Tagged Maryland

Con reportes parciales de los estados, el panorama de COVID-19 en el país es borroso

Varios estados informan solo resultados positivos de la prueba para COVID-19 de laboratorios privados, una práctica que pinta una imagen engañosa de la velocidad de propagación de la enfermedad.

Por ejemplo, Maryland, Ohio y otros están publicando los números de nuevas pruebas positivas y de muertes, pero no informan los resultados negativos, lo que ayudaría a mostrar a cuántas personas se evaluó en general.

“Esto es importante, porque da una falsa sensación de lo que está sucediendo en un lugar en particular”, dijo el doctor Eric Topol, director del Scripps Research Translational Institute. Agregó que se debería exigir a los estados que reporten resultados positivos y negativos para que expertos en salud pública puedan revisarlos.

“Todos los datos deberían estar juntos. Debería ser automático”, enfatizó Topol.

Muchos estados muestran una imagen más completa de los datos de la pandemia, incluido el número total de pruebas ejecutadas y las que arrojan resultado negativo.

El COVID Tracking Project, un esfuerzo privado para recopilar información de pruebas en todo el país, ha encontrado al menos nueve estados que han reportado resultados completos solo de los laboratorios estatales, o faltan algunos informes sobre resultados negativos.

Melanie Amato, secretaria de prensa del Departamento de Salud de Ohio, dijo que su estado solo está recolectando resultados positivos, ya que muchos laboratorios privados han comenzado a evaluar a los residentes. Hasta el martes 24 de marzo por la tarde, el estado reportó 564 casos confirmados, 145 hospitalizaciones y ocho muertes en su sitio web.

“No exigimos que los laboratorios privados informen resultados negativos sobre cualquier enfermedad infecciosa”, explicó. Cuando se le preguntó si esa política podría cambiar, dijo: “Esa es una discusión para más adelante”.

Del mismo modo, el Departamento de Salud de Maryland “actualmente informa solo el número de casos positivos. Estamos trabajando en un proceso para proporcionar oportunamente datos de número de pruebas”, dijo el departamento a KHN en un comunicado, y agregó:” Proporcionaremos información adicional tan pronto como esté disponible “. Hasta el miércoles 25 por la mañana, el estado informaba 423 casos confirmados.

En los estados que reportan todos los resultados de las pruebas, la tasa de infecciones varía ampliamente. Algunos informan que el 5% o menos de las pruebas son positivas, mientras que otros confirman el virus en el 10% o más de las muestras. Los resultados pueden cambiar. Hasta el martes, Utah reportó 346 casos confirmados de 6,837 evaluados, o alrededor del 5% de resultados positivos. Las autoridades señalaron que algunos resultados pueden tener un retraso de hasta 72 horas.

Los funcionarios de Florida habían realizado 10,338 pruebas hasta el domingo 22, de las cuales 1,007 fueron positivas, a una tasa de poco menos del 10%. Autoridades dijeron que se asociaron con laboratorios comerciales para “aumentar la cantidad de pruebas realizadas cada día y garantizar que los floridanos reciban la información crítica de salud que necesitan de manera oportuna”.

Hasta el lunes 23 por la tarde, el estado de Washington, golpeado fuerte por el coronavirus, había reportado 2,221 resultados positivos de pruebas y 31,712 negativos, con una tasa positiva de 7%. El estado también informó 110 muertes.

Tener una imagen más completa en esos estados que limitan los informes “podría proporcionar información útil sobre el seguimiento de la transmisión y el tiempo”, dijo Charles Root, veterano consultor de laboratorios en Chicago.

La Oficina del Cirujano General de los Estados Unidos tuiteó el domingo: “no todos los laboratorios informan todavía (o puntualmente), pero los que sí lo hacen, informan que el 90% de las pruebas (que generalmente son personas expuestas o con síntomas) son #COVID19 negativas”. Eso significa que incluso entre las personas de mayor riesgo, la mayoría no tiene #coronavirus…”

No está claro cómo las autoridades federales se están ajustando al subregistro de pruebas negativas, lo que podría empañar lo que realmente está sucediendo en todo el país.

El lunes 23, el grupo de trabajo de la Casa Blanca tomó medidas para aumentar los informes a nivel nacional.

“También hoy les recordamos a los gobernadores que todos los laboratorios estatales, todos los laboratorios de hospitales ahora están obligados por ley a informar los resultados de las pruebas de coronavirus a los CDC”, dijo el vicepresidente Mike Pence, según una transcripción de la sesión informativa de la Casa Blanca.

Topol dijo que la nación perdió un tiempo precioso al no reunir los recursos para evaluar a un gran número de personas en los últimos dos meses y contar todos los resultados.

“Deberíamos estar haciendo una evaluación masiva, un millón de personas al azar por edad y sexo para analizar”, dijo. “Si hacemos eso, obtendríamos respuestas. Hasta entonces, no tenemos ninguna pista. Todo está muy borroso”.

Para complicar aún más las cosas, los criterios para evaluar a las personas han cambiado a medida que los casos de COVID-19 se dispararon.

En un sitio de pruebas al paso en Nueva Jersey, el lunes 23, un letrero electrónico mostraba el mensaje: “No síntomas. No prueba”. Otras áreas han permitido a los médicos ordenar pruebas cuando las personas sospechan que podrían haber estado en contacto con alguien que tenía la enfermedad.

El sitio web de los Centros para el Control y Prevención de Enfermedades (CDC) dice: “No todos necesitan hacerse la prueba de COVID-19”.

Los CDC también señalan que la mayoría de las personas tienen una forma leve de la enfermedad y que se recuperarán en casa, y agregan que “no existe un tratamiento específicamente aprobado para este virus”.

Las decisiones sobre las pruebas “son a discreción de los departamentos de salud estatales y locales y/o los médicos”, dice. La agencia señala que los adultos mayores y las personas con afecciones médicas crónicas y/o un estado inmunocomprometido pueden estar en “mayor riesgo de malos resultados”.

Y a medida que la enfermedad se ha propagado, las áreas afectadas han pedido que se reserven las pruebas para las personas en el hospital y los trabajadores de la salud, tanto para garantizar que puedan permanecer en el trabajo como para conservar el equipo de protección.

El ex comisionado de la Administración de Drogas y Alimentos (FDA), Scott Gottlieb, en un tuit la semana del 16, señaló que la cifra nacional del 10% para resultados positivos de las pruebas es “significativamente mayor” que en el Reino Unido, Corea del Sur y China.

“Hasta que veamos una disminución significativa de la tasa de positividad, todavía no estamos evaluando lo suficiente”, escribió Gottlieb.

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Some States Are Reporting Incomplete COVID-19 Results, Blurring The Full Picture

Several states are reporting only positive COVID-19 test results from private labs, a practice that paints a misleading picture of how fast the disease is spreading.

Maryland, Ohio and others are posting the numbers of new positive tests and deaths, for instance, but don’t report the negative results, which would help show how many people were tested overall.

“This matters because it gives you a false sense of what is going on in a particular location,” said Dr. Eric Topol, director of the Scripps Research Translational Institute. He said states should be required to report both positive and negative results for review by public health experts.

“They should all be pulled together,” Topol said. “It should be automatic.”

Many states display a more comprehensive picture of their pandemic data, including the total numbers of tests run and those yielding negative results.

The COVID Tracking Project, a private effort to collect testing information nationwide, has found at least nine states that have reported complete results only from state labs, or are missing some reports on negative results.

Melanie Amato, press secretary for the Ohio Department of Health, said her state is collecting only positive test results as many private labs have begun testing residents. As of Tuesday afternoon, the state reported 564 confirmed cases, 145 hospitalizations and eight deaths on its website.

“We don’t require private labs to report negative labs in any infectious disease,” she said. Asked if that policy might change, she said: “That is a discussion for later down the road.”

Similarly, the Maryland Department of Health “is currently reporting the number of positive cases only. We are working on a process to provide timely testing number data,” the department told KHN in a statement, adding: “We will provide additional information as soon as it is available.” As of Tuesday afternoon, the state was reporting 349 confirmed cases.

In states that do report all test results, the rate of infections varies widely, with some reporting 5% or fewer tests as positive, while others confirm the virus in 10% or more of specimens. The results can change by the day. As of Tuesday, Utah reported 298 confirmed cases out of 5,823 tested, or about 5% positives. Officials noted that some results may have a lag time of up to 72 hours.

Florida officials had conducted 10,338 tests as of Sunday, of which 1,007 were positive, for a rate just under 10%. Florida officials said they partnered with commercial labs to “increase the number of tests conducted each day and ensure Floridians receive the critical health information they need in a timely manner.”

As of Monday afternoon, hard-hit Washington state had reported 2,221 positive test results and 31,712 negatives, for a positive rate of 7%. The state also reported 110 deaths.

Having a more complete picture in those states that limit reporting “could provide useful information of tracking transmission and timing,” said Charles Root, a veteran laboratory consultant in Chicago.

The U.S Surgeon General’s Office on Sunday tweeted: “not all labs are reporting yet (or promptly), but the ones that do, report that 90% of tests (which are usually people exposed or w/ symptoms) are #COVID19 negative. That means even among the highest risk people, most don’t have #coronavirus…”

It’s unclear how federal authorities are adjusting to underreporting of negative tests, which could blur what’s actually happening across the country.

On Monday, the White House task force took steps to ramp up nationwide reporting.

“We also reminded the governors today that all state laboratories, all hospital laboratories are now required by law to report the results of coronavirus tests to the CDC,” Vice President Mike Pence said, according to a transcript of the White House briefing.

Topol said the nation wasted precious time by not marshaling the resources to test large numbers of people over the past two months — and tallying all results.

“We should be doing a massive screening, a million people randomly by age and gender to get our arms around it,” he said. “If we do that, we would get answers. Until then, we don’t have any clue. It is all very fuzzy.”

Complicating things further, criteria for testing people have changed as COVID-19 cases soared. At a New Jersey drive-thru testing site on Monday, an electronic sign flashed the message: “No symptoms. No Test.” Other areas have allowed doctors to order tests when people suspect they might have been in contact with someone who had the disease.

The federal Centers for Disease Control and Prevention website says: “Not everyone needs to be tested for COVID-19.”

The CDC also notes that most people have mild illness and will recover at home, adding “there is no treatment specifically approved for this virus.”

Decisions about testing “are at the discretion of state and local health departments and/or individual clinicians,” it says. The agency notes that older adults and individuals with chronic medical conditions and/or an immunocompromised state may be at “higher risk for poor outcomes.”

And as the disease has spread, hard-hit areas have asked that tests be reserved for people in the hospital and health care workers, both to ensure they can stay on the job and to conserve protective gear.

Former Food and Drug Administration Commissioner Scott Gottlieb in a tweet last week noted that the nationwide 10% figure for positive test results is “significantly higher” than in the United Kingdom, South Korea and China.

“Until we see the positivity rate decline significantly, we are still not screening enough,” Gottlieb wrote.

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Listen: The Reverberations of Gun Violence In Baltimore

When a good friend in Baltimore said he was offering a final haircut to a client who had been killed by gun violence, Chaseedaw Giles knew she had to write the story. Her article appeared in The New York Times, and Giles, the social media manager for KHN, later spoke with WBAL News Radio.

“There was no one in the barbershop who hadn’t either been shot themselves, including the barber who had been shot before, or known someone that had been shot. And it was just kind of this sense of acceptance that, you know, this is what life is like in West Baltimore,” Giles told WBAL radio host Bryan Nehman.

When barber Antoine Dow went to the funeral home to give a final haircut to one client, the trauma to the young man’s skull was so severe Dow didn’t recognize him.

“He didn’t look like himself. I had to ask was this the right person, and they said, ‘Yes, this is the right person,’” Dow said. “There wasn’t much I could do. So I did the best I could.”

Dow is committed to running his business as a safe space for the neighborhood.

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The Final Cut

Antoine Dow cuts a customer’s hair as others wait in line at his barbershop in the Druid Heights neighborhood of West Baltimore.(Nate Palmer for KHN)

BALTIMORE — The barber had with him his tools of trade: a black leather smock, a razor, clippers, scissors and tufts of black locks he had collected from the floor of his shop.

He would use them to try to cover the bullet hole that tore through his client’s head.

Antoine Dow owns a barbershop in the Druid Heights neighborhood of West Baltimore and has often been called upon to provide clients who have been gunned down with their final haircut. It’s a ritual that he says helps bring some dignity to the young black men whose lives are disproportionately affected by gun violence, many of whom Dow knew and serviced while they were still alive.

“When I walked into the room and saw his body, I didn’t recognize him because the trauma to the skull was so bad,” Dow said of Deontae Taylor, 20, a young man who was killed last fall. “The entry wound was a hole and the exit wound was sewed up in the back like a football,” he said.

After he finished, he called Taylor’s mother. “I did the best I could do.”

Antoine Dow has been cutting hair for 24 years. Dow, who owns a barbershop in West Baltimore, gives many of his clients their last haircut at local funeral homes, after losing them to gun violence.(Nate Palmer for KHN)

The decline in gun deaths in some major cities across the country has made headlines, but in places like Baltimore, the numbers remain high. There were 348 homicides in Baltimore last year, up more than 12% from the year before, and only five fewer than the record set in 1993. Firearms were involved in 312 of the 348 killings, according to an analysis of the latest numbers in the Baltimore Police Department Crime Stats Open Data database by Kaiser Health News.

Dow has been cutting hair for 24 years. He started when he was 19, giving haircuts to friends in his father’s basement. In 2001, at age 27, he found a small shop with a reasonable rent that had only enough room for one barber. He had the shop remodeled and has been open ever since. On Saturdays, he can be found cutting hair for as many as 70-odd clients, his barber chair positioned at the shop entrance, where he can greet each person as they enter.

On Saturdays, the busiest day at Antoine Dow’s barbershop in the Druid Heights neighborhood of West Baltimore, Dow can be found cutting hair from 6:30 a.m. to as late as 9 p.m., cutting the hair of roughly 72 clients in a single day.(Nate Palmer for KHN)

Tufts of hair lay at the feet of assistant barber Quant’e Boulware inside Antoine Dow’s barbershop in the Druid Heights neighborhood of West Baltimore. Dow has collected and incorporated such hair samples in some postmortem haircuts for his clients.(Nate Palmer for KHN)

“I always wanted my own barbershop. I pretty much knew what I wanted to do, because I enjoyed it, and people would pay me for it,” he said.

The issue of gun violence has followed Dow for years. In 2000, at a barbershop on the corner of Lafayette and Division streets in West Baltimore where he worked, Dow was shot in the leg after he tried to intervene in an argument between a client and another man. His client, Howard Robinson, 35, was shot in the back and died later that day.

Typically, funeral homes dress the bodies of the deceased and cut their hair, if necessary. But sometimes a favored barber is brought in.

Dow was 26 when he performed his first haircut for a deceased client. In that case, it was an older man who had died of natural causes, circumstances that Dow said are much easier to manage than a shooting victim. He has continued to take on the difficult task of providing haircuts for clients who have been killed, for a straightforward reason, as he sees it — “because I cut their hair while they were alive.”

And as his business has expanded, Dow has hired other barbers who have also learned the trade of post-mortem hair cutting.

Quant’e Boulware, 24, has worked for Dow the past four years and has cut the hair of two customers no longer alive. One was a 2-year-old child who died in a car crash — his godson. “I rather me cut his hair than somebody else,” he said softly.

Quant’e Boulware combs the hair of Davonte Robinson before cutting his hair.(Nate Palmer for KHN)

When clients leave Dow’s shop, he said he tells them to “please be safe,” but he knows that can be hard in a city like Baltimore. He estimates that as many as eight of his clients were murdered in the last year alone.

Dontae Breeden, one of Dow’s younger clients, said that he and his peers often feel invisible in a city where violence is so common and that some young men turn to gun violence out of desperation. “People just want to be known for something,” said Breeden, 22. “They just want recognition.”

Rashad Jones has been a client of Dow’s for three years. In March 2019, he was shot at a bus stop on East Northern Parkway after work. Not only has Jones lost two of his best friends to gun violence this year, but in 2013 his brother was shot and paralyzed from the waist down at age 25.

The barbershop is one of the few places in West Baltimore where Jones, 29, said he feels safe and Dow has tried to provide that comfort to his clients, both in life and in death.

He talks to his clients while cutting their hair, even those who have passed away, like the young man who had been shot in the head.

“I was talking to him while I was cutting his hair, like I do a lot of my deceased clients,” said Dow. “I just said, you know, ‘I hope you rest well.’”

Antoine Dow (center) stands outside his West Baltimore barbershop with one of his assistant barbers, Quant’e Boulware (left), and Dow’s daughter, Akerah Dow, who runs a hair salon across the street from her father’s barbershop.(Nate Palmer for KHN)

KHN reporter Victoria Knight contributed to this article.

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