There were 71,135 new cases reported Thursday, topping the previous high of 67,791 new coronavirus cases reported across the country two days ago.

Florida reported 13,965 of Thursday's cases, the second most reported in a day in the state.

Right now, tests are being done in much larger numbers -- a positive development -- but this increase is also slowing down results.

Adm. Brett Giroir, assistant secretary for health at the US Department of Health and Human Services, said Thursday that health officials want to reduce wait times for results.

"Even in the large commercial labs, and we follow this every single day, there may be an outlier that's 10 days or 12 days, we can't deny that that happens," Giroir said. He wants test results back as fast as possible, but a three-day turnaround is "very reasonable."

Commercial labs have said they are backed up, with results often taking as long as seven days to turn around. "I'm never going to say that I'm happy with any turnaround time, Giroir added.

Giroir says 700,000 to 800,000 people are being tested each day.

That means it'll be a week before officials know how many of them are infected.

In the meantime, state and local leaders are making decisions on whether to stop reopenings or reimpose restrictions.

And with a lack of federal mandates, they're taking matters into their own hands, such as requiring people to wear masks in public.

Colorado Gov. Jared Polis announced that face masks are required in public places when social distancing is impossible. The order takes effect at midnight on Thursday.

Arkansas Gov. Asa Hutchinson announced a statewide order effective Monday. Masks will be required when people are in the presence of non-household members and aren't able to socially distance.

Alabama and Montana issued statewide facial covering orders on Wednesday.

Large retail chains have also mandated masks in stores. CVS, Publix and Target announced new rules for stores in states and cities where there are no government-mandated ordinances.

Fauci has warning for young people

Dr. Anthony Fauci cautioned against young people assuming they are immune to serious infection.

While the data shows that young people are less likely than older people to become seriously ill, Fauci said he has seen ample evidence of young people being "knocked out on their back and brought to their knees pretty quick" by Covid-19. "I've never seen an infection with this broad range of manifestations."

He told Facebook CEO Mark Zuckerberg that many young people are getting infected and some of them feel horrible for weeks.

The nation's leading infectious disease expert directly urged young people to consider their societal responsibility.

"You're going to get back to normal, and you'll be able to freely have fun, go to the bars, go with the crowds, but not now," he said. "Now's not the time to do that."

As morgues fill up, two counties bring in refrigerated trucks

Thirty-nine states reported an increase in the number of new cases from the week before. California, Florida, Arizona and Texas have become the states to watch as surging coronavirus cases lead to a shortage of hospital beds.

In Arizona's Maricopa County, which has the most Covid-19 cases in the state, the medical examiner's office has ordered four portable coolers with additional ones expected in the coming days, said Fields Moseley, the county spokesman. The medical examiner's office morgue had a total of 156 deceased people -- with a surge capacity of just over 200, Moseley said Wednesday.

In Texas, the city of San Antonio and Bexar County have secured several refrigerated trailers to store bodies until they can be released to funeral homes, Mario Martinez, Metro Health Assistant Director, said in a video interview released by the city.

He said that they currently have two in operation and another three will be operational by the end of the week.

Cameron and Hidalgo counties in Texas are sharing a large refrigerated trailer to store bodies of coronavirus patients because of a lack of space at the morgues.

"I'm pleading with everybody in our neck of the woods, help us do your part, people's lives are at stake -- not just the people getting sick, but doctors, nurses working to the bone, EMS personnel, transporting people," Cameron County Judge Eddie Trevio Jr. told CNN affiliate KVEO.

The Dallas County morgue had to use an external refrigerated truck this week due to the increased caseload, the Medical Examiner's Office told CNN.

"We have had to go to the external refrigerated truck once this week due to increased caseload, but today we are back with all cases inside," Dr. Jeffrey Barnard, the Dallas County Medical Examiner, said in a statement. "I anticipate that we will at some point have to use the truck again based on continuing increased volume."

Georgia governor, Atlanta mayor clash

Gov. Brian Kemp extended Georgia's emergency coronavirus restrictions and said while people are "strongly encouraged" to wear face coverings -- they're not required. The order, which expires July 31, limits public gatherings to 50 people and mandates social distancing.

His order prevents local governments from implementing stricter rules than the state's -- including requiring face masks.

But on Thursday, Michael Smith, press secretary for Atlanta Mayor Keisha Lance Bottoms, told CNN the "Mayor's Order remains in effect, as science and data will continue to drive the City's decisions. Masks save lives."

Epidemiologist says California needs more contact tracers

To combat the rise in coronavirus cases in California, there needs to be enough contact tracing staff in regions where Covid-19 infections are increasing, the principal investigator for the state's contact tracing program told CNN, but not all regions require an equal number of tracers.

"They're not, in their current level, they're not in all places," said University of California, San Francisco epidemiologist Dr. George Rutherford, who also leads the university's contact tracing training program. "If we spread it evenly there still probably wouldn't be enough in the highest incidence areas."

Health officials, he said, cannot forecast how much contact tracing is needed in a region until public health departments are alerted to positive results, but the teams are scalable. "We can call in extra people if there's a surge," Rutherford said.

CNN's Lauren Mascarenhas, Joe Sutton, Jon Passantino, Sarah Moon, Jennifer Henderson and Maggie Fox contributed to this report.

Read the original:

More than 71,000 new cases of coronavirus were reported in the US on Thursday, the most ever - CNN

COLUMBUS, OhioCuyahoga County and two southwest Ohio counties have been taken off the states watch list for the highest coronavirus alert status, Gov. Mike DeWine said Thursday.

However, all three of those counties, as well as 19 counties in total, are now on red-alert for coronavirus, meaning that about 60% of Ohio residents are now required to wear masks in indoor public places and when riding public transportation.

Speaking during a televised briefing, DeWine said that even though Cuyahoga County is no longer on the cusp of reaching purple status, the county is still at a critical stage, averaging 179 new cases per day up 49 additional cases per day since June 23.

The reason Cuyahoga was downgraded was because hospital admissions have not been increasing at the rate they have in the past weeks, according to DeWine spokesman Dan Tierney. However, the governor said during his briefing that the county is very close to meeting the threshold for new hospital admissions -- one of the factors that determine each countys threat level.

Some new cases in Cuyahoga are being driven by out-of-town travel and recreational activities, the governor said. Its critical the residents of Cuyahoga County remain vigilant and do all they can to reduce their risk and exposure to the coronavirus, he said.

Butler and Hamilton counties were also removed from the purple watch list, though like Cuyahoga they remain on red alert. Only one red-level county was downgraded: Trumbull County, which fell to orange, the second-lowest of the four alert levels.

Eight other counties have been elevated to red-alert status for the first time: Allen, Athens, Delaware, Licking, Lucas, Richland, Scioto, and Union counties, DeWine said. Athens County is now the only Ohio county on the purple alert watch list, the governor said.

Outbreaks at bars in the college town of Athens have resulted in the Southeast Ohio county logging more coronavirus cases during the last two weeks than the rest of the pandemic combined, he said.

The governor has said there is community spread of COVID-19 in all of Ohios 88 counties. Each countys color designation is determined by monitoring seven different data indicators, including recent increases in community spread, doctors visits, hospitalizations, and ICU visits, among other factors.

Counties are designated red if they trigger 4-5 of those metrics; counties that have six or all seven of the factors are designated purple.

Besides the mask requirement for both red and purple counties, the DeWine administration largely leaves it up to individual Ohioans to determine for themselves what the difference is between red and purple levels. In red counties, residents are encouraged to consider necessary travel and limit attending gatherings of any number. In counties under the purple, or Level 4, counties, people are advised to limit themselves to necessary travel and only leave home for supplies and services.

During a statewide address on Wednesday, DeWine urged all Ohioans to take immediate action to slow the spread of the virus, including wearing masks while in public. But he also didnt announce any new health orders, saying that discussion is for another time.

Dr. Andrew Thomas, chief clinical officer at Ohio State University Medical Center, said during DeWines Thursday briefing that the color-coded system is meant to be an alert in the same way a weather forecast is.

This is not a grade. This is a warning system, he said.

DeWine

In this case, we can do something with this information.

"

Read more Ohio coronavirus stories:

Ohio Democrats turn on Gov. Mike DeWine for not imposing sterner coronavirus rules

Gov. Mike DeWine implores Ohioans to take immediate action to slow coronavirus, but gives no mandates

Ohio travelers must now quarantine when visiting New York, New Jersey, Connecticut due to coronavirus spike

Ohios new color-coded coronavirus alert system guidelines leave a lot of room for interpretation

Gov. Mike DeWine cancels Tuesday coronavirus briefing, the first scheduled since the state hit a record number of cases

Read the original post:

Cuyahoga County taken off coronavirus watch list,' but more Ohio counties put on red-alert for the virus - cleveland.com

The BDN is making the most crucial coverage of the coronavirus pandemic and its economic impact in Maine free for all readers. Click here for all coronavirus stories. You can join others committed to safeguarding this vital public service by purchasing a subscription or donating directly to the newsroom.

Another 20 cases of the coronavirus have been detected in Maine, health officials said Thursday.

There have now been 3,598 cases across all of Maines counties since the outbreak began here in March, according to the Maine Center for Disease Control and Prevention. Thats up from 3,578 on Wednesday.

Of those, 3,207 have been confirmed positive, while 391 are likely positive, according to the Maine CDC.

New cases were tallied in Androscoggin (1), Aroostook (1), Cumberland (10), Hancock (1), Lincoln (1), Penobscot (1) and York (4) counties. Daily changes in county-level data may vary from new case reports as the Maine CDC continues to investigate cases.

No new deaths were reported Thursday, leaving the statewide death toll at 114. Nearly all deaths have been in Mainers over age 60.

So far, 374 Mainers have been hospitalized at some point with COVID-19, the illness caused by the coronavirus. Of those, 13 people have been hospitalized, with 11 in critical care and four on ventilators.

Meanwhile, 15 more people have recovered from the coronavirus, bringing total recoveries to 3,094. That means there are 390 active and likely cases in the state, up from 385 on Wednesday.

Heres the latest on the coronavirus and its impact on Maine.

Maines top epidemiologist said Thursday he is concerned about the rollout of a controversial new federal requirement that hospitals send their data on the coronavirus response straight to a database in Washington rather than first directing it to the state. Charles Eichacker, BDN

Maintaining mental health during this uniquely stressful time is more important now than ever. There are many steps you can take to address mental health issues at this moment in the pandemic. Sometimes, though, the best help is going to come from a professional. If your daily stress and anxiety has started to interfere with your daily life and functioning, here is how to go about finding a therapist during the pandemic. Sam Schipani, BDN

Maine saw a spike in new jobless claims last week, but state labor officials said they are investigating whether that could be attributed to fraud. Christopher Burns, BDN

The Maine Center for Disease Control and Prevention said Thursday that new COVID-19 outbreaks have been detected at three Portland-area businesses. Bill Trotter, BDN

The number of new coronavirus cases in Maine dropped again last week alongside a small dip in testing, leaving the state among one of only two where daily cases are decreasing. Jessica Piper, BDN

As of Thursday evening, the coronavirus has sickened 3,556,403 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 138,141 deaths, according to Johns Hopkins University of Medicine.

Read the rest here:

July 16 evening update: The latest on the coronavirus and Maine - Bangor Daily News

While good ventilation can dilute aerosols, it is far less effective against droplets, which are much wider and heavier in the same way that a passing breeze would perturb the trajectory of a Ping-Pong ball, but not a cannonball.

The study points to a more important role for aerosolized flu transmission than some might assume, Dr. Marr said.

Determining the exact size of that role, however, is another matter entirely. Its very hard to conduct these human challenge studies and separate the different modes of transmission, Dr. Marr said. That problem applies across respiratory viruses, including the coronavirus.

Part of the problem is the continuum on which aerosols and droplets exist. Though they go by different names, the two categories really belong to the same group: globs of fluid that come in varying sizes. Blobs less than five micrometers in diameter are termed aerosols, which can exit the airway at the slightest breath and waft away; anything larger is a droplet, hefty enough to fall to the ground within a few feet of its source. The boundary between them is somewhat arbitrary, though generally speaking, the smaller the particle, the farther it travels.

When people expel fluid from their airway, it tends to manifest in a mixture, some bigger, some smaller and everything in between, said Seema Lakdawala, who studies influenza transmission at the University of Pittsburgh.

Updated July 16, 2020

Even after they exit an individual, these fluidic blobs remain dynamic. Large droplets, for instance, can disperse or evaporate into little aerosols in midair. Others might scatter onto a surface or a hand, lingering for minutes or hours before encountering someone new. And the rates at which all these events occur can shift, depending on the force with which someone, maybe a loud talker, expels these droplets or the amount of air flow in an area, Dr. Lakdawala said.

Everyone thinks transmission is a very binary concept, she added. The reality is that there is a continuum of aerosols.

See the article here:

The Flu May Linger in the Air, Just Like the Coronavirus - The New York Times

Well, I was writing just the other day about what we dont know about the T-cell response to coronavirus infection, and as of today we know quite a bit more. And from what I can see, we have encouraging news, mixed with some things that were going to need to keep an eye on.

Heres a post from May on a paper in Cell that looked at T cell responses in recovering SARS CoV-2 patients and compared them to reports of people who had been infected with original SARS back in 2003, and to people who had never encountered either. It also has some background on T cells in general, which might be useful if you dont have that info right at the top of your brains queue. Thats the paper that showed that the T-cell response to this virus is less Spike-o-centric than it was to SARS. It also showed that there are, in fact, people who have both CD4+ and CD8+ T cells that recognize protein antigens from the new coronavirus even though they have never been exposed to SARS, MERS, or the new virus. The paper speculated that this might be due to cross-reactivity with proteins from the common cold coronaviruses, and raised the possibility that there might be a part of the population that has at least some existing protection against the current pandemic.

Now comes a new paper in press atNature. It confirms that convalescent patients from the current epidemic show T-cell responses (mostly CD4+ but some CD8+ as well) to various epitopes of the N (nucleocapsid) protein, which the earlier paper had identified as one of the main antigens as well (along with the Spike and M proteins, among others, with differences between the CD4+ and CD8+ responses as well). Turning to patients who had caught SARS back in 2003 and recovered, it is already known (and worried about) that their antibody responses faded within two or three years. But this paper shows that these patients still have (17 years later!) a robust T-cell response to the original SARS coronaviruss N protein, which extends an earlier report of such responses going out to 11 years. This new work finds that these cross-react with the new SARS CoV-2 N protein as well. This makes one think, as many have been wondering, that T-cell driven immunity is perhaps the way to reconcile the apparent paradox between (1) antibody responses that seem to be dropping week by week in convalescent patients but (2) few (if any) reliable reports of actual re-infection. That would be good news indeed.

And turning to patients who have never been exposed to either SARS or the latest SARS CoV-2, this new work confirms that there are people who nonetheless have T cells that are reactive to protein antigens from the new virus. As in the earlier paper, these cells have a different pattern of reactivity compared to people who have recovered from the current pandemic (which also serves to confirm that they truly have not been infected this time around). Recognition of the nsp7 and nsp13 proteins is prominent, as well as the N protein. And when they looked at that nsp7 response, it turns out that the T cells are recognizing particular protein regions that have low homology to those found in the common cold coronaviruses but do have very high homology to various animal coronaviruses.

Very interesting indeed! That would argue that there has been past zoonotic coronavirus transmission in humans, unknown viruses that apparently did not lead to serious disease, which have provided some people with a level of T-cell based protection to the current pandemic. This could potentially help to resolve another gap in our knowledge, as mentioned in that recent post: when antibody surveys come back saying that (say) 95% of a given population does not appear to have been exposed to the current virus, does that mean that all 95% of them are vulnerable or not? Ill reiterate the point of that post here: antibody profiling (while very important) is not the whole story, and we need to know what were missing.

There are still major gaps in our knowledge: how many people have such unknown-coronavirus-induced T-cells? How protective are they? How long-lasting is the T-cell response in people who have been infected with the current SARS CoV-2 virus, and how protective is it in the declining-antibody situation that seems to be common? What sorts of T cell responses will be induced by the various vaccine candidates? We just dont know yet. But were going to find out.

More:

New Data on T Cells and the Coronavirus - Science Magazine

Since the beginning of the pandemic, the World Health Organization has stressed that, primarily, Covid-19 spreads through very close personal contact. The virus-laden droplets exhaled from a sick persons mouth and nose, the thinking goes, are heavy, and fall to the ground before they can get much farther than 6 feet.

But as the pandemic has unfolded, contact tracing studies have shown this isnt always the case. In China, an air conditioner pushed virus-laden air across three tables in a restaurant, infecting people seated at each one. Researchers reviewed video from the restaurant and saw many of these patrons were more than 6 feet apart from one another, suggesting that the virus traveled through the air.

In Washington state, one person at a choir practice infected 52 of the other participants; its thought the singing could have led more virus to linger in the air. Carefully controlled laboratory studies are also suggesting that under the right indoor conditions, SARS-CoV-2, the virus that causes Covid-19, can float in the air and, to a certain degree, spread that way.

Last Thursday, the WHO changed its language to recognize that fact. Short-range aerosol transmission, particularly in specific indoor locations, such as crowded and inadequately ventilated spaces over a prolonged period of time with infected persons cannot be ruled out, the WHO now states. Previously, the organization maintained that airborne transmission was unlikely to occur outside the hospital setting, where some procedures can generate super-small particles that linger in the air longer than large respiratory drops.

This change comes after a letter appeared in the journal Clinical Infectious Diseases, co-signed by 239 scientists and engineers, which implored WHO and other public health agencies that its time to address airborne transmission of Covid-19. With the WHOs recognition of this mode of transmission, the authors hope, communities can think more about the ventilation of indoor spaces and perhaps engineer solutions to make these spaces safer.

It turns out scientists have been debating whether respiratory diseases like the flu and coronavirus should be labeled airborne for a century. More commonly, the airborne designation is only applicable to extremely contagious diseases, like measles.

A lot of these terms are confusing (even to the scientists), and they dont answer the question laypeople care about: Which air is safe to breathe in during the Covid-19 pandemic, and which air is not safe?

To answer that question, its helpful to understand two different scientific perspectives on the matter. One is: What physically happens when a sick person breathes, sneezes, or coughs into a room? The other is: What patterns have epidemiologists observed in the way people are exposed to the virus and get sick?

Lets start with the first.

Theres a relatively simple, if outdated, way of thinking about how respiratory diseases can spread.

It starts like this: When you exhale, sneeze, or cough, you release a cloud of gas and liquid droplets.

If those droplets are relatively big, theyre heavy and fall to the ground before evaporating, like raindrops do. Others are smaller, and made smaller still by evaporation. These smaller droplets can linger in the air longer, drifting on air currents for perhaps hours. If a droplet is small enough, the moisture in it evaporates before it has the chance to reach the ground (provided the humidity in the room is average). If theres stuff like germs in that droplet, they become light enough to float on air currents, like the dust you can see suspended in the air. These particles are often called aerosols.

This framework is old, and it comes from William Wells, a scientist who studied tuberculosis transmission in the 1930s. In a 1934 paper, Wells concluded: It appears, therefore, that transmission of infection through air may take one of two forms depending upon the size of the infected droplet.

When it comes to Covid-19, one of the first questions epidemiologists tried to answer was: Is the virus spread in the dust that floats or the big drops that fall?

If its the small dust, alarm bells go off. These are the prototypical airborne diseases. They include measles, chickenpox, and tuberculosis, and they are extremely contagious. On average, one person infected with measles will infect 12 to 18 others.

If its the big drops, its still concerning. Diseases like the flu, whooping cough, the common cold, and coronaviruses are primarily large droplet-borne. With these diseases, only the closest contacts to an infected person get infected because large droplets quickly fall to the ground (within 6 feet or so). Its also possible for these big drops to fall on surfaces, and those surfaces can become contaminated too. Luckily, in the case of Covid-19, theres a growing consensus that getting sick from touching contaminated surfaces is rare. But keep washing your hands!

(Interestingly, theres no one reason a new virus, like SARS-CoV-2, would go one route or the other. Its possible, says University of Leicester virologist Julian Tang, that there may be a difference in the immune response with these airborne diseases that makes saliva and mucous less viscous, leading to more virus in small drops. Also, Tang writes in an email, it is possible (though no one has studied this yet) that exhaled breath from measles/chickenpox cases may just be shedding much more virus (maybe millions of virus per minute) compared to respiratory viruses, which only exhale 100s to 1000s of viruses per minute.)

A part of why the terminology here is so confusing, and theres so much debate about it, is that the words aerosol and droplet mean different things to different scientific disciplines.

An aerosol is a particle in the air, said Lidia Morawska, an engineer and the director of the International Laboratory for Air Quality and Health at Queensland University of Technology. A droplet is a liquid aerosol. To her, the distinction between droplets and aerosols doesnt make any sense. To her, they are all aerosols.

Wells outlined a clear distinction between droplets and aerosols according to their size. Big drops fall, and little aerosolized drops float. Its now appreciated that the actual picture is a lot more complicated.

Were always exhaling, in fact, a gas cloud that contains within it a continuum spectrum of droplet sizes, says Lydia Bourouiba, an MIT researcher who studies the fluid dynamics of infections. And, as she explained in a March paper in JAMA, the conditions of the cloud itself can affect the range of some of the droplets. If propelled by a cough or sneeze, Bourouiba finds, droplets can travel upward of 20 feet. The cloud mixture, not the drop sizes, determines the initial range of the drops and their fate in indoor environments.

The speed of the cloud, the temperature and humidity of the environment, and the individual droplet makeup of each cloud determines how long the droplets persist in the air, Bourouiba explained in JAMA.

Which is to say: There are conditions (coughing and sneezing) under which large drops dont immediately fall to the floor and can spread more than 6 feet away from a person, and they can linger in the air for longer.

Theres growing theoretical evidence for the airborne spread of the coronavirus. Lab studies, in idealized conditions, also show that the virus can live in an aerosolized form for up to 16 hours (the scientists in this case intentionally created aerosolized droplets with a machine).

Another study tracked with lasers the various droplets expelled from a human mouth during speech. It found normal speech generates airborne droplets that can remain suspended for tens of minutes or longer and are eminently capable of transmitting disease in confined spaces.

Some studies, the WHO reports, have found evidence of the viruss RNA in the air of hospital rooms, but notes no studies have found viable virus in air samples, meaning the virus was either incapable of infecting others or was in very small quantities unlikely to infect others.

What we are trying to say is, well, lets not worry about whether you call it aerosol or whether you call it a droplet, Morawska, the co-author of the recent commentary imploring the WHO and others to address airborne transmission of Covid-19, says. It is in the air, she says, and you inhale it. Its coming from our nose from our mouths. Its lingering in the air and others can inhale it.

That the WHO updated its language is a sign that its starting to appreciate this perspective.

But this perspective is limited. These lab studies cant perfectly generalize to the real-world conditions in which the virus spreads and infects others. Just because a virus travels far in a drop doesnt mean it can infect people across great distances. Viruses can degrade quickly outside the body. Also, dose matters. Small exposures to the virus may not be enough to get a person sick.

So to find out how people actually get sick with Covid-19, we need contact tracing studies.

Lab studies note the theoretical possibility of airborne transmission. But thats only one part of the answer to the question which air is safe to breathe? Epidemiologists come at this question from another angle, looking at patterns of virus spread observed in the real world and working backward to determine if airborne spread factors in.

Contact tracing studies show us that while droplets being inhaled by people within 6 feet of an infected person explains most of the transmission of Covid-19, there are limited times and environments in which SARS-CoV-2 can behave a bit like an airborne virus.

So we need to define which types of contact, which type of environments, lead to that type of transmission, Muge Cevik, a physician and virology expert at the University of St. Andrews, says. In households, she says, an infected person can be isolated in one room and not spread the virus to others in the home (if they remain isolated). A systematic review of studies in The Lancet of both SARS-CoV-2 and similar viruses found large reductions in risk if people just stay 1 meter (3 feet) away from one another. This suggests a lot of the risk of catching Covid-19 is from the large drops that fall quickly to the ground.

But then there are cases where people are packed together in an enclosed space like a church, with singing or shouting where the transmission looks a little more like airborne transmission.

The infamous choir practice in Washington state is an example of where airborne transmission might have happened. But what made this event so risky was the convergence of many risk factors: the singing activity (during which the infected person released viral particles into the air), the time spent together (the practice was 2.5 hours), and the interaction between the choir members in an enclosed space (not only did they all practice together, they also split up into smaller groups and shared cookies and tea).

Another study from China investigated an outbreak that started at a Buddhist temple event, tracing much of the spread to the confines of one of the buses transporting people to the function. The bus had one sick person aboard, and 24 out of 67 people on that bus got sick, possibly indicating airborne transmission. Those who sat by the windows fared better, indicating the importance of ventilation.

I think we just need to get away from this terminology and give much more clear definitions, Cevik says. For her, its about getting people to think critically about which situations are riskier than others. Risk is a spectrum. Its not only the distance, but its about timing, what type of activities youre involved in. I know its a bit complex, but thats the reality.

Perhaps part of the reason the WHO has been slow to address the airborne transmission of Covid-19 is because in a health care setting, airborne means a very specific thing.

Though infection prevention experts know theres a fuzzy boundary between drops that fall and specks that float, the dichotomy between airborne and droplet-borne is baked into how health care workers are trained to respond to outbreaks. Weve trained [health care workers] for decades to say, airborne is tuberculosis, measles, chickenpox, droplet is flu and pertussis and meningitis, Saskia Popescu, a hospital epidemiologist in Arizona, says. And thats, unfortunately, kind of antiquated. But thats how weve always done it.

They do it because there are very specific sets of guidelines in place to deal with extremely contagious airborne diseases in a hospital setting. For instance, a patient with a dangerous airborne disease often needs to be put in a room with an air pressure lower than the rest of the rooms in the building. That way, no virus in the air of that room can escape it (since air flows from high pressure to low pressure).

For droplet transmission, health care workers can be a little more lax; they can wear simple surgical masks during routine care and can save high-filtration (and sometimes scarce) respirators for the most dangerous procedures and cases.

In this light, it makes some sense that the WHO has been hesitant to label Covid-19 an airborne infection. Its not an airborne infection like measles is. It is not as contagious. Contact tracing studies consistently find that Covid-19 is spread most readily among people in the closest physical contact to one another. Airborne means something very specific, very resource-intensive, and very scary for hospitals and the people who work in them. And Covid-19 doesnt match that definition.

The debate often isnt very nuanced because of these rigid categories, Daniel Diekema, an infectious diseases physician and epidemiologist at the University of Iowa, says. As soon as you say airborne in the hospital infection prevention world, it brings to mind pathogens like tuberculosis, measles, chickenpox. Its clear the respiratory viruses, influenza, coronaviruses, are not airborne in the same way that the measles, varicella [chickenpox] become airborne.

But at the same time, with Covid-19 and other respiratory viruses, there definitely are small-particle aerosols produced, he says. And in the right setting, where theres poor ventilation, indoors, and a crowded environment, there is a risk for transmission among individuals, even if they may be more than 6 feet apart.

Neither contact tracing studies nor lab studies can perfectly answer the question of which air is safe? But thats science for you. Scientists use imperfect methods, attacking from many angles, to try to arrive at the truth, which can take a while to nail down precisely.

Overall, the recognition that Covid-19 can spread through the air shouldnt really change how we, individually, protect ourselves and others against it. Six feet of distance between people is still a good barrier to prevent spread via large drops. Mask-wearing could help prevent both large drops and small drops from being released in the first place. Time matters too: the longer we spend in an enclosed, poorly ventilated space with others, the greater the chances of being exposed to an infectious dose of the virus.

The bottom line, as a trio of engineers from Clarkson University writes in the Conversation, is that while staying six feet from other people reduces exposure, it might not be sufficient in all situations, such as in enclosed, poorly ventilated rooms.

We still need to think about the environments were in: Indoors is much riskier than outdoors (where greater airflow can disperse drops and aerosols more quickly, and where the environment is less conducive to SARS-CoV-2 survival). And indoors, ventilation can make a big difference. An indoor space where the air is constantly refreshed with air from the outdoors is better than one where the air is stagnant. (The American Society of Heating, Refrigerating and Air-Conditioning Engineers has published extensive guidelines on how to reopen buildings with increased ventilation during the pandemic.)

We also still need to think about the activity were engaging in. Shouting, singing, and other such activities produce more droplets (of any size) than just sitting quietly.

Morawska hopes that in bringing attention to airborne spread of Covid-19, there can be more attention paid to engineering solutions for indoor spaces to mitigate the spread of the pandemic.

Public health officials have continually stressed social distancing, mask-wearing, and hand-washing as ways to stop the spread of Covid-19. But have you ever heard a restaurant reopening announce theyve improved ventilation or increased ventilation? No. This is really the point, Morawska says. If Covid-19 is in indoor air, we should also be doing something about the air.

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Is the coronavirus airborne? The latest guidance from the WHO, explained. - Vox.com

The number of confirmed cases of the coronavirus illness COVID-19 world-wide rose to 13.6 million on Thursday, after a record of about 230,400 new infections were counted on Wednesday, according to data aggregated by Johns Hopkins University.

That was higher than the previous one-day record of roughly 229,000 counted last Friday, the data show. The U.S. recorded another 66,300 cases on Wednesday, just below the record of more than 67,000 cases reported on Tuesday.

A full 43 states and territories have seen case numbers rise in the past 14 days, according to a New York Times tracker, showing Florida is the new hot spot in the U.S. Hospitals in parts of the South and West are straining to handle the case load. The cities of Houston, Miami and Phoenix are reporting dire shortages of intensive-care unit beds and staff.

Public health experts and academics are astounded at the White House move to order hospitals to report COVID-19 data to the Department of Health and Human Services, instead of the Centers for Disease Control and Prevention, the nations premier public health agency. The decision is expected to make the data less transparent to the public and to researchers.

See also:Trumps pandemic response was hindered by missed opportunities, ignored warnings

... HHS and the White House broke a system that was working to put in a no-bid contract contractor, inexperienced to try to do something that is mission-critical to solve the pandemic, said Tom Frieden, a former head of the CDC and now a senior fellow for global health at the Council on Foreign Relations. Just when you think cant get less organized or less functional, it does, in this country.

There was further outrage about Georgias Gov. Brian Kemp ban on Georgias cities and counties from ordering people to wear masks in public places. Kemp voided orders on Wednesday that at least 15 local governments across the state had adopted, as the Associated Press reported.

Georgia has lost 3,091 people to the pandemic so far, the Johns Hopkins data show.

The ban comes as other states are moving in the opposite direction, ordering residents to cover their faces, including Alabama on Wednesday. Public health experts agree that wearing a face mask, washing hands frequently and socially distancing are vital measures to contain the spread. Retailers Walmart Inc. WMT, +0.15% and Kroger Co. KR, -0.11% have both said face masks are mandatory for shoppers in their stores. The National Retail Federation is recommending that all retailers follow their example.

Savannah Mayor Van Johnson was the first local official to defy Kemp and order masks, and had said police would start writing $500 citations to businesses that didnt enforce the law. Johnson called Kemp out by name on Twitter.

The Harvard Global Health Institute (HGHI) shot down a suggestion by CDC Director Robert Redfield earlier this week that COVID-19 cases in the South were being caused by people from the North vacationing there after Memorial Day weekend. Redfield said there was a pop in cases around June 12 to June 16 caused by vacationers driving down south.

This is not what the data say, the HGHI said in a report. Infections in states including Nevada and Florida actually stared rising on June 1.

Remember that there is always a lag between when infections occur and when they begin to be diagnosed, said the report. This means that the increase in confirmed cases around June 1 comes from infections occurring around May 24, right around the Memorial Day weekend (and well before mid-June, as Dr. Redfield suggests.) So the data show that these outbreaks started before Northern vacationers supposedly traveled South.

The more likely explanation is that infections are spiking because states reopened far too early.

Virginia, on the other hand, remaine

d in phase 1 of its reopening through the end of May and has fared significantly better than its neighbors, said the report.

The HGHIs tracking tool is currently showing 11 states flashing red, led by Florida, which now has a seven-day average rate of 51.8 cases per 100,000 people. Harvard researchers say those states the other 10 are Arizona, Louisiana, South Carolina, Alabama, Texas, Georgia, Nevada, Tennessee, Mississippi and Idaho need to reimpose stay-at-home orders.

The number of confirmed deaths from COVID-19 climbed to 584,990, while the number of people who have recovered climbed to 7.6 million.

The U.S. leads the world with 3.49 million cases and 137,420 deaths.

Brazil is second to the U.S. with 1.97 million cases and 75,366 deaths. India is third measured by cases at 968,876 followed by Russia with 751,612 and Peru with 337,751.

The U.K. has 45,138 fatalities, the highest in Europe and third highest in the world.

China, where the illness was first reported late last year, has 85,247 cases and 4,644 fatalities.

Read also: Russia accused by U.S., Britain, Canada of hacking coronavirus vaccine trials

Johnson & Johnson CFO Joseph Wolk told CNBC that the company expects the Phase 1 trial for its COVID-19 vaccine candidate to begin next week.

Wolk said the Phase 1 trial is expected to enroll more than 1,000 participants, primarily between the ages of 18 and 55 years old, although the company also plans to include a group of people who are 65 years old or older in the early-stage trial.

He also said that J&J is in talks with the National Institutes of Health to move up the timeline for the anticipated Phase 3 trial to late September.

The science still has to play out, Wolk said.

Dynavax Technologies Corp. DVAX, +1.38% announced that it will work with the Icahn School of Medicine at the Mount Sinai Hospital system in New York on a universal influenza vaccine. Mount Sinai has received funding from the National Institute of Allergy and Infectious Diseases to develop a vaccine and aims to use Dynavaxs adjuvant technology to support that process.

A universal flu vaccine would get rid of the need for annual flu vaccination, the organizations said in a news release.

See also: This new study shows how well a coronavirus vaccine must work before we can stop social distancing

The number of Americans applying for jobless benefits fell slightly in the second week of July to a post-pandemic low of 1.30 million, but the grudgingly small decline points to ongoing stress in the labor market as the economy struggles to cope with the latest coronavirus outbreak, MarketWatchs Jeffry Bartash and Greg Robb reported.

New applications for unemployment compensation, a rough gauge of layoffs, fell 10,000 in the seven days ended July 11 to 1.30 million from a revised 1.31 million in the prior week, the Labor Department said Thursday. The figures are seasonally adjusted.

Economists polled by MarketWatch had forecast 1.24 million new claims. These figures reflect applications filed the traditional way through state unemployment offices.

An unadjusted 928,488 people also applied for benefits through a temporary federal-relief program.

Initial jobless benefit claims have stalled since mid-June when they hit 1.57 million. An economic rebound in May and June has lost momentum in July amid a fresh wave of coronavirus cases that has forced many states to either reimpose partial lockdowns or pause reopening plans.

The latest setback is expected to put more people out of work again and delay the return of others to their jobs, making it harder for the economy to recover. Economists say Washington has to extend emergency unemployment benefits and increase other aid to prevent the situation from getting worse.

The trend in initial jobless claims has now just about stopped falling; next week could easily see an increase, for the first time since March, in the wake of the continued gradual reimposition of restrictions across the South and parts of the West, said Ian Shepherdson, chief economist at Pantheon Macroeconomics.

Separately, sales at U.S. retailers posted a big increase in June for the second month in a row, but that trend too may be sapped by the rise in new cases. Retail sales climbed 7.5% last month following a record 18.2% increase in May, the government said Thursday. Economists polled by MarketWatch had forecast a 5.4% increase.

Retail sales may have had a strong showing for June, but thats old news given how quickly the coronavirus resurgence is beating up the economy, said Robert Frick, corporate economist at Navy Federal Credit Union.

Morgan Stanley and Bank of America were the latest big banks to post earnings and they showed the same trend as other banks of strong trading and investment banking fees, offset by the need to set aside huge provisions for potential loan losses.

Banks are warnings that they may be facing a wave of defaults as companies struggle in the pandemic.

There was more upbeat news from Dominos Pizza, which has been thriving during lockdown periods and as consumer eat at home more. Johnson & Johnson beat profit and sales estimates for its latest quarter, amid strong demand for drugs.

Cowen downgraded Walt Disney Co.s DIS, -1.21% stock on concerns that its parks and film business will be disrupted for longer than investors anticipate, and Citi reiterated a sell rating on Tesla Inc. TSLA, -2.93%, after its massive year-to-date rally, which has come even as its main plant in Fremont, California was shut down for much of the last quarter.

What hasnt changed, in our view, is the lack of evidence to support the recent narrative in the stock-namely that Tesla is already experiencing seemingly unlimited demand thats decoupled from autos, that traditional & emerging competitors stand little chance, that FSD/AV [fully self-driving technology] is industry leading and that Tesla should be valued vs. large Tech names, analyst Itay Michaeli wrote in a note to clients.

It is tough to fight the momentum, but its even tougher to construct a fundamental risk/reward framework that makes sense here (particularly with COVID-19 risks), even if one is constructive on Tesla the company.

Elsewhere, companies offered updated guidance and outlined ways they are managing liquidity in the pandemic, among other issues. MMM, +0.73%

Heres the latest news about companies and COVID-19:

3M Co. MMM, +0.73% , the maker of Post-it Notes and industrial products, has filed 18 lawsuits and shut down thousands of deceptive websites and social media posts as it moves to prevent COVID-19 fraud and profiteering. The company is working with law enforcement agencies to help protect the public against those parties who are exploiting the strong demand for its products, which include N95 masks and other equipment. The schemes we shut down were not only unlawful, they also endangered lives and wasted precious time and resources by diverting buyers from legitimate sources of much-needed respirators, Denise Rutherford, senior vice president of corporate affairs said in a statement. 3M has created hotlines and websites for consumers to report suspected fraud and has published pricing information for N95 masks to help them avoid inflated prices. The company has won 6 temporary restraining orders and 4 preliminary injunction orders from courts that halted unlawful actions, said the statement.

Abbott Laboratories ABT, -0.34% reported second-quarter profit and revenue that beat expectations and provided an upbeat full-year outlook. For 2020, the company expects adjusted EPS of at least $3.25, above the FactSet consensus of $2.90. Were a leader in the global COVID-19 testing efforts, weve continued to advance our pipeline and, importantly, we saw significant improvements in growth trends throughout the quarter in the business areas that were initially most impacted by the pandemic, said Chief Executive Robert Ford.

Alcoa Corp. AA, +6.30% reported a narrower second-quarter loss and sales were slightly ahead of expectations. The company made progress on its continuing asset review in preparation for potential sales and cost-cutting goals related to the pandemic. It increased its liquidity after completing the sale of $750 million worth of bonds on Monday, at a 5.5% coupon rate that was lower than any of its previous debt issuance. Despite challenging market conditions, our team has lowered production costs, increased output, maintained stable shipments, and improved our balance sheet, Chief Executive Roy Harvey said in a statement. We continued to make progress in executing our strategic actions and 2020 programs, and we finished the quarter with a cash balance of nearly one billion dollars.

American Airlines Group Inc. AAL, -7.36% sent notices to 25,000 workers -- about one-fifth of its workforce -- about potential furloughs as the airline copes with what it calls slackening demand for air travel during the pandemic. American, which is prohibited from slashing jobs or pay rates through Sept. 30 under terms of $25 billion in federal payroll support, also urged employees to take buyout and early retirement packages before being forced to cut their jobs. The airline, which reported an 80% plunge in June revenue, says it will be overstaffed by 20,000 when federal aid expires Oct. 1.

Separately, American Airlines Group Inc. and JetBlue Airways Corp. JBLU, -4.58% announced a partnership aimed at creating more options for travelers in the Northeast U.S., to give the more choices across the airlines domestic and international routes. The partnership includes an agreement that proposes code-share and loyalty benefits for flight offerings in New York and Boston. The partnership will allow American to launch service from New Yorks JFK airport to Tel Aviv and to Athens, and the JFK to Rio de Janeiro flight will return as a daily route in winter 2021, and will allow JetBlue to add flights in New Yorks LaGuardia Airport and New Jerseys Newark airport and grow its presence at JFK.

Bank of America Corp. BAC, -2.72% posted net income of $3.5 billion, or 37 cents a share, in the second quarter, down from $7.3 billion, or 74 cents a share, in the year-earlier period. The number was weighed down by a $4 billion build in loan loss provisions during the coronavirus pandemic. Revenue fell to $22.3 billion from $23.1 billion. The FactSet consensus was for EPS of 28 cents and revenue of $21.8 billion. Strong capital markets results provided an important counterbalance to the COVID-19-related impacts on our consumer business, Chief Executive Brian Moynihan said in a statement. Net interest income fell 11% to $10.8 billion, driven by lower interest rates. Noninterest income rose 5% to $11.5 billion, buoyed by strong capital markets results. Sales and trading revenue rose 28% to $4.2 billion, as FICC (fixed income, currencies and commodities) revenue climbed 50% to $4.2 billion and equities revenue rose 7% to $1.2 billion. Investment banking fees rose 57% to a record $2.2 billion, amid record capital raising by companies seeking to bolster liquidity during the pandemic.

Charles Schwab Corp. SCHW, -2.07% reported a second-quarter profit that topped expectations but revenue that fell why, as the pandemic created a myriad challenges for its clients. Total client assets as of the end of June were $4.11 trillion, up 11% from a year ago. We grappled with the ongoing health crisis, a contracting U.S. economy, and sustained pressures on interest rates, yet there were some encouraging signs as the quarter progressed, including domestic equity markets recovering to pre-pandemic levels, said Chief Executive Walt Bettinger.

Dominos Pizza Inc. DPZ, -1.48% reported second-quarter earnings and revenue that far exceeded expectations during the pandemic. U.S. same-store sales grew 16.1%, and international same-store sales rose 1.3%. The FactSet consensus was for domestic growth of 11.9% and a global rise of 0.7%. As of June 14, Dominos had $248 million in cash and equivalents and $4.17 billion in total debt. The company borrowed $158 million under its variable funding notes during the quarter as a precautionary measure.

Bankrupt department store retailer J.C. Penney Co. Inc. JCPNQ, -0.36% announced a company restructuring that includes 152 store closures and a head count reduction of 1,000 workers across corporate roles, management and internationally. J.C. Penney filed for bankruptcy protection in May after which Cowen analysts forecast the company would have to shutter 25% of its locations. J.C. Penney has 90,000 employees, according to FactSet and, as of February 2020, had 850 locations in the U.S. and Puerto Rico.

J.Jill Inc. JILL, +38.07% reached an agreement with lenders to extend a forbearance period to July 23 to give the company more time to complete negotiations. We are making progress with the negotiations and expect a resolution soon, Interim Chief Executive Jim Scully said in a statement. The Quincy, Mass.-based womens clothing retailer entered the forbearance agreements in June after falling out of compliance with certain covenants on its asset-based lending facility and term loans during pandemic. The uncertainty created by recent events generate scenarios that raise substantial doubt about our ability to continue as a going concern within one year after the date the financial statements are issued, the company said in its 10k filing published in June.

Johnson & Johnson JNJ, +0.66% reported second-quarter profit and sales that beat expectations, and raised its full-year outlook. Consumer health sales fell 7.0% to miss expectations, while pharmaceutical sales grew 2.1% to slightly top expectations and medical device sales dropped 33.9% but was above expectations. Our second quarter results reflect the impact of COVID-19 and the enduring strength of our pharmaceutical business, where we saw continued growth even in this environment, said Chief Executive Alex Gorsky. The company raised its 2020 guidance ranges for adjusted EPS to $7.75 to $7.95 from $7.50 to $7.90 and for sales to $79.9 billion to $81.4 billion from $77.5 billion to $80.5 billion

Morgan Stanley MS, +2.51% reported a second-quarter profit that rose above expectations, amid strength in the trading and investment banking businesses. Net income increased to $3.20 billion, or $1.96 a share, from $2.20 billion, or $1.23 a share, in the year-ago period. The FactSet consensus for earnings per share was $1.12. Revenue 30.9% to $13.41 billion. Noninterest revenue grew 28% to $11.81 billion, to beat the FactSet consensus of $9.36 billion and net interest income rose 31% to $1.60 billion to top expectations of $985.2 million. Within noninterest revenue, trading revenue soared 71% to $4.68 billion and investment banking revenue jumped 35% to $2.14 billion. The second quarter tested the model and we performed exceedingly well, delivering record results, said Chief Executive James Gorman. This builds on the momentum of a very strong first quarter, while more than 90% of our employees continue to work from home, demonstrating the ongoing operational resilience of our platform.

Norwegian Cruise Line Holdings Ltd. NCLH, -15.62% is offering $250 million of stock in a syndicated deal. J.P. Morgan, Citigroup, Goldman Sachs, Barclays, Mizuho Securities and UBS are joint book-runners on the deal. Proceeds will be used for general corporate purposes. Cruise operators have been hit hard by the coronavirus pandemic, which has halted all sailings due to the high risk of passengers becoming infected in close quarters.

Penske Automotive Group Inc. PAG, +3.82% preannounced expectations of a surprise second-quarter profit, citing a significant improvement in operations during June. Based on the performance of its U.S. and U.K. retail automotive dealerships and its used vehicle supercenter, Penske expects to report EPS of 52 cents to 57 cents, which compares with the FactSet consensus for a loss of 16 cents a share. All of its U.S. retail automotive dealerships are open after closing during the pandemic. Strong sales of used units in June led to combined U.S. and U.K. operations generating a profit that was more than double that of the period last year. Our performance in June is the result of a strong operational focus to control costs, manage vehicle inventory, and maximize gross profit, said Chief Executive Rob Penske.

Sleep Number Corp. SNBR, -9.19% reported a steep drop in second-quarter revenue caused in large part by the pandemic. The mattress companys revenue tumbled 20% to $284.9 million from $356 million a year ago. Analysts surveyed by FactSet had expected sales of $251 million.

Additional reporting by Tim Rostan and Jaimy Lee

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Coronavirus update: Global COVID-19 cases climb to 13.6 million after record one-day tally of 230,400 new infections - MarketWatch