Patronus Medical Blog

COVID-19 Updates 3/19/20

Posted by Kerri Wright on Mar 20, 2020 5:49:04 PM

Daily Message: Throughout the past week, authorities at all levels have begun acquainting citizens with more restrictive containment measures indicating that this may become the new normal. The announcement today from the State Departing advising against all foreign travel set the stage for greater action by the federal government on a domestic level. This action by State is a call to bring citizens home before the potential unconditional closure of borders for nonessential travel is implemented worldwide. California’s move requiring its population to “shelter in place” is further indicative of measures to come either at the state or national level. In the coming days, significant changes could be handed down for an indefinite period of time. During this time, risk will take a different shape. Authorities will prepare for the ramifications of a potential total nationwide lockdown including increased security risks on account of rioting, looting, and resource insecurity. Furthermore, individuals may experience different kinds of stress as a result of being more confined. It will become imperative to disseminate information regarding healthy practices for sheltering in place and to promote mental health.

Important Updates: International Desk ASIA - China, Singapore, and South Korea are experiencing a second wave of coronavirus cases imported from abroad. It will be essential in the coming months to monitor global cases and to determine the appropriate time to lift travel bans so as not to reinvigorate the spread of the disease.

CARIBBEAN - The spread of the coronavirus continues to remain relatively low, but should continue to be monitored.

ANTIGUA AND BARBUDA - a reminder that all foreigners who have traveled to the following countries within the past 28 days will be denied entry: China, Italy, Iran, Japan, South Korea, and Singapore.

DOMINICAN REPUBLIC (D.R.) - Haiti announced closure of its border with the DR today in an effort to combat the spread of the disease. Haiti remains one of the only countries in the Caribbean to currently be without COVID-19.

EUROPEAN UNION (E.U.) -. Case numbers and death tolls are mounting in Europe as the illness begins its ascent to the peak. Stringent measures have been taken across the board inside he European Union. Movement within individual member states still remains with the States’ authorities, but many have chosen to impose complete lockdowns.

ITALY - Italy’s death toll from COVID-19 superseded China’s today. Italy saw over 425 deaths in one day bringing the nation’s total to 3,405. China has recorded just under 3,250 deaths. Shockingly, Italy has about half the number of cases at 41,035 as compared to China’s 81,199 confirmed cases. This brings the case fatality rate (CFR) to over 8% in Italy, which has sent shockwaves through the international community. Many countries are now looking to avoid a situation like Italy’s, but it will require immediate, stringent, and actionable containment measures.

PORTUGAL - The President officially declared a state of emergency calling for people “to cancel everything and stay home”. Stricter regulations such as closure of non-essential businesses and restrictions on individual movements are expected. The state of emergency will last until 3 April.

SPAIN - Spain still continues to struggle with the outbreak recording a staggering 18,077 cases, second only to Italy in Europe for the total number of cases. The President of the Region of Madrid announced today that 80% of people in the country’s capital, Madrid, will acquire COVID-19. Also on Thursday the number of confirmed cases rose by 25% and the number of deaths increased by 28% in one day. Although the country is on strict lockdown, Spain’s Prime Minister acknowledges that the peak of the outbreak has yet to come.


CANADA - Yesterday closure of the U.S./Canada land border was announced for all non-essential movements. Discussions detailing a comprehensive travel ban between the U.S. and Canada are ongoing, but are expected to be announced and implemented Friday night (20 March 2020).

MEXICO - The State Department announced this evening, 19 March, that the U.S. and Mexico are hammering out a plan to restrict non-essential travel across the land border. More details are expected in the coming days.

UNITED STATES - 18 March, The U.S. Department of State issued a Level 4 Travel Advisory for international travel. The warning strongly advises against all foreign travel due to the ongoing COVID-19 outbreak. The State Department encourages all American citizens to return to the United States immediately; otherwise, citizens may be faced with staying abroad for an indefinite period of time. Many airline carriers have or will cancel their international routes in the coming days. Additionally, U.S. Embassies abroad may be operating with limited staff due to the global outbreak which could result in restricted embassy and consulate services for U.S. citizens.

OCONUS Desk - 18 March saw more restrictive directives implemented countrywide. States and counties have been trending toward tighter restrictions on movement and social interactions. Stricter regulations are to be expected across all states in the coming days.

ARIZONA - Governor Ducy activated the National Guard today. In another move, he required that restaurants in counties with confirmed cases cease dine-in service and close all theaters, bars, and gyms. Elective surgeries have been suspended to free up medical resources in anticipation of further spread of the virus throughout the state.

CALIFORNIA - Governor Newsom announced Thursday evening a “shelter in place” directive for the entire state of California. The shape and enforcement of this mandate has yet to take place, but in essence ALL non-essential activities must cease and citizens are asked to remain at home for an indefinite period of time. The Governor did not want to specify a termination date for the order, but alluded that residents may be homebound for up to eight weeks. This comes after an announcement that it is predicted that 56% (25.5 million people) of Californians will acquire COVID-19 within the next two months. California is the first state to implement such restrictive measures, more states are expected to follow suit in the coming days.

HAWAII - The state’s House Speaker asked the governor to implement a 15-day shelter in place mandate after 10 new cases were confirmed in one day bringing the total number to 26.

IDAHO - The state announced its first case of community spread of the virus. Several counties in Idaho announced a joint statement regarding an upcoming “shelter in place” mandate that will be announced in the coming days. Blaine County and the cities of Bellevue, Carey, Hailey, Ketchum, and Sun Valley were present at the press briefing.

NEW YORK - Due to increased testing availability, the number of cases in New York has risen by over 2,200 in one day. The total number of confirmed cases in NYC alone has risen to over 4,000. Cases have quadrupled since Monday.

NEVADA - The Governor has shut down all schools and non-essential businesses until April 13th.

NORTH CAROLINA - North Carolina recorded its first case of community acquired COVID-19 today. The Medical Director with the Department of Health has urged people to stay home in order to prevent further spread of the virus, but no official mandates have been implemented yet.

TEXAS - Governor Abbott issued an executive order calling for a statewide shutdown of all schools, bars, restaurants, and gyms today.

Useful Precautions: Given today’s travel advisory change to Level 4 (Do Not Travel), the State Department has issued guidance for international travelers. Foreign travel is not advised as the outbreak mounts. Countries are imposing restrictive travel measures, mandatory quarantines, and/or are closing their borders without notice. It is recommended that U.S. citizens return immediately.


● U.S. citizens and permanent residents are permitted to travel back to the U.S. from the U.K., Ireland, and the 26 Schengen countries. All travelers from these areas must fly into one of the permitted U.S. international airports for additional screening. For comprehensive information regarding those ports of entry, refer to the DHS website. Non-U.S citizens or permanent residents are still prohibited from entering the U.S. if they have traveled to Europe within the past 14-days.


● U.S. citizens or permanent residents having traveled to China within the past 14-days should expect to be quarantined for 14-days upon arrival to the U.S.


● The CDC does not recommend cruise travel for anyone with underlying health issues or in advanced age at this time. Other travelers should note that ships may have difficulty disembarking at ports of call and passengers may be faced with quarantine upon arrival.


● The CDC recommends that universities and other institutes of higher education postpone study abroad programs. It also recommends that students currently participating in study abroad programs return to their home countries.

Credible Information Sources:

● CDC COVID-19 Information

● Johns Hopkins Global COVID-19 Map

● National Institutes of Health COVID-19 Profile

● U.S. State Department Travel Advisories

● U.S. State Department Travel Guidance

● World Health Organization COVID-19 Profile

Topics: Covid-19