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12 months ago · by · Comments Off on Research On Long-Term Effects On Covid 19 Begin As Cases Surge

Research On Long-Term Effects On Covid 19 Begin As Cases Surge

 

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The U.S. death toll from the coronavirus pandemic has topped 156,000 as the number of people hospitalized with COVID-19 soared in July by nearly 50%. There are now over 5 million confirmed cases in the US with California, Florida and Texas each reaching over 500,000 confirmed cases, nearly double the cases reported in New York City, the former leading epicenter of the pandemic in the US. Nearly half of the US confirmed cases have recovered.
The Centers for Disease Control and Prevention (CDC) said that a significant number of COVID-19 patients do not recover quickly, and instead experience ongoing symptoms, such as fatigue and cough. Eight months into the global pandemic, we’re still measuring its effects only in deaths. Non-hospitalized cases are termed ‘mild’ and are largely not followed up. Recovery is implied by discharge from hospital or testing negative for the virus so ongoing ill health in those classed as ‘recovered’ is going largely unmeasured as the focused has mainly been on slowing the infection rate.
Research that follows COVID patients after discharge from hospital is starting but there is still a gap in quantifying and characterizing COVID-related illness in those not hospitalized. The few studies on those who have recovered indicate that previously healthy people with persistent symptoms such as chest heaviness, breathlessness, muscle pains, palpitations and fatigue, which prevent them from resuming work or physical or caring activities, are still classed under the umbrella of ‘mild COVID’. As many as a third of patients who were never sick enough to be hospitalized are not back to their usual health up to three weeks after their diagnosis. Many with long-term symptoms are otherwise young and healthy. Among those surveyed between ages 18 and 34, about 20 percent experienced lasting symptoms.
Among the patients who experienced lasting symptoms in a CDC report, 71 percent reported fatigue, 61 percent had lasting cough, and 61 percent reported ongoing headaches. Although clinicians and researchers have an idea of who is at increased risk of dying from COVID, we don’t know who is more likely to experience prolonged ill health following symptomatic, or even asymptomatic, infection. The CDC still states that preventative measures, such as physical distancing, face masks and frequent hand-washing, continue to be important to slow the spread of COVID-19. They warn that worldwide, millions of those still alive who got ill without being tested or hospitalized are simply not being counted.
The World Health Organization reports cases are now doubling every six weeks. The United States, Brazil, and the United Kingdom have been among the countries hardest hit by the pandemic. The global death toll from the coronavirus has surpassed 700,000, with nearly 19 million confirmed cases, as the pandemic continues to accelerate. During the month of July, more than 8 million people tested positive — almost as many as in the first six months of the pandemic combined. Nearly 12 million of those confirmed cases have recovered.
The top White House coronavirus adviser Deborah Birx has warned the country has entered a new phase in its fight against the pandemic. A new model by the Institute for Health Metrics and Evaluation suggests the U.S. coronavirus death toll is on pace to reach nearly 300,000 by December. The institute projects 66,000 lives could be saved if 95% of people in the United States wear face coverings. The U.S. death toll currently stands at the highest total in the world.

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1 year ago · by · Comments Off on Covid 19 Cases Surge As Research On Lasting Effects Continues

Covid 19 Cases Surge As Research On Lasting Effects Continues

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Coronavirus cases continue to surge in much of the United States, where the number of confirmed infections has topped 4.6 million, with nearly 155,000 reported deaths. Florida has surpassed New York to become the state with the second-highest number of infections after California. Almost 66,000 new COVID-19 cases and more than 1,400 deaths from the virus were reported in the U.S. on July 29th, 2020. The toll marks the highest number of deaths from COVID-19 in a single day since May 15. A total of 773 of those deaths were reported by coronavirus hot-spot states Arizona, California, Florida and Texas. Florida reported a state record of 216 coronavirus-related deaths in 24 hours.
In California, healthcare providers say they are again dealing with shortages in testing, which is hitting low-income and immigrant communities the hardest. In Texas, doctors at a rural hospital in Starr County have received critical care guidelines to help them decide which COVID-19 patients the hospital can treat and those whom they send home because they are more likely to die. With the virus continuing to spread out of control, researchers at Johns Hopkins University are calling for a “reset” in the U.S. coronavirus response with universal mask mandates, federal support for expanded testing and a new round of stay-at-home orders in hot spots. And in an open letter published Wednesday, the Association of American Medical Colleges writes, “If the nation does not change its course — and soon — deaths in the United States could be well into the multiple hundreds of thousands.”
Globally, coronavirus cases have now topped 16.2 million and over 650,000 have died since the first cluster of cases were reported in late December 2019 in Wuhan China. Last week, the worldwide caseload jumped by 1 million in just four days. The World Health Organization declared the outbreak the most severe global health emergency the WHO has ever faced.
As European nations scramble to prevent a second wave of infections, Britain has reinstated a 14-day quarantine for travelers coming from Spain. Globally, 11 million people have recovered. For those who survive COVID-19, there’s increasing evidence of long-term organ damage with more studies underway. A new study published by the Journal of the American Medical Association found that of 100 middle-aged patients who recovered from COVID-19, 78 had structural damage to their hearts.
One study group in Italy found that 87% of patients hospitalized for acute COVID-19 were still struggling 2 months later. Data from the COVID Symptom Study, which uses an app into which millions of people in the United States, United Kingdom, and Sweden have entered their symptoms, suggest 10% to 15% of people—including some “mild” cases—don’t quickly recover. But with the crisis just months old, no one knows how far into the future symptoms will endure, and whether COVID-19 will prompt the onset of chronic diseases.
Distinct features of the virus, including its propensity to cause widespread inflammation and blood clotting, could play a role in the assortment of concerns now surfacing. Survivor studies are just starting to probe them. Researchers across the United Kingdom have launched a study that will follow 10,000 survivors for 1 year to start, and up to 25 years. Ultimately, researchers hope to understand the disease’s long shadow and hopefully be able to predict who’s at highest risk of lingering symptoms and learn whether treatments in the acute phase of illness can head them off.

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1 year ago · by · Comments Off on Covid 19 Cases Continue to Rise in the US

Covid 19 Cases Continue to Rise in the US

 

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There have been over 15 million confirmed coronavirus cases around the world with 618,000 deaths. Of those cases 8,500,000 have recovered. In the US there are over 4 million confirmed cases and over 145,000 have died in the 6 months since the first case was confirmed in the US. Almost 8,500,000 of the US cases have recovered. The United States has set another grim record for coronavirus infections, with more than 75,600 new cases confirmed. At least 11 states are reporting record hospitalizations, with nearly 1,000 new deaths in just 24 hours. Officials in Texas and Arizona have put out calls for refrigerated trucks, as morgues overflow with the bodies of COVID-19 patients. Texas and Florida both reported their highest death tolls of the pandemic.
As the number of new global coronavirus cases reaches record highs, the World Health Organization is warning the coronavirus outbreak will continue to worsen if governments don’t take basic public health measures. Reports the number of coronavirus deaths in Latin America has now exceeded the death toll in the United States and Canada. Researchers estimate the US will have 219,864 total Covid-19 deaths by November 1, according to the Institute for Health Metrics at the University of Washington.
In Florida, confirmed coronavirus cases topped 300,000 even as Disney World completed a phased reopening of its Orlando theme parks. Nearly 50 Florida hospitals said they were out of ICU beds. In Miami, hospitals have run out of regular intensive care beds, with new patients moved into converted ICUs. Governor Ron DeSantis said he was mobilizing 1,000 medical workers to fill critical staffing shortages.
California, the most populous state and the first to shut down months ago, appeared to have Covid-19 under control — only to suffer a massive resurgence and surpass New York with the most coronavirus cases in the nation. California, which now has 417,000 confirmed cases due to the recent spikes, is largely shutting down again. California Governor Gavin Newsom has a plan to halt the recent surge by ordering all indoor restaurants, wineries, movie theaters and museums to be closed again. Bars have been ordered to cease all operations. Indoor businesses have been shuttered in many areas. Newsom said the new shutdowns are needed to address the public health crisis. The Los Angeles and San Diego school districts have announced that all classes will be conducted online at the start of the school year due to the pandemic.
Covid-19 is set to become one of the leading causes of death in Los Angeles County, according to Barbara Ferrer, the county’s health director. “It’s killing more people than Alzheimer’s disease, other kinds of heart disease, stroke and COPD,” Ferrer said. Comparing Covid-19 to the flu, Ferrer said data shows Covid-19 killed twice as many people in six months as the flu did in eight months.
The city of Atlanta announced a similar plan. In New York, Governor Andrew Cuomo said schools will be allowed to reopen, but only in regions with low daily infection rates. At least 41 states have some kind of mask requirement in place or planned. In Colorado, Governor Jared Polis issued a statewide mask mandate, a week after refusing public health officials’ pleas to require facial coverings in public. Arkansas Republican Governor Asa Hutchinson issued a similar mask mandate. The CDC reports that 10 states have reported 10,000 new cases while three states each reported over 60,000 new cases in the last week.
Several vaccine trials are progressing well, and researchers say a vaccine might be publicly available by early 2021. Health and Human Services Secretary Alex Azar said any Covid-19 vaccine that’s sponsored by the US government will be free or affordable for the American public.

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1 year ago · by · Comments Off on Covid 19 Surges in 36 States

Covid 19 Surges in 36 States

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The World Health Organization is warning “the worst is yet to come” as countries across the globe are experiencing new spikes, with some putting the brakes on reopening.   The pandemic is the worst in the Americas, where the number of COVID-19 deaths are projected to nearly triple to 627,000 by October 1.  Coronavirus cases have now surpassed 11 million worldwide, with over a half-million deaths. Cases continue to surge across much of the United States, where confirmed cases have now topped 2.8 million, with over 128,000 reported deaths — that’s one-quarter of the world’s cases and deaths, though the U.S. has just over 4% of the global population.

Spikes are being reported in 36 states. Only two states — Connecticut and Rhode Island — saw a decline in new cases compared to the previous week.  The United States has set another grim coronavirus record, confirming nearly 52,000 cases of COVID-19 in just 24 hours.  Alaska, Arizona, California, Georgia, Idaho, Oklahoma, South Carolina, Tennessee and Texas all reported single-day record levels of the disease with hospitals in some regions already overwhelmed with patients.

At least a dozen states have “paused” their reopening. In California, Governor Gavin Newsom ordered bars in seven counties, including Los Angeles, to close. The governors of Florida and Texas have ordered bars to close, among other restrictions, in an attempt to curb the surge in cases.  A major hospital system in Houston reportedly stopped disclosing COVID-19 data after its ICU capacity hit 100%, and following conversations with Governor Greg Abbott in which he expressed concern over negative headlines.  Both governors are refusing to impose statewide stay-at-home orders and mandate the wearing of face masks.

More states around the country are imposing new measures and rolling back their reopening as coronavirus cases continue to surge. The governors of Oregon and Kansas are mandating face masks for residents. Jacksonville, Florida, also said it will make face coverings mandatory.  Seven cities in Texas say they will impose orders mandating face masks.  Meanwhile, hospitals in Texas report a dire situation as cases surge.

Meanwhile, beaches in Los Angeles, as well as several Florida counties, were closed for Fourth of July weekend.  Despite skyrocketing cases, crowds still packed many of the open beaches in coastal cities for the Fourth of July holiday weekend, sparking further fears of new spikes.

Officials in Texas, Florida and Arizona say the states’ early reopenings helped fuel the explosion in cases. In California, Governor Gavin Newsom reimposed coronavirus restrictions, shutting down bars and indoor dining in 19 counties that are home to more than 70% of California’s population.  In Arizona, Governor Doug Ducey ordered bars, gyms, movie theaters and water parks closed for at least 30 days amid an exponential rise in new infections.  New York City has also halted plans to reopen indoor dining at restaurants. New York, New Jersey and Connecticut have ordered travelers from 16 states with high infection rates to self-quarantine upon their arrival.

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1 year ago · by · Comments Off on Missouri Resident At Lake of Ozarks Positive for Covid 19

Missouri Resident At Lake of Ozarks Positive for Covid 19

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A Missouri resident has tested positive for COVID-19 after going to the Lake of the Ozarks over the Memorial day weekend, health officials said. The Camden County Health Department said one person tested positive for the virus from Boone County. Health officials said the person did visit Backwater Jack’s, which is the outdoor pool and bar, where a viral video of people not social distancing was taken on Memorial Day weekend. Authorities say the person developed the illness on Sunday and was likely incubating illness and possibly infectious at the time of the visit.
Health officials provided the following timeline for contact tracing:
Saturday, May 23- Backwater Jacks – 1pm to 5pm, Shady Gators and Lazy Gators Pool — 5:40pm to 9pm,
Backwater Jacks — 9:40pm to 10pm, Sunday, May 24 – Buffalo Wild Wings – 1pm to 2pm, Shady Gators — 2:30pm until about 6:30pm or 7pm, Taxi from Shady Gators to private residence about 7pm. They encourage anyone who was at these locations during these times to get tested for Covid 19.
Photos and videos of partygoers crowded into the swim up bar-Backwater Jacks circulated social media over the holiday weekend. Backwater Jack’s Bar and Grill in Lake of the Ozarks is a popular vacation spot in the Midwest that regularly draws summer crowds. It was no different last weekend, even given the pandemic, and people are blasting the restaurant and attendees for ignoring social distancing advice. It’s clear from posts on social media that even if the venue was operating at reduced capacity, it was too crowded to maintain 6 feet between attendees.
Visitors and lake area residents told news outlets they were concerned with the lack of social distancing and safety that lead to a positive coronavirus case because they know the area attracts people from out of state also. “Everyone saw it coming so it’s kind of irony. Everyone’s like oh it’s fine we won’t do anything. But, there’s 200 people in a little pool. So I saw it coming. That’s why I tried to protect myself and make sure I keep others safe as well.” One Lake area resident said.
A visitor to the Lake Area said “They were taking a chance and I’m concerned about what the outcome will be in another week or two. With the one case showing up. Everyone that was exposed to that person is exposing a lot of other people. So it’s a bit concerning.”
The Missouri Department of Health and Senior Services said Monday 773 deaths have been attributed to COVID-19 in the state and there are over 13,000 confirmed cases since the outbreak started. The Kansas Department of Health and Environment said Monday the state has almost 10,000 confirmed cases of COVID-19 and there have been 217 deaths since the outbreak started. The US death toll over 100,000.

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1 year ago · by · Comments Off on Some States Reopen As Researchers Confirm Covid Was Circulating the US Earlier Than Believed

Some States Reopen As Researchers Confirm Covid Was Circulating the US Earlier Than Believed

 

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As many states slowly reopen, a pair of studies predict the COVID-19 outbreak is set to become far deadlier in the United States. A draft Federal Emergency Management Agency report forecasts that daily coronavirus deaths in the United States would rise to 3,000 people a day by June 1 — that’s a 70% increase over the current figure. Separately, the Institute for Health Metrics and Evaluation at the University of Washington estimates the U.S. death toll will reach around 135,000 by August in the United States.

The U.S. death toll from the coronavirus outbreak has topped 75,000 and is projected to keep rising in the coming weeks. The official coronavirus death toll worldwide has topped a quarter of a million, with over 3.6 million confirmed cases.  The United States makes up close to one-third of confirmed cases and a quarter of known deaths, even though it represents less than 5% of the world’s population.

Over half of U.S. states have relaxed, or are preparing to loosen, social distancing and other restrictions but it has not been a smooth transition.  In Georgia, more than 120 Atlanta restaurants have refused to open, saying it is not safe to do so despite Georgia Governor Brian Kemp’s lifting of the state’s shelter-in-place order.  In Miami Beach, the governor had to close a popular park — just five days after reopening it — after thousands failed to adhere to new rules requiring social distancing and wearing a face mask.

Meanwhile, we continue to learn more about the virus globally as scientists and doctors try to create a vaccine.  A French hospital says they treated a COVID-19 patient as early as December — a month before the government confirmed its first cases.  A preliminary new study finds the novel coronavirus that first emerged in China mutated in Europe in February to become more contagious, speeding its spread around the globe. The authors of the study said they released their findings early so that people working on vaccines could see their results.

US Researchers say the novel coronavirus silently spread in the United States earlier than previously thought as well, infecting tens of thousands of people in New York and other major cities before the first US case was confirmed on January 21.  A new model by the Network Science Institute at Northeastern University in Boston shows the first infections came from China in early or mid-January, and that the virus went undetected because many people were not presenting symptoms or were misdiagnosed because US doctors had not seen the virus first hand yet.

The model suggests that while Americans were still focused on China, about 28,000 people in major cities — such as New York, San Francisco and Seattle — were infected by March 1.  Santa Clara County officials announced that tissue samples confirmed two people who died in early February tested positive for coronavirus. That month, a number of physicians saw patients, without travel histories, who had flu-like symptoms.

Several states, including California and Indiana, have been retracing their coronavirus timelines after discovering that the highly infectious disease started killing people earlier than previously known.  These discoveries have emphasized just how much about this pandemic remains unknown. Four months since the novel coronavirus was first discovered in Wuhan, China, experts worldwide still do not fully understand how the virus started, how it impacts the body or what treatments are effective.

 

 

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1 year ago · by · Comments Off on Experts Warn of Spikes In Covid 19 Cases 2 to 3 Weeks From Reopening

Experts Warn of Spikes In Covid 19 Cases 2 to 3 Weeks From Reopening

 

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In just a few months, Covid 19 has spread across the globe and left in its wake a trail of social paralysis, economic ruin and even death.  While states across the US issued stay at home orders to slow their healthcare systems from being overrun, other states like New York, weren’t so lucky.  As some U.S. states start to lift pandemic-related restrictions on businesses and public spaces, there is a fear that infections will resurge in those places — and that if that happens, the virus won’t stay put.

Crystal Watson of the Johns Hopkins Center for Health Security said “I do believe we are going to see additional surges of cases from this epidemic that will not be contained within a state.  Neighboring states and perhaps states across the country and countries across the world are going to have cases imported from those outbreaks.”  Experts say the problem is that diagnostic testing remains so limited that a second surge of cases could silently build. The nationwide goal of conducting 2 million tests a week is below what most experts say is needed to adequately track the virus and that plan won’t be in place until at least the end of May.

No one knows how quickly and how expansively the spread of the virus will pick up as states roll back restrictions, and governors are generally outlining gradual changes.  The incubation period of 2 to 14 days coupled with the turn-around time of test results in some areas taking a few days, means we just have to wait and see if reopened states will experience a surge in cases.  More than half the states have relaxed restrictions but experts say it will be at least two to three weeks before we see an increase in the number of infections because it takes time for individuals to infect others and for them to display symptoms.

Public health experts warned of the possibility of spikes before states made the decision to reopen. Even as their predictions prove true in some states, others are still moving forward with plans to reopen. Proponents of relaxing social distancing restrictions also point out that spikes in positive cases are to be expected with expanded testing.

In Georgia, gyms, salons, and restaurants are operating with limits. In Colorado, retail stores can have curbside pickup and elective surgeries are back on. And starting tomorrow, malls, theaters, and restaurants in Texas can open with 25% occupancy. These and other states have plans for further easing of distancing policies as long as case counts don’t spike.  If these states do see spikes they may have to roll back the restrictions as needed.

 

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1 year ago · by · Comments Off on Meat Processing Plants Close Due to Covid 19

Meat Processing Plants Close Due to Covid 19

 

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The coronavirus outbreak has hit workers in the food processing industry hard, with meatpacking plants reporting explosions in coronavirus cases. In Sioux Falls, South Dakota, a Smithfield Foods pork processing plant that employs 3, 700 people closed down indefinitely after the mayor put pressure on the CEOs to shut down for two weeks as the virus continued to spread through the plant.

The mayor spent two weeks asking them to shut down to no avail with daily reports of more workers becoming infected.  He finally forced their hand by releasing a letter, signed by the governor, requesting that the plant shut down and released it to the press.  At the time of the closure, the plant had 238 workers that tested positive.  Now, just 3 weeks after their first worker tested positive, there are more than 700 workers who are confirmed to have Covid 19 and another 143 infections that were traced to them.  The number of confirmed cases from the Smithfield plant represent 55% of the states’ cases.

Cargill Meat Solutions, a 900-worker plant in Hazleton, Pa., that packages meat in plastic for supermarket shelves in Pennsylvania and surrounding states, shut down temporarily as 130 hourly workers have tested positive for COVID-19 and a rash of employees called out sick.  Three other Pennsylvania plants closed due to the virus.  According to a union rep, JBS Beef in Souderton, CTI Foods hamburger-grinding plant in King of Prussia and Empire Kosher Poultry Inc. in Mifflintown are all closed amid outbreaks among employees.  A 70-year-old union steward at the JBS Beef slaughterhouse in Souderton died on April 3 from respiratory failure brought on by the pandemic virus.

Meat-processing plants across several other states including Colorado, Iowa, and Nebraska are reporting COVID-19 outbreaks. A federal food inspector in New York died from the disease last month.   Some companies are temporarily closing to sanitize facilities while also boosting hourly pay and offering bonuses to workers in an “essential” industry. Cargill said it would reopen its Hazleton plant as soon as it is safe. In late March, Cargill and the United Food and Commercial Workers negotiated a $2 per hour raise for shifts worked between March 23 and May 3. JBS Beef employees will be eligible for a one-time $500 bonus on May 15.

The World Health Organization, the U.S. Food and Drug Administration, and the Centers for Disease Control and Prevention say COVID-19 cannot be spread through food.  It’s an “unstable virus” that is mostly spread through sneezing and person-to-person contact. Stomach acids also mostly neutralize the virus if it’s eaten as well.

 

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1 year ago · by · Comments Off on Covid 19 Projections

Covid 19 Projections

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The coronavirus pandemic continues in almost every corner of the globe, with the number of confirmed COVID-19 cases worldwide surpassing 1 million people — though the true number is certain to be far higher due to a critical lack of testing globally.  The largest number of cases is in the United States with over 350,000 confirmed.  Over 10,000 people in the US have died of Covid-19 as the virus continues to spread.

In Europe, COVID-19 has pushed hospitals across the continent past their breaking points. Spain has reported over 120,000 cases and their death toll topped 10,000.  In the U.K., London’s ExCeL convention center has been converted into an enormous field hospital with plans to treat up to 4,000 COVID-19 patients. Over 2,300 people have died from the disease across the U.K.

In Italy, there are over 100,000 confirmed cases and their COVID-19 deaths have topped 15,000.  It’s been reported that Italy’s true toll is far higher because the country can’t spare the resources to test every dead body.  U.S. Vice President Mike Pence said models predict the United States faces a trajectory of COVID-19 deaths similar to Italy’s.  The computer model used by the White House projects close to 82,000 COVID-19 deaths in the United States by August 4, assuming the country implements full social distancing until the end of May.

The 81,766-death projection is a slightly less grim figure than the 93,531 cited earlier by the administration. The model projects that the country may need fewer hospital beds, ventilators and other equipment than previously estimated, and that some states may reach their peak of COVID-19 deaths sooner than expected.  Not all states are using the federal government’s forecasting model.

While the White House projects that coronavirus cases in the nation’s capital would peak later this month, the local Washington, DC government is relying on a different computer model that says it won’t peak until late June or early July.  Health experts warn against early optimism and say it’s best to prepare for worst case scenarios.

Experts say that pandemic modelling is almost never precise and the Covid-19 pandemic, the uncertainty in the projections is because of lack of access to good data coupled with the fact that we just don’t know enough about the coronavirus.  Another factor that adds to the uncertainty is how people will behave and what kinds of policies will be enacted to change contact patterns in the weeks and months ahead.  The ranges estimated really depends on how much people actually adhere to social distancing policies and how quickly these policies are issued.

 

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1 year ago · by · Comments Off on Non Essential Businesses Shut Down Across US

Non Essential Businesses Shut Down Across US

 

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At least 24 states have enacted policies to close nonessential businesses in an effort to slow the spread of Covid-19 in the United States.    While guidance varies from state to state, recreational spaces like museums, movie theaters, gyms, day cares, music venues and malls, as well as personal care retailers like spas, nail and hair salons, tend to fall in the nonessential businesses category.

The states with nonessential business shut-downs are Washington, California, Oregon, Nevada, New Mexico, Oklahoma, Louisiana, Illinois, Kentucky, Indiana, Wisconsin, Minnesota, Ohio, West Virginia, Virginia, Pennsylvania, New York, Vermont, Massachusetts, Connecticut, New Jersey, Delaware and Maryland.  Other states like Missouri and Kansas have shut down orders in certain counties.

Shuttering nonessential businesses resulted in tens of thousands of American workers losing their jobs in recent weeks. In New York and New Jersey, so many people filed for unemployment insurance over the past week that both states’ online systems crashed.  While guidance varies from state to state, recreational spaces like museums, movie theaters, gyms, day cares, music venues and malls, as well as personal care retailers like spas, nail and hair salons, tend to fall in the nonessential businesses category.

In New York, where Gov. Andrew Cuomo on Tuesday warned that the “rate of new infections is doubling about every three days,” essential businesses that remain open include health care facilities, infrastructure and manufacturing entities and essential services like trash collection, law enforcement and homeless shelters. Bars and restaurants can only offer take-out or delivery.

 

 

 

 

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