Patronus Medical Blog

Patronus Medical COVID-19 Update - 017 21 May 2020

Posted by Kerri Wright on May 22, 2020 9:43:57 AM

Current as of 2300 EDT/ 2000 PDT

Current COVID-19 Statistics:

5,102,424 - Worldwide Cases (106,712 increase, up 2.1%)*

1,948,739 - Worldwide Recovered

332,900 - Worldwide Fatalities

 

1,577,140 - U.S. Cases (25,472 increase, up 1.6%)*

298,418 - U.S. Recovered

94,402 - U.S. Fatalities

 

United States Locations 15,348 - Arizona Cases

88,031 - California Cases (2,219 increase, up 2.6%)*

647 - Hawai’i Cases

2,506 - Idaho Cases

479 - Montana Cases

356,458 - New York Cases (2,088 increase, up 1%)*

- 195,675 - New York City Cases (1,125 increase, up 1%)

7,393 - Nevada Cases

20,512 - North Carolina Cases

18,961 - Tennessee Cases

53,053 - Texas Cases (1,380 increase, up 3%)*

 

*Calculations based on previous day’s statistics

Daily Message:

 

Governments have begun gradually easing restrictive measures at the domestic level. Globally, countries look to get their economies back online and make preparations to open their borders to international travel by mid-summer in the Northern Hemisphere. Travel for the foreseeable future will be changed, we should expect health screenings to become standard in airline, boat, and train travel. The world will likely see creative restrictions and policies implemented to mitigate 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 travel. Domestically, all of the states have begun some phase of opening up, it will be imperative during the early days of rolling back restrictions that industries take the appropriate steps to implement proper health and safety measures in order to prevent a resurgence of the disease or mass transmission from high risk zones to low risk areas.

 

Important Updates:

International Desk

NORTH AMERICA - Travel restrictions between the U.S. and Canada/Mexico’s land borders have been extended until 22 June. The three nations jointly agreed yesterday to limit land crossings between the countries to “essential travel” only. Essential justifications for travel include: American citizens returning to the U.S., medical emergencies and/or response, lawful

cross-border trade, military or diplomatic missions, and those traveling for work in certain industries. For a complete list of allowances please click here. Air and sea traffic is permitted between the countries, but flights may be routed to specific airports that are equipped to conduct additional public health screenings.

CANADA - Provinces are gradually reopening, but Prime Minister Trudeau still urges people to still stay home unless absolutely necessary. In accordance with the Prime Minister’s set of principles for reopening the economy, certain industries have begun opening for business. 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.
  • Ontario began opening golf courses, construction, media operations, scheduled surgeries and certain health services this week.
  • In Quebec individual recreational sports are now allowed, most industries will not open until 25 May.
  • British Columbia has reopened certain social activities including religious services. Gatherings of 50+ are still If infections rates continue to decline hotels can open between June and September.
  • In Alberta, retailers opened last week at 50% capacity, restaurants and salons will open on 25 May.
  • Face coverings in public are required in most municipalities.

MEXICO - Mexico recorded its largest single-day death toll yesterday with 424 fatalities bringing the nation’s total to 6,510. Mexico City remains the country’s epicenter with over 16,700 infections; cases in the capital city are expected to peak this week as hospitals edge over 75% capacity. The number of cases in the state of Baja California Sur remains low at 489 total infections with the majority of active cases found in the municipalities of Los Cabos (75) and La Paz (80). The governor of Baja California Sur stated on Monday that the region is still classified as a “red” and will not be opening up on 1 June as previously expected.

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

UNITED STATES (U.S.) - The USS Roosevelt got underway yesterday after it required an emergency docking in Guam following a COVID-19 outbreak aboard. The ship will recommence its mission in the Indo-Pacific. Thirteen of its crew members who initially tested positive for COVID-19 and subsequently recovered, have tested positive again for the virus in recent days. Examples like this have been observed in some of the Asian countries experiencing the second wave of infections prompting further questions about the nature of recovering from COVID-19.

  • Many airlines within the United States are requiring temperature checks for staff and face masks for passengers prior to travel. Major airlines are also reducing load capacity until mid-July.

WORLD HEALTH ORGANIZATION (WHO) - The WHO expressed concern yesterday regarding the number of new infections in poor countries while many nations begin relaxing lockdown restrictions. The 24-hour period between Tuesday and Wednesday this week, there were 106,000 new recorded cases, the most in a single day since the beginning of the outbreak.

AFRICA - There is growing concern in the international medical community regarding the gross under testing on the African continent. In the Democratic Republic of Congo, only 4,493 tests have been conducted by 18 May where over 895,000 tests would need to be performed in order to reach 1% of the population. While many countries implemented some form of mandatory lockdown to mitigate the spread of COVID-19, predictive models indicate a quarter of a billion Africans could become infected with between 150,000 - 190,000 fatalities.

ASIA - Many Asian countries that were experiencing downward trajectories hopes have been dashed for eradicating the disease after scattered outbreaks have sprung up across the continent. 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 - Shulan, a town of 600,000 inhabitants in the northeast of the country has been put on full lockdown after infections were detected. Similar outbreaks in the northeast province of Jilin have prompted heavy-handed responses by the government. Hundreds of thousands of people are being subjected to testing and manadoty lockdowns. The government is critically concerned about a second wave and will not risk another widespread outbreak.

HONG KONG - Hong Kong is ramping up COVID-19 testing aiming to test 7,000 people per day in an effort to identify asymptomatic cases and reduce the chances of community acquired disease. The city retains a low total number of cases with 1,051, an impressive figure considering its proximity to mainland China.

  • Social distancing mandate extended until 4 June.
  • Entry is barred to all non-residents.
  • Residents traveling into the country are subjected to testing and mandatory quarantine.

SOUTH KOREA - Schools reopened on Wednesday, but those in the town of Incheon outside of Seoul were quickly shut down after two students tested positive for COVID-19. Despite this discovery, only 13 new cases have been detected, nine of which were linked to an outbreak from a nightclub in the capital region.

CARIBBEAN - The region appears to have successfully dodged the curve of COVID-19. Countries are anxious to kickstart their economies and resume tourism; however, many nations that export tourists still have stringent ‘Do Not Travel’ advisories in place.

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/resorts and limit interaction with
    • 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 has been extended until 31 July.

THE BAHAMAS - The Prime Minister announced further easing of restrictions on 17 May. This statement addressed entering Phase II and the resumption of commercial activity on Cat Island, Long Island, Abaco, and Andros. The weekday curfew and weekend lockdowns will remain in effect until 30 May. Further allowances for pharmacies, recreation, and hardware stores can be viewed here. The Prime Minister is looking to resume commercial travel into the country on or before 1 July. 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.
  • 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.
  • 20 May individuals may begin applying for a COVID-19 Authorization Travel Card for travel to specific Family People must register with the Ministry of Health, for more information click here.

DOMINICAN REPUBLIC (D.R.) - The state of emergency has been extended until 1 June. The country has increased their public surveillance dispatching additional military and police to patrol the streets.

  • On 20 May, public transportation resumed with the ability to operate at 30% capacity.
  • The curfew has been amended, residents must stay home from 1900-0500 (7pm-5am) Monday - Saturday and from 1700-0500 (5pm - 5am) on Sunday until 1 June .
  • It is mandatory to wear a mask in public.
  • All air, land, and sea borders are closed until 1 June.

EUROPEAN UNION (E.U.) - The E.U. is keen to get tourism on board for the summer and as such the European Commission released an action plan last week to reopen borders. The plan centers around providing guidance on ID border checks, health and sanitation protocols at hotels, and safety precautions for all modes of transportation. It is likely that any cross-border travel from outside of the E.U. will occur before 15 June, but many countries heavily reliant on tourism, like Greece, have already announced that they will be opening their doors to international visitors by mid-June. While the news is positive, visitors should expect additional screenings, use of contract-tracing apps, and the possibility of 14 day self-isolation periods upon arrival depending on predetermined agreements with the country of origin.

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

PORTUGAL - On 18 May Portugal entered its second phase of reopening, allowing bars, cafes, restaurants, museums, and other cultural centers to reopen. The third phase is expected to commence on 1 June and beaches will reopen on 6 June.. 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 - Spain has begun a measured 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.

  • Face masks are required in public.
  • Border crossings with Portugal are prohibited and have been extended indefinitely.

 

Domestic Desk - All 50 states have begun some phase of reopening, but guidelines and progress varies greatly. Many states have implemented social distancing and the use of face masks in public, but beyond that protocols and regulations differ from state to state and regionally as well. In an effort to assist those industries with safely reopening their doors, the CDC released a series of one page guidance last week, they provide simple guidance for safe and measured ways to reopen: child care facilities, restaurants and bars, schools, transit, workplaces, and youth camps. The CDC expanded this guidance in a comprehensive

  • page document detailing safe practices for businesses, public transportation, restaurants, schools, and several other key industries (Appendixes C & F).

ARIZONA - Governor Ducy has implemented a “Stay Healthy, Return Smarter, Return Stronger” executive order. However the seven-day average for new infections has been on the rise in the state which has been attributed to an increase in testing..

  • Restaurant dine-in services are permitted.
  • Gyms and pools are open.
  • Public parks remain open, social distancing is encouraged.
  • Elective surgeries are permitted if the facility meets certain criteria.

CALIFORNIA - 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 possible. Bookstores, clothing stores, florists, and sporting goods stores have been permitted to open. Officials have amended an earlier requirement to demonstrate two weeks without a COVID-related death before lifting the lockdown measure. Governor Newsom stated all by five counties might qualify for clearance in the coming days. The third phase 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. 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.

HAWAI’I - Currently the state is unders a safer-at-home order and infection rates remain low with just over 645 cases statewide. Low-risk businesses are now permitted to reopen, this includes: malls, landscaping companies, and wholesale warehouses permitted reduced occupancy requirements are observed. The Governor announced this week that Hawaii will begin Phase III at the beginning of June where medium-risk businesses will be able to open. A roadmap for reopening Hawai’i can be viewed here.

  • Residents are currently under a safer-at-home order until 31 May.
  • Travelers are required to self-isolate for 14 days, including inter-island travel until 30 June.
  • 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. Phase II of the plan commenced on 16 May. Now personal care businesses such as gyms and salons as well as restaurants are permitted; dine-in restaurants can open 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. Click here for guidance on reopening bars and here for outdoor pools.

  • 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”. On 19 May, the governor announced that the state will move into Phase II o on 1 June and plans to lift the 14-day mandatory quarantine period for travelers coming into Montana.

  • Residents are asked to wear a mask or face covering in public.
  • Gyms, museums, and theaters are open, but 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 governor announced Nevada has observed a 20 day downward decline in the cumulative percentage of new infections and is set to commence Phase II as early as 23 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.
  • Casinos are set to open on 1 June.

NEW YORK - 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. Seven counties 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. Certain regions in the state may experience continued restrictions while others might see a more swift return to personal freedoms. The governor has released a guide to reopening entitled, New York Forward, which gives g

  • Employers of essential employees must provide cloth or surgical masks if employees engage with the public.
  • New Yorkers must wear face coverings in public and remain under lockdown.
  • The stay-at-home order has been extended until 13 June.
  • Religious gatherings of 10 or less can recommence today.

NORTH CAROLINA - A three phase plan to reopen the state is currently in place. Phase II is set to go into effect at 1700 (5pm) 22 May. Under Phase II, the stay-at-home order will be lifted and replaced with a safer-at-home recommendation. Gatherings of 10 or less inside and less than 25 outside will now be permitted. Some businesses like restaurants and salons will be permitted to open at 50% occupancy, while others like bars and gyms will remain closed.

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

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. Nasheville will start Phase II on Monday 25 May. Phase II allows retailers and restaurants to operate at 75% capacity, live music venues can open with 25 or fewer people, gyms and salons can open at 50% capacity, bars are still closed during this phase.

  • People are urged to wear masks in public, essential employees must wear masks.
  • Telework and social distancing are encouraged.

TEXAS - On 22 May Texas will commence Phase II of its plan to reopen which will allow bars operate at 25% capacity. For timelines of other industries permitted to open under Phase II, click here.

  • Movie theaters, malls, museums and libraries can open at 25% capacity.
  • Restaurants can operate at 50% capacity beginning 22 May.
  • 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.
  •  

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