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Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) – United States, February 12-March 16, 2020

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On March 18, 2020, this report was posted online as an MMWR Early Release.

Summary

What is already known about this topic?

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.

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, start highlight36%end highlight 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 start highlight≤19end highlight 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).

Discussion

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-nCoV/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.

Source: https://tools.cdc.gov/api/embed/downloader/download.asp?m=403372&c=405308

Covid19

Israeli Health Officials To Government: Vaccinate All Palestinians

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Palestinian elementary school students wearing protective face masks take their seats in their classroom amid the coronavirus pandemic on the first day of class in September at a United Nations-run school in the West Bank city of Ramallah.

An outgoing high official told NPR that Israel has a public health imperative to protect all Palestinians from COVID-19, plus a humanitarian obligation.

(Image credit: Majdi Mohammed/AP)

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Source: https://www.npr.org/2021/03/01/972573521/israeli-health-officials-to-government-vaccinate-all-palestinians

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Covid19

Israel’s Supreme Court Ends Spy Agency Cellphone Tracking Of COVID-19 Infections

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A man speaks on his mobile phone in the Mahane Yehuda market in Jerusalem in December. In the early days of the pandemic, Israel began using a mass surveillance tool on its own people, tracking civilians

About a year ago the country’s domestic intelligence agency began monitoring Israelis’ movements through cellular phone location data, leading critics to say it was spying on its own citizens.

(Image credit: Maya Alleruzzo/AP)

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Source: https://www.npr.org/sections/coronavirus-live-updates/2021/03/01/972560038/israels-supreme-court-ends-spy-agency-cellphone-tracking-of-covid-19-infections

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Covid19

Johnson & Johnson Vaccine Rollout Begins In U.S. As COVID-19 Cases Tick Up

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The first box of Johnson & Johnson

Johnson & Johnson has started shipping its first vaccine doses across the U.S., adding a third vaccine to the country’s arsenal as public health officials warn of an uptick in cases.

(Image credit: Timothy D. Easley/Getty Images)

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Source: https://www.npr.org/sections/coronavirus-live-updates/2021/03/01/972538146/johnson-johnson-vaccine-rollout-begins-in-u-s-as-covid-19-cases-tick-up

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AR/VR

Remote Assistance: How Augmented Reality is Helping Businesses During the Pandemic

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In recent years, the way businesses operate and how consumers buy and consume has faced many changes. The current reality has made thousands of offices unnecessary by replacing them with work from home, at the same time the development of the so-called work remotely has undergone drastic development. Of course, when embracing remote work there are many tools and technologies that have made it easier to adopt in this new reality.

As is a quite evident day by day, the current market environment forces businesses to continue to find and use innovative solutions to cope with these difficult conditions. Now, more than ever, Remote Assistance and Augmented Reality /AR are the key to business continuity and are playing an important role in fostering future business growth. Given that the transformation that has taken place has centered on technology, then many businesses have also focused on AR technology as a way to increase productivity and create an interconnected interaction between the workforce.

Already accepting AR technology many businesses have at their disposal many tools and platforms to continue remote service operations. We can mention here VSight Remote, which despite the impact the pandemic has had, continues to provide sustainable solutions by turning remote assistance into an essential tool for avoiding operational outages on the ground.

The following points highlight how businesses can use AR Remote Assistance to continue operations, not only during the COVID-19 pandemic but also further, considering the positive and long-term impact that this technology makes possible.

Trending AR VR Articles:

1. Ways to Get Your Business into VR

2. How Augmented and Virtual Reality (AR/VR) can transform Education

3. 2021 — the year of AR glasses?

4. How Augmented Reality and Virtual Reality are Revolutionizing Healthcare

1. An unexpected problem requires an immediate solution.

Many businesses not only produce and sell but at the same time have to maintain specialized equipment belonging to the industrial sector where they operate. As the distribution of workforce varies in locations around the world, there is a need to reduce site visits — including pre-installation visits. To reduce reliance on site visits, businesses through AR Remote Assistance enable the headquarter workforce to interact at a distance with site workers and improve efficiency by being able to solve problems encountered quickly — without the need to make a trip towards the location of the problem. In this way businesses do not waste time but continue to work normally, finding the right solutions thanks to Remote Assistance.

2. Distribution of knowledge at a distance but with the same efficiency.

Another goal that businesses aim to keep in check at all times is the quality of service they provide. Not only in the expert-site worker connection but also in the one between the expert and the customers, it is important that the distance support is provided at the right time and in high quality. Now through Remote Assistance site workers especially gain from the extraordinary benefits by receiving the guidance of headquarter experts who make it possible to disseminate knowledge in real-time. Businesses using Remote Assistance make it possible for their experienced experts to be anywhere, right away. This means a greater engagement on the part of site workers. In addition, integrating remote assistance into their wearable devices, such as smart glasses facilitate the freedom of action during the performance of various tasks. Remote Assistance solution is seen as a valuable way not only for knowledge transfer but also for faster and more efficient employee training.

3. Fast cooperation worldwide.

The Remote Assistance solution offers ease of use by connecting the workforce worldwide. As mentioned above, site employees can now take advantage of the opportunity to successfully perform their tasks hands-free. Experts can now interact in real-time with site workers and at the same time interact in the same documents or images, using AR annotations and even adding 3D models to the live video streaming environment. With the help of remote collaboration, the time to perform all these operations is faster and does not require numerous manuals that are often quite distracting.

4. Create long-term and efficient solutions for the future of the business.

Successfully adopting AR-based Remote Assistance is a step towards ensuring business continuity not only during this global pandemic. The wide potential of this Remote Assistance is quite favorable to be used further by businesses for a longer period. All of this may be feasible given the fact that this technology makes it possible for businesses to reap the benefits that are quite valuable. Some of these benefits, as touched on above, are to facilitate remote maintenance inspections, improve remote collaboration, reduce the number of technicians deployed on the site, and facilitate the way the workforce performs its tasks.

Businesses that have adopted Remote Assistance and Augmented Reality prove how they can benefit from them by facilitating the operating processes between the trio of actors expert-technician and customer. This AR Remote Assistance has long-term benefits that enable significant business growth and the need to ensure business continuity is seen as a much-needed reason to start utilizing it.

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Remote Assistance: How Augmented Reality is Helping Businesses During the Pandemic was originally published in AR/VR Journey: Augmented & Virtual Reality Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.

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Source: https://arvrjourney.com/remote-assistance-how-augmented-reality-is-helping-businesses-during-the-pandemic-88cdf610a77f?source=rss—-d01820283d6d—4

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