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New York City 10 Days Away From ‘Widespread Shortages’ Of Medical Supplies, Mayor Says

Topline: New York City Mayor Bill de Blasio said during a Sunday CNN appearance that “if we don’t get more ventilators in the next 10 days, people will die who don’t have to die” as the city—now the epicenter of the U.S. coronavirus epidemic—faces a possible shortage of medical supplies.

  • “We’re about 10 days from seeing widespread shortages,” de Blasio said, adding, “We have seen next to nothing from the federal government at this point.”
  • De Blasio also said that the military hasn’t been mobilized by the Trump administration, and that the Defense Production Act, which the president invoked by executive order Wednesday, has not been put into motion.
  • “It feels like we’re on our own at this point,” de Blasio said, adding that April would be worse for New York City than March has been, and he fears May could be even worse.
  • CNN also reported Sunday that Federal Emergency Management Agency head Peter Gaynor could not provide a number of how many medical masks were in the federal stockpile or how many have been shipped to state and local governments.
  • In a sign of demand on medical supplies, a Friday letter from a New York-Presbyterian Hospital department head said each employee would only be given one N95 mask (when it typically uses 4,000 per day).

Big number: 300 million. That’s how many masks could be needed for healthcare workers versus the current stockpile of 30 million, as testified to Congress by Health and Human Services Secretary Alex Azar at the end of February.

Key background: The Defense Production Act is intended to be used by Trump to obtain “health and medical resources needed to respond to the spread of Covid-19, including personal protective equipment and ventilators.” Trump faced questions Thursday around his reticence to use the Defense Production Act to compel companies to produce healthcare items to combat the coronavirus, one day after he said he’d be invoking its powers. The New York Times reported Thursday that both the U.S. and countries abroad are facing a shortage of ventilators, with manufacturers saying that they can’t increase production to meet the demand.

Tangent: Tesla CEO Elon Musk volunteered his company’s factories to manufacture ventilators, but it’s unclear whether that will move forward.

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I’m a New York-based journalist covering breaking news at Forbes. I hold a master’s degree from Columbia University’s Graduate School of Journalism. Previous bylines: Gotham Gazette, Bklyner, Thrillist, Task & Purpose and xoJane.

Source: New York City 10 Days Away From ‘Widespread Shortages’ Of Medical Supplies, Mayor Says

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Hospitals are sounding the alarm that they need more equipment as the coronavirus outbreak grows. Greg Cergol reports.

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The Global Shortage of Medical Masks Won’t Be Easing Soon

This photo taken on February 18, 2020 shows a worker sorting face masks being produced to satisfy increased demand during China’s COVID-19 coronavirus outbreak, at a factory in Nanjing, in China’s Jiangsu province. – The medical equipment factory switched surgical instruments and dental equipment production lines to a mask production line to meet the increased demand. (Photo by STR / AFP) / China OUT (Photo by STR/AFP via Getty Images)

f you’re worried about the coronavirus and are having trouble getting hold of medical masks, these numbers will explain why: China is the world’s largest producer of them, with a reported daily capacity of 20 million pieces, but by the estimate of its manufacturers domestic demand alone is around 50 to 60 million per day.

No wonder you can’t find medical masks at your local pharmacy.

Some experts doubt the effectiveness of such masks for stopping transmission of the virus, officially named COVID-19. U.S. health officials say the bug spreads mostly between people who are in close contact with each other, and from respiratory droplets when an infected person sneezes or coughs.

“A surgical mask might provide some protection, but it’s going to be very modest,” William Shaffner, a professor of preventative medicine at Vanderbilt University says.

But that hasn’t put a damper on demand. The scale of the epidemic in China—where the virus originated and where almost 78,500 people are now infected—and the continued spread of the coronavirus globally has driven shortages across the globe.

Retailers on multiple continents are running out of masks, and prices for a box of masks on online retailers like Amazon have surged to hundreds of dollars. On Monday, aerial footage captured a line hundreds of people long in the city of Daegu, South Korea, where an outbreak is growing, waiting to buy them. On the same day, an industrial equipment store in Italy, where more than 370 people are confirmed to be infected, sold more than 500 masks—of the kind used in factories and on building sites—in the first 30 minutes it was open.

Chinese demand is outpacing supply

Chinese mask makers were only operating at 76 per cent capacity in mid-Feb. according to Chinese officials, which puts daily production at around five million pieces fewer than the 20 million maximum. The country’s output of N95 respirators, which are often worn by medical workers for additional protection, is even lower, at 200,000 a day, given the more complex technology and materials required to make them.

Demand in China could even be higher that what its mask makers estimate. Chaun Powell, vice president of strategic supplier engagement at North Carolina-based healthcare company Premier Inc., tells TIME that China’s need might exceed 400 million medical masks every day, if each workplace provides multiple masks per employee per shift.

To meet the shortfall, some Chinese companies in unrelated industries have started making masks. Foxconn, which manufactures Apple’s iPhones in China, has switched some of its production to masks; the company aims to produce two million units a day by the end of the month. Others, like an auto-maker in south China’s Guangxi Zhuang Autonomous Region, are making masks too.

Unable to produce enough of the protective gear to meet its own demand, Beijing has also been sourcing medical masks from overseas. Indonesian officials said at the beginning of February that China had placed “large orders” for Indonesian-made masks, equating to as much as three months of production, and Vietnam has exported huge quantities of masks to China. There are reports that Chinese traders have started sourcing supplies in markets as far away as Kenya and Tanzania.

Shortages are being felt across the world

Meanwhile, pharmacies from Germany to Canada to Italy and the U.K. are all low on medical mask supplies, according to posts circulating on social media.In a post on Twitter, a journalist for Agence France-Presse said that the only pharmacy in central London she could find stocking face masks was selling them for approximately $3.25 a piece.

Stores in the U.S., from Knoxville, Tennessee to New York City are also facing a dearth of the product. One medical supply company in Dublin, Ireland said it was struggling to find a supply of masks at a reasonable cost. And dentists in the U.K. and Australia say that with so much of their supply originally sourced from China, they now are facing a desperate shortage.

Withers Dental in Toowoomba, a city of 137,000 in Australia’s Queensland state, about 80 miles outside of Brisbane, tells TIME that they are among those affected.

“It’s extremely difficult, a lot of our regular suppliers have now put limits on the number of boxes we can buy,” says Anna Yarrow, the practice manager. “We’re limited to about two to three boxes a week, which is nowhere near enough to get us through our normal day of patients.”

Yarrow says that the practice has a back up supply of masks, which they’re relying on now.

“We’re trying every day single day with our suppliers and new suppliers to see what we can manage to get,” she says. “We’re just really hoping everything settles down and gets back to normal.”

Mike Bowen, an executive vice president and partner at the Texas-based mask maker Prestige Ameritech, says that he’s now receiving calls from people across the world who want to buy medical masks from his company, even though American-made masks tend to be more expensive than those produced elsewhere.

“I’m getting hundreds of calls every single day from people wanting to buy products from me because they can’t get them anywhere else,” he says. “You name a country, I’ve heard from them.”

Bowen, who is also the spokesman of the Secure Mask Supply Association, an organization that aims to ensure a sufficient supply of masks in a health crisis, tells TIME that he’s been trying to raise awareness of China’s global dominance in the supply chain for years.

“I’ve been very public about a prediction that one day China is going to have a pandemic and we’re not going to have masks over here,” he says. “And now it’s kind of happening.”

He says that about half of the U.S. supply of face masks comes from China, with Mexico another big supplier, but he’s seen less product available from China in recent weeks as the country grapples with the outbreak at home.

Powell, of Premier Inc., says that although China has not formally announced any embargoes on exports of personal protective equipment, he believes that no such gear has shipped out of China since mid-January. Other places, like Thailand, Taiwan and India have also restricted exports of masks to protect their domestic supply.

In Hong Kong, some have taken matters into their own hands. One film director imported a machine from India with which he hopes to begin manufacturing masks to sell online, and a Hong Kong property developer has announced plans to set up a factory capable of producing 200,000 masks a day.

Medical workers are facing supply shortages

Most seriously, the shortages are hitting medical workers—even those directly treating coronavirus patients.

In early February, Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization (WHO) warned that the fight against coronavirus was being hampered by “widespread inappropriate use” of protective gear by those who are not front line medical staff, and he cautioned against stockpiling masks.

“Demand is up to 100 times higher than normal, and prices are up to 20 times higher,” he said. “Global stocks of masks and respirators are now insufficient to meet the needs of WHO and our partners.”

U.S. hospitals are closely watching their mask supplies. According to the initial findings of a survey of more than 4,000 hospitals Premier Inc. ran in conjunction with the U.S. CDC and FDA, most hospitals have more than a week of inventory, but are managing and rationing mask usage to prevent shortages. Powell says that the demand for N95 masks by the U.S. healthcare system is estimated to be somewhere between 25 million and 40 million each year.

“I’m getting calls from large hospitals that used to not even answer my phone calls,” Prestige Ameritech’s Bowen says.

On Tuesday, U.S. health officials said that Americans should prepare for the the coronavirus to begin spreading locally. Health and Human Services Secretary Alex Azar reportedly told Congress Tuesday that the U.S. has far fewer medical masks than it would need in the case of a major outbreak in the country. The country has a stockpile of about 30 million N95 masks, but might need as many as 300 million during the outbreak, he said.

Bowen says that he hopes the crisis is a wake up call for U.S. hospitals who have been purchasing masks from overseas suppliers.

“What’s the difference between a Chinese mask and an American-made mask?” he asks. “Well, the main difference is [American-made masks are] here, and they’ll be available when China has a pandemic.”

By Amy Gunia / Hong Kong February 27, 2020 1:42 AM EST

Source: The Global Shortage of Medical Masks Won’t Be Easing Soon

Subscribe to our YouTube channel for free here: https://sc.mp/subscribe-youtube The demand for face masks has continued to surge in many places around the world including Hong Kong, Japan and Australia as the Wuhan coronavirus outbreak has spread. Follow us on: Website: https://scmp.com Facebook: https://facebook.com/scmp Twitter: https://twitter.com/scmpnews Instagram: https://instagram.com/scmpnews Linkedin: https://www.linkedin.com/company/sout…

Coronavirus Pushes Airlines To Their Worst Financial Hit In 17 Years

The deadly coronavirus discovered in China has traveled by air to some 25 other countries. It’s no wonder a lot of those countries are restricting flights and handing airlines their worst event-driven financial hit since 2003.

More than 25,000 flights were canceled in the first full week of February, according to data from air travel intelligence firm OAG. Thirty airlines have suspended services to China, reaching a combined 8,000 seats per week, OAG says. The virus, discovered in the central Chinese city of Wuhan in December, has sickened more than 40,000 people and killed over 900 as of February 10.

Airlines will feel a financial pinch that reminds them of the deadly outbreak of Severe Acute Respiratory Syndrome (SARS) that started in China in 2003, aviation experts predict. They say today’s suspensions are already as bad as the SARS peak from March through June 2003. They attribute that to the coronavirus’s quick, widely-reported spread and the equally fast moves around the world to ban travel-related activity—a result of everyone learning from the SARS crisis.

“The levels of cancelations that we are seeing are unprecedented and exceed any other pandemic event that we can recall,” says Mayur Patel, head of Asia at OAG. He attributes the pileup of cancelations to “swift action from regulators and airlines.”

The SARS epidemic hollowed out 8% of annual revenue per kilometer for Asia Pacific airlines and cost them $6 billion in revenues due to lost business, Singapore’s Business Times reports. That epidemic hit Hong Kong, Taiwan and Singapore as well as major mainland Chinese cities.

Losses expected from the coronavirus-linked cancelations are “broadly consistent with the SARS level” when China-headquartered airlines alone slashed at least 50% of flights, says Eric Lin, aviation analyst in Hong Kong with the investment bank UBS. He anticipates industry losses at least in the first quarter this year.

Mainland Chinese airlines have felt most of the impact this year to date, Lin says. Among those are state-owned carriers such as Air China and China Southern Airlines. Privately-owned peers including Hainan Airlines have cut back, too.

Taiwan’s airlines and Hong Kong-based Cathay Pacific will be especially hit hard because of their dependence on China flights, Lin forecasts. Going farther out, United Airlines and British Airways have both reduced China flights.

A spokesperson for Taiwan-based EVA Airways said Friday the carrier planned to scale back China flights through April and that it was “monitoring the development of coronavirus outbreak and passengers’ travel demand to adjust route network and flight frequency.” Taiwanese peer China Airlines set up a Q&A website for worried passengers on February 4 and said it would refund fares booked directly through the company.

Losses this year could add up further if the virus spreads more outside China, Moody’s Investors Service said in a January 31 research note, though a dip in oil prices might offset that. “Carriers with weaker business models or liquidity profiles are likely to be hit harder and take longer to recover,” Moody’s said in the note.

Airlines will probably cope with losses by cutting costs, including non-paid leave for employees, Lin says. But some diversified routes to avoid depending on China, he adds. On whether or not airfares will rise, “do not expect a lot of bargains,” he says.

Civil aviation will bounce back fast once the virus recedes, if the SARS progression repeats this year, analysts believe. The main airport in Beijing, a SARS outbreak area, reported peak passenger flows a month after SARS passed, while the country’s airlines were selling 90% of their seats, China Daily reported back then.

Lin expects a V-shaped recovery from the coronavirus slump that’s now addling airlines. That’s because passengers who spiked travel during the disease outbreak suddenly jump back into it with extra demand, Lin says.

“Our experience of such events is that air services will return quickly after the virus has been contained and demand will rapidly follow,” Patel says.

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As a news reporter I have covered some of everything since 1988, from my alma mater U.C. Berkeley to the Great Hall of the People in Beijing where I followed Communist officials for the Japanese news agency Kyodo. Stationed in Taipei since 2006, I track Taiwanese companies and local economic trends that resonate offshore. At Reuters through 2010, I looked intensely at the island’s awkward relations with China. More recently, I’ve studied high-tech trends in greater China and expanded my overall news coverage to surrounding Asia.

Source: Coronavirus Pushes Airlines To Their Worst Financial Hit In 17 Years

Airlines have begun suspending flights as fears mount over the coronavirus epidemic. Indonesia’s Lion Air is halting all flights to and from China from Feb 1, while Jetstar Asia will suspend flights between Singapore and several cities in China because of a drop in demand. British Airways said it is stopping all direct flights to and from mainland China. Subscribe to our channel here: https://cna.asia/youtubesub Subscribe to our news service on Telegram: https://cna.asia/telegram Follow us: CNA: https://cna.asia CNA Lifestyle: http://www.cnalifestyle.com Facebook: https://www.facebook.com/channelnewsasia Instagram: https://www.instagram.com/channelnews… Twitter: https://www.twitter.com/channelnewsasia

Why This Week Could Be Pivotal for Understanding the Coronavirus Outbreak

It has been less than two months since authorities in the central Chinese city of Wuhan announced they were investigating a mysterious pneumonia-like viral infection. In that time, the pathogen—later identified as novel coronavirus 2019-nCov—has spread around China with abandon—from a few dozen suspected cases to more than 20,000 confirmed infections, and causing more than 420 deaths.

But this week could prove crucial for understanding how much farther the outbreak is likely to spread and whether the dramatic efforts of Chinese authorities to contain the coronavirus have been effective.

Officials in China began placing entire cities on lockdown in an attempt to stop the spread of the deadly virus on Jan. 23, when outbound trains and flights from Wuhan— the biggest city in Hubei province, population 11 million— were suspended. The next day authorities broadened the lockdown to include 13 cities, and by Jan. 25 the blockade had expanded to 16 surrounding cities with a combined population of more than 50 million, creating what is believed to be the largest quarantine in human history.

“This week we should start to see the effects of the containment strategy,” Ben Cowling, a professor of infectious disease epidemiology at the University of Hong Kong, tells TIME. “This week is a critical week.”

The virus appears to have an average incubation period of about five days, according to a study published by researchers in China on Jan. 29 in the New England Journal of Medicine. The study focused on the first 425 confirmed cases of the coronavirus in Wuhan, where it is believed to have originated in a seafood market. Cowling says it can take at least another five days for a sick person to be tested and receive confirmation of a coronavirus infection.

“If the number of reported cases begin to slow, this might be an early indication that control measures are working, or are least having an effect on the trajectory of the virus,” Charles Chiu, a professor of laboratory medicine at the University of California, San Francisco, says.

Chiu adds that if the number cases continue to rise significantly this week, it’s reason for additional concern. “It would suggest that the stringent control measures that have been put into place by China to prevent spread… are not adequate to prevent spread of this virus,” Chiu says.

Researchers caution that there are a lot of details they don’t know for sure that could change this calculus. For instance, it’s still not certain how long the incubation period lasts. The U.S. Centers for Disease Control and Prevention (CDC) says it can take anywhere from 2 to 14 days for symptoms to appear. Additionally, it’s still not clear whether the virus can be transmitted in the incubation period—while patients are asymptomatic.

Katherine Gibney, an infectious diseases physician at Royal Melbourne Hospital and an epidemiologist at the Doherty Institute in Melbourne, tells TIME that if the control measures delay the epidemic from taking off in countries outside of mainland China—so far there are less than 200 confirmed cases elsewhere—it might buy medical experts time to develop a vaccine or antiviral medication.

Some researchers believe that, despite the efforts of Chinese authorities, that the number of infections is likely to rise for several months. Gabriel Leung, the chair of public health medicine at the University of Hong Kong said in a Jan. 27 press conference that by his projections, the outbreak might only peak in April or May in major cities in China.

That around 5 million people fled Wuhan before the lockdown went into effect might also have hampered containment efforts. The virus is transmissible enough that the average sick patient, according to the NEJM paper, will infect about two others.

Another factor that could push up infection numbers is the mild symptoms some patients experience. Shira Doron, an infectious disease doctor and epidemiologist at Tufts Medical Center, says that the first patients diagnosed are often those who are very sick, and it might be possible that in the coming weeks it will become apparent that the number of people with mild illness, or even asymptomatic infection, is much larger than currently recorded. Doron says that the death rate reported early in an outbreak often “grossly overestimates the true fatality rate.”

Infections shot up from 639 cases in mainland China on Jan. 23, when officials started putting control measures in place, to around 9,700 cases a week later on Jan. 30. As of Tuesday, the number of cases on the mainland stands at around 20,500. In mainland China, the number of both infections and deaths from the virus has already surpassed that of severe acute respiratory syndrome (SARS), which killed 348 people on the mainland and infected more than 5,000 during an outbreak in 2002 and 2003.

The first cases outside of mainland China were confirmed in Thailand and Japan on Jan. 13 and 16. Cases in South Korea, Taiwan and the U.S. were confirmed on Jan. 21, and there are now more than 194 cases in over 23 countries.

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As of Tuesday, 425 people have died in mainland China. There has also been one death in the Philippines and one in Hong Kong.

As infection counts have grown in China, other countries have imposed their own strict measures to curb the advance of the virus—most of them targeting travelers from the world’s most populous nation. Italy and Israel have cancelled all flights from China. Mongolia and Russia have shut their borders with the country, and Singapore has banned the entry and transfer of travelers holding passports issued in Hubei province. In the U.S., the Trump Administration on Jan. 31 declared the coronavirus outbreak a public health emergency and announced that it will temporarily deny entry to any foreign national who “poses a risk” of transmitting the virus. But on Monday, U.S. authorities confirmed the country’s second case of human-to-human transmission in a person who had no recent history of travel to China.

Experts will be watching closely this week for signs that the virus is continuing to grow and spread—especially outside the province where Wuhan is located.

“What we’re worried about is that we don’t see any reduction in the steady increase,” Cowling says.

By Amy Gunia February 4, 2020

Source: Why This Week Could Be Pivotal for Understanding the Coronavirus Outbreak

148K subscribers
An outbreak of a pneumonia-like illness that started in the city of Wuhan has put health authorities on high alert in China and around the world. The new coronavirus—named 2019-nCoV—is thought to have originated in the food market of the central China metropolis and has since infected hundreds of people. China first reported the outbreak on Dec. 30. Most of the deaths have been in Hubei province, where Wuhan is the capital. Ahead of the Lunar New Year on Jan. 25—often dubbed the largest annual human migration in the world—Chinese authorities have restricted some travel to try and stop the illness’s spread. In Wuhan, public transportation and ride-hailing services have been suspended, trains and flights from the city have been stopped and people have been told to leave only for essential reasons. Similar travel restrictions were announced in at least 11 other Chinese cities, impacting more than 40 million people. Subscribe to our YouTube channel: https://bit.ly/2TwO8Gm QUICKTAKE ON SOCIAL: Follow QuickTake on Twitter: twitter.com/quicktake Like QuickTake on Facebook: facebook.com/quicktake Follow QuickTake on Instagram: instagram.com/quicktake Subscribe to our newsletter: https://bit.ly/2FJ0oQZ Email us at quicktakenews@gmail.com QuickTake by Bloomberg is a global news network delivering up-to-the-minute analysis on the biggest news, trends and ideas for a new generation of leaders.

Hundreds of Americans Are in Quarantine. Here’s Why That’s Rare

RIVERSIDE, CA – JANUARY 29: A team in white biohazard suits watch as some of the approximately 200 passengers walk to waiting buses upon arriving on a charter flight from Wuhan, China, after landing at March Air Reserve Base in Riverside, Calif. Wednesday morning Jan. 29, 2020. The flight originated from the area where the coronavirus outbreak started. All the passengers will be held in quarantine for an unknown duration. (Photo by Will Lester/MediaNews Group/Inland Valley Daily Bulletin via Getty Images)

 A typical room has a ceiling fan, striped wallpaper and floral curtains. Above a neatly made bed is a chintzy print showcasing a cobblestone alley. In communal areas, residents have space to watch big-screen TVs or throw around a football or read a book under a tree, and the U.S. Marshals Service is providing security.

Such are the conditions at the March Air Reserve Base in Riverside County, Calif., where 195 people are subject to the first mandatory quarantine orders issued by the Centers for Disease Control and Prevention (CDC) in more than 50 years. Like more than 600 other people assigned to five other military bases around the country, these Americans were recently evacuated from China’s Hubei province, the site of the novel coronavirus outbreak that has now claimed more than 600 lives.

All but two of those deaths have occurred in mainland China, where more than 31,000 cases have been confirmed. The crisis is now creeping around the world, with cases reported in more than 24 other countries, including 12 in the U.S.

There is widespread anxiety about sickness, and much is still unknown about the virus, including whether people without symptoms are capable of spreading it. Facing such uncertainty, the CDC took the extraordinary measure on January 31 of drawing on legal authority that the department hasn’t used since the 1960s — when officials were combatting smallpox — to impose a mandatory, 14-day quarantine on recently repatriated Americans who had been in Hubei. Two weeks is the likely incubation period for the virus.

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“We are taking measures to minimize any contact. We expect confirmed infections among these and other returning travelers from Hubei province,” Dr. Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Diseases, said in a briefing on Feb. 5. “Now is the time to act so that we can slow the introduction and impact of this virus in the U.S.”

A few days earlier, when the federal government announced the quarantine, Messonnier called the action “unprecedented.”

There are several good reasons that ordering a quarantine is something that U.S. public health officials rarely do.

Finding quarters can be a challenge

For starters, the government does not have dedicated quarantine facilities just waiting to be used, explains Arthur Reingold, professor of epidemiology at the University of California, Berkeley’s School of Public Health.

Quarantine refers to the containment of apparently healthy people who may be incubating a virus they’ve come in contact with. (Isolation is the term for confining someone who is already sick.) In previous eras, this was often done on sea-going vessels. Passengers who might have a sickness like the plague would wait out the likely incubation period on a ship before being allowed to land. “But quarantine vessels went out of business a long time ago,” Reingold says.

Faced with a need to suddenly house hundreds of people, the Department of Health and Human Services turned to the Department of Defense, and six military bases were made available. The main criteria in choosing them, a DoD spokesman says, was their ability to comfortably house approximately 250 people in one or two buildings, like an on-base motel where everyone has their own bathroom, and close proximity to a hospital. Locations in the West, given the shorter flight distance from China, were also preferable, which is why half of the bases are in California, with one more in each of Colorado, Texas and Nebraska.

Quarantines are expensive

Even with locations secured, executing humane quarantines involves a lot of logistics, and that doesn’t come cheap. There are transportation and ongoing housing costs. Individuals need to be fed and regularly checked for symptoms. It requires medical care on-demand. And there’s security and maintenance to consider.

The CDC and HHS have not responded to requests from TIME asking about cost estimates for the current quarantines or whether the department will cover all costs. The HHS, which oversees the CDC, announced on Feb. 3 that it was making $250 million in emergency funds available to generally cover response, including screening and monitoring of U.S. citizens returning from various parts of China.

Tabulating the bills may also be a messy business. The DoD, for example, tells TIME that it expects full reimbursement for all costs from HHS. So does the state of California. A spokesman for Riverside County, meanwhile, says that while they hope to get reimbursed, it’s not been made clear if it will be.

With five county departments supporting the quarantine at March Air Reserve Base, including the provision of staff that includes doctors, nurses, behavioral health specialists and epidemiologists, as well a mobile health clinic that is at the base in case individuals get a migraine or scrape a knee, the estimated costs for the county alone are an estimated $115,000 per day.

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“Clearly the cost element of it is not a factor when we’re asked to provide services on an urgent basis. Our first priority is to figure out how to do it and then do it,” Riverside County spokesman Jose Arballo, Jr., says. That said, he adds, “The county isn’t in a situation where it’s flush.”

Putting aside the incalculable value of preventing an outbreak of the coronavirus, quarantines can potentially be cost-saving in the long run. “While expensive it’s more than worth it,” Larry Gostin, an expert in public health law and professor at Georgetown University, writes in an email. “It prevents spread of disease and serious illnesses. And it’s far less costly than having to hospitalize many patients who could contract the coronavirus infection.”

People’s freedom must be limited carefully

Another reason mandatory quarantines are uncommon in America is that they are, of course, coercive. Though federal and state governments have the legal ability to impose quarantines in the name of public safety, the ACLU has raised concerns about the government controlling people’s freedom of movement and noted that individuals’ livelihoods can be put at risk if they’re unable to work for weeks at a time. (The CDC has not responded to a request from TIME about whether the department will cover lost wages for individuals under quarantine orders.) It can also cause disruptions in childcare.

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Soon after the 195 people arrived at March Air Reserve Base, one individual did attempt to leave and was ordered back. Otherwise, Arballo says, the individuals in quarantine have been cooperative and “appreciative of the work being done.” Attitudes may have been tempered by gratitude that the U.S. government helped them escape the epicenter of the coronavirus outbreak, as well as knowledge that spread of the disease would be harmful. The U.S. Marshals Service says that agents have not had to stop anyone from leaving — that no one is revolting — but in the unlikely event that someone did, they would intervene.

Georgetown’s Gostin has noted that there is a world of difference between today’s relatively small quarantines at American military bases, where people are housed in the equivalent of a modest hotel room, and what is happening in China, where the government has essentially put 56 million people on lockdown in an attempt to stop the spread of the coronavirus. Such extreme actions can cause panic, drive the epidemic underground and potentially make it worse, leading to cross-infection and social isolation, he explains. People may have difficulty accessing basic necessities, much less sufficient medical care.

The Americans quarantined at the March Air Reserve Base, in contrast, requested and were brought beer to enjoy while watching the Super Bowl.

The efficacy is unclear

Even when quarantines are imposed on narrow populations and rolled out compassionately, it’s not clear how effective it is to limit the movement of people who aren’t showing symptoms, Berkeley’s Reingold says. “For many infectious diseases, transmission basically is limited entirely or almost entirely to people who are symptomatic,” he explains. “Quarantining asymptomatic individuals has generally been viewed as a low priority.”

Yet, in the case of the new coronavirus, there has been conflicting evidence about whether asymptomatic people are contagious. “Until we know more, given the concerns, given the anxiety, this is a reasonable measure to take,” Reingold adds.

W. Ian Lipkin, director of the Center for Infection and Immunity at Columbia University, recently traveled to Beijing and Guangzhou. Upon returning to the U.S., he was mandated by the government to self-quarantine for 14 days because the CDC views those areas of China as medium risk, he says. He is currently in his cabin in upstate New York, writing in to the government with temperature and status reports.

When asked for his thoughts on the quarantines, he responded with concerns about being objective given that he has been personally affected. “The new coronavirus is highly transmissible,” he wrote in an email. “Thus, I appreciate the concern underlying the decision to impose quarantines. I’m not sure that we need 14 days.”

While mandating quarantines could be an expensive and cumbersome overreaction, CDC’s Messonier suggested the department would rather be remembered for doing too much rather than doing too little as scientists race to learn more about the virus. And experts say Americans should feel reassured that they live in a wealthy country where expensive overreactions are an option. Populations who live in poor countries in Asia or Africa, where officials have more limited capabilities of response, are at higher risk if the coronavirus starts to spread.

At the March Air Reserve Base, two individuals — both children — have been found to have fevers. One was transported to a nearby hospital on Feb. 3, with a parent, and was transported back to the base when tests for the virus came back negative. A second was transported on Feb. 5. As of Friday morning, they remained in isolation at the hospital awaiting test results.

By Katy Steinmetz February 7, 2020

Source: Hundreds of Americans Are in Quarantine. Here’s Why That’s Rare

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195 Americans are under quarantine as blood samples and throat cultures get tested by the CDC after the group was evacuated to California from the epicenter of the coronavirus outbreak in China. 6,000 passengers stuck on cruise ship over coronavirus fears READ MORE: https://abcn.ws/392BsP1 #ABCNews #Coronavirus #China

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