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Coronavirus Pandemic

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20 hours ago, Brutus_buckeye said:

You have the right of free expression and liberty created in the first amendment. Wearing a mask or not wearing a mask is an expression of that liberty. Now, private businesses can compel you if you want to choose to do business with them, to wear the mask, but you have a choice. However, government cannot do so. there is a 1st amendment argument here. 

 

Again, should everyone where masks from a moral standpoint, YES. 

Does the law in the US have the ability to forcibly compel them to do so? That is what is up for debate.

 

We could probably agree that the right of free expression does not allow you to yell "Fire!" in a crowded theater.  Given that limit on freedom of expression, I don't see how you have any right to resist a temporary mandatory-mask order -- freedom from which entails the right to potentially infect and injure/kill people around you by not wearing a mask. That seems to fail the laugh test. 

 

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2 minutes ago, Foraker said:

 

We could probably agree that the right of free expression does not allow you to yell "Fire!" in a crowded theater.  Given that limit on freedom of expression, I don't see how you have any right to resist a temporary mandatory-mask order -- freedom from which entails the right to potentially infect and injure/kill people around you by not wearing a mask. That seems to fail the laugh test. 

 

It may seem that way, but it is how the facts and details would be analyzed. Again, the purpose of a broad restriction has to accomplish the state interest and there has to be no other alternative. Yelling Fire in a crowded theater is on there because there is no other reasonable alternative to restricting of the speech right to accomplish the state's intended goal.  A broad mask requirement with zero exceptions would have a difficult time surviving that standard. Would a more limited one pass muster? I dont know but it would have a better chance of survival. Any such requirements would need to be narrowly tailored in its nature.

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1 minute ago, jam40jeff said:

I think it's safe to say that Ohio hospitalizations are officially surging.

 

image.thumb.png.a4e2adfc9a2e2835495548d48d6391d7.png

 

Note that bottom line, "expanded case definition".  

ICU and vent are steady

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5 minutes ago, E Rocc said:

Note that bottom line, "expanded case definition".  


ICU and vent are steady

 

There's been an 18% increase in covid-positive ICU patients in the last four days.


Very Stable Genius

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21 minutes ago, E Rocc said:

 

Note that bottom line, "expanded case definition".  

ICU and vent are steady

 

They have been using expanded case definition since they started releasing this statistic in early May, so increases are not due to a change in methodology.

 

ICU and vent had been decreasing significantly and then leveled off, and ICU counts have now have increased for the last few days.  ICU numbers generally lag hospitalizations as people are not usually admitted straight into the ICU, and vents are even more of a lag.

Edited by jam40jeff

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9 minutes ago, DarkandStormy said:

Nearly 68% of all covid deaths in Ohio since April 15th have been in/from long-term car facilities.

 

Seems to be the case nationally.  They lack significant regulations, are staffed by people just there for a paycheck most of the time, and contain the most vulnerable population.  

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34 minutes ago, DarkandStormy said:

Nearly 68% of all covid deaths in Ohio since April 15th have been in/from long-term car facilities.

 

I thought this number was closer to 75% about a month ago.

 

EDIT: The number I'm thinking of may have included prisons as well.

Edited by jam40jeff

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36 minutes ago, jonoh81 said:

 

Seems to be the case nationally.  They lack significant regulations, are staffed by people just there for a paycheck most of the time, and contain the most vulnerable population.  

 

Did Ohio have policies to control the spread in same?   I know we weren't like New York actively contaminating them with the virus, but were any preventive measures taken at all?

Because this should have been obvious well in advance if we weren't trying to act like everyone was at more or less equal risk.

Edited by E Rocc

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13 minutes ago, jam40jeff said:

I thought this number was closer to 75% about a month ago.

 

EDIT: The number I'm thinking of may have included prisons as well.

 

Perhaps.  I took the # of deaths the state is reporting on their Long-Term Care Facilities tab within their dashboard - reported out since 4/15 - and then divided it by the total # of deaths the state has reported since then.  I do remember the 75% figure being both nursing homes and prisons.  I wonder what it gets to if you layer on hospital workers, who made up 20-25% of total cases early on.


Very Stable Genius

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Meanwhile unemployment is at historic highs, and millions are facing eviction? Aside from Amazon and some other big name brands which companies are flourishing during all of this? 

 

 

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10 minutes ago, troeros said:

 

Meanwhile unemployment is at historic highs, and millions are facing eviction? Aside from Amazon and some other big name brands which companies are flourishing during all of this? 

 

 

 

The rise in the stock market is a clear sign that the non-corporate citizens need to stop asking for handouts -- McConnell's excuse to not bring the HEROES act to a vote?

 

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The DOW is down about 9.5 percent, S&P down 4 percent, NYSE down 15 percent. Tech is doing very well, but we're still in bear territory with most other major indexes. It's great that there were gains from those crazy lows in February and March, but, tech notwithstanding, Wall Street isn't exactly in boom period.

Edited by TBideon

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18 minutes ago, troeros said:

 

Meanwhile unemployment is at historic highs, and millions are facing eviction? Aside from Amazon and some other big name brands which companies are flourishing during all of this? 

 

 

The headline is misleading. It is not really accurate measuring things on a qtr by qtr basis. Remember the Dow crashed toward the end of the 1st quarter. Some of that crash was based on market selling exhuberance. So when it stabilizes it looks like it roared back, when in reality it is still below where it was on Jan 1. 

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Weekend....

 

Monday....

 


"Life is 10% what happens to you and 90% how you respond." -- Coach Lou Holtz

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18 hours ago, DarkandStormy said:

 

Unfortunately our cases are increasing, hospitalizations are increasing and positivity is approaching 17%. As mentioned upthread, cases are now trending towards a younger demographic.

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17 minutes ago, DarkandStormy said:

^The outbreak was linked back to seven people from the weekend before, fwiw.

 

If you have contact tracers they can investigate, identify and isolate those individuals and their contacts. The State of Florida has 7 contact tracers; nowhere near the appropriate number of personnel to manage a pandemic.

Edited by Frmr CLEder

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56 minutes ago, DarkandStormy said:

The CDC has estimated that 35% of covid patients *never* show symptoms.  1 in 3 people currently positive with a covid-19 infection will never have any symptoms.  Wild.

 

And still may be contagious anyway and may not develop any real immunity.  

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10 minutes ago, jonoh81 said:

 

And still may be contagious anyway and may not develop any real immunity.  

Regarding the development of immunity for asymptomatic (the 35%± never-symptomatic) carriers, it should not matter for that individual anyway since you would think that if they 'get it' a second time, it would again be asymptomatic.  We need to figure out if the 35%± never-symptomatic are virus-shedders or not. If they are not, than can we infer that they have immunity already - maybe they had a coronavirus infection previously vis-a-vis an upper or lower respiratory infection in the past?

 

Sometimes the flu goes thru a house and others do not get it. My son had H1N1 a few years back and no one else got it. Do people carry the flu virus as asymptomatic? I mean, no one would get swabbed for H1N1 unless they go to their GP and are sick. 


Formerly "Mr Sparkle"

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I know there's a tendency to classify patients as asymptomatic, presymptomatic and symptomatic but those terms can be misleading. If infected, there will be viral shedding; the issue is the degree of viral shedding and whether or not it is an upper and/or lower respiratory infection with or without a cough or discharge, containing infected cells, mucous, saliva, expirations and viral particles. Those are better prognosticators of one's ability to infect others.

Edited by Frmr CLEder

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Speaking of H1N1...

 

Quote

Another pandemic may be building in China. This time, it’s a new strain of the H1N1 swine flu and it’s already jumped to humans. It was reported by 23 Chinese researchers in a June 29 paper in the Proceedings of the National Academy of Sciences (PNAS).

 

https://www.biospace.com/article/a-new-h1n1-strain-from-china-may-trigger-another-pandemic/

 


Very Stable Genius

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33 minutes ago, OldBearcat said:

Regarding the development of immunity for asymptomatic (the 35%± never-symptomatic) carriers, it should not matter for that individual anyway since you would think that if they 'get it' a second time, it would again be asymptomatic.  We need to figure out if the 35%± never-symptomatic are virus-shedders or not. If they are not, than can we infer that they have immunity already - maybe they had a coronavirus infection previously vis-a-vis an upper or lower respiratory infection in the past?

 

Sometimes the flu goes thru a house and others do not get it. My son had H1N1 a few years back and no one else got it. Do people carry the flu virus as asymptomatic? I mean, no one would get swabbed for H1N1 unless they go to their GP and are sick. 

 

That's a good question. I did a lot of reading before all this came down about the flu because I got the flu really bad this past year (it was right around Christmas).

 

I can't remember being that ill in a long long long time. Horrible cough. Anyways, I read that if you get really sick with a certain strain you can have immunity for your life or at least some protections against whatever strain it was.

 

I had A, which is presumably the H1N1. I may have never had it before in my life. There are so many different subtypes of strains that maybe in the future I will get H1N1 but a different strain where I would get sick but not that ill, where someone who hadn't had it may get extremely ill.

 

Take a look at this article, pretty interesting. Talks about you can get a flu shot for a certain strain and that strain immunity wears off pretty quickly but the base stays with you. At least that's how I read it and it makes sense to me.

 

That is why so many people apparently survived the 1918 flu that were older where younger people really suffered. Many older folks had been exposed to that type of flu before so had some developed immunity.

 

I expect this to be the same with COVID. Perhaps at one point in your life you had a really bad cold from a coronavirus. I know I got a really bad cold a couple years ago going to Orlando for a conference. It wasn't the flu but I was down and out (still functional) but sore throat, a bit of cough, plugged up, a bit of fever, no appetite for about 5 days. Maybe that was a coronavirus so maybe if I got the coronavirus now I wouldn't have horrible symptoms. Afterwards I would have even stronger immunity.

 

I suppose though it hasn't been proven yet that people who get a bad case of COVID-19 and survive well will have a pretty strong base immunity like they did with SARS number 1. 

 

"Among 176 patients who had had severe acute respiratory syndrome (SARS), SARS-specific antibodies were maintained for an average of 2 years, and significant reduction of immunoglobulin G–positive percentage and titers occurred in the third year. Thus, SARS patients might be susceptible to reinfection >3 years after initial exposure."

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851497/

 

More on COVID-19: https://www.sciencemag.org/news/2020/05/t-cells-found-covid-19-patients-bode-well-long-term-immunity

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^ Influenza vaccines are based upon the anticipated prevalent strains for any given year. In some years they contain a combined Inflenza A and Influenza B strain that is usually based upon what is prevalent in the Southern Hemisphere. Influenza vaccines are usually good for a year due to RNA mutagenesis and changes in the predominant circulating strains.

 

H1N1 is an Inflenza A strain, but the challenge with coronaviruses is, and has been the strength and durability of an immune response. Garnering that insight requires time. It would be great if we could place the immune system on "accelerated stability" to get the answers, but we cant.

For vaccines in development, only time will provide answers as to the durability of an immune response and whether or not it will also confer some level of resistance to closely-related viruses and/or mutant strains.

 

The receptor-binding domain, or the often referred to "spikes," appear to be the key for vaccine development and possible antiviral treatments, since it is the structure used for gaining cellular access. Other targets include the inhibition of enzymes and proteins involved in the SARS-CoV-2 replication process.

 

SARS-CoV-2 is a "new" coronavirus and it is the name of the virus.

COVID-19 is the name of the disease caused by SARS-CoV-2.

Edited by Frmr CLEder

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18 minutes ago, Frmr CLEder said:

^ Influenza vaccines are based upon the anticipated prevalent strains for any given year. In some years they contain a combined Inflenza A and Influenza B strain that is usually based upon what is prevalent in the Southern Hemisphere. Influenza vaccines are usually good for a year due to RNA mutagenesis and changes in the predominant circulating strains.

 

H1N1 is an Inflenza A strain, but the challenge with coronaviruses is, and has been the strength and durability of an immune response. Garnering that insight requires time. It would be great if we could place the immune system on "accelerated stability" to get the answers, but we cant.

For vaccines in development, only time will provide answers as to the durability of an immune response and whether or not it will also confer some level of resistance to closely-related viruses and/or mutant strains.

 

SARS-CoV-2 is a "new" coronavirus and it is the name of the virus.

COVID-19 is the name of the disease caused by SARS-CoV-2.

 

One thing I keep seeing in articles is the claim that this virus doesn't mutate much, so developing a vaccine shouldn't really be an issue long-term.  I recall, however, you saying that since it's an RNA-based virus, it was actually more prone to mutations and would make developing a vaccine potentially much more difficult.  This seems contradictory.  Can it be that it's the type of virus that usually mutates more often, but just hasn't?

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15 minutes ago, jonoh81 said:

One thing I keep seeing in articles is the claim that this virus doesn't mutate much, so developing a vaccine shouldn't really be an issue long-term.  I recall, however, you saying that since it's an RNA-based virus, it was actually more prone to mutations and would make developing a vaccine potentially much more difficult.  This seems contradictory.  Can it be that it's the type of virus that usually mutates more often, but just hasn't?

 

I have read that it mutates about once per every two transmissions, but that the mutations are negligible.  I could be wrong.

 

Here's a recent article focusing on the G strain - https://www.washingtonpost.com/science/2020/06/29/coronavirus-mutation-science/?arc404=true


Very Stable Genius

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15 minutes ago, jonoh81 said:

 

One thing I keep seeing in articles is the claim that this virus doesn't mutate much, so developing a vaccine shouldn't really be an issue long-term.  I recall, however, you saying that since it's an RNA-based virus, it was actually more prone to mutations and would make developing a vaccine potentially much more difficult.  This seems contradictory.  Can it be that it's the type of virus that usually mutates more often, but just hasn't?

I believe flu and coronaviruses are both RNA. That makes them more prone to mutation than DNA viruses. But relative to coronaviruses, flus are more likely to mutate in a way that requires a regular update of vaccines. I THINK

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https://ktar.com/story/3348077/arizona-hospital-data-with-record-covid-19-patients-not-affected-by-error/

 

Arizona's # of covid positive patients hospitalized has doubled since June 11th.

 

Their ICU bed usage is at 88%.  They have just 211 unused ICU beds as of late Monday, not counting the emergency standby beds that are being activated due to upcoming surge use.


Very Stable Genius

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18 minutes ago, DarkandStormy said:

 

I have read that it mutates about once per every two transmissions, but that the mutations are negligible.  I could be wrong.

 

Here's a recent article focusing on the G strain - https://www.washingtonpost.com/science/2020/06/29/coronavirus-mutation-science/?arc404=true

I have seen the same thing. Technically, it mutates with every host to adapt to their body, but the key parts of the virus do not significantly mutate which bodes well for a long term vaccine. 

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3 hours ago, jonoh81 said:

 

One thing I keep seeing in articles is the claim that this virus doesn't mutate much, so developing a vaccine shouldn't really be an issue long-term.  I recall, however, you saying that since it's an RNA-based virus, it was actually more prone to mutations and would make developing a vaccine potentially much more difficult.  This seems contradictory.  Can it be that it's the type of virus that usually mutates more often, but just hasn't?

Viruses have simple objectives: to infect a host, replicate and propagate.

 

Coronaviruses, as RNA-based viruses, have a high degree of mutagenesis. This contributes to their survival.

 

SARS-CoV-2 however, has an RNA polymerase proofreading capability that limits, but does not negate, its ability to mutate. Studies have shown that as SARS-CoV-2 moves around the globe, mutations are occurring. There are several different mutant strains, whose genomes have been decoded, on different continents.

 

What these mutations mean, from a clinical standpoint, if anything however, is still unresolved: ie; are they more virulent or do they lead to worse patient outcomes? 

 

If direct-acting therapeutics, such as remdesivir, are added to the mix, that "environmental pressure" may also induce mutations; mutations that are induced to bypass that environmental pressure. The end result is a strain that is resistant to environmental pressure (drug resistance) that overtakes the base strain (natural selection-survival of the fittest) and becomes predominant. As mentioned upthread, this is the rationale behind multi-drug treatment for HIV-1 infection, another RNA-based virus. The utilization of several drugs, with different mechanisms of action, targeting different biological processes, reduces the potential for the emergence of drug resistant strains.

 

There has also been reference to mutations in the spike protein. This could be clinically problematic because those changes could impact virulence. The spike protein is how SARS-CoV-2 gains cellular access.

 

https://www.scripps.edu/news-and-events/press-room/2020/20200611-choe-farzan-sars-cov-2-spike-protein.html

 

https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-020-02344-6

Edited by Frmr CLEder

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35 minutes ago, Frmr CLEder said:

What these mutations mean, from a clinical standpoint, if anything however, is still unresolved: ie; are they more virulent or do they lead to worse patient outcomes? 

 

The question I have is, it is possible for each little mutation to add up so that immunity to Version 1 of the virus will not necessarily make someone immune to Version 35,428 of the virus which has passed through 35,427 other people, with a tiny mutation each time?

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2 hours ago, taestell said:

 

The question I have is, it is possible for each little mutation to add up so that immunity to Version 1 of the virus will not necessarily make someone immune to Version 35,428 of the virus which has passed through 35,427 other people, with a tiny mutation each time?

What we can hope for is a vaccine that can at least provide annual immunity, similar to influenza. My concern is that it may not be possible. Immunity may prove to be short-term. We'll have to wait.

 

Mutations in and of themselves are meaningless unless they affect clinical outcomes: ie; does the virus become more infectious or more virulent?

 

Only double-blinded, randomized, placebo-controlled clinical trials (fortunately we have many), will give us the answers we seek and that will take time. As I mentioned upthread, the greater opportunity short-term, is with therapeutics. I still dont see any vaccine candidates ready before Q1, 2021, at the earliest.

 

We have had success moderating the up-regulated, hyper-inflammatory response, that is secondary to SARS-CoV-2 infection. That has reduced some of the morbidity and mortality and has impacted the number of fatalities. Antivirals however can interfere with the viruses life-cycle, minimizing its ability to infect, replicate and propagate. 

Edited by Frmr CLEder

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1 hour ago, Frmr CLEder said:

Viruses have simple objectives: to infect a host, replicate and propagate.

 

Coronaviruses, as RNA-based viruses, have a high degree of mutagenesis. This contributes to their survival.

 

SARS-CoV-2 however, has an RNA polymerase proofreading capability that limits, but does not negate, its ability to mutate. Studies have shown that as SARS-CoV-2 moves around the globe, mutations are occurring. There are several different mutant strains, whose genomes have been decoded, on different continents.

 

What these mutations mean, from a clinical standpoint, if anything however, is still unresolved: ie; are they more virulent or do they lead to worse patient outcomes? 

 

If direct-acting therapeutics, such as remdesivir, are added to the mix, that "environmental pressure" may also induce mutations; mutations that are induced to bypass that environmental pressure. The end result is a strain that is resistant to environmental pressure (drug resistance) that overtakes the base strain (natural selection) and becomes predominant. As mentioned upthread, this is the rationale behind multi-drug treatment for HIV-1 infection, another RNA-based virus. The utilization of several drugs, with different mechanisms of action, targeting different biological processes, reduces the potential for the emergence of drug resistant strains.

 

There has also been reference to mutations in the spike protein. This could be clinically problematic because those changes could impact virulence. The spike protein is how SARS-CoV-2 gains cellular access.

 

https://www.scripps.edu/news-and-events/press-room/2020/20200611-choe-farzan-sars-cov-2-spike-protein.html

 

https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-020-02344-6

 

Thanks.

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https://www.texastribune.org/2020/07/01/coronavirus-texas-houston-hospitals-cases-surge/

 

I'm not really sure why the media hasn't been covering more what is currently going on with texas.

 

There ICU's are at 102 percent capicity. Patients are beginning to be transferred to out of state hospitals for treatment.

 

The surge is incredibly daunting in Texas right for and has disaster waiting to happen written all over it. 

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14 minutes ago, troeros said:

https://www.texastribune.org/2020/07/01/coronavirus-texas-houston-hospitals-cases-surge/

 

I'm not really sure why the media hasn't been covering more what is currently going on with texas.

 

There ICU's are at 102 percent capicity. Patients are beginning to be transferred to out of state hospitals for treatment.

 

The surge is incredibly daunting in Texas right for and has disaster waiting to happen written all over it. 

 

https://www.newsweek.com/houston-icus-reach-102-capacity-hospitals-face-crisis-amid-coronavirus-surge-1514800

 

One hospital network's ICU capacity in Houston is at 102%, not the entire state.

 

Quote

Intensive care units in a Houston hospital system reached 102 percent capacity Tuesday as hospitals face a surge in coronavirus cases.

 

Texas Medical Center reported data stating there were 1,350 ICU patients in its health system as of June 30, including 480 patients with COVID-19. TMC indicated there is normally a 1,330 ICU bed capacity "under non-pandemic conditions," known as Phase 1, but also stated that "TMC leaders are actively managing, and can adjust, elective procedures to ensure sufficient capacity for COVID-19 needs."

 

The current number of unused beds at TMC stands at 3,080. If needed, Texas Medical's Phase 2 can increase ICU bed capacity to add an additional 1,703 ICU beds for the duration of the pandemic. Phase 3 can add another 2,207 ICU beds for surge capacity by converting non-ICU beds.

Quote

Harris Health System operates Ben Taub and LBJ hospitals in the Houston area. The hospitals are transferring both COVID-19 patients and others to help free up hospital beds, Bryan McLeod, a spokesperson for Harris Health, told CBS News on Wednesday. In the last 24 hours, they have moved 33 patients to other hospitals and are working to relocate at least 15 more, McLeod said.

 

McLeod said some patients have been transferred to other hospitals in the Houston area and some have been brought to Galveston, Conroe and other nearby cities. He said this is a common practice to free up beds at the hospitals.

https://www.cbsnews.com/news/houston-hospital-transferring-coronavirus-patients/

 

Can't find any reporting on patients transferred *out of state.*  It's bad, but let's at least be accurate with the info we are posting.


Very Stable Genius

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Dayton becomes the first Ohio city to require face masks in public. The State of Pennsylvania has done the same.

 

https://trib.al/fhG3H8p

 

https://www.nbcphiladelphia.com/news/coronavirus/wolf-to-pennsylvania-if-youre-leaving-your-home-wear-a-mask/2453539/?utm_source=facebook&utm_campaign=clevelanddotcom_sf&utm_medium=social

Edited by Frmr CLEder

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