Patronus Medical Blog

Patronus Medical COVID-19 Update - 016 14 May 2020

Posted by Kerri Wright on May 22, 2020 9:35:35 AM

Current as of 2200 EDT/ 1900 PDT

Current COVID-19 Statistics:

4,442,163 - Worldwide Cases (94,242 increase, up 2.3%)*

1,587,893 - Worldwide Recovered

302,418 - Worldwide Fatalities

 

1,417,512 - U.S. Cases (26,778 increase, up 1.9%)*

246,414 - U.S. Recovered

85,898 - U.S. Fatalities

 

United States Locations

12,674 - Arizona Cases

74,871 - California Cases (1,745 increase, up 2.4%)*

637 - Hawai’i Cases

2,351 - Idaho Cases

462 - Montana Cases

343,051 - New York Cases (2,390 increase, up .1%)*

- 188,545 - New York City Cases (1,295 increase, up .1%)

6,504 - Nevada Cases

16,968 - North Carolina Cases

16,699 - Tennessee Cases

44,480 - Texas Cases (1,460 increase, up 3.4%)*

 

*Calculations based on previous day’s statistics

 

Daily Message:

 

Governments have begun gradually easing restrictive measures at the domestic level. There is a global sense of urgency to reignite economies and get industries back up and running; however there is calculated hesitation and a desire to conduct staged reopenings. Many countries in Asia and Europe are experiencing downward trajectories of new infections and have their priorities set on completely reopening local industries within the next month or two and opening their borders to international travel by mid-summer. Travel for the foreseeable future will be changed, much like the enhanced security screenings implemented at airports after 9/11, we should expect similar health screenings to become standard in airline, boat, and train travel. The world will likely see creative restrictions and policies implemented so as to reduce the risk of imported cases. The key to reopening international travel is to circumnavigate this protocol by potentially providing proof that the traveler is COVID-free or developing regional pacts with countries considered to be low-risk. Over the coming weeks and months, governments will assess domestic gains in the fight against COVID-19 which will shape policies pertaining to foreign travelers.

 

Important Updates:

International Desk

NORTH AMERICA - Travel restrictions between the U.S. and Canada/Mexico land borders are in place through 20 May. Top officials in the U.S. and Canada have indicated that travel restrictions between the two countries could be extended to 21 June, the same will likely hold true for restrictions with Mexico.

CANADA - Provinces are gradually reopening, but Prime Minister Trudeau still urges people to still stay home unless absolutely necessary. Select businesses began opening last week upon release of the Prime Minister’s set of principles for reopening the economy. Quebec remains the province most adversely affected by the illness with over 40,700 cases trailed by Ontario with nearly 21,500.

  • Travelers (residents and foreigners) entering Canada via land or air must submit travel information upon Those with COVID-19 symptoms must self-isolate for 14-days. Click here for entry requirements.
  • Quebec has delayed reopening businesses, schools, and daycares until 25 May.
  • Face coverings in public are required in most municipalities.

MEXICO - Today, Mexico reported a record single-day increase in active infections with 2,409 while fatalities increased by 257 bringing the country’s total to 4,477. Authorities continue to encourage residents to shelter in place during this time. The number of cases in the state of Baja California Sur remains low at 421 total infections with the majority of active cases found in the municipalities of Los Cabos (87) and La Paz (82).

  • A stay-at-home order is in effect until 30 May.

UNITED STATES (U.S.) - The U.S. military has issued an order prohibiting travel for all personnel until 30 June. Some exemptions have been made including those in the middle of a temporary duty travel or permanent change of station and those requiring medical attention will be permitted to travel. On the civilian side, the Department of State continues to sustain a Level 4 - Do Not Travel advisory.

  • Many airlines within the United States are requiring temperature checks and face masks prior to travel.

WORLD HEALTH ORGANIZATION (WHO) - The head of the organization’s health emergencies stated Wednesday that COVID-19 “may never go away” and instead viewed as a long-term constant to be managed rather than eradicated. He also noted that there was no way to predict how long it will take to get an effective vaccine nor for enough community acquired immunity to make outbreaks more manageable in the future.

AFRICA - Today, the last remaining country in Africa that was virus free recorded its first case, detected in a batch of travelers from South Africa and Saudi Arabia. The U.S. Embassy in Tanzania also issued a warning today regarding the risk of exponential growth in the virus within the country as hospitals in the principal city of Dar es Salaam have become completely overburdened.

ASIA - Many Asian countries that were experiencing downward trajectories hopes have been dashed for eradicating the disease after numerous incidents of resurgence in random pockets have begun springing up this week. Scientists from around the world are looking at Asia’s asymptomatic patients as the primary reason that eradication seems unlikely at least without a vaccine.

With countries in the region experiencing different stages and severities of the disease, restrictions on international travel should be expected for the foreseeable future.

CHINA - Wuhan, ground zero for the outbreak, is back on alert this week after fears of a second wave of new infections hits the country. Over the next 10 days, the government plans to test 11 million Wuhan residents after six new cases popped up over the weekend.

HONG KONG - Hong Kong recorded its first community acquired infections in 23 days just as social distancing restrictions have begun to ease. The city retains a low total number of cases with 1,051, an impressive figure considering its proximity to mainland China. Despite the news, authorities do not intend on bringing back the stringent measures initially implemented.

  • Entry is barred to all non-residents.
  • Residents traveling into the country are subjected to testing and mandatory quarantine.

SOUTH KOREA - After more than 100 new infections have been detected in nightclubs, authorities have shuttered over 2,000 clubs after having just been given permission to reopen the week before. Nearly 8,000 police have been deployed in the capital city of Seoul to assist in contact tracing those associated with the new infections.

CARIBBEAN - On account of the region’s environment and climate, social distancing practices have been more easily implemented than in other areas of the world. For this reason, the region has experienced relatively low levels of infection.

ANTIGUA AND BARBUDA - The 24 hour curfew expires today; however a curfew from 21:00 - 05:00 (9pm - 5am) remains in effect. Retailers are now permitted to conduct business during those hours as long as strict social distancing practices are in place. Beaches are also open from 0500-1900 with some restrictions. For a complete list of allowances, visit the government’s updated reference page.

  • Face masks are required in public including markets and grocery stores.
  • VC Bird International Airport will reopen to commercial traffic on 1 June. Private planes may be permitted at this time with special governmental approval.
    • Restrictions at embarkation and debarkation will be imposed. Passengers must submit to a COVID rapid test to prove no evidence of disease upon arrival. Residents must sit a mandatory 14 day quarantine and guests must confine themselves to hotels or resorts and limit interaction with locals.
    • Persons with a travel history to: Canada, China, Europe, Iran, South Korea, Singapore, and the S. within the past 28 days WILL NOT be permitted into the country.
  • A state of emergency is in effect until 12 June. The government is seeking approval to extend it until 31 July.

THE BAHAMAS - While restrictions are in place until 30 May, some easing of these mandates have begun to take effect. Certain businesses will be permitted to provide curbside services or deliveries Monday through Friday from 08:00-17:00 (8am - 5pm). Construction in New Providence and Grand Bahama my recommence with limited operating hours. Some islands have also been cleared for resumption of normal commercial activity. For a complete list of the phased allowances, please reference the government’s announcement.

  • There is a 24 hour curfew in place until 30 May, essential activities are permitted.
  • Grocery shopping is strictly regulated and allowed on days based on the first letter of a person’s last name.
  • A total lockdown is in effect every weekend in May (2100 Friday - 0500 Monday), all stores will be closed.
  • Citizens and legal residents with homes in the Bahamas were permitted to return via air travel to New Providence or Grand Bahamas last week; however this was temporarily halted earlier in the week, but may resume at any time.
    • Residents must contact a Bahamian Embassy or Consulate for a molecular diagnostic COVID-19 test. Returning residents will be required to sit a mandatory 14-day quarantine. Failure to comply could result in a $20,000 or five years in prison.
  • Airports, beaches and seaports remain closed including domestic travel. Some flights to the U.S. are permitted, click here for more information from the U.S. Embassy in Nassau.

DOMINICAN REPUBLIC (D.R.) - There is a state of emergency due to expire on 17 May. The country has increased their public surveillance dispatching additional military and police to patrol the streets.

  • A nationwide curfew is in place until 17 May, residents must stay home from 1700-0600 (5pm-6am).
  • It is mandatory to wear a mask in public.
  • All air, land, and sea borders are closed until 17 May.

EUROPEAN UNION (E.U.) - The E.U. has been experiencing declining infection rates throughout most of the bloc. While many countries have begun easing restrictions within their borders, the approach to permitting international travel varies. The European Commission encouraged member states to begin reopening national borders within the bloc, but the statement is non-binding. Some countries like Germany plan on easing land restrictions with bordering countries as early as Saturday with the aim at completely lifting restrictions by 15 June. Other countries are experimenting with regional “travel bubbles” permitting visitors from certain low risk countries. Nations heavily dependent on tourism are eager to open for the summer season, but will likely subject passengers to COVID tests at expense to the traveler. With a recession looming, some European countries have also begun issuing temporary work permits for migrant laborers to assist with the growing season.

  • Travel to the E.U. from outside of the bloc is restricted until 15 June.

ITALY - Italy is in Phase II of its recovery program which has rolled back lockdown measures and allowed certain industries to reopen. This period is expected to rollover on 17 May when restrictions are expected to ease even further. Vacations and non-essential travel are still prohibited and schools are not in session. Regional restrictions for areas hardest hit like Lombardy are still intact.

  • Houses of worship, museums, and libraries will reopen on 18 May.
  • Dine-in services are bars and restaurants are expected to resume on 1 June.

PORTUGAL - Portugal is now in its second week of phasing out restrictions and reopening the country. While residents have more liberty to go outside, people are still encouraged to stay home. A complete list of the phased reopening strategy can be consulted here in Portuguse. Authorities have also announced hopes to welcome international tourists by mid-June. The following protocols are still in effect:

  • Face masks are required in public;
  • social distancing is enforced; and
  • gatherings of 10 or more are prohibited.
  • There is still a legal obligation to self-quarantine if an individual has tested positive or been exposed to someone who has tested positive for COVID-19.

SPAIN - The Prime Minister has stressed that there will be a measured and calculated easing of restrictions in two week blocks until 10 June. Restaurants and bars are expected to open then and will be permitted to operate at 50% capacity. Barcelona, Grenada, Madrid, and Malaga are still under full lockdown.

  • Border crossings with Portugal are prohibited and have been extended until 15 May.

OCONUS Desk - Today, the CDC released a series of one pager guidance for reopening the country. The documents address safe and measured ways to reopen: child care facilities, restaurants and bars, schools, transit, workplaces, and youth camps. Some states have already begun opening, while others remain in lockdown. There appears to be an understanding from the federal government that states are in various stages of the disease progression and should be permitted to reopen based upon the situation experienced in a particular state. The White House has urged that lockdown measures only be relaxed and reponening steps initiated if: there is a two week downward trend in cases; hospitals in the area are adequately equipped for a surge; and widespread testing available.

ARIZONA - Governor Ducy will not extend the stay-at-home order expected to expire 15 May, but a “Stay Healthy, Return Smarter, Return Stronger” executive order will be implemented in its stead. Last week the state began easing restrictions on non-essential businesses allowing delivery, curb-side, or appointment based services..

  • Effective 11 May, dine-in services are permitted.
  • Effective 13 May, gyms and pools may reopen.
  • Public parks remain open, social distancing is encouraged.
  • Elective surgeries are permitted if the facility meets certain criteria.

CALIFORNIA - Governor Newsom has rolled out a four-part plan to get the state up and running in a safe manner. The state is currently in Phase II with more counties meeting eligibility to move into this phase. Phase II involves a tempered easing of workplace restrictions for industries where teleworking is not a possibility. This includes reopening of bookstores, clothing stores, florists, and sporting goods stores with the implementation of safety modifications. The third phase of the roadmap consists of opening personal care businesses like gyms, hair salons, and places of worship, but is not expected to be implemented for several months. Finally, Phase IV will open the “highest risk parts of the economy” i.e. concerts and live audience sporting events. The state has already seen a mild relaxing of restrictions as many beaches and parks opened this week. For a real time update on California’s current phase, please click here.

  • A statewide stay-at-home order is in place, non-essential movements are still discouraged.
  • Most beaches and parks have reopened, including public golf courses.
  • California State Universities will keep classes online in the fall, students will not be permitted to return to campus.

HAWAI’I - Currently the state is unders a safer-at-home order and infection rates remain low with just over 630 cases statewide. Businesses deemed low-risk are now permitted to reopen, this includes: malls, landscaping companies, and wholesale warehouses permitted reduced occupancy requirements are observed. Places of worship, gyms and other personal care facilities are not included in this phase of reopening.

  • Residents are currently under a safer-at-home order until 31 May.
  • Travelers are required to self-isolate for 14 days.
  • Essential employees are mandated to wear a face mask while at work.
  • Beaches and parks are open for exercise.
  • Honolulu will remain under a stay-at-home order until 30 June with some minor concessions.

IDAHO - The governor has set in motion a four step plan to reopen the state that will continue through 13 June. From 1-15 May spaces like houses of worship and daycares can open barring adherence to strict sanitation and social distancing practices.

Personal care businesses such as gyms and salons as well as restaurants will be permitted to open 16 May under Phase II, as will dine-in restaurants with approval from local public health districts. Phase III (30 May) will see the ban lifted on non-essential travel and bars are expected to open in Phase IV on June 13. Today, the governor announced that the state is on track to enter Phase II on Saturday, 16 May.

  • A stay-healthy order was implemented on 1 May requiring businesses to adhere to social distancing requirements.
  • Social gatherings are strongly discouraged.
  • Anyone entering Idaho must self quarantine for 14 days.

MONTANA - The state is currently implementing a “phased reopening”. With no new cases today, a survey confirmed today that Montana is the least affected state by the coronavirus crisis.

  • Residents are asked to wear a mask or face covering in public.
  • Gyms, museums, and theaters can reopen tomorrow, 15 May and must adhere to strict guidelines.
  • Anyone entering Montana must self quarantine for 14 days.

NEVADA - The governor has implemented a ‘Roadmap to Recovery’. Industry-specific guidance can be viewed here. During Phase I, face masks in public are encouraged, telework is recommended if possible, and contact with vulnerable populations is not advised.

  • The stay-at-home order is set to expire tomorrow, 15 May.
  • Travelers into the state are urged to self-isolate for 14 days.
  • Retail stores are allowed to provide pick up services.
  • State parks near Las Vegas are closed, other state parks are open for day use.
  • Golf courses and tennis courts can open with modifications.

NEW YORK - The governor announced an extension of a statewise stay-at-home order until 13 June. As part of the phased reopening strategy districts may enter into Phase I once they have met three criteria: a decline in new hospitalizations, an increase in the total available hospital and ICU beds. Beginning Friday, five regions in Central New York will be allowed to open after meeting these benchmarks. Downstate New York, including New York City and the six southern counties continue to see the highest numbers of infection. It is evident that certain regions in the state may experience continued restrictions while others might see a more swift return to personal freedoms.

  • Employers of essential employees must provide cloth or surgical masks if employees engage with the public.
  • New Yorkers have been advised to wear face coverings in public and remain under lockdown.
  • The stay-at-home order has been extended until 13 June.

NORTH CAROLINA - A three phase plan to reopen the state is currently in place. Phase I includes the reopening of some retailers that observe strict social distancing protocols. The stay-at-home order will remain in effect until Phase II on 22 May, but has been modified to allow limited commercial activity..

  • The state is under a mandatory stay-at-home order until 22 May.
  • Gatherings must be kept to 10 or less.

TENNESSEE - The state is currently in Phase I of reopening which allows retailers and dine-in restaurants to open at 50% capacity. Counties have been given authority to move into Phase II 19 May if they see fit. Knox County will hold off until 28 May.

  • People are urged to wear masks in public, essential employees must wear masks.
  • Gatherings of 10+ people are not permitted.

TEXAS - A single day high in deaths was reported today in the state with 58, and 116 over the past three days. The state is currently in Phase I of the governor’s plan to reopen the state. Businesses may reopen at 25% capacity in cities and 50% capacity in rural areas. The governor is holding to the 18 May timeline for commencing Phase II which allows more businesses to open.

  • Restaurants, movie theaters, malls, museums and libraries can open at 25% capacity.
  • State parks and beaches are open, but park goers are required to wear a mask and stay in groups of five or less.
  • Salons and other personal care facilities are open.
  • Gyms, non-essential manufacturing, and business offices will be allowed to reopen on 18 May with at 25% capacity.
  •  

Useful Precautions:

As industries, states, and countries begin to reopen, the prevalence of COVID testing will increase and it is likely that you or someone you know may receive a COVID test. Below is some useful information provided by the CDC regarding the most common types of tests and what results can be determined from the different tests. Please note results should only be interpreted by a medical professional.

  1. Viral Test
    • This test will tell you if you are currently infected.

 

  • A viral test is usually performed on patients experiencing symptoms of COVID (cough, difficulty breathing, fever, chills, muscle pain, sore throat, and/or loss of taste or smell) or if the person meets the guidance criteria provided by the CDC.

 

  • This test is generally performed with a nasopharyngeal swab (looks like a giant cotton swab) that is inserted into the nostril. This particular nasal sample can cause discomfort for the 15 seconds it is inserted into the nose. Other forms of tests may be taken by swabbing your mouth and throat or taking a saliva sample.

 

  • Results are returned within a few hours, but can take up to one week depending on the lab’s capabilities. It is recommended that patients self-isolate until the test results are returned so as to reduce acquiring the disease unwittingly with exposure to the outside world in the interim.

 

  1. Antibody Test
    • An antibody test looks at your blood to see if you have previously been infected with the virus. This test will look at two types of antibodies, IgM and IgG. IgM antibodies are made in the body for about two weeks proceeding the infection whereas IgG antibodies are produced around one to three weeks after infection and can remain detectable for over a month.

 

  • Antibody tests are performed using a blood sample. Two common tests are:
    • Blood draw (serum test) - this method requires one to two tubes of blood to be drawn. Results of this test can be returned within hours, but can take up to a week depending on the laboratory.
    • Finger prick test - this will require a few small drops of blood to be placed on a sample collection pallet. A solution will be added to the blood. Results are usually visible within 5-10 minutes. The results of this test can be less sensitive and therefore less accurate than a blood serum test.

Credible Information Sources:

Topics: Covid-19, Coronavirus