corona virus alerts - Latest cruising Information for vessels/locations/rules

[Montanan]

Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020
Early Release / March 18, 2020 / 69

https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm

CDC COVID-19 Response Team (View author affiliations)

Early data from China suggest that a majority of coronavirus disease 2019 (COVID-19) deaths have occurred among adults aged ≥60 years and among persons with serious underlying health conditions.

What is added by this report?

This first preliminary description of outcomes among patients with COVID-19 in the United States indicates that fatality was highest in persons aged ≥85, ranging from 10% to 27%, followed by 3% to 11% among persons aged 65–84 years, 1% to 3% among persons aged 55-64 years, <1% among persons aged 20–54 years, and no fatalities among persons aged ≤19 years.

What are the implications for public health practice?

COVID-19 can result in severe disease, including hospitalization, admission to an intensive care unit, and death, especially among older adults. Everyone can take actions, such as social distancing, to help slow the spread of COVID-19 and protect older adults from severe illness.


COVID-19 Information for Older Adults

Globally, approximately 170,000 confirmed cases of coronavirus disease 2019 (COVID-19) caused by the 2019 novel coronavirus (SARS-CoV-2) have been reported, including an estimated 7,000 deaths in approximately 150 countries (1). On March 11, 2020, the World Health Organization declared the COVID-19 outbreak a pandemic (2). Data from China have indicated that older adults, particularly those with serious underlying health conditions, are at higher risk for severe COVID-19–associated illness and death than are younger persons (3). Although the majority of reported COVID-19 cases in China were mild (81%), approximately 80% of deaths occurred among adults aged ≥60 years; only one (0.1%) death occurred in a person aged ≤19 years (3). In this report, COVID-19 cases in the United States that occurred during February 12–March 16, 2020 and severity of disease (hospitalization, admission to intensive care unit [ICU], and death) were analyzed by age group. As of March 16, a total of 4,226 COVID-19 cases in the United States had been reported to CDC, with multiple cases reported among older adults living in long-term care facilities (4). Overall, 31% of cases, 45% of hospitalizations, 53% of ICU admissions, and 80% of deaths associated with COVID-19 were among adults aged ≥65 years with the highest percentage of severe outcomes among persons aged ≥85 years. In contrast, no ICU admissions or deaths were reported among persons aged ≤19 years. Similar to reports from other countries, this finding suggests that the risk for serious disease and death from COVID-19 is higher in older age groups.

Data from cases reported from 49 states, the District of Columbia, and three U.S. territories (5) to CDC during February 12–March 16 were analyzed. Cases among persons repatriated to the United States from Wuhan, China and from Japan (including patients repatriated from cruise ships) were excluded. States and jurisdictions voluntarily reported data on laboratory-confirmed cases of COVID-19 using previously developed data collection forms (6). The cases described in this report include both COVID-19 cases confirmed by state or local public health laboratories as well as those with a positive test at the state or local public health laboratories and confirmation at CDC. No data on serious underlying health conditions were available. Data on these cases are preliminary and are missing for some key characteristics of interest, including hospitalization status (1,514), ICU admission (2,253), death (2,001), and age (386). Because of these missing data, the percentages of hospitalizations, ICU admissions, and deaths (case-fatality percentages) were estimated as a range. The lower bound of these percentages was estimated by using all cases within each age group as denominators. The corresponding upper bound of these percentages was estimated by using only cases with known information on each outcome as denominators.

As of March 16, a total of 4,226 COVID-19 cases had been reported in the United States, with reports increasing to 500 or more cases per day beginning March 14 (Figure 1). Among 2,449 patients with known age, 6% were aged ≥85, 25% were aged 65–84 years, 18% each were aged 55–64 years and 45–54 years, and 29% were aged 20–44 years (Figure 2). Only 5% of cases occurred in persons aged 0–19 years.

Among 508 (12%) patients known to have been hospitalized, 9% were aged ≥85 years, 26% were aged 65–84 years, 17% were aged 55–64 years, 18% were 45–54 years, and 20% were aged 20–44 years. Less than 1% of hospitalizations were among persons aged ≤19 years (Figure 2). The percentage of persons hospitalized increased with age, from 2%–3% among persons aged ≤9 years, to ≥31% among adults aged ≥85 years. (Table).

Among 121 patients known to have been admitted to an ICU, 7% of cases were reported among adults ≥85 years, 46% among adults aged 65–84 years, 36% among adults aged 45–64 years, and 12% among adults aged 20–44 years (Figure 2). No ICU admissions were reported among persons aged ≤19 years. Percentages of ICU admissions were lowest among adults aged 20–44 years (2%–4%) and highest among adults aged 75–84 years (11%–31%) (Table).

Among 44 cases with known outcome, 15 (34%) deaths were reported among adults aged ≥85 years, 20 (46%) among adults aged 65–84 years, and nine (20%) among adults aged 20–64 years. Case-fatality percentages increased with increasing age, from no deaths reported among persons aged ≤19 years to highest percentages (10%–27%) among adults aged ≥85 years (Table) (Figure 2).

Since February 12, 4,226 COVID-19 cases were reported in the United States; 31% of cases, 45% of hospitalizations, 53% of ICU admissions, and 80% of deaths occurred among adults aged ≥65 years with the highest percentage of severe outcomes among persons aged ≥85 years. These findings are similar to data from China, which indicated >80% of deaths occurred among persons aged ≥60 years (3). These preliminary data also demonstrate that severe illness leading to hospitalization, including ICU admission and death, can occur in adults of any age with COVID-19. In contrast, persons aged ≤19 years appear to have milder COVID-19 illness, with almost no hospitalizations or deaths reported to date in the United States in this age group. Given the spread of COVID-19 in many U.S. communities, CDC continues to update current recommendations and develop new resources and guidance, including for adults aged ≥65 years as well as those involved in their care (7,8).

Approximately 49 million U.S. persons are aged ≥65 years (9), and many of these adults, who are at risk for severe COVID-19–associated illness, might depend on services and support to maintain their health and independence. To prepare for potential COVID-19 illness among persons at high risk, family members and caregivers of older adults should know what medications they are taking and ensure that food and required medical supplies are available. Long-term care facilities should be particularly vigilant to prevent the introduction and spread of COVID-19 (10). In addition, clinicians who care for adults should be aware that COVID-19 can result in severe disease among persons of all ages. Persons with suspected or confirmed COVID-19 should monitor their symptoms and call their provider for guidance if symptoms worsen or seek emergency care for persistent severe symptoms. Additional guidance is available for health care providers on CDC’s website (https://www.cdc.gov/coronavirus/2019...hcp/index.html).

This report describes the current epidemiology of COVID-19 in the United States, using preliminary data. The findings in this report are subject to at least five limitations. First, data were missing for key variables of interest. Data on age and outcomes, including hospitalization, ICU admission, and death, were missing for 9%–53% of cases, which likely resulted in an underestimation of these outcomes. Second, further time for follow-up is needed to ascertain outcomes among active cases. Third, the initial approach to testing was to identify patients among those with travel histories or persons with more severe disease, and these data might overestimate the prevalence of severe disease. Fourth, data on other risk factors, including serious underlying health conditions that could increase risk for complications and severe illness, were unavailable at the time of this analysis. Finally, limited testing to date underscores the importance of ongoing surveillance of COVID-19 cases. Additional investigation will increase the understanding about persons who are at risk for severe illness and death from COVID-19 and inform clinical guidance and community-based mitigation measures.*

The risk for serious disease and death in COVID-19 cases among persons in the United States increases with age. Social distancing is recommended for all ages to slow the spread of the virus, protect the health care system, and help protect vulnerable older adults. Further, older adults should maintain adequate supplies of nonperishable foods and at least a 30-day supply of necessary medications, take precautions to keep space between themselves and others, stay away from those who are sick, avoid crowds as much as possible, avoid cruise travel and nonessential air travel, and stay home as much as possible to further reduce the risk of being exposed (7). Persons of all ages and communities can take actions to help slow the spread of COVID-19 and protect older adults.†

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Acknowledgments
State and local health departments; clinical staff members caring for patients.

CDC COVID-19 Response Team
Stephanie Bialek, CDC; Ellen Boundy, CDC; Virginia Bowen, CDC; Nancy Chow, CDC; Amanda Cohn, CDC; Nicole Dowling, CDC; Sascha Ellington, CDC; Ryan Gierke, CDC; Aron Hall, CDC; Jessica MacNeil, CDC; Priti Patel, CDC; Georgina Peacock, CDC; Tamara Pilishvili, CDC; Hilda Razzaghi, CDC; Nia Reed, CDC; Matthew Ritchey, CDC; Erin Sauber-Schatz, CDC.

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Corresponding author: Hilda Razzaghi for the CDC COVID-19 Response Team, HRazzaghi@cdc.gov, 770-488-6518.

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All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

[Montanan]

Annapolis closes vessel pump out stations until at least the end of State of Emergency

Some marinas have been shut down as to social distancing lockdown as non-essential travel or activity with closure of offices.

Then there is the issue of hazards of SARS-CoV-2 transmission in sewage hence one will likely see closures of pump out stations which of course pretty much minimizes time on board until the State of Emergency is ended or until that marina staff can be vaccinated. By way of example:

Harbormaster
City Harbormaster to Suspend Pump-Out Services
During State of Emergency
ANNAPOLIS, MD (March 18, 2020) – City of Annapolis Harbormaster Beth Bellis, in consultation with Annapolis Fire Department and the Maryland Department of Natural Resources, has decided to suspend pump-out service to boaters after Saturday.

The last pump-outs will occur on Saturday, March 21, 2020. The closure will continue through the City’s declared State of Emergency for COVID-19.

Schedule a pump-out by contacting VHF 17 or calling 410-263-7973.

It is illegal to discharge untreated waste effluent into Annapolis city waters. Below is a list of local marinas with pump-outs. Please contact them for self-service availability and hours.

Bellis said, “we are making the decision to suspend pump-out operations in the interests of staff safety and public health.”

According to the Centers for Disease Control, it is currently unclear if novel coronavirus COVID-19 can be transmitted through sewerage systems. SARS, a similar coronavirus, has been detected in untreated sewage for up to 2 to 14 days.

This is why one should always lower the lid on your toilet before flushing as the aerosol particulates are tossed 3 to 5 feet every time one flushes. And why one should clean the toilet seats and lids frequently.

[Montanan]

Originally Posted by chrisr

a question ; is anybody aware of ANYBODY, ANYWHERE in the world, dying of corvin19 who was not already in a high risk group ie with impaired immune system, co-morbidity, chronic illnesses etc etc

i believe the answer is NO, however will be happy to be corrected

cheers,

Yes, COVID-19 can be serious for younger adults, too, CDC report shows
Ryan W. Miller, USA TODAY
USA TODAYMarch 19, 2020, 12:05 PM MD

It's not just adults 65 and older. Americans of all ages have faced serious health complications amid the new coronavirus outbreak, a federal health report says.

New data from the Centers for Disease Control and Prevention show that among the roughly 12% of COVID-19 cases in the U.S. known to need hospitalizations, about 1 in 5 were among people ages 20 to 44.

The CDC report released Wednesday tracked the health outcomes from February 12 to March 16 for the 2,449 COVID-19 patients in the U.S. whose ages were known.

Health officials have warned that older adults and people with underlying medical conditions face a higher risk of complications due to COVID-19, the disease caused by the new coronavirus.

The data still indicates older Americans face a higher risk of hospitalization, admission to an intensive care unit or even death.

What does the coronavirus do to your body? Everything to know about the infection process

However, that doesn't mean younger Americans will not face serious health outcomes, either, the report shows.

Anywhere from 14% to 21% of adults ages 20 to 44 with COVID-19 have been hospitalized, the CDC data estimates. Two to 4% of cases led to ICU admissions, and less than 1% were fatal.

"This virus is impacting the entire population, and it's something the entire population should be responding to," Dr. Wayne Tsuang, a pulmonary and critical care physician at the Cleveland Clinic told USA TODAY.

The data set the CDC used is limited and does not account for underlying medical conditions. Many more young adults could have COVID-19 with mild symptoms not requiring hospitalization and without their cases being tracked by public health officials.

Underlying conditions: Why people with diabetes, like Tom Hanks, may be at increased risk of coronavirus

Tsuang said more data collection is needed to better understand the risks younger people face. The data may overestimate the prevalence of severe disease, the report says, because testing has skewed toward those with travel histories or more serious symptoms.

Still, a hospitalization can have long-term effects on young people. Those hospitalized with COVID-19 will likely be isolated for many days and away from school or work, Tsuang said, not to mention the serious symptoms they're facing that caused their hospitalization.

"It takes a while for a patient to fully recover after a hospitalization," he said. "A hospitalization for this virus is very impactful, particularly for a young person."

The CDC report also underscores a warning from Dr. Deborah Birx, the White House’s coronavirus response coordinator.

"There are concerning reports coming out of France and Italy about some young people getting seriously ill, and very seriously ill in the ICUs," Birx said a news conference Wednesday.

Coronavirus Q&A: We've been flooded with thousands of reader questions on coronavirus. We're answering them.

Birx said younger adults taking fewer precautions may have gotten sick as they saw early reports from China and South Korea showing mostly older people and those with underlying conditions affected.

"(Within) the millennial generation ... there may be a disproportional number of infections among that group. And so even if it's a rare occurrence, it may be seen more frequently in that group and be evident now," she added.

Of the 2,449 cases the report analyzed, 508 have resulted in hospitalizations, including 121 patients known to have been admitted to an intensive care unit.

Cases of ICU admission remained low among younger people. Those ages 20 to 44 made up only 12% of ICU cases. There were no ICU cases among people under 19.

Deaths were also low for younger people. Only nine of the 44 known deaths in the report were among those between ages 20 and 64, and no one under 19 was known to have died.

The report also highlighted the serious risks older Americans face. Between 10% and 27% of cases among people over 85 were fatal. People ages 75 to 84 saw up to 31% of cases leading to ICU admissions and up to 11% of cases being fatal. Similarly, for people between ages 65 and 74, up to 19% of cases led to ICU admissions and up to 5% were fatal.

Public health officials have stressed for younger people to better practice social distancing by staying away from large gatherings and staying home if they feel sick.

'If I get corona, I get corona': Coronavirus pandemic doesn't slow spring breakers' party

Preliminary research has suggested that those with the virus can infect others before becoming symptomatic, posing a particular risk for older Americans who interact with young people who may feel no symptoms.

Photos on social media have shown spring breakers in Florida still partying on beaches or young adults out at bars and restaurants.

"We cannot have these large gatherings that continue to occur throughout the country for people who are off work, to then be socializing in large groups and spreading the virus," Birx said Wednesday. "You have the potential then to spread it to someone who does have a condition that none of us knew about and cause them to have a disastrous outcome."

[dannc]

I don't remember this being posted but the EU has shut it's borders,

EU leaders on Tuesday suspended all travel into the passport-free Schengen zone by non-EU nationals for at least 30 days in an attempt to instil uniformity across the bloc after some member states, including Austria, Hungary, the Czech Republic and Poland, unilaterally began imposing border checks.

https://www.theguardian.com/world/20...ks-down-macron

We had a trip scheduled to NL to see a boat yard, but the boat yard closed down, and even if they had not closed, there is no way for us to get in now. And I would expect the 30 day shutdown to be extended.

Later,
Dan

[Montanan]

New Zealand
Starting the night of March 19, New Zealand will ban any foreign citizens from entering the country, Prime Minister Jacinda Ardern announced in a news conference on Wednesday.
The travel ban will now apply to those coming from the Pacific Islands, who had previously been exempt from restrictions.
It will also close off travel between New Zealand and Australia for the majority of citizens in the two countries, who are typically able to travel back and forth without a visa.
"A small number of exemptions to the new measures can be sought for humanitarian reasons, essential health workers and citizens of Samoa and Tonga who need to travel to New Zealand for essential reasons," Ardern said.
New Zealanders' partners, legal guardians or any dependent children traveling with them may also return.

[Montanan]

Australia
From 9 p.m. on March 20, Australia will no longer allow entry to non-Australian citizens or residents, unless they are direct family members of Australians, Prime Minister Scott Morrison announced on Wednesday.
He added that people with travel plans to Australia should use these next 24 hours to make alternative arrangements.
Australians overseas can still return to the country, but will be subject to a 14-day isolation upon arrival.
On March 18, Morrison declared a "human biosecurity emergency" and announced new restrictions, including an upgraded travel advice to Level 4 -- meaning "do not travel."
He added that this travel restriction is because the biggest risk comes from imported cases -- "Australians returning from overseas."

[Mariano]

Originally Posted by chrisr

a question ; is anybody aware of ANYBODY, ANYWHERE in the world, dying of corvin19 who was not already in a high risk group ie with impaired immune system, co-morbidity, chronic illnesses etc etc

i believe the answer is NO, however will be happy to be corrected

cheers,

Spain reported the death of a 32 year old police officer with no other illnes after 4 days of first fever. He was an avid sportman. You can also see a viral video on YOUTUBE from a guy of 31, also from Spain, now with neumonia in both lungs. Sports guy too

[El Pinguino]

Originally Posted by Montanan

Australia
From 9 p.m. on March 20, Australia will no longer allow entry to non-Australian citizens or residents, unless they are direct family members of Australians, Prime Minister Scott Morrison announced on Wednesday.
He added that people with travel plans to Australia should use these next 24 hours to make alternative arrangements.
Australians overseas can still return to the country, but will be subject to a 14-day isolation upon arrival.
On March 18, Morrison declared a "human biosecurity emergency" and announced new restrictions, including an upgraded travel advice to Level 4 -- meaning "do not travel."
He added that this travel restriction is because the biggest risk comes from imported cases -- "Australians returning from overseas."

NSS!!
And self imposed isolation just is not working.. being that you are meant to isolate from your family... not just stay at home.

NZ case in point... friend in NZ works at a medical clinic in Auckland... patient turns up yesterday... asked the questions...
Yes her husband had just come back from the US a few days ago, yes she had picked him up at the airport, yes she had given him a hug and a kiss - probably got into a bit of horizontal folk dancing as well but I don't think that question was asked..
Was a bit miffed when told to foxtrot oscar...

Anyone arriving should be placed in proper quarantine.. plenty of cruise liners available... don't fill em right up... maybe 10%... pay off all crew except caterers and cleaners... and enough plumbers to keep the lights on.

[Montanan]

Originally Posted by El Pinguino

NSS!!

NSS ?????

Say what? Sorry this Montanan doesn't know what NSS means.

[belizesailor]

Panama: international borders to close in both directions Sunday midnight. This includes airline flights in or out.

[El Pinguino]

Originally Posted by Montanan

NSS ?????

Say what? Sorry this Montanan doesn't know what NSS means.

Not addressed at you... addressed at Morrison..No s*** Sherlock!

[rbk]

Originally Posted by Montanan

NSS ?????

Say what? Sorry this Montanan doesn't know what NSS means.

I would wager ‘No Sht Sherlock’

[delmarrey]

There is word now of potential looting stating to happen in the Philippines but it will probably get taken care of by the PNP very quickly. Duterte is pretty strong on law & order.

[belizesailor]

Originally Posted by delmarrey

There is word now of potential looting stating to happen in the Philippines but it will probably get taken care of by the PNP very quickly. Duterte is pretty strong on law & order.

Yep, people run out of money & food then things will turn ugly. I expect we will see a lot of that world wide soon.

Thats one of my concerns here in Panama too.

[Pelagic]

MANILA, Philippines – The Philippine National Police (PNP) refuted reports spreading on social media and messaging apps that people are already looting amid the*Luzon-wide lockdownwhich is in place to contain the*novel coronavirus.
In a press briefing on Friday, March 20, PNP chief General Archie Gamboa said stories about the poor getting desperate and resorting to crime are "fake news."

To combat disinformation amid the pandemic, Gamboa has directed the PNP Criminal Investigation and Detection Group and the PNP Cybercrime Division to track down those who have posted the supposedly misleading stories.
"Maghintay kayo at pupuntahan kayo ng pulis at aarestuhin kayo*(Just wait and the police will track you down and arrest you)," Gamboa said.
Stories on alleged looting and the poor "plotting" to rob grocery stores have gone viral online, yet accounts are, so far, said to be secondhand information or speculation.*– Rappler.com