I saw on the news channels this morning headlines implying that the Pandemic is over. It is far from it. When I pulled it up on-line "the Pandemic is Over" the first site was referring to the H1N1 Pandemic. But, COVID-19 is not over, far from it. The WHO reported the highest surge in new COVID-19 cases ever, yesterday. "Biggest Daily Spike Globally" 136,000 new cases in one day. The virus is starting to get to areas that were previously unaffected, such as New Brunswick, in Canada, which had no deaths until yesterday, its first one was reported. The US death rate from COVID-19 seems to have levelled off currently, but at a high rate. It has not come down to zero, and with the recent explosion in cases due to laxity of isolation protocols, the death rate will most probably increase in the US soon.
So, don't let the news fool you, the COVID-19 Pandemic is not over (and I really doubt that the Influenza Pandemic is over as well). There is hope, apparently vaccine research is proceeding well, with, I think, the world's largest effort to produce a vaccine in history.
Thank you for your support, and stay safe. June11, 2020.
Not over may be control the spread and without mass screening we should not say like this. May be many more undetected due to asymptomatic cases.
The next period will be a period of coexistence with the virus
Hermann Gruenwald COVID-19 is indeed levelling off in some countries such as Italy and France, whereas Denmark and Norway did the right thing with a complete shutdown and those had very few cases and fatalities and a CFR around 2% cudos to them!
This is however not the case for entire Europe, the crisis is still ongoing in the former east Europe. And my short answer is that it's my firm belief that this is far from over - at least for some parts of Europe.
Re: OP
Just like in the US the Government and PHA in Sweden have tried to spindoctor the idea that the pandemic is in a late stage and things soon will get back to normal.
Sweden who have had a CFR around 15% stand out again by easing up on the very loose restrictions the country had in the first place at a time where there's been an acceleration in the number of cases that nearly doubled from around 500 cases a day to nearly 1000 in average in the last week. The only graph that show a bit of a slowdown is the number of fatalities. If that is due to an actual improvement or that those who work in the medial profession starting to learn better procedures is unknown to me.
Now that there were festivities with a lot of crowds and participants yesterday, we might see another jump in a week or two.
WHO said to learn to live with the virus.
“We have to learn to live with the virus,” Ryan said. (June 13, CNN)
I would rather not live with the pulmonary, cardiac, immunological, neurological sequelae that have been identified, and the others that have yet to be identified, if I can avoid exposure and infection. The problem is those who say "just get exposed so that we can have herd-immunity." My point is that this may not be the wisest thing to do, until a good vaccine is given. My hope is for a good vaccine, then all of this will be moot.
Also, for those working on the vaccine, keep working diligently, please. It is unlikely there will be a chemical "cure" because of the extreme difficulty doing a double blind randomized placebo controlled study, which will be the proof required.
I agree with Dr. Gary. The pandemic is far from over. False reassurances will only make us drop our constant vigil.
SARS-CoV-19 is causing shocks and surprises
False claims that pandemic is over is living in fools paradise. You can only keep the COVID-19 rates down by preventive measures (masking, social distancing, and hand hygiene on touching anything). However, SARS-Cov-19 is not out, and COVID-19 pandemic will surge whenever there is relaxation in such preventive measures.
This is because immunity may be non-existent despite production of antibodies (just like for Hepatitis C), weak, or short-lived (Like corona viruses causing common cold), and the vaccine efforts against COVID-19 have stumbled.
June 26, 2020: Highest recorded number of new COVID-19 cases in the USA yesterday. The Pandemic is definitely not over. Here is todays headline in Doctors Guide Alerts:
📷COVID-19JUNE 26, 2020
COVID-19: US records more than 37,000 new cases
According to CDC's update on June 25, the case count of COVID-19 in the US stands at 2,374,282* cases, including 121,809* deaths, in 55 (50 states, District of Columbia, Puerto Rico, Guam, Northern Marianas, and US Virgin Islands) jurisdictions. This represents an additional 37,667 cases and 692 deaths compared to the update on June 24.
I watched the news this morning, nothing stated about this. If we are not going into Phase Two of the 1918 pandemic curve, then it is still very worrisome. The breakdown of the public health protocols is starting to show up. The massive social unrest did not help this, as has been documented in the massive protests, with a lack of personal viral hygiene. Thank you, stay safe. Gary Ordog, MD June 26, 2020.
June 29, 2020: Again in the USA, the highest recorded daily new cases today, higher than the record of 3 days ago:
JUNE 29, 2020
COVID-19: Close to 45,000 additional cases reported in US
According to CDC's update on June 28, the case count of COVID-19 in the US stands at 2,504,175* cases, including 125,484* deaths, in 55 (50 states, District of Columbia, Puerto Rico, Guam, Northern Marianas, and US Virgin Islands) jurisdictions. The CDC noted that this represents an increase of 44,703 cases and 508 deaths compared to the update on June 27.
From DG Alerts today.
Thank you and continue to stay safe; the Pandemic is definitely "not over."
Gary Ordog, MD
It's definitely not over. Even though the CDC for Sweden try to spin doctor the idea that things are improving, their own statistics tell another story - even though they continue to only report fatalities that occur in hospitals - while most COVID-19 cases remain in their homes, elderly care units or of the ramshackle isolation facilities made from construction worker barracks.
The dip in the curve for new cases is an artifact that remain even after averaging the numbers - as very few new cases were reported during the Midsummer festival.
Now when the numbers are in for Monday the increase in fatalities for the last 7 days end up at +4%.
I agree with Mr Ordog and repeat - stay safe, keep your distance, use whatever protection you can buy and wash your hands as often as you got an opportunity. (Alcohol only when you get home or use sparingly, it can dry out your skin too much.)
June 30, 2020: Quote from the news: " “If you look at what's going on and just look at some of the film clips that you've seen of people congregating, often without masks, of being in crowds and jumping over and avoiding and not paying attention to the guidelines that we very carefully put out," Fauci said. "
July 03, 2020: Another record day; 54000 new cases of COVID-19 reports in the USA. See that the death curve has not caught up yet; two or three weeks behind.
July 10, 2020: A new record USA high, and now the death toll is also nearing record highs. Per today's DG Alerts; Johns Hopkins data:
JULY 10, 2020
COVID-19: US records close to 65,000 new cases
According to CDC's update on July 9, the case count of COVID-19 in the US stands at 3,047,671* cases, including 132,056* deaths, in 55 (50 states, District of Columbia, Puerto Rico, Guam, Northern Marianas, and US Virgin Islands) jurisdictions. This represents an additional 64,771 cases and 991 deaths compared to the update on July 8.
The Phase One of the 1918 death curve was much smaller than the Phase Two, there was in between the equivalent of our 2020 Stage One and Stage Two Reopening, and news reports like the one I mentioned above, which led people to think that the pandemic was over, everyone came back outside and went wild; then 10 times as many died shortly afterwards. See graph below:
I am sorry to hear about this, it is happening everywhere. But, it is good to be alive, and not sick. Maybe this will be a wake-up call to governments to listen to their health departments, to prepare for the future. Obviously no one had prepared properly, even the largest most wealthy governments. This was all totally predictable, as I have been describing repeatedly in my comments, based upon history with previous pandemics, and notably the 1918 flu pandemic. The scenario is following the same format as has been done many times, it has been totally predictable, as I have been documenting for the past 6 months, and is predictable for the future. Human society needs to prepared better for the next time we have a pandemic, because it will happen again. Also, I think we are lucky in a way this time, as the mortality rate is only about 5%, but think about the next time, perhaps it will hit young people harder, or think about what happens if Ebola virus becomes airborne at 95% mortality. Obviously, this time no one was prepared, but the species will survive until the next hit. Everyone needs to wake up, and get better prepared. Thank you and stay safe. Gary Ordog, MD July 15, 2020.
I think this last discussion deserves a new category, hopefully with your permission I will launch it anew. Thank you.
Not over, just revving up!
USA deaths up to 1404 per day from COVID-19. See:
COVID-19 AUGUST 21, 2020
COVID-19: More than 46,000 new cases reported in US
According to CDC's update on August 20, the case count of COVID-19 in the US stands at 5,506,929* cases, including 172,416* deaths, in 55 (50 states, District of Columbia, Puerto Rico, Guam, Northern Marianas, and US Virgin Islands) jurisdictions. This represents an additional 46,500 cases and 1,404 deaths compared to the update on the preceding day.
September 26, 2020: Ordog's Summary and Comments on: September 22/29, 2020
The COVID-19 Pandemic and the JAMA Network
by: Michael Berkwits, MD, MSCE; Annette Flanagin, RN, MA; Howard Bauchner, MD1; Phil B. Fontanarosa, MD, MBA
in: JAMA. 2020;324(12):1159-1160. doi:10.1001/jama.2020.18298
The following are some of the concerns noted in todays edition of JAMA Covid-19 edition. These include multiple organ injury and debility that result from COVID-19 infections. As I have noted before, up to 97% of patients who have recovered and survived a COVID-19 infection have been left with at least some of the following sequelae, and this is of major concern. As the conclusion of the editors' written article, "No single event since the end of the Cold War has so affected the lives of virtually every person living in every country of the world." (Comments by Gary Ordog, MD)
These are the most prominent of the currently recognized COVID-19 concerns:
1. Benefits and harms of treatments and identifying mortality risk markers beyond age and comorbidities
2. Cardiovascular consequences of COVID-19 infection, including risks to those with comorbid hypertension and risks for myocardial injury
3. Risk for direct central nervous system invasion and COVID-19 encephalitis and for long-term neuropsychiatric manifestations in a post–COVID-19 syndrome
4. Risks related to SARS-CoV-2 infection for patients with compromised immunity, such as those receiving treatment for cancer
5. Challenges unique to patients with acute kidney injury and chronic kidney disease
6. Risks of viral transmission from aerosol-generating procedures, including most minimally invasive surgeries, and the need for eye protection as well as personal protective equipment as part of universal precautions
7. The prevalence and pathophysiology of skin findings in patients with COVID-19, determining if they are primary or secondary cutaneous manifestations of infection, and how best to manage them
8. The prevalence and significance of eye findings in patients with COVID-19 and the risk of transmission and infection through ocular surfaces
9. The role of anticoagulation for managing the endotheliopathy and coagulopathy characteristic of the infection in some patients
10. Developmental effects on children of the loss of family routines, finances, older loved ones, school and education, and social-based activities and milestone events
11. Effects of the pandemic, mitigation efforts, and economic downturn on the mental health of patients and frontline clinicians
12. Seasonality of transmission as the pandemic enters its third season
13. How to implement reliable seroprevalence surveys to document progression of the pandemic and effects of public health measures
14. Effects of the pandemic on access to care and the rise of telehealth
15. Consequences of COVID-19 for clinical capabilities, such as workforce availability in several specialties, delays in performing procedures and operations, and implications for medical education and resident recruitment.
16. Additional important questions that require careful observation and research include
17. Randomized evaluations of treatment: what is effective and safe, and what timing of which drug will reduce morbidity and mortality? Will a combination of therapies be more effective than any single drug?
18. Randomized evaluations of preventive interventions, including convalescent plasma, monoclonal antibodies, and vaccines. Which are effective and safe enough to prevent COVID-19 at a population level?
19. How can COVID-19 vaccines and therapeutics be distributed and paid for in ways that are fair and equitable?
20. Is immunity complete or partial, permanent or temporary, what is its mechanism, and how best is it measured? Can the virus mutate around host defenses?
21. How important are preadolescent children to the spread of infection to older family members and adult communities, and what are the implications for parent, caregiver, and teacher personal risk and disease transmission?
22. Is SARS-CoV-2 like influenza (continually circulating without or with seasonality), measles (transmissible but containable beneath threshold limits), or smallpox and polio (eradicable, or nearly so)?
23. Has the pandemic fundamentally altered the way health care is financed and delivered? By shining a spotlight on health inequities, can the pandemic motivate changes in health care finance, organization, and delivery to reduce those inequities?
24. The public’s health is threatened by sophisticated campaigns churning disinformation into social media and other platforms as part of what the World Health Organization is calling an infodemic.15 Careful, deliberative science is at a disadvantage in today’s instantly networked information economy, validating the classic saying (misattributed to Mark Twain) that “lies travel halfway around the world while the truth is still putting on its shoes.” As a matter of health and potentially national security, health agencies, public health authorities, elected leaders, news organizations, and editors and publishers all need to find strategies to counter the disinformation.15-17 The health of the global population depends on this effort.
25. The pandemic has exposed vulnerabilities in public and private health systems, with the costs to health and lives borne by the least fortunate.
26. The national US pandemic response has been halting and fragmented. Just as airport security has not and would never be ceded to individual states, health security for the country cannot come from states acting alone without coordination to manage regional infectious disease outbreaks. A restored and strengthened US Centers for Disease Control and Prevention—better funded and structurally protected from political influence—could provide the public health leadership necessary to manage future similar outbreaks and protect the US population.23
References:
1. Paules CI, Marston HD, Fauci AS. Coronavirus infections: more than just the common cold. JAMA. 2020;323(8):707-708. doi:10.1001/jama.2020.0757
2. Bonow RO, O’Gara PT, Yancy CW. Cardiology and COVID-19. JAMA. Published online September 22, 2020. doi:10.1001/jama.2020.15088
3. Shinkai K, Bruckner AL. Dermatology and COVID-19. JAMA. Published online September 22, 2020. doi:10.1001/jama.2020.15276
4. Redberg RF, Katz M, Steinbrook R. Internal medicine and COVID-19. JAMA. Published online September 22, 2020. doi:10.1001/jama.2020.15145
5. Winkelmayer WC, Khairallah P, Charytan DM. Nephrology and COVID-19. JAMA. Published online September 22, 2020. doi:10.1001/jama.2020.16779
6. Josephson SA, Kamel H. Neurology and COVID-19. JAMA. Published online September 22, 2020. doi:10.1001/jama.2020.14254
7. Disis ML. Oncology and COVID-19. JAMA. Published online September 22, 2020. doi:10.1001/jama.2020.16945
8. Bressler NM. Ophthalmology and COVID-19. JAMA. Published online September 22, 2020. doi:10.1001/jama.2020.17595
9. Piccirillo JF. Otolaryngology–head and neck surgery and COVID-19. JAMA. Published online September 22, 2020. doi:10.1001/jama.2020.15779
10. Christakis DA. Pediatrics and COVID-19. JAMA. Published online September 22, 2020. doi:10.1001/jama.2020.14297
11. Öngür D, Perlis R, Goff D. Psychiatry and COVID-19. JAMA. Published online September 22, 2020. doi:10.1001/jama.2020.14294
12. Kibbe MR. Surgery and COVID-19. JAMA. Published online September 22, 2020. doi:10.1001/jama.2020.15191
13. Rivara FP, Fihn SD, Perencevich EN. JAMA Network Open and COVID-19. JAMA. Published online September 22, 2020 doi:10.1001/jama.2020.15194
14. Ayanian JZ. JAMA Health Forum and COVID-19. JAMA. Published September 22, 2020. doi:10.1001/jama.2020.18432
15. World Health Organization. WHO ad-hoc online consultation on managing the COVID-19 infodemic. Accessed August 27, 2020. https://www.who.int/teams/risk-communication/infodemic-management/who-ad-hoc-online-consultation-on-managing-the-covid-19-infodemic
16. Tangcharoensathien V, Calleja N, Nguyen T, et al. Framework for managing the COVID-19 infodemic: methods and results of an online, crowdsourced WHO technical consultation. J Med Internet Res. 2020;22(6):e19659. doi:10.2196/19659
17. Eysenbach G. How to fight an infodemic: the four pillars of infodemic management. J Med Internet Res. 2020;22(6):e21820. doi:10.2196/21820
18. Fuchs VR. Is single payer the answer for the US health care system? JAMA. 2018;319(1):15-16. doi:10.1001/jama.2017.18739
19. Naylor CD. Canada as single-payer exemplar for universal health care in the United States: a borderline option. JAMA. 2018;319(1):17-18. doi:10.1001/jama.2017.19668
20. Fuchs VR. How to make US health care more equitable and less costly: begin by replacing employment-based insurance. JAMA. 2018;320(20):2071-2072. doi:10.1001/jama.2018.16475
21. Fuchs VR. Health care policy after the COVID-19 pandemic. JAMA. 2020;324(3):233-234. doi:10.1001/jama.2020.10777
22. Bauchner H, Fontanarosa PB. Health care is a right and not a privilege. JAMA. 2020;323(11):1049. doi:10.1001/jama.2020.0891
23. Gostin LO, Cohen IG, Koplan JP. Universal masking in the United States: the role of mandates, health education, and the CDC. JAMA. Published online August 10, 2020. doi:10.1001/jama.2020.15271
The summary above are some of the concerns noted in todays edition of JAMA Covid-19 edition. These include multiple organ injury and debility that result from COVID-19 infections. As I have noted before, up to 97% of patients who have recovered and survived a COVID-19 infection have been left with at least some of the following sequelae, and this is of major concern. As the conclusion of the editors' written article, "No single event since the end of the Cold War has so affected the lives of virtually every person living in every country of the world." How true! (Comments and further editorializing by by Gary Ordog, MD; County of Los Angeles, Department of Health Services, Physician Specialist, with roles of Residency and Research Director, Interim Vice-Chairman, Department of Emergency Medicine, King/Drew/UCLA Medical Center(retired)). September 26, 2020: Please add your thoughts to the current list condensed from JAMA:
Thank you, Gary Ordog, MD
DECEMBER 7, 2020
COVID-19: Close to 207,000 new cases reported in US
According to CDC's update on December 6, the case count of COVID-19 in the US stands at 14,462,527* cases, including 280,135* deaths, in 55 (50 states, District of Columbia, Puerto Rico, Guam, Northern Marianas, and US Virgin Islands) jurisdictions. The CDC noted that this represents an increase of 206,992 cases and 2,310 deaths compared to the update on the preceding day.
Yes, vaccine almost ready to distribute, but we are breaking all-time record numbers of infections and deaths. Like I said previously, the worst part is just before the end. The pandemic definitely wasn't over, it has barely begun!!