latimes--2020-03-06--Chaos at hospitals due to shortage of coronavirus testing

As COVID-19 cases spike , the testing needed to help stem the spread of the disease remains below what is needed to address the growing crisis , with healthcare workers across the state reporting widespread failings in the response by local and federal government officials .
Federal officials said nearly 1 million tests were expected to be available by the end of this week .
But in California , one of the country ’ s hardest-hit regions with 60 cases , the total testing capacity is limited to only 7,400 through the weekend , according to the California Department of @ @ @ @ @ @ @ widely and swiftly for the novel coronavirus has impeded the country ’ s ability to beat back the spread of the virus , experts say .
Without testing , public health officials don ’ t know where the virus is spreading and where to target efforts to contain it .
Twelve Americans have been killed so far by the disease .
The shortage of test kits as well as lab staffing to screen for the virus are creating chaos for doctors and nurses as their triage efforts are complicated by testing restrictions and @ @ @ @ @ @ @ a patient with clear coronavirus symptoms , but the health department didn ’ t think he should be tested , ” said an emergency room doctor in Downey who spoke on condition of anonymity .
“ I went from that patient into the next room , where I had an 80-year-old , immune-compromised , diabetic patient .
If I ’ m taking coronavirus in there , it ’ s mild for me , but it ’ s deadly for her.
” Though the Centers for Disease Control and Prevention on Wednesday lifted some @ @ @ @ @ @ @ tested by their physician , L.A. officials did not immediately adopt that criteria because of a backlog at the local health lab and continued to limit tests to hospitalized patients .
Lab staff were working at least 18-hour days to keep up , county officials said .
On Friday , L.A. County officials , in a reversal , said they would adopt the CDC guidelines .
Now doctors can recommend testing for anyone with symptoms .
Officials also announced that two commercial labs will be online by Monday to test for the virus @ @ @ @ @ @ @ capacity to test hundreds and hundreds and hundreds of people every day ” at the county-run lab alone , said L.A. County Public Health Department Director Barbara Ferrer .
“ Now it ’ s up to the individual provider to make that determination.
” California has only tested 516 people for COVID-19 to date , far below what is probably needed in a state where Gov .
Gavin Newsom declared a state of emergency this week due to the outbreak .
Though there are only about nine known instances of community spread of @ @ @ @ @ @ @ of people who have been exposed to it appears to be growing daily .
About 1,250 Californians who were possibly exposed to COVID-19 on a cruise ship need to be tested for the virus .
There are more than 9,000 people in California who have recently returned from countries experiencing severe outbreaks .
Then there are others who may have been exposed within the community , and are now worried about infecting their families .
Renee Schwartz , a 60-year-old North Hills resident , said she was told by her doctors that her @ @ @ @ @ @ @ be COVID-19 .
But staff at multiple Los Angeles-area hospitals this week told her they don ’ t test for the virus .
“ I said ‘ Who does testing ?
And they said , ‘ No idea , ’ ” Schwartz said .
Ferrer estimated that 50 people in the county have been tested for the novel coronavirus .
The low numbers have been due to limited testing capacity at the lab , not a shortage of test kits , she said .
Workers in the lab had been working at least @ @ @ @ @ @ @ Thursday night , LabCorp , a commercial lab , came online , Ferrer said , and on Monday , Quest Diagnostics is expected to begin offering testing as well .
“ This is all good news , ” she said .
“ The limitation of our lab was not the lab kits , but we ’ re only one lab and we could only process a certain number of tests in one day.
” On Friday morning , Health and Human Services Secretary Alex Azar told reporters that the agency had provided all @ @ @ @ @ @ @ that they ’ ve asked for.
” A spokeswoman from the California Health and Human Services Agency appeared to agree with Azar , saying in an email to The Times that California “ has continually requested more testing capacity from the federal government , and the CDC has continued to fulfill those requests on an ongoing basis.
” “ As this need expands , we continue to ask for more tests — including just today , ” she added .
The CDC has shipped enough test supplies to evaluate up to 75,000 people @ @ @ @ @ @ @ to Azar , who said he expected up to 4 million tests would be available next week .
“ Everything is on schedule for the testing , ” he added .
Integrated DNA Technologies , a private company working with HHS , also said Friday that it had produced enough supply to enable testing for more than 700,000 patients , but a spokeswoman said she did not have further information regarding when or where those supplies were delivered .
In a letter sent to medical staff at one Downey hospital and viewed by @ @ @ @ @ @ @ instructed doctors to discharge patients with mild coronavirus symptoms , asking them to self-isolate at home .
In the long run , that tactic will make the total number of coronavirus cases virtually unknowable — at least until retrospective testing is available .
“ Myself and my colleagues have been working in the trenches in the ER , and we can ’ t get people tested , ” said another doctor who works at a hospital in Downey .
Both declined to be identified because they are not authorized to speak to the @ @ @ @ @ @ @ coronavirus patient was a transplant nurse , whose job is to work with immune-deficient patients .
“ I said , ‘ Come on !
Please !
We need to test her !
’ ” Amid the testing shortfalls , some healthcare workers also cast doubt on federal officials ’ stringent approach to testing .
One California nurse who was exposed to a confirmed coronavirus patient has symptoms and is in quarantine , but has not yet been tested for the virus by the CDC .
“ They said they would not test me @ @ @ @ @ @ @ recommended protective equipment , then I wouldn ’ t have the coronavirus .
What kind of science-based answer is that ?
” the nurse , who asked to remain anonymous , said in a statement read by the National Nurses United ’ s union president Deborah Burger in a news conference in Oakland on Thursday .
“ I ’ m a registered nurse and I need to know if I ’ m positive before going back to care for patients , ” the nurse added .
“ Delaying this test puts the whole @ @ @ @ @ @ @ patients had been tested at the CDC as of Wednesday , which does not include the testing done at local and state labs , said agency spokesman Richard Quartarone .
In a call with reporters on Tuesday , Dr. Nancy Messonnier evaded a question about whether the narrow testing criteria early in the outbreak was linked to the limited availability in tests and potentially hindered the nation ’ s response to the outbreak .
She also would not name the cause of flaws in the early test kits , saying the investigation is @ @ @ @ @ @ @ to focus on is where we are today , ” she said .
“ We need to be focused on what we ’ re doing today to identify patients who are ill , make sure that they ’ re getting appropriately treated and tested and make sure that we ’ re protecting our communities.
” It is unclear if those steps are being taken quickly enough as local health departments strain to keep up as the outbreak swells .
In Los Angeles County , a 34-year-old woman has been self-quarantining for two days @ @ @ @ @ @ @ her high fever and pneumonia were caused by the novel virus .
She has been waiting to hear from the public health department for next steps .
“ I haven ’ t been contacted , I haven ’ t been tested , ” she said .
“ I ’ m not being treated and I ’ m still exposing people by staying here at home .
I live with family — they have jobs , they have schools.
” “ I ’ m sick with something obviously , ” she said .

A researcher works in a lab that is developing a test for the coronavirus last week in Nutley, N.J.
As COVID-19 cases spike, the testing needed to help stem the spread of the disease remains below what is needed to address the growing crisis, with healthcare workers across the state reporting widespread failings in the response by local and federal government officials.
Federal officials said nearly 1 million tests were expected to be available by the end of this week. But in California, one of the country’s hardest-hit regions with 60 cases, the total testing capacity is limited to only 7,400 through the weekend, according to the California Department of Public Health.
The inability to test widely and swiftly for the novel coronavirus has impeded the country’s ability to beat back the spread of the virus, experts say. Without testing, public health officials don’t know where the virus is spreading and where to target efforts to contain it. Twelve Americans have been killed so far by the disease.
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The shortage of test kits as well as lab staffing to screen for the virus are creating chaos for doctors and nurses as their triage efforts are complicated by testing restrictions and shortfalls.
“Last night I had a patient with clear coronavirus symptoms, but the health department didn’t think he should be tested,” said an emergency room doctor in Downey who spoke on condition of anonymity. “I went from that patient into the next room, where I had an 80-year-old, immune-compromised, diabetic patient. If I’m taking coronavirus in there, it’s mild for me, but it’s deadly for her.”
Though the Centers for Disease Control and Prevention on Wednesday lifted some guidelines so anyone with symptoms can be tested by their physician, L.A. officials did not immediately adopt that criteria because of a backlog at the local health lab and continued to limit tests to hospitalized patients. Lab staff were working at least 18-hour days to keep up, county officials said.
On Friday, L.A. County officials, in a reversal, said they would adopt the CDC guidelines. Now doctors can recommend testing for anyone with symptoms.
Officials also announced that two commercial labs will be online by Monday to test for the virus.
“We don’t have capacity to test hundreds and hundreds and hundreds of people every day” at the county-run lab alone, said L.A. County Public Health Department Director Barbara Ferrer. “Now it’s up to the individual provider to make that determination.”
California has only tested 516 people for COVID-19 to date, far below what is probably needed in a state where Gov. Gavin Newsom declared a state of emergency this week due to the outbreak. Though there are only about nine known instances of community spread of the virus in California, the number of people who have been exposed to it appears to be growing daily.
About 1,250 Californians who were possibly exposed to COVID-19 on a cruise ship need to be tested for the virus. There are more than 9,000 people in California who have recently returned from countries experiencing severe outbreaks. Then there are others who may have been exposed within the community, and are now worried about infecting their families.
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Renee Schwartz, a 60-year-old North Hills resident, said she was told by her doctors that her sinus infection and breathing problems could probably be COVID-19. But staff at multiple Los Angeles-area hospitals this week told her they don’t test for the virus.
“I said ‘Who does testing? And they said, ‘No idea,’” Schwartz said.
Ferrer estimated that 50 people in the county have been tested for the novel coronavirus. The low numbers have been due to limited testing capacity at the lab, not a shortage of test kits, she said. Workers in the lab had been working at least 18-hour days, she said.
On Thursday night, LabCorp, a commercial lab, came online, Ferrer said, and on Monday, Quest Diagnostics is expected to begin offering testing as well.
“This is all good news,” she said. “The limitation of our lab was not the lab kits, but we’re only one lab and we could only process a certain number of tests in one day.”
On Friday morning, Health and Human Services Secretary Alex Azar told reporters that the agency had provided all tests to the state of California “that they’ve asked for.”
A spokeswoman from the California Health and Human Services Agency appeared to agree with Azar, saying in an email to The Times that California “has continually requested more testing capacity from the federal government, and the CDC has continued to fulfill those requests on an ongoing basis.”
“As this need expands, we continue to ask for more tests — including just today,” she added.
The CDC has shipped enough test supplies to evaluate up to 75,000 people in public health laboratories nationwide, according to Azar, who said he expected up to 4 million tests would be available next week. “Everything is on schedule for the testing,” he added.
Integrated DNA Technologies, a private company working with HHS, also said Friday that it had produced enough supply to enable testing for more than 700,000 patients, but a spokeswoman said she did not have further information regarding when or where those supplies were delivered.
In a letter sent to medical staff at one Downey hospital and viewed by The Times, an infection control coordinator instructed doctors to discharge patients with mild coronavirus symptoms, asking them to self-isolate at home. In the long run, that tactic will make the total number of coronavirus cases virtually unknowable — at least until retrospective testing is available.
“Myself and my colleagues have been working in the trenches in the ER, and we can’t get people tested,” said another doctor who works at a hospital in Downey. Both declined to be identified because they are not authorized to speak to the media.
The doctor said another suspected coronavirus patient was a transplant nurse, whose job is to work with immune-deficient patients. “I said, ‘Come on! Please! We need to test her!’”
Amid the testing shortfalls, some healthcare workers also cast doubt on federal officials’ stringent approach to testing. One California nurse who was exposed to a confirmed coronavirus patient has symptoms and is in quarantine, but has not yet been tested for the virus by the CDC.
“They said they would not test me because, if I were wearing the recommended protective equipment, then I wouldn’t have the coronavirus. What kind of science-based answer is that?” the nurse, who asked to remain anonymous, said in a statement read by the National Nurses United’s union president Deborah Burger in a news conference in Oakland on Thursday.
“I’m a registered nurse and I need to know if I’m positive before going back to care for patients,” the nurse added. “Delaying this test puts the whole community at risk.”
Nationwide, 1,526 patients had been tested at the CDC as of Wednesday, which does not include the testing done at local and state labs, said agency spokesman Richard Quartarone.
In a call with reporters on Tuesday, Dr. Nancy Messonnier evaded a question about whether the narrow testing criteria early in the outbreak was linked to the limited availability in tests and potentially hindered the nation’s response to the outbreak. She also would not name the cause of flaws in the early test kits, saying the investigation is ongoing.
“What we really need to focus on is where we are today,” she said. “We need to be focused on what we’re doing today to identify patients who are ill, make sure that they’re getting appropriately treated and tested and make sure that we’re protecting our communities.”
It is unclear if those steps are being taken quickly enough as local health departments strain to keep up as the outbreak swells.
In Los Angeles County, a 32-year-old woman has been self-quarantining for two days after her doctor told her he suspected her high fever and pneumonia were caused by the novel virus. She has been waiting to hear from the public health department for next steps.
“I haven’t been contacted, I haven’t been tested,” she said. “I’m not being treated and I’m still exposing people by staying here at home. I live with family — they have jobs, they have schools.”
“I’m sick with something obviously,” she said.


latimes--2020-03-06--Coronavirus spreads across California as officials fight to contain disease and fears

The novel coronavirus continued its spread across California and the nation on Friday , with new cases reported from Los Angeles to Placer County as cruise passengers stuck off the coast of San Francisco were tested for what appears to be an outbreak on board .
At least eight of California ’ s cases have been tied to the cruise , including one confirmed death in Placer County and one suspected death in Sunnyvale .
Speaking at the White House Friday afternoon , Vice President Mike Pence said a total of 21 people on the Grand Princess have tested positive @ @ @ @ @ @ @ .
He said the federal government is working with the state of California to bring the cruise ship in to a non-commercial port over the weekend and to quarantine passengers as necessary .
“ All passengers will be tested , ” the vice president said .
“ Those that need to be quarantined will be quarantined.
” Pence said 24 people on the cruise ship had tested negative , and one test has been inconclusive .
Meanwhile , L.A. County confirmed two additional cases of the new coronavirus Friday , bringing the total @ @ @ @ @ @ @ cases of the virus continue to be reported elsewhere in California and in other states , including Texas , prompting the city of Austin to cancel the massively popular SXSW festival .
Of the most recent cases announced in L.A. County , one person is part of a group of travelers who went to northern Italy .
Seven other members of that same group had already have tested positive for COVID-19 .
The second is a second screener at Los Angeles International Airport .
A screener at LAX also was diagnosed with the @ @ @ @ @ @ @ familiar with the matter said .
The L.A. County Department of Public Health has asked the Centers for Disease Control and Prevention for help investigating those two cases .
The individuals ’ close contacts are being self-quarantined in case they also develop symptoms .
The new cases still don ’ t point to community spread in Los Angeles County , L.A. County Department of Public Health Director Barbara Ferrer said .
She estimated that 50 people in the county have been tested for COVID-19 and emphasized that more tests are coming back negative @ @ @ @ @ @ @ tests run in L.A. County so far have been due to limited testing capacity at the lab , not a shortage of test kits , she said .
Lab workers had been putting in at least 18 hour days , she said .
On Thursday night , commercial lab LabCorp came online , and on Monday , Quest Diagnostics is expected to begin offering testing as well , she said .
“ This is all good news , ” Ferrer said .
“ The limitation of our lab was not the lab kits @ @ @ @ @ @ @ lab and we could only process a certain number of tests in one day.
” She said these changes does not mean that everyone will be tested for the virus .
Providers will determine which patients with symptoms require testing .
As of Friday , L.A. County expanded its criteria to follow guidelines to test for anyone a doctor recommends , not just people with a travel history to countries with major outbreaks , Ferrer said .
“ Now it ’ s up the individual provider to make that determination , ” she @ @ @ @ @ @ @ to consult CDC criteria .
Yolo County reported its first case of the new virus Friday — a woman who officials think contracted the virus in the community .
The woman has underlying health conditions and has been hospitalized , officials said .
She appears to have acquired the virus “ through community transmission , ” the Yolo County Health and Human Services Agency said in a news release .
The agency will monitor the woman ’ s close personal contacts for symptoms of the illness and said staff is working with healthcare @ @ @ @ @ @ @ “ Given the rapid spread of COVID-19 around the world , I am not surprised that the virus is in our county , ” Dr. Ron Chapman , the county ’ s public health officer , said in a statement .
The county plans to declare local and health emergencies , the agency said .
Solano and Santa Clara counties also have reported coronavirus cases that are believed to have been contracted through community contact — that is , by people who have not traveled to areas where COVID-19 is widespread or by @ @ @ @ @ @ @ with another confirmed case of the virus .
New coronavirus cases were also reported Friday in Placer , Ventura , Contra Costa and Santa Clara counties .
In Placer County , three cases were announced , all of them among people who had traveled on the Grand Princess cruise ship from San Francisco to Mexico on Feb. 11-21 .
The ship docked in San Francisco on Feb. 21 , with some passengers disembarking before the ship moved on to Hawaii .
The ship is now being held off the coast of San Francisco @ @ @ @ @ @ @ of the people had mild symptoms that have already resolved , while the third continues to experience mild symptoms , the Placer County Public Health Department said in a news release .
None of them required hospitalization , and all three are isolated at home , officials said .
The public health department is working on tracing the people ’ s contacts to identify more possible cases , officials said .
“ We are moving as quickly as possible to limit the spread of disease , ” Dr. Aimee Sisson , the county @ @ @ @ @ @ @ a statement .
“ To be frank , we would not be surprised to see a second wave of cases connected to these cruise passengers given the amount of time that ’ s passed since they disembarked.
” Placer County had previously reported two cases of the coronavirus , including one death .
Ventura County ’ s public health lab also confirmed a positive result for a passenger on the Grand Princess cruise ship .
The person had only mild symptoms and was being quarantined at home , officials said .
It was @ @ @ @ @ @ @ the new virus .
“ There is no evidence of community transmission in Ventura County , ” Dr. Robert Levin , the county health officer , said in a statement .
“ This is a travel related case.
” The state Department of Health on Wednesday night notified the Ventura County Public Health Department that six county residents had traveled on the cruise , and public health officials contacted all of them , the Ventura County Public Health Department said in a news release .
One of the travelers had been in contact @ @ @ @ @ @ @ had requested that the person be tested for COVID-19 , officials said .
The doctor had the patient stay in their vehicle while dropping off the sample curbside to limit possible exposure , officials said .
The person diagnosed with the virus had remained home resting since returning from the cruise , and only left to seek medical attention , officials said .
Public health officials said they were working with the state Department of Public Health to notify anyone else who may have come into contact with the person while they were @ @ @ @ @ @ @ Ventura County from San Francisco , where they disembarked the cruise .
The person ’ s spouse , who was also on the cruise but did not have symptoms of the virus , was also being quarantined at home , officials said .
Of the four remaining Ventura County residents who were on the cruise , one was symptomatic and being tested , officials said .
The other three had reported no symptoms .
In Contra Costa County , two of the three cases announced Friday were also passengers on the Grand Princess @ @ @ @ @ @ @ close contact with a person who was diagnosed with the coronavirus in another jurisdiction , county health officials said .
All three people were being isolated at their homes .
The county is now recommending that adults over 50 and people with underlying medical conditions that could put them at risk of contracting COVID-19 avoid mass gatherings like parades , sporting events or concerts .
Public health officials in Santa Clara County reported four new cases Friday , bringing the total there to 24 .
One was a man who officials described as @ @ @ @ @ @ @ COVID-19 case in Santa Clara County , and one was a male who had recently returned from a trip to India , officials said .
Both people were isolated at home .
Officials weren ’ t sure how the other two people contracted the virus .
One was a male who was isolated at home ; the other was a woman who was hospitalized , officials said .
Both cases were under investigation .
The number of coronavirus cases worldwide has surpassed 100,000 — with California recording at least 69 — as officials @ @ @ @ @ @ @ rapid spread .
World Health Organization officials pressed countries Friday to aggressively pursue containment and expand testing for COVID-19 as the outbreak swells .
WHO director Tedros Adhanom Ghebreyesus said that trying to contain the epidemic and slow it buys time for more research and preparedness to handle cases when they do arrive .
“ Every day we can slow the epidemic is another day , governments can prepare their workers to detect , test , treat and care for patients , ” he said .
In California , officials announced what may @ @ @ @ @ @ @ death in Santa Clara County , where residents are being urged to postpone or cancel large gatherings and events , and minimize work in big groups .
The number of positive COVID-19 test results in the state reached 60 Thursday as authorities announced what may be the state ’ s second virus-related death in Santa Clara County .
That number is expected to grow .
UCLA Chancellor Gene Block announced Friday that three students were being tested for the virus .
There have not been any confirmed cases in the university community or @ @ @ @ @ @ @ officials told students they will continue to monitor what remains a fluid situation .
In Sacramento County , officials declared a public health emergency Thursday .
The action follows Gov .
Gavin Newsom ’ s state of emergency declaration related to the virus .
Several other counties and cities across California have made similar proactive decrees , which will allow them to ask for help if their own resources become exhausted .
At least 15 counties in the state have reported cases , with the highest counts in Santa Clara and Los Angeles @ @ @ @ @ @ @ London Breed declared a public health emergency last week , reported its first two cases Thursday .
Officials think the cases indicate the virus is spreading in the community because the two new patients — a man in his 90s and a woman in her 40s who are not related — have no travel history to places with COVID-19 and had no contact with anyone who ’ s tested positive for the illness .
“ We do not know at this point how they were exposed to the virus , ” Dr. Grant @ @ @ @ @ @ @ of health , said in a statement .
Also on Thursday , Nevada announced its first confirmed case of COVID-19 , in Las Vegas , a man in his 50s who had recently traveled to Washington state , where dozens of cases have been reported .
He is hospitalized in isolation , officials said .
President Trump on Friday signed an $ 8.3-billion emergency spending package intended to help with prevention and response efforts to the virus , including the extension of telemedicine services to seniors , one of the groups most vulnerable @ @ @ @ @ @ @ , authorities in Santa Clara County reported the death of a 72-year-old man who had been on a cruise with two passengers suspected of having the coronavirus — but cautioned they have not yet confirmed whether he had contracted the virus .
Officers performed CPR on the unresponsive man , who later died , then learned from his family about his cruise travels , said Phan Ngo , chief of the Sunnyvale Department of Public Safety .
Santa Clara County announced Thursday that the number of cases there had grown from 14 to @ @ @ @ @ @ @ , nine had contacts with other confirmed COVID-19 patients and seven were believed to have caught it in the community , officials said .
“ Our cases to date indicate to us that the risk of exposure to the virus in our community is increasing , ” Dr. Sara Cody , the county ’ s health officer , said Thursday .
In response , county health officials issued more stringent recommendations meant to slow the spread of the virus , calling on residents to postpone large gatherings and cancel large events .
Employers @ @ @ @ @ @ @ meetings , consider allowing employees to telecommute and stagger work start and end times , they said .
Lockheed Martin reported that one of its employees in Sunnyvale tested positive for the virus , and like other businesses , the company is taking extra precautions to safeguard workplace areas .
“ We have taken actions to ensure a safe workplace for employees and visitors , including deep cleaning of work areas and common spaces .
The health and well-being of our employees is our top priority , ” Lockheed Martin said in a @ @ @ @ @ @ @ recommending that schools or businesses be shuttered but said they ’ ll consider such closures on a case-by-case basis if a school employee or student is confirmed to have the coronavirus .
At this point , officials have recommended that schools consider online learning possibilities in the event that a school is closed and that businesses have a work-from-home contingency plan .
Lowell High School in San Francisco announced Thursday it would close and cancel all events and gatherings for the rest of the week after learning that a relative of one of @ @ @ @ @ @ @ .
San Mateo County ’ s health officer , Dr. Scott Morrow , said in a statement Thursday that COVID-19 “ has likely been spreading for weeks , perhaps months.
” “ We now all need to take assertive actions to inhibit the spread of this new virus , ” Morrow said .
Among other steps , Morrow recommends that people stop shaking hands , use a barrier such as a paper towel or tissue to touch door handles , elevator buttons and other commonly touched surfaces and “ under all circumstances , @ @ @ @ @ @ @ nose , or mouth with your unwashed hands.
” Echoing Santa Clara officials , he said residents should cancel or postpone nonessential gatherings .
In the future , other steps may be needed , Morrow said , including school closures that are “ extensive and extended , ” rationing of critical supplies and social distancing — that is , staying at least six feet away from other people .
Ferrer said there is no evidence of community spread in L.A. County at this point , but there are mild cases that have gone @ @ @ @ @ @ @ at one point soon we will have a case of a person who was symptomatic , who we can ’ t trace back to a known exposure and that will allow us to confirm that in fact there ’ s community spread , ” she said .
“ Do we have more novel coronavirus here than we have cases ?
I would say the answer to that is probably yes.
” She said that for now the county has the capacity to do contact tracing for known cases and keep up with demand @ @ @ @ @ @ @ We have capacity right now ; should there be hundreds of cases , we will just flip to mitigation , and with a concentration on working with institutions where there might be small outbreaks , ” she said .
She said that more extreme measures , such as closing schools , canceling mass gatherings and shutting down public transit , will be considered as the outbreak grows .
She said at this point , county health officials feel confident in their ability to find people who are symptomatic and identify and quarantine their @ @ @ @ @ @ @ lot more cases … we would move toward more widespread social distancing measures , and if we have exposures in places like schools where lots of people got exposure and needed to be quarantined you would see possible closures , ” she said .
Los Angeles County health officials on Thursday confirmed four more cases of the coronavirus among patients who had recently returned from a group trip to northern Italy .
Three travelers in that group had previously tested positive for the virus .
The San Diego area reported its third case @ @ @ @ @ @ @ T store in Chula Vista .
Six stores were closed and deep-cleaned , the company said in a statement .
In the Bay Area , the was being kept offshore amid concerns that more people on board might be sick after a 71-year-old passenger on an earlier voyage died this week of the virus .
Sonoma County health officials confirmed that a second passenger on the cruise tested positive and was in isolation .
Health officials said they were contacting Sonoma County residents who were on the cruise or on the shuttle that @ @ @ @ @ @ @ .
Meanwhile , Newsom and state Insurance Commissioner Ricardo Lara announced they were ordering all public and commercial insurance plans to fully cover the cost of testing for the coronavirus as an essential benefit .
The order will ensure that Californians will not incur any out-of-pocket expenses , including co-pays and deductibles , even if they are tested at hospital emergency rooms or urgent care facilities , they said .
“ This action means that Californians who fit the testing requirements can receive the test at no cost .
We ’ re all @ @ @ @ @ @ @ m grateful to those health providers who have already stepped up and heeded our call , ” Newsom said in a statement released Thursday afternoon .
Californians without insurance should contact their county public health departments for information about their options for testing and screening , state officials said .
Visiting Washington state Thursday afternoon , Vice President Mike Pence acknowledged that the federal government still has not been able to get enough coronavirus test kits to hospitals , clinics and health departments around the country .
“ We still have a ways @ @ @ @ @ @ @ But he again promised millions would be on the way soon , predicting that 4 million tests would be distributed by the end of next week .
Pence and other Trump administration officials had promised that 1 million would be distributed by the end of this week , but there has been no verification that has occurred .
Washington remains the hardest-hit state , with 70 confirmed cases , including 11 people who have died .
World Health Organization officials said Thursday that it is not too late to curb the spread of @ @ @ @ @ @ @ morning had infected 100,685 people wordwide and killed approximately 3,460 .
In parts of China , where the outbreak originated , the daily new infection rate has been brought down to the single digits , health officials said .
Eight provinces have not reported any new cases in the last 14 days .
Officials emphasized that tried-and-true public health measures , like testing and isolation , are working to control the virus .
Countries need to take proactive steps , said Dr. Maria Van Kerkhove , the WHO ’ s acting head of @ @ @ @ @ @ @ look for all of your cases aggressively.
” Times staff writers Ruben Vives , Anita Chabria , Noam Levey , Rong-Gong Lin II and Phil Willon contributed to this report .

Alex Wigglesworth, Soumya Karlamangla, Tony Barboza, Colleen Shalby

In a growing sign of how coronavirus is disrupting California, Stanford University said Friday night that it will move classes online for the final two weeks of the winter quarter.
Stanford also said large events would be “canceled or adjusted.”
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“The university is actively monitoring the local and global health situation and is taking precautionary measures in an effort to help limit the spread of infection,” officials said in a statement.
The move comes after a faculty member tested positive for the virus.
USC said Friday that it would conduct lectures and seminars online rather than in classrooms for three days next week to test the ability to operate remotely should the coronavirus spread and force the campus to suspend in-person contact. The University of Washington announced Friday it was moving all instruction online for the next two weeks, keeping more than 50,000 students out of classrooms as the death toll from COVID-19 in that region continued to rise.
Meanwhile, coronavirus continued its spread across California and the nation on Friday, with new cases reported from Los Angeles to Placer County, while cruise passengers stuck off the coast of San Francisco were tested amid what appears to be an outbreak on board.
At least seven of California’s cases have been tied to the cruise, including one confirmed death in Placer County.
Speaking at the White House on Friday afternoon, Vice President Mike Pence said a total of 21 people on the Grand Princess have tested positive for coronavirus, including 19 crew members.
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He said the federal government is working with the state of California to bring the cruise ship in to a non-commercial port over the weekend and to quarantine passengers as necessary.
“All passengers will be tested,” the vice president said. “Those that need to be quarantined will be quarantined.”
Pence said 24 people on the cruise ship had tested negative, and one test has been inconclusive.
Meanwhile, L.A. County confirmed two additional cases of the new coronavirus Friday, bringing the total to 13.
That comes as more cases of the virus continue to be reported elsewhere in California and in other states, including Texas, prompting the city of Austin to cancel the massively popular South by Southwest festival.
Of the most recent cases announced in L.A. County, one person is part of a group of travelers who went to northern Italy. Seven other members of that same group had already have tested positive for COVID-19.
The second is a second screener at Los Angeles International Airport. A screener at LAX also was diagnosed with the virus earlier in the week, sources familiar with the matter said. The L.A. County Department of Public Health has asked the federal Centers for Disease Control and Prevention for help investigating those two cases.
The individuals’ close contacts are being self-quarantined in case they also develop symptoms.
The new cases still don’t point to community spread in Los Angeles County, L.A. County Department of Public Health Director Barbara Ferrer said.
She estimated that 50 people in the county have been tested for COVID-19 and emphasized that more tests are coming back negative than positive.
The low numbers of tests run in L.A. County so far have been due to limited testing capacity at the lab, not a shortage of test kits, she said. Lab workers had been putting in at least 18-hour days, she said.
On Thursday night, commercial lab LabCorp came online, and on Monday, Quest Diagnostics is expected to begin offering testing as well, she said.
“This is all good news,” Ferrer said. “The limitation of our lab was not the lab kits, but we’re only one lab and we could only process a certain number of tests in one day.”
She said these changes does not mean that everyone will be tested for the virus. Providers will determine which patients with symptoms require testing.
As of Friday, L.A. County expanded its criteria to follow guidelines to test for anyone a doctor recommends, not just people with a travel history to countries with major outbreaks, Ferrer said.
“Now it’s up the individual provider to make that determination,” she said, adding that providers are encouraged to consult CDC criteria.
Yolo County reported its first case of the new virus Friday — a woman who officials think contracted the virus in the community.
The woman has underlying health conditions and has been hospitalized, officials said. She appears to have acquired the virus “through community transmission,” the Yolo County Health and Human Services Agency said in a news release. The agency will monitor the woman’s close personal contacts for symptoms of the illness and said staff is working with healthcare providers to identify potential additional cases.
“Given the rapid spread of COVID-19 around the world, I am not surprised that the virus is in our county,” Dr. Ron Chapman, the county’s public health officer, said in a statement.
The county plans to declare local and health emergencies, the agency said.
Solano and Santa Clara counties also have reported coronavirus cases that are believed to have been contracted through community contact — that is, by people who have not traveled to areas where COVID-19 is widespread or by those who have come in direct contact with another confirmed case of the virus.
New coronavirus cases were also reported Friday in Placer, Ventura, Contra Costa, Santa Clara and Alameda counties.
In Placer County, three cases were announced, all of them among people who had traveled on the Grand Princess cruise ship from San Francisco to Mexico on Feb. 11-21. The ship docked in San Francisco on Feb. 21, with some passengers disembarking before the ship moved on to Hawaii. The ship is now being held off the coast of San Francisco amid an outbreak of COVID-19.
Two of the people had mild symptoms that have already resolved, while the third continues to experience mild symptoms, the Placer County Public Health Department said in a news release. None of them required hospitalization, and all three are isolated at home, officials said.
The public health department is working on tracing the people’s contacts to identify more possible cases, officials said.
“We are moving as quickly as possible to limit the spread of disease,” Dr. Aimee Sisson, the county’s health officer, said in a statement. “To be frank, we would not be surprised to see a second wave of cases connected to these cruise passengers given the amount of time that’s passed since they disembarked.”
Placer County had previously reported two cases of the coronavirus, including one death.
Ventura County’s public health lab also confirmed a positive result for a passenger on the Grand Princess cruise ship. The person had only mild symptoms and was being quarantined at home, officials said. It was the county’s first case of the new virus.
“There is no evidence of community transmission in Ventura County,” Dr. Robert Levin, the county health officer, said in a statement. “This is a travel-related case.”
The state Department of Health on Wednesday night notified the Ventura County Public Health Department that six county residents had traveled on the cruise, and public health officials contacted all of them, the Ventura County Public Health Department said in a news release.
One of the travelers had been in contact with their primary care doctor, who had requested that the person be tested for COVID-19, officials said. The doctor had the patient stay in their vehicle while dropping off the sample curbside to limit possible exposure, officials said.
The person diagnosed with the virus had remained home resting since returning from the cruise, and only left to seek medical attention, officials said. Public health officials said they were working with the state Department of Public Health to notify anyone else who may have come into contact with the person while they were seeking medical attention or in transit to Ventura County from San Francisco, where they disembarked the cruise.
The person’s spouse, who was also on the cruise but did not have symptoms of the virus, was also being quarantined at home, officials said.
Of the four remaining Ventura County residents who were on the cruise, one was symptomatic and being tested, officials said. The other three had reported no symptoms.
In Contra Costa County, two of the three cases announced Friday were also passengers on the Grand Princess cruise ship. The third person had close contact with a person who was diagnosed with the coronavirus in another jurisdiction, county health officials said. All three people were being isolated at their homes.
The county is now recommending that adults over 50 and people with underlying medical conditions that could put them at risk of contracting COVID-19 avoid mass gatherings like parades, sporting events or concerts.
Public health officials in Santa Clara County reported four new cases Friday, bringing the total there to 24.
One was a man whom officials described as a household contact of a previously confirmed COVID-19 case in Santa Clara County, and another was a male who had recently returned from a trip to India, officials said. Both people were isolated at home.
Officials weren’t sure how the other two people contracted the virus. One was a male who was isolated at home; the other was a woman who was hospitalized, officials said. Both cases were under investigation.
In Alameda County, the health department confirmed a third case of COVID-19 — an older adult with underlying health conditions who was a passenger on the Grand Princess cruise ship from Feb. 11 to 21.
At the Lawrence Livermore National Laboratory in Livermore, 25 lab employees were sent home Thursday for a 14-day period of self-monitoring after an employee informed the lab of having been exposed to coronavirus, said Lynda Seaver, spokesperson for the facility. The employee in question had shown symptoms of the virus, Seaver said, and “we are presuming it’s coronavirus, but we don’t have verification.” The Alameda County lab has 7,500 employees.
And in Riverside County, the Murrieta Valley Unified School District announced Friday night that it would close Murrieta Valley High School after an employee who recently traveled to a country affected by the coronavirus outbreak became ill and will be tested. The school district said the school would be closed until testing was completed.
The number of coronavirus cases worldwide has surpassed 100,000 — with California recording at least 69 — as officials work to contain the virus despite its rapid spread.
World Health Organization officials pressed countries Friday to aggressively pursue containment and expand testing for COVID-19 as the outbreak swells.
WHO director Tedros Adhanom Ghebreyesus said that trying to contain the epidemic and slow it buys time for more research and preparedness to handle cases when they do arrive. “Every day we can slow the epidemic is another day, governments can prepare their workers to detect, test, treat and care for patients,” he said.
In California, officials announced what may be the state’s second virus-related death in Santa Clara County, where residents are being urged to postpone or cancel large gatherings and events, and minimize work in big groups.
The number of positive COVID-19 test results in the state reached 60 Thursday as authorities announced what may be the state’s second virus-related death in Santa Clara County. That number is expected to grow.
UCLA Chancellor Gene Block announced early Friday that three students were being tested for the virus. By that night, Block reported that the Los Angeles County Department of Public Health informed the university that each of the three students had tested negative for the virus.
In Sacramento County, officials declared a public health emergency Thursday. The action follows Gov. Gavin Newsom’s state of emergency declaration related to the virus. Several other counties and cities across California have made similar proactive decrees, which will allow them to ask for help if their own resources become exhausted.
At least 15 counties in the state have reported cases, with the highest counts in Santa Clara and Los Angeles counties.
San Francicso, where Mayor London Breed declared a public health emergency last week, reported its first two cases Thursday. Officials think the cases indicate the virus is spreading in the community because the two new patients — a man in his 90s and a woman in her 40s who are not related — have no travel history to places with COVID-19 and had no contact with anyone who’s tested positive for the illness.
“We do not know at this point how they were exposed to the virus,” Dr. Grant Colfax, San Francisco’s director of health, said in a statement.
On Friday, San Francisco’s public health department issued new guidance to reduce the spread of the disease, including recommendations that people over 60, or with underlying health conditions, “stay home as much as possible,” avoid gatherings of 50 or more people unless necessary and telecommute if possible. The city’s St. Patrick’s Day Parade was also postponed “until further notice” on Friday in an effort to contain the disease, and events at the Davies Symphony Hall, home to the San Francisco Symphony, and War Memorial Performing Arts Center venues were canceled for two weeks.
And on Thursday, Nevada announced its first confirmed case of COVID-19, in Las Vegas, a man in his 50s who had recently traveled to Washington state, where dozens of cases have been reported. He is hospitalized in isolation, officials said.
President Trump on Friday signed an $8.3-billion emergency spending package intended to help with prevention and response efforts to the virus, including the extension of telemedicine services to seniors, one of the groups most vulnerable to the virus.
The day before, authorities in Santa Clara County reported the death of a 72-year-old man who had been on a cruise with two passengers suspected of having the coronavirus — but cautioned they have not yet confirmed whether he had contracted the virus.
Officers performed CPR on the unresponsive man, who later died, then learned from his family about his cruise travels, said Phan Ngo, chief of the Sunnyvale Department of Public Safety. On Friday night, Santa Clara County officials announced that the man tested negative for COVID-19.
Santa Clara County announced Thursday that the number of cases there had grown from 14 to 20. Four are related to travel, nine had contacts with other confirmed COVID-19 patients and seven were believed to have caught it in the community, officials said.
“Our cases to date indicate to us that the risk of exposure to the virus in our community is increasing,” Dr. Sara Cody, the county’s health officer, said Thursday.
In response, county health officials issued more stringent recommendations meant to slow the spread of the virus, calling on residents to postpone large gatherings and cancel large events. Employers should take steps to minimize large group meetings, consider allowing employees to telecommute and stagger work start and end times, they said.
In San Jose, Mayor Sam Liccardo said he would propose a temporary moratorium on evictions in the city for renters contending with lost wages due to the coronavirus outbreak. San Jose State President Mary A. Papazian said she would move the university’s State of the State address online and anticipated that other spring campus events would be affected by the outbreak. There are no reported cases of COVID-19 at the campus.
Lockheed Martin reported that one of its employees in Sunnyvale tested positive for the virus, and like other businesses, the company is taking extra precautions to safeguard workplace areas.
“We have taken actions to ensure a safe workplace for employees and visitors, including deep cleaning of work areas and common spaces. The health and well-being of our employees is our top priority,” Lockheed Martin said in a statement.
Health officials aren’t recommending that schools or businesses be closed but said they’ll consider such closures on a case-by-case basis if a school employee or student is confirmed to have the coronavirus. At this point, officials have recommended that schools consider online learning possibilities in the event that a school is closed and that businesses have a work-from-home contingency plan.
Lowell High School in San Francisco announced Thursday it would close and cancel all events and gatherings for the rest of the week after learning that a relative of one of its students is being treated for COVID-19.
San Mateo County’s health officer, Dr. Scott Morrow, said in a statement Thursday that COVID-19 “has likely been spreading for weeks, perhaps months.”
“We now all need to take assertive actions to inhibit the spread of this new virus,” Morrow said.
Among other steps, Morrow recommends that people stop shaking hands, use a barrier such as a paper towel or tissue to touch door handles, elevator buttons and other commonly touched surfaces and “under all circumstances, stop touching your face, eyes, nose, or mouth with your unwashed hands.” Echoing Santa Clara officials, he said residents should cancel or postpone nonessential gatherings.
In the future, other steps may be needed, Morrow said, including school closures that are “extensive and extended,” rationing of critical supplies and social distancing — that is, staying at least six feet away from other people.
Ferrer said there is no evidence of community spread in L.A. County at this point, but there are mild cases that have gone undiagnosed.
“At some point and at one point soon we will have a case of a person who was symptomatic, who we can’t trace back to a known exposure and that will allow us to confirm that in fact there’s community spread,” she said. “Do we have more novel coronavirus here than we have cases? I would say the answer to that is probably yes.”
She said that for now the county has the capacity to do contact tracing for known cases and keep up with demand, but that could change.
“We have capacity right now; should there be hundreds of cases, we will just flip to mitigation, and with a concentration on working with institutions where there might be small outbreaks,” she said.
She said that more extreme measures, such as closing schools, canceling mass gatherings and shutting down public transit, will be considered as the outbreak grows. She said at this point, county health officials feel confident in their ability to find people who are symptomatic and identify and quarantine their contacts.
“If we have a lot more cases … we would move toward more widespread social distancing measures, and if we have exposures in places like schools where lots of people got exposure and needed to be quarantined you would see possible closures,” she said.
Los Angeles County health officials on Thursday confirmed four more cases of the coronavirus among patients who had recently returned from a group trip to northern Italy. Three travelers in that group had previously tested positive for the virus.
The San Diego area reported its third case, an employee of an AT&T store in Chula Vista. Six stores were closed and deep-cleaned, the company said in a statement.
In the Bay Area, the Grand Princess cruise ship was being kept offshore amid concerns that more people on board might be sick after a 71-year-old passenger on an earlier voyage died this week of the virus.
Sonoma County health officials confirmed that a second passenger on the cruise tested positive and was in isolation.
Health officials said they were contacting Sonoma County residents who were on the cruise or on the shuttle that carried passengers to and from the ship.
Meanwhile, Newsom and state Insurance Commissioner Ricardo Lara announced they were ordering all public and commercial insurance plans to fully cover the cost of testing for the coronavirus as an essential benefit.
The order will ensure that Californians will not incur any out-of-pocket expenses, including co-pays and deductibles, even if they are tested at hospital emergency rooms or urgent care facilities, they said.
“This action means that Californians who fit the testing requirements can receive the test at no cost. We’re all in this together, and I’m grateful to those health providers who have already stepped up and heeded our call,” Newsom said in a statement released Thursday afternoon.
Californians without insurance should contact their county public health departments for information about their options for testing and screening, state officials said.
Visiting Washington state Thursday afternoon, Vice President Mike Pence acknowledged that the federal government still has not been able to get enough coronavirus test kits to hospitals, clinics and health departments around the country.
“We still have a ways to go,” Pence said. But he again promised millions would be on the way soon, predicting that 4 million tests would be distributed by the end of next week. Pence and other Trump administration officials had promised that 1 million would be distributed by the end of this week, but there has been no verification that has occurred.
Washington remains the hardest-hit state, with 70 confirmed cases, including 11 people who have died.
World Health Organization officials said Thursday that it is not too late to curb the spread of the virus, which as of Friday morning had infected 100,685 people wordwide and killed approximately 3,460.
In parts of China, where the outbreak originated, the daily new infection rate has been brought down to the single digits, health officials said. Eight provinces have not reported any new cases in the last 14 days.
Officials emphasized that tried-and-true public health measures, like testing and isolation, are working to control the virus.
Countries need to take proactive steps, said Dr. Maria Van Kerkhove, the WHO’s acting head of emerging diseases. “You need to look for all of your cases aggressively.”
Times staff writers Ruben Vives, Anita Chabria, Noam Levey, Rong-Gong Lin II and Phil Willon contributed to this report.


latimes--2020-03-07--As people worry about gathering in public because of coronavirus, blood donations steadily dwindle

Blood donations have started to dwindle as cases of novel coronavirus continue to rise .
The toll of the illness has so far been especially pronounced in the West Coast , where at least 11 deaths have been reported in Washington state and at least one in California .
But the decrease in donations has been widespread , with the American Assn .
of Blood Banks saying that a number of blood drives in the U.S. have been canceled , including one that was expected to collect 500 units — enough to help about 1,500 patients .
( Each donation @ @ @ @ @ @ @ The American Red Cross , one of AABB ’ s partners , has also reported cancellations in blood donations .
There is currently no shortage of blood supply in the country .
But Eduardo Nunes , vice president of quality , standards and accreditation for AABB , said that it would be cause for serious concern if the decline continues for weeks over fears of falling ill to COVID-19 .
Experts say the decrease may simply be related to people ’ s fears of gathering in public and contracting the virus from others @ @ @ @ @ @ @ life of 42 days .
To keep the supply stable , constant donations are necessary .
“ The use of blood seems to be steady at this point while collections are dropping , ” Nunes said .
“ We ’ ve had a steady depletion of inventory over the past few weeks , with no sign that we ’ ll be able to make up deficit.
” Before the outbreak of coronavirus , there was already a strain on the blood supply , said Dr. Claudia Cohn , chief medical officer for AABB @ @ @ @ @ @ @ that older people — who have been deemed one of the most at-risk for the virus — had been the most engaged when it came to giving blood .
But as this demographic shrinks , others are not filling in the void .
“ Younger generations are not showing up in the numbers as the ‘ Greatest Generation ’ ” Cohn said .
“ That is the fact.
” Officials are already taking precautionary measures to boost donations .
The San Diego Blood Bank in San Diego County , which has not yet @ @ @ @ @ @ @ , is asking for donations in anticipation of possible travel restrictions that may arise as cases continue to grow .
In Washington state , where at least 11 people have died , the public health department said earlier this week that the coronavirus has affected the state ’ s blood supply .
“ The COVID-19 outbreak is starting to impact the blood supply in WA .
Anyone who is symptom-free is encouraged to donate blood !
” the department tweeted .
Curt Bailey , the CEO of Seattle-based nonprofit Bloodworks , issued a @ @ @ @ @ @ @ at a local community blood center .
Still , the Red Cross is asking that people who have recently traveled to China , Iran , Italy and South Korean or have come into contact with a person suspected of having the virus , refrain from making a donation for 28 days .
“ We ask that only healthy people give blood , ” Claudia said , stressing the fact that people are unlikely to be exposed to a knowingly sick individual at a blood drive since good health is a requirement to donate @ @ @ @ @ @ @ Force on Domestic Disasters and Acts of Terrorism , which was created in 2002 before the SARS outbreak , the U.S. Food and Drug Administration has not reported any cases of a transfusion-transmitted respiratory virus , including COVID-19 , that ’ s emerged over the past two years .
That also includes two previous coronaviruses — SARS and MERS-CoV .
“ We are all very concerned about what the next few weeks may look like , ” Nunes said .
“ There ’ s a potential need for much more dire messaging in @ @ @ @

The World Health Organization has confirmed two more deaths from coronavirus, bringing the total to 11.
Blood donations have started to dwindle as cases of novel coronavirus continue to rise.
The toll of the illness has so far been especially pronounced in the West Coast, where at least 11 deaths have been reported in Washington state and at least one in California.
But the decrease in donations has been widespread, with the American Assn. of Blood Banks saying that a number of blood drives in the U.S. have been canceled, including one that was expected to collect 500 units — enough to help about 1,500 patients. (Each donation can help roughly three people.)
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The American Red Cross, one of AABB’s partners, has also reported cancellations in blood donations.
There is currently no shortage of blood supply in the country. But Eduardo Nunes, vice president of quality, standards and accreditation for AABB, said that it would be cause for serious concern if the decline continues for weeks over fears of falling ill to COVID-19.
Experts say the decrease may simply be related to people’s fears of gathering in public and contracting the virus from others.
A blood donation has a shelf life of 42 days. To keep the supply stable, constant donations are necessary.
“The use of blood seems to be steady at this point while collections are dropping,” Nunes said. “We’ve had a steady depletion of inventory over the past few weeks, with no sign that we’ll be able to make up deficit.”
Before the outbreak of coronavirus, there was already a strain on the blood supply, said Dr. Claudia Cohn, chief medical officer for AABB. One possible reason for that is that older people — who have been deemed one of the most at-risk for the virus — had been the most engaged when it came to giving blood. But as this demographic shrinks, others are not filling in the void.
“Younger generations are not showing up in the numbers as the ‘Greatest Generation’” Cohn said. “That is the fact.”
Officials are already taking precautionary measures to boost donations.
The San Diego Blood Bank in San Diego County, which has not yet reported any confirmed cases of the virus, is asking for donations in anticipation of possible travel restrictions that may arise as cases continue to grow.
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In Washington state, where at least 11 people have died, the public health department said earlier this week that the coronavirus has affected the state’s blood supply.
“The COVID-19 outbreak is starting to impact the blood supply in WA. Anyone who is symptom-free is encouraged to donate blood!” the department tweeted.
Curt Bailey, the CEO of Seattle-based nonprofit Bloodworks, issued a public call for 1,000 people to donate at a local community blood center.
Still, the Red Cross is asking that people who have recently traveled to China, Iran, Italy and South Korean or have come into contact with a person suspected of having the virus, refrain from making a donation for 28 days.
“We ask that only healthy people give blood,” Claudia said, stressing the fact that people are unlikely to be exposed to a knowingly sick individual at a blood drive since good health is a requirement to donate.
According to the AABB Interorganizational Task Force on Domestic Disasters and Acts of Terrorism, which was created in 2002 before the SARS outbreak, the U.S. Food and Drug Administration has not reported any cases of a transfusion-transmitted respiratory virus, including COVID-19, that’s emerged over the past two years. That also includes two previous coronaviruses — SARS and MERS-CoV.
“We are all very concerned about what the next few weeks may look like,” Nunes said. “There’s a potential need for much more dire messaging in the future.”


latimes--2020-03-07--What is the fatality rate for the new coronavirus, and why does it keep changing?

If 100 people become infected with the new coronavirus from China , how many will die ?
For weeks , it seemed that the answer was 2 .
Perhaps a little more , perhaps a little less .
The calculation was made by comparing the total number of people with confirmed cases of COVID-19 to the number of people who died of it .
As both of those numbers grew , the ratio was bound to shift .
The 2 % figure seemed stable on Feb. 24 , when a massive study of nearly 45,000 Chinese patients whose infections had @ @ @ @ @ @ @ case fatality rate of 2.3 % .
Later that week , on Feb. 28 , a study of nearly 1,100 Chinese patients suggested a lower death rate , of 1.4 % .
Four days later , on March 3 , the World Health Organization said the global mortality rate was 3.4 % .
How could it have changed so much in such a short period of time ?
“ It ’ s hard to say what the case-fatality rates are until the dust settles , ” said Dr. George Rutherford , an epidemiologist @ @ @ @ @ @ @ Francisco .
“ It ’ s not a statistic to be looking at kind of on an ongoing basis , even though I do it just as much as everybody else does , ” he admitted .
That includes members of Congress .
On Wednesday , they asked Dr. Anthony Fauci , director of the National Institute of Allergy and Infectious Diseases , what was going on .
He urged them not to get so fixated on the fatality rate , emphasizing that scientists still have a lot to learn about it .
@ @ @ @ @ @ @ people who have been infected with the coronavirus .
The official count has surpassed 100,000 , but the true number is probably much higher .
Scientists suspected that many patients who experienced only mild illnesses never saw a doctor and therefore never got an official lab test to see if they were infected .
As a result , they weren ’ t factored into the case-fatality rate .
Neither were people who wanted to be tested but weren ’ t due to a lack of resources .
In a situation where test kits @ @ @ @ @ @ @ to save them for 80-year-olds with poor lung function and skip the healthier 40-year-olds with mild illness .
Counting problems aside , the case-fatality rate can change over the course of an outbreak .
For instance , the authors of the study of nearly 45,000 Chinese patients noted that the case-fatality rate in Hubei , the province at the center of the outbreak , was 2.9 % .
Elsewhere in China , it was 0.4 % .
It ’ s possible that as China catches up on counting deaths , the fatality rate @ @ @ @ @ @ @ it ’ s also possible that the difference is real because public health authorities outside of Hubei had a chance to get ready for the coronavirus , “ so people aren ’ t dying at the same rates as they did before , ” Rutherford said .
At UCSF , for instance , doctors are prepared to treat the coronavirus in a containment facility set up in the parking lot for the emergency room , he said .
Other countries are reporting different case-fatality rates .
With 6,767 confirmed cases as of late @ @ @ @ @ @ @ patients than any country besides China .
That high number may in part be a function of the country ’ s sweeping testing program that involved tens of thousands of people .
When balanced against the country ’ s 44 deaths , the case-fatality ratio is less than 0.7 % .
That figure may offer a better sense of COVID-19 ’ s true fatality rate , said Dr. Jeremy Faust , an emergency physician at Brigham and Women ’ s Hospital in Boston and an instructor at Harvard Medical School .
“ By @ @ @ @ @ @ @ actually able to find more cases , ” Faust said .
“ It means they noticed the disease was everywhere , and it doesn ’ t kill that many people .
“ The more testing you do , the more accurate your numbers become , ” he added .
Rutherford predicted that by the time the dust settles , the overall case-fatality rate for COVID-19 will fall to somewhere between 1 % to 2 % .
Fauci agreed that the death rate could end up being as low as 1 % .
But @ @ @ @ @ @ @ , he said , it would still be 10 times worse than the average death rate for the seasonal flu .

South Korean soldiers work to contain the coronavirus outbreak by spraying antiseptic solution in the Gangnam district of Seoul. The COVID-19 fatality rate in South Korea is much lower than it is in China.
If 100 people become infected with the new coronavirus from China, how many will die?
For weeks, it seemed that the answer was 2. Perhaps a little more, perhaps a little less.
The calculation was made by comparing the total number of people with confirmed cases of COVID-19 to the number of people who died of it. As both of those numbers grew, the ratio was bound to shift.
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The 2% figure seemed stable on Feb. 24, when a massive study of nearly 45,000 Chinese patients whose infections had been confirmed with laboratory tests reported a case fatality rate of 2.3%.
Later that week, on Feb. 28, a study of nearly 1,100 Chinese patients suggested a lower death rate, of 1.4%.
Four days later, on March 3, the World Health Organization said the global mortality rate was 3.4%.
How could it have changed so much in such a short period of time?
“It’s hard to say what the case-fatality rates are until the dust settles,” said Dr. George Rutherford, an epidemiologist and infectious disease expert at UC San Francisco.
“It’s not a statistic to be looking at kind of on an ongoing basis, even though I do it just as much as everybody else does,” he admitted.
That includes members of Congress. On Wednesday, they asked Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, what was going on. He urged them not to get so fixated on the fatality rate, emphasizing that scientists still have a lot to learn about it.
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The biggest uncertainty surrounds the number of people who have been infected with the coronavirus. The official count has surpassed 100,000, but the true number is probably much higher.
Scientists suspected that many patients who experienced only mild illnesses never saw a doctor and therefore never got an official lab test to see if they were infected. As a result, they weren’t factored into the case-fatality rate.
Neither were people who wanted to be tested but weren’t due to a lack of resources. In a situation where test kits are limited, it’s better to save them for 80-year-olds with poor lung function and skip the healthier 40-year-olds with mild illness.
Counting problems aside, the case-fatality rate can change over the course of an outbreak.
For instance, the authors of the study of nearly 45,000 Chinese patients noted that the case-fatality rate in Hubei, the province at the center of the outbreak, was 2.9%. Elsewhere in China, it was 0.4%.
It’s possible that as China catches up on counting deaths, the fatality rate outside of Hubei will rise.
But it’s also possible that the difference is real because public health authorities outside of Hubei had a chance to get ready for the coronavirus, “so people aren’t dying at the same rates as they did before,” Rutherford said.
At UCSF, for instance, doctors are prepared to treat the coronavirus in a containment facility set up in the parking lot for the emergency room, he said.
Other countries are reporting different case-fatality rates.
With 6,767 confirmed cases as of late Friday, South Korea has more coronavirus patients than any country besides China. That high number may in part be a function of the country’s sweeping testing program that involved tens of thousands of people. When balanced against the country’s 44 deaths, the case-fatality ratio is less than 0.7%.
That figure may offer a better sense of COVID-19’s true fatality rate, said Dr. Jeremy Faust, an emergency physician at Brigham and Women’s Hospital in Boston and an instructor at Harvard Medical School.
“By testing so many people, they were actually able to find more cases,” Faust said. “It means they noticed the disease was everywhere, and it doesn’t kill that many people.
“The more testing you do, the more accurate your numbers become,” he added.
Rutherford predicted that by the time the dust settles, the overall case-fatality rate for COVID-19 will fall to somewhere between 1% to 2%.
Fauci agreed that the death rate could end up being as low as 1%. But even if that’s the case, he said, it would still be 10 times worse than the average death rate for the seasonal flu.


latimes--2020-03-07--Column: Readers weren't happy with what I had to say about D.A. Jackie Lacey — and neither was she

They weighed in quickly and their message was clear .
With only a few exceptions , the readers who bothered to write did not like my recent column on Jackie Lacey ’ s husband pointing a gun at protesters who knocked on the door of the L.A. County district attorney ’ s on the eve of the election .
Lacey wasn ’ t too thrilled with my work , either .
When I asked her if she wanted to talk about it , she said yes .
Don ’ t get the idea here that I ’ m ready and @ @ @ @ @ @ @ .
That would take decades .
But I respect Lacey , the first woman and first African American leader of the D.A.
’ s office , and so I paid her a visit Wednesday afternoon .
At that point , the two-term incumbent led two challengers in her bid for reelection , taking about 50 % of the votes while the others split the rest .
But it was not yet clear — and still isn ’ t — whether Lacey will finish the race above 50 % and thereby avoid a November @ @ @ @ @ @ @ it takes so long to count votes in the state that invented technology is beyond me , and I ’ m wondering if messenger pigeons would be an improvement .
Before I get to what Lacey told me , I have to say , I still think it wasn ’ t the best idea for the husband of the county ’ s top law enforcement official to threaten to shoot Black Lives Matter protesters .
But Lacey has been somewhat circumspect about the incident , and readers came to her husband ’ s @ @ @ @ @ @ @ death threats and harassment .
...
It ’ s a wonder the rudely awakened Mr. Lacey did not shoot anyone , ” said one .
According to Lacey , her husband later apologized for waving his gun .
“ Mr .
Lacey was simply standing his ground , protecting his wife and property .
It ’ s his home and the Black Lives Matter people should have respected that , ” said another reader .
I wrote that Lacey might have avoided the scene if she had met with critics , as promised @ @ @ @ @ @ @ shins on that point , too .
“ As to the notion that she should have met with the Black Lives Matter group , ” said one , “ they lost any right to that when they deprived her of her 1st Amendment right to speech by shouting her down during a campaign debate.
” When I sat face to face with Lacey , she told me she knew she surrendered some of her privacy the moment she became D.A .
And while she defended the 1st Amendment right of free speech , @ @ @ @ @ @ @ used by her vocal critics , some of whom disrupted a candidate forum she participated in , and she thinks her home should be off-limits .
“ I think to call this a protest is mis-categorizing it , ” she said .
Lacey told me she expected that when she was ready to head home on the day we spoke , protesters would be outside her office waving signs and calling for her ouster .
“ I think that ’ s fair , and I even think it ’ s fair if they @ @ @ @ @ @ @ event , ” Lacey said .
But twice now they ’ ve come to her home .
“ They didn ’ t come onto the property ” the first time , Lacey said , but they did startle her .
“ What they do is they beat the drums to wake up everybody in the neighborhood because they ’ re trying to embarrass me.
” Last week , she said , they crossed a line .
“ This time they were on the property and they were ringing the doorbell , ” Lacey @ @ @ @ @ @ @ thing .
Speaking out is one thing .
But bullying is when you are screaming and yelling and trying to embarrass somebody into doing what you want them to do … and what they want me to do is file criminal charges against every police officer who shoots someone in L.A. County .
That ’ s what they want.
” She described another incident that crossed a line for her last May , when she attended a mental health event and art exhibit .
“ I was just in there with my family @ @ @ @ @ @ @ a group rushed toward me and started screaming and yelling at me .
So my security team grabbed me and backed me out of a circle of angry people and … I fell to the ground , ” Lacey said .
“ And you ’ re thinking , are these people going to kick me in the head ?
” As I said in the first column , I get her frustration .
If I were a public official , I wouldn ’ t want people rushing me or marching on my home @ @ @ @ @ @ @ critics are making , even if their tactics are debatable .
As my colleague Sandy Banks wrote , some in the black community celebrated Lacey ’ s rise eight years ago , but soured on her after two terms .
As they see it , mass incarceration of poor young men of color is unconscionable in L.A. and beyond .
They argue that Lacey isn ’ t doing enough about it , even as prosecutors in other parts of the country are embracing criminal justice reform and calling for reduced charges , lower @ @ @ @ @ @ @ to the death penalty .
They claim Lacey has dragged her feet or chosen not to file in high-profile police shootings involving victims of color , even when the officers were fired for their actions and millions in settlements were paid .
In one case , even LAPD Chief Charlie Beck urged Lacey to prosecute an officer who killed a homeless man during a tussle in Venice .
She chose not to .
And then there ’ s the case of the white Democratic donor and West Hollywood resident Ed Buck , who @ @ @ @ @ @ @ drugs .
Critics screamed for Lacey to prosecute , but it was only last fall , after a second man died at Buck ’ s home , that charges were filed .
Lacey sees it differently , arguing that her decisions on individual cases are guided by laws and not public persuasion .
She grew up in South L.A. , where she sometimes worried about her safety as a child .
Later , her father was shot and wounded after painting over some graffiti .
There ’ s not enough focus , Lacey @ @ @ @ @ @ @ crime .
Lacey ’ s bid for reelection drew national attention because her opponents — former police officer and San Francisco D.A .
George Gascón , and former public defender Rachel Rossi — campaigned as criminal justice reformers .
Lacey said she thinks the early election results reflect an affirmation of her policies .
“ People want to be safe , ” she told me .
And what about the disproportionate number of minorities behind bars ?
“ It ’ s not lost on me , ” Lacey said .
“ But ... @ @ @ @ @ @ @ crime , what is your obligation as a prosecutor ?
I think your obligation is to make sure that whatever your decision is , you make it not based on race.
” “ I don ’ t pretend to have all the answers on this , ” Lacey said , but the way to address poverty is with “ better schools and opportunities , it seems , for African American and brown children.
” Lacey argued that she ’ s been a reformer , too .
She mentioned her role in the dismissal @ @ @ @ @ @ @ critics saw that as politically convenient timing , coming three weeks before an election in which her challengers were running to her left .
Lacey said that she has tried to divert as many mentally ill people as possible into treatment and other programs rather than incarceration , but that there aren ’ t enough options available yet .
And she would like to see her office focus more on diversion for juvenile defendants .
As Lacey predicted , protesters were outside when I left her office .
They included the family of @ @ @ @ @ @ @ and killed by sheriff ’ s deputies in a controversial 2018 incident in East Los Angeles .
A Vargas family member , along with two protesters who had gone to Lacey ’ s home last week — Greg Akili and Melina Abdullah — told me they want more accountability from Lacey .
Akili said he ’ d like to see Lacey prosecute the crimes of police with the same zeal she uses in prosecuting citizens .
“ This ‘ lock ‘ em up and throw away the key ’ mentality has made America @ @ @ @ @ @ @ it hasn ’ t proved necessarily to make us any safer , it ’ s only proved to criminalize us , ” Akili said .
He offered no apologies for the protest at Lacey ’ s home .
“ The civil rights movement , the labor movement and the women ’ s movement never would have changed anything if people were polite and respectful , ” Akili said .
So as the rest of the votes are counted , is there any way forward ?
I ’ m going to be optimistic and @ @ @ @ @ @ @ willing to stop being so provocative and engage in constructive conversation , and if Lacey is willing to elaborate on her comments to me about juvenile diversion and other reforms .
“ I can always see a point to a meeting , ” Lacey said , “ as long as there ’ s a mediator .
”

They weighed in quickly and their message was clear.
With only a few exceptions, the readers who bothered to write did not like my recent column on Jackie Lacey’s husband pointing a gun at protesters who knocked on the door of the L.A. County district attorney’s on the eve of the election.
Lacey wasn’t too thrilled with my work, either. When I asked her if she wanted to talk about it, she said yes.
Don’t get the idea here that I’m ready and willing to meet with all my critics. That would take decades. But I respect Lacey, the first woman and first African American leader of the D.A.’s office, and so I paid her a visit Wednesday afternoon.
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At that point, the two-term incumbent led two challengers in her bid for reelection, taking about 50% of the votes while the others split the rest. But it was not yet clear — and still isn’t — whether Lacey will finish the race above 50% and thereby avoid a November runoff against the second-place finisher.
Why it takes so long to count votes in the state that invented technology is beyond me, and I’m wondering if messenger pigeons would be an improvement.
Before I get to what Lacey told me, I have to say, I still think it wasn’t the best idea for the husband of the county’s top law enforcement official to threaten to shoot Black Lives Matter protesters. But Lacey has been somewhat circumspect about the incident, and readers came to her husband’s defense.
“Jackie Lacey has received death threats and harassment. ... It’s a wonder the rudely awakened Mr. Lacey did not shoot anyone,” said one. According to Lacey, her husband later apologized for waving his gun.
“Mr. Lacey was simply standing his ground, protecting his wife and property. It’s his home and the Black Lives Matter people should have respected that,” said another reader.
I wrote that Lacey might have avoided the scene if she had met with critics, as promised. But readers kicked me in the shins on that point, too.
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“As to the notion that she should have met with the Black Lives Matter group,” said one, “they lost any right to that when they deprived her of her 1st Amendment right to speech by shouting her down during a campaign debate.”
When I sat face-to-face with Lacey, she told me she knew she surrendered some of her privacy the moment she became D.A. And while she defended the 1st Amendment right to free speech, she said she objects to the tactics used by her vocal critics, some of whom disrupted a candidate forum she participated in, and she thinks her home should be off-limits.
“I think to call this a protest is miscategorizing it,” she said.
Lacey told me she expected that when she was ready to head home on the day we spoke, protesters would be outside her office waving signs and calling for her ouster.
“I think that’s fair, and I even think it’s fair if they want to show up at a public event,” Lacey said.
But twice now they’ve come to her home.
“They didn’t come onto the property” the first time, Lacey said, but they did startle her. “What they do is they beat the drums to wake up everybody in the neighborhood because they’re trying to embarrass me.”
Last week, she said, they crossed a line.
“This time they were on the property and they were ringing the doorbell,” Lacey said. “Peaceful protest is one thing. Speaking out is one thing. But bullying is when you are screaming and yelling and trying to embarrass somebody into doing what you want them to do … and what they want me to do is file criminal charges against every police officer who shoots someone in L.A. County. That’s what they want.”
She described another incident that crossed a line for her last May, when she attended a mental health event and art exhibit.
“I was just in there with my family members looking at artwork, and suddenly a group rushed toward me and started screaming and yelling at me. So my security team grabbed me and backed me out of a circle of angry people and … I fell to the ground,” Lacey said. “And you’re thinking, are these people going to kick me in the head?”
As I said in the first column, I get her frustration. If I were a public official, I wouldn’t want people rushing me or marching on my home.
But I also get the points critics are making, even if their tactics are debatable. As my colleague Sandy Banks wrote, some in the black community celebrated Lacey’s rise eight years ago, but soured on her after two terms.
As they see it, mass incarceration of poor young men of color is unconscionable in L.A. and beyond. They argue that Lacey isn’t doing enough about it, even as prosecutors in other parts of the country are embracing criminal justice reform and calling for reduced charges, lower penalties, more diversion and an end to the death penalty.
They claim Lacey has dragged her feet or chosen not to file in high-profile police shootings involving victims of color, even when the officers were fired for their actions and millions in settlements were paid. In one case, even then-LAPD Chief Charlie Beck urged Lacey to prosecute an officer who killed a homeless man during a tussle in Venice. She chose not to.
And then there’s the case of the white Democratic donor and West Hollywood resident Ed Buck, who allegedly plied young gay black men with drugs. Critics screamed for Lacey to prosecute, but it was only last fall, after a second man died at Buck’s home, that charges were filed.
Lacey sees it differently, arguing that her decisions on individual cases are guided by laws and not public persuasion. She grew up in South L.A., where she sometimes worried about her safety as a child. Later, her father was shot and wounded after painting over some graffiti.
There’s not enough focus, Lacey told me, on the victims of crime.
Lacey’s bid for reelection drew national attention because her opponents — former police officer and San Francisco D.A. George Gascón, and former public defender Rachel Rossi — campaigned as criminal justice reformers.
Lacey said she thinks the early election results reflect an affirmation of her policies.
“People want to be safe,” she told me.
And what about the disproportionate number of minorities behind bars?
“It’s not lost on me,” Lacey said. “But ... when someone of color commits a violent crime, what is your obligation as a prosecutor? I think your obligation is to make sure that whatever your decision is, you make it not based on race.”
“I don’t pretend to have all the answers on this,” Lacey said, but the way to address poverty is with “better schools and opportunities, it seems, for African American and brown children.”
Lacey argued that she’s been a reformer, too. She mentioned her role in the dismissal of 66,000 marijuana convictions, but some critics saw that as politically convenient timing, coming three weeks before an election in which her challengers were running to her left.
Lacey said that she has tried to divert as many mentally ill people as possible into treatment and other programs rather than incarceration, but that there aren’t enough options available yet. And she would like to see her office focus more on diversion for juvenile defendants.
As Lacey predicted, protesters were outside when I left her office. They included the family of Anthony Vargas, a 21-year-old man shot and killed by sheriff’s deputies in a controversial 2018 incident in East Los Angeles.
A Vargas family member, along with two protesters who had gone to Lacey’s home last week — Greg Akili and Melina Abdullah — told me they want more accountability from Lacey. Akili said he’d like to see Lacey prosecute the crimes of police with the same zeal she uses in prosecuting citizens.
“This ‘lock ‘em up and throw away the key’ mentality has made America the largest jailer in the world ... it hasn’t proved necessarily to make us any safer, it’s only proved to criminalize us,” Akili said.
He offered no apologies for the protest at Lacey’s home.
“The civil rights movement, the labor movement and the women’s movement never would have changed anything if people were polite and respectful,” Akili said.
So as the rest of the votes are counted, is there any way forward?
I’m going to be optimistic and say yes, if the protesters are willing to stop being so provocative and engage in constructive conversation, and if Lacey is willing to elaborate on her comments to me about juvenile diversion and other reforms.
“I can always see a point to a meeting,” Lacey said, “as long as there’s a mediator.”
steve.lopez@latimes.com