Coronavirus, Covid 19, Keeping Watch on Earth News, Solano County CA

COVID-19 cases in Solano County up sharply again, with one new death

Wednesday, July 1: 114 new cases today,
1 new death. Since the outbreak started: 1,402 cases, 104 hospitalized, 25 deaths.

Compare with previous report, Tuesday June 30:Summary

  • Solano County reported 114 new cases today, total of 1,402 cases since the outbreak started.  Over the last 7 days, Solano reported 338 new cases, an average of 48 per day.
  • 1 new deaths today, total of 25, 2 more hospitalized, total of 41 currently, 104 since the outbreak started.
  • Solano reported 98 more ACTIVE cases today, total of 307.  This figure has been on a yoyo this week.  For whatever reason, 250 last Friday, only 70 on Monday, back up to 209 yesterday and 307 today.  An increasing number, no matter how you look at it….
  • Note the drop in ICU beds Available, from 37% to 32%.  Need to keep an eye on this one.
  • Testing – Solano county reported 831 residents were tested since yesterday.  Good progress!

Details and Demographics tab

The County’s new Public Health Dashboard design includes a second tab (panel), “Details and Demographics” (shown here).  Note that both tabs are user interactive – hover over a chart (or tap) to get details. On this Details/Demographics tab, most of the small charts have a small additional tab showing the rate per 100,000.   Go there and explore the two tabs.  (Expand a chart by clicking the small button in its upper right corner.)

SEVEN DAY MOVING AVERAGE

Yesterday’s Seven Day moving average of confirmed cases showed an uptick (see at right).  Today’s chart is back to its misleading look, supposedly tracking as a 7-day average the increase of 717 cases (!) we have seen in the last 2 weeks…

Don’t let these “smoothed out” charts fool you – cases are up dramatically here.  Masks and social distancing are still required and important!  Today’s chart shows a 7-day moving average of 21 new cases per day, supposedly down from 27 in yesterday’s report.

BY AGE GROUP

  • Youth 17 and under – 15 new cases today, total of 126 cases, only one ever hospitalized.  Two weeks ago, there were only 52 cases among this age group – we’ve seen 74 new cases in 14 days!  I continue to be alarmed for Solano’s youth.  Cases among Solano youth have increased in recent weeks to 9% of the 1,402 total confirmed cases.
  • Persons 18-49 years of age – 66 new cases today, total of 805 cases.  This age group represents 57% of the 1,402 total cases, by far the highest percentage of all age groups.  The County reported no new hospitalizations among this age group today, and no new deaths.  Total of 27 hospitalized at one time and 2 deaths.
  • Persons 50-64 years of age – 22 new cases today, total of 282 cases.  This age group represents 20% of the 1,402 total cases.  No new hospitalizations today, total of 35 hospitalized at one time.  No new deaths, total of 3 deaths.
  • Persons 65 years or older – 11 new cases today, total of 188 cases.  This age group represents 13% of the 1,402 total cases.  No new hospitalizations, total of 41 hospitalized at one time.  1 new death, total of 20 deaths.  In this older age group, 22% were hospitalized at one time, a substantially higher percentage than in the lower age groups.  And this group counts for 20 of the 25 deaths, or 80%.

CITY DATA

  • Vallejo added 28 new cases today, total of 534.
  • Fairfield added 39 new cases today, total of 462.
  • Vacaville added 17 new cases today, total of 200 cases.
  • Suisun City added 8 new cases today, total of 89 cases.
  • Benicia added 1 new case today, total of 27 cases.
  • Dixon added 19 new case today, total of 70 cases.
  • Rio Vista was reported greater than 10 cases for the first time today, showing a total of 14 cases.  (The other cities added up to 112 of today’s 114 new cases, so… supposedly Rio Vista must have added 2 new cases.  Perhaps the County failed to note Rio Vista as >10 yesterday?)
  • Unincorporated areas – Although the County still still shows Unincorporated at <10 (less than 10), a little math tells the story: Solano’s unincorporated areas must account for the 6 cases unaccounted for in the other City totals.  Residents and city officials have long pressured County officials for full and transparent city case counts.  Finally we have complete city data for ALL areas of the County!
  • A “Rate” column shows the rate of positive COVID-19 cases (per 100,000 population) for each city.  Benicia is leading the way here, with a rate of only 97.9 cases per 100,000. Compare with other Solano cities in the chart, and note that the CDC reports today’s rate in California at 566 per 100,000 (up from 547 yesterday).  Johns Hopkins lists the overall Solano County rate at 252 (unchanged, as it reflects incomplete data for yesterday). UPDATE: Johns Hopkins updated its listing for cases per 100,000 in Solano County to 314 (a significant jump, up from 252 on Tuesday).

RACE / ETHNICITY

The County report on race / ethnicity data includes case numbers, hospitalizations, deaths and Solano population statistics.  There are also tabs showing a calculated rate per 100,000 by race/ethnicity for each of these boxes.  This information is discouragingly similar to national reports that indicate worse outcomes among black and brown Americans.  As of today:

  • White Americans are 39% of the population in Solano County, but only account for 24% of cases, 22% of hospitalizations and 21% of deaths.
  • Black Americans are 14% of Solano’s population, and account for 13% of cases, but 29% of hospitalizations, and 38% of deaths.
  • Latinx Americans are 26% of Solano’s population, but account for 37% of cases.  They account for 25% of hospitalizations, and 17% of deaths.
  • Asian Americans are 14% of Solano’s population, and account for 11% of cases and 15% of hospitalizations, but 21% of deaths.

MUCH MORE…

The County’s new and improved Coronavirus Dashboard is full of much more information, too extensive to cover here on a daily basis.  The Benicia Independent will continue to summarize daily and highlight a report or two.  Check out the Dashboard at https://doitgis.maps.arcgis.com/apps/MapSeries/index.html?appid=055f81e9fe154da5860257e3f2489d67.

Benicia Fire Department, Coronavirus, Covid 19

Benicia Firefighter Tests Positive for COVID-19

CITY OF BENICIA
Benicia Fire Department
250 East L Street,
Benicia, California 94510

Contact: Fire Chief Josh Chadwick
Benicia Fire Department
(707) 746-4275
jchadwick@ci.benicia.ca.us

CITY OF BENICIA UPDATE ON COVID-19
Benicia Firefighter Tests Positive for COVID-19

Benicia, CA (July 1, 2020) — On July 1, 2020, a Benicia Fire Department firefighter informed the City of Benicia that they received a positive test result for COVID-19. The source of the infection has not yet been determined, but the Benicia Fire Department is working with the Solano County Public Health Department to attempt to determine the source.

Fire Chief Josh Chadwick has been in close contact with Solano County Public Health staff who have determined that, based on the firefighter’s last shift on duty and the date of onset of symptoms, there was no exposure to City staff or to the community during the firefighter’s infectious period.

“We are fortunate that during the period of infection, the firefighter was not present in the City of Benicia. The Benicia Fire Department is committed to preventing the spread of COVID-19 and ensuring the safety of the residents of Benicia,” said Benicia Fire Chief Josh Chadwick.

The Benicia Fire Department has standing operating guidelines and county protocols in place to limit or prevent the infection between patients and fire personnel. Fire personnel follow these guidelines and protocols during treatment and interaction with residents. The firefighter had no fever or symptoms during their last on-duty shift. The affected Firefighter is in self-quarantine at home and has not required hospitalization.

All Benicia fire stations remain fully staffed and the City does not anticipate any disruption to service delivery.

Due to health privacy rights, the City is prohibited from providing any information about the identity of the affected firefighter.

For up-to-date information about the City of Benicia’s response to COVID-19, please go to https://www.ci.benicia.ca.us/coronavirus.

###

California Governor Gavin Newsom, Coronavirus, Covid 19, Re-opening, Solano County CA

Solano County among 19 California counties ordered to close bars, indoors restaurant seating and more

Newsom orders new shutdown of restaurants, other indoor business in 19 California counties

San Francisco Chronicle, by Dustin Gardiner July 1, 2020
Gov. Gavin Newsom at a news conference in Sacramento on Jan. 10.
Gov. Gavin Newsom at a news conference in Sacramento on Jan. 10. Photo: Rich Pedroncelli / Associated Press

SACRAMENTO — Gov. Gavin Newsom ordered 19 counties with surging coronavirus outbreaks to close indoor restaurants, wineries, movie theaters and other venues on Wednesday, saying California must act to keep the pandemic from spiraling out of control.

Newsom said the state has directed counties on its “watch list” — those with spiking numbers of new cases and hospitalizations — to reimpose parts of their stay-at-home orders. His directive came as the state warned that the virus could spread from family gatherings on the the Fourth of July weekend.

In the Bay Area, the list includes Contra Costa, Santa Clara and Solano counties.

“We’ve seen increased activity where people simply aren’t able to practice social distancing,” Newsom said at a briefing.

His order requires restaurants, wineries, family entertainment centers, movie theaters, museums, zoos and cardrooms in the 19 counties to halt indoor operations for at least three weeks. The affected establishments are allowed to operate outdoors, such as restaurant patios.

Newsom also ordered the full closure of all bars and breweries in the 19 counties, both indoor and outdoor operations.

Combined, the 19 counties include nearly three-fourths of California’s population. Besides the Bay Area counties, the list includes Los Angeles, Orange, Sacramento, Stanislaus, Fresno, Glenn, Imperial, Kern, Kings, Merced, Riverside, San Bernardino, San Joaquin, Santa Barbara, Tulare and Ventura counties.

The governor said the state will also close parking lots at state beaches, including those in the Bay Area, for the holiday weekend.

Newsom implored Californians to practice social distancing and wear masks as they mingle and travel for the holiday. He said people must “disabuse” themselves of any notion that people have stopped dying of COVID-19, noting that the statewide death toll hit 110 on Tuesday.

“Let’s do our best to meet this moment, as we met the moment many months ago and bent the curve again the first time,” he said. “Let’s do it again.”

On Tuesday, the state recorded 7,820 new cases — its second-highest tally in a 24-hour period — and surpassed 6,000 deaths. The state reported 5,898 new cases on Wednesday.

Newsom’s administration began allowing counties in May to move ahead on reopening businesses including indoor restaurants and shopping malls if they hit benchmarks in slowing the spread of the virus and creating capacity to contain a surge.

Most of California’s 58 counties have allowed some nonessential businesses to reopen, although the pace has been slower in the Bay Area than elsewhere.

In recent days, however, some of those efforts have been reversed — several counties have closed bars again, and San Francisco, Marin, Alameda and Contra Costa counties all pulled back on plans to let gyms and hair salons reopen.

Alarming updates about the virus’ toll continue to mount: San Francisco announced Tuesday that the city has seen a 49% spike in hospitalizations over the last week as patients from San Quentin State Prison and hard-hit rural Imperial County were transferred to city hospitals.

Dustin Gardiner is a San Francisco Chronicle staff writer.

 

Coronavirus, Covid 19

Coronavirus autopsies: A story of 38 brains, 87 lungs and 42 hearts

What we’ve learned from the dead that could help the living.

The Washington Post, by Ariana Eunjung Cha, July 1, 2020
An examination room in the morgue at the Franklin County Forensic Science Lab in Columbus, Ohio. (Ty Wright/The Washington Post)

When pathologist Amy Rapkiewicz began the grim process of opening up the coronavirus dead to learn how their bodies went awry, she found damage to the lungs, kidneys and liver consistent with what doctors had reported for months.

But something was off.

Rapkiewicz, who directs autopsies at NYU Langone Health, noticed that some organs had far too many of a special type of cell rarely found in those places. She had never seen that before, yet it seemed vaguely familiar. She raced to her history books and — in a eureka moment — found a reference to 1960′s report on a patient with dengue fever.

In dengue, a mosquito-borne tropical disease, she learned, the virus appeared to destroy these cells, which produce platelets, leading to uncontrolled bleeding. The novel coronavirus seemed to amplify their effect, causing dangerous clotting.

She was struck by the parallels: “Covid-19 and dengue sound really different, but the cells that are involved are similar.”

Autopsies have long been a source of breakthroughs in understanding new diseases, from HIV/AIDS and Ebola, to Lassa fever — and the medical community is counting on them to do the same for covid-19, the disease caused by coronavirus. With a vaccine likely many months away, autopsies are becoming a critical source of information for research into possible treatments.

When the pandemic hit the United States in late March, many hospital systems were too overwhelmed trying to save lives to spend too much time delving into the secrets of the dead. But by late May and June, the first large batch of reports — from patients who died at a half-dozen different institutions — were published in quick succession. The investigations have confirmed some of our early hunches of the disease, refuted others — and opened up new mysteries about the novel pathogen that has killed more than 500,000 people worldwide.

Among the most important findings, consistent across several studies, is confirmation the virus appears to attack the lungs the most ferociously. They also found the pathogen in parts of the brain, kidneys, liver, gastrointestinal tract, spleen and in the endothelial cells that line blood vessels, as some had previously suspected. Researchers also found widespread clotting in many organs.

But the brain and heart yielded surprises.

“It’s about what we are not seeing,” said Mary Fowkes, an associate professor of pathology who is part of a team at Mount Sinai Health that has performed autopsies on 67 covid-19 patients.

Aerial view showing new graves in the Nossa Senhora Aparecida cemetery in Manaus, Brazil. (Michael Dantas/AFP via Getty Images)
Aerial view showing new graves in the Nossa Senhora Aparecida cemetery in Manaus, Brazil. (Michael Dantas/AFP via Getty Images)

Given widespread reports about neurological symptoms related to the coronavirus, Fowkes said, she expected to find virus or inflammation — or both — in the brain. But there was very little. When it comes to the heart, many physicians warned for months about a cardiac complication they suspected was myocarditis, an inflammation or hardening of the heart muscle walls — but autopsy investigators were stunned that they could find no evidence of the condition.

Another unexpected finding, pathologists said, is that oxygen deprivation of the brain and the formation of blood clots may start early in the disease process. That could have major implications for how people with covid-19 are treated at home, even if they never need to be hospitalized.

The early findings come as new U.S. infections have overtaken even the catastrophic days of April, amid what some critics say is a premature easing of social distancing restrictions in some states mainly in the South and West. A new modeling study has estimated that about 22 percent of the population — or 1.7 billion people worldwide, including 72 million in the United States — may be vulnerable to severe illness if infected with covid-19. According to the analysis published this month in the Lancet Global Health, about 349 million, or four percent of those people would require hospitalization — underscoring the stakes as autopsy investigators continue their hunt for clues.

Microclots in lungs

A health care worker in full protective gear examines the chest X-ray of a patient in a ward reserved for covid-19 patients at Hospital Juarez in Mexico City. (Eduardo Verdugo/AP)
A health care worker in full protective gear examines the chest X-ray of a patient in a ward reserved for covid-19 patients at Hospital Juarez in Mexico City. (Eduardo Verdugo/AP)

At their best, autopsies can reconstruct the natural course of the disease but the process for a new and highly infectious-disease is tedious and requires meticulous work. To protect pathologists and avoid sending virus into the air, they must use special tools to harvest organs and then dunk them in a disinfecting solution for several weeks before they are studied. They must then section each organ and collect small bits of tissue for study under different types of microscopes.

One of the first American investigations to be made public, on April 10, was out of New Orleans. The patient was a 44-year-old male who had been treated at LSU Health. Richard Vander Heide remembers cutting the lung and discovering what was likely hundreds or thousands of microclots.

“I will never forget the day,” recalled Vander Heide, who has been performing autopsies since 1994. “I said to the resident, ‘This is very unusual.’ I had never seen something like this.”

But as he moved onto the next patient and the next, Vander Heide saw the same pattern. He was so alarmed, he said, that he shared the paper online before submitting it to a journal so the information could be used immediately by doctors. The findings caused a stir at many hospitals and influenced some doctors to start giving blood thinners to all covid-19 patients. It is now common practice. The final, peer-reviewed version involving 10 patients was subsequently published in the Lancet in May.

Other lung autopsies — including those described in papers from Italy of 38 patients, a Mount Sinai Health study on 25 patients, a collaboration between Harvard Medical School and German researchers on seven and an NYU Langone Health on seven — have reported similar findings of clotting.

Most recently, a study out this month in the Lancet’s eClinicalMedicine, found abnormal clotting in the heart, kidney, liver, as well as the lungs of seven patients, leading the authors to suggest this may be a major cause of the multiple-organ failure in covid-19 patients.

Heart cells

The next organ studied up close was the heart. One of the most frightening early reports about the coronavirus from China was that a significant percent of hospitalized patients — up to 20 to 30 percent — appeared to have a heart issue known as myocarditis that could lead to sudden death. It involves the thickening of the muscle of the heart so that it can no longer pump efficiently.

Classic myocarditis is typically easy to identify in autopsies, pathologists say. The condition occurs when the body perceives the tissue to be foreign and attacks it. In that situation, there would be large dead zones in the heart, and the muscle cells known as myocytes would be surrounded by infection-fighting cells known as lymphocytes. But in the autopsy samples taken so far the dead myocytes were not surrounded by lymphocytes — leaving researchers scratching their heads.

Fowkes from Mount Sinai and her colleague, Clare Bryce, whose work on 25 hearts has been published online but not yet peer reviewed, said they saw some “very mild” inflammation of the surface of the heart but nothing that looked like myocarditis.

NYU Langone’s Rapkiewicz, who studied seven hearts, was struck by the abundance of a rare cell called megakaryocytes in the heart. Megakaryocytes, which produce platelets that control clotting, typically exist only in the bone marrow and lungs. When she went back to the lung samples from the coronavirus patients, she discovered those cells were too plentiful there, too.

“I could not remember a case before where we saw that,” she said. “It was remarkable they were in the heart.”

Vander Heide from LSU, who reported preliminary findings on 10 patients in April and has a more in-depth paper with more case studies on the topic under review at a journal, explained that “when you look at a covid heart, you don’t see what you’d expect.”

He said a couple of patients he performed autopsies on had gone into cardiac arrest in the hospital, but when he examined them, the primary damage was in the lungs — not the heart.

Brain grid

New graves are seen at dusk at a Muslim burial area provided by the government for victims of the coronavirus disease at Tegal Alur cemetery complex in Jakarta, Indonesia on June 27, 2020. (Willy Kurniawan/Reuters)
New graves are seen at dusk at a Muslim burial area provided by the government for victims of the coronavirus disease at Tegal Alur cemetery complex in Jakarta, Indonesia on June 27, 2020. (Willy Kurniawan/Reuters)

Of all the novel coronaviruses’s manifestations, its impact on the brain has been among the most vexing. Patients have reported a host of neurological impairments including reduced ability to smell or taste, altered mental status, stroke, seizures — even delirium.

An early study from China, published in the BMJ, formerly the British Medical Journal, in March, found 22 percent of the 113 patients had experienced neurological issues ranging from excessive sleepiness to coma — conditions typically grouped together as disorders of consciousness. In June, researchers in France reported that 84 percent of patients in intensive care had neurological issues, and a third were confused or disoriented at discharge. Also this month, those in the United Kingdom found that 57 of 125 coronavirus patients with a new neurological or psychiatric diagnosis had had a stroke due to a blood clot in the brain, and 39 had an altered mental state.

Based on such data and anecdotal reports, Isaac Solomon, a neuropathologist at Brigham and Women’s Hospital in Boston, set out to systematically investigate where the virus might be embedding itself in the brain. He conducted autopsies of 18 consecutive deaths, taking slices of key areas: the cerebral cortex (the gray matter responsible for information processing), thalamus (modulates sensory inputs), basal ganglia (responsible for motor control) and others. Each was divided into a three-dimensional grid. Ten sections were taken from each and studied.

He found snippets of virus in only some areas, and it was unclear whether they were dead remnants, or active virus when the patient died. There were only small pockets of inflammation. But there were large swaths of damage due to oxygen deprivation. Whether the deceased were longtime intensive care patients, or people who died suddenly, Solomon said, the pattern was eerily similar.

“We were very surprised,” he said.

When the brain does not get enough oxygen, individual neurons die and that death is permanent. To a certain extent, people’s brains can compensate but at some point, the damage is so extensive that different functions start to degrade.

On a practical level, Solomon said that if the virus is not getting into the brain in large amounts, that helps with drug development because treatment becomes trickier when it is pervasive, for instance, in some patients with West Nile or HIV. Another takeaway is that the findings underscore the importance of getting people on supplementary oxygen quickly to prevent irreversible damage.

Solomon, whose work was published as a June 12 letter in the New England Journal of Medicine, said the findings suggest the damage had been happening over a longer period of time, which make him wonder about the virus’s effect on people who are less ill. “The big lingering question is what happens to people who survive covid,” he said. “Is there a lingering effect on the brain?”

Jan Claire Dorado, 30, and a physician, tends to a patient in an emergency room designated for coronavirus patients in Manila. (Eloisa Lopez/Reuters)
Jan Claire Dorado, 30, and a physician, tends to a patient in an emergency room designated for coronavirus patients in Manila. (Eloisa Lopez/Reuters)

The team from Mount Sinai Health, which took tissue findings from 20 brains, was also perplexed not to find a lot of virus or inflammation. However, the group noted in a paper that the widespread presence of tiny clots was “striking.”

“If you have one blood clot in the brain, we see that all the time. But what we’re seeing is some patients are having multiple strokes in blood vessels that are in two or even three different territories,” Fowkes said.

Rapkiewicz said it is too early to know whether the newest batch of autopsy findings can be translated into treatment changes, but the information has opened new avenues to explore. One of her first calls after noticing the unusual platelet-producing cells was to Jeffrey Berger, a cardiac specialist at NYU who runs a National Institutes of Health-funded lab that focuses on platelets.

Berger said the autopsies suggest anti-platelet medications, in addition to blood thinners, may be helpful to stem the effects of covid-19. He has pivoted a major clinical trial looking at optimal doses of anticoagulants to look at that question as well.

“It’s only one piece of a very big puzzle, and we have a lot more to learn,” he said. “But if we can prevent significant complications and if more patients can survive the infection, that changes everything.”

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