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The Many Symptoms of Covid-19 – The New York Times

Rob Gregson, 52, of South Orange, N.J., went to bed feeling under the weather and woke up with chest tightness, a weird cough, difficulty breathing and crazy fatigue. It was March 11, just before lockdowns were imposed, and he immediately suspected Covid-19. But because he never had a fever, it took him more than a week to find a doctor to help and get a swab test. He tested positive.

Its been the fatigue that is the most debilitating, said Mr. Gregson, executive director of a faith-based nonprofit, adding that hes still struggling to regain his stamina nearly five months later. Ive been on the coronavirus roller coaster, feeling better and thinking Ill be OK, then it comes roaring back.

When Erin, a 30-year-old who works for a nonprofit in Washington, D.C., first developed a cough and headache in May, she wasnt worried. I did not have a fever, and Id been very diligent about wearing a mask and washing my hands, so I figured it was allergies or a cold at the beginning, she said.

About four days after the cough began, Erin was hit with severe fatigue, sore throat, congestion, chills, body aches and a slight loss of sense of smell but still no fever. She also had one unusual symptom: severe pain in her hip muscles, which she described as really weird.

Although body aches are a common symptom of Covid-19, some patients are reporting severe joint and body pain, particularly in large muscles. Although its rare, Covid-19 can cause painful inflammation in the joints or lead to rhabdomyolysis, a serious and potentially life-threatening illness that can cause excruciating muscle pain in the shoulders, thighs or lower back.

A New York cyclist who developed severe leg pain in May was initially diagnosed via telemedicine with a bulging disc. She sought a second telemedicine opinion with Dr. Jordan Metzl, a sports medicine specialist at the Hospital for Special Surgery in New York, who asked her to move, twist and put pressure on her legs as he watched her on video.

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The Many Symptoms of Covid-19 - The New York Times

SD County Reports 263 New COVID-19 Cases, Five Deaths And Six New Outbreaks – KPBS

Photo by Matt Hoffman

Above: Coronavirus testing at the San Diego county lab, Feb. 28, 2020.

San Diego County health officials Thursday reported 263 new COVID-19 infections and five additional fatalities, raising the county's totals to 31,127 cases and 583 deaths.

The three men and two women died between July 23 and Aug. 4 and ranged in age from 57 to 87. All had underlying medical conditions, according to the health department.

The county reported 11,106 tests Thursday, 2% of which returned positive. The 14-day running average is 4.9%. The state's target is fewer than 8% testing positive.

Of the total positive cases in the county, 2,681 or 8.6% required hospitalization and 674 or 2.2% were admitted to an intensive care unit. Officials estimate more than 24,000 people have recovered from the virus.

County Supervisor Nathan Fletcher said Wednesday that the state had reported issues with private labs and reporting, meaning some additional cases might be retroactively added to both local and statewide case totals in the coming weeks.

The rate of the population testing positive has dropped to 105.7 per 100,000. The state's goal is to be below 100 per 100,000. One week ago, the rate was 134.4 per 100,000 in the county.

The number of people hospitalized due to COVID-19 also continues to trend downward, with 392 in regional hospitals as of Thursday, including 125 in intensive care units.

The percentage of people testing positive for the illness who have been contacted by a county contact tracer in the first 48 hours has increased from 7% on July 18 to 73%. The county's target for this metric is more than 90%, but 70% is good enough to get it out of the "failed" trigger category.

A half-dozen additional community outbreaks were reported Wednesday, bringing the number of community outbreaks in the county in the past week to 31. The latest outbreaks were reported in a preschool, a restaurant, two healthcare settings and two businesses.

There have been 170 community outbreaks reported since stay-at-home orders in March. In skilled nursing facilities, 145 deaths have been linked to 59 outbreaks.

A community outbreak is considered to have occurred if three or more people from different households contract COVID-19 from one location.

Officials say declining case numbers and other important metrics show positive trends, leading some lawmakers to begin looking at ways to move forward with further reopening of the economy.

The Board of Supervisors over the past three days opened county-owned parks for worship and fitness activities; approved spending $48 million in federal pandemic-related funding to help child care providers, testing in schools and meals for senior citizens; added a pilot walk-up testing program at the San Ysidro Port of Entry for essential workers and U.S. citizens; and approved a plan that adds 22 members to a "safe reopening compliance team" to crack down on businesses refusing to follow public health orders.

The compliance team will focus on three types of violators, starting with the most blatant cases such as those who host mass gatherings. The next level of enforcement would focus on businesses or groups that have experienced community outbreaks. Lastly, the team will check on less serious violations reported to them by concerned individuals, including businesses not requiring social distancing protocols or mask-wearing.

A compliance call center has been established so county residents can submit complaints of violations. The number is 858-694-2900.

Of the total hospitalized during the pandemic due to the illness, 71% have been 50 or older. But county residents ages 20-29 have accounted for 25.5% percent of COVID- 19 cases, the highest of any age group, according to county data. That age group is also least likely to take precautionary measures to avoid spreading the illness, officials said.

"Some San Diegans think they're not going to get sick and therefore are not following the public health guidance," said Dr. Wilma Wooten, the county's public health officer. "What they don't realize is that they could get infected and pass the virus to others who are vulnerable."

The age group with the second-highest number of infections residents ages 30-39 represent 18.9% of the county's COVID-19 cases.

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SD County Reports 263 New COVID-19 Cases, Five Deaths And Six New Outbreaks - KPBS

COVID-19 Daily Update 8-4-2020 – West Virginia Department of Health and Human Resources

The West Virginia Department of Health andHuman Resources (DHHR) reports as of 10:00 a.m., on August 4,2020, there have been 298,290 total confirmatorylaboratory results received for COVID-19, with 7,051 totalcases and 124 deaths.

DHHR has confirmed the deaths of a70-year old male from Preston County, a 55-year old female from Taylor County,a 68-year old female from Kanawha County, a 73-year old male from Marshall County,a 92-year old male from Grant County, a 43-year old male from Mingo County, anda 91-year old male from Wood County. Eachdeath reported is a solemn reminder of the seriousness of this disease. We sendour deepest sympathy to these families, saidBill J. Crouch, DHHR Cabinet Secretary.

In alignment with updated definitions fromthe Centers for Disease Control and Prevention, the dashboard includes probablecases which are individuals that have symptoms and either serologic (antibody)or epidemiologic (e.g., a link to a confirmed case) evidence of disease, but noconfirmatory test.

CASESPER COUNTY (Case confirmed by lab test/Probable case):Barbour (29/0), Berkeley (637/24), Boone (88/0), Braxton (8/0), Brooke(60/1), Cabell (341/9), Calhoun (6/0), Clay (17/1), Doddridge (4/0), Fayette(131/0), Gilmer (16/0), Grant (80/1), Greenbrier (87/0), Hampshire (74/0),Hancock (100/4), Hardy (53/1), Harrison (198/1), Jackson (158/0), Jefferson(287/5), Kanawha (835/13), Lewis (26/1), Lincoln (68/1), Logan (157/0), Marion(174/4), Marshall (126/3), Mason (50/0), McDowell (45/1), Mercer (167/0),Mineral (112/2), Mingo (142/2), Monongalia (913/16), Monroe (18/1), Morgan(25/1), Nicholas (32/1), Ohio (259/1), Pendleton (40/1), Pleasants (7/1),Pocahontas (40/1), Preston (102/23), Putnam (173/1), Raleigh (191/7), Randolph(203/3), Ritchie (3/0), Roane (14/0), Summers (6/0), Taylor (52/1), Tucker(11/0), Tyler (12/0), Upshur (36/3), Wayne (189/2), Webster (3/0), Wetzel(40/0), Wirt (6/0), Wood (228/12), Wyoming (23/0).

As case surveillance continues at thelocal health department level, it may reveal that those tested in a certaincounty may not be a resident of that county, or even the state as an individualin question may have crossed the state border to be tested.Such is the case of Kanawha and Marion counties in this report.

Pleasenote that delays may be experienced with the reporting of information from thelocal health department to DHHR. Visitthe dashboard at http://www.coronavirus.wv.gov for more detailed information.

On July 24,2020, Gov. Jim Justice announced that DHHR, the agency in charge of reportingthe number of COVID-19 cases, will transition from providing twice-dailyupdates to one report every 24 hours. This became effective August 1, 2020.

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COVID-19 Daily Update 8-4-2020 - West Virginia Department of Health and Human Resources

There are 5 easy steps to tame COVID-19, says Fauci – Harvard Gazette

Our society is, in so many ways, at a tipping point. Theres so much that we need to do right now, and theres one thing we need most of all, and thats voices of conviction, voices of reason to help guide us through these difficult times, Bacow said.

Williams said the field of public health has had a profound and positive effect on the lives of Americans over the past century but wondered whether the evidence suggests that in this case, it somehow failed.

Our goals are enormous, and our struggles at times are heavy, yet when public health works, our impact extends far and wide and becomes deeply embedded in our culture and our history, Williams said. Has public health failed or have those in education, government, and policy failed public health? Believe me, there are no simple answers, but we do know this: We are in the middle of one of the worst public health crises this country has ever seen, and many factors that got us to this point must change.

In his comments, Fauci avoided responses and phrasing that blamed any single individual or small group of individuals for missteps, but he was firm in his contention that basic public health measures are enough, if universally observed and applied, to send the coronavirus into retreat.

The NIAID director was asked how the U.S., the most powerful nation in the world, ended up faring so poorly in its battle with the pandemic, racking up the highest numbers of cases and deaths. Fauci said that the critical point came after the initial springtime peak. Nations in Europe kept their lockdown measures in place until infections fell to very low levels, allowing them to shift resources to detecting and tracing cases that inevitably accompanied reopening. In the U.S., he said, new daily cases were still at about 20,000 a week when states began reopening, and relatively soon thereafter the numbers began rising again, recently hitting a peak over 70,000.

If you wanted to get control over it, it would be nice if everybody was singing the same tune.

Anthony Fauci

In addition, he said, state reopening plans proceeded at different paces. Some states reopened slowly, similar to the pace of European nations, while others went much faster. Another variable, he said, was the extent to which residents of different states adhered to reopening guidelines, with some following recommendations while others ignored the restrictions, sometimes in notably large groups.

If you wanted to get control over it, it would be nice if everybody was singing the same tune, Fauci said. But what has happened is we have a situation where we say, Open up in a measured, prudent way, and you get some that do it fine, and then you see the pictures of people at bars with no masks and not social distancing.

Many of those flouting precautions, Fauci said, wrongly believe that their behavior endangers only themselves. He said they dont understand that not only can they get sick, but they can also transmit the virus to people who are more vulnerable.

And, while it is true that the virus does seem to hit the young less hard than older adults, going into bars is still a gamble, he said. Despite overall trends, many younger people have gotten sick and even died of the virus.

As long as you have any member of society, any demographic group, who is not seriously trying to get to the endgame of suppressing this, it will continue to smolder and smolder and smolder, Fauci said. And that will be the reason why weve plateaued at an unacceptable level.

Fauci said his abiding faith in the American spirit makes him cautiously hopeful that people who have resisted complying will ultimately do whats needed to avoid more drastic measures that would worsen the economic harm being felt nationwide.

The more we give a consistent message, the more people will realize what we should do, Fauci said.

During the hourlong event, Fauci addressed a number of other topics, including his optimism about vaccine prospects by the end of the year, the importance of ensuring equitable treatment and vaccination in communities of color, as well as his concern about the distrust of science and the anger directed at experts. Fauci said he has continued to receive harassment and death threats against himself and his family and has had to hire security guards.

Looking ahead, Fauci said the one certainty is that this pandemic will be followed by another, and we should prepare for it. Since this is the third coronavirus pandemic after SARS and MERS it would behoove us not only to continue to invest in public health infrastructure after COVID-19 fades, but also to begin searching for a universal coronavirus vaccine.

Shame on us if were not prepared for the next coronavirus pandemic, Fauci said.

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There are 5 easy steps to tame COVID-19, says Fauci - Harvard Gazette

A 7-year-old boy in Georgia died of Covid-19, the youngest victim in the state – CNN

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A 7-year-old boy in Georgia died of Covid-19, the youngest victim in the state - CNN

NIH harnesses AI for COVID-19 diagnosis, treatment, and monitoring – National Institutes of Health

News Release

Wednesday, August 5, 2020

Collaborative network to enlist medical imaging and clinical data sciences to reveal unique features of COVID-19.

The National Institutes of Health has launched the Medical Imaging and Data Resource Center (MIDRC), an ambitious effort that will harness the power of artificial intelligence and medical imaging to fight COVID-19. The multi-institutional collaboration, led by the National Institute of Biomedical Imaging and Bioengineering (NIBIB), part of NIH, will create new tools that physicians can use for early detection and personalized therapies for COVID-19 patients.

This program is particularly exciting because it will give us new ways to rapidly turn scientific findings into practical imaging tools that benefit COVID-19 patients, said Bruce J. Tromberg, Ph.D., NIBIB Director. It unites leaders in medical imaging and artificial intelligence from academia, professional societies, industry, and government to take on this important challenge.

The features of infected lungs and hearts seen on medical images can help assess disease severity, predict response to treatment, and improve patient outcomes. However, a major challenge is to rapidly and accurately identify these signatures and evaluate this information in combination with many other clinical symptoms and tests. The MIDRC goals are to lead the development and implementation of new diagnostics, including machine learning algorithms, that will allow rapid and accurate assessment of disease status and help physicians optimize patient treatment.

This effort will gather a large repository of COVID-19 chest images, explained Guoying Liu, Ph.D., the NIBIB scientific program lead on this effort, allowing researchers to evaluate both lung and cardiac tissue data, ask critical research questions, and develop predictive COVID-19 imaging signatures that can be delivered to healthcare providers.

Maryellen L. Giger, PhD, the A.N. Pritzker Professor of Radiology, Committee on Medical Physics at the University of Chicago, is leading the effort, which includes co-Investigators Etta Pisano, MD, and Michael Tilkin, MS, from the American College of Radiology (ACR), Curtis Langlotz, MD, PhD, and Adam Flanders, MD, representing the Radiological Society of North America (RSNA), and Paul Kinahan, PhD, from the American Association of Physicists in Medicine (AAPM).

This major initiative responds to the international imaging communitys expressed unmet need for a secure technological network to enable the development and ethical application of artificial intelligence to make the best medical decisions for COVID-19 patients, added Krishna Kandarpa, M.D., Ph.D., director of research sciences and strategic directions at NIBIB. Eventually, the approaches developed could benefit other conditions as well.

The MIDRC will facilitate rapid and flexible collection, analysis, and dissemination of imaging and associated clinical data. Collaboration among the ACR, RSNA, and AAPM is based on each organizations unique and complementary expertise within the medical imaging community, and each organizations dedication to imaging data quality, security, access, and sustainability.

About the National Institute of Biomedical Imaging and Bioengineering (NIBIB):NIBIBs mission is to improve health by leading the development and accelerating the application of biomedical technologies. The Institute is committed to integrating engineering and physical science with biology and medicine to advance our understanding of disease and its prevention, detection, diagnosis, and treatment. NIBIB supports emerging technology research and development within its internal laboratories and through grants, collaborations, and training. More information is available at the NIBIB websitehttps://www.nibib.nih.gov.

About the National Institutes of Health (NIH):NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

NIHTurning Discovery Into Health

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NIH harnesses AI for COVID-19 diagnosis, treatment, and monitoring - National Institutes of Health

COVID-19 Daily Update 8-5-2020 – West Virginia Department of Health and Human Resources

The West Virginia Department of Health andHuman Resources (DHHR) reports as of 10:00 a.m., on August 5,2020, there have been 302,443 total confirmatorylaboratory results received for COVID-19, with 7,159 totalcases and 124 deaths.

In alignment with updated definitions fromthe Centers for Disease Control and Prevention, the dashboard includes probablecases which are individuals that have symptoms and either serologic (antibody)or epidemiologic (e.g., a link to a confirmed case) evidence of disease, but noconfirmatory test.

CASESPER COUNTY (Case confirmed by lab test/Probable case):Barbour (30/0), Berkeley (643/27), Boone (92/0), Braxton (8/0), Brooke(60/1), Cabell (353/9), Calhoun (6/0), Clay (17/1), Doddridge (4/0), Fayette(134/0), Gilmer (16/0), Grant (88/1), Greenbrier (88/0), Hampshire (75/0),Hancock (102/4), Hardy (53/1), Harrison (203/1), Jackson (158/0), Jefferson(287/5), Kanawha (843/13), Lewis (27/1), Lincoln (75/0), Logan (162/0), Marion(175/4), Marshall (126/3), Mason (51/0), McDowell (47/1), Mercer (173/0),Mineral (114/2), Mingo (151/2), Monongalia (913/16), Monroe (18/1), Morgan(25/1), Nicholas (32/1), Ohio (262/1), Pendleton (41/1), Pleasants (8/1),Pocahontas (40/1), Preston (102/23), Putnam (173/1), Raleigh (200/7), Randolph(203/3), Ritchie (3/0), Roane (14/0), Summers (7/0), Taylor (54/1), Tucker(11/0), Tyler (12/0), Upshur (36/3), Wayne (192/2), Webster (3/0), Wetzel(40/0), Wirt (6/0), Wood (228/12), Wyoming (24/0).

As case surveillance continues at thelocal health department level, it may reveal that those tested in a certaincounty may not be a resident of that county, or even the state as an individualin question may have crossed the state border to be tested.

Pleasenote that delays may be experienced with the reporting of information from thelocal health department to DHHR. Visitthe dashboard at http://www.coronavirus.wv.gov for more detailed information.

On July 24,2020, Gov. Jim Justice announced that DHHR, the agency in charge of reportingthe number of COVID-19 cases, will transition from providing twice-dailyupdates to one report every 24 hours. This became effective August 1, 2020.

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COVID-19 Daily Update 8-5-2020 - West Virginia Department of Health and Human Resources

Free COVID-19 testing with quick turnaround times to end soon – Louisiana Department of Health – Louisiana.gov

Free COVID-19 testing at sites sponsored by the federal government will end next week. Testing is available at Cajun Field at the University of Louisiana, the Lake Charles Civic Center and the Rapides Parish Exhibition Center in Alexandria. These sites are supported locally by the Louisiana National Guard and the Louisiana Department of Health (LDH).

Limited number of tests remain

Louisiana launched the surge testing initiative last month with 60,000 tests made available by the U.S. Department of Health and Human Services. About 3,000 tests are still available, according to LDH. The average turnaround time for results has been 3.5 days much quicker than at most other COVID-19 testing sites.

These sites use the laboratory eTrueNorth to conduct the tests and provide results. Pre-registration is NOT required but encouraged by going towww.DoINeedaCOVID19test.com.

People must provide a telephone number and email address to be tested. An ID is NOT required.

Test results will be provided by email notification and on the eTrueNorth portal. If someone tests positive, they will also be contacted by phone. There is no phone number to call for results. Results will only be provided by email and in the portal.

Who can be tested?

With a limited number of tests remaining, people who have COVID-19 symptoms or anyone who has been exposed to someone with the virus are encouraged to get tested. However, testing is available to everyone.

LDH testing coordinator Kimberly Hood said the sites have been designed to support communities identified as COVID-19 hotspots. She encourages students and teachers who are returning to school in these regions to get tested.

With the school year starting for some students, this is the perfect opportunity for any student or teacher who is concerned that they might have the virus to get a test, she said. With a three-day turnaround, people can get their results in time to make the best decision about returning to the classroom.

Test site locations

Lafayette:Cajun Field, University of Louisiana at2351 W. Congress St.Friday, August 7;Saturday, August 8; Monday, August 10; andTuesday, August 118 a.m. 4 p.m. each day

Lake Charles:Lake CharlesCivic Center at900 N. Lakeshore DriveFriday, August 7; andMonday to Friday, August 10-148 a.m. 2 p.m. each day

Alexandria:Exhibition Hall at 5600 Coliseum Blvd.Friday, August 7;Saturday, August 8; and Monday to Friday, August 10-148 a.m. 4 p.m. each day

Symptoms of COVID-19

Local contact information

For more information about the test sites in specific regions, contact the Office of Public Health medical director listed below.

Lafayette:Dr. Tina Stefanski, 337-262-5311 ortina.stefanski@la.gov

Lake Charles:Dr. Lacey Cavanaugh, 337-475-3203 orlacey.cavanaugh@la.gov

Alexandria:Dr. David Holcombe, 318-487-5262 ordavid.holcombe@la.gov

Save the number 877-766-2130 in your phone

Anyone who receives a call from 877-766-2130 is urged to answer, as the call is from a contact tracer who will keep an individual's information private. Personal information is used to quickly identify anyone a COVID-positive individual may have been in close contact with to help contain the spread of the coronavirus. Everyone called by a contact tracer is advised to watch themselves for signs of illness for 14 days from when they first came in contact with the COVID-19 person.

If a resource need is identified through the contact tracing interview, the case is flagged for follow-up from a resource coordinator social worker who can connect individuals with resources including medication, masks, food assistance and even help locating alternative housing.

Contact tracers employed by LDH will only ask you for your first and last name and your date of birth to confirm that you are the person they intended to call. They will not ask for any financial information, social security numbers or health insurance information. If someone claiming to be employed by LDH does ask for that, immediately hang up and call877-766-2130to be connected with LDH's contact tracers.

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Free COVID-19 testing with quick turnaround times to end soon - Louisiana Department of Health - Louisiana.gov

COVID-19 Daily Update 8-6-2020 – West Virginia Department of Health and Human Resources

The West Virginia Department of Health andHuman Resources (DHHR) reports as of 10:00 a.m., on August 6,2020, there have been 307,255 total confirmatorylaboratory results received for COVID-19, with 7,277 totalcases and 124 deaths.

In alignment with updated definitions fromthe Centers for Disease Control and Prevention, the dashboard includes probablecases which are individuals that have symptoms and either serologic (antibody)or epidemiologic (e.g., a link to a confirmed case) evidence of disease, but noconfirmatory test.

CASESPER COUNTY (Case confirmed by lab test/Probable case):Barbour (29/0), Berkeley (647/28), Boone (95/0), Braxton (8/0), Brooke(60/1), Cabell (358/9), Calhoun (6/0), Clay (17/1), Doddridge (5/0), Fayette(137/0), Gilmer (16/0), Grant (96/1), Greenbrier (88/0), Hampshire (76/0),Hancock (103/4), Hardy (56/1), Harrison (206/1), Jackson (160/0), Jefferson(288/6), Kanawha (863/13), Lewis (27/1), Lincoln (79/0), Logan (176/0), Marion(175/4), Marshall (125/3), Mason (53/0), McDowell (48/1), Mercer (174/0),Mineral (114/2), Mingo (154/2), Monongalia (913/16), Monroe (18/1), Morgan(25/1), Nicholas (34/1), Ohio (262/3), Pendleton (57/1), Pleasants (9/1),Pocahontas (40/1), Preston (101/22), Putnam (177/1), Raleigh (203/7), Randolph(203/3), Ritchie (3/0), Roane (14/0), Summers (7/0), Taylor (55/1), Tucker(11/0), Tyler (13/0), Upshur (36/3), Wayne (194/2), Webster (4/0), Wetzel(40/0), Wirt (6/0), Wood (230/12), Wyoming (29/0).

As case surveillance continues at thelocal health department level, it may reveal that those tested in a certaincounty may not be a resident of that county, or even the state as an individualin question may have crossed the state border to be tested.Such is the case of Barbour, Preston, and Marshall counties in this report.

Pleasenote that delays may be experienced with the reporting of information from thelocal health department to DHHR. Visitthe dashboard at http://www.coronavirus.wv.gov for more detailed information.

On July 24,2020, Gov. Jim Justice announced that DHHR, the agency in charge of reportingthe number of COVID-19 cases, will transition from providing twice-dailyupdates to one report every 24 hours. This became effective August 1, 2020.

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COVID-19 Daily Update 8-6-2020 - West Virginia Department of Health and Human Resources

NIH launches clinical trial to test antibody treatment in hospitalized COVID-19 patients – National Institutes of Health

News Release

Tuesday, August 4, 2020

Study aims to determine safety and efficacy of experimental monoclonal antibodies.

Patients admitted with COVID-19 at select hospitals may now volunteer to enroll in a clinical trial to test the safety and efficacy of a potential new treatment for the disease. The Phase 3 randomized, controlled trial is known as ACTIV-3, and as a master protocol, it is designed to expand to test multiple different kinds of monoclonal antibody treatments. It also can enroll additional volunteers in the middle of the trial, if a specific investigational treatment shows promise.

The new study is one of four ongoing or planned trials in the National Institutes of Healths.Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV)program,a public-private partnership to speed development of the most promising treatments and vaccine candidates. Italso is receiving support throughOperation Warp Speed, the U.S. governments multi-agency effort to develop, manufacture and distribute medical countermeasures to fight COVID-19.

The trial will take place at select hospitals around the world that are part of existing clinical trial networks. They include the lead network, the International Network of Strategic Initiatives in Global HIV Trials (INSIGHT), operated by the National Institute of Allergy and Infectious Diseases (NIAID), a part of the National Institutes of Health. Collaborating clinical trial networks include the Prevention and Early Treatment of Acute Lung Injury network (PETAL) and Cardiothoracic Surgical Trials Network (CTSN), supported by the NIHs National Heart, Lung and Blood Institute through the Collaborating Network of Networks for Evaluating COVID-19 and Therapeutic Strategies (CONNECTS) program, and the U.S. Department of Veterans Affairs Medical Centers.

Under Operation Warp Speed, the U.S. Government has brought together multiple agencies to accelerate the development, manufacture and distribution of medical countermeasures for COVID-19, said NIH Director Dr. Francis S. Collins, M.D., Ph.D. The ACTIV studies are just a few examples of this critical activity, which emphasizes flexibility and minimizes delays to generate scientifically sound results.

ACTIV-3 uses an adaptive two-stage Phase 3 protocol design. The ACTIV-3 trial can be modified to test additional experimental therapeutics and flexibly allow novel therapeutics to enter at either stage 1 or stage 2. In addition, if a treatment appears to be safe and effective in the initial stage after review by an independent data and safety monitoring board (DSMB), the investigational therapeutic proceeds to stage 2 testing, where more volunteers are enrolled. If an investigational therapeutic is unsafe or not likely to be effective, it will be dropped.

The ACTIV-3 study will begin by studying the investigational monoclonal antibodyLY-CoV555, which was identified in a blood sample from a recovered COVID-19 patient. Antibodies are infection-fighting proteins made by the immune system that can bind to the surface of viruses and prevent them from infecting cells. Synthetic versions of antibodies can be reproduced in a laboratory. These manufactured antibodies are known as monoclonal antibodies. The LY-CoV555 antibody was discovered by Abcellera Biologics (Vancouver, British Columbia) in collaboration with NIAIDs Vaccine Research Center. Subsequently, it was developed and manufactured byLilly Research Laboratories, Eli Lilly and Company (Indianapolis, Indiana), in partnership with AbCellera. The investigational product also is being tested in another ongoing NIAID study, ACTIV-2, which is studying its safety and efficacy in people with mild to moderate symptoms of COVID-19 who have not been hospitalized. Safety data and other findings will be shared across the ACTIV-2 and ACTIV-3 studies through the DSMB.

Studying the impact of this investigational therapeutic on multiple patient populations at the same time is critical to determining whether it can help COVID-19 patients with differing levels of disease severity, said NIAID Director Anthony S. Fauci, M.D. These concurrent trials have the potential to yield significant and comprehensive clinical data.

The initial stage of the ACTIV-3 clinical trial aims to enroll approximately 300 volunteers who have been hospitalized with mild to moderate COVID-19 with fewer than 13 days of symptoms. Once their COVID-19 infections have been confirmed and they have consented to take part in the study, participants will be randomly assigned to receive either an intravenous (IV) infusion of LY-CoV555 or a saline placebo infusion. Participants also will receive standard care for COVID-19, including the antiviral remdesivir. After five days, participants symptoms will be assessed, as will their need for supplemental oxygen, mechanical ventilation, or other supportive care. Volunteers will be followed for 90 days after enrollment and will receive regular examinations and have blood samples taken periodically during this time to analyze their response to the investivational therapeutic.

Data collected on the fifth day of the volunteers participation will determine whether the investigational therapeutic will be administered to a larger group of volunteers. If LY-CoV555 appears to be safe and appears to be effective, the trial will enroll an additional 700 participants. It also will begin enrolling more severely ill participants, such as those with organ failure requiring mechanical support, or COVID-19-associated dysfunction of organs other than the lungs. The primary endpoint of the trial is the participants sustained recovery for 14 days after release from the hospital.

The principal investigator of ACTIV-3 is Jens Lundgren,M.D., of the University of Copenhagen and Rigshospitalet. Leads of the participating networks include James Neaton, Ph.D., of the INSIGHT network, Taylor Thompson, M.D., of the PETAL network, Annetine Gelijns, Ph.D., and Alan Moskowitz, M.D., of the CTSN, and Rachel Ramoni, D.M.D., Sc.D., of the U.S. Department of Veterans Affairs. To ensure that the trial is being conducted in a safe and effective manner, an independent DSMB will oversee the trial and conduct periodic reviews of the accumulating data.

NIAID conducts and supports research at NIH, throughout the United States, and worldwide to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on theNIAID website.

About the National Institutes of Health (NIH):NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

NIHTurning Discovery Into Health

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NIH launches clinical trial to test antibody treatment in hospitalized COVID-19 patients - National Institutes of Health

Scientists Uncover Biological Signatures of the Worst Covid-19 Cases – The New York Times

Although the delineations arent always clear-cut, the immune systems responses to pathogens can be roughly grouped into three categories: type 1, which is directed against viruses and certain bacteria that infiltrate our cells; type 2, which fights parasites like worms that dont invade cells; and type 3, which goes after fungi and bacteria that can survive outside of cells. Each branch uses different cytokines to rouse different subsets of molecular fighters.

Updated August 6, 2020

People with moderate cases of Covid-19 take what seems like the most sensible approach, concentrating on type 1 responses, Dr. Iwasakis team found. Patients struggling to recover, on the other hand, seem to be pouring an unusual number of resources into type 2 and type 3 responses, which is kind of wacky, Dr. Iwasaki said. As far as we know, there is no parasite involved.

Its almost as if the immune system is struggling to pick a lane, Dr. Wherry said.

This disorientation also seems to extend into the realm of B cells and T cells two types of immune fighters that usually need to stay in conversation to coordinate their attacks. Certain types of T cells, for instance, are crucial for coaxing B cells into manufacturing disease-fighting antibodies.

Last month, Dr. Wherry and his colleagues published a paper in Science finding that, in many patients with severe Covid-19, the virus had somehow driven a wedge between these two close-knit cellular communities. Its too soon to tell for sure, but perhaps something about the coronavirus is preventing B and T cells from talking to each other, he said.

These studies suggest that treating bad cases of Covid-19 might require an immunological reset drugs that could, in theory, restore the balance in the body and resurrect lines of communication between bamboozled cells. Such therapies could even be focused on specific subsets of patients whose bodies are responding bizarrely to the virus, Dr. Blish said: the ones who have deranged cytokines from the beginning.

But thats easier said than done. The challenge here is trying to blunt the response, without completely suppressing it, and getting the right types of responses, Dr. August said. Its hard to fine-tune that.

Timing is also crucial. Dose a patient too early with a drug that tempers immune signaling, and they may not respond strongly enough; give it too late, and the worst of the damage may have already been done. The same goes for treatments intended to shore up the initial immune response against the coronavirus, like interferon-based therapies, Dr. Blish said. These could stamp out the pathogen if given shortly after infection or run roughshod over the body if administered after too long of a delay.

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Scientists Uncover Biological Signatures of the Worst Covid-19 Cases - The New York Times

New Covid-19 cases are declining in Arizona, once a hot spot. Here’s how the state is turning things around – CNN

Today, that decision appears to have paid off.

This turn around has caught the attention of health experts, who have praised Arizona as an example of a state that successfully reimplemented mitigation efforts as cases rose.

"We saw in Arizona, which was a good example, they went up (in cases) and they started to really clamp down and do things right. And the cases came right down," Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, told CNN's John Berman on Thursday morning.

The state and its governor, Doug Ducey, were praised on Wednesday by President Donald Trump and Dr. Deborah Birx in the Oval Office, where Ducey credited the downward trend to Arizonans wearing masks, physically distancing, washing hands and staying home if sick.

"They've really done a great job putting these pieces together and really creating that path forward," Birx, the White House coronavirus response coordinator, said. She pointed to the improvement in Arizona as a model that could work for other states.

Of course, while things are improving, the state -- like the rest of the country -- is not in the clear.

Arizona reported nearly 1,400 cases on Thursday, bringing the statewide total to more than 183,000. And the number of deaths continues to climb, with more than 4,000 total deaths as of Thursday.

"This is not a victory lap," Ducey said last week after discussing the state's downward trend. "This is not a celebration. If anything, it's evidence that the decisions and the sacrifice that Arizonans are making are working."

How Arizona did it

"We did take some further steps," Ducey said on Wednesday. "We were in the unhappy but responsible position of dispersing large crowds, so bars and nightclubs and gyms all closed temporarily," he said.

"But upon putting those steps out there, we've seen improvement every week, week-over-week for four weeks," he said.

On May 8, retail stores, barbershops and salons were allowed to resume in-person business with some guidelines. A few days later, on May 11, restaurants were allowed to resume dine-in service. That day, the state had a total of 11,383 cases of Covid-19.

Then things went downhill from there. Cases rose throughout the month of June, totaling 79,228 on June 30 -- up from 20,129 on June 1. The state was forced to try and rectify the situation before it spun out of control.

"The Covid-19 crisis didn't hit Arizona until later," Ducey explained. "We had a very difficult June, we've had a much better July."

At the time, Ducey warned his state it would take time for the restrictions to be reflected in the state's Covid-19 numbers.

In early July, the state was paid a visit by members of the White House coronavirus task force, including Birx and Vice President Mike Pence. A few days later, on July 9, Ducey took another step back, limiting indoor dining to 50% capacity before things started looking up.

The average of new daily cases over a seven-day period began steadily declining each week, something the governor touted in his visit to the Oval Office on Wednesday.

Despite the improvement, Ducey recognizes that the Grand Canyon State was not out of the woods.

"Like I said, no celebration, no victory lap," he said. "We're going to stay the course, stay vigilant and keep our guard up. But we have a path forward in Arizona."

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New Covid-19 cases are declining in Arizona, once a hot spot. Here's how the state is turning things around - CNN

COVID-19 Has Overwhelmed One Essential Strategy To Control The Virus – Honolulu Civil Beat

With Hawaii facing a surge in COVID-19 cases, the states effort to trace close contacts of someone who has tested positive has been overwhelmed a situation that a number of state and local officials warned about months ago when the virus was still under control.

Nearly three months after state and local officials called for the Hawaii Department of Health to hire hundreds of additional public health contact tracers to help target and contain community spread of the COVID-19 virus, the states epidemiologist told a state Senate panel Thursday that the department still has only 105 contact tracers actively working.

And that isnt enough, said State Epidemiologist Dr. Sarah Park.

State Epidemiologist Sarah Park on Thursday said contact tracing is n0t a panacea for controlling the spread of COVID-19.

Cory Lum/Civil Beat

To be effective at keeping cases confined to small clusters, contact tracers generally need to reach all potentially infected people in a day or two. Now, with the state facing a surge of more than 100 new cases a day, it takes three to four days for the workers to track down all of the people those infected with the virus have been in close contact with, Park said.

Its exactly the situation that officials such as Honolulu Mayor Kirk Caldwell raised alarms about back in early May, when Hawaii was reporting only a few new cases per day and was preparing to reopen the economy.

At the time, officials such as Caldwell pointed to criteria published by theNational Association of County and City Health Officials, saying the state needed to hire a small army of contact tracers to get ahead of a possible surge in cases that could happen once businesses started reopening and restrictions on gatherings relaxed.

According to those standards, a locale with a population the size of Hawaii would need about 420 contact tracers during a pandemic. Although Park pushed back at the time by saying the department could bring on trained contact tracers quickly if they were needed, advocates like Caldwell warned that if the department waited until there was be a surge, it would be too late.

Mayor Kirk Caldwell months ago called on the Hawaii Department of Health to stand up a team of hundreds of contact tracers.

Cory Lum/Civil Beat

And thats exactly what appears to have happened.

Hawaii House Speaker Scott Saiki said it was predictable.

We said months ago that we needed to be prepared, said Saiki, who co-chairs the House Select Committee on COVID-19 Economic and Financial Preparedness. We knew there would be a surge some time over the summer, and we knew that we needed to be prepared.

Contact tracing is essentially epidemiological detective work that entails a public health worker tracking down, usually by phone, all of the people who might have been exposed to an infectious person over a two-week period. The standard for a so-called close contact is someone who was within 6 feet of an infected person for at least 15 minutes.

The idea is that if close contacts can be tracked down quickly, they can be isolated into clusters and keep the disease from spreading widely in the community. Contact tracing is so central to Hawaiis plan for responding to the virus and to safely opening the economy and businesses that it was designated one of four pillars of the states response plan, along with screening, testing and isolating those who were sick.

But during Thursdays testimony before the Senate Special Committee on COVID-19, Park downplayed the importance of contact tracing, saying that some states no longer even do it. Park ultimately blamed the public for the surge in cases. She cited beach and house parties and other gatherings that people should have known not to engage in as causes for the surge in cases that quickly overwhelmed the system.

What we could not have predicted, quite frankly, is how badly our community would behave, she said.

After months of hearing health officials and others talk up the importance of contact tracing, some senators were taken aback by Parks apparent change of position. Park at one point got into a heated discussion with Sen. Donna Mercado Kim, a former Hawaii Senate President and Honolulu City Councilwoman known for asking tough questions.

After Park accused Kim of mischaracterizing Parks earlier remarks, Kim said she was merely holding Park accountable for earlier statements.

Were not saying and I have never believed that contact tracing is the panacea, Kim said.

After the meeting, Sen. Donovan Dela Cruz said he was shocked by Parks apparent backpedaling on contact tracing. He said that months ago, when some people were calling for more aggressive testing, health department officials were pointing to contact tracing as the key.

When people were pushing testing, she said it was all about these other things, Dela Cruz said.

He said that Parks reactive response was symptomatic of the administration of Gov. David Ige, which he said does not act unless there is overwhelming public pressure.

House Speaker Scott Saiki, center, said that at some point the Department of Health will be responsible for the surge in COVID-19 cases.

Cory Lum/Civil Beat

While Park downplayed the importance of contact tracing, she did acknowledge that the surge in cases had pointed to the need for more contact tracers. And she noted some of the challenges that tracers face, chiefly that some people dont want to share personal information with government officials because of the fear of a stigma or concern that a relative could suffer financially if forced to quarantine.

Were dealing with people, she said. Were not dealing with robots.

She also said contract tracers simply could not trace contacts of all the people infected at mass gatherings.

Park said the department has another 198 trained contact tracers who are not working and plans to bring on board 30 to 40 more contact tracers next week. She said the department lacks managerial capacity and physical space to bring them aboard faster.

While Park blamed the public for the diseases surge, Saiki, the House Speaker, blamed the department for not sharing more information to let the public know how the disease was spreading.

On Thurdsay, he wrote a letter to Department of Health Director Bruce Anderson asking for information so the public could know what activities not to do. Saiki said the department could avoid violating privacy by not reporting names or other identifying information.

The narrative could be very simple, e.g., the asymptomatic, unmasked individual attended a graduation party at Lanikai Beach on Memorial Day with approximately 25 other unmasked individuals, 12 of whom subsequently tested positive possibly as a result of attending the event, Saiki wrote.

In an interview, Saiki reiterated that members of his committee had warned that the state needed more contact tracers. And he said the public has a right to know how the disease is spreading.

The health department needs to be careful because at some point it will be responsible for creating this surge, he said.

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COVID-19 Has Overwhelmed One Essential Strategy To Control The Virus - Honolulu Civil Beat

Grieving Minnesota family overwhelmed after funeral leads to COVID-19 outbreak – Minneapolis Star Tribune

They gathered on a summer weekend in the small northwestern Minnesota town of Lake Park to pay their respects to 78-year-old Francis Perreault and share their grief and memories of the good times.

They hugged. They cried. They held hands and prayed and honored a man who was described by his daughter as wonderful.

Yet despite wearing masks and taking precautions, 30 family members became infected with COVID-19 within weeks of the mid-July services at St. Francis Xavier Catholic Church, and five became so sick they were hospitalized.

We tried to do everything right, but of course when youre grieving, you let your guard down, said Stephanie Schindler, Perreaults daughter. One of my friends that got sick was wearing a mask the whole time. But of course when youre crying, youre going to be rubbing your face.

Schindler said the attendees did a good job observing precautions during the services, but discipline broke down afterward as people cried, hugged and held hands to pray. Even amid a pandemic, the natural human instinct to comfort one another is strong.

I think its part of the process of coming to terms with things, Schindler said. Its closure for the living and support for each other.

Painful as it may be, its probably a good idea not to have such family gatherings during the pandemic, said Doug Schultz, a spokesman for the Minnesota Department of Health.

All of us at the department, from the leadership down to the individuals working the front lines, understand peoples need to have gatherings like funerals and weddings and graduation parties, Schultz said. As the governor has said, it pains us all to see that its probably not a good idea to have those gatherings. And it pains us to see Minnesotans not having these important rites of passage. But COVID-19 is still very much with us. The pandemic is still very much with us. And so gatherings like these do pose a risk.

Perreault suffered from Parkinsons disease and several strokes, so his death didnt come as a shock to the family, Schindler said Thursday.

We were at peace with that. But then this aftermath happened, and that has been harder for us to come to terms with, she said. Im kind of overwhelmed.

Schindler said several of those hospitalized have since been released, though she couldnt give an exact update on all involved. But the illnesses have brought home the reality that COVID-19 is a threat even in sparsely populated settings in rural Minnesota, she said.

I think in a rural area, you have to be aware that if you have people coming from out of state or even interstate places different from your own home you are going to share that space and the germs are gonna fly, she said. I just have to caution people about please be careful. Even in this rural area, there is still COVID.

Among Minnesotas 87 counties, Becker County is in the middle of the pack for COVID-19 infections, with a rate of 45 per 10,000 residents. The statewide rate is 109 cases per 10,000 residents, according to data released Thursday by the Health Department.

As Schindler talked about the virus, she reflected on her father.

He was very trustworthy, constant in the family, believer in Jesus, she said. He was a hard worker believed you just keep going.

Thats what family members will have to do now as they cope with their loss and the health troubles that followed.

Whats done is done. We have to go forward, we have to grieve, Schindler said. We have to pray for each other and raise each other up with support.

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Grieving Minnesota family overwhelmed after funeral leads to COVID-19 outbreak - Minneapolis Star Tribune

A 26-year-old Oregon man died after testing negative for COVID-19. Now his family wants answers – KGW.com

Two days after Matthew Irvins death, his coronavirus test came back negative. Irvins stepfather said no one he was around has tested positive either.

MCMINNVILLE, Ore. The Oregon Health Authority reported the youngest COVID-19-related death last week: a 26-year-old man from Yamhill County. His family told KGW his name was Matthew Irvin, a father of three. But after his coronavirus test came back negative his family said they're looking for answers.

To lose a son so suddenly, at such a young age, has left a hole too massive to comprehend. Michael Laheyne, Irvin's stepfather, said Irvin was starting to move up in his job and progressing in life.

"It was hard, really hard," Laheyne said. "It's just like it was yesterday still. My heart hurts."

He leaves behind a baby girl, two sons, and a whole family who loved him.

"Matthew was a good father. And it's sad that his kids won't be able to have that father figure in their life," Laheyne said. "He had a great smile. You know, he was a real outdoorsy guy. Really into the faith of Jesus Christ."

Laheyne said Irvin's death in early July also leaves a lot of unanswered questions. Irvin first felt sick the Monday after the Fourth of July. He came down with a high fever, nausea, diarrhea and had terrible stomach pain. He went to an emergency room in McMinville the next day where doctors told him he had COVID-19-like symptoms. Laheyne said they tested Irvin and sent him home.

"Then, Thursday morning he called and said, 'Mom, I feel like I'm dying,'" Laheyne remembered.

Just hours later, early in the morning on July 10, he died.

Laheyne said a sheriff's deputy and medical examiner came out to investigate and determined he likely died from COVID-19.

"We requested an autopsy at that time but we were denied. The medical examiner said there's no reason to do an autopsy because it was related to COVID, he was pretty sure," Laheyne told said.

KGW reached out to the Yamhill County Medical Examiner's Office to better understand the justification behind why they didn't perform an autopsy on Irvin, but they aren't commenting at this time.

Two days after his passing, his coronavirus test came back negative. So far, Laheyne said no one he was around has tested positive either. The family hired a pathologist who couldn't reach a definitive answer, so they sent tissue samples off to the Centers for Disease Control and Prevention (CDC).

"We just want the truth. We want to know exactly what happened to him. Twenty-six years old, healthy as an ox. Supposedly got COVID and he's gone in, well, three days. There's just something wrong with that," Laheyne said.

Now, a month after he passed, they have to wait even longer for confirmation -- and some form of closure.

"The outcome of that is going to change the world right there," Laheyne said.

The Oregon Health Authority (OHA) included Irvin in their death toll. The public health agency wouldn't give specifics on his death but said it determines COVID-19-related deaths based on the following:

Irvin's death certificate listed COVID-19 disease or SARS-CoV-2 as a cause of death or as a significant condition that contributed to his death.

"It's just got me puzzled, that's all," Laheyne said.

Although they're not yet certain it killed him, Irvin's family wants people to realize how serious this virus is. Laheyne said the more he shares his son's story, the better he feels because he is reaching people and hopefully getting through to them.

"You can be a healthy person with no underlying conditions and if you get it - if he had it, I mean, you could go that quick," Laheyne said. "I just want people to know that this virus is no joke, it's no joke. If you get it and say, for instance, you test positive, dont go out and about just because you have no symptoms. Stay home."

If a silver lining exists it's that the family has grown closer through this.

"I'm sorry, Matt, that it had to take this to have that happen but we'll see you soon, I'm sure," Laheyne said.

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A 26-year-old Oregon man died after testing negative for COVID-19. Now his family wants answers - KGW.com

U.S. job growth forecast to slow sharply in July as COVID-19 cases soar – Reuters

WASHINGTON (Reuters) - U.S. employment growth likely slowed significantly in July amid a resurgence in new COVID-19 infections, which would provide the clearest evidence yet that the economys recovery from the recession caused by the pandemic was faltering.

FILE PHOTO: Hundreds of people line up outside the Kentucky Career Center, over two hours prior to its opening, to find assistance with their unemployment claims, in Frankfort, Kentucky, U.S. June 18, 2020. REUTERS/Bryan Woolston

The Labor Departments closely watched employment report on Friday could pile pressure on the White House and Congress to speed up negotiations on another aid package. Talks have been dragging over differences on major issues including the size of a government benefit for tens of millions of unemployed workers.

A $600 weekly unemployment benefit supplement expired last Friday, while thousands of businesses have burned through loans offered by the government to help with wages.

A labor market relapse would be more bad news for President Donald Trump, who is lagging in opinion polls behind former Vice President Joe Biden, the presumptive Democratic Party nominee for the Nov. 3 election.

The steam has gone out of the engine and the economy is beginning to slow, said Sung Won Sohn, a finance and economics professor at Loyola Marymount University in Los Angeles. The loss of momentum will continue and my concern is that the combination of the virus resurgence and lack of action by Congress could really push employment into negative territory.

According to a Reuters survey of economists, nonfarm payrolls likely increased by 1.58 million jobs in July, which would be a sharp step-down from the record 4.8 million in June. That would leave payrolls 13.1 million below their pre-pandemic level. Employment peaked at 152.5 million in February.

The economy, which entered into recession in February, suffered its biggest blow since the Great Depression in the second quarter, with gross domestic product dropping at its steepest pace in at least 73 years.

There is, however, a risk of an outright decline in payrolls in July. Reports this week showed a sharp slowdown in hiring by private employers in July and continued decreases in employment at manufacturing and services industries.

Data from Homebase, a payroll scheduling and tracking company, showed a slowdown and modest reversal in employment since mid-June. The Census Bureaus Household Pulse Survey suggested at least 6 million job losses from mid-June to the week ending July 18, when the government surveyed employers and households for last months employment report.

The implied job losses were in areas hardest hit by a surge in coronavirus infections. Cases of COVID-19, the respiratory illness caused by the virus, soared across the country last month, forcing authorities in some of the worst affected areas in the West and South to either shut down businesses again or pause reopenings, sending workers back home. Demand for goods and services has suffered.

This should not be a shock, said Elise Gould, senior economist at the Economic Policy Institute in Washington. Economic recovery depends entirely on success in managing the spread of the virus, and this management has failed spectacularly since early June.

The anticipated pullback in hiring would challenge the U.S. stock market's expectation of a V-shaped recovery. The S&P 500 index .SPX is up nearly 50% from its March trough. As COVID-19 cases spiral higher, and Republicans and Democrats bicker over another stimulus package, economists see a W-shaped recovery.

Economists estimate the Paycheck Protection Program that gave businesses loans that can be partially forgiven if used for employee pay saved around 1.3 million jobs at its peak. The extra $600 weekly unemployment checks made up 20% of personal income and helped to boost consumer spending in May and June.

The second phase of the recovery will be much more challenging, said James Knightley, chief international economist at ING in New York. We should be braced for weaker employment and spending numbers in the absence of a new broad and substantial fiscal package.

Average hourly earnings are forecast to fall 0.5% in July after a drop of 1.2% in June, with most of the job gains skewed towards lower-wage industries. The workweek is seen falling to an average of 34.4 hours from 34.5 hours in June.

The unemployment rate is expected to have dropped to 10.5% from 11.1% in June. But the measurement of the jobless rate has been biased downward by people misclassifying themselves as being employed but absent from work. At least 31.3 million people were receiving unemployment checks in mid-July.

Economists expect state and local government payrolls will account for more than half of the employment gains in July, but this should not be viewed as a sign of strength.

The model that the government uses to strip out seasonal fluctuations from the data normally anticipates education workers to drop off payrolls in July. This, however, happened earlier because of the pandemic, which threw off the model.

Many of the education-related layoffs that typically occur in July probably came earlier this year, so the July reading for government payrolls could be artificially strong, said JimOSullivan, chief U.S. macro strategist at TD Securities in New York.

Reporting by Lucia Mutikani; Editing by Paul Simao

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U.S. job growth forecast to slow sharply in July as COVID-19 cases soar - Reuters

Giroir: The ‘worried well’ probably don’t need COVID-19 tests – NBC News

Young, otherwise healthy adults most likely can forgo COVID-19 testing, Dr. Brett Giroir, who oversees coronavirus testing for the Trump administration, said Thursday.

"A lot of people are getting tests that probably aren't needed," Giroir said during a "Doc to Doc" interview with NBC News medical correspondent Dr. John Torres, which was streamed on Facebook.

Full coverage of the coronavirus outbreak

Even if a person has been exposed to the coronavirus, the advice is to "self-isolate, no matter whether that test is positive or negative," said Giroir, the assistant secretary of health and human services for health.

That's because people who go on to develop COVID-19 may not initially test positive in the days shortly after they've been exposed to the coronavirus. It's possible, therefore, for people to first test negative but then test positive several days later. The incubation period for the illness can be as long as 14 days, according to the Centers for Disease Control and Prevention.

Always make believe that you are infected.

"You should always make believe that you are infected particularly young, healthy people," Giroir said.

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The advice, meant specifically for people without symptoms, appears to be aimed at easing demand for COVID-19 testing, which has led to long delays between getting tested and receiving the results. People who have symptoms of the illness should still get tested, according to the CDC.

Giroir said that 73 percent of test results are ready within three days and that more than 80 percent are ready within five days. That leaves a significant number of people who must wait longer than a week for test results, potentially exposing others in the meantime. Last week, the CDC said self-isolating until test results come back could slow the spread of COVID-19 by up to 86 percent.

Giroir's guidance is meant to "take down the fervor" of testing, he said, even though the country can now handle about 800,000 COVID-19 tests a day.

"We sort of created a frenzy," he said, adding that he has been working with the CDC to issue guidance on testing for otherwise healthy people. It was unclear Thursday when the guidance would be available.

The one exception for young, healthy people, Giroir said, is if they are living with others who are medically vulnerable, such as elderly grandparents.

"In those circumstances, it's much more of a reason to test. But even if you're negative, you need to be really careful around them," Giroir said. "Wear your mask. Keep a safe distance. We can prevent transmission in the household if you do those simple steps."

Download the NBC News app for full coverage of the coronavirus outbreak

Giroir predicted that point-of-care tests, like rapid flu or strep tests, would be readily accessible within the coming month or so.

"By September, we're going to have about 23 million individual point-of-care tests in the market," he said. Most are expected to be in high-risk places, such as nursing homes and schools.

It's also anticipated that such tests would be administered in conjunction with flu tests, using the same samples.

The federal government has ordered extra flu vaccines this year, and it is encouraging everyone to get flu shots, Giroir said. While they're not 100 percent effective in preventing the flu, they can reduce the severity of the illness.

Giroir discouraged people from relying on COVID-19 tests to ease the pandemic, saying tests should be considered "supplemental" only after extensive mask-wearing and physical distancing.

"If you let your guard down, this is a highly infectious disease that will run rampant. As soon as that horse gets out of the barn, it's really hard to put it in."

Follow NBC HEALTH on Twitter & Facebook.

Erika Edwards is a health and medical news writer and reporter for NBC News and "TODAY."

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Giroir: The 'worried well' probably don't need COVID-19 tests - NBC News

3 cases of COVID-19 detected among workers who sought access to Wisconsin Center ahead of 2020 DNC – Milwaukee Journal Sentinel

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The Wisconsin Center in downtown Milwaukee.(Photo: Mike De Sisti / Milwaukee Journal Sentinel)

Three positive cases of COVID-19 were detected this week among workers who wanted access to the Wisconsin Center, site of the 2020 Democratic National Convention.

But convention organizers said those positive tests didn't trigger Wednesday's announcement that speakers, including Joe Biden, would not be traveling to Milwaukee.

A convention spokesperson said Thursday: "Ensuring the safety and well-being of everyone involved with the convention is our top priority. In consultation with public health officials and experts, the Democratic National Convention Committee has implemented stringent health and safety protocols including daily testing for anyone accessing the convention complex and contact tracing."

The news about the positive tests was first reported by The Daily Beast.

Daily testing for the novel coronavirus began last week during the build-out for the Aug. 17-20 convention. The tests were part of stringent health protocols being put in place for the event that is taking place in the middle of a pandemic.

The testing system was set up three weeks before the convention. The aim was to make sure the system worked and to screen workers who were required to be on the site.

Organizers sought to identify cases early before people entered the site and were around others.

Under the protocol, anyone who needed to access the Wisconsin Center needed to test negative 24 hours before entry.

Last week, there were two "equivocal test results" that indicated the potential presence of the virus. But follow-up testing showed those were false positives.

This week, three positive cases were detected and the cases were reported to the Milwaukee Health Department. Those who tested positive were given instructions to self-isolate.

"It demonstrated the system was working," said a source familiar with the matter.

A representative of the Wisconsin Center District said staff there "followed the guidelines set forth by our client regarding daily health screens."

"The Wisconsin Center has followed all of the guidelines established for everyone entering the building," the statement said. "Ensuring the safety and well-being of everyone involved with the convention is the top priority of the client and the venue alike."

Our subscribers make this reporting possible. Please consider supporting local journalism by subscribing to the Journal Sentinel at jsonline.com/deal.

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3 cases of COVID-19 detected among workers who sought access to Wisconsin Center ahead of 2020 DNC - Milwaukee Journal Sentinel

‘Despair’ spreading throughout the Military Sealift Command fleet over ‘draconian’ COVID-19 restrictions, unions warn – NavyTimes.com

For nearly five months, thousands of civilian mariners assigned to the Navys fleet of U.S. Military Sealift Command ships have been living under what are believed to be some of the strictest COVID-19 restrictions in the military. And those restrictions were dropped on them with almost no notice, according to their advocates.

Under the Gangways Up order issued by MSC March 21, the mariners or CIVMARs have been forced to live on their ships, unable to go home when pierside and sometimes unable to obtain basic hygiene and comfort supplies, according to union officials representing the workers.

Such restrictions aimed at keeping the crews free of coronavirus infection are pushing the crews to their breaking point, three unions representing the workers warned in a July 29 letter to Rear Adm. Michael Wettlaufer, MSC commander.

The letter, posted to the Seafarers International Unions website, notes increasingly grave concerns regarding the mental health and well-being of MSCs CIVMARs as a result of the order.

There is growing anger, frustration and despair throughout the fleet, the letter states. People have a breaking point and many of these crewmembers are nearing it.

The letter was also signed by leaders of the Marine Engineers Beneficial Association and the International Organization of Masters, Mates and Pilots.

It alludes to the July 22 suicide of Third Officer Jonathon Morris aboard the deployed dry cargo ship Amelia Earhart.

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While not explicitly tying Morris death to the order, the unions wrote that the Gangways Up restriction may have, in some part, contributed to this unnecessary and senseless act.

MSC officials have declined to comment further on Morris death, citing an ongoing Naval Criminal Investigative Service investigation.

Morris father, Jeffrey Morris, told Navy Times Thursday he was sure Jon was equally stressed as other CIVMARs but that he would not speculate on why Jon took his own life.

We are genuinely worried that if restrictions are not eased, the likelihood of shipboard emotional instability will increase, the unions letter states. Further, the stress-related fatigue caused by the Gangways Up restrictions could lead to safety and mission degradation and operational mishaps.

The current situation is taking a terrible toll on the families of these mariners as well, the letter continues. The CIVMARs feel unsupported and abandoned.

It ends with the unions asking Wettlaufer to reconsider the order and adopt a more appropriate and reasonable leave and liberty policy.

An effective policy

MSC spokesman Tom Van Leunen defended the policy in an email to Navy Times, stating that it has proven effective in protecting against COVID-19 and preserved mission capability.

The order affects about 3,900 CIVMARs and 1,500 contract mariners, he said.

MSC ships resupply other vessels at sea and are supposed to serve as vital surge capability should conventional war break out, ferrying troops and materiel to the fight.

This relatively small number of mariners are essential to national security, Van Leunen said.

While Van Leunen confirmed that MSC received the unions letter, he declined further comment as the unions have filed grievances over the policy and taken the matter to arbitration.

Randall Rockwood, a retired CIVMAR and vice president of the International Organization of Masters, Mates and Pilots union that cosigned the letter sent to MSC, questioned the efficacy and fairness of the order.

Active-duty sailors and contractors come and go from some pierside ships each day, he said, even as the CIVMARs are forced to remain onboard.

The amount of holes in the bubbles the CIVMARs are supposed to be in for their own safety are too numerous to count, Rockwood said.

The CIVMARs are being treated like second-class citizens, worse than convicts, he added. The convicts are being let out of jail.

Zero foresight'

Rockwood also said the order went into effect with next to zero foresight.

Relating what he had heard from union members, Rockwood said some CIVMARs received so little notice that their cars were left parked at the pier because they showed up for work the day the order went into effect and were unable to leave again.

It was as close to instantaneous as you can describe, Rockwood said. One minute theyre coming and going, the next its no one can go ashore.

For the first few months, CIVMARs on pierside ships were not allowed to go to the Navy Exchange for basic supplies, and their colleagues had to toss supplies aboard from the pier, Rockwood said.

They would literally throw the required products onto the ship and receive money via Venmo or a weighted packet, he said. It was so archaic and thoughtless.

In recent weeks, CIVMARs have been allowed to get off the ship for supply runs to the base NEX, but morale is terrible among the crews, Rockwood said.

Some crew members have been stuck on the ship up to four months beyond their contracted assignment, he said.

Rockwood blamed Wettlaufer, the MSC commander, for the ordeal the mariners are enduring.

He continues to treat them as if their interests, well-being, families and loved ones are irrelevant, he said.

A complaint filed to the U.S. Equal Employment Opportunity Commission late last month on behalf of one ship captain alleges that MSC acted unfairly and negligently by forcing CIVMARs to remain on their ships while failing to provide adequate protective equipment for the crews.

More than 40 CIVMARs have since been added to the complaint.

Darrin Gibbons, a Virginia attorney who filed the EEOC complaint, said he is seeking class-action status to bring in more CIVMARs.

The Navys actions are tantamount to false arrest and false imprisonment of its own employees, the complaint alleges.

The complaint seeks an end to the order and compensation owed to the crews, he said.

While the Navy has allowed active-duty sailors, civilians and contractors to move freely between work and home while observing COVID-19 protections, civilian mariners haven been subject to draconian measures due to a perception that CIVMARs are at risk due to their age, the complaint states.

The only public explanation for the order was found in a May 7 letter from MSC leadership to Washington Sen. Maria Cantwell, according to the EEOC complaint.

In a copy of the letter enclosed in the EECO complaint, MSC Executive Director Steven Cade writes that the 5,400-person CIVMAR force is older on average than their active-duty peers, making them potentially more vulnerable to effects of the COVID-19 virus.

Maintaining physical distance from others who might be carrying the virus and restricting close personal contacts off the ships is vital and necessary to protect MSCs Mariners and embarked personnel from virus exposure, Cade wrote.

Exceptions to the policy are granted on a limited, case-by-case basis, he wrote, including for medical reasons, to obtain basic health and comfort items or for travel to essential training.

We understand the strain this puts on our mariners and families, Cade wrote in the letter, which was sent in response to a complaint from one of Cantwells constituents, a mariner.

The senators office did not respond to a Navy Times request for comment.

Cade wrote that the policy had proven effective because only two of 166 MSC ships reported positive COVID-19 tests among its CIVMARs.

We are operating in unprecedented times and countering COVID-19 is critical to ensuring the health and safety of our CIVMARs, he wrote.

Twenty-four CIVMARs assigned to the fleet replenishment oiler Leroy Grumman tested positive for COVID-19 in April while the ship was undergoing maintenance in Boston, Van Leunen said.

One mariner, Joseph Bondoc, passed away of complications from COVID-19 at a Massachusetts hospital on May 21, Van Leunen said.

The ships crew was living in a hotel at the time of the outbreak and was not subject to the Gangways Up order because the ship was not inhabitable, he said.

A crew member aboard the hospital ship Comfort also tested positive for COVID-19 this spring.

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'Despair' spreading throughout the Military Sealift Command fleet over 'draconian' COVID-19 restrictions, unions warn - NavyTimes.com


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