Tuesday, March 31, 2020

Tom Green County has Nine COVID-19 Cases

The City of San Angelo Health Department reported three new COVID-19 cases, bringing the total to nine in our area:

Case #1: male in his 70s who traveled 
Case #2: male in his 20s who came into contact with a positive case within the state 
Case #3: female in her 30s who had no known contact with a positive case, categorized as a case of community spread 
Case #4: male in his 30s, close family member of case #3 
Case #5: young boy, close family member of case #3
Case #6: female in her 20s who came into contact with a confirmed positive travel-related case
Case #7preteen female, she and her household have been self-isolating since March 24
Case #8: man in his 50s from out of town who was here for work purposes - currently hospitalized in San Angelo
Case #9: man in his 70s - currently hospitalized in San Angelo
Testing continues to rise, reaching 451, but turnaround remains a concern as 209 of those results are pending as of 2:00 pm today (3-31-20).
While testing is growing the number of patients with the virus can double in less than a week.  Roughly ten days ago an influential community leader estimated San Angelo had 600 COVID-19 cases.  If that were true it could have doubled twice, from 600 to 1,200 to 2,400 during that time. 

State Governors continue to share concerns about the limited number of tests available.  A nurse in Midland, Texas has symptoms but cannot get a test to see if they have the coronavirus.  This is concerning to co-workers and a potential risk for patients.  Shannon's Dr. Shultz explained the CDC testing criteria in a short video

Chris Martensen researched and posted videos over the last two months on his Peak Prosperity website.  Early on Chris illuminated a gold standard panedemic approach. 

Super spreader stories and MIT researchers lend credence to COVID-19 being airborne.  Those who need to go out in public to run critical errands should wear a mask and gloves, especially if someone in their home is medically fragile.  This novel coronavirus is easily spread and not a disease to be taken lightly.  The pattern in other communities has been case, case, case, cluster, cluster, boom.

I pray that our community be spared the sudden devastation this coronavirus has wrought elsewhere.  May it be manageable for our local health resources.

Update 4-2-20:  The City reported a tenth case.  Case #10: male in his 30s who had no known contact with a positive case, categorized as a case of community spread.  Seven of the first ten cases are under 40 years of age.

Saturday, March 28, 2020

City Ramps Up Testing

The City of San Angelo reported 287 COVID-19 tests have been performed and that 3 positive cases have been identified to date.  The number rose from 108 and no positives on 3-21-20.

A high profile community leader estimated San Angelo had 600 coronavirus cases This was prior to the city announcing the first positive case on 3-24-20.  Without testing it is difficult to know the rate of spread.  Other communities have seen cases double in 3-4 days and go up an order of magnitude every two weeks (examples:10 to 100, 100 to 1,000, 1,000 to 10,000, 10,000 to 100,000). 

Yahoo Finance reported:

Philanthropist and billionaire Bill Gates believes that the best way to stop the spread of the coronavirus, or COVID-19, is to “quite dramatically” ramp up testing while keeping social distancing measures in place for six to ten weeks.

“We have to raise the level of testing and the prioritization of that testing quite dramatically ... so that we take the medical problem and really stop it before there's a large number of deaths.
Healthcare workers, especially those working with patients in the home, are flying blind at the moment.  Testing has increased in our community in the last week but it needs to increase dramatically for leaders and clinicians to understand the scope of the problem.  It will also help citizens make better decisions going forward.

God's peace, joy and strength be with us during this difficult time.

Update 3-29-20:  San Angelo has five total cases as two new cases of COVID-19, a young boy and man in his 30's, tested positive.  They are family of third case in Tom Green County, which resulted from community spread.

Pandemic spread goes case, case, case, cluster, cluster, boom.  

Update 3-30-20:  A small town in Northern Italy distributed masks to residents and is yet to experience their first case of coronavirus   A Washington choir experienced a cluster outbreak when no member was sneezing or coughing.  This led experts to conclude the virus is airborne.  Everyone wear a mask.

Tuesday, March 24, 2020

Tom Green County has First COVID-19 Case

The City of San Angelo reported this morning:

The City of San Angelo Health Department has confirmed one positive case of coronavirus disease 2019 (COVID-19) in Tom Green County. This is the first case to be confirmed in the area. 

The affected person is a male in his seventies who had traveled, officials stated. 
As of now citizens don't know where in Tom Green County he lives.  A press conference is scheduled for 3:30 pm today.  It's officially here, five days after City Council held an emergency meeting.

One high profile community leader said last week that San Angelo likely had 600 cases.  Testing will begin to reveal the extent of the coronavirus in our community.  God bless us all, especially the elderly and medically fragile.

Update 3-25-20:  The City reported a second positive case, a young man in his 20's who'd contacted someone else in the state with the disease.  He received a test at Shannon and it was positive.

Update 3-28-20:  The City reported a third possible case, a woman in her 30's with no identifiable contact with a known coronavirus patient.  San Angelo has community spread. San Angelo is at case, case, case.  Next up cluster, cluster, boom.

Update 3-29-20:  There are two new cases bringing the total to five.  The new cases are family members of case #3, a young boy and a man in his 30's.

Update 3-30-20:  A sixth case has been identified, a young woman who had contact with a traveler who contracted COVID-19

Saturday, March 21, 2020

Conservative Senator, This Citizen and San Angelo Mayor Concerned about Coronavirus

The Republican Chairman of the Senate Intelligence Committee said the following on February 27th in a meeting with supporters:

"There's one thing that I can tell you about this: It is much more aggressive in its transmission than anything that we have seen in recent history.  It is probably more akin to the 1918 pandemic."
The United States is about ten days behind Italy where coronavirus cases have overwhelmed hospitals and taken out healthcare professionals.  I had elective cancer surgery Monday at Shannon Medical Center.  Had I been in Washington state or New York City my procedure would've been cancelled.

The evening of my surgery Shannon reduced visitation to one family member.  They set up visitor screening at the front door, asking visitors to complete a COVID-19 screening.

While there I kept the door to hall closed.  Outside my room I could hear people coughing and wondered if that was a yet to be diagnosed person, patient or staff.  I needed to walk as part of my recovery and decided loops at my end of the hall would provide the best protection.

My goal was to get home as soon as possible and needed to complete a checklist to do so.  One of those was coughing.

During my two day hospital stay the world changed dramatically. Mayor Gunther and City Council went from addressing the potential outbreak in public comment on 3-17-20 to a full blown press conference on 3-19-20.   The City has links to substantial resources on its website.

The City is following CDC guidelines and recommendations.  Yes, that's the same CDC that botched testing, one of many key strategies required to control a pandemic.

San Angelo Live reported:

At the end of Friday, March 20, the City of San Angelo Heath Department reported:
  • 108 total tests taken
  • 16 negative tests
  • 92 tests are pending, awaiting the results from the lab
Today, a Shannon Medical Center spokeswoman said the labs are turning around the tests in about seven days.
On February 23rd, (nearly a month ago)

South Korea has raised its coronavirus alert to the "highest level" as confirmed case numbers keep rising.

President Moon Jae-in said the country faced "a grave turning point", and the next few days would be crucial in the battle to contain the outbreak. 
South Korea chose mass testing.  Our current seven day turnaround with 85% of test results not back falls well short of what is needed/required.

That means everyone has to do their part to protect themselves and their loved ones until the threat abates.  Listening to the call to help others during this time is encouraged.  Just do it safely.

May God's peace and love be upon you and remain with you.  In Christ's name we pray.  Amen

Monday, March 02, 2020

City Public Health Addresses Coronavirus Topic

KSAN interviewed Health Department Director Sandra Villareal.  In addition the city added information on the Coronavirus to the Health Services webpage.  This information was not available over the weekend.

A number of states experienced community spread of the Covid-19 coronavirus.  Physicians estimate the virus has been in the United States for six weeks as travelers returned from areas that had coronavirus outbreaks.

San Angelo has Goodfellow Airforce Base which serves all branches of the military in its training mission.  Angelo State University has a large contingent of international students.

The Health Department did not mention testing or what to do if one has the symptoms listed.  It also did not mention what people without health resources should do if they get a respiratory illness.

The U.S. strategy has been light on testing, without which tried and true public health measures like contact tracing and isolation cannot be implemented.

The City of San Angelo finally said something about the pandemic coronavirus.  However, it did not rise to the level of a news story or press release.

Update 3-3-20:  One month ago a CDC representative said "The goal is to catch the majority of cases and slow the entry of the virus into the country. She added the public health system remains on high alert." As of this morning the CDC website states "CDC is remanufacturing the reagents with more robust quality control measures. New tests will be distributed once this issue has been addressed."  An ER physician offered advice for the public and stressed the role of local health departments.

Update 3-4-20:  The City published a news story about the coronavirus.  The piece stated "there are no cases of COVID-19 in the general population in San Angelo or Texas at this time."  It did not say if any testing of patients had been conducted.

Update 3-5-20:  The Trump coronavirus team refused to answer a question on uninsured people paying for the diagnostic test.  The Hill reported on the potential cost of the test. 

The Trump team will miss its promise to make 1 million tests available by the end of this week.  Bloomberg reported "The lack of testing kits for hospitals and health departments has created a gaping vulnerability in the U.S. effort to contain the virus."

San Angelo Live ran a story on Health Department preparations for the coronavirus coming to town.  Their piece did not address testing or what to do if one has the symptoms listed.  It also failed to advise people without health resources what they should do if they get a respiratory illness.  Three new cases of coronavirus arose in the Houston area from people who traveled overseas, at least one to Egypt.

Update 3-6-20:  Mayor Brenda Gunter put out an official communication on the city's preparedness for a possible coronavirus outbreak.  "Any positive case of coronavirus will be confirmed through the City Public Health Department and distributed to the public via the City Public Information office."  Health Department Director Sandra Villareal gave a coronavirus update to City Council during public comment on 3-3-20.  Council later approved a Hazard Mitigation Plan for the City and Tom Green County.  Council asked if it included pandemic.  A search of the document showed it lacked the words "pandemic" and "epidemic."

Update 3-11-20:  The World Health Organization declared the coronavirus a pandemic.  Dr. Anthony Faucci told Congress "If we don’t do very serious mitigation now, what’s going to happen is that we’re going to be weeks behind, and the horse is going to be out of the barn, and that’s the reason why we’ve been saying, even in areas of the country, where there are no or few cases, we’ve got to change our behaviour. We have to essentially assume that we are going to get hit. And that’s why we talk about making mitigation and containment in a much more vigorous way."  In some parts of the U.S. we are already weeks behind.

How many contagious individuals traveled to San Angelo during this time?   The City's Health Services webpage added two CDC videos, one for elderly patients and another on how the disease is spread.

Update 3-13-20:   City Council's agenda for 3-17-20 has only one item on the regular agenda.  It is not the coronavirus, but a resolution for Republic Services to access tax exempt bonds through the State of Texas.  Of the nearly $500 million San Angelo's landfill would get $6.2 million for improvements.  There is no agenda item for the novel coronavirus.  One columnist wrote "So, to our elected officials: You have critical responsibilities to the country. It is essential that you trust the experts from CDC, the National Institutes of Health and local health departments. Make sure they have the funding they need to manage this crisis. Tell us the truth … this is a dangerous virus, not a hoax, and there is no magic bullet."

Update 3-14-20:  San Angelo Independent School District canceled classes through March 20th after the district became "aware of the self-reporting and self-quarantining of people in the community who traveled to areas of high exposure." Bell County confirms their first case of coronaavirus.  The person recently returned from a trip to Europe.  Austin has three cases of coronavirus, one a "transfer from a rural hospital in a different region" of the state.  Another recently traveled from Houston, which is believed to have community spread.  Yesterday Dallas County reported its ninth coronavirus case.  Fort Bend County also has nine cases.  Tyler has three cases while Gregg County has one.  As of yesterday Texas Tribune reported 50 cases in Texas and broke that number down by county.

Update 3-15-20:  Texas eliminated access to primary care as part of its public health responsibility in the early 2000's.   That was part of a U.S. wide dismantling of public health resources and capabilities.  "America has no real public health system – coronavirus has a clear run.  Local and state health departments are already bare bones, having lost nearly a quarter of their workforce since 2008, according to the National Association of County and City Health Officials."