ซึ่งทั้งผู้ป่วยและผู้ติดตามต้องผ่านการตรวจ ซึ่งไม่พบเชื้อก่อโรคโควิด 19 ที่ประเทศต้นทาง และมีเอกสารสำคัญครบถ้วนก่อนได้รับอนุญาตให้เดินทางเข้ามาในประเทศไทย ได้แก่ติดตามข่าวสาร “คมชัดลีก” ผ่าน Line official
By The Washington Post · Lena H. Sun, Amy Goldstein · NATIONAL, HEALTH, POLITICS, SCIENCE-ENVIRONMENT
WASHINGTON – On the eve of a new coronavirus reporting system this week, data disappeared from a Centers for Disease Control and Prevention website as hospitals began filing information to a private contractor or their states instead. A day later, an outcry – including from other federal health officials – prompted the Trump administration to reinstate that dashboard and another daily CDC report on the pandemic.
On Thursday, the nation’s governors joined the chorus of objections over the abruptness of the change, asking the administration to delay it for 30 days. In a statement, the National Governors Association said hospitals need the time “to learn a new system, as they continue to deal with this pandemic.
Meanwhile, the disappearance of the real-time data – the CDC dashboard was taken down Tuesday night before resurfacing Thursday morning – was a ripple effect of the administration’s new hospital reporting protocol that took effect Wednesday, according to a federal health official who spoke on the condition of anonymity to discuss internal deliberations.
On Thursday evening, the nation’s governors objected to the abruptness of the change, asking the administration to delay the altered requirements for 30 days. In a statement, the National Governors Association said hospitals need the time “to learn a new system, as they continue to deal with this pandemic. In addition, governors urge the administration to make this information publicly available.”
The disappearance of the real-time data from the CDC dashboard, which was taken down Tuesday night before resurfacing Thursday morning, was a ripple effect of the administration’s new hospital reporting protocol that took effect Wednesday, according to a federal health official who spoke on the condition of anonymity to discuss internal deliberations.
Without receiving the data firsthand, CDC officials were reluctant to maintain the dashboard – which shows the number of patients with covid-19, the disease caused by the virus, and hospital bed capacity – and took it down, the federal health official said. The CDC dashboard states that its information comes directly from hospitals and does not include data submitted to “other entities contracted by or within the federal government.” It also says the dashboard will not be updated after July 14.
The dashboard “was taken down in a fit of pique,” said Michael Caputo, the assistant secretary for public affairs at the Department of Health and Human Services. “The idea CDC scientists cannot rely upon their colleagues in the same department for data collection, or any other scientific work, is preposterous.”
This week, the CDC, the government’s premier public health agency whose medical epidemiologists analyze the hospital data, also stopped producing reports about trends in the pandemic that had gone twice a week to states, and six days a week to officials at multiple federal agencies. Adm. Brett Giroir, an assistant secretary in the HHS who oversees coronavirus testing, was unhappy that the CDC hospital report stopped Wednesday and Thursday mornings, according to the federal health official.
Caputo said that the goal is to maintain transparency, adding that conversations were still taking place between HHS officials and the CDC on a plan to keep producing the dashboard updates and the reports. “We expect a resolution,” he said.
Another HHS spokesperson said the CDC might create a new dashboard, based on a wider set of information.
During a conference call for journalists Thursday on coronavirus testing, Giroir did not acknowledge his displeasure with the reports’ discontinuation. But he said: “Those data are really critical to all of us. . . . I wake up in the morning and first thing I do, I look at the data. I look at midday. I look at it at night before I go to bed. . . . Those kind of data are really important to us. We drive the response based on that.”
The CDC site had been one of the few public sources of granular information about hospitalizations and ICU bed capacity. About 3,000 hospitals, or about 60 percent of U.S. hospitals, reported their data to the CDC’s system.
The president of the American Medical Association, Susan Bailey, spoke out Thursday on the uncertainties about access to data. “[W]e urge and expect that the scientists at the CDC will continue to have timely, comprehensive access to data critical to inform response efforts,” she said.
Governors, hospital officials and state health officers were given scant notice of the change in the reporting system. Two top administration health officials said in a letter to governors early this week that some hospitals were not complying with the previous protocols, suggesting that states might want to consider bringing in the National Guard to help gather the information. Hospital industry leaders vehemently protested that characterization, as well as the idea that they should be assisted by the National Guard in the midst of a pandemic.
HHS and CDC officials have said the protocol was changed to streamline reporting of data that is used, among other things, to determine the federal allocation of therapeutics, testing supplies and protective gear. Instead of reporting to the long-standing CDC system, hospitals must send data about covid-19 patients and other metrics to a recently hired federal contractor, called TeleTracking, or to their state health departments.
At least some state health departments that have been collecting data for their hospitals and sending it to Washington have already said the switch will make it impossible for them to continue, at least for now. The changed protocol includes a requirement that hospitals send several additional types of data that some state systems are not equipped to handle, state health officials said.
The Pennsylvania Department of Health sent a notice to hospitals Tuesday night saying that its platform was not ready to accommodate the new federal requirements, so that hospitals needed to report every day to both the state and to TeleTracking.
Charles Gischlar, spokesman for the Maryland Department of Health, said the reporting change “is a heavy lift for hospitals.”
The new system “exceeds the capacity of the current statewide system” to which hospitals had been reporting, he said, so the state no longer can send consolidated information to the federal government. As a result, he said in a statement, hospitals must provide data individually to the government.
By The Washington Post · Hannah Denham, Taylor Telford · BUSINESS A slew of retailers have joined Walmart in requiring shoppers to wear face coverings at every U.S. store amid an upswing in coronavirus infections.
Target and CVS Health announced new policies Thursday. Kohl’s and Kroger made the change Wednesday afternoon, hours after Walmart – the world’s biggest retailer – said it would require mask-wearing at its 5,300 namesake and Sam’s Club locations.
Target said its new mask policy, which takes effect Aug. 1, does not apply to young children or those with underlying medical conditions. Like Walmart, it will station employees at store entrances to remind shoppers to wear masks and to provide disposable ones if needed. It also will install signage, run reminders on store audio systems and encourage no-contact shopping options. More than 80% of its 1,871 U.S. stores already have mask requirements in compliance with local and state mandates.
CVS said its policy takes effect Monday at its 10,000 U.S. locations.
“To be clear, we’re not asking our store employees to play the role of enforcer,” CVS Chief Operating Officer Jon Roberts said in a news release. “What we are asking is that customers help protect themselves and those around them by listening to the experts and heeding the call to wear a face covering.”
Kroger, the nation’s largest supermarket chain, announced Wednesday in a tweet that masks will be required at all 2,758 stores. The Ohio-based grocer’s banners include Kroger, Harris Teeter, Ralphs and Fred Meyer.
Kohl’s policy takes effect Monday at more than 1,100 stores nationwide.
Both companies already required employees to wear masks.
Walmart said that masks would be required at all its stores starting Monday, and that it will position “health ambassadors” at the entryways to help with enforcement. The retailer said about 3,500 of its more than 5,300 Walmart and Sam’s Clubs locations already are observing public health mandates within their respective markets.
“We know some people have differing opinions on this topic,” said a news release from Dacona Smith and Lance de la Rosa, the chief operating officers of Walmart and Sam’s Club, respectively. “We also recognize the role we can play to help protect the health and well-being of the communities we serve by following the evolving guidance of health officials like the [Centers for Disease Control and Prevention].”
The world’s biggest retail trade group lauded Walmart’s move and expressed hope that it would be a “tipping point” for the retail industry. Costco, Apple and Best Buy already had mask policies in place.
“Workers serving customers should not have to make a critical decision as to whether they should risk exposure to infection or lose their jobs because a minority of people refuse to wear masks in order to help stop the spread of the deadly coronavirus,” the National Retail Federation trade said in a statement.
“Shopping in a store is a privilege, not a right. If a customer refuses to adhere to store policies, they are putting employees and other customers at undue risk,” the statement continued.
Mixed messaging from local and state governments, and varying business policies, have politicized mask use despite CDC guidance that suggests masks can help prevent the spread of the novel coronavirus, the pathogen that causes the disease covid-19, which has killed at least 133,000 Americans. The number of confirmed U.S. coronavirus infections is approaching 3.5 million. The CDC, which originally downplayed the importance of masks, now calls face coverings “a critical preventive measure” and says they should be worn in public.
The move comes amid a surge in infections, particularly in the South and West, that has overwhelmed hospitals and raised fears of more outbreaks this fall and winter. The United States topped 50,000 new cases in one day for the first time on July 1, shortly after the nation’s top infectious-disease expert, Anthony Fauci, warned that the country could expect to see 100,000 new cases a day “if this does not turn around.” On Wednesday, the United States reported 65,852 daily new cases.
Economists say nationwide mask requirements could prevent a return to widespread shutdowns and further economic turmoil. Last week, a Goldman Sachs analysis estimated that a nationwide mask requirement could avert more shutdowns and the potential loss of $1 trillion from U.S. gross domestic product.
The patchwork approach to masks and the political tempest surrounding them has left retail workers vulnerable as they enforce mask policies. Some workers say they have been told that they cannot refuse service to maskless customers, even if local laws require the wearing of masks. During the pandemic, retail workers have been physically assaulted, even suffering broken limbs and, in the case of a security guard at a Family Dollar store in Michigan, killed while trying to enforce the mask requirement.
By The Washington Post · Griff Witte · NATIONAL, BUSINESS, HEALTH, POLITICS, SCIENCE-ENVIRONMENT
They have emerged as an unlikely symbol of partisan divide and a source of bottomless derision for President Donald Trump.
But masks on Wednesday moved ever closer to becoming a new national reality in America’s pandemic-scarred life, with businesses, states and health experts preaching their promise as the country’s last line of defense against a fast-growing viral threat.
Even as the White House continued to resist pushing for a national mask mandate, evidence abounded that face coverings were becoming a de facto requirement – and not only in big cities where they have been in widespread use for months.
Alabama’s governor, who leads one of the country’s most conservative states, on Wednesday said people would be obligated to wear masks when leaving the house. The announcement, which came as Alabama recorded a new single-day novel coronavirus death record, means nearly half of all states now have a mandate.
The world’s largest retailer and a staple of rural communities nationwide, Walmart Inc., issued the same requirement for shoppers in its stores. A powerful trade group quickly embraced the choice, raising the prospect that other major chains will soon follow.
“Shopping in a store is a privilege, not a right,” said the National Retail Federation. “If a customer refuses to adhere to store policies, they are putting employees and other customers at undue risk.”
The moves came only hours after Robert Redfield, director of the Centers for Disease Control and Prevention, declared that coronavirus outbreaks – now raging across much of the country – could be “under control” within one or two months if the public adopts widespread mask use.
So far, that hasn’t happened – despite a toll that on Wednesday topped 134,000 deaths and hit nearly 3.5 million cases. Health experts say that if masks aren’t more routinely used, governors will have little choice but to continue rolling back economic reopenings as cases surge.
Trump has led the charge in casting doubt on mask use, mocking those who don one and refusing for months to wear one in public. He has recently endorsed their use, but only grudgingly, and late last week wore one in public for the first time.
Trump’s contempt has been emulated by rank-and-file Republicans, who polls show are significantly less likely than Democrats or independents to wear masks, as well as by GOP officeholders.
One such official, Oklahoma Gov. Kevin Stitt, on Wednesday became the first state chief executive to announce that he has tested positive for the coronavirus. Just over three weeks ago, Stitt appeared unmasked at a Trump rally in Tulsa, where the president joined thousands of others in dispensing with face coverings.
Stitt said he felt “fine” and would be isolating. The governor, who urged residents to flock to restaurants early in the outbreak even as other state leaders were shutting down, said he did not believe he had contracted the virus at Trump’s rally.
The news came as Oklahoma reported more than 1,000 new coronavirus cases – a single-day record as the average number of new deaths also increases.
In Florida, which has the dubious distinction of leading the nation with an average of more than 10,000 cases a day over the past week, hospital officials said they had seen a spike in covid-19 patients that caught them off-guard.
Carlos Migoya, president and CEO of Miami’s Jackson Health System, Florida’s largest hospital group, told CNN on Wednesday that the number of patients with covid-19, the disease caused by the coronavirus, jumped from 129 on June 14 to 420 patients on July 14.
One of the main culprits, he said: resistance to wearing a mask.
“The biggest issue is that we have a lot of aggressive noncompliant people, people that just do not believe that masking is the right thing to do,” Migoya said. “A lot of the young people are saying, ‘So what if I get it? If I get it, it doesn’t mean anything.’ “
The evidence that masks are effective in stopping the spread of the coronavirus has existed nearly as long as the virus itself has. But the messaging about whether the public should wear them has often been muddled.
Early on, the country’s top scientific and medical officials warned against them.
“Seriously people- STOP BUYING MASKS!” U.S. Surgeon General Jerome Adams tweeted in late February as the coronavirus was beginning to circulate in communities across the country. “They are NOT effective in preventing general public from catching #Coronavirus.”
The country’s leading infectious-disease specialist, Anthony Fauci, also counseled against widespread mask use, saying the United States needed to conserve its fast-dwindling mask stockpile for front-line medical workers.
He changed his mind in early April, telling the public that “the better part of valor when you’re out and you can’t maintain that six-foot distance is to wear some type of facial covering.”
Trump, however, has remained resistant and has mocked Democratic rival Joe Biden for wearing one. That has, in turn, fed conservative suspicion of masks as an infringement on personal liberty – a refrain repeated at city council meetings nationwide and in viral videos as shoppers insist on their constitutional right to not mask up.
Health experts on Wednesday applauded Alabama Gov. Kay Ivey, a Republican, and Walmart for doing what the federal government has not, which is to insist that masks are not a choice.
“It’s the right thing to do. We can’t afford for this to continue as an us-versus-them issue or as a science-versus-politics issue,” said Marc Hahn, president of the health-sciences-focused Kansas City University. “We’ve got to come to a point where we can adopt sound public health strategies.”
And the time for that is limited, Hahn said. He compared the drive to promote masks to the push for mandatory seat belt use in the 1970s.
“It took three to five years for folks to comply with those legal mandates,” said Hahn, who served as anesthesiologist for two U.S. presidents. “We don’t have three to five years. We don’t have three to five weeks. This is serious.”
The urgency was underscored by Ivey’s decision Wednesday, which came after prominent public health officials in her state urged a mandate.
Coronavirus hospitalizations and new cases in Alabama have risen sharply in recent weeks, while daily covid-19 deaths have hit a record high for the third time in six days. The state reported 47 new deaths Wednesday, and on Tuesday, it reported 1,365 current hospitalizations, though officials say some of the recent increase stemmed from a change this week in hospital reporting methods.
More than 20 other states have mask mandates, including California, Maryland, New York and Virginia. Some states, such as Ohio and Texas, require masks only in counties where coronavirus infection rates have hit a high level. Ohio Gov. Mike DeWine, a Republican, had attempted to institute a statewide mandate in early May before backing down in the face of fierce resistance.
Walmart’s decision to require masks – with its potential to alienate the company’s clientele in red states and rural areas – echoed its choice last year to end the sale of ammunition following a mass shooting at its store in El Paso, Texas.
The Arkansas-based retailer announced the mandate in a Wednesday news release, citing the recent resurgence in U.S. covid-19 cases and the need for consistency across its operations. Walmart said roughly 3,500 of its more than 5,300 namesake stores and Sam’s Club locations already comply with public health mandates in their respective markets.
“We know some people have differing opinions on this topic,” according to the news release from Dacona Smith and Lance de la Rosa, the chief operating officers of Walmart and Sam’s Club, respectively. “We also recognize the role we can play to help protect the health and well-being of the communities we serve by following the evolving guidance of health officials like the CDC.”
The CDC on Tuesday stepped up its efforts to promote masks, publishing an editorial in the Journal of the American Medical Association that concluded “cloth face coverings are one of the most powerful weapons we have to slow and stop the spread of the virus – particularly when used universally within a community setting.”
The agency pointed to the example of two hair stylists in Missouri, both of whom exhibited covid-19 symptoms for days as they snipped and cut and both of whom later tested positive for the virus.
But because they were wearing masks, as required by law, investigators found that “none of the stylists’ 139 clients or secondary contacts became ill, and all 67 clients who volunteered to be tested showed no sign of infection.”
Redfield told an interviewer Tuesday that mask-wearing may be the key to allowing businesses to stay open and, if employed widely, could set the United States on a very different trajectory.
“If we could get everybody to wear a mask right now,” he said in a JAMA Live webcast, “I really think in the next four, six, eight weeks, we could bring this epidemic under control.”
By The Washington Post · Fenit Nirappil, Ovetta Wiggins, Rachel Chason, Dana Hedgpeth · NATIONAL, HEALTH WASHINGTON – The greater Washington region recorded its highest daily coronavirus caseload in weeks Wednesday as the city lost more ground in its fight to quell the pandemic.
Maryland, Virginia and Washington, D.C., combined to report the region’s highest single-day case increase since June 4. Area leaders are monitoring a rise in cases in hopes of staving off outbreaks that have occurred elsewhere in the country.
While much of the increase is the result of infection spikes in Virginia’s Hampton Roads region, many other localities have also reported increases in recent days.
City leaders said Wednesday that a key transmission rate metric rose to alarming levels for the first time since late April.
The transmission rate – the number of people a new patient is likely to infect – surpassed 1 earlier this month after steadily rising since mid-June. City leaders want the rate below 1 for five consecutive days before considering a shift into the third stage of coronavirus recovery, although the D.C. Health Department has cautioned that the metric becomes a less reliable indicator of transmission as cases decline.
D.C. public health officials have said the next stage of coronavirus recovery will be difficult to achieve because it requires drastically lower risks of the virus spreading.
The city also has struggled to achieve two weeks of declining new cases, measured by the date a person developed symptoms, excluding patients from confined facilities. Officials have measured seven days of declining cases as of Wednesday, but the clock has reset several times, with cases going up and down rather than a steady decline.
Hospitals in the city have been running at just short of 80 percent capacity – a threshold that could trigger additional restrictions or measures to handle a surge of coronavirus patients.
Mayor Muriel Bowser, D, said at a Wednesday news conference the city has been testing record numbers of people, which might lead to a higher raw number of cases, but she noted the rate of people testing positive has stayed below 5% in recent weeks.
“Our message continues to be the same: The virus is still in our community, it’s still circulating, and we have to be very vigilant in wearing masks, practicing social distancing and washing our hands, and in being judicious about the activities that we participate in,” she said.
Maryland Gov. Larry Hogan, R, said Wednesday that noncompliance of restrictions in bars and restaurants could force the state to shut down those businesses like other states that have seen surges in cases.
“At this point, we’re trying to crack down on the bad apples without killing the whole industry,” Hogan said. “If it gets out of control, we’ll have to take another look.”
Contact tracers across the county are finding the virus is being spread in bars and restaurants where young customers are not wearing masks or practicing social distancing, he said. Maryland health officials are monitoring an uptick in the positivity rate on coronavirus tests among residents under the age of 35.
“While our health metrics are continuing to slightly decline or plateau, this battle is not behind us, not by a long shot,” he said. “Low risk does not mean no risk.”
He urged residents to refrain from traveling to states experiencing high caseloads. Those who do travel should get tested when they return, he said.
The governor said Maryland has not experienced a surge seen in states like Texas and Florida because Maryland put restrictions in place for bars and restaurants under the state’s reopening plan. For example, he said, bars were instructed to serve seated customers and prohibit people congregating.
On Tuesday, Hogan sent a letter to county leaders pressing them to enforce those restrictions on establishments. He said Wednesday that “it really is a responsibility of the counties” to devise a coordinated response with its liquor boards, health departments and police departments.
Statewide in Maryland, hospitalization numbers increased for a second consecutive day Wednesday, while the seven-day average increased for the fifth day in a row. At the same time, the state conducted a record number of tests with a decline in the positivity rate, as well as its rate of deaths.
In the state’s most populous jurisdiction, Montgomery County Executive Marc Elrich, D, said Wednesday the county will continue enforcing physical distancing and mask requirements and plans to focus next on construction sites, shutting down projects where workers are not wearing masks.
“We are going to double down,” he said, noting that construction workers might go back to communities where residents live in close quarters, making community spread more likely. “We are not going to go the way of these other states where reopening has led to a reemergence of the virus.”
The county reported 103 additional cases on Wednesday, though its seven-day average has held steady for weeks.
Elrich said he was “a little surprised” by Hogan’s letter a day earlier telling local leaders they “have the responsibility to enforce the laws.” He said Montgomery County has been doing so already, and noted that Hogan could have offered to work jointly with the localities, using state police to help enforcement efforts.
Elrich said county officials would give businesses a warning before taking any actions.
Virginia took its own set of actions Wednesday on a first-in-the-nation measure to protect workers from the coronavirus.
The state’s safety and health codes board voted to adopt a set of coronavirus-related workplace safety mandates, requiring businesses to implement a raft of safety measures to protect people from being infected with coronavirus at work. Companies could face steep financial penalties if they are found to have violated the policies.
The new mandates come as Virginia, Maryland and Washington reported 1,920 new cases and 25 additional fatalities Wednesday.
Maryland saw 759 new cases and seven deaths, while Virginia had new 1,084 cases and 15 deaths. Washington’s caseload increased by 80, while three new fatalities brought an end to the city’s five-day streak with no reported deaths.
While each jurisdiction eclipsed its seven-day average caseload, the biggest spikes continued to occur in Virginia’s Hampton Roads region, which saw 494 new cases.
The seven-day average of coronavirus cases in that area has increased for 11 consecutive days, reaching 383 daily cases Wednesday. That’s five times higher than in late June.
Northern Virginia’s 241 daily cases Wednesday was above its seven-day average and the highest daily total since July 5. Despite the increase, the seven-day average in the state’s D.C. suburbs is virtually unchanged since mid-June.
A rise in hospitalizations across the greater Washington region has followed the caseload increase. The area’s seven-day average of covid-19 patients in hospitals has risen for six consecutive days.
But not every metric in the Washington region was worsening. The number of patients in intensive care or using ventilators has held steady, while the average number of daily deaths dropped to its lowest point since early April.
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