How to discontinue COVID-19 home isolation

Centers for Disease Control guidelines say someone who has tested positive for coronavirus can end isolation if he or she has not had a fever for three days, other symptoms have subsided and it’s been seven days since symptoms first appeared.

People with COVID-19 who have stayed home (home isolated) can stop home isolation under the following conditions:

If you will not have a test to determine if you are still contagious, you can leave home after these three things have happened:

  • You have had no fever for at least 72 hours (that is three full days of no fever without the use medicine that reduces fevers)

AND

  • other symptoms have improved (for example, when your cough or shortness of breath have improved)

AND

  • at least 7 days have passed since your symptoms first appeared

If you will be tested to determine if you are still contagious, you can leave home after these three things have happened:

  • You no longer have a fever (without the use medicine that reduces fevers)

AND

  • other symptoms have improved (for example, when your cough or shortness of breath have improved)

AND

  • you received two negative tests in a row, 24 hours apart. Your doctor will follow CDC guidelines.

When to Seek Medical Attention

Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases.

These symptoms may appear 2-14 days after exposure. If you develop emergency warning signs for COVID-19 get medical attention immediately.

Emergency warning signs include:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

https://youtu.be/IN_GVlbyC4Y

This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

Do the Least Harm* | Monday Morning Outlook by First Trust

By Brian S. Wesbury, Chief Economist and Robert Stein, Deputy Chief Economist

Date: 4/6/2020

Doctors think differently than economists. They put patients with a potential for brain damage in an artificial coma to stop swelling, and when it stops, they bring them out. This fits with the Hippocratic Oath all doctors take, which states “First, do no harm.” The idea is to “limit” damage and then “restart” a more normal body with fewer problems.

The economy doesn’t work that way. You can’t just “turn it off” and then “restart it” as if nothing happened. When you turn off an economy you create permanent damage. While this is impossible to prove – there is no precedent in history from which to judge – it is easy to surmise.

We have all heard news stories about small business owners (or know them ourselves) who have been moved to close their businesses for good. They will never re-open. Some studies say the median small business has enough cash to last less than a month. That’s the median. And there are 30 million small businesses.

Shutdowns of restaurants and bars started in mid-March, and now cover most of the United States. These shutdowns spread to “non-essential” (as deemed by government) businesses over the past month. It is now April. In other words, many of those 30 million small companies are already in serious trouble. Many will be forced to close their doors for good before this is all over.

Simply put, shutting down the economy has serious consequences. If the economy were to reopen by Easter, which seems impossible now, it would probably open with, at most, 97% of its original capacity. It’s like a muscle, without use it atrophies. And when it does, it needs physical therapy to recover. The longer it’s sedentary, the worse the atrophy, the more difficult (and painful) the recovery.

If we wait until the end of April, it will be, say, 92%. The end of May and it’s 85%. The end of June and it’s even less. These are just guesstimates, we know that, but it’s what we think is the right framework to look at things. The longer the shutdown lasts, the more permanent damage to the economy. Capacity would eventually come back, but it would take time, perhaps years. Businesses that had just the right mix of managers, workers, and suppliers, can’t just magically re-create that mix by snapping their fingers when this is done. The US economy is not Sleeping Beauty, ready to wake up at first kiss by the government.

During the Great Depression, the suicide rate in the US hit the highest level in history. Recessions are traumatic, both physically and emotionally. Anxiety and depression multiply the problems of being jobless. The consequences are very real, though often hard to track.

The faster the economy opens again, the less the long-term damage. But this would mean government has to do a cost-benefit analysis of economic damage as well as the health costs of Coronavirus. So far, that’s not happened. It’s time government set up a Coronavirus Economic Task Force.

It’s true that $2 trillion in government bailout money, and trillions more from the Fed, will blunt the damage. But it won’t stop the atrophy. It just slows it down. More importantly, it significantly grows the power of government. It also boosts demand for goods, while the shutdowns artificially hold back supply, which causes inflation because demand exceeds supply.

One thing to remember is that even leaving parts of the economy open – grocery and drug stores, gas stations, restaurants for take-out, etc. – risks spreading the virus. So, by choice, we are already taking risk. Let’s expand that risk assessment and take into account all the risks, including the economic ones.

Things need to change. Why can’t landscapers work? Construction crews in many states are still working. Why can’t factories or machine shops that normally produce 8 hours a day, go to 24-hour production schedules – three, 8-hour shifts with fewer employees? If I can pick up food, why can’t I eat somewhere 6 feet away from others? There have to be a million ideas. Let’s start thinking about them, because the costs of the shutdown must be balanced with the benefits. It may not be possible to “do no harm” in the response to this pandemic, but we can at least try to “do the least harm.”


  1. https://www.ftportfolios.com/Commentary/EconomicResearch/2020/4/6/do-the-least-harm

*This report was prepared by First Trust Advisors L. P., and reflects the current opinion of the authors. It is based upon sources and data believed to be accurate and reliable. Opinions and forward looking statements expressed are subject to change without notice. This information does not constitute a solicitation or an offer to buy or sell any security.

Wear a Cloth Face Covering

CDC continues to study the spread and effects of the novel coronavirus across the United States.  CDC now know from recent studies that a significant portion of individuals with coronavirus lack symptoms (“asymptomatic”) and that even those who eventually develop symptoms (“pre-symptomatic”) can transmit the virus to others before showing symptoms. 

This means that the virus can spread between people interacting in close proximity—for example, speaking, coughing, or sneezing—even if those people are not exhibiting symptoms.

In light of this new evidence, CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission.

Cloth face coverings should:

  • Fit snugly but comfortably against the side of the face
  • Be secured with ties or ear loops
  • Include multiple layers of fabric
  • Allow for breathing without restriction
  • Be able to be laundered and machine dried without damage or change to shape

CDC also advises the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others.  Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure.

https://youtu.be/tPx1yqvJgf4

Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.

The cloth face coverings recommended are not surgical masks or N-95 respirators.  Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance.


  1. https://www.whitehouse.gov/wp-content/uploads/2020/03/03.16.20_coronavirus-guidance_8.5x11_315PM.pdf
  2. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html

Asymptomatic People Should Wear Face Masks

Updated: April 4, 2:53 p.m.

CDC: Use Face Coverings in Public

As more studies show that people without symptoms of COVID-19 are spreading the virus, the CDC is advising that people use cloth masks or face coverings in public.

Scientists now know that a portion of people  with the coronavirus may lack symptoms – possibly 25% or higher. And others who are pre-symptomatic can transmit the virus before they show signs of COVID-19.

“In light of this new evidence, the CDC recommends wearing cloth face coverings,” U.S. Surgeon General Jerome Adams, MD, said, including in grocery stores and pharmacies. “The CDC is always looking at the data and evolving the recommendations, and new ones will come as the evidence dictates.”

The guideline discourages people from using medical-grade or surgical-grade masks, such as N95 masks, and instead, leave those for medical professionals. People can purchase basic cloth or fabric masks online or make them at home.

If people choose to wear a face covering, they should wash their hands first, Adams said. They should not touch their faces while wearing a mask, and carefully remove the mask after use and wash their hands.

“This is all about you protecting me and me protecting you,” Adams said.

The new precaution doesn’t replace CDC guidance on social distancing, including staying at home as much as possible. That includes staying six feet away from others, not shaking hands, and washing hands with soap and water for 20 seconds throughout the day.

Asymptomatic spread of COVID-19

“It’s good to think about wearing a mask as protecting your community and asking your community to do the same for you.” Jeremy Howard

However, the idea of universal face mask use in the U.S. has been gaining support with the growing belief by health experts that many people who have no idea they are infected are spreading the virus because they either have no symptoms or have not begun to experience symptoms.

A study by researchers in Singapore estimated that around 10% of new coronavirus infections may be spread by people who carry the virus but have not displayed any symptoms such as fever, cough, difficulty breathing or sore throat.

And, according to Jeremy Howard, a Melbourne-raised research scientist at the University of San Francisco who has become one of America’s leading champion of universal mask-wearing, stated that, “The primary transmission [of coronavirus] is now known to be droplet-based, and we now know that that transmission largely occurs in the first seven days after infection, when people are largely asymptomatic. So that means that if you’re highly infectious, you probably won’t know it. So we should all assume that we are potentially lethal to people around us. The way we are potentially lethal to people around us is when we speak: that’s when these micro droplets get ejected up to six feet.”

In response, the CDC has changed how it defined the risks of infection, saying essentially that anyone may be a carrier, whether they have COVID-19 symptoms or not. But neither it nor the World Health Organization changed their recommendations that everyone did not have to wear masks.

CDC reconsiders guidance to wear masks 

There is a growing number of Americans and vocal proponents of wearing face masks believe that wearing a mask reduces how many times they touch their eyes, nose and mouth, “but there aren’t any data to support that that’s a useful intervention,” Dr. Schaffner says.

There has been a fair amount of person-to-person coronavirus spread by people not showing symptoms, the CDC will look at whether having more Americans wear masks will prevent transmission of COVID-19.

Nevertheless, staying at home, “social distancing” and washing your hands remain the most important things people can do to help flatten the curve and mitigate the spread of the coronavirus.


References:

  1. https://time.com/5794729/coronavirus-face-masks/
  2. https://www.foxbusiness.com/technology/coronavirus-carrier-covid-asymptomatic-pandemic
  3. https://www.theguardian.com/world/2020/apr/02/face-masks-coronavirus-covid-19-public
  4. https://www.bbc.com/news/world-us-canada-52148534
  5. https://www.bbc.com/news/science-environment-52126735
  6. https://thehill.com/changing-america/well-being/prevention-cures/490579-surgeon-general-asks-cdc-to-review-guidance-on

Economy and Markets will Recover

“There are ‘tremendous opportunities’ in markets.”  Larry Fink

To build wealth, it is advised that investors should take a long-term view of markets; and that they should take a long-term view in the way they manage their personal finances and investment portfolios.  It is certain that the world will get through; and, the economy and markets will recover once the COVID-19 crisis has abated.

For investors who keep their focus on the long-term horizon, “there are tremendous opportunities to be had in today’s stock markets”, according to Blackrock’s Chairman and CEO Larry Fink. For many of Blackrock’s clients, “the recent sell-off created an attractive opportunity to rebalance into equities,” Fink said.

Take banks as an example, “the damage has already been done” to the industry according to most financial professionals and traders.  Yet, the banks are in better condition financially than they were during the 2007-2009 financial crisis.  Once the virus spread stalls and the economy returns to normal operation, the Fed will still be supporting the banking system.

Positive sign for comeback

“Don’t watch their lips, instead watch their feet.”

Extraordinary monetary stimulus measures by the Federal Reserve and fiscal stimulus measures by Congress and the White House have put a proverbial floor under the market in late March.  As a result, many C-suite executives are buying up their own company’s stocks at a record pace, according to InsiderSource.

“Insiders have a 35+ year track record of buying on the type of extreme weakness experienced in Q1′20,” InsiderScore director of research Ben Silverman said in a note. “A dramatic increase in insider buying volume combined with dampened levels of insider selling has resulted in the generation of industry buy inflections – our strongest, quantitative macro signal – for the entire market.”

In his 2010 newsletter to Berkshire-Hathaway shareholders, Warren Buffett wrote: “When it’s raining gold, reach for a bucket, not a thimble.”  Based on his vast and highly successful investing experience, he states that in period like the present, “Big opportunities come infrequently”.


  1. https://www.cnbc.com/2020/03/30/larry-fink-says-economy-will-recover-from-coronavirus.html?recirc=taboolainternal
  2. https://www.cnbc.com/2020/03/30/coronavirus-stock-market-jpmorgan-top-bank-stock-pick-for-trader.html?__twitter_impression=true&recirc=taboolainternal
  3. https://www.cnbc.com/2020/03/26/executives-are-buying-stock-in-droves-giving-a-strong-signal-that-the-comeback-is-for-real.html?recirc=taboolainternal
  4. https://www.cnbc.com/id/35616702

Dr. Fauci sees ‘Glimmers’

US health official Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Disease, sees ‘glimmers’ that social distancing is working in the U.S.

“We hope and I believe it will happen that we may start seeing a turnaround, but we haven’t seen it yet,” Dr. Fauci said in a Tuesday afternoon COVID-19 briefing.


https://www.cnbc.com/2020/03/31/us-health-official-fauci-sees-glimmers-that-social-distancing-is-dampening-coronavirus-outbreak.html?__source=iosappshare%7Ccom.apple.UIKit.activity.Message

Should You Wear a Mask | Mayo Clinic

Should you wear a face mask to protect yourself from the virus, even if you’re not sick?

In a video posted by Dr. Nipunie Rajapakse, a Mayo Clinic infectious diseases specialist, states CDC current recommendation:

“The current recommendations regarding masks are that if you yourself are sick with fever and cough, you can wear a surgical mask to prevent transmission to other people. If you are healthy, there is not thought to be any additional benefit to wearing a mask yourself because the mask is not airtight and does not necessarily prevent breathing in of these viral particles, which are very tiny,” says Dr. Nipunie Rajapakse, a Mayo Clinic infectious diseases specialist.

If you are going to a clinic or hospital to be seen by a health care provider because of concerns of cough or fever, Dr. Rajapakse recommends wearing a face mask to avoid transmitting possible infection or virus to other patients and medical staff. Face masks also are recommended for health care workers and people who are taking care of someone infected with COVID-19 in close settings (at home or in a health care facility).

“Most people who do not work in a health care setting have not received training on how to put on and take off the masks properly. Doing this incorrectly can actually increase your risk of infection. Also, people who are wearing masks tend to touch their face more than those who are not, which can paradoxically result in an increased risk of infection as well,” says Dr. Rajapakse.

She says instead of wearing masks, people need to:

  • Wash their hands frequently using soap and water for 20 seconds or an alcohol-based hand rub.
  • Avoid touching their eyes, nose and mouth.
  • Practice cough etiquette. Cough into a flexed elbow or tissue, discard the tissue in the trash, and wash hands.
  • Stay home from school, work and public places if feeling unwell.


  1. Nipunie Rajapakse, M.D./Infectious Diseases/Mayo Clinic
  2. https://newsnetwork.mayoclinic.org/discussion/covid-19-when-should-you-wear-a-face-mask/

Coronavirus 2020 Outbreak: Latest Updates | By WebMD News Staff

Updated Mar 29 at 4:41 PM

Facts and Faith, not Fear

The United States leads the world in cases of “confirmed” COVID-19 infections.

We stress “confirmed” cases since it is difficult to believe the accuracy and reliability of the number of cases of actual COVID-19 infections within China. We do not know if China’s reported number of cases of confirmed COVID-19 infections stands lower than the U.S. because there were less tests performed or due to obfuscation. We will probably never know for sure.

WebMD provides the latest updates on cases, government response, travel restrictions, and more here.

Coronavirus cases in U.S.

“Just a little bit of separation can stop a fire from spreading”  – CDC Director Dr. Robert Redfield

The first coronavirus case in the U.S. was confirmed back on January 20 when a 35-year-old man went to an urgent care clinic in Snohomish County, Washington. He’d recently returned from visiting Wuhan, China, where the coronavirus was first noticed.

Since the first reported case, the virus has spread to all 50 states. The worst-hit state is New York, with more than 40,000 cases and 500 deaths. Other states with high case numbers include New Jersey, Washington, and California.

The first coronavirus death in the United States occurred in late February in Washington state. Since then, about 1,500 people have died in the United States. The only states not reporting deaths are Hawaii, Rhode Island, West Virginia, and Wyoming.

The Centers for Disease Control and Prevention, citing “extensive community transmission” of COVID-19 in New York, New Jersey and Connecticut late Saturday urged residents to refrain from non-essential travel for 14 days effective immediately. The advisory does not apply to employees of critical infrastructure industries such as trucking, public health professionals, financial services and food supply.

Worldwide Coronavirus Cases

According to Johns Hopkins University, there are more than 701,525 cases and 33,174 deaths worldwide. More than 145,000 people have also recovered.

As of early Sunday afternoon, the U.S. has the most cases followed by Italy’s 97,689, and China’s 81,439:

  • United States: 131,366
  • Italy: 97,689
  • China: 81,439
  • Spain: 78,799
  • Germany: 60,887
  • Iran: 38,309
  • France: 37,611
  • United Kingdom: 19,522
  • Switzerland: 14,795
  • Netherlands: 10,923
  • Belgium: 10,836
  • South Korea: 9,583

The top five in COVID-9 deaths are:

  • Italy: 10,779
  • Spain: 6,606
  • China: 3,300
  • Iran: 2,640
  • United States: 2,328
  • France: 2,314

Rapid-Result Coronavirus Test

The FDA has authorized a coronavirus test that the manufacturer says can tell if someone is infected with the virus within 5 minutes.

The test is meant to be used in places like a doctor’s office, emergency room, or urgent care center. The test will provide results through a platform currently used by many of those locations for tests like flu and strep, instead of sending the throat or nasal swab to a lab for analysis.

The FDA’s emergency use authorization (EUA), does not mean that the FDA has approved the test, but that it is allowing its use because of the coronavirus outbreak.

To read more of the update, go to:

https://www.webmd.com/lung/news/20200124/coronavirus-2020-outbreak-latest-updates


https://www.cnbc.com/2020/03/31/china-coronavirus-case-numbers-cant-be-compared-to-elsewhere-economist.html?__source=facebook%7Cmain

Sources:

  1. https://www.bloomberg.com/news/articles/2020-04-01/china-concealed-extent-of-virus-outbreak-u-s-intelligence-says
  2. https://www.who.int/emergencies/diseases/novel-coronavirus-2019
  3. https://www.cdc.gov/coronavirus/2019-nCoV/index.html

* The respiratory infection, named COVID-19 by the World Health Organization (WHO), is closely related to SARS and MERS.

Black Swan Events

An financial or investment plan established during less volatile times should not be abandoned in the midst of a market downturn caused by a “black swan” event.

The Black Swan is a conceptual framework for thinking about potential risks that were both highly destructive and low probability. Author, investor and mathematician Nassim Nicholas Taleb, in his 2007 book about unpredictable events, “The Black Swan”, defines:

  • It is an outlier, as it lies outside the realm of regular expectations, because nothing in the past can convincingly point to its possibility.
  • It carries an extreme ‘impact.’
  • Human nature makes us concoct explanations for its occurrence after the fact, making it explainable and predictable.

Pandemic

The novel coronavirus (COVID-19) pandemic is an unprecedented challenge for Americans and continues to be a central focus around the world.  It has had material implications for the economy, fiscal and monetary policy, and global financial markets.

The impact on equity markets thus far has been notable, with the U.S. equity market exhibiting unprecedented volatility than in recent years. These reduced valuations and market swings can present challenges for investors who are investing with
purpose, like those saving for retirement. However, this kind of volatility should not be unexpected.Market downturns are simply part of the saving, investing and accumulating wealth experience. During any 20-year period, the stock market typically will suffer at least three (considered a drop of 10%) and at least one bear market (a drop of 20%).

Stay the course

It is important to stick with an investment strategy to avoid volatility during these downturns.  In the wake of the 2008 financial crisis, an estimated 10% of investors liquidated their entire accounts, with 20% switching to less risky assets. These individuals, unfortunately, mistimed the market rebound and subsequent robust economic recovery. As a result, they were left worse off than if they had maintained a long-term view and stayed the course.

Chart shows the coronavirus spreading slowly in tropical countries

Living in a warmer environment doesn’t mean you can’t catch coronavirus. But it sure seems to help.

High Temperature and High Humidity Reduce the Transmission of COVID-19 according to a paper that investigates how air temperature and humidity influence the transmission of COVID-19.

Analysts at Jefferies plotted coronavirus cases in temperate climates — everything north of latitude 23 degrees and south of 23 degrees — and compared them with countries in the tropical and subtropical areas. The brokerage excluded China, where the virus first emerged, from the analysis.

High temperature and high relative humidity significantly appear to reduce the transmission of COVID-19, respectively, even after controlling for population density and GDP per capita of cities.

Chart shows, there’s a big difference.

This result is consistent with the fact that the high temperature and high humidity significantly reduce the transmission of influenza. It indicates that the arrival of summer and rainy season in the northern hemisphere can effectively reduce the transmission of the COVID-19.


Source:

  1. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3551767&mod=article_inline