CORONAVIRUS UPDATE 3/22/2020 10 am

Coronavirus Update

3/22/2020 10:00 am

Lisa Reynolds MD

This is Lisa Reynolds, MD. Portland Pediatrician on the frontlines of the coronavirus epidemic. Mom and daughter. Candidate for Oregon HD36.

Factual update Coronavirus

WORLDWIDE: 298,000 confirmed cases, 13,000 deaths, 157 countries

US CONFIRMED CASES: 24,000 confirmed cases, 340 deaths (the confirmed cases have doubled in 2 days, deaths up by 50% in 2 days)

OREGON CONFIRMED CASES: 137 confirmed cases, 4 deaths.

OREGON update

ONGOING: All K-12 schools closed until April 28, gatherings of more than 25 people banned, bars and restaurants closed - except for take out. Strong wording on social distancing.

While Gov Brown calls for better compliance with social distancing, mayors and health professionals call on Gov Brown to order a “stay at home” order. Gov Brown is not expected to issue such an order. Mayors will likely do so on their own Mon 3/23, including Portland Mayor Ted Wheeler. Mayors are requesting:

Oregonians must be directed to reasonably comply with social distancing requirements at all times

Non-essential businesses need to cease all activities except minimum basic operations; businesses can continue to operate if all employees are working from home.

Essential businesses are encouraged to remain open, while complying with social distancing requirements. Essential businesses (CA): grocery stores, pharmacies, medical facilities, those necessary for infrastructure.

Public and private gatherings prohibited, with exceptions.

Non-essential travel prohibited.

(from Lisa): One can still exercise, be outside, as long as you maintain 6 feet from those you are with.

Testing for the coronavirus will be at medical provider discretion (ie lifting state regulations). But there is little to no testing equipment/reagent. Very few tests are being performed.

To mitigate Oregon’s shortage of medical beds, the state fairgrounds in Salem will become a 250 bed hospital (the Oregon Medical Station) for those who test negative for COVID19.

Multnomah County and the City of Portland have placed a moratorium on evictions. Gov Brown is expected to extend this statewide.

Gov Brown will make access to Medicaid health insurance easier.

Kindercare Is closing most of its child care centers, keeping open enough to take care of the enrolled children of essential workers. They will keep 8 centers open in OR and 3 in SW Washington. (Kindercare serves 185,000 children in 2,300 locations and is based in Portland.)

Communities on the Oregon coast are imploring tourists to leave. They are rightly concerned about Coronavirus being introduced or spread by the influx of travellers.

Oregon hospitals and frontline medical providers face a severe shortage in Personal Protective Equipment. Measures taken: cancelling all elective procedures; taking donations from dentist, veterinarians, construction companies (read about that here); repurposing factories to make PPE (read about that here). I talk about this in Willamette Week (3/18) here. NEW: We are seeing huge donations to health centers! THANK YOU!

Yes, this means massive disruption in our work and our education and our personal lives. The lives of Oregonians and the safety of our health system depend on making the right choices right now. REMEMBER THE CURVE. We need to #Flattenthecurve

What to do - the list is pretty short now

Extreme Social Distancing: Practice “shelter in place” - staying home except to procure food and medicine, or to exercise outdoors (keeping 6 feet away from others). Or travel to your essential work (health care, feeding others/grocery workers, pharmacy).

We really should call it PHYSICAL distancing, not social distancing: Look for ways to engage your community. My neighbors met from our balconies last night (I live in a multi unit building). Schedule walks with friends. Use video conferencing to share a meal.

Continue to wash hands/hand sanitizer. If you’re in an essential job, strip down and shower when you get home, and wash your clothes. And, thank you.

Services

Many Oregon internet companies are offering free service; energy and telecommunications utilities are suspending service disconnections, and waiving late fees to support Oregonians impacted by coronavirus. In addition, state and federal programs can provide assistance to qualified individuals and households. Read more here.

Portland public schools is providing meals for families. Details here.

Medical students and nursing students, whose classes are cancelled, are offering childcare and other services for health care workers. Twitter users can send a direct message to Medical student Emily Lane at @EmilyCALane. There’s also a program hotline: 503-383-9776.

The state and the federal governments are pouring more resources to help businesses and employees affected by furloughs, layoffs, decreased hours and lost revenue. More information: unemployment benefits, small businesses.

Resources:

Tips for families by my amazing friend doreen in Psychology Today

Education resources:

Story of the World for school aged kids: accessible history curriculum with reading lists and projects.

Kahn Academy - amazing online classes on everything from calculus to psychology.

I’d love to hear MORE from you all.

Scientific discoveries on COVID19

In Italy and China, men have an almost TWO FOLD higher death rate from COVID19 compared with women. Being male is a risk factor. Proposed reasons:

Women have stronger immune system: Estrogen plays a role in immunity. The X chromosome contains immune-related genes (which make proteins for the immune system). Women have two X chromosomes, men have one.

Women are more likely to wash their hands

Men have a higher rate of heart and blood pressure issues and they smoke at a higher rate. All of these make one more more vulnerable to severe disease with COVID19.

What I’m worried about

Of course, disease and illness overwhelming our health system.

Doctors will have to decide who gets life saving treatment (ventilators) and who doesn’t because equipment is in short supply.

Doctors getting sick because of inadequate PPE.

The strain this is taking on health care providers. Read here.

The health and safety of my friends and family

My own exposure on the frontlines

That Oregon public schools are not equipped (nor do they seem to be making plans to become equipped) to provide substantive online learning. See this article. This will lead to a larger learning and performance gap for our vulnerable kids. This could have lifelong consequences for those kids whose families cannot fill the void. The inequities in our education system was a driving force for me to run for office. Seattle Times covers this here and WA seems to be a bit ahead of the game compared to OR. We can do hard things and must. Our kids’ futures depend on finding a solution and not writing off weeks or months of instruction. Remember, the brain is a muscle (this is metaphor) and must be used!!!

What lifts me up:

People are inherently good. Everyone is kinder and gentler right now. Folks are donating time and PPE and money. Neighbors are checking on each other and singing together from their balconies.

Equipment: Scientists and manufacturers and inventors are working non stop to innovate and to build the equipment we need. (I need to add: In the absence, at this point, of swift, definitive government action.)

Amazing health care providers writing about the pandemic and offering up solutions, such at this Boston MD writing about ventilators. “This is our moonshot.”

The stories of teachers reaching out to their students on the phone or via video. Schools working to get computers and wifi to those who lack these essential tools for remote learning.