Dr. David Katz | Real Time with Bill Maher (HBO)

Posted on by

Dr. Katz believes the fight against coronavirus is worse than the disease

Preventive medicine and public health specialist Dr. David Katz joins Bill Maher to discuss whether the fight against coronavirus is worse than the disease.

Dr. Katz wrote a New York Times op-ed on March 20 titled “Is Our Fight Against Coronavirus Worse Than the Disease?”

In the op-ed, Katz argues against the self-isolation policies put in place by most of the U.S. He advises that instead locking down the country; we should isolate the elderly and most at risk, which would thus “allow most of society to return to life as usual and perhaps prevent vast segments of the economy from collapsing”.

Finger Pulse Oximeters by Patients with COVID-19

Posted on by

In a recent New York Times opinion piece, New York City’s Richard Levitan, MD, after working at Manhattan’s Bellevue Hospital Center in early April at the height of the COVID-19 surge, stated that everyone needs a pulse oximeter in their pandemic supply kit.

Levitan says that use of home finger pulse oximeters by patients with COVID-19 could preempt the precipitous oxygen desaturation that leads to a crisis that needs intensive care.

In a NY Times’ Opinion piece, Dr. Levitan said, “If we could detect it earlier, we could initiate treatment earlier. We need to change messaging to the public, to physicians, to get earlier recognition of the disease.”

There is a way the medical community could identify more patients who have Covid pneumonia sooner and treat them more effectively by detecting silent hypoxia early through a common medical device called a pulse oximeter.

Pulse oximetry is no more complicated than using a thermometer. These small devices turn on with one button and are placed on a fingertip. In a few seconds, two numbers are displayed: oxygen saturation and pulse rate. Pulse oximeters are extremely reliable in detecting oxygenation problems and elevated heart rates.

Pulse oximeters can help save the lives by alerting individuals early to the need for treatment. When people notice their oxygen levels declining, they can go to the hospital earlier and have a higher chance to recover. Detection of hypoxia, early treatment and close monitoring apparently also worked for Boris Johnson, the British Prime Minister.

Widespread pulse oximetry screening for Covid pneumonia — whether people check themselves on home devices or go to clinics or doctors’ offices — could provide an early warning system for the kinds of breathing problems associated with Covid pneumonia.

References:

  1. https://www.webmd.com/lung/news/20200424/covid-19-home-pulse-oximetry-could-be-game-changer-says-er-doc?src=RSS_PUBLIC#1
  2. https://www.nytimes.com/2020/04/20/opinion/coronavirus-testing-pneumonia.html?referringSource=articleShare

Nearly All NYC COVID-19 Patients Hospitalized had Chronic Health Issues

Posted on by

Study finds Nearly All Patients Hospitalized With Covid-19 Had Chronic Health Issues

A new Journal of American Medical Assoication study of thousands of hospitalized coronavirus patients in the New York City area has found that nearly all of them had at least one major chronic health condition, and most — 88 percent — had at least two.

Though earlier research has shown chronic conditions like obesity, high blood pressure and diabetes are common risk factors for severe Covid-19, the ubiquity of serious medical conditions in these patients was striking: Only 6 percent of them had no underlying health conditions.

The researchers reported that when patients first came to the hospital and were triaged, 17 percent had an abnormal respiratory rate of more than 24 breaths per minute, and 28 percent received supplemental oxygen.

But fewer than one third of the patients had a fever, even though they were sick enough to be hospitalized, a similar observation to one noted by a large Chinese study.

This indicates that taking people’s temperatures in order to screen them for the coronavirus is likely to miss many people who are not only asymptomatic but also acutely ill.

Nearly 60 percent of those hospitalized at the Northwell facilities had high blood pressure, 40 percent were obese, and about one-third had diabetes. Smaller numbers of patients suffered from other chronic illnesses, such as heart disease, kidney disease and chronic respiratory illnesses.

The study included 5,700 patients hospitalized with COVID-19 in the New York City area, the most common comorbidities [simultaneous presence of two chronic diseases or conditions in a patient] were hypertension, obesity, and diabetes. Among patients who were discharged or died (sample size (n) = 2,634 patients), 14.2% were treated in the intensive care unit, 12.2% received invasive mechanical ventilation, 3.2% were treated with kidney replacement therapy, and 21% died.

References:

  1. https://www.nytimes.com/2020/04/23/health/coronavirus-patients-risk.html?referringSource=articleShare
  2. https://jamanetwork.com/journals/jama/fullarticle/2765184

Auto Insurance Companies are giving Refunds due to Coronavirus

Posted on by

Some auto insurance companies start giving refunds and credits to commuters stuck at home during the coronavirus outbreak.

Atlanta traffic

USAA, the country’s fifth largest property-casualty insurer, will return $520 million to its members. This payment is a result of data showing members are driving less due to stay-at-home and shelter-in-place guidance across the country.

Car traffic has plummeted as states impose “shelter in place” orders and scores of companies have told employees to work from home. Personal travel has been declining for three straight weeks, according to Inrix, a traffic data analytics company. From late March to early April, personal travel traffic in the U.S. dropped 47% compared to traffic in late February, the data showed.

Consumers are driving much less. That makes the driver less risky to insure and justifies a lower premium.

The nation’s biggest car insurer, State Farm, is slashing $2 billion of premiums owed on 40 million vehicles, making it the latest carrier to offer a financial-relief program for consumers as auto claims have plunged under shelter-at-home restrictions.

References:

  1. https://www.marketwatch.com/story/some-auto-insurers-are-giving-refunds-because-of-the-coronavirus-outbeak-heres-how-you-can-get-a-break-too-2020-04-09?mod=mw_more_headlines
  2. https://communities.usaa.com/t5/Press-Releases/USAA-to-Return-520-Million-to-Members/ba-p/228150?_ga=2.74504658.1537537724.1587742333-1534249610.1587742333
  3. https://www.marketwatch.com/story/state-farm-to-slash-2-billion-in-car-insurance-premiums-amid-pandemic-2020-04-09?mod=article_inline

The Power of Compounding

Posted on by

“Compound interest is the eighth wonder of the world. He who understands it, earns it … he who doesn’t … pays it.” Albert Einstein

When money is invested, it produces earnings that can then be reinvested, so that you receive earnings on your earnings in addition to the earnings on your original investment.

This added boost is the power of compounding, and the longer the money is invested, the more powerful are its effects. Over long periods of time—20, 30, or 40 years—the effects of compounding at different rates can be substantial. For instance, if you invested $10,000 today and it earned 8% annually, you would have $100,626 at the end of 30 years; if it earned 9% you would have $132,676 after 30 years. That’s a $32,000 difference with only a 1% difference in return annually.

In retirement planning, there are advantages of earning higher returns over long time periods. But, keep in mind that small differences in investment return assumptions can turn into large differences in accumulation.

Start early and reap the rewards

 “Letting your money work for you is a key component of saving for retirement. Compound interest, dollar cost averaging, tax-deferred savings, and diversification help lower your risk and boost your return on investment over time. Compound interest is the interest on your principal plus interest on the interest you earned previously.

For example, a single investment of $10,000 at 5% compounded annually earns $10,789 in interest over 15 years for a net amount of $20,789. Straight interest would accrue at the rate of $500 per year, $7,500 in total interest, for a net amount of $17,500. When interest is reinvested and compounds at 5%, it adds another $3,298 to the value. That is the magic of compound interest.” Taylor Larimore et al, The Bogleheads’ Guide to Retirement Planning

Compounding gives invested money the ability to grow over time.  The Rule of 72 is the number of years needed to double invested money at a given interest rate. Divide 72 by the interest rate…money invested at 10% will double in 7.2 years

Be conservative in your estimates.

The first modern pandemic | by Bill Gates

Posted on by

https://www.gatesnotes.com/

The scientific advances we need to stop COVID-19.

By Bill Gates | April 23, 2020

The coronavirus pandemic pits all of humanity against the virus. The damage to health, wealth, and well-being has already been enormous. This is like a world war, except in this case, we’re all on the same side. Everyone can work together to learn about the disease and develop tools to fight it. I see global innovation as the key to limiting the damage. This includes innovations in testing, treatments, vaccines, and policies to limit the spread while minimizing the damage to economies and well-being.

This memo shares my view of the situation and how we can accelerate these innovations. The situation changes every day, there is a lot of information available—much of it contradictory—and it can be hard to make sense of all the proposals and ideas you may hear about. It can also sound like we have all the scientific advances needed to re-open the economy, but in fact we do not. Although some of what’s below gets fairly technical, I hope it helps people make sense of what is happening, understand the innovations we still need, and make informed decisions about dealing with the pandemic.

Read more: https://www.gatesnotes.com/Health/Pandemic-Innovation?WT.mc_id=20200423060000_Pandemic-Innovation_BG-EM_&WT.tsrc=BGEM

The 6 Feet Office | Cushman & Wakefield

Posted on by

Helping Adjust to a New COVID-19 Normal

Cushman & Wakefield has begun visualizing life after the COVID-19 lockdowns and ‘stay at home’ orders come to an end. From their prospective, it is important for employers to think about the new normal and how they plan to adjust once people return to the workplace.

“The 6 feet rule” isn’t going away any time soon and it is critical to normalize this guideline into everyday life. Eventually, Americans will return to the workplace, but they must not forget the ‘six foot’ physical distancing rule.

The core premise is to ensure that six feet, the recommended measurement for safe social distancing, stays between people at all times. This behavior is encouraged through properly spaced desks, but also visual signals, such as a circle embedded in the carpeting around each desk to ensure people don’t get too close.

Cushman & Wakefield Introduces the 6 Feet Office. 

The 6 Feet Office is Cushman & Wakefield’s conceptual idea to help their clients prepare for their employees to return to the office. 

Cushman & Wakefield: 6 FEET OFFICE CONCEPT CONSISTS OF SIX ELEMENTS:

  1. 6 Feet Quick Scan: A concise but thorough analysis of the current working environment in the field of virus safety and any other opportunities for improvement.
  2. 6 Feet Rules: A set of simple and clear workable agreements and rules of conduct that put the safety of everyone first.
  3. 6 Feet Routing: A visually displayed and unique routing for each office, making traffic flows completely safe.
  4. 6 Feet Workstation: An adapted and fully equipped workplace at which the user can work safely.
  5. 6 Feet Facility: A trained employee who advises on and operationally ensures an optimally functioning and safe facility environment.
  6. 6 Feet Certificate: A certificate stating that measures have been taken to implement a virus-safe working environment.

References:

  1. https://www.cushmanwakefield.com/en/netherlands/six-feet-office
  2. https://www.fastcompany.com/90488060/our-offices-will-never-be-the-same-after-covid-19-heres-what-they-could-look-like

U.S. Senate passes $500 bln coronavirus aid package

Posted on by

The U.S. Senate on Tuesday unanimously approved $484 billion in fresh relief for the U.S. economy and hospitals hammered by the coronavirus pandemic, sending the measure to the House of Representatives for final passage later this week.

The bipartisan bill would replenish funds for emergency small business lending programs and shore up national coronavirus testing as a stopgap ahead of another round of major relief legislation.

  • The bill includes an additional $310 billion for the Paycheck Protection Program, with $60 billion of that money reserved for smaller businesses without existing banking relationships.
  • Another $60 billion ($50 billion in loans and $10 billion in grants) is also set aside for the Economic Injury Disaster Loan fund, which is administered directly by the Small Business Administration rather than banks. Farms and other agricultural programs are now eligible for those funds.
  • The bill will also provide another $75 billion for cash-strapped hospitals and healthcare providers to help them cover the massive costs associated with responding to the virus. 
  • The bill allocates $25 billion for coronavirus testing—a major sticking point for both Democrats and Republicans during late-night negotiations on Monday. $11 billion of that money is earmarked for states and local governments to expand their testing capacity.
  • Under the terms of the legislation, the federal government is required to develop a “strategic plan related to providing assistance to states for testing and increasing testing capacity.” State and local governments must also submit their testing plans for review.
  1. https://www.forbes.com/sites/sarahhansen/2020/04/21/senate-passes-484-billion-interim-relief-package-heres-whats-in-it-and-whats-missing/#5f1656cc3e34

Southern States, Like Georgia, Push to Reopen With Economic Pressure Rising | Bloomberg

Posted on by
  • Georgia, South Carolina moves come days after Trump guidelines
  • Questions remain about whether those states meet benchmarks

Southern Republican governors who were among the last to institute shelter-at-home orders are now pushing to become the first to lift them. In Georgia, for example, the state will begin opening up this week with:

  • Gyms, fitness centers, bowling alleys, body art studios, barbers, cosmetologists, hair designers, nail care artists, estheticians, their respective schools and massage therapists can reopen Friday, April 24, Kemp said, provided workers wear masks and gloves, stay six feet away from each other and are screened for symptoms.
  • Dine-in options at restaurants, private social clubs and theaters will be able to reopen on April 27 “subject to specific social distancing and sanitation mandates,” which will be released in the coming days, Kemp said.
  • Bars, nightclubs, amusement parks and live performance venues will remain closed.

“In the same way that we carefully closed businesses and urged operations to end to mitigate the virus’ spread, today, we are announcing plans to incrementally – and safely – reopen sectors of our economy,” Governor Kemp said on Monday.

The announcements came Monday afternoon after Georgia Governor Brian Kemp spent the weekend talking to his fellow Republican governors in the South about how best to restart their economies in response to guidelines issued last week by the White House.

Coming just four days after President Donald Trump issued the guidelines, the announcements raised questions about whether the states were moving too quickly.

Dr. Deborah Birx, the U.S. State Department immunologist and one of Trump’s top medical advisers, said Monday evening that it was up to governors to determine whether they are meeting the criteria set by the White House last Thursday.

Recommendations, not Requirements

Public-health experts say all of these conditions should be met before a state considers reopening.

With the virus still spreading across the country, states would be hard-pressed to meet all of these criteria. But because they are only recommendations, not requirements, states can proceed with reopening their economies.

In Georgia, the public health department reports a peak of 811 confirmed cases on April 6. Cases show a downward trajectory since then, though April 14 came close to the peak with 779 confirmed cases. A decrease of 32 cases is still a decrease, but not one which would necessarily leave public-health experts feeling confident in a state’s ability to reopen.

In any case, the guidelines are merely suggestions. If the states decline to follow them, they won’t be held liable by the federal government.

The swift reopening in Georgia is premature, said Harry Heiman, an associate professor at Georgia State University’s School of Public Health.

“On the one hand,” Heiman said, Kemp and his team “seem to understand the elements that need to be in place. On the other hand, those elements don’t seem to be in place.”

Read more: https://www.bloomberg.com/news/articles/2020-04-21/southern-states-push-to-reopen-with-economic-pressure-rising

  • Sources:
    1. https://gov.georgia.gov/press-releases/2020-04-20/gov-kemp-updates-georgians-covid-19
    2. https://dph.georgia.gov/covid-19-daily-status-report
    3. https://www.forbes.com/sites/rachelsandler/2020/04/20/georgia-will-reopen-gyms-hair-salons-and-bowling-alleys-as-early-as-friday/#1699cbdb2ce7