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China is building a new hospital in Wuhan the center of the coronavirus outbreak, to contain the outbreak. The plan is to build it in just 6 days. China has taken a new approach to tackling this health crisis, isolating the area and speeding up action to find solutions to the virus. A shortage of hospital beds and resources in Wuhan led to the decision to build a new hospital rapidly. China's rapid response is the first high speed response and could be a model for future outbreaks. Before this during the SARS crisis in China, and other health crises worldwide, action was taken gradually by hospital and government authorites leading to more deaths and wider spread of disease.

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Every day lost in the struggle with coronavirus is a big thing, which is why Itay's most affluent northern region has gone from being well equipped with resources of healthcare to seeing the health system overburdened to the point of disaster. This WSJ report shows why this has a lesson and an early warning for how the U.S. and other countries should design their response. It is also why the White House team that includes President Trump in the U.S. emphasized the plan for just the first 15 Days in the news conference at the Brady Room in the White House on March 16. It is saying the first 15 days are critical, not a day to lose.  It does not matter if you are an advanced economy with state of the art hospitals. Social behaviours must change, old rules rewritten and implemented throughout nations, quickly in days. Here WSJ shows lessons learned by Dr. Cereda at the Hospital of the University of Pennsylvania who trained in Milan and was in constant contact with colleagues in Milan and elsewhere. Many of the lessons relate to not overburdening hospitals and health systems and protecting health systems. This means mild to moderate cases are managed from home and not in the hospital, through massive deployment of outreach services and telemedicine. It means therapies can be delivered at home or through mobile clinics. The second major lesson from Italy is to protect healthcare workers and doctors. The entire White House team with Dr Faucci of CDC and Dr Brx, head of Infectious Diseases in the U.S. news conference of president Trump March 16, focused on the goal of protecting healthcare workers, doctors and hospitals, so they remained strong to take on the crisis. The second goal of the White House team is to protect the elderly with medical conditions. To do this only the most serious patients are treated in hospitals the rest for mild to moderate at home.  Studying the conditions in Bergamo and other parts of Lombardy and northern Italy, is helping U.S. medical leaders to prepare for the current nationwide effort, the 15 days plan announced by the White House. The lessons from the Papa Giovanni Hospital in Bergamo are important say U.S. medical leaders, including Dr. Brendan Carr, head of emergency medicine at Mount Sinai Health System in New York.  He says build capacity in hospital beds before we need it. Clear out hospital space and add new hospital beds.  ...

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Coronavirus testing is being ramped up in the U.S. as the Food and Drug Administration new regulations allow commercial labs to manufacture and distribute  coronavirus tests. Now many players can now acquire and conduct tests including state and local governments, hospitals, universities, and private companies. so that tracking nationwide distribution is still difficult. Deborah Brx the response coordinator of the White House task force on coronavirus says U.S. has completed 220,000 tests in last 8 days.  In New York the scaled up efforts in a region with over half the coronavirus cases in the U.S., 13,000 were tested on Monday, March 23. Some hospitals in New York such as Mount Sinai expect to do double or triple the tests a day in a scaling up effort by March 30. In Los Angeles a city councilman negotiated with a South Korean company for delivery of 100,000 tests a week, having already secured 20,000 new tests. Additionally swabs and protective equipment are also needed to conduct tests and labs need to process results with speed. ...

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With U.S. crossing the 300,000 mark in infections on April 5 the country enters a new and critical phase in the fight against the global pandemic. Globally cases of infections jumped by 100,000 for the first time to 1.2 million. Health experts say the next 2 weeks are critical for winning the war against the global pandemic. White House coronavirus response coordinator Deborah Birx urges people to isolate themselves, avoiding even the trips to the grocery store or the pharmacy. Models show the infections peaking in New York, Detroit, and New Orleans in the next 6-7 days Birx says. In Europe the pandemic may be reaching a peak in Paris area and eastern France. High speed trains transferred patients from eastern France to western France as the fight continues. In Italy and Spain strict containment measures are now bringing in results with rate of infections increasing by less than 5% from the previous day. Daily deaths are less and pressure on hospitals is beginning to ease, with number of patients in intensive care decreasing. Queen Elizabeth II will address the British nation in a prerecorded address, the fourth one in seven decades of her reign, to thank health care workers. ...

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Kerala state of 35 million people who speak the language Malayalam, is one of the rare places today that has only 4 deaths from coronavirus, 524 cases confirmed and no community transmission. Here the Guardian looks at the reasons why. The Health minister KK Shailaja started very early on January 23, with a meeting of her rapid response team when the virus was still in China.  She setup a control room and instructed Kerala's 14 districts to do this on Jan. 24. When the first case arrived on Jan. 27 on a plane from Wuhan, Kerala had already adopted the WHO  protocol of test, trace, isolate and support. These passengers were checked for temperature, tested and quarantined. With some at a nearby hospital and others in home isolation. This is all the more amazing considering that Kerala is a state in southern India on the west coast that has a large number of people living and working overseas. Many are in the Gulf countries and the arrival of these refugees could have triggered a second outbreak. This was prevented by careful testing, and contact tracing of clusters.  When one group was evasive and concealed information from an airport surveillance team -arriving from Venice, Italy,  in late Feb- a case was detected back to them.  Contact tracers tracked down all of the hundreds whom they had been in contact with and quarantined them.  By 23 March all flights to 4 Kerala airports from overseas were stopped, including Cochin and Trivandrum. On March 25 India went into lockdown.  Some of the achievements in Kerala include quarantining 170,000 people early. with strict surveillance, which is now down to 21,000. Accomodating and feeding 150,000 migrant workers from other states, before returning them on charter trains to their home areas. A big reason for the success is the high literacy rate in the state. A big emphasis on education and healthcare is a part of the Kerala model. Shailaja is a secondary school teacher, and Health minister. From the days since independence of India in 1947 the state has a strong socialist tradition of taking care of the basics- health, education and public services. It also generates a part of its GDP with income from workers who are overseas.  Another reason for the success in dealing with coronavirus is experience. The state had a virus epidemic called Nipah in 2018 which has become the story for a movie called Virus in Malayalam. There is decentralized public health system in the state and people value their health care facilities, understand and trust the health care authorites. There are hospitals at every level of administration and 10 medical colleges. But trust and education, experience tackling the virus before, are key. Kerala is showing that poor countries can deal effectively with the virus, and create a better life by adopting the right model of creating good societies that value education, healthcare services, better economic structures and distribution of wealth, and  a degree of trust and responsibility found in a state that values public spiritedness. ...