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US As New York’s coronavirus crisis deepens, experts split over how to contain its spread to new areas

16:40  26 march  2020
16:40  26 march  2020 Source:   washingtonpost.com

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NEW YORK — Marisa Hunter believes she may have contracted coronavirus earlier this month, when severe fatigue and Hunter’ s three-week journey is an example of the behaviors and travel habits now at the center of a deepening split among public officials and health experts over how best to

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NEW YORK —Marisa Hunter believes she may have contracted coronavirus earlier this month, when severe fatigue and gastrointestinal issues left her feeling weak.

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She tried to get a test for the virus but was not able to get one, and by the time she spoke to a doctor, her symptoms were resolving.

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Initially, the 31-year-old social media manager and model left her apartment in Long Beach, N.Y., where her lease had just expired, and went to her mother’s house in Connecticut to try to recuperate. Then over the weekend, she flew from Connecticut to Bonita Springs, Fla., to live with her fiance, who had already moved.

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Hunter’s three-week journey is an example of the behaviors and travel habits now at the center of a deepening split among public officials and health experts over how best to contain the spread of the coronavirus as sick New Yorkers begin inundating hospitals while others try to flee. 

On Tuesday, amid concern that New York residents and visitors were exporting the virus to other cities, President Trump’s coronavirus response team instructed anyone who has been in New York recently to self-quarantine for at least 14 days if they left the city, even for the suburbs. Florida Gov. Ron DeSantis (R) has gone even further, signing an executive order mandating visitors and residents of his state to self-quarantine if they have recently been to New York.

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New York sees early signs that social distancing could be working. States shun visitors to limit the spread As the number of confirmed coronavirus cases in New York continued to grow — reaching more Even as the crisis deepened in New York , which does not have enough hospital beds or

The actions have touched off debate about whether it is practical for the Trump administration or individual states to issue guidance that seeks to restrict the movement of Americans, based on where they have recently visited domestically.

The debate is expected to intensify in coming weeks as the number of coronavirus cases in some cities is predicted to grow dramatically while other regions of the country could largely escape the pandemic, according to public health officials.

“These are exigent circumstances, so you got to be able to exercise good judgment in a situation like this,” said Rep. Charlie Crist (D-Fla.), a former Florida governor and attorney general who said he supported DeSantis’s order. “I think he is doing exactly what is right to protect the people of Florida and, frankly, our visitors.”

But with the number of confirmed coronavirus cases also spiking in Louisiana, Michigan and Texas, many local officials appear hesitant to embrace isolating residents based solely on their domestic travel history. 

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Experts believe this is a new kind of coronavirus , which The potentially deadly coronavirus is thought to have spread from animals into humans at a live So by the time something like, say, a medical crisis gets really big, it may be too late for the local officials who have been trying to contain

Economic anxiety deepens as lawmakers clash over stimulus package and Europe plunges further into crisis . Hospital officials were assuming the efforts to contain the virus would delay, not prevent, a pandemic — sustained transmission of the coronavirus on more than one continent.

“The last thing we want is our states and cities and counties pitting our residents against each other,” said Matthew Chase, executive director of the National Association of Counties. “This is a time when the country needs to come together, and not start pointing fingers at each other. … It’s a very mobilized society, people move around every day, and we like to remind everyone … this is a national and a global issue, and we want a coordinated federal, state and local response. ”

At a news conference Wednesday, New York Gov. Andrew M. Cuomo (D) largely sidestepped the White House’s suggestion that New Yorkers self-isolate if they leave the city.

“That is a medical advisory, and the most important thing in life is to know what you don’t know, and I don’t know medicine,” Cuomo said.

But Howard A. Zucker, the New York health commissioner, flatly rejected the guidance, which had been issued by Anthony S. Fauci and Deborah L. Birx, who are advising the White House coronavirus response. Zucker said people who have recently been to New York City but traveled elsewhere should follow guidelines by the Centers for Disease Control and Prevention about “social distancing” but otherwise should not feel compelled to self-quarantine unless they are Ill. 

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With cases in New York threatening to spread worldwide, the WHO also admitted the US could soon become the epicentre of the coronavirus . However, the Governor criticised that small number and insisted many more will be needed if they are to contain the crisis .

New York has been the worst-hit city by the coronavirus outbreak in the US (Image: REUTERS). the World Health Organisation (WHO) also admitted the US could soon become the epicentre of the coronavirus as cases continued to spread across New York State.

Gallery by photo services

“The CDC guidelines recommend you stay a social distance away whether that is in New York City or not,” Zucker said. “These cases are all over the country. It’s not just New York.”

Other New York health officials were more guarded in their skepticism, noting that the virus has spread throughout New York City with such speed that they are now telling city residents to assume they have already been exposed.

Demetre Daskalakis, deputy commissioner for disease control at the New York City Department of Health and Mental Hygiene, said his message for New York “isn’t very far off” from the message being delivered by the White House.

“We have to be honest with ourselves and realize that diseases, infections always come with stigma,” Daskalakis said. “And I think a lot of New Yorkers aren’t used to that.”

Since moving to Florida, Hunter said she has been mindful that many of her new neighbors are elderly, which makes them susceptible to severe illness if they contract covid-19, the disease caused by the novel coronavirus. She has been mostly staying home and wears a mask and gloves when she’s out.

“Statistically, I think people who travel out of New York do have a higher chance of carrying it,” said Hunter.

Still, she said she doesn’t plan to comply with DeSantis’s order because she arrived in the state on Saturday, before he issued it. 

With an additional 5,100 cases reported Wednesday, New York now represents half of the more than 65,000 cases across the country. With 31,000 cases, it has nearly 10 times as many as the state with the second-highest total, neighboring New Jersey.

“I have no doubt that the virus was here much earlier than we even knew,” Cuomo said. “And I have no doubt the virus was here much earlier than any other state.”

Based on projections from New York health officials and independent analysts, Cuomo said he expects the virus will peak in the state in about three weeks. At that point, he said, New York may need 140,000 hospital beds, more than double current capacity.

Working with the Trump administration, Cuomo said he hopes to fill much of the shortage by expanding the existing capacity of current hospitals, while the Federal Emergency Management Agency and the Army Corps of Engineers have begun constructing field hospitals. The state also plans to convert college dormitories into hospital rooms, which could produce an additional 29,000 beds. 

Even after all of that, however, Cuomo said New York could still need an additional 20,000 hospital beds to reach 140,000. The state may have to use hotel rooms to meet those needs, he said.

Meanwhile, New York City officials were making plans for additional morgue capacity. Aja Worthy-Davis, a spokeswoman for the New York City Office of Chief Medical Examiner, said the city has a capacity for up to 900 bodies in the city’s morgues across its five boroughs. Although Worthy-Davis said the morgues “are not right now at or near capacity,” she said the Office of Emergency Management has set up “contingency plans” that include positioning “tents and trucks” outside of city hospitals.

“We need to be prepared to have the space,” Worthy-Davis said.

FEMA said in a statement Wednesday that, in addition to New York state, it has received requests from North Carolina and Hawaii for “Disaster Mortuary Operational Response Teams,” staffed by the Department of Health and Human Services, which assist states and cities with mass casualty events. 

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To try to head off a surge of fatalities, Cuomo has stressed that the state needs to amass 30,000 ventilators, which help covid-19 patients breathe if their lungs begin to fail. New York has so far amassed just half of that amount, Cuomo said.

“We need help from the entire country right now,” said Cuomo, adding that he is pleading with Trump to fast-track ventilators to the state that the governor will then ship to other states when they are needed.

For Lenore Cheeseman, who lives in Manhattan’s Tribeca neighborhood, the shortage of ventilators means she spends her days terrified that her 18-year-old son could contract the virus.

Her son, Michael, is a quadriplegic who has been confined to the family apartment since his high school was closed.

He had been going to physical therapy most days before closures started happening, but the program he was participating in also shut down.

“He’s dissecting his odds of catching it and his mortality rate,” said Cheeseman, 52. “If he gets it, he would absolutely need a ventilator.”

Amid signs that the lockdown of New York is starting affect residents’ mental health, state leaders have been trying to boost the availability of mental-health services. Cuomo said 3,100 mental-health counselors have volunteered to respond to those needs. 

shayna.jacobs@washpost.com

ben.guarino@washpost.com

tim.craig@washpost.com

Craig reported from Washington. Nick Miroff in Washington contributed to this report.

Trump finally leveled with the American people (opinion) .
Peter Bergen writes that at his Sunday coronavirus briefing at the White House President Trump sounded like he had just been mugged by reality. require(["medianetNativeAdOnArticle"], function (medianetNativeAdOnArticle) { medianetNativeAdOnArticle.getMedianetNativeAds(true); }); There were no more Trumpian fantasies about reopening the country so that church pews could be filled with people on Easter Sunday on April 12.Instead, Trump talked soberly about the 2.2 million Americans that could have died if the US government had done nothing to stop the spread of the virus.

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