure at UCLA Health hospitals and clinics beginning in late December, suggesting that COVID-19 may have been circulating in the area months before the first definitive cases in the US were identified, it was announced Thursday.
This sudden spike in patients with these symptoms, which continued through February, represents an unexpected 50% increase in such cases when compared with the same time period in each of the previous five years.
The findings, the study authors say, demonstrate the importance of analyzing electronic health records to monitor and quickly identify irregular changes in patient populations. The researchers’ approach, in which they focused not only on hospitalization data but also on data from outpatient settings, may help epidemiologists and health systems detect future epidemics sooner.
The study appears in the peer-reviewed Journal of Medical Internet Research.
“For many diseases, data from the outpatient setting can provide an early warning to emergency departments and hospital intensive care units of what is to come,” said Dr. Joann Elmore, the study’s lead author and a professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA. “The majority of COVID-19 studies evaluate hospitalization data, but we also looked at the larger outpatient clinic setting, where most patients turn first for medical care when illness and symptoms arise.”
As scientists and doctors continue to learn more about SARS-CoV-2, the virus that causes COVID-19, health systems and public health agencies are also attempting to predict and monitor cases. Analyzing electronic patient records, the researchers say, could help health authorities more effectively identify and control outbreaks like the current pandemic, which has killed hundreds of thousands worldwide and disrupted billions of lives.
“The pandemic has really highlighted our need for agile health care analytics that enable real-time symptom and disease surveillance using electronic health records data,” said Dr. Michael Pfeffer, a study co-author and chief information officer for UCLA Health. “Technology, including artificial intelligence powered by machine learning, has further potential to identify and track irregular changes in health data, including significant excesses of patients with specific disease-type presentations in the weeks or months prior to an outbreak.”
The researchers evaluated more than 10 million health system and patient visit records for UCLA Health outpatient, emergency department and hospital facilities, comparing data from the period between Dec. 1 and Feb. 29 — the months prior to increased public awareness of COVID-19 in the U.S. — with data from the same period over the previous five years.
They found that outpatient clinic visits by UCLA patients seeking care for coughs increased by over 50% and exceeded the average number of visits for the same complaint over the prior five years by more than 1,000. Similarly, they discovered a significant excess in the number of patients seen in emergency departments for reports of coughs and of patients hospitalized with acute respiratory failure during this time period. These excesses remained even after accounting for changes in patient populations and seasonal variation, according to UCLA.
PUBLISHED: September 10, 2020
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美國紐約時間 2020年9月11日
美國已確認感染人數：6,417,186
死亡人數：192,448
作者: xeno-2007 時間: 2020-9-12 03:00 AM
[attach]133105806[/attach]
Should Bob Woodward have reported Trump’s virus revelations sooner? Here’s how he defends his decision.
Two waves of outrage greeted the news on Wednesday of Bob Woodward’s latest White House chronicle, a book titled “Rage.”
The first was Trump’s disclosure to Woodward that he knew as early as February — even as he was dismissing the novel coronavirus publicly — that the looming pandemic was far deadlier than the flu.
The second was that Woodward, long associated with The Washington Post, didn’t reveal this to the public sooner.
The fact that this second outrage mostly circulated among journalists talking to one another made it no less furious: If the famous Watergate reporter knew that Trump was lying to the public about a matter of life and death, why didn’t he reveal it immediately?
Woodward book: Trump says he knew coronavirus was ‘deadly’ and worse than the flu while intentionally misleading Americans
Woodward is hardly the first journalist to save juicy information for a book. But “is this traditional practice still ethical?” tweeted David Boardman, dean of the Temple University journalism school and a former longtime editor of the Seattle Times.
Other critics were less circumspect: “This is really troubling. As journalists we’re supposed to work in the public interest. I think there’s been a failure here,” wrote Scott Nover, a reporter for the industry journal Adweek.
In fairness, it wasn’t just journalists raising concerns. A reader wrote to me arguing that Woodward’s revelation “could have been helpful in the spring, both explaining the seriousness of the disease to the public, showing the Trump administration’s bungled and inept response, and pushing the Trump administration to do more.” He added, with a touch of cynicism, that he hoped the author’s advance fee made the delay worthwhile.
The questions are valid — and as Boardman notes, far from new. They surface almost every time a journalist writes a book that contains newsy information, especially about matters of national security or public well-being: Why are we only reading about this now?
As recently as last week, New York Times reporter Michael Schmidt was criticized for withholding some meaty revelations for his book about the investigation into Trump’s ties to Russia and the Robert S. Mueller III investigation. “It is not immediately entirely clear why these reports, many dating back as far as three years, made it into the pages of Schmidt’s book rather than the subscription-based newspaper that employs him,” wrote Roger Sollenberger in Salon.
I took the questions and complaints to Woodward, who initially was reluctant to speak on the record until after a “60 Minutes” segment airs on Sunday because he had promised the publisher and CBS not to give any interviews until then. But because my questions were about process, rather than the content of the book, he agreed to address the ethical issues.
Woodward told me that — contrary to speculation — he did not have any signed agreement or formal embargo arrangement with Trump or the White House to hold back their conversations until the book published.
“I told him it was for the book,” he said — but as far as promising not to publish in real time, or signing such an agreement, “I don’t do that.”
Woodward said his aim was to provide a fuller context than could occur in a news story: “I knew I could tell the second draft of history, and I knew I could tell it before the election.” (Former Washington Post publisher Phil Graham famously called journalism “the first rough draft of history.”)
What’s more, he said, there were at least two problems with what he heard from Trump in February that kept him from putting it in the newspaper at the time:
First, he didn’t know what the source of Trump’s information was. It wasn’t until months later — in May — that Woodward learned it came from a high-level intelligence briefing in January that was also described in Wednesday’s reporting about the book.
In February, what Trump told Woodward seemed hard to make sense of, the author told me — back then, Woodward said, there was no panic over the virus; even toward the final days of that month, Anthony S. Fauci was publicly assuring Americans there was no need to change their daily habits.
Second, Woodward said, “the biggest problem I had, which is always a problem with Trump, is I didn’t know if it was true.”
Trump spoke with Woodward on more than a dozen occasions, and in some cases, “he started calling me at night.” It took months, Woodward told me, to do the reporting that put it all in context, which is what he believes his mission as an author is: “My job is to understand it, and to hold him accountable, and to hold myself accountable.” He added: “I did the best I could” toward those ends.
But why not then write such a story later in the spring, once it was clear that the virus was extraordinarily destructive and that Trump’s early downplaying had almost certainly cost lives?
Again, Woodward said he believes his highest purpose isn’t to write daily stories but to give his readers the big picture — one that may have a greater effect, especially with a consequential election looming.
Woodward’s effort, he said, was to deliver in book form “the best obtainable version of the truth,” not to rush individual revelations into publication.
And always with a particular deadline in mind, so that people could read, absorb and make their judgments well before Nov. 3. “The demarcation is the election.”
Woodward, despite his longtime association with The Post, is no longer a Post employee, though he maintains an affiliation and the honorific title of associate editor. He’s no longer in the daily journalism business.
The Post, like CNN, received the book galleys only recently, so that it could ready its article based on the book.
I don’t know if putting the book’s newsiest revelations out there in something closer to real time would have made a difference. They might very well have been denied and soon forgotten in the constant rush of new scandals and lies.
Still, the chance — even if it’s a slim chance — that those revelations could have saved lives is a powerful argument against waiting this long.
Here’s what the media must do to fend off an election-night disaster
Fact-checking Trump’s lies is essential. It’s also increasingly fruitless.
Kellyanne Conway undermined the truth like no other Trump official. And journalists enabled her.
Washington Post September 10, 2020
作者: salone1001 時間: 2020-9-12 09:49 AM
一直哭妖中共隱匿疫情結果自己也沒好多少，去諂媚這樣的國家真是為台灣好? 作者: gogosp 時間: 2020-9-12 11:56 AM
63 seconds that shows why Trump politicizing mask-wearing is so, so destructive
(CNN)Thousands of people flocked to Freeland, Michigan, Thursday night to hear President Donald Trump make the case for why he deserves a second term in office. Very few among those thousands wore a mask.
Which prompted CNN White House correspondent Jim Acosta to ask "why" -- given that masks are one of the few proven ways that we can mitigate the spread of Covid-19, which has sickened more than 6 million Americans and killed nearly 200,000 Americans since March. The responses Acosta received to his simple question, are, well, startling.
Here are some (thanks to CNN's Angie Trindade for transcribing these):
* "I have a hard time understanding people when they talk, so that's why I don't wear it."
* "Because there's no Covid. It's a fake pandemic created to destroy the United States of America."
* "I am not wearing a mask because I had my temperature taken already and I'm not sick."
* "Why am I not wearing a mask? I am not wearing a mask or a couple different reasons. Mainly because a lot of the numbers that have come out on coronavirus are not as big as -- ... the media makes them a lot bigger than they actually are ... one other reason is that I'm very young and people who are here, coronavirus is a very serious issue..."
* "Part of it, I'm not really worried about it. Because the death rate for this is pretty low unless you have low immunities."
* "Why? Because it really doesn't do anything really. These little things? *pulls out mask* This is the worst pandemic in the world and a little mask? A little mask? This protects you from the world's deadliest and serious virus that ruined our economy? We have to wear this?"
* "To me there isn't as big of a concern as it really is. If everybody's afraid of it, you could die in a car crash. I mean heart disease is one of the leading killers in the country, no one has stopped making cheeseburgers."
* " I'm not afraid. The good Lord takes care of me. If I die, I die! We gotta get this country moving. What are we gonna do? Wear masks and stay inside for another year? Where will that get us? Let's just mail out more checks to everybody and let the country go bankrupt."
In truth, you really need to watch how people responded to get the full effect.
Jim @Acosta asks folks at a Trump event why aren't they wearing masks.........
OK, now go back and read through the responses above. And consider that Covid-19 is projected to kill more than 410,000 Americans by the start of 2021. Assuming that projection is roughly right, the coronavirus will kill more Americans than died in World War II (291,557) and nearly as many as died in the Civil War (498,332).
How, you ask, given those staggering numbers, could people not only balk at wearing a mask to prevent the spread but also raise questions about whether the virus even exists?
The answer is not solely Donald Trump, of course. The rise of conspiracy theory-pushing message boards on dark Internet corners has sowed the seeds of this sort of thinking. The rising distrust in institutions -- the government, the church, the military, the police -- in recent years also, without doubt, plays a role in the promulgation of these uninformed and dangerous views.
But it it also impossible to watch or listen to comments like those from Trump supporters in Michigan on Thursday night and not see the outsized role that he has played in promulgating views like those.
Trump has, by his own admission, downplayed the severity of the virus. (He says he did so to avoid panicking the public.) He has repeatedly undermined the necessity of mask-wearing. He has pushed quack cures for the virus -- including ingesting disinfectants. He has suggested that Democrats are making the virus out to be worse than it really is for solely political purposes.
And what all of that misinformation and conspiracy-theory embracing is what Acosta captured in 63 seconds of voter interviews on Thursday night. And that should scare all of us.
UN assembly approves pandemic resolution; US, Israel object
UNITED NATIONS — The U.N. General Assembly overwhelmingly approved a wide-ranging resolution on tackling the coronavirus pandemic Friday over objections from the United States and Israel, which protested a successful last-minute Cuban amendment that strongly urged countries to oppose any unilateral economic, financial or trade sanctions.
The 193-member world body adopted the resolution by a vote of 169-2, with Ukraine and Hungary abstaining. It was a strong show of unity by the U.N.’s most representative body, though many countries had hoped for adoption by consensus.
The resolution, which is not legally binding, is the third and most extensive adopted by the General Assembly. A resolution adopted April 2 recognized “the unprecedented effects” of the pandemic and called for “intensified international cooperation to contain, mitigate and defeat” the new coronavirus. A Mexico-sponsored resolution approved April 20 urged global action to rapidly scale up development, manufacturing and access to medicine, vaccines and medical equipment to confront the pandemic.
In Friday’s resolution, the General Assembly says the pandemic poses “one of the greatest global challenges in the history of the United Nations,” and calls for “intensified international cooperation and solidarity to contain, mitigate and overcome the pandemic and its consequences.”
The resolution urges U.N. member states “to enable all countries to have unhindered timely access to quality, safe, efficacious and affordable diagnosis, therapeutics, medicines and vaccines … as well as equipment for the COVID-19 response.”
And it recognizes “the role of extensive immunization against COVID-19 as a global public good for health in preventing, containing and stopping transmission in order to bring the pandemic to an end, once safe, quality, efficacious, effective, accessible and affordable vaccines are available.”
Afghan Ambassador Adela Raz, who coordinated the drafting of the resolution with Croatian envoy Ivan Simonovic, told the assembly the resolution is not only a response to the disease “but a tribute to the victims,” noting that more than 900,000 people worldwide have died and over 25 million have been infected.
“The world is experiencing the worst economic recession since World War II, and equality and poverty are increasing, and more people are experiencing hunger,” she said. “We are indeed facing the most significant global catastrophe since the founding of this important organization, the United Nations.”
Raz said adoption of the resolution shows the world’s nations are ready to respond, despite failing to reach consensus, and are committed to U.N. goals for 2030 including ending extreme poverty, preserving the environment and achieving gender equality “for building back better after the pandemic.”
Simonovic said the great majority of nations “have chosen the path of solidarity and multilateralism” and called the resolution “a powerful tool for mobilization of political will and financial resources.”
He said political and financial support are badly needed “to curb COVID-19, strengthen our stressed health systems and to save jobs and livelihoods.”
The resolution calls on all countries “and other relevant stakeholders to advance, with determination, bold and concerted actions to address the immediate social and economic impacts of the COVID-19 pandemic, while striving to get back on track” to achieve the 2030 goals.
It calls on governments and international financial institutions “to provide more liquidity in the financial system, especially in all developing countries.” It supports recovery plans that “drive transformative change towards more inclusive and just societies including by empowering and engaging all women and girls.”
And it urges U.N. member nations “to adopt a climate- and environment-responsive approach to COVID-19 recovery efforts” including by aligning investments and domestic policies with the U.N. goals and the 2015 Paris agreement to combat climate change.
Cuba succeeded in changing a paragraph in the resolution that originally called for “the urgent removal of unjustified obstacles in order to ensure the universal, timely and equitable access to, and fair distribution of, all quality, safe, efficacious and affordable essential health technologies and products, including their components and precursors that are required in the response to the COVID-19 pandemic.”
By a vote of 132-3, the assembly amended the resolution to urge all countries “to refrain from promulgating and applying any unilateral economic, financial or trade measures not in accordance with international law and the Charter of the United Nations that impedes the full achievement of economic and social development, particularly in developing countries.”
The United States was then overwhelmingly defeated in attempts to remove two paragraphs from the resolution, one referring to women’s rights to “sexual and reproductive health” and the other to “promoting global sustainable transport.”
In addition to arguing against the language on sanctions, the United States opposed all references to the World Health Organization, which the Trump administration stopped funding, accusing the U.N. agency of failing to do enough to stop the virus from spreading when it first surfaced in China.
It accused China of hiding the truth about the outbreak from the world in the early days which “imperiled all of us and caused needless additional suffering and death.”
Chinese diplomat Xing Jisheng responded, alluding to the recent revelation that President Donald Trump “recognized the danger of the virus at a very early stage, but deliberately played it down to avoid panic.” He asked: “Who is hiding the truth?”
Xing also asked why the U.S., with the most advanced medical system in the world, has the most COVID-19 cases. “If the United States is serious about fighting the pandemic, it should focus on protecting lives and health of its people, instead of being busy with blame-shifting,” he said.
引述CNN報導，
美國研究機構 the Institute for Health Metrics and Evaluation (IHME) at the University of Washington 的電腦模擬推演評估，
在Trump的倒行逆施下，美國疫情會不斷惡化，在將至的寒冬，病毒會更猖狂暴虐，預期美國要再死四十多萬人，才捱到春回大地，病毒休眠。
[attach]133131708[/attach]
US could see a 'very deadly December' with tens of thousands of coronavirus death to come, computer model predicts
(CNN)An influential model is predicting a catastrophic winter with a significant rise in coronavirus deaths.
A possible scenario sees 415,090 Covid-19 deaths by January, the Institute for Health Metrics and Evaluation (IHME) at the University of Washington says in its latest forecast. The worst-case scenario is 600,000 deaths by January 1.
"When we look ahead into the winter with seasonality kicking in, people becoming clearly less vigilant, you know mask use is down, mobility is up in the nation, you put all those together and we look like we're going to have a very deadly December ahead of us in terms of toll of coronavirus," IHME director Dr. Christopher Murray told CNN's Anderson Cooper.
Adults with Covid-19 about 'twice as likely' to say they have dined at a restaurant, CDC study suggests
The IHME model is essentially predicting the number of deaths will double in the next four months. As of Friday, nearly 6.4 million infections have been recorded in the US and more than 192,000 Americans have died, according to data from Johns Hopkins University.
Despite the dire prediction, President Donald Trump says the US has done "really well" in fighting the virus, according to a Thursday video on the White House official Facebook page.
"I really do believe we're rounding the corner and the vaccines are right there, but not even discussing vaccines and not discussing therapeutics, we're rounding the corner," Trump said.
Speaking with MSNBC's Andrea Mitchell on Friday, Dr. Anthony Fauci said he does not agree with the President's statements.
"We're plateauing at around 40,000 cases a day, and the deaths of around 1,000," said Fauci, the director of the National Institute of Allergy and Infectious Diseases.
He said test positivity is increasing in some regions of the country and people are spending more time indoors because of cooler weather.
"That's not good for a respiratory-borne virus," he said. "You don't want to start off already with a baseline that's so high."
House Democrats seek information on $250 million contract on coronavirus PR campaign
Fauci's disagreement with that comment is another example of a top scientist and a member of the White House coronavirus task force publicly disputing the President's claims about the virus.
"We're in a very politically-charged atmosphere now and whenever you're trying to get people all together singing from the same tune and doing the same things as a society, unified against this common enemy -- this virus -- it's very difficult to do that when you have such a charged atmosphere that we have right now," Fauci told CNN's Wolf Blitzer Friday. "And that really is truly unfortunate."
Fauci warned that the country needs to get the levels down lower "so that when you go into a more precarious situation, like the fall and the winter, you won't have a situation where you really are at a disadvantage right from the very beginning."
US may not return to normal until 2021, Fauci says
The US might not return to pre-coronavirus life until the end of next year, Fauci said, but he is cautiously optimistic the US will have a vaccine by the end of this year.
"But it's not going to be turning a switch off and turning the switch on. It's going to be gradual and I think it's going to take several months before we get to the point where we can really feel something that approximates how it was normally before Covid-19," he said.
Blitzer to Fauci: Who should we trust, you or President Trump? 01:49
There's also the issue of how many doses of the vaccine will be available and how long it takes to distribute the vaccine.
"It's going to take several months to get the country safe and vaccinated," Fauci said.
Nearly 30 US states are reporting downward trends in Covid-19 cases, but the pandemic will likely worsen again, Fauci said.
"We need to hunker down and get through this fall and winter because it's not going to be easy," Fauci said.
Fauci says normal life may not be back until the end of 2021
Experts -- including the US Centers for Disease Control and Prevention director -- have warned the months ahead will be challenging. The US continues to see about 36,000 new cases each day -- which is better than August but still too high, Fauci said.
"I keep looking at that curve and I get more depressed and more depressed about the fact that we never really get down to the baseline that I'd like," he said.
As the weather gets colder, Americans will move indoors more, where the virus spreads more easily.
The coming flu season will complicate diagnoses. The strains on the healthcare system will make for one of the "most difficult times that we experienced in American public health," CDC Director Dr. Robert Redfield has said.
Where we stand now
The actual number of infections could be far greater. Many may have had Covid-19 without knowing, as the CDC projects about 40% of people who are infected don't show any symptoms.
9/11 and Covid-19: 2 mass trauma events with different recovery challenges
Others could have been sick but never got tested. A new study says the US greatly undercounted Covid-19 cases at the start of the pandemic -- missing 90% of them -- mostly due to a lack in testing.
Across the US, 28 states are reporting downward trends -- including Florida and California -- compared to the previous week, and 14 are steady.
Experts worry a surge could come weeks after Labor Day celebrations, like cases soared after the Fourth of July.
An ensemble forecast from the CDC now projects that between 205,000 and 217,000 people in the US will die by October 3.
Medical experts also worry about the upcoming flu season. Fauci told CNN Friday the CDC recommended people getting their flu vaccines by October 31.
White House coronavirus task force focuses on higher education in state reports
"What we're hoping for -- and I hope this happens -- is that a combination of people getting vaccinated against the flu and the fact that the very public health measures that they implement to avoid coronavirus will actually help them avoid influenza," Fauci said.
Fauci also recommended people "hunker down" for the fall and winter, but he says that does not mean shutting down the country again.
"We don't need to shut down, we can do this if we pull together and abide by relatively simple and understandable public health measures," Fauci said, adding that the measures include social distancing, wearing masks and avoiding crowds.
Non-symptomatic children can transmit virus, data show
Even children with mild or no symptoms can transmit Covid-19, according to contact tracing data from three Utah child care facilities released Friday.
Researchers said 12 children got Covid-19 in a child care location and transmitted it to at least 12 people outside, including household members.
They analyzed contact tracing data from 184 people with links to three child care centers in Salt Lake County from this April to July.
They found at least two children who had no symptoms not only had caught the virus but passed it to other people, including one mother who was hospitalized. One 8-month-old child spread the virus to both parents.
The researchers say that two of the facility outbreaks began with staff members who had household contacts with the virus.
Overall, children accounted for 13 of the 31 confirmed Covid-19 case linked to the facility, and all of the children had mild or no symptoms.
Infected college students shouldn't be sent home
Colleges across the country have made face masks a requirement hoping to keep Covid-19 cases down. But just weeks into the first semester, campuses from all 50 states have reported infections.
The psychology behind why some college students break Covid-19 rules
The University of Texas at Austin announced this week three confirmed clusters on campus which collectively account for about 100 cases. San Diego State University confirmed almost 400 infections among students, after announcing a halt on in-person instruction.
And more than 1,300 Arizona State University students have tested positive since August 1.
Colleges and universities should try to isolate infected students instead of sending them home, Fauci has said.
"You send them back to their community, you will in essence be reseeding with individuals who are capable of transmitting infection, many communities throughout the country," he said earlier this week.
"So it's much, much better to have the capability to put them in a place where they could comfortably recover."
CNN's Ben Tinker, Maggie Fox, Haley Brink, Jen Christensen, Amanda Watts, Lauren Mascarenhas and Shelby Lin Erdman contributed to this report.
