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Long road back for one COVID-19 survivor

At 1 p.m. Tuesday, the Unified Government COVID-19 webpage reported 3,114 positive cumulative cases in Wyandotte County, up 49 cases from 1 p.m. Monday. The number of deaths was the same, 88. The number of hospitalizations was 36, up seven from Monday, according to the UG COVID-19 website. (From UG COVID-19 website)

Recovery has been a hard journey for one COVID-19 survivor.

Anil Gharmalkar of Parsons, Kansas, who participated in a video news conference Tuesday morning at the University of Kansas Health System, is still feeling some of the aftereffects of COVID-19, months after he got it and then recovered from it.

A small business owner who drives a delivery truck, Gharmalkar began feeling fatigued and having trouble breathing in April while on the road in Indiana, he said. He thinks he might have got infected when he was out on the road making deliveries in Louisiana. He had recovered from a bout of pneumonia in March.

It took him about a day and a half longer to get home than usual because of the fatigue. He went to a hospital in Parsons, where he was put on a ventilator. Then he was transferred to the KU Health System in Kansas City, Kansas, where he was in the intensive care unit for 10 days, and five more days in a regular room before being discharged.

He came back to the hospital once for treatment of inflammation of his throat. Inflammation is not unusual in COVID-19 patients.

While he doesn’t have the virus now, he is taking steroids, his voice is hoarse and he is still dealing with some aftereffects of COVID-19.

Some Parsons residents don’t wear masks, and now they have been asking him to wear a mask when he is around them, thinking he might spread the disease.

Dr. Dana Hawkinson, medical director of infection prevention and control at KU Health System, said other people are more of a risk to Gharmalkar than he is to them now. In general, it is believed patients cannot spread the infection after about two weeks of first showing symptoms.

Tests have come back from his family, showing they did not get COVID-19 from him, he said. His family was assiduously following cleaning and health guidelines, Gharmalkar said.

Dr. Hawkinson said they don’t really know if Gharmalkar can get COVID-19 again. They are learning more about the coronavirus every day.

“It takes six to 12 months to fully recover from episodes as serious as yours,” Dr. Steve Stites, chief medical officer at KU Health System, told Gharmalkar.

“I would encourage people to be more careful,” Gharmalkar said. .

“I definitely think there’s quite a large misunderstanding on what recovery means,” he said. What he has seen in survivor groups is there’s quite a long road back, he said.

One of the hardest things about the whole ordeal is to ask questions and to have people tell you they just don’t know the answer, he added.

Dr. Hawkinson said they are continuing to see exponential spread of the coronavirus. Case numbers in a lot of states continue to increase.

“I think we all need a full culture change,” he said.

He said they need to work toward keeping everyone healthy, not gathering in groups, washing hands, wearing masks and socially distancing to stop the spread of COVID-19.

People can reopen society, but they have to do it in a thoughtful, conservative way and not go back to the normal, Dr. Stites said.

“It’s still a COVID world. We want to work toward a post-COVID world,” he said. Everyone’s halfway through it now, he added.

On Tuesday morning, KU Health system reported 25 COVID-19 patients in the hospital, including two children, up from 24 on Monday, according to Dr. Hawkinson. There were eight patients in the ICU, down from 10 on Monday, and two patients on ventilators, down from three on Monday. The age range of patients in the ICU was 33 to 83.

At 1 p.m. Tuesday, the Unified Government COVID-19 webpage reported 3,114 positive cumulative cases in Wyandotte County, up 49 cases from 1 p.m. Monday. The number of deaths was the same, 88. The number of hospitalizations was 36, up seven from Monday, according to the UG COVID-19 website.

Kansas removes three states from its quarantine list

On Tuesday, Kansas removed Alabama, Arkansas and South Carolina from its quarantine list, according to a news release.

The Kansas Department of Health and Environment modified its international travel list from all international travel to just countries with a CDC Level 3 Travel Health Notice and restrictions on entry into the United States, plus Bahrain and French Guiana. Those traveling internationally are subject to CDC re-entry guidance and protocols.

The list is for all persons returning to or entering Kansas on the dates listed. The state reviews the list every two weeks. Visitors and Kansas residents need to quarantine for 14 days if they have traveled to:

• Florida on or after June 29.
• Arizona on or after June 17.
• Been on a cruise ship or river cruise on or after March 15.
• International travel to Bahrain or French Guiana on or after July 14.
International travel on or after July 14 to countries with a CDC Level 3 Travel Health Notice, including China, Iran, European Schengen area, United Kingdom, Republic of Ireland and Brazil. International travelers must follow CDC guidance and protocols

Others needing to continue quarantining:
• Anyone subject to a travel-related quarantine for a state or country previously on the travel-related quarantine list must complete their 14-day quarantine period.
• Received notification from public health officials (state or local) that you are a close contact of a laboratory-confirmed case of COVID-19.

Kansas bases its list on new case rates by population size, and Kansas numbers are increasing significantly, according to Dr. Lee Norman, Kansas secretary of health. The Kansas cases by population base have approaches or surpassed the states they had on the list, he said.

“We must do better, Kansas,” Dr. Norman said. “Practice social distancing, wear a mask, stay home if you’re sick, avoid large gatherings. Each one of us is responsible for our actions.”

Critical infrastructure sector employees who have traveled to these destinations should contact their local health department regarding instructions for application of these quarantine orders while working, according to KDHE. Critical infrastructure employees, such as public health, law enforcement, food supply, need to have the staffing resources to continue serving Kansans so the local health department may allow a modified quarantine. The only exemption for these quarantine mandates for critical infrastructure sector employees is work – they are not to go any other locations outside of work.

More information is at www.kdhe.ks.gov/coronavirus.

To view the KU doctors’ news conference, visit https://www.facebook.com/kuhospital/videos/582605922426522

The governor’s executive order on masks is at https://governor.kansas.gov/wp-content/uploads/2020/07/20200702093130003.pdf.

The governor’s news release on the mask order is at https://governor.kansas.gov/governor-laura-kelly-signs-executive-order-mandating-masks-in-public-spaces/.

The Wyandotte County mask order is at https://www.wycokck.org/WycoKCK/media/Health-Department/Documents/Communicable%20Disease/COVID19/06272020LocalHealthOfficerOrderRegardingMasks.pdf

A news release on the Wyandotte County mask order is at https://www.wycokck.org/WycoKCK/media/Health-Department/Documents/Communicable%20Disease/COVID19/06272020PressReleaseLHORequiresPublicToWearMasks.pdf.

Wyandotte County now has posted an application for nonprofits, government agencies, school districts and businesses in Wyandotte County that want to apply for CARES Act funding. The web address is https://us.openforms.com/Form/6273fe80-8bba-4c18-b4e7-e551096d8a83.

For information on how to make an easy no-sew mask, visit https://wyandotteonline.com/how-to-make-a-no-sew-cloth-mask/.

For more information about COVID-19 testing, including other sites, visit https://wyandotte-county-covid-19-hub-unifiedgov.hub.arcgis.com/pages/what-to-do-if-you-think-you-have-covid-19. Residents also may call 3-1-1 for more information about testing.

The state’s COVID-19 test page is at https://www.coronavirus.kdheks.gov/280/COVID-19-Testing.

Residents may visit the UG COVID-19 website at https://alpha.wycokck.org/Coronavirus-COVID-19-Information or call 311 for more information.

Wyandotte County is currently under Phase 3. See covid.ks.gov.

The state plan’s frequently asked questions page is at https://covid.ks.gov/wp-content/uploads/2020/05/Reopening-FAQ_5.19.2020_Final.pdf.

The CDC’s COVID-19 web page is at https://www.cdc.gov/coronavirus/2019-nCoV/index.html.

Kansas City pharmacist who diluted cancer meds is getting out of prison early

Robert Courtney was serving a 30-year sentence after pleading guilty to diluting medications for as many as 4,200 patients and pocketing the resulting profits.

by Dan Margolies, Kansas News Service

This story was updated to include the comments of the assistant U.S. attorney who prosecuted Courtney.

Robert Courtney, the Kansas City pharmacist whose drug dilution scheme drew national headlines 19 years ago, is being released from prison seven years early.

In a letter last week, the U.S. Justice Department informed some of Courtney’s victims and members of their families that Courtney will be moved to a halfway house this week and then to home confinement in Trimble, Missouri.

The letter said that Courtney, 67, had been found eligible for home confinement due to the COVID-19 pandemic. Attorney General William Barr instructed the Federal Bureau of Prisons to release inmates who are “at a minimal risk of recidivating.”

Courtney, whose pharmacy was located in Research Hospital in Kansas City, was sentenced in 2002 after pleading guilty to diluting medications for cancer patients and other seriously ill people and pocketing the resulting profits. He had been serving a 30-year prison sentence in the Federal Correctional Institution in Englewood, Colorado, a low-security prison for male inmates. He was due to be released in 2027.

People who learned of his imminent release said they were appalled.

Kelly Ann Allen, whose grandmother was treated with cancer drugs mixed by Courtney and died in 2000, said she had people whose parents were victims of Courtney’s scheme reach out to her this week.

“I lost my grandma when I was a teenager and that, of course, was difficult,” Allen said. “It’s hard to go from thinking an illness took your family member to thinking that greed and murder took your family member.”

Michael Ketchmark, a Leawood, Kansas, attorney who helped negotiate legal settlements on behalf of Courtney’s victims, said he couldn’t imagine the pain they were feeling.

“My heart goes out to all of Robert Courtney’s victims, the thousands of lives that he impacted. The pain that they must be feeling on hearing this is unimaginable.”

Gene Porter, a now-retired assistant U.S. attorney who prosecuted Courtney, said he disagreed with the decision to release him from prison.

“I can no longer speak on behalf of the WDMO USAO [U.S. Attorney’s Office for the Western District of Missouri] and can only speak as a private citizen,” Porter said in an email. “In that capacity I can say this was an unfortunate and misguided decision. Robert Courtney should not have been released early and should have served the full 30 year sentence justly imposed by the district court.”

FBI and Food and Drug Administration agents began an investigation in the summer of 2001 after Kansas City oncologist Verda Hunter notified them that a salesman from drugmaker Eli Lilly and Co. had told her Courtney was dispensing far more of the cancer medication Gemzar than he was purchasing.

Agents set up a sting operation to buy drugs from Courtney, who mixed cancer drugs for Hunter, and discovered that the drugs were far less potent than Hunter had ordered. One sample contained less than 1 percent of the prescribed amount.

Authorities said the scheme lasted for a decade and affected as many as 4,200 patients and 98,000 prescriptions for cancer medications and a variety of other drugs.

Hundred of his victims and their families sued Courtney and the makers of two of the cancer drugs Courtney diluted, claiming the companies knew or should have known of Courtney’s scheme through their detailed sales records.

The drug companies, Eli Lilly and Co. and Bristol-Myers Squibb Co., eventually entered into a confidential settlement with the plaintiffs, later revealed to total about $71 million. The company that insured Courtney and his two pharmacies agreed to pay an additional $35 million.

The settlements came after a Jackson County jury in October 2002 ordered Courtney to pay Georgia Hayes, an ovarian cancer patient, $225 million in compensatory damages and $2 billion in punitive damages. The judge later reduced the amounts to $30.1 million and $300 million.

The Hayes case was the only one to go to trial. The judgment was largely symbolic because Courtney had already agreed to forfeit his assets to the government. But the bellwether case was a major factor in persuading the drug company defendants to settle.

In handing down a maximum 30-year sentence in December 2002, U.S. District Judge Ortrie Smith told Courtney: “Your crimes are a shock to the conscience of a nation, the conscience of a community and the conscience of this court.”

In a statement before his sentencing, Courtney apologized to his victims and his family: “From this moment, and for a long time to come, I will be agonizing over what I have done,” he said. “My hope is that … everyone knows that I apologize. And I’m sorry. For the rest of my life, any good that I can do, any kindness that I can show, I’ll do.”

Dan Margolies is senior reporter and editor at KCUR. He can be reached by email at [email protected] or on Twitter @DanMargolies. The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy.
Kansas News Service stories and photos may be republished by news media at no cost with proper attribution and a link to ksnewsservice.org.

See more at https://www.kcur.org/news/2020-07-13/kansas-city-pharmacist-who-diluted-cancer-meds-is-getting-out-of-prison-early.

Kansas sees 1,447 new COVID-19 cases over weekend

On the Wyandotte County UG COVID-19 website, Wyandotte County had 3,065 cases at 1 p.m. Monday, an increase of 15 cases from 1 p.m. Sunday. The number of deaths was the same as Sunday, at 88 cumulative total. (UG COVID-19 website)

Kansas reported 1,447 new COVID-19 cases from Friday morning to Monday morning, according to the KDHE. There were a total cumulative 20,058 cases Monday morning, and an increase of four deaths since Friday morning. (KDHE chart)

Kansas recorded 1,447 new COVID-19 cases from Friday morning to Monday morning, according to figures from the Kansas Department of Health and Environment.

The numbers rose to 20,058 on Monday morning, KDHE reported on its website.

There were four more deaths statewide, according to the KDHE.

According to KDHE figures, Wyandotte County had a 239 case increase from Friday morning to Monday morning.

On the Wyandotte County UG COVID-19 website, Wyandotte County had 3,065 cases at 1 p.m. Monday, an increase of 15 cases from 1 p.m. Sunday. The number of deaths was the same as Sunday, at 88 cumulative total.

Other counties on the KDHE website included these total cumulative cases:
Johnson, 3,160
Leavenworth, 1,248
Sedgwick (Wichita area), 2,422
Shawnee County (Topeka area), 1,048
Douglas, 456
Riley, 331

Dr. Rachel Liesman, director of microbiology in pathology and laboratory medicine at the KU Health System, said the health system would perform its 40,000th test on Monday. Currently, the health system is doing 800 to 900 tests a day, she said. They have limited supplies and cannot do more tests, she added. Everyone continues to have concerns about the supply chain, she said.

She said saliva testing for COVID-19 is pretty good, but the nasal swab test is still the most accurate test. She added studies are being done to gauge the results of the accuracy of the tests. The saliva test is gaining in popularity because of the shortage of supplies needed for the nasal swab test.

Dr, Dana Hawkinson, medical director of infection prevention and control at the University of Kansas Health System, reported 24 patients with COVID-19 in the hospital on Monday morning, an increase of two from Friday. Ten patients were in the intensive care unit, up from seven on Friday. Three patients were on ventilators, the same number as Friday.

Dr. Hawkinson said the slightly increased numbers are a trend around the Kansas City metropolitan area.

During the video news conference, Dr. Hawkinson said when a vaccine becomes available, perhaps in six to nine months, that will contribute to herd immunity.

Currently, only 10 to 12 percent of the population is estimated to have been infected with COVID-19, and herd immunity usually requires 80 to 90 percent, he said. Even if 60 to 70 percent of the people got vaccines or had previously been infected, that would still leave 30 to 40 percent that were susceptible to the virus.

Vaccines are the safer way, according to doctors. Doctors don’t support people trying to get to herd immunity through “COVID parties,” or through exposing more people to the virus.

“The problem is it overwhelms health systems and a lot of people die,” Dr. Steve Stites, chief medical officer at KU Health System, said. They also don’t want to shut down the economy, he added.

Dr. Stites advised people to follow social distancing guidelines, don’t go into crowded places, wear a mask and wash hands. Be responsible and don’t think that it doesn’t matter, he added.

To view the KU doctors’ news conference, visit https://www.facebook.com/kuhospital/videos/312310916622001