TÓM TẮT BLOG VỀ COVID NGÀY 14, THÁNG 8, 2020
/Ngày 14 tháng 8 năm 2020
Bác sĩ Tùng Nguyễn
Giáo sư Y khoa, Đại học California San Francisco (UCSF)
Chủ tịch, PIVOT - Hội Người Mỹ Gốc Việt Cấp Tiến
· Hiện đã có 21 triệu ca bị nhiễm Covid-19 và gần 750 ngàn người chết trên toàn thế giới.
· Theo một nghiên cứu của CDC – Trung Tâm Kiểm Soát Bệnh Dịch – trong tháng sáu, 40% của những người trả lời cuộc thăm dò cho biết họ có vấn đề về tinh thần, trong đó 11% đã nghĩ đến tự tử trong vòng 30 ngày trước đó. Những nhóm báo cáo họ có tỉ lệ bệnh tinh thần cao hơn trung bình: người Da đen, người gốc Châu Mỹ La-tinh, những người chưa học hết bậc trung học, những nhân viên trong những ngành dịch vụ cần thiết, những người chăm sóc người khác không lương.
· Số người Mỹ sẽ có khả năng mất nhà cửa có thể cao đến mức 30 triệu.
· Số trẻ em bị nhiễm bệnh dịch đang tăng. Dữ kiện khoa học chứng minh lời phát biểu của Trump rằng trẻ em “hầu như không nhiễm dịch” Covid-19 là hoàn toàn sai.
· Lời phát biểu của Trump rằng hydroxychloroquine hữu hiệu cũng đi ngược với các khám phá khoa học.
· Lời phát biểu của Trump rằng khẩu trang không hữu hiệu về ngăn chặn bệnh dịch là sai, theo các khám phá khoa học.
· Covid-19 như một sao băng dội vào trái đất và ngoài sự tàn phá trực tiếp, các đợt sóng sốc của nó còn gây ảnh hưởng trong mọi lãnh vực y tế.
Chúng tôi kêu gọi mọi người Mỹ hãy làm những điều cần làm. Nhân danh sức khỏe cộng đồng, chúng tôi kêu gọi những ai không giữ khoảng cách với người khác và không mang khẩu trang hãy thay đổi. Là bác sĩ và chuyên gia về y tế cộng đồng, tôi biết rằng luôn luôn có những người hành động gây hại đến chính họ và người khác. Nhiệm vụ của các người phục vụ y tế, các hệ thống y tế và chính quyền là bảo vệ để họ không bị hại bởi chính họ và để mọi người chúng ta không bị họ làm hại. Thí dụ như luật bắt buộc bạn phải đeo giây lưng an toàn khi lái xe và cấm hút thuốc lá tại không gian công cộng. Chúng ta cần có những nhà lãnh đạo hành động đúng bằng cách thi hành những chính sách dựa trên khoa học để ngăn ngừa bệnh dịch lây lan hơn nữa.
COVID Blog August 14, 2020
As of August 13, 2020, there are nearly 21 million people who had COVID-19 and nearly 750,000 deaths worldwide. In the US, there are nearly 5.3 million infections and more than 167,000 deaths. In the first 14 weeks of the pandemic, when we thought things were going badly, there were 2 million infections. In the last 8 weeks, we have an additional 3.3 million infections. California, Florida, and Texas all passed the 500,000 cases threshold already.
The only bit of optimism is that the trend in the number of new cases have been decreasing in a quite a few states. To balance that optimism though, as we would expect that deaths would lag behind new cases, the trend line for the last 2 weeks shows an 11.6% increase in deaths nationally.
A report just came out today from the CDC looking at the 79 counties in the US identified as “hotspots” for the pandemic in the first 2 weeks of June . There were actually 205 counties in 33 states accounting for 93 million Americans that were hotspots. Unfortunately only 79 counties or 39% had adequate race data, which in itself is an indictment of our government, public health, and healthcare system. 76 of those counties had racial/ethnic disparities, with 59 reporting Latinx disparities, 22 Black disparities, 19 had Pacific Islander disparities, 4 Asian disparities, and 3 indigenous disparities.
A report just came out from the CDC this week regarding mental health issues during the COVID pandemic. During June, 40% of the respondents in this survey reported mental health issues, including 11% who had considered suicide in the last 30 days. For comparison purposes, the usual rate of having suicidal thoughts in the US in the last 12 months is about 4%.
Young adults in particularly had much higher rates than older adults, with 75% of those age 18-24 reporting mental health issues and a staggering 25% reporting having thoughts about suicide in the preceding 30 days.
No surprise, Black and Latinx reported higher rates of mental distress compared to whites, with twice as many in those groups reporting suicidal thoughts compared to whites.
Almost 1 out of 3 Americans who had less than a high school education reported suicidal thoughts. And 22% of essential workers did, although mental health distress was not significantly worse among them compared to other workers.
However, a major new finding from this study was that unpaid caregivers had a suicidal thought rate of 30%, and they were 3x more likely to have suicidal thoughts or start using substances to cope compared to those who are not unpaid caregivers. From a disparities perspective, what this says is that not only are racial/ethnic minority people dying more from COVID, their family caregivers are suffering more as well.
As distressing as this study on mental distress is, I think it is going to get worse. There are reports that up to 30 million more Americans will become housing insecure due to the economic impact of the epidemic. I am viewing the COVID19 pandemic as being more than about a single disease caused by a single virus. We are witnessing the beginning of associated epidemics of mental illness, bad outcomes in many other diseases, and a terrible change in the social determinants of health such as income, employment, and housing. The metaphor I’m using is that COVID19 is a meteor dropped on the earth and in addition to the direct destruction, we are also seeing the ripples of shock waves in all health.
There’s been some back and forth about children and COVID, an important topic as we consider what to do with schools. The number of infections among children have been rising. As of July 30, there were nearly 340,000 children who had COVID, for an infection rate of about 447 per 100,000. A third of those cases were reported in the last 2 weeks of July. The states with the worse infection rate among children was Arizona, with 1098 cases per 100,000, South Carolina with 959, Louisiana with 859, Mississippi with 797, Florida with 711 cases per 100,000. The American Academy of Pediatrics has issued a recommendation that children age 2 and older should wear face covering when they cannot socially distanced.
Children who get COVID do not get as sick as adults, who are about 20 times more likely to be hospitalized compared to children. But children do get hospitalized, at a rate of about 8 out 100,000, and when they do, about 1/3 end up in the ICU, just like adults. Racial/ethnic disparities for adults with COVID has been shown for kids as well. Compared to white infected children, the rate for hospitalization for Black infected children was 5 times and for Latinx children was 8 times.
Which leads me to the last portion of my update. One function of science is to guide policy decisions. And it wouldn’t do for me to ignore policy decisions that are contrary to science. So here is my update on our leadership’s policies, through the lens of science.
The children data directly contradicts President Trump’s statement that kids are “virtually immune” to COVID.
If you have been attending the prior briefings I have held, President Trump’s statement about the efficacy of hydroxychloroquine is contrary to the scientific findings.
President Trump’s statements about masks not being helpful in preventing COVID 19 infections is wrong, based on the scientific findings.
We ask every American to do the right thing. We rightly call out those who do not maintain social distancing or do not wear masks. But as a doctor and a public health practitioner, I know that there are always individuals who do not do what is good for themselves or for others. The job of healthcare providers, public health systems, and governments is to protect them from themselves and protect us from them. Examples include wearing seatbelts and prohibition on cigarette smoking in public spaces. We need leaders who will do the right thing by implementing scientifically proven policies to prevent further spread of the pandemic.