Tag Archives: Epidemic

Pharmacy chain operator Giant Eagle settles Ohio opioid lawsuits mid-trial

By Nate Raymond

(Reuters) -Regional pharmacy chain operator Giant Eagle Inc. on Friday said it had agreed to settle lawsuits accusing it of fueling the opioid epidemic in several Ohio communities, including two counties that had taken it and three larger rivals to trial.

The settlement came during the fourth week of a trial in federal court in Cleveland over claims by the Ohio counties of Lake and Trumbull against Giant Eagle, Walgreens Boots Alliance Inc, CVS Health Corp and Walmart Inc.

The settlement resolves claims against Giant Eagle in 10 lawsuits by those counties and others in Ohio, the company and the plaintiffs’ lawyers said in a joint statement. It operates grocery stores and pharmacies in five states including Ohio.

Financial terms were not disclosed.

“While Giant Eagle denies it was a cause of the opioid crisis, it recognizes the severity of the crisis, its impact on the public and the hard work of the public officials working to address the harms,” the company said.

The case underway in Ohio is first trial the pharmacy chains have faced in nationwide litigation over an opioid abuse epidemic that U.S. government data shows led to nearly 500,000 overdose deaths from 1999 to 2019.

More than 3,300 cases have been brought largely by state and local governments against pharmacies, drugmakers and drug distributors.

The Ohio counties claim the pharmacies failed to prevent excessive amounts of opioid pills from flooding their communities or identify “red flags” of misuse. The companies deny wrongdoing.

The three largest U.S. drug distributors – McKesson Corp, Cardinal Health Inc and AmerisourceBergen Corp – and drugmaker Johnson & Johnson in July proposed paying up to $26 billion to settle cases against them.

A bankruptcy judge in August approved a settlement by OxyContin maker Purdue Pharma LP and its wealthy Sackler family owners that the company values at more than $10 billion.

(Reporting by Nate Raymond in Boston; editing by Diane Craft and Steve Orlofsky)

Wisconsin faces COVID-19 crisis, positive test rates rise in New York hot spots

By Jonathan Allen and Lisa Shumaker

NEW YORK (Reuters) – COVID-19 trends are all moving in the wrong direction in Wisconsin, where U.S. President Donald Trump will hold rallies over the weekend, while the pandemic’s early U.S. epicenter of New York state reported an uptick of positive coronavirus tests in 20 “hot spots” on Thursday.

New cases of COVID-19 rose in 27 out of 50 U.S. states in September compared with August, with an increase of 111% in Wisconsin, according to a Reuters analysis.

Wisconsin is also dealing with a troubling rise in serious COVID-19 cases that threaten to overwhelm hospitals.

“Our emergency department has had several instances in the past week where it was past capacity and needed to place patients in beds in the hallways,” Bellin Health, which runs a hospital in Green Bay, said in a statement. “Our ICU (intensive care unit) beds have also been full, or nearly full, during the past week.”

Health officials in the state said public gatherings have become even more dangerous than earlier in the pandemic, and Governor Tony Evers issued an emergency order easing licensing rules to increase the number of healthcare workers able to deal with the mounting crisis.

“We are seeing alarming trends here in Wisconsin, with today seeing our highest number of new cases in a single day, and yesterday seeing our highest death count,” Evers said in a statement.

Dr. Ryan Westergaard, chief medical officer at the Wisconsin department of Health Services, said the state’s outbreak started in younger people and has now spread throughout the community.

“Public gatherings of any kind are dangerous right now, more so than they have been at any time during this epidemic,” he told CNN on Thursday.

In New York, which grappled with the world’s most rampant outbreak earlier this the year, officials said they were worried about clusters of cases in 20 ZIP code areas across the state, where the average rate of positive tests rose to 6.5% from 5.5% the day before.

New York Governor Andrew Cuomo and New Jersey Governor Phil Murphy encouraged residents to download onto their smartphones a new voluntary contact-tracing app, COVID Alert, they launched on Thursday. The app uses Bluetooth technology to alert users if they have recently been near someone who later tested positive for the novel coronavirus.

Many of New York’s 20 hot spots – half of which are in New York City – include Orthodox Jewish communities. Cuomo said he talked to community leaders about enforcing social distancing measures.

“A cluster today can become community spread tomorrow,” Cuomo said on a briefing call with reporters. “These ZIP codes are not hermetically sealed.”

He implored local authorities to increase enforcement measures. “If they’re not wearing masks, they should be fined,” Cuomo said.

Wisconsin health officials are urging residents to stay home and avoid large gatherings ahead of Trump’s weekend rallies in La Crosse and Green Bay in the run up to the Nov. 3 election.

An indoor Trump rally in Tulsa, Oklahoma, in July likely contributed to a subsequent rise in cases there, city health officials said.

“This spike we’re seeing in Brown County, Wisconsin should be a wakeup call to anyone who lives here that our community is facing a crisis,” Dr. Paul Casey, medical director of the emergency department at Bellin Hospital, told CNN.

Cases, hospitalizations, positive test rates and deaths are all climbing in Wisconsin, according to a Reuters analysis.

Over the past week, 21% of coronavirus tests on average came back positive and have steadily risen for five weeks in a row from 8% in late August.

The number of hospitalized COVID-19 patients has doubled in the last two weeks hitting a record of 646 on Wednesday, the same day Wisconsin reported its biggest one-day increase in deaths since the pandemic started with 27 lives lost.

Beyond the Midwest, western states were also facing spikes in coronavirus cases. Montana on Friday reported a record increase in cases for the second day in a row and had a record number of hospitalized COVID-19 patients.

(Reporting by Jonathan Allen and Maria Caspani in New York and Lisa Shumaker in Chicago; Editing by Bill Berkrot)

As U.S. schools reopen, concerns grow that kids spread coronavirus

By Deena Beasley

(Reuters) – U.S. students are returning to school in person and online in the middle of a pandemic, and the stakes for educators and families are rising in the face of emerging research that shows children could be a risk for spreading the new coronavirus.

Several large studies have shown that the vast majority of children who contract COVID-19, the disease caused by the virus, have milder illness than adults. And early reports did not find strong evidence of children as major contributors to the deadly virus that has killed more than 780,000 people globally.

But more recent studies are starting to show how contagious infected children, even those with no symptoms, might be.

“Contrary to what we believed, based on the epidemiological data, kids are not spared from this pandemic,” said Dr. Alessio Fasano, director of the Mucosal Immunology and Biology Research Center at Massachusetts General Hospital and author of a new study.

Schools across the country are trying out a wide range of strategies to reopen, from all online classes to all in person. They are asking whether reopening schools with stringent mitigation measures is worth the risk to students, families and educators, given that keeping schools closed will likely harm academic progress, social and emotional development, mental health and food security.

Dr. Fasano and colleagues at Boston’s Massachusetts General and MassGeneral Hospital for Children found that infected children have a significantly higher level of virus in their airways than adults hospitalized in intensive care units for COVID-19 treatment. The high viral levels were found in infants through young adults, although most of the participants were age 11 to 17.

The study, published on Thursday in the Journal of Pediatrics, involved 192 participants ages 0-22 who were seen at urgent care clinics for suspected COVID-19. Forty-nine of them – a quarter of the total – tested positive for the virus. Another 18 were included in the study after being diagnosed with multi-system inflammatory syndrome, a serious COVID-related illness than can develop several weeks after an infection.

The research suggests that children can carry a high viral load, meaning they can be very contagious, regardless of their susceptibility to developing a COVID-19 illness.

“There has been some conflicting data out there about the degree to which children can be contagious,” said Dr. Marybeth Sexton, assistant professor of infectious diseases at Emory University School of Medicine in Atlanta, who was not involved in the study. “This is further evidence that we may see children as sources of infection.”

She added more extensive research is needed.

“NOBODY IS SPARED”

A separate study published last month in JAMA Pediatrics found that older children hospitalized with COVID-19 had similar levels of the virus in their upper respiratory tract as adults, but children younger than five carried significantly greater amounts.

However, other medical groups show differing information over children’s potential to spread the virus. The American Academy of Pediatrics on Wednesday updated its guidelines to reflect “that children under 10 years may be less likely to become infected and spread infection, while those 10 years and older may spread it as efficiently as adults.”

A recent South Korean study found that people were most likely to contract the new coronavirus from members of their own households, with children aged nine and under least likely to be the first identified case.

Since most children infected with the coronavirus have very mild symptoms, they were largely overlooked as a demographic in the earlier stages of the pandemic, Dr. Fasano said.

The U.S. Centers for Disease Control and Prevention reported a pediatric COVID-19 hospitalization rate of 8 per 100,000 for March 1 to July 25, compared with a rate of 164.5 per 100,000 for adults.

Experts say the incidence of a related issue, which can develop after COVID-19 infection, multi-system inflammatory syndrome, is concerning. “The number of these patients is growing,” Dr. Fasano added.

Concerns have also been raised about cases of type 1 diabetes among children diagnosed with COVID-19. A small UK study found that the rate of diabetes almost doubled during the peak of Britain’s COVID-19 epidemic, suggesting a possible link between the two diseases that needs more investigation.

“The more we understand, the more it boils down to nobody is spared in this pandemic,” Dr. Fasano said.

(Reporting By Deena Beasley; Editing by Peter Henderson and Aurora Ellis)

U.S. Treasury to sell $112 billion next week, continue shift to longer-dated debt

By Ross Kerber

BOSTON (Reuters) – The U.S. Treasury Department said on Wednesday it will sell $112 billion next week in notes and bonds and that it plans to continue to shift more of its funding to longer-dated debt in coming quarters, as it finances measures to offset the impact of the COVID-19 epidemic.

The Treasury said it expects its debt needs to moderate but remain elevated, after borrowing a staggering $2.753 trillion in the second quarter.

“Treasury continues to face unprecedented borrowing needs as a result of the federal response to COVID-19,” Brian Smith, Treasury’s deputy assistant secretary for federal finance, said on a conference call.

The Treasury will sell $48 billion in three-year notes, $38 billion in 10-year notes and $26 billion in 30-year bonds next week as part of its quarterly refunding.

It said on Monday that it plans to borrow $947 billion in the third quarter, about $270 billion more than it previously estimated for the July-September period.

The federal agency will use “long-term issuance as a prudent means of managing its maturity profile and limiting potential future issuance volatility,” Smith said in a release.

As Treasury increases auction sizes, it will have larger increases in 7-year, 10-year, 20-year and 30-year notes and bonds, he said.

Treasury has been raising extra money to fund trillions of dollars in coronavirus-related economic aid allocated by Washington. As of Tuesday, White House negotiators were trying to reach a deal with congressional Democrats to extend relief measures including unemployment benefits, liability protections for businesses and a moratorium on evictions.

Borrowing has spiked far above the quarterly record set during the 2008 financial crisis.

A declining economic outlook has driven down U.S Treasury yields across the curve to record or near-record lows, helping raise equity prices and lower borrowing costs.

(Additional reporting by Karen Brettell in New York; Editing by Paul Simao)

Congressional Democrats, White House set new round of coronavirus aid talks

By Patricia Zengerle

WASHINGTON (Reuters) – Top White House officials and Democratic leaders in the U.S. Congress will try again on Tuesday to narrow gaping differences over a fifth major coronavirus relief bill to help stimulate the economy and possibly provide new aid to the unemployed.

The two sides have reported some progress in recent days. But they remain far apart on a range of issues including unemployment benefits for workers made jobless by the epidemic, as well as liability protections for businesses and funding for schools, state and local governments and election security.

Treasury Secretary Steven Mnuchin and White House Chief of Staff Mark Meadows were due to meet with Senate Republicans at a midday policy lunch, before resuming negotiations with House of Representatives Speaker Nancy Pelosi and Senate Democratic leader Chuck Schumer at 3:30 p.m. EDT (1930 GMT).

Federal Reserve officials are urging Congress and the White House to help the struggling U.S. economy. Tens of millions of Americans have lost their jobs during the crisis.

Congress passed more than $3 trillion in relief legislation early in the epidemic. But lawmakers missed a deadline last week to extend the $600 per week in enhanced unemployment payments that have played a key role in propping up the U.S. economy.

Democrats are pressing for another $3 trillion that would retain the $600 benefit and add nearly $1 trillion in assistance for state and local governments.

Senate Republicans, who have not taken part in the White House talks with Democrats, have proposed a $1 trillion package that would slash the unemployment payment to $200 a week and eventually move to 70% of wages.

Republicans say the $600 benefit – which is on top of state unemployment payments – discourages people from taking lower-paying jobs. A Fed official on Monday said there was little evidence to support that view.

Differences also remain on whether to extend a moratorium on housing evictions and Democrats’ demand for around $1 trillion in aid to state and local governments suffering revenue shortfalls as a result of the epidemic.

(Reporting by Patricia Zengerle; Writing by David Morgan and Richard Cowan; Editing by Scott Malone, Sam Holmes and Paul Simao)

Cuomo blasts Trump’s COVID-19 response as U.S. death toll tops 130,000

By Lisa Shumaker and Maria Caspani

(Reuters) – As U.S. coronavirus cases surge and deaths topped 130,000, New York Governor Andrew Cuomo harshly criticized the White House’s COVID-19 response on Monday, accusing President Donald Trump of “enabling” the virus and downplaying its threat.

Infections are on the rise in 39 states, according to a Reuters tally, and 16 states have posted record daily case counts in July. The surge has prompted many local leaders to slow or roll back economic re-openings despite Trump’s insistence that the epidemic is being handled.

At a news conference on Monday, Cuomo, a Democrat who has clashed with the president over his efforts to tackle the health crisis, said Trump was “enabling” the virus if he failed to address the severity of the situation.

“Acknowledge to the American people that COVID exists, it is a major problem, it’s going to continue until we admit it and each of us stands up to do our part,” Cuomo said, directing his comments at the president.

During a speech at the White House on Saturday, Trump asserted without providing evidence that 99% of U.S. coronavirus cases were “totally harmless.”

Steve Adler, the Democratic mayor of Austin, Texas, on Monday also criticized Republican Trump’s message.

“It’s incredibly disruptive and the messaging coming from the president of the United States is dangerous,” Adler told CNN.

White House Chief of Staff Mark Meadows on Monday defended Trump, saying the president was not trying to play down the deaths.

“But it’s really to look statistically to know that whatever risks that you may have or I may have, or my, my children or my grandchildren may have, let’s look at that appropriately and I think that’s what he’s trying to do,” Meadows told reporters outside the White House.

RE-OPENINGS HALTED

Local leaders across the country are considering slowing down or rolling back business re-openings to curb spiking infection rates that are already overwhelming hospitals in some areas.

Mayor Carlos Gimenez of Florida’s Miami-Dade County, which currently has some 48,000 COVID-19 cases, issued an emergency order on Monday shutting down on-site dining at restaurants and closing ballrooms, banquet facilities, party venues, gyms and fitness centers, and short-term rentals.

“We can tamp down the spread if everyone follows the rules, wears masks and stays at least six feet (2 meters) apart from others. I am counting on you, our 2.8 million residents, to stop the spread so that we can get back to opening our economy,” Gimenez said in a statement.

After the announcement, some Miami chefs and restaurant owners said they felt they were facing the impossible predicament of balancing their businesses’ survival against the safety of their employees and guests.

“We’re burned out emotionally, we’re burned out financially, and we’re burned out from the trauma of seeing everything that’s happening,” said Karina Iglesias, a partner at two popular downtown Miami Spanish restaurants.

Nationally, cases are approaching 3 million, by far the highest tally in the world and double the infections reported in Brazil, the world’s second most-affected country.

Florida confirmed a record high 11,000 new cases in a single day, more than any European country reported in a day at the height of the crisis there.

Gimenez imposed an indefinite nightly curfew in Miami-Dade County on Friday and halted the re-openings of entertainment venues such as casinos and strip clubs.

In New York City, where the percentage of people testing positive for the virus has dropped to 1%, residents were allowed to enter nail and tanning salons on Monday as part of the city’s Phase III of reopening, but Mayor Bill de Blasio delayed the resumption of indoor dining indefinitely.

Soaring case numbers and packed hospitals in Texas have prompted some mayors and other local leaders to consider launching a new round of stay-at-home orders. Cities are getting together and lobbying the state’s governor to restore the authority to impose local anti-coronavirus measures, Austin Mayor Adler said.

“It’s something that we’re considering. It’s only to be used as a last resort,” Adler told CNN.

(Reporting by Lisa Shumaker, Doina Chiacu, Peter Szekely, Gabriella Borter and Zachary Fagenson; Writing by Gabriella Borter; Editing by Howard Goller and Bill Berkrot)

Supplies for coronavirus field hospital held up at U.S.-Mexico border

By Julia Love and Mica Rosenberg

(Reuters) – Red tape and rules on exporting medical gear have delayed work on a field hospital for migrants in an asylum camp near Mexico’s border with Texas, undercutting efforts to prepare for the coronavirus pandemic, according to organizers of the project.

Migrants are seen waiting at clinic of Global Response Management at a migrant encampment where more than 2,000 people live while seeking asylum in the U.S., while the spread of Coronavirus disease (COVID-19) continues, in Matamoros, Mexico April 9, 2020. REUTERS/Daniel Becerril

Mexican authorities approved construction of the 20-bed field hospital on April 2. But since then, a trailer laden with supplies for the project has been parked in Brownsville, Texas, less than a block from the U.S.-Mexico border.

Global Response Management, the nonprofit sprearheading the project, said the trailer contains an X-ray machine, cots, heart monitors, medical tents, generators and other equipment. Its staff fear time is running out to prepare for a coronavirus outbreak.

“If we are trying to set up the hospital in the middle of the epidemic, it’s too late,” Andrea Leiner, director of strategic planning for the organization, told Reuters on Tuesday.

“We are in a situation where containment and quarantine are not possible, so we need to be aggressive on prevention.”

There are no confirmed cases yet in the camp on the banks of the Rio Grande that houses about 2,000 migrants, mostly Central Americans seeking asylum in the United States. The camp also holds Cubans, Venezuelans and Mexican asylum seekers along with other nationalities.

But testing has been limited. Health experts say the migrants are exceedingly vulnerable, their immune systems worn down after months living in closely packed tents.

Due to a U.S. order banning the export of key protective medical gear, the nonprofit had to remove equipment such as gloves, surgical masks and N95 masks from the trailer in Brownsville. It is now trying to source what it can from Mexico.

The Federal Emergency Management Agency (FEMA) and U.S. Customs and Border Protection have said they are trying to prevent brokers and intermediaries from diverting critical medical resources overseas.

In a rule issued on Friday, FEMA said it would consider the “totality of the circumstances,” including humanitarian considerations, when determining whether to detain shipments of medical gear.

Global Response said U.S. authorities cleared its remaining supplies on Sunday, but it is now awaiting a letter from the Matamoros mayor’s office certifying the equipment will only be brought into the country for six months, so the shipment can be approved by Mexican customs.

Mexico’s customs agency, the Matamoros mayor’s office and the National Migration Institute (INM) did not respond to requests for comment.

In addition to the trailer, Global Response has collected hundreds of cloth masks sewn by volunteers for the camp, but it has only been able to bring them in three at a time, the quantity deemed for “personal use” and thus not subject to import duties in Mexico.

The group has accumulated 3,500 rapid tests for the coronavirus to use in the camp, said executive director Helen Perry.

Many in the camp are awaiting U.S. hearings under the Trump administration’s Migrant Protection Protocols policy. All hearings under the program have been suspended until May 1.

In Matamoros, which has a population of about half a million people, the five public hospitals have 25 ventilators and 11 intensive care beds between them, according to figures provided to Reuters by the state government last month.

A Mexican government plan to relocate the migrants to a stadium was abandoned, Global Response’s Leiner said.

The nonprofit and INM are now working to fence off the camp and conduct temperature checks as people enter, she said.

(Reporting by Julia Love in Mexico City and Mica Rosenberg in New York, additional reporting by Verónica G. Cárdenas and Daniel Becerril in Matamoros,; Writing by Julia Love; Editing by Tom Brown)

Trump’s halt to WHO funding prompts condemnation as coronavirus cases near 2 million

By Jeff Mason and Paulina Duran

WASHINGTON/SYDNEY (Reuters) – U.S. President Donald Trump’s move to halt funding to the World Health Organization over its handling of the coronavirus pandemic prompted condemnation on Wednesday from world leaders as recorded global infections approached the 2 million mark.

Trump, who has reacted angrily to accusations his administration’s response to the worst epidemic in a century was haphazard and too slow, had become increasingly hostile towards the U.N. agency before announcing the halt on Tuesday.

The WHO, which is based in Geneva, had promoted China’s “disinformation” about the virus that likely led to a wider outbreak than otherwise would have occurred, Trump said.

He said WHO had failed to investigate credible reports from sources in China’s Wuhan province, where the virus was first identified in December, that conflicted with Beijing’s accounts about the spread and “parroted and publicly endorsed” the idea that human to human transmission was not happening.

“The WHO failed in this basic duty and must be held accountable,” Trump told a White House news conference on Tuesday.

A U.S. official told Reuters that Trump made the move despite pushback within his administration, especially from top health advisers. There was no immediate reaction from the WHO, which has been appealing for more than $1 billion to fund operations against the pandemic.

The United States is the biggest overall donor to the WHO, contributing more than $400 million in 2019, roughly 15% of its budget.

Some 1.99 million people globally have been infected and nearly 128,000 have died since the disease emerged in China late last year, according to a Reuters tally.

U.N. Secretary-General Antonio Guterres said it was not the time to reduce resources for the WHO.

“Now is the time for unity and for the international community to work together in solidarity to stop this virus and its shattering consequences,” he said in a statement.

China, which has won WHO praise for its actions to curb the virus’s spread, urged the United States on Wednesday to fulfil its obligations to the WHO.

“This decision weakens the WHO’s capability and harms international cooperation,” Foreign Ministry spokesman Zhao Lijian said.

EU foreign policy chief Josep Borrell said on Twitter: “Deeply regret U.S. decision to suspend funding to WHO. There is no reason justifying this move at a moment when their efforts are needed more than ever.”

German Foreign Minister Heiko Maas said apportioning blame did not help. “The virus knows no borders,” he said in a tweet.

New Zealand Prime Minister Jacinda Ardern said the WHO was essential to tackling the pandemic.

“At a time like this when we need to be sharing information and we need to have advice we can rely on, the WHO has provided that,” she said. “We will continue to support it and continue to make our contributions.”

GRAPHIC: Tracking the novel coronavirus in the U.S. – https://graphics.reuters.com/HEALTH-CORONAVIRUS-USA/0100B5K8423/index.html

‘BLAME CHINA, NOT WHO’

Australian Prime Minister Scott Morrison said he sympathised with Trump’s criticisms of the WHO, especially its “unfathomable” support of re-opening China’s “wet markets”, where freshly slaughtered, and live, animals are sold.

“But that said, the WHO also as an organisation does a lot of important work including here in our region in the Pacific and we work closely with them,” Morrison told an Australian radio station.

“We are not going to throw the baby out of with the bathwater here, but they are also not immune from criticism.”

John Sawers, the former head of Britain’s MI6 foreign intelligence service, said China concealed crucial information about the outbreak from the rest of the world and that it would be better to hold China responsible rather than the WHO.

Former Norwegian Prime Minister Gro Harlem Brundtland, who headed the WHO from 1998 to 2003, said an attack on the organization was “the last thing we need right now” since it had the power and ability to oversee the outbreak.

In its latest Strategy Update, the WHO said countries that ease restrictions should wait at least two weeks to evaluate the impact before easing again.

It said that the world stands at a “pivotal juncture”.

More than 2,200 people died in the United States on Tuesday, a record toll according to a Reuters tally, even as it debated how to reopen its economy.

New York City, hardest hit by the outbreak, revised its death toll sharply up to more than 10,000, to include victims presumed to have died of the lung disease but never tested.

U.S. health advocacy group Protect Our Care said Trump’s WHO funding withdrawal was “a transparent attempt … to distract from his history downplaying the severity of the coronavirus crisis and his administration’s failure to prepare our nation”.

Global stocks fell as oil prices dropped and warnings of the worst global recession since the 1930s underscored the economic damage done by the pandemic. The International Energy Agency forecast a 29 million barrel per day dive in April oil demand to levels not seen in 25 years.

Denmark became the latest country to ease its coronavirus lockdown on Wednesday, by reopening schools and day care centres. But concerns they might become breeding grounds for a second wave of cases convinced thousands of parents to keep their children at home.

(Open https://tmsnrt.rs/3aIRuz7 in a separate browser for an interactive graphic to track the global spread)

(Reporting from Reuters bureaux across the world; Writing by Lincoln Feast and Nick Macfie; Editing by Robert Birsel and Philippa Fletcher)

Exclusive: Nurses at Mexico hospital hit by coronavirus say they were told to avoid masks

MONTERREY, Mexico (Reuters) – Nurses at a public hospital hit by Mexico’s worst coronavirus outbreak were told by their managers not to wear protective masks at the start of the epidemic to avoid sowing panic among patients, nurses and other medical workers said.

Two doctors and a hospital administrator have died and at least 51 staff members have been infected since the new coronavirus was detected at the IMSS General Hospital in Monclova in the northern state of Coahuila in late March, the state health department said.

The hospital became Mexico’s first hot spot for the COVID-19 illness caused by the coronavirus.

At least four of the infected workers are currently hospitalized as a result of the outbreak, which has fed concerns that Mexico’s underfunded healthcare system is ill prepared to cope with a major epidemic in the nation of nearly 130 million people.

At the beginning of the outbreak, managers “said that protective equipment wasn’t necessary,” said nurse Charly Escobedo Gonzalez who works at the Monclova hospital.

Answering questions from Reuters about the reports that hospital management told staff not to wear masks, a senior official at Mexico’s main public health service IMSS which runs the hospital said that the health workers should be believed, but he did not confirm details of the reports.

“Specifically, if they are saying that then of course we have to believe it,” said the IMSS official, Raul Pena Viveros. He said there can be misunderstandings inside a hospital about where it is appropriate to wear protective equipment.

“Not all of the workers have to wear the same equipment inside the hospital. And when this type of equipment is used badly…it runs out more quickly and they put workers who are in contact with patients at risk,” he said.

Mexico has registered 4,661 people with the coronavirus and 296 deaths, a fraction of the figures in the neighboring United States, but the coronavirus arrived weeks later in the Latin American country.

The Monclova hospital became a coronavirus focal point in the third week of March, highlighting a lack of masks and even soap and bleach there, staff said.

As staff began to fall ill, hospital floor managers instructed healthcare workers not to use facemasks, which some had bought for themselves due to the lack of hospital equipment, seven workers told Reuters.

Pena Viveros said the hospital had been short of protective equipment as well as other materials to fight the coronavirus in March.

Health officials have not given a detailed explanation of why so many Monclova healthcare workers became infected.

Hospital workers are at greater risk of contracting the coronavirus if they do not wear protective equipment like facemasks and gloves. The N95 respiratory masks offer more protection from other people who are infected while more simple surgical masks help the wearer avoid spreading the virus.

Due to a lack of proper N95 masks, some staff at the hospital were also wearing inappropriate industrial-style masks that were donated to them, Pena Viveros said.

The lack of N95 masks was later resolved, said Pena Viveros, who was sent by the head of the IMSS from Mexico City to investigate the Monclova hospital and spent a week there in early April. Staff say the hospital has more protective equipment now but that they still lack gear such as masks.

Three nurses said that while some colleagues chose not to wear facemasks after being told by managers or supervisors that they were not necessary, other staff kept wearing them.

NO “PANIC”

On the night of March 22, one of the heads of the nursing staff told a group of doctors and nurses gathered in the emergency room to take off their N95 masks because they were not necessary, according to a nurse who heard the order.

Another nurse, surnamed Hernandez Perez, was given a similar order by a deputy head of nursing a few days earlier.

“In a morning clinical class, the sub-head told us not to create panic…that we shouldn’t wear facemasks because we were going to create a psychosis,” said Hernandez Perez, who did not want her full name used. She is now at home sick and has tested positive for the COVID-19 respiratory illness caused by the coronavirus. A second nurse confirmed Hernandez Perez’s account.

Reuters was unable to speak to two of the nursing managers who nurses say spoke at that meeting.

After media accusations that the Monclova hospital badly lacked equipment to deal with the virus, the head of the IMSS, Zoe Robledo, announced in early April that the director of the hospital had been temporarily replaced.

Neither the suspended hospital manager, Ulises Mendoza, nor the current hospital director answered repeated requests from Reuters for comment.

One nurse, who asked that her name not be used for fear of retaliation, said that during the second half of March she was repeatedly told by superiors not to wear a facemask while working in high-risk areas such as on the ground floor of the hospital, where the emergency room is located.

As well as the 51 confirmed cases, Pena Viveros said more than 300 other workers were temporarily sent home as the hospital scrambled to contain the outbreak.

He said the hospital contracted nurses and doctors from other facilities to address the personnel shortage, nevertheless the hospital’s ability to care for patients has been impeded, some staff said.

(Editing by Frank Jack Daniel, Daniel Flynn and Alistair Bell)

Navy hospital ship arrives to help New York battle coronavirus

By Stephanie Kelly and Daniel Trotta

NEW YORK (Reuters) – A 1,000-bed Navy hospital ship docked in Manhattan on Monday and a field hospital was going up in Central Park for coronavirus patients, as officials in New York City, the epicenter of a widening U.S. outbreak, pleaded for more help from Washington.

In an image that captured the hopeful spirit of the national mobilization against the outbreak, the USNS Comfort steamed into New York Harbor, accompanied by a flotilla of support ships and helicopters hovering ahead.

New York Governor Andrew Cuomo, a prominent public figure in the battle to stop the virus, waited at a Midtown Manhattan pier when the converted oil tanker, painted white and adorned with giant red crosses, arrived at about 11 a.m. EDT.

The Comfort will treat non-coronavirus patients, including those who require surgery and critical care, the Navy said.

Hospitals in New York City have been overrun with patients suffering from COVID-19, the respiratory illness caused by the virus. New York state accounts for almost half of the country’s 141,883 cases and more than a third of its 2,477 deaths, according to a Reuters tally. The United States has the most cases in the world.(Graphic: https://tmsnrt.rs/2w7hX9T)

Construction of a 68-bed field hospital began on Sunday in Central Park, and the new site was expected to begin accepting patients on Tuesday, New York City Mayor Bill de Blasio said in a statement.

The makeshift facility, provided by Mount Sinai Health Systems and non-profit organization Samaritan’s Purse, will not take walk-ins, and admissions and transfers will be managed by Mount Sinai, de Blasio said.

De Blasio, among a growing chorus of officials who have voiced frustration at the Trump administration’s handling of the crisis, said the death toll in the city would rise soon if Washington did not provide more medical supplies and assistance.

“If we don’t get more consistent federal help in a growing crisis, there’s a danger we start to lose lives that could have been saved,” the New York City mayor said in an interview with CNN. “Sunday is D-Day, we need help by Sunday.”

(Reporting by Dan Trotta, Maria Caspani, Barbara Goldberg and Stephanie Kelly in New York and Doina Chiacu and Lisa Lambert in Washington; Writing by Paul Simao; Editing by Howard Goller)