COVID-19 Timeline: March 2020
September 30, 2021
At Bioethics.com we have kept up with the spread of COVID-19 and the related bioethical questions that this pandemic brings. The posts that follow highlights news from March 2020 and were originally posted at Bioethics.com. These posts focus on the bioethical issues that medical professionals, bioethicists, public health officials, and scientists grappled with as SARS-CoV-2 swept the globe.
March 2: “CDC: Coronavirus Patient Released in San Antonio Later Turned Up Positive” by Sig Christenson, San Antonio Express-News
An evacuee from Wuhan, China, who had been in isolation at a San Antonio health facility was released over the weekend but then turned up positive for the coronavirus after having had contact with the public, possibly exposing them, the San Antonio Express-News has learned. The Centers for Disease Control and Prevention said Sunday that the patient met the criteria for release, including two negative test results, and left the facility Saturday. That patient was later returned to isolation after a pending, subsequent lab test came up positive for the virus that causes COVID-19.
March 10: “Containment Area Planned for New York Suburb to Stem Coronavirus Spread” by Jimmy Vielkind, Leslie Brody, and Coastas Paris, The Wall Street Journal
Gov. Andrew Cuomo said New York would establish a “containment area” in New Rochelle to control the spread of a novel coronavirus in the Westchester County suburb at the center of the outbreak in the state. The area would close facilities—including schools—within one mile of the center of the outbreak for two weeks, starting Thursday, state officials said. The containment step would close “major gathering places” and facilities, such as temples in the area, the governor said, although individuals would still be free to walk around.
March 11: “WHO Declares the Coronavirus Outbreak a Pandemic” by Helen Branswell and Andrew Joseph, STAT News
The World Health Organization on Wednesday declared the rapidly spreading coronavirus outbreak a pandemic, acknowledging what has seemed clear for some time — the virus will likely spread to all countries on the globe. Director General Tedros Adhanom Ghebreyesus said the situation will worsen. “We expect to see the number of cases, the number of deaths, and the number of affected countries climb even higher,” said Tedros, as the director general is known.
March 12: “The Medical Ethics of the Coronavirus Crisis” by Isaac Chotiner, The New Yorker
As the number of cases rises, we will soon face decisions on limiting movement and, potentially, rationing supplies and hospital space. These issues will be decided at the highest level by politicians, but they are often influenced by medical ethicists, who advise governments and other institutions about the way to handle medical emergencies.
March 12: “U.S. in Crisis Mode as Coronavirus Cases Soar, Travel Restrictions Loom” by Jonathan Allen and Steve Holland, Reuters
The United States went into crisis mode on Thursday to contain a coronavirus outbreak that has played havoc with businesses, shuttered schools and universities and severely disrupted the sports and entertainment world. Fears of a recession grew as U.S. cases of the virus that causes the sometimes fatal COVID-19 respiratory illness rose and the Trump administration prepared to roll out restrictions that threaten to cripple the travel industry.
March 12: “Researchers Rush to Test Coronavirus Vaccine in People without Knowing How Well It Works in Animals” by Eric Boodman, STAT News
That isn’t how vaccine testing normally happens. Regulators require that a manufacturer show a product is safe before it goes into people, and while it isn’t enshrined in law, researchers almost always check that a new concoction is effective in lab animals before putting human volunteers at potential risk. “This is very unusual,” explained Akiko Iwasaki, a Yale University microbiologist who studies the immune response to viruses. “It reflects the urgency to develop vaccines to counter the Covid-19 pandemic.”
March 13: “As Pressure for Coronavirus Vaccine Mounts, Scientists Debate Risks of Accelerated Testing” by Julie Steenhuysen, Reuters
Drugmakers are working as quickly as possible to develop a vaccine to combat the rapidly spreading coronavirus that has infected more than 100,000 people worldwide. Behind the scenes, scientists and medical experts are concerned that rushing a vaccine could end up worsening the infection in some patients rather than preventing it.
March 13: “U.S. Hospitals Brace for ‘Tremendous Strain’ from New Virus” by Lindsey Tanner , Medical Xpress
U.S. hospitals are setting up circus-like triage tents, calling doctors out of retirement, guarding their supplies of face masks and making plans to cancel elective surgery as they brace for an expected onslaught of coronavirus patients. Depending on how bad the crisis gets, the sick could find themselves waiting on stretchers in emergency room hallways for hospital beds to open up, or could be required to share rooms with others infected. Some doctors fear hospitals could become so overwhelmed that they could be forced to ration medical care.
March 13: “Coronavirus Testing Is Starting to Get Better—But It Has a Long Way to Go” by Matthew Herper, STAT News
Friday morning a ray of light cracked through the ominous cloud of the pandemic caused by the novel coronavirus: The Swiss health care giant Roche introduced a new test for the virus that could be run more efficiently and with less manpower than existing diagnostics, potentially doubling the capacity in the U.S. to detect the virus.
March 13: “President Trump Just Declared the Coronavirus Pandemic a National Emergency. Here’s What That Means” by Lev Facher, STAT News
President Trump declared the Covid-19 pandemic a national emergency on Friday, the first time such a declaration has been issued over an infectious disease outbreak since the H1N1 influenza pandemic of 2009. In a Rose Garden press conference, Trump said his declaration would free $50 billion in federal resources to combat the spread of the novel coronavirus and the respiratory disease it causes, which has sickened over 1,000 Americans and killed thousands more worldwide.
March 16: “Health Care Workers Getting Sicker from Coronavirus Than Other Patients, Experts Say” by Jacqueline Howard, CNN
It remains unclear why the novel coronavirus seems to hit health care workers harder than it does other sufferers, an expert said Monday. “We know the high mortality in older people, but for reasons that we don’t understand front-line health care workers are at great risk for serious illness despite their younger age,” said Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston. “There’s nothing more destabilizing” than health care workers falling ill, he told CNN, and it will take time to determine what is making them sicker than other patients.
March 17: “Italy Struggles to Make Room for Onslaught of Virus Patients” by Andrea Foa, ABC News
Three weeks into Italy’s coronavirus crisis, Dr. Sergio Cattaneo has seen an unused ward outfitted into an intensive care unit in six days, a hospital laundry room converted into a giant stretcher-filled waiting room and a tented field hospital erected outside to test possible new virus patients.
March 17: “US Slashing Testing Rules to Speedup Coronavirus Screening” by Matthew Perrone, ABC News
The Trump administration is slashing regulations governing test development in a bid to ramp up screening for the coronavirus amid nationwide frustration with the slow pace of the effort. The unprecedented steps by the Food and Drug Administration could boost testing capacity at some U.S. labs, but also complicate efforts to assure the accuracy of tests and track who receives them.
March 18: “Hospital Workers Are Making Their Own Face Masks Using Craft Supplies” by Matt Novak, Gizmodo
Hospital workers in Washington state have started to make their own face masks from supplies they’ve purchased at craft stores, according to a new report from Seattle’s KOMO TV station. The DIY face masks are just the latest example of health workers around the world getting creative as they struggle with shortages of vital medical supplies during the covid-19 pandemic.
March 18: “WHO to Launch Multinational Trial to Jumpstart Search for Coronavirus Drugs” by Helen Branswell, STAT News
The World Health Organization said Wednesday that it would launch a multiarm, multicountry clinical trial for potential coronavirus therapies, part of an aggressive effort to jumpstart the global search for drugs to treat Covid-19. Four drugs or drug combinations already licensed and used for other illnesses will be tested, said WHO Director-General Tedros Adhanom Ghebreyesus. Ten countries have already indicated they will take part in the trial.
March 18: “The Value and Ethics of Using Phone Data to Monitor Covid-19” by Will Knight, Wired
Still, the plan may test people’s attitudes toward privacy and government surveillance, amid growing concerns about the ways in which big tech companies track their users. Some companies already share some aggregate data, but it would be new for Google and Facebook to openly mine user movements on this scale for the government. The data collected would show patterns of user movements. It would need to be cross-referenced with data on testing and diagnoses to show how behavior is affecting the spread of the virus.
March 20: “Coronavirus Risk Looms Large for America’s Elderly and Sick Prison Population” by Hope Corrigan, Quartz
The American Civil Liberties Union (ACLU) this week sent a letter to the Department of Justice and the Bureau of Prisons calling on the agencies to immediately release incarcerated individuals, who are either elderly or have chronic health conditions, to reduce the risk posed by Covid-19. The request came as jails around the country grapple with how to respond to the growing threat of widespread infection among a vulnerable prison population.
March 20: “Millions of Older Americans Live in Counties with No ICU Beds as Pandemic Intensifies” by Fred Schulte, Elizabeth Lucas, Jordan Rau, Liz Szabo, and Jay Hancock, Kaiser Health News
More than half the counties in America have no intensive care beds, posing a particular danger for more than 7 million people who are age 60 and up ? older patients who face the highest risk of serious illness or death from the rapid spread of COVID-19, a Kaiser Health News data analysis shows.
March 20: “What Coronavirus Means for Pregnancy and Other Things New and Expecting Mothers Should Know” by Nina Martin, ProPublica
Over the next three months, nearly a million women in the United States will give birth to nearly a million babies — a huge influx of mostly healthy, highly vulnerable patients into a hospital system that’s about to come under unprecedented strain. Pregnant women, not surprisingly, are anxious. Those in their third trimester, looking to deliver during an epidemic, are close to frantic.
March 23: “FDA Relaxes Clinical Trial Rules for Covid-19 Emergencies” by Jeannie Baumann, Bloomberg Law
The coronvirus pandemic prompted the FDA to relax some clinical trial requirements, so last-minute decisions to safeguard research participants won’t trigger the agency’s enforcement arm. The Food and Drug Administration issued guidance Wednesday to help drug and device companies manage their clinical trials during the Covid-19 outbreak, the disease caused by the novel coronavirus SARS-CoV-2. Ongoing clinical trials face disruptions such as site closures, quarantines, travel limitations, and supply chain issues that could lead to shortages of the investigational drug or device, the agency noted.
March 23: “Coronavirus Evolved Naturally, and ‘Is Not a Laboratory Construct,’ Genetic Study Shows” by GEN
Researchers at the Scripps Research Institute say their genetic analysis of SARS-CoV-2 coronavirus and related viruses has found no evidence that SARS-CoV-2 is the result of bioengineering in a lab. Rather, said Kristian Andersen, PhD, an associate professor of immunology and microbiology at Scripps Research and corresponding author of the published report in Nature Medicine, “By comparing the available genome sequence data for known coronavirus strains, we can firmly determine that SARS-CoV-2 originated through natural processes.” And as Anderson and colleagues concluded, the results “clearly show that SARS-CoV-2 is not a laboratory construct or a purposefully manipulated virus.”
March 23: “‘Chilling’ Plans: Who Gets Care as Washington State Hospitals Fill Up?” by Karen Weise and Mike Baker, The New York Times
Medical leaders in Washington State, which has the highest number of coronavirus deaths in the country, have quietly begun preparing a bleak triage strategy to determine which patients may have to be denied complete medical care in the event that the health system becomes overwhelmed by the coronavirus in the coming weeks. Fearing a critical shortage of supplies, including the ventilators needed to help the most seriously ill patients breathe, state officials and hospital leaders held a conference call on Wednesday night to discuss the plans, according to several people involved in the talks.
March 23: “How Surveillance Could Save Lives Amid a Public Health Crisis” by Sidney Fussell, Wired
Officials have a powerful potential surveillance tool unavailable in past epidemics: smartphones. Government officials are anxious to tap the information from phones to help monitor and blunt the pandemic. White House officials are asking tech companies for more insight into our social networks and travel patterns. Facebook created a disease mapping tool that tracks the spread of disease by aggregating user travel patterns. Such efforts clash with people’s expectations of privacy.
March 23: “Coronavirus Pandemic Leads Big Drugmakers to Hit Pause on Clinical Trials” by Manas Mishra and Michael Erman, Reuters
U.S. drugmakers Eli Lilly and Co (LLY.N) and Bristol Myers Squibb (BMY.N) said they are delaying the start of new clinical trials in part to free up doctors and healthcare facilities to deal with the surge in patients infected with the new coronavirus. Lilly and Bristol are the biggest drugmakers yet to announce clinical trial delays in the face of the pandemic that has killed over 16,000 people worldwide, after several small biotech companies said last week that they would be pulling back on drug studies.
March 25: “Who Should Be Saved First? Experts Offer Ethical Guidance” by Austin Frakt, The New York Times
How do doctors and hospitals decide who gets potentially lifesaving treatment and who doesn’t? A lot of thought has been given to just such a predicament, well before critical shortages from the coronavirus pandemic. “It would be irresponsible at this point not to get ready to make tragic decisions about who lives and who dies,” said Dr. Matthew Wynia, director of the Center for Bioethics and Humanities at the University of Colorado.
March 26: “I’m on the Front Lines. I Have No Plan for This.” by Daniel J. Lamas, The New York Times
But now, as we tighten our protocols to protect our patients from the threat of Covid-19, she’s alone. Here in my hospital, as in so many others throughout the country, we’ve banished most visitors. It’s a tough decision that leaves our patients to suffer through their illnesses in a medical version of solitary confinement. And I’m worried for them. Because those of us on the front lines simply don’t have a plan for this. The isolation is, of course, even more profound for those who are infected with, or are being evaluated for, coronavirus.
March 26: “Blood Plasma from Survivors Will Be Given to Coronavirus Patients” by Denise Grady, The New York Times
Can blood from coronavirus survivors help other people fight the illness? Doctors in New York will soon be testing the idea in hospitalized patients who are seriously ill. Blood from people who have recovered can be a rich source of antibodies, proteins made by the immune system to attack the virus. The part of the blood that contains antibodies, so-called convalescent plasma, has been used for decades to treat infectious diseases, including Ebola and influenza.
March 26: “Should Scientists Infect Healthy People with the Coronavirus to Test Vaccines?” by Ewen Callaway, Nature
As hundreds of millions of people, maybe billions, avoid social contact to spare themselves and their communities from coronavirus, researchers are discussing a dramatic approach to research that could help end the pandemic: infecting a handful of healthy volunteers with the virus to rapidly test a vaccine. Many scientists see a vaccine as the only solution to the pandemic. Clinical safety trials began this month for one candidate vaccine, and others will soon follow. But one of the biggest hurdles will be showing that a vaccine works. Typically, this is done through large phase III studies, in which thousands to tens of thousands of people receive either a vaccine or a placebo, and researchers track who becomes infected in the course of their daily lives.
March 24: “Some Hospitals Continue with Elective Surgeries Despite COVID-19 Crisis” by Jenny Gold, Kaiser Health News
In the same week that physicians at the University of California-San Francisco medical center were wiping down and reusing protective equipment like masks and gowns to conserve resources amid a surge of COVID-19 patients, 90 miles away teams of doctors at UC Davis Medical Center were fully suited up performing breast augmentations, hip replacements and other elective procedures that likely could have been postponed. Across the nation, hospitals, nurses and physicians are sending out desperate pleas for donations of personal protective gear as supplies dwindle in the regions that have emerged as hot spots for the fast-spreading new coronavirus. The Centers for Medicare & Medicaid Services, the Surgeon General and the American College of Surgeons (ACS) have urged hospitals to curtail non-urgent elective procedures to preserve equipment.
March 24: “The Hardest Questions Doctors May Face: Who Will Be Saved? Who Won’t?” by Sheri Fink, The New York Times
Health workers are urging efforts to suppress the outbreak and expand medical capacity so that rationing will be unnecessary. But if forced, they ask, how do they make the least terrible decision? How do they minimize deaths? Who even gets to decide, and how are their choices justified to the public? Medical providers are considering these questions based on what first occurred in China, where many sick patients were initially turned away from hospitals, and now is unfolding in Italy, where overwhelmed doctors are withholding ventilators from older, sicker adults so they can go to younger, healthier patients.
March 24: “New York Launches New COVID-19 Drug Trials; More Underway in China” by Brian P. Dunleavy, UPI
New York, “ground zero” for the U.S. coronavirus outbreak, is taking the lead on drug testing, with trials beginning this week on three drugs believed to have potential for treatment. Trials to assess the efficacy and safety of the anti-malaria drug chloroquine, its sister agent hydroxychloroquine and the antibiotic azithromycin will join trials of other drugs going on globally, including tests of an HIV drug and an antiviral.
March 24: “Spanish Military Finds Dead Bodies and Seniors ‘Completely Abandoned’ in Care Homes” by Lucía Benavides , NPR
The Spanish military has found older residents of some care homes “completely abandoned” and even “dead in their beds,” Defense Minister Margarita Robles said in a television interview on Monday. They were found as soldiers disinfected and provided emergency health care services this week to residential homes across the country. Robles did not give an exact figure for the number of dead bodies found by Spanish soldiers. With more than 39,000 confirmed cases of COVID-19 and 2,800 deaths as of Tuesday, Spain is the second hardest-hit country in Europe.
March 25: “The US Is Fast-Tracking a Coronavirus Vaccine, But Bypassing Safety Standards May Not Be Worth the Cost” by Paul Komersaroff, Ian Kerridge, and Lyn Gilbert, The Conversation
Last week American biotech company Moderna commenced the first clinical trial of a vaccine for COVID-19. Similar studies are reportedly being planned in the US, China, Israel, Australia and elsewhere, with at least 20 potential vaccines under development. The usual time scale for the development of a new vaccine is five to ten years. But the scale of the emergency we are facing creates overwhelming pressure to speed up this process.
March 25: “‘Delivering Coffins Non-Stop’: Coronavirus Stalks a Paris Nursing Home” by John Irish and Gonzalo Fuentes, Reuters
Outside a Paris retirement home on Wednesday, a director rushed out and told the man delivering a coffin to use a side entrance, away from prying eyes. The coffin, one of three brought the same morning, came hours after officials said 13 elderly residents had died in the home since March 11 and that more than 80 others were believed to have the coronavirus.
March 25: “Cancer Drug Trials on Hold Amid Coronavirus Disruption” by Heidi Ledford, Nature
Scientists are rushing to launch clinical trials of experimental vaccines against the coronavirus, and treatments for COVID-19. But as hospitals brace for an onslaught of critically ill patients and laboratories worldwide are disrupted, researchers have had to shelve clinical trials of therapies for other illnesses. “We’re going to see a nearly complete close-down in clinical research,” says Tim Dyer, chief executive of Addex Therapeutics, a biotechnology company based in Geneva, Switzerland. “The health-care systems will simply be overloaded.” On 18 March, Addex announced that it would delay the start of a clinical trial to treat involuntary movements in people with Parkinson’s disease.
March 27: “In Desperation, Hospitals May Double Up Patients on Ventilators” by Ryan Gabrielson and Kyle Edwards, Undark
A ventilator is designed and can be set for only one patient at a time. Since two patients are unlikely to require oxygen at the same amount and pressure, one might get too little oxygen while the other receives too much, injuring their lungs either way. Also, the air tubes might distribute contaminants between patients. Reflecting these concerns, one major ventilator manufacturer and the American Association for Respiratory Care both discourage hospitals from connecting machines to multiple patients. Some hospitals are reluctant to try it under any circumstances and are looking for other backup plans.
March 27: “Some Kenyan Nurses Refuse Coronavirus Patients in Protest Over Shortages: Union” by Katharine Houreld, Reuters
Nurses in Kenya’s capital and at least two towns have launched protests or refused to treat suspected coronavirus patients because the government has not given them enough protective gear or training, a medical union chief said. Only a fraction of Kenya’s estimated 100,000 healthcare workers had received any instruction in how to protect themselves, Seth Panyako, the secretary general of the Kenya National Union of Nurses, told Reuters.
March 27: “Telemedicine Surges, Fueled by Coronavirus Fears and Shift in Payment Rules” by Phil Galewitz, Kaiser Health News
Getting heath care by phone or video conferencing has been around for several decades, but the outbreak of coronavirus has led to an increase in telemedicine use as never seen before, according to health systems and provider groups across the country. Millions of Americans are seeking care by connecting with a doctor electronically, many for the first time. Health systems, insurers and physician groups said it allows people to practice social distancing while reducing the spread of the disease and protecting health workers.
March 27: “Hospitals Consider Changes to Do-Not-Resuscitate Situations Amid Coronavirus Pandemic” by Jacqueline Howard, Wesley Bruer, and Jen Christensen, CNN
As the coronavirus pandemic continues to sweep the United States, some hospitals are considering whether to make changes to policies and practices when it comes to do-not-resuscitate situations. Such conversations come as hospitals brace for a surge of patients, despite dwindling supplies of personal protective equipment for doctors and ventilators for seriously ill patients.
March 30: “Where to Find Ethical Guidance in a Pandemic” by Timothy M. Smith, AMA
The COVID-19 pandemic has demanded of U.S. physicians, medical educators and policymakers to ask many difficult ethical questions. Among them: What is the physician’s duty to show up for work during a deadly outbreak? When is it appropriate to prescribe drugs that haven’t been approved to treat COVID-19? And when the supply of life sustaining equipment like ventilators is severely limited, which patients should get priority? The AMA has created an ethics resource, “AMA Code of Medical Ethics: Guidance in a pandemic,” that offers guidance to these questions and others relevant to the unfolding public health emergency. Drawing on numerous opinions from the Code, this resource includes discussions of ethical challenges particular to the COVID-19 response.
March 30: “Coronavirus: Poverty and Ethics” by Augustino Fontevecchia, Buenos Aires Times
Before dwelling on utilitarian versus Kantian ethical conceptions, it is important to put Argentina’s own, unique set of circumstances in context, making the response to Covid-19 very different from what could happen in the United States, Europe, and even China. Assuming social distancing enforced through differing levels of quarantines is indeed the necessary initial response to the pandemic, how would one deal with the more than 320,000 households in a state of “critical overcrowding,” meaning three or more people share each room, in which some two million people live in Argentina?
March 31: “Relaxation of UK Abortion Rules Welcomed by Experts” by Aamna Mohdin, The Guardian
Leading UK healthcare providers have welcomed the government’s decision to allow women to take abortion pills at home without travelling to a clinic. A spokesperson for the Department of Health and Social Care confirmed the government was updating its guidance to help women who need an abortion, but cannot access a clinic because of measures put in place to stem the spread of coronavirus. The move will be made on a temporary basis, limited for two years or until the coronavirus crisis is over, and applies for medical abortions up to the tenth week of pregnancy.
March 31: “Coronavirus: US Navy Captain Pleads for Help Over Outbreak” by BBC
The captain of a US aircraft carrier carrying more than 4,000 crew has called for urgent help to halt a coronavirus outbreak on his ship. Scores of people on board the Theodore Roosevelt have tested positive for the infection. The carrier is currently docked in Guam. “We are not at war. Sailors do not need to die,” Captain Brett Crozier wrote in a letter to the Pentagon.
March 31: “A New Covid-19 Problem: Shortages of Medicines Needed for Placing Patients on Ventilators” by Ed Silverman, STAT News
On top of the overwhelming shortages of medical equipment required to combat Covid-19, there are now signs that medicines needed for patients who are placed on ventilators are also in short supply. The medicines include more than a dozen sedatives, anesthetics, painkillers, and muscle relaxants, and the shortages raise the possibility that it could become more difficult for health care providers to place these patients on ventilators. This is because the drugs are used to help manage patient pain and comfort levels so they can benefit from mechanical ventilation.
March 31: “With Surgeries Delayed, Patients Wait with Anxiety—Some in Pain—as Hospitals Make Way for Coronavirus Cases” by Hal Bernton, Medical Xpress
“I actually burst into tears and started crying,” Rayburn said. “I really wanted that cancer out … I felt like I was being sacrificed … for the good of the people.” Rayburn is one of many Americans whose surgical procedures, tests and examinations have been canceled as part of the broader response to the rapidly unfolding crisis. These disruptions represent a huge but largely hidden toll of the pandemic, which has slashed services available to patients and inflicted a major economic blow on hospitals and health care workers, one intended to be softened with $100 billion from the stimulus package approved by Congress last week.
