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On Nov. 30, 2020 in the U.S. there were 161,796 new Covid-19 cases, a decrease of approximately 10,000 new cases from data reported for Nov. 23. Total cases have reached 13,920,038. There were 1,238 deaths (a week ago there were 972 deaths) and the death total has reached 274,332. This week we at Revitalize dig further into state data as illustrated in the table: “Select U.S. States Ranked by Total Cases per 1 Million Population and Deaths per 1 Million Population” (the full data sets are found at Worldometer). The table illustrates key data, most notably cases and deaths per 1 million for: 
  • The top eight U.S. States 
  • U.S. totals 
  • States where we or our partners have offices (AZ, MI, NY, CA, PA)
  • Early outbreak states New York, Connecticut, and Washington
The data reify that the pandemic has taken a turn for the worse and will truly test President-elect Biden’s admonishment that “we need to remember, we're at war with the virus, not with one another. This is the moment where we need to steel our spines, redouble our efforts and recommit ourselves to the fight.” 

Europe is reporting about the same number of cases and deaths; here is the data for Nov.30:

  • In Italy, there were 16,337 new cases (an approximate 6K decrease from data reported for Nov. 23, which was a 5K decrease from the prior week),1,601,554 total cases. There were 672 deaths–42 more deaths than on Nov. 23 (55,576 total deaths).  
  • In France, 4,005 new cases , an approximate 10 percent decrease over Nov. 23. France has had 2,222,488 total cases as of Nov 30. There were 406 deaths, 74 fewer than Nov. 23, and there have been a total of 52,731 deaths. 
  • In Germany, there were 14,156 new cases (approximately 40 fewer cases than Nov. 23 with 946,648 total cases) and deaths increased by 89 to 329 over data reported here last week (14,156 total deaths). 
  • The United Kingdom had 12,230 new cases, approximately 3,000 fewer than Nov. 2 the number of total cases has increased to 1,629,657. There were 205 deaths, one fewer than Nov. 23, increasing the UK's Covid death total to 55,488.

The curators find a story from NPR to be a most timely and comprehensive summary of the question asked at all of our Thanksgiving tables and Zooms: “How do we stop this Covid-19 surge? Here's what experts say could help.” We offer answers below to questions and theories posed at many Thanksgiving real and virtual tables.   

And as stories circulate about Pandemic fatigue among the public, The New York Times' Katherine Wu delivers a piece to steel our public resolve in "Covid combat fatigue: ‘I would come home with tears in my eyes.’" Wu describes the doctors and nurses on the front lines running on empty, under increasing pressure amid surges and overrun hospitals.

As of publication, we do know who will be appointed to many key Cabinet and White House posts, yet we do not know “Who Will Lead HHS” (and other key health care and social welfare departments). Articles from Politico, HealthCare Dive, and Health Affairs are linked for your information.

States will begin receiving the first doses of COVID-19 vaccines in mid-December and, as of publication, the CDC advisory panel is making a list of who will receive the first doses; we take a “shot” at understanding the process by linking our explainers at The Hill. As we go to press, Skilled Nursing News star reporter Maggie Flynn offers us the following scoop: "A Centers for Disease Control and Prevention (CDC) advisory committee on immunization on Tuesday voted to recommend that health care personnel and long-term care residents get first priority on a COVID-19 vaccine, when it is authorized."

Last and not least for our many long-term care administrators, regulators, experts, and advisors is an interview with a former CMS Director in Skilled Nursing News that explores “how to improve nursing homes, especially in the wake of the still-unfolding COVID-19 tragedy. The interview is spot on in finding and explaining that discussions on Skilled Nursing Facility improvements tend “to divide observers into two broad camps: the industry partisans who call for more collaboration from the federal government and better funding, and the sharp critics who insist regulation should primarily—if not exclusively—take the form of steeper fines and other punitive actions.” What is well argued in this article is as stated in the title: “Feds must reimagine nursing home enforcement with sharper sticks—and smarter carrots." Because virtually all health care providers are funded, regulated, and rules are enforced by CMS, we encourage all of our readers to read this article that applies to so many health care settings.

From the hoped to be last-time-in-lockdown Culver City, surging states across the Midwest, and your healthy and Holidays'-ready home, this is Revitalize for Dec. 2, 2020:
Revitalize: The week in health-care news you need
First vaccine doses expected to be shipped to states by mid-December, government says states will begin receiving the first doses of COVID-19 vaccines in mid-December, but will make their own determinations on who will be first in line for a shot.

How do we stop this COVID-19 surge? Here's what experts say could help.

Covid combat fatigue: ‘I would come home with tears in my eyes.’ Doctors and nurses on the front lines are running on empty, under increasing duress as the pandemic surges and hospitals are overrun with patients.

Biden eyes New Mexico governor, Obama surgeon general.

Who could run HHS?

What history can tell us about who will lead HHS.
CDC panel says health workers, long term care residents should get Covid vaccine first.

Skilled Nursing News offers: "A Centers for Disease Control and Prevention (CDC) advisory committee on immunization on Tuesday voted to recommend that health care personnel and long-term care residents get first priority on a COVID-19 vaccine, when it is authorized."

Former CMS Chief: Feds must reimagine nursing home enforcement with sharper sticks—and smarter carrots.
Jerry Seelig, CEO
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