Ahead of the Halloween and Thanksgiving holidays, California Health and Human Services Secretary Dr. Mark Ghaly addressed new guidelines the state released this week allowing private outdoor gatherings with friends if specific conditions are met.
Ghaly said attendees must be from no more than three separate households and gatherings should last no more than two hours.
ASH Releases Clinical Practice Guidelines on the Use of Preventive Anticoagulation in Patients with COVID-19
WASHINGTON, Oct. 8, 2020
Evidence-based recommendations will inform prevention of COVID-related blood clotting
WASHINGTON, Oct. 8, 2020 /PRNewswire/ — Today, ASH released new guidelines to help clinicians prevent serious blood clotting complications affecting COVID-19 patients. The recommendations suggest that clinicians should use a standard prophylactic anticoagulant dose over higher doses to prevent clotting in patients who have been hospitalized with COVID-19, including those in intensive care.
Abnormal blood clotting has been reported as a complication associated with increased risk of death in patients with COVID-19, particularly hospitalized patients. The guidelines address both critically ill hospitalized patients – people who are ill enough to require intensive care – and acutely ill hospitalized patients – people who require monitoring and treatment in the hospital but not intensive care. It is common for clinicians to administer anticoagulants to these patients upon admission to try to prevent formation of blood clots; however, there is uncertainty regarding the right dose to give. For both acutely and critically ill patients, the guidelines suggest the use of a standard prophylactic dose of anticoagulation upon admission to the hospital. The use of higher doses of anticoagulants is not recommended, as it may pose greater risk for serious bleeding that outweighs potential benefits. However, the guideline panel highlighted the importance of individualized decision-making and acknowledged that a higher dose of anticoagulants may be appropriate in patients judged to be at especially high clotting risk and low bleeding risk.
“COVID-19 is the most important public health problem of our lifetime, with more than one million deaths worldwide. Data suggest that abnormal blood clotting plays an important role in why patients die or get very sick from this disease. Thus, it is important that these patients be given anticoagulants to try to prevent clots, and data available right now suggest that standard dosing provides the best balance of benefits and risks,” said ASH President Stephanie Lee, MD, of Fred Hutchinson Cancer Research Center. “Equipping clinicians with evidence-based guidelines that focus on the prevention of clotting has the potential to save lives.”
In June 2020, ASH formed a multidisciplinary, internationally representative panel to develop the guidelines. The panel was chaired by Drs. Adam Cuker, of the University of Pennsylvania; Holger Schunemann, of McMaster University; and Reem Mustafa, of University of Kansas Medical Center. The panel urgently examined all available evidence, including early reports from observational studies. Development of these guidelines, including systematic evidence review, was supported by the McMaster University GRADE Centre, a world leader in guideline development. At this time, the best available evidence is very low quality, and the recommendations are framed with conditions, explanations, and a call for more research. The systematic reviews and recommendations will continue to be maintained and updated, especially as better evidence from randomized clinical trials becomes available.
The Food and Drug Administration released updated, stricter guidelines on Tuesday for coronavirus vaccine developers — a step that was blocked for two weeks by top White House officials. The guidelines make it highly unlikely that a vaccine could be authorized by Election Day.
The move, which was cleared by the Office of Management and Budget, appeared to be an abrupt reversal a day after The New York Times reported that White House officials, including Mark Meadows, the chief of staff, were blocking the guidelines.
The new recommendations, which do not carry the force of law, call for gathering comprehensivesafety data in the final stage of clinical trials before an emergency authorization can be granted.
On Tuesday evening, President Trump showed his displeasure at the action of his own White House, and charged that the new guidelines were a conspiracy against his reelection prospects.
“New F.D.A. Rules make it more difficult for them to speed up vaccines for approval before Election Day. Just another political hit job!” he tweeted, tagging Dr. Stephen M. Hahn, the F.D.A. commissioner.
Since the start of the coronavirus pandemic, the F.D.A. has said that it has been seeking ways to accelerate the development of vaccines without sacrificing safety. In June, the agency released an initial set of guidelines to give vaccine developers a better idea of how the F.D.A. would decide if a vaccine were acceptable, either for an emergency use authorization or for a full license.
Four vaccines have reached the final stage of testing, known as a Phase 3 trial, in the United States. A fifth is expected to start this month. President Trump has repeatedly suggested that a vaccine would be ready by Election Day, if not before.
But with public confidence declining in opinion polls about what could be a rushed coronavirus vaccine, the F.D.A. submitted a new set of guidelines to the White House for approval on Sept. 21.
Among the recommendations, the agency advised vaccine makers to follow volunteers for a median of two months after the final dose. The F.D.A. also expected vaccine makers to document five cases of severe infection in people who received the placebo instead of the vaccine.
The F.D.A. submitted the guidelines to the Office of Management and Budget for approval more than two weeks ago, but they stalled in part because of Mr. Meadows’s involvement, according to a senior administration official and others familiar with the situation.
The White House objected that the guidelines would add more time before a vaccine could be authorized. In a conversation with Dr. Hahn days after the guidelines were submitted, Mr. Meadows said the recommendations amounted to changing the rules on drugmakers in the throes of clinical trials, according to one senior administration official. He also suggested that Dr. Hahn was overly influenced by career scientists, who had drafted the document, the official said.
Trump administration officials have the authority to intervene with such nonbinding documents, partly because of a 2019 executive order that tightened
On Saturday, President Trump released a four-minute video from Walter Reed National Military Medical Center in Bethesda, Md., where he is receiving inpatient care for the coronavirus, to say that he is “starting to feel good.”
Wearing a blue jacket, cuff links and an American flag pin but no necktie, the president looked much paler than he did during his debate in Cleveland on Tuesday with former Vice President Joseph R. Biden Jr. Thanking the staff at Walter Reed, Trump said that he “wasn’t feeling so well” when he arrived at the hospital on Friday, but that he felt “much better now.”
He congratulated himself for his job performance and said, “I think I’ll be back soon.”
The video, released Saturday evening, contrasted with what Mark Meadows, the president’s chief of staff, had told reporters earlier in the day outside the hospital. “The president’s vitals over the last 24 hours were very concerning,” Mr. Meadows said. “And the next 48 hours will be critical in terms of his care.”
For a president who often serves as his own spokesman, the video’s release may have been a way to reclaim the narrative from doctors who have offered conflicting reports of the president’s health, and from statements made by his own White House staff.
According to people close to the president, he was furious about Mr. Meadows’s comments. With only a month remaining until the Nov. 3 election, there is precious little time to recast the president’s current health problems in a positive light before the nation decides whether to give him a second term in office. Mr. Trump has canceled previously scheduled public appearances, and it is unclear whether he will be able to rejoin the campaign trail.
No matter the tone of the video, the public has been left without a clear picture of the president’s health. Military doctors on Saturday morning offered a rosy picture of the president’s medical condition at a televised news conference outside Walter Reed. Afterward, Mr. Meadows told reporters that the president’s health was more worrisome, though he asked that that assessment not be attributed to him by name.
Soon, however, it became clear that Mr. Meadows was the source of the information once a video posted online captured him approaching the pool reporters outside Walter Reed after the doctors’ televised briefing and asking to speak off the record.
Mr. Meadows later tried to walk back his comments. “The president is doing very well,” he told Reuters. “He is up and about and asking for documents to review.” He called into Fox News on Saturday night, knowing the president was most likely watching, and praised his “unbelievable courage” and “unbelievable improvement.” But he also confirmed that Mr. Trump’s condition on Friday was worse than originally described. “Yesterday morning we were real concerned with
SANTA CRUZ COUNTY, CA — Haunted houses, large parties and indoor mazes should be a no-go in the era of the coronavirus, Santa Cruz County officials announced Monday.
And even if your Halloween costume comes with a mask, you should still wear a face mask, officials said in a news release jointly issued by Bay Area health officers. Maybe this year is the one to focus on decorations and virtual costume contests.
The public should keep a close eye out for COVID-19 symptoms after the holiday — especially three to seven days afterward. Anyone who experiences symptoms can learn how to get tested in Santa Cruz County here.
“These holidays are no different than the rest of the year when it comes to reducing the spread of COVID-19,” health officials wrote.
Officials gave guidance on which seasonal activities are lower-risk, moderate-risk, high-risk and very-high risk. Here’s the official word on Halloween and Día de los Muertos traditions, according to the county:
“Stay home, keep it small.”
Carving pumpkins, scavenger hunt trick-or-treat with members of your household
Outdoor pumpkin patch visit (while masked and maintaining six feet of distance from others)
Carving pumpkins outside with very small group (while masked and maintaining six feet of distance from others)
Virtual costume contest
Decorating your home
Creating in-home ofrendas
Preparing traditional recipes and playing music at home to honor loved ones who have died
Vehicle-based gatherings, such as drive-through attractions or drive-in movies
“If you must.”
One-way trick-or-treating, with individually wrapped goodie bags for guests to grab and go at the end of a driveway (while masked and maintaining six feet of distance from others)
Small outdoor movie night or costume parade (while masked and maintaining six feet of distance from others)
Themed outdoor dining
Traditional trick-or-treating, which brings people from various households together
Rural fall festival outside of your community
Very High Risk
“Not permitted by state and local orders.”
Crowded parties, whether indoors or outdoors, are linked to many Bay Area COVID-19 cases
Sharing, eating, drinking, talking loudly, singing with people outside of your household
Trunk-or-treat, with candy handed out from cars in parking lots
There have been 2,394 cases of the coronavirus reported in Santa Cruz County as of Tuesday morning, including 10 confirmed deaths and 2,082 recovered cases. Here’s the breakdown by location:
Ben Lomond: 18
Boulder Creek: 18
Santa Cruz: 446
Scotts Valley: 56
Under investigation: 103
This article originally appeared on the Santa Cruz Patch